The 4 Functions of Behavior series: Escape

The other function of a behavior is escape. Escape refers to negative socially mediated reinforcement. This involves escaping from an aversive experience, involving another person, in the outside environment (e.g., noisy classroom, difficult task, etc.).

Most children with Autism often resort to challenging behaviors to get out of work. They may display various types of behaviors, for instance, throwing into tantrums, self-injurious behaviors, property destructions, and at times self-stimulatory behaviors (e.g., hand flapping, body rocking, etc.) to escape a difficult task.

 These inappropriate behaviors can last for a long time because they are effective. They work. When a child cries, and tears the paper at school when presented with a math worksheet activity, and is brought outside for time out – the child stops doing the work. This is exactly what the child wants; to escape from the task. Teachers may think that they are teaching the child a lesson and hoping that the child would learn to comply next time. But no, they are just teaching the child to continue engaging in those types of behaviors to escape from the task. They are just reinforcing the escape behavior of the child.

 Parents encounter these types of situations as well at home. They also struggle on how to have their children comply with simple instructions without the child resorting into challenging behaviors (e.g., brushing teeth, wearing clothes, putting away their toys, etc.) The main key is to figure out some ways to stop these behaviors and have the child comply to have the task done.

 There are some effective strategies like enriching the environment, using high probability sequence (e.g., easy task, difficult task, then easy task), giving the child choices of activities, setting up schedules, being creative in presenting the activities, using a token economy system, FCT (Functional Communication Training), using the Premack principle – First and then, and more other techniques for the child to be more motivated in completing a certain task and not resort to escape it.

 In addition to those strategies, don’t forget to use highly preferred items/activities as reinforcers. You can easily see which items or activities are reinforcing to the child as those are the items they choose to play with or activities they engage in most if not all the time at home. Simple tips. After finding out those reinforcements, try to keep them and just have the child access to them after completing a certain task or demand. In presenting the task, make it enticing and fun for the child. You can do this by knowing what your child enjoys doing (e.g., flying him like a superman or like an airplane or moving like his preferred animal - hop like a bunny to go to a room in your house where you planned on doing the activity, etc). 

 Let’s go back to the strategies. As you can see, there are lots of different strategies to motivate the child to complete a task. But keep in mind that one child is different from another. We can actually just use one strategy or combine some strategies, whichever fits the child’s needs. For now, let’s learn how to use three strategies together like using FCT (Functional Communication Training), giving the child choices of preferred activities, and the use of the Premack principle that parents can use easily and effectively at home to teach their children to comply, stay on task and use more appropriate behaviors in escaping a demand. 

Functional Communication Training (FCT)

 We have already learned how to teach the child to communicate to gain attention and to access a preferred item/activity. This time, teach the child a replacement behavior for escape. Teach the child to ask for a break, go or I want to go. Why do we need to teach the child to ask for a break or ask to go? Because we much rather have the child verbally imitate us to say ‘Break or I need a break, I want to go, or get handed a ‘break or go ’ card than a child slap you on the face, or throw into tantrums for an extended period of time. So let’s replace it with an appropriate behavior because if we don’t teach them a replacement behavior to get what they want, they will continue to engage in those inappropriate behaviors to escape.

 We have to remember that the child can be escaping a social situation, a specific environment or a person, and not just from a task or demand. There are different techniques to teach the child how to request appropriately to escape from a demand. The strategies can be tailored to their language skill level and the severity level of their behaviors. You can use break/go cards, verbal prompts, visual cues, social stories, scripts and more. You just need to be creative and make sure to match it to your child’s needs and abilities.

Giving Choices

Knowing the child is the key here. You can start with simple preferred activities that you think are easy for the child to do it to completion. Present two preferred activities (e.g., inset puzzles, sorting colored toys, matching colored cars, or any activities that you see the child engage in most of the time). In this technique, the child will have a higher probability of complying and completing the task.  So for instance, ask the child ‘Which one do you want? The puzzle or the cars?’ as you present the two preferred items in front of the child. The child can either respond verbally or use gestures (e.g., pointing or touching the chosen item).

