Toilet Training Made Easy

A common struggle for parents is to teach their child to use the bathroom independently. Mary Barbera in “The Verbal Behavior Approach,” discusses steps that she has found over the years to successfully train a child to use the bathroom consistently and independently.

Ensure that your child is ready to be toilet trained

It is important to make sure that the timing for training your child is right. Do not begin toilet training if your child has just been diagnosed, mands are weak, your family will be moving soon, or another big change will be happening. It is important to establish a system in which they can learn to mand first and positive behavior programs are in place. A few important questions to ask are: Does your child seem to notice or indicate when diapers are soiled? Does your child move away from you or hide to have a bowel movement? Does your child have regular bowel movements with no soiling overnight? These may be signs that your child is ready to begin training.

Before you begin toilet training

·         Begin pairing the toilet with reinforcement

o   Have the child sit on the toilet and provide reinforcement for simply sitting there. This will begin to pair the toilet with reinforcement and after pairings, the child may start to feel more comfortable with the toilet and even use it! This may happen by accident, but if it does, reinforce heavily!

·         Choose the words you will use to talk about the behaviors and make sure that everyone that the child will interact with is consistent

·         Notice any patterns in your child’s bathroom schedule

o   Keep in mind when they eat or wake up/nap because this can often affect their bathroom schedule

Daytime training

·         Make a toilet schedule that everyone is aware of. Place the child on the toilet consistently and reinforce with a treat that get exclusively for a successful bathroom trip.

·         Teach your child the separate steps that are involved in using the bathroom; for example, how to pull pants up and down, how to wash hands, and how to wipe themselves.

·         Give your child extra drinks so there is strong motivation and opportunity for bathroom trips

·         Do dry pants checks

o   Reinforce whenever their pants are dry and run a check immediately if you notice that they have had an accident

·         Use positive practice for accidents

o   Take your child quickly from the spot of the accident to the toilet and back again five to ten times in a row.

·         Keep a record of successful trips to the bathroom and accidents.

For more information regarding toilet training tips, refer to “The Verbal Behavior Approach” by Mary Barbera.

Augmentative Communication

Some children do not naturally develop language or begin to babble sounds in order to learn how to make words. With children diagnosed with Autism, this is often the case. However, these children often begin to form their own language and communicate in others ways with their parents and peers. This is called augmentative communication. In "Teaching Language to Children with Autism or other Developmental Disabilities," Sundberg and Partington discuss the ways in which children with Autism learn language and communicate with those around them.

It is important to encourage and reinforce when the child attempts to communicate with you in order to prevent the child from getting frustrated or from ceasing attempts to reach out. The four general options for selecting a form of communication for a specific child are 1) speech, 2) sign language, 3) picture pointing and exchange systems, and 4) independent writing, typing, or pointing to words.

Speech is the end goal; however, some children will need thousands of trials in order to build up their verbal repertoire. For children with strong to moderate motor imitation skills, sign language is a preferable way to learn language. Teachers can fade their prompts, they do not have to carry around a external object in order to talk to others and motor movements can actually increase language by the motion triggering the vocalization. Some advantages of the picture pointing and exchange systems are the listener does not have to have any special training in order to understand what the child is asking for, matching at first makes acquisition easier for the child and there is no shaping required. However, with this system, there is usually no improvement in speech.

It is important to build up a rapport with the child and complete an assessment in order to gauge exactly where the specific child's deficits lie. With this information in mind, a teacher can effectively choose what system to use and begin to effectively teach the child language.

The basic steps to teaching sign language

Establishing Operations, Inc. has a series of videos titled Teaching Verbal Behavior in the Natural Environment that lay out the basic concepts in order to teach your child how to communicate. I will be focusing on the video that explains how to use sign language with your child. Using sign language does not mean that they cannot or will never be able to communicate vocally, but rather that they have weak echoic skills and need another way to communicate with those who may not be able to understand them.

