Promoting Positive BehaviorsPromoting Positive Behaviors Stacy A. Layer, MA, BCBA Behavior Analyst, Manager

Stacy.Layer@mch.com

and

Julie Sevilla Aquatics Coordinator

Julie.Sevilla@mch.com

MMiamiiami CChildren’shildren’s HospitalHospital

Dan Marino Outpatient Center ◦ 2900 S. Commerce Pkwy, Weston, FL

33331

MMiamiiami CChildren’shildren’s HospitalHospital

Dan Marino Outpatient Center ◦ 20,000 gallon, heated, covered pool

Needs AssessmentNeeds Assessment Find out what goal(s) the family or caregiver hopes

to accomplish through swim lessons. Determine the child’s diagnosis, physical and

cognitive limitations, communication abilities, and levels/types of problem behaviors.

Learn about any medical considerations and allergies the child may have.

Determine the child’s preferred games, toys, activities, and form of praise and reward system.

Determine the child’s preferred method of teaching to facilitate learning (prompts, instructions, visual supports).

StrategiesStrategies Be prepared!

◦ Minimize transition time between activities ◦ Keep children engaged at ALL times

Establish rules and review at start of EVERY activity and frequently throughout activities

Transitions: Provide verbal warnings prior to changes in activities

Demonstrate the new skill Keep the fun in fundamentals Always end on a good note

◦ Stop activities while interest is high Provide pro-active choices Follow a consistent schedule Carefully select demands and follow through always

Strategy: Create RulesStrategy: Create Rules

Be brief and clear Avoid rules that start with “no” or

“don’t” ◦ The child what to do and give rules that are

incompatible with undesirable behavior ◦ Example: “Keep your hands and feet to

yourself” versus “No hitting, kicking or pushing”

Praise or reinforce rule following more often than you call attention to rule breaking

Post rules using both written words and pictures or symbols

Promoting Instruction FollowingPromoting Instruction Following Use a participant’s name prior to a specific instruction

or comment When giving directional instructions, label landmarks ◦ Tell the participant to “swim to the ladder” instead of “swim over there”

Use the least number of words possible in your instructions ◦ Say, “swim to the wall” instead of, “now we are going

to swim over to the wall nice and fast”

Give one set of directions at a time Check for understanding by asking participants questions

such as, ◦ “Where will you stop?” ◦ “How many laps will you do?”

StrategiesStrategies

Only the materials relevant to the target skill should be within the child’s reach

Minimize potentially aversive aspects of the lesson and transitions ◦ Warnings ◦ Non-directive prompting ◦ Choices ◦ Errorless Teaching

Prompting StrategiesPrompting Strategies

Errorless: If there is no or little likelihood that the child can perform the skill

Three-step prompting: If there is some or a high likelihood that the child can perform the skill

EEasierasier saidsaid thanthan done…done…

If all else fails, here are some behavioral tips!

Human BehaviorHuman Behavior Behavior is ◦ a function of both genetic and physiological factors as well as each child’s history of personal experiences (Cooper, Heron, & Heward, 2007).

◦ Anything a person says or does that can be observed by more than one person

◦ Does not include internal events, such as thoughts or feelings

◦ DOES include behavioral bi-products of internal events

Respond to behaviors, not perceived emotions

Behavioral FunctionBehavioral Function

Topography is what the behavior looks like Function is why the behavior occurs

Topography ≠ Function

Focusing on function will help you respond

effectively

Behavioral FunctionBehavioral Function

Behavior Not Behavior

Crying Being sad, scared, or

upset

Smiling Being happy

Kicking Mad or angry

Hand Flapping Sensory or self-

stimming

Compliance Ignoring, defiant

Heart Palpitations

w/Sweating Anxious

Functions of BehaviorFunctions of Behavior

Socially Mediated ◦ Access to Attention ◦ Escape from Demands/Aversive Situation ◦ Access to Tangible Items

Non-socially Mediated ◦ Automatic/Sensory Input

Example BehaviorExample Behavior

Tantrum ◦ Crying ◦ Yelling ◦ Flopping to floor ◦ Hitting ◦ Kicking ◦ Throwing objects

Attention Maintained TantrumAttention Maintained Tantrum Attention includes: ◦ Eye contact ◦ Any vocal response Reprimands, praise, comforting, shhing

