Tip of the Week: Two Essential Considerations When Toilet Training Boys

Last year, I had the opportunity to interview Gary Weitzen, the Executive Director of POAC Autism Services and the Autism Shield Program. (You can see the blog post about that interview here.) In the months since our interview, many of his comments have stuck with me, but one in particular has impacted my daily work with students. He said, “A lot more boys have autism than females but the vast majority of educators in special ed, and in particular with autism, are females.” He went on to provide examples of how this fact influences some skill development, specifically with toilet training.

Child on Toilet 2 BlogThis leads to several considerations to take into account when toilet training boys. I agree with Weitzen that some of these issues arise from the simple fact that women are predominantly toilet training boys. However, it’s also possible that such issues arise from the fact that many boys are trained in early intervention or preschool years without consideration of the implications of those training techniques several years down the line, and without further intervention or training later in life. Either way, it’s important to recognize that training of life skills should be completed in such a way as to develop effective skills that are similar to those of the child’s same-age peers. To that end, here are two considerations:

Consider hygiene. Something I had never thought about prior to my conversation with Weitzen is that after boys use the bathroom, then zip up their pants, it’s easy for a little urine to drip onto their pants. Especially once children reach upper elementary and middle school grades, a spot of urine can be socially isolating or an invitation for bullying. Weitzen acknowledges that it can be difficult to teach boys to gently shake their penis before zipping up, especially because teachers don’t want to inappropriately touch the students. However, for the long term, it’s essential that teachers find a way to teach this simple action.

Consider the topography of the behavior. When we think about topography, we basically mean, “What does the behavior look like.” When initially toilet training, teachers will typically have the student pull his/her pants down to the floor. Weitzen shared a personal experience from several years ago, when he was a chaperone on a field trip with his son who is autistic. At one point, the teachers asked him to take the boys to the bathroom, so Weitzen went in with eight 14-year-old boys with autism. He said, “They took their pants and pushed them right down to their knees at the urinal at Medieval Times. So we had seven hairy tushies in the room. Out in public! And what happens is other dads and other boys came in there and everyone’s laughing and commenting and pointing.” This is the type of situation that teachers and parents do not want students to experience. When toilet training, it’s essential to recognize that the topography of the behavior in the male restroom is to unzip the pants, and then pull the fabric aside in order to urinate in the urinal. While it may be easier to teach students to pull their pants down in the initial phases of toilet training, it’s important to continue shaping behavior until it has the appropriate topography.

If our students continue to pull their pants down completely, they become targets for bullying, or worse. Weitzen says that on multiple occasions, he’s had parents report to him that their child used the bathroom at the urinal, and when they pulled their pants to the floor, another student took a picture of them. “Four different moms told me that, and if four moms told me that, I can’t imagine how often that’s happening,” Weitzen said. “And even if they’re not sharing the photo, well now you’re the weird kid who sticks his butt out. And you’re isolated and you’re picked upon, so we have to be real. We have to realize our guys live in the real world and teach them the skills that they need.”

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

Simplifying the Science: Teaching Siblings About Behavior

When I first came across this study, Behavioral Training for Siblings of Autistic Children, I was immediately hesitant. There’s something about the idea of sibling-as-therapist that makes me cringe a little bit. When I work with the families of children with autism, the hope is that the siblings of the child with autism still have a childhood without being pushed into the role of caregiver. And I also want the child with autism to have independence and feel like an individual who is heard, which may be more challenging if their siblings are issuing demands just as a parent or teacher would. But as I read the study, I realized that the work they completed had incredible social significance.

Siblings Playing Together BlogIn the study, there were three pairs of siblings. The ages of the children with autism ranged from 5 years old to 8 years old. The ages of the siblings ranged from 8 years old to 13 years old. The researchers trained each sibling of a child with autism how to teach basic skills, such as discriminating between different coins, identifying common objects, and spelling short words. As part of this training, the researchers showed videos of one-on-one sessions in which these skills were taught, utilizing techniques such as reinforcement, shaping, and chaining. What the researchers did next was the part that really stood out to me: they discussed with the siblings how to use these techniques in other environments. Finally, the researchers observed the sibling working with their brother/sister with autism and provided coaching on the techniques.

It should be noted here that the goal of the study was not to have the siblings become the teacher of basic skills. Instead, it was to provide a foundation of skills in behavioral techniques for the sibling to use in other settings with the hope of overall improvement in the behaviors of the child with autism. The researchers demonstrated that, after training, the siblings were able to effectively use prompts, reinforcement, and discrete trials to effectively teach new skills. But, perhaps the most meaningful aspects of the study were the changes reported by both siblings and parents. The researchers provide a table showing comments about the sibling with autism before and after the training. One of the most striking comments after the training was, “He gets along better if I know how to ask him” (p. 136). Parents reported that they were pleased with the results and found the training beneficial.

