August 2008
ACT Newsletter
In This Issue
How to Use A Conditioned Reinforcement System
Behavior Therapy for Older Children
Eric's Story
Quick Links
 
 
 
 
 
Dear Reader,
 
Welcome to another issue of our ACT Newsletter!  In this issue we share with you the key ingredients to using a conditioned reinforcement system effectively.  We also discuss the use of Applied Behavior Analysis to treat older children on the Autism Spectrum.  Sometimes people question whether ABA is effective for older children.  We address this question with a resounding, "Yes!" and provide some research findings on this topic.  Lastly, we will share Eric's story with you.
 
Please enjoy this issue of the ACT Newsletter!
How to Use a Conditioned Reinforcement System: Another Tool for Your Behavior Toolbox 
 
One of the most effective and efficient ways of providing reinforcement is with a conditioned reinforcement system (CRS).  A CRS is any system by which a person is reinforced when they receive a conditioned reinforcer (e.g., a token, star or sticker). The conditioned reinforcer is a neutral object that would not usually be reinforcing. It is paired numerous times with a very reinforcing stimulus (e.g., a preferred toy or candy). Because the neutral object and the reinforcing object are paired repeatedly, the previously neutral object now represents the reinforcing stimulus (e.g., the sticker now represents the preferred toy).  The neutral object has become a conditioned reinforcer. 
 
Though there are many different kinds of CRSs, one of the most commonly used is a star chart or sticker chart.  In this case, the stars and/or stickers are the conditioned reinforcers and they represent an actual reinforcer that the child will receive at a later time.  A star chart can be used in many ways.  A common way of using a star chart is having the child earn a specified number of stars before he earns a reinforcer.  For example, the child might have to earn ten stars in order to receive dessert that night.  The child must earn all of his stars to receive the reinforcer.
 
When you begin using a star or sticker chart, you will have to condition the stars to the reinforcer that the child is earning.  One way to do this is to start by having all of the stars on the chart except the last star.  When your child engages in the behavior you wish to reinforce, you can have her put on the last star and immediately give her the specified reinforcer.  Starting this way teaches your child two things: 1) the star represents the reinforcer that she wants, and 2) she gets the reinforcer when the star chart is completed.  When your child is accustomed to earning one star to complete the chart, you should set up the star chart with all except the last two stars.  When she has earned the last two stars, she should receive her reinforcer.  In this same fashion, continue to reduce the number of stars that you start with until the child is starting with no stars and earning all of them before being reinforced.
 
The number of stars on a star chart will vary depending on a number of factors including the difficulty of the behavior, the length of the behavior you are reinforcing, the child's ability to wait, and the reinforcing value of the reinforcer itself.  If the behavior you are rewarding is a relatively easy one for the child, you might require that the child earn more stars in order to earn his reinforcer.  Similarly, if the behavior is a very short and discrete behavior, you might consider having the child earn a greater number of stars before he receives his reinforcer.  If the behavior you are reinforcing is particularly difficult or lengthy, you might consider having your child earn fewer stars to get his reinforcer.  Lastly, the type of reinforcer you use can influence how many stars you require.  Small reinforcers (e.g., M&Ms and chips) or short and discrete reinforcers (e.g., sensory input or singing a song) can be given more frequently because they are easily delivered. However, lengthy reinforcers (e.g., watching a favorite video or playing in the pool) are not as easily delivered; you may want to require more stars for these activities. 
 
Keep in mind that reinforcers which are very strong (i.e., a reinforcer that is very reinforcing for the child) should not be used too often.  Your child may satiate (i.e., get used to) this reinforcer and it will not be as valuable to the child.  Conversely, if you have a slightly less preferred reinforcer, you can increase the strength of the reinforcer by limiting your child's access to it. This is called "establishing operations."
 
