Prevention can go a loooong way

Rest before you’re tired, eat before you’re hungry, and drink before you’re thirsty. LAFD spokesman Brian Humphrey said “people overestimate their ability and underestimate the danger.” This advice is especially relevant when it comes down to parenting. Once you’re tired or overwhelmed it is too late. And the same happens to your child. A lot of meltdowns can be avoided by just establishing a routine that includes eating and sleeping times, and sticking to it. Prevention can go a long way, and is the most cost-effective strategy. As we discussed previously in these blogs, once meltdowns occur it is too late and more challenging.

Downtime, unexpected changes, too many or too little activities, lack of physical outlets, are a recipe for disaster. Lack of predictability increases anxiety, which leads to problematic behaviors.

I know, sometimes it is difficult putting them in bed or having kids come to the dinner table. And because you want to avoid a struggle, they get their way. But this only makes it more difficult for you because they learn how to obtain their objectives.

As it happens at school, children get used to predictable schedules and respond to it automatically. You have them on “cruise-control.”

Some tips worth to remember:  

-        Keep times, places and people in charge as consistent as possible. Start with the “must do’s”: meals, bed time,homework, 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". First “must do’s”, then “can do’s.” It can be helpful to present it in a visual schedule format. Here is a link where you can find tons of creative ideas:  https://www.google.com/search?hl=en&site=imghp&tbm=isch&source=hp&biw=1078&bih=513&q=visual+schedule&oq=Visual+sch&gs_l=img.1.0.0l10.2756.7943.0.11665.10.10.0.0.0.0.256.1236.0j9j1.10.0.ckpsrh...0...1.1.64.img..0.10.1215.GEotCZt-wjQ 

 

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".

And make some time to spend quality time with your kids where they can choose the activity and be the boss. In plain English, have some fun with them.

 

Daniel Adatto, BCBA

cadatto@tesidea.com

Measurement of Behaviors

When asked what had been his main contribution, Skinner, the father of applied behavior analysis, used to say the measurement of behaviors.

ABA is a scientific approach to understanding and changing behaviors. Science relies on direct and objective observation, measurement and experimentation of phenomena, which leads to effective interventions.

We start by taking baseline data: the behaviors are measured in the absence of the treatment variable. This gives us a measurement of the behavior before intervention is applied and allows for comparison further on for evaluation of treatment purposes. In other words baseline data is used to measure effectiveness of the intervention plan.

In order to measure behaviors operational definitions are a “must.” We need an accurate, observable and objective description of behaviors, including data on events that precede and follow the occurrences of the behaviors, and the frequency, duration and intensity of the problem behavior. It is a count of the present (i.e., pre-treatment) level of performance.

Benefits:

•        Allows all team members to identify and discuss the same behavior

•        Ensures consistency when implementing behavior plans

Direct and frequent measurement enables a dynamic, data-based decision making process concerning the continuation, modification or termination of treatment. Without this information, an ineffective treatment could be continued or an effective treatment could be discontinued based on subjective judgment. Continuous evaluation of success and failures in the treatment allows us to make the necessary changes in the behavior modification plan. Through measurement we “hear” our clients’ messages.

Additionally, measurement enables practitioners to be accountable to clients, employers and referral agencies.  

Because behaviors occur within and across time, they have three dimensional quantities:

–       Frequency: Instances of a behavior. Behaviors can be counted. (i.e. Johnny engages in 7 tantrums per day)

–       Duration: Behaviors occur during time. Therefore, the duration of behaviors can be measured (i.e. each tantrum episode lasts 5 to 7 minutes)

–       Magnitude: The intensity of the behavior. One standard way is to define the intensity as followed:

–       Severe: the behavior may be harmful or dangerous to self and/or others.

–       Moderate: the behavior is disruptive to the life of the individual and/or others.

–       Mild: the behavior is bothersome to others.

Usually a simple tally of number of occurrences is enough. For example, the number of times a student raises his hand. The behavior must have a clear onset and offset (beginning and end). The observation period must be reported (i.e. 10 times per hour, day, week, etc.)

When the behavior does not present a clear beginning and end, percentage of responses per unit of time is used (i.e. students engages in eye contact 20% of the time per session) 

Comparing measures without referencing to units of time can lead to faulty interpretations. For example, stating that Will reads 100 correct words is not enough. Time must be reported. For example, 100 correct words per hour, session, etc.

Oftentimes data isn’t taken correctly because practitioners don’t know how to take the data or track the wrong behavior. This is one of the reasons why interventions have to be supervised by knowledgeable professionals. Board Certified Behavior Analyst are the gold standard in the field.   

Once I heard the phrase “What gets measured can be improved.” And this applies to our practice.

As a parent or teacher, be sure the professionals working with your child are experienced and knowledgeable enough to ensure the effectiveness of their treatments. And monitor regularly, at least monthly, the data. The answer is usually there.

 

Daniel Adatto, BCBA

cadatto@tesidea.com

 

Dealing with GOOD behaviors

We usually spend a lot of time discussing dealing with challenging behaviors and not nearly enough about good behaviors. However, mastering the skill of not ignoring desired behaviors is a key component in any behavior management program.

