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• Getting good
stuff (reinforcement)
• Avoiding bad s=
tuff
(negative reinforcement)
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=
How is
this like language? What is Jacob saying =
by
crying and throwing himself on the floor? =
=
How
about “Can I have five more minutes Mom?”
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1. Try to get i=
t in
an appropriate way
2. Try to get i=
t in
an inappropriate way
2. Don’t =
give
them what they want for destructive behavior
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Slide 1
Slide 1
Click to edit Master text styles
Second level
Third level
Fourth level
Fifth level
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=
;
Autism & Challenging &nbs=
p;
=
;
Behaviours
=
Designing Effective Treatments: Latest <=
span
lang=3DEN-AU style=3D'font-family:"Arial Black";font-size:167%;color:#3333=
99;
mso-color-index:5'>Trends in Functional Behavior =
Assessment & Intervention
Rachel S. F. Tarbox, Ph=
D
Center for Autism and R=
elated
Disorders
Challenging Beha=
vior
=
•My name is Rachel Tarbox
•I am the co-director of Research a=
nd Development
at CARD
•We serve almost one thousand kids =
with
autism around the world, one child at a time
•My job: do research on how to fix =
real
problems with real kids; problems that involve behavior
in some way
Introductions
Challenging Beha=
vior
=
•How many parents of kids affected =
by
autism or some other developmental disability in the audience?
•How many professionals who work wi=
th
affected kids?
•How many people who have had
experience with some kind of behavior problem they wish they could
fix?
•Why am I here today? Because most =
you
are on the front lines, everyday
Introductions
Challenging Beha=
vior
=
•This talk is
designed to be of some practical use to you, so I encourage yo=
u to
participate
<=
span
style=3D'mso-special-format:bullet;color:#333399;mso-color-index:5;positio=
n:
absolute;left:-7.57%;top:-.3em;font-size:150%'>•Note cards=
3;
•Describe in o=
ne
or two very informal sentences a problem that you might ha=
ve
questions about
•Include your
first name if you want to discuss the problem in front of the
group
<=
span
style=3D'mso-special-format:bullet;color:#333399;mso-color-index:5;positio=
n:
absolute;left:-7.57%;top:-.3em;font-size:150%'>•This is, of
course, totally optional
•I will try to=
get
to all the questions that people have
Your input
Challenging Beha=
vior
•It’s anything anyone does:
<=
span
style=3D'mso-special-format:bullet;color:#333399;mso-color-index:5;positio=
n:
absolute;left:-3.87%;top:-.3em;font-size:150%'>•Good
<=
span
style=3D'mso-special-format:bullet;color:#333399;mso-color-index:5;positio=
n:
absolute;left:-3.87%;top:-.3em;font-size:150%'>•Bad
<=
span
style=3D'mso-special-format:bullet;color:#333399;mso-color-index:5;positio=
n:
absolute;left:-3.87%;top:-.3em;font-size:150%'>•Neutral
<=
/span>
•Today I’m going to talk about
your children’s behavior that makes his/her life and=
/or
the life of his/her family more difficult and less
fulfilling
•Also going to review what a Functi=
onal
Behavior Assessment is and talk about some new
developments
Let’s begin: What is behavior?
Challenging Beha=
vior
=
•My training is in behavioral psychology, specifica=
lly Applied Behavior Analysis, or ABA
<=
span
style=3D'font-size:86%'>=
•Areas within ABA you may have heard of:
•Positive
behavioral support (PBS)
•Discrete
trial training (DTT)
•Verbal
behavior analysis (VBA)
•Pivotal
response training (PRT)
•Natural
environment training (NET)
•Natural
language paradigm (NLP)
=
•These are all based on the same basic principles o=
f learning and motivation which come from the same <=
/span>body of scientific research
<=
span
style=3D'font-size:86%'>=
•ABA includes all of these
What’s my perspective?
