© David Sponder, L.E.P., BCBA, RDI-CC, Floortime C2
Executive Director, Sponderworks Children’s Services

Mastery is the Reinforcer

It is so important to understand the withdrawal and resistance you get in teaching individuals with autism as a chronic discouragement; a chronic feeling of not understanding what people really want or why, and a subsequent feeling that others don’t know what you want or care.  That is the premise we start from.

Technique 1: Slow Down

There are so many forms of slowing down that it is difficult to summarize it.  The best metaphor I can think of is watering a plant.  Soil can only absorb water at a certain rate.  Pouring too much too quickly will cause most of it to be wasted.  In a way, “soil processes” water by absorbing it and making chemical bonds with it.  The slow processing individual is more like hard soil – slower to absorb, easier to overspill.

Be ‘Analytic’ as in AB “A”

The “Analytic” of ABA refers to the relationship between intervention and the changes that result.  When we think more about our own [teaching] behavior and less about what the individual is actually absorbing, we aren’t being analytical.  For instance, we often repeat ourselves when we already know the child has heard and understood us.  Conversely, we repeat ourselves because we talk when we really don’t have the child’s mindful attention.  Subsequently, there is much less take-away at these moments than there could be.

Let’s be careful about these kinds of assumptions…

  • Just because we are teaching , it doesn’t necessarily mean the Student is learning
  • Just because we are prompting, it doesn’t necessarily mean we are improving performance
  • Just because we are modeling, it doesn’t necessarily mean that the child can learn from the model
  • Just because we break tasks down to small steps, it doesn’t necessarily mean that we are simplifying
  • Just because life moves quickly, it doesn’t mean that the child can absorb what’s going on.  We have to slow down before we can speed up.

Analytic can mean that we focus on the child’s “take-away” rather than the teaching.  Focusing on the teaching leads us to the belief that there are certain right ways of teaching and wrong ways, when we know that what is right for one can be wrong for another.  Focusing on the take-away helps you focus on what is right for the Student.

I like to use the example of the guy in the back of the aerobics class that always starts one beat behind and then ends up 20 beats behind and totally out of sync.  That’s me.  The annoyingly fit and peppy Instructor (is that you?) is leading the class:  She’s going boom- boom-boom-boom… at 180 beats per minute, and I’m going boom-huh-boom-wha-boom-huh-wha-oops-boom-ah crap!  I’m actually moving much slower and not getting any workout.

Now think of the songs we do with kids with ASD – especially if we’re playing commercial audio.  Maybe one kid can keep up and stay in sync and the rest are now spectators.  This is teaching nothing but perhaps- “don’t try this at home.”

Many of us were taught – especially if we were originally taught to do DTT, that “pacing” is critical.  We don’t want to lose their attention.  This is backwards analysis.  They lose interest easily because there is little inherently appealing interest in the skills being taught.  We have to be lively in order to keep the kids awake and peppy to remain attractive.  When that doesn’t work we go to the bribe – oh sorry – reinforcer.  But what are they paying attention to – you – the “reward” or the stimulus (the problem or challenge you present)?  We want them focused on the changes and challenges and on organizing their response and little else.

I’ll give some different examples of different forms of slowing down here, and you can try to generalize from that…

Slow Down Your Words

Slow Down by Making Your Words Count
Use Fewer Words and More Nonverbal Communication

Force Attention Shifting: I’m not talking about coercive or physical force here.  I’m talking about removing the elements that allow individuals to listen without looking.

Think about this: you don’t have to turn your head to listen to wordsYou don’t have to look.  Most people with ASD would prefer not to look.  This allows their attention to remain sticky and to remain inside their bubble and not notice stuff.

If you can communicate it without words – do it

Along with using fewer words (below), you supplement your communication with ample nonverbal communication.  This teaches associations in a richer way.

So if instead of saying, “the book is on the table,” (too direct) you say instead, “the book is over there” and point to it with your eyes – the person has to look at you!
Instead of saying “No” when a kid asks you if he or she can have or do something, shake your head.
Instead of saying, “Come here” you get in the kid’s line of sight and make the arm or finger gesture.

Sponder’s 50 Time Rule

If you’ve said something 50 times to a kid, stop saying it and give him or her “a look” that communicates the same thing.

How many times have you said or reminded  [to] Say “Thank you.”                
The look that replaces it could be…
 
Eyes wide, palms up, shoulders shrugged

How many times have you said or reminded  [to] “Stop that”                
The look that replaces it could be…
 Hands on hips; “Are you kidding?” or “Knock it off” look on your face

How many times have you said or reminded  “Lower your voice”
The look that replaces it could be… 
Wince; respond in a much lower voice

How many times have you said or reminded  “Calm down”                 
The look that replaces it could be…
 
Palm down and lower it slowly

How many times have you said or reminded   “Be quiet”
The look that replaces it could be…
  Finger to mouth “Shhh

Speak at a slower pace

Auditory processing is often slow.  Even when it is not, connecting to the other parts of the brain (e.g., the part that creates the visual representation of the word(s); the parts that evaluate the emotional meaning of the words; the parts that organize the behavioral response, etc.) are poorly hooked up and synced.   

Also, leave space between your words.  “Get…up” rather than “g’tup

Speak in shorter (but not choppier or “telegraphic”) sentences.

You want to speak in sentences that are commensurate with what the child can imitate or echo(see “Recasting” technique, below).  But they should sound natural and grammatical.  Modeling language that is approximately the length of typical utterances prevents you from saying more than the Student can actually absorb.  Your goal is complete understanding of the whole phrase – not just parts of it.  Avoid use of choppy, “telegraphic” language used in some traditions of ABA – you know, “Put in” instead of “Put it in.”  Researchers (Fey, Long, & Finestack, 2003) found it not to be effective.  For more on this, refer to the article ”Language Techniques Used at SCS: Making Words ‘Pop.’”

Be sure to Wait for Mindful Attention Before You Speak at all

Wait for the Student’s full and directed attention (mindful attention) to you.  Your goal is to become the primary stimulus in their open window of consciousness.You may have to stop their activity in order for them to fully attend and you may have to wait a second or two or thirty-five, because their minds reel every time they have to form a new attentional (brain) system (remember that a shift in attention forms an emergent neural pathway that has to sync up in order to be ready to take in input– there is often a delay here).

