BEHAVIOURAL APPROACHES (OR ACQUISITIONAL FRAME OF REFERENCE)

      BEHAVIOURAL APPROACHES (OR ACQUISITIONAL FRAME OF REFERENCE)

1.      HISTORY:

·         According to Royeen and Duncan (1999), occupational therapists’ use of the acquisitional frame of reference flourished in the late 1960s and early 1970s.

·         Mosey (1986) described the acquisitional frame of reference as the linking of learning theories prominent at this time, focusing on the mastery of specific skills required for optimal performance within the environment.

·         Intervention is provided with this focus in mind, and activities given solely for the purpose of acquiring specific skills.

2.      THEORETICAL BASIS:

·         Theoretical basis : context of environment /functional behaviour/learned skills

·         The behavioural approach is based on the theory of operant learning. Its use requires acceptance of the view that behaviours (both good and challenging) are learned and that consequently manipulating the learning process can change behaviours.

·         Operant learning is one of two main types of conditioned learning, the other being classical conditioning/learning. Classical conditioning occurs when an association is formed between a conditioned stimulus (i.e. one that has no previous connection with the response) and an existing behaviour (unconditioned response) that can already be elicited by another stimulus (unconditioned stimulus). By repeated association, the conditioned stimulus becomes linked with the unconditioned response, and can produce a response that is very similar, if not identical, to the original unconditioned response; this new learned response is called a conditioned response.

·         Operant conditioning is similar in some ways to classical conditioning, but it changes behaviours by reinforcing or rewarding desired behaviours after they have occurred. Classical conditioning elicits certain behaviours in response to a presented stimulus; operant conditioning does not require any stimulus to be present to produce the desired behaviour, but relies on the subsequent reinforcement/reward to teach new responses.

·         Operant learning is particularly useful in solving specific learning or behavioural problems because change occurs through the positive manipulation of interaction and environment and the behavioural approach makes full use of this as a teaching technique

3.      ASSUMPTIONS:

·         Core assumptions

Ø  Nurture more value than nature

Ø  Therapist accepts the child unconditionally and without judgment

Ø  Competence results from learning skills

Ø  No skills is more importance than others

Ø  Repetition and practice 

·         Theoretical base assumptions

Ø  Believes that one can act and influence the environment

Ø  The therapist accepts the child unconditionally

Ø  With constant practice leads to mastery of the skills. Learning does not follow a developmental sequence    

4.      AIMS AND GOAL:

·         This focuses on the learning of specific skills that are required for optimal performance with in the environment and the mastery of these skills.

·         This addresses both motor and cognitive skills  

·         The primary goal of this FOR is the learning and mastery of the skill

5.      PRINCIPLES:

·         The behavioural approach has two main principles:

Ø  The reaction to any behaviour determines the likelihood that behaviour is repeated.

Ø  Behaviour is defined as anything that can be seen/perceived, described and measured.

·         Behaviours can be divided into challenging behaviours and skill-related behaviours.    

Ø  Challenging behaviours usually refer to previously learned inappropriate behaviours. Examples of challenging behaviours might be physical aggression, screaming or running away, but would not be frustration, anger or boredom. Challenging behaviours associated with frustration, anger or boredom can indeed occur, but only the physical manifestation of such feelings can be defined as ‘behaviour’ in this context, e.g. boredom could be measured only subjectively but verbal abuse, self-harm or falling asleep (which may be symptomatic of boredom) can be seen/perceived, measured and described more objectively.

Ø  Skill-related behaviours usually refer to performance areas where the child needs to progress developmentally. Examples of skill-related behaviours are usually functional, e.g. manual dexterity, eating and drinking, or dressing.

6.      ASSESSMENT:

{Standardized and non-standardized}

6.1.The environment

·         Many inappropriate behaviours first develop in response to inadequate environments and, although the behavioural approach can be very successful in reducing or eliminating inappropriate behaviours, the best approach (if possible) is to work to prevent their initial development.

·         The ideal environment is one that prompts and reinforces appropriate responses and behaviours, and offers varied opportunities for the child to engage in acceptable and appropriate activities.

·         The environment should also be stimulating and interesting, and actively encourage children to initiate and explore.

