What Do We Tell the Kids?

Taking a moment to just pause and remember that fateful day.  This morning on The View, Elisabeth Hasselbeck wondered what to tell the kids about 9/11.  Her 7 year old daughter asked her why we remember 9/11.  Elisabeth told her that some bad people tried to take our freedom.  To which her daughter replied "Did they?"  Elisabeth's answer: "No, and they never will."

So, what do we tell our kids?  I have yet to really experience this.  As a preschool teacher, we danced around the topic telling our students that we celebrate that our country came together as one big family in a time of tragedy and we appreciate all the people that keep our country safe.  For us, it was our responsibility to get the topic in their heads, but their parents might want to be the ones to explain the tragedy in their own words.  My own daughter is nearly 2 and we have a while before she asks these questions.  But, it got me thinking about other difficult life experiences and what we will teach her about them - death, war, violence.  It's all so complex.  There are things you just want to protect your children from in order to hold on to their innocence as best you can.  Nurture, protect, educate, and worry.  Such is the life of a parent.       

My First Book Review!

First, let me say I am flattered that anyone would ask me to review a book and blog about it.  I mean, I'm just a mom with a blogging hobby.  I'm no Heather "Dooce" Armstrong with 1.5M Twitter followers.  Second, it was kinda fun to review a book!  Third, I'm still amazed at the connections you can make in the world through social media.  Exploring these connections through the blogging world is proving to be very enjoyable!  With that said, this post has nothing to do with ABA, but it does have to do with our children.  Lillie LOVES to read books every night at bedtime.  She'll pick book after book after book until we finally say "Last one, time to get in bed".  I've really enjoyed reliving my old children's books as well as exploring some new favorites with my daughter.   

This week Marta Cappa sent me one of the acts from her Stories from Slumber Village book titled "The Best Grandma in the World".  It was, of course, about becoming the best grandma.  At first glance I wasn't in love with the illustrations.  I wasn't quite sure what exactly the characters were.  I assumed they were cats as they had whiskers.  My daughter assumed the same.  As usual she asks "what's that?" to which I replied "I don't know?"  "Kitties?"  So we did a little poking around at Slumber Village and guess what?  They're guinea pigs!  Now THAT's a character you don't see everyday!  We also find out the illustrations are watercolor.  Also something you don't see everyday.  Pretty unique but somehow less appealing than the illustrations of the stories we typically read.   As I continued to read the story, the illustrations didn't much matter.  The story was heartwarming.  Initially the book spoke to me more as a parent and future (way WAY in the future, God willing and supposing my daughter takes a path to motherhood) grandparent.  I wondered if my own parents (first time grandparents) felt these same emotions as they became more than just Mom and Dad but Nana, Grampa, and Granny.

Let me tell you about the story.  Bonny Pea was anxiously awaiting a call from the doctor.  He promised to let her know when he had a grandbaby for her to hold.  But she didnt yet know how to be a grandmother.  She didnt want to be just any ol' grandmother.  She wanted to be the best.  So with the help of her friends they tried to find all the qualities of a really great grandmother.  But poor Bonnie Pea just didn't measure up.  Before they could even come up with her very own special grandmother name the doctor calls.  Oh no, shes not ready!  As they visit the baby in the hospital, Grandmother Pea finally receives her special name.  You'll have to read the book to find out how.  I wonder if Bonnie ever figured out her special grandma talent? 

You can find out more about Marta Cappa and her Stories from Slumber Village here.  Grandparents day is Sunday, September 9th.  Why not purchase this heartwarming story for the grandparents in your life?! 

A Behavior Plan for Myself

I'm on a weight loss journey - one that I hope to be the ultimate success for me.  If ABA works for our kids, our husbands, and our pets, then why not for ourselves?  The key ingredients for my behavior plan include reinforcement and shaping.  First of all, I HATE exercise and I LOVE food!  I'm a tv watching, sugar/carb/fat consuming, self-proclaimed couch potato.  To make this work, I need to fix this love-hate relationship.  I need to make exercise fun and reward myself for participation.  I need to train myself to use food for nurishment and punish overindulgence.

I have learned from past attempts that I cannot use food as a reinforcer and I cannot use exercise as a punisher.  I used to reward myself for exercise and diet by indulging in favorite foods.  In order for that to work, I had to abstain for those foods until I met whatever requirement to earn it.  The problem with that is when I abstain from favorite foods, I tend to overindulge (once I start I can't stop).  Also, food reinforcement is notoriously bad news and often leads to weight gain - not the direction I need to go. 
I also used to use exercise as punishment for not exercising (i.e. instead of the planned 30 minutes I would do an hour).  The problem with using exercise as a punishment is that I will continue to view exercise as a punisher (i.e. aversive).  This is exactly the relationship I am trying to change!  I want to enjoy exercise not hate it.

