Behavioural Skills Training (BST)

Keep it simple.

We’ve heard this expression over and over again and it is often at the core of different methods for teaching new skills. ABA practitioners use Behavioural Skills Training (BST) because it is an evidence-based training method that has been shown to be effective in teaching people all sorts of skills, from things like tying shoes, to working complex machinery. BST has 4 basic steps, they are:

Instruction (Explain the skill): The instructor is clear and concise and lays out expectations and consequences for appropriate behaviours as well as instructions on how the task is to be completed. They may also provide a rationale for the skill or describe why it is important. 

• For example:  Someone using BST to teach appropriate movie-going behaviour would initially explain, “When you are in the theatre you must walk slowly, stay within arms reach of me, and use a quiet voice, so that everyone can hear and get to their movie on time.”

Modelling (Show the skill): The instructor creates an opportunity wherein they can model the skill they are teaching their learners. This creates a reference point for the learner to come back as they learn the skill.

• For example: Someone using BST to teach movie-going behaviour would show the learner what walking slowly, staying close, and  speaking quietly look like by physically performing these actions or showing a video clip of someone performing these actions.

Rehearsal (Practice the skill): The instructor creates an opportunity for the learners to practice performing the desired skill.

• For Example: Someone using BST to teach movie-going behaviour might take a field trip to the theatre or set up a “mini” movie theatre in their house so the learners can practice the skill.

Feedback (Report on how the skill was performed): The instructor provides calm, factual, and helpful feedback to the learner on how the skill was performed and then provides rewards (ABA people would say positive reinforcement) for successful performance and more training on whatever the learner may still need help learning.

• For example: Someone using BST to teach movie-going behaviour might congratulate a learner on how well they are walking quietly and remind them to keep their voice low. The instructor would then model keeping their voice low for the learner again. It is important to note that modelling, rehearsal, and feedback are repeated as many times as needed while teaching a skill, and are repeated until the learner has shown that they possess the skill (what those in ABA call “mastery”). 

Different people learn differently and, using the movie theatre example above, some may quickly learn to walk quietly, but may struggle staying close and keeping their voice low. With others it may be the opposite. BST provides learners with many opportunities to perform all parts of a skill along with modelling from those that already know how to perform the skill.

While anyone can use the steps of BST to teach someone, it is important that the person using BST have a good relationship (in ABA terms we call that being “paired”) with the individual they are teaching. It is also important to be able to adapt to the learner’s needs. For example, a teacher using BST with someone that has a sensitivity to sound may use visual instructions or the least amount of words while speaking/describing a skill. 

Sometimes, when we don’t feel understood, or when we think others haven’t understood us, we may want to think of other ways to explain things. While we may say things that are very true and full of good information, it can actually make it less likely that you will successfully teach the skill. 

Remember that it’s better to keep it simple and show your learner what you mean than tell them; then give them the chance to practice it, giving feedback and rewards for doing the skill correctly. 

Interested in learning more? Check out these resources on Behavioural Skills Training (BST):

https://bsci21.org/behavior-skills-training-in-4-steps/

https://prezi.com/qdv493njkua7/behavioral-skills-training-procedures/

How Autism Differs in Boys vs. Girls

Autism Spectrum Disorder, better known as Autism, is a very complex neurodevelopmental disorder that affects cognitive and executive functioning. To find out more about Autism itself, visit this page for a simplified look. Autism has been studied more and more throughout the years, and an interesting area of study has been looking at the difference between boys/males with Autism vs. girls/females. It has been suggested that Autism is diagnosed 4 times more often in males versus females (Autism Speaks, 2020), but, why? Within the research, we have determined how signs and symptoms can look different, along with how males and females may internalize Autism differently. Although there may be some differences between males and females, it is important to remember that Autism presents uniquely in every individual, regardless of sex or gender. This blog will take a look at how different components of Autism have been proposed to differ between gender populations. 

Why are boys diagnosed 4X more often than girls?

It has been suggested throughout the literature that Autism is more heavily studied in boys rather than girls. Consequently, there are a few theories as to why females present significantly lower rates of Autism than males. One theory has to do with differing levels of hormones in the body and biological sex differences. This theory ultimately suggests that females with Autism may not be diagnosed as often because they present milder symptoms due to hormone variation (Soloman, Miller, Taylor, Hinshaw & Carter, 2012). Additionally, another theory emphasizes that some girls may in fact be more impaired than boys with Autism. This theory explains that girls may either require a higher genetic or environmental load to be affected, or that males present higher rates of less severe Autism symptoms (Soloman et al., 2012). Both of these theories have been supported through journal articles, however it still remains unclear exactly why males are diagnosed more frequently than females.

How does ASD differ between males and females?

A famous quote from Stephen Shore details, “if you have met one person with Autism, you have met one person with Autism”. This amazing quote outlines how broad the spectrum is, and how every single individual has their own strengths and areas of need. Keeping this quote in mind, we know how unique each child with Autism is, but is it common for Autism to present differently in boys versus girls? Many studies have suggested sex differences for displaying characteristics of Autism, such as boys exhitbiting higher levels of repetitive behaviours and stereotypical play (Soloman et al., 2012). Girls, on the other hand, have been suggested to be at an increased risk for internalizing their symptoms (Soloman et al., 2012), meaning they keep their feelings inside their mind rather than expressing it with behaviours. Unfortunately, there are considerable gaps in the literature that fully determine significant differences between males and females with Autism. This is most definitely a topic for further research, and it will be interesting to see what is to come. 

