A parent writes:  “Dear Behavior BFF, My son likes to talk about the Octonauts (Cartoon). If I hear one more thing about Kwazii the cat, I may stab myself in the ear. Help!”

I think so many parents can make this exact statement, just change out Octonauts for whatever your kid is into right now: Santa, trains, Frozen, the weather, a book, the number four, whatever! But please refrain from injuring your own eardrums. There are positive behavior supports to employ before resorting to anything extreme! 

Let’s get technical for a minute. Have you ever heard of DRL: Differential Reinforcement of Low Rates? If you are an ABA nerd like me, the answer had better be yes. If you are a mom (also like me), the answer is probably now. With DRL, you provide reinforcement for responses that are lower than a criterion you set.

How many times a day does your child talk about (insert preferred and rather annoying subject here)? Let’s say 20. Set a number lower than 20. Your child can talk about that subject 15 times tomorrow to earn positive reinforcement.

You set a number that is acceptable to us and achievable to the child. You can’t go from 20 times a day to 5 times a day. That may be acceptable to you, but will your child ever get to earn that positive reinforcement? Doubtful.

A structured way you can set this up in your family is to create a behavior contract (aka contingency contract). This is a physical document that outlines the exact behavior that must be completed to earn a specified reward. It also includes a place to keep track of that behavior & reward. It needs to be specific.

Write down the exact task to complete. The task in this situation would be talk about ___subject____   no more than __number___ times. 

Specify the reward. If this contract is going to last all day, the reward had better be pretty good — what is the reward, when will it be received, how much of it — be precise!

And finally, include a task record. This means you write down whether or not they achieved it that day. You could put some tally marks down to show the number of times your child talked about that subject. Or you could just put a check mark or happy face on days when the reward was earned.

What’s the purpose of documenting this? So you can review it again with your child and show them the progress they are making!

What if the contract isn’t working? If they aren’t making progress, then revisit your criteria. Do you need to raise the number of times they talk about Octonauts a little? Is the reward not awesome enough? Do you need more options? Is a whole day too long? Do you need to do a reward opportunity for the morning and the evening? There are options here! Step away from the silverware — do not stab yourself in the eardrum!

The physical visibility of the contract can be a helpful cue or response prompt to remind your child how many times they have left to talk about Octonauts or it may be a visual reminder of that potential reinforcer coming their way. Hang it on the fridge or some other prominent spot to serve as a helpful tool in and of itself!

Over time, you should be able to lower that daily goal. From 20 times a day, to 18 times a day, to 15 times a day, to 12 times a day, etc. Don’t go too fast. Let your child be successful at each level a few times before lowering that number of allowed times they can talk about their favorite thing. And don’t go too low. I don’t want my daughter to think I never ever want to hear about what she is into. I do, however, want her to learn some balance and variety when it comes to conversation topics.

If your son’s conversations about Octonauts are decreasing, does he know what else to talk about? You need to teach him some other replacement topics that are appropriate and interesting to him. We aren’t going to jump from Octonauts to the Blacklist or Grey’s Anatomy, but maybe he can talk about books instead of just his favorite TV show. How about talking about experiences he’s had? Making plans for the future? Give him some choices of topics and model those conversations. Encourage and provide positive reinforcement when he uses any different appropriate topic of conversation.

Here it is in a nutshell:

Set a reasonable & doable number of times your child can engage in that behavior (talking about Octonauts). Provide positive reinforcement when he stays at or under that level. This is called DRL: Differential reinforcement of low rates of responding.

Formalize it with a behavior contract. Be specific. Hang it where it can be seen. Document progress. Revise as needed.

Teach your child a replacement behavior. What CAN he talk about instead? Make it appropriate for your child, for the situation, but make it something he is interested in. Maybe he doesn’t love these other topics as much as Octonauts, but pick some interesting topics to keep him engaged.

And most importantly, don’t stab yourself in the ear!  Find a way to make pleasant conversations in your home possible.  No, more than just a possibility, make pleasant family conversations a regular occurrence. You can do it!