This study provides excellent evidence that structured training for siblings has real potential for making life a little easier for the whole family. The idea isn’t that they become the therapist, but instead that knowledge truly is power.

References

Schriebman, L., O’Neill, R.E. & Koegel, R.L. (1983). Behavioral training for siblings of autistic children. Journal of Applied Behavior Analysis. 16(2), 129-138.

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

Workshop with Mary Jane Weiss, PhD, BCBA: Identifying the Elements and Process for Ethical Decision Making in Behavior Analysis – Andover, MA, April 23rd, 2015

Mary Jane WeissMary Jane Weiss, Ph.D., BCBA-D, speaks to the complexities of being an ethical behavior analyst and the complex skill set required. In this workshop Dr. Weiss will review the Guidelines for Responsible Conduct, and will identify core themes and responsibilities.  She will also review several sample scenarios, and discuss the decision making tree that would assist a behavior analyst in identifying the best and most ethical course of action. This workshop is geared toward professional with BCBA Type II CEU credits available.

Workshop presented by Melmark New England. For registration or more information, visit the Eventbrite page here.

Pick of the Week: NEW! Time Timer Watches in Bright Colors

We’re thrilled to announce that the popular Time Timer Watch PLUS (Youth Size) now comes in new, bright colors! The Time Timer Watch PLUS allows you to visually see how much time has elapsed while simultaneously displaying the actual time. It has a sporty design and uses simple icons and a large display to ensure ease of use for all age and ability levels.

This week only, take 15% off* your order of a brand new Time Timer Watch PLUS with promo code TIMER15 at checkout!

Ideal for anyone who wants a discrete and portable visual timer, the Time Timer Watch PLUS is customizable: there are two Time Timer modes (Original 60 minutes and Customized), vibrating and/or audible alerts and repeatable time segments for interval training. There is also a 12- or 24-hour clock with one alarm.

Water-resistant, the soft, silicon watch band measures from 4.75″ to 7″, making it perfect for children or adults with small wrists. The Youth Watch PLUS comes in bright, vibrant bluegreen or berry and in charcoal.

Watch the video below to see how the Time Timer Watch PLUS works!

Don’t forget to use our promo code TIMER15 at check-out to save 15%* on your order of the Time Timer Watch PLUS (Youth Size).

*Offer is valid until 11:59pm EST on April 14th, 2015. Not compatible with any other offers. Be sure there are no spaces or dashes in your code at check out!

Autism Awareness Month Interview Series: Essentials of Verbal Behavior with Mark Sundberg, PhD, BCBA-D

Today marks the start of Autism Awareness Month. This year, we’re thrilled to introduce a series of exclusive interviews with renowned experts on topics that are of interest and importance to both parents and professionals working with students on the autism spectrum. We can’t think of a better way to kick off this series than with an information-packed interview with Mark Sundberg, PhD, BCBA on the Essentials of Verbal Behavior.

Dr. Sundberg hardly needs an introduction. He is the author of the VB-MAPP, Teaching Language to Children with Autism and Other Developmental Disabilities, and co-author of the original ABLLS. Additionally, he has published over 50 professional papers and 4 book chapters and taught more than 80 university courses on behavior analysis, verbal behavior, sign language, and child development. He is a licensed psychologist with over 40 years of clinical experience.

We’re honored that Dr. Sundberg agreed to kick off Autism Awareness Month here at Different Roads and answer these questions on Verbal Behavior from BCBA Sam Blanco. A big thank you to Cindy Sundberg as well for her help with the interview.


Essentials of Verbal Behavior
with Mark Sundberg, PhD, BCBA-D

SAM BLANCO: There is often confusion about what differentiates ABA and Verbal Behavior. Can you tell us what Verbal Behavior is and how it relates to ABA?

MARK SUNDBERG: In the 1950s B. F. Skinner published the book Science and Human Behavior (1953). In that book he described how the basic concepts and principles of behavior analysis could be applied to human behavior. This book is credited for starting the field of Applied Behavior Analysis (ABA) (Morris, Smith, & Altus, 2005). A few years later Skinner published the book Verbal Behavior (1957) which contained a detailed analysis of language, a topic he addressed frequently in Science and Human Behavior and other writings. The verbal behavior (VB) approach (or ABA/VB) to autism treatment is based on these two Skinner books, and over 60 years of conceptual and empirical research that has evolved primarily from this original material.

