Tolerating Removal: Part 2

Photo by Tobyotter

A previous blog entry of mine discussed a student by the name of Johnny, who had difficulty tolerating the removal of preferred activities he was engaging in throughout the day. This problem impeded his ability to work and participate in classroom activities with peers, and was taking over his daily agenda. Teaching could not continue following a break or earned time with a reinforcer, as Johnny would immediately become agitated if the break was to end. 

As a brief recap, we initially set out to teach Johnny to play appropriately with requested art materials. Once achieved, we targeted tolerating the removal of these materials. Our initial target was to have Johnny tolerate a simple touch of the item without actually removing it from him. Over time, we achieved our goal of having Johnny tolerate delays in reinforcement and the removal of preferred activities at varying intervals of time. Johnny began accepting alternative items in lieu of his original request, and work tasks became easier to complete. Meeting these goals was ideal, but we soon came up against a new problem: How do you remove items that cannot be physically removed and offer an alternative option for these requests? Although Johnny was learning to tolerate the removal of preferred items, he still had difficulty being denied access to requests that did not involve activities that could physically be removed. These requests included requests such as walking in a specific direction and working with a specific staff member. 

Our new objective has now become teaching Johnny to tolerate changes in his schedule that relate more to routines and daily events. We started off with denying immediate access to walking a specific way. Once Johnny was able to tolerate waiting to go a specific way, we began to build in walking increasing lengths of the opposite direction requested. Currently, Johnny will tolerate being denied access to walking a specified way and tolerate changes in his daily routine. We did the same for working with specific staff members. Since we cannot control staff absences, this has become our biggest challenge. We continue to work towards having Johnny tolerate being told no, and coping. Coping has become our focus, and we are continually strategizing on how we can achieve this end goal. Again, working towards meeting our overall goal is a long term project, but we move towards it every day.