EL IVING

SSENTIAL
FOR

An Introduction
and User Guide
A
EEEL
SSENTIAL
SSENTIAL
SSENTIAL Communication,
ELELEL
FOR
SSENTIAL
FOR
SSENTIAL
IVING
FOR
SSENTIAL
IVING
FOR
LL
IVING
FOR EEEL
SSENTIAL
SSENTIAL
SSENTIAL Behavior and
ELELE
The Assessment
FOR
Record IVING
andThe Assessment
FOR
IVING
of Progress
andThe [ARP] Manual
Assessment
SSENTIAL
FOR
IVING
SSENTIAL
FOR
IVING
LLL
IVING
SSENTIAL Functional Skills
Record of Progress [ARP] Manual
andThe Assessment
FOR
Record of Progress
andThe
Record
[ARP] Manual
Assessment
of Progress [ARP] Manual
andThe Assessment
IVING
The Essential Assessment
FOR
IVING
andThe Essential Assessment
FOR
Record
and of Progress [ARP] Manual
for ___________________________
Record
IVING
of Progress [EARP] Manual
andThe Essential Assessment

IVING Curriculum,
Record of Progress [ARP] Manual for Record
the and of Progress
Essential Eight [EARP]
Skills Manual
for ___________________________ The Essential Assessment
andfor the
Record of Progress
Essential [EARP] Manual
Eight Skills
for ___________________________ andThe Essential Assessment
Problem
andforBehavior
Record
the of Progress
Essential
andThe [EARP] Manual
Eight Skills
for ___________________________ Problem Behavior Essential Assessment
andfor Record
the of
EssentialProgress [EARP] Manual
Eight Skills
for ___________________________ and
Problem Behavior

Assessment,
andfor Record
the of Progress
Essential [EARP] Manual
Eight Skills
for ___________________________ for ___________________________
Patrick McGreevy Problem
and Behavior
for the Essential Eight Skills
for ___________________________
Patrick
Troy Fry andMcGreevy
Colleen Cornwall Problem
and Behavior
for ___________________________
Patrick
Troy Fry andMcGreevy
Colleen Cornwall Problem Behavior
for ___________________________
TroyPatrick
Fry andMcGreevy
Colleen Cornwall

Skill-tracking
Patrick
Troy Fry andMcGreevy
Colleen Cornwall for ___________________________
Patrick McGreevy
TroyPatrick
Fry andMcGreevy
Colleen Cornwall Patrick
Troy Fry andMcGreevy
for ___________________________
Colleen Cornwall
Troy Fry and Colleen Cornwall TroyPatrick
Fry andMcGreevy
Colleen Cornwall
TroyPatrick
Fry andMcGreevy
Colleen Cornwall

Instrument,
TroyPatrick
Fry andMcGreevy
Colleen Cornwall
TroyPatrick
Fry andMcGreevy
Colleen Cornwall
Troy Fry and Colleen Cornwall

and
Patrick McGreevy
Troy Fry
Professional
Colleen Cornwall Practitioner’s
Handbook
‘More than just a list of skills... for
it’s when and how Children and Adults
you teach those skills’
with
Moderate-to-Severe
Disabilities

Patrick McGreevy Troy Fry

[email protected] [email protected]
407-415-5241 952-412-6206

www.essentialforliving.com
2 Essential for Living: An Introduction and User Guide

EL IVING
SSENTIAL
FOR the most innovative and comprehensive instrument of its kind
on the market today...

1. Includes functional skills that ‘matter’ in the lives of learners with

moderate-to-severe disabilities
2. Includes the Essential Eight Skills that are often absent when
problem behavior occurs
3. Includes skills that are linked to the Common Core State Standards
4. Reaches learners with very limited repertoires
5. Provides a method for selecting and testing the effectiveness of
an Alternative Method of Speaking for non-verbal learners
6. Permits the seamless inclusion of skills into IEP, ISP, program plan
and hab plan goals and objectives
7. Provides a platform for transdisciplinary interactions
8. Includes easy-to-follow, evidence-based teaching procedures
9. Permits the effortless tracking of small increments of learner
progress
10. Permits the tracking of skill acquisition, fluency, maintenance, and
generalization
11. Permits the effortless tracking of problem behaviors and the
supports these behaviors require over extended periods of time
12. Permits teachers to become comfortable using this sophisticated
instrument with 1-2 days of training and a few days of practice
13. Provides a platform for fair, outcome-based teacher evaluations

Join the increasing number of

school districts, private schools, ABA programs,
residential programs, and vocational programs
who are using
ELSSENTIAL
FOR
IVING
1- to select and prioritize functional skills
for their IEPs, ISPs, program plans, and hab plans,
2- to increase the effectiveness and efficiency of
their instruction and behavior management, and
3- to improve outcomes for the children and adults
they serve
 Essential for Living: An Introduction and User Guide 3

EL IVING
SSENTIAL
FOR was designed for children and adults of all ages with moderate-
to-severe disabilities and limited skill repertoires, specifically...

young children with Down Syndrome, Angelmann Syndrome, Microcephaly,

Cornelia de Lange Syndrome, Hunter Syndrome, and other congenital disorders
that consistently result in moderate-to-severe disabilities;
children who are struggling to become vocal;
non-verbal children or adults who have no effective method of speaking;
children with limited skill repertoires and/or severe forms of disruptive, aggressive, or
self-injurious behavior;
children with autism or related disorders, who, after 2-3 years of intensive, behavioral
intervention, have not acquired matching or imitation skills, are not answering simple
questions without scripts, are not experiencing generalization, are not beginning to
exhibit novel responses, and are no longer making progress on a developmental
curriculum, such as the VB-MAPP, the Early Start Denver Model, or the ABLLS;
adults with congenital disorders and acquired conditions that result in moderate-to-
severe disabilities;
children or adults who require extensive supports or 1:1 supervision; or
children or adults who cannot be instructed or integrated with peers or taken into
the community without severe problem behavior.
The Purpose of ‘Essential for Living’ is to help teachers, curriculum coordinators,
speech-language pathologists, QIDPs, behavior analysts, and support coordinators..
select functional skills for instruction and problem behaviors for management, and
include these selections in IEPs, ISPs, program plans, and hab plans;
manage these problem behaviors and teach these functional skills;
teach learners who are echolalic or who have limited vocal skills;
select appropriate, alternative methods of speaking for non-verbal learners or
learners with a limited spoken-word repertoire;
track learner progress with respect to skills selected for instruction and problem
behaviors selected for management, measure and document very small increments
of that progress through skill acquisition, maintenance, and generalization, and
provide reasonable and fair measures of teacher performance based on that
progress; and,
document specific supports that learners currently require, keep documentation of
learner progress and required supports in one place, and make certain that this
documentation ‘makes it’ to the learner’s next classroom, residence, or program.
‘Essential for Living’ can be used along with developmental curricula, such as the
VB-MAPP, the Early Start Denver Model, and the ABLLS...
when young learners exhibit severe problem behavior; and
when these learners have not acquired basic listener and daily living skills -- e.g.,
when they do not follow basic directions and are not toilet-trained.
4 Essential for Living: An Introduction and User Guide

The Structure and Content of Essential for Living

As shown below (and in NTK: chapter 1 of the handbook), Essential for Living includes seven
skill domains and one domain on problem behavior. These domains are centered around
The Essential Eight Skills, which are described on the following page. Essential for Living also
includes a chapter on Facilitating and Teaching Spoken-word Communication and Select-
ing, Confirming, and Maintaining an Alternative Method of Speaking for non-verbal learn-
ers, a Quick Assessment for new users and learners with severe problem behavior, and an
array of Teaching Protocols.