Don’t accept or communicate during “half-attentional states.”  Don’t talk unless you’re sure the Student has you in his or her conscious window frame.  Don’t talk to the back of kid’s heads.  Don’t talk to them while they’re focused on something else.  Don’t talk to them while they’re moving (unless you’re sure they can multitask like this – many cannot).

Focus on communication rather than language

DON’T OVERDO OR OVER EMPHASIZE LENGTHS OF UTTERANCE.  This is a colossal clinical mistake – rampant in our field.1. Avoid prompted communication of any sort.  It is better to model conspicuously and then wait for an imitated or echolalic response, or, to wait for some approximation that you can shape. (See SCS Language techniques: Intensive Language Input Technique)

  • Approximations can be a gesture, vocalization, or attempt at a word.  Respond to it (reinforce it, and use shaping procedures thereon [reinforcing successive approximations])
  • The Student taking an appropriate action can be considered the right communication in some circumstances.  This is not recommended when the Student is supposed to request something or permission.

Too long utterances and the Suck-Swallow-Breathe Synchrony

Ask your local Speech Therapist about the “Suck-Swallow-Breathe” synchrony and how you can create artificial dysarthria by having kids utter too-long sentences (Stevie on “Malcolm in the Middle”).  If they don’t sound dysarthric speaking sentences that are beyond their real comprehension of the syntax and semantics involved – they’ll sound scripted and robotic.

Use fewer varieties of sentences or “word patterns” and more repetition

Language is called “recursive” and “recombinant” because novel utterances usually involve embedding shorter chunks (recurring) into novel combinations (recombinant).The recursive aspects of this sentence are in italics…“I’d like   to go to   the store with   Mary and   Martha.”Before we get that far, we usually have to teach the smaller chunks using very repetitious recursions.  So as we clean up, we can use declaratives (putting groceries away)Let’s put the  eggs  in the refrigeratorLet’s put the  can  on the shelfLet’s put the  juice  in the refrigeratorLet’s put the  rice  on the shelfLet’s put the  baggies  in the drawer

Let’s put the  grapes  in the refrigerator
Let’s put the  
milk  in the refrigerator
Let’s put the  
straws  in the drawer
Let’s put the  
cereal  on the shelf

Note the emphasis on the pattern.  Only one word is added and the rest is recursive. Now you can use “cloze” techniques to get the child to “fill in the blanks after hearing the pattern many times.   For more on this, refer to the article ”Language Techniques Used at SCS: Cloze techniques.

Later, you might do the same thing, emphasizing the recombinance:

The eggs go in the refrigerator
The
can goes on the shelf
The
juice goes in the refrigerator
The
rice goes on the shelf
The
baggies go in the drawer
The
grapes go in the refrigerator
The
milk goes in the refrigerator
The
straws go in the drawer
The
cereal goes in the refrigerator

There is a difference between the singular and plural verbs here.  If the learner is more skilled, this shouldn’t be a problem, but for those with more severe language learning impairment, you might want to discuss this with the Speech/Language Specialist

Use “Language Recasting” to expand language

For more on this, refer to the article ”Language Techniques Used at SCS: “Recasting Language

Speak softly/Whisper

Many Students with Autism have extremely sensitive hearing.  This can make for a bad combination of our natural tendency to speak louder when teaching or when dealing with people that are not forthcoming with a lot of language expression.Speaking softly actually gets the Student’s attention better – especially if you whisper.  They have to make more of an effort to listen, and young children like the idea too. 

Slow Down Your Actions

Move more slowly and quietly

First of all, the emotional or “mammal brain” reads quick pacing as excitement or fear.  Moving fast conveys a sense of urgency.  It can be fun when used in excited play, but it can be like kerosene on a fire when a child is anxious or upset.  Moving slower is a calming influence in general.  This can be very hard to do if the child’s agitation or possible aggressive and hostile actions activate your emotions.Secondly, children with autism are often very impaired in their ability to process motion and to detect motion patterns in space.  This is why the beginning DTT programs always start with actions to imitate that end clearly (e.g., drop block in a bucket; clap hands; slap knee; knock on table), rather than motions that occur in mid-air (e.g. waving; moving arms in a circle; turning around).  This is due usually to underlying problems with vestibular processing and if not, visual processing (i.e. visual sequencing; visual/spatial and depth processing; shape processing, and especially motion processing).

Stop your action sequence when you notice the child looks away

Many children on the spectrum “spot” instead of track.  “Tracking” refers to watching a series of actions and being able to tie it mentally into a single action melody or ‘gestalt.’  I’ve explained this above.  They pay attention to parts of the sequence and then tune out or look away, getting a fragmented idea of how one thing leads to another – if at all.

This is related to their later difficulties with narrative, and explains why they seem so unfamiliar when you ask them to participate in [what should be] familiar sequences.  The spotters are notorious for doing a step – after a prompt – and then attempting to leave.

Billy and his Mom make a sandwich…

Mom: “Billy, get the bread.”
Billy: Gets the bread and then tries to leave.
Mom: “No, Billy, now get the peanut butter.”
Billy: Gets the jar, doesn’t open it, and tries to leave.
Mom: “No Billy.  Come back.  Now get the jelly.”
Billy: Sticks his finger in the jelly, puts it in his mouth and then runs away.

This is why you should stop your movement as soon as the child looks away.  Freeze the frame.  When the child returns his attention or gaze, move forward.  I once saw a Therapist take 10 minutes to put a hot dog in a bun because the child looked away so much.  Instead of prompting him to look, she just stopped and waited.  He was reorganizing because the motion was difficult for him to process.  She also didn’t let him leave either.  That is critical.

As an aside, and as yet another plug for Natural Environment Intervention or Guided Participation teaching, this is also why it is better do most teaching in the context of natural routines that produce finished or “authentic” (read: meaningful to the child) products.  Teaching individual steps out of context, or teaching in DTT type trials devoid of context can force you into to prompting and artificial incentives in order to maintain cooperation.

