Task Analysis/Skill Training


Doing Task Analysis & Skill Training with SymTrend

You can create Health Logs to monitor performance of tasks/skills of any kind. The user of the log can be an observer or the individual self-monitoring while performing the skill. The logs described below can be used when “shaping” functional behaviors (such as teaching a child how to put on pants – see below) or when coaching a trainee how to stock a shelf at a grocery store. We've done a task analysis of generating an app for this purpose and outline the steps below. Think about all of the steps before you actually start creating the application. It is especially important to think about what you want your output to look like before you create the application screen. Who is your audience for the output? Professionals? Parents? The patient/client/student you are observing? You must measure what you are comfortable displaying to that audience and what is possible to put in a table or graph within the SymTrend system.

Step 1. Do a Task Analysis First

Before developing an application for task analysis or skill training, you must break down the task into its subtasks. Depending upon the nature of the skill, who will be using the application, and the learning needs/training requirements, the specificity and level of detail of each subtask will vary.

First, carry out the task yourself. Write down each of the sub-skills required to complete it. Decide upon the number and complexity of the sub-skills on the basis of what is manageable and easily accomplished.

Brushing Your Teeth
Step
Component Skill
1
Pick toothpaste up.
2
Twist off cap.
3
Apply toothpaste to toothbrush.
4
Turn on cold water.
5
Wet toothbrush.
6
Brush teeth.
7
Spit in sink.
8
Wash mouth out with cup of water.
9
Spit out water.
10
Put cap on toothpaste.


Step 2. Define Success & Measurement Requirements

If a professional is to use the Health Log to monitor performance on the steps of a task, the professional is likely to want to record success with separate measures of accuracy and independence and perhaps what type of instruction/prompting/help was needed for completion. The prompt may be measured with a scale or as just a check of a label for the type of prompt. If a trainee is self-monitoring, the response may be recorded as a check on a list of steps, indicating “I did this.”, and perhaps also as a time to complete, rating of difficulty, or check of the assistance required. Below is a sample of a paper form used by an observer in a pre-school classroom for recording a child’s performance doing a dressing task as part of toileting.

Paper form for task analysis of putting on pants



In this case the observer records a “+” when done correctly/unprompted and with the label for the other prompting levels. The observer grades all steps every time the child is taken to the bathroom each day. The observer wants to record the level of success for each step with the same four point scale.



Step 3. Design a Set of Screens That Both Record What Is Needed and Fit the Observation Process

Below is a set of seven screens that fits the form displayed above. The observer would get to the section of the log that contains these screens and would rate the performance of each step one by one.

You can make the first screen from scratch and then “clone” it so that the scales are exactly the same, and then just change the title and Question/Response Aid (the line of text above the answers). The four levels of performance were specified as a rating scale with an “intensity” question type. The prompt levels were given a numeric value: physical prompt was given a value of 1 and the correct/unprompted/+ score was given a 4.

Task analysis handheld screens

Step 4. Design Your Output

The data collected with these screens can be displayed in multiple ways with SymTrends reporting tools. Each type of report handles the data in a different way. Some types of output require recoding the answers and some do not. Output types and their requirements include:

  • Chronological table: a tabular display with each recording session listed in chronological order. Each step is displayed in a separate column. This form of display is easy for everyone to understand. It is easy to look at the progress of one step at a time by looking down that column. You can also look across the row of a particular day and see how many steps were at a particular level of prompt. You can look at the bottom row to see the most current level of performance.

