What do educators need to know about EBPs for children with autism?
Page 3: Foundational Strategies
Many practices found effective for either teaching children with ASD appropriate behaviors and skills or for decreasing inappropriate behaviors are based on applied behavior analysis (ABA). ABA is an academic discipline interested in applying the principles of behavior to the improvement of socially important problems. When working with students with ASD, this includes systematically applying an intervention to teach an appropriate behavior or to decrease a challenging behavior, as well as collecting data to evaluate the effect of the intervention. The theory behind this approach is that, if a student is reinforced after performing a behavior, the student will continue to demonstrate that behavior, but if the behavior does not result in reinforcement, the student will decrease or stop engaging in it.
Over the last 40 years, research has demonstrated that interventions based on ABA are effective for increasing desired behaviors and skills and decreasing undesired behaviors of children with autism. (Leaf, Leaf, McEachin, Taubman, Ala’i-Rosales, Ross, Smith, & Weiss, 2015; Hagopian, Hardesty, & Gregory, n.d.)
Ilene Schwartz discusses why ABA is the most effective treatment for children with autism and provides examples of how it can be used to increase positive behaviors (time: 2:23).
Ilene Schwartz, PhD
Professor, Special Education
Director, Haring Center for Research
and Training in Inclusive Education
University of Washington
Applied behavior analysis, often referred to as ABA, is the most evidenced-based approach to work with children with autism, and we’ve known this since the late 1960s when people first started working with children with autism. ABA is the use of behavioral principles to address socially important behaviors. The behavioral principles that we are talking about primarily are reinforcement and punishment. We primarily, though, use reinforcement. Reinforcement is the contingent application of a stimulus after a target behavior that increases the likelihood of a behavior happening again.
Let me give you an example. When you have a toddler and they raise their arms up to their parents, they’re basically asking to be lifted. When the parents pick them up then that increases the likelihood, next time they want to be picked up, they’re going to raise their arms when they see their parents. That’s an example with a typically developing child.
Let me give you an example with a child with autism. The child with autism sees their very favorite toy, which is the blue truck on the shelf, and they can’t reach that toy. At first, they might get frustrated and start to stomp their feet or cry because they can’t reach the truck. What the teacher might do when they see that is actually show the child the card that has the picture of the truck on it and help the child give that card to the adult. And the teacher says, “Oh, you want the car?” and hands the child the car.
The next time the child sees the car, again out of reach, and the card with the picture on it, they’re more than likely to give that card to the teacher. And through that kind of teaching and use of positive reinforcement, we teach children a huge array of skills and behaviors. And that’s one of the reasons that applied behavior analysis is the most effective treatment for children with autism.
Many of the 27 EBPs identified for students with ASD are based on ABA. These practices are focused interventions—that is, they target discrete skills or behaviors and are employed for brief periods of time until the goal is achieved. Five of these interventions—reinforcement, prompting, time delay, modeling, and task analysis—reflect the building blocks of ABA and, therefore, are sometimes referred to as foundational strategies. Each of these strategies is described in the tables below, and each is accompanied by an example of how it would be applied. It is important to note that these fundamental strategies can be used to target discrete skills or behaviors or they can be included as part of a larger intervention (i.e., ones that consists of multiple components). Subsequent pages explore multicomponent practices that embed these strategies.
Positive reinforcement involves providing a desired consequence (e.g., a tangible item, access to an activity, or social reward/praise) after a student engages in a desired behavior, which, in turn, leads to the likelihood of increased occurrence of the behavior in the future.
Negative reinforcement involves removing an unwanted object or condition (e.g., an aversive noise or non-preferred task) once the student has engaged in the desired behavior, which, in turn, leads to the likelihood of increased occurrence of the behavior in the future.
It is important to understand that reinforcers differ from child to child (i.e, what’s reinforcing for one child might not be for another) and change over time (i.e, the reinforcer may become less effective). Therefore, it is important to assess the child’s preferences—for instance, by talking with the child or via a reinforcer survey—when selecting reinforcers.
