Challenging Behaviour – Part 3

We should always keep the learners’ safety and dignity as paramount. It’s also important to rule out any medical issues when dealing with problem behaviour.

 

One very important thing to consider when working on decreasing challenging behaviour is an extinction burst. An extinction burst basically means that when you start working on reducing problem behaviour, it gets worse before it gets better. Two bi-products of an extinction are intensity (more of the same behaviour, at a higher intensity) and variety (some challenging behaviour you haven’t seen before). An example of this is the classic ‘child trying to get mums attention scenario’.

extinction-burst-graph

 

Mum is talking, and the child comes up and says ‘mum’, the mum ignores, the child persists ‘mum, mum, mum’ (this is the intensity; more of the same behaviour), but the mum continues to ignore, so the child pulls on mum’s arm (variety, a new behaviour).

 

Your consultant should have a good chat with you about this, because if you ‘give in’ and reinforce the challenging behaviour during the extinction burst, you are likely to make the whole thing worse in the long run. You’re better off not working on it at all if you think you can’t manage the extinction burst, so think carefully. If you reinforce during the extinction burst, you’re essentially encouraging the learner to engage in more intense problem behaviour, sooner.

 

So here are some of the key tips to remember when dealing with problem behaviour;

  • Remember, as hard as it might be initially, keep calm, think about the antecedent (why the problem behaviour occurred), and what consequence you should deliver. The better your analysis becomes, the calmer you will be during incidents of problem behaviour.
  • Make sure you are reinforcing appropriate behaviours, and your reinforcement is being delivered well.
  • Don’t get caught up talking during the incident, it’s consequences that will shape behaviour.
  • Don’t negotiate during problem behaviour; nothing positive should occur in the learner’s environment until problem behaviour has ceased.
  • You could also try video the problem behaviour, so you can watch it back to analyse the situation. 

This concludes the 3 part challenging behaviour posts, I hope you found it useful!

Challenging Behaviour – Part 2

When working on reducing problem behaviour you need to be sure to deny any reinforcement related to the antecedent when problem behaviour occurs.

 

Here are some common reasons challenging behaviour may occur, with typical consequences we should deliver in brackets;

  • Lack of effective communication (requests) (the ‘count and mand’ procedure could be used for this)
  • Avoidance/escape of demands (follow through with reasonable demands)
  • Sensory reinforcement is valuable (block and re-direct)
  • Wanting attention (ignore)
  • Having to wait (continue to wait until the learner has waited appropriately)
  • Being told no (continue to deny access to what the learner wanted)
  • Being interrupted from a preferred activity/having to transition (continue to interrupt /transition)

praising-your-children

It’s also important to reinforce appropriate alternative behaviours where we can. This,
coupled with ensuring the appropriate consequence is delivered if problem behaviour does occur, will most likely reduce problem behaviours faster.

 

Here are some of the best ways to do this;

  • Lack of effective communication (requests) – teach mands, the more spontaneous mands a learner has in their repertoire, the less likely they are to engage in other, less desirable, challenging behaviours.
  • Avoidance/escape demands – implement an appropriate schedule of reinforcement that competes with the motivation to avoid/escape. Chances are, if there is a lot of problem behaviour when demands are placed, your reinforcement needs to be better.
  • Sensory reinforcement is valuable – teach an appropriate behaviour to achieve sensory reinforcement (e.g. if your learner swipes things off of a table to see them fall, teach them to build blocks and knock them down instead).
  • Wanting attention – teach to request attention appropriately (tap on arm, saying someone’s name).
  • Having to wait – initially provide reinforcement during periods the learner is expected to wait (as long as there is no problem behaviour), and fade reinforcement gradually over time (as long as the learner is waiting successfully).
  • Being told no – provide alternatives as long as there is no problem behaviour (you can’t have chocolate, but you can have some raisins).
  • Being interrupted from a preferred activity/having to transition – use promise reinforcers (provide something the learner wants, initiate the interruption and immediately deliver reinforcer in the absence of problem behaviour).

 

This is a very brief snippet of what could be done, and there are comprehensive protocols for working on a range of problem behaviours, that should be overseen by a BCBA/BCaBA, with thorough data being taken.

Challenging Behaviour – Part 1

This will be part 1 of 3 on challenging behaviour. There’s a lot that could be covered, so I thought I would spread them across 3 posts to not overwhelm readers!

 

First, the following point should be noted. I’ve heard people say something like, ‘little Jonny had a behaviour in the last session’; well I should hope so, as behaviour is anything a living organism does. Referring to an incident  as a challenging behaviour, or problem behaviour is clearer.

 

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Challenging behaviour is a reality for many of those on the spectrum. Challenging behaviour can present in many different ways, but it’s important to look at why something is happening – the antecedent.

 

For each incident of challenging behaviour, we should strive to look at the ABC (antecedent, behaviour, consequence).

 

A – Antecedent – the ‘trigger’, why did it happen, the function

B – Behaviour – what the learner did, the challenging behaviour

C – Consequence – what consequence was achieved

 

Rather than adopting a blanket consequence for a challenging behaviour, we should use the consequence appropriate to the antecedent. For example, a child may hit regularly, but each incident may occur for a different reason. What we do should be dictated on why the problem behaviour occurred.

