Transcript for Podcast Episode: 098
What Manners to Teach Kids with Autism
Hosted by: Dr. Mary Barbera

You're listening to The Turn Autism Around podcast episode number ninety-eight. I'm your host, Dr. Mary Barbera. And today I'm doing another solo show covering the three mistakes parents and professionals make when teaching manners to children with autism or signs of autism. And I've made all of these mistakes, so I'm going to tell you about them and tell you how to teach manners, including excuse me and thank you. Before we jump into the episode, I am going to give a listener shout out to Melinda Mae, who gave a five-star rating on review on Apple podcast.

She said, "I listened to your podcasts since you started. Completed your online courses and bought your book. This is such important information that Dr. Klim is doing. And as a professional, I have been utilizing this within my practice. And I'm so glad you're extending this out to your audience. So much can be done if we work together and share with each other along the way. Excited to see what's to come". So if you are like Melinda. Thank you so much for chiming in there and giving a five-star rating review. It really does help me get the word out.

And if you are like Melinda and you've listened to podcasts and you've loved them, I would love it if you wherever you're listening, especially at Apple podcasts, if you would leave a great rating, a review like Melinda did. It really does help with my dissemination. OK. So right now, let's get into the three mistakes parents and professionals make when teaching manners.

Welcome back to another episode of Turn Autism Around. Let's dive into those three mistakes parents and professionals make. So I, like I said, made all of these mistakes. And early on, we were so eager to teach my son Lucas manners that we ended up inadvertently chaining all the manners together and really making a mess of things. For example, when he was about four, I think we would sneeze or pretend to sneeze and we would teach him to say God bless you.

And then we would say thank you. And then we would try to teach your welcome all at the same time. This was a critical mistake. So what happened then is after a few of our little trials, I too, Lucas, would say, God bless you. Thank you. You're welcome. Altogether. And because I wasn't a behavior analyst back then, I had no idea how to fix it. And it took me I don't know how long it took me to fix it.

But to this day, Lucas is we'll say thank you after someone. I mean, God bless you after someone sneezes. But we do not teach your welcome. And we. He's he doesn't say you're welcome, but he does say God bless you. He says thank you. He says, excuse me. He says, move, please. And today I'm going to talk about three mistakes and also what to do instead so that you can have a child that has good manners. And I remember back I mean, probably when Lucas was a teenager, he needed to get a two-day EEG to rule out seizures at a medical center. And I had to stay over with him, of course, for the two days, and he tolerated it well.

And we were able to rule out seizures at that time. And I remember, like all the nurses there were so impressed with his manners. And they kind of made me laugh because, you know, the messes we made with his manners early on gave me a chuckle. But like I said, we did teach Lucas to have really good manners. And it was several nurses who complimented Lucas and me on his manners, even though he has pretty impaired verbal abilities. He can communicate, but he is not conversational. So let's talk about. Mistake number one.

Mistake number one is like I did with Lucas teaching manners too early before your child or clients have hundreds of spontaneous two-word utterances. I used to say one to two-word utterances. But I recently did a podcast where we talked about the mistakes that people make when building language and some research that I found out about through Dr. Carbone�s National Autism Conference lecture shows that really we need to develop two word pivotal phrases before we can really hone in on teaching more advanced language such as manners.

So we don't want to teach too early. If your child can't request what they need, they can't label hundreds of items. They can't label some actions. They can't request some actions. They can't imitate. They can't match. They can't talk. Teaching please and thank you. Which a lot of early intervention professionals recommend and a lot of parents are eager to teach if it's taught too early. It may very well backfire.

So we do teach a lot about length of utterance, like adding carrier phrases, which I would suggest you avoid. I did a video blog on why I would avoid teaching career phrases and carrier phrases are at the beginning. Usually at the beginning, sometimes at the end. But there pat, rote kind of responses.

