The flapping is known as a stereotypical behavior or STB. STB’s are learned behavior and are related to their consequences. Hand flapping is related to an imbalance with the visual and/or proprioceptive sensory systems. I would recommend an evaluation from an Occupational Therapist to determine this as well as treatment for the behavior. Treatment for STB’s is focused on finding replacement behaviors and not eliminating the behavior. For children who appear “clumsy,” hand flapping may serve as a way to create balance while in the environment. For individuals that have STB’s, the most common function is self-stimulation, where the behavior is a calming mechanism such as sucking the thumb. This may be why you are seeing more of the flapping in social settings, because the environment may provoke anxiety. Try to provide other sensory inputs throughout the child’s day while you are shaping the STB. It may be a good idea to allow the child to rock in a rocking chair before going out, swinging, or bounce on a ball. While out, give the child a toy to keep in her hand. If she is verbal, you can teach her to request for a break from the environment. Be sure to reinforce your child and give praise for using the toys appropriately or asking for a break appropriately.
It is likely that he may be seeking sensory input, meaning he is grinding his teeth in order to gain a sensation. Our sensory seekers are usually in need of a good message if they are hypersensitive to touch. The key here would be to find more socially appropriate ways for him to still get the sensory input he needs. I suggest you try to use a vibrating toothbrush twice a day. You can also give him gum massages, where you are running a finger along his gums. You may also try doing cheek massages. If he is able to tolerate it, use a lotion with this exercise so your hands will flow freely along his skin. Rub the lotion bilaterally on his cheeks and chin. It is important to check his reaction as you are trying these new methods. Because these are new activities, there may be an aversive reaction so introduce these techniques slowly and make sure they are enjoyable for your child.
First there are some prerequisite skills the child must have to ensure readiness for potty training. They must exhibit some self-help skills such as being able to pull their pants up and down, be able to sit on the potty for at least 3 minutes without inappropriate behaviors, and have the ability to inhibit urine for at least 1 hour. After they have mastered these skills, then you want to set a 30-minute potty schedule. It is easiest to use a timer to make sure you adhere to the time. The timer also serves as a prompt for the child. Take the child to the potty every 30 minutes. Be sure to require the child to drink many fluids to give him or her multiple opportunities for reinforcement. Avoid salty foods because salt retains water. Require them to sit for 3-5 minutes. If urination occurs, provide your strongest reinforcer. If nothing occurs, try again in 30 minutes. Be sure to require the child to complete the entire bathroom routine such as washing and drying hands. Provide praise for these tasks as well but save your strongest reinforcer for elimination. Start by using physical prompts. This is when you physically guide your child through the process without using words. Gradually fade your physical guidance as they begin to complete steps independently. Limit the amount of conversation you use with your child while in the bathroom. This prevents prompt dependency where the child will wait for your instructions before performing a skill. When you decide to switch to underwear, it is important not to go back to diapers. It may get messy, however it creates the idea that the rules for using the bathroom have changed. Initially, diapers may be worn at night without compromising the procedure. Never allow a child to sit in a soiled diaper or underwear. If they have an accident, do not give your child attention during this time. Have them to assist in the clean up. This serves as an aversive consequence for the learner. Check with your behavior analyst for more information on generalizing and fading, as well as bowel training.
First, a functional assessment would need to be conducted in order to determine the function of the behavior. Assuming that the function is to obtain a preferred item, you want to run practice trials where the child must accept no. When the child asks for an item, say “No,” then offer an equally reinforcing item. For example, if the child asks for orange juice, say, “No, but you can have apple juice.” If the tantrum does not occur, then deliver the additional reinforcer. If the tantrum does occur, then withdraw the reinforcer and ignore the tantrum. Run several practice drills across people and environments. As your child becomes familiar with accepting no, practice the same technique during more challenging situations or when they request for more highly preferred items. As tantrums begin to decrease, offer less reinforcing items as the alternative instead of the equally reinforcing item. Eventually, you will be able to fade out the additional reinforcer option, and the child will accept no. It is extremely important to follow through after saying no and not to give your attention to any tantrums that may arise.
