Tip of the Week: Using a MotivAider to Help Parents Give Positive Reinforcement

Several years ago I worked with an eight-year-old girl named Stella in her home. Gina, her mother, was at her wit’s end. She had Stella, a four-year-old daughter, and an 18-month-old son to care for plus household duties, balancing work and home life, and maintaining her marriage. She constantly felt stressed, which was compounded by the fact that Stella was not yet speaking or communicating any needs beyond what she wanted to eat, was still not toilet trained, and made a mess everywhere she went. Gina felt that she spent her days following Stella around the house, picking up after her, and yelling at her to stop. She frequently would find Stella dumping out a bin of toys or sweeping all the books off of a shelf, then try to distract her with a Youtube video or a snack.

At this point, Gina was feeling hopeless.

DRT_382_MotivAiderSo you can imagine that she was highly skeptical when I suggested that using the MotivAider, a simple device that vibrates at timed intervals, might make her life easier. And while she was prepared for me to try to change Stella’s behaviors, she was not expecting me to suggest she change some of her own behaviors. However, she decided to give it a try.

She set the MotivAider to vibrate every two minutes, then clipped it to her waistband. Her instructions? Every time she felt it vibrate, she should go find Stella. If Stella was engaging in appropriate behaviors (sitting calmly, looking at a book without damaging it, playing with a toy she enjoyed, or watching a video) Gina would give her some positive reinforcement. This included but was not limited to giving her hugs, presenting a snack, watching the video with her, or bringing up her favorite Youtube videos if she was doing something else. If Stella was engaging in an inappropriate behavior, Gina would ignore it (as long as Stella was not in any danger.)

To Gina’s surprise, Stella quickly stopped dumping out bins of toys and making a mess all over the house. All Gina needed was an easy reminder to catch Stella doing something good.

The MotivAider is one of my all-time favorite tools. You can program it to vibrate on a fixed or variable schedule at different duration and intensity levels. I use it for many things, but I’ve had great success in using it with parents. It’s easy for them to use independently, they can use it even when I am not present, and it fits into their busy lifestyles.

Many parents (and teachers) get stuck in the same cycle as Gina did, consistently reinforcing undesirable behaviors by providing attention whenever those behaviors are present. With the help of the MotivAider, Gina was able to change that contingency. (It should be noted that this intervention would not work as described above for a behavior that is not maintained by attention.)

While I was brought in to help change Stella’s behavior, we also changed Gina’s behavior. When we started, Gina provided reinforcement to Stella at every two minute interval in which she found her behaving appropriately. Over time we increased that interval, so that Stella wasn’t receiving such a high rate of reinforcement.

Gina reported that the house felt more calm now, and she had more energy during the day. It also gave her a confidence boost. Having success in this one area made her feel more hopeful and invested in creating success in other areas. Other families I’ve used it with have experienced similar results. One simple tool can lead to massive change for a family.

**Names and identifying characteristics have been changed to protect the identities of my clients.

Tip of the Week: Avoid Prompt Dependence When Teaching New Skills

“She won’t say hi unless I say ‘Say Hello.’” “He will only wash his hands if I put his hand on the knob to turn on the water.” “He won’t use his fork until I put it in his hand.”

I hear statements like this all the time from both parents and providers working with learners what autism. What they are describing is “prompt dependence,” which is when a learner requires a prompt from a teacher or parent in order to complete a task. So how do you avoid prompt dependence with your own learners?

Let’s start with the prompt itself. There are many different ways to prompt which can be divided into levels by how intrusive the prompt is. Below is a sample of a prompt hierarchy, with the least intrusive prompt at the top and the most intrusive prompt at the bottom. Your goal is to quickly move through the prompt levels to move your learner to independence.

Prompting Hierarchy

Now let’s look at two different examples to show these prompt levels. In the first example, the goal is for the learner to greet a person who walks into the room. In the second example, the goal is for the learner to pull up his/her pants after using the bathroom as a part of a toileting routine.

Prompt Chart

Research shows that least-to-most prompting increases potential for errors and slows down rate of acquisition for new skills. Therefore, most-to-least prompting is preferred for teaching new skills. This means that you would start at a full physical prompt, then move your way up the prompt heirarchy until your learner achieves independence with the task.

In the past, when working with discrete trials, it has been common practice to have a learner master a skill at a certain prompt level, then move to a less intrusive prompt and have the learner master the skill at that prompt level, steadily moving towards independence. This can actually encourage prompt dependence because the learner remains on the same prompt level for too long.

