But We Tried That Already!

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But we tried that already” is a statement I hear very often from new clients, or people who contact me seeking general recommendations.

Often the statement is said with exasperation and frustration, like “Don’t tell me to try things that I know won’t work!”.
Clients often come to me with specific expectations that I will unveil these space age, highly complicated, magical ways to fix behavior that the average person could never dare to dream up. In a way, this is true. It isn’t often that I work with a client who is familiar with DRA, Extinction, or Task Analysis when I first meet them. However, much of what I bring to the table in consultation with a new client will be very simple, very basic changes to what the parents are already doing.
Most of the time, the devil is in the details.

Do I meet people who are just doing everything wrong? Yes. But it’s FAR more typical that I meet people who are just a few tweaks away from behavioral success.

This post was inspired by a client I saw the other day, for a pairing session. The team and I were able to show the parents how to quickly accomplish seated behavior with their child. This is a child who refused to sit at daycare, during meals, in waiting rooms, etc. After some time playing with the child and just getting to know him, we were able to successfully pair sitting down with immediate reinforcement (Fruit Loops cereal). So there was no “forcing him to sit down”. It was a choice: if you sit, here are some Fruit Loops. If you don’t sit, the Fruit Loops go away.
It took no time at all for the child to make this connection, and then quickly choose to sit down upon request.

This success led to the parents asking why we as professionals could do that when they had been struggling with this behavior for months.  What’s the explanation for that? Well, there are several explanations to what seems like such a simple question.

It isn’t that what you are trying as a parent is all wrong, or all ineffective. Usually, there are many things you are doing right. If you are not seeing the behavior change you want to see, it often means something about your intervention is ineffective--- too much, too little, too often, not often enough, etc. The job of the BCBA you are working with is to help you locate the barrier, and remove it.

Throw away the idea that you have no idea how to change your child’s behavior: that’s not true.
You just need some guidance as to how to apply scientific strategies to what you are doing. So please allow me to speak for all the supervisors and BCBA’s out there and say “I know you already tried this, but let’s try it again”. Be open-minded to the idea that it isn’t what you are doing that’s ineffective, it just could be how you’re doing it.

Ready for some Troubleshooting 101? Here are some common reasons why the ABA team who just met your child last week can get him/her to do things you can’t:

1.       Learning History (History of Reinforcement) – You have a unique learning history with your child that I do not have as the ABA professional. This works to my benefit, as I have a blank slate. With you, your child knows “When I cry, mom does _____” or “If I scream, dad does _____”. With me, the child doesn’t know yet how I will react to what they do. So I am not coming in and trying to fix previous errors, I am coming in with no learning history at all. This is a big reason why your child often responds better to new teachers, new therapists, etc., than they do to you.

2.        Instructional Control/Consistency – Instructional Control  is basically moving from your child running the house and being in control, to you running your home. Inconsistency kills instructional control. How consistent are you with behavior change? Using the example above of getting a new client to sit in a chair, we were prepared to work on that skill as much as we needed to. That means carving out time to practice over the next 30 minutes, a day, 2 days, whatever it takes. You can’t get “tired” of behavior change...... If you want to see the results, you have to put in the work.

3.       Persistence - When parents say to me “But we tried that already!” my response is often “For how long?”. For many parents, your intervention just needed more time to succeed.  Usually what I see parents do is decide to get serious about behavior change, try a strategy, see it not work after a day or two, and then give up on the strategy and never try it again. How do you know the strategy just didn’t need some tweaking? Or maybe the child needed to be taught some pre-requisite skills? Or maybe YOU were following the strategy but your spouse was not (see point #2).

4.      Reward/Incentive – Other than “Because I said so” why should your child do what you say? What is the child’s payoff for compliance with your instructions? Have you thought about that? I wouldn’t approach any of my clients to give a demand without first determining what happens when they comply. For some of them, it may just be attention or praise (“Hey, nice listening David!”). For some of them, the payoff needs to be much bigger than that…..maybe time on the swing, a walk outside, or playing on their iPad. We ALL contact desired things when we perform specific behaviors such as going to work, kissing our spouse, or letting someone cut in line at the grocery store. Your child is no different, in that they also expect to get something out of their effort. 

5.        Negative Reinforcement – Think of negative reinforcement as seeking to avoid or escape something that is non-wanted or unpleasant. So let’s say every time you tell your 3- year -old to sit down at the dinner table, she cries and screams. Since you love her and don’t like to see her unhappy, you quickly stop trying to make her sit down and allow her to walk around the house chewing on a piece of bread instead of sitting down at the table. In this scenario, you were just negatively reinforced. The problem with this is that over time behavior grows. So you will continue to be negatively reinforced to give in to more and more problem behaviors, as your child continues to expand upon their problem behaviors.

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