Verbal Behavior Approach

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

2010-11-23T05:19:00.000-08:00

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/.

Programming for Happiness in Clients with Autism

2010-09-03T08:13:00.000-07:00

I attended a Keynote presentation last fall at the Autism New Jersey conference where Dennis Reid, PhD, BCBA spoke about the importance of programming for (and measuring) happiness in clients with autism.

During one of the activities, the participants spent 3 minutes writing down every choice we made that morning prior to arriving at the conference. We had the choice of whether to hit the snooze alarm, what to wear, what we wanted to eat and drink, whether we wanted to bring a jacket along, where to park, where to sit, etc.

Basically he made the point that we have many choices throughout our days and that choices lead to happiness. He also pointed out that our children and clients with autism have few choices.

As Dr. Reid suggested, I have now begun to measure and count behaviors such as smiles and laughs and I give more choices than ever before. I, of course, continue to focus heavily on pairing and manding as well as reducing problem behaviors in my effort to program for happiness. Since seeing this presentation, I feel strongly that we need to provide our clients with many choices throughout the day and should consider happiness as an important (and attainable) goal.

For more information about pairing, manding and measuring behaviors, go to http://www.vbapproach.com/ and read my book: The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders.

Mia’s Journey with the Verbal Behavior Approach

2010-07-05T18:13:00.000-07:00

I am happy to announce a series of you tube clips that I posted a few days ago that may make getting started with the Verbal Behavior Approach a little easier for both parents and professionals! There are now three short (6-8 minute) You Tube clips on the assessment and beginning ABA/VB intervention for Mia, a 2 year old lgirl recently diagnosed with PDD-NOS.

I have permission from Mia's parents to post these clips on you tube so that others may benefit from my work with Mia. Hopefully these clips will be the first three in a series of videos that I will post as Mia makes progress!

Clip #1 shows Mia's problem behaviors and poor instructional control at baseline. Clip #2 demonstrates for parents and professionals what to do to help Mia and Clip #3 shows me reviewing Mia's VB-MAPP and Barriers with her mother. All three clips were filmed during a 3-hour initial assessment in June 2010.
Clip #4 was filmed in July 2010 and shows progress in 3 weeks.
Here are the links:

Clip #1/Mia's Baseline Problem Behavior: http://www.youtube.com/watch?v=FCbBLhLjoXA

Clip #2/ABA/VB Interventions to Start Immediately: http://www.youtube.com/watch?v=rPUII8DWlCo

Clip #3/VB-MAPP: http://www.youtube.com/watch?v=8zgn3Tqy8nM

Clip #4/Progress after 3 weeks: http://www.youtube.com/watch?v=665jj4i29Ag

I’m looking forward to watching Mia progress on her journey with ABA/VB! For more information about the Verbal Behavior Approach, go to: http://www.verbalbehaviorapproach.com/

TAGteach and Autism

2010-05-11T16:49:00.000-07:00

Last spring a friend of mine asked me if I had ever heard of TAGteach. When I said that I hadn’t, she asked me if I knew anything about clicker training for animals. I was familiar with the concept of using audible markers with animals, thinking mostly of the whistle blowing at Sea World to signal to the dolphin that the move was correct and that the dolphin would be receiving reinforcement soon. My friend explained that TAGteach used the same principles of positive reinforcement, conditioned reinforcement and shaping as clicker training. She also told me that TAGteach was being used at her son’s school for children with autism. I was intrigued by the concept and assumed that the “A” in TAG stood for autism but I was wrong.

The acronym TAG means Teaching with Acoustical Guidance and was used first with gymnasts, not children with special needs. It all started when Theresa McKeon purchased a horse in 2005 and had difficulty training it. She went on-line and learned about Karen Pryor’s clicker training technology. Theresa used clicker training until the horse was calmer and then sold it. In the process of using clicker training with her horse, Theresa, a national gymnastics coach, decided that clickers might be very helpful to her young students. When a gymnast had difficulty with a handstand, for instance, the skills of the handstand could be broken down and each skill could be taught separately. When one of the students got her feet to the 12 o’clock position or put her arms over her ears, the coach could click to signal that the position was correct.

In her book, Reaching the Animal Mind, Karen Pryor describes her experience in visiting Theresa’s gym for the first time. After the parents of the gymnasts complained that they didn’t like the use of animal clicker training with their children, Theresa and Joan Orr (the co-founder of TAGteach) made the decision to change the name to TAGteach instead of clicker training when the technology is applied to humans. This simple semantic change worked to ease the concerns of the gymnasts’ parents and TAGteach began to spread to dancing, golf, other sports and eventually to special education. To view videos of TAGteach from Karen Pryor’s Reaching the Animal Mind web site, go to: http://reachingtheanimalmind.com/chapter_11.html.

Dr. Julie Vargas (BF Skinner’s daughter) also wrote an excellent book, Behavior Analysis for Effective Teaching, which highlights some applications of TAGteach to children with autism. In addition TAGteach has a great web site (http://www.tagteach.com/), a Yahoo group, Facebook page, and an excellent e-learning program I completed last summer. I highly recommend the e-learning program and/or a live 2-day TAGteach seminar to anyone and everyone!