Challenging Beha=
vior
=
•Restraint
•Aversives
•Seclusion
•First priority with your children:
service providers cannot do anything you don’t wan=
t them
to do. Know your rights and demand to know what is being done w=
ith
your child
•Practitioners: you are legally
required to provide the most effective treatment for a
child
Intrusive procedures
Challenging Beha=
vior
=
•We don’t use aversives, restraints, or
seclusion
•If a child is going to actually hurt him/herself o=
r someone else =
right
now, service providers have a responsibility
to protect the child
•But this has to be a temporary emergency procedure=
•So, if your child is being restrained on a regular
basis, and the number of
restraints being implemented is not decreasing,
then his/her behavior plan is not
working
•Demand that your child’s school or other ser=
vice provider reassess what they are doing
<=
/span>
•
•
•
CARD’s position on intrusive procedures=
Challenging Beha=
vior
•Just about all the reasons can be
explained as either:
•It’s basically a way of tell=
ing
you what they want
•They may not know or may not care =
that
their way of telling you is not the “appropriate” way&#=
13;
•Kids with developmental disorders =
may
not have the language to ask for what they want
Why do kids do stuff they aren’t supposed to
do?
Challenging Beha=
vior
Example: avoidin=
g bad
stuff
Jac=
ob hates
baths. Parent says “Time=
to <=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>tak=
e a
bath”
Jac=
ob cries
and throws himself on <=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>the=
floor
Jac=
ob gets =
to =
avoid
the bath for five more =
=
min=
utes
Challenging Beha=
vior
•
Example:
getting good stuff
§
§
Jen=
ny is =
pla=
ying
with her favorite toy. Parent =
=
says
“okay, time to put <=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>awa=
y the
toy”
Jen=
ny
starts whining
Par=
ent lets
Jenny have the toy a <=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>lit=
tle
longer
=
How is
this like language? What is Jenny saying =
by
whining? How about “I don’t want to put my =
toy
away, can I play a little longer?”
Challenging Beha=
vior
•
Example:
getting good stuff AND avoiding bad stuff
§
§
Joh=
nny is =
pla=
ying
outside. Parent says =
=
220;Time
to come inside and =
cle=
an your <=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>roo=
m”
Joh=
nny runs
away
Joh=
nny gets
to play outside a =
lit=
tle
longer AND doesn’t =
hav=
e to
clean his room yet
=
How is
this like language? What is Johnny saying =
by
running away? How about “I want to keep =
playing
AND I don’t want to clean my room”
Challenging Beha=
vior
=
•I know from experience with my own two year old th=
at it works the same way for us parents
=
•The way that we interact with our kids either help=
s us get good stuff or avoid bad stuff
<=
span
style=3D'font-size:86%'>=
•What can be good stuff for parents?
•Seeing
your kid happy
•Some
time to rest
<=
span
style=3D'font-size:86%'>=
•What can be bad stuff for parents?
•Seeing
your kid unhappy
•Dealing
with problematic behavior (tantrums, etc.)
=
•Let’s have another look at the examples, but=
from
the parents’ po=
int of
view…
<=
span
style=3D'font-size:86%;visibility:hidden'>•
Parent behavior
Challenging Beha=
vior
Jac=
ob hates
baths. Parent says “Time=
to <=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>tak=
e a
bath”
Jac=
ob cries
and throws himself on <=
/span><=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>the=
floor
Par=
ent gets
to avoid Jacob crying <=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>and=
gets <=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>som=
e peace <=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>and=
quite
for five minutes by delaying =
<=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>bat=
h for
five minutes
Challenging Beha=
vior
Jen=
ny is =
pla=
ying
with her favorite toy. Parent =
=
says
“okay, time to put <=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>awa=
y the
toy”
Jen=
ny
starts whining
Par=
ent
avoids seeing Jenny unhappy by <=
/span>=
let=
ting
Jenny have the toy a little longer
Challenging Beha=
vior
Joh=
nny is =
pla=
ying
outside. Parent says =
=
220;Time
to come inside and =
cle=
an your <=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>roo=
m”
Joh=
nny runs
away
Par=
ent gets
to see Johnny have fun <=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>out=
side and
gets to avoid the
“fight” of chasing Johnny <=
/b><=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>and=
getting
him inside by not chasing him for =
<=
span
lang=3DEN-AU style=3D'font-size:133%;color:white;mso-color-index:0'>a w=
hile
Challenging Beha=
vior
=
•People do what they do because they get something =
they want or need out of it
•Would your child keep doing the problematic behavi=
or if he/she didn’t get what they want out of it
anymore?
•What if he/she was able to get what they want for =
doing something more appropriate?
•What if the appropriate behavior got them what the=
y want, and was easier than the problematic behavior?
