We've All Been There - The Public Meltdown

Have you ever found yourself in the cookie aisle with a screaming child looking around at all the other normal people (you know, the ones without kids) and think to yourself "What? That's not my kid!"  For a second you think about actually saying that phrase and walking away (c'mon, we've all been there).  But, of course, you can't walk away so you stand there, embarrased, pleading with your child and inevitably you give in just so the tantrum will STOP!  I see it happen at the grocery store ALL THE TIME!  It makes me cringe because I know that the same scenario will just happen again the next time.  I feel bad for the mom (or dad) and do my best to pretend like I didn't see anything so I don't add to their embarrassment.  So what are you supposed to do if you find yourself in this situation?  To spare yourself the embarrassment and nasty looks from those "normal people" I suggest you scoop up your child and walk right out of the store.  Will the tantrum continue?  OF COURSE because your child has not gotten what they wanted - those darn cookies!  What now?  This insomnia induced mini-post is about antecedent manipulations (i.e. what happens before the behavior) to avoid those tantrums in the future.

You are the walking, talking, breathing functional behavior assessor now and you need to assess the situation.  Review the data in your head:
Antecedent - You went down the cookie aisle, your child asked for oreos, you said "Not today."
Behavior - Your child screams "But I want cookies," and falls to the floor in an all out tantrum (screaming, kicking, crying)
Consequence - You left the store, or maybe you didn't but PLEASE tell me you didn't get him the cookies!       

The data tells us that the cookie aisle and you saying "no cookies" are the source of the problem.  So, you have some options:
A) Avoid the cookie aisle like the plague
B) Prepare your child by saying "We're going to go on the cookie aisle but we're not buying any today.  But if you are a good boy then when we get to the check-out line I'll get you a candy bar - or a soda, gum, tic tacs, whatever (reinforcement people!)
C) Why the heck did you bring that kid back to the grocery store?!  Oh sorry, I mean endure a tantrum (and the embarrassment) while you continue to shop
D) Go down the cookie aisle, throw some oreos at your child, and finish your shopping in peace

I hope you chose option B.  It was the only serious option.  And maybe next time you could bring some cookies in your purse.  'Cause sometimes a kid just needs a cookie:)

Let's develop a simple behavior plan...

So we last discussed that the first step before creating a behavior plan was to assess your child's behavior and take some data.  Behavior typically has 1 of 4 functions: attention, tangibles, escape, and sensory.  This week I'm going to create 3 sample behavior plans for a tantrum - one with the function of attention, one with the function of access to tangibles, and one with the function of escape from non-prefered activities.  These are very simplistic plans using only reinforcement and extinction. 

ATTENTION
Antecedent:  Mommy is cooking dinner in the kitchen.
Behavior:  Child comes into the kitchen and begins tugging on mommy's leg.  When mommy doesn't attend the child begins crying then falls to the floor kicking.   
Consequence:  Mommy stops cooking dinner and picks the child up saying "stop crying".   
Result:  The child stops crying. 
Function:  The child's tantrum successfully gained mommy's attention - both in the form of acknowledging the behavior "stop crying" and in the form of mommy stopping her current activity to pick up the child.
Plan of action:  First, decide on a replacement behavior.  For instance, the child wanted to be picked up so you may teach the word "up".  Try to do this during play time when the child is happy and not engaging in tantrum behaviors.  Tell the child to say "up" and immediately pick the child up to reinforce that behavior.  Practice this several times.  For young toddlers, their closest approximation may be "uh".  Next, when the child engages in tantrum behavior to gain your attention you should apply extinction - meaning that if the child wants attention then you do not provide any attention and do not pick the child up.  When the child becomes calm, prompt the child to say "up" and immediately reinforce this behavior. 

