Autism: Fostering Positive Behavior Through Routines and Schedules

1. Autism: Fostering Positive Behavior Through Routines and Schedules Kristin McCoy, MS, BCBA Stephanie Shrock, MA

2. Autism Basics • Neurodevelopmental Disorder • Includes 3.5 diagnostic areas • Communication • Socialization • Repetitive pattern of behavior/interests/activities • Sensory needs • Affects 1 in 68 (1 in 42 boys; 1 in 189 girls) • No cure • Affects all races, religions, socioeconomic status

3. Applied Behavior Analysis • ABA is the use of behavior analytic methods and research findings to change socially important behaviors in meaningful ways. ABA breaks a task down into its smallest components, builds each component then chains it all together. • Discrete Trial Training (DTT)-a clear instruction is given to a child and the child is reinforced for the completion of this instruction. Every instruction is broken down into steps so that the child is being taught the basics of an instruction. This type of training is most often used in a classroom setting. • Incidental Teaching—aka Natural Environment Training—takes the same concept as DTT but applies it to moments throughout the child’s day. Doing laundry, washing dishes, hygiene, etc.

4. Applied Behavior Analysis • Pivotal Response Training—teaches children with autism behaviors that are considered ‘pivotal’; responding to cues, motivation, initiating and responding appropriately to social cues, self-direction of behavior. • Verbal Behavior—uses concepts of reinforcement, prompting and fading to increase a child’s communicative repertoire. • Fluency building—takes the information learned from each of the different intervention models and repeats the learning until the behavior being taught becomes second nature to the child.

5. Behavior Analysis Asks the Question: Why is this childengaging in this behavior,in this setting,at this time?

6. Functional Behavior Assessment • EVERY behavior has a purpose; an FBA helps us to determine the purpose. • Any attempt at the appropriate behavior must be reinforced, which increases the likelihood that the appropriate behavior will recur. • Behavior management focuses less on consequences to negative behavior and more on positive response to appropriate behavior. • Because children with autism have difficulty with communication, we have to be detectives to figure out what the child is trying to tell us. • A behavior plan must be followed across all environments: in the home, school setting, community, etc.

7. 4 Most Common Functions of Behavior: Attention When I hit myself in the head, an adult comes over and asks me if I’m okay. Escape When I punch an adult, I get sent to my room and don’t have to do my chores Tangible Reward When I throw things, staff give me my favorite food to get me to stop. Sensory Stimulation/Automatic Reinforcement When I scream really loud, I like the way it sounds. NOTE that EACH of these functions also includes communication!

8. The Art of Doing Nothing • Often, our reaction to the child’s behavior is the most reinforcing thing they have. • If we don’t react, they aren’t getting what they are looking for. • It is against our nature, but very important.

9. The ABC’s of Behavior Antecedent an event, action, or circumstance that occurs before a behavior. Behavior any observable and measurable act of an individual Consequence any action or response which follows a behavior

10. Extinction • What is it? • Discontinuing of reinforcement of a behavior that was previously reinforced • EXAMPLE: Every time Johnny screams, staff says, “STOP IT, JOHNNY”, reinforcing his screaming with attention. Staff stop responding at all.

11. Extinction Burst • The behavior increases temporarily. • Johnny has grown used to staff saying, “STOP IT, JOHNNY” when he screams. When this doesn’t happen, he tries harder to get the response that is reinforcing, so he yells more often and louder. • It gets worse before it gets better.

12. Verbiage • “Do you want to….” • “Can you……” • Forced Choice • Choice = Control---reduction of possible power struggle

13. Visual Schedules • These can be done through pictures, written words or symbols. • The schedule is set up so that the child’s day is laid out in a visual format. • The components of a visual schedule are symbols or words, something on which to present the symbols/words, and all “ALL DONE” area to indicate that the task is over. • The schedule should begin when the child wakes up and should be broken down so that there are not too many symbols that will overwhelm the child. • Visual schedules help kids know what to expect and help relieve anxiety related to “what’s next”. • The last picture should be something that is preferred, so that the child is motivated to get to the last step. For example, picture 1 is math, picture 2 is reading, picture 3 is cleaning and picture 4 is computer time.

14. Social Stories • A social story is a way of teaching new rules about social situations to a person with autism. • Social stories can address a wide variety of topics such as hand washing, bathing, raising hand in class, waiting in line, following directions, etc. • A social story should be phrased in a positive manner so that the child is taught what they are allowed to do rather than what they shouldn’t do. • For example, it should say, “we use nice hands when we are at the store” rather than “we don’t hit people at the store.”

15. Questions?