Module 6: Problem Behavior
Problem behavior is very common in toddlers with typical development as well as in toddlers with developmental delays or disorders, including autism. In this module, we will talk mainly about how to prevent such behavior or head it off once it’s started. This chapter is long and has a lot of ideas and suggestions. No one expects you to use all the ideas in this module. If your child has difficulty with following simple instructions or shows a lot of problem behavior, read through the module and see which ideas you think you can try that might be helpful for your child. But remember – each of these ideas may take a lot of practice to really start working, so don’t give up easily! You may want to review some of the topics a few times. For this section, read the story about Adrian and some of his behaviors that make it difficult to teach him skills. Then read Some Basic Ideas About the Function of Problem Behavior, found just below the Adrian story. Then, work your way through each of the following sections in the order listed. When you reach the end of each section, you will find a link to the next.
Prevention Of Problem Behavior
Functional Communication Training
Using Visual Schedules To Prevent Problem Behavior
Module 6 Problem Behavior Quiz
Module 6 Vignette: It’s okay to say “no” but it’s better to say “soon.”
It was just two weeks before Adrian’s fourth birthday. He was learning to talk and was able to ask for most of the things he wanted using words. Adrian was very good at matching and sorting and was learning a lot of new words and phrases. He was even beginning to make short sentences.
Adrian’s mother was generally very pleased with his progress. However, she was beginning to avoid telling him, “No,” when he asked for things that she didn’t want him to have. As she thought about it, she had been saying “No,” less and less over the past few weeks. Instead, she tended to give him whatever he wanted. She did this because Adrian seemed to be getting more and more upset when told, “No.”
The iPad was a particular problem. Adrian had started asking for the iPad during most of his free time. Mom kept it out of his sight, but he would ask for it whether he could see it or not. She wanted him to use the iPad only as a reward. She preferred that he play outside with his brother and sister or with his toys during his free time. However, whenever she refused to give it to him, he would cry. To make matters worse, once he got it, he would usually refuse to give it back. He often became aggressive, hitting, kicking and twice, even biting, whoever tried to take it away.
Adrian’s mother considered putting the iPad away and telling him that it was gone. However, his older brother and sister enjoyed using it for fun and sometimes for school projects. And she knew that if she could somehow get better control of the iPad, it would be a powerful reward during their special learning sessions. There were also some very good learning programs on the iPad. She wanted Adrian to benefit from using the iPad. She just didn’t want to give him so much screen-time.
Mom had finished Module 6 of Opt-in Early and had some ideas about things she could try. She reviewed Module 6 again and decided to try using a “First/Then” approach. She made a First-Then board and put a picture of the family’s iPad under the word “Then.” (See below). She thought it would be a good idea to start with something Adrian enjoyed and could do quickly. So, she put a picture of his favorite puzzle on the left side of the First-Then board, under the word “First.”
She knew that it might be difficult to get Adrian to give the iPad back. So, she got out the kitchen timer and took out a small bowl into which she planned to place a scoop of ice cream, Adrian’s very favorite treat. Then she waited for Adrian to ask for the iPad.
It didn’t take long. It was about 1:30 PM in the afternoon. After lunch, Adrian had agreed to go outside with his older sister. They played in the sandbox and then she pushed him on the swing. He played nicely but wanted to come inside after only 15 minutes. Sure enough, as soon as he walked in the door, he asked for the iPad. But Mom was ready. “Yes!” she said, in a happy tone of voice. I will get the iPad. Then she showed him the First-Then board she had made. She handed him the puzzle shown in the picture under the word “First.” “First, you make this puzzle. Then, you can play with the iPad for 10 minutes.” She waited until Adrian had started the puzzle before retrieving the iPad.
As soon as he finished the puzzle, she praised him enthusiastically and said, “Great job making the puzzle! You get the iPad for 10 minutes!” Then she handed Adrian the iPad and set the kitchen timer for 10 minutes. Adrian was watching some of his favorite YouTube videos. After nine minutes passed, she gave him a one-minute warning. “One more minute and the timer is going to go off,” she said. She put a scoop of ice cream in the bowl and waited for the timer to ring.
When the timer went off, mom walked over to Adrian. “iPad is all done,” she said. “It’s time for ice cream.” She handed him the little bowl of ice cream. As she moved the bowl near him, she held it in front of the iPad and gently took the iPad with the other hand. Before he knew what had happened, he was happily eating a spoonful of ice cream while mom put the iPad away. Then she got out some bubbles and had them ready when Adrian finished his ice cream. “Let’s go outside and blow bubbles,” she said.
It had worked. But mom knew that she would need to be ready again soon and she wouldn’t always be able to offer him something as wonderful as his favorite ice cream for giving up the iPad nicely. She would also need to gradually require him to do things that took more time to complete before getting the iPad. She made some pictures for the First-Then board showing things like taking the dog for a walk, going to the park, taking a bath, and putting on pajamas.
