AppendixWhy Artie Can’t Learn1
A teacher presents the following lesson in a hypothetical preschool classroom in everyday Americana:
Teacher: Today we are going to learn about prepositions. I have a large box in the middle of the room. Does everyone see the box? We will use that box. Listen carefully. When I call your name, stand up and see if you can follow my direction. I want Sarah to stand up. (Sarah stands up.) Good, Sarah, I want you to stand in front of the box. Show us where “in front of ” the box is.
Sarah: (Demonstrates correct behavior by getting in front of the box; Artie is looking at a discolored spot on the drop ceiling.)
Teacher: Good, Sarah. You stood in front of the box. You did not stand behind the box. Class, did Sarah stand on the box?
Most of class: No. Teacher: Where did Sarah stand? Kid raising hand: She stood in front of the box. Teacher: Let’s try another one. Bobby, stand up. (Bobby complies and stands
up.) Good, Bobby. I want you to stand behind the box. Show us where to stand so that you are behind the box (vocal emphasis on “behind” is made).
Bobby: (Walks to the box and stands behind it.) Teacher: Very good, Bobby. You stood behind the box. You did not stand in
front of the box. Class, did Bobby stand inside the box? Most of class: No. Teacher: Where did Bobby stand? Kid raising hand: He stood behind the box. Teacher: (Stops lesson seeing Artie is still looking at the ceiling, and has not paid
attention during this entire time.) Artie, you need to pay attention. How can you learn where “in front of ” is if you don’t watch?” (Artie still does not attend)
Teacher: (Moves closer to Artie.) OK. Artie, get behind the box.
Copyright Springer Publishing Company. All Rights Reserved.
From: Functional Behavioral Assessment, Diagnosis, and Treatment (Third Edition)
DOI: 10.1891/9780826170330. 0https://doi.org/10.1891/9780826170330.ap02
316 Appendix B
Artie: (He gets up and piles inside the box.) Teacher: Now see, Artie, if you were listening, you would have gotten behind
the box, instead of inside the box. Now pay attention so you can learn the difference between “inside,” “in front of,” and “behind.”
In reviewing this scenario, ask yourself which students profited from this lesson.
ll Did Sarah learn? ll Did Bobby learn? ll Did Artie learn? ll Why did Artie not learn?
Perhaps you have seen children like Artie in preschool classes, that is, children who do not attend while a lesson is being presented. Attending skills in the early grade levels is critical to academic success. Listening to the teacher as well as observing the teacher and other students demonstrate a skill, such as placing an object in a box versus outside the box, is critical to skill acquisition in preschool. One-to-one direct teaching, prompting, and requiring child attention is not usually provided. Rather, instruction is geared toward the entire group via the oral presentation of a lesson. In the previous scenario, children who watched their classmates get up and place themselves in a position relative to the box will hopefully learn the relational concept involved in prepositions. The ability to acquire skills by observing others has been termed observational learning. Much of what young children learn is through observation. If a child does not attend in the first place, it is hard to learn observationally.
Artie’s ability to profit from this form of instruction is very unlikely. He does not attend to the verbal presentation by the teacher. He does not observe his classmates performing the requested behavior. Subsequently, he will probably be unable to imitate those actions when asked. If his ability to observe and imitate the behavior performed by another child or the teacher does not improve, will he be any further along in his acquisition of prepositional relations?
Looks Good, but Smells Bad! While traditional forms of teaching/instruction for preschool children may look great, the efficacy for young children with autism is minimal at best. Given the previous scenario, is it wise to deploy an instructional approach whose requisite for success is the attending skills of the child? Does that make sense for children like Artie, when their attending skills are minimal to nil? Here is a hypothetical example of looking good, but smelling bad.
The Itsy-Bitsy Spider. It is the start of the class time, and all the children arrive in their special education preschool classroom. The five boys and girls in the class have autism, with severe adaptive and cognitive deficits. Only one of them says words, but not in any useful or functional sense (repeating “mama” every so often). The class is heavily staffed, with a credentialed teacher and two instructional aides.
It is the beginning of the day, and that means “the morning circle,” a staple in everyday preschool programs for language-capable children. Such a format in a regular preschool class with language-capable children conjures up an image of children learning though doing and saying. But this is a special education class with language-deficient children. The teacher walks over to the CD player and pushes the play button, while all five children are seated in a semicircle around the teacher’s chair at the front of the carpet area. The instructional aides, whose job is to help keep the children in their seats (no small feat), are seated behind the children. The music comes on:
“The itsy bitsy spider, went up the water spout . . .”
