Assignment # 4 A Snapshot of my Practice

PRE-ENGAGEMENT

Preparation and Purpose

            For the previous session I brought in 2 small notebooks and some stickers. The plan was that for every completed homework problem A would get to put a sticker in her little notebook. The other notebook was for T who is often with A and I when we work on homework because her homework completion takes longer then most of her other classmates as well. I spoke with A all about the project I had planned for her and she was very excited about receiving a prize. Although A had expressed great interest in receiving a prize her actions did not show that a prize was her top concern. I kept trying to get A to sit at the table so we can get her work started and she made it very difficult. She insisted on running around and did not appear ready to sit down and be serious.

            Eventually I realized that I was pushing too much and it was time for A to take her own initiative and learn about the consequence of not finishing her homework on her own accord. I also had to eventually stop chasing after her because she was not my only concern that session because we were understaffed and I needed to take a whole table of children to help with their homework. This time, T was at a table with another counselor but had the little notebook that I gave her. Throughout the session T kept calling to me to show me every time she completed a homework problem. I responded by saying "oh wow great job ok so we'll count up the amount of problems you completed at the end and we'll put that many stickers in your notebook". It was very interesting that although the study was initially meant for A it seemed to really work with T.

NARRATIVE

            Before the session had begun I saw that A already looked like she would not be able to sit down and concentrate on homework completion because she went in and out of the classroom and was very difficult to convince to stay in one spot. I decided to take the opportunity to again discuss the evaluation study with her. I said to her "remember A, if you get a certain amount of homework done, you can receive a prize" she showed enthusiasm and said "ooh yay a prize! When do I get it?” I answered her and said "well you get a prize when you get 10 stickers but to get a sticker, you must complete a homework problem". I wanted to hear it from her own mouth to see if she comprehended the plan so I asked her to tell me what it takes to get a prize and she said "I have to listen better" I said to her yes that and you have to complete a homework problem so you can get sticker and then you can get your..." she said "then I could get my prize" I said "yes exactly". Again we were understaffed and I was not able to work individually with A and T. I again had to take a whole table of children.

            Although A and I had a whole conversation and what seemed like an agreement, A would not sit down in her designated seat at the particular table that I was working with the rest of the children. T was at my table this week and did not forget about my sticker system. But both little notebooks were lost the previous week so I had to improvise and make a chart on a regular piece of paper where stickers could be placed after completion of a homework problem. Because I felt like it was counterproductive to chase A around and my responsibility was not just her, I told A that she can come to me when she's ready to get her homework started so she can receive a sticker which can ultimately lead to receiving a prize.

            I sat down with the other children and they all wanted in on this sticker chart and prize thing. Because it would be unfair to not include them in the process at this point, I wrote all their names on the paper in sections so stickers could be placed there. I decided to collectively include them and explained the process to them. In order to encourage them and get them excited I made an agreement with the children at the table by saying that every child can choose a sticker to start with  and wear, and this sticker meant that they would participate, listen and get their homework done which in turn meant receiving stickers. For them, I decided they would need 20 stickers to get a prize because many of them work faster than A.

            Because the process became a sort of kind of "club" and everyone at the table was listening and participating A eventually came over to the table ready to do her homework. A's homework is modified (she does not have to do as many homework problems as the rest of the children so although she came late, she pretty much finished all of her homework, but this was not exactly an easy process. I then had A do her Hebrew homework because it was easy and due in 2 days as opposed to the next day.

            Probably because this homework sheet was not difficult and because the directions were simple and it was clear to A what to do, she finished it faster than I've ever seen her complete homework. She didn’t even look away once; she just concentrated carefully and completed it quickly. Completely surprised and impressed from what I had just witnessed I said to A "wow I am so proud and impressed by how fast you finished that homework sheet and I noticed that you did not look away from that sheet once!" She had a big smile on her face and it was clear that she enjoyed receiving the compliment. The session was almost over so I put stickers by everyone's name according to how many homework problems they completed and then it was time to go.

IMPRESSIONS

            For the previous session, I learned a lesson that I feel is important for the social work experience as well as in life in general. Although I had a whole plan of how I would conduct the study and how great I thought the plan was, it takes more than that for a plan to work. A was not ready to participate and the circumstances were not ideal (understaffing, leaving me to take on more children than expected...). I found this frustrating and I was disappointed, especially because I felt like this could be helpful to A, but I had to accept the reality of the situation. But, it was very interesting to see that for T the plan seemed to work even though that is not where my focus was to begin with. T is a bit slower compared to her peers when it comes to homework completion but not as slow as A and does not show the same signs of ADHD as A.

            For this session, it seemed that A eventually realized that she was missing out by fooling around and not doing what she was supposed to. I think that although it caused a slow start for beginning the homework, it was a good idea to get everyone at the table on the same page, so that composure and participation was present. This was not only beneficial for the children at the table but it appeared to have an impact on A as well. I assume that seeing the children behaving and benefiting from that, made her pay attention to what was going on and gave her a sense of clarity. Seeing all of the children receiving stickers just for agreeing to behaving at the beginning was probably the first thing that appealed to A, but after seeing that they were involved and engaged even a while after, must have solidified that this was the thing to do and the place to be.

PLANS FOR FUTURE ACTION

Remind A about the sticker system and remind her about how quickly she completed the Hebrew homework sheet the last time, and reiterate to her how impressed I was. I will probably again have to work with A and T along with other children.

QUESTIONS

It seems that A's ADHD and lack of maturity for the first grade is more severe than I initially realized. Is it still proper to continue with this same type of process even though it seems that she may need something more intense then this? Maybe even punishment that she can understand and learn that there is a consequence for not behaving and not doing her homework?

