Building Echoic Control in Children with Autism

Hi there and welcome to another episode of the Turn Autism Around podcast. I’m your host, Dr. Mary Barbera, and today is all about how to get echoic control to enable kids to talk, or talk more. I see a constant struggle with people who report, both parents and professionals, they report that their kids have pop out words or have words here and there, but they can’t get them to talk or talk more. So today I’m covering five tips to get echoic control.

Welcome to the Turn Autism Around podcast for both parents and professionals in the autism world who want to turn things around, be less stressed, and lead happier lives. And now your host, autism mom, behavior analyst, and bestselling author, Dr. Mary Barbera.

I’m so happy that you’ve tuned into another episode of the Turn Autism Around podcast. Today is all about echoic control. And if you’ve been listening to my podcast throughout 2019, you know I ended the year with a couple of podcasts that were important. Number 51 for instance, was all about kids getting stuck and how to get them unstuck. And I really think that this is going to be a real effort on mine to cover where people are getting stuck, because there’s a lot of research out there, there’s a lot of application, but there’s a whole lot of people getting stuck at various areas. So one of the areas where kids get stuck is trying to get them from nonverbal to verbal; or get them talking or talking more.

Like I said in the intro, there’s what I call pop out words, which is where kids say things every now and again. Some kids have pop out words every day. Some kids have pop out words only every week or every month. And if there’s autism regression involved, like with my son, Lucas, he actually had words and he lost them, but he also lost the, you know… I didn’t know back then how to get his words back, how to get him talking. And over the past two decades, I have developed procedures and better and better procedures over the past few years, which is really enabling kids to start talking in some cases within hours, days, or weeks within my online courses and community. I just recently had a grandmother who joined my toddler course, for instance, who posted a video of her grandson who was saying ‘apple’ for the first time, and he was completely nonverbal she said two weeks prior when she purchased the toddler course.

Even that to me is just, you know, hard to believe. And it’s not a race. You know, some kids don’t get verbal, don’t get talking for the whole 60 days of the toddler course. And so because there are still people stuck getting kids talking and getting that echoic control. I actually met with a few moms recently about ways they could get a echoic control, because I don’t want to have anybody get stuck.

So echoic control, let’s just define these terms a little bit. Echoic control is basically, I say something, whether that’s a word or a sound or a phrase, and you repeat it either exactly or close enough. So if I say ‘apple’ and you say ‘apple’ or ‘apple’ or whatever, you know, word approximation, it’s still an echo. Okay. So you hear something and you say something.

When I say echoic control, some people who have a bad history with ABA kind of maybe are a little turned off by that. Like why are we trying to control people? And basically, it’s just getting them to imitate you verbally and that’s the way little kids learn to talk. They listen, they repeat, they start putting things together in a very natural way. But with our kids with autism or signs of autism or regression, we need to get echoic control as quickly as possible. Because once you do, in my experience, the floodgates oftentimes open and there’s a lot, lot more skills we can teach. So today I’m going to cover five strategies or tips for getting a echoic control and it hopefully will clear things up.

And this is just scraping the surface. Like always, these podcasts are only going to be 30 to 45 minutes, so we’re not going to cover everything. There’s not going to be any videos embedded like there are in my courses. And I really feel like that’s the key: is learning how to do it by seeing videos and participating in the Facebook community where we are… If you are stuck leading… Did you see this video? Did you do this procedure? Okay, he’s crying when it’s, you know, when the potato head gets pulled out. So what can we do to repair the situation? So a lot of times it’s not this… Join the course. Two weeks later the child’s talking and you’re off to the races. A lot of times it’s a little bit harder. So I would encourage anybody, parents or professionals who want to learn my whole approach to attend a free workshop and consider joining our online course and community. You can find out more at marybarbera.com/workshop.

So I worked as a board certified behavior analyst since 2003, and I was predominantly from 2003 to 2010, I was predominantly with the verbal behavior project in Pennsylvania schools. I also had some private clients who were young, who were very young and who taught me a lot. And then in 2010 I left the project to finish up my PhD and at that point I got a contract with the birth to three agency in my county. And this is really where I took all of my learnings and really started implementing procedures that were easy for parents to do in their homes. And a lot of the procedures that I’m going to tell you today had direct impact from all of those years of working with the young kids who were not talking or were not talking a lot.

Some of my initial clients like Daniel and Mia and Curt, all who I have permission for to talk about, but they taught me a lot and they didn’t… I didn’t get a echoic control over them for months, and in Daniel’s case, for over a year. So now that I’ve learned those procedures, I am experiencing better, quicker echoic control using these procedures.

