#011: How to Teach Conversational Skills to Children with Autism

I cannot over-emphasize the importance of verbal language skills. In this episode, I focus on how to teach your child conversational skills, why it’s so important, plus share strategies that I’ve developed over the course of two decades.

Verbal communication is the easiest form of communication between a child and parent or professional and is known to decrease problem behaviors and increase desirable results. I’m all about helping your child or client lead their safest life and reach their fullest potential—being able to answer and ask questions is a great way to help them do just that. It’s imperative that your child can answer questions such as: what is your first name? what is your last name? what is your address?

My son Lucas was diagnosed with autism one day before his third birthday and is considered an intermediate learner. Since that diagnosis, I’ve been very involved with intermediate teachings and what I can do to help not only Lucas but other children who may be labeled intermediate learners. I’m passionate about this topic because I’ve seen too many professionals not be adequately equipped to teach intermediate learners the skills they need to communicate.

Trying to teach a child conversational skills is not an easy task, but you can’t let problem behaviors stand in your way! Consistency is key. Intermediate learners don’t just get “stuck” with language; they always have the room to make great strides and improve. Don’t let yourself become discouraged and give up; stay focused on your goals and never lose hope!

Mentioned in this episode:

marybarbera.com/workshops
marybarbera.com/abaspeech
—Verbal Behavior, by BF Skinner
VB-MAPP
One Page Assessment

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Transcript

You’re listening to the Turn Autism Around podcast, episode number 11. In today’s podcast I’m discussing how to teach conversational skills to children with autism. And before we get started, I’d like to give a shout out to someone who left an iTunes review, a five star rating and a review, and this person’s name is Hope Luke, and she said this podcast is awesome. Mary has so many ideas and strategies that help children with delays and autism. It helped my son so much so thank you for that great review. If you haven’t subscribed to my podcast on iTunes and left me a rating and review, I would love it if you would go there and maybe next time I’ll give you a shout out. So let’s get started with today’s episode.

Welcome to the Turn Autism Around podcast 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.

Welcome back to the Turn Autism Around podcast, episode number 11, and I am your host, Dr. Mary Barbera. I am thrilled that you’re here and I hope that you listened to at least some of the first 10 podcast episodes. If you haven’t, you may want to check those out. The last two podcast episodes were all about speech and language and today’s episode will also be on a similar topic. So in episode number nine I discussed some strategies to get kids from non-vocal to vocal, and get them talking or talking a little bit more. And last week we had a special interview with Rose Marie Griffin who is both an SLP as well as a behavior analyst and she gave us a lot of good tips as well. So today is all about how to teach conversational skills.

So whether your child is talking at all or your clients are pretty close to conversation. This is an important topic because a lot of kids seem to get stuck as talking but not conversational. I call these kids intermediate learners and the term intermediate learner can be a little bit subjective in the autism and verbal behavior world. But my definition of an intermediate learner is usually a level two or three VB-MAPP learner. And we’re going to get more into that in a second. But before we do, I do want to tell you that this is sponsored by my free online workshops for both parents and professionals. So if you want to sign up, you can go to Marybarbera.com/workshops and you’ll be able to pick the workshop that best fits your need and it’s totally free. I first got interested in teaching intermediate learners and teaching conversational skills because Lucas, my son, who is now 22 years old, has been an intermediate learner for most of his life.

He was diagnosed one day before his third birthday and probably when he was three and four when he was just learning to talk, or we were just learning how to gain what I call echoic control and teach him to talk. Um, he was probably an early learner, but starting at about age five, he was what I would consider an intermediate learner, but he was stuck for a lot of his life with language because they’re not a lot of people in the whole world that know how to teach intermediate learners and know how to teach advanced language skills to kids with autism. When I say advanced language skills, I’m talking about things like prepositions and pronouns and intraverbals webbing. Teaching kids academics like reading, math and writing, self-care skills, leisure skills, pre-vocational skills. They’re…professionals aren’t very good at teaching these things in kids with moderate severe autism because there’s usually problem behaviors that get in the way not responding, conditional discrimination errors, and just a host of other things and attention, self-stimulatory behavior.

And so I always been interested in how I can best teach Lucas and then how I can best teach a host of other kids with autism who happened to also be intermediate learners. With the Pennsylvania verbal behavior project where I worked for seven years from 2003 to 2010, we spent quite a bit of time learning from the experts like Dr. Mark Sundberg and Dr. Vincent Carbone. We went up to Dr. Carbone’s clinic in New York several times for two day workshops and it was great learning experience. And I vividly remember going up to Dr. Carbone at some point in the early 2000s, I’m not even sure if I was a BCBA or not at that point, but I remember going up to him and saying, don’t you think intermediate learners just get stuck with language and there’s nothing you can do? And I remember him looking at me like, no that is not true.

If a, if an intermediate learner is stuck or an early learner is stuck, it’s because you haven’t figured out how to teach them. And so we just kind of went back to the drawing board, and I use the analogy of like peeling back the onion and seeing what prerequisite skills are missing, what, what am I missing? The reinforcements not high enough. I need to bring this down a notch. And over time I learned how to teach Lucas and then went on to do dozens of case studies and dozens of… worked with dozens if not hundreds of intermediate learners where I tried out many of my procedures.

