education and training in autism and developmental · of arkansas, college of education and health...

Education andTraininginAutismandDevelopmentalDisabilities

Focusing on individuals withautism, intellectual disability and other developmental disabilities

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Education and Training in Autism and Developmental DisabilitiesThe Journal of the Division on Autism and Developmental Disabilities,The Council for Exceptional Children

Editor: Stanley H. ZuckerArizona State UniversityMary Lou Fulton Teachers College

Editorial Assistant: Stephanie McBride-SchreinerArizona State UniversityMary Lou Fulton Teachers College

Consulting EditorsMartin AgranKevin AyresDevender BandaJuliet Hart BarnettLaura BassetteKyle D. BennettEmily BouckAmanda BoutotMichael P. BradyStacy Carter

David CihakGinevra CourtadeSamuel A. DiGangiTeresa DoughtyKimberly W. FisherYoujia HuaBree JimenezRuss LangJustin LeafRose A. Mason

John McDonnellHedda Meadan-KaplanskyPam MimsWendy OakesJenny RootKarrie ShogrenTom E.C. SmithScott SparksFred SpoonerRobert Stodden

Keith StoreyWilliam TherrienMatt TincaniJason TraversToni Van LaarhovenElizabeth WestJohn WheelerMark WoleryLeah WoodDalun Zhang

Education and Training in Autism and Developmental Disabilities is sent to all members of the Division on Autism and DevelopmentalDisabilities of The Council for Exceptional Children. All Division members must first be members of The Council for Exceptional Children.Division membership dues are $30.00 for regular members and $15.00 for full time students. Membership is on a yearly basis. All inquiriesconcerning membership, subscription, advertising, etc. should be sent to the Division on Autism and Developmental Disabilities, 2900 CrystalDrive, Suite 100, Arlington, VA 22202-3556. Advertising rates are available upon request.

Manuscripts should be typed, double spaced, and sent (three copies) to the Editor: Stanley H. Zucker, Mary Lou Fulton Teachers College,Box 871811, Arizona State University, Tempe, AZ 85287-1811. Each manuscript should have a cover sheet that gives the names, affiliations, andcomplete addresses of all authors.

Editing policies are based on the Publication Manual, the American Psychological Association, 2009 revision. Additional information isprovided on the inside back cover. Any signed article is the personal expression of the author; likewise, any advertisement is the responsibilityof the advertiser. Neither necessarily carries Division endorsement unless specifically set forth by adopted resolution.

Education and Training in Autism and Developmental Disabilities is abstracted and indexed in Psychological Abstracts, PsycINFO, e-psyche,Abstracts for Social Workers, International Journal of Rehabilitation Research, Current Contents/Social and Behavioral Sciences, ExcerptaMedica, ISI Social Sciences Citation Index, Adolescent Mental Health Abstracts, Educational Administration Abstracts, Educational ResearchAbstracts, and Language and Language Behavior Abstracts. Additionally, it is annotated and indexed by the ERIC Clearinghouse onHandicapped and Gifted Children for publication in the monthly print index Current Index to Journals in Education and the quarterly index,Exceptional Child Education Resources. Access is also available in EBSCO, ProQuest, and JSTOR.

Education and Training in Autism and Developmental Disabilities Vol. 53, No. 4, December 2018, Copyright 2018 by the Division on Austimand Developmental Disabilities, The Council for Exceptional Children.

Division on Autism and Developmental DisabilitiesThe Council for Exceptional Children

Board of DirectorsOfficers

Past President Elizabeth WestPresident Jordan ShurrPresident-Elect Michael WehmeyerVice President Ginevra CourtadeSecretary Meaghan McCollowTreasurer Gardner Umbarger

Members

Autumn Eyre (Student Representative)Kimberly MaichNikki MurdickLeah Wood

Executive DirectorTeresa DoughtyPublications ChairMichael WehmeyerCommunications ChairEmily C. BouckConference CoordinatorCindy Perras

The purposes of this organization shall be to advance the education and welfare of persons with autism and developmental disabilities, researchin the education of persons with autism and developmental disabilities, competency of educators in this field, public understanding of autismand developmental disabilities, and legislation needed to help accomplish these goals. The Division shall encourage and promote professionalgrowth, research, and the dissemination and utilization of research findings.

EDUCATION AND TRAINING IN AUTISM AND DEVELOPMENTAL DISABILITIES (ISSN 2154-1647) (USPS 0016-8500) is pub-lished quarterly, by The Council for Exceptional Children, Division on Autism and Developmental Disabilities, 2900 Crystal Drive, Suite100, Arlington, Virginia 22202-3556. Members’ dues to The Council for Exceptional Children Division on Developmental Disabilitiesinclude $8.00 for subscription to EDUCATION AND TRAINING IN AUTISM AND DEVELOPMENTAL DISABILITIES. Subscriptionto EDUCATION AND TRAINING IN AUTISM AND DEVELOPMENTAL DISABILITIES is available without membership; Individual—U.S. $100.00 per year; Canada, PUAS, and all other countries $104.00; Institutions—U.S. $249.00 per year; Canada, PUAS, and all othercountries $254.00; single copy price is $40.00. U.S. Periodicals postage is paid at Arlington, Virginia 22204 and additional mailingoffices.

POSTMASTERS: Send address changes to EDUCATION AND TRAINING IN AUTISM AND DEVELOPMENTAL DISABILITIES,2900 Crystal Drive, Suite 100, Arlington, Virginia 22202-3556.

Effects of TEACCH Structured Teaching on Independent Work Skills amongIndividuals with Severe Disabilities 343INHWAN PARK and YU-RI KIM

Curricula to Teach Skills Associated with Self-Determination: A Review ofExisting Research 353SHEIDA K. RALEY, CRISTINA MUMBARDO-ADAM, KARRIE A. SHOGREN,DAVID SIMO-PINATELLA, and CLIMENT GINE

Effectiveness of Video Modeling Presented via Smartboard for TeachingSocial Response Behavior to Children with Autism 363ESIN PEKTAS KARABEKIR and NURGUL AKMANOGLU

Comparison of Individualized and Non-Specific Video-Prompts to Teach DailyLiving Skills to Students with Autism Spectrum Disorders 378SARAH DOMIRE MONACO and PAMELA WOLFE

Improvements in Proxy Individualized Education Program MeetingParticipation among Latino Parents 393MEGHAN M. BURKE, KRISTINA RIOS, BRENDA LOPEZ, MARLENE GARCIA, andSANDRA MAGANA

Effects of a Self-Management Intervention to Improve Behaviors of a Childwith Fetal Alcohol Spectrum Disorder 405MEGAN M. GRIFFIN and SUSAN R. COPELAND

Investigating Components, Benefits, and Barriers of ImplementingCommunity-Based Vocational Instruction for Students with IntellectualDisability in Saudi Arabia 415HUSSAIN A. ALMALKY

Participation in Related Services and Behavioral, Social, and AdaptiveSymptom Presentation in Young Children with Autism Spectrum Disorder 428STEPHANNY F. N. FREEMAN, TANYA PAPARELLA, JOANNE J. KIM, FIONA WHELAN,GERHARD HELLEMANN, and STEVEN FORNESS

INDEX—VOLUME 53, 2018 438

Manuscripts Accepted for Future Publication in Education and Training inDevelopmental Disabilities 342

Education and Training in Autism and DevelopmentalDisabilities

VOLUME 53 NUMBER 4 DECEMBER 2018

The Division on Autism and Developmental Disabilities retains literary property rights on copyrighted articles. Upto 100 copies of the articles in this journal may be reproduced for nonprofit distribution without permission fromthe publisher. All other forms of reproduction require permission from the publisher.

Manuscripts Accepted for Future Publication in Educationand Training in Autism and Developmental Disabilities

March 2019

Parent implementation of structured work systems on child acquisition of independence skills throughfamily preferred routines. Suzanne Kucharczyk, Peggy J. Schaefer Whitby, and Tiffany Mrla, Universityof Arkansas, College of Education and Health Professions, 410 Arkansas Avenue, Room 303, Fayette-ville, AR 72701.

International trends in inclusive education intervention research: A literature review. MayumiHagiwara, Antonio Manuel Amor, Karrie A. Shogren, James R. Thompson, Miguel Ángel Verdugo,Kathryn M. Burke, Hatice Uyanik, and Virginia Aguayo, University of Kansas, Dept. of SpecialEducation, Joseph R. Pearson Hall Room 517, 1122 West Campus Road, Lawrence, KS 66045.

Teaching soft skills to students with disabilities using UPGRADE Your Performance. Kelly A. Clark,David W. Test, and Moira Konrad, University of North Carolina at Charlotte, 9201 University CityBlvd., Charlotte, NC 28233.

Comparing multiple stimulus preference assessments without replacement to in-the-momentreinforcer analysis on rate of responding. Aditt Alcalay, Julia L. Ferguson, Joseph H. Cihon, NormaTorres, Justin B. Leaf, Ronald Leaf, John McEachin, Kimberly A. Schulze, and Eric H. Rudrud,Autism Partnership Foundation, 200 Marina Drive, Seal Beach, CA 90740.

Systematic review of using portable smart devices to teach functional skills to students with intellectualdisability. Minokowan Goo, Adela L. Maurer, and Michael L. Wehmeyer, Texas Woman’s University,Teacher Education PO Box 425769, Denton, TX 76204-5769.

Implementing evidence-based practices to promote self-determination: Lessons learned from astate-wide implementation of the self-determined learning model of instruction. Kathryn M. Burke,Karrie A. Shogren, Sheida K. Raley, Michael L. Wehmeyer, Anthony A. Antosh, and Terri LaPlante,University of Kansas, Department of Special Education, Joseph R. Pearson Hall, Room 517, 1122West Campus Road, Lawrence, KS 66045.

Educational programs for students with intellectual disability: Demographic patterns. Edward A.Polloway, Emily C. Bouck, and Lihua Yang, School of Education, Leadership Studies, and Coun-seling, Lynchburg College, 1501 Lakeside Drive, Lynchburg, VA 24501-3113.

Comparison of antecedent activities for increasing engagement in a preschool child with ASDduring a small group activity. Elizabeth A. Pokorski, Erin E. Barton, Jennifer R. Ledford, Abby L.Taylor, Elisabeth Johnson, and Heather K. Winters, Vanderbilt University, 230 Appleton Place,Peabody 228, Nashville, TN 37203-5721.

Address is supplied for author in boldface type.

Effects of TEACCH Structured Teaching on IndependentWork Skills among Individuals with Severe Disabilities

Inhwan Park and Yu-Ri KimEwha Womans University

Abstract: To support employment of individuals with severe disabilities, instructional approaches for improvingindependent performance are urgently needed. The purpose of this research was to assess the effects of TEACCHstructured teaching on the independent work skills of individuals with severe disabilities in a job setting. Amultiple probe across participants design was used for this study. Results demonstrated that structured teachingwas effective in enhancing engagement and reducing disruptive behavior in three individuals with severedisabilities in the absence of adult prompting. In addition, their performance was generalized in a different jobsetting.

For many individuals with disabilities, having ajob is a significant stepping stone in life (Goh& Bambara, 2013; Holwerda, van der Klink,Groothoff, & Brouwer, 2012; Lee & Kim,2014). Aside from providing for a meanstoward independent living, employment en-ables them to develop meaningful relation-ships, experience the feeling of success, par-ticipate in communities, and increase thequality of their lives. However, it is unrealisticto expect that every individual with a disabilitywho reaches the proper age to work will find ajob (Erickson, von Schrader, Bruyere, Van-Looy, & Matteson, 2014; Lee & Kim, 2014). Inparticular, finding a job is more complicatedand challenging for individuals with severedisabilities (Trembath, Balandin, Stancliffe, &Togher, 2010). In South Korea, more than63% of individuals with disabilities face unem-ployment or tremendous difficulties in find-ing a job (Korea Employment Agency for theDisabled, 2016), and the employment rate gapappears to be even wider when it comes toindividuals with severe disabilities comparedwith other disabilities (Jo & Kang, 2012).

Researchers have reported several reasons

for not employing individuals with severedisabilities, including insufficient work expe-rience, limited job opportunities, and lackof employment policies (Shier, Graham, &Jones, 2009). Individuals with severe disabili-ties also have low motivation, poor self-moni-toring skills, and serious problem behaviors(Park, Joe, & Hosp, 2013; Shier et al., 2009),and these characteristics often lead them torely on adult prompts or corrections to re-main engaged in work tasks. In order toobtain and retain employment, however,they must demonstrate job skills with a cer-tain level of job independence (Goh & Bam-bara, 2013).

As independent work skills are recognizedas critical for successful employment of indi-viduals with severe disabilities, a substantialbody of research has focused on instructionalapproaches for promoting independent per-formance (Snell, Brown, & McDonnell, 2015).Recently researchers have begun to use visualsupports (e.g., photography schedules, videomodeling) to teach individuals with severe dis-abilities to independently guide and maintaintheir work performance (Berenak, Ayres,Mechiling, & Alexander, 2012; Copeland &Hughes, 2000; Robinson & Smith, 2010; Wu,Wheaton, & Cannella-Malone, 2016). How-ever, research that evaluates the effectivenessof visual supports has typically included addi-tional instructional strategies such as behav-ioral rehearsal and adult corrections (e.g.,

The Ewha Womans University Scholarship of 2015supported this research. Correspondence concern-ing this article should be addressed to Yu-Ri Kim,Department of Special Education, Ewha WomansUniversity, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul,KOREA 03760. E-mail: [email protected]

Education and Training in Autism and Developmental Disabilities, 2018, 53(4), 343–352© Division on Autism and Developmental Disabilities

Structured Teaching and Independent Work Skills / 343

mailto:[email protected]

Copeland & Hughes, 2000; Robinson & Smith,2010; Wu et al., 2016).

Structured teaching as defined by DivisionTEACCH (Treatment and Education of Autis-tic and related Communication handicappedCHildren) is an instructional approach witha strong emphasis on visual components ofstructure that aims to increase and maximizeindependent work (Mesibov, Shea, & Schopler,2005; Shopler, Mesibov, & Hearsey, 1995). Itcomprises four major components: (i) physi-cal structuring (organizing the physical en-vironment), (ii) visual schedules (visual in-formation depicting where/when/what theactivity will be), (iii) work systems (indicatingwhat the individual will do in a work area),and (iv) visual organization (clear informa-tion on the goals and steps of a task) (Mesibovet al., 2005). TEACCH structured teachinghas been demonstrated to be effective at en-hancing independent performance in numer-ous studies that found that it increased en-gagement (Bennett, Reichow, & Wolery, 2011;Hume & Odom, 2007; Hume, Plavnick, &Odom, 2012; Taylor & Preece, 2010) andreduced problem behaviors (Bennett et al.,2011; O’Reilly, Sigafoos, Lancioni, Edrisinha,& Andrews, 2005) in educational settings.However, to date, scant research has empiri-cally validated its positive effects on enhancingindependent work skills in individuals withdisabilities in job settings. Additionally, fewpublished studies have shown that structuredteaching can be applied to individuals withsevere disabilities.

