“From Panic to Progress: Supporting Students with Autism Who Escalate” by Patrick Mulick, BCBA, NBCT

In this week’s guest article, Patrick Mulick, BCBA, NBCT explains the escalation cycle by which educators and caregivers can evaluate what to expect in their students’ behaviors and how to intervene in the most effective and least intrusive ways. We’ve also included FREE downloadable data sheets so you can try incorporating Patrick’s Escalation Cycle into your program!

From Panic to Progress: Supporting Students with Autism Who Escalate
by Patrick Mulick, BCBA, NBCT

As critical as it is to change the behaviors of those who escalate, it can be particularly hard to do so in those with autism. The antecedent (trigger) can range greatly from observable events, such as a puzzle piece not fitting properly to a private event that is difficult to predict (such as a strong discomfort from flickering lights in a room). The learner often will exhibit behaviors in attempt to escape the overwhelming experience that they have entered, but those behaviors are often uncoordinated, lack reasoning, and are unsafe. It is here that students may break windows, chase after staff, or hit themselves. And it is here where educators need to be at the top of their game to support a safe de-escalation.

This entails knowing the student, knowing their escalation cycle, and having a system by which one can continually evaluate the de-escalation strategies being used. Ten years ago I created the cycle below to help do just that. In many cases, it has been the starting point to great gains for my students who were prone to escalate.

Breaking down the cycle into five levels of observable behaviors allows for a much clearer understanding of what to expect. Identifying the appropriate interventions for each level allows for the actions of staff to be the least intrusive and the most effective. It is easy to be reactive in a moment of crisis, yet the moment calls for everyone involved to act in a prescribed manner. Whether it be dimming the lights, providing a break area, or clearing the room of other students, every intervention is with good purpose and good timing.

Visually representing all of this for an entire school team, from parents to principals, allows for a better common understanding of the plan and greater fidelity in its implementation. Any issues with ineffective supports used at the wrong times can be quickly weeded out, and any staffs’ fears who interact with the learner can be eased. To allow the school team more depth or specifics, this overlay can be used to spell out more details.

Escalation Cycle-2

Knowing that a plan is being implemented with higher fidelity, we can then begin to look at data. A standard A-B-C data sheet for specific incidents should suffice in tracking the plan’s effectiveness.

Where the above tools can help most significantly is in the coding of behavior clusters, which can then be tracked in the student’s day, such as on a chart similar to the below.

Escalation Cycle-3

As the student progresses through their tasks and activities, staff indicate the highest escalation cycle level the student reached, even if only for a moment (think partial interval recording). This tracking done all day, every day, provides teams with data that can inform the effectiveness of the de-escalation techniques being used. For example, learners with a tendency to become aggressive are generally perceived as escalating with high frequency. Utilizing objective data tracking can substantiate such subjective perceptions, more clearly showing the frequency of escalation behaviors and if they are improving week to week. Working from a place that is measurable and observable can help move your team from being reactive to proactive, fearful to confident, and from helpless to equipped.

WRITTEN BY PATRICK MULICK, BCBA, NBCT

Patrick is the Autism Specialist of the Auburn School District in Washington State. Over his twelve years as a teacher and consultant, he has grown to have a particular passion for equipping school teams that support students with autism. Patrick enjoys engaging educators through his hybrid of inspirational and instructional speaking. He is currently working toward becoming a certified member of the John C. Maxwell Leadership program. To learn more, visit his website at www.patrickmulick.com.

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Tip of the Week: DRA and DRO – Differential Reinforcement Tools for Behavioral Change

Recently we’ve been delving into different types of differential reinforcement. We’ve taken a look at why differential reinforcement is valuable as well as how to use DRI. Today, we’ll look at two more that are closely related: Differential Reinforcement of Alternative behavior (DRA) and Differential Reinforcement of Other behavior (DRO).

DRA is “a procedure for decreasing problem behavior in which reinforcement is delivered for a behavior that serves as a desirable alternative to the behavior targeted for reduction and withheld following instances of the problem behavior (e.g., reinforcing completion of academic worksheet items when the behavior targeted for reduction is talk-outs)” (Cooper, Heron, & Heward, 2007). The key thing to remember here is if you are implementing a DRA, a specified alternative behavior has been selected for reinforcement.