The Essential Eight Skills

Facilitating and Teaching Spoken-word Communication

and
Selecting, Confirming, and Maintaining
an Alternative Method of Speaking
The Essential for Living Quick Assessment

How Children and Adults

Interact with The Domains of Essential for Living
the World Around Them
Speaking and Listening
Domain 1: Requests and Related Listener Responses (R)
Domain 2: Listener Responses, Names, and Descriptions (LR, LRND)
Domain 3: Answers to Questions and Conversations (AQ, C)

Doing Domain 4: Daily Living and Related Skills (DLS)

Domain 5: Functional Academic Skills
• Responding to Text as a Listener and Reading (RTL, Rdg)
• Schedules, Lists, and Time (SLT)
• Math Skills (Mth)
• Writing or Typing Skills (WT)
Tolerating Domain 6: Tolerating Skills and Eggshells (T)
Inappropriate Behavior Problem Behavior Domain (PB)
Tool Movements Domain 7: Tool Skills and Component Skills (MM, M, Im)
Teaching Protocols

Skills within the seven skill domains are sequenced from less to more difficult and more to less
functional and designated as:
must-have,
should-have,
good-to-have, and
nice-to-have.
Assessment and teaching should generally begin with must-have skills.
 Essential for Living: An Introduction and User Guide 5

The Essential Eight Skills

As shown below (and in NTK: chapter 1 of the handbook)...
Domain 1, Domain 2, Domain 4, and Domain 6 include must-have skills.
These skills, also known as The Essential Eight, are absolutely essential for a happy, fulfilling,
and productive life as an older child or an adult, and are the central focus of Essential for
Living. In the absence of these skills, children and adults with moderate-to-severe disabilities
will, almost certainly, exhibit forms of problem behavior, have limited access to preferred
items, activities, places, and people, and have limited contact and interaction with the
community in which they live.

Skill Domain and the Must-have Skills within that Domain The Essential Eight

Domain 1. Requests and Related Listener Responses (R)

R7. Makes requests for highly preferred snack foods, One. Making Requests for Access to
drinks, nonfood items, or activities... Highly Preferred Items and Activities and
and 13 other skills that include making requests for the Removal or Reduction in intensity
of Specific Situations

R9. Waits after making requests for each of the items Two. Waiting
and activities in R7 and R8 for... increasing periods of
time
R13. Makes transitions from preferred items and activities Three. Accepting Removals -- the
to required tasks... Removal of Preferred Items and
and 2 other skills that include accepting removals Activities, Making Transitions, Sharing,
and Taking Turns
R11. Completes 10 consecutive, brief, previously Four. Completing Required Tasks -- 10
acquired tasks Consecutive, Brief, Previously Acquired
Tasks
R15 & R16. ‘Accepts no’ after making requests... Five. Accepting ‘No’

Domain 2. Listener Responses, Names,

and Descriptions (LR, LRND)

LR2. Moves toward and stands or sits next to an Six. Following Directions Related to
instructor, care provider, or parent when directed to do Health and Safety
so...
and 10 other skills that include following directions

Domain 4. Daily Living and Related Skills (DLS)

DLS-HS4. Fastens and remains in a seat belt... Seven. Completing Daily Living Skills
and 38 other skills that are part of daily living Related to Health and Safety

Domain 6. Tolerating Skills and Eggshells (T)

T-BHI5. Tolerates touch, physical guidance, or prompts... Eight. Tolerating Situations Related to
and 70 other skills that include tolerating specific Health and Safety
situations
6 Essential for Living: An Introduction and User Guide

Conducting an Assessment
When to conduct an assessment. Conduct an assessment with Essential for Living (EFL) when
you first begin working with a child or an adult. This assessment will permit you to identify
deficits in functional skills and problem behaviors, and to develop goals and objectives for
an IEP, ISP, behavior plan, program plan, or hab plan. Conduct additional assessments when
the learner has acquired several skills or when priorities change, necessitating the selection
of additional skills or problem behaviors and the development of new goals and objectives.
How to conduct an assessment of skill deficits. Begin conducting an assessment by obtain-
ing a copy of The Assessment and Record of Progress [ARP] Manual (with the blue band on
the left), which includes all the skills in Essential for Living. If the learner with whom you are
working has an extremely limited skill repertoire, exhibits severe forms
ELSSENTIAL
IVING
of problem behavior, or is still acquiring skills from the VB-MAPP, the E
FOR
L
SSENTIAL
IVING
FOR

and
Denver Early Start curriculum, or the ABLLS, but has not acquired all
The Assessment

Record of Progress [ARP] Manual

The Essential Assessment
and
Record of Progress [EARP] Manual

of the Essential Eight Skills, you may want a copy of The Essential
for the Essential Eight Skills
and
Problem Behavior

for ___________________________

Assessment and Record of Progress [EARP] Manual (with the red

for ___________________________

Patrick McGreevy Patrick McGreevy

band on the left), which includes ‘just’ the Essential Eight Skills and
Troy Fry and Colleen Cornwall Troy Fry and Colleen Cornwall

Problem Behavior.
Then, complete the following four activities as indicated:
Activity 1 -- Complete The Essential for Living Quick Assessment (QA: chapter 5 of the
handbook) and note ‘deficits in the Essential Eight Skills’ suggested by the
interviewees (see the ARP Manual, pp. 18-20 or the EARP manual, pp. 5-6).
The EFL Quick Assessment assists you in conducting the first assessment for a
learner, especially a learner with severe problem behavior. This activity invol-
ves interviewing one or more people who know the learner. Responses during
this interview suggest possible deficits in functional skills and problem behaviors
and direct you to those specific deficits or sections within EFL which address
those deficits. An item from the Quick Assessment is provided below.
One. Making Requests – the tendency to make requests for highly preferred
items and activities
4 Makes requests for 10 or more preferred items or activities without prompts
using an effective method of speaking 7a. Domain 1. R14, R17-21, R22-24,
R27-28, R30-31
3 Makes requests for 1-3 preferred items or activities with or without prompts
7a. Domain 1. R7-8
2 Makes requests by leading others to items 7a. Domain 1. R1-5, R6, R7-8
1 Makes requests by exhibiting problem behavior 7a. Domain 1. R1-5, R6, R7-8
Paraphrasing the description of this item, ask one or more interviewees, “Does
this learner make requests for highly preferred items and activities”. Then,
determine which of the four options most closely resembles their responses. For
example, if two interviewees say, “He makes requests by leading others to
what he wants”, circle option 2 as shown. Then, go to chapter 7a., Domain 1,
skills R1-5, R6, R7-8. To determine other possible deficits, complete the remain-
ing items in the Quick Assessment. As you become more familiar with Essential
for Living, you may want to bypass this activity, in favor of Activity 3.
 Essential for Living: An Introduction and User Guide 7

Activity 2 -- Determine the learner’s vocal profile, that is, the extent and understandability
of the learner’s spoken-word repertoire; if necessary, select and confirm an
alternative, primary method of speaking (MS: chapter 6 of the handbook);
and indicate this method on the inside front cover of the ARP or EARP Manual.
This activity was designed for children and adults with a limited repertoire of
spoken words or no spoken words at all. This includes learners who are often
described as either echolalic or non-verbal. This also includes learners who
have been provided with an alternative method of speaking which is inef-
fective, that is, which does not permit them to easily, efficiently, and continu-
ously make requests for preferred items, activities, places, and people.
Activity 2 is described in MS: chapter 6 of Essential for Living, which was co-
authored by Janine Shapiro, a speech-language pathologist and behavior
analyst. Essential for Living is the only curriculum or assessment instrument on
the market today that includes such a chapter.
Activity 2 will help you determine...
When to select ‘saying words’ or an alternative primary method of speak-
ing, in other words, when ‘saying words’ can function as a learner’s pri-
mary method of speaking and when you will need to select an alternative
method of speaking.
Making this decision is accomplished by aligning your learner with one of
six Vocal Profiles based on that learner’s repertoire of spoken words and
spoken-word repetitions and the extent to which these repertoires are
understandable. And, when an alternative method is necessary, these pro-
files help you decide how to allocate resources between increasing the
learner’s spoken-word repertoire and selecting, confirming, and maintain-
ing an alternative method.
Two of the six Vocal Profiles are provided below.
Vocal Profile 2 -- Uncontrolled and Controlled Spoken-word Repetitions
This profile describes learners who exhibit many understandable spoken
words and phrases, but only as repetitions of what others have said.
Some of these repetitions are controlled, that is, if an instructor says
“say, car”, these learners will say “car”; more frequently, however,
these repetitions are uncontrolled, that is, learners will say “say, car”.
If your learner can be aligned with this profile, you should use a specific
teaching procedure that is part of Teaching Protocol 1 (see the echoic-
to-request transfer procedure on page 265 of the handbook), and
‘saying words’ should be selected and confirmed as the learner’s
primary method of speaking. And, all resources should be committed
to a goal for the learner of spontaneous requests with spoken words.
Vocal Profile 3 -- Occasional Words and Phrases
This profile describes learners who exhibit a limited number of spoken
words and phrases, which are understandable but which occur
infrequently across situations, inconsistently within the same situation,
and rarely as spoken-word repetitions.
8 Essential for Living: An Introduction and User Guide

