Episode 6 - Presession Pairing w/ Dr. Amanda Kelly

(upbeat music) - Welcome to "ABA Inside Track." The podcast that's like reading in your car, but safer. I'm your host, Robert Perry Cruz, with my co-hosts. - I'm Jackie. - I'm Diana. - I beat her this time. So everyone at home, this is episode six of the show. And this week we're gonna be talking about pre-session pairing. If you listen to our preview episode, then you'll know the secret. We'll be talking with a special guest, live via Skype, live for us, not for you. Dr. Amanda Kelly, all the way from sunny Hawaii. - It's cold here in Massachusetts if you know I have a head on. - Yes, it's spring in Massachusetts, which means it's cold and wet. - That's supposed to winter when it's cold and snowy. So the article again, for those of you who decided to just listen to episode six 'cause you'll love number six, is the effects of pre-session pairing on the challenging behavior and academic responding of children with autism. And that's by Amanda Kelly, Judith Axe, Ronald Allen, and Russell McGuire from behavioral interventions, volume 30, from 2015. So it was really nice to get this chance to talk about the article with the primary author. We have very limited recording capabilities in this epic studio of ours, which is a table microphone laptop. And sometimes we have ear buds to listen in on ourselves. So hopefully-- - We're making it work. - We're making it work. So hopefully the sound quality is up to normal standards and doesn't get too fuzzy. If it does, please purchase some CE from us so we can buy new equipment for the future episode. (laughing) - Awesome. - And without any further ado, here's Jackie Diana and Dr. Kelly. - Amanda, we're so excited that you're here today. Hey guys, how's it going? - Great. I was sunny Hawaii. - Today's pretty sunny. It's nice, really big waves today, which is unusual for the season. It's cold here. - It's been raining here for like a solid week. - Wow. I went to California and they need rain, you know? (laughing) - I didn't help. - No. - Okay, so let's talk about your article that you got published in Behavioral Interventions. Is this your dissertation? - This is my dissertation article topic, yeah. - Woo! - Nice to be done. - Woo, awesome. Thank you. So, do you wanna tell us why you were interested in this and what got you doing this article, like doing this research? - Sure, I mean, the dissertation process is kind of long and painful, I think, for most people. Definitely. - Me, yeah, I was gonna say it definitely was for me. And I had multiple topics. I had tried a couple of different avenues and projects and subjects would graduate or move on, go to a different grade before things could get through the IRB process. And so, this was actually my third dissertation topic, the third one. - Oh really? - Yeah, that was seen through to the end, which was very satisfying in that way. It was a really fortunate topic because it, to me, with something that I already knew was gonna be effective. And not to go in, you know, with a preconceived notion, but it seems, right? Like, it seems like if you have fun before you do work, then work might be a little bit more fun or a little less work, I guess. - I should use that in my own life, like do something awesome in the morning. My husband actually does that. He probably won't like it that I tell everyone, but he gets up an hour early to play video games. - And then you've been on like a work day? - Oh yeah, on a work day always. - Oh wow. I find Tweet more reinforcing than almost anything. - 'Cause he doesn't. - Oh, good for him. - But maybe he's doing this pre-session pairing. I'm not sure what he's doing. (laughs) - Well, I think, but I totally agree with you. It's like one of those things that you, you kind of have that bag of tricks where, you know, if you wanna make a work session easier, then there's a bunch of different things that you might try. And I think that, whether you call it pre-session pairing or not, trying to do a fun activity at the table before you present your work demand is one of those things that might be in your bag of tricks. So it was cool to read this and say, oh yeah, like that totally makes sense, and then getting to see more of this theoretical background kind, why it might be that that does work. - Yeah, I mean, when I looked at, you know, some of the education I had, you know, running and able to see assessment for basic language learning, prior to maybe now the VB map, there was a lot of talk about establishing yourself as a reinforcer, that's section A, right? Very beginning, right? How effective are reinforcers? And so there's a lot of talk about this procedure and how to pair yourself or how to become fun. And Sunberg and Partington are some of the first authors to mention that. We also look at Mary Barbera, who did the verbal behavioral approach or wrote that book. And her book, The Primus of getting language, you know, acquisition is to use motivation and to be fun and pair yourself. So I felt confident that it was not gonna necessarily be an easy dissertation process. But how could we have sort of an outcome that we know works and document that through a difficult dissertation process? (laughing) - So here's some preliminary questions that we had. Well, we are reading this that one thing that we like to do for our listeners that are in their car or listening on their couch or in their rooms, wherever you listen, guys. We like that to be of like a general overview and some definitions of words. So that if they're not as familiar with the literature, that they kind of have a grasp of what's going on before we talk about the article. And your article talks about CMOs. Can you tell us what those are? - I'll do my best. I bet you're gonna do better than me. (laughing) - CMOs stand for Condition Motivating Operation. Going back further prior to when I was studying, motivating operations were often called establishing operations. So if you're looking at literature in the past, you might be seeing EOS versus the description of an MO. So that can be confusing if you're not aware of that. And there's a further distinction, the further our field evolves. And now we are looking at motivating operations as that umbrella. They can either be establishing or abolishing. So when we are talking about condition motivating operations, there are obviously situations in which pairing has occurred of some sort. So a neutral stimulus now has acquired these properties. When we talk about motivating operations, they're momentary states. So they're not an item or a particular piece of an environment, they're that sort of interaction, the context, if you will. So it's momentary and momentarily impacting behavior. When we look at a condition motivating operation, momentarily it may signal the worsening set of conditions. So work, work might be coming, traffic might be on its way, something that we're not really looking forward to is coming. That would make momentarily anything that gets that warning signal to go away, more reinforcing. When I think of the R, it stands for Reflexes. I try to remember, as it means, the removal of itself is reinforcing. So R is for removal? R is, to me, it's for the removal. That's a good harmonic. I like that. That actually is really helpful. Yeah, OK. And then you