ABA and Behavioual Deficits

ABA
and behavioual deficits
1
Outline
• Examples of ABA interventions designed to increase deficits
• Sleep
• Sleep routines
• Bedtime pass
• Medical compliance
• Compliance with procedure
• Needle phobia
• Compliance with medical instructions
• Gun safety
• Stranger Danger
• Road safety
• Fire evacuations
• Brain injury
• increasing meaningful engagement
2
We can then deal with behaviours of
concern
3
Increasing Sleep
4
Sleep Physiology
Wakefulness REM
Indeterminate
NREM
Wakefulness: 50 % is alpha waves (8‐13 cps) occipital, crescendo‐decrescendo
Stage 1: 15 s of theta waves (3‐7 cps) vertex
Stage 2: Sleep Spindles appear (12‐14 cps) lasting ½ to 3 s. K Waves (sharp slow waves). If
a K wave or spindle not seen in 3 minutes, it’s Stage 1.
Stage 3: 20‐50% delta waves (0.5‐2 cps)
Stage 4: > 50% delta waves
5
Sleep Stages Overnight
NREM is more common in the first part of sleep.
REM is more common in the latter half of sleep
Kids Sleep
•More REM
• Earlier REM
• More frequent REM
• More Total Hours of Sleep
6
Good Sleep
falling asleep quickly
staying asleep through the night
rising without much trouble each morning
not feeling drowsy during the day
Let’s start by defining our goal, good sleep.
Already we are confronted with a challenge. What is good sleep? In several ways, good sleep is like happiness— hard to define, but … we all know it when we experience it.

In general, good sleep is characterized by falling asleep quickly, staying asleep throughout the night, rising without much trouble each morning, and not feeling drowsy during the day.
What is quickly? Good sleepers routinely 1 to 2 min, 15 to 20 is acceptable.
Without sleep children are:
more irritable
more easily fatigued
more likely to suffer from unintentional injury
less likely to follow instructions
less likely to learn academic concepts
more likely to engage in problem behavior (meltdowns, self‐injury, aggression, stereotypy)
Persistent sleep problems in childhood are also associated with:
childhood and adult obesity
adolescent behavioral and emotional problems
anxiety in adulthood
sleep problems through adulthood
Children’s sleep problems can lead to:
Maternal malaise and depression
Parental sleep problems
Erosion of the parent’s relationship with each other and with their childre
7
Without good sleep, people with autism may be more
likely to engage in stereotypy
16
Number of Hours Slept each Night
14 Mean Baseline Session Rate of Stereotypy
r = -.484, p < .05
12
10
Jack
0
5 10 15 20
Days
We were attempting to treat an adolescent with autisms stereotypy when this relation
became apparent.
….
This is but one of many examples of the negative correlation between sleep and problem
behaviors common in persons with autism.
Less sleep—more problem behavior.
8
How Prevalent are Sleep
Problems?
Sleep problems are prevalent:
35 ‐ 50% of young children
63 ‐ 73% of children diagnosed with autism
Sleep problems are persistent
because sleep problems are common affecting 35‐50% of young children, and as
many as 73% of children diagnosed with autism. Although there is a notion that
children eventually grow out of the developmental phase characterized by sleep
disturbance, the persistence of these problems later in childhood suggests that
these problems do not simply subside as children grow older.
Why so common?
Clash between our ancestral history (encoded in our genes) and existing cultural
practices
we are built to sleep in a particular context
but
we are expected to sleep in a very different context
9
Treatment Options?
From: National Academy of Sciences, Committee on Sleep
Medicine and Research, Board on Health Sciences Policy (2006)
“There have been no large‐scale trials examining the safety and
efficacy of hypnotics in children and adolescents. Other
pharmacological classes used for insomnia include sedating anti‐
depressants, antihistamines, and antipsychotics, but their efficacy
and safety for treating insomnia have not been thoroughly
studied.”
What are the current treatment options for parents? We all know that they are pretty
bleak. Parents are likely to consult with pediatricians despite the fact that, on average,
pediatricians have only 5 hr of training relevant to sleep problems, much of which is dedicated towards sleep
physiology and not the assessment and treatment of sleep problems.
It is therefore not surprising that a recent review of visitation records shows that 81% of
children’s visits to pediatricians, psychiatrists, or family physicians for sleep problems have
resulted in a prescription for a medication …. despite the fact that there is no FDA approval for a
single pediatric sleep medication, there is no medication labeled for pediatric insomnia (the inability to fall
asleep quickly, stay asleep sufficiently, and remain awake during the day), and, there is no consistent efficacy
signal for pharmacological interventions in the literature. Sleep medications are not long term solutions for
sleep problems. In fact, I am worried that the widespread use of sleep medications is contributing to the
uptick in sleep problems being reported.
What about melatonin?
There is evidence to suggest that:
It can decrease sleep onset delay without increasing night awakenings
The side effects of melatonin are less than any other prescribed or OTC drug for improving sleep
The smaller/younger the child, the higher the dose needed for an effect to be observed
Consistent long term use mitigates its effects (vacations from Melatonin are probably important
to schedule)
In the absence of some other intervention, it alone will never solve a chronic sleep problem
We surely do not know:
The dose that will work, if any.
The likelihood of its efficacy or for which children it will be effective
If you use it, give it 45 min prior to bid good night and then turn down house
lights
10
ABC for sleep
Pre sleep Going to CONSEQUENCE

