Self-Care & Potty Training Archives - Autism Mom, ABA Help for Professionals and Parents
Using ABA to Teach Functional Self-Help Skills to Children with Autism and Other Developmental Disorders

Using ABA to Teach Functional Self-Help Skills to Children with Autism and Other Developmental Disorders

Many people are confused about how to use ABA to teach functional, multi-step skills such as putting on shoes, washing hands, or setting a table. Several years ago I was consulting in a classroom and we were working with a 14 year-old girl with Down Syndrome who was minimally vocal. We were focused on trying to teach her to mand for items when her teacher jumped in and asked if we could help the girl learn how to set a table since this was a goal on her IEP.

Following the teacher’s motivation, I switched gears and told her that we could use ABA to teach her student how to set a table. I went on to explain that a multi-step skill like setting the table is taught much differently than teaching a child to mand for or tact items. When the teacher pointed me toward the table setting supplies, I began asking questions such as “Should she set the table for 2 or 4 people?” and “Do you want her to carry the plates over with the silverware on top or should she carry just the plates over first?” The teacher said she didn’t know and that she just wanted her to set the table.

For chained skills, the first step is to create a task analysis. This involves writing down each step of the skill in order. If there is more than one adult working with a child on a skill, it is important that the task list be created with everyone’s input and this needs to be followed closely. For hand washing, for example, you’ll need to decide if adults are going to prompt the child to pump the soap 3, 4, or 5 times and for setting the table, it needs to be decided in advance how the child should proceed with each step. Once the task analysis is created, the key to teaching these skills is that, in most cases, adults should use gentle physical prompts from behind and NO vocal prompting.

Chapter 11 of my book (The Verbal Behavior Approach) covers the basics of teaching chained skills using hand washing as the example.

There is another book which I would also recommend reading to learn how to teach these skills called Self Help Skills for People with Autism.

One other resource that is excellent is a self-care checklist developed by Dr. Mark Sundberg available as a supplement to the VB-MAPP. This will help you assess your child’s self-help skills and assist you with prioritizing which skills should be taught first.

Once you assess your child’s self-help abilities, I recommend you start with easy-to-prompt skills such as putting on shoes or hand washing so you can practice your skills by getting behind your child. For hand washing, I suggest you stand directly behind the child with your arms around the child gently prompting his hands. As the child turns on the water and pumps the soap dispenser three times, for instance, you can feel how much physical prompting is needed and guide his hands from behind. You should also be able to feel when prompting for each step can be faded.

Avoid vocal language during the teaching of chained tasks. This is not the time to be asking the child to tact “soap” or to be questioning “what step is next?” During multi-step self-care, leisure and/or vocational tasks, you should remain silent and provide as much gentle physical guidance from behind as is needed for the child to be successful with each step of the task.

Consistent prompting and prompt fading will be most effective when the adults working with the child take data and make decisions based on the data. Don’t forget about reinforcement too since teaching these tasks can involve high demands.

If the child you are working with seems uninterested or avoidant of the task, your goal may not be to teach the whole task. Instead you may need to start with the last step of the task first followed by high reinforcement and then fade in the other steps gradually and systematically.

I go over this and so much more in my Autism ABA Help Course, so take a look to see if it is right for you.

Teaching Nose-Blowing to a Child or Adult with Autism

Teaching Nose-Blowing to a Child or Adult with Autism

Experiencing a cold, allergies, or symptoms of the flu is annoying for many people. A runny or stuffy nose is especially difficult for a child or adult with autism who cannot blow his or her nose.

My son, Lucas, in his late teens, had still not mastered this nose blowing skill. During one of his colds, I decided to once again try to tackle teaching him this skill by coming up with procedures that would lead to nose blowing success. While he didn’t completely mastered the skill right away, we made great gains!

Here are the steps and a short video to illustrate the techniques we are using:

1) Start a nose-blowing program when the child is well with no stuffy or runny nose.

2) Practice these steps a few times/day through imitation:

a. Deep breath in through open mouth, cover mouth, and let air out through nose (x 3).
b. Deep breath in through open mouth, cover one nostril and close mouth, blowing air out of one nostril (x 3 each side).
c. Hold clipboard or hardback book above child’s mouth and under nose and have him blow a cotton ball with nose (x 3).
d. Open tissue, deep breath in through mouth, close mouth and breathe out through nose while covering nose with tissue (x3)

For a detailed demonstration, watch this 1-minute video

TAG teach and Autism (Teaching Shoe Tying)

TAG teach and Autism (Teaching Shoe Tying)

A few years ago, a friend of mine asked me if I had ever heard of TAGteach. When I said that I hadn’t, she asked me if I knew anything about clicker training for animals. I was familiar with the concept of using audible markers with animals, thinking mostly of the whistle blowing at Sea World to signal to the dolphin that the move was correct and that the dolphin would be receiving reinforcement soon. My friend explained that TAGteach used the same principles of positive reinforcement, conditioned reinforcement and shaping as clicker training. She also told me that TAGteach was being used at her son’s school for children with autism. I was intrigued by the concept and assumed that the “A” in TAG stood for autism but I was wrong.