Regarding the similarities and differences between ABA and VB, first they both make use of the same principles, procedures, and research basis of behavior analysis (Skinner, 1953). That is, they both use the basic procedures of prompting, fading, shaping, reinforcing, and so on (cf. Cooper, Heron, & Heward, 2007). The primary difference between the two approaches is the analysis of language that underlies the assessment and intervention programs. The VB approach makes use of Skinner’s (1957) behavioral analysis of language along with ABA principles and procedures, while most ABA and cognitive-based programs use the traditional expressive and receptive framework of language. Although this seems to be changing in that more ABA approaches and outcome studies are incorporating aspects of Skinner’s analysis (e.g., manding) into their intervention programs (e.g., the Sallows & Graupner, 2005 outcome study).

The main advantage of Skinner’s treatment of language for children with autism is that he breaks down expressive language more thoroughly and functionally. He suggests that the “mand,” “tact,” and “intraverbal,” are functionally different from each other because they are controlled by different environmental variables. For example, the mand is under the functional control of motivational variables (what a child wants), while the tact is under the functional control of nonverbal discriminative stimuli (what a child sees, hears, etc., but may not want). It is not uncommon to encounter children with autism who have dozens of words as tacts, but no words as mands (their mands may occur in the form of tantrums or other negative behavior). In the traditional analysis of expressive language this distinction between the mand and the tact is not made, thus a resulting intervention program may not completely or accurately address a child’s needs. These important differences in verbal skills are not typically assessed by most of the common assessment tools used for children with autism (Esch, LaLonde, & Esch, 2010). For more details on the value of incorporating Skinner’s (1957) analysis of verbal behavior into ABA programs, the reader is referred to Petursdottir and Carr (2011) and Sundberg and Michael (2001).

SB: Can you tell us a bit about developing the VB-MAPP? It must have been quite an undertaking!

MS: I’ve been working on applying Skinner’s (1957) analysis of verbal behavior to language assessment and intervention since the 1970s when I was one of Jack Michael’s graduate students at Western Michigan University. This topic became the foundation of my doctoral dissertation (Sundberg, 1980), and has been the main focus of my professional career. The VB-MAPP was designed to be an assessment tool that is comprehensive, precise, developmentally matched, and functionally valuable to the child. As a result, the information obtained from the VB-MAPP can assist in IEP planning and help to establish intervention priorities, and serve as a curriculum guide for the program. The VB-MAPP is also designed to serve as a dependent measure in empirical research, and outcome research. In addition, problem behavior and various other “barriers” impact learning and should be assessed along with language, learning, and social skills. If left unattended, these barriers can slow down a child’s skill acquisition or possibly bring any gains to a complete standstill, and leave the child susceptible to other problems. Thus, the VB-MAPP also contains an assessment of 24 barriers that might affect a child (e.g., escape and avoidance, prompt dependency, demand weakens motivation).

The VB-MAPP has greatly benefited over the years from the many parents and professionals who have provided feedback or conducted field-testing with typical children and children with special needs in schools, homes, clinics, and community settings. This feedback and field-testing provided us with a wealth of information that influenced many aspects of the VB-MAPP, such as checks for generalization throughout the assessment, tips for the tester, more information in the Guide about the skills being assessed, and a placement program to provide general direction for intervention and IEP development. Our own field-testing activities also helped us with many of the improvements, such as the refinement of the sequence and validity of the intraverbal assessment (e.g., Sundberg & Sundberg, 2011), and separating play skills into independent play and social play for a tighter assessment of this area. In addition, there is now a more extensive body of conceptual and empirical research that has advanced our overall understanding of language acquisition and the treatment of autism.

We were also fortunate to have Barbara Esch, Ph.D., CCC-SLP, BCBA-D include her Early Echoic Skills Assessment to the VB-MAPP. Her tool presents a state-of-the-art method to quickly assess a child’s echoic repertoire, and it fits well within the VB-MAPP. The VB-MAPP also contains a short transition assessment that resulted from many years of consulting to special education classrooms and attending IEPs. We thought it would be useful to create a piece of the assessment that could help to determine what type of educational format might best suit an individual child (e.g., 1:1 vs. small group instruction, inclusion). The targeted milestones in the VB-MAPP have been carefully chosen and matched to those of typically developing children, thus providing a clearer picture of how a child with autism is performing. We aligned the VB-MAPP with standardized, and well-respected assessments, including the APES, Bayley-III, PLS-IV, and the Vineland-II. As a result of these various features, the VB-MAPP moves beyond just an assessment of basic skills to a more thorough and functional assessment of the whole child.

