Step 2.2 Identify learning activities and stimuli

a. Follow the child's lead

Following the toddler’s lead in order to identify child-preferred teaching materials or activities and natural reinforcers is an important component of establishing motivation in PRT. This step allows toddlers to choose play materials, toys, and activities that will be used in the PRT learning opportunity.

  • Begin following the child's lead by observing when the toddler has free access to materials and activities to identify their preferences for items, activities, and toys. Entice the toddler with toys and activities and observe how they toddler responds in order to assess if, in that moment, they are interested in playing with the materials or engaging in the activity.
  • If the toddler indicates interest in the moment, then the item or activity can be used within the PRT learning opportunity.

A toddler might indicate interest by reaching for the materials, begining and playing with the materials, or by smiling and giviing eye contact during the social activity.

EXAMPLEtoddler playing with blocks

A teacher notices that a toddler plays with dinosaurs for most of free play. The teacher follows the toddler’s lead by going over and playing with the dinosaurs together. By following the toddler’s lead and combining it with shared control, the teacher could intersperse PRT learning opportunities as they play with the dinosaurs.

Beginning learners, or younger toddlers, working on developing communicative intent could be prompted to vocalize “dino” or point to the “dino” in order to take a turn playing with the dinosaur. A more advanced learner, or older toddler, working on play skills such as block building could be prompted to build a tower together prior to letting a dinosaur knock over the tower.

b. Embed social interests and preferences

Identifying individualized, socially oriented reinforcers and embedding preferred social interaction within the delivery of natural reinforcement has been shown to improve social engagement and joint attention (Jones, Carr, & Feeley, 2006; Koegel, Vernon, & Koegel, 2009; Vernon, Koegel, Dauterman, & Stolen, 2012).

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Why embed social activity interests and preferences?

These strategies may help increase social behaviors such as reciprocal social smiling, eye contact, social orientation toward a parent instead of toward an object, and joint attention. Some researchers suspect that early challenges in social motivation are core to the development of ASD (Dawson, Webb, & McPartland, 2005).

PRT can be used to increase social motivation early in an infant or toddler’s development before secondary symptoms arise (Dawson, 2009; Voos et al., 2013).

Preferred social activities:

  • incorporate as activities more frequently in the child’s day.
  • embed within natural reinforcers.
  • use as an idiosyncratic social reinforcer as a consequence for joint attention.

It is important, especially for infants and young toddlers, that rewarding social activities comprise many of their PRT learning interactions. A rewarding social activity is an activity where another person, such as a parent, is a crucial component of the reward value associated with the activity. In other words, the reinforcer does not exist without the social engagement of the parent or practitioner with the toddler or infant.

Infant and Toddler Social Activities

  • Being held and walking around together
  • Peek-a-boo games
  • Blowing on stomach to make silly noises
  • Singing songs/rhymes with sensory actions (i.e., “This Little Piggy,” “Itsy Bitsy Spider,” and “Patty cake”)
  • Jumping, bouncing (“Giddie-up horsie” on knee), swinging, spinning, and dancing together
  • Going “night, night” games
  • Fall down games
  • Playing “airplane”
  • Silly face games- such as, raspberry lips
  • Silly noises/voices games (such as making animal sounds; making silly “sneezes”)
  • Chase “I’m gonna get you!” games
  • Tickle games
  • Splashing water at each other
  • Driving/pushing/pulling around in a wagon/sled
  • Blowing bubbles
  • Blowing up balloons and letting them go
  • Juggling balls in the air

It may be the case that an infant or toddler’s involvement in social activities is restricted, minimal, and fleeting. Combining this step with Interspersing Maintenance and Acquisition, as well as the other motivational components, can help increase the duration and quality of engagement in social activities. Researchers and clinicians at the UCSB Koegel Autism Center have developed Five Steps for Building Early Developing Engagement in Social Activities. These are described below:

Five Steps for Building Early Developing Engagement in Social Activities

1. Identify social activities

Follow the infant’s lead and identify a variety of social activities in which s/he will engage – even if briefly! Parents and practitioners may have to do some enticing and “try outs” of the different social activities in different contexts. Be persistent and look for even fleeting moments of eye contact and positive affect, such as brief smiles. Categorize the social routines according to neutral or preferred activities. Parents may have different levels of preferred activities, such as, “sometime preferred” versus “often preferred.” Parents can turn the list into a preference hierarchy of social activities.

2. Incorporate preferred (maintenance) social activities only, and rapidly vary them

Begin with strengths! Start by incorporating the most preferred social activities in which the infant will usually engage. Spend 10 seconds on each preferred social activity before varying the task to the next activity. Do this for approximately 5 minutes or less. Start with smaller amounts of time and increase gradually. End each social activity on “a positive note,” when interest levels are still high. Do not wait until the infant or toddler has indicated lack of interest before varying the social activity.

3. Add a neutral (acquisition) social activity

Within the next few times a parent provides these opportunities, they should attempt to introduce the next social activity on the hierarchy list and add it to the activity repertoire. Intersperse it among the preferred maintenance social activity. For instance, engage in the social activity the infant/toddler is most likely to happily engage in (maintenance), and then vary the task by introducing the neutral acquisition activity while they are still engaged. Make the acquisition social activity very brief at first.

4. Reinforce and take frequent breaks

Reinforce the infant or toddler by quickly going back to the preferred maintenance social activity. Take a break after the designated amount of time for staying socially engaged in social activities (e.g., 5 minutes total). Remember, these simple social interactions could be taxing on an infant or young toddler. Try to choose social breaks, such as being carried around by an adult, but make sure it is a break!