Goal: To teach new skills or to increase appropriate or desired behaviors
Example: Recall that David has a tendency to avoid food with textures that he does not like. His teacher and parents determine that praise is reinforcing to David. Every time David tries a new food or one that he has avoided, his teacher or parents praise him (e.g., “David, I’m proud of you. You tasted the cracker.”).
Video Example: Emma has difficulty completing her mathematics classwork. To increase her classwork completion, Emma’s teacher decides to use negative reinforcement. In the video below, the teacher temporarily removes the aversive task (i.e., completing mathematics problems) by allowing Emma to take a short break. After the break, she will complete five more math problems, alternating between classwork and breaks until she has completed the task. Over time, the teacher will gradually require her to complete more problems before getting a break. The goal is for Emma to complete the classwork without a break (time: 0:39).
Teacher: Okay Emma, you need to start working on your math problems. Emma: I don’t want to do it. Teacher: Okay Emma, just do five problems. Then you can take a break. Emma: Fiiiiiine.
[Emma works problems on her worksheet.] Emma: All done. Teacher: Great! Read a book for five minutes and then do five more math problems.
Description: Using a prompt to assist a student when he is learning a new skill or behavior to help improve his chances of success. The five types of prompts are:
Gesture—Includes pointing at or touching an object
Verbal cue—Includes verbal hints and directions
Visual cue—Includes illustrations, photos, and objects
Modeling—Includes demonstrating or showing a child how to perform a skill
Physical—Includes physically directing or touching a child to help him perform a behavior or skill (Note that this is especially useful for teaching motor skills)
Goal: To reduce incorrect responses when a student learns new skills, thereby promoting success and reducing frustration
Start with a prompt that meets a student’s individual needs but requires the least amount of assistance. Typically, teachers should not start with physical prompting, which provides the most assistance.
Gradually fade prompts over time.
Always use positive reinforcement after a child complies. Doing so will increase the likelihood that the student will use the skill or engage in the behavior in the future.
Example: When he plays with cars, Drew lines them up instead of playing with them in a traditional manner. His teacher uses a physical prompt to demonstrate how to push the cars on the floor. She places her hand over Drew’s, and together they push the car. The teacher then verbally praises Drew.
Video Example: Watch as a teacher prompts Emory, age six, to spell the word “dog” using a word puzzle. Also, notice that the teacher provides verbal reinforcers throughout the task and a tangible reinforcer at the end of the task (time: 0:34).
Teacher: Okay, Emory, what’s this a picture of? Emory: A dog. Teacher: Good! Can you spell the word “dog”? Can you put the “d” in first? Good. Can you put the next letter, the letter “o”? Good job, and can you put the last letter “g”? Okay. And what did we spell? Emory: “Dog.” Teacher: “Dog.” Good job! Here’s a sticker. Are you going to put it on your shirt?
Description: A means of systematically providing and then fading prompts. When teaching a new behavior or skill, the teacher prompts the child and then immediately provides the correct response (e.g., “What is this? A plane.”). Then the teacher increases the time between the prompt and the student’s response using one of the methods below.
Constant time delay—After the student has been cued to perform a task and does not comply, the student is prompted at a set interval (typically 3–5 seconds).
Progressive time delay—Initially, the student is prompted when the cue is presented (0-second delay); then the time between the cue and the prompt is increased (e.g., beginning with a 1-second delay and then increasing to a 2-second delay, and so forth).
The child is always reinforced for providing the correct response.
Goal: To prevent dependence on prompts
Example: When asked to roll a car on the floor, Drew continues to line up cars instead of pushing them around unless he receives a physical prompt. His teacher uses progressive time delay to fade this support, beginning with a 0-second time delay, in which she prompts with “Roll the car,” and places her hand over his and pushes the car. The teacher gradually increases to a 1-second delay, in which she provides the prompt, “Roll the car,” and waits one second. If Drew responds within one second, the teacher provides a reinforcer. If Drew does not respond, the teacher places her hand over his and pushes the car. After Drew can respond correctly within the 1-second time delay, the teacher increases to a 2-second delay, and so forth, until Drew no longer needs prompting to push the cars instead of lining them up.
