2. What are Hidden Disabilities?
A hidden disability (HD) is a serious
emotional, behavioral, developmental or
neurological disorder with no outwardly
apparent symptoms
3. Examples of Hidden Disabilities:
• Autism, autistic spectrum disorders
• Developmental disabilities
• Attention-Deficit Hyperactivity Disorder (ADHD)
• Learning disabilities
• Anxiety disorders
• Mood disorders (depression, bipolar disorder)
• Attachment disorders (common among adopted, foster
children)
• Fetal Alcohol Effects (FAE)
• Brain injury: resulting from trauma, epilepsy, stroke
Stephen Grcevich, MD, Case Western Reserve University School of Medicine
5. “Rethinking” disability and church
• An individual with a disability is defined as a person
who has a mental or physical impairment that
substantially limits one or more major life
activities, a record of such impairment, or is
regarded as having such an impairment.
Taken from www.joniandfriends.org
6. “Rethinking” disability and church
• If a mental or physical impairment
substantially limits a person’s ability to
actively pursue spiritual growth and fully
participate in the ministry of a local
church, is that person “disabled?”
7. The Ultimate Low-Hanging Fruit for
Evangelism, Outreach?
• 9% of U.S. kids ages 6-17 received Rx for ADHD
meds
• Prevalence of anxiety disorders-U.S. youth: 8-20%
• 1/91 kids born in 2008 will be diagnosed with
autism
• 22% of U.S. kids entering first grade meet criteria
for one or more psychiatric disorders
• What about siblings and church?
• Who equips parents to shepherd their kids in the
faith?
• Key Ministry estimate: families of children with HD at
least 50% less likely to be involved with a local church
J Am Acad Child Adolesc Psychiatry - July 2010 (Vol. 49, Issue 7), Pages 686-698
8. • What strategies are useful when
a child exhibits inappropriate
behavior at church?
9. Increasing positive behavior
• Know the A,B,Cs
(Antecedents, Behaviors, Consequences)
• Understand the function of his/her behavior
(obtain/avoid)
• Be preventive – look for antecedents to behaviors
• Be consistent
• Keep kids busy
• Teach appropriate behaviors
• Use of Social Stories
10. Strategies: Behavioral Approaches
Finding Solutions for Problem Behaviors: ABC Analysis
• ABC Analysis is a process for gathering information about the
environmental stimuli that are controlling the behavior.
• Antecedents (A)
Antecedents are things or situations which happen before the target behavior.
Examples of antecedents are asking a question, time of day, loud noise, a
particular toy, etc. Certain behavior may regularly follow each of these
antecedents.
• Behavior (B)
This is the target behavior we are studying. It is very important to be specific in
our descriptions so that others could easily recognize it.
• Consequences (C)
Consequences are things or situations which immediately follow a particular
behavior. They serve two purposes: to increase the behavior or to
decrease the behavior that just happened.
From Olson & Marker (2000) In-service Training Manual – Pine Grove School.
11. Strategies: Behavioral Approaches
Analysis of Function
• Two main functions of behavior:
– To OBTAIN something desirable or communication
– To AVOID/ESCAPE something undesirable
• By identifying the variables that maintain a behavior, we can
also identify more adaptive ways of obtaining the same
function.
Always teach a more appropriate behavior!
From Olson & Marker (2000). In Service Training Manual – Pine Grove School.
12. Strategies: Behavioral Approaches
. A = Antecedent B = Behavior C = Consequences
Teacher reads paragraph
A = Antecedent Danny draws on worksheet
B = Behavior Teacher redirects verbally
C = Consequences
aloud
A stands for antecedent or what happens before the B stands for behavior. Behaviors are functional, C stands for consequences or what happens
behavior. Antecedents can be a person, place, time, meaning they serve a purpose. Behaviors most often immediately following the behavior.
command, object, smell, noise, etc. are used to obtain or avoid something. Behaviors
should be described in detail.
Function: To obtain (e.g., communication, attention, stimulation, food, toy, activity, person) or to avoid (e.g., homework, person, attention, etc.)
Function: To obtain or avoid: Avoid listening to story
Appropriate Behavior to Teach:
Appropriate Behavior to Teach: On-task behavior, listening
Function: To obtain or avoid –
Appropriate Behavior to Teach: -
From Olson & Marker (2000). In-service Training Manual – Pine Grove School.
13. Strategies: Behavioral Approaches
A = Antecedent B = Behavior C = Consequences
.
Teacher asks question to J. Danny calls out Teacher ignores
A = Antecedent B = Behavior C = Consequences
Teacher asks question to R. D. Stamps foot. “I NEVER Teacher puts hand on D’s
get called on.” shoulder
A stands for antecedent or what happens before the B stands for behavior. Behaviors are functional, C stands for consequences or what happens
T. says, “I like how T. is time,
behavior. Antecedents can be a person, place, D. Puts serve a purpose. desk most often T. says, “Good job calming
meaning they head on Behaviors immediately following the behavior.
waiting. object, smell, noise, etc.
command, are used to obtain or avoid something. Behaviors
should be described in detail.
down.”
Function: To obtain (e.g., communication, attention, stimulation, food, toy, activity, person) or to avoid (e.g., homework, person, attention, etc.)
Function: To obtain or avoid:
Appropriate Behavior to Teach:
A turn in the lesson, attention
Appropriate Behavior to Teach: turn-taking
Function: To obtain or avoid –
Appropriate Behavior to Teach: -
From Olson & Marker (2000). In-service Training Manual – Pine Grove School.
14. Be sure that reinforcement is:
• Clear
• Fair
• Honest
• Positive
• Systematic (ratio of behavior/reinforcer)
• Manageable
Alberto and Troutman, 1986
15. Strategies: Behavioral Approaches
INCREASING DESIRABLE BEHAVIORS
• Reinforcement: Something serves as reinforcement if
1) it immediately follows a behavior and
2) it increases the frequency of that behavior in the future.
• If it does NOT increase the behavior, it is NOT a reinforcement for
that child.
• It is always better to reinforce (increase) a desirable behavior than
to punish (decrease) an undesirable behavior. Doing so teaches
good behavior! You should be giving at least 6 positives to your
child for every negative you give. Make sure the reward is
motivating for your child and is realistic for you to give the child!
From Olson & Marker (2000). In Service Training Manual – Pine Grove School.
Courtesy of Cara Marker-Daily, Ph.D.
16. Strategies: Behavioral Approaches
DECREASING BEHAVIOR
We can decrease unwanted behaviors through a variety of methods. The
following list ranges from least to most intrusive.
– Extinction/Ignoring
– Differential reinforcement of others (DRO)
– Response cost
– Time Out
– Physical restraint
From Olson & Marker (2000). In-service Training Manual – Pine Grove School.
17. Key Ministry: How Can We Serve You?
Key Ministry: www.keyministry.org provides
resources to churches free of charge:
Best Practices Resource Kit “Key Ring Binder”
Web-based resources (Blogs, Twitter, Facebook)
Opportunities to network with other churches
Phone consultation
On-site consultation, training
Celebrating your successes
Local and National conferences
Praying for you
18. Please Stay in Touch!
Key Ministry Foundation
Rebecca Hamilton, Executive Director
8401 Chagrin Road, Suite 14B
Chagrin Falls OH 44023
Phone: 440/708-4488
rebecca@keyministry.org
katie@keyministry.org
steve@keyministry.org
Web: www.keyministry.org
Steve’s blog: http://drgrcevich.wordpress.com
Katie’s blog: http://katiewetherbee.wordpress.com