Hello! Sadie (3, preverbal) has been very scratchy/pinchy lately. We’ve talked to her BCBA and are going to start implementing their program for dealing with it at home. They have identified the functions as primarily escape and tangible with some attention. However, I feel like, at home anyway, it can often be automatic. I’m not sure what to do because I’m not sure exactly what the problem is or what kind of input she needs (that would be appropriate)? And didn’t know if you had any ideas. Thanks!
Answer:
What does the word "automatic" mean to you? To me it means she's just gotten into a habit that when she wants to escape, wants something, or want's attention she uses behaviors to get what she needs and does it very well. Automatic the way you worded it to me feels like she has not control over the response... and we want to be careful with that language because it will keep our brains stuck and not problem solving.
I would not try to treat it as one big behavior with one big answer. I would track each incident individual and take data for a few days noting:
What happened right before?
What was the behavior?
What happened right after?
put that here.. and it will tell you/me a lot.
In the meantime, I’d focus on two things:
Block it calmly and safely. Not a huge emotional reaction, not a big lecture. Just calm body block/hands down if you can safely do that.
Immediately teach the replacement. If it’s escape, prompt “break.” If it’s tangible, prompt the request for the item. If it’s attention, teach “mommy”/tap shoulder/hand you a card/AAC button. If it’s sensory, give her a safe replacement that gives similar input — squishy, textured toy, chewy, fidget, deep pressure, squeezing a pillow, etc.
The key is she cannot learn “scratching gets me what I want.” She has to learn “my communication gets me what I want.”
Also, I’d rule out the boring but important stuff too: nails trimmed, skin irritation, teething, sleep, constipation, ears, reflux, allergies, etc. When a behavior spikes, I always look at medical/discomfort first because our kids often communicate pain through behavior.
You’re doing the right thing by working with the BCBA. I would just make sure the home plan includes what to do for each possible function and what replacement behavior you are teaching her every single time.
What does the word “automatic” mean to you? To me it means she’s just gotten into a habit that when she wants to escape, wants something, or want’s attention she uses behaviors to get what she needs and does it very well. Automatic the way you worded it to me feels like she has not control over the response… and we want to be careful with that language because it will keep our brains stuck and not problem solving.
I would not try to treat it as one big behavior with one big answer. I would track each incident individual and take data for a few days noting:
What happened right before?
What was the behavior?
What happened right after?
put that here.. and it will tell you/me a lot.
In the meantime, I’d focus on two things:
Block it calmly and safely. Not a huge emotional reaction, not a big lecture. Just calm body block/hands down if you can safely do that.
Immediately teach the replacement. If it’s escape, prompt “break.” If it’s tangible, prompt the request for the item. If it’s attention, teach “mommy”/tap shoulder/hand you a card/AAC button. If it’s sensory, give her a safe replacement that gives similar input — squishy, textured toy, chewy, fidget, deep pressure, squeezing a pillow, etc.
The key is she cannot learn “scratching gets me what I want.” She has to learn “my communication gets me what I want.”
Also, I’d rule out the boring but important stuff too: nails trimmed, skin irritation, teething, sleep, constipation, ears, reflux, allergies, etc. When a behavior spikes, I always look at medical/discomfort first because our kids often communicate pain through behavior.
You’re doing the right thing by working with the BCBA. I would just make sure the home plan includes what to do for each possible function and what replacement behavior you are teaching her every single time.