October 20, 2021
Cindy Lopez:
Welcome to Voices of Compassion, CHC’s podcast series providing courage, connection and compassion, highlighting topics that matter to our community, our parents, families, educators and other professionals. My name is Cindy Lopez, and today we’re talking with Dr. Jody Miller about behavior. Behavior strategies, isn’t that for kids with really challenging behavior? Maybe your child just doesn’t want to go to bed at night, will behavior strategies work for that? Or perhaps your child is defiant and resistant to anything and everything, will behavior strategies work for that? What happens when the behavior strategies you have been using with your child are not working anymore? Well, listen in to this podcast episode today with Dr. Jody Miller, Head of Esther B. Clark schools at CHC, and also a board certified behavior analyst herself. We’re going to discuss behavior strategies including her top three go-to tools for challenging behavior.
Welcome Jody. Thank you so much for joining us today. I’m just wondering if there’s anything that you’d like to share with our listeners as we get started.
Jody Miller, EdD, BCBA:
I’m excited to be here and really sharing some of the information and experience and strategies that I have had in my career of working with kids and families that have had emotional or behavioral challenges. I also have two children of my own, so I can relate in many ways. They are young, but I’m starting to see some of the struggles that they are having and I’m really happy to be here with you today.
Cindy Lopez:
We talk a lot about positive behavior strategies. So can you tell us a little bit about what that means?
Jody Miller, EdD, BCBA:
Positive behavior strategies are really proactive approaches that we want to take that have the potential of changing challenging behavior and those can be really simple and many people do engage or implement proactive or positive behavior strategies all day long. It can be as simple as prompting or using positive reinforcement, verbal positive reinforcement. It could be making sure that your day is visually represented through a schedule if you have a child that needs that type of routine. It could be antecedent management so we’re going to kind of avoid the situations that make the child uncomfortable or frustrated. So that’s what, really, positive behavior strategy is, it’s intended to shape or change behavior.
Cindy Lopez:
Positive reinforcement – could you give an example of that?
Jody Miller, EdD, BCBA:
Yeah positive reinforcement could be, “hey Cindy, I like your glasses.” If you had been averse to wearing glasses, saying something about your glasses could propel you to want to wear them more. So it changes the behavior in the future, but it’s really adding something positive to a situation. It could be verbal, it could be a comment, it could be something earned like a toy, it could be a show, could be just time with an adult, but it’s intended to shape the desired behavior in the future.
Cindy Lopez:
Yeah and lots of parents and teachers, you know, use those strategies. Maybe they don’t refer to them as positive reinforcement, but they use them all the time and the other term you use is antecedents. So could you say something about that?
Jody Miller, EdD, BCBA:
So antecedents are what is occurring right before the behavior and typically they elicit the behavior. So it could be that you say it’s time to clean your room. You’re telling your child it’s time to clean your room and they engage in a tantrum behavior or just a kind of a snarky remark back. The antecedent is the demand to clean the room. And so when we manage antecedents, we’re very cautious about what we’re delivering so that sometimes we can avoid the behavior from occurring.
Cindy Lopez:
At CHC we see kids and families with some behavioral and/or emotional challenges and they’re looking for strategies, they’re looking for tools. So lots of parents have incorporated or integrated tools and strategies that have been working for them, but what do you do as a parent or even as an educator, when those strategies aren’t working?
Jody Miller, EdD, BCBA:
I think that most parents, regardless of the degree of challenging behavior that your child is exhibiting and every child has challenging behavior, you know use positive behavior strategies, they use punishment strategies or in other words, consequences. And a lot of times, or most of the time, those strategies work, but there are occasions that students or children are having more complex struggles or challenges and one strategy typically is not going to work, it needs to be kind of a comprehensive approach or multiple interventions at place and in play at one time. The students that I work with who have not really done well in the public school setting, they really need a more complex approach and so sometimes those interventions would include psychotherapy, you know exploring psychiatry, in combination with behavior management and applied behavior analysis strategies. So a lot of times it’s not going to be just that one intervention that’s going to reduce or eliminate the behavior. It may be a combination of things that need to be in place in order for that to happen.
Cindy Lopez:
So you mentioned some specialists, psychiatrists, you talked about psychotherapy. Typically what does that team look like for parents who are looking for help and support around those kinds of challenges with their children?
Jody Miller, EdD, BCBA:
It can be quite a few individuals or it could be only a few individuals. It could include a school district team. The students that I’m working with are all in special education and they have been identified by their school system and their families that they need that extra support. Psychiatrists for medication management, psychologists, and then psychotherapy whether in school or outside the school setting. For the students at Esther B. Clark, we have that comprehensive multidisciplinary team on site. So, it makes it a little bit easier for the families to manage when those individuals can kind of come together and work together to really solve these struggles.
