Teaching Play

1
Teaching Play Socialization Skills to Children
with Autism

• Amy McGinnis, M.S., OTR
• March 2007
• POAC of PA

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Importance of Play

• Play is the format through which neurologically
  typical children acquire a variety of skills
• Language
• Fine motor skills
• Gross motor skills
• Graphic motor skills
• Academic skills
• Social interaction

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Play in Children with Autism

• Children with autism often lack age-appropriate,
  purposeful play skills
• Resort to repetitive stereotypies that can be
  stigmatizing
• Limits opportunities for interaction and learning

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Stereotypy vs. Play

• Teaching play skills may decrease a childs MO to
  engage in stereotypic, repetitive behaviors
• Play with toys is also under the control of
  automatic reinforcement, but is considered
  socially acceptable

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Stereotypy vs. Play

• Children with autism may also engage in
  self-stimulatory vocalizations (scripting movies,
  etc.) under the control of automatic positive
  reinforcement
• Neurologically typical children talk to
  themselves (also under the control of automatic
  positive reinforcement) while playing

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Functions of Behavior
Socially Mediated Positive Reinforcement To get
reinforcing items/attention
Socially Mediated Negative Reinforcement To
escape demands
Automatic Positive Reinforcement The reinforcer
is the behavior itself
Automatic Negative Reinforcement The reinforcer
is the self-removal of aversive stimuli
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Evaluating Play Skills

• Questions to ask before targeting play skills
• What is the learners ABLLS profile?
• Are adults paired with reinforcement?
• Are play materials paired with reinforcement?
• Should teaching play skills be a priority at this
  time?

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Play Skills ABLLS
K1 Explores toys in environment K2 Plays with
toys as designed K3 Multiple responses with
toys related to a theme K4 Independently plays
with toys and engages in verbal behavior K5
Plays interactively with other children
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Play Skills ABLLS
K6 Plays with toys talks with peers K7
Sociodramatic play K8 Independent indoor
leisure activities K9 Interactive leisure
activities K10 Outdoor games activities
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Early Learner Profile

• Requests a limited number of items/actions
• Typically less than 300 mands per day
• Intraverbal responses (if any) typically limited
  to a few fill-ins to songs or phrases
• Often poor mimetic/echoic skills
• Few tacts of items
• Responds to minimal number of directions

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What if child is an early learner?

• Focus on developing mand repertoire
• Identify potential new reinforcers
• Pair reinforcers to increase their value
• These reinforcers can be used later to teach
  play skills

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Play Skill Goals for Early Learners

• K1 Exploring toys in the environment
• Build interest in toys through the use of
  stimulus-stimulus pairing

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Stimulus-Stimulus Pairing

• Simultaneous presentation of two stimuli (one
  reinforcer, one neutral stimulus)
• Through stimulus-stimulus pairing, toys can
  become conditioned reinforcers

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How to Pair Toys with Reinforcement

• Have child hold Incredibles figurines while
  watching the movie
• Give child candy while s/he holds baby doll
• Turn on music while child holds crayon
• Give child a toy boat while s/he splashes water
  in a tub

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Choosing Appropriate First Toys

• Look at the behavior the child engages in during
  free time
• Analyze the apparent reinforcing properties of
  those behaviors
• Try to choose simple cause effect toys or
  activities that produce similar forms of
  reinforcement

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Signs that Pairing Has Been Successful

• Is child spontaneously approaching the toy?
• Is the child interacting in any way with the toy?

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Fading the Primary Reinforcer

• Once child begins to spontaneously approach toy
  and manipulate, fade the use of reinforcement
• Frequency
• Magnitude
• If manipulation of the toy persists after primary
  reinforcer has been faded, then it is likely that
  the behavior is now under the control of
  automatic positive reinforcement

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Shaping Complex Play Schemes

• Baby doll
• Feed baby
• Give baby bath
• Change babys diaper
• Dress baby
• Put baby to sleep

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Corresponding ABLLS Goals

• K3 Multiple responses with a toy
• K5 Plays interactively with others
• K6 Plays with toys and talks with others

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Skills Required for Play Scheme

• Interest in toy (baby doll)
• Intermediate to advanced verbal behavior
  repertoire

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Intermediate Learner

• Many mands for items, some mands for actions
• Emerging mands for assistance, removal of
  aversives, and attention
• Mands several hundred times per day
• Generalizes tacts and intraverbals taught in the
  context of intensive teaching
• Follows many 1-2 step directions

