Based On Interviews With Annie's Parents And Direct Observat

Based On Interviews With Annies Parents And Direct Observation In Ann

Based on interviews with Annie’s parents and direct observation in Annie’s home and school, the first behavior to target is skin picking. When Annie picks her skin, she uses the forefinger of one hand to scratch and dig at the skin of her arms and legs. She has only been observed to pick at the skin on her arms and legs. The behavior occurs mostly during down times: while waiting, while watching television, while in her bedroom alone. A brief functional analysis was conducted and revealed that skin picking never occurred during attention, escape, or tangible conditions. The behavior only occurred during alone conditions. The second issue of concern identified by the parents and confirmed via observation is Annie’s lack of functional speech. After consulting with Annie’s speech pathologist, it was determined that Annie is capable of vocal speech. She echoes simple words spoken by others and has a strong echoic repertoire of one-syllable words. She does not currently use vocal speech to get her needs and wants met or to identify things in her environment. During the observation, there were multiple occurrences of Annie pulling her mother and father into the kitchen and pointing at the refrigerator. If her parents did not guess what she wanted in the first or second try, Annie would jump up and down and start screaming, getting louder and louder until her parents guessed correctly. This episode went on for as long as 10-15 minutes. Her parents report that Annie’s favorite foods are pretzels, raisins, cheese crackers, apples, and grapes. They said that they can get her to “do almost anything” for some grapes. She also likes to drink chocolate milk and apple juice. For fun, she plays with toys and watches television. Her favorite toys are little animals and little dolls (she collects them), tiny furniture. Her parents report that Annie loves “tiny” things. When she watches television, she usually watches Teen Titans Go or Littlest Pet Shop. She has an iPad her parents control her access to. She sometimes watches YouTube videos on her iPad. She also enjoys swimming and swinging outside. Referral Parent/Guardian Name(s): Juan and Maria Rodriguez Client name: Annabelle “Annie” Rodriguez Client Age: 7 Gender: Female Current diagnoses: Moderate Intellectual Disability, Autism Spectrum Disorder, GERD Brief description of behaviors of concern: Annie’s most frequent and most worrisome behavior is skin picking. She picks at her skin using her fingers and creates open sores on her arms and legs. At any given time, she has several open sores on her body. This has led to skin infections in the past. She often does this when she is watching television or alone in her room. The second concern is her lack of speech. She is able to repeat words she hears others say, but does not initiate communication on her own. If she gets frustrated, she will jump up and down and scream until someone figures out what it is she wants. She usually leads people around the house and points at things if she wants something. It is getting harder and harder to understand what she wants. Assessment for the behaviors identified in the referral (See Referral Form and Brief Summary of the Functional Behavior Assessment). You are ready to begin your intervention plan, but you need to get the parents’ approval first. In a meeting with the parents, you describe your behavior intervention plan and provide a rationale for your intervention choices. Question Behavior Excess for Decrease: Skin Picking Operationally Define the target behavior by writing a 1–2 sentence that meets all of the following criteria: Observable Passes the “Dead Man’s” test and the “stranger” test Uses no labels or hypothetical constructs Explain the difference between habit behaviors and behaviors controlled by social reinforcers. Include examples. Explain how you plan to implement all four components of habit reversal with Annie. Include a specific competing response. Explain why you expect this procedure to be effective, including a description of the applicable behavioral principles that explain why habit procedures work to reduce habit behaviors. Including a description of the applicable behavioral principles that explain why habit procedures work to reduce habit behaviors. Question Behavior Deficits for Increase: The Mand and the Tact Begin by explaining to the parents the difference between the behavioral view of language and the cognitive view of language. Accurately represent the behavioral view of how language is learned. Define the two verbal operants you plan to teach, i.e., the mand and the tact. Clearly differentiate between the two by providing examples for the parents. Your definitions should include the controlling antecedents and consequences for each verbal operant. Identify which verbal operant you will teach first and explain your rationale for this choice. Explain your procedures for teaching each verbal operant. Include details of what a typical teaching session would look like. In your description of how you will teach a mand, identify: A specific mand to teach How you will set up the relevant motivating operation A description of how you will use shaping to teach the new verbal operant Include how you will prompt and differentially reinforce the mand (identifying the reinforcement to be used). How you will fade your prompts In your description of how you will teach a tact, identify: A specific tact to teach How you will set up the relevant discriminative stimuli A description of how you will use shaping to teach the new verbal operant Include how you will prompt and differentially reinforce the tact (identifying the reinforcement to be used). How you will fade your prompts Reference Cooper, J. O., Heron, T. E., & Heward, W. L. (2019). Applied Behavior Analysis (3rd ed.). Pearson Education (US).

Paper For Above instruction

Title: Behavioral Intervention Plan for Addressing Skin Picking and Enhancing Communicative Skills in a Child with Autism Spectrum Disorder

Introduction

Children diagnosed with Autism Spectrum Disorder (ASD) often exhibit challenging behaviors such as skin picking, which can lead to medical complications, and exhibit deficits in functional communication, which impairs their ability to express needs effectively. This paper presents a comprehensive behavioral intervention plan aiming to reduce Annie’s skin picking behavior and increase her functional speech, specifically focusing on teaching her to mand (request) and tact (label) appropriately. Grounded in applied behavior analysis (ABA) principles, the intervention combines habit reversal techniques to diminish skin picking and behavioral techniques to promote effective communication.

