"ME Book" VideotapesAs Dr. Lovaas himself demonstrates in the videos, early introduction to basic skills is critical in preparing children with developmental disabilities to confidently learn and interact with others. Now these videotapes are available on the web FOR FREE to benefit parents and teachers of autistic children (IE is a preferable browser). Videotape 1: Getting Ready to Learn Videotape 2: Early Language Videotape 3: Basic Self-Help Skills Videotape 4: Advanced Language Videotape 5: Expanding Your Child's World DESCRIPTIVE ACCOUNT OF THE ME BOOK VIDEOTAPES O. Ivar Lovaas University of California at Los Angeles TAPE 1: GETTING READY TO LEARN Scene 1. The (list part of this tape shows a student teacher, an intelligent and devoted person, trying to teach an autistic child a relatively simple task such as telling the difference between black and white. As can be seen, she's markedly unsuccessful. Although this section only lasts for a few minutes, there are some reasons to believe that she could be continuing her effort for many hours, days, and perhaps years and still not succeed. What would most likely happen is that the failures to help this child would lead the teacher to become discouraged and feel inadequate and finally give up, perhaps describing herself as not suited to work with autistic-retarded children. The child, Valentine, would not learn anything either. And that would destine him for institutionalization. A most critical part of his future rests on the success of this early teaching. If these seemingly easy and early steps fail, later and more difficult steps would most surely fail also. The teacher may label herself unsuited as a teacher, and Valentine would be labeled as brain damaged or otherwise incapable of learning. As these tapes will show, such inferences are far from the truth. To help a child like Valentine move ahead, the teaching process has to be changed as these tapes (and the teaching manual The Me Book) will illustrate. It is wise to assume that if a child does not learn, then he is not being taught appropriately. Therefore, let us note certain main problems with the teacher's approach that can be summarized below. First, she should try to arrange the situation where the child can be successful, put out positive behaviors that the teacher could reinforce and strengthen. As was seen, Valentine was not helped to engage in any positive or correct behaviors, therefore the teacher was not able to reinforce him, and consequently he was not learning. Note that the amount of learning is directly proportionate to the number of positive rewards a child receives for trying to master a task. In order to set up a situation where the child will be successful, the teacher could either simplify the task, or she could use effective prompts. There are some reasons to believe in this particular instance that the use of successful prompts would help the child learn. For example, if the reader or the viewer turns to the very last section on the fifth or last tape, this particular child, that very afternoon, working with a competent behavioral teacher, mastered the black-white discrimination. Returning to the teaching situation, a second area of difficulty can be seen in the fact that the child engages in a tremendous amount of incorrect behaviors. There are some reasons to believe that a high rate of incorrect behaviors like these are directly interfering with the teacher's attempt to teach. In other words, the child's being distracted by the presence of other toys, getting out of the chair on numerous occasions, engaging in self-stimulatory behavior, etc., are instances where the child is in a way outside the teaching situation. He is not engaging in positive behaviors, which could be rewarded and strengthened, but instead is presenting his teacher with an array of interfering behaviors, which in turn must be ignored or reprimanded. The teacher is unable to provide this child with much joy. To remedy this, a teacher may want to reduce the number of interfering behaviors. She could do this in part by changing the physical structure of the teaching situation. For example, she could remove the table and sit closer to him and thereby physically hold him still for longer periods of time and physically prevent him from actively engaging in interruptive behaviors. The second avenue would be to provide some form of a negative feedback for the kind of interfering behavior so as to reduce it, as we will discuss later on in the tape. The third manner in which his teacher could improve Valentine's performance would be to make her positive rewards maximally different from her negative consequences. Observe how this teacher's rewards ("Good") sound pretty much like her corrections ("No"). In other words, the child is not being taught by the use of differential reinforcements, and that would be another reason why the child would move ahead. Fourthly, the instructions are much too complex. All the teacher needs to do, in these early states, is to emphasize the salient or relevant part of the stimulus, like "black" or "while." This would make it much easier for the child to learn. Statements like, "Valentine, please look at this. I want you to point to the black card," tend to hide or obscure the client's attention to the critical component. Once the client has mastered black vs. while, the additional verbalizations (i.e., "point to," etc.) can be gradually faded in. There are other problems with the teaching situation that can be brought out, such as the possibility that this teacher is actively reinforcing the interfering behaviors, but these problems might be illustrated better by going ahead to subsequent sections of the tape. Scene 2. The next scene shows the building of eye contact. This is a relatively simple response to build. Note that the situation is set up in such a fashion, by the use of prompts (sight of the food in front of the teacher's face) and the physical closeness between teacher and child, that the child cannot help but be successful. A good teacher is a teacher who helps a child put out winning behaviors, while reducing the number of losing or negative behaviors. Incidentally, one problem with the use of eye contact as a starting point is that