case study about Carter

Read the case study about Carter on pages 190–192 in theFunctional Assessmenttext, see case study below:

 

Carter is a 14-year-old student enrolled in ninth grade. He is diagnosed with attention-deficit/hyperactivity disorder. Carter struggles in school and historically has received failing grades in many subjects. During interview, Carter indicates that he does not like school. His most difficult and least preferred subjects are math and science. His favorite times of the day are lunch and recess or anytime when he can “hang out with his friends.” Carter indicates that health and art are OK subjects, although he does not do well in them and often receives close to failing grades for these subjects.

Carter has several teachers as he moves from class to class for different subjects. Each of his teachers has expressed concern with his behavior in terms of its effects on other students and in light of his failing grades. They feel that if his behavior cannot be changed or controlled, he would be best served in more restrictive types of classrooms. They feel he doesn’t try hard enough to attend to lessons, stay on task, or complete in-class and homework assignments. The following list of behaviors was included on the teachers’ referral for behavioral consultation:

Does not participate in classroom activities. Often sleeps in class. Does not complete homework. Does not complete classroom assignments. Does not comply with group instructions. Does not comply with individual instructions. Refuses redirection. Refuses assistance with assignments. Does not begin activities in a timely manner.

Mr. Kasuba, a member of the teacher assistance team, is assigned to work with Carter and his teachers. He first interviews Carter then each of Carter’s classroom teachers. After interviewing each teacher, Mr. Kasuba observes Carter’s behavior over a 5-day period. During observations, Carter walked from class to class with peers and arrived promptly at each class. He talked with some of his teachers prior to class about his interests and activities. In other classes, Carter simply talked with peers before the class started. A sample of the observations collected by Mr. Kasuba on the ABC recording form is presented here:

Antecedents and Setting Events	Behavior	Consequence
Class lecture, students should take notes	Head down on desk, eyes closed	Told to wake up and take notes
Told to wake up and take notes	Continued to lay head on desk, eyes closed	Told he would fail the test if he slept through class
Physical education, baseball practice, batting instruction from coach	Complied with instructions	Praise, movement
Health class, group	Participates in group	Peer interaction project
Math, lesson introduction, given worksheet	Head on desk, eyes closed, throws worksheet to floor	Reprimand, offer of assistance
Offer of assistance, students receive homework assignment	Rips worksheet, head on desk, eyes closed (does not copy assignment)	Teacher leaves, teacher gives a copy of assignment
Teacher gives copy of assignment	Leaves assignment in desk	Left alone
Music period, group	Sings with peers	Praise to group singing
Science, asked to read assignment to the class	Refuses	Teacher selects another student to read
Geography, given individual work	Head on desk, eyes closed	Teacher repeats instruction assignment
Teacher repeats instruction	Refuses, argues	Argues, repeats instruction*
School-wide canned goods collection drive	Serves as leader of geography class team	Peer interaction, success in meeting team goal
Science test	Breaks pencil	Teacher gives new pencil
Teacher gives new pencil	Rips paper while writing name	Teacher gives new test
Teacher gives new test	Throws test in garbage	Sent to principal’s office
Resource room, group discussion	Asks to go to nurse’s office	Permission granted
Nurse’s office, period ends	Says he is better now and leaves	Moves to next period (lunch)

*Note: This argumentative interaction escalates to shouting for both Carter and the teacher and it continues until the end of the period. At this point, Carter moves to the next classroom and subject.

The function of Carter’s challenging behavior is negative reinforcement. His behavior results in escape from academic activities and assignments. The negative reinforcement function was selected because Carter engages in challenging behavior during academic-related tasks only. Carter has a long history of poor grades and failure in academic subjects. For Carter, academic activities are aversive, and he engages in challenging behavior when presented with aversive academic tasks or assignments (antecedent/setting event conditions). The consequences for his behavior (e.g., arguments, left alone) effectively terminate aversive antecedent tasks, activities, or assignments.

The negative reinforcement function also was identified for Carter because he does not engage in challenging behavior during social and non-academic-related activities such as the canned-goods drive, transition, lunch, and physical education. During nonacademic antecedent task conditions, he engages in appropriate behavior. Thus, there are clear differences in the types of antecedent/setting event conditions that trigger appropriate versus challenging behavior. The only exception to this is health class, where he works with peers on a group project. Remember, however, that Carter identifies health class as an “OK” subject. It is not an aversive activity for him. The academic activities from which he escapes all were identified as nonpreferred or aversive subjects during interview.

It may seem as though the function of Carter’s behavior is sensory reduction because a frequent form of behavior that he displays is putting his head down on his desk and closing his eyes. However, Carter readily participates in active activities such as baseball practice and music. He puts his head down on his desk during only aversive or nonpreferred academic subjects. Therefore, the function of this behavior is not to reduce stimulation. The function is to escape or avoid an aversive activity. For Carter, the activity level per se is not a relevant context. Rather, the relevant context that triggers appropriate or challenging behavior is a preferred or nonpreferred activity.

Carter’s behavior also is not a function of positive reinforcement. His behavior does not consistently produce or add a desired consequence to the situation (e.g., peer or adult attention, access to material, or access to peers). In fact, the consequences that followed challenging behavior varied. For example, sometimes he is left alone, sometimes teachers argue with him, and sometimes they offer assistance. If the function of his behavior were positive reinforcement, he would not have stopped engaging in challenging behavior when he was left alone. Instead, he would have continued to seek attention, seek access to materials or peers, and so forth. Rather than add a desired variable to the behavior equation, the consequences that followed Carter’s challenging behavior consistently delayed or prevented the assigned activity or task.

In designing an intervention plan to address Carter’s behavior, you typically would need to decide if it was appropriate for Carter to avoid and escape academic tasks and activities. If it was OK to escape, then the goal of your intervention plan would be to match the function of his behavior. In other words, the intervention would allow Carter to continue to avoid and escape aversive activities and tasks, but through more appropriate forms of behavior. However, if you decided that escape and avoidance were not appropriate for Carter, then your goal should be to change the function from negative to positive reinforcement. To do this, you would need to alter both antecedent and consequence conditions so they trigger and support appropriate behavior instead of challenging behavior and so they prevent the occurrence of challenging behavior.

1. Because most school programs are not likely to agree that it is all right for Carter to escape or avoid aversive academic tasks and activities, your intervention plan should be twofold. First, you should develop strategies to allow temporary escape or avoidance using appropriate behavior. Temporary escape and avoidance contingent on appropriate behavior may be used in the initial stages of intervention and faded throughout the course of the intervention plan.

2. Second, your intervention plan should include strategies to reduce the triggers and supports for challenging behavior and to provide triggers and supports for appropriate replacement behavior. Change the function from negative to positive reinforcement.

 

 

 

 

Based on this, post a substantive response to the following two-part discussion question:

1. Discuss what you believe are the key features needed for an intervention plan to decrease Carter’s challenging behavior and increase appropriate replacement behavior (or behaviors).
2. Explain how you would change relevant antecedents and setting events, as well as the consequences of addressing the negative reinforcement function.