Topic 3: Behavior Management:
Modify Targets to Facilitate "Success"
When a client's troublesome behaviors escalate, I have to step back and look closely at the situation. What I often realize is that the targets are just too difficult for the child. It may be that the child has not reached the maturity required for a specific target or maybe they just don't have the ability to focus long enough to do the required work to achieve it. This is one of the reasons it is important to consider developmental norms. I have no qualms about addressing /r/ in a four year old, if he is ready for it. Many four year olds produce the /r/ just perfectly. How do you know if it is an appropriate target? Can he produce the sound in any of the various /r/ forms? Is he stimulable for the sound? If I choose this target and work on it for a couple of weeks with no real progress and an escalation of behavioral problems, it is most likely that the child is simply not "there" yet and that target should be delayed. It also may mean that you have advanced too quickly with the target and it requires too much concentrated effort. Scale back to a simpler level (auditory discrimination, sound in isolation, or consistent placement in a word). If you are trying to move a child forward from an area of mastery to the next level, don't just jump 100% to the next target. Continue to practice the successful targets the majority of the time and throw in a difficult one every 4th, 5th, or 10th trial. Make sure the child is experiencing 80% success on target trials at any given time. The success gives them the confidence to try the harder targets 10-20% of the time without them feeling so challenged that they shut down. I have often described therapy (especially speech work) as a "dance". You lead and let them follow, you slow down if they are mis-stepping, you give them the lead sometimes, you glide along easily together, then you push them along with a more challenging step, then you fall back into the easier gliding along... like dancing back and forth. A basic principle of behavior modification is to build on success. When teaching a new skill, you must always stop at the point of error and go back to the last point of success. You then facilitate the next step by providing maximum necessary support and assistance for the child to achieve that step. As the skill improves, you fade the support.
So if you have a client who suddenly is misbehaving, take a look at what you are asking him to do and whether he is ready to do that yet.