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Behavior      ​BluePrints

Behind the Mask: How to Teach Wearing a Mask

6/24/2020

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Now that we are in unprecedented times, we are all facing new things in daily life. One of the main things we are having to “face” is wearing a mask to keep ourselves safe, as well as others. As this is new, for both adults & children, strategies may be needed to teach children about why & how to wear a mask.
 
Why teach children how to wear a mask?
While many children may have unique sensory needs, wearing a mask may feel different for them. While it may be a transition to have children wear a mask, masks may be needed at different locations where children may have to go to in the future (e.g. stores, restaurants, schools/childcare centers, doctor’s offices, etc.). It is important to prepare them now, just in case in the future a mask is needed in order to avoid other challenges when in the “real world” again. In a worst-case scenario, if your child had an accident & needed immediate medical attention at a hospital, you would want to make sure they are protected. Depending on your child’s cognitive ability, it may be helpful to explain to them the significance of wearing a mask that it helps keep everyone “safe”, so they understand the reason of why they need to wear it.
 
Where do you start to teach wearing a mask?
Modeling
Children first need to become comfortable seeing others’ wearing a mask, so they understand that it is common for people to wear them. If your child has primarily been inside, they may associate with only medical professionals wearing a mask, which may lead to some stigmatization with masks. It is helpful to have you as a parent/caregiver show your child you wearing a mask, show them how to put it on & take it off & most importantly, letting them know that it is still “you” behind the mask. You can also practice modeling with having other family members wear masks, preferred toys (e.g. stuffed animals, etc.) wearing a mask, or showing them their favorite character (e.g. Doc McStuffins) wearing a mask. A social story/video can also be helpful to view with your child, to explain & show how masks are worn.
 
Pairing
You also want your child to associate the mask in a positive way, mask=good! If there are mask options to choose from, perhaps your child can help choose the mask they are wearing, maybe it is their favorite color, has a cool design on it, etc. After practicing wearing a mask, provide your child something that they like-this could be giving them lots of extra attention (e.g. “I’m so proud of you!”, “Woo hoo!”, tickles, etc.), maybe a small piece of a preferred snack, access to a preferred activity, the options are endless! If possible, it could be something that they get ONLY after they practice wearing the mask, so they are motivated to continue trying to wear the mask.      
 
Setting Clear Expectations
From the beginning, it is important that you set clear expectations of how long the mask will be worn for. It is better to start with a short amount of time (e.g. 3 seconds) that goes well, rather than having the time be too long (e.g. 5 minutes) & things not go as well. You should also inform the child of how long they are going to wear the mask for & initially count outloud as they are wearing the mask so they know when the time will end (e.g. “we’re going to wear a mask for 3 seconds, 1, 2, 3, all done!”). The adult practicing with the child should also wear their mask as the child is wearing a mask to continue modeling practice. As even for adults wearing a mask can be difficult, it is important to set a realistic expectation from the beginning. Perhaps this includes getting adjusted to having the mask cover their mouth first by holding it over their mouth rather than fully wearing a mask. The next step could include being able to move up to holding the mask over their mouth & nose before practicing wearing a mask over their ears/head. Once the child is consistent with meeting the current expectation, then you can slowly start to increase the duration the mask is worn for as well as how the mask is worn (e.g. holding it over face vs. wearing over ears/head). Wearing a mask should also be practiced first at home before wearing outside as you want to make sure that you practice in a familiar environment first that is comfortable for the child. Once the child has mastered wearing a mask at home, then you can practice by going on a walk outside, going inside a store (if comfortable), etc. 
 
Teaching How to Put On & Take Off
It is important the child knows how to put on a mask as well as take it off, should they need to take a short break from wearing the mask to take a breath. When practicing putting on a mask with over the ears, the mask can initially be hung from one ear, while teaching the child to pull up the mask over the other ear & then adjusting the mask as needed to cover mouth & nose areas. With taking it off, you can teach the child how to pull the mask down when needed & also how to take the mask off, hopefully to prevent it from breaking.
 
