Alternatives to the Use of “No” in Discrete Trial Teaching

When Dr. Ivar Lovaas pioneered discrete trial teaching in the 1980’s the use of “No” as a SR (Reinforcing Stimulus) or consequence was required. In the “Behavioral Treatment for Autistic Children” [video recording (44 min.)] by O. Ivar Lovaas (1988) Dr. Lovaas himself can be seen saying “No” quite loudly and slapping the table with his hand to startling effect. This clip has often used as a negative example of ABA (Applied Behavioral Analysis) over the years, even though training sessions rarely resembled that particular sequence.

In the mid to late 1990’s the use of “No” fell out of favor for various reasons. These reasons ranged from its lack of political correctness; to the more important fact, it often desensitized children to the word “No”. Many parents found their child ignoring the word “No” making it useless when they might actually need to use the word effectively; such as if their child was about to do something dangerous.

Today, the word “No” has commonly been replaced with the informational “Try again” or “Do it better”, with modern practitioners. (If you are still using “No” your information is seriously out of date). While this has been effective and is still the preferred SR for early learners and new instructors the use of informational feedback, SR’s has been in practice with Autism & Aspergers Consulting, LLC www.aactnow.com since 2001 to great effectiveness.

The concept is simple: Use feedback as a SR that matches the child’s response so that the child can elicit improved and more accurate responses more quickly. In practice the difficulty in implementation does not usually lie at the child’s ability to discriminate the SR, as proper shaping typically has the desired result, rather the difficulty often lies at the instructor level, as instructors have a greater tendency to break discrete trial as the consequences to the SD (Discriminative Stimulus) become more natural.

The following are some suggested R’s (responses) and the appropriate replacement SR:

Child's Response-SR Delivered

• Non-response- Try again, I didn’t hear you, I asked you a question, Etc. 
• To soft of voice- Say it louder, I didn’t hear you, etc 
• Mumbled response- Say it better 
• Close answer- Not quite, that’s not quite right, your close. 
• No eye contact- Look, I didn’t see your eyes, etc 
• Wrong response- Try again, nope, mm no, etc. 
• Vague Answer- But what kind, I need an example, etc.

It is very important not to break discrete trial procedure when implementing this procedure. Similar to the use of “Try Again” staff should immediately redeliver the SD after the SR. On the third trial, the instructors should always prompt the desired response in the desired manner. If the child corrects the problem on his own, but demonstrates a new problem, give the new feedback with the appropriate SR and begin counting over toward the try again, try again prompt, retrial sequence.

Example Teaching Sequence
Instructor SD: “What’s your name?”
Child response: “Jacob” with no eye contact.
Instructor SR: “Look”
Instructor SD: “What’s your name?”
Child response: “Jacob” with no eye contact.
Instructor SR: “Look”
Instructor SD: “What’s your name?” Instructor prompts by holding reinforcer near instructors eyes.
Child response: “Jacob” with eye contact.
Instructor SR: “Good!”
Instructor SD: “What’s your name?”
Child response: “Jacob” with eye contact.
Instructor SR: “Excellent” and deliver preferred reinforcer for unprompted quality response.

Summary
The eventual goal of ABA should be to help a child learn naturally, and ready them for learning from the environment as much as possible. The technique of using alternatives to “try again” with natural feedback helps achieve more natural responses and is an important transition step on the way to more natural learning.

Can a Child Really Recover from Autism?

It has been hotly debated, whether a child who is diagnosed with Autism can really recovery from such a debilitating and profound disorder. Many misconceptions and broad generalizations have been reached by both the people who believe in recovery and those who do not believe that recovery is possible. So before we state our position, it is necessary to define what we really mean by recovery.

When we speak of recovery we are referring to the child being able to meet three key characteristics:
1. The child demonstrates normal intellectual functioning by scoring within average or better range on all age appropriate psychological & academic testing.
2. The child has achieved a normal academic school placement by the end of third grade.
3. The child is able to maintain peer relationships and appears indistinguishable from peers to a trained outside observer.

This generally means that a child who has recovered from Autism has all the same opportunities as if they did not have Autism. This does not necessarily mean they won’t still have some odd quirks or needs, but those peculiarities that remain would not be in excess of those peculiarities seen in the population as a whole.
It also does not necessarily mean that the person who has recovered from Autism have changed their thinking style; rather they may be using compensatory procedures to arrive at socially appropriate strategies and to fit in.

Finally it is important to note that treatment does not generally make a person who is naturally an introvert into an extrovert, nor will in change someone who is naturally uncoordinated into an all-state sports star. Each child’s personality and genetics guide a child’s potential. A treatment program can only help children maximize their own potential.

So, yes, recovery is possible! I have seen it myself with dozens of children that I have guided from nonverbal beginning learners to fully functional and active students with whom you would never have known there was ever a problem. You can read more about recovery and a few success stories at www.aactnow.com

Keys to an Effective Home ABA Program for Beginning Learners.

Every ABA program needs a curriculum to determine what to teach each student. The curriculum should be all encompassing and prepare the student for school & life as best as possible.  Currently the Lovaas curriculum is the only entire curriculum validated through research, however portions of differing curriculum have also been shown to be effective for specific problems.  Therefore the best approach to promote Recovery appears to use all methods that have been validated through research and clinical trials.  

While a home ABA curriculum should follow a child’s natural developmental as closely as possible, I believe there are a few notable exceptions.

1)  Some basic concepts, which are innate in typically developing children, require higher-level language and conceptualization in order to be explained and taught to children with special needs.  Therefore some precociousness is encouraged so that the children are able to learn these skills.

2)   When the child is ready for inclusion into a normal classroom being of above average academic skills can serve to be beneficial for two reasons:

a)   The child can be seen as very smart and relied upon by other children for information,  this also serves as a way for our children to socialize in which they are often more comfortable.

b)   The child can focus more of there energy on socialization rather then learning academics.  This is often one of the most difficult things for children who are close to recovery.

In the first months of therapy it is important, through the use of behavioral techniques to teach the child to understand ten basic principles. A program, which fails to teach these basic principles, generally does not promote recovery.

1. To remain sitting during learning.

2. To attend to the instructor.

3. To respond to the instructor.

4. To change their response based upon prompting.

5. To understand the connection between responses and reinforcement.

6. To change ones response based upon feedback.

7. Not to play with materials during instruction.

8. When to respond receptively vs. expressively.

9. To stay on task for gradually longer periods of time.

10. To remain compliant during difficult tasks or situations.

To learn more about ABA curriculum and treatment visit www.aactnow.com