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Identify a strategy that may be effective in this scenario.When describing the treatment to caregivers or staff, what would you tell them to expect as far as implementation and outcomes?What are the possible clinical obstacles you may encounter?
Response interruption and redirection (RIRD)

feasibility of implementation within the natural environment
lack of generalization

increase in disruptive behaviors

Competing stimulus
Augmented competing stimulus assessment (Hagopian et al., 2020)

Be consistent with recommendations and lower your expectations as far as completely extinguishing the target behavior.

Disagreement with treatment intervention, lack of treatment integrity due to high behavioral effort on the part of staff.

Response interruption and redirection (RIRD)

time

inattention

FA screening for automatically-reinforced behavior (Querim et al., 2013)

That stereotypy interferes with is learning, must first assess then identify competing stimuli

Identifying competing stimuli, having opportunities to run treatment during school day

Intervention for perseverative speech (Kuntz et al., 2020)

T

Test

Intervention for perseverative speech (Kuntz et al., 2020)

Generalization will require concerted effort to apply procedural fidelity across all environments.

Procedural fidelity.

Competing stimulus
Competing stimulus

An initial increase in vocal stereotypy followed by a decrease

Finding no competing stimulus

Response interruption and redirection (RIRD)

We are going to redirect him away from his behavior to alternative educational activities. We will make the educational activities as engaging as possible and provide very little if any attention to the sterepthy as we have defined it.

There are competing environmental stimuli that may be problematic when they are more stimulating than the educational program. We will try to eliminate those that we can from the environment.

FA screening for automatically-reinforced behavior (Querim et al., 2013)

It is a quicker alternative to an FA and is more accurate than an FBA
It will help ensure the most effective treatment is implemented
There is a possibility the findings will indicate additional assessment conditions are needed

If the stereotypy provides automatic negative reinforcement, such as escape from environmental stimuli that is not socially mediated (e.g., lights, sounds, crowds), then the assessment may show no rates of the target behavior

Intervention for perseverative speech (Kuntz et al., 2020)

1.Ignore the statement if you have already responded to it

2. Redirect with a visual to talk about something else or to a relaxation strategy

If ignoring just isn’t going to cut it, and especially if the behavior is tied to having difficulty finding a topic to talk about to get attention, try using a visual to redirect the person to talk about something else. For instance, if a child can only talk about Toy Story, show a visual that says, “Talk about another movie” or “I want to talk about something else.” I suggest using a visual because it keeps you from attending verbally to the behavior and because the individual can’t argue with the visual. Think of it as a polite way to make your eye rolling or other more subtle facial expression at the 15th time you have talked about Minecraft today more clear to the individual. You are giving information about what he or she should do instead. You can use a picture or write out the words as a way to redirect, but the picture is a tangible item that you can leave behind when you walk away from the conversation if he or she continues to perseverate.

You can also redirect to a calming strategy to try to relieve anxiety if you think that is a possible function of the perseveration. For instance, if your student has talked about going to the dentist 20 times today, perhaps it is because he is anxious about it. This would be a good time to use a visual that says, “take 3 deep breaths” or “squeeze some putty.” Some good visuals for this can be found in my anxiety post on A Special Sparkle.

3. Direct the student to his / her schedule with a time he can talk about the topic
Schedule a time that the student can talk about his or her favorite topic and then put that time on his or her visual schedule. This way, he or she learns to talk about it at an appropriate time and you can use the schedule to redirect (e.g., “When can we talk about Minecraft? Check your schedule. OK, we have to wait for pack-up time for that then.”). Now clearly if this doesn’t work you have to ignore and continue to redirect by pointing to the schedule, but you know that there is a time when he or she can talk about it and that you have given him or her the information about it. I had a colleague who had a group of students who all used to talk about Power Rangers constantly. Rather than constantly fighting it, she scheduled a time at the end of the day and put it on the calendar that the class could talk about their favorite topics. She then used that time to write her homenotes while they talked to each other about their perseverations. Whenever they talked about it at other times, she told them to check their schedules and they quickly learned when it was allowed. You can also reinforce following those redirections to help them be successful at first.

