Looking for Variables

Robert learned numbers (symbols,counting, names, order) by the time he was five years old. Soon after that he learned to add 1 to any other number.

And then for the  next five years he DID NOT LEARN  one math fact.

For five years! Nothing!

Not because he was not taught.  He was taught at school, he was taught at home.

School used not only flash cards, this antediluvian staple of American math education, but also cleverly designed program that involved cute counters and number cards.

I used counters, number line, two math curricula from SRA and yes, in my desperation, against my better judgement, and betraying my principles, I tried the  flash cards too.

Nothing worked!

Susan, the clinical supervisor of Robert’s program, sadly advised me to accept that Robert would never learn to add numbers.

Such outcome seemed both unavoidable and unacceptable.

The same week or month a parent on old ME-List advised another parent to use Saxon Math with her child.  Since the price was not prohibitive I ordered it without really knowing what I was buying.


The order in which  math facts were introduced seemed  counter-intuitive to me.  The first math facts to remember were additions of duplicates: 1+1, 2+2, 3+3 and so on.  It took Robert a week to add duplicates until 5+5.  It took him another week to memorize additions from 6+6 to 10+10.

Although it seemed so strange at first I quickly understood how much simpler  8+8 was than 2+4.  In the first addition there was  one number to remember.  So it sufficed to just learn that 8 was related to 16.  In the second addition there were two numbers.  You had to remember them both and that was hard for Robert. Which of the two numbers  is the  important one?  The first one or the last one?   It cannot be 4 because 1+4 is not the same as 2+4. It cannot be 2 because…

The second step in memorizing addition fact was to practice adding double plus one in the form: 1+2, 3+4, 7+8…

The problem 7+8 was written next to 7+7.  Since Robert knew the first fact and knew how to add one to any number he didn’t have much problem with 7+8.

Yet, that was just a mechanical approach.  Without seeing 7+7 first Robert was not able to solve 7+8.

I added new worksheets.  I wrote 7+8 first and 7+7 next so Robert would learn to use the second problem  as a support for the first one. Just looking to the right  was an important step.  Next, I wrote only 7+8 and next to it I drew empty squares.  Robert filled those squares with supporting addition 7+7 =14 and then solved  7+8.  In the  next step  I wrote just 7+8  and let Robert write himself   the next column.  Finally I wrote 7+8  but when Robert wanted to write 7+7 next to it I blocked the space.  He had to write an answer to 7+8 as he deduced it in his head without writing 7+7 on the paper.

So Robert knew how much was 8+9 before he knew 2+4.

Similar trick I used with practicing adding 2 to the number.

Someone (surprisingly a parent) asked me why I spent so much time on teaching addition instead of just introducing a calculator.

The answer is complicated. Of course it is nice that Robert can add, subtract, multiply and divide large numbers.  Typical people and peers with disabilities  who because of Robert  terrible problems with communication tend to  dismiss him after first encounter, might  realize that he has some relatively advanced skills.

I also believe that in this process Robert learned not just how much is 7+8 but also some strategies that he might one day apply to solving other problems.

However,  the main point of teaching Robert math facts was to LEARN how ROBERT LEARNS.  To find out what works, what doesn’t. During this process  I realized that Robert had problem with short and/or working memory. But I also discovered  that Robert learns through patterns.  Moreover, I  found out that even when he doesn’t have any visual support Robert  can still solve problems by using his mind.

Thank You, Ruth

Soon after my son’s diagnosis I met with many specialists familiar with autism.   What I noticed was that the specialists I talked to about Robert released only that information which I already had.  When I knew less, they told me less.  When I knew more, they told me more, but not more than I already knew.  The benefits of these appointments were that the specialists wrote reports.  They put all the information I had  in writing and legitimized it with their signatures with “PhD” respectfully displayed at the end of their names. That did help with schools.

But it was not enough for Robert.

Ruth A.  never met my son but, nonetheless, helped him the most.  She helped me to learn how to  help my son.  From one of the campuses of Indiana University she sent an internet list.  ME- List.  I think that it was  very hard for her to moderate the list where overeager and overstressed parents without any  other place to turn to for instruction and emotional support gathered  to learn, to share, and to vent their frustrations.  The ME-List was a life saver for me, because I, too, was overstressed, overeager,frustrated,  completely lost, and  bitterly lonely.