Here are some of the first steps in teaching sign language:

How to teach sign:

If the child has poor motor imitation, start off with modified signs that are as close to original signs as possible. If your child does not like to be touched, begin doing exercises where you pair touching their hands with reinforcement and once touching their hands is no longer aversive, you can begin physically prompting signs.

A) Model

B) Prompt

C) Give

Say the name of the item with each step. Model the sign, prompt the child to imitate the sign, and then give the reinforcement. Be quick with steps to avoid a battle over the reinforcement; you can cut out the model step if they are grabbing at reinforcement. Make sure to give reinforcement within seconds of the sign. Prompt what the child is focused on rather than what you are trying to teach; be sure to follow child’s motivation.

Manding Guidelines:

• Teach mands in the natural environment: use child’s motivation for objects in situation to teach manding
• Motivation must be present before prompting the mand, make sure motivation is present and high for the object you are manding for
• Practice teaching mands before you work with child, mistakes with the child makes it more likely that they will get upset
• Teach mands in a variety of locations; they should be able to generalize to outside situations
• Capture and contrive many opportunities each day to teach mands, you have to actively set up situations in which they will be motivated to ask for something
• Track the number of mands each day; use tally counters to keep track of how many mands child makes per day
• Be a giver, not a taker: give a little bit at a time so that the child has to keep coming back to you for more, rather than taking back items to get more mands, do not kill value of the items by taking them away and making them ask for them
• Sanitize the environment so that you can control the reinforcers: set up environment strategically, know how to make each activity better before the child comes over
• Avoid killing the motivation: don’t make them ask for every little piece, keep number of demands fair, give them a few pieces for free
• Be sure to fade prompts: try to get the best quality of prompts with the least amount of prompting
• Avoid placing unnecessary demands on your child when teaching mands: do not ask for names of items or ask them to play with objects a certain way
• When teaching the first mands avoid teaching: yes, no, more, help, please, give me, and eat or anything that can turn into a generalized mand for many things, teach individual item names rather than a general name
• Avoid teaching mands for the removal of something aversive: leave, bye bye, move, go, break
• Want children to learn that when they talk good things happen rather than bad things go away

Teaching sign language should be fun and easy! As the teacher, you just have to stay one sign ahead of the learner and watch their motivation level to keep the child engaged in the activity. Learning signs can take many trials, so be patient and consistent. Never be afraid to reinforce!

Happy signing!

Functions of Language

In everyday language, our words serve various purposes that flow seamlessly in conversation and do not normally get noticed. However, the functions of these words are crucial in the way that we communicate with those around us. Sometimes children on the Autism spectrum do not learn the nuances of language and the different functions that words serve on their own. Typical children pick this up through social cues and everyday interactions but as Behavioral Therapists, the process of correctly using language is something that we teach often. Here I will discuss some of the main types of verbal relations and their importance so that parents may better understand the functions of their children’s language and have some pointers about how to increase the proper functions of communication.

ECHOIC

An echoic is when a child will repeat what they have heard another person say. They might have a favorite line from a T.V. show that they repeat after the character says it. It is important to encourage this if the child rarely makes sounds and the parent wants to promote talking. Children naturally go through a babbling stage in which they practice making noises and forming words; echoics is similar and while it is a more basic part of language, it can be important in a child’s development.

TACT

A tact is simply a label, or what an object is called in everyday conversation. Tacting occurs when a child looks at a picture and begins naming things that they see. They are not asking for these objects, but merely saying the names aloud. Learning tacts is important but is often a lower priority for Behavioral Therapists than mands. In comparing tacts and mands, Jack Michael states in his book, Concepts and Principles of Behavior Analysis, “the mand permits the speaker to alter the environment through someone else’s behavior, and the tact permits the listener to react to the behavior of others,” (p. 204).

