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Choices: The power of "Or"

Disruptive or destructive behavior is often a cry for control. Many individuals with disabilities have such high barriers to communication, compounded by sensory overload, that the right to make even the most basic of decisions is stripped from them on a regular basis. Behavioral training is sometimes essential but caregivers must remember a student may simply feel overwhelmed. Choices are the key to good behavior because the word “or” empowers a student. Giving students choices, even between very similar items or activities, allows them a sense of control over their environment. Caregivers may be surprised that simply asking which pair of scissors or what color paper is preferred can improve a student’s behavior. Many decisions should and will remain out of a student’s control, but there are almost endless ways to build options into the day if a caregiver develops a habit of offering choices. Keep in mind that the choice should never be to work or not to work! Examples of simple choices: Which cup would you like to drink from? Would you like to go on the blue swing or the yellow one? Which shoe should we put on first? Would you like to listen “How Many”? or “Letter Sounds”?

It may take time and practice to understand what “or” means. A student may not understand that a choice is being offered since it has never been directly taught. Children with autism and other delays may become stuck in a pattern, such as always choosing what is offered last. If this is the case, occasionally offer a preferred item, like an m&m candy, first and a non- preferred item, like a slice of lemon, second. Then let the student live with his or her choice. If need be, offer the choice again, in the same order, a few minutes later.

Critical Communication

Underneath the fun of Tuneville is a passion to help student's with disabilities communicate. The majority of the most troubling behaviors stems from an inability to make wants and needs known. The greater degree of control and ownership a person has of his life, the less work a caregiver or teacher has to invest in continually managing behaviors. In conjunction with Tuneville lessons, teach key words or signs like “finished” and “more”. Then make “or” and “then” primary vocabulary goals. More on these two power words in the next entries.

Breaking Prompt Dependence

The goal for all students is to be able to perform a skill (like identifying a cat and saying the “meow” sound) independently with no direction. However, in order to gain a brand new, never before preformed skill, a student is dependent on prompts. Tuneville prompts new interaction but it can, like all teaching methods, foster prompt dependence. Prompt dependence is when a child cannot perform a task without being prompted in the way that the skill was first taught. To lessen dependence on Tuneville, play a lesson where a student can hear it but not see it. See if he can fill in the blanks with auditory cues alone. When a session with Tuneville is done, immediately voice just heard lyrics and see if a student will fill-in for a “live” prompt. Slowly stretch the time between the Tuneville session and this real life test. Then look for opportunities to use lyrics in real world situations. The end goal is to have real world situations spontaneously prompt language learned in Tuneville, i.e., your neighbors cat crosses your lawn and the Tuneville lyric “the cat says, ‘meow’” pops out as real practical everyday language.

Taking Tuneville into the Real World

Children with autism often have great difficulty using knowledge or language gained in one setting in a variety of settings and with a variety of people. In other words, they do not easily generalize.  Since at Tuneville we believe that one skill generalized is worth ten done on the ipad, Tuneville imbeds the first two steps for generalization into every lesson: 

1. the lesson learned through music is then taught in spoken form and 
2. the illustrations used initially are traded out whenever possible for photographs for the fun activities after track D. 

In this way, the new presentation will be closely associated, or paired, with the old. Parents and teachers can continue this process of generalization by looking for real world opportunities (or other games, shows, or books) to use the language learned from a Tuneville lesson, then gradually begin to change the wording slightly. For example, if you learned Animal Sounds from Tuneville (release date 5/30/11) say, "I’m thinking of an animal that says meow.” Later,  change the question again to: “Find an animal in this book that says meow.” And again, another slight change in a future opportunity,“There is uncle Joe's cat. What does he say?”

Encouraging Vocalization

A student’s first vocal responses to a second Tuneville track might not be truly classified as speech but more accurately described as grunting or humming. These two types of vocal responses are important initial steps towards speech and should be praised and encouraged. Modeling the fill-ins and then fading prompts will help children gain independent speech. Group or one-on-one settings may be experimented with to encourage participation. Have children participate in group settings by listening to track A (musical training track) or C (spoken training track) repeatedly. Then take turns having each child fill in the blanks in tracks B or D. Friends or teachers may need to model filling in the blanks at first but quickly work on fading these prompts. Repeat songs for multiple attempts at a single response. Full verbal prompts may be necessary initially but quickly work on fading all prompts - model only part of the fill in, just the initial sound, or press the pause button for more time to respond.

