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

Thursday, February 25, 2010

Using the Verbal Behavior Approach to Teach Adolescents and Adults with Autism, Down Syndrome and other Developmental Disabilities

I consulted this week with a client I will call Dan. Unlike most of my other clients who are children with autism, Dan is in his twenties. He attends an adult day training program each day and volunteers with a job coach at various locations such as the hospital laundry.

Over the past three or four yeas since I’ve consulted on Dan’s case, I have learned a lot from him and his parents. I learned about adult services waiting lists, adult day training programs, and job coaches. I also feel that working with Dan has helped me improve my ability to teach others self care and vocational skills.. The most important thing that I continue to learn from Dan during each consultation is the importance teaching children functional skills. After this consultation, for example, I decided to hold an extra reading program we were using at home with my son, Lucas (who is now 13) because it was starting to cause him frustration and was not completely functional. Dan’s last consultation also made me decide to start teaching Lucas to identify numbers past 100 since Dan was sorting music into hymnals and needed to find the spot in between number 345 and 347 to place song number 346.

I believe that all of my previous blogs are applicable to adolescents and adults with autism (as well as other disabilities such as Down Syndrome). One of my blogs about the top three skills all individuals with autism need is particularly relevant: http://verbalbehaviorapproach.blogspot.com/2009/09/big-three-skills-for-individuals-with.html.

Since working with several teenagers and a few adults with autism using the verbal behavior approach, I would recommend the following,  especially if the teens and adults you are working with are not conversational:

1) Read my book (The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders) and take advantage of many free resources on my web site: http://www.verbalbehaviorapproach.com/. Also read Self Help Skills for People with Autism: http://www.amazon.com/Self-Help-Skills-People-Autism-Systematic/dp/1890627410/ref=pd_sim_b_11.

2) Purchase the VB-MAPP (http://www.avbpress.com/vbmapp-set.html) and complete the assessment (parents will most likely need assistance from a teacher or behavior specialist to complete this assessment). With the assessment complete, you can use this information to prioritize language goals based on your son’s or daughter’s (or client’s) strengths and needs. Self help and vocational goals are very important too and should be a major focus for older children, teens, and adults.

3) Parents may need to locate an advocate to help you navigate the system and to ensure that the transition to adult services is as smooth as possible. To find an advocate, contact your local autism society or mental health association.

Saturday, February 6, 2010

Teaching Children with Autism to Greet Others

A few months ago, I evaluated a 4-year-old boy named Bobby. When I said “Hi Bobby,” he replied “Hi Bobby.” My son Lucas (who is now 13) had similar issues when he was younger so I learned strategies to help him overcome this problem well before I became a Behavior Analyst. As a BCBA, I now run into greeting problems fairly frequently so I thought I’d write about some strategies I often use to address this issue.

1) Until you can build the component skills required for greetings, encourage parents, staff and other students to eliminate the child’s name when saying “hi” and “bye.” This way you will prevent the error and the child will be more successful. If someone interacts with the child and does not know this strategy or if they forget and say “Hi Bobby” and get an echo, just have them drop back to “hi” and get a correct echo of “hi.”

2) Next take pictures of all important people in the child’s life who he sees often (i.e. mom, dad, sister, grandma, cousin, friend) and make two sets of these pictures. You will need two copies of each picture since you will want to start with matching picture to picture. Instead of saying “match” or “put with same,” just say “mom” or “mommy” as you hand the picture to the child and point to the identical picture of “mom” while you have him match. If the child is echoic, he might say “mom.” If he does say “mom” you might want to ask “who’s that?” and have him say “mom” as a tact.

3) Once the child can easily tact all the people he sees regularly without any prompts (both in pictures and when the real person is around) and he can also say “hi” and “bye” without prompts, you can try to put greetings together. If the child cannot fluently tact pictures of people who he sees often and/or if you don’t have good echoic control (Child echoes “hi” when someone says “hi” or the child says “ball” when a therapist says “ball”), I think it is probably too early to put greetings together. In this case, just have all people say “hi” and “bye” without the child’s name until the pre-requisites are met.

4) To work on putting the greeting with the name, you’ll need two people. One is the person walking in or out and greeting the child and the other person is used to prompt the child from the side or behind. For example I’m with Bobby so when mom says “Hi Bobby,” I immediately prompt “Hi Mommy.” You will most likely need several prompted trials before systematically fading your prompts.

5) If the child is still having difficulty, you might also consider making a video of people ringing the doorbell and someone opening the door and having each person who comes to the door say “Hi Bobbie.” When viewing the video, an adult should sit and watch the video with the child and prompt the child for each clip as each new person rings the doorbell and the door is opened. This was a key strategy for Lucas and after viewing the video only a few times with prompting, Lucas mastered this skill. The video showed the doorbell ringing, me opening the door then therapist # 1 (Nina) would say “Hi Lucas.” I would prompt “Hi Nina.” On the video, she would ring the bell again, door would open, Nina would again say “Hi Lucas.” This time, Lucas would say “Hi Nina” with a reduced prompt or without a prompt from me. Therapist # 2 (Eric) would then ring the bell for the same type of practice.

6) The two main things to remember when considering teaching greetings are: 1) Make sure the child has the pre-requisite skills for greetings (tacting of people’s names and good echoic control of 2-3 word utterances) and to teach greethings errorlessly as many times as needed using two adults and/or a video.

For more information about teaching greetings, see page 99 of my book, The Verbal Behavior Approach (http://www.verbalbehaviorapproach.com/).
email: mary@verbalbehaviorapproach.com