A Guide to Behavioral Intervention

A Guide to Behavioral Intervention

Assess intellectual, instructional, learning, and situational factors and how they affect / contribute to the behavior problem. Develop and utilize a decision-making tree.

• Identify specific problem behaviors and their source / function.
• Conceptualize positive alternative behaviors.
• Progressively teach, coach, and support the student in developing and utilizing the positive alternatives: healthy, value-system-based behavioral and coping strategies in support of school / community / family success.
• Encourage the practice and progressive growth of positive alternative behaviors with coaching and positive, proactive behavioral planning.
• Scaffold: provide more support, encouragement, and behavioral skill instruction until the child begins to show some sense of competence, then wean and monitor.  
• Alter academic / instructional components as needed in accordance with assessment data and educational best practices.
• Establish realistic expectations that the child is capable of achieving. Expecting something more than what the child can actually achieve is highly likely to result in failure, inspire behavioral problems, and foster a sense of ineffectiveness and helplessness.
• Provide a reasonable and constructive disciplinary structure that will work in support of the positive behavior plan to contain and reduce the frequency and / or intensity of the problem behavior over time while simultaneously facilitating positive behavioral growth and academic progress. 
• Collaboration between the child, family, and school personnel is essential. Fractured teams may contribute to costly, counter-productive and / or harmful outcomes.
• Ongoing assessment and outcome evaluation is an essential component.
• Ongoing assessment enhances understanding and accurate conceptualization of the problem.
• If, after a reasonable trial period, whatever is being tried is not producing positive results then reassessment; a different plan or approach may be needed.
• Reasonable trial periods and outcome assessments guide the process.
• There are no guarantees in behavioral work.

Research indicates that gentle, patient, and positive interventions lead to better long-term outcomes.  Avoid critical, punitive, and harsh disciplinary measures as much as possible.

Kenneth H. Little, MA / 135 Lee Brook Road / Thornton, NH 03285 / 603-726-1006 / Achieve-ES.com / KenLittle-NH.com

Interpreting Behavior

You can't. Don't do it.

Ok, so we can a little bit, to a point. Some behavioral gestures are so common, like smiling, laughing, etc., that we can safely infer meaning.

But, if we go past the basic observation, we can also get our selves into some pretty deep trouble ... pretty quickly ... by over reaching - interpreting more complex behaviors, one's that matter a bit more.

We can see that a client is angry, but we cannot know what specifically she is angry about -- even if we observe a conflict in action. The client may have been angry about something that happened early in the day, last week, a few years ago, and / she may be trauma reactive (more on this another time), and then brought her pre-existing condition into a current situation.

Note: We all bring our pre-existing condition into current situations.

The problem with interpreting behavior is ... it requires us to become psychics, to read minds. We can observe a behavior, but we cannot know what it means without asking the child, who may or may not know.

We all try to interpret behavior. It's like a behavioral staff hobby. But, it's pretty disrespectful to interpret behavior without any input from the client / child and ... we are most often wrong.

An observed behavior is like an ambiguous situation.

We observe it but we don't have all the facts, the whole story, then we make up a story about what we think is happening. This is the same thing that happens when psychologists give projective tests, like the Rorschach or Thematic Apperception Test (TAT). Subjects are asked to look at an ink blot or picture and tell what they see in the ambiguous image. Observing behavior is like peering into an ink blot or TAT image. We often project our own stuff into the behavior and make up a story about what we think we see.

We even do it with pictures of animals.  Most people who looked a the cat image above had some inkling ideas about what the cat is thinking flickering through their mind.  It's that automatic. But, we cannot possibly know what the cat is thinking. Go ahead and try it, if you did not before.  Scroll back up and look into the cat's eyes, examine it's posture.  What happens to your mind when you do?

Really good behavioral observationists know the limits of interpretation. They resist the temptation to over-reach.

It's best to observe the behavior then suspend decision-making about what it means until further information is obtained.  We might be able to see a look of anger written onto a child's face, but is it anger, concentration, determination ... ?  We will need to ask.

Asking the child is a really good place to start.
  
