001i am a clinical director and clinical consultant at caio um so today we are going to be talking about our top three strategies for navigating challenging behaviors um so i'm going to go ahead and share my screen and that way we can get started on our our presentation for today alrighty okay like i mentioned we are going to go over top three strategies to navigating challenging behaviors and this can be applied both in homes and also in our school settings this is going to be our agenda for today first we are going to go to how go into how we define behaviors or a behavior then we'll discuss how to identify functions of a behavior or behaviors meaning how can we identify why a behavior is occurring then we'll go into those three strategies for
002navigating challenging behaviors so how to reduce those challenging unwanted behaviors and then lastly we will go into questions and answers feel free to ask questions in the chat as we go i will stop and look and answer questions throughout the presentation or if you like to hold off to the very end either way is fine with me okay so before we go into our presentation um this is who we are and what we do so kyo is a team of over 800 professionals in behavioral health ranging from behavior analysts down to program supervisors our behavior therapists who implement the direct therapy and then our admin staff we provide a variety of different services including aba therapy in-home and centers and also via telehealth we provide parent training behavioral consultation and school and community shadow support
003so we are kind of in all the different types of settings and communities uh this is where we serve we serve in uh major metro areas in over 10 plus states across the united states um if you like to look into more of our services feel free to take a look at this link i'll be sending a copy of this training presentation to kevin to share with you all okay so now going into our presentation i'm determining the function of a behavior so what is the behavior trying to tell us um and when i talk about behavior this doesn't just mean you know inappropriate behaviors or unwanted behaviors but it also can mean those could mean um they're talking about those appropriate behaviors however in this training we're probably going to go more into inappropriate
004behaviors so there are four main functions of behaviors um the way that it's been really helpful to remember the four functions is through this acronym eats e-a-t-s e is for escape avoidance a is attention from others t is tangible meaning getting access to tangibles like things activities environments and s is sensory self-soothing now we'll go into detail about each four function and what they mean and what they look like so first going into escape avoidance this is when a behavior occurs because a child wants to get away from something or someone so this can be delaying or postponing a demand a non-preferred task maybe a non-preferred person or even a non-preferred setting maybe it can be homework bad time if bath time is not preferred maybe seeing a specific teacher or a specific adult anything
005that we do to get to avoid or escape that would be escape avoidance so here's an example of escape avoidance behavior we have a dad maybe um asking their child to go for a walk and let's assume going for a walk is non-preferred the child says no and flops on the floor uh once dad sees that the behavior of flopping in vocal protests the dad then says fine we'll just go back home inside we won't go for a walk so as you can see the child has learned that every time they vocally protest and flop to the ground when a non-preferred activity is presented like going for a walk they now know they don't have to go on a walk and that demand is removed our second function is attention from others this is when
006a behavior occurs because a child is trying to gain social attention or a reaction from a person or people this can be familiar people like family members teachers but it could also come from um strangers so maybe someone on a sidewalk um maybe a an acquaintance um just a random person this social attention can be positive or negative so positive meaning cuddles um maybe giving a loving like a lot of tension like cuddles hugs and so forth or negative meaning reprimands being yelled at punishment maybe time out those kind of things um so for this example we have a mom that picks the phone to make a call as soon as my mom picks up the phone the child starts crying mama the mom quickly hangs up the phone and says yes love so here
007the child has learned that every time mom makes a phone call and that attention is diverted from them um they cry mom then provides that attention to the child and again feel free to ask any questions in the chat if you have any as we go through the presentation our third function is tangibles so access to tangibles this can be again items it can be activities or environments this behavior occurs because a child is trying to get physically trying to physically get access to something they want or need like an item or activity and this can this is most likely something that is preferred uh motivating and they want this item so in this example the sibling is playing with a toy so maybe we have an older sibling playing with a toy the younger
008sibling then pulls the sibling's hair pull the hair and then older sister or brother drops a toy and runs off crying now the younger sibling has a toy so the youngest sibling has learned that if i pull my big sister or brother's hair they let go of the toy then i get what i want uh one common example that i see often is maybe around electronics um maybe it's time to go to bed and turn off electronics and no more screen time maybe your child starts to scream cry and then you just give them the ipad and that kind of stops the crying so now the child has learned that i can engage in the screaming behavior in order to get access to that tablet or that preferred item our fourth function is sensory so
