The Effects of a Scripted Calming
Procedure
Steve Ward, MA, BCBA
Whole Child Consulting, LLC
Incidence of Anxiety Disorders
• Many learners with ASD also demonstrate anxiety
disorders, leading to demand for treatment
development (Attwood, 2003)
• Compared with a group of adults with intellectual
disabilities, adults with Autism Spectrum
Disorders demonstrated 3 times the incidence of
anxiety disorders (Gillott & Standen, 2007)
• Children with ASD demonstrated greater anxiety
than typically-developing peers (Gillott, 2001)
Anxiety Disorders and Autism
• Kanner (1943) speculated that there was a link
between an insistence on sameness and
anxiety.
• Groden (2002) speculated that individuals
with ASD lacked coping mechanisms and/or
the ability to cognitively appraise stressful
situations.
The Inventory of Good Learner
Repertoires
• The Inventory of Good Learner Repertoires
assesses a wide variety of learner behaviors,
with consideration for the contexts required
to maintain those behaviors.
• In the IGLR, C12 and C13 relate to calming
when upset and calming when excited. The
former is more frequently relevant, and will be
addressed here.
Screwing it up and wasting time
• Calming has nothing to do with learning to
associate your level of tension with a color or
a number. In fact, we can skip verbal
responses, entirely. *More on that later.
• Too many people only say “calm” or “relax”
when their student is already upset. Before
training, those words don’t have stimulus
control, and tend to become conditioned
aversives.
Doing too much, or at least doing it at
the wrong time
• Teachers often make the faulty assumption
that they need to do something to calm an
upset student. Interventions frequently do
more harm than good.
• The ultimate goal is for students to calm
themselves, and sometimes it’s a simple
matter of giving them long enough to do so.
Why are they upset?
• A functional assessment may be relevant.
*It’s never completely irrelevant, but may be
of primary relevance. For example, “upsets”
may earn immediate escape from demands or
improved access to attention or tangibles. In
those cases, a simple extinction procedure
may completely fix the problem. If supports
aren’t necessary, don’t introduce them!
But,
• Extinction (and DRA) are not always enough,
and not always feasible.
• Some learners begin protesting things they
typically enjoy, like riding escalators or
swimming (and their protests are not
attention-maintained).
• The tendency not to calm may represent a skill
deficit.
DRA is not always feasible
• An “escape extinction haircut” almost never
looks fashionable.
• Planned ignoring first leads to increases in
intensity, which may not be tolerable. Waiting
for increases in intensity, and THEN providing
attention only increases the “explosiveness” of
future episodes.
Planning to avoid stressors
• Some teachers will plan to avoid stressors. If
there is one stressor, and it is located at the
bottom of the ocean, this is a pretty fair strategy.
• Avoiding stressors does not teach a student to
manage tension.
• Stress avoidance can become increasingly
debilitating.
• Look at stressors as “opportunities for growth”.
One “cookbook” approach has
consistently helped
• “Calm counts” , combined with desensitization
procedures, when used PROACTIVELY, have
provided multiple benefits, where other
procedures have provided none.
• It’s not really “new”…it’s basically a
combination of systematic desensitization and
very sensitive socially-mediated feedback.
Potential Benefits of “Calm Counts”
• They teach learners what “calm” is.
• They teach learners (even if they’re
nonverbal) to recognize what tension feels
like, and to undo tension.
• Support is provided when they’re “calming”,
and withdrawn when they’re escalating (lay
folk tend to get this upside down). We should
“catch ‘em calming”.
More benefits…
• Learners can contact a greater variety of
reinforcers (also minimizes future limitations,
e.g., E.S.)
• Learners come to see their teachers as sources
of support (Jon stuck to me more).
Even more benefits!
• The procedure can potentially be extended
into “calm boxes”, or interval schedules of
reinforcement for absence of inappropriate
behavior.
• Calm counts directly remediate the stressors
to which they are applied.
OK, let’s see a calm count
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Provide a small stressor (picking stressors)
Count to 10 (5 for some learners)
It’s OK to use your fingers
Count roughly “1” per 1.25 seconds
Model very calm affect
Calm counts, continued
• At ANY sign of tension, say “Ooh, you need to
be calm”, pause counting, and avert your gaze
• As soon as the tension subsides, resume
counting and looking at them
• Only start over at “1” if it takes more than 10
seconds to calm down
Jon’s Calm Count Data
Reactive Calm Counts
• Be VERY CAREFUL (we don’t want to create
unhealthy behavior chains, beginning with
problem behaviors and ending with
reinforcement). *Remember, if calm counts
are being “learned”, they are being reinforced.
Leaving a stressor equally present after a calm
count puts the calm count on extinction.
More Reactive Warnings
• Reinforcement after calming down CANNOT
be better than it would have been if they
hadn’t become upset in the first place.
• You must very carefully monitor the timing of
your increases/decreases in
feedback/support.
When should we NOT use calm
counts?
• For a learner who is already upset and has not yet
developed competence with proactive calm
counts.
• In circumstances in which there is no logical way
to reinforce a calm count. *Note, blocking
transition from an area is sometimes an effective
motivational operation.
• For a learner who has progressed to a point at
which you are targeting decreased dependence
upon your support to calm down.