Close Server: KOPWWW05 | Not logged in

Welcome to Health Care POV | sign in | join
Early Intervention Speech Therapy

Behavior Modification During Speech Therapy

Published April 26, 2011 9:00 AM by Stephanie Bruno-Dowling
"I didn't go to school for this..."

Every once in a while this thought goes through my head when I have a student throw a tantrum, drop to the ground or act out aggressively towards myself or another student. Behavior modification was not a big part of either my undergraduate or graduate level schooling; however, it is a huge part of what I do now everyday as a speech therapist in an early intervention preschool classroom. Many of the techniques I currently use now are either: a) something I have learned in a training, b) the direct policy of the institution where I currently work, or c) a combination of the two.

Today's topic of behavior modification was once again inspired by a comment from the February SLP poll, which specially asked for: "Behavior management techniques." I will do my best, as this is certainly not my forte. However, I recognize the incredible need for discussion. Also, please refer to two posts I wrote this past December entitled "Aggression in the Classroom" and "Aggression Answers," which may provide some helpful questions and answers regarding this topic as well. 

Where I work, we do not use "time out" in the classroom. We attended a training fairly recently, in the last year or so, that directly addressed this issue. The belief of the presenter was that "time out" promotes "shame" and "we do not want to shame our students." Instead, we were given other techniques to manage and prevent behaviors, some of which are listed below and are common methods we practice today:   

  • Reward the Positive: Verbally recognize the good children do to inspire all the children to follow the positive behavior that is occurring. And of course, reinforce the positive.
  • If/Then Statements: Tell the child, "If you do this ____, then you can ____."
  • Remove from Activity...but Not from the Room: The policy of our institution is that it is never OK to physically "isolate" a child. Instead, turn their chair around and remove them from the activity. Or when all else fails bring them to what we call "the soft area" and allow them time to "calm down in a safe place." The soft area is filled with pillows and soft mats to protect the child.
  • Model Good Behavior: Adults and/or peers demonstrate preferred, appropriate behavior, providing students with a tangible model of what is expected.
  • Ignore the Bad Behavior as long as it isn't dangerous to the child, yourself or others!


Join me next week as we continue this discussion and talk about ways to prevent "bad behaviors" BEFORE they occur!



This week at our preschool it is evident that the "honeymoon phase" of the beginning of a new school

October 3, 2014 9:30 AM

Naomi Barsky is absolutely right. Choice within specific boundaries has been the key to my being able to stay on top of caseloads that are over 60-70 students per year. It doesn't go over well when therapy providers have to take students back to class or to the principals office. This strategy works well at the high school level as well for me.

maxine miller, Speech Pathologist April 29, 2011 9:29 AM

I try to be careful with the "if ... then" statements.  I think that a lot of three-year-olds don't hear or process the "if" part, particularly those with language or attention disorders.  I find that it works better to put it into a "when ... then" format ("when we finish this, we will do that.")  The effect is the same, but I find that kids often understand this better.  It also puts the issue in a more positive light, making the assumption that they will finish the desired task.

I also find that it is easy to underestimate how difficult some of the things we ask kids to do are.  This is particularly true with repetitive tasks -- they tax the motor system as well as attentional and cognitive systems.

Lastly, one of the critical things I learned in my behavior mod training as an undergrad psych major and in grad school is to always substitute a desirable behavior for an undesirable one.  This is much much more effective than simply trying to get rid of an undesirable one!

Thanks for the discussions, Stephanie.  As always they are fascinating.

David Harper, Birth-to-Three - SLP April 28, 2011 10:59 PM
Superior WI

I have a 3yr old client who gets up from the table frequently during our sessions.  He has almost reached all of his speech and language goals, however his attention to complete activities or participate in therapists lead activities is lacking.  I keep trying the "first x/then y" but he seems to care less about the x and only wants the y!  Any suggestions?

Gale Love, Speech Therapist April 28, 2011 7:42 PM

Rewarding the positive behaviour has been my strongest and most useful behaviour modification tool. %0d%0aAnother favourite of mine is a subtle take on the if/then statement - Its a "its your choice" statement. "If you choose to do (undesired behaviour), the consequence will be X. If you do (desired behaviour), the consequence will be Y. Its your choice. What do you choose?" I find that this allows the child to feel in control, but within your boundaries. The key here is to stick to the deal!!

Naomi Barsky, Speech Therapist - Private Practice April 28, 2011 1:36 PM

leave a comment

To prevent comment spam, please type the code you see below into the code field before submitting your comment. If you cannot read the numbers in the image, reload the page to generate a new one.

Enter the security code below:


About this Blog

    Stephanie Bruno Dowling, M.S. CCC-SLP
    Occupation: Speech-Language Pathologist
    Setting: Early Intervention in Delaware County, PA
  • About Blog and Author

Keep Me Updated