Getting through the Holidays in One Piece

Holidays are again upon us. This ought to be a time of great joy, sharing and spending time with your love ones. However, for those of us with kids, and more so with special needs kids, the holidays can present unique challenges. Holidays can be overwhelming because they cultivate many stressors that may cause a child to erupt: absence of routine, overstimulation, being away from home, and one important one that many of us may overlook – parents’ stress.   Kids are “sponges”: when they sense you are stressed, they can get extremely overwhelmed. Your stress management skills are put to a test, no doubt about it. And it is paramount you pass the test.

So, mom, dad, it is time to review some crucial tips:

-        Being sensitive to your child’s needs and keeping familiar routines in place as much as possible are the best ways to avoid holiday havoc.

-        Prepare your child for the social event: Explain to your child what is going to happen ahead of time. Be specific about every detail that might occur in any given situation. If part of your holiday itinerary includes flies, prepare your child for the crowds he might encounter and explain him about security procedures. Be sure to include the fact that he might be asked to remove his shoes, walk through a “funny machine” and that someone might look through his things. New or unexpected situations can be very frightening for a child with autism and being prepared can help him cope. It may be helpful to create a picture book that will show the sequence of events and prepare him for the sights, sounds and people he might encounter.

-        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 times as close to their usual time as possible.

-        Bring your child’s favorite snacks with you. Unfamiliar foods will leave your child hungry, which is literally a recipe for disaster.

-        Bring your child’s favorite movie, video game system, sensory and security toys. Having familiar items will give him a sense of normalcy and comfort.

-        Pre arrange for a quiet space for your child to retreat to when stimulus gets too intense and he needs a break.

-        Don’t give in to social expectations (“People are looking at us”) or worry about insulting your host or family members if you don’t abide by social norms. You are your child’s advocate, she is your priority. This means you don’t need to force your child to hug, kiss, shake hands or play games with anyone if they don’t want to. Try to motivate him instead. This goes for clothing as well. Don’t force your child to wear something or comb his hair if he really doesn’t want to. You have to pick your battles. In general terms, don’t force your child to do anything unless it involves a safety concern or an emergency.

-        Educate your family ahead of time if you feel necessary. You can explain to them possible behaviors that might occur so that you don’t find yourself constantly apologizing for your child’s behavior.

-        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

cadatto@tesidea.com

Behavior management vs. behavior modification

Behavior management and behavior modification are not exactly the same. In behavior modification the focus is on changing behavior by teaching functional equivalent replacement behaviors, while in behavior management the focus is on maintaining order. Hence, behavior modification focus on building functional (socially appropriate and valuable) behavior repertoires.

Behavior management skills are of particular importance to teachers in the educational system. Behavior management include all of the actions and conscious inactions to enhance the probability people, individually and in groups, choose behaviors already in their repertoires, which are personally fulfilling, productive, and socially acceptable.^[1]


There is a great deal of research related to "behavior change" and "behavior management". B.F. Skinner's approach says that anyone can manipulate behavior by first identifying what the individual finds rewarding. Once the rewards of an individual are known, then those rewards can be selected and provided in exchange for good behavior. Skinner calls this "Positive Reinforcement Psychology". In order to effectively address behavior problems, individual must be persuaded (motivated) to behave appropriately.

Behavior Management:

Many of the principles and techniques used are the same as behavior modification yet delivered in a less intensively and consistent fashion. Usually, behavior management is applied at the group level by a classroom teacher as a form of behavioral engineering to produce high rates of student work completion and minimize classroom disruption. In addition, greater focus has been placed on building self-control.

Brophy (1986) writes:

"Contemporary behavior modification approaches involve students more actively in planning and shaping their own behavior through participation in the negotiation of contracts with their teachers and through exposure to training designed to help them to monitor and evaluate their behavior more actively, to learn techniques of self-control and problem solving, and to set goals and reinforce themselves for meeting these goals." (p. 191) ^[2]

In general behavior management strategies have been very effective in reducing classroom and home disruption.^[3] In addition, recent efforts have focused on incorporating principles of functional assessment into the process.^[4] This means understanding the function (needs and wants) of the challenging behavior and developing interventions with the objective of teaching functional equivalent behaviors.

