7. Case Studies

Case Study #1

Morgan is a 9th grade student who has recently transitioned from middle school to high school. She first qualified for special education services in the first grade. She was initially found eligible for special education as a student with autism. In the fourth grade, the team did additional testing during her re-evaluation and the team noted that Morgan’s IQ indicated a mild intellectual disability. Although some of her services have shifted since fourth grade, she has received services in general education, co-taught, and inclusive settings. During middle school and now during high school, Morgan receives her English and Math instruction in a special education setting. Each of these classes have approximately ten students each. Her Earth Science and American History courses are in the general education setting, but she receives support from a special educator teacher in both of those classes. Her Earth Science teacher and special education teacher use a team-teaching model, and this has worked well for the entire class this semester. The remainder of Morgan’s day in 9th grade is spent in the general education setting to include physical education, and her electives, academic resources, and 2-D art design.

Morgan also receives speech and language therapy as a related service. This is directly connected to her delays in expressive language. Morgan struggles to find the words or phrases necessary to explain her ideas and uses random vocalizations when she gets “stuck.” These vocalizations include a low growling noise, repeating “no no no no,” and/ or a high-pitched fake crying noise. She spends one hour every other day with the speech pathologist, an increase from years past. As middle school progressed, Morgan began making more and more vocalizations. This was attributed to the nature of middle school to include changing classes with different and new teachers and students throughout the school day.

In the middle of Morgan’s 8th grade year, not only did her vocalizations increase, but she also began hitting herself on the side of her head with her palm. These incidents occurred approximately once a month. At that time, no formal behavior plans were developed, although in April of Morgan’s 8th grade year, her IEP team suggested it be completed. It is unclear to the high school team or Morgan’s parents why the plan was never completed and unfortunately, the special educator from the middle school is no longer an employee of the school division. Although Morgan’s parents were hopeful that a new setting would help Morgan with her behaviors, this has not been the case.

Although Morgan started high school without any vocalizations or self-injurious behaviors, in September of this year, Morgan’s self-injurious behaviors returned. Although her vocalizations did not accompany these behaviors, Morgan began hitting herself more frequently and with more intensity. As a first step, the administration met with Morgan’s parents and the team decided to assign a floating teacher’s assistant to all of Morgan’s classes. The intent of this decision was to provide additional support for Morgan when needed, and to make sure she did not hurt herself more severely. It is now November and in the past two weeks Morgan is beginning to bite herself to the point of breaking skin and banging her head on desks, walls, or bookshelves. The behavior occurs in brief episodes and sometimes involves one or both of the self-injurious behaviors. These episodes vary in intensity and while school personnel attempt to diffuse the situation, Morgan will calm down briefly, then begin the behaviors again. The team is very concerned about Morgan’s well-being and have reconvened to discuss a plan.

The team decides that more data is needed to better understand the behaviors since, at first glance, there does not seem to be an antecedent or reinforcing consequence. After deciding to collect both ABC and duration data, the administrator assigns the floating teacher’s assistant to complete all the data collection for the team. After it is collected, the team reviews the following information:

ABC Data

Student: Morgan                    Grade: 9th                  Eligibility: Autism, SLI

Description of behavior(s) of interest/ concern: self-injury (biting herself, head banging)

Duration Data

Student: Morgan                                                                                            Grade: 9

Data Collection Dates: 10/20 – 10/25

Behavior of Concern: Episodes of self-injury (usually biting or headbanging). Begin time at first self-injurious act. End time when she returns to and remains engaged in an assigned task without self-injury.

 Case Study #2

Background Information

Ivo McMillon is a third-grade student who receives special education services for a specific learning disability (SLD). He is new to the school this year, so the team knows little about him. His general education teacher, Mrs. Whelpley, has requested assistance because Ivo’s behaviors are impeding not only his learning, but the learning of others in the classroom. Prior to meeting with the Behavior Support Team (BST), Mrs. Whelpley and Mrs. Molenback, the special education teacher, reviewed Ivo’s school records to determine if there was any information that would shed light on his behaviors. Unfortunately, they found little helpful information other than learning that this was Ivo’s 3rd school since kindergarten and that Ivo’s older brother goes to a nearby middle school.