So how will I change my relationship with food and exercise?  Starting with exercise - the key to enjoying something is to pair it with something you already enjoy.  For example, spending time with my daughter is enjoyable and she enjoys active activities (neighborhood walks, bike riding, dancing, and the playground).  My goal is to work in one of these activities on a daily basis.  I will also begin the Slim in 6 series, which uses shaping to get you exercising.  The series has "Start It Up", "Ramp It Up", and "Burn It Up".  The workouts get progressively longer, more involved, and higher intensity.  Hopefully starting slow will make it less likely for me to give up before I start seeing weight loss results.  My relationship with food is already changing.  I have made small changes to eat healthier for as many meals as possible during the day, indulging when I crave it but not overdoing it.  Keeping track of my calories and sugar intake on a food diary helps greatly!

I'm starting with small goals and will reward myself for meeting those goals.  My ultimate goal is to lose 30 pounds, engage in at least 1 hour of exercise daily, and eat 3 well balanced meals (and a small snack) including appropriate portions following the USDA food pyramid guidelines.  My initial goals are to eat healthier alternatives for at least one of three meals, exercise 30 minutes daily, and lose 5 lbs.

*Since April 2012 I have lost 10lbs by using a food diary to track my sugar and calorie intake.  I'm now commited and upping the ante to include an exercise program "Slim in 6" and an "eating clean" diet plan to lose 20lbs.  You can follow my journey here.

Adventures in Toddler Potty Training - Revisited

A while back, we attempted to begin potty training with our then 16 month old daughter.  We had big girl panties, a potty chair, chocolate candy reinforcers, and a strategy (a modified positive practice method).  Our girl had been interested in sitting on the potty for months and going into the bathroom with mommy so we finally decided to crack down and get started with a potty training method.  Unfortunately, she quickly lost interest and began saying "NOOOOOO" everytime we prompted potty.  Not wanting to push the issue too much as to make the potty aversive (and thinking maybe she's just not ready) we discontinued.  We attempted again several weeks later and again several weeks after that.  Still no luck.  All of a sudden our now 23 month old started requesting panties and the potty.  Since SHE is the one who initiated this time, we figured we'd try again.  This time we took a more relaxed approach.  While wearing panties, we just let accidents happen and took her to sit on the potty when they did.  Her potty was wherever she was playing at the time so her activities were close by and she could continue to play (to an extent) while on the potty.  Within the first week she was requesting potty independently, holding it in until getting to the potty, and urinating in the potty seat.  Of course, we went through several outfit changes, loads of laundry, and paper towels along the way.  Then, a turn for the worse!  She started holding it in ALL DAY LONG, despite the amount of liquid she was consuming and despite wearing a diaper at naptime.  We worried that she would develop an infection if she didn't go so we resorted to (rather unpleasantly) placing her in the bathtub in order to get her to go and then placing her on the potty to finish.  She screamed!  She was so mad that we put her in the tub (I think she knew that it would make her go).  I don't know if it was a "fear" or a "control" thing for her.  Now she doesn't want to take baths at all.  NOW WHAT?!  It's a full on tantrum to sit on the potty or to get in the bathtub.  Nothing but the bathtub will "make" her go potty.  Running water?  Tried that.  Playing in a water bucket while sitting on the potty? Tried that.  Loading her with liquids?  Tried that.  Going back to diapers?  Tried that.  "Bribing" with candy and stickers?  Withholding favorite activities?  Oh yeah, tried that!  She's a stubborn one, she is!  TODDLERS!!!!  She holds it all day until she either naps or goes to sleep for the night.  Now I'm asking YOUR advice?!!  See, professionals need advice too;)  We have discontinued potty training for now and it seems she's back to going in her diaper (sometimes).  Guess we'll start again soon.  She's physically ready and capable, but maybe emotionally or mentally not quite there yet.   

Sensory Seeking Behaviors

Thanks to a friend for the inspiration on this one.  Just last week someone asked why their child was chewing on fabric.  We forget that our "neurotypical" children engage in somewhat strange behaviors too.  Nail biting, sleeve chewing, nose picking, hair twirling, hair chewing, thumb sucking, teeth grinding, etc.  Oh the things our kids do!  Maybe YOU even do a few of these yourself!?  These behaviors can be classified as sensory seeking.  They are most likely automatically reinforcing - that is, the sensory stimulation received from engaging in these behaviors makes the behavior reinforcing in and of itself.  While these behaviors are relatively harmless and normal, it is bothersome to most parents.   So what can you do?  A) live with it and hope they outgrow it on their own B) punish it or C) teach them an alternative behavior. 

