Let’s start by defining behavior modification, because this term often brings up negative images and issues of control or coercion. Properly implemented, behavior modification creates a very positive change in all members of the family – It improves both behavior and attitude. It builds cooperation and strengthens relationships. This reduces misophonia issues. Although behavior modification can apply to any individual at any age, I will limit this discussion to behavior modification for children.
Behavior modification is a method of addressing and improving observable child behavior. It is based on the principles of operant conditioning. Essentially it is a program, procedure, or technique to help a child reduce undesirable behaviors and increase more desirable ones.
What the heck is operant conditioning? It is the technical term for way humans and all intelligent creatures develop behavior patterns. Operant conditioning relies on positive and negative reinforcement (again, technical terms for why we do things). We have all experienced operant conditioning. When we chose to brush our teeth this morning, we did so because we have a learning history of positive and negative consequences from brushing our teeth (no bad breath, we like the way it feels, or we avoid cavities). If you made a piece of toast, that was because of operant conditioning. You learned that doing that behavior resulted in something good to eat. That is positive reinforcement. Does positive reinforcement help with misophonia – yes!
Operant conditioning applies to everyone, all the time. I push the button my car key fob, and the door unlocked. I performed a behavior and received the “reward” (technically a consequence) of the door unlocking.
For children with misophonia, we can set up expectations for desired behavior and then have earned rewards. This is a motivating situation that improves behavior. More importantly, this can be part of using primarily (or only) positive contingencies. For example, a child can learn that when they get ready for school in the morning, something good happens (that is a positive contingency). If we, instead, simply try to force (nag, yell, demand, etc.) the child to get ready in the morning, the child may get ready, but will have a bad attitude as a result. This is detrimental to a child with misophonia (and any child, but especially to a child with misophonia). This is negative reinforcement, where the child does what is needed to terminate your complaining.
Another principle of behavior modification for children with misophonia is to avoid giving consequences (punishments) for bad behavior. Punishment increases negative emotions. Once in a bad mood, the child will probably be more sensitive to trigger sounds. Instead of giving consequences, we can let the child make amends, or focus on the expected, appropriate behavior. We can use the same contingency in a positive way. Instead of taking away TV time because the child hit their sister, we can award (or allow the child to earn) TV time because they were nice to their sister. It is the same contingency, but the latter is spun as a positive contingency and is more appropriate for a child with misophonia.
The basic principles of defining what is expected of the child, and insuring there is some positive payoff (maybe a ride on your back, or a high-five) will promote good behavior, improve mood, and reduce general anxiety and distress. This will help a child with misophonia handle the challenges of misophonia.
I had a parent in a class tell me he thought I taught the best adult behavior change class he had ever attended. Behavior modification for children is about the adults learning to use methods and techniques that really work. In the process, the child’s behavior improves, the child’s attitude improves, and everyone is happier.
Behavior modification is not a universal cure for misophonia, but especially with children 12 and under, it can provide much relief for the family and the child suffering with misophonia. Because behavior modification required parent self-control, it is not for everyone. Behavior modification is for parents who can make and follow a play. When parents do this, wonderful things happen in the home.
For help using behavior modification principles in your home, you can get the help of a parenting coach, such as me (Tom Dozier, MS, BCBA). Done properly, everyone is happier, relationships are strengthened, positive character traits are developed, and misophonia severity is reduced. Everyone wins!