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All children are in the process of learning rules and norms of the society in which they live. They must be taught the expectations and boundaries requires to get along within their families, schools and wider community. For a child with autism, the learning process presents unique challenges. A typically developing child comes equipped with many tools which support development of appropriate social behavior. He can understand language and be given verbal directions for what is expected of him. He is naturally motivated by positive social feedback and praise, and is attracted to peers. He can observe others around him and perceive how different behaviors elicit responses- he can then imitate the behavior of others, to elicit similar results. He can understand that his behavior affects the feelings and opinions of people around him. His body allows him to filter environmental stimuli, modulate emotional responses, and control impulses. Even with all these skills in place, a lot of hard work is still needed to teach any child to manage themselves! A person with autism may lack any or all these abilities. Therefore it falls upon the parents and teachers to provide the child with other tools to learn these skills. Carefully planned behavioral interventions may be needed to communicate expectations and to teach appropriate self-management skills. To help plan those interventions, it is important that teachers and parents understand the principles of behavior modification. CAPSTAR
Antecedent, Behavior and Consequence: A-B-C Approach A simplified way to summarize the principles of behavior modification is the A-B-C approach. A-B-C stands for Antecedent, Behavior, Consequence. Antecedents are stimuli in the environment or internal sensations which trigger a behavior. The behavior is the reaction to these stimuli. The behavior elicits a result or consequence. Consequences can be pleasant, or unpleasant. If the consequences are experienced as positive, it is more likely the person will engage in the behavior again to achieve the same result. If the consequence is experienced as unpleasant, it is less likely the person will engage in that behavior again. After determining what antecedents and consequences are influencing a behavior, we can purposefully modify them in order to change the behavior. The following chart shows an example of the A-B-C process. CAPSTAR
Once you have determined why the behavior is occurring, you are ready to plan your intervention. First determine if there are ways the antecedent should be changed to make the situation more bearable for the child. Then think of a different, acceptable behavior the child could use instead, and figure out how you can show the child what she should do. Finally, alter the consequences: eliminate the consequences that have been rewarding the problem behavior; and at the same time, start giving positive consequences that reward the new, appropriate behavior you have chosen to teach. The behavior management handouts in this program demonstrate a variety of strategies, and examples of how they are implemented. It is not all inclusive; This would be impossible since each child is so unique, but think of it as a place to start. Get a feel for the A-B-C process. Start understanding what is about autism that makes these children tick. Recognize that behavior as communication and acknowledge that people with autism misunderstand much of the world….. Until you provide them with the appropriate supports. Realize how hard they must work to manage their behaviors, and reward them accordingly. CAPSTAR
The ABC’s of Behavior As a framework for addressing behavior issues, this handout describes the behavior modification approach. Behavior modification, also sometimes referred t o as Applied Behavior Analysis, is based on B.F. Skinner’s principles of operant conditioning, and the work of subsequent researchers including Ivar Lovaas (Crain, 2000) A simplified way to summarize the principles of behavior modification is the A-B-C approach. For all behaviors there are: • Antecedents- The circumstances that precede and probably cause the behavior. • Behavior- A person’s observable actions. • Consequences- The circumstances that occur after the behavior. The person experiences the consequences of their behavior as pleasant or unpleasant, and this either decreases or increases the likelihood that he will engage in that behavior again. CAPSTAR
Examples of antecedents, behaviors, and consequences Example 1 Result: Johnny learns that by screaming, he gets what he wants. He is likely to use screaming as a strategy again. Example 2 CAPSTAR