TANGIBLE
Antecedent:  Sister is playing with a toy that brother wants to play with.
Behavior:  Brother tries to take the toy away, unsuccessfully.  Then the brother begins to cry and hit his sister.
Consequence:  The sister gives the toy to her brother.
Result:  Brother's tantrum stops and he begins to play with the toy.
Function:  The child's tantrum successfully gained access to the toy (tangible).
Plan of action:  First, decide on a replacement behavior.  For instance, the child wanted the toy from his sister so you may teach the child to ask his sister to "share" or to say "please".  Again, try to do this when the child is engaging in appropriate behaviors and having fun, not when the child is in the middle of a tantrum.  Prompt the child to say the key word then immediately reinforce that behavior.  It helps if the other child is willing to do this but if not then mommy or daddy can share the toy.  Next, when the child engages in the snatching away and tantrum behavior to get access to a toy apply extinction - meaning DO NOT allow the child to have the toy.  When the child becomes calm, prompt the child to say the key words - "share" or "please" - and immediately reinforce the behavior.  Thank the child for asking nicely and have the other child share the toy.

ESCAPE
Antecedent:  Daddy says "time to do homework".
Behavior:  The child immediately says "No" and begins throwing toys, crying, and kicking.
Consequence:  Daddy says that we can do homework later. 
Result:  The child's tantrum stops and he continues to play with his toys. 
Function:  The child's tantrum behavior successfully earned escape from the homework activity plus the child continued to engage in the preferred play activity. 
Plan of action:  First, teach the child a replacement behavior.  For instance, the child did not want to do homework and wanted to continue playing so you may teach the child to ask for "5 more minutes, please".  This may not be acceptable in all situations but it is important that the child learns that sometimes you can delay non-preferred tasks.  It also leads us to preparing the child before transition.  It often helps to tell a child "In 5 more minutes, we're going to do homework", then "One more minute", and finally a 10 second countdown before putting away the toys and doing homework.  When the child engages in the tantrum behavior when told "time to do homework" you should apply extinction - meaning do not let the child escape doing his homework.  Hold the demand and put away the toys.  Inevitably the child will continue to tantrum and it will be impossible to do the homework under this circumstance.  This is why it is important to clean up the toys so that while the child is temporarily escaping homework, he does not have access to fun activities.  When the child becomes calm, prompt the child through the homework activity reminding them that when it is done he may go play.  "First homework, then play." 

Keep voting for the next topic: tantrums, diets, or eat your veggies!

The Good Behavior Game

For the teachers out there:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1310853/pdf/jaba00065-0063.pdf

This is a research article describing the "Good Behavior Game".  Basically you divide your classroom into teams.  Set specific rules and when any rule is broken by a single student their group recieves a point.  The group with the least points at the end of the day gets a reward.  If multiple groups have the same number of points then both groups get the reward.  It sounds very interesting!  The rewards can be pretty simple:  going to recess a little earlier than the other group, a special project, class helpers, etc.

So you've taken the data...now what?

Once you take some anecdotal ABC data you need to carefully look over the information.  What are you looking for exactly?  Consistencies and recurring themes.  For example, if your child always has a tantrum in a room full of people, chances are that room full of people is likely aversive (i.e. not pleasant).  When you move away from that crowd of people, does your child consistently stop tantruming?  Your child has just escaped an aversive stimulus (large crowd) and his tantrum behavior has been reinforced (i.e. it will likely occur again under the same set of circumstances).  Remember, one common function of behavior is escape (from homework, chores, people, etc).

Here is an example of what ABC data might look like:

Antecedent

Mommy says "time to put away the toys" 

Behavior

Child has a tantrum, crying, yelling "no", throwing toys     

Consequence        

Mommy says "okay, 5 more minutes to play"

What just happened?  Your child's tantrum stopped - success, right?  Not so!  Your child's tantrum behavior has just been reinforced and the next time you ask him to clean up his toys, he will tantrum again because he has learned that when he tantrums you will then allow him more time to play.  The function here is access to tangibles (i.e. toys) or it may be escape/delay of whatever activity comes next.  Here's what should happen: 

Antecedent

Mommy says "time to put away the toys" 

Behavior

Child has a tantrum, crying, yelling "no", throwing toys     

Consequence        

Mommy repeats the demand "time to put away the toys" and prompts the child through the task until complete. 

Did your child continue to tantrum?  Probably so.  Did the toys get put away?  Yes, though you may have helped your child by putting toys into his hand and moving them to the toy box.  Success?  YES!  Will your child tantrum the next time you ask him to put away the toys?  Well, that depends on how long his tantrum behavior has been reinforced.  Remember that extinction burst - where behavior may get worse before it gets better?  Just be consistent - keep the demand.  Eventually you won't have to help your child clean up.  Eventually your child won't complain while they clean up.  Eventually your child will comply with your demand to clean up the first time you ask.  

