Verbal Behavior Approach: How to Teach Children with Autism and       Related Disorders [Mary Lynch Barbera]

Saturday, November 21, 2009

Teaching Games to Children with Autism

On a plane ride home from an ABA conference last May, I read a book entitled: What You Need to Know About Motivation and Teaching Games by Steven Ward, MA, BCBA. I literally started recommending the book right away to Andy Bondy and Lori Frost who happened to be sitting next to me on the plane!

In the past six months, I have recommended this book to many Behavior Analysts and parents as I have found it to be a very useful guide to help effectively teach children with autism to play games. The step-by-step breakdown of how to teach 12 common games such as “Go Fish” and “Memory” is excellent and the data sheets provided are superb!

When I returned home eager to teach Lucas how to play “Go Fish,” his therapist stated that he already could play the game. So I copied the blank “Go Fish” data form from Steve’s book and asked her to play the game with Lucas. In the past when I’ve watched Lucas play games I knew it didn’t look good but, by taking data using the data sheet provided, I was able to easily count errors and prompts.  I was also able to quantify a lack of motivation. I was even able to immediately identify the trouble spots in the game such as Lucas’ inability to hold seven cards in his hand and fan them out so he could actually see what cards were in his hand. Using the book, Lucas can now play “Go Fish” with a few modifications. His motivation to play this and other games has improved too.

I highly recommend this book to parents and professionals interested in helping children with autism or related disorders learn to play and, most importantly, enjoy games! For more information about What You Need to Know About Motivation and Teaching Games by Steven Ward, MA, BCBA go to: http://www.wholechildconsulting.com/.

On another note, I also ventured into the social media world a little more and created a Facebook fan page for The Verbal Behavior Approach. Become a fan by going to: http://www.facebook.com/pages/The-Verbal-Behavior-Approach/183142072329?ref=mf#/home.php?ref=home. As always visit my web site: http://www.verbalbehaviorapproach.com/ for more information about my book, to listen to VB radio shows, or to download free information.

Sunday, November 15, 2009

Using ABA to Teach Functional Self-Help Skills to Children with Autism and Other Developmental Disorders

Many people are confused about how to use ABA to teach functional, multi-step skills such as putting on shoes, washing hands, or setting a table. Several years ago I was consulting in a classroom and we were working with a 14 year-old girl with Down Syndrome who was minimally vocal. We were focused on trying to teach her to mand for items when her teacher jumped in and asked if we could help the girl learn how to set a table since this was a goal on her IEP.

Following the teacher’s motivation, I switched gears and told her that we could use ABA to teach her student how to set a table. I went on to explain that a multi-step skill like setting the table is taught much differently than teaching a child to mand for or tact items. When the teacher pointed me toward the table setting supplies, I began asking questions such as “Should she set the table for 2 or 4 people?” and “Do you want her to carry the plates over with the silverware on top or should she carry just the plates over first?” The teacher said she didn’t know and that she just wanted her to set the table.

For chained skills, the first step is to create a task analysis. This involves writing down each step of the skill in order. If there is more than one adult working with a child on a skill, it is important that the task list be created with everyone’s input and this needs to be followed closely. For hand washing, for example, you’ll need to decide if adults are going to prompt the child to pump the soap 3, 4, or 5 times and for setting the table, it needs to be decided in advance how the child should proceed with each step. Once the task analysis is created, the key to teaching these skills is that, in most cases, adults should use gentle physical prompts from behind and NO vocal prompting.

Chapter 11 of my book (The Verbal Behavior Approach available at: http://www.amazon.com/Verbal-Behavior-Approach-ChildrenDisorders/dp/1843108526/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1205440059&sr=8-1) covers the basics of teaching chained skills using hand washing as the example.

There is another book which I would also recommend reading to learn how to teach these skills called Self Help Skills for People with Autism. This book is available at: http://www.amazon.com/Self-Help-Skills-People-Autism-Systematic/dp/1890627410.

One other resource that is excellent is a self-care checklist developed by Dr. Mark Sundberg available as a supplement to the VB-MAPP. You can download this free checklist at: http://site.avbpress.com/VB-MAPP_Supplement-Self-care.pdf. This will help you assess your child’s self-help skills and assist you with prioritizing which skills should be taught first.

Once you assess your child’s self-help abilities, I recommend you start with easy-to-prompt skills such as putting on shoes or hand washing so you can practice your skills by getting behind your child. For hand washing, I suggest you stand directly behind the child with your arms around the child gently prompting his hands. As the child turns on the water and pumps the soap dispenser three times, for instance, you can feel how much physical prompting is needed and guide his hands from behind. You should also be able to feel when prompting for each step can be faded.

