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Using the Verbal Behavior Approach to Teach Children with Autism


Using the Verbal Behavior Approach to Teach Children with Autism Mary Lynch Barbera, RN, MSN, BCBA May 2009 Autism One Conference – PowerPoint PPT presentation

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Title: Using the Verbal Behavior Approach to Teach Children with Autism

Using the Verbal Behavior Approach to Teach
Children with Autism
  • Mary Lynch Barbera, RN, MSN, BCBA
  • May 2009
  • Autism One Conference

My Autism Journey
  • July 2, 1999 Lucas was diagnosed with moderate
    to severe autism one day before his third
  • September 1999 Started 40 hours/wk ABA program
    with Lovaas consultant coming monthly.
  • June 2000 Founding President of Autism Society
    of Berks.
  • December 2003 Became a Board Certified Behavior
    Analyst and Lead Behavior Analyst for the PA
    Verbal Behavior Project.
  • May 2005 Published the results of a single
    subject multiple baseline study that I designed
    in The Analysis of Verbal Behavior.
  • May 2007 Publication of my book The Verbal
    Behavior Approach How to Teach Children with
    Autism and Related Disorders.

Lovaas Study
  • Published in 1987
  • 59 children (3 years age or under) diagnosed with
  • 19 received 40 hours/wk 11 ABA for 2 years
  • 20 received 10 hours/wk
  • 20 received standard special education
  • 47 of those receiving 40 hours/wk of treatment
    became indistinguishable from their peers by
    first grade

ABA as the treatment of choice
  • Applied Behavior Analysis (ABA) is the only
    scientifically validated treatment for autism and
    is recommended by the U.S. Surgeon General.
  • ABA treatment became popular in the mid-1990s
    when Catherine Maurice, a parent of two children
    with autism who both recovered from autism
    using this approach, published two books
    detailing Lovaas type ABA therapy.

An Overview of ABA
Applied Behavior Analysis (ABA)
  • Definition
  • Applied behavior analysis is the science in
    which procedures derived from the principles of
    behavior are systematically applied to improve
    socially significant behavior.
  • (Cooper, Heron, and Heward)

Basic Principles of ABA
  • Behavior is defined in objective and measurable
  • Examines the functional relationship between
    behavior and its controlling variables
  • Analyzes socially significant behavior in need of
  • Analyzes behavior through a three term

Three Term Contingency
  • Antecedent--Behavior--Consequences
  • ABC
  • Also Described As
  • Discriminative Stimulus--Response--Consequence
  • MO/SDRReinf. or Punish.

Basic Behavioral Principles
Antecedent - any stimulus that happens before a
behavior Behavior - an observable and measurable
act of an individual Consequence - any stimulus
that happens after a behavior
Three (Really Four) Term Contingency
  • Antecedent--Behavior--Consequences
  • Motivation is now seen as playing a significant
    role in this model (Michael)

Examples of Three Term Contingency
  • Touch nose Child touches nose receives
    piece of cookie
  • Do Puzzle Child falls to floor Demand

You use the principles of ABA all day long!
  • ABA is used to
  • Increase positive behaviors
  • Language, self care skills, academic skills.
  • Decrease negative behaviors
  • Tantrums, biting, kicking, crying

1000 Activity
  • Think of a child you know with challenging
  • If I gave you 1000 for that child to have a
    good day with little to no problem behavior,
    what would you do?

Pick one or two target behaviors
  • Select the target behavior to be reduced by
  • The seriousness of the behaviorif could injure
    self or otherstarget these before behaviors such
    as hand flapping or poor attention.
  • The frequency of the behavior

Define Setting Event
  • Aspects of a persons environment or daily
    routine that do not necessarily occur immediately
    before the behavior.
  • Medication adjustment
  • Medical problems (pink eye, diaper rash)
  • Sleep problems
  • Eating routines/diet
  • Number of people in room
  • Daily schedule (how predictable/how much choice)

Immediate Antecedents
  • What triggered the behavior
  • What happened immediately before problem
    behavior started
  • Computer was turned off
  • Told child to hang up coat
  • Child saw candy and wanted it

Using the principles of ABA to reduce problem
  • Define Behavior----Be Specific!!
  • Kicking his feet against the chair, throwing
    books, biting his own fingers, hitting his head
    with his fist.
  • NOT Having a tough time, frustrated, irritable

  • Reinforcement
  • A consequence that results in increasing or
    maintaining the future rate of behavior it
  • Punishment
  • A consequence that results in decreasing the
    future rate of behavior it follows.

