Introduction to ABA and Targeting Challenging Behaviors By: Kirsten Powers Trumpet Behavioral Health
Introduction to ABA and
Targeting Challenging Behaviors
By: Kirsten Powers
Trumpet Behavioral Health
• Introduction to ABA
• What, why, who
• Common Myths
• Principles and targeting challenging behavior
• Taking a functional approach
• Basic strategies for challenging behavior
• Identifying high quality ABA
• Barriers to Accessing Services
Topics
Behavior Analysis
The scientific study of behavior and the environmental events that affect it.
Experimental Analysis of Behavior
(EAB)
-Examines and identifies basic principles of
behavior
-Both animals and humans participate in
experiments
Applied Behavior Analysis (ABA)
-Approaches/techniques are developed and evaluated
from results of EAB studies
-Focuses on improving socially significant
behavior and quality of life
• Approach to understanding and changing human
behavior
• Looking at environmental variables that can influence
behavior through observation and measurement
• We can systematically change behavior to improve lives
• Reduce/change unwanted behavior
• Increase appropriate behavior
• Teach new behavior
• Evidence based: Means that the strategies and
techniques we use have been verified by others
(researchers) and have shown promising effects.
Applied Behavior
Analysis (ABA)
• ABA is the only treatment for ASD that is endorsed
by
• American Academy of Pediatrics
• the US Surgeon General
• the American Medical Association.
• ABA is the most clinically-supported therapy for
ASD, and no other intervention has been shown to
have the magnitude of success as intensive ABA
services.
• Howard (2005)
Why ABA?
• Use reinforcement across structured and natural
environments to establish and maintain new skills.
• Breaking complex skills down into simpler tasks
• Emphasis on making learning fun for the learner.
• Withholding reinforcement for inappropriate behavior, but
teach replacement skills.
• Rely on data collection and analysis to guide and determine
effectiveness of treatments and interventions and make
timely appropriate modifications.
• Individualized
Why is ABA an effective tx
for autism?
What the research has shown..• ABA is effective for learners with autism
• Children with autism who participate in early, intensive ABA-based programming learn many new skills and reduce their challenging behaviors substantially
• Children with autism who have not learned from typical
educational environments, may learn a great deal when the
environment is appropriately constructed
• Behavioral interventions are most effective when they are
intense and start at a young age
• Strategies have been used successfully with older students
and adults across a wide range of behaviors and skill levels
• Registered Behavior Technician (RBT)
• 40+ hours training
• Competency assessment and exam
• Board Certified Behavior Analyst (BCBA)
• Masters degree or higher
• Supervised fieldwork hours
• Assesses, development treatment plan,
monitors progress, supervising
• Behavior Analysis Certification Board (BACB)
• Family, client, other providers
Who is involved?
Misconceptions of ABA• ABA = Discrete Trial Teaching
• There are many teaching procedures for children with
autism that are based on the principles of ABA
• Relies on punishment
• Uses bribes
• Ignores the real causes of behavior, just treats
the symptoms
• “Behavior modification” only works with kids and
people with intellectual disabilities
• ABA creates rote, robotic skills
Early
Intervention?
? ?
Variety of Applications
• Matching
• Making sounds
• Functional
communication
• Receptive/expressiv
e language
• Imitation
• Play
• Group skills
• Food expansion
• Toilet training
• Self help skills
Early
InterventionSocial Skills
? ?
Variety of Applications
• Initiating
conversation
• Responding to
others
• Group interactions
• Appropriate
greetings
• Perspective taking
• Identifying social
cues
• Safe vs. unsafe
Early
InterventionSocial Skills
Independent
Living Skills?
Variety of Applications
• Money Skills
• Community skills
• Laundry
• Cooking
• Grocery shopping
• Dressing
Early
InterventionSocial Skills
Independent
Living Skills
Behavior
Reduction
Variety of Applications
• Self injurious
behavior
• Aggression
• Non-compliance
• Pica
• Property
destruction
• Elopement
• Discrete trial teaching
• Structured
• Many learning opportunities
• Naturalistic Teaching
• Contrived or spontaneous
• Motivated setting for child
• Child initiated
• Verbal Behavior
• Applies principles of behavior to language
• Separates language into categories of function
Examples of interventions
Core Philosophy of ABA
• All behavior happens for a reason
• Behavior is a function of it’s consequences.
