Martha: Here is another question. My daughter will throw herself to the ground during a tantrum if she gets very upset about not getting her way. How can I prevent this?

We have some suggestions. Observe the reinforcers that are in play that are maintaining the tantrum behavior. Observe the precursor emotional indicators of distress, fear or agitation. We talked about this in Webinar #3, to learn your child’s unique body language and to intervene at the first sign of emotional distress, to introduce successful or pleasing activities, to tag all productive responses or behaviors, and use high-level reinforcers. Questions, comments anybody?

Joan Orr: Shubata has a comment here: “When we teach a child to wait, for example in the grocery store, while the parent is buying stuff and paying at the cash register, how do you teach this? Do you tag every minute or do you tag at the end of waiting?”

Martha: We have an entire blog post on this.

http://autismchaostocalm.com/resources/resources-the-grocery-store/

There are multiple parts to the grocery store trip. There is walking through the store, and I always tag “Hands On Cart.” In the beginning, I kept the trips to the grocery store very short and tagged very intensively for “Hands On Cart.” That’s how you keep the child engaged as you go through the grocery store. They have to keep their hands on the cart and eventually they push the cart, which is a big help. At the check-out line, you simply have to teach “Wait.”

I taught my son how to wait as part of his walking curriculum, because of course you have to wait at corners and at traffic lights to cross the road. So you start out by reinforcing them just for “Stopping,” or, “Both Feet On Ground” or “Both Feet On Floor.” Then you extend that. You say, “I’m going to count to one,” and reinforce while you count to one. Then you count to two and three and then you start introducing little nursery rhymes. You say, “Twinkle, twinkle, little star.” If they can stand while you recite the nursery rhyme, you tag. If you can get them involved in reciting the nursery rhyme or counting, that’s great. They don’t have to be verbal. My son was not verbal and we did this with signs. He could sign the word “star” and he would sign his numbers or his letters. We would recite the alphabet or count. You reinforce your child for these activities while you’re waiting in line. Pretty soon they get to be good at waiting in line because they have a lot of successful interaction. It’s a whole little curriculum that is outlined in the Chaos to Calm blog, so we have lots of recommendations for that.

Joan Orr:  Cathy says: “It’s difficult for her to teach her daughter “Stop” to understand the concept of pre-teaching. Pre-teaching is crucial to her success.”

Martha: Yes, that I hope that would be something that the school or the program could implement for her. Maybe some other support could be brought in to help them with that. I can understand that that’s difficult.

Joan Orr:  Minuto asks, “Why do you think that keeping them engaged works?”

Martha: Do you mean, in the line? Because they love it. My son loved it when I was engaged with him, especially when I gave him little tasks that he could do that he got rewards for. And of course in the grocery store it’s very easy to pick out a nice little treat for your child. That can be the last thing you do at the check-out. They have all of those lovely little candy trays, so after your child does all of those little activities, like counting, touching eyes, ears, nose, counting to three, saying A,B,C, then you can pick out a nice little candy right there at the check-out, and they can get that when you’re through with the check-out. So, successive reinforcement, positive interaction with mom, were very motivating for my son.

In Part 3 of this course, the topic of tantrums and how to manage and reduce them was covered in detail.