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.