- The Verbal Behaviour Milestones Assessment and Placement Programme (VB-MAPP, Sundberg)
- The Assessment of Basic Language and Learning Skills-revised (ABLLS-r, Partington)
- The Assessment of Functional Living Skills (Partington, 2013)
- Essentials for Living (McCreedy, 2012)
- Early Start Denver Model
After a baseline assessment is conducted,an Individual Education Plan (IEP) is developed that outlines which skills need to be taught first. Below is a list of skills that we can teach using the principles of ABA/VB:
The first skill we will teach your child is how to cooperate so that they can be taught. We teach this skill by using preferred toys/equipment and interaction that your child likes and slowly start to ask your child to follow simple instructions and teaching demands,
such as to copy actions or to match identical pictures. Using hand over hand prompting we will show your child what to do. Their preferred toys and activities are then presented as a consequence for both cooperation and correct responding.
In the early stages of a programme, co-operation is usually taught by teaching your child to make requests. Requesting is one of the initial forms of language development, and forms the foundation for the development of other, more complex language skills. Your child will initially be taught to communicate their needs and wants using a system that is appropriate for them e.g. speech, sign language, Picture Exchange Communication System (PECS) or a communication aid. For non-vocal children, an augmentative system is used with the long term goal of developing speech (see below).
Teaching your child to request will involve manipulating their environment in a way that establishes their motivation and increases opportunities for them to communicate with others. This involves making their preferred items/activities harder for them to access independently. For example, preferred items are put up on to a shelf or in a clear container to ensure that they can see the items, but cannot access them freely. As soon as your child shows motivation for the item such as reaching, or taking an adult’s hand, your child is prompted to request the item using hand over hand prompting e.g. their hands may be shaped to make a sign, or to hand over a PECS picture, or if they are able to repeat words they would be required to repeat the spoken word that is modelled to them. Over a number of practice trials, prompts are then slowly faded so that your child starts to request independently.
Once your child is able to requests their basic needs and wants, more advanced requests are then taught, such as requesting for attention, requesting for help, requesting for information (what, where, why, how etc) and requesting using word classes such as adjectives, verbs, prepositions, pronouns etc.
Many children with autism are described as nonverbal which means that they are not able to communicate using words. Whilst many children on the spectrum are able to make sounds when babbling, it is quite common that they are not able to make those sounds when a model is presented and they are asked to repeat. Children with autism often show signs that are similar to verbal dyspraxia. Verbal Dyspraxia is a condition whereby an individual has difficulty making and coordinating the movements needed for speech in their mouths. Children often find it difficult to make individual speech sounds or to combined sounds together.
At Autism Fledglings we specialise in developing speech using a variety of procedures that address the symptoms of Verbal Dyspraxia. Theses include:
- Stimulus – Stimulus Pairing: this procedure aims to increase the frequency of specific speech sounds during vocal play and is based on the way in which babies learn to talk. It involves pairing an unconditioned stimulus with an already established form of reinforcement, so that over a number of pairing trials the previously unconditioned stimulus takes on the reinforcing properties of the established (for more information read Sundberg et al, 1996; Ward et al, 2007). The procedure requires that the therapist pairs a specific speech sound (usually a sound that is already present in the child’s repertoire during babbling) with established reinforcement. For example, the therapist may pair the sound ‘m’ whilst the child listens to music. Over a number pairing trials, the therapist can begin to add in a time delay by which he/she waits to see if the child emits the target sound. If the child emits the sound the music is delivered. If the child does not emit the sound pairing continues.
- Direct Reinforcement of Vocalisations: this is a procedure that is used to increase the frequency of vocal play of appropriate speech sounds. This procedure requires the therapist to deliver reinforcement every time the child emits a targeted speech sound. The speech sound is usually one that the child makes during vocal play. The therapist echoes the sound back to the child as they deliver reinforcement.
- Rapid Motor Imitation Antecedent (RMIA): this procedure is used to help evoke echoic behaviour i.e. the child emitting a targeted speech sound when the therapist presents the instruction “Say x”. In order to implement this procedure the child must first have a wide range of motor imitation skills. The therapist is required to present 3 gross motor imitations, followed by 2 fine motor imitations, in quick succession, with the child copying the actions as the therapist goes through the sequence. The therapist then quickly presents a target sound, for example, ‘ah’ and reinforces as soon as the child emits the sound.
