 Okay, so this is Veronica Howard. We're going to switch gears now. We're going to talk a little bit about timeout as a negative punishment procedure. Timeout is kind of an interesting variant on negative punishment because we're talking about the temporary removal. We're talking about the removal of some stimulus or some environment of reinforcing value. And timeout is actually super well known in everyday culture, but here's another example of a situation where we think that we know what's going on with this particular procedure, but what we actually know from our experience, learning about the second hand, learning about it from other people in our culture, it's actually really poor science. I'm going to talk to you a little bit about that, but there's also some optional reading material for this week that talks about timeout. And if you're interested in this and in how we change behavior or how we do kind of progressive behavior change or discipline for young kids, I would encourage you to check it out. Okay, just one second. Okay, pardon me there. So when we're talking about timeout, this is actually kind of an interesting variant because it's a procedure, a punishment procedure in which the person, rather than a stimulus, so the person themselves is removed from a reinforcing environment, contingent on behavior. And the examples I was giving you before, it was like the example of a stimulus being removed from the person. And in timeout, we switch it the other way, we say instead that we're going to take the person out of the environment. Now, what are the big myths that we have about timeout is what that means. The part that I find as a practitioner, the most frustrating and the most disheartening is that timeout is actually part of a larger expression, which is this. Timeout is timeout from reinforcement. It means that the person contingent on a specific target response is going to be temporarily removed from their environment. And that environment had to be incredibly reinforcing such that the removal of that person from the environment decreases the problem behavior because they're losing access to all these amazing reinforcers. In fact, one of the earliest examples of the use of a timeout procedure was in this Wolf-Risley and me study from 1964. This is one of my favorite studies about a kid named Dickie. Dickie was about three and a half. He had autism and he had a really severe cataract. So the lenses of his eyes were so, so thick. And the difficulty was that they were going to have surgery for this kid. But doctors said that if Dickie didn't wear his glasses regularly, that the surgery would actually not be effective. It would be very difficult at keeping the lenses of his eyes in the proper position. And if he wasn't actually wearing his glasses, he would go blind within about six months. So you see here, when we're talking about potential harm to the client because of a behavior or lack of behavior, this is one of those situations where it's kind of, it's high stakes. You have to get the behavior to occur because otherwise, this particular child who might otherwise be cited for the rest of their life and have maybe a little bit easier go of it because of their ability to see, they would lose that if they're not wearing their glasses. So this was also particularly challenging because whenever parents would try to get Dickie to wear his glasses, he would just lose it. He would have very aggressive tantrums so much so that he would try to hurt himself. He would hurt his caregivers. Like this was aggressive behavior plus a lack of a behavior wearing the glasses that we really need to see to make sure that Dickie was being safe and healthy. So you can see we kind of two target behaviors here. We have one, tantrums, which they themselves, they're very aggressive. They're dangerous to the client. They're dangerous to people around the clients. The parents, which we'll talk about, can send to this clinical procedure. And you see we have a very short time span. So while we might like to look through and find lots of less invasive procedures in the 1960s, they were not as worried about the humane hierarchy. So they just went ahead with this form of treatment that combined differential reinforcement and shaping. Those are two procedures that we're going to learn coming up. And essentially what it means is Dickie would earn some treats whenever he would approach the glasses and then when he would touch the glasses and then when he would wear the glasses. They were essentially trying to desensitize Dickie because he had this really bad learning history around those glasses. And if they had just started with, okay, we're going to make you wear them for a little bit, he would have flipped out. So we're doing kind of an approach procedure where we're reinforcing the value of the glasses or we're pairing the glasses with a reinforcer. But here's the negative punishment part. Dickie would earn a 10 minute exclusionary timeout whenever he had a tantrum or engaged in self-injurious behavior or aggressive behavior. So an exclusionary timeout is one where the client themselves are removed from the environment and placed in another, more restrictive in this case, it was a hospital setting, so a hospital environment. And he would stay there for the duration of the tantrum or 10 minutes, whichever occurred longer. So we see that we have a combination of reinforcement and punishment being used here. But the most important part here is this 10 minute exclusionary