• Learning occurs as a result of an individual’s
experiences within the environment and it is the
experiences that shape future behavior
• All behavior is changeable
• By understanding the impact that the environment has
on an individual’s behavior, we can learn how to change
the environment to change behavior and enhance
learning
What are “Reinforcers?”
• Reinforcers are not simply things
• Reinforcers are stimuli that, when used as
consequences for a behaviors, increase
future occurrences of the behavior
• Can change over time
• Different for everyone!
How do I Identify
Potential Reinforcers?• Interview: parents, other service provides, the
individual if appropriate
• Observe: what does the individual seem interested in
• Informal Preference Assessment:
▪ present two items and let the individual pick
▪ present several choices, allow time to choose and
interact with one, the sequentially represent the rest
of the items until you have gone through all of them.
Keep track of the rankings.
When Do I Reinforce
Behaviors?• Generally: Immediately following the response
• Schedules of reinforcement:
• Usually based on how difficult the responses are and
how difficult it is to keep an individual’s attention
• Fixed (set schedule at -time intervals or number of
responses)
• Intermittent (most powerful -slot machine example)
• Differential Reinforcement: ▪ Give smaller/lower quality reinforcers for easy
responses (e.g., mastered items, highly preferred tasks/activities, prompted responses)
▪ Give reinforcers less frequently for easy responses
▪ Give bigger/higher quality reinforcers for difficult responses (e.g., new targets, unknown targets, independent responses)
▪ Give reinforcers more frequently for difficult responses (e.g., new targets)
When Do I Reinforce
Behaviors?
How do I Deliver
Reinforcers?• Immediately
• Vary them, switch them up
• Pair tangibles edible items, toys, activities with praise
• Be creative
• Try out social games, songs, silly handshakes, winks
• Be smart.
• Do not give reinforcers that will make subsequent
responding difficult
• Don’t give a whole gummy bear in the middle of a verbal
imitation program
Reinforcement
• Reinforcement occurs when something following a behavior makes the behavior more likely to occur in the future• This is the most important principle used in behavior
change programs. • All behaviors that we exhibit and that others exhibit are
contacting reinforcement.
• Unwanted behaviors may be being reinforced too! • Even if we don’t see it or want to admit it.
• If the behaviors were not contacting reinforcement they would not be occurring.
Examples
Positive Reinforcement Negative Reinforcement
• a correct response is
followed by praise, treat, or
access to a toy and the
behavior is more likely to
occur in the future
• a screaming child is given
the thing s/he wants and the
behavior is more likely to
occur in the future
• appropriately asking
someone to move away from
you is followed by the person
moving away and the
behavior is more likely to
occur in the future
• a tired parent gives their
screaming child candy, the
screaming stops and the
“giving” behavior is more
likely to occur in the future
Challenging Behavior
• AKA: problem behavior, negative behavior,
inappropriate or aberrant behavior
• Generally, any behavioral excess or deficit that
falls outside the “typical” range for a given
behavior
• Challenging behaviors are those that present a
safety concern, prohibit learning, or reduce
social opportunities or independence
“Cookie Cutter” Interventions
• Not specific to each case, applied across the board
• Does not look at the specific antecedents and consequence of the behavior
• Examples of “cookie cutter” interventions• Ignore students who scream
• Physically guide students who trash their environment to clean up their mess
• Hug a student who cries
• Vocally reprimand a student who is aggressive towards you
• Place a student in time out if they are aggressive to another student
ABC’s of Behavior
An
✓ Antecedent
▪ Event that evokes (“triggers”) the behavior
✓ Behavior
▪ The behavior itself
✓ Consequence
▪ An event that follows the behavior and determines how often the
behavior will occur in the future
AAntecedent
BBehavior
CConsequence
• Triggers
• Occur before the behavior
• Two effects:
• Makes the behavior more likely to occur
• Makes the behavior less likely to occur
• Can be:
• Events
• People
• Sensations, etc.
