By James Macon, M.Ed., BCBA

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 already learned, making for a potentially difficult therapy session.

Scripting can be defined as contextually inappropriate repetitive vocal behavior, maintained by automatic reinforcement. In lay 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 are guilty of singing in the car or shower. Other’s might hum or privately “sing” a song in their head, during a meeting.   What separates these examples from those of clients with ASD is a manner of context and appropriateness. 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 with our clients, however.

A child with ASD who engages in vocal stereotypy often place themselves in a position to be stigmatized when out in the community. This can be very difficult for the family and parents. It can also be difficult for the Behavior Analyst to treat clinically.

Research that has been conducted on scripting often takes place in clinical laboratories, far away from the applied clinics most Behavior Analysts 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 with them, 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 measure with this type of behavior is loaded with challenges.

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 it’s behavior 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 begs 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.

The intervention. Appropriate time. Appropriate place.

The most 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 instruction are given that, based on 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, however. Everyone engages in scripting behavior from time to time, and our clients deserve no less. It is important to build into your intervention components to teach appropriate time and place, where they can engage in scripting. This can be highly customizable, and will likely change as the clients preferences change. Some examples include the use of picture boards, wearable wrist bands, or token boards. The main ingredient of course is that the client learns conditions in which scripting will either be allowed or redirected.