9- Main stream behavior analysis Flashcards by Kathleen Dugan

A collective term for anything a living
organism does

Occurs as a function of genetic-physiological predispositions + environmental events

Behavior

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Determining the environmental events

Behavior analysis

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Manipulating environmental events to bring about desired changes in behavior

Applied Behavior Analysis

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The application of behavioral analysis and developmental psychology to child behavioral problems presenting in primary care settings

Behavioral Pediatrics in Primary Care

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One major emphasis

• Prevention over cure or rehabilitation

Behavioral Pediatrics in Primary Care

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Two types of intervention
• Supportive health education
• Prescriptive treatment

Behavioral Pediatrics in Primary Care

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Three domains of care

• Common behavior problems
• Behavior problems with significant medical (biological) dimensions
• Medical (biological) problems with significant
behavioral dimensions

Behavioral Pediatrics in Primary Care

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Approximately 50% of all primary
care child visits involve behavior problems.

High frequency, low intensity problems

Responsive to prescriptive behavioral treatments

Common Behavior Problems Presenting in Primary Care

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Girls

Night wetting
Poor appetite
Fears
Night waking
Sleep with parents
Day wetting
Picky eating
Sibling rivalry
Overactive
Bedtime struggles
Attention seeking

Ranked Behavior Problems:

3 Year Old Children

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Night wetting
Day wetting
Soiling
Poor appetite
Overactive
Bedtime resistance
Night waking
Non compliance
Picky eating
Sleep with parents
Sibling rivalry

Ranked Behavior Problems:

3 Year Old Children

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Common behavior problems are not
pathologies, they are skill deficits. So
parents are on their own with these.

Common Tactics

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Ignoring,

Warning,

Yelling

Spanking,

Rewarding

Reasoning

Placating or Indulging

Rule of thirds

Tactics commonly employed to reduce

typical child problem behavior include:

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Behavior is largely a function of circumstances

Core of Behavior Analysis

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Percent of Sample

11-25%

Incidence/Prevalence of Psychiatric

Problems in Community-based Children

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Gap In Behavioral Health Care for
Children

 Primary care pediatrics on one side
 Conventional mental health services for 
children on the other
 Vast range of behavioral health 
problems in the gap

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Average Office Time with Patients

11 to 15 minutes

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Average Time Spent in Anticipatory

Guidance Birth to 18 years old

Seven to 97 seconds

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Pediatricians don’t address common

behavior problems. Why? 3 X

Limited or no time
Limited or no training
Lack of inclination

Gap In Behavioral Health Care for
Children

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Conventional mental health services
don’t address those problem very
well either. Why? 2x

Parents are reluctant to go because of a low and variable quality of care.
Stigma

Gap In Behavioral Health Care for
Children

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Over interpretation in practice

Research Practices

Public Impressions

Why parents are reluctant to seek mental health services for children:

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Evidence based or empirically supported treatment

Parents like it

Physicians like it

It works

We have a specialized standard of

care. (Behavior Analysts)

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Sample Topics

Learning

Crying

Sleep

Toileting readiness

Supportive Health Education-

Behavioral Pediatrics for Common
Behavior Problems

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Learning: Children Learn Through ..

Repetition with Contrast

Underlying problem syndrome
Berkson’s bias

•Textbook case bias

Over interpretation in practice:

Why parents are reluctant to seek mental health services for children

Correlative theory building over intervention

Research Practices Why parents are reluctant to seek mental health services for children

Not flattering

Public Impressions Why parents are reluctant to seek mental health services for children

Change in experience-Two types of change 1. Quality—determines DIRECTION of learning • Pleasant— -Reward (positive reinforcement) -Relief—(negative reinforcement) • Unpleasant – - Pain (positive punishment) -Loss (negative punishment) 2. Quantity—determines NEED for repetition •Large—large change, less repetition •Small—small change, more repetition

Clarifying Contrast

Average sleep requirements by age.l; See hand out or instructor notes  Fatigue deteriorates neural controls  Sleep associations To bed sleepy but awake