Unless learners already exhibit at least some tendency to repeat what

they hear, there is no consistently effective way to prompt them to say
sounds or words. In other words, there is no way to ensure that sounds or
words occur in response to prompts. As a result, if your learner can be
aligned with Vocal Profile 3, you should use procedures that are part of
Teaching Protocol 1a. If spoken-word repetitions begin to occur often,
the learner should be aligned with Profile 2 and all resources should be
committed to spoken-word communication. If repetitions do not begin
to occur within 2-3 months, an alternative method should be selected
and confirmed as the learner’s primary method of speaking. Then, as
you teach the learner to make requests, you should use all of the
procedures that are part of Teaching Protocol 1, in other words, select
and begin to use an alternative method of speaking, but do not
abandon the quest for spoken words.
Activity 2 will also help you learn...
How to select an alternative, primary method of speaking.
Selecting an alternative method of speaking is accomplished by match-
ing a learner with specific sensory, skill, and behavioral repertoires with
specific, alternative methods of speaking that tend to be effective when
most of those repertoires occur. These repertoires include:
H -- hearing S -- sighted HI -- hearing impaired
VI -- visually impaired HVI -- hearing and visually impaired
Am -- ambulatory NAm -- non-ambulatory A -- active I -- inactive
FM -- fine motor coordination <FM -- limited or no fine motor coordination
MI -- motor imitation <MI -- limited or no fine motor imitation
M -- matching <M -- limited or no matching PB -- moderate or severe problem
behavior -PB -- no moderate or severe problem behavior.
This matching task is accomplished with a mylar, called ‘The Selection Dia-
gram’, which is enclosed with the handbook. These repertoires for a speci-
fic learner are depicted on this diagram, as they are in the example below.
These repertoires can also be entered into a computer program, which
can be found at www.essentialforliving.com.
The Selection Diagram

The Learner’s Current Sensory, Skill, and Behavioral Repertoires

H S HI VI HVI Am NAm A I FM <FM MI <MI M <M PB -PB

 Essential for Living: An Introduction and User Guide 9

As the diagram indicates, this learner is hearing, sighted, ambulatory, and

active, with good fine motor coordination, limited fine motor imitation, no
matching skills, and problem behavior.
The selection diagram is then superimposed on diagrams for each of 46
alternative methods of speaking, which depict the repertoires that tend to
occur when each of these methods is effective, along with the advan-
tages of spoken words that each method retains. As shown below, The
Selection Diagram for this learner was superimposed on the diagram for
Alternative Method of Speaking 2 (AMS 2), Forming Standard Signs.

The Learner’s Current Sensory, Skill, and Behavioral Repertoires

H S HI VI HVI Am NAm A I FM <FM MI <MI M <M PB -PB

Alternative
Method AMS 2: Forming standard signs (e.g., Signed English)
of Speaking

The Repertoires that Tend to Occur When AMS 2 is Effective

H S HI VI HVI Am NAm A I FM <FM MI <MI M <M PB -PB

The Advantages of ‘Saying Words’ Retained by AMS 2

Speaker P E 1S -CD Rq ND AQ Con Rd RA Large Audience LA

As indicated by the boxes in bold, there were seven ‘repertoire matches’,

suggesting that this method should be set aside for consideration as an
alternative, primary method of speaking for this learner. Then, after super-
imposing The Selection Diagram on the remaining alternative methods of
speaking, several other methods with a similar number of ‘matches’ should
also be set aside for further consideration.
Then, with the methods that have been set aside, a second step in the
selection process is added, which examines the extent to which these
methods retain the advantages of ‘spoken words’ with respect to the
speaker and the audience. These advantages are listed below and shown
in the diagram above:
P -- Children and adults can convey messages at any place and time with-
out need for environmental supports E -- Information can be conveyed with
very little effort 1S -- In the beginning, only one-step (i.e., single-word) res-
ponses are required -CD -- In the beginning, complex discriminations are not
required Rq -- Many requests can be easily conveyed ND -- Many items,
activities, people, & places can be clearly named and described AQ --
Answers to questions can clearly and easily occur Con -- Conversation can
easily occur Rd -- Reading can be taught RA -- Requests can be conveyed
in the absence of what is being requested... and,
10 Essential for Living: An Introduction and User Guide

LA -- The speaker can be understood by a large audience of instructors,

care providers, parents, and peers with and without disabilities who do not
require training
As shown in the diagram on the previous page, ‘AMS 2: Forming standard
signs’ retains all ten advantages of spoken words with respect to function-
ing as a speaker, but results in a much smaller audience.
From the methods that have been set aside, the one that retains the great-
est number of advantages of spokening words, with respect to both the
learner and the learner’s audience, is generally selected as the learner’s
alternative, primary method of speaking.
Activity 2 will also help you learn...
How to confirm an alternative, primary method of speaking
In order to confirm an alternative, primary method of speaking for a speci-
fic learner, Essential for Living describes eight procedures that should be
used to test the effectiveness of this method. Three of these procedures are
provided below.
providing a minimum of 2-3 months of daily instruction;
teaching a learner to ‘make requests’ for specific, highly preferred
items, activities, and persons, NOT to ‘name or describe’ items or
persons, NOT ‘to comment’ on experiences, and NOT to ‘answer
questions’;
teaching requests for specific items, activities, and persons (see R6, R19,
R20, and, for some learners, R13, R15, R16, R17, and R18); NOT requests
for ‘more’, ‘food’, or ‘eat’ and NOT requests with ‘please’, ‘yes’, or ‘no‘;
When you have used these procedures and collected data for 2-3
months, you should begin to estimate the effectiveness of the selected,
alternative, primary method of speaking using the following criteria:
the requesting repertoire...is improving rapidly (8-10 requests for new
items or activities per month)...or...is continuing to improve gradually
(1-2 requests for new items or activities per month, or in some cases, per
year)...or...includes most of the learner’s preferred items and activities;
the audience responds appropriately to the learner’s requests
(i.e. provides what the learner requests);
the learner makes frequent, spontaneous requests throughout
the day; and
the frequency of self-injurious, aggressive, destructive, or
disruptive behavior has decreased significantly.
If any of these four criteria are not met, this method should be rejected
and another method should be selected.
 Essential for Living: An Introduction and User Guide 11

Activity 2 will also help you learn...

How to maintain, expand, and extend the use of an alternative, primary
method of speaking
In order to make certain that a learner’s alternative method of speaking
endures into the future, expands the learner’s speaking repertoire, and
extends that repertoire to several environments, five goals must be accom-
plished. Two of these goals are provided below.
to make certain that the learner’s method of speaking is as portable as
possible, insuring frequent responding as a speaker, and
to capture and contrive many opportunities each day for the learner to
respond as a speaker,
Activity 2 will also help you learn...
How to select, confirm, and maintain concurrent, back-up, and secondary
methods of speaking
Some learners will require concurrent methods, that is, two methods at the
same time; others will require back-up methods to increase the size of their
audience, and still others will require secondary methods that increase the
extent of the speaker repertoire. Procedures for selecting, confirming, and
maintaining these methods are also described.
Activity 3 -- Scan the Must-have Skills, which are part of Domain 1 (R), Domain 2 (LR, LRND),
Domain 4 (DLS), and Domain 6 (T) (a.k.a., The Essential Eight Skills) and note
‘possible skill deficits’ not suggested by Activity 1; if there are no apparent
‘must-have skill deficits’, proceed to the ‘should-have’ and the ‘good-to-have
skills’ in each of the Seven Skill Domains, using the First Things First Diagram
(see page 14, and the diagram on page 17 of the handbook).
If you completed Activity 1, and have assembled a list of ‘possible skill deficits’
for your learner, you may bypass Activity 3 or add to this list by completing this
activity. If you did not complete Activity 1, complete Activity 3 now.
Using one of the learner scoring manuals, begin scanning the must-have items
in Domain 1 (R), circling items with a pencil that, your knowledge and exper-
ience with the learner suggest are ‘possible skill deficits’…
R1-5. Interests of the learner...as determined by instructors, parents, and care
providers, and... as indicated by the learner
R1 R2 R3 R4 R5
R6. Exhibits a reliable motor movement that permits a learner to use an
alternative method of speaking which includes selecting photographs,
pic-symbols, printed words, or letters
R7. Makes requests for highly preferred snack foods, drinks, non-food items,
or activities that can be made frequently and immediately available
R8. Requests the opportunity to entertain themselves or to reduce anxiety by
making stereotypic movements with highly preferred items or engaging in
highly preferred stereotypic activities
12 Essential for Living: An Introduction and User Guide