Are you hoping they will outgrow it?  I'm a 28 year old nail biter.  Apparently I didn't outgrow that one.  The problem with punishing such a behavior?  Well, you can't be with your child 24/7, right?  Remember how punishment works?  You have to punish EVERY instance of a behavior, otherwise the behavior is reinforced on an intermittent schedule (meaning every now and again).  Remember intermittent reinforcement is THE worst kind of reinforcement when you are trying to get rid of a behavior - it just makes the behavior stronger!  What's an "alternative behavior" you say?  Well, an alternative behavior is a behavior with which you want to replace the problem behavior.  It should be something that is incompatible with the problem behavior (meaning both behaviors can't occur at the same time), is equally as reinforcing as the problem behavior (in this case meaning it serves the same sensory function - touch, taste, smell, sight, sound), and that is an appropriate alternative (meaning a behavior that you can live with and that doesn't seem "strange" to society).  Of course, you can always chock it up to part of your child's unique personality;)  Everybody needs a little something to make them quirky, right?   

Help Support Individuals with Disabilities

Time is running out! Please support the DOJ settlement by writing a letter. I wrote one and now it's YOUR turn! Even if you do not live in Virginia, please support the disabilities community.

Dear Judge Gibney,

I am writing to you today on behalf of more than 7000 individuals with disabilities residing in Virginia, including approximately 1100 individuals residing in institutions and training centers and more than 6000 waiting for Medicaid waivers.  I would like to pose the following:  In the 21^st century, with as much research that has been done on the importance of community involvement, independent living, and employment opportunities for individuals with disabilities, why does Virginia have the 10^th largest institutionalized population in the nation? 

If we find it beneficial for our children to be served with their peers in the public schools, then why should we advocate for any less of adults with disabilities?  The children that we advocate for so passionately today will become the adults of tomorrow.  Unfortunately, these individuals are destined to end up on waiting lists that are too long and never receive the assistance they so desperately need. 

Individuals with disabilities have the right to access community settings and assistance to live in their own homes.  Sadly, it does not appear to be our state’s priority to move these individuals quickly from training centers to the community.  Segregating these individuals from their peers is a violation of their civil rights.  These individuals deserve housing and employment assistance in their communities.  Furthermore, continuing to serve these individuals in institutions rather than in the community further exacerbates their disability, making them dependent on others for the rest of their lives.  The longer these institutions remain open the harder it will be to find community resources to serve them and each new individual entering the system every year.  Closing these institutions will not only help restore some independence for these individuals, but it will also cost the state about 1/3 less money per person which will in turn allow the state to serve those on the waiting lists.      

I work with children with disabilities on a daily basis.  I watch these children grow up and I worry.  I worry about when they leave us.  I worry about when the services stop.  I worry about where they will go and who will care for them.  I worry that these children will end up institutionalized for the rest of their lives.  We have helped them make tremendous progress during the years they have spent with us.  And I worry.  Is it all in vain?  Our hard work.  Their hard work.  Is it all for nothing?  Is it all so that they enter these institutions and never leave or get placed on never ending waiting lists?  The answer should be a resounding NO!  But I worry.       

Judge Gibney, I support the DOJ settlement which aims to close these institutions and create more waivers to allow these individuals to live and work in their communities!  Please support this settlement, support civil rights, support individuals with disabilities!

Sincerely,

Heather Chandler, MS, BCBA

Token Economies - Using sticker charts as reinforcement

To follow-up my reinforcement post, I thought I would talk about token economies (i.e. sticker charts, token boards, etc.)  This strategy can be helpful both for parents and teachers.  A couple examples might be to use sticker charts at home for performing chores or at school for completing homework.  Stickers could be traded for reinforcers, with each reinforcer having a different "cost" (i.e. number of stickers needed to trade in for the item).  The ultimate reinforcers don't have to be tangible items and don't have to cost you any money.  Maybe your child likes to watch TV or play on the computer.  These activities don't have to be "free" - they can be EARNED!  Imagine that, right?! 

Parents and teachers can easily create a chart using cheap items from the Dollar Store or the $1 bins at Target.  These stores often have sections with cheap school supplies, including chore charts, calendars, stickers, etc.  You can even make your own chart using your computer (WordArt, Clip Art, Tables, etc.)  It's helpful to make your stickers/tokens removable (I LOVE velcro dots and foam shape stickers).  For one thing this allows you to reuse the chart, but you may also set up contingencies that stickers can be removed if your child engages in certain behaviors.  For example, if your child is a big "complainer" then maybe they lose a sticker for complaining about how many chores they have to do.  Google is filled with ideas of sticker charts - take a look for yourself!    

