Abstract
E.J. is an 8-year-old boy who was diagnosed with autism and referred to the Functional Behavior Analysis that revealed tantrums as interfering behavior. It is suggested that his tantrums occur when he fails to obtain peers’ attention to satisfy the need for sameness. This paper presents the behavior intervention plan based on differential reinforcement and communication training strategies. Mastery, generalization, and maintenance criteria are identified to ensure the consistency of treatment.
Functional Assessment
E.J. is an 8-year-old male student that was referred to the Functional Behavior Analysis (FBA) by his teacher, Ms. Murano. Based on the Functional Assessment Screening Tool (FAST) and interviews with parents and teachers, it is found that the student engages in tantrums predominantly in the first half of the day. It was also noted that this interfering behavior often appears as a response to asking him to complete academic tasks. During the latter part of the day, the student has choice time and shows significantly less number of tantrums. Also, E.J.’s tantrums occur before his intention to have the attention of his peers. The functional assessment allows for concluding that auto-reinforcement of the target interfering behavior can be changed by redirecting the student’s attention and using the replacement behaviors.
Target Behaviors for Increase and Decrease
In children with autism, tantrums appear as the consequence of the fact that his or her needs for information, an item, or sameness were not met. In the given case, E.J. seems to practice tantrums because of the inability to receive attention from his peers in the class. The target behavior to decrease is tantrums and associated expressions, such as crying, lying on the floor, and so on. It is expected to replace this dysfunctional behavior by increasing the student’s ability to ask for the required attention or an item (Cooper, Heron, & Heward, 2014). The behavior intervention plan aims to provide the basis for mastering such skills as raising a hand or using vocal identifiers instead of tantrums. It is preferable to achieve socially-appropriate forms of clarifying needs and intentions for E.J. The non-examples of target behavior include rumbling, poking or pushing others, and screaming.
Proactive and Reactive Intervention Strategies
The strategy of differential reinforcement is the main idea of this behavior intervention plan that involves both reactive and proactive approaches. Every time the student shows the signs of the upcoming tantrum case, he will be offered to use vocal explanations or raise his hand. While following these suggestions, he will be granted tokens in terms of positive reinforcement. The list of activities that are preferable for this particular student will be designed in advance and given to the student. In case of tantrums, positive reinforcement will be withdrawn, which is a reactive strategy to discourage unwanted behaviors. The application of differential reinforcement is likely to activate E.J.’s pro-social behaviors while decreasing challenging ones. To ensure treatment continuity, the identified intervention will be first adopted at home and then implemented in school settings as well.
The assistance of parents is required in the adaptation of children with autism not only at home, but also on the street and at school. By persistently and gently overcoming E.J.’s resistance and unwillingness to communicate, parents should ultimately make it clear to the child that it is possible for him to communicate in words, play with peers, and so on. A clear and logical chain must be formed in the minds of children, such as that poor behavior will lead to bad consequences that will occur regardless of other factors. Considering that the chose student is non-vocal, he should be given the instruments to interact with teachers and peers. For example, the iPad or the Picture Exchange Communication System can be applied to this child to help him in handling his communication challenges. Every time the student wants to receive peer attention, he will be aided by the teacher or paraprofessional to refer to the chosen communication instrument.
It is important to teach the child to explain his feelings and desires in words or vocal identifiers, which will help him in finding a common language with peers and prevent internal dissatisfaction. There are several ways to solve this problem; for example, by gradually teaching the child to choose words, signs, symbols, or pictures to explain his desires (Wood, Kisinger, Brosh, Fisher, & Muharib, 2018). If necessary, an image system or other messaging method that both the child and peers can use may be applied. E.J. will also be explained to define his emotions and understand his behavior better. If the child has autism, this turns into a difficult task, but it is not impossible. If a child can point to some pictures, thereby explaining that he is angry, it will be better than if he decides to engage in tantrums.
Another strategy is to create a table of behavior and mark good behaviors with a special sticker or label. The child will receive a reward when he earns a certain number of stickers. E.J. will be allowed to stick the stickers on his own so that he participates in the process. It seems to be beneficial to use sensory rewards that are more difficult to submit as a reward, but for a child, such a reward is important to correctly stimulate his sensory activity. For example, to stimulate vision, it is important to consider that sometimes children like to look at new books, animals, or flying airplanes. A song or quiet, soothing music on simple instruments like a piano develop hearing. One more option is to teach E.J. to distinguish between different smells like apples, orange, and some flowers. For the sense of touching, sand, a pool with balls, water, or even food packaging can be used as positive reinforcement. In general, the key goal of using a variety of reinforcements is to stimulate the interest of the student in learning new behaviors.
Data Collection and Criteria for Mastery
Using the ABC method, the data on what causes the attacks of aggression in the child will be collected. Then, based on this information, the child will receive the identified interventions to link cause and effect and develop an action plan for all complicated situations. For example, if the toys are scattered by someone else, the child should ask someone to help clean them. E.J. will be explained to communicate and anticipate the consequences of his actions. For example, if a child is upset and throws a tantrum, this means that parents and teachers should spend more time with him. If the child can tell parents that he is upset, the parents will help him, and the child will receive what he needs. To assess the effectiveness of the interventions, the frequency of tantrums will be documented before and after the implementation of the strategies. The comparison of the collected data will be made based on observations and interviews.
The criteria for mastery of the proposed interventions will be showing the expected behavior instead of tantrums. If E.J. will use the newly mastered behaviors in 85% of critical cases after six months, it would mean that he achieved a positive result. At the same time, the extent to which the student will use communication instruments and gestures will demonstrate his ability to seek help when it is needed.
Generalization and Maintenance Plans
The use of differential reinforcement to adjust tantrums is proposed in home and school settings. After its successful implementation in these environments, it will be possible to consider such settings as on the bus, the street, and in different other facilities. The communication skills that will be acquired during this plan will allow for developing them in generalized settings with minor adjustments. For example, it will be easier for the child to understand that certain behaviors are unacceptable in public places, and that positive reinforcement will be given if he will demonstrate the socially-appropriate behaviors.
As for the maintenance plan, the target behaviors will be supported by means of a consistent and transparent positive reinforcement based on the token economy system. The student will be reminded of the need to follow the identified rules to receive the desired item or be allowed to engage in the preferred activity. More to the point, depending on the interests of the child, the list of items and activities can be changed with time.
References
Cooper, J. O., Heron, T. E., & Heward, W. L. (2014). Applied behavior analysis (2nd ed.). United Kingdom, London: Pearson.
Wood, C. L., Kisinger, K. W., Brosh, C. R., Fisher, L. B., & Muharib, R. (2018). Stopping behavior before it starts: Antecedent interventions for challenging behavior. Teaching Exceptional Children, 50(6), 356-363.