References

Autism Statistics and Facts. (n.d.). Retrieved April 7, 2020, from http://www.autismspeaks.org/autism-statistics 

Solomon, M., Miller, M., Taylor, S., Hinshaw, S., & Carter, C. (2012). Autism symptoms and internalizing psychopathology in girls and boys with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(1), 48–59.

Behaviour as Communication

The way that humans behave with each other often has communicative properties, even when they aren’t speaking. Even when humans are speaking, most of what they say to each other is non-verbal (tone, expression, etc.). In other words, we use our behaviour to ask others to help us with things we can’t do alone or by ourselves. 

Think of it this way. What could an infant having a tantrum in a store be communicating? It could be that they are hungry. It could be that they are ready to leave. It could even be that they don’t feel well and need comfort from someone else. This leads to one of the hard things about communicating, which is; others don’t always hear what we are trying to say.

What Are You Trying to Tell Me?

How can we tell what someone is trying to say if they can’t speak? Really, it isn’t very different from speaking, but it can be a lot harder to “hear” when others don’t speak. One trick is to look at the response that stops a person’s behaviour. 

That can be a bit confusing so let’s look at an example with speech. With typical, spoken communication, if someone calls your name and you respond, the person tends to stop calling your name, because you responded. Imagine if someone called your name and you didn’t respond. What might happen? The person might call your name more loudly, they may get nearer to you, and they may try to get your eye contact. If any of those other behaviours gets your attention, they will probably stop.

Let’s look at the same situation without speech. If someone starts to stomp and grunt they may be trying to get your attention. If you don’t respond, they may grunt and stomp more loudly, or they may get closer to you. They may try tapping you or grabbing you. If you finally look at the person and say, “What do you need?” and they stop, then they were probably trying to get your attention.

Let’s look at one more example without speech. You are talking to a friend and the person you are with starts to fidget and grab at your phone. If you just keep talking, they may become louder, more insistent, or just walk off. They probably aren’t trying to bug you, they may be bored or looking for something to do while you  talk.

A Very Brief Look at Functions

The trick to understanding what people are “saying” with their behaviour is to find out what the person is trying to get with their behaviour, what those in ABA call a “function”. In ABA, we look at what happens right after a behaviour to figure out why the behaviour happened. People have complex needs but they can all be fit into 4 broad categories of needs (or functions) and if one of these happens right after a behaviour, it might be why the behaviour happened. First, let's look at the things that can happen after a behaviour;

Accessing Items or Activities

The person is able to access something they can feel, eat, or use. An example is buying movie tickets so that you can access the activity of watching a movie. 

Accessing Social Attention

The person does something so that other people will engage with them. An example is telling a funny story or calling an old friend to chat.

Accessing a Sensation

The person does something because of the sensation it produces. An example is clicking a pen, tapping a foot, or twirling your hair

Escaping Something Unpleasant

The person does something to get out of, or avoid, something unpleasant to them. An example of this is driving the speed limit and following all traffic laws so that you do not get a ticket, which is unpleasant

When Words Fail Us

People we encounter do not always have the skills needed to communicate their needs. A person like this cannot tell you that they need to eat, or that they want some attention, or that they need help to do an activity they enjoy. So how do people that don’t speak learn to communicate? If there is no plan what often happens in cases like this is that the person does something (yells, cries, stomps, etc.) that ends with a need being met, so they become more likely to do the same thing again the next time they have that need. 

It can be confusing so here is an example. A child that cannot speak begins to stamp their foot and grunt loudly while standing in the kitchen. Their mother comes over and says “it’s okay, what is wrong?”, but the person can’t respond so they keep stomping and grunting, maybe even getting louder or more intense. The mother wants to stop the grunting and stomping so she gives the child some food and comfort. If the child was hungry, or wanted attention they would likely stop grunting and stomping when their mother gave them food and comfort, but they will be more likely to stand in the kitchen and stomp and grunt the next time they are hungry or want attention. 

So What Now?

So what do you do about it? Knowing what a person is trying to get, or “say” with their behaviour lets you make sure they get it only for doing what you want. Let’s look at it practically with our prior example. Since we see that the child grunting and stomping their feet results in food and attention, we can make a plan to teach the child how to ask for food and attention first thing in the morning and before meal times. 

This can look a lot of ways. You could have a small packet in the kitchen filled with pictures of different food items that the child can select and bring to you. You could teach the child sign language for “food” and “hug”. You could even teach the child to come and tap your arm a certain number of times to indicate food. The idea is to find out what the person wants and then teach them to ask for it in a way that they can easily do. 

Hopefully this article will give you some ideas about communication and some strategies for figuring out what others are trying to tell you. Look at what happens right after a behaviour for help in figuring out why it happens and remember that knowledge is power; the more you know about a person, their strengths, weakness, likes and dislikes, the better you can help them.