Opposites Sample

Yucky Stuff Sample

Letter Sounds Sample

Music Avoidance

Even though most people love music, a very small minority will respond negatively. Sensory sensitivity or overload most likely accounts for this response. While attention needs to be given to special sensory needs, it is important to not allow an individual to attempt to dictate what goes on in the environment at all times. The more tolerance is built, the more there will be an ability to cope with the chaos of real world. Keep in mind music is everywhere!  To overcome aversion to music, give away a little, but not all, control:

1. Prepare an individual for what is about to happen by telling him in simple language or showing him the Tuneville icon.
2. Give him a few minutes to process this information.
3. Allow a student to choose which song she would like to listen to. She can communicate her wishes by pointing or saying the first word or two of a song’s title or lyric.
4. Give a choice between two songs. This is a simple way of eliciting a preference and giving away some, but not very much control.Allow a student the option of earphones or, being covered by a blanket to block out other visual stimulation while he listens.
5. Allow a student to control the volume for a minute or two. 
6. Play only a few seconds of a song and then turn it off. Then, each time the song is played, extend the time of listening. Do not to give the student the job of turning on and off the music. The sign for finished, or the word “stop” can be taught to communicate his or her wishes but the right to turn on and off the music should not be extended.

THE JOY OF THE MUSIC AND BEHAVIORISM?

battles for control=
hidden hearts

Many who have spent time building, studying, or implementing autism interventions, recognize the behavioral roots of Precision Songs and Tuneville. Others are surprised to learn the majority of our lyrics come straight from ABA (applied behavior analysis) drill books. While we honor and greatly appreciate the principles and amazing outcomes of ABA, we have found ABA to have a few major practical drawbacks: ABA programs require immense dedication for new skill acquisition through drills and almost equal dedication to retain a skill through relentless review. Motivation is a recurrent problem, not to mention the financial burden and lack of trustworthy practitioners. Even more disheartening, we have personally seen consistent, successful behavioral programs degenerate into out of balance control games. Practitioners find out what is reinforcing and then dole it out in exchange for compliance. An intelligent student then learns to withhold his heart, not showing what truly motivates and excites him. This withholding blocks the path to discovering the joy of learning for its own sake, the optimal reinforcing experience. Precision Songs is a powerful path back to rediscovering  this joy by imbedding critical lessons in catchy tunes. Tuneville goes one step further by combining the joy of music with the fun of the ipad. Initial phases of learning are purely self-directed causing the user to forget, if he realizes in the first place, that underneath all the fun are the hard core principles of the most researched based learning intervention - ABA.

The Tuneville Protocol

Tuneville is a fun place for kids to visit, to the extent that learning seems a side benefit that the adults in their lives secretly celebrate. Yet for children with language disabilities, Tuneville is a such serious intervention that it merits a protocol:

1. Play only the first version of a song until a student is thoroughly familiar with all the lyrics. Then move on to the second version of the lesson. This way, the missing lyrics will  be an obvious omission and a student may feel immediately compelled to fill-in. If not, classmates, caregivers, siblings or teachers should model the missing lyrics. Keep in mind that fading these verbal prompts will be crucial for independence.
2. Once a student is regularly filling in missing lyrics with the music, move quickly to the third version of the song. If necessary, make an occasional return to the second track as a reward for listening to the third.
3. After a student is thoroughly familiar with the third version of the lesson, move on to the fourth.  Again, modeling fill-ins may be necessary initially. 

Wherever your student is on the protocol, continually expand the student's abilities through the following techniques:

• Apply the song’s content to everyday situations. Create situations if necessary and sing the song during that activity.
• Sing or chant lines of a song out of order and alternate between singing and speaking lyrics in an everyday voice. 
• If your student has provided fill-ins before, sung or spoken, expect a response. 
• Give plenty of time for processing and praise every step of success.

How the Brain Deals with Gaps in Music

Much about music remains shrouded in mystery, but light is being shed as brain scanning and other tools of measurement advance in their precision. A 2005 study out of Dartmouth College* used functional magnetic resonance imaging (MRI) to investigate the physiology of brain activity when blanks are left in familiar tunes. Muting short gaps of familiar music was sufficient to trigger auditory imagery showing that the phenomenon was automatic and irresistible. Pictures (c) and (d) below show that silent gaps embedded in familiar songs induce greater activation in auditory association areas than silent gaps embedded in unknown songs.

So, when children listen repeatedly to Tuneville track A, they become very familiar with how a song ought to be. When track B introduces gaps for students to take turns filling in the blanks, the brain literally “lights up.” The bottom right image is a picture of the obligatory, irresistible urge for completion as it shows up on a MRI.

*D.J. Kraemer, C.M. Neil, Kelley, W.M. and Green, A.G., “The Sound of Silence,” Nature, Vol. 434 (2005).

