Each task provides visual instruction: borders that define the task area, a

Two Color Sort Task

clear sequence and obvious cues for completion. Irrelevant or distracting features are minimized. The types of tasks are determined by the developmental level and degree of indepence of the learner. Beginning learners may complete simple “put-in” tasks. The main purpose of “put-in” tasks is to teach the motor sequence required in the work area. At advanced levels, children use folders, binders and worksheets to complete complex academic tasks within a structured environment. Between the put-in tasks and the folder tasks is a progressive sequence of skill development outlined in “Part 5: The Curriculum” of this series.

Teaching the Tasks: The first step in teaching the tasks is to ensure that the student has the skills to complete it at a table with the teacher. For example, the beginning student learning to complete the “put-in” task is first given the task (a container of objects to put in and a container to place them). Both containers should be framed within a larger container, that defines the border of the activity.  The teacher works from behind the student and teaches with motor prompting (if possible). Initially use “hand-over-hand” for the first object, then point to the second object (gestural prompt), or hand it to the child to put in. If the child stops after that, 0po

Sample Work Station Tasks

The Work Flow. The student:

1. Takes the “work” card from the main schedule and matches it on the work card in their area. 
2. Takes the first card from the mini-schedule and match it to a task on the shelf on the left.
3. Takes the first task off the shelf and places it on the table.
4. Completes the task
5. Places the completed task on the shelf to the right.
6. Takes subsequent cards from the mini-schedule and repeats the sequence.
7. Removes the final card from the mini-schudule that returns the student to the main schedule.

On the main schedule, the next activity for the student should be highly reinforcing. This will motivate the student to finish the tasks and return to the main schedule. Remember that in the example given, the student has progressed systematically to a level of indepence that is the goal of individual work areas. Most students will start with one task and the reinforcer card (or object) placed directly after that task is completed (no need to return to the schedule). Some children have a great compulsion to complete tasks and will quickly progess to mulitple tasks in sequence. Other children will need the visual reminder of the reinforcer that awaits them. The tasks themselves are individualized and must be kept novel and appealing to the students. This means classrooms must have space to store tasks that are not currently “in the rotation.”

Teaching the System. Before the student is placed in the work area, the teacher should first teach the workflow in another area of the room. Set the area up identically to the work station, with shelves on left and right and the mini-schedule on the table. Initially, the teacher will need to provide a combination of verbal instruction and gestural prompts, but these should be faded as soon as the student gets the idea. The reason for teaching outside the work area is to minimize the need for prompting (especially verbal) in the work area. If the student associates the work area with verbal instruction, they may become dependent on these prompts. Once the student has shown the ability to complete the tasks independently, they can be moved into the work area. This process should be repeated each time a new task is introduced.

Transition: There are several approaches to establishing schedules for children with autism. One approach provides a verbal prompt for the student to go check the schedule. The student removes the card from the schedule and then places it in a container at the bottom or side of the schedule and then proceeds to the next activity. While this approach may be adequate for a more advanced student, the purpose of the schedule is to remind students where they are going throughout the transition process without adult assistance. Verbally instructing students to” go check the schedule” may require additional adult prompts to get them there. After the student looks at the card, places it in the basket and heads to the next activity, he may become distracted and forget where he is going. Once again, an adult prompt (usually verbal) is needed to guide the student. A better approach is for the student to have an object/picture in his hands at all points of the transition. Using the transition card as a self-prompt, students can refocus without adult direction. If an adult prompt is needed, the teacher can point to the transition card or manually guide the student while pointing to the card (without a verbal prompt). This will allow easy prompt fading and avoid dependency on adult assistance.

Main Schedule & Mini-Schedules: Visual schedules serve two primary purposes: 1) to allow students to transition effectively from one activity or location to another; and 2) to break down complex tasks into an understandable sequence of smaller tasks. These are sometimes referred to as between-activity schedules and “within-activity” schedules. Since the “within-activity” schedules are usually nested within a “between-activity” schedule, I describe them as the “main schedule” and “mini-schedules.” For example, if a student goes to the main schedule and finds a card that instucts her to go to the work area (TEACCH workstation), she will then find a mini-schedule that gives directions for which tasks to complete. Mini-schedules are useful in many complex classroom routines, such as washing up for lunch, packing up the backpack at the end of the day, or steps to complete a complicated math problem.  

Components of the beginning schedule:

1. A transition card with the student’s name and picture is handed to the student and they’re told to “check the schedule.”
2. The student places the card on the top (if it’s a vertical schedule) or on the left (if horizontal).
3. The student removes the first picture/object from the schedule (upper, or left-most).
4. The student carries the picture/object to the location of the next activity.
5. The student matches the picture/object to an identical one at the location of the activity.

Teaching the Schedule: Since transition is a motor activity, beginning learners are taught to use a schedule following “most-to-least” physcial prompting. In other words, the teacher hands the card to the student and holds the card in the student’s hand while they walk to the schedule together. The teacher gently guides the student physically toward the schedule, “hand-over-hand,” the teacher assists the student to remove the activity card, and then they progress to the next activity where the student places the card on a matching one at the new location. On subsequent transitions, the teacher fades the physical assistance and the student moves throughout the room independently. When first teaching a child to use the schedule, it is helpful to introduce it using preferred or reinforcing activities as the destination. Once independence is established, begin introducing other less preferred activities.