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Leanne Page, MEd, BCBA, is the author of Parenting with Science: Behavior Analysis Saves Mom’s Sanity. As a Behavior Analyst and a mom of two little girls, she wanted to share behavior analysis with a population who could really use it- parents!

Leanne’s writing can be found in Parenting with Science and Parenting with ABA as well as a few other sites. She is a monthly contributor to bSci21.com, guest host for the Dr. Kim Live show, and has contributed to other websites as well.

Leanne has worked with children with disabilities for over 10 years. She earned both her Bachelor’s and Master’s degrees from Texas A&M University. She also completed ABA coursework through the University of North Texas before earning her BCBA certification in 2011. Leanne has worked as a special educator of both elementary and high school self-contained, inclusion, general education, and resource settings.

Leanne also has managed a center providing ABA services to children in 1:1 and small group settings. She has extensive experience in school and teacher training, therapist training, parent training, and providing direct services to children and families in a center-based or in-home therapy setting.

Leanne is now located in Dallas, Texas and is available for: distance BCBA and BCaBA supervision, parent training, speaking opportunities, and consultation. She can be reached via Facebook or at Lpagebcba@gmail.com.

Take A Deep Breath

This advice seems so absolutely silly and obvious. I used to hate when people would tell me to take a deep breath. “Got it. I’m breathing. I’m not going to suffocate myself. Chill.” But then I realized that sometimes in a crisis I jump in split-second too early. Yes, when there is a safety risk we want to act as quickly as possible. But the 3 seconds of taking a deep breath before acting usually resulted in me responding not reacting. A reaction is based off of emotion, it’s impulsive, and it’s more likely to be wrong. A response is planned and thought. A deep breath is the difference.

Have A Crisis Plan

Sick of hearing me talk about crisis plans? Too bad! They are still THAT important. This is your insurance policy. Hopefully, you’ll never have to use it but you sure as heck better have one. Check out my mini video training series on Developing a Crisis Plan. You can also download my simple and visual crisis plan here. 

Keep Other Students Safe And On Task

What’s worse that one crisis? More than one crisis. Keep your other students safe but also try to keep them on their schedule and engaged in an activity. I always recommend keeping bins of puzzles, file folders, and other independent work in every area of the classroom so you always have something to give other students. If students are getting distracted, give headphones and an iPad to keep them occupied during this time. 

Gather Information

Every major behavioral incident is a chance to learn about your student. What are his triggers? What helps him deescalate? Even though you are working on keeping your student and others safe, be gathering valuable information while doing so. Write it down as soon as you can. This information may help prevent this issue in the future. 

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About The Author 

Sasha Long, BCBA, M.A., is the founder and president of The Autism Helper, Inc. She is a board-certified behavior analyst and a certified special education teacher. After ten years of teaching in a self-contained special education classroom, Sasha now works full time as a consultant, writer, and behavior analyst. Sasha manages and writes The Autism Helper Blog, as a way to share easy to use and ready to implement strategies and ideas. Sasha also travels internationally as a speaker and consultant providing individualized training and feedback to parents, educators, therapists, and administrators in the world of autism. She is currently an adjunct professor in the school of Applied Behavior Analysis at The Chicago School of Professional Psychology. Sasha received her undergraduate degree in Special Education from Miami University and has a Masters Degree in Applied Behavior Analysis from The Chicago School of Professional Psychology. Contact Sasha at sasha.theautismhelper@gmail.com.

This month’s ASAT feature comes to us from Karen Parenti, MS, PsyD. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

I am a parent of a young man with autism. I also work in the area of law enforcement. What are some important considerations when teaching first responders and law enforcement personnel how to interact with individuals with an autism spectrum disorder?

