Making a Case for Communication

When a Learner Comes into Therapy saying “More” what do we do about it in ABA?

As a therapist that wants extended and specific vocabulary, “more” is not the way to go.  Why?  Because when neurotypicals say “more”…the environment wants to ask “more what?”   There is a whole line of factual research that supports teaching specific vocabulary and the merits behind it being most beneficial.  But what do we do about Core?  Core vocabulary that is.  The “want, more” teaching that seems to take us away from teaching vocabulary.  Or does it really?     So in a team meeting a few weeks ago, a case was made for communication.

This meeting included two ABA Technicians (both working with this learner), an SLP, and an SLP-BCBA.  We discussed behavior, parts of his program, updates to his ABA program from supervision, and the organization of this learner’s day.  In this conversation, PECS and AAC was brought up as a choice to support communication and the variation needed to customize for this learner.  Core vocabulary was introduced as we discussed the organization of the board and what items were needed in the communication system.  The team meeting became more about the methodology and teaching procedures needed to support this learner’s communication and model.

Here are some excerpts (recalled) from the team meeting.  It’s important to note that the conversation started with all members and ended with the SLP and SLP-BCBA discussing what would happen.  The ABA Technicians kept commenting that this was nice to see and helpful.

Well he says more.  He signs more occasionally.
And then what happens?  
Well it's contextual so we know what he wants.
Okay.  But we want to shape the naming of the item that he wants. Rather than honoring "more".
Understood.  But he is communicating.  
But more is so non specific.
Yes. But there is good evidence behind core.  Let's do a core board that includes teaching him to say "want, more" so that he can request.
Um...we really want him to mand for specific vocabulary.  And broaden that vocabulary.  He will be more independent.
But, he is having trouble with an array of picture to picture ID.
Teaching him communication is key as we broaden the vocabulary.
Okay.  Let's customize this.  Focus on "want + specific vocabulary item" we shape this.  Stimulus to stimulus pairing -match with the object to picture.  A two step motor process.  So we are getting the want and teaching the specific at the same time.  We are going to emphasize the two part communication.  
Sounds good.  A good compromise.
What do we do about more?  
We honor it and then point him to the specific vocabulary to shape "more + target item"

When looking at who I am.  I am a therapist that wants the clients that I work with to be positively impacted and get better. I want increased communication skills.  I want to see data move up.  I want less challenging behaviors and increased social fluency.  I want it all.

The extended parts of the plan included, how we would collect data and measure effectiveness of the plan.  We agreed that this would be a great writeup in both and SLP and ABA journal as a single case study focusing on the methodology that we used from both sides of the aisle.

In a space of collaboration, disagreements will happen.  It was important to us that the conversation centered around that child and his current repertoire and how we would use our knowledge and influence to make him better.

#GetMomentum

~Landria Seals Green, MA., CCC-SLP-BCBA

Executive Director

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