In preparation for a symposium on TAGteach at the ABA International Conference in Texas, I used TAGteach to teach my son, Lucas, how to tie shoes. It took about 1 ½ hours in total over a few weeks and I will be presenting data and this video in Texas. Here is a you tube video as a sneak peak: http://www.youtube.com/watch?v=6K2FsjICr34

To learn more about TAGteach, check out the books listed above and/or http://www.tagteach.com/. For those of you who will be in Texas for the ABAI conference over Memorial Day Weekend, you can learn more about this technology by attending the TAGteach symposium #379 held on 5/31/10 at 10:30am where I will be presenting on TAGteach and Autism.

Visit my web site: http://www.verbalbehaviorapproach.com/ for more information about me or my book and/or join The Verbal Behavior Approach Facebook fan page: http://www.facebook.com/pages/The-Verbal-Behavior-Approach/183142072329?ref=mf.

Teaching Children with Autism to Indicate When They Are in Pain

2010-04-10T06:55:00.000-07:00

I recently received a question related to my last blog on the importance of looking at medical issues before treating problem behavior. The question a few weeks ago was “How do you teach children with autism and severe language impairments to indicate they are in pain and to tell you where the pain is coming from?” I remember asking a very similar question to Lori Frost (co-creator of the Picture Exchange Communication System – PECS) years ago when I attended an introductory PECS workshop. Lori’s response was to make sure you label and preferably have your child label (with speech, PECS, or sign) when he has something visible that is obviously hurting him. In other words, when your child has a skinned knee or when he gets a bee sting, make a big deal out of labeling the pain for him. This is an important step with the goal that eventually your child will be able tell you he has internal pain which you can’t see such as a head ache or belly pain.

For a non-vocal or minimally vocal child, you might try -- Boo Boo (with a Band-Aid picture card or the words) on my ______________ or my _________ hurts and have your child fill in the body part by speaking or choosing a picture of a body part from an array. Even if your child is speaking, he or she might need added visual supports to learn this concept. To teach the labeling of pain, I would also recommend you try to put a real Band-Aid on a large picture of a boy (on various body parts) and have your child fill in the blank --boo boo on the boy's ___________ or the boy’s ________ hurts. You could also use the same idea to teach this concept with a simple talking device and/ or with sign language. I have found that receptive body parts and tacting body parts are usually prerequisite skills for labeling pain so I would also recommend working on these programs when your child is not in pain.

I believe the ability to label pain is an important skill which can and should be taught. For more information including details about my book (The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders), check out my web site: http://www.verbalbehaviorapproach.com/.

The Importance of Ruling Out Medical Issues Before Treating Problem Behaviors

2010-03-20T08:21:00.000-07:00

As both a Registered Nurse and a Board Certified Behavior Analyst (BCBA), I find myself frequently reminding people that some behaviors are caused by medical issues and cannot effectively be treated behaviorally.

Here is a little review of the four main functions of problem behavior. Two functions are Socially Mediated which means that other people have been involved in the past that have reinforced the behaviors. The other two functions are Automatic which means that no other person needs to be involved. The child or adult engages in problem behavior because the behaviors are automatically reinforcing. Here are the four main functions broken down further:

1) Socially Mediated Positive Reinforcement (Attention/Access to Tangibles). In the past when the child engaged in problem behaviors, things were ADDED such as attention and tangibles.

2) Socially Mediated Negative Reinforcement (Escape from Demands). In the past when the child engaged in problem behaviors demands were REMOVED (or delayed or made easier).

3) Automatic Positive Reinforcement (Self Stimulation). The child engages in problem behavior because in the past when they have engaged in this behavior pleasure/reinforcement has been ADDED.

4) Automatic Negative Reinforcement (Pain Attenuation). The child engages in problem behavior because in the past when they have engaged in the behavior, pain was REMOVED (or lessened).

In Chapter 2 of my book (The Verbal Behavior Approach), I cover the first three functions in pretty much detail but I don’t explain Automatic Negative Reinforcement too well except to mention that children with problem behaviors which come on suddenly or which you suspect might be medical should see a physician. In many cases, however, it is difficult for you or any physician to determine if a problem behavior is caused by a medical problem, especially in children with autism who cannot fully communicate about pain or discomfort.

I had an experience with my own son in the past few weeks since I wrote my last blog which I decided to write about to illustrate the importance of looking at medical issues when evaluating a child for the first time or when an established client experiences problem behaviors which start abruptly or increase without a clear explanation.

Lucas, who is 13 and has moderate autism, showed an increase in self injurious behavior (SIB) over the past few months. While in the past he would occasionally bite his knuckle at school, the rate and intensity of his knuckle bites went up significantly (from approximately one knuckle bite a day at school to 10 knuckle bites occurring both at home and school). This increase occurred in the past two months and at times, in addition to the knuckle bites, Lucas would sometimes hit his head and cry.

