Motivational Problems

Although motivation and attention appear to be closely related, we discuss them separately in an attempt to clearly describe the idiosyncrasies embedded in each. Most typical individuals seem motivated and eager to learn, but most individuals with developmental delays seem unmotivated when confronted with educational tasks. As described in Chapter 5, it is likely that the negativism shown by individuals with developmental delays is caused by the frustration they experience when failing to learn what well-meaning adults hope they would learn. To help reduce this continual failure, these individuals develop tantrums to ward off demands, isolate themselves by acting as if they cannot see or hear, and fail to develop eye contact. In turn, persons with developmental delays come to rely on their own reinforcers such as self-stimulatory rituals.

Early in treatment, social praise, the company of others and most other subtle rewards that are important to typical individuals are unlikely to be effective reinforcers for most students with developmental delays. Similarly, being incorrect and receiving social feedback such as the teacher providing an informational 'No' in the early stages of treatment often do not work to correct behaviour. Technically speaking, these students show a delay in the acquisition of secondary (acquired, social, or symbolic) reinforcers.

We recommend that the teacher rely on primary or biological rewards, such as small bites of food, at the be-ginning of treatment. Food reinforcement has its limitations, as we shall describe later, but it constitutes a good reward in the early weeks of treatment. Food reinforcers may also signal a sense of security for the student. Anticipate, however, that the student may have difficulty accepting the teacher's food rewards in the first hours of teaching (see Chapter 9).

Allowing the student to escape from a stressful situation is also a powerful and primary reinforcer, as is giving the individual the opportunity to self-stimulate. Letting the student leave a stressful teaching situation, for a minute or so, contingent on a correct response may be the most effective reward in the early stages of treatment. As the teacher becomes more familiar with the student, the teacher will discover other types of reinforcers that are unique to and effective for that particular student.

Given the importance of social rewards to a typical individual's learning, it follows that an individual's functioning in society would be seriously curtailed if social rewards were not effective. On the other hand, if one could help the individual with developmental delays succeed, and then one might concurrently 'normalize' the individual's motivational structure. Over our years of working with individuals who have developmental delays, we have found that a much wider range of effective reinforcers are available than anticipated in the early days. Given access to this larger range of reinforcers, teachers have become more effective and the persons taught have become more motivated to learn. To illustrate our search for potentially rewarding consequences, the following story was provided by Gordon Hall, a grandfather of a child with autism.

Positive Reinforcement or What Would You Do for $1 Million

'Twenty-five reinforcers,' our consultant said. 'You need to come up with at least that many as Kendra is not working for just sips of Pepsi and pieces of a cookie.' 'You must be crazy,' I thought. 'There isnt 25 things I can think of that Kendra wants.' Our consultant continued, 'Kendra will teach you how to work with her, because if you don't do it right, she will punish you by not working. And the key to effective teaching is the use of proper reinforcers.' Our consultant then asked, 'Would you sit and stack blocks all day for $1 million?' My answer was, 'Of course.' The same principle, I learned, applies to working with what motivates the student.

I asked how I should start to discover effective reinforcers. Our consultant suggested I take Kendra to Toys 'R' Us and buy whatever she became attracted to. I didn't go to Toys 'R' Us, but from working with Kendra, I have a good idea of the toys and activities she enjoys.

The hardest part for me was starting to make my 25-item list. Near the top of the list I placed the fallback items of food and drink: Mini M&M's, Fig Newtons (each Newton cut into 12 pieces), root beer (instead of other soda pop be-cause root beer has no caffeine), and apple juice. We use small plastic containers for the food items and a 12 x 14-inch cake pan to place all the food, drinks, and other small items in so they are readily available. Next on the list are small tops that you can spin with your fingers. Kendra also loves trains, so we got some wind-up trains. The tops and wind-up trains go in the cake pan with the food and drink items so that they are easily accessible during the programs. Other items on the list include a bottle of soap bubbles, a small toy bug with bouncing beads inside, physical tickling, lightly pounding on the bottom of Kendra's feet, getting out of the chair to ring a bell across the room, getting out of the chair to put a block or beanbag in a bucket, and running across the room to push a key on the piano. Kendra especially loves out-of-the-chair activities.