also talk about pre-session pairing. You want to tell us a little bit what that is? Yeah, it's a term that I think we've coined, the authors. It's not maybe the very first time it was used and some would say you have to demonstrate an effect before you can call it something. And this article, my dissertation, was the first demonstration of that effect that we saw. So certainly, additional studies will be needed to make it more robust before we say it's a procedure. But what it means, essentially, is, according to Sunberg and Partington, they said, it's approaching a child who's not engaged or an individual who's not engaged in a reinforcing activity, presenting that reinforcing activity. So Jackie, for your husband, it would be, hey, here I am with those video games. But we're going to participate in the consumption or we're going to engage in that item together. So it's not just happening. That's not happening at my house. That's the same. All the duty for you. No halo in the morning. All right. So yeah, so it's really important that the engagement happens with the instructor when we're talking about work tasks. And then I actually sought the advice of Dr. Mary Barbera and said, do you have to pair at a table? Can I pair on the floor? Can I pair on the hallway? When I'm logistically retrieving these students from their classroom, is that a con found? What are her thoughts on that? And she really shared that she feels it's very important to pair at the place of instruction. So where the instruction is going to occur and where you want to go. want to have the most control. So while you may initially have a lot of instruction on the floor for an early learner, if your goal is to have some tabletop instruction or to have the best attending skills, I think not just the most control, she encouraged it to be at the table. So for us that was the table, that was the face of instruction for our learners in this study. - I think that would make sense though, because it would. - It would. - It's not just the instructor who might be part of the presentation of the aversive event, but it's the setting as well. So if you have the reinforcing activities happen in that setting, also it'll be a little more reinforcing. - So you were saying with the setting, it's not just the teacher who could acquire those aversive, the aversive property. It really is the environment, it's the place of instruction. When you think about the classroom, the classroom isn't always aversive. The table where you ask a child to come over and do work isn't always aversive. The teacher isn't always aversive. And actually that's something that we really tried to consider when we did our functional analysis. And maybe I can talk more about that when we talk about some of that section. But looking at having those items that are part of the environment, that evokes some of those challenging behaviors, it's interesting that they don't always evoke that behavior. So it's that combination and sort of teasing apart how many components have to be in place before it's aversive. Or signaling may be the worsening set of conditions. - So Amanda, what was the purpose of your study? - The purpose of our study was to determine what would be the effects of this precession pairing. And that's what we coined it for this study. So providing access to highly reinforcing or preferred items with the instructor at the place of instruction. To see if we could decrease challenging behaviors. I think it's a really practical study. I think it's something that everyone can relate to. Very significant, high social validity. And social acceptability with our procedures and with what we were trying to do here. So we wanted to see, did it have any effect on the rate of challenging behavior, as well as what was the impact on actually the acquisition of new skills. And so we were targeting some academic acquisition as well. - Awesome. We were talking about that earlier. - Yeah, I felt like that was a really nice addition here. But you could have just looked at overall decrease in challenging behavior or general compliance to task, but you also were looking at acquisition of skills, which was like a nice little cherry on top, I felt. - Yeah, we loved that part. - Yeah, I also really liked the name precession pairing. It makes perfect sense. Like you can picture it exactly what it is. You know, like a little order before the main course. (laughing) - It was a good name sampling. - Yeah. - Yeah, exactly. Can you tell us a little bit about who you used as participants? - Sure, yeah. I was really fortunate the school I worked at in Massachusetts, the special education director, their team, the teachers. Everybody really helped make the study possible in a public school setting. And so I think that was blew my mind. And maybe of my professors more than anything was to see that we were able to get separate classrooms used, as well for our study. So we had three students, three participants, who met the criteria. We were looking for those who had escape maintain behavior. So we did do a functional analysis of actually six different students. Three met the criteria for the function we were looking for. We had Ariel, who was nine years old with autism. She had no real functional communication. So these were students who were in need of some support and services who also were not necessarily accessing that at the time. So the study allowed students to access services I felt they needed to be able to conduct some assessments and share with their teams. And it also wasn't pulling them away from any other services that they might have been getting 'cause they weren't really in that situation. With Ariel, we saw self-injurious behavior. Some of it was pretty intense, fighting to her wrist, facelapse. And then there were table hits. So her face to the table or her face to a wall. - Oh yeah. - Yeah, and so that's a behavior I'd love to see decrease for her team, for her family. Obviously like to see communication increase. Those were some sort of collateral pieces I think of this study. Not our original intention. With Jonah, he was an 11 year old male with autism as well, a diagnosis. He was considered very fluent. Actually, his challenging behavior was negative statements. And some of those were quite colorful. His language was pretty well developed. But we also saw a task refusal, just non-responsiveness and swearing behaviors. For our third participant, she was also 11 years old, female with an autism spectrum diagnosis. She was a capable verbal communicator, but she was very selective when she communicated. She didn't have an official diagnosis of anything impacting her selectivity, although she may have certainly qualified. She had similar challenging behaviors that she exhibited to Jonah, which was task refusal, non-responsiveness, those negative statements. Also property destruction, which involved like smushing the marker tips and ripping up tissue paper and paper. - That is very fun. So I'm on board with her. I actually love ripping the chips off of markers. - Really? - Yeah. - Doesn't it go over your fingers? - So what? It's like, it's like a little triangle when you do it. It's like, and then it just falls off. - I don't mean so sad. When that happens to my marker, I'm so sad. - Don't let me out your markers. I guess