Any observer to this class sees the following. Of the five boys and girls in the class, four of them at any one time are engaged in some other distracting activity, such as hand weaving, turning around, tantrum behavior, or getting out of their seats. All the children seem oblivious to the concept that this is a learning activity and continue to not attend as the
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music plays on. One boy makes eye contact with the teacher for awhile. But within a second he gets up and starts jumping around, upon which time he is directed to sit back down by the nearest adult.
The aides are in rhythm and sing their hearts out with the lead of the teacher. But what also is apparent is the lack of vocal responding from the five students. Of course, one might expect that, given four of them have no capability to produce intelligible words. Even the girl who does speak upon occasion does not join in, but rather seems interested in the knot in her shoelaces. Are the children supposed to be singing? One could make a convincing argument that the production of words via sing-song is a great way to enhance a young child’s sophistication in language. But there is a caveat: you have to be able to produce words and actively engage in the activity to learn.
A naïve conception of many personnel who work with children with severe disabilities is that repeated practice using this group approach will eventually work. They believe that children like Artie just take longer to learn. Hence, they do these group activities month after month, year after year. When asked, these people proclaim, “He will get it eventually, it just takes more time and patience.” Four years later, Artie (now age 8) still does not sing the first five words of the “itsy bitsy spider.” What did they mean by getting it eventually?
Why Is Group Daily Practice Not the Answer for Artie? An interesting series of experiments sheds light on this learning enigma with children with autism. Lovaas and his colleagues addressed why children with autism often took a long time to acquire a target skill, even when being directly taught by an experienced behavior therapist (Lovaas, Koegel, & Schreibman, 1979). These researchers conducted a number of experiments that included two phases. In the first study, the following two phases were implemented (Lovaas, Schreibman, Koegel, & Rehm, 1971). In the first phase, each child was taught to press a bar when one target stimulus (called a discriminative stimulus) was presented and not to press the bar in its absence. The discriminative stimulus comprised three elements (called a compound stimulus): (a) a moderately bright visual light (red floodlight), (b) an auditory stimulus (white noise sound), and (c) a tactile event (pressure cuff on child’s leg). Here is what this phase of the study looked like. Imagine that the child is in the experimental room with the therapist. When all three of these elements are presented simultaneously, the child was taught to press a bar. The occurrence of the child pressing the bar when all three elements are presented would result in food reinforcement. No food reinforcement was presented for bar pressing in the absence of this presentation. The research study encompassed training on this simple discrimination to three groups of children: (a) “normal” children, (b) children with mental retardation, and (c) children with autism.
Children in all three of the groups acquired this discrimination. All children pressed the bar when all three elements were presented simultaneously and did not press the bar in their absence. A reasonable person would assume that all these children had come to equate any of the elements as the basis for responding. In other words, the children attended to all three elements (light, white noise, and pressure on leg) equally, and their responses were under control of any and all of these elements.
The second phase of the study tested that notion. In this phase, each element was presented in isolation to see whether its presence would evoke the bar press (this was called “single cue testing”). The single cue test involved 70 presentations of one of the elements (probably divided equally) to each child. The experimenter noted for each presentation whether the child pressed the bar when a given element was presented. For example, in this phase, the white noise would come on and then end. Sometime later, the light would come on and then be terminated. The numbers of times the child pressed the bar in the presence of each element (light, white noise, and pressure cuff on the leg) was tabulated.
The results were astounding. The nonhandicapped children (called “normal” in the study) responded to each of the elements equally. In other words, whether the light, white noise, or pressure to the leg was presented singly, the child pressed the bar. In contrast, the children with autism primarily pressed the bar to just one of the elements; three of these children responded to the auditory stimulus, while two would press the bar only when presented with the red floodlight. None of the children with autism responded to the pressure cuff. This “restricted focus” characterized these children when compared to nonhandicapped
318 Appendix B
same-aged peers.2 Had the autistic children attended to only one of the elements to the exclusion of the other two during phase I training? It seemed so! But what does it mean?
What Are the Implications for Teaching Children with Autism? In one word: profound! First, to get the attention of a child with autism requires instructional procedures that make that a requisite of their attention for task presentation. Hence, even small group teaching strategies do not ensure that attention because it is hard to get initial and sustained attention when working with several children at once. If the children are not attending to your instructional presentation, bet dollars to dimes that they are not going to learn the task, irrespective of how much practice they are given every day. However, even if you get attention to an instructional command in one-to-one training, the child may still not learn the skill. If the child attends to an irrelevant piece of the instruction, even repeated practice will be futile in acquiring the skill. An example will best illustrate this.
Let us say you are trying to teach a little girl with autism to discriminate a request for a coat versus a request to get shoes. You will attempt to teach her to respond differentially to these two different commands, “Pick up the coat” and “Pick up the shoes,” as they both are lying on the bed. Although we see this as a fairly simple skill to acquire, you should now see that these commands comprise multiple elements. In addition to nonverbal actions that may or may not accompany these commands, there are also four words for each command.
