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Teaching Joint Attention to Children with Autism

February 9, 2018 Leave a comment

Joint Attention – Why it is Important and How it Can be Taught to Children With Autism

Sridhar Aravamudhan

(The author is a Board Certified Behavior Analyst working with Behavior Momentum India. The views in this blog are his own. I hope to keep in mind parents and therapists as I write and will try to keep the jargon to a minimum. Do feel free to contact me via smbehavioranalysis@gmail.com)

In very simple terms, Joint Attention involves two persons attending to an object or an event with the purpose of sharing an interest. This happens all the time such as when

  • Two teens spot the third one with a new hairdo and one of them exclaims “isn’t that weird”.
  • A child points out a helicopter flying overhead to parent and says ‘chopper’,
  • One person in a group going on safari sights a tiger, taps his friend’s shoulder and gestures in the direction of the tiger.
  • When two commandos on a mission spot an enemy patrol and one of them uses his hand to signal caution.

Joint attention begins at a very young age and plays an important role in a typically developing child’s language acquisition (Baldwin,1995). For instance, the correct linking of words to objects, events and features in this world are learned by parent facilitation with attending behavior and gestural feedback. The child says “big elephant” when one such stomps on the screen and the parent readily smiles, looks at the screen, looks at the child and says “ Huge, isn’t it”.

Children with autism can have serious deficits with joint attention and social referencing and this has been documented in many studies (MacDonald etal., 2006). In very simple terms, Joint Attention involves two persons attending to an object or an event with the purpose of sharing an interest. A series of behaviors are involved in joint attention such as looking at an object or stimulus in the environment, shifting gaze to another person, calling for their attention and asking them to attend to the same thing with a “look”. Social referencing a related skill which involves scanning and adults face or voice, identifying the expression and modifying own behavior based on the same. For example, when a child picks up a crumb the floor and looks at the adult, if the adult shows an expression of disgust the child could put the crumb away and not eat it. On another occasion, the child could throw a ball towards the adult because of signs of encouragement seen. In typically developing children, the linkage between objects in the environment, the words used to denote them and several language and pragmatic skills are acquired through joint attention and social referencing. Hence it becomes important to teach these skills to standard to children with autism as they are pre-requisite component skills for language and communication development.

Carolyn Walker and Rebecca Mac Donald presented a paper in Association for Behavior Analysis 43rd convention in May 2017 on teaching social referencing to toddlers with autism. The idea was to teach the children to approach a novel item if the adult smiled or otherwise indicated it is ok to approach and avoid if the adult wore a negative facial expression. This could be an important life skill, the authors explained. For example, while approaching something dangerous like a hot stove they should learn to look at an adult and see if it is ok or not ok to proceed. In their procedure, they hid a toy under a basket in a set of ‘joyful’ trials when the therapist wore a joyful expression. The child would reach for the basket and be rewarded with toy. In an alternating set of trials the therapist would wear a fearful expression and if the child reached for the basket it would a) find nothing b) the therapist put the basket away and c) removed attention for 10 seconds. They used a combination of Time delay and differential reinforcement to teach appropriate responding. Once the child learnt to discriminate when to reach and when not to, they conducted generalization probes with other types of containers and different people. The results showed that social referencing, which involves gaze shifting from basket to therapist and reaching or not reaching for the basket based on the therapist’s expression could be taught to toddlers with autism.

Brianna Holohan and Rebecca MacDonald(2017)  too made an interesting paper presentation in the same convention, on training parents and therapists to teach three children with autism who were less than 3 years old. Three joint attention behaviors were selected – pointing to pictures in a book with gaze shift to adult, showing an item to adult with gaze shift and making choices with gaze shift. They could show that video modeling with voiceover narration, written text and screenshots with feedback was effective in training both parents and therapists to run the teaching procedures with good fidelity. Only written instructions, on the other hand, were not effective.

Joint attention and social referencing are interdependent and important foundational skills.  Readers can also refer to an article by Jan Blacher and Stacy Lauderdale (see selected references at the end) on additional targets in the realm of joint attention and some pointers on how to teach these.

 

References

Baldwin, D.A. (1995). Understanding the link between joint attention and language. In C. Moore & P. J. Dunham (Eds.), Joint attention: Its origins and role in development (pp. 131-158). Hillsdale, NJ: Lawrence Erlbaum. Google Scholar

Blacher, J., & Lauderdale, S. (2010). Do You See What I See? Joint Attention and Its Importance

in Autism. Exceptional Parent40(11), 38-40.

MacDonald, R., Anderson, J., Dube, W. V., Geckeler, A., Green, G., Holcomb, W., … & Sanchez, J. (2006). Behavioral assessment of joint attention: A methodological report. Research in Developmental Disabilities27(2), 138-150.

Holohan and MacDonald (2017). Training Therapists and parents to implement Joint Attention Procedures, Powerpoint Presentation at the 43rd Annual Convention of Association for Behavior Analysis International, Denver.