5. Gradually increase

Gradually increase the duration of each social activity, the overall amount of time socially engaged (e.g., from 5 minutes to 7 minutes), as well as the number of social activities added to the infant or toddler’s preferred social activities.

Incorporate into PRT opportunities at a later time. As the infant or toddler develops, embed the preferred social interactions into natural reinforcers for other PRT opportunities. For instance, as the infant or toddler begins to prefer the tickle activity, intersperse prompts to vocalize “tickle” and naturally reinforce attempts by tickling the infant or toddler.

(Koegel, Singh, Koegel, Hollingsworth, & Bradshaw, 2013)

See Natural Reinforcers, for more on embedding social activities in natural reinforcers and using individualized social reinforcers.

EXAMPLE

A mom observes that her 9-month-old rarely socially smiles, however sometimes likes being held and walked around, having her toes nibbled, and having her stomach blown. Her infant, though, will only play peek-a-boo for very fleeting moments and will almost never socially smile during the routine. Mom wants to increase her infant’s social engagement during this peek-a-boo activity. Mom begins the social play routines at a time she has found her infant to most likely respond with eye contact and smiles, which happens to be right after bath time. Mom quickly varies between nibbling on her toes and blowing her stomach, and after a few minutes (before her daughter disengages), mom picks her up and walks around the room together. Mom continues this all week.

After a few days her infant is consistently giving eye contact and socially smiling, and sometimes laughing during these brief social routines. Mom then decides to add peek-a-boo to the routine. After going through the maintenance social activities, mom begins playing peek-a-boo and as soon as her infant responds by looking at her with a smile, mom smiles back enthusiastically and goes back to blowing her stomach. A couple days later, mom mixes in two peek-a-boos because her daughter is spending more time happily and socially engaged during the ten seconds of peek-a-boo. This interaction becomes a part of their bath time routine. Soon her infant is anticipating the peek-a-boo game after her bath. Later in her child’s programming, when she is 13 months and highly prefers peek-a-boo, her mom prompts her to say, “boo,” in order to initiate playing peek-a-boo together.

c. Incorporate interests and preferences

You may also incorporate a toddler’s interests into established or new activities, tasks, and routines. For instance, if the toddler has a perseverative or strong interest in dinosaurs, during the play dough center, the dinosaur cookie cutters could be used to motivate the toddler to play functionally with the play dough. A toddler working on receptive language skills and functional play could be told to either roll the play dough or pat down the play dough. Making dinosaurs with the dinosaur cookie cutters naturally reinforces the toddler’s attempts. During book time, books with dinosaurs could be read together and PRT opportunities could be interspersed during the engagement (e.g., asking the toddler, “What do you see?” and then naturally reinforcing them by turning the page to see more dinosaurs).

EXAMPLE

A mom wants her older toddler to wash her hands, but often refuses and tantrums. Mom decides to incorporate her interests, including bubbles and letters. Mom fills up the sink and makes bubbles and puts plastic letters in the sink. As her toddler begins to accept going to the sink to wash her hands, mom gradually fades out the bubbles and letters.

Arrange the toddler’s environment with child-preferred, developmentally appropriate objects and activities. During free time a parent could lay out an array of art materials for a toddler who enjoys arts and crafts.

d. Provide choices

Incorporate choice-making opportunities into naturally occurring routines, activities, and task demands or instructions throughout the day. Choices enhance engagement, increase rates of learning, and decrease challenging behavior. Choices also provide outstanding communication and language development opportunities.

EXAMPLE
A ball, a clear box of blocks, a shape sorter, and a bottle of bubbles can all be placed on a high shelf, in sight, but out of reach. When the toddler points to the bottle of bubbles and says an approximation of “bubbles,” the parent can say, “blow bubbles!” (a recast) and take them down and start to open them with the child (the natural reinforcer). The toddler had the choice of several different objects, each providing an equal opportunity to practice communicating through requesting items. For an older toddler with more language skills, you might ask, “Do you want to play more ball or go on the slide?”

Choices are also provided within adult-directed instructions, providing a level of shared control (see Shared Control) that improves a toddler’s response to adult direction. A variety of choices can be offered in terms of: what / which (what to do, which one to play), where  (to do the task), with whom (to play), how (the action should be done), and when (to do the activity). image ABC

EXAMPLE

During a transition away from a preferred activity such as trampoline, a practitioner could ask the toddler if she wants to run inside or walk to the swing, or if she wants to jump five more times or ten more times before going inside for snack. If it is time to work on fine motor skills and scribbling with crayons, the toddler could choose which color crayon or paper to use.

Allow toddlers to select materials, topics, and toys during teaching activities. This may be particularly important when introducing new skills and tasks. Using toys, items, and activities that individual toddlers prefer may increase their motivation to participate and thus may increase the likelihood that they will rapidly acquire target skills and use them spontaneously. For example, when a toddler chooses to use colored Legos instead of wooden blocks, he may be more motivated to complete a tower building task during fine motor center.

Examples of Incorporating Perseverative Interests to Increase Joint Attention

Perseverative Interest

Puzzle

Pretend Figurines

Books

Numbers

Number puzzle

Draw numbers or put number stickers on existing figurines

Counting and number books

Opening and closing various doors

Wooden board with different doors and latches to open

A doll house or barnyard set with various doors

An interactive book that has flaps hiding pictures and text (flaps that can be open and closed)

Animals

Zoo animal puzzle

Barnyard play set, animal figurines

Zoo books

Vehicles

Vehicle puzzle

Miniature vehicles with ramps/garage

Car books