The Personal Case for using Skill Based Treatment
Let me set the scene: you have a dinner party at your house with your family, including your 3 young kids, your friends, their families, and their kids. Everyone is having a great time, all the kids are sitting with you at the table, and they’re all following directions and eating nicely. All of a sudden, your 3 year old daughter starts to have a meltdown. She doesn’t want to eat what is served and doesn’t want to sit at the table. She starts crying, screaming, refuses to sit at the table, and wants to sit on your lap. Remember, you’re a behavior analyst so you must know what to do! Put that behavior on extinction; don’t ignore the child, but ignore the challenging behavior. Ignore the crying until they stop and then address what they want after they follow at least one of your directions. Your friends are behavior analysts too, so they understand this. They can tolerate a crying child, you do this for a living!
So that is what I did, I ignored my daughter crying until she stopped and she followed my direction to sit down in her chair. Then I reinforced that behavior, which was allowing her to sit in my lap while she ate. This is what I recommend, right? Isn’t this what I have recommended to parents countless times? Isn’t this what I thought was right? In the future, the challenging behavior will reduce and she won’t cry to get what she wants. She will know she needs to ask nicely for things. Right? But if that’s the right thing to do, why did I feel so horrible? Why was I still thinking about this that night, the next day, two days later? Why did I feel the need to apologize to my friends? Not for my daughter’s behavior, but for mine?
After that dinner party, I felt like I had not done the right thing. I thought, “there is no way that I have recommended this procedure for clients I’ve worked with. There is no way I thought that was the best thing to do.” Then I realized, while ABA may have recommended extinction based procedures in the past, we’ve grown and adapted to recommend more child directed and empathetic procedures such as Skill Based Treatment (SBT). In my own recommendations and in our company’s recommendations, SBT has taken its place in our treatment plans and our parent support. Gone are our recommendations to ignore a client’s behavior. Instead, ignoring is replaced with empathy and understanding of why a client is engaging in the behavior in the first place. We have focused on teaching them to request things their way, and to tolerate less preferred changes to their schedule and activities.
So what did I do at home for my daughter?
Well, I didn’t go through the formal SBT process. However, I started to use the language from SBT for my 3 year old. I will say things such as “I understand that this is hard and it’s okay to be mad”. I will give her time to be angry and give hugs when she’s crying – even if I’ve asked her to do something and she’s crying in response. Even if she’s thrown something on the ground, acting out towards her sisters, or is otherwise engaging in a tantrum. I will give her time that is exclusively “her way”, which means we do what she wants, in the way that she wants, without questions. I will be present for her without my cell phone, without other distractions, and without asking her to do anything specific. In return, this allows her to do things that I ask, even if they’re less preferred, because she knows that eventually, she will also get her way back where she can do what she wants.
This process has reduced her tantrum behavior, has gotten her to communicate more efficiently with me, and has made me feel much closer to her. We haven’t had a meltdown like that dinner party since I have started utilizing more SBT procedures. This also makes me feel like I’m doing my best for my daughter and for her two younger sisters. I feel like a stronger BCBA and confident in my recommendations for using SBT and being more empathetic with our clients.
After reading this, you might be thinking, why would I share this personal experience? Why would I call into question my parenthood, my clinical recommendations, and my skill as a behavior analyst? Because I think it’s important to know that every person learns and grows as they have experiences, additional training, and time as a parent and a professional. I think this story can help people realize that behavior analysts are human too. We’re not immune to typical parent stressors and we don’t always do the right thing. But we will learn and grow and can adapt our procedures and recommendations, at home and clinically.
If you are experiencing any difficulties with your children or would like to work through challenging behaviors, contact Graham Behavior Services about ABA therapy or our Purposeful Parenting program.