Walker & MacDonald (2017), Teaching Social Referencing to Toddlers with Autism, Powerpoint Presentation at the 43rd Annual Convention of Association for Behavior Analysis International, Denver.

 

 

 


		
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Updated Part 3 – Teaching Discrimination to Children with Autism and Overcoming Error Patterns

September 22, 2017 Leave a comment

The author is a Board Certified Behavior Analyst working with Behavior Momentum India. The views in this blog are his own. I hope to keep in mind parents and therapists as I write and will try to keep the jargon to a minimum. Do feel free to contact me via smbehavioranalysis@gmail.com

In parts 1 and 2 of this series, we saw the various examples and types of errors children with autism and learning disabilities make.  In the concluding part of this series, we will see some proven strategies to overcoming error patterns while teaching receptive language.

 

Don’t be too sure that the child ‘knows’ – do a counterbalanced assessment with distractors

Firstly it is important not to be satisfied with a confident assertion that the child ‘knows’ and has acquired the targeted discrimination. The first is done by performing a thorough assessment with the target items and distractors counterbalanced across all positions and across the number of times asked for.

For example, if you are testing for discrimination between say a,b and c ( or tiger/ leopard/panther or cup/spoon/ fork for that matter) then a minimum of 18 trial probes will be needed.  a, b and c should appear in each of the three positions in the array equal number of times and the instruction asking the child to select a,b or c should be done an equal number of times for each one in each position. This will help us find out if there is a  position bias in the students responding, a dominant item response or other errors such as win-stay errors.  An example of a counterbalced array is as below for assessments.

Array Position of stimuli Ask For Observer 1 Observer 2
Left Mid Right SD
1 yellow PINK brown   brown
2 PINK yellow brown PINK
3 brown yellow PINK yellow
4 yellow brown PINK yellow
5 brown PINK yellow brown
6 PINK brown yellow yellow
7 brown yellow PINK PINK
8 PINK yellow brown yellow
9 yellow PINK brown yellow
10 yellow brown PINK PINK
11 PINK brown yellow PINK
12 brown yellow PINK brown
13 PINK yellow brown brown
14 brown PINK yellow yellow
15 yellow brown PINK brown
16 brown PINK yellow PINK
17 PINK brown yellow brown
18 yellow PINK brown PINK

I once had a heart-rending situation.  Mom was confident that ‘Of course, my child knows his mom’. With due permissions, I ran a test. when there were 3 ladies, one of them being mom standing at random distances from the child we asked the child to give some item to mom, he would go and give it to the nearest person. The results were not much better when they were equidistant or when we instructed the child to “go to mom”. While the child would engage in play and singing with rhymes and other manners of sharing affection with her, he could not respond based on the instruction, “give this to mom” or ” go and touch mom”

Don’t be too sure that the student ‘knows’ – Are there some inadvertent prompts :

To rule out the possibility of inadvertent prompts a parent or therapist may be giving, it is important to have other people conduct the same set of assessments. If the child succeeds with everyone with a scientific assessment then it is possible to conclude that the discrimination is acquired. If the child is not able to make correct selections at more than chance rate ( only 33% of the times correct when an array of 3 stimuli is used and child is asked to select one randomly) with other people then either there is a failure to generalize, or, more likely the discrimination acquired is faulty.

Re-cap: error patterns exist if:

■Selection is right sometimes – wrong sometimes “ inconsistent”

■Response starts before instruction is given ( the student is basing responses on some ‘rule’ other than listening to you and selecting’)

■Child attends to /looks at a particular stimulus before instruction is given ( Sometimes instructors instruction coincides with child’s pre-selection)

■Responding occurs  without scanning  ( but some do respond well without directly looking)

■Escape behaviors happen  during receptive ID tasks

The first step is to ensure correct level of  discrimination in target selection :It is not a good idea to train fine or nuanced discriminations if grosser discriminations are not in place – Example – subtle shades in colors, words such as meet/ meat , sew/ sue, concept of honest vs dishonest/ b,d,p,q .

Some strategies to overcome error patterns in teaching receptive language/  discrimination tasks:

No one procedure is guaranteed to work. but if you give considerable thought to the various options you have and if you are prepared to be flexible and if you take data on correct responding and errors under different strategies you will soon find what would work. For a full tutorial read Grow and LeBlanc (2013) – they have put it all together in the form of a tutorial. You will still need a guidance from an experienced Behavior Analyst for children with severe discrimination problems