the response itself might be difficult for the child to discriminate. That is, the child may not be aware of why he or she is being reinforced because the response is so fleeting, simple, and quickly delivered. Perhaps teaching a child to sit, which is a more discrete and noticeable response, would be easier to accomplish in these early stages. Note also a problem which we now encounter in removing the prompt. If the child is reinforced for looking at the teacher when a prompt is present, then we are reinforcing the relationship between the prompt and looking. A teacher will want to remove the prompt as soon as possible to allow reinforcement for responding to the instructions (i.e., look) instead of the prompt. (On the other hand, when one removes the prompt one may run into the problem that the child may not engage in the correct behavior.) Scene 3. This scene illustrates the building of eye contact and our attempt to verbally admonish a child for engaging in self-stimulatory behavior, which probably interferes with the acquisition of new, more appropriate behavior. Note the use of DRO (differential positive reinforcement for other behaviors) to replace the behavior that the teacher tries to weaken or suppress. Such DRO's are essential. Note in this scene the difficulty of getting the behavior without the use of the prompt. Again and again a teacher will be placed in this dilemma. That is, if one reinforces a child for responding in the presence of a prompt, one is building a relationship between the prompt and the behavior instead of building a relationship between instructions and the behavior. If one now removes the prompt altogether, then the child may not respond when the instructions are presented by themselves. If the teacher does not get the behavior at the third or fourth presentation of the instructions alone, the teacher has no choice but to present the child with the prompt. Otherwise the behavior will extinguish totally, and the teacher loses the child. This is a dilemma that is difficult to resolve. One has to remove the prompt, otherwise the child isn't learning. The Me Book discusses this problem and potential solutions. Scene 4. This scene also shows a client engaged in self-stimulatory behavior and being verbally admonished. Note again that if one uses admonition like this, then it is critical that one remember to use a DRO, the opportunity to build the alternate behaviors, the behaviors that should replace the self-stimulatory or other interfering behaviors. If this is not done, then the client is ill-served by the use of verbal aversives. The effectiveness of verbal aversives is short-lived. Long-lasting effects can only be hoped for if alternate or more appropriate behaviors are taught to replace the earlier, more primitive forms of self- stimulatory behaviors. Scene 5. We are beginning to teach a child non-verbal imitation. The scene illustrates certain problems. First, it can be seen that the reinforcement is delayed. This is apparent in several scenes. There is as much as a three or four second lapse between the correct behavior and the primary reinforcer. It is critical that this reinforcer be delivered immediately upon the occurrence of the response. Otherwise, the teacher may be reinforcing an incorrect response, such as the child moving her hands down (as this scene shows). A second problem in this scene is that the instructions and the prompt do not overlap in time. As can be seen, the instruction is given and then several seconds later, the prompt is delivered. It is optimal that the two occur concurrently in time. Another potential problem occurs when the teacher moves on to a new task (hand-clap) before the first task (arms raised) is mastered. Scene 6. This scene shows imitation training in a client who has been taught imitation for two to three months. As can be seen, Chris* self-stimulatory behavior has already been reduced by the increase in the strength of alternate behaviors. He seems engaged in, and appears perhaps to enjoy, the task. The teacher has been able to reduce (thin out) the use of primary reinforcement. The scene illustrates how comfortable and pleasant interactions between the teacher and the client can become. And it must be to facilitate learning. Note also that a large number of trials are occurring within a short period of time (massed trials). In other words, the inter-trial interval is short. One should probably run a trial every ten seconds, so that the child would get a maximum of five to ten reinforcers every minute. The children learn faster with massed rather than spaced trials. Scene 7. This scene shows the teacher intermixing already mastered material with more difficult tasks so as to maintain the child's motivation. We are still occasionally using primary reinforcers here; it is a good idea to have some goodies like this around during the first year of treatment. It helps establish new reinforcers, and food reinforcement is reassuring to the child. We're going back to the child who had the earlier problems with imitation. Note how extremely well this particular child performs on facial imitations. Sometimes one can observe that one can start teaching one form of imitation and not go very far. Then, if one switches to another kind of imitation, one may be surprised to observe how easy it is to teach. In general, if you have worked on a simple task intensively for several hours and not made much progress, switch to another task, perhaps the child learns the new task more quickly. One can always go back to the earlier, more difficult task. This scene shows how one can use imitation to build play behavior. Notice how easy we have made it for the child to succeed. In a way, the child has no choice but to succeed. This particular boy has already mastered the task, and we are just running through various steps to illustrate the succession or movement from one level of nonverbal imitation to another. Note how easily these behaviors can be prompted so that the child would be successful throughout. The viewer may now want to pay attention to the exactness with which this particular child imitates the teacher's movements. What is happening here, perhaps, is that the child is being reinforced by matching and lining. For