*****

A cautionary note: if the behavior we observe is dangerous, if it poses a risk of significant and imminent harm to self or others, we must act. The key operational words here are: significant and imminent. The potential for harm has to be large enough and likely to happen very soon in order to warrant the risk of a direct intervention. This can be a difficult judgment call. If the risk is not imminent, it's best to slow the process down and wait.  If the risk of harm is not significant, it's better to utilize de-escalation techniques to try to avert a behavioral crisis. Behavioral staff should always adhere strictly to the policies and procedures manual at their work place. Safety and well-being are always the highest priority. 

  Kenneth H. Little, MA / 135 Lee Brook Road / Thornton, NH 03285 / 603-726-1006 / Achieve-ES.com

Bad Words! Bad!

No, not swear words.

There are certain words we use to describe children and their behavior that are counter-productive; one of the most destructive of which is the word "manipulative".

Bad words!  Bad!  Words matter.  To keep one's head straight, it's important to think about and describe behaviors in a constructive manner that makes success more likely.  

Using the wrong words makes success less likely.

Have you ever had a phone call from someone trying to sell you something, during which you felt like you were being manipulated?

If yes, what did you do?  

I hang up, cut the call off . Bam!  Discussion over. Problem solved.

As parents and mental health professionals, the last thing we ever want to do during our work with a child is to "hang up on them".  We can take breaks, this is sensible, but we never want to cut the conversation off.  

Try this.  Re-conceptualize "manipulative" behavior as a maladaptive behavior to get a need met.  

By changing the way we describe the behavior, we also change our relationship with the behavior. 

When we think of a behavior as a maladaptive effort to get a need met, we feel compelled to wonder -- what is the need and what would be an adaptive way to get that need met?

This is what parenting and treatment are all about, the process of teaching adaptive skills to children so that they can cope with and navigate the complexities of life in a better, healthier, more effective manner.

And, yes, we all want our needs met.  Let's not be 'judgy' about this. The challenge is to get needs met in an adaptive manner.      

When we think of behavior as manipulative, we feel a strong need to disengage, withdraw from the child (see Counter-Transference).  When we think of behaviors as maladaptive, it leads us to ask ... how can we help this child and what would be the adaptive opposite behavior?   

What we really want, is to keep the communication open, to figure out what the need is and how to teach, train, encourage more adaptive ways for the child to get his needs met.   

It's best to be very careful what terms we use to describe behavior.  

Always respond to maladaptive behaviors in an adaptive way.

Kenneth H. Little, MA / 135 Lee Brook Road / Thornton, NH 03285 / 603-726-1006 / Achieve-ES.com

Misused Term: Consequences!

Consequences are not what we think they are.  

Consequences are simply the variety of results or outcomes that naturally occur in the wake of a behavior.

For example, you step out onto thin ice and fall through.  The consequences of which could be that you get wet, get cold, drown, swim, laugh and have fun, etc. You may be rescued by a stranger -- fall in love, get married, have children, and so on.

The variety of natural outcomes can be all negative, all positive, or a mixture. 

Consequences can be experienced immediately following the behavior (fall through ice - get wet) or be experienced many years later (rescued by stranger - have children).   Smoking cigarettes can have immediate positive consequences (calming) and negative long-term consequences (cancer).

As the responsible adults working to manage behavioral situations, we typically have little or no control over the consequences that occur and no control over how they are perceived by the child.

Punishment is typically what we mean when we say consequences. (see staff training, Counter-Transference)

Punishment is something intentionally constructed and imposed by an authority figure - parent, teacher, referee, coach, principal, judge, etc. - after a negative behavior or infraction that we wish to discourage or suppress – make less frequent or less intense.

A punishment can be either the imposition of something aversive (not-recommended examples of aversive punishments include: hitting, yelling, soap in the mouth, electric shock, pepper spray, etc.) or the removal of something positive, beneficial, pleasurable, or rewarding (examples include no dessert after dinner, no TV, no cell phone).

(Book mark for later: rewards and punishments can be logical or arbitrary. Logical is preferred. Arbitrary is typically counter-productive -- makes the situation worse.)

