Understanding the ABLLS-R part 8: Section H Intraverbals
I would like to make it very clear that reading this series DOES NOT replace formal training on the ABLLS-R and that anyone using the ABLLS-R should read the companion guide as well prior to using the assessment. Here is the link for purchasing the ABLLS-R and/or Companion Guide Additionally, what you will find below is all based on my OWN experience. As far as I know there is limited to no research to support my suggestions. I made theses suggestions and provided these explanations based on my experience with how clients acquired skills and what worked best for my purposes. Always remember to invdividualize programming for your child/client and consult the research. The information that I am sharing here is to provide a basic skeleton for people who are not familiar with the sections of the ABLLS. Hopefully after reading this series you will have a better understanding of what skills are targeted in each section of the ABLLS, how to combine goals when possible, and what the typical progression of skills is like for children on the spectrum. "Typical" progression means that typically the skills are easier when done in this order however this is not always true. For instance, sometimes you will have a child who is highly verbal but does not listen well so it is easier to teach them expressive tasks first then receptive. If any providers/parents who read this blog have suggestions on other ways to combine/target/organize goals, please do share 
ABLLS-R Section H – Intraverbals
Focus: The focus on this section is on basic fill-ins at first then developing advanced conversation.
Skill progression: filling in words in preferred activities answering personal information fill in feature function and class answering wh questions naming previously observed events identifying items based on several descriptors describing items conversation exchange telling stories
When/how to implement: This goal can be started when the child is reliably saying or signing for a few items in mand training and/or if you have a child who loves music and already sings. You want to make sure to go in the order listed at first up to about H7. Then you get into feature/function/class. For this area you want to find all of the goals related to feature, all related to function, and all related to class. Progress through each of those in the order described. DO NOT implement these goals until they have been mastered in B, C, and G. Some of them may seem similar but you are presenting the material differently. Make sure to probe these goals though. The more advanced goals will not be implemented with most children until they have pretty much mastered all of the previous sections.
Goals that can be combined:
- H10/11/23/24 – all of these deal with answering “what” questions. You can target these at one time by making sure the program has “what” questions from each of the areas described. You do not need to do the number listed in criteria. Shoot for about 25 to start. If the child learns them quickly you can stop. If the child has difficulty and there are other “what” questions you think they should be able to answer then continue with the program.
- H12/13/25 – all of these deal with answering “where” questions. You can target these at one time by making sure the program has “where” questions from each of the areas described. You do not need to do the number listed in the criteria. You want the child to answer 50 “where” questions or acquire novel questions within one session whichever comes first. Make sure the child can answer obvious “where” questions first.
- H19/20/21 – these all deal with name previously observed items, activities, and people. Combine these and target each one in the same program. This program is often done by asking the child immediately then increasing the duration.
Understanding the ABLLS-R part 7: Section G Labeling
I would like to make it very clear that reading this series DOES NOT replace formal training on the ABLLS-R and that anyone using the ABLLS-R should read the companion guide as well prior to using the assessment. Here is the link for purchasing the ABLLS-R and/or Companion Guide Additionally, what you will find below is all based on my OWN experience. As far as I know there is limited to no research to support my suggestions. I made theses suggestions and provided these explanations based on my experience with how clients acquired skills and what worked best for my purposes. Always remember to invdividualize programming for your child/client and consult the research. The information that I am sharing here is to provide a basic skeleton for people who are not familiar with the sections of the ABLLS. Hopefully after reading this series you will have a better understanding of what skills are targeted in each section of the ABLLS, how to combine goals when possible, and what the typical progression of skills is like for children on the spectrum. "Typical" progression means that typically the skills are easier when done in this order however this is not always true. For instance, sometimes you will have a child who is highly verbal but does not listen well so it is easier to teach them expressive tasks first then receptive. If any providers/parents who read this blog have suggestions on other ways to combine/target/organize goals, please do share
ABLLS-R Section G – Labeling
Focus – The focus in this section is teaching basic labeling and then more advanced labels.
Skill Progression- Label items label feature/function/class/etc label two component advanced labels
When/how to implement – If the child is requesting items using signs or words you can implement this program. You will start with labeling reinforcing items then move to common items/pictures. You typically do not want to implement some of the goals in this program unless they have been mastered in B and C first. Sometimes some of our children learn better expressively so if this is the case you can target the G items first then do them receptively. You will progress through this section in the basic order given. If you are targeting a goal that has already been mastered receptively, make sure to probe it first. Some of these goals can be targeted informally like using carrier phrases and stringing labels together. If the child doesn’t pick up the carrier phrases and stringing words together, then you will need to have a program for this.
Goals that can be combined:
- G1/2/3/4 – these all deal with labeling items. Start with reinforcing items then move to pictures and objects. You can target the picture and object by having a column for each. Make sure to use items that have already been taught in B and C first then do novel items.
- G7/G8 – these both deal with actions. One is label ongoing actions and one is to label pictures. You can do together by having 2 columns and recording mastery of both.
- G11/G18/G19/G20/G21/G22/G34/G36/G38/G44/G45 - these all deal with various ways of combining words and using carrier phrases. You can combine them all into an advanced language program and target the different combinations as appropriate. It is typically best to target this informally in the natural environment. A common mistake with these goals is they are taught at the table and lack functionality. When taught this way, the responses often become rote and do not generalize to the natural environment.
ABA Myth: ABA is not fun!!!
Here is a list of ideas from Scott Cross and the folks at UCLA.
Here’s a fun list of silly reinforcing social activities to try with your child. This list goes way beyond a simple “101 ways to praise” type of list, because every child is different and wants different reinforcers at different times. Many aren't as interested in what you say, but in how you say it. Remember that your excitement, smiles, laughter and interest in their success is often what is most important. Rely on engagement with observably effective reinforcers to result in positive motivation. Many of these ideas will work much better after the child has been able to sample them and build some anticipation for you to "do it again." Be sure to look for their reaction and adjust to use the ideas that get a positive response. Vary the exciting actions with quiet, gentle reinforcers, to suit the mood. Don't let these reinforcers go stale. Keep a list of effective reinforcers and rotate them off of the list before the child becomes routinely “bored” with them. They can be brought back several weeks later with renewed enthusiasm. Be sure to use them as reinforcers (the child earns them –) rather than only as entertainment (provided noncontingently to gain their interest).