Cindy Lopez:
You mentioned a behavior specialist too previously – what’s the difference between what they do and what some of those other specialists you referenced do?
Jody Miller, EdD, BCBA:
So, you know, a board certified behavior analyst and I’m a board certified behavior analyst, a board certified assistant behavior analyst and a registered behavior technician are the three licensed or credentialed individuals in the United States or in the state of California that actually are certified by the school districts and also by a governing agency to provide behavior intervention services. There are also other terms that school districts, even Esther B. Clark, use such as behavior specialists, they’re actually implementing behavior intervention plans, they’re doing parent training, those types of things. Those individuals have to be overseen by a board certified behavior analyst. So again at Esther B. Clark, we have two, myself and another BCBA and we oversee all of our behavior specialists in the classroom.
Cindy Lopez:
Thank you for explaining that. I think that it can be a little overwhelming to support your child through those emotional and behavioral challenges and so it gets confusing when thinking about how do I find help, who do I go to, who are the specialists I should see. As you work with kids and families and parents, even teachers, other caregivers, what are some common mistakes that you see occur as parents or caregivers are implementing behavior management strategies?
Jody Miller, EdD, BCBA:
I think that we can say their mistakes, but when we’re really working with a really challenging situation, it’s no fault of the parent or the individual working with the student or the child of why these things are typically happening. But I would say when we’re trying to change behavior and I’m working with families or teachers or caregivers, the thing that I emphasize the most is consistency. And so a lot of times as parents we try something and it may not work the first time or the second time and we abandoned that and really we need some time for strategies or interventions to work and so the consistency in whatever you’re implementing is really important. You know, we don’t learn something typically the first time do it, we typically need some practice in order to gain a new skill and that’s really what you’re doing when you’re shaping behavior, you’re actually teaching a new skill to the student or to the child. So it takes some time for that to shape and for that to take hold. And so I would say the biggest area to focus on when you’re trying to change behaviors is to be consistent with whatever intervention that you’re implementing.
The other kind of things that our common areas of need would be really establishing a consistent routine or schedule in the home, in the community at school, that really does support the child and support shaping and changing behavior and that has to be consistent as well, but the more our children know the more comfortable they are, the less anxious they are, and it helps them to understand what’s expected during a specific time period. And I would also say that you should reach out, you know, don’t feel like you’re alone in the situation, there are many, many people that care and so when you feel like you’re not making change or you can’t kind of handle the situation that may be occurring at home, reach out for help and then an extension of that is then trust the professionals that are helping you, that they are really there with an unbiased opinion about the situation and so as much as you can trust in the recommendations and the advice that they’re giving.
Cindy Lopez:
Just a note before we continue on with today’s episode, we hope you’re following us on social media, so you don’t need to wait a whole week between episodes to get engaging, inspiring and educational content from CHC. Our social handles are linked on our podcast webpage at podcasts.chconline.org.
I think that consistency as you said is really key and also I think parents can feel perhaps embarrassed or I’m messing up somehow as a parent like my child wouldn’t be doing this if I were somehow, you know, being this super parent, right. So I think what you said about, reach out for help, if something’s going on kind of trust your gut and reach out. We often say this at CHC, if they could, they would, right. So, kids are doing the best they can. So it’s helpful to give them some additional strategies and teach them as Jody was saying. If you could narrow it down, what are your top three go-to strategies for challenging behavior?
Jody Miller, EdD, BCBA:
I want to go back to something you said about, a parent feeling you know, inadequate or embarrassed, I’ll tell you I’ve been in the field of special education for almost 20 years. I have two children of my own, a six year old and a three and a half year old and they have had some fairly challenging behavior. I’m a board certified behavior analyst. So when my son began to bite almost daily at preschool, obviously I’m like whoa this is not supposed to be happening I’m supposed to have all these skills to, you know, curve this behavior and it shouldn’t even be happening, but it did, and you know, I relied on the preschool and the knowledge that they had of working with those young children and eventually it went away. So I kind of get that feeling because I’ve experienced myself and I won’t even tell you about the feedback I’ve gotten about my daughter. She’s just now three and a half and, you know, she’s had some difficult times at school to the point where I thought they might exit her. So, you know, we’re all, no matter what type of experience or education that we’ve had, have challenges or experiences with our children. So please don’t think that you know, you shouldn’t reach out because of those things.
