Increasing Compliance and Decreasing Problem Behavior

1
Increasing Compliance and Decreasing Problem
Behavior

• Tammy Hammond Natof, M.A., B.C.B.A.
• Facing Autism ABA Ireland, 2005

2
How behavior is learned

• All behavior is learned (strengthened) through
  reinforcement
• Positive Reinforcement The presentation of a
  stimulus increases the likelihood that the
  response will occur
• Negative Reinforcement The removal of a stimulus
  increases the likelihood that the response will
  occur

3
Problems with calling reinforcement positive and
negative

• Is food a positive reinforcer?
• Behavior strengthened from presentation of food
  (positive reinforcement)
• Behavior strengthened from consumption of food
  reducing hunger (negative reinforcement)
• Is money a positive reinforcer?
• Behavior strengthened from presentation of money
  (positive reinforcement)
• Behavior strengthened from ending a moneyless
  period (negative reinforcement)

4
Alternative for describing reinforcement

• Instead of thinking in terms of presenting or
  removing a stimulus, talk about changes from one
  stimulus condition to another (Baron Galizio,
  2005)
• Change in condition can include one or more of
  the following
• Change in social attention from others
• Access to tangibles
• Sensory stimulation
• Change in demand situation
• Improved biological condition

5
Designing an intervention

• Determine the function of the behavior
• Change in social attention from others
• Access to tangibles
• Sensory stimulation
• Change in demand situation
• Improved biological condition
• Each aspect of intervention must match the
  function
• Using extinction
• Strategies for shaping compliance
• Improving communication

6
Increasing Compliance

• Extinction
• If the behavior is happening to
• Gain attention, Access tangibles
• Escape demands, Escape attention
• Can you restrict attention or tangibles?
• Can you maintain demands or attention?
• Caution Child should not gain access to the
  desired outcome immediately after the problem
  behavior stops. This may create a chain, where
  the child learns to tantrum and then stop in
  order to get it.

7
Increasing Compliance

• Shaping compliance
• If the behavior is happening to
• Gain attention, Access tangibles
• Escape demands, Escape attention
• Can you develop and use a shaping procedure?
• To gradually increase distance, duration,
  difficulty, etc. before providing access to the
  item
• If child engages in problem behavior on any of
  the steps, use extinction
• If child continues to have difficulty with
  current step, go back to the previous step or
  make a modification

8
Increasing Compliance

• Examples of shaping compliance
• Tolerating removal of preferred item or activity
• Tolerating no
• Accepting that the item is not available
• Waiting
• Tolerating a delay in reinforcement
• Shaping difficulty of demands/instructions
• Shaping duration of completing instructions

9
Increasing Compliance

• Improving communication
• Functional communication training
• How to request appropriately
• How to get attention from others appropriately
• How to indicate biological conditions (e.g.,
  pain)
• Complaining appropriately
• Complaining in a socially acceptable way
• Negation
• How to say no at appropriate times

10

• When the therapist arrives, Tina seems happy to
  see her and immediately goes to the therapists
  bag to see what toys she has brought with her
  today. The minute Tinas mom says goodbye and
  begins to leave the room, Tina falls to the floor
  and begins to scream and kick.

Gain Attention
11
Increasing Compliance with Separating from a
Parent/Caregiver

• Extinction
• Child does not gain access the parent while
  engaging in problem behavior
• Caution Child should not gain access to parent
  immediately after the problem behavior stops.
  This may create a chain, where the child learns
  to tantrum and then stop in order to see the
  parent.

12
Increasing Compliance with Separating from a
Parent/Caregiver

• Shaping Compliance
• Tolerating separation from parent
• Gradually increase distance away from parent
• Waiting
• Gradually increase time away from parent
• Tolerating no
• Shape by first giving an alternative, then
  gradually fading to a simple no, not right now.
• If child engages in problem behavior on any of
  the steps, use extinction
• If child continues to have difficulty with
  current step, go back to the previous step or
  make a modification

13
Increasing Compliance with Separating from a
Parent/Caregiver

• Improving communication
• Functional communication training
• How to request for parent appropriately
• How to get attention from parent appropriately
• Complaining appropriately
• Complaining about it in a socially acceptable way

14

• When Arnie arrives to the classroom in the
  morning, he puts away his coat an bag and then
  goes to a learning center to play for about 10
  minutes. When instructed to get his reading
  folder and go to his seat, Arnie screams and
  begins to run around the classroom.

