Cues, Prompts, and Objectives

Introduction to Skills Training : 

Introduction to Skills Training Section 2: Cues, Prompts, and Reactions By Shane Alan Community Integrated Work Program

Introduction to Skills Training : 

Introduction to Skills Training Section 2: Cues, Prompts, and Reactions By Shane Alan Community Integrated Work Program

Overview : 

Overview Outline of the skills training process Cues Prompts Verbal Physical Visual Reactions Reinforcement Corrections Review 1

Slide 4: 

A skills is simply the ability and willingness to exhibit a certain behavior. Skills-training is the process of putting supports in place to assist the learner to exhibit the behavior, and providing reinforcement upon the completion of the behavior. This associates the behavior with reinforcement and make the behavior more likely to occur in the future. The supports and the reinforcement are then gradually removed until the behavior/skill is occurring independently. 2

Slide 5: 

Every skills training program is made up of 3 primary components: The Cue The Prompt Including a prompt fading sequence The Reaction Reinforcer for correct responses Correction for incorrect responses Every instruction should have a cue and a reaction built in. Most instructions will also include a prompt and a prompt fading sequence. 3

Slide 6: 

The cue, also called discriminative stimulus or Sd, is the stimulus that tells the individual that it is time to engage in a certain behavior. Specifically, the cue tells the individual that reinforcement is available contingent on the behavior. The cue can be different depending on the support needs of the learner. For one person the cue for cleaning up after lunch could be the statement “lunch time is over” while for another person the cue could be the presence of dirty dishes. A statement that acts as a cue is called an instructional statement. Unlike a prompt, the cue will not fade away as part of a goal - it is a permanent part of the behavior. The cue should be as normalized as possible, meaning that it looks like the cue that would be given to any person that age and in that situation. 4

Slide 7: 

A prompt is the artificial help that comes after the cue but before the response. The prompt is designed to help elicit the behavior you want. This is called error-free learning. The theory behind this is that by assisting the learner in successfully completing the behavior they will strengthen their ability to complete the behavior, and will naturally associate the behavior with the reinforcer of completing the task. By definition a prompt is intended to be faded away toward independence. Therefore you should only use a prompt if you know how you’re going to fade it away. 5

Slide 8: 

The types of prompts we’ll be discussing are: Verbal Direct Verbal Indirect Verbal Physical Partial physical Full physical Visual Gestures Modeling Pictures Proximity 6

Slide 9: 

Verbal prompts involve making a statement intended to direct the learner to the correct behavior. Direct verbal prompts explicitly tell the learner what to do. For example, “okay, now put some soap on your hands” could be a direct verbal prompt during hand washing. Indirect verbal prompts help lead the learner to the correct behavior without stating what the behavior is. For example, “okay, what do you do next?” could be an indirect verbal prompt during hand washing. 7

Slide 10: 

Fading direct verbal prompts. Direct verbal prompts are generally the easiest prompts to become dependent on and can be very hard to fade away. To make this easier, direct verbal prompts should be used along with another prompt, such as a visual or physical prompt. The verbal prompt can then be faded away while keeping the other prompt in place. One way to fade the prompt is to increase the time between the cue and the prompt. Another way is to decrease the directness until it becomes and indirect verbal prompt. 8

Slide 11: 

Fading indirect verbal prompts. Decrease the time between the cue and the prompt, allowing the learner to attempt the behavior independently. Decrease the directness. For example, “what do you put on your hands next?” could be changed to “what do you put on next?” then to “what do you do next?” to “what’s next?” and finally to “next?” as a prompt during hand washing. Verbal prompts are the most common type of prompt used, and are probably used more than they should be. Remember that verbal prompts should only be used if you have a plan to fade them away. 9

Slide 12: 

Physical prompts involve physically guiding the learner’s movement to engage in the behavior. With full physical prompts, the prompter physically guides the fine motor movements of the learner. For example, when teaching someone to use a microwave it may be necessary to initially guide their fingers to the correct button. With partial physical prompts the prompter physically guides the large motor movements of the learner. For example, the prompter could lightly press on the learner’s elbow to guide it to the microwave, signaling the learner to hit the button. 10

Slide 13: 

Physical prompts are never forceful, they only serve to guide the learner’s movement. There are some pretty simple ways to fade physical prompts Reduce the pressure of the physical prompt, or the location of the prompt so that less assistance in being provided. Full physical prompts are generally pretty easy to fade into partial physical prompts and partial physical prompts are generally easy to face to independence. 11