Schedules of Reinforcement

There are so many ways to use reinforcement!  It can be overwhelming when trying to determine what will work best for the situation at hand.  I will do my best to explain various schedules of reinforcement and when to use them.

Immediate and Delayed:  Reinforcment can occur immediately after a behavior or it can be delayed.    When teaching a new behavior or when initially trying to increase a behavior, it is best to reinforce the behavior immediately (and also continuously but we'll get to that in a bit...).  Once your child is pretty consistently engaging in the behavior, you can move to less immediate reinforcement.  Delayed reinforcement is pretty difficult for very young children, though preschoolers (3+ years) can adapt pretty well with practice.  It often helps to have some form of reinforcement in between the behavior and the ultimate (delayed) reinforcer.  You might think of token boards or sticker charts in this way.  The ultimate reinforcer (i.e. cookie, playtime, etc.) comes after earning a set number of tokens or stickers.  The older the child is (and the more practice the child has) the less likely you are to need the tokens/stickers and you can begin to fade these out. 

Continuous and Intermittent:  As stated previously, when teaching a new behavior or when initially reinforcing a behavior, it is best to use continuous (and immediate) reinforcement.  In other words, reinforce EVERY time the behavior occurs.  As your child masters the new behavior (will engage in the behavior without prompting, in a variety of settings, and across different people), then you can begin to move to intermittent reinforcement.  Schedule thinning is the term used to describe how you would transition from continuous to intermittent reinforcement.  At first, you may reinforce every other time the behavior occurs, then every third time, every fifth time, every tenth time, and so on.  The best way to ensure that this intermittent schedule will sustain the behavior long term is to use a variable ratio schedule (which I will get to soon).

Fixed and Variable:  You can reinforce behaviors on a fixed schedule (for example, always every 2 minutes) or on a variable schedule (for example, on average every 2 minutes - meaning sometimes 1 minute sometimes 3 minutes).  Fixed schedules are easy for children to figure out therefore variable schedules have the advantage in most cases.  For example, if your child knows you are going to deliver reinforcement only every 3 minutes, then he/she will likely wait until it's just about time for reinforcement delivery to start engaging in the behavior you want to see.  If you child knows you are going to deliver reinforcement only after every 5 behavior occurences, then you are setting a ceiling on how often they will engage in the behavior.   

Ratio and Interval:  To go along with the fixed and variable schedules, you have to determine if you will provide reinforcement based on a time schedule (interval) or based on the number of behavior occurences (ratio).  Ratio has the advantage here as you are reinforcing a certain number of occurences, rather than a minimum of one occurence in a certain time frame (as seen in interval schedules).  With regard to maximum performance, the variable ratio (discussed above) has the advantage over all other combos (variable interval, fixed interval, or fixed ratio).  The reason is that it is not predictable (due to its variability) and it is based on a certain number of behaviors.  Predictability is important because if a child can predict the schedule, he/she is likely to manipulate it and you will see minimum performance.   

Punishment:  With all of these schedules in mind I find it important to say that with regard to punishment, the least effective techniques are intermittent and delayed.  When using punishment techniques ALWAYS use IMMEDIATE and CONTINUOUS schedules.  In other words, provide the punishment for every occurence of the problem behavior with the least amount of time delay as possible. 

Understanding these schedules seems to be one of the most complex components of reinforcement.  If you are confused, don't worry!  I'm a professional and I had to reread this post several times to make sure I stated these schedules correctly.  If you'd like further discussion, feel free to comment.

"Idle Hands..." - Active Engagement as a Behavior Reduction Technique

Grandma always said "Idle hands are the Devil's workshop" and I, for one, agree!  Active engagement of our children is an excellent behavior reduction technique.  When children are not actively engaged they can get into a world of trouble.  Keeping them actively engaged in preferred activities can go a long way in avoiding problem behaviors.  While independent play is an important skill for children to learn, it also gives parents and teachers an excuse to not actively supervise.  This lack of active supervision (a key component for active engagement) can often lead to children engaging in problem behaviors. 

Take, for example, when you leave your toddler or preschooler in the living room while you are cooking dinner in the kitchen.  You may initially set them up with activities (coloring, puzzles, books, etc.) and walk away.  Since you are cooking dinner, your full attention is not on your child.  The next thing you know, your child has colored on the wall!  In my daughter's words (hands on cheeks) "Ah nah!"

A classroom example might look like this:  You have instructed your Kindergarteners to play freely (i.e. "free play") prior to morning instruction.  While your students are engaged in "free play", you continue to plan the morning lesson.  Your can see and hear all of your students; however, your full attention is not focused on the children.  The next thing you know, someone is crying.  Why?  Because they are Kindergarteners and when left to their own devices they will likely not engage in sharing behaviors (or a multitude of other behaviors).  The likely scenario?  Someone took someone else's toy resulting in that someone hitting the offending child who is now crying. 