- Basket Airlines! Put the child in a laundry basket and pick them up and fly them around the room as if they are the pilot of a jet plane (with sound effects).
- Squirt Gun Attack! Let the child squirt you with a squirt gun. Be sure to act up like you don't want them to get you. Let them chase you around the room.
- To Infinity and Beyond! The child is Buzz Lightyear. After hesitating to build anticipation, shout, “To infinity and beyond!” and then throw the child over your shoulder onto the bed.
- Paper Spool Surprise! Hide your hand in a large round wrapping paper spool and cover it with a towel. With mock suspense tell the child to look inside. When they lift the towel, push your hand out to "scare" them.
- I’m Gonna Eat Your Toes! Shout, “I’m gonna eat your toes!” Take the child’s foot toward your mouth with pretend chomping sounds. Build anticipation with repetition.
- Scare Me! Say, “do this” and make a roar sound. When the child does, act terrified and fall off your own chair. Try other silly actions.
- Washing Machine Vibrator! When the washing machine is running, go sit on it to feel the vibration. Imitate drone noises to go with it.
- The Big Dipper! Hold the child in your arms in front of you and dip forward, lowering the child to the floor. Let them hold on tight while you unpredictably dip and pull. Pretend to drop them and act scared, like you can’t hold them.
- Whipped Cream Shower! Have the child decide who gets sprayed with the whipped cream.
- Scary Dinosaur Cave! Build a cave with a table and blankets. Sit in the cave to run programs, while Dad stomps around outside like a dinosaur sumo wrestler. The reinforcer is getting to open the blankets and look out at the scary dinosaur.
- Confetti Sneeze! Put confetti in a shallow bowl and "sneeze" into it to blow it everywhere. A bonus reinforcer might be to vacuum up the confetti.
- Get the Maid! Try to pick up toys while bending from the waist. Let the child push you over whenever you try to bend over.
- Whistle Praise! Try to praise with a whistle in your mouth, which forces you to simulate talking with a whistle (or blow-out noisemaker, sound vibrator, guitar amplifier or microphone).
- Magician’s Chain! Make a magician's chain of kerchiefs and stuff them all in your sleeve. Let the child pull them out. When will they end? Possibly tie a reinforcer onto the end of the chain.
- Wind-up Hand! Wind up your hand like it's a toy - use cranking sound effects - then let it go and flap your hand wildly over the table and child's tickle spots in a flip-flop motion.
- Laughter Zone! Bury your head into the child's stomach, burrowing your head in a wiggly way. At the same time laugh and shout, "it's the laughter zone!"
- Let’s Not Go Play! When you tell the child, “let’s go play," surprise them by pulling them back to you by the back of their shirt. Do several times. It usually builds a smile and a lot of times when you don’t grab the shirt the child will back up to you to do so.
- Tell Me What to Do! Model an instruction to do something silly, and then comply with the child's instruction when they say it. For example, give the instruction, "say, 'walk like a duck.'" When the child says so, start crouching on the floor and struggle around while quacking like a duck. Try other silly actions, like falling down or imitating "Barney."
- Train Ticket Tokens! For a child who likes trains, wear a conductor’s cap and punch their ticket as token reinforcement. Print up tickets with a train on them to look like train tickets.
- Wake Up! Fall asleep and snore loudly on the child’s lap. Then wake up suddenly for the school bell — "ding ding ding!"
- Emotional Clown! Act out silly, exaggerated emotions like sad — with a real sappy "boo hoo hoo" and drip water on your face for tears (all very fake) or happy - with a silly song and dance.
- Paper Cup Shower! Poke some holes in a paper cup. Then sit Dad in a chair with the empty paper cup balanced on his head. Pour water into it until…
- Keep My Arms Down! Put one of your arms out and when the child pushes it down, make a cranking sound, and raise the opposite one up. If they try to hold both down, raise a foot.
- Milk Carton Spray! Punch holes in a milk carton, and pour water into it. Pour water in until the shower starts.
- Where’s My Hand! Say, "Give me five" but lose your hand in your sleeve - have child help you find it and then lose the other hand.
- Keep It Up! Cooperate keeping one balloon floating in the air.
- I’m Pouring! Hold a spring water bottle above the child’s head - tilt ever so slightly in anticipatory way —drop droplet. Fair play, however, is allowing them to get you. But they are usually less reserved about the amount they drop!
- Drink from the Squirt Gun! Put juice in a squirt gun to deliver it that way.
- Where’d He Go! Take the child's arms in yours behind your back, and then lean over until the child leans on your back. Then pick them up, hanging behind you, and start calling out, “where is (child)?” “(Child’s name)--where aaaarrrreeee you?”
- Lost in the Hood! Wear a hooded sweatshirt with a drawstring and make your head disappear as you tighten the string. Ask the child to help to get you out.
- Crack an Egg! Crack a pretend egg in their hair. Put the fingertips of your hand together and touch them to the top of the child's head. Then gently bop the top of the hand to simulate "cracking the egg." Then slowly drizzle your fingers down their hair.
- Bubble Gum Bubble! Blow a big bubble of bubble gum and pop it with a big pop.
- Hand Grenade! Deliver reinforcers like a hand grenade. Instead of giving an M&M, pretend to send it through the air with a whistling sound until it gets to child’s mouth then explodes (i.e. you make an exploding sound). Run from the child and toss the (soft) reinforcer back to them.
- Reinforcer Presents! Wrap the reinforcer like a real present. Sustain the anticipation by gradually unwrapping across many trials.
- Treasure Hunt! Hide the reinforcer and go on a treasure hunt, giving out clues for each trial.
- P-U! Smell the child's feet with a dramatic "P-U" and pass out on the floor. Most children will proceed to put their feet in the proximity of your nose. Then wake up and chase after them.
- Break Dance! Put the child on a table or slippery floor for some break dancing. Lay the child’s stomach on the table with their head toward you and feet away. Put your left hand by their feet and your right by their head to generate a pretty good spin.
- Foot Flying! Make the child fly on your feet. Then say, “Its Barney’s turn” and make Barney fly on feet, then child again.
- Silly Telephone Calls! Make a ringing noise and pick up the telephone and say, "it’s for you, (child)!" Add in silly praise dialog. Alternatively say that you've got to call Mickey Mouse to praise the child's performance.