Slide 14: 

Visual prompts make up a large portion prompting strategies, as most people learn better visually. We will be discussing: Gestures Models Pictures Proximity 12

Slide 15: 

With a gesture prompt, the prompter uses a part of their body to direct the learner to the correct behavior without actually touching the learner. For example, the prompter can point at the correct button on the microwave to show the learner what button to push. 13

Slide 16: 

Gesture prompts are faded by decreasing the amount of assistance provided by the prompt. Here are some tips in doing so: Increase the distance between the gesture and what the gesture is directing the learner to. For example, if the prompter is pointing to a button on the microwave, they can point at the microwave face instead of the specific button, then to the microwave in general, and then to the kitchen. Decrease the duration of the prompt. For example, if the prompter is pointing to the microwave for 5 seconds to initiate the behavior, they can decrease to 4 seconds and so on. 14

Slide 17: 

With a model prompt the prompter demonstrates how the behavior is done while the learner watches. Model prompts are useful when working with learners who have strong imitation skills To fade the model prompt, we simply demonstrate less and less until the model becomes a gesture prompt. For example, if the prompter is using a model prompt to show the learner to use the microwave they can switch from pushing the buttons on the microwave to touching, but not pressing, the buttons. Then they can move to mocking the pushing of buttons and then to pointing at the microwave. 15

Slide 18: 

When using model prompts, be cautious about verbally explaining what you’re doing. It may be necessary during initial training, but you should not couple model prompts with verbal prompts unless you have a plan to fade both. 16

Slide 19: 

Picture prompts provide a visual reminder of a behavior or a step in a behavior. Unlike most prompts, picture prompts can be easily transferred to a permanent adaptation instead of a prompt. Picture adaptations are a common part of society. Think about restroom doors and Ikea instructions, not to mention road signs. Picture prompts can be made so that they are not dependent on staff to deliver; though set-up and maintenance are usually needed. 17

Slide 20: 

Picture prompts are especially useful with learners who need assistance with sequencing. It can be useful to have a visual reminder of what step comes next. An entire behavior chain could be converted to pictures and used to remind learners of all steps in the process. For example, pictures of each step of buckling a seatbelt could be posted in the van to help guide a learner through the process. Single steps can also be targeted with pictures. For example, if a learner needs help with one step of behavior, a picture representing it can be introduced after the previous step. This is often hard to manufacture and works best in a controlled environment. 18

Slide 21: 

Picture prompts are faded by reducing their use or prominence. For example, if we are using picture prompts to help guide a learner through using a seatbelt, we can remove pictures for steps one at a time until the learner masters each step. You can also make pictures smaller, less accessible, or faded. If this is done gradually enough, it can fade to independence effectively. 19

Slide 22: 

Proximity prompts involve arranging the environment to direct the learner to the correct behavior. This can be done by placing key items in the environment so that the learner is directed to the appropriate behavior. For example, if the learner is learning to put a dish in the microwave, we can put the dish near the microwave to signal to the learner that it goes in the microwave. This can also be done by the prompter placing themselves in a position that directs the learner to the correct behavior. For example, if the learner is learning to put a dish in the microwave, we can stand near the microwave while they our holding the dish to get the learner’s attention directed at the microwave. 20

Slide 23: 

To fade the proximity prompt, we simply move the object (or ourselves) farther away from the area. For example, to fade away a prompt where the dish is close to the microwave, we can gradually move the dish away from the microwave while keeping it on the counter, then move it to the cupboard but leave the door open, and eventually remove the prompt by leaving the dish in a normalized situation. 21

Slide 24: 

When fading prompts in general, it is essential that the fading sequence is done in an organized way based on documented results. For example, when teaching a learner to use a microwave, a prompter could move from one level of prompt to another after 3 consecutive correct responses and could have the following fading sequence (note that the cue has been left out of this example): Full physical guide to push the button on the microwave while verbally stating “now push the button”. Partial physical guide to the microwave wile verbally stating “now push the button”. Indirect Verbal guide “what do we push now?” Indirect Verbal guide “what do we do now?” Indirect Verbal guide “next?” No prompt. 22

Slide 25: 

