Commentary: Evolution of Positive Behavior Support and Future Directions

Historical Perspective

Historically, one important distinguishing feature of the applied science of Positive Behavior Support has been emphasis on both social and ecological validity (Carr et al., 2002). The increasingly diverse nature of the contexts within which Positive Behavior Support is being applied today further highlights the importance of being mindful of ecologically and socially valid procedures. The field will continue to be challenged moving forward in finding the balance between internal validity of the metrics employed when viewed in context of the complexities associated with conducting training and research in Positive Behavior Support within increasingly diverse naturalistic settings. In an ideal world, researchers and trainers will be working hand in hand with practitioners and families to design, implement, and evaluate the impact of Positive Behavior Support. However, when such partnerships are inaccessible, it will be essential for researchers and trainers to find other ways to authentically engage practitioners and families to achieve sufficient utility in concert with consumer satisfaction as Positive Behavior Support is applied across expanding contexts, populations, and units of analysis. When we envision the future through the prism of socially valid outcomes, we can further appreciate the growing importance of stakeholder perspective. That is, do the stakeholders (and in particular, the people who will both implement and live with the results) see meaningful, positive changes through application of Positive Behavior Support? Beyond the importance of further generating sound empirical evidence in the form of data, the essential question to really be addressed is, “has the application of Positive Behavior Support enriched the lives of all involved in the process?” Furthermore, when entertaining this question, the more contemporary view of the concept of enriched lives as a result of Positive Behavior Support is no longer exclusively focused on the quality of life of given individuals with histories of serious challenging behavior. Rather, the contemporary view now includes the entire continuum of children, youth, and adults that comprise schools and communities. One challenge as a field we will continue to confront given this broader frame of reference will be maintaining the capacity to address the needs of individuals with the most complex life circumstances while concurrently having a positive impact on quality of life with the broader masses. In other words, adequately addressing both arenas of need is required prospectively rather than viewing this as a proverbial “Sophie’s Choice” either/or decision pitting one group of stakeholders against the other.

Contextual Fit

As these broader opportunities continue to emerge and we expand application of Positive Behavior Support, the field will continually be challenged with issues of ecological and social validity. In this sense, finding acceptable degrees of goodness of fit by meaningfully engaging stakeholders in the process will be of paramount importance prospectively.

This growing emphasis on social and ecological validity aligns with two additional premises put forth by Carr and colleagues (2002): flexibility with respect to scientific practices and alignment of multiple theoretical perspectives. It is increasingly important for those of us promoting Positive Behavior Support to be open to collaborating with others that share similar goals but view the world through a different theoretical lens and resultantly utilize different measurement procedures and training curricula. The opportunities appear to abound most recently in relationship to collaboration with friends and colleagues in the field of mental health. More specifically, as the fields of education and human services continue to gain appreciation for the broader constructs of social, emotional, and behavioral wellness, those of us promoting Positive Behavior Support need to be open to alignment and integration with the conceptual framework of what is referred to as trauma-informed approaches. This is becoming increasingly salient to the applied science of Positive Behavior Support when considering the impact that trauma (and in particular repeated exposure to traumatic experiences resulting in toxic stress) can have on short term-learning and quality of life across the life span. Beyond the mental health community, opportunities are further emerging with medical researchers and practitioners from the biomedical community as we consider the growing body of knowledge associated with understanding the adverse impact of toxic stress on health and well-being across the life span (e.g., the neurobiological impact of toxic stress on the body’s normal response to challenging events or environments). While to some within the behavioral perspective, this pushing of the boundaries and openness to other perspectives may seem a bit unsettling, to others it represents a natural evolution of practice toward society-wide behavioral impact that Skinner liked to envision (Putnam & Knoster, 2015). As Carr and colleagues (2002) aptly posited concerning the perils of narrowly defined allegiance to scientific practices or orthodoxy, by adhering rigidly to laboratory-based criteria of excellence, we are in danger of putting ourselves in the position of learning more and more about less and less. Rather, flexibility and openness is actually required as the field expands application of Positive Behavior Support across increasingly diverse, real-world contexts that look broadly at the human experience. Therefore, as the field further embraces scientific flexibility, it must concurrently become increasingly open to multiple theoretical perspectives to find common ground in a manner that aligns with such real-world contexts. Positive Behavior Support, of course, has its scientific origin in the applied behavior analytic literature and belief systems firmly rooted in the principle of normalization, inclusion, and person-centered planning. It is increasingly evident that other kindred disciplines align with these underlying tenants (e.g., various branches of psychology, systems analysis, and most recently implementation science). While flexibility and openness in this regard has been a part of the history of Positive Behavior Support, the field will likely be further pushed in the future as this emphasis continues to grow in direct relationship to expanded contexts of application.