As I started listing items, more and more came to mind: a Mexican rain stick that makes a pleasant sound, a Disney Beauty and the Beast talking book, an inflatable Yogi that Kendra likes to punch, a Farmer Says toy, a pop-up toy, and large beads to string. Also on the list are items that are used during Kendra's programs, such as Play-Doh. She likes to put her finger into it or pound on it. Kendra also enjoys stacking Lincoln Logs, so we hand her one at a time during the Verbal Imitation Program. In addition, we have a vibrating ball that she likes to hold or put on her back.

The way the programs are set up can make them reinforcing in and of themselves. For the Colours Program, we have felt swatches that are placed on the floor, and we make a game out of having one of the aides and Kendra alternate jumping onto the correct colour. We often put an array of items in front of Kendra and let her pick her own toy or food item. She works better when she can decide what she is working for.

The list is of no good if it is not used, so I made two copies and tacked one on the wall above the table where we work. The other is kept with the list of daily programs. As it is so easy to revert to food and drink, we make a special effort to vary reinforcers among and within programs.

If you are having a problem discovering reinforcers, you might try the approach that was effective for me. Just sit down and start writing down the food, toys, and other items your student enjoys. Good luck!

One helpful way to deliver reinforcers is through the use of a prize board. A prize board provides a visual display of reinforcers, is economical, and is enjoyable to most students.

The Prize Board

A prize board is a visual display that clearly shows a prize the student may obtain once a preset number of tokens has been earned. Under a prize board system, a student can earn tokens by completing any of a number of different tasks and can later exchange these tokens for a valued prize, such as a favourite food, toy, or activity. In this sense, tokens are similar to money in that they can be traded in to obtain desired items.

When the student gives a correct response, the teacher gives the student a token to place on the board. Such tokens are similar to points typical children earn toward enjoying a favourite activity such as watching a certain television program or obtaining some other special treat such as ice cream. Tokens are also similar to grades in school where so many As can earn a special prize. Prize boards are commonly used with typical kindergarten and first-grade children who may need this type of visual display to compensate for the lack of skills needed to bridge the delay between behaviour and its eventual reinforcer. For students with developmental delays who tend to lack the verbal language necessary to make this bridge, the visual display appears to be helpful in maintaining the student's motivation. In addition, delaying reinforcement through the medium of a prize board may increase retention (memory) of learned material.

Another important reason for introducing a prize board is that it helps the student become accustomed to delays in obtaining primary reinforcement. During most of the early teaching performed from this manual, the student is exposed to instantaneous and powerful reinforcement: Each time the student responds correctly, she is immediately reinforced with a strong, often primary, reinforcer. To function in everyday life, however, the student must learn to work for delayed and 'thinned-out' reinforcement schedules. For example, in a classroom setting, a student is not immediately rewarded by the teacher following each and every one of the teacher's instructions. The student may, however, be selected to go out first to recess because she followed the teacher's directions during the preceding hour. For displaying good behaviour, the student may also be given some stars on a piece of paper, and later on grades, to show her parents at the end of the day or the week, a procedure very similar to that of the prize board.

Keep in mind that the prize board should not replace the one-on-one reinforcement the student already receives for correct responses in teaching sessions; rather, it should be used in addition to such reinforcement, particularly if the student's motivation seems to drift and decrease. The reinforcement the student gains through the prize board should be more valuable than reinforcers obtained after each correct response. For instance, a student may be given hugs or small bites of food for each correct response but receive an ice cream cone after earning five or more tokens.