This is a very important question and one on which many local communities are focused. In addition, treatment of individuals with autism spectrum disorders (ASD) by law enforcement is a common worry for parents. As such, the topic requires training to increase awareness of ASD for first responders and local community members, as well as collaboration between service providers and law enforcement. As in any crisis situation, it is important to focus on positive and preventative approaches, as most behavioral crises with individuals with ASD can be prevented or lessened. To promote awareness on the part of first responders and prevent crises, ASD service providers should proactively prepare individuals with ASD for a possible encounter with emergency personnel and law enforcement using understandable language, pictures, books, or video models about emergencies so they know what to expect and how to respond. Additionally, building rapport and familiarity between individuals with ASD and local police might help ensure the person with ASD perceives the first responder as a helper when a behavioral or medical event occurs. In many cases, situations will arise that require emergency intervention by first responders because of the unique challenges and behavioral escalations that commonly occur with individuals with ASD. Therefore, training for first responders is of the utmost importance.

Police officers expertly respond to a large number and variety of emergency situations on a daily basis. Each emergency situation has its own unique characteristics, and so do the individuals involved in that crisis. First responders and police receive standard and rigorous training on how to respond to emergencies compassionately and effectively. This training, while appropriate and efficient for the vast majority of situations, is not necessarily the best way to respond to a child or adult who is diagnosed with ASD. This can lead to an outcome such as this example of how an unfortunate misunderstanding can result in tragedy.

Whether the emergency is a medical or behavioral crisis, understanding ASD and how someone with ASD might behave is crucial to ensuring a favorable resolution to the incident. Individuals diagnosed with autism may have heightened emotional responses in these volatile and stressful situations. For persons with ASD, emergencies are difficult to comprehend. During these confusing events, a person with ASD may fail to respond to vocal directions, may exhibit a startle response when touched, may run when addressed, or may engage in self-injurious or aggressive behavior.

For emergency responders, interacting with individuals with ASD can be ambiguous and unpredictable. Therefore, it is essential that emergency personnel learn to respond as sensitively and efficiently as possible to individuals diagnosed with ASD, so attempts to speak with or care for the individual does not inadvertently cause the individual’s behavior to escalate. As you may know, this is especially important during a medical crisis because individuals with autism cannot always communicate feelings of pain or discomfort. A person with ASD may already be feeling frustrated and possibly agitated by his or her inability to convey his or her experiences and needs, thus when approached that individual may respond in an unpredictable and unconventional manner. It is important that first responders be prepared for such unusual responses, incongruent emotions, and failure to respond to directives and questions.

In addition to providing police officers and first responders with information about autism symptoms more generally, an important next step is to teach first responders how individuals with ASD might behave in a crisis. In particular, emergency personnel need to understand how individuals with ASD might act when they are agitated, confused, overwhelmed, or in pain.

A Child or an Adult Diagnosed with an Autism Spectrum Disorder May:
• Avoid eye contact.
• Walk away from familial residence or a group home to local pools or other places they enjoy. They may wander into traffic, not understanding environmental dangers.
• Be overstimulated and not comply appropriately to police or first responders’ instructions. For example, they may not respond to directives such as “get out of the street” or “let me see your hands.”
• Become preoccupied with certain objects or interests, such as planes, trains, fire trucks, or movies.
• Repeat or echo phrases, words, or actions.
• Not know how to relate, talk, or play with others.
• Have sensory sensitivity, manifested by stereotypical behaviors which may include covering their ears, flapping their hands, spinning, toe walking, or making unusual noises among others.
• Become agitated due to the disruption in their routine.
• Have unusual reactions to the way things in the environment look, feel, smell, sound, or taste.
• Be nonverbal and unable to communicate effectively.
• If verbal, may have difficulty understanding questions or may respond noncontextually. For example, they may simply script from a movie or speak about their special interests or ask repeated questions about the responder’s personal life.
• Be unable to communicate that they are in pain.

A first responder will be able to interact more appropriately with a person with autism if he or she is able to recognize that the person may have ASD. Once the first responder has learned to make this identification, he or she should become familiar with the following crisis response and intervention safety habits.