Individuals with Autism Often have Characteristics that Affect their Behavior and Learning It is important that parents and teachers understand that individuals with autism possess characteristics that can contribute to undesirable behaviors and learning. They can have difficulty following verbal directions, shifting their attention to new activities, understanding social expectations, predicting sequence of events, or perceiving time passing. They also have sensory issues that affect their behaviors. From: http://www.natashaspencer.co.uk
What is ”Behavior”? Individuals with autism can show behaviors that others sometimes don’t understand. Following are some reasons why individuals with autism may have certain behaviors. • Behavior may be a way of communicating: People with autism may not know appropriate ways to communicate, so they use other ways to get the messages across. • Behavior may be a way of coping: People with autism often experience high levels of stress and anxiety in situations that others perceive as ordinary. • Behavior may be response to impulses: People with autism may have less ability and social motivation to control their impulses. • Behavior may be a result of trying to conform to social expectations: People with autism may not perceive or know how to react to social circumstances. Some difficult behaviors may be attempts to behave appropriately, or the result of not knowing they need to conform. • Behavior may be a way of feeling in control: A person with autism, like anyone, may have personality traits that make them feel a need for more or less control. Anxiety associated with autism, and the experience of living with a disability, may increase the need for feeling in control. • Behavior may be the result of complex neurological & sensory process: Sensory processing deficits result in self- stimulatory behavior, and other issues beyond the person’s control. CAPSTAR
Examples of Sensory Issues That Can Affect Behavior Characteristic: Verbal Directions and explanations Are not Easily Understood, Processed, Or Remembered • Child doesn’t understand what you want him to do. • Child understands but later doesn’t remember what you said. • Child understands part of what you said. • Child understands, but it takes him a minute to think about what you said. Possible Resulting Behaviors • Apparent refusal to follow directions, or non-compliance with commands (“no” “later” “stop’) and simple requests. • Difficulty transitioning between places and activities. • Becomes upset because something unexpected happens, even if you told him about it. • Repeated requests or asking when something will happen. • General stress and fear leading to outbursts.
Characteristic: Shifting Attention or ‘Switching Gears’ is Difficult • Child cannot pull away from one thing and think about something else. • When child must stop doing something he likes, he doesn’t know when he will be able to do it again. • Child feels scared because he doesn’t know what is happening next. Possible Resulting Behaviors • Difficulty with transitions to something new. • Difficulty ending activities, or parting with something he likes to do. • Extreme anger or frustration during transitions.
Characteristic: Child Does Not perceive or Understand Social Expectations • Child does not value social rewards of acting like others. • Child doesn’t know why his actions make others feel angry. • Child doesn’t know acceptable way to express his emotions. • Child doesn’t know what he did wrong. Possible resulting Behaviors • A wide range of “odd” or “annoying” behaviors • Inappropriate expression of emotions such as anger, frustration, excitement, or affection. • Insecurity in social situations & further withdrawal.
Characteristic: Sequence of events are difficult to predict or remember & perception of time passing is impaired • Daily events are all blurred together. Child doesn’t really known when or why one thing ends and the next begins. • Child has trouble making a plan to complete a task. • The small parts of the world that the child can understand makes him or her feel safe, and he/she doesn’t want them to change. • Child doesn’t understand that he/she will be able to do a fun activity again if he/she is asked to stop. Possible Resulting Behaviors • Difficulty with transitions, waiting or understanding “later”. • Apparent refusal to follow directions or take turns • Apparent refusal to start or complete tasks. • Rigid attachment to routines
Characteristic: Sensory Issues • Light, sound, touch & movement may hurt or scare the child. • Child cannot deal with anything else when their body feels awful. • Child doesn’t know socially acceptable ways to meet their sensory needs. • Child would rather withdraw than cope with sensory overload. • Child cannot calm down when upset. Possible Resulting Behaviors • Self stimulatory behaviors to get or tune out sensory input. • Total withdrawal and inability to perform skills. • Active avoidance of overwhelming situations. • Refusal to touch or use certain objects. • Increased anxiety and pain contribute to many behavior issues.
