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A WORK IN PROGRESS

(Mareile Koenig, Ph.D., CCC-SLP, CBA/PA)

(Mareile Koenig is an Associate Professor of Communicative Disorders at

West Chester University in West Chester, Pennsylvania and is a Certified Behavior

Analyst.

CT FEAT Newsletter, 2(2) 1999

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Have you ever wished for a state-of-the-art manual that would describe the

fundamentals of intensive behavioral intervention

*in plain English,

*with clear guidelines,

*concrete examples,

*a behaviorally-defined developmental curriculum,

*sensitivity to individual differences,

*techniques for assessing and documenting progress, and

*an absence of distracting references within the text?

Have you dared to wish that such a manual be written by professionals whose

credibility and ideas are validated not only by a peer-reviewed publication

record but also by a substantial history of world-class, hands-on experience

in treating children with autism? If so, click here

to order Ron Leaf and John McEachin's new book A Work in Progress: Behavior

Management Strategies and a Curriculum for Intensive Behavioral Treatment of

Autism (DRL Books, L.L.C., New York, 1999). What you'll get...is a marvelous

400-page manual summarizing procedures with proven

effectiveness for teaching children with autism and written in the spirit of

parent-professional partnership. Need more information? Read on…

Given all the complexities and challenges presented by individual children

on the autism spectrum, no single book can possibly cover every essential

detail. However, from a behavioral/educational perspective, A Work in

Progress offers a substantial piece of the foundation. In the words of its

talented and well-known authors, the book seeks to "provide a road map and

enough detailed examples that people who work with autistic children might

develop a good understanding of the (behavioral) teaching process." It is

organized into 3 parts: 1) Behavioral Strategies for Teaching and Improving

(the) Behavior of Autistic Children, 2) the Autism Partnership Curriculum

for Discrete Trial Teaching with Autistic Children, and 3) an Appendices

section consisting of seven forms that can be used in setting up and

implementing an intervention program.

The section on behavioral strategies is divided into 12 chapters written by

Ron Leaf, John McEachin, Jamison Dayharsh, and Marlene Boehm.

Chapter 1

provides a general overview of intensive behavioral intervention (IBI) for

children with autism. A brief summary of the historical foundations is

followed by a description of nuts and bolts issues, including curriculum

development, the number of hours of training, the teaching format, various

settings in which teaching takes place, stages in the evolution of therapy,

assessment, and guidelines for program effectiveness. While IBI is best

initiated during the early years,

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Chapter 2 presents special considerations

for older children and adolescents.

Chapter 3 addresses the all-important issue of reinforcement - - the bottom

line of any effective behavioral approach. This topic is introduced by

clarifying misconceptions about the use of reinforcement. It is followed by

important tips for the identification of reinforcers, and by a discussion of

other reinforcement issues, including types of reinforcers, schedules of

reinforcement, guidelines for the use of reinforcement, and specific

examples of differential reinforcement.

Chapters 5 to 10 offer excellent guidelines for understanding and addressing

behavioral challenges common to children on the autism spectrum. Included

here are the elements of positive behavioral support systems for reducing

disruptive and self-stimulatory behaviors, and strategies for the

normalization of sleeping patterns, toilet training, and the reduction of

food selectivity.

Chapters 11 and 12 address strategies for shaping play skills, social

skills, and social play. Overall, the chapters in this section offer

succinct, behavioral guidelines and real-world examples for increasing

adaptive behaviors and reducing the maladaptive behaviors that frequently

accompany autism.

The second part of A Work in Progress is The Autism Partnership Curriculum.

It is introduced by guidelines that shape each instructional session. This

is followed by an in-depth description of the discrete trial protocol. Here

the reader will find information about the components of a discrete trial,

strategies for maintaining a child's attention, guidelines for maximizing

progress, and a checklist for planning generalization training. Clear

examples are offered throughout to illustrate specific points.

The curriculum itself includes about 60 skill sequences. These sequences

are tied to 5 skill domains: pre-academic, communication/language, academic,

social, and self-help. Each skill sequence is accompanied by general goals,

teaching guidelines, special considerations unique to the sequence, and

specific methods for achieving each skill within the sequence.

To illustrate this, consider the skill sequence called "Categories". The

general goals for introducing this sequence are to teach 1) associations

between related items, 2) expanded communication, and 3) abstract reasoning.

The following general guidelines are given: "Select groups of items that are

related. Start with simple categories like animals, food, and clothing. It

will usually work to use pictures of items. Some children may need to have

this first presented with 3D items." Suggestions for specific categories

are included (e.g., animals, foods, furniture, transportation/vehicles,

toys, rooms, tools, shapes, letters, numbers, fruit, drink, objects in the

sky, plants, etc.).

Prompt options are defined for shaping the responses, and mastery criteria

are offered (e.g., "Student performs response eight out of ten times

correctly with no prompting. This should be repeated with at least one

additional teacher.") Next, the reader is provided with specific

information for teaching each of the five skills in this sequence. Included

here is a description of the instructional materials, the specific verbal

instruction that should be given to the child, and a behavioral description

of target responses. The specific skills in the category sequence include

1) Matching - placing a given pictured item with others in the same category

(e.g., "put with {animal{"); 2) Receptive - identifying a member of a

category that is named (e.g., "give me {animal}"); 3) Expressive - naming an

object and then its category (e.g., "What is this?" and "What is a {cow{?");

4) Naming - identifying category members (e.g., "Name an {animal"); and 5)

Complex Categories - naming an item that meets two or more requirements

(e.g., "Name an animal that lives in the ocean").

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Several aspects of content and style make A Work in Progress a particularly

compelling source for parent-professional partnerships. First, while the

approach is clearly behavioral, Leaf and McEachin emphasize the value of an

interdisciplinary approach and the importance of collaboration. Moreover,

the clarity and pro-active style with which this manual is written invites

its accessibility to a variety of readers who may be a part of the child's

team at one level or another (e.g., teachers, therapists, and administrators

as well as behavior analysts and parents). The authors take great care to

address common misconceptions about intensive behavioral intervention by

offering accurate information and examples in a non-inflammatory style.

Second, while A Work in Progress includes wonderful checklists and concrete

behavioral descriptions of strategies and targets, it is intended to serve

as a "road map", not as a cookbook. It highlights functional analysis as a

crucial aspect of intervention design. Further, while the curriculum

sequence is based on developmental data, the authors remind us to leave room

for flexibility. For example, some children on the spectrum will learn to

read before they learn to participate in extended conversations, and this

variation can be used to a child's advantage in teaching other skills. The

content of the curriculum itself may require modification to meet the needs

of a particular child. However, the principles described in the manual will

assist teachers and professionals to collaborate in making modifications

appropriately.

A third strength of this manual is its balance. We are reminded of ways to

build and maintain a good rapport with children throughout the teaching

process while at the same time being consistent in our application of

behavioral strategies. An emphasis on discrete trial teaching is balanced

with a push towards greater naturalness in the instructional sequence as a

child progresses. Opportunities for social play with family members and

peers outside of discrete trial teaching sessions are noted with equal

importance to the structured teaching sessions. As a speech-language

pathologist, I appreciated the authors' acknowledgement that "language

{develops} much more naturally through social interaction and play" and that

"children learn from other children how to speak naturally and childlike".

However, as a behavior analyst, I recognize that children with autism must

learn how to learn from experiences in the natural environment, and that a

carefully crafted balance of structure and naturalness (as recommended by

Leaf and McEachin) is absolutely essential.

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