Evaluating & Teaching Yes/No Responses Based on an Analysis of Functions Jennifer Albis, M.S., CCC-SLP
About the Author The research presented today was conducted while the author was a Speech- Language Pathologist at Melmark New England. The author is now the Director of Therapy Services at the Evergreen Center. We are a private educational and residential program serving students aged 6-22 with developmental delays, brain injury, and challenging behaviors. Both schools are committed to educating students using evidence-based interventions, including Applied Behavior Analysis. Presenter Disclosure Requirement - The author has no financial or nonfinancial relationships that exist related to the content of this session.
Yes/No Questions Why are they important? Common Close-ended Only 2 choices Lower demand on memory and vocabulary Provide valuable information Wants/Needs Comprehension What problems do we have teaching them? Scattered skills, especially in children with ASD Inconsistent responses Students that will answer all Yes or all No Echolalia Do you want this? Want this? Yes. Do you want a marshmallow? Marshmallow Difficult to teach correct response if you don t know the answer
Learning Outcomes Applied Behavior Analysis (ABA) Skinner s Analysis of Verbal Behavior Applications to Yes/No questions Research procedures and results Discussion
What is ABA? Applied - social significance Behavioral objectively measure and change observable behaviors Analytic data-based science, analysis of antecedents and consequences, clear demonstration of change in the dependent variable as a result of a change in the independent variable and no other confounding factors Technological describe methods in sufficient detail for replication Generality change should last across time and settings Effective demonstrated effectiveness by comparing data before and after treatment, social (not just theoretical) importance Conceptually Systematic relate procedures and results to the behavioral principles ABA & Evidence-based SLP
ABA
Also ABA
Skinner s Analysis of Verbal Behavior 1957 - B.F. Skinner s wrote Verbal Behavior Theoretical framework in which language is compared to all other forms of human behavior, subject to the same controlling variables Defines and categorizes types of language by functions A response is categorized based on the stimuli that evoke the response and the consequences that mediate the response Skinner theorized that the verbal operants were functionally independent of each other Responses may, but do not consistently, transfer across functions e.g., a child may request a ball but not be able to label a ball when he sees one (Kelley, et. al, 2007)
Elementary Verbal Operants Verbal Operant Antecedent Response Consequence SLP equivalents Echoic A verbal response Identical verbal response Social reinforcer child hears bear child repeats bear parent praises, Good! Imitation, repeating Motivating condition deprivation or satiation Verbal response Specified by the mand Mand child is hungry and/or wants a cookie child states cookie adult gives child a cookie Requesting, asking, protesting, child dislikes milk child states no milk! adult removes milk from the table Tact Nonverbal stimulus Verbal response Social reinforcer child sees or hears an airplane overhead child states airplane! adult praises child or gives attention by commenting about the airplane Labeling, expressive identification, vocabulary, commenting, naming, concepts Intraverbal Verbal stimulus by another speaker teacher or class sings, Twinkle twinkle little teacher asks, Where does a cow live? Verbal stimulus that does not match preceding stimulus child completes the phrase with star child answers, on a farm Social reinforcer child receives praise or continued engagement in a preferred musical activity teacher praises student or continues with a fun activity Answering questions, cloze responses, verbal associations, categories, reciprocal comments, fillins, conversation, greetings
Echoic Verbal Operant Antecedent Response Consequence SLP equivalents Echoic A verbal response Identical verbal response Social reinforcer Imitation, repeating child hears bear child repeats bear parent praises, Good!