- Face Machine! Have the child push your nose to make your tongue come out, or pull left ear to move your tongue right and vice versa. Have them push your stomach to make you blow air in their face.
- Barney’s Working! Make Barney, Buzz, or Woody doll do trials.
- Where’d the Tickles Go! Look for the “tickles.” Be surprised, asking, “Where’d they go?" Then find them: "Oh, there they are!”
- Intense Edibles! Try out intensely flavored edibles, like red hots, war heads, pop rocks, breath-mints, or taco sauce.
- Hide Behind the Table! Turn the table on its side with the legs toward you. Hide until the child stands up to find you and then either roar or act scared.
- Stayin’ Alive! Break out your best John Travolta Disco imitation.
- I Won’t Drop You! Hold the child, worry and say, “I hope I don’t drop you...” Then drop and catch them pretty low to floor (without letting go) with a, "Whew! Thank goodness!"
- Table Tent! Use the table for a tent with a blanket over it; crawl underneath for chasing or quiet hiding.
- Cardboard Fan! Swing cardboard in front of the child to create wind.
- We’re So Quiet! Sit close to the child and whisper gently next to their ear. Keep it up till they talk back in a whisper. Get a simple conversation going, or just echo each other’s whispers.
- Sock Imitation! Put socks on the child’s hands then say, “do this” and clap or other wacky commands.
- Banana Ears! Say, "Ohhhhh, you want a (food) in your ear?" "Nooooooo." "In your nose?" "Noooo." "On your head?" "Nooooo." "Oh, in your mouth!" In an unpredictable fashion.
- Mr. Froggy! Put the child on your lap and say, “Mr. Froggy’s sitting on a rock, along comes (therapist), and the Froggy goes “kerplop!” Throw the child on couch or beanbag chair. (Or let the child fall through your legs).
- Thumb Wrestle! Thumb wrestle by hooking fingers together with the child, with your thumbs on top. See who can trap the other person’s thumb. Do it with both thumbs sticking out a large, stretched-out sock, or through a cardboard wrestling ring.
- Puppet Teacher! Have a stuffed puppet praise and tickle the child. Have the puppet give the instructions.
- Mandy! Sing Barry Manilow songs with either a good or an outrageously bad voice.
- Funky Dancing! Sing and dance to really funky songs. Hold the child in your arms, or on your feet.
- Cookie Monster Praise! Practice your imitations of kid show actors, such as Barney, Goofy, or Cookie Monster. Give praise in their voices.
- There’s a Monster at the End of This Book! Play with the Sesame Street Book, "There is a monster at the end of this book." Ham up the Grover parts. Use each page as a reinforcer.
- Blow Raspberry’s! Give Raspberry’s (blowing and making noises) to the belly or fake tickles kissed to the ticklish part of the neck.
- Hair Torture! Lay the child down and gently sweep your hair over their face with “oh, no” or whatever to let them know it is coming.
- Pillow Fight! Have pillow fights.
- Let Me Draw! Try to draw on paper with the child pushing your hand to wreck the picture.
- Motor Cycle Racer! Put the child on your lap, facing away from you, for a motorcycle ride. Use your fists as handlebars and rev up. Go around curves by leaning the child left or right with all important motorcycle sounds. Then crash!
- Monster Palm! Draw a monster on your palm. Use the other hand to hold the wrist of monster palm so it can’t get you. However, we all know monster palm is stronger. Elicit the child’s help to get rid of monster palm.
- Feed Me! Have the child feed you. Will he smear you?
- Shall We Dance! Sing, “shall we dance” from the King and I with the Tango, where you hold the child cheek-to-cheek, then walk one way, then turn your body and cheeks and walk the other way. Freeze and play up the anticipation of lunging to “Shalala… Weeeee… DANCE! Dum Dum Dum!
- It’s Time to Mambo! Do the "Mambo," with your best John Candy imitation. Head upstairs to get Dad in on the dance. Dance a chain through the house to get Mom and siblings into it.
- I’m Trying to Talk But Nothing’s Happening! Put tape over your mouth and try to talk - or pretend you’re trying to keep your hand from covering your mouth but can’t.
- Macarena! Dance the Macarena. Learn all the moves in gross-motor imitation and build it together.
- Who Let the Dogs Out! Sing, "Who let the dogs out?" with exaggerated arm motions.
- Media Player! Work with the computer on, and Microsoft Media Player turned on. Set it to a song or punch line that the child likes to hear, and click start to play it while the child watches the light show.
- Tower Disaster! Set up a tower ten feet away and let the child run at it.
- Who Let the Boy Fall! Hold the child up in the air and sing, "Who let the (boy) fall?" (to the tune of “Who let the dogs out?”) While pretending to drop the child.
- I’ve Got a Secret! Tell the child, "I have a secret," and when they listen up close, blow quiet raspberries to the ear.
- Soft Tickles! Give soft ticklish back, arm, leg or foot rubs by slowly drizzling your finger tips over their skin.
- Jump! Sing, “Jump” by Van Halen with a model and jump when the song tells you to.
- I’m Shocked! Fall completely over with surprise and shock that the child answered the question correctly.
- Car Ride! Line your chairs up next to each other and go for a car ride. Put seat belts on. Checks left and right for traffic, beep the horn, etc.
- Electro-Glide! Do a line dance such as the "Achy breaky heart dance."
- Blanket Pull! Pull the child by a blanket wrapped around their waist in circles then tease, “Nope we got to go left, no right, no left...”
- I’m a Little Teapot! Sing, "I’m a little teapot" and act it out, but have water to tease that you will pour on the child.
- Aladdin’s Magic Carpet! Put the child on a towel or blanket and pull them across floor.
- Chest Vibrator! Hit the child’s chest gently with your palms while they vocalize so they can hear the funny reverberation.
- Kick the Can! Play kick the can by racing to be the first one to kick the can over. The child doesn’t know which trial you’ll let him go on, so you’ve got a head start. The anticipation of trying to race you keeps his attention. (But don’t cheat by going when he’s not attending!)
- Water the Plants! The child helps water plants with a small pitcher.
- Imitate the Child! The child says, "Uh" and puts their hand on table and you imitate. After a while the child realizes he can run the show in reinforcement.
