Achieving Vocal Imitation and Echoic Control in Kids with Autism
How to Increase Language Skills
Now, like I said before, there’s what I call pop out words. Pop out words are where kids say things every now and again. Some kids have pop out words every day, while some kids have pop out words only every week or every month. If there’s autism regression involved, like with my son Lucas – he actually had words and he lost them, and I didn’t know back then how to get his words back. Over the past two decades, I have developed procedures which really enable 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 saying “apple” for the first time. He was completely nonverbal when he started my course two weeks prior. Even that to me is hard to believe. But it’s not a race, and some kids don’t ever get verbal for the whole 60 days of the toddler course.
I met with a few moms recently about ways they could get 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 when I say something, whether that’s a word or a sound or a phrase, and then you repeat it either exactly or close enough. So, if I say “apple,” you would say “apple” or “appa” or some other word approximation. Like an echo.
When I say echoic control, some people who have a bad history with ABA are a little turned off by that because they think, why are we trying to control people? But really, it’s just getting them to imitate you verbally and this is the way little kids learn to talk. They listen, they repeat, they start putting things together in a very natural way. With our kids with autism or signs of autism or regression, we need to get vocal imitation as quickly as possible. Because once you do, in my experience, the flood gates oftentimes open and there’s a lot more skills we can teach.
Try, and Try Again
I worked as a board-certified behavior analyst predominantly from 2003 to 2010 and was with the Verbal Behavior Project in Pennsylvania schools. During that time I also had some private clients who were young and taught me a lot. In 2010, I left the project to finish up my PhD. At that point I got a contract with the birth to three-year-old agency in my county. This is really where I took all of my experience and started implementing procedures that were easy for parents to do in their homes. A lot of the procedures I’m going to tell you about today were directly impacted by 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 that I’ve been given permission to talk about, like Daniel, Mia, and Curt, didn’t have echoic control for months, and in Daniel’s case, for over a year. Now that I’ve learned these procedures, I am gaining better, quicker echoic control.
I really thank my initial clients and their parents for hanging in there while we continued to fine tune the methods to get echoic control as soon as possible.
Let’s go through the five tips for getting vocal imitation. These were things I wasn’t really doing the the first half of my career as a behavior analyst but learned the longer I worked with my clients.
Combine All the Operants Together
With my clients now, I combine all the operants together. I use what we call multiple control procedures. For instance, the shoe box program. Basically, with the shoe box program, you get a large shoe box, cut a slit into it and get pictures of important family members, pets, and other reinforcers. You can even have two pictures of the same thing. You can’t use just the pictures on your phone. Make sure you print out a regular size, 4×6 picture with one person or one item in each picture. So, not a picture of mom on a bike with a helmet, that’s too many things in a picture and that could get confusing.
Next, you take those pictures one at a time and you sit diagonally from your child or client so that you’re close enough that you can physically help the child put the pictures in the box. You want to hold the picture up one at a time and say the item name, usually up to three times, in a slow, animated way, “Mommy… mommy… mommy…” As you say it, the picture is actually coming closer to the child and the box. You can hold it to your mouth, “mommy…” get a little bit closer, “mommy…” and then hand it to the child, “mommy.” This is called stimulus stimulus pairing.
VB Bundle and Early Learner Programs
Now, some kids get stuck on having to say the word three times, or they might cry because you’re holding it out too long and they’re getting frustrated. In that case, you just do it quicker. You say “mommy” and you just put it in the box. We don’t want the child crying at the table, or ever, if we can avoid it. We really want to make this fun and light. You can use the same procedure for Mr. Potato Head, inset puzzles, and for cause and effect toys.
These are called the early learner programs and materials, which are all a part of the VB bundle. So, if you have a child who’s 5 or 10 and still not talking, you would join the VB bundle. These techniques work great for speech delayed kids without any autism as well as kids with signs of or diagnosed with autism.
Vocal Imitation Techniques
Programs like the shoebox are multiple control programs. If a child or client says “apple” while you’re holding up a picture of an apple in front of the shoebox, it is actually part mand, or request, because he wants that picture to put in the box. It’s also part tact, or label, because he can see the picture of the apple, and it is part echo because you will say apple while holding up the picture.
It also builds up compliance at the table. It builds up listener responding, sitting, and putting things inside a box. 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 will have a much better chance of getting echoic control.
The old way of doing echoic control of the child sitting down with the therapist and saying, “say ball, say ball” doesn’t work. 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, going in the back door, making it fun, and making it appealing. Because the program is part mand it helps us get rapid responding and hundreds of responses.
Mix Things Up
Even if a child is not echoing – and this happens for some of the kids – they should still do these programs. Some kids will join my programs and sit for 15-20 minutes a day, listening to “apple, apple, apple,” and putting the picture in the box. But they won’t repeat “apple.”
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That’s where tip number two comes in. We want to vary up the programs a little bit because once kids get used to the you say it, then I say it method, then they just listen, maybe they’ll put it in the box and that’s how they’ll get their reinforcement.
A lot of really young kids or kids that are older with developmental ages of a young child like that cause and effect. They just sit and wait, accepting the picture and putting it in the box. If we can’t get vocal imitation that way, then we have to think, what can we do to mix it up? Maybe that means not saying the word three times. Maybe say it once, or four times.