R9. Waits after making requests for each of the items and activities in R7 and R8
for gradually increasing periods of time
R10. Accepts the removal of access to 10 items or activities from R7 and R8 by a
person in authority
Continue with the must-have skills in Domain 2 (LR, LRND)…
LR1. Holds and maintains contact with the hand of an instructor, care provider,
or parent when directed to do so
LR2. Moves toward and stands or sits next to an instructor, care provider, or parent
when directed to do so
LR3. Moves toward and stands or remains in a line when directed to do so
the must-have skills in Domain 4 (DLS)…, and
DLS-EDF1. Consumes thick or thickened liquids orally
DLS-Slp1. Goes to sleep at bedtime
DLS-MT1. Transported from/to a bed, the toilet, a gait trainer, a walker,
a wheelchair, or a MOVE device with a hoist
DLS-AHS1. Does not pick up knives, scissors, and razors without supervision or
training
DLS-HS1. Performs required exercises or therapeutic activities
and…
the must-have skills in Domain 6 (T)…
T-BHI1. The sight, sound, or scent of an unfamiliar person
T-EDF1. A gastrostomy or nasogastric tube
T-DM1. Medication hidden in food
T-Slp1. Parents’ bed
T-Toil1. Someone changing your diaper
T-PRM1. A bed chair
T-PTA1. Glasses or contact lenses
T-PEMR1. A helmet
T-BPH1. Someone washing your hands
T-DD1. Someone brushing your teeth

If there are no apparent ‘must-have skill deficits’, proceed to the ‘should-

have’ and ‘good-to-have skills’ in each of the Seven Skill Domains.
Activity 4 -- Confirm and determine the extent of the ‘skill deficits’ suggested by Activities 1
and 3, using the procedures described and illustrated on pages 28-29 of the
EFL Handbook; and, indicate the learner’s performance on the assessment as
shown below.
From the skill deficits suggested by Activity 1 and/or those circled in Activity 3,
begin to complete the assessment process by placing the learner in the situ-
ations in which these skills typically occur and recording the learner’s initial
performance.
 Essential for Living: An Introduction and User Guide 13

You can use your own method of recording this performance or the method
suggested by Essential for Living, an example of which is shown below and in a
video, which will be available soon on www.essentialforliving.com.

R7. Makes requests for highly preferred snack foods, drinks, non-food items, …

1 crackers IA IM -SA -DC -RP FP PP MP Ind 2S 2P <M NI Det

2 grape juice IA IM -SA -DC -RP FP PP MP Ind 2S 2P <M NI Det
When motivating events occur, learners request specific items, activities, or persons, or
request specific information consistent with those events on three consecutive occasions...
IA [ the initial assessment of this skill has been completed ]
IM [ instruction or management has begun ]
-SA without self-injurious, aggressive, or destructive behavior
-DC without disruptive behavior or complaints
-RP without resistance to prompts and without leaving the area
FP with a full physical, full demonstration, or full echoic prompt
PP with a partial physical, partial demonstration, or
partial echoic prompt
MP with a minimal touch, minimal gestural, or minimal echoic prompt
Ind without prompts, without scrolling, and within two seconds
2S in two or more settings
2P in the presence of either of two people
<M when motivating events have occurred, but are weak
NI when the learner does not have sensory contact with the requested item or
activity (does not apply to some requests)
Det [ requests are no longer occurring consistently ]

This method permits an extremely sensitive measure of learner performance,

which takes into account…problem behavior, resistance to prompts, prompt-
fading, fluency, generalization, and maintenance over time.
In the example shown above, an initial assessment of skill R7, Making Requests
for Highly Preferred Snack Foods, Drinks, Non-food Items, or Activities that can
be made Frequently and Immediately Available, was conducted for our learn-
er, who has a history of aggressive and self-injurious behavior and no method
of speaking. Activity 2 was completed and AMS 3, Forming a Repertoire of
Standard, Adapted, and Idiosyncratic Signs, was selected as his alternative
method of speaking. Skill R7 was indicated as a ‘possible skill deficit’ during
Activities 1 & 3, both of which were conducted. Based on a preference assess-
ment (R5), two items, crackers and grape juice, were selected for the assess-
ment of this skill.
The teacher sat down with several learners during snack time. She began by
making the crackers and grape juice available and waiting until our learner
indicated that he wanted the crackers by reaching for them. When he did so,
she waited a few seconds before prompting the designated sign. He did not
exhibit self-injurious or aggressive behavior (indicated by shading the -SA box
in yellow). Also, he did not exhibit disruptive behavior or complaining, or resist-
ance to prompts (indicated by shading the -DC and -RP boxes in yellow).
 ! Chapter 10. Problem Behavior Domain (PB) 249