While we are not sure how long masks may be needed, it can be helpful to practice wearing just in case masks stick around for longer than we initially expected. If you have any questions, please feel free to reach out to the ABA department & we will be happy to assist!
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Marisa Goudy, M.S, BCBA - National Therapy Center

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Matching Law

10/8/2018

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The definition of matching law is the following: a phenomenon according to which organisms tend to proportionally match their responses during choice situations to the rates of reinforcement for each choice ((Cooper, Heron, & Heward, 2007).   In other words, individuals tend to engage in behaviors that result in higher rates of reinforcement rather than behaviors that result in lower rates of reinforcement.  For example, when collecting ABC data (to determine antecedents and consequences to challenging behaviors), it may be found that a child engages in higher rates of attention-seeking behavior with a specific caregiver because their attention-seeking behavior of dropping or self-injurious behaviors typically result in some form of attention, whether positive or negative.  On the contrary, the same child may engage in those same challenging behaviors at a much lower rate with another caregiver who offers attention as reinforcement when the child is engaging in compliance behaviors like standing or sitting quietly instead of when that child engages in those challenging behaviors.
 
In other words, if a behavior is reinforced about 60% of the time in one situation and 40% in another, that behavior tends to occur about 60% of the time in the first situation, and 40% in the second. Although there are many other factors to consider when deciding which behavioral strategy will work best, implementing the matching law by "maximizing reinforcement for the desired behavior...[and] minimiz[ing] reinforcement for the problem behavior" can prove to be rather effective (McLean, 2018).  
McLean, M.Ed, BCBA, S. (2018). Applying the Matching Law to Behavior Intervention. Retrieved from https://bsci21.org/applying-the-matching-law-to-behavior-intervention/
Cooper, J. O., Heron, T. E., & Heward. W. L. (2007). Applied Behavior Analysis (2nd  ed.). Upper Saddle River, NJ: Pearson.

Janelle McDonald, ​M.A., BCBA, LBA - National Therapy Center


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Reinforcement Part II: Say What, There's More!

2/28/2017

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​In the reinforcement post, we went through the basics of what a reinforcer is, some key concepts to remember and a quick way to remember how to apply it.

This post outlines two types of reinforcement and go over punishment too, after all punishment has it's own role to play in the game of life.

2 Types of Reinforcement:
 Is it added or taken away?

Positive Reinforcement- adding something, which makes behavior more likely to happen in the future.
  • When I share my toys, mom and dad give me a high five.  
    • Behavior- Sharing my toys
    • Reinforcer- mom and dad give me a high five.
    • Next time, I am more likely to share my toys, because last time something I loved what happened.

Negative Reinforcement- take something away, which makes behavior more likely to happen in the future.
  • When I cry and drop to the ground, I no longer have to share my toys.
    • Behavior- cry and drop to the ground.
    • Reinforcer- I no longer have to share my toys (sharing my toys, is not longer expected of me).
    • Next time, I am more likely to cry and drop to the ground, because last time when I cried, I no longer had to share my toys.

In both examples, the behavior was more likely to happen in the future and, the behavior which increased was directly connected to the consequence that came after it.
In positive reinforcement- a high five was added. While in negative reinforcement- the expectation to share was taken away. The only difference was that in one example, a consequence was added, in the other, a consequence was taken away.

Punishment - anything that makes behavior less likely to happen in the future. Yes, anything. 

Just like reinforcement, there are also two types of punishment. You guessed it... positive punishment and negative punishment. And Just like reinforcement, the difference is if something is added to decrease behavior in the future or if it is taken away to decrease behavior in the future.
To recap: 
  • Reinforcement always increases behavior regardless of if it is positive or negative.
  • Positive or negative tells you if something is added or if something is taken away.
  • There is a direct connection between the behavior and the consequence that follows it.
  • Consequences can be either rewards or punishers.    


Shari Pirnia Adler, M.S, ED,BCBA,LBA - National Speech/Language Therapy Center

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Reinforcement: What is it and How can I use it?