See instructors notes or handout

``` Physical readiness  Raise and lower pants  Pincer grasp  Fully ambulatory  Sit independently ``` Bladder readiness  Dry for several hours Language readiness  Toileting words Instructional readiness  Follow simple instructions Proprioceptive readiness  Awareness of urge Emotional-social readiness  Assess for clinical significance

Toileting readiness

Drink, Undress, Play and Pay

Toileting Program

 Toddler misbehavior  Bedtime Problems  Simple Habits  Defiance, non compliance, and rule infractions in older children  Simple phobia

Sample Targets

 Danger seeking  Systematic use of carrot and stick  Repetition  Strategic use of nothing - Time in - Time out

Toddler Misbehavior

Escape extinction (ignoring) Often avoided by caregivers because of the extinction burst

Treating Bedtime Resistance

Bedtime Pass

Treating Bedtime Resistance

When to treat: 1. Older than 5 years 2. Done in Public 3. Oral/ Physical Problems- Physician says to treat Non punitive procedure reminding rather than punishing. “reminder fluid” taste treatment) Child Involvement (done with, not to, child)  Systematic application  Fading procedure

Taste Treatment for Thumb Sucking

Menial jobs are assigned when child engages in misbehavior Grounding is done when the job(s) are completed

Job Based Grounding- Middle school and high school students

 Attending school ```  Performing required chores  Following house rules  Staying in room except for meals, homework, chores or school  Nothing with a plug Nothing with a battery  Nothing with an electric current  Nothing with door leading outside  No snacks ```

For Child, Grounded Means

No nagging No reminding about jobs to be done

For Parent, Grounded Means

Subject -14 year old Boys Town boy  General dependent variable -Insect phobia  Specific dependent variable -Math calculations  Independent variables - Exposure - Incentives

Simple phobia

Treatment: exposure and response prevention- (Main stream psychology) Escape extinction - ( ABA)

Phobia Treatment

“Performance is where the impairment was”

Phobias- Skinner

Anxiety is a category. Doesn’t exist in the real world. Inside the category is stuff you can point to: “conditioned suppression”; suppression of operant behavior, i.e. school work

Insect phobia study

Controlled by antecedent stimuli

Respondents

Controlled by both antecedents and | consequences

Operants

What was once a respondent becomes an operant Ex., - Fear of bugs* and the reinforced escape response. *insert any “phobia - The reinforced knee jerk

How do they interact?

``` To name a few:  Anxiety  Phobias  Problem behavior  Example: The crying baby ```

Problems Based in Respondent- | Operant Interactions

Sperm are organisms that behave Their behavior occurs in an environment That environment exerts strong influence on sperm behavior That environment is changeable

Spermatogenesis- Why important in ABA

```  Heat. - GENERIC VARIABLE  Fever  Climate  Stress  Illness  Allergies  Abstinence  Chemotherapy  Smoking  Cryptorchidism  Age  Renal failure  Steroids  Radiation  Nutrition  Fit of clothing ```

Variables That Change the Sperm | Environment

 General dependent variable -Spermatogenesis  Specific dependent variables - Total volume of semen - Total sperm count - Sperm concentration (density) - Total # of motile sperm - Total # of motile sperm per hour of abstinence  Independent variables - Loose fitting “boxer” type shorts - Tight fitting “bikini” type briefs •Subjects -2 Caucasian men, single, good health, mid 30s, paid sperm donors  Semen analysis -Hemocytometer grid  Data analysis -ABAB

Representative Study- sperm

Intrinsic Aspect of Behavior: | Effort

Littering

Subjects: - Smokers entering the hospital *GENERAL dependent variable- Littering • SPECIFIC dependent variable- Cigarette butts in ashtrays • Independent variable -Distance from door to ash tray  Data analyses - A-A, B-C-D-E-F - ABAB

Representative Study

```  Depression  Sleep problems  Difficult people  Sexual performance and satisfaction  Anger control  Athletic performance  Voting  Traffic  Diet  ‘Neurosis’  Life extension  Life satisfaction  Medical compliance  Marital problems  Etc. etc. etc… ```

Other Mainstream Possibilities

Emphasis on highly impaired populations

Berkson’s bias

• Emphasis on extreme cases

Textbook case bias

Determines DIRECTION of learning • Pleasant— -Reward (positive reinforcement) -Relief—(negative reinforcement) • Unpleasant – - Pain (positive punishment) -Loss (negative punishment)

Quality

Determines NEED for repetition | •Large—large change, less repetition •Small—small change, more repetition

2. Quantity

suppression of operant behavior | i.e. school work

conditioned suppression