Designing Receptive Language Programs: Pushing the Boundaries of Research and Practice

Abstract

Initial difficulty with receptive language is a stumbling block for some children with autism. Numerous strategies have been attempted over the years, and general guidelines for teaching receptive language have been published. But what to do when all else fails? This article reviews 21 strategies that have been effective for some children with autism. Although many of the strategies require further research, behavioral practitioners should consider implementation after careful review. The purpose of this article is to help behavior analysts in practice to categorize different teaching procedures for systematic review, recognize the conceptually systematic rationale behind each strategy, identify different client profiles that may make 1 strategy more effective than another, and create modifications to receptive language programming that remain grounded in research.

Appendices

Appendix 1

Sound Discrimination Variations

As a final product, receptive labeling begins with a vocal stimulus (e.g., the word pizza) that results in a nonvocal response (e.g., touching a toy pizza). This is indicated at the bottom of Fig. 1 by the program with a thick black border. The sound discrimination program begins with a broader auditory stimulus (e.g., the sound of a drum) that requires the child to produce the same auditory response (e.g., banging an identical drum). This is indicated near the top of Fig. 1 by the program with a thick dotted border. Overall, the figure illustrates through a basic flowchart the ways in which variations to the sound discrimination program can be made, gradually teaching skills through changes to the discriminative stimulus (SD) or the response that ultimately arrive at receptive labeling. Sounds can progress from auditory sounds (e.g., a horn, a bell, a train whistle) to vocal sounds (e.g., consonant sounds, vowel sounds, or even a raspberry noise) to vocal words. These combinations are indicated by thicker arrows that curve vertically in the figure. Combinations can also change from auditory stimuli and auditory responses that are identical (column 1) to other formats with auditory stimuli and auditory responses that are identical (column 2) to auditory stimuli and auditory responses that are not identical (column 3) to auditory stimuli and responses with no auditory stimuli (column 4). These combinations are indicated by thinner arrows that point in a horizontal direction. All variations should be studied further to determine if learning these skills will facilitate the development of receptive labeling. Programming should attempt to progress as quickly as possible to a standard receptive labeling program but could focus on related skills when a child demonstrates difficulty with changes to the SD or response.

• Variation 1: Auditory SD—Auditory Response

Fig. 1

Progression from sound discrimination to typical receptive labeling. AUD = auditory sound; VOCS = vocal sound; VOCW = vocal word

SD: The therapist shakes a bell from behind a barrier with three objects in front of the child (the same bell, a rice shaker, and a drum).

Response: The child picks up the bell and shakes it.

• Variation 2: Two Auditory SDs—Two Auditory Responses

SD: The therapist shakes a rice shaker and then pounds a drum from behind a barrier with three objects in front of the child (a bell, a rice shaker, and a drum).

Response: The child picks up the rice shaker and shakes it, then picks up the drum and pounds it.

• Variation 3: New Auditory SD—Test Auditory Response

SD: The therapist plays a novel instrument from behind a barrier (e.g., a squeeze horn) with three novel objects that make sounds in front of the child (the same horn, a xylophone, and a piano).

Response: The child plays each of the instruments and places the correct instrument on a plate or in a container to indicate that that is the one the child has chosen as making the same sound.

• Variation 4: Nonidentical Auditory SD—Auditory Response

SD: The therapist shakes a rice shaker that sounds similar to but is not the same rice shaker the child has. For example, the therapist could shake a larger rice shaker and play rice shaker sounds from an iPad that sound similar. Three objects are in front of the child (a bell, a rice shaker, and a drum).

Response: The child picks up the rice shaker and shakes it.

• Variation 5: Vocal Sound SD—Auditory Response

SD: The therapist makes a vocal sound such as “shhhhhhh.” Three objects are in front of the child (a bell, a rice shaker, and a drum).

Response: The child picks up the rice shaker and shakes it.

The therapist initially shakes the rice shaker while making the vocal sound and then gradually fades the rice shaker sound.

• Variation 6: Vocal Word SD—Auditory Response

SD: The therapist says “rice shaker.” Three objects are in front of the child (a bell, a rice shaker, and a drum).

