ABA for Intermediate Learners

You’re listening to the turn autism around podcast, episode number 54 and today’s episode is an excerpt from a video webinar I did as a bonus video for my online course participant members. It is on how to help conversational or almost conversational kids with ABA verbal behavior. And specifically, with my approach, I haven’t done this type of a webinar ever. So, I did the webinar, got great feedback from my members. One member said, this is the best video that Mary Barbera has done. I’m speechless and so happy and she has a child who’s level three on the VB-MAPP and beyond. There’s a lot of confusion about how to help these kids that are talking in sentences, are they too high functioning for ABA? Should they have pull out, should they just be included? And today’s podcast is going to cover all of those issues. So, I hope you enjoy it and I’ll see you on the other side.

Welcome to the Turn Autism Around podcasts for both parents and professionals in the autism world who want to turn things around, be less stressed and lead happier lives. And now your host, autism mom, behavior analyst and bestselling author, Dr. Mary Barbera.

I actually have had a lot of people come up to me or email us and say you don’t have anything for a product or a program for kids who are, have higher language skills or conversational or almost conversational. So, ABA, verbal behavior for conversational or almost conversational kids with autism. So, here are five mistakes that people make no matter what the functioning is, but specifically for kids that are quote unquote higher functioning. And when I say quote unquote higher functioning, I did a whole podcast, I believe its number four on high functioning versus low functioning. My, my beliefs in calling someone high functioning is, doesn’t really help anybody because every child and every adult, whether they have autism or not, has their strengths, weaknesses, challenges, and we can always get to a higher level. So, if you want to listen to that podcast on high functioning versus low functioning, it would be marybarbera.com forward slash four.

So, here are our mistakes with any child, especially with intermediate learners and above not assessing the whole child correctly. So, you’re working on one thing and then something else getting worse. We’re going to talk about all of these more and what to do instead at the end. Mistake number two is focusing too heavily on academics. If the language and the language comprehension is not intact. Mistake number three is not focusing on self-care. Mistake number four is programming that is almost always too high. And mistake number five is poor collaboration between the parents and the team and the home and the school and the community. And you know, kids with high functioning autism are very at risk for other diagnoses such as mental health issues, OCD, oppositional defiant, ADHD. They’re more at risk for problem behaviors. More at risk for being diagnosed with bipolar disorder, anxiety, depression, they tend to be on if they’re on any meds, a lot of times they’re on a cocktail of meds and the higher functioning, the less behavioral people get and they just kind of blame the child on being bad.

A lot of high functioning autistic teenagers and adults end up in the criminal justice system. So there’s a whole host of issues and while my current courses are really for kids that are not conversational, I am now, you know, at least doing this, this presentation and taking your additional questions and maybe there’s another course or membership site or something to help support kids that are at a higher level. So, wherever your child is at or client, we need to assess and we need to think about how is their language, how is their leisure skills, how is their academics social skills, eating, sleeping problem behaviors, self-care, toileting, grooming, dressing. I think that got missed. Inclusion in general, education settings, inclusion in general, community settings like boy Scouts and team sports and those sorts of things. It’s not just inclusion in school and I am very pro inclusion, but I see inclusion especially with kids with higher functioning autism being included and then not getting the support they need to make it to their fullest potential.

And what I mean by turning autism around or reaching your fullest potential is that each child be as safe as possible – number one. As independent as possible. -number Two. And as happy as possible – number three and happiness goes here. A lot of kids with high autism are not happy. They are having trouble at school, they’re struggling at home, they’re having tantrums, they are not understanding, they’re getting bullied, they’re getting made fun of. And while kids with more severe autism, like my son Lucas, who’s now 23, he doesn’t understand if somebody would bully him. He doesn’t understand those kinds of concepts, but kids with higher language do. And so, it’s something that we definitely have to address. Okay. So those of you that are in my verbal behavior bundle in the intermediate course, we, I developed an intermediate assessment, which I would definitely recommend that we are going to talk about the VB-MAPP a little bit.