=
•Let’s take a step back; how does Functional
Analysis fit into all of t=
his?
The take home point:
Functional Behav=
ior
Assessment
•Methods of identifying functional relations betwee=
n environmental variables and problem behavior
<=
/span>
•Functions:
•Positive reinforcement in the form of caregiver attention or tangible reinforcers
•Negative reinforcement in the form of escape from =
aversive events/stimuli
•Automatic Reinforcement
<=
span
style=3D'font-size:83%'>&se=
ct;positive (e.g., sensory stimulation)
<=
span
style=3D'font-size:83%'>&se=
ct;negative (e.g., pain attenuation)
•
•
What is it:
Then and Now
•The most common method
of controlling SIB, particularly in institutional settings,
is to restrain the subject totally or partially. Perhaps the most popular =
method
for suppressing SIB is application of a strong
aversive stimulus [electric shock] immediately contingent upon
the response.
§=
;Baumeister & Rollings, 1976
•Current best practice in the
treatment of SIB involves behavior management, pharmacological
intervention, or, more often than not, some combination
of these approaches [and] through these
approaches…SIB.. has often been decreased
dramatically.
•MRDDRR, 2001
Functional Behav=
ior
Assessment
=
•Indirect assessment
•Descriptive (naturalistic) assessment
•Analog assessments (experimental
functional analyses)
Methods:
Indirect Assessment
•Ratings scales used to interview caregivers regard=
ing the events surrounding the behavior
•Examples:&=
nbsp;
•Motivational Assessment Scale (Durand & Crimmi=
ns,
1988)
•Questions About Behavioral Function (Paclawskyj et=
al.,
2000, 2001)
•Functional Assessment Screening Tool (Iwata et al.,
1996)
•Easiest to conduct, but limited by faulty report,
limited options
Example: MAS
•16 items, 7-point Likert Scale (never - always)=
3;
•Sample Questions:
•Would this behavior occur continuo=
usly
if your child was left alone for long periods of time?
•Does the behavior occur when any
request is made of your child?
•Does the behavior occur when you s=
top
attending to him or her?
•Does the behavior occur when you t=
ake
away a favorite toy or food?
§
Descriptive Assessment
•Observations of behavior as they
naturally occur
•Code for relevant antecedents and =
consequences
surrounding the behavior
•Hypotheses based on conditional
probabilities
•e.g. what is the probability that =
the
behavior occurred given that a demand was issued
Analog Assessments
•Arrange conditions designed to
simulate natural circumstances that give rise to problem
behavior
•Compare rates of behavior in each
condition to a control condition devoid of the motivational =
variables
and consequences hypothesized to maintain behavior
=
•Using
single-case experimental designs
Review
•With any FBA we are looking at:
=
§What happens=
before
the problem behavior
§What happens=
after
the problem behavior
•Once we have determined this we can:
§Change what
happens before
§Change what
happens after
§Teach the ch=
ild
a new more appropriate way to get what they wanted in the f=
irst
place
Sample
Analog Assessment
(from
DeLeon, Arnold, Rodriguez-Catter, & Uy, 2003)
Function-based Treatment
•It
was determined that the problem behavior was maintained by attention
•So
what was happening before?
=
•Child
was being ignored
•What
happened after?
=
•Child
got attention
•What
do we need to do
•Gi=
ve
child enough attention before so it doesn’t happen
=
•But
if it does happen; do not give the child attention
•Al=
so,
teach the child a more appropriate way to get attention
Large-Scale Analyses
of Behavioral Function
of Behavioral Function
•Iwata et al. (1994), SIB only, data from two
settings
•n =3D 152
•83.4% for attention, escape from t=
ask
demands, and automatic reinforcement
•Kahng et al. (2002), SIB only, literature review&#=
13;
•n =3D 265, 1964 to 2000
•85.2 for social positive, social
negative, and automatic
•Kurtz, Chin, Huete, Tarbox, et al. (2003). Combine=
d behaviors, single setting
•n =3D 30, children under 5
•87.5% positive, negative, automati=
c,
or combined
When an FBA is u=
seful
=
•Timmy was an 8
year old boy with Asperger’s disorder with near-typical
language abilities
•Timmy had
recently begun throwing objects in the classroom &
Timmy’s teacher noticed that his classmates would laug=
h
•Timmy’s
teacher implemented a time-out procedure, and also provi=
ded
social praise when he was not throwing items
•Timmy’s
throwing increased in severity & frequency
=
Case study: Timmy throws objects in the <=
/span>classroom
Challenging Beha=
vior
=
•Why did Timmy throw items?
