Consistency

In my practice, I often see that “consistency” is one of the most misunderstood concepts in behavior management: parents and caregivers discontinuing effective strategies, implementing them seldom, or not practicing what they demand from their kids.  Today, I’ll focus on this misconceptions. 

Consistent parents follow the same principles and practices they expect from their children. For example, if you are teaching your child not to scream and yell, you should not scream or yell at your child (or at anybody, for that matter). If you don’t want them to lie, do not tell them that you are not home when they pick up the phone.

And do not lie to them. Tell them the truth in simple terms and do not go beyond what they ask. It is much better to say less than lying. And always fulfill your promises. Do not think that they have forgotten. You want to teach them that they can trust you. 

At the same time you should be consistent when setting boundaries with your child. If your child goes beyond the limits, deal with him/her in similar ways for similar actions. A child is more likely to behave well if he or she has some idea of what to expect from you.

As children learn how limits work and what happens when they go past those limits, they will trust you to be fair. Your child is also more likely to come to you with questions or problems if he/she knows what to expect. Children need limits. Limits help build their sense of security and in turn build self-confidence.

Consistency between parents/caregivers is also crucial as your child learns about behaviors that work and behaviors that don’t work. Disagreements between parents are normal but it can be harmful and undermine the other parent’s authority in front of a child. Try discussing your differing perspectives when your child is not present, until you achieve a meeting of minds. Then, you present a united front to your child. DO NOT ARGUE IN FRONT OF YOUR CHILDREN. It gives them the wrong message by teaching them an inappropriate way of dealing with conflicts. Keep in mind that children learn more from what they see than from what we tell them.

Consistency leads to predictability, which in turn reduces anxiety and challenging behaviors, and teaches children that the world is truthful.

 

 

Daniel Adatto, Board Certified Behavior Analyst.

 

How to talk so your kids will too

Communication is paramount in the relationship with your children, or any healthy relationship for that matter. A lack of communication or deficits in this area can lead to problematic behaviors. Children face a lot of pressure and many emotions. They don’t always know how to express these emotions but the “pressure” has to come out somehow. If they don’t have the right tools to express themselves, problems can arise and it will start to manifest itself in the form of challenging behaviors.

This is even more so when it comes to children with special needs. If children did not learn the necessary skills, they will resort to methods that worked during the time they were babies: crying, screaming, throwing things, etc. As a child gets older and stronger, this can be incredibly problematic.

For this reason teaching and encouraging functional communication should be a key component of any school and parenting program.

An essential component of effective communication is to listen. This helps to make children feel comfortable and secure: you care about their feelings and needs, you respect their point of view, and you are interested in what they have to say.

As teachers and parents we can take important steps to build healthy communication repertoires. Both ways. I mean, you are talking and listening to them and at the same time you are teaching them how to talk and listen. How many times you felt as if they were not listening to you? Well, they felt the same. Every time you feel the other person is not listening to you is because you are not listening as well. Think about the other person as a mirror that reflects your image. So, the best way to get the other to listen, is to start listening.

Parents, teachers and caregivers can show and teach positive communication skills by:

Listen patiently before disciplining your kids. Instead of asking them to stop, encourage communication, even if they need to scream and cry for a little while. They probably need to vent, let the anger out before they talk about the problem. And do not interrupt or criticize when they are communicating. Keep in mind that communication is not only words. Crying, gestures, facial expressions, breathing patterns are all means of communication as well.  

Do not rush to give solutions or directions, in many cases venting is what the other person needs.

Clarify the situation by paraphrasing what your child is saying. Repeat back to your child what he said. This helps your child feel that you are listening.

Give them the opportunity to solve the problem by themselves, coach them in the right direction so they feel they discover the solution.

Encourage your children to express their opinions by just responding “Yes” or “Really?” Ask them open-ended questions such as “How would you feel if that would happened to you?”, or “What is the right thing to do?” If needed provide them with 2-3 choices.

