Clinicians are often presented with physical symptoms that suggest medical involvement during assessment or intake. The first thing that therapist should consider doing is to recommend that the parent or caretaker immediately or as soon as possible follow-up on a medical issue. The medical issue should be ruled out and addressed by the parents in order to treat the client effectively with behavioral treatment. Some examples of medical issues might be something as simple has hearing loss or ear infections. There is a large body of research and talks at conferences about the relationship between hearing or ear problems and diagnosis such as autism or other developmental delays or diagnosis. There is a large body of research regarding other medical problems such as blood pressure, diabetes or low blood sugar, constipation and the resulting behavior problems that may occur. A thorough physical or a specialist such as an otologist may be a good recommendation. If there is a strong reason to believe that a general physical may not be sufficient then an expert in the problem such as an otologist or cardiologist might be something for the caregiver to consider in order to completely rule out the medical origin of the behavior. However, even if there are medical causes of a behavior one can still treat the problem with non-restrictive behavioral procedures. Often the behavior problem has both medical and behavioral causes that are revealed in the functional assessment. Therefore both behavioral and medical treatment can work together to resolve the issues and the child can look forward to the possibility of achieving a normal life without behavior problems!
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Social Skills Training it is important to generalize to situations, locations and stimuli easily.8/2/2013 Therapist can more easily generalize behavior with the session by introducing different antecedents, situations and consequences within the training session. This reduces the cost, time and inconvenience of going to different location and situation in the community. The formal program may contain the basic skills and informal reinforcement can be used during the day to program for generalization outside the session.
For example, the therapist may work on saying "hello" during the session and then have the client practice saying hello by answering the telephone throughout the day or greeting people that come to the door. The informal parts of the program that are modeled and discussed with the family can lead to a more dramatic and improvement in the client overall behavior observed by others in the community. Pshychotropic medication and behavior therapy work together and separately. There are advantages to using behavior therapy in conjunction with medication. The parent or client can gradually reduce the medication as the problem behavior becomes manageable or disappears. This is usually done with through the use of graphic displays of the progress/outcomes, data collection sheets, observation in different environments and analysis of the trends of the problem behavior compared to the medication changes.
It should be noted that some problems do respond well to medication based on the research and some problems are merely improved by a sedation of all behavior. One might consider researching the medication to affirm that there is some validated benefit before using it for yourself or a child. It is helpful to note exactly when the changes are made in the clients medication so that it can be determined whether any benefit is derived from the medication. Discussion about reduction or changes should be brought up at each meeting with the doctor prescribing the medication. It is useful to bring a graph of the behavior and general procedures used so that the doctor understands all variable affecting the progress of the clients behavior. For example, if a new program procedure started last month and the behavior decreased dramatically then a reduction in the medication might be discussed and considered. Generally, the doctor usually reduces the medication slowly so that there are no side-effects. Generally, taking medication for long periods of time or even short time periods can cause serious and mild side effects and this should be considered in deciding whether to use medications. It should be noted that each individual case is deferent and other factors in the environment or health factors also effect the behavior of the client. Individual differences and specific graphs or data should be used as tools in making decisions about whether to take medication, reduce medication or change medications. Behavioral Procedures and Effectiveness in increasing or decreasing the desired targeted behaviors8/1/2013 Many Procedures have bee identified in Studies as effective. However, it is crucial for both parents and researchers to consider the exact methods they use to implement the procedures and compare them to what was done in the research in order to make sure they are implemented in the same manner and are effective. In fact it is very common for a proven procedure to be ineffective or actually make the behavior worse if they are implemented inappropriately. Almost all Procedures such as reinforcement, token programs and overcorrection must be implemented in the specific manner that will allow them to perform functionally and increase or decrease the behavior. For example, a therapist that give reinforcement without smiling and just say "good job" may be meaningless to the client and the function of the behavior if not done in the correct manner or even could increase inappropriate responding. The therapist/parent/teacher should be careful in some areas in particular for example the non-verbal behavior must match the words. If you say "good job" then a beautiful smile, clapping or jumping up are examples of non-verbal behaviors that will stenghten the procedures.
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