Lucas’ teacher and aid at school kept careful ABC data and the behaviors usually appeared to be related to access to tangibles and/or escape. But the demands were not higher than usual and sometimes he would engage in problem behavior without a clear antecedent. The professionals who worked with Lucas for years were all concerned that his behaviors were worse than ever. I was concerned too and noticed that sometimes at home when he engaged in problem behaviors, he cried real tears (and engaged in SIB) while on reinforcement. At these times when I asked him what was wrong, he would almost always say “eyes” but I didn’t know if he was saying eyes because he was crying or if he was truly in pain.

I finally took him to the pediatrician who agreed to do a battery of blood tests and a CAT scan of his head and sinuses. Because we knew Lucas wouldn’t tolerate a CAT scan without sedation, the doctor had to arrange a CAT scan with anesthesia. The MD and I agreed that is everything came back normal; we would chalk up Lucas’ problem behaviors to puberty and treat it behaviorally.

While the blood work and CAT scan of the head were within normal limits, Lucas’ sinus CAT scan showed “sinus disease” which has responded well to antibiotics and allergy medicine. I’m happy to report that Lucas’ problem behaviors are now back to baseline and we will work hard to implement behavior procedures to get rid of his SIB altogether.

For more information about reducing problem behaviors in children with autism, please read Chapter 2 of my book (http://www.verbalbehaviorapproach.com/), listen to a radio show on reducing problem behavior (http://old.autismone.org/radio/?archive=5729) and/or read my previous blogs.

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

2010-02-25T13:10:00.000-08:00

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.

Teaching Children with Autism to Greet Others

2010-02-06T17:30:00.000-08:00

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/).

New Blog: HBO film entitled "Temple Grandin"

2010-01-26T17:47:00.001-08:00

A new HBO film entitled "Temple Grandin," will premier on February 6th. This movie details the life of animal researcher and autism advocate, Temple Grandin. Here is a blog about the movie which includes an interview with Temple written by a friend of mine, Chantal Sicile-Kira: http://www.huffingtonpost.com/chantal-sicile-kira/temple-grandin-the-hbo-mo_b_420575.html.

I have always found Temple to be incredibly inspirational. For the past few years I have been working with Jodi Goren-Rode and Keystone Pictures to support Jodi’s effort in making a documentary about Temple Grandin. Here is a 5-minute video clip Jodi put together a few years ago available on YouTube: http://www.youtube.com/watch?v=iAu6_Llfh2A. This YouTube clip, which gives an overview of the documentary Jodi is producing, has been viewed over 24,000 times and gives a brief synopsis of the life and work of Temple. As I say in the clip, Temple is probably the most recognized person with autism in the world and has done many great things for the autism community.

I had the privilege of having lunch with Temple a year before I wrote my book. After I told her a little about myself (that I had a son with autism and became a BCBA to help others), she said “You should write a book!” It was an amazing experience to have lunch with Temple and she provided me with much hope and inspiration.

I also met Temple’s mother, Eustacia Cutler a few years later and, after reading my book (The Verbal Behavior Approach), Eustacia wrote the following endorsement which is available on my web site under book endorsements (http://www.verbalbehaviorapproach.com/book3.html) :

“Written with style, warmth and real know-how, Mary Barbera has managed to combine valuable therapeutic advice with her own eloquent story.”

Eustacia Cutler, Author
A Thorn in My Pocket: Temple Grandin's Mother Tells the Family Story

I am excited to see the HBO movie premiering Feb 6th! I’m sure as I watch the movie, I will learn much more about Temple’s life and work.

Getting Children with Autism to Respond to Their Names

2010-01-16T10:54:00.000-08:00

I recently conducted a full day assessment on a child I will call Dennis, a 4-year-old with a diagnosis of autism. One the concerns of Dennis' parents was their inability to get his attention by calling his name. As I conducted a VB-MAPP assessment, this was a deficiency in the Listener Responding area and was also an IEP goal not mastered for over a year.

Not responding to name when called can be one of the first hallmark signs of autism. This is considered a “red flag” on the Modified Checklist for Autism in Toddlers (M-CHAT) and a diagnostic indicator on the Autism Diagnostic Observation Schedule (ADOS). Since many children and adults with autism have difficulty in this area, I thought I would address it in this week’s blog.

I created and have used the following procedure to address this issue with dozens of children with autism and found it to be very successful. The key is to pair the child’s name with improving conditions (reinforcement) since any behavior that is reinforced will maintain or increase. The following is an excerpt from page 106 of my book (The Verbal Behavior Approach).

First, tell everyone in the environment to stop using, or limit the use of the child’s name throughout the day. Most importantly, do not link the child’s name to demands (e.g.: “Dennis, go get your shoes”, “Dennis come here”, etc.) . Limiting the use of the child’s name will actually help him to learn to respond when his name is called, because he won’t tune it out as part of a long list of demands.

Next gather several of Dennis’ strongest consumable or controllable reinforcers (chips and bubbles, for instance) and go behind him when he’s engaged in another activity. Call his name while standing behind him and then immediately touch his shoulder and hand him a chip or blow bubbles. Gradually fade your prompts by standing a foot or two further away and by delaying the touching of his shoulder by a second or two. By using this procedure, Dennis will learn that when he hears his name, good things happen.