But I can tell you that kids that are older than six or seven who are level three of the VB-MAPP, it is going to take a skilled person hours and hours to complete a VB-MAPP accurately. And a lot of times that’s just not feasible. It’s not covered by insurance. It’s not. A lot of times you’re dealing with a crisis situation of the kid’s going to get kicked out of school, their placements going to change. They need an FBA. The BCPA onsite isn’t familiar with the VB-MAPP. All of the VB-MAPP is just for little kids, which is not the case. It’s just I don’t think that if a child has no VB-MAPP in place and is older than six or seven with no BCPA that is really fluent with the VB-MAPP. I’m suggesting and I suggest in my intermediate course is that we start with my mini-assessment here.

The other thing we have to do is we have to also, in my opinion, especially if your child, well no matter what the age is, if you have any deficits on here, so maybe you don’t have to start, say you have a six year old who’s high functioning. Maybe you don’t have to start with the 18-month skills, but you know he should be able to do all the 48 months skills and if he can’t then you need to look at the 30 months skills. I know for a lot of my clients with higher language, a big push was to get them, well obviously toilet trained, obviously dressing themselves. This is all within the the intermediate course. I have videos showing you exactly how to do this and then also from taking a bath to taking a shower independently, washing hair independently. Those are all skills. If you think about, okay, if your child is six or 10, or whatever age, okay, at what point would he or she be taking a shower independently and then you work up to that.

So, I recommend people do with a high functioning kid. We do the intermediate assessment, self-care checklist. And the third component of this quicker assessment is the intraverbal sub test. Again, this was written by Dr. Mark Sundberg. It’s completely free. If I’m starting without very high functioning kid, I’m not going to go a Kitty says twinkle twinkle. I’m going to actually start at group seven and group eight, which are the hardest. So, I’m going to start and say what makes you sad? Named some clothing. Tell me something that is not a food. What helps a flower grow. When do we set a table? What’s inside a balloon? What do you take to a birthday party? So, when you say, what do you take to a birthday party? A lot of people, a lot of kids, even with higher language will say cake. You don’t actually take cake; you take a present.

But if they’re not able to distinguish, what do you take to a birthday party or what do you get at a birthday party? Or what do you see at a birthday party? You change one word and it changes the whole context. And that’s where we really look at is their language really intact. And I think this is a big, big mistake I see with kids with higher language is most professionals and even parents will say, Oh, he’s high functioning. He’s, you know, that that’s, yeah, he’s, he’s conversational, he’s good. And then I’ll suggest, you know, what, just do group seven and eight and see what happens. And it may not be as intact as you think. And this is for a typically developing 48-month-old, so five-year-old max. So, if you have an eight-year-old who is has deficits in this intraverbal group, seven and eight, you’re not just looking at a behavior issue or an academic issue.

You are looking at a language comprehension issue which is going to get in the way for every area it’s going to get in the way or behavior it’s going to get in the way for inclusion. It’s going to get in the way for self-care. It’s going to get in the way for community outings for karate and boy Scouts and all that type of thing. Those of you that have taken my courses and are familiar, it should be familiar with the VB-MAPP. Again, I’m not saying that with a six or eight or 10-year-old that you definitely need a VB-MAPP because like I said, it’s going to take a very skilled professional. The higher the kid, the more difficult that is and the more hours it’s going to take to complete this VB-MAPP. There’s a third part too that’s a transition assessment. But before I get there, I’ll just talk in general that we have, you know, failure to assess the whole child and programming too high.

So, programming too high in a lot of ways for an intermediate learner and beyond is too much tit-for-tat programs picking the wrong target. So, for one of my clients, for a lot of my clients, because this picture of the corn dog was in the language builder cards, that was a target even for my Indian client who didn’t eat meat. You know, that was a cultural thing for kids that have never seen a corn dog. You really have to, as behavior analyst or teachers or speech pathologists learn what targets are most relative relevant to individual clients. Mine, one of my clients, they, and he was probably a Jacobs level on the VB-MAPP, not ready for a lot, you know, they had him tacting labeling the watermelon, but then they also had on targets labeling the rind of a watermelon. And I would suggest that many adults don’t even know what the rind of a watermelon is called.

So really be careful about what targets you are teaching. Also, a common mistake I see is teaching interverbals and losing the tact. So, if you hold up a cow and the child says, Moo-moo says a cow or the cow goes, Moo-Moo, you might think, wow, let’s link the butter in see he’s doing better. It’s messing with his language and you’re going to build a pyramid that’s going to fall down, you know, labeling toothbrushes, toothpaste, or a labeling a toothbrush as brushing your teeth, labeling this as a red chair instead of just a chair. That’s what happens when we start to build language in a wrong way. I had a client once who we taught him, and this was many years ago, so we taught him the corded phone in the classroom and it was, you know, the phone, which had the tact for.

