Autism, PDD-NOS & Asperger's fact sheets | Example of Applied Behavior Analysis (ABA) to help a child listen to conversations
Information on Applied Behavior Analysis, Autism and Aspergers syndreome - common Autism Spectrum Disorders
 
 

EXAMPLE OF APPLIED BEHAVIOR ANALYSIS-
LISTENING TO CONVERSATIONS

This is a selection of notes from over two years of behavioral intervention sessions with a young child who ultimately recovered completely from Autism. It includes many curricula ("drill sheets"), therapists' notes, and parents' notes, covering (in part) his development from no pretend play skills all the way to fully independent, spontaneous, creative play.


The notes are by the parents, Megan and Jim Sumlin (pseudonyms), who feel strongly that this information should be freely available to all who might benefit from it. They ask only that these drills belong in the public domain, and are not to be claimed or copywritten by any person who is or will in the future be seeking monetary gain for wide distribution of same. Feel free to re-distribute this document, but please include this entire preface.


These notes are just one part of a comprehensive program guided by a behavior analyst; there were other parts of the total program, not included here, that were necessary to the child's development and eventual recovery. They are specific to one individual child. Use them as a resource to help you plan your child or student's curriculum. What works for one child will not work for all. While much of the material here addresses problems common to many or most children with an Autism Spectrum Disorder, you will want to select carefully based on individual needs, learning style, and personality.

 

A few notes on terminology:

Discriminative Stimulus (SD)

This is the instruction given to the child.

 

Response

This is the response expected or desired from the child.

 

No-No-Prompt (NNP)

This is one specific technique for presenting the "Discriminative Stimulus," then prompting (providing the "R") if the child responds incorrectly.

 

Time Out

This is a brief removal of all reinforcement, where the child must sit and do nothing. This is meant to reduce certain unwanted behaviors but it has no moral or emotional overtones; it is not a punishment for "being bad."

 

Reinforcement

This is a reward for a correct response, which may be anything the child loves: a bit of chocolate, a piggy-back ride, an enthusiastic "You're so great!" Proper reinforcement is the key to learning.

 

Differential Reinforcement of Other Behavior (DRO)

Much more common in these notes is Differential Reinforcement of Other Behavior. In addition to reinforcement for getting the right answer, the child was frequently praised for unprompted appropriate behaviors (in place of undesirable, stereotypical behaviors). For example, when playing with dolls, the therapist may say, "I'm glad you're not banging the characters together," or as the notes say in many places, "DRO'd flexibility"--unprompted spontaneity. Remembering to "catch 'em being good" takes a lot of practice, but it is essential to the development of a truly natural repertoire of age-appropriate skills.

 

USING APPLIED BEHAVIOR ANALYSIS in listening to a conversation

Listening to a conversation 1

First have only person speak and ask child questions Then have two people ("Listen to us...."; "Listen to both of us...", etc.) speak and have him answer each. [Once he was able to do this well enough, we continued doing a form of this with dolls and animals.]


SD examples: "Listen...."
"Listen to a conversation...."
"Listen to us....Ó
Therapist and parents:
Therapist: "Yesterday I [action]; then I [action]"
Parent: " " " " " " " "
Therapist: "What did I do yesterday?"
R1: Child: "You [action]"
SD2: Therapist: "(Then) What did I do (next)?"
R2: Child: "(Next) you [action]


Once other grown up begins telling a story too (only after child has mastered remembering two things one grown-up has done) - this would be followed by (as SD1, R1, SD2 & R2 above) SD3, R3, SD4 and R4. We shaped additions of "first", "then", and "next".....


Yellow post-its on drill cover sheet:
DO THINGS HE WOULD LIKE SUCH AS "PLAYED WITH -------", "WATCHED [VIDEO TITLE], "LISTENED TO [MUSIC HE LIKES]", ETC.
ANSWER HIS "I DON'T KNOW"S WITH "LISTEN AGAIN...." AND RETELL

Therapist's and Parents' Notes (P.N.):
[Only found one page of notes, however these notes began after we were doing this drill for almost two months (we know that prob more exist but weren't able to find them). We obviously started telling stories so that we could ask more than "WHAT....?" Used all other WHs too.]
Used more future tense and conditional phrases...."if it's hot, I will wear shorts", etc. "After I talk to you I will say 'hi' to your brother"
Worked on WHY. Put on A/C because it's hot outside.
Worked on WHYs. He's doing well.
Worked with animals. He really liked this. Only problem is that he was imitating the voices of the animals in his responses.
P.N. - Please tell him not to, but we'd like to continue using voices. He will see puppets with funny voices in life and he'll need to deal with it without acting bizarre.
I used pig and penguin puppets. He answered well and I didn't allow him to imitate. P.N. - GREAT! [we always reinforced our therapists in the notes this way, although I'm not going to add them here]
Used rat and frog. Could NOT answer WHEN questions (as in most drills). Tried putting on various hats and having conversations with myself but it was too hard for him.
Chicken and frog; frog and skunk. Poor attention.
[After a couple of months, there was a NEW drill cover sheet for this....]

Listening to a conversation 2

Include WHY sometimes... (e.g., "Yesterday I put a jacket on...it was cold. What did I do yesterday? WHY did I do it?")


Insist on eye contact with person who speaks.
Do ONLY things he would like or things we've [parents & him] done together. Very relevant stuff to him.
He doesn't always get turns--none on contingencies especially.


YELLOW POST-ITS:
DO WHY ONLY ONCE and PLEASE keep it obvious! [this was prob added when he was having a very hard time w/WHY]
Use Puppets Instead and have puppets ask the questions (in the first person - e.g., "Where did I go?") [This began about a month in ]
He gets a puppet and you get another - Stimulate appropriate social interactions and conversations.

Selected Therapists' Notes
[many "positive" ones omitted] and Parent's Notes [P.N.] for LISTEN CONV II
Very poor attn at 1st. Switched drills. Then much better attention.
Great job! Answered WHY appropriately but still couldn't answer WHEN.
Answered WHY questions well, as long as they answers were given in context.
P.N. - Stick with WHY. NO work on other WH- questions.
Not good. I pretended the first two puppets were mad because he wasn't paying attention and left. He was upset by this and paid better attn.
Concentration not great (glue on his hands was more interesting) but eventually he did ok. I'm sorry but I asked WHAT questions to get him back. Only did a few WHY questions.
Did a pretty good job. Asked WHERE, WHAT and WHY.
Very nice job with only ONE question asked per story.
Only two stories with one question (WHEN AND WHAT) each. Answered both correctly so I let him go.
P.N. - Keep it this way because in REAL life we're requiring him to stop asking five questions about the same thing. [he'd ask the same question in five different ways..."verbal" stuff like this (all things being relative) as great as it might seem to many, was a new perseveration that lasted a very long time.]
Great job. Still one question per story.
I combined this with DOLL PLAY/SCHOOL. He had large problem staying focused.
Did nicely. Even had puppets ask me if I like chocolate ice cream (after I told story about eating choc ice cream).
Got confused on 1 story and answered questions on one character w/info about another character.
I had him choose the puppets he wanted me to use. Did a pretty good job. At break be careful of his using rat and telling story about going to the basement to eat cheese.
I let him pick too...rat and pig. He tried to dictate how the pig would talk. He did an excellent job.
Used Ses St characters from one of brother's toys. He was very interested in stories and did wonderfully. Even able to answer WHEN & HOW MUCH questions. WHY too.
[The following therapist constantly got into power struggles with him.... ] Awful. He could not answer any questions. Could be because he had glue on his hands. I finally made him sit on his hands and gave him some simple ones which he answered.
Great. He answered WHEN WHY & HOW ?s amazingly well. P.N. - [Ther], what did you do/use? Let us know if you think you can pinpoint why he did so well.
I used the chicken and the chick. Once in a while he didn't look at the characters so the chick said to his mom that [name] was being rude by not looking at the chick when he talked. He then looked and did nicely.
[obviously began using dolls after this] In context of SCHOOL, classmates (dolls) talking to each other and he had to listen and "Frankie" didn't want to be his friend. Answered WHEN, WHY, HOW pretty well.
I used the mouse and elephant puppets. I think he did well again (not first questions so well) with Ernie and Honker dolls.
I used Mickey and Buddy doll in a School context. M & B talked about their weekend and what they did. He answered WHO WHAT WHERE and WHEN nicely. WHEN was a little wobbly but overall he was attentive and engaged in the conversation.
[Other therapist] and I did a puppet show w/the chick and the turtle. He was unfocused at first...then the animals complained that it made them feel bad when he didn't listen. He improved.
Used the bear and caterpillar. We glued with pompoms. Didn't answer WHEN HOW WHY well. WHERE was ok. (glue problem)
Not very good. He was too busy looking at the new doll to do well.
Monkey and Chick. Did ok. Making conversation with some prompting and ans WH questions. However he was tactile s on the puppet too much.
I drew faces on my hands. He was TOO into it. We conversed. He did well; needed some prompting. Began getting silly. When I asked him what his father's name was, he said "[all the other therapists' names]."
Nice job. He was Big Bird and I was Bert. Look out however for his touching doll in S way [S = stimming...it was our school book code that transferred into our home drill book].
Saying things out of context. Not responding accordingly. Needs lots of practice.
Had conversation about trick or treating. What did you get [I said Milky Ways, he said water]. Kept talking about "brothers" and "sisters" EVEN WHEN THE CONVERSATION SHIFTED. We definitely need to stop talking about brothers and sisters for a while.
Squirrel and elephant. Worked on having him ans my questions and then ask me the same question back. He did fine answering various WH- ?s.
Working on HIS having PUPPETS maintain eye contact.
He put a fireman hat on and a cowboy hat on me so I decided to just go w/the flow and turn it into a conversation. He maintained good eye contact and proper distance. Ans questions appropriately. He needed prompting for asking questions.
We used the Barbie and Ken dolls. He carried on a decent conversation but had to be reminded to keep his doll still and facing mine.
[After another few months passed by, the drill sheet changed as follows....]

