If you are looking for behavioral services or resources:

A successful behavior intervention helps to make undesired behavior(s):

• irrelevant (so there's no need to do it);

• inefficient (so there are easier ways to get what you want); and

• ineffective (so the problem behavior(s) no longer work to produce the desired outcome). (Roberts, 2017)

For meaningful and lasting reduction, the individual needs to learn either:

• A new replacement skill, or

• A more effective version of a skill they already have

The replacement skill must be:

• Easier than the problem behavior

• Faster than the problem behavior

• Reliable in getting the need met

• Reinforced consistently by staff

• More socially appropriate and acceptable

ABA services are best indicated when a primary need is:

• the assessment, treatment, development, and/or refinement of socially significant behavior(s)

• Any of the following:

  • • addressing skill acquisition

    • adaptive functioning

    • communication

    • safety

    • challenging behavior

• caregiver training tied to treatment goals, or behavior function.  

ABA guides collaborative support decisions about clinically necessary treatment to develop, maintain, or restore functioning for individuals with complex needs. (https://www.casproviders.org/asd-guidelines/)

However, ABA Services IS NOT respite care.  In other words:

• Those looking for respite care will lean more towards: “We are looking for and need safe supervision and a break so we, the caregivers, can function.”

• Those looking for ABA will lean more towards: “We need a behavior plan to help us currently manage an undesired behavior and also to produce lasting, long-term effects for an individual.  We're looking for skill-building programs, communication/adaptive goals, safety intervention, and/or caregiver training tied directly to measurable behavior change that can lead to more independence and options for someone I love.”

More specifically,

Respite care is best indicated when the primary need is temporary/intermittent supervision or relief for the family/caregiver. One pediatric respite study defined respite need as whether the family needed someone to care for the child so the caregiver could do other things; regional respite tools similarly define respite as intermittent relief/supervision, not daycare or full replacement care. (Nageswaran S. Respite Care for Children With Special Health Care Needs. Arch Pediatr Adolesc Med. 2009;163(1):49–54. doi:10.1001/archpediatrics.2008.504)

A person may need both when caregiver strain is high, and the individual has persistent challenging behavior, safety risks, or major adaptive-skill deficits.

A behavior plan can help reduce the intensity, duration, or frequency of challenging behavior, especially when people in the individual's environment make environmental changes and respond consistently. These strategies are important, but they are usually not enough by themselves to create long-term behavior change. If no new skill is taught, the individual will not likely learn a better way to get their needs met. The challenging behavior will most likely continue to be the most effective way for them to:

• Escape a demand

• Gain attention

• Access a preferred item or activity

• Communicate their comfort or discomfort level

• Express frustration

• Manage emotions such as anxiety or feeling overwhelmed

When behavior is only managed versus teaching a new skill, a behavior may improve only when the environment is controlled or when familiar people respond "correctly."

✨A New Skill or More Consistent Use of a Skill They Already Have is Necessary ✨

A Replacement Skill - Most Likely Result

If no new skill is taught, the individual has not learned a better way to get their needs met. The challenging behavior may still be the most effective.  When only the environment is changed, and those in the individual's life are trained to respond, the plan may depend too heavily on them doing everything correctly.  This can feel like a constant balancing; you're always trying to avoid walking on eggshells. As a result, the behavior may improve only when the environment is controlled or when familiar people in the individual's life, in all areas, contexts, and settings, respond in a very specific way that the individual grows to understand, becomes accustomed to, and becomes dependent on to function.

Consistent opportunities are necessary to strengthen a new skill; a behavior is more likely to return when:

• New/unfamiliar people are present

• The environment changes

• Demands increase

• The individual is tired, sick, hungry, stressed, and/or overwhelmed

• !!!The problem behavior continues to work faster than any appropriate response (i.e., desired response)!!!

In this case, a good behavior support plan may reduce temporary escalations but most likely will not produce long-lasting behavior reduction.

Environmental modifications and training for people in the individual's daily environment can help by:

• Reducing known triggers

• Making the setting calmer and more predictable

• Preventing behaviors from escalating

• Helping ALL staff respond consistently before, during, and after the behavior

• Lowering the intensity or frequency of behavior in specific settings

• Improving safety for the individual, peers, and staff

These changes can be very effective for behavior management, especially in the short term.

Environmental changes can set the stage (i.e., create better conditions) for learning, but alone do not guarantee a new skill is learned.

Examples may include:

• Reducing noise or distractions

• Changing the schedule to prevent overwhelm

• Offering choices throughout the day

• Giving more wait time

• Responding calmly and consistently

• Making preferred items or activities easier to access appropriately

• Reducing wait time to receiving access to a preferred item, person, or actvity

These changes may help the individual experience fewer triggers and may give them more chances to use appropriate behavior. However, the learning is incidental because staff are not directly teaching, prompting, practicing, and reinforcing a specific replacement skill each time.

Resources

Behavior Pathway Chart

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