We’ve all seen children with autism who engage in toe-walking: the child walks on his or her toes or the ball of foot without putting much weight on the heel or any other part of the foot. Toe walking is so common that it has become one of the early indicators for a potential autism diagnosis.
When we first see it, we may feel amused. However, when we see it go on and on, we may feel concerned. Should we be concerned?
Prolonged toe walking through childhood can lead to physical problems:
Tightening of the heel chords
Incorrect foot position
Abnormal stress on the bones and ligaments in the knees, hips, and lower back (Yoell, 2001).
Toe walking can lead to social problems:
Toe walking can make walking long distances very tiring
Children may have trouble keeping up with family and friends
It can create problems with shoes; they get worn down quickly in odd places or may be difficult to fit (Unity Therapy, 2016)
A few weeks ago, a behavior popped up after a long absence: finger licking and face rubbing. Having already dealt with this once before, I was ready to tackle it again.
This time, my son (nonverbal, severe autism) added a new twist – a much more complex presentation of this behavior: he licked his fingers and rubbed vigorously around his mouth with one hand, then the other hand, and finished up by frantically rubbing his fingers together. The skin around his mouth was red and rubbed raw, with tiny white blisters popping up on his cheeks.
It took three long walks over three days to address this issue (often I use long walks as a time to work on behaviors). My plan was to tag and reinforce Hands Down behavior, also described in the previous post.
From a child’s point of view (whether that child has special needs or not), he or she needs to feel successful and happy when learning. A trusting, supportive relationship allows a child to thrive. Behavioral science gives us the tools to make this possible.
Dr. Susan Friedman, Professor of Psychology at Utah State University, explains how ABA (Applied Behavior Analysis) offers a scientifically sound teaching technology and ethical standard that can improve the lives of all learners.
Enjoy the 1 ½ minute video or read the transcript below!
Recently my son with autism had a bad flu that lasted for ten days. As his illness unfolded, he developed a deep cough.
Initially, a sick child coughs because of the irritation. However, as many autism families have experienced, a deep cough can turn into an unpleasant self-stimulatory behavior.
Problems of the coughing stim
If this problem develops, you have a situation where the child may walk up to people and cough loudly into their faces or ears, or may cough over someone’s dinner or the produce aisle at the grocery store. It’s unsanitary and stressful for all concerned.
When my son’s cough developed I decided to take action to prevent the possibility of it turning into a stim. With TAGteach I had success in one day.
“Behavior” is a huge concern in the autism community. Yet, when we talk about “behavior,” we’re actually using a technical term that has a specific meaning. Since so many issues in the autism community relate to “behavior,” it’s important that we all talk about the same thing!
The Mirriam-Webster on-line dictionary states that behavior is:
the manner of conducting oneself
anything that an organism does involving action and response to stimulation
the response of an individual, group, or species to its environment (1)
The Iris Center for the study of disabilities says:
“Behavior is something that a person does that can be observed, measured, and repeated.” (2)
Check out the latest in our Interview with a TAGteacher series. This time we talked to Mary Handley, a school-based occupational therapist who is working with a 3rd grader to improve his handwriting. Noah’s handwriting skills were not functional and this was affecting his grades and his attitude at school. Mary explains with several video examples how she helped Noah to improve significantly in just four sessions using TAGteach applied with her usual method of teaching.
How do you feel when you try something and make mistakes over and over? How do you feel when it seems that you are disappointing the person trying to teach you? Do you feel energized and excited to be “learning from your mistakes” or do you feel frustrated and discouraged? For most people and especially kids with autism, repeated failure and “just one more’s” make them anxious, frustrated and wanting to escape to do something less stressful. Sometimes the result of too much pressure to try something too hard results in a full-on meltdown. Once this happens, there is no more learning.
This is why we suggest the three try rule. If a learner fails three times (or fewer) to meet the specific learning goal (the tag point), go to a past point of success and move forward in smaller increments. A point of success is something earlier in the learning process that you are 100% sure the learner can get right. By starting at a point of success and moving forward in small steps you build on existing success instead of searching blindly for a good starting point. Of course the ‘three try rule’ isn’t really a rule. The learner doesn’t HAVE to fail three times. If it is clear the learner will not likely achieve the tag point criterion after the first failure, or the learner is very sensitive to failure, jump right in and clarify or break the skill down further and change the tag point.