timeout. And I am of course very happy to report that these researchers were very effective that not only decreasing the self-injurious behavior, because remember the self-injurious behavior in the tantrums were probably paying off by keeping Dickie from having to wear these really awful glasses. When that didn't work anymore, and when the glasses became less awful, we see that the rate of the problem behavior decreased dramatically, and Dickie went on to wear the glasses and keep his eyesight. There's also some important ethical considerations to be made here for Dickie's situation. Remember that I made a couple references a moment ago to this idea of the humane hierarchy. And so remember that the humane hierarchy refers to this kind of level or order of intervention. When we're doing behavioral interventions, we always want to start with the least restrictive procedure possible. The first one here being determining whether there even really is a behavioral problem to be addressed or whether it's medical or something else that might be better accomplished by a different kind of practitioner. So in this case, we saw that Dickie did have a legitimate medical problem, but the difficulty with the cataracts was that if he wasn't engaging in the eyeglass wearing behavior, that he would have been blind again. So we've addressed the wellness or nutritional issues there. And to see an arrangement just looks at whether or not you can change the environment to promote behavior and sometimes intervening before the behavior happens is helpful. So you're like putting up a hand washing sign in restaurants at restaurants. And then we go through the more restrictive procedures. So in the scenario that I described for you for Dickie, what we had was differential reinforcement, which we'll come back to and we'll talk about in a little bit, where Dickie was earning reinforcement for approaching the glasses and wearing the glasses. But there was also negative punishment in that he was removed from the environment every time he was wearing or every time he would engage in self-endurious behavior or aggression or have a tantrum. So it might be more ethical to say that perhaps there could have been some ways to intervene up here, but ethics are always very squishy. The difficulty is that remember there was a very limited timeframe that's six months. And so this is a tough situation. Was it appropriate to jump to negative punishment for the self-endurious behavior and timeouts? What I think a modern behavior analyst would tell you is that we have other more effective tools in our arsenal now. And we'll talk about how do we figure out what's maintaining a behavior? How do we make sure that we're intervening in the right way when we talk about functional analyses coming up in just a couple weeks? But for now, I think that this was a study from 1964. This was one of our earliest studies. So giving it just a little bit of slat, giving it just a little bit of patience there and recognizing that we have advanced quite a bit from that. All right. So let's finish up by talking about some of the most critical mistakes that I hear about when consulting on the behavior of clients. First of all, remember timeout is part of a larger expression, part of a larger statement. The longer version of this is timeout from reinforcement. So if you have a problem with the client, you have to first, before you even consider the use of timeout, is ask the question, okay, is time in reinforcing? If your time in environment, if the environment where the client finds themselves is not reinforcing, it's definitely not going to be punishing to be removed from that environment. A good example of this would be, for instance, sending a kid to the principal's office. If the person in school is going from say, like a really difficult history lesson, and they dislike history and they have a bad history with history, no pun intended, and you say, all right, enough goofing off, Julie, you're going to go down to the principal's office. And that allows them to go from an environment where it's aversive to one where they have to do maybe a little bit less, or maybe the principal's fun to talk to, or maybe the secretary who or the administrative assistant who's waiting outside the principal's office will talk to Julie about her day and try to be very comforting and figure out what's wrong. Well, what you've done is you've taken the client from a less reinforcing environment where they engage in a problem behavior and you move them into more reinforcing environments contingent on problem behavior. And that's a pretty common mistake that I see. Another example of this could be sending a sassy kid from the dinner table to their room where their Xbox is. Well, you've just moved them from a time in environment that's not reinforcing to a time out environment that's incredibly reinforcing. So I would expect to see an increase in problem behavior. Another problem that I see here is what if the behavior is maintained by escape? So going back to Julie from a moment ago, remember, she hated history. And so if we send her out of the room, whenever history is going on and she's engaging in problem behavior, we can actually be reinforcing that behavior just because we're giving her another way of getting out from having to do history. So even just the process like ignore the administrative assistant who talks to her, just getting away from something unpleasant can be reinforcing. If you've ever taken a mental health day, you