So I really thank my initial clients and their parents for hanging in there while we continued to fine tune the methods to get a echoic control as soon as possible. Okay. So let’s go through the five tips for getting echoic control. So the first tip is, and I was making all these mistakes, I wasn’t really doing this the first half of my career as a behavior analyst. But what I do now is I combine all the operants together. I use what we call Multiple controlled procedures. So the shoe box program, which you may or may not have heard me talk about, if you Google Mary Barbera shoe box, you’ll find a video blog and other information about the shoe box. But basically what the shoe box is is you get a shoe box, a large shoe box, cut a slit into it and get pictures of important family members, pets, enforcers, and while you’re at it get two pictures of the same thing. Yes, you can’t use just the, the picture on the phone, you actually have to print it out, print out a regular size, four by six picture, not little ones.

So big pictures, two of each, all reinforcers, all one person or one item in the picture. So not of mom on a bike with a helmet. That’s too many stimuli that could get confusing. Not a picture of mom and dad together, one person or one item per picture. And then you take those pictures one at a time and you sit diagonally from the child so that you’re close enough that you can physically help the child put it in the box or that sort of thing. And you want to hold the picture up one at a time and say the item name usually up to three times in the slow animated way. So mommy, mommy, mommy. And as you say it, the pictures actually coming closer. So you hold it to your mouth, mommy, get a little bit closer, mommy hand it to the child, mommy.

And this is called stimulus stimulus pairing. And we want to be saying words. Now, some kids get stuck on, you have to say it three times and, and they get wrote right away. So in that case, or they might cry because you’re holding out too long and they’re getting frustrated. So in that case, you, you just do it quicker, mommy. And you just put in the box: daddy, fruit snack. And you just get the child… We don’t want the child crying at the table or ever if we can avoid it. I mean we really want to make this fun, make this light; the same procedure of saying words up to three times and handing it to the child and being animated. Same procedure for potato head, for puzzles, for cause and effect toys. And these are called the early learner programs and materials, which are all a part of my toddler course and early learner course which is part of the BB bundle.

So if you have a child who’s five or 10 and still not talking, you still use, you would join the BB bundle in that case, not the toddler preschooler course, but the same procedures would be shown. There just might be a little bit difference with the age of the child. But really if a child’s not talking no matter what their chronological age is or if they even have a diagnosis, I mean these techniques were great for just speech delayed kids without any autism. So, so it doesn’t matter if they are not talking or not talking much, or you have no echoic control… These shoe-box programs, potato head all that stuff is just so critical.

The key to this multiple control is if the child like this little boy did saying ‘apple’ in two weeks for his grandmother… If the child does say ‘apple’ while I’m holding up a picture of an ‘apple’ and he’s got the shoe box and I say ‘apple’ and he says ‘apple’, it is actually part manned or request because he wants that picture to put in the box.

It’s part tact because he can see the picture of the ‘apple’ and it is part echo because I am saying ‘apple’. It also builds up just compliance at the table. He was smiling, he was happy. It builds up listener responding, sitting, putting things in. It is just great too for the parent or professional to use the mand, the tac, the echoic, listener responding, to get good responding and not just five mands in an hour or five minutes. We’re talking hundreds of interactions that all have the manned as the base for it all. And when we put the manding or requesting at the center of a child’s program, whether that program is 15 minutes at the table with the parent each day, or whether that’s six hours at school, we put the mand in the center of a child’s program, we will have a much better chance of getting echoic control.

The old way of doing echoic control of sitting the therapist and this child and saying, say ball, say ball. You can’t make a child say ball. You can’t make a child say anything. Even if they said ball two seconds ago, even if they said it 30 times yesterday, you can’t make a child say ball. So we are… With these early learner programs kind of going in the back door, making it fun, making it appealing, having it part manned and getting rapid responding and hundreds of responses. And even if a child is not echoing, and this happens for some of the kids, is they will do these programs. Someone will join my course, they’ll start the programs, and they’ll get the materials to start the table time. They’ll do these programs. Okay. 15, 20 minutes a day. I’m doing them. He likes it, he’s happy. He’s sitting there, he’s having me say ‘apple’, ‘apple’, ‘apple’, three times. He’s putting it in the box, but he’s not saying anything. And then we’re still getting pop out words and no echoic control.

Okay. So that’s where I met with these few moms about a month ago and told them, okay, now it’s time to go to strategy or tip number two, which is this: we want to vary it up a little bit because once kids get used to you say it, then I just listen and then I put it in the box and I get my reinforcement. Like actually the reinforcement is putting it in the box. A lot of really young kids or kids that are older with developmental ages of a young child like that cause and effect. So they’re just sitting in waiting and accepting the thing and putting it in the box. So if we can’t get echoic control just like that, then we have to think, okay, what can do to mix it up?

