Friday, December 24, 2010

TAGteach Seminar Report - Hershey PA

Theresa and I were in Hershey PA last week for a terrific TAGteach seminar at the wonderful Vista School. The Vista School brings state-of-the-art special education and therapeutic services to children living with autism in Central Pennsylvania. We had a great group of people from several different backgrounds and we all learned a lot from each other. There were four behavior analysis professors there and all of them have plans for research studies, which is very exciting for us.



One of the homework exercises is to think of something that you would like to change in your own behavior and do some self-tagging to see how this works. Everyone takes home the tagulator that they made for themselves and pulls down a bead to mark the tags when they successfully execute the tag point they set from themsleves.

Here are some creative examples of self-tagging tag points that people invented:
After printing off a sheet from the printer file it right away rather than leaving it on the printer to pile up. The tag point is file the paper
While shopping, rather than getting annoyed at other people for pushing or other rude behavior, have empathy for them and think about what they might be thinking and why they might be in a hurry or stressed out. The tag point is think about others.
Instead of giving unsolicited and often unwanted advice to older teens and twenty-something children, keep quiet and let them enjoy the time together as a family. The tag point is keep quiet.
Associate Professor from Penn State, Rick Kubina told us that he has a 6 year old client with autism whose parents have struggled unsuccessfully for the past year trying to teach the child to tie his shoes. Rick had also been unsuccessful in an attempt to teach this. Rick went straight home and tried out his new TAGteach skills on this problem and posted the following on his Facebook page:

After my two day TAGteach seminar I had the chance to use my new acquired skill with a 6-year-old boy (he has autism). For the last year parents have been trying to teach him to tie his shoe. I tried about a month ago and failed miserably. After one, 20 minute TAGteach session I tagged what you see in the picture. Very proud of my little guy.
We had lots of interesting discussions about the application of TAGteach principles to real-life teaching situations that the attendees face. We look forward to hearing from everyone about their successes with TAGteach.

Monday, December 13, 2010

TAGteacher Tale - TAGtone for Medical Students

Thanks to Dr. Karen McLean for telling us about her application of TAGteach with medical students.

I recently took the TAG teach workshop in LA and thoroughly enjoyed it. (Thanks Theresa and Hello fellow students!) I use tagging in the hospital environment where I teach medical students and residents, particularly in physical examination skills or procedures at the bedside. This has been enthusiastically received by the residents who all want their own taggers so they can practice in small groups (they are preparing for a major exam). For use at the bedside I want a "tag tone" that fits better (is less intrusive) in the hospital environment. The click is harsh and may be disruptive or annoying to some patients (we have few single rooms), if used repeatedly. Sadly the clicker plus is not readily available.

There is an iphone clicker app for a clicker but I have found nothing for blackberry (my device of choice), and the iphone app as far as I know only produces the "click". I want a higher pitched tone, more musical than metallic, that will blend better into the ambient background noise, yet still be audible to small groups at the bedside. Our IT guys suggested two options - one being to use the custom profiles (for setting alerts) on the BB and the "try it" function to trigger the tone - that proved to be a bust as the time delay is anywhere
from almost 1 to 3 seconds, even though there are some suitable tones already available on the device.

The second suggestion was to try an online sound generator and import it into the device (should work for any device). After a few unsuccessful attemtps I found a site that works like a charm and within about 5 minutes I was able to generate and load to my blackberry a couple of suitable tones. (my IT guys call me an "early adopter" - but I am definitely not a techno-geek.) On my device this plays instantly with a press of the trackball as long as I have it selected.

If you are interested in trying it out for yourself - here is the website and the steps I used - it is pretty intuituve.

http://www.planetofnoise.com/midi/morse2mid.php

This website is intended for generating morse code ring tones – but if you pick a single letter and adjust the SPEED, PITCH and SOUND functions you can get pretty much what you want. For example, the letter 'e' gives you a single tone, 'h' is a short burst and 'm' is biphasic. I like the pitch high (3) because I want it to be less audible to older folk (which includes the majority of my patients) who often have high frequency hearing loss.

The "make Morse" bar allows you to check out the sound and keep adjusting paramters until you have what you want. Then click on "this file" as per the instructions and it will bring it up as a file on a webpage by itself. If you use the "file" option on the menu bar and "send page by e mail" you can then get it on your device, down load the attachment to a ring tone file...and there you have it. (this last is a little different than the instructions on the website.)

To use it you just open the ring tone file, select the one you want and hit play.

Now, I can get rid of one more thing from my pockets and I will always have my "tagger" with me. Next I am going to see if I can find a sound that is close enough to a clicker to work with my dogs and I won't have to have a clicker in every room in my house and every carry bag I use for classes!

Karen McClean

Tuesday, December 7, 2010

Rehearsing Polite Manners with TAGteach

One of the things we learned early on with TAGteach is that the principles we have been developing are brilliant for allowing the rehearsal of specific small pieces of behavior. In our work with children and with adults in occupational and management training we have used a lot of role playing with tag points for specific areas of focus. The role playing allows us to set up situations that are non-threatening and allow the learner a chance to practice and succeed while gaining the skills required to accomplish a specific task in a real situation.

