Whenever I write about something that has worked with Janey, I feel I have to say that I can't promise it will still work a day later, to say nothing of anything longer term than that. But today's little triumph was very interesting to me, and I wanted to share it even if it doesn't last.
This all got started after I wrote a despairing post on my Facebook page that is a companion to this blog, about Janey screaming over and over and how it made it so impossible to get out of the house. One of my great Facebook friends, Audrey, posted a link to this site, which talked about a method using a clicker of reinforcing good behaviors in lower functioning kids with autism. The click clearly tells them they have done a good job, and they get a reinforcing treat for that, eventually not every single time, but after a certain number of good times. The article was followed by some pretty extreme comments by people that didn't like this method at all, and felt it was treating the kids like "animals", but I didn't feel that way. It seemed like a pretty mild and easy way to tell kids they were doing well, by making a sound that wasn't used for any other reason and then by reinforcing good behavior, like "quiet mouth" (not screaming)
However, the problem with this method for Janey is nothing really works as a positive reinforcer on a long term basis. She doesn't have any food she always likes that can be easily given as a treat, she doesn't care about stickers or little toys or anything like that. And I am not sure she'd get having to wait for more than one instance of good behavior for a treat. Thinking about it, I realized her favorite reinforcer is just plain praise, given in a way that's part of a bit of a ritual. Lately, when she's done something very good, I say "Great job! High five! Thumbs up! A-OK!", and give her a high five, a thumbs up and a symbol of A-OK with my fingers. She loves that.
So, I waited until a minute she wasn't screaming, and said "Great job not screaming!" Then I went through the whole routine. I did that about 10 times in a row, keeping on saying what a great job she was doing not screaming. And then I waited, and didn't have to wait long, for her to ask the question she asks a million times a day "Want to go to Maryellen's house?" If I say no to this request to go to my friend's house, she screams. So this time, when she asked it, I said "I'm going to say no, and if you don't scream, I will say 'Great job not screaming!' and give you a a high five and thumbs-up and A-OK!" I then said "No, we can't go to Maryellen's house" and without any time in between for her to start screaming, immediately started the praise routine. She looked surprised and kind of pleased. I said "Let's try it again! Ask again to go to Maryellen's house!" which she looked positively startled to hear, as usually I try to discourage that repeated question. She asked again, and I again did the praise routine. We did this over and over, each time leaving a little more time for her to maybe scream after I said no, but she didn't!
I was worried when she asked again a few hours later, it wouldn't work, but she asked with a look in her eyes that let me know she was waiting for the fun praise routine, and I gave it to her. She did the same thing about 10 more times later in the day, and every time, she didn't scream. I felt a rare feeling of having actually accomplished something with her. Maybe I've turned a question that had become a ritual of anger into a fun ritual.
Janey has been cheerier this afternoon than she has in a few days. I think I might have finally found something she actually does get reinforced by, and it's not so much praise, although that's a part of it, as it is a set routine. I have been letting her set the routines, and they were not routines I wanted. I think I need to try to set the routines and rituals myself, at least some of the time, and try to make them positive ones.
We'll see if this keeps working!