The following behavioral strategies are derived from How to Teach Self-Management to People with Severe Disabilities: A Training Manual (1992) by Lynn Kern Koegel, Robert L. Koegel and Deborah Rumore Parks.
Providing support for family members with disabilities can, at times, be quite demanding of one’s time. When will I get all this laundry done?; How will I manage to prepare dinner (without starting a fire!)?; When will I be able to catch up on The Walking Dead? The following are basic guidelines for teaching self-management skills, whether your goal is for your loved one to be able to clean their room independently or be able to play with a sibling for a certain amount of time without aggressing towards them. No matter what the desired goal, these guidelines will help to facilitate the process of transferring control of the desired behavior from yourself or a treatment provider to the individual. Who can learn to self-manage their own behaviors? Recent research suggests individuals ranging from mild to severe levels of cognitive impairment can be taught to successfully manage their behaviors.
There are four general steps to self-management:
- Getting Ready
In this initial step, one wants to be sure to define the actual behavior(s) you would like to increase and/or decrease. It is ideal to very specifically define the behavior (pick up clothing off the floor, do not hit/pinch/kick sibling) so that the individual has a clear understanding of what they will ultimately be responsible for measuring and so that this information can be clearly communicated in other settings in the future. After specifically defining the inappropriate behaviors to decrease and/or appropriate behaviors for increase, you will need to decide how to measure/record the target behavior. One may use simple paper and pencil to record occurrences of a behavior or a wrist counter that you only need to click to record the number of occurrences of a behavior. If the goal is to avoid a behavior for a particular interval of time, a simple wrist watch with a timer may be used (Mark can play with his sibling for a half hour without kicking him). The ultimate question is; how will the individual record the presence or absence of behavior? The third step in getting ready is to determine a reward for the individual when they meet their goal. The reward should be chosen by the individual to create maximum motivation for achieving the goal. Rewards should be given immediately and paired with verbal reinforcement. Pairing the tangible reward (toy/food/hug) with verbal praise will allow for those rewards to be more easily faded in the future so that a more natural reinforcer, “great job” will be sufficient to maintain the behavior. The last piece in getting ready is to select an attainable initial unit of behavior. For example, if Matty bites his sister every 3-5 minutes when left unattended (or even if you are sitting right there!), a great starting goal could be 5 min. We have observed his capability to reach this goal so it is a great place to begin to provide a reward when reached. We will expand this goal incrementally as each goal is met successfully. - Teaching Self-Management
Before even beginning to teach self-management you will need several of your previously identified rewards (to provide immediately) and any of the previously identified tools for recording/measuring the behavior. Next, you will need to teach the individual how to identify the target behavior(s). You can do this through modeling the appropriate behavior and asking them to identify whether it is appropriate or inappropriate and then do the same by modeling the inappropriate behavior and following up with the same question. You can then have them model what they think is the appropriate and/or inappropriate behavior. Next you will want to teach the individual how to record the target behavior when it occurs. Place the chosen reward within eyesight, but out of reach. Teach the individual how to use the recording devices and when they reach the predetermined goal verbally label that goal and allow them access to the reward! - Creating Independence
This is the ultimate goal of teaching the individual to self-manage their behaviors. This can be accomplished by gradually fading your presence in these training sessions. If you begin with a 10 minute training session and if the individual requires less prompting and redirection, you can gradually increase the duration of these sessions. The next step in creating independence is to decrease the individual’s reliance on your prompting through the systematic decrease of your prompting. As the individual demonstrates increased independence, you will want to gradually increase the goal they need to reach in order to gain access to that valuable reward! - Teaching Self-Management in Additional Settings
This step is typically pretty easy! First, communicate to the individual that they can earn extra rewards by engaging in the target behavior in the additional setting. It is ideal if you are in that setting the day the individual is asked to work towards this goal. It is vital that provisions are discussed ahead of time with those that will be present in this additional setting. Be sure to make expectations clear to the individual and systematically fade your presence, similar to how it was done in the initial setting. You may be able to fade your presence/prompting a bit quicker given that the behavior has already been learned and we are now generalizing it to a different environment!
While this four step process may initially require a great deal of work on your part, the benefits are invaluable. Not only will you reap the rewards of finding a little extra time to meet your own daily needs, but the individual has gained a meaningful pathway to some level of independence. Priceless!!