For the best results, I recommend using this procedure in both home and school environments and also recommend taking data every trial (10 or 20 trials per day) so that your distance and the reinforcement can be systematically faded out as the child becomes successful with responding to his name.

For more information, read my book and/or past blogs available at: http://www.verbalbehaviorapproach.com/.

The Importance of Conducting a VB Assessment When Completing an FBA

2010-01-09T06:36:00.000-08:00

I completed a Functional Behavior Assessment (FBA) recently on 9-year-old boy I’ll call Sam. His mother decided to home school Sam because she was worried that the public school her son attended might call the police if his behaviors continued to escalate.

Sam was diagnosed with high-functioning autism just after the age of three. He was included in general education classes since his IQ was in the normal range. Sam spoke in full sentences and could reportedly read at grade level. Sam’s outbursts, however, were very disturbing to the teachers and other students. While at school, Sam was sent to the principal’s office on multiple occasions and was suspended once when he knocked over a desk.

While an FBA is conducted to analyze the function of problem behaviors, I believe that a big part of an FBA should be dedicated to examining the child’s language and academic skills. In Sam’s case, his language deficits were very apparent to me as I completed a VB-MAPP assessment, even though he was a puzzle to school district personnel.

Sam displayed defective mands throughout the assessment since almost all of his requests revolved around escaping work. He asked his mom “Can we be done?” and “Is it almost time for a break?” 30 times during a 20-minute work session. During the full day evaluation, Sam also only asked a few general questions starting with words such as “what,” “can” and “does.” I didn’t hear any complex mands for information with “why,” “how,” or “which” questions.

While Sam’s tacts were relatively strong, things fell apart for Sam when he was asked questions and needed to respond intraverbally. When I asked Sam to tell me some animals, foods, colors, and pieces of clothing or asked him simple “what” and “where” type questions, he was fairly accurate. However, when I asked him to tell me some things that are usually red, he looked around the room (looking for something to tact). I then asked him to close his eyes and tell me some things that are usually red and he demonstrated problem behavior. He screamed “Don’t tell me to close my eyes!” Similar problem behaviors were seen when how and why questions were asked.

The VB-MAPP assessment showed major skill deficits in manding for information and in the intraverbal repertoires. Sam’s problem behavior was primarily related to a history of escape from work involving high intraverbal demands. A few of the interventions recommended included the introduction of a token economy system, teaching Sam how to mand for information and using tact to intraverbal transfers to teach him to more effectively answer complex “wh” questions. An SRA program called Language for Thinking as well as a BCBA for six hours per month to oversee programming were also recommended and implemented.

If a student is displaying problem behaviors that are disruptive to his learning or the learning of others, the “problem behavior” box should be checked off on one of the first pages of the IEP. If this box is checked, a FBA needs to be conducted, preferably by a Board Certified Behavior Analyst (BCBA). A Behavior Intervention Plan should also be written and, once staff are trained on the plan (by the person who wrote it), it should be followed closely. Ongoing analysis and support for staff is also needed.

I believe that assessing the verbal and non-verbal operants as well as all academic areas should be a part of every FBA. Professionals who conduct FBA’s, as well as other professionals and parents who are working with students with significant problem behaviors need to understand the difference between mands, tacts, and intraverbals and the importance of assessing the verbal and non-verbal operants. A focus on the skill strengths and deficits (and not just on the problem behavior) will help each student with autism reach their full potential.

For more information, read my book (The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders) and/or check my web site (http://www.verbalbehaviorapproach.com/) for downloadable information at no cost.

Getting Started with the Verbal Behavior Approach

2009-12-12T13:22:00.000-08:00

An ongoing challenge is how help parents and professionals get started with the Verbal Behavior Approach. Several months ago I published a short article entitled “Getting Started with the Verbal Behavior Approach” in Autism File magazine I think it is great for both parents and professionals who are brand new to the VB Approach and want a very brief overview. The article appears on the home page of my web site in the lower right hand corner. Here’s the direct link: http://www.verbalbehaviorapproach.com/autism_file.pdf
I do have permission to copy and distribute freely so feel free to pass it along!

In addition, there are many other free resources on my web site including Frequently Asked Questions Regarding VB and Frequently Asked Questions Regarding Potty Training. These two FAQ articles are available in both English and Spanish: http://www.verbalbehaviorapproach.com/faq.html

Several 30-minute radio shows are also available on my site and listed on the radio page of my site. Here is the link for the radio show list: http://www.verbalbehaviorapproach.com/radio.html.

Go to: http://www.verbalbehaviorapproach.com/ to access information to help you (or a parent or professional you know) get started with the Verbal Behavior Approach.

A Quick Assessment for an Intermediate Learner with Autism

2009-12-04T08:26:00.000-08:00

The term “Intermediate Learner” is very subjective and in the ABA/VB field, this usually indicates that the manding, tacting and intraverbal areas on the ABLLS or VB-MAPP are not well developed. While the intermediate learner can mand for basic items and some actions, he or she is usually weak at manding for attention and information. Basic tacts are solid and the child may have hundreds of tacts but usually has difficulty tacting features, functions, actions, prepositions and more abstract concepts. In addition, intraverbals (answering questions with no visuals) are extremely weak. Basically an intermediate learner is usually able to talk but unable to hold a conversation.

