Early Childhood: Intensive Instruction ’12-13 Amy Matthews, Ph.D. & Jamie Owen-DeSchryver, Ph.D. Grand Valley State University Linda Elenbaas, M.A. Spring Lake Schools / OAISD

Agenda Welcome Back and Review Intensive Teaching/Applied Behavior Analysis (ABA) ABA Components Discrete Trial Teaching (DTT)/Intensive Teaching and NET Preparing for intensive teaching

Intensive, Individualized Intervention What is it? Why is it critical?

Why was Anne Sullivan’s teaching successful? Individualized Intensive Repetition Follow through Targeted High expectations Failure was not an option

Children with ASD Need Good Teaching Even More Than Most Kids 5

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More Learning Opportunities Provide individualized intensive teaching to increase learning for students who do not learn from the natural environment or through typical classroom activities

Presenting Instruction 3 R’s Request (Stimulus) Response Reaction (Consequence) One to one teaching trial At lunch Walking to speech Video 191, 194, supernanny calling

Presenting Instruction PROMPT REINFORCEMENT What makes the behavior happen REQUEST SECTION 7 Specific Strategies Slide Summary Section 7 Time Estimate: 1-2 hours This Slide: Behavior Teaching Strategies CONTENT slide Key Concepts Discuss how discrete trial instruction / teaching is built on the ABC paradigm and is intended to teach students with ASD very specific skills while eliminating or decreasing irrelevant distractions. Provide examples of skills taught using discrete trial instruction. Discuss that there are many FORMS of discrete trial and various TERMS for the same basic tenets: Discrete Trial, Errorless Learning, others??? Training Activities Obtain video clips of various strategies being utilized for demonstrative purposes. Give examples of various skills that can be taught using this strategy. Materials Needed RESPONSE REACTION What increases the chance the behavior will happen again Instruction “Do This”: Imitation “MATCH”: Pre-academic “Do Puzzle”: Play Skills “Give me the . . .”: Receptive Language

The 3 Rs are what we call a “Learning Opportunity” or “Learning Trial”

Using the 3 Rs… 100% success is expected so… Failure is not an option A child will be assisted until he is successful Don’t make a request unless you can follow through

Request Response Reaction More About the 3 Rs Who presents Where to present What do you present How to prompt How to reinforce How many times to present How quickly to present Request Response Reaction

Applied Behavior Analysis (ABA) What is ABA? The Basics of Applied Behavior Analysis (ABA) ABA is Good Teaching

What is ABA? ABA systematically applies procedures based on behavioral principles to the instruction and modification of socially significant behaviors.

Why ABA? Based on over 60 years of scientific evidence Research supports intensive, structured intervention Best way to prepare young children with ASD to learn Effective way to teach many new skills Individualized and intensive Ongoing monitoring through data collection

ABA as a Broad Science Applied behavior analysis contributes to a full range of areas including: AIDS prevention, conservation of natural resources, education, gerontology, health and exercise, industrial safety, language acquisition, littering, medical procedures, parenting, seatbelt use, severe mental disorders, sports, and zoo management and care of animals. ABA-based interventions have gained recent popularity in the last 20 years related to teaching students with ASD.

What is ABA? ABA is Not: Only applicable to young children with ASD. It can be used with any age group and individuals with and without various disabilities.

Applied Behavior Analysis The broad approach to changing behavior based on behavioral principles

Seat-Belt Use Negative reinforcement tactics work to increase seatbelt use unless buzzing can be disconnected Research would suggest positive reinforcement strategies will increase use Researchers suggest: a light on the license plate to indicate the belt is buckled followed by a large scale community effort to reward drivers for their use, including entrance to “fast” traffic lane, discounts given by businesses with drive-thru window (banks, fast food, etc) Geller, E.S., Casali, J.G., & Johnson, R.P. (1980). Seat belt usage: A potential target for applied behavior analysis. Journal of Applied Behavior Analysis. 13(4) pp. 669-675.

ABA methods are used to support persons with autism in at least six ways: to increase behaviors (e.g. reinforcement procedures increase on-task behavior, or social interactions); to teach new skills (e.g. systematic instruction and reinforcement procedures teach functional life skills, communication skills, social skills); to maintain behaviors (e.g. teaching self control and self-monitoring procedures to stay on task);

ABA methods are used to support persons with ASD in at least six ways: to generalize or to transfer behavior from one situation or response to another (e.g. from completing assignments in the resource room to performing as well in the general ed classroom); to restrict or narrow conditions under which interfering behaviors occur (e.g. playing with trains has a time and a place); and to reduce interfering behaviors (e.g. aggression, stereotypy)

Different Forms of ABA Teaching Discrete Trial Teaching (DTT) Incidental Teaching Verbal Behavior PECS Pivotal Response Training

ABA Credential ABA isn’t just another strategy It is a field of study based on many years of research that serves as a foundational approach to teaching Board Certified Behavior Analyst (BCBA) is the credential given to people with significant expertise and experience with ABA Behavior Analysis Certification Board (BACB) – www.bacb.com

ABA and Evidence-based Practice ABA is listed as an evidence-based practice by: National Professional Development Center on ASD National Standards Project Association for Science in Autism Treatment Numerous recent books and articles on evidence-based practice

ABA Effectiveness According to a cost/benefit analysis conducted by Jacobson, Mulick & Green (1996), competently-delivered, early, intensive behavioral intervention (EIBI) can offer the hope of unprecedented gains for both children and taxpayers: estimated savings per child to age 22 are about $200,000; to age 55, $1,000,000. Similar analysis by Chasson, Harris, & Neely (2007) suggested the use of EIBI can lead to a savings of $208,500 per child across 18 years of education in the state of TX.