MAND

A mand is a request, or when the speaker asks for a reinforcer. In conversation, it sometimes may be difficult to distinguish what is a mand and what is not. However, mands are used more often than we realize. Parents most often want their children to learn how to mand for objects so that they can communicate what they want with the parents. The best way to train your child to mand is through practice; set up situations in which the child is directly reinforced for manding. Have a favorite toy or snack on a table and have your child come over to you. Let them sample the reinforcer and then gently remove it again. Try to encourage them to ask for the reinforcer, whether through verbal words or sign language. If they attempt at all (not whining, but a close approximation of the word or sign), reinforce them! Once you have established a system in which they get reinforced for attempting to communicate, they will most likely do this most often. Practice with many trials a day; make sure to change the level of response that you are reinforcing. It should be slightly increasing each time. If you know they can say to whole word, don’t reinforce part of it. This will help to teach them how to ask you for things and better communicate their wants.

INTRAVERBAL

An intraverbal is perhaps the most advanced function of language. Intraverbals are discussing objects that are not in the room, categorizing objects, filling in the blanks of common phrases and more. This requires a higher foundation of language because the child has to be well versed in features of objects, functions of objects, common phrases, etc. and understand how to interact with another person when discussing these things in conversation. For example, a more elementary intraverbal would be to fill in the phrase “Ready, Set, ___!” or saying what number comes next when counting. These are abstract ideas that the child has to learn how to fill in through the social environment beyond basic conversations.

Knowing these functions of language can improve the way that you understand your child’s language and the ways in which to help them learn to better communicate with you. Further research on the subject of the functions of language can be found in the works of B.F. Skinner or Jack Michael.

Upcoming FREE ABA & Autism Workshop

South Sound Behavior Therapy will be hosting a FREE workshop on Decreasing Problem Behavior in Lacey, WA on April 7th. Email jennica.ssbt@gmail.com or kaitlyn.ssbt@gmail.com for a registration form and more information!

Decreasing Problem Behavior

(9AM-12PM Sat April 7^th 2012 )

Location:

Candlewood Suites

4440 3^rd Ave SE

Lacey, WA 98503

Attendees will learn:

ABCs of behavior

‡ Why problem behaviors occur(4 functions of behavior)

‡ Treating problem behavior: extinction, positive and negative reinforcement and punishment

‡ How to apply techniques of treating problem behavior

‡ Additional tools for treating problem behavior: token systems, cost response, and contingency contracts

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**Each workshop includes copies of PowerPoint

presentation and other training materials

Instructional Control

In his book, Educate toward Recovery, Robert Schramm discusses the importance of instructional control, or having your child respond to your instructions. Gaining instructional control is a process with specific rules that must be applied in every learning situation with your child. Schramm breaks this process down into seven steps for parents to follow to establish and maintain instructional control.

1) Show your child that you are the one in control of the items he/she wants to hold or play with and that you will decide when and for how long he/she can have them.

By remaining in control of the desired items, you can begin to associate yourself with positive items, therefore, becoming a conditioned stimulus. The child will learn that they can gain access to reinforcement through you rather than trying to access it independently.

2) Show your child that you are fun. Make each interaction you have with him an enjoyable experience so that he will want to follow your directions to earn more time sharing these experiences with you.

Make sure to allow time in your interactions with your child to get lost in play. Allow them to direct the activities and make decisions about what they want to do. Try to become an active, engaged partner in their playtime. This in turn will help them want to follow directions in the future.

3) Show your child that you can be trusted. Always say what you mean and mean what you say. If you instruct your child to do something, do not allow him access to reinforcement until he has complied with your request. This step allows for prompting him to completion if necessary.

While it is important to have time where a child can play freely with you, it is important that when not in free play, you make sure that the child follows through with your request. By allowing your child to not comply, you have reinforced whatever behavior they engaged in before you withdrew the demand you had placed on them. For example, if you asked your child to clean their room and they threw a fit, then you withdrew the task by walking away or another response besides making them follow through with the request, you inadvertently reinforced the behavior of throwing a fit!