009sensory is when a behavior occurs because the behavior is internally pleasing to the child in some way this can be due to any one or maybe five multiple over five senses like sight smell hearing taste or touch um not only can i be self soothing like internally pleasing but we can also be engaging in sensory behaviors to remove an unpleasant feeling so in this example we have a parent baby just going about their day maybe they're working preparing dinner um getting the evening the evening settled and then the child starts biting their nails or rocking back and forth so the child biting their nails or walking back back and forth has nothing to do with the parent or the caregiver it's just a behavior that they are doing that is self suiting themselves in the
010classroom maybe you see a student um tapping their foot on the floor or maybe they're tapping the table and that could be that it's self-soothing providing some sort of sensory input for them um an example of removing an unpleasant sensory feeling or internal feeling could be a child may be wearing noise cancelling headphones because maybe the sound like loud sudden noises startle them so putting on those cancelling headphones could remove that loud noise from them okay so now that we know what the four functions of behavior behaviors are and why it's occurring what now what do we do how do we teach new skills or how do we reduce these challenging behaviors um so these are our top three behavior strategies that will help reduce those challenging behaviors regardless of the functions of those four
011functions of behaviors and they're pretty effective for not if not all of those functions so our first one is um choices we'll go over what choices are then we'll go into the pre-mac principle and then our token system the number one choices this is my ultimate favorite um so choices enhance a personal a person's quality of life we're providing that buy-in for the individual but also increasing that motivation so instead of giving the child one option for everything we're giving them choices of what they can do and what they can use material wise so i'll go into a few different examples of choices um i use choices pretty often with my my nephew also with the clients that i work with the students that i work with it's pretty effective for for all of them
012so examples of choices lunchtime maybe um for lunch you know we give two choices of food options do you want an apple for lunch or do you want a banana and that way they have the buy-in of what they want to eat maybe a writing task do you want to start off with your sentences or do you want to start off with say a word scramble uh worksheet so give them an option of what they want to do first or even math tasks do you want to do two problems or do you want to do five problems and that way again they have the say in um that choice but they still have to complete the work um also transitions so maybe you're transitioning from a preferred to non-preferred activity but giving them two options
013if not preferred hey after we finish um playing with bubbles do you want to go inside and do uh math or do you want to do science or even breaking it down do you want to do um do you want to do counseling or do you want to do identifying letters whatever it is so again you're giving the child a say as to what they want to do our second uh strategy is called the premack principle also known as grandma's law uh the pre-med principle states that making the opportunity to engage in a high probably probability behavior contingent on the low occurrence of a low frequency behavior will function as a reinforcement but low frequency behavior that is a mouthful however what it means is that we want to be able to reinforce our our
014child or the student for engaging in a more difficult um more difficult task and give them something fun to play with after so you might use the statements first you do this and then you do that or if you do this then you get that um so in this example we say first do homework which is that more difficult task then we can go play and that play is that more reinforcing motivating task so they know that if they do this more difficult task reinforcement is to follow sometimes we just assume that our students or our children just know that you know hey you do homework then you know by finishing it that is reinforcing yes it might be to us however um our students and children might just need that extra push of having
015of knowing what their reinforcement is afterwards um a couple other examples are you know first we wash hands and then we can go outside or first we wash hands and then we have our lunch maybe lunch is reinforcing here are a few other examples so when you have finished your math worksheets you can read a book so assuming that math worksheets are a little bit more difficult and then reading is a preferred task our second second example is first writing a journal then you can have free play and lastly first you finish your dinner then you may watch tv again always that first activity or first task is always that non-preferred or more difficult task and that then is always that reinforcer token system so this is our third effective strategy um also one of
016my other favorites it's a system in which an individual earns tokens for targeted behaviors once the individual has collected a predetermined number of tokens they can trade those in for an item or an activity they desire so you might see this as a point system a class point system um maybe a star jar or marble jar can be just marking tallies on a piece of paper but essentially you are reinforcing the child after they engage in a certain number of behaviors and then they can exchange those those points or those tokens for an external reinforcer like you know a prize in a price box maybe extra free play they get maybe an extra break and so forth these are some examples of our token system so they can be super simple or you can make
