(6) Example Interventions to Decrease Challenging Behaviours?
- Antecedent Interventions
- Educative Procedures
- Reinforcement-based Procedures (DRL, DRO, DRI,
DRA, DRC, NCR) - Extinction, Planned Ignoring
- Response Cost & Time Out
- Aversive Stimulation
Antecedent Interventions
- Involve altering antecedent conditions to change the
probability of behavior. - Before behaviour occurs.
- Arrange environmental conditions to prevent
behaviour from occurring (remove triggers).
Basic Examples
* Offering choice
* Changing routines
* Pre-activity warm-up
* Changing how demands are given.
* Enriching the environment
Example Antecedent Strategies:
- Class Wide Strategies:
o Establish clear classroom rules and expectations.
o Increase predictability in the environment.
o Increase praise for appropriate behaviour, and
increase behaviour specific praise.
o Present material that is appropriately matched to
student instructional level.
o Provide a high number of opportunities to respond
to academic material.
o Arrange classroom seating so that it is appropriate to
the instructional activity.
o Use effective instructions and commands.
o Intersperse brief and easy tasks among difficult
ones.
o Use a brisk pace of instruction.
o Provide opportunities for choice.
o Incorporate student interests and preferred
activities. - Individual Strategies:
o Present material that is appropriately matched to
instructional level.
o Provide alternative modes of task completion.
o Incorporate student interests into academic
material.
o Allow opportunities for choice.
o Provide scheduled attention to reduce the need for
students to engage in attention-seeking behaviour.
o Establish a clear and predictable schedule.
Function-Based Antecedent Interventions
- Antecedent interventions can be made into a
function based intervention. - Escape:
o Allow choice between work tasks.
o Provide more frequent breaks.
o Incorporate the person’s interests into the work
tasks.
o Use behaviour momentum (i.e., have the students
complete several easy tasks before asking them to
do a more difficult one; gradually increase the task
demands once student complies with demands; 3:1).
o Providing different methods of completing assigned
tasks. - Attention:
o Non-contingent reinforcement (i.e., provide attention
on a fixed time schedule)
o Allow for frequent opportunities to respond
o Provide high-quality verbal praise (i.e., enthusiastic,
behaviour-specific). - Tangible:
o Use a visual schedule to indicate when the preferred
item will be available and for how long.
o Non-contingent reinforcement (i.e., allow access to
the item on a fixed time schedule).
o Provide adequate opportunities to have access to
the preferred item. - Sensory:
o First, address any potential medical concerns.
o Enrich the learning environment.
o Provide a set time for sensory behaviours.
o Provide more socially acceptable ways to access the
same sensory input.
o Include sensory activities in instructional tasks.
Choice Making Antecedent Intervention Example and Steps
Choice Making Examples
* Choosing own clothes
* Selecting own rewards (juice or apple)
Identifying activities or materials for a given activity
* Deciding what to eat
* Choosing colours for writing or painting
* Choosing which task to do first
Steps for Choice Making
* Assess the environment to identify choice making
opportunities.
* Assess preferences
* Teach prerequisite skills if necessary
* Identify the target behaviour to increase or decrease.
* Provide choices prior to problem behaviour
* Evaluate the procedure and the student’s progress.
* Choice given when child is not engaging in the
problem behaviour.
Using Antecedent Art Intervention to Improve the Behaviour of a Child with Autism (Kuo & Plavnick, 2015)
- Method
o 39-month old boy with ASD
o Early childhood centre, group activities
o Off-task behavior (out of seat, touching others,
fiddling with materials).
o Time off-task
o The AI was a 10-min 1-1 art activity - Why did it work?
o Abolishing operation related to
Attention or sensory stimulation?
o Established a predictable routine
o Getting one on one attention reduces need to act
out for attention in groups (more likely explanation)
o Sensory stimulation through art materials reduces
need to act out for sensory stimulation
Educative Procedures
- Teaching & reinforcing alternative skills
- Teaching & reinforcing incompatible skills
- Bringing behaviour under stimulus control
- Reinforcing Other Behaviour
- If behaviour is occurring at a low rate you may need
to teach child new skill instead of waiting for them to
engage in it and reinforce them. - Stimulus control when a behaviour is only
appropriate in one environment and not another (i.e.,
kicking ball and not people or in playground not
classroom; do not want to extinguish behaviour just
teach them there is a time and a place for it).
Reinforcement Procedures (DRO)
A Comparison of Response Cost and Differential Reinforcement of Other Behaviour to Reduce Disruptive Behaviour in a Preschool Classroom (Conyers et al., 2004)
- Method
o 25 preschool children
o Classroom setting
o Screaming, crying, throwing objects, not complying
o 10-s partial interval recording
o RC – lost tokens if disruption in 1 min
o DRO – tokens earned for no disruption - Discussion
o RC better than DRO
o RC procedure also involved feedback for disruptive
(You lose a token because . . . )
o RC is punishment, but no side effect.
o Why is RC better then DRO but not token economy?
Due to individual difference in the participants
between the two studies. Effects of single subject
studies do not generalize to all children.
o There is no single intervention that is effective for
everyone. Typically, you compare multiple evidence-
based treatments to see what is most effective for a
particular student(s).
o Another reason why the results differed is due to
this study including feedback.
o Try not to use reinforcers that you have to take away
(children act out to keep it). Reifnorcement main
effect increase and secondary aminated and happy
effect. It also has consequences.
o Punishment main effect to decrease behaviour and
secondary effects of feeling bad, not likeing person
who punishes you, and aggression.
o RC is a mild punisher because it decreases behaviour
but it didn’t have any side effects.