The work on the VB-MAPP and making ABA and verbal behavior understandable and accessible continues to be an on-going process. After the VB-MAPP was published in late 2008, we received interest from professionals wanting electronic versions and foreign language translations. The VB-MAPP is now also available as an app and web-based format, as well as in several different languages including Chinese, French, Italian, Polish, Russian, and Spanish, with other languages in various stages of development.

SB: For a learner who is just developing language, what does research show is the appropriate developmental order for teaching verbal skills? (For example, do you teach “I want _______” to a learner who only has ten words?)

MS: The design of the VB-MAPP directly addresses the issue of using typical developmental milestones as a framework for the assessment and the intervention program. For example, it is common to have adjectives, prepositions, and answering WH questions on an IEP for a child who may only have a 30-word vocabulary. Developmentally, that small of a vocabulary size indicates that the child may not be ready for tasks that require the child to modify nouns with their properties or location, let alone answer WH questions about them. Likewise, adding carrier phrases such as “I want” to a mand may be of little value to a child who only has ten words. The child would probably benefit more from first learning more mands and tacts. There are many aspects to developing a child’s verbal skills, even though the learning patterns demonstrated by typical children can guide us, each child is different and still requires an individual analysis of what curriculum sequence might work best for him.

SB: Why is it important for a learner to have a certain number of mands before moving on to other verbal skills?

MS: There is no magic number of mands. My point (from Skinner) has been that manding is the only type of verbal behavior that directly benefits the child. Mands allow a child to get access to things and activities that are important to him. That’s motivating for the child, and increases chances that he will initiate verbal interactions and emit language in a more natural way, as well as participate in other instructional activities. The other types of verbal behavior (e.g., echoic, tacting) don’t have the same effect. I have found repeatedly that it is often quite easy to establish a mand for a nonverbal child (especially using sign language or PECS), and it becomes much easier to use this newly established rapport to teach the child other skills. A variety of different verbal skills are necessary for a functional communication repertoire. Sooner or later the child must learn other language skills such as tacts, intraverbals, and listener skills. My tendency to encourage practitioners to emphasize the mand has been mainly due to its value to the child, but also to offset the historical tendency by many ABA programs to ignore the mand, teach it late in an intervention program, not appreciate the difference between motivational control and stimulus control, or assume that the mand will just emerge from other types of training.

SB: How do you measure verbal behavior?

MS: Verbal behavior can be measured by using many of the same recording systems common to behavior analysis (e.g., Cooper, Heron, & Heward, 2007), such as rate, frequency, time samples, discontinuous measurement, etc. However, it is important to carefully identify all the antecedent variables that are involved. For example, it is not enough to simply record that a child says the word “ball” 10 times in a 1-hour period. The measurement system, like all ABC recording systems, must also include the antecedent sources of control that evoked that response. If the ball is present, the response is part tact, if an EO for the ball is present, the response is part mand, if an echoic prompt is given, the response is part echoic, and so on. A child who emits “ball” 10 times as an echoic is not behaving in the same way as a child who emits “ball” 10 times as a mand or tact. In short, a verbal behavior measurement system not only records the topography of responses, but their function as well. Thus, there may be several different data sheets that all measure a child’s acquisition of the word “ball,” but each differ in important ways (e.g., “ball” as a tact vs. “ball” as an intraverbal). More detail on measuring and recording verbal behavior can be found throughout the VB-MAPP Guide, as well as in Sundberg & Partington (1998).

SB: One resource I frequently use is the 300 Common Nouns list. Can you talk about how this list is useful?

MS: The goal of the list is to take some of the guesswork and randomness out of selecting new targets for vocabulary development by providing a group of common nouns that young typically developing children might acquire. In addition, the lists are designed to track the acquisition of a new word (e.g., spoon) across a variety of conditions. For example, there are columns for both tacting and listener skills, as well as for generalization and more complex demonstrations of a skill. The list also provides the basis for moving an individual word to more complex types of verbal behavior. For example, when adding a verb or an adjective to a noun (e.g., “white plastic spoon”) staff should cautiously select nouns that have been acquired and generalized as identified by the data entered on the list. Movement to intraverbal and LRFFC tasks should also involve nouns that have been mastered and the list provides an initial guide for making this progression. There is a common verbs list as well posted in the downloads section at www.avbpress.com.

