Saturday, November 2, 2013

Say It Nicely




Resource: Allen, R., Hastings, R.., McDermot, K., & Still, D. (2002). Factors Related to Positive Perceptions in Mothers of Children with Intellectual Disabilities. Journal of Applied Research in Intellectual Disabilities, 15(3), 269-275


Positive reframing is a psychological tool that can be implemented  within ABA strategies or treatment to make a decision to focus on positive aspects for intervention: what the learner should be able to DO, not what the learner should stop doing. The family is viewed as a necessary and integral piece of the treatment puzzle, and “barriers to treatment” are viewed as teaching opportunities. I am not a teacher, but as a BCBA much of my job involves teaching: teaching behaviors, teaching families, teaching kids.


The way you view your clients and their families will impact the services you provide to them. The way you speak to a resistant parent, or a smothering parent, will be shaped by how you view that parent. Words have power (Proverbs 18:21). Negativity breeds negativity, and a “Me vs. The Family” perspective will only lead to conflict, miscommunications, and hurt feelings. 


This isn’t some unusual or new concept, we all learn at an early age that the way someone says something to us is often more important than what they actually say.  However, does that impact the way you speak to your clients or their families? Imagine your supervisor says to you “Reports must be submitted to me every week by Friday, NO exceptions!!” vs. “You can submit reports on Monday, Tuesday, Wednesday, or Thursday…..your choice”. Wow, what a difference some positive reframing can make! :-)
 
  If we as adults want to be communicated with in a positive way, then imagine how your 6 year old nonverbal client feels when you take the time to offer choices to her (“Do you want juice or milk? Pick one”) vs. just giving orders (“Drink your juice”).

It is SO important to positively reframe your thoughts, expectations, and opinions about your clients so you can help them in a caring and professional manner. The individuals you work with as an ABA professional may exhibit challenging, frustrating, and exhausting problem behaviors. If you decide to view those behaviors in a negative way (“This kid is just being a brat”) then that will affect how you interact with that client. If you view problem behaviors in a positive way (“This child needs to learn new coping strategies”) it changes your interactions with the child…..it really does. 
Positive reframing helps ABA staff realize that the client really needs your help so they can have a better future. I suggest you do this today: think about what kind of life your client will have in 10 years if these problem behaviors are still happening. For some kiddos that may be a very sobering thing to think about.

It may be necessary to help the family or school staff use positive reframing techniques. Some people really don’t hear how negative their words are. I cringe when I walk into classrooms and see huge visuals with things like “NO hitting/We do not spit!/Stop running” or a color coded behavior system that lists out “red” or “bad” behaviors. That is all suuuuuper negative. Did that teacher intentionally mean to sound that negative? Probably not. As the ABA professional that is a great opportunity for you to help the teacher understand positive reframing.  You want the child to stop hitting? Teach them “nice hands”. You want the child to stop running in the hallways? Tell them to have “walking feet”. The teacher tells you about a challenging student with many attention seeking behaviors? Point out how the child is clearly socially motivated (that isn’t always the case!) and with redirection and reinforcement they can be taught to seek out attention appropriately.

This may sound like a super simple concept, but I interact with professionals and families quite often who don’t realize how negative they sound, or that they are interacting with the child based on  low expectations of behavior. Remember, reinforcement always increases what it directly follows. So what do you want to increase in the client/family: the positive or the negative?


Examples of Positive Reframing

Negative view
Positive view
Your clients mother is very demanding and critical of you and your treatment plan
The clients mother is engaged and wants to be involved with what is going on with treatment. This is an opportunity to really include the parent in your treatment design, gather their input, and work on conflict resolution
Your clients father states to you he doesn’t believe in this “ABA nonsense” and you find him to be very argumentative
The clients father is openly communicating to you his thoughts and concerns about the therapy process, and engaging you in a dialogue. This is an opportunity to work on communicating respectfully, and also to educate the father about exactly what ABA is
Your clients teacher is using a behavior support system in the classroom that is poorly written and not reinforcing to your client
The teacher wants to implement ABA strategies in the classroom to help the students…great! This is an opportunity to provide ABA training to the teacher, which will benefit your client
Your client has many problem behaviors that really frustrate you, such as aggression and noncompliance
Your clients behaviors are serving a need and a function for that child, and if faster, easier, or more functional options were available the child could easily learn to extinguish these problem behaviors. This is an opportunity to teach new skills
Your clients younger sibling constantly intrudes upon your ABA sessions, and gets into your toys and reinforcers

Your clients sibling is interested and fascinated with you, and the therapy process. They would likely LOVE to be asked to participate. This is an opportunity to work on social interaction, group responding, or even toy play with your client and their sibling

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