14 Essential for Living: An Introduction and User Guide

Providing Effective Treatment for Problem Behavior and Recording Progress

The effective treatment of problem behavior can be accomplished by conducting a formal, functional
assessment (Beavers,
Since heIwata,
had and Lerman, 2013).
no previous The resultswith
experience provide
this an
newestimate of whether
sign and he didspecific prob-
not imitate
lem behaviors are a function of one or more of the following types of consequent events:
motor movements, he required a full, physical prompt in order to form the sign
(indicated by shading the FP box in yellow). This concluded the initial assess-
attention,
avoidance
ment or ofescape from demands,
‘requesting crackers’ (indicated by shading the IA box in yellow).
access
Since our learnerand
to tangible items didactivities,
not reach or for the grape juice, an assessment of request-
someing this item was conducted later.event.
sort of automatically-occurring sensory Meanwhile, the teacher conducted several
other
In other words, initial indicate
the results assessments ofspecific
whether skill R7problem
with other learners
behaviors at the snack
are followed by andtable.
maintained by
one or more of these types of consequent events. Then, as part of behavioral treatment that is based on
For ouroflearner,
function, examples theofteacher
these types completed
events are Activity
withheld when problem4 with 8 of occur
behaviors 20 the ‘possible
and then madeskill
available
! deficits’
when that
designated emerged
replacement from Activities
behaviors occur. 1 and 3. She did not continue
Chapter 10. Problem Behavior Domain (PB)
Activity
249
4
with other ‘possible deficits’, as she felt that the 8 confirmed deficits would
In most situations, we prefer an alternative approach that takes function into account, but also includes
keep her
managing problem busyinfor
behavior thesome
context time. She
of skill planned to
development. Thiscontinue
approach with Activity
includes 4 and the
two components:
other
(1) The Essential ‘possible
Eight, deficits’
the must-have skillswhen
in skill significant
domains 1, 2,progress
4, and 6, wasin themade
absence onofthe 8 confirm-
which problem
Providing Effective Treatment for Problem Behavior and Recording Progress
behaviors tendedtodeficits.
occur, and (2) function-based teaching protocols which include procedures designed to
teach
The these skills
effective and, at of
treatment theproblem
same time, decrease
behavior can thebe frequency
accomplished of problem behaviorsa that tendfunctional
to occur
How to conduct
in their absence.
anEssential
assessment
The Iwata, Eight
of problem
were initially
behavior.
described
Beginby conducting
conducting anformal,
assessment of
assessment (Beavers, and Lerman, 2013). The results in chapter
provide an1estimate
and are of
presented
whether again in prob-
specific Table
specific
14, along
lem problem
with are
behaviors the a behaviors
likely function
function by completing
of problem
of one or morebehaviors Activity
that occur
of the following 1 and noting
typesinoftheir the responses
absence.events:
consequent of inter-
viewees to the Quick Assessment or by carefully observing each learner and...
attention, Table 14.
defining
avoidanceproblem
or The behaviors
Essential
escape fromEightas and
instances
demands, the Likely or episodes,
Functions of and designate
Problem each as self-injurious
Behaviors
(SIB), aggressive(Agg),
access to tangible items anddestructive(Des),
thatactivities,
Occur in the disruptive(Dis),
or Absence of These Skills or repetitive (Rep);
recording
some sort the daily frequency of instances
of automatically-occurring sensory event.or episodes of these behaviors on the Problem
The Essential
Behavior Eight: Eight Must-have
Direct Observation and Interview Skills that
Form are
orpart
a dataof Skill Domains
sheet 1, 2,choice
of your 4, and 6and display
In other words, the results indicate whether specific problem behaviors are followed by and maintained by
One. these
MAKING data on a graph
REQUESTS for an or chart;
One. MAKING REQUESTS for the One. MAKING REQUESTS for
one or more of these types of consequent events. Then, as part of behavioral treatment that is based on
audience
recording the intensity of these removal
behaviors or reduction
(Sev, Mod,
function, examples of these types of events are withheld when problem behaviors in intensity
Mild); preferred
occur and items and
then made
recording
available the extentreplacement
when designated of
to which protective non-preferred
behaviors equipment
occur. situations activities
or mechanical restraints are used
and specify whether either Two.
is continuous (PEA or MRA) or contingent (PEC or MRC);
InOne.
mostMAKING REQUESTS
situations, we preferfor an alternative WAITING
approach that takes function into account, but also includes
recording the
companionship extent to which crisis stabilization
managing problem behavior in the context of skill development. procedures(CS)
This approach areincludes
used; two components:
(1) Therecording
One. MAKING the extent
Essential REQUESTS
Eight, the for to which
must-have theinACCEPTING
skills
Three. learner exhibits
skill domains 1, 2,self-restraint
REMOVALS 4, and 6, in (SR);
-- the and,
the absence of which problem
after
behaviors 6-10
tend
affectiontodays,
occur,transfering these data
and (2) function-based Removalto theofARP
teaching or theItems
protocols
Preferred EARP
which Manual (see next page).
include procedures designed to
teach these skills and, at the same time, decrease the frequency of problem behaviors that tend to occur
and Activities,by
Making
Then, begin conducting a functional assessment
in their absence. The Essential Eight were initially described
estimating
in chapter
which of the Essential Eight
1 and are presented again in Table
Transitions, Sharing, and
Skills did not occur when these behaviors occurred
14, along with the likely function of problem behaviors and, thereby, indirectly estimating their
that occur in their absence.
Taking Turns
function. Three of the Essential Eight Skills and their likely functions are shown below.
Table 14.
One. MAKING REQUESTS for Four. COMPLETING REQUIRED TASKS --
The Essential Eight and the Likely Functions of Problem Behaviors
feedback, approval, or 10 Consecutive, Brief, Previously
that Occur in the Absence of These Skills
confirmation Acquired Tasks
The Essential
One. MAKING REQUESTSEight:
for EightFive.
Must-have Skills that
ACCEPTING ‘NO’are part of Skill Domains 1, 2, 4, and 6
acknowledgment
One. MAKING REQUESTS for an One. MAKING REQUESTS for the One. MAKING REQUESTS for
audience removal or reduction in intensity preferred items and
Six. FOLLOWING DIRECTIONS Related
of non-preferred situations activities
to Health and Safety
One. MAKING REQUESTS for Two. WAITING
Seven. COMPLETING DAILY LIVING
companionship
SKILLS Related to Health and
One. MAKING REQUESTS for Safety
Three. ACCEPTING REMOVALS -- the
affection Removal of Preferred Items
Eight. TOLERATING SITUATIONS
and Activities, Making
Related to Health and Safety
Transitions, Sharing, and
Taking Turns
One. MAKING REQUESTS for Four. COMPLETING REQUIRED TASKS --
The Likely Functions of Problem Behaviors that Occur in the Absence of The Essential Eight
feedback, approval, or 10 Consecutive, Brief, Previously
attention
confirmation avoidance or escape
Acquired Tasks from demands, access to tangible items or
and, possibly, attention as well activities, and, possibly,
One. MAKING REQUESTS for Five. ACCEPTING ‘NO’
attention as well
acknowledgment

Six. FOLLOWING DIRECTIONS Related

to Health and Safety
Seven. COMPLETING DAILY LIVING
SKILLS Related to Health and
 Essential for Living: An Introduction and User Guide 15

Or, begin conducting a formal, functional assessment.

An initial assessment of problem behavior for a learner with self-injurious behavior and a
limited speaking repertoire is described below and depicted in the diagram:
The learner hits his own head with his fist, typically in the absence of ‘making requests’ (R7)
and ‘waiting after making requests’ (R9). His treatment team decided to record episodes of
this behavior, rather than instances, as ‘hits’ often occur in rapid succession, making them
difficult to record. During the initial assessment, the intensity was severe (Sev); episodes
occurred from 20-50 times per day (20-50D). The learner was taking 2 psychoactive medi-
cations per day (Med2), wore a protective helmet continuously (PEA, PE), did not require
mechanical restraints (-MR), and did not exhibit self-restraint (-SR). He did, however, require
the use of crisis stabilization procedures from 2-5 hours per week (CS 2-5hW).

PB1 (Problem Behavior 1): hits own head with his fist

IA IM Instance Episode SIB Agg Des Dis Rep

Sev Mod Mild
Med3+> Med3+ Med3+< Med2> Med2 Med2< Med1> Med1 Med1< -Med
PEA PEC PE>2 PE>1 PE PE<1 PE<2 PE<3 -PE
MRA MRC MR>2 MR>1 MR MR<1 MR<2 MR<3 -MR

CS CS CS
CS>5hW CS<30mW -CS
2-5hW 1-2hW 30m-1hW

SR>2 SR>1 SR SR<1 SR<2 SR<3 -SR

>100D 50-100D 20-50D 10-20D 1-10D <1D <1W <1M <1Y

PB1 occurs in the absence of these skills:

R7 & R9

Mechanical Restraints: Protective Equipment:

MRA- continuous MRC- contingent PEA- continuous PEC- contingent
MR>2 have been increased twice PE>2 has been increased twice
MR>1 have been increased once PE>1 has been increased once
MR at the time of the initial assessment PE at the time of the initial assessment
MR<1 have been partially faded once PE<1 has been partially faded once
MR<2 have been partially faded twice PE<2 has been partially faded twice
MR<3 have been partially faded 3 times PE<3 has been partially faded 3 times
-MR are not required -PE is not required

Crisis Stabilization Procedures: Self-restraints:

CS>5hW are used more than 5 hrs./week SR>2 have been increased twice
CS2-5hW are used 2-5 hrs./week SR>1 have been increased once
CS1-2hW are used 1-2 hrs./week SR at the time of the initial assessment
CS30m-1hW are used 30 mins. -- 1 hr./week SR<1 have been partially faded once
CS<30mW are used < 30 mins./week SR<2 have been partially faded twice
-CS are not required SR<3 have been partially faded 3 times
-SR self-restraints are not occurring
16 Essential for Living: An Introduction and User Guide

Psychoactive Medications:
Type of Problem Behavior:
Med 3+> 3 + medications with some increases in dosage
SIB: Self-injurious
Med 3+ 3 + medications
Agg: Aggressive
Med 3+< 3 + medications with some reductions in dosage
Des: Destructive
Med 2> 2 medications with some increases in dosage
Dis: Disruptive
Med 2 2 medications
Rep: Repetitive
Med 2< 2 medications with some reductions in dosage
Med 1> 1 medication with some increases in dosage
Intensity of Problem Behavior:
Med 1 1 medication
Sev: Severe
Med 1< 1 medication with some reductions in dosage
Mod: Moderate
-Med No medications
Mild: Mild

Teaching and Recording Learner Progress

Teaching Specific Skills and Managing Problem Behaviors. After conducting an assessment
of functional skill deficits and problem behaviors, begin reducing the extent of those deficits,
along with the intensity and frequency of those behaviors, by using the Teaching Protocols
that begin on page 265 of the Essential for Living handbook. Each of these protocols
includes procedures that have been validated in the scientific literature. The first four steps
of Teaching Protocol 1 are provided below.

