Client: that he has run away on occasion

Client:  a 16 year-old boy (Adam) with Asperger’sdisorder. ProblemBehaviors: verbal violence, physical violence to objects and irrationalbehaviors such as running away.

(Threatening his parents and brother withviolence and running away if they deny his requests. There have been episodesthat he has run away on occasion and broken furniture and windows in the housewhen his requests were denied or he been told not to do things.) In this case the aim is to decreaseAdam’s problematic behavior by using some behavioral techniques. Before we planthe intervention, we need to find target behaviors that we will work on. Target Behaviors: Using questionsentences such as ‘ Can I…’ or asking for something nicely by using the word’please’. Secondly, we will apply functionalanalysis to see what are the ABCs (antecedent, behavior, consequence) of theproblematic behavior.

Antecedents: Being denied by his parents and/or brother after a request, being told not todo things. Behavior: Non-compliance, threatening with violence and running away, and breakingfurniture and windows. Consequences: His parents are worn out and afraid of him. As the next step we need to find atechnique to decrease the problematic behavior and increase the targetbehavior.

In this case, the best technique will be differential reinforcementof alternative behavior. Differential reinforcement is a veryeffective technique in order to decrease undesirable behaviors. While usingthis technique we need to consider two components of it: 1.      Providingreinforcement: selected items as reinforcers should be provided to clientcontingently when the problem behavior does not occur or occurs at a reducedrate, 2.

Withholdingreinforcement: selected items as reinforcers should be taken away as much aspossible from the environment when the problem behavior occurs. Differential reinforcement ofalternative behavior is commonly used to decrease noncompliant behavior. Beforestarting the intervention with this technique, a behavior that is a desirablealternative to the problem behavior should be selected. The desirablealternative behavior should not be too complicated or too difficult and shouldbe already in client’s repertoire not to have any problems of adopting theselected desirable behavior. During the intervention, the item oritems serve/s as reinforcer/s should be presented in any occurrence ofdesirable alternative behavior or if the problem behavior is reduced. According to what is explained above, thedesirable (alternative) behavior should be already in client’s repertoire andshould require equal or less effort than the problem behavior. However, in thiscase, we have no access to client’s repertoire and we will have to assume thatthe target behavior will require less effort.

Our alternative behavior that isselected to increase -as defined above- will be starting requests with ‘ CanI..’ and using word ‘ please’ at the end of the request sentence. Normally, to be able to detect areinforcer we needed to conduct stimulus preference assessment, however, wehave no contact with the client so we need to check the previous observation. The previous observation shows that hewas using his iphone and video games most of the time.

Therefore, we assumethat iphone and video games are preferred items and we can use them asreinforcers. Also the access for reinforcers will be no longer than 2 hoursafter they are presented. Next, we need to define the schedules ofreinforcements. Since we are using DRA, in the beginning, reinforcements willbe contingent; will be given after each occurrence of desirable (target)behavior. After the first successful outcome of the intervention (if theproblematic behavior occurs at a reduced rate or if the selected behavior occursat least 1time instead of problem behavior) we will start thinning thereinforcement (the reinforcement will no longer be contingent. Thinning procedure: Variable-ratio scalewill be used instead of contingent reinforcement. As mentioned above, we will start theintervention by presenting the reinforcement after each occurrence of target (alternative)behavior. Then according to the checklist that parents will fill out, if thefirst phase of the intervention works successfully and we can reduce the problematicbehavior (if the problem behavior occurs only 80% at a time instead of 100% orthe selected behavior occurs 20% at a time) the reinforcements will bepresented after 2 occurrences of target behavior.

Later, if we see that thereis no problem with adopting the selected behavior according to the checklistand the problem behavior was successfully reduced below the rated of 60%, thenreinforcements will be presented after 4 occurrences of target behavior. If theoccurrences of the selected behaviors are more than occurrences of problematicbehavior (below 50% of problematic behavior, over 50% of selected behavior)then we will present the reinforcement after 6 occurrences of selectedbehavior. At the end, f there is a significant decrease on problematic behavior(occurrence below the rates of 20%) and significant increase on selectedalternative behavior (occurrence over the rates of 80%) then we will onlypresent the reinforcement after 8 occurrences of selected behavior. We willcontinue this procedure until the problem behavior reduces below the rates of5% (almost no occurrence) and the selected behavior occurs over the rates of95% at a time (full adoption). By thinning the reinforcement as givenabove, we aim to generalize the target behavior into natural settings withoutany expectation of reinforcement.

However, if there are any increases ofthe problem behavior after we record 50% decrease on problem behavior, then wewill go back to the beginning of the thinning process until the problembehavior successfully reduces to 50% again. Moreover, after he starts developing thetarget behavior, he is likely to develop better relations with his parents andhis brother and will earn his sister’s (that he is getting along well)appreciation more. Therefore, we expect him to be more successful at his schooland develop better social skills. All those positive outcomes ofdeveloping the target behavior will be the generalized conditioned reinforcersof our intervention. As the DRA using methods require, weneed to use extinction in our intervention to be able to strengthen the targetbehavior and decrease the number of occurrences of problem behavior.

