- Autism & Developmental Services
Wouldn’t it be amazing if we could prevent the occurrence of all problem behaviors? This would be a powerful feat. Well maybe we can’t prevent them all from occurring but we can definitely decrease the likelihood of many problem behaviors by making changes to the environment proactively. This is still a rather powerful feat but one that can be attained. Such interventions that are put into place to help prevent the occurrence of problem behaviors are referred to as antecedent-based interventions. We often hear the terms antecedents and consequences when it comes to the discussion of behaviors.
Our focus at this time will be on antecedents. Antecedents refer to the events and conditions that take place right before a behavior is emitted. These events and conditions cue the individual to engage in these problem behaviors, therefore our goal is to modify these cues and signal the individual to engage in more appropriate behaviors by putting antecedent-based interventions in place. Many antecedent interventions are easy to implement and require little effort. Over time with consistent implementation, these interventions will become part of your daily routine.
There are many antecedent-based interventions available and can be found in the ABA literature. We will be discussing a few of the more common interventions that can prevent maladaptive behaviors.
Provide Choices – Allow your child to make choices about the materials they are using, the task to take part in, where to sit, who to work with, and what to do first. Providing your child with choices helps increase his or her motivation and gives him or her some control over the situation. Providing choices also teaches your child to engage in language and communication instead of behaviors to get what he or she wants.
Real Life Example – Whenever I tell my son it’s bath time he screams and runs away. One night, instead of telling him it was bath time, I asked him, “Who do you want to give you your bath?” He responded “Daddy”. Daddy cheered in excitement and took my son’s hand and said “Let’s go”. My son was running to the bathroom. Giving him a choice each night for bath time has been our regular routine now. We even provide choices of what toys to put in the tub, the washcloth to use, and the towel to dry off with.
Make Changes to the Physical Environment – Making changes to the physical environment is a strategy that takes little effort and can make a big difference. Putting up a gate is a common environmental change we make when we have younger children to prevent them from climbing up the stairs. We may put locks up high so young children can’t open the front door, locks on kitchen cabinet’s so our pots and pans aren’t found thrown all over the floor, use sippy cups so that juice doesn’t spill all over, and electric socket covers so objects and fingers don’t get put in the socket. Sometimes making environmental changes can make a big difference with the least amount of effort and time.
Real Life Example – During dinner time, we are working on having my son ask permission to leave the table before running off. We were having a difficult time because he was faster at getting up and running away than we were at stopping him. My son sat in a chair closest to the kitchen exit between his little brother and his dad. He had a quick, straight path to the exit and only one adult there to stop him from running. My husband and I decided to change his seat. We now have our son sit furthest away from the exit between myself and his dad. This seat provides the two of us enough time to stop him and prompt him to request permission to leave the table. We have been able to prevent the running away while teaching him a more appropriate behavior.
Incorporate Your Child’s Preferences into Activities – Use materials and tasks that include characters, colors, or items that your child loves. Increasing your child’s interest in an activity or task increases the likelihood that he or she will complete it. Using a pencil with Cookie Monster on it to write his or her name. Using a plate shaped as a firetruck to eat off of. Using a soap dispenser with Barbie on it when washing his or her hands. Glitter stickers placed on a chart for brushing teeth. These may be simple ways to motivate your child to follow directions and engage in tasks.
Real Life Example – One of my son’s goals was to complete interlocking puzzles. Whenever we took out a puzzle, he would begin screaming and throwing the pieces. They were puzzles of different animals. He liked animals so I didn’t understand what the issue was. Maybe he just doesn’t like puzzles. One day at my friend’s house, her daughter took out a Mickey Mouse puzzle. To my surprise my son sat down next to her and watched her put the puzzle together. When she got up and walked away my son started putting the puzzle together and taking it apart over and over again. Now that I purchased various Disney character puzzles, completing puzzles is no longer an issue for my son.