Cindy Lopez:
Thank you for sharing that. Hearing from you as a BCBA and thinking like, oh, she probably has everything under control and you know, everything happens like it’s supposed to at Jody’s house.
Jody Miller, EdD, BCBA:
Yeah exactly. The top go-to strategies I would say is somewhat of what I’ve said already, make sure you’re as consistent as possible and that is across settings. And so I think that’s where, kind of relying on the team that you have formed whether that be a grandparent or a psychologist or psychiatrist, or a school district, all of those individuals as much as possible need to be, you know, using the same language, using the same interventions, communicating, so that it is consistent across environments for that child. When things are getting pretty hairy at home, you want to think about trying to kind of reduce the stress as much as possible, reducing demands, getting to a spot where the child can feel successful and that you can then provide all that positive reinforcement, that positive feedback that you really want to be providing to change the behavior, but if there are challenging behaviors that are taking up the majority of the time, there’s little opportunity to provide that positive reinforcement. So you know basically reduce as many demands and tasks and feedback and things like that as possible, so that you can get through that successful point and you know, we use a ratio here at Esther B. Clark it’s a five to one ratio. So with every one corrective feedback that we may deliver, we want to then give five positive pieces of feedback to a student. And so you know, we’re not sitting there counting that, but the idea is that to change a behavior, you really need to let the child or the student know what they’re doing that’s correct, that’s what you want to see over and over again and I would say the last thing is make sure you’re working on your relationship, it’s the most important thing. It is the biggest tool that you’ll ever have in your toolbox in terms of changing behavior and all of those strategies will help with that, but the focus really should be on the relationship, not on completing math homework. It should be about building a core family unit that’s positive.
Cindy Lopez:
Yeah, thank you for that. I think that’s really important for parents to remember. And I know that over the past year, as parents have been, trying to be the parent and teacher at home that it’s gotten kind of crazy for parents. And so, you know, if you have to choose between the role of parent or teacher, or even enforcer of homework, like choose the parent role.
Jody Miller, EdD, BCBA:
Absolutely agree wholeheartedly.
Cindy Lopez:
So if parents are experiencing these challenges with their kids, when do they need to seek additional help or outside help?
Jody Miller, EdD, BCBA:
Yeah, I think that when you said earlier about listening to your gut, I mean, I think as a parent you know when things aren’t really improving and you’ve tried everything that you know to try, that’s when really you should begin to think about reaching out for help. And there’s certainly, some behaviors to be cautious of when they begin to occur, if they occur or if they are occurring frequently and that would be things like self-harm, verbalizing self-harm, aggression, property destruction, risky type behaviors, leaving home at night, you know, substance abuse, things like that. I mean, certainly when those things are occurring, definitely reach out for help.
Cindy Lopez:
Yeah and for our listeners, just want to remind you that CHC is here for you. You can find out about our services at chconline.org. You can schedule a free consultation with one of our clinicians and talk about what’s happening and they can give you some advice and guidance regarding next steps. So if you’re a parent out there and you’re trying to figure out what to do or what’s next, please reach out to us, please call. As we wrap up, I’m wondering if parents have a child with challenging behavior, what’s the most important thing you want them to hear from you today?
Jody Miller, EdD, BCBA:
It will improve. I think believing that and knowing that is very important. I’ve seen it, I see it on a daily basis at my work, and that improvement will happen either through your efforts as a parent or with the help of others, but either way it’s going to improve and really, I’m pretty lucky because I get to meet a lot of families, and a lot of children and students that are struggling and they’ve been on this very challenging journey when they reach us, and we see and learn and know about all the things that they struggled with when they come into our school and then, you know, a couple of years later, they’re a completely different student, different child, different family. And so it’s really an amazing position to be in to see kind of the beginning and the end of a student’s enrollment because we see those significant changes in students and in children, and it can happen and it will improve, believe that.
Cindy Lopez:
Thank you for those encouraging words. I think it’s really important for parents to hear that when they’re in the middle of it — they’re not seeing a lot of change or the change that they would like and so it’s important to remember that there is, you know, the proverbial light at the end of the tunnel, there is hope. I should be calling you Dr. Miller. Thank you again Dr. Miller for sharing with us today and spending some time with us talking about behavior, challenging behavior, behavior strategies, and we do have several resources in our resource library and actually Jody has done some presentations for us in the past. And we’ll put some of those resources in our show notes and on our podcast web pages so you can reference those. So again, thank you so much for being with us today and to our listeners thank you for listening in and we hope you’ll join us again next week.
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