By Michael Mueller, Ph.D., BCBA
A Lesson from Language
Defining characteristics of children on the autism spectrum include underdeveloped language and communication abilities. Early language is absolutely essential if a child will eventually come to control their world, express their wants and needs, develop peer relationships, and interact with others in myriad settings and situations throughout the lifespan. Because language and communication skills are of such vital importance, it is best to teach these skill sets as early as possible. Language skills are very commonly the focus and thrust of early intervention programs and ABA programs in homes and schools. Further, as its name implies, early language is always the focus of verbal behavior (VB) programs with young learners. Language development in typical children begins just months after birth with major developmental language milestones occurring at around six months with babbling, around 1 year for an initial or a few initial words with meaning, and onward to three years when children have conversational speech, usage of tense, pronouns, humor, and even demonstrate the ability to tell elaborate stories! Making-up progress of these early language skills is paramount for several reasons. First, the earlier the start, the more time you have to teach the life-long skills. Second, the developing brain is “primed” for language development at early ages and it is commonly held that after childhood, the same developmental language sequences cannot be learned in the same manner. Third, when language remediation can occur early, that language can be used early to springboard other valuable skills that include academics, social skills, and peer relations.
Functional Living Skills
Although the timing of early language skill development and the importance of teaching early language seems to be universally accepted by those who care for and teach individuals with ASD, parents, behavior analysts, teachers, and other professionals often overlook the parallel logic and approach when teaching other skill sets with lifelong importance. The skills that will enable a learner to take care of themselves – feed themselves, toilet themselves, and interact with the physical and social world around them – are known by a variety of names. Functional skills, self-help skills, adaptive skills, skills of daily living, and life skills are all synonymous. Regardless of the name by which the essential life skills are known, their importance is unrivaled when it comes to developing independence in learners of all ages and in every setting and situation. Language skills should always be a focus of teaching regardless of the age or the setting. Just as “language skills” are a massive collection of tiny skills and steps that are foundational for more advanced skills and steps, functional skill development and instruction works the same way. Small achievements and advancements in early skills are prerequisite for later skills whether those small steps and advancements occur in language or in essential life skills. The approach is the same: Identify the skills a learner currently possesses and build from those skills to teach more advanced skills. The, identify the areas in which a learner does not have certain skills and begin to expose, teach, and reinforce the development of new skills from which to build more advanced skills.
What are Functional Skills?
In the lives of every person on the planet, from the moment we awake in the morning until the time we go to bed at night, we interact with the world around us. Although this seems straight-forward and obvious, this simple notion can guide the development of life-skill independence for all learners with ASD. Every room we enter, everywhere we go, everything we do, everyone we see and meet, and every action we take can be an opportunity for teaching. This holds true for young children, older children, adolescents, young adults, and older learners. Unfortunately, functional skills are sometimes viewed as “survival skills” that only include the most rudimentary skills that enable a learner to simply “get by” in the real world. Conceptualizing functional skills as only encompassing early self-help, hygiene, dressing, and self-feeding skills is very limiting to teaching new skills, routines, and skill sets beyond the very basics. To be independent in real life requires long lists of skill sequences that go far beyond simply surviving.
If learners do not master functional skills, someone will have to do for them. Functional skills are practical and immediately useful. Functional skills have a place and a purpose. For example, sorting colored bears is not a functional skill because it does not need to be done and it had no accepted place in which it occurs. Conversely, sorting clothes or silverware are functional skills because they need to be sorted to maintain the flow and organization of the home and they each have an accepted place in which they occur. Sorting silverware is a kitchen skill and sorting laundry is a bedroom or laundry room skill. These general rules of thumb can be useful in determining the real benefit of any particular goal. Every learner, regardless of cognitive ability can be taught new functional skills- new ways to improve their independence and new behaviors to aid in making their world around them a better place for them. All too often, we see learners completely dependent on others when they possess the ability to do so much for themselves! Why is this?
Barriers to Teaching
Through talking with hundreds of professionals, parents, and caregivers over the years, some similarities have emerged to help explain why some of the most important skills that lead to real life independence go untaught early in life, not until right before high school graduation, or not at all. The reasons we hear from people around the country and around the world are all valid and they exist because of the difficult challenges that come in all areas of life parenting, caring for, educating, and providing professional services to learners with ASD. Identifying the barriers is a good first step to finding supportive ways to move past them. Problem solving strategies initially involve determining the problems to solve. Education and new ways to conceptualize existing limitations can change our ways of looking at things we need to do better.
