Icon Exchange

1. Icon Exchange Discrimination Phases

2. What is discrimination? • We’re not talking about race and gender, what we are referring to is being able to choose between a preferred item and a non preferred item. • Which icon will get me something cool, and which one will get me something crappy?

3. General Info • Always have the correct icon for each item • If you do not have the correct icon, ask for it • Reinforce the response within ½ second • Use a variety of tutors and items, both prefered and non-prefered • Tutor should set up for next trial while child is engaging with the item • Number of icons on bottom strip is phase specific • Remember kids: There should never be more than 4 icons on the bottom strip for discrimination phases

4. Preferred Vs. Non-preferred • A preferred item is an item the child consistently likes and eats/engages with for a 10 – 15 second interval • Eating goldfish • Putting a puzzle together • Flipping through a book • A non-preferred item is an item the child consistently does not like, and will not engage in for the 10 – 15 second interval of time • A spoon • A shoe • A piece of paper

5. Non-preferred Vs. Neutral • Again a non-preferred item is an item the child consistently does not like and rejects by either not taking it from you or pushing it away. • Paper towel • A sock • A neutral item is an item that is non-preferred but used functionally: • Using a fork to eat • Drinking from a cup • Putting on a shoe • If you find a neutral item for your child do not use it in the discrimination trials.

6. Phases 3 and 3A • In phases 3 and 3A of the icon exchange, we start teaching the child how to discriminate between a reinforcing preferred item and a non-preferred item • Previously the child always got something good from exchanging the icon, now they have to look at the icons to make sure they are getting what they want Question #1: What is the maximum number of icons that can be on the bottom strip of the PECS book?

7. Enticing vs. Prompting • Enticing a child to “want” an item is different from prompting a child to ask for an item • Examples of prompting with an item: • “WOW look at this COOL car!” • “OOO this is a YUMMY cheeto!” • Examples of enticing with an item: • Pretend to eat an edible without attending to the child • Play with the car by yourself

8. Enticing vs Prompting Enticing Prompting

9. What does an incorrect trial look like? • An incorrect trial happens when the child chooses a non-prefered icon and rejects it when it is presented to them • Examples of rejection include: • Not taking the item from you • Throwing the item • Pushing the item away • Dropping the item • If rejection of the item occurs, move into the 4 Step Error Correction

10. Tips for Emotional Responding Question #2: Which is an example of rejection? A. The child grabs the sock and makes a hand puppet. B. The child eats the cheetoh. C. The child ignores the item and pretends to sleep. • In certain instances of rejection the child may respond emotionally or aggressively • If the child cries or tantrums: • Do not give the child a different prefered item to calm them • Work through the rest of the trial, giving prompts as needed • After completing the trial do as many ELOs as necessary to get compliance and move on to the next trial • If the child aggresses: • Block it and continue to work through the trial • After completing the trial do as many ELOs as necessary to get compliance and move on to the next trial

11. Phase 3 • Allow the child to play with the preferred item for 10–15 seconds before the trial begins • 1 preferred item and 1 non-preferred item is used • Do preference assessments every few trials to find both preferred and non-preferred items • “OOO the new” • Reinforce the childs correct reaching response • Make a reinforcing “OOO” sound as the child reaches for the correct icon during the trial • For incorrect trials go straight into the 4 Step Error Correction

12. Question #3: • Silently reading a child’s book is an example of what? • Question #4: • “VROOM VROOM, this car is so much FUN!” Is an example of what?

13. Phase 3A • Again allow the child to play with the reinforcer for 10-15 seconds or allow them to eat the edible • 2 preferred icons and 1 non-preferred icon • Pay attention to amount of icons used • Remember number of icons on bottom strip is phase specific • Do preference assessments every few trials • No longer “OOO the new” • For incorrect responses go directly into the 4 Step Error Correction

14. Question #5: • If a child is given a sock and puts in on his/her foot, what kind of item is it? • A: Prefered • B: Non-prefered • C: Neutral • Question #6: • What phase do we “OOO” the new?

15. The 4 Step Error Correction • Step 1: Model • Step 2: Practice • Step 3: Distract • Step 4: Repeat

16. Step 1: Model • Gesturaly prompt to the correct icon • If gestural prompt is not effective, move to partial physical prompt and full physical prompt if necessary • That is all step one requires move on to step 2

17. Step 2: Practice • Let the child give you the icon you prompted towards • Label item but do not give it to the child, this is just for practice • Move on to step 3

18. Step 3: Distract • Flip the book over and do an ELO: • Clap hands • Tap table • Touch nose • Move on to step 4

19. Step 4: Repeat • Flip book back over • Wait for the child to make an independent response. • Entice if necessary • If child makes incorrect response, repeat the 4 Step Error Correction

20. What problems could occur? • Children’s preferences may change often • If the child changes reinforcers often, make sure you do frequent preference assessments to ensure that you have what the child will be motivated enough to ask for • Finding a non-prefered item can sometimes be difficult • If you are having trouble finding a non-prefered item, keep doing a preference assessment until you find one, or ask a supervisor for help Question 7: What are the 4 steps in the 4 Step Error Correction? No Motivation

21. Tips • Switch icon positions only after a correct trial on the initial trial • DO NOT switch icons after a correct response on the “repeat step” of the 4 Step Error Correction • After 3 incorrect initial trials, which include the 4 Step Error Correction, stop the procedure • Continuing the procedure then punishes responding • Get a supervisor to code the data sheet, end that PECS session and move on using the reinforcer the child tried to grab for another procedure Your supervisor should use the Implementation Problem code (IP) or the Off Task Code (OT) How should the supervisor code it?