But most importantly I got concrete, useful, and usable information.  Information that allowed me to try new approaches, to move forward when I was trapped, to find resources.

Have I not heard from ME_LIST parents then about Edmark Reading Program (I believe it was not on the disk yet only in an immense plastic case) or such  SRA Publications like Horizon Reading, Language for Learning, Reasoning and Writing (SRA is now a division of McGraw-Hill) my son would not read, would not write, would not learn important language concepts.

Have I not heard about Saxon Math my son would not add numbers up to ten, and certainly would not add fractions with different denominators. I would not supplement his math program with Math U See   (for extra practice) or with Singapore Math (for clarification of concepts) have it not been for an advice provided by one of the parents on Me- LIST

Have I not heard about Fun Deck cards from Super Duper School Company and language workbooks from Great Ideas  for Teaching, my son’s language would be in much, much worse shape.  (Well, it is still very delay in the most important aspect of language and so we are still practicing every day with support from other sets of cards and other workbooks)

Have I not heard about Sensible Pencil,  Writing Without Tears, or Write from the Start my son would neither print nor write in cursive.

I heard about those curricula not from teachers and not from distinguished professionals.  I heard from parents on the ME-LIST.

I lost the track of the Me-List.   Maybe it emigrated to Facebook or Twitter. Maybe it doesn’t exist anymore.

But wherever you are Ruth, please, know that you did for Robert, a boy you had never met, more  than almost anybody else did.

Thank you

Utilization Behavior

I am glad that I learned about UTILIZATION BEHAVIOR when Robert was already 17.  For a few previous years I suspected that Robert’s behavior was controlled by his environment. I attributed this enslavement by the environment to Robert’s  severe language deficits.

Language gives flexibility.  Language allows for modification.  Language provides directions. Language is  a tool . Language is a shield.   But Robert didn’t have language.  Because of that,  Robert had to deduce all the relevant information from his surroundings.

When the bicycle was in the garage Robert ignored it.  But when the same bicycle was left in a driveway Robert “read” the message from the environment and act upon it.  He got on a bike, crossed the street, and rode alone to the church’s parking lot, the place where his father had taught him to ride a two wheeler.  He did it “only” twice as only twice the bike was left in the driveway by the member of the family.  Each time his sister, Amanda, took another bike and rushed after him.  Robert followed Amanda home without any reluctance.  Why should he resist?  He had already fulfilled the command expressed to him loudly and clearly by the placement of the bike in the driveway.

Robert didn’t feel urge to light matches when he saw them on a shelf, although he could reach and get them.  But when someone left matches  next to a candle he had to lighten it.   He “utilized” the matches and the candle the way they should be used. Still,  the candle was near the curtains, the curtains near the bookshelf.  Although  the fire was mostly extinguished  before firemen arrived a couple minutes later  the smoke and the uneasy feelings lingered longer.

It became obvious to me that  the environment was controlling Robert’s behavior.  The question is, why didn’t I become aware of that fact  before those dramatic events took place?

Well, I didn’t feel the need to analyze everyday, repetitive events.  If they struck me as unusual I found it sufficient to rely on a few artificial explanations based on stereotypes about autism .  Moreover, Robert had complex relations with his environment.  He was a guardian of his surroundings.  He had to maintain it by bringing it to the previous balance when something was disturbed. For instance, empty space on a shelf over the coffee maker was calling on Robert to give it back the missing phone.  Objects out of place were requesting that Robert puts them back in the right drawers, closets, cabinets,or shelves. Those behaviors could be considered just “tiding up” or… signs of obsessive compulsive disorder.  Only after incidents with a bike and matches I view them as the examples of Robert serving his environment.

If I knew more about utilization behavior when Robert was younger I would have considered it a  result of the frontal lobe damage and felt unable to alleviate it.

Luckily, I didn’t know.  So Robert and I spent  a lot of time squeezing new words between Robert and objects that surrounded him.  Those little words “up, under, first, later, if, then” and many other did what words supposed to do.  They imposed a new structure with passable roads, tunnels, and bridges over Robert’s environment.  They showed that he could move between any two objects, modify them, or even … ignore them.  Those little words  considerably lessened the pressure coming from the environment and ( to some degree) liberated Robert.