know, sometimes it can just be reinforcing to not be in that environment. And then finally, another problem is that this is a really dangerous procedure in a lot of settings because the child, especially if you're using like an exclusionary timeout, the child could be unsupervised. So there are difficulties with that. First, it could be that they're accessing unauthorized sources of reinforcement, which means that time out could be more reinforcing than time in. But more importantly, if the child is unsupervised and something happens to them, there's the safety of the child to be considered. There's also liability to be considered, which is to say that in order to protect an agency from the legal liability of a child being hurt, you have to have a staff member specifically dedicated to literally sitting and watching the client when they're in timeout. So you've taken the client away from a learning environment. You've also secluded one staff and now you have a one to one staffing ratio just to use a punishment procedure, which I'm going to tell you right now is not a very effective punishment procedure. There's also a variety of other myths that come along with timeout. So among these other myths that I've heard before are things like you should use a certain amount of time per years of life of the child, so 30 seconds for every year of life. If the child is five, then time out time should be two and a half minutes, which is just there's no evidence to support that. I've heard and read in different child care blogs that you want to make sure that whenever you're doing a timeout procedure that you spend some time talking with the child and explaining to the child why it is that they're in timeout so that they better understand the relationship between their behavior and what's happened. And again, there's very little evidence to support that any kind of attempting to reason with the child or help them to cognitively understand what's happening in the situation is going to make timeout more effective. In fact, if you're providing high quality one-on-one attention for the child during that period of timeout, it could actually backfire insofar as you're giving really high quality attention, which then itself may function as a reinforcer. So there's a lot of myths related to timeout. It's so difficult to implement properly. You've got emotional responding. You've got the child potentially being excluded. You've got there's so many difficulties with it that I would argue that the better way to go is a time and alternative called the time in ribbon. This is where we're going to end today. So the time in ribbon works. It flips all of this on its head. We have a culture where we say, if you've been bad, get out. And it's a terrible misguided way of trying to treat behavior. Instead, what the time in ribbon says is, when you're doing the right thing, you keep access to the reinforcing environment. So remember what I'm showing you on the right hand of the screen here is the client, the learner is going to have some sort of token item. It can be like a wristband, like one of those lift strong bracelets, like a rubber bracelet, or it can be a slap bracelet, or it can be literally anything. It could be a name tag that the person is wearing. But essentially they have the token item. And when they have the token item, when they're wearing a token item, they qualify for all sorts of reinforcement in the time and environment. When they do something inappropriate or they engage in a target behavior that is marked for decretion or deceleration, then they lose that target item. And they are no longer eligible for a brief period of time to earn that reinforcer. Now, this is a much better approach because one, it's super easy to use. You don't have to have a staff member specifically dedicated to managing the behavior of the client when they're in timeout. You can keep the learner in the environment where they are. So not only are they staying supervised and you're not splitting your staff and you're not creating all these problems, but they're in the environment, they're being supervised and they're seeing other peers engaging in the behavior that they should have presumably been engaging in, which means they see models of appropriate behavior. We also mentioned that removing the client from the environment can sometimes reinforce escape maintain behavior or can reinforce behaviors that lead to removing an aversive environment. So in this case, we're preventing that from happening because the client's always going to be in the environment. They're not actually leaving, they're just losing available reinforcer in that environment. The time in ribbon itself or in this case a wrist or a name tag or whatever it is the token is, that becomes a conditioned reinforcer. People will want to work to earn it. It's really portable. It's really flexible. And I think perhaps the most important one that's not listed here is that it really focuses on us remembering that the most important part of timeout, what makes timeout most effective, is when time in is reinforcing and it doubles down on it, reiterates that idea that when you have reinforcement available in the environment, a lot of other problem behaviors don't exist. And if you still have problem behavior, you have to make time in reinforcing so that timeout will be punitive. All right, so that's finishing up with timeout and timeout alternatives. Let me know if you have any questions and check out the optional materials for this topic.