Teaching Protocol 1. Making Requests (R7-8, R14, R17-21)

[this protocol includes the echoic-to-request teaching procedure
and can be used with any skill that includes making requests]
What to Do What Not to Do
1. Make items and activities available that are highly preferred; 1. Say, “What do you
wait for the learner to indicate by gesturing what he ‘wants’ at want?”
that moment; proceed to step 2 or 3
2. For learners aligned with Vocal Profiles 1 or 2 (i.e., learners who 2. Say part of the word
reliably repeat spoken words) immediately provide an echoic or phrase…
prompt -- say the word or phrase that corresponds to the item
or activity the learner wants (e.g., “cookie”); if a learner’s repe-
titions are controlled, also provide a vocal cue to do so (e.g.,
“say, (pause) cookie”)
For learners who use an alternative method of speaking, pro- or, provide a partial
vide an immediate full demonstration prompt or a full physical demonstration or
prompt of the sign, picture or word selection, or typed word partial physical
until the learner makes the appropriate response; then, pro- prompt
ceed to step 4
3. If the learner makes the appropriate response several consec-
utive times, begin to fade the prompts; fade echoic prompts
all-at-once, fade demonstration prompts all-at-once or grad-
ually, and fade full physical prompts gradually; proceed to
step 4
 Essential for Living: An Introduction and User Guide 17

4. If the learner exhibits the appropriate word, forms the appro-

priate sign, selects the appropriate picture or printed word, or
types the appropriate word, say the word and provide access
to the requested item or activity; if a learner who uses an alter-
native method of speaking, says part or all of the word, pro-
vide an additional amount or duration of the item or activity;
proceed to steps 1 & 3 until all prompts have been completely
faded; continue returning to step1 until the learner is making 10
requests from R7, R8, R14, and R17-21

Recording Learner Progress. Some people choose to record learner progress by using their
own data sheets, graphs, or anecdotal progress notes. Essential for Living, however, provides
a sensitive method of recording learner progress that should be strongly considered. And,
while it requires several weeks to become familiar with this method, the outcome is the
documentation and summarization of small increments of learner progress with respect to
both functional skills and problem behaviors.
Shown below is an assessment of a specific skill (R7) previously depicted on page 13 of this
guide.

R7. Makes requests for highly preferred snack foods, drinks, non-food items, …
1 crackers IA IM -SA -DC -RP FP PP MP Ind 2S 2P <M NI Det
2 grape juice IA IM -SA -DC -RP FP PP MP Ind 2S 2P <M NI Det
When motivating events occur, learners request specific items, activities, or persons, or
request specific information consistent with those events on three consecutive occasions...
IA [ the initial assessment of this skill has been completed ]
IM [ instruction or management has begun ]
-SA without self-injurious, aggressive, or destructive behavior
-DC without disruptive behavior or complaints
-RP without resistance to prompts and without leaving the area
FP with a full physical, full demonstration, or full echoic prompt
PP with a partial physical, partial demonstration, or
partial echoic prompt
MP with a minimal touch, minimal gestural, or minimal echoic prompt
Ind without prompts, without scrolling, and within two seconds
2S in two or more settings
2P in the presence of either of two people
<M when motivating events have occurred, but are weak
NI when the learner does not have sensory contact with the requested item or
activity (does not apply to some requests)
Det [ requests are no longer occurring consistently ]

After the assessment was completed, instruction was begun using Teaching Protocol 1 and
data was collected using a first-opportunity, probe, self-graphing data sheet, which was
downloaded from www.essentialforliving.com. A portion of this data sheet is shown on the
top of the next page.
18 Essential for Living: An Introduction and User Guide

Essential for Living

Makes Requests: First Opportunity of the Day Probe Data Recording Form

Day/Date and First Opportunity of the Day Probe

Specific Request 15 16 17 18 19 20 21 22 23 24 25 26 27
S M T W T F S S M T W T F

R7. crackers NI NI NI NI NI NI NI NI NI NI NI NI NI
<M <M <M <M <M <M <M <M <M <M <M <M <M
2P 2P 2P 2P 2P 2P 2P 2P 2P 2P 2P 2P 2P
2S 2S 2S 2S 2S 2S 2S 2S 2S 2S 2S 2S 2S
Ind Ind Ind Ind Ind Ind Ind Ind Ind Ind Ind Ind Ind
MP MP MP MP MP MP MP MP MP MP MP MP MP
PP PP PP PP PP PP PP PP PP PP PP PP PP
FP FP FP FP FP FP FP FP FP FP FP FP FP
-RP -RP -RP -RP -RP -RP -RP -RP -RP -RP -RP -RP -RP
-DC -DC -DC -DC -DC -DC -DC -DC -DC -DC -DC -DC -DC
-SA -SA -SA -SA -SA -SA -SA -SA -SA -SA -SA -SA -SA
0 0 0 0 0 0 0 0 0 0 0 0 0

Several days each week, the teacher conducted one or more instructional sessions during
snack and lunch time. Before the first session of the day, she provided the learner with an
opportunity to respond without prompts and only added prompts when they were neces-
sary for him to make the request. The learner’s performance on this first opportunity was
recorded on this data sheet and no other data on this skill were recorded that day.
As shown on the data sheet, the learner continued to require a full, physical prompt on the
first two days of instruction. On the first day of the following week, however, on the first
opportunity of that day, he made the request with only a partial, physical prompt. Then, on
Tuesday and Thurdsay of that week, he repeated that same performance. Then, as a result
of three consecutive instances of improved performance on the first opportunity of the day,
his teacher recorded this performance in his scoring manual (see below).

R7. Makes requests for highly preferred snack foods, drinks, non-food items, …
1 crackers IA IM -SA -DC -RP FP PP MP Ind 2S 2P <M NI Det
2 grape juice IA IM -SA -DC -RP FP PP MP Ind 2S 2P <M NI Det
When motivating events occur, learners request specific items, activities, or persons, or
request specific information consistent with those events on three consecutive
occasions...
IA [ the initial assessment of this skill has been completed ]
IM [ instruction or management has begun ]
-SA without self-injurious, aggressive, or destructive behavior
-DC without disruptive behavior or complaints
-RP without resistance to prompts and without leaving the area
FP with a full physical, full demonstration, or full echoic prompt
PP with a partial physical, partial demonstration, or
partial echoic prompt
MP with a minimal touch, minimal gestural, or minimal echoic prompt
Ind without prompts, without scrolling, and within two seconds
2S in two or more settings
2P in the presence of either of two people
<M when motivating events have occurred, but are weak
NI when the learner does not have sensory contact with the requested item or
activity (does not apply to some requests)
Det [ requests are no longer occurring consistently ]
 Essential for Living: An Introduction and User Guide 19

The PP box was shaded in green to indicate the change in performance. Additional
improvements in performance on the first opportunity of the day for three consecutive days
during the same school year will be indicated by shading the appropriate boxes in green.
Improvements in performance in subsequent years will be indicated by other colors. Addi-
tional assessments will continue to be shaded in yellow.
If a deterioration in performance were to occur, the Det box would be circled in pencil and
an arrow would be drawn from that box to the box that indicates the deteriorated perfor-
mance. As shown in the diagram below, the learner, who was respondiing with a partial
physical prompt, began to wait for a full physical prompt. When, the learner’s performance
returned to its previous level, the pencil marks were erased.

