The Verbal Behavior Approach:
Teaching Children with Autism
Mary Lynch Barbera, RN, MSN, BCBA
www.vbapproach.com
Autism One
May 2008
Autism Epidemic
• Rate of autism has skyrocketed from 1 in
10,000 in the 1970’s and early 1980’s to 1
in 150 today.
• PA statistics from Department of Education
(students ages 6-21)
– 1993---346 students with autism
– 2003---5,805 students with autism
*****1578% increase in a decade*****
Cause, Treatment, and Cure
• No known cause although most speculate
an environmental trigger to those with a
genetic predisposition.
• Treatment of choice is early and intensive
behavioral treatment.
Lovaas Study
• Published in 1987
– 59 children
• 19 received 40 hours/wk 1:1 ABA for 2 years
• 20 received 10 hours/wk
• 20 received standard special education
classrooms/OT/speech
• 47% of those receiving 40 hours/wk of treatment
became “indistinguishable from their peers by first
grade”
ABA as the treatment of choice
• Applied Behavior Analysis (ABA) is the only
scientifically validated treatment and is
recommended by the U.S. Surgeon General.
• ABA treatment became popular in the mid1990’s when Catherine Maurice, a parent of
two children with autism who both “recovered”
from autism using this approach, published two
books detailing Lovaas type ABA therapy.
My Autism Journey
• July 2, 1999 – Lucas was diagnosed with moderate to severe autism
one day before his third birthday.
• September 1999 – Started 40 hours/wk ABA program with Lovaas
consultant coming monthly.
• June 2000 – Founding President of Autism Society of Berks.
• December 2003 – Became a Board Certified Behavior Analyst and
Lead Behavior Analyst for the PA Verbal Behavior Project.
• May 2005 – Published the results of a single subject multiple
baseline study that I designed in The Analysis of Verbal Behavior.
• May 2007 –Anticipated publication of my book: The Verbal Behavior
Approach: How to Teach Children with Autism and Related
Disorders.
An Overview of ABA
Applied Behavior Analysis (ABA)
• Definition
“Applied behavior analysis is the science in
which procedures derived from the principles
of behavior are systematically applied to
improve socially significant behavior.”
(Cooper, Heron, and Heward)
Basic Behavioral Principles
Antecedent - any stimulus that happens
before a behavior
Behavior - an observable and measurable
act of an individual
Consequence - any stimulus that happens
after a behavior
Three (Really Four) Term
Contingency
Antecedent--Behavior--Consequences
Motivation is now seen as playing a
significant role in this model (Michael)
Examples of Three Term
Contingency
• “Touch nose” – Child touches nose – receives piece
of cookie
• “Do Puzzle” – Child falls to floor – Demand withdrawn
You use the principles of ABA
all day long!
• ABA is used to:
– Increase positive behaviors
• Language, self care skills, academic skills.
– Decrease negative behaviors
• Tantrums, biting, kicking, crying
Using ABA and Verbal
Behavior (VB) to Increase
Positive Behaviors
• Increasing language and learning skills
using the principles of ABA and B.F.
Skinner’s Analysis of Verbal Behavior
Applied Behavior Analysis
Discrete Trial
Direct
Instruction
Teaching
Lovaas type
Therapy
Intensive
behavioral
Intervention
Precision Teaching
Fluency Based Instruction
Verbal
Behavior
Incidental
Teaching
What is Verbal Behavior?
Behavior that is reinforced through the
mediation of another person’s behavior
Dual Path of Applied Behavior Analysis Research
LOVAAS (UCLA)
MICHAEL (WMU)
ABA Research
Plus
Discrete Trial Training
(structure)
ABA Research
Plus
Discrete Trial Training
Plus
Skinner’s Analysis of
Verbal Behavior
(function)
Common terms for the Verbal
Operants
Mand = request
Tact = label
Intraverbal = conversation,
answering a question, responding
when someone else talks
Echoic = repeating what someone
else says
Receptive or Listener Responding =
following directions
What is “Coffee”???????
