Tactile Sensory Flip Books

Some children with autism have a need to an increase of tactile input. I have made sensory books for children to touch and feel to help them calm down when they need extra tactile sensory input.

These flip books are small enough to carry and easy to make. They also are not very expensive.  I went to the local Lowe's Home Improvement Store and they gave me free carpet, outdoor carpet and laminate samples.

I then cut bright colors or card stock that were an inch larger than the largest piece of carpet. I then had the card stock laminated and one hole punched in the upper left hand corner. Make sure the hole is are enough away from the corner so tugging and throwing the flip books won't rip through the holes.

Then put a metal ring through the holes, and make a flip book out of them. Use a strong glue to glue the carpet and laminate samples to the pages.

You now have a Tactile Sensory Flip Book.

Motivation

What is motivation? It is the desire to do things.  What gets you up in the morning? What gets you to work? When I work with children with disabilities, they are often not very motivated to work. I must find something to motivate them to learn.

What motivates you? I love this TEDtalk by Dan Pink:

There is extrinsic vs intrinsic motivators, or external vs internal motivators. 

People who have even the most rudimentary cognitive skills necessary for their jobs are more motivated by:

1.autonomy

2. mastery

3. purpose

People who need only mechanical skills are motivated by:

1. bonuses

2. carrots and sticks

3. extrinsic rewards/motivators

What motivates

If giving an incentive for a behavior that isn't motivating, it will not incentivize.

If…then or carrots and sticks, external/extrinsic motivators are best for children and the cognitively impaired. For internally motivated, cognitively high functioning, look for autonomy, purpose and mastery as motivational rewards.

Managerial styles that use carrots and sticks will often find the employees unhappy at work, missing work, a high turn over rate, late work, missing work.

Using carrots and sticks for high functioning  will not be rewarding and will feel more like punishment.

Reinforcers

re·in·force

1.

to strengthen with some added piece, support, or material.

What motivates a person?  A reinforcer is something added to support a behavior you want to continue, or motivates them to behave in a desired way.  You can also reinforce a maladaptive behavior by adding support or attention to it.  There are two types of reinforcers, primary and secondary.

*Primary- a primary reward is one that doesn't have to be taught is desirable or motivating.  This is food/drink; you don’t have to teach that food and drink are motivating.

*Secondary- a secondary reward is one that does have to be taught is desirable or motivating.  A sticker has no innate value in and of itself.  Why would someone work for a sticker unless value is instilled in it? Earning a preferred activity or free time, positive affirmations or praise, giving a high five, are all learned reinforcers. 

*Satiation – When a reinforcer is offered to the point that the child has received enough to be full or satiated, they will no longer be motivated by the reinforcer. It is important, then, to only offer the reinforcer on a limited basis and/or in small amounts.

*Moving from primary to secondary – To move from primary to secondary reinforcers, pair the two together.  Do this by offering praise each time a primary reward is given.  Vary the reinforcer of primary and secondary.  If building in value of a sticker or activity, pair that with the primary reinforcer on a 1:1 basis and then a variable schedule. Fade the primary.

Stimming

Stimming

The word stim is short for self-stimulation. Stimming is the process of a repetitive behavior. We all stim to one degree or another. We tap our foot, tap a pencil, twist our hair, pick at our cuticles, rocking. What is different about the type of stimming that children with autism do, is the excessive amount or degree with which they do it.

Stimming helps block out excessive sensory stimulus, or it may provide extra sensory stimulus.  It may help manage emotions (this may be for the detriment or the benefit of the child/adult) thus emotions or difficult

situations may lead to an increase in stimming. Some stims serve the purpose of comforting or soothing.

Stimming, when done with boundaries, should be allowed and considered normal. There are times when stimming should be limited or an alternative stim should be found as a replacement.

We use all of our senses to interpret the world. When we walk into a room, we use sound, a kind of sonar, to determine the size of the room, the furniture placement, and our relationship to the room, how quiet or noisy the room is. We use visual see how many people are in the room, were furniture placement is, etc. Taste, tactile, all help us interpret the world around us. Our senses do this for us automatically without us being stimming                      conscious of this.

 A child with autism or sensory processing disorder, their senses and brain do not work in the same way. Their senses take in the information, but the brain does not process the information, or doesn't process it correctly. For example, some children, when they walk into a room, their auditory doesn't automatically tell them, through sonar, where they are in relationship to the size of the room or the location of the furniture. These children then immediately feel unsafe and uncomfortable, since they cannot place themselves in a new location. To feel safe, they will then need to adapt, they do this by running around the room to get a *feel* for the size of it and location of furniture. They will often start screaming to let their brain get a sonar picture as well, similar to what dolphins do.

Stimming, just like OCD, starts in the brain and the part of the brain that is in operation, has the neurons fire repeatedly. When this part of the brain is in operation, then other parts of the brain are not in use. When a child is stimming excessively, or for example, they are flapping their hands in front of their face for 30 minutes or more, they are not able to take in visual stimulus around them.  This limits their brains ability to take in visual information and then interpret the environment around them. In this way, stimming gets in the way of their ability to learn from their environment.

