Learning to Comply

1. Hosted By Exceptional Services 4 U Authored by Maritza Pardo M.A., BCBA Learning to Comply

2. Overview of the presentation • The definition and importance of compliance • ABA approach and criticism • Setting up our children for success (i.e., environment) • The importance of motivation • Delivering Commands and maintaining autonomy • Scenarios and examples of the procedure and consequences • Consequences and consistency (i.e., slot machine effect) • Reminders and notes

3. What is compliance? • Compliance is the act of obeying an order, rule or request. (Cambridge English Dictionary)

4. Why is compliance important ? • Required for safety of one self and others (i.e., obeying a command to not cross the street until given permission to do so) • Considered a fundamental element to learning new skills (i.e., social skills- one must often ask permission to obtain a preferred item from a peer as well as comply with the response if denied) • Involved in our daily roles in society (i.e., individuals who put forth or enforce rules and boundaries; parent, teacher, law enforcement, etc.)

5. Compliance does not…

6. Compliance training has many forms • Compliance training ( learning to obey or complete a request) has been approached by methods passed through culture and previous generations (i.e., often the motivation to avoid punishment as discipline) • Compliance training (learning to obey or complete a request) has been approached by some through religious philosophy (i.e. “spare the rod, spoil the child”). • Compliance training (learning to obey or complete a request) through ABA involves teaching a skill as any other skill, through steps (i.e., Instruction, behavior , consequence). • Please note that positive behavior support methods are the preferred methods of teaching for most ABA professionals and currently most schools (PBIS: How Schools Support Positive Behavior by Andrew M.I. Lee)

7. Criticism for ABA approaches to compliance training • Compliance training based on ABA principles is like training an animal in that it removes an individuals right for autonomy. • Compliance training based on ABA principles is abusive when involving hand-over-hand procedures with the learner. (Blog Article: ABA and Autism- the thorny problem of control and consent by Omumn22 on 6/16/15)

8. Using ABA principles for compliance training • For the purpose of this training, we will teach compliance from an ABA approach. Like ANY strategy or philosophy, when ill applied, it will cause harm. However, when applied according to ethical standards and best practices, it can be the most effective treatment. “ABA (Applied Behavior Analysis) is the process of systematically applying interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree, and to demonstrate that the interventions employed are responsible for the improvement in behavior” (Applied Behavior Analysis; Baer, Wolf & Risley, 1968; Sulzer-Azaroff & Mayer; 1991)

9. Compliance training involves… • Setting up the individual (child’s) environment for success (i.e., identifying variables which may effect the individual’s ability to complete the instruction or demand given) • Identifying the individual’s motivation to follow or complete commands (i.e., Identified motivators will play a key role in consequences) • Making sure the individual is capable of processing or comprehending the instruction given (i.e., 1 step, 2 step and 3 step instructions) • Being able to deliver the appropriate consequence for compliance or non-compliance (i.e. reinforcement or punishment) IMMEDIATELY following the behavior

10. Setting up the individual/child for success • Begin with acknowledging the physical state of the individual/child (i.e., are they ill or lacking in sleep, which may effect their ability to comply) • Is the environment in which they are expected to complete the demand/instruction, a place where they are able to do so (i.e., are there several distractions, noisy, etc.,). Remember, gaining full attention prior to delivering the command is crucial, otherwise you may find yourself repeating the command. • Acknowledge when your children engage in appropriate behaviors. Lavish your children with praise and attention, so they do not resort to challenging behaviors to gain attention.

11. Most individuals comply for a reward or to avoid a negative consequence • Compliance is a skill every individual has had to learn at some point in their life • Compliance requires that one has the capacity to comprehend the instructions or commands given • Compliance, like any skill requires practice • Compliance requires that one is motivated to comply/obey a command “As educators, understanding what motivates children to engage in certain behaviors (or not), allows us to better arrange educational environments and opportunities to encourage the development of new skills”. (Motivating Operations: An Introduction by Zachary Ikkanda-www. behavioradvisor.com)

12. The thought of being presented with something preferred? The thought of avoiding punishment? What motivates the individual?