SB: What recommendations do you have for a parent or practitioner who is first encountering verbal behavior?

MS: Language and the ability to communicate is perhaps the single most important aspect of human behavior, correspondingly, it is quite complex. Language is a part of everyday life and can be taught not only in formal (discrete) sessions, but in everyday activities including play, bath time, arts and crafts, in the grocery store, and while out on a family drive. Our book “Teaching Language to Children with Autism or Other Developmental Disabilities” (Sundberg & Partington, 1998) was designed to be an easy-to-understand application of Skinner’s analysis, and I would recommend that book, or other user-friendly VB books (Barbera, 2007; Weiss & Demiri, 2011). In addition, there are websites that contain tips, materials, data sheets, YouTube videos, and a variety of other material that can be useful for helping parents and teachers to understand how to apply a behavioral analysis of language in an ABA program.

ABOUT MARK SUNDBERG, PHD, BCBA-D

Mark SundbergMark L. Sundberg, Ph.D., BCBA-D received his doctorate degree in Applied Behavior Analysis from Western Michigan University (1980), under the direction of Dr. Jack Michael. He is the author of the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP), and co-author of the original ABLLS and the book Teaching Language to Children with Autism or Other Developmental Disabilities. He has published over 50 professional papers and 4 book chapters. He is the founder and past editor of the journal The Analysis of Verbal Behavior, a twice past-president of The Northern California Association for Behavior Analysis, a past-chair of the Publication Board of ABAI, and has served on the Board of Directors of the B. F. Skinner Foundation. Dr. Sundberg has given hundreds of conference presentations and workshops nationally and internationally, and taught 80 college and university courses on behavior analysis, verbal behavior, sign language, and child development. He is a licensed psychologist with over 40 years of clinical experience who consults for public and private schools that serve children with autism. His awards include the 2001 “Distinguished Psychology Department Alumnus Award” from Western Michigan University, and the 2013 “Jack Michael Outstanding Contributions in Verbal Behavior Award” from ABAI’s Verbal Behavior Special Interest Group.

References
Barbera, M. L. (2007). The verbal behavior approach. London: Jessica Kingsley Publishers.

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis (2nd ed.).
Upper Saddle River, NJ: Merrill/Prentice-Hall.

Esch, B. E., LaLonde, K. B., & Esch, J. W. (2010). Speech and language assessment: A verbal behavior analysis. The Journal of Speech-Language Pathology and Applied Behavior Analysis, 5, 166-191.

Morris, E. K., Smith, N. G., & Altus, D. E. (2005). B. F. Skinner’s contributions to applied behavior analysis. The Behavior Analyst, 28, 99-131.

Petursdottir A. I., & Carr J. E. (2011). A review of recommendations for sequencing receptive and expressive language instruction. Journal of Applied Behavior Analysis, 44, 859–876.

Skinner, B. F. (1953). Science and human behavior. New York: Free Press.

Skinner, B. F. (1957). Verbal behavior. New York: Appleton-Century-Crofts.

Sallows, G. O., & Graupner, T. D. (2005). Intensive behavioral treatment for children with autism: Four-year outcome and predictors. American Journal on Mental Retardation, 110,
417-438.

Sundberg, M. L. (1980). Developing a verbal repertoire using sign language and Skinner’s analysis of verbal behavior. Unpublished doctoral dissertation, Western Michigan University.

Sundberg, M. L., & Michael, J. (2001). The benefits of Skinner’s analysis of verbal behavior for children with autism. Behavior Modification, 25, 698-724.

Sundberg, M. L., & Partington, J. W. (1998). Teaching language to children with autism or other developmental disabilities. Concord, CA: AVB Press.

Sundberg M. L., & Sundberg, C. A. (2011). Intraverbal behavior and verbal conditional discriminations in typically developing children and children with autism. The Analysis of Verbal Behavior, 27, 23–43.

Weiss, M. J., & Demiri, V. (2011). Jumpstarting communication skills in children with autism. Bethesda, MD: Woodbine House.

Guest Article: Tips on Encouraging Picky Eaters

This week, we’re thrilled to share some exclusive tips from Julia Singer Katz at the Kutest Kids Early Intervention Center on how to deal with picky eaters, from using colors and schedules to modeling good habits.

Don’t let picky eating ruin meal time or divide your family at the dinner table. Encouraging healthy eating habits with a stubborn child requires patience with a firm touch. Here at Kutest Kids Early Intervention Center, our therapists are all too familiar with this phenomenon and would like share some common tips. Begin by setting the stage for healthy choices, thereby helping your child overcome their picky habits with a few key strategies.