So, then we’re, we’re trying to teach him features of the phone, including the cord and the buttons and the receiver. And so, then I went back a couple of weeks later and we said, what is it? And he said, phone cord receiver buttons. And I was like, okay, now we have to undo that. So, you always want to keep the tact strong as you teach clients or children actions and adjectives. Okay. So other resources for high language kids include the VB bundle for almost conversational kids. I do have an intermediate learner, a bonus video if you just want to jump in there to get some more videos and more ideas. I have a book program, bonus video within the VB bundle. That’s really excellent. I have an advocacy bonus video, which I talked about the topic game. So, one of the questions pre-submitted was like changing topics or getting kids to talk about other topics.

But what we used to do for one, one little piece of paper, we’d say Christmas and we would fold it up and we would put it in a little bag or a little box and we put sports and we would put summer time and we would put maybe not sports, maybe we would put soccer cause she was on a special needs soccer team. We would, you know, those kinds of topics. And then we would mix them up. We’d have. Okay. So, okay, we’re going to talk about Christmas and then I would start like, oh wow, Christmas is in December. And then she would say, you know, we see Santa on Christmas. That’s right. You know I know I, we get gifts for Christmas. I’m hoping I get a necklace and then we would go back and forth talking about a certain topic and then when that was exhausted, we would pick another topic.

And so this is a way to practice within a really tight time with one competent adult, getting her to talk more on topic. Boy Scouts, girl Scouts. I know. Julie Torbet, who’s one of our Facebook advisers, she’s a friend of mine behavior analyst for many years. She has a daughter that just graduated from college. She’s big on get, she was big on getting her, her daughter to participate in girl Scouts. Now Julie had to be the co-leader of the girl Scouts. But you know, there’s a lot of skills that can be taught within things like girl Scouts or boy Scouts. A karate, actually, Julie’s daughter is I think a black belt or almost a black belt in karate. So those are kind of some of some of the sports that some kids Excel in any kind of sports. There’s a book called acting antics which is great for teaching social skills through acting games.

Steve Ward has a couple of game books. I did a podcast with him. You can Google Mary Barbera, Steve Ward to find that podcast and his resources. Michelle Garcia Winner has some books that are excellent. They are not ABA, evidence-based supposedly, but I have used her work and have embedded that in a lot of the programs that I do. Temple Grandin had – is the most famous person with autism and there’s an HBO movie named Temple Grandin. So, if you haven’t watched that, definitely you want to check that out. She also has a bunch of books including thinking in pictures, which is probably her most famous book. She also has a book on picking vocational things through talents. So, if you Google Temple Grandin talents, you’ll be able to find that book. I found that to be pretty helpful. And then Steven Chores, also a man with autism who has a PhD, both temple and Steven have PhDs I believe.

And Steven has some books too that are very insightful. Okay. So regardless of where your child or clients fall, I believe that you should do the Intermediate assessment. Do the intraverbal sub test. I put intraverbal webbing here. So, I’ll give an example. One time I was in the verbal behavior project classroom and this teacher said, “Oh, we have a new boy. His name is Tommy. He’s sitting over there. He’s very high functioning though I don’t think he’s going to need anything kind of thing or always very high functioning.” Oh good. So, I go over and I’m like, “Hey buddy, what’s your name?” And he didn’t respond. And then I said something else. I asked him another question and he was like, “Three, two, one, blast off!”. And I’m like, okay. So, don’t think somebody’s just high-functioning because someone told you they’re high functioning. So the best way I know to quickly find out how high functioning a child’s language is, no matter what their age, if they, if you think they’re high functioning or somebody told you they’re high functioning, is to go up and do some intraverbal webbing, which is, “Hey can you tell me some colors?” Or “Can you tell me some clothing?”

