CD IISCA Progression Video

Summary

This video showcases a transformative behavioral intervention for a child (cd) struggling with severe aggression, self-injurious behavior, and property destruction. Through functional analysis, therapeutic strategies like reinforcing preferred activities (e.g., walks), and expert feedback, cd’s disruptive behaviors significantly decreased. The process also led to increased engagement in academic tasks and new functional skills such as folding laundry and making deliveries. Key to the success was adapting the environment to meet cd’s needs, reinforcing positive behaviors, and eliminating the use of physical restraints. Overall, the intervention fostered a more effective, enjoyable school experience for cd.

Takeaways

• 😀 CD exhibited severe aggression, self-injurious behavior (SIB), and property destruction before the intervention.
• 😀 Spitting was the most frequent and disruptive behavior, often resulting in self-inflicted injury (e.g., bloody nose).
• 😀 Physical restraints were often used to prevent CD from harming himself or others during episodes of aggression.
• 😀 Staff wore gowns and masks to protect themselves, attempting to reduce demands on CD, even with low-level requests.
• 😀 Functional Behavior Assessment (PFA) helped identify subtle environmental triggers (e.g., diverted attention) that led to problem behaviors.
• 😀 Walks were identified as a powerful reinforcement for CD, helping him stay calm and engaged in the intervention process.
• 😀 The reinforcement context was extended beyond the therapy room, showing that positive reinforcement doesn’t have to be confined to the treatment space.
• 😀 Over time, CD was able to engage in tasks for several minutes without displaying spitting or other disruptive behaviors, which was a significant improvement.
• 😀 Dr. Ditty and Dr. Raj Rahman provided ongoing feedback and guidance, helping refine the intervention strategies and making subtle but effective adjustments.
• 😀 The intervention successfully reduced CD’s problem behaviors even before new skills were fully developed, showing the impact of the new context.
• 😀 CD's improved behavior generalized outside of therapy sessions, resulting in fewer aggressive behaviors and no need for physical restraints.
• 😀 CD's increased participation in academic tasks and functional skills (e.g., folding laundry, making deliveries) marked the beginning of successful skill development.

Q & A

What was the primary issue CD exhibited before the intervention?

CD exhibited high-frequency problem behaviors such as severe aggression, self-injurious behavior (SIB), and property destruction. The most disruptive was spitting, which occurred in response to task demands and attention diversion.

How did the staff manage CD's spitting behavior?

To manage CD's spitting behavior, the classroom was rearranged to prevent him from spitting at peers. Physical restraints were frequently used to protect him from self-injurious behavior, and staff wore gowns and masks throughout the day.

What was the breakthrough discovery regarding CD's behavior?

Through functional behavior analysis (PFA), it was discovered that CD's problem behavior was linked to diverted attention. Additionally, CD responded positively to certain reinforcement contexts, such as walking, which became a key part of his treatment.

What role did walks play in the intervention process?

Walks became a significant reinforcer in the intervention. It was initially assumed that the treatment room lacked appropriate reinforcers, but when walks were incorporated into the process, CD responded positively, showing that reinforcement didn’t have to be confined to the treatment space.

How did CD respond to the increased academic demands during the intervention?

Despite the increased academic demands, CD continued to choose to participate in the sessions. This indicated that the intervention created a meaningful and engaging environment that supported his participation and progress.

What significant change occurred outside of the intervention sessions?

A significant reduction in CD's problem behaviors, including spitting and aggression, occurred outside of the intervention sessions almost immediately after the process began. This change occurred before CD had developed or generalized new skills.

How was the generalization of CD's skills managed?

The generalization of CD's skills was supported by involving his classroom teacher and other staff. These individuals applied the same intervention strategies, ensuring that CD could transfer his newly acquired skills to other settings.

What were some new skills that were introduced during the intervention?

New skills introduced during the intervention included functional tasks like folding laundry and making deliveries to classrooms. These tasks aimed to further develop CD's functional capabilities.

What was the role of Dr. Ditty and Dr. Raja Rahman in the intervention?

Dr. Ditty and Dr. Raja Rahman played crucial roles in supporting the intervention process. They reviewed session videos and provided feedback, helping identify conditions under which to progress the motivating operation (EO) and make adjustments to improve the quality of interventions.

What was the impact of the intervention on CD's overall behavior?

The intervention led to a dramatic reduction in problem behaviors, such as aggression and spitting, which CD had previously relied on to meet his needs. The treatment provided CD with an opportunity to engage meaningfully without resorting to these disruptive behaviors.