So maybe not say it three times, maybe say it once, maybe say it four times, and here’s a real trick that worked for establishing echoic control with the client, Mia. I could not get echoic control for months and until we started showing her ‘apple’, saying ‘apple’ once, then covering up the ‘apple’, saying ‘apple’ again. And then that covering up actually helped Mia say the word because she wanted to see the picture. Sometimes another idea… So cover it up, turn the picture around. Another idea is to put the pictures in a box or a bag, and this holds true for potato head parts or puzzle inset parts too. You could put them in a brown bag and you reach in and you can see what it is and you can say ‘apple’ and not show the item to the child and then they might say ‘apple’.

Then if, say they don’t say ‘apple’, then you show them the ‘apple’ and then you hide it again, just be a little bit more playful, a little bit more sabotaging to see if you can get them to talk. So those are the two actually three main things I would do if you are having a compliant child, but they’re still not talking during these early learner programs.

Another early learner program that I forgot to mention, which I’ll just mention briefly is matching. Remember how I said get two pictures, identical pictures of the mom standing there with no bike, no helmet? Get two pictures of mom, two pictures of dad, two pictures of juice, fruit, snack, whatever the child likes. If you have a pet, get two pictures of the pet and call that pet the pet’s name. But we want to get two pictures at the same time and we can push them all into the shoe box. But we also want to try matching. So we might have two or three pictures down on the table. We hold up a picture of banana and the child loves bananas. So that’s why bananas in there, mostly it’s one to two syllables, but bananas kind of one of those acceptable things even though it’s three syllables. But okay, so mommy, you might have a picture of mommy. You say mommy, mommy, mommy. And then you say mommy instead of match. And you might even have to help the child by pointing to the right one. It’s identical to identical picture matching. So those matching and puzzles, they all for the same reason: we want to get language going, we want to get echoic control. So doing a puzzle or saying match, match, match. I don’t do that with my programs. Everything is language enrich and taking advantage of that multiple control of, if they say it as part man, part tact, part echo.

Okay. So tip one is to use the early learner materials. Tip two is to make a game of it, hide it, surprise, and variate to mix it up. Tip three is to use or to try intraverbal fill ins for songs. I know with my son Lucas… This is more than two decades ago, before Lucas was diagnosed, I didn’t know anything about ABA, very little about autism. My husband goes, Hey, watch this. And he said, he started singing the Arthur cartoon theme song and my husband said, and I said, and Lucas said, Hey; my husband said, what a wonderful kind of, Luca said, day; you can learn to work, and Lucas would say play. And I was like, wow, that’s cool. That’s weird. Because he won’t say, if I say play, say day, he won’t say it. So my husband had intraverbal fill-ins without even knowing.

Neither of us knew what they were for a long time after. You don’t have to really… It doesn’t have to be that technical to know what the term is. But basically we’re going to try to sing songs and leave the last word blank. So twinkle, twinkle little, and the child doesn’t say it, star. And then instead of keep going with the song, I might do it again: twinkle, twinkle little.. Star. So I’m leaving a pause. I’m making it fun. And you could do that for a variety of songs. You can also get a picture of a star or if you’re singing, if the child likes you to sing by little ducks went out one day, get pictures of ducks, get pictures of animals for, you know, Old McDonald and those sorts of things. And we’re going to try to go in the back door to get song fill ins.

Now you could see if, if you don’t have echoic control, that’s going to be a lot harder to get. But sometimes for kids, like especially for kids like Lucas, they’ll start to do fill ins before a echoic control and then we can actually use that to get a echoic control. So twinkle, twinkle little star, twinkle, twinkle little star. And the child might say, star the next time. So it’s definitely worth a serious try and not just one time. Try, keep trying. If they like Peppa Pig or my son’s case, he liked Barney. So get Barney songs, get nursery rhyme songs; really shape up songs.

Tip number four, which I don’t talk about that much but I should talk about it more. And I am going to be doing a video blog on this soon because it is a great tip and a great strategy to use, it’s called video modeling and it is an evidence based tool that we use to teach language and play skills.

