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?   

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!

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.

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

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:)

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...