Cultural Relevance

As Positive Behavior Support grows in application across diverse environments, culturally responsive practice will rightfully gain in importance and attention. To illustrate, when viewed within the school-wide context, Culturally Responsive Positive Behavior Intervention and Support (CRPBIS) has become an increasing focus as part of a solution set to address issues of disparity in disciplinary procedures in schools. McIntosh, Girvan, Horner, Smolkowski, and Sugai (2014) articulated essential components of effective intervention to prevent and reduce disproportionality in disciplinary procedures. In this context, McIntosh and colleagues proposed the concept of Vulnerable Decision-Making Points (VDPs) that can be heavily influenced by implicit and explicit bias. In keeping with this notion of implicit and explicit bias, it would appear logical that VDPs have relevance when it comes to implementation across new, unfamiliar contexts and therefore the field would be well served to create mechanisms associated with processes to minimize the potential adverse impact of bias associated with application of Positive Behavior Support within increasingly unfamiliar environments. Authentic engagement (beyond mere participation) of stakeholders as previously highlighted further increases the likelihood of culturally competent and contextually relevant application of Positive Behavior Support.

To further illustrate, the application of School-Wide Positive Behavior Intervention and Support (SWPBIS) has experienced exciting degrees of application across school settings around the globe (e.g., Europe, Australia, and Taiwan). This growth in application of SWPBIS has paralleled the growth of internationally based networks of the Association for Positive Behavior Support (APBS). This expansion of both SWPBIS in tandem with the emergence of APBS networks is exciting on many levels and most certainly requires the field to thoughtfully view such opportunities through culturally competent approaches that authentically engage those local stakeholders in design, implementation, evaluation, and plans for sustainability. In a kindred manner to how civil engineers engage members within local communities in authentic ways at the onset of project design, those of us promoting expanded application of Positive Behavior Support should apply this same approach.

Newly Emerging Frontier

Beyond the previously noted challenges and opportunities, one area that represents a newly emerging frontier that is both logical and exciting for the application of Positive Behavior Support is that of higher education environment or what has been referred to as the arena of College and Career Readiness. Institutions of higher education have increasingly acknowledged and subsequently programmed for the fact that college students are complex individuals with many interrelated aspects to their lives (Empson, 2017). This naturally occurring complexity becomes even more complicated when considering that one in four college-age students may have a diagnosable behavioral health condition such as an anxiety disorder, depression, or eating disorder (Eisenberg, Daniel, & Lipson, 2014) and that as many as one third of college students report feeling so overwhelmed that they are not able to sufficiently function for extended periods of time during the academic year (Duckworth, 2007). Further concerning is the fact that suicide is currently noted as the second leading cause of death of young adults in the United States up through the age of 24 (Substance Abuse Mental Health Services Administration, 2016).

In light of these challenges across higher education environments, it is not surprising to find that 95% of school administrators agree that social, emotional, and behavioral health are significant issues at their institutions (American Psychological Association, 2013). In response to these emerging trends, institutions of higher education have been increasingly organizing efforts to support students under the broad term of wellness initiatives. It is within this frame of reference that the application of Positive Behavior Support appears as a logical, empirically based approach to enhance social, emotional, and behavioral wellness across institutions of higher education.

Science and Values

Positive Behavior Support, beyond the characteristics previously noted, has the additional distinguishing feature of emphasizing the relationship between the science and values that guide its practices (Carr, 2007). Such growth and application across contexts, populations, and units of analysis will require the field to keep clearly in sight these moorings with the understanding that expanded application across real-world environments may situate those of us doing this important work within cultures unknown or unfamiliar to us. In this spirit, the emphasis on Quality of Life as defined by those directly affected by our endeavors must increasingly guide our work. Our collective emphasis on prevention through multi-tiered frameworks of support portends great opportunity for societal impact. This preventive approach to working up-stream emphasizing skill building to further enhance resilience and protective factors of individuals and community/school-based systems reflective of data-driven environmental changes continues to represent the great promise of Positive Behavior Support. However, this progress will not always be a smooth or carefree ride. It is very likely that we may find ourselves increasingly working in settings that do not appear particularly inclusive or person-centered as defined in our familiar culture at a particular moment in time as we explore new contexts for application. As such, we may experience mixed emotions or feelings ourselves as we endeavor to provide training and conduct research consistent with our shared values (i.e., the principle of normalization, inclusion, and person-centered planning). This is not to suggest that we should avoid such situations. To the contrary, we should respectfully and cautiously engage in such environments. Simply preaching to the already converted does little to expand the footprint, impact, and ultimate influence of Positive Behavior Support. It is essential that, as a movement, those of us promoting Positive Behavior Support engage people where they are at in terms of philosophy, locations, and practices. Doing so will require us to further build on and create new linkages among disciplines to facilitate advancement of Positive Behavior Support. It is morally imperative that we explore these broader, deeper, and more diverse levels of application, with the understanding that things may become less pristine and on occasion downright messy, but this is the nature of the continued evolution of the applied science of Positive Behavior Support.