A Behavior Analyst’s Tips for Picky Eaters

A Behavior Analyst’s Tips for Picky Eaters

Caring for a loved one with developmental disabilities can pose unique challenges, which are not always adequately addressed by conventional methods. We have covered how to tackle toilet troubles and chronic sleeping issues. Below, Dr. Joyce Tu, Ed.D, BCBA-D, shares one program to help parents and caretakers introduce new foods to picky eaters.

Overview

From a behavior analyst’s perspective, eating may be addressed using the following framework:

  • The Premack principle (the principle that more likely behaviors, can be used to reinforce less likely behaviors);
  • Shaping (reinforcement of behavior resembling a target behavior);
  • Fading (gradually reducing prompts or reinforcers); and
  • Positive reinforcement (presenting a reinforcer to make behavior more likely).

If this seems too technical, don’t be discouraged; the program itself is fairly simple!  Your child (or other “picky eater”) will be introduced to various types/shapes/sizes of food throughout the day by using these principles, and can gradually expand her daily menu.

Program

First, you’ll need to identify a reinforcer—a favorite food that your “picky eater” already likes.  Then, choose a new food which you would like to introduce to her diet.  Next, for each bite of new food that your “picky eater” eats, immediately give her a bite of her favorite food.  This is “positive reinforcement.”  (See, it isn’t so hard!)

Alternatively, you can start more slowly and present a bite of her favorite food when she first touches the new food.  Then, when your “picky eater” gradually brings the new food closer and closer to her mouth, give her a bite of her favorite food.  This is called “shaping.”

Gradually increase the ratio of new food to a favorite food, to 2:1.  In other words, when your “picky eater” eats two bites of new food, present one piece of her favorite food.  Later, increase the ratio to  3:1, then 4:1. By changing the ratio this way, you are using a “fading” procedure.

When the ratio of new food vs. favorite food has increased to 5:1, you can then introduce a second new food.

When introducing the second new food, have your “picky eater” take a bite of the second new food, then a bite of first new food, then five bites of her favorite food. The ratio of the second new food, to the first new food, to a favorite food should be gradually increased to 2:5:1 (i.e. two bites of the second new food, five bites of the first new food, and one bite of a favorite food).

Gradually increase this ratio of the second new food vs. the first new food, vs a favorite food, to 3:5:1, 4:5:1, etc.—until your “picky eater” begins eating both new foods without your help.

Using the same procedure, you can then introduce other new foods.

Disclaimer: The recommendations provided are general. For specific recommendations for you and/or your child please consult with a behavior analyst.

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Toilet Training Made Easy

 

Toilet Training Made Easy

A step-by-step guide for tackling toilet troubles

by Dr. Joyce Tu, Ed.D., BCBA-D

December 5, 2017

Caring for a child, potty accidents come with the territory, especially for those with developmental disabilities such as autism. As common these issues are, the good news is that they are also highly manageable. Our step-by-step guide below aims to tackle even the trickiest of toilet troubles. Let’s dive right in.

Goals of this Process:

  1. Short-range: Seven days in a row with no more than one accident.
  2. Long-range: Your child will use the toilet for every elimination with no assistance.

Before you begin:

This program requires that your child be able to walk, sit for approximately 2-3 minutes, and grasp with her hands.

You will need:

  • Training pants (preferably regular underwear).
  • Simple clothing: no pants/elastic waistband pants, or short shirts for girls.
  • A child-size toilet seat, or child’s potty chair if your child is uncomfortable on the adult toilet. (If you use a potty chair, keep it in the bathroom at all times.)
  • A variety of your child’s favorite drinks.
  • A variety of small food treats that your child likes. (Note: be sure to only make these food treats available as a reward for dry pants! Do not use this treat for anything else.)
  • A variety of your child’s favorite toys and activities.
  • Two or three days of free time with minimal disruption for training.

Understand the two basic procedures:

Procedure 1: Toileting

Using the toilet is a chain of many small steps. Your child must be taught each of these steps to help her learn these habits effectively.

Steps:

a. Come up with a signal for your child to use to tell you she needs to go to the toilet:

Ask, “where do you go potty?” and vocally prompt the answer “toilet” or “bathroom.” Have your child imitate “toilet” or “bathroom” aloud if necessary. Praise your child for answering “toilet” or “bathroom.” If your child cannot talk, have her use a gesture or a picture.

b. Have your child walk to the bathroom in front of you. Physically prompt your child to do so if necessary.
c. Have your child take down her pants and sit on the toilet.
e. Give your child 2-3 minutes to use the bathroom. Encourage her to do so by stating “go potty.”