I had a client, Kurt was one of my first clients, I was with him for months and I could not get echoic control. So we had done strategy number one where we had all the early learner programs and potato head and shoe box and inset puzzles and Kurt… And I’m taking data, the whole two hour session I’m there. I’m taking data up, writing down every word I can hear. And he was saying about 10 words in two hours. And they were predictably eyes, ears, nose, mouth, those kinds of words because of potato head. So I was going away, I was trying to teach him… I was making a plan to teach him sign because if you can’t get a echoic control pretty quickly, you should really move to sign so that a child can get their wants and needs met.

So I was going to be teaching him sign and I was having a therapist, another therapist that was there who I was training take a video of me teaching Curt the initial three to five sides. But Kurt got up, went behind the therapist to watch me on camera and that’s what made me think about video modeling for him. So I had this graph of 10 words and two hours for weeks or months, which is kind of embarrassing because I should have really acted more quickly with getting sign in place. And, but you know, these were the early days where I was defining my methods and I mean he at least he was talking some and he was really cooperative when I started. He had significant aggression and self-injurious behavior. And so we were working on a lot of behaviors, not just talking.

So I had the therapist take two videos of me. One I was singing head, shoulders, knees and toes, very slowly animated. And another one, another video. I just said, eyes, ears, nose, mouth, glasses. Hi. As I touched my own face, body parts. And I asked mom, I’m like, Hey, could you do me a favor? Could you get these two videos on Kurt’s iPad? I’m going to be gone for two or three weeks. It was around the holidays and I was taking a trip. I said, just get these on, you know, maybe this is called video modeling. Maybe it’ll produce something; completely forgot about it. And when I we came back two or three weeks later, I walk in, I’m like, Hey, hi. And Kurt goes, eyes, nose, mouth, teeth, glasses, high. And I’m like, Oh my God, I forgot about the video. And you must have put the video on the iPad. And he must’ve watched it because it was the exact same order that I did it.

That day, instead of getting 10 words in two hours, I got 100 words in two hours, and we were off to the races. We actually put all of Kurt’s programs initially on video modeling. We would just say touch banana and just a video right over top of us. Our hand, it was just our hand. He was not in the room. We were like touch banana and then the finger would go and that’s all he would see. We would have mom hold up different pictures and just say cup, car, video, you know, whatever the words were. She would hold up the picture, cat, and she would say the word one time and he started talking with video modeling. So after that happened with the head, shoulders, knees, and toes with the eyes, ears, nose, I had a lot of kids that were really interested in letters and that’s called hyperlexia, which I did a video blog about.

So I would do the Mary videos, which were just me with a doodle: A, B, as I’d write the letters. So all of my kids, because there were no kids in these videos, they were just me doing silly things and singing songs. All my kid’s got the Mary videos, and this was a big boost in a lot of their languages. So highly, highly recommend it.

And if you’re still not getting echoic control after using these four strategies I’ve talked to you about, even if you do get echoic control, whether you get a control or not, the next step is more assessment and more learning on your part, whether you’re a parent or professional. So I highly recommend the VB-MAPP assessment for all kids that have a language ability of under four-year-old, whether they are, you know, not talking at all or have some words because just because they have some words doesn’t mean they’re going to be conversational. And there’s a whole host of many more complicated strategies that you need to be putting in place.

Not just for language but to control problem behavior, to teach self-care, to make sure the child remains happy, to get independence, to teach academics. So complicated. But I think actually the these five tips to get echoic control are really what’s going to open up the flood gates; or if the flood gates don’t open, in my opinion, the best thing you can do is to do further assessment and further learning on your part. Again, I think the best learning, the best way I can help you besides these free videos and podcasts, are for you to consider joining my online course and community. I know the materials and the community is really making major gains with kids and I’m so excited about that.

So again, the five strategies for gaining echoic control are using the early learner programs such as the shoe box and matching potato head. Number two is mixed things up; variate don’t always say it three times. Hide the card potentially during the sessions. Make it a surprise, put it in a bag, make it fun, make sure the child is happy and having fun the whole time.

Number three, try song fill-ins to songs the child likes. Number four is video modeling and I would make your own videos based on what your child or clients like, and that might really be the key to getting echoic control and getting good responding going across operants. And the number five strategy is to do a VB-MAPP assessment, do standardized language assessments to make sure where we’re at, what the gap is, how to get to the next place. I think is the VB-MAPP assessment and my courses.

So to find out more about how you can teach echoic control and how you can learn how to do the VB-MAPP, how to learn errorless learning and error correction procedures and how to teach colors and academics and language for learning and all those kinds of things… attend a free workshop at marybarbera.com/workshop and I hope that I hear from you, or you hear from me, next week.

Thanks for listening to the Turn Autism Around podcast with Dr. Mary Barbera. For more information, visit Marybarbera.com.