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Advanced Learner

• Mands for information
• Answers novel WH- questions about past events
• Begins to initiate and maintain conversation with
  others
• Tells stories
• Describes steps of activities
• Follows multi-step directions

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Challenges

• Develop intermediate to advanced learner verbal
  behavior skills, including
• Mands
• Echoics
• Tacts
• Intraverbals
• Develop an interest in wide variety of toys

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Teaching the Child to Play

• Complete task analysis to determine which
  specific skills are necessary to play with the
  toy
• Prompt child to engage in these behaviors
• Reinforce desired response
• Differentially reinforce any novel interactions
  with the toy
• ABLLS K2, K3

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Teaching Child to Talk While Playing

• Start with manding
• What if MO is weak?
• Do not force a mand
• Continue to pair until value of toy has increased

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Teaching Child to Talk While Playing

• After manding for toy is strong, begin to
  incorporate other operants (echoic, tact,
  intraverbal) relevant to the play theme
• Keep response effort low by incorporating only
  easy, mastered skills

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Example

• Incorporating Verbal Behavior
• Into Baby Doll Play Scheme
• Mand
• Tact
• Intraverbal
• Receptive command / receptive ID
• Echoics
• Vocalizations likely to start as narration
  rather than conversation

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Shaping Desired Behavior

• Heavily reinforce any of the following behaviors
• Novel verbal statements during play
• Manipulating toy in novel appropriate ways
• Combining previously taught play skills in a
  new sequence

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Common Mistakes in Teaching Play Skills

• Failure to bring the play behavior under the
  control of automatic reinforcement
• Attempting to teach complex play skills too early
  on in programming
• Failure to choose toys/activities that child may
  have interest in
• Placing too many demands during play
• Killing value of play by forcing child
  to share or take turns

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Socialization Skills in Children with Autism

• Children with autism commonly demonstrate social
  skill deficits
• Limited interaction, tendency to isolate
• Poor MO for attention
• Tendency to interact with adults rather than peers

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Benefits of Teaching Socialization Skills

• Children with autism can learn new skills modeled
  by peers
• Increased interaction with peers may decrease
  need for adult support
• Socialization skills can and should be taught to
  early to advanced learners

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Steps to Teaching Socialization Skills with Peers

• Pair
• Mand
• Receptive instructions
• Mand for attention
• Interactive play with reinforcers
• Pretend play

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Setting up Socialization Sessions

• Keep play date sessions brief at first
• Use only 1 peer per play date until socialization
  skills are well developed
• Prompt typically developing peer to facilitate
  interactions
• Remember to reinforce peers behavior!
• Intervene in least-intrusive manner when
  necessary

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Pair Peers with Reinforcement

• We want to condition peers as reinforcers
• To do this, have the peer approach the child and
  hand him/her a preferred item
• The peer should NOT place any demands
• Adult should then praise peer and/or deliver a
  tangible item to to the peer (we want the peer to
  be motivated to continue pairing)

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Manding for Reinforcers from Peers

• When the child begins to approach peers to take
  reinforcers when offered, you are ready to begin
  requiring mands
• Require only those mands that have been
  previously taught (do not have peers attempt to
  teach new mands)
• Instruct peer to hold onto item until the child
  asks for it
• Adult may initially need to prompt the child to
  mand

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Following Instructions Given By Peers

• When the child is manding from peers with no
  prompts needed, you can begin teaching the child
  to respond to instructions given by peers
• Teach in the context of fun activity
• Do not teach too early to children with
  compliance issues

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Manding for Attention from Peers

• Once your child is frequently manding for items
  or actions from peers, you will want to teach
  mands for attention
• If the attention of peers is not reinforcing to
  your child, begin to pair peer attention with
  reinforcement

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Interactive Play with Toys

• Start to teach the children to engage in a game
  or activity together that they both enjoy and
  that the child with autism can complete without
  prompting

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Sociodramatic (Pretend) Play

• Start to teach the children to act out pretend
  scenes from stories they have heard or movies
  they have watched.
• Once the children begin to act out stories
  spontaneously with no prompts needed, begin to
  reinforce any playing that occurs that is
  different from the original script.

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Common Mistakes in Teaching Socialization Skills

• Failure to pair peers with reinforcement
• Failure to condition attention as a reinforcer
• Forcing child to share or take-turns too
  early on
• Forcing eye contact
• Requiring greetings too soon
• Failure to teach necessary verbal behavior and
  play skills necessary for interaction
• Failure to fade adult presence (prompt dependency)

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