My Favorite (and Least Favorite) Behavior Philosophies discusses a real-life client who struggled with behavior, and how we problem solved that behavior in speech therapy sessions. I also discuss how my own behavior philosophies have changed in my ten years as a speech-language pathologist.
A Case Study
Seth was a young client who was bright, happy-go-lucky, and fun to be around.
He had started elementary school, and was doing well. His teacher loved him. He liked the work and structure of school, and he was doing well.
In speech, though, we had a problem. When it was time to transition to speech, he refused. Seth wouldn’t talk to me or any other adults. Instead, he would lay down on the ground and hide his face. He wouldn’t move. We tried giving him time to transition, but more time didn’t seem to help.
I wondered if it was because he didn’t like speech. However, once he transitioned he was happy and enjoyed the session. In fact, he said he wanted to come to speech every day!
He also struggled with leaving speech. He would wiggle, wander the room, and take a long time to get his jacket on and get out the door. Sometimes, leaving the speech room took 10 minutes (or more).
There are many ways to approach behavior. In fact, my philosophies have changed dramatically since I started as an SLP 10 years ago.
Ten years ago, I would have gone with a consequence.
Five years ago, I would have praised behavior (such as smooth transitions). I would have offered rewards (stickers, choices).
Now? I’m trying something different. And I want to invite you on the journey as I figure it out. Here’s a review of some popular behavior philosophies (I’ve got experience with them all) and some thoughts on each.
Punitive (aka Consequences)
If I wanted to take this approach with Seth, I would have reminded him that he’d miss out on a preferred activity if he didn’t transition. The idea is to find a motivator and remind the child of that motivator during the behavior problem.
There are some times when this can work. However, in this case it was clear to me that Seth was trying his best. He was genuinely having a hard time with transitions and processing his emotions.
If I had gone this approach, Seth likely wouldn’t have transitioned at all. If he is extremely upset, and I remind him we won’t get to do what he really wants to do in speech, where would that leave me? Seth would be less (not more) likely to transition with me in this case.
Antecedent/Behavior/Consequence, Positive Behavior Intervention Support
Being a team member creating behavior plans was a big part of my work when I worked as a school district employee. In fact, the amount of time I spent being a part of creating behavior plans is one of the reasons I left that work setting. In addition to being time consuming, the behavior plans often were ineffective. This was incredibly frustrating given the amount of time we school employees spent on these plans.
Let’s problem solve through Seth’s scenario using this framework.
First, we’d figure out why the child was demonstrating the behavior. For instance, if he was trying to get or avoid something. We would take the positive route by rewarding him when he transitioned. Rewards included stars, stickers, and preferred activities.
The idea of the Antecedent/Behavior/Consequence (ABC) plan is to uncover the antecedent, behavior, and consequence. The antecedent is what happened right before the behavior (such as: when it was time to transition to speech). As far as behavior, we want to understand its purpose. Is it to get something? To avoid something? and Consequence (What happens after the child does this? Does the behavior work?). A strength is that these plans often focus on positivity (for example, verbal praise or a sticker on a star chart). However, a challenge is that these plans often don’t teach specific behavior skills to children.
ABC Plan: The Why
These ABC behavior plans reward children for what they are doing right, but don’t really focus on teaching them the skills they need to learn when the problem behavior happens. Children don’t work through why others want them to demonstrate that behavior and they often don’t work through the empathy and social problem solving skills they need to understand why that behavior isn’t serving them or those around them.
Beyond the challenge of children working for stars and stickers without fully understanding why they should demonstrate these behaviors, we often don’t involve children directly in these plans. In other words, we aren’t involving children in the problem solving and we aren’t teaching them to recognize their behaviors and problem solve through them. When this happens, skills often don’t generalize to other scenarios.
For example, the plan may be focused on a certain child not blurting out in class. This child may be given positive rewards for not blurting out in class. But, why is he/she doing this? Is it about impulse control? Is attention an issue and is it hard to hold on to a thought? Is this a social skill the child hasn’t learned yet? How can this specific child learn the underlying social/emotional/behavior skills he/she needs to be successful?
Collaborative Problem Solving (Dr Ross Greene)
This idea takes a different approach. It asks:
What specific skill is lacking? How can we teach that skill?
The idea is to a) define lagging skills and b) collaboratively create a plan (with the child) moving forward.
In the case of Seth, emotional regulation and transitioning locations were difficult. The idea would be to have a conversation with Seth and implement some things that might help him. In fact, that is what I’m currently trying. We’ve figured out that:
1. Seth will walk straight into my room (to make for a quicker transition). If it’s time for speech and I’m with someone else, he’s still allowed to walk in the room (and wait quietly, of course).
2. We’ve developed a visual schedule and have a predictable routine for Seth to help with emotional regulation.
3. Seth has asked that choices are offered when he’s having a meltdown. It usually means he doesn’t want something to happen, so we can offer two choices of different options. These options would still both be OK with adults and he can choose which he’d rather have.
4. Seth is working at home on saying “I need help” when he feels overwhelmed. When there are minor transitions at home and he’s able to use his words, he’ll be encouraged to use this phrase. If he practices this, it’ll become easier and easier so that he can use his words when he feels overwhelmed (instead of laying on the floor and hiding his face).
Collaborative Problem Solving – Pros and Cons
This approach, outlined in the book Lost at School, is detailed and can’t possibly be covered in one blog post. I highly recommend the book mentioned.
However, one positive is that it focuses on teaching specific skills, and that does really seem to result in growth for children.
The con of this plan is that it can be difficult to get buy in for both teachers and parents. They may want to see consequences and not support collaborative problem solving.
Teaching Specific Skills
Are some behaviors willful? Yes, absolutely! For example, if a child consistently gets out of bed at night, and gets (as a result) an extra hour to stay up with his/her mom and dad, you can bet that child will continue to use that behavior to get the preferred result.
However, we are talking about solutions where kids have big reactions that demonstrate struggling with a specific skill. I’m counting on you to wear your Behavior Scientist hat to consider the lagging skills involved when your child (or the child you are working with) has behavior challenges.
The idea of this framework is that kids do well if they can. By outlining a specific skill a child needs to learn, we can teach children specific skills to help them overcome that lagging skill.
Growth and Setbacks
If you are working on a specific, consistent behavior (which I suggest you do), keep in mind there will be growth, setbacks, and times where behaviors increase. During these times, you’ll wonder if your plan is working. Be flexible, and adjust as needed. First, make sure you see overall growth. Children have sleepless nights, fights with siblings, and school assignments. These can all cause stress and may impact their behavior.
Keeping data is a helpful way to look at overall growth. For example, in the case of Seth, I might tally the number of sessions where he transitioned in less than 5 minutes, or the length of time (by minutes) he took to transition. If one day seems particularly difficult, I can zoom out of the situation as a whole to see if what we are doing is working.
Did it Work?
As to if it worked, my answer is, I don’t know – yet. To be honest, I’ve gone through other behavior philosophies without the results I’ve wanted to see. I’ve found that consequences don’t teach behavior skills. I’ve learned that sticker charts reinforce priority behaviors, but don’t teach children how to act.
By continuing to use strategies that don’t seem to be working, we aren’t helping our kids.
So, here’s to trying something new as we support children as they learn new skills, instead of punishing them for the skills they don’t (yet!) have.
Try This at Home
Agree? Disagree? My hope is to share some ideas that may get you thinking about behavior differently – even if you disagree.
If you enjoyed this article, you may enjoy another philosophy-type post: my thoughts on speech therapy and the long haul, or another real-life client story: a discussion of a client’s impressive progress who has a Childhood Apraxia of Speech (CAS) diagnosis.