Speak calmly, especially during stressful situations. This is a skill difficult to achieve, but it can go a long way. When they are stressed they need you to calm them down rather than stress them further.

Do not discuss discipline during stressful situations, such as when your child is hungry, tired, or upset. Deescalate the situation and wait for a good moment to discuss behaviors and solutions.

Use a positive language. Instead of telling your kids what not to do (i.e. “Stop screaming”) tell them what to do (i.e. “If you use your words I can understand you and help you”).

Focus on the behaviors, not the person. For example, instead of saying “You are a bad boy because you don’t want to clean up” try “Your room is messy, please, clean up your toys.”

It is important to teach your children that it is okay to disagree or be upset, as long as they express their opinions and feelings in an appropriate manner. Emotions are always okay, behaviors can be problematic. Validate their feelings by saying “You seem very upset”, or “You are mad, and I understand why”, for example.

Create opportunities to communicate with your children by:

Read to them: ask questions about the story, make comments, and relate the story to real life situations.

Have family outings for the purpose of spending time together.

Make time to play with them, preferably daily.

Have at least one family meal a day and encourage conversations between all family members. Remember, kids learn what they see, not what you told them. Adults conversing can be a strong model for your kids.

Be sure to make eye contact when talking to your children. Giving instructions or asking questions from the other room or while talking on the phone? Not a good idea.

I would like to recommend some good books about this subject:

“How to talk so your kids will listen, and listen so your kids will talk”, Adele Faber & Elaine Mazlish.

‘Raising your spirited child”, Mary Sheedy Kurcinka.

“Everyday opportunities for extraordinary parenting”, Bobbi Conner.

In summary, the best approach to listening and talking is to do so in the way you would like the other person to listen and talk to you. This is the healthiest way.

 

Daniel Adatto, BCBA

Teaching Teachers

Henry D. Schlinger Jr., Director of the Graduate Applied Behavior Analysis Program at Cal State Los Angeles, published a very interesting letter in the June 22, 2013 edition of the Los Angeles Times. His position is that “the main thrust of teacher training programs should be how to teach.” To do so, he proposes that schools of education need to “stop relying on trendy but unscientific “theories” of learning and instead focus on those based on good science, such as behavior analysis.” I can not agree more.

He adds that “when teachers actually teach, behavior problems in the classroom decline.” This is because students need to be active and interactive learners.

So now the question becomes how can behavior analysis accomplish that?

One of the core principles of Applied Behavior Analysis is that behaviors are related to the environment in which they occur. B. F. Skinner, the father of Behavior Analysis, sheds some light:

“The subject is always right” (Skinner, 1948, p 240).

“Control the environment and you will see order in behavior’’ (Skinner, 1967, p. 399)

“The task of a behavior analyst is to discover all the variables of which probability of response is a function.”

Applying this to our subject matter, we can conclude that instead of forcing the kids to fit teachers’ way of teaching, teachers need to be able to change their way of teaching to fit their students’ needs. This couldn’t be more relevant than when talking about special education. Children with special needs do not learn the way we teach, so we need to teach the way they learn. Applied Behavior Analysis is a single-subject design. Each student needs an individualized program. That is the idea of IEP’s (Individual Education Plan).   

As a first step, teachers can have more of an impact by learning the art of motivation and the power of stimulating instructional routines and structure.

The art of motivation: Simply put, this means motivating students to perform non-preferred activities. Good teachers motivate their students when they tell them they can have 10 extra minutes of recess if they finish their work on time, or give them points towards a pizza party or a preferred activity. It is important to note that motivation does not always mean a treat, or a prize. Motivating materials (i.e. arts & crafts, music, computers and tablets loaded with educational software, etc.), topics relevant to kids, and a loving, warm, and passionate approach to teaching are excellent tools. Education does not have to be synonymous with boredom. It should be an amazing experience.

In my opinion it’s time to mainstream the concept that people engage in behaviors because they work, we get or avoid something through our behaviors. When we ask children to do something they don’t want to do, we need to motivate them, so they want to do it. Plain and simple.