not. - I was just thinking how fun it is to engage in negative, escape maintain statements. - Oh, yeah. - Yeah. - What are some of yours that you use? - I can't say them on our podcast, Jackie. - Yeah, there is no swearing allowed. - Oh, good. Okay, so that's really helpful. And I love getting that background. We're finding out things like you did six FAs to land on participants who seem like they were appropriate for these sessions. And it also helps me interpret some of the functional analysis data further too in that for Jonas, Susanna, you saw responding and both the attention and the demands, conditions. So there was likely that that was maybe multiply maintained. But you most wanted to see some responding in the demand. - Yeah, yeah. So I asked for participants who were presenting with challenging behavior when their teachers asked them to do work. That was originally sort of the first way to scope out a sample was who's available, who's having these challenging problems. And then are those challenges really related to the demand themselves? Or were they related to something else? And so what we found was for some of our students, so for Jonas and Susanna, we did have multiply maintained behavior. We had an attention component and demand really came out as the secondary maintaining function possibly with Ariel, it was much a clear, much clearer distinction. So it's okay if it had other functions. It's certainly lots of behaviors, multiply maintained lots of times, many, many occasions. But with Ariel, I think when we saw just how intense her behaviors were and how clear that function was, I think for replications, I'd like to look at more Ariel's. Honestly, you know, more challenge. And then if you can see the improvement, it feels obviously more convincing, I think. - Oh yeah, and her functional analysis data were so clear. You saw responding almost exclusively occurring in the demand condition. And then when it was occurring, it was 90 to 100% of the intervals she engaged and challenged me for. - Yeah, when you have a chance to look at the graphs, and I know that's hard for people on the podcast here, but for Ariel, we actually looked at percentage of challenging behavior and we'd like to intervals because the rate of the frequency of the behavior was much higher. Whereas for Jonas and Susanna, we were able to do a frequency count and stick with our direct measures, which I think are a deal whenever possible, you know, trying to convert the data, but with Ariel, we really just, that was the most accurate way to depict her rate. (upbeat music) - Hey, everyone, Rob here, just popping in for a real quick second to tell you our secret code words. If you're interested in purchasing CE's for this week's episode, the first code word is Apple, APPLE. One of the best fruits that you could possibly have, Apple. Okay, and back to the conversation. (upbeat music) - So can you tell us a little bit about your dependent variable? - Sure, so for each participant, they were slightly different. We were looking at their challenging behavior, so the bite-sourced, facelapse, tablehead, high-pitched crime for Ariel. We didn't really delineate or separate which behaviors were occurring. They were just sort of a self-injury, was called self-injury. - Okay. - When we looked at the effects and saw some behavior occurrences, it's important to note that that was the crime behavior, so I could report that sort of topographically, it was very different. So the intensity was also very different, which makes the effects even more, I think, compelling and helpful. - Mm-hmm. - And with Joan and Susanna, we were looking at the non-responsiveness, the property destruction. now for their academic acquisition. We did have a token system in place, they had history with token systems, they were in the fourth and fifth grade, so they had probably mixed history with those. And that was just correct responses, resulted in that item or token, five correct responses. It's interesting that we did look at correct responses, and we can talk about that a little bit more when we get to the results. The compliance to task way increased, so they were highly focused, engaged, seeking out the table, but it doesn't necessarily make math any easier. Right. I wish it did. Yeah. So you guys reported on both challenging behavior and correct responses. We did. For Ariel, when we were looking at her task, just so you guys are aware on the line as well, she had picture words that I would then say, so CVC words like "sun." So I would say "sun, sun, sun." And she had letter tiles A through Z that she could scan and was working on composing those sounds. If she didn't make an error but paused, I could repeat the instruction, so sun, sun, sun, and then she would then either spell it correctly or incorrectly. Prompts were given for preventing sort of, when an incorrect response occurs, excuse me, the correction procedures were in place, but we were looking at skills that were currently in their IEP, so their individual education plan. These were not the particular items they hadn't been exposed to themselves. And then we also did a novel task, and the novel task for Ariel was where we would have a number card, a flash card that would say like seven, and then she'd have manipulators where she'd need to count out seven items or corresponding amount. For Jonah and Susanna, I think something that really surprised a lot of people was that we were working on reducing, adding, and subtracting fractions as our top industry trial. Yeah, I had to definitely get more fluent. Right? Yeah, I was just going to be, I might have to re-learn. Right, I had to do that. Yeah, like getting those common denominators, I'm like, okay, don't forget that. Nothing worse than prompting or correcting response when you're incorrect. So that happened once, actually. That must be a grade level skill for an 11-year-old? Yep, I guess that's what was there for where they were at, at least, working towards those grade level objectives. And so it's interesting when you think about doing discrete trial, or when we talk about doing discrete trial, I think a lot of my previous experience had been with what I would think of more simple tasks, or tasks that weren't maybe as multiple steps as you could have here. And the reason why we also looked at adding and subtracting those fractions was because the instruction occurred over a period of time. And so they are going to acquire skills if I'm effectively teaching. So I wanted to make sure that the level of difficulty of the task was maintained throughout the dissertation study. So if we just worked on reducing fractions the whole time, it would have become too easy. I think we would have seen the reduction in challenging behaviors for a different reason. Yeah. And then their novel tasks, so just a follow-up, was looking at identifying nouns and verbs. So I would say something like, or hold up a card that said, "The book fell off the shelf." And then it would be right the noun and blue in the verb and black. And they would have two markers in a dry race board. So again, pretty complex, but interestingly, they became relatively fluent in that task. Cool. Wow. That's really awesome. I love that you use things that would fit in with their IEP as well. I think that that really adds to