Task analysis output in form
			of chronological table

  • Data Plot: You can plot performance on a line graph, with each step as a separate line, using the values 1-4 on the y-axis. You can see the degree and rate of progress over time. While you can look at the table above to see whether the numbers go up continuously, the visual image makes it easy to see that change.

task analysis data plot

How to Do Task Training: for People with Limited ABA Training

The material below was prepared for parents using our product SymTrend ADL who are interested in using some behavioral approaches to instruct their child how to perform activities of daily living. It is reprinted below for professionals who want to try these techniques with their students/clients, using the data recording methods described above. This systematic approach to instruction requires practice and patience. For children with autism, teaching of these tasks also requires the use of prompts, shaping, and reinforcement (described below). Before beginning instruction, you should ask yourself the following:

  • Does the child have a condition that might make learning the ADLs more difficult? These may include delays in language, learning, social, medical, motor skills, or physical problems. Consult your child’s pediatrician before beginning a training program.
  • Does the child have the basic skills to begin the training? In order to teach each steps in a skill set, such as getting dressed or using utensils, a child should be able understand and follow basic instructions. Using SymTrend ADL can help you keep track of the child’s readiness to learn these skills.

Preparing for Skill Instruction

In order to teach your child how to brush his teeth, put on his pants, or other ADLs, it is important to organize the environment where the teaching takes place, repeat instruction consistently, reserve enough time for teaching, and make instruction part of the daily routine. In Self-Help Skills for People with Autism,1 Stephen Anderson and his colleagues suggest the following steps to help make learning easier:

  • Prepare materials ahead of time – place soap, face cloth, and towel together near the sink.
  • Make sure that physical supports – special chair, spoon, bowl – are readily available.
  • If partial prompts are offered, such as clothes are laid out one-by-one, toothpaste is placed on toothbrush, make sure these are in place before beginning instruction.
  • If a reward is offered, have it available.

1Stephen R. Anderson, Amy L. Jablonski, Marcus L. Thomeer, & Vicki M. Madaus (2007). Self-Help Skills for People with Autism. Bethesda, MD: Woodbine House.

Sequencing

Your job, when teaching your child skills, is to break down the task into individual steps. How simple you make the component steps will depend on your child’s learning needs. Typically you would teach each step one-by-one (also referred to as chaining). As one step is mastered, move on to the next step, until the child is able to complete all the steps independently. This is a great way for a child who needs more support and is struggling to learn a particular skill, feel success early and often in a process that may be long and difficult to master.

Teaching the Skill Sequence

The skill can be taught from the first step to the last (Forward Chaining) or vice versa (Backward Chaining). The process of using forward chaining is outlined here:

  • Show the child the first step by modeling it for him.
  • Help him with the rest of the steps until teeth are brushed.
  • Once the child has mastered the first step, then model the second step.
  • The child completes steps one and two, and you help him with the rest of the sequence.
  • Teach the steps one at a time until the child can brush his teeth himself from start to finish.

An advantage to backward chaining is that the child is naturally rewarded for completion of her portion, by the fact that the whole task is done with her contribution. To teach a task using backward chaining:

  1. Show the child the last step first.
  2. Complete each step for her until the last step.
  3. Once the child has mastered the last step, then teach her the preceding step.
  4. You complete each step, and the child does the last two.
  5. Teach the preceding steps one at a time, until she can do the whole activity herself from finish to start.

Prompting and Fading

There are various types of prompts, listed below, which can help a child complete a task. The prompt you use depends on the learning needs of the child. Physical prompts are effective for children who have difficulty understanding verbal instructions and for trying a skill for the first time. Many children with autism are visual learners who can benefit from the use of visual prompts to help them understand ideas in a concrete way. Verbal prompts tend to be the most challenging to fade (see below for information about fading, eliminating the use of, prompts). Whatever prompts you use to teach your child a skill, make sure you use them in the same, consistent way.

  • Verbal: spoken instructions, cues, or hints
  • Gestural: pointing, looking, touching/moving an object towards the child
  • Physical: hand-over-hand, partial guidance, or a light touch on the shoulder to initiate a response
  • Visual: pictures/photographs of each step (schedules); written instructions; flash cards; labeling objects
  • Modeling: acting out the target behavior, such as having your child watch you brush your hair
  • Positional: placing the materials in a way that promotes success, such as having the toothbrush, toothpaste, towel together on the counter so the child can reach these items. Another positional approach would be putting the toothpaste on the toothbrush for him, if he hasnít learned this skill.

