Some Techniques of Behavior Modification with an Autistic Child

S was a 7-yr.-old boy diagnosed as autistic. His speech was characterized by echolalia, pronoun reversals, and an inability to answer questions. He typically roamed around the therapy room, gesturing, and repeating snatches of conversation, TV commercials, etc. Eye contacts and social behaviors were rare. In spite of being untestable on conventional psychometric devices, he was a precocious reader with a variety of materials; however, because of deviant speech there was no evidence that he comprehended written materials. Speech training focused on establishing verbal responses to questions and was carried out in a manner similar to previous studies (Wolf, Risley, & Mees, 1964; Risley & Wolf, 1967). A question was asked and before he could inappropriately mimic the question, the answer was prompted. He was reinforced with Mas for correct imitations of the prompt. Prompts were gradually faded and a€ter 14 sessions (15 min. each) he was acquiring 10 new responses per session with usually only a single prompt per question. By the 22nd session, over 100 correct answers had been developed. Reading seemed an aid to developing appropriate speech. Two sets of five questions each were typed on separate pages with the correct answer following each question. One set was read to S and he was prompted orally in the usual manner. The other set was given to him to read. He was never prompted on this set. These questions were asked during subsequent sessions, and it was found that new responses were acquired by reading but at a somewhat slower rate than by oral prompting. Once acquired, however, retention for items learned by the two approaches was comparable. Attempts were also made to modify S',s tendency to reverse pronouns. Articles of his clothing were touched and he was asked, Whose is this?" He was prompted to say "mine." Then the same items of the therapist's clothing were touched, the same question asked, and he was prompted to say "yours." In spite of extensive training in this area, correct pronoun use was never developed. Within-session alternations between "yours" and "mine" were discontinued in favor of a single concept per session. On tasks requiring sustained arrention or the following of rules, S was unable to withhold responses until the apptopriate time. For example, on the Peabody Picture Vocabulary Test, he would point to and name each picture on the page without waiting for the examiner to name the one stimulus picture to which he should respond. By rapidly naming each picture on the page while having S point to each, the pointing response was brought under control while allowing S to point to all of the pictures. Once this was accomplished, the number of pictures named on each page was reduced gradually until only one picture was named, as in the standard procedure. Training required one session. In order to increase generalization, therapy sessions were held in several different rooms and different people were involved in asking S questions. Having his current repertoire in written form for distribution to persons other than the therapist greatly facilitated generalization training. Anorher technique involved phone conversations held on the interoffice system and later at home. In addition, S's family was trained to extend these techniques into the home. Later in therapy, new responses were ofren an elaboration or extension of earlier, well-established responses. During 50 twice-weekly training sessions, marked changes in social behavior occurred. Eye contacts were frequent and sustained and the bulk of S's time was spent in close proximity to the therapist, often asking the same questions he had previously learned. The therapist would answer these questions and follow with another question. These "conversations" and other spontaneous appropriate verbalizations were always responded to with tangible rewards and/or attention and have greatly increased over the course of therapy. As social behaviors have been developed, time-out from social attention has worked effectively to control disruptive behavior. Both the time-out and reading procedures, however, were effective only after S had acquired specific prerequisite skills. REFERENCES