Slide 1: We are so glad that you were able to make it to this webinar. It’s addressing the challenging behaviors of children with Autism. Before we begin I want to quickly make sure that everybody can hear us. If you could quickly down at the bottom of the screen go to chat and message me yes that you can hear. That would be great. Can everyone hear? Okay great. So as well, just a couple of housekeeping announcements, if you have any questions, I’ve seen a couple of people have already been able to write into that question box. Please feel free to type any questions you may have throughout this presentation. Laura will try to answer questions as we get them, but we know sometimes with lots of attendees, we don’t have a chance to answer them all immediately. If we miss them we will answer these questions at the end during our question and answer portion. So without further a due here is Laura Ferguson with the Basics of Behavior Management. Alright everyone hello, we are going to start talking about the Basics of Behavior Management. So we are going to get right into the Presentation. What Comes First: Alright, every time we look at a behavior what we want to first do is we want to look at what comes first. In the first step in addressing problem behavior is to discover the reason it is occurring. In order to do this we need to look at the problem behavior as a form of communication. Often times you see in classrooms and other situations individuals begin to say well they know how to do this or they should know what to do, but if we start to look at behavior as a form of communication, then we can better understand why the behavior is occurring. If we then determine the reasons for the behavior we can apply meaningful strategies to help prevent it. When A Behavior Occurs: When a behavior occurs we need to ask ourselves some questions. What we need to look at is what happened right before the behavior occurred and this is known as the antecedent. Then we need to look at what happened right after the behavior occurred and this is known as the consequence. So now we can use the ABC’s of behavior and I know you guys have probably been familiar with this, but a lot of times we use things called ABC charts that look at the ascendant, the behavior, and the consequence. So we are going to look into that a little bit. Three Term Contingency: Alright, so this is known as the Three Term Contingency and the A is obviously the antecedent. The B stands for the behavior and the C stands for Consequence. So when we are looking at behaviors we want to first, if we are using an ABC chart, chart the behavior. For example, if a child is falling to the floor we might first put falling to the floor in the behavior category. Then when we are looking at the antecedent a lot of times people want to make this a big event, but when we are looking at antecedents we want to make sure we are looking at what happened directly before a behavior occurred. For example, for children with Autism a lot of times it is difficult to find these antecedents, so if we are looking at what happened right before a behavior occurred then we might see it might be a occurrence something we weren’t paying attention to before. And then the consequence is what happened directly after that behavior and a lot of times we need to look at exactly what happened after the behavior occurred. Antecedents Alright, antecedents are environmental condition or stimulus change existing or occurring prior to the behavior of interest. So again we want to look at what happens directly before a behavior occurs. A lot of times if you’re in a classroom you’ll hear a teacher say “I don’t know why that occurred” or you’ll here parents saying “I have no idea, we were walking outside and he fell to the floor.” So these ABC charts are very beneficial because you start to not only look at big events that might have occurred, but small events. For example, they may have walked outside and the sun was too bright. They may have wanted to exit a door that they exited last time. So when we start to chart these behaviors we might see some things that are truly the antecedents that we weren’t thinking of before. Behavior The next is the behavior and this is the activity of a living organism, or a human behavior, this includes everything we do. And again as we said before we want to start looking at behaviors as communication because ultimately everyone is trying to communicate when they’re displaying behavior. Consequences: The next is the consequence and this is a stimulus change that follows a behavior of interest. So consequences make a behavior more likely to occur and this is when we are reinforcing the behavior or less likely to occur and sometimes that is when we are implementing punishment procedures. Let’s Look At Some ABC’s: So lets look at some ABC’s: one antecedent: a child sees a cookie, the behavior: the child hits the teacher, the consequence: the teacher gives the child a cookie. So in this example we are looking at what directly occurred before the behavior and after the behavior. Another ABC, an antecedent: worksheet is given to a child, the behavior: the child screams, the consequence: the worksheet is removed. So in both of these consequences we can see if we start to chart the ABC’s of these behaviors we might see that these consequences are directly related to why the behavior is continuing to occur. For example, if you give the child a cookie and the child hits the teacher again the next day and the teacher gives the child a cookie we might see that we need to replace this hitting behavior with maybe a request or a picture or some type of device in order for the child to get the cookie instead of hitting in order to get the cookie. In the second example the child screams and the worksheet is removed. We then need to maybe give the child some form of communication in order to say “I don’t want that worksheet”, “Can we stop this”, and “can we do something else.” So we want to make sure that we are teaching the child an appropriate behavior and when we are charting these ABC’s we can start to see what the behavior is directly related to and can we change on the antecedent side or can we change it on the consequence side as well. Why is it important we look