Step 1.1 Select and describe the target skill or behavior in observable and measurable terms

Beginning with the IFSP, the EI team discusses with the parent the toddler's strengths and challenges in order to develop a priority outcome and then describe a target skill. The IFSP outcome should be observable and measurable in order to be able to clearly describe the expected skill that the toddler will learn and how to determine when the toddler has mastered the skill.

Step 1.2 Identify the activities and routines within which to teach the target behavior (or skill)

Once target behaviors are described, the EI team and parents identify everyday activities and routines within which to use negative reinforcement to increase the toddler’s behavior. Negative reinforcement is effective when used in routines and activities that are mildy aversive to the toddler.

It is important to note, that mildly aversive activities, events, or items occur naturally in a young child’s environment and do not cause harm to toddlers with ASD.

EXAMPLE

Toddlers may be bothered by taking a bath, sitting for dinner, having the light off in the room at bedtime, and so on.

Step 1.3 Determine implementation of other evidence-based practices

Negative reinforcement is usually implemented in conjunction with other evidence-based practices (e.g., prompting, activity systems, naturalistic interventions, and discrete trial training). If another evidence-based practice is being implemented review the module for that practice.

Step 1.4 Collect baseline data

Once the skill or behavior and activities or routines are identified, the team and family collect data on that skill or behavior within those activities or routines to determine how often the toddler uses the target skill or behavior if at all. Conducting a baseline clearly illustrates the toddler’s current performance level. If an accurate baseline is not established the EI team is unlikely to develop appropriate goals and criteria by which to measure progress. And further, the EI team is unlikely to be able to make the right adjustments to their and the family’s implementation of reinforcement and other evidence-based practice necessary to support the toddler and family’s success.

a) The EI team, with the family, measure the toddler’s use of the skill or

behavior by collecting the following data:

Frequency data

Frequency data measures how often the toddler engages in the skill/behavior. Data are collected through time sampling or event sampling.

Sampling: When using time sampling, data are collected after a certain amount of time has passed (e.g. every 5 minutes). For example, if collecting data on frequency of screaming behavior a parent or provider would mark if the behavior happened every 5 minutes. This technique is useful for behaviors the toddler engages in frequently such as for engagement and parallel play.

Event sampling: Event sampling is used by marking every time that the toddler engages in the behavior. This technique is used for low frequency behaviors or skills such as requesting help, playing specifically with a toy, helping put on clothes, and so on.

For Aiden, the team could take frequency data on the number of bites that he eats during a sitting.

Data: How frequently Jack requests for more snack during snack time by signing “more”, pointing to the food, or approximating the food (“cracker”).

The event sampling data shows that his use of requests increased across the four days that data was collected:

Duration data

Duration data are used to record the length of time that the toddler engages in the skill/behavior. For example, a parent or provider might collect data on how long a toddler sits at the table during dinner before demanding to be let down. A parent or provider might collect data on how long the toddler spends playing with one open-ended toy before moving on to something else.

Data: The length of time that Aiden sits at a table eating or playing

Data: The length of time that a toddler spends in each bathroom's tub before demanding to be taken out. 

Although the time in bath increased it’s not clear whether that is due to time or whether Caroline prefers the master bathroom.

b) EI team members collect baseline data for a minimum of four days or until a

trend is clear and stable before beginning implementation of reinforcement

A stable baseline helps the team know whether their use of reinforcement is impacting the toddler’s behavior. If the baseline is not stable, the team will not know whether it was their and the family’s implementation of negative reinforcement that produced a change in the toddler’s behavior or use of a skill.

Baseline data should be graphed in order to best determine if a trend is stable such as in the following graphs. The graph below illustrates the number of times a day a toddler urinated in a potty across 4 days. In both of the graphs below a stable trend can be identified. While the graph on the left is more erratic, it is clear that the frequency or duration of the behavior is at the level of a 2 and that the level is overall flat. The graph on the right clearly slows an increasing trend. Generally, at least 3 data points are needed to begin to identify a trend.

Step 1.5 Establish goals and criteria

Now that the team and family have identified skills or behaviors and routines, they determine the criteria that will be used to evaluate whether their use of negative reinforcement is effective.

