Verbal Behavior Therapy

What is Verbal Behavior Therapy?

Verbal Behavior (VB) therapy teaches communication and language. It is based on the principles of Applied Behavior Analysis and the theories of behaviorist B.F. Skinner.

This approach encourages people with autism to learn language by connecting words with their purposes. The student learns that words can help them get desired objects or results.

Verbal Behavior therapy does not focus on words as labels only (cat, car, etc.). Rather, it teaches why we use words and how they are useful in making requests and communicating ideas.

Language is classified into types, called “operants.” Each operant has a different function.

Verbal Behavior therapy focuses on four word types:

• Mand: A request, such as saying “Cookie,” to ask for a cookie
• Tact: A comment used to share an experience or draw attention, such as “airplane” to point out an airplane
• Intraverbal: A word used to respond or answer a question, such as “Where do you go to school?” “Castle Park Elementary”
• Echoic: A repeated, or echoed, word, such as “Cookie?” “Cookie!” This is important as imitating will help the student learn.

VB and classic ABA use similar techniques to work with children. VB methods may be combined with an ABA program to work towards communication goals.

How does Verbal Behavior work?

Verbal Behavior therapy begins by teaching mands (requests) as the most basic type of language. For example, the individual with autism learns that saying “cookie” can produce a cookie.

As soon as the student makes a request, the therapist repeats the word and presents the requested item. The therapist then uses the word again in the same context to reinforce the meaning.

The person does not have to say the actual word to receive the desired item. At first, he or she simply needs to make a request by any means (such as pointing). The person learns that communicating produces positive results.

The therapist then helps the student shape communication over time toward saying or signing the actual word. 

In a typical session, the teacher asks a series of questions that combine easy and hard requests. This allows the student to be successful more often and reduces frustration. The teacher should vary the situations and instructions in ways that keep the student interested.

Errorless Learning

Verbal Behavior therapy uses a technique called “errorless learning.”

Errorless teaching means using immediate and frequent prompts to ensure the student provides the correct response each time. Over time, these prompts are reduced. Eventually the student no longer needs prompting to provide the correct response.

Example of errorless learning

1. The therapist holds a cookie in front of the student and says “cookie” to prompt a response from the child.
2. The therapist holds the cookie and make a “c” sound to prompt the response.
3. The therapist holds the cookie in the child’s line of sight and waits for the request with no cue.

The ultimate goal is for the child to say “cookie” when he or she wants a cookie – without any prompting.

What is the intensity of most VB programs?

Most programs involve at least one to three hours of therapy per week. More intensive programs can involve many more hours.

Instructors train parents and other caregivers to use verbal-behavior strategies in their daily life.

Who can benefit from Verbal Behavior therapy?

Verbal Behavior Therapy can help:

• Young children beginning to learn language
• Older students with delayed or disordered language
• Children and adults who sign or use visual supports or other forms of assisted communication

Who provides VB?

A VB-trained therapist may be any of the following:

• Psychologist
• Behavior specialist (BCBA)
• Special education teacher
• Speech and language pathologist

Is Verbal Behavior Therapy covered by insurance?

Sometimes. Many types of private health insurance are required to cover services for autism. In many cases, insurance would provide coverage for VB when used as part of an ABA therapy or speech therapy program. This depends on what kind of insurance you have, and what state you live in.

Please see our insurance resources for more information about insurance and coverage for autism services. 

You can also contact the Autism Response Team if you have difficulty obtaining coverage, or need additional help.

Where do I find a VB-trained therapist? 

Search the Autism Speaks Directory to find VB-trained professionals in your area.

What is the evidence that Verbal Behavior is effective?

A 2006 review of 60 published studies concluded that Verbal Behavior Therapy helps many children with autism develop spoken language. The same review noted a lack of evidence on whether the approach produces broader benefits in daily living skills and overall improved outcomes.

For more information

B.F. Skinner published Verbal Behavior in 1957 to describe his functional analysis of language. In the 1970s, behavior analysts Vincent Carbone, Mark Sundberg and began adapting Skinner’s approach to create Verbal Behavior Therapy. Since 1982, the Association for Behavior Analysis International has published the annual, peer-reviewed journal The Analysis of Verbal Behavior.

For Information on VB, visit the Cambridge Center for Behavioral Studies website.