1. Indiana University South Bend Partnership for Behavior Change
Closing the Bathroom Door: The Effect of Teaching a Categorization Task on a Crucial Safety Behavior
Shelley Gorski, BA
Sorah Stein, MA, BCBA, CSE
Indiana University South Bend
And
Partnership for Behavior Change
Introduction
Results
During instruction, the learner started to acquire the conditional discrimination at week 4 and mastered it at week 10. We added the open doors at week 18.
For the closing of physical doors, after the start of instruction, a prompt delay was implemented; when the client entered either a bathroom or the daily living skills room he was given 10 seconds to independently shut the door before prompt was given. Following this, more independent door closures were recorded, however, due to inconsistent prompting, snow days, and medication changes, regression occurred. During this time the client also began scratching his groin area intermittently, and while he often went to the bathroom to do so, he did not close doors. We next attempted to induce generalization by placing an enlarged picture of the door used in the instructional protocol on the physical doors in the center that he would need to close; he started to close doors with fewer prompts at week 4 following this intervention. Our final intervention was to include open doors in the conditional discrimination task, in addition to increasing his fluid intake due to weather. This had an almost immediate effect of significant increase in independent door closures. Tests for emergent relations failed to indicate that we established equivalence.
Many individuals with intellectual disabilities do not receive adequate sexuality education (Swango-Wilson, 2008). Studies that assess sexual knowledge and experience (Mehzabian & Stokes, 2011; Stokes & Kaur, 2005) indicate that individuals with intellectual disabilities have poor social behavior, do not sufficiently engage in privacy behaviors, have less sexuality education, and engage in more inappropriate social and sexual behavior than people with physical disabilities and those without disabilities. Nichols & Blakely-Smith (2009) indicate that there are insufficient studies assessing the sexuality education needs of those with intellectual disabilities. The few studies that have been conducted, such as Zylla & Demtral (1981) and Swango-Wilson (2008) indicate the need for more effective and appropriate education towards the development of healthy sexuality and decreasing vulnerability to exploitation impacting individuals with intellectual disabilities. Unfortunately, the majority of generally available sexuality education curricula are too complex for and do not meet the needs of learners with intellectual disabilities (Gougeon, 2009; Grievo et al., 2006). Because sexuality is part of who each person is, and healthy sexual behavior is so important, sex education should be seen as part of individualized education or person centered support plan. Assessment should be completed so that each person has individually tailored education, with measureable goals and objectives (Lumley & Scotti 2001). When teaching various skills to individuals with intellectual disabilities, we often use categorization tasks and develop concepts, such as animals, foods, and the weather.
Miguel, et al. define categorization or classification as “the process of determining how to group objects or events together” (2008, p.383). Then, the grouped objects form a category or class. They define concepts as units of representation – groups of objects that control similar responses, or stimulus classes. In the present study we examine the use of pictures from BoardMaker® and Communicating About Sexuality® in a categorization task, with the goal of teaching concepts of open-door and closed-door. The researchers sought to determine if teaching sexuality education concepts via a picture matching, categorization task results in 100% mastery of the concepts and generalizes to a daily task.
Method
The study took place in an Autism center over the span of 5-months. The participant was a 15-year-old boy who did not close doors for toileting or masturbation. Previous attempts to teach him to close doors included verbal and gestural prompts, but were unsuccessful. The learner worked one-on-one with several male and female ABA therapists from 12:30 pm to 6 pm, daily. Each day the open door-closed door program was completed at least once. Each time the participant entered either a bathroom or the Daily Living Skills room, data were collected on whether a prompt was needed to close the door. The data sheet used for these purposes included time of day, staff working with the individual at the time, and the room in which the behaviors occurred, and the prompt required.
Baseline data were collected to determine the learner’s current knowledge of body parts and activities that permit open doors versus those that require closed doors. Additional baseline data were collected to determine the frequency with which the learner independently closed doors when needed. In the training task the instructor presented the learner with two pictures, one each of private and non-private body parts /activities of daily living. The learner placed a picture of a closed door atop the picture that represented the body part or activity requiring a closed door. After the learner mastered this conditional discrimination (Sidman,1994), because he did not yet generalize to closing physical doors, we added pictures of open doors for discrimination in both directions. Data were collected on the number of items correctly discriminated as open door or closed door with mastery set at 100% correct across 3 days and therapists. Data collection continued for independent closure of doors to determine the effect of the instructional program on the learner’s behavior. Probes for emergent relations were conducted.
Daily data for match-to-sample task
Daily data for closing doors
Discussion
Results suggest that teaching conditional discrimination was effective in that it generalized to the learner’s environment, such that he now more reliably closes doors as needed. Before discrimination was taught the participant left the door open when engaging in behaviors considered private acts.
Previous research indicated that some individuals with intellectual disabilities do not consistently engage in adequate privacy behaviors (Mehzabian & Stokes, 2011; Stokes & Kaur, 2005). Not closing the door limited the learner’s privacy and made him potentially vulnerable to exploitation in public settings, while simultaneously potentially exposing other learners to unwanted visual stimuli. Teaching this skill allowed for more independence and better safety skills for the learner and consequently increased community access. These findings suggest a possible teaching method for improving privacy skills with individuals with intellectual disability.
This study was completed with only one participant, future research with multiple participants would offer better validity.
Gougeon, N.A. (2009). Sexuality education for students with intellectual disabilities, a critical approach: Outing the ignored curriculum. Sex Education, 9(3),
Grieveo, A., McLaren, S., & Lindsay, W.R. (2007). An evaluation of research and training resources for the sex education of people with moderate to severe learning disabilities. British Journal of Learning Disabilities, 35,
Lumley, V. A., & Scotti, J. R. (2001). Supporting the Sexuality of Adults with Mental Retardation: Current Status and Future Directions. Journal of Positive Behavior Interventions, 3 (2),
Miguel, C.F., Petursdottir, A.I., Carr, J.E. & Michael, J. (2008). The role of naming in stimulus categorization by preschool children. Journal of the experimental Analysis of Behavior 89 (3),
Sidman, M. (1994). Equivalence relations and behavior: A research story. Authors Cooperative.
Stokes, M.A. & Kaur, A. (2005). High-functioning autism and sexuality. Autism, 9(3),
Swango-Wilson, A. (2008). Caregiver perceptions and implications for sex education for individuals with intellectual and developmental disabilities. Sexuality and Disability, 26,
Zylla, T. &Demetral, G. D. (1981). A Behavioral Approach to Sex Education. Sexuality and Disability, 4 (1),
The authors wish to thank Dr. Bobby Newman for input on procedure that resulted in success of this study.