NAVIGATING MELTDOWNS AND DIFFICULT BEHAVIOR · 2019-06-20 · FINAL THOUGHTS •Changing behavior...

NAVIGATING MELTDOWNS AND DIFFICULT BEHAVIORPRESENTED BY: CLIFF COWAN, M.A., BCBA

BACKGROUND OF PRESENTER

• 9 years of experience working with individuals with autism, ranging from 2 years old to 35 years old.

• Masters degree in applied behavior analysis from Florida Institute of Technology

• Became a BCBA in May of 2018

APPLIED BEHAVIOR ANALYSIS

• ABA is a scientific approach for discovering environmental variables that influence behavior of social importance. It focuses on using this information to develop processes that produce meaningful behavior change. (adapted from Cooper, Heron, & Heward, 2007).

• More information at….

• Behavior Analyst Certification Board - https://www.bacb.com/

• Behavior Babe - https://behaviorbabe.com/ > caregiver’s corner

EVIDENCE FOR APPLIED BEHAVIOR ANALYSIS

• Over 50 years of scientific support.

• National Standards Project

• Reviewed hundreds of scientific articles to find evidence based treatments for autism spectrum disorder.

• Both reports from 2009 and 2015 confirm that interventions that are behaviorally based have the most research support.

• More information at

• https://www.nationalautismcenter.org/national-standards-project/

COMMON CHALLENGING BEHAVIORS ASSOCIATED WITH AUTISM

• Self Injury

• Aggression

• Tantrums/Meltdowns

• Destruction of property

• Stereotypical Behavior• Examples: repetitive vocalizations, hand flapping, body rocking, etc.

• Ritualistic Behavior• Examples: lining up objects, excessive hand washing, checking if doors are open, etc.

• Other examples?

CRISIS INTERVENTION VS. BEHAVIOR INTERVENTION

• Crisis intervention

• Offers immediate, short-term help for emotional, mental, physical, and behavioral distress or problems.

• Emphasis on safety and stopping the maladaptive behavior immediately.

• Behavior intervention

• Designed to reduce maladaptive behaviors over time.

• Does not necessarily emphasize finding the fastest way to stop a behavior in the moment.

CRISIS INTERVENTION

• Safety first!!!!

• Crisis intervention resources

• Call 911 for medical or life threatening emergencies.

• Visit this website for a list of other resources

• http://crisissolutionsnc.org/

DISCLAIMER

• This presentation is not primarily focused on techniques that immediately stop problem behavior in the moment.

• This presentation will offer a few techniques that may be helpful in reducing problem behavior and teaching functional alternative behaviors across time.

• Attempting to use behavior analytic techniques without supervision from a behavior analyst may not produce intended results, and in some cases, may result in a worsening of problem behavior.• In order to prevent this, suggestions from this presentation may be general and limited in scope.

• Pursue behavior analytic services if maladaptive behaviors are pervasive and/or intense.

ABA RESOURCES NEARBY

• St. Gerard House• https://www.stgerardhouse.org/

• Access Family Services• https://www.accessfamilyservices.com/

• WNC Best• http://www.wncbest.org/index.php?id=asheville-autism-treatment

• Autism Society• https://www.autismsociety-nc.org/clinical-services/

GENERAL CONSIDERATIONS

• Behavior change is a process, not a procedure.

• Strategies work best when everyone involved is part of the same team.

WHY DOES CHALLENGING BEHAVIOR HAPPEN?

• Challenging behavior serves a function for that individual.

• In many cases, problem behavior is a form of communication.

• The individual might not know how to change their behavior.

WHY DOES CHALLENGING BEHAVIOR HAPPEN?

WHY DOES CHALLENGING BEHAVIOR HAPPEN?

• In order to help us figure out the function, we have to look at the ABC’s.

• A = Antecedent

• What occurs directly before the behavior.

• B = Behavior

• Observable action

• C = Consequence

• What occurs directly after the behavior

WHY DOES CHALLENGING BEHAVIOR HAPPEN?

• Example

• Thoughts on the functions of this behavior?• Perhaps… escape from social situations

AntecedentMom asks child to say hi to a family friend.

BehaviorChild screams and punches

mom

ConsequenceChild is put in time out

WHY DOES CHALLENGING BEHAVIOR HAPPEN?

• Example

• Thoughts on the functions of this behavior?• Perhaps… sensory

AntecedentNo

interaction.

BehaviorChild is picking

as skin.

ConsequenceNo

interaction.

WHY DOES CHALLENGING BEHAVIOR HAPPEN?

• Example

• Thoughts on the functions of this behavior?• Perhaps… access to attention.

AntecedentDad is on the

phone.

BehaviorChild dumps box of cereal

on the ground.

ConsequenceDad

reprimands child.

WHY DOES CHALLENGING BEHAVIOR HAPPEN?

• Example

• Thoughts on the function if this behavior?• Perhaps… escape from going to bed and access to video games

AntecedentAsked to stop playing video

games and go to bed

BehaviorChild yells and

cries

ConsequenceProvided with

10 more minutes to

play.

WHY DOES CHALLENGING BEHAVIOR HAPPEN?

