Applied Behavior Analysis by Thara Srikanth, M.A.T, BCBA

Hi All,

Sharing details of another session (online), I have attended recently. The details of the session are:

The session was organized by Dr. Aravind Kannan, Consultant Speech Language Pathologist , Impower Centre for Education and Rehabilitation. He gave a short introduction about the speaker and kicked off the session. The speaker was Kamalathara Srikanth, known as Thara Srikanth. She is a BCBA i.e. Board Certified Behavior Analyst. The presentation which she used for the session was dated year 2017, she clarified nothing has changed since that; she retains the same deck till date.

What is Applied behavior Analysis ?

As defined by Cooper, Heron & Heward, 1987, “Applied behavior analysis is the science in which procedures derived from the principles of learning are systematically applied to improve socially significant behavior and to demonstrate experimentally that the procedures used were responsible for the improvement in behavior”

Socially Significant Behavior is the key aspect from the above definition. We have to decide what behavior we need to focus on, is it meaningful or is it going to be harmful to correct the behavior, is it going to make an impact in my child’s life. Socially significant behavior for a 3 year old is different from that of a 15-year-old. As a parent, you need to decide what is socially significant for your child at this point of time.

Seven Dimensions of ABA

1) Applied – Applied interventions deal with problems of demonstrated social importance. It is critical to know what those problems are. For example,

• A 12 year old not being able to read and write is not a problem, however if the same 12 year old child is unable to go to bathroom by himself/herself then it is a problem.

• There are parents who focus of academics and say that their child is able to read and write, whereas the question which they should be asking is does their child able to go to bathroom by himself, use independently.

• Can your daughter who is 15 years old is able to take care of her menstrual cycle needs

• 8 year old child cannot eat independently is an issue if the child has no physical barriers to do the same.

The above points are the real important ones when compared to their ability to read and write. It is important that the child is independent in performing the basic life skills before focusing on academics.

2) Behavioral – Applied Interventions deal with measurable behavior (or reports if they can be validated). When a parent thinks that their child is angry, how does she know or what made her to think that her child is angry? Parent responds that the child went under the table and sat there, hence concluded that the child is angry. This behavior cannot be measured i.e. one cannot measure the thought process. We can only focus if it is socially significant, observable and measurable behaviors. When there is no demonstration of a behavior, there is nothing to be corrected in first place.

3) Analytic – Applied interventions require an objective demonstration that the procedures caused the effect. Continuing from the previous example, i.e. the child sitting under the table, you remove the table and now ask him what does he wants? The child responds that he needs a cookie. So next time before the child goes under the table, ask what he wants and offer him the cookie before, so that the child does not need to sit under a table.

4) Technological – Applied Interventions are described well enough that they can be implemented by anyone with training and resources. A child can demonstrate a skill with me, but cannot perform the same with another person. or A child will listen only to mom or dad. Individuals diagnosed with autism struggle with generality, i.e. what they learned from one person they will not be able to demonstrate with another. To overcome this, let’s say if the child demonstrates a skill with me (Behaviorist) in a therapeutical setup,  i shall take him to his classroom teacher and make him do the same, but he does not do it. To make this generalization what we need is a Stimulus Transfer.

For example, let’s take the skill of “Give me five”, the child does it when the Behaviorist asks for it, but does not do it when the Class teacher asks for it. So to fix this, myself (behaviorist) and the class teacher both would ask for “Give me Five” and put up our hands for the child to reciprocate. After 20 min interval, we do this again, this time i will lower my voice and let the Class teacher takeover. After another 20 min interval, we do this again, this time i will put my hand behind the class teachers hand. We repeat this in multiple intervals on a single day. This is how stimulus transfer is done. The skill learned inside a room that cannot be used in a society has no purpose.

AB is a science because of the reason, whatever i do, when someone else does the same thing, he should also get the same result which i have received. There may be slight variations. If i had 100% success, some one should have at least 80% success when they apply the procedures in the same way in which i have applied.

5) Conceptual systems – Applied interventions arise from a specific and identifiable theoretical base rather than being a set of packages or tricks. ABA is based on many concepts and theories, among all those the major contributor is the concept of Operant conditioning.

ABC (Antecedent – Behavior – Consequence) system is nothing but operant conditioning as mentioned by Skinner. She explained ABC with an example,

A – Parent asks child to come inside the house/room

B – Child says no, i will not come inside

C – Parent goes to the child and makes him come inside.

She also simplified that “You do what you do, because of what you get”. Consequence should not be treated as a negative outcome all the time, whatever happens after the behavior is treated as consequence, hence it can be good or bad.

6) Effective – Applied interventions produce strong, socially important effects. She explained with an example, parent says that her child is making noises all the time while watching TV, what shall be done to stop this ..? She asked the parent, why do you want to make your child stop the noises, you have two options in this case, you could ask the child to quiet down the noise being made or as a parent you have to put a headset on. This behavior is not socially important when you and the child alone are in the house and there are no guests.