In honor of the United Nations World Autism Day, the Kindle version of the book Chaos to Calm: Discovering Solutions to the Everyday Problems of Living with Autism is FREE in the Amazon Kindle store from April 3-6, 2016.
Please tell an autism parent about this. Change a life!
If you are outside the US and you don’t have an Amazon.com account, you can get the book at your own country’s Amazon site. Search Google for Amazon + [name of your country].
If you get your free copy of the book, please help us out by writing a review on Amazon.
“This remarkable book is something that any ABA person would be proud to offer parents. TAGteach has an important future in the treatment of autism and other developmental delays and this parent has shown the way. I will be recommending the book to both parents and ABA therapists.” Joseph Morrow, PhD, BCBA-D President, Applied Behavior Consultants
Professor of Psychology and Behavior Analysis (Emeritus) California State University, Sacramento Licensed Psychologist, State of California
“I am on the Autism Spectrum. I’m both high and low functioning but have achieved a level of integration in neurotypical society because of my higher functioning attributes. It has been a difficult path to walk alone though. If TAGteach had been around when I was a child I am one hundred percent sure I would have a had an even more successful, less frustrating, anxiety ridden childhood and been a higher achiever than I currently am.” Katie Scott-Dyer
“I completely enjoyed this book. It was an engaging and easy read with the appropriate amount of personal testimonial and practical generalization. I wish I could have read it years ago. Parents and practitioners alike will benefit from reading this book regardless if your child is high functioning or severe. After reading, you’ll know that all those other books you read on autism, sensory processing disorder, auditory processing disorder, apraxia, etc. were mostly a big waste of time and money. Don’t let your child’s doctor or other professional convince you that nothing can be done. It’s not true and this book proves it.” Aimee Taylor – Autism Parent
Chaos to Calm describes how Martha Gabler discovered that effective solutions really did exist for the overwhelming behavior problems of her own son with profoundly nonverbal, severe autism.
Here are some of the things Martha explains in this book:
How to observe your child
How to use positive reinforcement to shape simple behaviors
How to notice even tiny moments of desirable behavior
How to break behaviors into tiny pieces
How to add simple behaviors together to build complex behaviors
How to communicate to the child “Yes!” without using words
How to organize the child’s environment to maximize success
How to arrange the day’s activities for maximum success
How to stop tantrums, aggressive, destructive and self-injurious behaviors
How to teach the child to go to bed, stay there and sleep
How to manage and teach without force, threats or coercion
When Doug turned five, Martha realized that she and her family were basically on their own. During the “dreadful early years,” Doug’s behavior worsened and worsened. The family floundered. Daily, if not hourly or even more often, there were screaming, tantrums, self-stimulatory “verbal stimming,” running off, and even violent, self-injurious and destructive actions. The Gablers were exhausted beyond description by lack of community understanding, by lack of help that they could afford, and perhaps worst of all, by night after night of severe sleep deprivation.
A chance reference in an email listserve lead Martha to TAGteach, a teaching system based on the structured delivery of positive reinforcement. TAGteach gave Martha the tools she needed to observe Doug’s behaviors, break them down into manageable pieces, and reinforce his previously-rare positive actions – in fact, positive actions that sometimes lasted only a few seconds in the beginning, but which gave Martha the precious key she needed to unlock major improvements. With a few basic rules and a commitment to practice them, Martha was able to apply step-by-step solutions to Doug’s disruptive behaviors. In TAGteach, Martha found a powerful supplement to other scientifically-based behavioral interventions, many of which required difficult-to-find behavioral experts whose costs would have taxed the family’s financial resources in the extreme
The result? A boy who was once wild and chaotic now has the skills that enable him to be a charming teenager who loves life and enjoys going places.
This book explains, step-by-step, how Martha taught Doug to vocalize appropriately, go on walks, wait in line, go to the grocery store, ride a bike and many more skills that are normally taken for granted, but for a child with autism, they do not come easily if at all. Perhaps the most important skill was how to lie quietly in bed and go to sleep, so the other exhausted members of the Gabler family could themselves get some badly-needed sleep. Martha uses simple language and engaging prose to explain how she achieved all this. The book is in turn heartbreaking, humorous and brutally honest.