CONVERSATION III - DOLLS / PUPPETS

Stay in character! i.e., Animals are animals! People are people!
I. CONVERSATION - DOLLS / PUPPETS
STAY IN CHARACTER
- Animals are ANIMALS!
- People are PEOPLE!
Stay in character ... he has to get into the mind set of the puppet and NOT assign human attributes if it's an animal.
e.g. - You: I'm a rabbit; I live in the garden
Prompt: I'm a monkey, I live in [state]
You: [Name], you're a monkey! Monkeys live in the jungle!
KEEP THIS DRILL SHORT! DON'T ALLOW IT TO DETERIORATE!
[Later, probably when "Sustaining Conversation" started, the drill cover sheet changed]
II. CONVERSATION - DOLLS / PUPPETS
Use Puppets/Dolls AND props, etc. and have the kind of conversation outlined in: Sustaining Conversation, Snack Time, etc.
YELLOW POST-IT: Use blocks in this drill. Build house/place for them first.
III.
[An additional related drill cover sheet, not used until much later, has no title but you can see it's an example of one of the ways to use Social Stories.]
1. Have two dolls/puppets/figurines (not in character...e.g., call Curious George "Alex", call Dopey "Murphy", etc.) act out appropriate and inappropriate behaviors based on the Social Stories themes above (improvise please...do not use word-for-word Social Stories).
2. Ask him questions about your Puppet (or whatever) Show. Ask the questions from both the positive AND negative side ("What would happen: if he kept doing that/if he stopped?, etc.)
3. If working on inappropriate behavior, re-enact it appropriately after asking him the questions.
4. He is NOT allowed to act it out himself -- just observe -- unless he is PERFECT (i.e., not zoney, answers all questions, does not stim on or grab puppets, etc.).
If he asks for a puppet, use it as ULTIMATE reinforcer for PERFECT behavior: e.g., "it might be a really long time because you have to be sitting perfecting and looking in the right direction", etc., etc.
5. If he's zoney, cut it short and go back to it later.
6. DO NOT re-enact incidents from his real life...only imaginary/novel situations.