Is it a…
• MAND?
• TACT?
• INTRAVERBAL?
Verbal Operants
Verbal
Operant
Antecedent
Behavior
Consequence
Mand
Motivative Operation
( wants cookie)
Verbal behavior
(says “cookie”)
Direct reinforcement
(gets cookie)
Tact
Sensory Stimuli
(sees or smells
cookie)
Verbal behavior
(says “cookie”)
Non-specific
reinforcement
(gets praised, for
instance)
Intraverbal
Verbal stimulus
(someone
says:”What do you
eat?”
Verbal behavior
(says “cookie”)
Non-specific
reinforcement
(gets praised, for
instance)
Echoic
Verbal Stimulus
(someone says
“cookie”)
Verbal behavior:
repeats all or part of
antecedent
(says “cookie”)
Non-specific
reinforcement
(gets praised, for
instance)
Receptive
(actually not a
verbal operant)
Verbal stimulus
(someone says
“touch cooke”)*
Non-verbal behavior
(child touches
cookie)
Non-specific
reinforcement
(gets praised, for
instance)
Two other related skills:
Imitation: Given another person’s motor
action in the antecedent condition, the
child performs the same action.
Match to Sample: matching activities
involving either identical or non-identical
items. (This is a very simplistic definition
for a very critical skill area also referred
to as conditional discriminations.)
Teaching the Mand
Why Teaching Mands is
Important
• It helps children avoid frustration in
communicating their needs and wants
• It is relatively easy to do because you are
using the child’s own motivation as a tool
• It is a natural first step in teaching
communication
The Mand
(Requesting)
All mands have one thing in common: in
the antecedent condition, there is a
Motivative Operation (or motivation) in
place.
A= thirst (MO)
B= “I want juice”
C= student gets juice
If a child does not want the item, you
cannot teach them to mand for it.
Examples of contriving an MO
• Holding up an M&M within eyesight of the
child
• Giving the child a bottle with a tight lid. In
the bottle is his favorite toy.
• Giving the child a bowl of cereal with no
spoon.
• Giving the child a toy that requires batteries
but withholding the batteries
• Briefly turning on his or her favorite video.
• Giving a bit of his or her favorite snack to
another child.
When Negative Behaviors
Occur During Mand Training
Do not reinforce whining/crying or other
negative behaviors
Count and Mand
Child has to learn that crying will not get
them anything….appropriate manding will!
Keep Number and Effort of
Demands Low at First
• Gradually fade in more difficult tasks
• Avoid escape oriented behaviors: effort
and demands should always be
outweighed by easy responding
• Make demands low at first: deliver
reinforcement much more often than
you ask the child to perform
Daniel’s ABLLS A-H
ABLLS is an assessment of language and learning skills originally developed by James W. Partington, Ph.D. and Mark L. Sundberg, Ph.D.
This spreadsheet is for private use only
Color Key
Date
January 0, 1900
C 52 ● . . . .
January 0, 1900
C 51 ● . . . .
January 0, 1900
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A 9 ○ 1 1. .
B 9 ○ 1 1. .
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A 3 ○ 1 1 1 1
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F 2
A 1 ○ 1 1 1 1
B 1 ○ 1. . .
C1 ○ 1 1. .
D 1 ○ 1 1. .
E 1 ● . . . .
F 1
A - Cooperation &
Reinforcer
Effectiveness
B - Visual
Performance
C - Receptive
Language
D - Imitation
E - Vocal
Imitation
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F - Requests
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G - Labelling
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H - Intraverbals
Daniel’s ABLLS I-R
I
I
I
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I
9
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7
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2
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I - Spontaneous
Vocalization
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J - Syntax and
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M - Group
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P - Generalized
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Q - Reading
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Daniel’s ABLLS S-Z
S
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T - Spelling
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U
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U
U
U
U
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
?
?
?
?
?
?
?