•To get his classmates to laugh?
<=
/div>
•If so, then putting Timmy in time-=
out
removes the attention of his classmates
•Also, by giving Timmy praise for n=
ot
throwing, the teacher is reinforcing a more appropriate behavior
•But, it’s not working
Case study: Timmy
Challenging Beha=
vior
=
<=
span
style=3D'mso-special-format:bullet;color:#333399;mso-color-index:5;positio=
n:
absolute;left:-8.27%;top:-.3em;font-size:150%'>•What did we
do?
<=
span
style=3D'mso-special-format:bullet;color:#333399;mso-color-index:5;positio=
n:
absolute;left:-8.27%;top:-.3em;font-size:150%'>•Conducted a
descriptive FBA
•Observed Timm=
y in
the classroom and systematically recorded what happened before the
behavior and what happened after the behavior
•90% of the time
Timmy threw items during academic demands
•100% of the t=
ime
Timmy’s friends laughed & Timmy was sent to time-ou=
t
Case study: Timmy
Challenging Beha=
vior
=
•It is more likely that Timmy was
throwing items for attention or to escape from work?
•By not conducting an FBA an
ineffective procedure was implemented and Timmy’s behavior
got worse
•Now that the function of the behav=
ior
had been identified it was possible to implement a function-based
treatment
Case study: Timmy
Challenging Beha=
vior
=
•Started by teaching Timmy to
appropriately ask for a break when academic demands were placed
(did this BEFORE the problem behavior occurred)
•Provided Timmy with social praise =
for appropriately
asking
•No longer allowed Timmy to escape =
from
work
•Then taught Timmy to appropriately=
ask
for help with academic demands
Case study: Timmy
Challenging Beha=
vior
=
•Did it work?
•Yes
•Timmy almost immediately stopped
throwing items
•Timmy started to ask for help
•Within 2 weeks Timmy was working <=
/span>independently
Case study: Timmy
Challenging Beha=
vior
=
•Okay, but was this actually practi=
cal
for the teacher?
•Yes and No
•More work was required upfront (it=
was
easier for the teacher to send Timmy to time-out and less
disruptive for his classmates)
•But over time, the teacher spent o=
ver
all MUCH LESS time addressing Timmy’s problem
behavior
Case study: Timmy
Challenging Beha=
vior
=
•Danny was a 25 year old man with autism and moderate mental retardation
•Danny hit others, spit, kicked, bit, banged his he=
ad against others, banged his head against the wall, =
scratched others, destroyed property, bit himself,=
hit himself, stripped, and urinated on the floor, all =
on a regular basis (every day)
•Danny could speak in two to three words sentences&=
#13;
•Danny lived in a group home and attended a worksho=
p during the day
•
•
•
•
Case study: Danny learning to communicate=
Challenging Beha=
vior
<=
span
style=3D'mso-special-format:bullet;color:#333399;mso-color-index:5;positio=
n:
absolute;left:-6.92%;top:-.3em;font-size:150%'>•Why did Danny=
do
all these destructive things?
•We didn’=
;t
know, so we did a Functional Behavioral Assessment (FBA)
•It turned out
that most of these behaviors got Danny two things:
=
•Escape
from work (avoiding bad stuff)
=
•Preferred
items from others (getting good stuff)
•Why did he ne=
ed
to be destructive? Because he didn’t know how to ask for
these things and when he did, his staff would often ignore him
=
;
<=
span
style=3D'visibility:hidden'>•
<=
span
style=3D'visibility:hidden'>•
<=
span
style=3D'visibility:hidden'>•
<=
span
style=3D'visibility:hidden'>•
Case study: Danny
Challenging Beha=
vior
=
•What did we do?