the social validity of the study and that they shared skills that they needed to be practicing within their regular school day. So kudos to that. Hey. Did they make kudos bars anymore? Yeah. They told me kudos bars. It does. Maybe I was in like 4th or 5th grade, actually. Right? Yeah. Sorry. They told me there. Yeah. Next we'll do some kudos bars and some bugles. So we'll put them on our fingers. Alright. That sounds great. Oh my gosh. I don't actually think they make bugles anymore. Talking about MOs. Man, it's got me all hungry for kudos. One thing that I like before we talk about the procedures is that you did procedural integrity. This has been like my main power point of a pet peeve. Yeah. Power point. They like to call it. Power point. Like not as a power point as in one word, but like two words. Oh, yes. Of course. Two cap, I got you. Power point. Yeah. Okay. Basically, anytime I'm teaching a class or reading an article, I like skip straight to the procedural integrity section and I'm like, is it there? And it's here. And when we were looking at it initially, today at Diana's oldest son's baseball game, I was like, oh, I'm so bummed there's no procedural integrity because I figured it would be next to the I.O.A. and I was like, oh, I'm so sad. And then I was like, it's here. And it's great. So that makes me really happy that you did that because I don't know why people don't include that always. Right? Yeah. If you could take an I.O.A., you might as well take procedural integrity. I feel like it's assumed sometimes and we don't often think about separating them apart. And when you're looking at a dissertation, I mean, they really want you to just write and write and write and you think you're done and then they need to go on a family vacation. So now you got to go and do more integrity and write and review and read. That's just the painful process of dissertation writing. But really, it was, we wanted to make sure and it was done throughout the study before moving on to another condition, making sure that the conditions that were run. So we didn't just collect the procedural integrity throughout the study on 30 percent. It was done throughout conditions before we would even move on to the additional conditions. So we did look at it on 30 percent of our sessions but equal balance to cross conditions. High range. I think a lot of that also had to do with the people who are observing and doing a lot of my I.O.A. with me and looking at some of the integrity they were highly trained to behave around. So it was easy to get the definitions understood. But I also was following checklist and I was the one implementing the dissertation study and I was doing it many days a week and so it became relatively easy to ensure fidelity when you have only one person or one or two people really implementing things. Still the one important to have. So now I know that you did what you said you did and everyone agreed and everyone agreed with it. So now let's talk a lot about why you did it. Can you tell us what you did? Yeah, absolutely. So I had students, these students were being serviced. Ariel was pretty much fully self-contained whereas Jonah and Susanna were in an integrated situation at classroom as well as received some instruction in a self-contained classroom. Wherever they were located I tried to make sure that I wasn't taking them during a time that they really wanted to be there so I didn't want to compete with what was happening in the classroom. I wanted to keep it as neutral as possible. For example, if they were having ice cream or a pizza party it wouldn't be like hey let's go work with Amanda down the hall. I think that would have also skewed the results. You made your bummer. Yeah. Yeah. Worried about also pairing myself and having to place the demand and transitioning down to the office or the room in which we did the study. So I was really fortunate that there was a behavior analyst working at the school, working towards her BCBA and was able to work with me and would retrieve the students and sort of drop the moss for me. So I didn't have to cloud or engage with them prior to what I was looking to do for the study. What that looked like when they would come into the room. We had done preference assessments, we had done brief free offer preference assessment. So items are laid out on the table. They could engage with more than one item. We would see how long they engage with items, which items they chose for Susanna. She only engaged with one item and access to attention, attention was one of the items. So that was great. We know it was super highly reinforced right potentially but nothing else. So had her classroom special education teacher run a pair of choice preference assessment after training the teacher that was video recorded and we also conducted IOA of that. And we were able to get it a range of items for all the participants after that. So they would come into the room. It was a pretty sterile room, a table with two chairs and a desk, someone's office desk, but it was cleared of clutter, clean of clutter. And we had a rug on the floor and there were moderate or low items that rated as moderate or low preferred that were available. So free access. You can play with the little viewfinder or flip through some cards or put a sticker on your hand. What was in those bins would vary depending on which student was coming in the room. I would then say come here, cue them over to the table and in our baseline conditions. I would then present the demand, I would say hold up a picture of the cat and say cat cat and then Ariel would compose or construct their response or I would prompt her or correct her in her response. And then after earning, yeah, blue, blue, blue, blue, blue. it was five tokens, they could then trade in, engage in access to that item for a few minutes, and then we'd go back into additional trials. What the only difference really was for the pre-session pairing was they would come in the room, still go to the rug, play with moderately or low preferred items. I would say come here, so at this point nothing feels different about the instructional environment, and the second they would sit down, I would say what do you want and hold up two items that rated as highly preferred. So I think we were looking at 80% or higher. For Ariel, that would be like the iPad with Angry Birds, or it was music with Lady Gaga, or it would be this other game or stringing beads, and it was a self-simulatory behavior, she would engage in. I was not necessarily looking to change that as part of the study, so it was a highly preferred item or activity. I would give her a bead, she'd string it, we would both sort of stare at that string, and then we would exchange it, and it was a beautiful thing, you know. And they sort of interject yourself into the beads. Right, yeah. I would just sort of like hold them, and then I could give one to her, and she would like to then string them on. She started to offer me the string, and then I'd put the bead on, and I would mimic what she had done with the string, and then what I did was I'm highly animated at this time, so I'm like, "Wow, can you show us?" "Show us." "You want me to do it for you?" Yeah, yeah, so I'm like, "Whoa, look at these beads!" "That is amazing," and I was dancing to Lady