13. There are two types of reinforcement Positive Reinforcement: Presentation of Something (Stimuli) following the behavior Negative Reinforcement; Removal of something following the behavior Removes further demands or tasks Removes items (i.e. removes the rest of broccoli if willing to just eat two bites- if broccoli is non-preferred). Removes further lecturing • Privileges • Token economy (i.e., items which can be exchanged for an item, privilege or activity) • Stickers • Toys or other preferred items • Vocal praise • Attention • High fives

14. There are two types of Punishment Positive punishment occurs when a stimulus/something is added after the behavior which decreases the likelihood of the behavior occurring again in the future Negative punishment occurs when a stimulus is taken away after the behavior and it decreases the likelihood of the behavior occurring again in the future. Taking away a favorite item/token/toy (i.e., Known as “response cost”) Taking away a privilege or activity (i.e., Known as “response cost”) Time-out (The individual is taken away from the preferred activity for a certain period of time). • Lecturing an individual • Adding an extra task or chore

15. “Time-out” considerations • Time- out is a method most used in schools and homes as a punishment procedure (i.e., when an individual/ child is removed from the current area or activity for challenging behavior) • Time-out is only effective ( a strategy for decreasing future occurrences of unwanted behavior) if the individual is being removed from a preferred activity, not from an unwanted (aversive) task or demand. • Most frequently a time-out has been administered or viewed by others as a “break”, when an individual/child is escalated in challenging behavior. However, it typically serves as a method of “escape”, rather than a break. • Note that an individual who escalates in challenging behavior (i.e. yelling, protesting in inappropriate ways, exhibiting aggression) when presented with an un-preferred task or demand, should NOT be given a “time-out”. In these circumstances the “time-out” allows the individual to escape the task/demand or simply delays its completion.

16. “Time-out” considerations • Knowing in advance that a specific task or demand (i.e., sharing a preferred toy, being asked to clean-up, etc.) is a trigger for an individual should allow you to present the demand or task in a different way (i.e., in smaller segments with breaks in between) as well as consider other consequences outside of “time-outs”. • Research regarding brain activity during a “timeout” has been published ( Book; The Whole Brain Child) by Daniel J. Siegel, M.D., and Tina Payne Bryson, Ph.D.,

17. Research on “Time-out” • A summary of the research can be reviewed by Time Magazine www.time.com. The research, by professionals mentioned earlier, indicate that brain scan results during isolation (caused by punishment)- can look similar to that of physical abuse. • The Child Development Institute is under a different impression and has published; Guidelines For Using Time Out With Children and Preteens. A summary of Do’s and Don’ts when implementing “time-outs”. • https://childdvelopmentinfo.com

18. Notes to Remember….. • Reinforcement and/or other Consequences should be carefully chosen ahead of time (i.e., prior to delivering the demand). • Delivery of the consequence (reinforcement or punishment) should be implemented immediately following the individual’s/child’s behavior . Timing for the delivery of consequences, is crucial. • Consequences are delivered when compliance is expected for tasks/demands ,which are known to the individual (i.e., not for novel, unfamiliar tasks which require teaching). • Novel tasks should be taught or modeled prior.

19. Delivering Commands….. • Make sure to have the individual’s/child’s attention prior to delivering the command to ensure they hear you. • Deliver the command in a concise manner (i.e., “Pick up all the cars and put them on the shelf” vs. “ Clean up the mess”). • The instruction should be delivered as a command and not in a question format (i.e., “Bring me your cup” vs. “Can you bring me your cup”?), otherwise the individual may answer by saying “No” and technically they have simply answered a question not disobeyed an instruction or command.

20. Commands with options…. • Instructions and commands may often be presented with options on “How” it will be completed, or the sequence in which it will be completed. Offering choices, will also help foster a sense of autonomy. • Example: You need to get dressed…..Do you want to wear the blue shirt or the black shirt today?

21. Autonomy …. • “Autonomy means a lot more than simply growing up. It’s also having the self-confidence to do certain things and become independent, the ability to act and think for yourself”…….. • The above interpretation of autonomy is from an article; 8 TIPS TO STIMULATE YOUR CHILD’S AUTONOMY (www.motherforlife.com)

22. Autonomy and Compliance • By presenting choices (when ever possible) within instructions or commands we are giving the individual control over how it will be completed. • Likewise by informing the individual/child of the consequences for their choice, we are teaching them that the have a great deal of control over what happens to them.

23. Scenario 1 Parent observes her son grabbing the toy out of his sister’s hands as she begins to cry. Parent get’s close enough to her son to ensure undivided attention and delivers the following: Parent: “Stop grabbing your sister’s toy. You can wait for your turn in 5 minutes (parent uses a timer), or pick another toy to play with”. Parent: “Make a good choice or I will have to help your body”. Child: “ Ok mommy” (child chooses a different toy to play with). Parent: “Great choice! Now you will get to ------” (name the reinforcement/earned item or activity as a reward for compliance).

