• Behavioral Strategies for Families

    Use Positive Behavior Supports -- Your family should develop strategies for you to use to increase the behaviors you want to see in your child. These will need to be individualized to them or their particular needs and challenges. They can often be helpful in building a sense of pride in accomplishments and personal responsibility, and a sense of what is expected. This will reduce the anxiety and reactivity that results in aggression or other behaviors.

    Some helpful strategies:
    ■ Celebrate and build strengths and successes: Tell them what they do well and what you like. A sense of competence often fosters interest and motivation. Strive to give positive feedback much more frequently than any correction or negative feedback. ‘Great job putting your dishes in the sink!’

    ■ Try to set up a daily routine for children. A routine and clear expectations help to reduce anxiety and stress in children. Try having meals at the same time daily, a regular bedtime and wake-up time, and a regular work and play time daily.

    ■ Respect and listen to them: You may have to look for the things they are telling you, verbally or through their choices or actions. ‘You keep sitting on that side of the table. Is the sun in your eyes over here?’ 

    ■ Validate their concerns and emotions: Do not brush aside their fears or tell them not to worry. Their emotions are very real. Help to give language to what they are feeling. ‘I know you do not like spiders. I can see that you are very afraid right now.’ ‘I can see that you are angry that our plans have changed.’ 

    ■ Provide clear expectations of behavior: Show or tell your child what you expect of them using visual aids, photographs or video models. A great way to teach new skills is Tell-Show-Do. During this exercise the person tells the student a direction, then shows the student with accompanying verbal directions, and then provides an opportunity for the student to follow the direction independently.

     ■ Set them up for success: Provide accommodations. Accept a one-word answer instead of demanding a whole sentence. Use a larger plate and offer a spoon to allow them to be neater at the dinner table. Use Velcro shoes or self-tying laces if tying is too frustrating. 

    ■ Ignore the challenging behavior: Do your best to keep the challenging behavior from serving as their way of communicating or winning. This is hard to do, but in the long run it is effective. Do not allow screaming to get them out of brushing teeth, or biting to get the lollipop that their wants. Behaviors may get worse before you start to see them get better. Stay the course! And make sure all family members are consistent in this approach and that you pair this with other positive strategies.

     ■ Alternate tasks: Do something that is fun, motivating or that your child is good at. Then try something hard. They will be less inclined to give up or get agitated if they are already in a positive framework. 

    ■ Teach and interact at your child’s or loved one’s learning level: Take care to set your child up for growth and accomplishment, rather than the anxiety produced by constant failure or boredom. 

    ■ Give choices, but within parameters: Everyone needs to be in control of something, even if it is as simple as which activity comes first. You can still maintain some control in the choices that you offer. ‘Do you want to eat first, or paint first?’ 

    ■ Use an If-Then framework: ‘If you make your bed now, then you can have 10 minutes of screen time.’ 

    ■ Provide access to breaks: Teach the individual to request a break when needing to regroup (e.g. a hand signal, single word, or use a visual cue to request a break). Be sure to provide the break when asked so they learn to trust this option and do not have to resort to challenging behaviors. 

    ■ Promote the use of a safe, calm-down place: Teach your child to recognize when they need to go there. This is a positive strategy, not a punishment. 

    ■ Set up reinforcement systems: Use simple, predictable processes that reward your child for desired behavior. Catch them being good and reward that, verbally and with favored activities, objects or ‘payment.’ ‘I love that you stayed with me during our shopping trip. You earned a ride on the airplane toy!’ 

    ■ Allow times and places for them to do what they want: Even if it is a behavior that may not seem important to adults, it is important to provide these options when it is not an intrusion or annoyance to others.

    ■ Reward flexibility and self-control: ‘I know you wanted to go to the pool today and we were surprised when it was closed. For staying calm and being so flexible about that change in plans, let’s go get some ice cream instead!’ 

    ■ Pick your battles: Strive for balance. Focus on the behaviors and skills that are most essential. Be sure to include positive feedback and intersperse opportunities for success and enjoyment for you, your family, and your loved one. Be resilient. Celebrate the fun and the good things!

