Promoting Functional Communication, Cooperation, and Language Skills in Children with Autism Spectrum Disorders
Speaker: Tamara Kasper, MS/CCC-SLP BCaBa Jan. 10, 2004
Hey guys, it's Jenn! Happy New Year and what a great conference to kick-off 2004!
I don't know about you but I need my conference "fix" once every couple of months to help recharge the battery, stay motivated and be refreshed in topics/procedures I may have forgot about inspiring new and old ideas. This conference was co-sponsored by ELIJA and the LISHA. You ready for some great ideas for creating motivation???
The purpose of this conference was to help attendees learn how to 1. build a positive reinforcing relationship with the learner 2. expand their communication without making learning aversive or killing motivation 3. how to teach communication and which topography to choose with non-verbal learners 4. how to decrease the chance of problem behaviors during learning 5. strategies to build vocal language, help clear articulation as well as increase volume.
Tamara showed us many video examplers and explained clearly and in great detail how to achieve all of the above. She LOADED us with a TON of information, its AMAZING what she fit into one day ;0)!
Luckily I've seen Dr. Carbone, Dr. Partington, Dr. McGreevy, as well as Christina Burk (see past notes on these presentations) on teaching how to apply Skinner's Analysis of Verbal Behavior to an ABA program so some of what Tammy went over was review.
Most of the meat of her presentation was on pairing and mand training. (from hand out:) PAIRING: Establishing a willing learner:
*discover likes/dislikes*Make desirable items available*Pair yourself with delivery of the goods/activities *Create a history of being associated with wonderful items and fun experiences*You should signal improving conditions.
When the child sees you, you should be triggering for that child "my life gets better when this persons around!!" I know with my sons history, most teachers triggered for him "when she's around, my life gets worse!" Since many of his reinforcers were killed when: (from hand out:) The effort necessary to obtain the reinforcement outweighs the value of the reinforcer. The child doesn't 'want' the toy if it 'looks like he might have to work for it'.
Here were some great strategies Tammy shared with us for kids with fragile interests and that are hard to motivate or who maybe, like my son, have had a history of reinforcement being killed by not keeping that delicate balance of demands vs. value of reinforcement in check: (from handout)
BUILD MORE REINFORCERS: *follow his lead *imitate him *become interested in items which interest him *help him do what he wnats to do or help him find out! * Engage, entice, woo, and motivate *pair yourself with the objects/activities he loves--EVEN IF THEY ARE ATYPICAL, but have a PLAN (note: this was great. Tammy showed some video examplers that showed us how she was able to pair herself, and get the childs interest capitalizing on the childs motivation which was atypical behavior and how she quickly moved it from atypical to functional/more appropriate by using all of these steps)
*identify the reinforcing feature of "his" toy and find your own that is even better!*create a situation in which "his" activities are more fun because you are there*Scheme about ways to contrive situations using the things that are reinforcing to him to teach communication.*use repeated exposure (note: do not assume something is out of the question just because the child didn't show interest after the first presentation, present something at least 20 times--not in a row for you mass trialers out there!-- for repeated exposure) *use stimulus-stimulus pairing.
Tammy was very creative and brought a table full of fun stuff along with her black bag of tricks to give attendees some great ideas of how many possibilites there really are (LOVED the spider balls!! she said they can be found at Monkey Business Sports--I haven't looked up the website yet) Now onto building the curriculum. DO NOT start with verbal imitation. DO start with funciton communication traing (manding). "Manding (requesting) should be the first type of language to teach because it directly benefits the student. Manding should be targeted regardless of the student's current skill level." (Personal Note: You know what, I literally get sick to my stomach everytime I think about this. That in a centerbased program and first 1 1/2 years of intervention, my son was taught at under 3 years old for MONTHS how to identify specific pictures of "bankteller, afraid, scared, librarian, but had only about 3 mands, chip, doodle, soda that he wouldn't have even of HAD if it wasn't for the persistancy of an awesome SLP introducing PECS after getting approval since PECS was against policy! anyway, where was I....)
MANDING TIPS: (from handout)
*create unmet needs *use the principles of satiation and deprivation*gain the support of all those who interact with the child--why would he work for it now when he can have it "free" later.*select Items that can be requested repeatedly: --consumables--music/video--items with natural termination bubles, spinning, wind-up toys, cause and effect items, etc*Multiple exemplars*use a termination signal for physical play
The way to increase Manding is through capturing and contriving situations (capturing/contriving EO -establishing operations AKA MO motivational operations)
From handout: Methods to contrive/create "a reason to communicate":
*set up the environment so the child needs you to gain access to the "goods"'*clear, plastic containers out of reach*ziplock bags hanging on a cork strip*the black bag*the black box*reinforcer bags
Tammy tip:
*for some children, you may have to select several items and place them on the floor. you can begin your training after they have engaged in play and you are paired with reinforcement. For some children, pairing may be necessary with each item they select before training can occur.