at the antecedents and consequences: For individuals with autism why a behavior is occurring is not always clear as we have said before and if we assume a behavior is occurring because of one stimulus and it is really occurring because of another stimulus we may treat these behaviors incorrectly. And this may lead to strengthening of inappropriate behaviors. And often times we see this a lot with individuals with autism. We assume that for example, behavior may be occurring because they’re tired or want to escape or they don’t like something, but when really we might see these behaviors are occurring for attention or for access to items. So we need to make sure we are appropriately looking at why these behaviors are occurring in order to determine how we need to treat these behaviors. Four Functions of Behavior: So I want to talk about the four functions of behavior and it is very important to look at these functions. The four functions of behaviors are: access to tangibles, attention, escape, and automatic reinforcement. We see that we can truly look at these four functions of behaviors that occur with individuals with autism and usually we can pile the behaviors that we see into one of these categories. For example, access to tangibles, a child may cry because they want their favorite movie or they may hit in order to access a toy from another child. Attention they may scream then someone gives them attention, so they’re more likely to scream in order to get that attention. Escape you see them throwing everything on the floor in order to escape a demand or task. An automatic reinforcement, this one is a very important one and the hardest one to treat. And this is self stimulatory behavior. This is what we often see hand flapping, rocking, twirling things in front of their face and that is often the hardest behavior in order to get under control because self stimulatory behavior can occur rather anyone is around or there by themselves. Functions: So the functions of behavior, if we can determine the function then we can effectively treat that behavior. If we do not treat by the function then we may strengthen that behavior again. So it’s very important that we understand why these behaviors are occurring and what function they’re serving because if we can look at the behaviors in terms of their functions then we can better understand how to treat those behaviors. Examples: Alright so now we’re going to look at an example and then we are going to take a poll throughout the group. So I am going to read an example and then ask a question and then a poll will appear on your screen and click on it then we will discuss the answers. So for example, a student falls out of his chair during coloring time at the table. The teacher tells him that it is not ok to fall to the floor and removes him from the activity. What do you think as a group the function of this behavior may have been? Hopefully the poll is appearing on your screen and then we’ll look at what everyone put. Alright great it looks like 100 percent of you guys; ok we are seeing some escape and some attention. Alright the polls are coming in, sorry. I was wrong on a 100 percent, great guys. Ok so it looks like we have about 60 percent of people saying its escape motivation and about 40 percent saying its attention seeking behavior. So looking at this I think both of you guys could be right. By looking at this example the student falls out of his chair during a coloring activity and what we need to look at this is we can’t just look at this as a one time thing and say what is the function of this behavior? Because if he comes in tomorrow and falls out of his chair during coloring time again its coloring time then we can accurately say “you know what I think coloring time may not be his favorite activity and I think falling out of the chair might be escape”. So what do we need to do in order to make coloring time better for him or to make it be a more enjoyable activity or if we feel it is attention which it may be tomorrow when he falls out of his chair it might be all day and not during just coloring time so then we can determine that he may be falling out of his chair in order to receive attention. Do you think that this behavior will increase or decrease in the future by the consequences that we put into place? So for example we are not going to poll you guys on that one But for example if we put a behavior in place we have done ABC data we find that the behavior is escape motivated and we put something into place that allows the child to continue to escape then we may be increasing that behavior and this might only start to occur during coloring time but if the student finds that hey if I always fall out of my chair during coloring time or during play activities or during math routines or when I am transitioning with my parents then they may find oh okay this has always worked to get me out of the activity that I do not want to do so let me continue to do this behavior/ But then if we have effectively have taken the ABC data and we find that this is escape motivated we need to put something in place in order to allow them not to escape and if they want to escape maybe teach them appropriate way to do it. So that is why it is very important to look at these behaviors in terms of functions. We are going to look at another example so get ready for your poll again after I ask you the question. All right a student yells out during group instruction. Every time the student yells the teacher uses a verbal reprimand the yelling continues throughout group instruction. What do you think could be the function of the behavior? Your poll should be appearing We have about 67 percent say attention, we got some for escape and then we got 27 percent for automatic reinforcement Again these examples are not always clear cut we want to look at these over time For example if we come in tomorrow and we see that the student is yelling out again during group instruction and again they are receiving attention and the behavior continues to occur we can look at that and say you know what I think this is an attention seeking behavior and what do we need to do in order to get them to better get attention for not screaming. A lot of those times it may be that we