    ■ Use positive/proactive language: Use language that describes what you want the individual to do (e.g. ‘I love how you used a tissue!’), and try to avoid saying ‘NO’, or ‘don’t’ (e.g. ‘stop picking your nose.’).  

    Research shows that positive, reinforcement-based strategies are most effective in creating long-term behavioral change. However, it is also important to have an immediate response to a behavior in order to maintain safety or minimize disruptions. Planning in advance for the type of situation is important, so that caregivers across settings (home, school, etc.) are consistent in their responses and delivery of consequences. Most reactive strategies fall into three areas as listed below:

    ■ Ignoring the behavior (extinction) is often used when the behavior is used for attention and is mild or not threatening. Example: A child is tapping their pencil on the table for adult attention.

    ■ Redirection, often supported with visuals, may involve redirection to an appropriate behavior or response and is often paired with positive strategies. Example: A child exhibits frustration by breaking a pencil. Child is then redirected to use their words to describe their emotions instead of breaking the pencil.

    ■ Removal from a situation or reinforcement through a time out is often used for calming down opportunities. Ignoring challenging behavior means not giving in to the behavior that you are trying to eliminate, to the best of your ability. If they kick to get a cookie, ignore the kicking and do not give a cookie. But, use other strategies here to teach how to request a cookie, and be sure to give the cookie when the child uses an appropriate way to ask for a cookie. Note that when you first start to ignore a behavior (called extinction) it may increase the behavior. This is called an extinction burst and is very normal. Stay the course. 

    **Certain behaviors (those that are dangerous or injurious) are more difficult to ignore and sometimes need to be redirected or blocked (e.g. putting a pillow by their head so that their self-hitting does not do damage), even as you strive to not allow the behavior to ‘win.’ 

    Other strategies your family might employ include teaching accountability (if the student spilled the milk, they are the one to clean it up), or using positive practice, sometimes known as do-overs. For example, if the student lets the door slam in someone’s face, they might practice in the doorway how to enter the house and hold the door five or ten times. ‘Oops, let’s practice doing that the right way.’ In doing this, try to limit the sense of punishment, keeping positive strategies employed (reinforcement, praise) to build the desired behaviors over time. ‘I love that you noticed I am right behind you and you held the door open!’ 

    When behavior does occur, be careful not to:
    ⦁ Feed into the behavior, give in or provide what your child wanted to get from the behavior 
    ⦁ Show disappointment or anger 
    ⦁ Lecture or threaten
    ⦁ Physically intervene (unless necessary for safety, such as keeping a child from running into the street)

    If behavior occurs, time-out may be implemented. A new look at time-out, contrary to popular belief, is not sitting in a chair for a few minutes. Time-out is losing access to cool, fun things as a result of exhibiting problem behavior, usually by removing the individual from the setting that has those cool, fun things. Time-outs can only occur when the individual is in time-in. That is, if nothing enjoyable was happening before time-out, you are simply removing the individual from one non-stimulating, non-engaging room to another. For example, if the individual is watching their favorite TV show, but hits and screams at their sibling for getting in the way, taking the child to a chair located in the same room will not serve as a time-out since they can still see and listen to the TV. Removing them from accessing the TV completely, however, is an example of a time-out. In this case, time-in (watching a favorite show) was in place, allowing for time-out to be effective upon the occurrence of the problem behavior. Once the individual is in time-out, let them know that they must be calm for at least 10 seconds (or a duration of your choosing, usually shortly after they are calm) before they can return to time-in. Do not talk to the individual or explain to them what they did wrong while they are in time-out. You may use a timer to indicate to the individual when the time-out will be over. When the timer goes off, they should be allowed to return to what they were doing, i.e. time-in.

    How to use time-out correctly:
    ⦁ A fun, enjoyable activity should be in place before using time-out (e.g. playing video game, visiting friends).
    ⦁ Time-out should not lead to the individual avoiding or delaying an unpleasant task or work activity. 
    ⦁ Time-out should take place in a boring and neutral setting.
    ⦁ No attention should be given during time-out. Simply tell the individual, “You hit your brother, no TV. Go to time-out until you are calm”. 
    ⦁ Time-out should be discontinued shortly after the individual is calm and quiet (approximately 10 seconds of calm behavior).