Part 1: Behavior Management in Speech and Language Therapy

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Who hasn’t had a client / patient / student crawl under the therapy table and refuse to come out? Or hit, yell, and pinch instead of using functional communication? We are willing to bet that most SLPs (especially those who work in pediatrics) have come across behavioral challenges at some point in their careers.  That’s no surprise - the comorbidity of communication disorders and behavior challenges is high and is documented in the literature across different ages and disorders.   ASHA acknowledges this, and suggests that SLPs may find behavior management strategies and components of applied behavior analysis “effective compliments to their own communication interventions” (ASHA, n.d. https://www.asha.org/njc/applied-behavior-analysis-and-communication-services).

We all have a solid bag of tricks to use when a client / student won’t come out from under the table - star charts, prize boxes, etc.  But what happens when it doesn’t work? What if the unwanted behavior is having a significant negative impact on your client’s ability to make effective and meaningful progress? Having a deeper understanding of the science behind behavior management can make a huge difference in therapy.  Not only can it help reduce unwanted behavior during your session, but it can make your client / student more available for learning, which will make your intervention that much more effective. 

In this episode we provide a cursory overview of some basic behavior management principles related reinforcement.  Our goal is that our listeners can apply these basic principles to their current behavior management strategies and tweak them as needed to be more effective.  We feel pretty strongly about this topic and couldn’t fit it all into one episode.  Stay tuned for Part 2 where we discuss antecedent management strategies and review common behavior management techniques. 

Learning Outcomes:

  1. Identify at least two distinguishing factors between reinforcement and punishment

  2. Identify at least two different types of reinforcement

  3. Describe at least 1 method for choosing reinforcement and describe at least two schedules of reinforcement

Stay tuned for Part 2 where we will cover:

  1. Identify at least 2 differences between components of antecedent-based interventions and consequence-based interventions

  2. Identify at least 2 ways in which antecedent-based interventions can help improve client behavior during SLP sessions

  3. Identify at least 2 commonly used behavior management strategies and the science behind them

References

Cooper, J., Heron, T. & Heward, W., 2020. Applied Behavior Analysis. 3rd Ed. Upper Saddle River, Nj: Pearson

Duerden, E. G., Oatley, H. K., Mak-Fan, K. M., McGrath, P. A., Taylor, M. J., Szatmari, P., & 

Roberts, S. W. (2012). Risk Factors Associated with Self-Injurious Behaviors in Children and Adolescents with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 42(11), 2460-2470. doi:10.1007/s10803-012-1497-9 

Dunlap, G. (2005). Clinical Issues: Positive Behavior Support: An Overview. Perspectives on Language Learning and Education, 12(1), 3-6. doi:doi:10.1044/lle12.1.3

Johnston, J. M., Foxx, R. M., Jacobson, J. W., Green, G., & Mulick, J. A. (2006). Positive behavior support and applied behavior analysis. The Behavior analyst, 29(1), 51-74. doi:10.1007/bf03392117

Karasinski, C. (2013). Behavior Problems and Social Functioning in Adolescents With Language Impairment. Perspectives on Language Learning and Education, 20(2), 36-43. doi:doi:10.1044/lle20.2.36

 Keller-Bell, Y., & Short, M. (2019). Positive Behavioral Interventions and Supports in Schools: A Tutorial. Language, Speech, and Hearing Services in Schools, 50(1), 1-15. doi:doi:10.1044/2018_LSHSS-17-0037

Online Resources

 ASHA resources on ABA: 

https://www.asha.org/njc/applied-behavior-analysis-and-communication-services/

Building rapport

https://pro.psychcentral.com/child-therapist/2019/12/building-rapport-a-way-of-looking-at-strengthening-relationships/

Disclosures:

Kate Grandbois financial disclosures: Kate is the owner / founder of Grandbois Therapy + Consulting, LLC and co-founder of SLP Nerdcast.  Kate Grandbois non-financial disclosures: Kate is a member of ASHA, SIG 12, and serves on the AAC Advisory Group for Massachusetts Advocates for Children. She is also a member of the Berkshire Association for Behavior Analysis and Therapy (BABAT), MassABA, the Association for Behavior Analysis International (ABAI) and the corresponding Speech Pathology and Applied Behavior Analysis SIG. 

Amy Wonkka financial disclosures: Kate is an employee of a public school system and co-founder of SLP Nerdcast.  Amy Wonkka non-financial disclosures: Amy is a member of ASHA, SIG 12, and serves on the AAC Advisory Group for Massachusetts Advocates for Children.

Time Ordered Agenda:

10 minutes: Introduction, Disclaimers and Disclosures

20 minutes:  Descriptions of the differences between reinforcement and punishment

15 minutes:  Descriptions of the different types of reinforcement

10 minutes:  Descriptions of methods for choosing systems of reinforcement

5 minutes: Summary and Closing

Disclaimer

The contents of this episode are not meant to replace clinical advice.  SLP Nerdcast, its hosts and guests do not represent or endorse specific products or procedures mentioned during our episodes unless otherwise stated.  We are NOT PhDs, but we do research our material.  We do our best to provide a thorough review and fair representation of each topic that we tackle.  That being said, it is always likely that there is an article we’ve missed, or another perspective that isn’t shared.  If you have something to add to the conversation, please email us! Wed love to hear from you!

This course is offered for .1 ASHA CEU (Intermediate Level, Related Area)

This course is offered for .1 ASHA CEU (Intermediate Level, Related Area)

 

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Part 2: Behavior Management in Speech and Language Therapy

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