Extinction:the use of extinction to occasion a sound is used to evoke initial speech sounds on demand. The child must first have oral motor imitations such as open mouth, close mouth and be able to blow which can be taught as part of the child’s imitation programme. The therapist is required to perform an activity that the child is particularly vocal during. The therapist then presents an imitation trial such as ‘open mouth’ and instructs the child to “say ‘ah’”. As the child opens his mouth, a tactile cue can be used to extend the duration that child opens their mouth. As soon as the child makes any sound, reinforcement is delivered.
Talk Tools:Talk Tools Therapy focuses on providing proprioceptive-tactile input to attain correct phonetic placement (Bahr, Rosenfeld-Johnson, 2010) for speech production and appropriate feeding. The therapy focuses on first, evaluating the movement and placement of mouth structures for speech production, and appropriate feeding. A hierarchy of tactile-proprioceptive therapeutic exercises are then introduced to teach the targeted movements needed for speech and feeding. The exercises also work on increasing strength within the oral musculature. The exercises teach the child the ‘feel’ of speech such as where their jaw, lips and tongue are, while developing motor plans for speech and feeding.
- Tactile Cues: Tactile input is used to help evoke speech sounds and/or improve articulation. These cues are applied by the therapist to the child’s mouth to evoke different speech sounds. As the child becomes successful, tools, hands and verbal cues are faded so that the child is able to produce the sound with correct placement independently.
Kaufman Sign to Talk Kits: Kaufman Sign to Talk Kits are used to shape word approximations toward intelligible articulation (Kaufman, 2004). Each word is broken down into an approximation (wordshell) using sounds that the child may be producing e.g. the word ‘bubble’ can be broken down into ‘buh-buh’ and eventually shaped in to ‘buh-bo’ and so on.
We use a variety of assessments and curriculums to develop Individual Education Plans that address your child’s cognitive skills in developmental sequence this includes:
- Visual Performance Skills
- Receptive and Expressive Language
- Gross and Fine Motor Skills
- Reading and Comprehension
Life and Leisure Skills
Using positive teaching techniques, we are able to teach your child to tolerate procedures such as dental visits, hair cutting, and teeth brushing, as well as increasing leisure skills such as riding a bike, swimming, and horse riding etc.
Self-Help & Feeding Skills
Self-help skills are taught using a step-by-step approach. This includes skills such as dressing and toilet training and other essential daily living skills. We are also able to use effective intervention for increasing the range of foods your child will eat.
Some of the children that we work with require intervention that addresses the fundamental skills required to develop meaningful interactions with other.
The type of approach that we use will depend on the language ability and skill sets of the individual. It is important to know the theory behind social rules and expectations as well as putting this it into to practice. We use a holistic approach to ensure that our children can understand the rules of social expectations, and we use the science of ABA to prompt, shape and reinforce the use of this knowledge in real life situations.
We use the following social skills curriculums:
Michelle Garcia Winner explains Social Thinking as what we do when we interact with people: we think about them. She explains that how we think about people affects how we behave, which in turn affects how others respond to us, which in turn affects our own emotions.
For the majority of people, this ability is developed from birth onwards when we start to observe and acquire social information and learn how to respond to people. But for individuals on the spectrum this can be very difficult.
Michelle Garcia Winner’s curriculum targets improving individual social thinking abilities by offering a range of strategies that address individual strengths and weaknesses in processing social information.
This assessment and curriculum offers useful resources designed specifically for children aged 4 and above. It includes activities and games for developing self awareness and self esteem which are prerequisites to developing social skills. This resource has already been piloted across the UK and abroad and has proved to be very popular with teachers, therapists and children.
Social Skills Groups
In 2015, we will be setting up social skills groups for 3-4 individuals per group. Following an assessment, individuals will be matched according to their social skills strengths and deficits. The groups will follow a combination of the above curriculums. Following each session a record of the student’s progress will be kept with an end of term report provided to parents. Groups will run as a 6 week block throughout the year.