ABA in Teaching to Individuals with Special Needs: The Role of the Transitive Conditioned Establishing Operation in Teaching Novel Verbal Behavior and Other Meaningful Responses

Following the learner’s motivation is fundamental when teaching new skills to people with autism. Novel verbal behavior, play skills and functional skills are easily acquired by the learner when they directly benefit him.But sooner or later the variety of teaching opportunities available to the teacher may be hindered by restricted interests and limited motivation for social consequences. The severity of this barrier varies across the learner’s profile and features, but the challenge has to be faced at some point. Behavior analysis can help, by providing powerful strategies with which to overcome these barriers and expand teaching opportunities. Analysis of the Transitive Conditioned Establishing Operations (CEO-T) describes how, when access to a terminal reinforcer is blocked or denied, the environment operates to condition new stimuli as reinforcers [16; 12]. To date, several studies have demonstrated the effectiveness of strategies derived from the analysis of the CEO-T in teaching verbal and nonverbal behavior [6; 2]. The variety of target behavior taught suggests that teaching opportunities based on this analysis are countless, but despite its power in explaining behavior and inspiring teaching strategies, the concept of CEO-T has been overlooked in the teaching of skills other than manding. The defining features of the CEO-T will be discussed and a list of teaching ideas will be provided in order to stimulate a broader use of the analysis of CEO-T in clinical practice.

Introduction

In three different places in the world, at the same time, a child is looking for a piece of his train track to build the track and play with his new trains, a teen-ager is buying an online ticket to show at the gates of her favourite band’s show and a salesman is scheduling his new appointment with a potential new client. What makes these three behavior alike, even though they are emitted in the most different circumstances is that their product is not rewarding in itself, but it is valuable to the extent that gets each of the three individuals closer to a terminal reinforcer.

After finding the missing piece of the track, the child will not stare at it for hours, but will use it to build the track and finally play with his new trains; after buying her ticket, the teen-ager will not hang it on the wall like a famous painter masterpiece, but will bring it with her to the venue, show it and finally enter the concert area; after scheduling his new appointment, the salesman will not shake his client’s hand wishing him good luck for his life, but will use the textual note on his schedule to meet him at the right time and place and hopefully selling him an expensive product or service.

Each day we can observe countless examples of behavior that produce only an approximation to a terminal reinforcer and whose effect does not reduce a state of deprivation for a desired item or activity, but is used as a means to advance in the chain between a need and its fulfillment.

To give an idea of the ubiquity of this process, one need only ask herself how many behaviors, throughout the day, are intrinsically reinforcing for us and how many behaviors are instead only necessary to get us closer to a terminal consequence. We search on the internet for a place to hike, plan our vacation, carefully choose our fellowship, pack up items needed, drive for hours to get to the place and walk for hours driven by the motivation to watch an unforgettable landscape at the end of our adventure. People that love cooking can search for unique ingredients days before the scheduled meal, pay them a considerable amount of money, wake up at 5 am and cook for hours before tasting the delightful product of their work. Not to mention how how much work we are willing to do to please someone that we love.

The concept describing how a motivation for a terminal reinforcer can increase the value of stimuli until then neutral is called transitive conditioned establishing operation (CEO-T) [16]. The concept of CEO-T is a powerful conceptual tool in the explanation of many everyday behavior and its usefulness in the design of effective teaching strategies in education is great.

No one is completely unaware of this concept and we have all certainly used it at least once in interactions with other people. A mother who will satisfies her daughter’s request to go to a concert only if she gets good grades at school and keeps her room clean for one month is using the concept of CEO-T, and so is a father who gives his son money to buy a new skateboard only if he gathers all the dry leaves in the frontyard on Sunday morning.

The writing of the present paper is also part of a CEO-T. The authors’ terminal reinforcer is an increase in practitioner creativity in the design of teaching applications for the benefit of their students, and hopefully writing a paper on the topic of CEO-T will bring the authors to this desired outcome. To accomplish this goal, the reader will be provided with a definition of the concept of  CEO-T, a brief overview of the related literature and a list of  31 teaching application across several skill domains.

Theory

In a commentary dedicated to the 20th anniversary of Michael’s paper “Establishing Operation” [16], Miguel [17] describes the history of the approach to motivation in the field of the analysis of behavior, tracing back its beginning to the concept of drive and following its development  coming through Michael’s concept of motivating operations.