ABA is no easy task.  It is time consuming, it requires you to constantly assess your child's behavior, it is sometimes difficult to be consistent between parents and teachers.  The list goes on and on.  Is it worth it?  DEFINITELY!  I've seen these strategies work with toddlers, preschoolers, young children, teenagers, and adults.  I've seen these strategies work with children with special needs, children with attention deficit disorder and typically functioning children.  I've used these strategies with my dogs, my toddler, my husband, my coworkers, and that rude cashier at the grocery store.  ABA is an invaluable tool in everyone's life!        

Functional Behavioral Assessment and The ABCs of Behavior

The ABCs of behavior, often refered to as the "three term contingency" are the Antecedents, Behaviors, and Consequences.  Antecedents are what occurs before the behavior.  Behaviors can be described by topography (what it looks like) and function (the maintaining consequence).  Consequences are what occur after the behavior.  Maintaining consequences are those that reinforce the behavior (i.e. increase the future probability of that behavior’s occurrence).  We have to look at each of these things in order to determine our plan of action for getting rid of unwanted behavior. 

If your child is engaging in a behavior that you would like to decrease, the first step is to define the behavior so that everytime you, your husband, your child's teacher, and anyone else involved sees that behavior you can all agree that it happened.  For sake of consistency, I will continue with the example of my daughter.  She "hangs on my leg and whines" when she wants me to pick her up.  What I really mean is that she wraps her arms around my leg and makes an unintelligible crying sound without producing tears.  I have just defined the behavior according to topography (what it looks like).  I have determined the function of that behavior to be attention - specifically for me to pick her up. 

Behavior typically has 1 of 4 functions: access to tangibles (toys, food, etc.), escape (from homework, chores, people, etc.), attention (including when you sigh out of frustration - yes some kids like to get under your skin), and sensory (the behavior appeals to one of their senses - sight, sound, touch, taste, smell).  To determine the function we should implement a functional behavioral assessment (FBA).  Start with collecting anecdotal data on the behavior.  When an unwanted behavior occurs, write down exactly what happened before it, no matter how small or insignificant it may seem.  You should also write down exactly what the behavior looked like and anything that happened after the behavior.  This will include naturally occuring consequences and anything that you or others did.     

Keep in mind - sometimes a behavior may have the same topography but a different function depending on the environment.  Think in terms of a baby (i.e. my 15 month old).  She has limited communication and sometimes when she hangs on my leg and whines it means "pick me up and hold me" but other times it means "Mommy, I'm really tired and want to escape all this interaction".  She has not yet learned to say "night night" so she resorts to the only communication she knows.  It's important to always assess the environment to determine the function of a behavior.  YOU should be a walking, talking, breathing functional behavior assessor.   

Reinforcement (and other stuff)

Reinforcement is one of the most important principles of behavior and is a key element to behavior change programs.  The addition of a stimulus following a behavior that serves to increase the likelihood of that behavior is termed positive reinforcement. The removal of a stimulus following a behavior that serves to increase the likelihood of that behavior is termed negative reinforcement.  In short, when a behavior is reinforced (either positively or negatively) then the behavior occurs more often.  This is not always a good thing.  We frequently and inadvertently reinforce problem behaviors.  For example, when my daughter hangs on my leg and whines I usually pick her up.  Do I want my daughter to hang on my leg and whine? NO!  But I have just effectively reinforced that behavior because what she wanted was for me to pick her up.  Now, she is only 15 months old and I can't expect too much; however, she is learning to say "up" and this is the behavior I should be reinforcing.  So what should I do?  Well, that leads us to the next principle of behavior: extinction.

