Week 5 Review, ASD

TYPES OF MODELS

1) Adult Models 2) Peer and Siblings 3) Computer-based modeling programs 4) Animated modeling 5) Self as model

TYPES OF VIDEO MODELING

1) Adult/peer modeling 2) Watching adult or peer 3) Point-of-view modeling 4) View task through point of view of student 5) Self modeling 6) Support learner so that learner is doing skill

Overview of How to: Pivotal Response Training

1) PREPARATION 2) CHOICE 3) MIX IT UP 4) MULTIPLE CUES 5) CAUSE/EFFECT 6) SHAPE 7) NATURAL REWARDS

Video Modeling and Task Analysis

1) Talk with child or parents about what is to be highlighted. Make sure it is not used in how to be 'normal' but something that the child wants to learn or his parents feel is healthy for him/her 2) List the steps that need to be done to complete the actions you both have chosen. This is called task analysis. It outlines how the task should be done. It helps to observe someone doing the behavior and right down the steps.

MILIEU-LANGUAGE TEACHING Types

1. Child-Directed Modeling 2. Mand-Model Procedures 3. Time Delay procedures 4. Incidental Teaching

STEPS FOR TAPING

1. Have your actor or actors practice the steps on the task analysis until it is comfortable. 2. Locate the camera to highlight the important steps. If you are videotaping conversation make sure to get the facial expression and body language. 3. Eliminate distractions and background noise 4. Hold the camera steady or use a tripod. 5. Direct the actor to do everything slowly 6. Actors should be animated. 7. Consider including something motivating in the tape. This could be a t-shirt with Sponge Bob on it or a favorite person doing the acting. 8. Don't be afraid to have fun but make sure the focus is on what they want to learn!

Key Pivotal Behaviors of PRT

1. Motivation 2. Responsivity to Multiple Cues 3. Self-Initiations 4. Self-Management

4. Self-Management

Ability to independently monitor one's own behavior and respond without prompting.

Principle 4: Add more as child gets comfortable

Add multiple cues Add describing language Use gestures Use nonverbal cues

How to: Know when to reward and how much to support

Any attempt toward goal should be rewarded. Know we don't start out perfect! Be aware of how much support you are giving. Gradually reduce how much support you give

SCRIPTING

Autistic Adults think this is ableism since it teaches how to look normal. Takes routines of common sequence and makes a plan or a schema for a particular event. Children learn language for specific common contexts and the sequence of events. Particularly popular with socio-dramatic events Ends with fading

IMMEDIATE ECHOLALIA AND INTERVENTION

Break automatic pattern establishing conversational turn-taking pattern Asking question, saying the answer louder and repeating the question Using object cue Using gesture/sign cue Using visual cue

EXAMPLE OF BREAKING DOWN A BEHAVIOR (TASK ANALYSIS)

Brushing Teeth Materials: Toothbrush; water in a cup, pump toothpaste Pick up tooth brush Put tooth brush under toothpaste pump Push down on toothpaste pump Turn on cold water Put toothbrush under water Brush teeth (use song such as the Raffi song (https://www.nurseryrhymes.org/brush- your-teeth-song.html) or counting to brush long enough Pick up water Drink and spit Wash out toothbrush Put up on rack

How to: Language Use

Clear Avoid being to lengthy or too complex. Appropriate Keep on topic. Don't add extraneous information. Uninterrupted Avoid interruptions. Don't talk over long distances. Speak closely. Attentive Pause, give time for child to process and talk. Add excitement to voice.

NATURAL LANGUAGE PARADIGM INTERVENTIONS

Contemporary ABA Approaches

Delayed echolalia has been defined as the "echoing of a phrase after some delay or lapse of time" Taps into long-term auditory memory, May be a different phenomenon from immediate echolalia.

DELAYED ECHOLALIA

FUNCTIONS OF DELAYED ECHOLALIA (PRIZANT 1983)

Delayed Interactive Echolalia Turn taking-Utterances used as turn fillers in alternating verbal exchange Verbal completion-Utterances which complete familiar verbal routines initiated by others. Providing information-Utterances offering new information not apparent from the situational context (may be initiated or respondent). Labeling-Utterances labeling objects or actions in the environment.

Most echolalia has a specific communicative function. Determining the function of echolalia requires knowing the person and the communication context well. The more functions of echolalia is a positive sign that the child is moving to more spontaneous language. Children may go through what seems like a language regression as they move to more spontaneous language but in fact it is the beginning of analytic language production

ECHOLALIA

MILIEU-LANGUAGE TEACHING

Environmental arranging so it is motivating for the child and focused on goal is important in Milieu Natural language interventions such as Milieu, PRT, and Incidental Teaching have been found more effective and generalized than discrete trial training They are based on basic ABA behavioral techniques such as: Shaping Fading Differential Reinforcement

Noninteractive 1) Nonfocused-Utterances produced with no apparent intent and often in states of high arousal; may have a calming effect (e.g., fear, pain). 2) Rehearsal-Utterances used as a processing aid, followed by utterance or action indicating comprehension of echoed utterance 3) Self-regulatory-Utterances which serve to regulate one's own actions. Produced in synchrony with motor activity.

FUNCTIONAL CATEGORIES OF IMMEDIATE ECHOLALIA Noninteractive

Delayed Interactive Echolalia Protest-Utterances protesting actions of others. May be used to prohibit others' actions. Request-Utterances used to request objects. Calling-Utterances used to call attention to oneself or to Affirmation-Utterances used to indicate affirmation of previous utterance. Directive-Utterances (often imperatives) used to direct others' actions

FUNCTIONS OF DELAYED ECHOLALIA (PRIZANT 1983)

1. Child-Directed Modeling

Focus on child interest to establish JA Providing verbal model related to child's interests Natural reinforcement

2. Mand-Model Procedures

Focuses on child interest to establish joint attention Present verbal mand (instruction or request) Praise for correct response or prompts a more complex model (Shoot for natural praise within context)

3. Time Delay procedures

Focuses on child interest to establish joint attention Provide pauses that increase in duration before providing cues or models

4. Incidental Teaching

Focuses on child interest to establish joint attention Support child to produce more elaborate or complex language Support child in answering questions Cue child to initiate more elaborated request

There are disagreeing theories about why echolalia. This discussion will discuss the topic in a way that combines the approaches.

For instance, some people differentiate vocal stereotomy (VS) from echolalia by saying that VS has no relation to current context. In Dr. Diehl's opinion, this is difficult. Many utterances have idiosyncratic meanings that are often difficult to discern by immediate context.

OTHER NATURAL PROGRAMS NOT BASED ON ABA THAT WILL BE DISCUSSED LATER IN THE SOCIAL-EMOTIONAL CHAPTER

Hanen: More Than Words® http://www.hanen.org/Programs/For-Parents/More- Than-Words.aspx DIR/Floortime® https://www.icdl.com/dir The PLAY Project® https://playproject.org/about-the-play-project/ SCERTS® https://scerts.com/

1. Use visuals first to support verbal initiation. Start with low-constraint utterances. 2. Assess understanding and underlying functions of the echolalia. Watch mitigations carefully for progress. Look for sources of echolalia and gestalt utterances. This will help in search for functions. 3. Watch for echolalic in response to questions. 4. Insert joint-action-routines that vary into already established verbal routines that the child enjoys. 5. Scripting is controversial and should be used with care. 6. Be careful to conserve social closeness. 7. You need to advocate for appropriate understanding and teaching techniques for individuals showing echolalia.

IMMEDIATE ECHOLALIA AND INTERVENTION

Intervention is tied to functionWork on producing analytic language that reflects their real message Important to naturally send message that anything said out loud is interpreted as communicative by others Enter content of delayed echolalia when you can (i.e., "Nemo? You are thinking about Nemo?" ) Use comic strip conversation symbols to show difference between thinking and speaking

INTERVENTION FINAL THOUGHTS

Two basic types of echolalia

Immediate Delayed

Immediate ECHOLALIA

Immediate echolalia appears to tap into the person's short-term memory for auditory input. Immediate echolalia is defined as the repetition of a word or phrase just spoken by another person.

How to: Include Choice

Increases motivation. Use natural choices. Shared control promotes turn-taking.

3. Self-Initiations

Initiation increases independence and frequency.

FUNCTIONAL CATEGORIES OF IMMEDIATE ECHOLALIA Interactive

Interactive Turn taking-Utterances used as turn fillers in an alternating verbal exchange Declarative-Utterances labeling objects, actions, or location (accompanied by demonstrative gestures). Yes answer-Utterances used to indicate affirmation of a prior utterance. Request- Utterances used to request objects or others' actions. Usually involves mitigated echolalia.

MODELING

MODELING

ECHOLALIA

Most autistic children who are verbal go through a period of echolalia It is a positive sign that the person is able to imitate language. All children copy sounds, words, and eventually phrases and sentences that they hear adults use in specific, repetitive contexts. Autistic children tend to acquire language in the whole form rather than learning it in tiny chunks.

FUNCTIONS OF DELAYED ECHOLALIA (PRIZANT 1983)*

Non-Interactive DELAYED ECHOLALIA Nonfocused-Utterances with no apparent communicative intent or relevance to the situational context. May be calming. Situation association-Utterances with no apparent communicative intent which appear triggered by an object, person, situation, or activity. Self-directive-Utterances which serve to regulate one's own actions. Produced in synchrony with motor activity. Rehearsal-Utterances produced with low volume followed by a louder interactive production. Appears to practice for subsequent production. Label (noninteractive)-Utterance labeling objects or actions in the environment with no apparent communicative intent. May be a form of practice for learning language. The prime focus is to teach a communicative response that is more appropriate but answers the same function. The automatic echolalic response pattern also has to be diminished. Remember that habitual motor patterning has to be broken.