Despite strong recommendations to usestructured teaching as a comprehensive model(Mesibov et al., 2005), a pool of previous re-search has experimentally tested its individualcomponents, including visual schedules (Bryan &Gast, 2000; Pelios, MacDuff, & Axelrod, 2003),task organization (Mavropoulou, Papadopou-lou, & Kakana, 2011), and work systems (Car-nahan, Hume, Clarke, & Borders, 2009;Hume & Odom, 2007; Hume et al., 2012).However, little is known regarding how struc-tured teaching functions as a comprehensivemodel. The purpose of the present study wasto examine the effects of TEACCH structuredteaching as a comprehensive program on in-dependent work skills in individuals with se-vere disabilities in a job setting. The followingresearch questions were addressed:

1. Does TEACCH structured teaching in-crease engagement among individuals withsevere disabilities in a job setting?

2. Does TEACCH structured teaching de-crease disruptive behavior among individu-als with severe disabilities in a job setting?

Method

Participants

The participants were three individuals withsevere disabilities who lived in South Korea.They were served in a day program with voca-tional emphasis at G Rehabilitation Center.The criteria for participation were (i) diagno-sis of severe disability, (ii) no fine motor dis-ability, (iii) low engagement in work tasks, (iv)high problem behaviors, and (v) no prior ex-perience with structured teaching. Writtenconsent was obtained from the parents of thethree participants after the study procedureswere explained.

Kim was a 22-year-old male for whom theKorean Wechsler Adult Intelligence Scale-IV(K-WAIS-IV; Hwang, Kim, Park, Choi, &Hong, 2012) indicated an IQ of 44. On theKorean Community Integration Skills Assess-ment (CIS-A; Kim, Park, & Lee, 2004), hetested at an overall score of 67, which placedhim in the severely below average range offunction related to adaptive behavior. He alsoscored in the moderately autistic range on theKorean-Childhood Autism Rating Scale (K-CARS; Kim & Park, 1996). Kim could speak insentences with two or three words and readsimple words. He also could match the num-bers 1–10 to relative quantity. He tended torefuse or avoid non-preferred or unfamiliaractivities.

Yu was a 29-year-old male for whom theK-WAIS-IV (Hwang et al., 2012) indicated anIQ of 40. On the CIS-A (Kim et al., 2004), Yumeasured an overall score of 67, placing himin the severely below average range of func-tioning in adaptive behavior. He also scoredin the severely autistic range on the K-CARS(Kim & Park, 1996), and he had vision prob-lems. He could communicate his basic needsin one word but often demonstrated self-inju-rious behavior (e.g., slapping his face, yelling)and damaged property as a means of commu-nication.

344 / Education and Training in Autism and Developmental Disabilities-December 2018

Lee was a 24-year-old female. On the K-WAIS-IV (Hwang et al., 2012), she was rated ashaving an IQ of 40. On the CIS-A (Kim et al.,2004), her overall score was 81, placing her inthe low range of functioning in adaptive be-havior. She also scored in the severely autisticrange on the K-CARS (Kim & Park, 1996). Leeexhibited problem behaviors, including self-injury, escape, and refusal. She could speaksome urgent needs in one word, but she wasmore likely to use problem behavior to com-municate her needs.

Settings and Materials

Settings. The sessions in the baseline and in-tervention conditions were conducted in a work-room at the day program setting in which thethree participants were provided job trainingand leisure activities. The workroom containeda round table, work tables, and chairs, and matsand cushions were also placed in a corner.

Generalization probes were conducted in ajob setting similar to a sheltered workshop atthe G Rehabilitation Centre.

Materials. A variety of materials were cre-ated for individual participants based onTEACCH guidelines for physical structuring,visual schedules, work systems, and task orga-nization (see Table 1). Other materials usedin this study included a visual timer, a stop-watch, and a webcam.

Target Work Tasks

Several steps were used to select target worktasks for the intervention. First, recommenda-tions of potential target tasks were obtained

from service providers in the day program thatthe providers considered would promote thepossibility of employment. Second, participantswere observed in the day program setting toassess their current work performance. Finally,three work tasks were identified that partici-pants continued to require adult prompting orcorrections to stay on. The task selected for Kimwas to pack letters into envelopes, the task for Yuwas to separate items into different recyclingbins, and the task for Lee was to sort bolts andnuts.

Dependent Measures

Engagement and disruptive behavior were ob-served to measure the participants’ indepen-dent work skills in this study. Engagement wasdefined as the participant’s appropriatelyparticipating in the work task without adultprompting. It was recorded if the participantmaintained physical orientation toward thework tasks and manipulated work materialsappropriately (e.g., separating recycle items,putting finished materials into the finish box)in the absence of adult prompting. Disruptivebehavior was defined as inappropriate behav-ior that was unrelated to the task. It was re-corded if the participant used materials in aninappropriate way or displayed problem be-haviors (e.g., aggression, self-injury).

All sessions were recorded with a webcamduring the baseline, intervention, and gener-alization conditions. For Kim, 10-minute sam-ples of engagement and disruptive behaviorwere collected, and 5-minute samples werecollected for Yu and Lee. Two dependent vari-ables were recorded by 15-s partial interval

TABLE 1

Materials Used for Work Tasks

Kim Yu Lee

- partition - partition - partition- visual schedule - visual schedule - visual schedule- laminated cards with written & picture

symbols illustrating steps needed topack a set

- two recycling boxes with objects(a milk carton, a bottle ofyogurt) adhered to them

- two colored iron containers- colored bolts and nuts- laminated bolt and nut pictures

- letter paper and envelopes made withcolor paper and kraft board paper


recording, by placing “�” for occurrence and“�” for nonoccurrence. The ratios of engage-ment and disruptive behavior were estimatedusing the number of occurrences divided bythe total number of intervals multiplied by100.

Experimental Design

A multiple probe across participants design(Horner & Baer, 1978) was used to examinethe effects of structured teaching on engage-ment and disruptive behavior. The first step ofthis design was to evaluate levels of targetbehavior under baseline conditions until sta-ble baselines were established. The interven-tion was then applied in a staggered fashionuntil all three participants had received it. Itwas completed when the participant displayedhigh engagement (80% or more) for at leastthree consecutive sessions. Generalization ses-sions were conducted within 10 days after theintervention.

Procedure

Pre-baseline. The trainers in this researchwere two service providers who provided train-ing in the day program at G RehabilitationCentre. They had no experience with struc-tured teaching and were unfamiliar with be-havior intervention; they received one train-ing session of 2.5 hours. During the session,research objectives were introduced and themajor components of structured teachingwere explained. Information was also given ina detailed manual to aid in better understand-ing and applying structured teaching, andfeedback was delivered to the trainers acrossintervention sessions.

Baseline. During baseline, participants wereobserved in the workroom during times whenindependent work was expected. A trainerguided the participant to the work table, andprovided only general instructions (e.g., “let’sstart your work.”) with target tasks. Promptswere given when the participants engaged inbehavior that was dangerous to themselves orothers (e.g., calling a participant’s name,grabbing a participant’s hands). The sessionswere videotaped, and data collection beganwhen the participants were instructed to beginthe work task.

Intervention. The intervention occurred dur-ing times when independent work was ex-pected. Independent work time typically oc-curred in the morning during 20-minuteperiods, and the intervention for this studywas conducted two to three times a week.

The intervention consisted of four compo-nents of TEACCH structured teaching (i.e.,physical structuring, visual schedules, worksystems, and task organization), and the com-ponents were adapted to the individual needsof each participant. Physical structuring wasdefined as the organized environment thatprovided a visually distinct area for work tasksand removed distractions (Mesibov et al.,2005; Schopler et al., 1995). To organize thephysical environment, a work table was placedagainst one side of the wall and partitionswere built around the table.

The visual schedules presented what andwhen activities would be using symbols (Mesi-bov et al., 2005; Schopler et al., 1995). Thevisual schedules in this study showed a se-quence of activities that occurred in the morn-ing, and the sequence of scheduled activitiesconsisted of greeting, independent work, andthe preferred activity (e.g., walking, viewingvideo). Information on the participants’ pre-ferred activities was obtained from interviewswith service providers, and then an individualvisual schedule was made for each participant.The visual schedule (4 � 19 cm) for Kim andLee was made with considering “readabilityand portability.” A larger schedule (23.5 �36.5 cm) was made for Yu because of his visiondifficulties. All of the visual schedules in-cluded words and/or pictures that repre-sented different activities; they were adheredto the wall where the work table was placed toprovide participants with information on whatthey would do in the work area and what thenext activity would be.

The work system was defined as a visuallyorganized space to inform an individual ofwork tasks, amount of work to be completed,and total work time (Mesibov et al., 2005;Schopler et al., 1995). The work systems inthis study consisted of placing boxes of taskmaterials and a visual timer on the table.Boxes of materials required for the work taskwere placed to the participants’ left, and ma-terials were always visible. This setup allowedfor to visually communicating how much the


participants should work and what progressthey were making. With respect to the packingtask for Kim, because it included several steps,boxes of materials required for individualsteps and a finished box were placed on thetable in sequential order from left to right. Inaddition, a visual timer was used to communi-cate total work time and passage of time.

The aim of task organization was to provideinformation on goals, steps, and materials re-garding the task using pictures, colors, num-bers, words, and objects (Mesibov et al., 2005;Schopler et al., 1995). In this study, visualinstructions were provided with various sym-bols to explain how to perform tasks. For Kim,the task of packing letters and envelopes wasanalyzed into six steps, and visual symbols(pictures, numbers, letters) were used to illus-trate the steps for completing the task. ForYu’s task, in front of him were recycling boxesthat corresponding objects adhered to. ForLee’s task, bolts and nuts were coated with twodifferent colors (i.e., red, blue), and each oftwo containers was colored with the samecolor as the bolts and nuts; pictures were alsoattached to the containers to indicate whichone should be put where.

A trainer provided general instructions(e.g., “let’s start your work.”) with target tasks.She also provided gestural prompts (e.g.,pointing) related to using the structuredteaching system (e.g., indicating the workarea, attending to visual instructions, transi-tioning to the next activity) when necessary,and the prompts were faded as the partici-pants used the system independently. Thetrainers did not prompt them to completetheir task. As in the baseline condition, how-ever, prompts were provided during the inter-vention when the participants engaged in be-havior that was dangerous to themselves orothers. All sessions were videotaped, and datacollection began when the participants wereinstructed to begin their work tasks.

Generalization. Generalization probes wereconducted in a job setting similar to a shel-tered workshop within 10 days after the par-ticipants completed the intervention condi-tion. The setting was different from the oneused in the intervention condition, but com-ponents of structured teaching were appliedin an identical manner to that used in the

intervention condition. All baseline proce-dures were used in the generalization probes.

Interobserver Agreement

The first author and the second observerindependently rated participants’ recordedresponses in 33% of the sessions across allconditions for each participant. The secondobserver had prior experience in teachingchildren with disabilities in agencies. Reliabil-ity was calculated by dividing the number ofagreements by the number of agreements plusdisagreements and multiplying by 100. Anagreement was scored if both observers re-corded the occurrence or nonoccurrence ofdependent variables. Mean interobserveragreement (IOA) was 93% for engagement(range � 85–100%) and 90% for disruptivebehavior (range � 85–100%). Regarding theIOA for each participant, the average for Kimwas 88% for engagement (range � 85–100%)and 90% for disruptive behavior (range �85–100%). For Yu, average IOA was 94% forengagement (range � 85–100%) and 91% fordisruptive behavior (range � 85–100%). Av-erage IOA for Lee was 98% for engagement(range � 95–100%) and 90% for disruptivebehavior (range � 85–100%).

Procedural Integrity

Procedural integrity data were collected on allintervention sessions for each participant. Theprocedural integrity survey used 10 items inyes/no format (e.g., placing all required ma-terials in a planned manner, preparing indi-vidual work area). Procedural integrity wascalculated by dividing the number of itemsimplemented correctly by the total number ofitems completed, multiplied by 100. Proce-dural integrity across intervention sessions was96.5% for Kim (range � 90–100%), 98.4% forYu (range � 90–100%), and 97.0% for Lee(range � 90–100%).

Results

Independent work skills, as measured by en-gagement and disruptive behavior, improvedfor all three individuals with severe disabili-ties. The findings indicated that TEACCHstructured teaching was effective in increasing


engagement and decreasing disruptive behav-ior for the three participants (see Figure 1).

During the baseline condition, Kim showedengagement behavior in a mean of 27.5% of

Figure 1. Percentage of intervals of task engagement and disruptive behavior across the baseline, interven-tion, and generalization conditions for Kim, Yu, and Lee.


the intervals (range � 0–42.5%), and he en-gaged in disruptive behavior in an average of35% of the intervals (range � 15–82.5%). Inthe baseline condition, Kim’s disruptive be-havior was slightly above 80% of the intervalsfor the first sessions but decreased for the lastthree sessions. It was partly due to his ten-dency to avoid unfamiliar activities or tasks.During the intervention, his rate of engage-ment increased to 77.6% (range � 52.5–92.5%), and his disruptive behavior decreasedto 14.4% of the intervals (range � 2.5–52.5%). In the generalization probes, Kim’smean for engagement behavior was 81.8% ofthe intervals (range � 80–85%), and his av-erage disruptive behavior was 1.6% of the in-tervals (range � 2.5–4%) with two of foursessions being 0%.

Yu initially demonstrated engagement be-havior in 53% of the intervals (range � 45–55%) and disruptive behavior in 68% of theintervals (range � 35–85%) with an increas-ing trend during the baseline conditions. Dur-ing the intervention, Yu’s engagement behav-ior increased to 92.3% of the intervals(range � 75–100%) with an immediate levelchange. His disruptive behavior varied, rang-ing between 20% and 85% of the intervalswith the average rate of 52.8%. However, Yu’sdisruptive behavior revealed a decreasingtrend for the last five sessions. It was notedthat his mood and behavior were affected byhealth conditions. During the intervention,he had sleeping issues that could have causedthe variability in his disruptive behavior. Inthe generalization sessions, Yu’s average en-gagement behavior was 92.3% of the inter-vals (range � 85–100%), and his disruptivebehavior dropped to 32.5% of the intervals(range � 10 –55%).

During the baseline condition, Lee exhib-ited engagement behavior in 0.4% of the in-tervals (range � 0–5%), and disruptive behav-ior occurred in all sessions, with an averagerate of 100%. The introduction of structuredteaching resulted in an immediate levelchange in engagement, with eight of 10 sessionsbeing above 70%. Her mean rate of engage-ment behavior was 78.2% (range � 55–100%),and her disruptive behavior decreased to 41.4%of the intervals (range � 5–85%). Lee’s engage-ment behavior increased to 90% of the intervals(range � 90–90%) during the generalization

probes, whereas she showed disruptive behaviorin 40% of the intervals (range � 25–50%) witha decreasing trend.

Discussion

This study demonstrated that TEACCH struc-tured teaching was effective at keeping allthree participants with severe disabilities inde-pendently engaged with their work tasks andat reducing their disruptive behavior. Theirperformance was also generalized into a dif-ferent job setting. These positive findings sup-port literature on using structured teaching asan effective intervention for children with se-vere disabilities to enhance independent per-formance (O’Reilly et al., 2005; Panerai, Fer-rante, Caputo, & Impellizzeri, 1998; Taylor &Preece, 2010).

A number of factors may explain why struc-tured teaching was effective for improving in-dependent work skills in individuals with se-vere disabilities. First, individual work areashelped the participants to pay their attentionsto their tasks. The participants in this studyhad typically shared a work table for job activ-ities in a day program setting, and this couldhave introduced extraneous environmentalstimuli that impeded the participants’ abilityto engage in work tasks. However, at the be-ginning of this study, the setting was designedto minimize visual distractions. A work tablewas placed against one side of the wall, andpartitions were used to designate an individ-ual work area. This setup enabled the partici-pants to devote their attention to their worktasks without adult prompting.

