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 Teaching a Child to Use Their Words

- Friday, February 12, 2010
I have noticed on a few of the list servs that I am on that a lot of parents and providers ask questions about children who are hitting, tantruming, etc because they do not have the words to communicate what they want/need. Sometimes people will focus too much on reducing these behaviors and not enough on increasing functional language and responses. It is very important to teach a child what to do rather than just focusing on what not to do. Children who engage in tantrums, aggression, SIB, etc typically have a skill deficit of: not being able to communicate and not being able to calm themselves, or leave the situation. I highly recommend using Behavior Skills Training (BST) and Functional Communication Training (FCT) to help children acquire these skills. Both of these methods are supported by the research and are used very often by behavior analysts. In this blog I will provide a brief description of each of these procedures with examples. It is important to keep in mind though that the examples I am giving are specific to a particular child and should not be used directly for your child/client. I am only providing them as a model. It is also important to read the research on BST and FCT for yourself in order to better understand the techniques. I have included resources at the end. It is also important for both of these techniques that the behavior is analyzed to determine the function and the areas of deficit so that you are training the child a response that is functionally equivalent. If you think that the behavior is occurring because the child wants out of a demand and you teach the child to ask for a break but really the behavior is happening because the demand is too hard and you don't teach the child to ask for help, then the behavior will probably still occur. 

Behavior Skills Training

Behavior skills training is a technique that is used to help people acquire complex/difficult behaviors. This method is frequently used to train employees, parents, and behavior analysts. Research indicates that people learn skills better when the steps used in behavior skills training are followed as opposed to other training methodologies. 

Behavior Skills Training consists of these steps:

  1. Explain the steps of the behavior
  2. Have the person tell you the steps
  3. Model the steps for the person either via video or in vivo
  4. Have the person do the steps
  5. Provide feedback and reinforcement

I usually combine BST in this way:

Behavior Skills training + additional practice +prompting + reinforcement 

Here is an Example of BST for Calming techniques:

  1. Explain the steps: “ when you something is hard or your are upset you should: 1. use your words 2. calm yourself 3. ask for help”
  2. Have the person tell you the steps: “what do you do when you are upset”
  3. Model the steps “ok  now I am going to show you what to do when you are upset” Pretend like you don’t like a worksheet, say “this is hard”, ask for rubs and a break, and then go back to work. YOU DO ALL OF THIS
  4. Have the person do the steps - “its your turn. Show me what to do when you are upset” NOW THE CHILD DOES THE STEPS
  5. Provide feedback and reinforcement - you can video tape and have the child watch her self and point out what she did well and what she needs to do different, you can have a checklist for her that you check off or put smileys next to the steps that she did, etc
  6. Continue to follow these steps until the child is able to do all of the steps independently 

This needs to also be paired with:

Additional Practice - throughout the day and session ask the child “show me what you do when you are upset” and reinforce for her doing the steps

Prompting - set up situations that you know upset her and remind her prior to starting the situation “remember what to do when you get upset: 1____ 2______ 3______” present the demand and prompt again “if this is to hard, you can calm down” 

Reinforcement - provide reinforcement: smiley faces, longer break from demands, etc anytime the child engages in the appropriate behavior Make sure it is more reinforcing for her to stay calm than get upset. It is ok to give her a change in demands/manipulate the environment for her, for now when she engages in appropriate behavior to express she is not happy. But if she is whining and tantruming you absolutely must not give in to her or manipulate the situation. 

Example: You give the child a worksheet and she says “this is hard” and whines a little but chooses a calming technique - it is ok to say “we will do it later thank you for staying calm.” If however she said “this is hard” and had a tantrum, you would HAVE to follow through on the doing the worksheet or at least part of it once she is calm. So that she learns: when I stay calm, I can remove the demand. If I get upset, the demand stays.

Functional Communication Training

The purpose of Functional Communication Training is to teach a more appropriate/functional response to replace an inappropriate response.  FCT has successfully been used to teach a wide variety of responses to children with autism and other communication deficits. It is important to determine the function of the behavior and to choose a response that is appropriate for the child. My example below is for a child that is vocal. However, FCT can be used for nonvocal children as well by teaching them a sign, gesture, or even a response as simple as holding up a card. The response should be something that is already in the child's repertoire so that you are not trying to teach them a whole new response and to use that response during the situations where they typically engage in tantrums, aggression, etc. The response can be shaped over time to a more complex response but always start with a response that is easy for the child. 

Steps of Functional Communication Training

  1. Identify the function of inappropriate behavior
  2. Choose a functional replacement (a behavior that serves the same function and is already in the child's repertoire)
  3. Teach the functional replacement (using training trials a few times a day)
  4. Provide reinforcement for replacement behavior and no reinforcement for inappropriate behavior

Here is an example of this process:

Identify the function of the inappropriate behavior

A functional assessment indicated that the behavior functions as an escape from a demand or to indicate that the environment is aversive in some way. 

Choose a functional replacement behavior

The replacement behavior for XXXX will be to teach her to request breaks, to indicate when she doesn’t like something, and to indicate when she needs to go somewhere or do something to calm herself down.  

Teach the functional replacement

Typically the functional replacement is taught by doing training trials and reinforcing for appropriate responses. For XXXX we will teach the functional replacement by:

  1. Training the use of the skills by purposely presenting situations that we know will trigger XXXXs inappropriate behavior. (more info on this below)
  2. Prompting XXXX immediately when a situation arises where she needs to engage in the appropriate behavior

Provide reinforcement for the replacement behavior and no reinforcement for inappropriate behavior

It is EXTREMELY important that the appropriate responses result in access to reinforcement: ending the demand, fixing the situation, AND access to a preferred item for now (skittle, pop rocks, etc). Additionally, when XXXX engages in the inappropriate behavior, she should NOT receive access to the reinforcement. 