are reinforcing them when they are not screaming. So in a lot of those times it may be so they achieving reinforcement and attention for not screaming Then the automatic reinforcement we had a lot of answers on that. That may be true as well! We often see that automatic reinforcement or self stimulatory behavior does not always occur just with hand flapping or rocking back and fourth but it can also be screaming out in class so if we determine that this does not only occur during group instruction but it happens over several events and throughout the day automatic reinforcement might be into play so then again we are going to have to look at replacement behaviors. What can we do to in order get them that same self stimulation? For example if they like the noise or if they like the sound that it makes or if they like the movement of their mouth how can we better give them something to replace that with in order that they are not screaming during group instruction and then they are not receiving attention for those inappropriate behaviors but they are receiving attention for the replacement behaviors the more appropriate behaviors Let’s Practice: We have yet another example A child walks onto a playground, and moves towards the swings. There are no swings left. The child falls to the group and beings screaming. Teacher walks over to the child and ask one of the children to get off the swing and give the child a turn. So not on your paper but on the poll can you determine what you think the function of this behavior may be? It looks like everyone think that is access to items. I agree! I definitely think this is a pretty easy one. Usually access to items is pretty easy to determine! You know if they want the swing, they are going to scream for the swing. So here again we talked about this throughout several examples but most importantly I feel that a lot of times we as adults we want to find a way to change it and we are looking at other behaviors to put into place when most of the time if we are looking at behaviors as communication then we can teach them a word or a picture or using a device in order to get the swing so the child falls to the ground and screams when no swings are left if we can teach them I want a swing you can have a swing in five minutes or things like that then we can teach them to better communicate without screaming and falling to the ground. So I think we often overlook how important what we look at as mand training, which is teaching request or teaching using PECS or augmentive devices. We often overlook this and we want to put a big behavior plan in place but a lot of times we can look at those simple man training techniques in order to get the behavior under control. We have to teach those replacement behaviors and must of the time it can be replaced with a Manned. Let’s Practice All right we are going to do another question Sally is playing on the computer. The teacher approaches her and tells her it is time to come over and color. Sally screams and holds on to the table. Teacher then tells Sally she can have five more minutes. All right polls are open what do you think the function of this behavior is? It looks like most of you guys are saying it is access to items and some of you are saying attention and that is great what I really want to get out of this is I want to poll you guys and get you guys thinking about behaviors in terms of their functions. Because ultimately with just one question and just this little bit of information we cannot determine exactly what the function can be but if you guys start thinking about that and determining that within your own minds you can start to think hey what are they trying to communicate with me and how can I help them communicate better. So it could be attention and we have to take ABC data over time to determine that and it could be access to items and again we have to take data over time to see is this occurring in these situations? What is the antecedent? What is the consequence? So then we can start to determine yes this is the function of the behavior and how can we treat it. Slide 16 Interventions All right guys we are done with the polls for a few minutes so I will give you a rest on that and we are going to move into some interventions. So an intervention is something that produces change through the arrangement of antecedent events to get the student in contact with reinforcement for desirable behavior. So we are putting interventions in place because we want to get that student to contact their reinforcement to be able to appropriately communicate in order to get the desired behavior that us as adults want to see. Antecedent interventions Setting clear behavioral expectations for all students or children. We say students a lot, but this is true throughout their whole environment. This is because we have to consider the individualized needs of learners and when delivering their expectations I do not know if you guys have seen this but a lot of times when individuals are attempting to talk with individuals with autism or just smaller individuals we are seeing those long expectations put on them. I need you to sit in your chair, and pull up a seat and put your hands on the table and be ready to listen. A lot of times those children have heard I need you to sit in your seat and everything else went out the door. So we have to consider the individualized needs of these learners. If we want them to follow a demand we need to make it short and sweet. If we say sit they sit! We got compliance with sit now they know to sit, so lets move on to something else. Sit now put your hands on the table! OK they have learned sit put your hands on the table. So we have to teach those clear behavioral expectations in small snippets. We need to make sure they are doing that we have paired that with reinforcement then we have given them reinforcement for sitting we can move on to making those demands longer. This involves manipulating the learning environment and the learning environment is across school, across home, across all variables of their environment. So decreasing the amount of demands before the student or child contacts reinforcement. So a lot of times when they walk into a school classroom they are expected to put up their