Avoid vocal language during the teaching of chained tasks. This is not the time to be asking the child to tact “soap” or to be questioning “what step is next?” During multi-step self-care, leisure and/or vocational tasks, you should remain silent and provide as much gentle physical guidance from behind as is needed for the child to be successful with each step of the task.

Consistent prompting and prompt fading will be most effective when the adults working with the child take data and make decisions based on the data. Don’t forget about reinforcement too since teaching these tasks can involve high demands.

If the child you are working with seems uninterested or avoidant of the task, your goal may not be to teach the whole task. Instead you may need to start with the last step of the task first followed by high reinforcement and then fade in the other steps gradually and systematically.

For more information, visit my web site:  http://www.verbalbehaviorapproach.com/

Sunday, November 8, 2009

Why do Students with Autism Have Such a Difficult Time with Transitions?

Imagine you are at the beach on a beautiful sunny day having a cold drink and reading a great book. On a scale of 1 to 10 with 10 being the most reinforcing activity, you would rate being at the beach on this day to be a 10. Without warning, I abruptly come up to you and say “all done beach, time to load heavy boxes in a truck.” You would most likely not like this at all and might start displaying problem behaviors in the form of arguing, stomping you feet, and slamming your chair onto the sand. You might even refuse to leave your preferred activity and literally dig your heels into the sand. What I want to illustrate is that we all have problems with transitioning from high preferred to low preferred activities. The key is to ease transitions by not asking a child to transition from a 10 (a highly preferred activity) to a 2 (work) constantly throughout their day. I will briefly describe five techniques to ease transitions.

1) Dangle the carrot (the reinforcement) before problem behavior occurs.

In the beach example above, if I would have come up to you and offered you $50 to help me load 5 heavy boxes in the truck that would have been fine but waiting to offer cash until you start stomping your feet and refusing to move is a very bad idea. Remember any behavior that is reinforced will maintain or go up. Propose the reinforcement while you place the demand to transition not after problem behavior occurs.

2) Don’t physically move a student from one location to another (even if they are small enough to carry or move).

I wouldn’t even think about physically dragging you off the beach to help me load heavy boxes as this could lead to me getting arrested for assault. It amazes me that some people try to physically move students with autism from one activity to the next. If you try to prompt the child to move and he or she resists with equal but opposite pressure, this is considered a physical restraint. If you are currently using too much physical guidance for transitions, you need to stop and implement some other appropriate interventions.

3) Whenever possible, give choices.

If I would have come up and stated that I needed help with some heavy boxes and asked you when would be a good time for you to transition, you would probably have been a lot more cooperative. You may have suggested that we load the boxes when you finished your drink or after you read to the end of the chapter in the great book you were reading. We make a lot of choices throughout the day, especially when we are faced with difficult or unpleasant tasks. We need to give our students with autism as many choices as possible to ease transitions.

4) Sandwich harder activities between two preferred activities and consider using schedules and timers.

Some students benefit from visual schedules and the use of timers to indicate that one activity is over and a new one is beginning. The use of a “promise” reinforcer is also successful for many students. A promise reinforcer is used when it is time to transition to a less preferred area. The child is approached with a favorite toy or a small edible reinforcer and this is used as the “carrot” and a visual reminder that reinforcement is available for a smooth transition. Some students need several small edible reinforcers on the way to a less preferred area. It is also important that all the hard activities are spread out throughout the day and placed in between reinforcing activities. In the beach example, if you knew that you would be at the beach from 1 to 4 pm then you would spend 10 minutes helping to load boxes in a truck followed by going home for pizza, the task of loading boxes would not have been such a big deal.

5) Make sure all “work” stations are paired with reinforcement and avoid the word work whenever you can.

Some of the best classrooms and home programs I have seen have strong reinforcers at every “work” area. Each area has some electronic device (a computer, DVD player, or music box) as well as a separate box of toys and items kept on top of a rolling cart that can go with the student and his instructional materials to each area. I often tell professionals and parents to avoid the word “work” for students who have difficulty with transitions and to spend a few minutes at the beginning of each session pairing yourself and the materials with reinforcement. If students are not running towards the next activity or at least moving there without problem behavior, your demands are too high and/or your reinforcement is too low.

Check out chapter 2 and 4 of my book (The Verbal Behavior Approach) for more tips on easing transitions! http://www.verbalbehaviorapproach.com/.



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email: mary@verbalbehaviorapproach.com