One of the most difficult tasks of parenting a child or teaching children is dealing with problem behaviors. Problem behaviors range from the simple temper tantrum exhibited by a three year old all the way up to very complex, harmful behaviors that we often see with children who have serious emotional challenges.
Many problem behaviors are just developmental issues and if we ignore them, the child eventually gives up on them from lack of reinforcement, or outgrows the behavior. Oftentimes behaviors can be dealt with just through a simple conversation.
However, sometimes we encounter very challenging behaviors in children that are a result of their developmental delays rather than just typical childhood issues. This is particularly true with children on the autism spectrum. If you are parenting or working with a child who has a persistent and inappropriate problem behavior, you are faced with the challenge of how to make that behavior go away.
Destructive, inappropriate, self-mutilating, disrupting or harming peers are not behaviors that should be ignored. As tempting as it may be to use a punishment, we know that in the long run, punishment-based schemes are ineffective, have bad side-effects and sometimes make the problem worse, especially in children with special needs. So, how do you extinguish (get rid of) a problem behavior without using a punishment? DRO schedules. Differential Reinforcement of Other Behavior schedules are non-aversive (not punishment-based) behavior management protocol that will extinguish specific problem behaviors.
DRO schedules can be very complicated or very simple. In this part one article, we’ll start with the most simple reinforcement schedule and a relatively simple target behavior so you can get an idea as to how these work.
Let’s use the example of Gabe, a second grade student in a self-contained classroom for children with autism. Gabe has a difficult time dealing with transition times in class. Frequently when it is time to move from one center to the next, he falls out of his chair, screaming and rolling around on the floor, kicking at things and even using his feet to remove entire shelves of books and toys. This is obviously very disruptive behavior. The classroom currently deals with it by having two paraprofessional aides restrain the child, then physically pick him up and drag him kicking and screaming to the next learning station, where they would try to distract him with new and exciting opportunities and they simply wait out the meltdown. This behavior has been occurring for months. The behavior is the primary reason that the child is in a self-contained classroom as opposed to being in a mainstream classroom with his regular education peers. A DRO schedule could help extinguish this behavior in a matter of weeks and quite possibly allow the child to be mainstreamed in with his peers, at least for a portion of the day. Let’s look at how we would set this up.
Step 1: Identify the target behavior. We will use the example listed above of Gabe who falls out of his chair screaming during transition times in the classroom. We will define our target behavior as “rolling around on the floor while screaming”. This is the behavior that we are trying to extinguish, or get rid of.
Step 2: Get a baseline on the frequency of occurrence. This means we have to determine how often this behavior is displayed. You literally are going to watch and count, during the day, how often the child falls out of his chair and rolls around on the floor screaming. During this observation, you can continue to deal with him as you normally do. Our purpose at this point is simply to get a frequency count. This usually takes a full day, but you might want to get a baseline count for a couple of days if the behavior occurs infrequently.
Let’s say in this example that we discover the child, on average, falls out of his chair and screams twice an hour. Remember this is not an exact time, it’s just an average time. He may have actually gone a full hour without falling out of his chair, or he may have done it 3 times in an hour, but on average over the course of the day or two it is about twice an hour. So our baseline is once every 30 minutes. We will use this time when we start the DRO schedule.
Step 3: Find a reinforcer. For this first example let’s start with a very simple reinforcer. Perhaps the child really enjoys holding a truck for 5 minutes, or maybe he enjoys putting on a headset and listening to some music, or maybe it’s that he gets to sit with an iPad and play a game for a few minutes. Choose something that he really enjoys doing, and doesn’t get an option to do or have very often – something special and enjoyable.
I’m not a fan of using food reinforcers, particularly candy. We cause a lot of problems by using food as reinforcers in childhood. But, in extreme cases, you might have to use a food reinforcer. Do not use food reinforcers that contain sugar, corn syrup, or artificial sweeteners. Perhaps you could use a small piece of string cheese, a bit of rice cake, olives, dried apple pieces or grapes.
We will get into more complicated reinforcement schedules later, but for this first example we will just focus on using a simple and immediate reinforcer. So in this example let’s suppose that we’re going to use the putting on headphones and listening to music for one song, as a reinforcer.
Step 4: Begin reinforcing the child for doing anything other than the target behavior for half of the baseline time. This means that we are going to literally set a timer, that the child can see, for one half of our baseline time.
In this example, since Gabe falls out of his chair and screams on the floor, on average, every 30 minutes, we are going to start with our timer set for 15 minutes. (half of 30 minutes). Make it very clear to the child that if he can sit in his chair and not fall out and scream on the floor by the time the timer goes off then he can have the reward.
If Gabe can go for the 15 minutes without falling out of his chair and screaming on the floor you administer the reward, immediately. Use lots of verbal praise. Explain the fact that “YAY” he did it. “That was awesome. I knew you could do it. Here’s your music player. As soon as that song is finished, let’s go again and I’m setting the timer for another 15 minutes”. Etc. etc. Be prepared that this will be a busy day. Every 15 minutes, you will need to set the timer and administer a reward – at least during the sections of the day where this is an issue (perhaps lunch, recess, or pull-out times are not an issue).
It is important to remember that we are reinforcing the absence of the target behavior. This means that the child can do anything during that 15 minutes OTHER than the target behavior. So even if he exhibits another inappropriate behavior we still administer the reinforcer at the end of the time period. If he turns to his neighbor and spits on them, throws something across the room, or any other inappropriate behavior, we are going to ignore (apart from dealing with the offended classmate and/or distracting and ignoring as appropriate) those because our focus is on our one specific target behavior. When the timer goes off, if he has not fallen out of his chair screaming on the floor, he is administered the reward.
If the child has multiple behaviors, we will deal with the other behaviors in order of importance. This week we are just dealing with this one target behavior.
In extreme cases, you may have to do something called “forcing a success”. This is where you put the child in a situation where he physically cannot express the behavior. Perhaps an aide would sit holding him to the chair for the 15 minutes, or if your work setting uses seat belts for restraint or he’s just simply in a chair that’s designed so it cannot be gotten out of. We use this in extreme situations when children do not quite understand the relationship between not doing the behavior and getting the reward.
Step 5: Increase the time between reinforcers. Each day, increase the time by double. So on day two, I will set the timer for 30 minute increments. On day 3, I’ll set it for an hour and so on. You will increase the time until the child can go for the entire morning without the target behavior and eventually the entire day. This may take several days or possibly even a couple of weeks.
Any time there is a failure, this will be ignored at the time the behavior is expressed and we will wait for the timer to go off before addressing it. For example, if 5 minutes into our timer the child falls out of his chair rolling and screaming on the floor we will do our best to ignore that behavior – perhaps moving our attention to other children, having a third-party restrain him if needed so that he doesn’t hurt himself or others but ignore the behavior to the best of your ability. When the timer goes off ten minutes later, then we will say to the child unfortunately he did not get the reward this time. Always try to sound disappointed rather than angry. You are on his team. “I’m sure you’ll get it the next time. Let’s reset our timer and go again.”
If you are having multiple failures, you will need to shrink your time shorter. In the beginning it is critical that you get a success, no matter how short you have to start the time period. But even as you move along, you may have to back up on the time, if you start to see more than one failure in a row. Depending on the behavior, it can take 1 – 3 weeks to see it extinguished. But the protocol does work.
This is the simplest form of DRO schedules. There are many others – more complex and some that target very hard to extinguish behaviors, such as self-stimulating behaviors which are so reinforcing themselves. During DRO behavior intervention, we also co-work on redirecting anxiety, communication, and other issues that are at the root of the target behavior. We’ll deal with some of these in a future discussion.