Parents, teachers, and others working with children with autism often want the answer to the question “What should I do when he hits, kicks, screams, bangs his head, etc.?” The answer to that question takes some assessment; but as BCBA’s, we would try to figure out why the child was engaging in those behaviors and tell the parent to just not let him get what he wants when the behavior is happening. For example, if the child tantrums because he doesn’t want to do his homework, then making sure he finishes his homework would be part of the advice. Although that sounds logical and there is certainly a strong research base for that advice, it often doesn’t work in practice, and can potentially make the problem worse–much worse.
We know that virtually all problem behaviors have a logical reason for occurring. In other words, if the child is engaging in problem behaviors, it is likely benefiting the child in some way—usually multiple ways. For example, when the child engages in problem behavior, adults probably do a lot of things to “calm them down.” This might include things like giving them more time in preferred activities, not requiring them to do non-preferred activities, and interacting with the child in preferred ways. Of course, we know in the long run it is likely that some combination of these adult behaviors results in more problem behaviors over time.
Therefore, it seems logical that one of the first things we teach parents, paraprofessionals, teachers, and others is to simply “not give them what they want” or “don’t reinforce the problem behaviors.” When the child is having a tantrum, don’t give them what they want. Simple, right? Now, that’s rarely a strategy that is recommended in isolation. While avoiding reinforcing the problem behaviors is considered a critical component, additional treatment strategies like teaching communication and reinforcement for appropriate behaviors are almost always included in behavior plans.
If the above is done in a laboratory or highly controlled setting, it works. It works extremely well. But in practice, it often doesn’t. That’s because when the problem behavior isn’t effective for the child, the first thing that happens is the intensity increases. The common warning is “It gets worse before it gets better.” In practical settings, this almost always results in at least some compromise on the part of the adults, at least occasionally. That is much worse than just giving the child what they want right away. Now, you have taught him unless you take it to 11, you don’t get what you want. It also can ruin rapport, relationships, and get kids kicked out of schools, daycares, and other settings. And there is now research that suggests maybe that approach isn’t needed.
Early in my practice, I was very skeptical that this was an essential component of treatment. I wrote a paper for publication (which was rejected) arguing that the research didn’t fully support this practice. All the research showed is that when the reinforcement for engaging in problem behavior versus the preferred behavior was equal, treatment usually wasn’t effective. Reinforcing problem behavior less efficiently than preferred behavior might be effective, but it hadn’t been tested. The paper was thoroughly skewered by reviewers. I took that rejection in stride and had long forgotten about the idea after the paper rejection. But many years later, other researchers demonstrated what I had only hypothesized. It turns out my early hunch was exactly correct; you may not have to completely avoid reinforcing problem behavior. I made a mistake giving up on the idea because it is incredibly useful in practice.
This is an exciting finding. One of the most difficult to implement procedures, which causes huge negative side effects and produces negative responses from parents, teachers, and other non-professionals, may not even be necessary. Of course, more research is needed. We don’t know if this would work in every case. Still, teaching skills that work in the real world is what matters. In most cases, a bit of reinforcement for problem behavior while teaching new skills will not ruin the effects. It might even be helpful if it keeps kids in school, prevents injuries to clients or staff, and maintains rapport with clients and other stakeholders.