Fresh Air (NPR) with Temple Grandin

Mary Lynch Barbera’s journey began in 1999 when her son Lucas was diagnosed with autism. She went from knowing almost nothing about autism to becoming a Board Certified Behavior Analyst working with hundreds of children. In 2007, she published the book: The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders.  Since September 2007, Ms. Barbera has hosted a monthly radio show on AutismOne Radio. The episodes feature the topics covered in her book and expand upon her experiences using the Verbal Behavior Model in the treatment of children with autism.

The Verbal Behavior Approach: Teaching Children with Autism Archive

Structure. The visual elements of the learning environment telegraph relevant information to the student. Without words, the classroom should inform children of expectations, notify them of what is next, and provide clear visual prompts if the student gets lost in the process. Whether it’s transition between activities, completion of tasks, or becoming more fluent in typical life skills, students become more independent in an environment that is intentionally designed for that purpose.

Predictability. The anxiety of children with autism increases when they do not understand expectations, when they are faced with novel demands and when instructions are presented through complex verbal directions. Often this anxiety translates into behaviors that interfere with teaching and learning. In the face of ambiguous instruction, children with autism may withdraw, act out aggressively, or engage in other behaviors to escape from or avoid tasks. By increasing the predictability of the learning environment, anxiety and related behaviors are decreased. Preparing students in advance for changes in routines, presenting instructions using consistent language, and introducing tasks using a standard format are all methods teachers may use to increase the predictability of the learning environment.

Independence. One of the key skills learned using the TEACCH Method is the completion of mult-step tasks and sequences of activities without assistance. The use of visual cues, schedules, and “mini-schedules” embedded within activities allow students with autism to gain increased independence and decreases the need for adult prompting.

Components of the TEACCH Method. The unique contribution of the TEACCH approach is the detailed attention to environmental structure. The four main components of this structure are: the classroom, the individual schedule, the work system, and the learning tasks. In each case, the student is taught a consistent process in which to approach varying stimuli. So, although the schedule may change from day-to-day and the activities the child completes will vary, the format and presentation remain the same. This consistency focuses the child on the elements relevant for learning. 

Although there is still controversy regarding the “best intervention” for children with autism, it is clear to no single approach corners the market. Behavior Analysts acknowledge that “antedent control” requires careful attention to the enviroment of the learner. However, ABA has not systematically detailed the means for doing this: TEACCH has. And while the developers of TEACCH acknowledge the need for well developed programs to teach social and communication skills, they emphasize the “space” in which it happens, not the methodology for teaching these skills: ABA has. Educators of children with autism would benefit most by recognizing the unique contributions provided by each intervention methodology.

Three-quarters of the behavior plan focuses on proactive strategies for avoiding problem behaviors: teaching & reinforcing replacement behaviors (#3 & #4) or preventing situations that result in the behaviors (#1). By re-focusing behavior plans on proactive strategies, the need for reactive responses is decrease and ideally eliminated. Most educators would agree that avoiding negative consequences (punishments) is a worthy goal, but they lack the strategies for teaching replacement behaviors to children with limited verbal skills. A series of videos developed by Autism Partnership demonstrate the process of teaching children with autism how to recognize and self-manage behaviors. In the first video, a 12-year-old girl with autism is taught to wait quietly rather then tantrum when she does not immediately receive a desired tangible (snack):

The therapist, Rick Schroeder and Marissa were recently featured in a CNN report on ABA services for children with autism. In the second video, a boy with higher verbal skills, but poor language pragmatics is taught to recognize the difference between “silly talk” and “cool talk.” In this video, the skill of “cool talk” is explained, rehearsed, and generalized. The teacher uses the student’s desire to talk about his “special interests” as natural reinforcer to encourage the replacement behavior:

As a Behavior Analyst, I am thankful to Rick Schroeder, Marissa, Kevin (and their families) as well as Autism Partnership for taking the time to document and share their process with the public. With greater understanding of the positive approaches to supporting children with autism, educators and children will have a lot more fun in school! If you would like to view other examples addressing elopement (running away), SIBS (self injurious behavior) and several other behaviors, please visit Autism Partnership’s YouTube web page.

Military families attempting to receive ABA services face many challenges in securing services. One company, Autism Services North, works with families to connect them with providers. ASN is an approved provider in all three Tricare regions (North, West and South). ASN recruits qualified BCBAs across the country and does the legwork in setting up programs for children.

RESOURCES:

Behavior Analyst Certification Board

Autism Services North. Contact information:  Lisa Gibbner (Director of Operations); Paul Eschback (Director).

Department of Defense Report and Plan on Services to Military Dependent Children with Autism

Podcast Interview with Karen Driscoll, who is lobbying congress to increase services for military dependents with autism:

Producer: McGraw-Hill Films; Creative Commons license: Public Domain.