Handling Behavior Problems in the Home and in the Community

1. Handling Behavior Problems in the Home and in the Community by Mark L. Sundberg, Ph.D., BCBA and Cindy A. Sundberg

2. Common Behavior Problems for Children with Autism • Looking away, non-responding, non-compliance • Self-stim (rocking, mouthing objects, etc.) • Falling to the floor • Running from adults • Climbing on tables, counters, bookcases, etc. • Screaming, yelling, loud noises, etc. • Crying • Tantrums (combination of behaviors) • Property destruction • Hitting, pushing, biting, etc. • Self-injurious behaviors

3. Behavioral Psychology can be a powerful tool to understand and change problem behaviors • The three-term contingency (An ABC analysis) AntecedentBehaviorConsequence Stimulus (SD) Behavior (all kinds) Reinforcement

4. What is Reinforcement? • Reinforcement is anything that increases a behavior • Reinforcement can be getting good things (e.g., attention, toys, food) • Reprimands and negative attention can sometimes be reinforcers for kids • Reinforcement can be getting rid of bad things (e.g., demands, bedtime, shoes) • Reinforcement increases good and bad behavior • Most reinforcement occurs unplanned or naturally • Understanding how reinforcement works is essential to solving behavior problems

5. What Causes Negative Behaviors? • There are many possible causes of negative behaviors • The first task to identify what is causing the specific behavior • Use the three-term contingency to identify the cause of a behavior • Step one: Define the behavior (start small--1-2 behaviors) • Step two: Identify the antecedents (events before the behavior) • Step three: Identify the consequences (what happened after the beh.) • AntecedentBehaviorConsequence

6. Both good and bad behaviors are strengthened by reinforcement

7. What Causes Negative Behaviors? • Many negative behaviors are caused by inadvertent reinforcement • Negative behaviors may get attention, reaction, reprimands... • Negative behaviors may get access to reinforcers • Negative behavior may allow one to avoid undesirable activities • Negative behavior may allow one to escape undesirable activities • Negative behavior may be fun (Stim, destruction, climbing) • Positive behaviors don’t have the same effect as above • No alternative skills to achieve the same reinforcer (language)

8. How to Change Problem Behaviors • Identify the cause and frequency • Reinforcers are your behavior change tools: Identify and control them • Three parts to the intervention • Teach and reinforce (positive) replacement behaviors • Change the consequence after the problem behavior (reduce) • Prevention (antecedent intervention)

9. Attention Seeking: Minor Negative Behaviors • Behavior: Loud voice, knocking things off the table, taking other’s toys for attention, noisy, fidgeting, whining, mild tantrums, pouting, sulking, etc. • Cause: Seeking attention (high motivation for attention) • Intervention: • Extinction: Ignore minor negative behaviors • Reinforcement: Deliver reinforcement for appropriate behavior, on a consistent basis (e.g., 10-30 times per hour) • Prevention: Identify high probability settings and time for problem behaviors and increase reinforcement, re-schedule competing activities (e.g., phone calls, bill paying), plan child activities, etc.

10. How to use Reinforcementto Reduce Negative Behaviors • Make sure you really have a reinforcer • Deliver the reinforcer immediately after good behavior • Set up lots of opportunities for good/correct behavior (Don’t just wait for them) • Use a variety of reinforcers • Deliver some reinforcers free (pairing) • Smile, be sincere, laugh, goof around, have fun with your child • Some kids will require lots of reinforcers per hour (30-50) • Engagement usually is reinforcing! • Lack of reinforcement for positive behavior can increase negative behavior

11. Examples of Reinforcers that Many Children Like • Social/physical reinforcers: attention, smiles, hugs, praise, funny faces, high fives, tickling, rough housing, chasing clapping hands, praise, a good laugh together, thumbs up, pats on the back, etc. • Activity reinforcers: playing a game, going to the park, reading a book together, pushes on a swing, riding a bike, wagon rides, swimming, adventures, put up a tent in the yard, watching a DVD, helping cook, etc. • Material reinforcers: food, drink, toys, bubbles, balloons, crayons, musical toys, playdough, cars, sand play,etc.

12. Ignoring Bad Behavior: Extinction • Be prepared for an extinction burst • Eye contact is often attention (reinforcement) • Don’t show facial reactions. • Don’t argue, scold or talk (attention) • Don’t show anger (attention) • Act absorbed in some other activity, walk away • Give your child lots of attention shortly after the bad behavior stops

13. More Serious Behaviors andNoncompliance • Behavior: Tantrum, hitting, throwing, scratching, falling to the floor, etc. • Causes: Parental demand (e.g., go to bed, eat at the table, put on your shoes) • Remove/denial of reinforcers (turn off TV, Come inside, turn off game boy, can’t have desired toy in the store) • Intervention: Teach positive behavior, weaken negative behavior, prevention • Part 1) Strengthen compliance repertoires • Begin to establish a new working history with the child (may take a while) • Obtain the most powerful reinforcers for that child • Carefully control and deliver those reinforcers on your terms (compliance) • However, periodically deliver free reinforcers (pairing) • Provide lots of opportunities for the child to comply/be successful • Create a hierarchy of demands beginning with the simplest tasks

14. More Serious Behaviors andNoncompliance • Part 1) Teaching compliance • Initially avoid demands that compete with powerful motivators • Gradually increase the demand (VR2, VR3, VR4) • Work in short sets of trials throughout the day (this is 24/7) • Work in all environments • Transfer control to other new adults (generalization) • Gradually begin to include high problem area demands (e.g., giving up reinforcers) • Occasionally give back the reinforcer when given up • Always end the session on the adult’s terms, and on a positive note

15. More Serious Behaviors andNoncompliance • Intervention: Part 2) Weaken the negative behavior • Extinction: Do not remove the demand • Follow through with the demand • Be prepared for an extinction burst • Make your expectations clear • Caution: Removing the demand will make the problem worse • Make sure negative behavior DOES NOT get reinforced in any way • Do not promise reinforcers for stopping • Do not show reinforcers when engaging in negative behaviors • Do not try and “talk a child down” (reinforcement) • Be very non-emotional about it all

16. More Serious Behaviors andNoncompliance • Intervention: Part 3: Prevention • Prevention: Identify high probability problem areas • Verbally prepare the child if possible • Use “if-then” contingency for more verbal children • Take activities and reinforcers to Dr.s office, store, friends houses, etc. • Ask for the same behavior under less “high probability” times, and reinforce • Break demand into small steps and reinforce each step • Make your expectations clear, and be consistent • Reinforce approximations • Establish time limits for reinforcers. • Use extra time as reinforcers for no tantrums

17. Be Organized and Plan Ahead to be More Effective • Anticipate your child’s needs before his bad behavior forces you to meet his needs • Avoid situations that you think might make the child irritable (e.g., staying out past their bedtime, shopping for a long time) • Teach others in the home what you have learned today • Always be a good role model

18. Summary • Use the three-term contingency to identify what causes the behavior • Identify a wide variety of reinforcers and frequently deliver them for good behavior. You get “paired” with these reinforcers. • Negative behavior often gets reinforced more often than positive behavior. • Don’t reinforce the problem behavior • Ignore minor negative behavior • Prevent behavior problems (Change the task or demand levels, increase prompts, increase reinforcers for approximations) • Directly teach replacement behaviors • Have lots and lots of fun time with the kids (pairing)