  • Any behavior that occurs repeatedly is serving
    some useful function and producing some type of

  • After a behavior has occurred the environment can
    change in several ways
  • 1. A neutral event can happen if nothing happens
    that is relevant, the consequence will likely
    have no effect on the behavior.
  • 2. Things can get better if things get better,
    the behavior will likely occur again under
    similar conditions. This is called reinforcement.
  • 3. Things can get worse if things get worse, the
    behavior will likely not occur again under
    similar conditions. This is called punishment.

Things Get Better Reinforcement
  • Reinforcement is a change in the environment
    following a behavior that increases the future
    probability of that behavior under similar

Things Get Worse Punishment
  • When things get worse following a behavior, the
    behavior is less likely to occur in the future
    under similar circumstances. This is punishment.
  • Punishment decreases the likelihood of behavior
    Reinforcement (including negative reinforcement)
    increases behavior.

Is Time Out a Reinforcement or a Punishment?
  • Need to look whether time out is increasing or
    decreasing the frequency of the target behavior.
  • Most people think Time Out is a punisher but it
    functions as a reinforcement for many children.

Take Data To Identify the A, B, and C
  • Without taking baseline date and identifying the
    antecedent, behavior, and consequence, it is not
    wise to implement a behavior reduction strategy

Functions of Problem Behavior
  • To obtain something desirable (Attention,
    Tangibles, Sensory Stimulation).
  • To avoid or escape something undesirable (Task

Antecedent Interventions
  • Changing the environment before the behavior
    occurs to prevent the behavior.
  • Focus on pairing/manding
  • 8 positives to every negative
  • Reconfigure class layout or ratio
  • Give more or less time at a center
  • Get more sleep at night or nap
  • Eat breakfast or serve snack earlier
  • Provide transition warnings

Reactive Interventions
  • Interventions implemented after problem behavior
  • Some examples
  • Count and Mand (use for attention only)
  • Planned Ignoring (use for attention only)
  • Time Out (use for attention only)
  • Work through Demand (use for escape only)

Count and Mand
  • Explained in Chapter 2 of my book
  • Used for access to tangibles/attention only!
  • Can also use count and give choice, count and R,
    or count and give attention.
  • Steps
  • Stop the problem behavior (hands down, be quiet,
    no kicking)
  • Silent count to 3, 5, or 10if problem behavior
    resumes, return to 1.
  • Prompt the mand cookiechild echoes cookie
    Righthow do you ask?child responds
    cookie.deliver R.

Combined Approach
  • Spend 95 of your time preventing problem
  • When negative behaviors do occur, use reactive
    intervention consequences at the moment.
  • Count and Mand
  • Planned Ignoring
  • Time Out
  • Work Through Demand

If you find yourself using reactive interventions
  • You need to continue to take data or re-start
    data taking to determine setting events,
    antecedents and functions of target behavior
  • Your demands might be too high and/or
    reinforcement might be too low
  • The environment might need to be changed

Three things that matter no matter what the age
or functioning level!!
  • Problem behaviors at or near 0
  • Ability to request wants and needs to an
    unfamiliar adult
  • Independent toileting
  • 2-minute activity

Case Studies
  • Case Study 1 
  • Amys mother reports that Amy is a poor sleeper.
    Each Monday morning she arrives to daycare and
    begins to play. When she is called to circle,
    Amy cries and throws herself to the ground. The
    staff tries to find something less aversive to
    Amy and usually tries bouncing Amy on the ball to
    get her calm. Amy does usually quiet down on the

Case Study Questions
  • What might be a setting event?
  • What is the immediate antecedent?
  • What is the behavior?
  • What is the consequence?
  • Does the consequence serve as a Reinforcer or

Case Study 1 (cont.)
  • Will the behaviors likely go up or down?
  • What is the most likely the function of Amys
  • What are some interventions you would recommend
    to help reduce Amys negative behavior

Using ABA and Verbal Behavior (VB) to Increase
Positive Behaviors
  • Increasing language and learning skills using the
    principles of ABA and B.F. Skinners Analysis of
    Verbal Behavior