Start With a Schedule.  Hungry kids are often less picky than those that have been snacking on junk foods all day. Scheduling snack time – and sticking to it – ensures your kids are hungry when a healthy meal is served. Don’t just schedule snacks, though. Having breakfast, lunch and dinner at regular times further encourages kids to eat only when the food is available.

Skip the Junk.  A pantry or fridge full of unhealthy options further encourages picky eating. What kid is going to fill up on broccoli when they know there are ice cream and chips just a few steps away? If the only options are healthy options, a hungry child is more likely to choose those with few complaints. Keep the healthy snacks accessible – cut up carrot and veggie sticks and keep raw fruit washed and cubed for easy serving.

Add Some Healthy Elements.  Even the most adventurous eater may turn up their nose to a completely unfamiliar food. Instead of making a full change out of the gate, begin by introducing healthier elements to their favorite dishes. Try oven-baked chicken fingers with a whole-meal coating instead of processed and fried nuggets. Mix in some shredded zucchini with their macaroni and cheese. Add fruit to a no-sugar cereal. Small changes can win over a picky eater.

Eat the Colors.  Most kids respond well to games and challenges. Brightly colored foods, such as vegetables and fruits are healthier than most dull and bland-colored foods. Make a game out of eating as many colors in a day as possible! This may encourage an otherwise picky eater to eat more vegetables and to try new foods.

Loosen Up the Rules.  A strict clean-your-plate rule does more harm than good. In the end, it just encourages over-eating while also making the dinner table a place of stress and tears. Allow your kids to decide when they are full. If they want a snack later, it’s not an issue if you have a scheduled after-dinner snack time, and they only have access to healthy snacks.

Model Good Eating Habits.  Often, picky eating is a learned behavior. Only serve foods that you will eat, and don’t complain about any food within the child’s hearing. Have meals at the table, and never encourage mindless snacking while watching television.

Many kids naturally go through phases of picky eating. Keeping unhealthy food to a minimum and only serving it as an occasional treat will help your family weather these finicky moments.

WRITTEN BY JULIA SINGER KATZ, MSS, LSW

Julia Singer Katz MSS, LSW is the Supervisor of Clinical Program Development at the Kutest Kids Early Intervention Agency, an all-inclusive therapy center in Philadelphia. She’s very passionate about helping each child reach his or her fullest potential and making a difference in the community.

Tip of the Week: Use Noncontingent Reinforcement – A Powerful Addition to Your Intervention

Noncontingent reinforcement (NCR) is the presentation of reinforcement independent of behavior, and there are many studies out there that demonstrate it can have a significant impact on behavior.

Before we get to how you can use it with children with autism or other developmental disabilities, it’s important to recognize that noncontingent reinforcement happens all the time with all of us. A few common examples:

  • You’re walking alongside your child. Your child reaches up and grabs your hand. This is a behavior you like, but it did not occur because of any one behavior you exhibited, such as reaching for their hand or requesting their hand. They just did it spontaneously. This probably changes your behavior: you may smile, initiate a conversation, or give their hand a special squeeze.
  • It’s snack time at your preschool. You realize the bag of popcorn you’re giving for snack is almost empty, so you give each student a few extra kernels of popcorn. They did not “earn” it for good behavior, it was just a little extra reinforcement. This may change your students’ behavior: they may sit still a little longer as they eat the additional snack, say thank you, or exclaim, “More popcorn! Yay!”
  • A common example in preschool is placing a child on your lap during story time. They didn’t earn it, but it may change their behavior. For example, instead of calling out to get your attention, they may sit quietly for the duration of the story.
  • You’ve come home from a stressful day at work. You want to just sit down and veg in front of the TV for a few minutes, but discover that your husband has cooked dinner. This may change your behavior: you may sit down at the dining room table or give him a hug. Again, you didn’t exhibit a specific behavior that “earned” you dinner; it was presented independent of your behavior.

Noncontingent reinforcement can be a powerful addition to your interventions. But it looks a bit different when you’re using it as part of your intervention. You want to provide continuous access to the reinforcer maintaining the problem behavior so that the problem behavior becomes unnecessary. The preschooler sitting on the teacher’s lap is an excellent example, because the child has continuous access to the teacher’s attention. This can be faded over time, but can be an effective starting point for reducing problem behaviors when used in conjunction with other strategies.