JABA and Sundance Publishing

Journal of Applied Behavior Analysis is a drab looking magazine published a few times a year. Between two unappealing covers there  are many articles written in  a relatively precise but nonetheless hard to follow  jargon which only the most dedicated BCBA (Board Certified Behavior Analyst) can tolerate.  The Journal is swarmed with  graphs which by demonstrating relations between well defined variables  convey the message that the journal is indeed a scientific one.

Books from Little Red Readers, slightly overpriced series published by Sundance Publishing, are short and colorful.  The sentences are simple.  The same sentence pattern is repeated on at least seven  pages.  The last page usually carries sentence of a different construction for a ‘dramatic’ ending. In a non-nonsense approach the publisher didn’t  bother with  title pages or tables of contents.   Title pages are redundant since  they carry the same information which was already presented on the cover.  There is no need for tables of contents for books that have only 8 pages each. No, the books from Little Red Readers series cannot be considered scientific.

One lazy afternoon in 1997 a few issues of JABA and many Red Little Reader books were spread on a table.  Robert and I were sitting on the sofa and reading three of the Little Red Books.  It went so well.  It was a very satisfying (to me) endeavor.  Robert demonstrated proper decoding skills.  His comprehension was  correct.  The sentences in which only one word kept changing from page to page helped with pronunciation and with mastering a language concept.  After we finished, Robert got up and started running around the large room while I relaxed on the sofa as proud of Robert’s reading accomplishments as if they were mine.

I wanted more.  More satisfaction, more teaching, more learning.  More, more of the same since it went so well.

So I called to Robert to bring another book from the table.  “More reading Robert.”  “Bring a book from the table.”  “Bring another book.”  “One more book.”  I kept on asking.  I did that instead of picking a book myself because I wanted Robert to follow verbal directions.  (Well, well, well… Not exactly.  I just was too lazy to get up.) I knew that Robert understood directions I had given him.  So why was he still circling around the room approaching the table and turning away from it?

I kept repeating, “Bring another book.  Just one more book”.  Robert got closer to the table, walked around it twice or three times, looked at the books.  Although I was watching him closely I didn’t realize that he was slowly concocting his solution to the request I made. He didn’t want to read, but he wanted to comply with my demand.

And so…

He grabbed an issue of JABA and threw it to me with a sly smile as if he were saying, “Read Yourself”.

Could he really develop such a response or was it just an accident?  Despite all the details confirming that it was indeed a purposeful action I still had doubts.  So, I  called to Robert, ” You want to read JABA? OK, come here, let’s read.”  I opened the Journal as if I meant to carry this threat.  Robert’s eyes widen from unexpected horror.  He made a loud “quack” sound, turned around, and sought refuge in the bathroom.

I have never read even one complete article from JABA.  My mind was fixated on finding methods of dealing with disturbing excesses of behaviors and equally troubling deficits. I needed short answers, concrete ideas. I couldn’t force my brain to deal with painstakingly constructed definitions of variables or multiple graphs.  Yet, I still consider JABA goldmine of ideas which were clearly presented in summaries preceding each article.  These summaries described clever designs of  educational procedures.  I remember that I was so impressed by the abundance of solutions to many problems I had already encountered that I called JABA and suggested that the journal publishes one issue with just the summaries . Somehow the person I spoke to didn’t seem trilled by that idea.  Maybe such publication would undermine scientific character of the magazine. It is a pity as it demonstrates a chasm between research and everyday classroom practice.  Very little of the educational research permeates the special education classrooms and that is not entirely the fault of teachers or school administration.

I am not sure if the books from Little Red Readers (Blue Readers and Green Readers) entered many special education classrooms.  They certainly had been present in our house for many years.  I purchased over 50 books.  Robert read them all many times.  Finally, I donated most of them to Big Brothers Big Sisters. I felt at that time that they already had completed their job.  Now, I am not so sure.  I think I could use them yet again to practice pronunciation.  Repeating the same sentence structure with one exchangeable element would certainly ease Robert into speaking in sentences.  Or maybe not. You never know….

Quest for Language 4

I have already written about  a few easily definable moments in Robert’s life when he made so called “breakthroughs”.  He generalized imitation of gross motor movements; he said first word “pop” or first part of a word “o” ; he understood computer voice giving him simple directions; he understood human voice as asking him to point to one of two objects.  Yet in times between any two of the  steps forward some changes were brewing.  Except, it is much harder to document, pin point, or describe  what it was and when exactly did it happen.   One might think that getting  data from Robert’s school that documented every single response would provide some clues.  Unfortunately, it is not so.  Data from discrete trails documented only what was happening during discrete trails. Not outside of it. And that is one of many reasons why the collected data provides little information on formation of language.