4. Set a Limit in a Concrete Way

Finally, this is probably my favorite way of handling verbal perseverations. Set a limit. It could be a time limit with a timer. He could have 5 minutes to talk about something that interests him and when the timer goes off it’s time to move on.

If you have a student who really likes lists or likes checking things off lists, use a list of people he or she can talk to about the topic. Then each time he talks about Minecraft with a person, he has to cross that person off his list. So, if he comes up to me to talk about Minecraft, I would direct him to look at his list. If he has already talked to me about it today, and my name is crossed off, then he has to either talk to someone else he hasn’t talked about it with today or talk to me about something else. And after all, isn’t that what we do when we really want to talk to someone? We just read social signals better.
Another option is to give the student a set of tickets with the number of times he can talk about his favorite topic. For instance, if he has 5 tickets to talk about movies, he has to give up a ticket each time he does. If he can’t give me a ticket because he ran out, he has to talk about something else.

With all of these options it’s important to make sure that you are teaching alternative topics of conversation and possibly anxiety-reducing strategies to replace the perseveration. But while those are being taught, these are strategies that can help address the behavior. And to help you try them, I have included 2 freebies. First, you can download the redirection visuals above. Download it here. Then, you can also download a set of editable talk tickets for which you can fill-in the topic of perseveration for the individual student. You can download the PowerPoint file here.

What strategies do you use to manage verbal perseveration in your classroom? Please share in the comments. The more ideas we have the more effective everyone can be for our students.

bootleg reinforcement

Augmented competing stimulus assessment (Hagopian et al., 2020)

We want to look for competing stimuli to introduce to the environment that can serve as more acceptable alternatives.

1. Objections to alternative stimuli
2. Practicality of chosen stimuli
3. Generalizability across other environments

Response interruption and redirection (RIRD)

Be consistent. Collect data. Provide reinforcement. All behavior change can take time

Hard time generlaizing to the natural environment. Reinforcement not as valuable as the behavior.

Competing stimulus

Initially, Cyrus will require frequent reinforcement for engaging with the competing stimulus. Reinforcement can eventually be faded over time.

Identifying an effective competing stimulus

Competing stimulus

Client may still choose his stereotype.

competing reinforcer

Choice-making intervention for restrictive behaviors (Fisher et al., 2019)

Give him choices

Not following the plan correctly.

Response interruption and redirection (RIRD)

We would block the vocal stereotypy by interrupting it and having him engage in 3 consecutive correct vocal tasks.

It is time consuming and requires constant supervision of the client.

Leveraging restrictive behavior for interactive play (Watkins et al., 2019)

• Identification of an activity may require some trial and error
• Should be an activity that requires little more than modeling

fidelity of implementation, bootleg reinforcement

FA screening for automatically-reinforced behavior (Querim et al., 2013)
Response interruption and redirection (RIRD)

Target times of the day will be identified and occurrences of vocal stereptypy will stopped and be redirected by interrupting the occurrence and asking Cyrus 3 known questions that require a vocal response.

Maladaptive behavior during intervention, resistance to redirection

Response interruption and redirection (RIRD)

I would tell them that anytime Cyrus begins stereotypy we are going to interrupt by delivering 3 known instructions and then redirect him to the task at hand. He will receive social reinforcement for engaging in the current task.

The interruption may not be effective or social reinforcement may not compete with the automatic reinforcement.

Augmented competing stimulus assessment (Hagopian et al., 2020)
Competing stimulus

With this procedure, we would plan to run different conditions to identify a powerful competing stimulus that reduces the stereotypy by at least 80%. Once this is identified, we will plan to provide this to the learner non contingently. This competing stimulus could then be provided to the learner at critical times of the day so that he is able to attend his educational program.

The biggest barrier to this procedure is identifying a truly powerful competing stimulus.

Augmented competing stimulus assessment (Hagopian et al., 2020)

Long time for change the behavior and difficult in generalization

Difficult to find a competiting stimulus in the natural environmental.

Identify a strategy that may be effective in this scenario.When describing the treatment to caregivers or staff, what would you tell them to expect as far as implementation and outcomes?What are the possible clinical obstacles you may encounter?