- Elevator Rides! Pick the child up - “First floor!” - Higher - “Second floor!” - “Do you want to go to the third floor?” Then, “Oh no! The elevator is going sideways!”
- Chair Rides! “Fasten your seatbelt! Hold on to the chair!” Begin to lift chair off ground slowly. Then take off like a racecar!
- Chair Tipping! “Fasten your seatbelt! Hold on to the chair!” Tip back just a bit at first. Next time a bit more, unpredictably.
- Music Video Shots! Set up a music video on the VCR. You control the remote to dole out parts of the song as a reinforcer.
- Butterfly Kisses! Put you eye next to their cheek and blink your eyelid onto it.
- Piggyback Ride! Go some place fun (imaginary!). Watch out for the potholes in the road! Weave around drunkenly. Run unexpectedly. Be sure to bounce the child on your back.
- Hand Spiders! Run your hand around on the table like spiders. Then let the child SPLAT them. Run at him and crawl onto him, if he’ll let you.
- Removing body parts! “I got your nose (holding your thumb between two fingers, to look like a nose) - I’ll put it in my pocket - want it back?”
- Big Bear Wants In! Stuff stuffed animals down the back of the child's shirt, up the pants leg, in the sleeves.
- The Big Spin! Pick the child up by the armpits for a big spin (don’t fall over!).
- Pump Me Up! Say, “It’s time to pump me up!” Mimic two-handed bicycle pump while inflating your cheeks. Now you can’t talk, but hold the child's hands and have them POP your mouth. You can also mime inflating your entire body by slowly lifting up onto your toes, and expanding your arms and stomach (in rhythm with the child’s pumping action).
- Hot Hands! Place the child's hands on yours. They have to pull them away before you can gently slap them.
- Choosing Firsts! Take turns putting your hands hand over hand over hand over hand with the child - flat or on a pole, as you would do when choosing ‘firsts’ with a baseball bat.
- Science Tricks! Baking soda dropped into vinegar makes a nice fizz volcano!
- Cornstarch! Play with cornstarch and water. It makes a terrific tactile effect.
- Musical Chairs! Play musical chairs, marching, or silly dancing and then FREEZE when the music stops. Be impressed by the child’s frozen poses.
- Magic Tricks! Pull a candy out of the child's ear. Transfer a reinforcer magically from one hand to another closed fist (the child doesn’t know you had it there already). Or even into a sealed container (where it already was).
- The Glomulator! Draw buttons on paper, have him press one - it makes you “glom” (make something up!) press another one, you stop, another, you hop. The child never knows quite what will happen.
- Horsy Ride! Ride the child on your back while you crawl on all fours. Be sure to vibrate the child. Try a bucking bronco ride, or just a very gentle ride.
- Echo Cup! Blow or say silly things into a cup to hear the echo.
- Why Are You Stomping! Hold the child's ankles and gently stomp their feet on the floor. Or stomp onto your feet, and complain, "Ouch!"
- Pavarotti! Sing lines of a favorite song, especially with a bombastic silly voice.
- Earthquake! Shake the child's chair like an earthquake.
- Creep-a-Mousey! Crawl a “mouse” hand up the child's leg, tummy, and arm and then quickly tickle them under the chin while making sounds that indicate, “I’m coming to get you…”
- Massage! Practice gentle or pressure massage the way the child likes it.
- Train Ride! Line up the chairs, one behind the other and go for a train ride. Who’s the engineer? Who’s in the caboose?
- Go Swimming! Manipulate the child's arms and legs so they are “swimming” or doing a “cheer".
- Blast Off! Turn the chair into a “rocket” which lifts off after a countdown.
- Musical Bounces! Sing silly songs while you bounce the child on your knee.
- Singing Your Song! Sing songs using the child's name within the song. Imitate a favorite character as you sing.
- Puppet Nibbles! Use a puppet to nibble on toes and fingers.
- Secret Joke! Whisper something silly in the ear.
- Eskimo Kisses! Rub noses with the child or on their cheek gently.
- Human Broom! Hang the child upside down and pretend that they are a broom.
- I’m a Real Character! Imitate lines and characters from the child's favorite movies or cartoons, i.e. Pumba saying, “Hakuna matata,” Donald Duck saying, “That was just wonderful,” or Curly saying, “I’m trying to think but nothing’s happening!”
- Kissing Machine! Have the child push an imaginary button to turn on a “kissing machine.”
- Chase! Play chase games, especially when on the way outside or to a favorite activity.
- Jack-in-the-Box! Crawl into a large box and pretend to be "jack-in-the-box." "Pop goes the weasel" is a great song for this.
- Lady and the Tramp! Suck strands of spaghetti quickly into your mouth.
- The Big Sneeze! Fake a long build up into an exaggerated sneeze.
- Commando Attack! Plan a commando attack on Dad. Sneak up and throw water at him.
- The Pokemon Polka! Dance to Weird Al's Pokemon Polka. Try to sing as fast as he does.
- Rubba Ribs! Tickle the child's ribs by rubbing your knuckles on them. Say, "Here comes the big one! Rubba Ribs!"
- Domino Disaster! Set up a domino chain to knock over.
- Balloon Chase! Blow up ten balloons and chase them all around the room simultaneously, with lots of laughter.
- Calling Daddy! Call Dad for praise on an intercom or walkie-talkie.
- Nesting Rewards! Place a treat inside multiple nesting boxes and lift each as a reinforcer.
- Adjective Search! Teach colors or other adjectives by hiding a reinforcer under one of many colored boxes. Tell the child, "It is under the "red" one, for example. In this way, the child is motivated to find the correct color to find the reinforcer more quickly. This works for other adjectives as well.
- Hide and Seek! Have someone hide and go find them. They can leap out to "scare" the child.
- It Wasn’t Me! Simulate the sound of passing gas, and act embarrassed.
- Go Ahead and Get It! Cut two holes in each end of a box. "Secretly" put one hand in the box. Then drop a reinforcer in the box with your other. Let the child reach in to get it, but grab their hand when they do.
- I’ve got ya! Trap the child in your legs and let them struggle to get out.
- Jumping Animal! Squeeze a wet foam animal tightly into your hand and open it to let it spring out to the child.
- Pan Parade! Hold a parade with pots and pans.
