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TherapistsFrequently Asked Questions: Moderate Behavioral Challenges


  1. If a student is on a consistently implemented behavior program for over two weeks and the behavior is getting worse what should you do?

This is an indication that the Behavior program is ineffective and should be changed. Begin by doing a QABF, Sensory Profile and preference assessment. If the problem does not improve proceed to collecting data on the setting behavior, antecedent, and consequence of the target behavior to experimentally determine the function. This will give information regarding the functions of the problematic behavior and the most helpful reinforcers. The QABF will indicate if the behavior is being done for sensory non-social, to get tangibles, escape, expressing physical illness, and/or for Attention. If the primary goal is sensory, try to determine their sensory need and find a less problematic way to meet the need.


  1. How can therapists address student’s limited self-control?

Low self-control can be addressed through brief movement break games: Simon says, May I, Freeze dance, and progressively rewarding the student for tolerating increasing levels of frustration (e.g., waiting one minute, then two).

  1. How can therapists increase client’s attention?

Increasing attention is crucial to learning, and is often the first goal for students with developmental disabilities. When addressing attention it is important to get baselines for two attention spans, attention to what the child wants to do and attention to what teachers/therapists want the child to do. If students have extremely limited attention to adult directed tasks but extensive attention for what they want to do find reinforcers they are motivated to achieve. If attention is limited for child as well as adult tasks, attention is likely a developmental issue that must be globally addressed. Reinforce students for progressively increasing their attention, and find motivating activities and reinforcers by looking at the student’s developmental level, sensory needs, and preferences.

  1. What good, free online resources are available to help therapists improve behavior? I especially want strategies I can integrate into my regular therapy that will improve therapy behavior.

Great resources for combining sensory processing and behavior challenges are at and For children with typical intelligence who are on the Autism Spectrum or students who have developmental disabilities that respond best to visual rather than auditory instructions

  1. I am having difficulty with getting clients who have severe behavior problems to leave the clinic when their session is over, which is a problem because I have another child right after them to treat.

This is a common problem because most children really enjoy therapy, particularly with therapists who are skilled at providing sensory activities and individual attention, because of course the kids never want to leave. It is important they know when the end of the session is approaching by using a visual schedule showing all the session activities in order. In addition, give both a five minute and two minute visual and verbal warning before the session ends. It can be helpful to provide a reward prize they get once they leave, and in extreme cases to bring them to a designated exit room where only the door leaving the building is unlocked.

This post first appeared on John Pagano, Ph.D., OTR/L, please read the originial post: here

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TherapistsFrequently Asked Questions: Moderate Behavioral Challenges


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