  • get an observing/ attending  to the stimuli   before  the student responds :
    • Prompt to attend to the therapist – ” look at me” / other attention getting tactics before issuing instruction
    • It can be a simple prompt to look at each of the stimuli
    • A prompt to attend to a critical feature – match stripes before asking to select zebra from an array of zebra, horse, and deer.
    • student echoes  the instruction to confirm that he has heard it right ( Instructor says “zebra”, student says “zebra” and then proceeds to select Zebra from an array of 3 animals
    • Non-vocal children can make a sign corresponding to the instruction and proceed to make a selection
    • In fine discrimination exercises, example ‘b’ vs. ‘d’ – answer first whether the semi-circle is to the right of the line or to the left
  • Minimize inadvertent prompts from parent or therapist such as
    • eye gaze prompts – look directly at learners face and avoid looking at stimuli while giving instructions
    • A relaxing of facial features when student hovers over the right selection
    • small movements of therapists hands or eye movements
    • patterns of instruction ( example always ‘cow’ first, ‘horse’ second and ‘zebra’ third; position-wise – Right, middle, left)
  • Introduce multiple targets simultaneously – over teaching one may make it difficult to introduce new targets
  • By rotation, cover each target equal number of times within a session
  • Introducing sequentially is not recommended as teaching in isolation, simple discrimination is not likely to help with acquiring subsequent discriminations ( Grow et al., 2011, Gutierrez et al., 2009)
  • Use at least an array of 3 unless you are targeting opposites- with 2, the student has a 50% chance of being right anyways !
  • Improve Behavior consequence – A strong reinforcer for correct response And a loss of privileges or delay to reward – guided by Fisher, Pawich, Dickes, Paden  & Toussaint (2014).
  • If there is a position or side bias – counteract with more trials with success in other positions or increase array size
  • If there is a long history of errors with certain targets consider starting with a new set of targets  altogether

If the responding demonstrates improved discrimination, you are on the right track. Otherwise be flexible, look at the rate of correct and error responses across sessions and with professional guidance attempt an alternate strategy.

Happy teaching discrimination.

Selected References

 

Fisher, W. W., Pawich, T. L., Dickes, N., Paden, A. R., & Toussaint, K. (2014). Increasing the saliency of behavior–       consequence relations for children with autism who exhibit persistent errors. Journal of applied behavior analysis47(4), 738-748.

Grow, L., & LeBlanc, L. (2013). Teaching Receptive Language Skills. Behavior analysis in practice6(1), 56-75

Part 3 – The Errors we See- Discrimination challenges in children with autism and Learning Disabilities

September 21, 2017 2 comments

The author is a Board Certified Behavior Analyst working with Behavior Momentum India. The views in this blog are his own. I hope to keep in mind parents and therapists as I write and will try to keep the jargon to a minimum. Do feel free to contact me via smbehavioranalysis@gmail.com

In parts 1 and 2 of this series, we saw the various examples and types of errors children with autism and learning disabilities make.  In the concluding part of this series, we will see some proven strategies to overcoming error patterns while teaching receptive language.

 

Don’t be too sure that the child ‘knows’ – do a counterbalanced assessment with distractors

Firstly it is important not to be satisfied with a confident assertion that the child ‘knows’ and has acquired the targeted discrimination. The first is done by performing a thorough assessment with the target items and distractors counterbalanced across all positions and across the number of times asked for.

For example, if you are testing for discrimination between say a,b and c ( or tiger/ leopard/panther or cup/spoon/ fork for that matter) then a minimum of 18 trial probes will be needed.  a, b and c should appear in each of the three positions in the array equal number of times and the instruction asking the child to select a,b or c should be done an equal number of times for each one in each position. This will help us find out if there is a  position bias in the students responding, a dominant item response or other errors such as win-stay errors.  An example of a counterbalced array is as below for assessments.

Array Position of stimuli Ask For Observer 1 Observer 2
Left Mid Right SD
1 yellow PINK brown   brown
2 PINK yellow brown PINK
3 brown yellow PINK yellow
4 yellow brown PINK yellow
5 brown PINK yellow brown
6 PINK brown yellow yellow
7 brown yellow PINK PINK
8 PINK yellow brown yellow
9 yellow PINK brown yellow
10 yellow brown PINK PINK
11 PINK brown yellow PINK
12 brown yellow PINK brown
13 PINK yellow brown brown
14 brown PINK yellow yellow
15 yellow brown PINK brown
16 brown PINK yellow PINK
17 PINK brown yellow brown
18 yellow PINK brown PINK

I once had a heart-rending situation.  Mom was confident that ‘Of course, my child knows his mom’. With due permissions, I ran a test. when there were 3 ladies, one of them being mom standing at random distances from the child we asked the child to give some item to mom, he would go and give it to the nearest person. The results were not much better when they were equidistant or when we instructed the child to “go to mom”. While the child would engage in play and singing with rhymes and other manners of sharing affection with her, he could not respond based on the instruction, “give this to mom” or ” go and touch mom”

Don’t be too sure that the student ‘knows’ – Are there some inadvertent prompts :

To rule out the possibility of inadvertent prompts a parent or therapist may be giving, it is important to have other people conduct the same set of assessments. If the child succeeds with everyone with a scientific assessment then it is possible to conclude that the discrimination is acquired. If the child is not able to make correct selections at more than chance rate ( only 33% of the times correct when an array of 3 stimuli is used and child is asked to select one randomly) with other people then either there is a failure to generalize, or, more likely the discrimination acquired is faulty.