I had this one girl once who’s supposedly high functioning and she was being homeschool because the police were called because she was overturning desks. She was nine. So she was being homeschooled. I go in, I have no idea if she was included, getting straight A’s and as a nine-year-old, okay. And having all these behavior problems. So, I’m assuming she’s pretty high functioning, right? So, I go in and I’m like, “Hey”. And her mom got an important phone call. Like the minute I walked in the door. So, I’m like, okay. It was Christmas time many years ago. And I say, “Hey. Oh, I said, “Hi! I’m miss Mary.” And she goes, “Hello doctor”, “Hello Mary Barbera” or something like that. “Hello, Dr. Barbera” or “Mrs. Barbera” or something like that. So, I’m like, okay. So, her mom must have told her I was coming. So, I go, “Hey, can you tell me some clothing?”

And she’s like, “Shirt pants underwear, capris, sandals, shoes, sneakers…”. I’m like, “Whoa!”. You know, like she’s pretty elaborate. Like, Hey, could you tell me some, some foods? And she’s listing a bunch of foods and animals. I’m like, okay. I’m like, “Hey, could you tell me some things that are usually red?” And so, I switched from stuff she’s been taught since she’s been two now, she’s nine to tell me some things that are red. And she looked around and she saw the Christmas lights. She’s like Christmas lights. So, I don’t want her to go look around the room for something red. I want her to think about something red, like a stop sign or a strawberry that’s not in sight. So, I’m like, “Oh honey, can you close your eyes and tell me something that’s red?” She goes, “Don’t tell me to close my eyes!” and I’m like, “Oh my gosh.”

So, what happened then was I was just like, Oh my God, she has major intraverbal problem, which is the answer part of WH questions. And so later I was just watching her, watching her mom. Her mom’s like, “Oh, her favorite subject is mythology.” Really? All right, let’s watch mythology in action. You know, like I’m thinking, how in this in the world is this girl comprehending mythology? Or what’s this look like? So, I’m just like, okay. So, mom started teaching within I think 10 or 20 minutes, the girl had 30 escape vocalization. She’s like, this is so dumb. Can I be done? Can I crawl like a baby? You know, all that stuff. All that nonsense. Escape kind of language, 30 times within 10- or 20-minutes during mythology, which is her favorite subject. And then when I asked her WH question, she was good with what and where and who. Fell apart with why.

So, she was aware, do you sleep in a bed? You know, she looked conversational, but then when I was like, why do you brush your teeth? Or why do you, yeah, why do you brush your teeth? Because there’s toothpaste and then I would put like a negative down on the paper. I mean very discreetly. I wasn’t like, no, that’s wrong. I would just put a negative. And it one time she saw me put a negative and she grabbed my pencil, she actually got upset with me when she got things wrong. So, when things, she was okay with regular straight up intraverbals that she knew. But when it got more abstract, she fell apart. And that was her problem. We ended up starting this girl right into language for thinking instead of language for learning because she was talking pretty well, but she had so many intervertebral problems.

So that’s intraverbal sub test and webbing. So, I would go up to a child and I would say, Hey, tell me some things that are, that are green or tell me some, maybe not clo-, just clothing, if you know, they know that. But tell me some clothing you would wear to the beach or tell me some clothing that you would wear in the winter time. Get it harder. Tell me some things that people wear that you don’t like to wear and those sorts of things. So, you’re adding complexity to your WH questions to see if they fall apart or become resistant to answering your questions. The self-care checklist is so important. An FBA functional behavior assessment is, is going to be key. But I would argue that an FBA without a VB-MAPP or an FBA without an assessment of language is probably going to lead you in the wrong path.

Also, academic assessments, IQ sub tests. I had a – a child I work with in the VB project and then five years later he was in ninth grade and I saw his mom and his mom’s like, I don’t know what to do with Joe. Like I don’t know if he could go to college. I’m thinking, well, five years ago it didn’t look like he could go to college to me. So, I said to her, well, how’s he doing? Like what’s his IQ? And more importantly than the IQ scores, the sub tests, the sub tests are really going to show you whether there’s learning disabilities. And she said, I don’t think anybody’s ever done an IQ test on him. Super important that you look under the hood and, and don’t just blame it on a behavior problem because it’s probably an academic problem. Language and language comprehension is more important than academics, which I think I’ve showed you today.

