Dr. Lina Patel - Understanding Problem Behaviors - English
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Transcript of Dr. Lina Patel - Understanding Problem Behaviors - English
Lina Patel, Psy.D. Senior Instructor at the University of Colorado Health Science Center
Director of Psychology at the Sie Center for Down Syndrome Children's Hospital Colorado
} None
} List 3 areas of difficulty typically experienced by children with Down Syndrome
} Identify 2 strategies used to manage problematic behaviors of children with Down Syndrome
} Understand the difference between antecedent, behavior, and consequence
} Behaviors that result in… } Self-injury or injury of others } Causes damage to the physical environment } Interferes with the acquisition of new skills } And/or socially isolates the learner
Doss and Reichle, 1991
} Running Away/Wandering from Caregivers } Struggles with Following Directions or
“Stubbornness” } Attention Issues } Social Withdrawal } Noncompliance with use of Adaptive Tools } Compulsive Behaviors or Hyperfocus } Hitting, Kicking, Physical Aggression } Yelling, Cursing, Inappropriate Language
Antecedent Response Consequence
Avoidance/Escape
• Pain/Discomfort • Interaction • Environmental Factors
(i.e. boredom, overstimulation, difficult work)
Acquisition
• Attention/Interaction • Desired Item • Sensory Input • Relief
} Events that occur at one point in time that may change the likelihood of a targeted behavior at a later point in time by momentarily altering the value of the consequence. Feeley and Jones, 2008
} Medical Issues ◦ Vision and Hearing Deficits ◦ Thyroid Function ◦ Celiac Disease ◦ Sleep Apnea ◦ Reflux ◦ Constipation ◦ Depression ◦ Anxiety
} Skill Deficits ◦ Communication ◦ Social ◦ Motor ◦ Academic/Cognitive
} Sensory
} Medical Issues } Skill Deficit ◦ Communication ◦ Social ◦ Motor ◦ Academic/Cognitive
} Sensory
� Strategies for Setting Events: � Checklist of setting events � Decrease presence of antecedents � Increase available reinforcers � Provide visual cues/structure � Provide predictable routines � Modify environment to decrease sensory distractions or
increase alertness
� Antecedent Strategies � Prespecified reinforcer � Preferred item as a distractor � Offer a choice � High probability request sequence � Offer of collaboration � Learn by “doing” � Use “first do this, then get that” directions and schedules � Highlighting (giving social praise) appropriate behaviors � Tell them what to do instead of what “not” to do � Cause-and-effect planned ignoring: “First get calm, then I
will talk with you” � Use strengths and interests to engage
� Skill Building Strategy � Teaching appropriate social skills � Social stories ™ (Gray, 2000) � Teach awareness and expression of feeling states � Role play-notice what was right/wrong
� Consequence Strategies � Differential reinfiorcement of the ommision of behaviors � Token System � Error correction- “Try again” with demonstration � Visual road map
Observed Behavior
Time/ Date/ Activity Initials of person documenting
Antecedent/ Trigger/ What happened right before?
Behavior/ Details of behavior
Consequence/ What happened after?
Function of the behavior?
} “The important point is that difficult behaviors do not occur by accident, or because someone has a disability. Difficult behaviors are expressions of real and legitimate needs. All behavior, even if it is self-destructive, is “meaning-full.””
David Pitonyak, PhD Blacksburg, VA Down Syndrome News
Questions?
Thank you for your time!