Today's QOTD is an amazing & fun discussion that I had the privilege to join, with the dope people over at: "ABA Inside Track".

"Special interests" are what we used to refer to as "obsessive interests/ritualized play/info dumping" or restrictive, repetitive interests or conversation topics.

If you are an ABA peep, or a caregiver of an Autistic, then you know exactly what I'm referring to. For non-Autistics, it can be hard to understand the intense interest (often to the exclusion of other important tasks and activities) in Toy Story, or Thomas the Tank Engine, or obscure 1970 bands, or construction sites, or objects that spin, or Mickey Mouse Clubhouse.

A unique special interest is an item, show, song, toy, etc., that sparks a very intense, and very elaborate fascination. If there is a toy or figurine, then ALL the figurines must be purchased. If there is a DVD or TV show, then the ENTIRE show must be watched, with 0 interruptions. If the interest is a place or location (such as a special interest of watching garbage trucks), then we MUST go watch the thing, at the place, right now.

There is an urgency to special interests that makes it difficult for teachers, therapists, caregivers, to transition the individual to other activities, or away from the special interest.

So how do we deal with this?

Well, the old way is to try to remove or lessen the fascination. To try to block or put away the interest, particularly if it isn't "age appropriate". To say "no, not right now", or "we're done with that", or "stop talking about that".

But is that the way we should approach this? Is that helpful or healthy, long term? And what does that say to the person with the special interest? Who may not cognitively understand why we CANNOT watch elevator videos on YouTube all day, every day.

Instead, let's talk about ways to include, embed, and incorporate special, unique interests into everyday life. Into instruction, into therapy, into school, into intervention. Think it can't be done?

Well, research would disagree with you. ;-)

Take a listen! This is good stuff.

ABA Inside Track Podcast, Episode 160

*Recommended Reading:

Autistic 'Obsessions' and Why We Really Need Them

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Tameika Meadows, BCBA, Blog Author

                                                                                 Photo source: www.slate.com

Disclaimer: Conducting an FBA is a very individualized process that must consider the setting, the learner's environment, and who will carry out the intervention. The following post contains suggestions to guide the process, and is not intended to be applicable for every learner or every situation. It’s also important to note that the usefulness of an FBA extends beyond individuals with Autism.

For my original post explaining how to conduct a FBA, click here: http://www.iloveaba.com/2012/02/everyday-fba.html

This post is for caregivers (parents, teachers, therapists, etc.) who have conducted a FBA to determine the function of a challenging behavior and it is:  Automatic Reinforcement.

Challenging behaviors that have a function of automatic reinforcement are often called Self- Stimulatory behavior, or you may hear the word "stim" used.
These behaviors are not dependent upon social interaction or receiving a tangible item…the behavior itself is reinforcing to the learner. Just think about when you get a mosquito bite and it begins to itch. You don't need someone to give you a sip of juice, or to clap and say "Yay!", in order to enjoy the scratching. Scratching the bite serves as its own reinforcement. So in the future if you get bit by a bug again, you are likely to scratch that bite again.
Some individuals seem to enjoy engaging in stims, while others seem to be agitated or upset as they flap hands, tip toe walk, or line objects up in a particular manner. So it also may be inaccurate to say that "stims" are always about enjoyment. Some "stims" may serve to alleviate or prevent anxiety or further behavioral escalation.

That means:

The child will engage in the behavior if they are alone.

The child will engage in the behavior if you put NO demands on them.

The child will engage in the behavior if they lose rewards, privileges, or reinforcers.

One thing I notice is that a sensory function is very overused. What I usually hear is "he/she can't help themselves, they have unmet sensory needs!". I would point out that its hard to imagine a part of your day when you are not receiving sensory input, and have to process it/deal with it.
For example, as I type this post I am in a room by myself. BUT, I am sitting on a not so comfortable office chair, I am feeling a few loose keyboard buttons under my fingertips, and I am a bit thirsty. I am processing all of these internal states as I type up this post. So to simply make a blanket statement like "he/she just has too many sensory issues going on today!" is a super over-generalization and wont help you to create an effective behavioral intervention.

What do automatically maintained behaviors look like?

For parents and teachers: If the child/student will engage in the challenging behavior when they are alone and under no demand, then it’s likely an automatically reinforced behavior.

For ABA professionals: If the results of your FBA or FA are inconclusive or the data has no clear pattern, then it’s likely an automatically reinforced behavior.

Common automatically reinforced behaviors can include: 
Hand flapping, rocking, inappropriate jumping/climbing, repetitive or extended vocal sounds, fingers in ears, toe walking, pica, saliva play or holding spit in mouth, stuffing cheeks with food, mouthing, chewing on fingers or clothing, screaming, smearing/playing with feces, licking objects, rumination (vomiting), immediate or delayed echolalia, and self-injurious behaviors such as eye poking, head-banging, or pulling hair.

Why do children engage in automatically reinforced behaviors?

These behaviors serve as their own reinforcement, so the short answer would be "Because they want to". :-) Especially for self- harming behaviors, there is the possibility that the individual may process the pain differently than you or I might. Just because you may not like or understand the behavior, does not mean it isn't serving a need for the individual.

How do I handle automatically reinforced behaviors?

Once you determine the function of a behavior, you need to do 2 things in order to reduce the behavior: stop reinforcing (feeding) the inappropriate behavior, and teach the child what to do instead.