Video Example: Watch as a teacher uses progressive time delay to help Emory learn sight words. Again, notice that the teacher provides verbal reinforcers throughout the task and tangible reinforcer at the end of the task (time: 2:50).
Progressive time delay is a means of systematically providing then fading prompts in order to teach a new skill. Initially, the student is prompted when the cue is presented, This is known as a 0-second delay. Later, the time between the cue and the prompt is increased, for example by beginning with 1-second delay and then increasing to a 2-second delay and so forth.
Zero-second time delay: During a 0-second time delay, the teacher provides the correct response when the prompt is presented, and then the student performs the skill.
Teacher: Okay, Emory, are you ready for our sight words? Okay, “we.” Emory: “We.” Teacher: Good! “Cat.” Emory: “Cat.” Teacher: Good job! “Dog.” Emory: “Dog.” Teacher: “Go.” Emory: “Go.” Teacher: Good job! Teacher: “If.” Emory: “If.” Teacher: Great job today on your sight words. Emory: “I.” Teacher: Perfect!
One-second time delay: During a 1-second time delay, the teacher provides the prompt and waits for one second, allowing the student to perform the skill. If the student doesn’t respond, the teacher demonstrates the skill.
Teacher: Okay, Emory, we’re going to do our sight words again today, okay? Emory: Okay. Teacher: Okay, what’s the first one? Emory: “I.” Teacher: Good job! Emory: “No.” Teacher: Good job! Emory: “See.” Teacher: Great. “Little.” Emory: “Little.” Teacher: Good job! Emory: “Cat.” Teacher: Okay. “Be.” Emory: “Be.” Teacher: Good job! You did great with your sight words today!
Two-second time delay: Once the student begins to respond correctly within the 1-second delay, the teacher increases the delay to two seconds between providing the prompt and performing the skill.
Teacher: Okay, Emory, are you ready to do your sight words today? Emory: Uh huh. Teacher: Great. Can you tell me what this word is? Emory: “He.” Teacher: Good job. Emory: “And.” Teacher: Great. Emory: “To.” Teacher: Perfect! Emory: “My.” Teacher: Good job! Teacher: Good job! Okay, this word is “mouse.” Can you say “mouse”? Emory: “Mouse.” Teacher: Good! Emory: “Go.” Teacher: Great. Emory: “In.” Teacher: Great. This word is “girl.” Can you say “girl”? Emory: “Girl.” Teacher: Good job. You did a great job today.
The teacher can continue to increase the time between presenting the prompt and the student’s response until no further prompting is required.
Description: Demonstrating how to perform a skill or behavior correctly prior to asking the student to perform the behavior; a visual demonstration can also be used to prompt a student after he or she has been asked to perform a skill or behavior.
Goal: To increase a student’s ability to correctly perform an action
Modeling is more successful when combined with prompting and reinforcement.
Although anyone can serve as a model, it is recommended that a peer similar in appearance and respected by the student model the skill or behavior.
Modeling can be used to demonstrate how to perform a skill or it can be used as a prompt once a student has been asked to engage in a behavior.
Example: Jaquese has a difficult time interacting with peers. His teacher asks Ryder, a well-respected peer with good social skills, to demonstrate how to initiate a conversation with peers and how to respond to the initiation of others.
Video Example: In the example above, modeling was used to teach social skills. However, teachers and peers can use modeling to demonstrate a variety of skills or behaviors. In the video below, the teacher models for Emory how to build a tower with a pattern (time: 0:55).
Teacher: Okay, Emory, are you ready to build a tower? Emory: Uh huh. Teacher: Okay, today we’re going to build a tower with a pattern, okay? Emory: Okay. Teacher: I’m going to show you how to do it, and then I want you to use the same color blocks to build the same tower. Emory: Okay. Teacher: I’m going to put a red one and then yellow then blue and red and blue. Can you build that kind of tower?
[Emory builds a tower.] Teacher: Good job, Emory! Okay, here’s a sticker.
