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Handling Behavior Problems in the Home and in the Community. by Mark L. Sundberg, Ph.D., BCBA and Cindy A. Sundberg. Common Behavior Problems for Children with Autism. Looking away, non-responding, non-compliance Self-stim (rocking, mouthing objects, etc.) Falling to the floor

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Handling Behavior Problems in the Home and in the Community

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    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)