Antecedents
Antecedent Strategies:
• Increase the value of a reinforcer for requesting,
difficult responses or non-preferred tasks
• Withhold or severely limit access to the items (be sure
to have family and other settings withhold too)
• Rotate toys or other reinforcing items/materials to
retain or enhance their reinforcing effects
• Decrease the value of a challenging behavior
• Increase access to the consequence in high levels to
produce satiation (e.g., frequent breaks make
outbursts to escape less frequent)
Example
Consequence: •Pizza
More valuable if….•Not having pizza for 6 months
•Finishing a 2 hour work out
•Not eating anything all day
Less valuable if…•Working in a pizza place
•Just eat pizza the day before
•Just ate a “double-double with cheese”
Antecedent Examples
Behavior More Likely Less Likely
Stomp feet Task given Fun activity or no task
given
Screaming Neighbor present Family present
Tantrum Denied activity Given activity
Hit sibling Mom on the phone Mom playing child
Run away Asked to work Asked to play video
game
Antecedent Examples
Behavior More Likely Less Likely
Stomp feet Task given Fun activity or no task
given
Screaming Neighbor present Family present
Tantrum Denied activity Given activity
Hit sibling Mom on the phone Mom playing child
Run away Asked to work Asked to play video
game
Examples of Behavior:
▪Hitting
▪Kicking
▪Biting
▪Yelling
▪Crying
▪Punching
▪Whining
▪Scratching
▪Smiling
▪Walking
▪Tying shoes
▪Doing homework
▪Asking permission
▪Sharing
▪Driving
• Change in the environment
• Immediately follows target behavior
• Makes target behavior more or less likely to occur in
future
• Two possible effects of consequences
• Target behavior is increased in future
• Target behavior is decreased in future
Consequences
• Antecedents determine the conditions under
which the behavior will or will not occur
• Determine “where,” and “when” behavior will
occur or will not occur
• Consequences determine whether or not
behavior is likely to occur again in the future
• Determine “if” behavior will occur again
Relationship of ABC’s
ABC’s of Behavior: Example
AAntecedent
BBehavior
CConsequence
“Do your
homework”
Child hits
you
Child is put
in timeout
(does not
have to do
HW)
ABC’s of Behavior: Example
AAntecedent
BBehavior
CConsequence
“Do your
homework”
Child hits
you
Child is put
in timeout
(does not
have to do
HW)
ABC’s of Behavior: Example
AAntecedent
BBehavior
CConsequence
“Do your
homework”
Child hits
you
Child is put
in timeout
(does not
have to do
HW)
ABC’s of Behavior: Example
AAntecedent
BBehavior
CConsequence
“Do your
homework”
Child hits
you
Child is put
in timeout
(does not
have to do
HW)
Functions of Behavior
Access to
AttentionAccess to a
preferred
toy or
activity
Something
about the
behavior
results in a
preferred
sensationEscape from
Aversive Event
Importance of Functions
• Tell us about the environmental
conditions under which the challenging
behavior reliably occurs
• Allows for:
• Predicting and Antecedent Management
• Teaching Replacement Behavior
• Purposeful Reactions/Consequences
Social Positive
To Gain Access To Something
• Access to Attention: adult, peers, very specific
person, particular “reaction”…
• Obvious (calming, reassurance, help, reprimands,
laughing, restraint, increased engagement, etc.)
• Subtle (eye contact, facial expression, increased
proximity, sighing, etc.)
• Access to Items: toys, edibles
• Access to Activities/Locations: including ability
to complete rituals/routines
Social Negative
To Escape/Avoid/Delay• Escape, avoid, or delay aversive/non-preferred
stimulus
• Work/Demands/Specific Activities
• Social Interaction
• Environmental Stimuli: noise, crowds, heat, etc.
• Anything the individual finds aversive
• The “escape” or “delay” can be VERY brief
Automatic/Sensory
• Something about the sensation produced is
reinforcing in and of itself
• Adding sensory stimulation (positive)
• Alleviating sensation/pain (negative)
• Cannot be determined by what the behavior
looks like
• Need to focus on function, not topography
• What does it mean to take a functional
approach to managing problem behavior?
• Identifying the target behavior
• Identifying why the behavior occurs• Behavior Analyst
• School/Teacher/Social Worker
Functional Approach
• What does it mean to take a functional
approach to managing problem behavior?
