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Posts Tagged ‘ADD’

In light of all the discussions this week regarding ADHD and medication, Using ABA to Address ADHD, and a research study on Addressing ADHD in Classrooms, this cartoon seems relevant!

Thank you Hank Ketcham for your brilliance all these years!

Dennis and Impulsivity

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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.

Related articles

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Ginger rated her behavior during carpet time

Hi! and welcome to What Works Wednesdays where a success story from clinical files is shared. Today’s story is about a little girl named Ginger who happens to be a typically developing 3rd grade. Ginger’s teacher contacted Applied Behavioral Strategies to assist her with Ginger’s behavior because Ginger had difficulty paying attention during morning meeting, sitting quietly during group instruction, and staying on task during independent seat work.

Record Review

A review of Ginger’s academic records indicated that she was performing at grade level in all areas. While she had some struggles learning to read, with focused intervention, she has remained on a 3rd grade reading level. Ginger is also very active and has difficulty keeping her hands, arms, and legs still. Finally, Ginger is highly distractable. Her focus is disrupted by butterflies, peers walking by, and particles on the floor.

Ginger’s teacher felt overwhelmed because she had tried verbal reminders, notes home to parents, and seating arrangements. She felt that none of these strategies worked effectively.

Student Interview

The behavior analyst asked Ginger why she had difficulty sitting quietly, completing her seat work, and listening to teacher instruction. She responded that, “I try to sit still and listen but my friend talks to me” and “I try to do my work but I have to sharpen my pencil” and “I sit away from my friend but she comes to sit next to me”.

ABC Observation and Analysis

Direct observation revealed that a variety of consequences followed these target behaviors. Sometimes Ginger received a verbal warning, sometimes the class received a reminder, and some times, no consequence occurred at all.

Self-Management

The behavior analyst needed more time to complete the assessment

so she developed a brief self-monitoring plan for Ginger to use until the assessment and behavior intervention plan could be completed. The self-monitoring plan consisted of Ginger evaluating her own behavior following each instructional activity. Her teacher reviewed the evaluation and confirmed if the evaluation matched reality. Ginger received praise and positive feedback for desired behaviors and her parents provided additional positive attention each day when Ginger shared her rating at home.

Additional Tips

The form was printed and put onto Ginger’s favorite color of construction paper. Then it was laminated so that one side showed the seat work and the other side showed the carpet time. Using a dry erase marker, Ginger could self-rate each day and then the chart could be wiped clean for the next day.

Ginger rated her behavior during seat work

Success

After 2 weeks, the assessment had to be put on hold because Ginger’s behavior improved. As with any student, Ginger continues to have difficulty when substitute teachers are present. However, this simple intervention worked to focus on Ginger’s strengths by reinforcing desirable behaviors.

Readers, have any of you tried self-management? What worked? Parents, have any of your children been placed on self-management plans? Did you like it? Did your child?

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Hi and welcome to Ask Missy Mondays where I respond to email questions from readers who have questions about behavior. Today’s question comes from Shannon and Gary who write:

“This feels like an odd question because we know there are many families who work hard to help their child(ren) learn to maintain appropriate eye contact when communicating. Our child has decent eye contact while requesting things, but when we speak to him, not only is his eye contact very poor, but he won’t stand still! He’s constantly rocking back and forth from one foot to the other (sort of like walking in place) or walking away. Sometimes he will maintain some eye contact while moving around, but we would prefer to have him stand still and look around the room than to have proper eye contact and have him wiggling.

Is it appropriate for us to expect a six-year-old to stand still while we give him directions? If so, how can we target that behavior? Should it be targeted separate from maintaining eye contact and listening to directions? Eventually we would like him to be doing all three at once.”

Thanks for writing Shannon and Gary! This is a great question  and it is not unrealistic to expect your child to stand still. However, it may be impossible for his body to be still. One of the things we have learned as behaviorists is that the foods we eat may affect our bodies and behaviors. So, the first thing you need to do is get a good nutritionist to take a look at your child’s dietary habits. We know that artificial food coloring causes big wiggle problems. This includes dyes of blues, reds, oranges, and yellows. It is fairly easy to cut out the artificial colors when you cut out artificial foods. So the next step is to move to a whole foods diet. While the store Whole Foods is helpful for this, you will find it more affordable to shop locally. Aim for foods that are grown or killed (fruits, vegetables, meats and fish).

Once you rid your child’s body of harmful ingredients that may be causing all of the movement, then the next step is to teach him step by step how to stand and attend. You do this by working on his focus and attention using principles of Applied Behavior Analysis (ABA). We usually start by having your child focus on something for a very short period. We use a simple laser pointer and shine it on the wall. When your child stands still for 5 seconds (you may need to start even shorter–at 3 seconds), then reinforce his behavior by providing him access to a preferred item or activity.

When your child can successfully focus for 5 seconds, then increase the goal time to 10 seconds and so on.  When your child can stand still and focus for one minute, then you add distractors like noise, music, and people. When your child can focus for a minute with distractors, then you start adding information for your child to remember while remaining focused.

There is a great game on the Wii for this under the balance games. It is called the Lotus Flame. It requires the child to sit but that may also be effective at teaching your child to focus. Good luck! Please let us know how it goes.

If you have a question about behavior, please email me at askmissy at appliedbehavioralstrategies dot-com.

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