Drive

The concept of drive was used by Hull [8] to describe an organism’s state of tension to behave in a way that satisfies it. Drive was used to describe the influence of hypotetical constructs, such as hunger, that would in turn explain behavior. According to Hull [8], hunger would generate a drive to act in a way that produces food and relieves the state of tension accompanying the drive.

Skinner [24] described the drive as a condition induced by environmental operations and not by hypothetical states. According to Skinner, the tension to act in a way that produces food would be function of a recent history of no access to food and not of an internal, hypothetical and unobservable state called hunger. The difference between the two definitions is radical: the amount of time of no access to food is an observable and measurable fact, it exists independently from the behavior to be explained (e.g. searching for food), as opposed to the hypotetical state of hunger, which is inferred from that behavior.

The concept of drive was replaced in Skinner’s later works with the terms deprivation, satiation and aversive stimulation [25].

Establishing Operation

In the book Principles of Psychology, Keller and Schoenfeld [10] indicated the relation between establishing operations and behavior as the defining aspect of the concept of drive or motivation. After its first appearance, the term Establishing Operation was used by Millenson [18] to describe the relation between reinforcer establishing operations and variations in the reinforcing value of a class of stimuli as the defining feature of the concept of drive.

Despite its appearance in the 1950’s, it was not until the 1982 that the concept of establishing operations gained an independent status among the antecedent variables of behavior. In his paper Distinguishing between discriminative and motivating functions of stimuli [14], Michael defined the EO as any change in the environment which alters the effectiveness of some object or event as reinforcement and simoultaneously alters the momentary frequency of the behavior that has been followed by that reinforcement (p.151).

For example, water deprivation (resulting from restricting an organism’s access to water for a certain amount of time) would (1) increase the value of water as reinforcer (reinforcer establishing effect) and (2) evoke behavior that have produced water in the past.

Therefore the effectiveness of stimuli as reinforcers would depend on environmental events that make a stimulus valuable in a given moment. Michael [14] also pointed out that when an establishing operation is in place, the value of conditioned reinforcers is sometimes altered not only by the establishing operation, but also by stimuli that the organism encounters in the chain between the establishing operation and the terminal reinforcer. With the term establishing stimulus (SE) Michael indicated a stimulus (S1) that establishes a second stimulus (S2) as a conditioned reinforcer and provided his well known example of the slotted screw.

In this example, an electrician finds a slotted screw (S1) while doing his job. The slotted screw makes a screwdriver (S2) necessary to complete the job. The electrician requests a screwdriver from his assistant and continues his job.

In the example the slotted screw functions as establishing stimulus, as it alters the value of the screwdriver and evokes the behavior of asking for it.

Michael called this stimulus a conditional conditioned reinforcer as the value of the conditioned reinforcer (the screwdriver in the example) is conditional upon the presence of an establishing stimulus (the slotted screw) and the high reinforcing value of disassembling the structure. In the paper Establishing Operations and the Mand the same relation was defined blocked-response CEO [15], before being defined transitive conditioned establishing operation (CEO-T) [16].  

Defining the CEO-T, Michael stated that when a stimulus condition (S1) is correlated with the functional relationship between another stimulus (S2) and some form of improvement, the presence of the S1 establishes the reinforcing effectiveness of S2 and evokes the behavior that has been followed by that reinforcement [16].

As Langthorne and McGill [11] describe, many example of clinical application of the concept of CEO-T are found in approaches such as incidental teaching [7] and are based on “contriving a situation in which one stimulus increases the value of a second stimulus as a type of reinforcement”. The next section will describe some of the clinical applications appeared in the scientific literature of the last thirty years.

Applied research

The use of the analysis of CEO-T in the design of applications to the teaching of meaningful behavior has been successful.

The first studies appeared in the 1980’s, but, as Carbone stated, “it was not until the publication of Michael’s 1993 paper on establishing operations (EOs) in The Behavior Analyst (TBA) that a broader audience of practitioners began to make use of the analysis of motivation as an antecedent variable” [2].

Although the concept of establishing Operation has been used in several studies[1], the vast majority of the studies available in the behavioral literature demonstrated the effectiveness of these applications to the teaching of verbal behavior to people with disabilities, and some of the studies of the last 30 years are briefly reviewed below[2].