Self-care is super important as well. Don’t do tit-for-tat program or programming too high. If a typical child that age can answer it or half the time, can’t answer it, it’s not worth your time. And don’t just keep programming with BB mixed VB when there are standard curriculums, namely language for learning, language for thinking and language for writing that are going already already made. You’re going to have to do an up work just pulling it out and figuring it out, but you won’t know what to do in what order. And those curriculums really do work if they’re done well. And then so important to have home and school collaboration and coordination. So, so one of the pre-submitted questions is about articulation and that is really tough because as children put more and more words together, if we haven’t straightened out their articulation from the beginning, a lot of times it gets more and more garbled.

So, talk tools is an oral motor kind of program. It’s not out of the question. Even for kids that are, are more fluent, getting a speech therapist on board. So, talk tools. I did do a podcast with a certified talk tools SLP who was also a BCBA Mags Kirk and she’s also a Facebook adviser for our group. So, you want to Google Mary Barbera talk tools or Mary Barbera mags Kirk. If your child, whatever the age is still using sippy cups, pacifiers, bottles, that all has to be out the window to improve articulation. We want kids to be sipping through straws, drinking out of open water bottles with no spout and then also drinking out of open cups. That’s all going to be better for our articulation. Okay, I’m going to look for live questions. I’m in Canada and currently in the VB bundle. My son is five and the intermediate learner with level two and level three skills, he’s almost conversational, quite hyperlexic anything you suggest to use hyperlexia to my advantage to expand his skills.

Yeah, just get through the intermediate course. Make sure you have a VB-MAPP and he’s, he’s five. So definitely want to have a VB mapped on all three parts. The milestones, the barriers to transition assessment. Also do my intermediate assessment, the self-care checklist and the intraverbal subtests, make a plan based on all of that. So, if he has potty training problems, well that’s a problem because he’s five and you want him included, you know, that is a main major issue. So, you have to assess and then plan and prioritize. So hyperlexia upwards since there with Alex with me, with the, using a script for him, that was very successful. One of the things, you know, I try to tell people is don’t have a keep going with learning to read harder and harder words unless the comprehension is good.

So, my book program bonus video should be, should be helpful and you can have him read the book, but you want to be building in that comprehension. It’s so important. So, if he goes to kindergarten for instance if you can get them to do language for learning or language for thinking, I bought my own language for learning copy years ago for a couple of hundred dollars on eBay. We just need to constantly be improving their language, which is really going to be the most bang for your buck. But we used with Alex there where he was very hyperlexic. I didn’t start working with him until he was sixth grade, unfortunately, because by that time a lot of things became wrote.

I remember an example who’s a really good example to not get too excited about hyperlexia is, it was 9-11 but it was 2005. So, I went in to do my first consultation of Alex and I was told hyperlexia is the ability to read before you can speak. So, it’s a very hyper focus on letters, numbers and reading. But reading a lot of times without the comprehension you need. Okay. So, Alex, its 9- 11, 2005, I think. I go in for my first consultation. Alex is in a learning support room with his teacher and with an aid with an aid. And Alex is reading out loud and he’s reading a passage about nine 11. So, he’s like, and it was a bright sunny day in 2001 September 11th, 2001 it was no clouds around the sky. So, he’s reading fluently the first tower, you know, the plane went into the first tower, blah, blah blah. And then he goes, you know, and, and then he turned around to his aid and he’s like, Alex, keep reading, keep reading. And it’s like, Oh my goodness. Like he has no comprehension of the event of nine 11 planes going into buildings.

It sounds like fun. It sounds like kitty games pretend. I mean, he didn’t even have the concept of pretend versus real. They were trying language for learning. He was up to lesson 50. He had so much nonsense language like this. Alex, keep reading. Can I hop like a kangaroo? Alex, stop throwing the ball. My first day I was like, Oh my God, I – it’s kind of gross. But I was like, it’s like verbal diarrhea. I mean it’s just like constant throughout the day. And so, I told them on the first day, I’m like, you’ve got to stop language for learning. You’ve got to start counting his nonsense language. It was really defective man’s for attention, counted on a clicker. And then instead of just giving me a number for the day, I want you to count it during each period. So, okay, he’s in learning support, reading and he has 50, five-zero, you know, defective mans.

