Teaching Tip: Using Differential Reinforcement of Other (DRO) to Modify Behavior

 We have many opportunities for creating behavior modifications in an autism classroom, but the big question is always: Which evidence-based practice (EBP) should I use?

To find the best answer to this question, first determine the function of the behavior. What is the target behavior? Why is this behavior occurring? Once the function of the behavior is determined, an intervention can be designed.

I’ll use an example that is very common, both at school and at home. What could be the cause of frustration that leads to a meltdown? If the student can’t effectively communicate their needs, behavior can go from 0-60 in a matter of seconds. By using visual supports, such as a choice board with food options paired with a sentence strip, we can teach the student how to express their needs or wants.

Of course, there will be times when their desired choice is not available, which seems to be the quickest way to a meltdown. So, this is a great time to use differential reinforcement of other behaviors (DRO). A DRO is a procedure in which the absence of a problem behavior or the presence of any and all behaviors beside the problem behavior are reinforced.

The following video demonstrates the effectiveness of this EBP.  This student loves grapes more than any other food in the world. And because we love our kids, the staff would bring grapes to provide him with his favorite food. But when we were out of his favorite food the meltdowns were intense. We wanted to teach him that his favorites would not always be available.

By presenting a sentence strip with the words “I want _____” or “I want more ____” and a food choice card, paired with the question “What would you like to eat?”, you are teaching the child that his action will bring a reaction. It helps if you know what the child wants, so you can tap on that choice and say the name of the item. “Do you want grapes?” Tap your finger on the choice to model, then guide his finger to teach him to tap. Then, break the news that the grapes are all gone. It’s important to teach that what we want is not always available.

            

Now, explain the choices that are available: “We have raisins and Goldfish. Which would you like?”  It’s very important to ignore any tantrumming that will occur. Children learn early in life that tantrumming gets a lot of attention. Don’t give in by reinforcing that behavior with attention! Reinforce any other behavior that occurs EXCEPT tantrumming. So, continue to say “We have raisins and Goldfish. Which would you like?” Tap the choices as you name them.

It may take days, or weeks as in our case. But when you see the results of your hard, consistent work, you will celebrate that little bit of progress, as we did today. (Watch the video ‘til the end to see our success.)

Click here: Teaching How to Communicate Wants and Needs by Using a Choice Board

References:

Savage, M. N., & AFIRM Team. (2017). Differential reinforcement. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. Retrieved from http://afirm.fpg.unc.edu/differential-reinforcement

Sam, A., & AFIRM Team. (2016). Antecedent-based intervention. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. Retrieved from http://afirm.fpg.unc.edu/antecedent-based-intervention

Nowell, S., Sam, A., Waters, V., Dees, R., & AFIRM Team. (2022). Augmentative & Alternative Communication. The University of North Carolina at Chapel Hill, Frank Porter Graham Child Development Institute, Autism Focused Intervention Modules and Resources. https://afirm.fpg.unc.edu/augmentative-alternative-communication

Using the MELD Board to Develop Communication Skills

The MELD (Multimodal Early Language Development) board is one of many low-tech communication devices we use in the classroom. You'll see in the video below that we use various resources to support the learning of our students with autism. Visual schedules, visual cards, choice boards, and the MELD boards are used throughout the day to teach communication to our students. 

                          Click here:  Visual Supports in the Classroom

MELD boards are available in various sizes. In our classroom we provide the placemat-sized board to each student, attaching it to their desk so that it's always within their reach; throughout the day, we use the boards in all areas of the classroom. This size is also perfect to send home! Remember, parents will need instruction on how to use the board, too. Share these steps with your parents and of course model these steps when training your classroom staff. It truly takes a village, but the investment of time spent training your village is worth it.

                                                        

• The first and most important step to using a core word communication board is having it within reach of the student, at all times. Using it consistently and throughout the day in various settings is essential to learning how to communicate.
  
  
• The most effective way to begin teaching how to use the board is to have a preferred reinforcer available, such as a favorite drink or a small edible that can be given each time the target word is touched.
  
  
• Some great first words to teach are help, yes, no, more, drink, or eat. Choose one word and create opportunities which require that the word be touched on the board in order to obtain the reinforcer. 
  
  
• Enlist a staff member to act as the learner. Within view of the student, work together to model the activity by saying, for example "Do you want drink? Touch 'drink'." Direct the staff member to touch "drink", then present the drink. In this example, the drink is the reinforcer.  Remember to use as few words as possible, for less stressful processing of this new skill.
  
