Case Examples of CBM

Example #3 -Tim: 5th Grader Working on Increased Independence

Tim is a 5th grader with ASD. He receives one-to-one instruction and spends approximately 50% of his school day in his 5th grade classroom. Although Tim is able to understand the concepts being taught during math given one-to-one instruction, when it is time to work on written assignments he is unable to attend to the task to complete the assignment without the program assistant sitting beside him telling him each step of the way which problem to work on and whether or not he did the problem correctly. Tim’s favorite leisure-time activity is drawing in his art book. This activity is very calming for Tim. The team determined that a high priority for Tim’s educational program was that he begin to learn to work independently and complete his assignments on time.

To that end, the team decided to teach Tim a self-monitoring system using cognitive behavioral management (CBM). The following system was developed.

Planning

• Tim’s teacher, Karen, decided to begin teaching the process focusing on math concepts Tim was already familiar with. Because Tim was unable to complete any assignments independently, she began by adapting the assignment to require only a fraction of the work given to the rest of the class.
• Karen knew that Tim needed a system that provided frequent feedback to maintain his attention and go on to the next problem in the assignment.
• Tim needed a visual system to record his progress towards completion of the assignment.
• Karen decided to minimize the amount of verbal direction given while teaching this new system to decrease Tim’s dependence on verbal direction from an adult.
• Karen decided to use a system based on amount of work completed rather than time on task because this type of system would be easier for Tim to understand.
• Tim needed reinforcement that involved both social reinforcement (the program assistant reviewing his work, assuring him he had done it correctly and praising him for completing the assignment on his own) and tangible reinforcement (time to engage in a leisure activity of his choice).

Teaching the Skill

Karen designed a simple task list that included each task Tim had to do with a place for him to mark as he completed each task. It looked like this:

Karen met with Tim and explained that they were going to start working on completing his assignments on his own. She told him that he was going to learn to keep track of the work he did. She assured him that she would show him exactly how to do it. She also explained that Mrs. Beal would be busy with other students while he was working but would check his work and talk to him about what he had done when all of the lines on the task list had been checked.

Teaching the System of Self-management

• Karen showed Tim the task list and modeled how to use it by reading each step out loud, doing the task and placing a check mark on the line beside each step once completed.
• Then she explained that it was now Tim’s turn to use the assignment sheet. She explained that she would sit beside him the first time.
• Karen pointed to the first step on the assignment sheet. Tim read step 1 then took out his math book, paper and pencil.
• Karen pointed to the line beside step 1. Tim said, “check when done” and drew an X on the line.
• Karen pointed step 2 on the sheet. Tim read the designated page in his book and drew an X on the line, as he said, “I’m done with that part.”
• Karen now pointed to step 3. Tim read step 3, turned to Karen and said, “I want to draw in my art book.” Karen pointed to each of the steps on the assignment sheet and Tim read each step. Karen said “That’s right, when each step is done, you may draw in your art book.” Tim started working on the problems indicated in step 3 and drew the X on the line when finished.
• Karen moved her chair back a bit and waited to see if Tim would read step 4 on his own. He read the step, completed step 4, drew the X and read Step 5.
• Karen handed him his paper and pointed to Mrs. Beal. Tim took his paper to Mrs. Beal who checked his work, thanked him for showing it to her, told him she was proud of him, and that he could get his art book and draw until the bell rang for lunch.

Karen made another math assignment sheet for the next day using the same format. This time, Tim was able to complete the steps on the sheet with only two visual prompts from Karen (pointing to the next step on the assignment sheet). Over the next few days Karen continued this process, gradually moving her chair away from Tim’s desk until he could follow the system on his own. Karen gradually increased the amount of work that needed to be completed in each step of the assignment sheet. Within a month’s time Tim was working independently for 20 minutes during math class and was able to complete 75% of the 5th-grade math assignment for the day.