Practitioner’s Notebook

Increasing speech in children with autism using the stimulus-stimulus pairing (SSP) procedure
Barbara E. Esch, PhD, BCBA-D Esch Behavior Consultants, Inc.

Most typically developing children learn to talk with seemingly little effort. Two critical repertoires help make this possible. First, children say many different
sounds during babbling and vocal play (i.e., high vocal variability). Second, children usually utter those varied sounds at an exceedingly high frequency (just ask any parent!).

This facilitates learning words, as babies repeat or echo sounds they hear frequently (e.g., “say ma-ma,” “say da-da,” “say bye-bye”). Parents are delighted by any early sounds that come fairly close to their models, and over time they shape those sounds into words that sound just like their own.

Children with autism spectrum disorders (ASD) often have limited pre-speech repertoires. It is estimated that 40% to 50% of those children with ASD fail to acquire speech (Hardman, Drew, & Egan, 1999; Johnson, 2004). They may be essentially mute, or may repeat the same few syllables over and over. When a child’s vocal production and vocal variability are very limited, a behavior analyst has virtually no vocal speech behavior to shape. This can greatly hinder training efforts and diminish the child’s prognosis for developing speech.

One behavior analytic procedure aimed at increasing the quantity of speech vocalizations is called stimulus-stimulus pairing (SSP). This procedure is based
on the hypothesis that young children engage in varied, frequent vocal play because doing so produces noises that “sound good” (Bijou & Baer, 1965;
Schlinger, 1995; Skinner, 1957). It follows that if a child doesn’t readily make speech sounds, it might be helpful to make sure that human speech sounds are
as reinforcing as possible. The pairing procedure attempts to increase the “sound good” factor (i.e., conditioned reinforcing value; see Catania, 1998) by pairing an adult’s speech sounds with items or activities that the child clearly finds reinforcing. This procedure is similar to parents’ natural caregiving or play interactions (e.g., rocking while singing a lullaby, or saying “whee” while pushing the child in a swing).

Research has shown that although SSP procedures have increased the production of speech sounds in some children with ASD, the effects have been
inconsistent, and observed increases were not always maintained. At present, however, practitioners have very few well-researched interventions at their
disposal for increasing speech production in children who have very limited vocal speech skills. SSP may offer promise for some individuals.

Interested in reading more from Dr. Esch’s article? Click http://www.thebaca.com/Esch_Increasing%20speech%20in%20children.pdf to read the article, “Increasing speech in children with autism using the stimulus-stimulus pairing (SSP) procedure,” in its entirety.

The interview aired as a three-part series on the program “My Health Matters,” a discussion of health and wellness issues affecting the local community. The program is a collaboration between the City of Bloomington and WFHB radio.

In the interview, Dr. Sundberg addresses such topics as what is autism, treatments, the principles of Applied Behavior Analysis (ABA) as well as signs and symptoms of a child with autism.

Listen in by clicking on the following links:

http://soundcloud.com/user373964/sundberg-interview-part-1
http://soundcloud.com/user373964/sundberg-interview-part-2
http://soundcloud.com/user373964/sundberg-interview-part-3

There are those who experience extreme discomfort when exposed to situations who could be considered every day or typical to most of us. These people could be said to suffer from an anxiety disorder (e.g., generalized anxiety, panic attacks, phobias, etc.). These people (who don’t have autism) will engage in behaviors that will relieve the anxiety as well (escape behaviors). Most often they result in escape behaviors (leaving the situation), avoidance behaviors (avoiding the situation entirely) or engaging in some incompatible behaviors (practicing relaxation techniques).

In all cases, a sophisticated repertoire is typically involved. Many people with autism do not have the repertoires to engage in the socially-accepted methods that relieve the anxiety or discomfort.

I am not suggesting that people with autism don’t have sensory issues. Certainly there are many cases. My point is that sometimes there are other explanations.

Interested in reading more from Dr. Sundberg’s article? Click www.thebaca.com/Sensory_Needs_Long.pdf to read the article,”Looking at Autism: A Behavioral Analysis of Sensory Needs,” in its entirety.

As a therapist, you are responsible for providing intensive behavioral intervention services to clients with Autism Spectrum Disorder and other language delays.

Your responsibilities include:

• You are responsible for providing a direct therapist role with your primary client and/or your secondary and/or your mid-day client or other temporarily-assigned clients up to 40 hours per week providing hands-on therapy, unless directed otherwise.
• You will work with your team leader for your assigned clients to ensure each client will receive a full VB-MAPP evaluation initially and every six months thereafter.
• You will implement the treatment plan as written and directed by your consultant.
• Working with your consultant, speech and OT consultants, implement the goals and checklists they have defined for the client.
• Implement mid-day program for at least two assigned groups. These groups may include: 1. lunch 2. motor room 3. preschool group 4. social group and play 5. SRA 6. functional living 7. calendar and 8. classroom.
• Complete any incident report and make three copies, giving one to director, your team leader and the parent.
• From time to time, you will be called upon to be the morning or afternoon floater.
• You are the second point of contact for the parents.
• Attend all staff meetings.
• Attend and be an active participant in staff development day.
• Complete assigned cleaning chore daily.
• Maintain respect and confidentiality for the clients.
• Conduct yourself in a professional manner when interacting or communicating with clients, parents and colleagues.
• Maintain and protect the wellbeing of all of the clients in the center.
• Report inappropriate behavior of staff members to your team leader.
• You are expected to follow your issues and concerns through the chain of command.

We’d love to have you join us at BACA! See our website at http://www.thebaca.com/employment.html for more details as well as an application. We look forward to hearing from you!

In early 2010, we opened the doors to our second facility, known informally around here as “BACA II”.  We conceived BACA II as a place geared toward the unique learning needs of older children and adolescents (ages 8-18).  At BACA II, individuals receive services that facilitate the development of communication, academic, self-help, social, leisure, and vocational skills in an individualized manner including both one on one and group settings.   Meanwhile our younger clients at BACA I are benefitting from having an entire facility geared toward their needs as well.

This Saturday, April 2nd, we are hoping you will join us for a few hours at our first BACA II Open House.  We are excited to showcase our talented staff, and a facility that we are all very proud of.  We will be giving guided tours, followed by a light lunch, and finally I will be giving a clinical presentation on ABA, Verbal Behavior, and some more thoughts about what makes BACA II such a cool place.  Things get started at 11am, and we should be done around 2pm.  I hope to see you there!

Carl