Prize boards are easy to construct using the following common household materials: a large, durable poster board approximately 26 x 36 inches in size, paints or felt pens, and a variety of the student's favourite foods, drinks, toys, and activities (depicted in two-dimensional form). Tokens can be items as simple as coin-size plastic circles or as creative as three-dimensional toys such as Disney characters, Sesame Street figures, or finger puppets. Choose tokens that are interesting and enjoyable for the student, possessing some reinforcing properties of their own. Affix Velcro pieces to the back of each token and in one or two rows on the board, allowing the student to easily fasten the tokens to the board. A clear plastic bag can be affixed to the board to position the particular prize (or symbol of the prize) used in the teaching session.

An example of a prize board is displayed in Figure 7.1. Note that the number of Velcro pieces for placement of tokens should vary according to the student's familiarity with the prize board system (see the next section, using the Prize Board). A transparent plastic bag for displaying various prizes one at a time is used for illustrative purposes. Other arrangements may be satisfactory.

Select the student's favourite foods as the initial prizes for the prize board. To maintain the reinforcing value of these foods, they should be available only through the prize board; that is, the student should not have any access to these reinforcers at other times. Once the student learns that the prize board can be used to gain preferred reinforcers, nonfood items, such as favourite toys, videotapes, or trips to a favourite restaurant or store, can be used as prizes. Regardless of the prize used, the student should be given a visual display of the prize she will obtain after earning a certain number of tokens. Prizes that are abstract or that do not fit inside the bag on the board, such as certain toys, videotapes, or trip destinations, are often best displayed through the use of photographs. For example, if the student's prize is a trip to Baskin-Robbins, a picture of Baskin-Robbins should be placed in the bag on the board.

As a general guideline, create a prize board that is visually appealing and fun for the student. Decorate the borders of the board, reserving the centre space for token display. When the prize board is completed, it should be placed prominently near the student's table and chairs.

Using the Prize Board

For the most part, the student receives immediate reinforcement for responses through discrete trial procedures (see Chapter 10). It is difficult to assess the proper time tokens earned so far Velcro for placement of tokens to introduce a prize board system to a student, and it will not be known whether the student can learn this form of delayed reinforcement until one attempts to teach it. If, after the system is introduced, the student does not seem to be reinforced by the use of tokens, this may be an indication that she is not ready for delayed reinforcement and may need more immediate reinforcement for the time being. Before putting the prize board system on hold, however, make sure you implement the system properly and examine possible ways of clarifying the contingency for the student (e.g., by decreasing the number of tokens required to obtain the prize).

As previously mentioned, variations of the prize board system are often used with typical individuals. It is therefore not necessary to fade the use of this system altogether. You may, however, eventually want to naturalize the system so the student learns to mentally keep track of her 'points' and earns more natural prizes, such as new toys. The following five steps are intended to help facilitate the use of the prize board.

Step 1

Teach the association between responses, tokens, and prizes. Choose a program with which the student can be successful. Place the prize board near the table and in clear view of the student. Place several tokens on the board, leaving one slot open for the last token (e.g., if there are 10 slots, have 9 tokens already placed on the board). With the final token within your reach, call the student to the table and begin a trial as usual. Immediately after a correct response, praise the student, hand her a token, and say, 'Put it on the board.' Prompt the student to place the token in its correct position on the board, and then give her the prize in the bag. You may want to help the student associate the tokens with the reward by having the student count the tokens, after which you comment something to the effect, 'Ten! You get a prize!' Through repeated practice of this procedure, it is likely that the student will learn the contingency between the tokens and the prize.

Step 2

Increase the response requirement. After the student makes the connection between the tokens and the prize, increase the requirement by leaving the last two slots open on the board so that the student must earn two tokens to obtain the

prize. After two to three times of giving two tokens for two correct responses (one token per correct response) within one program, give the student two tokens for two correct responses over two different programs.