Crisis Response and Safety Habits:
• Take 30 seconds to assess the situation and the scene before responding.
• Remain calm.
• Use an even, controlled tone of voice with minimal directives, including simple phrases and visual cues such as pointing or using simple gestures that may be easily understood by minimally verbal individuals.
• Pay close attention to the person’s body language, tone of voice, gestures, and any other signs of potential agitation.
• Practice trauma-informed care and assume that everyone has experienced some type of trauma and is easily startled.
• Respect personal space, except when it is absolutely necessary to approach the person. Remember that getting too close may increase agitation in some individuals with ASD.
• Assess the situation objectively and ask the person or someone familiar with the individual with ASD what he or she wants/needs while maintaining a safe distance.
• Reduce stimulation and allow time and space for the person to process information and requests. For example, it might be helpful to clear the area of additional people, turn off the lights of the emergency vehicles, and eliminate other extraneous noises as possible.
• Be prepared and practice situational awareness. Know your surroundings and the location of the closest exit.
• Deflect aggression and block self-abuse when possible.
• If a physical intervention is necessary because the situation is unsafe, establish control in a safe, non-threatening manner. Remind the person that you are there to help.
• Recruit familiar and trusted persons to assist you in understanding how to approach the individual.

When police officers and first responders receive training in interacting and treating individuals with ASD, incidents in the community may be resolved quicker and more effectively. With quality training, headlines reporting distressing incidents, such as that above, may be a thing of the past. Instead, the type of training discussed here, when offered regularly to our dedicated police officers and first responders, could result in positive approaches similar to this:

Autism awareness is essential for all members of the larger community, but is truly imperative for first responders. In the absence of information, first responders may misinterpret the behavior of a person with ASD, may ascribe hostile intent to agitated behavior, may inadvertently escalate the behavior of the individual, or may fail to safely calm the individual. In cases such as these, there can be dangerous consequences. An opportunity exists for ASD service provider agencies to provide specialized training to local first responders. Providers can contact law enforcement officials and other emergency personnel to offer informational training sessions on a local level. In our experience, the administrators are routinely grateful and accommodating about arranging such training.

First responders need a dual skill set. First, they need accurate information about persons with ASD, including their behavioral characteristics, and secondly, they must use skills to de-escalate the situation when they engage with a person with autism who is in a confused and agitated state. With community outreach, negative outcomes can be averted, bridges can be built, and wider acceptance of persons with ASD can become a reality.

The following resource provides additional information related to first responders:
• Living with Autism – Autism Information for Law Enforcement and other First Responders
• Training for Indiana’s First Responders: Recognizing and Responding Appropriately to Individuals with Autism Spectrum Disorders
• Living with Autism – Autism Information for Law Enforcement and other First Responders
The reader may also be interested in the following ASAT articles:
• Teaching Safety Skills to Adolescents
• Bolting and Neighborhood Safety

Citation for this article:
Parenti, K. (2017). Clinical Corner: First responders’ education in autism. Science in Autism Treatment, 14(4), 6-8.

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About The Author

Dr. Karen Parenti serves as the Executive Director of Melmark PA. Karen oversees the development and implementation of programs, as well as the daily operations of Melmark PA. She develops strategic objectives for the Pennsylvania Division, and provides leadership to direct reports in order to assure the achievement of these objectives. Karen also supports the CEO and the Board of Directors through various committees and activities, assuming responsibility for excellence in care and delivery of all services, policy development, quality assurance, risk management, regulatory compliance, and fiscal integrity. Joining Melmark in April 2016, Karen served as Senior Director of Adult Services. In this role, she was responsible for the oversight of all adult day and vocational programs, as well as the adult campus and community residential programs, which include intermediate care facilities that serve individuals with intense medical challenges. She has also served in the role of clinical trainer by teaching crisis prevention and intervention, dual diagnoses, ethics and boundaries, abuse prevention, and behavioral strategies. Karen earned her doctorate degree in clinical psychology, with a concentration in neuropsychology, from Immaculata University. A graduate of York College, Karen also holds a master’s degree in Human Services Administration from Springfield College in Wilmington, Delaware.