The following planning steps describe the process by which to identify the toddler’s skill or behavior that will be targeted for the Negative Reinforcement intervention. The steps also describe how to identify and select potential negative reinforcers.
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.
EXAMPLE
Parents discussed with the providers that their toddler, Aiden, preferred to graze rather than sit for meals. The team assessed whether this behavior was very different from the grazing behavior of most toddlers. Based on their observations, the team agreed that sitting for mealtime was something that Aiden disliked. The team helped the family to craft an observable and measurable outcome, which clearly described the context (WHEN), the target skill the toddler will perform (WHAT) and how will we know Aiden has mastered this skill (HOW).
Outcome: During dinner, Aiden will sit in his seat for at least 5minutes and finish at least 5 bites of food before leaving the table for 4/5 consecutive weekday dinners.
Creating an observable, measurable outcome ensures that the family and team can keep information on the behavior that tells them if the toddler is clearly progressing or if a change in the intervention needs to occur. The team considers how progress on sitting and progress on eating would need to be assessed separately.
They decide to look at both:
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.
Toddlers may be bothered by taking a bath, sitting for dinner, having the light off in the room at bedtime, and so on.
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.
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.
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:
Date |
# of Requests |
Total |
---|---|---|
9/18/2012 |
X |
1 |
9/18/2012 |
X |
1 |
9/19/2012 |
XXX |
3 |
9/20/2012 |
XXXX |
4 |
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
Date |
Start Time |
End Time |
Total Time |
Playing or Eating |
---|---|---|---|---|
5/9 |
5:55 |
5:57 |
3 |
Playing with blocks |
5/10 |
5:55 |
5:59 |
4 |
Eating/playing with blocks |
5/11 |
5:43 |
5:45 |
2 |
Eating/playing with cars |
5/12 |
5:40 |
5:43 |
3 |
Playing with blocks |
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.
Date |
Start Time |
End Time |
Total Time |
Bathroom Used |
---|---|---|---|---|
7/4/12 |
7:18 |
7:21 |
3 |
Guest |
7/5/12 |
6:55 |
6:59 |
4 |
Guest |
7/7/12 |
7:02 |
7:07 |
5 |
Master |
7/8/12 |
7:22 |
7:24 |
6 |
Master |
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.
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.
EXAMPLE
During the span of dinner, Aiden will sit in his seat for at least 5 minutes and finish at least 5 bites of food before leaving the table for 4 out of 5 consecutive weekday dinners.
In Aiden’s outcome there are multiple, clear criteria by which to measure success:
The goal of both positive and negative reinforcement is to increase the likelihood that the toddler with ASD will use the target skill again in the future.
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:
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.
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.
Time / Activity / Place |
Reinforcers |
Aversive |
Toddler’s Reaction |
---|---|---|---|
11 am before lunch exploring |
|
|
|
Lunch in the dining room |
|
NOT tomatoes |
|
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:
Target Behavior or Skill within Activity or Routine |
Aversive Aspect |
Target Behavior |
Reinforcing Aspect |
---|---|---|---|
During dinner, Aiden will finish at least 5 bites of food (i.e. teaspoon size) before leaving the table for 4 out of 5 consecutive weekday dinners. |
Sitting at the table |
Eats 5+ bites |
Mom or dad removes the expectation that Aiden sits at the table by allowing Aiden to leave |
During play, William will ask for help (say “help”, sign “help) rather than screaming when a toy is not operating correctly and he needs assistance. |
Toy not working |
Ask for help |
Make the toy work |
Jim will allow Mom or Dad to wash his hair once a week by sitting in the bathtub through rinsing, soaping, rinsing. |
Taking a bath |
Allowing 3 step bath process |
Expectation to stay in bathtub ends |
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:
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.
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.
Target Behavior or Skill within the Activity or Routine |
Aversive Aspect |
Reinforcing Aspect |
Verbal Instruction |
---|---|---|---|
During dinner, Aiden will finish at least 5 bites of food (i.e. teaspoon size) before leaving the table for 4/5 consecutive weekday dinners. |
Having to eat |
As soon as Aiden eats at least 5 bites he can leave the table |
Aiden, first eat, then leave table. |
During play, William will ask for help (say “help”, sign “help) rather than screaming when a toy is not operating correctly and he needs assistance. |
Toy not working |
As soon as Will asks for help someone (e.g., mom, dad, therapist, provider) will make the toy work |
Will, need help? (with anticipatory voice and body language) |
Jim will allow mom or dad to wash his hair once a week by sitting in the bathtub through rinsing, soaping, rinsing. |
Taking a bath |
As soon as the three step process is complete Jim is allowed to come out of the bathtub |
Jim, let’s wash hair then bath is finished. |
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:
Target Skill or Behavior within Activity/Routine |
Aversive Aspect |
Reinforcing Aspect |
Verbal Instruction |
Visual Instruction |
---|---|---|---|---|
During dinner, Aiden will finish at least 5 bites of food (i.e. teaspoon size) before leaving the table for 4 - 5 consecutive weekday dinners.
|
Having to eat |
As soon as Aiden eats at least 5 bites he can leave the table |
Aiden, first eat, then leave table |
|
During play, Will will ask for help (say “help”, sign “help) rather than screaming when a toy is not operating correctly and he needs assistance for 4 - 5 opportunities across 2 days. |
Toy not working |
As soon as Will asks for help someone (e.g., mom or therapist, provider) will make the toy work |
Will, need help? (with anticipatory voice and body language) |
Help Mom! |
Jim will allow mom or dad to wash his hair once a week by sitting in the bathtub through rinsing, soaping, rinsing for 2 consecutive weeks. |
Taking a bath |
As soon as the three step process is complete Jim is allowed to come out of the bathtub |
Jim, let’s wash hair then bath is finished. |
|
Arianna will sit on her bottom or knees in the pew at church on Sunday for at least 5 minutes before leaving for the church garden 2 - 3 consecutive Sundays. |
Sitting at church |
As soon as she finishes sitting for 5 minutes Arianna can leave |
___ more minutes sitting Arianna then garden |
|
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.
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.
Toddlers are developmentally ready for visual supports to be used in conjunction with negative reinforcement by 24 months.
As mentioned earlier, negative reinforcement is effective when used in routines and activities that are __________________ to the toddler.
When measuring how often the toddler engages in a skill or behavior, what type of data should be collected?
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?