She also thought that over time, she would teach him to wait for 3, 5, 10, 20 and 30 minutes. And she also planned to teach him to ask for, “One more minute please?” She would prompt him to ask for this whenever the timer went off and he was upset because he was right in the middle of a favorite video or game. And all the while, she would be teaching Adrian how to play more fun games and do other things that did not involve screen time. They had a long way to go. But they were off to a really good start!
Freepik/Flickr/Freepik/Freepik
Some Basic Ideas About the Function of Problem Behavior
Crying and Fussing are Forms of Communication
All new babies communicate their wants and needs by crying. When the baby cries, caregivers check the diaper and if it’s wet or soiled they change it. If the diaper isn’t wet or soiled, or if the baby continues to cry after his diaper is changed, they may offer him some milk. If he refuses the milk, or drinks some but continues to cry, they try putting him down for a nap, or rubbing his tummy. Most of the time, one or more of these things does the trick. The child feels better, stops crying and everyone is happy.
Babies Cry for Attention Too
Think about a baby waking from his nap. If he wakes up but nobody notices, it won’t be long before he begins to cry. Often, as soon as an adult picks him up, he stops crying, before his diaper is changed or he’s fed. In fact, many babies will quiet as soon as they see a trusted and familiar face enter the room, and especially when that familiar person picks them up to cuddle and talk to them. Within the first few months, they begin to smile back when caregivers smile at them. They’re communicating pleasure at being with the adult, and pleasure at seeing their caregiver happy.
Parents also learn to tell one cry from another. They can usually tell the difference between a cry of pain and the fussing of a tired infant. There are certain cries that send a parent dashing to their infant while, with other cries, they know that walking is fast enough. So – what we’re saying is that babies are not born knowing how to talk; but they can certainly communicate. All of the crying, whining, fussing and smiling serves as communication; each message that’s communicated serves some purpose.
Think about the examples we’ve discussed so far and let’s substitute words for the crying or smiling. If the baby’s crying because he’s wet, he could be saying, “I want OUT of this uncomfortable, wet diaper!”
“Wet cry” — I want OUT of this uncomfortable, wet diaper!
“Hungry cry” — I want some milk please!
“Tired cry” — Please put me in my crib. I need to sleep!
“Alone after waking cry” — I need a hug! I want my mommy!
“Pain Cry” — HELP!!!!! I’m hurt!!! Ouch!!!
Social Smile – I’m happy to be with you!
As Babies Get Older, They Learn Other Forms of Communication and They Cry and Fuss Less Often
As babies get older, they learn to communicate more clearly. They make a variety of noises to get a parent’s attention. They use gestures like raising their arms to be picked up or reaching for a small toy while looking at you or making a noise to let you know they want it.
They learn how to point to things they want, bring a toy to a parent to show it to the parent or to ask for help with it, or even to ask for things using words or approximations of words like, “bubba” for bottle, “mama” for Mommy or “dada” for Daddy. At the same time, they’re maturing in other ways too. They’re able to tolerate a little waiting – not much but a minute or two. They’re becoming a little more able to tolerate changes in their environment, like warmer or cooler room temperatures or noises, and they become more familiar and comfortable with family routines.
Children Who Have Difficulty Learning Other Forms of Communication Often Learn to Cry and Fuss More
All babies, in fact all children, continue to cry when they’re upset. Children can’t always communicate their wants and needs in any other way. But as children mature and become better and better communicators, they usually begin to cry and fuss less. Some of the crying is replaced by more mature forms of communication.
However, for children who have difficulty learning to communicate their wants and needs, crying and fussing often remain the only form of communication they can use. These children may feel very frustrated when they can’t communicate clearly what they need. Instead of crying less, children who have difficulty learning language may even learn to cry more. They may also, unfortunately, learn other behaviors that help them to communicate the things they need or want, behaviors like screaming, hitting, kicking, or throwing things.
And, of course, when a young child is obviously upset, his parents try hard to figure out what he wants or needs. Often they are able to find something that quiets him and makes him feel better, even if they can’t always figure out exactly what he really wants. In this way, crying as a means of communication is followed by reinforcement while other methods of communication are not being learned, practiced, or reinforced.
If you think about what you have learned so far about how reinforcement strengthens the behavior that it follows, it isn’t difficult to understand how problem behavior can develop, even in children as young as 2 or 3. The child is distressed for some reason, and cries because he doesn’t have a more effective way of communicating what he needs. His parents try different things until they find something that quiets him, and by doing that they are reinforcing the crying, which is the child’s only means of communication. In this way, crying or tantrum behavior can become a real problem. And what’s the solution? The main solution is to figure out what the child is trying to communicate and teach him a better way to communicate it. That is what we’ll describe in this module.