If your child eliminates, praise her and provide food treats (or other reinforcers of their choice). If your child does not eliminate, ignore it. Do not scold or express disappointment. Go to the next step.

f. Flush the toilet (or empty the portable potty) only if your child eliminates.
g. Say “Get down” and have your child pull up her pants.
i. If this was performed during a wet version of the “dry pants check” (Procedure 2 below), have your child walk back to the place she wet herself and change to dry pants
j. Continue with the toileting schedule.

Procedure 2: Dry Pants Check

A way to teach your child that you want her to have dry pants all the time.

Steps:

a. Ask your child “Are you dry?” Help your child place her hand on the crotch area of her pants so that she can feel for wetness.
b. If your child is dry:

Praise her for being dry (e.g., “Nice dry pants”), and give her lots of social reinforcers (e.g., hugs, kisses). Then give your child a small piece of the food treat or a sip of a drink.

c. If your child is wet:

Tell her “No wet pants.” Take her immediately to the toilet (using Procedure 1 above). Have your child do as many of the steps as possible and use hand-over-hand prompting for those steps your child does not know.

For the steps your child can partially perform:
*Pair every step in this procedure with the actual instruction (e.g., “walk to the bathroom”).
*Do not talk to or praise your child during this procedure; only give those verbal instructions to complete the step(s) involved. Your voice should be calm but firm.
*Do not scold or reinforce behavior (such as with a drink or affection) during this procedure.

Day 1:

Step 1. Change & Drink:

After a small breakfast (no starches) change your child’s diaper to training pants. At breakfast have your child drink at least 1 ½ cups (6 oz.) of her favorite drink.

Step 2. Perform Procedures 1 & 2:

Five minutes after breakfast perform a dry pants check (Procedure 2).

If your child is dry, praise her and give her a small piece of her food treat. Then ask, “What do you need to do?” Verbally prompt your child to state, “Go potty.” Proceed to performing toileting (Procedure 1). If your child eliminates, give her lots of praise and a reinforcer of her choice. If your child does not eliminate, say “nice try” and continue with the toileting schedule below.

Step 3. Toileting Schedule One:

After performing the above procedures, repeat the following cycles:

a. Every 10 minutes: Dry pants check (Procedure 2).
b. Every 20 minutes: Toileting (Procedure 1). Do this approximately 10 minutes before your child has a bowel movement (BM).  The BM schedule is based on what you recorded on the original toileting data sheet prior to training. Record whether your child was dry, wet, and/or had a BM.
c. Every 1 hour:  Have your child drink a ½ to 1 cup of her favorite drink.

Step 4. Toileting Schedule Two:

When your child is eliminating in the toilet with no accidents for at least three hours:

a. Every 15 minutes: Dry pants check (Procedure 2).
b. Every 30 minutes: Toileting (Procedure 1).
c. Every 90 minutes: Have your child drink a glass of liquid.

If your child has four or more accidents in a row, have your child repeat the toileting procedure after each accident two times and decrease consumption of the drink to a ½ cup.

Final Steps:

For every three-hour interval your child goes without any accidents:

  • Increase the intervals between dry pants checks and toileting procedures by 5 to 10 minutes.
  • Increase the intervals between liquid consumption by 30 minutes.

Diapers should only be worn when your child is asleep. Eating schedules should be kept the same, but prepare lighter meals with fewer starches.

Day 2 and Beyond:

Continue with the same toileting schedule you ended with on Day 1. When your child is eliminating every two to three hours, stop giving liquids on a scheduled basis and slowly thin out (decrease) reinforcers for eliminating in the toilet.

 

Adapted from Toilet training in less than a day by Nathan H. Azrin and Richard M. Foxx

Disclaimer: The recommendations provided are general. For specific recommendations for you and/or your child please consult with a behavior analyst.

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CBS Presents Its Research at the Bucharest International ABA Conference

In April, 2017, Dr. Joyce Tu, Ed.D, BCBA-D traveled to Romania on behalf of Center for Behavioral Sciences, along with other invited speakers from all over the world for the Bucharest International ABA Conference.  Ten international lectors attended from Great Britain, the United States, Norway, and Spain to present the newest theories and practices in Applied Behavior Analysis. Dr. Tu presented CBS’ original research on the following topics: “The Role of Joint Control in Manded Selection Responses and Generative Responding,” and “Teaching Social Verbal and Non-Verbal Behavior to Children with Autism.”

The Bucharest ABA International Conference is Romania’s main event dedicated to research and theory in Applied Behavior Analysis. The conference is accredited at the international level by Behavior Analyst Certification Board, and at the national level by the Romanian College of Psychologists and College of Physicians.

