Hi, I'm Dr. Mary Barbara, autism mom, and board certified behavior analyst. I did a
survey a few years ago as I was creating my first online course and 300 autism
professionals and parents responded within a week and they told me that
their number one challenge, by far, hands down, was handling problem behaviors. As a
board certified behavior analyst at the doctoral level, I have analyzed a lot of
different problem behaviors, ranging from severe self-injurious behavior to one
student who said, "are you happy?" 48 times in 10 minutes, to another boy who became
aggressive if anyone said the word "okay." At that point, I realized how much I
actually say "okay" each and every day. No matter what the problem behavior is, the
first step is to always start with an assessment -- and don't just assess the
problem behaviors. Instead, assess the whole child and look at the entire
situation first. Let me tell you about a little boy, I'll call him Tony. He was 6
years old and he was in one of the autism classrooms and I had only met
him a few times. I was working at school only and not in the home and I was
coaching the staff to work on things like manding and early learner
programming. Tony had a few words, not a lot, and he had only mastered a few
skills. He ate cereal and corn chips during the time that I saw him. Tony's
mom requested to meet with me and when Tony's mom came in, she told me
that her husband, Tony's father, was serving in the military and overseas for
several months. She was having financial difficulties and Tony was very
disruptive in the community. He was clearing shelves when they would go to
the grocery store. He was just having a really difficult time which was not a
behavior that I would have expected of Tony who was
pretty compliant and quiet at school. Tony was also not toilet trained and
since he was 6 years of age mom was spending a lot of money on diapers. When
I was assessing Tony's food intake mom told me that he ate french fries, corn
chips, and other neutral colored crunchy foods, which was not surprising that's
what I saw him eat. But when I asked her "does Tony get any vegetables fruits or
protein in his diet?" she casually said "well yeah only in the baby food."
Without trying to look shocked I said, "oh he gets baby food?" She replied, "yes it's
the only way I can get him to eat anything with any substance." So I said, "ok
how many jars of baby food does he go through each week?" and she said "52 jars
of baby food a week" and this is for Tony who was able to chew and swallow corn
chips, french fries, and cereal. Financially, the diapers, the baby food
and mom's inability to take him out to stores to do grocery shopping, all these
things combined were so much more important than many of the things, most
of the things, we were working on at school. So without assessing all of these
areas, we weren't able to program effectively. You can download the
one-page assessment sheet I used for Tony, and initially for all my clients. I
created the sheet, and you can download it using the button right below this
video. If you have the time, funding, and an experienced person to complete a VB
map assessment, that would be my recommendation but if you can't, this
one-page assessment can get you started and the best news is that it will only
take you about five or ten minutes to complete. After you do this general
assessment, then next I would recommend getting more
details about the actual problem behaviors.
I want the parent or professionals that work with the child to fully describe
the problem behavior. When you describe behaviors, be as specific as possible. So
instead of saying, "he melts down" or "he has a tantrum," tell me what that looks
like. To coach other professionals and parents to be more specific, ask them if
he melted down right now what would that look like, what exactly would I see? Would
a meltdown include flopping to the floor, screaming, hitting mom, biting other
peers, or biting his own hand? When you hear a behavior described such as "he
gets anxious," what does look anxious look like for
that specific specific child? Does he pace around the room, does he verbal stim,
does he script, does he put his head down on the desk? How do you know he's anxious
and what does that look like? Being out of control, frustrated, or anxious are not
specific behaviors that you and I can count reliably. Describe what the
behavior looks like in a way that we can see and we can both count because
it helps us to get an accurate starting point so we can develop interventions.
For instance, one boy was hitting his head on a wall during instruction. So
while this was certainly not my only recommendation, moving the desk away from
the wall was a good start. As a behavior analyst, I know how
important it is to define a behavior clearly, especially when conducting at
functional behavior assessment, so instead of "Susie hits her head," BCBAs
would say something like "Susie hits the right side of her head with a closed,
right handed fist" or "Susie bites the knuckle of her index finger of her right
hand and will sometimes draw blood and will always make indents
marks." This gives you a sense of how severe the problem behavior is. If the
child causes open wounds, indent marks or lesions, that certainly is important
to note too. In summary, the first step to tackling any problem behavior is to
start with an accurate assessment of the whole child and then to do a thorough
description of the problem behaviors that he or she is exhibiting. To start
your free assessment, click the link right below this video and I'll see you
next week. In next week's video blog, I'll discuss the second step to
tackling any problem behavior. If you're watching this video anywhere other than
marybarbera.com, hop on over and leave me a comment and don't forget to
download my free one-page assessment so you can get started today.