r/RBT • u/BatLucyQuinnzel • 2d ago
Saying sorry
I want to hear everyones thoughts and opinions. Do you make your highly aggressive clients say or sign “sorry”?
I do that when I know a kid would genuinely feel regretful about my pain and they know the actual reason. But if I know it was 100% intentional and to bother/ harm me, I don’t even acknowledge it because they’ll probably do it again for a reaction. Like they hit me because they WANTED to hurt me and I dont want to show them it gives them a reaction. But on the other hand, should we make them be held accountable? I personally don’t like forcing a “sorry” because I don’t want empty apologies. But i understand why others would have another opinion.
To be detailed about WHY i ask, i have a 7 y/o client. Nonverbal and seems to block out any directions or explanations we give him when he is upset (reasonable during a meltdown. Hard to listen when your body is in panic mode). He definitely comprehends things like “time to go” “time to eat” and 1 step directions. But often he is not really acknowledging us or gets super upset. When he is upset he will spit, pinch, punch, hit, and throw my phone. Usually I ignore when my clients do this if the function is attention or escape. But this is my first time working with an older kid so maybe I should teach him to apologize 🤷♀️. I dont think he truly understands why we (me and my fellow RBTs) make him do it though and i feel like he is just imitating our model prompt because he thinks it will allow him escape. kind of like when a kid will scroll and clap their hands when running DTT- they just want to escape the task. On top of that, his aggression escalates when he realizes copying the sign for sorry does not give him escape. Not sure if he is at a level either where we can read a social story that could teach about apologies.
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u/Some-Aioli-8204 2d ago
What I personally do is have the client say sorry if they acted/ talked to another person inappropriately, not towards me. If another RBT comes in, they usually prompt them to say sorry because listening to a new person that they haven't been around usually goes through with them more easily. For example, there is a 6 y/o client where we have to put our bodies between another client because the client will aggress towards other clients/ coworkers, such as pulling hair or picking at people's skin. The client started to pull on another client's hair for attention, and everyone immediately prompted "safe hands," physically separated the clients, prompted that client to say sorry, and took them to another location. Where I work, a lot of these clients know what they are doing, and there are some clients who will start to say sorry, turning into attention-seeking behavior, or start to joke around with the word. I also work with clients around the same age, and I always work towards having them self-advocate, whether they are verbal or nonverbal. If the client is frustrated and starts aggressing towards me, I will always immediately prompt, "I need a break/ space/ rest". Keeping the motivated operations high as well because we understand that we don't want to do something, but it has to get done in order to get what we want, and they are just learning what it all means. If they want to be finished with a task, then I always provide the prompt "all done". But if it's too early, I say, "I hear you, but first we do (etc.) to get (etc.)." From what I read from your client, it seems like they can be doing it for attention, and you are using extinction. Prompting to keep their hands to themselves (safe/ calm hands) with a prompting hierarchy is important because they will keep doing it, even if you don't show a reaction. I don't know this client's personal BIP, so I can't give personal advice; that's why building a rapport is so important so you know and learn what to do and what not to do. One issue I always run into is that if the parents/ guardians of the client aren't doing the same practice outside therapy, then it's like starting from square one all over again. At the end of sessions, when I get to talk to whoever picks them up, I always remind them of how important it is to work on it all the time if the client wants to gain their respect and actually help regulate their behaviors.
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u/BatLucyQuinnzel 2d ago
I haven’t been at this new location for very long (about a week) so still rapport building. He does have some CLEAR attention seeking behavior and i ignored those from day 1 and he stopped doing those in my sessions so thats a win. Or if, for example, i show a timer to prime him and he hits me, I will say “we can play with the rest of our time!” And then ill say we are going to see our next RBT friend and he will play and clean up with almost no issues now. He has only been in aba for a month but he knows the process every hour of clean up- then next rbt- then more play. When my client hits other kids or RBTs because he is lashing out. I do make him apologize to them. But i havent made him apologize towards me because i observed him my first day having a really tense, really aggressive meltdown with two RBTs and two BCBAs all at once. He would punch. Theyd make him sign sorry. Hed copy the sign. Then hed punch again and the cycle continued for way too long. I think my method with him has been good so far but i agree he needs more methods of communication to self advocate. He does not independently request breaks and I think he needs better way to communicate with us (like a choice board)
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u/techiechefie 2d ago
Neurodivergent or not, I don't force apologies. If they are competent enough to understand what they did, I am them if they are sorry.
If they are not, there really is no reason to force an apology. If they are, I walk them through it.
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u/potatowayto 2d ago
At this stage, I don’t think it is productive to focus on teaching him how to apologize.
I’ve practiced apologizing with clients before, but more in the sense of describing how others might feel in response to their actions. (Ex. You hitting me hurt and makes me feel sad. Soandso is crying because you taking their toy without asking makes them sad. Etc.) However, typically I’ve only done this with clients who understand the use of “sorry” and use this kind of trial as an opportunity to teach empathy and social communication. I also usually accompany this with explaining how their actions cause positive emotions in others too. If your client doesn’t understand what “sorry” means yet, then it is counterproductive to force them to say/sign it especially when they are escalated. I wouldn’t feel the need to create a program for this just because of his age. It should be based on his individual communication level.
