Introducing learning Experiences
The next step is for the child to become very aware that contingencies are present in the environment and that being aware of the contingencies will enhance the child’s ability to control sensations and to satisfy needs or desires. This is the difference between randomly reacting to the environment versus skillfully impacting the environment in a meaningful way.
We typically begin teaching a child about contingencies by adding an unstated expectation into a pre-established chain of events. The child already has the experience of needing something and having the caregiver get the desired object for the child. This chain of events (the child’s signal-parents’ response-child attains item) has been well established. An unstated expectation is now added to this established chain of events. In other words, the novice predictive skills are challenged, expanding the range of options to consider, requiring more problem-solving ability, and exercising areas in the brain related to problem solving. One exercise related to the above involves having the parent hold a desired item until the child looks at their eyes whereas in the past the item would have just been handed to the child. It is important that no stated demand is introduced here. The child is given a problem to solve. As the parent holds on to the item, the usual response is for the child to pull at the object and to get mildly confused. When first challenged in this manner, a child behaves very predictably. The child is usually seen to scroll through a variety of behaviors and vocalizations that have worked in the past (crying and pulling). Eventually the child looks up at the caregiver confused because the normal chain and strategies to finish the chain have not worked. The second the child looks into the eyes of the caregiver, the caregiver lets go of the desired item. When done frequently and intensely enough, learning has occurred. Now the child has another, more adaptive behavior added to their repertoire to gain access to desired items and to exert control over their environment.
The above example is basically a preverbal request that will teach a child a very functional and adaptive behavior. The child learns that they can control the caregiver and the world with their eyes. It is often stated that children with autism have an aversion to looking at the eyes of others. Think back to a high-school or college class where the teacher or professor called on class members to test their knowledge of the day’s lesson. What happened if you did not want to be called on because you did not feel confident or competent with the material? If you were like me (CVD), feelings of anxiety developed and I avoided eye contact. The possibility of eye contact would increase the chances of engagement with the teacher which I desperately hoped to avoid. However, those who studied and felt confident and competent to engage the teacher demonstrated different behavior. They actively sought the teacher’s eye contact and raised their hands to increase chances of engagement. The difference in the two was the learned contingency- one positive, one negative. If a child learns that looking at the eyes predicts positive outcomes the good feelings from the positive outcomes will transfer to the behavior of looking at others eyes. The aversion lessens as it is paired with the positive outcome of functional productivity. The child also learns that, when in doubt, s/he should scroll through successful strategies and try new behaviors until the desired outcome occurs. Facial referencing, having been established as successful strategy, is now one more very important method he/she can utilize when solving future problems.
It is important to note that this one facial referencing exercise is only the beginning in a series of exercises that address the shaping of positive outcomes through referencing information from the faces of others. It is also important to note that in the above exercise, more is being taught than just teaching the child to look at an adult’s eyes. Paramount in the above exercise is teaching that problems can sometimes be solved. The above exercise rewards the process of trying several methods in problem solving. The child is very motivated and the usual strategy did not work. What should he do? We want the child to be creative in thinking up new solutions with the end result a success. The lesson is that “I can solve problems if I exert effort.”
It has been said that children with Autism lack the internal motivation to learn and do not derive much satisfaction from the learning process. This statement needs to be challenged vigorously for if we accept this at face value we are doing children with Autism and all those who care about them a great disservice. Generally, children and people in general do not like to experience repeated failure and tend to gravitate to things they are good at and get pleasure from. This is not any different for the child with Autism? When key skills to successfully navigating the world are missing, they need to be taught.
The beginnings of understanding contingencies in the environment start to emerge and the child becomes more persistent with problem solving strategies. This persistence, along with varying behavior patterns, will pay off for the child in numerous ways throughout his/her life. The child learns that when something doesn’t work, try harder and try different things. Throughout the process of encountering contingencies and solving contingencies the child develops an internal locus of control and feelings of self-efficacy. Learning self-efficacy in such a manner requires providing the child with, monitoring, and maintaining a carefully crafted set of challenges. Later in this book, we will more specifically address such challenges in a series of carefully thought out programs. However, for the purposes of this chapter, let us continue describing the development of contingency responsiveness.
