Sunday, June 21, 2009

Learning about behavior - Lesson Two

Here's a really simple idea. Put the horse before the cart.

What we used to do was hold out a reward in front of a child and ask him to do something. Call it a demand, a stimulus, a command, but it was rarely anything so mild as a request or suggestion. The child was then expected to follow with the proper response. If he did what was asked, he got his reward. The rewards were deliberately chosen from things the child really liked - candy, stickers, soda pop, TV or computer time, even money. Naturally the thinking was that if what we were offering was highly motivating, the child was more likely to do what we wanted. The rewards could be immediate (a single piece of candy) or a little more delayed (earning chips to trade in later for something special).

If a child wasn't behaving as we wanted, we would often take away privileges. Again, we tried to use things that meant a lot to each child. If he liked to play with trains, that would be the first thing we took away when his behavior wasn't acceptable. And for kids who loved recess, we might even take that away. We thought we were using behavioral techniques that should be effective. Sometimes they were, but often things got worse. We had a lot to learn!

Putting the horse before the cart was an idea that came from a wonderfully wise occupational therapist who helped me learn so much about kids, behavior, out-of-whack sensory systems, and the value of sensory integration.

The simple part: give them what they need/want, as much as they need/want (within reason, and as long as it's good or at least harmless). Let them have their fill, and then try some meaningful work or requests for particular performance goals.

Instead of using time on the swing as a reward for finishing the first grade math work, let the child swing first and work later. If the child is hungry or thirsty, give him what he needs before asking him to sit and listen. If Disney movies are particularly motivating, watch one segment then work, watch another segment to help them organize themselves before leaving for a class that might require them to hold themselves together for a longer time than usual.

We ended up running a classroom that was much more like a therapy room - swings, a mini-trampoline, music playing, a wide variety of toys and games. We helped the kids learn to play before asking them to work. We kept our "demands" to a minimum, trying always to be sure there was a valid reason for what we were asking kids to do - never just busy work, and certainly never just to establish their compliance.

We were ever on the alert for signs that a particular child was dealing with sensory issues that interfered with their success at school. And then we tried to intervene in the most appropriate way. What I learned from that particular O.T. was that most kids will seek what they need in the way of sensory input. If they need a quiet place with little stimulation, they will run and hide. If they need more activity, they will bounce, run, rock, whatever works for them. If things are chaotic and overly stimulating, if a situation is particularly anxiety-producing, they might scream or become aggressive. If their needs can possibly be met in advance, the chances for undesirable behavior are greatly decreased.

It's a powerful combination: meet their needs and make sure we making reasonable, meaningful requests.

We gave up the candy, chips, and soda pop. We did away with "time-outs". We didn't need them any more. Everyone was much happier. School became an OK place to be.

Wednesday, June 10, 2009

Learning about behavior - Lesson One

As the years went on, I gradually became the teacher who was willing to work with the most challenging students in whatever school I found myself. In many cases, the kids were "challenging" because of the severity of their needs - they couldn't feed themselves, or weren't toilet trained, or needed to be lifted and moved from one position to another throughout the school day. None of us had learned anything about how to "teach" kids like that, and not all of us were comfortable with the type of care they needed. Other kids were highly mobile, but unable to speak or write - again the idea of presenting a watered down version of what was being taught in regular classrooms didn't seem to fit, and many teachers felt unqualified to "teach" in such a situation.

The ones I found most endearing were the ones who seemed to know what we were asking them to do, but simply refused. Or the ones who managed to outsmart any behavioral plan we might try to put in place to get them to comply.

My training in the techniques of behavior management had been quite good, but it didn't suit me, and it didn't seem to work for most of the kids I met. I kept trying, and they kept trying to let me know they didn't like what I was doing at all!

And then I attended a presentation by Anne Donnellan of the University of Wisconsin, who was saying things I had never heard before. She maintained that a child who is unable to speak is actually communicating in the only way available to them when they act out in ways we consider to be inappropriate. I loved the idea! It fit with my experience exactly. And the kids who misbehaved the most were probably the ones with the most to say! What an idea: Behavior IS communication! Maybe we should listen rather than manage.

At about the same time, I became a member of TASH, an organization dedicated to issues related to those with the most severe and challenging disabilities, those who might have been labeled at the time as "severe to profound"-ly mentally retarded. The term sounds so very inappropriate now, but at the time I was excited to find myself among people who truly cared about these kids and wanted to provide whatever was meaningful in the way of an education for them. For the most part, we focused on teaching them functional life skills - things we thought they needed to survive, to live as independently as possible later in their lives. They didn't really present challenging behaviors as such, but most of them didn't learn much in the way of life skills either.

It wasn't until I learned to use Facilitated Communication that it all came together for me. With a communication system that really worked for them, kids of all ability levels started showing us what they really knew. But it was so much more than that. Kids who hadn't shown any interest in the life skills we were trying to teach actually started doing whatever they possibly could on their own. And the kids who had been labeled as "behavior problems" seemed to have a whole new approach - they actually wanted to cooperate, and most of the behaviors disappeared.

It didn't happen overnight, of course, and if they encountered people who refused to see their intelligence or respect their communication as valid, some of the problems became even more serious than they had been before FC was introduced. Many had strong feelings of anger or frustration that needed to be dug out and dealt with. But we could do that, in a much more respectful manner than what we had been trying to do with rewards and punishments. We were talking things through, changing things whenever we could, and helping them deal with things we couldn't change.

Looking at my grandkids, as I so often do, I see similar lessons we've all learned. A major part of what happens during the "terrible twos" can be explained by the child's inability to communicate. They don't have a way to tell us what they want or need, or what might be hurting them, worrying them, causing them distress. Some of my younger grandkids have been taught basic sign language from the time they were infants. What a difference it makes when they can put their fingers together to ask for "more" or make the sign for eat, drink, or please to let us know they want something. Not that tantrums or meltdowns have been eliminated completely, of course, but things go so much better when there is an effective means of communication in place.