Kids don’t misbehave all the time. Even those children with intense problem behaviors. Every once in a while they are calm and quiet, or they comply with a direction. And when they do, adults interacting with them feel it is their break and more often than not ignore those desired behaviors. They shouldn’t.

“Catch them being good.” You probably heard this statement numerous times. But, what it means?

-        Reward: make a big deal, praise, provide attention, offer rewards. Do not ignore good behaviors.

-        Identify those variables conducive to the appropriate behaviors and replicate them as much as possible. On the same token that you want to change the variables conducive to problematic behaviors, you want to recreate those ones that facilitate good behaviors. For example, if you were able to do groceries with your child in peace, ask yourself “Why?” What happened?” Pay attention at the time of the day and identify patterns. Was your child rested or tired? Did you feed him before leaving home? Was the store not crowed? Did you promise him a treat if he behaved?

-        Ask other people in your child’s life (teachers, grandparents, speech therapist, etc.) what helps your child behave. There are aspects of his/her personality you don’t know. How they give directions? Do they yell “No” at the first misbehavior? How they motivate your child to engage in non-preferred activities? Do they reward her or praise is enough? How do they manage to stay calm when problems arise?

This and other information is gold. Do not leave it on the table. 

Be sure you and the other people interacting with your child are consistent in reproducing those appropriate situations. The more you do it, the more they become second nature and thus, it becomes easier and easier.

And when that happens the quality of your family life will improve dramatically.

 

Daniel Adatto, BCBA

cadatto@tesidea.com

 

Problems with Transitions

Difficulty with transitions from one activity to the next is a common problem for some children with special needs. If you struggle when is time to turn the TV off or going to bed, you are not alone.

A variety of antecedent-based interventions have been evaluated to address problem behavior that occurs during transitions. For example, providing advance notice of an upcoming change in tasks (i.e., a 2-min warning) decreased transition related challenging behaviors.

Visual prompts, often in the form of visual schedules, are commonly recommended to aid with transitions for children with autism. However, studies suggest that if the behavior is maintained by avoidance of non-preferred activities, access to preferred activities/items, or escape from the transition, visual schedules alone, a commonly recommended intervention, may not produce decreases in transition-related problem behavior unless extinction (not allowing access to reinforcement) is also used.

The importance of identifying the function of problem behavior that is occasioned by transitions and developing treatments based on these results is commonly overlooked in recommendations to parents and teachers regarding the use of visual schedules.

The combination of visual schedules and a function-based intervention for problem behavior that occurred during transitions appear to be the most effective intervention.

Try this at home. When is time to turn off the TV, to stop playing in the computer or to go to bed use a visual schedule before the preferred and when you prime your child (“Remember, in 5 minutes…., in 3 minutes…, etc.). Also, make the preferred activities contingent on preferred ones. “When you finish your homework, you can watch TV.”

Another recommendation is to make the non-preferred activity motivating by adding some fun (i.e. make it a race, include motivating items and activities, sing a song).

And be consistent. Follow the same routine, like teachers do in the classrooms. Not only the activities, but times and the way the activity is performed. For example, standing in line before going to recess, or cleaning up desks before free time. Kids do much better when they follow a predictable routine. We all do.

 

Daniel Adatto

cadatto@tesidea.com

 

 

 

The Five Most Common Parenting Mistakes That Are Easily Avoided:

Making positive behavioral changes can help every parent avoid these common parenting mistakes.

1. Giving attention to bad behaviors   
2. Ignoring good behavior
3. Placating the whining or crying request
4. Saying No when you can say Yes
5. Using time-out as a punishment

1. We parents devote far too much time attention when our children misbehave. In a child’s mind, negative attention is better than no attention so by eliciting a negative reaction (yelling, punishing etc.), the child has in essence won the battle. By rewarding the bad behavior with attention, you are teaching your child that crying, hitting, disobeying, etc., is the way to get your attention and you are perpetuating the bad behavior.

2. This brings us to common mistake no. 2. We punish the bad behaviors, but do we take notice of the good ones? Reverse your negative patterns by catching your child doing something good and reward him/her for behaving. Is your child playing nicely? Don’t run away to make a phone call. Commend that behavior first, reward your child with a positive interaction and you will increase good behaviors while reducing the undesired ones.

3. Placate now – pay later. And pay dearly you will! We parents are so irritated by the crying or whining child that we so often give into the request just to make it stop. Children are very clever. They know that this works.  But ask yourself, is the price worth it? By giving into the request, we are teaching the child to cry or whine to get whatever he wants. I can not stress this enough - Never ever give in to a crying, whining or tantrum request! If your child requests something while crying, you must demand that he/she stops crying and asks nicely before you give him whatever he/she wants. If you are consistent, the crying and whining will decrease over time.

4. We say “NO” 100 times a day and I can almost guarantee that 75% of those NO’s could be Yesses. If we rephrase our response to a more positive alternative and redirect the child instead of just saying no, we can reduce the child’s frustration in being told NO.