24. Scenario 2 Parent observes her son grabbing the toy out of his sister’s hands as she begins to cry. Parent get’s close enough to her son to ensure undivided attention and delivers the following: Parent: “Stop grabbing your sister’s toy. You can wait for your turn in 5 minutes (parent uses a timer), or pick another toy to play with”. Parent: “Make a good choice or I will have to help your body”. Child: “No” ( Child chooses to continue grabbing the toy out of his sister’s hands). Parent: “Now I have to help your body stop grabbing your sister’s toy” (Parent physically removes her son from the presence of her daughter, leaving her daughter with the toy). The consequence should immediately be given, following the removal from his sister’s presence or play space.

25. Scenario 2- Consequences As the parent had to remove her child (i.e., help his body follow comply with her command). A consequence should immediately be given and explained to the child. The following will teach the child what his choice of not complying (the command to stop grabbing the toy from his sister) has resulted in. The consequence may be removal of the play/toy area completely (i.e., going to another room in the house) or the presentation of an unwanted task (i.e., clean up chore). We want to teach individuals/ children that their actions have consequences and that it is the result of “THEIR” choice rather than the idea that their caregivers are simply “Mean”.

26. Consistency is Key • Which ever consequence (i.e., reinforcement or other consequence) you have decided to implement, be sure it is something you can follow through with. • If you say that you will remove a privilege, token or toy and don’t actually do it then your child will learn that sometimes there is a consequence and other times there is not. Sometimes the parent means what they say and sometimes they do not. • This is a guarantee that your child will test you as there is a 50/50 chance that any consequence will truly be given.

27. The slot machine effect • Inconsistency with reinforcement or other consequences, compares to a slot machine. • Individuals will often keep spending money in slot machines as sometimes it will pay out, and just maybe they might get lucky. • The same goes for children, as they will keep taking their chances with the behavior (i.e., tantrum for access to a toy) as sometimes their parents will give them a consequence, and other times the parents will give into the behavior (i.e., give them the toy so they stop the tantrum behavior).

28. Caregivers should know their limits • As a caregiver, you should be aware of what you are able to do and when (i.e., public vs. home- time out’s in public outings are nearly impossible to implement) • For example if you are exhausted or on a time constraint, do not present consequences that you will not be able to carry out (i.e., “if you finish your homework, we can go to the park”- when there is no time to go to the park) • Remember that you know your child best, and therefore you are the best person to personalize your child’s training in this area (i.e., choose the most effective motivators and consequences)

29. How do I know the strategy is working? • Every individual is different, therefore the rate of progress will vary per individual. • Consistency is the key to effectiveness and improvement (i.e., increase in compliance and decrease of non-compliant behavior). • A clear indicator that you are using an effective strategy for presenting commands is when challenging behaviors are avoided • A clear indicator that you are using an effective consequence is if there is an observable increase in compliance and a decrease in non-compliant behavior (i.e. the child stops hitting others after a few instances of experiencing the consequence for hitting).

30. Do Not Compare • Remember caregivers are learners too…..comparing parents to one another or children to one another will only bring resentment and self-doubt. Parents need positive reinforcement for their effort too. • Supporting one another and complimenting each other as caregivers, sets a good example for the individuals/children we are entrusted with. • Let us model patience with ourselves and our children

31. Recap and Summary • Identify motivators and appropriate consequences that will be implemented (i.e., reinforcement or other consequence such as punishment) • Gain the individual’s/child’s attention and deliver instruction • State the individual’s/child’s choices (i.e., to comply or have someone help their body comply) • Wait for the individual/child’s response/behavior and immediately implement the consequence (i.e., reinforcement or other consequence such as punishment)

32. Questions Final questions and additional scenarios may be reviewed at this time.

33. References • Andrew, M.I. Lee (2014). PBIS: How Schools Support Positive Behavior • Baer, Wolf & Risley (1968); Sulzer-Azaroff & Mayer (1991). Applied behavior analysis • Daniel, J. Siegal, M.D. & Tina, P. Bryson, PH.D ( 2011). The Whole Brain Child • Daniel, J. Siegal, M.D. & Tina, P. Bryson, PH.D (2014). “Time-Outs” Are Hurting Your Child- https://www.time.com • OMum22 (2015). ABA and Autism- the thorny problem of control and consent • Zachary Ikkanda (2010). Motivating Operations: An Introduction • Guidelines For Using Time Out With Children and Preteens- https://www.childdevelopmentinfo.com • 8 tips to stimulate your child’s autonomy- https://www.motherforlife.com • https://www.dictionary.cambridge.org

34. Contact Information Maritza Pardo M.A, B.C.B.A Phone: 818-281-3648 Email: mpardoservices@outlook.com