  • Making food is usually the most popular.  For the more immature – make things that can be eaten immediately.
  • If possible – show a finished project of any art or block construction before making another one.  Children with autism have difficulty projecting the finished product from the parts laid out.  If you don’t do it this way, you’re relying either on the child’s ability to imagine the finished product and then carry out the sequential steps necessary in order to complete it.  This can be a big mistake that brings on a whole host of other problems for the Therapist.When the child has no idea how to move forward though a project – you can end up pushing the child forward with prompting, and you are most likely to get resistance and prompt dependence doing it this way.
  • For the more immature – try to make things that you can finish.
  • Keep action sequences of lessons short – just a few steps.  Once the children
  • Demonstrate the use of a toy before giving it to the child
  • Do some parts of the task – the more complex ones – and give the child the easier parts (see Reducing Complexity, below)

Leave space for response time

Because of the problems with neural dyssynchrony and over- or under-connectivity between brain modules, it is a rule of thumb that people with autism process information slowly.  Yes, sure, there are some that have savant abilities, islands of precocity or whatever where they can process certain types of information faster than neurotypicals, but in the areas in which we are teaching – the rule of thumb regarding slower processing almost always applies.   Therefore, you can expect some sort of delayed or latent of response when there is new information or new patterns to process.   Latencies can be as long as 30 or 40 seconds or more.

That’s why I wish the Students came with the same program our computers have – the one that pops up an hourglass, spinning circle, busy-bee or whatever to tell you to STOP INPUTTING.  It is hard to wait; and you can be unsure whether the child is processing or not.

During waiting time, several things can be going on:

The child is actively processing and a response is coming.  This can be seen as:

  • the child freezing (can look like an absence seizure – and it could be so that has to be ruled out)
  • turning or looking away
  • “Looping:” these are single step motor plans such as hand-flapping that repeat over and over and are [at such times when the child is processing] mistaken for sensory self-stimulatory behavior.
  • “Discharging:” these are burst of spastic like behavioral energy that are often mistaken as “off-task” behaviors.  People with autism have described their loops and discharges as beyond their control – but they occur at times when they are actively thinking and trying to organize responses.  It is important to recognize loops and discharges as possible signs that the Student is trying.

When this is the case – wait and don’t prompt.  STOP INPUTTING.

Control distracting input if you can (e.g. external noise, people talking, people presenting objects or motion, etc.).

Don’t prompt when your child is thinking about whether or not to cooperate!   This is the brat hypothesis.  This happens a lot.  This child knows what you’re asking her to do, so an additional reminder is unnecessary.   In such a case, you want to use “negative extinction” or in other words – disallow access to any other reinforcement (i.e. anything else that she would want to continue doing or that would allow her to continue ignoring you).  Slowing down in this sense is a matter of waiting until the child understands that escape is not possible and then offers an acceptable or reinforceable response.

Does this mean that I should confront my child?  Take things away from him?  He’s bigger than me now!  He’ll just throw a fit!

No!  It might make more sense to stand in the way of a toy or to turn off the TV with a smaller or more amiable person.  In the case where this could be dangerously inflammatory – YOU WAIT.  Don’t confront directly.  Don’t take something out of someone’s hands – even if it a distraction and a way of ignoring you.

But eventually, the person will want something that you do have control over, and it is at that time that you can deliver the indirect prompt, “Remember what I asked you to do?”

The better idea of course is to be as mindful as possible about the lesson you’re teaching and to control for distractions before they become a problem.

So when should you prompt?

Some prompting will always be necessary, even with the best Guidance.  What we’re trying to get rid of are unnecessary prompts that act as harmful compensations (i.e. they eliminate the opportunity and responsibility to think).

Sponder’s Rules of Thumb for Prompting

  • Prompt when the Learner has forgotten and is lost.  Sometimes, the dyssynchrony ends up in such a glitch – so much looping or discharging or other failure of short-term memory occurs that child has lost her train of thought.In this case – re-cuebut avoid giving a direct prompt.  Do for the child what you usually would do for yourself if you lost your train of thought temporarily – facilitate scanning of the environment and retracing steps – instead of simply telling the child what to do or repeating the direction.
  • If you have to prompt, go with a nonverbal gesture or cue if you can.  For instance, if the person is lost or has forgotten what she was supposed to do, conspicuously look or wave in the direction of objects or events that might remind her.  If the person was going to retrieve the key to the basement, then looking at the basement lock or at the keyring on the wall would be a gestural prompt.  If the person forgets to take a tray at the cafeteria – then looking conspicuously at others taking their trays, or waving your hand in the general area of the trays might be just enough to get the thinking back on track.
  • If a nonverbal gesture won’t do it, try an indirect or vague sort of prompt.  These are prompts that still lack important pieces of information.  So in the case of retrieving the basement key, you could say, “Remember, we were going to play Ping Pong?”  If the person gets a plate instead of a tray, you might just suggest, “Think about that for a moment.”

Patience on the part of the Therapist is recommended in all of the above scenarios, and a continued commitment to allowing the person to think through a response – instead of simply responding to prompt after prompt.  The last thing you want to do is to tell the person exactly what to do.

When should you speed up your pace?

This is tricky to know.  You have to be attuned to the child’s mood and need at the moment.In general, it is not a good idea to go too fast or “to be too much.”  This causes children to watch and not participate.  It can even cause them to withdraw and avoid, because it’s “too much” for them to process.It is very important to leave space for responding.  Very often – we fill that space with a prompt instead of waiting for the child to figure out or “organize” a response.Some methods emphasize liveliness and enthusiasm.  Floortime recommends “going for that gleam in the eye.”  Rapid pacing can facilitate excited and enthusiastic play and require quicker thinking.

Importantly – slowing down is a means to an end.  It helps a child remain with you mindfully and to maximize “take-away” or absorption of the lesson you’re teaching.  But at some point, once the child masters skills, you want to quicken the pace to levels closer to those expected in natural environments.So how do you know?  You pay attention to the child’s manner of responding.  If there is a great deal of synchrony and reciprocity in your actions and those of the Student, your pacing is probably good.  However, if you see that the child is not “with you completely,” you’re probably going too fast.

