Evidence-Based Strategies to Address Deficient Repertoires in Young Children with Autism Coyne & Associates Educational Corporation ABAI Phoenix 2009

Facilitation of an Echoic Repertoire Christine Dausch Essex, SLP Sally D. Moore, MA BCBA Len Levin, PhD Nicola Bogie, MA Celia Newkirk, MA

Introduction A primary goal for children with Autism receiving EIBI is to establish a system of communication EIBI curricula emphasize development of listener and speaker repertoires (i.e. following instructions, identification, manding, tacting, etc.) Included in EIBI curricula is a “standard” method for establishing an echoic repertoire Reinforce spontaneous vocalizations Gain stimulus control over vocalizations via Vocal Imitation or mand training Shape approximations

Introduction Continued Some alternative methods have been utilized to try and establish an echoic repertoire when “standard” methods are unsuccessful What happens when attempts to establish an echoic repertoire are unsuccessful Program focus is shifted to non-vocal modalities of communication (eg. PECS) Referrals are made to other providers (Speech-Language Pathologists)

Introduction Continued Due to the nature of vocal targets, it is often impossible to directly evoke the correct response following the delivery of the S D Traditional prompting and prompt fading techniques are not applicable to most vocal responses There is little empirical literature addressing how to proceed with children who display severely deficient to no vocal repertoire

Collaboration Behavior Analysts are trained HOW to teach by utilizing the 3 term contingency: S->R->S Speech-Language Pathologists are trained WHAT to teach (i.e. developmental sequence of phonemes, speech/oral motor development).

Collaboration Continued This collaborative model relies equally on the principles of Behavior Analysis and behavior change and the science of speech/oral motor development In our opinion, the protocols and procedures cultivated from this model could not have been developed by behavior analysts or speech-language pathologists working individually

Characteristics of Participants Limited babbling/spontaneous vocalizations No obvious difficulty with non-vocal imitation Lack of progress with vocal imitation targets Utilizing PECS as primary mode of communication Diagnosis of autism Ages 2-3

Method-Participant 1 Oral Motor Imitation with ObjectsVocal Imitation/EchoicsEchoic to Mands

Oral Motor Imitation with Objects Introduced targets that would act as a bridge to production of specific phonemes Example: Wipe mouth with washcloth-bridge to /m/ Target List 1 Blow train whistle Wipe mouth with washcloth Chant Blow harmonica Lick lollipop Raspberry Lips

Oral Motor Imitation with Objects Target List 2 Blow train whistle  /h/ Wipe mouth with washcloth  /m/ Chant  /a/ Blow harmonica  /h/ Lick lollipop  tongue control Raspberry Lips  /p/ and /b/ Teaching steps Targets were introduced in groups of 2-3 Each target was presented in block trials of 5 Mastery Criterion-90% over 2 days, 80% over 3 days

Vocal Imitation Sounds targeted through Oral Motor Imitation with objects were introduced in vocal imitation in block trials of 5 Anecdotally, the OMI program increased visual regard for the Interventionist’s mouth when modeling vocal Imitation targets Additional targets were introduced that were not specifically targeted through the OMI program

Echoic to Mand Mastered vocal Imitation targets were introduced as manding targets 3 targets were introduced simultaneously Format as in Greer & Ross 2008

Method-Participant 2 Fine Discrimination with Non Vocal ImitationVocal ImitationEchoic to Mands & Tacts

Non Vocal Imitation Previously taught targets were re-taught requiring a response that more accurately mimics the S D A variety of new gross motor & action with objects targets were introduced incorporating finer discrimination Teaching Steps Imitation targets were introduced 1 or 2 at a time Errorless -> Error Correction Mastery Criterion-90% over 2 days, 80% over 3 days Increasing accuracy with less complex behavior chains (i.e. non-vocal imitation) would lead to the acquisition of imitation with complex behavior chains (i.e. vocal imitation)

Vocal Imitation Vocal imitation targets were reintroduced after several targets were mastered in the revised NVI Targets were selected based on a developmental sequence of phoneme acquisition Teaching Steps Target sounds were presented in block trials of 5 Each target sound was presented between trials per session Mastery Criterion-90% over 2 days or 80% over 3 days Mastered targets were presented in random rotation

Echoic to Mands & Tacts After mastery was achieved with various vowel and consonant vowel combinations in vocal imitation, targets were shifted to functional language programming Mand and Tact targets were introduced in the Echoic to Mand/Echoic to Tact format as described by Greer & Ross

Mastered Targets to Date Mands Read DVD Book Bubble Flip Tacts Dog Horse Sheep Hat Shoe Bed Waffle Apple Papa Tito Abu Tita Aba

Discussion We made the Discriminative Stimulus more salient via the use of objects and minor discriminations with motor imitation Participant 1-through pairing actions with objects with vocal targets Participant 2-through fine discrimination with non-vocal imitation targets Ongoing collaboration led to better and better refinements of the procedures Within the procedures continual problem solving was utilized When acquisition was not present sometimes it was a teaching issue and sometimes it was a speech issue

Discussion Continued Future Directions Collect experimental data to support our hypothesis Establish a “profile” to determine which procedure will be most effective with which children