She compares these noises such as humming, self talking as equivalent to head twirling behavior, which need not be corrected as it does not harm. Whereas if you take a nail biting habit, it needs to be stopped across all ages due to various health reasons and socially inappropriate.

7) Generality – Applied interventions are designed from the outset to operate in new environments and continue after the formal treatments have ended.

For example, your child knows apple is red, banana is yellow. But there are apples that are green in color and there are banana’s which are green and red in color. Can you child identity all of them as apples or bananas irrespective of the colors ? This is the generality, which is one of the major issue faced by the child. We have to teach the child one thing is many different ways, to achieve the generality.

Operant Conditioning

An Antecedent spurs a Behavior to occur. Whether the behavior occurs again in the future will depend on the Consequence that follows the action.

In other words, in recurring situations (Antecedent), we keep doing the same things (Behavior) because it has brought benefits (Consequences) during those times. We don’t show other behaviors because they didn’t bring benefits in those situations OR we don’t see new actions as bringing any more benefits than the action that is working for us right now.

She explained it with an example, in her childhood when both the parents were working, her mom took an electric train as a commute to office. The train by itself is like a a little mobile market, where vendors jump in with their fruit basket and sell it to the passengers. Her mom used to buy such stuff depending on what is being sold. As a child, it made her excited to wait for mom to return from work at the gate, as she always had something in her bag, which as a child meant a lot to her. But this was not the case when Dad returns from work, as he never got anything to them.

Now apply the above to your situation, where you ask your child to come and sit, from child’s perspective what does the child gets in return for sitting, it does not excite him to do it.

In Indian context, lot of parents do this, i.e. either they talk to the child in long sentences or short sentences. Or they simply call their child by name and expect them to look in to your eye …. there is absolutely nothing in it for the child, that will make him/her to look in to the parents eye. These can be achieved through reinforcements.

Skinner Quote:

All we need to know in order to describe and explain behavior is this: Actions followed by good outcomes are likely to recur and actions followed by bad outcomes are less likely to recur

Adding a letter to the Behaviorist Alphabet:

The classical school of behaviorists was familiar with the ‘A’ and the ‘B”, Operant folks added the C.

A- Antecedent B – Behavior C- Consequence

Types of Punishment

She clarified that she is not against punishment, but she is against it when punishment is looked in to as a first choice, instead of replacement behaviors

• Positive – Receives an undesirable response

It is important to understand what is undesirable or desirable for that particular child/individual. What may be undesirable for many could be desirable for the child/individual you deal with and vice versa. For example, Broccoli is a most hated vegetable among all children, but a child who is being treated for behavior loves to eat Broccoli. In this case, i cannot give Broccoli as a punishment for stop a behavior, as the child likes to eat it, the behavior will not get stopped. Similarly hitting the child, most kids on the spectrum likes the sensation of being hit by others, as it is like a pat on the back to them and it provides kind of a deep pressure.

• Negative – Something desirable is taken away

Negative punishment is like taking things away from the child.

Which problems accompany the use of punishment ?

• Emotional or Physical harm can result.
• The kids fear you
• The kids come to dislike you
• The kids think that you don’t like them
• The punishment may not outweigh the rewards of the behavior
• The kids avoid you or just learn to be sneaker so they don’t get caught.
• The punishment might actually be a reinforcer
• Punishment does not teach better behaviors, so the same one keeps popping up.

What problems often occur when ignoring a behavior?

• Hard to ignore some behaviors (Like nose picking, playing with spit etc.)
• Will you ignore the hitting of another (when kid does hitting, do not ignore it. Make the child to do the task what made him to hit others in first place, do not offer relaxation on this)
• Expect a “behavior Burst” (Escalation of a behavior. As a parent, when you follow the above and feel like the behavior is on the increase, it is to be considered as  a positive sign, whatever you have done is working, continue to do that to see the results. In majority of the cases, where you do a behavior intervention, you will see the behavior getting spiked up before it goes extinct)
• You get the kids to ignore too (For a reinforcer), but a colleague who is unaware of the implementation of the strategy leans in the door and tells the kid to stop.

Schedules of Reinforcement

Reinforcement is giving something that you like. (It may be giving a break, giving an activity, etc..)