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U - Dressing
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V
V
V
V
V
V
V
V
V
V
10
9
8
7
6
5
4
3
2
1
?
?
?
?
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1 1.
1 1 1
V - Eating
.
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.
1
W
W
W
W
W
W
W
7
6
5
4
3
2
1
?
?
?
?
?
?
?
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W - Grooming
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X
X
X
X
X
X
X
X
X
X
10
9
8
7
6
5
4
3
2
1
?
?
?
?
?
?
?
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?
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X - Toileting
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.
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
28
27
26
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
?
?
?
?
?
?
?
?
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1 1
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1 1
1 1
. .
1 1
1 1
1 1
1 1
1 1
.
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1 1
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1 1
1 1
. .
1 1
1 1
1 1
1 1
1 1
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.
.
.
Y - Gross Motor
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
Z
28
27
26
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
?
. . .
. . .
1 1 1
. . .
. . .
. . .
. . .
. . .
. . .
. . .
. . .
1 1 1
1 1 1
. . .
. . .
. . .
. . .
. . .
. . .
. . .
1 1 1
1 1 1
. . .
1 1 1
1 1 1
1 1 1
1 1 1
1 1 1
Z - Fine Motor
.
.
1
.
.
.
.
.
.
.
.
1
1
.
.
.
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.
.
.
1
1
.
1
1
1
1
1
Mason’s ABLLS
Name: Mason
DOB:
Jan 05 2005
2/25/2005
o A11
o A10
o A9
o A8
o A7
o A6
o A5
o A4
o A3
o A2
o A1
Cooperation
& Reinforcers
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
B21
B20
B19
B18
B17
B16
B15
B14
B13
B12
B11
B10
B9
B8
B7
B6
B5
B4
B3
B2
B1
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
C52
C51
C50
C49
C48
C47
C46
C45
C44
C43
C42
C41
C40
C39
C38
C37
C36
C35
C34
C33
C32
C31
C30
C29
C28
C27
C26
C25
C24
C23
C22
C21
C20
C19
C18
C17
C16
C15
C14
C13
C12
C11
C10
C9
C8
C7
C6
C5
C4
C3
C2
C1
Visual
Receptive
Performance
Language
o
o
o
o
o
o
o
o
o
o
o
o
o
D13
D12
D11
D10
D9
D8
D7
D6
D5
D4
D3
D2
D1
Imitation
o
o
o
o
o
o
o
o
o
E9
E8
E7
E6
E5
E4
E3
E2
E1
Vocal Imitation
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
F27
F26
F25
F24
F23
F22
F21
F20
F19
F18
F17
F16
F15
F14
F13
F12
F11
F10
F9
F8
F7
F6
F5
F4
F3
F2
F1
Requests
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
G42
G41
G40
G39
G38
G37
G36
G35
G34
G33
G32
G31
G30
G29
G28
G27
G26
G25
G24
G23
G22
G21
G20
G19
G18
G17
G16
G15
G14
G13
G12
G11
G10
G9
G8
G7
G6
G5
G4
G3
G2
G1
Labeling
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
H42
H41
H40
H39
H38
H37
H36
H35
H34
H33
H32
H31
H30
H29
H28
H27
H26
H25
H24
H23
H22
H21
H20
H19
H18
H17
H16
H15
H14
H13
H12
H11
H10
H9
H8
H7
H6
H5
H4
H3
H2
H1
Intraverbals
o
o
o
o
o
o
o
o
o
I9
I8
I7
I6
I5
I4
I3
I2
I1
Spontaneous
Vocals
ABLLS--Lucas
Color Key
A
A
A
A
A
A
A
A
A
A
A
11
10
9
8
7
6
5
4
3
2
1
Date
9/6/2007 Lucas B.
June 7, 2007
January 0, 1900
1 1 . .
. . . .
. . . .
1 2 2 2
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
A - Cooperation &
Reinforcer
Effectiveness
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
21
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
. .
. .
1 1
1.
1.
1.
1 1
1 1
1 1
1 1
1 1
1 1
1 1
. .