My son is now 13 years old and has been an intermediate learner for several years. At this point many would consider Lucas to be at the cusp of an advanced learner in some areas but most of the years since we’ve implemented ABA, my son has been at the intermediate learner level. Programming for intermediate learners, therefore, has always been an issue of great importance to me.

A few people have made comments such as “Well if Mary is a BCBA and VB works, then why isn’t her son conversational or why isn’t he recovered from autism?” I write about this in Chapter 12 of my book and I suggest that if it were just about how hard you worked to help your child, Lucas (and many other children with autism) would be long recovered. But Lucas remains moderately autistic and, while his language improves, it does so slowly but surely. I equate it to climbing a very huge mountain with a lot of stuff on our backs.

I often encounter vocal children who appear to be an intermediate learners and I need to assess them very quickly without using a lot of materials and without completing a VB-MAPP or ABLLS. A few years ago I wrote down the steps I usually use to assess these intermediate learners in a few minutes with only a small amount of materials.

This mini-assessment is not all that is needed for these learners but it may help you get started in terms of knowing which children need a more thorough assessment and careful ABA/VB programming. Intermediate Learners (who do not “pass” the mini-assessment below) need a more thorough assessment such as the VB-MAPP and also need very specific programming. Ideally, these learners should also have access to on-going consultation by a BCBA familiar with intermediate learner ABA/VB programming.

Here are areas I assess:

For language I focus on assessing mostly the tacting and intraverbal repetoires. While I’m assessing these areas as well as some basic academic skills, I’m also listening for the child to spontaneously mand for items, actions, help, attention, and information.

Personal information/Intraverbals
What's your name, how old are you, what's your phone # and address (assess both knowledge and articulation of these).

Tacts of functional items such as chalkboard, stapler, paper towel, toothbrush (pictures and items).

Tacting body parts/clothing (what’s this called (nose)) and actions (what am I doing (clapping))

Tacting features (use real items)....”What's this called?”...chair. “What is this part called?”....legs/back/seat (also assess: computer...keyboard, mouse, screen, phone....cord, buttons, receiver, and car....wheels, roof, door).

Tacting prepositions....Hold a pencil over a book and ask "where's the pencil?" Do the same procedure for in front of/behind/next to/under/in/on ....the answer needs to be “over the book”...not just “over.”

Tacting pronouns....whose shirt (while touching your own shirt....his answer should be "your shirt" or "yours" ...same procedure for my (clothing or body part)....then test Who has the book (you do or I do) ....test boy/girl and he/she too if the child is successful with my/your and I do/you do.

Yes/No tacts....Is this a bed (show him a spoon)......Does this have wheels (show him a car)...Does this have wheels (show him a bed)....Is this blue (show him something that is yellow)

If the student is successful with Yes/No tacts, I then assess Yes/No intraverbals…does a cow say quack, does an airplane fly in the sky, does a boy where a dress.

Intraverbal feature/function/class and Intraverbal Webbing
Tell me a color, tell me another color, tell me something that is yellow, name two things that fly in the sky, close your eyes and tell me some things that are usually red, tell me a vehicle, tell me a hot breakfast food, tell me something with four wheels, what do you do with a sink.

Math abilities...count to 7, give me three, circle four, what is 2 + 3 (no visuals). What time is it? Check tacting money and adding amounts of money (place a quarter and dime on desk…how much money is that?)

Reading/comprehension ....If child can read, have him read a few sentences or pages from a book. While he is reading, note errors and fluency. After he is finished, ask who, what, where, when, how and why questions regarding the content.

Writing....I ask the child to write his name (looking at pencil grip, spacing, size). If the child is successful I might ask him to also write some other words or draw a picture.

During the assessment, I also record the child’s ability to mand for items present and note any ability for the child to mand for help, attention or information during the assessment. If he doesn’t spontaneously mand for information then I sabotage the situation (Hide something in the room and tell him..."I have a swedish fish somewhere in this room"....see if he says "where").....I might also hide something in a box or bag and say "I have something in this bag for you" and see if he says "what." During the assessment, I also look for barriers to learning including issues with instructional control and problem behaviors. I record all significant problem behaviors and note which operant or skill seemed to trigger the behaviors.

Once this mini-assessment is finished, you should know if the child or adult needs a more thorough VB assessment such as the VB-MAPP. You’ll also have an idea of some programs that might be useful.

For more programming advice, listen to my radio shows on programming: http://www.verbalbehaviorapproach.com/radio.html

More assessment information and programming advice can also be found in my book: The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders available at: http://www.amazon.com/Verbal-Behavior-Approach-Children-Disorders/dp/1843108526/sr=8-1/qid=1167954419/ref=pd_bbs_sr_1/102-6326506-0064953?ie=UTF8&s=books.