1/12/2017

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There are many things that people like, whether it be praise, food, activities, toys, money, touch, sound, smell, etc.. which may very well be things that we like. If these items do not increase our future behavior, they are preferred items and not reinforcers. One of the key concepts to remember about reinforcement, is that reinforcers will ALWAYS increase the behavior that came before it.

Reinforcers are, in a nutshell, any reward or consequence that comes after behavior AND increases that behavior.

The reinforcers must be motivating-  the reward needs to be something that is wanted or desired AND worth it. It also should be individual- What one person likes, another may not. Both of these things matter,  otherwise, no mater what you do, rienforcement will not be effective.

Example: You say, 'If you eat all your vegetables, you can watch one episode of Mickey Mouse Club house before bed'
Is Mickey Mouse Club house motivating?
Is it individual?  

If your child does not like Mickey Mouse Club house, then there is no incentive and so this is not a reinforcer for them.  Perhaps they do like Mickey Mouse Club house but they still didn't eat all their vegetables;  In this case, they like the show, but it's not worth it to have to eat all the vegetables- Mckey Mouse Club house is not a reinforcer for eating vegetables for this person.  Now you might say the same statement to someone else and find that they ate all their vegetables-  Mickey Mouse Club house is a reinforcer for this person's behavior.

Reinforcement vs. Bribery
Isn't reinforcement the same thing as bribery?   No, it is not. Which brings us to the third key concept to reinforcement, timing/immediacy.

Reinforcement comes AFTER the behavior you are trying to increase and increases it; bribery comes BEFORE the behavior in hopes that it will influence the behavior. 

When you reinforce a behavior, it will always come after the behavior and only if that behavior happens. 

Reinforment:  " If you eat all your vegetables, you can eat a delicious ice cream sundae for dessert"- The behavior is, eating vegetables, and the reinforcer is an ice scream sundae.  Also known as 'Grandma's Rule', they would get the ice cream sundae after they ate all their vegetables, not before they ate them. Now they could eat the vegetables or not eat the vegetables, but, if they don't eat the vegetables, then, there is no ice cream sundae.  

Bribery:  "Here's five dollars to buy your favorite snack, but you have to do the laundry when you get home." Who's to say that they will do the laundry? They may do the laundry or not, but they still got the $5 no matter the outcome.

So how do you use positive reinforcement effectively?  Remember the phrase- I'M In Control (IMIC), to remember the following concepts: 

I ndividualized- Understand that reinforcement is unique to the individual- what one person likes, another may not.

M otivation-  If there is no motivation for what you are offering, then your reinforcement will NOT be effective no matter what you do. Consider the fact that motivation may change based on the circumstances.

I mmediate: Timing is important- When reinforcement is delivered immediately after the behavior, the connection between the behavior and the reinforcer is easier to make.  When there is a delay in the delivery of reinforcement, the connection between the two becomes much more difficult to make and less likely that the behavior will increase.
​
C onsistent- At least initially when you are first teaching behavior, reinforcement should be delivered consistently as opposed to randomly. This produces faster learning and less confusion.


Shari Pirnia Adler, M.S, E.D,BCBA,LBA - ​National Speech/Language Therapy Center


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What's the Function?! Part Two....

12/28/2016

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In the last post we discussed why behaviors happen (the functions of behavior) and why it’s necessary to determine the function.  In this post, we will go through some steps to help determine the function. 

Remember, we want to know the function so we can find a behavior we would rather have the person perform instead.  In order for this to work, the behaviors must serve the same purpose. 

Example- If a child screams and is given juice we can replace the screaming with asking for the juice. Asking for juice serves the same function as screaming for the juice (the child gets the juice). 

Determining the function of the behavior is therefore very important.  For instance, in the example above where the child is screaming and we want him to instead ask for the juice we have to remember this only works if the reason (function) of the behavior is the same.  Sometimes we guess incorrectly.  In this example, we understandably guessed the child was screaming to get the juice but… If they were actually screaming to get their mother’s attention, our intervention of having them ask for juice would not work.  In this case, we would have to adjust our intervention to get at the correct function.  Now we may have him say “Hey Mom.” So that he gets the attention that he is seeking. 