Given these two commands, what element (or feature) tells you what behavior is being requested? In other words, what is the most critical element to focus on in order to get this right? The answer: the last word of each command, that is, “coat” versus “shoes.” Remember that, while you may believe the child is attending to all the elements of these commands, if she is autistic, she is probably attending to one element within the compound stimulus. If she focuses on the last word uttered and discerns the different syllables involved in each (“coat” versus “shoes”), she will learn this task.
But suppose she focuses on the word “pick.” Unfortunate for this child, the word “pick” is inherent in both commands. Therefore, unless she attends to a different element, she will be able only to guess which article of clothing to pick up. Correcting her mistake will prove fruitless. She will continue to not learn the task, despite practice day after day on that skill. Her attending to only one element in this compound stimulus will keep her from mastering this simple discrimination. In my (E.C.) clinical work with children with autism, it is often the case that they ignore all the different unique phonemes of the English language that compose words.
This results in the illusion of learning when they respond correctly to a designated task. Let me illustrate with the previous teaching example. Suppose the tone or voice volume with which the trainer or parent says the first command, “Pick up the shoes,” is markedly louder than the command “Pick up the pants.” The child may look like she has learned the difference between the two commands, but again it is just an illusion. When she hears a loud voice volume, she picks up the shoes. When she hears the teacher present a command in a softer voice, she picks up the coat. She makes her decision on what to pick up by listening intently to the voice volume, not the syllables of the last word.
It is now obvious what is wrong with this manner of learning. When other people do not use the same differential voice volume for each of these two commands, the child appears to have not learned at all. Again, what she actually learned is the louder voice volume means pick up the shoes, softer volume means pick up the coat.
Let us look at another, everyday teaching example and examine the ramifications of restricted focus. Here are two white cards that a teacher might use to teach a child to learn to read the printed numbers 1 versus 2.
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How does any child learn the difference? By the teacher saying “one” when presented with the card that has number 1 on it and “two” for the other card? By attending to the difference between the form of the number 1 versus the number 2, right? The child might learn that with a vertical line, he or she says “one” when asked what number this is. In contrast, the number with the curve is the element the child uses to respond differently, that is, he or she says “two.” Attending to those single elements with the numbers 1 and 2 will be fine as long as the lesson does not proceed to other numbers. When the instructional program proceeds to other numbers that share a similarity with those elements (e.g., “4” with the number 1 and “3” with the number 2), life will become more difficult. What might the child say when asked what the number “3” is? You guessed it. He or she might say “two.” If the child is to acquire more sophistication with reading numbers, he or she will have to make the selection on the basis of critical differences in the other elements of these two numbers.
Let us complicate this example even further. Suppose the child does not attend to the form of the numbers. He or she ignores those elements. Rather, the child just sees two rectangle- shaped cards with something printed on each. Looking at the shape of the cards that have the printed number will be no help in responding correctly. Over time, the child demonstrates differential responding to these two numbers. Can we assume that he or she has learned these two numbers? Such responding may just be an illusion of skill acquisition. Suppose, as the school year wears on, the card with the number “1” gets ripped at the corner (whereas the card with the number 2 is not ripped at the corner). The child begins to use that difference as a basis for answering “one” when presented that card, and “two,” when presented with the nonripped card. Of course, a new set of cards with these two numbers makes the skill “go away.” You can see that the “restricted focus” to a single, unfortunately irrelevant element in this task will be to the child’s detriment in acquiring the skill of reading numbers.
What do these examples demonstrate? As long as the child with autism continues to focus on one (possibly irrelevant or redundant) element within any given compound stimulus, the concept you are trying to teach will never be learned. You could give weeks, months, or years of teaching to develop a target skill and get nowhere. With children with autism, it matters how you teach, not just that you teach. All teaching strategies are not created equal!
Notes 1. Taken in whole from: Cipani, E. (2008). Triumphs in early autism treatment (pp. 175–183).
New York, NY: Springer Publishing. Used with permission. 2. Termed stimulus overselectivity in the research study.
REFERENCES Cipani, E. (2008). Triumphs in early autism treatment. New York, NY: Springer Publishing. Lovaas, O. I., Koegel, R., & Schreibman, L. (1979). Stimulus overselecting in autism: A review of research. Psychological Bulletin, 86, 1236–1254. Lovaas, O. I., Schreibman, L., Koegel, R. L., & Rehm, R. (1971). Selective responding by autistic children to multiple sensory input. Journal of Abnormal Psychology, 77, 211–222.
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