September 13, 2009
Deconstructing the Meltdown
By Toni Lapp
Behavior analyst Baker Wright vividly recalls the first time he was called in to consult on a child with Asperger’s syndrome. A school had referred a sixth-grader for behavioral services because of his disruptive behaviors – ranging from refusal to follow directions to crying and yelling in class.
The day Wright first entered the classroom, the teacher was drilling the students in preparation for a math exam. But Jeremy (not his actual name) was sitting with his legs curled under him and his head on the desk; he was angry that his calculator had been taken from him and he had refused requests to put his feet on the floor.
Wright, with Tallahassee, Fla.-based Behavior Management Consultants Inc., attempted to approach Jeremy with what he thought would be a simple request to begin to gain his compliance. He offered: “If you put your feet on the floor, I’ll get your calculator for you.”
But instead, the boy took the calculator and remained steadfast with his feet beneath him. Wright tried to persuade Jeremy to return the calculator, but the boy refused. Wright tried to take the calculator back. The boy just held tighter. The situation quickly deteriorated.
“I made a laundry list of mistakes,” Wright now acknowledges. He realized that kids with Asperger’s Syndrome require a unique approach. Because of the social deficits they deal with, their perception of social rules, boundaries and interactions is not the same that a typical person has; thus typical reinforcements and punishments do not apply.
Using applied behavioral analysis – known in psychology circles as ABA — Wright has since developed a more effective intervention plan. He’s identified three components of success: Management, prevention and treatment.
Management
The idea here is to minimize meltdowns as they occur. In the situation with Jeremy, Wright had helped contribute to the intensifying behavior by arguing with the boy. His attempt to offer him the calculator only served to reinforce negative behavior. It would have been better to avoid the confrontation, Wright said.
“Is avoidance of confrontation at this time giving in?” Wright asked. “Yes. But this is about management. The path of least resistance is OK. The point is to lessen the chances of intensifying the behavior.”
When children are in meltdown mode, Wright said the behavior should be allowed to run its course in a contained, secluded spot so further engagement is not necessary. Parents and teachers should have a predetermined place for a child to go to cool off. (Note, the approach here is not to treat this as a “time out”; the difference being that a “cooling off” is his choice, a “time out” is not.)
Don’t try talking sense into a child during a meltdown, Wright said. Trying to reason with a child at this point is futile, said Wright, as is attempting to issue directives.
Not just futile, but counterproductive. “Every request becomes an opportunity where noncompliance would be reinforced,” said Wright.
Instead, parents and educators want to find opportunities to reinforce compliance. More on that later.
Prevention
The second step in Wright’s technique is what he considers the most important piece: developing strategies that make inappropriate behavior less likely to occur in the first place.
Children with Asperger’s thrive on consistency and organization, but have difficulty providing these things for themselves. Thus, they often depend on others to provide routine for them. Changes to the environment can make a big difference.
In Jeremy’s case, several interventions were made:
•An aide was assigned to help keep him on task.
•A laminated index card with his schedule helped him anticipate class changes.
•A plan to provide more transition time between class changes was implemented, which Wright dubbed “5 Before-5After.” It’s exactly as described: Jeremy would get a five-minute head start to pack his papers up and leave class, and was allowed to join class five minutes late so that he would be spared from the chaotic moments that occur during class changes.
• Items used as rewards – GameBoy, comic books – were kept by a teacher to be delivered to Jeremy when the moment was right. Before, the items had been kept by Jeremy, and then taken from him when his behavior warranted punishment – which had the effect of creating a spiral of worsening behavior.
Parents struggling with children’s meltdowns at home can implement their own strategies. Look around your home. Are items that can be used as reinforcements (game systems, computers, comic books) kept in your child’s possession, or do you maintain control of them? Can you identify triggers that set your child off that you can control? Can you provide more predictability in your child’s schedule?
The idea is to reduce meltdowns and create teachable moments where compliant behavior is rewarded. This is where the third step, treatment, comes in.
Treatment
Consider treatments to be behavior strategies – reinforcements – implemented to encourage appropriate behavior.
“Most folks try to put this first,” says Wright. But if a child is in a crisis, a parent/teacher has to first deal with managing the meltdowns, and then putting prevention steps into place to reduce their occurrence.
As damaging as a behavior might seem, it occurs because it serves a function for your child. For instance, failing to do classwork might prompt “help” from a well-meaning teacher – and reinforce work avoidance. A child’s professorial diatribe on, say, communism, might initially, win attention from others — but also serve to alienate them from peers.
Treatment involves finding teachable moments where desirable behavior is reinforced. Parents can create scenarios where they intend to teach a behavior – such as acceptable conduct at a store. When Wright is called in to consult on a case, he breaks the teaching down into three parts, likening it to telling a story: “Preteaching,” “You Are There,” and “Retelling.”
During “preteaching,” behavior analyst and child discuss what is about to ensue – say, a trip to the store. Wright talks to the child about all aspects of the lesson. In the example of a shopping trip, they would discuss waiting in line patiently, being polite to the cashier, saying thank you, etc.
In the next step, they arrive and Wright steps back and acts as observer (and occasionally intervenes, if necessary) and allows the child to use the techniques they discussed.
Lastly, is the “retelling,” a sort of postmortem where they go over everything that happened. Here, Wright says it’s important to focus on the positive aspects on the lesson, but briefly touch on things that need improvement.
By implementing strategies that address prevention, Wright says he has seen dramatic results in the children he’s worked with, including Jeremy.
In Wright’s practice, “we talk about fighting fires versus preventing fires. Preventing fires is much easier.”
NOTE: Baker Wright, who practices applied behavior analysis in Tallahassee, Fla., was brought to Kansas City to share his insights by the Kansas Center for Autism Research
I really enjoyed this piece.
Good article, informative and well written. Thanks for the tips!