THERAPISTS & PARENT'S NOTES (P.N.):
Rooster and Barney - We talked about my friend's birthday party that I'm going to tomorrow. He did an excellent job. Really tried to respond correctly and even added in a few "That's great!"s and "really excellent" when they were appropriate!
Barbie & Snow White - He asked too many WHY questions. Asked a WHO ? unprompted. Barbie (me) told Snow that she reminded her of somebody. He (Snow) said "who?" and Barbie said "Sleeping Beauty". Then he called Barbie a "bubble head". P.N - Let's slow this down too...Careful also of perseverative "reminds me of".
Still too many WHYs but did nicely and asked a few unprompted ?s.
Rooster and Bug - He did well with WHAT but incorrectly asked WHY to everything else. Told him once that his rooster wasn't looking at me.
Oscar and Elmo - Good job sustained - Too many WHYs still. Prob with HOW. WHAT is fine. At end Elmo (he) was not looking at Oscar. Oscar walked away from Elmo and said he wouldn't be his friend.
Did well. Had to be told 2x to look at my doll but asked WHY only 1 inappropriate WHY, a couple of WHATs and a WHERE and a WHO. WHEN is a problem.
Did this with Legos. Visited a Tinker Toy zoo. Boy and Girl talked. He initiated conversation at some points. Appropriate use of WHY. Looked at doll with his doll the entire time!
Asked too many WHs. Asked me a WHAT for a WHO. I said "Not something...SOMEONE, and he got it.
He was playing w/a doll and doll furniture during a break (inappropriately) so I took a doll and joined him. His conversation was good. He was climbing on the dog house so I asked him if he had a dog. Said "no..I live in this house". I told him that house was too small. Then he said to my doll "let's play hide and seek" and he hid in the house. Conversation was good.
Used dolls - He was too focused on the doll and not on the conversation. Had to comment many times that his doll was not looking at me. Used [other ther's] prompt for WHO -- "I said someBODY." It worked.
Big brother (him) and little brother (me) went to amusement park and barber shop. Conv started out good and then his doll started doing weird stuff on little brother doll so little bro went home and told his mom he doesn't want to stay with big bro anymore.
My doll and his doll were friends playing...Talking about zoo. He asked good ?s but walked away from my doll 3x so my doll didn't want to play w/him anymore. He still had his doll and I told him to give it to me. He threw it so I made him give it to me again nicely and he did.
He was chicky and I was froggy. Went to the ice-cream parlor to buy ice cream and had a good time. We picked out flavors. Vanilla for me; green choc mint for froggy. Good eye contact
He was rat and I was kangaroo. We met at a desert. I told him I saw a great big snake. Used this to arouse his curiosity for sust conv. He had good eye contact but still tends to utter choices when a WHAT ? is presented -- i.e., "what did you see in the desert..a rat or a bug?" Then we went to find food at a garbage can...he was creative! stiffed the shape sorter!
Again his doll wasn't looking at me. He had trouble asking most ?s and kept interrupting me to ask things that didn't make sense.
***Don't allow him to ask if the dolls can say "hi" to each other. He's perseverating on this.
P.N. - GIVE THE DOLL A TIME OUT!
His doll didn't look at me and got a t.o. He said "what isn't the rat (his doll) looking at the kangaroo?" i.e., he's VERY aware of what he's doing wrong.
His doll not looking at mine. [Child] got t.o. this time. Being rigid also when I took doll. Said "I have to hold doll." Before that needed prompts to sustain conv properly (WHEN WHO, etc.) Asked WHEN on his own. DRO'd.
P.N. - Better to T.O. him if he's doing it on purpose.
Played Barbie with [playdate]. At first it was hard to get their dolls to talk to ea other because she was so excited about all his stuff [toys]. At the end the dolls went to the movies. She took two other dolls and put on a puppet show. She just hummed...no words for show, but he didn't get stuck on this! (-: By end their dolls were talking more.
Our dolls talked to each other. Needed prompting. Good WHERE by himself. DRO'd dolls. Emphasis was on dolls looking at ea other. Did well DRO.
Was frog at first. Not holding puppet approp so I took it away after two chances. Then I gave him kangaroo puppet. Did well for a while and puppet looked at me and asked good ?s. Then started doing really weird arm movements with puppet. Told him to stop..he didn't so I took it away and stopped drill.
GAK puppets. We put GAK on our hands and had conv. His started to run after mine but my puppet was losing his hair so he had to stop running. Conv. was good. Lots of DRO (in puppet voice - for looking).
Blue dino and Cookie Monster. He needed prompt for WHEN only (got all others incl WHICH). His doll only maintained good eye contact when he was answering but while I was talking it was fleeting. I let this go...should I have targeted? Also, he kept trying to change topic..it was very rude.
W/Legos. Built hopscotch course. At first was ok. Asked Barbie to play w/her (Snow White) but then stopped looking and began talking weird and looking at dolls clothes and hands. 1st doll got T.O. and another doll came to play but he still didn't look so we had to stop.
He had puppets and said they were going to bite me so I put them away in toy chest and told him why. He ans ?s really well. Not WHEN first time, but answered two well. DRO.
Terrible w/WHEN and HOW. Good on other ?s.
He was chicky and I was bear. Talked about bear going to the movie "Beauty and the Beast". We planned on going together and inviting friends so that we can all be together. He tended to start talking about how he wanted to go too... He forgets that it's "chicky" who is supposed to be talking and not him. I responded by only acknowledging chicky and asking chicky "who's [child's name]? what are you talking about?" He got idea and tried to focus more on chicky and not himself. Needed prompts for WHICH.
Nice vocal animation. Prompt for him to volunteer things about his doll and ask other doll.
He was Clifford and I was Beany-Bear. We had nice conv about going to the store together. Good doll eye contact, but needed to be reminded (a little) to talk about the doll and not himself. Asked lots of good ?s, "what will we buy?", etc.
I was lamb and said something scared me. He said something scared him too. A bug bit him on the tongue and then he went to the doctor and got a shot in his tongue! Then brought the cow back to me and said "what bit you?" -- I corrected "what scared you?" VERY GOOD!!!!
Did nicely at beg. Took Dopey doll and started talking to me indep. Then when we started talking about school pictures tomorrow I tried to prompt Dopey w/concrete statement and ?s but Dopey wasn't paying attn to me so I stopped talking to him. [Child] was really affected by this and said "not me...I was listening. Will you still talk to me?" !!!
P.N./T.N -We played with Barbie and Snow White dolls. He wasn't too good at pretending b/c he had trouble being only that character. He tends to bring himself of others (family, therapists, etc.) into the immediate pretend situation. The boundaries of pretend and reality are blurred in this program. Megan & Jim recommend that we should just state to him that we are pretending NOW and can't talk about anyone else except the dolls.
Did well. Stayed in pretend mode. Held man doll & I held little boy doll. Little boy was worried b/c he got in trouble in school. Father told him not to worry b/c he does good things in school. Boy was upset 'cause father didn't listen to him. He was not good in school and he wanted help to be better. Voice was appropriate. No high talk. Mild DRO.
Good voice. He had a prob w/giving the "man" a name. Kept calling it Daddy. I told him he had to give man a real name, i.e. Mike, Alex, etc. Fooled around and said "Susan". I said I'm serious and that this would be his last chance. He finally named him "Joe". Once he did we had a nice conv about work. He worked at an office. I worked at MacDonalds. Told him I had great idea "why don't we go to eat?" He had asked what idea do you have. Did this to get him to eat. It worked.
He was Doc & I was Barney. I was sick and Doc prescribed OJ (in the bottle from toy chest). I had to prompt approp ?s - Doc just shoved the bottle in Barney's face. Doc even sort of got a joke and we both laughed. Doc said something about his glasses and Barney said "yeah, they're crooked. Oh wait...it's just your face".
Used Sleepy and Doc. Had very good eye contact I had to prompt him in places where he needed to ask WH ?s b/c I didn't give leading statements. Otherwise, the other reciprocal statement were very good and were said without prompting.
He was brown horse and I was white horse. He was very animated. Voice and affect were good. I told him my name is "Giraffe". He said "Why don't they call you 'Horse'?" It was really cute. He helped me find something I lost. Changed topic of conversation once but I stayed in character and steered him back.
He was man in car, I was a chicken he run over (my foot so I was ready to start a lawsuit..just kidding). I said OUCH, you ran over me. Had the police come and reprimand him. He explained that he had a prob w/his car and that was why he was speeding. He said he needed to take it (the car) to the car dealer! Police told him he can't speed and he must help the chicken go to the doctor to fix his leg. Lots of DRO for being creative.
We were Santa Claus (he was skinny one--used tree ornaments). Said he was going to order in...I said is it b/c you're so skinny? Conversation was downhill from there. He perseverated on banging on the piano with Santa and repeating nonsense words so I told him if Santa did this again, I'd blame it on [name]. He stopped.
I was Dr. (Barbie) and he was the other Barbie. Right away he told me I have to say "What's wrong?" and stuck his finger in Barbie's face (T.O. for this and doing strange tactile s w/Barbie's stethoscope). Conv required a lot of prompting but instead of telling him exactly what to say verbatim, I instead gave him open-ended choices. e.g., say "I have a cough or cold" or say "I caught the cold from..." and he would fill in the rest.
Selected from subsequent Ther Notes:
- No changing topic. DRO'd
- Used the Octopus we made in Arts & Crafts for conv. Was animated & motivated to go on even after drill ended
- Changed subject 2x & had trouble w/Big Bird keeping contact w/Cat, etc.
II.
P.N. - THE DRILL HAS CHANGED...See new cover page. Extensive notes please.
He was whale; I was seal. He did pretty good job staying in chair. Prompted answ & he elaborated on them. Started talking about something unrelated (but related to his own life) so I said "good-bye" and told him he can't come out of water b/c he's a whale. Had hard time saying good-bye. Needed prompts.