Second, visual schedules including preferredactivities might have increased the participants’motivation. A visual activity schedule affixed tothe wall in the work area included “the nextactivity,” which was a preferred activity that fol-lowed the work task. During the intervention,the participants frequently checked their visualschedules, and this could have led them to ex-pect what was coming when the tasks were done,resulting in increasing their engagement andmitigating disruptive behavior.

Third, the work systems may have contrib-uted to the effectiveness of the intervention.In the work systems, there were work boxeswith their contents visible, which enabled par-ticipants to self-evaluate their progress. These


findings confirms findings from previous studiesthat showed that self-monitoring was an effectivestrategy for increasing independent perfor-mance (Coughlin, McCoy, Kenzer, Mathur, &Zucker, 2012; Ganz & Sigafoos, 2005; Hume,Loftin, & Lantz, 2009).

Fourth, visual supports provided concretecues and information on goals and appropri-ate steps of the work tasks. Visual supportshave been considered effective for promotingindependence (Mechling, 2007; Robinson &Smith, 2010) in that they enable individualswith disabilities to better understand worktasks. This study used several visual cues andsymbols to address the participants’ individualneeds. For example, for Lee’s task, pictures ofbolts and nuts were attached to two correspond-ing containers. This visually accessible informa-tion might have promoted her understanding ofthe task and prevented task avoidance. Thesefindings suggest that providing visual promptsshould be considered an intervention compo-nent for improving work independence in indi-viduals with severe disabilities.

As did previous research in this area (Humeet al., 2012; Mavropoulou et al., 2011; Pelios etal., 2003), this study provided evidence thatTEACCH structured teaching was effective inpromoting generalization of independentwork skills for individuals with severe disabili-ties. These positive results may be attributedto a number of features of structured teach-ing. First, structured teaching enabled the in-dividuals with severe disabilities to rely on vi-sual cues within the environment to remainengaged in their tasks. Thus, once they werefamiliar with components of structured teach-ing, the participants might have responded tosimilar visual cues in the different setting. An-other possible explanation for the generaliza-tion could be the continued practice that tookplace during structured teaching. During theintervention condition, the participants wereprovided with opportunities to repeatedly per-form simple work tasks (e.g., sorting bolts andnuts), which allowed them to have job skillswith a certain level of proficiency. It has beenshown that proficiency and automaticity en-hance generalization of skills (Gray, 2004).

During the intervention, the trainers werenot instructed to alter their typical prompting(e.g., calling a participant’s name, grabbing aparticipant’s hands) in response to the partic-

ipants’ dangerous behavior (i.e., self-injuriousbehavior, harming others). While this increasedintervention feasibility, the trainers’ promptingmight have affected the participants’ disruptivebehavior. However, dramatic changes in theirbehavior were observed between the baselineand intervention conditions for Kim and Lee.With respect to Yu, disruptive behavior showed aslight decline during the intervention andreached its lowest mean rate in the generaliza-tion. These findings suggest that structuredteaching, rather than the trainers’ prompts, isresponsible for decreasing disruptive behavior.

A major concern is the extent to whichbenefits of scientific research are translatedinto best practices in actual job settings (Volk-mar, Lord, Bailey, Schultz, & Klin, 2004).Therefore, it is essential that structured teach-ing can be easily implemented in natural jobsettings. The service providers in this studywere provided training and a manual aboutstructured teaching to be prepared as trainers.They indicated that the detailed manual wasuseful in implementing the intervention, andthey strongly recommended the interventionat the end of the study. This finding suggeststhat if appropriate training and a detailedmanual are provided to personnel in job set-tings, they may successfully implement struc-tured teaching.

Limitations and Future Research

Several limitations in this study should be ad-dressed. First, structured teaching is an in-structional approach with multiple compo-nents that might have affected enhancing theparticipants’ independent work skills. How-ever, it is possible that some components arenot necessary for an individual with severedisability to increase engagement and reducedisruptive behavior. Component analyses ofstructured teaching may be helpful in deter-mining if all of the components used in thisstudy are essential for replicating these out-comes. Second, trainer prompting was notcontrolled perfectly during the interventionsessions. The trainers were guided not to pro-vide prompting related to the work tasks.However, it was observed that the trainers in-termittently prompted the participants tocomplete their tasks at the beginning of theintervention. Future research should make an


effort to provide a clear protocol to guidefrequency and type of prompting. Third, in-terpreting the results is limited by the absenceof generalization measures at actual job sites.The authors asked permission to conduct gen-eralization probes in the sheltered workshopat the rehabilitation centre that the partici-pants were attending, but it was not feasiblebecause the center had regulations on pro-gram administration. Thus, additional re-search is necessary to investigate the efficacyof structured teaching in actual job settings.Finally, social validity data were not obtainedin this study. Efforts should be made to obtaindata from parents or other relevant people(e.g., center staffs).

Despite these limitations, this study ex-tended the current literature on TEACCHstructured teaching by evaluating its effects onengagement and disruptive behavior in indi-viduals with severe disabilities in a job setting.The findings of this study suggest that compo-nents of structured teaching may be a meansof assisting individuals with severe disabilitiesin performing independently in job settings.

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Received: 2 August 2017Initial Acceptance: 4 October 2017Final Acceptance: 18 December 2017


https://www.kead.or.kr/common/comm_board_v.jsp?no=380&gotopage=1&search=NAME&keyword=&data_gb=007&branch_gb=B01&station_gb=000&main=4&sub1=4&sub2=0&sub3=0&option=





Curricula to Teach Skills Associated with Self-Determination:A Review of Existing Research

Sheida K. RaleyUniversity of Kansas

Cristina Mumbardo-AdamUniversitat Ramon Llull

Karrie A. ShogrenUniversity of Kansas

David Simo-Pinatella andCliment Gine

Universitat Ramon Llull

Abstract: Researchers have linked the promotion of skills associated with self-determination with positive schooland post-school outcomes for students with disabilities, and there is an ongoing need to promote greater accessto instruction that enhances student self-determination. To that end, curricula were developed that provideteachers with content and strategies to promote skills associated with self-determination. The purpose of thisliterature review was to examine empirical studies of curricula to teach skills associated with self-determinationfor students with disabilities with an anticipated outcome of enhanced self-determination. The intent was tosynthesize what is known about existing curricula, their implementation, and outcomes of conducted interven-tions. Five different curricula were identified across seven studies. The results suggest that curricula associatedwith increasing self-determination are limited in availability and research in this area is declining. Implicationsfor practice and future research are discussed.

Research over the past 20 years has shown thatself-determination is linked to positive out-comes for people with and without disabilities(Hoffman & Field, 1995; Shogren, Lopez, We-hmeyer, Little, & Pressgrove, 2006; Shogren,Wehmeyer, Palmer, Rifenbark, & Little, 2015;Wehmeyer, 1996; Wehmeyer, Palmer, Shogren,Williams-Diehm, & Soukup, 2013). Further,enhancing skills associated with self-determi-nation (i.e., decision-making, goal-setting,problem solving) has been shown to improveacademic (Lee, Wehmeyer, Soukup, & Palmer,2010), postsecondary education (Kleinert,Harrison, Mills, Dueppen, & Trailor, 2014),and employment and independent living(Martorell, Gutierrez-Rechacha, Pereda, &Ayuso-Mateos, 2008) outcomes. Researchhas also shown that an individual’s self-de-termination predicts quality of life and lifesatisfaction (Nota, Ferrari, Soresi, & Weh-meyer, 2007).

Recently, self-determination has been re-conceptualized through the lens of CausalAgency Theory, an empirically-validated theo-retical framework for understanding self-de-termination and developing and enhancingsupports to enable people to develop greaterself-determination (Shogren et al., 2015a).Causal Agency Theory defines self-determina-tion as a “dispositional characteristic mani-fested as acting as the causal agent in one’slife” (Shogren et al., 2015a, p. 258). CausalAgency Theory maintains that self-determina-tion is an enduring tendency that is shapedover time by contextual factors (i.e., personal,school, community factors) that impact the de-velopment and expression of skills associatedwith self-determination. Skills associated withself-determination include choice-making, prob-lem solving, goal-setting and attainment, self-management skills, planning, self-advocacy, andself-awareness and self-knowledge. When teach-ers provide instruction and opportunities forthe development of these skills, their studentsengage in self-determined action, thus contrib-uting to the development of self-determination.One means through which to provide instruc-

Correspondence concerning this article shouldbe addressed to Sheida K. Raley, University ofKansas, 1200 Sunnyside Ave, Lawrence, KS 66045.E-mail: [email protected]


Self-Determination Curricula Review / 353


tion and opportunities is the use of curricula topromote self-determination.

Defining Curriculum

Curriculum has been defined as the what ofinstruction (Sands, Adams, & Stout, 1995). Assuch, curriculum defines the content of in-struction and typically begins with goals andobjectives, then moves on to content as ameans of delivering information (Squires,2002). To meet these aims and objectives, spe-cific interventions are embedded within cur-riculum to teach skills. The 1997 and 2004Amendments to the Individuals with Disabili-ties Education Act made clear that curriculardecisions for students with disabilities shouldbe based upon two sources: (a) the generaleducation curriculum, defined as the samecurriculum provided to all other students;and (b) the student’s unique learning needs(Browder, Spooner, & Meyer, 2011).

Teaching skills associated with self-determi-nation provides a means to address studentsunique learning needs, as well as the generaleducation curriculum, as research has demon-strated that skills associated with self-determi-nation (e.g., goal-setting, problem-solving, de-cision-making) are embedded in generaleducation curriculum standards for all stu-dents (Wehmeyer, Field, Doren, Jones, & Ma-son, 2004). Organizing instruction in the spe-cific skills associated with self-determinationinto a standalone curriculum provides ameans to ensure students learn and developthese skills. Alternatively, teaching modelstreat the curriculum, or the what in teaching,as a variable affecting the basic process ofteaching (Squires, 2002). A teaching modelserves as a framework within which multiplecontent areas can be taught through imitationof the basic framework, while a standalonecurriculum provides a framework for instruc-tion to enhance specific skills. Recent reviews(Lee, Wehmeyer, & Shogren, 2015) have fo-cused on the existent research examining theimplementation and outcomes of teachingmodels, specifically the Self-Determined LearningModel of Instruction (SDLMI; Mithaug, Weh-meyer, Agran, Martin, & Palmer, 1998) to en-hance self-determination. Furthermore, curri-cula can be compared based on the numberof skills associated with self-determination that

are targeted (e.g., goal-setting, planning, andself-monitoring). Recently, teaching multipleskills concurrently (i.e., multi-component in-terventions) has demonstrated efficacy in fos-tering self-determination (Cobb, Lehmann,Newman-Gonchar, & Morgen, 2009). How-ever, there has not been a recent review ofstandalone curricula designed to teach multi-ple skills associated with self-determination.Therefore, the purpose of this review is toexamine the implementation and outcomesof existing curricula intended to promoteskills associated with self-determination.

Purpose

In the late 1990s, Wood, Test, Browder, Algoz-inne, and Karvonen (1999) initiated the Self-Determination Synthesis Project (SDSP) withthe support of the U.S. Department of Educa-tion Office of Special Education Programs.The objective of SDSP was to synthetize anddisseminate knowledge of best practices of thetime in promoting skills related to self-deter-mination for students with disabilities. TheSDSP identified 450 published articles relatedto teaching skills and 60 curricula that targetedspecific skills associated with self-determinationthrough the synthesis (Test, Karvonen, Wood,Browder, & Algozinne, 2000). Given the lengthof time since this review, as well as subsequentresearch suggesting that the efficacy of multi-component interventions in enhancing overallself-determination (Cobb et al., 2009), an exam-ination of the currently available curricula thatpromote the development of self-determinationis warranted.

Therefore, the goal of this review was toexplore available curricula designed with theintent of increasing overall self-determinationand the degree to which there have beenchanges in the availability and implementa-tion of curricula since the SDSP. As such, it issignificant to note that this examination wasnot intended to identify the most effectivecurriculum associated with increasing self-de-termination; rather, the authors intend to pro-vide an overview of the available curricula anddescriptions of their use within the literature.Specifically, we were interested in (a) thecharacteristics of samples that have been rep-resented within research of curricula associ-ated with self-determination, (b) the types of


available curricula intended to increase over-all self-determination, (c) the patterns of boththe described use and implementation of cur-ricula related to self-determination, and (d)the reported outcomes of curricula imple-mentation.

Method

Search Procedures and Inclusion Criteria

A comprehensive review of the literature wasconducted using the following electronic da-tabases: EBSCOhost, PsycInfo, and Web of Sci-ence. The search terms included “self-deter-mination” and “disabilities” as keywords andwere combined with: “curriculum,” “curri-cula,” “curriculum intervention,” “curriculuminstruction,” “program,” “program instruc-tion,” and “program intervention.” The elec-tronic search parameters included articlespublished between 2000 and 2016 to capturerelevant curricula used in educational re-search since Wood et al. (1999). Article inclu-sion criteria included: (a) published in a peer-reviewed journal, (b) included participantsages 3 to 21 who were identified as havingdisabilities, (c) provided empirical data on theimplementation of a specified curricula, (c)included at least one outcome related to en-hanced self-determination, and (d) reportedon the outcomes of an implemented interven-tion using a specified curriculum associatedwith self-determination. Studies that includedstudents without disabilities were included solong as the sample contained students withdisabilities as well.

Procedure

The initial search yielded 1,434 studies thatrequired further screening for inclusion. Aftereliminating duplicates, a total of 573 articleswere assessed for their alignment with theinclusion criteria and those that did meet thecriteria were selected for further review (n �76). The first and second authors reviewed theabstracts of these 76 articles and excluded 50articles for not meeting the inclusion criteria.Full-text records of the remaining 26 articleswere independently examined and coded onthe inclusion criteria by the first and secondauthors separately, resulting in the identifica-

tion of four articles with 100% agreement. Ofthe 22 excluded articles, four did not includean outcome related to enhancing overall self-determination (e.g., Agran, Wehmeyer, Cavin,& Palmer, 2008), four did not report on anintervention (e.g., Karvonen, Test, Wood,Browder & Algozzine, 2004), and eight didnot use a specific, defined curriculum to teachself-determination (e.g., Finn, Getzel & Mc-Manus, 2008). Further, the participants inthree other articles were not students ages 3 to21 (e.g., Pascual-Garcıa, Garrido-Fernandez,& Antequera-Jurado, 2014). Lastly, one refer-ence was identified as a conference communi-cation and did not meet the peer-reviewedcriteria, and a final article was not translatedinto English.

To find additional articles that may nothave been identified through the search orwere published recently and not yet indexed,we conducted an ancestral search of the ref-erence lists of the 2016 volumes of two, top-ranked Special Education journals: ExceptionalChildren and Remedial and Special Education,and of the two journals where most of theincluded articles were published: The Journal ofSpecial Education and Career Developmental forExceptional Individuals. Further, the referencelists of these newly identified articles werecrosschecked with the previous search. Theancestral search resulted in the identificationof nine additional articles from which ulti-mately three aligned with the inclusion crite-ria. Thus, seven total articles were identifiedthat met inclusion criteria (marked with * inthe references).

