1. C enter for A utism and R elated D isorders, Inc. Using ABA to Teach Children with Autism CARD Austin January 16, 2005 Rachel S. F. Tarbox, PhD Center for Autism & Related Disorders, Inc.

2. Overall Objectives Review of “What is Autism?” Introduction to ABA Some basic applications  How to teach skills to children with autism 3-step training Task Analyses

3. What is Autism? is Autism?

4. What is Autism? 1. Social Interaction  Failure to develop peer relationships  Impairment in use of non-verbal behaviors (e.g., gestures, eye contact)  Lack of seeking to share enjoyment 2. Communication  Delay or lack of spoken language  If have language, deficient conversational skills  Repetitive use of language  Impaired make-believe play 3. Restricted repetitive & stereotypic behavior patterns  Routines / rituals  Repetitive motor mannerisms Diagnostic Criteria for Autistic Disorder DSM-IV, 1994

5. What is Autism? Deficits  Language  Play Skills  Social Skills  Perspective Taking / Theory of Mind  Executive Function  Motor Skills & Self Help  School Skills Excesses  Stereotypy / Self- Stimulatory Behavior  Non-compliance  Tantrums  Aggression  Self-Injury From a behavioral perspective, what can we observe?

6. WhatisABA?

7. Applied Behavior Analysis (ABA) Definition  The application of the principles of behavior to issues that are socially important to produce practical change Some applications  Special Education  Regular Education  Pediatric Medicine  Treatment of troubled teens  Sports Psychology  Business & service organizations  Early intensive treatment for children with autism

8. Core Principle The consequences that follow a behavior influence whether that behavior will increase or decrease  Why do we go to work?  Why do we stop at red lights?  Why do we use oven mits?  Why do our children do what we ask them to do? Applied Behavior Analysis (ABA)

9. Core Principle Continued The Law of Effect: Behavior that is rewarded will be strengthened Behavior is Lawful, Observable, Measurable We can change behavior by manipulating its antecedents and consequences ABC Model (Antecedent-Behavior-Consequence) Applied Behavior Analysis (ABA)

10. Using the Principles of Behavior Analysis

11. Over the past 30 years, several thousand published research studies have documented the effectiveness of ABA across a wide range of:  populations (children and adults with mental illness, developmental disabilities and learning disorders)  interventionists (parents, teachers and staff)  settings (schools, homes, institutions, group homes, hospitals and business offices), and  behaviors (language; social, academic, leisure and functional life skills, self-injury, and stereotyped behaviors) Application to individuals with autism is only one aspect with it’s own set of techniques based on the same principles used with other individuals in other settings Applications of ABA

12. 3-Step Compliance (TELL-SHOW-DO)

13. Three step-guided compliance is a prompting strategy that teaches your child what you want him/her to do by providing a model and physical guidance if he/she does not do what you asked them to do. This procedure does not allow your child to avoid requests If you use this procedure consistently, you should find that your child becomes more compliant and requires less assistance to complete tasks over time 3-Step Compliance

14. TELL-SHOW-DO Demands: first prompt given for a particular task Prompts: all additional statements, gestures, or physical guidance displayed by the caregiver during demands 3-Step Compliance

15. 1.State your child’s name. 2.Tell your child what to do. Never ask. 3.State the request clearly so that your child knows exactly what he/she is supposed to do; keep requests as brief and as specific as possible. 4.Wait 5 to 10 seconds for your child to carry out the request. Do not repeat the request. 5.If your child complies provide them with praise. State exactly what they did that you liked. 6.If your child does not comply, repeat the request with a demonstration. 7.Wait 5 to 10 seconds for your child to carry out the request. Do not repeat the request. 8.If your child complies, provide a small amount of praise. 9.If your child does not comply, physically guide them but do not provide praise. Always use the minimum amount of physical contact necessary for the request to be completed. 10.Never “give in” or complete the request yourself. Once you give your child a request, they must follow through. 3-Step Compliance

16. Back to our A-B-C’s How does 3-step fit the A B C model? What is the A? What is the B? What is the C? Why will it work? What are some potential problems with it? 3-Step Compliance