Description: Amethod of breaking multi-step skills or behaviors into smaller components that can be taught one at a time
Forward chaining—The first step of the skill is taught, and once mastered the second step is taught; this process continues until the student can successfully perform the entire skill sequence.
Backward chaining—The last step of the skill is taught, and once mastered the previous step is taught; this process continues until the student can successfully perform the entire skill sequence.
Goal: Tohelp students learn to successfully perform multi-step or complex skills and behaviors
Watch as a teacher uses forward chaining to teach Emory how to tie her shoes (time: 3:27).
Teacher: Okay Emory, are you ready to learn how to tie your shoes today? Emory: Uh huh. Teacher: Okay, first, we’re going to take your laces and cross them over like an “X,” okay? Then we’re going to put this one in the hole and pull it tight, okay? Emory: Okay. Teacher: Then I’m going to make a tree, and my bunny is going to go around the tree and through the hole, okay? And then I’m going to take my tree and my bunny, and I’m going to pull them tight, okay? Can you help me with the first step? Emory: Uh huh. Teacher: Okay. Can you cross your laces? Put your string through the hole and pull it tight. Good job! And then remember the next step we’re going to do is, we’re going to make a tree? Our bunny’s going to run around the tree and through that hole. Then I’m going to take my bunny and my tree, and I’m going to pull them tight, okay? Emory: Okay. Teacher: Okay, can you help me again? This time I’m going to have you do two pieces, okay? Emory: Okay. Teacher: Two steps. So, take your strings. You made a nice “X.” Remember how to put it through? Good! And pull it tight. Good job! And now make a tree, and I’m going to show you how to have your bunny run around the tree, okay? Emory: Okay. Teacher: Have your bunny run around the tree and through the hole, and then you take your bunny and your tree and pull them tight, okay? All right, are you ready to do the next step? Emory: Uh huh. Teacher: Can you do that by yourself? Okay. Take your laces. All right, what’s your first step? Emory: You do the “X” and you go under. Teacher: Great! Oh, and you pulled it tight. And what’s the next step after that? You’re making your tree, oh, and your bunny, and then I will pull it tight for you, okay? Emory: Okay. Teacher: See how I take them and pull it tight? Emory: Uh huh. Teacher: Yeah, you’re doing a great job! Okay, let’s see if you can do all the parts by yourself this time, okay? Do you remember what your first part is? What’s the first step? Let’s hold them up and make an “X” first. There! You got your “X.” Now put that one through the hole. Good. Now pull tight. Good job. What comes next? I like the way you made a tree. Oh, and your bunny just ran around and crawled in the hole. And, pull tight. Good job! That looks great.
Watch as a teacher uses backward chaining to teach Emory how to tie her shoes (time: 3:39).
Teacher: Okay, Emory, are you ready to learn how to tie your shoes today? Emory: Uh huh. Teacher: Okay, let me show you how. First, we’re going to make a big “X,” and we’re going to pull this through and tighten it, okay? Emory: Okay. Teacher: Then we’re going to make a tree, and this is our bunny. The bunny’s going to run around the tree and right into that hole, and then I’m going to take the tree and the bunny and pull them tight, okay? Emory: Okay. Teacher: So can you help me with the last step? Emory: Uh huh. Teacher: Okay, let’s watch. You ready? First we make an “X,” okay? And then I reach through and pull it. Pull it tight, okay? Emory: Okay. Teacher: Then make a tree, and my bunny is going to run around the tree and into the hole, and what’s the last step? Can you help me with the last step? What did we do? We… Emory: Pull it. Teacher: Pull it tight! Good job. Okay, now can you help me with the last two steps? Let’s do it again. Okay, first we’re going to make an “X,” right? We’re going to pull it tight. Then we’re going to make a tree. And our bunny is going to run around the tree, and what else does the bunny do? Emory: Go into the hole. Teacher: Go into the hole, and then we… Emory: Tie it tight. Teacher: Pull it tight. Good job. That was great. I like the way you’re pulling it tight so it’s not going to come undone. Okay, let’s see if we can do another step, okay? Emory: Okay. Teacher: Okay, we first make an “X.” All right, pull it tight, and then I make a tree. And what’s this piece? Emory: The bunny? Teacher: The bunny! Can you take the bunny and run around the tree and into the hole? Then what do you do? Emory: I pull it tight. Teacher: Pull it tight. Good job. That was a really good job! I like the way that bunny ran through that hole. Okay, you ready? Emory: Uh huh. Teacher: Are you still paying attention? Emory: Uh huh. Teacher: Okay, we’re going to make an “X” and pull it tight. And then what do we do with this one? Oh, that was a good tree. Is that your bunny? Emory: Uh huh. Teacher: Running around the tree and through the hole. Emory: Yep. Teacher: And pull it tight. Good job. That’s a super job. Okay, do you think you can do it all by yourself this time? Emory: Uh huh. Teacher: What’s your…What do you do? First step? Did you get it to go through? Good job! And I like the way you pulled it tight. Oh, look at that nice tree. There goes the bunny. Whoops! There goes the bunny, and the bunny’s running into the hole. Good job! And pull it tight. Good job, Emory! And I like the way you tied your shoe today.
