Limitless Teaching Opportunities

In applied behavior analysis, two of the most predominate methodologies include discrete trial training (DTT) and incidental teaching. Core features of DTT include repetition and sequenced instruction, in order to target certain skills, while on the other hand, incidental teaching involves elaborating on what a child initiates (Weiss, 2005). Today, we will be discussing the latter.

So, what is incidental teaching?
– The teacher arranges opportunities or sets the environment to encourages the learner’s interest.
– It is child-initiated, which means once the environment is arranged, the teacher waits for the student to initiate interaction.
– Once the child either asks or makes a comment about the item/topic, the teacher prompts an elaboration.
– After the child responds, the teacher provides reinforcement (e.g., teacher gives him/her the item, attention, etc., for what he/she has initiated).

Why is it used?
– It is an effective way of teaching a variety of language and conversation skills, including the ability to initiate interactions.
– It provides learning opportunities where the skills naturally occur.
– It promotes generalization.
– Seems less like “work” for child as the child is initiating and therefore, motivated.

Examples of incidental teaching:
– Child loves apple juice. Dad is pouring a glass of apple juice that is out of reach, yet near the child. Child reaches for juice, dad prompts “J—-,” child says “juice,” dad gives child juice to reinforce the elaborated response. (This demonstrates an example of controlling access to item and moving item closer to student/child).
– Mom is pushing child on a swing. Mom stops pushing child and waits for the child to ask for more pushes. (This demonstrates an example of starting a preferred activity and then stopping).
– Therapist brings in special farm animal toys. Child asks for toys, therapist gives child toys. Child says, “Duck.” Therapist responds with, “A yellow duck!” as the child moves duck around. (This demonstrates an example of using items of special interest to student).

It is important to prompt the child to produce just a slightly more complex level of their current language skills. For example, if child says single words, model 2 words. Once a child is using 2-3 word sentences, prompt for more complete sentences by adding adjectives (e.g., colors, shapes, size, numbers), adverbs (e.g., fast, slow, soft, rough), and prepositions (e.g., in, on under, next to, behind). For example, if a child is asking for help they may first say “help,” and then, “Help me,” to “Can I have help?”

An example of an interaction in incidental teaching. Illustration by Tale Hendnes.

In conclusion, learning may occur in a highly structured and systematic manner or be embedded into our day to day lives. While ABA therapist are trained in using incidental teaching, really anyone can do it. You may already be doing it without realizing it! Regardless, it is important to recognize the idea that learning can occur at any time or place and with incidental teaching, any opportunity can be turned into a learning moment!

References

Comprehensive Guide to Autism – Scientific Figure on ResearchGate. Available from: https://www.researchgate.net/An-example-of-an-interaction-in-incidental-teaching-Illustration-by-Tale-Hendnes_fig2_268443242

Hart, B. M., & Risley, T. R. (1982). How to use incidental teaching for elaborating language. Austin, TX: Pro-Ed.

Weiss, M. J. (2005). Comprehensive ABA programs: Integrating and evaluating the implementation of varied instructional approaches. The Behavior Analyst Today, 6(4), 249.

Addressing Writing Skills

Despite the immense growth of typing and texting in our technology-driven world, writing skills remain essential. Children use writing skills both for fun and academic purposes. In order to scribble, color, trace, copy, or write, writing skills are required. If a child is having trouble with writing, not only could coloring or completing written school work be affected, but other fine motor tasks (movements using smaller muscles in the hands, fingers, wrists) could also be difficult for the child to complete (e.g., getting dressed, holding a cup, various play activities). Therefore, if we notice writing skills as a concern, we will address this through a variety of researched based interventions.

Below are a few focal interventions often implemented:

Prompt Fading – Prompt fading involves starting with the level of prompt the child currently needs and fading prompts until the child learns the writing skill independently. For example, the therapist may begin with using hand-over-hand physical prompts to help teach a child to hold a crayon correctly to color. Next, the therapist might prompt the child by modeling how to hold the crayon and color within the lines. Once the child is able to model the therapist, the therapist may just need to remind the child to stay within the lines when coloring (a verbal prompt) until the child independently colors within the lines.