Data Extraction

The first and second author coded the sevenarticles that met inclusion criteria in two do-mains: (1) relevant study information, and (2)intervention procedures and characteristics.The first domain included variables associatedwith study design and the samples of eachstudy, including: (a) sample size, (b) partici-pant age(s), (c) disability categories, and (d)the inclusion of students without disabilities.The second domain included variables in-tended to provide an overview of the interven-tion implemented, including: (a) researchdesign, (b) location of delivery, (c) implemen-tation length, and (d) facilitator of the imple-


mentation. Further, implementation-related vari-ables were collected such as: (e) the measureof self-determination used, (f) outcomes, and(g) social validity measure(s), if applicable.Given these categories of variables and thesmall number of articles, each reviewer inde-pendently identified and recorded the afore-mentioned variables and interrater agreementwas established for each variable of each arti-cle. Interrater agreement was calculated bydividing the number of agreements by thenumber of agreements plus disagreementsmultiplied by 100. Interrater agreement wasfound to be 97.7%, and identified disagree-ments were discussed until a consensus foreach was reached.

Results

Results were summarized and descriptively re-ported in four domains. First, the includedsample and study characteristics were aggre-gated and summarized. Second, the curricularintervention features (e.g., settings, facilitators,measures of self-determination) were described.Third, the curricula associated with self-determi-nation that were identified through the searchwere briefly presented. Finally, outcomes re-lated to self-determination and other relateddomains (e.g., academic, social, behavioral)were reported.

Sample and Study Characteristics

Across the seven included studies, four uti-lized a pre- and post-test design (e.g., Leeet al., 2011) and three used a randomizedcontrol trial design (e.g., Seong, Wehmeyer,Palmer, & Little, 2015) to examine the effectsof the curriculum on changes to overall self-determination. All the studies exclusively in-cluded children and youth with disabilitieswith a total sample of 1,042 students with dis-abilities. Sample sizes ranged from 15 (Weh-meyer, Garner, Yeager, Lawrence, & Davis,2006) to 371 participants (Wehmeyer et al.,2013). Participant disability labels included,intellectual disability (n � 5 studies; e.g., We-hmeyer et al., 2006), autism spectrum disor-der (n � 3 studies; e.g., Wehmeyer, Palmer,Lee, Williams-Diehm, & Shogren, 2011),learning disabilities (n � 6 studies; e.g.,Zhang, 2001), emotional and behavioral dis-

orders (n � 3 studies; e.g., Lee et al., 2011),Attention Deficit and/or Hyperactivity Disor-der (n � 2 studies; e.g., Wehmeyer et al.,2011), speech impairment (n � 1 study; Leeet al., 2011) and other health impairment(n � 1 study; Seong et al., 2015). Participantages ranged from 11 to 21 years, althoughsome studies only reported the mean andstandard deviation of age (e.g., Wehmeyeret al., 2013).

Self-Determination Curricula Use

The findings of the implementation of curri-cula associated with self-determination acrossthe seven selected studies are displayed inTable 1. Almost all the curricula were imple-mented in segregated settings, such as a self-contained special education classroom (n � 5;e.g., Seong et al., 2015), with the total inter-vention length ranging from 10 weeks (Lee etal., 2011) to 3 years (Wehmeyer et al., 2013).Further, implementation facilitators were pri-marily special education teachers (n � 6 stud-ies; e.g., Wehmeyer et al., 2011). Self-determi-nation outcomes were assessed through theuse of the Arc’s Self-Determination Scale (SDS;Wehmeyer & Kelchner, 1995; n � 7 studies)and the AIR Self-Determination Scale (AIR; Wol-man, Campeau, Dubois, Mithaug, & Stolarski,1994; n � 4 studies). Only one study includedmeasures of social validity in the form of stu-dent and teacher feedback forms (Lee et al.,2011).

Across included articles, five curricula asso-ciated with self-determination were identified,almost all of which were incorporated in We-hmeyer et al. (2013) which evaluated theimpact of using curricula associated with self-determination in general instead of one spe-cific curriculum. Therefore, and unlike theother studies included in this review, Weh-meyer et al. (2013) provided teachers with avariety of research-based curricula to choosefrom, and teachers were able to select thecurricula they would implement based on theneeds of their students. As the primary pur-pose of the study was to evaluate the impact ofinterventions related to enhancing self-deter-mination, not specific curricula, student par-ticipants of Wehmeyer et al. (2013) may havereceived instruction from multiple curricula


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or teaching models, which are further de-scribed below.

Curricula descriptions. Whose Future is it Any-way? (WFA; Wehmeyer et al., 2004) was themost frequently used curriculum among stud-ies (n � 5 studies; e.g., Lee et al., 2011). WFAis designed to promote student involvementin transition planning and consists of 36 ses-sions to enable students self-instruct to (a)develop disability awareness, (b) make deci-sions regarding transition-related outcomes,(c) identify community supports, (d) commu-nicate effectively, and (d) develop skills tobecome an effective team member or self-advocate.

The ChoiceMaker Curriculum (Martin & Mar-shall, 1994) and its components, the Self-Di-rected IEP (Individualized Education Program;Martin, Marshall, Maxson, & Jerman, 1996),were used in two studies (i.e., Wehmeyer et al.,2013; Seong et al., 2015). The ChoiceMakerCurriculum is divided into three sections: (a)choosing goals, (b) expressing goals, and (c)taking action. Lessons related to choosinggoals are intended to enable students to learnthe skills necessary to self-select goals based ontheir own interests. The second set of lessonsare from the Self-Directed IEP (Martin et al.,1996) and intend to teach students necessaryleadership skills to manage their annual IEPmeetings by communicating their interestsand goals with the IEP team. Lessons relatedto students taking action guides students inbreaking up their goals into specific andachievable action plans that together result inattainment of the final goal.

Steps to Self-Determination (Hoffman & Field,2005) was used as a curriculum option in We-hmeyer et al. (2013) and is composed of 16classroom-based lessons intended to teachskills related to self-determination, such as set-ting and attaining goals, self-advocacy, anddecision-making. Lessons are designed to im-prove adolescents’ and young adults’ insightsabout their goals, and how to set them anddeal with upcoming obstacles during the tran-sition to adulthood (e.g., post-secondary edu-cation, employment). Through these lessons,students are guided in learning about theirstrengths, areas of improvement, interests,and preferences as well as how skills includinggoal-setting, communicating, accessing re-sources and supports can help them reach

their goals or adjust previously made plansand set new goals.

The Next S.T.E.P. Curriculum (Halpern,Herr, Doren, & Wolf, 2000) was used in twoincluded studies: Zhang (2001) and Weh-meyer et al. (2013). This curriculum is de-signed to enable students to learn necessaryskills to successfully participate in a self-di-rected transition planning process. The cur-riculum consists of 19 lessons that teach stu-dents to self-evaluate the targeted skills andchoose personally selected goals across fourdomains: (1) personal life, (2) education, (3)employment, and (4) living on your own. Col-lectively, these lessons are intended to leadstudents into their personal transition plan-ning meeting, then take action based on de-cisions made, and keep track of their progress.

Finally, the Self-Advocacy Strategy (Van Re-usen, Bos, Schumaker, & Deshler, 2002), wasalso used as a curriculum option in Wehmeyeret al. (2013) and is composed of seven instruc-tional stages intended to increase a student’ssense of control and empowerment over theirown learning. The Self-Advocacy Strategy is de-signed to help students prepare for and par-ticipate in education or transition planningconferences, which are often IEP meetings.Using this curriculum, it is intended that stu-dents learn to determine and list their per-ceived strengths, areas of improvement, edu-cation and transition goals, and necessaryaccommodations. Further, students areprompted to share their lists during confer-ences or meetings, listen and respond to oth-ers, ask questions, and communicate theirgoals to various stakeholders.

Also, it is worth noting that two teachingmodels were used in conjunction with previ-ously described curricula to teach skills asso-ciated with self-determination in several stud-ies, including Beyond High School (Wehmeyeret al., 2006) and the SDLMI. Beyond HighSchool has been used across included articlessimultaneously with other curricula includingNext S.T.E.P Curriculum (Wehmeyer et al.,2006). Beyond High School is a multi-step teach-ing model designed to promote student self-determination and involvement in educa-tional planning throughout the transitionprocess by enabling students to set short- andlong-term goals, self-directed action planning,and evaluate program implementation. Simi-


larly, the SDLMI is a teaching model for prac-titioners to use across content areas to teachstudents skills related to self-determinationthat will subsequently enable students to self-direct the instructional process by settinggoals, planning action, and evaluating prog-ress to then make adjustments accordingly.

Curricular Interventions Outcomes

Although the purpose of this review was not toevaluate the quality of available curricula, theoutcomes of the included studies were sum-marized to explore their reported efficacy.Overall, reported outcomes highlighted theefficacy of curriculum associated with self-de-termination across studies, regardless of thespecific curriculum implemented. Only onestudy reported no significant changes in self-determination scores after implementation ofthe Self-directed IEP curriculum (i.e., Seong etal., 2015). However, the authors of this studydid report an increase in students’ percep-tions of their levels of autonomy. Differencesin assessment scores of self-determinationwere identified depending on the measure ofself-determination used as the AIR demon-strated differences in the capacity to engage inself-determined action and the opportunity toact in a self-determined way while the SDSdemonstrated a global snapshot of self-deter-mination (Wehmeyer et al., 2013; Zhang,2001). Additionally, other skills that are notdirectly associated with self-determinationwere improved through the use of the identi-fied curricula, such as transition empower-ment (n � 2 articles; e.g., Seong et al., 2015),and students’ knowledge about the transitionplanning process and self-efficacy for educa-tional planning (i.e., Lee et al., 2011).

Discussion

As mentioned previously, the purpose of thisreview was not to examine and report on thequality of existing curricula associated withself-determination; rather, it was intended todescribe the available curricula that specifi-cally intend to increase overall student self-determination and their associated implemen-tation outcomes. In contrast to Wood et al.’s(1999) comprehensive review of self-determi-nation literature and Test et al.’s (2000) sub-

sequent identification of over 60 availablecurricula that targeted skills associated withself-determination (e.g., self-advocacy, goal-setting), this review found that curricula in-tended to promote overall self-determinationhave been scarcely examined in the researchliterature since the early 2000s as evident bythe publication year ranges of the articles se-lected in this review. Simply stated, new curri-cula to promote overall self-determinationhave not been developed recently and existingcurricula have been rarely used and examinedin the research literature. Further, althoughreported outcomes of curricular interventionshave demonstrated an increase in overall self-determination and transition-related skills,this finding is only supported by seven studiespublished in the last 16 years. As such, thisfinding implies that despite the evidence ofpositive outcomes related to self-determina-tion curricula, they might not be the first op-tion selected to teach skills related to self-determination.

Amongst the identified articles, curriculawere primarily implemented with studentswith disabilities in segregated settings (e.g.,self-contained special education classroom).However, this finding is in contrast to recentresearch that has demonstrated significant dif-ferences in student participation in generaleducation and school- and community-basedactivities that are structured to promote inclu-sive practices (Hughes, Cosgriff, Agran, &Washington, 2013). Furthermore, a growingmovement focused on school reform that sup-ports the design and implementation of tieredmodels of support intended to provide high-quality support to all students in the generaleducation classroom, including students withdisabilities (Shogren, Wehmeyer, & Lane,2016). Within multi-tiered systems of supportsmodels, all students with varying supportneeds and from diverse cultural and linguisticbackgrounds are a part of Tier 1 and receiveacademic instruction and behavioral supportsin the general education classroom. Studentsthat remain unsuccessful with only Tier 1 uni-versally-designed instruction then receive ad-ditional, more intensive Tier 2 and 3 supportsto address specific academic, behavioral, andsocial needs in the inclusive classrooms oreducational setting (Sailor, 2009). As such,the results of this review suggest that available


curricula associated with self-determinationhave been utilized within research outside ofinclusive settings and separate from the gen-eral education curriculum, demonstrating aneed for further consideration of how to in-corporate curricula designed to teach skillsassociated with self-determination into multi-tiered systems of support models.

Future Research and Practice Directions

As inclusive practices are continually sup-ported through policy and by national organi-zations (U.S. Department of Education andHealth and Human Services, 2015), questionsregarding the degree to which curricula in-tended to teach skills associated with self-de-termination should be utilized in inclusive set-tings must be asked. Specifically, shouldvarious curricula related to promoting self-determination be used outside of the scope ofgeneral education? Is it possible that specificcurricula designed to teach skills associatedwith self-determination do not have a place inan inclusive setting? These are both questionsraised given the findings of this review andtheir answers will significantly impact howskills associated with self-determination aretaught in schools today.

Given the scarce use of curricula related toself-determination in research, it is importantto consider other alternatives to teach skillsassociated with self-determination. As previ-ously mentioned, researchers have identifiedteaching models as an alternative to stand-alone curricula to increase overall self-deter-mination. Teaching models provide a frame-work for how teachers organize and delivertheir instruction. One such teaching model,the SDLMI overlays instruction related to self-determination on other areas, which is uniquein terms of relevance across domains. A num-ber of research studies have recently evaluatedthe efficacy of the SDLMI when overlaidacross curricular domain areas (e.g., aca-demic, social, behavioral), settings (e.g.,school, home; Lee et al., 2015; Wehmeyer etal., 2012), and individuals with a broad rangeof support needs. Interestingly, reviews of theSDLMI have found that it has been morewidely used and examined across studies inrecent years (Hagiwara, Shogren & Leko, inpress). Therefore, models of teaching might

be more appropriate in addressing multipleareas of need related to self-determinationthan other standalone curricula. As such, fur-ther research is needed to explore contexts inwhich curricula or teaching models may bemost effective, or if there are ways to embedcurricula within inclusive settings like teach-ing models intend to do, or pull apart ele-ments of curricula to implement in the class-room.

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Received: 24 August 2017Initial Acceptance: 23 October 2017Final Acceptance: 22 November 2017




http://www.uncc.edu/sdsp

http://www.uncc.edu/sdsp

Effectiveness of Video Modeling Presented via Smartboard forTeaching Social Response Behavior to Children with Autism

Esin Pektas Karabekir and Nurgul AkmanogluAnadolu University

Abstract: This study aims to examine the effectiveness of video modeling presented via smartboard for teachingchildren with autism about social response in the form of gestures, and verbal and facial expressions indicativeof happiness and anger, and evaluate the method in terms of maintenance and generalization. The study useda multiple probe design across participants. Three male subjects diagnosed with autism, ages 3 to 5, participatedin the study. Results showed that with video modeling presented via smartboard, all three subjects were able tolearn about social response in the form of gestures, verbal and facial expressions indicative of happiness andanger, and generalize their learning to different settings, materials and persons. In addition, maintenancesessions conducted in weeks four and six and month seven following the end of the instruction showed thatsubjects retained the learned behavior. Social validity results showed that mothers and teachers of the childrenhad positive views about the study.

Children diagnosed with autism under DSM-5have visible deficiencies in social communica-tion and interaction (American Psychiatric As-sociation-APA, 2013). Among the most visibledeficits in this field include (a) deficits ininitiating, engaging in or maintaining socialinteraction, (b) deficits or inability in makingeye contact, using unusual gestures or facialexpressions, and understanding and usinggestures and facial expressions, and (c) defi-cits in dialogue and sharing interests and feel-ings (APA, 2013; Webber & Scheuermann,2008). Limitations in the use of gestures andfacial expressions, in particular, may preventthese individuals from engaging in successfulsocial interaction, and create difficulties informing and maintaining friendships withpeers (Baron-Cohen, 1988; Leaf, Dotson, Op-penheim, Sheldon, & Sherman, 2010).