Steps that Should be Taken to Change Undesirable Behaviors There are 4 steps that should be considered when examining and changing a child’s behavior: 1) Define the behavior, 2) Determine the function of the behavior 3) Change the behavior, and4) Revise and Refine. 1.)Define the Behavior • What exactly does the child do? • How frequently does it happen? • How long does it last? How severe is it? 2.) Determine the Function of the Behavior • Antecedent: What is setting it off? • Behavior: What is he trying to communicate or accomplish with behavior? • Consequence: What in his environment is rewarding the behavior? 3.) Change the Behavior • Antecedent: Find the strategy to help the child better understand and cope with the situation. • Behavior: define and teach alternative, more appropriate behavior for the child to use instead. • Consequence: Stop reinforcing the “bad” behavior and start reinforcing the “good” or alternate behavior 4.) Revise & Refine • Most interventions only solve part of the problem.. maybe there is more than one antecedent or consequence at work? • Kids catch on to your tricks! Change the rewards, add more strategies.. keep at it until it works! CAPSTAR
Behavior Planning Example Plan modified to change antecedent by changing the order of activities in schedule and using a Token System.
Strategies for Rewarding “Good” Behavior Praise and social rewards may not be very valuable to a child with autism, and may not be enough to motivate her to change her behavior. So it is important for parents to identify some tangible reinforcers for their children. Using tangible reward systems (e.g., food. toys or tokens) will help motivate her and reward her hard work! Types of Rewards • Food toys or other small portable items can be the easiest rewards to use at first. • Use special activities if you have a way to communicate them with a picture or on a schedule. • If the child’s interest shifts, or she needs a variety, put several rewards in a “treasure box” or use a choice board for him to use to choose a different reward each time. Types of Token Systems • “Token systems” are a way for a child to incrementally earn her reward. • The child gets a token for good behavior. • Once she earns a predetermined number of tokens, she gets her reward! Over time, you can add tokens so she has to accomplish more before being rewarded. CAPSTAR
Advantages of Token Systems Over Items Such as Food • Tokens make it possible to delay the reward a little while, instead of giving it all at one time. • You can give tokens frequently to keep motivation high and note when she’s doing something right. • You can use a wider variety of activities for rewards (swings, walks; TV) without interfering as much in daily activities. • Token systems can be portable and used in public. Token Systems can be Fun Too! • By tailoring the token system to your child’s interests, the tokens themselves can be highly rewarding. • Basketball stickers as tokens for a sports-lover. • The letters COMPUTER for a child who loves letters and words…and earns the computer. • A picture of what the child earns, cut into puzzle pieces . She earns a piece at a time, until the puzzle is completed! • For a child who loves space, a picture of the solar system, with each planet as a token. CAPSTAR
Link http://www.latitudes.org/behavioral_charts.html http://www.latitudes.org/behavioral_charts.html
Link http://www.ehow.com/how_4892000_token-reward-system-students-autism.html
How to Introduce a Token Reward System to Students with Autismby Nicole 22 on eHow One example of a token reward system.It is often motivating for students with Autism to be rewarded with snacks, toys, or other fun activities, for completing tasks. While these rewards can be used for each correct response, it is helpful for the student to learn to earn points or tokens toward a reward. This article outlines a strategy to teach student with Autism to use a point or token system.
Instructions for Token Board Assembly (11 Steps) Step 1 Become familiar with the principles of Applied Behavior Analysis when teaching any skill to a child with Autism. The book, "Principles of Everyday Behavior Analysis" by L. Keith Miller is the best book on the subject and will make it very fast and easy to learn. • It is often motivating for students with Autism to be rewarded with snacks, toys, or other fun activities for completing tasks. When first teaching a new skill, it is important to give a small reward after each correct response. This lets the student know that the response was correct and it increases motivation to continue working on the skill. After the student can successfully sit and work consistently for tangible or edible rewards it may be beneficial to introduce a token-based reward system. Step 2 Step 3 Select a token. I like to use gold coins from party supply stores. Tokens can be a variety of things such as stickers, large buttons, or laminatedpictures of favorite characters. Step 4 Make a token board. Laminate a strip of construction paper and place a piece of sticky-back Velcro in the center. Attach the opposite side piece of sticky back Velcro to the back side of the tokens.