Quick pacing should not be used to try to manufacture interest and excitement.  That should come from the authenticity and meaning of the lesson.  Excessive cheerleading can be overwhelming.  It can also be a joke – on you.  You’re acting excited and peppy, and the kid is looking at you as if you’re a fool.  You can’t manufacture excitement.

Slow Down  Your complexity

Keep in mind that “Mastery is the Reinforcer.”  If you simplify and scaffold a lesson properly, the child should feel competent and get enough motivation from finally knowing what to do – from finally knowing what people want.

Use Guided Participation teaching with “Scaffolding

Feeling incompetent and not knowing what people want is a pervasive source of anxiety and withdrawal in the population with autism. Withdrawal, poor cooperation and availability for learning can be signs that the child feels incompetent in the system in which you are involving him. In other articles, I will explain the Vygotskian technique of Guided Participation and its application in Autism – Relationship Development Intervention or “RDI” (Gutstein, 2009).   In Guided Participation, the “Guide” or more masterful person in the teaching role (You; Parent), frames learning experiences so that the Guide and Student perform complementary roles.  The Guide reserves the more complex parts of the frame for herself and assigns a role to the Learner that provides the right amount of challenge.

Guided Participation type teaching utilizes what they would refer to as a “Whole Task” approach in a forwards chain – just as the skill or task would be performed anyway.  Simplifying is a matter of assigning an appropriately complex and challenging role to the Learner with opportunities to think and discover solutions rather than simply to follow directions (as in traditional didactic teaching).

Instead of lowering the bar or breaking the task down into steps taught separately or out of context (this would exacerbate the person with Autism’s difficulties assembling steps into behavioral gestalts), the Guide provides a scaffold.  Prompts may be part of the scaffold, but they are usually indirect, offered in a “least-to-most” intrusive hierarchy, and often involve doing the Learner’s part along with the Learner in some sort of reciprocal fashion.

Teach within the Learner’s “Zone of Proximal Development

Vygotsky described this as “…the distance between the actual developmental level as determined by independent problem solving and the level of potential development as determined through problem solving under adult guidance, or in collaboration with more capable…” [individuals] (Vygotsky, 1978).

In education – it is generally thought of as the teaching range or “frustration level.”  That is because in the ZPD, the Learner possesses only rudiments or emergent elements of the skill and requires the assistance of a more able person in order to perform acceptably and without undue frustration.

Finding the ZPD can vary from day to day in the same child, but it shouldn’t be a random process.  Various authors provide skill sequences that help you predict where these skill levels will be next.  In general, I prefer to refer to the Child Development Stage theorists[7]for choosing these skills, rather than most ABA curricula.  This is because ABA curricula often teach skills out of natural developmental order (e.g., speech before joint-referencing).  This can create a developmental house of cards, where a child gives responses that he doesn’t understand.  This can account for the scripted, “taught” sounding responses you often hear – responses that often come only after an artificially presented prompt.

Create Simple Systems

Arnold Miller described several types of systems (above), but the ones he mentioned cannot possibly be an exhaustive list.  Basically, a system involves a person and her behavior.  Inside the person, neurological systems consist of neurological and neurochemical pathways that take up sensory input and form emergent neural pathways to make meaning of them and/or to filter them out and manage them.  New neurological pathways emerge that manage responses such as tuning and focusing attention, holding sensory and conceptual meaning in memory, and motor actions – all of which – both sensory (input) and the rest (output) are inseparable from each other.

There’s a lot going on here – even with the simplest responses. It is important to note that once pathways are formed, they can remain mostly emergent (which feels chaotic), or more likely, consist of a combination mostly of previously acquired systems that are embedded in emergent ones.   For instance – you walk into a movie theater and take a seat.  The emergent parts of the system involve:

  • The continuously evolving and emerging neural pathways that form as you scan for seats
  • the recalling and evaluating and matching of your choices of where to look with your emotional preferences for where you like to sit – which is a result of…
  • …prior learning regarding how your sensory systems react to where you sit (how close or far from the screen and speakers; how comfortable you are sitting in the middle or on the aisle, etc.  Think of the “sensory friendly” movie experiences now offered to people with autism!).  This learning is old, but it is new in light of the current conditions and choices.

The embedded systems that run in script-like fashion, parallel to the newly emergent ones (mainly from your cerebellum and basal ganglia)[8] involve: the walking, the balancing as you move down the slanted aisle, the breathing, the eye-movements, etc.

These constant recombinations are very complex, although we take them for granted as simple.  We can appreciate how complex they are when we see individuals with autism experience dyssynchrony in these systems and engage in looping, spastic-like behavioral discharges, and withdrawal and avoidance of uncertainty.

Circuits

I don’t know who made this technique up – but it isn’t new.  Arnold Miller (Miller & Cretien, 2007) made it a science and an art form, but you don’t need to be complicated. Miller is also known for his elevated platforms – which are great, and you can be creative with a few chairs and stuff, but you don’t really need them.

A circuit is a simple system that is made very clear through repetition.  You start with simple movements and activities at different stations in the circuit – which is your “system.”  You make some very simple movements between the “stations” by going from one to the other.  The activity at a station could be anything from simply taking a seat and waiting for a movement cue* that everyone is switching chairs (think “musical chairs”).  It could be turning on a toy, doing a little dance, singing a song,doing a somersault, whatever.

* (not a verbal prompt – we’re teaching noticing remember?)

Because of the repetition, the child begins to anticipate.  Because of the simplicity and the repetition, the child gets to mastery quickly and you see eagerness earlier than you would otherwise.  MASTERY IS THE REINFORCER.

Once the circuit is well established and you see the Learner anticipating, then you “break” the system by adding a variation.  Breaking the system provides a little uncertainty (see “Productive Uncertainty”) about what to do – and you use that moment to let the child figure out what to do, or, you might teach something new at the moment so the Learner learns to accept variation and becomes more flexible.

Slowing down your agenda

Fewer Tasks, More Meaning.

This involves an emphasis and a commitment to quality over quantity.  Slowing down means that fewer things will get done – at least initially.

MOST PROMPTING IS MEANT TO HURRY KIDS UP – no matter what you THINK you’re doing with prompting. A rushed agenda usually results in more unnecessary prompting and gives kids less time to think and solve problems.  It leaves less time for teaching persistence.

