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Take a look at our picture below. (Thanks go out to Bil Keane for this wonderful cartoon (c) 1976.) See if you can guess why PJ is tantrumming. When there is a reason for a behavior, behavior analysts called it a function or a purpose. This is the first time we have tried a poll so please participate! We will post the answer tomorrow! Thanks for playing.

Let's BEE Friends

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Now we have proof that children engage in tantrums in order to gain attention from their parents! Have you fallen for this type of trick?

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We realized after we posted yesterday regarding the necessity of parent permission for a Functional Behavioral Assessment (FBA), that several of you were in the dark about the definition of an FBA as well as what makes a good FBA.

So, we thought we should provide our readers with a simple overview. Please keep in mind that one daily blog post on FBA is insufficient for a topic so broad and important.

What is a Functional Behavioral Assessment (FBA)?

We will provide two definitions of the FBA. The first is from the Behavior Analyst Certification Board, the entity responsible for certifying behavior analysts also known as BCBA and BCaBA. Under the conduct guidelines, FBA is defined as:

Functional assessment includes a variety of systematic information-gathering activities regarding factors influencing the occurrence of a behavior (e.g., antecedents, consequences, setting events, or motivating operations) including interview, direct observation, and experimental analysis.

The second definition is from the Technical Assistance Center on Social and Emotional Development. They define FBA as:

“Functional Behavioral Assessment involves the collection of data, observations, and information to develop a clear understanding of the relationship of events and circumstances that trigger and maintain problem behavior.”

What Makes a Good FBA?

To answer this question, let us look more closely at the definition of FBA as both entities define the FBA by the actual components of the assessment. Let’s take a closer look:

  1. Data. Both describe the data collection or systematic information gathering as one component of an FBA. Thus, a good FBA is comprised of data. Typically, behavior analysts will include graphs of data so that readers will have a clear picture regarding the behavior.
  2. Influential factors. Both definitions include the importance of finding factors, events, or circumstances associated with the behavior. Thus, a good FBA will include a list of events, activities, situations, people, or materials that are associated with the behavior.
  3. Observation. Both definitions specifically list observation as an activity within the FBA process. Thus, a good FBA will include observations of the student’s behaviors. While the IEP team will discuss the findings of the FBA during a team meeting, the FBA is not actually conducted during the IEP meeting as direct observations of student behavior should occur during home, community, and school situations where the behavior occurs.
  4. Behavior Triggers. Both definitions describe how antecedents or events and circumstances trigger behavior. A good FBA will include detailed descriptions of events that set off the behavior or precede the behavior.
  5. Reinforcement for Behaviors. Both definitions describe the consequences that reinforce or maintain the challenging behavior. Thus, a good FBA specifically identifies events, items, and activities that maintain or reinforce the challenging behavior. Most assessments will identify this as the “function” of behavior.

What Are the Functions (or Reinforcers) for Challenging Behavior?

As part of the FBA, the assessor will identify the items, events, and activities that are responsible for maintaining the behavior. Most assessors agree that behavior occurs for 8 different reasons or any combination of the 8 reasons.

  1. Obtain access to a preferred item
  2. Obtain access to a preferred activity
  3. Obtain access to attention
  4. Obtain access to sensory reinforcement or non-social reinforcement or automatic reinforcement
  5. Avoid a non-preferred item
  6. Avoid a non-preferred activity
  7. Avoid attention
  8. Avoid sensory or non-social reinforcement or automatic reinforcement

Combinations of these 8 functions may occur in any way. For example, a student may escape a non-preferred activity (calendar time) to obtain access to attention (being held in time out in the corner). Another student may engage in hand flapping (often assumed to be sensory seeking) as a way of avoiding a non-preferred interaction with the teacher. We could go on and on with combinations.

In summary, if your child receives an FBA as part of his or her program, be sure to read the final report to ensure that: data were presented within the document, observations were completed as part of the assessment, influential factors were identified and described, behavior triggers were listed, and an appropriate function or functions of the challenging behavior were provided.

We want to know, has your child received an FBA from the school? Did it include the items we have identified? Did you provide consent for the assessment in writing? Please share!

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Hi and welcome to “What Works Wednesdays” where we share a success story from one of our clinical cases. All names have been changed to preserve the privacy of the child and family. Our intent is to show readers how successful ABA can be.

Today’s success story is about a little guy that we call Nihar. Nihar was not even three when we first met him. His mother contacted us because she needed help. Nihar was having difficulty with eating, getting dressed, and brushing his teeth. For a toddler, well, that was most of his life’s daily activities. Nihar had extreme difficulty coming to the table for all meals. He also had food selectivity, a condition that is common among children on the spectrum. Nihar often rolled around on the floor when it was time to get dressed. His mother often had to chase him and she could not get him to be still in order to put clothes on him. Tooth brushing was a nightmare. He screamed and ran and fought at even the mention of brushing his teeth.