• Identifying the target behavior
• Identifying why the behavior occurs• Behavior Analyst
• School/Teacher/Social Worker
• Introduce a strategy that compliments the
behavior
• Teaching an alternative behavior in order to
replace the negative behavior• Matching the behaviors
Functional Approach
4 Steps to Decreasing
Challenging Behavior
1. Identify and operationally define the challenging
behavior
2. Determine the function of challenging behavior
3. Place the challenging behavior on extinction
4. Teach a replacement behavior
Step 1: Operationally
Define the Challenging Behavior
• Objective –no need to interpret
• Observable –exactly what you see/hear
• Measurable –can you count/measure it
• A definition is NOT a label:
• “Aggression” vs.
• “single hit with one or both open hands,”
• “any attempt to actual biting any part of another’s body,”
• “one or more of the following: kicking, head butting, pulling
hair, pinching, scratching –may occur singly or in combination”
Step 2: Identify Function
• Why not just guess?
• Need information about the conditions
under which the challenging behavior
reliably occurs • Antecedents
• Consequences
• What consequences are reinforcing (social positive,
social negative, automatic)?
Step 2 Contd.
• Functional Assessment: interviews, direct
observation of the student, and experimental
manipulation of antecedents and consequences
to evaluate their effects on behavior
• ABC Data
• Descriptive Analysis Data
• Functional Analysis (FA)
Descriptive Analysis (DA) Card
Student: Date: Time:Staff Member:
AntecedentsCheck all that apply
__ student is asked to do something
__ student is asked not to do something__ preferred activity ends
__ non-preferred activity begins__ group instruction__ one-on-one instruction__ student is alone
__ preferred object is taken away__ other:
BehaviorCheck all that apply__ hits other student__ hits staff __ hits self__ throws objects
__ at someoneat something
__ spitting__ kicking
__ screams or makes other sound__ property destruction
what: __ runs away from staff__ other:
ConsequencesCheck all that apply
__ verbal reprimand (e.g., told “no” or “stop that”)
__ activity ends/demand is removed
__ request is repeated until student complies__ behavior is ignored
__ preferred object is removed__ preferred object is given
__ student is escorted outside to “cool-off”
length of time until student is calm: __ other:
Step 3: Place the
Challenging Behavior on Extinction
• Withholding the reinforcer that has previously
maintained a response
• In order to implement an extinction procedure,
we must know the function of the challenging
behavior
• Extinction is a critical component of most
interventions designed to decrease problem
behavior
Extinction
• Knowing the function of behavior before
implementing an extinction procedure is critical
• If the function of behavior is not known beforehand,
a well-intentioned “extinction” procedure might end
up increasing the challenging behavior
• “Planned ignoring” is only extinction if the behavior
is maintained by social attention!
• Typically used in combination with another
procedure
Extinction
• Withholding the typical reinforcement may
produce initial increases in the challenging
behavior (extinction burst)
• Data can help determine how long we need to
“stick with it”
Maintaining Function Extinction Procedure
Gain access to attention
(social positive)
Do not give attention
following occurrence of
challenging behavior
Gain access to tangible
(social positive)
Do not give access to
tangible following
occurrence of challenging
behavior
Escape/avoid/delay work
(social negative)
Do not remove work demand
Automatic Prevent/block access to
sensory stimulation
Importance of
Consistency
• If a behavior is reinforced only now and then, it
is more likely to persist (intermittent
reinforcement)
• The client will keep engaging in the challenging
behavior because it periodically “pays off” sometimes
• Not only will the challenging behavior persist, it
may increase in intensity
• Functionally Equivalent
• Produces SAME consequence
• As fast, or faster
• More often
• Same or better quality/magnitude/intensity
• Already in repertoire
• Needs to be strengthened
• New Skill
• Needs to be taught
Step 4:
Replacement Behavior
Examples
Client slaps instructor to
escape work tasks.
Client hugs and grabs people
to get attention.
Client chews and occasionally
swallows inedible items.
Teaching Replacement
Behavior
• Teach the new skill: teach how and when (think
antecedents) to use
• Set up many opportunities to practice, practice,
practice
• With support/prompting
• During times student is likely to be successful
• In successively more natural/difficult situations
• Reinforce, Reinforce, Reinforce (start rich and
lean out)
• The more you reinforce it, the more likely it is to occur!