But  memory is also unreliable. It coils itself around a few events that left  visible marks but somehow ignores everyday boring developments. There is no time card to pin point when a new concept entered the mind. At best  we can say that something happened before or after something else and thus we can detect the sequence.

I don’t claim that Robert learned/knew/possessed the skills listed below at the times I assigned to them.  The approximate times I wrote in parenthesis tell  when  I REALIZED that Robert had those abilities.  But then, those abilities do count only if another person can confirm their existence.

1. Robert could hear. (1year)

2.He could crave beautiful sounds. (18 months)

3.He learned that one sign from American Sign Language ” more”  gave him what he wanted  (mostly bubbles)  (around his third birthday)

3a Robert learned to imitate other people’s gestures (3 and 9months)

4.Robert was able to interpret many environmental sounds:  That his father  walking  upstairs; that mother’s car passed by without stopping;  (2 years old, 3 and 4)

5.He learned that producing a specific sound can result in a sweet and sour taste of a lollipop, or make the door open, or bring the box of juice from the top shelf straight into his hands. (between 3 and 4)

6.Robert learned that if I said something with a specific tone of voice he supposed to do something. (Around 3 )   He didn’t know what exactly he should do, but he knew it was something.  Luckily for him there were only three or four tasks I asked him to perform at that time: close  the front door or refrigerator door,  put the bottle of grape juice back in the refrigerator,and pick up something from the floor.

I do remember being with Robert in the kitchen and asking him to close the refrigerator’s door after I took something out of it.  I remember Robert backing off into a hallway to check the main door. It was closed.  I remember him looking at the floor and picking  a small breadcrumb.  I remember him scanning the table to check for large bottle of juice. Finally, I remember him closing the refrigerator door.  I remember that because, at that time this chain of actions proved to me that Robert didn’t have “receptive” language.  He scanned the environment for cues that would allow him to decipher the sounds I produced. He already decoded my voice as a request upon which he should act, but for the specifics of the request he referred to his surroundings. He understood my voice as a request, but he didn’t decipher the meaning of that request.

At the time this happened I interpreted this development as a negative one.  It showed Robert didn’t understand me. Now, I realized how positive  it was.  Robert understood sounds coming from me as a request upon which he should act.  He just didn’t understand the details.  That was a step toward formation of language.  Moreover, he was able to differentiate the tone of voice with which I expressed demand from all other tones I used for different situations.

Have I realized then that this was the step in right direction  I might  utilize this skill better and build on it.

7. Robert followed commands given by computer voice (around his 4th birthday).

8. Robert discriminated aurally between two labels (4 years 6 months)

Now, at twenty, Robert still struggles with language.

He could do so much better if…

He could do so much worse if…

The unpleasant thing is, I don’t know what those “ifs” are.

Quest for language 3

I had a terrible migraine.  Still, I had to watch Robert in our two story townhouse. My friend, Lisa, once said, “It is easy to take care of a child with autism, as long as you don’t blink.” She didn’t mention migraines.  I couldn’t keep Robert purposefully occupied by himself for more than  one minute and I couldn’t occupy him either.   But if Robert was not occupied he would run from room to room and up and down the stairs.  I couldn’t run after him. I needed to lie down  and hope the migraine would pass.   Somehow I decided that the safest place for us both would be in the smallest bedroom.  It was  small enough for me to reach  Robert from the bed on which I hoped to recover from the pain.  I moved the bed in such way that it blocked the door and was ready to rest.   Except, blocking the door was not something Robert would ever accept.  For him, the whole idea and/or essence of ‘door’ was that they could be opened and closed freely.  Although Robert had already accepted the concept of a door lock,  he, nonetheless, was not ready to tolerate such outrageous action as blocking the door with an object which was  not meant to do it.  He explained his position to me clearly by spreading himself on the floor, stumping his feet and walking around his head with his back on the floor.  He also produced a few but constant and loud sounds. So I moved the bed to the old place.  As soon as I did that Robert stopped screaming, got up, opened the door and shut them with all his might. Open and shut, open and shut….

