ADHD: Changing a behaviour? How about teaching a new one instead?

Often parents and teachers approach me with questions about changing, or more specifically, getting rid of, a behaviour that is driving them crazy, disrupting their family or classroom, or maybe even dangerous!

I'd like to start by describing a very formal procedure we use in the schools when dealing with a problematic behaviour, and take it from there.

Sam, an 8 year old boy who becomes upset when given math work often rips it up, hides it, or just starts acting out by disrupting other students. His teacher says he's "just trying to get away with it! He knows he can do it, he just doesn't want to!"

Following the philosophy of Dr. Green, I try to think "kids do well when they can" rather than "kids do well when they want to." And I wonder about why he might not be able to do well. I assume Sam would rather complete the work and get a good grade and bring it home to show his parents. Something is keeping him from doing that. And that's the first of two interventions we are going to engage Sam in. This one we call the environmental intervention. We ask "What allows or causes Sam to engage in this behaviour?" It's tempting to think that more punishment, stricter rules or some other form of control will help, but that is usually not the case. Such interventions, if they would work, would already have worked.  We want to check out the environment and make some decisions. This often includes academic testing. More often than not students object to academic work because it's at the wrong level. Too hard, or maybe too easy. If that's the case we change the work to meet his ability level. That means Sam can do whatever work we give him at about an 85% level of efficiency. We call this his level of "efficacy." It's that point where doing the work is easy enough to not cause stress, but not so easy as to be boring or meaningless. This is especially hard to do in today's classrooms where everyone is suppose to operate at exactly the same level! Even though we know there are hugh developmental differences between students in every class. At any rate, we try to determine what in the environment allows this to happen, or makes it happen. With his math it may be the work is too hard, so we change the work to meet his level of competence. It might also have been he has ADHD and can only focus for 15 minutes before becoming distracted. So, we might set a timer for him to react to and come and get feedback. Or simply shorten the work by making a line that says "get here, see me" so that he comes to the teacher for feedback.  Sometimes a student may get in arguments on the playground because he isn't supervised. What allows his behaviour to happen? A lack of supervision. So we either provide it or we put him in a more successful environment. That's step one. We figure out what environmental changes we need to make to reduce Sam's need to engage in the behaviour. And we mean positive, support based changes.

But that isn't the end of the problem. We need to also understand the specific function of the behaviour to teach a new skill that helps Sam meet that goal next time in an appropriate way. We do what is called a Functional Behaviour Analysis (FBA). We observe Sam and try to figure out WHY he doesn't do his math. What is the function of his behaviour? He makes noises and disrupts to? In this case we determine he does this to avoid work he finds difficult.

Yes, we have changed the work so it's difficulty level is reduced, but step two of changing a behaviour is teaching a new skill that meets the function of the previous behaviour. In this case Sam was avoiding difficult work. Instead of avoiding difficult work by being disruptive we might teach him to ask for help. We could do this any number of different ways. We might start assignments by having Sam look them over and asking one question that will make it easier. We might give him "question tokens" he can use to ask for help, or give him yellow tabs he can attach to any piece of work and use to get rid of the work and complete it at another time with the help of a classroom aide. Every day he gets three stickers he can place on work he is having difficulty with and place it on the teacher's desk. When the aide comes in she takes Sam aside and quickly and painlessly (a key element) helps him get his work done and answers questions.

The key point here is that we are teaching Sam what we call a Functionally Equivalent Replacement Behaviour. Previously, when confronted with something he found hard and difficult, he acted out and disrupted the class. Now when confronted with something he finds hard and difficult he knows how to ask for help. He still is avoiding doing the work alone. But we all do that. Think of how many times a difficult project at your job was given to a committee and divided up. It's an appropriate replacement behaviour. And we can't make the behaviour go away by changing the work and be satisfied, because the real problem was Sam's behavioural response to this kind of situation. Now we have taught him a new skill.

This is how to deal with almost every behaviour of concern. You make environmental changes to reduce the need to engage in it, and then you teach a new functionally equivalent replacement behaviour. For an excellent, complete and FREE set of training materials for yourself or your school you can go to the State of California's PENT (Positive environment Network of Trainers) site. There you will find complete programs for working with children in the schools, for training teachers and for completing a Functional Behaviour Analysis. Their site is located here.

This blog isn;t written to teach you everything you need to know about dealing with school or home behaviours. But I do hope it helps you understand that there is a formal way to look at, understand and intervene in schools. And if your child is having behaviour problems, especially if they are "coded: H or R, ask your school "Where is the FBA?" You want to make sure both of these important components of a behavioural intervention are present.

For more information on children and behavioural issues you can visit my web site at www.relatedminds.com