Making Sense of Autistic Spectrum Disorders by James Coplan M.D

Author:James Coplan M.D. [Coplan, James]
Language: eng
Format: epub
ISBN: 978-0-553-90717-9
Publisher: Random House Publishing Group
Published: 2010-09-15T00:00:00+00:00

I like VB because of its eclectic, do-what-works approach, combining oral instruction and—when necessary—picture exchange or signing. Despite its name—verbal behavior—it’s the underlying strategy, rather than the specific communication channel (pictures, signs, spoken words), that distinguishes VB from other forms of communication therapy. VB terminology (mand, tact, intraverbal, echoic, prompting, fading, transfer trials) takes a bit of getting used to, but once you begin to think about communication in VB terms, you’ll see how powerful this method is. There is more to the story than what I’ve shown you here, but these few examples give you the flavor. For additional information, see the Resource List.

Verbal behavior and picture exchange share some common underlying features, based on a behavioral ABC model. In each case, a highly desired item is presented as the enticement (the antecedent). The child then responds (the behavior), sometimes spontaneously and sometimes with the benefit of prompting by an adult. Prompting can be physical guidance (as we saw with Kevin, where the second adult guided his hand to deliver the picture card, or with Joe, where the adult guided him to form the desired sign), a verbal prompt (again with Joe, where the therapist models the spoken word), or something as subtle as a gesture from the adult. Prompting is faded as quickly as possible over succeeding trials. If the child produces a behavior in the desired direction, the therapist delivers a reward (the consequence). The reward is always something known to be highly desired by the child. Usually the parent or therapist spends several days observing and recording the child’s behavior to determine which foods, objects, or activities are most rewarding to a particular child. Items that work best at the beginning are often edibles that can be consumed quickly (individual M&Ms or pieces of cookie rather than a bag of M&Ms or an entire cookie). Soap bubbles are good because they have a short life span and can be delivered over and over without having to be taken away from the child in between times (unlike, say, a spinner toy—once you give it to the child as a reward, it may be hard to get it back without provoking a tantrum).

Another shared behaviorist feature is that of deprivation and satiation. Simply put, if you deprive the child of an item beforehand, the child’s desire to obtain the item will increase. If you give the child unlimited access to the item, then eventually the child will have had his fill of that item, and his desire for more of it will decrease. So if you will be using M&Ms, bubbles, or potato chips as a reward during therapy sessions, your best bet is to restrict or eliminate access to these items at other times. From now on, your child can gain access to them only as a reward for demonstrating the desired behavior. This may seem a bit harsh, but remember that your child with ASD does not intuitively understand the relationship between his or her behavior and the reactions of others.

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