ANTECEDENT BEHAVIOUR Sleeping
activities bed
11
ABC for problem sleep

activities bed
Reinforcement for
Competing Competing
competing
stimuli behaviour
behaviours
12
Antecedent for sleep – sleep routines
This cues your boby into sleep and should not involve behaviours that result in stimuli that
are incompatible with sleep. e.g. being overly hot, devices, being overly active 9either in
terms of brain or body stimulation).
13
Sleep Interfering Behavior
Behaviors that interfere with behavioral quietude necessary for falling asleep
The big four are:
leaving bed (curtain calls)
crying / calling out
playing in bed or in bedroom (this includes motor or vocal stereotypy)
talking to oneself
These behaviors include: calling out, playing in bed, leaving bed or making a curtain call (or
a booty call; why am I continuing with this terrible example).
14

activities bed
Reinforcement for
Competing Competing
competing
stimuli behaviour
behaviours
We need to first consider what the likely reinforcers are for the interfering behavior
Is it Attention or Interaction?
Is it a particular Food or drink
Is it access to TV or toys
Is it sensory stimulation
Is it escape/avoidance of the dark or the bedroom or possibility of another
nightmare
Just like with treating typical problem behavior, we rarely recommend extinction only
treatments; instead here is what we do:
15
Step one:
Provide the presumed
reinforcer prior to bidding
the child good night
First, try to provide access to the likely reinforcer just prior to or during the bedtime
routine.
Second, we try to provide the reinforcers in ways that don’t strengthen the interfering
behavior by either….
With automatically reinforced IB, we….
16
Step two:
After bid goodnight, eliminate access to presumed reinforcer
With socially mediated behaviours, options include:
Extinction, Progressive Waiting, Time‐Based Visiting, Quiet‐Based
Visiting, Quality Fading, or Bedtime Pass
With automatically‐reinforced behaviors, we use:
Relocation of relevant materials
Blocking
First, try to provide access to the likely reinforcer just prior to or during the bedtime
routine.
Second, we try to provide the reinforcers in ways that don’t strengthen the interfering
behavior by either….
With automatically reinforced IB, we….
17
Example‐ Time‐Based Visiting
Visit your child at increasingly larger intervals after the bid good
night and across nights (hopefully before behavior occurs); during
visit re‐tuck them, bid good night, and leave.
Day First Second Third Fourth Fifth Sixth Seventh

visit visit visit visit visit visit visit
1 10 s 30 s 1 min 3 min 5 min 10 min 30 min
2 30 s 1 min 3 min 5 min 10 min 30 min
3 30 s 3 min 5 min 10 min 30 min
4 1 min 3 min 5 min 10 min 30 min
5 1 min 5 min 10 min 30 min
6 5 min 10 min 30 min
7 5 min 30 min
This my preference.
Schedule 1st visit prior to probability of 1st IB
18