Team Meeting

The BST meets at Mrs. Whelpley’s request to discuss the challenges related to Ivo’s behavior and identify possible solutions. The meeting consists of Mrs. Whelpley, Mrs. Molenback, the assistant principal, the school counselor, and Mrs. McMillon (Ivo’s mother). Mrs. Whelpley gives some background information on Ivo to the group to include information about Ivo’s eligibility and previous Individualized Education Program (IEP). According to previous documents, Ivo has a learning disability in the area of reading and he does well in math and any hands-on activities. Previous teachers noted that Ivo quits easily if an assignment involves reading and/ or spelling.

Mrs. Whelpley shares that currently, there are two other students in the classroom with learning disabilities and a total of 17 students in the class. Ivo has several friends he plays with at recess. Outside of the behaviors Mrs. Whelpley is concerned about, she reports there have not been other challenges, to include academic concerns. Mrs. Molenback disagrees and is unsure how academics are impacting Ivo because he is usually quietly working and does not share much about his progress or ask any questions. His work has been inconsistent, but Mrs. Molenback isn’t sure if this is because of the new curriculum in a new school district or because of his disability.

When asked about previous school experiences, Mrs. McMillon reports that she “left Ivo’s education to the teachers” in his previous school. She reports that Ivo has always disliked school and sometimes had trouble following directions. She believes his behavior has been worse since starting his current school. When asked about how Ivo interacts with the family at home, she quickly replies “fine” and says nothing more.

As the team begins discussing some of the behaviors they are seeing at school, they identify throwing objects, disruptive outbursts, and physically aggressive behaviors as Ivo’s concerning behaviors. After more discussion with the team, the behavior identified as most problematic is physical aggression since it has the biggest impact on school safety. This becomes the behavior the team decides to focus on for the FBA and subsequent BIP. The team knows it is very important to define the behaviors in measurable, objective, and observable terms to get a clear picture of the behavior across all settings and times of day.

After clearly defining the target behavior, the team develops a key of possible contexts, antecedents, behaviors, consequences, and student reactions. These components are put on an Antecedent, Behavior, Consequence (ABC) chart so the team can duplicate the ABC form for Mrs. Molenback to collect data for Ivo’s behaviors. In this way, the same contexts, antecedents, behaviors, consequences, and student reactions are measured the same way each day for ten days. The team decides they want at least ten occurrences of a behavior in order to determine the function so they commit to ten days of data collection. They believe ten days will likely result in at least ten occurrences.

The team is taught how to fill out the charts and behavior data form for ten days. This data will be analyzed to form the FBA and BIP. Mrs. Molenback agrees that she and Mr. Phillips, the paraprofessional, will collect the data since they see Ivo consistently and have more opportunities for intensive data collection. Should any behaviors occur during specials (e.g. art, physical education, music, etc.), Mr. Phillips will be there to record the behaviors. The team agrees to meet again in 2 weeks to analyze the data and determine the function, or the reason behind Ivo’s behaviors. In the meantime, Mr. Clorafina, the social worker, will also be conducting a home visit to speak with Mrs. McMillon and to better understand Ivo’s behavior in the home.

Two weeks later the team reconvenes to analyze the data and Mr. Clorafina shares his interview with Mrs. McMillon. Mrs. McMillon declines to attend the meeting and notes that she has shared Ivo’s information with the social worker and feels confident that the school team can develop a plan to help Ivo. Mr. Clorafina shares the following information from his meeting with Mrs. McMillon:

Mrs. McMillon was asked if she would talk about Ivo’s home life and if she could share some background information on Ivo to help the school better understand his behaviors.

Mrs. McMillon is a stay-at-home mom but does some editing work for the local newspaper on an intermittent basis. Mr. McMillon is currently deployed in Afghanistan and has been away for approximately two months. This deployment occurred shortly after the family moved into this school district. This is Mr. McMillon’s second tour in the past three and a half years. During his last deployment, he was gone for a year.

Ivo is the middle child of three boys. Mrs. McMillon reports that Ivo and his brothers frequently fight and he shows signs of aggression and defiance. She doesn’t feel that Ivo’s behavior is much different than his brothers but admits that she has given up trying to control them when they are together. She believes that Ivo is often the “instigator” and “wants to be in charge” when it comes to his siblings. Her response to the behaviors includes ignoring, spanking, and trying to separate the boys.