According to Ganz (2006), ninety percent of children with ASD who are deprived of intensive, effective early intervention will require special or custodial care throughout their lives, and this is estimated to cost the United States $35 billion dollars a year.

Getting STARTed with Intensive Teaching First, we need to review some of the basic components of ABA Many of them will look familiar to you; you might be surprised that much of it isn’t new!

ABA Components Prompting Errorless Learning Reinforcement Behavioral Momentum Stages of Learning

Prompting Prompting involves helping the child give the correct response after a given request. When learning new tasks, a child needs help to understand the connection between the request and the desired response. Prompts increase the success of the student. Prompting may occur at the same time as the request, right after the request, or even before the request.

Summary: Types of Prompts Verbal prompts Visual prompts Model prompts Picture prompts Gestural prompts Positional prompts Physical prompts Blocking Initiation prompts Full Physical prompts There are five basic varieties of prompts: Verbal prompting is the providing of a verbal instruction, cue, or model, or overemphasizing the correct word in an array of choices. A full verbal prompt might involve the adult saying the entire word or phrase that he is trying to illicit from the child, whereas a partial verbal prompt might be providing only the first sound or syllable to cue the child to proceed. Modeling is the acting out of the target behavior by the adult or another child with the hope that the child will imitate. Physical prompting involves actually touching the child. A full physical prompt might involve moving the child through the entirety of the behavior (for example, guiding his hand to select the right card from an array, and then guiding it further to hand the card to the adult). A partial physical prompt might be just touching a hand or shoulder to get the child started on the behavior. Gestural prompting includes pointing to, looking at, moving, or touching an item or area to indicate a correct response. Positional prompting involves arranging the materials of the trial so that the correct item is in a position advantageous to the child. For example, if a trial consists of picking a picture of a named object from a group of three pictures, one might initially arrange the trial so that the correct choice is directly in front of the child, while the two incorrect choices are on the other side of the table. As the child progresses, the other cards can be gradually moved closer until they are even with the correct choice.

Verbal Prompts Verbal prompt involves providing a verbal instruction, cue, or model, or overemphasizing the correct word in an array of choices (direct and indirect).

Visual Prompts Model prompts is the acting out of the target behavior by the adult or another child with the hope that the child will imitate. Picture prompts provide a visual cue to the child. Gestural prompts includes pointing to, looking at, moving, or touching an item or area to indicate a correct response. Positional prompts involves arranging the materials of the trial so that the correct item is in a position advantageous to the child.

Physical Prompts Blocking involves stopping an incorrect response or behavior before it occurs Initiation prompts involves helping the child to begin an action to complete a task Physical prompts involves actually touching the child.

Prompting Least to most (reduces dependency) Using the right level of prompting Least to most (reduces dependency) Most to least (errorless learning)

Errorless Learning Learning it wrong Have you ever… Learned a name and later discovered it was the wrong name Made a wrong turn the first time going somewhere and then made the same mistake next time Added the wrong ingredient to a recipe and then did it again

When are errors not okay? Surgery Pilots Bridge architects When it will take just as much work to unlearn errors

Errorless Learning In errorless learning, children only learn the correct skill. That is, the teacher teaches in such a manner that students do not make any mistakes. As a result, they do not learn an incorrect skill that will have to be corrected or re-taught.

It might look like cheating but it isn’t Examples: You’re wearing blue shoes. If you have blue shoes, line up. My name is Miss Lisa. Who am I? “Raise your hand” while modeling raise hand and providing an initiation prompt. This is a truck. What is this? You have an apple and milk for lunch. What are you having for lunch? While showing a picture of apple and milk.

Errorless Learning Errorless learning offers the following benefits: Minimizes the number of errors Increases time available for instruction Reduces the likelihood that errors will be repeated in the future Reduces frustration and increases opportunities for reinforcement

Errorless Learning Prompting leads to success 90-100% of the time Errorless process: Give an instruction once Wait for a response; prompt before an error occurs within 3-5 seconds of request When a child is first learning a skill, the prompt may be immediate

When to use Errorless Learning Has few skills/acquisition phase Unlikely to learn without many trials, supported by prompts When not to use Has skills; working on mastery or fluency

Prompting Cautions Watch for unplanned prompts (e.g. Clever Hans) Beware of prompt dependency

Goal is to use the least amount of prompting necessary to get the child to respond correctly

Fade Prompts Time delay Delay prompt by 1-3 seconds Prompt fading Gradually reduce the level of prompting needed. For example: Full physical to partial physical Full physical to gestural Model to verbal Verbal to visual

Prompting: Application/Activity Consider 2 tasks Dressing or completing a drawing activity Identifying features of an object or labeling pictures How would you prompt your student in these tasks Most to least – errorless teaching Least to most How would you fade Coat off Cookie sheet letters Show backing up to receptive for an expressive task not performed

ABA Components Prompting Errorless Learning Reinforcement Behavioral Momentum Stages of Learning

Hurray for Reinforcers!!

