The Cigna Group · NYSE:CI
The Cigna — Investor Presentation (July 2013)
46 slides from The Cigna's investor presentation, July 2013
Slide 1: Addressing Challenging Behaviors
Addressing Challenging Behaviors Presented by: Cori Wickett, M.S. BCBA LeafWing Center
Slide 2: Why does your child misbehave?
Why does your child misbehave? • When he wants something? • When you tell her no? • When you ask him to do something he doesn’t want to do? • When you take away her toy? • When you are talking to someone else? • Because it seems like it feels good?? LeafWing Center
Slide 3: Everything a child does serves a purpose
Regardless, everything a child does serves a purpose There is a payoff LeafWing Center
Slide 4: A payoff = getting what you want
• A payoff = getting what you want LeafWing Center
Slide 5: No payoff = not getting what you want
• A payoff = getting what you want • No payoff = not getting what you want LeafWing Center
Slide 6: Key: Take away the payoff for bad behavior
• A payoff = getting what you want • No payoff = not getting what you want Key: Take away the payoff for the bad behavior, give the payoff for good behavior LeafWing Center
Slide 7: Bad behavior payoff / Good behavior payoff
Bad behavior payoff Good behavior payoff LeafWing Center
Slide 8: Sitting on the couch eat cookies vs. work out
Sitting on the couch eat cookies Work out for 30 minutes eat cookies LeafWing Center
Slide 9: Teaching "good" behaviors
Teaching “good” behaviors 1. Figure out more specifically why your child does the bad behavior • There are four reasons 2. Teach a good behavior to fulfill that same reason (remember, same payoff) 3. Make sure there is a payoff for the good behavior and no payoff for the bad behavior LeafWing Center
Slide 10: Four reasons for bad behaviors
Four reasons for bad behaviors First: think of one “bad” behavior • Because it feels good (Sensory) • To get out of something (Escape) • To get attention (Attention) • To get something (Tangible) S—E—A—T LeafWing Center
Slide 11: Four reasons for bad behaviors
Four reasons for bad behaviors First: think of one “bad” behavior • Because it feels good (Sensory) • To get out of something (Escape) • To get attention (Attention) • To get something (Tangible) S—E—A—T LeafWing Center
Slide 12: Four reasons for bad behaviors
Four reasons for bad behaviors First: think of one “bad” behavior • Because it feels good (Sensory) • To get out of something (Escape) • To get attention (Attention) • To get something (Tangible) S—E—A—T LeafWing Center
Slide 13: Four reasons for bad behaviors
Four reasons for bad behaviors First: think of one “bad” behavior • Because it feels good (Sensory) • To get out of something (Escape) • To get attention (Attention) • To get something (Tangible) S—E—A—T LeafWing Center
Slide 14: Four reasons for bad behaviors
Four reasons for bad behaviors First: think of one “bad” behavior • Because it feels good (Sensory) • To get out of something (Escape) • To get attention (Attention) • To get something (Tangible) S—E—A—T LeafWing Center
Slide 15: S-E-A-T: It feels good (Sensory)
S—E—A—T 1. It feels good (Sensory) • Flapping hands • Spinning round and round • Jumping up and down laughing • Rolling train back and forth looking at wheels • Bouncing leg or tapping pencil LeafWing Center
Slide 16: S-E-A-T: To get out of something (Escape)
S—E—A—T 2. To get out of something (Escape) • Bedtime • Homework • Dinner time • Any instruction you give your child LeafWing Center
Slide 17: S-E-A-T: To get attention (Attention)
S—E—A—T 3. To get attention (Attention) • Aggress and laugh • Throw things when you are talking LeafWing Center
Slide 18: S-E-A-T: To get something (Tangible)
S—E—A—T 4. To get something (Tangible) • Cookie in cupboard • Candy in grocery store • All out of juice • Sibling took a toy LeafWing Center
Slide 19: Write down the entire situation: A-B-C
• Sometimes it’s difficult to figure out the reason! • Good strategy: write down the entire situation A—B—C LeafWing Center
Slide 20: A-B-C (Antecedent)
• Figuring out what reason your child does the bad behavior A—B—C (Antecedent) LeafWing Center
Slide 21: A-B-C (Behavior)
• Figuring out what reason your child does the bad behavior A—B—C (Behavior) LeafWing Center
Slide 22: A-B-C (Consequence)
• Figuring out what reason your child does the bad behavior A—B—C (Consequence) LeafWing Center
Slide 23: Example ABC's
Example ABC’s Antecedent Behavior Consequence Dad turned off Tom fell to the Dad ran back the TV while floor, banged his into the room Tom was hand on the and turned the watching floor and cried TV back on. Sesame Street Tom stopped crying LeafWing Center
Slide 24: Figure it out!
