Opinion, Editorial and the occasional Freudian slip

Behavior analysis- is it only for autism?

ABA or applied behavior analysis is always seen as being associated with autism and particularly with children with autism. We often talk about in lighter vein to participants of workshops on ABA about how it is a set of principles that can be used to teach anybody anything- be it their spouse, mother-in-law, child or pet. It has always felt like people see that as a joke and leave it at that. They don’t really see ABA as applicable anywhere beyond autism and people who are attending workshops for ABA are there because they have children who have autism, or work with kids who have autism. And even if they do, they probably don’t care at that point because they are focused on the child with autism, whose behavior needs to be managed. Yes, ABA is all about behavior management in popular perception and children get referred to us as BCBAs when they have maladaptive behaviors. 

Recently, during a session with a couple who were going through a rough patch in their relationship, this truth hit home again. A series of events had led to a state of mutual mistrust and suspicion. There were loud arguments, days of punishing silence and accusations flying back and forth. Any attempt to get them to come together for a discussion ended up with the same set of accusations. It would gradually lead to them questioning each other on why you said the, why you did that- including instances and words uttered ten years back. Everything was seen as an insult and a slur that had scarred them permanently. Repeated efforts to get them to offer constructive suggestions to each other did not get far. Repeated explanations of what is a constructive suggestion also fell on deaf ears. 

Let’s look at what it really is. When we talk to parents of children with autism about managing maladaptive behaviors, one of the things they describe is the way they have dealt with it. They have usually said “no” when the child threw something or hit them, they have pinched the child back to show him how it feels to be pinched, hiding away objects that can provoke behavior, they have distracted the child and offered him exciting stuff to stop the behavior. Another thing many parents talk about is the way sneak out of the house when they need to go to something as routine as office, because the child will scream and cry if he saw dad or mom leave the house. They hide away toys that the child engages with as soon as it is seen as repetitive or inappropriate, like when he spins the wheels of a car for example and watches that for a while or insists on using building blocks to make the same pattern every day. It is seen as a behavior representing autism and hence the toys are put away. Or what about the parent who specified the following as short-term goals- the child should not spit, scream or throw objects. 

What is common in all these scenarios? Every one of them is about preventing the child from doing certain things, either verbally of by physically hiding objects and people. It is all about preventing the behavior from occurring, that forgets the most important principle of human behavior- every behavior is lawful. This principle implies that the child is engaging in a behavior for a reason, and it also follows then that saying ‘no’ or putting away the toy or worse pinching him back, so he knows how it feels do not remotely address the reason for which the child is engaging in the behavior. 

So, lets look at what is constructive suggestion, technically called replacement behavior. Let’s go back to the couple who were not seeing eye to eye. After repeated attempts, they got down to defining what they want to see in each other, in terms of actions, and verbal expression. It was not easy so they listed everything that the other person was not doing right or not doing at all and they then listed what the behavior should be on the other side. So they generated a series of antonyms that stated what the other person can do differently to make their relationship better. The entire tone of the therapy sessions changed dramatically after this exercise. The partners knew what the other person wanted and that helped them find a path through what was earlier sucking them in like quicksand. 

When it comes to being a parent of any child, not necessarily one with autism, the instinctive response to certain behaviors is a resounding ‘NO’. While it temporarily puts the behavior on hold, it will be back with a bang because the cause has not been addressed, nor an equal but more acceptable behavior been taught. If parents instead made a list with the current behaviors and what the child should do instead against each other, then the child is learning a skill, learning an alternate behavior and is not hearing just a no. The child who is screaming, hitting, and throwing objects clearly needs an alternate behavior like communication maybe? Every situation in life presents with alternatives- criticism, finger pointing, anger, refusal or an alternate behavior that is just the opposite of the existing one. Instead of consistently focusing on the negative behaviors, can we start focusing on the positive alternate? Choosing the constructive option gives everyone a chance to change relationships. Just criticism yields no change and no learnings. It just sours the relationship.