Some Points to Consider
• Be aware of their own behavior at all times and how it
may be affecting the client’s behavior
•eye contact •waiting
•sighing or annoyance •pausing the activity
•laughing •changing activities
•Repeated verbal
instructions
•Presenting options or
alternatives, esp if preferred
Novel Behaviors• Without knowing the function, generally speaking you
should:
• Remain neutral – minimize comments to student or other
staff
• Stay on task – do not change or delay the activity for
extended periods of time
• Deliver brief praise for appropriate behaviors – hold off on
trade-ins or edible items until appropriate
• Maintain a safe environment
• Provide the client with the opportunity to appropriately
communicate – and reinforce any appropriate
communication, even if it is at a lower level then the
student is capable of
Definition:
• Making contact with other individual’s body with an
open or closed fist
Antecedent event (triggers)
• Behavior is most likely to occur when tasks are
issued
Consequent events
• Child gets to leave work table and have a break
Function (what does the child want?):
• Avoiding tasks
Target Behavior: Hitting
Strategy:
• Use a Behavioral Contract• “If then” statement
• Continue to place tasks until the child
completes
• Use positive reinforcement when the client
completes the task
• Avoid timeout (do not use)
• Alternative behavior:
• Teach the child to appropriately requests a
break
Target Behavior: Hitting
• Alternative Behavior Cont’d
• Children who are verbal
• Teach them an appropriate word to say:
• “Break”
• “Play”
• “Toys”
• Consider starting with a visual prompt
• Children who are non-verbal
• Use a visual prompt
Target Behavior: Hitting
• REMEMBER!
Avoiding Task:
Closer Look
If you use timeout in this situation…then chances are the
next time you do homework the same thing will happen
again!
• REMEMBER!
Avoiding Task:
Closer Look
•Continue to do the homework
•Give break when replacement
behavior is used
•Use positive reinforcement
•Stay calm! Break
• Demand Fading
• Start with easy tasks, then gradually fade in harder tasks• Example: “Eat your food, throw your napkin away, clean your dish”
• Make it fun!
• Use positive reinforcement
• Visual supports
• Schedule (either picture or written)• “To do list”
• Include fun things on the list as well as harder tasks
• The last item on the list should be the highest reinforcer
• Token System
• Behavioral Contract
Target Behavior: Hitting
• Target Behavior:
• Yelling/Crying
• Antecedent event (triggers)
• Behavior is most likely to occur when a parent is on the phone talking with someone else
• Function (what does the child want?):
• Attention from parent
• Strategy:
• Withhold your attention• Refrain from verbal reprimands
• Block and move away
• Keep others safe
• Once your child is calm, provide attention
• Alternative behavior:
• Teach the child how to ask for your attention
Example: Getting Something
• Provide free attention!
• “Non contingent attention”
• Enrich the environment
• Prepare for success! • Example: You have a very important call at 4:00pm, at 3:30 provide
lots of 1:1 attention, closer to 4:00 provide your child his favorite toy. Every so often if your child is being quiet while you are on the phone provide him with small amounts of attention (“good job”, a pat on the back, a hug).
• Planned Ignoring
• Eliminate your verbal reprimands (this is a form of attention)
• Reduce your “frustrated” body language in front of the child
Attention: Closer Look
• REMEMBER!
Attention:
Closer Look
By delivering verbal reprimands you are providing 1:1
attention to the child…chances are that could
reinforce the behavior!
• REMEMBER!
Attention:
Closer Look
•Continue to talk on the phone•Stay calm•Avoid verbal reprimands•When the child is quiet, provide attention•Provide free attention through-out
• Things might get worse before they improve!
• It is a signal you are on the right track!
• Don’t give up now or it could be harder to
change behavior in the future!!!!!
Behavior (Extinction) Burst
• Model correct behavior
• Say calm
• Consider your language
• Consider your behavior
• Use visual supports
• Schedules
• Use reinforcement
• Praise
• Token
• Be consistent
• Have follow through! If you say it then stick to it!
• Use motivation/antecedents to your advantage!
General Tips for Success
• Supervision and staffing
• Appropriate credentials
• Adherence to BACB guidelines
• Clinical quality systems
• Easy to work with
• Scheduling, insurance services
• Case Coordination
• Treatment plan
• Parent training
• Evidence based
High Quality ABA
Peer
Review
Ethics
Hotline
Quality
Assurance
Research
Base
• Many children don’t receive the help they
need
• Knowledge
• Acceptance
• Choices of therapy
• Schedules/availability
• Insurance
Maximizing Access to
Services