So, three words: Motivation, Motivation, Motivation. Let’s get out there and motivate our kids instead of forcing them, or just hoping they will comply.

Under the title “The Power of Structure and Routines”, we published a blog on April 28^th, 2013, where we wrote “Structure and routines mean a stimulating, predictable and consistent daily schedule (time-space-people in charge). Lack of predictability and down time increase anxiety, which leads to problematic behaviors.” Predictability is what children need, and it should be implemented in the classroom setting. Keeping them busy is part of all this.

Skinner also pointed out that his main contribution was the measurement of behaviors. Behavior Analysis is a data-based decision making process. We need to be certain, through constant measurement and experimentation, that the program is working and it will continue to work. Data should be the indicator to make decisions to continue an educational program or change it. Sustaining an ineffective instructional program is like knowingly keeping a patient on medication that is not working. Doctors (scientists in general) analyze data and make changes accordingly. Teachers should do the same.

But more than anything good teachers share a crucial feature: passion. They are passionate about their jobs. They wouldn’t change it for anything else. Thus, the system should reward them. Parents should acknowledge and thank them.

As Henry D. Schlinger Jr. put it at the end of his letter, “It’s not rocket science, but judged on the basis of how rarely it occurs, one would think it is.”

I could not agree more.

 

Daniel Adatto, BCBA

The Lovaas Legacy in Autism Treatment

The autism community continues to mourn the loss of pioneer Dr. Ivar Lovaas. Realizing that Skinner’s systematic approach using reinforcement could be instrumental in teaching functional skills to children with autism , Lovaas was one of the pioneers in the implementation of  Applied Behavior Analysis (ABA) principles and procedures in the treatment of autism, and in doing so helped thousands of children across the globe. The Lovaas Method of ABA starts with "discrete trials therapy” often referred to as DTT. A discrete trial consists of a therapist asking a child to perform a particular behavior. For example, “Timmy, name the animals in this picture.” If the child complies, he is given a "reinforcer" which is usually a desired prize or reward that is meaningful to the child in order to increase motivation, often times an area of deficit in children in the spectrum. The reinforcer could be a food treat, a high five, stickers in a chart towards earning play time, or anything else that has meaning for the child. If the child does not comply, he does not receive the reward, and the trial is repeated. Prompts are added as necessary to ensure the trial ends in success.  Since ABA is a data-based decision making process, data collection and analysis is warranted in order to continue a specific program or make changes.  

It's important to note that ABA interventions are single-subject designs: the specific content of the discrete trials therapy is based on an assessment of the individual child, his needs, and his abilities. So for example a child who is already capable of sorting shapes would not be asked to sort shapes indefinitely for rewards. Instead his therapy would focus on different, more complex functional skills.

As children master specific programs, therapists will start to take them out of the therapy or home setting and into more natural environments, where they can practice their learned skills in the real world. This is the meaning of “Applied” in Applied Behavior Analysis, which differentiates ABA from other therapies that are implemented only in a contrive setting where the therapist has full control over the variables in place. In simple words, we consider that a skill is mastered when the child is fluent in the real world. This often presents a challenge because the therapist does not have control over the environment when at the groceries store, a restaurant or a play-date at the park. However, research shows that this is the only way to achieve generalization of gains across settings and maintenance across time.   

Additionally, ABA therapists are required to keep detailed records on their outcomes. This means that ABA has been extensively researched and replicated. As such, ABA has a reputation for being the most scientifically researched form of successful therapy available for autistic children.                     

As I said in a previous blog (see “Common misconceptions about Applied Behavior Analysis”) I fell in love with ABA when I learned all that. The more I learn, the more passionate I am. ABA gives me the answers I need to do my job effectively.  Everyone who jumps on the ABA bandwagon gets hooked. Have you ever thought about why?

 

 

Daniel Adatto, BCBA

 

Summer Time and Autism

The summer is already here. Having a child with special needs at home all summer is extremely stressful for parents. As we’ve discussed in previous blogs, this kind of stressful environment often leads to behavioral issues.  