Developing persistence and a pushy internal self-initiation is one main focus here. The second focus is getting the child to understand that the world is full of contingencies, and usually the contingencies present are not specified. Hence, the child has to self-initiate, problem solve and persist at trying multiple behavior strategies to attain the desired item. While striving to control the world and the desired items in the world, the child is learning that social contact and communication are the most productive behaviors.
Contingency responsiveness can continue to be taught through play. Using all that is known about the chains of events, movements, sights, and sounds the child loves, the therapist can now insert mild demands into the existing chains of fun activity. Some of the demands can be specified by a cue, such as a label; others can be non-specified. Each will add more flexibility to the child’s responsiveness. An example of a time to use a specified cue and a time to leave it non-specified follows.
We recently started a five-year-old child that I’ll call J.D. The senior therapist on the case was concerned that the child was not very responsive and would tantrum much of the time. I (EJL) spent the first half-hour of the workshop listening to the senior therapist describe WEAP and the beginning programs. Most of my attention was on J.D., as I watched what he did while the adults talked. He wandered around the house almost aimlessly. He did not stop to play with toys. Periodically he stopped to stand by his mother.
As I watched him walking around, I caught a glimpse of his eye every now and then as he glanced at me. Every time he did, I made a funny face and got him to smile back at me. He started to look more and more in my direction as he continued to wander. Over the first ten minutes he became more and more fascinated with getting me to react to him. The senior therapist finished her talk and began to play in a very sedate and tentative way with J.D. She tried to push a ball back and forth with him. He wandered off as if she hadn’t tried to interact with him. She made a few more attempts that he rejected by turning away.
I decided to take this opportunity to demonstrate how to use his curiosity to develop rapport. I got up and hid behind the couch. Slowly I peeked around the couch at J.D. until he caught my eye. At that time I quickly moved back behind the couch and hid. Tentatively I peeked out and withdrew again as soon as he caught my eye. As I withdrew J.D. came around the couch to catch me hiding. I withdrew further and affectively demonstrated to him that I was intimidated by his approaches. His face lit up with a smile as he began to chase me around the room. Within five minutes we were taking turns chasing each other around the room. I stopped the chasing game when he ran up to me, and I flipped him onto my shoulder, spun around and gave him what I call a “body slam”. I yell “body slam” and set him gently on the couch. J.D. clamored after me to get me to do more “body slams.” I gave him five or six more, pausing each time to give him time to push me (bug me to do it again). At this point I am not cuing him at all. I just want him to force me to interact with him.
Eventually, I looked over to see that the senior therapist was going to call him over to do a program at the table. She was going to demonstrate the puzzles program with backward chaining (only removing one piece). I took the puzzle, pulled out a piece and bent down to J.D., who was trying to get me to give him a “body slam” and I motioned to him and said “do puzzle.” J.D. readily put the piece in, and I gave him a “body slam.” I next took out two pieces and had J.D. put them in for a “body slam,” then three, four and eventually all eight pieces for a “body slam.” He was doing the whole puzzle within minutes, and he wanted to complete the puzzle.
I then called him over to the table and had him do the puzzle at the table for a “body slam.” He came over willingly. Within the next ten minutes, I was able to do the rest of his beginning programs. J.D. is a child who would have struggled with listening to instructions and complying with instructions had I not used this fun approach. Within this example, I used specified cues, such as “do puzzle” and at times also didn’t specify the desired action. When I wanted him to do a specific task I used a cue. When I wanted to build self-initiation and problem solving, I did not cue the response I was looking for. When I didn’t cue him, I was looking for any behavior that I wanted to increase and when it occurred I provided a fun activity.
As previously mentioned, placing the unstated expectation of a glance up at the therapist eyes into an established chain of events, begins to teach a child how to problem solve via facial referencing. The child is also learning the beginnings of contingency responsiveness. We want the child to become very confident in his/her own ability to recognize when contingencies are present in the environment and very productive at problem solving a solution to the contingency presented. Along with preverbal requesting via eye contact we can also systematically provide fun activities to increase following behavior, watching hand prompts and sitting where the therapist points, as well as receptive instructions.