Using the above examples, prompts for brushing the teeth could be the following:

  • Verbal: “Reach your hand out to the tooth brush, Amy.”
  • Gestural: Pointing at or touching the toothbrush.
  • Physical: Guiding Amy’s hand onto the toothbrush.
  • Visual: Showing a picture/photograph of a toothbrush.
  • Modeling: Grabbing a toothbrush yourself and hoping Amy will copy this.
  • Positional: Placing the toothbrush within her reach.

Prompting: Teaching Your Child How to Use a Fork
Prompt
Example
Hand-over-hand Stand behind the child, tell him that you are going to help him learn to use his fork, place your hands over his hands, and physically guide him through the process of eating with a fork.
Hand at elbow Stand behind child, tell her that you are going to help her learn to use a fork, place your hand at her elbow, and physically guide her through the steps of the process.
Hand at shoulder Stand behind child, tell him that you want him to eat his food with a fork, place your hand on his shoulder to indicate that you want him to eat with a fork.
Verbal + visual Tell the child that it is time to wash her hands and provide a picture sequencing board that shows each step in the process. If she gets stuck on a step, use a verbal reminder of what is needed.
Visual Show child a visual cue that indicates that she needs to use a fork to eat (a picture symbol or a gesture), have the child use the picture sequencing board to go through the process. If he gets stuck on a step, point to it on the board.
Independence Child is able to eat with a fork independently.

You can approach using prompts in two ways: 1) most-to-least or 2) least-to-most. Most-to-least prompting involves using the greatest level of assistance at the beginning and then fading the support over time. Least-to-most prompting starts with providing the minimum amount of support and increasing the level of prompting when needed.

Fading Prompts

Prompts should be faded or reduced over time so that the child will eventually do the skill without you and not become prompt dependent. In their book, Is It Sensory or Is It Behavior? authors Carolyn Murray-Slutsky and Betty Paris2 point to several ways to fade physical prompts:.

  • Gradually apply less and less pressure to the child’s hand or arm.
  • Then ease away from the hand or arm so that eventually you are not touching the body. Fade the physical prompt to a gesture and then to a verbal prompt.
  • Let the child try the skill independently and if necessary, again provide a physical or verbal prompt until the child can do the task.
  • Increase the amount of time between giving a physical or verbal prompt.

2Carolyn Murray-Slutsky & Betty A. Paris. (2005). Is It Sensory or Is It Behavior? Austin, TX: Hammill Institute on Disabilities.

Using Rewards

Parents can use rewards to help reinforce newly learned skills. Rewards are used in a very systematic way in the Applied Behavior Approach. ABA is a scientific approach to understanding behavior and how it is affected by the environment that is especially effective in teaching social, motor, and verbal behaviors, as well as reasoning skills.3 The belief is that when a behavior is followed by something that is valued, such as a reward, that behavior is likely to be repeated. For example, if you ask your child to “pick up the toothbrush” and he complies, you then give him a reward in the form of food he likes “How about some ice cream for a job well done”, praise “Good job Bob”, or another reward that has meaning to the child ñ a favorite toy ñ “You earned time to play with your train set”. It is hoped that the child remembers that he gets the reward for doing the behavior and repeats it when you ask him the next time. Here are some tips on using rewards:

  • Giving a reward that has meaning to the child. First determine which rewards mean the most to your child. Make sure that you put the items away or reserve them so that your child will not have easy access to them.
  • Letting him choose. Let your child choose which reward he wants to receive.
  • Telling him the purpose of the reward. Explain to the child that he is going to earn this reward by doing a certain task.
  • Reinforcing with praise. Begin by praising your child for trying to do the task, along with using a reward or special toy or activity.
  • Making the reward an incentive. Keep the amount of time the child has with the reward brief – 1-5 minutes – so that he will want to try to earn it again.