·         Achieving an ideal environment is made easier when living and working groups are small. Teaching areas may need to be more specifically structured to allow staff to alter the arrangement of resources to meet differing needs. Generally, the more able the child, the more visual stimuli can be included in a teaching room, but a child whose concentration is poor initially benefits from being taught in a small, functional area. When skills have developed in specific settings, the environment then needs to be changed to allow the child to tolerate progressively more stimulating environments and ultimately cope with any situation.

6.2.Observing behaviours

·         Detailed observation of behaviour is most commonly found in relation to the incidence/frequency of challenging behaviours, whereas information about functional problems tends to be gathered by planned assessment.

·         The principles of observation apply to both types of observation scenario.

·         Once behaviour has been identified as needing intervention, it must be precisely defined so that information about its characteristics and frequency can be gathered.

·         When a behaviour has been defined, the data collected from observation are useful only if there is a high level of consistency in those responsible for recording it.

·         There are various methods of gathering information, some of which are described below.

                              Continuous recording

Ø  This involves recording everything a child does within a specific period of time, which in practice is very difficult to carry out.

Ø  The main cost to this type of observation is the time needed to view and analyse the recorded material.

Ø  Continuous recording can be useful in establishing the frequency of a range of behaviours in certain children, as long as staffing levels can be temporarily increased either to observe and record manually, or to analyse the videotaped evidence.

                               Event recording

Ø  This involves recording every occurrence of a defined behaviour over a given period of time.

Ø  This is useful in comparing initial frequency with frequency after a period of intervention, and can usually be managed within normal staffing levels because data can be collected numerically.

                               Duration recording

Ø  Duration recording measures when these behaviours occur and the length of time for which they last.

Ø  This then provides a baseline for measuring whether a problem behaviour is  decreasing in duration or a new skill is being completed in less time.

                          Interval recording

Ø  This is used to discover when behaviours occur within a given period. The period (e.g. 10 min or 1 h) is divided into equal intervals (e.g. single minutes or 10-min blocks), and the observer then records whether or not the designated behaviour occurs within that period, irrespective of the number of times that it may have occurred.

                  Time sampling

Ø  In time sampling, regular times are chosen (e.g. every 15 min) and at those times the observer records whether or not the defined behaviour is occurring.

Ø  The defined behaviour can have occurred between these times, but if it is not occurring at the chosen time it is not recorded. This method is economical of staff time and can be useful in toilet training programmes, but may not always yield sufficiently detailed information.

Ø  After a suitable period of observation the data are analysed and used to help make decisions about management of the behaviour.

                           Reinforcement

Ø  Reinforcement is the agent of change in the behavioural approach and can be either given to increase the frequency of behaviour, or temporarily withheld or withdrawn to decrease the frequency of behaviour.

Ø  Giving reinforcement in response to desired behaviour is easily understood but the withholding of reinforcement must be carried out in an environment.

Ø  Reinforcement can be divided into two types: positive and negative. Positive reinforcement describes any interaction where something pleasurable is given in direct response to a desired behaviour. Negative reinforcement also describes a situation where something pleasurable is given in response to a desired action, but the pleasurable response usually takes the form of escaping from, or stopping, something that is disliked.

Ø  It is often the preferred method of reinforcement because of the following:

§  It makes the teaching environment and the teaching experience more pleasant and motivating.

§  The rewarding response always happens after the action has been completed.

§  It stops the teaching session from becoming aversive.

§  It is much easier to understand and use, which is an important consideration when many people may participate in carrying out programmes.

                                        Primary reinforcers

Ø  These are things that satisfy basic human needs, e.g. food and drink. They are the most immediately effective form of reinforcer because their value does not have to be taught, and because the giving of food and drink is a regular event.

Ø  They are particularly useful for children who have a small range of enjoyed activities or events.

Ø  Physical contact can also be seen as a primary reinforcer.

                                            Secondary reinforcers

Ø  This type of reinforcer has no value in itself and cannot satisfy basic needs but the reinforcers acquire value through their association with more pleasurable items, i.e. they are conditioned reinforcers. For example, tokens or money gain value because they can either be used to purchase desired items or lead to desired social interaction.

