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:

• Case Study A : Jack
• Case Study B : Tim

Common behaviour management techniques

Positive reinforcement
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).

Negative reinforcement
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
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’.

Extinction
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 time.

Differential reinforcement of other behaviour (DRO)
DRO involves reinforcing someone for not engaging in a particular behaviour. There are many 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
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.

Response cost
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 example, ‘If you have over 80 points left you can buy the motor bike magazine you want’.

Overcorrection
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 neatly.