Both autism professionals and parents report that their number one challenge by far, hands down, is the reduction of problem behaviors. So in today’s video blog, I am pulling out a short excerpt from podcast number six which is all about reducing problem behaviors.
First, I want to tell you about a little boy named, well, I’ll call him Tony. That wasn’t his real name. He was about 6 years old. He was in first grade in a verbal behavior project classroom. We did the VB-MAPP assessment and he was pretty much a level one VB-MAPP learner. And he could talk a little bit and didn’t have major problem behaviors that I could remember from the classroom. Tony’s mom asked if she could come in and meet with me. She was very stressed and she reported that Tony had major problem behaviors in stores. He would clear shelves when she was at the grocery stores to the point where she couldn’t take him out. So I was asking some questions trying to get a bigger picture of what Tony was like.
And one of the questions was to describe his eating. Some kids drink out of a bottle or use a pacifier, even older kids. I always ask what are they drinking from and what are they eating? And a lot of kids, including the boy that used to use the straw, who are very picky eaters can have problem behaviors around food. So the first step is absolutely an assessment and a lot of behavior analysts, they kind of jump right away to assess the problem behavior and try to develop the function and all that. But what I like to do is step back and take a look at generally what is the child like? Do they have a diagnosis? What kind of school programming are they receiving? What kind of therapy are they receiving? Do they have any siblings? Do they sleep through the night in their own bed?
How do they eat? Are they addicted to a bottle or a pacifier or something like that? Did they have any allergies? After this general assessment’s done, then I look more closely at language through, preferably the VB-MAPP assessment and that’s what I recommend for non-conversational kids. The assessment part is actually never done. You’re always constantly assessing what is going on. Why is he having problem behaviors? Is it related to a skill deficit? Is it related to a medical issue? Is it related to intermittent reinforcement across all different people in all different settings? We just really need to constantly assess. At some point too, we need to start making a plan and intervening. So assessment is number one and then the number two step is to make a plan. So what you want to do is you want to plan and prioritize.
Your first order of business is to try to get major problem behaviors, which are self-injurious behavior, aggression, and property destruction, down to near zero levels. And in the end, it really does come back to those skills. We need to break things down, to pair up the learning environment, and to incrementally desensitize the problems. So the child might have a problem. He may not like the bathtub, he may not like the water temperature. The water temperature varies. So could we keep the water temperature warmer than colder? Could we check the temperature of the water to make sure it’s at a consistent temperature that he likes? Can we pair the bathtub up with foamy soap or alphabet letters that he can stick to the sides of the walls? Could we have him just practice getting in the bathtub fully clothed without water and give strong reinforcement?
Maybe it’s just the hair washing part that’s the problem. So with any activity where there’s problem behavior, we need to kind of be the Monday morning quarterback, step back and look at how we can repair the task, make it more appealing, teach the skills, teach your prerequisites and give very strong reinforcement. Step three is your intervention. Like I said all along throughout this podcast, I’m not going to be really able to give you any specific guidance, but just in general, I think if you see problem behaviors that demands are too high and or reinforcement is too low. As I said, one of the activities that I have in my book is, if I gave you $1,000 for your child or client to have a good day with little to no problem behaviors, what would you do? And when I do this in front of live audiences, people generally get the answers pretty quickly.
It’s basically like, let the child do what they want. So if they want to eat 5 pieces of candy, that’s fine. If they want to run around without shoes on, that’s fine. If they want to spin in circles or script or play with a straw, that’s fine. And so give them a lot of reinforcement and don’t make them do anything. Limit your demands. That’s how you’re going to get that thousand dollars a day. You’re going to say “okay, I’m not going to teach you anything. I’m not going to require that you keep your shoes on. I’m not going to require you to keep your clothes on.” But as parents, teachers and behavioral analysts, we know that letting a child do whatever they want and not requiring anything is not very realistic. Children have to stay dressed when they go out in public.
They have to keep their shoes on at school and at recess. They can’t eat loads of candy or sit there spinning in circles all day. Teachers and the education system have IEP goals in the United States. We want our children to be as functional as possible. But what this thousand dollar activity really teaches us, I think, is that while we can’t eliminate all demands, we want to lower the demands and increase the reinforcement. We want to be the spoiling grandmother when the child is engaging in good behavior. We want to be very reinforcing. We want to limit our demands. So if the child is not able to sit in a 20 minute circle time without problem behaviors, part of the plan and the intervention might be to have them join circle time for the last 5 minutes when we do the goodbye song, which is really the only part of circle time that the child likes. The rest of the circle time they’ll actually be working on one to one skills, in which case they’d really need to catch up on their language.
Breaking down things and being super reinforcing and teaching incrementally and systematically is one of the reasons I’m such a big believer in errorless teaching and gradually fading in demands. We know that schools have a lot on their plates and so I’m just giving you permission to say, you know what, let’s look at this. Maybe we can break this down. If the child is pounding on the desk during math instruction, let’s really look at it, well they’re doing double digit addition. Well, they’re not really fluent with single digit addition, so let’s go back. Let’s make the reinforcement higher, let’s make the math instruction lower and let’s see how we can help this child not have problem behaviors. The final step after we get through with assessment planning and intervention is that we want to keep data, and this might sound scary to a lot of parents out there and even some professionals might be a little leery about data collection.
