Disruptive Behaviors

Question 1

Types of Disruptive Behaviors

Answer 1

• social skills deficits
• restricted interests
• behavior management
• emotional disruption
• suicidal behavior
• ADHD

Question 2

High Functioning Autism Asperger Syndrome

Answer 2

• Functional analysis to identify antecedents and consequences by interviewing, observing, or systematically manipulating the environment
• Teaching alternative behaviors, manipulating environment
• Punishment procedures when reinforcers are not effective
• Behavioral cusp- “A behavior change that has consequences for the organism beyond the change itself.”

Question 3

Autism and Asperger Syndrome Techniques

Answer 3

• Shaping- successive approximations of the desired behavior
• Prompting- various types of assistance, such as guiding, reminding, verbal instructions, modeling, gestures
• Chaining- forward and backward (e.g. putting on pants)
• Discrete trial training (DTT)- teach one small skill and reinforce
• Pivotal Response Training- (PRT)- Focus on pivotal responses such as motivation, responsivity to cues, self-management, and self-initiation. All attempts to respond correctly are reinforced, not just successes

Question 4

Autism and Aggression

Answer 4

1. Social extinction- identified sources of positive reinforcement are withheld following every occurrence of aggression and noncompliance
2. DRO (Differential Reinforcement of other behavior)- pleasurable consequences are contingent on the absence of problem behaviors during a specific period
3. Noncontingent Reinforcement (NCR)- behavior- independent delivery of pleasurable consequences. Dense time schedule changed to lean over time, with initial reinforcement being almost continuous
4. Escape extinction- in response to aggression, block and redirect. Re-present instructions until subject follows through appropriately. Very time-consuming; done one on one

Question 5

ADHD

Answer 5

• Psychopharmacological treatment and behavioral treatment has been shown to be superior to behavioral treatment alone (Ritalin or Adderall)
• Parenting education- behavior issues are not reduced, but oppositional behavior is reduced, and parents stress was reduced
• School-based interventions showed high effect sizes for behavior

Question 6

Oppositional Defiant Disorder (ODD)

Answer 6

• Parent Management Training (PMT)- parents taught to discourage problem behaviors and encourage prosocial behaviors. PMT teaches positive reinforcement, nonviolent and consistent discipline, effective monitoring and supervision, and constructive family problem-solving (Patterson, Reid, Jones & Conger, 1975)
• Child Social Skills Training (CSST)- youth taught CBT techniques for interpersonal skills

Question 7

Tools for Positive Behavior Change

Answer 7

• avoid coersion
• stay close
• use reinforcement
• pivot- take attn away from undesirable behavior in one student toward desirable behavior in another student the back to desirable behavior in student one
• redirect- use differential reinforcement
• set expectations
• use contracts
• timeouts
• ABCs of behavior (antecednets, behaviors, consequences)

Question 8

Disruptive behavior in older adults

Answer 8

• Ability to learn can be impacted
• Capacity to form associations is intact until very end-stage dementia
• Behavioral interventions successful in treating physical aggression, verbally aggressive outbursts, paranoid speech, inappropriate sexual actions, and wandering
• Antecedents: other residents’ threats, paranoid delusions, environmental factors such as noise, unpleasant family visits, and discomfort from physical conditions

Question 9

Behavioral Interventions for Older Adults

Answer 9

• modify the antecedent situation
• modify consequences
• reinforce incompatible behaviors (activity other than wandering)

Question 10

Interventions for Older Adults

Answer 10

• Pharmacotherapy (thorazine, antipsychotics) is overused
• DRO- differential reinforcement of other (appropriate) behaviors
• DRI- differential reinforcement of incompatible behaviors
• Combinations of DRO, social reinforcement, extinction, and staff feedback all require an analysis of the antecedents of behavior
• Social skills training- instruction, modeling, roleplaying, and feedback

Question 11

Treating Wandering In Older Adults

Answer 11

• Redesign of environment to allow limited wandering without danger
  
  • can paint dark parts on the ground, they will think they are holes, or make a fake bus stop
• Take action on antecedents
• Reinforce alternate behaviors