The 4 Functions of Behavior series: Access to Tangibles

Parents often struggle with how to handle their kids at home as they don’t understand why their kids engage in challenging behaviors like self-biting, headbanging, throwing into tantrums, breaking things, and more. At times, it can start from simple tantrums to a potentially full-blown outburst.

Challenging behaviors are behaviors of such intensity, frequency or duration that the physical safety of the person or others is placed in serious jeopardy, or behaviors which likely to seriously limit or deny access to the use of ordinary community facilities.

As we’ve already discussed before, there are four functions of challenging behaviors. Please refer to our previous blog. This time, we will focus on access to tangibles as a function of challenging behaviors. Access to tangibles is a form of positive socially mediated reinforcement. Tangibles are anything that we can touch/feel (e.g., toys, food, hugs, tickles, heat, playground, etc.). Oftentimes, challenging behaviors result in the individual getting something from another. What are some strategies that you can implement at home to address this problem?

Functional Communication Training (FCT)

Teaching the child to verbalize as a replacement behavior for challenging behaviors is the main key. Most of these children don’t have the skillset on how to approach people and ask for what they want. For non-verbal kids, we can teach them to use sign language, use pictures to communicate via Picture exchange Communication System (PECS), or use an assistive device (iPad) as well. Collaborate with your therapy team on what is the best way for your child to communicate with others that would fit his/her needs.

Contriving teaching situations at home

Create teaching situations at home that would set an opportunity for your child to ask for the items/ activity that he/she wants. The misconception that usually parents do at home is to have the child access to everything to avoid the challenging behaviors. In doing so, you are not teaching your child skills to communicate with you and it would be hard for you to know what he/she wants when you are in a different environment or in the community.

 Just like addressing attention, try to schedule 10-15 minutes of your time contriving of teaching moments for the child to ask for the preferred toys/ activity at home. This time, engage with the child (e.g., play with him, help him complete a puzzle, play together with an iPad, etc.). I will use the iPad as an example as a highly preferred item. Most children nowadays love this gadget to watch videos and play games.

 Let’s say that the child wants to listen and watch nursery songs on the iPad. As you listen to the song, try to pause and play the song. When the song is paused, verbally prompt the child to say ‘Play it.’ Praise the child heavily ‘Great saying play it.’ and immediately play the song. This is just an example. You can prompt your child to request based on their needs and level of language skills. Then gradually fade the prompt.

 Please take note that delivering the reinforcement within 0-3 seconds and labeling what you are reinforcing for (e.g, Great saying ‘Play it.’) are crucial for the child to clearly understand that he/she just needs to use his words to gain access to the activity/item. You also need to vary the tone of your voice and your facial expressions in providing reinforcement. When the child uses his/her words, praise him/her as if you won a lottery. Exaggerations of your tone and facial expressions will help the child distinguish which is the right response to emit.

 Another way to teach them to request for items at home is by keeping all the preferred ones out of reach but still visible. This will drive the child to request those items as you verbally prompt them. Again, gradually fade the prompt and reinforce heavily every independent and appropriate request.

During the occurrence of challenging behaviors

 When the behavior already occurred (e.g., full-blown tantrum) in spite of your efforts to contrive teaching situations, disengage with the child (e.g., pause the song and remove the iPad). Don’t let the child have access to the item. Still keep the preferred item visible but out of reach. Remain calm and don’t attend to the child (e.g., don’t talk to the child or try to calm him/her down) but just stay close enough to keep the child safe. You can also ask someone to be with you in the room and pretend to be talking about something or pretend to be working.

Clear the room by removing all the toys or other things that could probably harm you and the child. Wait for the child to calm down. Once the child calms down, allow a few minutes (e.g., 1- 5 minutes) before you prompt the child to request for the item again. The few minutes interval between the end of challenging behavior and the start of your prompt is important. This will allow the child to totally calm down and to make sure that the child will not resort back to engaging in challenging behaviors again. This will ensure getting successful positive responses as well.

While dealing with challenging behaviors at home, remember to be consistent and always require your children to use their words or teach them to use gestures (e.g., point / touch the item) to indicate what they want. Have the other family members learn to handle the child as well to promote consistency in dealing with the behavior of the child.

The 4 Functions of Behavior series: Gaining Attention

Most children diagnosed with Autism have difficulty in expressing their needs. Some are verbal but still don't know how to efficiently use their language to communicate with others. They often engage in challenging behaviors as their way of communication.

 In ABA, we learned that finding out the function of the inappropriate behavior rather than focusing on the behavior itself, is the key to help understand these children. The function of the behavior is important to identify for several reasons, including behavior prevention, choosing socially appropriate replacement behaviors and the creation of Behavior Plans.