Here are some general questions to ask ourselves that can help determine the function:
  • Does the behavior stop occurring shortly after you give the child a toy, food, or activity? (If yes this behavior may be to get access to the item/food/activity e.g., hitting a sibling to get a toy)
 
  • Does the behavior occur following a request to perform a task? (If yes this behavior may function to escape from the activity, e.g., screaming/crying            to get out of taking a bath)
 
  • Does the behavior occur when you stop attending to or start talking to another person? (If yes this behavior may function gain attention from you, e.g., whining or throwing a toy when parents are talking to each other when they get home from work)
 
  • Would the behavior occur continually even if no one was around? (If yes this behavior may function as automatic reinforcement, e.g., chewing on fingernails.)
 
Try some of these out at home and see if you can determine the function of a behavior and pick a replacement behavior that will work better for your family.
 
*Remember if your child is having severe behavior problems or is engaging in dangerous behaviors it is best to consult a professional.


Chris C. Shaw Jr. M.A., BCBA, LBA - National Speech/Language Therapy Center

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What's the Function?! Part One...

12/19/2016

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​In the first post we gave a brief description of the history/definition of ABA and today, we will discuss probably the most important thing we come across and use in daily ABA---Functions. 

Not surprisingly, functions in ABA refer to the functions of behavior.  Simply put, this means why is someone performing a behavior?  Are they doing it to get something or someone?  Are they doing it simply because it feels good?  Are they doing it to get away from something? 

In ABA, we categorize functions into four main groups-
  • Access (wanting an item or activity, e.g., a toy, food, playing a video game)

  • Escape (wanting to get out of an activity/ away from an item/ e.g., away from a loud noise, homework)

  • Attention (wanting attention from someone/ e.g., trying to impress a parent or friend)*remember this can also be negative attention e.g., hitting a sibling can get mom’s attention

  • Self-Stimulatory/ Automatic (something that soothes an inner need/ e.g. eating food, scratching an itch).  
 
We categorize this way because in order to change a behavior we must find a replacement behavior that serves the same function;

Example- if your child is throwing their plate/food on the floor towards the end of the meal you probably would like them to change that behavior.  If we determine the function to be escape (from the task of eating) we can come up with an alternative (replacement) behavior that serves the same function (like saying “All done” or handing plate to mom). 
As long as we have guessed the correct function-The behavior we want to change “throwing the plate on the floor” should decrease and the replacement behavior we would like to see i.e., handing plate to mom or saying “all done” should increase.  Yeah!

Next time- How do we know what the function is?


Chris C. Shaw Jr. M.A., BCBA, LBA - National Speech/Language Therapy Center

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What is ABA.....

12/6/2016

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Many people have heard the term or had experience with ABA in recent years yet still are not completely sure what it is. So…

Applied Behavior Analysis (ABA) is a treatment approach based on scientific principles of behavior developed over the past 50 years.  It is considered to be the most effective, evidence-based treatment for children diagnosed with autism spectrum disorder and other developmental disorders.  ABA is recommended as a “best” practice by the American Psychological Association and the US Surgeon General. 

ABA therapy includes many different techniques all of which focus on the things that happen before and after a behavior (antecedents and consequences).  Positive reinforcement is arguably the most widely used technique.  This is when a behavior is immediately followed by a “reward” which then increases that behavior in the future.  Example- Your child picks up their room and you give them a hug and $5 and they start cleaning their room more often.  

ABA is committed to improving behaviors that improve the day to day life of the clients and their significant others.  The field of ABA strives to include family members/ significant others in order to make sure it is effective in the “real world” of the person and not just in a clinic.
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In the past 20 years there has been rapid growth in the field fueled mainly by work with children diagnosed with autism spectrum disorder.  This growth has been based on a study showing the success of ABA in treating children diagnosed with ASD and more recently by insurance mandates in states requiring ABA coverage for children diagnosed with ASD. 

Chris C. Shaw Jr. M.A., BCBA, LBA - National Speech/Language Therapy Center
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