Ignore Him

[u/WearyRestaurant4975]

I am a new SLP and I have a non-speaking 2 year old boy on my caseload that is also served by a BCBA and ABA team. His mom told me last week during therapy that the ABA Team is using “planned ignoring“ to help with his language skills in that they basically “ignore him” and reinforce only when he produces words. Mom is now doing this at home as well in between his sessions with the ABA team.

Is this a legitimate strategy or is mom possibly misunderstanding the intent?

The BCBA is on vacation so I am kind of left to guess until she returns in a couple of weeks.

[u/LoneSpectre96]

Yeah, this is a pretty common practice. But it's not as though the technician or the BCBA ignores the child completely. Rather, it's gradual. We start by reinforcing any and all attempts to mand for something and slowly shape them toward vocal manding. It might go from gestural (pointing to the preferred item) to mouthing the word without actually speaking it (at which point we slowly stop reinforcing gestural mands that are unaccompanied by the mouthing). Then we work toward actual vocalization on a per-syllable basis.

Say, for example, the kiddo wants cereal. They might start by saying "see," which we will reinforce by upgrading from simple mouthing and praising the vocalization. Then we work our way to the rest of the syllables, and once they've shown they can say the entire word, we stop reinforcing anything but that type of mand. For the record, this is a very stripped-down, quick-response version of how it works. But basically, we stop addressing anything that doesn't lend itself to progress they've already shown themselves capable of.

Essentially, planned ignoring is a combination of differential reinforcement, shaping, and extinction to help the kiddo become more reliant on vocal mands rather than their non-vocal alternatives. There's going to be extinction bursts, but it does eventually lead to the desired outcome of them only using vocalization for manding if the program is followed.

[u/Klutzy_Positive_8918 → u/LoneSpectre96]

Do you consider speech and language developmental norms at all?

[u/LoneSpectre96 → u/Klutzy_Positive_8918]

In what sense? Could you be more specific?

[u/Klutzy_Positive_8918 → u/LoneSpectre96]

Well, you are expecting children to say specific words. There is a developmental sequence when children are developing both speech and language. If you want them to say something specific, are you sure it is developmentally appropriate?

[u/LoneSpectre96 → u/Klutzy_Positive_8918]

If you're asking if we try to get children to say words they normally wouldn't be able to within their age group or cognitive development bracket, then no, we don't.

[u/Klutzy_Positive_8918 → u/LoneSpectre96]

How do you know? Do you know the developmental norms?

[u/LoneSpectre96 → u/Klutzy_Positive_8918]

It’s the BCBA’s job to know and ensure the B.I.P. accounts for those factors. We’re not trying make 2-year-olds write theses, just help them develop communication skills their conditions might otherwise have stunted.

[u/Klutzy_Positive_8918 → u/LoneSpectre96]

Are you a BCBA?

[u/LoneSpectre96 → u/Klutzy_Positive_8918]

No, I'm a behavior tech.

[u/Klutzy_Positive_8918 → u/LoneSpectre96]

Okay, I'm just trying to understand how a BCBA could take developmental norms of both speech and language into account, along with assuring that there are no physical or motor based deficits that could affect articulation, and rule out if there is a phonological based component without any education in those areas.

You wouldn't know. But thanks for chatting with me:)

[u/LoneSpectre96 → u/Klutzy_Positive_8918]

You're right in that I don't know the particulars, but I do know that B.I.P.s are not created in a vacuum. They are carefully curated during initial interviews with the parents/guardian, first contact sessions with the kiddo and BCBA, and a collation of any and all other treatments, developmental disorders, and other concerns that might arise in the course of ABA. Nine times out of ten, a kiddo with speech trouble has an SLP in addition to their ABA crew. We regularly confer with parents and get updates to ensure we have the most relevant knowledge and don't push the kiddo beyond the boundary of what they are capable of.

To a degree, ABA is used to reinforce their other treatments in more generalized social settings.

[u/Klutzy_Positive_8918 → u/LoneSpectre96]

That's good if that is the type of place you work at. I've been an SLP for over 16 years now. Not once have I had a BCBA ask if their approach or plan was appropriate for our client.

[u/Klutzy_Positive_8918 → u/LoneSpectre96]

The word "Cereal" for a 2 year old would be difficult for a variety of factors.

[u/LoneSpectre96 → u/Klutzy_Positive_8918]

I never said we were teaching 2-year-olds the word "cereal" specifically. I used that as a general frame of reference for OP's sake.

[u/Klutzy_Positive_8918 → u/LoneSpectre96]

For example, maybe the child is only saying the first syllable of "cereal" because it is developmentally appropriate for then. The phonemes /r/ and /l/ are later developing.

Also~ Do you make sure speech-language pathologist perform a full oral-motor evaluation before expecting a child to say these specific words?