Easier and Faster for Caregivers to Do It
We live in a fast-paced world where we want results and we want them now! If I push a button on my computer or on my phone to initiate an app and I have to wait even 30 seconds for results, I get frustrated. Isn’t that incredible? We simply have become accustomed to immediacy and lightning-fast response expectations. One of the main reasons we find in homes and schools that explains why some very able learners are dependent on others to do life skills relates to this very phenomenon. Why didn’t I have my daughter put her own socks on this morning? It is easier and quicker if I do it myself. I’m running late; it’s a struggle when she’s in one of her little moods; she doesn’t do it very well and I don’t have time to play games this morning, etc. These real life reasons are so true. It is easier if we do it. It is faster if we do it — so, we do it for them. But doing so only creates the same situation tomorrow, and the day after that, and next month, and next year. Teaching that skill now and requiring that it becomes part of her routine, everyday, will create more time when she can do it herself. I will have more time in the long run if I do not have to do those things for her. Whether it’s getting dressed, turning on the TV, buckling her seat belt, feeding the dog, filling the tub, setting the table, or unpacking her bag at school, if we take a little time to teach these skills we currently do for our learners and then require they use the skills we teach, we can change the dynamic completely in any environment and arm them with an increasingly complex set of skills they can use for the rest of their lives. The benefit that caregivers see, beyond the increased independence of their learners gaining valuable life skills, is that it really does create more time and more flexibility for us!
Not Sure What to Teach
Another commonly heard reason for not teaching life skills is that most caregivers and professionals genuinely do not know what to teach. And, for many of us, even if we have some good ideas about what we would like our learners to eventually master, we might not have a good idea of when particular skills are appropriate or expected in real life. Where do we start? How do we start? What do we do next? Looking back through the progression of behavioral and educational intervention and support strategies over the past 20 years, we can follow a similar scenario with early language instruction and developmental skill sequences. Prior to the mid 1990s, very few commercially available products and assessments existed to guide caregivers through the assessment and teaching realm of language skills. Best practice demands early language assessment to both determine present levels of skill mastery and to choose starting points for additional instruction. An historical lack of emphasis in teaching functional skills for learner independence can also been seen in the number of products and guides available for assessing and teaching functional skills. However, with new assessments and teaching programs emerging, we are seeing the same logic and approach we follow for early language applied to life skills. That is, in order to know what to teach, you must first identify what your learner can already do. Because functional skills occur everywhere, all the time, it is important to use an assessment that reaches across all relevant settings. Functional skills at home can be different than those at school, which are different than those in the community. Functional skills in vocational settings and in the workplace, for older learners, are different from those in other settings with younger learners. Knowing where you want to focus teaching leads to the possible skills to assess and teach. As the assessments of functional living skills become more widespread and popular with recent pushes to highlight the importance of functional independence, not knowing which skill sequences to teach in different settings as a barrier to promoting independence will hopefully be a thing of the past.
Many caregivers complete activities for their learners because of the danger involved in the activities themselves. Much of what we do every day is inherently dangerous. We live and exist around heat, electricity, water, roads, sharp objects, poisons, strangers, cars and parking lots, open spaces, crowded spaces, novel places and in relatively novel situations on a daily basis. Whether in the home, at school, at work, or even during leisure activities in and out of doors, we are exposed to some amount of danger. As parents and teachers, it is our job to protect our learners from harm. We do a really terrific job at it too! In many situations however, safety ultimately comes from teaching the skills necessary for a learner to safely interact in the situation on their own. Teaching specific skills in many dangerous situations can lead to more benefit in the long run. Teaching a learner what kitchen items might be hot and how to check those items for whether or not they are, is ultimately a better strategy than trying to constantly monitor in every instance the learner is in the kitchen. Teaching a learner to stop at curbs, attend to and make discriminations between cross walk signs, look both ways and to scan traffic while crossing the street will enable lifelong street crossing safety over time even when we are not around to hold their hands. These kinds of skills seem like far off and perhaps monumental tasks for many of us. But, with small goals that build on other small goals, over time, our learners will be closer and closer to doing these things safely on their own.
Teaching Early Developmental Skills for Too Long
Behavior analysts have been a driving force in shaping the educational practices of learners with ASD. The vast majority of research guiding these practices comes from studies with young children. Some of the most convincing data supporting these methods has documented how well ABA-based instruction can positively affect the language and early conceptual acquisition of young children. The same goals of teaching mastery of early language and developmental sequences to older learners has not been as fruitful in the literature. In many situations, behavior analysts, parents, and educators have held on to early learner goals for way too long. In some instances, our rigid adherence to un-mastered early learner goals has interfered with our use of common sense regarding what skills to teach learners of different ages. Unfortunately, it is commonplace to visit middle and high school classrooms for students with autism and other developmental disabilities and observe an over-reliance on teaching goals generated from early developmental language assessments. It is not uncommon for IEP goals for older students to be driven by curricula generated from developmental language and conceptual skills assessments best used in an early intervention setting. Behavior analysts might be guilty of creating a one-size-fits-all culture in how we educate learners on the spectrum, regardless of age or setting, that persists too long to in teaching early developmental, rather than functional, skill sets. This sentiment can be heard in another consistent answer we get when we ask why functional skills have not been highly prioritized in many instructional programs. “No one told us they should be.” Or, “No one suggested we emphasize these areas” are common responses. However, highly prioritizing functional skills into instructional programs for learners of all ages is imperative to their long-term success in preparing them for life after school, for independence at home, and for life in all private and public community settings. Language should always be a teaching priority. This holds true for any learner at every stage of life. Teaching the developmental sequence to language however, has an expiration date. The developmental language approach teaches sound imitation, word approximations, words, words with articles, and then more advanced syntax and usage. Early conceptual learning includes sorting, matching, basic visual discriminations, and other “concepts” that in and of themselves have no immediate practical usefulness in a learner’s life. When these skills sets are mastered in early childhood, they are useful and beneficial forever in ways that have infinite possibilities for communication and application. They are cornerstones for most areas of life when mastered in young childhood. However, if they are not mastered fairly early in life, a shift to immediately useful functional language and functional living skills should take place.