In child development, the ability to under-stand and express feelings in social contexts in

which one is placed is an important concept.Giving the proper response both to discrimi-native stimuli in the social context and toaffective behaviors of others is an importantbehavior for the development of interper-sonal social interaction (Gena, Couloura, &Kymissis, 2005). This skill involves the abilityto make connections between contexts, affec-tive states and messages sent via facial andverbal expressions, intonation and gestures(Saymaz, 2008). These behaviors are alsocalled social response behaviors. Social re-sponse behaviors include understandingand expressing emotions that have a socialcommunicative function, and observable be-haviors such as facial and verbal expressions,intonation and gestures (Buffington, Krantz, Mc-Clannahan, & Poulson, 1998; Gena, Krantz,McClannahan, & Poulson, 1996; Gena et al.,2005).

Facial expressions and gestures are amongthe most important social response behaviors.In children with autism, the development ofgestures is affected by both qualitative andquantitative deficits. Children with autismhave deficits in the natural and spontaneoususe of gestures to express emotions depend-ing on the social context, comprehending ges-tures used by others, and imitating gestures(Ingersoll, Lewis, & Kroman 2006; Plimley &

This study was supported by a Grant from An-adolu University Research Fund (Project No:1508E574). Authors are grateful to NOVA Lan-guage Services for proof reading of the manuscript.Correspondence concerning this article should be ad-dressed to Nurgul Akmanoglu, Anadolu University,Research Institute for the Handicapped, Eskisehir,26470, TURKEY. E-mail: [email protected]


Social Response Behavior / 363


Bowen, 2007). Facial expressions, which playan important role in the development of so-cial competence, are considered to be theprimary and most important source of infor-mation mediated via social affective andverbal communication (Balconi, Amenta, &Ferrari, 2012; Tardif, Laine, Rodriguez, &Gepner, 2007). Facial expressions, when usedproperly, reflect emotions and allow the trans-mission of emotions appropriate for the socialcontext via the face. Expressing emotions us-ing specific facial expressions is considered toplay a very important role in social interactionand communication (Gena et al., 1996). Inaddition, the social context that gives rise tothe emotion is considered to have an impor-tant effect when assigning meaning to facialexpressions and emotions. For a child to learnabout the affective responses that are appro-priate for the social context, the ability toperceive the reasons and conditions that giverise to the emotion in question, known asaffective experience in the literature, is alsoimportant (Akmanoglu, 2015; Balconi & Car-rera, 2007; Balconi et al., 2012).

One of the well-known strengths of childrenwith autism is that they are able to perceivevisual stimuli more easily compared to otherstimuli, and can use visual clues in a moremeaningful way. In addition, some studies re-port that children with autism tend to be vi-sual learners rather than auditory learners,and therefore watching videos is a pleasurableactivity for them (Nikopoulos & Keenan,2006; Quill, 1997; Schneider & Goldstein,2010; Weiss, 2013). Because children with au-tism prefer visually presented stimuli and re-spond more positively to visual interventions,video modeling is an evidence based methodused effectively to instruct children with au-tism (National Autism Center-NAC, 2015; TheNational Professional Development Center onAutism Spectrum Disorders-NPDC, 2014).Video modeling involves the child watching avideo in which a model presents the targetbehavior or skill in an appropriate manner,and then independently performing this be-havior by taking the behavior presented in thevideo as a model (Charlop-Christy, Le, & Free-man, 2000; Delano, 2007; Murray & Noland,2013; NAC, 2015; Nikopoulos & Keenan,2006). In a report published by the NAC(2015), modeling is considered to be effective

in teaching higher order cognitive skills, aca-demic skills, communication skills, interper-sonal communication skills, interpersonal re-sponsibility, play skills, problem behaviors,social affective skills and sensory control.

With the development of technology andeasy access to devices, images used in videomodeling started to be presented via varioustechnological tools. The manner in whichvideo modeling is presented depends, in ad-dition to child characteristics and characteris-tics of the skill being taught, on the opportu-nities available to the trainer and the trainer’sexperiences and preferences. Today, videomodeling is presented via portable and newertechnologies such as tablet computers, smartphones, laptop computers, and smartboards(Argott, 2012).

A limited number of studies show that videomodeling can be used effectively for teachingsocial response behaviors to individuals withautism (Akmanoglu, 2015; Axe & Evans, 2012;Charlop-Christy & Daneshvar, 2003). We wereable to find only a single study on the use ofvideo modeling to teach all social responsebehaviors including, gestures, intonation, ver-bal and facial expressions. Charlop, Dennis,Carpenter, & Greenberg (2010) aimed toteach proper social response behaviors (ges-tures, intonation, verbal and facial expres-sions) during social interaction to three chil-dren with autism, using the video modelingmethod. In the study, video modeling wasused to present the proper gestures, intona-tion, verbal and facial expressions during so-cial interaction. The study was conducted withthe participation of three children diagnosedwith autism, ages 7 to 11. The study used amultiple baseline design across behaviors, asingle subject design. Results of the studyshowed that video modeling was effective inteaching social response behaviors to all theparticipants with autism, and all subjects wereable to generalize the acquired behaviors todifferent contexts, persons and stimuli. Thestudy did not collect maintenance data.

These studies on the teaching of social re-sponse behaviors suggest that video modelingcan be used to teach gestures, intonation, ver-bal and facial expressions, but they have somelimitations. These limitations, which also jus-tify the present study, are as follows: (a) In theone study on teaching all social response be-


haviors including gestures, verbal and facialexpressions, social responses were taught with-out associating these responses with affectivestates or contexts related to these affectivestates (Charlop et al., 2010). This study (Char-lop et al., 2010) did not include affective statesassociated with social responses or contexts inwhich emotions arise, which are known to bean important variable in the emergence ofemotions and related social responses. There-fore, there is a need for studies that includesocial contexts associated with emotions thatgive rise to social responses. (b) As limitationsof their study, Charlop et al. (2010) state thatthey did not collect generalization data onwhether the social responses taught would begeneralized to other contexts not included inthe study, or maintenance data that would testthe retention of the behaviors taught. Collect-ing generalization and maintenance data isimportant to remove doubts about the depen-dent variable (Kennedy, 2005). (c) A review ofthe literature shows that only about one thirdof the studies on the use of video modeling toteach social skills report social validity data.Failure to collect social validity data from thedirect stakeholders in the study is an impor-tant limitation as it hinders the evaluation ofthe social acceptance of the behavior taught,the appropriateness of video modeling, andthe significance of the effects (Acar & Diken,2012; Banda, Copple, Koul, Sancibrian, &Bogschutz, 2010).

For these reasons, the present study aims toexamine the effectiveness of video modelingpresented via smartboard for teaching chil-dren with autism about social responses in theform of gestures, verbal and facial expressionsindicative of happiness and anger. To thisend, answers were sought to the followingquestions: (1) Is video modeling presented viaa smartboard is effective in (a) the acquisitionof social response behaviors in the form ofverbal expression, use of gestures, and facialexpressions indicative of the affective states ofhappiness and anger, (b) the maintenance ofthese behaviors 4 weeks, 6 weeks and 7months after acquisition, and (c) the general-ization of this skill to different people, differ-ent settings and different social contexts cre-ated using different materials? (2) What arethe views of the parents and teachers of the

children who participated in the study (socialvalidity)?

Method

Participants

Subjects. The study was conducted with theparticipation of three male subjects diagnosedwith autism by the child psychiatry clinic of apublic hospital. All of the subjects attendgroup sessions from 09.00 a.m. to 12.30 p.m.in the Developmental Support Unit of An-adolu University’s Research Institute for Indi-viduals with Disabilities, and a preschool at-tended by children with normal development.Prior to the study, the Gilliam Autism RatingScale-2- Turkish Version (GARS-2-TV), devel-oped in 1995 by Gilliam and adapted for usein Turkey and standardized by Diken, Ardıc,and Diken (2012), was administered to all thesubjects.

Prerequisite skills for teaching the targetskills to the subjects are explained in the fol-lowing. As a prerequisite, subjects were re-quired to have the ability to (a) understandand perform verbal and visual instructionsthat involve at least two actions, (b) followvisual, verbal and auditory instructions, (c)direct attention to the images on the smart-board screen and watch the images for at least2 minutes, (d) imitate verbal skills that involveat least two words, (e) direct attention to anevent or situation for at least 5–6 minutes, (f)make eye contact, and (g) imitate facial ex-pressions. To decide whether the subjects hadthese skills, first, meetings were held with theirteachers and the subjects were observed inclass. Then, the researcher tested the subjectsfor each skill.

Efe is 3 years and 9 months old. On theStanford Binet Intelligence Test administeredby an expert, Efe received an intelligence quo-tient score of 114. Moreover, he received anautistic disorder score of 77 on the GARS-2-TVadministered. This score indicates that Efe islikely to have autistic disorder.

Uzay is 4 years and 3 months old. On theStanford Binet Intelligence Test administeredby an expert, Uzay received an intelligencequotient score of 130. Moreover, he receivedan autistic disorder score of 103 on the GARS-


2-TV administered. This score indicates thatUzay is highly likely to have autistic disorder.

Eren is 5 years and 3 months old. On theStanford Binet Intelligence Test administeredby an expert, Efe received an intelligence quo-tient score of 98. Moreover, he received anautistic disorder score of 86 on the GARS-2-TVadministered. This score indicates that Efe ishighly likely to have autistic disorder.

All subjects in the study were able to followinstructions that involve two or three actions,and speak in sentences that consist of a mini-mum of three or four words. The subjectshave deficits in initiating communication, andare unable to use verbal language appropriatefor the context. The subjects are comparableto their peers in terms of gross motor skillsand fine motor skills.

Models. One female and two male adultmodels have participated in the study. Adultmodels took part in the study to demonstratethe social response behaviors (facial expres-sions, gestures and verbal expressions) thatwere necessary for creating the social contextin the instructional videos to be watched bythe subjects. Care was taken to ensure thatmodels in the videos have as much diversity aspossible in terms of age, gender and physicalcharacteristics (weight, height, hair color andhair type). This is because the more diversestimulus and response examples in the in-struction process are, the more likely the sub-jects are to generalize the newly acquired skillswithout further instruction (Alberto & Trout-man, 2013; Sulzer-Azaroff & Mayer, 1991).

Models in the study participated in a 2-hourinformation session about the research pro-cess and expectations from them in this pro-cess. This information session proceeded asfollows: (a) explaining the aims of the study,(b) presenting discriminative stimuli that areappropriate for the context and that elicitsocial response behaviors, and explaining anddemonstrating the proper social responsebehavior elicited by the discriminative stim-ulus, (c) explaining and demonstratingwhat the models need to pay attention towhen shooting the videos, and (d) the re-searcher acting as a model and allowing themodels to practice.

To establish the validity of the instructionalvideos, an Instructional Video Validity Formwas prepared. Two experts who have worked

on autism spectrum disorder and video mod-eling were shown the videos, and their opin-ions were obtained about the appropriatenessof the videos. Experts were asked to evaluatethe videos in terms of whether the videos con-tained social contexts related to affectivestates of happiness and anger, whether facialexpressions were appropriate, and whetherthe images and audio were clear. Both expertswere of the opinion that the videos were fit forthe aims of the study.

Settings

Video modeling and probe sessions were con-ducted in one of the individual educationrooms of the Developmental Support Unit ofAnadolu University’s Research Institute forIndividuals with Disabilities. The rooms areequipped with observation mirrors, a rectan-gular table, two chairs, a closet for storing classmaterials, shelves and a smartboard.

Generalization probe sessions were held ingroup training rooms, a different setting fromthe rooms where instruction took place.

Materials

Materials used during the study were as fol-lows: (a) a digital video camera, (b) a laptopcomputer for editing the videos, (c) videorecordings with instructional content, (d) asmartboard, (e) objects and toys used to elicitthe expected social response behavior fromthe subjects, and (f) data collection forms.

Studies show that preparing individual vid-eos for each child is important in video mod-eling (Charlop et al., 2010; Murray & Noland,2013). Therefore, individual videos were pre-pared using the favorite toys and activities ofeach child, and taking their individual charac-teristics into account. To identify the favoriteactivities and toys of the children, the re-searcher had meetings with the parents andteachers of the subjects, and observed them inclass. The researcher also held preferenceevaluation sessions for the subjects to identifytheir preferences. Table 1 reports materialsand activities identified for each subject basedon information received from teachers andfamilies and from preference evaluation ses-sions informed by observations.


Trainer

The trainer of the study was the first authorof the manuscript. The trainer is currentlyworking toward a PhD in special education.The trainer also has experience providingone-on-one and group training to childrenwith autism.

Experimental Design

This study uses multiple probe design acrossparticipants, which is a single-subject design.In multiple probe design across participants,experimental control is achieved when thesubject instructed starts giving more correctresponses, no significant change is observedin the responses of the subjects not yet in-structed, and this effect is consecutively re-peated in the other subjects (Kennedy, 2005).To achieve experimental control, certain mea-sures were taken to control factors that mightaffect internal validity. To control externalfactors prior to the study, the researcher in-formed the families and the teachers at theinstitution attended by the subjects about thestudy, and asked them not to provide trainingconcerning the target behavior. In addition,the study was completed in a reasonableamount of time to control for maturity effect,and reliability data were collected in at least20% of all sessions throughout the study tocontrol measurement effects.

Dependent variable. The dependent vari-able of the study was defined as the perfor-mance of the appropriate social response be-havior by the subject within 5 seconds of theemergence of a discriminative stimulus thatelicits social response behaviors in the form ofverbal expressions, gestures or facial expres-sions indicative of the affective states of hap-piness and anger. A literature review con-ducted to identify the dependent variable ofthe study showed that social response behav-ior was defined as facial expressions, gestures,verbal expressions and intonations that areused in the presence of a discriminative stim-ulus that elicits appropriate social responsebehavior (Charlop et al., 2010).

Six basic universal emotions (happiness, an-ger, sadness, fear, surprise, pain) are known toplay a role in the comprehension and expres-sion of emotions appropriate for the context

(Ekman, 1999). This study, however, focuseson the emotions of happiness and anger.These emotions were selected because it isconsidered that preschool children with nor-mal development, particularly in their inter-action with peers in daily life, frequently useexpressions of happiness and anger. The se-lection of the independent variable to betaught to the subjects was also informed bymeetings held with the families and teachersof the children, the researcher’s in-class obser-vations, and preference evaluation conductedby the researcher.

Target responses and discriminative stimuli.Discriminative stimuli were identified on thebasis of the objects, toys and activities mostpreferred by the subjects according to prefer-ence evaluation. Table 1 reports the discrimi-native stimuli selected for each subject. Afteridentifying the discriminative stimuli, the re-searcher also prepared scenarios concerningsocial response behaviors that correspond tothe affective states of happiness and angerelicited in the presence of each discriminativestimulus. Scenarios involving the discrimina-tive stimuli and the target social response be-haviors are presented in Table 2.

Independent variable. The independent variablein this study is video modeling presented viasmartboard. Video modeling was provided ona one on one basis in two training sessions aday, 5 days a week.

Experimental Procedures

Experimental procedure of the study con-sisted of probe (baseline and daily probe ses-sions), instruction, maintenance and general-ization sessions.

Probe sessions. There were two types of probesessions in the study: baseline probe sessionsand daily probe sessions.