Instead, you should try to quickly move up the prompt hierarchy in a way that makes sense for the skill you are trying to teach. Below are some tips to help you help your learners achieve independence.

  • Follow the rule of three: Whether you are teaching with discrete trials or in the natural environment, once your learner has successfully responded to a demand three times consecutively, move to a less intrusive prompt.
  • If you are taking data, make a notation of what prompt level you are using at each step. (And remember, that only independent responses should be counted towards the learner’s percentage of correct responses.)
  • At the end of a session or group of trials, note what prompt level you were at by the end of the session. Then start at that level during the next session.
  • If your learner does not respond correctly when you move to a less intrusive prompt, then move back to the most recent prompt level. Once they respond again correctly at that prompt level three times consecutively, move again to a less restrictive prompt.
  • Remember that verbal prompts are very difficult to fade. Though they are less instrusive, you should avoid using them when possible.
  • You can pair prompts and then fade out the more intrusive prompts. For example, with the sample of pulling up pants described above, you can pair a visual prompt with a gestural prompt by showing the symbol for pulling up pants while pointing at the pants. Over time, you stop using the symbol and just use the gestural prompt. The gestural prompt can be faded by moving your point further and further away from the pants.
  • Write down what the prompt levels will look like for the specific task you are teaching. This way you will be fully prepared to quickly move your learner towards independence.
  • Differentiate your reinforcement! If you move to a less intrusive prompt and the learner responds correctly, then you should immediately provide a stronger reinforcer than you did for previous responses. If a learner spontaneously responds without a prompt, you should do what I call “throwing them a party” by combining reinforcers (such as tickles and high fives) or providing a highly desirable reinforcer.

Prompting can be very difficult to do well, but following these tips should help set your learner on the path to independence.

Tip of the Week: Do It Again

Teacher and Student In A Classroom At SchoolTeaching learners with autism or other developmental delays can frequently be a complicated, stress-inducing labor of love. This is why I especially appreciate that one of the most useful strategies in working with learners of all ages is just three simple words: “Do it again.”

The basic idea behind “Do it again,” (Or “Try it again,” or “Do it better”) is that you are calmly stating that the learner must try an action again and do it better than previously done. You are not yelling, you’re voice isn’t even raised. And you are communicating to the learner that you know he/she is capable of doing more.

In some cases, working with learners who may require more invasive prompts such as physical prompts, it may be necessary to have two adults for this to work best. Below are a few example scenarios of how this might work.

Scenario One

  • Teacher asks student to hand a paper to her.
  • Learner drops paper on desk next to her hand.
  • Teacher: (Hands paper back to student.) Try it again. (Holds hand out for paper.)
  • Learner places paper in hand.
  • Teacher: Thank you.

Scenario Two

  • Non-verbal learner wants to get attention from teacher. Grabs teacher’s shirt and pulls.
  • Second adult (possibly another teacher or paraprofessional): Try it again. (Provides hand-over-hand assistance for giving a light tap to get teacher attention.)
  • Teacher: What do you need, _____?

Scenario Three

  • Learner: S@*!
  • Teacher: Try again.
  • Learner: S@*!
  • Teacher: Try it again. (calm, even tone)
  • Learner: I’m mad.

Scenario Four

  • Learner is running across the room to get a toy.
  • Teacher: Go back. Try again. (The learner must return to the point in which he/she began to run.)
  • Learner walks across the room.

Behaviors to use this with:

  • recurring behaviors in which you know the student knows the rule, or you have repeated the rule many times
  • behaviors that are maintained by attention or desiring “shock value” such as cursing, insulting, or using rude language
  • increasing behaviors related to polite speech
  • decreasing behaviors that could cause injury (such as running in the classroom or being rough with peers or adults)

Why it works:

  • you are demonstrating a calm sense of control
  • you are demonstrating that you have and enforce high expectations
  • you are willing to spend the time to have your learner complete requests correctly
  • the learner is still receiving attention, but it is low-quality attention. You should differentiate the quality of the attention you provide based on the quality of the learner’s behavior.
  • the learner still gets what he/she desires, but only after behaving in the desired manner. It is important that the learner still receives the tangible, attention, or escape instead of being punished for finally engaging in the desired behavior, EVEN IF the learner has to “do it again” multiple times. Over time, the learner will engage in the appropriate behavior more quickly because it increases the speed with which they receive the desired item or activity.