First, the team and family double check that the outcome is still appropriate given the baseline data collected. If it is not, the outcome is revised as described in the first step.

Step 1.6 Select negative reinforcers

As mentioned earlier, negative reinforcement is effective when used in routines and activities that are mildy aversive to the toddler. When using negative reinforcement, identification of mildly aversive, non-preferred activities and tangible items is critical to ensure that the toddler is motivated to use the target behavior to avoid or get rid of the aversive activity or item. As with positive reinforcement, team members and families begin with an assessment of preferred and non-preferred items or activities.

Team members conduct a negative reinforcement assessment that identifies preferred or nonpreferred activities, events, and items that produce positive and negative reactions in the toddler with ASD.

The EI team and family come together to:

• Make a list of preferred and nonpreferred activities, events, and items

The EI team give examples to the family to help them begin to consider activities and events if needed. These may include washing hands, turning on water faucet, sitting for extended periods of time, waiting for materials to be available, certain food, certain toys, certain textures and so on.

• Observe the toddler

During the observation they direct the toddler to engage in various activities and with various toys and other items. They look for the toddler’s response (e.g., positive, negative, disinterested). If the toddler makes evasive movement or negative vocalizations (e.g., turning away, physically resisting, crying, screaming, dropping to the floor, yelling), or engages in interfering behaviors (e.g., self-injury, aggression, disruption, trying to leave) they allow the toddler to leave the activity or offer another object. Observe if the behavior decreases when the aversive event, activity, or object is removed.

The following table can be used to document the toddler’s reactions to presented activities, events, and items and the toddler’s reactions when aversive activities, events, and items are removed. Sitting in seat is clearly an aversive for Aiden. From the observation, the team also has a list of potential reinforcers to support intervention – Elmo, water play, etc.

Step 1.7 Identify a reinforcer that is appropriate for the target skill and routine or activity

The team considers the list of reinforcers and mild aversives identified through interviews with family members and observations of the toddler. They identify those that are appropriate for the target skill within the identified routines or activities.

Examples of negative reinforcers used during common toddler routines or activities:

Step 1.8 Select a method for instruction

When using negative reinforcement it is important to plan for the method of instruction. This is so the toddler is clear what behavior or skill is expected for him to escape the aversive situation. Instructions should be determined based on:

• the individual toddler’s preferences,
• developmental level,
• the behavior or skill, and
• activity or routine.

Instructions are most often verbal, visual, or a combination of the two.

Please review the Prompting Module for more information on prompts which work well for some toddlers and how to implement these systematically.

a) Verbal instructions should be brief, clear, and consistent with the toddler’s

ability to understand receptively.

Early intervention providers and family members should determine what verbal instructions will be used so that they are consistent in the delivery of these instructions.

b) When incorporating visual supports it is important to ensure that they are

consistent with the developmental level of the toddler. 

Many toddlers with autism react well to visual supports. Some toddlers may not be able to make the necessary connection between an abstract black/white drawing of a toy and a toy itself, but they may make the connection given a photograph of the toy. Other toddlers may need to see the actual object to understand the instruction. Early intervention providers should talk with the toddler’s family, observe the toddler, and take data on the toddler’s reaction to various visuals to determine the type and format of visuals that are most likely to be understood by the child.

Please refer to the Visual Supports Module for more information.

Examples of visual instruction:

c) A combination of verbal (or other prompt) and visual instruction can be

used.

The EI team and family members should determine that the toddler responds well to multiple forms of instruction and is not likely to be overwhelmed by these. The team should clearly outline how these instructions will be given so that all members are delivering them consistently. The toddler will learn best when expectations appear to be the same across EI team members and family members.

Planning Scenarios: Negative Reinforcement

The practice scenarios provide example cases of using the evidence-based practice (EBP) that follow a toddler case through each of the implementation steps, following the Knowledge Check. We recommend that you select and follow the same setting (home or center-based) throughout the module steps.

If you have trouble viewing, review the Troubleshooting Tips.

Knowledge Check

Is this statement True or False?

Toddlers are developmentally ready for visual supports to be used in conjunction with negative reinforcement by 24 months.

