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

Terminology

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

Addressing

Challenging

Behavior

WHY IS HE/SHE DOING THIS???

Behavior is…

… a function of it’s environment.

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)

• What happens next time you ask the child to

do his homework?

Participation

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

• 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

Questions?

Kirsten Powers

kpowers@tbh.com

872-242-5014

Thanks!