 As parents, it is helpful to observe your child and try to find out why he/she is acting out. It is crucial to find out first the function of the inappropriate behavior then it will be easier for you to help them. There are four functions of behavior (attention, access to tangibles, escape and Automatic/sensory), but let’s just focus on attention for now.

 Attention is a form of positive socially mediated reinforcement. The attention itself may appear positive (e.g., a child looking at you and says ‘hug’, or tapping your shoulder, etc.); or negative (e.g., biting, crying, hand flapping, tantrums, etc.).

Children with autism who have difficulty in communicating may resort to different forms of challenging behaviors just to get your attention because they don’t know how to. How do we overcome these types of situations at home? How do we teach our children to gain our attention in a more appropriate way? Let me give you simple ways that you can use effectively and practice at home and that will help you and your child cope.

Functional Communication Training (FCT)

In our practice, we utilize functional communication training (FCT) as a replacement behavior to any challenging behaviors. Teach the child to verbalize to gain your attention in replacement for inappropriate behaviors. We can also teach a non-verbal child to tap your shoulder, walk to you, pull your hands or use an assistive device (e.g., iPad) if any, in getting your attention.

Contriving teaching situations at home

Let say that you’ve identified the function, which is attention, and you know how to teach the child to gain your attention more appropriately. Spend at least 10-15 minutes of contriving teaching situations at home. Set up situations where your child will have lots of opportunities to practice using his/her words in gaining your attention (e.g., ‘mommy, come or help me.’). It might be beneficial to set up any situation where you pretend to be work in close proximity to the child (e.g., 3-5 feet away) while the child is completing a simple inset puzzle, playing with toys or playing with his/her iPad. I would say pretend to be working because your focus right that moment is catching every opportunity in prompting your child and reinforcing communication. Working near the child will also provide easy access for the child to get your attention (e.g., asking for help, asking you to look at his work, etc.).

 The first thing that you need to do is to verbally prompt the child or use a full physical prompt (e.g., physically guide him/her in tapping your shoulder) then gradually fade the prompt until the child learns how to gain you attention independently. It is also important to know the verbal skill level of your child. If the child can only say one word, then just teach him/her to just use one word (e.g., ‘Help’, come, etc.). If the child can already utter simple phrases or sentences, then teach phrases or full sentences in gaining your attention whether verbally or using an assistive device.

During the occurrence of challenging behaviors

 You can only teach them the replacement behaviors when they are calm and not when they are engaging in those other behaviors (e.g., crying, kicking, hand flapping, tantrums, etc.). We don’t want them to learn the pattern of displaying inappropriate behaviors first then using their words. Most children with autism can quickly learn that way.

 When the child is engaging in challenging behaviors to gain your attention, try your best to not attend to it (e.g., don’t try to talk to him or calm him down). This can be done by just calmly being there but at the same time making sure that the child is safe from hurting themselves or hurting others. Clear the room by removing all the toys or things that can hurt them or hurt you or other family members. Ask the other family members to just stay outside the room and let you handle the situation not unless you need help. Wait for the child to calm down which can take a few minutes to an hour or so. Don’t be alarmed and just make sure that the child and everyone else is safe. Once the child totally calms down, set another opportunity to prompt him/her to gain your attention and praise the communication heavily. It is important to always end any situations at home with the child responding calmly and appropriately.

In teaching children with autism, consistency in dealing with the behavior across people and the environment is crucial to your child’s success. Attention must be sufficient to meet the individual preferences of the child. Implementing proper behavioral strategies at home will help your child learn socially appropriate ways to have his or her wants and needs met. It will help decrease problem behaviors and help your child to be independent.

Morning Routines

Children with autism have difficulty communicating and interacting with other people. They also engage into other types of behaviors like performing repetitive activities and movements (e.g., body rocking, spinning, pacing, lining objects, etc.), become sensitive to any changes in daily routine, and have unusual responses to certain situations. Due to these difficulties and limitations, as parents, you may find it difficult to have your child get up in the morning and out of the door with the least amount of conflict.

The morning can be the most difficult part of the day. You sometimes may feel exhausted from your day-to-day work but you need to get yourself up and get ready for another day. But apart from rushing in getting the things done in the morning for work, you have to get your child up as well. But mornings are definitely tough and this is maybe the time of the day where your child may actually be defiant and at times would resort into mild tantrums to full-blown outburst in getting things done like getting dressed, making their bed, taking a shower, brushing their teeth, or eating breakfast.

So, how do we alleviate these challenging situations in the morning? One effective way is to establish a morning routine that will help you and your child cope. Routines provide predictability and help ease anxiety and uncertainty about what is happening around, thereby helping the child to have greater control over his/her environment. Following through in accomplishing the same routine every day, consistency in handling the situations and setting up clear expectations make parents feel more comfortable and make any situations more manageable. In addition, it will help your child to be comfortable in going through their daily activities as well. So, how to establish a good morning routine?