Re-cap: error patterns exist if:

■Selection is right sometimes – wrong sometimes “ inconsistent”

■Response starts before instruction is given ( the student is basing responses on some ‘rule’ other than listening to you and selecting’)

■Child attends to /looks at a particular stimulus before instruction is given ( Sometimes instructors instruction coincides with child’s pre-selection)

■Responding occurs  without scanning  ( but some do respond well without directly looking)

■Escape behaviors happen  during receptive ID tasks

The first step is to ensure correct level of  discrimination in target selection :It is not a good idea to train fine or nuanced discriminations if grosser discriminations are not in place – Example – subtle shades in colors, words such as meet/ meat , sew/ sue, concept of honest vs dishonest

discrimination applicators-2022599_1280

 

Some strategies to overcome error patterns in teaching receptive language/  discrimination tasks:

No one procedure is guaranteed to work. but if you give considerable thought to the various options you have and if you are prepared to be flexible and if you take data on correct responding and errors under different strategies you will soon find what would work. For a full tutorial read Grow and LeBlanc (2013) – they have put it all together in the form of a tutorial. You will still need a guidance from an experienced Behavior Analyst for children with severe discrimination problems

  • get an observing/ attending  to the stimuli   before  the student responds :
    • Prompt to attend to the therapist – ” look at me” / other attention getting tactics before issuing instruction
    • It can be a simple prompt to look at each of the stimuli
    • A prompt to attend to a critical feature – match stripes before asking to select zebra from an array of zebra, horse, and deer.
    • student echoes  the instruction to confirm that he has heard it right ( Instructor says “zebra”, student says “zebra” and then proceeds to select Zebra from an array of 3 animals
    • Non-vocal children can make a sign corresponding to the instruction and proceed to make a selection
    • In fine discrimination exercises, example ‘b’ vs. ‘d’ – answer first whether the semi-circle is to the right of the line or to the left
  • Minimize inadvertent prompts from parent or therapist such as
    • eye gaze prompts – look directly at learners face and avoid looking at stimuli while giving instructions
    • A relaxing of facial features when student hovers over the right selection
    • small movements of therapists hands or eye movements
    • patterns of instruction ( example always ‘cow’ first, ‘horse’ second and ‘zebra’ third; position-wise – Right, middle, left)
  • Introduce multiple targets simultaneously – over teaching one may make it difficult to introduce new targets
  • By rotation, cover each target equal number of times within a session
  • Introducing sequentially is not recommended as teaching in isolation, simple discrimination is not likely to help with acquiring subsequent discriminations ( Grow et al., 2011, Gutierrez et al., 2009)
  • Use at least an array of 3 unless you are targeting opposites- with 2, the student has a 50% chance of being right anyways !
  • Improve Behavior consequence – A strong reinforcer for correct response And a loss of privileges or delay to reward – guided by Fisher, Pawich, Dickes, Paden  & Toussaint (2014).
  • If there is a position or side bias – counteract with more trials with success in other positions or increase array size
  • If there is a long history of errors with certain targets consider starting with a new set of targets  altogether

If the responding demonstrates improved discrimination, you are on the right track. Otherwise be flexible, look at the rate of correct and error responses across sessions and with professional guidance attempt an alternate strategy.

Happy teaching discrimination.

Selected References

 

Fisher, W. W., Pawich, T. L., Dickes, N., Paden, A. R., & Toussaint, K. (2014). Increasing the saliency of behavior–       consequence relations for children with autism who exhibit persistent errors. Journal of applied behavior analysis47(4), 738-748.

Grow, L., & LeBlanc, L. (2013). Teaching Receptive Language Skills. Behavior analysis in practice6(1), 56-75

The Errors we See- Discrimination challenges in children with autism and Learning Disabilities – Part II

The author is a Board Certified Behavior Analyst working with Behavior Momentum India. The views in this blog are his own. I  hope to keep in mind parents and therapists as I write and will try to keep the jargon to a minimum. Do feel free to contact me via smbehavioranalysis@gmail.com

In Part 1 of the series we saw the types of discrimination challenges and issues we run into when teaching children with autism or other learning disabilities.  These are often a part of larger error patterns that children acquire inadvertently because of the way materials are used, the way responses may be prompted or the way they are reinforced. In this second part, we will look at inspecting and understanding error patterns. In part III we will look at strategies to avoid and overcome them.

Most of the receptive language tasks involve :

  • the teacher presenting an array of 3 or more items, asking for one of them
  • prompting and fading prompts if the child does not know the correct response
  • and rewarding ( reinforcing)  correct responses and ignoring incorrect responses.

Several potential errors creep in depending on how the training procedures are run.  Step one, in most cases, we must recognize that the student may not really interested in acquiring the discrimination between purple and Red or Tall and short. We believe, these are useful and functional and set up the teaching environment while the student could only aim to get a reward with minimum effort. The reward can be a preferred item or activity given by the therapist for correct responses or just completing the task as fast as possible and getting away from it all ( Technically. these are called reinforcers that increase future occurrence of the behavior that they follow) !! Behavior Analysts, both researchers, and practitioners have, in studies since the 1960s documented the kind of errors that could happen and newer and newer strategies are still being researched for improving outcomes. Laura & Grow ( 2013), have published a great article which details the type of errors that occur in teaching receptive language and strategies to overcome them.