Excessive stimming also prevents other parts of the brain from developing. This is especially critical in childhood when the brain is still developing and learning and growing.  When large amounts of time are devoted to stimming, then that time cannot be used to interpret the environment, to learn new things such as reading or math, and only that part of the brain devoted to the stimming is being developed at the expense of other parts of the brain.

There are stims that are also harmful, either to the child or to others, or create a maladaptive environment. A child who bites themselves, pulls their hair out, are examples of bringing harm to themselves. A child who screams in a classrooms inhibits the learning environment for the other students and creates agitation in the other students and teachers. Any stim that is self-harming or harming to others should be limited and an alternative stim should be actively found.

Stims that are done to excess should also be limited, as this prevents healthy brain development in the child. Stims can be used to motivate the child to finish their work, can be used as a reward and should be limited. 

For example, a child who needs to flip a rubber band on their wrist, they can be given the rubber band after they finish a school assignment, for following the rules, after they eat, or when they are being quiet in their room. In this way, they still have access to the stim, but on a limited basis.

It's important to remember that the stim provides a vital role for the child and should not be eliminated, just boundaries put around it. A stim provides comfort for many children, so in stressful situations, offering the stim as comfort or after completing a difficult task is highly motivating for the child.

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Generalization

Generalization is the process of teaching a skill or behavior in one setting and having that skill or behavior transfer to another setting.  In most children, this happens naturally and does not need to be taught. With children with autism, this does not always happen naturally.

For example, if a child is taught to measure a cup of flour at home, the child can naturally measure a cup of flour at school. If a child is taught to sit with quiet hands at school while the teacher is talking, the child can sit in church with quiet hands.

A child is able to generalize when they are able to work with a variety of people, in a variety of therapy as well as natural settings, with a variety of stimuli (using different materials), and produce the same responses in different ways (count to ten with blocks, on their fingers, on pater, etc).

When working with a child that doesn't generalize naturally, it is important to teach the new skill in a therapeutic setting. The new skills must then be taught in other settings. The skill can be taught in another classroom, in the hallway, with other children present, outside, etc. By using multiple settings, the skill can be generalized to

multiple settings.

It is important to use formal and informal settings, as the more informal setting occur more naturally.  Reinforce the new skill as often as possible to increase the rate of learning. It is also important to move from continuous reinforcement to intermittent reinforcement, as this is a more natural reinforcement rate and actually increases the rate of the behavior. Just as in Vegas, they reinforce intermittently and get a higher rate of behavior, so you will, too.

If it is possible, have other people teach the skill. This helps the child learn from other people and to generalize to take instruction from other people. This can be another aid, the parents, peers, etc.

Once the skill has been taught in a therapy setting, take the child to more natural settings, such as the lunch room, the playground, the hallways, etc.

Vary the language: For example, if you are teaching shapes, say, 'show me a square' the next time you could say, 'where is a square?' the next time, take him around the room, and ask, 'do you see a square?'​

Vary the materials: have the child count blocks, puzzle pieces, numbers on a paper, door handles, etc.

Differential Reinforcement

Any behavior that gets attention will likely be reinforced and repeated in the future.

​While there are aspects to all of these that can be beneficial, there are two primary ones that are most beneficial; positive reinforcement and extinction.  We all need praise and to know that our efforts to improve are being noticed, and children are no different. Catching a child or adult in the act of being on task, doing their work well, finishing their work on time, being quiet, are all important in increasing these behaviors.

Behaviors that are maladaptive should receive the least amount of attention as possible, as paying attention to them increases the likelihood they will be repeated. When a child turns in their school work late and the teacher reprimands them, they have just increased the likelihood that the child will turn in school work late in the future. Rewarding children who turn their homework in on time, and giving little attention to the lateness will increase the likelihood of promptness. A child who habitually turns in late work and one day turns it in on time, should get as much positive reward as possible.​ 

An adult who maintains a messy work area and is told how messy they are, will likely maintain a messy work area in the future, since they get attention for this behavior. An adult who finishes their work on schedule and is promptly rewarded by being given the afternoon off, will likely get work done on time in the future. 

Things like a break or time out should only be used when the child's safety or another person's safety is at stake. Punishment does not provide an alternative behavior to the maladaptive behavior and does not change future behavior, it only stops the present behavior. Likewise for adults, when they are punished by being told in front of co-workers (adding an adverse stimulant) that they are always late to work, will not change this

behavior in the long term.

Negative reinforcement is used a great deal in schools. It increases the likelihood that a behavior will increase in the future.

Differential reinforcement

The use of extinction in conjunction with positive reinforcement is called differential reinforcement.  This is alternating between conscious ignoring the maladaptive behavior and then giving positive reinforcement when they exhibit the alternative behavior. Example: If the child is hitting, you back away so they are not being reinforced for the hitting, turn your head away so they are not getting your attention for the hitting, tell them to have quiet hands, then as soon as they put their hands down, reinforce that they have quiet hands.