some children, lining and precision in matching appears to be very reinforcing in its own and this might very well be the case of Ken. An interesting implication can now be formulated: when one has reached a certain state of learning, as when a teacher exposes her students to different tasks, she will begin to discover strong and idiosyncratic reinforcers. In other words, by being exposed to matching (as in imitation) Ken has also been exposed to a new reinforcer. The reinforcer is a sensory/perceptual event: the sight of seeing his behavioral output match that of the teacher's. The task takes on intrinsically reinforcing properties; one doesn't have to use food reinforcement any longer. There are large individual dif- ferences in what children find reinforcing. Scenes 8, 9,10, 11, and 12. In these subsequent scenes, nonverbal imitation is extended into more meaningful parts of the child's environment, dancing, gymnastics, playing with toys, etc. Instead of shaping the new behaviors piece by piece, the teacher may now provide a model of the behavior and add some minor shaping steps. We are becoming more efficient as teachers, and this is critical, because these children do not have any time to lose if they are to avoid or postpone institutionalization. Scene 13. This scene illustrates a match to sample exercise. Such an exercise is akin to imitation since it involves the matching of visual stimuli. There is a great value in teaching match to sample because the matching to sample appears, at least in many cases, to be intrinsically reinforcing. When the match is made, the match is its own reinforcer, as we discussed earlier in the case of imitation training. Note the care that we take here in rotating the position of the stimuli (left vs. right placement) so that position does not become a cue in helping the child solve the problem. Note also that we remove the stimuli between trials in these early stages of learning so that when the stimuli are presented they appear discrete and easy for the child to notice. Note how we go from the easy to the complex. That is, we start the child on a black-white discrimination, we then move on to colors, we go from colors to different forms, and then we finally combine color and form. In the latter discrimination, the child would now have to attend to more than one attribute of the environment (both the color and the shape) in order to succeed. Such exercises might also help in future mastery of new teaching situations since he is now becoming increasingly skillful in attending to outside cues. Our experience is that it is easy to get the children involved in match to sample tasks. Note that we moved from two-dimensional to three-dimensional objects and from relatively non- representative objects to everyday objects. A teacher could probably be as successful by starting in the opposite direction, moving from three-dimensional to two-dimensional stimuli. Match to sample tasks could be easily extended to teach the child new and interesting concepts. For example, the child very well could be taught here to sort objects or dimensions, such as human vs. animals, children vs. adults, etc. In other words, the extension of match to sample into more meaningful, academic, and intellectual behaviors is relatively easy to contemplate. Scene 14. Ken and his teacher are involved in early receptive language training. Once a teacher has built 10 to 20 nonverbal imitations then the nonverbal imitations are used as prompts to teach the same behavior in response to verbal input. It can be said that one shifts from visual to verbal control over behavior. This is probably similar to the way an average or normal child would be taught when he is two or three years old. That is, the parent or the teacher prompts a correct behavior by modeling it at (he same time as the instructions are given. The adult's modeling of the behavior (the prompt) is then removed. It can be said that one obtains verbal control over the various behaviors of the child. That is, one is teaching receptive language. Scene 15. This scene shows the teaching of two-pan commands. Note how involved Ken is in this learning situation and how logical or rational his behavior is. The last scene shows how an adult can engage the child in appropriate behavior at all times. The purpose behind much of this teaching is to keep the child involved in appropriate behavior, attending to other people and his external environment. This is important to do because the child will look normal and more easily fit into a larger, more normal environment. Note that at this level almost anyone can help because there is no attempt to teach the child anything new; the scene describes maintenance and generalization of what has already been acquired. TAPE 2: EARLY LANGUAGE Scene 1. Teachers here are attempting to teach verbal imitation. This is a very difficult task to teach, perhaps the most demanding one, even though it may look very simple. It is difficult to teach (and hard for the child to learn) verbal imitation because the discriminations between sounds and sound combinations are very difficult to make, requiring more detailed knowledge of discrimination learning. In any case, one can observe in Scene 1 how this particular child is trying very hard to vocalize in response to the teacher. It is as if she has the verbal expressions on the tip of her tongue. Her efforts are admirable. Scene 2. This scene is quite long. It shows some of the nuances in our attempts to build verbal imitative behavior. It is doubly important at this point to familiarize oneself with The Me Book and the steps outlined there because the procedure is too complicated to show on a short segment of tape. Note how comfortable the child is, how much love and affection he gets. This becomes particularly important because a child who is happy is more spontaneous and will feel free to vocalize. An anxious child inhibits vocalizations. The teacher will want to reinforce these spontaneous vocalizations so as to achieve the beginnings of social control over them. This is hard work for any child. The teacher may conduct one hour of imitation training, then intersperse one hour of less intense training, then go back to another hour of imitation