It can be difficult to do a true extinction (extinction means to disconnect the reinforcement from the behavior) with automatically reinforced behaviors. The reason for this is typically some type of protective equipment is involved. For example, an extinction technique with a child who head bangs would require placing a helmet on the child. It has been my experience that most families do not want to use protective gear in the home or out in the community, or even know where to purchase these types of items. In severe situations, like a teen who bites open the skin on his hand, this is why inpatient facilities are recommended.

Automatically maintained behaviors are often managed by combining response blocking with a functionally equivalent (and as possible, topographically similar) replacement behavior. So if a child bangs a table because they enjoy the sound that is produced, giving the child a puzzle to play with is not functionally equivalent. Something like giving the child a drum to bang would be functionally equivalent, and a more acceptable behavior than banging on a table repeatedly.

Remember: When creating a behavior intervention for automatically reinforcing behaviors you are competing with a highly preferred, free, & easily accessible activity. If the child bites their arm to receive automatic reinforcement, then you are competing with an always available arm that requires minimal effort to bite into it.  Trying to teach the child to come find you and request a teething toy will not be effective because that requires much more work than simply biting ones arm.

Recommended Resources:

Chandler, L., & Dahlquist, C. (2006) Functional Assessment: Strategies to prevent and remediate challenging behavior in school settings.

Does Sensory Integration work?

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Tameika Meadows, BCBA, Blog Author

To be or not to be? No, actually a very popular question I get asked is: "To stim, or not to stim??"

Sterotypy, aka "Stimming" (see my Glossary for an explanation why the term "self-stimulatory behavior" is misleading, and ABA professionals use "stereotypy" instead), can take many forms and can be frustrating or confusing to parents and caregivers.  These repetitive behaviors can be highly enjoyable and automatically reinforcing to the individual doing them, and many Autistics see any attempt to reduce their stims as harmful, ableist, and unnecessary.

 Some examples of stims can include:

• Rocking, spinning, hand flapping, mouthing items/objects, lining items up, spinning items, dropping items to watch them fall, vocal stims such as squeals, shrieks, or scripting scenes from favorite TV shows, visual stims such as staring closely at objects or flicking eyelashes, saliva play, tearing or ripping paper into tiny pieces

From a teaching perspective (either at school or during a therapy session), when children engage in repetitive sterotypy they may seem to completely shut out the outside world and may not respond to instructions or someone speaking to them. Some of my clients will engage in loud vocal sterotypy in group or classroom settings, that makes it near impossible for other children present to focus or learn.

So what's the answer here? What is the balance between personal rights to choose to engage in an enjoyable activity, and the rights of other people present to not tolerate this activity?

Not all individuals on the ASD spectrum have repetitive behavior to the degree that it interferes with learning or social interactions. That must be said. However for those that do, it can sometimes be a pretty significant issue, particularly in a school or work setting.

Many parents feel they don't want their child to "stim" at all. Other parents feel they want their child to know when to engage in sterotypy and when not to, and for some of the families I consult with this isn't even an issue (they do not want sterotypy reduced in any way).

Just imagine that your way of de-stressing after a long day is to have a warm bath and listen to music and everyday a therapist stops you right as you go to turn on the bathtub faucet and says "No. Hands Down". How would you react to that??

I don't recommend simply removing a behavior. You must remember, there is a function (need) involved. It would be better to teach a replacement behavior that is less disruptive and does not prevent learning/social interaction. To put it simply, teach the child what TO do instead of just focusing on what you DON'T want them to do. Consider redirection, Differential Reinforcement, environment enrichment, social interaction, or teaching toy play/hobbies.

I understand sterotypy can be very trying on a parent or teacher, can be intrusive upon learning tasks, and also difficult to handle in public.
A large step towards viewing "stims" as commonplace and not an annoying habit to extinguish is to realize that everybody engages in repetitive behaviors! Really, they do.

The next time you are standing in line at the bank, or waiting at a stoplight, look at the people around you. Do you see someone twirling their hair? (I do that one). Do you see someone tapping their foot? What about humming to themselves? So if you and I engage in repetitive behaviors at times, then what is the difference between that and your child engaging in repetitive behavior? Well, one big difference is the frequency/intensity (especially if the behavior causes harm), and the barrier to interacting or engaging with others while the sterotypy is occurring. So in other words, maybe think about ways to help your child choose better times and places to stim rather than trying to keep the child from stimming at all.

*UPDATE: After reading this post, a young lady contacted me to share her perspective. Her name is Tracy, and she is Autistic.  I think her words are valuable:

"I enjoyed your post on stimming. I like so much how you tell how everyone does it, and the analogy of a neurotypical person not being allowed a hot bath at the end of the day. 

Not being allowed to stim would sometimes be very much like this. Other times, it would be more like not being allowed to smile when I am happy. 

It's interesting to hear a neurotypical perspective: when we stim you feel we're in our own world. This is sometimes true....sometimes stimming helps me concentrate. Actually, stimming almost always helps me concentrate, just not always on the thing I am supposed to be concentrating on! :) When I spin around and flap, though, I don't feel like I'm in my own world. I feel like the I am surrounded by the world, held by the world, and my hands are moved up and down by what is the rhythm, the essence of the world. I stim to get the magical feeling of connection you might feel in the redwoods. True, this does sometimes require less being-with-people, but the world is just so magical and so wonderful and whole that- I don't know. 

As a spur of the moment choice, and as a conscious choice, I think my limited time is better spent spinning than small-talking. Stimming is also catharsis. You're right, it can be used when bored...... and it is a wonderful way to order the world in the midst of sensory overload."

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Tameika Meadows, BCBA, Blog Author