 

There’s no such thing as ‘out of the blue’. It may seem that way as the antecedent isn’t clear, but there is always a reason. When it’s difficult to see the antecedent, it may be worth taking some video, and if you catch any challenging behaviour, watch it back and see if you notice anything. Try looking at what happened immediately before the onset of the incident.

                                                                                       

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Here is a 0-50 graph used to plot data

Taking constant accurate data is vital. It’s the data, and graphing the data that informs us whether we are making good decisions, and whether the improvement is because of our interventions. It’s a good idea to take data on the following; total frequency of problem behaviour, total duration of problem behaviour, and frequency of problem behaviour for each antecedent (I’ll discuss common antecedents in Part 2).

 

Is ABA all about Punishment?

NO.

This is a tough piece to write, as it’s a bit of a delicate subject to approach, but I thought I may as well get stuck in. 

There is a common misconception about ABA, that it heavily relies on punishment. This is not true.

Two consequences are reinforcement or punishment. Now, punishment is a word that has many negative connotations, but it shouldn’t. Punishment is a consequence that decreases the future likelihood of a behaviour. Punishment as the field of ABA defines it is not as sinister as the general perception of punishment may be. Most views on punishment are probably misguided, uninformed, and/or outdated. Punishment has helped us thrive as a species,and played a big part in all our lives. 

 


The misconception is probably because oDoctor_review_brain_imagesf early research in to punishment in the field of
ABA, when punishment was a lot more common. Times when children would still get the cane at school, or you’d get a ‘clip round the ear’ if you did something wrong. But science evolves, ABA has moved a long way since then, just like people’s beliefs have. Science is always advancing, finding more effective ways to get better results; so is ABA. Whilst I was studying, my supervisor (Gina
Tirri, BCBA) spoke of how doctors aren’t treating all illnesses the way they were treated over 60 years ago, and that they use the most up to date treatments available to them, as do behaviour analysts.

 

Punishment occurs daily for everyone. A punisher is ANYTHING that occurs after a behaviour that reduces the future likelihood of the behaviour;

  • If you eat food that’s too hot and it burns your mouth, and you don’t do the same thing straight after, then the behaviour of eating piping hot food has been punished.
  • If you hit the snooze button too many times and miss your train, and in the future you don’t hit the snooze button, the behaviour of hitting the snooze button has been punished.
  • If a learner is rude to a teacher, they may get a detention, if the learner is less likely to be rude to the teacher again, then the detention was a punisher.

 

Parents would likely reprimand a child if they misbehave, and so would teachers for that matter, to the end that they want them to ‘behave’ more acceptably, learn more effectively, and be kept safe, so they are well equipped for life in the world. So why isn’t it acceptable to shape children with autism’s behaviour? We should have high expectations for our learners.

 

51pm2vhyXSL._SY344_BO1,204,203,200_The first time I used a punishment procedure was with a young learner during a toilet training protocol (I’ll do another post down the line on the toilet training procedure by Azrin and Foxx). Basically, the child receives positive reinforcement for ‘good toileting practices’, and positive practice (a type of overcorrection – a punishment procedure where you get the learner to do the desired behaviour several times) when there is an accident. I remember feeling sceptical initially. Naturally, I asked questions, and read in to the research. Using reinforcement and punishment was such an effective way to toilet train, and being toilet trained is such a valuable life skill. If faced with the option of a couple of negative experiences or being toilet trained, what would you choose? Sitting around in wet/soiled pants is not dignified, so I know what I’d rather.

 

 

There are 2 types of punishment, positive (the addition of something – verbal reprimand) or negative (the removal of something – response cost). I have been trained to use reinforcement over punishment if possible, but sometimes, punishment may be necessary to decrease challenging/inappropriate behaviour. These could be strategies such as;

  • response cost (removal of something good, e.g. confiscating a learner’s iPad for a short period, or losing playtime)
  • time out [which is commonly misused] (is the withdrawal of the opportunity to earn reinforcement e.g. sitting outside of the ball pit, away from the fun)
  • verbal reprimands
  • over correction (doing the correct behaviour several times)

There are of course more punishment procedures.

 

It’s important to remember that something is only a punisher if the target behaviour decreases, so you shouldn’t be using the same consequence over and over with no change, as it’s actually ineffective. If a child becomes upset when you deliver a consequence, but it doesn’t decrease the target behaviour, then it’s not working as a punisher.

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If using punishment, we should always be reinforcing a desired alternative behaviour. For example, if there was a punishment procedure used for a learner hitting other children during playtime, then we should also be reinforcing playing appropriately with peers. This way we can say things such as ‘play with ……’ rather than ‘stop ….’; give the learner something to do rather than something to don’t.

 

One last thing to consider is the delivery of punishment. I’ve seen teachers send children to the headmaster, and the head will give a verbal reprimand, which it turns out the learner loves, thought it was hilarious, so it’s likely the problem behaviour was actually reinforced! Remember, it’s not about how you mean the consequence to be taken, it’s about the effect on the future likelihood of the behaviour, how it’s received by the learner.

 

I hope this has clarified a subject that is sometimes tiptoed around, and hopefully you will convince others to not jump to conclusions, because in reality, behaviour analysts will only use punishment procedures after careful thought and planning, and always for the benefit of reducing an undesirable behaviour.