For example, in hockey, infractions can result in game stoppage, time in the penalty box or possible expulsion from the game, possible loss of control of the puck, and the requirement that the team play short-handed,

None of these are naturally occurring consequences -- they are authority-figure-constructed results that follow an infraction.

The penalty box is a punishment, but it's not an aversive punishment. The time spent in the box is the removal of something pleasurable, enjoyable, positive, beneficial -- playing hockey.

It also requires the team to play short-handed -- a punishment imposed on the team for an individual player infraction. This too is not an aversive punishment. Playing short-handed is the removal of something positive or beneficial -- a full line of players.

Note: a reward is the removal of a punishment or the delivery of a privilege, benefit, positive, etc. I'll discuss this in more detail elsewhere.

Please keep in mind, regardless of whatever an authority figure thinks a constructed punishment might mean, how the child / student / athlete perceives this can be very different:  mixed and / or the exact opposite.

For example, for a student who experiences school as unpleasant, out-of-school suspension can be experienced by the student as wholly rewarding. In which case, the infraction is encouraged, not suppressed.

(More to follow)

Kenneth H. Little, MA / 135 Lee Brook Road / Thornton, NH 03285 / 603-726-1006 / Achieve-ES.com

Think Win-Win, or No Deal

Win-win or no deal is borrowed from Stephen R. Covey's 7 Habits of Highly Effective People. This is a fantastic resource that I strongly recommend. I've incorporated Covey's idea into the collaborative process developed by Ross W. Greene and described in The Explosive Child, another resource I strongly recommend. More about Dr. Greene's approach can be found at his "Lives in the Balance" web site. I strongly encourage you to study these resources thoroughly.


Think Win-Win, Whenever Possible

We are working toward a parent-child collaborative process; outcomes that are mutually agreeable are preferred whenever possible.

Win-lose and lose-win outcomes are not sustainable solutions. 

These types of inequitable outcomes will contribute to growing mistrust and resentment; increasing frustration, anger, hostility — ever acting-out behavior.

Avoid Win-Lose and Lose-Win outcomes as much as possible.

Remember “No Deal”. Rather than accept a win-lose or lose-win proposition, agree to no deal. Then take a break from discussions and try to come up with fresh possibilities. Come back to the discussion later when you have some new ideas in mind for solving the problem in a way that will work well for both you and your child.

Parent-Child Problem Solving

	Parent	Child	Outcome
	Lose	Win	Parent Frustration
	Win	Lose	Child Frustration
	Win	Win	Mutual Satisfaction
No Deal	Think	Think	Delayed

Solutions to problems work best when they work for both of you in a mutually agreeable way. If you cannot come to a reasonable, mutually agreeable solution, no deal is a good temporary conclusion. Agree to disagree for the time being and to discuss it again another time.

If you agree to discuss another time, please make sure you do; especially if you value keeping agreements.

Keep in mind that by using this type of process in problem solving with your children, you are role modeling and teaching by example an excellent life skill; a skill that will serve your children well in all relationships, personal and professional, for many decades to come.

Teaching these important skills when children are young will give them a strong advantage in verbal reasoning and verbal problem-solving over their peers. Verbal reasoning and problem solving are both highly effective and beneficial skills; associated with academic success.

Children who possess good verbal reasoning skills tend to accelerate ahead of their same age peers.

Kenneth H. Little, MA / 135 Lee Brook Road / Thornton, NH 03285 / 603-726-1006 / Achieve-ES.com

Flipping, Positively Flipping

 All rights reserved by Alex-de-Haas

Flip negative behaviors into their positive opposites; maladaptive behaviors into their adaptive opposites.

Example: "tantrum" is flipped into "using words".  Children at times use tantrums to get needs met.  This is a negative, maladaptive skill. The positive, adaptive opposite skill is to use words to get needs met.

As we move forward we will begin to focus our attention on enhancing skills and abilities, the capacity to manage in and navigate a complex world.


Whenever we encounter a problem or concern we will begin the work of "flipping" the negative behavior into its positive opposite behavior or skill. From here, we will teach, coach, and encourage the use of the positive behavior or skill in the difficult situation.