Research has shown that noncontingent attention can decrease destructive behavior, noncontingent juice can decrease rumination, noncontingent access to preferred items can decrease inappropriate mealtime behavior, and noncontingent social interaction can decrease vocal stereotypy (Hanley, Piazza, & Fisher, 1997; Kliebert & Tiger, 2011; Gonzalez, Rubio, & Taylor, 2014; Enloe & Rapp, 2013). There is much more research out there that demonstrates that noncontingent reinforcement can impact behavior. Here are a few tips for using it:

  1. Make sure it matches the function. If your student is engaging in destructive behavior in order to escape a task, then providing noncontingent attention is unlikely to produce the behavior change you are expecting.
  2. Decide on a method for providing noncontingent reinforcement. Will you provide it continuously (like the preschooler sitting in the teacher’s lap) or provide it on an interval schedule (such as providing verbal attention every 2 minutes)?
  3. Take data! You need to know if the noncontingent reinforcement is actually decreasing the problem behavior or increasing the desired behavior. Define the behavior you want to change and then take data on its frequency, rate, or duration.
  4. Account for other students’ needs. If you are only using noncontingent reinforcement for one student, you need to be prepared to address the needs of other students. For example, if just one preschooler gets to sit in the teacher’s lap every day at story time, you may see an increase in problem behaviors from the other preschoolers in the class.
  5. Plan ahead! Our ultimate goal is that our learners be as independent as possible. Plan for how to fade your intervention over time.
  6. Take a look at the research. There are a few studies cited at the end of this article, but you may be able to find research simply by searching for “noncontingent” and the name of your problem behavior.

Noncontingent reinforcement is much easier to implement than many interventions that are available and can have a huge impact on your learner’s behaviors.

References
Enloe, K., & Rapp, J. (2013). Effects of noncontingent social interaction on immediate and subsequent engagement in vocal and motor stereotypy in children with autism. Behavior Modification , 38(3), 374-391.

Gonzalez, M., Rubio, E., & Taylor, T. (2014). Inappropriate mealtime behavior: The effects of noncontingent access to preferred tangibles on responding in functional analyses. Research in Developmental Disabilities , 35(12), 3655-3664.

Hanley, G. P., Piazza, C. C., & Fisher, W. W. (1997). Noncontingent presentation of attention and alternative stimuli in the treatment of attention-maintained destructive behavior. Journal of Applied Behavior Analysis , 30(2), 229-237.

Kliebert, M. L., & Tiger, J. H. (2011). Direct and distal effects of noncontingent juice on rumination exhibitied by a child with autism. Journal of Applied Behavior Analysis , 44(4), 955-959.


WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

Guest Article: “Speech-Language Pathology and ABA – Can’t We All Just Get Along?” by Danielle McCormick, MA, CCC-SLP

We’re excited to share with you an exclusive article “Speech Language Pathology and Applied Behavior Analysis: Can’t We All Just Get Along?” by co-founder of Bridge Kids of New York, Danielle McCormick, MA, CCC-SLP, with contributions by Ashley Stahl, MSEd. In this article, Danielle shares with us her quirky and humorous opinions on the importance of combining traditional speech-language pathology practices and those of Applied Behavior Analysis.

SLP-ABA

I have vivid memories of a professor in graduate school essentially condemning the field of Applied Behavior Analysis (ABA) as the most “robotic” and “unnatural” way to help a child learn communication skills. As a passionate and dedicated Speech-Language Pathologist (SLP), I took these words to heart and kept them with me as I continued my career. That was until my first job as a Clinical Fellow at an Early Intervention center—that (insert gasp!) followed the principles of ABA. This center was also filled with the most diverse, beautiful children I have ever known, many of whom were diagnosed with Autism Spectrum Disorder—my passion. I had to take this job!

As if starting my first job in New York City was not daunting enough, here I was surrounded by the enemy—the big, bad ABA therapists! As a newbie who was still building confidence in my field, and having been trained to always respect other professionals (especially those who are above you in the pecking order), I took a backseat and opened my ears and eyes to the ABA that was happening all around me. The voice of my graduate professor was ringing still in my ears, so in my sessions, I made sure there was to be absolutely no ABA (at least I thought at the time!). If they wanted to “do ABA” in the classrooms, that was their business, but I wanted nothing to do with it!

Except—wait a minute—how did they teach that child to start pointing so quickly?

As time went on, I started to notice that some of my children were exhibiting extreme interfering behavior that I had not been trained to deal with. I was lost and did not know how to support these learners. Much to my relief, in came my super hero colleagues wearing ABA capes, telling me exactly what to do and why to do it.