• Instead of saying just NO, what he CAN’T do, tell the child what he CAN do. “Can I have a cookie mom?” Instead of immediately saying no, you can say “you can have a cookie when you finish your dinner”.
• Do not forget to give at least two Yesses for each NO. “I want to play outside” Try “It’s too cold right now but we CAN play blocks or dance inside”.

By the way, when you say “NO” to your child, you are teaching him/her to say “NO” to you when you place a request on him/her. So, save the NO’s for when it is necessary. If you child is running to the street or playing with a knife, that’s a NO.

5. A Time-Out should be used to remove a child from an environment where he is receiving attention for a bad behavior, and place him/her in an environment where he/she receives NO attention for the behavior. If you are in the grocery store and your child throws a tantrum, be ready to leave the cart full of groceries and remove your child from that environment where he is getting a lot of attention from you and the rest of the customers, and take him to the car, where you are able to ignore the crying and screaming, thus placing the behavior on extinction: no attention.

Be sure that the tantrum is your child’s way to get attention. If your child is over stimulated by the environment, in pain, scared, hungry or tired, do not use time-out, do not ignore the behavior. Your child needs your help.

And remember, you are there to help your child, not the other way around.

Daniel Adatto, BCBA

cadatto@tesidea.com

Don’t fight lost battles

It’s very inspiring when I see a good teacher focusing on his/her skills rather on students’ deficits. It makes a world of difference when we pay attention on what can we do, instead of what the kids do or don’t do.

Ok, let me give you a real life example.

I was supervising a school case when the class was at PE (Physical Education). An excellent and experienced teacher was conducting the class. The activity was manipulating one of those big parachutes that everybody holds by the edges and lift up. Every time the parachute was lifted the teachers named two kids to go inside. As you can imagine, seven or eight kids went inside ignoring the teacher and aides’ directions. After a couple of times, the PE teachers whispers to herself “this is a lost battle” and instructs everybody to go inside. The kids get very excited and start running in and out, or staying inside when they were supposed to go out. 

At that point the PE teacher says to herself “I lost control” and ends the activity instructing all the kids to sit down. Once everybody was calm. She moved to another activity soon regaining control.

What a great and clever teacher! She didn’t have to yell or get upset.

How many times we as parents or teachers lose control and keep fighting lost battles insisting in forcing our kids to comply instead of rethinking our strategies and switching to an effective plan?

So the advice is simple:

“Don’t fight a lost battle,” be aware when you lost control and have to change gears because what you’re doing is not working. This could mean leaving the cart full of groceries and walking out the store, or leaving a social gathering and going home. It could be that homework is not done that day, or is broken down into short segments, allowing your child for breaks instead of demanding him to work for two hours in arrow.

Another example could be letting your child eat in front of the TV instead of sitting at the dinner table.

As I always say in my blogs, you change kids’ behaviors by changing the behaviors of the adults who deal with those kids. Pure and simple.

Keep this in mind, and have a great summer.

 

Daniel Adatto, BCBA

cadatto@tesidea.com

 

The Crying Game

As we discussed repeatedly in previous blogs, one of the primary principles of applied behavior analysis (aba) is reinforcement, a system that creates desired behaviors by breaking them down into small, teachable steps and rewarding them with positive interaction and desired objectives. Keep in mind that you want to reinforce direction, not perfection.

You reinforce a behavior based on the kind of reaction the behavior elicits. You can increase desired behaviors by rewarding a child when he does something good. The flip side of that is that you can also increase undesired behaviors by rewarding them with attention, so we want to be careful of this. Parents have a tendency to notice misbehavior more often than good behavior. To a child, negative attention is better than no attention so even though we think we are disciplining or trying to teach them the right way, we inadvertently end up reinforcing a bad behavior.

From the time an infant is born, parents instinctively respond when their baby cries.  This is completely natural and appropriate because crying is a baby’s only way of communicating his needs. Problems arise when babies mature into toddlers and continue to use crying and whining as a way of getting something they want while parents, out of habit, continue to respond. Your child cries “I’m hungry”, you give him food.

If you want to eliminate the crying and whining, you need to insist that your child repeat his request without crying or whining and only then attend to his need. You might need to model the appropriate way of communicating wants and needs. You are then rewarding him for communicating his request in an appropriate manner. Over time, the child will learn that his needs will be responded to only when his requests are made without crying. It is difficult at first but if you are consistent over time, the crying and whining will diminish and eventually disappear.  You can further reinforce this by “catching” him being good and offering praise when he does communicate appropriately. Remember, do not ignore desired behaviors. Give your child a strong reason to repeat them.

There is some disagreement about what age a baby stops being a baby and when he is mature enough to understand that mom or dad is not going to respond to crying. Sometimes parents underestimate how smart their little ones really are. But if you have any doubts that even toddlers are clever enough to understand how to manipulate their parents, watch this:

http://www.youtube.com/watch?v=rWy9xjijaKE

 

Daniel Adatto, BCBA

cadatto@tesidea.com