When to Teach Functional Skills
For most children, by the time they are three years old, they can feed themselves with utensils, drink from a variety of open-faced containers, use napkins, and can help put things on the table to ready meals. They can identify where different clothing items are stored, complete part of the dressing process, put on shoes and jackets, and adjust clothing. They are likely able to wash and dry their hands, help washing their bodies in the tub or shower, dry off, and put on lotion. They might be able to get into bed and adjust sheets and blankets. They can put away their toys, line up shoes, put books in the book case, and other useful household routines. They can help pack and unpack lunch containers and backpacks for day care or preschool as well. So, even very early in childhood, functional skills develop and are expected. These kinds of rudimentary goals should be part of early teaching programs.
As learners age into late childhood, the expectations for increased functional skill demonstration should increase too. Around the home, setting the table, folding their clothes and putting them away, sorting laundry, making their beds, cleaning up after a shower, spraying and wiping tables, vacuuming, and other more advanced chores are completely reasonable expectations. These are valuable skills that enable an individual to feel part of the family system and participate in new ways at home. There are literally hundreds of potential skills to teach around the home, in every room of the house that can lead to increased participation, social interactions, and independence. In the community, using a shopping cart, selecting items from a list, putting items in the cart, locating parts of a store, handing the cashier money, ordering or selecting food from a menu, finding a clean table at a restaurant, etc. are lifelong skills to teach. Many learners take a lot of time to fully master and acquire skills. This is not uncommon in children with developmental disabilities. Because it takes some folks a long to learn valuable skills, we have to begin teaching them early enough that when they are able to acquire the skills, it is appropriate to use them. In other words, we need to start teaching the skills before the time we expect a learner to use them regularly.
Early adolescence is a critical time to evaluate the focus of learning programs. Some learners will be on an academic track and might need additional support with social skills, community skills, and self-management or organizational issues. Others who have been slow to learn early language and developmental concepts should look towards a shift to alternative communication systems and functional skills. When learners reach middle and high school, well-designed instructional programs should have included many functional skills already. The focus of instructional programs for many learners in this age range might be completely geared towards functional skills and language in the community, at home, and in preparation of a transition to any number of settings.
The level of independence a learner possesses will have a profound impact on the choices available socially, domestically, and vocationally after high school. For learners in the workplace, at vocational workshop settings, in sheltered living or supported living arrangements, and for those who live at home or in group homes, there is always a next step. There is always more to learn that will continue their path to independence.
Functional skills need to be taught throughout the lifespan. The approach and the benefits never end. Caregivers and professionals are becoming more aware and more concerned with understanding the impact of teaching skills that develop participation and independence in home, school, and community settings. As individuals grow up, we have to prepare them for life. We have to develop their skills sets, routines, and expectations to function with as little dependence on others as possible to allow them the best opportunities and chances at a happy productive life. We can achieve these reasonable goals by following the lessons we have learned over the years in language instruction. Assess these skills early and often. Determine what skills a learner possess currently in the different areas of their life. Choose starting points for instruction and set a high bar for mastery. Use every day as an opportunity to teach essential, useful, and practical skills that will truly last a lifetime.
About Michael Mueller, Ph.D., BCBA
Dr. Mueller obtained his Ph.D. in School Psychology from the University of Southern Mississippi in 2002. Co-founder of Southern Behavioral Group, Mike has practiced Applied Behavior Analysis with children with Autism in home, public school, private school, state residential, group home, clinic, and a variety of community settings. Mike is the author of eight books including the Assessment of Functional Living Skills, and 25 journal articles. He has delivered more than 100 conference presentations around the United States and internationally. Mike is a past president of the Georgia Association for Behavior Analysis and a past chair of the Behavioral School Psychology Interest Group of the National Association of School Psychologists. He is the 2002 recipient of the Sidney and Janet Bijou Award given by the Association for Behavior Analysis for scholarly activities in behavior analytic child development research. Dr. Mueller has served on the Editorial Board of several scholarly journals in the field of Applied Behavior Analysis and School Psychology including Psychology in the Schools, Behavior Modification, Journal of Early and Intensive Behavior Therapy, and the Journal of Evidence Based Practices in Schools. His published research has involved functional skill assessment and instruction, parent training, teacher training, functional behavioral assessments in school settings, functional analysis in school settings, pediatric feeding disorders, compliance training, functional communication training, discrete trials therapy, errorless learning strategies, behavior analytic consultation to schools, behavior analytic approaches to early reading and reading comprehension, aggression, self-injury, property destruction, noncompliance, tantrums, object mouthing, hand flapping, and other behavioral challenges demonstrated by children with autism.