And then I was able to analyze those data. He had 500 a day, 500 of these nonsense words a day. Like he’d say, well, Ms. Mary has a Stripe shirt on, or Ms. Mary has earrings on. He didn’t say, I like your earrings. He said he would just comment constantly. And so, we had to undo all of that in sixth grade. So that’s why I’m so passionate about, I’m really happy Sarah, even though I can’t answer your questions now cause this presentation is just about higher, you know, conversational kids. But you know, I’m so passionate about getting to the little guys and making sure the parents know what to do. So, we need to really make sure that language comprehension is catching up to the reading skills. Otherwise you get a very not capable individual who really can’t be included much because of all the comprehension issues.

Kelsey asked about emotional regulation, things not going a child’s way, changing topics which are covered with the topic game and so emotional regulation and things not going their way. I really think for most of our kids, things not going their way and behavior problems are caused by a language comprehension issue that people have not done dug deep enough. That is my, my thing. And so, knowing a little bit about your boys, Kelsey, I would look very deep into their language abilities and I think it’s always a good idea too to get a standardized speech and language assessment for each child every single year. With this, hopefully the same speech pathologist, if you can, to kind of be an external, making sure your child is really on target. Because they may be talking like a five-year-old and they’re four to you or to the doctor to his regular speech therapist.

But until you really do those in-depth speech therapy assessments, standardized testing, you can have a child that has actually sounds good but there are holes. So that would be my thing. And in terms of things not going their way, I would just make sure they have a lot of structure. Make sure you’re going into it with the child, knowing, okay, what are the expectations? This is the reinforcement; this is the promise reinforcement. And if everything goes well and then sticking to that. So, pronoun reversals in the natural environment, make sure you’re doing pronouns within table time. I do, we do. And my, and your, which is in the intermediate course lesson module seven, I believe. But then also throughout the natural environment, if they say me want a cookie or something like that, which is an error we pick up or, or whatever.

And I know he’s probably having more elaborate pronoun reversals, which you can post exactly what he’s saying. And I might have a different answer within the Facebook group, but if there’s pronoun reversals in the natural environment, one thing I would say is, so say somebody says me want water? So that’s an error. I don’t want to correct that. And I might wait a few seconds, even do this kind of thing. And then say, say it like this, I want water. They say I want water. Right. How do you say it? I want water. Good. You might even want to do in throw in some distractors. Oh, what, what color is this a word? Word. You know, the child can read, what’s this word say? Water. what color is it? Blue. Right. Okay. So, tell me again. And then they say, I want water. So, what I’ve seen with pronoun reversals in the natural environment is people don’t correct the error right.

And they, sometimes you need distractors in there to really get, get it going. Okay. So, what’s the difference between a webbing and sub test and the intraverbal assessment? Okay. So intraverbal assessment is like I showed you with Izzy and Jacob. Where do you sleep? What flies in the sky? What’s inside a balloon? That’s the intraverbal subtest. We don’t want to teach those items. Those are just to give you a general feel in my course. In the bonus video, there is an intraverbal bonus video, which explains all that. And then webbing is when you are fluent with several categories. It’s explained in a module four of the intermediate learner course. That’s where you put everything together. So, you start off, it’s a web. So, you start off with telling me a color. The child says, red. Now my choices, I can say, tell me another color.

Yellow. Or I can say, tell me something that’s red and I can web from that. So, tell me something. Tell me something that’s red. Strawberry. Tell me something else that’s red. A stop sign. Tell me something else that’s red fire truck. Good. A firetruck is a vehicle. The child says vehicle. Right. Tell me another vehicle. Car. Tell me another vehicle. School bus. Good. What color is the school bus? Yellow. Tell me something else that’s yellow, banana. What do you do with a banana? Eat it. Tell me something else you eat. And you could see how these things web and that’s really explained in module four of the intermediate learner course. Great question.

I hope you enjoyed that podcast episode talking about conversational kids or almost conversational kids and how we need to apply the strategies of ABA to help our kids reach their fullest potential. So, if you would like more information about how you can use my approach with these higher functioning kids and kids that are almost conversational, attend a free workshop at marybarbera.com forward slash workshop. If you love this podcast, I would love it if you would leave me a five-star rating and review on Apple podcasts or wherever you’re listening and I hope to see you right here next week.

Thanks for listening to the Turn Autism Around podcast with Dr. Mary Barbera. For more information, visit marybarbera.com.