Difficult situations require adaptive skills in order to navigate successfully. Skills require a lot of practice to master. 

Please keep in mind that all children ... will learn through experience an ever expanding set of behaviors and strategies for the dealing with difficulty.  Some of these may be adaptive and effective.  Some of these will be maladaptive.  

Important note: a maladaptive behavior in a current situation may have been an adaptive behavior in some previous difficult circumstance.  Try not to judge behaviors, but do provide constructive feedback that will enable the child to learn, practice, and develop more and more adaptive behaviors.

More on this soon.

* I'm using child, kids, children, teen interchangeably.

With much gratitude to Tufts University.

Kenneth H. Little, MA / New Hampshire / 603-726-1006 / https://kenlittle-nh.com/index.html

A Sledgehammer Is ...

A Sledgehammer is ... Not ... a Behavior Change Tool.

Constructive Feedback

Behavioral kids and teens*, typically get absolutely inundated by crushing waves of criticism.  Pause for a moment right here.  Read this again to establish a deep empathic connection with this reality.  Imagine crushing waves of criticism inundating you every day for years and years.  Close your eyes. Breathe gently and deeply.  Imagine how it would feel.

Not only do behavioral kids tend to get subjected to frequent negative feedback on their problem behaviors, but they are very typically hyper-criticized for ordinary behaviors as well.

Behavioral kids tend to get scrutinized frequently, in everything they do.  Many behavioral kids know this and say it very clearly.

This is extraordinarily destructive to the child and very counter-productive. Imagine for a moment, being hyper-criticized at work; moment to moment, day-in-and-day-out, for years and years. Would your well-being and job performance be improved or would it decline? 

As the responsible adults -- whether parents or staff -- we cannot psychologically "smashulate" children and believe that this will turn out well. 

A sledgehammer is not a behavior change tool.

Yes, I am using the word "smashulate". I made it up one day while working with a very guarded child who tended to smash things when angry.  I needed a humorous way to approach the subject.  "Smashulate" worked.  He laughed and we were able to talk about the struggle in a very real way.  

My point here is, as the responsible adults we cannot continue to "smashulate" kids and teens who have behavioral problems with large doses of criticism.  It is not healthy.  It does not work.  It makes things worse. It is destructive.  It is not congruent with our mission or purpose.  Stop doing it. 

In order to grow into healthy adults, kids need a diet of feedback that is more constructive than destructive.  The positive to negative ratio should tilt to the positive, constructive side. 

For children with significant behavioral problems, the objective is to increase the use of constructive feedback to achieve a ratio of positive:negative feedback of approximately 10:1 –  this is the number one, most immediate priority.

All rights reserved by Ken Little

10 positive, uplifting, constructive comments regarding the child's behavior, attributes, interests, characteristics, accomplishments, etc. to every 1 negative comment or criticism. The gardening metaphor, if you can imagine it, is one of watering / nurturing the flowers and for the most part ignoring the weeds. 

Note: This is important for parents, but it's particularly important for behavioral staff working in a program to remain mindful of this ratio. If the program ratio of positive to negative feedback gets too low, or worse, inverts, the program will be in for a very rocky ride. I'll say more on this on the staff training page.     

Ordinary children benefit from a ratio of 6:1, positive to negative feedback.

Think about it.  Each child has tremendous positive energy and many excellent attributes. 

They are really terrific kids with lots and lots of positive potential. We want to encourage and support the growth of these very important positive elements while gradually, patiently, carefully working to address the lesser, but significant problems and concerns.  (See previous blog post: The Whole Child)

If we attend too heavily to problems and concerns we risk increasing these elements to the point at which they may consume and diminish the really terrific positive qualities that make up the bulk of who each child genuinely is.

We must work with intention, purposefully and progressively to address concerns while fully encouraging the growth and development of the whole child. 

* I'm using child, kids, children, teen interchangeably.
  
Photo credit, sledgehammer: All rights reserved by Antti Tassberg

Kenneth H. Little, MA / 603-726-1006