Most parents and therapists miss the first step- recognizing that there is a problem. After doing a few tests it is very easy to be deluded into believing that the child ‘knows’ what is being taught though he sometimes makes incorrect responses. Some of the error patterns and how they creep in are discussed below:

I bet on a position ( Dominant position bias):

When you place pictures or dolls of cat, dog, and cow in an array and ask for one, say ‘cow’,  the student could adopt several strategies to complete the task which does not require him/her to listen carefully and make a correct selection – One is a position bias. As a student, I go for one particular position more often,  for example, the right most. Soon the therapist/mom inadvertently starts placing the target item there more often in that position, for, after all, the therapist or mom is also rewarded by students correct responses. The mistakes that happen when the target item is in other positions are overlooked and attributed to the student being ‘inconsistent’. In such a strategy, the student can completely avoid paying attention to what the instructor/ therapist/parent is asking to be selected( Technically called the Auditory stimulus presented by an adult which should serve as a discriminative stimulus for the student response).

I bet on a particular target item ( Dominant Response Bias):

Using the same example, possibly because I was taught ‘cow’ first and reinforced several times, even when the new targets of dog and cow are introduced I keep selecting cow more often regardless of what I am asked to select. On the occasions when I am correct, I get rewarded. Sometimes, this too could result in the teacher/ therapist asking for ‘cow’ more often creating an illusion of successful discrimination!

I bet on a familiar looking item :

There was a student who could identify spoon, cup, pen, socks, fork, lunch box, toy, and nearly a dozen such items from an array of 5 different objects. He never made a mistake until his teacher started presenting the array with 2 or more from his ‘known’ list. Then he started making mistakes. In the earlier procedure, the student merely had a rule that is something like ” If I see that familiar one, I will go for it”.

I respond based on body language or other inadvertent cues from the teacher:

While teaching receptive language the teacher may be inadvertently supplying additional cues which indicate where the correct responses lie. The student can be sometimes seen intently looking at the teachers face before selecting the item asked for. Some inadvertent prompts could be

  • the therapist’s eyes  dart at the target item before she asks for it (called eye-prompts or eye-gaze prompts)
  • the target item could be placed closer to the child than the other items, as the student’s hand hovers over an incorrect response the therapist’s features are taut and they relax as he switches to the correct response midway
  • the teacher uses exaggerated intonation correlated to a specific target ( Biiiiiig vs small, nineteen versus nine) but does not fade such intonation prompts.

Switching bias :

The student, after being asked to select big, switches the next response to small ( even if ‘big’ is asked for again) because historically his therapist has always switched the target from the previous teaching trial.

Random responding:

Here the student randomly selects any item without regard to what was asked. Afterall,  in an array of 3, he could be successful 33% of the times and that is fine!

Stimulus Overselectivity:

Stimulus over-selectivity or attending to one part of an item to the exclusion of all other parts of the whole could result in errors. For example, a child who looks only at wheels may find discrimination between a car, a truck and a van difficult.

Generalization Problems:

While discrimination is acquired with specific items taught it has not generalized to novel items 0r contexts.

Laura and Grow in their 2013 article talk about several evidence based strategies to avoid errors and teach receptive identification to children with autism.   These include counterbalanced assessments and presentations, requiring an observing response, avoidance of instructor errors, use of simultaneous targeting versus introducing targets one by one and use of appropriate array sizes.  In addition, Fisher, Pawich, Dickes, Paden and Toussaint (2014) conducted a very important study that explains how and why it is important to manage the consequences of correct responses in relation to errors ( they call it managing the behavior-consequence salience for children with autism who present persistent errors).

We will discuss these strategies to over come error patterns in part II of this blog series.

 

Selected References

Grow, L., & LeBlanc, L. (2013). Teaching Receptive Language Skills: Recommendations for Instructors. Behavior Analysis in Practice6(1), 56–75.

Fisher, W. W., Pawich, T. L., Dickes, N., Paden, A. R. and Toussaint, K. (2014), Increasing the saliency of behavior-consequence relations for children with autism who exhibit persistent errors. Journal of Applied Behavior Analysis, 47: 738–748. doi:10.1002/jaba.172

The Errors we See- Discrimination challenges in children with autism and Learning Disabilities – Part I

July 22, 2017 1 comment

The author is a Board-Certified Behavior Analyst and works with Behavior Momentum India as a Research Associate, Faculty in teaching Applied Behavior Analysis course sequence and trains therapists who work with children with autism. He attempts to avoid jargon to make topics in Applied Behavior Analysis intelligible to parents of children with autism and learning disabilities, students, and therapists. The views in this blog are his own. This is the first blog and is expected to run into 3 parts because of the vast amount challenges in teaching receptive language to children with autism and recent advances.

