Tuesday, January 1, 2013

Behavior Management 101: Topic 1

 Behavior Management in a Typical speech therapy session (remember, as a private practice therapist I usually work one-on-one, but I also run small social skills groups with 2-6 students; so I will try to include strategies applicable to both settings).  Some ideas will be mine, some will come from other sources and I will "try" to give credit where it is due.  But, after having been an SLP for 30 years I have simply incorporated good ideas with no remembrance of where I found them.

Use visual reinforcements - Very young clients (3-4 years old) or those with short attention spans often have difficulty focusing on a task, especially articulation drills, for a full 30 minute session.  So I will focus on this population first.  One very effective method for even the most ancy child has been to use a visual behavior chart.  I do not have time to get fancy in most instances so I grab a post-it note or other scrap of paper.  I draw 5 circles on the paper and tell the child he will get his desired reward only when I have drawn 5 happy faces into the circles.  I do not set up complicated protocols for what earns the happy face. It is at my discretion and I usually award them for completing a given task or for even just "staying on task" for a few minutes.  Rewards in my speech room are not complicated.  I have a drawer with stickers and little items that I sometimes offer.  But most often the reward is a favorite game or activity at the end of the session.  Now, for most clients this is enough and it works like a charm.  The secret is to give that first happy face quickly (the carrot and stick approach).  Some clients however just cannot contain the poor behaviors (whatever it may be) so I identify the problem behavior for them.  Then I flip the post-it over and draw 3 more circles and tell them this is where I will draw a "sad face" for each time they are not behaving.  If they fill up the sad face side before they fill up the happy face side, the reward will not be given; they lose the reward.  The secret here is to work hard to make sure the child is successful.  The first sad face given is met with surprise and unhappiness.  I then work at "reminding" the student frequently about getting another one.  It has been rare that a student has actually earned all 3 sad faces and lost their reward. If a child is having lots of difficulty I may give up to 5 sad faces and scale it back next time as they learn to control them selves.  I only add the "sad face" option when the "happy faces" are not enough to keep the child on track.  I usually only have to use this system a few times.  I fade it away if behavior improves.  I pull it back out on difficult days.  

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