Contingent Imitation as a De-escalation Procedure

A few years ago, I worked with a severely autistic, non-verbal young man who would have very violent half hour and hour long tantrums 3 to 4 times a week. Since this young man was sixteen years old and about 6'2" this was quite a problem. This client, well call him Bill, had a basically sweet affable disposition and was friendly and affectionate towards his family. However when one of these tantrums began they could be quite destructive, with torn and thrown furnishings.

However his Dad pointed out that they always knew when one of these tantrums was about to begin, because Bill would stand up and do a little agitated dance, a sort of quiet two step. To de-escalate this young man's agitation we tried a distractor: balancing on one foot. We would have contests of who could stand on one foot the longest. Bill, would usually win, and then he would get a favorite cookie or cupcake.

This usually worked quite well. I also trained the parents in a simple, effective technique to get Bill's attention: Contingent Imitation. As many of you may know, this is an intervention, where the staff or caregiver imitates whatever behavior the client is presenting. All day long teachers and caregivers are trying to get the student to learn by imitating them. The novelty of someone imitating the client is so great that it almost never fails to get his immediate attention, and amusement. One afternoon, Bill stood up and started to do his quiet little two step dance. His father, to get Bill's attention, started to imitate Bill's odd little dance. Almost immediately Bill focused on his father exactly copying his dance, and burst into sustained loud laughter. He continued dancing and laughing at his father's version of his dance, and the tantrum was completely averted. His dad and I used this version of Contingent Imitation a number of times to successfully avert a number of what would otherwise have been half hour long violent tantrums.

While each of our clients is very unique in the behaviors they display, and the interventions that are effective with them, it seems worth a try to use Contingent Imitation, not only to get clients to attend to us, but also as a de-escalation procedure.

Please let me know if you decide to try this and let me know how well it works with your client.