Clinic Notes: Performance deficits

ABA Program for Eliminating Performance Deficits

After you have your child making eye contact, following directions, and have eliminated behaviors that interfere with learning, such as tantrums, aggressive behavior, and self-injurious behavior, you are ready to start teaching skills so that your child can overcome developmental delays. (ABA Program Number 9 for toilet training is a good place to start if your child is not toilet trained.)
ABA Program Number 10, Teaching Stimulus Discriminations (Colors, Shapes, Letters, etc.), covers Discrete Trial Training (DTT), one of the most useful ABA techniques for teaching skills to children with autism or other neuropsychological disorders. But with many children DTT doesn’t work as well as it should. Usually, this is because caregivers, as well as clinicians, have not determined if the child they are working with has skill deficits or performance deficits before they start DTT.
A child with skill deficits cannot perform a task because the task has not been learned for one reason or another. For example, the child may have sensory, motor, or cognitive problems that interfere with learning. However, with performance deficits, the child has learned the task and can perform the task. But the child has learned that giving the wrong answer, or simply not performing the task when asked to do so, results in more reinforcement (usually in the form of attention) than performing the task.
Generally, if a child can perform a task at one time and not another time, or perform the task with one caregiver and not another caregiver, then we know we are dealing with a performance deficit. (There are exceptions to this. Some children with neurological problems fatigue easily and cannot perform a task consistently.) Often caregivers tell me that their child can name different colors or shapes, but then seems to “forget.” Most of the time the child did not forget. The child has learned not to perform.
Once you have determined that your child has performance deficits, stop all drills. The following drill should be the only drill you run until performance deficits are eliminated:
1. Choose material that you know your child knows. For example, flash cards the child can name or shapes or colors the child can identify.
2. We only want to practice giving correct answers so only run 3-4 trials at a time. Wait 20-30 seconds between trials so we can be sure that we are eliminating fatigue as a variable.
3. On trial one present the stimulus that you are using. For example, ask the child to tell you what is on a flash card that you know the child can name. Only ask one time. If the child gives the correct answer, then give tangible reinforcement plus praise. Tell the child, “Good, you gave the right answer.” If the child gives the wrong answer say, “No, you gave the wrong answer” and do the body part drill 25 times (See ABA Program number 7). Then ask the child again. If the child gives the correct answer, follow the directions above for correct answers above. If the child gives the wrong answer, repeat the body parts drill 25 times until the child gives the correct answer. If the child gives the correct answer while you are doing the body part drill, stop and follow the instructions above for correct answers. If the child does not give the correct answer when you ask again, repeat the directions above for incorrect answers.
4. Once the child gives the correct answer, wait 20 to 30 seconds and go to the next trial.
5. After 3-4 trials, give the child a short play break.
6. Once the child is answering correctly 100% of the time, slowly increase the number of trials, one trial a day, until you get to ten trials. Once the child is performing consistently on ten trials, then this should be the number of trials you use before a short break in most cases.