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The Incredible 5-Point scale

It is not uncommon for individuals with autism spectrum disorders (ASD) to have problems with social competence and understanding how their behavior impacts themselves and others. In addition, they frequently battle with anxiety and have difficulty regulating their emotions and stress levels.

As a result, they repeatedly struggle in social situations. The behavioral support known as the Incredible 5-Point Scale, created by Kari Dunn Buron and Mitzi Curtis (2003), provides a visual representation of social behaviors, emotions, and abstract ideas. It is a simple scale used to teach social understanding. Kari stresses, that "the scale is about breaking social and emotional concepts into 5 parts. It is a teaching tool".

Given that the majority of individuals with ASD are visual learners, the Incredible 5-Point Scale simplifies behaviors by assigning them a number and /or color. A scale is created for a specific individual or group of individuals and tailored for a specific situation or behavior. Individuals with ASD have social cognitive differences; they learn differently
than others learn. This is an important concept to keep in mind when working with these individuals and teaching them to use this tool.

The premise is easy and can be adapted for almost every behavior or expectation imaginable. In their book, The Incredible 5-Point Scale: Assisting students with autism spectrum disorders in understanding social interactions and controlling their emotional responses, Buron and Curtis (2003), provide multiple examples for use including: (a) controlling voice level, (b) dealing with obsessive behaviors, and (c) meeting and greeting others to name a few.

The key is to identify the behavior, whether it be reducing anxiety around a situation by providing 5 steps or strategies, or labeling the levels of voice from whispering to shouting. Once a behavior is identified, it needs to be task analyzed or broken into concrete parts. Working with the individual with ASD, these parts need to be assigned a label. An example provided by Buron and Curtis deals with understanding emotions from happy to angry. For their example faces are used to identify or tag the feelings for the child. The child, working one on one with an adult, is taught what "angry" looks like, what it "feels" like, and how to get help or what to do when they are angry.


Teaching the 5-Point Scale

As stated in the overview, Kari Dunn Buron stresses that 'the scale is about breaking social and emotional concepts into 5 parts. It is a teaching tool'. Ideally, a scale is crafted by the individual with ASD, if appropriate, and a teacher, therapist/s, parent/s, employer, etc. Once developed, the scale should initially be used in a 1:1 direct instructional session. When the individual comprehends the ratings and how to use the scale, it can be utilized in a group situation.


CASE STUDY: Jonah

Jonah has Asperger Syndrome; he is in the second grade. Jonah is always being reminded by his teacher to speak with an 'inside' voice. Whether in class, in the cafeteria, in the library, or out on the playground, Jonah uses the same volume ... very loud. Jonah's peers get frustrated with him when he is working with them in a group and is supposed to be whispering or talking softly, but instead speaks loudly. More often than not, his group does not receive a sticker for appropriate group work due to Jonah's voice volume. Jonah's teacher has attempted to curb his voice volume by verbally prompting him and using gestures. However, these strategies have not worked. Jonah's
speech and language pathologist (SLP) suggested creating a 5-point scale. The SLP and second-grade teacher designed the scale using 'big' and 'little' as comparisons for volume. They developed a list of concrete behaviors representing each number of the scale so that Jonah could understand how to rate his volume level and when or where to use each volume level.

Volume Control:

Rating When/where to use voice volume

5

I am hurt and need help

4

Playing on the playground

3

In the lunchroom, talking to friends or answering questions

2

In the library, at church, working in a group

1

When the teacher is talking, when walking in the hallway

1 = no words, sounds, noise out of my mouth (when adults say I should be totally quiet; when walking in the hallways at school)

2 = little voice ... also called very quiet voice (when I am in the library, at church, or working in a group)

3 = normal voice ... also called inside voice (when I am in the cafeteria, answering questions, or talking to the teacher or my friends)

4 = loud voice (when I am on the playground or at my brother's football game)

5 = very loud voice...also called screaming (when I am hurt and need help)