Definition of extinction in general isblocking the access to reinforcers for selected amount of time after eachoccurrence of problem behavior. In our intervention, we will block theaccess to Iphone and video games for 30 minutes if non-compliance, aggression, verbal violence, and/or physical violence towards parents and/or brother occur. The extinction duration should not belong because it may cause grater occurrence of problem behavior or may causeoccurrences of different problem behaviors such as negative emotionalreactions. However, if we do not observe anydecrease of problem behavior after 30 minutes of extinction, then, we canenlarge the duration of extinction procedure to 1 hour or more according to thereduction rates of problem behavior. If we detect any negative outcome ofextinction procedure no matter how long the duration is, then we need towithhold the procedure and try to reduce the problem behavior only bypresenting the reinforcement. Therefore, we need to work on the aggressivebehavior to prevent the negative outcomes of extinction procedure by directingthe client to a professional therapist who is specialized in this specificarea. If we can manage to prevent the negative outcomes, then we need to startimplementing the extinction procedure again but with low durations.

Forexample, at first, we will block the access to the reinforcers only for 10minutes after each occurrence of problem behavior. Then if the problem behaviorstarts reducing, we can enlarge the duration of extinction up to 30 minutes ifthere is no negative outcome.  Moreover, punishment (another techniqueto decrease the problem behavior) can be applied during the intervention. Punishment has two components: Positivepunishment and negative punishment. Positive punishment is applied by addingstimuli to the environment to reduce the undesirable behavior. It consists ofreprimands (“ don’t do it”, “ no”), response blocking, contingent exercise, andovercorrection – restitutional overcorrection, positive practiceovercorrection. And negative punishment is removingstimuli from the environment to reduce the undesirable problem behavior.

Itconsists of time out – non-exclusion time out, exclusion time out, and responsecost. In this intervention, we could applypositive punishment by adding contingent exercise or restitutionalovercorrection since we may receive negative outcomes due to client’saggressive behaviors (disadvantages rather than advantages). Contingentexercise technique could include more task demands at school. If the problembehavior occurs more than 50% at a time every day, then we can ask theteacher/s at school to give more home assignments for the next day. Andrestitutional overcorrection technique could be applied if there is anyoccurrence of physical violence towards objects. If the client hits, throws orbreaks any object, he has to clean the mess he makes and/or repair the objectshe beaks and also he has to clean the whole house afterwards. Theadvantages of these techniques would be less likelihood of receiving negativeoutcome after application of punishment, reducing the aggressive behavior, reducing physical violation and therefore verbal violation, and better gradesat school. Or we could apply negative punishment byadding direct fine response cost technique.

Definition of direct fine technique isfining specific amounts of positive reinforcement (1).  For example as explained in the reinforcementprocedure, we will present the reinforcement after occurrences of selectedalternative behavior however, he will only have access to the reinforcers at areduced duration if the problem behavior occurs (he can only have access toiphone and/or video games for 1 hour and 30 minutes instead of 2 full hours). The advantages of this technique is thatit can be combined with other intervention techniques, easy to apply, andconvenient. However, in this case, application of punishmentprocedures (positive or negative) would have more disadvantages thanadvantages. For example, punishment procedure might cause bigger issues likeself harm, harm to others, emotional breakdown etc.

., and this may causefailure of the whole intervention. That is why, in this intervention, we willnot consider applying punishment techniques. Overall, we need to consider what kindof involvement do we expect from parents and how are we going to make sure thatthey implement the treatment plan correctly. First of all, we need to consider thefact that his parents are worn out and afraid of him, and he does not have goodrelation with his brother. The only person he gets along is his sister. Before we do that, we need to considerthe fact that he has access to items and he escapes from tasks he does not likeas a result of his parents fear of him.

In the intervention we need to make surethat his parents maintain stronger attitude towards him in daily basis and willbe able to block the access to items and get him back on tasks that he tries toescape. Whenever he engages in problem behaviors, they should keep theirattitude and should not show any weakness that he can take advantage of. Theyneed to be aware of the time durations and try not to extend or limit thedurations of reinforcement and/or extinction.

To be able to make sure that theyimplement the treatment plan correctly, we will ask them to fill a checklistafter each occurrence of problem behavior and target behavior and after eachimplementation of reinforcement and extinction (with durations). We should also consider the fact thatthe only person he seems to get along with is his sister and in theintervention we can observe the relational differences that he has with hissister to see to in which ways they get along with and how, so we can work onthose behavioral attitudes and try his parents to adopt to those attitudes tobe able to get along with him even after the intervention.