Gaga, and there are videos I, for luckily, I don't think they exist anymore, of the fun. You have to be fun. We can operationally define that. I think that's very hard for a lot of people to get really good fidelity and integrity on how to be fun and not feel foolish, and it's okay if you feel foolish. I think that means you're doing it right. Now, for our students, I didn't just end the task. It wasn't like, "Oh, you have two minutes to play with me." The timer went off, but Lady Gaga is still singing about poker face, you know? Because of that, we made the decision that we were going to end at the natural end of an activity. There was a range. You'll see a two to four minute range when you look at the study, when you look at the data. Some songs are shorter than others. Some games are longer than others, but we were able to pick tasks that could end there. I think that simple consideration, that simple adaptation, could make all the difference on its own and should just be investigated. What happens when we don't cut our students off of reinforcing activities at arbitrary time limits, you know? Yeah. I know it. I don't like it when people cut me off from like my favorite show that I'm watching right now. I can't finish. Yeah. Can't finish, can't finish, can't finish. One thing that we like, and we wrote down-- That's being a carb. Oh, I didn't know who was. In the article, when we were reading it, is Diana wrote, "Can't wait to read this in 20 years when you were like looking at Lady Gaga." Oh, we don't have. All the re-enforcers are like so specific to like the day, right? Lady Gaga, Katy Perry, Angry Birds. This one wants to be a millionaire board game-- It's a time capsule article. Plants versus zombies and fruit ninja. Like, that is like 2015. Like right now. Yeah, we're like, wow. We'll put in the time capsule. I love it. We'll put it up later. These kids are with the time. They really are. Yeah, very happy to. These kids are hip. They're really hip. Yeah. That's great. Well, that sounds pretty fun. It seems fairly easy to-- It's such a simple manipulation. It is easy. I think if you are a person who can be fun and have fun, I think if we're looking to teach others to do this, it can be really easy. It doesn't cost me anything. I use items that were in their classrooms or that were available in their school because I wanted to see the effects of this. I wanted to see the benefits of it. Be able to be continued when I wasn't conducting a dissertation study. So, as a behavioral analyst, what should we do? We should set up the natural environment and make sure that these behaviors can be reinforced with what's naturally around them. Yeah, I mean, I would like to say and can hope that their teachers didn't take it as too prescriptive and know that now, that these students are in the seventh grade, they can, you know, like Miley Cyrus or whoever. It's only Katy Perry forever. That's it. That would be really funny. Hey, I have a quick question for you. Before we get to the results, I love to ask this question when I read other people's articles. So, this is just the question that I love to ask. So, when you did your FA, you said you did a brief FA based on Wilder in all 2001. Why did you choose that one? Because I was in a public school, because it shorted, because it was abbreviated and because it had pretty high reliability or accuracy with their results for extended FAs. Also, I think, as I mentioned, just time, time being difficult, and I wanted to run enough of those conditions. So, yep, they were short. It was easily replicable and tough work for me to say, but I couldn't replicate it. And we got those clear differentiated results. I think without those results, then we would need to do more, but be as parsimonious as possible. During your pre-session pairing phase, did you require the students to make eye contact with you or interact, or were you just there having fun and they were attending to you because you were so fun? Usually because I was the one who had access to the items. It was easy to get their engagement. For Susanna and Jonah attention also rated as a function for some of their behaviors. So, I think it was naturally kind of going to occur for them. But there was a challenge that came up. And I think that this is a real challenge. What do you do when the learner doesn't want to interact or participate with you? That came up with Jonah and I initially, where we were playing the game together on the iPad and then he took it and was like, okay, I'm going to do this and he just started narrating what he was doing, but he was in no way wanting to give it back. And asking for it back or interjecting his game, I think would have not been well received. And so I started commenting like, oh no, that zombie is going to eat you. You better shoot him. I don't know if you can do that. Can you get that? He's going to, oh, and then we got into a lot of verbal engagement. That was really positive. And it was like, I'm going to beat my high score. And I'm like, I don't know if you can do it. Yeah, what do you mean? So there were other ways to engage that were not what I had originally anticipated. And I think that when we are viewing this as a teaching procedure, we want to keep in mind that the purpose is to have fun and to be engaged and to do it together. And if that is not the right item or the right task, then maybe you let them engage with that task. And next time you reassess what you're going to engage with. Smart. Okay, cool. All right. Do you want to tell us what you found? Yeah, we found that a relatively simple, easy cost-free, other than my time, intervention reduced our challenging behaviors near immediately. When we look at, and I teach a lot, talking about change and level in the amount of overlap, it would be easy for someone to believe or to question whether or not this is real data. The good news is it is. We have a strong agreement. It went through rigorous publication. It's the dissertation, but it's very clean data. It is. And it's awesome. Yeah, and I'm really grateful for that, certainly for the purposes of the dissertation. Now when we look at the baseline rates for Ariel, they were fluctuating, but they were between 40 to 70% of the time we were seeing challenging behavior. For Jonah, he started off kind of maybe I think thinking this novel situation might not have been so bad. The next day, it got worse, and I think that, right? And then it's just this really good stuff. It's like a deep fluid bin real quickly, which is actually why when you look at the intervention phase there, for Jonah, he was only, we only held him in baseline one session longer than Ariel, because truly when he was starting to engage in those challenging behaviors, they were intensifying in their topography and in their intensity. And I wasn't sure we were physically going to be able to have him in the room if I kept him in baseline for much longer. So that was a decision made based off the data, made based off those participants. Obviously, if we were going to do this again or if we didn't have that concern, we would have held him in baseline longer. I don't know if you had to though. I mean, the increasing trend. Yeah, you have an increasing trend. The baseline is staggered. No one says you have to like stagger it forever. And if it's