Addressing Challenging Student Behavior

By Amber Rundle Kahn and Paula Conroy, Ed.D.

Amber Rundle Kahn is a doctoral candidate in special education: visual impairments & blindness at the University of Northern Colorado.

Paula Conroy, Ed.D. is a professor at the University of Northern Colorado and the coordinator of the visual impairment and orientation and mobility programs.

Abstract

“Addressing Challenging Student Behavior” is a professional practice report. This paper provides perspective on important and relevant issues for teachers of students with visual impairments and families related to challenging student behavior. This paper provides legal implications and resources for strategies from the larger field of special education for both educators and families.

Keywords

Visual impairments, challenging student behavior, special education

 

A case example: First-year teacher of students with visual impairments (TVI), Amanda, is eager to meet her students and get started with her new career. She has been assigned to work with a third grade student named Tabitha, who has a diagnosis of Optic Nerve Hypoplasia and has a visual acuity of 20/400 in both eyes. Tabitha moved into the school during the middle of second grade and her IEP includes several literacy goals, including a goal to tactually identify 150 high-frequency words in contracted braille. Tabitha is reading below grade level, at a mid-first-grade level, and currently uses a closed-circuit television (CCTV) for reading and writing to complete the majority of her class assignments. Tabitha receives services from an occupational therapist (OT), Ms. Cense, for 20 minutes a week, and her OT goals are to cut out both a circle and triangle along a raised-dot line and tie her shoes. Within the first month of school, Amanda and the classroom teacher, Ms. Joy, notice that Tabitha begins to withdraw and refuse to work on her braille lesson whenever Amanda attempts to work with her. Within five weeks, Tabitha is grinding her teeth when she is asked to write on the braille writer and refusing to touch any tactile materials. Amanda is worried and she doesn’t know how to proceed. She prepares new materials for every lesson and tries a variety of approaches that she learned for teaching braille in her university program. She is a new TVI and does not have a supervisor who understands visual impairment.

Introduction

Teachers of students with visual impairments (TVIs) are charged with assessing, designing, and providing individualized instruction for access to core content, as well as instruction in the expanded core curriculum (ECC). Increasingly, general and special educators are called upon to support students who have behavioral challenges (Beam & Mueller, 2016). TVIs are included in this trend. Research indicates that students with visual impairments (especially those with intellectual disabilities) are at an increased risk of having behavioral challenges (Bak, 1999; Bahar, Brody, McCann, Mendiola, & Slott, 2003; Gense & Gense, 2005; Ryabets-Lienhard, Stewart, Borchert, & Geffner, 2016). Lack of sensory stimulation, complexities of multiple disabilities, and a need for explicit direct instruction in areas of social skills may put students at risk for abnormal/problematic behavior.  

The two predominant causes of childhood visual impairments (VI) in the United States are optic nerve hypoplasia (ONH) and cortical visual impairment (CVI); both are neurologically based etiologies (Garcia-Filion & Borchert, 2013; Zuidhoek, 2015). The complexities of providing services for a child with a neurologically based visual impairment warrant careful, thorough, and collaborative medical and educational assessments to address both the vision loss and any concomitant challenges from damage to the brain (Garcia-Filion & Borchert, 2013; Pawletko, Chokron, & Dutton, 2015). There is empirical evidence that students with ONH are at increased risk for concomitant behavioral concerns (Ryabets-Lienhard, Stewart, Borchert, & Geffner, 2016). In addition to neurological visual impairments, students with visual impairments and autism spectrum disorder (ASD), as well those students with additional disabilities including intellectual and communication disabilities may have symptoms that multiply the severity of the diagnoses (Gense & Gense, 2005). There are consistent reports in the scholarly literature indicating that more children with VI have additional disabilities than those who have VI alone (Erin, 2017; Parker & Pogrund, 2009; Sacks, 2016). Some students may have significant health needs such as severe seizure disorders, hypertonia, incontinence, and inability to eat by mouth or speak. For students with significant support needs and limited communication skills, behavior may be their only means for expressive communication. Given the broad spectrum of needs that individual students exhibit, TVIs are destined to encounter challenging behavior throughout the course of their careers. However, due to the heterogeneity of the population of students with VI, some TVIs may not have experience with positive collaborative teams, or develop necessary skills for managing challenging student behavior. When TVIs are the primary educational provider for a student with behavioral challenges, the TVIs’ need for skills to support the student and guide the student’s educational team toward appropriate interventions is crucial.

