Using stimulus-stimulus pairing and direct reinforcement to teach vocal verbal behavior to young children with autism

Assessing the Effects of Observational Conditioning and Response-Contingent Pairing on the Vocalizations of Children With Autism Spectrum Disorder

Children with autism spectrum disorder (ASD) often display impairments in communication, such as limited echoic behavior, few vocal-verbal responses, and a lack of functional communication. One potential way to foster the acquisition of vocal responses in individuals with disabilities is by conditioning vocalizations as reinforcers. Conditioning procedures include stimulus-stimulus pairing, response-contingent pairing (RCP), operant discrimination training, and observational conditioning (OC). However, previous research has not evaluated whether OC can be used to condition vocalizations as reinforcers. The current study assessed whether two conditioning procedures, RCP and OC, were effective in conditioning vocalizations as a reinforcer and also evaluated their effect on the rate of vocalizations. Participants included three children with ASD, ages 5-10 years old. During the conditioning phase, rates of vocalizations during the RCP and OC conditions and a control condition were compared within an adapted alternating-treatments design. Reinforcer assessments were completed in a multielement design, pre- and postconditioning, to assess whether the target vocalizations acquired reinforcing properties. A conditioning effect and an increase in the rate of vocalizations were observed for two of the three participants; however, the conditioning effect was minor for one participant. Overall, the results of this study indicate both the RCP and OC procedures may be beneficial in increasing vocalizations for some children and could be incorporated into clinical programs and further explored in future research.

Comparing Skill Acquisition Under Different Stimulus Set Sizes With Adolescents With Autism Spectrum Disorder: A Replication

A number of variables may influence the effectiveness and efficiency of skill acquisition. One variable that may be important is set size. The current study replicated and extended Kodak et al. (2020, "A Comparison of Stimulus Set Size on Tact Training for Children With Autism Spectrum Disorder," Journal of Applied Behavior Analysis, 53(1), 265-283) by evaluating the stimulus set size that led to the most efficient skill acquisition for 2 adolescents with autism spectrum disorder. More specifically, we evaluated tact acquisition in stimulus set sizes of 3, 6, and 12. The set sizes of 3 and 6 stimuli were associated with the most efficient acquisition, whereas the set size of 12 stimuli was not.

The Use of Prompts and Precision Teaching to Address Speech Sound Disorders in a 17-Year-Old Girl With Autism

Precision teaching is a measurement system that uses frequency as its basic data and plots those data on a standard celeration chart for practitioners to make decisions (Maloney, 1998). Kay, a 17-year-old girl with autism spectrum disorder and profound speech sound disorder, participated in this multiple-baseline across-behaviors study. The syllables "thu," "fu," and "cu" were targeted for higher frequencies of correct echoic responding in isolation. Lip-tongue-teeth position prompts, frequency building (Fabrizio & Moors, 2003, European Journal of Behavior Analysis, 4(1-2), 23-36), and feedback were used in brief timed practice trials for the first 2 skills. Priming (Cihon et al., 2017) was also added to the third syllable. The frequency of correct responses accelerated from low levels in baseline to a frequency aim of 60 per minute or higher, with intervention for all 3 targets. The accuracy of her articulation with 30 functional words with the component consonant sounds was measured and showed significant improvements from baseline to postintervention. The outcomes representing fluent performance were also achieved. The implications of training for fluency of syllables on word speech are discussed.

Translations in Stimulus-Stimulus Pairing: Autoshaping of Learner Vocalizations

Stimulus-stimulus pairing (SSP) is a procedure used by behavior analysis practitioners that capitalizes on respondent conditioning processes to elicit vocalizations. These procedures usually are implemented only after other, more customary methods (e.g., standard echoic training via modeling) have been exhausted. Unfortunately, SSP itself has mixed research support, probably because certain as-yet-unidentified procedural variations are more effective than others. Even when SSP produces (or increases) vocalizations, its effects can be short-lived. Although specific features of SSP differ across published accounts, fundamental characteristics include presentation of a vocal stimulus proximal with presentation of a preferred item. In the present article, we draw parallels between SSP procedures and autoshaping, review factors shown to affect autoshaping, and interpret autoshaping research for suggested SSP tests and applications. We then call for extended use and reporting of SSP in behavior-analytic treatments. Finally, three bridges created by this article are identified: basic-applied, respondent-operant, and behavior analysis with other sciences.

