Teaching mands for information using speech generating devices: A replication and extension

Approximately 30% of individuals diagnosed with autism spectrum disorder (ASD) fail to develop vocal communication and, therefore, use some form of augmentative or alternative communication system. The current study replicates and extends previous research on teaching “Who?” and “Which?” mands for information to 3 young children diagnosed with ASD using a speech generating device. Procedures were evaluated using a multiple baseline across participants design. All participants learned to mand for information and, subsequently, used the information to access preferred items.     

FACILITATING CONVERSATION THROUGH SELF-INITIATED AUGMENTATIVE COMMUNICATION TREATMENT

We examined the conversational skills of 2 adult males with severe motor and speech deficits resulting from cerebral palsy. A multiple baseline design across subjects was used to determine the effectiveness of an intervention strategy designed to teach them to use an augmentative communication system (Touch Talker) independently. The dependent measure was the number of conversation initiations relative to conversation reactions during spontaneous communication across baseline and treatment. The treatment included specific training on using the augmentative system to participate in communication. Once the intervention began, the production of conversation initiations accelerated at a rapid rate. The treatment program was effective in training the subjects to use the augmentative system to increase conversation participation. These results demonstrate that training on the operation of the device alone is not sufficient to ensure improvement in conversation performance, and that it is important to incorporate direct conversational treatment when providing instruction on the use of augmentative communication systems for severely speech-impaired individuals.     

The effects of behavioral skills training on mand training by staff and unprompted vocal mands by children

We evaluated the effects of a training package, including instructions, modeling, rehearsal, and feedback, for training staff members to conduct mand training with children. Experimenters collected data on staff performance on each step of a task analysis of mand training and on unprompted child vocal mands. Training resulted in increases in staff performance in mand training and in unprompted mands by children. We observed replication of these effects across settings for all staff and for 3 of the children.     

ACQUISITION OF MANDS AND TACTS WITH CONCURRENT ECHOIC TRAINING

Previous studies have identified a number of effective teaching procedures to increase verbal behavior in individuals with developmental disabilities. However, few studies have evaluated modifications of treatment procedures when children fail to acquire communication skills. In the present investigation, a 4‐year‐old boy with autism failed to acquire unprompted mands and tacts during mand‐only and tact‐only training. Results indicated that combining echoic training with mand or tact training increased unprompted manding and tacting.     

THE EFFECTS OF THE QUESTION “WHAT DO YOU WANT?” ON MAND TRAINING OUTCOMES OF CHILDREN WITH AUTISM

Mands sometimes are taught using the question “What do you want?” as a supplement to the required features of the mand relation: an establishing operation and a related consequence. Although verbal prompts have been used during mand training, they also may result in undesirable stimulus control. However, no direct empirical evidence exists to support this concern. The purpose of the present study was to compare mand training with and without supplemental questions on acquisition rate and maintenance when those questions were no longer presented. The 2 training conditions did not differ substantially in their outcomes for 2 children with autism.     

Assessment of mand selection for functional communication training packages

We evaluated the effects of training novel and existing mands during functional communication training (FCT) to decrease problem behavior for 2 children. A functional analysis (Phase 1) identified mands for FCT. Phase 2 used distinct stimulus conditions to train novel and existing mands. Phase 3 evaluated allocation of responding within a concurrent-schedules design. When reinforcement for either mand was concurrently available, the children used existing mands more than novel mands, but higher levels of problem behavior occurred with existing mands.     

Effects of foreign mand training on the emergence of foreign tact and listener responses for Chinese-speaking children with autism spectrum disorder

In China, there is an increasing demand for preschool children with autism spectrum disorder (ASD) enrolled in general education to learn English vocabulary. The purpose of this study was to evaluate the effect of foreign mand training in English on the acquisition of mand responses, and the emergence of tact and listener responses for three Chinese-speaking preschool children (boys; 4–5 years of age) with ASD. Echoic-to-mand training was implemented to teach mands in English. The study employed a concurrent multiple-probe design across behaviors. The results of the study indicated that the training was effective in the acquisition of mand responses. Moreover, untaught tacts and listener responses for the same vocabulary emerged without explicit training. Implications for small-group mand training in foreign language acquisition were discussed.     

