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Chaining is a type of intervention that aims to create associations between behaviors in a behavior chain. A behavior chain is a sequence of behaviors that happen in a particular order where the outcome of the previous step in the chain serves as a signal to begin the next step in the chain. In terms of behavior analysis, a behavior chain is begun with a discriminative stimulus (SD) which sets the occasion for a behavior, the outcome of that behavior serves as a reinforcer for completing the previous step and as another SD to complete the next step. This sequence repeats itself until the last step in the chain is completed and a terminal reinforcer (the outcome of a behavior chain, i.e. with brushing one's teeth the terminal reinforcer is having clean teeth) is achieved. For example, the chain in brushing one's teeth starts with seeing the toothbrush, this sets the occasion to get toothpaste, which then leads to putting it on one's brush, brushing the sides and front of mouth, spitting out the toothpaste, rinsing one's mouth, and finally putting away one's toothbrush. To outline behavior chains, as done in the example, a task analysis is used.


Chaining is used to teach complex behaviors made of behavior chains that the current learner does not have in their repertoire. Various steps of the chain can be in the learner’s repertoire, but the steps the learner doesn’t know how to do have to be in the category of can’t do instead of won’t do (issue with knowing the skill not an issue of compliance). There are three different types of chaining which can be used and they are forward chaining, backward chaining, and total task chaining (not to be confused with a task analysis).

Forward chaining

Forward chaining is a procedure where the learner completes the first step in the chain and then is prompted through the remaining steps in the chain. Once the learner is consistently completing the first step, one has them complete the first and second step then prompt the remaining steps and so on until the learner is able to complete the entire chain independently. Reinforcement is delivered for completion of the step, although they do not attain the terminal reinforcer (outcome of the behavior chain) until they are prompted through the remaining steps.

Backward chaining

Backward chaining is just like forward chaining but starting with the last step. The tutor will prompt the learner through all the steps in the chain except the last one. The learner will complete the last step in the behavior chain independently and once they are doing so consistently, one can begin to have them do the second to last step and the last step and so on until they complete all the steps in the chain independently. The biggest benefit of using a backwards chain is that the learner receives the terminal reinforcer (the outcome of the behavior chain) naturally. Backward chaining is the preferred method when teaching skills to individuals with severe delays because they complete the last step and see the direct outcome of the chain immediately rather than having to be prompted through the remaining steps to receive that reinforcement.

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B. F. Skinner American psychologist and social philosopher (1904-1990)

Burrhus Frederic Skinner was an American psychologist, behaviorist, author, inventor, and social philosopher. He was a professor of psychology at Harvard University from 1958 until his retirement in 1974.

Instructional design (ID), also known as instructional systems design (ISD), is the practice of systematically designing, developing and delivering instructional products and experiences, both digital and physical, in a consistent and reliable fashion toward an efficient, effective, appealing, engaging and inspiring acquisition of knowledge. The process consists broadly of determining the state and needs of the learner, defining the end goal of instruction, and creating some "intervention" to assist in the transition. The outcome of this instruction may be directly observable and scientifically measured or completely hidden and assumed. There are many instructional design models but many are based on the ADDIE model with the five phases: analysis, design, development, implementation, and evaluation.

Operant conditioning is a type of associative learning process through which the strength of a behavior is modified by reinforcement or punishment. It is also a procedure that is used to bring about such learning.


A toothbrush is an oral hygiene instrument used to clean the teeth, gums, and tongue. It consists of a head of tightly clustered bristles, atop of which toothpaste can be applied, mounted on a handle which facilitates the cleaning of hard-to-reach areas of the mouth. They are usually used alongside floss.

Reinforcement A consequence applied that will strengthen an organisms future behavior

In behavioral psychology, reinforcement is a consequence applied that will strengthen an organism's future behavior whenever that behavior is preceded by a specific antecedent stimulus. This strengthening effect may be measured as a higher frequency of behavior, longer duration, greater magnitude, or shorter latency. There are two types of reinforcement, known as positive reinforcement and negative reinforcement; positive is whereby a reward is offered on expression of the wanted behaviour and negative is taking away an undesirable element in the persons environment whenever the desired behaviour is achieved. Rewarding stimuli, which are associated with "wanting" and "liking" and appetitive behavior, function as positive reinforcers; the converse statement is also true: positive reinforcers provide a desirable stimulus. Reinforcement does not require an individual to consciously perceive an effect elicited by the stimulus. Thus, reinforcement occurs only if there is an observable strengthening in behavior. However, there is also negative reinforcement, which is characterized by taking away an undesirable stimulus. Changing someone's job might serve as a negative reinforcer to someone who suffers from back problems, i.e. Changing from a labourers job to an office position for instance.

Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities, gingivitis, and periodontal disease. People routinely clean their own teeth by brushing and interdental cleaning, and dental hygienists can remove hardened deposits (tartar) not removed by routine cleaning. Those with dentures and natural teeth may supplement their cleaning with a denture cleaner.

Discrete trial training (DTT) is a technique used by practitioners of applied behavior analysis (ABA) that was developed by Ivar Lovaas at the University of California, Los Angeles (UCLA). DTT uses direct instruction and reinforcers to create clear contingencies that shape new skills. Often employed as an early intensive behavioral intervention (EIBI) for up to 30–40 hours per week for children with autism, the technique relies on the use of prompts, modeling, and positive reinforcement strategies to facilitate the child's learning. It previously used aversives to punish unwanted behaviors. DTT has also been referred to as the "Lovaas/UCLA model", "rapid motor imitation antecedent", "listener responding", errorless learning", and "mass trials".