For example, Miss Watson wants her students to stop calling out answers. She decides she will not reinforce students calling out. In her situation, this means that if a student calls out she will not provide them with any attention, including reminders not to call out. She is going to reinforce the alternative behavior of raising your hand. This is a very common use of DRA, and it works well.

In another example, Lisa’s daughter often cries when she doesn’t get what she has asked for. Sometimes this results in attention, and sometimes it results in Lisa finally giving in and providing the item. Lisa decides to use DRA to address this behavior. With this intervention, any time that her daughter says “Okay” instead of crying when refused an item, Lisa provides reinforcement in the form of attention or playing with a different item than was requested.

DRO is quite similar. It is “a procedure for decreasing problem behavior in which reinforcement is contingent on the absence of the problem behavior during or at specific times” (Cooper, Heron, & Heward, 2007). With DRO, you would reinforce any behavior that wasn’t the behavior targeted for change.

For example, Mrs. Cuthbert notices that Anne is staring out the window frequently during lass. She decides to implement DRO. She sets a MotivAider for 5 minute intervals. Each time the MotivAider buzzes, she looks up and if Anne is doing any behavior other than staring out the window, Mrs. Cuthbert provides reinforcement. (There are two ways to implement DRO, which we’ll get to in a future post.)

DRO is especially beneficial because it is widely applicable, relatively rapid, and often durable and general (Mayer, Sulzer-Azaroff, & Wallace, 2014). However, you should be aware that you may run the risk of reinforcing other unwanted behavior. It can also make you focus on the “negative,” since you’re always looking for the problem behavior or the absence of the problem behavior (as opposed to a specific desired behavior, as in DRA.)
DRA and DRO are useful tools to add to your arsenal of behavior change tools. You may be wondering why it’s important to consider the differences between DRI, DRA, and DRO. The key to remember is that using these terms and understanding the possible strategies for reinforcement improves your implementation of interventions and your communication with other adults implementing those interventions.

References

Cooper J.O, Heron T.E, Heward W.L. Applied behavior analysis (2nd ed.) Upper Saddle River, NJ: Pearson; 2007

Optional Text: Mayer, G. Roy, Sulzer-Azaroff-B. & Wallace, M. (2013). Behavior analysis for lasting change (3rd ed.). Cornwall-on-Hudson, NY: Sloan Publishing.

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

Pick of the Week: Unstuck & On Target! – An Executive Function Curriculum to Improve Flexibility for Children with ASD

For students with autism spectrum disorders, problems with flexibility and goal-directed behavior can be a major obstacle to success in school and in life. Unstuck & On Target! – a robust classroom-based curriculum book – will help educators and service providers teach these executive function skills to high-functioning students with autism through ready-to-use lessons that promote cognitive and behavioral flexibility. This week, you can save 15%* on Unstuck & On Target! by applying promo code UNSTUCK at check-out!

This curriculum gives clear instructions, materials lists, modifications for each lesson, and intervention tips to reinforce lessons throughout the school day. Topics include:

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Written by Lynn Cannon, Lauren Kenworthy, Katie C. Alexander, Monica Adler Werner, and Laura Anthony. Software operating requirements: Windows 95+ and up, Mac OS 8.6 and up.

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Tip of the Week: Differential Reinforcement of Incompatible Behavior

In a recent post, I talked about Skinner’s emphasis on differential reinforcement. Today, we are going to take a closer look at Differential Reinforcement of Incompatible behavior (DRI). DRI is defined as “a procedure for decreasing problem behavior in which reinforcement is delivered for a behavior that is topographically incompatible with the behavior targeted for reduction and withheld following instances of the problem behavior (e.g., sitting in seat is incompatible with walking around the room) (Cooper, Heron, & Heward, 2007).

