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Archive for December, 2012

English: A child not paying attention in class.

After yesterday‘s post regarding the use of ABA to treat ADHD, readers expressed interest in learning more. So today, one intervention to address ADHD behaviors will be discussed.

Reinforcement

Readers should not be surprised to hear that reinforcement is a recommended intervention. Reinforcement is a key topic in almost every single post on this blog. The important thing to remember is that reinforcement must be individually designed and administered in order to obtain maximum results. Individualization is not easy for teachers or parents. However, if appropriate reinforcers and correct schedules of reinforcement are utilized, great changes in behavior will be observed.

Differential Reinforcement

There are many types of differential reinforcement:

  • differential reinforcement of other behavior (DRO)
  • differential reinforcement of incompatible behavior (DRI)
  • differential reinforcement of alternative behavior (DRA)
  • differential reinforcement of higher rates of behavior (DRH; designed to increase desirable behaviors!)
  • differential reinforcement of lower rates of behavior (DRL)

Essentially, differential reinforcement is the use of reinforcement for one behavior and not for others. Differential reinforcement requires implementors to reinforce one behavior while withholding reinforcement for another.

Differential Reinforcement of Alternative Behavior (DRA)

In this intervention, reinforcement is provided when an alternative behavior is observed but not when inappropriate behaviors are observed. Specifically, if a child is engaging in off task and distractable behaviors, alternative behaviors would be identified. It is important to know why (e.g., to get out of work, to get teacher attention, etc). An assessment must first be conducted to know why a behavior is occurring. To read more on assessment, check here, here, and here. Once the assessment has been completed, then alternative behaviors to obtain the same reinforcers are identified.

If a child is trying to get out of work, an alternative behavior is to work faster so that play and non-work time may be accessed. If a child is trying to gain teacher attention, then the child is taught to use appropriate behaviors to get teacher attention.

The next step is to reinforce the new/alternative behavior. If the child is working quickly, she needs to be reinforced with a nice long work break or play time. If the child appropriately recruits teacher attention, the teacher needs to come over quickly to give attention.

Thin Reinforcement

As with any intervention, the goal is to get appropriate behavior then to thin or reduce reinforcement so that the child may function like the rest of children in the class or home. It is important to thin reinforcement at a pace that will prevent the ADHD-type behaviors from escalating.

I hope this helps readers better understand one way that ABA may be used to address ADHD.

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ADHDHi and welcome to Ask Missy Mondays where I respond to a question from readers. Today’s question comes from Andrea who asks,

“I have a 4-year-old who was diagnosed with autism within the last 6 months. He is extremely hyperactive and inattentive. What medication do you find to be most helpful?”

Hi Andrea, and thanks for taking the time to write. I am sorry to hear about your child being diagnosed with autism but he is young so there is ample time to get appropriate intervention to help him.

Please know that as a behavior analyst and special educator, I am not licensed to practice medicine. So, making recommendations about medication is out of my preview.

However, as behavior analysts, we are trained to address all types of behaviors, including hyperactive and inattentive behaviors.

Assessment

Before we address any behaviors, we first complete assessments to better understand why the behaviors are happening. The assessment includes record reviews, interviews, and asking those who know the child to complete rating scales. The assessments also include observations of the child to better understand when the behaviors are good versus when the behaviors are bad. Finally, we may even conduct analyses to determine which environmental conditions directly affect the behavior.

Intervention

Once the assessments have been completed, the behavior analyst will help design interventions to address the behaviors of concern. Behavioral interventions can be designed to address attentive behaviors, impulsive behaviors, and skills related to following instructions.

Health Interventions

In addition to behavioral intervention, parents should also consider whole body interventions that address the overall health of the child. Children need daily physical activity and I am not talking about using their fingers to control the remote or the iPad. Children need full body physical activity every single day.

Children also need a healthy diet. If your child eats mostly processed foods full of sugars, fake color, and other artificial ingredients, then you should change the diet before considering the use of medication to treat behaviors that may very well be caused by foods.

Finally, children need far more sleep than they are getting. Children need at least 10 hours of sleep each night. Children (nor adults) can make up for lost sleep so make sure that your child goes to bed early and sleeps as late as possible.

When All Else Fails

If you have followed all of the other advice above (consistently) and your child continues to have behavioral issues, then consider seeing a behavioral pediatrician to assist you in determining if medication is the right thing for your child. Medication should not be your first stop, it should be your last.

If you have a behavioral question for me, email askmissy at applied behavioral strategies dot com.