Baseline probe sessions. Prior to initiatingthe teaching of the social response behavior tobe studied, a minimum of three baselineprobe sessions were held with each subjectuntil stable data were obtained. With the firstsubject, stable data were obtained for threesessions in a row prior to initiating the instruc-tion. With the other subjects who had notstarted receiving instruction, baseline datacontinued to be collected on an intermittentbasis (once every 4 days). After the first subject


achieved a 100% correct response rate for thebehavior taught in three consecutive sessions,baseline data were collected from the secondsubject until stable data were obtained inthree consecutive sessions. After the secondsubject achieved a 100% correct response ratein three consecutive sessions, the same proce-dure was repeated for the third subject.

In baseline sessions, a total of six trials weremade for each subject, consisting of three dis-criminative stimuli for each of the affectivestates of happiness and anger, to give the sub-jects the opportunity to display the target be-havior. The intertrials intervals were fiveseconds. In all probe sessions, trials werepresented in an unpredictable order. In probesessions, correct responses were reinforced us-ing verbal reinforcements (e.g. Great!), fol-lowing a continuous reinforcement schedule.Incorrect responses, on the other hand, wereignored. Focused and cooperative participa-tion of the subject in the session was rein-forced at the end of each session using verbaland social reinforcers (e.g. you worked greattoday, you were amazing. High five!).

When collecting data for the probes, scenar-ios (Table 2) developed for evaluating thebehaviors to be taught were acted out. Thetrainer initiated the interaction with the sub-ject by presenting one of the discriminativestimuli to the subject (e.g. giving an iPad forthe subject to play with for a while, and thentaking it back) to elicit the appropriate socialresponse behavior. When the subject dis-played the appropriate social response behav-ior within 5 seconds (e.g. frowning with anangry facial expression, shaking his finger atthe researcher and saying “Don’t take.”), thesubject was verbally reinforced, and incorrectresponses were ignored.

Daily probe sessions. Daily probe sessionswere held to measure the performance of thesubjects concerning all the skills being taughtduring the instruction process, and data fromthese sessions are reported on the graph,marked as instruction phase data. Trainingsessions continued until the subjects achieveda correct response rate of 100% in three con-secutive daily probe sessions. Daily probe ses-sions were held following every two trainingsessions, and once prior to training sessionsheld every day. In daily probe sessions, correctresponses by the subjects were reinforced us-T

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aces

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e10

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wth

eri

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onto

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tin

gto

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line.

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esu

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tta

kes

the

rin

gsan

dto

sses

them

atth

est

ake.

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,I

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.”“Y

es,

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ade

it.”

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ing verbal reinforcers (e.g. “Well done.”), fol-lowing a continuous reinforcement schedule.The procedure followed in baseline probe ses-sions was followed in daily probe sessions aswell.

Training sessions. Training sessions wereheld twice a day, for 5 days a week. At least 45min. had been interrupted between the twotraining sessions. Training sessions were heldon a one-on-one basis. There were a total ofsix training videos, three for each of the affec-tive states of happiness and anger. A total ofsix trials were made in each training session.Once the subjects met 50% of the criteria intraining, trials in videos started to be pre-sented in an unpredictable order in eachtraining session. The intertrials intervals were5 seconds.

In training sessions, the trainer and the sub-ject sat side by side in front of the smartboard.Then, the trainer made a brief commentabout the video in order to attract the atten-tion of the subject to the video (e.g. “Now, wewill watch a video with you. Look, there aretwo people. Let’s see what they are going todo.”). Then, the trainer played the video, andpresented the target stimulus (e.g. “Uzay,please watch the video.”). The trainer had thesubject watch all six trials in the video withoutany intervals. If the subject got distractedwhen watching the video, the researcher di-rected the attention of the subject to the im-ages on the smartboard by giving an instruc-tion (e.g. “Uzay, please watch the videocarefully.”). When the subject watched thevideo carefully and made the correct re-sponses, he was verbally reinforced.

Immediately after watching the video, thetrainer created a setting in which the subjectwould have a chance to implement what thesaw on the video. To attract the attention ofthe subject to the practice, the trainer pre-sented discriminative stimuli (e.g. “Now weare going to play the game you have watchedon the video, alright?”). The trainer initiatedthe interaction with the subject by presentingone of the discriminative stimuli to the subject(e.g. giving an iPad for the subject to play withfor a while, and then taking it back) to elicitthe appropriate social response behavior (fa-cial expression, gesture and verbal expres-sion). When the subject displayed the appro-priate social response behavior within 5

seconds (e.g. frowning with an angry facialexpression, shaking his hand at the researcherand saying “Don’t take.”), he was reinforcedusing verbal reinforcers (e.g. “Well done, youare great!”), following a continuous reinforce-ment schedule. In addition, because all of thediscriminative stimuli used in training sessionswere selected from among the favorite activi-ties, games or toys of the subject, these dis-criminative stimuli also served as natural rein-forcers for the subjects. Incorrect responses,on the other hand, were ignored. Focused andcooperative participation of the subject in thesession was reinforced using verbal and socialreinforcers at the end of the training session.

Maintenance and generalization sessions.Maintenance sessions were held 4 weeks, 6weeks and 7 months after the criteria for tar-get behavior were met. Pretest and posttestmeasures were used to evaluate whether thesubjects generalized the skills that they haveacquired. Generalization was evaluated withdifferent people, settings, and contexts thatwere created using materials not included inthe training sessions for teaching the targetbehavior. The procedure followed in probesessions was also followed in maintenance andgeneralization sessions. Differently fromprobe sessions, reinforcement was faded, andfocused participation by the subject was rein-forced using verbal and social reinforcementsat the end of the session only.

Social validity. A “Social Validity Question-naire” was developed to examine the appropri-ateness of the methods used to teach the targetbehavior, and the significance of the results forthe teachers and mothers of the subjects. Socialvalidity data were collected using the subjectiveevaluation approach. The questionnaire forfamilies contained a total of 10 questions. Ofthose, eight were closed ended and two wereopen ended questions. The questionnairefor teachers contained a total of nine ques-tions, of which seven were closed-endedquestions and two were open ended ques-tions. These forms were distributed to fam-ilies and teachers in closed envelopes, andcollected without asking the participants toidentify themselves. Data from the question-naires were examined using descriptive anal-ysis (Schwartz & Baer, 1991).

Reliability. Inter-observer reliability andtreatment integrity data were collected in at


least 20% of the sessions held during the ex-perimental stage the study. Reliability datawere collected by the trainer and by an indepen-dent observer, a PhD student in special educa-tion. Inter-observer reliability data were ana-lyzed using the following formula: [(Agreement/Agreement � Disagreement) � 100] (Alberto& Troutman, 2013). Inter-observer agreementwas 99.3%.

Treatment integrity data were analyzed us-ing treatment integrity percentage, calculatedusing the following formula: “Observedtrainer behavior / Planned trainer behavior �100” (Billingsley, White, & Munson, 1980).Treatment integrity data for the training ses-sions were collected on the basis of the follow-ing behaviors: (a) preparing the video to beplayed on the smartboard, (b) preparing thematerials and arranging the room, (c) pre-senting the attention prompt for watching thevideo, (d) presenting the target stimulus (e.g.“Please watch the video.”), (e) having the sub-ject watch the video, (f) reinforcing the watch-ing of the video by the subject, (g) inviting thesubject to the play area, (h) attracting attentionby initiating interaction in an appropriate man-ner, (i) presenting the discriminative stimulus(toy or activity), (j) waiting for the responseperiod (5 seconds), (k) reacting in an appropri-ate manner to the subject’s response, (l) havingan interval between trials, and (m) reinforcingthe subject’s participation. Treatment integritywas 98.6%.

Results

Effectiveness Results

An examination of the data on social responsebehaviors concerning the affective states ofhappiness and anger, target behaviors for Efe,Uzay and Eren to learn, showed that they didnot display any correct responses in the initialstages. In the training stage, when video mod-eling was presented via smartboard, Efe, Uzayand Eren were observed to have a correctresponse rate of 100%. Data from mainte-nance sessions 4 weeks, 6 weeks and 7 monthsafter the training showed that Efe and Uzaymaintained the social response behaviors theylearned with a 100% correct response rate,and Eren with an 83% correct response rate(see Figure 1).

Generalization Results

Generalization data were collected with differ-ent people, settings, and contexts that werecreated using materials not included in thetraining sessions for teaching the target behav-ior. Generalization data showed that Efe, Uzayand Eren were unable to display correct re-sponse behaviors in pretest generalization ses-sions. Data from the posttest session, on theother hand showed that Efe and Uzay wereable to generalize their skills with a correctresponse rate of 100%, and Eren with a cor-rect response rate of 83 % (see Figure 1).

Instructional Data

Data from the training sessions showed thatEfe and Eren learned the social response be-haviors concerning the affective states of hap-piness and anger after 18 sessions, and Uzaylearned them after 14 sessions. A total of 108trials were made in training sessions with Efeand Eren until the criteria were met, and 84trials in the case of Uzay. Training sessionswith Efe lasted 3 hours, 57 minutes and 3seconds in total, 2 hours, 31 minutes and 7seconds with Uzay, and 3 hours, 49 minutesand 55 seconds with Eren. Efe and Eren ac-quired the target social response behavior af-ter nine daily probe sessions, and Uzay afterseven daily probe sessions. A total of 54 trialswere made in daily probe sessions with Efeand Eren, and 42 trials with Uzay. Trainingsessions with Efe lasted 1 hour, 15 minutesand 1 second in total, 40 minutes and 41seconds with Uzay, and 1 hour, 9 minutes and51 seconds with Eren. Before reaching thecriteria for the target behavior in training ses-sions, Efe gave 53 (49.07%) incorrect re-sponses, Uzay gave 40 (44.61%) incorrect re-sponses, and Eren gave 58 (53.70%) incorrectresponses. In daily probe sessions, on theother hand, Efe gave 15 (27.7%) incorrectresponses, Uzay gave 18 (42.85%) incorrectresponses, and Eren gave 22 (40.74%) incor-rect responses (see Table 3).

Social Validity Results

Parents’ opinions about the social validity of thestudy. Results of the study showed that allfamilies were of the opinion that teaching


social response behaviors in the form of verbalexpressions, gestures and facial expressionswas very important for their children, andvideo modeling presented via smartboard inthe teaching of these behaviors was effective.When talking about the aspects of the studythat they liked, parents said that their childrenrepeat what they learn at school in non-schoolcontexts as well. Families talked about thechanges they observed in their children after

the training as follows: “He talks about his feel-ings in out activities, for example when we go to apark or mall.” “He started saying ‘I did it!’ aftervisiting the bathroom.” “He used to remain silentwhen his toy was taken away, now he started saying‘No, don’t take!”

Teachers’ opinions about the social validity of thestudy. All of the teachers said that teachingsocial response behaviors to their studentsand the use of video modeling presented via

Figure 1. Percentage of correct responses in baseline, training, maintenance and generalization sessions.

TABLE 3

Instructional Data on Social Response Behaviors

SubjectsNo. of TrainingSessions/Trials

No. and %of Training Errors

Training Timeh:m:s

No. of Daily ProbeSessions/Trials

No. and % ofDaily Probe Errors

Daily Probeh:m:s

Efe 18/108 53–49, 07% 03:57:03 9/54 15–27, 7% 01:15:01Uzay 14/84 40–47, 61% 02:31:07 7/42 18–42, 85% 00:40:41Eren 18/108 58–53, 70% 03:49:55 9/54 22–40, 74% 01:09:51


smartboard to this end were important for theeducation of their students. When talkingabout the aspects of the study that they liked,teachers said that they observed the childrenrepeat what they learned in the classroom.

Discussion

This study examined the effectiveness of videomodeling presented via smartboard for teach-ing children with autism about social responsebehaviors concerning the affective states ofhappiness and anger. In addition, social valid-ity data in the form of subjective evaluationswere collected from the parents and teachersof the subjects who participated in the study.In the following sections, various aspects ofthe study are discussed in light of study results,and recommendations are made for futurestudies.

In the relevant literature, a limited numberof studies were found on the teaching of socialresponse behaviors concerning the affectivestates of happiness and anger (Akmanoglu,2015; Axe & Evans, 2012; Charlop-Christy &Daneshvar, 2003; Gena et al., 2005), and asingle study that aimed to teach all social re-sponse behaviors in the form of gesture, into-nation, verbal and facial expression (Charlopet al., 2010). Results of the present study areconsistent with the results of other studies onthe teaching of social response behaviors.However, the previous study aiming to teachall social response behaviors (Charlop et al.,2010), social response behaviors were plannedand taught without associating these re-sponses with affective states or contexts re-lated to these affective states. In the presentstudy, on the other hand, differently from theprevious study, different affective states anddifferent people associated with the social re-sponses, identified as important variables inthe emergence of social responses, were ex-amined. One of the strengths of the presentstudy is that it teaches all of the behaviorsrelated to the main deficits of children withautism in a holistic manner and in relation todifferent contexts. In addition, the results ofthis study contributes to the limited literatureon the teaching of this skill (Charlop et al.,2010).

Seven months after the instruction of thesubjects who participated in the study was

completed, data were collected to see whetherthe social response behaviors concerning theaffective states of happiness and anger weremaintained. Results of the study showed that,7 months after the instruction, all of the sub-jects maintained the behaviors they havelearned. Results of the present study concern-ing maintenance are consistent with those ofprevious studies on the teaching of varioussocial response behaviors to children with au-tism (Gena et al., 1996; Gena et al., 2005).However, the one study on the teaching ofsocial response behavior in the form of bothverbal and non-verbal behaviors does not re-port maintenance data (Charlop et al., 2010).Therefore, results of the present study onmaintenance makes a contribution to this lim-ited literature.

Results of the study show that social re-sponse behaviors concerning the affectivestates of happiness and anger, taught usingvideo modeling, is generalized to differentpeople, settings and contexts that are createdusing different materials. Results of the studyare thus consistent with those of other studiesin the literature (Charlop et al., 2010). How-ever, an examination of the data on general-ization in other studies shows that these stud-ies did not evaluate the target behaviors bycreating different social contexts. The presentstudy, on the other hand, has evaluated gen-eralization with different people, settings andsocial contexts created using materials not in-cluded in training, and by taking into accountprobable scenarios that the subjects may en-counter in daily life. Given the problems ex-perienced by children with autism concerninggeneralization (Neisworth & Wolfe, 2005),generalization sessions constitute anotherstrength of the present study. In addition, re-sults of the present study concerning general-ization expand the existing results reported inthe literature.

In terms of social validity, results of thepresent study showed that mothers and teach-ers of the children who participated in thestudy had positive opinions of the study. Char-lop et al. (2010) collected social validity datafrom undergraduate students. In the presentstudy, on the other hand, social validity dataare collected from parents and teachers. Inother words, the two studies collected socialvalidity data from different sources. Neverthe-


less, both studies report similar social validityresults. Collecting social validity data exclu-sively from the subjects that are the directparticipants in the study is an important limi-tation, and collecting social validity data fromparents and teachers of the subjects removesthis limitation (Schwartz & Baer, 1991). More-over, very few studies on the exclusive use ofvideo modeling to teach social skills reportsocial validity data (Acar & Diken, 2012).Thus, another contribution of the presentstudy to the literature is that it collects socialvalidity data from both parents and teachers.

