Family-Centered Prevention


Boettcher, M., Koegel, R. L., McNerney, E. K., & Koegel, L. K. (2003). A family-centered prevention approach to PBS in a time of crisis. Journal of Positive Behavior Interventions, 5, 55-59.

This article summarized the implementation of positive behavior supports in a family –wide program for prevention of problem behaviors. The mother of the children involved in the study was to soon undergo a major surgery and would be hospitalized for a week and incapacitated for several weeks afterwards. The children under study were 7-year-old Kelly Smith and two of her siblings. Kelly had autism and would often display such behaviors such as tantrums, aggression toward her siblings, noncompliance, and running away. Her siblings also had some sort of disabilities. Due to the unpredictable nature of the new situation with Mrs. Smith, a proactive, preventative approach was employed. First of all, in order to prepare the children in advance concerning what to expect, a priming intervention in the form of a fun and motivating family activity was held in which the children took part in the making of a calendar and then writing on each day of the calendar where their mother would be, how she would be feeling, and how they needed to behave.

In addition to this priming intervention, a temporary system of support was needed to avoid the lack of predictability, structure and supervision that would occur as a result of Mrs. Smith’s incapacitation. For collaboration purposes, a stakeholder meeting was held in which coverage of respite hours for all times that the children were not in school were coordinated and driving schedules were set up. Those involved in this meeting were family members, clinicians, and the respite providers. Also, a daily schedule was arranged to determine who would provide services on which days during the duration of the incapacitation. All involved in providing these services were trained beforehand in PBS in order to be able to deal with any possible behavior challenges.

The family-wide PBS plan that was developed by the care providers was as follows: They would provide positive consequences to the children to encourage appropriate behavior and deter problem behavior. Each child would choose a chore for which he or she would be responsible, and a chart was made on which the children could accumulate points for completing their assigned chores. There was ongoing support by the clinicians in the form of twice-weekly visits. The results of the interventions were positive with Kelly and her siblings displaying a lack of problem behaviors in both the home and school settings.