When asked why she thinks Ivo is having difficulty at school, Mrs. McMillon pointed out that mornings are very hectic with everyone going in different directions and that Ivo’s lack of organizational skills causes him to have a “bad” morning on most days. He rarely knows where his shoes are, his backpack is often in disarray, and he is usually running late. She believes the stress of the morning carries over to school. Outside of challenges in the morning, she doesn’t have any other ideas about the cause or root of Ivo’s behavior.

Mr. and Mrs. McMillon are willing to assist the team with any plans they devise to help Ivo with his behavior problems. Mr. McMillon is aware of this meeting and according to Mrs. McMillon, he has been debriefed on the situation. Mrs. McMillon notes that she is unable to attend meetings at this time because of childcare challenges with her youngest son.

After sharing this information, the team decides to look at the ten pages of data and begin the analysis. While one person reads off the data, another person tallies the analysis forms. The administrator then calculates the percentages. Once this is done, they are ready to discuss the data. The team looks at the beginning time of each incident and marks the 30-minute time frame in which the incident began. Next they tally the number of incidents on each day to determine if there is a behavioral pattern based on day of the week. The team also analyzes each context to determine if a pattern exists with locations or subject areas. Neither of these analyses yield any specific patterns. Therefore, they tally the behaviors to get a better understanding of what is really happening. Even though the target behavior is physical aggression, each member of the team recognizes that other behaviors are also occurring consistently and sometimes, concurrently with the physical aggression. The calculations are as follows:

Given that no patterns exist with times of day, subjects, or days of week, they examine the antecedents to see if what is happening prior to the behavior incidents that might be triggering the behaviors. They think it might be interesting to see if behaviors can be paired with certain antecedents. The team also thinks it might be beneficial to see if behaviors are paired with specific consequences. They also want to understand if any consequences effectively stop the behaviors. After they tally the number of consequences and the number of times the behavior stopped or continued in each column, they add up the total tallies beside each consequence. Then, they add up the number of times Ivo’s behavior stopped and the number of times it continued. Finally, they divide the total stopped by the total number of tallies in each row to get a percentage of the effectiveness of each consequence during this behavioral observation.

That data is displayed below.

Now that the team has a good idea of the function of Ivo’s behaviors, the team feels they can confidently fill out a Competing Pathways Form and brainstorm some ideas to teach Ivo replacement behaviors. Together they brainstorm replacement behaviors and desired behaviors with the identified function. Everyone agrees they need to identify and recognize Ivo’s prosocial behaviors and give him behavior specific praise for those behaviors. They also determine that Ivo needs to be given choices with assignments (to the greatest degree possible) and have planned breaks with either his special education teacher or a paraprofessional.

Implementation Plan

Mrs. Whelpley and Mrs. Molenback take the suggestions of the BST back to the classroom. They implement the following, based on Ivo’s FBA and BIP:

• Mrs. Molenback teaches Ivo a “secret signal” of placing a yellow sticky note on his desk when he needs a break. This way Ivo can tell Mrs. Whelpley, Mrs. Molenback, or Mr. Phillips that he needs a break. Mrs. Molenback and Ivo make a deal that Ivo will look at a book until he is ready to return to the classroom, but this cannot be longer than 10 minutes.
• Both Mrs. Whelpley and Mrs. Molenback provide Ivo with as much choice as possible with assignments. For example, to get started with an assignment, Ivo might be able to complete odd problems on a worksheet first, with the expectation that he would then complete even problems if time permitted. He is also given choices with writing topics and graphic organizers, whenever the writing objective is aligned with these choices.
• In addition, Mrs. Molenback and Mrs. Whelpley implement several ways for Ivo to have more support during the school day. Ivo is paired up with a morning mentor, the physical education teacher, who meets with Ivo each morning for 10-15 minutes to talk about the previous evening and the morning bus ride, and to review the day’s goals and agenda. Ivo is allowed to select his own goals for the day. At dismissal, Ivo meets with the same physical education teacher to show her his goal progress for the day. The physical education teacher focuses on providing behavior specific praise, specifically targeting choices Ivo made throughout the school day.

Follow Up

After two months of implementing the BIP, Ivo’s team reconvenes. They report that Ivo has had few incidents of physical aggression or disruptive outbursts. He enjoys visiting with the physical education teacher and they have expanded his goal setting to include charting his behaviors. Ivo takes great pride in his success and reports that he shares his progress with his mom each afternoon. Mrs. McMillon has asked for support to implement something similar to Ivo’s school plan in their home for all three of her children.