•Give him what he wants
•He has the right to have his prefe=
rred
items
•He has the right to a break from w=
ork
or help with work that is difficult
Case study: Danny
Challenging Beha=
vior
=
•We taught him=
to
ask for a break from work using sign language
•We trained his
staff to give him much more frequent access to preferred items s=
o he
wouldn’t feel the need to be destructive in order
to get it
<=
span
style=3D'mso-special-format:bullet;color:#333399;mso-color-index:5;positio=
n:
absolute;left:-7.7%;top:-.3em;font-size:150%'>•We tried to ig=
nore
his destructive behavior
•In summary,
destructive behavior =3D don’t get what you want, adaptive
behavior =3D get whatever you want
<=
span
style=3D'visibility:hidden'>•
<=
span
style=3D'visibility:hidden'>•
<=
span
style=3D'visibility:hidden'>•
<=
span
style=3D'visibility:hidden'>•
Case study: Danny
Challenging Beha=
vior
<=
span
style=3D'mso-special-format:bullet;color:#333399;mso-color-index:5;positio=
n:
absolute;left:-8.27%;top:-.3em;font-size:150%'>•Did it work?&=
#13;
<=
span
style=3D'mso-special-format:bullet;color:#333399;mso-color-index:5;positio=
n:
absolute;left:-8.27%;top:-.3em;font-size:150%'>•Yes
<=
span
style=3D'mso-special-format:bullet;color:#333399;mso-color-index:5;positio=
n:
absolute;left:-8.27%;top:-.3em;font-size:150%'>•Depended on s=
taff
consistency
=
•When
staff didn’t give him what he wanted, the behaviors would
return
=
•When
staff let him out of work when he did something destructive or
they didn’t give him a break when he asked for it, destruct=
ive
behavior returned
•When his beha=
vior
plan was implemented correctly, the destructive behaviors =
were
gone
<=
span
style=3D'visibility:hidden'>•
<=
span
style=3D'visibility:hidden'>•
<=
span
style=3D'visibility:hidden'>•
<=
span
style=3D'visibility:hidden'>•
<=
span
style=3D'visibility:hidden'>•
Case study: Danny
Challenging Beha=
vior
•Whenever a child wants something, he/she has two <=
/span>choices:
•Helping your child have appropriate behavior means=
making that choice easy for them by:
=
1.Give them wh=
at
they want for good behavior (conduct an FBA)
=
3.Make it EASY=
for
them to do the good behavior (take baby steps)
•
•
•
•
•
•
•
Recap
Challenging Beha=
vior
=
•“The kid should be do=
ing
it anyway because that’s how he is supposed to act. We
shouldn’t need to reward him for being good.”
•Yes, BUT, it doesn’t work ve=
ry
well to worry about what a child should be doing
•If you want to help the child chan=
ge
his/her behavior successfully, then you should be =
thinking
about what he/she is doing
Common objections to using rewards to teach <=
/b>adaptive behavior
Challenging Beha=
vior
=
•“If we reward him for doing something good, =
then
it will ruin his internal
motivation for doing it.” (the “over-justification effect”)
•This objection doesn’t apply here because if=
your
child already had the
internal motivation to do the behavior you want them to, then they would already be doing
it
•Even more importantly, the approach we are talking=
about directly addresses the child’s internal
motivation – you teach=
them
a new way of getting what they wan=
t, not
artificially reward them with something else
•
•
•
•
•
•
Common objections to using rewards to teach <=
/b>adaptive behavior
Challenging Beha=
vior
=
•“This sounds too hard”
•Yes, this is hard
•But what is harder, fixing the pro=
blem
now, or dealing with the problem forever and never fixing
it?
•Fixing the problem now is harder in
the short term but is MUCH easier in the long term
Common objections to using rewards to teach <=
/b>adaptive behavior
Beyond
the “Standard” Functional Analysis
•“Attention-seeking, escape,
sensory reinforcement, and tangible events are key =
variables
in any analysis of problem behavior, but they are not the only
variables.” (Carr, 1994)
•“To date, efforts to design
functional assessment procedures have often focused on a
four-part taxonomy of the variables that maintain problem =
behavior
(tangible, attention, escape, automatic). In the future, I believe we will =
need =
to be
more specific about the stimuli that control problem
behaviors.” (Horner, 1994)
“Other”
Functional relations that are:
•Atypical: Maintaining variable is not
attention, tangible stimulus, escape from academic <=
span
style=3D'position:absolute;top:44.25%;left:9.73%;width:100.18%;height:6.0%=
'>demands,
or suspected automatic reinforcement
•
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