Needs Assessment Survey Results

In an effort to understand the needs of TVIs related to student behavior management, the authors conducted a national survey to address the following research question: What are the training needs of teachers of students with visual impairments related to behavior management? The survey yielded responses from 125 TVIs around the United States. While a majority of participants reported that they employ collaborative approaches (family interviews, data collection, co-teaching/treatment, meetings, and contributing to development of behavior plans) for assessing behavioral concerns in students with VI, only 31% of respondents reported that they received training in functional behavior assessments in their teacher training programs. Less than 23% of the participants reported receiving training specific to autism and visual impairment and less than 32% of the respondents reported awareness of modifications for behavioral assessments for students with visual impairments.

Challenging student behavior is impacting the service delivery of TVIs. The major themes reported by survey respondents included: students with challenging behavior make slower academic progress and changes in service delivery structures for students (movement from direct to consultative services for children with significant behavior challenges). The results of this inquiry into TVIs’ needs for working with challenging student behavior suggest that TVIs need access to professional development for assessment, collaboration, and strategies for working with this population. Supervisors and leaders in the field of VI must begin training and appropriately supporting both TVIs and parents of children with visual impairments to manage challenging student behavior.

Behavior is an exploding topic in education and special education for students from preschool to transition age (21). Schools are implementing multi-tiered systems of supports (MTSS) processes, employing restorative practices, and increasingly hiring Board Certified Behavior Analysts (BCBAs) to assist in handling challenging behavior (McIntosh & Av-Gay, 2007; Menendez, Mayton, & Yurick, 2017; Smith, Frey, & Fisher, 2018). TVIs need skills and strategies to guide their approach to challenging student behavior. Professional development offerings and teacher preparation programs are beginning to address VI professionals’ needs for training in the area of managing challenging student behavior. It is imperative that all TVIs have access to professional development and support in this area. Challenging student behavior impacts the child and all educational team members. TVIs need to understand the legal requirements for supporting challenging behaviors, possess skills for opening and maintaining collaborative partnerships with educational team members, and have strategies to approach programming and instruction for challenging student behavior.

Individuals with Disabilities Education Act

The latest reauthorization of the Individuals with Disabilities Education Act (IDEA) occurred in 2004. Since 2004, numerous regulations, white papers, and statutes have been written on the topic of student behavior. There are clear implications that TVIs need to have strategies and support systems to mitigate challenging behavior. Litigation and legislation of special education cases has increased dramatically since the last reauthorization of IDEA (Yell, 2016). Development of behavior intervention plans, application of peer reviewed research, and incorporation of parent involvement to design appropriate educational programs are strategies that the IDEA articulates. All TVIs, especially those addressing challenging student behavior, need familiarity with the IDEA requirements for each of these strategies.

Behavior Intervention Plans

While the use of positive behavioral interventions and support (PBIS) systems are required for students with disabilities, the decision to include a behavior intervention plan (BIP) on a student’s IEP is at the discretion of the educational team. IDEA is primarily concerned with student behaviors that result in disciplinary action. IDEA only requires a functional behavior assessment (FBA) when a student with disabilities’ behavior results in a suspension for more than ten days due to behavior that is a manifestation of the student’s disability, or when there is a long-term removal of that student for behavioral concerns. However, §300.324(i) of IDEA 2004 states: “in the case of a child whose behavior impedes the child’s learning or that of others, [teams must] consider the use of positive behavioral interventions and supports, and other strategies, to address that behavior.” Therefore, students’ behavior need not impact other students to warrant documented consideration and targeted interventions for the challenging behavior. IDEA’s lack of specific and detailed requirements for FBAs and BIPs has resulted in considerable commentary from the field of behavioral disorders and each state may interpret IDEA differently, creating vast inconsistencies with expectations for managing difficult student behavior (Collins & Zirkel, 2017).

Peer-Reviewed Research

IDEA requires that special education teachers use data and peer-reviewed research to design and deliver services (Yell, 2016). The field of VI is lacking a body of research specific to interventions for students with VI and challenging student behavior. However, the broader field of special education does have evidence-based practices for managing challenging student behavior. There is a strong body of evidence supporting the efficacy of FBAs and BIPs for students with challenging behavior (Collins & Zirkel, 2017). No intervention research on FBAs or BIPs for students with VI could be located. TVIs may be called to discuss their use of evidenced-based research in providing services to students. Thus, access to, and initiation of, research-based methods for supporting challenging behavior is critical (Yell, 2016). TVIs, classroom teachers, and special education team members need to infuse and adapt methods from other areas of disability to provide instruction to their students with challenging behaviors.