Operational Definition of Skin Picking

Skin picking is defined as the repetitive use of the fingers to scratch or dig at the skin of the arms and legs, resulting in open sores. This behavior is observable, consistent, and passes the “dead man’s” test, as no one can pretend to perform it. It occurs predominantly during times of solitude and low stimulation, such as when Annie is waiting, watching television, or in her room alone. The behavior has been confirmed through functional analysis to be maintained primarily by automatic reinforcement, as it occurs during alone conditions without social reinforcement.

Habit Behaviors and Socially Reinforced Behaviors

Habit behaviors are automatic, stereotyped actions often performed without conscious awareness, typically maintained by automatic reinforcement. For example, nail-biting or hair-twisting are habits that are triggered by internal states like boredom or anxiety, and they tend to persist even without external social consequences. In contrast, behaviors controlled by social reinforcers are directly maintained by environmental responses such as attention, praise, or tangible rewards. An example would be a child calling for attention or requesting a toy through speech (mand), which is reinforced by the social response.

Implementation of Habit Reversal for Skin Picking

The habit reversal procedure involves four main components: awareness training, competitive response training, motivation strategies, and generalization procedures.

First, Annie will be trained to become aware of her skin picking episodes by using self-monitoring techniques, such as a checklist or a token system to increase her awareness. Second, a competitive response—specifically, softly clenching her fists or engaging her hands in a way that prevents skin picking—will serve as a competing response, making the skin picking behavior physically difficult to execute.

Third, motivation strategies include providing positive reinforcement for periods without skin picking, such as praise or access to preferred activities, which reinforce her effort to replace the habit. Finally, generalization strategies involve practicing these techniques in various settings (home, school) to promote maintenance of treatment gains.

The behavioral principles underlying habit reversal are based on the concept that actively substituting a competing response reduces the likelihood of habit behaviors by occupying the available response space and creating an incompatible behavior. This technique leverages the principles of classical and operant conditioning—specifically, response prevention and reinforcement—to diminish automatic stereotyped behaviors.

Behavioral Strategies to Increase Communication: Mand and Tact

The behavioral view of language emphasizes that language acquisition occurs through learned associations between stimuli and responses, reinforced by social consequences. It contrasts with the cognitive view, which posits that language development is internally driven and innate.

In ABA, the two primary verbal operants targeted are the mand and the tact. A mand is a request driven by a desire or need, controlled by motivating operations that increase the value of specific reinforcers and reinforced through immediate access to the requested item or activity. For example, teaching Annie to say “more grapes” when she wants grapes involves establishing a motivating operation where prior deprivation increases her motivation to request this item. The teaching involves shaping approximations of the mand by prompting closer responses and reinforcing the correct response with access to grapes or preferred snacks.

The tact, on the other hand, involves naming or describing items or events in the environment, controlled by discriminative stimuli that signal the availability of that label, with reinforcement provided for correct labeling. For example, prompting Annie to say “dog” when she sees a picture or toy dog and reinforcing her with social praise or access to the toy.

Teaching the Mand

Initially, the focus will be on teaching Annie to mand for grapes, as it is a highly motivating item. To establish the mand, a motivating operation will be set up by slightly depriving Annie of the item, creating a motivating context. A shaping procedure will be employed, starting with approximations—such as pointing to the grapes or vocalizing “Grapes”—and gradually reinforcing closer approximations until she produces a clear “more grapes” request.

Prompting will include model prompts, gestural prompts, and partial verbal prompts, used in a fading hierarchy to promote independence. Reinforcement will consist of immediate access to grapes, which will motivate her to use the verbal response consistently. Prompt fading will involve gradually reducing gestures and models, encouraging Annie to produce the mand independently.

Teaching the Tact

The tact will be taught by presenting Annie with her favorite toys or pictures of animals and objects (e.g., the tiny doll, the dog picture). Discriminative stimuli will include visual cues such as pictures or tangible items. Shaping will involve reinforcing her initial attempts at labeling, even if incorrect, and reinforcing accurate labels with social praise and access to the item. Prompts will include gestural or verbal cues, which will be systematically faded over time to foster independent tacting responses.

Typical Teaching Sessions

A typical session will include providing motivating stimuli, prompting responses, reinforcing successes, and gradually fading prompts. The session will be brief, about 10-15 minutes, to maintain engagement. The therapist or parent will start with one stimulus—either for mand or tact—then alternate between the two, ensuring that Annie experiences reinforcement and success with each verbal operant. Consistent implementation, reinforcement, and prompt fading strategies are critical for effective acquisition of these communication skills.

Conclusion

By applying habit reversal techniques to reduce skin picking and systematically teaching Annie to mand and tact, this intervention plan aims to reduce harmful behaviors and promote functional communication. The success of these strategies relies on the behavioral principles of reinforcement, response competition, prompt fading, and stimulus control, which have been shown to be effective in modifying both stereotyped behaviors and language deficits in children with ASD.

References

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