Step 5 Introduce the system to the student. Give the student the token and prompt him or her to put it on the token board. Immediately give the student their reward: snack, toy, or favorite activity. The goal is for the student to associate the token with the reward. Step 6 After doing this several times, start using the system as part of the student's routine. Have the student complete a single response or small activity, then give the tokens as described in step five. Step 7 Do this for several weeks until the student understands that the token equals a reward. At this point, you are still essentially reward every correct response, which is fine.
Step 8 Add one extra token space to the token board. You'll now continue giving one token for each correct response, but the student will complete two responses before receiving the reward. To ease this transition make the task to receive the second token very fast and easy for the student. Step 9 Continue this for a few weeks. Eventually, require the student to complete three responses before receiving a reward and so on, still receiving a token for each response. It is okay to increase the size of the reward based on how long the student works in order to get it. Step 10 An example of another token board you could use. This one has small stones that Velcro on, with an attached picture of the student's chosen reward. Step 11 Another example of a token board with attached reward picture for a student who is able to work for a longer period of time before receiving the reward
How to Use a Reinforcement Schedule When and how often the child gets the reward makes the difference! • Reward frequently when the child is first learning, or when she is having a particularly hard day. Frequent reinforcement keeps motivation high! Several times a minute is okay for some children, especially when they only behave well momentarily • Gradually decrease how often you give rewards. • Increase time intervals gradually. • Wait until entire activity is over. • Only give reward at difficult times of the day. Other reinforcement Tips • Make it immediate: the faster you give it the more likely the child will make the association between the reward and the good behavior. • Contingent: Only reward the good behavior, or very good tries. Also pair with the specific phrase ”Good sitting!” • Mention reinforcement in other visual strategies: • Social script- ”If I do__ I’ll get a __” • Pictures of rewards at the bottom of the rule boards, or end of mini-schedules. If a behavior plan fails, or needs revision, it is the reward that is often the reason. Make sure the reward is really motivating to the child. Change rewards frequently, or offer a choice, to keep them new and exciting. CAPSTAR
Timing is Everything! • Even when you are using the right strategies, bad timing can accidentally reward bad behaviors, and confuse the child. • Be careful that you are not presenting a reward during an undesirable behavior. Wait until it stops, then present your reward. • Be careful that you are reinforcing good behavior immediately! • Eliminate opportunities for the child to disobey your requests or react inappropriately. The following examples illustrate situations in which bad behaviors were reinforced, followed by information on what should have been done instead to reinforce good behavior. CAPSTAR
Teaching New Ways Of Communicating Children with autism often have difficulty verbally expressing their needs and wants. As a result, they may sometimes use inappropriate behaviors (e.g.. Pinching, pushing) when trying to communicate with others. Adults can teach them how to communicate appropriately and effectively so their needs can be met. If a child is using an inappropriate behavior, what does he need to say? • Think of what he is trying to tell you with his behavior. • If he had words, what might he be trying to say? Teach Him to “Say” it Nicely • Teach during calm times, outside the behavior situation. • Use visual cues: • PECS-even if your child is verbal and does not use PECS, a single cue for “help” or “no” can still be helpful! • Write key words or pictures. Practice reading them or labeling them together. • Practice verbal requests. • Create a less upsetting, or silly situation to practice: • “Help” with coat just before going outside. • “oh no” when blocks fall over, but not his favorite blocks! • “I want_” when he is not desperate for it. • “Hurt toe” when pre4tending to stomp on his toe. “Hurt head” when pretending to bonk heads. • Flash a visual cue, or prompt him to give it/ read it during your teaching situation, so it becomes easy. CAPSTAR
Keep your visual cue ready! • It is SO MUCH easier to get a child to use appropriate communication in a stressful • moment if you have already taught it with a visual cue! • When the situation arises, present the visual cue. Index cards kept in your back • pockets are very handy! • Help him say the words or give you the PECS cue. Reward him with what he needs. • If he won’t say the words at first, physically prompt him to point or hand you the visual. • Push a little harder each time for him to say the words independently. • For some children, you can stop using the visual cue after a while. However, keep it • available until he really starts saying the words independently. CAPSTAR
Example of How to Teach a Child to Appropriately Express His Needs or Wants This child is just learning how to communicate his wants by requesting with a picture. In this example he has a small laminated photo of himself on the swing, to request “more swing” or “push.” The parent places the card in a position where the child can see it, and when the swing stops, she waits expectantly. In their first attempts, the child pushed the picture onto the ground. After several more prompted attempts he begins to use the picture to request “more swing.”