What is Verbal Behavior?
  • Behavior that is reinforced through the mediation
    of another persons behavior

Applied Behavior Analysis
Direct Instruction
Verbal Behavior
Discrete Trial Teaching
Intensive behavioral Intervention
Lovaas Therapy
Incidental Teaching
Precision Teaching Fluency Based Instruction
Dual Path of Applied Behavior Analysis Research
LOVAAS (UCLA) ABA Research Plus Discrete Trial
Training (structure)
MICHAEL (WMU) ABA Research Plus Discrete Trial
Training Plus Skinners Analysis of Verbal
Behavior (function)
Common terms for the Verbal Operants
  • Mand request
  • Tact label
  • Intraverbal conversation, answering a question,
    responding when someone else talks
  • Echoic repeating what someone else says
  • Receptive or Listener Responding following

What is Coffee???????
  • Is it a
  • MAND?
  • TACT?

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Verbal Operants
Verbal Operant Antecedent Behavior Consequence
Mand Motivative Operation (wants cookie) Verbal behavior (says cookie) Direct reinforcement (gets cookie)
Tact Sensory Stimuli (sees or smells cookie) Verbal behavior (says cookie) Non-specific reinforcement (gets praised, for instance)
Intraverbal Verbal stimulus (someone saysWhat do you eat? Verbal behavior (says cookie) Non-specific reinforcement (gets praised, for instance)
Echoic Verbal Stimulus (someone says cookie) Verbal behavior repeats all or part of antecedent (says cookie) Non-specific reinforcement (gets praised, for instance)
Receptive (actually not a verbal operant) Verbal stimulus (someone says touch cooke) Non-verbal behavior (child touches cookie) Non-specific reinforcement (gets praised, for instance)

Verbal Behavior Activity
As a result of One has a tendency to This is a
Seeing a grape Saying grape
Hearing a horn Saying truck
Someone saying what says moo? Saying cow
Wanting a push on the swing Saying push
Being told to stand up Standing up
Someone winnie the Saying pooh
Someone says potty Saying potty
Seeing a stranger Saying whats your name?
Seeing a tree Saying tree
Two other related skills
  • Imitation Given another persons motor action in
    the antecedent condition, the child performs the
    same action.
  • Match to Sample matching activities involving
    either identical or non-identical items. (This is
    a very simplistic definition for a very critical
    skill area also referred to as conditional

Teaching the Mand

Why Teaching Mands is Important
  • It helps children avoid frustration in
    communicating their needs and wants
  • It is relatively easy to do because you are using
    the childs own motivation as a tool
  • It is a natural first step in teaching

The Mand(Requesting)
  • All mands have one thing in common in the
    antecedent condition, there is a Motivative
    Operation (or motivation) in place.
  • A thirst (MO)
  • B I want juice
  • C student gets juice
  • If a child does not want the item, you cannot
    teach them to mand for it.

Examples of contriving an MO
  • Holding up an MM within eyesight of the child
  • Giving the child a bottle with a tight lid. In
    the bottle is his favorite toy.
  • Giving the child a bowl of cereal with no spoon.
  • Giving the child a toy that requires batteries
    but withholding the batteries
  • Briefly turning on his or her favorite video.
  • Giving a bit of his or her favorite snack to
    another child.

When Negative Behaviors Occur During Mand Training
  • Do not reinforce whining/crying or other
    negative behaviors
  • Count and Mand
  • Child has to learn that crying will not get them
    anything.appropriate manding will!

Keep Number and Effort of Demands Low at First
  • Carefully assess skills
  • Gradually fade in more difficult tasks
  • Avoid escape oriented behaviors effort and
    demands should always be outweighed by easy
  • Make demands low at first deliver reinforcement
    much more often than you ask the child to perform

The Assessment Of Basic Language and Learning
  • The ABLLS

Structure Of ABLLS
Daniels ABLLS A-H
Daniels ABLLS I-R
Daniels ABLLS S-Z
Masons ABLLS
Recommendations for Mason 1/5/05
  • Matching Identical Objects/Pictures (F/3)
  • Increase Verbal Imitation using Mand
  • Work on Fill-ins with songs
  • Baseline Labels
  • Set up Mand Sessions (2) 10-minute sessions/day
  • Keep demands low (VR 3 or 4)