- Garden Hose Surprise! Spray Dad outside with a garden hose for each correct trial. Go outside to do the trials.
- Dryer Time! Have child sit on the dryer while it is running.
- It’s Coming Baack! Hang a soft toy from a long rope and let the child hit it away from them. "It's coming baaack!"
- Dancing to Ernie! Get a mechanical musical toy (Ernie, or the fish, or the sunflower) and dance to its song.
- Chattering Teeth! Get chattering mechanical teeth and throw them on the table by surprise.
- Watch it Go! Set up a remote control car and tell the child to "look at the car." When they look, turn it on to reinforce compliant eye contact. When they turn away, stop the car, and repeat the instruction to turn it on again.
- Get Her! Tie a stuffed animal to a string and place it on the table. Let the child race you to grab it before you yank it off the table and vice-versa.
- What’s So Funny! Find a suction toy that will stick to your forehead.
- I’m Batman! Give praise while wearing a new mask.
- Bombs Away! Drop water balloons from the second story.
- Hula Dad! Have Dad dress up in a grass skirt and lei's and dance the hula for the child.
- The Limbo! Set a broom handle across two chairs and do the limbo to Caribbean music.
- Ham It Up! Do your favorite silly actions and noises from your childhood
Understanding the ABLLS-R part 6: Section F Requesting
I would like to make it very clear that reading this series DOES NOT replace formal training on the ABLLS-R and that anyone using the ABLLS-R should read the companion guide as well prior to using the assessment. Here is the link for purchasing the ABLLS-R and/or Companion Guide Additionally, what you will find below is all based on my OWN experience. As far as I know there is limited to no research to support my suggestions. I made theses suggestions and provided these explanations based on my experience with how clients acquired skills and what worked best for my purposes. Always remember to invdividualize programming for your child/client and consult the research. The information that I am sharing here is to provide a basic skeleton for people who are not familiar with the sections of the ABLLS. Hopefully after reading this series you will have a better understanding of what skills are targeted in each section of the ABLLS, how to combine goals when possible, and what the typical progression of skills is like for children on the spectrum. "Typical" progression means that typically the skills are easier when done in this order however this is not always true. For instance, sometimes you will have a child who is highly verbal but does not listen well so it is easier to teach them expressive tasks first then receptive. If any providers/parents who read this blog have suggestions on other ways to combine/target/organize goals, please do share
ABLLS-R Section F – Requests
Focus: The focus of this program is teaching the child to make basic requests then more advanced requests.
Skill Progression: indicates wanting an item request items with item present and prompt request item with item present request item without seeing item request missing items/request actions/requests help requests using a sentence requests using descriptive requests information/future events
When/how to implement: This area is almost always targeted first in a program using mand training. It will depend on the child whether you use signs, vocalizations, or PECS/Visuals. Always start with just having the child request the item by labeling it. As the child reliably requests the item using the label, you can shape the request into a sentence and start requiring more descriptive mands. When teaching requests for information you will need to set up situations that would require the child to use WH questions and prompt heavily. It helps if the child can read at this point because you can use cue cards. Some examples of how to do WH questions:
- What is it? – show child an item they have never seen before and say “Look” and then prompt the child to say “what is it” only reinforce and tell the child what it is if they ask without a prompt. Make the item something interesting.
- What is it? – hide something in a box or your hand or pocket and say “I have something for you” then prompt “what is it” only reinforce and tell the child what it is if they ask without a prompt. Make the item something interesting.
- Where is it? – hide a preferred item and tell the child “get your (item)” prompt the child to say “where is (item)”
- Where is it? – ask child to get you an item that is not visible “can you get my (item)” prompt the child to say “where is (item)”
- Who is it? – have someone knock on the door and prompt child to say “who is it?” have the person on other side have a preferred item some of the times
- When – tell the child you are going to do something fun but not yet prompt the child to say “when will we do it?”
- When – when the child asks to do something say “yes but not yet” prompt the child to say “when will we do it?”
- How – give the child something interesting but hard to do like new toy or game prompt the child to say “how do I do it.”
- How – tell the child to do something silly using a made up word or phrase and prompt the child to say “how do I do that?”
- Why – tell the child how you feel and prompt them to ask “why” make your emotions very exaggerated
- Why – tell the child you really like something and prompt them to ask “why”
- Which – have some similar items on the table like different pens and tell the child to get you one, when they reach for one say “no not that one” and prompt them to say “which one?”
Goals that can be combined:
- F2/3/4/5/6/7 – all of these deal with first teaching the child to request and fading out the prompts. The last one is eye contact which we should always be targeting. Target each goal by changing the reinforcement criteria as the child meets each goal.
- F16/17/22/23 – these deal with using descriptors you can target these informally by prompting the child to include these as they start manding more reliably or formally by having each be a target in a program.
- F19/F20/F21/F24/F25/26/28 – these deal with requesting information. Combine into one program and target each.
Understanding the ABLLS-R part 5: Section E Vocal Imitation
I would like to make it very clear that reading this series DOES NOT replace formal training on the ABLLS-R and that anyone using the ABLLS-R should read the companion guide as well prior to using the assessment. Here is the link for purchasing the ABLLS-R and/or Companion Guide Additionally, what you will find below is all based on my OWN experience. As far as I know there is limited to no research to support my suggestions. I made theses suggestions and provided these explanations based on my experience with how clients acquired skills and what worked best for my purposes. Always remember to invdividualize programming for your child/client and consult the research. The information that I am sharing here is to provide a basic skeleton for people who are not familiar with the sections of the ABLLS. Hopefully after reading this series you will have a better understanding of what skills are targeted in each section of the ABLLS, how to combine goals when possible, and what the typical progression of skills is like for children on the spectrum. "Typical" progression means that typically the skills are easier when done in this order however this is not always true. For instance, sometimes you will have a child who is highly verbal but does not listen well so it is easier to teach them expressive tasks first then receptive. If any providers/parents who read this blog have suggestions on other ways to combine/target/organize goals, please do share
ABLLS-R Section E – Vocal Imitation
Focus: The focus of this section is on basic vocal imitation then advanced vocal imitation.
Skill Progression: imitating basic sounds imitating sound combinations imitating words matching the model exactly imitation of phrases imitation of number sequences repeating a message to a person/spontaneous imitation.