 

Tip of the Week: Stop Behavior Early in the Behavior Chain

Recently I was working with a family to toilet train their son Jonathan, a six-year-old with autism. (Names and identifying characteristics have been changed to protect confidentiality.) When he eliminated in the toilet, part of his reinforcement was getting to watch the water go down the toilet after flushing. At some point, he developed the behavior of putting his hands into the toilet water as it was flushing.

When I went in to observe the behavior, one of my goals was to identify the steps in the behavior chain. Pretty much everything we do can be viewed as part of a behavior chain, in which one action is a cue for the following action. For Jonathan, each time he placed his hands in the toilet water, the behavior chain looked like this:

Pulled up pants
Stepped towards toilet
Pressed button to flush toilet
Stepped back
Watched water as it flushed
Stepped forward again
Leaned down
Put hands in water

Behavior chains can be even more detailed than the one above, depending on the needs of your learner. Identifying the steps in the behavior chain for an undesirable behavior can have a huge impact on your interventions. For Jonathan, we were able to stop the behavior of putting his hands in the toilet water by interrupting the behavior early in the behavior chain. It’s too late and unsafe to stop him once he’s leaning forward to put his hands in the water. Through prompting, which we faded as quickly as possible, we changed his behavior chain to this:

Pulled up pants
Stepped towards toilet
Pressed button to flush toilet
Stepped back
Watched water as it flushed for 3-5 seconds
Stepped towards sink
Leaned forward
Turned on water
Put hands in water

Instead of waiting for him to engage in the inappropriate behavior, we redirected him several steps earlier in the chain, providing a gestural prompt toward the sink and had him start washing his hands 3-5 seconds after he had started watching the water flush. This was ideal for two reasons: first, it was the expected step in an appropriate toileting behavior chain and second, it provided an appropriate and similar replacement behavior since Jonathan was still able to put his hands in water.

This behavior chain was relatively easy to change. While it may not be as easy in some interventions you may try, it’s essential to remember to stop the behavior early in the behavior chain. It’s much easier to give a child an activity that requires use of their hands as soon as you see them lift their hands out of their lap than it is to remove their hand from their mouth if they’re biting it. And it’s much easier to redirect a child to put their feet back under their desk than it is to get them to stop once they’re sprinting out of the classroom. Looking at the behavior chain and considering when to intervene as a part of your intervention plan is quite possibly the extra step that will make your plan successful.


WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.

Tip of the Week: Using Activity Schedules to Improve Bedtime Routine

Many of the families I work with struggle to get their child with autism through the bedtime routine. An activity schedule can help your child independently manage the routine.

You should select 3-5 tasks that your child can complete independently. The final task should be something that your child finds reinforcing, preferably something that can be done in or near the bed, such as being read to or listening to music. Based on your child’s reading skills, you can use pictures or text for the schedule.

You can arrange the activity schedule as a picture schedule or a checklist. Below are two samples. For the picture schedule sample shown below, I did an online search for the appropriate images, but when possible, I prefer to actually take a picture of the item or the learner engaged in the activity.

PICTURE SCHEDULE: I use self-adhesive laminating paper (which you can purchase at any office supply store) and laminate all pieces. Each task on the schedule has Velcro so the learner can arrange items in the order he/she wishes and can remove them once that activity is complete.

CHECKLIST SAMPLE: I use self-adhesive laminating paper for checklists as well. This way the learner can use a dry erase marker or crayon and reuse the same page each day. For many learners, I attach this to a clipboard and the clipboard hangs in an easy-to-reach spot.

What I like about the activity schedule beyond the fact that it promotes independence is that it also allows for some choice. The reinforcing activity must always come last, but the learner can choose what they want to have for that reinforcing activity. The learner can also have some flexibility for what order to place the items on the schedule. For example, your learner might prefer to pack his lunch before taking a shower. When implemented correctly, it’s a win-win for both parents and children.

For more information on implementing activity schedules, I highly recommend the book Activity Schedules for Children with Autism by McClanahan & Krantz.

Note: if you decide to use the iPad as the final item on the activity schedule, you should set the timer so the iPad turns itself off. To do this:

1) open the Clock app
2) click “Timer” on the bottom right of the screen
3) click “When Timer Ends”
4) scroll all the way to the bottom of that menu and click “Stop Playing”
5) set the timer for the appropriate amount of time,
6) hit “Start”


WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-12 in NYC. Working in education for ten years with students with Autism Spectrum Disorders and other developmental delays, Sam has developed strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently pursuing her PhD in Applied Behavior Analysis at Endicott College.