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Reduce Stress This Holiday Season

Reduce Your Stress and Enjoy Yourself More

The holidays are filled with excitement and joy. With all of the excitement comes the stress of juggling multiple holiday activities. While you may be excited, you also may be feeling stress from the unknown. Several questions may run through your mind: Will my child have a behavior problem? Will I get to enjoy myself? Or, will I spend the entire time worrying about my child’s behavior?

Here are a few simple strategies to help you get through the holidays, and even to enjoy them!

Set Your Expectations

Set your expectations for your child and for yourself. How long do you want to be at the holiday event? How long can your child really be there? We all have limits regardless of any disability.  Expecting any child to behave and stay longer than they really can, will only lead to anxiety and stress on your part.

If it helps, call the host prior to the party and explain that you will attend, but only be for a certain time. This way, if and when you have to abruptly leave, the host will understand. And this can help reduce your anxiety and stress.

Prevention

Prevention is key.  This means not waiting for a problem to happen, but trying to prevent it from happening.  It can be easier to prevent than to react in the heat of the moment. There are several things you can do to prepare yourself, your child, and your family for the a holiday event.

  1.  Bring reinforcers (i.e., items that motivate your child’s good behavior, such as their favorite snacks or toys). If your child is on a token system, bring your token system.  Having reinforcers available can help you to remember to praise good behavior. We often get distracted at parties and ignore children while they are being “good.”  But if a child is going to continue to exhibit good behavior, she has to remain motivated. By having reinforcers available to present according to your child’s program, it is more likely that everyone will be happy and you will actually have more time to enjoy yourself.
  2. Bring games and activities that your child can do independently. Often, we expect children to be good, but a holiday party may not necessarily be child-friendly. This can make it difficult for you and your child to relax. If your child enjoys coloring, puzzles, or a particular game, bring it with you. Set your child in an area with her own space to play with her toys or an activity that she can do on her own. If you child only enjoys watching videos bring your iPad, etc. Give yourself the night to enjoy, and just let your child watch videos if that is going to reduce your stress. Every once in awhile, it’s ok.
  3. Reactive Strategies. Plan for the worst.  You need to know before a holiday activity what you will do if a behavior problem occurs. Knowing the right response will reduce your stress level, even if it means leaving the holiday activity.

Ultimately, it is better to be over-prepared then overwhelmed. While the preparation may be stressful, you will feel relieved knowing that you have a plan. You may even be able to enjoy yourself knowing your strategies are in place, and they can buy you time to enjoy yourself — even if only for a short while.

We hope that you’ll find these tips helpful during the holiday season.

Happy Holidays,

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New Year’s Resolution Tips

Here’s to a New Year and a New Resolution!

Hello 2012! The start of a new year always brings the excitement and hope of many possibilities for the next 365 days. We come up with resolutions that tend to be more focused on the things we are NOT going to do this year. I’d like to offer you an alternate view of your resolutions.

Rather than focusing on the “not,” let’s look at what you “are” going to do in the new year. With our children, we often focus on what they are “not doing” when compared to their typical peers. In behavioral programs, you will find the complete opposite. Reinforcement (such as praise) is given for successive approximations of the ultimate behavior, thus shaping the behavior we desire.

This can be applied to your New Year’s resolution. Let’s take exercise as an example. Your ultimate goal may be to exercise five days a week. If you’re not exercising at all, this could be an unattainable goal. Rather than not meeting your goal and giving up by February, look at the number of times you have exercised thus far. Praise yourself and reinforce the smaller accomplishments. Even if you have exercised only once this week, give yourself a pat on the back, a special treat. Acknowledge the step you made towards your ultimate goal.

Then the next week, focus on increasing the number of times you exercise, compared to the previous week and so forth. You will see that reinforcing your desired behavior along the way to your ultimate goal is much more satisfying; and, it will increase your chances of actually reaching your goal and fulfilling your New Year’s resolution.

You can do the same thing when viewing your child’s program. Is there one program that you want to learn to implement, or you want your child to master? Remember, these short tips and you will be well on your way to achieving your goals:

1.  Determine the ultimate goal:  Decide what it is that you want to do.

2.  Clearly define the ultimate goal:  Create a description of what you want to achieve. This should be specific, observable and measurable. The goal should be so clear that you can visually picture it with your eyes closed.

3.  Break the ultimate goal into smaller steps:  By breaking the goal down, it will be attainable.

4.  Determine your reward schedule:  From the onset, decide when you are going to give yourself that special treat. In the beginning, the rewards should be fairly frequent to increase your chances at maintaining a new behavior; and as you get closer to your goal, the rewards should be less frequent since you are closer to achieving the ultimate reward of accomplishing your goal and meeting your New Year’s resolution.

These tips offer an alternate way of viewing any new year’s resolution! Happy New Year!

Disclaimer: The recommendations provided are general. For specific recommendations for you and/or your child please consult with a behavior analyst.

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