Free Appropriate Public Education (FAPE) and Collaboration

In 2016, the Office of Special Education and Rehabilitative Services (OSERS) issued a Dear Colleague memo on behavioral supports in IEPs. Dear Colleague memos provide guidance and clarification to states on interpretations of IDEA. The memo articulates: “The IEP team must consider when, whether, and what aspects of a child’s IEP related to behavior need to be addressed or revised to ensure FAPE” (p. 4). The memo goes on to state that when student behavior impedes their own, or other students’ learning, IEP teams need to “include and revise needed behavioral supports in the child’s IEP” (p.14). If non-compliance, perseveration of sensory-stimming, and off-task behaviors are impacting the child’s functioning, then these behaviors need to be described in the Present Levels of Academic Achievement and Functional Performance statement (PLAAFP). Development of students’ goals, accommodations, and modifications is driven by the information presented in the PLAAFP statement (Pacer Center, 2011). Providing functional outcomes and realistic representations of student needs in the IEP provides an authentic start to collaborative practices (Lohmeier, Blankenship, and Hatlen, 2009). 

Collaboration and Behavior

Just as TVIs advocate and provide access for students to reach literacy and mathematics standards, TVIs should also advocate that students be held accountable for meeting their schools’ behavioral expectations. Employment, independent living, and social skills outcomes depend on individuals’ abilities to work within established norms and expectations for social behaviors (McDonnall, 2011; Wolffe & Kelly, 2011). The school environment affords families and educational teams a supportive and structured place to hold students accountable for working with and beside others. For these reasons, establishing collaborative partnerships with school personnel and family members is directly linked to a student with visual impairment’s long-term success. Well-coordinated approaches between strategies used at school and home can help reduce disruptive behaviors, and fidelity of implementation of behavior plans depends on shared efforts (Koegel, 2018; McIntosh, Av-Gay, 2007).

Data Sharing

Educational team members should develop agreed-upon methods for collecting and sharing data. Clear documentation of challenging behaviors provides teams with an empirical starting point to address the students’ educational programming needs. The educational team should work together to establish the best method of communication (including frequency of home-school communication) about the students’ behavior. Data drives decision-making; data can catalyze necessary changes in supports for students who need more intensive behavioral support.

When a student’s behavior impacts their access and success in academic progress, the IEP team is beholden to take action to make corrective changes to the student’s program. Educational teams need to revise and adjust programming to provide appropriate supports for students with behavioral challenges (OSERS, 2016). When students with VI exhibit consistent and impactful challenging behavior, TVIs must collaborate and share data. TVIs who neglect to collect and share data on challenging student behavior may make and invite presumptions that additional supports are not needed (Crocket & Yell, 2008).

Strategies for Addressing Challenging Behavior

Data collection is the critical first component of programming for students with challenging behavior. Special education teachers are required to report on their students’ educational progress (Yell, 2016). For TVIs working with students who exhibit off-task or non-compliant behavior, taking and maintaining notes on the student’s level of participation and engagement throughout specific times of the school day is critical. A tally sheet of time on-task and time off-task provides the team with a running record of the student’s engagement in daily activities, and is one example of a simple way to collect targeted data.  Daily logs, when maintained with fidelity, provide information that to can be used in collaborative conversations about strategies and interventions with the student’s team (Hirsch, Bruhn, Lloyd, & Katsiyannis, 2017). Schools may have preferred behavior inventories and tools that are used for developing BIPs. It is the due diligence of the TVI to request assistance with determining which inventory or assessment will best capture the student’s needs.

Strategic Implementation of Multi-tiered Systems of Supports

Multi-tiered systems of supports (MTSS) are making their way into public schools around the United States. MTSS is a framework that includes a layered continuum of interventions to meet the needs of all students. MTSS involves a process of documenting and analyzing student performance so that educational teams have data that provides evidence for (or against) needs of additional support for students. The MTSS approach can serve to assist students’ educational teams in making decisions about adjusting accommodations and modifications, and increasing support services (PBIS, n.d.). For students with VI, “MTSS may be used to identify additional learning disabilities or at-risk educational performance” (Zebehazy, Kamei-Hannan, & Barclay, 2017). By working within a MTSS framework, a TVI can help a team understand when behaviors are not explained by loss of vision, or when an etiology has risk factors specific for challenging behaviors.

