by Heather Logan | Jun 07, 2017
Written By: Brian J., Clinical Director, A is for Apple, Inc.

One of the challenges that every clinician faces when providing services to families is preparing them for extinction bursts. How do we prepare them? Before I get into the how, allow me to explain what an extinction burst is.

According to the ABA bible AKA, Applied Behavior Analysis 2nd edition by Cooper, Heron and Howard, an Extinction Burst is an increase in the frequency of responding when an extinction procedure is initially implemented. This is a great definition however for a parent such a simple, albeit accurate definition, does not prepare caregivers for what their children do in real life. I should explain what extinction is before we move any further.

Cooper and colleagues, mentioned previously, define operant extinction as the discontinuing of a reinforcement of a previously reinforced behavior (i.e., responses no longer produce reinforcement); the primary effect is a decrease in the frequency of the behavior until it reaches a pre-reinforced level or ultimately ceases to occur. (See extinction burst, spontaneous recovery; compare respondent extinction). Cooper and his colleagues sum up extinction very well but for my families, I use a different example, that I was exposed to during my coursework in ABA known as the coke machine. I have found the coke machine example to be very relatable for families, and it seems to prepare them better, for when their child demonstrates escalated behaviors.

So how do I tell them? First I explain how behavior works in very simple terms. Behaviors emerge and become well established because they work. If they do not continue to work they do not have much reason to continue to occur. The more established the behavior is, due to a history of reinforcement, the more likely it is to occur in the future. So in terms of a coke machine we learn that if we have enough money, and follow the correct sequence of steps, we will get our coke from the machine. Here is where extinction bursts come into play.

I explain rather humorously what happens when we follow all the steps and the machine doesn’t give us our coke? What do we do? What we do next is basically an extinction burst, we keep trying, we might kick or shake the machine, etc. Why do we do this? Because of the history of reinforcement! We followed all the steps and we didn’t get what we wanted. “We had a deal coke machine! You broke it!” I compare the coke machine to other vending machines like the ones that give us candies and joke around about people I have seen that are very mild mannered, basically losing it, when the candy is just there dangling. Parents usually smile, and give me that uh, huh look, like they get it. I call this the light bulb moment. Which is fitting because every time I see the light bulb moment it makes my day. So it’s easier for them to understand when their child starts displaying more frequent, longer duration, more intense, or some new behaviors, when we cut off the reinforcer, following their engagement in the target problem behavior.

I usually follow up with the family about how important it is to make sure the behaviors we don’t want to occur stop working. If we do not want tantrum behavior it has to stop producing the coke. We want to give them replacement skills instead. In the coke machine example I remind them that usually there is a number on the machine they can call, we could find another machine, etc. There’s better ways to get what we want without destroying property.

Why is it so important to connect with parents about implementing procedures like extinction? Because, if we do not, we leave the door wide open for problems trying to get buy in again with them. I have seen examples of families that were not sufficiently prepared for extinction bursts and they lost buy in with the treatment team. They were less likely to follow the treatment plan and fell back to previously reinforced behaviors of their own, following problem behaviors. Parents have their own motivations, i.e., to get behaviors they don’t like to stop as soon as possible. In my experience getting parents on board early is crucial to effective treatment so I encourage every clinician I come across, to use more relatable examples, and break down Applied Behavior Analysis (ABA) treatment procedures and principles for families, so that they can get and stay onboard with us. As a relatively new field we have a duty to the families that we serve, and our ABA community of professionals to maintain relationships between those we serve and our practice. Effective service delivery is the best way to spread the word about ABA therapy. In my experience you cannot have significant effective service delivery without buy in from the most significant people in the individuals lives.

If you have a story about how you got buy in, and assisted families through some of the most challenging aspects of behavior change procedures, please share, you might have a broader impact than you think.