Chaining – This is used to breakdown a task that requires multiple steps. For example, when learning to trace, copy, or write one’s name, breaking it down into small steps by first teaching only one letter in the child’s name such as the last letter (if using backward chaining) can be helpful. If the child’s name was “Carl” you would have “Car_” already written and the child would first learn the letter “l.” Once this was learned, the letters “Ca__” would already be written and the child would then learn to write both “r” and “l.” The next step would be for only “C____” to be written out, and the child would then learn to write “a,” “r,” and “l.” Lastly, the child learns to write his whole name, “Carl.”

Backward-Chaining/Trace, Imitate, Copy, Memory Worksheet (Klee, I. C., McLaughlin, T. F., Derby, K. M., Donica, D. K., Weber, K. P., & Kalb, G., 2015, p. 63)

Handwriting Without Tears is a common program used to teach handwriting that incorporates a variety of strategies.  An example of one strategy is through verbal prompts and utilizing the program’s language to help with formation of numbers and letters (e.g., writing an R – “Big line, little curve, little line”). Another strategy is through visual prompts. For example, some Handwriting Without Tears worksheets provide a smiley face to indicate where the child should begin writing.

Writing Without Tears Worksheets id#0 Worksheet. (n.d.).

Writing Without Tears Worksheets id#0 Worksheet. (n.d.).

Besides these interventions, there are many other ways to practice fine motor/writing skills such as:

  • Create a necklace/bracelet (can be modified by using different sizes of beads or string thickness)
  • Play-doh
  • Games (e.g. Connect Four, Pop the Pig, card games like Uno)
  • Shaving cream (e.g., draw pictures, practice writing shapes/letter/words, play tic-tac-toe)
  • iPad apps (e.g., iWrite Words, Letter School, HWT – Wet Dry Try, Alphabet Tracing – Free) Having the child use a stylus can work on holding a writing utensil.
  • Cooking (e.g., make chocolate chip cookies and encourage child to pick up chocolate chips using only their “pinchers” – thumb and index finger)

To conclude, a tip to promote a child to use their fingers and work on fine motor skill is to give a child small, broken crayons to color, draw, and/or write. This way children are required to use their fingers, instead of grabbing it with their fist.

 

References

Carlson, B., Mclaughlin, T. F., Derby, K. M., & Blecher, J. (2017). Teaching preschool children with autism and developmental delays to write. Electronic Journal of Research in   Education Psychology,7(17). doi:10.25115/ejrep.v7i17.1313

Klee, I. C., McLaughlin, T. F., Derby, K. M., Donica, D. K., Weber, K. P., & Kalb, G. (2015). Using Handwriting Without Tears® and a modified copy, cover, compare through chaining to teach name writing to a preschooler with developmental delays to write his                           name. IJAR1(3), 59-65.

MacDuff, G. S., Krantz, P. J., & McClannahan, L. E. (2001). Prompts and prompt-fading strategies for people with autism. Making a  difference: Behavioral intervention for autism, 37-50.

Writing Without Tears Worksheets id#0 Worksheet. (n.d.). Retrieved from   http://bookmarkurl.info/worksheet/writing-without-tears-worksheets-0.html

Community Outings

Participating in community outings is an important skill for children, but can often be overwhelming to practice. Writing a behavior plan can help provide guidance to increase tolerance of community outings for your child.

While creating a plan, it’s important to have contingencies in place to support your child and to facilitate success while in the community. Identifying common places in the community that you and your child frequently encounter is a good place to start. Brainstorming what can go right – or wrong – ahead of time can help everyone involved. Consider a scenario in which a child frequently engages in tantrums while grocery shopping. To begin, we would identify the grocery store that parents typically go to, select a time in which the grocery store is not busy, and plan for specifically challenging aspects of the grocery store (e.g., avoiding the candy aisle). Additionally, collecting baseline data may be helpful while planning for outings. For instance, if baseline data suggest that your child typically begins to demonstrate negative behaviors after 15-minutes of shopping, we may want to design our trips to be 10-minutes long to facilitate success. As your child learns to tolerate these trips, we can systematically increase the length of the outing.