Did this w/Math. Two Barbies asking for food; sharing beads. He had easier time staying in character because they were people. I worked on liking things and WHY.
Nice. He was a rhino; I was a whale (bad choice) (hah). I stuck to conversation about the animals- i.e., habitat, where they eat, drink, etc. I had to prompt a few answers for him. He did nicely afterwards -- prompts were accepted.
Good. He was squirrel. I was a dog. He immediately asked what I ate, initiating conv. DRO. Good imaginative answers. Said he lived in a stone house in the park. Told me that most dogs say "ruff ruff"--asked ?s about what my owner fed me and what I liked!
He was groundhog and I was giraffe. Asked him about what he would do and why. Prompted answers where he hesitated or was moving off character.
He was pig and I was dog w/puppies. We used puppies for a conv about giving birth, being pregnant and the names of baby animals. Towards end he started doing weird things w/the pig (talking w/his nose and tail). My dog told him he didn't want to talk to him anymore b/c he was weird. Then dog told all the other animals in toy chest not to play w/or talk to the pig. He did not care.
At lunch the onion ring spoke to the french fry. This was really cute and he got into it, elaborating on prompted statements. DRO'd and stopped on a very positive exchange (leaving him wanting more...maybe).
Demanded his eye contact for asides, prefacing these w/ him, otherwise if he was looking at doll that was acceptable. Hot dog man and witch. At first he wasn't really engaged in task but got into it. Told him hot dog man has to look at witch. Prompted conver - then he initiated some on his own.
P.N. - For this drill his eyes should be FOCUSED on the doll/puppet UNLESS you are talking directly to him. In other words if you said, "[name], rabbits don't drive cars", he MUST look at you since you addressed HIM and not the rabbits.
Nice job. He looked at me whenever I directed comments towards him, otherwise he focused attn on the animals' convers. Very appropro. He stuck to the topic. He was the kitty; I was a pig. Asked appropro ?s. At one point he used a remark about the kitty working. I told him "[Name] (he looked at me)..cats don't work. Only people do" He accepted this and had no complaints.
Used two cats. Prompted most of his answers. He stayed in character nicely and looked at me when I addressed him.
Horse and teddy bear. Often needed prompts repeated before he said them. Needed prompts not to bounce horse up and down.
He stayed in character well. He was cow, I was camel. Looked at me only when appropriate.
He was sandal and I was snowboot. He was anxious to say his own stuff. I tried to prevent this by prompting all the answers but occasionally he managed to slip them in. Two of those times he went out of character and said something about eating and growing. I reminded him that shoes don't eat and grow and had him say it.
He was blue crayon and I was a red crayon. Full prompted answ -- he elaborated. He went out of character once. I prompted with a quest and had him repeat "when I go out of character I'm not pretending anymore and the game ends."
I blew up balloons and drew faces on them -- we discussed ?s and answers [See Qs & As post] that are on the wall. My balloon did the wrong thing and I prompted his to correct mine. Stayed in character (DRO) and looked at me when appropriate. Elaborated appropriately on his answers.
Needed prompt for eye contact two times. He was pig and I was bunny. He went off topic 1x. I corrected this and he looked -- DRO. Full prompted convers except when he jumped it with something of his own. This only happened once and it was not successful.
Man and woman...married couple of dolls. All was prompted. I had him mostly answer (prompted) my ?s rather than having him ask me ?s. As usual, he elaborated on the prompts -- they were all appropro. The only prob was he kept playing w/the man doll's arms -- I used physical intervention.
Played students in class. Girl (me) was not following rules (ones on wall - calling out, touching other kids). He was boy she was playing with. He kept correcting her bad behaviors and then told her he couldn't play w/her until she learned to control herself. At end he got T.O. for rigidity (he didn't want to stop playing and was stuck on moving doll's arms).
Played with two girl dolls - good friends on way to school. We forgot to do our homework and were worried about what the teacher would say. I prompted him w/?s and answers -- he also spontaneously added some phrases. Needed a couple of prompts to look at doll when he talked to my doll and to look -- when dolls didn't talk and I gave him instructions. Accepted prompts nicely. DRO.
In classroom three kids and 1 teacher. Went over various situations where kids were either rude or were able to control themselves. His doll was behaving beautifully (he said "I controlled myself") and teacher really DRO'd him and other kids said they wanted to be just like him. No prob accepting prompts. Glanced up during breaks when I gave him instructions. Lots of DRO.
Mom and little girl went out food shopping (#13, 11 & 10) [these refer to our Q & A sheet--a precursor to Social Judgement/Social Stories]. He was the mommy and I prompted him to ask girl ?s. Good eye contact One phys intervention for laying doll on the floor.
I was the teacher doll and he was the student doll. We were having a private conversation while a little girl was riding a donkey across the table. We covered Q & As #7 and #9.
Dr. Barbie talked to Aerobic Barbie. He was Dr. He was great. Aerobic Barbie (#3, #18) asked Dr. B how she did so well in school (by controlling herself). Also for beh in schl #5,6,7,9. He needed prompt not to bounce doll up and down. Otherwise ok.
School with dolls. Hit Q&A #s5,6,7,9,18. He stayed in character. eye contact w/me was poor. Needed lots of physical intervention. Distracted by Q&A signs on wall! Prompted control questions and then self pride questions about it. This worked!
P.N. - Sometimes do unusual stay in character stuff, but keep up school situations (for Qs and As).
He was gorilla and I was giraffe. Gorilla came to visit at giraffe's home. He touched things w/o asking. Did Q & A for this. E.C. was ok...needed physical prompt once.
He was a kid at magic show and I was magician. Performed tricks, etc. worked in Q&A #12,13,15. Then his doll wasn't looking at mine so he made her go back in the audience and picked another kid. This upset his doll. What could you have done to stay on stage --- Looked at you when I talked to you.
Two adult sisters (dolls) discussing day. Set it up to make his doll do things that would cause Qs and As. His doll took the prompts very well and even corrected itself after saying the answer!
He was [girl playmate he really sometimes had] and I was him. Dolls talked to ea other. He was good. DRO'd self for looking. Lots of reinf.
Great --- he was hen, I was bear. He looked at bear nicely. HAD A LOT OF SPONTANEOUS COMMENTS AND ideas. BIG DRO (i.e., he sat on the couch with him and bear went to foot of couch and said, "Hey bear...come down, I can't see you" His hen said "Well, why don't you come up here?" !!! Really smart! Big DRO. Did Q&A #13,10,2. Wonderful!
Q & As #s 3,2,7. He was elephant, I was alligator. Stayed in character. "You swim in the water - Can I swim with you?" BIG DRO for these appropro statements. Played with elephant and stopped talking for a second. Otherwise great. Prompted positive self-control statements.
He was baby doll and I was variety of other kid dolls. Had my dolls do the wrong thing and he corrected them with Qs & As. He was resistant to correcting my dolls. Instead would say things like "...but you didn't try to guess what would happen. Good job." When he did this 2x in row (not taking my prompt), I said, "I'm giving you a warning." Then he straightened out. I hope that was ok.
He was boy doll & I was whale. I wanted to go to school and asked him if I could. Even though I knew how to behave, I couldn't 'cause I had to stay in water. He couldn't control self - kept playing with boy's shirt. Being R [rigid] about touching boy's clothes so we had to stop. Got him in control w/statements, prompts re: control & forgetting about obj stuck on.
I was little sister and he was big brother. He told little girl rules. He needed some prompting to keep hands still. Controlled self. Praise.
We were two best friends. He was Nico and I was Josh. Josh invited Nico over to his house to play w/his toys. Did lots of Qs & As (4, 2, 13). He needed some prompts to look at who he talked to. Was pretty good otherwise. Lots of DRO & self-praise, esp when he caught his own mistakes (i.e., not looking at the doll, etc....he accepted prompts nicely and generated a few spontaneous conversations following the prompts.
He was man and I was frog. I had lots of ?s for him b/c I wanted to be a human. He was really cute. In end we made a compromise. I could go to school but I had to stay in the tank. Needed prompts & control statements to stop moving doll. Did this .... praise & "proud I'm in-control" statements.
I was new student in class. Teacher appointed his doll to show me around and teach me the rules. I did everything wrong and he had to correct me. Only one reminder for not looking at my doll. DRO & self-praise from teacher.
He was Sara and I was Samantha. Basic classroom stuff except Sara didn't stand still when she was talking to Sam and Sam didn't want to be her friend. Full prompts through control statements. Then Sara controlled herself. Lots of DRO.
He was Mr. & Mrs. Piggy; I was gorilla. Talked about where these animals live and like to eat. He was great. Looked at animals & me appropriately. He was really up w/the verbal descriptions of animals. VERY into it. Lots of DRO for eye contact -- not too bad with the shoulders either.
[fem playdate] was Snow White & he was Dr. Barbie, but he couldn't control himself so we had to stop. Then we played with family. He was Daddy, she was Mommy and I was little daughter. He needed to be refocused on interaction occasionally, but basically did good job. Needed prompts to not move figure's arms and look at other dolls. She was good at prompting.
He was Tophat and I was various trains from Thomas puzzle. Pieces were lost & not behaving properly & needed to get back to their resting places. He held piece appropriately & was very involved in play. A noticeable improvement from last time. DRO holding man still.
He was Josh and I was Julie. Had a conv about visit to the zoo. Talked about when & with who we went to zoo, what type of animals we saw, etc. Excellent eye contact & control. He self-praised himself for not talking w/his mouth full of oranges. Big DRO since this occurred after a major battle & T.O.
He was daddy & I was little boy doll. He praised me for controlling myself & standing still w/arms down. DRO. He needed lots of control statements to hold doll still when he talked to his son. Talked about school day & little boy told daddy how good he was (following various rules) & daddy was very proud and boy felt happy & proud of self.
