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  • Children with autism frequently engage in unusual behaviors. Those behaviors are referred to as

  • stereotypies. In fact these repetitive sort of behaviors that occur are diagnostic of a child with autism.

  • In other words, it is one of the criterion used to make a decision to whether or not someone meets the criteria

  • for a diagnosis of autism. They can be of many sorts. They can be repetitive behaviors that are vocal in nature,

  • we sometime refer to those as non-functional vocalisations. They use words and phrases that have

  • no social meaning but are just repetitive, and occur frequently in conditions in which the child is not

  • engaged and stimulated in other sorts of ways. The repetitive stereotypies could also occur

  • in other situations in which they are motor in nature. Rocking, hand-flapping, movements of the

  • eyes - all unusual sorts of behaviors which are not meaningful in any social sort of way. When then

  • asked "well, what is the purpose of them, why does a child with autism engage in those? " Well, they

  • derive some reinforcing value, and the reinforcing value is what is referred to as "automatic reinforcement".

  • The reinforcement for doing so, that strengthens the behavior, is the sensation that the behavior actually

  • produces. So they have no benefit in terms of having an effect on the social environment. They serve no social

  • purpose, their only purpose is to produce self-stimulation that is enjoyable and therefore strengthens the

  • behavior. Most typical individuals engage in stereotypies as well. They occur however at very low frequency

  • and due to social inhibition they generally occur privately and not in public places. Children with autism without

  • the type of social inhibitions that will drive the stereotypies to privacy will engage in this responses across all settings

  • and two difficulties in particular is one, they interfere with the learning of other skills,

  • and secondly they are stigmatising when they bring undue attention to the individual from others in the public environment.

  • This is a video of a boy with autism by the name of Andrew and his

  • teached working with him, Lianne. Andrew engages in high rates of

  • vocal stereotypies, basically non- functional vocalisations that he repeats

  • continuously, that generally interferes with his learning. If you watch this video

  • Lianne is teaching him during discrete trial instruction. Andrew is responding but

  • in between his responses to her are these strings of non-functional vocalisations or

  • what we call automatically reinforced stereotypies. He likes the sensation of hearing

  • himself repeat these words and phrases continuously. There was just an example right

  • there where his voice got louder. So if you watch this, while he is responding,

  • it is very interfering - these stereotypies and these non-functional vocalisations.

  • I will let you listen just a little bit to it.

  • That "stop, stop" kind of comment there was unrelated to what she was presenting,

  • and those are examples of vocal stereotypies. We decided to put in place a treatment method -

  • a treatment method based upon some research in the field of Applied Behavior Analysis, that suggests

  • that the stereotypies can act as reinforcers for appropriate behavior. In other words, any behavior

  • that you engage in at high rates and repetively must have some reinforcing value. So what we are going to do

  • is use Andrew's stereotypies as a reinforcer, contingent upon not engaging in the stereotypies. What you

  • are seeing right now is a baseline before we began our treatment.

  • And now we will go into a video showing how we used his stereotypies as treatment.

  • This is Andrew now in a situation in which he is now allowed to engage in the stereotypical

  • behavior to the degree that he will like to. You will see motor stereotypies - repetitive behaviors -

  • automatically reinforced and vocal stereotypies. He's pushed a timer there, the button on the timer,

  • indicating that he has one minute and now he is engaging in these stereotypical sort of behaviors.

  • We have taught him, however, as soon as he comes out of this area, which is a very circumscribed area

  • in our Clinic, he is not allowed to engage in the stereotypical behavior - he will receive a reprimand

  • if he does. If he does not he will continue to earn tokens which will then allow him to exchange those

  • tokens, to go back to his stereotypies. The general idea is that we are using the stereotypies as a

  • reinforcer. He leaves the area, the stereotypies stop immediately. He comes back over to the table,

  • and he responds to Shawnessy with no stereotypies whatsoever - he just earned a token. So many tokens,

  • five to ten tokens that he earns, will allow him to go back and engage in the stereotypies. Shawnessy is

  • teaching Andrew much the same way that Lianne did, but there are no stereotypies occurring. Mainly

  • because Andrew has learned that he can earn tokens for engaging in anything other than stereotypies

  • which then allows him to go back to the area and engage in his automatically reinforced self-stimulatory

  • behavior. And you can see very nicely there after a few trials of this Andrew is responding nicely,

  • no interfering behaviors, earning tokens for responding to targeted academic skills,

  • without any stereotypies at all. Shawnessy is telling him he has got one more and he will

  • be able to go back to stim. Now he has earned his token. And notice, as soon as he walks back into the

  • circumscribed area, in which the stereotypies are allowed to occur, he immediately starts

  • engaging them. The opportunity to do what he is doing right now acted as a renforcer for

  • responding without stereotypies in the academic setting. So it is making use of the stereotypies and

  • the automatically reinforced self-stimulatory behavior as a reinforcer. There have been about four or five

  • papers published on this topic. It seems to be an effective way to overcome automatically reinforced

  • repetitive behaviors during academic instruction. This treatment procedure might not be used in everyday

  • life, for example going to the mall, you would not be able to use this procedure to reduce stereotypies.

  • But during instruction it seems to be a very effective way of overcoming this. After a minute, you

  • will see Andrew will go back to his academic setting and you will notice how quickly the

  • stereotypies turn on and off. That is called "stimulus control", we have brought the responses under the

  • control of only this environment, the environment he is currently in as opposed to all the rest of the

  • Clinic as an environment. In a few seconds or few minutes you will see -

  • there he goes - stereotypies stop, immediately. Back to instruction.

  • Shawnessy describing to him how many tokens he will need in order to go back to the

  • environment in which stereotypies are OK to engage in, with no consequence and no

  • interruption from the teacher. He is earning tokens for effective responding.

  • No non-functional interfering vocalisations occurring. Responding to the academic material,

  • given himself tokens when directed by the teacher.

  • He is close to meeting the criterion for exchange of the tokens for opportunities to go back to the

  • video area.

  • He earned a chip and the opportunity to go back. Watch how quickly the stereotypies occur.

Children with autism frequently engage in unusual behaviors. Those behaviors are referred to as

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言葉のステレオタイプ-Carbone博士による説明と例のABA治療 (Verbal Stereotypies - Description and Example ABA Treatment by Dr. Carbone)

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    marie に公開 2021 年 01 月 14 日
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