Access to Tangibles
Escape from Demands
15
Increasing Compliance with Following Instructions

• Extinction
• Access to tangibles Does not gain access to the
  toys while engaging in problem behavior
• To prevent a learned chain, student does not gain
  access to toys immediately after the problem
  behavior stops
• Escape from demands Must complete the
  instruction before the demand is lifted
• To prevent a learned chain, student must complete
  the original instruction and at least one
  additional instruction without problem behavior
  before the demands are lifted

16
Increasing Compliance with Following Instructions

• Shaping compliance
• Tolerating no or removal
• Accepting that he cant have the item now
• Waiting
• Tolerating a delay in getting the toys
• Shaping difficulty of demands/instructions
• Shaping duration of completing instructions
• If child engages in problem behavior on any of
  the steps, use extinction
• If child continues to have difficulty with
  current step, go back to the previous step or
  make a modification

17
Increasing Compliance with Following Instructions

• Improving communication
• Functional communication training
• How to request for more time with items
• Complaining appropriately
• Complaining about having to leave to toys or
  having to do work in a socially acceptable way

18

• Pete engages in problem behavior in the form of
  hitting his closed fist to his head or banging
  his head against the desk or furniture. A
  functional assessment indicated that he does this
  when instructed to transition to a less preferred
  activity, when denied access to items or
  activities that he wants, and when the instructor
  is talking to others or not giving Pete her
  undivided attention.

Access to Tangibles
Gain Attention
19
Pete Program Goals

• Shaping compliance
• To tolerate transition to less preferred activity
• Accepting no without engaging in problem
  behavior
• Improving communication
• Functional communication training using
  spontaneous commenting to get attention from
  others

20
Program To tolerate transition to less preferred
activity Baseline Completes 1 to 3 simple
instructions Step 1 Completes 1 to 3 simple
instructions with pre-instruction reinforcer
choice Step 2 Participate in less preferred
activity for 30 seconds with pre-instruction
reinforcer choice
Baseline
Step 1
Step 2
of transitions without problem behavior
Pete
1 2
3 4
5 6
7 8 9
21
Program Accepting no without engaging in
problem behavior Step 1 You cant have __, but
you can have __. Step 2 No, you cant have
__, but you can have __. Step 3 No, you can
have __ later.
of trials without problem behavior
Pete
1 2 3 4
5 6 7
8 9 10 11
12 13 14
22
Program Spontaneous commenting Step 1 Comments
with gestural cue Step 2 Comments without a
gestural cue
Step 1
Step 2
Frequency of tacts in 15 minute interval
Pete
23
Reducing hitting by matching intervention to
function
Tolerate transition program
Hitting after demands (frequency)
Hitting after delayed Sr (frequency)
Accepting no program
Pete
Commenting program
Hitting after attention removed (frequency)
24

• Namon has difficulty remaining in his seat. He
  also engages in inappropriate vocalizations and
  bites his hand. Namon frequently engages in
  these behaviors when given instructions to
  complete a nonpreferred task, when a preferred
  item or activity is removed or terminated, and
  when denied access to a preferred item or
  activity.

Access to Tangibles
Escape from Demands
25
Namon Program Goals

• Shaping compliance
• Increasing compliance to instructions
• Tolerating removal of a preferred item or
  activity
• Accepting no without engaging in problem
  behavior

