CHAPTER 6: BEHAVIOUR THAT HURTS
Overview of Applied Behavioural Analysis
Key Points for Caregivers
People may hurt themselves (called self-injury) or other people (called aggression). Self-injury or aggression may occur because of pain, a health-related disorder, stress, as a symptom of a psychiatric disorder, or because a person lacks social skills. Medications may even make the problem worse. These possibilities must all be investigated. Challenging behaviour that starts for one reason may continue even when that reason is no longer there. Behavioural analysis looks at what needs are served by a behaviour and then finds other ways that people can meet those needs.
Functional Behavioural Analysis
Key Points for Caregivers
Functional behaviour analysis helps us understand why people continue injuring themselves or being aggressive. Three common reasons for any behaviour are that it:
- provides an escape from something a person does not like
- provides access to something a person does like
- provides stimulation that a person can create when they are alone.
When people need to escape from an activity that is difficult or unpleasant, providing a break may help. When they need access to something they value, such as favourite people, food, or activities, providing this access before challenging behaviour begins may prevent the challenging behaviour from occurring. When people are alone and need stimulation, they can be given alternatives through opportunities for them to see, hear, smell, touch, and taste.
Topography of Behaviour
Key Points for Caregivers
Challenging behaviours must be described and reported in detail so that others have a clear picture of what people are actually doing. Topography of behaviour, like topography of a geographic area illustrated in a map, describes only what is there and what we see. Topographies of behaviour do not judge value or include expectations.
Strategies to Help Decrease Self-Injurious and Aggressive Behaviour
Key Points for Caregivers
Strategies to help decrease self-injurious and aggressive behaviours provide individuals with alternative ways to meet their needs.
1. When people need to escape difficult situations, strategies can prevent escape, can offer instruction to make the situation less difficult, or can offer an alternative way to escape.
2. When people want access to stimulation they like, such as food, activities, or attention from people, strategies can make these people and things available. Strategies can include
a. card reading or saying “Help please” or “Break please” as an alternative to aggressive or self-injurious behaviour
b. presenting fewer or less difficult tasks for the individual to complete
c. breaking down larger or complex tasks into smaller steps
d. providing help and prompts to the individual at regular and ongoing points of time, only reducing help when the individual shows that he or she has mastered the skill independently
3. When people want stimulation for their senses when they are alone, strategies can offer comparable ways to experience the sensations and feelings. An example of a strategy is substituting appropriate food treats to provide alternate sensations experienced during hand mouthing.
a. regular scheduled praise from a caregiver, such as ‘Good job not …’ when challenging behaviour does not occur within a specified period of time
b. providing preferred items for the individual to interact with instead of engaging in challenging behaviour.