Sleep Issues and Extinction - An experience

Sleep Issues and Extinction - An experience

I apologise if you feel I tangent too much.

I was very much put off ABA in general for many years - I think I should mention that up front.

This is as a result of exposure through my work and through some of my own research. Through work I have met many people who have officially had a great deal of training in ABA with lots of qualifications, they tended to mention “Science” a lot.

However - I fundamentally disagreed in the past with one element which has led me to write this and other blog posts. I felt the things I was being shown missed the fact that we are in a relationship. Don’t bark at me - I am now an ABA student and having now met better practitioners I am, over 20 years later, on side.

My son was born in December 2001.

In December 2002 I noticed that my son would not fall asleep alone but was falling asleep while in the arms of one of his parents while we were watching television. He would then sleep alone in his cot in his own room but he could not fall asleep alone in his cot in his own room.

To set some of the other scene he had with in a matter of days of birth slept in his cot in his own room and he was used to sleeping the whole night save feeding of course. I appreciate most of the readers will not have had this situation.

At the time, in my memory, there was an awful lot of conversation around controlled crying. This in my understanding involved increasing the amount of time that a child was crying so the child gets used to it. Taking this as a simple behavioural issue, going on the advice of the books etc, I was to let my child cry and increase the amount of time that this crying happened up to a maximum, I believe at the time, of 10 minutes.

That to me meant the child would be getting used to asking for assistance and it being denied. One of the most common reports from parents when they get asked to try these sorts of programs is that they cannot do it they cannot listen to the child cry, they cannot see the child in distress and they're the ones that are putting the child in distress by denying access to the attention that is being requested.

I was in my early 30’s this was my second child and quite frankly firmly disagreed with these ideas. It is simplistic to say “it is attention seeking - just ignore it, it will go away” I have written posts about that before. Certainly if you hear Greg Hanley he would say you must first turn off the behaviour before you work with it - i.e. give the item, in this case attention. Again I have written other posts on his work.

For a number of years before this and since I have been involved in work around what used to be called challenging behaviour. Yet distress here is the key, I no longer use the term challenging behaviour in my teaching we use the phrase “assisting individuals in distress” the foundation course is titled “Developing Positive Relationships with Individuals in Distress”. People who are learning to “manage challenging behaviour” generally interact differently to those who have learnt to “assist individuals in distress”. It is simply fundamental reframing of your role as a carer. (see blog on Challenging Behaviour being an outdated term) de-escalate.com/de-escalation/2014/3/challenging-behaviour-an-outdated-term

As I tended to work away from home a lot I put aside time around Christmas 2002 where I knew that I was going to be home for several nights in a row.

Behavioural

From this point I will make sure that I add in some of the behavioural terms so that those who are into the science can follow along with that terminology. If you are not into the science I apologise for some of the terminology and I hope I can explain enough as I go on.

Sleep was under the stimulus control of the presence of a parent, in fact the parent was physically the pillow :-) This intervention was needed so that as my son grew he would be able to happily fall asleep in his own room which would have made a socially significant difference to himself and improve his parents quality of life.

Procedure

The first night in question I sat watching TV, he became tired, making sure that he was tired before I started the process creates a motivating operation. This motivating operation means that he is much nearer sleep than if I was to try this at a set time. I'm not saying that in the future we do not need routines in our children’s lives - there is a lot of research on the fact that routines around things like bedtime and reading etc for children is incredibly positive for them to see this video on that subject.

However at this time I am using his tiredness as a motivating operation. It puts him in a more motivated state to achieve what I was planning for.

In terms of my son and I hugging each other this is very much on a schedule either of us can initiate. So very contrary to the training of the time I believed that should he call out in any fashion I would give him attention / hug to make sure he did not have to display the distress behaviour to gain a interaction from me. This works very well with my belief system around the fact that I do not want to damage my relationship with him. As I am his emotional gatepost (one of them) I need to be the adult in the situation, when he displays distress I give him support. Therefore in behavioural terms for this procedure hugs are on an FR1 schedule. This means that with any slight display of distress or request for a hug, for example putting his arms up, I will give him one. I will not deny him access to such a basic human need.