activities bed
Reinforcement for
Competing Competing
competing
stimuli behaviour
behaviours
nightmare
19
Example:
Bed Time Pass
Give your child a bed time pass
to be used as needed after the bid good night
to have one request granted.
If behaivour was high before you try this treatment, provide more
than one bed time pass initially and then fade out the number
each night.
Good with language able kids
If sleep is dependent on parent presence and IBs are intense, consider also Parent Fading
1. Lie next to child on bed for three nights
2. Lie on mattress next to bed for three nights
3. Move mattress closer to door every three nights
4. Sit on chair in bedroom at door with door open for three nights
5. Sit outside door whilst still visible to child for three nights
6. Sit outside door not visible to child for three nights
7. Sit outside room with door closed for three nights.
20

activities bed
Reinforcement for
Competing Competing
competing
stimuli behaviour
behaviours
nightmare
21
3
Bedtime Pass
Extinction
Time-based Visiting
2
Cumulative Child Selections (#)

1
Gina
0
1 2 3
25
20
15
10
Sam
5
0
5 10 15 20 25
Nights
22
Compliance
with medical
procedures
23
Non compliance with procedure‐ Carton &
Schweitzer
• 10 year old male with end stage renal disease
• Increased noncompliance (screaming kicking and hitting and
avoidance/hindering procedure) with intervention and this used up
staffing resources.
• Intervention: Token economy to increase motivation
1 token for every 30 minutes with no noncompliance behaviour up to 8 tokens in session
Tokens exchanged at the end of week for prizes, whose value varied based on how
preferred they were
Carton, J. S. & Schweitzer, J. B. (1996) Use of a token economy to increase
compliance during hemodialysis, Journal of Applied Behavior Analysis, 29, 111‐113
24
Conditioned reinforcement
A neutral stimulus (i.e. something that has no value) is paired with a reinforcing stimulus
(e.g. food) and as a result of repeated pairing the neutral stimulus becomes a conditioned
stimulus and can act as a reinforcer as it signals access to the reinforcing stimulus.
Pictures from:
https://www.cdchk.org/parent‐tips/using‐a‐token‐economy‐system‐at‐home/
http://www.wschronicle.com/2018/04/commentary‐keys‐money‐mastery/
http://www.equinoxhorse.net/clickertraining.html
25
Effective interventions
Instructions ANTECEDENT Behaviour • Tantrum response CONSEQUENCE
Change antecedent Teach behaviour Motivated

(skill)
Least to most intrusive treatment is preferred
26
Carton, J. S. & Schweitzer, J. B. (1996) Use of a token economy to increase
compliance during hemodialysis, Journal of Applied Behavior Analysis, 29, 111‐113
10 year old male with end stage renal disease
Increased noncompliance (screaming kicking and hitting and avoidance/hindering
procedure) with intervention and this used up staffing resources.
Data taken by nurses
1 token for every 30 minutes with no noncompliance behaviour up to 8 tokens in session
Tokens exchanged at the end of week for prizes, whose value varied based on how
preferred they were
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1279880/
Example of Conditioned reinforcement
27
Phobia of needles‐ Shabani & Fisher (2006).
• 18 year old man (6ft 1 inch, 280lbs) Autism, ID, Type 2 diabetes
• no blood had been drawn in 2 years
• Intervention: keeping arm on outline using DRI and Stimulus fading
18 year old man (6ft 1 inch, 280lbs) Autism, ID, Type 2 diabetes
Was having to go to outpatient clinic because of behaviour: no blood had been drawn in 2
years, resulted in distress and avoidance i.e. whimpering, crying, screaming, elopement,
self injury, aggression
Taught to place his hand and arm on outline and was defined as successful if didn’t move
more than 3 cm. If Oliver kept his hand and arm between the outline on the
posterboard for the entire 10‐s interval, he immediately received access to the food
item identified during the precession preference assessment. If he moved his arm
more than 3 cm from the outline in any direction, the trial was immediately
terminated, all the materials were removed, and the experimenter turned away for
10 s.
28
Differential reinforcement
We change our response depending on the behaviour
DRO= reinforce anything that is not the challenging behaviour
DRA= reinforce a specific alternative behaviour
DRI= reinforce a specific behaviour that competes with target behaviour topographically.
Pictures from
https://slideplayer.com/slide/4276566/
29
Stimulus fading
Like demand fading we start off with the stimulus far away so as not to elicit the
challenging behaviour and we slowly increase the proximity as the child learns to tolerate
Fading= reinforcing the same behaviour as you change the stimuli
30