Reinforcement All people use reinforcement in every day life. Something is a reinforcer if it increases the behavior that occurred immediately before the reinforcer was delivered. NEGATIVE REINFORCEMENT Loud buzz in some cars when ignition key is turned on; driver must put on safety belt in order to eliminate irritating buzz (Gredler, 1992)  the buzz is a negative reinforcer for putting on the seat-belt. Feigning a stomach ache in order to avoiding school (Gredler, 1992)  school as negative reinforcer for feigning stomach aches. Rushing home in the winter to get out of the cold (Weiten, 1992). Fanning oneself to escape from the heat (Zimbardo, 1992).  Cold weather as negative reinforcer for walking home (the colder the faster you walk..), and heat sa negative reinforcer for fanning. Cleaning the house to get rid of disgusting mess (Weiten, 1992), or cleaning the house to get rid of your mother's nagging (Bootzin, et al , 1991; Leahy & Harris, 1989).  Nagging/Mess as negative reinforcer to cleaning. Studying for an exam to avoid getting a poor grade (Bootzin & Acocella, 1980).  Low grade as a negative reinforcer for studying (but.. a high grade is a positive reinforcer for studying at the same time) Taking aspirin to relieve headache (Bootzin & Acocella, 1980; Buskist & Gerbing, 1990; Gerow, 1992).  Good example: headache as negative reinforcer to taking medication. Removing a stone that has lodged inside the shoe while walking (Pettijohn, 1992; Roediger, Capaldi, Paris, & Polivy, 1991).  Pain as negative reinforcer to stopping to take off your shoe.. Prisoners try to break out of jail to escape the aversiveness of being locked up (Domjan & Burkhard, 1993). Leaving a movie theater if the movie is bad (Domjan & Burkhard, 1993). Running from the building when the fire alarm sounds (Domjan & Burkhard, 1993).  Fire alarm as negative reinforcer for leaving building. Smoking in order to reduce a negative emotional state (Baron, 1992).  Negative emotional state as negative reinforcer to smoking. Turning down the volume of a very loud radio (Roediger, Capaldi, Paris, & Polivy, 1991). Changes in sexual behavior (e.g., wearing condoms) to avoid AIDS (Gerow, 1992).

Reinforcement A reinforcer can be positive or negative. Positive – giving something to increase a behavior, like a smile, a cookie or a toy Negative- taking something away to increase a behavior, like turning off the alarm clock, or a teacher removing a demand so the child will stop screaming. NEGATIVE REINFORCEMENT Loud buzz in some cars when ignition key is turned on; driver must put on safety belt in order to eliminate irritating buzz (Gredler, 1992)  the buzz is a negative reinforcer for putting on the seat-belt. Feigning a stomach ache in order to avoiding school (Gredler, 1992)  school as negative reinforcer for feigning stomach aches. Rushing home in the winter to get out of the cold (Weiten, 1992). Fanning oneself to escape from the heat (Zimbardo, 1992).  Cold weather as negative reinforcer for walking home (the colder the faster you walk..), and heat sa negative reinforcer for fanning. Cleaning the house to get rid of disgusting mess (Weiten, 1992), or cleaning the house to get rid of your mother's nagging (Bootzin, et al , 1991; Leahy & Harris, 1989).  Nagging/Mess as negative reinforcer to cleaning. Studying for an exam to avoid getting a poor grade (Bootzin & Acocella, 1980).  Low grade as a negative reinforcer for studying (but.. a high grade is a positive reinforcer for studying at the same time) Taking aspirin to relieve headache (Bootzin & Acocella, 1980; Buskist & Gerbing, 1990; Gerow, 1992).  Good example: headache as negative reinforcer to taking medication. Removing a stone that has lodged inside the shoe while walking (Pettijohn, 1992; Roediger, Capaldi, Paris, & Polivy, 1991).  Pain as negative reinforcer to stopping to take off your shoe.. Prisoners try to break out of jail to escape the aversiveness of being locked up (Domjan & Burkhard, 1993). Leaving a movie theater if the movie is bad (Domjan & Burkhard, 1993). Running from the building when the fire alarm sounds (Domjan & Burkhard, 1993).  Fire alarm as negative reinforcer for leaving building. Smoking in order to reduce a negative emotional state (Baron, 1992).  Negative emotional state as negative reinforcer to smoking. Turning down the volume of a very loud radio (Roediger, Capaldi, Paris, & Polivy, 1991). Changes in sexual behavior (e.g., wearing condoms) to avoid AIDS (Gerow, 1992).

Guidelines for Reinforcement If it doesn’t increase behavior, it isn’t a reinforcer. Each child will have different reinforcers. A reinforcer for a child won’t be a reinforcer forever. Vary reinforcers. Reinforcers should be immediate. Always pair tangible reinforcers with social praise, eye contact, high fives, hugs, brief games.