backpack, go sit down, you know find your seat but really when we first get these children and we are first starting to work with them and learn from them it is only going to take one thing for you to do before you contact some kind of reinforcement. So if you walk into the classroom quietly or you walk down the stairs without trantruming I am going to reinforce you, because I want you to contact reinforcement for those appropriate behaviors. Then pairing the learning environment with reinforcement A lot of times us as therapists, or teachers, or parents we are like ok we are going to set up this event, and we are going to have our child learn and we want this to be successful so we come in and we start delivering demands all the time. We want them to love this place so a lot of times we have to do what we call pairing the learning environment with reinforcement. So if they come into the room their favorite things are there, we are sitting there ready to play we want them to learn to like us first before we start delivering demands. If we are always seen as the person who says “Don’t do that!” or “Stop it!” or “Come Here!” and we are not really looked at as someone that is fun and easy to play with then that learning environment or place may not be paired with reinforcement. Once we pair that with reinforcement we can start sliding in demands. We need to make sure that the place in which we are attempting to teach our children is reinforcing to them. Slide 18-Antecedent Interventions-Specific demands All right and again looking at an anteccdent intervention placing specific demands. So if I say “sit” versus “sit down in your chair and show me you are ready to work “ A lot of time we can do this with other individuals, other children we have worked with but we need to make sure that we are placing that specific demands reinforcing the child therefore it is more that if we place that demand again and then we can start to shape up more words and more demands. Slide 19-Antecendent Interventions-Offering Choice Another big thing in antecedent intervention is offering a choice. Often individuals with disabilities may not be provided with opportunities to make choices. I always like to say look at your life and think about the ability you have to make choices. You chose what you wanted to wear today, what you ate for breakfast, what time you went to bed. A lot of times individuals with autism we do want to set up their life as a structure because it has been proven that they learn with a lot of structure But we also want to make sure we are providing and offering those choices to them that if we are only allowing them to access this type of reinforcement and we are never changing up the type of reinforcement they can get. I may have had 10 cupcakes yesterday so you bring in a cupcake today and that is not reinforcing to me. So we have to be sure we are constantly changing up those reinforcements and we are constantly in that area assessing the reinforcers. I have been in situations as a therapist and as a teacher where individuals are like the only thing he will work for is a movie! He only likes movies! But then I start to take reinforcer inventory you know putting new things on the table and seeing what they are attracted to and what they gravitate towards. Once I start to see that I will learn oh he has 5 things that he loves today that we can work for. So constantly making sure we are taking those reinforcer inventories. Slide 20 Giving them a choice of material. For example if you are at home and you are working on homework with your child, ask do you want to do math first or this first those are those situations where it is a forced choice really. They have to start with math or they have to do reading but if we are offering that choice ok some of the power is in my hands. I can demand what I want to do first. Plus who they want to play with, locations where they want to learn you know they have always worked in this place at that time you know those type of choice may be minimal but we really want to make sure we are offering those choices. Slide 21 Again we will talk about pairing the learning environment with reinforcers. Often times where they have always learned is where a high rate of problem behavior occurs. You know they walk over to the table someone places a math sheet in front of them. They walk over to breakfast and there are eggs and they do not want eggs but they cannot communicate to you. So it is very important that we start to pair that table with reinforcement. The table is not only where math occurs but it is also where we play legos and we put the little miniature DVD player so that you can have fun there. When you start to see that this table does not always access work does not mean that they start to see hey the DVD was here last week and we got to watch Wiggles here and my favorite train ran across the tracks here. Then they start to see oh this table or desk or whatever is in your house or school does not always mean that things are going to occur that I do not always love so often times once things are paired with reinforcement then often times the desk, or table or your living room may be start to be compared with reinforcement because things happen there that are fun. Instead of immediately placing those demands, have the reinforcers available like we said and do not immediately begin placing them. Make sure they start to come over and your offering chips or rewards and then you might put breakfast in front of them or whatever your demand that you want to have next before you start to place that. Make sure those fun things are occurring Slide 22-Consequent Interventions-Extinction Those were all antecedent interventions and those are all things we can do before the behavior occurs to make it more likely that the behavior will not occur. So those were all antecedent things. Now we are going to look at consequent intervention and one consequent intervention we are going to look is called extinction. This occurs when reinforcement of a previously reinforced behavior is discontinued, and as a result the frequency of that behavior decreases in the future. A lot of times when people have heard the word extinction they think planned ignoring. I want you to go away knowing