The first step when we are introduced to a situation like this is to complete a functional behavioral assessment (FBA) to determine why the behavior is happening. We discovered that:

  1. Nihar was trying to avoid meal times at the table.
  2. Nihar was trying to avoid non-preferred foods.
  3. Nihar was trying to gain access to TV during meal time.
  4. Nihar was trying to gain access to preferred foods.
  5. Nihar was trying to gain his  mother’s attention during meal times.
  6. Nihar was trying to avoid tooth brushing.
  7. Nihar did not have any tooth brushing skills.
  8. Nihar was trying to gain his mother’s attention during tooth brushing.
  9. Nihar was trying to avoid getting dressed.
  10. Nihar was trying to gain his mother’s attention during dressing routines.

We offered Nihar’s mother a variety of interventions from which to choose. We have found that when parents are decision makers in their child’s behavior plan, they are more likely to implement the plan. When plans are implemented, they are more likely to be successful. Nihar’s mom selected an intervention called Premack’s Principle. In early childhood we call it If:Then or First: Then. Still others may call it Prespecified Reinforcement or Grandma’s Rule (“First eat your vegetables and then you can have dessert”). Regardless of what you call it, the Premack Principle is an easy intervention to implement. It is effective and it has substantial research to support its use. See for example this study, or this one, or even this one.

We first introduced the intervention during meal times. We used some other helpful strategies here as well (e.g., appropriate size table and chair, mom sitting with Nihar during meals). We simply told Nihar (and showed him with a visual support), “First eat your chicken and then you can have some mango.” Nihar quickly responded. When things were going well during meal times, we added the picture card to the dressing routine. Here we told Nihar that “First put on pants, and then have car”. His dressing behaviors improved immediately. Finally, we added it to tooth brushing. “First brush your bottom teeth, then you can have a hug from mommy”.

Congratulations Nihar on your great behaviors and congrats to your mom for all of her hard work. Also, Dr. Mandy Rispoli needs a shout out as she worked closely with Nihar’s family during this intervention.

Do you use Grandma’s Rule/Premack Principle/If Then with your child? Does it work? Please share with us!

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Morning Schedule

We are often called out to consult in classrooms to help with “problem children”. Most of those visits confirm that the child, is in fact, having difficulties in the classroom. Sadly, many staff in those settings view the child as the problem rather than recognizing that the child is merely responding to his environment. As teachers, we often forget that children with disabilities, including autism, need ongoing support to be successful. We often try a strategy for a few days and then over time the strategy slowly slips off our instructional radar. This is especially true for a support strategy such as visual schedules.

Similarly, we are frequently called by families who need our help with tantrums and other difficulties in the home. Many times, families do not have any strategies to use in the home. Often, we meet families who have never seen a visual schedule, let alone know what to do with one.

A visual schedule (also known  as visual supports and picture schedules) is a task list with pictures. For example, this picture shows the “task list” for a child’s morning. First, he must put away his backpack. Then he participates in circle time. Then he has math followed by snack and toileting. Finally, it is time for reading.

Just as task lists help us remember all that we need to do in a day, visual schedules help children remember what they need to do each day. Visual schedules also help children predict their day. When children anticipate activities, they are less likely to engage in challenging behaviors around those activities.

Visual schedules may be used to show a morning routine such as the one just described. Visual schedules may also be used to show

Hand washing Steps

steps of a routine such as hand washing, toileting, or getting dressed. Visual schedules are a great support for individuals who are learning a new job such as putting together a packing list.

iPrompts Countdown Timer

Many resources exist to help you make visual schedules. One of our favorites is an application for the iPad called iPrompts. The photo library in iPrompts is not nearly as inclusive or as high quality as the one in Proloquo2go. However, you may add as many pictures from your personal library in to the iPrompts library.

Another excellent resource is Meyer-Johnson. We have used their product, Boardmaker, for many years. While it is somewhat cost prohibitive, you will find the software to be extremely useful. Using Boardmaker, we have made countless picture schedules, communication icons, choice boards. We work with a parent who uses the software to make many instructional materials for her child. You will need some training and practice to become proficient with this software. However, once you learn to use it, your options are unlimited.

Finally, Do2Learn is another excellent source of support for making visual schedules. You will find their website helpful with pictures, schedules and other tools.

Meyer-Johnson Afternoon Schedule

We recommend the use of visual schedules for children with and without disabilities. Children need to understand and predict the activities within their day. Visual supports will help them. Visual supports are another excellent way to support the beginning stages of reading as well.

Do you use visual schedules? Do you find them helpful for your child? What resources have you found helpful?

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I want to start off by saying that I will not write about accidentally changing places with one of the children in this house. But rather, I am writing to say there is nothing more freakish to a behavior analyst that when members of her own family engage in challenging behavior. And since it’s Friday, well, I’ll just call this post Freaky Friday.

