Olivia’s Story

Where Olivia Started


When Olivia started at Cornerstone on August 27, 2018, she was eager to learn but struggled with discrimination and required physical prompting to complete many tasks. Olivia displayed many vocals but had very limited functional communication. Olivia often had tantrums for a long duration and struggled to communicate her wants and needs. She gained a few mands through American Sign Language and started using a picture exchange system to further her manding abilities. Olivia enjoyed engaging with a variety of reinforcers, especially looking at books, but she had difficulty transitioning from reinforcement. In addition, she sought physical play from her therapists and engaged in parallel play with her peers. However, she found group work to be aversive and required a group desensitization program to increase her tolerance of completing group activities. Olivia only tolerated complying with a few instructions at a time and often engaged in self-injury or physical aggression when completing programming or asked to transition to a different setting. Her skills were in Level 1 of the VB-MAPP, with an overall score on the VB-MAPP Milestones Assessment of 14 points at the time of her initial assessment.

How Olivia Improved


By the time Olivia graduated from Cornerstone, she demonstrated the ability to spontaneously mand for a variety of reinforcers, actions, and missing items via her picture exchange system. She was able to transition from reinforcement to programming with the aid of a visual in the absence of maladaptive behaviors. She also gained many self-management skills and would ask for a break when desired. Olivia continued her love of books and expanded her play skills by engaging with playground equipment and cause-and-effect toys. She also gained many classroom skills, such as gluing papers together, and was able to attend and participate in a classroom group for the entire group time of 10 minutes. She worked on other programming for an average of four minutes before receiving reinforcement and consistently demonstrated skills across all operants of the VB-MAPP without prompting. In addition, she greatly improved her discrimination skills through listener-responding programming with pictures and in the natural environment. Her overall score was 61 on the VB-MAPP Milestones Assessment when she transitioned from Cornerstone.

Olivia’s clinical team is proud of Olivia for working so hard to gain the skills needed to communicate and self-manage her behaviors effectively. Kayla Helms, Olivia’s BCBA, said, “It has been an incredible joy to watch Olivia’s progress over the years. I will miss hearing her happily playing and having her reach her arm out as I walk by to request some tickles and share a smile. I am excited to hear about the new things Olivia learns in the school setting with her peers!”