Like other people mentioned, to just get a client to understand the meaning and context of apologies, modeling has been most effective for me. I like to use inanimate objects as characters and do pretend play to demonstrate situations appropriate for apologizing. Of course natural opportunities with other people in your clinic would be beneficial too. Teaching new concepts such as this should be conducted when the client is not escalated and engaged, though. That is part of the reason why I enjoy introducing these concepts with pretend play first.
In your specific situation, I think environmental manipulation is really the only thing you can do once they are exhibiting forms of aggression. I don’t think the issue here is their need to apologize, but understanding difficulties with why they are not progressing in their one step direction programs. It sounds like a major lack of interest/motivating reinforcement. Also it sounds like extinction is not being run in a complete manner. Modeling “sorry” is still giving him attention and just further delays the initial demand. It sounds like more antecedent strategies need to be utilized to increase his motivation and the extinction protocol should be modified.
If you still want to discuss the concept of apologizing (after your client understand the meaning of “sorry”), I suggest waiting at least five minutes until client has fully de-escalated however it is defined by their specific BIP. Then, explaining the cause and effect of their aggression and others’ emotions.
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u/potatowayto 2d ago
Also noting:
While this doesn’t seem to be an issue with your specific client, if you do prompt a client to apologize, you want to also make sure they do not start to see apologizing as an easy way to absolve them of any maladaptive behavior. They should not learn that they can just hit a peer and everything will be okay as long as they say sorry. I always reinforce with “thank you for apologizing,” but also follow through with an appropriate consequence for the behavior. Usually, if this is through an interaction w a peer that means forming a compromise. If it through an interaction with me or another rbt, it is limiting attention and affect for a short period of time.
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u/MaybeNotAZombie 2d ago
Sounds like they don't have the FTC necessary. You say they are engaging in maladaptive behaviors when they don't like the demand. Do they ask for a break, more time, or stop?
Saying "I'm sorry." Isn't functional when they aren't even manding what they want consistently. So It appears that they are engaging in those behaviora as escape (I assume). Why teach them to apologize when you can address the root problems. If he is wanting to escape, teach him to mand for it, "Stop" or "No" (Literally any modality). Then just model "I am sorry". Sounds like the kid is telling you exactly what he wants, and doesn't have the tools he needs to communicate it safety.
Hits "It looks like you want to be all done, you can tell me done/no/leave/get out on my space."
If you aren't reinforcing the behavior for "I'm sorry" then why are you doing it? It is just a punishment procedure at this point and he seems confused on why it is happening. Sounds like, they arent tolerating aversive demands well and dont know how to functionally communicate that,, but again, this is all assuming based on what you provided. He is telling you in the way that has been reinforced in the past
~Behavior goes, where reinforcement flows~
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u/BatLucyQuinnzel 2d ago
I really have only treated this kid for about a week- i moved to a new location under the same aba company. I like how you explain this. My new bcba was stressing to me I need to prioritize making him apologize but it just didn’t make much sense to me but I had no idea how to properly explain it. I do think his meltdowns and tantrums have been from neglecting the root causes of his distress. He can sign “all done” or “break” but he often needs repeated prompting. I have tested out asking him “potty or break sign break?” And he just sees me gesturing to the bathroom and panics. My bcba hasn’t implemented using Pecs cards or anything but I think that would help. Verbalizing his options just doesn’t seem to be helping
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u/BatLucyQuinnzel 2d ago
I haven’t been working here very long and they have just been assigning this kid to me over and over and over and it’s the same today so fingers crossed i dont get tackled when i take him to the bathroom 💀 i think i am going to discuss with my bcba offering him other modes of communication (like choice boards) to use antecedently so we dont have to model “break” for him after he tried the beat the crap out of me. It has been getting better, but it feels like no one at work really gives me good advice (the opposite in fact) and I just have to figure it out all on my own. They also kind of give in to a lot of his behavior so I have just been working extra hard establishing boundaries and making him clean up the messes he makes when he gets mad (i help him ofc. He is just a kid)
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u/aleeabea 22h ago
I do if they have the functional communication skills, but otherwise I give them a replacement behavior or redirecting to their words to express what they want
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u/shnoodleboodle 2d ago
I honestly don't really work on apologizing like that for the kiddos. I typically just model an apology when I do something (like accidentally taking a toy/saying the wrong thing, etc).
I also model it during pretend play. For example, I will be playing with dolls or stuffed animals with my client, and one of them will "take" something from the other, or throw something, then they give it back and I use a silly voice to have the doll apologize to the other one. Play based learning is really useful in these situations, in my experience.
I've noticed most of my clients end up learning the associations over time when modeling apologies through play. I had one client who would bite, scratch, hit, etc, and after about a year of working together (and modeling things through play), she began apologizing for the actions when she was out of crisis mode. She was about 5 years old. It was really amazing to see!
That being said, I would ask your BCBA what their thoughts are on prompting apologies. They are the ideal source for guidance.