Video: Creating a Brain-Friendly Life

This video provides information for how to support people with FASD to achieve independence, environmental adaptation and self-regulation.

About this video

Production date: October 27, 2010
Length: 1 hour, 49 minutes
Presenter: Karmen Krahn Schulties
Download slide notes for this video (PDF, 12 pages)

Karmen Krahn Schulties, MA, has served as Behaviour Consultant for the Cognitive Disability Strategy of Saskatchewan since 2007. She worked for 10 years in areas of economic justice, adult education and spiritual care for people with disabilities. With a background in Visual and Performing Arts, Karmen approaches FASD prevention, intervention, public education and resource development with plenty of creativity. Her FASD resources are strength-based, just as her strategies are positive and non-aversive.

About the ‘Brain Boxes’ program

Brain Boxes is an empowering program that teaches young people how their brain works. “Creating a Brain-Friendly Life” is a collaborative session intended for young people affected by FASD and those who support them. It results in a positive, plan for self-improvement, independence and behavioural intervention.

Outcomes

This video will help you understand how to:

  • support independence through environmental adaptation
  • harness existing strengths to achieve maximum independence and self-regulation
  • take inventory of internal motivators for use in relationships, decisions and vocations
  • design a support plan to reduce frequency, intensity and duration of behaviours

Content

  1. Designing a behaviour support plan (58:05)
  2. Teaching behaviour (34:53)

Designing a Behaviour Support Plan

Consider the following when designing your plan:

  • supported independence must be flexible and responsive, integrated and long term
  • address the needs that persons with FASD have for supporting change over their lifetime
  • to promote independence, always start with the least amount of support

Creating a brain-friendly life

Creating a brain-friendly life involves:

  • supporting independence through environmental adaptation
  • recruiting existing strengths to achieve maximum independence and self-regulation
  • taking inventory of internal motivators for use in relationships, decisions and vocation
  • designing a support plan to reduce frequency, intensity and duration of negative behaviours

FASD behaviours are brain based and need outside supports to properly manage. Secondary disabilities are the product of a “chronic poor fit” between person and environment.

We need to ask:

  • how we can take advantage of the strengths of the individual?
  • what other adaptations can be made other than environmental?

Diane Malbin (MSW) helped us recognize the impact of environmental mismatch, different learning styles, and external motivation – leading to reevaluate beliefs about working with people with disabilities. Behavioural support plans are based on functional assessments of targeted behaviours. 

ABCs of behaviour

Look at ABCs of behaviour:

  • Antecedents
  • Behaviour
  • usual Consequence

Usual consequence may give a good idea of why the behaviour continues. The consequence could be reinforcing the behaviour.

Functional assessment components

Core components of the functional assessment are:

  1. Latency (rate of behaviour)
    • a good support plan celebrates the time lapse between the behaviour incidents
  2. Duration (how long behaviour lasts)
    • the plan should reward decreased duration of behaviour
  3. Intensity
    • the plan should monitor the severity of behaviour and reward a decrease
  4. Frequency
    • plan should target a decrease in behaviour frequency
  5. Course
    • assessment identifies what leads up to it and what follows the behaviour
  6. Cycle
    • assessment identifies when the behaviour begins and ends
  7. Topography
    • identifies behaviours linked with certain functions such as avoidance
    • the function can be achieved through different behaviours such as lying, hiding, running away

Core strategies of behavior support plans

Four core strategies form the basis of behaviour support plans:

  1. Adaptation
    • including environmental
    • set the person up for success
    • “smooth the fit”
    • make related adaptations
    • nothing more or less than is needed
  2. Teaching
    • using specialized instructional techniques
    • “teach a skill” for growth
    • specific instruction for functional learning
    • not utilizing learning theory
  3. Affirmation
    • with flexible expectations for success criteria
    • give feedback “to motivate the behaviour we want to see”
  4. Restoration
    • using non-aversive reactive strategies, which includes shame and guilt
    • “restore order”
    • safe, rapid restoration when things go wrong

Behaviour plan designs

The design depends on whether we want to reduce, eliminate or increase behaviour.

Changing the environment

  • changes in physical space, equipment, stimuli, time,
  • changes in mediator behaviours such as feedback, beliefs (about punishment for example)
  • perceptions and interpretation of behaviours

Mediator analysis

  • ask if primary caregivers able to carry out this plan
  • need to consider the mediator’s common reactions to:
    • behaviour
    • attitudes
    • available time
    • resources and supports
  • assess agency mediators level of expertise and knowledge about FASD

Ecological magic

  • neurological differences caused by FASD increase the need to adapt behavioural interventions
  • some examples of creative interventions can come from:
    • visuals
    • rituals
    • symbols
    • cultural practices
    • time markers
  • these may be expressed through:
    • art
    • poetry
    • drama
    • theatre
    • music
    • photography

Teaching behaviour

There can be many functions of FASD behaviour. The behaviour could meet a sensory need, communicate a message, or substitute for a missing skill.

We can teach to parts of the brain other than the frontal lobe through hands-on teaching, which relies on experience rather than memory.

  • teach related or equal skills, perception, coping and tolerance, vocation, leisure skills (how to have fun)
  • effective techniques include teaching naturally (in the moment)
  • distinct trial (teach how skills are to be used)

Teaching coping and tolerance

  • can teach stimulus control, reframing of cognitive perceptions, delayed gratification
  • replace punishment with positive feedback
    • positive reinforcement is powerful
  • when a person defines a positive reinforcement, it is delivered immediately, it is current and it meets a need
  • rule: reinforce 50% more often than the behaviour occurs
    • need to catch them being good
  • need to conduct fixed reinforcement inventories
  • make sure feedback plan is meaningful to the child

Factors for behavior

Several factors at different levels can act as behaviour inhibitors or enablers:

  • system level
    • supervision
    • preparation
    • teamwork vs. union
    • culture
    • beliefs
    • staff ratio
  • community level
    • accommodation
    • inclusion
    • capacity vs. stigma
    • wrong labels
    • flawed expectations
  • day time level
    • prompting
    • meaningful feedback
    • positive reinforcement vs. inadvertent reinforcement
    • aversive practice
  • individual level
    • new skills
    • strengths
    • cognitive ability vs. learned helplessness
    • secondary FASD disabilities

Emergency response plan

Have an emergency response plan in place for when bad days happen. Things to consider include:

  • humor can bring threat level down
  • read body language and try to salvage any self-regulation tools
  • once threat is perceived, work on threat reduction
  • do not argue perception
  • the goal is harm reduction through safe, rapid, non-aversive control

Summary

A brain-friendly life provides as much independence as possible. To manage complex behaviour we need to adapt, teach, affirm and restore using a wide-ranging behaviour plan.

This plan is developed based on a functional assessment of the problem behaviour(s). There can be many contributors to FASD behaviour such as a missing skill or a mediator problem.

Created:
Modified: 2015-09-09
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