I was lizard & he was frog. Talked about what he liked to eat & where we lived. He touched frog funny & squeezed him to make noise. Scripting took care of this. DRO for looking at my doll. Calling lizard a hermit crab! Lizard told frog we better not say that anymore
P.N. - Thanks for letting us know that scripting is working. ["Scripting" often consists of large amts of long, full prompts]
Kids at bus stop waiting to go to school. Talked about Qs & As re: school to see if JoJo [therapists' real-life dog] could go to school. Even though "Joey" answered all questions right and other kid said he thought JoJo could behave in school, at end "Joey" said "April Fools" because dogs can't go to school. Lots of praise for doll staying still when he talked to people. Control & self-praise for his great control over doll & attn to what other doll was saying.
I was Fluffy the cat; he was Ford the chicken. Talked about laying eggs and where the chicken lives on the farm (chicken coup). He was great. I asked him how many eggs a chicken lays ea day and he first said 100 and then said "Nah, that's too many. She really lays two a day." AMAZING! He held animals very nicely. Needed a little reminder to look at the other animal when talking, otherwise great job. Lots of praise and self-praise.
Man and woman w/doll house furniture. He had a hard time staying in character when asked to go to diff rooms or get stuff. Couldn't negotiate doll & accessories. With intensive prompting was getting a little better (phys prompting of how to hold doll, etc. too).
He was monkey and I was Barney -- not too good. He needed scripting to look at Barney & phys prompts to stop touching the eyes on his monkey & also Barney. I did Q & A re: interpersonal space. Prompted lots of answers and scripted T.O. warnings. He gained better control at end. DRO'd his control over not touching eyes on dolls & accepting scripting.
Needed scripting/control statements to hold doll still. He was teacher (at first resisted b/c I gave him man doll & he said I'm not a teacher; I'm a man but understood after explan. that men are teachers too) and I was student. His doll got in control. DRO'd him for holding doll still. Accepted prompts well. DRO & kept it relatively short so I could DRO holding doll still w/lots of praise & self-pride statements at end.
[At some point, this drill might have had more in it about building a doll house and putting it away w/o being rigid than conversing (though that was always in it as well)]
His doll worked for mine and had to get things and bring to "me". Needed to follow directions & manipulate doll. If doll didn't look at mine/answer, he could be fired (this worked to keep doll still also). He responded well & had his doll carry things to mine and kick ball to it. DRO'd following instructions. We worked in office. He told me about his other job where he worked with [names of dad's co-workers he's visited]. DRO'd for great job.
Playmobile playground & doll stuff out, so I joined him. Needed occasional prompting for doll to look at other doll & once used babbling instead of real words (did Q&A), but otherwise good job. DRO looking & holding doll still. Played many games. Self-pride for learning how to play nicely w/dolls.
Used bunnies we made from Play Doh. Bunny stood still & looked at other bunny. DRO. They used crayons as carrots. He needed some prompting to follow along in the game, but scripting worked. Praise & self-pride. Thinking/feeling scripting worked when he wasn't participating.
My doll wanted to buy his doll's Lego house. They made friends. I prompted him to make his doll give mine flowers, then they went swimming. His doll wanted to go inside -- talked about how my doll felt that he didn't want to be w/her. Then he started dancing w/her in pool (scripted this & it worked). He needed two verbal prompts to keep his doll looking at mine. Repeated -- scripted about this. He stopped.
It was a little hard to get him & [playdate] to interact b/c they both wanted to do their own thing. I scripted [name] to listen and look at whoever was talking & DRO'd great sitting/setting up dolls. [Playdate] had to be reminded to be quieter a few xs. Q&A about interpersonal space. DRO'd [name] about his remembering not to get into anyone's face. Also had him repeat answers to questions [playdate] responded to first. Good listening on his part.
Two kids met in park. Sat under trees (bean bags). He needed prompting & scripting to look at doll - w/feeling scripting. Otherwise nice job. Good attn. DRO. At first had hard time w/bean bags for trees but got through it relatively quickly with scripting. DRO'd control & listening to directions.
P.N. - Be sure the dolls/puppets do some IMAGINARY things (stuff where there are no CONCRETE props or where the props have another identity). Notes please!
We were two camels on the beach. Blue bucket was water...we were thirsty and almost drowned. He had NO problem pretending carpet was sand & bucket was w/water. Great participation and creativity. DRO'd.
I was tiger, he was gorilla. I pretended my pen was a tree. Did a few perspective-taking roles about friends I have that he doesn't know. Also things like what I see & what he sees from the position our animals were sitting at. Good listening & interacting.
P.N. - Be sure to integrate lots of social stories.
Enveloped was our dolls' school. Did lots of Q&A social stories & perspective-taking concerning feelings. Also kids discussed summer vacation -- if they weren't there, did they have a good time (there)? etc. He did great. Even made doll kiss & hug mine! Then suggested we dance. Did well until I tried social scripting & he kept singing. This led to a T.O. b/c he couldn't stop singing.
He was playing w/musician dolls so I joined him. Had his doll teach mine how to play drums. Used bucket for seat at drums (he resisted at 1st but then did it w/talk -- social story -- about pretending & rules & learning how to pretend). My doll walked away from his. Social story. Then his doll was paying more attn to drum than to my doll - perspective taking/emotion. DRO'd sitting still & eye contact Observ. learning at beg for eye contact -- self-pride. I can do it, etc.
Dentist office (Playmobile). He was patient, I was dentist. Needed only one prompt for doll to look in right place (non phys-gesture). Otherwise participated very well. At end girl was good so she got a lollipop (dental instrument). Lots of DRO for paying attn & being very polite.
Schoolhouse - he was teacher & I was kids. Asked various ?s in soc stories & he (prompted) answ. His teacher doll stood still & looked at people when she talked to them so the children would learn how to behave. Stayed in chat w/lots of DRO for paying attn.
Concen. on social stories & persp taking. Great imagination & very appropro responding. Needs prompts on most persp taking but accepts them. Great ideas. His doll wasn't facing mine at one pt. Used story about walking away from convers.
He got stuck on doing weird stuff w/elephant puppet so I took it away & made him be monkey. He resisted. Did control stmts. & soc story about rules. He finally settled down & did a nice convers. about where monkey lives & eats. Kept it brief & to the point. DRO'd getting into control.
P.N. - Make him work w/o STIM to earn elephant back as reward....lay this type of contingency out to him 1st.
He was lizard & I was dots all over. Piece of paper was lake w/area around as grass. At 1st he said "grass" w/double s sound at end b/c it has a "lot of ss" in it. Corrected this. He was great. Animated & involved in play. Finished on a positive note. Lizard had good eye contact & he received reward at end.
He was boy; I was girl & we played game where he asked me ?s & I only gave him the right answ when his doll was standing still when he talked to me. Great participation & his doll learned to stand still. Lots of DRO.
It was his doll's b-day party. Threw in some soc stories. His doll was jumping all over the place. I warned a T.O. & then he did great. Held doll still & convers was great. DRO.
Convers was really good. He was Curious George; I was a dog. Talked about where we live, what we eat, etc. Did persp-taking about feelings - e.g., Curious G had big ears -- I asked if people laugh at them and he said no. I as puppy said I was sad b/c little boys are afraid of me. Got him to ask why. He also said they shouldn't be afraid b/c dogs are nice. They don't bark at little boys.
Talked about my doll's prob of walking away from people when they talked to me & what I could do about it. Then used "camera" (crepe paper) to take pictures of ea other. He did nice job. DRO.
Used clay figures we made (snake & fish). Snake lost collar - clay & fish jumped into lake (Play Doh canister) to find it. Persp- taking & partic. were great. DRO.
P.N. - First set up a scene...always declare the dolls to be in a certain location. e.g., the kitchen, living room, school, museum, etc. & be sure the play is consistent with the setting -- Lots of notes on this pls.
From Parallel Play - He helped me set up kitchen in doll house & then he was the daddy & I was the little girl. He gave me hot cereal for b'fast (used button as dish). Then bought dishes to sink & washed them. Then we went to Snow White's house (puzzle) to visit her & her pets. great participation. DRO.
We were at the airport. I had to catch a plane. He worked at airport. Partic. well. Play consistent w/airport setting. DRO.
[When we realized he couldn't do this w/o stimming, we decided to teach him how to set up a house and then play with dolls in it -- we mostly used Playmobile 1-2-3 playhouse for this -- very Lego-like. We were able to use this as a visual tool to show him some of his own problems doing persp-taking as far as space, behaviors, etc. This drill was being done much earlier than our more systematic, general role play drill re: his behaviors. We also used drill to target ritualistic play behaviors (putting things away, banging toys together, etc.) Usually I don't include all the tedious therapist notes we had, but I've included many of these here to show how hard we worked stuff over & over until we got rid of perseverations & rigidities and made what we thought was a lot of progress in a specific area of play or whatever.]
P.N. - Build a KITCHEN on top of the small doll house (see us). Have him:
1. Pick what belongs in a kitchen (mix kitchen furniture w/non-kitchen furniture in a pile and have him pick) 2. Make a kitchen (he can't add characters until all the furniture is in place; vary the position of the furniture ea time you do it 3. Play w/the dolls appropriately in the kitchen.
*Do not let dolls/characters out of the room/scene.
*Be sure he applies proper pressure when attaching pieces to the doll house (also be sure he uses his hands appropriately)