ACTIVE ENGAGEMENT!  Yes, it requires much more from us as parents and teachers.  But it also reduces the chances for our children to engage in problem behaviors.  With active engagement, we can stop the behaviors before they start and teach appropriate behaviors in the moment.                  

The High Price of Negative Reinforcement

In his book, "Bringing Out the Best in People", Dr. Aubrey Daniels points out that the dominant management style in today's workplace is based on negative reinforcement.  It's no wonder we tend to employ the same strategy in our personal lives.  Below, I've summarized his chapter on "The High Price of Negative Reinforcment" in the context of the parent-child relationship. 

Dr. Daniels says that "doing things because you have to do them is a sure sign that negative reinforcement is the consequence at work".  In case you don't remember, negative reinforcement is the removal of an aversive stimulus or condition following a behavior which serves to increase the likelihood that this behavior will occur again.  You might think of it as the "do it or else" tactic.  At work - "You need to improve your performance or I will have to let you go."  At home - "Please do your homework now or you're on restriction for a week."  The person will likely engage in the appropriate behavior immediately in order to avoid the aversive condition (i.e. being fired or put on restriction).           

While using such tactics will likely result in the behavior you were asking for, Dr. Daniels asks us to think about this:  If both positive and negative reinforcement get results, why should it matter which we use?  First, people like positive reinforcement.  Second, positive reinforcement maximizes performance while negative reinforcement often produces just enough to get by.  In the above example, your child might have completed his homework, but did he provide his best performance?  Did he complete the assignment correctly?  We're warned that negative reinforcement serves us well in circumstances where all we need is compliance or minimum performance: going to the dentist, paying our taxes, using an umbrella in the rain.  But if the goal is excellence, attaining such requires much more than minimum performance. 

Dr. Daniels points out another problem with using negative reinforcement.  Often, in order for negative reinforcement to work, the "punisher" or "enforcer" must be ever present either in person or by representation (i.e. video cameras to monitor performance, programs that monitor computer or phone use, etc).  Under negative reinforcment, you can't trust people to monitor themselves.  This is highly time consuming for managers, teachers, and parents!  What happens when a subsitute teaches your class?  What happens when mommy is the enforcer and daddy if left in charge for the day?  Also, negative reinforcement cannot occur without some degree of fear, which leads to an environment filled with stress where short tempers, hurt feelings, and hostile interactions occur daily. 

Dr. Daniels points out that negative reinforcement does have it's place in management.  If you have to look hard for something to reinforce (i.e. "you sure do have a neat, clean desk") then you may have a performer in serious need of negative reinforcement.  Negative reinforcement may be the way to start some behaviors that you can positively reinforce.  He warns that we often wait too long to employ the "do it or else" tactic, get disgusted with the poor behavior, and therefore lose the desire to positively reinforce the right behaviors when we see them.  You may be required to reinforce some very small improvements at first - which is often difficult when you have a performer who has been the source of problems.  But if we do not positively reinforce even small improvements, then the improvments will soon disappear and past problems will resurface.  So, forget the problems of the past and focus on improvements (however small) in the present!  "Negative reinforcement can start a poor performer moving in the right direction, but only positive reinforcement can keep that person going."

So why do we continue to use negative reinforcment as our first and often only tactic?  Turns out that our own behavior of using negative reinforcement is reinforced far more immediately than if we had used positive reinforcement.  Let me explain:  When we use positive reinforcment, we have to wait until the behavior occurs again before we know whether or not the positive reinforcement worked.  However, when we use negative reinforcement we are likely to see results right away.  So, the question is this:  Do you want immediate, minimum performance or long-term, excellent performance?  If your answer is the latter, then the best strategy is positive reinforcement.  Starting today, let's all make a concentrated effort to use positive reinforcement to bring out the best in our kids!   

Keep Your Cool!

Anyone seen the video Father Teaches Daughter Lesson About Facebook?  Of course you have, it's gone viral.  I see no need to post it here - you're welcome to Google it if you so desire.  Basically, his teenage daughter posted a rant on Facebook about how her parents treat her like a slave - insert several expletives.  The father, in turn, went to Youtube and posted his own video rant ending with placing 9 rounds from his handgun into her computer.  As someone said, we're likely to see their story on Dr. Phil soon!

I do not condone the behavior of this father.  While he was justifiably upset with his daughter, this was not the adult way to handle the situation.  He basically did the same thing his daughter did - went on a public forum to rant about someone who made him mad.  The difference?  Instead of using expletives, he used a gun (a lethal weapon) to get his point across.  Now I don't know about you, but I would avoid placing such a weapon into my own hands while upset.  He lost his cool.  He did not control his impulse to act on his angry thoughts.  As adults, it is important that we do this!  I guarantee you that in the face of an angry teen or grumpy preschooler when you keep your cool you will avoid further escalating your child's behavior.  It's not easy and it takes practice - lots of practice!     