Reinforcement systems are also an important part of the plan. Examples of reinforcers could include small treats delivered throughout the store for appropriate behaviors (e.g., sitting nicely, using an indoor voice), descriptive praise, and a larger reward at the end of a successful trip (e.g., selecting a toy). However, it is important to withhold these rewards if your child engages in inappropriate behaviors while shopping. For instance, while entering the grocery store you may describe to your child that they will receive treats for sitting nicely, and if they walk nicely the entire trip they will get to pick out one item from the toy aisle. If your child engages in a tantrum, we would want to ensure that the child does not receive attention or get to pick out a toy.

As your child becomes successful with the initial steps of the plan, we will want to fade the program to resemble typical trips to the grocery store. Examples of fading could include going to the store at higher-traffic times, increasing the length of trips, reducing the frequency of delivering treats, or providing a toy after every-other trip to the store. Data should be collected (e.g., duration of trip, time of trip, instances of problem behavior) to see whether the child is ready to move on to the next step of the program.

Overall, community outings can be overwhelming, but with a concrete plan we can increase tolerance of outings and facilitate success for our children.

Facilitating Independence

While teaching new skills, we often use prompts. Prompts serve as intermediary steps between the child’s current skill set and the target goal. Although prompts are a necessary aspect of teaching skills, there is a delicate balance between under and over-prompting. If we under-prompt, it will be unlikely that the child will learn the skill. Conversely, if we over-prompt, the child will likely become dependent on the prompt and will thus not be able to complete the skill independently.

Let’s take the example of teaching a child to wash their hands. With this skill, the emphasis is on independence; that is, the goal is for the child to be able to complete each step of hand-washing without the assistance of an adult. If we teach a child to scrub their hands with soap using hand-over-hand prompting they will likely not learn to independently do so as they are not required to make any movements of their own – and are now dependent upon adult help. On the other hand, if we continually use the verbal reminder such as “scrub” to a child that doesn’t know this meaning, they will likely never develop the skill of scrubbing soap – it’s an ineffective prompt. These two types of prompts demonstrate the balance we work towards while prompting to facilitate independence.

Given these concerns, how can we decide what prompt to use to ensure that we are teaching the skill while facilitating independence? One common method is to use a “least-to-most” prompting hierarchy. Least-to-most prompting could include a verbal prompt (i.e., least invasive), a gestural prompt, and a physical prompt (i.e., most invasive). Simply put, least-to-most prompting procedures use the least invasive prompt that facilitates responding from the child. If that prompt does not facilitate the task, then we move up to a slightly more invasive prompt. This process continues until the child completes the task.

In the example of washing hands, we may begin with a verbal prompt of “turn the water on”. Then, after there is no response we may gesture towards the faucet. Then, if the child doesn’t respond again we may gently guide their hands towards the faucet to prompt them to turn it on. As the child begins to learn the skill, we will likely not need to guide them towards the faucet but instead we may be able to simply point towards the faucet. In this example, we have now have taught the child to be more independent with hand washing. Future practice could focus on moving lower and lower on the prompt hierarchy until the child can do so without any reminders from an adult.

While teaching new skills, we want to ensure that the child can complete the task independently. Least-to-most prompting is an effective teaching method to improve independence.

The Importance of Follow Through

Most parents have experienced their fair share of tantrums from their child. Although tantrums serve different purposes, they can often be a form of communicating a child’s wants or needs.

As a pre-school teacher during graduate school, I saw plenty of tantrums. Each semester began with young children being separated from their parents, and these kids often engaged in the one thing that is hardest for parents to see – crying. Typically, parents would rush back in the room to comfort their child. Unsurprisingly, the child would often continue to cry (and more intensely) during future drop-offs; likely because this behavior worked so well with gaining access to their parents!

In these situations, we would suggest that parents provide a comforting good-bye to their child but stay out of the room for the duration of the tantrum. Although a short-term solution for a tantrum is to give in by providing the child with attention, this typically sets a new standard for that child that can result in even more intense tantrums in the future. In this situation, the child can quickly learn that whining didn’t work last time but screaming did, so they will likely scream in the future to get what they want. However, the child will soon learn that their cries no longer result in their parents coming back and they are able to move on to more fun activities in the classroom.