I knew he would go like that for an hour or two.  So I did the only thing I could think of.  From the bed I stretched my arm to block the door and I demanded that Robert says, “Open”. He didn’t.  But he produced some sort of the sound. Good enough.  I released the door.  Robert shut them.  I blocked the door, asked for “open” .  Robert produced another sound.  Although he wasn’t trying yet to imitate me I released the door.  Over and over.  Slowly Robert got an idea that producing a sound opens the door.

I don’t remember if I still had a headache some time later when I got up from the bed and started working with Robert.   He had to look at me and make an effort to say,”Open”.  He did.  I mean, he made an effort.  That day he was able to produce purposefully long “o” sound. A few days later he added, “pen” , to it.   But that  came about in less dramatic circumstances, so I don’t remember them at all.

Quest for Language 2

The first word “pop” Robert said during the first and the last visit from a speech pathologist from Robert’s school.  She brought with her a lollipop and let Robert lick it only if he said the word “pop”.  Unfortunately, that was her only visit.  The private school, which provided Robert with home program from August of 1995 until August of 1996 had a policy of having, so called, “consultative model”. Under this model, the speech pathologist  made consultation with therapists, gave them suggestions but very rarely worked one on one with a child.  This particular speech pathologist met Robert only once in the  school year 1995/1996.  She obviously knew what to do while providing therapy to the child.  But her effect on Robert’s language under consultative model was mostly disastrous.   That was because after her visit the therapist worked only on this one word “pop”.

Days, weeks and probably months. “POP, POP, POP, POP, POP!!!!

I don’t blame the therapist too much.  If the speech therapist observed Robert regularly – even once a month- she might give new directions or make corrections. But despite my repeated calls to school asking for another session/observation she never came back. (Oh,  how bitter I still am about that! Please, don’t tell me to forget and move on.  We do too much forgetting and moving on already. By  eliminating  our bitter experiences we make sure our knowledge is ignored and errors continue to happen.) The ABA therapist did what she observed during speech pathologist’s visit. She was practicing with Robert almost only this one word: “POP, POP, POP”.  She did that because that was what she was shown; because Robert was successful;because she felt successful as well. The end result, however,  was that Robert couldn’t say anything else.  The more often he repeated the same and only word, the more difficulty he experienced with saying anything else.

There is an obvious question to ask.

Why did I allow this to happen for such a long time?  Well, I didn’t see any other choices for teaching Robert.  At that time I didn’t believe I could teach my son.  The school was (and still is) highly regarded.  And let me add, rightly so.  Moreover, the aura of “specially tailored program for children with autism” was such that any rational thinking was excluded.  The mantra was (and maybe still is) that children with autism learn differently.  And that is the  truth.  Many children with autism learn many things differently than their “typical” peers.  There are no doubts in my mind.  But learning differently doesn’t mean that logic doesn’t apply.

While I Was Teaching Him to Glue Stickers He Was Learning What’s Important

I didn’t post anything yesterday because I was  upset  with myself.  I yelled at my son.  The reason? . There is never a reason to yell.  There are circumstances.  But they are of my creation, not Robert’s.

Sixteen  years ago  I used  extinction and redirection to deal with Robert’s excessive behaviors: bumping into furniture, opening and shutting doors multiple times while aiming for the greatest impact, screaming, kicking, and more.   Whenever I wanted to stop the behavior I pretended not to notice it.  Instead I was waving a toddler level workbook and telling Robert that we have to work. (Well, in the beginning I was carrying Robert to the table). I  found those  workbooks in Toys R Us and bought the whole series.   Three whole series.  Maybe fifteen or eighteen workbooks all together.  I had to.  There were many tantrums to extinct and redirect.  These workbooks were  very suitable. They didn’t make the same impact when they hit the floor as pegs or puzzles did when Robert threw them off the table.  So he didn’t see any point in throwing them.  They were pleasing and simple.  The tasks were reduced to matching stickers or connecting objects.    After a while Robert didn’t protest when I called him to the table by always using the the same phrase, “Work, work, work”.   I believe that he too found this routine calming.

One day it was I who had a tantrum.  I don’t remember circumstances.  I remember that I felt utterly unhappy and so in loud rumblings and grumblings kept accusing the whole world of wrongdoing.  Robert, little peanut, became alerted  and extremely concerned.  No, he didn’t scream  or cry.  He ran to the table, grabbed the toddler’s workbook and ran toward me holding the workbook in extended arms.  “Ork, ork, ork”, he kept repeating fervently as he handed me the workbook.

