What's the Function
Richard is a 4-year-old boy that engages in pinching. He is eating at the kitchen next to his BT. When his BT starts looking at their iPad, Richard pinches them. Their BT stops looking at their iPad, makes eye contact, says “ouch, that hurts”, and moves their arm.
Attention/Sensory
The RBT is cleaning up after mealtime while Bluey is standing nearby watching. Bluey runs away from the meal area (more than 6 ft away) to the sensory bin and begins to play with beans. The RBT finishes cleaning up, then joins Bluey at the sensory bin and says, "Oh, you want to play with the sensory bin. Cool!"
No, the function was access. Elopement was reinforced. What should you do instead?
Your client is engaging with a preferred item inappropriately that is beginning to cause property damage so you remove the item. They respond by flopping to the floor, screaming and crying that they want the item back, and then eventually begin to engage in aggression and elopement when the item is placed out of sight in a different location.
- Should you reinforce?
- What should you do instead?
- Should you reinforce? No!
- What should you do instead? Continue to withhold access to the item and block aggression and elopement.
Describe all 3 levels and what they mean.
Level 1: precursor behaviors, space, implement response effort, antecedent modifications
Level 2: behavior is escalating, remove clients from the area, specify if standby assistance or immediate assistance is needed, what protective gear is needed
Level 3: escalated, high behaviors, avoid the area, specify if assistance is already provided or if you need more ASAP, what is protective gear needed
Your client engages in mouthing with a ball in the gym. What do you do? What items would be useful?
-Identify the function
-Provide replacement/incompatible behavior, remove item, clean item, track behavior data, write ABC data
-Chewy, cleaning supplies
Mark is a charming 12-year-old who loves attention. Occasionally, he has difficulty doing activities that are not his choice. It is time for his BT to pick the activity on the schedule and they pick a game. Mark starts yelling he doesn’t want to do it and throwing the cards of the game. Everyone in the room looks at him.
Attention/Escape
Scooby and his RBT are engaged in a finger-painting activity, one of Scooby's preferred things to do. While the RBT and Scooby are painting together, Scooby licks paint off his fingers one time then continues to paint. The RBT pauses + observes Scooby for 3 seconds, ready to block further instances of licking paint, then praises Scooby for appropriately engaging in finger-painting.
Yes, the function was automatic.
Your client is halfway through a round of DTT when they say, “I need a break.”
- Should you reinforce?
- Should you reinforce? Yes!
You are with your client in the social corner. You notice AlGr is starting to cry and his technician is providing sensory input with both hands. You want to be helpful so you go to send a message:
-What level is this?
-What does your message say?
-What level is this? Level 2
-What does your message say? AlGr level 2 standby kitchen
Your client's BSP and previous data indicate frequent occurrence of biting, scratching, and pinching. What materials should you bring to your session?
-Arm guards, long sleeve shirt, fidgets, bite board, etc
Leo is doing questions with his RBT. After the question is presented, a child starts screaming behind Leo. Leo gets up from his chair, runs to the kid screaming, and pushes the child onto the floor. His RBT blocks any further attempts, redirects him to do questions, and offers noise-cancelling headphones.
Escape/Automatic sensory
Pluto is engaged in playing with puzzles while the RBT collects data on iPad. Pluto reaches over to the RBT and pinches RBT's arm. The RBT turns towards Pluto, provides him with a sensory item and states, "You can squeeze your ball instead".
No, the function was attention. What should you do instead?
Your client is beginning to engage in precursor behaviors when getting frustrated that they ran out of time during a preferred activity after all of their “more times” had been reinforced and they begin whining, stomping their feet, and hitting items around them.
- Should you reinforce?
- What should you do instead?
- Should you reinforce? No!
- What should you do instead? Work on any relevant coping skills and do not allow any more time in the activity.
You hear EvHo screaming in the next room over. You want to be helpful so you go to send a message:
-What level is this?
-What does your message say?
-What level is this? Level 2
-What does your message say? EvHo screaming, sounds like level 2 art room
Your client begins to engage in aggression toward you and you suspect an outburst is occurring. You do not have a mat on hand. What do you do?