Response: The child picks up the rice shaker and shakes it.

The therapist initially shakes the rice shaker while saying the word or initially includes the vocal sound (e.g., “shhhhhhhaker”), depending on which formats were previously mastered.

• Variation 7: Auditory SD—No Auditory Response

SD: The therapist shakes a rice shaker from behind a barrier with three objects in front of the child (a bell, a rice shaker, and a drum).

Response: The child points to the correct object rather than making the sound, or the inside of the rice shaker is removed so that when the child picks it up and hands it to the therapist, it does not make a sound.

• Variation 8: Vocal Sound SD—Vocal Sound Response

SD: The therapist makes a vocal sound such as “mmmmmm” or “shhhhhhh” or a blowing sound, or the therapist presses an icon on an iPad that has a prerecorded vocal sound associated with it.

Response: The child touches his own iPad with the picture that makes the same sound (e.g., “mmmmm” for a food the child really likes; “shhhhh” for a rocketship blasting off into space; a blowing sound for a canister of bubbles).

Through apps such as SpeakAll, the iPad can be used to record the therapist’s voice and the child’s iPad can be programmed to repeat the therapist’s voice when the child touches a picture.

• Variation 9: Two Vocal Sound SDs—Two Vocal Sound Responses

SD: The therapist makes the vocal sound “mmmmmm,” pauses for 1 s, and then makes a blowing sound.

Response: The child touches his own iPad with the two pictures in order of the same sounds (e.g., “mmmmm” for a food the child really likes and then a blowing sound for a canister of bubbles).

• Variation 10: New Vocal Sound SD—Test Vocal Sound Response

SD: The therapist plays a novel vocal sound on his iPad.

Response: The child presses new pictures on his iPad until he finds the correct sound and then stops pressing buttons.

• Variation 11: Nonidentical Vocal Sound SD—Vocal Sound Response

SD: Different therapists make the same vocal sound such as “mmmmmm” or “shhhhhhh” but vary the pitch, volume, or inflection.

Response: The child touches his own iPad with the picture that makes the original sound.

• Variation 12: Vocal Word SD—Vocal Sound Response

SD: The therapist says “rocket.”

Response: The child touches his own iPad with the picture that makes the vocal sound (e.g., pressing the rocket results in the sound “rrrrrrrrrr”).

This program may work best when the vocal sound that was originally used is part of the vocal word. Vocal sounds can either sound like the auditory sound of an object (e.g., “shhhhhhh” may sound similar to the sound a rocket makes) or like part of the word (e.g., “rrrrr” is the initial sound of “rocket”). Which type of vocal sound is used will partly depend on the expected progression through the sound discrimination program (e.g., Is the focus on transferring from auditory sounds to vocal sounds or from vocal sounds to vocal words?) and may also include a transition from one vocal sound to the other.

• Variation 13: Vocal Sound SD—No Vocal Sound Response

SD: The therapist makes a vocal sound such as “mmmmmm” or “shhhhhhh” or a blowing sound, or the therapist presses an icon on an iPad that has a prerecorded vocal sound associated with it.

Response: The child touches a picture, an object, or a picture on his own iPad or on the table. No sound is made during the response.

• Variation 14: Vocal Word SD—Vocal Word Response

SD: The therapist names an object (e.g., Woody), or the therapist presses an icon on an iPad that has a prerecorded vocal word associated with it.

Response: The child touches his own iPad with the same picture that says the same word (e.g., the icon of Woody says “Woody” when touched).

• Variation 15: Two Vocal Word SDs—Two Vocal Word Responses

SD: The therapist says “Woody” and then says “train.”

Response: The child touches the two pictures on his own iPad in the same order (e.g., “Woody” results in the word Woody repeated by his iPad and then “train” results in the word train repeated on his iPad).

• Variation 16: New Vocal Word SD—Test Vocal Word Response

SD: The therapist plays a novel word on his iPad (e.g., Buzz Lightyear).