Behavioral Interventions to Treat Speech Sound Disorders in Children With Autism

Children with autism are at a higher risk of being affected by speech disorders and often require remedial intervention. Eikeseth and Nesset (Journal of Applied Behavior Analysis, 36(3), 325-337, 2003) used sufficient-response exemplar training of vocal imitation in conjunction with prompting, chaining, and shaping procedures to successfully teach 2 typically developing children to articulate several Norwegian words with blends. The present study extends and adapts these procedures to children with autism. Participants were TA, an 11-year-old boy, and KS, a 15-year-old girl, both with autism and speech sound disorders. For each participant, 3 sets of 10 words with specific blends in the initial position were targeted for training. Vocal imitation training with within-stimulus prompts was used for both participants. For KS, lip-tongue-teeth position prompts and chaining were added during the training of certain words. A multiple-baseline across-behaviors (word sets with target blends) design demonstrated improvement in the articulation of trained words and generalization of correct articulation to untrained words with both participants. The findings suggest that speech sound disorders in children with autism can be addressed with behavioral interventions.

An investigation of the effects of a parent delivered stimulus-stimulus pairing intervention on vocalizations of two children with Autism Spectrum Disorder

Communication deficits in children with Autism Spectrum Disorder (ASD) can manifest in a myriad of lifelong social and educational challenges. Many children with ASD fail to learn vocal verbal behavior and may require intensive individualized intervention to learn early verbal operants. The current research aimed to evaluate the effects of a parent delivered stimulus-stimulus pairing (SSP) procedure on target vocalizations of two young children with ASD who did not present with vocal verbal behavior. Results indicated the intervention was successful in increasing the frequency of the target vocalizations for both participants. Social validity results indicated that parents were satisfied with the intervention and their own implementation of these procedures. These results are discussed in terms of their implications for parent delivered interventions.

Empirical Application of Skinner's Verbal Behavior to Interventions for Children with Autism: A Review

Sundberg and Michael (2011) reviewed the contributions of Skinner's (1957) Verbal Behavior to the treatment of language delays in children with autism spectrum disorder (ASD) and discussed several aspects of interventions, including mand training, intraverbal repertoire development, and the importance of using Skinner's taxonomy of verbal behavior in the clinical context. In this article, we provide an update of Sundberg and Michael's review and expand on some discussion topics. We conducted a systematic review of studies that focused on Skinner's verbal operants in interventions for children with ASD that were published from 2001 to 2017 and discussed the findings in terms of journal source, frequency, and type of verbal operant studied.

An Assessment of Three Procedures to Teach Echoic Responding

The research literature has revealed mixed outcomes on various procedures for increasing vocalizations and echoic responding in persons with disabilities (Miguel, Carr, & Michael The Analysis of Verbal Behavior, 18, 3-13, 2002; Stock, Schulze, & Mirenda The Analysis of Verbal Behavior, 24, 123-133, 2008). We examined the efficacy of an assessment procedure for identifying the most effective echoic teaching procedure to six students diagnosed autism spectrum disorder (ASD) and other developmental delays. The assessment procedure included a within-participant comparison of vocal imitation training (VIT), stimulus-stimulus pairing (SSP), and a mand-model procedure (MM). A functional analysis of the responses was conducted to determine whether responding was functionally an echoic or a mand. The results indicated that the assessment was effective in identifying a teaching procedure for five out of the six participants and that responding was established under echoic control. These outcomes support the efficacy of this assessment procedure for identifying effective echoic teaching procedures.

Inducing Novel Vocalizations by Conditioning Speech Sounds as Reinforcers

Automatic reinforcement by response-produced auditory stimuli has long been hypothesized to play a role in the vocal development of infants. Clinicians and researchers have translated this idea into stimulus pairing interventions intended to increase novel vocalizations of nonverbal children with autism and other developmental disabilities by conditioning speech sounds as reinforcers. A number of studies have demonstrated positive effects of stimulus pairing procedures, but negative results have also been reported in the literature. This article provides a brief review of the existing literature on stimulus pairing procedures and a discussion of alternative procedures that may serve to establish speech sounds as reinforcers. Directions for future research are discussed and recommendations provided to clinicians.

Stimulus-Stimulus Pairing to Increase Vocalizations in Children with Language Delays: a Review

Stimulus-stimulus pairing (SSP) is a procedure used to increase vocalizations in children with significant language delays. However, results from studies that have examined the effectiveness of SSP have been discrepant. The following review of the literature summarizes the results from 13 experiments published between 1996 and 2014 that used this procedure with children with language delays. Studies were analyzed across various participant and procedural variables, and an effect size estimate (nonoverlap of all pairs) was calculated for a portion of the participants in the studies reviewed. Results indicated an overall moderate intervention effect for SSP of speech sounds. Recommendations are provided for future researchers about information to report and potential avenues for future studies.