It is better to include fewer tasks in a therapy session, and fewer teaching frames at home.  If – especially at home, time is of the essence and therefore you must move at a quick pace – then you should reconsider using Guided Participation teaching at that moment.  You may choose to have the Student do something else, or you may choose to stay with Guided Participation teaching – but you would radically alter the Learner’s role – so the task can be done more quickly.  The point is to avoid relying on prompting to speed up the Learner.

Technique 2:  Use “Productive Uncertainty” as a primary teaching tool

Instead of telling or showing a Learner what to do and then supply them with prompting so they can perform a task in an “errorless” way, it is better to work by leaving things out.  What you want to leave out is the solution or the answer to a problem.  You want the Learner to notice problems, and to be uncertain about what to do.
All changing systems involve some measure of [at least] momentary uncertainty. We notice something has changed, and the old meaning of things is broken in a way.  We seek to repair these expected breaks in our ongoing systems by figuring out what to do.  We figure out what to do by using reference points.

Uncertainty can be Harmful and Unproductive: Too much uncertainty leads to feelings of randomness and chaos.  We feel out of control or incompetent.  No one wants to experience unproductive uncertainty.  We tend to avoid situations where we feel this way.

This is why Guides seek to make the [necessary] uncertainty involved in teaching thinking tools “productive.”  The term, used in many different fields is “Productive Uncertainty.”

Uncertainty can be Productive and Beneficial: “Productive Uncertainty” exists within carefully, mindfully thought-out demands and challenges.  Uncertainty is most productive when:

  • The challenge is right: it is neither too easy (so that nothing new is learned), or so hard that it results in overwhelming failure (and the person has even more reason to avoid it)

o    The challenge is doable with a worthwhile amount of effort

o    Help is available in order to keep the challenge regulated and remain productive

  • It becomes an expected and welcomed part of life: Many individuals with Autism Spectrum, Attachment-related and other disorders characterized by anxiety, withdrawal and lack of self-esteem spend their lives avoiding uncertainty.These people prefer static systems – utter predictability.  They resist change and are otherwise inflexible.

Teaching a person not to be afraid of uncertainty and to embrace change is one of the most fundamental ways you can change a person.

To learn more about Productive Uncertainty, click here.

Technique 3: The Therapeutic Pause

Wait for “activated”  volitional (rather than reactionary or respondent) attention from the Student.

We do not want overtly elicited attention (i.e. directing him or her attention with words, such as “Look at me” “Look at…” “Pay attention…”) – that’s a trap.  Avoid rushing or cueing attention directly.  That provokes reactionary or respondent attention.

Note: Technically, a “Respondent” is an involuntary reflex – so I am stretching the term here.  What I mean is that instead of getting a Student to notice something and switch attention to a cue from volitional pathways in the brain, you intrude with a direction or a prompt.   Different neurological pathways control reacting and voluntary action.    Different pathways exist for attention that comes in reaction to a stimulus, than pathways that control choosing to attend and switching attention out of interest or to pursue opportunity or reward.

These are referred to as the “Behavior Activation System (BAS)” v. “Behavior Inhibition System (BIS).”   The Behavior Activation system is the volitional pathway – it pursues incentives.  When an animal approaches something out of curiosity (possible reward), it uses the BAS.  This is what we want to appeal to, so we avoid direct or intrusive prompting.    Intrusive prompting or responding to directions, since it is usually preceded (perhaps imperceptibly) by an initial inhibition response (withdrawal).  This sets up defensive pathways we would rather not deal with – and that may be overtrained in individuals with developmental or behavioral disorders.

Reacting appropriately to a stimulus is good – but think about the stimuli you’re asking the Student to respond to.  Artificial, imperative prompts are simply not present in natural environments like they are in autism training environments.  A great deal of effort is wasted when the first half of a lesson involves prompting and the second half involves fading the prompts.  And, as many of us have seen, those Students that cannot discover patterns on their own often learn the prompt as indivisible from the response:

Adult: “Say ‘Milk please.’”
Student: “Say Milk please”

A pause is an indirect cue that a response is expected.

The following Techniques help the individual notice without needing a prompt.  Noticing is the first part of adapting and thinking.  The following are some ways in which you can enhance the natural environment to increase noticing.

Technique 4:  Stay in “the Zone”

The zone is the space where you feel effectively connected to your Student’s attention, and where your actions matter the most and you get the greatest consistency of engagement.

Piaget referred to something he called the “Zone of Efficacious Intent,” which is where a person feels his or her efforts will make a difference.  For instance, if I shout in the middle of a room, I expect that those in the room and nearby would hear me “effectively.”  I would not expect anyone to hear me from a mile away.

Arnold Miller refers to a “Zone of Intention” (Miller & Eller-Miller, 1989) and Steven Gutstein (Gutstein, 2009) refers to “The Zone” as “The Zone of Connection.”
Piaget’s, Miller’s and Gutstein’s concepts are dynamic in that there is no predetermined ZoI or ZoC. The Zone is measured in terms of its moment-to-moment boundaries of space, time and content.  Whatever parameter one uses to describe the “zone,” one knows it when one is “in it” or when one is “not in it.”

When you’re in the zone with a Learner, they are fully oriented to you and your actions; they are meaningfully engaged; they are not distracted easily; they are responsive and you and your actions are at the center of their momentary emotional landscape.

Proximity

This is your first and best choice usually.  Simply get closer and let him or her feel your presence.  Move in as close as you have to, including playfully invading his or her space.  Get in position where he or she can easily see your face, so kneel down if you have to or bring the materials up high.

One way to measure a zone is to look at how close the Guide has to be to the Learner in order to maintain meaningful engagement and responsiveness.  People with Autism Spectrum and Attention-related Disorders often require a more proximal zone than comparative neurotypicals.  They have difficulty noticing or dividing their attention and can become so locked on competing stimuli that they can be quick to leave the important zone and go to one of their more pleasant zones.People who are anxious or overwrought may be in a withdrawn zone that is very close to their body or removed from meaningful reference points, or, they may be hypervigilant and fearful and subsequently have a wide and fearful zone.In general, the more impacted by disability, the more proximal or close the Guide has to be to the Learner in order to get meaningful engagement.

