S​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​etting the Scene: Freddie is a 7-year old second grader. He was diagnosed with autism when he was 2 years old. Freddie has a loving family that consists of his mother, father, and two older brothers. Recently, Freddie woke up in the middle of the night in terrible pain — it was a severe toothache. His parents took him to a pediatric dentist, Dr. Jim, who told them that Freddie had an abscess of his second molar of the right upper jaw. Thankfully, this was a baby tooth and would have been lost by, at the latest, 12 years of age. The parents explained that Freddie is very resistant to brushing his teeth, or even having his parents brush his teeth. They expressed great concern about his health and the impact his oral hygiene would have. Dr. Jim told Freddie’s parents that he had seen many cases just like Freddie’s and that he always refers his patients who have this “resistance” to a BCBA who designs individualized skill acquisition programs to increase independence in brushing teeth, as well as reduce the resistance. Freddie’s parents were thrilled to learn that there is this type of help available to them — for Freddie’s oral hygiene and other activities of daily life with which Freddie struggles. This could help Freddie in so many ways! PROPOSED PLAN: Get out toothbrush and toothpaste Take toothpaste cap off Wet toothbrush Put toothpaste on toothbrush Put cap back on too​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​thpaste Put toothbrush in mouth and begin moving the toothbrush around in a circular motion, back and forth on both sides teeth (front and back) Once all teeth have been brushed, pull the toothbrush out, and spit into the sink. Repeat steps 6 and 7 for at least 2 minutes. Rinse toothbrush off in water Put toothbrush and toothpaste away I would first assess to see which type of chaining Freddie learns best with. Let’s say he learns best using forward chaining. I would start with step one and reinforce him for doing this until he masters it. Then we will move to the second step and repeat the same process for all of the steps; reinforcing him at the one step until he masters it. If Freddie needs to be prompted, I would use a low to medium valued reinforcer. When Freddie is able to complete all steps without any prompting (independently) he will earn a highly preferred reinforcer to show him the difference between the reinforcement used when he needs prompts vs. when he does a step all on his own. This will show him that he gets more reward for doing something on his own, which will promote more independent actions. NOW: Respond by identifying one component in their task analysis and explaining how you would apply a shaping procedure to teach that component if Freddie were having difficulty achieving proficiency. Be sure to break down the process by setting the predetermined criteria ​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​for DR.

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