Thursday, August 27, 2009

Using Behavioral Approaches in Autism (And on Anyone)

by Shannon Des Roches Rosa (Guest Post, Thank you- Shannon)


Behavioral methods are usually associated with autism and early intervention, or orca training.

But guess what? You can use them to change the behavior of almost anyone: your children, your partner, your co-workers, even icky blog or Twitter trolls.

I am a huge fan of behavioral methods because they have helped my son gain so many skills, but I also confess that I use the methods to mold behaviors whenever I can.

Let me tell you how you can play puppeteer, too.

All you have to do is ignore undesired behavior, and instead seek out, role model, and reinforce desired behavior. If your subject doesn't respond, then analyze their motivations, and appeal to those motivations instead using reinforcers (okay, bribes) if necessary, which you can taper off once the behavior becomes routine.

That's pretty much it. I know.

Behavioral methods are straightforward, but they're not instinctive unless you're the kind of naturally empathetic and kind person I tend to avoid because you make me feel like a jerk.

And implementing behavioral approaches systematically and consistently, especially in parenting, takes more effort than asking children to talk about what they were feeling when they hit their brother over the head with a lunchbox (though understanding that motivation is important, too).

It takes a lot more analysis and upfront effort to be proactively positive instead of impulsively negative, but the results are generally worth it because you're not reacting and reprimanding, you're planning and conditioning -- and conditioning sticks.

Behavioral methods aren't foolproof, but they usually work. Here are some examples:

• Instead of yelling at a kid who picks her nose, hand her a tissue, and tell her how proud you are when she blows her nose instead of excavating. Actively watch for opportunities to catch her doing the right thing, and praise her with gusto when it happens. If this approach doesn't work, up the ante with a sticker or other reward chart. If you still can't find any motivation strong enough to stop the nose-picking, then you need to decide if it's a critical battle, or if you should change your focus to "I'm proud of you when you don't pick your nose in public," and start reinforcing that behavior instead.

• Instead of chastising a co-worker who takes the last cup of coffee and leaves the carafe empty, ask them if they wouldn't mind refilling it, and be emphatic but not patronizing in thanking them when they do so. Repeat repeat repeat. (You might want to wait until after they've had their first sip of coffee.)

Behavioral methods form the cornerstone of ABA therapy, which is one of the most commonly used approaches to help children with autism and other special needs learn. it is a 1:1 -- one child, one therapist instructor -- intensive, data- and evidence- driven educational program for addressing a child's learning deficits. Whether it takes place at home, at school, or across both places, all the learning is tracked, and the resulting data scored and analyzed to see what kind of progress the child is making.

Many autistic children have difficulty learning from their environment or in traditional educational settings, because there are so many assumptions involved in each lesson.

How can a child learn to write the letter A if they don't understand how to hold a crayon, that you need to hold the paper with the other hand, or even that you're supposed to remain seated? These kids need their learning broken down into small steps, and bolstered by repetition. This is what ABA therapy does.

It is not the only way to help our kids with autism and other special needs learn, and it doesn't don't work for all kids with autism because there is no one type of kid with autism, just as there is no one type of gifted child or one type of Deaf child.

But ABA is worth trying, to see if your child responds. ABA therapy methods taught my son Leo to dress himself, play with other kids, ask for help, and occupy himself independently. He simply did not respond to other ways of learning when he was little.

Some critics protest that ABA therapy is too rigid, too intense, and uses aversives or negative consequences to shape behavior. While these practices were used in the early days of researchers like Ivar Lovaas, an ideal modern ABA program is customized for each child's skills sets and learning needs, and is flexible not only in what it teaches but in where the teaching takes place.

There should be no forty hours per week of sitting at a table doing boring drills. There should be no punishments, only praise and reinforcements. ABA therapy, like most credible learning systems, continues to evolve through evidence regarding best practices.

ABA therapy is also frequently downplayed by a media that prefers to sensationalize autism "cures" achieved through dietary supplements or questionable medical protocols or Martian rocks, but I guarantee you: most "cured" or "recovered" children, including Jenny McCarthy's, Karyn Seroussi's, and Age of Autism's had ABA therapy as well, and likely made much of their progress in that environment.

Many of Rethink Autism's learning tips are simple but not necessarily something I'd come up with on my own, an example being color-outlining the inside edges of separate color areas to encourage children to use more than one color per picture

Using a one-inch-thick boundary around the coloring area, and then gradually increasing the size and complexity of the white space while reducing the thickness of the outline. Coloring inside the lines is an ongoing challenge for Leo, but the Rethink Autism approach seems to be helping so far:

We are currently in a situation that is testing our and Leo's long-time ABA program supervisor Emma's behavioral chops: Leo has decided that he would prefer not to have a little sister. My son may have many challenges, but his memory is tremendous, and he remembers his years as Mommy's baby quite clearly. He has tolerated his sister for almost five years, and now feels it's time for the usurper to go. He has spent the last few months trying to hit, pushing, and terrorize her non-stop.

My husband and I have been trying to ignore Leo's behavior (when safe to do so), or keep the two of them separated and supervised. But Supervisor Emma pointed out that this is not a long-term approach; we are not addressing Leo's motivation, which is to make his sister miserable enough to leave. So we need to take his motivation away. We need to create as many safe positive interactions between Leo and his sister as possible, so that Leo starts to like his little sister, sees that there many benefits to having her around, and stops trying to remove her from the picture.
Cross your fingers for us; if Emma's approach works, it'll be one more victory for behavioral techniques.

Source: http://www.blogher.com/using-behavioral-approaches-autism-and-anyone

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