Hunt and collegues conducted a study of 3 participants with intellectual disability and limited communication skills, using a variation of a picture exchange communication system as a form of communication. Before beginning the intervention, Each participant was taught 4 behavioral chains (e.g brushing teeth, getting a drink of water). Once participants learned the chains, the researcher implemented the intervention, blocking the chain, holding one object required to continue the chain and asking the subject: “What do you want?” The purpose of the study was to teach the participants to request items needed to complete the chain, and results showed that participants learned to mand for the target item within all each of the four interrupted chains [9].

Similarly to Hunt and collegues, Hall and Sundberg [6] used the interrupted chain procedure to condition some items as reinforcers with three deaf adolescents using manual signs as a form of communication. Using the interrupted chain procedure, participants were taught requesting items needed to complete a sequence, and the requests were shown reliably after teaching the mands using imitative prompt.

Albert et al. [1] replicated the Hall & Sundberg study with three students with ASD/PDD  that already had the skill to emit unprompted vocal mands. Participants were taught to complete some chains (e.g. coloring a picture, making juice), and interrupted chain was used to condition some items as reinforcers and teach the participants to emit novel vocal mands. The target skills were acquired, demonstrating that the use of this procedure can produce the acquisition of new and untaught skills.

Requesting items has not been the only skill taught through manipulation of the CEO-T. Sundberg et al. conducted a study with two participants with autism, with the purpose of conditioning the information about location of a missing item as a reinforcer, and to use this motivational condition to teach manding “where” and “who.” The authors demonstrated that the procedure based on manipulation of CEO-T was effective in teaching the mand for information targeted and in producing generalization to novel setting [27].

Sundberg and collegues’ study was successfully replicated by Endicott & Higbee with 4 four children with autism, who learned to mand “where” and “who”, showing again that the manipulation of the CEO-T was effective in producing acquisition of the targeted mands and generalization. The requests for informations were shown not only with highly preferred stimuli but also when low less preferred stimuli were used [5].

The strategy of the interrupted chain was also successfully used by Rodriguez and collegues., in which researchers manipulated task material so that the child was uncapable of completing the some assigned task. As a result, three children diagnosed with autism spectrum disorder were taught to request help [22].

The analysis of CEO-T has also led to important clinical applications in the teaching of non verbal behavior. Carbone and collegues used manipulations of CEO-T to teach eye contact to a 3-year-old with autism. When the participant requested an item or activity and eye contact occurred immediately prior to or simultaneously with the vocal mand, the request produced an immediate presentation of the item or activity requested. When the participant emitted a mand that was not accompanied by eye contact, extinction was implemented and the reinforcer specific to the mand was withheld. The extinction interval continued until a vocal mand was immediately preceded or accompanied by an eye contact response. As a result of the intervention, manding with eye contact increased dramatically, also supporting the use of strategies based on the analsis of the CEO-T to non verbal behavior [3].

In the last example, Carbone provided a demonstration that the analysis of the CEO-T can help practitioners designing environmental manipulation to teach non verbal behavior to students.

The purpose of the following section is to build from Carbone’s study [3], and to provide practitioners and families with a list of teaching targets across ten skill domains, placing an emphasis on non verbal behavior and using analysis of the CEO-T as a conceptual framework to design environmental manipulations.

Teaching application using analysis of the CEO-T

Many teachers report that students do not pay attention to the teacher’s words. From a behavioral perspective, they are describing that their words do not act as reinforcers for the student, which, in turn, does not engage in proper listener behavior, by emitting subvocal verbal behaviors in response to their words[3].

In other terms, the teacher’s words are not valuable to the student. Making them more valuable entails altering their function and conditioning them as reinforcers. In this case, the analysis of CEO-T can assist the practitioner likewise in the design of teaching strategies for mand training.

During a consultation in a middle school, I suggested to a teacher that in order to make her words more valuable she could give the student a sheet with five questions and tell the student “You are going to earn access to the tablet for 15 minutes if you answer these five questions correctly. The answers to the five questions are embodied in my talk, therefore pay attention to my words and when you recognize I’m talking about the content of one question, write the answer down”. The student was also given a pen and allowed to write the answers during the lesson. Anecdotal observation showed a dramatic increase in on-task behavior (e.g. eye contact with the teacher, requests of help, writing on the questions sheet). All that because of a question sheet.