*He must put things away when he's done with NO RITUALS. Have him practice (overcorrection) until he gets it right.
Built kitchen with small doll house. He got rigid about moving table so that doll had room to sit down on the chair. I modeled how the doll was stuck & wouldn't fit -- how it would have no place to move. Worked on problem solving the chair arrangement. He moved the chair to the other side of the doll table to make things fit. Nice strategy. DRO'd the prob solve technique. Putting things away --- he had to do it several times b/c he used weird rituals like putting baby in chair and THEN putting it away. He finally shaped up towards the end.
Kitchen - left some LR & BR furniture to choose from among pink refrigerator (didn't call it a bookshelf -- DRO'd that). Put doll house under the table. He had to move it out. Did it on his own - DRO. A little rigid about having all FOUR kitchen chairs and baby in baby chair. I talked him through. Put stuff away quickly. While playing w/dolls he figured out strategies to make room for them e.g., taking table away from refrig so doll could get through. No rituals when putting things away. BIG DRO.
Set up kitchen. I put out a few extra pieces of furniture that didn't belong. He sorted all the appropo pieces of kitchen furn & set it up nicely w/fridge, oven, cabinets, etc. Lined up on one side. Provided enough room for people to move. DRO'd his use of pressure when putting pcs on board. He had to put away toys 2x b/c he did some hand stuff the 1st time. Overall he was pretty good. Convers was excellent. He pretended to be a step mom & I was a girl, Jessica. Came home from school & wanted dinner. He was creative w/content of convers. He made a pasta sandwich. We talked about trying new foods.
Put out stuff to set up kitchen, mixed w/other stuff & baby with NO baby chair. Reminder to use two hands setting up -- DRO'd two hands. Needed prompt to look at what he was doing. DRO'd for this after. Set up house against table [his table in room]. Needed to prompt him to move it out so he could work better. Tried to make "grandma" come in house through roof window. Talked about how impossible this was & she went in through door & up the pretend stairs. Then made her go up the side of the house. Had him make her come in through front door. Resistant -- Told him I would put it away if I had to (going up the house & in through the roof window becoming a "thing" --- WATCH OUT for this). Talked about rules. When putting away first "walked" stuff in but had him do over & he did it right. DRO'd.
Kitchen - He sorted appropriate appliances for the kitchen. Set up nicely. Fridge, oven, sink in a row. DRO'd for leaving space so people can pass. We had a dinner convers. Had him go get dessert from fridge. He tended to pick up the characters and fly them through the air. Prompted to stay on floor. Putting away - got a t.o. b/c of wiping. Jim took grapes he was eating away. He gained control pretty quickly & put the rest of the toys away nicely after that. DRO'd quickness. [Wiping was something that came out of phys interventions -- e.g., if you touched the "offending" body part, usually foot or hand -- sometimes face for a grimace, to let him know he was stimming, he would "wipe" where you'd touch to negate what you were trying to tell him.]
P.N. - Have him set the kitchen up on one of the sides of the house. Be sure furniture is against the walls and table is out on the flap. Begin setting up a living room on top.'
Set up kitchen inside house against wall. Chose pieces approp. (table on flap). No problems walking dolls around inside house. Stayed away from doors & windows, except when pizza man came & it was appropriate. Still needed prompts to keep dolls on floor. Set up living room on top. Picked out correct pcs but had trouble pointing them in correct direction. Prompted that furniture usually faces middle of rm. Put pcs away nicely. Beautiful behavior. DRO.
Did kitchen on top. Tried to use the miniature pieces [I think this means the tiny forks, knives, cups, etc.] but he was rigid and didn't deserve it. He wanted them badly though. Every time he lifted people off the kitchen floor I took them away. Told him people do not fly & they have to stay on the floor. He set up kitchen nicely -- matched colors. DRO'd facing. Putting away was a prob - He had little rituals i.e., putting in the [can't read handwriting] before putting it away & walking all the people in the door first. Made him do it over & said he was acting like a baby & that's why he couldn't get the miniature stuff.
Kitchen inside house; living room on top. Needed prompts to keep dolls on the floor. Set LR up with couch in front of coffee table. Used square cabinet as a TV. Put chair at 90 degree angle to couch. Had a hard time w/plates & cups. He wanted to put them in sink instead of doll, but he listened when I told him that the doll has to do it. DRO'd. When we were putting stuff away he put dolls in through door. I used overcorrection & he finally did it right way.
Kitchen inside; LR on top. Kept dolls on floor w/o prompt. DRO'd great job. When putting away again tried to put doll through door. Wouldn't let him; otherwise good job. Then was moving fingers strangely & making noises w/furniture. Had him do it over until he got it right and then reinforcements.
Kitchen - Pretty good job. He started out by asking to build a LR. I said "no, we can only do the kitchen and only if you're good can we do the LR" -- I hurried to engage him in kitchen only so that he wouldn't talk about doing the LR anymore. This worked & he didn't persev on the idea, although he did ask at end to do it. Play & convers were good. He set kitchen up & some pieces didn't fit well so I had him problem solve it by throwing out ?s like "Can you open the refrig door if the fridge is over there?" He finally set up nicely. People moved off the ground a couple of times. I took away person & he didn't pose any arguments. I DRO'd this heavily & gave it back as soon as he started to play appropriately. Put away things nicely. DRO'd eye contact throughout.
Nice kitchen. Was a little rigid about LR. Wanted to line couch & chairs up in a row. I suggested L style. He was flexible so he could set up other furniture. Bathroom -- walked person through house w/o going near door. Kept person on floor. DRO'd. At end almost tried to stuff person through door but controlled himself. DRO and scripted pride statements.
We built kitchen on top of house. Did this well. No prob picking out furniture. Set it up nicely. LR - good. Tried to set up seats in one line -- put chair at a diagonal & said "I like to be flexible" BIG DRO. Put together bathroom. Needed some direction putting toilet next to sink & not in front of it. Good job otherwise. DRO. He was so well behaved & listened so well that he got to make the bedroom. Played very appropriately w/dolls when house was complete. Great job cleaning up. Natural Reinf -- got to play w/miniatures.
Started out nicely w/an agreement that he would get to build other rooms if he did nice kitchen. He became very rigid about arrangement & fridge color [there was a yellow & pink piece that looked the same]. I told him to use the same colors for the appliances b/c kitchens usually match. He started w/weird grimacing & hand stuff as well as head shaking. Threatened to take away whole thing if he didn't stop. This turned into an argument on his part -- I remained neutral & put away the house. He hit me & pushed. I cont'd being neutral & told him to sit down, be quiet & calm down for his T.O. He finally sat quietly. When he was done I went over T.O. in detail. Why it began, why it lasted long, what could have happened if he hit me again (i.e., he almost pulled my chain off -- I said I would have been very upset). He listened nicely. DRO'd good listening & calming down.
Worked on kitchen. He had to teach [playdate] how to build kitchen. Did a pretty good job so I let him use miniature utensils but he got stuck on putting little spoon between the edges of the kitchen floor. I gave him a T.O. - Took away toy. He pushed. Told him to calm down or T.O. would last longer. I remained neutral. He finally calmed. Said he wanted kitchen again...said please, but I didn't give in. Said that sometimes even though T.O. is quick & short, you can't always have what you want. Got angry; started to argue. I ignored this time & just turned to [playdate] and asked (in animated voice) "What should we do next?" -- [name] popped up and said "Let's play!" I DRO'd him for forgetting about the kitchen, etc. Nice job.
P.N. - Please don't use miniatures! [re: forks knives, etc.]. Each room can be a reinforcer for the previous room. If he does all the rooms well he can play with the dolls.
Did kitchen 1st & then LR. Couldn't do BR b/c he didn't do nice job w/other rms. Was stuck on steps & door. Was flexible w/door. Able to leave it open. Lots of DRO. We played w/dolls in house. Nice job. No prob cleaning up. DRO. Sorry - we played w/dolls even though he didn't do all rms. I didn't look at directions carefully & told him if he does LR and kitchen he could do BR & gave him doll play for being flexible about door & forgetting about steps.
Beautiful job - He worked for stairs. He build the kitchen, bathroom & BR and then got the stairs. Wasn't rigid about anything. Gave him a lot of freedom w/the people he chose. We had a great doll conversation. Mom, dad, baby. Dad woke up, cooked b'fast for baby. Mom did dishes and drove baby to school and drove Dad off at work. Heavy DRO in the beg....then he was amazing during play. DRO'd a lot at end also. While I wrote notes, I let him play. Excellent job. No babbling! Used characters very nicely. Little weird stuff. Great job!
He built rooms by himself. I sat at a distance & told him that when the entire house was built, if he did a quick, good job, we could play w/dolls. He did an amazing job building LR, BR, bathroom, kitchen. Then great playing w/dolls, mommy, grandma and grandpa. DRO.
P.N. - All read [therapist/date] notes. We like the idea of having him do this independently!
Followed [ther's] idea about sitting back & letting him build rooms independently. Did amazing job. Quick. All the rooms done in 2 to 5 min. BR, LR, bathroom, kitch. Nice & neat. I don't think he did any weird stuff b/c he probably didn't have time. He got stairs & people as a nat. reinf. This was nice & funny. At one point I decided my person had to go use the bathroom. He watched the lady go downstairs to the bathroom. He said "Why are you going to the br?" I said, "I have to urinate". I sat the doll on the toilet and he said, "no silly, you have to stand up." Of course I was rolling w/laughter. I explained simply that girls sit & boys stand. Nice job.
P.N. - Please stop giving the stairs as a NR [natural reinforcer]...it will make him rigid.