As children become more proficient at predicting, and more responsive to contingencies during the beginning stages of therapy you will see a child who was once aimless, lacking any organized or directed behavior move to appearing very goal directed and confident. The child will be more “organized” in their actions. Confidence grows in the child as he or she starts to understand the rules governing contingencies in the environment, and the child is able to solve the contingencies at will. In the above described case example J.D. was wandering around aimlessly until he was presented problems to solve and then consequently was able to recognize and skillfully manipulate the contingencies to get what he/she wanted. When he recognized that he had control over my facial expressions his face lit up with happiness. He started to play with the control he had, looking at me more and more to get me to make a silly face. He stopped wandering aimlessly and started demonstrating purposeful action. His attention moved from an internalized focus with fleeting focus toward the environment to an external focus on me connecting his desires to behavioral outcome. As I became more the focus of his attention and behavior his behavior became much more purposeful and goal directed. The child was able to test his control over the world and the therapist and test his predictive assumptions. You got the sense from watching him that for the first time J.D. understood the world he lived in.
It is important to note the “in the moment” recognition of self-efficacy and competence of the child. None of the above would have been possible had unrealistic expectations been placed on the child. Expectations need to be well within the child’s ability and need to be adjusted according to motivation and interest. The resulting goal directed organized behavior is so much better than the alternative retreat into the world of autism.
A new child started in our program last week that demonstrated the same aimless wandering toward the beginning of his workshop. It was the first session where the new therapists are being trained to consistently perform Lovaas based programs. Mom had just decided to switch the child to a special diet which meant we couldn’t use candy or food to motivate him. The child, I’ll call him B.C., wandered around the living room only glancing at the therapists. He showed no organized plan to accomplish anything. As therapists tried to play with him he allowed them to do what they thought he would like and he often enjoyed their interactions. He would smile and laugh as he was being swung in a blanket or tickled. The problem, as I (EJL) saw it, was that when the therapist stopped the interaction B.C. just walked away. The world was acting on him and he was just a passive recipient of the good and bad things the world threw at him.
I discussed my concerns with the B.C.’s mother and asked her if she had any snacks that we could use. She took gummy bears out of the freezer and we cut them up into tiny pieces. B.C. immediately recognized that the Gummy Bears were available and he went to where they were placed on a dish and tried to take one. This was the first clear sign this day of purposeful behavior as B.C. acted upon his environment to satisfy a desire. Unfortunately I was in his way as I took the plate of Gummy Bears. I immediately gave him one to encourage his attempt at satisfying his desire and to allow him to sample the Gummy Bear.
The next one I held on to until B.C. looked up at me. As he looked at me I let go of it without saying anything. Over the next five minutes he started to look into my eyes as a strategy to get me to release the Gummy Bear. First he tried pulling and looking away. Glancing at my eyes was easily shaped as a solution to the problem of how to get the Gummy Bear out of my hand. After this behavior (glancing at my eyes) became more predictable, I walked away and went over to the other side of the room. B.C. followed further demonstrating to me that the Gummy Bears was motivating and that B.C could persist at a goal. His attention was now focused on another human being. After I gave B.C. a few Gummy Bears for following me back and forth across the room I stopped and patted a chair at the table and waited for him to sit down. I had to overhand prompt him to sit in the chair. He did not recognize the prompt as a prompt. I then gave him verbal praise followed by a Gummy Bear. I want verbal praise to be predictive of good things so that the good feelings from the Gummy Bears transfer to the verbal praise. I then walked across the room to another chair and waited for B.C. to follow. Again, I prompted him by patting the chair and then helped guide him to sit down. I praised him and gave him another Gummy Bear.
After about four trials where I had to guide him into the chair he was able to watch my prompt of patting the chair and sit down on his own. The great thing to see was B.C.'s attention to me as he solved the contingencies that I was placing before him. Within fifteen minutes he was able to follow a point prompt to sit in the chair I pointed to in order to get verbal praise and Gummy Bears. After I had him coming over and sitting to get the Gummy Bears I had the rest of the therapists practice guiding him.
From here we would go on to labeling the behavior we were looking for with “come here” and “sit down.” After a half hour B.C. had four strategies to try, glancing at the eyes, walking across the room, following the therapist, and sitting. When we withheld the Gummy Bears he would try each of the strategies he had learned. What is amazing to me here is that during the first part of the session B.C. appeared very aimless in how he wandered about the room. As he was exposed to contingencies and able to solve the contingencies his attention and behavior became more focused and persistent and he began to relate socially to attain desired items.