Extinction is the technical term to describe the procedure of withholding/discontinuing reinforcement of a previously reinforced behavior, resulting in the decrease of that behavior.  In the example above, when my daughter hangs on my leg and whines, the reinforcement for that behavior was picking her up.  Instead, I should use extinction - meaning that when she does this behavior I should not pick her up.  If she does not recieve reinforcement (picking her up) when she engages in the hanging and whining behavior then she will eventually stop that behavior.  It's important to remember 2 things:  First, when you extinguish a behavior you must provide/teach an alternative behavior.  I have taught my daughter to request "up" which provides her the same reinforcement (i.e. picking her up).  Second, the extinguished behavior is most likely going to get worse (i.e. occur more often) before it gets better.  This is called an extinction burst.  Be consistent (i.e. NEVER reinforce the behavior) and the behavior will eventually decline and even stop completely.  If you find yourself occasionally reinforcing the behavior, do not fret!  It does not mean you have failed and it does not mean that you cannot continue using extinction.  It just means it may take a little longer to get rid of the behavior until you can train yourself to stop reinforcing the behavior you don't want to see.  

Sometimes reinforcement and extinction just aren't enough.  When you find yourself in this situation, it often leads to the use of the least desirable behavior principle: punishment.  The addition of a stimulus following a behavior that serves to decrease the likelihood of that behavior is termed positive punishment. The removal of a stimulus following a behavior that serves to decrease the likelihood of that behavior is termed negative punishment.  In short, when a behavior is punished (either positively or negatively) then the behavior occurs less often.  Punishment gets a bad rap for a lot of reasons.  Punishment can result in undesirable emotional responses, may cause escape and avoidance responses, and may lead to aggressive responses.  However, there are many advantages to using punishment: results are rapid, behavior that may be resistant to other forms or treatment may respond to punishment, there may be positive side effects such as generalization, and it may lead to complete suppression of the unwanted behavior.  With these things in mind, here is what you should consider before using punishment:  use only after other less restrictive procedures have failed, punishment is more easily justified when the behavior can cause injury (to themselves or others), and it may be necessary when the behavior is maintained by strong reinforcers that we cannot control.  To use punishment effectly you must punish EVERY instance of the behavior immediately, when possible provide instructions about the contingencies (i.e. when you do this then this will happen), and identify appropriate alternative behaviors and reinforce them if they occur.  In the example above, if I were to use punishment to decrease my daughter's hanging and whining behavior I might add a firm "No" whenever my daughter engages in that behavior.  Be careful - we adults often think of the word "no" as an aversive (i.e. something we don't like); however, many children will see this as a form of attention to their behavior which is often HIGHLY reinforcing.  It is often hard to determine exactly what is reinforcing an unwanted behavior.  And with that comes the next post: Functional Behavioral Assessment and The ABCs of Behavior.  Stay tuned...  

What is Behavior?

Behavior is the activity of living organisms - the interaction between an organism and its environment. Human behavior includes those that we cannot directly see - thinking and feeling.  If you're unsure whether or not something is a "behavior" then you should apply the "Dead Man's test":  If a dead man can do it, it's not behavior. And if a dead man can't do it, then it is behavior. 

Behavior can be thought of in two ways: operant and respondent behavior.  In short, operant behavior "operates" on the environment and respondent behavior is "in response" to an environmental stimulus.  In order for a respondent behavior to occur, some environmental change must happen first.  For example, when I open a jar of jalepenos and get a whiff (environmental change), my salivary glands go crazy (respondent behavior).  In essence, a respondent behavior is a reflex.  When an operant behavior occurs, a change in the environment happens after the behavior occurs.  For example, when my daughter says "done" (operant behavior) at the dinner table, I remove her dinner plate (environmental change).

Behavior Analysis deals with both operant and respondent behavior; however, applied behavior analysis is most often concerned with operant behavior and this will be the focus of my blog.

What is Applied Behavior Analysis (ABA)?

Applied Behavior Analysis (ABA) is best known for it's use in the treatment of people with developmental disabilities, namely Autism Spectrum Disorders.  What is less known is that ABA contributes to a variety of settings including: education, health and exercise, care and training of animals, industrial safety, organizational management, parenting, and much more. 

Applied Behavior Analysis is defined as the science in which the principles of the analysis of behavior are applied systematically to improve socially significant behavior, and in which experimentation is used to identify the variables responsible for change in behavior. 

What you need to know about ABA is this:

ABA is a science.  

ABA involves assessing the relationship between a behavior and the environment.

The methods of ABA can be used to change behavior.

  

If you like all the technical jargon, history, and reading lots of words I suggest:  http://en.wikipedia.org/wiki/Applied_behavior_analysis.