  
• Now ask the student the scripted question, in this example "Do you want drink? Touch 'drink'." Tap "drink" as a prompt, make sure he is able to see the board and your finger tapping the word.
  
  
• Often, the learner will tap the board, realizing that this action brought a reaction, but not understanding that the tap must occur on a specific picture/word. When this happens, say the word the learner touched, for example: "You touched 'happy'. I'm glad you told me you are 'happy'!" And then repeat the script for the target word "Do you want drink? Touch 'drink'." Wait for a response. If no response, guide the learner's finger to touch the target word, then immediately say "You touched 'drink'! Here's a drink!" 
  
  
• Use shaping to encourage continued growth towards the target behavior. Reinforce approximations, but immediately begin thinning reinforcements for any response other than touching the target word.  Immediately present the reinforcer when the correct picture/word is touched.
  
  
• Introduce two-word requests using the same steps, after seeing progress with one-word choices. 

In my classroom, we have seen significant progress in all of our students' communication skills, by consistently using this strategy. During instructional activities, the students raise their hand, then touch "my" and "turn." During attendance, we use the smartboard to display the attendance roster, then use the roster dropdown menu to show each student's picture. When they see their picture they raise their hand, then touch "that" and "me," followed by "I" "see" "me."

As you see greater understanding of the process developing, create phrases that will be the most beneficial to the learner in his/her everyday life. Being able to say "I want  ____" or "I feel _____" will make such a positive difference in a non-verbal person's behavior and his/her overall demeanor.   

You'll soon see that investing the time to teach your staff and parents how to use a core communication board such as MELD will be time very well spent.

There are many videos available, showing many versions of core word communication boards. Here's a great example:                         

Click here: Introduction to Core Boards 

References:

Sam, A., & AFIRM Team. (2015). Task analysis. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. Retrieved from http://afirm.fpg.unc.edu/task-analysis 

Hanline, Mary Frances PhD; Dennis, Lindsay R. PhD; Warren, Amy W. MS. The Outcomes of Professional Development on AAC Use in Preschool Classrooms: A Qualitative Investigation. Infants & Young Children: July/September 2018 - Volume 31 - Issue 3 - p 231-245 doi: 10.1097/IYC.0000000000000120

Sam, A., & AFIRM Team. (2015). Reinforcement. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. Retrieved from http://afirm.fpg.unc.edu/reinforcement 

Teaching Communication Skills to Non-Verbal Students

Imagine living in a world surrounded by the chatter of your family, your friends, your teachers. You understand what they're saying to each other and what they say to you, but your brain works differently. For some frustrating reason your brain and the physical components that work together to create verbal communication don't function properly. You have no means to communicate your most immediate needs, no means to produce even the simplest of requests. Imagine this is your world. How frustrated would you be?

This is the world of our non-verbal students.

As special education teachers, autism teachers, paraprofessionals, and as parents or caregivers, our most important task is to find a way to teach our non-verbal children to communicate.  There are many programs and resources available, including American Sign Language (ASL), or Augmentative Alternative Communication (AAC) devices which range from low-tech to high-tech options. Our school district has adopted the MELD (Multimodal Early Language Development) board as a device used to teach non-verbal students how to communicate.



Undeniably, using a device you're unfamiliar with can be intimidating. Negative thoughts may fill your mind: "This won't work", "My students can't do this", "It's too much trouble"...Just clear your mind, KNOW that this evidence-based program not only works, it is absolutely life-changing when you help a student learn to communicate. 

My next blog will teach you step-by-step how to use the MELD board in your classroom or in your home. Remember: early intervention and parental involvement are key factors to helping a child with special needs, especially autism spectrum disorder, to become successful. This is even more important when teaching a non-verbal student how to communicate. 



References:
Nowell, S., Sam, A., Waters, V., Dees, R., & AFIRM Team. (2022). Augmentative & Alternative Communication. The University of North Carolina at Chapel Hill, Frank Porter Graham Child Development Institute, Autism Focused Intervention Modules and Resources.
https://afirm.fpg.unc.edu/augmentative-alternative-communication 


Griffin, W., & AFIRM Team. (2017). Functional communication training. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. Retrieved from http://afirm.fpg.unc.edu/functional-communication-training

Sam, A., & AFIRM Team. (2015). Visual supports. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. Retrieved from http://afirm.fpg.unc.edu/visual-supports