Tuesday, February 26, 2013

Limits and Consequences

In today’s pursuit of having confident children who believe they can achieve whatever they want, many parents overlook their responsibility to set limits for their children. Ironically, children who don’t learn limits may not develop the sense of security and self-esteem they need to achieve important life goals. One of the most challenging but fundamentally important principles of parenting is the ability to set limits for children and follow through with consequences when the boundaries have been crossed. Limits and boundaries provide children with a feeling of safety and love. Confidence develops when children know that their parents are looking out for them.

Limits and consequences are also a vital tool in behavior management. Limits are set to help your child to understand respect for himself and the world around him. The purpose of using consequences is to motivate children to make responsible decisions, not to force their submission. Consequences are effective only if you avoid having hidden motives of winning and controlling your child. Try not to establish rules solely for your convenience and always make sure you have realistic expectations. A child must have the cognitive capacity to understand the rules and the consequences for breaking the rules before the consequence is given. For example, an 18-month old child does not understand that he can get burnt from touching the stove. If he does not understand, he can’t be held responsible and should not receive a consequence. Instead, a parent can use distraction techniques or can arrange the environment to secure safety, such as putting up a safety gate when the stove is hot.
Consistency and follow-through are crucial when using limits and consequences to change a problematic behavior. If a limit has been established and been broken, a parent needs to follow through with a consequence. Any flexibility will teach the child what he can get away with in the future. In other words, mean what you say.

It will help you to set reasonable limits if you remember that your child needs freedom to explore, to learn and to discover. The right of children to play freely and to learn by doing things themselves must be acknowledged.
Here are some important guidelines when setting limits and consequences:
  • The person whose rules were broken is responsible for enforcing and administering the consequence whenever possible. For example, school rules should be enforced at school by the teacher.
  • One consequence per violation should be enforced.
  • Be both firm and kind. Firmness refers to your follow through with the limit and consequence. Kindness refers to the manner in which you present the choice. A consequence should not be perceived as a punishment if it is to deter the behavior in the future. Be firm with the problem; be kind with your child.
  • Consequences should be over as quickly as possible so a positive family atmosphere can be reestablished.
  • Whenever possible, offer you child the chance for a do-over before enforcing a consequence. Give the child another chance to practice an appropriate behavior and be successful.
  • Follow through with consequences as soon after the violation as possible so the child connects the consequence with his/her action.
  • Be in control of yourself when administering or enforcing consequences. Any show of anger and frustration, such as yelling, name calling, criticizing or rage by the parent, cancels the effect of the consequence. Remember: it is you AND your child against the problem, not you against your child.
  • Be patient. It will take time for the consequences to be effective.
  • If you make the child feel bad, he’ll hold on to the behavior as part of his arsenal against the parent and this will not foster a parent-child alliance against the problem behavior.
  • Consequences must be planned in advance. You should be prepared with a list of consequences you can call upon when the situation arises. Both parents should agree in advance what is an appropriate consequence.
  • Choose consequences related to the violation, whenever possible. For example, if your child exhibits antisocial behavior, sending him to his room is a logical consequence (not as a punishment). If he’s disrupting the rest of the family, logically he needs to leave the room so as not to disturb the rest.
  • Make sure the consequences you choose do not negatively affect you or the rest of the family more so than the child receiving the consequence. For example, limiting TV or cancelling a weekend outing may affect you and other siblings.
In sum, do not react to the behavior out of frustration and anger. When you implement consequences to manage challenging behaviors, think of it as helping your child to get back in control and teaching him important life skills such as patience, respect for others, and respect for himself.

After all, our kids are not our enemies. They don’t wake up in the morning thinking how to make us miserable. They are children, our son, our daughter, they are the most important thing in our lives, by far, and our love for them should be unconditional.

Daniel Adatto, BCBA

Thursday, February 7, 2013

Understanding Applied Behavior Analysis

Behavior disorders in children are common and could be the result of a variety of causes. We, Applied Behavior Analysts, sort those causes and develop individualized treatment plans. We will evaluate your situation and work with you to develop a treatment plan. We believe that every child is unique and deserves an in-depth look into their particular situation. Each treatment plan we develop is tailored to meet the needs of each individual child.  Not all challenging behaviors in children are cause for concern but if you have any doubt, it is always best to have a professional assess your child.

The process starts with a comprehensive evaluation: The Functional Behavior Assessment. 
Functional Behavior Assessment is a process for gathering information to understand problem behaviors and develop effective behavior intervention plans. Functional Behavior Assessment is a set of methods for defining the environmental factors that contribute to, reliably predict, and maintain challenging behaviors. Understanding why a behavior occurs directly leads to how it can be changed. “By determining the contingencies that maintain problem behavior, functional analyses allow the development of effective function-based treatments.” (Iwata et al.,1994).

According to E. Cipani and K. Schock, “a function-based diagnostic does not presume that challenging behaviors are driven by characteristics inherent in the person, which is a sharp contrast with the traditional psychiatric approach to diagnosing clients’ behaviors (e.g. DSM-IV-R).” “In a function-based diagnostic, the form of the behavior (how the behavior looks like) does not dictate the function.”  This has significant implications in designing effective behavior interventions. If behaviors are identified according to their form, each and every behavior would require a different plan. When behaviors are assessed according their function, one intervention could be prescribed for different behaviors that serve the same function. As an example, a child that engages in hitting, kicking, throwing objects, crying, and screaming in order to avoid non-preferred activities (negative reinforcement function), would be prescribed with one intervention rather that five (one for each behavior).

Therefore, when trying to understand problematic behaviors in children it is important to consider the many different variables that could be playing a role in the behavior.  Every child throws tantrums. But each situation is different and there are countless motivating factors that could be causing the tantrum. Evaluating the environment in which the tantrum occurs, understanding the child's motivations, and assessing how the adults and caregivers in the child’s life react to the behavior are all factors that help us develop a strategy to treat the behavior disorder.  To give us the complete picture, we look at all the possible reasons why a child is behaving a certain way. We include interviews with the family as well as all those who interact with the child, such as a teacher or relative, to give us a more in-depth look at the child’s life.
We observe the child in different situations, including when and where the behaviors are less likely to occur, because those situations give us an insight of what works for this child. We analyze the variables that contribute to the occurrence and non-occurrence of the challenging behaviors, and develop hypotheses about their functions, the why this child engage in these behaviors? What is the child trying to obtain or avoid?

We manipulate those variables to prevent undesired behaviors and trigger desired ones, thus confirming or ruling out our hypotheses.
And we develop behavioral plans that match the functions of the behaviors.

In sum, by taking an individualized approach, we maximize the chance of success of the treatment plan.

Daniel Adatto, MA, BCBA