If two prompts are used together, there must be a plan to fade both of them. Unless it’s apparent that the learner did not hear or see the prompt, only one prompt should be given. If the learner does not exhibit the desired behavior, you will begin the correction. If the learner is consistently not exhibiting the desired behavior with one prompt, the prompt will need to increase. 23

Slide 26: 

Cues and prompts help us to elicit the desired behavior. However, regardless of whether the behavior the learner exhibits is the desired one or a mistake, the stimulus that comes after it will determine the likelihood that the learner will exhibit the behavior again in the future. The reaction is generally broken down into two categories: The reaction to a correct response, and The reaction to an incorrect response 24

Slide 27: 

The reaction to a correct response should be a type of secondary reinforcer. Secondary reinforcers come from one of 4 categories: Social – these involve interaction with other people, such as high-5’s, hugs, praise, smiles, etc. Material – these involve tangible, physical items such as books, DVD’s, toys, etc. Activity – these involve an actual act taking place, such as playing basketball, walking, talking, etc. Token – these involve non-reinforcing items that become reinforcing because they can be traded in for things that are reinforcing. Money is an example of a widely-used token reinforcer. Tokens can be tangible, such as a poker chip, or abstract, such as points. 25

Slide 28: 

The reinforcer used for the correct response should be pre-determined by making a reinforcer menu. A reinforcer menu is a list of possible reinforcers that can be provided contingent on the desired response. By using a pre-set menu of reinforcers we can avoid making our mood and personality a contingency for what type of and how much reinforcement will be provided. This helps make the association of desired behavior and reinforcer stronger and will increase the likelihood that reinforcement will increase the behavior in the future. 26

Slide 29: 

Corrective procedures are pre-determined reactions to incorrect behavioral responses. Corrective procedures are intended to prevent incorrect responses from becoming associated with reinforcement so they are less likely to be repeated in the future. There are as many corrective procedures as there are objectives. The corrective procedure should be determined by the reason for the mistake. We will look at a few examples of common mistakes and examine corrective procedures for them. 27

Slide 30: 

When using a corrective procedure you must continue the association between the cue, the behavior, and the reinforcer. If you are using an artificial cue (such as a statement indicating that it is time to engage in the behavior), you should repeat the cue. You must always continue the association between the end of one step and the beginning of the next. When working on skills that follow a specific sequence, you should repeat the last step that was successfully completed and add an additional prompt if necessary to ensure that the learner completes the next step. 28

Slide 31: 

Example 1 Desired behavior – James will correctly sort items into 1 of 5 categories. Cue – natural cue of the presence of unsorted items Prompt – 1 model prompt of placing each item in it’s correct category. Response (behavior) – places an item in incorrect category. Corrective procedure – Job Coach states “that was the wrong category, please try again”, removes the item, and replaces it to its original location. 29

Slide 32: 

Example 2 Desired behavior – Sandra will complete the following steps of hand washing after using the restroom: get hands wet, put soap on hands, wash hands, dry hands. Cue – natural cue after using the restroom Prompt – point to the object needed for each step (gesture prompt) Response (behavior) – Sandra puts soap on her hands, but goes directly to dry her hands. Corrective procedure – Job Coaches non-verbally directs the learner back to the sink, gesture-prompts Sandra to put soap on her hands (the last level of mastery), and uses a model prompt to wash her hands. 30

Slide 33: 

Example 3 Desired behavior – Helen will clock in after her coffee break. Cue – “break time is over” Prompt – Job Coach will walk with Helen toward the time clock (proximity). Response (behavior) – Helen walks near the time clock but does not clock in. Corrective procedure – Job Coach will repeat the cue and point toward the time clock (gesture). 31

Slide 34: 

Every instruction should have 3 components, the cue, the prompt, and the reaction. The cue is the stimulus that tells the learner that it is time to engage in the behavior. The cue is not targeted for reduction. The prompt is the assistance that comes after the cue but before the behavior. The prompt is intended to help the learner engage in the correct behavior. Reinforcement (a reaction) is a stimulus change after the correct response that makes the behavior more likely to occur in the future. The correction is the reaction to an incorrect behavioral response. The correction helps reduce the likelihood of a future mistake. 32

Slide 35: 

The cue, prompt, and reaction should be determined BEFORE skills training takes place. This allows us to better control the contingencies surrounding the behavior and help the learner learn the skill more effectively. The cue is a permanent stimulus that is not targeted for elimination. The prompt and the reaction should be faded away until they are independent or natural. 33

Slide 36: 

The End