Case Study: Jonah Conclusion

Jonah's SLP made a 5-point scale for all the adults who came into contact with Jonah during the school day. When Jonah was too loud, the adult would simply take out the scale and point to the volume that was appropriate for the activity in which he was participating. Jonah initially became very upset when the staff took out the scale and pointed to a number. He frequently screamed at the adult and tells him/her, 'I'm at 3. Stop pointing to 3.' Remaining quiet and calm, the adult continued to point to the appropriate number until Jonah's volume adjusted. Within a few days of incorporating the scale, Jonah began responding positively, and he became more aware of his voice volume.


Using the 5-Point Scale

The Incredible 5-Point Scale can provide support at school, home, work or in the community. It can be used to address disruptive behaviors, feelings, voice volume, body awareness, leisure skills, peer interactions, and many other social issues. For individuals who are unable to recognize numbers, the Incredible 5-Point Scale can be created with colors and pictures representing the different ratings on the scale. For others, the numbers one through five can be used. While the number '5' can represent the most positive behavior or situation, it can also signify when the individual has the least amount of control of his/her behavior. Regardless of the design, the scale provides a visual breakdown of a problem behavior, the look and/or feel of the behavior, and appropriate responses or ways to cope at each level.

An adult or peer can point to a specific number on the scale to show the individual where they happen to be on the scale, such as in the example of Carson. If he is at a #5, the adult or peer could slide their fingers down the scale to a #1 showing Carson where his hands need to be. As with most interventions, repetition and consistency in use across settings will help the individual with ASD internalize the more appropriate behavioral choice.


CASE STUDY: CARSON

Carson Thomas is a freshman in high school diagnosed with autism. Recently, his peers have seen him in the hallways and in class touching girls in inappropriate places on their bodies. Two of his neurotypical peers who have taken an interest in Carson felt that the behavior needed to be addressed by adults in the school. They believed that his female peers were becoming uncomfortable around him and beginning to shy away from him as they are afraid of him touching them.

Touching Others

Rating What is being touched When/where/who
5 Butt/ Breasts

When girlfriend says she would like to be touched or says she is ok with touching her on the butt or breasts

4 Kisses If she is your girlfriend and wants to be kissed
3 Friendly Hugs Halls, Classrooms, only when the girl asks for one
2 Handshake or Highfives Halls, Classroom, School cafeteria, guys and girls 
1 No touching Anywhere

Carson's special education teacher, speech and language pathologist, and school psychologist, along with his mother, sat down with Carson to discuss the issue. The team decided that Carson was attempting to communicate to the girls that he liked them. The speech and language pathologist recommended that the team write a social narrative, a story that described what was appropriate and not appropriate in terms of touching girls. The narrative included ideas such as types of touching (high-fives, friendly hugs, kisses), when and where certain types of touching are appropriate and when they are not, and who is the recipient of certain types of touches.

The narrative was written specifically for Carson and his peers. The social narrative was to be used initially to teach/clarify touching rules. The team, including Carson, also created a 5-Point Scale addressing what kinds of touching are appropriate and where and when it is appropriate to touch females.


Other Suggestions for Using the 5-Point Scale

The Incredible 5-Point Scale can be applied prior to, during, or after an event or situation. As a proactive behavioral support, it can be employed prior to an event to remind an individual of behavior that is and is not acceptable for the event. During a situation, the support can provide a visual reminder of the individual's behavior at that specific point in time. Finally, after a situation, it can serve as an evaluation tool.

This intervention is not just for those with autism spectrum disorder (ASD). It can be used for individuals with and without disabilities. As reported by Buron and Curtis (2003), beyond ASD the Incredible 5-Point Scale has proven effective with individuals with diagnoses other than ASD, such as attention deficit hyperactivity disorder, obsessive-compulsive disorder, and Tourette Syndrome.