clinical, like, come on. Yeah. Thank you. I felt good about the decision, but certainly, I guess in a hypothetical situation, I would have extended it, you know, at least another session. Maybe not another 12 sessions, right? Susanna, we held off in implementing with her or intervening with her the last, she was the least intense with her challenging behaviors. And that's That's why she got to go online. And her challenging behaviors, as I mentioned, were things like smashing our markers and ripping up our tissues, which mattered. I had to make several runs to target in their dollar bin that week, you know what I mean? But it didn't really pose any significant harm. So for all three participants, we saw an immediate change in level, a huge significant change, no overlap, except for one data point, four sessions into intervention for Ariel. It skyrocks back up to baseline rates. She had an unusual dental procedure completed that weekend that I was not aware of. And then what happens, it's like, wow, my data is horrible. What happened? And they're like, oh, yeah, we took them off meds. And then we put them on the snow meds. And then we gave them dairy and he's allergic to dairy. Hope it's not pooping his pants. Hey folks, Rob here, just one more time with our second secret codeword, if you are going to be purchasing CE's. And that codeword is Disney, D-I-S-N-E-Y, doesn't matter if it's capitol or not, Disney. Like the guy and the park, the land and the world, all right, anyway, here's the end of our conversation with Dr. Kelly. Yeah, well, you know, I guess the release was that we were able to attribute it to something instead of it just being this random, you know, or feeling random, or at least not having an explanation. So we saw that and then we saw the rates recover, so it didn't feel like it was too much of a threat. Well, we did want to identify it, is there in our data because it existed in real life? And then for Ariel, had access to her five months later. The other two students who were in fifth grade had moved on to middle school. They were gone. Right. So that was just a logistical limitation for why we didn't do maintenance trial with them. And with maintenance went in and sort of returned to the baseline conditions. There was no pairing and her rates are just low and stayed low. So what we saw was this reduced the amount of challenging behavior significantly, immediately and it persisted and so much so that pairing wasn't needed indefinitely. Now there's a lot of aspects and components and replications and extensions that I think are needed here, definitely. But for our first demonstration, it's really compelling and I think it gives us a lot of support for what like you said, Dana, like that we've been doing. It's been in our bag of tricks for so many years, for so many of us. And then for their academic behaviors, what we saw was the accurate responding went down in baseline for Jonah. So as his challenging behaviors are increasing, his academic responding was plummeting. Now, math wasn't getting harder for him. He was still capable to do the task and Friday that he could do on Monday. But with the presence of challenging behaviors, it was sort of an incompatible behavior. Responding correctly while you're engaged in challenging behaviors isn't happening. So when I look at his graphs next to each other, I'm like, wow, look, the behaviors go up and the responding goes down. You can see that. Yeah. So those are overlapped on a graph, I think, wow, that's pretty telling. But what we saw was, what I saw was persistent and consistent compliance to tasks. Really a variable acquisition rate for accurate responding. And for Ariel, we never really saw the responding or the acquisition of the task that we would have liked to have seen. And I think that some teaching applications were needed for her program there. But what we did see was a substantial reduction in her challenging behaviors, which had never afforded her that time for instruction. So now that we had the time for instruction, we were like, oh, this might not be the right instructional approach. Yeah. That's actually a good point. I wish some of these points we could put in articles, right? Like, we can't write forever, but I mean, we wouldn't want to write forever, right? But we do write forever for your dissertation. Right. And then it all gets challenging. And then they're like, now take one out of 365 pages, and that's what you were copy. But that would be interesting, because that's something that I really pulled from the article, but I think it's really important to hear about, because, you know, when we look at the academic graph, I mean, it looks okay, but there's not like a ton of change, but for Ariel. For Ariel. Yeah. Right. And, but there's really not a lot of time either. I mean, like, we can't really expect a student that previously wasn't making any progress to then all of the sudden make progress after only like 12 sessions. Right. Like, who learns? Yeah. And she likely needed, you know, a lot of assistance to learn skills. Right. But this wasn't really that long a period of time. Not at all. Yeah. Yeah. And then her novel task performance was pretty high. But was she learning that task at another point in time? Or was it a brand new task to her? It was a task that I hadn't presented to her and it was a task that was on her IEP, but not yet introduced. So, the fact that she was doing so well, and it was excellent. Yeah. And we were thrilled, but I'm not sure what kind of conclusions can be made from her. Yeah. Just the one point. Yeah. Yeah. Yeah. So cool. All right. Wow. Do you want to give us any more like take home points before we talk about future research and where this could go in our life? I think we've made a lot of the points that I really wanted to make that we should have natural ends to those accessory enforcing times that like interrupting the middle of a song is a practice that I had done early on is something I was told to do. The timer goes off. Right. You're talking about it. I used to do that too. I never do it anymore. Yeah. I absolutely want to do it now. And I start now to think a lot about like, oh, hey, like, let me help you erase that instead of like grabbing someone's pencil to erase things like. So just from being a practitioner and a clinician, I think those things are really important. Remembering to have fun that when we walk into homes or schools or classrooms, it should not be like, oh, here's the behavior analyst that should be like, hey, here's the behavior analyst. Yeah. Something really amazing that I didn't anticipate, but was so pleased to see in our study was students would come in and they would be instructed to go play on the rug. And we did have conditions indicated by different colors on the door and on the table and the work and system with other studies that just try to, you know, discriminate those for or help our learners just discriminate those. And Jonah especially would come in and he just was come sit at the table with me and he'd like, wait, and I'm like, whoa, what are you doing? You have to go over here. And I would try to like look busy. And so I tried to write down like the entire alphabet and I'd write down like, how many A, B, A words start with A and I'd be like, I'm a student of five, because