Guidelines for Reinforcement Use descriptive praise for correct responses (e.g. “You are sitting so quietly, we are ready to get started!” or “Thanks for closing the door, you are a great helper.”). If reinforcement is being presented after each trial, short-lived reinforcers should be used. A single mini M&M, one blow on the bubble wand, a quick high five and a "Great job!" Start with reinforcement after every trial then thin out the reinforcement schedule once a behavior is learned. Guidelines for Reinforcement There are a few additional guidelines that may prove useful when dealing with reinforcements: If the reinforcement is to be consistent and effective the criteria for the response need to be planned out in detail, understood, and used consistently by everyone involved in the child's program. Consequences for correct and incorrect responses should be easily distinguishable. This may seem obvious, but is often harder than it sounds. For instance, I happen to have a great affinity for naughty kids. So, for example, when James takes his shoes off in class, which he does regularly, and I know that he is just doing it to be naughty, I often crack a smile, and tell him jovially, "C'mon James. Put your shoes on." Is this a bad thing? Well, if I really wanted James to keep his shoes on, it probably was not the best thing I could do. Since I had determined that James takes his shoes off to be naughty -- that is, to gain the attention of an adult -- I gave him just what he wanted by having fun with it, smiling at him, etc. I did ask him to put his shoes back on, but the manner in which I did it really reinforced the undesirable behavior (the removal of his shoes) rather than the desirable. If I was truly concerned about James's shoes staying on, a better approach might have been to say, with a straight face, in a flat tone, "No James. Put your shoes on." This takes some of the fun out of this particular naughty behavior, lessening the chances that it may happen again. Of course, if that behavior has been reinforced for a long time, knowingly or not, it may take an equally long time to establish that it is no longer going to be reinforced. Now, am I likely to be so concerned about James's taking his shoes off that I am going to eliminate a chance for him to have fun with me? Not on your life. If reinforcement is being presented after each trial (see schedules of reinforcement) short-lived reinforcers should be used. A single M&M (baking M&Ms are great as well), one blow on the bubble wand, a quick high five and a "Great job!" are all good choices. Longer lasting rewards -- time on the computer, a chance to play with playdough, gummy bears -- may detract from the inter-relatedness of consecutive trials. These rewards are great, however, as a break after a series of trials, or as a big reward "paid for" with a token economy system. The next section is quick look at schedules of reinforcement.

101 Ways to Praise WOW • WAY TO GO • SUPER • YOU'RE SPECIAL • OUTSTANDING • EXCELLENT •GREAT• GOOD • NEAT • WELL DONE • REMARKABLE • I KNEW YOU COULD DO IT • I'M PROUD OF YOU • FANTASTIC • SUPER STAR • NICE WORK • LOOKING GOOD • YOU'RE ON TOP OF IT • BEAUTIFUL • NOW YOU'RE FLYING • YOU'RE CATCHING ON • NOW YOU'VE GOT IT • YOU'RE INCREDIBLE • BRAVO • YOU'RE FANTASTIC • HURRAY FOR YOU • YOU'RE ON TARGET • YOU'RE ON YOUR WAY • HOW NICE • HOW SMART • GOOD JOB • THAT'S INCREDIBLE • HOT DOG • DYNAMITE • YOU'RE BEAUTIFUL • YOU'RE UNIQUE • NOTHING CAN STOP YOU NOW • GOOD FOR YOU • I LIKE YOU YOU'RE A WINNER • REMARKABLE JOB • BEAUTIFUL WORK • SPECTACULAR • YOU'RE SPECTACULAR • YOU'RE DARLING • YOU'RE PRECIOUS • GREAT DISCOVERY • YOU'VE DISCOVERED THE SECRET • YOU FIGURED IT OUT • FANTASTIC JOB • HIP, HIP, HURRAY • BINGO • MAGNIFICENT • MARVELOUS • TERRIFIC • YOU'RE IMPORTANT • PHENOMENAL • YOU'RE SENSATIONAL • SUPER WORK • CREATIVE JOB • SUPER JOB • FANTASTIC JOB • EXCEPTIONAL PERFORMANCE • YOU'RE A REAL TROOPER • YOU ARE RESPONSIBLE • YOU ARE EXCITING • YOU LEARNED IT RIGHT • WHAT AN IMAGINATION •WHAT A GOOD LISTENER • YOU ARE FUN • YOU'RE GROWING UP • YOU TRIED HARD • YOU CARE • BEAUTIFUL SHARING • OUTSTANDING PERFORMANCE • YOU'RE A GOOD FRIEND • I TRUST YOU • YOU'RE IMPORTANT • YOU MEAN A LOT TO ME • YOU MAKE ME HAPPY • YOU BELONG • YOU'VE GOT A FRIEND • YOU MAKE ME LAUGH • YOU BRIGHTEN MY DAY • I RESPECT YOU • YOU MEAN THE WORLD TO ME • THAT'S CORRECT • YOU'RE A JOY • YOU'RE A TREASURE • YOU'RE WONDERFUL • YOU'RE PERFECT • AWESOME • A+ JOB • YOU'RE A-OK MY BUDDY • YOU MADE MY DAY • THAT'S THE BEST • A BIG HUG • A BIG KISS • I LOVE YOU!