26
Program Increasing compliance to
instructions Baseline Complete 1 to 3 simple
instructions while accessing preferred
items/activities Step 1 Completes 1 to 3 simple
instructions, remove preferred item/activity
before giving instruction Step 2 Modification
add pre-instruction reinforcer choice Step 3
Participate in less preferred activity for 30
seconds with pre- instruction reinforcer choice
Baseline
Step 1
Step 2
Step 3
of trials without problem behavior
Namon
27
Program Tolerating removal of a preferred
item/activity Step 1 Removal of preferred
item/activity (1 sec) Step 2 Removal of
preferred item/activity (3 sec) Step 3 Removal
of preferred item/activity (5 sec) Step 4
Removal of preferred item/activity (10 sec) Step
5 Removal of preferred item/activity (25
sec) Step 6 Removal of preferred item/activity
(30 sec)
Step 1
Step 2
Step 3
Step 4
Step 5
Step 6
of transitions without problem behavior
Namon
28
Program Accepting no without engaging in
problem behavior Step 1 You cant have __, but
you can have __. Step 2 No, you cant have
__, but you can have __. Step 3 No, you can
have it later. Step 4. No, not now. Step 5.
No, not now. Adult continues to manipulate item.
Step 3
Step 4
Step 5
Step 2
Step 1
of trials without problem behavior
Namon
29
Reducing problem behavior by matching
intervention to function
Increasing compliance program
Inappropriate vocals (frequency)
Tolerate removal of item
Biting (frequency)
Namon
Accepting no program
Out of seat (frequency)
30
Considerations

• Remember to refrain from providing access to the
  item or activity immediately after the behavior
  stops (even if the child mands appropriately).
  This can create chain!
• Bowman, L. G., Fisher, W. W., Thompson, R. H.,
  Piazza, C.C. (1997). On the relation of mands
  and the function of destructive behavior. Journal
  of Applied Behavior Analysis, 30, 251-256.

31
Considerations

• Types of instructions that interrupt a preferred
  activity (do versus dont requests) can
  influence compliance.
• Say sit up instead of dont lay on the floor.
• Adelinis, J. D., Hagopian, L. P. (1999.) The
  use of symmetrical do and dont requests to
  interrupt ongoing activities. Journal of Applied
  Behavior Analysis, 32, 519-523.

32
Considerations

• Parents have been shown to be effective
  implementers of programs designed to shape
  compliance for completing instructions with
  gradually increasing difficulty level
• Important to create a hierarchy of levels to use,
  from least to most difficult for the child
• Important to change steps/add steps if change in
  difficulty level is too much
• Ducharme, J. M., Drain, T. L. (2004). Errorless
  academic compliance training Improving
  generalized cooperation with parental requests in
  children with autism. Journal of the American
  Academy of Child and Adolescent Psychiatry, 43,
  163-171.

33
Considerations

• What to do when the behavior occurs for sensory
  stimulation?
• Compliance programs are not likely to decrease
  these behaviors
• Need to utilize other methods of behavior
  reduction, such as differential reinforcement of
  incompatible behavior, interruption and
  redirection etc.
• Falcomata, T. S., Roane, H. S., Hovanetz, A. N.,
  Kettering, T. L. (2004). An evaluation of
  response cost in the treatment of inappropriate
  vocalizations maintained by automatic
  reinforcement. Journal of Applied Behavior
  Analysis, 37, 83-87.

34
Considerations

• What to do when SIB occurs to improve biological
  conditions?
• Compliance programs are not likely to decrease
  these behaviors
• Communication training - How to indicate
  biological conditions (e.g., pain)
• May need to utilize other methods of behavior
  reduction, such as differential reinforcement of
  alternative behavior, protective equipment, etc.
• Moore, J. W., Fisher, W. W., Pennington, A.
  (2004). Systematic application and removal of
  protective equipment in the assessment of
  multiple topographies of self-injury. Journal of
  Applied Behavior Analysis, 37, 73-77.
• OReilly, M. F., Murray, N., Lancioni, G. E.,
  Sigafoos, J., Lacey, C. (2003).  Functional
  analysis and intervention to reduce
  self-injurious and agitated behavior when
  removing protective equipment for brief time
  periods. Behavior Modification, 27, 538-559
• Thompson, R. H., Iwata, R. A., Conners, J.,
  Roscoe, E. M. (1999). Effects of reinforcement
  for alternative behavior during punishment of
  self-injury, Journal of Applied Behavior
  Analysis, 32, 317-328.