First thing he requested was stairs. Told him he can't have it today b/c we were going to make the house w/o stairs. He didn't argue. DRO'd. Waited nicely until I brought the doll house in. DRO'd flexibility & patience when he was finished. I let him construct rooms on his own. LR was on top. He did nice job. Doll convers was very good. After we were done, I let him play on his own until I wrote notes. I noticed nothing bizarre. He was having very nice convers with the dolls! Lots of DRO when putting it away. He tried to set up some conditions about getting to play w/ the house later, but I ignored his comments & redirected him to put on socks to go out for Ball Play drill.
He didn't request stairs. Lots of DRO for getting into activity quickly. Set up rooms quickly & independently. There was some humming. I didn't interfere but I did DRO quiet working when I could but not directly after he stopped humming. Doll play was nice. I even told him he could walk his character through the door and he controlled himself. Lots of DRO. I was grandpa & I brought a TV so I moved some furniture in the LR around to make rm. He was flexible about this -- DRO. Some difficulty during clean-up but overcorrection / redirection worked.
P.N. - Good! Always use overcorrection and re-direction for cleaning up.
Requested stairs but accepted "no". DRO'd flexibility. Set clock at 12:50. I made the doll change it and he was fine about it. Lots of singing but I didn't interfere so I let it go. I will DRO its absence later (if it ever ends 0-:) He built all the rooms on his own & interacted beautifully in doll play. When I asked him to feed the cat he said he didn't like food (interesting). Cleaning up was difficult. Overcorrection & redirection worked though it took a long time. He hit me earlier in the drill w/a piece of doll furniture. We put it away (I was neutral) & I told him we'd do it again when he controlled himself. He apologized & calmed down so we started again.
I took the stairs away before we started. He asked about them but accepted that we couldn't find them. DRO'd flexibility. Stuck on making clock [doll clock] 10 to 1 again. Jim talked about how time changes. He stopped being rigid. Getting stuck then on having people talk through upstairs window. Put away nicely at first and then singing a little. Responded when Jim told him to do it quietly.
Before I brought house in, I told him I was doing so. He immediately said OK, I'm going to build all the rooms AND STAIRS too! I just neutrally said that I think the stairs are missing. He didn't bring it up again. DRO. Just gave him the condition that kitchen has to be on the top today. He didn't resist. DRO. Absolutely no weird thing occurred while building. No twisting, turning furniture, etc. Worked quickly & quietly. DRO'd this heavily since singing was a problem today with other breaks and drills. Very nice convers too. Told him he can play on his own until I finished writing notes but then he'd have to put them away.
Did a beautiful job setting up rms. We put bedroom on top. No probs with clock. He asked me what time it was (7:30) & he put hands on the 7 and 3. Didn't ask about stairs. Played appropriately with me using grandma & grandpa doll & put things away nicely. Only problem was clicking lamp into dresser which straightened out quickly w/overcorrection.
Excellent work - Beautiful set up w/rms. I asked if I can do some and he was flexible and allowed me to do bathroom & kitchen. Lots of DRO. Asked about stairs once but didn't mind that they were still "missing". Convers was beautiful. He was grandma. DRO'd that he didn't take both grandma & grandpa like last time. He did something "different" for a change. BR was on top. I let him play until notes were finished.
Doing lots of beh that interfered w/putting dollhse together so I neutrally said we'll do it later. Had a fit. Told him we could do it after he does a good job w/something else. Interfering beh were twirling objects in fingers & getting up to put lamp under blanket. He sat down and we went to expr. categories. Went back to dolls. NR - Oh the Places You'll Go. Putting lamp under fireplace before and asked me time to put on clock. So when we went back to this asked for those right away. Took them away on break. Then was piling furniture on top of ea other on floor. Gave SD - Put the kitchen in the house. He listened and I DRO'd. Lots of singing had to be ignored but tried to redirect by having convers. This worked. Refused to do LR so I said OK and started putting dolls away. Changed his mind quickly. Talked about doing house calmly in beg b/c he was body jerking. As I thought, didn't want to do LR b/c clock wasn't there. Taking long time & hiding bathtub so I put away the house. All this was done neutrally -- he got upset so I said next time he'll do a better job.
I told him to do three rooms & surprise me. He did LR, BR, bathroom, quickly & relatively quietly. There was some quiet humming that stopped quickly w/redirection. He was the daddy & I was the girl. Great job playing & putting things away quietly & quickly. DRO'd.
Let him do this independently. A bit slow at first but I told him I was really excited to see what it would look like when he finished and that I wanted to play dolls w/him. Worked quickly and COMPLETELY quietly! Lots of DRO. Was sticking stuff in the fireplace. Redirected. When I talked about why he was doing so well (being quiet), he started making mouth noises, so I pretended to go to BR & watched him. The mouth stuff gradually stopped, he quickly finished the house & came after me to tell me he was done. Then we played dolls. He was grandpa and I was granddaughter. Let him continue playing until I finished the notes. Putting stuff away was resistant. Didn't want it to be put away at all. Explained that he got to play w/it for a while & that now it was time to do something else. He put it away w/some noises.
Set up rooms quietly (LR on side-outside, BR on top) & quickly w/ [little bro] in the room playing with Play Doh. Lots of DRO w/statements about how little brother is learning to play nicely from [name] to which he said "I know" and DRO'd his brother! Beautiful job w/ rooms -- Didn't put away anything in fireplace. Accepted absence of suitcase w/o a prob. Played w/dolls. He was mommy & I was daddy. In the middle of playing he left situations & went to get grandfather doll. Game stopped. Reminder about walking away from friends. Put objects away nicely & quietly. DRO.
Set up rooms. LR was on top. Did a few weird things w/the fireplace. Put lamp under it. I took it away & asked him if he wanted to play w/it. He said yes. Told him he can only play w/ it nicely. Told him he was an angel all along & hope he could continue this behavior. He played well afterwards. DRO'd appropro play & quick set up of rms. At end was a little rigid about putting things away -- redirected by telling him he can read his Madeline book & he went for it. DRO'd flexibility later. Nice work.
P.N. - Careful -- no N.R. mid-drill [N.R. = natural reinforcers]
Set up house indep. Bookended no silly stuff with furniture, w/lots of DRO for putting items down quickly. I had to intervene as he was doing the 2nd room & he was going through box of furniture & making cat noises & playing w/cat. This interfered with his ability to set up rms. Redirected by asking him what room he was doing next. This worked. (He has no prob w/setting up this dollhse -- should we move on to something else...i.e., extra items or cooperative setting up of the dollhse?) Two young girls (friends) played together. He was very hesitant not to use adults but went along w/it
P.N. - Start doing cooperative setting up and get him to ask you to join him.
Built it w/him. I arranged things quite differently on my part (e.g., two sep bedrooms, LR & BR on same floor, bathroom & kitchen on same part). He was very rigid, esp about my putting clock in BR. Redirected by making him ask ?s -- e.g., can there be more than one BR? This worked. Prior to that he was trying to move the furniture I laid out. We talked about how people get angry when you mess up things they make. Then he played nicely. DRO'd flexibility. Putting away was awful.
Lots of rituals. Used overcorrection. He screamed each time I did. I told him to do it right & I won't take them out. Didn't listen so I neutrally put them away. Let [little bro] play w/it b/c he wouldn't let me put it away. He tantrummed & said he was younger and [little bro] was older & he couldn't play w/his toys. I ignored him.
P.N. - Get him to INVITE YOU TO PLAY
You: "Would you like me to join you?"
Him: "Yes"
You: "Ask me..."
- Sometimes say "yes" and sometimes say "no"
- Do cooperative play with each of you being a different character.
Notes please.
We worked on this for about 15 min. Very nice throughout except for when we got to end. He put away dollhse pcs very ritualistically. I had to overcorrect & this escalated to grabbing, pushing & ultimately a t.o. Tried to redirect when he came back, but still did the same behaviors when putting away. At beginning I prompted him to ask me to play w/him by saying that I was bored w/my toy. Asked him if I can help him build. He refused & said you can play w/the people when I'm done. This gave me opportunity to tell him NOT to forget to ASK ME! He did remember -- lots of DRO. Played beautifully w/dolls. Lots of DRO.
At 1st he told me he would set up rooms & I would play w/dolls w/him. I told him that's no fun. If he wants me to play with him he has to invite me for the entire thing. He did. DRO. We cooperatively built house & I prompted him that he couldn't touch other people's furniture & move it. He balked at 1st when I placed things in diff places but he complied & participated wonderfully. Tons of DRO & really good play. We finished on a positive note & he put things away nicely with constant DRO.
At first things were great -- played cooperatively, compromised, ignored [little bro], etc. DRO for all these things. We built together & he was flexible. Then when I asked him to clean up he refused and then was ritualistic (banging pieces, etc.). Stayed in clear discrete trials -- n/e, n/e, prompt [n/e = "no" equivalent] -- he hit me & Jim gave him a t.o. -- then put away Barbie dr.'s office.
P.N. - Keep using new doll house furniture, castles, etc.
While TV was on new channel...very nice setting up. Np persev on any particular toy. Lots of DRO for quick setup of all rms. Got right into a doll convers that was nice & coherent. Lots of talk about school & what he did at the firehouse he visited. Pretended to drive him to school & Drove him off with grandma & mommy. Very flexible about toys -- lots of DRO. While I wrote notes, no weird behs, except for singing "This Old Man" & trying to rhyme very strangely. Tried to redirect by conversing w/him. TV didn't seem to interfere w/his performance.
