RE: jperron85@...

June 11, 2005

By description, these behaviors sound like they are automatically reinforcing.

My daughter has had and continues to have many repetitive behaviors and rituals

similar to what you describe - all the cushions on the floor, the door must be

all closed, the step stool must be on the right of the dresser, walking in and

out of the bathroom door with the " number two " from the foam hopscotch, etc. Our

approach has included:

1) choose to intervene with repetitions or rituals that are disruptive, socially

unacceptable or interfere with learning - in our case cushions on the floor for

instance was at everyone's house and this is not socially acceptable behavior,

but, we allow the step stool at home in the same location (it is in her room and

used only by her)

2) accepting " no " procedure - we used a promise procedure " no you may not turn

the light on but, you may play with the whirly toy " if there was no problem

behavior she got the whirly toy. If problem behavior ensued she got neither. We

also used contingent effort - in her case a ring stacker, simple puzzle or other

task she could do and we could guide her compliance. This procedure is more

thoroughly described at www.verbalbehaviornetwork.com . We did do FBA prior to

implementation and had a behavior analyst to train us and follow the data

collection.

3) we have given our daughter an SSRI - paxil and lexapro. This has helped

tremendously with anxiety and repetitive behavior. They are used frequently in

the treatment of OCD in children and adults not on the autism spectrum.

We have used these techniques for 18 months and have seen a dramatic improvement

in these behaviors. We of course saw an extinction burst first! She continues to

have many of these behaviors come up- so, we choose our battles wisely. I am

only a parent - so this is my opinion. Professionals may have other advice.

[ ] jperron85@...

Hello,

I am writing for suggestions on a behavior of a

five-year-old boy with PDD that my team and I are

having a difficult time decreasing. This group has

been extremely helpful in the past, so we look forward

to your helpful suggestions once again:)

Our five-year-old is very verbal and high functioning.

In the past few weeks, he has taken to switching on

and off the light switches excessively. It seems

almost irresistible to him to engage in this behavior-

he sees a light switch and cannot help but switch it

on and off, multiple times. He has begun to do this

at other people's homes and other environments as

well. The behavior does not seem to be maintained by

attention from others, as we have taken all attention

away and tried to re-direct, but this has not resulted

in a decrease in his behavior. The feeling of the

light switch and seeing it go on and off are the

reinforcing elements.

While this is the main behavior, we have also noticed

some opening and shutting of doors, and insistence

repetitiveness in tasks like putting the marker cap on

a marker the same way every time.

He definitely has a lot of anxiety around routine, but

has not had many stims up until now.

Your help is greatly appreciated.

Amber

__________________________________________________

June 11, 2005

Did you try to ignore and redirect in the same treatment? If so,

redirection could equal attention. Did the behavior increase, decrease, or

stay the same when you implemented the treatment?

Around the house, you may want to try disabling the light switches. So if

it is a stim, he cannot gain access to the reinforcer by moving the switch

up and down. If it is attention, no one will pay attention if the lights

are not going on and off. In other people's homes or community, I would

block access to the switches and redirect.

For the other behaviors, it is important to consider if they are impairing

his ability to function in society. If he needs to put the cap of a marker

on a certain way, that's probably OK, but if he takes a half an hour to do

it because it needs to be just so, then it can be considered debilitating.

There is definitely gray area in there and no set guidelines for what is

acceptable and what requires change.

If your son has to do things a certain number of times, you may want to try

a DRD (Differential Rates of Decreasing behavior). This is where you would

provide reinforcement for gradually fewer instances of the behavior. So if

he has to do things 10 times, you would provide reinforcement for him doing

it only 9 times. In order to be successful with this, you would need to

provide reinforcement as soon as he finishes the 9th time and distract him

away from the activity. Once he stops the activity on his own the 9th time,

then reduce your reinforcement to 8 times. Although, since you mentioned

that he is higher functioning, you could just explain that he will receive

something after 9 or write a social story. The reinforcement would have to

be VERY strong.

Please let me know if you have any questions.

e

<http://www.autismbehaviorconsult.com/> Everyone Can

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e Quinby, M.Ed.

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