Effectiveness and acceptability of parent training via telehealth among families around the world

Teaching parents to conduct functional analyses and to implement functional communication training is an efficacious approach for treating socially maintained problem behavior (Derby et al., 1997). Research has found that delivering this assessment and intervention package via telehealth technologies is efficient and acceptable to caregivers in the United States (Wacker et al., 2013b). We replicated this work with families residing in rural and urban areas of eight countries. Two behavior therapists located in the United States conducted appointments in the participants' native languages, using interpreters as needed. Parent‐implemented functional analyses and treatment with functional communication training were highly effective in reducing problem behavior in children diagnosed with autism. Furthermore, parents rated the procedures as acceptable and indicated that the treatment would be effective with their children. These findings indicate that telehealth technologies are a viable option for clinicians to provide behavior analysis services to families around the world.     

Effects consistent with behavioral contrast during a multiple schedule for discrimination training on mands for attention

This study used a multiple schedule to assess the effects of an S+ or S- in the absence of rules on excessive mand rates with three school-aged children with disabilities and assessed possible contrast effects occurring in conjunction with the intervention. Each of the three participants was exposed to the presence or absence of an S- (black baseball cap). When it was worn, mand approach rates decreased for all three participants; conversely, mand rates increased to twice the baseline rates when the experimenter was not wearing the black baseball cap. Generalization probes conducted for one of the three caregivers showed similar changes when the caregiver wore the cap. Results suggest that effects consistent with positive behavioral contrast occurred with all participants.     

A DEMONSTRATION OF INDIVIDUAL PREFERENCE FOR NOVEL MANDS DURING FUNCTIONAL COMMUNICATION TRAINING

Preference for mand topography was evaluated for 2 individuals with developmental disabilities who exhibited problem behavior. The results of a functional analysis showed that each participant's problem behavior was maintained by social reinforcement. Participants were taught two novel mand topographies for the same functional reinforcer, and each proved to be effective in reducing problem behavior. Finally, preference for mand topography was assessed within a concurrent‐schedules design. Results indicated that functional communication training was an effective treatment, regardless of the mand used, and that each participant demonstrated a preference for one mand topography relative to the other.     

Serial functional communication training: Extending serial DRA to mands and problem behavior

Functional communication training (FCT) is commonly used to eliminate problem behavior. Not surprisingly, the efficacy of the intervention depends on fidelity to programmed procedures. For instance, problem behavior is likely to resurge if caregivers fail to reinforce mands during the maintenance stages of FCT. Despite this, recent translational work on arbitrary human responses suggests that incorporating multiple‐mand instruction into a serial‐training format may increase the probability of a recency effect, and a reversion of response resurgence (both desirable outcomes when mands are the most recently reinforced responses prior to extinction). Although promising, this effect has not been replicated with socially significant human behavior. Thus, we compared the relative effect of traditional FCT with that of serial FCT on the resurgence of the problem behavior, and mands, of 2 children. In contrast to previous research, we observed primacy effects for both subjects (i.e., the magnitude of the resurgence of problem behavior was greater than it was for any subsequently trained mand), and mand resurgence never occurred for one subject. Notwithstanding these limitations, the percentage of total responding allocated toward the resurgence of problem behavior was less in the serial FCT component relative to the traditional FCT component, and we observed a reversion of response resurgence for one subject.     

DEVELOPMENT OF SPONTANEOUS MANDING IN LANGUAGE DEFICIENT CHILDREN

Six institutionalized children, aged 7–11, with little or no spontaneous vocal manding, were trained to request food items under appropriate natural conditions when snacks were presented. “I want a” was appropriate when an adult presented food in the playroom. “Out” was appropriate when the items were displayed in the hallway, across a half-door barrier from the child. A sequence of steps was trained, through increasingly naturalistic setting and cuing conditions. The two mands were trained in sequence, not concurrently. To encourage “spontaneous” productions, no vocal cuing was provided by the adult. After criterion performance in each step, several probe sessions were conducted for various cuing conditions, adults, and settings. Probes after imitation training showed no spontaneous manding. Thus, failure of manding was not due to production difficulties. In probes after training for “approximately” natural cues, most children showed little transfer to the natural cues. This implies that training for the specific appropriate cues may often be required. However, good transfer generally occurred across persons, and from training room to playroom. Probes also showed that most children did not use one of the trained mands in the stimulus conditions that were appropriate for the other mand. Thus, adding a second mand did not generally disrupt use of the first. However, significant disruption occurred for two children. Finally, at the end of training, extinction training was given for one mand in one setting. Performance of the other mand was litle affected. In sum, the appropriate form of a mand depends on specific stimulus and setting characteristics, and these characteristics must be considered in training.     

