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

Tuesday, November 23, 2010

Teaching Children and Adults with Autism to Answer “Yes” and “No”

The ability to respond “yes” or “no” to questions is a very complex skill involving different operants. It has been my experience that a child needs to master yes/no mands (Answering yes or no to “Do you want a cookie?”) before you should attempt to introduce yes/no tacts (Is this a bed?) or yes/no intraverbals (Does a cow say quack?). Assessing yes/no within each operant is a good place to start.

I've done a lot of work with teaching yes/no mands to my son with autism as well as several other children. Teaching a child to say “no” or to respond with a head shake NO can be taught early to replace problem behavior such as crying or pushing items away but teaching a child to say “yes” should not be done until important prerequisites are in place.

I recommend not teaching "yes" mands until the child is spontaneously manding for dozens of items in and out of sight and manding for several actions too. I've see many children who have a defective yes mand because someone taught them to answer “yes” too early. The main issue is that they say "yes" when someone offers them something (Do you want candy or Do you want a tickle) but they cannot ask for those items (candy) or actions (tickle) spontaneously by using the item or action name. This often leads to problem behavior.

Once children can spontaneously mand for many items and actions out of sight, this is how I start teaching yes/no mands. First, I gather three things the child loves (and will almost always mand for or take) and three things they don't like and would usually push away (raisins or another non-preferred food item and certain videos). I then use these items during short (10-15 minute) yes/no mand sessions. I ask “Do you want a ___?” while holding one item and prompting yes/no and doing a transfer trial. For some children I have used textual prompts which are the written words "yes" and "no.” Textual and/or verbal prompts need to be faded carefully though by using transfer trials.

Here is an example of a prompted trial followed by a transfer trial:

Hold up a raisin (non-preferred) and say “Do you want a raisin?” prompt NO verbally, with a head shake and/or the word NO written on an index card. The child needs to say or head shake “no.” Then immediately complete the transfer trial by taking away the textual prompt (if used) and asking the question again “Do you want a raisin?” The child says “no” without any prompt and the item is removed.

I create many contrived situations, alternate between things they want and don’t want, and take trial by trial data during these short yes/no mand sessions. Once this skill is solid with the 6 items (3 items they like and 3 items they don’t like) in sight, I then specifically work on generalizing to other items and moving mastered items out of sight.

You also have to be careful about not accepting sloppy responses such as "pretzel, yes." The answer has to be yes or no when teaching yes/no mands. Be careful also not to overuse yes/no questions outside of these yes/no mand sessions when the child is just learning this skill. Otherwise, the child may lose the ability to spontaneously mand for items.

Yes/No tacting (answering “Is this a pen?” or “Is this blue?” or “Am I standing?”) is a much harder skill and should not be introduced until the child can indicate yes/no for mand items out of sight (Do you want ketchup on your hot dog? Or Do you want ice cream?). He or she also needs a solid tacting repertoire for items, features, actions, etc.

For children with the ability to respond yes or no with manding but who have yes/no tacting difficulty, I have had success with teaching yes/no tacts within the mand frame. When my son was learning to tact yes and no and would mand for cheerios spontaneously, I pulled out cheerios and asked "Are these cheerios?" He said "yes" and then got the cheerios. Once he had this skill solid I pulled out a different box of cereal when he manded for cheerios and said "Are these cheerios"....then he said “no” and I pulled out another box and asked "Are these cheerios?" and he said “no” then I finally pulled out the cheerios. Eventually (and in random order) the answer was “yes” and he received the cheerios. I then moved on to presenting yes/no tacts with flash cards without a mand component. When I started with flashcards I used “Is this an apple?” as the only question and had a mixed pile of apples and other things that were very different from apples. Once yes/no tacts are mastered (Is this a bed?, Is this a car? as you present random pictures), you’ll need to also teach children to respond to yes or no to tacts involving feature, function and class (“Does this have wheels?” or “Can you eat this?”).

For yes/no intraverbals, it is important that the instructor know the answer to the question they are asking. For example, asking “Have you ever been on a boat?” is not a good question if you don’t know whether the student has ever been on a boat. There are many children and adults with autism who answer “yes” often (and incorrectly) because they don’t understand complex language. For this reason, I usually don’t focus on teaching intraverbal yes/no responses. I directly teach yes/no mands and tacts and let the intraverbal yes/no responses develop more gradually (and only teach basic, functional and important yes/no intraverbals).

For more information about improving verbal behavior in children and adults with autism, go to my web site: