The Benefits of Including B.F.Skinner s Analysis of Verbal Behavior in Programs for Teaching Children with Autism

1. 1 The Benefits of Including B.F.Skinner�s Analysis of Verbal Behavior in Programs for TeachingChildren with Autism  Presented by: Vincent J. Carbone, Ed.D. BCBA Carbone Clinic Valley Cottage, NY National Autism Conference National Autism Association Myrtle Beach Convention Center Myrtle Beach, South Carolina November 10-13, 2005

2. 2 Introduction ? The application of behavioral principles to the learning needs of children with autism enjoys strong empirical and experimental support (Lovaas, 1987, Howard, Sparkman, Cohen, Green and Stanislaw, 2005) In recent years many behavioral practitioners have been influenced by the conceptual and experimental support leading to the inclusion of B.F. Skinner�s analysis of verbal behavior as a tool for guiding the teaching of language within the context of already exisiting applied behavior analytic (ABA) programs.

3. 3 Introduction Cont� ? Programs that have adopted Skinner�s analysis as a conceptual tool have been said to apply the �Verbal Behavior Approach� to intervention for children with autism. What I would like to do with the time I have available today is to provide you with a brief overview and description of the verbal behavior approach and then demonstrate through discussion and video illustrations the benefit that this approach promises for teaching language to children with autism.

4. 4 CHARACTERISTICS OF THEVERBAL BEHAVIOR APPROACH ? First of all, treatments based upon behavior analytic principles have been demonstrated to be more effective than other forms of intervention for children with autism. (Lovaas, 1987; Green, 1996) ? Consequently the verbal behavior approach uses behavioral principles in much the same way as other effective methods of intensive early intervention. These verbal behavior approach shares several characteristics with other intensive behavioral approaches, (Lovaas, 1987) such as the precise organization of the learning environments, emphasis upon early intervention, frequent daily training sessions, teaching both speaker and listener behavior and the use of discrete trial training methods (Carr and Firth, 2005.

5. 5 Michael, (2001) point out that many behavioral programs have not been influenced by Skinner�s (1957) analysis of verbal behavior and state ��that failure to make use of the technical concepts and principles that appear in B.F. Skinner�s (1957) Verbal Behavior seems inconsistent with the stated behavioral focus of many intervention programs.� ? Nevertheless, there appears to be growing interest in the application of Skinner�s analysis to the language problems of children with autism. ? Workshops on the topic draw many participants. Parents and practitioners have developed well subscribed internet list servers devoted to discussions of teaching verbal behavior to children with autism and an increasing number of practitioners are relying on the approach.

6. 6 What characterizes this approach? 1. First of all reliance on the same basic behavioral principles and independent variables that account for nonverbal behavior, e.g. evocative and function-altering stimuli such as motivative operations, reinforcement, stimulus control, etc. 2. Secondly, reliance on B. F. Skinner�s (1957) definition of verbal behavior as behavior that is reinforced through the mediation of another person�s behavior and therefore differentiates it from nonverbal responding. Any response form that is altered in strengthen through consequences provided by another person constitutes verbal behavior, e.g. pointing, speaking, picture exchange, manual sign, writing, etc.

7. 7 Thirdly, classification of language that identifies the verbal operant as the unit of analysis as opposed to the word or sentence and therefore makes less use of the descriptive terms of �ordinary language such as labels, requests, nouns, verbs, prepositions . . .� Sundberg and Michael, 2001, p.700) 2.Fourth, recognition of the differences in the controlling variables that differentiate one verbal operant from the other, e.g. echoic, mand, tact, intraverbal, etc. and therefore establishes their functional independence. This recognition suggests the use of stimulus control transfer procedures that are necessary to teach the multiple �meanings� of the same response units. (See Sundberg and Partington, 1998, for a practical guide to the elementary verbal operants).

8. 8 5. Fifth, language assessment that measures response units across verbal operants as opposed to �the traditional linguistic unit of words and meanings.� (Sundberg and Michael, 2001, p 705.) 6. And finally, reliance on the literature of topography and selection based verbal behavior to determine alternative communication methods for non-vocal learners.

9. 9 THE MAND BENEFITS OF TEACHING THE MAND ? Let�s now look at the first line of VB research and clinical applications I have chosen to discuss. ? Skinner (1957) defined the mand as �a verbal operant in which the response is reinforced by a characteristic consequence and is therefore under the functional control of relevant conditions of deprivation or aversive stimulation� (pp.35-36) The diagram below shows the controlling variables for the mand MO/Sd--------------- RESPONSE------------SPECIFIC CLASS REINFORCEMENT

10. 10 ? For example, when I am thirsty (deprived of water) only the delivery of water will strengthen the response that produces water. ? Consequently, any response that produces water through the mediation of another person under these conditions will receive direct and specific reinforcement and is therefore defined as a mand. ? Since the mand is the only verbal operant that directly benefits the speaker it may be the most easily acquired initially and with the greatest functional value to the language disordered child.

11. 11 ? Mand training during initial language teaching of children with autism is particularly important yet it does not always occur in remedial programs. Instead receptive language training, echoic training, and labeling drills are the initial focus of many programs. ? Notwithstanding these circumstances, it is clear that mand training can immediately begin to address the specific behavioral deficits that characterize autism as described in the DSM-IV. ? By definition children with autism: 1.engage in aberrant behaviors which interfere with their learning, 2. they fail to develop functional communication, and 3. they fail to develop appropriate social responses.

12. 12 Mand training immediately benefits persons with developmental disabilities by specifically targeting these core deficits. In fact, mand training has been shown to reduce problem behavior, increase spontaneous language and increase social initiations (Mirenda, 2003; Charlop-Christy, Carpenter, Le Blanc, and Kellet, 2002; Durand and Carr, 1991; Shafer, 1994.)

13. 13 HOW TO TEACH THE MAND ? Given the benefits of mand training in remedial language programs for children with autism, let�s discuss how to teach it. Mand training with children with autism requires the instructor to have a well developed repertoire of teaching skills, e.g. prompting, fading, shaping, differential reinforcement, etc. In addition, the effective teacher must have a conceptual and practical repertoire related to capturing and contriving motivation.

14. 14 ? Since the form of the mand is evoked by motivational variables an understanding of Michael�s (1982, 1988, 1993, 2000, 2001/2002) analysis of establishing operations (EOs), re-named recently (Laraway, Snycerski, Michael and Poling, 2003) to motivative operations (MOs), is critically important to effectively teach the mand. ? Michael�s (1993) two (2) part definition of the MO includes: an environmental event, operation or stimulus condition that affects an organism by momentarily altering (a) the reinforcing effectiveness of other events (REINFORCER ESTABLISHING OR ABOLISHING EFECT) and (b). alters the frequency of occurrence of that part of the organism�s repertoire relevant to those events as consequences. (EVOCATIVE OR ABATIVE EFFECT).

15. 15 ? In the case of unconditioned MOs it may be relatively easy to teach an appropriate mand for a food item to an early learner by merely waiting for the value of food items to become effective as reinforcement, e.g. just before meals. This type of mand training takes advantage of the second part of the definition (EVOCATIVE) with only minimal regard for the first (ESTABLISHING). However, a great deal of language is acquired and maintained by conditioned reinforcement and therefore a teaching repertoire related to the first part of the definition, REINFORCER ESTABLISHING OR ABOLISHING of conditioned reinforcement is necessary to teach a broad, varied and functional mand repertoire to children with autism.

16. 16 Teaching mands for conditioned reinforcers is an important skill that requires the instructor to arrange the learning environment to : 1.condition objects, actions and events as reinforcers, (ESTABLISHING) 2.then recognize when the MO is at an appropriate value, and 3.then prompt (EVOKE) the response and subsequently fade the prompts to control by the MO and audience. ? Failure to contrive motivation properly may result in verbal responses that have mand-like qualities but may actually be responses under the control of the availability of a generalized conditioned reinforcer and not specific to the MO that is usually associated with a specific response. Example: The learner asks for candy due to the reinforcing value of the teacher�s attention and not because candy is now effective as reinforcement.

17. 17 ? The practical steps to teaching mands once the MO has been established include stimulus control transfer procedures. The quick transfer procedure for teaching the mand as recommended by Sundberg and Partington (1998) includes these steps

18. 18 Let�s now look at video of instructors contriving motivation and teaching mands during early language training. In this first video note how Kelly must physically prompt this 12 year old boy�s hands to shape the sign for popcorn since he has very poor motor imitation skills. Prior to developing a mand repertoire Jimmy exhibited high rates of self-injurious and aggressive behavior and rarely approached others.  Note in the second video clip how Kelly has been able to fade her prompts to presentation of the item through the recommended stimulus control transfer procedures.

19. 19 In the third video clip, Kelly has established herself and other activities as conditioned reinforcers and is teaching the manual signs when the motivation is strong for items, activities and physical contact. In this fourth and fifth manding video demonstration Vincent�s vocal mands have been brought under the control of the relevant MOs and discriminative control of the �context� for certain activities, actions and food items.

20. 20 TEACHING ADVANCED MANDING  MANDING FOR ACTIONS AND MISSING ITEMS Advanced manding allows a learner to more effectively control the social environment. ? Teaching these skills to children with autism usually requires a sophisticated teacher repertoire related to the manipulation of the relevant motivative operations. ? In some cases the presence of one stimulus may increase the value of a second stimulus. For example, when it is important to retrieve an item from a locked closet (S-1) and the key is not to be found (S-2), the key is now established as a reinforcer and will evoke behavior that in the past has produced misplaced items, e.g. searching, asking someone where it is, etc.

21. 21 ? Michael (1993) named this type of independent variable a conditioned transitive MO. The conditioned transitive MO (CMO-T) plays an important role in teaching children with autism by increasing the number and variety of items that act as reinforcers and therefore increases the pool of mands that can be taught. Several researchers have demonstrated the benefit of contriving transitive MOs to teach mands to persons with developmental disabilities and autism (Carroll & Hesse, 1987; Hall & Sundberg, 1987; Sigafoos, Doss and Reichle, 1989; Sundberg, Loeb , Hale and Eigenheer, 2002; Sundberg & Partington, 1998) Let�s look at some video examples of applications of this research with children with autism.

22. 22 The diagram below illustrates the controlling relations that you will see in the first video example.

23. 23 ? Initial teaching of social skills with children with autism often requires the manipulation of relevant motivative operations Note in the next video clip how Andrew has learned to ask for Jimmy and Allison to join him in his favorite play activity; swinging in a manner he calls �bumpy�.

24. 24

25. 25 MANDING FOR INFORMATION ? Skinner (1957) states �A question is a mand which specifies verbal action�. ? In other words, there are stimulus conditions under which a verbal response (information) has been established as a reinforcer and therefore evokes a question (mand), the answer (verbal action) to which in the past has produced some form of reinforcement, e.g. more effective action by the asker.

26. 26 ? For example, if my hat becomes valuable as a piece of warm clothing (S-1) AND I discover that it is not to be found in its usual place (S-2), then information about its location will be established as a reinforcer and may therefore evoke the response �where is my hat?� since that response has previously produced information that directed me to my hat when it had reinforcing value. ? Sundberg, et al. (2002) demonstrated that mands for information regarding location (where) and specific information about a person (who) could be taught to children with autism by manipulating transitive establishing operations.

27. 27 ? Let�s now look at a video example of manding for information. Notice how the instructor must prompt some forms of the appropriate mands for information (questions) when the MO is strong but when the learner does not have the form of the response in his repertoire. As you watch the video, follow along with the diagram below which specifies the controlling nature of each stimulus in the chain of responses. In this video you will hear Diego mand information with the response forms why, where, how which and who. Notice the complex arrangement of motivational conditions that are necessary to evoke these responses and the precise timing of the prompts to teach the responses. Before watching the video lets look at the diagram below.

28. 28 CHAIN OF MANDS FOR INFORMATION Manding Why? S-1 Watching the video is effective as reinforcement S-2- Kim says to Diego �press stop� ESTABLISHES An explanation of her request as a reinforcer EVOKES Diego to say WHY? Reinforcer: Kim says: �Because we are going to go play with some toys�

29. 29 Manding Where? S-3- �Because we are going to play with some toys� ESTABLISHES Additional information about the location of the toys as a reinforcer EVOKES Diego to say WHERE? Reinforcer: Kim says �Over at the other table�

30. 30  Manding How? S-4 Placing parts on Mr. Potato Head is effective as reinforcement S-5 Diego tries but can not put the back pack on the to ESTABLISHESInstructions about how to do it as a reinforce EVOKESDiego to say with an echoic prompt �HOW DO I DO IT?�Reinforcer: Kim tells him how to do it.

31. 31 Manding Where? S-6 The nose on potato head is effective as reinforcement S-7- Diego can not find it ESTABLISHES Information about its location as a reinforcer EVOKES Diego to say �WHERE IS IT?� Reinforcer: Kim says �On the shelf

32. 32 Manding Which? S-8- Kim says �on the shelf� S-9 There are several shelves ESTABLISHES Information regarding a specific shelf as a reinforcer EVOKES Diego to say �WHICH ONE?� Reinforcer: Kim says �the one over there�

33. 33 Manding Where? S-10 The potato head eyes are effective as reinforcement S-11 Diego can not find them ESTABLISHES Information about the location of the eyes as a reinforcer EVOKES Diego to say �WHERE ARE THE EYES?� Reinforcer: Kim says �I don�t know but I know someone who does.

34. 34 Manding Who? S-12 Kim�s information about someone who knows ESTABLISHES Information about a specific person as a reinforcer EVOKES Diego to say with an echoic prompt �Who?� Reinforcer: Kim says �Emily. WATCH DIEGO VIDEO

35. 35 ? In this second video, Tyler�s repertoire of manding for information is now quite strong and therefore requires no prompting. The appropriately contrived MOs evoke all of the mands. Let�s watch this video of Tyler and note how Jimmy contrives the motivation that increases the value of information as a reinforcer for Tyler.

36. 36 THE ROLE OF AUTOMATIC REINFORCEMENT IN EARLY LANGUAGE ACQUISITION ? Criticisms of a behavioral account of language have focused on the apparent low rate of direct reinforcement for vocalizations produced by young children. ( Brown and Hanlon, 1970; Chomsky, 1959, Piaget, 1951) Schlinger (1995) suggests that these criticisms result from a general misunderstanding of the concept of reinforcement. Environmental consequences which are much more subtle than food, tokens or praise may play an important role in strengthening vocal behavior. Glances, smiles, touches and even continued question asking might well serve the function of reinforcement for children�s vocal responses.

37. 37 ? In his discussion of verbal behavior Skinner (1957) suggested that some reinforcement might be automatic in the sense that there are not any immediate external consequences. ? Michael and Vaughan (1982) state that automatic reinforcement ��is a natural result of behavior when it operates upon the behaver�s own body or the surrounding world�. What makes this form of reinforcement automatic is that it does not depend upon the mediation of another person. ? Specifically related to the development of vocal responding Skinner (1957) said �If someone repeatedly reinforces someone with the verbal stimulus RIGHT! we must not exclude the possibility of the speaker�s reinforcing himself in the same way. The young child alone in the nursery may automatically reinforce his own exploratory vocal behavior when he produces sounds he has heard in the speech of others.� (p.58)

38. 38 ? This two step process may play a significant role in the development of language of young children and appears to have important implications for the teaching of vocal responding in children with autism who do not acquire this repertoire typically. ? The two (2) step process is as follows: STEP 1. The speech sounds and words heard by young children are frequently conditioned as reinforcers by correlation with parent positive reinforcers (food, caresses, smiles, etc). STEP 2. Subsequent production of these sounds by the child is strengthened by the product of his/her verbal behavior in the form of auditory stimuli. The closer the sound production matches the sounds that have been conditioned as reinforcers the greater the reinforcement. (Sundberg, Michael, Partington, and Sundberg, 1996; Schlinger, 1995)

39. 39 Schlinger (1995) states that �automatic reinforcement is a plausible process that is imminently observable and testable�� (p.181) Palmer (1996) concludes that �The auditory feedback from one�s speech can play a special role for a speaker who is already a competent listener.� (p.289) What follows is a diagram of the stimulus-stimulus pairing procedure.

40. 40 PAIRING PROCEDURE Step 1 STIMULUS ---------------- STIMULUS (speech sound) Paired (reinforcer) Step 2 Speech Sound ------------What is Heard Produced Acts as Reinforcer

41. 41  In the last several years a few studies have experimentally verified the effects of this stimulus-stimulus pairing and automatic reinforcement and punishment process on the development of vocalizations of typical children and children with developmental disabilities. ? Stimulus-stimulus paring and automatic reinforcement and punishment produced by the response product has been experimentally demonstrated to increase and decrease vocalizations without the use of direct reinforcement or punishment in children with an existing repertoire of vocal behavior. (Smith, Michael, & Sundberg, 1996; Sundberg, Michael, Partington and Sundberg, 1996) Additional experimental research has extended these findings to children with very limited vocal repertoires (Yoon and Bennett, 2000) and children with autism (Miguel, Carr and Michael, 2002)

42. 42 ? Miguel et al. (2002) suggest that further demonstration of the practical benefits of this process when combined with direct reinforcement methods will be necessary for wide scale adoption by practitioners. In our clinical practice and research we have used the stimulus-stimulus pairing procedure to develop novel vocalizations and following Miguel et al.�s suggestion we have modified the process by simultaneously providing direct reinforcement to bring the target response under multiple echoic and motivational control. The higher frequency and variety of sounds produced through this process subsequently provides a large pool of vocalizations from which to select word approximations during mand and other verbal operant training. Moreover, the development of a generalized echoic repertoire allows for efficient transfer of stimulus control from the echoic stimulus to the motivative operation during mand training.

43. 43 ? Let�s watch a video showing the implementation of this procedure with a 20 month old boy with autism. James had no echoic repertoire and produced only a few sounds heard during babbling. This first video shows the early stages of the intensive stimulus-stimulus pairing process. You will see the teacher presents a vocal stimulus �cuh� and then immediately presents a second stimulus which had been determined to act as a reinforcer. Note how the response �cuh� was not under echoic or antecedent motivational control at this point. (SHOW SOUND DATA) Play Video

44. 44 ? In the second segment you will notice that after hundreds of pairings with positive reinforcers and direct reinforcement over several days the response �cuh� is now occurring at a high rate and even seemed to be functioning as a mand. Play Video

45. 45

46. 46 ? In the next video segment, notice how each of the phonemes taught during the stimulus-stimulus pairing procedure over several weeks were now easily established as echoic responses. The teacher is using the facilitative effects of a sequence of motor movements presented prior to the echoic stimulus. (Ross and Greer, 2002) PLAY VIDEO ? Finally, these sounds and word approximations established through the stimulus-stimulus pairing procedure were ultimately transferred to vocal mands under the control of motivational variables (Drash, High and Tudor, 1999)

47. 47 Manding with balls and Puzzle pieces ? After several months and extensive mand training and shaping of vocalizations note the relatively precise vocal tact repertoire of this now 27 month old boy. . Play Video

48. 48 CHOOSING AN ALTERNATIVE METHOD OF COMMUNICATIONFOR NONVOCAL LEARNERS ? A substantial number of children with autism are non-vocal and therefore require some type of alternative form of communication. The choice as to the type of communication response form to teach can be a difficult one. Skinner�s (1957) analysis of verbal behavior has helped to identify the issues that should be considered when making this important decision.

49. 49 ? The conceptual analysis offered by Michael (1985) suggests that the choices of an alternative method of communication are between a selection-based and topography-based forms of verbal behavior. ? Selection-based methods include picture, symbol, or icon selection or exchange methods as compared to topography-based methods that include gestures, manual sign, or writing. The conceptual analysis of these two (2) very different forms of communication favors the choice of a topography-based response form, e.g. manual sign. (Shafer, 1993) ? Research directly comparing the two (2) forms of verbal behavior however is limited and therefore empirical evidence strongly in support of one or the other is not available to the practitioner. ( For a review of the literature on this topic see Mirenda, 2003; Sundberg and Michael, 2001; Sundberg and Partington, 1998; Potter and Brown, 1997; Shafer, 1993; Sundberg, 1993; Sundberg and Sundberg, 1990.)

50. 50 ? The benefits derived from mand training with an alternative form of communication seem to be mainly related to the independent variables that affect the mand, stimulus-stimulus pairing and the MO. ? Given the conceptual analysis and the practical considerations of teaching mands to very active children who enjoy physical activity, who may be unwilling to carry picture symbols or electronic devices, who do not easily tolerate effortful response requirements and for whom efficient responding may be essential, manual sign language may be the best choice for many children with autism.

51. 51 ? Practitioners who choose manual sign as the alternative response form are frequently confronted with at least two (2) substantial challenges: 1. the requirement of prompting and shaping the signs of learners with poor motor imitation 2. development of a verbal community and audience of competent �listeners� of manual sign language. ? Neither one of these obstacles need stand in the way of developing an effective manual sign repertoire, however. ? Lets now look at some video of how signs can be shaped in young children with very poor motor imitation skills. In this first video you will see me physically shaping the first manual sign of a 2.5 year old boy with very poor motor imitation.

52. 52 ? Solutions to the problem of how to develop a community of effective signers and �listeners� of manual sign can be found. Lets now look at how teachers developed an appropriate verbal community for one 6 year old public school student with autism. Play Video

53. 53 CONCLUSIONS ? In a personal communication Mark Sundberg (2004) wrote �While clearly a substantial amount of research now exists, there is much more research that needs to occur before it could be said that the necessary and sufficient evidence for the empirical support of Skinner�s conceptual analysis of verbal behavior is available�. Given the empirical evidence that we currently have in support of Skinner�s (1957) analysis it appears that practitioner�s who provide services to children with autism have an obligation to develop a repertoire related to teaching verbal behavior.

54. 54 References Carr, J. & Firth, A. (2005) The verbal behavior approach to early and intensive behavioral intervention for autism: A call for additional empirical support. The Journal of Early and Intensive Behavioral Intervention, 2, 18-27. Carroll, R. J., & Hesse, B.E. (1987). The effects of alternating mand and tact training on the acquisition of tacts. The Analysis of Verbal Behavior, 5, 55-65. Charlop-Christy, M., Carpenter, M., Le, L., LeBlanc, L., & Keller, K., (2002). Using the Picture Exchange Communication System (PECS) with children with autism: Assessment of PECS acquisition, speech, social-communicative behavior, and problem behavior. Journal of Applied Behavior Analysis, 35, 213-231. Drash, P. W., High, R. L. & Tutor, R. M. (1999). Using mand training to establish an echoic repertoire in young children with autism. The Analysis of Verbal Behavior, 16, 29-44. Durand, V.M., & Carr, E. G. (1991). Functional communication training to reduce challenging behavior: Maintenance and application in new settings. Journal of Applied Behavior Analysis, 24, 251-264.

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