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© 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 FBA process specialized to the specific routine being targeted.

  2. Normalize’ the routine rather than it always being an obvious 'intervention.' 

  3. Identify key related deficits & related skills….proactively identify and teach pivotal/collateral skills which will help make the targeted routine more successful.

  4. Consider behavior cusps; create successful new experiences rather than repeating/force fitting the old. 

  5. Identify similar Interfering Behaviors which are functionally aligned and can occur during meal routines AND other times of the day.

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

  7. Teach these related skills across the day (e.g., time delays/waiting; self regulation/coping; FCT; social interaction; ‘orientation;’ sustained attention; 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).

  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!