◦ Physical contact Hugs, pat on the back

◦ Non-verbal reactions Gasping, laughing, thumbs up

◦ Facial Expressions Smiling, frowning

Attention Maintained TantrumAttention Maintained Tantrum

Indicators: ◦ Child looks at you or caregiver prior to engaging

in the behavior ◦ Behavior begins when caregivers are engaged in

conversation and not focused on the child ◦ Behavior stops temporarily when attention is

provided

Attention Maintained TantrumAttention Maintained Tantrum

Proactive Strategies: ◦ Provide children with some form of attention

every couple of minutes ◦ Ignore any behaviors you do not want to see

repeated

Attention Maintained TantrumAttention Maintained Tantrum

Reactive Strategies: ◦ Ignore the behavior, not the child ◦ Continue activity without disruption ◦ Do not make eye contact ◦ Wait to provide attention until a desirable

behavior occurs

Escape Maintained TantrumEscape Maintained Tantrum

Escape includes: ◦ Delaying compliance or aversive event Repeating instructions multiple times Providing “1 more minute”

Waiting until child is calm – this may never happen!

◦ Avoiding compliance or aversive event completely

Escape Maintained TantrumEscape Maintained Tantrum

Indicators ◦ Behavior begins immediately following a demand

or onset of aversive event ◦ Behavior decreases temporarily when a break

(escape or avoidance) is provided

Escape Maintained TantrumEscape Maintained Tantrum

Proactive Strategies: ◦ Provide clear instructions Use minimal number of words during interactions

◦ Disguise instructions with games “My turn…Your turn…”

“Stick out your tongue like a frog catching a fly for dinner”

◦ Avoid asking too many questions Questions resemble demands

Escape Maintained TantrumEscape Maintained Tantrum

Reactive Strategies: ◦ 3-step prompting Give directive instructions

Tell, Show, Help or Vocal, Model, Physical

◦ Do not stop or delay demand or aversive event

Tangibles Maintained TantrumTangibles Maintained Tantrum

Tangible Items include: ◦ Toys ◦ Food/Candy ◦ Clothes ◦ Security blankets/pillows/dolls ◦ All objects

Tangibles Maintained TantrumTangibles Maintained Tantrum

Indicators: ◦ Child requests an item and is denied prior to

engaging in the behavior ◦ Behavior begins when caregivers remove objects from child’s possession

◦ Behavior stops temporarily when items are returned

Tangibles Maintained TantrumTangibles Maintained Tantrum

Proactive Strategies: ◦ Provide choices prior to undesirable behaviors

(NOT after) ◦ Arrange environment so that dangerous/enticing

items are out of reach Have child friendly items readily available

Tangibles Maintained TantrumTangibles Maintained Tantrum

Reactive Strategies: ◦ Block access to items until an appropriate

request is made ◦ Once item is removed, continue activity without

disruption

Automatic/Sensory Maintained Automatic/Sensory Maintained TantrumTantrum Automatic/Sensory input includes: ◦ Auditory stimulation from screaming ◦ Tactile input from hitting ◦ Visual stimulation from watching thrown objects

Automatic/Sensory Maintained Automatic/Sensory Maintained TantrumTantrum Indicators: ◦ Behaviors occur regardless of socially mediated

consequences

Automatic/Sensory Maintained Automatic/Sensory Maintained TantrumTantrum

How to Respond: ◦ Provide the sensory input proactively to prevent

problem behavior ◦ Provide alternative, appropriate means of gaining

sensory input ◦ Block inappropriate sensory input to prevent

future occurrences

Healthy ConsequencesHealthy Consequences

Avoid saying, “No,” or “Don’t do that” ◦ Tell the child what he should be doing instead

Use positive, descriptive comments to the exclusion of negative phrases, criticisms, or empty threats

Remain calm

Functional Functional ReinforcersReinforcers

Discover why the problem behavior occurs Use the specific behavioral function as a

reinforcer instead of arbitrary rewards ◦ Example: A child cries and throws tantrums

every time he is at a table-top activity because he would rather be up walking around and looking out the window. How could you reinforce sitting quietly?

NOT Healthy ConsequencesNOT Healthy Consequences