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

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

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

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

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

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

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

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

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

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

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

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

For more information about improving verbal behavior in children and adults with autism, go to my web site: http://www.vbapproach.com/.

Programming for Happiness in Clients with Autism

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

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

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.