Mand Verbal Operant Antecedent Response Consequence SLP equivalents Mand Motivating condition deprivation or satiation Verbal response Specified by the mand Requesting, protesting child is hungry and/or wants a cookie child states cookie adult gives child a cookie child dislikes milk child states no milk! adult removes milk from the table
Tact Verbal Operant Antecedent Response Consequence SLP equivalents Tact Nonverbal stimulus child sees or hears an airplane overhead Verbal response child states airplane! Social reinforcer adult praises child or gives attention by commenting about the airplane Labeling, expressive id, vocabulary, commenting, naming
Intraverbal Verbal Operant Antecedent Response Consequence SLP equivalents Intraverbal Verbal stimulus by another speaker teacher or class sings, Twinkle twinkle little teacher asks, Where does a cow live? Verbal stimulus that does not match preceding stimulus child completes the phrase with star child answers, on a farm Social reinforcer child receives praise or continued engagement in a preferred musical activity teacher praises student or continues with a fun activity Answering questions, fill-in/cloze responses, verbal associations, reciprocal comments, greetings, conversation
Why is this important? If responses are functionally independent, we must teach across all verbal operants Because children with ASD can be poor at generalizing skills, teaching within meaningful contexts is important to promote acquisition, generalization, and maintenance (NRC, 2001; American Speech-Language-Hearing Association, 2006c). Functional context is about more than just natural settings We can analyze the function context (i.e., antecedents and consequences) of the target skill and can better replicate these conditions during instruction The relatively recent introduction of Skinner s theory to the instruction of children with ASD has led to a number of effective practices within ABA and SLP (Michael & Sundberg, 2001) Picture Exchange Communication System (PECS) Functional Communication Training Focus on spontaneous communication / Mand training Assessment by function using tools such as the Assessment of Basic Language and Learning Skills - revised ( ABLLS-R) and the Verbal Behavior Milestones Assessment and Placement Program (VB- MAPP).
Why are Yes/No Questions so difficult? The meaning of the word Yes/No changes based on the question Yes can mean: Yes, I want this Yes, that is a cat No can mean: No, I don t want that No, it s not a cat Request vs. Label - requires different level of comprehension No, it s not a cat requires you to understand cat, negation, and question
Applying Skinner s Analysis Yes can have many meanings Echoic Say yes Mand Do you want this? Tact Is this a cat? Intraverbal Can a cat fly? Functionally independent Emerging research Students were taught to respond to yes/no questions in one condition (e.g., mand), but were unable to respond to yes/no questions in another, untaught condition (e.g., tact or intraverbal) (Neef, Walters, & Egel, 1984; Shillingsburg et al., 2009). Research remains limited at this time, especially within the SLP literature. The focus of this study is to add additional cross-disciplinary research to the application of Skinner s analysis of verbal behavior to the assessment and teaching of Yes/No responses to children with ASD
Verbal Behavior & Yes/No Questions Verbal Operant Mand Antecedent Response Consequence Motivating condition + Yes-No question Verbal Yes-No response Specified by the mand child is hungry and/or wants a cookie yes adult gives child a cookie SLP equivalents Yes/No preference child dislikes milk no adult removes milk from the table Tact Nonverbal stimulus + Yes-No question child sees an airplane and adult asks, Is that an airplane? Verbal Yes-No response yes Social reinforcer adult praises child or gives attention by commenting about the airplane Yes/No verification Intraverbal Yes-No question Verbal Yes-No response Social reinforcer teacher asks, Does a cow say nay? no teacher praises student or engages in joint affect by laughing at the absurdity Yes/No verification
Yes/No Mands Do you want this? Verbal Operant Antecedent Response Consequence SLP equivalents Mand Motivating condition + Yes-No question child is hungry and/or wants a cookie Verbal Yes-No response yes Specified by the mand adult gives child a cookie Yes/No preference child dislikes milk no adult removes milk from the table
Yes/No Tacts Is this a? Verbal Operant Antecedent Response Consequence SLP equivalents Tact Nonverbal stimulus + Yes-No question Verbal Yes-No response Social reinforcer Yes/No verification child sees an airplane and adult asks, Is that an airplane? yes adult praises child or gives attention by commenting about the airplane
Yes/No Intraverbals Verbal Operant Antecedent Response Consequence SLP equivalents Intraverbal Yes-No question teacher asks, Does a cow say nay? Verbal Yes-No response no Social reinforcer teacher praises student or engages in joint affect by laughing at the absurdity Yes/No verification
The students 3 students with ASD Ages ranged from 7 years, 9 months to 10 years, 2 months Yes/No questions were chosen as an IEP goal by the SLP, based on formal and informal evaluations of skills All 3 produced spoken words All 3 could imitate, request, and label with single words Ability with answering other types of questions varied Echolalia or no response