Non-Contingent Reinforcement to Improve Classroom Behaviour of a Student with Developmental Disability (Moore et al., 2016)
- Reinforced based on time not behaviour. Change
environment to give plenty of reinforcers to reduce
need to engage in CB. - Method
o 8-year-old, Year 3, moderate disability
o Engagement - at end of each 10-s interval.
o Disruption – partial interval
o Context was instruction on fine motor tasks
o NCR – a 3-min break every 2-min - Happy with increase in engagement and not happy
with reduction in disruptive behaviour. - Why did it work?
o Disruption was maintained by escape and/or access
to preferred items.
o But, also involved reinforcer menu and picture
prompts
o What components are required?
o Maybe function of behaviour was tangible rather
than escape and that is why disruptive behaviour
was only modestly reduced.
Mindfulness Training for Parents and Their Children With ADHD Increases the Children’s Compliance (Singh et al., 2010)
- Mindfulness Training
o Accepting life as it is
o Knowing and experiencing “I am not my thoughts”
o Being compassionate
o Listening with calm attention
o Seeing through other’s eyes
o Engaging in loving kindness
o Being in the present moment
o When in trouble. Breathe! - Method
o 2 mothers and sons with ADHD (10 and 12)
o Recorded requests and compliance w/o disruption.
o Mother and child received 12 mindfulness sessions - What is it and why does it work?
o Taught parents to “listen” to child.
o Follow the child’s lead
o Take what the child gives you
o Taught child to listen to what was asked, focus on
doing that task, and not multi-task and not multi-
think
o But also perhaps there was increased natural
reinforcement for compliance?
Extinction/Planned Ignoring
- Planned ignoring, or extinction, is not paying
attention to a problem behaviour in order to
decrease the behaviour in the future. Your behaviour
support provider will teach you how to use planned
ignoring. When you start to use planned ignoring to
end a behaviour, you need to keep doing it.
Indications for Use
* For attention-maintained behavior
* For behaviour that is lower level disruptive
* For behaviour that is not likely to escalate too much
* E.g., interruption, making noises, and annoying other
students.
Implementation Steps
* Step 1: Define problem behaviors that you will
ignore.
* Step 2: Decide how you will ignore the behaviors
(e.g., turning away, removing eye contact, continuing
instruction).
* Step 3: Provide positive attention for desired
behaviors that you DO want to see (DRA)
* Step 4: If the behaviors are maintained by peer
attention then teach other students to ignore those
behaviors as well.
* Step 5: Record data
* Step 4: Perform steps 2-3 daily for one week and
evaluate your implementation efforts at the end.
The Long Term Successful Treatment of the very Severe Behaviours of Preadolescent with Autism (Foxx & Garito, 2007)
- Participant
o Ned
o 12 year old male with autism, mental retardation,
and ADHD.
o Suffers from seizures and impaired vision.
o Somewhat verbal but is difficult to understand due
to several speech deficits.
o A history of aggression, self-injury, and property
destruction that has resulted in injuries to himself,
family, staff and peers.
o He currently lives at home with his parents and older
sister.
o He was kept in a cage-like enclosure and feed from a
communal baby bottle whilst at an orphanage at the
age of 2.
o Initially showed no response to verbal stimuli.
o His father used behavioural techniques to teach Ned
to make eye contact, communicate verbally, and
exhibit some social behaviour. - Dependent Variables
o SIB – head banging, self hits, body slamming
o Aggression – head butting, kicking, hair pulling
o Dangerous behaviour – undoing seatbelt, climbing
furniture, touching electrical outlets
o Disruption – breaking & throwing objects
o Self-induced vomiting - Phase I
o Ned could choose what to do for 5 min and then
comply for 10 min.
o Compliance was prompted.
o Planned ignoring
o Time-out for aggressive or dangerous behaviour
o Scheduled snack times - Phase 2
o Treatment moved to Home and Church “classroom”
o 2.5 hour school day versus 6 hour
o DRO
o Tokens with Response Cost
o Redirection/Restraint - Phase 3
o Treatment moved to additional “classrooms”
o Increase school day to 5 hour
o DRO and Tokens, which could also be used to earn a
break
o Nap times
o Language training with errorless procedures
o 15-min Contingent Exercise
o Overcorrection with positive practice and restitution
o Moved to SCC in regular school - Phase 4
o Returned to a self-contained classroom in his regular
school.
o Contingent exercise replaced by additional response
cost - Results
o Effective intervention.
DRA
All differential reinforcement combines reinforcement plus extinction.
DRO
- Reinforce the absence (0 rate of behaviour) of
behaviour within a specified time period. - Differential reinforcement on interval schedules.
- Useful for immediate reduction in behaviours that
are harmful. - Function based treatment
- Does not teach a replacement behaviour
- Focuses on single behaviour and could
unintentionally reinforce other challenging
behaviours (i.e., when child has multiple challenging
behaviours in their repertoire) - Use baseline rates of challenging behaviour to
identify the interval schedule to reinforce other
behaviours - Momentary DRO is most appropriate for classrooms
- Jeff’s go to intervention at the beginning of a case
when you do not know what to do.
Extinction
- DRA speeds up extinction process and avoids
negative side effects of extinction - Punishing consequence with rules to implement.
- Things get worse before they get better.
- If you give in after placed on extinction you can
maintain it at a higher rate/intensity, accidently
providing intermittent reinforcement can maintain
challenging behaviours long term. - Extinction in DRA can be called modified extinction.
Spontaneous Recovery
- Side effect of extinction. Previously extinguished
response reoccurs after a brief break. Usually not at
the same strength as the original response. Extinction
does not equal unlearning. - Child test extinction rule to see if the contingency is
still in effect.