017them as elaborate um as you want them to be one thing that i like to really consider are the the child's preferred activity so if i have a client or student that enjoys let's say paw patrol i might incorporate paw patrol into that token board um because maybe stars don't have any kind of positive association to them but they see paw patrol like oh i get five little puppies on there then i get um you know a prize in the price box if you're maybe working with older students and maybe 16 of stars or maybe just marbles in a jar you can make it as simple as you want it to be so before we go into questions and answers um i kind of want to hear from our um if you all feel comfortable
018sharing any experiences that you may have had using token systems or maybe even first and then and also maybe choices maybe students or with children that you have if you feel comfortable sharing so i think there's a couple folks that join a little bit late we'll reiterate um if you have any questions you want to speak you can either put your information in the chat box or you can use the raise your hand feature and i'll let you ask your question or share your input i'm also going to put the sign-in sheet in the chat box one more time if you haven't signed in please sign in so we have a good accounting of who um attended our training so yeah please use the raise your hand feature if you want to share an experience
019or an example or ask any questions about what we've covered so far awesome and i see bill here says that his son uses a point system at school and banks points to buy rewards from a menu yeah i absolutely love that um you can also one thing that it's not mentioning here but you can also kind of delay or kind of time how um when you want your child or your student to earn that reinforcer so maybe you know it's they you know at the end of the day once they heard hit a certain number of points or tokens then they get that reinforcement throughout the day or maybe they kind of store those points and at the end of the week they can earn something larger like a pizza party um or a larger
020you know toy or some sort so you can either do it short term or kind of push it to long term it really depends on the child's ability to be able to wait um for longer periods of time if it's something that's relatively new then we do suggest kind of using that short term token system and then eventually working up to a longer term where they can wait a few days or a week or so great thank you for sharing bill has anyone ever used choices or first and then statements or even boards i see a question here see i have a question here from elena but i'm not sure if i quite understand this um i'm gonna let her try to speak yeah of course elaine are you able to are you there yes
021sorry but i i i miss some works so my question is for consistent example it's just in case have the children have a behavior problem or what is the difference between a behavior problem or stress or engaging what is it what is the next step for eating identify is behavioral or mental health support so that's his question yeah that's a great question so i think the first step is um you know getting maybe an input from the child's pediatrician or other professionals as well um because if it is something that is contributing to more of mental health maybe some psychological aspect um i wouldn't say aba or behavioral tactics alone would be effective they may also be you know in addition to maybe cognitive behavioral therapy or other types of psychological therapies in addition to
022behavioral tactics may be more effective so i think that if you're concerned if it's whether it's behavioral or a mixture of behavioral and mental health um definitely consulting with other professionals like a pediatrician teachers school psychologist or counselor and kind of taking those next steps from there i hope they answer your question then just from like the school perspective for me i think there sometimes is a lot of overlap right mental health stress anxiety and and some of these challenging behaviors they they can definitely interact right so i think those suggestions that eva suggested um if you're seeing these things both at home and at school your iep team should be supporting you with the the school behaviors and potentially helping like align between what's happening at school and in home um but it's it's
023not a super clear like this is one thing this is another thing right so i think really having clear support systems knowing kind of what's happening on the medical and kind of physiological side of things is really important um as well as knowing kind of again what works and what doesn't work for your specific student so yeah thank you um i see another question um from michelle what is your strategy for aggressive behavior great question so what i would first go to um regardless of what other what kind of behavior it is but whether it's aggression maybe tantrum or what have you um first you want to identify that function of the behavior so if we go back let's see here we want to figure out why the child is engaging in aggression so maybe
024looking at past occurrences or maybe even going forward future occurrences and seeing okay is is this child engaging in aggression because they want to escape or avoid something or is it because they want to get attention or remove attention get attention remove some from someone um or is it because they want to get access to an object or item or is it sensory so once you first identify the function of that behavior then you can implement um actually all three of these strategies would be effective um but having that key piece of identifying the function will help you um kind of pinpoint why it's happening um so michelle if you have maybe any if you want to share um if you think maybe it's one of those four functions we can see how we can
025apply um the strategies to um that aggressive behavior you might be seeing but yes so first you want to identify that function of behavior and then go from there however all three strategies that we talked about today are effective for these four functions of course no problem okay so i'm gonna go back down here i know that this was a pretty uh a little shorter presentation but any additional questions or even comments or feedback that any of you may have regarding personal experiences with students or children that you work with um elena wants to ask another question bring her back go ahead elena i thank you so for example and um i know how very hard my my son only have a speech uh this is the ip is very low so for for exam
