Over the past couple of weeks I have engaged in training sessions to prepare me for my summer internship with the Columbia University Medical Center, specifically in the Columbia University Clinic for Anxiety and Related Disorders. The program is called BUDS and focuses on treating kids diagnosed with ADHD and behavioral disorders to prepare them to cohesively participate in various school settings. The kids are aged 6 to 9, and their goals all vary based on the individual needs. The ADHD manifests itself in different ways, from anxiety to a lack of regulation of emotions like anger or excitement, as well as low attention spans and bodies constantly in motion. The program will follow a schedule that embodies a fusion of camp and school, with plenty of unstructured time (morning playtime, lunch/snack, and two recesses), structured academic time (reading, writing, and math), and semi-academic time (physical education, social skill building, morning meeting, and coping skill building).
The training covered the rules and expectations of the program (this includes the rules students are going to have to abide by to succeed in their individual treatment plans), scaffolding activity types, how to give an effective command, positive reinforcement, the token economy system, consequences, ignorable behavior, response cost, time outs, crisis management, and daily procedures. Much of the content revolved around creating an operational definition for every behavior identified (for example, what constitutes verbally aggressive behavior, what is positive reinforcement, etc.) to unify everyone’s perception of how to go about implementing the procedures of the program. We also participated in skill drills to practice specific procedures and increase our fluency with giving effective commands, positively reinforcing desired behavior, and delivering consequences for unwanted actions (including but not limited to skin picking, using unkind language, and leaving the activity area without asking).
Our skill drills were similar to some of my experiences in education classes in the sense that my coworkers played roles of students with all types of personalities, styles of interacting, and distracting tendencies, which was helpful to paint a more realistic scenario of the context we would later be put in. At times it felt overwhelming because we were adamant on sticking to the script of each protocol and making sure to include an even distribution of types of positive reinforcement given (labeled praise, reflection, behavior description, and social/token reinforcement) to better prepare ourselves for every situation, when sometimes our instincts were telling us to handle a pretend situation otherwise.
We went over schedules of reinforcement to establish the type of reinforcement schedules we’d be utilizing to give points throughout the day. Since praise should be given immediately either during or following the desired behavior, fixed interval point checks were decided to be the most fitting schedule of reinforcement for unstructured activities like recess where kids are running around the gymnasium or morning play, where they are free to roam the classroom.
My favorite aspect of the training program was how open the program director was to feedback and improvement on the implementation of the program. Since this is its first run, counselors got a lot of say in contributing to the structure of the program, from the content of academic and social instruction to the procedures utilized for praise.