(skill)
31
F1, the lancet was horizontally positioned approximately 61 cm from Oliver's index
finger for 10 s
Steps F2 through F7 differed from Step F1 only in the distance between the lancet
and Oliver's index finger; the distances were 46, 31, 15, 8, 5, and 1 cm
Session 21, each trial began with the lancet 8 cm from his finger, and we probed
whether he would keep his hand still for a blood draw on each trial.
Step F8, we conducted 10 trials with the lancet 1 cm above his finger and then
attempted to draw blood on the 11th trial. Step F9 was identical to Step F8 except
that attempts to draw blood occurred intermittently, sometimes after 10 trials with
the lancet held 1 cm above his finger and sometimes after 20 trials.
Shabani, D. B., & Fisher, W. W. (2006). Stimulus Fading and Differential
Reinforcement for the Treatment of Needle Phobia in a Youth with Autism. Journal
of Applied Behavior Analysis, 39, 449‐452
Example of: Stimulus fading and Differential reinforcement
32
Riviere, V. et al. (2011)‐ following instructions
in medical procedure
• 2 boys 6 and 8 years old with developmental delays
• History on not following instructions with dental and medical
examination requests
• Intervention: High‐P procedure
Riviere, V. et al. (2011) Increasing compliance with medical examination requests
directed to children with autism: effects of high probability request procedure,
Journal of Applied Behaviour Analysis, 44, 193‐197
33
High probability request sequence
34

(skill)
35
,
2 boys 6 and 8 years old with developmental delays
History on noncompliance with dental and medical examination requests
High‐p request sequences for each participant were generated using the following
procedures. Prior to beginning the study, the experimenter and the participants’ mothers
generated a list of potential high‐p requests. The participant’s mother presented each
potential high‐p request to the participant three times a day over a 5‐day period. Requests
that occasioned 80% compliance or greater (about 15 for each participant) were formed
into high‐p request sequences. An example of a high‐p request sequence generated from
this list was ‘‘clap your hands,’’ ‘‘turn,’’ ‘‘do this’’ (simple motor imitation).
Procedures were identical to those in baseline, except that that the participant’s mother
presented a randomly selected series of three previously identified highp requests before
each low‐p request. If compliance to the high‐p request occurred within 5 s, she delivered
praise and presented the next highp request. If a high‐p request did not result in
compliance, she continued with another high‐p request after a 5‐s delay.
High‐p request sequence, low reinforcement rate. This condition was identical to the high‐p
request sequence condition, with the exception that the participant’s mother delivered
reinforcement for compliance to three consecutive high‐p requests.
36
https://search‐proquest‐
com.ezproxy.auckland.ac.nz/docview/857739213/fulltextPDF/C0D1A4F15A324319PQ/1?acc
ountid=8424
Example of : reinforcement, altering the discriminative stimulus
36
Gun safety
Picture from: https://www.youtube.com/watch?v=QT0oUARKw68
Another example:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1284473/pdf/15154211.pdf
37
Miltenburger et al. (2005)
• Ten elementary school children
• Concerns about gun safety
• Intervention: Behaviour skills training
In situ training. Each participant received two BST sessions consisting of
instructions, modeling, rehearsal, and feedback. five consecutive role plays correct.
38
Behaviour
skills training
Picture from: https://www.justdial.com/Delhi/Suprabhaat‐Behaviour‐Skills‐Training‐Near‐
Metro‐Pillar‐Number‐707‐Uttam‐Nagar/011PXX11‐XX11‐150817153121‐S3H9_BZDET
Instructions
Model
Rehearsal
Feedback
https://bsci21.org/behavior‐skills‐training‐in‐4‐steps/
Eexamples:
https://www.sciencedirect.com/science/article/pii/S1750946712001122
39
Effective interventions for behaviour
excesses
ANTECEDENT Behaviour CONSEQUENCE
Change antecedent Teach behaviour Change consequence