So once a child can ask for cookie, a lot of times people recommend teaching "I want" or once they can label Sky or cup somebody might, you know, well-meaning, they're trying to expand length of utterance, but they might teach "thatsa" or "Isee-uh". And those pat phrases really get in the way when we're trying to teach more flexible responding. So the length of utterance is a big deal. I like to go with instead of word length. I like to go with syllable length. So adding a please or a thank you.

Like I want cookie, please. That's a lot of syllables I want. Cookie, please. It's five syllables. If you don't have spontaneity with one to two syllable words, teaching rote responses like that is probably going to not be a good idea. The other thing that we look at when we look at length of utterance is articulation.

So, if the cookie sounds like "ooggi" or "oo-ee", adding more words and more syllables really is just going to get in the way. And what we have to really think about "please" and like what what does that do for the child? Pretty much nothing.

It reminds me of a little boy I, I saw years ago, and he had some words and I was trying to assess him and he was reaching for this bag of chips and he was saying, Chip or I want Chip and I would give him a chip or I would break off, you know, half a chip and give it to him.

But he was having problem behaviors. He was tantrumming. And I said to his mom, like, why is he tantrumming? And she said, because he wants the whole bag. He wants a whole chip. And so adding, I think he was even saying, please. So he was saying, I want Chip, please. And I was giving him a chip, but he wanted the whole bag. So he didn't have enough language.

So that I want and please really was not helpful. Like whole chip, which is a pretty intense concept. So that's probably too early to teach. But we need to teach actions, adjectives and nouns and get kids flexibly responding. Avoid putting please on the end of things. It's just going to add more length buttons, more articulation problems potentially. And it could shape up weird language if we're not careful.

OK, so what we want to do instead of starting manner too early, is we want to focus on the child's wants and needs. The manned or requesting should be at the center of each child's programing. It should be at the center of what we you know, if I were learning a foreign language, I would be wanting to know, like, say, I was going to Japan tomorrow and I know zero Japanese. So what kind of words am I going to look up in the dictionary or have an app on my phone?

I'm going to look for words like eat, taxi, drink, hungry. Those are all requests to meet my needs. I'm not going to look up in the dictionary how to say things in a complete sentence because that's. Obviously very complicated. So we want to really focus on one word utterances, one to two syllables. And then as we expand two word utterances, we want to slowly expand those syllables and the complexity. And we want to forget about manners early on.

OK, so mistake number two is chaining manners together. That's the example I used with Lucas. God bless you. Thank you. You're welcome. Another big one. An example of a manner that's chained together is I'm sorry. And I did do a video blog on "I'm sorry". So you may want to check that out. Anything I'm mentioning here that you, quote unquote, may want to check out. You can find in the show notes at MaryBarbera.com/98. I know you may be exercising or driving in a car or doing other things, but you can always get to the show notes. Even if you want to search Mary, autism and manners you'll find my show notes and you'll find all of the things that I'm recommending.

So I'm sorry is chained together with problem behaviors a fair amount. So child has problem behaviors. And so they have language and they have the ability to echo you, I did a podcast on echoic control, so the child hits his brother and mom comes in and brother's crying and the child with autism is sitting there and mom says, that's not nice. Say, I'm sorry. The child says, I'm sorry. And it gets chained together. So next time Johnny hits his brother. He might be hitting him saying, I'm sorry, I'm sorry, doesn't cancel the fact that now we have a hitting problem. We have aggression and aggression is serious. And if especially if it's not your brother in your family or if this child is bigger, he can hurt his brother if he's in a preschool and he bites is a classmate.

That's very common for biting to get children thrown out of daycare. I did a video blog on getting kicked out or held back in daycare or preschool and fighting, I always say, is like a behavior that will get you thrown out of places because it's dangerous. If a child bites and they end up having something like hepatitis or AIDS or anything, they could transmit that. The bite could also get infected whether they bite a child or an adult. And so biting is something that's really dangerous. So if you're changing in I'm sorry for biting. It's not solving the problem. We need to figure out why the child is biting. And we need to spend 95 percent of our time preventing problem behavior, not reacting to it.