1. Use the slide step method to avoid/block agg (Hold your hands together palm to palm. Raise them to about forehead height. Keep elbows about rib cage width apart. Keep forearms at 90-degrees to your upper arms. Move your arms as a unit very slightly to either side. Bring your forearms together for protection if necessary. Continue to slide step until you’ve reached a safe distance)
2. Call for help (ask someone to message the level, room, and ask for assistance)
3. Request necessary blocking pads and safety equipment
Role Play! Andy is a 6-year-old boy who usually engages in a low rate of challenging behavior and has a wide variety of skills. Occasionally he has tantrums and refuses to do tasks. He has some sensitivity to certain types of clothes. His BT places the demand to put on his jacket to go and play with friends outside. Andy starts crying and elopes to hide under a table. His BT gives him an option of different jackets he can wear and lets him pick the game he would like to play.
Escape/Automatic Sensory
Role play! Clifford is an 8-year-old boy who when he has to transition to the bathroom or told to give up the tablet will tantrum or aggress toward RBT. When the RBT presents the demand, "Time to go to the restroom", Clifford throws his tablet and starts to engage in a tantrum behavior. The RBT says, "Pick up your tablet" in response to the behavior.
No, the function was escape. What should you do instead?
Role Play! Technician tells their client that iPad time is over. The client responds by yelling “I WANT MORE TIME!”
- Should you reinforce?
- What should you do instead?
- Should you reinforce? No!
- What should you do instead? Shape the request to occur without yelling.
Role Play! Technician tells JaMi we are all out of more time in the motor lab and it's time for technician's choice. The client starts engaging in property destruction, aggression, screaming, elopement, and vocal protesting.
-What level is this?
-What does your message say?
-What level is this? Level 3
-What does your message say? JaMi level 3 motor lab need 2 people, mats
Role play: Client engages in unsafe property destruction and or SIB
Antecedents: Client engaged in Refusal following the presentation of a demand, but is now 20 minutes into an emotional outburst maintained by attention
-Remove item with minimal attention (neutrally narrate "I am going to take this to help keep you safe")
-Remove all potentially harmful items (Small items [mouthing], Items to climb, sharp items, etc)
Role Play! Carter is an 8-year-old boy who engages in SIB. Carter and his BT sit down at a table to play a game with a peer. After his BT places the demand to take his turn, Carter hits his leg with an open hand two times with enough force to be heard across the room. His BT represents the Sd to take his turn and follows through with the demand. The client moves his piece. His BT looks at their iPad to track data while the peer is taking their turn. Carter attempts to make eye contact with his therapist and hits his stomach three times with an open hand.
Escape/Attention
Role play! Snoopy followed all of his DRA rules and earned access to watching preferred videos on the iPad. While Snoopy was watching videos, the RBT was updating data on the tablet. Snoopy turned the volume on the iPad to the highest level, looked at the RBT, and said, "What is Snoopy doing?" while smiling. Without making eye contact with Snoopy or commenting on the behavior, the RBT adjusted the volume, pretended to be busy on the iPad, then prompted Snoopy to mand for attention.
Yes, the function was attention.
Role play! You are getting ready to complete a puzzle with your client, which is a non-preferred activity. Before beginning the program, you conduct a preference assessment and your client says they want to go outside. You implement the Premack Principle and tell them “first puzzle, then outside.” Your client elopes outside when you say it’s time to start the puzzle.
- Should you reinforce?
- What should you do instead?
- Should you reinforce? No!
- What should you do instead? Follow through with completing the puzzle.
Role Play! You are with SaBr and she's cheating during the game. You tell her she has to follow the rules and she starts crying, yelling, and apologizing. She knocks the game off the table.
-What level is this?
-What does your message say?
-What level is this? Level 1
-What does your message say? SaBr level 1 work room
Role Play: You are alone outside and your ipad overheated. Your client is engaging in level 3 behavior
What do you do?
Find the nearest window to knock on and shout for assistance. Use immediate consequences and EBM strategies to protect yourself and the client.