Time/Duration and Latency

This set of parameters has to do with how long it takes for one person to get through to the other; how long it takes to get a meaningful response.  Time matters in the Zone because one has to make a determination whether slow responding or under-responsiveness are matters of proximity and not due to some other issue, such as slow neurological processing. We keep in mind that different kinds of challenges require different types of mental effort, and a child may have to spend more time thinking – or even possibly “regrouping” (see below), and yet still be in “the zone.”Another aspect of the time parameter is that some individuals might not be able to produce the desired response until the next day – perhaps after a good night’s sleep.  They may not be able to produce a response on demand – as when affected by apraxia.

Content

Interest makes for a wide zone or a restricted one, depending on what the object or subject of interest is.  When someone is interested, they tend to fix their attention on it longer. If the interest is on your mutual activity – that’s a good thing.  It’ll be easier to keep the person’s attention from a distance.  They will track your actions and monitor your whereabouts and make more efforts to meet challenges, without the need for proximal guiding. One problem is competing interests. When a person appears to be paying attention to something or thinking about something, they are less vigilant and you might have to approach them to get into their zone.
This bears repeating: you know when you’re in or not in the zone of connection with your Learner.  When you are not in the zone, you have to do something to garner that mindful level of attention – that true engagement.  The tips that follow can be helpful in finding and maintaining an effective “zone.”

Technique(s) 5: Be more Noticeable

Accentuate/Exaggerate

Make your motions and emotions larger.  “Play to the back row.”  Imagine that you’re trying to communicate with someone far away.  You would have to make your motions larger and your facial expressions larger.  Think childrens’ television and how broad the acting is.  Don’t yell though – his or her hearing is not the problem and you shouldn’t use your voice to get his or her attention.

Bump into chairs.  Put things down with a thud.  Walk too fast or too slow.  Put some things out front and hide others.  Accentuating and Exaggerating are part of a larger body of “Stimulus Enhancement” techniques.

Noticeable Movement

Movements, especially large ones in someone’s periphery usually alerts attention to the movement.  So by changing positions, handing him or her things, jerking them away, etc., you create noticeable movement.   Also, by discontinuing a regular movement or an expected movement, you create a “noticeable” change.  

Unexpected Events

You want to be playful versus annoying, but Random, Unexpected Events can create reasons for him or her to be vigilant.   For instance, when a person looks away, you can move things around so when they return their attention they know something has changed.  This way – the Learner learns to keep her eye on you.  Unexpected tickles, funny noises, throwing a balled-up piece of paper (in a fun way) are other ways to keep his eyes looking out for you.

Unexpected Sounds

Make funny noises, or exaggerate the sound of something (make a louder, more conspicuous sound as you push the chair into the table).  This can include changing the volume of your voice conspicuously; say from loud to a whisper, or vice versa.

Unexpected Touch

Make him or her vigilant of the “tickle finger” or an unexpected tap on the shoulder as you look playfully away (“It wasn’t me!”).

Unexpected Visuals

Put a hat on your head when he or she looks away, so when he or she turns around you’ve changed.  Once he or she gets used to you having your hat on, take it off the next time he or she fails to keep paying attention.  Be funny and playful.  Put a phone-book or a hat on the table when he or she looks away while you’re both setting the table together.  Have everyone turn sideways or make funny faces at the table every time she looks away, so that when she turns around – she has the feeling that turning away misses out on the fun.

Unexpected Words

A lot of interactions continue in a scripted, perfunctory way.  “How are you?”  “I’m fine.”   This technique is for the verbal individual that doesn’t look at his partners.

How about, “How are you?” “I’m a giraffe.”

How about, “What’s for dinner?” “We’re going to eat our shoes tonightI’m serving underwear for dessert.

Noticeable change

Anything you can change that gets his or her notice can be good.  Place a sticker on your face and don’t tell him or her.  Wear a hat (take it off or put it on when he or she’s not looking so that when he or she turns back to you he or she notices).   Remove the object without him or her noticing it so he or she will look to you.

Pausing Momentarily

Stopping the action should be a natural cue.  This is often how we sense the need to look.  Exaggerated pauses, as well as simple hesitations help him or her understand that something is expected of him or her.

Absurdity

Do and say ridiculous things.  Give ridiculous answers to his or her questions.  BE SURE AND GET FACE-to-FACE EMOTION SHARING whenever you have the opportunity.

Interrupting his or her activity

This is another form of stopping the action.  If he or she stims or pays attention to anything else (including a mistaken reference such as watching your hands, feet, or watching the movement of the object back and forth), you may wait for him or her to regroup and return to the activity voluntarily, or if another object or activity ends up monopolizing and completely interfering with correct attention, then remove it and gently redirect the child back to the pattern.

When redirecting a person back to the pattern it is important not to provide too overt cues.  Bring him or her in close enough proximity to the correct cues or begin actions, so the person can reorient without a direct instruction.  Remember, we always looking for dynamic thinking, not just following directions or prompts.

Building and “MilkingExcitement

Don’t just walk through doors, open closets; or open bags, letters, gifts, boxes, etc. without acting as if they contain the most mysterious and awesome things.   Try to add a little “productive uncertainty” or in other words, a sense of surprise, fun and adventure to mundane things.

Try to put a little fun in otherwise mundane things.  Playfully act as if you are on little adventures and discoveries when opening doors, drawers, or boxes, as I modeled for you.  Stop just before you open whatever it is, and then make sure to exchange mutual gazes into each other’s face for sharing the excitement.

Variation

Again, the primary function of referencing is to resolve uncertainty.  We look because we don’t know.  By adding noticeable changes to any pattern of action, you create some uncertainty about what will happen next.  This should spark a reference, although the Student may attempt to solve the problem without looking.  Therefore, you would still use the above techniques.

Technique(s) 6:  Managing Interference or Competition for a Child’s Attention

Control or Eliminate Competition

Remove distractions.  When it is important that the child focus on you and a particular reciprocal coordination pattern, don’t allow him or her to have complete control of the objects or have free access to them (keep them behind you – out of his or her reach).  Turn off TVs, close windows, shades, cover mirrors – whatever you have to do to help him or her focus on what is relevant to the pattern.

