Functional assessment is a critical component to creating and implementing function-based treatment. This is standard practice in the assessment of the challenging behavior of the individuals we serve. Staff may also engage in challenging behaviors such as tardiness, missing meetings, or not completing required tasks or paperwork. When managing staff performance issues, it can be too easy to jump to writing someone up and having them meet with human resources. Staff performance issues should be identified using functional assessment. Carr et al. (2013) created the Performance Diagnostic Checklist – Human Services (PDC – HS) to assess and identify the variables that contribute to staff performance issues.

What is the PDC – HS?

The PDC-HS is an assessment that supervisors can complete to identify environmental factors that contribute to staff performance issues and implement targeted interventions based on the specific function (Carr et al., 2013).

The PDC-HS is a checklist with 20 questions organized into 4 domains:
a) Training
b) Task Clarification & Prompting
c) Resources, Materials, & Processes
d) Performance Consequences, Effort, and Competition

Many questions can be answered based on report by the staff’s supervisor while 7 questions require direct observation (Carr et al., 2013). Questions are answered either yes or no. Each question scored as no is a possible area of intervention. Domains with multiple items scored no should be prioritized first for intervention. Intervention options and literature are provided for each potential function/domain.

How can it help?

It is critical for supervisors to use systematic tools to identify staff performance issues. It can be all too easy to become busy and implement punitive strategies to try to fix staff behavior problems. By using a systematic assessment such as the PDC-HS, it can help supervisors be more effective by:

1. Saving time
2. Reducing punitive consequences
3. Improving staff performance

Supervisors can save time by targeting an intervention to address the specific staff deficit. This saves time by only targeting the specific issue and not providing extra training or instruction for areas that are not indicated in the assessment.

A staff performance assessment can also reduce the use of punitive consequences such as getting a “write up”, a note in their file, or sending an email to human resources. These consequences do not teach a new behavior (ie; staff member performs the task correctly next time). Sometimes supervisors may change the staff’s schedule or tasks to avoid the performance issue. Instead, the PDC-HS helps by identifying the specific concern and targeting the concern with a tailored intervention to solve the issue.

Not only does the PDC-HS reduce the need for punitive consequences, it identifies areas for supervisors to teach staff so that they can be successful with their job. Punitive consequences create an environment where supervisors are looking for behaviors to criticize. However, teaching staff the skills to be successful at work creates a collaborative environment where supervisors support their staff and reinforce positive behaviors.

Supervisors should use an assessment such as the PDC-HS when considering how to manage staff challenging behavior. Using a simple and quick assessment can save time, create a supportive workplace, and improve staff performance. When staff are performing at their best, we can provide effective treatments and quality outcomes to benefit the individuals we serve.

Reference

Carr, J.E., Wilder, D.A., Majdalany, L., Mathisen, D., and Strain, L.A. (2013). An assessment-based solution to a human-service employee performance problem: An initial evaluation of the Performance Diagnostic Checklist – Human Services. Behavior Analysis in Practice, 6(1), 16-32.

Individuals may use challenging behavior to escape, delay, avoid a situation, task or instruction, or other non-preferred activity. When an individual escapes a situation by exhibiting challenging behavior, they will continue that behavior since it was effective in getting them the results they want.

Example: Caregiver Rachel asks individual Sam to clean up. Sam says “no!” and hits Rachel. Rachel says, “Sam – you need to take a break and calm down.”

In this example, Sam did not want to clean up and did not have to clean up after he hit Rachel. Since hitting got Sam the results he wanted, he will likely hit again next time he is asked to clean up.

De-escalation Strategies

A common myth is that using Safety Care de-escalation strategies might allow escape (“getting away with it”). This would unintentionally reinforce and increase challenging behavior.

Safety Care uses 3 de-escalation strategies: Help, Prompt, and Wait. These strategies are designed to help the individual engage in calmer, safer behavior while maintaining everyone’s safety. This does not force the individual to immediately comply with staff directives. Instead, Safety Care teaches communication, instructs likely behaviors, and withholds reinforcement from challenging behavior. While these may temporarily reinforce less severe or intense forms of the challenging behavior, it prevents the situation from escalating to more dangerous and unsafe behavior.

The chart above displays potential outcomes from the example with Sam.

1. Rachel could have used Safety Care de-escalation strategies to prompt Sam to communicate that he needed a break. This would reinforce functional communication and teach Sam a way to escape cleaning up in a more appropriate way.
2. If Rachel were to continue the instruction and physically force Sam to clean up, it is likely that the challenging behavior would become more intense and severe. As a result, Rachel may need to intervene using more restrictive strategies and Sam would still get out of cleaning up.

From both of these scenarios, Sam escapes cleaning up. In the first example, communication gets him a break. With the second example, more intense behavior gets him a break.

Additional Strategies to Manage Behavior

Geiger et al. (2010) provide additional recommendations when working with individuals who engage in challenging behavior maintained by escape:

1. Provide choices of activities and tasks
2. Ensure curriculum and tasks are an appropriate level and difficulty
3. Start with few or no instructions and gradually increase
4. Reinforce desirable behavior and withhold reinforcement from challenging behavior
5. Avoid giving escape when the challenging behavior happens
6. Every so often allow escape – just because!

“We can’t let them get away with it” may not be the safest or most practical option when dealing with challenging behavior. Safety Care recommends use of de-escalation strategies to effectively decrease and teach functional alternatives to challenging behavior.

For more information about Safety Care and de-escalation, please contact us at info@qbs.com.