Clinic Notes: When Time Out Does Not Work for Children with Autism

In my last blog I discussed how to do time out properly. As I mentioned time out is a often used and misused procedure. But even when used properly time out can have limited success with children with autism. Time out means time out from positive reinforcement. So if a child with autism is engaging in a reinforcing activity such as playing with a toy, watching a video, etc, and you send the child to time out for some inappropriate behavior such as not following directions then time out will in all probability be effective. On the other hand, if you are running discrete trial training and trying to teach a child with autism letters of the alphabet, which is hard for the child, then sending the child to time out for an inappropriate behavior such as not paying attention will not be effective. The drills are not reinforcing so time out will not work. In this situation we usually run the body parts drill. In this drill we take the child’s wrist and use the child’s hand to point to different body parts. Fade the physical prompts as the child begins to do the drill on his or her own. In other words, use less and less force to move the child’s hand as the child becomes compliant. (This is the same behavioral principal a rider would use to get a horse that balks to cross a ditch or go up a hill. The rider would pull the reins to the right or left and make the horse go around in a circle several times. If the horse did not comply then the rider would have the horse go around in circles several more time and try again.