3.2 Behavioural approaches
Behavioural therapies are based on principles of classical conditioning and operant conditioning (the latter being more properly referred to as behaviour modification therapy). Operant conditioning is about the presentation of a reinforcement being dependent.contingent) on the appearance of a given behaviour. Based on this idea, Skinner (1953) suggested that sometimes ‘abnormal’ behaviour is the result of bad contingency management, where inappropriate behaviours have been reinforced. He suggested that such behaviours could be modified by a process of more appropriate contingency management to become ‘normal’. A simple form of this is the so-called ‘token economy’, often used by schools in the UK to encourage children to engage in good work or behaviour, for which they receive awards such as gold stars. Behavioural therapies are also well suited to the treatment of conditions such as phobias where unwanted emotional reactions can sometimes be extinguished by behavioural means (see Box 11).
Box 11: The three stages of a contingency management programme (Klein, 1996)
Observations are made of the client, and the frequency of the inappropriate behaviour is noted along with the characteristics of the situations that it occurs in. From this it is possible to generate hypotheses about what is reinforcing these behaviours inappropriately.
Based on the data from stage one, an intervention is designed which seeks to establish new contingent relationships between desirable behaviours and suitable reinforcement.
The situation is monitored as in stage one to ascertain whether the new relationships are having the desired effect. Changes to the contingent relationships are made if necessary.
There are emotional consequences of dyslexia which can also be treated using a programme of this kind. Although there has been little research in this area, the studies that have been conducted do show that poor self-esteem and high levels of stress are real problems (Riddick 1996; Riddick et al., 1999). If this is the case, remediation programmes need to address both the direct symptoms of dyslexia and the emotional difficulties that people with dyslexia often experience. One example of a study that has done this was the summer camp programme devised by Westervelt et al. (1998) outlined in Box 12 below.
Box 12: The Westervelt et al. (1998) summer camp study
Over a six-week residential summer camp in the USA, 48 dyslexic students aged between 9 and 14 years received daily tuition in phonics using the Orton-Gillingham multisensory method (see Section 3.3) and oral reading. Student progress was monitored and individual achievements were shared in a weekly newsletter. Psychosocial difficulties were addressed by praising the children, encouraging them to praise and support each other and by creating opportunities for each child to demonstrate success and receive recognition for it. Awards were presented daily to children who had shown progress in socialising. At the end of the summer camp the children showed significant gains in phonetic reading, spelling skills and self-esteem. However, it was noted that children who also had ADHD showed little gain in self-esteem, despite showing the same degree of improvement on the literacy measures. It would seem that the additional difficulties experienced by these children prevented them from receiving praise as readily as the other children with dyslexia did.
You will notice that this programme of intervention has a behavioural element to it. It was observed that much of the children's low self-esteem was associated with failed attempts at reading and writing, and with socialising with other children who might judge them. The researchers attempted to break this cycle by praising the children when they worked hard, rather than criticising them for their errors, and by rewarding the children with awards when they started to engage socially with other children. While this benefited many children, the ADHD/dyslexic children were not benefiting emotionally from the programme, and so some modification to the contingency management programme would be needed for these children in future.
Can you think of any modifications that might increase opportunities for praise for the children with ADHD/dyslexia?
Box 13: Definitions
Contingency management: An alternative term to ‘behaviour modification therapy’, used to describe a behavioural intervention that is based on principles of operant conditioning.
Cognitive therapy: Involves working with a therapist who highlights maladaptive beliefs that an individual may have about their situation. The individual is retrained to monitor their own thoughts, recognise when their thoughts are based on emotion rather than reality, reject biased cognitions and learn to change whatever beliefs have caused them to distort their interpretation of reality.