Stimulus-Stimulus Pairing of Vocalizations: A Systematic Replication

The current study replicated an enhanced stimulus-stimulus pairing (SSP) procedure used by Esch et al. (Journal of Applied Behavior Analysis 42: 42-225, 2009) for increasing vocalizations in children with autism. The enhanced SSP procedure consisted of pairing target vocalizations with high-preference items, interspersed target and nontarget trials, an observing response, and the presentation of the vocalizations in "motherese" speech. Results showed substantial increases in target vocalizations above baseline levels and above nontarget vocalizations for two of three participants.

Three myths from the language acquisition literature

THREE POPULAR ASSERTIONS HAVE HINDERED THE PROMOTION OF AN EMPIRICIST APPROACH TO LANGUAGE ACQUISITION: (a) that Brown and Hanlon (1970) claimed to offer data that parents do not reinforce their children's grammaticality; (b) that Brown and Hanlon also claimed to offer data that parents do not provide negative evidence (i.e., corrective feedback) for ungrammaticality; and (c) that Gold (1967) claimed to offer a formal proof showing that, without negative evidence, a child cannot acquire a language solely from environmental input. In this paper I offer introductory comments on the nature-nurture distinction (including interactionism, and the nativists' claim to have found a gene for language). Next I debunk the three aforementioned assertions by arguing that the authors (Brown & Hanlon; Gold) never made the claims attributed to them; review evidence on the role of reinforcement and corrective feedback in language acquisition; and offer some concluding comments.

An evaluation of the number of presentations of target sounds during stimulus-stimulus pairing trials

We evaluated the differential effects of 2 variations of a stimulus-stimulus pairing procedure on the vocalizations of 2 children with autism. For both participants, presenting 1 sound per pairing trial resulted in a higher rate of vocalizations than 3 sounds per pairing trial.

Advancing imitation and requesting skills in toddlers with Down syndrome

Drawing upon information about the Down syndrome behavioral phenotype and empirically based intervention strategies, we examined intervention addressing early communication impairments in young children with Down syndrome. Intervention involved multiple opportunities, shaping, prompting, and reinforcement to address both verbal imitation and requesting. Intervention also incorporated the relative strengths in social development characteristic of the Down syndrome behavioral phenotype by focusing on a more social request prior to addressing the more impaired instrumental request, as well as incorporating social consequences. Three of the four toddlers with Down syndrome were taught verbal imitation skills, two of whom generalized to novel sounds. All four toddlers with Down syndrome acquired requesting skills in the form of gaze shifting and vocalizing; three were also taught verbal approximations of requesting words (e.g., "mm" for "more") using imitative prompts. These results contribute to the small, but growing, literature demonstrating behavior analytic interventions informed by an understanding of the Down syndrome behavioral phenotype.

Analyzing stimulus-stimulus pairing effects on preferences for speech sounds

Several studies have demonstrated effects of stimulus-stimulus pairing (SSP) on children's vocalizations, but numerous treatment failures have also been reported. The present study attempted to isolate procedural variables related to failures of SSP to condition speech sounds as reinforcers. Three boys diagnosed with autism-spectrum disorders participated. Phase 1 was designed to assess SSP effects on production of auditory stimuli via button pressing. When SSP failed to produce a preference for the target stimulus, we instituted a series of procedural manipulations intended to address potential reasons for failure. One participant preferred the target stimulus when given the opportunity to select preferred items for pairing prior to each session, but a subsequent reversal attempt produced ambiguous results. Two participants showed no consistent preference in Phase 1 and underwent a within-session reinforcer evaluation in Phase 2, in which alternative controlling variables were demonstrated by delivering preferred stimuli contingent on button pressing.

New directions in behavioral treatment of autism spectrum disorders

PURPOSE OF REVIEW

The review explores current trends in the behavioral intervention literature for children with an autism spectrum disorder (ASD) during 2008 and 2009. Noteworthy findings and intervention strategies are highlighted. Additionally, the quality of all reviewed studies is systematically evaluated.

RECENT FINDINGS

During 2008 and 2009, there was nearly a quarter increase in the number of behavioral intervention studies, as well as more randomized controlled trials and approaches other than applied behavior analysis. Many of the studies investigated commonly used ASD intervention practices or novel treatments. A few were conducted with underserved populations, such as toddlers and adults with ASD. Social impairment was the focus of the largest number of intervention studies. A small percentage of studies were rated as high-quality.

SUMMARY

Overall, the reviewed studies suggest that ASD-specific deficits can be improved through behavioral intervention. However, whereas progress continues to be made in our understanding of effective treatments for children with ASD, confidence in these findings would be improved with higher-quality studies.