Reinforcement Better responses get a better reinforcer Faster responding Louder responding Longer responding (e.g., time on task) More accurate (e.g., says word more clearly) Better reinforcers are More (e.g., popcorn) Better (e.g., favorite color m & m) Longer access (e.g., more time to watch video)

Reinforcement Schedules Continuous – Reinforce after every correct response Used for acquisition and difficult tasks Intermittent – Fixed or variable schedule Used to maintain a behavior

Identifying and Individualizing Reinforcers Ask / Survey Observe Sample/Preference assessment

Reinforcer Assessment Survey Reinforcer survey 1 Reinforcer survey 2 Conduct a reinforcer assessment

Rapport Building (Pairing) High quality programs have positive teacher child interactions The goal of pairing is for the learner to enjoy being with the instructor (the instructor is a big chocolate chip cookie) The learner should not want to escape from the instructor When a child sees you, he should know that great things are going to happen and not bad things Pairing happens before instructional demands start

Rapport Building (Pairing) We don’t want kids working to escape from the teacher. It’s okay to work to get a fun reinforcer and learn to associate that reinforcer with a person. So… Why wouldn’t you try to use pairing? What is better than this?

Rapport Building (Pairing) A process of establishing yourself as a reinforcer in order to build rapport with child. Associate yourself with a reinforcer. Best types of reinforcers for pairing: Are controlled by you Can be delivered multiple times in small amounts Go away by themselves and don’t need to be taken away Are somehow better with you than without you (toy that only you know how to turn on)

Pairing: Steps Identify the learner’s reinforcers Best types of reinforcers for pairing: Are controlled by you Can be delivered multiple times in small amounts Go away by themselves and don’t need to be taken away Are somehow better with you than without you (toy that only you know how to turn on) Limit the availability of other reinforcers during pairing Create an environment that is fun Offer something that is more desirable than what they are already doing Pair your voice and yourself with the reinforcers

Engaging Tasks Boring is not always in the task, but in the environment because you don’t have enough reinforcement (lever example) A task has to be so engaging that children do not want to escape

ABA Components Prompting Errorless Learning Reinforcement Behavioral Momentum Stages of Learning

Behavioral Momentum

Behavioral Momentum Faced with a list of tasks, we often complete the easier tasks first so we can check them off the list and achieve satisfaction from small successes before we tackle the harder tasks… This is the concept of behavior momentum

Behavioral Momentum Use the same procedure with your students Roll with successes Provide the student with a series of high probability (motivating) requests or directions. This will increase the likelihood that the student will comply with the less likely (low probability) direction/request.

Behavioral Momentum and the Classroom Schedule Avoid starting the day with “unlikely” or “nonpreferred” activities, such as a review of the previous day’s problems, a difficult assignment, or calendar review. Instead, begin with “likely” or “preferred” behaviors, games or activities, such as “Simon Says,” team guess of a teacher’s selected mystery animal, or reading a high-interest story. Follow the preferred activities with less likely activities (e.g., academic assignments, problem review). Ben’s Picks

Behavioral Momentum and Individual Student Responses Use behavior momentum to encourage students to follow directions and complete demands Start by giving three or more requests that a student will readily do. After successfully completing each request, reinforce the student—this builds “behavior momentum.” Next make a more difficult request This is why we use “mixed trials” – more about this later

Behavioral Momentum: Example Mrs. Cleaver is working with 4-year-old Allison to improve following directions. After identifying high and low probability behaviors for Allison, she uses the following sequence . . . “Allison, where’s the dog?” “Allison, give me five.” “Allison, what’s your favorite animal?” “Allison, put your puzzle back on the shelf.”

ABA Components Prompting Errorless Learning Reinforcement Shaping Behavioral Momentum Stages of Learning

Stages of learning For each targeted goal, consider the stage of learning. Acquisition Fluency building Maintenance Generalization

Acquisition Characterized by high rates of inaccurate responses. Students have little or no skill at this stage. With careful teacher-directed instruction, the rate of accurate responses rises.

Acquisition Acquisition requires intense teacher-student interaction Numerous prompts are needed for correct responses Correct responding is the focus not fast responding Use errorless learning to reduce errors

Acquisition Foreign languages Reading Picture Exchange Communication: Request

Fluency Building When the responses reach independence at 80-90% accuracy, students are moving into fluency building. Students practice to increase the speed of responding accurately. Teacher provides corrective feedback.

Fluency Foreign languages Reading Picture Exchange Communication: Request

Maintenance Once students respond fluently, instructional time for the target skill is reduced Practice is provided for maintenance (Goal selection)

Maintenance Foreign languages Reading Picture Exchange Communication: Request

If you don’t program for generalization, don’t bother teaching at all.

Generalization Transfer of learning: Stimuli – use multiple exemplars and real objects People – use multiple instructions, parents Settings – use varied and natural settings Behaviors – teach behaviors of similar response class Reduce the level of prompting and reinforcement used so the student can demonstrate the behavior independently.

