Good News Friday!

Today, I'd like to share a success story from Imagine!'s Behavioral Health Services (IBHS) team. The story is a great example of how a combination of knowledge, hard work, and creativity can lead to extremely positive outcomes. Congratulations to all the staff at IBHS.

Timmy (not his real name) was 30 months old when he was referred to IBHS, or Imagine! Behavioral Health Services. A delightful child who makes eye contact readily, smiles and laughs often while interacting with others, Timmy also used intense and unsafe behaviors that were difficult to understand and manage, including biting, scratching, hitting, and pulling others’ hair, screaming for long hours during the day and night, mouthing feces, and banging his head on hard surfaces. This situation baffled his team of therapists for two years before they asked IBHS for help in the form of a Functional Behavior Assessment.

IBHS began by conducting a Functional Behavior Assessment (or FBA) to understand Timmy’s interaction with his environment, in order to develop his individual behavior treatment plan. IBHS quickly learned that Timmy used the dangerous behaviors to produce responses in the environment that met his needs, and within a month Timmy’s mother and caregivers were educated in providing attention after behaviors that were socially appropriate, and were often “incompatible” with his old patterns of behavior. For example, when Timmy met a favorite person he used to look up, smile, reach out and grasp then pull their hair. Now, Timmy’s mother is very skilled in prompting Timmy to give his favorite people a high five! Fortunately for Timmy, this new behavior is both acceptable in the community and comfortable and effective in helping him to greet a person using his hands. Now Timmy’s family is using behavioral techniques to move beyond inappropriate behavior, to teach him new skills like how to wear his new glasses.

Now that he has turned 3, Timmy’s team supported by IBHS has accomplished several things important to his family. After the FBA was completed, Timmy’s team learned that he had Angelman’s Syndrome. In the context of this genetic diagnosis, Timmy’s behavior makes much more sense! In children with this diagnosis, it is very common for the child to not use verbal language, and to use all sorts of difficult and dangerous behaviors that the caregiver responds to, often because of safety reasons. IBHS understood that this diagnosis makes it even more important to teach caregivers and others to prevent dangerous behaviors by providing appropriate attention, while teaching and strengthening alternatives like playing with toys. That’s why IBHS developed a unique transition document called the “Go Team Timmy” Booklet. This booklet explained in family and school friendly language, all of the important ways to prevent problem behaviors, and how to use teaching moments to make sure Timmy enjoys his time with favorite people, meets his needs, and stays safe.

After Timmy had stopped receiving services from IBHS and went to a family reunion, his mother wrote: “your book was a huge [hit], I sent it to my uncle who has three adolescent daughters with lovely long hair, and they all read it and did an amazing job … It was so helpful! Since they read it ahead of time we didn't have a single instance of hair pulling. I think it really helped them to feel comfortable around him too since they hadn't seen him in 2 years and have never really known what to say about his disabilities.” Timmy is now attending a local preschool, which has asked IBHS to teach their staff to use behavioral techniques, to ensure he continues to make progress.

(story stated by Camille Kolu, Ph.D, BCBA-D)