stereotypies. In fact these repetitive sort of behaviors that occur are diagnostic of a child with autism.

In other words, it is one of the criterion used to make a decision to whether or not someone meets the criteria

for a diagnosis of autism. They can be of many sorts. They can be repetitive behaviors that are vocal in nature,

we sometime refer to those as non-functional vocalisations. They use words and phrases that have

no social meaning but are just repetitive, and occur frequently in conditions in which the child is not

engaged and stimulated in other sorts of ways. The repetitive stereotypies could also occur

in other situations in which they are motor in nature. Rocking, hand-flapping, movements of the

eyes - all unusual sorts of behaviors which are not meaningful in any social sort of way. When then

asked "well, what is the purpose of them, why does a child with autism engage in those? " Well, they

derive some reinforcing value, and the reinforcing value is what is referred to as "automatic reinforcement".

The reinforcement for doing so, that strengthens the behavior, is the sensation that the behavior actually

produces. So they have no benefit in terms of having an effect on the social environment. They serve no social

purpose, their only purpose is to produce self-stimulation that is enjoyable and therefore strengthens the

behavior. Most typical individuals engage in stereotypies as well. They occur however at very low frequency

and due to social inhibition they generally occur privately and not in public places. Children with autism without

the type of social inhibitions that will drive the stereotypies to privacy will engage in this responses across all settings

and two difficulties in particular is one, they interfere with the learning of other skills,

and secondly they are stigmatising when they bring undue attention to the individual from others in the public environment.

This is a video of a boy with autism by the name of Andrew and his

teached working with him, Lianne. Andrew engages in high rates of

vocal stereotypies, basically non- functional vocalisations that he repeats

continuously, that generally interferes with his learning. If you watch this video

Lianne is teaching him during discrete trial instruction. Andrew is responding but

in between his responses to her are these strings of non-functional vocalisations or

what we call automatically reinforced stereotypies. He likes the sensation of hearing

himself repeat these words and phrases continuously. There was just an example right

there where his voice got louder. So if you watch this, while he is responding,

it is very interfering - these stereotypies and these non-functional vocalisations.

I will let you listen just a little bit to it.

That "stop, stop" kind of comment there was unrelated to what she was presenting,

and those are examples of vocal stereotypies. We decided to put in place a treatment method -

a treatment method based upon some research in the field of Applied Behavior Analysis, that suggests

that the stereotypies can act as reinforcers for appropriate behavior. In other words, any behavior

that you engage in at high rates and repetively must have some reinforcing value. So what we are going to do

is use Andrew's stereotypies as a reinforcer, contingent upon not engaging in the stereotypies. What you

are seeing right now is a baseline before we began our treatment.

And now we will go into a video showing how we used his stereotypies as treatment.

This is Andrew now in a situation in which he is now allowed to engage in the stereotypical

behavior to the degree that he will like to. You will see motor stereotypies - repetitive behaviors -

automatically reinforced and vocal stereotypies. He's pushed a timer there, the button on the timer,

indicating that he has one minute and now he is engaging in these stereotypical sort of behaviors.

We have taught him, however, as soon as he comes out of this area, which is a very circumscribed area

in our Clinic, he is not allowed to engage in the stereotypical behavior - he will receive a reprimand

if he does. If he does not he will continue to earn tokens which will then allow him to exchange those

tokens, to go back to his stereotypies. The general idea is that we are using the stereotypies as a

reinforcer. He leaves the area, the stereotypies stop immediately. He comes back over to the table,

and he responds to Shawnessy with no stereotypies whatsoever - he just earned a token. So many tokens,

five to ten tokens that he earns, will allow him to go back and engage in the stereotypies. Shawnessy is

teaching Andrew much the same way that Lianne did, but there are no stereotypies occurring. Mainly

because Andrew has learned that he can earn tokens for engaging in anything other than stereotypies

which then allows him to go back to the area and engage in his automatically reinforced self-stimulatory

behavior. And you can see very nicely there after a few trials of this Andrew is responding nicely,

no interfering behaviors, earning tokens for responding to targeted academic skills,

without any stereotypies at all. Shawnessy is telling him he has got one more and he will

be able to go back to stim. Now he has earned his token. And notice, as soon as he walks back into the

circumscribed area, in which the stereotypies are allowed to occur, he immediately starts

engaging them. The opportunity to do what he is doing right now acted as a renforcer for

responding without stereotypies in the academic setting. So it is making use of the stereotypies and

the automatically reinforced self-stimulatory behavior as a reinforcer. There have been about four or five

papers published on this topic. It seems to be an effective way to overcome automatically reinforced

repetitive behaviors during academic instruction. This treatment procedure might not be used in everyday

life, for example going to the mall, you would not be able to use this procedure to reduce stereotypies.

But during instruction it seems to be a very effective way of overcoming this. After a minute, you

will see Andrew will go back to his academic setting and you will notice how quickly the

stereotypies turn on and off. That is called "stimulus control", we have brought the responses under the

control of only this environment, the environment he is currently in as opposed to all the rest of the

Clinic as an environment. In a few seconds or few minutes you will see -

there he goes - stereotypies stop, immediately. Back to instruction.

Shawnessy describing to him how many tokens he will need in order to go back to the

environment in which stereotypies are OK to engage in, with no consequence and no

interruption from the teacher. He is earning tokens for effective responding.

No non-functional interfering vocalisations occurring. Responding to the academic material,

given himself tokens when directed by the teacher.

He is close to meeting the criterion for exchange of the tokens for opportunities to go back to the

video area.

He earned a chip and the opportunity to go back. Watch how quickly the stereotypies occur.