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Tracy Palm, MS, BCBAExecutive Director
Transformations Autism Treatment Center
Why does my child act like this?Assessment is keyTreatment strategies
Severe Self Severe Self InjuryInjury
Physical Physical AggressionAggression
The child has been reinforced.Positive Reinforcement in the form of attention
I scream you come over and ask what’s wrong.Positive Reinforcement in the form of access
I scream you come over and ask if I want to go outside.Negative Reinforcement in the form of escape
I scream when you ask me to do something and you say ok fine we’ll do it later.
Automatic ReinforcementI scream when get water on my hands even if I’m by myself.
Your child is being reinforced differently by different people.
The Grandma EffectYour child has a different learning history with different people.
I’ve going known your child for 1 month vs you have been with them their whole life.
Your child experiences different environmental situations in different locations.
At school they use a classroom management system.
WATCH your childWrite down what happened right before during and after the behavior happened (A-B-C’s)Read over your notes while asking yourself:
Is there a certain time that my child does this?Does my child do this behavior when he is asked to do something?Does my child do this behavior when he wants to do something?Does my child do this when he is alone?
Physical Aggression caused by Positive Reinforcement from attention1) Time out
1) Make sure that you are not attending to the person in time out by talking to them or interacting with them in any way
2) Ignore/ Don’t react3) Teach appropriate attention seeking behaviors
1) Tapping you on the arm2) Saying your name3) Asking you to do something with them
Physical AggressionCaused by Positive Reinforcement in the form of
access to items or activities1) Do NOT give the person the item/activity!2) Ignore/ Don’t react3) Teach the person what they need to do to get
the item/activity1) Handing you a picture2) Use a choice board3) Saying the name of what they want4) Ask for things that they want
Physical AggressionCaused by Negative Reinforcement in the form of escape 1) Do NOT let the child escape from the task or activity until
he/she has completed the activity.2) If you can not “make” the child complete the activity due to the
aggression then use restraint or time out then bring the child back to the activity immediately following.
3) Use physical prompts to make the child complete the task.4) If you have to “help” the child do the activity then make the
child do it again on their own before moving on to something else.
Physical AggressionCaused by automatic reinforcement1. Immediately stop the behavior then prompt using the
teaching methods below.2. Prompt the person to engage in a behavior that
mirrors the problem behavior.3. Teach the person a way to communicate what he/she
is feeling and needing1. Pictures, sign, vocals
4. Use physical prompts to “help” the person get them to “fix” anything that is brothering them1. Ex. I scream when I get wet. (use PP to get the child to dry
themselves off)
Self Injurious BehaviorsCaused by Positive Reinforcement in the form of
attention1. Block any severe behavior. Do not make eye-contact
or say anything to the person.2. Teach the person what to do to get your attention and
prompt these behaviors when the person does this behavior.
3. Medications (serotonin reuptake inhibitors, opiate blockers, and beta-adrenergic blockers)
Self Injurious BehaviorsCaused by Positive Reinforcement in the form of
access to items/activities1. Block any severe behavior. Do not make eye-
contact or say anything to the person.2. Do NOT allow the person to access the
items/activities at this time.3. Teach the person how to get the item
appropriately.1. Vocal communication, pictures, sign
Self Injurious BehaviorsCaused by Negative Reinforcement in the form of
escape1) Block any severe behavior. Do not make eye-
contact or say anything to the person.2) Make sure to continue with the task, while
blocking the behavior until the person has completed the activity appropriately
3) Present the task that normally causes the behavior often but in short increments
Self Injurious BehaviorsCaused by automatic reinforcement1) Teach the person a more appropriate behavior
to do that will “feel” the same but not cause harm.
2) Medications3) Block the behavior while reinforcing more
appropriate behaviors. 4) Set a timer and reinforce the person for doing
other behaviors for a period of time.
General
o Token Systemo Positive Reinforcement Jaro Behavior Contractso Positive Practiceo Compliance Trainingo Overcorrection
Tracy Palm, MS, BCBAExecutive DirectorTransformations Autism Treatment [email protected]