Carefully Manage Object Presentation

Children with ASD often become “captured” by any object he or she’s handling or looking at, or any physical motion that he or she is doing.  Neurologically, this has to do with underdeveloped dyssynchronous neural mechanisms that require too much attention to one’s own thoughts and actions.

Temporary Autism

Malcolm Gladwell in his book “Blink” described how police officers became so hyperfocused on a suspect that they could not hear people yelling at them that the suspect did not have a gun.

We become “temporarily autistic”  when we take on a new task that is particularly complex, such as learning a new dance; learning to drive a stick-shift car; learning to play the piano.  We become “temporarily autistic” when we do any particularly complex activity such as tying a very small knot; delicately removing a hard-boiled egg from the shell, etc.  We become “temporarily autistic”  when we are so interested or fascinated in something (e.g. a video game; a basketball game on TV; a coyote in the back yard).  It is at these moments when we pay a lot of attention to what we’re doing, and we stop paying attention to what’s going on around us – which is why Gladwell referred to the phenomenon as “temporary autism.”

People with real Autism or attentional issues like that, can be “captured” by their own interests and activities far too often.  They fail to switch their attention often enough to notice changes and monitor what’s going on around them.

The way we manage objects then should help the individual

1) release attention from one stimulus

2) hold that stimulus in “working memory” while

3) shifting attention to another relevant part of the pattern (stimulus2), holding stimulus2 in working memory while releasing attention from stimulus1 and back and forth.

Difficulties with this are signs of difficulty with coordinating the various neural circuitry that control these different aspects of attention and memory.  IT IS EXTREMELY IMPORTANT THAT THESE NEURAL MECHANISMS DEVELOP, and the only way to do that is to provide practice and motivation.  Making objects appear and disappear while your face becomes an important intermediary object, recapitulates early development in a way that matures this circuitry and allows for much for frequent and efficient attention to the world around the child.

I CANNOT UNDERESTIMATE THE FOUNDATIONAL IMPORTANCE OF GETTING THIS TYPE OF ATTENTION-SHIFTING GOING!  ”Sticky attention” is probably the most prevalent and damaging trait people with autism have, and they can definitely learn to break the habit.  Breaking this habit usually brings the most pivotal breakthroughs in their developmental pathway.

People with autism will also follow your hands or feet to coordinate movements when we want them looking towards your face.  Whenever you notice this – stop.  Take the object away or put it behind you.

Present objects carefully

Don’t just hand the person an object, because more than likely he or she will not take his or her eyes off of it.  This behavior precludes the gaze-shifting and the referencing of facial gestures, eye-direction, and non-verbal language necessary for joint attention and that are necessary to address directly core deficits of autism.
To do this, keep objects behind you, bring them to your chest first, place your hand over the object or otherwise conceal them some way – before placing them in front of him or her.  Once he or she references you and attends to your non-verbal communication, you can put the object down in front of him or her.  Be prepared to take the object back if him or her begins to talk to you, work or relate to you with him or her eyes riveted on the object.

Also, as you move the object, you might see him or her watching the movement of the object exclusively (not gaze shifting and visual joint attention).  If this happens, jerk the object back closer to you or conceal it again.  Be on the watch for this.  We need to break this habit.

Never allow him or her to reach for an object before he or she references your face for some sign of permission or direction before doing so.  If this happens, gently place him or her hands back in his or her lap or on the table – or wait for him or her to self-correct.  Once him or her has manual control over the object – you then have to compete with it for his or her attention.  Once there is face-to-face communication, you can then re-present the object.

Facilitate giving responses to your face, not the object

Whenever you expect a response to your face – don’t let the object interfere with that.  Now it is not always important or appropriate for 100% of communications between you to occur face-to-face.  But in the beginning of therapy, we err on the side of using these techniques to promote a high frequency of shifting and referencing to break old bad habits of eyes riveted to objects, and to build new habits of shifting regularly and habitually to the wider environment.

Facilitating “smooth visual pursuit” of the object

Smooth visual pursuit means keeping one’s eyes focused on some kind of moving target or motion, whether it is the motion of your actions or the motion of an object through space.  Smooth visual pursuit is necessary to observe how things happen, how a cause leads to an effect for instance (e.g. how water gets poured into a glass, or in other words, how the water went from the pitcher and ended up in the glass), or how a series of events result in some kind of product (e.g., get the bread, get the bologna, get the cheese, place the bologna and then the cheese on the bread, close it up and voila – bologna sandwich).

This addresses another common visual deficit in autism, which has to do with a habit of taking one’s eyes off the object at critical times during a motion or sequence.  The tendency to look away a lot during motion is due to slow visual motion processing[9] as once a motion is observed, it can become blurred as it moves and then becomes uncomfortable or confusing to focus on.  Recent research shows that our understanding of motion is very similar to how a motion camera fools the brain into perceiving motion.  Yes, our eyes and brains do take a series of static photographs, much as a motion camera does.  Other parts of the brain fill in the gaps to give the illusion of motion.  Current theories of the deepest underlying neurological deficits in autism focus on their difficulties with processing visual motion and connecting series of actions into “action gestalts” (seeing actions as part of an action pattern with a purpose).

To facilitate smooth pursuit, or in other words, if you need him or her to keep watching you as you perform a motion, you think of “catching him or her eyes.”

First, you slow motions down so that smooth pursuit is easier.  The quicker the motion, the more difficult it is to see the whole arc of it.
When you see him or her look away – Stop the motion (see “Stop the Action,” below) and allow him or her to return to the motion.  This doesn’t improve smooth visual pursuit necessarily, but it does help establish the expectation that he or she is to follow the motion, and it makes sure he or she can see actions flowing from cause to effect.

Technique 7: Wait for Coherence

Recognize Signs of Dyssynchrony, Reorganizing and Regrouping

We regularly see discharges of behavior and/or behavioral loops that we common misdiagnose as self-stimulatory.  The rookie Therapist will often intervene to interrupt or extinguish this “off-task” behavior.Systems theory can help us understand this.
Systems theory views behaviors as systems, as well as the behavior of systems. Arnold Miller identified body, social, communication and symbolic systems.  Those are just heuristics.  Systems are overlapping and involve many other types.