TUNEVILLE TIPS FOR FOSTERING EXPRESSIVE LANGUAGE

After track A of a Tuneville song is completely familiar, the urge for completion when track B is played will become so strong that most kids will fill in the blanks with little or no prompting from caretakers. To encourage the selection of track B, Tuneville purposefully puts engaging interactive games only at the end of tracks that include blanks. Still, since some individuals need further encouragement, here are a couple tips for overcoming this resistance:

1. Take turns. Let a child choose a track and then you you choose one. Obviously you will choose a track that presents the opportunity for a fill-in. Model filling in the blank in a jovial, happy manner, and see if the child will follow your example.
2. Use the pause button. Tuneville purposefully omitted fast-forward and rewind buttons in its programming but we definitely saw the benefit of a pause button. Some children need more time - especially if language or enunciation is still an emerging skill. Give the few extra seconds needed for success and then celebrate little steps of progress.

PUTTING THE FUN IN FUNCTIONAL

Tuneville is a great place to go, but underneath all of the fun lessons is a rock solid foundation of research. By combining music with engaging visuals, we help students make meaningful steps to improve daily living. We put the fun in functional. Other companies might produce beautiful arrangements of the Hokey Pokey and Hickory Dickory Dock but since reaching the often literal mind of someone with autism is our primary goal, we won’t mix in lines about cows jumping over the moon, men selling muffins, or mice sprinting up a clock. We avoid the use of nonsense nursery rhymes because the special needs mind is often so literal. If it's a Tuneville song, the lyrics are functional.

The 4 Steps in Tuneville - Harnessing the Urge for Completion

Rituals, routines, sameness. These are terms that are familiar in the autism community. Human nature likes routines and patterns but with autism, the desire is greatly magnified. Manifested by lining up trains and other toys, insistence on detailed routines before bedtime, and meltdowns when an article of furniture is moved even slightly, these precious kids are extremely uncomfortable with change. Tuneville uses this desire for sameness in our 4 track program.

Track A: a learning song is presented in its entirety. All lessons are sung using two voices. The first voice prompts, the second voice responds. The child has fun and learns the song in both voices  (♪first voice:"the cat says...", second voice: "...meow"♪).

Track B: the song is repeated with key omissions. The second voice is dropped and the need for sameness compels the child to become the second voice (♪ first voice: "the cat says..." second voice: “.....”♪). This step has been instrumental in drawing first verbal, non echoic,  responses from persons with autism as old as 21 years. 

Track C: the song topic is spoken. The child has already responded during the music, but needs to transition to speaking. Tuneville also uses slightly different wording for this prompt. More on this when we cover Generalization (first voice: “What does the cat say?” second voice: “Meow.”).

Track D: the song topic is spoken with key omissions. Since the verbal exchange has already been modeled and mimicked with the sung tracks, the learner understands his or her role of becoming the second voice (first voice: “What does the cat say?” second voice: “....”).

Imagine the great effort given to manipulate the environment in order to maintain things as they were first observed and routines as they were first learned. Now imagine that same effort used to vocalize meaningful language. That is what lies at the core of Tuneville: harnessing an overwhelming urge for completion.

A Little Tuneville History

Around 2002, Arlyn’s son Willson was newly diagnosed with autism. She and her husband Will began pouring the emotion of being hit with this strange diagnosis into understanding the cause and treatment. Looking back, they are grateful to many friends and professionals who urged them to begin ABA treatment as soon as possible.

The Kantz family program involved an ABA practitioner coming to their home for treatment sessions three days per week. Because their budget would not allow the full five days of therapy as recommended, they decided to video their son's sessions in order to equip themselves with as many skills as they could glean.* Early in his therapy, as they were watching a video of their son struggling to grasp language, Arlyn exclaimed, "But he can sing all the Veggie Tale songs!"  That day she picked up our old guitar and beat out the first song to teach Willson to respond to social questions .i.e. “What is your name?, How old are you?”, etc.

The Kantzs sang "Social Questions" in call/response style on the only recording equipment readily available - a Mr. Microphone. That weekend they took a  3 hour trip and played the song there and back. Upon their return, Willson resumed therapy and, at the end of his session, the therapist came out wide-eyed asking, "Willson can answer all the social questions, what happened?" At this point the Kantzs realized that they were doing something special and began to convert, with the help of Willson’s teacher Erica, all upcoming treatment drills into songs.

The Tuneville Team is now excited to share the philosophy and background of Tuneville with all their new partners. The next entry will explain the 4 steps implemented in the Tuneville songs which capture the autistic "urge for sameness" and maximize learning. 

We know you will have the same success with interactive music that we have.

* One of these early sessions is available for view at http://www.youtube.com/watch?v=2biWBiiTg1E