Generalization Foreign languages Reading Picture Exchange Communication: Request

Ways to Increase Generalization Teach in the target situation Use common items that will be encountered in the natural environment Provide multiple examples Vary instructors Increase reinforcement in the natural environment for taught behaviors Teach meaningful behaviors that are useable across people and settings

Discrete Trial Teaching (DTT)

What is the difference between ABA and DTT?

Discrete Trial Teaching (DTT) DTT is a teaching procedure based on ABA principles Steege, M. W., Mace, F. C., Perry, L., & Longnecker, H. (2007). Applied behavior analysis: Beyond discrete trial teaching. Psychology in the Schools, 44(1), 91-99.

Discrete Trial Teaching (DTT) Primarily adult-directed and implemented in a structured setting Particularly effective for teaching early learning and language skills One component of a comprehensive program for children with ASD

Discrete Trial Teaching (DTT) Breaks skills into small parts Provides concentrated teaching opportunities Uses prompting & prompt fading Uses reinforcement procedures Data collection informs programming decisions Teaches to fluency and generalization

What works: Research about teaching and learning, US Dept of Ed, 1996 To Master a Concept 8-12 repetitions for a gifted student 23-35 repetitions for an average student 1400 repetitions for a “naïve” student What works: Research about teaching and learning, US Dept of Ed, 1996

Presenting Instruction PROMPT REINFORCEMENT What makes the behavior happen REQUEST SECTION 7 Specific Strategies Slide Summary Section 7 Time Estimate: 1-2 hours This Slide: Behavior Teaching Strategies CONTENT slide Key Concepts Discuss how discrete trial instruction / teaching is built on the ABC paradigm and is intended to teach students with ASD very specific skills while eliminating or decreasing irrelevant distractions. Provide examples of skills taught using discrete trial instruction. Discuss that there are many FORMS of discrete trial and various TERMS for the same basic tenets: Discrete Trial, Errorless Learning, others??? Training Activities Obtain video clips of various strategies being utilized for demonstrative purposes. Give examples of various skills that can be taught using this strategy. Materials Needed RESPONSE REACTION What increases the chance the behavior will happen again Instruction “Do This”: Imitation “MATCH”: Pre-academic “Do Puzzle”: Play Skills “Give me the . . .”: Receptive Language

Instructional Delivery Request  Response  Reaction Stimulus  Response  Consequence Nuances of presentation Environment Teaching session length Instructor language Mixing vs. massing Pacing Varying placement Set size

Instructional Delivery: Environment Work in the most natural environment that will still allow the child to learn Use the environment to block and manage behavior, but gradually move to a natural learning environment

Instructional Delivery Request  Response  Reaction Stimulus  Response  Consequence Nuances of presentation Environment Teaching session length Instructor language Mixing vs. massing Pacing Varying placement Set size

Instructional Delivery: Session Length Keep track of when a child starts to lose momentum and stop a minute before Always end on a positive request Work up to longer periods of work

Instructional Delivery Request  Response  Reaction Stimulus  Response  Consequence Nuances of presentation Environment Teaching session length Instructor language Mixing vs. massing Pacing Varying placement Set size

Instructional Delivery: Instructor Language Simple vs. complex When do you keep the lead constant vs. vary the lead (e.g. point to…, touch…, show me…, where is…)

Instructional Delivery Request  Response  Reaction Stimulus  Response  Consequence Nuances of presentation Environment Teaching session length Instructor language Mixing vs. massing Pacing Varying placement Set size

Presentation: Mass Trial vs. Mixed Trial Mass trial is repeated practice of the same task Provides lots of practice Rote and sometimes hard to generalize Mixed trials involve asking a combination of questions More natural and easier to generalize Some students may have a hard time learning a task in a mixed presentation

Mass Trial vs. Mixed Trial

Instructional Delivery Request  Response  Reaction Stimulus  Response  Consequence Nuances of presentation Environment Teaching session length Instructor language Mixing vs. massing Pacing Varying placement Set size

Instructional Delivery: Pacing How quickly to you present a request to a student? Considerations: Child’s processing speed Errorless learning approach Stage of learning (acquisition vs. fluency)

Instructional Delivery Request  Response  Reaction Stimulus  Response  Consequence Nuances of presentation Environment Teaching session length Instructor language Mixing vs. massing Pacing Varying placement Set size

Instructional Delivery: Vary Placement Change position of item presented each time Change from horizontal to vertical Change setting (e.g. PECS) Change location (table vs. held by instructor)

Instructional Delivery Request  Response  Reaction Stimulus  Response  Consequence Nuances of presentation Environment Teaching session length Instructor language Mixing vs. massing Pacing Varying placement Set size

Instructional Delivery: Set Size How many items are presented at a time? When do you present two? When do you present three? (why is this better?) When do you present multiple items?

Autism and ABA Apps Autism Apps ABA Apps

Day Two

How do we set up intensive teaching? Next Steps How do we set up intensive teaching?