Fading Rewards

Giving rewards for desired behavior should be faded when the child becomes better at the skill. Here are some suggestions for gradually eliminating rewards, (adapted) from the book, Self-Help Skills for People with Autism:4

  • Food and activity rewards should be faded first.
  • Start by giving the rewards every other time the child completes the task successfully.
  • Slowly increase the times between rewards, so that eventually you are not giving food or an activity as a reward.
  • Continue to praise the child every time he successfully does the task.
  • Don’t withdraw rewards too quickly or the child may regress. If so, you may have to go back to giving the rewards temporarily.
  • This process may take weeks or several months.

Shaping

Another teaching technique is called “shaping” – using reinforcement to target close responses to the behavior that is desired. To give an example of this method, think of how a runner trains for a marathon. She doesn’t go out and run the entire 26.2 mile at first. The runner uses the reinforcement of being able to run 10, 15, or even 20 miles to train her body to approximate running the longer distance. Similarly, we cannot expect that a child will learn each step of putting on his shirt or brushing his teeth at the first try, since the steps are often complex. By dividing up the steps into smaller, incremental steps and building on them – one leads to another – the child will be able to learn a task. At the same time, it is important to reinforce each small step a child accomplishes. Shaping is used in combination with prompts. Here is an example of how to use shaping to teach a child to dry his face with a cloth, (adapted) from Self-Help Skills for People with Autism.5

  1. Place your hands over the child’s hands, bring the towel to the child’s face, and wipe his forehead, cheek, and chin.
  2. Place your hands over the child’s hands, bring the towel to the child’s face, and apply less pressure to wipe the face, verbally reinforcing the child’s effort to do this.
  3. After bringing the towel to the child’s face, continue to gradually lessen the pressure so that the child is moving the towel on his face (again verbally praise the child) himself.
  4. If the child is progressing and doesn’t resist, you can prompt the child by touching or nudging the child’s hand – praise him when he begins wiping and withhold praise, if he doesn’t do this action.
  5. Provide some verbal prompts and encouragement, use gestures, and withhold physical prompts unless your child does not dry his face with the towel.
  6. Fade the use of verbal prompts and gestures.
  7. Fade praise.
  8. Combine this step with the other steps that need to be learned.

You can use shaping to ease your child into trying new foods. This involves expanding on his food preferences by gradually altering them. Note that this process takes time. It is also important to take into account his sensitivities to taste and texture, temperature, and the color of the food. For example, if your child strongly prefers the smooth texture of baby food and you want him to eat rougher textures of food, such as apples, start by doing the following (adapted) from Self-Help Skills with People with Autism.6

  • Step 1: Add a tablespoon of regular applesauce to one cup of baby food applesauce. Praise your child. Response needed to go on to Step 2. If your child eats the food without resisting (or gagging) during three consecutive meals, go on to the next step. If the child resists reduce the amount of regular applesauce.
  • Step 2: Add ¼ cup of regular applesauce to ¾ cup of baby food applesauce. Praise your child. Response needed to go on to Step 3. Same as above.
  • Step 3: Add ½ cup of regular applesauce to ½ cup of baby food applesauce. Praise your child. Response needed to go on to Step 4. Same as above.
  • Steps 4: Serve your child one cup of adult applesauce. Response needed to go on to Steps 5 & 6. Same as above.
  • Steps 5 & 6: Slowly add more texture at each step – small bits of crushed apple to the adult applesauce – until your child is eating apple pieces. Praise your child.

Positive Behavioral Momentum

It can be difficult for you to teach an ADL when your child is constantly refusing to cooperate. You can minimize negative responses and build self-confidence and a positive outlook by first asking your child to do a series of tasks he will readily do and then adding on the objectionable task at the end of the list. Here are examples:

  • To get him dressed: “Give me a high-five”, “Wave your hands”, “Put your foot out”, “Let’s find your pants to get dressed”.
  • To get him to eat breakfast: “Tell me your favorite color”, “Hug me”, “Are you hungry?”, “We’ll go to the kitchen to eat”.
Close