The acronym TAG means Teaching with Acoustical Guidance and was used first with gymnasts, not children with special needs. It all started when Theresa McKeon purchased a horse in 2005 and had difficulty training it. She went online and learned about Karen Pryor’s clicker training technology. Theresa used clicker training until the horse was calmer and then sold it. In the process of using clicker training with her horse, Theresa, a national gymnastics coach, decided that clickers might be very helpful to her young students. When a gymnast had difficulty with a handstand, for instance, the skills of the handstand could be broken down and each skill could be taught separately. When one of the students got her feet to the 12 o’clock position or put her arms over her ears, the coach could click to signal that the position was correct.

In her book, Reaching the Animal Mind, Karen Pryor describes her experience in visiting Theresa’s gym for the first time. After the parents of the gymnasts complained that they didn’t like the use of animal clicker training with their children, Theresa and Joan Orr (the co-founder of TAGteach) made the decision to change the name to TAGteach instead of clicker training when the technology is applied to humans. This simple semantic change worked to ease the concerns of the gymnasts’ parents and TAGteach began to spread to dancing, golf, other sports and eventually to special education. Take a look at these videos from Karen Pryor of TAGteach.

Dr. Julie Vargas (BF Skinner’s daughter) also wrote an excellent book, Behavior Analysis for Effective Teaching, which highlights some applications of TAGteach to children with autism. In addition TAGteach has a great web site, a Yahoo group, Facebook page, and an excellent e-learning program I completed last summer. I highly recommend the e-learning program and/or a live 2-day TAGteach seminar to anyone and everyone!

In preparation for a symposium on TAGteach at the ABA International Conference in Texas, I used TAGteach to teach my son, Lucas, how to tie shoes. It took about 1 ½ hours in total over a few weeks and I presented data and this video in Texas.

To learn more about TAGteach, check out the books listed above and/or visit http://www.tagteach.com/.

No More Diapers: Using a Behavioral Approach for Toilet Training Success

No More Diapers: Using a Behavioral Approach for Toilet Training Success

As a Registered Nurse and Board Certified Behavior Analyst, I have always been interested in and comfortable with the topic of toilet training children on the autism spectrum. Chapter 11 of my book (The Verbal Behavior Approach) is dedicated to potty training and over the past decade, I have assisted in toileting training dozens of children, many with severe disabilities. In preparation for an Advanced Training Solutions (ATS) webinar on toilet training in January 2013, I conducted a literature review and also created and distributed a survey for parents to complete on the topic. Within a week of advertising that a toilet training survey was available, more than 200 parents of children and adults with autism completed the 5-minute on-line survey. The results indicated that about half of the children and adults whose parents completed the survey were not fully toilet trained. Even for those who were successful, most parents indicated that toilet training required a lot of effort and that many still had issues with toileting in public bathrooms. One other surprising finding was that almost 70% of the respondents still had difficulties with wiping, a huge issue not found in other studies or surveys. Over 450 participants including behavior analysts, teachers, other professionals, and parents viewed the webinar when it initially aired in January. The feedback was excellent and included:

 

“Your presentation was wonderful! Evidence-based, clear, filled with practical suggestions, great illustrations and videos and excellent references. Thank you!!”

“It was a GREAT webinar! Mary, as always…….did an amazing job! Thank you so much for all you do”

Don’t wait, register now to watch my two-hour instructional webinar on toilet training (which includes a pre- and post-test and active responding throughout and two BCBA CEU credits if needed). Independent toileting is one of the most important life skills to learn for children with autism and other disabilities. Whether or not a child is toilet trained impacts many areas of life including school placement options, access to childcare and the ability to participate in leisure activities. My webinar is offered in collaboration with Autism Training Solutions (ats) and the cost is $60. Upon clicking the button, you will be directed to the Autism Training Solutions website where you will learn more about the webinar and have the opportunity to pay for and watch the webinar. For best results while watching the webinar, please download the Toilet Training Toolkit.

“The webinar provides the most comprehensive yet easy to understand guidelines to toilet training that I have ever found. I especially liked the toilet training plan, which gives everyone working with the child a clear overview of the most important elements and procedures to be used. I strongly recommend this webinar to parents and professionals, even to those who already have some experience with the topic!”

Julia Buchenau-Schloemer, BCBA

I purchased this webinar after 5 years of attempts to train my son who has autism. Most of what I ran across previously assumed a level of language ability that my son does not have. This webinar provides excellent advice for those working on toilet training with someone who needs a high degree of support. I enthusiastically recommend it! Regina Conti, parent of 8-year-old son with autism

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