026one time say i'm sorry i i feeling very stressed i know i don't want to do this i don't want to do this so i hate i have direction for my son but other times is very uh for example in the pandemic i think it's very hard for funding the new um the new the school for example is a new for uh check the new uh friends everything so what is the other i don't know i think for mothers working very hard for i don't know other supports in the school or more i don't know more guys for [Music] a live stress maybe tips something yeah i'm not sure if i quite understand um the question um it's only for for example i you know the the iep is very different each person right for
027example my my son have very only have i not have any disabilities the any bad disabilities for example another another person or their friends have different disabilities in my case i can work directly with my my my son but okay you tell me have a stretch you tell me have a lot of confusion for new friends and in school in person for my question is what support you have for other students you know can eat a lot and talk a lot for expression you know so what is the next step for help directly in the students but maybe mom i she helped you for no can extend while you express you're feeling expressed directly with mom this is what my no questions is more support maybe in the other this different disabilities maybe or tips
028for yeah i'm not quite sure um i think i don't know if kevin if you have more of a clearance around this and how um others with different disabilities might get additional support at school but i think it definitely depends on the evaluation and the assessments that they might conduct but i'm not maybe having to be a little bit more to add on to that yeah um elena if um you want to send me a chat in the chat box um directly to me with your information i can kind of connect you with with whoever your um right person is um so that we can kind of figure out what's going on in the school side there's a little couple details that we want to kind of find out what's going on more okay yeah
029thank you thank you also helpful i send the information thank you of course we have a question from lucia um i think this is for you eva uh just like what is your like what services do you guys provide at kyo and what does that look like and how do referrals happen i don't know if you want to speak to that yeah of course um so yes so refer so it depends on a couple things so um what you want to do is i can also actually pull up a link here so we provide in home and also community-based applied behavior analysis therapy um also we provide support in school schools as well but if you are looking for services you can contact our intake department in which you will be connected to and take
030specialists and um they will give you kind of like a rundown as to what the intake and assessment process looks like um typically it does require a a diagnostic report from like a psychologist or diagnosing physician like a pediatrician um then recommending epa services and then we go through an assessment with a behavior analyst and then if our behavior analysts does see that um that based on their findings at 88 would it be would be appropriate for your child um then they would submit a request to the insurance for direct therapy i am going to link see i will put a link in the chat and if you go here you can set up a phone call um a phone appointment with an enrollment specialist in english or in spanish and to follow um with
031lucia's question which assurances do we take um so we do uh accept a variety of different insurances i don't have off the top of my head which ones we accept but we do accept a lot of different ones um it depends on the subgroup and the network that you have but during the phone appointment um the enrollment specialist can see if possibly if your insurance is covered or if we cover your insurance um and they can go from there and then i see another another comment here so the behavior sometimes is getting better the next week instantly turns very bad and why is this happen so yes this can definitely happen it's pretty common um most of the time so one day you see that this behavior is getting better maybe you see a decrease
032in that challenging behavior but all of a sudden the next day or next week it's like uh came back again this can be due to a variety of different factors one of the main reasons would probably be that seeing if those strategies you're implementing are consistent maybe not just with you but with across all the adults that this person is coming into contact with so going back to okay is are maybe caregivers are they all consistent with these expectations or is one caregiver reinforcing this inappropriate behavior if we find that there's some inconsistency that definitely can kind of then um give that child big signals of like oh okay with one person let's say this aggression is getting reinforced but with these other people it's not and even if it's just getting reinforced by one
033person um that can kind of continue that behavior to occur so it doesn't have to kind of happen every day it can stop and then all of a sudden if the child learns oh hey this worked with uncle billy um i'm gonna try it again so as long as you guys are consistent as much as possible then you will also see that behavior decrease consistently of course there are other factors like environmental factors that could contribute to that maybe changes in enviro schedules routines and even physiological factors like illness lack of sleep so taking all those into consideration but definitely consistency is key thank you for your question i thought i saw a question in the q a but he lost it there [Music] i took care of it oh thank you any other questions
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