Summer should be a time of joy, sharing and spending time with family and friends. However, for those with family members who have special needs, the holidays can present unique challenges because it can often be overwhelming to children. The comfort and predictability of the school time with its routines and schedules is gone and now there is a lot of free time.

As discussed in previous blogs, being sensitive to your child’s needs and keeping familiar routines in place are the best ways to avoid summer havoc. Let’s review some recommendations to help keep parents sane during the summer. 

Prepare your child for the unexpected event: Explain to your child what is going to happen when there are changes in routines ahead of time. Be specific about every detail that might occur in any given situation, such as meal times, preferred and non-preferred activities, time to come back home, etc. New or unexpected situations can be very frightening for a child with autism and being prepared can help him cope.

Prepare the social event for your child: Avoid long trips whenever possible. Airports, planes and long car rides could be very stressful.

Stick to your normal routine as much as possible. Keep sleep and meal/snack times as close to their usual time as possible.

Keep your child busy: Don’t expect that your child will entertain himself independently. Your role here is crucial. I know that finding activities for kids with special needs can be challenging. However, there are some options available. Consult with your Regional Center or your social services agency. Schools and community centers sometimes offer activities for children with special needs. Try to build a schedule of activities similar to the schedule your child follows during the school year. 

 

Know the triggers and read the precursors of challenging behaviors, such as facial expressions, changes in breathing, body movements, etc. Look for the signs that your child may be unraveling and retreat to your safe place. Preventing a meltdown is always easier than managing a tantrum once it begins.

Finally, relax and enjoy. You are your child’s barometer and if you are stressed out, he will be too.

 

Daniel Adatto, BCBA

Pivotal Behaviors

Individuals with developmental disabilities present a myriad of challenging behaviors. Addressing each one of them separately can be a daunting task for parents, staff and the clients themselves. Successfully addressing multiple behaviors with one intervention is often necessary. PRT (Pivotal Response Training- Koegel, O’Dell and Koegel, 1987) focuses on critical behaviors that are central to many areas of functioning, such as communication and social skills. PRT is built on the premise that improvement in these key pivotal behaviors opens the door to improvement in other areas as well. In other words, teaching pivotal behaviors produces widespread positive effects on other behaviors.  

This is a positive, naturalistic behavior intervention based on Applied Behavior Analysis principles that focus on teaching specific behaviors in the natural settings and is used successfully to help children with ASD and other developmental disabilities. Key pivotal behaviors addressed include motivation and responsivity to multiple cues. 

Motivation: Children with developmental disabilities are frequently viewed as lacking motivation to initiate and respond appropriately to stimuli, to learn new tasks or engage in their social environments. They demonstrate this lack of motivation by engaging in non-compliance, tantrums or other challenging behaviors to escape tasks and social interactions. They may not initiate conversations or ask and answer questions. These children are so difficult to motivate perhaps because since they often fail, they have learned not to try.

Thus, motivation is a key component of a behavior modification program. Lack of motivation constitutes a barrier to teaching appropriate behaviors. A motivated child is interested in learning. Research indicates that increase motivation has a dramatic positive effect on children’s learning (Koegel, O’Dell, & Dunlap).

I like the phrase “We can not teach if we cannot motivate” because it summarizes the importance of focusing on motivation.

Responsivity: Children with developmental disabilities are characterized by “stimulus overselectivity”, and attention deficit in which they select or focus on only one part of the environment or an object. A child may focus only on round part of an object such as the wheels on a car. Increasing children’s responsivity to multiple cues is an important pivotal behavior that may help them to learn more from typical educational strategies and naturally occurring situations, which ultimately leads to engage more in desirable and functional social behaviors.

Parents and professional should focus and take advantage of naturalistic child and family-centered situations. Here are some tips:

1. Implement teaching sessions around objects, activities or topics that the child prefers in order to increase motivation. For example, if your child is “crazy” about cars, engage in playing with him the way he plays with cars (start imitating what he does), and slowly include and model social interactions, such as “the red car asks the blue car to play”, or “all the cars are having a playdate” and they take turns while playing games, share toys, collaborate in building with Legos, etc.