TVIs who work in schools without an established process may find it helpful to borrow strategies from MTSS; within MTSS, students who struggle to meet behavioral expectations receive more intensive supports (Lancaster & Hougen, 2017). Because TVIs may be the only special education provider on a child’s IEP, documentation of behavioral challenges, when they exist, is crucial for catalyzing team-driven problem-solving for students with VI. TVIs serve as experts in interpreting the strategies and interventions that work to address a child’s sensory needs. For children with pervasive sensory-seeking and off-task behaviors, the TVI’s role in deciphering the fine line between sensory integration challenges and defiance is critical, and can be difficult to determine. For these reasons, the entire educational team must work together to determine causation of students’ behavior.

Teachers of Students with Visual Impairments Suggest Strategies

In an effort to investigate TVIs’ experiences with challenging student behavior, the lead author conducted a small qualitative study with six TVIs in 2017. This study investigated TVIs’ experiences with students who regularly exhibit non-compliance or off-task behaviors. While articulating creative and individualized approaches to address challenging behavior, the participants described limited experiences with developing formal BIPs. The participants’ sentiment was echoed in a flurry of follow-up conversations at national VI conferences. Both the study participants and conference attendees indicated that peer-to-peer discussions yield significant and meaningful approaches to challenging scenarios. Alternating preferred with non-preferred activities, sequencing lessons to include elements of music and movement, and maintaining positive parent-school partnerships were among the suggested strategies. As TVIs gain more knowledge and understanding of the FBA process, skills in implementing BIPs, and confidence with relationship-based behavioral approaches, they can develop shared resources for strategies and interventions that are evidence-based.

Designing Support and Instruction

The student’s daily schedule is the starting point for designing supports and intervention. The educational team should identify the times of day when the student’s independent participation is a priority. Some parents expect and want their child to have constant adult support throughout the day. Other parents may expect and assume that their child is working independently for large parts of the day, when in fact, they aren’t. Team consensus on expectations and levels of support for the student must be established for the student’s entire day. Preference assessments may yield information to help reinforce positive behaviors throughout the school day (Chazin & Ledford, 2016). Explicit teaching of expected behaviors by all team members will inform the student’s understanding of school-wide expectations (Maroney, 2018).

Resources for Managing Challenging Student Behavior

As the unique learning needs of the population of students with VI change, professional resources for TVIs are evolving to incorporate behavioral considerations. Gense and Gense (2005) provided a framework for addressing challenging behavior in students with VI and ASD by reminding readers to look at the child’s communication skills to determine if the challenging behavior is a function of the child’s communication. The authors then described strategies for a whole team approach to developing a behavior intervention plan by suggesting interventions in the form of environmental alterations, skills instruction, and behavioral consequences. Recently, Denno authored a chapter entitled Positive Strategies for Behavioral Intervention in the 2016 text Teaching Students with Visual Impairments and Multiple Disabilities. Denno’s chapter articulated comprehensive descriptions and examples of behavioral interventions. While published in a textbook specific to teaching students with VI and multiple disabilities, the suggestions and examples provided by Denno may be applied to students who do not have additional disabilities identified. Hagood (2008) explored the use of a relationship-based approach for developing the social behavior of children with visual impairment and autism or other types of atypical social development (anxiety, oppositional defiance, or obsessive-compulsive disorders). The goal of the relationship-based approach is for the child to develop interdependence and mutually rewarding partnerships with others in order to achieve social growth. 

In addition to textbooks, there are many online resources for challenging behavior. The Perkins School for the Blind hosts a webpage with resources entitled Behavior Issues in Children with Visual Impairments: http://www.perkinselearning.org/scout/behavior-issues-children-visual-impairments. Additionally, PBISworld.com contains a comprehensive list of approaches to a wide variety of challenging behaviors. PBISworld.com hosts a discussion forum, provides data tracking sheets, and offers targeted suggestions for all levels of behavioral challenges. The Kansas Technical Assistance System Network (TASN) offers another helpful and free resource: http://moodle.tasnatbs.org/. TASN offers comprehensive and free online trainings in many areas related to behavior intervention (TASN, n.d.). Each of these online resources offers strategies for addressing challenging student behaviors from the expertise of the behavioral disorders field.

