| 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? |
|---|---|---|
| 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 | 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 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. 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 |
| 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 | 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. |
| Intervention for perseverative speech (Kuntz et al., 2020) | Would need strong competing reinforcers to compete with the preservative speech. | Other students in the classroom. |
| Response interruption and redirection (RIRD) | Conustency is key, expect an extinction burst, communicate often | The interruption behavior may not be strong enough to compete with the automatically reinforced behavior |
| Augmented competing stimulus assessment (Hagopian et al., 2020) | riduzione immediata delle stereotipie | il trattamento richiede molto esercizio e i risultati potrebbero non essere mantenuti in assenza degli stimoli concorrenti |
| Choice-making intervention for restrictive behaviors (Fisher et al., 2019) | I would tell them to not expect perfection, but to expect progress even if it's slow. | Aggressive behavior towards staff or one's self |
| FA screening for automatically-reinforced behavior (Querim et al., 2013) | Expect extinction burst before observing a decrease. | Finding a competing and alternative behavior |
| Response interruption and redirection (RIRD) | when stereotypy occurs, it will be interrupted with an appropriate on topic statement and Cyrus redirected to the task at hand | the RIRD procedure could be disruptive during class time |
| Response interruption and redirection (RIRD) | Behavioral Burst could be occurred | Ethical Issues |
| Augmented competing stimulus assessment (Hagopian et al., 2020) | First identify competing reinforcer, which may take time. Long-term outcome will likely involve doing further stimulus assessments and continuing procedures to decrease vocal stereotypy. | Vocal stereotypy will likely re-emerge due to it's positive reinforcing properties. |
| Competing stimulus | Implementation will require 1:1 direct support during training and treatment phases. Outcomes can result in increased duration of engagement with desired behavior and decreased engagement in undesired behavior. | Satiation, lack of generalization, and difficulty fading the reinforcement |
| Competing stimulus | Selecting the appropriate competing stimulus is key to success | A reinforcer that is not powerful enough or inconsistent application |
| 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? |