It is important to vary the token requirement of the program and the schedule in which tokens are given so that the student does not learn a pattern of reinforcement delivery. Such a pattern would eventually need to be broken, leading to frustration when the teacher increases the token requirement or changes the schedule of token delivery. To illustrate, a student who is accustomed to earning a token for each correct response may become frustrated when the teacher begins giving tokens for every other correct response. The key to avoiding frustration is preventing the student from developing a pattern in the first place by randomizing the token schedule.

Increase the token requirement in gradual steps until the student must earn 10 tokens before the prize is delivered. As you increase the token requirement, be sure that the student can observe the board and that she acquires the required number of tokens within 30 minutes or less. This will help her tolerate the delay between earning the tokens and receiving the prize. Once this step is mastered, increase the time interval to 45 minutes. At this point, the student's prizes should have more value in order to keep her motivated for the duration of the longer time interval.

► Step 3

Lengthen the reinforcement delay. To approximate the reinforcement delay that typical first-grade students can tolerate (e.g., cashing in the tokens at the end of the day), start increasing the time interval in gradual steps between earning tokens and obtaining the prize. Students who have limited receptive or expressive language may need shorter time intervals (e.g., less than 30 minutes) between the last token delivery and the prize. Students who have mastered advanced receptive and expressive language, counting, and if-then reasoning (e.g., 'If you get 10 tokens, then we'll go to McDonald's') may respond to a time interval of, for example, 3 hours between the time of receiving the last token and the prize.

Motivational Problems 41

► Step 4

Further increase motivation. Try giving the student a choice of prizes: At the beginning of the teaching session, has the student selected her own prize from a display of two to three items. Be sure to hold the token requirement constant; if the student does not meet the requirement within the session (e.g., because her responding was not as good as usual for that session), then she does not earn her prize.

► Step 5

Use a prize board system to decrease behaviour. Once a prize board system of reinforcement is established, it can also be used to decrease inappropriate behaviours. This can be accomplished through response cost, which involves the loss of a desired item contingent upon behaviour. Once the tokens have been established as valuable to the student, the removal of a token contingent upon an inappropriate behaviour can decrease such behaviour.

Begin this step by delineating which behaviours will result in the loss of a token. When the student engages in one of the predetermined behaviours, remove a token from the board while explaining the contingency to the student. For example, if the student has seven tokens on the board and needs three more to achieve a prize, and the student then engages in an inappropriate behaviour (e.g., bites the teacher), the teacher should quickly bring the student to the board, remove a token from the board, and firmly state, 'No biting. You lose a token.' The student then would have only six tokens on the board and must earn the seventh token again.

Behaviours can also be decreased by creating a separate board system for inappropriate behaviours. In this system, the student is given a red card for engaging in a given behaviour. If the student acquires a certain number of red cards (e.g., three) within a specific interval (e.g., a single 3-hour teaching session), the student receives an undesirable consequence. Sometimes a student's behaviour is so extreme that one occurrence should earn a consequence. For example, if the student makes a threatening move toward a younger sibling, she may then be given a red card with the contingency explained during the delivery of the red card (e.g., 'No hitting. You get a red card.'). The student's parents can then determine an appropriate consequence to be used with this procedure.

Reinforcement and Success

The rewards described by Gordon Hall in the beginning of this chapter and those described here for use with the prize board are all extrinsic rewards; that is, they are rewards that are dispensed by persons other than the student. Such a reward system is undoubtedly essential to helping the student develop into a typical individual. There is another kind of reward discussed in Chapter 6 on self-stimulatory behaviour. This type of reward consists of sensory-perceptual reinforcers, which seem less dependent on being provided by others, although many forms can be controlled by others. For example, a teacher may allow the student to self-stimulate (e.g., rock back and forth) for 5 to 10 seconds contingent on a correct response while blocking the self-stimulatory behaviour at all other times.