Implications for Practitioners and Families

In addition to understanding the laws and current practices around challenging behavior and IEPs, TVIs need confidence in their strategies to meet the specific needs of children with VI who have challenging behaviors. Beam & Mueller (2016) discovered that general education teachers feel less equipped to manage challenging student behavior than do special educators. For the itinerant TVI, Beam & Mueller’s (2016) finding carries considerable weight: when TVIs provide services to students who have challenging behaviors, the educational team may look to the TVI for answers and strategies. TVIs might not know what strategies will work with individual students who exhibit such behaviors (Banda, Griffin-Shirley, Okungu, Ogot, & Meeks, 2014). Therefore, having access to resources, maintaining documentation, and fostering collaborative processes are critical strategies for success with challenging behaviors. Honest conversations between families and TVIs are an excellent starting point for targeting challenging behavior.

Involving and partnering with parents as active decision-makers in their child’s education is a pillar of IDEA (Yell, 2016). Research indicates that families of children with ASD experience significantly high levels of stress (Koegel et al., 1992; Openden, Symon, Koegel, & Koegel, 2006). Extrapolation from these studies indicates that the added challenges of caring for a child with a visual impairment and ASD (or other behavioral challenges) could intensify the parents’ stress levels. Consequently, both TVIs and parents may be experiencing high levels of stress and be at a loss for solutions and answers to addressing challenging student behavior. 

Determining the function of a student with VI’s behavior may be difficult: is it sensory-based, defiance, part of a larger neurological etiology, or all of these things? By starting with honest conversations and focusing on primary areas of concerns, TVIs and families can develop a plan for data collection and consistent responses to challenging behaviors. Teachers who work with students with challenging behaviors are at increased risk for compassion fatigue and professional burnout (Brunsting, Sreckovic, & Lane, 2014). If the field is to continue to recruit and retain high-quality TVIs, there must be dialogue and teamwork advocating for and supporting the professional development needs around challenging student behavior.

The case resolution: Amanda is not only worried about her student Tabitha’s academic progress, but is also afraid to be seen as a failure by her supervisor. Tabitha’s family is going through a rough time and seems angry with the school. When Amanda expresses concern to Tabitha’s mother, the mother offers no suggestions and seems to be getting increasingly frustrated with Amanda’s calls. During an after-school planning session with Mrs. Joy, Amanda breaks down and cries. She is having so much trouble reaching and connecting with Tabitha, she wonders how she’ll ever be successful as a TVI.  Luckily, Mrs. Joy has worked with several students with special needs and has a few suggestions for Amanda. Mrs. Joy suggests that Amanda write down all of the strategies she has tried and recommends her meeting with Ms. Cense, the OT, to review the ideas that she has tried. During the meeting with the Ms. Cense, both she and Amanda decide to rearrange their schedules so that they can both be at the school at the same time, at least for several sessions, in order to collaborate on the problems that Tabitha is experiencing. They agree that Amanda will work with Tabitha and Ms. Cense will observe, then they will reverse roles and Amanda will observe Tabitha’s OT session with Ms. Cense. Amanda leaves the meeting with Ms. Cense feeling relieved; she doesn’t have the answers yet, but she has a starting place and a teammate who is willing to help her address the student’s challenging behavior. Together, Ms. Cense and Amanda decide to write an email to the elementary school psychologist to ask if he has any informal assessment tools that might be helpful for defining challenging behaviors and motivational strategies. Amanda also calls her university advisor and asks if they could set up a time to chat so that she can go over strategies that might work for Tabitha. Her advisor, Dr. Emerald, suggests that Amanda go back to some of her resources on working with students with multiple disabilities. Dr. Emerald reminds Amanda that although Tabitha doesn’t have any additional diagnoses, she may need a more comprehensive IEP to meet Tabitha’s sensory and behavioral needs. After talking with Dr. Emerald, Amanda feels empowered to speak to her special education director to request support for holding a meeting with Tabitha and her family in order to discuss concerns Amanda is having about Tabitha’s behavior during braille lessons. Amanda also plans to ask her director for permission to attend an upcoming professional development workshop and webinar series for children with special needs who have behavioral challenges. Amanda now has a plan!

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