Although this is a specific example of a child being dropped off at pre-school, it can be applied to many relatable instances in a child’s life. Parents may see these challenging behaviors when their child wants to avoid something (e.g., chores, homework), or when they want something that they can’t have (e.g., a cookie before dinner, candy at the store). Despite the differences in these situations, the concept remains the same – if you give in it will likely result in an increased likelihood that the challenging behavior will occur next time. Giving in is a short-term solution that typically results in more intense and problematic behaviors in the future, as it sets a new standard for that behavior (e.g., whining didn’t work but screaming did so I will scream next time I want something).

Summary:

  • There are times that parents are unable to give their children what they want – not out of neglect, but because it is simply not feasible at the time. It is part of the learning process for kid’s to learn when their requests are appropriate or inappropriate.
  • There may be an initial increase in the intensity/duration of the challenging behavior after planned ignoring.
    • This is a sign that what you are doing is working, as there is typically a burst in intensity before the challenging behavior subsides.
  • Pairing reinforcement systems with appropriate behaviors can be a helpful way of decreasing challenging behaviors and increasing appropriate behaviors.
    • For instance, if your child sometimes struggles with transitions you may consider ignoring screaming but providing a highly-preferred item or activity whenever they appropriately transition.
      • Ignore tantrums and always follow-through by ensuring that they transition to the next activity.
      • Provide access to a reinforcer only for appropriate transitions.

Incorporating Games into Social Skills Instruction

Finding different ways for children with ASD to engage with their peers socially can be a challenge. Incorporating game play into the child’s social skills repertoire can be a great way to create new social opportunities for the child with his/her friends and family.

Skills that can be targeted using game play:

  • Asking someone to play
  • Turn taking
  • Waiting
  • Staying with the group
  • Team work- e.g. set up and clean up
  • Sharing
  • Appropriate voice level
  • Collaborative play
  • Resolving conflict- e.g. not going first or not getting the desired game piece
  • Handling winning and losing

Keep it simple! For children who have limited exposure to game play, don’t work on too many skills at once. As the child masters a skill you can build on that skill and target others.

Keep it fun! For some children, you may need to adjust the rules prior to playing so the game can progress more quickly. Be sure to look for signs of fading interest during the game and find a way to end the game successfully. For example, have each person take one more turn before ending the game. Keeping the experience fun is key so the child will want to play again.

Provide praise! Be sure to provide immediate and specific praise when the child exhibits the skills you are targeting. You need to meet the child’s level on communication when providing praise. For example, “Wow, you’re doing a great job waiting your turn!” or “Great waiting!” depending on the level of the child.

Make the game meet your needs! You may want to adapt the game to take out skills your child isn’t quite ready to work on yet. For example, in Candyland take out the cards that advance or move back your game piece if the child isn’t ready to work on handling disappointment. You can also adapt game by adding in skills you want to target. For example, add in cards that target asking another player a question before moving his/her game piece. You can also find ways to add in movement for children who need it. For example, every time someone lands on green you do 3 jumping jacks. Just think of the directions in the box as being suggestions so be creative and think of ways to make the game meet your needs.

Don’t give up! Remember that the first try might not go as planned so go easy on yourself. Continue to provide the opportunities to the child so they can continue to grow and learn. Progress can’t be made if opportunities are not available. Be sure to collect your data so you can track the progress.

Overall, games allow for a great opportunity for children with ASD to play with peers and family members while learning social skills and life-long leisure skills. Be creative and have fun!

Activities for a Fun Summer

Summertime is my favorite time of the year with warm weather, no school, and baseball! Below are my top three favorite summer time activities and suggestions for making them a hit with your child.

Sidewalk Chalk:

Sidewalk chalk is the perfect activity for kids with creative minds and perhaps not enough paper to write or draw on. It is also an enjoyable way to work on  shapes, letters, and color recognition.   Ed Emberly has a variety of step by step drawing books that use simple shapes to create an assortment of objects, animals, or faces.

