Module 8: Stereotypic Behavior Interventions

What is Behavior Interruption?

Interrupting maladaptive or stereotypic behaviors with appropriate and incompatible Behavior (e.g., asking a client to perform 3 incompatible behavior such as clapping, giving a high-five, and touching nose to interrupt hand-flapping)

What is alternating Passive vs. Active Activities and Providing Breaks?

Arranging a client's schedule so that more passive tasks (e.g., listening to a book, working at the table) are alternated with more active tasks (e.g., gross motor activities, automatic reinforcement) and providing breaks when needed.

What is Sensory Extinction?

Making or removing the sensory consequence of a behavior (putting a long-sleeved shirt or gloves on a client who obsessively scratches his arms, placing a door stop on a door a client repetitively opens and closes to hear it slam).

What is Vestibular sensation?

Senses balance and movement and connects movement of eyes, head, and body.

What is proprioceptive sensation?

Senses where your body is in space

What are stereotypic behaviors?

Also referred to as self-stimulatory Behavior or stimming and defined as repetitive physical movements and/or vocalisations (e.g., hand-flapping, toe walking, spinning, hair twirling/pulling, nail-biting, jumping, climbing, clapping, turning lights on and off, moving objects in front of eyes, lining up items, fixating on objects or parts of objects, rewinding videos repetitively, rocking, crashing into wall/Furniture, running in circles, self-injurious behaviors, making repetitive sounds, immediate or delayed echolalia parentheses imitating sounds words phrases parentheses, and repeating lines from movies, books, songs for television shows).

What is Systematic desensitization?

Gradually providing a client with longer and longer exposures and closer approximations to feared sounds, environment, items, and or activities while encouraging relaxation.

What are behaviors surrounding Tactile stimulation?

1. Avoids textures/substances or excessively touches objects/people 2. Avoids touching messy substances or appears upset when clothing gets slightly wet or messy 3. Doesn't notice when face, hand, or body is messy 4. Eats a limited repertoire of food. mouths objects 5. Obsessed over specific clothing, appears to dislike certain clothing 6. Avoids groups or crowded areas 7. Avoids haircuts, baths, face washing, brushing teeth, combing hair, and/or clipping nails. 8. Uses fingertips instead of whole hand for activities 9. Appears over or under sensitive to pain 10. Engages in maladaptive behaviors toward others for no apparent reason 11. mouths inedible items

What are behaviors surrounding dyspraxia?

1. Difficulties performing in and acting on the environment 2. Difficulties planning and carrying out skills, non-habitual motor actions in the correct sequence 3. Difficulties learning new tasks- not receiving correct feedback of results 4. Splintered skills- the ability to learn just one task through repetition, but the inability to learn the skill set

What are the four additional Sensory stimulations?

1. Oral 2. Auditory 3. Vision 4. Praxis

What are the behaviors surrounding visual stimulation?

1. Difficulties with awareness of body in soace 2. vertigo 3. difficulty with movement and moving objects 4. Looking away or refusing to look at people or items 5. Excessively moving items across eyes 6. Staring at spinning and or moving objects (e.g., spinning a wheel on a toy car) 7. Spinning self 8. Lining items up

What are the behaviors surrounding Auditory Stimulation?

1. Ignoring or delayed responding to sounds and the voice of others (appears deaf) 2. Distractibility due to the client's inability to ignore slight noises 3. Strong adverse reactions to certain noises/objects that make noise (e.g., toilet, vacuum, blender, drill, lawn mowers) causing a fight or flight reaction 4. Putting fingers in ears or hands of ears

What are the behaviors surrounding Vestibular stimulation?

1. Low muscle tone (e.g., hyper-extension of joints, soft skins, floppy grip) 2. Seeks excessive movement, holds head upside down 3. Avoids inverting head or engaging with moving equpment 4. spins self or objects (somersaults) 5. Continually follows objects with eyes 6. Difficulty with balance 7. Appears fearful when lifted off the ground 8. Difficulty crossing midline 9. Poor ocular motor movements and eye contact 10. Poor ability to plan actions (e.g., unable to catch a ball)

What are the behaviors surrounding oral stimulation?

1. Mouthing or chewing inedible items 2. Sucking or chewing on fingers, hair, or shirt 3. Biting self or others 4. Avoiding certain textures of food 5. Seeking out or limiting self to certain types of foods 6. Overeating to the point of getting sick 7. Making sounds with mouth or tongue

What are the five senses?

1. Olfactory- Smell 2. Gustatory- Taste 3. Auditory - hearing 4. Visual- vision 5. Tactile- touch

What are some examples of stereotypic behavior interventions?

1. Sensory extinction 2. Replacement behaviors 3. Behavior interruption 4. Systematic Desensitization 5. Self-management 6. Alternating passive vs. Active activities and Providing Breaks 7. Differential Reinforcement 8. Non-contingent Access

What are the 3 power sensations?

1. Tactile Touch 2. Proprioception 3. Vestibular

What are Behaviors surrounding Proprioceptive Stimulation?

1.Bangs into walls, likes to crash or hit hard, often with disregard for safety 2. Has poor sense of body awareness 3. Appears clumsy or uncoordinated and falls or trips frequently 4. Difficulty carrying out novel movements 5. Manipulates small items too hard/soft 6. Slaps feet, toe walks, or sits on feet 7. Cannot do simple tasks with eyes closed

What is Non-contingent Access?

Providing a client with frequent non-contingent access to stimulation matching a sensory function of a stereotypic behavior as a form of antecedent satiation (e.g., providing access to sensory stimulation activities and/or breaks throughout the day).

What is Replacement Behavior?

Providing access to appropriate stimulation matching the sensory stimulation function that is equally or more reinforcing, equally or easier to produce and/or competes with a sensory stimulation (e.g., providing crunchy foods are gum to a client who obsessively choose inedible items).

What is Differential reinforcement?

Reinforcing a desired replacement behavior while withholding or masking reinforcement for an undesirable stereotypic behavior (e.g., reinforcing a client with attention/praise for appropriately answering questions while withholding reinforcement when a client repetitively echoes the question back to you).

What is Tactile (touch) sensation?

Tactile touch- senses light touch, registers touch pressure, provides information regarding personal space, protective and put to warn about pain, and alerts fight/flight response

What is self-management?

Teaching a client to provide him/herself with appropriate sensory stimulation instead of engaging in stereotypic behaviors by providing breaks or a time to engage in these activities (e.g., tent, beanbags, pillows, blankets, deep pressure).