Warnings: Not a Consequence for Misbehavior

I recently read this blog article and it got me thinking...

As parents (and teachers), we give warnings ALL DAY LONG!  We warn our children "If you do that, then you're going to be in big trouble!"  "This is the last time I'm going to tell you!"  There is nothing wrong with gentle reminders ("Remember, if you hit your brother again you will have to put that toy away" or better yet "Remember to keep your hands to yourself and you can play with the spiderman toy"); however, we must be consistent with consequences.  Meaning, we must actually follow-through with what we say.  A warning cannot continue to be followed by more warnings.  A warning only works by it's association with consequences.  If a warning is only associated with further warnings, our children will have no reason to change their behavior. 

It seems our reasoning behind so many warnings is likely avoidance of tantrums that occur when we do follow-through with consequences.  Or, on occasion, we don't know what consequence to apply so we just keep hoping that the warning will do the trick.  The problem with this logic is that warnings followed by warnings don't change behavior.  The behavior you are warning against continues to occur until you apply a consequence.  And while I admit that applying consequences may lead to tantrums, in the end the tantrums will decrease because the warning will have worked (after being consistently paired with actual consequences).  Don't forget the positive consequences as well.  When your children respond appropriately to warnings such as "Remember to keep your hands to yourself and you can play with the Spiderman toy" then please remember Spiderman!

As I've said before, ABA is hard work up front but well worth the results in the end!

The Threat

Often, parents at their wits end throw out threats like “if you don’t do [this] then you won’t get [that]!”  How often does this work for you?  Typically, your child gets upset, has a tantrum, they don’t do what you’ve asked them to do, and they don’t get the thing they wanted to get.  I’ve got a way for you to turn this around.

Want to read more?  Great!  I got "published" on Tots2Tweens!  Check it out
here.

Does your child accept "no"?

Telling your child "no" is something we all must do from time to time.  When you have a toddler "no" tends to roll off your tongue every other word!  And often results in a tantrum.  So, how do you teach your child to accept "no"? 

Dr. Vincent Carbone is a leader in the Behavior Analysis field. He has coined the "Accepting 'No' Program" for use with children with developmental disabilities. However, my staff and I use this program at our preschool with typically developing children and it usually works like a charm. It goes a little something like this:

1) Before denying access to items, activities, etc. (or just plain ol' saying "no"), have an approved alternative in mind.  Offer that alternative when you say "No, you can do that but how about you play with this instead."

2) If your child accepts “no” without problem behavior, deliver the alternative reinforcer and social praise.

3) If problem behaviors occur, do not provide access to the alternative reinforcer and do not provide any attention to the problem behavior.

*Initially you should offer an equally preferred reinforcer.  For example, instead of mommy's keys offer your child a set of play keys.  Gradually fade the preference level of the alternative reinforcer (i.e. equally preferred, slightly less preferred, neutral stimulus) and the frequency of its delivery until no alternative reinforcer is offered.  Your child is now expected to accept no without an alternative offered. 

Speaking of telling your child "no":
After cleaning up cheerios for the 5th time this morning I had to tell my daughter "no more cheerios" despite her constant "more", "more", "more" and instead gave her one animal cracker for each hand.


Spillproof:  designed to prevent spilling.
The Gyro Bowl is spillproof.

Gyroproof: possessing the ability to spill the unspillable.
My kid is Gyroproof.

Adventures in Toddler Potty Training

Any moms out there potty training?  We started this weekend (with our 16 month old daughter) and so far no wet pants.  Wow, right?  Well, I didn't mention the pee pee in the freshly drawn bath water (just 3 minutes after sitting on the potty) or the little puddle in the middle of my bathroom floor (just 5 SECONDS after sitting on the potty).  Oops!  Still, it has been a good first day.  Our timing is just a tiny bit off but I'm confident we'll get the hang of it and finally get the pee pee inside the potty.   

For anyone interested, we're using a modified Positive Practice technique. 

1. Don't make any plans.  Stay at home and keep your full attention on potty training. 

2. Wear regular underwear - with Pull-ups and diapers for naps/bedtime.
 
3. Give lots of liquids but don't give them foods to make them thirsty.  The idea is to be well hydrated, not overhydrated. 