From a behavior analytic standpoint, the on-task behavior of the student improved because the student was motivated by the tablet and needed to correctly answer five question to get the tablet, but access to the verbal stimuli embodied in the teacher’s talk was blocked until she engaged in interfering behaviors like chatting with his school mates or quietly singing her favourite song. The motivation for the tablet, the necessity of correct answers and the blocked access to the answers formed the CEO-T. This combination of a motivation (tablet) and context (blocked access to the correct answers, needed to earn the tablet) increased the value of spoken words that matched[4] words in the question sheet and evoked behavior that put the student in contact with teacher words (proper listener behavior).

The next section will provide, without claiming to be exhaustive, some examples of the use of analysis of CEO-T in the teaching of meaningful behavior across several skill domains, most of whom belonging to the realm of non verbal behavior.  The reader is encouraged to read the examples with the purpose of using them as a starting point to create their own, based on the needs of the students they serve. Three teaching applications in 10 skill domains and one final example will be proposed. The first example in each area will be described in behavior analytic terms, whereas the remaining two will be stated in plain language, thus giving the reader the opportunity to analyze the CEO-T in behavior analytic terms.

1. Personal hygiene:

– When food is valuable to the student and student needs to ask his parent to prepare the food, but requests will only be reinforced after student washes his hands, the sight of hands clean will be conditioned as reinforcer and behavior that produces hands clean will be evoked. Target behavior: hand washing.

– When TV is valuable to the student, his requests to turn on the TV after dinner will be reinforced only after teeth brushing.

– When going to a preferred place is valuable to the student, parent will reinforce student’s request to go to a preferred place only after student has a shower.

2. Dressing

– When a hot bath is valuable to the student and student needs to fill the bathtub, but access to the faucet is allowed only after preparing fresh clothes to wear after the bath, a set of clothes located near the bathtub will be conditioned as reinforcer and behavior that results in fresh clothes near the bathtub will be evoked. Target behavior: Preparing clothes before taking a shower/bath.

– When riding a bike is valuable to the student, therapist will provide keys to open the bike lock only after student gets dressed with the minimal help of the adult.

– When beach is valuable to the student, a bus ticket to go to the beach will be given to the student only after he packs appropriate extra clothes.

3. Navigating the community

– When a place of interest is valuable to the student and access to that place is possible only after choosing the correct bus stop, but the student is engaging in interfering self stimulatory behaviors, the sight of some signals in the community (e.g. buildings, street signs…) will be conditioned as reinforcers, self stimulation will be abated and behavior that produces sight of those stimuli will be evoked. Target behavior: recognizing approaching destination when travelling on public transport.

– When going to the cafè is valuable to the student, adult will provide directions to get to the cafè only if student walks close to the adult.

– When going to the playground is valuable to the student, the adult will reinforce his request to turn on the car only if student buckles his seat belt.

4. Housekeeping

– When a favourite food is valuable to the student and student needs to heat the food, but ingredients have to be mixed, the mixed ingredients will be conditioned as reinforcers and behavior that turns ingredients into favourite food will be evoked. Target behavior: Cooking a meal.

– When sleep is valuable to the student and he needs his bed to sleep, access to bed will be available only after bed has been made up with clean sheets.

– When food is valuable to the student and he needs to sit at the table, access to his seat will be allowed only after setting the table.

5. Time knowledge

– When a TV show is valuable and access to it is possible only after turning on the TV at the right time, but there is no alarm signaling when turning the TV on, the sight of a clock that shows the time scheduled for the show will be conditioned as reinforcer and behavior that produce the sight of the clock will be evoked. Target behavior: reading the time on a digital/analogic watch.

– When playing computer is valuable to the student and he needs to read the written card “computer” on his visual schedule, access to the written card “computer” will be allowed only after completing the previous activities shown on a visual schedule.

– When information about scheduled day of vacation is valuable to the student and adult does not provide the information, access to the information will be available only searching it on a calendar.

6. Using technology

– When a song is Valuable to the student and he needs to play the song on the computer, but the file is not on the desktop, the sight of the file will be conditioned as reinforcer and the behavior that produce that sight will be evoked. Target behavior: retrieving a file in computer’s folder.

– When a snack is valuable to the student and the adult that usually brings that snack to the student is not present, access to the snack will be allowed only after asking it to the adult through a phone text.

