Over the last few weeks I’ve been increasingly asked about supporting and reducing self-stimulatory behaviour (i.e repetitive behaviour functioning to gain a physical, visual, auditory, tactile stimulation automatically when the behaviour occurs such as repetitive skin scratching to gain tactile stimulation etc). I thought I would share some key considerations when designing intervention using a Positive Behaviour Approach.
Firstly, Does The Behaviour Need To Be Reduced?
We may be asked to support in reducing the behaviour by a parent, teacher or support worker or the individual themselves, however this doesn’t necessarily mean that we need to intervene. Using a positive behaviour approach, we firstly check what impact the behaviour is having on the person’s quality of life and only plan to intervene if the behaviour is disruptive to the person’s access to learning, community or social interactions or damaging to the person’s health and wellbeing. We all do annoying things at times to gain self-stimulation such as humm or tap a pen but it doesn’t mean the behaviour should be reduced. However, if the behaviour is disruptive to the persons learning, such as excessive rocking on the chair resulting in being unable to focus on work, or the behaviour is restricting access to community events (such as constant loud vocalizations resulting in not being allowed to go to the cinema or on the bus) then the behaviour may be targeted for reduction if it is a priority at that time as there may be bigger priorities affecting the persons quality of life at that time that take priority at the time.
Is The Behaviour Functioning For Self-Stimulation?
Just because it looks like a duck it might not be one! A behaviour may look like a self-stimulatory behaviour (such as rocking, spitting etc) but it might not be so, the behaviour may actually be functioning to get your attention, get you to stop placing demands, increase the likelihood or preferred activities or toys being given etc. therefore, functional assessment of the behaviour is needed.
Notice When You Are Thinking Reactivity And Resist The Temptation
Don’t focus on closing the barn door once the horse has bolted – the temptation is to focus on what to do once the behaviour happens, often i am asked by, understandably, desperate teachers and parents – what do i do when he spits, what should i do when he rocks, what should i do when he makes loud vocalizations in the community.
If the behaviour is functioning to gain self-stimulation then by the time the student has done the behaviour they have already got reinforced for it (as the reinforcer is automatic when the behaviour occurs, i.e they have got the auditory feedback from the loud vocalization or they have got the visual or physical stimulation from rocking etc). Therefore, while you can design reactive strategies to redirect from or prevent further self-stimulation this is not getting at the heart of the matter and won’t reduce the behaviour properly. The focus must be on proactive intervention.
Firstly, consider why does the person need to get self-stimulation in this way? From a PBS standpoint, we are looking at how to increase the person’s quality of life and as a by-product observe behaviours which challenge reduce. A perfect example for self-stimulation is to think about “plugging the gap” that self-stimulation is currently filling, work on filling the client’s day with meaningful activities and leisure to reduce the need to fill time with self-stimulation this may take time to teach and may need structuring. It’s important to also look at the specific reinforcement the person is seeking from the behaviour is it visual, auditory, tactile or movement sensations they are seeking and how can you enrich their environment with plenty of this type of activity and better yet teach them to get this type of stimulation in new ways. Additionally, teaching someone when they can and can’t access this type of stimulation may be needed along with self-management skills such as recognizing when they are doing the behaviour and the impact on others.
As with all PBS interventions the focus is not on how to stop self-stimulatory behaviour, instead the focus is on how to increase the person’s quality of life, teach new skills and see a reduction in behaviours which challenge because the person is more engaged, skilled and able to cope with the world around them appropriately.
Consultation with a behaviour analyst is essential a functional assessment and consideration of the specific setting and variables is needed before intervention.