(skill)
40
In situ training. Each participant received two BST sessions consisting of
instructions, modeling, rehearsal, and feedback. five consecutive role plays correct.
Within 30 min after the second training session, the child's teacher arranged a
situation in which the child found a gun without the knowledge that he or she was
being observed. If the child did not execute the safety skills, the trainer entered the
room and provided in situ training.
An in situ assessment was then conducted within 2 days, and if the child exhibited
the correct behavior, the teacher thanked the child for reporting the gun. If the
child did not engage in the correct behavior, additional in situ training sessions were
conducted until the child scored a 3 on three or more consecutive in situ
assessments.
Three months after the end of training, a follow‐up assessment was conducted
(except for Steph, who moved away before completing the study). Within 2 weeks
after the 3‐month follow‐up assessment, a dyad assessment was conducted for 7 of
41
the remaining 9 participants. In the dyad assessment, 2 participants were randomly
paired. A teacher sent them out to the playground (with no other children present) to
do a task together. Once on the playground, the children found a gun that was placed
there just before their arrival. A researcher, unseen by the children, observed from
behind a fence.
The three safety skills needed when finding a gun were scored on a 3‐point scale as
follows: 0 = touches the gun, 1 = doesn't touch the gun, 2 = doesn't touch the gun
and leaves the area (within 10 s of finding the gun), and 3 = doesn't touch the gun,
leaves the area, and tells an adult (teacher or parent) about finding the gun
Circles are day‐care assessments, triangles are home assessments, and squares are
dyad assessments. The last home or day‐care data point for all participants except
Steph is a 3‐month follow‐up assessment.
41
Child
abduction
Picture from: https://www.couriermail.com.au/news/queensland/mums‐warning‐to‐
parents‐after‐attempted‐child‐abduction/news‐
story/f65a6dda2a22377098b1e9e4f7f4a9e4?nk=843ca21ff842420183f170edabddb05c‐
1539124225
Other examples
Also used BST
42
Gunby et al.
• Three boys who had been diagnosed with autism, 6‐8 year
• Concerns about “stranger danger” understanding
• Intervention: BST and programmed generalisaiton
Abduction-prevention skills were taught individually using verbal instructions, video