R7. Makes requests for highly preferred snack foods, drinks, non-food items, …
1 crackers IA IM -SA -DC -RP FP PP MP Ind 2S 2P <M NI Det
2 grape juice IA IM -SA -DC -RP FP PP MP Ind 2S 2P <M NI Det
When motivating events occur, learners request specific items, activities, or
persons, or request specific information consistent with those events on three
consecutive occasions...
IA [ the initial assessment of this skill has been completed ]
IM [ instruction or management has begun ]
-SA without self-injurious, aggressive, or destructive behavior
-DC without disruptive behavior or complaints
-RP without resistance to prompts and without leaving the area
FP with a full physical, full demonstration, or full echoic prompt
PP with a partial physical, partial demonstration, or
partial echoic prompt
MP with a minimal touch, minimal gestural, or minimal echoic prompt
Ind without prompts, without scrolling, and within two seconds
2S in two or more settings
2P in the presence of either of two people
<M when motivating events have occurred, but are weak
NI when the learner does not have sensory contact with the requested
item or activity (does not apply to some requests)
Det [ requests are no longer occurring consistently ]

As has been shown on the past few pages, the learner’s performance on all skills that have
been assessed can be precisely documented. And, on skills in which instruction has begun,
small increments of progress or deterioration can also be documented.
In each of the learner scoring manuals, performance on these skills can also be summar-
4 A Summary of the Learner’s Assessments and Subsequent Progress (SAP)
ized ‘by skill number’ or ‘by skill number and current performance level’. Small segments of
each of these summary pages are provided below and on the next page. The first is a
summary ‘by skill number’, which is shown below.
ESSENTIAL FOR LIVING
A Summary of the Learner’s Assessments and Subsequent Progress
on The Essential Eight Skills (SAP)
Must-have Indications of interest, Requests, and Related Listener Responses.... Part of Domain 1 (R)
Indications of Interest and Initial Requests R1 R2 R3 R4 R5 R6 R7 1 2 3 4 5 6 7 8 9 10

Special Requests and Waiting R8 1 2 R9 1 2 3 4 5 6 7 8 9 10

Accepting Removals R10 1 2 3 4 5 6 7 8 9 10

Completing Required Tasks, Sharing and Taking Turns R11 R12 1 2 3 4 5 6 7 8 9 10

Making Transitions R13 1 2 3 4 5 6 7 8 9 10

Requests for Removal or Reduction and Accepting No R14 R15 1 2 3 4 5 6 7 8 9 10 R16 1 2 3

20 Essential for Living: An Introduction and User Guide

As you can see in this summary diagram, only one box is provided for each skill and the
scoring is yes/no (binary). As a result, our learner’s performance on skill R7-1, requesting
crackers, can only be summarized, either during an assessment or after instruction has be-
gun, when prompts are no longer required.
A Summary of the Learner’s Assessments and Subsequent Progress (SAP
The second summary is ‘by skill number and current performance level’ and is shown below.
This time, the learner’s performance during the assessment, and after instruction has begun,
can easily be summarized before, while, and after prompts are required.
ESSENTIAL FOR LIVING
A Summary of the Learner’s Assessments and Subsequent Progress
on Specific Performance Levels of The Essential Eight Skills (SAP)
Must-have Indications of Interest, Requests, and Related Listener Responses.... Part of Domain 1 (R)
R1 R2 R3 R4 R5 R6 1 2 5 10 R7 1 -SA-DC-RP FP PP MP Ind 2S 2P <M NI 2
3 -SA -DC -RP FP PP MP Ind 2S 2P <M NI 4 5 6
7 8 9 10
R8 1 -SA -DC -RP FP PP MP Ind 2S 2P <M NI 2 -SA -DC-RP FP PP MP Ind 2S 2P <M R9 1 1s 2s 5s 10s 20s 1m 2m 5m 10m20m 2
3 4 5 6
7 8 9 10
R10 1 -SA -DC -RP FP PP MP Ind 2S 2P >M 2 3 4
As shown
5 below, in a continuation 6 of the previous example, 7 Essential for Living also 8 permits
users to
9 track learner progress 10 with respect to problem R11 behaviors,
1 2 5 10andR12the supports
1 -SA-DC those
-RP FP PP MP Ind 2S 2P >M
behaviors
2 may require over extended 3 periods of time. 4 5
6 7 8 9
At the end of the first school year (indicated by the boxes shaded in green), our learner was
10 R13 1 -SA-DC-RP FP PP MP Ind 2S 2P >M 2 3
exhibiting
4
fewer (10-20) episodes 5
of head-hitting per day, 6
but with the same intensity.7
He
continued
8 to wear a helmet continuously
9 and required the
10 same two medications, but with
R14 -SA -DC -RP FP PP MP Ind
a R15
dosage reduction.
1 -SA -DC 2S 2P >M 2 In addition, 3he required only 4 30 minutes5 to one hour 6 of crisis stabili- 7
zation 9procedures per 10 week. R16 1 -SA-DC 2S 2P >M 2 3 R17 -SA -DC -RP FP PP MP Ind 2S
ByR18
the 1end of-RPthe
-SA -DC FP PPsecond 2P <M 2 year (indicated by the3 boxes shaded in pink), our
MP Ind 2S school R19 learner
-SA -DC -RP FP PP MP Ind
R20 -SA -DC -RP FP PP MP Ind 2S 2P <M NI R21 -SA -DC-RP FP PP MP Ind 2S 2P
was exhibiting less than one episode of head-hitting per day with less intensity, was taking
only one Must-have
medication, Listener
and Responses:
was wearingFollowing theDirections
helmet Related to Healthalthough
continuously, and Safety.... Part of
it had Domain 2 (LR)
been
reduced
LR1 1s 2sin 5ssize 3 times.
10s 20s 1m 2m 5m And,
10m20m our
LR2 learner noPPlonger
-SA -DC -RP FP MP Ind 2S required
2P LR3 crisis stabilization procedures.
LR4 1s 2s 5s In
10s 20s 1m 2m 5m
summary,
LR5 -SA -DCover a MP
-RP FP PP 2 year period
Ind 2S 2P LR6 of time, our learner LR7 demonstrated
10s 20s 1m 2m 5m substantial
LR8 20s 1m 2m improvement
5m 10m20m
LR9respect
with -SA -DC -RPto
FP both 2S 2P LR10
PP MP Indproblem behaviors and the supports LR11 20sthose
1m 2m 5mbehaviors
10m20m required.
Must-have Daily Living Skills Related to Health and Safety.... Part of Domain 4 (DLS)
PB1 (Problem Behavior 1): hits own head with his fist
DLS- EDF1 -SA -DC-RP FP PP MP Ind PPA APD CO 2S 2P EDF2 1 -SA-DC-RP FP PP MP Ind PPA APD CO 2S 2P 2 -SA-DC-RP FP PP MP Ind PPAAPD CO 2S 2P
IA3 IM Instance Episode EDF3 1 SIB Agg Des 2 Dis Rep
3 EDF4 1 2
3 EDF5 1
Sev Mod
2
Mild
3
Med3+> Med3+ Med3+< Med2> EDF6Med2
1 Med2< Med1> Med1 2 Med1< -Med
3 EDF7 1 2
PEA PEC PE>2 PE>1 PE PE<1 PE<2 PE<3 -PE
3 EDF8 -SA-DC-RP FP PP MP Ind PPA APD CO 2S 2P EDF9
MRA MRC
Slp1 -SA -DC-RP FP PP MP Ind PPA APD MR>2 MR>1
CO 2S 2P Slp2 MR MR<1 MR<2 MT1MR<3 1st 1/4 1/2 3/4-MR
Ind _m PPA APD CO 2S 2P
MT2 MT3 MT4
MT5 -SA -DC-RP FP PP MP IndCS>5hW CS
PPA APD CO 2S 2P AHS1
AHS1-SA-DC-RP CS
FP PP MP Ind PPACS 2P AHS2
APD CO 2S CS<30mW -CS
AHS3 2-5hW
AHS4 1-2hW 30m-1hW AHS5
AHS6 SR>2 SR>1AHS7 SR SR<1 SR<2 AHS8
SR<3 -SR
AHS9 AHS10 AHS11
>100D
AHS12 50-100D 20-50D 10-20D AHS13 1-10D <1D <1W <1M AHS14 <1Y
AHS15 HS1 1st 1/4 1/2 3/4 Ind _m PPA APD CO 2S 2P HS2
HS3 HS4 -SA-DC-RP FP PP MP Ind PPA APD CO 2S 2P HS5
HS6 HS7 HS8 1st 1/4 1/2 3/4 Ind _m PPA APD CO 2S 2P
Must-have Tolerating Skills Related to Health and Safety.... Part of Domain 6 (T)
T- BHI1 Egg -Egg 10s 1m 1/4 1/2 3/4 Ind BHI2 BHI3 BHI4 BHI5
EDF1 Egg -Egg 10s 1m 1/4 1/2 3/4 Ind EDF2 EDF3 EDF4 EDF5
 Essential for Living: An Introduction and User Guide 21

