Mia’s Journey with the Verbal Behavior Approach

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/

Getting Children with Autism to Respond to Their Names

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

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.

A Quick Assessment for an Intermediate Learner with Autism

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.

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

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/).