Again, notice in each video that the teacher verbally reinforces Emory throughout the task and provides a sticker at the end of the session.
Cross the laces, slip one lace through the bottom of the X, and pull tight.
Form a loop with one lace (i.e., make a tree).
Wrap the other lace around the loop (i.e., make the bunny run around the tree).
Put the lace through the hole (i.e., the bunny runs in the hole).
Pull both laces tight.
Note: This is only one example of a task analysis for tying shoes.
Reinforcement, prompting, time delay, modeling, and task analysis have been found effective for improving the outcomes of children and students of varying ages and in different domains (e.g., social, behavior, academic).
The five foundational strategies are really the heart of good teaching for students with autism or students that don’t have autism, even students served in general education settings. And if you’re able to master these five foundational strategies, that will strengthen the implementation of any other evidence-based practices that you choose because they are all related. Prompting and reinforcement are just very basic teaching principles that you can use to teach any skill across any age range with most populations. For example, if you conduct a task analysis, which is one of the five foundational evidence-based practices, teachers then need to use prompting and reinforcement to teach those discrete skills of the larger task, or if you choose Picture Exchange Communication System, prompting is a very key piece of that.
Foundational strategies are a very good place to start, and what we often find is that even very experienced teachers can benefit to spend more time learning about how to implement these practices. Often, we see teachers that are using reinforcements, but the behavior that they are wanting to increase is not actually increasing, meaning the reinforcement is not actually effective. So spending some time to really learn foundational strategies will only benefit all of the other practices that they are implementing in their classrooms.
Transcript: Kara Hume, PhD
The most important consideration about how EBPs are implemented differently across age groups is really the context. You want to think about where is the most appropriate place that this EBP will be implemented. So, with young children, the home and the early childhood classroom are likely be the most appropriate setting for implementation, where for older students we need to consider implementing EBPs in the job setting, in the community setting. How the EBPs are implemented doesn’t necessarily change, but what needs to be adjusted is where the EBPs are implemented and what the purpose is for the implementation of those EBPs. So across the age group, we might think about implementing EBPs to support community access or to support job skills at a jobsite, where with younger children we might use the same EBP but we’re thinking about teaching play skills or teaching communication requests. It’s really the context and the purpose that is adjusted across age groups.
For Your Information
To learn more about each of these foundational practices, as well as many of the EBPs highlighted on upcoming pages, visit Autism Focused Intervention Resources and Modules (AFIRM). There you will find information about the key components of an EBP and the behaviors and skills it addresses, guidance on implementing the practice, and downloadable and customizable materials that can help with implementation.
Now that the five foundational strategies—reinforcement, prompting, time delay, modeling, and task analysis—often used with children and students with ASD have been introduced, this module will explore several of the remaining EBPs. As Kara Hume discussed above, many of these strategies are effective with children of different ages. However, they are presented by age group on the following pages simply for the purpose of illustration and to provide examples.