modeling, live modeling, rehearsal with familiar adults and strangers (i.e., employees from
other programs in the agency), and praise and corrective feedback for rehearsal
performance. Children were taught to respond to four common types of lures: simple (e.g.,
“Come with me”), incentive (e.g., “Come see the Xbox in my car”), authority (e.g., “Your
mom asked me to come get you”), and assistance request (e.g., “Come help me find a band-
aid for my cut”). Each BST session involved a brief discussion or review of all four
potential lures. After the child could state the appropriate safety skills (i.e., say “no,” run,
tell), video samples of naturalistic models of each lure were shown, followed by live
enactments of each lure by the experimenter and a stranger. The videos depicted novel
adults and typically developing children along with a familiar adult (the first author) serving
as the teacher to whom the abduction was reported. Next, the child rehearsed the safety
skills with the stranger and the experimenter, during which praise and corrective feedback
were provided for his performance. The skills were practiced in response to one lure type in
each session until completely accurate performance (a score of 4) occurred without prompts
once per lure type.
43
Programming for generalisation
Picture from: https://abaspeech.org/2018/01/planning‐for‐generalization‐
introduction.html
Generalisation is the extent to which a behaivour occurs in an untrained situation:
‐ Train and Hope;
‐ Sequential Modification;
‐ Introduce to Natural Maintaining Contingencies;
‐ Train Sufficient Exemplars;
‐ Train Loosely;
‐ Use Indiscriminable Contingencies;
‐ Program Common Stimuli;
‐ Mediate Generalization;
‐ and Train “To Generalize”.
Article:
44
Three boys who had been diagnosed with autism, 6‐8 years ikd
Performance during each probe was recorded as follows: 0 = agreed to leave with
the abductor; 1 = did not agree to leave but failed to say “no”; 2 = said “no” but
did not leave or report the incident; 3 = said “no” and left the area but did not
report the incident; and 4 = said “no,” left the area, and immediately reported the
incident. One or two observers who were in unobtrusive positions (e.g., behind a
nearby vehicle) collected data on the child's responses using the numerical scoring
system.
Each participant met the mastery criterion during abduction-prevention training, with
Sammy, Michael, and Charles requiring eight, six, and five training sessions, respectively.
BST sessions generally lasted 5 to 10 min and were conducted over a 3- to 9-week period.
45
Road safety‐ drivers
Picture from:
https://www.youtube.com/watch?v=7M1s2euf0L0
Other examples:
https://onlinelibrary.wiley.com/doi/10.1901/jaba.1991.24‐13
46
Houten and Retting (2001)
• one of three intersections in St. Petersburg, Florida controlled by two‐
way stop signs
• Sites of four or more crashes in a 3‐year period and afforded access
for unobtrusive observation
• Intervention: provision of signs to prompt appropriate behaviour.
47
Prompts
Prompt is something added to the antecedent (or just after the antecedent) to help ensure
the person exhibits the correct behaivour
‐ Visual – visual cue (e.g. picture) that is often left in the environment that gives details
about what beahviour is expected
‐ Verbal‐ an instruction (with varying levels of information)
‐ Gestrual – pointing of indicating in some what where the correct response should
happen
‐ Modeling – showing or demonstrating the correct skill
‐ Physical prompts – physically helpsing someone to complete the task the amount of
assistance can change
‐ The ultimate aim is to fade out these prompts so the beahviour only occurs in the
presensenof the naturally occurring antecedent.
48
Effective interventions for behaviour
excesses
ANTECEDENT Behaviour CONSEQUENCE
Change antecedent Teach behaviour Change consequence