Figure it out! • Milton, a preschooler, cries when the teacher is passing out popcorn and accidentally skips him. The teacher quickly gives him some popcorn. Milton stops crying. LeafWing Center
Slide 25: Let's do the ABC's
Let’s do the ABC’s A = not getting popcorn B = Milton cries with tears C = teacher gives Milton popcorn LeafWing Center
Slide 26: Milton's reason
Milton’s reason Tangible: communicate wanting access to a tangible (the popcorn) LeafWing Center
Slide 27: Figure it out!
Figure it out! • Steven, a 3 year old hits the teacher and says “no” when given a puzzle to complete. The teacher removes Steven from the table and places him in a chair away from the group. LeafWing Center
Slide 28: Lets do the ABC's
Lets do the ABC’s: A= being given a puzzle B = Steven says ‘no’ and hits teacher C = Steven is removed from the situation and no longer required to complete the puzzle LeafWing Center
Slide 29: Steven's reason
Steven’s reason Escape: from doing the puzzle LeafWing Center
Slide 30: Teaching the "good" behavior
Teaching the “good” behavior • Now we know why your child does the bad behavior • What should the new “good” behavior be?! LeafWing Center
Slide 31: Reminder!
Reminder! Bad behavior payoff Good behavior payoff LeafWing Center
Slide 32: Sensory- the Good behavior!
Sensory- the Good behavior! Flapping hands feels good to look at Flapping a fan feels good to look at LeafWing Center
Slide 33: Escape- the Good behavior!
Escape- the Good behavior! Mother Screaming removes dinner Child asks to Mother be “all done” removes dinner LeafWing Center
Slide 34: Attention- the Good behavior!
Attention- the Good behavior! Hitting mom Mom pays when mom is attention to talking to child (“what adult at park Johnny?!”) Saying “excuse Mom pays me” attention to child (“hi honey!”) LeafWing Center
Slide 35: Tangible- the Good behavior!
Tangible- the Good behavior! Child hits and Dad gives child kicks because the cookie he wants a cookie kept up high Child asks for Dad gives child cookie the cookie LeafWing Center
Slide 36: Teaching the "good" behavior
Teaching the “good” behavior • Now we know some ideas for “good” behaviors to teach • How do you actually get your child to do the “good” behavior? • Help your child do the good behavior when you know the bad behavior is going to happen • Be PROACTIVE! LeafWing Center
Slide 37: Teaching the "good" behavior
Teaching the “good” behavior • Examples: • Sensory (flapping fan) • Escape (dinner time) • Attention (talking to mom at park) • Tangible (getting a cookie) LeafWing Center
Slide 38: Non-vocal communication
Non-vocal communication • What if my child does not talk??!! • Sound approximations • Sign language • Picture communication systems • Electronic communication devices LeafWing Center
Slide 39: Getting rid of "bad" behaviors
Getting rid of “bad” behaviors • We expect that as good behaviors increase, bad behaviors will decrease • Bad behaviors WILL happen at first though Bad behavior Payoff LeafWing Center
Slide 40: The "bad" Sensory behavior
The “bad” Sensory behavior Flapping hands feels good to look at • Remove the payoff for the hand flapping • Help your child do the good behavior so he sees what he should do to get the same payoff LeafWing Center
Slide 41: The "bad" Escape behavior
The “bad” Escape behavior Mother Screaming removes dinner • Remove the payoff for screaming = do not remove the dinner if screaming happens! • Wait for screaming to stop then help your child ask for “all done” LeafWing Center
Slide 42: The "bad" Attention behaviors
The “bad” Attention behaviors Hitting mom Mom pays when mom is attention to talking to child (“what adult at park Johnny?!”) • Remove the payoff for hitting = do not attend to your child when he hits you for attention • When he is standing quietly, help him to say “excuse me” LeafWing Center
Slide 43: The "bad" Tangible behavior
The “bad” Tangible behavior Child hits and Dad gives child kicks because the cookie he wants a cookie kept up high • Remove the payoff for hitting = do not give the cookie for hitting • When he is NOT hitting, help him to ask for the cookie nicely LeafWing Center
Slide 44: Reducing the payoff
Reducing the payoff • What happens when my child asks for cookies ALL THE TIME?! • This will happen and this is great • Change how often you make the payoff happen for the good behavior • The more random the payoff occurs, the more the good behavior will continue to occur LeafWing Center
Slide 45: Summary
Summary • Examples of bad behaviors • What a payoff is • Reasons for bad behaviors (SEAT) • Figuring out the reason (ABC) • Teaching the good behavior • How to react to the bad behavior • Reducing the payoff LeafWing Center
Slide 46: Thank You!! Questions?
Questions? Thank You!! Cori Wickett, M.S., BCBA cwickett@leafwingcenter.org LeafWing Center