Rarely echolalia may have no intent or purpose

OR more frequently it has a very specific non-communicative purpose for the individual.

IN-VIVO MODELING

Observation of parents, siblings, teachers, and peers in modeling numerous behaviors. Attending is paramount Modeled behaviors should be cleared and exaggerated; consider a slower pace Watching and imitation promotes generalization

2. Responsivity to Multiple Cues

Overselectivity is common. Use multiple cues.

WHAT IS PRT EXACTLY?

Pioneered by Robert and Lynn Koegel Tasks of different Motivation and who combined difficulty Reinforcement research from: 1) Tasks of difficulty 2) Motivation and Reinforcement 3) Role of Choice

Because it is in natural setting, works on more than one skill and generalizes more than one skill (pivotal response). In conclusion, Pivotal Response Training (PRT) provides a guideline for teaching skills and has been most successful for language, play and social interaction skills in autistic children.

Pivotal Response Training (PRT)

How to: Connect with your child's behavior

Response should be immediate and appropriate. Make sure to reward correctness. Pay attention to attempts. Don't reward incorrectness. Even if the child is cute or funny.

How to: Presentation of Tasks

Start easy; get child on a roll! Increases motivation and self confidence. Maintains previous skills. Comment positively with excitement! Sprinkle in different levels of skill!

AFTER WATCHING FILM

Support the child when he/she tries to the behavior Tell other members of your child's team so that they can encourage too. Keep track of what your child does well and what is challenging. Use the tape to help you review it. Remember to be positive. "Wow you remembered to get the toothpaste and brush your teeth! I bet next time you will get the water."

VARIATIONS of Events in Video Modeling

Talk together about possible variations of events so the child has opportunities for flexible learning and thinking. If needed, video model possible variations for viewing after discussing with the child the variations Role play the variations so the child can use his/her knowledge in other setting

PIVOTAL RESPONSE TRAINING (PRT)

Targets increasing social-communicative repertoires and the child's responsiveness to the environment. Focuses not only on language, but also on motivation, self-regulation, responding to multiple cues, and self-initiation of social interactions

1. Motivation

The more motivate a child is, the more active participation.

Play based intervention Takes place in a natural environment The family is involved All members of the team know how to participate Treat many areas at one time ABA based Research supported

UNDERLYING IDEAS FOR PRT

How to: Presentation of Tasks *

Use natural joy when possible! Increases joint attention! Makes connections to what you are learning.

The focus of the video helps the attention of the autistic child on the relevant stimuli in the video. Supports understanding of what is involved and gives a suggested sequence Repeated viewings support the child's ability to learn the specific vocabulary associated with situations

VIDEO MODELING

WHO DOES IT WORK FOR?

Video Modeling has been shown to be effective for ages preschool to adult (The Autism Research Project, 2009; 2015). It will probably work best on children who watch television, screens, or videos but I have used itwith success with children who don't. I usually include familiar people in the video. The autistic child does not have to be in the video. Actors can be adults or other children. They are both effective.

WHAT IS VIDEO MODELING?

Video modeling is a really simple but effective idea. The child learns from a video showing something he/she would like to learn. The lesson can involve numerous targets such as shoe tying, conversation, or dressing. A simple way to get the whole picture. Provides a focus for attention for autistic children in a way that they enjoy.

TEACHING STEPS for Video Modeling

Viewing 1. Watch the video modeling particular target behaviors (e.g. conversational scripts, self-help skills, greeting, etc.) with the child 2. Help focus the attention of the autistic child on the relevant stimuli in the video 3. Pause video to highlight target behaviors and/or expressions 4. Rewind to review important parts. Talk to the child about what he/she is watching. 5. Watch it repeatedly. This will help the child get the big picture of the steps and the vocabulary that is with the targeted behavior.

WORKING WITH BEGINNING COMMUNICATORS WHO ARE VERBAL

WORKING WITH BEGINNING COMMUNICATORS WHO ARE VERBAL

Choices of Activity

What you are going to do In what order How long or how many

Environmental

Where to sit What to sit on Light on/off

Choices within activity

Which song or book What color Drawing Instrument

4) MULTIPLE CUES

• Give multiple cues •Change it a little verbally •Visual •Gestural

6) SHAPE

• Shape •Look for attempts •Know where you are in your support

2) CHOICE

•Activity •How long •Order •Environmental •Within Activity (song, book, color, writing implements)

1) PREPARATION

•Language •Attention •Clear •Appropriate •Uninterrupted

5) CAUSE/EFFECT

•Responses should be related to correct behavior or attempt to correct behavior

3) MIX IT UP

•Start easy •Mix it up with complex and easy tasks

7) NATURAL REWARDS

•Use natural rewards when possible •Make sure there is a connection to behavior