Skills to add on:

  • Basic Concepts
  • Endless Expressive-Receptive Language
  • Fine Motor Skills: Writing Letters, Name, Numbers; Drawing
  • Gross Motor: Draw a maze to navigate through or ride bike/scooter

Scavenger Hunts:

Scavenger hunts can happen anywhere: your backyard, in a park, on a walk, or even inside your home on rainy days! Invite some friends/peers to join you and your child, which gives an opportunity to facilitate social interactions. Chelsey at Buggy and Buddy put together an amazing list of free printable scavenger hunts that are sure to keep you and your child learning while targeting some of the skills listed below.

Skills to add on:

  • Gross Motor Skills: Walking; Climbing (if needed); Jumping
  • Social Interactions
  • Shape/Object Recognition
  • Identifying items by feature, function, class

Water Play:

What better way to cool off on a warm summer day than to play in the water?! Here are a few water activities that are sure to keep you cool: colored water (food dye) mixing and pouring, water table, water balloons, and playing in the sprinklers.

Skills to add on:

  • Color Identification
  • Fine Motor-use an eyedropper, funnel, measuring cups to transfer water
  • Shape/Object Recognition
  • Imitation
  • Gross Motor
  • Play and Leisure Skills

I hope that you will enjoy these activities with your child this summer. Remember to incorporate meaningful activities into your daily routines and always take DATA!!

Teaching Appropriate Requesting

Teaching Appropriate Requesting as a Way of Reducing Challenging Behaviors

Often, children with Autism demonstrate a wide variety of ways of communicating their wants and needs. In the earliest form, babies request attention, food, or a diaper change by crying; they quickly learn that most parents will respond to crying. This is a natural form of communication that serves an important purpose for babies. However, after time, most children learn other ways of communicating. For instance, as a baby grows they may learn that they receive lots of attention for walking up to their parents with outstretched arms. This new behavior now replaces crying as an effective way of gaining attention, and is a more socially accepted way of communicating a need for attention.

It can be challenging for parents when their child does not naturally pick up on these more appropriate ways of communicating. Some children may not independently learn these skills, and instead may require extra support and practice to do so.

Limit Challenges & Teach Appropriate Requesting

While teaching children to request, it is important to a) select an appropriate way of communicating that is conducive with their current skill level, b) teach the child the appropriate way of communicating, and c) consistently require the child to request using the more appropriate way. Consider a situation in which a child wants food but does not have the words to communicate. They may go through a variety of behaviors while trying to tell their parents what they want, including pointing, guiding their parents to the kitchen, or trying to open the fridge. If the child does not get what they want (usually because parents are busy guessing what their child wants), we may see the child escalate to whining or crying. At this point, the parent may find the item that the child requested. However, this can be problematic, as we may have now set a “new standard” for that child, such that they may escalate to more extreme behaviors such as whining or crying in the future because they got what they wanted for doing so. Examples like this are often why we see children demonstrate more challenging behaviors when they are attempting to communicate their wants/needs.

It may be beneficial to identify a behavior that is appropriate for the child’s skill level and to begin teaching the child this new way of requesting. For instance, in the example above, the child does not independently vocalize while requesting but may have the fine motor skills to begin learning sign language. Therefore, it may be beneficial to initially prompt the child to sign “eat” as an approximation of the vocal word “eat” before they receive food. Then, once the child is consistently signing “eat”, parents can begin to require this request each time the child wants food, while simultaneously ignoring any inappropriate requests (e.g., whining, crying). By teaching the vocal word or sign “eat”, this allows the caretaker/parent to narrow down what the child wants, he/she is hungry. Once “eat” is being used functionally, specific foods items would be taught.

Although this is a simple description of a complex series of behaviors, the general outline can help parents identify areas in their child’s lives that could benefit from more appropriate communication. Whether the child cries to gain attention from their mother, or the child wants escape from a difficult task, it is important to teach and require appropriate ways of communication.

Summary

Teaching requests to reduce challenging behaviors:

  • Identify what your child wants
  • Identify a skill-appropriate replacement behavior
  • Teach the appropriate replacement behavior
    • Contrive situations for your child to practice this replacement behavior
      • For instance, if you are teaching the child to say “eat” you may consider holding their plate of food and prompting them to say “eat” prior to having each bite. This is a quick way of teaching the association between the word “eat” and receiving food.
    • Ignore the challenging behaviors and prompt the new appropriate behavior.
      • If your child whines for food at any point, do not provide food but instead prompt them to say “eat”. Then, you would immediately provide them with the requested food.