Situations to Present

The following are some examples of situations you can present to practice use of functional appropriate communication. You will also follow these steps when situations like this naturally come up throughout XXXX’s day. 

Low Preference Demands 

  1. Remind XXXX before presenting the demand “if you don’t want to do something, remember you can ask to do it later”
  2. As you start the demand tell her “you can say ‘can I do this later’”
  3. If XXXX says the phrase, tell her she can do it later and provide a time (we will do this AFTER.....) because she does need to do it eventually and provide her with extra reinforcement (candy, a smiley, etc)
  4. If XXXX doesn’t say the phrase and starts to engage in inappropriate behavior offer her choices “XXXX you can say ‘can I do this later’ or you can do this sheet now.” 
  5. If XXXX starts to tantrum, follow through with the demand.
  6. Make sure to tell XXXX the phrase “if you don’t want to do something you can ask to do it later” prior to high preference demands too so that she doesn’t think you only say it before a low preference demand

Difficult Demands or making mistakes 

  1. Remind XXXX before presenting the demand “if something is hard, remember you can say ‘this is hard will you help me?’”
  2. As you start the demand tell her “you can say ‘can you help me’”
  3. If XXXX says the phrase, help her with the task either by providing help or modifying the task so that it is easier and provide her with extra reinforcement (candy, smiley, etc)
  4. If XXXX doesn’t say the phrase and starts to engage in inappropriate behavior, offer her choices “XXXX you can ask for help or you can do the sheet.” 
  5. If XXXX starts to tantrum, continue the demand WITHOUT help. If she asks for help after the tantrum make her do about 5 seconds without help and then help her. 
  6. Make sure to tell XXXX the phrase “if something is hard, you can say ‘this is hard will you help me?’” before easy demands occasionally too so that she doesn’t think you only say it before a hard demand.

Aversive Environment/interaction (Situations that are not liked by XXXX)

  1. Remind XXXX before presenting the aversive situation “if you don’t like something, you can say ‘I don’t like that’” and then you can (calming technique)
  2. As you start to present the aversive situation tell her “you can say ‘I don’t like that’”
  3. If XXXX says the phrase, and it is appropriate to stop what you are doing, stop. If it is not appropriate to stop, tell her “thank you for telling me you can (calming technique)” and provide her with extra reinforcement (candy, smiley, etc)
  4. If XXXX does not say the phrase and starts to engage in inappropriate behavior, present her with the choice “you can say ‘I don’t like that’ or you can stay here
  5. If XXXX starts to tantrum, continue the aversive situation and do not provide extra reinforcement. If she says “I don’t like that” after the tantrum, wait a few seconds and then acknowledge.
  6. Make sure to tell her “if you don’t like something, you can say ‘I don’t like that’” during non aversive situations too
  7. This is going to be the trickiest one to do and it is important to provide her with appropriate phrases and a lot of practice. Phrases we need her to learn include: “I don’t like that” “Stop” “Can I leave”
Resources for BST and FCT
SkillStreaming is a program designed to teach social skills/problem solving skills to children using BST. Manuals and videos can be purchased on their website

Miltenberger and colleagues have done a lot of research on using BST to teach safety skills to children. Here is a reference to one of their articles but I highly recommend doing a google search or search in the Journal of Applied Behavior Analysis for Behavior Skills Training. 

Miltenberger, R. G., Flessner, C., Gatheridge, B., Johnson, B., Satterlund, M., & Egemo, K. (2004). Evaluation of behavioral skills training to prevent     gun play in children. Journal of Applied Behavior Analysis, 37, 513–516. 

A longer explanation of FCT from Reinforcement Unlimited

A book on using FCT with Severe Behavior Problems by Durand

Articles on FCT:

Carr, E. (1988). Functional equivalence as a mechanism of response generalization. In R. Horner, R. Koegel, & G. Dunlap (Eds.),Generalization and maintenance: Life-style changes in applied settings (pp. 221-241). Baltimore: Paul H. Brookes.

Carr, E., & Durand, V. M., (1985). Reducing behavior problems through functional communication training. Journal of Applied Behavior Analysis, 18, 111-126.

Durand, V. M. (1993). Functional communication training using assistive devices: Effects on challenging behavior and affect.Augmentative and Alternative Communication, 9, 168-176.

Mirenda, P. (1997). Supporting individuals with challenging behavior through functional communication training and AAC: Research review. Augmentative and Alternative Communication, 13, 207-225.

Sigafoos, J., & Meikle, B. (1996). Functional communication training for the treatment of multiply determined challenging behavior in two boys with autism. Behavior Modification, 20(1), 60-84.

Fisher, W. W., Adelinis, J. D., Volkert, V. M., Keeney, K. M., Neidert, P. L., Hovanetz, A. (2005). Assessing preferences for positive and negative reinforcement during treatment of destructive behavior with functional communication training. Research in Developmental Disabilities, 26, 153-168.

Hagopian, L. P., Kuhn, S. A., Long, E. S., & Rush, K. S. (2005). Schedule thinning following communication training: Using competing stimuli to enhance tolerance to decrements in reinforcer density. Journal of Applied Behavior Analysis, 38, 177-193.

Lalli, J. S., Casey, S., & Kates, K. (1995). Reducing escape behavior and increasing task completion with functional communication training, extinction, and response chaining. Journal of Applied Behavior Analysis, 28, 261-268.

O’Neill, R. E., & Sweetland-Baker, M. (2001). Brief report: An assessment of stimulus generalization and contingency effects in functional communication training with two students with autism. Journal of Autism and Developmental Disorders, 31(2), 235-240.

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