Next Steps: How do we set up intensive teaching? Identify curricula Complete a student skills assessment Select targets based on the assessment Establish a data collection system Complete reinforcer survey and collect items Identify time in the daily schedule for intensive teaching

Intensive Teaching Curriculum Areas Readiness skills/Learning to learn Attention Imitation Motivation Making choices Language Play/Social skills Pre-academic/Academic/Literacy Self help/Adaptive Motor

Curriculum to Teach Specific Skills Assessment, Evaluation and Programming System (0-3 and 3-6) (AEPS) - http://aepslinkedsystem.com/ The STAR Program – www.starautismprogram.com Rethink Autism - http://www.rethinkautism.com/ Teaching language to children with autism or other developmental disabilities by Sundberg & Partington Behavioral Intervention for Young Children with Autism by Maurice, Green, & Luce Teach Me Language by Freeman & Dake A Work in Progress by Ron Leaf and John McEachin. A Work in Progress has a fairly extensive curriculum. It has suggestions for dealing with disruptive and self-stimulatory behavior, toilet training, eating, play and social skills, and sleep problems, among areas. Instructional programs in this curriculum can fit roughly into the following categories (these are my divisions, not the authors), with a few examples of the specific programs they've included: Imitation: nonverbal, blocks, verbal Language and Communicative Readiness: joint attention, following instructions, labeling, conversation, assertiveness, yes/no, negation, asking questions, plurals, prepositions, pronouns, attributes, "I don't know" Concepts: same and different, first and last, before and after, quantities Academics and pre-academics: Reading, writing, stories, sequencing, recall Behavioral Intervention for Young Children with Autism by Catherine Maurice, Gina Green, and Stephen C. Luce While Behavioral Intervention is certainly more than a curriculum and touches on almost every aspect of a program for children with autism (from funding, to staffing, etc.), the curriculum it does provide is solid. The book provides instructional programs, at three different ability levels, in the following domains: Attending Imitation Receptive language Expressive language Abstract language Pre-academics Academics School readiness Self-help Socialization

Next Steps: How do we set up intensive teaching? Identifying curricula Complete a student skills assessment Select targets based on the assessment Establish a data collection system Complete reinforcer survey and collect items Identify time in the daily schedule for intensive teaching

Conducting a Skills Assessment You only know what to teach by assessing a child’s current skills and knowing where you want the child to go next. One day Alice came to a fork in the road and saw a Cheshire cat in a tree. “Which road do I take”? she asked. His response was a question: “Where do you want to go”? “I don’t know,” Alice answered. “Then,” said the cat, “it doesn’t matter.” ~Lewis Carroll Alice in Wonderland

MDE Approved Assessment Systems Assessment, Evaluation, and Programming System (AEPS) Battelle Developmental Inventory, 2n edition (BDI-2) Brigance Inventory of Early Development-II (IED-II) Carolina Curriculum for Preschoolers with Special Needs (CCPSN) Preschool Child Observation Record, 2nd ed (COR) Creative Curriculum Development Continuum for Ages 3-5 (CCDC) Learning Accomplishment Profile – Third Edition (LAP-3) http://www.michigan.gov/documents/mde/REPORTING_PRESCHOOL_SPED_OUTCOMES_for_the_WEB_4.08_235053_7.pdf

Assessment systems often used with children with ASD Assessment, Evaluation, and Programming System for Infant and Children (AEPS) AEPS Interactive (AEPSi) http://www.aepsi.com The Assessment of Basic Language and Learning Skills-Revised (ABBLS-R) Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP)

Classroom Skills Assessment You can use a skills assessment data sheet for all of your students to assess performance in typical classroom activities and self-help skills This data can be used for the development of IEP goals and intensive teaching targets

Skills Data Sheet Across Students Fine motor Social Eating

Basically…know thy student Student summary Student summary example

Student Example Gavin knows his upper and lowercase letters, letter sounds, numbers to 29, the concept of one and all in a set, basic colors and shapes. He is able to copy simple lines, trace letters and lines. He is independent in eating and beginning toileting. He has some overall delays in motor coordination for his age but navigates safely in multiple environments. He has significant delays in functional use of language and speaks in primarily one word utterances. He does not communicate to get his needs met, seek information or interact by answering questions or recalling events. He is able to receptively and expressively identify pictures and objects. He is beginning to understand the features, function and category of objects. He understands the concepts of small, medium and large He has difficulty initiating interaction with peers and primarily plays alone or with an adult. He will participate in organized games supervised by an adult and do some basic pretend play with adult supervision. He rarely responds to peer initiated interactions or initiaties with peers.

Student Example: Gavin Progress record Graph 1 Graph 2 Child report

Select a student for intensive teaching Based on your assessments of all students, who would require more intensive instruction. Develop an intensive teaching program for one student to begin.

Next Steps: How do we set up intensive teaching? Identifying curricula Complete a student skills assessment Select targets based on the assessment Establish a data collection system Complete reinforcer survey and collect items Identify time in the daily schedule for intensive teaching

What do we teach? We teach those skills that will help the child become better learners, gain independence, and be successful in general education

Choosing Goals Expectations are addressed throughout the day in all activities and generally are not chosen as IEP goals and targets Choose your IEP goals and targets from the items on the assessment and from a solid curriculum

Choosing Targets Balance across curriculum areas Ask the following question: Does the child have the necessary prerequisite skills for this target? Is this target developmentally/age appropriate for the child? Will this skill help to reduce problem behaviors? Will this skill lead to the teaching of other meaningful skills? Is this skill likely to generalize? Will this skill be maintained? Will the child acquire this skill in a reasonable amount of time? Is this skill important for the child and family?

