Applied Behavior Analysis (ABA) is most notably used in the treatment of children with Autism Spectrum Disorders. But in truth, ALL children experience problem behaviors at some point in their lives - from the “terrible twos” to the rebellious teen years. This blog is designed to provide an overview of ABA and how it can be a useful tool for typically developing children, teenagers, and even your husband;)

Wednesday, January 25, 2012

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

Sunday, January 22, 2012

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.

Saturday, January 14, 2012

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!

Thursday, January 12, 2012

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.             

Monday, January 9, 2012

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"
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? 

Monday, January 2, 2012

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.