When/how to implement: This program obviously cannot be started unless the child is making vocalizations. The program can be implemented with basic sounds if you start using the sounds the child already makes. It is very tricky to implement and hard to reinforce. We typically informally target imitation during mand training first. Once the child is making sounds/words reliably for preferred items then you can target sounds. Some clients do better with sounds and some do better with words start with what you client does better with. Vocal imitation may be an ongoing programming in order to improve articulation of words as the child has difficulty with annunciating them.
Goals that can be combined:
- E1/E3/E8/E9/E10/E12 – all of these goals focus on imitation of sounds or words. They can be combined in a vocal imitation program. For targets use the resources listed above, resources from the speech teacher, and work on sounds/words you hear the child have difficulty with. Always start with sounds/words you hear the child say then move onto novel sounds/words.
- E2/E4/E5/E6/E7 – These all focus on advanced imitation of sounds. You might want to target these before targeting words if you have a client that has difficulty saying words. Each goal can be a target in an advanced imitation of sounds program. A lot of the children probe out of these goals.
- E15/E16/E17 – These focus on advanced imitation of sounds and words. You want to wait to target these until the child is reliably imitating a variety of sounds and words.
Convincing your school to allow ABA
Understanding the ABLLS-R part 4: Imitation
I would like to make it very clear that reading this series DOES NOT replace formal training on the ABLLS-R and that anyone using the ABLLS-R should read the companion guide as well prior to using the assessment. Here is the link for purchasing the ABLLS-R and/or Companion Guide Additionally, what you will find below is all based on my OWN experience. As far as I know there is limited to no research to support my suggestions. I made theses suggestions and provided these explanations based on my experience with how clients acquired skills and what worked best for my purposes. Always remember to invdividualize programming for your child/client and consult the research. The information that I am sharing here is to provide a basic skeleton for people who are not familiar with the sections of the ABLLS. Hopefully after reading this series you will have a better understanding of what skills are targeted in each section of the ABLLS, how to combine goals when possible, and what the typical progression of skills is like for children on the spectrum. "Typical" progression means that typically the skills are easier when done in this order however this is not always true. For instance, sometimes you will have a child who is highly verbal but does not listen well so it is easier to teach them expressive tasks first then receptive. If any providers/parents who read this blog have suggestions on other ways to combine/target/organize goals, please do share
ABLLS-R Section D – Motor Imitation
Focus: Teaching basic and advanced imitation skills. Imitation is a skill learned very early on by typically developing children and it is a prerequisite skill for learning a lot of other skills.
Skill Progression: basic imitation imitation of facial/mouth movements advance imitation matching model exactly imitation of sequence of actions/combining imitation with vocals spontaneous and delayed imitation
When/how to target: A basic imitation program for motor movement and object imitation should be included at the very beginning of programming. More advanced imitation skills can be targeted as soon as basic imitation is mastered but only if the child attends well. Sometimes the child also needs to be tested to see if the more advanced imitation is frustrating. If it is you want to hold off on teaching it for a few months, and then try to introduce again. Also, make sure to use the phrase “do this”. The biggest mistake I see with this program is the instructor saying the action “clap” or “push car” instead of “do this.” If you tell the child what you want him/her to do, then the child might not even be attending to your movements. The child might just hear the phrase and do the action. The whole point of imitation is for the child to attend to a model and then imitate. You want them to learn that the phrase “do this” means do what I am doing.
Goals that can be combined:
- D1/2 – Both of these target imitating with objects. The first is in isolation and the second is with discrimination. You can either have a column on the program sheet for mastery of both ways or you can have it understood in the program protocol that targets start in isolation then are put in discrimination before being mastered. Some children don’t need the isolation portion. Doing in discrimination means you have the object and 2 other objects so the child has to watch what you do with the object and discriminate from the field which object to use. It is important that your objects are identical at first to make discrimination easier. For instance, if you are doing imitation of pushing a car; you should both have the same exact car.
- D3/4/5/9 – these all deal with imitation of different body parts. Combine them into a motor imitation program and make sure to target a variety of movements. Use movements that are distinctly different at first. For instance clapping and stomping because these movements involve different parts of the body.
- D10/D11/D14 – these all deal with facial and oral movements. Combine into one program and target AFTER body part imitation is mastered unless you have a child who spontaneously imitates facial movements. A mirror is often helpful for this program.
- D12 – this isn’t combined with anything but its fine motor skills and typically you want the child to be able to do the movement but do it a few times in a row to build endurance. So instead of touching pointers together have the target be touches pointers together five times. Then you would say the child scores correct if he will follow the instruction “do this” touch pointers 5x in a row.
- D6/D15/D16/D17/D21/D22 – These all deal with advanced motor imitation. They can be combined into an advanced imitation program and each goal can be targeted as a target in the order of the ABLLS.
Parent Question about Joint Attention and Referencing
Parent Question about Referencing and Joint Attention
A while ago a parent asked me about the difference between referencing and Joint Attention. Joint Attention is a relatively new concept in the behavioral literature with a few studies being conducted prior to this century but most studies occurring within the past 10 years. Because of this, the skill and techniques to teach the skill is a little trickier to explain. Research is still being conducted on effective ways to teach Joint Attention which I will discuss later in this blog. While I do focus on teaching Joint Attention with my clients, I also decided to send this question to some of my BCBA colleagues to get their input on the topic as well. First I will provide my response and then responses from 2 other BCBAs who kindly shared their input on the topic.
When I first read this question, my initial response was simply: Joint attention is a more complex skill whereas referencing is one of the precursor skills that a child would need in order to engage in Joint Attention. I didn’t have much more of an explanation than that but after reading input from my colleagues, I am now better able to explain what I meant.
Steve Ward, BCBA provided an excellent explanation of the difference between referencing and Joint Attention. He also provided some of the techniques that he uses for teaching Joint Attention. Here is Steve’s response:
Referencing refers to looking at others, especially others' eyes, for a variety of reasons, including things like: attending to name, looking for information about the location of a reinforcer, waiting for the answer to a question, checking for emotional reactions, etc.
Joint attention is a higher skill than simple referencing, requiring the learner to:
- Demonstrate motivation to direct anothers' attention to an item or event,
- Recruit that person's attention,
- Direct that attention toward the item/event,
- Monitor that person's attention to assure that it is fixed on the relevant item or event.