Choosing target words to teach If you were going to Japan and you wanted to choose 12 words that would be very relevant to get around, what would they be? When choosing any target, choose what is most relevant and likely to be learned and used This concept applies generally across all areas: pre-academic skills, play, etc.

Choosing target words to teach Teach words that can be used broadly (e.g., “open” can be understood and used for open door, open jar, open lid, open goldfish bag, open mouth and say ahh) Avoid choosing words that do not convey a concrete meaning (e.g. more) or words that are not critical for understanding (e.g. please, more) Choose words that are motivating to the child and will be used frequently and reinforced Teach yes and no

Target Examples Target Areas Target Areas with Examples Circle Time Targets

Student Example: Gavin Student summary IEP Summary IEP Goals 1 IEP Goals 2 IEP Goals 3

Next Steps: How do we set up intensive teaching? Identifying curricula Complete a student skills assessment Select targets based on the assessment Establish a data collection system Complete reinforcer survey and collect items Identify time in the daily schedule for intensive teaching

Identifying a Data Collection System Identify an appropriate data sheet Clearly define targets and instructions Probe data collection vs. trial by trial Indicate prompt level

Sample Probe Data Sheet Taking Data Identify an appropriate data sheet Clearly define targets and instructions Probe Data Sheet Sample Probe Data Sheet

Develop criteria for success/mastery Consider how same aged typical peers perform this skill. Does a typical child perform this skill 80% of the time or more? Do not set your criteria too low or the child will not achieve true mastery. Anything less than 80% mastery probably will not be maintained once intensive teaching is ended. Do not set your criteria higher than would be observed in same aged peers without a disability For intensive teaching, the criteria often used in the Ottawa program is independent responses on the first cold probe over 3 consecutive days

Student Example: Gavin Probe data sheet

Multiple students Data Tracking Goals may be clustered across students Examples Skills Assessment Classroom Behavior Social Goals

Classroom IEP Data Sheets IEP Goals 1 IEP Goals 2 Skills Assessment Toilet training data sheet

Monitoring Progress The data needs to be reviewed weekly to decide whether changes need to be made to the program Use a systematic process to decide when to make changes: Mastery criteria for movement forward Problem solving model for lack of progress

Probe Data Sheet Example

What does this graph tell us?

What does this graph tell us?

What does this graph tell us?

What does this graph tell us?

Next Steps: How do we set up intensive teaching? Identifying curricula Complete a student skills assessment Select targets based on the assessment Establish a data collection system Complete reinforcer survey Identify time in the daily schedule for intensive teaching

Reinforcer Assessment Ask/Survey Reinforcer survey 1 Reinforcer survey 2 Observe Create a Summary Reinforcer Summary

Next Steps: How do we set up intensive teaching? Identifying curricula Complete a student skills assessment Select targets based on the assessment Establish a data collection system Complete reinforcer survey and collect items Identify time in the daily schedule for intensive teaching

Accumulated Information You now have lots of knowledge about practices and strategies. Let’s go back to your schedule and think about maximizing time.

Finding Time: Be Creative Specials class (e.g., art or music) when another teacher is in the room – only a segment of the time Snack – two children do intensive teaching and the snack can be part of the reinforcer Story time – two children do intensive teaching, especially if you have children that have trouble sitting and paying attention and may require lots of redirection, and thus adult attention, anyway Coloring time may be a good time for a couple of children to get some intensive teaching time Speech or OT time when some children might be with the therapist, then the other children can get intensive teaching If a child is having behavior problems that require 1:1 adult time anyway, then change the schedule to give intensive teaching time to that child Set up stations/centers, including at least 1-2 independent centers, and have 1-2 centers be intensive teaching with a teacher and a para In all of these situations, rotate the children so they do not consistently miss the same activity

Next Steps: How do we set up an intensive teaching program? Complete reinforcer survey and collect items: Review Handout Fill in scheduling activity form Identify time in the daily schedule for intensive teaching: Review Handout

Guidelines to Maximize Progress Make it fun; Use lots of interesting and varied reinforcers (and materials when appropriate) Begin with shorter sessions then extend time Take breaks Mix the trials Alternate difficult & easy trials (behavioral momentum) Generalize skills daily

How do we do intensive teaching with more than one child?

Working with More than One Child at a Time Identify students with same targets or similar targets (quick movement back and forth between students) If students have different targets, create a system for moving between different materials and presentations (occupy non-engaged student)

How do we find time to offer intensive teaching?

Models of Intensive Teaching Additional staff to run intensive teaching sessions across classrooms (TBA model) Extra training and assistance to classroom staff when a child with ASD starts in a new classroom Project DATA/extended day (Schwartz et al.) Embedded in classroom schedule (McBride & Schwartz)

Expanding Learning Opportunities Project Rethink Autism curriculum Project DATA model Undergrads supervised by professional staff

What to do before the next training? Keep Working on the Classroom Priorities Develop Intensive Teaching for one student