Behavior analysts, by nature, change behavior. We tweak variables in the environment and then we watch to see how behavior changes as a result of those tweaks. Another interesting thing about behavior analysts is that we take pride in knowing that our procedures work. We proudly show off our graphs as an indicator of success. There is nothing more geeky than the Annual Convention where thousands of behavior analysts gather to show their data. What we do works.

Well, what we do works most of the time. Sometimes behavior gets worse before it gets better. Sometimes behavior gets better slowly. No matter how good a behavior analyst professes to be, all behavior cannot be controlled. “What!” you scream in surprise, “All behavior cannot be controlled?!?!” Sadly, it is true. I must confess that behavior is influenced by a number of variables that are, at times, out of the behavior analysts’ control. Let’s take the weather as an example. We can teach children to engage in a behavior day after day for many days. However, the weather can come along and change the behavior in an instant. Each day we teach Johnny to tie his shoes. Day after day he gets his sneakers, puts them on, and ties them. What an accomplishment! Then BAM! It’s raining and now Johnny needs to wear different shoes. While we taught Johnny to put his shoes on successfully, we only taught him to do it with one pair of shoes. We should have taught him to put on all types of shoes so that when it is raining, he can put on his rain boots.

The same thing holds true for behaviorists and their our families. While we teach our family members to engage in the right behaviors as often as possible, other things come along and impact the behavior. Lack of sleep, illnesses, medications, and peer reactions also impact behavior. Take all of those things and add them to a family situation simultaneously and you get a chaotic Freaky Friday (or whatever day of the week it happens to be). You see, behavior happens. And more often than not, it happens when we want it least.

  • When you are shopping in Costco and your child is crying because she doesn’t want to wear a long sleeve shirt under her coat this winter
  • When you are trying to park to get to a medical appointment (for which you are already) and there are 10 cars in line to park and the sibling with autism starts screaming because he does not like to sit still in a car
  • When you are at a restaurant and your child is crying because she does not want to eat her vegetables and everyone in the restaurant is looking
  • When you are trying to catch the bus and there is a meltdown about how to wear the hair that day
  • When ________________________________________ (you fill in the blank yourself)

Because behavior happens when you least expect it, here are a few tips to avoid your own Freaky Friday:

  1. Stay calm. No matter how bad the behavior or situation seems, stay calm. If you lose your cool, it could cause the behavior to escalate.
  2. Use a calm voice. Easier said than done but your voice can set the tone for subsequent behaviors. Be cool.
  3. Walk away. Sometimes, it is easier to just walk away from the behavior. You do not have to have the last word. You are the adult, aren’t you?
  4. Take a deep breath. Repeat (as often as necessary).
  5. Laugh when it is over and when your child is out of earshot. Repeat.

Enjoy your weekend! Whatever freaky behavior it may bring.

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Lately, I have begun paying attention to the ways people parent when they are on community outings. Many times, I see toddler tantrums that make me laugh. Why do I laugh? Well, if the parent is laughing, then the parent understands why the toddler is throwing such a fit.

You see, many parents understand that toddlers are going to tantrum. Many parents also know why their toddlers throw tantrums. Toddler tantrums are really just words that the toddler has not yet acquired.

“I want _______”

“I don’t want __________”

“_______ is mine”

This is true and there is even a shirt about it. This is a shirt showing the toddler tantrum yoga poses. See? Parents know their children’s tantrums!

You know what else? Pet owners often understand what their pets are trying to tell them.

“I’m hungry”

“Let’s play fetch”

“Let’s go outside”

“I have to potty”

“I’m tired and can’t walk anymore. Carry me.”

Pet owners know what their dog is saying, even though they cannot speak.

What I have never understood, however, is why people don’t understand (or don’t even try to understand) the tantrums exhibited by individuals with autism. Individuals with autism who are non-verbal have tantrums because they, too, have not yet acquired the words. Yet, when they have a tantrum, people are not laughing. Whey they have a tantrum, people get mad. When they have a tantrum, they get restrained, punished, or yelled at.

What we, as behavior analysts have learned over the years, is that individuals with autism are using their behaviors to communicate. A behavior analyst’s job is to assess what the individual with autism is trying to say with his tantrum.

“I want ________”

“I don’t want ______”

“I need help ________”

“I am all done”

That assessment is called a functional behavioral assessment. After the assessment, the behavior analyst designs a communication intervention program to teach the individual to communicate instead of tantrumming. You’ve heard the old saying, “Use your words”. When an individual is non-verbal, she does not have words. So, behavior analysts teach augmentative and alternative communication strategies or AAC. Individuals can learn to sign. They can learn to use pictures to express their wants. Or they can use an iPad equipped with proloquo2go. The options are endless.

So, next time you are out in public and you see an individual with autism throwing a tantrum, think about your toddler and her tantrums. Know that the individual is trying to tell us something. We just need to stop and listen.

Addendum

This is one of our favorite posts. We are hoping to share it with others today as we link up with Ado over at the Momalog as she celebrates her blog’s first birthday. Hop on over there and check out the other bloggers’ favorite posts.
Blog Bash

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