1 1
1 1
1 1
1 1
1 1
1 1
B - Visual
Performance
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
C
52
51
50
49
48
47
46
45
44
43
42
41
40
39
38
37
36
35
34
33
32
31
30
29
28
27
26
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
1 1 1 1
1 1 1 1
1 1. .
. . . .
1 1. .
1 2 2.
2 2. .
1 1 1 1
1 1 1 1
. . . .
1 1. .
1 1 1 1
1 1 1 1
1 1 1 1
1 1. .
1 1 1 1
1 1 1 1
1 1. .
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
. . . .
1 1 1 1
1 1 1 1
1 1 2 2
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
C - Receptive
Language
D
D
D
D
D
D
D
D
D
D
D
D
D
13
12
11
10
9
8
7
6
5
4
3
2
1
. . . .
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
D - Imitation
E
E
E
E
E
E
E
E
E
9
8
7
6
5
4
3
2
1
1
1
1
1
1
1
1
1
1
E - Vocal
Imitation
1
1
1
1
1
1
1
1
1
1
1
1
2
1
1
1
1
1
.
1
1
.
.
1
1
1
1
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
27
26
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
1 1 . .
. . . .
. . . .
1 1 . .
. . . .
1 1 . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
1 1 . .
1 1 . .
1 1 . .
1 1 1 1
1 1 1 .
1 . . .
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
F - Requests
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
42
41
40
39
38
37
36
35
34
33
32
31
30
29
28
27
26
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
1 . . .
. . . .
. . . .
. . . .
1 1 1 1
1 1 1 1
1 1 . .
1 2 2 2
. . . .
2 2 2 2
2 2 2 2
. . . .
. . . .
. . . .
2 2 . .
1 1 1 .
1 1 1 2
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 2 2
1 1 1 2
1 1 1 1
. . . .
. . . .
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
G - Labelling
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
H
42
41
40
39
38
37
36
35
34
33
32
31
30
29
28
27
26
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
1 1 . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
1 . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
. . . .
1 1 . .
1 1 1 .
1 . . .
1 1 . .
1 1 1 .
1 1 . .
1 1 . .
1 1 . .
1 1 . .
1 1 1 .
1 1 1 1
1 1 1 1
1 1 1 1
. . . .
1 1 1 1
1 1 1 1
H - Intraverbals
I
I
I
I
I
I
I
I
I
9
8
7
6
5
4
3
2
1
. . . .
1 1 . .
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 1
1 1 1 .
1 1 1 1
1 1 1 1
I - Spontaneous
Vocalization
VB MAPP--Lucas
Key:
Child's name Lucas Barbera
1st test:
Date of birth
2nd test:
7/3/1996
Score
117.5
Date
Tester
Color
Aug-07
M. Barbera
3rd test:
LEVEL 3
Mand
Tact
Listener
VP/MTS
Math
Reading
Mand
Tact
Listener
VP/MTS
Imitation
Echoic
Mand
Tact
Listener
VP/MTS
Imitation
Echoic
Writing
Social/play
LRFFC
IV
Group
Ling.
15
14
13
12
11
LEVEL 2
Play
Social
LRFFC
Social
Vocal
10
9
8
7
6
LEVEL 1
`
5
4
3
2
1
Play
IV
Group/CR
Ling.
Language Barriers--Lucas
Date
Key
Child's name:
Lucas Barbera
Date of birth:
Color Tester
1st Asses. 08/2007
7/3/1996
M. Barbera
2nd Asses.
3rd Asses.
Inst. Control
Behavior Prob.
Defective Mand Defective Tact
Defective Imit.
Defective Echo
Defective MTS
5
4
3
2
1
1
2
3
Defective List.
1
2
3
Defective IV
1
2
3
Prompt Dep.
1
2
3
Generalization
1
2
3
Scrolling
1
2
3
Defective Scan
1
2
3
Defective C
D
5
4
3
2
1
1
2
3
Weak MOs
1
2
3
1
2
3
RR Weakens MO Self-Stim
1
2
3
1
Defective Artic.