• Example

• Thoughts on the function if this behavior?• Perhaps… access to cookies

AntecedentSister holding a

cookie.

BehaviorChild hits head

and cries

ConsequenceSister gives student a cookie.

NOW WHAT????

• Let’s take a proactive approach.

FUNCTIONAL ALTERNATIVE BEHAVIORS

• Functional alternative behaviors consist of appropriate behaviors that can accomplish the same or similar outcome of the problem behavior.

• Functional alternative behaviors may need to be taught.

• These behaviors should be easy for the person to learn.

FUNCTIONAL ALTERNATIVE BEHAVIORS

• Example

AntecedentSister holding a

cookie.

Problem Behavior

Child hits head and cries.

ConsequenceSister gives

child a cookie

Functional Alternative Behavior

Child uses the ASLsign for “cookie”

Consequence

Sister gives child a cookie

REINFORCEMENT!!!!

• An item or event that occurs after a behavior, which increases the chance the behavior will happen again in the future.

• Things that might function as reinforcement…

• Rewards (e.g. candy, toys, video games, etc.)

• Specific social praise (e.g. “You are so good at cleaning up your toys!”)

• Be careful!!! Sometimes unexpected things function as reinforcement

• Examples:

• Reprimands

• Time out

REINFORCEMENT!!!

• “Catch me being good!”

A PROACTIVE APPROACH TO ADDRESSING CHALLENGING BEHAVIOR

• Anticipate behaviors before they happen…

• Make a list of common antecedents to problem behavior.

• Select functional alternative behaviors to teach.

• Develop a plan…

DEVELOPING A PLAN OF ACTION

• Lay out exactly what your expectations are for the learner. These should include…

• Exactly what behaviors you would like to see under specific circumstances (e.g. functional alternatives).

• What will happen if the child meets those expectations (i.e. reinforcement).

• If the child has a strong verbal repertoire, explain expectations to them frequently and ahead of time.

DEVELOPING A PLAN OF ACTION

• Decide what you are going to do if challenging behaviors occur.

DEVELOPING A PLAN OF ACTION

• Behavior Contracts

• Consists of a document that outlines expectations and rewards that the child agrees to and signs.

• Key components include a description of the task, a description of the reward, and a task record (Cooper et al. 2007, pp 551-552).

• Is only useful for individuals with an advanced verbal repertoire.

DEVELOPING A PLAN OF ACTION

Behavior Contract Sample

• https://latitudes.org/behavior-contract-spiderman-style/

DEVELOPING A PLAN OF ACTION

• Behavior Contract Task Record

• https://www.pinterest.com/nbelmonte8/behavior-chart-preschool/

IF CHALLENGING BEHAVIOR OCCURS

• Specific suggestions regarding how to respond to problem behavior may require a formal and ongoing professional relationship with a BCBA.

• However… here are some general strategies.

IF CHALLENGING BEHAVIOR OCCURS

• Some things to remember…• Stay calm. You planned for this and it will not last forever.

• Use clear and concise language.• Stick to your plan.

• Some things to avoid…• Arguing/yelling

• Excessively repeating yourself• Bribing• Empty threats

• Use of unplanned punishment

BRIBERY VS. REINFORCEMENT

• Good use of reinforcement involves laying the expectation out ahead of time and only providing that reinforcer when the expected behavior occurs.• Example: “If you can walk next to me quietly the entire time we are in the grocery store, I’ll

buy you a toy on our way out.”

• Should always be in the best interest of the child.

• Bribery involves offering a reward or reinforcer after a problem behavior has already occurred in order to get the person to stop.• Example: “I’ll buy you a toy if you stop crying.”

• May involve a malicious intent.

PUNISHMENT

• Potential side effects of punishment include… (Cooper, Heron, & Heward, 2007, pp. 336-338)• Counter control: immediate or delayed

attempts to retaliate.

• Emotional responding: examples – crying, aggression, etc.

• Diminished self esteem

• Modeling the punisher

• Avoiding the punisher

PUNISHMENT

• Be careful…

• Punishment can addictive.

AFTER A MELTDOWN IS OVER

• Wait… sometimes when we think it’s over, the child needs a little more time.

• Avoid holding a grudge.

• Start with very easy instructions to assess if they are ready for more challenging instructions.

• When they listen, give them a little praise. The more they listen, the more you should reinforce.

• If they have been calm for a while, it may be a good time to review what happened and plan for next time.

DATA COLLECTION

• Data is important!

• Be honest and objective.

• Describe what you observed.

• There are lots of different options...

DATA COLLECTION

• Data collection options• Describe what happened.

• Example: aggression, property destruction, crying, ect.

• Document how long it occurred.

• Example: started screaming at 7:45 am. Stopped screaming at 8:00 am.

• Rate how intense it was

• Example: 1-5 scale

DATA COLLECTION

• Data collection options• Resources available at... http://www.behaviorguy.com/For_Parents.html

DATA COLLECTION

• Use data to make decisions about what is working and what isn’t.

FINAL THOUGHTS

• Changing behavior is easier said than done!

• Pursue professional help if necessary and/or possible.

• Using effective practices to help a child with difficult behavior is an act of caring and love.

DISCUSSION