Every autism family seeks the light in an ocean of despair. Every autism mom, every autism dad, in fact every person who loves another person with autism, can use TAGteach with ease. This book shows you how.
What is TAGteach?
TAGteach stands for Teaching with Acoustical Guidance. TAGteach is a teaching and communication method based on the scientific principles of Applied Behavior Analysis (ABA).
TAGteach enables extremely precise positive reinforcement of behavior by using an acoustical signal to “mark” the behavior – at the precise moment the child performs the behavior! The acoustical signal is a short, sharp sound made by a handheld device (the “tagger”). When the child performs the correct action, the parent/instructor immediately presses the button on the tagger and hands over a treat (candy, treat, token, praise, social recognition, or money) as a reinforcer.
With TAGteach, it is easy to reinforce behaviors precisely and quickly. The immediate, accurate feedback and positive reinforcement result in the child performing the correct action more often, and for longer periods of time. With immediate feedback and learning tasks broken down into small steps, children can learn many new skills with TAGteach — at their own pace.
TAGteach in Action
Watch this video that shows TAGteach in action in an autism school setting. This approach is unique in that it allows the child to “be the teacher”. The child gets to be the teacher before he takes his turn to try the new skill. This is fun, gives him control over his own learning and lets the teacher know for sure that he understands the skill before he tries it himself. One of the critical features of the TAGteach approach is that only one aspect of a skill is worked on at a time. There is no error correction by the teacher. If the child makes a mistake, it is up to him to self assess or try again. There is also no physical prompting, nagging, coercion, cheerleading or verbal coaching in TAGteach.
In this example the teacher gives two tag points, with five tags for each. The first tag point is “paper in lines” so that the child will know how to position the paper for printing. The second tag point is “hand on paper” so that he learns to hold the paper still with his other hand. Notice that even when the tag point changes to “hand on paper”, the child still remembers and tries to position the paper properly.
Have you wondered how to apply TAGteach in a group sports setting with special needs kids? Will it be too noisy for the learner to hear the tags? Will the learner be too distracted by everything else going on the room? How do you handle the reinforcers? Can you use TAGteach to manage behavior and social issues? Do coaches really think that kids taught with TAGteach learn better? Listen to this month’s interview with a TAGteacher and watch the accompanying videos to get answers to these and more questions.
This month, Martha Gabler interviewed TAGteacher Joey Iversen (in red shirt above). Joey is a Level 2 TAGteacher with extensive experience from both ends of the tagger. Joey has trained several tennis coaches to use TAGteach during her own lessons because she wants to learn in the most efficient way possible. Joey has also been working with a special needs tennis program and successfully integrated TAGteach into the teaching protocols.
Martha had questions for Joey on the following topics:
How did you get started with TAGteach?
What was the one feature that really “pulled” you in?
Where did you first start using TAGteach?
Tell us about TAGteach and tennis for special needs kids
How did the coaches react?
What were their positive comments?
Where there any negative reactions?
Joey referred to a couple of videos and these are shown lower down in this post so that you can watch them after you listen to the interview.
This video shows a tennis lesson in which the tag point is “step forward”. The player is focusing on stepping forward with her right foot after hitting the ball.
This video shows a group tennis lesson. Three players are hitting the ball and the other three are tagging. This means that everyone is participating, focusing on one thing and learning, even when it’s not their turn to play.
As part of our online course: TAGteach for Autism, we are holding monthly live Q&A sessions with author and mother of a child with autism, Martha Gabler. A feature of these Q&A sessions is an interview with a TAGteacher. We will be posting the interview section in our blog each month for you to view for free. The full Q&A session will be available for purchase.
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Your special needs child will do best with a strong team of professionals and parents working together. You are the expert when it comes to your child. The professionals working with your child will have more success when you work to support a relationship with them. Here are 10 tips from Bethan Mair Williams to help you get the most for your child through a successful relationship with your support team. Bethan is a Speech Language Therapist/Board Certified Behavior Analyst (BCBA) with more than twenty years of experience in working with children with special needs, training and supervising classroom staff, and developing data collection and interpretation systems.