There are behaviour
management techniques and concepts that can be useful in managing
behaviour changes following a TBI
Read through the
following list of techniques and then work on:
Study A : Jack
- Case Study B : Tim
behaviour management techniques
This serves to maintain or increase behaviour, as a result of the
individual seeing the consequence of the behaviour as
something positive. Positive reinforcement can be tangible (If I work hard, I will
get a raise) or social (praise or smile).
This also serves to maintain or increase behaviour. In this case
we do something to prevent a negative outcome.
Negative reinforcement can be tangible (If I stick to the speed limit,
I will avoid a fine and I will keep my licence) or
social (being ignored).
Punishment is when something unpleasant follows a behaviour, which
results in a reduction of the behaviour. For example, ‘The
last time I punched someone, I ended up in jail – This
time I will not use violence, I will walk away’.
This occurs when you withhold reinforcement for a specific behaviour.
It is common when using extinction to see an
initial increase in the behaviour. For example, making a
commitment to totally ignore inappropriate comments
made by a person with TBI will initially result in the person
becoming more vocal and explicit. Continue to ignore inappropriate
comments and they should decrease/cease over
Differential reinforcement of other behaviour (DRO)
reinforcing someone for not engaging in a particular behaviour. There
different types of DRO, such as differential reinforcement
of alternative responses or differential
reinforcement of incompatible responses.
With DRO any response, whether it is desirable or not,
is reinforced so long as it is not the
response to be eliminated. For example, if your goal
is to encourage an individual to socialise
with others, they would be rewarded for just coming out
of their room, whether they
participated in the program/ talked with others or not.
Timeout is when a person is removed from the source of reinforcement
for a specific period of time. Timeout
may refer to isolation, as in a timeout room, or contingent
observation, such as being able to watch
activities but not participate in them. Timeout should
be no longer than five minutes.
A response cost is the ‘price paid’ when an individual
exhibits an undesirable response, which results in
a loss of privileges or other reinforcement. For
example, if you use a point system, you start with a set number
of points and the person is
'charged' a predefined number of points for a particular
behaviour. At the end of the week/time
period, the points would earn them a reward. For
you have over 80 points left you can buy the motor bike magazine you want’.
There are two types of overcorrection procedures that you may be
familiar with. During restitutional training,
a person is required to make restitution by returning
the environment to a better condition than its original
state. For example, if you throw some rubbish out
in the driveway – then you have to pick up
all the rubbish in the driveway. The
other type, positive practice, involves the person
practicing the correct response repeatedly. For
example – if someone does something in
a sloppy fashion, then they not only do that
task over again but must also perform another task