Let’s look at a few examples of DRI in action:

  • Mrs. Clark is teaching a classroom with six students with autism. One of her students has recently begun to pinch his arms. She takes data on the behavior and discovers that it functions for attention. (When he pinches his arms, she or a teacher’s aid comes over and tells him “no pinching.”) She decided to implement an intervention that utilizes DRI. She teaches him how to sit with his hands intertwined on his desk. This is an incompatible behavior with pinching because he is not able to pinch while his hands are intertwined. She and the teacher’s aid reinforce him for intertwining his hands (come over and tell him, “great job” or “I like how you’re sitting”) and do not provide attention when he engages in arm pinching.
  • Carly has a 9-year-old daughter. When her daughter wants a break from doing homework, she reaches over and hits Carly’s arm. Carly typically says, “Do you need a break now?” Then, she allows her to take a five-minute break. Carly recognized that her daughter’s intensity with hitting seemed to be increasing, and she was worried she might get hurt. She decided to implement an intervention that utilized DRI. She put a timer on the table within her daughter’s reach, and taught her daughter to touch the timer when she wanted a break. This is an incompatible behavior because her daughter cannot simultaneously touch the timer and hit Carly. When Carly’s daughter touched the timer, she immediately received a break. When she hit Carly, she did not receive a break. This was an especially useful intervention because, over time, Carly taught her daughter to set the timer on her own and become more independent with managing break times.
  • Mr. Holley teaches a preschool class. During circle time, many of his students become very excited and can be quite loud. Sometimes it seems as though all of his students are yelling at the same time. Once they become too loud, it is very challenging to regain their attention. He decides to implement an intervention utilizing DRI. He uses a decibel meter on his tablet (such as the app Too Noisy). He teaches the students that when the noise level is below a certain number or threshold they all earn stickers. This is differential reinforcement of an incompatible behavior because the children cannot possibly speak loudly and softly simultaneously.

DRI is not always the best option. For example, it may be very challenging to come up with an incompatible behavior. Or, in the case of self-injurious or aggressive behavior, it may be dangerous to use such an intervention.

If you do use DRI, you may consider explicitly telling your learner(s) that you are implementing this new plan, such as Mr. Holley did in the third example above. And remember, this is only one form of differential reinforcement. If DRI is not appropriate for your situation, there are definitely still options for reinforcing appropriate behavior in an effective and efficient manner.

References

Cooper, J.O., Heron, T.E., & Heward, W.L. (2007). Applied Behavior Analysis – 2nd ed. Englewood Cliffs, NJ: Prentice-Hall.

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

Pick of the Week: I Can Do It! My Daily Checklist

Daily planners are an effective way to help kids stay organized as they become more responsible and self-reliant. The I Can Do It! My Daily Checklist helps children with their daily routine by providing structure and reinforcement. This week, take 15% off* your order of the I Can Do It! My Daily Checklist with promo code ICANDOIT at check-out!

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The Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) offers a new generation of the application of B.F. Skinner’s analysis of verbal behavior to language assessment for children with autism or other developmental disabilities. Developed by Mark Sundberg, PhD, BCBA, the VB-MAPP is an assessment tool, curriculum guide, and skill tracking system that is also based on established developmental milestones, and research from the field of behavior analysis. This week, to help you gear up for the start of the schoolyear, we’re offering 15%* off all orders of the VB-MAPP Set. Just use our promo code VBMAPP at check-out to redeem these savings!

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Tip of the Week: Why Differential Reinforcement is Preferred to Punishment

In B.F. Skinner’s phenomenal book The Technology of Teaching, he briefly discusses problems with punishment. He explains that the use of punishment (defined as adding or subtracting something from the environment in order to reduce the occurrence of a behavior), is not as clear-cut as we might imagine.  When we attempt to punish a behavior, it’s quite likely that we will unintentionally suppress a broader range of behaviors than we intended.

Skinner gives the example of a child who has touched a candle flame and been burned. The child has probably been taught not to touch the flame, but Skinner argues that it’s quite possible that “in the presence of a candle flame he will not be likely to explore any part of the environment, to reach for or grasp objects of any kind” (Skinner, 1968, p. 186). This is an important consideration, especially when we consider the classroom.  We have to ask ourselves, when we punish certain behaviors, are we unintentionally suppressing other, desirable behaviors?  And in punishing the undesirable behavior, are we clearly communicating to the child what the desirable behavior is?

