There are three commonly used procedures for teaching the component responses of a chain: Backward and forward chaining and total task prompting. The consideration of which one to use will involve multiple variables such as the skill being targeted and factors related to the learner such as his cooperation with prompts and his ability to complete multiple responses before a reinforcer is presented.

In a backward chaining procedure, the last step in the chain is taught first and the second to last step is not introduced until the child can produce that step independently (without prompts). For example, a caregiver teaching her child to put her shirt on would perform all the responses for her (e.g., place the shirt over her head, place her arms through, etc.) but would stop right before the last step (e.g., pulling the shirt down over her stomach). She would then provide an instruction such as, “Put your shirt on please,” and would then prompt and reinforce that step. Once the child is able to perform that response without prompts the second to last step (e.g., putting her left arm through the sleeve) is taught. The child would then be required to complete both steps (e.g., putting her arm through the sleeve and pulling the shirt over her stomach) before a reinforcer is provided. Backward chaining can be helpful for young children who do not yet cooperate with a lot of physical guidance (e.g., they may find too much physical guidance aversive). It can also be helpful to shape multiple responses before a reinforcer is provided.

A forward chain procedure is similar to backward chaining but starting with the first step in the chain. For example, when teaching a child to put on his shirt, the teacher would present the instruction, “Put your shirt on please,” and would then prompt and reinforce the first step (e.g., picking up the shirt). Once this response in the chain is acquired, the next step in the chain (e.g., opening the shirt to place over the head), is added to the chain and the child is expected to complete both responses before a reinforcer is presented. Again, this procedure can be helpful for young learners who are only beginning to cooperate with physical guidance.

Total task prompting would involve prompting the entire sequence of the task and differentially reinforcing component responses in the chain that occur without prompts or with the least amount of assistance. For instance, a father teaching his son to put on his shirt would say, “Please put on your shirt,” and would then prompt all components of the response and would systematically fade assistance across teaching opportunities.

When determining which chaining procedure to use, teachers and caregivers should consider: (a) the response being taught, such as determining if it is a task composed of many responses, (b) the child’s overall compliance with prompts, and (c) the child’s sensitivity to delayed reinforcement. It may be the case that for a young learner with autism, using a backward or forward chaining procedure may be best because it helps limit the amount of manual guidance used. On the other hand, a child may be able to learn a long response chain faster if all components of the response are prompted simultaneously as in the total task method. Thus, a careful consideration of the task and the learner is necessary when determining which one to use.

As mentioned earlier, in order to develop independence with many skills associated with independent living, a learner must be able to demonstrate the skill with fluency that is demonstrate speed and accuracy with the component responses of the long response chain (Binder 2010). Fluency procedures incorporate timed practice of component responses. For example, if a child is learning to complete the steps of putting on his pants and the pants have a snap, his teacher would conduct timed practice sessions of the skill of snapping. A fluency aim (a goal for how many times he should snap within a predetermined time period) is established usually by observing typical peers perform the same skill. The teacher would then arrange for a series of timed practice sessions (e.g., repeated 1 min practice sessions) until the child meets the fluency aim. To shape responding toward the aim, the rate of responding required for reinforcement is systematically increased until the aim is met (e.g., snaps 15 times in 1 min). Once the goal is reached for speed and accuracy for snapping, this response is then expected to be demonstrated within the long response chain of putting pants on. Because the child has developed fluent snapping skills, he may require less prompting for this response when completing the long response chain of putting on his pants.

Fluency procedures can be used to address the deficits in fine motor skills which can impede acquisition of daily living skills. If teachers incorporate timed practice of component fine motor responses (e.g., buttoning, snapping, zipping, twisting, open containers, and so on), it should improve performance in demonstrating the long response chain where these skills are expected (e.g., removing the cap to the toothpaste to complete the response of toothbrushing). Some researchers have argued that combining chaining procedures with procedures that increase fluency results in better acquisition and maintenance of response chains associated with daily living skills (Twarek et al. 2010). While more research is needed to demonstrate this connection, it stands to reason that teachers and caregivers should provide ample opportunities to practice component responses associated with long response chains.

As previously mentioned, children with autism may become reliant on teacher and caregiver prompts to complete self-care and daily living routines. One reason for this may be that socially mediated interventions promote reliance on prompts. For example, a child who is provided with repeated verbal prompts to complete a routine may come to rely on his mother stating each response in the chain before he completes it. Further, it may be likely that an individual with autism will always require some type of prompt or guidance to complete certain daily living routines. A goal then should be to identify prompts that are less obtrusive than adult directives and that the individual may utilize independently. It is common for typically developing adults to rely on various types of prompts to complete tasks during the course of their everyday lives. For example, we may rely on a list to complete our shopping, a video to know how to complete a recipe, and photos or instruction manuals to assemble a new bed. Similarly, individuals with autism should be taught to attend to these types of stimuli to complete tasks, thereby reducing reliance on adult prompts and increasing independence.

A number of procedures have been researched that facilitate independence and reduce dependence on adult prompts. The use of photographic activity schedules (McClannahan and Krantz 2010) is one intervention designed specifically for this purpose. A separate chapter in this volume is dedicated to photographic activity schedules but they will be briefly discussed here as they relate to independent living skills. A photographic schedule is a series of photos that represent for the learner the responses that he should perform in order to complete a task. Photos are taken of each component of the task and arranged in a photo book or in a list. For example, if a child is learning to get dressed, his father would take photos of each component of the dressing routine (e.g., a photo of a shirt to indicate he should get his shirt, a photo of his shoes, indicating he should get his shoes, and so on). He would then provide the instruction for his child to get dressed (e.g., “Get dressed please”) and would guide his son to point to the first picture in the schedule, complete the task associated with the picture (e.g., put on his underwear), and continue to guide him through the task of pointing to each picture and completing each step. Initially many prompts are provided to avoid errors and a dense schedule of reinforcement is used to teach the child to attend to the photos and to complete the routine. Eventually, only independent responses are reinforced. The goal is to shift responding from the father’s prompts to the photo schedule, thus, reducing the child’s reliance on his father’s prompts and directives to get dressed (Krantz, McDuff and McClannahan, 1993).