Premack Principle – First and Then

 The Premack principle is a principle of reinforcement, which states that an opportunity to engage in more probable behaviors (or activities) will reinforce less probable behaviors (or activities). For example, if a child enjoys playing games or listening and watching nursery songs on the iPad (more probable) and avoids putting away toys (less probable), we might allow the child to play with the iPad after (contingent upon) finishing putting away the toys. 

 This principle is often referred to as “grandma’s rule” because grandmothers (or any caregivers) often apply this principle: “First, you clean your room (less probable) then you can play with your computer (more probable).” This strategy is effective in teaching children with autism as it gives them a clear view of all the expectations.

 Contriving teaching situations at home

Now, let’s learn how to combine these three strategies in teaching your child to comply and learn to escape from a task more appropriately. During your free time, set at least 10-15 minutes to contrive situations in teaching your child. Let's say that you’ve already chosen two preferred activities (e.g., 3 piece inset puzzle and matching superheroes card game) for the child to choose from. Present the two activities and ask the child “Which do you want? The puzzle of the Superheroes card? Let’s say the child chose the puzzle. Then, present the instruction ‘First do the puzzle then you can play with your iPad (highly preferred item). For starters, just ask the child to fit in one piece of the puzzle. Provide a physical prompt if needed to complete the task then gradually fade the prompt as the child learns to do it more independently. Upon completing the task, immediately prompt the child to say ‘break, I want a break, go or I want to go’ or physically prompt the child to hand you a break / go card. Then reinforce heavily for using his words. Give the child 5 minutes to play and repeat the process. So, one instruction, then break. This process may vary depending on the skill and severity level of the child. I was just setting an example.

 You are maybe wondering why you just ask a child to fit in one piece of the puzzle and he/she gets a break for five minutes. One technique to avoid any challenging behaviors in presenting a task is to start from a quick, easy, and simple activity that ensures success. In this example, we are just teaching the child to learn how to complete a simple task and use his/her words ‘Break or I want a break or I want to go.’ to escape from a task rather than a child punching you in the face.

 You can build up the difficulty level of certain demands at home from simple putting away toys, dressing up, or brushing then give the child time to play. Let’s say, for example, you presented two pictures (e.g., brushing teeth and putting away toys in the box), then ask “Which do you want to do? After choosing one of the activities, then present the instruction ‘First brush your teeth then iPad.’ You can have the child play for a certain period of time (e.g., five minutes) after teaching him/her to ask for a break / or to go appropriately and then present another demand. You can only present more difficult tasks once the child learns to escape more appropriately. 

During the occurrence of challenging behaviors

 When the behavior occurs upon presenting a demand, don’t let the child escape from the demand. Let’s go back to our example. When giving an instruction to fit in the one piece of the puzzle but the child starts crying, kicking, and throwing; physically prompt the child to fit in the puzzle if you still can and verbally prompt him to say ‘Break or go.’ Even if the child didn’t imitate you for a break, let the child go. You have already successfully had him fit in the puzzle even if it was with a physical prompt.

But if you can’t physically prompt him anymore because it was too late and the child is already in a full-blown tantrum, then disengage with the child.  Do not continue giving the child a demand. Let the child calm down and keep him safe from hurting himself. Make sure not to attend to the child (e.g., don’t talk to the child and try to calm him down) and clear the room by removing all the toys or other things that could probably harm you and the child. Once the child calms down, allow a few minutes (e.g., 5 minutes) before you give the same demand. 

We may or may not present another demand after the tantrums. It would depend on the situation. It is essential to present again the same demand after the tantrum so that the child would learn to complete a task calmly and ask for a break more appropriately. We don’t want the child to learn the pattern of throwing into tantrums, get prompted for a break then he can go and play. Children with autism can easily pick up a pattern of behaviors. We want to avoid having them learn a pattern of engaging in inappropriate behavior first and then end with a prompted response.

 These are just some of the strategies in dealing with escape behaviors. Parents must learn just simple ways of addressing problem behaviors at home that are doable and easy to implement. Learning simple techniques at a time. Again, just remember to be consistent in dealing with the behavior.

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.