that planned ignoring is not the same thing as extinction. For example I always got reinforced for running in the kitchen and yelling. Now everybody in my life determines you know what Laura does not need to be reinforced for running into the kitchen and yelling lets put this on extinction we are no longer going to reinforce her for this. So I want you to understand that it is different behavior so planned ignoring is not the same as extinction, sometimes we do planned ignoring when we are running extinction procedures. Slide 23 What we want to do is we want to withhold all reinforcers for that problem behavior. But since we have now withheld all, it is only fair that we introduce a replacement behavior. This is what we were talking about a lot earlier. As you remember we started the discussion we wanted to know that all behaviors are a form of communication. So now for example if I walk into the room and I have always yelled and somebody has come over and said “are you ok?” Now we have determined that Laura does not need to get reinforced for yelling so we are not going to give her attention we now need to give her a replacement behavior. The replacement behavior for example could be I walk in and someone gives me a help card, and they can determine what they want for help. Most often the best replacement behavior we can give them is another form of communication. So whether it is a PECS card, or sign language, or Mand or whatever we can do we have to make sure that we give that replacement behavior because our only voice has been that problem behavior in the past so my voice has only ever been for screaming so I have always gotten someone to come and help me when screaming has occurred. So now I need some way to tell you that I need help, so it is only fair that you introduce a replacement behavior Slide 24-Let’s Take a Look So now we are going to take a look at a video about extinction Miss Wish: Hey, what is this one (pointing to the banana) Miss Wish: Apple, Pear Nana, nana here you go! See how Miss Wish does not acknowledge his attempts to get the toy with crying, grabbing, and pushing. She prompts him to use a request and then promptly reinforces his response. Where is eight? There! You found it, nice job buddy! Good Job! Watch here how Miss Wish uses extinction with Sarah when she screams to communicate that she wants to wash her hands. Miss Wish: Wash your hands, you do not have to wash them here Sarah screams Miss Wish: Say Mom I need to wash my hands Sarah: I need to wash my hands Miss Wish: Say I got paint on my fingers See how Miss Wish calmly blocks Sarah from leaving the paint area, does not verbally acknowledge her screaming, and prompts her to use appropriate language to gain access to the activity of washing hands OK sorry we are getting back to our screen but that is an example of extinction and a lot of times when people think of an extinction procedure but most of the time it is what we want the child to do in order to achieve a more appropriate behavior. For example the child in the video was screaming and screaming because he wanted the puzzle piece and she just said banana and he said nana and then she gave it to him because what she wants him to learn in the future is that when I say nana I get reinforced and I get what I want but screaming is no longer going to get me that reinforcement. The big thing to remember with extinction is when we start to use extinction we are going to see something called an extinction burst. Extinction bursts occurs when extinction procedures are often followed by an immediate increase in the frequency or intensity of a target behavior. For example if you always get someone’s attention by saying Laura and then I determine I am going to put that on extinction, then what usually occurs when someone says my name is if I do not answer they get louder, they get longer, their voice gets stronger they might start exhibiting some other behaviors. So when we do extinction procedure with a child, we are probably going to see an extinction burst and this is an immediate increase in the frequency or intensity of that target behavior. So we might see that the behavior gets stronger and louder because if you think about it that behavior has always been reinforced so now someone is taking that behavior away from me and if behavior is a form of communication I am going to show you other ways that I can probably access that reinforcement. So it is important to remember that if we are running extinction we do not want to run extinction on aggressive behaviors or self-injurious behaviors. If we run extinction on these behaviors what occurs is self-injurious behaviors get stronger, harder, and more intense and we do not want to see that with these children. The same with aggression, if they are aggressive to you and you say well I am going to put that on extinction then often times what you see is you get more aggressive and more intense. So these types of produces should be run that might be like flopping to the ground for example yelling out, things like that. So we can teach an appropriate replacement behavior for them, and we can stand them getting a little more intense for awhile. Slide 25 But with extinction it is very important to also remember that we have to be consistent with it. For example if one person is running extinction we may see that ok well if Johnny always runs it then he is not exhibiting these behaviors with Johnny but if Sue does not always run it then we see a high intensity of behaviors with Sue. Slide 26 All right guys we are going to get into another question, and we are going to do a poll. I am going to read the question again, and then you guys can poll in your answer. So looking at replacement behaviors for example John always runs to the snack area and begins to scream for cookie and continues screaming. In the past he has been reinforced by adults in order to stop screaming. So looking at this what do you guys think might be an appropriate replacement behavior for screaming? Great guys! You guys have been listening! One hundred percent of you guys said teach him to appropriately ask for the cookie, and that is exactly right. Again this is the behavior that is often times overlooked because what we see is John runs to the