Learning how to solve contingencies at this level through the use of candy and physical activity set’s the stage for learning about contingencies in more advanced and delayed ways. In the above example, candy and physical activity can be considered motivators. However, what is motivating to a child is as infinite as the imagination allows. There is an easy way to tell if something is motivating to a child. Apply the following criteria: 1. Does the child seek it out? 2. Does he or she care if you take it away? If the answer is yes to both of these questions you more likely than not have a motivating item that can be used to teach contingencies. As a side note, EVERY child is motivated by something. We can’t tell you how many times we are presented with the argument – “he just doesn’t want anything, nothing motivates him.” Such words foster an atmosphere of excuse giving and stifle creative thinking. A preferred attitude goes something like this: “I have not yet discovered something that he consistently wants…This is what I have tried…Let’s brainstorm new ideas…”
All of the programs that we teach the child at the table and away from the table have basic contingencies that must be solved. The child moves from working on the level of trying to get candy, to trying to figure out why a friend behaved in a certain way. The world that we live in inundates us with contingencies every moment of the day. The ability to surmise the situation and come up with a plan of action is integral to successfully navigating the physical and social world.
Therapists need to constantly assess that child’s ability to stay connected with and persistent at solving contingencies. Attention will be best when the child is pushing the therapist to release the valued items or behaviors. Whenever you find yourself following the child around and begging them to take what you have to offer you need to stop and assess the environment. Following the child’s lead is exactly the opposite of what we want. Very little productive learning takes place in such an environment. In fact, what the child learns is this: I make a fuss and people scurry like mad to figure out what I want. A child learns that how big a fuss he/she has to make depends on other people and their tolerance levels. In such scenarios, where is the child’s opportunity to expand adaptive functioning? It does not exist. Many well-intentioned people fall into this trap. However, breaking this trend is essential in the healthy development of the child with ASD. The therapist should ask themselves, “What is it about the environment that is leading to the child not want interaction and the usual desired items?” The answer to this question usually comes down to certain desired items being offered too often or being freely available. The therapist’s task is then to gain control over the things in the environment that the child desires. You will know that you successfully control desired items when the child is now bugging you for interaction. How is such control gained? By making sure the things the child wants are only available through the caregiver. When such control is established the caregiver can then control the learning opportunities by controlling contingencies and desired items. In order to attain the desired items contingencies must be solved and learning takes place.
The child becomes more connected to their environment and the good things that can be attained through a focus on teaching a child to solve contingencies. Learning that contingencies are present in the environment and all that has to be done is try what has been most successful in the past and if that doesn’t work try something else that has been successful. When all else fails look to another human being for guidance.
Contingency responsiveness can involve solving contingencies to attain desired items or behaviors from others as described above or to avoid an undesired behavior or experience. For example a child that is very self-absorbed and spends much of his time flapping a stick in front of his face could be taught contingency responsiveness through a response cost procedure. M.C. was brought in for a progress review by his parents. He was making good progress as he went through the programs but when not engaged he spent most of his time flapping a stick in front of his face. M.C.’s parents were very concerned about this behavior.
As I (EJL) watched M.C. walk around the room flapping the stick I got up and took the stick from him and then gave it right back. He looked at me confused as if he was wondering why I took his stick for a second, then after the pause he began flapping the stick again. As soon as he did I got up and took it away again and gave it right back to him. You could tell by the look on his face now that he knew something was up. He didn’t take his eyes off of me as he tentatively shook the stick which got the expected reaction of me moving toward him to take his stick. He smiled as I came this time. M.C. began to play with different movements to see which movements elicited my behavior of taking his stick.
What I like most about this interaction is that it is an interaction. M.C. is no longer in his own little world oblivious to what others in the room are doing. He is referencing me and goading me with alternative behaviors to see my reaction. He has a sense of power in being able to control my behavior. I may be trying to shape away the behavior of flapping the stick but he is playing with his ability to control me and he is learning to understand the world at the same time.
I was able with this simple procedure to shape away the flapping of the stick while in the progress review. It would be a very difficult and time consuming task to shape away a self-stimulatory or what I refer to as a self-soothing behavior in all aspect of the child’s life. Our general strategy is to put time and location requirements on the self-soothing behaviors and shape the behaviors into socially acceptable behaviors. For example the behavior of flapping a stick in front of the face could be changed into drumming. Exposure to very clear shaping exercises teaches a child to be aware of the environment and the social contingencies in the environment. These programs set the stage for more advanced shaping experiences while learning to differentiate auditory, motor, and visual sensations in upcoming programs.