As you can see, star charts require a bit of preparation and conditioning; however, once you've conditioned the stars, using a star chart can be more effective than simply giving your child her reinforcer immediately.  Most importantly, by using stars instead of the actual reinforcer, you are guarding against satiation.  Secondly, your child is learning to wait for her actual reinforcer. Lastly, a star chart is useful because it is portable, generalizes well to other people, and can be easier than delivering lengthy reinforcers after every target behavior.
 
Here are a few tips to make your star chart especially successful:
 
1)   Give a star immediately after the behavior you want to  
      reinforce.
2)   Deliver the unconditioned reinforcer immediately after 
      your child has completed her star chart. If the reinforcer
      can't be delivered within a timely manner, don't use that
      reinforcer.
3)   Decorate the star chart with your child's favorite character
      or subject.  She will be maximally motivated to use it.
4)   Let your child put on the stars.  This will likely be more
      reinforcing than watching you put them on for her.
 
It is often asked if the stars on a star chart can be removed as punishment for undesirable behavior.  In general, it is not advisable to remove stars.  This is especially true if the child engages in frequent undesirable behaviors throughout the day.  When a star is removed consistently, your child may learn that he will lose the stars faster than he earns them.  This will make the stars less valuable to your child and he may not be motivated to earn them.
 
Lastly, there are some small variations that can be made to the traditional star chart.  One might attach a value to each star.  For example, each star may be worth one piece of candy.  If your child earns one star, he receives one piece of candy; however, if he earns five stars, he earns five pieces of candy.  This way, the level of reinforcement is comparable with the level of effort.  You can also attach different reinforcers to different amounts of stars. If, for example, your child completes his star chart, he would get a very preferred reinforcer (e.g., a trip to the pool). If he earns all but one of his stars, he would get a slightly less preferred reinforcer (e.g., a trip to the park). 
 
In conclusion, with a little bit of effort, conditioned reinforcement systems can be a very effective and useful addition to you behavior toolbox. 
 
Good luck!

 

Research Demonstrates that Behavior Therapy is Effective for Older Children with Autism 

 
Much attention has been given to the importance and efficacy of intensive behavior intervention for very young children with Autism; however, a recent Meeting Point Article from the Lovaas Institute website, "Data-Based Research in Applied Behavior Analysis for Older Children with Autism," (June, 2007) points out that research has also demonstrated that behavior therapy has a significant impact on the lives of older children with Autism Spectrum Disorders. 
 
Behavior therapy is used primarily to improve the quality of an individual's life.  Research has shown that this can be accomplished for people of all ages through Applied Behavior Analysis (ABA).  In fact, the Lovaas article points out the there are over 70 published research articles which document the use of Applied Behavior Analysis to teach new skills to people with Autism over the age of five.  Below is a short review of some of this research.
 
Koegel, Firestone, Kramme & Dunlap (1974) looked at the spontaneous play of two children with Autism (ages 8 and 6) with high occurrences of self-stimulatory behaviors.  During the first baseline phase of the study, the researchers observed and recorded the children's levels of spontaneous play and self-stimulatory behaviors.  During the treatment phase, the researchers implemented behavior therapy to suppress the self-stimulatory behaviors across weeks and recorded the levels of spontaneous play that the children exhibited.  During the last phase, the researchers discontinued the suppression of the self-stimulatory behaviors and recorded the levels of spontaneous play for a third time.  This study demonstrated that when self-stimulatory behaviors were suppressed in these two children, their levels of spontaneous play increased significantly.
 
In another study Gena, Krantz, Mclannahan & Poulson (1996) examined whether contextually appropriate affective behavior could be taught to four children with Autism (ages 11.3 - 18.9 years). They also investigated whether these behaviors would generalize to new responses, across new settings and to new therapists at a one-month follow up.  The treatment consisted of modeling, prompting and reinforcing the appropriate affective responses.  The study indicated that appropriate affective responses systematically increased throughout the treatment phase for all four children.  Also, it was found that the children were exhibiting the new appropriate responses with untrained scenarios, with new therapists, in new settings and at new times, suggesting that generalization occurred.
 
