• What is the High Probability Instruction Sequence?

    This month's ASAT feature comes to us from Amanda Marshall, MEd, BCBA and Nicole Stewart MSEd, BCBA, LBA-NY. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!

    I am a parent of a 6-year-old girl with autism. She used to be very cooperative, but recently, every task is a battle leaving us exhausted. She doesn’t want to do things that I know she can do like taking a bath or getting dressed in the morning. My child’s teacher offered a variety of suggestions which we are putting into action. She also mentioned a technique called the High Probability Instruction Sequence. What does this particular technique involve and how can it be used to address my current struggle?

    Answered by Amanda Marshall, MEd, BCBA
    Brighter Outcomes and
    Nicole Stewart, MSEd, BCBA, LBA-NY
    Solutions for Exceptional Children

    Lack of cooperation with non-preferred tasks is a very common challenge for all parents. It can be draining and can leave you grasping at straws to figure out the path of least resistance. We suspect that each time you know you have to encounter these situations, you’re probably bracing yourself because you are anticipating a less than desirable outcome.

    At a time when parents are spending more and more time with their children, these battles are becoming more frequent. It is common for frustration to mount on both sides. To add to that challenge, a lot of interventions are time or labor intensive, which are both scarce commodities in the current environment. We understand how challenging it can be to make changes with everything that a parent has on their plate on any given day.

    Even with the stress of parenting, a pandemic, and other personal situations, positive outcomes are something we all want to see for ourselves. It could be passing an exam, baking a cake that rises, or having our children do as we ask. We want our parenting strategies to work for ourselves, as the parents, and for our children. When either of us experiences a positive outcome, we feel good. Because it feels good, we’re both more inclined to do the same thing in the future to contact the same positive reinforcement again.

    Let’s turn to your question. Think about when you’ve asked your daughter to do something for you. What has the outcome been? Was it positive or downright negative? Were you successful at asking her to complete the task? Or was it a significant battle with no winners, just a lot of unpleasantness lingering in the air? We know many of our personal outcomes with our own children have consisted of the latter. It often goes like this – “It’s time for a bath!,” swiftly moving to a tantrum because our child is avoiding getting in the bathtub. Oh yes, you say, we’re familiar with that unpleasant experience!!!

    We are very glad that you are working with your daughter’s team to address this issue. It would be important to look closely at each situation and ask questions like:

      1. Is the resistance related to skill deficits that could be addressed?
      2. Is there a sensory hypersensitivity in place such as the smell of the shampoo or discomfort with water on her face?
      3. How is cooperation currently being reinforced and is that reinforcement adequate? We don’t necessarily mean an actual reward (although you could!) but think about what is in it for your daughter – what is her positive outcome?
      4. Are demands happening at times in which a competing reinforcer is in play (e.g., siblings playing with a game system)?
      5. To what extent is your daughter’s day predictable?
      6. Is there any opportunity to use choice-making?
      7. Is sufficient time allotted for the task such that it is less of a “battle?”
      8. If it’s something your child can’t yet do on their own, are you providing the necessary teaching and/or support?Is the context for the task oriented for teaching to ensure near-errorless performance?

    The answers to these questions will guide your next steps. As you learned from your daughter’s teacher, there is a behavioral procedure that many parents find breaks the ice when it comes to those unpleasant “must do” tasks. It’s called the High-Probability Instructional Sequence. While there are many ways to address the issue at hand, this one is free, requires limited forethought, and can thread a little laughter and fun into those previously challenging moments.

    The High Probability Instructional Sequence is often used when you need your child to complete a task or follow an instruction. Cooper, Heron, and Heward (2020) define the High Probability Instructional Sequence as “a non-aversive procedure for improving compliance and diminishing escape-maintained problem behaviors.” In other words, the child is more likely to listen and complete the demand because you are creating a fun and more conducive environment beforehand. We’ve all experienced escape-maintained problem behaviors when our children continuously do things to get out of doing what we need them to do. Examples of common scenarios that many parents struggle with could be getting homework done, getting dressed, or picking up toys. As parents, we know that many of these non-preferred tasks often lead to aversive interactions, which negatively impact both parties.

    The High Probability Instructional Sequence involves the teacher or parent presenting a series of approximately 3 to 5 easy to follow (high probability) instructions for which the child has a history of compliance. What do these high probability requests look like? It could be many simple, short, and easy to achieve tasks like touching their nose, a high five, running on the spot, clapping, doing a wiggle dance, or growling like a lion. Think about what’s fun and easy for your child to do! These requests are delivered fairly rapidly, followed immediately with powerful and positive reinforcement for each instance of compliance. Lipschultz and Wilder (2017) recommend a time interval between 1 to 5 seconds between each instruction. Reinforcement could be in the form of verbal praise, hugs, high fives, dancing on the spot, or some cheering. Use whatever form of positive reinforcement your daughter will respond to positively and will increase the likelihood of repeating the behavior in the future.