training and so on. Perhaps the ideal time allotment is two hours in the morning and two hours in the afternoon for this intense kind of training. Note that when a child has learned nonverbal imitation, he has not made any progress on verbal imitation and vice versa. These are separate forms of imitation, and they do not seem to overlap. Note also that the child may leam to imitate sounds but he does not appear to simultaneously imitate decibel level or duration. These various dimensions of verbal behavior would have to be taught separately. Scene 3. Here a teacher and a girl rehearse and practice verbal and nonverbal imitations. This is a very instructive scene because one can observe that the child is fussing throughout the scene even though there appears to be no substantial demands placed on this child. A variety of causes could lie behind such fussing. For example, the child may be medically ill and therefore uncomfortable, the task may be more difficult than anticipated, etc. But if one closely observes an interaction like this, it may be possiblc to detect that the teacher is inadvertently rewarding the child for fussing. This reward could come about because of two reasons. First, the icacher gives a gentle "shrT and other attention each time the child is fussing, which may serve as a positive reinforcer. The second form of reinforcement may lie in the fact that the teacher is actually discontinuing or otherwise postponing the teaching situa- tion whenever the child is fussing. The teacher discontinuing her demands, even for a few seconds, may be a sufficient reward for the child who finds the teaching situation disagreeable. The fussing may be seen as a communication: in the first instance the child is saying, "Pay attention to me/' in the second interaction the child is saying, "Don't ask me to do all this." The interaction underscores the impor- tance of building appropriate language to replace the fussing. Scene 4. The teacher is shaping verbal imitations. This time one can see how closely the teacher is working with the child and how immediately (he responses are being reinforced. One can observe the fastest rate of learning when the reinforcer is literally on top of the response. We choose various kinds of nutritional everyday food items for the children who need such rewards so they get their main meals around teaching time in the early stages of treatment. That is, we break cereal, toast, and so forth, into small pieces, and then they are fed their breakfast, lunch, dinner and in-between snacks while they are being taught. Scene 5. This scene demonstrates how already mastered and more difficult learning are intermixed so as to keep the child's level of motivation high. By intermixing one or two previously mastered trials with practice trials on a new and difficult task, one is more assured that a child's motivational level will stay high. Anyone would need a certain level of success in order to maintain an opti- mal teaching relationship. Scene 6. This scene shows the building of receptive language, as in object labeling. Note that the situation is set up in such a fashion that the child cannot help but be successful: first he has no choice, the correct stimulus (the cookie) is presented alone. Then, when the incorrect stimulus is presented (the doll), the negative stimulus is introduced in a slow, gradual manner. What the child is learning, in addition to identifying the correct stimulus (the cookie), is to withhold responding to the negative stimulus (the doll). Note that we moved (he stimulus to avoid teaching a position preference. When the doll and cookie arc presented simultaneously, he responds to the cookie. Why is that? Probably because the cookie has been reinforced so much in the past. It is a stronger response. Children always act in a lawful and systematic manner. Their behavior makes good sense in every teaching situation once one has the opportunity to observe them closely and think about it. The teacher presents the stimulus choice and the child does not succeed. After a few trials of failing to respond, the teacher has to prompt the correct response, which is being done here. He is then presented with the material again. The prompt is now removed and he responds correctly. It can be said that he has learned to drop the prompt. A critical situation is arranged when the doll and the cookie are interchanged on the table, and the teacher interchanges requests for the cookie and the doll. Note how aware the child seems to be of his environment at this point, and how incredibly hard he is concentrating on the task at hand. It is at this point, where the child has a choice between cor- rect and incorrect, where one can observe the best performance and the maximum amount of awareness or attention to the external envi- ronment. It is as if he is starting to think. Scene 7. Ken is in a group with his mother, his teachers, and student volunteers who work with him. It is important to work in a group so that everyone can see what everyone else is doing so as to provide feedback to each other and learn. Note again how we arrange a situation where it is maximally likely for Ken to succeed: the teacher's instructions (the receptive language) prompts the child*s expressive language. Note again that in order for learning to proceed, one has to remove this kind of prompting. We do this sim- ply by not preceding the child's expressive labeling by the receptive label. Scene 8. This scene shows us teaching a child to label his own behaviors, in this instance standing vs. sitting. This is a very instructive scene because it shows how easy it is to teach a child the wrong response (the correct response to the wron^ stimulus). Notice that the child makes the mistake of giving the response that was reinforced on the previous trial. Such a mistake is easy to under- stand, from a learning point of view. For example, if the child has just been reinforced for saying, "I am silting," then, if one moves to standing and asks what he is doing, he will repeat again, "I am sil- ting." Something important is now happening: the child makes the incorrect response, he is given a dclinite and loud "No!", and he then changes from the incorrect to the correct response and is