Used Barbie kitchen. We were husband & wife. Cooked dinner, put away the food from shopping, washed dishes, used the blender & food processor. He stayed in character & did overall great job. DRO'd.
Dollhse. Set it up together (TV on news channel). He had some difficulty leaving my pcs where I put them but no equivs & redirection worked. Play was OK; needed redirection away from windows & doors, but it was OK.
Dollhse. Set up. Had some prob w/lamp & fireplace. I spotted him putting lamp under fireplace. I let him do it & then, when it was time to have a convers., I made believe a fire had started b/c of it & burned down the entire house. Had the fire dept. look for the arsonist/culprit. He of course got very into this & wanted to make "excuses" about why the lamp was under the fireplace. I had detectives reprimand him by throwing away all the burned furniture & apologizing. Good lesson -- he said he learned to put things where they belong. Let's see if he remembers. I DRO'd good attn, play & construction.
P.N. - Great -- let him fail. He could handle this now & we can find good opportunities for teaching lessons.
Nice job. Cooperatively put house together. Needed prompt at beg to not move my pieces but otherwise no probs. Played nicely w/DRO for following my lead.
He & I both built the rms. Very nice job - no weird stuff w/toys. We sort of contracted in the beg that he would have a surprise for me -- i.e., move bowels -- He kept it at the end. Convers was great. Did whole skit on little Joey defecating on his own in bathroom w/o telling parents. He was very into this. A little rigid ending the "show" but redirection worked. I just started putting away things that I built. He was OK. DRO'd flexibility.
Some really bad grimacing & toy tapping as he built the kitchen & also opening & closing the window non-stop. I took off the window & the kitchen & redirected to having him build another rm. This caused a tantrum. I tried to ignore a lot of the behaviors. He was very upset. Almost hit me but managed to only squeeze himself on me. Megan told me to open & close his window. I did this and asked "what's wrong with this?" and he said "it's weird - you shouldn't do it." I told him he was right & that this was why I took his window away. He denied this -- I neutrally moved on. DRO'd being quiet & flexible as he started to build a new rm. Convers was good & so was play when we got into it.
Big dollhse. Wow! Really nice. We were both very absorbed in the details. he was good w/playing, setting up & convers. He wanted to open & close doors a bit too often, but redirection worked nicely. He was flexible w/the furniture & it's placement in rooms & with the characters. Lots of DRO. Needed a little n/e, n/e, p for eye contact [no equiv, no equiv, prompt for eye contact] and switching attn. (not too bad). All else was very good.
P.N. - This is DOLLHOUSE ONLY (which he perseverates on in school) to desensitize him. While you can include some of the themes we're working on in Play With Narration, remember you're restricted to the doll house, it's rooms and furniture. P.S. - Barbie extras OK here too; NEVER USE Victorian giant doll house...if he asks. tell him we said he's "not allowed".
Used schoolhouse. He did great job. We did show & tell and my doll asked his for pointers on how to do well. Nice job. Stayed in character, but after drill, in play, he acted crazy. No interventions worked. Kept playing w/him but he'd immediately go back to stims & babbling. Other kid's statements went ignored. Narration worked only for a moment & he didn't respond to switching attn ?s Got a T.O. from Megan.
Used schoolhouse. I tried to work on concept of sharing/asking instead of telling & grabbing. Worked in context of school situations i.e., in playground, outside, classroom, etc. Asked him to comment on all that was appropro & why. He understood that sharing & asking is better b/c kids will like you more. If he grabs or acts like a bully, kids will leave him.
Dollhse. Played beautifully! Assembled rooms w/me. Needed one n/e not to move my pieces but then did a great job. Was not bossy. DRO'd his not telling me but asking me things. Dolls conversed well & went to movies. He was great - stayed in character & did not get stuck on any pcs. Lots of DRO. WE played for a long time & ended on a positive note.
Used some old playground figures. Told him to help me set up. He could barely move b/c he had to go to the bathroom but wouldn't. I just pretended everything was OK & went about conversing w/ dolls. Did a whole story on the kid in the playground having to go to the bathroom to make. She didn't want to make in pants b/c other kids may laugh & not play w/her. The outcome was she went to bathroom on her own & was proud of herself for not making in pants. He listened w/intensity.
Dollhse - Nice setting up. I purposely did things to see his reaction, e.g., put cat in LR before all furniture was in the house. He moved it & we talked about bossing around, etc. He was flexible & not bossy. DRO. I moved his things & had to prompt a reaction. Played nicely for most part, ignored me at times so I told him he made me feel like he didn't want to play w/me. After some nonsense about being disappointed in me & other kids statements, he stopped ignoring. DRO. Made dolls do weird things. I used "other kids" & he told me it was b/c they had magic so I had him narrate his play so I'd know he wasn't doing weird things. Cleaned up nicely. Natural Reinf - keeping out the dollhse.
Great play. Beautiful convers. Nothing weird. Ans. irrelevant ?s on the side (should we be doing this -- sort of like switching attn?) P.N. - YES!!! That's great. No weird play. DRO. He did get rigid about ending dollhse & yelled at me. I played it out like a kid & pretended my feelings were hurt & started to cry. This caught his attn. Debriefed on what happened & what would or could happen in real school. He was attentive & cooperated w/putting things away finally.
P.N. - All read [therapist/entry date]. She brought in extra switching attn. as well as letting a rigidity play out, acting like a kid and then de-briefing.
Again, as w/[above therapist], he got rigid, but this time b/c I started playing before he finished setting up his rms. I also let it play out & debriefed. It worked well (I did this another time too - but results weren't as good. See [date/section].)
Used dollhse. Great job. Setting up was great. I did lots of switching attn. w/him while we did drill. Great w/both. Doll convers was amazing. Focused on one major theme throughout the drill (sick kid eats good food, feels better next day). eye contact was also very good. Gave him regular DRO. Nice.
Used school house. He got rigid about having "King Arthur" in the school. It was hard to redirect at first b/c he was banging on the door & asking for his servants. I picked up the teachers & asked the class to line up. Started talking about how kids shouldn't be wearing costumes to class & about how only on Halloween can they do this. He was rigid about accepting this but I remained neutral & persistent until he submitted. He finally did nice job. Defended "Jerry" (King Arthur) by saying it was only a "pretend sword" he had. Teacher gave lecture on school rules. Finished up nicely. Had a hard time looking up when name was called.
Used school again b/c I wanted to work on listening to adults. He was rigid & doing lots of tapping w/dolls. Wouldn't stop. Tried to have [playdate] redirect but he had little effect on it. He got into "a little quarrel with [playdate] over a toy." They started to "fight" just like kids -- e.g., I had it first -- I took the opportunity to act like a disciplinarian teacher. Took away the school (& castle b/c he started to drift towards it) and "yelled" saying no sharing or playing. I made it look as if it was [playdate's] fault so that he couldn't act up, but then I generalized to the "whole class". He became VERY cooperative. Almost scared! Did everything I asked him to & listened, paid attn. & gave very good eye contact! Kept this going as long as I could.
Used dollhse. He was letting out a lot of S behaviors [s = stimmy]. I remained very neutral about it. He banged toys, made lots of weird sounds, etc. Convers was hard b/c of his beh. He did help to set up (even though he was rigid about where the BR went & how many beds there had to be). Helped to clean up. Complimented him on this.
Joined him in wild play -- tried to redirect (stop fighting at the castle). Worked well. I asked him why they're always doing this (fighting) and he said it's their last day. I said "Hallelujah!" Let's fight until everyone is dead (reverse psych). This got his attn. BIG time. He obeyed the rules that those soldiers who died cannot be woken w/any magic sword & they can only become alive tomorrow morning. Also - there will never be any more fighting in the castle (let's see how long this lasts). He totally stuck to this & continually responded when I called [name]. Gave natural praise.
P.N. - [therapist name]...He can fight (kids his age do); just make sure the fighting isn't stimmy.
Used dollhse. We made some compromises & we ea got to place some furniture. No fighting - DRO for respecting my choices. Played appropriately & stayed in character. Able to use narration when character asked what he was doing. Put everything away w/o a prob. Great job. DRO'd.
Worked w/castle soldiers but I sort of moved away from the castle, He was very flexible. Got him to change all his characters' names. We did Hamlet w/major script changes. He was really getting into it. eye contact & attn was good & he was excellent on following leads. Nice job. No wild or weird play. Gave him lots of compliments.
Played w/schoolhouse & dolls. He was flexible about set-up & played nicely. Stayed in character. No strange voices. Good job.
We used dolls & Lego airport he built. What a disaster! He completely ignored me & began stimming on elephants right in the middle of our dolls talking to ea other. He was stimming on Dr. Barbie's stethoscope so my doll walked away & Dr. B got bossy & hit her, so another Barbie, who was a police officer, put her in jail for assault & resisting arrest. He was upset b/c Barbie was in jail. [we had some fun therapists, we did]
Dollhse - good; worked through silly rules, etc. compromised, gave him what he wanted & didn't. When I wanted to stop playing, he walked away & ignored me. He picked up a brush & got crazy, roughly putting it through my hair (= hit). Told him to "take time for himself" [P.N. - Don't label it "taking time for himself" pls. Just do it.] - he refused. I ignored him. Asked me later if I was ready. Told him to let me know when HE was by showing me he'll stop w/silly stuff (hitting brush on things, etc.). I waited neutrally until he did.
[This drill went on for another FULL YEAR!!!!!! after the last entry.]

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Practical examples of how to use Applied Behavior Analysis in listening to a conversation