For an adult, you consciously ignore the maladaptive behavior of being late, and at the same time, when they show up to work on time, reward that behavior by noticing it and rewarding it.

Reinforcers

Positive Reinforcement *Adding a stimulant to increase a behavior *Designed to increase behaviors, by increasing the likelihood the behavior will increase in the future *Penny chart *Praise *Primary reward *Preferred activity *High five *Reinforce 1:1 in beginning *Varied reinforcing more reinforcing 1:2	Punishment *Designed to decrease behaviors by adding an  aversive stimulant *Does not teach an alternative behavior *Works  on Highly conscious children *Natural consequences *Time out *Spanking * Works while in the authorities’ presence, not so effective when the authority is not present * Does not change behavior, only temporarily stops it
Negative Reinforcement *Taking a stimulant away *Taking away a stimulant to increase a behavior *Designed to increase behaviors in the future *Penny charts, sticker charts *Response cost *Take away a preferred activity (video game, access to cell phone or TV) *Take away time from recess *For each minute they waste from your time, take a minute away from lunch time, recess, TV, etc.	Extinction *Designed to decrease behaviors by taking away a stimulant *Conscious ignoring *Take attention away from behaviors *Expect an initial spike in the behavior at the beginning (child is used to gaining attention and will increase the behavior to get the attention)

Positive and Negative Supports

Positive Reinforcement

People often think of positive as something good and negative as something bad, but in ABA (Applied Behavioral Analysis), it's more like math; positive is where we add something in (think addition) and negative is where we take something away (think subtraction). 

With positive behavioral supports, we add something to increase a behavior. For example, to increase a child's ability to focus on writing 5 sentences, we add in something that will motivate the child. What is important here is to add in what is motivating for the child and not necessarily what the adult thinks will motivate the child. Often, 

*positive attention is rewarding, so saying to the child, 'that was very good finishing your sentences' will work...but if this doesn't encourage the child to finish, you have found a child that isn't rewarded by praise. 

*Another example is where you give a piece of candy to a child for each piece of clothing they pick up off their floor.

Negative Reinforcement

Negative supports is where we take something away to increase a behavior. For example:

* we tell a child we will take away one minute of recess for every minute they do not work on their school work.

* Joey can't get up from the dinner table until he eats a few bites of his peas.

Maslow's Heirarchy

One of my favorite behaviorists is Maslow. His hierarchy of needs helps me each day in my job.  When I am working with children or adults or even myself,  if we are tired, hungry or thirsty, we are not going to listen well, follow directions and may even have an increase in maladaptive behaviors such as  whining, crying, fidgeting, poking the student next to them, etc.

When a person's basic physiological needs are not being met, their ability to learn or work cannot be met.

If you have a child or adult in the classroom or workplace who are being disruptive, stop and ask yourself if they are too hot or too cold, hungry, tired, thirsty, etc.

maslow chart

Applied Behavioral Analysis, What is it?

Many years ago, when I was getting my Social Work degree, I took classes in behavior modification. Most people have an idea what behavior modification is, since it is introduced in psychology 101 as classical or operant conditioning.  This is the modification of behavior through the observable relationship of the behavior and the environment.

The basis of this is the Antecedent, the Behavior and the Consequence or  A  +  B  =  C
The antecedent is what happens before the behavior, the consequence is what happens after the behavior. The behaviorist has some control over these two variants, but should not consider they have control over the behavior itself.

 Let's look at some examples.
Example 1: 
Antecedent:
A small child goes to the store with their parent. They walk down the candy aisle.
Behavior:
The child sees a candy bar they want and begins to scream for the candy bar.
Consequence:
The parent gives the candy bar to the child.

Example 2:

Antecedent:
A small child goes to the store with their parent.They walk down the candy aisle.
Behavior:
The child sees a candy bar they want and begins to scream for the candy bar.
Consequence:
The parent  makes sure the child is in a safe place, waits for the child to stop screaming, does not make eye contact to avoid giving attention to the behavior of screaming, then when the child stops screaming, calmly walks the child away and explains that there will be no candy bar for rewarded for screaming.

In each case, the parent has reinforced a behavior through the consequence and increased the likelihood that a behavior will increase the next time they go to the store.  In example one, the consequence given will increase the likelihood that the child will scream for a candy bar the next time and in example 2 the consequence will increase the likelihood the child will not scream.

Example 3:
Antecedent:
A small child goes to the store with their parent. The parent avoids the  candy aisle.
Behavior:
The child does not see the candy bar they wanted last time and does not scream.
Consequence:
The parent praises the child for having a quiet voice in the store.

In this example, the parent controlled the antecedent by avoiding the trigger that set off the child the last time they were in the store. By controlling the trigger, or antecedent, they decreased the likelihood the behavior would be repeated. They reinforced the behavior they desired in the consequence by giving praise.

This is how Applied Behavioral analysis works.

The behavior is owned by the child, but the antecedent and consequences and be controlled for, therefore increasing the likelihood of a better outcome.