Some of the Skills of Essential for Living

There are hundreds of must-have, should-have, good-to-have, and nice-to-have skills which
are included in the seven skill domains of Essential for Living. Some of these skills are listed on
the next few pages .
Domain 1: Requests and Related Listener Responses
R1-5. Interests of the learner... as determined by instructors, parents, and care providers,
and... as indicated by the learner
R7. Makes requests for highly preferred snack foods, drinks, non-food items, or activities
that can be made frequently and immediately available
R9. Waits after making requests for each of the items and activities in R7 and R8 for
gradually increasing periods of time
R15. ‘Accepts no’ after making requests for items and activities that were taught and are
often honored (R7, R8, and R14)
R17. Makes very forceful and repeated requests for a stranger, an intruder, a person
teasing, threatening, bullying, or instigating a fight, or a person making sexual
advances to ‘go away’
R18. Makes a generalized request for help in a threatening or dangerous situation, by
yelling “help”, screaming, or otherwise making contact with an audience, calling
‘9-1-1’, or activating a medical alert device
R19. Makes a generalized request for an audience, followed by requests for items or
activities in R7 and R8
R23. Makes requests for highly preferred items and activities that cannot be made either
frequently or immediately available
R28. Says “thank you” when requests are honored
R38. Makes a request to delay the onset of a required activity
R44. Makes requests from peers
R47. Makes a request for assistance during menstruation
R49. Makes a request for privacy and to increase personal space
R54. Makes a request for others to clarify something they have said
R59. Makes a request to perform an activity without assistance
R72. Makes requests that require 2 words, signs, or pictures and that include a specific
item or activity, for which a request was previously acquired, along with a feature or
a specific quantity
R84. Makes requests for information, with 2-4 key words or signs, regarding the location of
items, people, or places, some with features [‘where’ questions]
Domain 2: Listener Responses, Names, and Descriptions
LR1. Holds and maintains contact with the hand of an instructor, care provider, or parent
when directed to do so
LR2. Moves toward and stands or sits next to an instructor, care provider, or parent when
directed to do so
LR10. Turns toward others when her/his name is called and makes two consecutive listener
responses from LR1-9
LR11. Fastens a seat belt while in a car, a car seat, or a mobility device and remains in the
seat belt for gradually increasing periods of time when directed to do so
LR12. Completes five activities of dressing and personal hygiene when directed to do so
LRND1.1 Breakfast -- Recognizes a spoon, a bowl, and a cup; Retrieves a spoon, a bowl, and
a cup; Relocates a spoon, a bowl, and a cup (to the dishwasher); Names a spoon;
Wipes the table; Describes wiping the table
22 Essential for Living: An Introduction and User Guide

Domain 3: Answers to Questions and Conversations

AQ.1.1 Breakfast -- When a spoon, bowl, or cup is missing, answers the question ‘What do
you need’
C1.1 Breakfast -- Participates in a conversation with two exchanges
Domain 4: Daily Living and Related (Leisure and Vocational) Skills
DLS-EDF1. Consumes thick or thickened liquids orally
DLS-EDF4. Chews three soft foods
DLS-EDF18. Wipes mouth and hands with a napkin
DLS-EDF21. Feeds self cereal
DLS-MM4. Administers own pills or vitamins using a weekly pill sorter
DLS-Slp5. Remains in own bed throughout the night
DLS-MT8. Walks with a gait trainer
DLS-MT16. Rides a train, bus, or taxi to 5 specific locations
DLS-Toil6. Urinates and defecates in the toilet
DLS-BPH1. Washes hands
DLS-BPH8. Applies and changes a sanitary napkin or tampon during menstruation
DLS-BPH19. Applies deodorant
DLS-AHS10. Does not plug in or touch an iron
DLS-AHS12. Does not put harmful, non-nutritive items in their mouth
DLS-D25. Puts on socks, stockings, or leggings
DLS-D32. Fastens shoes with velcro
DLS-SIT12. Completes two-response tasks while working alone
DLS-SIT15. Returns to tasks after significant interruptions
DLS-SIT16. Participates in instruction with 2-4 peers
DLS-V3. Participates in supported employment
DLS-RDA5. Cleans own room
DLS-HS4. Fastens and remains in a seat belt for the duration of specific trips
DLS-HS8. Engages in safe, personal, sexual behavior in an appropriate setting
DLS-C2. Washes and dries dishes
Domain 5: Functional Academic Skills
Responses to Text as a Listener and Reading Skills
RTL2. Responds appropriately to public safety, street, and emergency signs (e.g.,
‘Walk’, ‘Don’t Walk’, ‘Wet Floor’)
RTL11. Selects items from restaurant menus that include printed-words or Braille letters,
such as, ‘blueberry waffles’, ‘scrambled eggs and bacon with toast’,
‘cheeseburger and french fries’, and others
Rdg4. Reads the text on containers of common food and non-food items that
represent some risk of safety (e.g., ‘Ant and Roach Spray’, ‘Furniture Polish’)
Schedules, Lists, and Time
SLT1. Participates in events and activities slated to occur later that same day using a
personal, daily, picture or tactile schedule
Math Skills
Mth1. Counts a specified number of items from 1-10 using an inset counting jig
Mth10. Makes purchases using a debit or credit card
Mth12. Makes purchases with coins using a vending machine
Writing or Typing Skills
WT7. Writes, types, or Braille writes words that often appear on shopping lists
 Essential for Living: An Introduction and User Guide 23

Domain 6: Tolerating Skills and Eggshells

T-EDF1. A gastrostomy or nasogastric tube
T-EDF3. Thickened liquids
T-DM9. Ventilation and suction
T-BHI5. Touch, guidance, or physical prompts
T-PTA9. AFOs
T-C1. Someone putting on your clothes
T-DD1. Someone brushing your teeth
T-Trp3. Seat Belt
T-Toil9. Public restrooms
T-PRM3. A corner chair
T-ORM1. A heart and lung examination with a stethoscope
T-BHI7. The word “no” or other indications of disapproval or incorrect responding
T-BDA2. A change in a schedule or sequence of events
T-BDA5. Not being first or first in line
T-HC2. Vacuum cleaners
Domain 7: Tool Skills and Component Skills
MM2. Reaches for items
MM7. Grasps items
M3. Matches items to corresponding containers or locations
Im2. Imitates motor movements with items

Getting Started with Essential for Living

To get started using Essential for Living, the following 7 steps are suggested:
Step 1 -- Read chapters 1-4 of the Professional Practitioner’s Handbook;
Step 2 -- Select a child or an adult with moderate-to-severe disabilities and problem
behavior or a limited skill repertoire, or both, and obtain a copy of the
Assessment and Record of Progress [ARP] Manual or the Essential Assess-
ment and Record of Progress [EARP] Manual;
Step 3 -- Conduct an Assessment of Skill Deficits: Activities 1-4 as described on pages
28 and 29 and chapters 5 and 6 of the handsbook;
Step 4 -- Conduct an Assessment of Problem Behavior, including the supports these
behaviors may require as described on pages 30-32 of the handbook;
Step 5 -- Select 5-8 skills deficits and problem behaviors for inclusion in the learner’s
IEP, ISP, behavior plan, hab plan, or instructional plan, and begin instruction
and behavior management using the Teaching Protocols in chapter 12 of
the handbook;
Step 6 -- Track learner progress using your own data sheets or self-graphing data
recording forms from www.essentialforliving.com and periodically transfer
data to the ARP or EARP Manual as described on pages 33-37 of the hand-
book; and,
Step 7 -- As the learner acquires skills that have been assessed, or priorities change in
the life of the learner, conduct another assessment (Steps 3 and 4) and iden-
tify new skills or problem behaviors.
24 Essential for Living: An Introduction and User Guide

The

EL IVING
SSENTIAL
FOR

Speaker Initiative
There are many thousands of children and adults
with moderate-to-severe disabilities,
and
No Effective Method of Speaking.
As a direct result, many of these individuals
exhibit problem behavior, which limits their
participation in community activities.
The goal of ‘The Essential for Living Speaker Initiative’
is to provide a method of speaking for as many of
these children and adults as possible and to expand
their speaking repertoires to include requests for a
wide variety of preferred items and activities.
To accomplish this goal, we need to...
1- Identify these children and adults one at a time,
2- Select a method of speaking for each of them,
and
3- Teach each one of them to make requests
for their most preferred items and activities.
Essential for Living will help you accomplish these
goals and become part of this initiative.

For more information on helping

these children and adults become speakers...

www.essentialforliving.com