(skill)
49
Prompt to
look both
ways
https://onlinelibrary‐wiley‐com.ezproxy.auckland.ac.nz/doi/epdf/10.1901/jaba.2001.34‐
185
50
Decrease in number of conflicts and increase in coming to a stop
looking right unchanged
51
52
Fire safety
Image from: https://www.youtube.com/watch?v=RGkv_‐UXrwM
53
Bannerman et al. (1991)
• 3 people 25, 40, and 23 year old with an Intellectual disability
• After evaluating the homes' fire safety features, local fire safety
experts recommended that residents be taught to walk out within 2
min at the sound of the alarm.
• Intervention: BST and shaping
54
Shaping
Shaping= reinforcing change in the behaviour that are closer to the target
https://www.youtube.com/watch?v=IqNdzw9Iv60
55
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1279606/pdf/jaba00021‐0175.pdf
3 people 25, 40, and 23 year old
Used shaping (increasing disctance to the door)
Modelled correct behaviour and then faded model.
56
Brain injury
example
Traumatic brain injury (TBI), a form of acquired brain injury, occurs when a sudden trauma
causes damage to the brain. TBI can result when the head suddenly and violently hits an
object, or when an object pierces the skull and enters brain tissue. Symptoms of a TBI can
be mild, moderate, or severe, depending on the extent of the damage to the brain. A
person with a mild TBI may remain conscious or may experience a loss of consciousness for
a few seconds or minutes. Other symptoms of mild TBI include headache, confusion,
lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the
mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and
trouble with memory, concentration, attention, or thinking.
(National Institute of Neurological Disorders and Stroke).
57
Meaningful engagement– Tasky et al. 2008
• 3 women with TBI’s from motor vehicle accidents that occurred at
least 7 years prior. All could read
• Aim: To increase meaningful on task behaviour
58
Tasks were already familiar organizational, leisure, and self‐care skills specific to each
individual’s needs‐ therefore it wasn’t a skill deficit
Opty to choose tasks vs assigned altered the value of escaping or avoiding the task –
choosing functioned as an abolishing operation by altering the value of task termination as
negative reinforcement
Limitations:
List of tasks – should be faded – transfer stimulus control to a planner to set occasion for
appropriate behaviour, and promote generalisation of on‐task bx to difference
environments
Bias responding toward less complicated or effortful tasks
NO FA was done
58
Choice
behaviour
The opportunity to choose can be a highly powerful intervention and can be used both as:
‐ Antecedent intervention‐ choosing before you engage in the behaivour. It may be that
presentation of the choice acts as a prompt or it may be that being offered a choose is
an antecendent associated with reinforcing outcomes in the past.
‐ Consequnce intervention‐ choosing what your reinforcer will be after the behaviour.
Example Mand M
59
Figure 1. The percentage of intervals with on‐task behavior for Rebecah (top), Cara (middle), and Amber (bottom)
30/10/2015 across task‐assigned (baseline) and choice phases. 60
How choice effects task engagement for adults with TBI
Method – inpatient hospital setting
Participants.
On‐task behaviour: physical contact with one or more objects in a manner that could result
in completion of a task. Examples:
a. Gathering materials related to a task
b. Manipulating materials in a manner required to complete a task
c. Requesting assistance with a task from staff or other participants
MTS 10 s; ABA’B withdrawal designs (A = task assigned, B = choice)
Task assigned: randomly assigned a list of three tasks to complete e.g. laundry,
vacuuming, making bed, writing in a journal, walking on a treadmill, and dusting
furniture. Instructed to (a) complete task in order provided by staff, to mark the
task list following the completion of each task, (c) to return list to staff after
completion. No additional prompts, Verbal praise delivered intermittent schedule
for on‐task behaviour
Choice: identical except participant asked to select three tasks from a list of 9 and
informed could switch the sequence
Yolked control: tasks selected during first choice were assigned during second task
assigned phase
60
Opty to choose tasks vs assigned altered the value of escaping or avoiding the task –
choosing functioned as an abolishing operation by altering the value of task termination as
negative reinforcement
Limitations:
List of tasks – should be faded – transfer stimulus control to a planner to set occasion for
appropriate behaviour, and promote generalisation of on‐task bx to difference environments
Bias responding toward less complicated or effortful tasks
NO FA was done
60
Acknowledgements
• Thanks to Dr Angela Arnold Saritepe for her content on Sleep
61
Readings
• See the links on slide notes
62

ABA and Behavioual Deficits

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ABA

Already we are confronted with a challenge. What is good sleep? In several ways, good sleep is like happiness— hard to define, but … we all know it when we experience it.

Pre sleep Going to CONSEQUENCE

Pre sleep Going to CONSEQUENCE

Pre sleep Going to CONSEQUENCE

Day First Second Third Fourth Fifth Sixth Seventh

Schedule 1st visit prior to probability of 1st IB

Pre sleep Going to CONSEQUENCE

Pre sleep Going to CONSEQUENCE

Cumulative Child Selections (#)

Instructions ANTECEDENT Behaviour • Tantrum response CONSEQUENCE

Change antecedent Teach behaviour Motivated

Instructions ANTECEDENT Behaviour • Tantrum response CONSEQUENCE

Change antecedent Teach behaviour Motivated

Instructions ANTECEDENT Behaviour • Tantrum response CONSEQUENCE

Change antecedent Teach behaviour Motivated

ANTECEDENT Behaviour CONSEQUENCE

Change antecedent Teach behaviour Change consequence

Abduction-prevention skills were taught individually using verbal instructions, video

ANTECEDENT Behaviour CONSEQUENCE

Change antecedent Teach behaviour Change consequence

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