Create a Daily Schedule – Developing a routine or daily schedule that is predictable and consistent is an antecedent strategy that can be very effective. A schedule that visually displays what your child’s day will be like may be beneficial and help with transitions. Schedules can be written words, picture cues, or real objects. Also, schedules can be of the whole day, half of the day or just a small group of activities at a time. It is important that whenever new activities are going to take place or there are changes in the schedule, that you provide your child with several warnings. You may want to use a star or special symbol on the schedule to signal that there is a change in the schedule as well.
Real Life Example – My son loves to go to his preschool. Every morning he jumps out of bed and wants to get dressed. On the weekends when I tell him there’s no school, he starts crying and yells that he wants school. This can be quite stressful for everyone. I would tell him it was Saturday or Sunday and school is closed but that didn’t help. One week school was closed on a Wednesday and I had marked the calendar with an X to remind myself of the closure. That morning he began crying so I decided to show him the calendar.
I told him to look there’s an X on the calendar which means no school. To my surprise he stopped crying and responded by saying “O.K”. We then set up a calendar in his room. We put X’s on any days there was no school. Each morning my son gets up and checks his calendar. We place a sticker on each day right before bed so my son knows what days are finished. He is able to find today’s box by looking at the box after the last sticker. We are beginning to add other activities onto his calendar as well.
Provide Pre-Activity Strategies – Transitioning can be a difficult task for most individuals especially if the transition is from a preferred activity to a non-preferred. Some things that can be put into place to help with a smooth transition is to use a timer. The timer will cue your child for the transition. With the timer running, you should also provide warnings to your child about how much time is left and what he or she is expected to do when the timer rings. You may want to provide a warning when there is 2 minutes left, 1 minute left, 30 seconds, and 10 seconds.
The number of warnings will depend on your child. For example, you tell your child, “The bell is going to ring soon, then it’s clean up time.” When the bell rings, you say, “Clean up time.” As your child cleans up, you can then provide information on what’s going to happen next. “First clean up, then time for lunch.” Using first ____, then ____ is helpful language that provides your child with an understanding of what is going to happen. Being prepared can mean a decrease in problem behaviors. Using first___, then ___ visual cards may be more beneficial especially if your child has to engage in a non-preferred activity first, he can visually see what he’ll be doing next.
It is also a beneficial strategy to explain and describe to your child what activities will be taking place next especially if it’s a new activity. For example, you may tell your child, “After school today, we have to stop at the store. The store sells shoes. We are going to pick out a pair of shoes for you. We are going to have so much fun.” You may want to have a visual picture of shoes to show your child after school that you are going shoe shopping. You could even extend your visual by adding a drawing of home.
Real Life Example – Getting my son to clean up his toys is such a struggle. I have to say it over and over again and eventually I wind up cleaning up because he is crying. His therapist uses a timer during their sessions and I asked her why. She explained that the “blame” of the transition comes off of her. He does not associate her as the one making him clean up. It was the timer. She also uses a visual timer which shows him how much time is left before the transition.
She recommended that I use a visual card in combination with the timer like she does. She uses a first clean up, then shows him a picture of the next activity which will vary throughout the session. Sometimes if she doesn’t have the picture, she just writes the words and my son is okay with that. Since cleaning up is a non-preferred activity, one that my son doesn’t like, I started using a first/ then card that shows first clean-up, then a big hug. He loves hugs! I have been able to use a timer to indicate that one activity ends and a new one is beginning with tasks other than cleaning up as well.
Antecedent-based interventions take some time to think about, plan, and practice, but with consistency, creativity, and resolve, can be very effective at preventing problem behaviors. First, then cards, changing the physical environment, increasing predictability, using visual supports, providing transition warnings, and providing choices are just a few of the interventions that can be implemented before behavioral issues arise. For more information on antecedent-based interventions please reference the following sources used in the development of this post.
Cooper, J. O., Heron, T. E., & Heward, W. L. (2020). Applied behavior analysis. Pearson Education, Inc.
National Center on Intensive Intervention (February, 2016). Antecedent modification, DC: U.S. Department of Education, Office of Special Education Programs, National Center on Intensive Intervention.
Sam, A., & AFIRM Team. (2016). Antecedent-based intervention. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. Retrieved from http://afirm.fpg.unc.edu/antecedent-based-intervention
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