It is very important to note that this should not be called "joint attention" if the motivation is merely to receive the relevant item. It is only “joint attention” if the motivation is to share the experience of the item with the other person.
In terms of skills, I frequently start teaching joint attention by establishing all of the components of the skill under motivation for tangible gain (e.g., the learner wants a cookie). I'll begin by requiring attention mands, teaching learners to point at reinforcers that are out of reach, and teaching them to repair the actions of a deficient listener. One exception to this is a learner who either naturally demonstrates, or can easily be taught, that our reactions to items/events is very interesting to them. In that case, I use that natural motivation to shape responses that direct my attention to an item/event. Another program I'll introduce is essentially a very early version of "show-and-tell", particularly for items a learner has produced, about which they can brag. I use a lot of reinforcement for this bragging, preferably social, but tangible if necessary.
For simple referencing, the first thing I do, especially during pairing, is capture as many spontaneous demonstrations of referencing as possible, and look for ways to contextually reinforce. I may walk around with small tangible reinforcers and occasionally say the learner's name, and reinforce looking toward me within a second or 2. I sometimes play "Hide-the-prize" (taken from RDI). I can almost always establish strong referencing by playing Red Light/Green Light (described in the play book I mentioned). For slightly more advanced learners, I can usually get some referencing by teaching Hotter/Colder (also described in the play book).
-Steve Ward, BCBA www.wholechildconsulting.com (352)425-2063
I would like to thank Steve for his excellent description and explanation of some activities to do to help develop Joint Attention and Referencing skills. I also would recommend using activities from RDI (Relationship Development Intervention). It is important to note that there are not very many studies (at least that I know of) indicating the effectiveness of the RDI protocol but the exercises in the RDI book serve as wonderful ideas for relationship developing programs to do with a child. For each activity in the book, there is also a description of which skills the activity is targeting such as eye contact, gaze shifting, etc.
Toby Stahlschmidt-Kah, M.A., BCBA also provided me with a powerpoint and poster presentation that she did which focused on a literature review of Joint Attention. A summary of the presentation is below:
- Research on Joint Attention started in the 1970s, however the focus has shifted over time from defining Joint Attention to determining techniques on how to teach Joint Attention
- Some points on Joint Attention from a behavioral perspective:
- The initiative behavior observed at the beginning of a JA behavioural chain such as gaze shifting, could be seen as a mand for someone else’s behaviour of attending ‘to’ an object which is different, than a mand ‘for’ an object.
- Contingencies of behaviour are important to demonstrate this concept.
- A change in motivating variables sets the occasion for different behaviours.
- The likelihood a child will or will not look to an adult at the onset of the interesting event, is contingent on whether or not the adult-mediated consequence has a positive value for the child, and also depends on the individual’s learning history; if in the past looking to an adult has yielded reinforcing effects
- Both form and function define JA behavior. This means that you cannot just teach a child to look at an object and then look at you and call this joint attention. In order to have really taught the skill of JA the child must be looking from the object to the person in order to determine if the person is sharing in the experience.
Toby’s presentation also included references to some of the studies that have been done regarding techniques to teach Joint Attention. Below is the description of these studies from Toby’s presentation:
- Pierce and Schriebman (1995) found that Pivotal Response training led to gains in JA for 4th graders diagnosed with autism.
- Leekam, Hunniesett, & Moore (1998) shaped JA Gaze shifting responding by using remote controlled boxes with flip opening lids. The trainer would flip the lid on the box if the child followed their gaze. At first, the lid was flipped regardless of whether the child looked in the right direction. Then, the lid was only flipped if the child followed the experimenter’s gaze.
- Baker (2000) incorporated ritualistic behaviors into games that were played with the autistic children’s siblings. The study showed that positive supported and coordinated JA increased during the intervention and were maintained at 1 and 3 month follow-ups
- Hwang & Hughes (2000) used social interactive training to increase JA for 3 preverbal autistic children. The training consisted of imitation of participant’s actions, presenting an expectant look, and naturally occurring reinforcement. The JA behaviors did not generalize though.
- Tsuchiya & Yamamoto (2001) presented preferred stimuli passing behind an adult who was facing the child. Guiding the examiner to look at the objects, referential looking, pointing and declarative responses all increased.
- Whalen & Schreibman (2003) used response training with 11 children teaching them 6 levels of skills: hand on object, tapping on object, showing of object, eye contact, following a point, and following a gaze to increase JA.
- Robins, Dickerson, and Stribling (2004) used a Robot to increase JA for 3 children with autism. The children interacted with the robot and their ability to follow pointing and gaze of the examiner increased.
Toby also sent me a description of how she focuses on Joint Attention and an article about Joint Attention. I have pasted her response here:
Something I really focus on when teaching JA, is the three-way relationship. For example the child is taught to look from me, to the item they are showing, and back to me. This is very different than a 2-way, where the child looks from me to an item, or from an item to me. I've used techniques from Per Holth (2005) for teaching JA. The article can be found here: http://www.eric.ed.gov:80/ERICDocs/data/ericdocs2sql/content_storage_01/0000019b/80/44/a8/82.pdf
-Toby Stahlschmidt-Kah, M.A., BCBA Email: tskbxservices@istar.ca
I would like to thank Toby for her thorough review of the literature on JA. It is important to note that Toby’s review included studies up to 2005. More studies on JA and techniques to teach JA can be found in the behavioral literature.