4. Tell your child "let's go potty" (you can also simultaneously use sign language if you anticipate teaching your child the sign for potty).  Sit on the potty once every hour.  If the child voids on the potty, reset your timer for 1 hour.  If the child does not void, reset the timer for 15 minutes.  (We are only sitting from 1-5 minutes so as to not make this process aversive).  FYI: the sign for "toilet" is fairly simple - make a fist, place thumb between your index and middle fingers (ASL for the letter T), and twist your wrist back and forth so that you are kind of shaking your fist.  You do not need to require your child to use the sign or say "potty" at this time.  This will come when they begin to self-initiate.

5. If the child voids on the toilet, reinforce with a tangible item (miniature M&Ms work well) as well as verbal praise (you could even do the "potty dance" and sing "pee pee in the po-tty"). Help the child to pull up their pants.

6. When your timer rings, do a dry check.  Guide the child's hand on their pants to feel if they are dry or wet.  If dry, provide reinforcement and verbal praise. (We've been skipping this step for now as I don't think a 16 month old would truly understand this part.)

7. If during a "dry check" the child is wet, have them touch the wet pants and tell them where they should void ("Pee pee in the potty.  No pee pee on the floor".) Bring child to the bathroom right away, help them pull down their wet pants, sit on the potty, and then pull up their wet pants and bring them back to where they urinated.  Follow this routine of positive practice 5 times. After the fifth time, change the child and have child help clean up the wet spot.  Do not provide a lot of attention at this time. While this practice is not suppose to be fun for the child, you should not use punishment but also do not reinforce any problem behaviors.

8. When your child begins to "self-initiate" or independently tell you they need to potty, stop scheduling the child for potty time. If you continue to run this schedule the child is likely to become dependent on a schedule rather than initiate on their own.

9. Continue to keep child's bladder filled with fluids. At this time more accidents are likely to occur, but continue to use the positive practice procedure when this happens.

10.  If the child stops self-initiating and continues to have accidents, start scheduling again. 

11. Once the child has several consecutive initiations (over multiple days) without accidents, stop forcing fluids. 

12. When you are ready to go to public places, make sure you fill your child's bladder before you go.  When you reach your destination, show your child the bathroom (not just where it is but go in and see the potty) and see if your child will self-initiate.  Use some prompting if necessary. 

13.  The child will likely not master bowel training just because they have mastered bladder training. It's important to NOT go back to using diapers.  There is no need to use positive practice but you should have the child help you clean up.  Always reinforce for going on the potty!  Many children have a pretty regular schedule for bowel movements so it's a good idea to have them sit on the potty at that time. 

14. If you have a boy, wait until he is both bladder (sitting down) and bowel trained to begin teaching them to stand while urinating.  And just a heads up, get a shield for your child's potty and teach them to "tuck" or you're going to get wet! 

15. Once the child has mastered self-initiation, it's a good idea to start teaching them to request for the potty.  You can use simple words - pee pee, potty - or even sign language.  When the child self-initiates and begins heading for the bathroom, stop them and prompt them to use their new word or sign. 

And there you have it.  Happy training!

Reinforcing New, Appropriate Behaviors

I’ve written several posts on reducing problem behavior (it’s a pretty popular topic) but in this post I want to focus on increasing appropriate behaviors.  By definition, in order to increase behaviors one must reinforce those behaviors.  If you are reinforcing a new behavior, you should be sure to reinforce the behavior EVERY time it occurs (in the appropriate context).  In ABA, this schedule of reinforcement is called continuous reinforcement.  Obviously this is time and labor intensive on your part!  Don’t worry, the next step is called “schedule thinning”.  This involves decreasing the schedule of reinforcement by increasing the number of times the behavior occurs before you provide reinforcement.  In other words, at first you reinforce every time the behavior occurs, then every other time, every third time, and so on.  Eventually you will be reinforcing the behavior on a rather random schedule.  This intermittent schedule of reinforcement will help maintain the behavior for the long run.    

Just to provide an example, let’s go back to when I began teaching my toddler to ask for “up” when she wanted me to pick her up.  Every time she said “up” I picked her up because I wanted her to understand the correlation between her behavior (saying “up) and my behavior (picking her up).  Obviously I can’t pick her up every time she says it for the rest of her life.  She’s going to get heavy for one (she’s already pushing 30 lbs)!  And sometimes it’s just not feasible for me to hold her – cooking dinner with hot oil, taking the dogs for a walk, etc.  Now that she has really mastered and understands what the word “up” means - she uses it in a variety of contexts, such as “help me get up in my highchair”, “pick me up”, and so on - I can start reducing the number of times I reinforce that behavior.  When I am cooking dinner and she asks “up” I tell her “not right now” or “wait”.  This has not by any means reduced the number of times she asks to be picked up; if anything it has increased the number of times she asks (which is very tiring by the way so be careful what you ask for!)  To my daughter, it may seem pretty random as to when her behavior is reinforced and when it isn’t reinforced.  That’s what “intermittent reinforcement” is designed to do.  Since she doesn’t know when her behavior will be reinforced, she tries again and again and again until she receives the reinforcement.  When you use this intermittent schedule it is pretty unlikely that your child will ever stop engaging in that behavior.  With that in mind, be sure to reinforce behaviors in the correct context so that your child will learn when it is appropriate to engage in the behavior and when it is not.  It’s not a good idea to ask mommy to pick you up when she is cooking with hot grease; therefore, I should never reinforce that behavior under that condition.

