my biggest struggle (so far)

29 Sep

As a CF, I’m not great at everything quite yet (as you may have noticed from the previous post.) But the thing I’m struggling MOST with is what to do about escape behaviors.

Let me give you an example: I’m working with a kid in his home, everything is going smoothly, and then he takes off. Runs away, down the hall, up the stairs, into another room…wherever. He’s gone. I’ve set up the environment to decrease the chance of his escape (I.E. I’ve trapped him with my body and furniture.) I’ve brought items that I know motivate him. Mom is in the room and playing. Or siblings are present and playing.

I’m not a bad therapist I swear. I know how to set the scene appropriately.

And I know to analyze the behavior. Why is he running? Sometimes it happens during transition between toys and tasks. Sometimes it happens because something better is going on elsewhere (crying baby, TV is on, Grandma is in there, food is in there). Sometimes he’s mad at me and wants to go away. Sometimes he needs a sensory break.

Once the kid has run away…what do you do? In early intervention we want to follow the child’s lead. We want the child to be engaged and interested in you. When a child elopes, what do you do? Do you follow him and do therapy in the hall or the kitchen? Do you ask the crying infant to come sit and be a part of therapy? Do you try to entice him back? Do you ignore the behavior and wait for the two year old to return? Do you comment on and describe what he’s doing? Do you go get him and bring him back to the task at hand? Do you look at Mom and hope that she’ll be a disciplinarian?

There are pros and cons to each thing you could possibly do, and it seems like no matter what I do it feels wrong. I want the kids to have SOME structure and follow directions, but I’m also supposed to take their lead. If I let them do their thing and ignore it they might never come back! And I can describe what they’re doing or seeing but if they aren’t engaged then my voice is white noise. If I become a part of what they’re doing or describe what they’re doing then they might get more amped up and run more, thinking it’s a game. Then I’m reinforcing the behavior by giving it my positive attention. And I’ve found you can’t really count on the caregiver to help corral them. Sometimes I’ll let them do their thing once – Okay check on the baby once. Turn on the TV once. Go find some carpet fuzz to play with ONCE. But then they’re likely to tantrum when they don’t get to do it again. Sometimes enticing them back works if you can get their attention, but usually going to get them and sitting them down just causes more running or a tantrum. And some kids I do squeezes or jumping or some other kind of sensory break and that’ll work for a little while.

Basically I have no clue. I know it’s a dance, it’s a balancing act, it’s finding a happy medium. But what IS that happy medium? How do I find it?

So what do YOU do with runners? Please help!

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3 Responses to “my biggest struggle (so far)”

  1. Annie September 29, 2012 at 5:20 pm #

    I have a kid who runs away regardless of any other factors – he has autism and is highly distractible so we are working on task completion. I almost always end up physically getting him and making him finish what we were doing. But for my other kids, I usually just let them run for a second and then try to entice them back with some toy. If they’re still in the same room but not participating, I’ll usually play by myself and act really into it. But I agree, it is so hard to know what to do, especially with parents who have tactics that are different from mine.

    • weathersby September 29, 2012 at 5:38 pm #

      Thanks girl! Enticing is probably the best chance for most kids, but autism and distractibility definitely makes things all sorts of more complicated.

  2. sam September 30, 2012 at 12:57 pm #

    My friend Kristen shared an ABA perspective on elopement with me. So I wanted to share it with you:

    You can do a bunch of different things when it comes to elopement. However, I deal with children who are strictly on the spectrum. For me, I find that the best technique is pace prompting. Example; Noah is doing homework, then throws his pencil and says, “I’m going to punch you and never do homeowork again!” (again, my kids are on the spectrum). Noah then gets up from the table and runs to another room. I then pace prompt. He goes for a toy, I block him, he goes to play with his brother, I block him, he reaches for mom, I block him. I give him the sd (or demand), “First homework, then play,” and continue to pace prompt. I will give him the sd every 30 seconds. I continue to pace prompt until the child does the demand. It’s very hard at first, but once they know who’s in charge (so to speak) , they’ll start to listen. I have to do this with a very violent child all the time. If after pace prompting, the child becomes violent (I don’t know if you have this problem) find a spot to put them. I put this kiddo in a chair. He gets up, I sit him back down, he goes to hit me, I block him and sit him back down, he tries to run, I sit him back down, ect.  I will give the sd, “I’ll wait,” and then look away. I don’t bring any attention to the behavior. If I bring attention to the behavior, the child begins to think it’s a game. If I chase him around the house, he thinks it’s funny. I ignore ALL behaviors. Example;  Sarah puts her hand in her mouth during speech. Therapist tells her over and over again to put her hand down. The best thing to do is to block the behavior and look away. Same thing applies to when a child runs away. Don’t laugh or yell, just follow them, pace prompt when you can, give them the sd or demand (first this, then this) and go from there. One thing that works well with my kids is a number chart. I ask them what they would like to work for (break, ipad, stickers, ect.) and tell them, “first work, then___,” Once they get to the number 5 (I use board maker) they get their reinforcer. This seems to help with compliance.

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