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Decreasing the Amount of Prompts or Reinforcement Over Time with Children with Autism

Tara Warwick, MS, OTR/L

February 20, 2013

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Question

Over time, how do you decrease the amount of prompts or reinforcement given to children with autism?

Answer

Even though you have decreased the challenging behavior, it does not mean you stop there.  You also want to think about how we can decrease the amount of help or prompts we are providing the child.  We are always thinking about what is that next level that we need to get to with the child.  How can we get them a little bit more independent?  How do we reduce the frequency of the reinforcement. 

Reinforcement is something that you are always going to have at some level.  We all do.  But how can we mature it over time?  Maybe we have gotten to the point where they do not need a Skittle every time they take five steps down the hallway.  Now they are going to get a star when they get from their classroom to music, and then when they go from music to recess, they get another star, and so on.  By the time they have all five stars, it has been three or four class periods.  With an older child, we might use a point system.  They work on getting points and over time, it takes them longer to get whatever the reinforcement is that they want. 

We also should think about if we need to increase the variety of reinforcers.  If you are working with one of those children who really only have one reinforcer, you need to work on getting them more reinforcers.  One of the ways I do this is I combine them.  I work with children who have only one reinforcer.  We have to use that reinforcer to teach them how to use other reinforcers.  If it is iPad, then I might let them play on the iPad while I am playing music in the background.  Now they are starting to pair this iPad with music, and eventually maybe the music will be enough of a reinforcer.  Then I can gradually decrease the iPad because now the music is reinforcing as well.  Maybe it is while they are watching a favorite movie, we are also playing with a toy or Play-doh.  I am pairing something enjoyable with something else, which might in turn make that other thing enjoyable as well. 


tara warwick

Tara Warwick, MS, OTR/L

Tara Warwick is an occupational therapist who graduated from the University of Oklahoma Health Sciences Center in 2006 with her Master of Science in Rehab Sciences. She received a Bachelor of Science in Occupational Therapy in 2000 also from the University of Oklahoma Health Sciences Center. She has spent her entire career focusing on improving the quality of services for children, primarily targeting children with autism. She currently owns an Oklahoma pediatric therapy practice called Today’s Therapy Solutions and is a consultant for Project PEAK through the University of Oklahoma Health Sciences Center – Child Study Center. She practices as an occupational therapist in home settings, clinic settings, and school settings. Her specialty includes working with children with autism and challenging behavior.


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