By the way, this intermittent reinforcement schedule is exactly the reason that you must be sure (when using punishment techniques) to punish a problem behavior EVERY time it occurs.  If you are only punishing intermittently, then you must also be reinforcing intermittently.  And as we just discussed, if you reinforce something intermittently then it is pretty unlikely your child will ever stop engaging in that behavior!! 

Well, I almost made it through a post without talking about decreasing behavior, ALMOST.             

Escape-Driven Behaviors - Why?

All to often we find ourselves caught up in trying to get rid of behaviors without thinking about the whys.  Why does my child want my attention?  Why does my child want to escape this activity? 

Let's take homework, for example:
Antecedent:  "Time to do homework"
Behavior: "No, I don't want to"
STOP
Before applying a consequence, assess why the child doesn't want to do the homework.  Does the child simply want to continue playing with toys?  Then the consequence must be to put away the toys and do the homework.  BUT, maybe the homework is too much or too hard.  Of course, the consequence must still be to complete the homework, but maybe you provide help.  In this case, what you may need to do is teach your child to ask for help when something is too hard instead of refusing to do the activity and engaging in problem behaviors to avoid it. 

There are lots of things our kids want to escape:  homework, chores, the grocery cart, crowded areas, and the list goes on.  When we ask ourselves "why?" then we are able to take some antecedent steps (before the behavior happens) to help avoid those problem behaviors in the first place.  For example, we can make activities more pleasant.  Instead of 20 items on the homework list, maybe they do 10 items then they have a chance to play.  Instead of doing the dishes alone, maybe you can do them together.  And for that cold, metal, boring shopping cart maybe you could bring some toys along to the grocery store (and a cushion to sit on).

The next time your child engages in a problem behavior the first step is to ask why is the child engaging in the behavior (to escape, to gain attention, to get access to a toy/food, etc.)  and then why does the child want to escape, gain attention, etc? 

Do diets really help control behavior?

The short answer is...there is no short answer.  While in graduate school, we kind of glossed over diets as a "fad," defined as an intense but short-lived fashion.  There is no real data to say without a doubt that complicated diets work.  True data requires experimentation with a control test.  During control NO OTHER METHOD can be used.  It is often too difficult to have a true control.  Also, behavior occurs on an individual level and to test whether or not a diet will work in your particular case it must be tested for the individual not some experimental group.  In my opinion if your child is receiving the nutrition he or she needs and is gaining weight (or maintaining) appropriately for their age then trying complicated diets can't hurt.  The problem I often see is that diets restricting gluten, casein, and certain dyes often lead to spending lots of $$$ and very limited meal options which your child may not eat - thereby reducing their nutrition.

Now, with that being said, I've seen children whose behavior skyrockets after eating certain foods and I've seen their behavior reduced when certain foods are removed from their diet - with no other changes involved (behavior plans, life events, medication, illness, etc).  One thing we did learn in graduate school is that sometimes you have to rule out medical problems first.  With that in mind, some people do have actual allergies and sensitivities to certain foods and ingredients in foods.  If these allergies and sensitivities make you feel like crap, your behavior is likely to reflect that.  All I can recommend is to create your own experiment and find out.

When you decide to try one of those diets, you're probably gonna need a little ABA help!  If your child has never been big on fresh fruits and veggies (a likely staple when trying such diets) then you're going to need some reinforcement to help them eat.  First of all, try to make it fun to increase the likelihood that they will even try it in the first place.  If you have one child (or husband) who is willing to eat, you can reinforce their behavior while the other child observes.  In the beginning, you may have to revert to some of their old favorites to use as a reinforcer - "First eat one bite of carrot, then you can have one teddy graham".  There are lots of strategies to try to get kids eating non-preferred or new foods.  There are also tons of cookbooks out there that are kid friendly and actually make these foods taste good.      

http://www.amazon.com/G-Free-Diet-Gluten-Free-Survival-Guide/dp/1599951886
http://www.doitdelicious.com/cookbooks/deceptively_delicious
http://www.amazon.com/Allergy-Cookbook-Gluten-free-Casein-free-Nut-free/dp/0979754208