Participant
A. is a 3 years and 6 months old child diagnosed with autism. At the beginning of the ABA intervention, A. had some favourite activities, understood some simple instructions, had the ability to orient himself towards the adult and initiate the interaction with him using looks and smiles when he wanted to share an emotion or an experience. A. was not using words and although he could understand the meaning of some gestures (for example, the gesture of waiting, coming, following pointing, stopping an activity), he was not using the gestures to communicate in turn.
A. did not have in his repertoire behaviours through which to express his needs and desires. When he wanted a specific object that was visible, but that he could not reach, he used to take the adult’s hand and look in the direction in which the object was located. The adult then tried to guess what exactly the child wanted and, through trial and error, managed to find out and offer it. If A. wanted to get an object that was in the adult’s hand, he tried to get it by snatching it most of the time.
Objective
Our objective with A. was to teach him to ask for what he wants when the objects were not within his reach, using the gesture of pointing with a finger towards the desired activity or item.
Requests or mands arise as a result of special environmental conditions and describe a person’s initiatives to communicate his needs and desires to someone else. Requests are more likely to occur in conditions of deprivation and are less likely to occur in a state of satiety. In requests, the reward is that I get exactly what I asked for. The purpose of requests is to teach the child how to improve his life day by day by satisfying his desires.
From birth, requests help the little one to control the environment. For example, a baby cries when it is hungry or unwell and receives food or attention as a result of crying. As the child grows, the application methods differentiate and become more complex. But children quickly learn from interactions with their parents and other people around them that certain behaviours bring them specific consequences.
Teaching mands brings the challenge of keeping children’s motivation high. A child who has few preferences or weak interests will not be motivated to make requests easily. Constantly discovering new game ideas and potential rewards increases the chances of turning in more requests in the same session. As a rule, requests are taught by first targeting eye contact as a form of request, then gestures, then vocal requests. In general, the child quickly learns to make requests because they directly respond to his wishes.
Procedure
To implement the procedure, we chose A’s most favourite toys or activities. A. likes the most to see vegetables or fruits drawn by the adult with the marker on the sheet or board, to pour a lot of coloured balls over him, to wave over him a coloured blanket, to paint, play with sand and hold Minnie or Mickey in his hand. In the initial training sessions we used as activities the drawing of vegetables and fruits, the coloured blanket, the coloured balls and Mickey.
The training sessions were done each day, 2 times per day, in one room. The duration of one session was 30 minutes. The intervention was conducted by the child’s therapists.
At the beginning of the session, the therapist made sure that A.’s favourite objects were in his possession. A. could see them, but could not access them. In order to start the training on mands, the therapist first offered access to the reward for 15-30 seconds. In this way, he checked to what extent the child was motivated by the respective item. If A. showed that he is not interested in the object, then the adult would put the item on the shelf and tried to test a new favourite object. If A. showed that he was interested in the object (for example, he approached the item, he tried to pull it off, he smiled or laughed at the sight of it), then the adult concluded that there was a motivation present and started teaching.
The therapist waited for A. to initiate his request to get the object and, at the moment when A. approached, looked smiling or tried to reach for the object, the adult waited for the little one to make visual contact with him and then helped him to point with the finger to the desired object. As soon as the child managed to indicate what he wanted, the adult offered him access to the object or activity for 30-45 seconds.
For example, when A. smiled and approached the adult at the sight of the coloured balls, the adult waited for A. to look at him and then helped him make the gesture of pointing with his finger to the box full of balls. When A. showed the box, the therapist poured the balls over him and said the name of the activity to promote language: “balls”. After 30-45 seconds of play, the therapist took back the box and repeated the opportunity for learning as long as the motivation was still present, for another 5 trials.
After 6 trials, the therapist tried to promote another preferred activity. For example, he took Mickey and offered free access to the child in order to see if the motivation was present. When A. smiled and approached the adult at the sight of Mickey, the adult waited for A. to look at him and then helped him make the gesture of pointing his finger at Mickey. When A. showed, the therapist offered access to play with Mickey for 30-45 seconds and promoted language: “Mickey”. And so on for another 5 trials, as long as the motivation was still present. In other words, the adult showed A. how he can obtain his preferred toys by pointing. In all teaching opportunities, the adult remained at a distance of 1-2 m from the child, facing him.
During the sessions that followed, the adult withdrew his physical help until the child demonstrated that he could indicate what he wanted independently.
If A. answered incorrectly, the adult did not deliver the reinforcer. Then he left a 10-second break until the start of the next trial and then he repeated the learning opportunity, helping the child to point to the object.
The therapists also mixed opportunities for the target behaviour with offering free access to the reinforcement in order to keep the child engaged.
Results and discussion
A. needed 13 sessions to learn to ask the adult to draw vegetables and fruits, the coloured blanket, the coloured balls and Mickey. He demonstrated that his responses were independent and in discrimination. After demonstrating these results for these specific items, a probe was made in order to test A.’s ability to ask for the desired objects in general. The therapist used three new activities for which A. was not trained (painting, playing with sand and Minnie). He exposed A. to them in the same way he exposed him to the learned items, the only difference being that this time the therapist did not provide a support for the response.
A. demonstrated that he can answer correctly in these three new situations as well. The next step for the established objective was to check if A. passes the generalisation test. A. showed that he can keep learning in environments different from the training environment, as naturally as possible (for example, at home, in the store, at grandparents). Also, A. continued to show that he can ask for untaught items intensively using pointing and he maintained his abilities to ask for preferred activities even after three weeks passed from the training session.