Results of the present study on effective-ness, generalization, maintenance and socialvalidity are positive, but there are a number ofadditional points that need to be considered.First, subjects who participated in the studywere observed to display gesture and verbalexpression behaviors in a more natural man-ner, but their facial expressions were moremechanic and it took longer to acquire thisskill compared to the other skills. It is thoughtthat subjects with higher degrees of autism,indicated by their GARS-2-TV scores, hadmore unnatural facial expressions, in the formof simple imitation and displaying a more me-chanic expression. Diagnosis criteria in theliterature show that children with higher de-grees of autism need more support, particu-larly in the fields of social communication andinteraction (APA, 2013; Kırcaali-Iftar, 2013).Results of the study are thus consistent withother results in the literature. Second, resultsfrom the training sessions showed that Uzayreached the target criteria in a shorteramount of time compared to the other sub-jects. Even though Uzay’s GARS-2-TV scorewas higher than those of the other subjects, healso received a higher score on the StanfordBinet Intelligence, which might explain whyhe reached the target criteria faster. Deficien-cies in the social affective development of chil-dren with autism are insufficient to explainaffective deficits in autism; deficiencies interms of cognitive development also hinderthe social and affective development of chil-dren with autism (Baron-Cohen, 1988, 1989).Third, given that preparing individual videosis important in video modeling (Charlop etal., 2010; Murray & Noland, 2013), all of thediscriminative stimuli used in training sessionswere selected from among the favorite activi-

ties, games or toys of each subject. These dis-criminative stimuli, selected from among thefavorite activities, games and toys of each sub-ject, also served as natural reinforcers, whichis among the strengths of the present study.

Limitations and Future Research

Results of the study in terms of reliability,effectiveness and social validity were positive,but the study had some limitations as well.First, of the social response behaviors, facialexpression, gesture and verbal expressionwere studied, but intonation was not includedin the study. Second, social response behav-iors concerning only two affective states, thoseof happiness and anger, were studied. Third,an effort was made to create diverse and nat-ural social contexts to elicit social responsebehaviors, but these contexts were not natu-rally occurring situations in daily life. A finallimitation that training was not provided con-cerning cases where the trainer refuses to giveback the object demanded by the child, eventhough he displays the social response behav-ior concerning the affective state of angerwhen his toy is taken away.

Future studies are recommended to holdtraining sessions to teach social response be-haviors to autism with children in more natu-ral settings. This study examined social re-sponse behaviors in the form of facialexpressions, gestures and verbal expressions.Thus, future studies are recommended to in-clude intonation among the social responsebehaviors taught. In addition, future studiescan aim to teach social response behaviorsconcerning other emotions besides happinessand anger taught in the present study. Futurestudies could also provide training concerningcases where the trainer refuses to give backthe object demanded by the child, eventhough he displays the social response behav-ior concerning the affective state of angerwhen his toy is taken away.

In conclusion, video modeling presentedvia smartboard was found to be an effectivemethod for teaching children with autismabout social responses in the form of gestures,verbal and facial expressions indicative of theaffective state of happiness and anger. Re-searchers and practitioners working with indi-viduals with autism are recommended to use


video modeling to teach social response be-haviors and different affective states.

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Comparison of Individualized and Non-SpecificVideo-Prompts to Teach Daily Living Skills to Students with

Autism Spectrum Disorders

Sarah Domire MonacoThe College of New Jersey

Pamela WolfePennsylvania State University

Abstract: Three elementary students with autism spectrum disorders (ASD) participated in this study, whichcompared video self-prompting using individualized videos and video self-prompting using non-specific videos.Video self-prompting involves students controlling video-prompts, which show shortened video clips of someoneperforming steps of a target skill. The student then performs individual steps of the skill before proceeding to thenext video clip. An adapted alternating treatments design was used to compare individualized and non-specificvideo-prompts in teaching six daily living skills. Improvements were noted for both the individualized and thenon-specific video-prompts for all three students and all six skills. All three students required a slightly highernumber of sessions to meet 100% correct using the non-specific video-prompts than the individualizedvideo-prompts. One student was able to maintain the target skills 2 and 4 weeks post-intervention without theuse of video-prompts. Limitations of the study, suggestions for future research, and implications for educatorsare discussed.

Video modeling has been identified as anestablished, evidence-based intervention toteach personal responsibility skills to individ-uals with autism spectrum disorders (ASD) bythe National Autism Center (Wilczynski et al.,2009). This intervention uses videos of a per-fomer (e.g. teacher, peer, etc.) completing atarget skill. Students are shown the entirevideo of the task performance and then askedto complete the skill independently. Video-prompting is a form of video modeling. Un-like traditional video modeling, video-prompt-ing breaks the target skill into discrete stepsfor the student. Students watch clips of thevideo depicting the task sequence that is typ-ically less than 30 seconds in length, and areasked to perform a step before the next step isviewed (Cannella-Malone et al., 2006).

Video-prompting is a promising instruc-tional technique for individuals with ASD, par-ticularly due to their deficits in short-termworking memory (Poirier, Martin, Gaigg &

Bowler, 2011; Williams, Goldstein, Carpenter,& Minshew, 2005). These deficits becomemore apparent as tasks become more complex(Minshew & Goldstein, 2001). When informa-tion is presented to students in small seg-ments, it can be processed more effectivelyand efficiently (Minshew & Williams, 2008).Video-prompting allows students to graduallyattain the steps required to perform the de-sired skill while demonstrating proficiency.

A recent review of the literature identified12 studies that examined video promptingand daily living skills (Domire & Wolfe, 2014).Findings of the review showed that, althoughvideo-prompting is a promising interventionfor teaching daily living skills to students withASD, there are components of the interven-tion that still require more research. Someareas for needed research include: level ofindividualization, video self-prompting witherror correction procedures, maintenance oftarget skills, and social validity.

Level of Individualization

Tailoring the level of individualization of vid-eo-prompts involves using similar stimuluscomponents in the video as the natural envi-

Correspondence concerning this article shouldbe addressed to Sarah Domire Monaco, The Col-lege of New Jersey, 312D Education Building, Ew-ing, NJ 08628. E-mail: [email protected]




ronment for the student. These componentsinclude the setting where the target skill isperformed, the materials used, and the modelor participant. Incorporating these compo-nents into the video could improve studentperformance of the target skill. Bandura(1977) postulates the model of the video is animportant factor in imitation, stating that themost effective models are similar to the stu-dents in terms of gender, age, and ability-level.Thus, according to Bandura’s theory, studentswill be more likely to attend to a video wherethe model was similar to themselves or if thestudent themselves modeled the behavior.

In addition to using a similar model, usingsimilar materials and settings in video-promptscould have an effect on student performance.Individualizing these components in the vid-eo-prompts is a way of programming commonstimuli. This technique could be essential forstudents with ASD, who have difficulty gener-alizing newly learned skills to settings, materi-als, and contexts that differ from training(Maurice, Green, & Luce, 1996). Tradition-ally, video-prompting relies on a “train andhope” technique; students are delivered in-struction via videos that use different settingsand materials and students are expected totransfer this knowledge to a different context.

Limited research exists on the effects of thelevel of individualization of video-prompts onstudent outcomes. The case for individualiza-tion with this intervention is of significantimportance, due to the efficiency of creatingvideo-prompts. Creating individualized videoscould be time-consuming, and teachers havevoiced concern about the time required tomake video-prompts (Mechling, Ayres, Foster,& Bryant, 2013). This could affect the usabilityof the intervention. Individualization alsobrings up concerns regarding commercial vid-eo-prompts that are available as applicationsor computer software. If video-prompts mustbe individualized for each student, these com-mercial video-prompts may not be as effective.Research is needed to compare the effects ofindividualized video-prompts to traditional ornon-specific video-prompts.

Mechling and colleagues (2013) addressedthis need to compare individualized andnon-specific videos by comparing the effectsof commercially available and custom-madevideo prompts. Four high school males with

autism participated in the study related tocooking skills. Results showed that althoughgains were made with both commercial andcustom-made video-prompts, larger gains werenoted with the custom-made (individualized)videos.

Video Self-Prompting with Error CorrectionProcedures

Allowing students to control video-prompts(referred to as video self-prompting), allowsstudents to gain independence and reducethe need for external prompting from others.The majority of the studies centered on teach-ing daily living skills have focused on video-prompts controlled by a researcher or teacher,rather than the student controlling theprompts independently (Domire & Wolfe,2014). Specifically, three studies (Bereznak,Ayres, Mechling & Alexander, 2012; Mechling,Gast, & Seid, 2009; Payne, Cannella-Malone,Tullis, & Sabielny, 2012) have looked atvideo self-prompting. Bereznak and colleagues(2012) found that three students with ASDbetween the ages of 15 and 18 performed anincreased number of steps independently us-ing video-prompting. Results showed that twoof the three participants were able to self-prompt. Mechling and colleagues (2009) alsofound that students between the ages of 16and 17 were able to self-prompt to completecooking tasks. Payne, Cannella-Malone, Tullis,and Sabielny (2012) taught one 18-year-oldstudent to video self-prompt.

Questions remain over real time error cor-rection procedures for video self-promptingand video-prompting. Providing error correc-tion ensures that the student learns to per-form the skill correctly and does not practicethe error itself. Two studies that formallycompared error correction procedures (Can-nella-Malone et al., 2011; Goodson, Sigafoos,O’Reilly, Cannella, & Lancioni, 2007) notedthat error correction improved skill acquisition.

Maintenance and Social Validity

The literature on video-prompting offers mixedresults on the maintenance of target skills af-ter video-prompts are removed. Some studieshave shown participants were able to retainthe skills demonstrated in the video for up to

Comparison of Video Prompts / 379

10 weeks after the prompts were removed(Van Laarhoven, Kraus, Karpman, Nizzi, &Valentino, 2010; Van Laarhoven & VanLaarhoven-Myers, 2010). Other researchershave noted difficulty maintaining target skillsduring maintenance sessions (Bereznak et al.,2012; Sigafoos et al., 2007). The conflictingresults of these studies raise questions aboutwhether different components of video-promptsaffect maintenance of target skills.

Social validity has been identified as a qual-ity performance indicator for research studiesusing single-case design (Horner, Carr, Halle,& McGee, 2005). Domire and Wolfe (2014)found that social validity was consistentlyoverlooked in the video-prompting literature.Only three studies formally looked at socialvalidity measures (Mechling et al., 2009; Rayner,2011; Van Laarhoven et al., 2010).

This study aimed to examine areas of lim-ited research in existing video-prompting lit-erature including level of individualization,video self-prompting with error correctionprocedures, maintenance, and social validity.To address the level of individualization, thestudy compared non-specific video-promptsto individualized video prompts. Video self-prompting with error correction procedureswas used to broaden the research in theseareas. Maintenance data were collected to de-termine if students could maintain target skillsand if the level of individualization of thevideo-prompts affected performance. Finally,social validity was formally addressed to offerinsight into teachers’ perceptions of the inter-vention. The following questions guided thestudy:

1) What are the effects of individualized vid-eo-prompts and non-specific video-promptson student performance when teachingdaily living skills to elementary-age stu-dents with ASD?

2) What are the effects of video self-prompt-ing with live error correction procedureson daily living skill acquisition?

3) What are the effects of the interventionson the maintenance of the target skill?

4) Do teachers view individualized and non-specific video-prompts as a socially validand feasible intervention for their class-rooms?

Method

Participants

This study focused on elementary-age stu-dents, a population previously underrepre-sented in the video-prompting literature(Domire & Wolfe, 2014). Three students withASD participated in the study. An elementaryclassroom teacher who taught students withASD in a suburban district nominated stu-dents that a) were unable to perform the tar-get skill, b) had normal vision, c) had themotor skills required to navigate the videoprompts using the touch screen of the iPad,d) would benefit from learning the target skilland improved independence, and e) hadn’tformally been taught the target skill.

Chris. Chris was an 11-year-old African-American male. Chris received speech andlanguage therapy. The classroom teacher re-ported that Chris’s strengths included grossand fine motor skills, desire to participate,and complete activities independently. Areasfor growth included increasing vocabularyand making requests, basic addition and sub-traction skills, peer interaction, and word de-coding. Chris’s preferred reinforcers were ed-ibles, gross motor activities, and drawing.

Nolan. Nolan was a 12-year-old Caucasianmale. Nolan received speech and languagetherapy and occupational therapy services.The classroom teacher noted that Nolan’sstrengths included rote memory, peer interac-tion, and imitation skills. Areas for growthreported included improving expressive lan-guage skills, word decoding, verbal request-ing, and independent daily living skills. Rein-forcers that were commonly used with Nolanin the classroom were edibles, gross motoractivities, and sensory activities.

Zack. Zack was a 10-year-old Caucasianmale. Zack received speech and languagetherapy, as well as occupational therapy ser-vices. The classroom teacher reported thatZack’s strengths included memorization skills,sight word recognition, and appropriate be-haviors. Areas for growth included verbal re-questing, expressive language, word decod-ing, and independent living skills. Reinforcerscommonly used with Zack were edibles, com-puter time, and time on a bike.


Setting

Baseline, intervention, and maintenance ses-sions were conducted in the students’ class-room in a suburban school. The classroomconsisted of several different stations aroundthe room, with six student desks in rows in themiddle of the classroom. Sessions were con-ducted at a table in the back, left corner of theclassroom. Sessions were conducted with eachparticipant individually (i.e., one at a time).

Materials and Video-Prompts

An assessment was conducted prior to selec-tion of the intervention skills. After the assess-ment, in which no instruction for completionof the task was given, six daily living skills weretargeted for the intervention: folding a shirt,wiping the table, hanging a shirt, sweeping thefloor, getting a drink of water, and setting thetable. These skills were selected after the as-sessment showed that the participants werenot able to complete the skills independently.They were also chosen because the topogra-phy, or form of the behaviors, were compara-ble; they all primarily involve basic arm andhand movements, grasping, and releasing. Atask analysis revealed a similar level of diffi-culty and number of steps required to com-plete the six tasks chosen for the intervention.Each skill required a total of five steps. The

steps for each skill are detailed in Figure 1.Materials needed to complete these skillswere: a t-shirt, plastic bin, plate, cup, fork,knife, button-down shirt, hanger, broom, pa-per, dustpan, paper towels, cleaning spray,large bottle of water, and paper cup. Studentsused an Apple iPad to view the video-promptsusing the Keynote application. Each video-prompt was presented on a single slide. AnApple iPhone and iMovie was used to createand edit both sets (individualized and non-specific) of video-prompts. Both sets of video-prompts were filmed using a spectator-basedpoint of view. This point of view is filmed sothat the viewer watches someone else perform-ing the skill with their entire body as a model,rather than a performer-based point of viewthat uses hands and arms as the model beingshown. Audio voiceover was used to state thedirections for each step, and these steps weredisplayed in text along the bottom of eachvideo. At the end of each clip, an icon repre-senting “turn” was displayed, with the voi-ceover prompt of “your turn.” The two sets ofvideo-prompts differed in terms of the model,“turn” icon, materials used, and setting.

Individualized video-prompts. The individu-alized video-prompts were customized foreach student. Peers were used as models in thevideos, so that each student watched a modelthat was similar in terms of age and race.

Figure 1. Task analyses for target skills.


When the “turn” slide appeared on the indi-vidualized video-prompts, a picture of the stu-dent was shown on the slide with the student’sname included in the audio prompt (e.g. No-lan’s turn). The materials used in the individ-ualized video-prompts were the same as theintervention setting. The setting for the indi-vidualized video-prompts also was the samesetting where the students were asked to per-form the target skill.

Non-specific video-prompts. The non-specificvideo-prompts used an unknown adult as themodel. The model differed from the studentsin terms of age, sex, and appearance. At theend of each clip, the “turn” slide displayed aline drawing representation of the concept“turn,” with an audio prompt of “your turn.”The materials used for the non-specific video-prompts differed from the materials used inthe intervention wherever possible (e.g. dishesused were different in terms of size and color,different brands of items were used, differentclothes). The setting used for this set of video-prompts was a home environment unknownto the students.