22. Tips on Coding Data Sheet • The 4 step error correction cycle can be repeated up to a total of 3 times if necessary • If you do complete 2 full cycles of the 4 step error correction & the child still has not responded correctly, remove the incorrect icon and repeat the 4 steps so the child can only make a correct response. Replace the incorrect icon move on to the next initial trial • This means in 3 initial trials, if you had to go through the 4 step error correction you could have gone through a total of 9 cycles of 4 step error correction (3 full cycles for each of 3 initial trials) If you have to go through the 4 step error correction a few times, you still only take data on the initital trials, which means you should never have more than 10 +/- marks on your sheet • Note: • If you do 3 consecutive initial trials & have to go through the 4 step error correction each time, STOP THE PROCEDURE & GET IT CODED BY A SUPERVISOR

23. Example Data Sheet

24. What do we mean by the Initial Trial? • The initial trial is the chance when the child gets to independently make a response and choose what item they want. • If they reject the item they chose only then do you go into the 4 step error correction. • Although the 4 step error correction comes right after an incorrect response it is not part of the initial trial, it is the correction procedure • When the child rejected the item they received a – on the data sheet and that was the end of the initial trial. So, if I start the initial trial and the child rejects the item, I mark the data for the initial trial as - and do the 4 step error correction, with the possibility of doing the 4 steps up to three times That’s right! Then what do I do? You start the next initial trial, and take your next data mark.

25. 4-Step Error Correction Child chooses icon Rejects item Accepts item TAKE DATA HERE Incorrect on data sheet Correct on data sheet Read from top to bottom following the arrows as necessary Go onto next trial Model-Gestural prompt to preferred icon Practice -Child exchanges preferred icon -Label, but do not give item Distract -Turn book over -Do ELO Repeat -Turn book back over -Child independently chooses icon -Label and give item 1 2 3 4 Accepts item Rejects item Go onto next trial 1 2 3 Accepts item 4 ModelPracticeDistractRepeat Rejects item Go onto next trial Accepts item 1 2 3 4 ModelPracticeDistractRepeat Do preference assessment Go onto next trial Rejects item Remove the incorrect icon and repeat the 4 steps On repeat they get the treat!

26. Phase 3B and 3C • Phases 3B and 3C teach discrimination between preferred items • For incorrect responses you still use the 4 Step Error Correction • Correspondence checks are necessary for 60% of the trials What do I do during a correspondence check? Instead we offer them both items at once to check that they want the item that did the icon exchange for • We do not label the items during correspondence checks in phases 3B and 3C

27. Correspondence Checks • After the icon exchange the tutor holds out both preferred items and says “Go ahead, take it” • Trial is correct if the child chooses the item corresponding to the icon they gave you • Trial is incorrect if the child chooses the item that does not correspond to the icon they gave you • Block the incorrect response and go directly into the 4 Step Error Correction • Start with pointing to the item the child should have taken( Teach to their reach) So we can label the item during a correspondence check right? • Absolutely NOT! • REMEMBER!!! We do not label the item

28. Phase 3B • 2 preferred items • Do correspondence check to make sure child is discriminating between preferred items • If the child chooses the item they didn’t ask for, go into the 4 step error correction

29. Phase 3C • 4 preferred items • Do correspondence checks using all 4 items • For this phase it is easier to put the items on a bin lid so that they are spread out and easily accessible to the child • When items are not spread out and accessible, tutors can easily mistake which item the child is reaching for • Trial is correct when child chooses the item they asked for • Trial is incorrect if child chooses a different item then what they asked for • Use 4 step error correction for incorrect trials

30. Question 8: True of False: We label the item during correspondence checks? • Question 9: How many data marks ( +/- ) should be on the PECS data sheet? • Question 10: How often should you do correspondence checks in phases 3B and 3C? • A: Never • B: 20% of the trials • C: 40% of the trials • D: 60% of the trials

31. 4-Step Error Correction Chooses correct item Chooses incorrect item Child chooses item TAKE DATA HERE Correct on data sheet Incorrect on data sheet Go onto next trial Model-Gestural prompt to preferred icon Practice -Child exchanges preferred icon -Label, but do not give item Distract -Turn book over -Do ELO Repeat -Turn book back over -Child independently chooses icon -Correspondence check 1 2 3 4 Correct item Incorrect item Go onto next trial 1 2 3 Correct item 4 ModelPracticeDistractRepeat Incorrect item Go onto next trial Correct item 1 2 3 4 ModelPracticeDistractRepeat Do preference assessment Go onto next trial Incorrect item Remove the incorrect icon and repeat the 4 steps On repeat they get the treat!

32. Tips • Remember we do not take data on the 4 step error correction, we only take data on the initial trial • There should never be any more than 10 + or – on the data sheet • Note: If you get three consecutive incorrect responses on the initial trials, stop the procedure and get it coded by a supervisor

33. Still have questions? • Contact the PECS/IE system manager: Jennie.l.shooltz@wmich.edu or ask a Croyden supervisor.