rein- forced. Specifically, the child is saying, "I am sitting." The teacher will say, "No!" The child then says, "I am .standing." The teacher now says, "Good," and otherwise rewards him. Note in this instance that the child is not learning to associate the words sitting and standing to his own behavior of sitting and standing but rather to the teacher saying, "No!" There is a good rule to remember: these children will learn any behavior accompanied by reinforcement and can just as easily learn the wrong S-R connection. A major concern in teaching these children is to make sure that they are responding to the correct stimulus. If the teacher concentrates on the details of the teaching situation and becomes aware of potential teaching mistakes, these problems can be overcome. Another instructive part of this scene concerns the great deal of eye movements and gazing, which probably renders the teaching situation difficult for the child. In other words, the child is attending to a number of (visual) stimuli that are not part of the teaching situation. Scene 9. Involving the same student, it can be seen how very adequately he has learned to label complex behaviors presented on two-dimensional stimuli while having difficulty with discriminating seemingly less complex stimuli from his own body. Nevertheless, it is obviously occurring here. A number of alternatives might now be suggested. For example, the child may be taught to label his own behaviors on a two- dimensional picture, then to label his behaviors in a mirror, and then by gradually fading the mirror, he may eventually come to label his own behavior as he experiences it through bodily cues (tactile and other proximal receptors). Scene 10. This child is expressing his wants and learning to manipulate his environment more effectively. All along it is important to note that the child's behavior must control, in great detail, the teacher's behavior. Although these are very controlling teachers, it is obvious that in order for teaching to proceed adequately, the teacher has to be controlled by the child also. The teacher must discriminate between being controlled by the child's appropriate behavior, which will help the child grow and develop, and being controlled by inappropriate behaviors, which will interfere with the child's growth. Note in this scene that, if we listen to what the child has to say, he prefers a cookie over a banana when given that choice. Note that when confronted with a banana and water, the child prefers a banana, which gives some indication that he knows what is going on. Even so, one has to help the child make the best decisions. Scene 11. Here we see the beginning of signing. For some clients who have particular problems in vocalizing, one may attempt to teach sign language. Sometimes signing facilitates vocal behavior, sometimes not. There is considerable literature on signing at this point, some of which is discussed in The Me Book. We sign whole sentences at this point, hoping to activate something that linguists have guessed to be latent structure. There is no reason to believe, from viewing these scenes, that we did in fact activate such latent grammatical structures. Perhaps they don't exist. Instead, it appears that we are closely guiding his sentence in a one-to-one, unit-by-unit procedure. The use of whole sentences, at this point, would be counter-indicated from a learning point of view. Scene 12. Note this very important scene. This teacher tries hard to teach this youngster to express himself with signs. Pay attention to how the student seems indifferent to the rein forcers that are provided and prefers instead to self-stimulate and act out. This is a warning sign: the teacher is not getting or maintaining adequate control over the student because she cannot offer him what he wants. What this might imply is that the student is more reinforced by engaging in self-stimulatory behavior than by responding to the teacher's praise and the food reinforcement (juice) that has been provided. Note how the teaching situation is gradually deteriorating, and the child is acting increasingly inappropriate. At a certain point, the teacher tells the student to go to the corner, that is, he is placed in time-out. The danger with this particular procedure at this particular time is that time-out (being in the corner away from the teaching situation) may in (act have been a reinforcer for the student. Perhaps he engaged in the interfering behavior as an attempt to avoid or escape the demands that the teacher placed upon him. Therefore, time-out at this particular point could well have served to reinforce his inappropriate behavior. This probable mistake was in part corrected in the last scene where the teacher dismissed the child from the teaching situation contingent on an appropriate response. TAPE 3: BASIC SELF-HELP SKILLS Tape 3 was constructed largely to show some f I lustrations of how the teaching techniques and curriculum that were presented in the first two tapes could be placed within a meaningful context in the community. The tape illustrates a deinstitunalization environment, which concretely means that the clients were removed from a large institution and placed in a group-home (Teaching-Home staffed by Teaching Parents) in the community. There is an immediate humanizing effect in the change of environment, and there is literature that is already available that describes procedures in quite some detail on how to help dеinstitutionalize. The program was modeled after one that was developed by Dr. M. Wolff at the University of Kansas, in Lawrence, Kansas. Scene 1. This scene shows a client making his bed as an illustration of the kind of self-help and self-care skills that the clients are taught. This is a client who has been institutionalized for some twenty years, and at the age of 25 is introduced to a home in which he will learn the kinds of skills that he needs to possess in order to be placed in a less restrictive environment (a group home) in the community. You can see Stan who, with his wife, lives in this home and takes care of and helps leach the four clients who also live with them. Note all the prompting that has to be provided in these early stages has to be removed in order to help the