Video modeling can also reduce dependence on adult prompts. Video modeling requires a number of prerequisite skills such as being able to attend to and imitate a video (Taylor and DeQuinzio 2011). For independent living tasks, a video would be recorded of an adult or other child performing each step in the self-care routine (e.g., each component of toothbrushing is portrayed on the tape). The child would then watch the tape and imitate the actions on the tape. Different variations of video modeling have been researched. For example, watching each component and then performing the task or watching the entire sequence (Tereshko et al. 2010). Very young children with autism will need to be taught the prerequisite skills associated with video modeling such as imitation and attending to a video for this intervention to be effective. Nonetheless, video modeling can be an effective intervention to decrease dependence on adult mediated prompts.

Audiotaped prompts are prerecorded verbal prompts which dictate each step to complete in a chain (Mays and Heflin 2011). This intervention could be especially helpful in addressing activities of daily living where the child is unable to attend to photo or video prompts. For example, the component steps for showering (e.g., “get shampoo,” “squeeze in hand”) could be recorded on an audio device (e.g., an iPad) and the recording could be played just outside of the shower. For this intervention to be helpful, the child would need to be able to respond to each verbal prompt or direction on the audiotape. Like activity schedules, the child could be taught to follow the directions on the tape by being prompted by an adult to complete each step after each directive is given. Eventually, with systematic prompt fading and differential reinforcement, the directions on the tape gain stimulus control over responding and the adult should no longer be necessary to prompt the responses.

While few studies have been published to date, emerging technology such as iPads, iPods, and other handheld electronic devices could create even more opportunities to increase independent living (Cihak et al. 2010; Hammond et al. 2010; Kellems 2012). With these devices, videos, photos, and audio prompts can be recorded fairly efficiently, which will allow caregivers to modify and change the prompts as needed. It also allows teachers and caregivers to create schedules which combine all of the above components. A parent for example could have a schedule that combines a video of certain steps in a chain, photos that would prompt responses, and audiotaped directions that can be played when the child taps the photo in the schedule.

While teacher and caregiver prompts are essential to teach independent living skills, due diligence is necessary to identify prompts the can be faded efficiently and to teach children with autism to attend to and respond to prompts that will reduce reliance on caregiver prompts (e.g., photos, text, videos, etc.).

Essential to any behavior change program is the continuous measurement of behavior before, during, and after training. This allows the caregiver to monitor the child’s progress, to make any necessary modifications in instruction, and to ensure the skills are maintaining over time. Before data collection begins, the responses to be measured are clearly defined. Being specific in defining the behaviors in a long response chain allows for more efficient teaching and data collection. For example, the target response of using a napkin independently may be, “When presented with a meal (e.g., lunch, breakfast, dinner) and a napkin, the learner will use the napkin appropriately by wiping his or her mouth and/or hands during appropriate times (every three or four bites or when food gets on his/her mouth and/or hands) at the table.” This definition is specific and includes the stimulus conditions under which the behavior should occur. Specific steps can then be identified to teach and to record data. For example, Step 1, “picks up the napkin,” Step 2, “brings napkin to face,” Step 3, “wipes napkin across mouth from left to right three times in a row,” Step 4, “puts napkin on table.” Data can then be recorded on whether each of these responses in the chain is demonstrated independently or with prompts. The percentage of steps completed accurately across opportunities can then be calculated and graphed for visual display (Fig. 19.2 provides a sample graph with hypothetical data depicting percent correct of the whole sequence of using a napkin).

Data can also be collected on one of the component responses in the chain (e.g., walks to the bathroom) and the percentage of opportunities that the response was demonstrated to proficiency can be calculated and graphed. Thus, a long response chain such as toothbrushing may have two measures: Percent correct on the current step (e.g., picks up toothbrush), and percent correct on the entire sequence (e.g., a twenty-step task analysis). Over time, the whole sequence for a long response chain (e.g., toothbrushing or shoe tying) should ascend as the learner masters each individual step, and the steps are chained together. Data are then graphed to visually display the data which allows the teacher to monitor if the intervention is leading to the acquisition of the skill (Fig. 19.3 provides a sample graph with hypothetical data depicting percent correct of the component responses of toothbrushing).

Data collection, although essential, can be cumbersome while simultaneously prompting a child to complete a long response chain. For example, when teaching a child to wash parts of his body during a bath, it would be disruptive to the flow of teaching to stop and record data on each response. To address this issue, a caregiver could conduct regularly scheduled “probes” of performance without prompts and reinforcement. The caregiver could teach bathing for several days in a row and then on a predetermined schedule allow the child to bathe himself without prompts and reinforcers. During these probe sessions, data are recorded on the responses performed independently. If necessary, more teaching would take place and intermittent probes would continue to be conducted to determine if independent performance improves.

Accurate and ongoing data collection allows teachers and caregivers to evaluate the effects of teaching interventions and to determine if modifications in procedures are necessary. Developing efficient data systems that do not interfere with teaching are essential to allow instructors to focus on shaping during the teaching interaction.