Could My Child Benefit From Behavior Intervention?

Tired of getting kicked, hit, and bitten? 

Is getting out of the house with your little one a struggle?

Does your child have trouble making friends at school?

Are the “time outs” just not working anymore?

Afraid your child is going to run away from you in public or at school and get hurt?

NEWSFLASH: Parenting is tough!

Raising a child with a disability is even tougher.

Life gets even more stressful when there are disruptive or problem behaviors.

The good news is… you don’t have to go this alone.

It’s not going to be easy, and it will take time, but you can get support.

Behavior intervention can come in a number of different formats.

ABA (Applied Behavior Analysis) intervention is a popular way that behavior intervention is delivered, especially for children on the autism spectrum disorder.

ABA can come in many forms and styles, but basically it is the idea that a person’s actions can be changed by looking at their behavior. For those who follow this approach, they define behavior as the result of an antecedent (cue/instruction), which leads to the behavior, and produces a consequence.

Woah, woah, woah… slow down a second there professor.

Let’s bring it into the real world. Say your stomach is growling because you’re hungry (antecedent), you eat an apple off the kitchen counter (behavior), and then you are satisfied (consequence). You get your need met, have a positive experience, and know that the next time your stomach growls, you can eat some food to feel the same satisfaction.

Believe it or not, you’re probably using “behavior intervention” as a parent already!

You tell Johnny to clean up (antecedent), but he doesn’t want to so he throws a toy at you (behavior). Then he gets put in a “time-out” (consequence). In an ideal world… you know, that place we all wish would exist but never does…Johnny would learn that the next time you ask him to clean up, he can avoid a “time-out” by just doing it the first time.

So, you ask yourself,  if you’re already doing a form of ABA as a parent, then what’s so special about this behavior intervention??

One of the more commonly known techniques of ABA is Discrete Trial Therapy (DTT). In this form of ABA, tasks or behaviors are broken down into small, individual steps. Each individual step is taught to the child in a systematic format, giving them rewards for the desired behavior along the way.

For instance, say your child throws a tantrum every time she is asked to wash her hands. A therapist providing behavior intervention using the technique of DTT might break down this task into each step:

1. Turn on the water 
2. Put hands under the water
3. Get soap
4. Scrub hands together
5. Rinse hands
6. Turn off water
7. Get paper towel
8. Dry hands
9. Throw paper towel into the trash can

The behavior interventionist would then teach your child to just turn on the water to start, giving her a reward (verbal praise- “yay!”, high five, small candy… whatever floats her boat) if she does it correctly. Then only when she’s able to turn the water on without throwing a fit will the behavior interventionist move on to the next step. On and on this goes until lil’ mama is actually washing her hands on her own!

Discrete Trial Therapy is widely researched in helping children with autism, and as a speech therapist, I’ve seen children have HUGE success by following this treatment plan. It’s helped a ton with my time with them because the little ones were finally able to receive the directions once their disruptive behaviors were eliminated. Even better, ABA providers work closely with families to educate and coach parents on strategies they can use at home and during their daily lives to set their children up for success.

As with anything, there are limitations…

• A lot of times insurance won’t fund this type of therapy unless the child has a diagnosis of autism spectrum disorder. We all know that there are other children who have disruptive behaviors that don’t have autism.
• ABA programs often take a huge time commitment of the child and the family… we’re talking 20-40 hours a week, and that’s often ON TOP of the time they’re already in school.
• Sometimes children are super successful during therapy time or in a certain environment (e.g. home), but when they go to another place (e.g. school, grocery store, park) those skills don’t carryover. This is what we call a lack of generalization and could be very frustrating for those who are working with the child.
• May not take into effect the underlying sensory needs of a child which may be causing or impacting the behaviors. If this is the case, then an occupational therapist may be better suited to work on sensory integration therapy.

Despite popular thought, DTT is not the only form of behavior intervention.

Other programs that follow an ABA philosophy include the Early Start Denver Model (ESDM) or Pivotal Response Treatment (PRT). Behavior assessments and behavior plans can also be requested through the school district if your child shows disruptive behaviors in class or during the school day.

In case that wasn’t enough info, we were really just scratching the surface! So fear not, there are plenty of resources available if your child could benefit from behavioral intervention.

ACTION STEPS:

1. Look through the differences between ESDM, PRT, and DTT to see which one resonates with you most.
2. Call a local therapist in your area to set up an assessment. Depending on the area where you live, there may be a waitlist. Ask how long is the wait. May help to get on multiple waitlists at different providers.
3. Determine how you will pay for these services. If planning to go through insurance, call your insurance company to ask about coverage and benefits.
4. Download the FREE ABC Chart to get more info on why your child might be having disruptive behaviors.