For nonverbal learners, Tammy talked about how to select the appropriate response form. PECS, sign language etc. Many don't realize or even think about sign language for our children which is such a shame. I'm not going to go into this, but in the Partington/Sundberg book "Teaching Language to Children with Autism and Other Developmental Disabilites" this topic is discussed thoroughly.
Here's a just a few of the important "rules" for Manding (from handout)
* teaching msut occur in the natural and everyday environment where the motivation is typically strong* Make sure the child has an EO for an item before prompting a mand. Never attempt to prompt a child to mand for items that they do not want*Capture and contrive as many opportunities per day to teach mands. Set a goal of hundreds of mands per day across many reinforcers, teachers and settings for early learners* Count the number of mands, prompted and unprompted per day and graph or chart your results (like many, we use tally counters we bought at www.difflearn.com) *Get the best quality response with the least amount of prompting*Consistency in methods accross trainers*be a "giver" not a "taker"*avoid "killing" EO's to prevent this with early learners, give some items for "free" or require less response effort at times*for vocal children, you can begin teaching mands for all EO's
Other important informative teaching topics Tammy went into detail about was prompting and prompt fading, how to avoid/fix scrolling in signers, the requesting hierarchy as per the ABLLS by Sundberg and Partington, all the Verbal Operants, Teaching procedures---how to fade in demands--behvaior momentum---SO MANY MANY important topics. Here's just a couple more things I'd like to share with you in a little more detail. For articulation, speech sound development Tammy talked about the products offered through the Sara Rosenfeld-Johnson catalog Blow toy hierarchy and other oral motor resources (go to www.talktools.com). Also for articulation speech/sound development, also check out the Kaufman Speech Praxis test and treatment kit. We actually use this kit in my sons program and have found this to be a great tool. Much more precise for verbal imitation since the prompt level is broken down for you. Really worth checking out, here's the link:http://www.kidspeech.com/ksp_kit.html .
Another thing I came away with this conference was about suggestions for manding expansions. My son has about 50 mands (actions, foods, toys) but they are all one word mands. He has used I want + Mand. "I want chip. I want soda. I want ball. I want bubbles. I want computer." The problem is, "I want" is actaully more like an autoclitic such as please and thank you. Meaning, it doesn't directly benefit the speaker, it only benefits the listener. How about instead training "flexible" pivot phrases as mands. It is considered a Pivot because like the example Tammy gave in her hand out with the pivot phrase "blow bubble" Blow as the pivot can be used also with horn, candles, balloon, harmonica...just as Bubble can be the pivot with pop, push, squeeze.
So instead we are now training "eat chip" "drink soda" "bounce ball" "blow bubbles" "play computer". My son has a tough time putting two words together. It's either "eat" or "chip" but NEVER "eat chip" that is until we tried another teaching procedure I forgot that I originally heard about at Dr. Carbone's #1 that Tammy reminded us of. This procedure can be used to teach new mands for vocal learners as well as to increase verbalizations in learners with limited vocalizations. The idea is to pair the sounds/words with reinforcement through 3 repeated echoic trials. With every echoic presentation, bring the reinforcement a little closer and ALWAYS deliver by 3rd presentation whether the learner echoes the sound/word/words or not. If the child echoes the target response on the first presentation or even the second, immediately deliver reinforcer. The idea is to teach the learner that the quicker they elicit the target response, the quicker they will receive the reinforcer. (A flow chart example of this empirically proven technique can be found on a website called autism teaching tools www.autismteachingtools.com under "curriculum management--teaching procedure flow charts. (if I'm not making sense or sound confusing, e-mail me and I'll explain in more detail!)
And finally, just a few more significant Tammy tips I'd like to share: SHAPING SPEECH SOUND PRODUCTION IN CHILDREN WITH ASD: *pair signs/aac with words during mand training *pair sounds and words with reinforcement * differentially reinforce words or word approximations *echoic training (vocal imitation) *oral motor treatment
FUNCTIONAL COMMUNICATION AND SOCIAL INTERACTION: *replace problem behaviors with communication, good teaching, and consistent procedures *Increase interaction *expand communication *consider vocal and/or manual communication *Supplement with additional strategies
I don't think that one person left this conference with at least a few great ideas to start implementing right away. If you ever get the opportunity to see Tamara Kasper, take advantage!
Hope you find this information helpful or at least inspiring,
take it easy,
Jennica 1/14/04