In his excellent book "The Kazdin Method for Parenting the Defiant Child with no pills, no therapy, no contest of wills", Dr. Alan Kazdin explains that children need to practice desirable behaviors in a no-stress simulated situation so that they have the skills available to offer these behaviors in a real situation. Building a strong alternative behavior is the best way to eliminate unwanted behavior. For example, if a child has trouble sharing, he is more likely to be able to share in a real situation if he has practiced sharing in a simulated role-playing situation. If a child has never had the opportunity to practice the behaviors associated with sharing, and any time he has been exposed to a sharing scenario it has ended in stress and frustration, he will never develop the skills required and will become even less likely to share. Giving a child (or an adult) the opportunity to succeed by applying a new skill in a low stress simulation, increases the likelihood that he will employ these skills in a real-life situation.

We have posted a video that illustrates how we insert a tag point into a simulated situation to help Lear (who is four) practice polite manners. We want him to ask permission before opening the fridge. The tag point is "ask to open the fridge". We have provided motivation for him to open the fridge by providing a bowl of melon pieces. This keeps the game going as long as he wants some melon. The tag comes when he asks, and the primary reinforcer is a plastic sea creature.

You may wonder why we don't just let opening the fridge and getting the melon be the primary reinforcer after the tag. The main reason for this is that we want to be in control of the primary reinforcer. He wants a sea creature more than he wants a piece of melon (or perhaps he is smart enough to know that he can get both!). He is free to open the fridge and take a piece of melon when ever he feels like it. If he did that without asking there would be no tag and no sea creature. We do not want to have to hold the fridge closed or otherwise use force if he does not ask permission. This would ruin our tag session and would result in a tantrum and no learning is possible in this state of mind. In fact he never did just take a piece of melon, he asked every time. In this session Lear asked permission to open the fridge many times. This increases the chance of him asking in the future under similar circumstances. The more practice a child has with polite behaviors, and the  more these are reinforced with a positive outcome the more likely he is to use these habitually.





This video was submitted by Anne Wormald as part of her Level 1 Certification project.

Monday, December 6, 2010

Interview with TAGteach Co-founder Theresa McKeon

Listen to an interview with Theresa McKeon published at the blog of BehaviorTherapist.com:

In this episode, R. Trent Codd, III, Ed.S. LPC interviews Theresa McKeon about TAGteaching.  Items discussed include:
  • An overview of TAGteaching
  • The range of applications for this technology
  • The research base
  • The relationship between TAGteaching and Precision Teaching
  • Current directions in TAGteaching
Click here to go to the BehaviorTherapist blog and listen to the interview

Back Chaining - The Key to Reliablity

Back chaining is a concept foreign to many and counter-intuitive to most who first learn of it. We want to talk about it briefly here, because it is a very effective way to build highly reliable behaviors and it is one of the key techniques that any TAGteacher should understand and apply properly. A reliable behavior is one that looks the same each time the subject performs it. For example, with forming the letter "E", we would consider the behavior to be reliable if the child drew the letter the same way every time and the letter was drawn correctly.

Back chaining involves teaching a skill starting at the end and working back to the beginning. For example we would teach a child to come down the ladder to the climbing structure safely before teaching him to climb up it. This way we know that once he climbs up he will be able climb down. To do this we would place the child on the bottom step and work on taking one step down to the ground until he is confident with that. The we would place him on the second step and work on coming down two steps. After a few steps he would be confident with coming down and we could start working on going up and then coming back down. By teaching the last part first the learner is always moving toward the part of the skill that he learned first and with which he is most confident. The gymnast that learns her balance beam routine from back to front will not be worrying about moving toward the part of the routine that she has practiced the least, she will be confident that she is less likely to fall as the routine moves forward. The pianist who learns the last part of the piece first will be moving toward the part he has practiced most and with which he has the greatest confidence. Karen Pryor has been tweeting lately about her experiences with a choir director who understands back chaining and has been applying it most effectively. Follow Karen on twitter and look back through her choir posts for a play by play description of this back chaining application.

We have posted a video at YouTube that shows a very simple application of back chaining. This is the formation of the letter "L". We taught the right to left stroke of the bottom part of the letter first using a template that already had the down stroke completed and with red and black dots to guide the cross stroke. The tag point is "red to black". The child is to draw a line from the red to the black dot thus completing the letter correctly and with the pen stroke going in the correct direction. After practicing this until he was confident, the next tag point was also "red to black", but this time completing the dots created the down stroke of the L. Notice in the first trial with down stroke he goes on to finish the letter without any instruction or prompting. Because he had learned the last part of the letter first he naturally went on to complete it by doing the behavior that he was first taught (i.e., the cross stroke). This is a very nice demonstration of the power of back chaining.


Many of you have already seen our famous high jump video. This is a very complex skill that involves simultaneous rotation about two different axes and incorporates the transfer of power from the run to the jump. How could we teach something this complex backwards? Watch the video again (or for the first time) and see back chaining in action with a complex skill.