– When a vacation is valuable to the student and he needs to reserve a hotel room, the reservation will be accepted only after sending a request via email.

7. Shopping

– When a preferred food is valuable to the student and he needs to buy the ingredients to the grocery store, but the number of the ingredients is high and the student is not able to verbally reharse the entire set of ingredients, a list with items to buy will be conditioned as reinforcer and behavior that produce the list will be evoked. Target behavior: writing a list of items to buy.

– When an art project is valuable to the student and she needs to buy the material needed, all the needed items will be in his shopping cart only after reading them on a list.

– When the items in the shopping cart are valuable to the student and she needs to pay them, paying items to the cashier will be allowed only after selecting correct amount of money.

8. Fine motor skills

– When coloring is valuable to the student and she needs to get the crayons from a container, but the container is closed with a cap, the removal of the cap will be conditioned as reinforcer and behavior that produce the removal of the cap will be evoked. Target behavior: twisting.

– When a soup is available to the student and he needs to mix the ingredients, mixed ingredients will be obtained only after stiring them with a spoon.

– When pizza is valuable to the student and he is given a whole pizza and the adult will not cut the pizza for the student, slices of pizza will be available only after cutting with kitchen scissors.

9. Reading

– When toys in a locked cabinet are valuable to the student and access to them is possible only after choosing one of them on a written list of items, the names of the items on the list will be conditioned as reinforcers and behavior that produced that names will be evoked. Target behavior: reading words.

– When completing an art project is valuable to the student and he needs to learn the next step, but the adult does not explain the step to the student, learning the next step will only be possible after reading a description of the step on a written list of instructions.

– When a movie is valuable to the student and she has to tell the adult which movie would like to watch, she will be allowed to ask only after reading and comprehending the stories of movies written on an internet page.

10. Social skills

– When talking about a favourite topic is valuable to the student and student needs peer’s attention, but her friend is available to attend only if the student answers some follow up questions, answers to the listener’s questions will be conditioned as reinforcers and behavior that produce answers to the peer’s questions will be evoked. Target behavior: answering to another person’s questions during conversation.

– When a toy is valuable to the student and student need to find the place in which the toy is hidden, access to the toy will be possible after following peers to the place in which the toys are hidden.

– When playing is valuable to the student and the material needed for the activity has not been prepared, starting the preferred games will be possible only after cooperating with a peer in setting up the game.

11. Chaining more than one CEO-T

Although the examples above are described as isolated behavioral contingencies, the vast majority of real-life contingencies are interconnected. Therefore, we can also chain more than one contingency in a longer sequence of contingencies, each of which is designed to establish a conditioned reinforcer and evoke the behavior that produce its specific reinforcer. Access to meals can be blocked until the table is set up, access to utensils needed on the table can blocked until student packs the school backpack for the next day, access to the school backpack can be blocked until student completes his schoolwork and so on in a long list of interconnected CEO-T, each one designed to evoke a specific target behavior (e.g setting up the table, packing the school backpack, doing schoolwork).

As happens in real life, environmental antecedents, target behavior and programmed consequences can be designed in countless combinations varying upon the content of the behavioral contingency and length of the chain. Furthermore, depending on learner’s skill and compliance, practitioners can either chain and introduce the contingencies all at once, or can gradually increase the length of the sequence using demand fading [21].

Conclusion

Carnett et al. stated that teaching strategies derived from the analysis of CEO-T may be easy to use for practitioners and that since these strategies “use naturally occurring reinforcement contingencies (i.e., the terminal reinforcer of the behavior chain) rather than contrived reinforcement, this may also be an added benefit for both practitioners and the participant, because it can be added into existing preferred activities” [4].

No list of teaching ideas can exhaust the enormous variety of teaching arrangements that can arise from the use of the analysis of CEO-T as a conceptual tool. Therefore, the most important purpose of this paper will have been accomplished if the reader has understood the concept of the transitive conditioned establishing operation, has understood the common features across the examples, and is now able to use the CEO-T as a conceptual framework with which to tailor his or her teaching strategies to the specific skills and needs of the students they serves.

Acknowledgements

The authors are very grateful to Vincent J. Carbone and Denise Smith for their critical reading and precious suggestions, when the chain of writing the present manuscript was interrupted.

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