© 2023 by Lou Sandler, PhD, BCBA - D.

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Self Care/Toileting

Sleep/Bedtime

Eating/Mealtime

Functional Communication:

Choice; Preference; Access: Engagement: Participation; Awareness/Orientation

QUALITY OF LIFE TRIANGLE

General Considerations

  1. Administer an ecological FBAassessment which can focus to the Point on the Triangle being targeted.

  2. 'Normalize,’ prioritize and teach to the routine - first - rather than making it another obvious 'instructional' program. 

  3. Identify key related/collateral deficits & related/collateral  skills….proactively identify and teach those specific pivotal/collateral skills which will help make the targeted routine more successful and leave less reason for Interfering Behavior.

  4. Consider behavior cusps; create successful and teach new/novel experiences rather than repeating/force fitting the old (and, often, already less successful). 

  5. Identify similar Interfering Behaviors which are functionally aligned with those in the specific Point of the Triangle being targeted which also occur at other predictable times of the day.

  6. Assess and identify MOs/EOs and setting conditions which both increase and decrease the probability of success.

  7. Teach related (pivotal) skills across the day (e.g., time delays/waiting; self regulation/coping; FCT; social interaction; ‘orientation;’ sustained attention; effective in-context choice making; shared control…).

  8. Utilize most to least/prompt fade model. Decide if that next prompt is REALLY necessary…& if it is, make sure it’s appropriate and given to the minimal degree needed for the individual (always be on the watch for ‘learned helplessness’ or prompt reliance). Necessary prompts should be, at the least, 80% effectiveness. 

  9. Focus on the effectiveness & in-context success of the full routine for each session (i.e., total task chaining or presentation).

  10. Watch out for Coercive Cycles (i.e. cycling positive to negative reinforcement).

  11. Remain actively & positively engaged...participate as naturally as possible.

  12. Minimize - eliminate - directly aversive strategies/punishment as part of meal/food routines

  13. Be proactive through the day…remember that the best time to respond to interfering behaviors is before they occur

  14. And, please, don't spend time teaching children to 'kiss' food!