Assignment # 3: My Intervention

            For my intervention with A, I have decided to use Behavior Modification. The desired behavior in this case is for A to have better focus during homework. This means a reduction in the amount of times A looks away from her homework. Research has shown that the most effective way of treating ADHD is using a combination of medication and behavior modification. For this case, medication is not an option; therefore it will rely on behavior modification alone. (Chang, H.H., Chang, C.S., Shih, 2007)

In an article by Pelham and Fabiano (2000), it is stated that above all behavior modification is the preferred method:

Attention deficit/hyperactivity disorder (ADHD) is a chronic and substantially impairing disorder. This means that treatment must also be chronic and substantial. Behavior Modification, and in many cases, the combination of behavior modification and stimulant medication, is a valid, useful treatment for reducing the pervasive impairment experienced by children with ADHD. Based on the research evidence reviewed, behavior modification should be the first line of treatment for children with ADHD. (Pelham, Fabiano, p. 1, 2000)

           

In Behavior Modification the consequence of the behavior is crucial to the efficacy of the intervention. Observable and measurable behaviors are assumed to be good targets for change. Reinforcers are consequences that strengthen behavior; they increase the rate or probability of a behavior. (Mather, Goldstein, 2001)

             In A's case, the behavior that we would like to strengthen is better focus during homework. In order to accomplish this, positive reinforcement will be used. Although the baseline will be measuring the amount of times A looks away from her homework, the ultimate goal is to strengthen concentration of the task at hand (homework). Therefore a significant reduction in the amount of times A looks away from her homework will signify improvement in homework concentration.

            When using positive reinforcement there are a few steps necessary for it to be done properly. The first step is that the problem must be defined. The second step is to illustrate a design to change the behavior. The third step is to choose a reinforcer and the fourth is applying the reinforcer consistently in order to shape or change the behavior. (Mather et al, 2001)

            The identified problem in A's case is distraction during homework time. This is defined by the amount of times A looks away from her homework. In order to reduce the frequency of A's looking away from her homework, she will receive a reward for the apparent times that she is concentrating. A chart will be made for both A and I to keep track of every homework problem she completes. Each time a problem is complete A will receive a sticker that both she and I will alternate putting on the chart. The purpose of having A sometimes put the sticker on the chart is to give her an active role in this process. If she feels like an active participant, she is more likely to be excited about the process and will hopefully be motivated to achieve the goal. (Mather et al, 2001)

            After speaking to A about what she would like as a reward for concentrating on her homework, she told me that she would like a prize. Because it is such a difficult process to get homework done with A, it would be unrealistic for A to be motivated to complete her homework if the prize was received only after all of her homework is completed; the waiting period would be too long and would make the goal appear out of reach. Therefore I have decided to use the stickers after each homework problem completion so A can see her progress as she goes about her homework and can view receiving a prize as a likely possibility. It is important that the reward is viewed as a viable option to A. (Mather et al, 2001)

The stickers will serve as a small reinforcer that can lead to receiving the larger, more desirable reinforcer. We will decide together on an appropriate amount of stickers received/problems completed, that will be required in order to receive a prize. We will also create a reinforcement menu; meaning that A will list prizes preferable to her so that her motivation to receive the reinforcement will be ensured (I will of course make sure that the prizes are realistic). The idea is that as long as the behavior is followed by a reinforcing stimulus, the possibility of that behavior to occur in the future is increased. (Mather et al, 2001)

Behavior modification comes from B.F. Skinner’s Operant Conditioning which is connected to the theory of Behaviorism. Operant Conditioning is the use of an antecedent and/or a consequence of a behavior to influence the occurrence and form that behavior. It is a method of learning that occurs through reward and punishment. The reward is a positive or negative reinforcement which strengthens or increases the behavior by adding something that is considered a reward or subtracting something that is considered unpleasant. (Gale Group, 2001)

Skinner created an environment for a rat in which the rat would receive food whenever it would hit the lever. Eventually the rat "learned" that hitting the lever resulted in the appearance of food and it would therefore continue to hit the lever in order to receive the food. Skinner related the same form of operant learning to human beings. Human beings operate in their own environments and learn from the consequences of their behavior as long as the behavior is consistently reinforced. In Skinner’s rat situation the food is the reinforcer and the lever is the operant. In A’s case, the stickers as well as the ultimate prizes are the reinforcers and the homework completion is the operant. I am very excited and curious to see the final outcome of this project and hope that it will make a significant difference in A’s learning. (Gale Group, 2001)

References

Chang, H. H., Chang, C. S., & Shih, 2. (2007). The process of assisting behavior modification in a child with attention-deficit hyperactivity disorder. The Journal of Nursing Research, 15(2), 147.

Gale Group. (2001). Operant conditioning. Gale Encyclopedia of Psychology 2nd Edition, , march 9th, 2011.

Mather, N., & Goldstein, S. (2001). Learning disabilities and challenging behaviors: A guide to intervention and classroom management. Paul H. Brookes Publishing Co, , 96.

Pelham, W. E., & Fabiano, G. A. (2000). Behavior modification. Child and Adolescent Psychiatric Clinics of North America, 9(3), 671.

"Operant conditioning". Encyclopedia of Psychology. FindArticles.com. 09 Mar, 2011. http://findarticles.com/p/articles/mi_g2699/is_0005/ai_2699000572/ Gale Encyclopedia of Psychology, 2nd ed. Gale Group, 2001.