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: http://www.vbapproach.com/.

10 comments:

  1. Fantastic write-up on such an important skill. Our 3 year old has just about mastered "no" but never says "yes". This is a great way to approach a task I've been unable to conceptualize.

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  2. Using reinforcements is an easy, available and fantastic way to get a child to answer yes or no!. Seems like a basic idea but you truly made this concept a tool for teachers, parents and caregivers to utilize. Way to go! I love it!

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  3. This article has come in a timely manner. We are trying to teach our daughter with ASD to say "yes" as well. She tends to say "no" in most instances even when she really means "yes" she would like more cookies. There are great ideas and guidelines to put into practice.

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  4. Thanks for this article. My 6 year old stepson will pretty much say "yes" to any question and I've wanted to work on this with him. Very helpful!! :)

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  5. Thanks for the detailed write up. We have been having trouble making our daughter answer yes/no for tacts. She does great with mands. Will employ the suggested techniques and see.

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  6. I use the VB approach in my class and am looking to find a some kind of a teacher's list of questions for intraverbals that can be used to create data sheets. Do you know of a good place to look? Thanks - Curran Pope, New Hampshire

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  7. I am a SLP and am working with an ASD kiddo who's parents want him to learn to respond "yes." He can say "no" when offered something non preferred in a natural setting. But when his parents asked him if he wanted a preferred item, he replies with "I want (preferred item.)" instead of just saying yes. I came across this article and used it to teach him yes in the same approach, using visual cues. I tried verbal but he ended up echolaic. The most recent session, he's now appeared to have "grasped" the concept "yes" but now answers everything "yes" even to non-preferred items.... help! What do you suggest I do?

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  8. Stephanie,

    I would suggest you stick with teaching yes and no within manding only. You may have to create yes/no manding sessions where you offer the child both things he wants and things he doesn't want. To teach my son, I needed to create about 20 trials per session alternating (but not in a pattern) yes and no responses. The other important point when teaching any skill is to use transfer procedures to fade prompts. This is explained in Chapter 7 of my book (The Verbal Behavior Approach)

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    1. Thanks for your reply! I have tried alternating yes/no mands but he gets "stuck" and then answers all questions with the one we'd be working on previously. But we've been focusing only yes for a few sessions, so it may take a while for him to get "unstuck." He has reached the point with answering "yes" that we don't have to use the visual prompt but now we're focusing on "no" using the prompt to which I fear he's going to get "stuck" on answering "no." I will try to alternate them next time I see him.

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  9. Background: My student is autistic with severe cognitive delays. He is non-verbal and communicates basic requests with attributes with PECS. He has been taught how to head nod YES to answer a simple questions, "Want banana?" The YES has been over-taught as he now says YES for everything. We've been using a physical prompter during head shake NO training to no avail. He is very confused...he head nods YES to things he doesn't want on some trials (as he's pushing them away), head shakes NO to things he doesn't want and then follows it up by a YES. I'd love some specific guidance. Any suggestions?

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email: mary@verbalbehaviorapproach.com