You may say, well, that's part of his consequence. He has to say, I'm sorry, then he has to sit in time out and this and that. But I am saying as a behavior analyst, as a nurse, as a mom, chaining together anything saying I'm sorry or having any kind of consequence like time out. If biting is occurring, something is not. We need to go back to the drawing board. Make sure you have an assessment like my one-page assessment, a plan you need to be preventing problem behaviors. And I know it's a ton of work, but changing I'm sorry and makes things confusing, especially if a child doesn't understand what I'm sorry is, doesn't understand language, can't request, can't label, can't imitate, can't match all of those skills.

They may sound like they have nothing to do with problem behavior and nothing to do with manners. But we need to look at the whole child and make sure that the child is as safe as possible, which if they're having problem behaviors, they're not being safe. They need to be as independent as possible and as happy as possible. And prevention is key.

So teaching I'm sorry, is difficult and really needs to be on the backburner until your child has developed language. If you follow the Vehbi map, which my courses go over, how to use the Vehbi map pretty extensively, unless your child is in level three or beyond the Vehbi map areas has a language ability of at least a high three-year-old or four-year-old or beyond. They are not going to be able to understand. I'm sorry. And that's just going to mess with the language and chain things together like a chain. Thank you. God bless you. Thank you. You're welcome. OK.

So the first mistake to avoid is teaching manners too early and the number two mistake. I see. That I've made in the past is changing manners with other things. Chaining manners with other language before the child's ready, chaining them with problem behavior. And the third big mistake that I see is once the child is ready to learn manners, not teaching it systematically.

So when the child is ready, and I learned actually some of this pretty early on when Lucas was four or five and he didn't have a lot of language, but I was able to teach him "excuse me" and "thank you". Based on the advice I saw in a workshop presented by Dr. Bridget Taylor. Bridget Taylor was interviewed in podcast number 56. It's a great interview. You may want to go back to that. We didn't touch on any manners, I don't think. But I did see her and she gave some good examples of how to teach man. Or so I do want to give credit to to Dr. Bridget Taylor for teaching me early on, two decades ago, some of the early work with manners.

So when a child is ready, when they have some flexible two word responses and they have major problem behaviors near zero. They have some language and it's it might be time to teach. Excuse me and thank you. So I'll teach thank you first. So thank you. The best way I have found, based on some of the examples that I saw early on, is to have a child request what they want. So say it's a drink. Right. And as you're giving the drink to the child and he's putting his hand on the drink instead of letting it go, kind of give a tug and say thank you. Child says thank you.

Now, this is for a child that has echoic control who has the ability to echo what you're saying. So I hand it to him, he requests drink. I hand it to him, but I don't release my hand. His hand is there and I prime "thank you". In this case with Lucas when he was little, he said thank you. And then I would give it to him. Then I would do another trial, maybe right then maybe an hour later, maybe the next day I would again hand it, you know, he'd request drink or a cookie or something that you can hold on to and give a little tug.

You're not in a tug of war with the item. You're just gently giving a little tug back to prompt the thank you. So in this case, say it was just a minute later he asked for a drink again. I handed it to him. I gave him a little tug. Now, this time, instead of giving a full prompt of thank you, I might give a partial prompt and just say for like �th-�.

And in that case, Lucas didn't take that prompt. I said "th-", he said thank you. And then I might have even, before I gave him that, done a transfer trial. And I've done a lot of work with Dr. Rick Carbone on transfer trials. I have a podcast episode about it. So I might right away not even give him a drink. Do it again.

He says drink. I pull it back and he says, thank you. Even independently. And then he had it. For Lucas and kids like that, even without a ton language who have a echoic control. You can teach thank you like this. I would avoid verbal prompting, like give it to him and then say "say thank you". Or "what do you say?" That's the way most people teach. Think of it. Thank you. And it gets kids really prompt dependent. So I like to give a little tug on the item and see if you can reduce your prompts and teach the child to say thank you. So that is how I routinely teach. Thank you. The other early manners that I teach is "excuse me".

