Community Living: Roberto, Don, Paul

A new fast food restaurant opened in Oakwood City. The restaurant offers fast food items: hamburgers, cheeseburgers, chicken sandwiches, kid’s meals, French fries, and ice cream. The menu lists items with the price for each type of food item. Recently, the restaurant modified their menu structure. Now, the menus list items with both their price and a color-photograph picture of each item. The menu is available in a large format behind the counter as well as a smaller format on the counter (where someone could point to items more easily). This new menu makes it easier for people to choose the food that they want to eat without needing to rely only on reading written words.

Roberto, Don, and Paul are regular customers at the restaurant. They are also persons with intellectual disabilities. They like to visit the restaurant two to three days each week. Roberto lives at home with his parents while Don and Paul both live in an apartment not far away from Roberto’s house. The three men typically arrive in the mid-morning when the restaurant is not busy but there are also fewer staff at work. It takes a bit longer for orders to be made.

Within the past few months, Roberto, Don, and Paul have engaged in problem behavior while waiting for their orders. They yell the names of the employees, trying to get their attention. Sometimes the men step behind the counter and walk into the food preparation areas. The restaurant manager contacted Roberto’s family and the group home where Don, and Paul live. Family members of the three men, the restaurant manager, and the group home director met to discuss strategies to support Roberto, Don and Paul. Together, the team identifies a number of strategies to address the problems occurring at the restaurant. Staff members will turn on a small timer when an order is made. The timer is set for three minutes, the average amount of time it takes to prepare an order. At least one restaurant employee agrees to check in with the men while they wait for their food. The employee will ask the men about their day and what they are going to eat. Staff members who work with Don and Paul offer to include Roberto in a social skills activity at Don and Paul’s home. The three men learn ways to politely request when a food order will be ready. Roberto, Don, and Paul practice these new skills before going to the restaurant. They celebrate with restaurant staff members during the practice sessions and after they finish their meals and are ready to leave when they are successful using new skills.

One gentleman, Roberto, continues to find it difficult to wait for his food order at the restaurant. It is difficult on busy days when his order is delayed for a long time. On these days, Roberto yells at other customers and pushes trays of food onto the floor. This has been happening two times each week. It is so problematic that the restaurant manager said that Roberto can no longer visit the restaurant. Going to the restaurant and spending time with his friends is very important for Roberto. Roberto’s family schedules a meeting with the restaurant manager, a county PBS Facilitator named Jeanne, and Roberto to address the problem. Roberto wants to keep going to the restaurant with his friends but he is frustrated when his food isn’t ready for him.

Jeanne describes a functional behavioral assessment. The restaurant manager says he will work with Roberto and his team to create a plan. The plan will make it possible for Roberto to continue visiting the restaurant. Jeanne observes Roberto at the restaurant while collecting Antecedent-Behavior-Analysis (ABC) data. Wait times greater than five minutes are associated with Roberto’s problem behavior.  Jeanne and Roberto’s family decide to use a tolerance for delay strategy. This will help Roberto increase the time he waits for his food without engaging in challenging behavior. Tolerance for delay can be used to gradually extend the time a person waits before a reinforcer becomes available. The team decides to use the timer to gradually extend Roberto’s waits for food at the restaurant. Over time, Roberto learns to tolerate longer periods of time his food is available at the restaurant.