Hi, I'm Dr Mary Barbera, autism mom, and board certified behavior analyst.
Last week I discussed the first step to tackle any problem behavior and that was to fully
assess the entire situation and accurately describe the problem behavior.
If you haven’t watched that video blog, you may want to hop on over and watch that one first.
After assessment and a really good, thorough description of the problem behavior, what does the problem behavior actually look like when
it occurs, we need to determine when and where the problem behavior usually happens.
Is it always with mom?
Does it usually occur with a particular teacher?
Is it usually within an inclusion or community setting or does it occur at home or in the
autism classroom?
Also, it’s just as important to find out if there is a location or situation where
the behavior never, or rarely, occurs.
Would the behavior never occur in a pool or would it never, or rarely, occur if the child was given free access
to videos or if the child was in bed?
If you let your child play on the computer all day, or line up cars, or eat unlimited snacks,
would they not engage in problem behaviors?
These are all important clues.
Next we need to look at what happens right before the problem behaviors occur. This is called the antecedent.
When Johnny is alone in the crib, he tends to bang his head.
When Sarah is called to the kitchen table to eat, she whines.
When Faith is told “no,” she screams and flops to the ground.
When TJ is watching movies, he scripts the lines from the movies.
The consequences are the next thing to determine….
what happens right after the problem behavior occurs?
What does the parent or teacher usually do when the problem behavior occurs to stop it,
if anything?
If Faith flops and she’s at home, does mom just walk away?
Does she walk away for 5 minutes, then if Faith doesn't get up from flopping does her mom
go back and pick her up?
Does Faith ever flop when she is in the grocery store or outside?
Also what happens if Faith flops and mom needs to go to an appointment?
In that case, what happens when she flops?
That’s usually the problem.
There are most likely a lot of different consequences based on the location and how much time the
parent or the teacher has to either ignore the behavior or to intervene.
While we’re assessing the actual problem behavior, ideally, you want to take frequency
and ABC data, and/or a partial interval data over a few days to get an accurate baseline.
In a lot of situations this simply can’t be done.
For example, getting a true baseline of how often a problem behavior is occurring is not
possible for kids who are having severe problem behaviors that could cause injury.
For instance, I had a client who banged his head on hard surfaces to the point where he
got an open lesion on the back of his head.
He was only 2 years old and just diagnosed
when I first assessed him. I had asked the caregiver “How much of the 9 hours that he’s here
at the child care setting does he bang his head?”
The person that was watching him said out of the 9 hours, he banged his head about 3 hours a day.
I can't wait for 3-5 days to establish a baseline.
I mean, 3 hours a day of banging his head on hard surfaces, I need to intervene very quickly.
If you can't take a full baseline, I would interview the person that is with him most,
preferably, the parent and/or the teacher if they’re in school.
Get an estimate of the frequency and magnitude and ask questions like does it happen 3 hours
per day, 10 times per week and each episode lasts about 5 minutes or does the episode happen 2 times per week or 2 times per month.
Finally, take a video of the problem behavior when it occurs and/or take a picture if there
are any open wounds, scabs, indent marks, or lesions.
If you are a professional make sure to obtain video and photograph permission early on.
This will help you document the severity of the issues and will provide a nice “before
and after” view of the situation after you implement successful interventions.
To wrap up, the first step to tackling any problem behavior is to accurately assess
the whole child, including a thorough description of the problem behaviors and the second step
is to understand when, where, and how often the behavior occurs and what usually comes
before and after each behavior occurrence.
To get a free Problem Behavior template that I created so you can start tackling any problem behavior,
click the link right below this video and I’ll see you next week.