So when I saw Bridget Taylor two decades ago and I have not a great memory, so if I can remember a video she showed two decades ago, it was powerful. Right. So it was an older child. So Lucas was only like four years old when I saw Bridget Taylor for the first time. It was an older child that came behind Bridget or somebody she was working with, this older teenager.

This person standing in front of the teenager was blocking access to cookies or something that the teenager wanted. So they were blocking it. The teenager came kind of close to them, behind them. And then there was a third person standing there like a therapist or mom. And she prompted, excuse me, excuse me. You can even prompt the teenager or the young child tapping on the shoulder and saying, excuse me. And then the therapist or the adult would move out of the way and the child would get access to the reinforcement.

So when I saw this, I thought, you know, excuse me, seems like a pretty reasonable thing to teach Lucas, even though is for I didn't have a ton of language. But we did have. I probably didn't even know what it was called. But we he would echo us.

So I remember he was doing ABA in the basement, day in and day out for six to eight hours a day, I mean, it was very rigorous. And I remember one of his reinforcers was that he really loved this C.D. playing the music nursery rhymes. And we would play bits of it and stuff, but only with this one song. Mary had a little lamb.

Lucas, who is four, would hop up out of his seat and he would run around the room, something in that song. Hey, Lucas run around the room. So what we did after I went to that lecture and I thought, OK, how could we prompt him in a fun way, like especially early on when he's maybe not ready to teach manners.

How could we see if this could work? So what we did was Lucas we played Mary had a little lamb. He would hop up and he would start running. And I would gently put my arm out to block him and say, excuse me, and he would go, excuse me. And I would pull up my arm right away and he would keep running around. And then even during the song, I may have gotten five trials and stop him. He would say, excuse me, I would remove. And I swear within one or two Mary had a little lamb. Lucas said, Excuse me. And best of all. Then I remember sitting I was in my other house. I remember vividly sitting on a little step and he wanted to get through. I wasn't doing any trials. I wasn't, you know, doing anything with him. He wants to get through and he said, Excuse me. And I was like, whoa, you know, jackpot.

Of course, I hopped on up and let him run through, but it was just teaching him "excuse me", with the Mary had a little lamb. Those are how I teach early manners. I don't teach "God bless you". Because what's in it for the child? There's something in it to teach "thank you". Because I'm tugging at the item gently and there's something in an �excuse me� that are built in reinforcement. And so I would start with those two and then go from there. So in summary, don't teach manners too soon. Wait for a fair amount of language to come in. If you don't have echoic control, you may want to check out that podcast or video blogs.

Don't change "please" and carrier phrases to requests and definitely don't chain "I'm sorry" to problem behaviors. And when it's time to teach manners, teach them systematically. I would start with "excuse me" and "thank you". Which tend to be the easiest to teach. And I hope you enjoyed this short podcast. I think it's important. I think it's important that we teach our kids to be as polite as possible and you can teach it in a fun way and like I did, and really see improvements pretty quickly if the child is ready.

So if you like this episode, I would love it if you hop on Apple podcast or wherever you're listening, give me a great review and rating if you didn't like it or if there's something that is causing you not to give a five star review. E-mail us at [email protected] We're open to constructive feedback. It's just we need to get the word out that I do have techniques to help parents and professionals help kids with autism or signs of autism do better, talk more, tantrum less and help them with eating, sleeping, potty, desensitization to doctors, dentists.

Those are all really big concepts. They're all going to be covered in my new book, Turn Autism Around, which is coming out in the spring. And I'm covering them here and my podcast. I need you to come out and help me in this action to get the word out that there is a better way and that we want our kids and ourselves to live happier lives, be more independent and get to their fullest potential. Have all of us get to our full potential, too. That's my goal. So have a great day. And I hope you enjoyed this podcast.