snack area and begins to scream and often times we see that people want to put in place ok how do we keep them from screaming? You know your going to time out and often what we see is Johnny is screaming in time out and then there might be another procedure put in place when really if we can teach Johnny you know what it is not fair that you have always gotten a cookie for screaming or anything else in your life for screaming we are going to teach you a more appropriate way to communicate that behavior. What we are going to do is we are going to teach you that if you want a cookie I am going to teach you to either sign cookie, give me a picture of cookie, say the word cookie, those things can replace screaming and then John can learn guess what you know what screaming never gets me cookie but you know if I use the sign or if I use this picture or if I use this word I always get cookies so that is what I am going to use in the future. So that behavior is reinforced whereas screaming is no longer reinforced Slide 27 Now we are going to look at another consequent intervention and this is called differential reinforcement and this is one of the most powerful tools that teachers can use. It is very important in the foundation for learning and a lot of you guys might use this at home and in schools and not even realize you are using it. So I wanted to really focus on this one because this is one of the most important tools that can be used in an interventionist repertoire. Slide 28 Differential reinforcement is when reinforcement is delivered other than the So you withhold reinforcement as much as possible for that problem behavior. So what is occurring is you are running a procedure where for example Tommy always gets out of his seat and he always stands up so I am going to give him reinforcement for not standing up as much as possible. So what that would look like is Johnny stands up, he contacts, no reinforcement, Johnny sits in his chair Nice sitting Johnny! I love the way you are sitting John! Great sitting John! So you’re reinforcing as much as possible for Tom not standing up, so your reinforcing that sitting behavior. Often times what we see is they get more attention and more reinforcement when they are so called acting up or doing so called problem behaviors that are not conducive with the environment in which they’re in. So what we want to do is we want to continually reinforce for doing behaviors that are appropriate and that we want to see more of Often times people are like I do not want to use tangibles all the time so you know for a lot of my children I have cut up gummy bears into sixteenth or eights so tiny reinforcement you know praise, a pat on the back a high five those type of things go a long way so if they are continually getting attention which may be the function of their behavior for appropriate behaviors they are more likely to display those more appropriate behaviors and less likely to show those problem behaviors. Slide 29 So again we are going to look at a video that shows you an example of differential reinforcement When choosing a behavior replacement procedure reinforcement procedures have many benefits Reinforcement does not have the aversive side effects of punishment, they do not teach another limitation of punishment and extinction is alternative behavior that can be used to replace a maladaptive behavior. Reinforcement procedures should be used first before punishment and extinction procedures are used. The reinforcement procedures we are referring to are called differential reinforcement procedure. Differential reinforcement is a procedure involving two separate behaviors. One behavior is being reinforced and strengthened, the second behavior is put on extinction. Here is an example of using differential reinforcement if Jill’s parents decide to use differential reinforcement to decrease food refusal and increase eating vegetables they might ignore the crying and pushing food away and provide praise and a small piece of Jill’s favorite treat in response to Jill eating vegetables. If Jill starts eating more vegetables and stops crying and pushing food away then it can be called differential reinforcement Differential reinforcement is the most widely known and most effective technique to decrease problem behaviors. Therapist to boy: Give me the one the Drive! A motorcycle! Give me ten! Let’s drive a motorcycle, let’s drive! Slide 30-Consequent Interventions All right guys as we see a lot of you guys may think oh I hear the word differential reinforcement and I do not use that but we are often using a lot of forms of differential reinforcement throughout our day. One of those types of differential reinforcement procedures is call differential reinforcement of other behaviors. So reinforcement is delivered contingent upon the absence of problem behavior during or at specific times. So say for example I wanted to target a child who was pulling on their shirt. I look at the data, and I saw that this child pulls at their shirt every five seconds. So what I might do is I might set a timer that vibrates on me and is not loud that interrupts the rest of the class. I might set that for just under five seconds, so I might set it at three seconds. So she has not pulled her shirt, so what I might do is throw a reinforcement to her and reinforce her for not pulling her shirt and then what I might do is start to set that time add another three seconds to it. So she has not pulled her shirt at six seconds now and reinforce. So gradually increase that time. So what we want to do is reinforce the absence of that problem behavior and we want to reinforce that at high rates. Slide 31-Punishment We are just going to touch on just a little bit of punishment. I feel like a lot of us use punishment procedures and punishment often times gets a really bad rap. When anything we are doing to decrease a behavior and make a behavior less likely to occur in the future are punishment procedures So just a few types of punishment procedures are: For example a reprimand so like a verbal reprimand Do not do that! Stop it! Another one could be response blocking So a child is hitting their head, and we block them from hitting their head. Another type of example is time outs lots of time we are using