I needed to look like really busy and that was, I was busy doing that. He would choose to sometimes just sit at the table and wait and not even play with anything else or he would try to engage me in conversation and I'd say like, oh, sorry, I'm busy and he'd be like, that's cool, I'll wait for you whenever you're ready. There was a lot of politeness, so not just like lack of certain behaviors but definitely the replacements. And the replacements were really shifting the qualitative value of interactions that these learners could have. So I thought, wow. And then also when I looked at for Ariel, she started doing the same thing and I'm thinking you know, she has definitely a style that she's functioning at a place that's not where Joan is at. And she has the communication deficits that are working against her as well and a barrier for her. And she'd come over and she tried to go grab the beads and be like, hey, let's do it. Let's, let's, let's, let's, let's, let's, let's play, stare these beads together. And then we also, I also saw that when it was time for the task to be presented, I expected to get punched in the face a few times, you know, or to be called a nastier name than what happened. Actually, students started cleaning up for me. So like a timer would beep and and I'm supposed to now take away your Lady Gaga plans versus zombie beads or whatever we're playing with and immediately say like, now do some work. What I would see happening and I try to be super immediate. Have the materials ready. Have things right there. And at times Ariel would just start cleaning up and she'd hand it to me and go put it away or she'd get her work, knowing it's time to get work. And that, I felt like that's the indicator of success, you know, scientifically whatever happened here. It's like, well, what happened here qualitatively is children are seeking out work. They are terminating. They're highly preferred activities and they are attending and being receptive for instruction that they weren't before. So I also did ask the three participants what they thought about the study and did a social validity measure from them. And I had asked, Jonah was my favorite response of, you know, so what did you like better? Did you like when you came in the room and then like you just did work or did you like when you came in the room? We played together and then you did work. And he was like, why is this a question obviously, he was like the second thing was better. And I was like, okay, right. And I was like, well, why was it better? You know, tell me why. And he said, because it was just much more fun. Awesome. Yeah. You're frying because I totally would have said that. Yeah, yeah, I just try to hide it. I have something in my eye. I'm cutting onions over here. Okay, it's okay. So that was definitely some unexpected and some really beneficial outcomes for me with that part of the study. Cool. All right, guys, do you know what time it is? What time is it? It's time to get on the dissemination station. Oh, yeah, the train. From the dissemination train. Train. It's because Rob usually says that. Yeah, trying to be Rob right now. It's not working. But here I go. We're here. Now we're in the dissemination station. We pulled in. We pulled in. So, Amanda, what should we do now? How can we disseminate this? What future research could we do? Oh, gosh. I think Accentance Replications looking at students with different functioning levels or current levels of performance. I think how long can the delay be between the pairing and the delivery of the demand to still have the effect? That would be something I'd be really interested in. You know, because if we're talking about just this as an effect, you know, parents, right? If they can do something prior to dinner time, what does that mean? What does it look like? But can it be 30 minutes before dinner time? Right. I think I know some of the answers to that. But it's all about empirically evaluating. Yeah. For sure. You know, how official does the preference assessment need to be to yield results? Could informal assessments also yield the same result? I'm not sure. So those would be some extensions or clarifications I think that could really add to the larger. Me too. That's awesome. You know, I'm always looking for ways to increase the value of social interaction for my very young learners that I work with. And I wonder if this would be an interesting way to, you know, do a pre-session pairing session and then sort of re-evaluate how open those learners would be to interacting in a less formal environment with their teachers. So what would an example of a formal environment be? And what would an example of an informal environment be? A formal environment would be the work session. Like you're saying, like going over to the table and sitting down. Okay. But if they were in a less formal, just play session. Oh, I get it. We've done studies in the past, where there's like a split room assessment. Right? There's a set of toys on each side of this piece of masking tape on the floor and you can either play with the toys alone on one side of the room or play with the toys with an adult on the other side of the room and we measure how much time kids engage in each set of toys. Set to be in 2008. It might be 2008, I have to look. I'm going to look right now. Okay, thanks. So what would change the value of that type of social interaction for a learner? Yeah. I mean, I think a lot about where the foundational and the building skills came for for this study. And we looked at pre-session access. And there's a lot by O'Reilly and colleagues as well. So if you load up on the attention, then can you get to a place where when you aren't able to provide that attention, they're no longer in a state of deprivation, but maybe momentarily satiated. I think when we look at the assessment style, like you were talking about Diana, I would want to do some reinforcement sampling, right? So like, hey, you're going to look like on this side of the room with me. And it's fun. And then see, you know, sort of what they engage in. I think that that could really be an interesting contribution as well. Amanda was talking about O'Reilly and colleagues in 2008 in O'Reilly and colleagues in 2009 in O'Reilly and colleagues in 2010. They were busy. They were busy. And awesome. Yeah. I forgot what I was going to say. That happens sometimes. Cool. So what I think I'm taking home from this is that it doesn't hurt to be fun. It probably helps to be fun. Yeah. If you're trying to get work done. It helps to be fun, but also respectful. I think that that's the undercurrent of what you're saying too. Right. It's an interaction with that child and you want to be respectful. You need to have a human. Yeah. Just like, oh, we have to get this work done. Yeah. I think we get on our, we have agendas and we have objectives and we have task and goals that we need to accomplish. And we're very data driven and oriented and we should be. But when I'm thinking about the social acceptability of our procedures and our approaches. I want parents thinking, oh gosh, Amanda's coming. My kid's going to have so much fun today. Yeah. Or this is going to look like play. And it should and it can look that way. The other thing is it's sort of also I think a piece of caution that should go