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princess KateAll the fuss this week seems to be about Princess “Kate”, her pregnancy, and resulting hyperemesis gravidarum (or extreme morning sickness). I (Missy) can admit that I have been enamored with Princess Kate in the past. She’s beautiful, smart, fit, and independent–all the ingredients for a role model.

When I read that she was hospitalized, my first thought was “what if her child develops autism?”

Don’t get me wrong, I would never wish autism on anyone. Ever. But maybe, if autism introduces itself to celebrity, someone will finally do something about the biggest epidemic facing our world.

Sure, there have been other celebrities with children with autism (Doug Flutie, Sylvester Stallone, Holly Robinson Peete, and Dan Marino). And while some of those individuals have done things to increase autism awareness, none of those individuals have actually stressed finding the cause, cure, or prevention of autism.

Thankfully, the US Committee on Oversight and Reform is interested in finding some answers. Hopefully, they will find the answers soon. Unfortunately, it may be too late for Princess Kate whose child, if it is a boy, has a 1 in 54 chance of developing autism.

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Last week, I (Missy) shared information about the Congressional Hearings on autism and I questioned why the news media had not picked up on the story. Clearly, they had more important things to talk about:

  • Lindsey Lohan getting arrested again
  • The lucky winners of the Powerball

Clearly, relying on television news media is not the best

Image representing Google Alerts as depicted i...

Image via CrunchBase

way to keep current on all things autism. For those of you who want to be in the know but who lack endless hours in front of the computer, I will share a few of my tricks with you.

RSS Feeds

One way to keep current, is to find your favorite webpages and set up RSS feeds so that you are alerted each time there is a change. I like to set up my RSS feeds right in my Outlook calendar so they appear like emails. You can also use Google to help you.

Google Alerts

I have several Google alerts set up including alerts for autism and applied behavior analysis. This is super easy! Visit this website and enter the term or terms that you are interested in. You will then receive alerts when those news items appear. Please note that you can set up weekly alerts and daily alerts and so forth.

Twitter Feeds

Several Twitter programs are available to assist you with information on Twitter. I tend to lean towards TweetDeck. I can set up columns on topics such as Step Parenting, Parenting, Autism, and behavior analysis. Within those columns I can read the twitter feed on that topic. You can also set up lists so that you organize your Tweeps by topic or content. I have a list on autism, GFCF, and behavior analysts. I have also written more in depth on Twitter and you can read about that here.

So, don’t feel overwhelmed as you try to keep up with the latest on your favorite topic. Many resources are available at your fingertips!

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cursiveHi and welcome to Ask Missy Mondays where I respond to a question from readers. Today’s question comes from Angela who is the mother of a 3rd grader with a diagnosis of autism. Angela asks,

“Hi Missy, I have been reading your blog for a while. Thanks for all the help and advice you provide to us as parents. I’m writing now because I have come to a crossroad for my child. Chris has responded brilliantly to ABA and is doing very well in many areas. He is reading on grade level, he is doing math on grade level, and he is above grade level in science. He continues to struggle with fine motor skills which is common among children in this population. As you probably know, in third grade, children learn to write in cursive. Chris tried this for the first two days but it is going to take him a long time to master the entire alphabet. Who knows how long it will take him to put letters together to form words? What do you think about this? Should we keep working on this even if it means he may fall behind in reading and math? Thanks in advance for your help on this.”

Hi Angela, and thanks for writing. It is ironic that you emailed with this question. One of my current clients went through this exact issue just a few weeks ago. As a supervisor, I always take the family preferences in to consideration.

Parent Input

Right away, the first thing I would do is ask the parent (in this case, it is you), “How important is it for you for your child to learn to write in cursive?”

Socially Stigmatizing

The next question I ask is, “If your child does not learn to do this skill, will it be socially stigmatizing for him?” In this same area, I have to also ask, “Is it going to be socially stigmatizing for him to learn how to do this skill? Will his friends laugh at him if he doesn’t learn it as fast as they do?”

Essential Life Skill

The next question I ask is, “Is this skill essential for your child to do in order to be independent?”. Some skills are absolutely necessary. Handwriting is not one of those essential skills. I cannot tell you the last time I wrote in cursive. Even my signature is a scribble more than a signature. So, your child will need to learn to sign his name but he is allowed some creativity in doing this. I honestly don’t think the majority of people use proper D’Nealian when signing important documents.

I hope this helped to answer your question, Angela. I also want to point you to some other blogs on this same topic (listed below) as you may find them helpful too.

If you have a behavioral question for me email me directly at askmissy at applied behavioral strategies dot com. Thanks!

 

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