that time out from reinforcement. Another one would be response cost and this might be occurring more likely if you are using a type of token system for example say they earn tokens and they do the target behavior that we want to reduce like stand up and when they stand up we remove a token. Slide 32 The problems associated with punishment based procedures are a lot of times they are not socially acceptable. As you heard in the video about differential reinforcement, they do not teach appropriate responding. So as we are seeing these behaviors with individuals with autism we ultimately want to teach them appropriate responding. So oftentimes punishment procedures do not do that and then sometimes we have collateral effects on responding so if you for example are running a punishment procedure it may more likely show that I am not going to respond because I may get punished. Slide 33 Some more problems associated are modeling of undesirable behavior for example if we see with punishment procedures being ran and then we model those undesirable behaviors we see put into place or might see aggressive responses to aversive events. So the punishment procedure is put into place we see more aggressive behaviors occur. And then that often leads to punishment induced behaviors. Sometimes we may be targeting for example hitting, we put a punishment in place and now we are not only targeting hitting but we are targeting another behavior that occurred when we attempted to run those punishment based procedures. And oftentimes this leads to overuse of punishment so for example a punishment procedure runs, they see it run, it was effective and then they start to use it all the time. Oftentimes we may see side effects from overusing that punishment procedure. Slide 34 One punishment procedure that I want to talk about is time out! I think time out is widely used, time out oftentimes gets a bad rap. I want to say that time out is effective if it is used effectively. One thing that I think should be done is we should not only call it time out it should be called time out from positive reinforcement. This would means that time out the withdraw of opportunity to access reinforcement or the removal of a reinforcer for a specific time, is contingent on the occurrence of that problem behavior. So for example I run into a room, and everyone is busy and I want the tiger toy and another child has the tiger toy so I run over slap the kid and they go “no hitting” and take me into time out. So in that instance they put me in time out, and my reinforcement was the tiger toy. So ultimately that was the right time to use time out because I wanted to access to items so you are putting me over in time out where I cannot access those items so then time out because I want access to those tangibles and whereas in time out I am not getting access to those tangibles. For children with autism time is often used and it increases the problem behavior because what happens is a lot of times individuals with autism want to be left alone they have that lack of social interaction with other individuals. So a teacher or parent says I am always going to run a punishment procedure for this specific behavior. What they really might not have known was that child wanted to escape that situation so time out For example child screams out, then reinforces that behavior. So it is very important that if we want to use the technique of time out that we look at those ABC’s that we look at in the beginning of the session and make sure what is the true antecedent of this behavior and what consequences has it gotten in the past and is time out really going to be effective. Since often he will put an individual with autism in time out and they think oh I got exactly what I wanted, because I enjoy this time away from people I want to sit over here and self-stimulate. So oftentimes we may increase those behaviors if we are not effectively looking at the situation and is it truly time out from that positive reinforcement. Slide 35 So again we are going to look at a video I thought it was a great use at looking at ineffective time out Ok so looking at the time out procedure, now again no blame placed on who is running it! Since they were probably told to run this time out procedure. But what is occurring is obvious, so really he is accessing more reinforcement in this time out procedure than he would be accessing in his time in procedure. So then we may be reinforcing behaviors that we were not reinforcing to begin with in the time in situation. Slide 36 So when thinking about time out and would it be an effective intervention some considerations to take into account is the time-in environment must be reinforcing? If it is not and we want to run time out if we take them from the time in environment and put them in a time out environment we are probably reinforcing those behaviors because the time in environment is not really a fun reinforcement to me so I would rather be in the time out. Also we have to make sure all relevant parties must be informed of these behaviors leading to time out. Since what you might see is if you say OK time out is going to be used, you might see it overused. For example if it is say it is always used for screaming out but then he hits and he bolts then time out might be overused with individuals. So we have to be sure that we know what is the behavior that is going to lead to the time out situation. Slide 37 Again if you are looking at punishment make sure your going to be under the advice of a behavior analyst if you are going to attempt to use punishment procedures. Since oftentimes punishment procedures are put into place and are not effectively used or there are not a lot of evidence based research to back them up. So punishments procedures are really our last resort in so at all times you need to make sure you are under the advice of a professional in order to put those punishment procedures into place Slide 38-Things to Remember Just things to remember we are at the end of our presentation just make sure that the success of any behavior change program is hinged on the accurate identification of reinforcers! Oftentimes we do not look back to what is reinforcing this child? Are we using these reinforcers effectively? So make