CASE STUDY: LILLY

Lilly is 19 years old and diagnosed with Asperger syndrome. She works at the local coffee shop. She loves coffee and learning how to create new coffee drinks. Lilly works the same shift every day and has established a good working relationship with the other employees. Her favorite part of the job is making the drinks. Recently, a new employee started. The employee was not familiar with all the recipes and, as a result, made some mistakes. Lilly had a very difficult time understanding why she was making so many
mistakes and yelled at her in front of customers. She not only yelled at her, she snatched the steamers from her hands and refused to allow her to make any more drinks.

Lilly's manager, Jill, values Lilly as an employee and sees what great work she does. However, she also recognizes that Lilly cannot treat fellow employees with disrespect nor react harshly toward employees in front of customers. Jill contacted Lilly's job coach to discuss ways to intervene when similar situations arise in the future. Tony, Lilly's job coach, shared with Jill ideas on how to create the Incredible 5-Point Scale specific to Lilly's needs.

Mistakes on the Job

Rating Looks/Sounds Like Feels Like How I respond
5 Screaming, Unkind Comments, Snatching I'm going to hit someone if I dont fix the situation and do it 'just right' Ask to take a break and calm down away from the situation
4 Pacing, wringing hands Angry Ask to talk to the manager
3 Grinding teeth, clenching jaw Anxious Talk to a customer,ask to clean the front of the shop or restock
2 Whispering to self Nervous Repeat: Take a deep breath, count to 5, its ok to make mistakes!
1 Normal Good Stay in a good mood

The following day, Jill met with Lilly after work to design a scale. They talked about how Jill feels when people make mistakes and how she responds. They agreed on the following: Jill shared the scale with Lilly's coworkers, with her permission, so that they could support Lilly in using the scale. Lilly also agreed to the scale being posted behind the counter as a visual/behavioral support. Over the next several days, the new employee made mistakes, however, Lilly was able to manage her behavior with the support of the scale.


FAQS: Frequenty asked questions

Q: What is important to keep in mind when creating a scale?

A: If at all possible, include the individual who will be using the scale when designing the scale. Take into consideration the person's cognitive and academic skills.

Q: Who benefits from using the Incredible 5-Point Scale?

A: Anyone who has problems with social competence and understanding how their behavior impacts themselves and others can benefit from the Incredible 5-Point Scale.

Q: What materials do I need to create a scale?

A: Some scales have been created simply with a piece of paper and a set of crayons. Other scales have been designed using computer programs such as Word. Construction paper, file folders, markers, and so on, may also be used to create a scale.

Q: Can this behavioral support be used with individuals of all ages?

A: Yes! The tool has been used with children as young as preschool age to adults.

Q: Who can create an Incredible 5-Point Scale?

A: A parent, teacher, therapist, employer, friend, administrator, and so on, can create an Incredible 5-Point Scale. Basically, anyone working with an individual with social difficulties can create a scale. Again, if possible, include the individual for which the scale is created in the designing of it.


Individuals without disabilities or those with ASD or other disabilities often lack the social competence needed to cope in difficult situations. The Incredible 5-Point Scale is a behavioral support that breaks down behaviors and social interactions into clear, visual, and tangible pieces so that individuals can learn appropriate ways to respond and interact in difficult situations. A scale can be created using colors, pictures, or a rating system of 1 to 5.

For further information on this strategy, please visit: www.5pointscale.com.

References:

Coffin, A. B., & Smith, S. M. (2009). The Incredible 5-Point Scale (Columbus: Ohio Center for Autism and Low Incidence). In Ohio Center for Autism and Low Incidence (OCALI), Autism Internet Modules, www.autisminternetmodules.org. Columbus, OH: OCALI.
Buron, K. D., & Curtis, M. (2003). The Incredible 5-Point Scale: Assisting students with autism spectrum disorders in understanding social interactions and controlling their emotional responses. Shawnee Mission, KS: Autism Asperger Publishing Company.

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