Angela khater, MA, BCBA, LBA
When working with young children with autism spectrum disorder (ASD), vocal stereotypy, sometimes referred to as scripting, can interfere with the ability of our clients to learn new material. It can also disrupt performance of previously learned behaviors, making for a potentially difficult therapy session.
Scripting can be defined as contextually inappropriate repetitive vocal behavior, maintained by automatic reinforcement. In simple terms, its vocal behavior that serves no other function except to produce its own reinforcers. Think, saying nonsense words or repeating lines from a TV show, over and over again, completely out of context.
We all engage in scripting from time to time. Some sing in the car or shower. Others might hum or privately “sing” a song in their head during a meeting. What separates these examples from those of individuals with ASD is engaging in the behavior in the wrong place or at the wrong time. Usually, a neurotypical person can stop singing when they need to listen to an instruction (learn) or follow through on a task (performance). This is not always the case for an individual with ASD.
As a fierce advocate for the autism community, it can be very frustrating to see individuals with ASD become stigmatized for engaging in this behavior. Parents can often feel embarrassed or frustrated when their children engage in scripting. Sometimes BCBAs will target this behavior for reduction, as a way to prevent social stigmatization. It is nonetheless important to remember that we all engage in this behavior, and we should never harshly judge an individual for it.
Research that has been conducted on scripting often takes place in clinical laboratories, far away from the applied clinics most BCBA work in. There are confounding variables, galore. Nonetheless, those working the field of ABA seeking to reduce stereotypy must utilize and adapt this research if they are to experience success. Here are 3 tips for getting there:
It’s not a frequency measure.
Scripting can be difficult to measure. Many practitioners are quick to rely on their old trusty favorites, such as frequency and duration. This is a mistake that they won’t make for too long, at least if they want to see their clients succeed, their technicians remain on the case, and their families empowered and seeing behavior change. Scripting is often a very high frequency behavior, with no clear onset and offset. Attempting to collect data using frequency or duration measures is an impossible task.
Instead, try a partial-interval recording (PIR) system. With PIR, you will be measuring the percentage of intervals that scripting occurs. Depending on the severity, the interval could be 20 seconds to 5 minutes long, or longer. The technician only needs to record whether the behavior did or didn’t occur within that interval (it gets easier, the longer the interval… more on that below). Data collected will be more accurate, as there are less opportunities for errors. As a Behavior Analyst, we rely on accurate data to determine if our interventions are successful, and data collection is where it all begins!
Start Small
You’ve done the FBA, you know the behavior is maintained by automatic reinforcement, and you know the intervention you want to use. You train the technician and the family, encouraged at finding an evidence based intervention to reduce scripting. You sit back and wait for the data to come in. A week later, to your dismay, there has been no reduction in scripting, and both your client and technician are both very stressed out. How did it all go wrong?
You may have been trying to do too much, too soon. A more behavior analytic approach suggests that we start small, and move slowly as we see success. In practice, this can look like dedicating a portion of therapy time to run the intervention. Perhaps you set aside 30 minutes interspersed throughout the day, with sessions lasting 5 minutes, and your PIR broken into 20 second intervals. Your technician will get accurate data, and you can slowly increase the length of the interval to 5 minutes. From there, it becomes about teaching appropriate time and place.
Appropriate Time, Appropriate Place.
A very common intervention we use for vocal stereotypy is Response Interruption and Redirection (RIRD). There are vocal, motor, and combined variants. When the client engages in stereotypy, 1 to 3 instructions are given that, based on the individual’s learning history, the client is likely to comply with. This effectively interrupts the scripting behavior, and redirects behavior back to task. On a conceptual level, it makes scripting behavior more effortful, thus reducing future probability.
It would not be sufficient to end here though. Everyone engages in scripting behavior from time to time, the behavior itself is normal and likely even adaptive. It would be wrong for us to restrict this behavior in individuals with ASD. Instead, our emphasis should be on teaching appropriate time and place. This can be highly customizable, and will likely change as the clients preferences change. Some examples include scripting only in the bedroom, scripting after earning it as a reward, or scripting after completing a homework assignment. If scripting were to occur at an inappropriate time or place, we would interrupt it and redirect the individual back to the task at hand. The main focus here is that the individual learns conditions in which scripting is appropriate or when it will be redirected.