    Once your daughter has completed the sequence of high probability requests that you’ve given, it’s time to add in the target instruction (low probability). What does a low probability request look like? A low probability request is an instruction that requires compliance from your daughter. It is the type of instruction that you would, as we stated in the beginning, brace yourself while delivering and anticipate a less than desirable outcome. Below is an example of how it might look to incorporate this strategy at bathtime.

    Sample Instruction sequence:

    Parent: Touch your nose.” (high – probability request)
    Child:   Touches nose.
    Parent: “Good job!!” “High five” (high – probability request)
    Child:   Slaps parent’s hand.
    Parent: Dancing and cheering on the spot “Take this duck and throw it in the bath.” (high – probability request)
    Child:   Takes duck and throws it in the bath
    Parent: “Woohoo, you rock!!! Now step in the bath and let’s save that ducky!!!” (low – probability request)
    Child:   Climbs into the bath.

      
    This procedure may take a lot of practice and persistence for parents to master. That’s ok, keep at it, be creative, and remember – you’re the one in control. Always be sure to vary your requests and don’t use the same sequence each time because it will become less effective over time. Above all, reinforcement is essential to the success of this procedure! If your child is not engaging in the “easier” or more fun tasks, try different ones or talk to your team about which ones they think are most likely to get the ball rolling for compliance.

    What we want to stress here is that parenting is downright one of the most challenging jobs in the world, so please don’t be hard on yourself. You’re not a bad parent. Your little ones don’t come with a manual. We encourage you to look for small ways to incorporate the High Probability Instructional Sequence into your time with your child. We also recommend this sequence for the ease of use: you don’t need materials, pre-planning or to prepare your child for a change. When you feel yourself mentally prepare for a challenging situation (as we know we do whenever we have to get kids to school!), take a moment to try this tactic out!

    There is so much assistance out there to guide you along a more positive path as a parent by using simple scientific evidence-based strategies. The High Probability Instructional Sequence is just one of many. For instance, you and your team can also try incorporating Functional Communication Training, modeling, or shaping, as well as addressing missing prerequisite skills. You’ve got this!!!

    References:

    Cooper, J. O., Heron, T. E., & Heward, W. L. (2020). Applied behavior analysis. Pearson Education, Inc.

    Lipschultz, J., & Wilder, D. A. (2017). Recent research on the high‐probability instructional sequence: A brief review. Journal of Applied Behavior Analysis, 50(2), 424-428.

    Mayer, G. R., Sulzer-Azaoff, B., & Wallace, M. (2013). Behavior analysis for lasting change (3rd ed.). Sloan Publishing.

    Rosales, M. K., Wilder, D. A., Montalvo, M., & Fagan, B. (2020). Evaluation of the high‐probability instructional sequence to increase compliance with multiple low‐probability instructions among children with autism. Journal of Applied Behavior Analysis. https://doi.org/10.1002/jaba.787

    Citation for this article:

    Marshall, A., & Stewart, N. (2021). Clinical Corner: What is the High Probability Sequence and how can it help increase responsiveness to everyday tasks? Science in Autism Treatment, 18(2).

    About The Authors 

    Amanda Marshall is a BCBA with a Graduate Certificate in Early Childhood Education and a Masters in Inclusive Education. She is currently the Owner/Behaviour Analyst for Brighter Outcomes, an early childhood behaviour intervention consultancy in Brisbane Australia. Having also worked in the education system for 10 years as an Inclusion Support teacher, she is passionate about advocating for her clients to ensure their successful and meaningful participation within mainstream schools and has authored blogs on a wide array of topics. She discovered the field of ABA 6 years ago identifying multiple opportunities to use ABA to support children with autism and other developmental disabilities in the Australian school system. 

    Nicole Stewart is a board certified behavior analyst (BCBA), a licensed behavior analyst (LBA-NY) and a certified special education teacher with over 15 years of experience working with children with autism, developmental delays and rare genetic disorders.  She focuses on improving supervision practices and ensuring that teaching practices incorporate what's functional and accessible for the learner and their family/community.  Nicole is currently the Clinical Director of an ABA agency in Manhattan as well as the co-founder of Solutions for Exceptional Children, an educational consulting company in Essex County NJ.  For more information or to contact Nicole, please see her website: solutionsforexceptionalchildren.com
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