April is Autism Awareness Month

Autism affects countless families across the World every day. In 2007, The United Nations declared April 2nd as World Autism Awareness Day. This year will mark the 10th anniversary of World Autism Awareness Day. On this day, autism organizations around the world celebrate the day with unique awareness raising-events.

During April, which is recognized as Autism Awareness month, organizations, businesses, communities, and professional sports teams across the United States sponsor events to help raise awareness for Autism. There are countless ways to get involved, whether it’s as simple as wearing blue, volunteering to help with these events, or establishing new activities in your community.

Are you or someone you know looking for a way to get involved?

Here are a few different ways to participate in Autism Awareness Month in our community:

Kansas City Zoo Autism Awareness Day – Sunday, April 2nd 2017
Do you, your friends, or your family love animals? If you answered yes, then maybe you should check out the Kansas City Zoo Autism Awareness Day on Sunday, April 2nd. Free admission will be provided to people with Autism and the Zoo will offer reduced admission of $6 per person for those accompanying them to the Zoo. If this sounds like the purrfect event for you, check out the KC Zoo’s website for additional information and explore all nature has to offer!

Kendra Scott Gives Back Party – Friday April 7th 2017
Kendra Scott has two locations in the Kansas City metro area which will host the party featuring special pricing, with a portion of the proceeds benefitting Autism research. From 5:00pm to 7:00pm the Kendra Scott stores located at Town Center in Leawood, KS and 412 Nichols Road in Kansas City, MO will host the party. If you or someone you know has their heart set on some new jewelry, stop by one of these locations to shop till you drop! Contact the Kendra Scott locations for more details on the sale.

Papa Johns – 40% Off All Orders – Now through April 7th 2017
Too tired to cook, but still need to eat? Take advantage of Papa Johns discounted pizza from now until April 7th 2017. Orders must be placed online with promo code AUTISM40. Contact Papa Johns for more details.

Walk to show support and raise awareness for Autism – Saturday April 8th
Be a Hero and join the Eudora ACES for their 7th Annual Walk for Autism on Saturday April 8th from 12:00pm to 2:00pm. The walk will take place at CPA Park in Downtown Eudora, KS. For more details visit the Eudora ACES Facebook page.

Sporting KC Autism Awareness Game at Children’s Mercy Park Sunday, April 9th 2017
Love Soccer? Hit the pitch with Sporting KC and Light Up Blue at Children’s Mercy Park on Sunday, April 9th as Sporting KC takes on the Colorado Rapids at 6:00pm. To score tickets, head to Sporting KC’s website:  or SeatGeek and use Access Code: 17AutismCC.

Kansas City Royals Autism Awareness Night Friday, April 14th, 2017
Few things are better than spending a night watching the “Boys in Blue” play ball at The K. If watching baseball is a hit with you, you can check out the Kansas City Royals as they take on the LA Angels on Friday, April 14th, 2017. Hit a homerun and get your tickets at KC Royals Ticketing.

The Importance of Routines

Day to day routines can be stressful, a routine is, by definition a sequence of actions regularly followed; a fixed program. Routines are performed as part of a regular procedure rather than for a special reason.

Everyone has them; they are a part of everyday life. Morning routines, school/work routines, and bedtime routines. Many children with autism thrive on predictability and structure. Routines give children a sense of security. When establishing a routine, consistency within the routine is key to its success.

Establishing a new routine isn’t always easy; it’s often difficult, the work you put in while establishing the routine will pay off in the end.

Here is an example of what morning routine looks like for my children.

  • Get Dressed
  • Put pajamas away
  • Eat breakfast
  • Brush Teeth
  • Pack Backpack
  • Get in Car

It is important to be consistent in the teaching and maintenance of your routine.   It’s predictable, reliable, and repeatable. No matter what sequence of steps have been decided on, it is crucial that all steps of the routine are followed. Provide positive reinforcement along the way. When a step is completed, praise your child. Celebrate all successes, no matter how large or small!