client learn to be more independent. Scene 2. This scene shows the client toileting himself— brushing his teeth in this instance. There is a problem here with the client's perseverating on the toothbrush, and one of the staff members introduced the idea of a tape recorder, which the client could use to better monitor his performance and move ahead in the sequence. The tape is a prompt that also has to be faded out eventually. Scene 3. This scene depicts a client shaving his face using a straight-edge razor. Some care has been given to the placement of soap on his face because that is a prompt, at least for the time being, of where he should shave. This particular client has also spent most of his adult life in a hospital before ho was placed in the Teaching Home. Scene 4. A child is learning to dress himself using backward chaining procedures. Il may be efficient to use nonverbal imitation procedures to help in this task. Scene 5. Here we sec a relatively long scene sequence illustrating toilet training. This program is built on a model developed by Drs. Foxx and Azrin and is referenced in The Me Book. The toilet training scene illustrates in concrete and easily understandable steps the use of prompts and rein forcers, the moving in successive steps from easy to more difficult behaviors, the strengthening of alternate behaviors, and so on. Note the variety of reinforcements: the client receives food reinforcement, social reinforcement, opportunity to escape from sitting on the toilet and to move about, to observe the water being flushed, etc. Note the slow and gradual manner in which we are making the task more difficult. A big step in this program occurs when the client has to move from the chair to the toilet so that he urinates in the toilet instead of on the chair. Whenever a client makes a mistake at one step in the hierarchy, one goes back to an earlier successful step. Note how the task is gradually made more difficult by placing the chair farther and farther away from the toi- let. Eventually the toilet is out of the client's sight. Additional behavioral requirements are gradually added for successful perfor- mance. The main behavioral prerequisite for successful toilet train- ing is that the client has learned to sit on a chair for a prolonged period of time. One scene here illustrates over-correction of an acci- dent. The client has to wipe off urine from the chair and surrounding area. Note that the client smiles during this task, which suggests that he enjoys over-correction, and this in turn means that it probably won't work. Notice that the client is being heavily reinforced for a correct alternate behavior, which is, in this instance, keeping his pants dry (dry pants check). Toilet training may seem like a rela- tively insignificant achievement to some, but it turns out to be of major importance in later successful community placement. Scene 6. The teaching of grooming skills, which are important to learn if one wants to belong to a larger community outside, are depicted in this scene. The teaching parents need to interact with the outside world, and they usually bring their child with them out in the community. Looking pretty is but one part of this more elaborate requirement of fitting in out there. Such requirements were rarely raised within the institution because the demands were not there. Scene 7. In the kitchen we see the clients helping prepare their own food. Food preparation and sitting down to eat three meals a day may consume several hours and is a very reinforcing task for most. Sometimes it is easier for an adult to do all these tasks for the client just like it is easier for a parent to do all the chores for one's own children. Bui, in ihc long run, such an attitude will backfire because it builds helplessness and inactivity on the part of the client. Note all the subtle and gentle prompts that this Teaching Parent provides in the kitchen to guide her clients to successful performance. It seems like her prompts are a natural part of her interaction with the children. So are her rewards. It is obviously important in any teaching sequence to approximate, as much as possible, the real world. The scene shows how we carefully teach the clients how to behave adequately in a potentially dangerous environment. In this instance, it is a hot stove. In another instance, it may be teaching a client to cross a busy street when the light is green, not to play with matches, etc. Scene 8. In this scene we see mealtime. This is a joyful event and allows for all kinds of interactions and all kinds of teaching to occur. Note that the people who care for the clients also eat with them. This puts additional requirements on both the clients and the staff. It is easier for a client to survive a placement in the less-structured environment when the client can help with the food preparation, can eat in an appropriate manner, can help clean up the table, is toilet-trained, can behave appropriately in the community, and so forth. Scenes 9 and 10. These scenes illustrate some of the effort that is expended on helping the clients establish appropriate leisure skills. Lack of such skills is one of the major problems with devel-opmentally disabled persons. What are the clients going to do if they aren't working or eating? Playing cards and playing musical instruments is something that we all can share, and these particular tasks are taught in a concrete step-by-step fashion to these clients. Scene 11. Bill is taught to sign his name in this scene. Note how absorbed he is in the teaching situation and how normal, adequate, and competent he looks. Now pay attention to what happens just a minute after this sequence when he is not engaged in teaching but rather in sitting and resting. At this point he looks so bizarre and psychotic that he might be mistaken for another person. What this implies is that psychopathological behaviors are situational; they are likely to occur in some situations but not others. The teaching of appropriate behaviors, to replace the bizarre and psychotic gestures, constitutes a most significant treatment. Tape 3 ends with a scene showing a man and a woman, both of them developmentally disabled, sitting on a park bench. How one would go from here is