Reinforcing Communication • When he is just learning a new way to tell you what he wants, you need to reward that attempt every time if at all possible. Understanding “No” • Does the child truly understand no? Questions to think about: • Does he repeat the behavior after you said ‘no’? • Does he continue to ask for things repeatedly? Suggestion:Use the visual strategies to help your child process and remember ’no’ and to take you seriously. • Visuals fro objects, doors, containers, or other stationary items: • Use stop signs, paper with ‘no’ or x written on it, or universal symbol of circle with line through it. • Put these visual cues on things that are off limits. • Stick up the visual as you say ’no’ and leave it there for however long the item is off limits. • Visuals foe behavior that do not involve a concrete object. • Draw a picture or write a word representing the behavior. Draw the circle with a slash, or an x through the picture and label it. Getting out of Giving In • Be consistent- Don’t give in! • If you are in the habit of saying ‘no’, then giving in, ’no’ will come to mean ’later’ or ’if I cause enough trouble’.
Eliminate Patterns of saying “No, No, Yes” It is hard to break the ‘No,No,Yes” pattern… so take it easy on yourself and your child. • Start with the small battles, and make sure you win. • Only say no when you have time to follow through. • Say no only to little things that he will not be quite so upset about. • Build a lot of success a home first, before trying in public places. • As you establish a pattern of following through, you will gain confidence. Your child will start learning his boundaries. The more3 small issues you tackle, the easier it will be to address the harder situations. Have Plans for the Fallout • When you first stop giving in, your child may be very frustrated. • Having a clearly planned alternative to deal with his reaction is the key to stopping it. • Have a calming area, time-out or other strategy to ride out the reaction. • Tell him appropriate ways to express his emotion, with social scripts or visual rules. • Know that it gets easier! The first couple of episodes are the worst. Gradually you will find he does not react so strongly, and he accepts your boundaries.
When You Get Stuck • Occasionally you will get stuck in a situation where you have said no, but now you have no way out except giving in. • Try to respond to the behavior as little as possible. Don’t tell him to get up, or be quiet if you know he won't. That reaction would only create more opportunities to disobey. • Establish some level of compliance before giving in. For instance, make him say' please’ or physically prompt him to point or reach for what he wanted. • Reward this small effort at communicating with verbal reinforcement. “Oh, you want cereal!” Stop… Start Strategy • Pause attention or activity when behavior starts. • Quickly shift to giving attention or continuing activity the second there is a pause or a moment of good behavior. • Shift back and forth- many times if needed, making sure your response is immediate. • Eventually the child notices that the moments of good behavior get him something and the negative behavior doesn’t. Why It Works! • Stop start works well when the child naturally pauses in a behavior… such as the breath between screams. • You get a foothold on controlling the behavior by reinforcing the pauses and ignoring the behavior. You have to be quick in your response to the child’s behavior! If your response is clear, the child will quickly realize what he needs to do to get what he wants!
How Adults Can use Spoken Language Effectively A common characteristic of autism is difficulty processing language. When the child is stressed, this becomes even more difficult. The fewer words an adult uses, the better. When giving instructions, such as asking the child to stand up, you need to keep it short and simple. For Example: • Do Say: “Stand up” • Don’t say: “You need to stand up now.” Processing Time Children with autism often have processing issues, so you need to make sure you also give them enough processing time. Here are some ideas to help your child process your requests: • Say the command; then wait. • Some children need 20 seconds to process what you said, and even more time to act on the request. • Do not repeat the command until you are sure she did not understand or is ignoring you. • Repeated and rephrased commands often cause more confusion! Say “Stand up” then wait.