Extinction

In behavioral terms you can put some behaviour on extinction that had previously been reinforced. For me to follow the extinction path I would have to deny him access to the hug / attention, I was not prepared to do this. I now know from the modern training that if you are not able to manage the extinction bursts you should not be using extinction. Use of extinction alone can lead to large extinction bursts, most parents would find this very difficult to work through. If you are placing a behaviour on extinction you should be reinforcing a replacement method of communication so the function of the behaviour can be met in another way. Extinction itself is to be followed 100% and this is just too hard to do for most parents. Indeed for problem behaviours modern practitioners doubt the ability for extinction to be used 100% in the natural environment 100% as the behaviour is likely to contact reinforcement you have not planned for.

From my coursework - Without knowing the reinforcer maintaining responding, extinction CANNOT be effectively implemented

I am not doing a post on extinction here however I do see many people suggesting you use extinction without functional understanding and alternative skill reinforcement. Then they blame the parents for not being able to work through it.

Back to our story…..

After all he had learnt to to fall asleep on us, and so a parent was already associated with falling asleep we needed him to associate his cot with falling asleep. I believe this procedure may therefore also fall into the category of transfer of stimulus control through stimulus stimulus pairing, leading to stimulus fading.

I took my son while he was still just about awake into his room where it was nice and dark and I placed him into his cot. I had already set up a little coffee table next to the cot so that I could sit with him rather than following the teaching of standing outside the room with a stopwatch. Every time I put him down he would stand up, reach up again for a hug. Every time he did this I would pick him up I would say gentle words to him and I would lay him back in his cot while he was still just about awake. The lying in the cot woke him up and he would again reach up for my neck and again I would lift him before he cried so it's not to have to let him show distress before I will pick him up.

I believe that this process would take several nights, however what I did was sit on the coffee table put my arms on the top edge of the cot so that he could touch my hair, my head put it's arms around my neck. I continued every time he initiated to pick him up and settle him down gently with quiet words and every time he stood up and initiated a hug. The time that I was holding him was become increasingly small because as soon as I picked him up he relaxed ready for sleep he was so tired.

There is a lot of research on mirror neurons, something we discuss on training, which I have mentioned elsewhere in other posts however if the term is new to you I encourage a google search.

My father inadvertently taught me about mirror neurons, I had seen him on several occasions pretend to be asleep so that a young grandchild would fall asleep next to him for an afternoon nap, he was a master at pretending to be asleep.

So with my arms on the cot I put my head onto my arms. My son stood up, went to put his arms around me I didn't respond so he tapped me on the head with his little hand. He walked up and down the cot, tapped me on the head once more so I started to gently snore. I had one eye open and could see exactly what was going on, he looked at me he looked at the other side of the room he tapped me on the head one last time when I was snoring and he lay down and fell asleep.

This is the only night I actually had to do this process as we never had a problem with this ever again. I realise that every child is different, I understand that every relationship is different, I am in no way suggesting that this should work for every child, every time at any age. What I am suggesting is if we have the ability to follow this sort of a path, which is what I've been teaching for well over 20 years, why do we believe that we have to follow standard extinction leading to a behavioural change through an extinction burst. Other technology exists.

Extinction may be very appropriate when the child knows and understands the rules. This was not the case I had.

I mentioned this story to my supervisor as I'm a student of ABA, and my supervisor discussed with me the concept of Graduated Extinction. I find it difficult in that my training states very clearly that Extinction involves no reinforcement at all and yet we are now hearing colloquially the term Graduated Extinction on a regular basis. I believe this concept needs new term as it cannot be Extinction - from my course:

Critical Attributes of Extinction

  • 1.The behavior has to have been previously reinforced.
  • 2.Reinforcement has to be withheld each and every time the behavior occurs.
  • 3.The behavior has to be weakened.

My supervisor has suggested the end product where I ignored him with one eye open is classic extinction. However she also highlighted that the procedural elements we put in place beforehand may well have mitigated against the extinction burst. Elements such as:

  • Motivating operation
  • Modeling
  • FR1 schedule

It is an interesting point. Perhaps it was not that I was saying I won’t do that stuff others suggested and I disagreed with - perhaps I was doing exactly what the modern training says but I did not know it.

tl:dr

I have many of these stories about parenting and people believe I am wrong - often when I talk about these things people used to say “your actions are bad for the child” or “the child has got to learn” or “what sort of child will he turn out to be”. These days when I tell these stories on training I can say to people come and meet him, ask him about how he has turned out when his father went against common wisdom of how to parent.