17. Back to our Core Principle Behavior is Lawful, Observable, Measurable We can change behavior by controlling its antecedents and consequences Easier said than done, what about complex behaviors that require a number of steps (and as such a number of antecedents and consequences)? Task Analysis

18. What is a Task Analysis Task Analysis: Break down a complex behavior into a sequence of identifiable single components We need to use chaining Task Analysis

19. Task Analysis Example: Teaching Self-Help Skills Chaining must be used to teach self-help skills Why do we use chaining?  To combine simple behaviors or responses into a more complex sequence For example: –Getting dressed –Washing hands –Brushing teeth –Taking a bath

20. Self Help Skills EatingDressing Hand Washing Brushing Teeth Brushing Hair Toileting

21. Question? What is the most important pre-requisite skill for teaching self-help skills?  Answer: COMPLIANCE What have we learned about increasing compliance?  Answer: 3-STEP! So we are ready to learn about TA’s

22. Chaining: Step 1 Perform a Task Analysis A Shirt flat on bed Shirt in hands Scrunched shirt in hands Shirt on over head Head & arms in shirt B Pick up shirt Scrunch shirt Put head through collar Put arms in sleeves Pull shirt down Example: Hannah needs a shirt

23. Chaining: Step 1 Perform a Task Analysis A Dirty hands Faucet on Wet hands Soap on hands Foamy hands Clean wet hands Water off B Turns on faucet Wets hands Gets soap Rubs hands together Rinse hands Turn off water Dry hands on towel Example: Thomas washes his hands

24. Chaining: Step 2 Build the chain Once a task analysis is performed and the required steps of the sequence are identified, the chain can be taught The chain can be constructed of behaviors already in the child’s repertoire New behaviors can also be taught within the process of the chain

25. Task Analyses: Methods of Chaining Forward Chaining In a sequence of A’s and B’s the 1 st B is taught, then the 2 nd, then the two are performed independently in order Then the 3 rd B is taught & performed in sequence with the previous 2 B’s The behaviors in the chain continue to be taught sequentially until they are performed independently

26. Chaining: Step 1 Perform a Task Analysis A Dirty hands Faucet on Wet hands Soap on hands Foamy hands Clean wet hands Water off B Turns on faucet Wets hands Gets soap Rubs hands together Rinse hands Turn off water Dry hands on towel Example: Thomas washes his hands

27. Forward Chaining Forward Chaining Example Thomas washes his hands…. Use 3-STEP to teach Thomas to 1.) Turn on the faucet 2.) Wet his hands Guide all the succeeding B’s in the chain When Thomas can perform the first 2 B’s independently in order, begin to teach 3rd B & so on…

28. Forward Chaining A Dirty hands B Turns on faucet Example: Thomas washes his hands C = REINFORCE

29. Forward Chaining A Dirty hands Faucet on B Turns on faucet Wets hands Example: Thomas washes his hands C = REINFORCE

30. Forward Chaining A Dirty hands Faucet on Wet hands B Turns on faucet Wets hands Gets soap Example: Thomas washes his hands C = REINFORCE

31. Forward Chaining A Dirty hands Faucet on Wet hands Soap on hands B Turns on faucet Wets hands Gets soap Rubs hands together Example: Thomas washes his hands C = REINFORCE

32. Forward Chaining A Dirty hands Faucet on Wet hands Soap on hands Foamy hands B Turns on faucet Wets hands Gets soap Rubs hands together Rinse hands Example: Thomas washes his hands C = REINFORCE

33. Forward Chaining A Dirty hands Faucet on Wet hands Soap on hands Foamy hands Clean wet hands B Turns on faucet Wets hands Gets soap Rubs hands together Rinse hands Turn off water Example: Thomas washes his hands C = REINFORCE

34. Forward Chaining A Dirty hands Faucet on Wet hands Soap on hands Foamy hands Clean wet hands Water off B Turns on faucet Wets hands Gets soap Rubs hands together Rinse hands Turn off water Dry hands on towel Example: Thomas washes his hands C = REINFORCE

35. Conclusion Remember the CORE PRINCIPLE Think about the A B C’s Reinforce the good stuff and do not reinforce the bad stuff Use 3-STEP as a tool Break down complex activities into steps (do a Task Analysis!) BE CONSISTENT HAVE FUN!!!!!!!!! Questions???