The sensory-perceptual rewards described in Chapter 6 are inherent to self-stimulatory behaviours; that is, the behaviours themselves seem to provide rewarding consequences. One may refer to such rewards as intrinsically motivating in contrast to rewards that are extrinsically motivating. In many instances, the two forms of rewards become interrelated, such as when a teacher uses extrinsic rewards to teach a student a behaviour that later becomes intrinsically rewarding. The following example is a good illustration of this process: When teaching nonverbal students to imitate the teacher's sounds or words, the use of extrinsic rewards, such as bites of food and then approval late in the program, result in about one half of the students becoming echolalia, perfectly matching the teacher's sounds or words (Lovaas, 1987). These students continue to echo without the adult having to reward them. The matching of the student's auditory output to that of the teacher becomes the student's reward, technically known as a perceptual reinforcer.

In Chapter 6 we describe how, in the course of teaching, one can change low-level forms of self-stimulatory behaviour into higher, more socially acceptable forms of self-stimulation. The acquisition of higher level forms may depend on extrinsic (adult-mediated) reinforcement; however, once established, such behaviours do not appear to extinguish when social reinforcement is no longer available. The behaviours appear autonomous or self-perpetuated. This step is of considerable importance because it comprises one of the strategies that help prevent relapse once treatment is terminated.

For the student to be appropriately reinforced, the learning situation must be constructed in such a manner that the student is consistently successful. If one examines a student's continual failure, the opposite side of success, then one can construct a hypothesis as to why the student engages in tantrumous behaviour and refrains from seeking the company of others. Why seek others when failure will ensue, in contrast to the steady supply of primary rewards engendered by the endless variety of self-generated self-stimulatory behaviour? Why not avoid eye contact when engaging in eye contact has signalled failure in the past? The student may have the sort of view that 'If I look at the adult, I will be asked to do something I don't understand; I will fail, so I won't look.' These are the exact conditions under which giving eye contact can acquire negative or aversive consequences and reinforce gaze avoidance. In contrast, the student's success in the teaching environment may be the key element in helping to normalize the student's motivation so as to increase not only eye contact, but many forms of social interaction. Perhaps the most important observation one can make some time into treatment is seeing the student come to the teaching situation on his own, preferring the learning environment to staying by him. Such a development helps to refute the many pessimistic predictions that have been made by so many people in their objections to behavioural treatment. Such pessimism includes the views that gains in treatment are short lived, that the students become robots, and that their emotional lives and intrinsic reinforcers are neglected. The longer one works with a student, the more uniqueness and richness one discovers both in terms of the increasingly large range of reinforcers effective for that student and the special skills or aptitudes possessed by the student.

Following are several methods by which motivation may be normalized so as to help the student succeed in acquiring new behaviours.

The basic rule is to maximize the student's success and minimize his failure. All professional persons and parents alike will agree with such a goal. Any differences in agreement rest in the methods by which this goal is achieved.

Simplify the learning situation such that the student and the teacher can succeed and gain confidence. Simplify instructions, prompt correct behaviours, and use powerful primary reinforces such as food or escape from stress. These reinforcers should be delivered immediately upon the display of correct behaviours. In an intensive one-on-one teaching session, the amount of time taken up by a reinforcer should not exceed 5 to 10 seconds so that the frequency of learning trials and the opportunities to learn new behaviours are maximized.

Exaggerate rewards in the beginning of treatment. Pretend you are an actor and show extreme enthusiasm when exclaiming, 'Good!' 'Fantastic!' 'Far out!', 'A winner!' and so forth while smiling, laughing, clapping, or gesturing as if you were attending a concert of great importance each time the student responds correctly. Merely saying, 'Good,' is often ineffective reinforcement in the beginning, but some other component of the consequence (e.g., clapping or laughing) may increase its effectiveness. You will need continuous reinforcement (one reward for each behaviour, or a one-to-one reinforcement schedule) when shaping new behaviours. After the student masters a particular behaviour, gradually move away from a one-to-one reinforcement schedule, shifting to intermittent reinforcement. 'Thin' the reinforcement schedule by giving a reinforcer after two, three, or more correct responses. Such a schedule will help avoid satiation and help the student to maintain previously learned behaviours.