But today we’re not going to be able to cover every intermediate procedure and the trials and tribulations with all of that. And perhaps future podcasts we can go more in depth with one or more of those intermediate learner topics.

But today I just want to cover conversation because I think, as a parent of a son with autism, I know and as a professional too, I know that parents really want kids to first, they want their child to talk. You know there’s this longing for, if my child could just say mommy, if they could just say I love you. If they could just talk. And that is a huge goal for many families. And then once kids do talk, then there’s another longing and another big desire for kids to become conversational, for kids to be able to answer like how was your day? What did you do at school today? To be able to tell you if they’re in pain, what hurts, describe the pain. All of those, those language skills that are a lot more complex then saying I love you. So that’s why I wanted to break this down in this podcast episode and hopefully it won’t be too confusing because whenever you talk about any intermediate topic, especially conversation, it is a little bit tricky.

So if we think about conversation, let’s just talk about a conversation where I would go to a conference where I didn’t know anybody and I would sit down next to somebody and I would start a conversation. Now I can, I have a couple choices to start a conversation. I can ask a question, like I could introduce myself. Hi, I’m Mary. What’s your name? I could ask, have you ever been here? I could ask. Um, do you know what time this program starts? Have you ever seen the speaker present before? You know, those kind of questions. They are a little bit direct. And if I wasn’t feeling too confident, I might actually start with just describing the room or the environment. Like it’s a beautiful sunny day outside or it’s really warm in here or it’s really cold in this room. I’m glad I brought a jacket. That’s a pretty blouse you have on.

So those are the ways that I would start a conversation. Now when I asked the question, what’s your name? Have you ever been here before? Where are you from? Those are all advanced mands. When I say mands, I’m talking about requests. Mands is a term that was coined by BF Skinner in 1957 in his book called Verbal Behavior. I didn’t make up these terms. So we have advanced mands, which are questions. We have advanced tax, which are when the, the examples when I was describing the room or the temperature or the way things look or feel, those are advanced tax.

And then the person who is sitting next to me hopefully would answer the question or pick up on my cue that I wanted to chat, and turn towards me and start asking me questions after answering the question I asked her. So answering my question, what’s your name? And she says, Suzy, that answer is an intraverbals. It’s quite an elaborate or complex advanced intraverbals. So all conversation is, is a mixture of questions, advanced mands and answers, advanced intraverbals. And then we throw in there the advanced tax or describing our situation. And that’s basically what makes up a conversation.

We can’t teach a child conversational skills unless they have basic language under their belt. Like basic mands basic tax and basic intraverbals, which I’m going to talk to you about in the next part of this episode.

So teaching, teaching basic or advanced mands, tax, and intraverbals do not happen overnight. And in many children and adults with autism, with severe autism who are, don’t have a lot of language, real back and forth conversational conversations don’t happen. But we, it’s still important to try to teach them as much as possible to get them functioning at their fullest potential.

And when I said before that BF Skinner in 1957 wrote a book called Verbal Behavior and he’s the one that coined the mands, the tax, and the intraverbals. That book Verbal Behavior was not about autism. It was not about teaching people with developmental disabilities, it was about how language is a behavior. And it was an analysis of language. And there’s a lot of explanations in that book about teaching barring languages, teaching a second language for instance. And I think it’s also good to use that example of the conversation at a conference to talk about breaking things down. But it’s also good if we think about conversations in terms of going to another country and not knowing the language. So say I was going to Japan tomorrow and I know no Japanese words, then I would need to learn… What words would I need to learn?

I would not be learning anything that wasn’t truly functional. I would be learning the things that I might want or need. So I might be learning the words for eat, hotel, taxi, drink, water, those kinds of words. And that’s where we have to start with kids. So it’s not going to happen overnight, but it’s worth teaching kids as many conversational skills that we can in hopes that they will eventually become conversational.

There’s many children that I know that have autism and are now teenagers learning to drive, go to college. They are fully conversational. It can happen. Even some of my young kids are in elementary school now. My young clients, they’re in elementary school, they are conversational. It took us years of systematic programming to help them be conversational, but now they are and for some kids and young adults like Lucas who has more significant impairment, we can teach him some conversational skills but it may never be truly conversational.

Lucas can request his wants and needs is awesome. He can request help. He can even ask me some questions like what’s in the bag? Or if I say we’re going somewhere fun, he can say where and he wants to know the answer. He can tell me a little bit about his day or a little bit about the trip that he took to three different activities and when he comes home he can tell me what he did, what he ate, who he saw, who he was with; those sorts of things. He can answer a lot of questions about safety, like his… He can answer his name, his last name, the spelling of his last name. He can answer his, his phone number, his address and those sorts of things. But for Lucas, we don’t really have those back and forth conversations on a variety of topics, at least at this point.

