The first day of ABA Therapy, Mini threw a 20 minute trantrum. 20? Maybe it was 40. Maybe it was an hour? I don't know, but it felt like an entire LIFETIME. The behaviors he displayed during this tantrum were horrifying to watch. I was ashamed, embarrassed, and sad, but mostly I was terrified. I kept saying to his evaluation team "I've never seen him act like this!" They asked how long his longest tantrums lasted at home. I said, wide eyed and barely breathing "None have been as long as this one, I guarantee."
He hit them. He tried to bite them. He took off his shoes and threw them at the wall, then at the therapist. He screamed as though he was being physically maimed. He cussed (yes, my three year old used real cuss words). He ripped boxes off of shelves and tossed all of the contents all over the room. He broke their crayons. He cried and screamed for help, screamed for me, screamed for his dad. It was absolutely shocking. He was WILD. FIERCELY mad. He had very likely never been that angry in his short three year old life. Actually, I wondered if any kid had ever gotten that angry, as I watched him thrash and kick, moan and hurl objects with his tiny hands and his blood-red face.
While this scene unfolded, I was instructed to not acknowledge him or address the behavior in any way. At all. Couldn't look him in the eye, tell him to stop, let him see me cry. Nada. The rest of the team ignored it as well. The therapists kept playing with the things he loved, which they'd brought to the therapy room intentionally for him. They slid down the slide, the swung in the swing, jumped on the trampoline, watched movies and sung songs, ate candy I'd brought for him. They created their fun oasis, right in the middle of his bad behavior desert....
...and then we all waited.
And eventually, he calmed down. Received reinforcement. After that, he answered some questions and played some. Reinforcement. Then he started interacting with them. More reinforcement. Two days later, when we arrived for therapy the second time, he walked in willingly and started playing. Although that first day was certainly not his final act of non-compliance at therapy, it was his worst, and his longest. He never tried most of that stuff ever again. I'm still struck, every time I'm in the waiting room at the Clinic, by how much celebrating is going on all the time there. I've never been in an environment where there is so much fun and so much encouragement and so much loving of children flowing all over the place all the time. "Except at home?" you say? No, no. Most DEFINITELY not at home!!
Many typical kids will not have tantrums like Mini's, but some do. Every child, though, will exhibit inappropriate behavior. Every kid will get angry and show that anger inappropriately. Every child will, at some point (or at many points), be insubordinate or "non-compliant" as ABA calls it. How we respond, as parents, will dictate how long that behavior lasts, whether it escalates, and whether and how it occurs again.
I'll give a few examples of typical children being non-compliant that my friends have recently brought up with me:
* My daughter HATES to have her diaper changed. She kicks and screams, tries to roll over, thrashes about and cries the ENTIRE time. I literally have to hold her down and force it. I hate it and so does she.
* When my son gets bored at the dinner table, he starts pushing all the food around on his plate, and then onto the floor. It's so annoying.
* We recently modified my daughter's nap schedule and now she is a terror at bedtime. Getting her in the bathtub is impossible, and she just screams and cries the whole time. Bedtime used to be fun but now she's absolutely miserable and I'm exhausted when we finally wrangle her into bed.
Perhaps you're nodding your head and these examples. And of course, we all have tools in our parental toolbox to shape the future of our child's non-compliance. Perhaps you have created your own tools. Perhaps you've tried everything your fellow playgroup moms have suggested, everything your pediatrician and Doctor Sears have suggested. Perhaps you haven't tried much at all, assuming it's just a phase and they'll get to the right place on their own as long as you stay calm and patient.
My toolbox consists primarily of techniques I've learned through ABA therapy. The principles are easily applied in each of the above situations. Not only can these behaviors be modified quickly, but the child typically doesn't even realize it's happening. Actually, their behavior is shaped while they are loving every minute of it, mostly.
There are a few terms you need to know in order to understand Applied Behavior Analysis and how behavior is shaped. I'll use examples from my own life to help explain them.
1) Problem Behavior: Any behavior that gets in the way of moving positively through time and space is a problem behavior. Mini's screaming, throwing things, kicking, and biting during tantrums, and the tantrum itself, are all problem behaviors that have been addressed in his therapy in the clinic, at home, and at school.
2) Non-compliance: Either actually saying "No" or physically demonstrating in some way that the child is not going to do what's being asked of him/her. If I ask Pumpkin to sit down at the table and she doesn't- whether she says no or not- that's non-compliance. Non-compliance is a type of problem behavior. Compliance is a very critical piece of ABA Therapy, which is why this specific form of problem behavior gets its own category.