The reinforcement inherent in self-stimulatory behaviour may compete with the reinforcement provided by the teacher, thereby interfering with the learning of new behaviours. Therefore, inhibit self-stimulatory behaviour by, for example, holding the student's hands down (if he hand-flaps) as you instruct him. At a later stage, the student may be taught to respond to the instruction, 'Hands quiet.' If the student uses visual stimuli to self-stimulate (e.g., gazes at lights and patterns on wallpaper), use indirect lighting or remove distracting self-stimulatory objects from the student's sight. Some students seem hooked on certain cartoons and will continually rehearse lines or songs from the cartoons during teaching sessions. Help lessen these kinds of self-stimulatory behaviours by reducing or preventing the student's access to such stimuli.

The teacher may try to interrupt self-stimulatory behaviour by instructing the student to perform a series of already acquired behaviours that are incompatible with the student's self-stimulatory behaviours. These behaviours may consist of clapping hands in imitation of the teacher if the student hand-flaps as self-stimulation or presenting three to five mastered tasks in quick succession such as 'stand up,' 'turn around,' 'sit down,' and 'clap.' These may be thought of as wake-up tasks. Once the teacher gains the student's attention, the instruction for the target response should be immediately presented.

As mentioned earlier, if the student is allowed to self-stimulate, it should be as a reward for following through with the teacher's instructions. Recess in a typical school is full of self-stimulatory behaviour, and it is provided contingent on the student's attending to the teacher during class. Teachers who fail to differentiate between recess and class time are likely to be ineffective as teachers. Adults also allow themselves self-stimulatory behaviour after work on evenings and weekends, as when they play golf, dance, read a novel, do crossword puzzles, listen to music, or just gaze at a pretty landscape.

A student who is anxious and angry about failure may be easier to motivate because you can help him reduce anxiety and anger by guaranteeing his success in the teaching situation. Aggressive behaviour reflects that the student is bothered by failure and wants to control his environment. Anger is a good motivator and can be used constructively.

The artificial and exaggerated rewards used at the beginning of treatment should be gradually faded out and replaced by more typical rewards. Rewards such as the company of others, praise (e.g., saying, 'Good'), success, mastery, grades in school, and money must eventually replace bites of food. Try to make the teaching situation look normal as soon as possible.

The use of artificial reinforcers, such as food rewards and tokens, is likely to lead to limited generalization (transfer) of treatment gains from one environment to another (as from the home to the community) or from teachers to novel persons. For example, if food rewards are used at home, the behaviours consequated with food reinforcers may not transfer to school, where food rewards are not ordinarily used. If the student sees that food is available, he will be teachable. If food is not available, the student may not cooperate. In our experience, most students with developmental delays are extremely skilful at discriminating whether or not effective rewards are available. To facilitate the generalization of skills, it is imperative that reinforcement delivery be gradually naturalized.

8. Reinforcers must be varied to help avoid satiation. In addition, the student's favourite reinforcers should be exclusive to the teaching environment and should not be provided excessively within that environment. If the student is provided with free access to reinforcers outside of the teaching environment, he will have little reason to be motivated within the teaching situation. Likewise, if the student is provided with large quantities of reinforcement for each response or is provided with only one type of reinforcer, the student is likely to rapidly satiate.

Concluding Comments

Normalizing the student's motivational structure is important for three reasons: It helps the student learn, it aids in the transfer of the student's new behaviours from the teaching situation to other environments, and it helps prevent relapse. The development of new behaviours and the all-important goal of preventing relapse are to a very large extent dependent on normalizing motivation, developing friendships with other persons, and learning from other persons. We will address the latter issues in an upcoming advanced manual in which programs geared toward integrating individuals with developmental delays with typical peers are described.