a most interesting question. Perhaps the teaching of affectionate interaction between these persons would be an important goal. TAPE 4: ADVANCED LANGUAGE On the whole, this tape builds upon the teaching steps as laid out in earlier tapes and extends them into a much more complicated level of functioning. No new teaching principle is introduced at this point. Scene 1. This scene illustrates pronoun training and ways we try to make such pronoun training easier. Note how complex pronoun training can become. It is important to keep in mind that the adequate and appropriate use of pronouns is merely started in this kind of controlled teaching situation. It is easier for the child to learn in a situation that is initially simple and where the teacher has good control over the relevant variables. However, pronoun training, like all other teachings, has to be extended to the everyday natural environment in order to become meaningful and useful. Scene 2. This scene depicts the teaching of prepositions. The teacher prompts (using her finger) ihc correct response. When she withdraws that prompt, the student is carefully studying the teacher's face for additional cues. It is very important now for the teacher not to visually guide the correct response, otherwise the student would learn to look at the teacher's eyes to solve this problem rather than listen to her instructions. It is often easier for these children to solve a problem by attending to visual rather than verbal cues. Perhaps this comes about because verbal cues are more difficult to discriminate than visual ones. The scene illustrates how it is all too easy, even for a competent teacher, to make teaching mistakes, emphasizing the need for continual updating and feedback on one's teaching techniques. Scene 3. This scene introduces expressive prepositions. Note how the language programs develop from receptive to expressive use of language. Ft is possible that the instructions employed in this scene may be too wordy. A more helpful (discriminablc) instruction would just consist of in as compared to under (or some other preposition) in the beginning stages. The complete sentence (Place X under Y) coufd then bo failed in during later stages of learning. Scene 4. The child is placinir himself in various physical rela- tionships to his environment. This is a point where the use of prepo sitions is becoming more meaningful and is introduced in everyday life. In order for language to become meaningful, it has to be extended. Scene 5. A student is learning to label colors. Note that his enunciation of color labels is so poor that the teacher encounters problems whether to reinforce or not. If the teacher experiences uncertainty whether to reinforce because the student's response is vague and ambiguous, then the client cannot discriminate when and why he is being reinforced either Not much would be learned in such a situation. In this instance, it might have been better to teach more adequate enunciation separately before one goes this far into meaning training. This scene shows the early stages in leading a client to attend to two verbally expressed dimensions concurrently. Scene 6, This scene shows how we attempt to teach the concept of time in a concrete and discriminate manner. The stimulus objects are arranged succinctly in front of the client, and he is asked to respond to temporal cues (the ordering of events in time). Note how we have tried to simplify the temporal cue. Note that the teacher, by the use of her instructions, prompts the clients to emit the correct response. Note again how slowly the task is made more complex. By teaching time in this particular controlled and simplified manner, one is helping the child make the beginning discriminations of time. Meaningful use of time concepts can best be accomplished in a more natural environment. For example, one goal of teaching about time may be to help the student describe his behaviors over time: what he did in the early morning, then after breakfast, then before lunch, and so forth. In helping a client order his behavior over time, the teacher teaches him to relate his experiences to others. That is complex and meaningful use of language. But the beginnings have to be made in a structured teaching situation that allows for better control over the teaching steps. Scene 7. This scene depicts the teaching of the volitional use of the yes and no responses. The use of yes and no may move from volitional acts to the use of terms like yes and no in factual contexts. Scene 8. This illustrates one of the numerous programs through which we hope the children may become more aware of their environment. In the "What is missing?" game we start in a highly structured environment and then move on to a more meaningful environment. That is, one starts with items and "What is missing?" on the table right in front of the child. One can then transfer that learning to "What is missing?" elsewhere, as at home when the dinner table is set with some items present and others not, when a person has put on clothes and left some items off, when a picture is removed from a wall, and so on. The program serves to help the children become more aware of their environment and to verbalize irregularities or deviations from what they are used to. Scene 9. The child is taught to teach the teacher This kind of control is extremely reinforcing for the child, which can be observed in the noticeable increase in the clarity of his diction and good use of language. Controlling others appears to be a reinforcing event, especially for these children. Scene 10. This scene shows that by reducing the number of teacher cues and asking for larger and larger chains of responding one may observe more spontaneous behaviors. With all the control and structure that has characterized the teaching up to this point, we may have suppressed (or not allowed for) spontaneous responding. Therefore, one attempts to reduce the control, in later stages of learning, leaving more and more responding to the child. The teacher has to arrange a situation that helps the children become more spontaneous. Perhaps the most spontaneous responding occurs in these situations where the child finds the task intrinsically reinforcing. Such intrinsically