 Setting up a schedule

 As parents, you may encounter some challenges at home especially in following through with your child’s morning routines. Daily schedules help lessen some of these challenges. Before you start setting up the morning schedule, you have to know the effects of certain activities on your child. Maybe your child gets upset getting up in the morning, maybe gets overwhelmed by the noises of people around or when presented with simple directives. After knowing all those things, then you can start up a schedule that would fit your child’s needs.

 Once you’re done with the list of activities for your morning routine, it will be easier for you and your child to get through it little by little each day.  It is also vital to have parents set up your own schedule that would help you with your morning routine, particularly for working parents and try incorporating it and try to be consistent or do it in the same manner, every day.

Using visual support

Children with autism may not understand social cues, may have difficulty in following simple directives, or may struggle in dealing with any changes around them as they go into their daily activities. In addition, these children can sometimes have difficulties with sequencing. Visual support will help your child have a clear picture of sets of activities that they need to complete for a certain period of time. It’s a clear way to communicate to your child the sets of activities needed to get done before going to school or before going out for therapy sessions. Visual supports can be pictures, drawings, objects, written words, or lists that you can utilize depending on your child’s needs. The fewer and clearer choices they are given to choose from, the easier for these children in following the routine.

 In presenting visual support, be creative and try to incorporate each activity with some pictures of your child’s favorite toys or favorite cartoon characters/superheroes, etc. Because in going through with each activity on the schedule, these children can easily have a meltdown or become overwhelmed. Creating visual support that will help catch your child’s attention, especially incorporating pictures of the reinforcing item/ activity that he/she can have as a reward, will help your child to be more motivated in completing each activity.

Setting up a timer

At the start of the implementation of the morning schedule, try to set a timer for each activity and reinforce it heavily when your child finishes the activity on time. Setting a timer will help you and your child get used to getting each activity done on time. It will help your child see clearly what is happening and when. It can be hard at the start but try to make each activity fun and enticing to the child as you prompt him/her with each activity and celebrate like you won a lotto (e.g., fly the child around the room, play his favorite song, tickle or lift the child up in the air, or anything the child prefer) once done on time.

Once the child is completing each task on the specified amount of time, then you can normally run the schedule without a timer. You also need to set clear expectations on what the child needs to do and what he/she can get when the activity is done on time and not get when not able to complete the task. Be consistent and be ready to follow through with all your conditions. With each activity done on a specified period of time, then you’ll have enough to get all the activities done on time before heading out.

Setting up a sequence of activities

In setting up the sequence of activities on the schedule, try to check first the preferences of your child. It is essential to tailor it to the sequence of activities that your child prefers. Your child may prefer to do some activities first over the others. To make your child more comfortable in going through with the schedule, try focusing on their priorities.

For instance, if your child prefers to take a shower first before breakfast or the other way around, then honor it. Involve your child in setting up the sequence of activities on the schedule and once you’re comfortable with the sequence then stick to it. The child can change the sequence provided that he/she conforms to the sets of expectations in place. Remember as well to follow through.

Preparing ahead of time

It can be very difficult for you to wake your child up in the morning. Your child can easily get into meltdown or tantrums when he/she still wants to sleep more. To avoid this problem, have your child sleep early and have a consistent time for bed.

In the morning, try to get up an hour or a few minutes early ahead of time to give you and your child extra time to go through each activity without being pressured. It will help you work at your own pace and to avoid getting late for work or school.

 You can also prepare things ahead of time or the night before like picking out their clothes, preparing their snack and lunch, preparing the school bag, and more to avoid getting late and have enough time to address some behaviors that may occur (e.g., meltdowns or tantrums). So, having a consistent time (e.g., 7:00 pm) of bed and wake up time (e.g., 6:00 am) will help your child settle in a routine.

Setting up a reward system

Make clear expectations on what your child gets upon completing each activity on the schedule and what your child gets upon completing all the activities calmly on time. Make all the activities fun and motivating to the child by incorporating on the schedule the things that they can get in completing the set of activities on the schedule. For instance, if your child completes the activities on the schedule calmly before heading out, then your child can have one chocolate muffin (e.g., child’s favorite food) as his/her snack at school. The most important thing is to keep your child motivated and not feel stress out in going through with his/her morning routine.

Establishing a morning routine will not only help your child feel relaxed in getting through each activity in the morning but can also help anxious parents as routines provide predictability. For children with autism, routines help them to feel comfortable in an environment that makes them feel in control. So try to apply these strategies at home to help your child have a fantastic start of his/her day.