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Welcome to my blog all about Applied Behavior Analysis!

This blog is about my experiences, thoughts, and opinions as an ABA provider. I love what I do and its an amazing thing to get to help people every day.

This is a personal blog: Views and opinions expressed here represent my own and not those of the people, institutions, or organizations that I may be affiliated with.

Friday, December 16, 2011

Program: Vocal Imitation

We all remember playing Simon Says as a child, which is at its core a game of imitation on demand. Someone does an action, and everyone else is supposed to do the same action as long as "Simon Says" was stated first. Imitation skills are so important because the ability to imitate will lead into being able to play/socially interact, learn sign language, be prompted, or just "learn to learn".

Vocal imitation is a verbal program designed to teach a child to imitate on demand. "On demand" is a key distinction. Many kids I begin working with are already babbling or have a few words. However these children cannot produce a sound or word on request. They sing songs all day, but if asked to sing a specific song they wont. Vocal imitation  is one of the first few programs I write to start working on language. If you have a client or child in either of these situations, then they would benefit from a vocal imitation program.

The ultimate goal of teaching vocal imitation is so the child will learn imitation skills, to get the child's language under instructional control, and to be able to prompt the child. If a child cannot imitate on request their language wont be very useful to them. In order to teach the child new and novel labels/words they need to be able to imitate you.

Research supported methods for teaching language to children with Autism include Echoics (this is a Verbal Behavior term for vocal imitation),  stimulus-stimulus pairing, alternative means of communication such as PECS, and shaping. Example of stimulus-stimulus pairing: the child says "Buh" while looking at some bubbles, and you hand the child some bubbles. You reinforce language (even approximations of language) to pair the language with the item. Example of shaping: the child is taught to say "Buh", then "Buh-ll", and finally "Bubbles" in order to receive access to the bubbles. You make the language requirement progressively more difficult over time.

The first step in teaching vocal imitation using  Echoics, would be to teach the child to repeat or echo words/sounds on demand. The therapist would say to the child (with no stimuli present) "Say ball" and the child should respond "Ball". When I write a vocal imitation program for a client, typically I start with simple sounds that come easily off the lips ("Ba"), then more complex sounds, simple words ("Up"), complex words ("Hospital"), and eventually numbers, sentences, and short phrases (such as, "Ready, Set, Go"). There is defenitely a hierarchy when writing a vocal imitation program. Depending on the child's current verbal abilities, you want to start where they are and build from there. So if the child is only able to babble, you wouldn't start asking them to say complex words like "Helicopter". Also, it can be very helpful to consult with a Speech Therapist to find out where to begin when selecting sounds or words. Certain sounds and words develop quicker than others and are easier for children to produce. If you do not have access to a Speech Therapist, then do some research on child development and look at what sounds develop first, and in what order. There is a massive volume of research on baby babble, speech production, and first words.

Some common questions/problems I get asked about in regards to teaching Echoics are:

  1. The child is imitating the entire phrase, not just the target word. If the therapist says "Say ball" the child responds "Say ball". This is a very common problem. I usually fix this by going to a 0 second prompt where once I give the SD  I immediately give the child the correct answer. This would look like: "Say ball. Ball (speak over the child if necessary)". The child should respond "Ball". Another trick is to drop the word "Say" and just say to the child "BALL". Then look expectantly at the child. They should echo you and say "ball".
  2. The child is imitating the echoic, but their articulation is very poor. Instead of "cup" the child says "up". Instead of "zebra" the child says "ee-a". Decide in advance before you begin teaching vocal imitation if you are focusing on vocal production, articulation, or both. I usually go with what the parents want to do. Some parents feel they just want to get the child talking and we can clean up the words later. Other parents feel they dont want the child to "learn" the word incorrectly. Decide this upfront, and either work on articulation with the child or reinforce them for saying the word at all and then fix the pronunciation later. This doesn't have to be an issue if the parents/caregivers are okay with using Shaping techniques. Shaping is an ABA strategy where you reinforce successively closer responses until you get the actual response you want. So if a child can currently say "ah" and I am teaching the word "apple", then in the beginning I will reinforce "ah". Then I will only reinforce "ah-pa", and eventually only "apple". Shaping is a gradual process, where you slowly increase the difficulty of the demand to get the child closer and closer to the terminal goal.
  3. The child isn't imitating at all. This is also a common problem. Its not unusual for an Echoics program to take weeks or even months before the child starts responding. So if a therapist tells me that the child is consistently getting a score of 0 on their Echoics program, that doesnt mean I'm going to automatically yank the program. I had one client not too long ago where we worked for quite some time to get her to say "Up". Everytime I tried to get her to repeat me she would just stare at me and say nothing. Now what was very interesting about this client, was she also had an Eye Contact program. For that program I would call her name and she was supposed to look directly at me, but what she would do instead was look away from me and babble. So I found it very interesting that when given a demand to look, she would babble. When given a demand to speak, she would look! :-) Clearly this was a behavioral response, and after amping up the reinforcement this child quickly began to vocally imitate.  Today that little girl is talking up a storm. So do not get discouraged or frustrated if you have been teaching Echoics for a while with no progress. Stay focused, use powerful reinforcers, and keep at it. 
** Quick tip:  If you have a child or client who is echolalic or babbles, start your vocal imitation program with what they can already say. If they babble, target #1 should be babbling (reinforce ANY babble sound). If they have certain words they use to verbally stim (like saying "monkey" over and over), target #1 should be monkey. The quicker the child can be successful and contact reinforcement, the quicker they will learn to vocally imitate.

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