Here are some additional articles and other resources regarding Joint Attention:
- Article about the importance of Joint Attention and techniques to use to increase social interactions, motivation, and Joint Attention from a Speech Therapist’s perspective: http://speech-language-pathology-audiology.advanceweb.com/Editorial/Content/Editorial.aspx?CC=116835
- Another blog about Joint Attention and how a teacher is using technology to develop JA http://techpsych.blogspot.com/2009/03/establishing-joint-attention-with.html
- Pivotal Response Treatments for Autism book by Koegal and Koegal ttp://www.amazon.com/Pivotal-Response-Treatments-Autism-Communication/dp/1557668191/ref=sr_1_1?ie=UTF8&s=books&qid=1264539179&sr=8-1
- Overcoming Autism book by Koegal http://www.amazon.com/Overcoming-Autism-Finding-Strategies-Transform/dp/0143034685/ref=pd_bxgy_b_img_b
- Relationship Development Intervention book by Gutstein http://www.amazon.com/Relationship-Development-Intervention-Young-Children/dp/1843107147/ref=sr_1_1?ie=UTF8&s=books&qid=1264539346&sr=1-1
Understanding the ABLLS-R part 3: Receptive Lanugage
I would like to make it very clear that reading this series DOES NOT replace formal training on the ABLLS-R and that anyone using the ABLLS-R should read the companion guide as well prior to using the assessment. Here is the link for purchasing the ABLLS-R and/or Companion Guide Additionally, what you will find below is all based on my OWN experience. As far as I know there is limited to no research to support my suggestions. I made theses suggestions and provided these explanations based on my experience with how clients acquired skills and what worked best for my purposes. Always remember to invdividualize programming for your child/client and consult the research. The information that I am sharing here is to provide a basic skeleton for people who are not familiar with the sections of the ABLLS. Hopefully after reading this series you will have a better understanding of what skills are targeted in each section of the ABLLS, how to combine goals when possible, and what the typical progression of skills is like for children on the spectrum. "Typical" progression means that typically the skills are easier when done in this order however this is not always true. For instance, sometimes you will have a child who is highly verbal but does not listen well so it is easier to teach them expressive tasks first then receptive. If any providers/parents who read this blog have suggestions on other ways to combine/target/organize goals, please do share
ABLLS-R Section C – Receptive Language
Focus: The focus in this area is on developing the child’s ability to follow directions and identify things receptively.
Skill Progression: follow instructions to do preferred activities follow instructions to touch common items follow instructions in routine situations select objects/select pictures/identify body parts/identify clothing discriminate instructions/follow gaze/follow hand signals/follow instructions to go to person select adjectives/select associations/select feature/select function/select class/demonstrate actions with objects selecting 2 items/select community helpers/select environmental sounds select items from larger picture/selecting items based on specific characteristics/two step instructions select prepositions/select pronouns/select emotions/select non-examples/select same
different
When/How to target: most of the programs in this section need to be targeted formally. Most of these programs won’t be targeted until the child has mastered a few goals in section B. When first starting with a child you will target C3 – attending to a reinforcing item. You will also target following instructions to do preferred activities and touch common items before targeting the rest of the goals. For this area, you will move through the goals mostly in the order given. Sometimes will we introduce the feature, function, class sections earlier so that the child can learn to sort and start doing them expressively but the child needs to be ready for this. You also typically don’t want to target C9 doing simple motor action until the child has mastered a few imitation items. This is so that you know the child can actual do the actions. If you have a child that has shown the actions in the natural environment you might start with naturally occurring instructions prior to mastery of a few imitation targets. Prior to implementing a goal make sure that it there isn’t a similar one in section B that you should be implementing first.
Goals that can be combined:
- C2/C6/C7 – Both of these target following instructions during activities. One is doing the preferred activity within context and one targets doing out of context and the last one targets following instructions during a routine. For this you would have 2 columns and show mastery in and out of context. You would also start with preferred activities then move to routines. For routines you wouldn’t target out of context.
- C3 is often combined with A3 in an attending program.
- C4/C5 – these both target touching an item. One is a reinforcing item and the other is common item. For this program you only have the item and you say “touch” You should start with reinforcing items then move to non-reinforcing items.
- C10/11/12/13/14 – these all deal with selecting items. The goals start with selecting reinforcing items and then moves to common objects and pictures. These can be combined such that you have columns for mastery of picture and object. Then you would target reinforcing items in isolation then with distracters then common items in isolation and with distracters. Use the same items you used for matching. You may be able to probe this goal for some children.
- C15/C21 – these both target body parts. One is touching body parts on self and one is on others or in pictures. IF the child is advanced enough you can teach them body parts on self and others at the same time. Have a column for mastery of both.
- C27/28/29/30 – these all deal with going to a person and some other criteria. Each of the goals can be targeted in one program.
Understanding the ABLLS-R part 2: Section B Visual Performance
ABLLS-R Section B – Visual Performance:
Focus: the focus is on developing a learners visual perceptive skills by starting with basic visual tasks and building up to more advanced tasks.
Skill Progression: Students progression in this area varies depending on their strengths typically our clients progress in a different order than the ABLLS in this section: Simple 3 piece puzzles/matching/shape sorter sort non-identical items more advanced puzzles/block imitation match associate pics/match patterns/sort feature function class delayed finding a sample/delayed replication of a sequence/extend patterns seriation/picture sequences/mazes
When/how to target: Most of the programs in this program need to be written as formal programs. Make sure to assess your child’s visual strengths when deciding which goals to implement. You definitely want to start with easier items such as 3 piece puzzles, matching, and shape sorter when first starting with a client. You don’t want to do sorting feature, function, and class until the child has learned these receptively or expressively. You also don’t want to do patterns until the child knows at least their colors. The child must have good attending skills before doing most of these goals.
Goals that can be combined:
- B1/B10/B11/B14/B15 – All of these goals target puzzles. You can combine them into a puzzles program and make sure to follow the sequence described in the ABLLS. Start with small puzzles and build up to more complex. Best way to teach puzzles is to chain the pieces. This means have the child either do the first 2 pieces of the puzzle and nothing else and then slowly add in pieces or have the whole puzzle done except the first piece and have the child put in that piece then build up the number of missing pieces (all of the puzzle is done except the first 2 pieces, then first three pieces, etc)
- B3/B4/B5/B6 – All of these goals target matching. You can combine them into a matching program. Have a column on the target sheet for each style of matching: object to object, picture to picture, object to picture, picture to object. Determine which order to teach based on the child’s performance. Some do better with objects, some do better with pictures, some do better with an object and a picture. Make sure to start with identical items/pictures first.
- B13/B22 – These both target patterns. Start with matching the pattern then do extending the pattern. This can be done by having intro/mastery columns for each. You can do all the sequences matching first then extend or you can run both at the same time and target the extension once the sequence is mastered matching.
- B9/B12/B23 – These all target block design. I tend to do blocks slightly different from the ABLLS. I prefer to do block imitation with base + number of blocks, imitating block structures (car, rocket, etc), and hidden block designs (building the structure then hiding it to see if the child can build the structure without seeing it).