Response: The child presses new pictures on his iPad until he finds the one that matches the same word and then stops pressing buttons.

• Variation 17: Nonidentical Vocal Word SD—Vocal Word Response

SD: Different therapists say the same word (Woody) but vary the pitch, volume, or inflection.

Response: The child touches his own iPad with the picture that makes the original sound.

• Variation 18: Vocal Word SD—No Vocal Word Response

SD: The therapist says “Woody” with three objects on the table.

Response: The child touches the correct object.

This is a typical receptive labels program.

Appendix 2

Receptive Language Program Format Variation Posted to the Me-List (1997)

The following is a list of possible formats for receptive programs. Some are messy and require laminating the cards.

• 1. Give the child a flyswatter. SD: “Slap __.”

• 2. Place cards or objects in clear plastic shoeholders that can be hung vertically. Give the child a ruler. SD: “Point to __.”

• 3. Place cards or objects on the floor. Give the child a beanbag. SD: “Throw onto __.”

• 4. Place cards in the gripping end of wooden clothespins and stand the clothespins up like bowling pins. You could also try using plastic tripod paper clips. Give the child a party blower that unrolls when inflated, a disc shooter, or a water gun, or have the child use his hand. SD: “Knock down __.”

• 5. Give the child a flashlight or a laser pen. SD: “Shine on __.”

• 6. Give the child a feather duster. SD: “Dust __.”

• 7. Give the child bingo chips or small figurines. SD: “Put on __.”

• 8. Make extra large flash cards (8 × 10) and place them on the floor. SD: “Step [or jump] on __.”

• 9. Use a chalkboard inside or sidewalk chalk outside with targets and distractors written or drawn on the surface. SD: “Spray __.”

• 10. Use regular flash cards or items but in sets, moving closer to reinforcers (like “Mother May I?”; i.e., 6 f. from trampoline: first set, 4 f. away: second set, 2 f. away: third set, then go on the trampoline), going up stairs, out the door, and so on.

• 11. Hang cards on a clothesline or on a hanger with a clothespin. SD: “Pull [or take] off __.”

• 12. Use tactile materials such as shaving cream, sand, finger paint, or Play-Doh for graphic motor. SD: “Write __ (with your finger).”

• 13. Tape small pictures or stickers onto a large rolling pin or plastic soda bottle. Have the child slowly roll the pin to find the target and then point it out. SD: “Find __.”

• 14. Hang a magnetic board on the wall. Attach pictures with magnetic clips. SD: “Pull [or take] off __.”

• 15. Give the child a favorite stuffed animal, figure, or puppet to “feed.” SD: “Feed Elmo __.”

• 16. Give the child a “magic wand.” You can buy ones that light up at some toy stores or make your own. SD: “Touch [or tap] __.”

• 17. Hide cards or objects in a container filled with rice or sand for the child to dig up. SD: “Give me __.”

• 18. Reverse the previous activity. Place cards in front of the container. SD: “Bury __.”

• 19. Attach paper clips to the flashcards you are using and then spread the cards out on the floor. Give the child a stick with the string tied on the end and a magnet tied to the end of the string to “catch” the target. SD: “Catch __.”

• 20. Tape pictures, flashcards, and so on to balloons. Give the child something that he can safely pop the balloons with. SD: “Pop ___.” “Poke ___.”

• 21. Tape each picture, flashcard, and so on to a flower shape you have cut out of colorful construction paper. Tape the shape to a tongue depressor. Go out to the garden (or find a pot if you can’t go outside) and plant them. SD: “Plant ___.”

• 22. Reverse the previous process and start with all of the flowers planted. Have the child pick the target flower. SD: “Pick ___.”

• 23. Give the child a stamper to stamp the target with. Use a baby wipe to clean off cards between trials, or just use a stamper without any ink on it. SD: “Stamp __.”

• 24. Give the child a paintbrush and a cup of water. SD: “Paint on __.”

• 25. Stick small lumps of clay on the tops of toy cars. Stick the cards vertically in the lumps of clay so that the cards stand up on the car roofs. SD: “Push __.”