But as I said, for many clients we can get there no matter where your child or client is at though the best thing to do when we’re talking about teaching conversational skills is we need to assess where they’re at right now. In addition to a one page assessment, which I talked about in episode number nine I’m going to include in the show notes as well so you can get it at marybarbera.com/ 11, you’re going to want to do that one page assessment. I would highly recommend you do a more in depth assessment too such as the VB-MAPP, which is going to really help you tease out some of the strengths and weaknesses of your child or client. And in addition, since we’re talking about conversational skills, I would encourage you to do the intraverbals subtest also created by Dr. Mark Sundberg and I’ll put that in the show notes as well.

So the intraverbals subtest is a great tool. It includes eight groups of 10 questions each, and I highly recommend this tool to help you figure out where your child is at with the answering part of WH questions. So in group one of this eight groups of questions, it would be really simple questions like, a kitty cat says, and you would just leave that blank and the child would hopefully say meow. It might have twinkle twinkle little, and the child would fill in star. Now if you’re in another country speaking a different language, you can adapt this tool and those are the really easy questions in group one. Then the questions systematically get harder and by group eight, which is the last group of questions, they’ll be questions like, what’s inside a balloon and, why do we get gas in our car, which are complex.

And even typically developing four and five year olds might stumble on a few. But in general we can kind of see a child’s conversational skills by giving this assessment and seeing where they answer without any visual presence. We need to teach a child based on that assessment, based on all of our assessments. But we want to make sure that we don’t teach to the test. We don’t want to take that intraverbal assessment and make those the targets because teaching, asking and answering converse, eh, these conversational skills, teaching, asking and answering questions is very complex. And if you don’t know how to systematically teach those skills, you might end up making a child’s language even worse. So we want to always start with the most basic mands to teach those first. Make sure the child can mand four items, in sight and out of sight.

Make sure the child can mand for actions. Answer yes and no. Do you want ketchup on your hot dog? Those sorts of yes and no questions. We want to make sure that they can manned for help, mand for attention. And finally, mand for information, we also want to teach the child at the same time to tact or to label things in their environment. And finally, we are going to have to teach intraverbal responding as well. And this is always the hardest operant, the intraverbals operate. Whether you’re talking about children with autism or you’re talking about me learning a foreign language. So we want to do this very systematically as well. I’ve heard Dr. Mark Sundberg present many, many times and he gives the analogy like when you ask someone, what do you wear to the beach versus what do you take to the beach? You just change one word and it changes the whole answer.

So this is important to know that it’s not just a matter of answering questions, it’s also questions that get harder and harder. So we might start out with the child answering, what do you eat? Okay, they can get that. But then when we make the question harder, like what do you eat for lunch versus what do you eat for breakfast? Those are two different classes of responses. It makes it harder. Then what do you eat for breakfast that’s hot or warm now that makes it even harder. And then if we throw in negation, like what do you eat for breakfast that’s warm that you don’t like, or what is your brother ate for breakfast that’s warm that you don’t like? You know, like it can get so complex that our children with autism and language problems tend to fall apart in terms of answering these questions and we have to find out what level they’re at so that we can teach them and they can be successful.

So obviously in this short podcast we’re not going to be able to cover this in depth, uh, how to teach the intraverbals, which are, are very, very complex. So you can again go to free workshops at marybarbera.com/workshop. I’ll kind of wrap it up with a story.

I was in a classroom many years ago and this teacher told me that she just got a new student in her class, and that he was quote unquote high functioning and his name was Johnny. So I said, oh great, let me go meet him. So I went over and I said, hi, uh hey buddy, what’s your name? And he said, what’s your name back. And I thought that was strange. I mean the teacher already told me what his name was, but I wanted to see if he could even answer the question, what’s your name? Which is a pretty easy question. It’s like in group two or three of the verbal sub tests.

And then I asked him how old he was or what flies in the sky and he started saying three, two, one blast off and made like a rocket noise. So somebody’s interpretation of quote unquote high functioning, you know, maybe way different than what is actually the strengths and needs of each child. So I did do episode number four is all about high functioning versus low functioning. But I do want to just remind you that it’s not a matter of putting somebody into a box or classifying them as high functioning or low functioning. It’s literally like looking at, can they ask questions, can they answer questions, how elaborate can the questions get before they can no longer answer them. And then learning techniques to help each child learn these important conversational skills. And even if you can’t get full conversational skills, it is always a great idea to help the child request mand for things, mand for actions, mand for your help, when there’s a problem, learn to tell you when they are having pain.

Learn to ask and answer questions is always going to be a great thing because part of my desire is for each child and client to reach their fullest potential and to be as safe as possible, and we can get them to be safer by having them answer questions about their address and their phone number and their name and their last name and those sorts of things. So we want them to be safe as possible, as independent as possible and as happy as possible. And I think teaching children conversational skills is one great way to get them to reach their fullest potential.

I hope you enjoyed this episode of the Turn Autism Around podcast. For more information about how you can download that intraverbals assessment, my free one page assessment or get to the free workshop to learn more, you can go on marybarbera.com/11 and I hope that you tune in next week for another episode of the Turn Autism Around podcast. Thanks again for listening.

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

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