out there. When I have worked at places or with people who are starting, let's say, with a new client. I'm going to pair for the first three weeks and then I'm going to start building in demand. And I think that that might be a mistake. And we should be actually. Yeah, we should be looking at the research and see, is that needed? Should it be the first 20 minutes of each session for three weeks? Should it be maybe just the first couple of sessions for three for, you know, one week? Should it be just the first two to four minutes of each session for one day? Those are really good questions. I think the whole point is that it should be the least amount that you need it to be. And the sense that work can still also be fun. Fun can happen within the task, not just before the task. And if we wait too long to build in demand, I think we're going to end up with a resistance. And an expectation that we're going to be only having funds. So yeah. So that did happen with me. I was consulting to a case and when I went to go watch the therapist work with the student, they were only having fun for eight months. And then they were like, "Whoa, what's this?" And the kid was like, "No way." And she's like, "Kal, I just really wanted to condition myself as a really fun reinforcer." And I was like, "Yeah, thank you." I had teachers in the friend zone. So I was like, "Ooh, you are." You really dug yourself a huge hole right here. You're never getting out. Eight months is a long time to be playing. And a poor kid, right? A young child, like under the age of three, could have probably used all that time to learn stuff. Oh, yeah. I was just like, "Let's put on my professional face." Well, good. It was so awesome to talk to you today. Thanks. I know I haven't seen you much. You know, you live on the other side of the world. What's up with that, you guys? I know. Are you going to ABAI? Of course. Yeah. I was thinking about taking a year off. No. I got chastise for that. So this will be actually my 10th consecutive oba, so we should celebrate. Yeah. Yeah. That's awesome. It's 10-year anniversary, so I'll be there for sure. Actually, I just bought my ticket today. Nice. Yeah. For both. Really close. So anyone that's listening to the podcast, if you see Amanda Kelly, aka Behavior Babe at ABAI, you have to go wish her a happy, happy conference anniversary. All right. And buy her a drink. Yes. Yeah. A drink and a selfie. That'll be great. That'll be awesome. So drink and selfie. There you go. Very cool. All right. Well, we will talk to you soon. Thanks so much for coming. And yeah, it was really great to talk to you about your research. Awesome. Aloha, guys. Take care. Bye. All right. Well, that was a great conversation, you guys. Thanks so much for Jenny. Thanks so much for helping set up this interview. It was really nice to have a special guest on to get to learn a little bit more about a topic, with probably a follow-up episode in the next few weeks about conditioned motivating operations. Because it's a pretty big and, I think, complex topic. I mean, big enough that we really were able to have an hour-long conversation just on one article related to it. And there's a lot of questions. And I have one of our guests that had a question about CMOs in the past. And we love to learn new things and bring new information to the audience. Well, did you guys have any other thoughts after having just a lengthy conversation on the topic of precession pairing? It was really cool to get to talk to Dr. Kelly about this article. And I thought that, you know, it's such a simple idea, but then really getting to talk with her in unpack it and hear even more about the ins and outs of what it was like working with these kids and how much this type of setting manipulation really benefited them over time was really cool. And I think, for me, was inspiring as far as taking it back to what are the roots of what we're doing and why do we do it? And we want to help kids, we want to help them learn. And if you can change something as simple as just spending a little extra time with them playing before you start doing work, and that can make such a big difference in decreasing their challenging behavior and increasing their learning, then why don't we should all be doing that? Yeah, I think it's important for us to think about that we're not, you know, finishing things on a checklist that we're actually interacting with a real human child. Yeah, and I talked to my teachers about these types of things a lot because I, for work, work with two-year-olds. And we have to really. It's not very nice to say about the employees you work with, yeah. I mean, not at all. No, no. The students are two-year-olds, the teachers are adults, but we have to really take into consideration that they are two and that they are half-shore attention spans. They haven't many of them been asked to sit down and do any type of demand-related activities before. And we need to make sure that we're establishing a rapport with us, which is one way that you can think about maybe alleviating some of the averse of contingencies in place. And also establishing ourselves as a social reinforcer for kids, too. So this fit really well into the type of work that I'm already doing and I'm going to take it back and share it with everybody. She's actually going to take it to work. Take it to work. There she goes. Singing again. That was my FD, right? Yeah. Okay. It works. I'm picking up what you're putting down. Cool. Yeah. It was really fun. I'm glad we're doing it. Coming on our show, send us an email at [email protected] and we'll think about it. We'll probably do more than think about it. We'll do more than think about it. We'll consider it. No. We'd probably love to have you. Yeah. All right. Without much more ado, I think that's it for this week's episode. So for everyone listening, thank you very much for doing so. If you're interested in continuing education credits for listening to our show, there is a link on the information button on this page. You can also go visit us at ABAInsideTrack.com. We're pretty much ABAInsideTrack. Everywhere is our social media presence or Facebook and iTunes and YouTube and Twitter. All those great places. You can email us, like Jackie said, at [email protected]. That's where we are in the internet. But hopefully you're listening to us directly in your ears on iTunes or Stitcher or whatever podcast app you like to use. YouTube. You can join us next week for a preview episode to discuss our next topic, trial-based functional analyses. So Rob, would you say that our preview episode is a means of doing precession pairing before listening to our full episode? I would say every moment listening to us is probably considered precession pairing due to the joy we bring our listeners. You're right. This is entertainment at its finest. I don't want to demean what we're doing. I think it's educational that is just so damn entertaining is what I would like to think. He said a swear word. Folks at home, Jackie usually swear as I just have to edit them all out. Yeah. That's funny. Pay now. All right. That's enough of these shenanigans, everybody. It's time to put our night caps on and go to sleep. So please join us next week for that preview episode. But remember until then, keep responding. Bye. Bye. Bye.