sure that you are looking at these behavior change procedures and saying hey, do I have an accurate account of what those reinforcers are? Am I using these effectively? So that is the end of our presentation, we are free to take questions now? Ok so are first question is if their nephew was hitting his head on hard surfaces, should you block him from hitting his head? Definitely! Exactly! Again punishment is anything that decreases a behavior from occurring so oftentimes response blocking you put that into place you are decreasing that behavior from occurring. Oftentimes when we hear the word punishment, we think of something bad, but it is not. Anything that we are doing to decrease the chance that behavior will again occur is a punishment procedure so that is why response blocking would be known as punishment. Another question Can you address teaching the skill of waiting when tantrumming occurs? A great question! That is often needed for individuals with autism. I think that oftentimes we attempt to teach waiting in very long periods of time. What I have often done for individuals with autism is we are sitting in a chair somewhere and I go Wait! I have them wait for two seconds, quickly reinforce. Then what I do is I gradually increase that time, since oftentimes when a child is asked to wait it may be five minutes or twenty minutes or twenty five minutes but they have not accurately been taught to wait. So I think that it is important that when you are teaching waiting, is that you start at a low period of time. So say for example five seconds the child is standing there they want access to a cookie for example you have contrived the situation you have set it up so you say Wait! Five seconds! Nice waiting! Then hand them the cookie. Then what you do is you gradually increase that time. Since oftentimes they have to wait in the doctor’s office or the dentist’s office and places where those periods are very long. So what you want to do is make sure that you are teaching it and gradually increasing that so that they can be more successful. A question was May we get a copy of the power point presentation? Definitely! Jennifer has said that she will email it to everyone. OK and then next question: My daughter screams for things juice, snack, video etc how do we get her to learn that screaming does not work? I definitely think that Mand training techniques should be put into place there! So what often happens is our kiddos are very fast, and we cannot catch them before they start screaming So what you want to do is make sure does not occur is when then they say Snack and then we give them a snack. Since what we have taught is a type of behavioral chain and what happens is the child feels like oh I scream, and then I ask, and then I get what I want. So what you want to do is you know they are going to want a snack after school so what you do is before they get to the kitchen or area where they are going to ask for it Prompt them to hand you a picture, use their device, mimic your voice say Cookie, Cookie! OK here is a cookie. Make sure you are running those opportunities throughout the day! Since because a lot of times those opportunities are not run at a high level so you want to make sure those opportunities are run a lot throughout the day so that they can be successful and understand I get it when I ask for it, and I do not get it when I scream. The question is what if No is the response? For example if the child wants chicken and learns to ask for chicken however the child he repeats incessantly until the parent finally gives in and gives him chicken. He has learned to ask, which is good, but has not learned that sometimes the answer is no. What you want to do is you want to say “No but” and I always work this in. How I have often done this is I work it in with two kinds of reinforcing items. So for example you have to teach this not only in the chicken situation because that is what you mostly wanted but teach it in a movie situation. So you may have Wiggles or this, and then they pick something you want to start to institute that is not a choice. So you want to have those backup reinforcers that can be kind of be reinforcing may not always be their choice but they start to understand this is not a choice but I have others choices to pick from. So those are kind of those forced choice situations. So I want chicken, that is not available but I can have this and this. However, more importantly make sure you set you set up those situations constantly throughout the day So you know that they might want a twirl toy and a pick of popcorn, both the twirl toy and the popcorn will be reinforcing. So they go for the popcorn oh no change my mind but you can have the twirl toy or the DVD and then work on those situations throughout the day. Since oftentimes people with autism and children in general think no means never. So once you start to tell them no but you can have this and this oh there is something else and that is kind of reinforcing too you can start to see that they start to understand oh I can have something that I may want OK next question I have made visuals for students to address inappropriate behaviors that show replacement behaviors such as No hit! Hands on legs! When I show these the students often hit the visual even when I present it when they are calm. Any other suggestions to teach replacement behaviors? I think that is where your DR procedure might come into effect like the differential reinforcement so if you start to reinforce for their hands being down like throw them a piece of popcorn or give them a high five and say nice no hitting or nice hands down and not even refer back to that problem behavior that that might be the best procedure instead of showing them a picture because then that might be a visual reminder I see that hit picture all the time I do not want to hit I might just slap this. So use those differential reinforcement procedures reinforce heavily for not hitting and do not bring as much attention when they are not might be the best procedure there. All right guys I think that is the end of the questions. Again Jennifer said she would email the Power Point. Thanks so much for coming and we look forward to seeing you guys at further webinars. Have a great day!