Reinforcement with autistic clients

At a young age, children are exposed to actions that are deemed appropriate to society through authority figures such as parents, teachers, religious figures, and other family members. These behaviours and actions are eventually imprinted on the child and they eventually learn typical and atypical behaviours. However, if a baby is born with autism, teaching targeted behaviours is harder to enforce due to the effects that are associated with autism itself (over-sensitized skin, aggression towards self and others, etc). In this way, it is extremely difficult to teach communication skills (i. e. the targeted behaviour) to an individual who is nonverbal or selectively-verbal, a behaviour that is typically associated with autistic persons. Behavioural modification is more profound when individuals change through positive and negative reinforcement. As shown through studies specific towards autism, the behaviours that are targeted to change are influenced by the instructor or counsellor by using praise and punishment.

The individuals tend to comprehend the behavioural analysist’s reasoning, motivation, instructions, and expectations. By reinforcing the patient, the behavioural analysist is able to motivate the client to follow rules, behave accordingly and in an appropriate manner, and establish a target behaviour. Altering an individual with autism’s behaviour is more efficient and effective when using positive and negative reinforcement rather than the use of extinction. Positive reinforcement is more compelling when extinction is not used specifically on individuals with autism. According to Hannah L. MacNaul, extinction is the disappearance of a previously learned behaviour when the behaviour is not reinforced (Hannah L. MacNaul, 2017). MacNaul has conducted many studies and through her research she has discovered that there are two major side effects of using extinction with autistic patients: one is that it increases the frequency of the target response, and the other is that it increases aggressive tendencies. In certain contexts, such as a school setting, extinction poses ethical considerations for certain topographies of behaviour (Hannah L. MacNaul, 2017).

For example, if a child is demonstrating a risk to themselves or other individuals in the classroom via certain behaviours (such as self-injurious behaviours), pressure may be put on a teacher/administration to implement an intervention to protect the child if extinction is not successfully eliminating the behaviour. Autistic children also acquire information, ask questions, and request differently compared to others. Sometimes, if things agitate them, they tend to not do what the authority figure asks of them. Extinction is not a theory that would be appropriate to use due to the tendency to ignore certain behaviours, and this could be severely dangerous especially if they have harmful tendencies to themselves or others around them. By avoiding this reinforcement tactic, individuals cease the inappropriate behaviours and eventually digest what they are expected to do from others.

Patients with autism are able to decrease aggressive behaviours and follow instructions because of the counsellor’s reinforcement. When a person is praised for behaviours, they eventually learn over time to continue or repeat those actions. When a negative consequence is enforced, the individual learns not to behave that way in fear of the punishment. In a study involving a young girl named Cari, the behavioural analysists were able to get her to focus on her tasks without as many aggressive behaviours during her hygiene routines by using positive reinforcement (Piazza, C. , 1997). Instead of using direct prompts, the analysists would use indirect prompts, light praise, and encouragement if she behaved appropriately. Through this study it showed that Cari, the young girl, was able to alter her aggressive behaviour and morph it into accepting the need to bathe. By using positive reinforcement without extinction, it did not make her feel forced to do the desired task, instead it showed the behavioural analysist that she knows what she can do and how it results in praise and glorification. Cari was able to establish the target behaviour of controlling her anger and frustration, and gearing it towards accomplishing her hygiene routines. Likewise, positive reinforcement prompts the individual to learn how to control their behaviours and engage in activities inside a classroom environment. Some children with autism have a hard time focusing and finishing tasks in a classroom setting and in result, are unable to finish tasks successfully (Harrop, C. , 2014).

The behavioural analysist’s job is to concentrate on creating a target behaviour that is appropriate and can be reasonably imposed upon. The target behaviour could be as simple as sitting at the desk with their hands being folded, or as complex as raising a hand to answer a question and not walking around the classroom and interrupting the lesson. Previous research has identified many negative impacts of extinction treatment integrity failures on behavioural outcomes especially in a classroom environment (Hannah L. MacNaul, 2017). If in a classroom, the most appropriate way to achieve a positive behaviour is through praise and appreciation of the behaviour that is shown. By giving light praise or using rewards such as treats, autistic children are able to understand that their original way of reacting is inappropriate and often offensive in some way, and it results in them learning the new behaviour being taught to them. Using positive reinforcement without extinction helps the individual feel like they are doing the action to demonstrate their comprehension to the authority figure instead of it feeling forced upon. Positive reinforcement with the aid of treats is also very beneficial in establishing appropriate behaviour especially looking at people on the autism spectrum.

In a study conducted by Boudreau, he investigated the effects of reinforcement using skittles and how it increases target behaviour and IQ of the individuals studied. The evidence concluded that the participants engaged in an average of 191 more cumulative responses in the praise condition than in the no-consequence condition and an average of 170 (Boudreau, B. A. , 2015). Every time one of the participants answered a question correctly, they were rewarded with skittles, if it was answered incorrectly he would reword the question. By teaching this way the children were able to successfully accomplish the tasks and increase their scholarly abilities. By using treats to ensure behaviour, extinction was not used. Extinction was not needed because the treats ultimately allowed the children to recognize problematic behaviour by themselves, and further allowed them to comprehend appointed tasks. By not using extinction, Boudreau was able to implement a change without having to ignore certain behaviours – instead he addressed them directly. He avoided using extinction in most studies and the outcomes were mostly positively affected. Aside from a few instances, the overall conclusion was that the children were more capable of obeying orders and behaving accordingly while being encouraged and rewarded instead of punished by answering incorrectly.

Communicating with other individuals is also a learned skill well enforced by positivity and recognition. Some children with autism are limited or non-verbal thus making it hard for them to communicate well with others. Sharing is difficult for these kids because they have a set schedule that they do not like to break, and when it does break, they tend to become upset. Early work showed that operant learning strategies could be used to increase social behaviours such as communication and social interaction, imitation, instruction following, and object naming in children with ASD (Schuetze M. , 2017). Rewards would be awarded if the children respectfully approach and communicate with peers and adult figures. Games, music, food and praise are typically the main contributors for positive reinforcement. Children are also taught how to express their needs or wants by using basic words such as itchy and hungry, or non-verbal communication such as putting their hands over their ears if something is too loud or if they need headphones. Each behaviour is progressively learned throughout a set amount of time conducted through the term, and enforced by both negative and positive reinforcement. Within a study it showed that positive reinforcement for compliance more effectively decreased problem behaviour and increased compliance than did the treatments based on negative reinforcement, even in the absence of extinction (Payne, S. W. , 2013).

In the end, it is evident that to change a problematic behaviour, a positive or negative reinforcer is more potent than using extinction especially with children on the autistic spectrum disorder. As explored through studies, behavioural analysists have discovered that using reinforcers is more beneficial, appropriate, and encouraging to the individuals. Using aids such as learning basic words or gestures, using toys, food, music and verbal praises help implement positive behaviour. By altering the inappropriate behaviour, the child eventually learns how to communicate his/her needs, finish assigned tasks, behave accordingly at home, in public, and in a classroom setting, and communicate well with others around him/her. These acquired skills will eventually become the normal, every-day behaviours of the child. The behavioural analysist or councillor is able to help the child comprehend questions and homework, establish a set schedule, a target behaviour for different environments, and they help the children feel confident in their abilities to accomplish tasks by themselves. This allows the child to feel comfortable in their abilities, communication skills, environment, and around others as well.