The best way to see improved outcomes in our patients is with creativity, fun and positive reinforcement.
BF Skinner (Wikimedia.org CC BY-SA 4.0)
The TAGteach approach is based on the science of behaviour and the principles of operant conditioning discovered by B.F. Skinner.
TAGteach has been used internationally in elite sports including gymnastics, golf, and track and field. It is widely used across the animal world with training horses and dogs. It is also being found to be particularly effective in teaching people with autism and other special needs.
TAGteach is a revolutionary new way of teaching; it’s a tag point. The tag point is the specific learning goal that the clinician will mark with a tag that highlights success for the patient; for example, “external rotation of the knees.” The tag becomes a conditioned positive reinforcer because of the endorphins that come from success and improvement, and praise from the podiatrist.
Clarity and simplicity are key aspects of TAGteach. A tag point is defined so that the patient does not need to ask why they didn’t get a tag if the tag does not come.
Tag points are never combined, since this can cause confusion, frustration and sometimes can lead to the patient “shutting down.”
The most common and effective way to mark a correct response is with a short sharp sound made using a handheld clicker or tagger. Some scientists think that the click sound is processed by the amygdala, a primitive part of the brain that controls emotion, and fight or flight responses. This bypasses the complex processing of speech and allows for immediate processing and action. This may explain the rapid acquisition of skills and excellent retention rates that have been shown to occur in high level competitive gymnasts taught with TAGteach.
Positively Together trainer Bex Tasker shows Resonance Podiatrists (here Katie Vodanovich) how to use TAGteach clicker training to, in this case, adjust posture.
In application, the podiatrist will give the patient a very specific goal; the goal is called a “tag point” and defines the precise movement we watch for and will reinforce with a tag if successful. There are four practical tips that your tag point MUST meet:
- Ask for what you do WANT. Keep this instruction uncluttered by removing descriptions of the many ways it could be done incorrectly.
- Ask for ONE THING at a time. Think about what will be that one key element on which the patient will put their full focus on.
- Be sure that you can clearly OBSERVE the exact moment that the patient meets your criteria for success.
- Formulate your final instruction to the patient in FIVE words or less. This is all they will remember anyway as they go to take their turn, so make those final words count! Make sure these words tell the athlete the exact, specific detail that you will be watching for and that they should be thinking about
Resonance are excited to be putting TAGteach into practice, and developing a new way to see improved patient outcomes with applications to bio-postural analysis and running gait training.
Article by Resonance Sports and Rehabilitation Podiatrist Katie Vodanovich
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Unless stated otherwise images are ©2018 Resonance Group