David is a 4-year-old boy with developmental disabilities. One day his mom was excited. She was working at training identification of everyday objects from a small array of 3 different objects and he seemed to get it right with 7-8 objects such as a spoon, cup, top and fork wherever they are placed in an array. At the ABA center he went to during the day, his case manager was surprised by mom’s report. At the center, David would only get his identifications right only 25- 30% of the time, around a chance level of success, as if he were selecting randomly. He requisitioned videos of sessions from home and played them a few times over and found that a simplified array of stimuli was being used. There would be the target object, selecting which produced rewards and two other objects such as scissors and crayon that the parent never asked. David had figured that he needs to go for the spoon or the cup whenever they appeared in the array- he did not have to listen to what was asked for and make a discriminated selection. When probed with spoon, cup, and fork in the same array, hi correct selections dropped to chance levels as now the correct response depended on his selection also tallying with what the adult asked for.


Girls who buy nail polish need to know the difference between two shades that are close to each other in appearance- one could be “just her type” and another one not so! Children with autism and learning disabilities often have serious problems mastering discrimination tasks. One of the reasons is making a selection based on one element or feature of an object instead of attending to all the parts. This is called stimulus over selectivity. For instance, a child whose attention is only on wheels may not be able to identify a car if a truck and a van are also present in the array of vehicle pictures. Examples of making a response based on attending to an incorrect part abound. Discrimination training procedures involve the use of rewarding correct responses, prompting and prompt fading procedures and may inadvertently result in responses with errors or prompt dependence.

Let’s look at some more examples of errors. At a simple level, let us say a student is taught to respond to the instruction “touch head” by touching his or her own head. When “touch elbow” is introduced as a next target, the student could proceed to touch his head as soon as he hears the word “touch”. Similar problems exist with training to answer questions such as “what is your name” and  “What is your mother’s name”. The response “David” could be blurted out as soon as “what is” is heard. A child who is taught to answer “air” when asked what does fan give could reply with “air” when asked what does cow give”. It is quite possible that the “what” or “give” part of the question controls the students answer of “air” and not the “fan” or “cow”.

At a certain stage of learning, generalization must stop and discrimination must set in. There could also be a problem of over generalization without discrimination setting in (or being taught). A child taught to request for “hug” from parent’s could request hug from complete strangers. A child who is taught to say “daddy” with her dad’s picture (let’s say dad sports a beard in the picture) starts labeling other pictures of persons with a beard also as “daddy”. Many children on the spectrum who perform discriminative tasks with nouns well, fail when it comes to discriminating even between the basic colors of red, blue, green and yellow. I have come across students who do a perfect job of matching red card to card, blue card to blue card and so on. However, when they are asked to point at the red card or the yellow card or the blue, in an array that has all these cards things start going wrong. There is some other discrimination issue at work here. Discrimination challenges are part of everyday life with all humans. Husbands could buy the wrong gift on the anniversary day, a writer, could place too many, commas in his sentences, or cops could overlook important evidence at the crime site and obsess with non-essentials while the criminal is thriving and on the run. However, with children with autism and other learning disabilities, these problems acquire serious proportions across several areas of their learning and the error patterns could become stronger confounding parents and therapists.
Behavior Analysts use research based methods to identify error patterns, understand why they could occur in discrimination training and use specific strategies to overcome these.I will look forward to examining additional error patterns and the current state of research on how they can be overcome in the next parts of this series on discrimination training.

Your queries will help me reflect further. Do send them to smbehavioranalysis@gmail.com

Errorless learning is the way- time to think outside trial and error

Trial and error learning is often counterproductive and too often we cannot afford the cost of errors especially when teaching children with learning disabilities. The proponents of trial and error learning will show you the example of throwing a baby into water without any training and behold! it swims!!!!. This is not an entirely  accurate proposition as babies may have certain reflex actions in their repertoire that may look like they are born with an ability to swim but it  is not true. such an attempt would be downright dangerous and irresponsible. Check out http://www.babycenter.com/404_is-it-true-that-babies-are-born-with-the-ability-to-swim_10313062.bc

We see examples of the danger and disasters that trial and error learning cause all around us. Recall the girl who, while learning to reverse crashed her car into a pillar in the basement and could never learn to drive after that. Do you not come across hundreds of children who ” hate math” ? Well they tried to learn by trial and error  and came across failures that stunt learning. If this is the case with typically developing chidren ( and adults) the problem with errors is much higher in children with learning disabilities trying to learn a new skill. If you have tried to teach them or have observed them being taught and you find that they engage in escape behaviors, fright reactions , aggression or behaviors suggestive of anxiety it is very probable that error rates are high. The necessary pre-requisites for successful performance may be missing or some irrelevant aspects of teaching procedures could be dictating the child’s response.These are also true about typical population where students fail in exams or people fail in their jobs without adequate training.