Teaching Games to Children with Autism

2009-11-21T05:54:00.000-08:00

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.

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

2009-11-15T19:57:00.000-08:00

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/

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

2009-11-08T07:38:00.000-08:00

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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The Pennsylvania Verbal Behavior Project

2009-10-31T06:11:00.000-07:00

As many of you know I’ve been the Lead Behavior Analyst for the PA Verbal Behavior Project since 2003. I always receive a lot of questions about the Project so I wanted to give some basic information via this blog.

The PA VB Project started in 2002-3 school year with two pilot classrooms in the Wilkes-Barre PA area. The main goal of the Project is to establish public school classrooms that provide teaching procedures using Applied Behavior Analysis and the Analysis of Verbal Behavior to improve communication, social and other relevant skills for students with autism.

The Project has grown over the years and we now serve over 100 public school autism classrooms throughout the State of PA. The Project is supported solely by the PA Department of Education and provides three main services. Each Project classroom receives: 1) training; 2) some materials such as Language Builder Cards, VB-MAPP protocols, and Direct Instruction Materials; and 3) on site guided practice by Board Certified Behavior Analysts (BCBA’s) and those studying to become BCBA’s. The largest parts of our budget has and will always be on site coaching since studies show that most people retain little information and are not able to apply much after lecture alone.

The VB Project does have some outcome data based on a site review checklist and student assessment scores and we have presented this data at the last several International ABA conferences. This year we will have even more outcome data since we are now using the VB-MAPP for all of our 600+ students. Hopefully this data will be published in the future.

Check out this youtube video about the PA Verbal Behavior Project:

http://www.youtube.com/watch?v=JCkYqW1GDdo

Here is a free downloadable parent handbook too:

http://www.pattan.net/files/Autism/VB-FamHandbk062209.pdf

Contact http://www.pattan.net/ for more information about the PA VB Project.

Getting ABA/VB Services Started in Your Child’s School

2009-10-24T07:34:00.000-07:00

There are lots of ways to try to educate school staff on the principles of ABA/Verbal Behavior and get this type of programming in place within educational settings. Bringing in a knowledgeable speaker on the topic of ABA/VB is probably the most common way to begin. This can often "jump-start" enthusiasm for ABA/VB but will take time and money to sponsor a speaker. If you have a local autism support group or autism school with some ability to bring in a speaker, you may want to try to get that agency to sponsor or co-sponsor a workshop.

Many parents and professionals have said my book (The Verbal Behavior Approach) gave them a great overview of the concepts so for relatively little investment, some parents have purchased multiple copies of my book for their child’s teacher, SLP, OT, and paraprofessionals.

But if education professionals are not motivated to read the book or attend a workshop, you could be wasting your money. And, even if they do hear a knowledgeable speaker present on ABA/VB and/or read my book, they still will most likely have difficulty applying the concepts.

Without on-going consultation and support, it is usually very difficult for teachers to learn how to apply ABA/VB concepts to correctly program and teach children on the autism spectrum. Some schools who agree to provide an initial training on ABA/VB will also contract with the trainer or another qualified Board Certified Behavior Analyst (BCBA) to provide on-going consultative support for a particular classroom or school. This is often a very good situation with program oversight provided for the entire classroom of students and training and guidance for the staff.

If you have difficulty getting things going in your child's classroom or school, another strategy is to start small and focus on getting ABA/VB for your child only (not for the whole classroom). One way to get things started for an individual child is to try to get a BCBA with VB expertise in your child's IEP for a specified period of time each month (i.e. 4, 6, or 8 hours) for program oversight. Putting staff training (for example 6 hours before anyone new works with the child) in the IEP also can also be essential and the BCBA whose services are the IEP can provide that training.

Having the BCBA hours within one child's IEP may not change the entire classroom immediately but over time it might. Plus, if these services are in your child's IEP, the BCBA and staff training requirements will follow the student to middle school and then to high school. This may mean that you won't have to start your advocacy efforts over again as the child transitions and as staff come and go over the years. Getting BCBA services and staff training in the IEP may be difficult but since the IEP legally drives services, I believe it might be something worth pursuing.

For more information, check http://www.verbalbehaviorapproach.com/.

ABA and the Verbal Behavior Approach for Children with “High Functioning” Autism

2009-10-17T07:19:00.000-07:00

I am often asked if ABA/VB is appropriate for children or adults with High Functioning Autism (HFA). Since my book is geared more towards helping adults learn how to teach early learners, many parents and professionals think that ABA and specifically the Verbal Behavior Approach is not appropriate for “higher functioning” children.

First I want to say that I really try to avoid using the terms “high functioning” and “low functioning” to describe learners with autism. I explain why I prefer not to use these terms in chapter 12 of my book but very simply it is the same reason I wouldn’t label a typical child or adult as “smart” or “stupid.” All of us are smart in some areas but not so smart in other areas. It is unfair for us to put children with autism in boxes and to try to classify kids as either high functioning or low functioning. Instead we need to assess the child’s strengths and weaknesses. An individualized ABA/VB program should capitalize on the child’s strengths while helping him or her overcome weaknesses.