4) Show your child that following your directions is beneficial and the best way for him to obtain what he wants. Give your child easy directions as often as possible and then reinforce his decisions to participate by following them with good experiences.

Make sure to give your child many opportunities in order to complete easy tasks in which they get reinforcement through your praise, a preferred activity, or a desired tangible reinforcer. Rather than placing big tasks on them all at once and having that be the only chance to earn reinforcement, have a series of activities in which they can participate and be reinforced.

5) Provide consistent reinforcement. In the early stages of earning instructional control with your child, reinforce after each positive response. Eventually change to an ever-increasing variable of reinforcement.

It is crucial to establish a system in which your child knows that they will be reinforced. If they understand that system of reinforcement, they will be more likely to participate and quickly follow your demands. However, to establish this system, they must be reinforced each time they comply. Regardless of the situation or circumstances you may be in, you must try to make the time to reinforce and acknowledge their compliance. Once this system has been established, you can begin reinforcing less often.

6) Demonstrate that you know your child’s priorities as well as your own.

Make note of your child’s preferred activities, edible items, toys, etc. so that you know what will motivate your child to comply. A child’s interests can sometimes change so be aware of shifting preferences. To avoid satiation, or when a child is bored or “full” of a reinforcer, rotate reinforcers often. Have many options that the child can receive for their cooperation.

7)S Show your child that ignoring your instruction or choosing inappropriate behavior will not result in the acquisition of reinforcement.

If your child begins engaging in inappropriate behaviors, you cannot reinforce them. You must intentionally make whatever behavior they are engaging in for something unsuccessful. Over time, the child will resort to this behavior less often if they are never reinforced for it. Instead, they will act in a way in which there is a history of reinforcement, all the appropriate behaviors you have been teaching and reinforcing.

These seven steps will increase your instructional control with your child and ensure that you can shape their behavior to be appropriate and compliant. More information about Applied Behavior Analysis and parenting can be found in Schramm’s book.

Schedules of Reinforcement

The frequency of a certain behavior depends on the reinforcement or extinction of that behavior. In order to increase the frequency, you must reinforce the behavior. However, there are many varying schedules of reinforcement that will affect how a behavior occurs and the future frequency of it. A schedule of reinforcement is simply which responses will be followed with reinforcement and which will not.

There are two main schedules of reinforcement: continuous and extinction. A continuous schedule of reinforcement is when each and every instance of a certain behavior is rewarded with reinforcement; for example, when potty training, parents often reinforce each occurrence of when the child uses the toilet. The other schedule of reinforcement is extinction, or when no instance of a behavior is reinforced. These two different schedules of reinforcement contain the basic principles that other intermittent schedules of reinforcement derive from.

Intermittent schedules of reinforcement are when a behavior is reinforced, but not every time it occurs. While there are several types of intermittent schedules, the one that produces high and steady rates of responding is a variable ratio schedule. A variable ratio schedule is one in which the behavior is reinforced after a certain number of responses but the number of responses necessary to gain reinforcement can vary slightly. For example, when a therapist is working with a child, the therapist might reinforce the child after around every 10 responses. It does not have to be after exactly 10 every time and by doing so, there is no predictable pattern of reinforcement.

Schedules of reinforcement are used in different contexts and serve different purposes; for example, you would not have a variable ratio of reinforcement for potty training because the child would be reinforced after around the 10^th time they use the toilet. They would not learn the new behavior! Continuous reinforcement is used to establish or strengthen behaviors while an intermittent schedule of reinforcement maintains previously learned behaviors. It is important to look at what the situation is and decide what the schedule of reinforcement should be depending on whether you are teaching a new behavior, maintaining motivation during a therapy session, or putting a behavior on extinction. Reinforcement is a crucial tool in Applied Behavior Analysis and when it used correctly on an appropriate schedule, it will increase the target behaviors while not reinforcing problem behaviors.