Dr. Murray Sidman, a pioneering behavioral scientist in  a 2010 publication argues that the typical learning curves which show an acceleration towards a peak performance (during which period learning is progressively happening by trial and error) followed by a plateau appears like pat explanation only because  such curves are developed by aggregating data of the learning process of hundreds of individuals. If an individual’s learning is tracked there will be seen a lot discontinuities and irregularities. He then presents an alternative learning path which is that when all pre-requisite skills are taught there is an instantaneous vertical climb (no acceleration or curve) to performance with all learning and no error. He quotes two simple and elegant examples from the non-human kingdom.

B. F. Skinner, taught rats to press a lever in a chamber in a errorless fashion by teaching 5 pre-requisites. He first let them explore a chamber and experience that the environment was safe. By mixing food pellets with the rats regular food, he taught them that pellets were food too. He then dropped the pellets in a food tray occasionally and the clanking noise from the dispenser was a indication of when pellets would be available. soon the rats started going to the dispenser whenever the dispenser made a sound and they picked up their food pellets.  Next a  lever was introduced in the chamber. When the rat pressed the lever the first time, the dispenser operated making a sound, the rat went to the food tray and ate the pellet. There after it continued pressing the lever at a high rate pausing only to eat the food pellets dispensed. The rat acquired the ‘lever pressing skill’ in a immediate fashion ( see figure 2 below). Imagine another rat which was not trained in the pre-requisites being let inside a similar chamber. How long could it be before it starts pressing the lever and accessing food is anybody’s guess. The latter rat may even give up after the fist lever press and stay hungry and anxious because it does not have the pre-requisite training to look into the food tray or even identify the food pellet as a reward.

Terrace in his Doctoral dissertation in 1963 built on the foundation and demonstrated error-less learning with pigeons. The first goal was to teach them to peck a key only when red light was on and not when green light was on in a chamber. He achieved this with a set of pigeons errorlessly by having the red light on in normal intensity and rewarding lever presses. He introduced the green light ( to which the pigeons should not respond) in a gradual fashion from low intensity to eventually an intensity equaling the red light. These pigeons made no error responses – never pecked the key when green light was on and always pecked when red light was on. Compare this with another group of pigeons which were introduced to both the lights at equal intensity from the start and they made a large number of error responses before acquiring the discrimination that it is worth pecking only when red light is on. There were many other brilliant facets to the great experiments done by Terrace. Suffice to note that the pigeons that learnt errorlessly also performed better later much after the training was withdrawn. Their learning endured. Another important note is that errors do not produce rewards and hence can produce fright reactions or aggressive behaviors.

Figure from sidman (2010)

The dad who successfully manages to teach his young son to cycle was not only patient but also manipulating the learning in such a way as to avoid nasty falls or unsuccessful turns. Every successful coach works hard on pre-requisites training and minimizing errors though he may seen to be commandeering. You would have doubtless come across the story of someone who succeeded in the eighteenth attempt. If you are able to examine closely you will find that the previous 17 attempts involved gaining some new ground everytime , identifying missing pre-requisites and working on them diligently and the 18th is a success. Otherwise if the previous attempts were a utter failure with no rewards contacted or no new pre-requisites identified it would have stopped at 2 or 3?

Behavior Analysts work towards promoting error less learning by a variety  of research based procedures such as shaping, prompts combined with effective and timely prompt fading procedures, evaluating the use of time delay before providing prompts, adding cues that can be faded to stimulus materials before fading and arranging rewards in proportion to task difficulty. There is now a large body of research that confirms the efficacy of these procedures not only in effectively facilitating skill acquisition but also in minimizing  escape responses and aggression during the teaching process. Pairing of the instructor with positive experiences and rewards also plays a key role. If  errors still occur then a Behavior Analyst would go deeper into component skills and focus training on those.

Play, A., Activities, G., & Team, T. (2017). Is it true that babies are born with the ability to swim? | BabyCenter.            BabyCenter. Retrieved 3 February 2017, from http://www.babycenter.com/404_is-it-true-that-babies-are-born-with-the-ability-to-swim_10313062.bc

Sidman, M. (2010). Errorless learning and programmed instruction: The myth of the learning curve. European Journal of Behavior Analysis, 11(2), 167-180.

Terrace, H. S. (1963). Errorless transfer of a discrimination across two continua. Journal of the experimental analysis of behavior, 6(2), 223-232.

 

 

Autism – A brief historic perspective

November 21, 2016 Leave a comment

History is in the past but can help place things in perspective. While autism diagnosis strikes most parents from the blue, suddenly from no where, history says it has been around and recognized atleast 5-6 decades ago ( probably even earlier??). I will present some key milestones, the early blunders in understanding and current evolving understanding.

Retrospectively viewed, the earliest known description of symptoms of autism could possibly relate to Victor, a French feral child found in 1800 and believed to have lived alone in the woods for nearly the first 12 years of his life. Despite a young physician’s (Itard) intense efforts to teach him he only learned to speak two words but did make progress in his behavior towards other people. One day when the housekeeper was crying in grief over loss of her husband, Victor is reported to have engaged in consoling behavior and Itard reported this as progress. In 1867, Henry Maudlsey is said to have described insanity in children and his descriptions are consistent with today’s ASD.