Vocal Imitation Programs
Here’s a real trick that worked for establishing echoic control with my former client, Mia. I could not get vocal imitation for months. That was until we started showing her the picture of an apple and saying apple once, then covering up the picture and saying apple again. Covering up the picture actually helped Mia say the word because she wanted to see the picture.
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 the bag, reach in, you can see what it is and say the word without showing them the object. Then they might say the word. Then if, say they don’t say the word, you show them the object and then you hide it again. Make it a little bit more playful, a little bit more sabotaging, to see if you can get them to talk.
Another early learner program is matching. Remember how I said earlier to get two pictures of the same person or object? For instance, get two pictures of mom, two pictures of dad, two pictures of juice, or whatever the child likes. Some of them should be identical. You might have two or three pictures down on the table at the same time. Hold up a picture of mommy. Say “mommy, mommy, mommy.” You can help the child by pointing to the matching one on the table.
Intraverbal Fill-Ins for Songs
Tip three is to try intraverbal fill-ins for songs. More than two decades ago, before Lucas was diagnosed, I didn’t know anything about ABA and very little about autism. My husband says, “Hey, watch this.” He started singing the Arthur cartoon theme song. “Hey, what a wonderful kind of,” and then Lucas said, “day!” My husband continued, “you can learn to work and,” Lucas would say “play!” I was like, wow, that’s cool. That’s weird because he won’t say play or day if I ask him. My husband had intraverbal fill-ins without even knowing it. Neither of us knew what they were for a long time after.
You don’t even need to know what the term is. Basically, we’re going to try to sing songs and leave the last word a blank. So, “twinkle, twinkle little…” and the child says “star.” But if the child doesn’t say it, instead of continuing with the song, I might do it again. “Twinkle, twinkle little… star.” 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 the child likes you to sing five little ducks went out one day, get pictures of ducks.
Now you could see, if you don’t have vocal imitation, 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 vocal imitation. We can actually use that to get vocal imitation. It’s definitely worth a serious try.
Tip number four is something I don’t talk about that much, but I should talk about more. 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, Curt, who was one of my first clients. I was with him for months and I could not get echoic control. We had done strategy number one where we had all the early learner programs and potato head and the shoe box and inset puzzles. And Curt would say about 10 words in two hours and they were predictably eyes, ears, nose, mouth, those kinds of words because of Mr. Potato Head.
I was making a plan to teach him sign because if you can’t get vocal imitation pretty quickly, you should really move to sign language so that a child can get their wants and needs met. I had another therapist there, who I was training, take a video of me teaching Curt the initial three to five signs. Curt got up and went behind the therapist to watch me on camera. That’s what made me think about video modeling for him.
How I Use Video Modeling
I had this graph of 10 words in two hours for weeks or months, which is kind of embarrassing because I should have really acted more quickly with getting signs in place. But these were the early days where I was refining my methods. He, at least, was talking some and he was really cooperative when I started. He used to have significant aggression and self-injurious behavior. We were working on a lot of behaviors, not just talking.
I had the therapist I was training take two videos of me. For one, I was saying head, shoulders, knees and toes, very slowly animated. And another video I just said, eyes, ears, nose, mouth, glasses. Hi. As I touched my own face and body parts.
I asked the mom if she could do me a favor, to get the two videos onto Curt’s iPad. I was leaving for two or three weeks as it was around the holidays and I was taking a trip. When I came back two or three weeks later, I walk in and Curt goes, “eyes, nose, mouth, teeth, glasses, hi.” And I’m like, “Oh my God, I forgot about the video.” The mom must have put the video on the iPad and he must have watched it because he was saying the words in the exact same order that I did it.
It Really Works
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 Curt’s programs initially on video modeling. We would just say “touch banana” and video right over top of our hands. He was not in the room. We would say “touch banana” and point a finger to the banana on camera. That’s all he would see.
We would have mom hold up different pictures and just say cup, car, video, whatever words we were working on. She would hold up the picture of a cat and she would say the word one time. He started talking with video modeling.
If you’re still not getting vocal imitation after using these four strategies I’ve talked to you about, the next step is more assessment and more learning on your part, whether you’re a parent or professional. You should even do this if you do have echoic control with your child or client.
I highly recommend the VB MAPP Assessment for all kids that have a language ability of under a four-year-old, whether they are not talking at all or have some words. 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. It’s all very complicated.
But I think actually these five tips to get echoic control are really what’s going to open up the flood gates. 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, 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.
The five strategies for gaining vocal imitation are using the early learner programs, such as the shoe box, matching, and Mr. Potato Head. Number two is mix things up. Vary it, don’t always say a word three times. Hide the card during the sessions. Number three, try a song that the child likes for a fill-in response. Number four is video modeling, and I would make your own videos based on what your child or clients like. That might really be the key to getting echoic control and getting good responses going across operants. And the number five strategy is to do a VB MAPP Assessment, or do a standardized language assessment to make sure find out what the gap is and how to get to the next place.
To find out more about how you can teach vocal imitation, learn how to do the VB MAPP, learn about 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.
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