Adaptive behavior is behavior that enables a person to get along in their environment with greatest success and least conflict with others. This is a term used in the areas of psychology and special education. Adaptive behavior relates to everyday skills or tasks that the "average" person is able to complete, similar to the term life skills.

Applied Behavior Analysis (ABA), also called behavioral engineering, is a scientific technique concerned with applying empirical approaches based upon the principles of respondent and operant conditioning to change behavior of social significance. It is the applied form of behavior analysis; the other two forms are radical behaviorism and the experimental analysis of behavior.

Abrasion (dental)

Abrasion is the non-carious, mechanical wears of tooth from interaction with objects other than tooth-tooth contact. It most commonly affects the premolars and canines, usually along the cervical margins. Based on clinical surveys, studies have shown that abrasion is the most common but not the sole aetiological factor for development of non-carious cervical lesions (NCCL) and is most frequently caused by incorrect toothbrushing technique.


Dentifrices, including toothpowder and toothpaste, are agents used along with a toothbrush to clean and polish natural teeth. They are supplied in paste, powder, gel or liquid form. Many dentifrices have been produced over the years, some focusing on marketing strategies to sell products, such as offering whitening capabilities. The most essential dentifrice recommended by dentists is toothpaste which is used in conjunction with a toothbrush to help remove food debris and dental plaque. Dentifrice is also the French word for toothpaste.

A token economy is a system of contingency management based on the systematic reinforcement of target behavior. The reinforcers are symbols or tokens that can be exchanged for other reinforcers. A token economy is based on the principles of operant conditioning and behavioral economics and can be situated within applied behavior analysis. In applied settings token economies are used with children and adults; however, they have been successfully modeled with pigeons in lab settings.

Tooth brushing Manual abrasion of the surfaces of the teeth.

Tooth brushing is the act of scrubbing teeth with a toothbrush, usually equipped with toothpaste. Interdental cleaning can be useful with tooth brushing, and together these two activities are the primary means of cleaning teeth, one of the main aspects of oral hygiene.

Behavioral momentum is a theory in quantitative analysis of behavior and is a behavioral metaphor based on physical momentum. It describes the general relation between resistance to change and the rate of reinforcement obtained in a given situation.

Oral hygiene Cleaning the mouth by brushing the teeth and cleaning in between the teeth.

Oral hygiene is the practice of keeping one's mouth clean and free of disease and other problems by regular brushing of the teeth and cleaning between the teeth. It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath. The most common types of dental disease are tooth decay and gum diseases, including gingivitis, and periodontitis.

Backward design

Backward design is a method of designing an educational curriculum by setting goals before choosing instructional methods and forms of assessment. Backward design of curriculum typically involves three stages:

  1. Identify the results desired
  2. Determine acceptable levels of evidence that support that the desired results have occurred
  3. Design activities that will make desired results happen

A behavioral cusp is any behavior change that brings an organism's behavior into contact with new contingencies that have far-reaching consequences. A behavioral cusp is a special type of behavior change because it provides the learner with opportunities to access new reinforcers, new contingencies, new environments, new related behaviors (generativeness) and competition with archaic or problem behaviors. It affects the people around the learner, and these people agree to the behavior change and support its development after the intervention is removed.

Response Prompting Procedures are systematic strategies used to increase the probability of correct responding and opportunities for positive reinforcement for learners by providing and then systematically removing prompts. Response prompting is sometimes called errorless learning because teaching using these procedures usually results in few errors by the learner. The goal of response prompting is to transfer stimulus control from the prompt to the desired discriminative stimulus. Several response prompting procedures are commonly used in special education research: (a) system of least prompts, (b) most to least prompting, (c) progressive and constant time delay, and (d) simultaneous prompting.

Chaining is a technique used in applied behavior analysis to teach complex tasks by breaking them down into discrete responses or individual behaviors that are part of a task analysis. With a backward chaining procedure the learning can happen in two ways. In one approach the adult can complete all the steps for the learner and give the learner the opportunity to attempt the last one and prompt as needed. For the other approach the adult can prompt the learner throughout the steps on the chain and give the learner an opportunity to complete the last one independently. However, if unable to do so the adult helps by also prompting the learner through the last step and reinforcement is given to the learner once the last step is completed. Because independency is desired the goal is to remove the prompts as soon as the learner can complete the steps without help.

The Picture Exchange Communication System (PECS) is an augmentative and alternative communication system developed and produced by Pyramid Educational Consultants, Inc. PECS was developed in 1985 at the Delaware Autism Program by Andy Bondy, PhD, and Lori Frost, MS, CCC-SLP. The developers of PECS noticed that traditional communication techniques, including speech imitation, sign language, and picture point systems, relied on the teacher to initiate social interactions and none focused on teaching students to initiate interactions. Based on these observations, Bondy and Frost created a functional means of communication for individuals with a variety of communication challenges. Although PECS was originally developed for young children with autism spectrum disorder (ASD), its use has become much more widespread. Through the years, PECS has been successfully implemented with individuals with varying diagnoses across the aged span. PECS is an evidence-based practice that has been highly successful with regard to the development of functional communication skills.