Sloan Publishing - Autism

Autism Teaching Methods that Work:
A Child's Awakening

A video produced by Dr. Ara Bahadourian, Mount St. Vincent College

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This 34-minute video documents two years of one-on-one treatment of two-year old Alexa, recently diagnosed as being on the autism spectrum, demonstrating several behavioral methods such as eliminating echolalia, teaching pronouns, teaching sight words, teaching literal comprehension, teaching language, teaching phonics, refocusing, teaching prepositions, and initiating conversation.

The following is a brief explanation of each (1) skill taught to Alexa and (2) method/technique used by Dr. Ara John Bahadourian in the video. This can be used as a guide to further clarify teaching methods explored in the video.

Skill No. 1 – Eliminating Echolalia
When Alexa began instructional sessions with Dr. Bahadourian, she had no conversational skills. Her language was limited to echolalia, which is the repetition of questions or comments heard by the student. This is common in children on the autism spectrum. During the Baseline, you see that when Alexa is asked, “What are you doing?” she consistently repeats, “Doing?” Alexa needs to be taught through scientifically demonstrated techniques (SDT) how to have a meaningful conversation with another person. During the Treatment/Intervention Phase, the SDT for teaching this skill is to block the echolalic behavior by giving Alexa the correct response before she has a chance to respond (i.e., zero second time delay). When Alexa gives the correct response, she receives verbal praise and an edible reinforcer. In the Independent Phase (after many repetitions/trials), she gives the correct answer and the reinforcers are eventually phased out. Also note that during the teaching of this skill, Alexa becomes silly and inattentive by closing her eyes, making sounds and tapping on the table. She is refocused through teaching her the practical (i.e., functional) skill of appropriately responding to the question. We are eliminating the echolalia while simultaneously teaching her not to “tune out.”

Skill No. 2 – Teaching Pronouns
When Alexa began instructional sessions, she had no understanding of pronouns. During the Baseline segment of this video clip, another child is being asked to do something – in this case, “touching her nose.” When Alexa is asked what the other child is doing, she responds, “I’m touching my nose.” Alexa needs to be taught to say, “She is touching her nose.” In other words, she needs to be taught through SDTs how to use the correct pronouns in different situations. The SDT for teaching this skill is to block the improper use of “I” and “my” by giving Alexa the correct response (in this particular case) of “she” and “her” before she has a chance to respond (i.e., zero second time delay). When Alexa gives the correct response, she receives verbal praise and an edible reinforcer. In the Independent Phase (after many repetitions/trials), she is able to give the correct answer and the reinforcers are eventually phased out. The teaching of “your” and “my” follows using the same techniques.

Skill No. 3 – Teaching Sight Words
For some children like Alexa, who have a strength in visual modality, teaching sight words should come before teaching phonics/decoding. The Edmark Reading Program, one of many sight word-based programs, was chosen to teach Alexa to read sight words. By the time this video clip was filmed, Alexa had already learned approximately 80 sight words through the Edmark Reading Program. We pick up where she is learning a new sight word, “my.” Each time she recognizes and reads the word “my,” she is rewarded using a Token Economy System* and verbal praise. After she has a good visual picture of the word, she is then asked to read it independently.

Skill No. 4 – Teaching Literal Comprehension
After Alexa learns a set of sight words, she is asked to read phrases and match them up with the corresponding picture. Again, the Edmark Reading Program is being used, along with a Token Economy System and verbal praise.

Skill No. 5 – Learning Language
Using the Language for Learning program, Alexa is shown pictures and is asked what is happening in each one. When she gives a correct response, she is given a token and verbal praise. Please note: when Alexa does not know the answer to a question, the answer is provided for her to repeat until she eventually internalizes it.

Skill No. 6 – Teaching Phonics
Alexa is taught how to pronounce all letter sounds (written on index cards) starting with the consonant letter sounds of "b" and "m" by immediately providing her with the correct sounds (modeling prompts). Alexa is then taught the critical skill of blending sounds to form words by using modeling prompts and delivery of tokens and verbal praise for her correct answers. With her knowledge base of sight words and phonetic/decoding skills, she is taught to read sentences and then paragraphs in the Merrill Linguistics Reading Program (Level A). Teaching Alexa to read and answer comprehension questions is a key step in her acquisition of language and communication/conversational skills.

Skill No. 7 – Refocusing
Often during instructional sessions, Alexa becomes distracted and inattentive. It is important to be able to refocus her to the task immediately by using verbal prompts and preferred reinforcers.

Skill No. 8 – Teaching Prepositions
Prior to this video clip, Alexa had learned several prepositions, and this clip focuses on teaching her the word and concept of “behind.” The SDT for teaching this skill is to immediately provide the correct answer. This is a particularly difficult skill for Alexa to learn and, therefore, took more than 100 repetitions/trials for Alexa to master.

Skill No. 9 - Initiating Conversation
At the start of these instructional sessions, Alexa could not initiate a conversation. To teach her this skill, we needed to break down a question, “Grandma, what are you doing?” into individual words, asking her to repeat each word. The motivation here is the edible reinforcer, favorite toys and verbal praise. After many trials in different situations, you can see Alexa begin to ask different children, “What are you doing?” An off-site (walkie talkie with headset) prompt is also used to help teach this skill.