The setting Private school for students with autism, brain injury, and developmental disorders The school specializes in applying the principles of Applied Behavior Analysis Classrooms contain 6 students, a lead teacher, and 3-4 ABA counselors In addition to individual sessions, ranging from 1 3 times per week, the SLP creates individualized lesson plans to target all IEP objectives Classroom teachers implement these lesson plans daily under the supervision of an educator, a Board Certified Behavior Analyst, and the SLP
Identifying Yes & No items Need to identify STRONG Yes & No items to make the skill as clear as possible, at least initially Formal preference assessments, conducted every 6 months for all students Interview parents/teachers Informal preference assessments, conducted within sessions Yes - based on items the student requested or reached for No - based on items the student pushed away or otherwise rejected If a student s preference was questioned on any trial or seemed to have changed mid-trial, teachers did not score data for that item
Baseline Students were offered one item at a time and asked with a neutral tone, Do you want this? Responses scored as correct yes for preferred items / no for non-preferred items Responses scored as incorrect incorrect response - says yes for a non-preferred item repeated back any portion of the question Want this? Yes? or Cookie, yes more than one response yes, no no response within 5 seconds
Mand condition Trials were not run consecutively; they were interspersed with other skills and throughout the day Most-to-least prompt fading 1. Full verbal model + gestural model (e.g., teacher says yes and nods head) 2. Phonemic cue + gesture model (e.g., teacher says y and nods head) 3. Gestural model 4. Independent Data was summarized by dividing the total number of correct trials at the current prompt level by the total number of trials run and multiplying by 100 Students advanced prompt levels after scoring 80% in 4 out of 5 consecutive sessions
Correct & Incorrect Responses Reinforcement For correct yes responses, students immediately received the target item For correct no responses, the target item was immediately removed and other items were offered Correction For incorrect responses, teachers moved up the prompt hierarchy until the correct response was achieved (e.g., gesture model phonemic cue full verbal model) After correcting the response, teachers provided verbal praise, but did not provide access to or removal of the target item The question was repeated with the same item, providing full reinforcement by providing/removing the target item
Tact condition Baseline Students were shown a single object or picture at a time and asked, Is this a? Correct yes for a true statement in which the stated label matched the item presented no for an untrue statement in which the stated label did not match the item presented. Incorrect wrong response more than one response no response within 5 seconds Repeated any portion of the question.
IOA Interobserver agreement to ensure reliability and treatment fidelity During both baseline and treatment phases, IOA was conducted with two observers simultaneously collecting data. For student B, IOA was calculated for 8% of the sessions, with an average of 100% agreement. For student M, IOA was calculated for 23% of the sessions, with an average of 100% agreement. For student Z, IOA was calculated for 8% of the sessions, with an average of 100% agreement.
Results
Limitations No follow up data available yet for transition from tact to intraverbal conditions There was no formal analysis before intervention of the student s baseline mand and tact repertoires (e.g., see if student can label apple if asked, What is it? before answering the question, Is this an apple? ) Inconsistent measures to ensure interobserver agreement Despite these limitations, these findings add to the growing body of research suggesting the functional independence of yes-no responses to varying verbal operant conditions.
What does this mean for our services? We cannot assume that Yes/No responses will generalize from mands to tacts Yes/No skills should be evaluated based on functions Yes/No programs should target mand and tact in succession Start with students motivation and use items that are clear Yes & clear No responses Yes/No responses can be taught with a relatively simple intervention run daily by classroom teachers with SLP supervision and consult
References American Speech-Language-Hearing Association. (2006c). Roles and responsibilities of speech-language pathologists in diagnosis, assessment, and treatment of autism spectrum disorders across the life span: Position statement. Available from http://www.asha.org/policy. Kelley, M.E., Shillingsburg, M.A., Castro, M.J., Addison, L.R., & LaRue, R.H. (2007). Further evaluation of ermging speech in children with developmental disabilities: Training verbal behavior. Journal of Applied Behavior Analysis, 40, 431 445. Michael, J.M., & Sundberg, M.L. (2001). The benefits of Skinner s analysis of verbal behavior for children with autism. Behavior Modification, 25, 698 724. National Research Council. (2001). Educating children with autism. Washington, DC: National Academy Press. Neef, N.A., Walters, J., & Egel, A.L. (1984). Establishing generative yes/no responses in developmentally disabled children. Journal of Applied Behavior Analysis, 17, 453 460. Shillingsburg, M.A., Kelley, M.E., Roane, H.S., Kisamore, A., & Brown, M.R. (2009). Evaluation and training of Yes-No responding across verbal operants. Journal of Applied Behavior Analysis, 42, 209 223. Skinner, B.F. (1957). Verbal Behavior. Englewood Cliffs, NJ: Prentice-Hall. Sundberg, M.L, & Partington, J.W. (1998). Teaching Language to Children with Autism or Other Developmental Disabilities. Pleasant Hill, CA: Behavior Analysts, Inc.
For more information: jalbis@evergreenctr.org