Select an answer:

As mentioned earlier, negative reinforcement is effective when used in routines and activities that are __________________ to the toddler.

1. highly motivating
2. mildly aversive
3. new

Question:

When measuring how often the toddler engages in a skill or behavior, what type of data should be collected?

Question:

An EI provider would like to collect data on what happens during car rides, since mom is concerned about the amount of screaming and frustration her son exhibits during car rides.

• What type of data should she collect?

• Why this type?

Step 2.1 Cue the toddler to use the skill or behavior

Use the methods of instruction selected in Step 1.7 to cue the toddler to use the skill or behavior.

Do not remove the negative reinforcer (the mildly aversive situation) until the toddler uses the skill or behavior.

Example of an Implementation Plan for Negative Reinforcement

In the following implementation plan for negative reinforcement with a toddler, the parent and the EI provider would cue the child, Jim, to take a bath and cue him through the steps until they are complete. Only when complete will Jim be able to leave the tub.

Step 2.2 Respond to the toddler based on the toddler's use of the skill or behavior

Respond using one of the following choices depending on the toddler's use of the skill or behavior:

a. If the toddler uses the skill/behavior, remove the negative reinforcer immediately.

b. If the toddler does not engage in the skill/behavior repeat your planned instruction.

If the toddler continues to not respond, reconsider your planned instruction. Instruction should include a control prompt. A control prompt is the most intrusive prompt, which will guarantee that the toddler engages in the skill/behavior If the toddler doesn’t engage in the skill or behavior, the chosen control prompt needs to be changed to one that will ensure the toddler’s response.

c. Negative reinforcement is often used to teach the toddler skills or behaviors to replace interfering behavior.

When using extinction, ignore the interfering behavior while prompting the toddler to use the target skill/behavior. Extinction should not be used if the challenging behavior is dangerous to the toddler or others. 

Practice Scenarios: Implementing Negative Reinforcement

The practice scenarios provide example cases of using the evidence-based practice (EBP) that follow a toddler case through each of the implementation steps, following the Knowledge Check. We recommend that you select and follow the same setting (home or center-based) throughout the module steps.

If you have trouble viewing, review the Troubleshooting Tips.

Knowledge Check

Select an answer:

When implementing negative reinforcement, you should ensure which of the following?

1. You remove the aversive immediately upon when the toddler uses the target behavior.
2. The aversive is actually aversive and that you can remove its presence quickly.
3. Your corresponding prompting hierarchy includes a controlling prompt if the toddler needs prompting to get to the use of the target behavior.
4. All of the above

Is this statement True or False?

Extinction is often used when the toddler engages in the challenging behavior during implementation of reinforcement.

Fill in the blank:

When should extinction not be used?

3.1 Use progress monitoring data to determine the toddler’s mastery of the skill or behavior

Data must be taken and monitored in order to determine if the planned intervention is working.

Data should be taken on the data sheets developed for the baseline data, unless through the course of intervention it is determined by the team and family that other information will be most useful. By using the same data collection sheets, the team and family can track the toddler’s performance before negative reinforcement was implemented and after it was implemented. Therefore, the team and family will be more able to see if progress increased after they used negative reinforcement. If not, changes will need to be made to the intervention plan.

3.2 Adjust negative reinforcement strategies if the target skill or behavior is not increasing

Data collection and review provides visual evidence of the effectiveness of the negative reinforcement strategy being used. If the skill/behavior is not increasing, the EI team and family must try to identify the reason why.

Practice Scenarios: Monitoring Negative Reinforcement

The practice scenarios provide example cases of using the evidence-based practice (EBP) that follow a toddler case through each of the implementation steps, following the Knowledge Check. We recommend that you select and follow the same setting (home or center-based) throughout the module steps.

If you have trouble viewing, review the Troubleshooting Tips

Sample Data Sheet: Monitoring Progress of Negative Reinforcement (Caitlyn's Data)

Sample Data Sheet: Monitoring Progress of Negative Reinforcement (Desmond's Data)

Knowledge Check

Question:

How is collecting implementation data on the same data sheets as baseline data helpful?

Question:

If the toddler is not progressing in their use of the target skill, what questions might the team ask about their use of negative reinforcement.