While such programs can come from a variety of behavioral change theories, the most common practices rely on the use of applied behavior analysis principles: positive reinforcement    and mild punishments (such as response cost and time-out). Behavioral practices such as differential reinforcement are commonly used.^[5] Sometimes, these are delivered in a token economy or a level system.^[6] In general the reward component is considered effective. For example, Cotton (1988) reviewed 37 studies on tokens, praise and other reward systems and found them to be highly effective in managing student classroom behavior.

Behavior Modification:

As parents and teachers we should be aware of the importance of incorporating behavior modification as a crucial component of our approach, especially when working with children with special needs. These kids do not learn from the environment like regular developed ones do. They have to be taught the appropriate behaviors that will replace the challenging behaviors ones. As I said in previous blogs, “We are in the business of building socially appropriate behaviors repertoires. We are behavior teachers.”

Daniel Adatto, BCBA

cadatto@tesidea.com

References

1.      ^ Baldwin J.D. and Baldwinn J.I. (1986). Behavior principals in everyday life (2nd Edition), Engle Wood Cliffs, New Jersey: Prentice Hall.

2.      ^ Brophy, J. (1986). "Classroom Management Techniques." Education and Urban Society 18/2, 182–194

3.      Brophy, J.E. (1983) "Classroom Organization and Management." The Elementary School Journal 83/4, 265–285.

4.      Angela Waguespack, Terrence Vaccaro & Lauren Continere (2006). Functional Behavioral Assessment and Intervention with Emotional/Behaviorally Disordered Students: In Pursuit of State of the Art. International Journal of Behavioral Consultation and Therapy, 2 (4), 463–474. [1]

Reading to your Kids

Strong language skills are important to success in school and life, and parents are their children first and most important teachers.

Reading is easily defined. But reading with engagement is a different story.

I frequently see parents walking in the park or grocery stores or driving with their kids. But they are talking on the phone, not really engaging their children, stimulating and challenging them.

When reading or just hanging out with your kids, ask them questions, tell them your personal story, tell them they can be anything they want to be, encourage them to imagine the future, make comments, and relate the story to real life situations.

Communication is paramount in the relationship with your children. 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.

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. 

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.

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.

Healthy and rich communication is paramount.

Oh, your phone is ringing.

 

Daniel Adatto, BCBA

cadatto@tesidea.com

 

 

 

ABA is not restricted to autism

I recently had a discussion about ABA (Applied Behavior Analysis) with a friend. His argument was that ABA can only be applied to children with autism.

In previous blogs I wrote about some of the real life applications of Applied Behavior Analysis (ABA) and specifically its use with autism. I also emphasized that ABA is not synonymous with treatment for autism. In fact, ABA can be applied to any situation where a behavior change is desired. That’s the meaning of “applied” in Applied Behavior Analysis. And of course, the principles and strategies can be implemented when it comes to every day parenting. Picky eating, doing homework, cleaning up their room, doing chores are great examples of this. 

Furthermore, the same systematic techniques can be used to teach skills. Actually when we target a behavior for reduction or elimination we teach appropriate behaviors to replace it. The problematic behavior is functional for the child because it gets his needs and wants met. Just eliminating it is leaving the child in the vacuum, which he will likely fill with another challenging behaviors. The solutions to this problem is teaching the skills that will allow this child to address his wants and needs in functional and socially appropriate ways.

Let’s take the example of a child who screams and cries when he needs something or is denied a request. In this case access to desired objective should not be allowed following the child’s misbehaviors. Once the child is calm and able to listen, acceptable alternatives ways to obtain what he wants should be model to him. He should be rewarded for engaging in those functional ways to obtain access. During the training process ample opportunities to request wants and needs should be provided.  

Another example can be a child who is picky eater. If your child has a severe aversion to a certain food, start with baby steps, breaking down each task into very small reachable goals. For example, you can start by just having the undesired food on the table. Get the child used to having it there next to his other food and seeing other people eat it. Once he accepts the food on the table, you can move on to having him smell it, bringing it closer to his mouth. Remember that every successful step needs to be rewarded with, for example, a bite of a food that the child likes. Possible next steps can be to have the child lick the food, getting him used to the taste. After that, move on to taking a bite. He may not even chew or swallow the food, just take a bite and spit it out. Remember, we are breaking this down into tiny achievable steps. After the child agrees to take a bite, you can move on to swallowing and so on and so forth until the child agrees to eat the new food.

These are just a few examples that show that ABA principles and techniques can be applied at everyday life situations and are not restricted to autism.

However, I’m not quite sure I was able to convince my friend.

 Daniel Adatto, BCBA

cadatto@tesidea.com

 

 

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