I spend at least half of my consultation time with children that most people would consider to be “high functioning.” These children look pretty indistinguishable in the community and some of these kids are even able to hold decent conversations. But most if not all of the high language learners I work with still have language deficits and social skill weaknesses that are in need of serious ABA/VB programming. Many of these students also have dyslexia and other learning disabilities too and this often complicates programming. Because of these skill deficits, all of the students I work with on a regular basis need a fine balance between demands and reinforcement.

ABA is the science of changing socially significant behavior and, in my opinion, is often mistakenly overlooked for children and adults with “high-functioning autism.” Check out my book (The Verbal Behavior Approach) specifically chapters 2 and 12 for more information about using ABA/VB techniques to teach children with autism, regardless where they fall on the spectrum by visiting my web site:(http://www.verbalbehaviorapproach.com/).

Teaching Non-Vocal and Minimally Vocal Children with Autism

2009-10-10T08:03:00.000-07:00

For children who do not yet speak, I usually recommend teaching 3-5 signs at a time and to teach these signs as mands first. Many of these signed mands will need hundreds of practice trials before a child will be able to request an item using a sign without assistance. Careful prompting and prompt fading across many trials per day is usually needed.

To teach a child to mand using sign language, hold out a preferred item and make sure the child wants the item by giving a “freebie” and/or looking for a reach, eye gaze, or smile. If the child does not want the item, you should not proceed. If the child wants the item and has some ability to imitate, I would then recommend you model the sign.

If the child cannot yet imitate, check for the motivation (MO) and then take the child’s hands and help him or her perform the sign. After the child performs the correct sign (with an imitative or physical prompt), deliver the reinforcer. Each time you or the child signs the word and when you deliver the reinforcer, it is important to say the item name.

I would also focus on trying to increase vocalizations by using simple inset puzzles or two sets of identical first word flash cards you can buy at the Dollar Store. As you hand the child a pig puzzle piece or a picture of a pig to match with the pig picture on the table, say the word “pig” three times (pig, pig, pig) as you hand the child the pig and as the child puts the pig in the puzzle or matches the picture. If the child says the word as he is matching, give lots of extra reinforcement but don’t worry if no words are heard during the activity. Bombarding your child with many single words a day is key so continue these activities daily.

My book (The Verbal Behavior Approach ) especially chapter six should be particularly helpful in learning more about teaching non-vocal and minimally vocal children. Check http://www.verbalbehaviorapproach.com/ for more information and listen to a free radio show on this topic at: http://www.autismone.org/content/2008-02-08-120000-mary-lynch-barbera-rn-msn-bcba

What are the Differences Between the ABLLS and the VB-MAPP?

2009-10-04T06:45:00.000-07:00

I received a question on my blog two weeks ago asking about the differences between the ABLLS and the VB-MAPP. This week I’ll address this question.

The Assessment of Basic Language and Learning Skills, otherwise known as the ABLLS, was written by Dr. James Partington and Dr. Mark Sundberg in 1998. The ABLLS was not written as a “stand alone” book. Instead, it is one of three books that were written to go together. Many people (including me) credit the publication of Drs. Sundberg and Partington’s three-book collection (including the ABLLS) with the creation of the Verbal Behavior Approach. Without the ABLLS, my son with autism who is 13 years old would not have progressed to the point he is now and I most likely would not have become a BCBA or written my book. I am therefore eternally grateful to Drs. Sundberg and Partington for publishing the ABLLS.

The Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) was written by Dr. Mark Sundberg and published by AVB Press (http://www.avbpress.com/) in 2008. This newer assessment tool has many advantages over the ABLLS.

Some of the things that I like better about the VB-MAPP include: 1) Skills as well as barriers are assessed; 2) The tool was field tested with over 150 typical children and dozens of children with autism; 3) There are three clear levels in the MAPP so you can gauge the skills of a child with autism with age ranges of typically developing children; 4) Once the VB-MAPP is completed, the boxes can be added up to obtain a score (making progress more objective and the tool more appealing to researchers); 5) Practitioners who use the VB-MAPP are more likely to develop a balanced program with emphasis on improving the child’s deficits without further splintering skills; 6) The MAPP contains a transition assessment which is helpful in making decisions about the level of inclusion or group instruction that may be appropriate; and 7) I find the VB- MAPP to be easier to administer.

Both the VB-MAPP and ABLLS can be used as assessments, curricula, as well as skills tracking guides. Both tools consist of a series of boxes (although the MAPP has far fewer boxes) requiring completion by an adult who is familiar with the child and, more importantly, knows how to assess skills accurately. The initial assessment using the VB-MAPP or ABLLS can take hours to complete, especially if the learner has more advanced skills.

They are both great tools for a consultant trained in the Verbal Behavior Approach, but for a parent without any background in ABA, the VB-MAPP and the ABLLS can be very overwhelming. In order to assess accurately using one of these tools and program most effectively for your child, consultation with a BCBA familiar with Skinner’s Analysis of Verbal Behavior is strongly advised.