3) Escalation: When a child is exhibiting a problem behavior and doesn't get what they want, they will typically try harder. If it crying doesn't work, they try screaming, then hitting, then throwing themselves on the ground, then throwing toys on the ground, then throwing things at mom, etc, etc, getting worse and worse, bringing their anger higher and higher. The entire example above of Mini's first therapy session shows his attempts at escalation.
4) Escape behavior: A child will manipulate you to try to get out of a demand or task they don't want to perform. They don't want to do it, so they try what they can to escape both the task and your accountability for it. If she feigns interest in the woodgrain of the kitchen table when asked to eat her peas, that's escape behavior. When he runs from you at bathtime, that's escape behavior. When she hits you, then immediately hugs you and says she loves you, that's escape behavior.
5) Extinction: When a child escalates their behavior to their highest point, and they still don't get what they want, calms down ON THEIR OWN, and then does not react in the same way again provided the same stimulus, this is called extinction. In Mini's first therapy session, he never got what he wanted no matter how terribly he behaved. The next session, he didn't try it again. That particular problem behavior- tantrum upon arrival at therapy- had become extinct.
6) Reinforcer: Anything that a child loves that is used to facilitate and repeat appropriate or desired behavior can be a reinforcer. Candy, movies, dancing, a jungle gym, a swing, hugs, ice cream, pizza, hot chocolate, time with mom, reading books, petting the dog. Literally anything a child loves to eat, play with, or do is a potential reinforcer. When Pumpkin is asked to sit down at the table and she does, she is rewarded by me excitedly telling her thanks for sitting down and how great it is that she did what I asked! She smiles and puffs her chest out. She feels great.. Feeling great is a reinforcer.
7) Ignoring: The most critical component of ABA, ALL problem behavior is completely ignored. No eye contact, no verbal correction, no reprimanding, no engaging of any kind happens while the child is engaged in problem behavior or non-compliance. No attention is given, at all, during a child's problem behavior. This is, perhaps, the most difficult component for me, as a parent.
8) Replacement behavior: A second key component of ABA is that, once a child is in a calm state, a replacement behavior is provided for a problem behavior. For example, if Davis screams and hits me when I try to put clothes on him that he doesn't want to wear, I would say "Buddy, say 'I want to wear something else, mommy.' " Then he'd repeat that, and I'd say "Oh, ok bud, let's go pick out something you want to wear!"
Those 8 terms are the short "glossary" of important ABA terms that I'll use when I talk about shaping your child's behavior. Reinforcers, ignoring, and replacement behaviors will be what I focus on most, as those are the most prevalent components in my behavior shaping with my own children- both my autistic child and my typically developing child.
Now, an important word about the term "bribing." The critique I most often hear of ABA therapy techniques is that "reinforcers" are "bribes." Parents say they don't want to bribe their children to behave well, that they should simply behave appropriately on their own. "Bribes" are bad. Right?
Here's what's important about reinforcers: WE ARE ALL WORKING FOR REINFORCEMENT. All the time! We work at jobs because we get paid (outside the home, at least!). We do well at our jobs because we want our boss's praise, a good reputation, a hefty bonus. We follow the rules of the road when we drive because we want to keep ourselves and our families safe. We workout and eat nutritious food because we want to live a long healthy life.
Hard work is reinforced by praise or paychecks.
Good parenting is reinforced by happy, well-adjusted children.
Working out is reinforced by a nice, strong body, and good doctor's visits.
Think about all the things you do each day that you'd rather not do, but that you do anyway because of the direct benefit to you once they are done. Those are all reinforcers, not bribes. It's payoff for hard work. As far as toddlers and young children are concerned, getting in the bathtub at night can be hard work! Their "work," at such a young age, is different than ours. Sometimes they need reinforcers to remind them it's worth it. In the end, the goal is to remove any tangible reinforcer (like toys, candy, TV time, etc) and replace it only with verbal praise- from parents, teachers, the bus driver.... whomever is placing a demand.
So there you have the intro, folks. Reinforcement of positive behaviors, using reinforcers to change problem behaviors into acceptable behaviors. Ignoring problem behaviors so that children don't get what they want from behaving badly (EVEN if it's just attention, that attention is reinforcing!). In my next installment, we'll talk about how problem behaviors are changed by using ignoring, replacement behaviors, and reinforcers. Although it may sound technical right now, it'll all make perfect sense in part 3! Stay tuned- you'll be a ignoring and reinforcing like a pro in no time!
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