He still couldn’t pronounce the word  “work” but he already knew that extinction and redirection were the best ways to deal with bad behavior.

What’s Wrong With This Picture

Everyday for the last few weeks we took a page from “What’s Wrong With This Picture?” workbook.  Robert had to point to all the  weird things in the picture and comment on it. The picture for today presented a cowboy on a six legged horse.  The horse’s tail was tied up around saguaro cactus.  The cowboy was chasing a small pig with huge horns.

Robert supposed to find those three anomalies.  First, he pointed his finger at the pig with horns. He wasn’t sure what to say. . So I fed answers to him.  “This pig has horns.  Pigs don’t have horns.”  As simple as possible.  Of course I was tempted to offer a better model, “Pigs not supposed to have horns”  but decided that I would skip the phrase, “supposed to” for the sake  of preparing Robert to utter  independent comments in the future . ( Although in the past, while introducing  inferences I used this phrase it was only to “try and see if it is workable”  It wasn’t.) The  goal I set for workbook “What’s Wrong”  was to  elicit at some point in the future  “spontaneous” (without any prompting) comment of the simplest form

Next, Robert touched the horse’s tail and  said “tail”.  I had an impression that he was aiming for the next word “tied” . If he was, then something stopped him.  Probably two similarly sounding words  confused him.  After so many years of difficulties with talking,  Robert become very insecure and overly careful with speech.

I should just praise him for this one, appropriate word.  I should say, “You are right.  The tail is tied up to the cactus.”  That would be the best response given my goals.  But then I couldn’t help myself.  I HAD TO TEACH!  So instead of rewarding Robert’s step toward self regulating speech I had to punish him with corrections and additional prompting to make him say what I wanted him to say. “The horse is tied up by his tail to the Saguaro cactus”. Too long for Robert, too confusing!  But the most damaging thing is that I imposed my speech over his.  I didn’t facilitate his speech.  I suffocated it.

I did that because I forgot how dangerous teachers can be when their ego gets into play.

Well, there was one more wrong thing with the picture.  The horse had six legs.  Robert didn’t notice.  So I pointed the horse to him and said what I would like him to say, ” Look, this horse has SIX!!!! legs. SIX!”  By being overly excited I tried to erase that ” bad teacher” out of me.

I did not.   But I  will have another chance tomorrow.

Relative Intelligence 3

The frustration I feel when confronted with neuropsychological evaluation of Robert comes from the fact that the information the tester derives from Robert’s responses  has a very limited use for my son.  Have I, or anybody who knows Robert as well as I do, observed Robert during the testing, many more  applicable facts could emerge.

If the neuropsychologist were not so concerned with “objective” numbers received after formal and rigid testing, but unconventionally manipulated the test in such a way as to increase (or decrease) the  probability of correct responses then we would find out the conditions that control child’s answers.

The formal test demonstrate disconnect between a tested child and society as it is perceived by psychologists. It provides mainly static statistic.  The informal test that would stray from rigid instruction of how it should be delivered and instead was adjusted in such a way as to have a child be as successful  or as unsuccessful as possible could deliver much more dynamic knowledge about a child. There are people with disabilities whose relatively higher (above the range that would provide them with state’s services )  IQ doesn’t account for their lack of ability to functionally understand the world around them.  Changing the wording of some of the questions and manipulating environment might uncover that weakness. There are people with developmental disabilities for whom changing the wording of the question and installing some changes in the surrounding could lead to higher scores brought by revealing the specific ways the tested individuals relate to the world.

My experiences with Robert proved to me that he can respond incorrectly to many questions  he knows answers to, and he can provide  correct responses when he doesn’t even understand the questions. For instance, if the questions on the test require only “yes” or “no” answer,  Robert will only read the first question, answer it correctly and from that point on he will circle, “Yes, no, yes, no, yes” in ABABA pattern.  If he were asked verbally the same  questions, his replies would be different.

He also has uncanny ability to observe the slightest movements of his teacher/ therapist and use them as cues directing him to the right or wrong answer.  Moreover, since he used to be rewarded constantly by reinforcers he still waits for them before choosing the answer.  He might aim for a correct one but if he doesn’t hear ” good job” or some other acknowledgement  of a right decision, he would end up with wrong response.

There are many more patterns that impact Robert’s ability to respond.  Had they been taken into account,  the neuro-psychological tests would have painted paint different picture of Robert.