Skinner then moves on to discuss alternatives to punishment. What he describes is known today as differential reinforcement.  Since Skinner wrote The Technology of Teaching, a great deal of research has been completed on differential reinforcement, which “consists of reinforcing particular behavior(s) of a given class (or form, pattern or topography) while placing those same behaviors on extinction and/or punishing them when they fail to match performance standards or when they occur under inappropriate stimulus conditions” (Mayer, Sulzer-Azaroff, & Wallace, 2014).  Put simply, we reinforce the desired behavior and do not reinforce the undesired behavior.

Today we have categories for many different types of differential reinforcement to better describe strategies for implementation.

Types of differential reinforcement include:

  • Differential Reinforcement of Alternative Behavior (DRA)
  • Differential Reinforcement of Other Behavior (DRO)
  • Differential Reinforcement of Incompatible Behavior (DRI)
  • Differential Reinforcement of High Rates of Behavior (DRH)
  • Differential Reinforcement of Low Rates of Behavior (DRL)

Differential reinforcement is an incredibly useful tool for teachers and parents.  So we will devote several Tips of the Week over the upcoming months to how to use it effectively, taking a closer look at each of the types listed above.

References

Mayer, G. Roy, Sulzer-Azaroff-B. & Wallace, M. (2013). Behavior analysis for lasting change (3rd ed.). Cornwall-on-Hudson, NY: Sloan Publishing.

Skinner, B. F. (1968). The technology of teaching. New York: Appleton-Century-Crofts.

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

Tip of the Week: Clearing Up the Misconceptions About Reinforcement

ABA often gets a bad rap due to misunderstandings about reinforcement. In my career alone, I’ve had people tell me that people are not like rats and pigeons, that reinforcement harms intrinsic motivation, and that when I do produce behavior change, it has nothing to do with ABA but with my abilities as a teacher. Today, I’d like to clear up some misconceptions about reinforcement.

Reinforcement is not equivalent to rewards. Reinforcement is anything that occurs immediately following a behavior that increases the future likelihood of that behavior. For instance, I am more likely to say hello to my neighbor down the street because in the past he has responded by saying “hello” back to me. However, I do not say hello to my next door neighbor because she has never responded to my greeting. My history of reinforcement with the neighbor down the street increases the likelihood that I will greet him upon seeing him.

Flowers GrassReinforcement occurs in the natural environment all the time, whether we are conscious of it or not. We are reinforced by paychecks for going to work, by our favorite dessert for visiting a restaurant 30 minutes out of our way, by compliments when we get a new haircut, and more. ABA utilizes reinforcement when an individual is not acquiring skills in order to help them learn. And when ABA is implemented correctly, reinforcement should be as close to naturally occurring reinforcers as possible and should be reduced systematically over time to levels that would naturally occur in their environment.

Reinforcement works for dogs and for humans. The previous two points illustrate that humans do respond to reinforcement, and decades of scientific research back that up. Comparing the work behavior analysts do with humans to the work behavior analysts do with other animals is not far off base. What is off base is using such a comparison to imply that behavior analysts treat people with disabilities like dogs. As with other professionals who work with individuals with disabilities, (such as speech therapists, physical therapists, nurses, etc.) most behavior analysts are professionals who put a lot of time, care, and love into their work.

Child Blowing BubblesReinforcement is individualized. Everything we do in ABA is individualized, because human beings are wonderfully complex creatures that cannot be characterized by statistics, averages, or norms. One of my students may find stickers reinforcing; another may show no interest. One student may find listening to music reinforcing; another may cover his ears and ask me to turn it off. In ABA, we seek to find the items and activities that are motivating for individuals; then use those as tools not only for reinforcement, but for increasing skills and broadening interests and opportunities. In an ideal ABA session, my students spend a lot of time engaging with items and activities that they enjoy while also learning and growing.

It’s easy to fall prey to misconceptions about reinforcement, but such misconceptions can make it impossible for us to understand how to alter the environment in order to provide the best possible outcomes for our students. As Skinner put it, “The ideal of behaviorism is to eliminate coercion: to apply controls by changing the environment in such a way as to reinforce the kind of behavior that benefits everyone.”

Over the next few weeks, we will be publishing a series on Differential Reinforcement procedures that will help you become more skilled in using reinforcement to affect behavior change.

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

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