The ABLLS, ABLLS-R (A revised ABLLS published by Dr. Partington in 2006) and the VB MAPP assessment tools are all available at http://www.difflearn.com/ and information regarding BCBA’s can be found at http://www.bacb.com/. After completion of a thorough ABA/VB assessment, lots of programming advice can be found in my book: The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders (http://www.verbalbehaviorapproach.com/).

Pairing with Reinforcement: The First Step to Teaching Students with Autism

2009-09-26T09:22:00.000-07:00

For all adults and children, including students with autism, when you see problem behavior (crying, whining, hitting, biting, flopping to the ground, etc.), the demands are almost always too high and/or the reinforcement is too low.

If the child is displaying problem behaviors when the parent interacts with him, when the therapist arrives or when it is time to go to school, the parent, therapist, or teacher has most likely become aversive. He or she did not pair themselves well with reinforcement and has most likely made abrupt demands. To correct the situation, the adults need to learn about pairing themselves, the materials, and the environment with reinforcement.

If your child loves to play legos a certain way, for instance, the adult should sit next to him and let him play "his way" for a session or two. He or she should be taking notes about what the child likes during the first few sessions and the child’s reaction if the adult sits near him, talks, or plays alongside. During subsequent sessions the adult should interject comments, demands or questions very carefully.

The adult's demands should be so subtle that the child is unaware when pairing has stopped and demands have begun.

If the child is not running towards the people, classroom, therapy room, and/or the materials, pairing most likely needs to be addressed. Pairing is not a once and done activity. It needs to happen every day as new activities, people and materials are introduced.

Chapter 4 of my book (The Verbal Behavior Approach) should help you learn more about pairing. http://www.verbalbehaviorapproach.com/.

Reducing Problem Behaviors

2009-09-19T04:17:00.000-07:00

I often get questions like this: My child displays problem behavior (screams/argues/ bites/kicks/flops to the ground ) when a demand is placed ( it is time to take a bath/do homework/go to bed). The answer to the question is similiar no matter what the problem behavior or demand.

Whenever problem behaviors occur, I believe the demands are usually too high and/or the reinforcement is too low.

The first thing I would recommend is to take data (how many times the behavior occurs per hour or per day and take some ABC data too, if possible). Next I would look at activities when the problem behavior almost always occurs (when it is time to take a bath) and when it never occurs (while your child is playing on the computer).

You then should look at ways to “re-pair” the bathing routine (get foam for the tub or bath paint/toys for instance) and try to sandwich harder activities with fun activities (first bath then computer). A heavy focus on pairing and manding as well as an 8 to 1 ratio for positive to negative comments is usually helpful too.

Continuing to take data while you intervene is necessary to make sure the behaviors are decreasing. If problem behaviors are severe you may need a Board Certified Behavior Analyst (BCBA) or someone with lots of experience with problem behaviors to help you. My book (The Verbal Behavior Approach) --specifically chapters 2, 4, and 5 explain these ideas more fully. Check http://www.verbalbehaviorapproach.com/ for more information.

The Big Three Skills for Individuals with Autism

2009-09-13T18:01:00.000-07:00

I’ve been consulting with children and a few adults with autism for seven years now and I had a revelation about two years ago soon after I published my book. I now believe that there are three main skills every child and adult with autism needs to be successful. These skills, I believe, are the most important skills regardless of the person’s age or level of functioning.

The Big Three are:
1) Problem behaviors at or near 0
2) The ability to request wants and needs
3) Independent toileting

Whether your child is 5, 15, or 50 years of age, I think without these three skills, he or she will have little opportunity for inclusion at school or in the community. In addition, without these three skills, parents often cannot access babysitters, respite providers, schools, or work opportunities for their children. They also have a difficult time taking their children to pools, restaurants, on planes and even to visit friends or relatives.

If you or other people are working on different skills (double digit math or reading for instance) but your child has not mastered “The Big Three,” think about suggesting some additions and/or changes to your child’s program.

For more information, check free resources on my web site: http://www.verbalbehaviorapproach.com/ and read my book (The Verbal Behavior Approach) specifically chapter 2 (reducing problem behaviors); chapter 4-6 (pairing and manding) and chapter 11 (toilet training). You can also access radio shows on these three topics on my web site.

Getting Up-To-Speed Electronically In the Autism World

2009-09-08T04:21:00.000-07:00

Today I’m writing my very first blog and I have to laugh because I didn’t even know what a blog was just three years ago when I started my doctoral courses!

I have come a long way electronically in the past decade since my first-born son, Lucas, was diagnosed with autism one day before his third birthday. In 1999, before Lucas was diagnosed, the internet was my first source of information. I first read about hyperlexia than stumbled upon PDD and finally realized that Lucas’ symptoms were actually all hallmark signs of autism.

I didn’t know how to search the internet and didn’t even have an email account back then but without getting up-to-speed electronically, I would have not learned what I know now about autism.

Check my web site http://www.verbalbehaviorapproach.com/ for more information about me and my book (The Verbal Behavior Approach: How to Teach Children with Autism and Related Disabilities), and stay tuned for future blogs where I will give lots of advice on parenting and teaching children with autism.