Ø  This type of reinforcer can be very effective, although the value often has to be taught by pairing the secondary reinforcer with a primary reinforcer, followed by the fading out of the latter.

                                              Social reinforcers

Ø  These reinforcers require the highest conceptual ability because their value depends on an understanding of abstract ideas and social values.

7.      INTERVENTION TECHNIQUES:

              Skill building

·         In the behavioural approach, specific techniques are often necessary to teach new skills.

·         Generally, most skill-building techniques use positive reinforcement, whereas many of the intervention techniques for behaviour management use negative reinforcement.

             Modelling

·         Modelling teaches new behaviours by prompting the child to copy and is therefore also called imitation.

·         Ideally, the model should demonstrate the desired behaviour while another person leads the teaching and prompts the child, but, if this is not possible, then good results can be obtained by positively reinforcing other children who model desired behaviours in front of the child being taught.

·         Children must be able to perceive the modelled behaviour accurately, and be able to achieve or reproduce it. This means that the child must be able to concentrate for appropriate periods of time and be able to imitate.

·         The model demonstrates part or all of the task, and asks the child to copy the action; if the child can independently copy the action, reinforcement is given straight away, but, if the child needs help, the desired action is prompted before reinforcement is given.

·         General use of modelling is based on the assumption that children will copy the behaviours of people with whom they work. This means that staff need to be conscious of the importance of modelling desirable attributes in appearance, attitude to work and attitude to others, and manners

Prompting

·         Prompting is a frequently used technique, and one that is common in daily life. It encourages children to perform actions by using various levels of support and encouragement. There are three types of prompts.

                                Physical prompts

Ø  This is physical guidance given in varying degrees to help the child complete an action. Physical prompts may be used, for example, to help encourage feeding or any other functional activity, and can vary from a full physical prompt to a very slight touch.

Ø  Physical prompts are even more effective when used in combination with verbal and/or gestural prompts.

Ø  There are two methods of fading physical prompts. First, support can be reduced throughout the whole task (while maintaining constant physical contact), by moving the point of prompt further away from the original position, The second type of fading out involves maintaining the same prompt position throughout the task, but breaking the physical contact at certain points.

               `                 Gestural prompts

Ø  This type of prompt uses gesture to indicate a course of action. A gestural prompt should mimic the movement required, e.g. pointing to a ball and then pointing to the person to whom it should be given, and to be really effective they should be used together with verbal prompts.

                                 Verbal prompts

Ø  A verbal prompt is simply a reminder to do something that includes relevant information, yet remains concise and succinct.

Ø  Verbal prompts are often identical to key phrases used in teaching programmes, e.g. ‘Give the ball to Tom’, and they should always be paired with gestural and/or physical prompts.

    Chaining

·         Chaining is a very powerful teaching technique because it allows complex skills to be broken down into component parts, and constantly reinforces previously learned elements.

·         To use chaining, the task first has to be broken down into its component parts with the size, range and difficulty of each part varying according to the needs of the child.

·         After this stage, two methods of teaching are available – forward and backward chaining. Forward chaining takes the component parts of the task and begins by teaching the first stage. Once the first stage has been learned, the second stage is introduced and is practised immediately after the first stage; the same procedure happens with each subsequent component until the whole task has been taught. Backward chaining takes the same task, and teaches the last stage first. Once this part has been learned, the previous stage is introduced and practised before the learned component is completed; this process is repeated until the whole task has been taught.

            Behaviour management

·         The best way to reduce problem behaviours is to eliminate the conditions that encourage them.

·         All intervention techniques assume that problem behaviours have developed because they have been inappropriately or inadvertently reinforced, and these techniques therefore describe methods of ensuring that access to whatever is reinforcing behaviour is strictly controlled.

·         Many techniques assume that attention is the reinforcing agent, and withhold that attention until appropriate behaviours are demonstrated. With any techniques of this kind, withdrawing or withholding attention inevitably makes the frequency of the behaviour increase, as the child repeatedly tries to gain attention through previously successful methods.

8.      FUNCTION AND DYSFUNCTION:

·         Function: Task need can be independently

·         Dysfunction: The task needed cannot be done independently