Progress Highlight- How we got Dillon started with language
Dillon and his Mand
By J.J. Tomash, Ph.D., BCBA-D - January 7, 2021
Dillon (fictional name) is a 3-year-old, non-verbal kiddo diagnosed with ASD and Speech Delay who started services with BehaviorSpan in May of 2020. He had no prior experience with ABA (Applied Behavior Analysis) or Early Intervention when he first came to work with us. His parents were concerned about his communication skills. He had lost the few words he had when he was younger- now he only made a few unintelligible sounds. Another thing they wanted to work on was his following instructions. With a new little brother at home, it was getting harder for them to devote all their time and energy to Dillon. Giving him instructions would evoke tantrums that included throwing items, crying, and hitting his little brother.
We recognized quickly that the most important breakthrough skill we needed to help Dillon with was mand training. Mand training is the process of teaching someone how to freely request items, activities and people that they want. While it seems like a simple thing, being able to request things one wants is the most foundational type of language. To an individual that doesn’t communicate at all, being able to ask for things shows them the power that they can have what they want by simply asking for it. It begins the process of showing them all of the powerful things language can do for them (which we take for granted daily).Knowing this, we started immediately with teaching communication. We started on a picture exchange program to help with his communication (manding by gesturing to a picture of what he wants). Initially, we found that Dillon only knew how to ask for one thing he wanted (a basketball). After the first three months we were able to teach him how to ask for up to 50 different objects and activities he wanted- including “help” and “eat”. This was a major break-through for him- he is now able to navigate through all his picture cards and ask for things on his own. Parents recalled a story where he was crying at home and they didn’t know what to do, so they showed him some picture cards, and he picked out the picture of his grandma. They called his grandma right away, and he immediately calmed down when she started talking to him. As for his following instructions, he is now able to do 15-minute table sessions twice every hour and tolerates waiting for up to 15 minutes for something he really wants.
Dillon scored 16.5 on his initial VB-MAPP (an assessment used to determine a client’s level of language development). After just 4 months of Early Intervention ABA therapy he had more than doubled his score to 35. He now also has a few word approximations, and has recently started babbling, which his parents are thrilled about. He has grown so much in such a small amount of time, and we are excited to see him learn more each day.
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Cognition
The ability to problem-solve, adapt to new situations, and take previously learned skills and apply them in new and different ways to new situations.
Communication
The ability to tell others what one wants and needs, to describe one’s environment to others, and eventually to have dynamic and meaningful exchanges with other people.
Managing Emotions
The ability to respond to difficult situations that would normally cause anger, fear, or sadness by recognizing the effect the situation is having on oneself and using adaptive skills to avoid becoming out of control.
Social Skills
The ability to make friends, recognize other’s emotions and needs, stand up for oneself, have difficult conversations, play with others, and other skills that help one have fulfilling interactions with others in their life.
Motor Skills
The ability to do everyday tasks that require gross or fine motor control, such as: zipping zippers, buttoning buttons, using switches, walking, eating with utensils, and other important skills for independence.
Play Skills
The ability to play well with others, including important skills such as: sharing, taking turns, being kind, helping others who need help, and making and keeping friends.
Indepent Living Skills
Help with daily skills such as toilet training, hygiene, dressing, eating, chores, health and safety, and a variety of other skills.