2. Take advantage of natural situations to teach. For example, having dinner, taking a bath or doing groceries are great opportunities to model behaviors and increase motivation.  

3. Parent, teacher, make sure that the child is attending to you by getting down to his level, calling his name or asking “Are you ready?”, and then presents the child with a question or instruction that is directly related to the setting, task and material available. In our example, playing with cars.

4. Very Important: All attempts to respond appropriately (even if the response is not perfect) are rewarded. Ample time is allowed so the child can try to respond without stress. Prompt (model, guide) appropriate responses to end always on a positive note, the reward. This allows the child to experience success, which increases motivation.

5. Use rewards directly related to the task and the natural environment. If you are playing cars, the child receives another car, or gets access to his favorite car, for example.  

In sum, teaching pivotal behaviors is a child-centered intervention that can be implemented across settings (school, home and the community) and across caregivers. Once parents learn how to do it, they become the therapists and thus, the intervention is in place 24/7.  

This intervention has been most successful in improving social and communicational behaviors of children with developmental disabilities in the areas of language, play and social interaction.

Another example of an effective way we can help to improve the quality of live of individuals with developmental disabilities and their families.

 

 

Daniel Adatto, BCBA

 

The Power of Structure and Routines

Try to imagine your life “unstructured”: you don’t know when you are going to have food again, or where it’s coming from; you don’t know at what time you’re going to be home, or if you are going home at all today; you don’t know when you are going to be done with a non-preferred activity, how long it’s going to last; and you don’t know when you are going to be able to rest, have fun with you preferred activity or see your loved ones again. In sum, your life is unpredictable, uncertain, chaotic.

 

I don’t know about you, but I’m “freaking out” just by thinking about that possibility.

 

Your child might be living in that state of confusion and anxiety all the time. So, let’s structure. 

 

What does "Structure" mean?

 

A predictable and consistent daily schedule (time-space-people in charge). Lack of predictability increases anxiety, which leads to problematic behaviors. Yes, I’m talking about your kids. Are you with me?

 

Predictability is what your children need, and something you can implement at home. You don’t need complicated IEPs, or your insurance to approve services, balanced state/federal budgets or lawmakers to pass bills.    

 

Benefits of "Structure":

 

q  Builds Confidence

 

q  Decreases Anxiety and Fears

 

q  Develops Positive Expectations

 

q  Encourages Cooperation and Compliance

 

q  Increases Predictability

 

q  Increases Motivation (when desired activities follow undesired activities)

 

q  Increases sense of Control

 

q  Increases Independence

 

q  Anticipates future events

  

Sounds good? Well, it is.

I can hear your question, How to Structure Activities?

--Keep times, places and people in charge as consistent as possible. Start with the “must do”: meals, bed time, etc.

--Adjust the environment to focus on the activity. For example, turn off the TV when it is bed time.

--Present scheduled activities in a positive manner. Do not be overly rigid. Some flexibility is necessary.

--Include free and play time: children need it.

--It is very important to allow time for transitions between activities. For example, when your child comes from school he/she typically will need some free, unstructured time. Or when transitioning between activities. Prepare the child ahead of time. For example: "It is almost dinner time, so you will need to come in soon. Be ready to put your toys away".

--Have preferred activities follow non- preferred activities. In order to be able to do the desired activity, the child has to finish the undesired activity. For example, "homework first, then play"; or "bath first, then video".

Children may not have independent play skills. You may have to set aside time to play with your child.

Choices can be built into the schedule by allowing the child to choose between 2 activities, such as "bath or shower", or "going to the park or to the store", or "video or TV".

In sum, structure and routines do not mean “militaristic”. They mean “predictable”.

Very cost-effective: easy to implement, excellent benefits. Sometimes, the solution is simple.

 

Daniel Adatto, MA, BCBA