Lastly, a study conducted by Gaylord-Ross, Haring, Breen & Pitts-Conway (1984) looked to increase the initiations and duration of social interactions between adolescents with Autism and their typically developing peers.  The subjects of this experiment were two adolescent males with IQ's ranging from 30-55.  Using Applied Behavior Analysis, the boys were successfully taught how to use common leisure items (radio, video games and gum) to initiate elaborate social interactions with neuro-typical peers.  The boys then generalized the skills to new peers in the same setting.
 
All three of these studies, and there are many more like them, show that Applied Behavior Analysis is very effective for helping improve the quality of life for older children with Autism.

Eric's Story 

ERic and Jessi 
ACT would like to introduce our readers to Eric!  Eric is a bright, inquisitive and energetic 12 year old who has a glint of mischief in his blue eyes and a smile that will brighten anyone's day.  Eric loves bugs and especially bees.  He swims, listens to all types of music, and enjoys exercising on the treadmill and stair climber. 
 
Eric began behavior therapy with ACT when he was 8 years old.  Before then, Eric was a frustrated child, his mother, Millie, says.  It was difficult for him to communicate his feelings and needs.  Eric didn't communicate appropriately.  To express his frustration and anger he would knock over desks, pull people's hair and throw things.  At home, Eric had a strained relationship with his older sister, Jessi.  It was difficult for them to play together nicely because of Eric's aggressive behaviors.
 
At school, Eric was bored.  Millie recalls that he was not challenged to do his work.  No one knew what academic concepts were mastered because Eric wasn't motivated and did not have a response format for showing what he had learned. He was aggressive, so he had trouble with peer relationships and class participation.  He also had difficulty sitting in his chair appropriately and following class rules.  Shortly before starting with ACT, Eric's parents had acquired a "talker" for him.  This augmentative communication device, also called a Voice Output Device (VOD), looked like a small computer with a touch screen.  Millie and Mark, Eric's father, worked to program endless pages of buttons into the talker.  Eric could touch a button and a word would be spoken aloud for him by the computer.  Unfortunately, no one at school used this talker with Eric.
 
Millie noted that ACT therapists were the first to take the time to learn how Eric's talker worked.  They learned how to program new pages and buttons and actively used his talker in therapy sessions and at school.  Now, four years later, Eric's ability to communicate has increased significantly.  He uses his talker to communicate his needs, express his feelings, tell jokes and ask questions. ACT therapists also began working on Eric's inappropriate behaviors in his classroom.  Currently, he is able to sit in a chair appropriately and do his schoolwork.  He is able to play games with friends and be included with regular education peers in their classroom.  Eric makes choices and circles to indicate correct answers.  He is learning to use a calculator, sight read, and tell time.  He is consistently learning new things.
 
At home, there have been many significant changes since starting behavior therapy.  Millie says that their home is now much calmer and more relaxed.  Now Eric can play alone, brush his teeth, make basic snacks, and more.  Eric's parents express that they feel more empowered than they did four years ago.  Millie says that she has learned tools from ACT to deal effectively with Eric's behaviors. She feels confident when the family goes on outings that she can structure the outing so that Eric will be successful.  If Eric is having a tough day, Millie feels sure that she can handle it effectively.
 
One major improvement that Millie sees is the relationship between Eric and Jessi.  Now, she says, they really enjoy their time together.  They watch tv, swing outside and play computer games together.  Eric affectionately calls her "Deedee".  For Millie, this was a very significant change. To see them playing together and really enjoying each other fills her with joy. "Watching them play," Millie declares, "that says it all!"

We hope that you have enjoyed this issue of ACT's Newsletter and found it useful!  Please contact us if there are topics you would like to see addressed in the newsletter in the future.  You may suggest topics by sending an email to:
 
Look for our next issue in October, 2008!