• Interval Schedules – Reinforcement given after a certain amount of time has passed.

i) Fixed Interval: Reinforcement is presented after a fixed amount of time expires (always the same) For example, you will give a 2 min break for every 10 mins, for the child.

ii) Variable Interval: reinforcement is delivered on a random (unpredictable to all) OR variable time schedule(unpredictable to the student)

For example, for every 10 mins, you will give a break but the duration will not be fixed, it would vary, some could have a duration of 1 min, so may have 5 min etc …

• Ratio Schedules – Reinforcement given after a certain number of responses have been emitted.

i) Fixed Ratio: Reinforcement is presented after each completion of a designated number of responses (Always the same number) For example, for every 3 math problems the child gets a break

ii) Variable Ratio: Reinforcement delivery is variable, but based on an overall average number of responses. For example, child gets a break when he completed a single complicated math problem.

Understanding Behavior

• Antecedent —> Behavior —> Consequence
• (Every parent who has a child with behavior issue should make a note of the ABC’s of the behavior issues that they face with their child.)
• To change behavior we must first define what we want to change.
• Can ABA be explained by ABA?
• Can ABA explain all of our behavior patterns and situational responses ?
• Do emotions come into play? How would ABA explain impulsive acts (Due to emotion or ADHD) ? Do our emotions develop from how the environment acts upon us?
• ABA is essential for working with young severely impaired kids. What do you do when kids outgrow ABA practices and Younger kids with conduct disorders laugh at your tokens and contracts. (You should be moving to points system of money system, that is appropriate to their age)
• ABA is not going to answer all your queries, it is a proven science that helps children with developmental delay to progress well.

Q & A Session

Q – How to generalize the toilet training ?

A – To begin with, make the child use all the toilets in the house, if he is accustomed to a single toilet. If you are part of community or live among relatives, you could practice this with one of the relatives house consistently first and then try in other places.

Q – How do I control Echolalia ?

A – I would be concerned if the echolalia is delayed. If there is immediate echolalia, where child repeats what is being said to him, it is of no concern. We do this ourselves, but within our mind, where we repeat the instructions said to us over and over. In most of the cases, the echolalia occurs when there is  dead time or time when there is no engagement.

Q – How do i control self injurious behavior ?

A – Any behavior is a way to communicate with you. The child is trying to tell you something, we need to look in to deep to find out what is the message behind. Also 99% of the causes of self injurious behavior is to get attention.

Q – Child A does not like a neighbor child B, so whenever Child B visits the house of Child A, Child A rolls in the floor and cries for 10 – 15 mins unless the parents takes him for a drive or give him something the child likes

A – If you are anyways going to take him for a drive or give something the child likes, give it immediately even before the behavior occurs. Next time when such a situation rises, you ask the child for a drive or train the child to come to you and ask for a drive, before the behavior occurs.

Q – How to engage the child who is 4 years old ?

A – This is the age, as a parents you have to spend maximum time with your child. Allow the child to spend time with grandparents etc. Do not focus on independence at this age, it will come at the respective age. He should be able to sit and play.

Q – How to improve eye contact for the child?

A – When you do something that the child likes, it will come automatically. I agree this is a important social skill, but for many people who are not faced with any disorders, face this issue as well. Typically people who work with computers a lot, who do not do a lot of eye contact. Keep an item which the child likes inside your palm, wait for the child to look in to your eyes, once done immediately given the item to him/her without any delay.

Q – My kid is toilet trained by giving jelly as a reinforcer. But whenever he wants to go to toilet, he does not say it, instead he says that he needs jelly. How can i make my son to say that ” I need to go to toilet/ su su etc..”). He is 4 years old, cannot open the toilet door by himself, we need to assist him.

A – If your kid is on a 2 hour bathroom interval, you take your kid in front of the bathroom after 1:45 mins, open the door and wait for him to say that he needs to go to toilet, only when he says , you let him go to toilet.

Q – My son is looked in to things like pencil designs, sticks, my chain etc, he makes sound often, he does self talking, also makes unwanted sound, does not control his laughter, does not chew his foods he swallows most of the time, etc?

A – The child is very creative, he is keen to observe things around him, but there are not enough opportunities to feed his need. Have a box full of items like your chain, toys or items with patterns, which will interest the child. Whenever your child is making a noise, or looking for your chain, give him that box to satisfy his need. You train the child to say “box” whenever he needs it.

Q – When bathing and coloring my son does self talk of the conversations that happened at school or with friends, how to reduce it ?

A – How does the self talking/humming impact you during the bathing and coloring process or impact his improvement? If your child is able to write, take him to creative level, where you make him to write the conversation, draw the characters and color them etc..

Q – Whenever i give a task to my child, he does the self injurious behavior, how to prevent that?

A – If your child is non verbal, teach him to use a “Break Card”, before he attempts to perform that self injurious behavior he should display the break card . Also check on what type of tasks such behavior is exhibited, like simple ones or complicated ones. If you see this happened whenever he was given with complicated tasks, you can train the child to ask for help or break. A token system by itself does not have a value, unless what can be obtained using that. Giving a star or a dollar is not the factor here, what can be bought or achieved through that is the key here. Like if he gets 5 stars, he will get a chocolate. or he will go for a drive in car. Try to avoid the delay in receiving the reinforcement.