Teaching caregivers to respond safely during agitated states before aggression using simulation training

Individuals who engage in aggression often display precursors or agitated behavior first, and it is important for caregivers to learn how to minimize risk of injury in the event that aggression were to occur. In this study, behavioral skills training was used to teach 4 caregivers of children who engage in aggression to position their body safely and prevent access to dangerous items during agitated states. Confederates were used during all baseline, training, and posttraining sessions to maintain consistency and the safety of the caregivers. All caregivers quickly learned to use these safety skills during agitated periods but not during calm periods with minimal between-session feedback regarding correct responding.     

Mand acquisition across different teaching methodologies

Many children diagnosed with an autism spectrum disorder lack functional independent communication. The current study used a combined multiple‐baseline and alternating‐treatments design to evaluate whether the presence or absence of a verbal prompt (asking a question) during teaching affected independent verbal manding. Two teaching procedures were used to teach specific responses (two per teaching condition) and evaluate if the acquired response, once trained, occurred independently (in the absence of stimuli or supplemental prompts). One student learned more rapidly under the mand training condition whereas the other learned at a similar rate under both conditions. The assessment methodology presented may be beneficial in future practice to determine if one teaching procedure is more effective than the other for a learner.     

Effects of three-step prompting on compliance with caregiver requests

Three-step prompting is a procedure commonly used in behavioral assessments and interventions; however, little research has evaluated the effects of this procedure on increasing children's compliance with caregiver requests. In this study, caregivers of children who demonstrated low levels of compliance were trained to use three-step prompting when presenting task requests to their children. Results indicated that training caregivers to implement this procedure decreased the frequency of caregiver-delivered prompts and increased compliance by the children.     

THE EFFECTS OF PARENT‐IMPLEMENTED PECS TRAINING ON IMPROVISATION OF MANDS BY CHILDREN WITH AUTISM

The present study examined the extent to which mothers were able to train their children, 2 boys with autism, to exchange novel pictures to request items using the picture exchange communication system (PECS). Generalization probes assessing each child's ability to mand for untrained items were conducted throughout conditions. Using a multiple baseline design, results demonstrated that both children improvised by using alternative symbols when the corresponding symbol was unavailable across all symbol categories (colors, shapes, and functions) and that parents can teach their children to use novel pictorial response forms.     

Evaluating the effects of functional communication training in the presence and absence of establishing operations

We conducted functional analyses of aberrant behavior with 4 children with developmental disabilities. We then implemented functional communication training (FCT) by using different mands across two contexts, one in which the establishing operation (EO) that was relevant to the function of aberrant behavior was present and one in which the EO that was relevant to the function of aberrant behavior was absent. The mand used in the EO-present context served the same function as aberrant behavior, and the mand used in the EO-absent context served a different function than the one identified via the functional analysis. In addition, a free-play (control) condition was conducted for all children. Increases in relevant manding were observed in the EO-present context for 3 of the 4 participants. Decreases in aberrant behavior were achieved by the end of the treatment analysis for all 4 participants. Irrelevant mands were rarely observed in the EO-absent context for 3 of the 4 participants. Evaluating the effectiveness of FCT across different contexts allowed a further analysis of manding when the establishing operations were present or absent. The contributions of this study to the understanding of functional equivalence are also discussed.     

The effects of training on caregiver implementation of incidental teaching

A brief training package consisting of modeling, rehearsal, and feedback was evaluated to train caregivers to use incidental teaching to teach 3 children with autism to request an item or activity. The training package improved correct implementation of the incidental teaching procedure by caregivers. In addition, probes indicated that caregivers could apply these skills to teach the child an additional skill.     

Functional analysis and treatment of problem behavior related to mands for rearrangement

This study is a systematic replication of a functional analysis (FA) of the relation between mands and problem behavior. We extended treatment approaches for this problem behavior function, and describe the treatment of problem behavior related to mands for rearrangement demonstrated by a 12‐year‐old girl with autism spectrum disorder and Smith‐Magenis syndrome. The mands consisted of requests for others to change their body positioning or proximity, or rearrange items back to their original position. An FA confirmed the relation between problem behavior and mand compliance, and functional communication training with extinction decreased problem behavior and increased functional communication responses. Problem behavior remained low as gradually longer nonreinforcement periods were introduced using a multiple schedule.