EXAMPLE OF APPLIED BEHAVIOR ANALYSIS-
PRETEND PLAY

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 PRETEND PLAY

SD: "Pretend you're [drill list items]......Do this." [model this yourself for child]

Discrete Trial Style: No-No-Prompt or No/Equivalent-No/Equivalent-Prompt if child is ready for that (i.e., by the time of this drill our son was ready for simple "no equivalents" such as "say it better", "almost", or "pretty good" when he was closest) used in the place of "no"s in a NNP sequence. We were using differential reinforcement (especially once items were mastered ... although we were ALWAYS using diff reinf for better responses) to shape down stims and non-compliance and to shape up eye contact. It wasn't until later that we used NNP to directly attack stims, noncompliance and poor eye contact, although we may have already been using NNP for these things sometimes.

Physically prompt child re: list items. Eventually fade "do this" (only use "do this" if child needs it).
Later vary SDs to: "Act like....." "Make like...."
"Make like" was an SD we hardly used as it rubbed us the wrong way grammatically, but it does say this on our drill over sheet. After all the list items below were mastered, we continued working on this drill for many months (randomly doing them and working harder on some than others at times).
• brushing your teeth
• eating
• drinking
• driving
• banging a drum
• a frog
• a bird
• a monkey
• an airplane
• an elephant [model head on shoulder with arm out]
• kicking a ball
• a baby
• riding a bicycle
• cutting with scissors
• stirring food
• riding a horse
• a teapot
• a cow [model two single fingers over head as horns]
• a penguin [model waddling w/hands near bottom/side of hips]
we probably did some of the following (again) because he WASN'T eating food or drinking out of a cup yet, wasn't washing himself, etc.
• drinking [using actual cup]
• eating [using real spoon]
• washing [use real soap]
• drying with a towel [use real towel]
• washing your hair
• washing your hands
• drinking from a straw
• drinking coffee [probably had him say "ahhhhh"]
Some examples of therapists' notes (other than the usual, which were therapists' initials and date and either "intro'd #4, still not at 90", "#6 at 90%, needs 2nd person to master", "mastered #5, intro'd #6..now at 90%, needs 2nd to master", etc., many longer (i.e., two or three line) descriptions of what went on in session came when we randomized these in the last few months of the drill's life:
"spoon...nice job, just needs a little more practice; wash hair - first prompted him by having him squeeze socks to get the hand movements & eventually did his head correctly, but w/the prompt of "squeeze" which now needs to be faded. Also, don't let him jump up and down while shampooing (stim)"
"Getting there with riding a bike. As he begins say "no arms" and he won't move them"
"Did well (eating) using one hand, but still turning the spoon upside down"
"When pretending to be a penguin he always says "say, 'Come back penguin boy' "
"Randomized. Drying hands needs to be reviewed!"
"Reviewed drying hands. He's perseverating on penguin. Leaves the room and insists on returning as a penguin."
"Washing hair: I poured shampoo in his palm, he rubbed palms together, palmed his hair (to spread shampoo) and then squeezed his hair (to lather) ...palmed again (to rinse). Watch out for: - he can't cover head and face with towel (like a ghost). Should look more like a nun (but DON'T use words "ghost" or "nun"). - has to look at body part as he dries. - for his back, it should be like a shimmy move. - he might start perseverating on "armpit" and "belly button".
"Great job eating raisins with a spoon. Did it quickly and easily. Shampooed well."
"For Cleaning with Soap and Drying, point to (for ex.) the top of his arm to the bottom of it to encourage using broad strokes. Make sure he uses the flat part of the soap and stands during the drill (no chair in bathroom)."
"Talking nonsense while using the soap. Getting broader strokes."
"Did entire shower routine in bathroom (in tub and at sink for Wash Hands). He pumps the soap well but needs to be reminded to wash the back of his hands."
"Shower looking good, but still perseverating on talking about different body parts."
"Worked on getting him to dry himself without talking about what body part he's drying."
"Beware of talk about turning water on/off, temperature of water, bouncing up and down, body part talk, closing shower door when he'd finished."
"Used a Lego for soap and he did a nice job. Persev a bit on washing his legs (but no talking!). Still bouncing. Asked if we were dancing or shampooing and he stopped."
"Outside - pretended to be a baby, various animals, a teapot. Did well."
"Car was a little sloppy (being silly). Other pretends were good, especially animals."

PARENT'S NOTES

These were examples of the notes taken over time during the drills.

Ask him to do same movements for rinsing AND washing hair. Moving fingers harder in circles all over head. Rounded part of soap on body in broader strokes - "how about your legs?" "did you forget your neck?", etc.
- Work hard on #22-25 only!
- Pretend you're taking an entire shower
- Pay attention to details on there. See [therapist name] entry on 8/22 for an example.
- For washing hands use empty soap pump (see us) and teach him to push pump w/hands underneath; scrub hands and dry w/towel.
- Do this drill in the bathroom for now on
- Be sure to use a different towel than the hand towel so he can learn that there are hand AND face towels hanging in many bathrooms.
- Don't use "legs quiet"...dangerous if he ever says this in school (therapist must have said s/he used this phrase as a prompt)
- Have him go through item list once or twice and then back to shower within a few days
when we were 3/4 way through with the above drill, we began......

ANIMAL PRETEND

SD: "My animal is [action]" prompt child
R: "My animal is [different action]"
Each has a toy animal picked by you (this instruction to the therapist is probably because he would perseverate otherwise and insist on some animal he may be "stuck" on)
Using furniture (chair, etc.) as props and demonstrate by acting out the actions with the animal...therapist says, "My animal is......
Examples: climbing up the mountain, falling off a cliff, swimming in a lake, jumping on a mountain, rolling down a -----, running, dancing, etc. in the grass, eating on the beach, sleeping in the desert, singing in the rain forest, etc.
Prompt child to say "My animal is......" and it must be something different but a similar nature-wise. Child will get ideas for later from the therapist. Remember that there was lots of prompting in this drill because I really don't think he had any idea what the places meant (except perhaps from some category cards or colorforms in another drill), although he did know the actions and was getting some idea about what cooperative play was.

Click here for the full range of Asperger's and Autism fact sheets at www.autism-help.org
See the Behavior & Life skills page for tips on developing programs you can implement at home.

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 notes belong in the public domain, and are not to be claimed or copyrighted by any person who is or will in the future be seeking monetary gain for wide distribution of same. If this information has proved useful, click here to download their information package. You will need the Winzip program to decompress the files.