2
3
OCB
1
2
3
Reinf. Depend.
1
2
3
Attending
5
4
3
2
1
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
A Baker’s Dozen Intervention Tips
for Children with Delays
• Thirteen tips based on the
science of ABA and BF Skinner’s
analysis of Verbal Behavior that
you can start using immediately
with all children and adults with
language delays and disorders
# 1 – Be Positive
1. Be Positive! Use 8 positives for
every negative. Don’t overuse the
child’s name especially when
saying “no” or placing a demand
#2 Pairing
2. “Pair” yourself and the environment
with reinforcement by giving the
child lots of reinforcement with no
effort required .
# 3 Giving Directions
3.
•
•
•
•
•
•
When giving a child a direction
Simplify the language
Make sure you are close enough and loud
enough for him to hear.
Get down to child’s level to get child’s attention
Only give directions you can make the child do
Give the instruction only once and, if no
response, prompt the child to complete the task.
Don’t give the child a direction you’re not willing
to follow through with
#4 Reinforcement
4.Look for things that reinforce the child.
Set up high interest activities: bubbles,
water play, balls, wind up toys to see if
any of these are motivators. Put these
things out of reach so the child needs
you to get them.
#5 Mand Training
5. Teach the child to communicate
his needs and wants…first by
pulling, reaching…then by using
sign language, pictures, or words.
Teach 3-5 signs at a time.
#6 Matching
6. Teach the child to match items and
pictures. Label the item instead of
using the command “match” or “put
with same.”
# 7 Imitation
7. Teach imitation skills.
–With objects/toys.
–Gross motor….Pick 2 or 3
movements to target at the
same time. Provide as much
prompting as needed to ensure
the child is successful.
# 8 Receptive Skills
8.
Teach receptive skills:
• touch body parts, items or pictures
• pick 2 or 3 receptive skills
• provide as much prompting as needed
to ensure the child is successful.
#9 Give Directions You Can
Prompt
9. Since you can’t force a child to
speak, do not use “say______” if the
child cannot speak or if this is a hard
skill. (Say “cookie, cookie, cookie”
as you deliver a small piece of
cookie)
# 10 Teach Fill-ins to Songs
10. Use music and familiar nursery
rhymes…leave the last word of
each line blank to see if child fills
it in.
# 11 Sabotage Daily Life
11. Sabotage daily life to see if child
notices/indicates/or requests:
•
•
•
•
•
Give cup without juice.
Cereal without spoon.
Coming upstairs, do not turn off music.
Spill milk…don’t clean it up immediately.
Go a different route in the mall.
# 12 Do Not Reinforce Problem
Behavior
12.
Do not respond whining, kicking,
screaming and other negative behaviors.
For problem behavior related to access to
attention/tangibles:
• Walk away, Ignore, or use the Count and
Mand procedure
For escape related problem behavior:
• Ignore problem behavior and continue
demand
# 13 Prevent and Correct Errors
throughout the day!
Instructor:
Child:
Instructor:
Child:
Instructor:
Child:
Instructor:
Child:
Points to an apple and says
What is it?
“bird.”
“What is it—apple”
echoes “apple”
Right, what is it?
“apple”
Presents 2-3 easy demands
and then “what is it?”
“apple”
Some Take Home Points
for Use With All Children (and Adults)
• Pairing
• Manding
• Once the child can mand for items, ease
in demands gradually
• Prevent and Correct Errors throughout
the day
• Don’t reinforce problem behaviors
Switching to an ABA/VB
approach
• Scientifically validated approach
• Child friendly
• Should see decrease in negative and
increase in positive behaviors fairly quickly
• Data based decision making
• Encourages all team members to treat
behaviors consistently and increase
demands at the same pace.
Questions?
• www.verbalbehaviorapproach.com
• Mary@verbalbehaviorapproach.com
• Thank You!