Q – Child makes noises deliberately when taken to public places like prayer time in Church, or in airports ?

A – The child seems not to like the places he is taken to. You can prepare the child in early about the place you are going to visit or give the child choices as to which place he/she wants to go. You can promise a reinforcer once he/she reaches that place. In Airports you have no choice, but when its church, you have a choice. Take him for 10 mins only initially i.e. even before he/she makes the noise, slowly increase the time duration. Also visit the church on a weekday instead of sunday to condition him.

Q – Child gotten used to western toilet in USA, but when in India he is not using the same?

A – The reason behind is due to the wet floor, place towels in the floor and make it dry. Even if you are going to lift him and make him sit, the moment he sees that the floor is wet, he would have the same response.

Q – My son 6 yrs old, developed behavior issues during COVID times, he screams loudly. whenever he wants something, and does not get it, screams loudly and cries it.

A – Kids and parents have learned a lot of behavior issues during COVID times. When your kid is in distress, ask him what he wants or give him options, do not take him to the extent of screaming. For example, if you cannot give him coffee which he wants, what else can you give him .. can you give him tea. Try to say NO for TV and yes for ipad or vice versa frequently so that you teach the word NO and make him accept it.

Q – My elder is 4 and younger is 2, both does not share toys among them always cries for same toys

A – This is a typical sibling rivalry. Even if you buy the same toy for both of them it will happen.

Q – My daughter is 4.5 years old, but not willing to wear dresses at home. She had skin problem in the past, as doctor suggested we let her free at home, this caused her dislike towards wearing dresses at home. She does wear dress when we go outside for playing etc.

A – Take the toys which your kid likes to play often, put them in a bucket. You give her the toy only after she wears the dress. Initially start with inners, then tops etc…. You have to practice this consistently.

Q – Brother is 4 years old, he shows hyperactivity to sounds. Covers his ears upon hearing them and runs away from that place, who is mildly autistic.

A – Is it for a particular sounds, for all sounds. Record all such sounds which he does not like, and play it in the background when he plays so that we desensitize them.

Q – How to improve sitting behavior ?

A – You need to do things which they like first and them improve it to other areas.

Q – How to teach alphabet and numbers to my 6 year old son?

A – The areas which you should focus for a 6 year old is that, is he toilet trained , is he able to tolerate his surroundings , etc. . why you want him to know alphabets and numbers ?

Q – How to improve focus and attention? At times he gets everything which i am trying to teach for a very long time, but at the same time, when asked the same thing on some other day, he does not able to say it. Some areas he does not forgets at all..

A – The issue seems to be on the retention. Identify the areas which he does not forget and has a good memory recall.  Kids on the spectrum who has learning issues, they really don’t get letters, they get word as a whole picture…. Any words which can be associated with a picture, they are able to memorize and recollect well.

Q – Child does not attempts an activity, where he senses he would fail in it, but he is capable of finishing that activity at ease. How to make him attempt such activities?

A – We will never attempt activities, where we know we would fail. In this case, even though the child is capable of completing an activity, in his mind he think he would fail, so model the activity few times in front of him, so that he knows what the activity is about. Give him the exposure whenever you do new activities, to take away the fear.

Q – Kids who is trained in Indian toilet does not use western toilet. How to make him use it?

A – Initially just make him sit in the western toilet, he does not need to anything apart from that. Start with few seconds and increase the time duration, to get the comfort, then train for toileting.

Q – How to make the child read the social stories ?

A – Initially as a parent you should be reading such stories to the child, child should get exposure, only then child would read it.

My personal feedback :

Kamalathara Srikanth has a bold/commanding voice and personality, her articulation skills are to the point. This is my second time listening to her. Probably one of the most disciplined online meeting I have seen in the recent times, everyone was on mute, when the session began, there was few slips in the middle, but overall the audience kept it tight. We had around 100+ participants.

ABA is not a one stop solution for children with developmental delays, it is to be used where it is required to reach the expected outcomes. It is going to help the child in attending all other therapies that is required to reach his potential. This session is purely about the basics, infact most of the sessions that happened in recent times are always in the nature of basics, overviews, introduction etc.. I would really like to see sessions which has content based on the speakers personal experience and research and not from free online content.

(It was unfortunate to see few unpleasant messages being shared in the group by a participant/parent, who clearly disliked the usage of tamil for few Q & A responses by the speaker, I was personally surprised by this attitude. The speaker clearly mentioned in the Q&A session, that she will take up questions in english for non tamil speakers and then she will address questions of tamil speakers later. It is a good thing that the host/speaker either failed to notice this or noticed but decided not to respond to it)

Regards,

Saranya and Karthik

karthiksaranyaparents@gmail.com