Eugene Bleuler (1911/1950), a Swiss psychiatrist coined the term autismus to describe idiosyncratic, self-centred thinking during his work on schizophrenia.
In 1943, Leo Kanner introduced the modern concept of autism while describing 11 children with “autistic disturbances of affective contact”. He not only used it to describe children who lived in their own world cut off from normal social intercourse but also proceeded to distinguish it from schizophrenia indicating a failure of development instead of regression. Children with autism were described as inflexible, preferring sameness and rigid. In the following years, Kanner proceeded to hypothesize that autism was influenced by parenting, a dearth of maternal warmth { and this shoes how even scientists who are dead right about certain things can be equally dead wrong about certain things) and that many such children were not motivated to perform though not retarded.

In 1944, Hans Asperger used the term autistic psychopathy, now referred to as Asperger’s disorder in DSM- IV- TR and his study became widely known only in 1991 when it was translated in English by Frith.

The DSM I manual first released in 1952, classified autistic-like features under Childhood Schizophrenia. In 1967 Bruno Bettelheim popularized the theory of “refrigerator mothers” as cause of autism amongst public and medical community ( Another example of a scientist being dead wrong leading to harm in society) . These have since been disproved in research literature (Mundy etal., 1986). In 1977 the first study of twins helped change the perceptions and look towards genetics for understanding ethology of autism.

In 1987, psychologist Ivar Lovaas presented his first study demonstrating that intensive intervention can help children with autism learn. In the same year, autistic disorder replaced “infantile autism” in the diagnostic manual. Dustin Hoffman, essayed the role of a Autistic Savant in the movie “Rain man” which raised public awareness of the disorder while at the same time creating a mis-perception that all autistic individuals have savant like qualities. In 1993, Catherine Maurice’s book “Let Me Hear Your Voice: A Family’s Triumph Over Autism” brought into public view the effectiveness of use of interventions based on the science of Applied Behavior Analysis. In the same year, Jim Sinclair, an autistic adult started a neuro-diversity movement and spoke at the international conference on autism.

MMR vaccine was proposed as a cause of Autism in a Lancet study of 1998 but it was debunked and retracted though the controversy it raised continues till today.

In 2007, the US Center for Disease Control and Prevention estimated prevalence of Autism at 1 in 150 recognizing it as assuming epidemic proportions . this had climbed to 1 in 68 by 2014 ( “ Autism Spectrum Disorder: Data and Statistics” , 2014). As the prevalence figures kept climbing geometrically some researchers started questioning the validity of the prevalence figures. Gernsbacher, Dawson & Goldsmith (2005) have argued that the diagnostic criteria have been diluted, particularly between DSM III (1980) and DSM 4 (1990)  and other statistical errors contribute to a misperception of an epidemic.
In 2013 , DSM V was released and it clubbed several separate diagnosis into one diagnosis of Autism Spectrum Disorders.

Research into the cause of ASD continues to be unsuccessful in pin pointing the cause however there are advances in interventions  that can help individuals with autism acquire new skills and lead a better adapted life.

A history of Applied Behavior Analysis and evidence based interventions could be the next blog topic.

 

 

References

Autism Spectrum Disorder, (2014). Retrieved April 10th,2014 from http://www.cdc.gov/ncbddd/autism/data.html

Autism: Rise of a disorder. Los Angeles Times 06 dec 2011, Data desk n. pag. Web. 10 Apr. 2014. .

Autism Timeline | Neurotypical | POV | PBS. (n.d.). Retrieved April 10, 2014, from http:/   /www.pbs.org/pov/neurotypical/autism-history-timeline.php#.U0aH8fmSySq

Gernsbacher, M. A., Dawson, M., & Goldsmith, H. H. (2005). Three Reasons Not to Believe in an Autism Epidemic. Current Directions in Psychological Science, 14(2), 55–58. http://doi.org/10.1111/j.0963-7214.2005.00334.x

Goldstein, S., Ozonoff, S., (2009), Historical perspective and overview. In S. Goldstein, J. A.   Naglieri & S. Ozonoff( Eds.,), Assessment of autism spectrum disorders (pp 1-13). New York, NY: Guilford Press

Wing, L., Potter, D.,  (2009), Historical perspective and overview. In S. Goldstein, J. A.   Naglieri & S. Ozonoff( Eds.,), The Epidemiology of Autism Spectrum Disorders: Is the prevalence rising?.  (pp 18-45). New York, NY: Guilford Press

Walsh, Neil, and Elisabeth Hurley. The Good and Bad Science of Autism. Autism West Midlands, UK. Web. 10 Apr 2014. <http://www.autismwestmidlands.org.uk/files/epub_goodbadscienceofautism(1).pdf>.

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