Recommendations for Mason2/25/05
  • Puzzles/easy toys (shape sorter)
  • Matchingstart categories make sure he knows
    tacts of exemplars
  • Prompt him to request actions and missing items
  • Baseline labels (buy flash cards)
  • Mix 80 easy to 20 hard w/VR 3
  • Continue teaching songs
  • Play doh and coloring
  • RFFC to TFFC to IFFC with item as answer
  • Count and Mand for access to tangibles

Lillys ABLLS
VB MAPP--Lucas
Language Barriers--Lucas
Recommendations for Lucas
  • Intensive teaching and NET sessions
  • VR 15 (with 80 easy/20 hard)
  • Teach prepositions/pronouns
  • Teach manding for attention/information
  • Edmark reading program
  • Teach coin and time identification
  • Leisure and self care skills

Thirteen Intervention Tips
  • Thirteen tips based on the science of ABA and BF
    Skinners analysis of Verbal Behavior that you
    can start using immediately with all children and
    adults with language delays and disorders

1 Be Positive
  1. Be Positive! Use 8 positives for every negative.
    Dont overuse the childs name especially when
    saying no or placing a demand

2 Pairing
  • 2. Pair yourself and the environment with
    reinforcement by giving the child lots of
    reinforcement with no effort required .

3 Giving Directions
  • 3.    When giving a child a direction
  • Simplify the language
  • Make sure you are close enough and loud enough
    for him to hear.
  • Get down to childs level to get childs
  • Only give directions you can make the child do
  • Give the instruction only once and, if no
    response, prompt the child to complete the task.
  • Dont give the child a direction youre not
    willing to follow through with

4 Reinforcement
  • 4.Look for things that reinforce the child. Set
    up high interest activities bubbles, water
    play, balls, wind up toys to see if any of these
    are motivators. Put these things out of reach
    so the child needs you to get them.

5 Mand Training
  • Teach the child to communicate his needs and
    wantsfirst by pulling, reachingthen by using
    sign language, pictures, or words. Teach 3-5
    signs at a time.

6 Matching
  • Teach the child to match items and pictures.
    Label the item instead of using the command
    match or put with same.

7 Imitation
  • 7. Teach imitation skills.
  • With objects/toys.
  • Gross motor.Pick 2 or 3 movements to target at
    the same time. Provide as much prompting as
    needed to ensure the child is successful.

8 Receptive Skills
  • 8.    Teach receptive skills.
  • Touch body parts, items or picturespick 2 or 3
    receptive skills provide as much prompting as
    needed to ensure the child is successful.

9 Give Directions You Can Prompt
  • 9. Since you cant force a child to
  • speak, do not use say______ if
  • the child cannot speak or if this is
  • a hard skill. (Say cookie, cookie,
  • cookie as you deliver a small
  • piece of cookie)

10 Teach Fill-ins to Songs
  • 10.   Use music and familiar nursery
  • rhymesleave the last word of
  • each line blank to see if child
  • fills it in.

11 Sabotage Daily Life
  • Sabotage daily life to see if child
  • notices/indicates/or requests
  • Give cup without juice.
  • Cereal without spoon.
  • Coming upstairs, do not turn off music.
  • Spill milkdont clean it up immediately.
  • Go a different route in the mall.

12 Do Not Reinforce Problem Behavior
  • 12. Do not respond whining, kicking,
  • screaming and other negative
  • behaviors.
  • For problem behavior related to access to
  • attention/tangibles
  • Walk away, Ignore, or use the Count and Mand
  • For escape related problem behavior
  • Ignore problem behavior and continue demand

13 Prevent and Correct Errors throughout the
  • Instructor Points to an apple and says
  • What is it?
  • Child bird.
  • Instructor What is itapple
  • Child echoes apple
  • Instructor Right, what is it?
  • Child apple
  • Instructor Presents 2-3 easy demands and
  • then what is it?
  • Child apple

Some Take Home Pointsfor Use With All Children
(and Adults)
  • Pairing
  • Manding
  • Once the child can mand for items, ease in
    demands gradually
  • Prevent and Correct Errors throughout the day
  • Dont reinforce problem behaviors

(No Transcript)
  • Thank You!
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