reinforcing tasks can, in transitory form, be observed in higher levels of self- stimulatory behavior. Scene 11. This scene shows the use of pictorial material to build increasingly long descriptions of the environment to include color, shape, behaviors of others, and so forth. Note again the use of prompts, the fading of the prompts and the gradual building up of more and more elaborate descriptive language behaviors on the part of the child. Scene 12. This scene illustrates teaching of the terms same and different. Note that this is a very difficult task and one which is approached after a great deal of prior language work. After one has worked with students in this kind of close and controlled fashion, a problem appears in that the student believes almost anything that the adult teaches him. In this scene, we illustrate how to explicitly build programs to teach the children to doubt the teacher and question the teacher's authority. TAPE 5: EXPANDING YOUR CHILD'S WORLD Scene 1. This scene shows a mother teaching her develop-mentally disabled youngster early academic tasks. (Many of the teachers depicted in earlier scenes are also mothers.) The mother is an integral part of the treatment team and has been taught behavioral teaching in an apprenticeship fashion, just like any other student. Note the careful way in which the letters are introduced. The new letter is introduced and is intermixed among the others in order for the child to make an adequate discrimination. Note that if the child is merely repeating the labeling of the letter, one is only teaching the child to repeat and perseverate. It is the intermixing of tasks that helps the child discriminate and brings him/her to mastery. As we mentioned earlier, this is called discrimination learning and is the most important part of a training program. When the parents are involved like Ken's mother is here, one ensures that the child is in teaching or treatment all his waking hours, seven days a week. Such is the case with most normal or average children. Note how happy Ken is when things are going well. A child who is taught well is also a very happy child because positive reinforcers are forthcoming often and predictably. A child who is taught well is not only happy but is also learning at a steady rate. Scene 2. Here is a demonstration of part of the teaching of quantitative reasoning as in teaching the difference between more and less. We go on to teach numbers and the early meaning of num- bers. At this advanced level of teaching, interesting nuances begin to occur. The more or less sequence between Anna and her mother illustrates this well. Anna easily learns that she has more and it is difficult for her to learn that she has less. Perhaps she understands the more basic implications of what more is talking about. Scene 3. In this scene we have a sequence teaching cause and effect relationships, staying with as concrete and elementary behaviors as we can. Note that earlier we have taught the components of these sequences in smaller steps. Scene 4. This scene illustrates how one may attempt to teach the child to discriminate feelings. Note that we start with teaching labels for facial expressions first because these cues are more easily identified. After that we go on to help identify the underlying feel- ings. Note how we go from the expression of feelings to the cause of feelings. Teaching about feelings is important for any child and perhaps especially for autistic/schizophrenic children. However, only half of the intensively treated children reach this stage. Scene 5. We are teaching the children here to ham it up and become more full of expression. In the kind of closely controlled programs that have been employed in the earlier stages, the teacher needs to put in more affect and spontaneity in later stages. Otherwise one ends up with children who act like robots. Scene 6, In the later places of treatment one may attempt to teach the use of language to create situations that actually are not present in the immediate physical environment. The beginning of teaching imagination is shown in this scene. Some professional persons have maintained that one could not reach such a level of functioning because retarded/autistic children were said to be incapable of such achievements or because the training paradigm (learning theory) could not help generate this kind of behavior. Obviously they were wrong on both counts, which is to the children's benefit. But it is also important to qualify this finding. With very intensive training (more than 40 hours of one-on-one per week), less than half of the children advance to this stage where they can use language for imaginative purposes. Note how similar this program is to the way an adult would help a more normal or average child learn to use imagination. Perhaps the procedures that work so quickly with nor- mal children also work with developmentally disabled ones. Scene 7. Programs for teaching a client to learn about other people in his environment are shown in this scene. Note again how we proceed in easy steps. This is one of the early steps in observational learning constructed with the intention to help the client to learn by just observing other people learn. This should allow him to more adequately function in a classroom where almost all learning is done through observation rather than by one-to-one shaping of individual behavior. Scene 8. This scene illustrates a program that is closely related to the previous program on observational learning. It deals with helping the children gain information from their environment. In this program, we attempt to teach the children to discriminate between information they do and do not possess, to inform us cor- rectly about that, and to seek information and answers to questions they do not understand. In conclusion, the point presented in the beginning of this booklet should be reemphasized, namely that the scenes depicted in these tapes are intended to help the teacher/parent by visually illustrating certain teaching steps. The tapes are, by themselves, not sufficient for teacher training and must be used in conjunction with The Me Book and other teaching materials. |
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