Dynamical systems involve ongoing change.  As the components change – the other must adjust.  Between the change and the adjustment is an interruption of homeostasis – a breakdown in Tronick’s Mutual Regulation Model.
Neurotypicals have fluidly synchronous nervous systems, so the signs of temporary homeostatic imbalance are so quickly adjusted that the ongoing function and flow of the [neurological, emotional, social, behavioral, interactive] system is barely noticeable.  In fact, the breakdowns are experienced as pleasant, as in the surprises and variety we have in conversation, the humor and spontaneity of social interaction – these are what we crave.
Individuals with neurological coherence disorders such as autism experience much more overt and prolonged homeostatic imbalance.  Weird and obvious loops and stalls in the system occur.

IT IS A MISTAKE TO DO MUCH MORE THAN WAIT AT THESE MOMENTS AND LEARN TO BE PATIENT AS THE BRAIN AND ITS CORRESPONDENT BEHAVIORAL OUTPUT READJUSTS.  This happens to computers.  Too much input too fast causes it to stall temporarily or even crash.  Some genius thought of notifying the User with an hourglass or spinning circle or busy bee to let the User know to stop clicking and typing and opening and closing windows.

Rethink Prompting

In the book, a prompt is meant to remind someone of something – presumably something they forgot or didn’t know.  But in practice, prompts are often used to speed kids up.  They are used to interrupt “off-task” behavior and promote “return-to-task.”  But prompting when a child is in homeostatic imbalance can worsen the situation.  You are adding more information to an already overloaded system.  Some kids might have to rock back and forth or run across the room or withdraw temporarily as they reorganize and regroup.  This is the system’s attempt to rebalance or – to return to homeostasis as the systems guys put it.

Technique(s) 8: Use Declarative Language and Actions

Reduce Imperative Stimulation

This has to do mainly with the over-use and over-reliance on commands, directions, questions and prompts to cue responses.The main problem with this is that it encourages rote responding and the notion that there is a correct response.  When you ask or tell someone to “clean up,” they may interpret that cleaning up is the only correct response and that the choice is only whether to comply or not to comply.But if you say, “This room is a mess,” the Learner has to think of a solution.  That could be to clean up by herself; to ask for help or partners in cleaning up; to divide the task up; to defer it, or any number of other solutions. I want to point out the very important fact that when you state the problem and not the solution, you encourage the person to not only think, but to prompt themselves!Some individuals do focus on the matter of compliance v. cooperation.  Perhaps due to prior abuse or attachment or conduct disorder, the polite request could be as innocuous as, “Please take out the trash,” but the individual hears instead, “I want you to please take out the trash for me.”  Imperatives have a particularly irritating and counterproductive effect on people that have issues with authority.  Imperatives to them, function as invitations to power struggles.Instead, use Declarations and Indirect Prompting

“People respond better in general to opportunities to solve a problem rather than being given directions and prompts. This room is a mess” is a declaration – a statement; an observation. Often, the Apprentice will volunteer and prompt herself, “I’ll clean it up.”  “We’re having soup and there aren’t any spoons” should lead your Learner to think and prompt himself, “I’ll get the spoons.”

Declarative Language

Declarative language has to do with the way you word things so that you encourage thinking and self-direction.
Almost any utterance that can be formed as a question, a direction or a prompt can be stated as a declarative verbal utterance.  Using more declaratives is a matter of noticing when you over-rely on imperatives and practicing to break those old habits.

Imperative Utterance Restated as a Declarative Utterance
“What do you call this? “I forget the name of that.”
“You have to wait.” “This is taking a long time.”
“Hurry up.” “It’s getting late.”
“Change your pants” “Those pants are too dirty to wear.”

Declarative Actions

A declarative action is something that you do conspicuously to suggest some sort of action.
Many individuals that we work with have an almost reflexive habit of saying “No” to any request – often before they’ve given any thought to what you asked.  Other individuals, perhaps not quite so inflexible, have difficulty thinking about something you’re talking about while they’re doing something else.
For instance, if the person is doing a puzzle, she may have difficulty thinking about your request or declarative statement to do something else.  So, while the person is doing the puzzle, you could declare, “it’s almost lunch time” and get little or no response.  However, if you start to bring out the lunchboxes or you hand the person a napkin, or you just bring your own plate out – the action provides a cue. That is why it is called a “declarative action” and it is one of the more powerful of these techniques.  This is exactly what we want – noticing, self-cueing, and volitional (rather than reactive) action.

If you can communicate it without words – do it. This is counterintuitive to those of us trained to pump language.  This is the legacy of Skinnerian theory of language and the subsequent overemphasis on spoken expressive language.It may be counterintuitive because it is true that neurotypical learners develop stronger and better language when immersed in language-enriched environments.There is also some truth to that for atypical learners …some truth.  Atypical learners may not hear all of the words in a sentence and can have a “gestalt” rather than analytical manner of hearing language.  This means that they may not notice or understand what certain word operators and grammatical word order do in a sentence (e.g., “the banana or the orange” v. “the banana and the orange.”  “…put the box in the hat” v. “put the hat in the box”).

This is a case for slowing down language rather than reducing it however.  The case for reducing spoken language is that it forces attention shifting to your nonverbal communication.  Many individuals with so-called “High Functioning Autism” or Asperger’s Syndrome can process language well – it is actually their strength.  They prefer to listen intently but not look.  They rely heavily on the auditory world.While they might rely heavily on spoken language and the auditory world, they may not discriminate the tonal and prosodic elements that add and clarify the meanings of words.  Often, you can’t really tell what someone really means with their words unless you hear how they say it and watch what they do when they say it.

Finally, the “50 time rule” still applies.  Sometimes, reliance upon hearing someone tell you things is a matter of cognitive laziness.  Instead of making efforts to remember and initiate, the person would rather wait until you say it.  This isn’t about teaching or learning – it’s about you talking too much.  Don’t stop using words, but when you use them, make your words count.