Research Design

An adapted alternating treatments design(AATD) was used to compare the effects ofthe individualized video-prompts and the non-specific video-prompts. In this design, afterthe baseline phase is complete, the interven-tions are administered, and the effects on be-havior are observed (Barlow & Hayes, 1979).The two interventions (individualized andnon-specific) were counterbalanced acrosstasks and participants in order to minimizethe risk of sequencing effects. The AATD is acomparison design that looks at the efficiencyof interventions. Wolery, Gast, and Hammond(2009) define efficiency as having two dimen-sions: 1) the strategy reliably produces learn-ing and 2) the strategy is superior to anotherstrategy on an important dimension.

Procedure

When selecting participants, the classroomteacher was asked to nominate students thatwere familiar with the touch screen interfaceof the iPad. Prior to the baseline session, stu-dents were introduced to the iPad and Key-

note application. Participants were not askedto locate this application on the iPad; Keynotewas already open to the video-prompts duringthis session and all phases of the study. Stu-dents were shown how to move through theslides by sliding the screen and play the movieby pressing the arrow in the center. Partici-pants were assessed on this skill by the re-searcher asking, “Show me the next slide” and“Play the movie.” During this session, the re-searcher also instructed the participant to per-form each step after watching the video. Tar-get skills were counterbalanced within andacross participants for all phases of the study.Sessions were recorded using a laptop com-puter.

Baseline. No video-prompts were used dur-ing the baseline sessions. Participants wereprovided with the necessary materials to com-plete the task (e.g., plate, cup, knife, fork) andverbally prompted to complete the task (e.g.,“Can you fold the shirt?”). If the student didnot initiate the step within 10 seconds, theresearcher provided the verbal prompt tocomplete the task again. If the student com-pleted some of the steps but not all, the re-searcher asked, “Are you finished?” If the stu-dent responded “yes,” the session was ended.Data were collected on how many steps thestudents could complete independently, with-out any external prompting. Baseline datawere collected for a minimum of five consec-utive sessions or until the data was stable. Sta-bility was defined as variability of less than50% from the mean of the baseline (Alberto& Troutman, 1982). Students showed slightlyhigher than 50% variability with 2 of the 18tasks across participants (i.e., Nolan’s task ofwiping table, Zack’s task of getting a drink ofwater). Despite this higher variability, effectswere still consistent across participants andacross tasks.

Comparison. During the comparison phase,students were given the same verbal prompt asin the baseline phase. Each participant stu-dent was then presented with the iPad open tothe video-prompts for that particular skill. Thestudent clicked on the arrow in the center ofeach slide, watched the video, completed thestep, and progressed to the next slide to watchthe video of the next step. If the studentplayed and watched the video, but did notinitiate any of the steps after 10 seconds, the


researcher modeled the step. If the studentplayed and watched the video, and began toperform the step incorrectly, the researcherinterrupted the error and modeled the step. Ifthe student played the video but didn’t look atthe screen, the researcher prompted the stu-dent to watch the video again. If the studentbegan to perform the step but didn’t com-plete the step within 30 seconds, the re-searcher modeled the step. Data were col-lected daily for 10 sessions and the number ofsessions to reach 100% correct was comparedacross interventions.

Maintenance. Maintenance sessions wereconducted two and four weeks after the in-tervention phases in the students’ classroom.The procedures for the maintenance sessionswere the same as in baseline, with no video-prompts being available to the student. If thestudent did not meet the criteria of 100%accuracy on a target skill, they were reintro-duced to the video-prompt set for that targetskill.

Dependent Variables and Data Analysis

The main dependent variable in the study wasthe percentage of steps performed by the par-ticipant that were independently correct. Datawere collected and analyzed across all condi-tions for this variable. Upon completion of allphases, the data were visually analyzed to com-pare changes of level and trend between thetwo sets of video-prompts. The average num-ber of sessions to meet 100% correct also wascalculated and compared across studentsand interventions. Finally, Nonoverlap of AllPairs (NAP) was calculated. NAP measures thenonoverlap or “dominance” between phases(Parker & Vannest, 2009). Another way todefine NAP is “the percentage of data whichimprove across phases” (Parker, Vannest, &Davis, 2011, p. 312). NAP is calculated by com-paring each baseline data point to each inter-vention data point. Each comparison is scoredbased on the level of overlap between the datapoints.

Inter-Observer Agreement and Procedural Integrity

Inter-observer agreement. Inter-observer agree-ment (IOA) was calculated for the percentageof steps completed independently. IOA was

calculated by dividing the number of agree-ments by the number of agreements and dis-agreements and multiplying by 100 (Caro,Roper, Young, & Dank, 1979). A trained grad-uate student observed and scored 30% of ran-domly selected videos of across all phases. Af-ter completing the scoring, the researcherand graduate student compared scores to de-termine if and where any discrepancies ex-isted. The average IOA across all participantswas 97% (range: 90%–100%). There wereslight variations in IOA between participants.Chris’s average IOA was 98% (range: 93%–100%), Nolan’s was 97% (range: 93%–100%),and Zack’s was 96% (range: 90%–100%).

Procedural integrity. The same graduate stu-dent also scored 30% of the videos for proce-dural integrity. A checklist was developed toensure that the researcher followed all of theadministration procedures across the base-line, intervention, and maintenance phases.Procedural integrity was calculated by dividingthe number of procedural steps completedcorrectly by the total number of proceduralsteps and multiplying by 100 (Billingsley,White, & Munson, 1980). The average proce-dural integrity across all participants was 96%(range: 88%–100%). Chris’s average proce-dural integrity was 100%, Nolan’s was 94%(range: 88%–100%), and Zack’s was also 94%(range: 89%–100%). Variation between par-ticipants can be attributed to the increasednumber of opportunities to correct errors forNolan and Zack.

Social Validity

Following the intervention, the classroomteacher was asked to complete a survey askingabout her opinions and attitudes on the ac-ceptability of the intervention, the outcomes,and the goals of the intervention. These threecomponents have been identified as a neces-sary framework for assessing social validity(Wolf, 1978). The survey consisted of the fol-lowing questions:

1) Would you use video self-prompting inyour classroom? Why or why not?

2) Do you feel that your students benefitedfrom their exposure to video-prompts?Why or why not?


3) Do you feel the goals (sweeping the floor,wiping the table, etc.) are social signifi-cant?

4) Do you feel the video-prompting interven-tion is accepted by society/families/peersas being an appropriate method for teach-ing?

5) Would you choose to use individualized orcommercial/non-specific video-prompts inyour classroom? Why?

Results

Results showed that students improved inthe percentage of steps performed correctlyacross all six target skills using both individu-alized and non-specific video-prompts. Differ-ences were noted amongst participants interms of the degree of the percentage of in-crease in performance, and the maintenanceof the target skills. All students required afewer number of sessions to meet 100% cor-rect using individualized video-prompts. Ta-ble 1 shows the students’ average performanceacross all phases and number of sessions toreach 100% correct for individualized andnon-specific video-prompts. Table 2 shows thestudents’ average Nonoverlap of All Pairs forindividualized and non-specific video-promptsbetween baseline and intervention phases.

Chris

Individualized video-prompts. Chris’s resultscan be seen in Figure 2. The target skills thatChris viewed using individualized video promptswere folding a shirt, hanging a shirt, and get-ting a drink of water. Using individualizedvideo-prompts, the average number of ses-sions for Chris to reach 100% correct for thethree target skills was 1.33 sessions. Chris’saverage NAP from baseline to interventionphase for all three target skills using individ-ualized video-prompts was 100%.

Non-specific video-prompts. The target skillsthat Chris watched non-specific video-promptsfor included wiping a table, sweeping thefloor, and setting the table. Using non-specific

TABLE 1

Students’ Average Performance and Number of Sessions to Reach Criterion across Baseline, Intervention,and Maintenance Phases

Individualized Video-Prompts

Student Baseline (%) Intervention (%) Maintenance (%) Sessions (#)

Chris 42.7 94.7 97.7 1.3Nolan 4.0 70.7 56.7 5.3Zack 30.7 74.7 61.7 4.7Average 25.8 80.0 72.0 3.8

Non-Specific Video-Prompts

Student Baseline (%) Intervention (%) Maintenance (%) Sessions (#)

Chris 17.3 90 93.3 3Nolan 26.7 68.7 65 7.3Zack 0 62 62.3 7Average 14.7 73.6 73.5 5.7

TABLE 2

Students’ Average Percentage of Nonoverlap ofAll Pairs

IndividualizedVideo-Prompts

Non-SpecificVideo-Prompts

Chris 100 100Nolan 100 93Zack 96 96Average 99 96


video-prompts, the average number of ses-sions for Chris to reach 100% correct for thethree target skills was three sessions. Chris’saverage NAP for skills taught using non-spe-cific video-prompts was also 100%.

Maintenance. Two weeks after the interven-tion, Chris was able to maintain 100% accu-racy for four of the six target skills withoutthe use of video-prompts. When the video-prompts were reintroduced for the setting thetable and getting a drink of water tasks, Chris’s

performance increased. Four weeks after theintervention, Chris was able to perform allsix target skills without the use of the video-prompts.

Nolan

Individualized video-prompts. Nolan’s resultscan be seen in Figure 3. The target skillsthat Nolan viewed using individualized video-

Figure 2. Percentage of steps performed correctly by Chris across baseline, intervention, and maintenancephases for the individualized video prompts (triangles) and non-specific video-prompts (circles).Target skills were counter-balanced in all sessions.


prompts were wiping the table, sweeping thefloor, and setting the table. The average num-ber of sessions for Nolan to reach 100% accu-racy with individualized video-prompts was5.33 sessions. Nolan’s average NAP for skillstaught using individualized video-prompts was100%.

Non-specific video-prompts. Nolan watched non-specific video-prompts for folding a shirt,hanging a shirt, and getting a drink of water.Using non-specific videos, the average num-ber of sessions to meet criterion for Nolan was

7.33 sessions. Nolan’s average NAP for non-specific video-prompts was 93% (folding ashirt: 95%, hanging a shirt: 85%, getting adrink of water: 100%).

Maintenance. During the 2-week mainte-nance session, Nolan’s performance droppedsharply to baseline levels without the use ofvideo-prompts. When the video-prompts werereintroduced, Nolan’s performance increasedto 100% for wiping the table, hanging a shirt,and getting a drink of water. He reached 80%using the video-prompts for folding a shirt

Figure 3. Percentage of steps performed correctly by Nolan across baseline, intervention, and maintenancephases for the individualized video-prompts (triangles) and non-specific video-prompts (circles).Target skills were counter-balanced in all sessions.


and sweeping the floor, and 60% for settingthe table. At the 4-week maintenance session,Nolan again displayed a decrease in perfor-mance without the video-prompts, but uponreintroduction of the video-prompts, achieved100% accuracy for all six target skills.

Zack

Individualized video-prompts. Zack’s resultscan be seen in Figure 4. The target skills that

Zack viewed using individualized video promptswere folding a shirt, hanging a shirt, and gettinga drink of water. The average number of ses-sions required for Zack to reach 100% correctusing individualized video-prompts was 4.66 ses-sions. The average NAP for Zack using individ-ualized prompts was 96% (folding a shirt: 100%,hanging a shirt: 88%, getting a drink of water:100%).

Non-specific video-prompts. The target skillsthat Zack watched non-specific video-prompts

Figure 4. Percentage of steps performed correctly by Zack across baseline, intervention, and maintenancephases for the individualized video prompts (triangles) and non-specific video-prompts (circles).Target skills were counter-balanced in all sessions.


for included wiping a table, sweeping thefloor, and setting the table. Using non-specificvideo-prompts, the average number of ses-sions for Zack to reach 100% correct for thethree target skills was seven sessions. Zack’saverage NAP for skills taught using non-spe-cific video-prompts was also 96% (wipe table:100%, sweep floor: 94%, set table: 94%).

Maintenance. Zack’s performance at thetwo-week maintenance session varied greatly.When asked to perform the skills without theuse of the video-prompts, Zack’s performancedropped for all target skills, with some return-ing to baseline levels (hanging a shirt, sweep-ing the floor, setting the table). When thevideo-prompts were reintroduced, performancelevels increased for all skills, with Zack reach-ing 100% correct for hanging a shirt, sweep-ing the floor, and getting a drink of water.During the 4-week maintenance session,Zack’s performance improved on most tasks.He completed one task without the use ofvideo-prompts (setting the table) and met100% correct with the reintroduction of thevideo-prompts for all tasks except for hanginga shirt (80% correct).

Social Validity

The classroom teacher stated that she woulduse video self-prompting in her classroom,noting that her students seemed very inter-ested in the intervention and that in generalthey are sometimes more successful with vid-eo-based instruction than face-to-face instruc-tion. She shared that she would chose to useindividualized prompts rather than non-spe-cific prompts, because she thought it wouldhelp her students become more successful.The teacher noted, however, that it would bemore difficult and time-consuming to createthe individualized video-prompts. When askedabout the acceptability of the outcomes, sheresponded that she felt as though her studentsbenefited and she could see their level ofindependence increase. The teacher sharedthat she also felt the goals and interventionwere acceptable and appropriate, stating thatthe goals would help her students “be a moreactive participant in the community and be-come more independent at school and home.”

Discussion

The study aimed to expand the current liter-ature on video-prompting by comparing theeffects of the level of individualization on stu-dent outcomes, effects of video self-promptingwith error correction procedures, mainte-nance of target skills, and social validity.

Level of Individualization

Adjusting the level of individualization ofvideo-prompts can be viewed as a way of pro-gramming common stimuli, which may im-prove student performance (Stokes & Baer,1977). Individualizing features of the modelso that he or she more closely mirrors thestudent in terms of gender, age, and ability-level, may also help the student to imitate theskill (Bandura, 1977). This study comparedthe effects of individualized and non-specificvideo-prompts to determine if the level of in-dividualization of the video-prompts affectedstudent outcomes.

Using the components of efficiency definedby Wolery, Gast, and Hammond (2009), bothinterventions were shown to be efficient interms of reliably producing learning. All stu-dents showed gains in performance with bothindividualized and non-specific video-promptsfor all target skills. One student was able toreach 100% correct for all six skills. The othertwo students were able to reach 100% correctfor five of the six target skills. All three stu-dents had high levels of NAP for both condi-tions (range: 93–100%), demonstrating littleoverlap between the baseline and interventiondata.

Individualized video-prompts were more ef-ficient than non-specific video-prompts whenlooking at the rapidity of learning; the meannumber of sessions to reach 100% accuracywas higher for all participants. These resultsmirror those of Mechling et al. (2013), whichshowed four students made positive gains us-ing commercial and custom-made prompts,but had faster skill acquisition using the cus-tom-made (individualized) prompts. In thisstudy, the average NAP across participants forthe two conditions was also slightly higher forthe individualized video-prompts (individual-ized: 99%, non-specific: 96%). Despite thesimilarities across participants, the students in


the current study did display individual differ-ences in performance.

Chris. Chris’s performance using the indi-vidualized and non-specific video-prompts wasvery similar. Chris did display a slightly higherincrease in his mean level of performancefrom baseline to intervention using non-spe-cific video-prompts (individualized: 52%, non-specific: 72.7%). This difference could be at-tributed to the fact that Chris displayed lowerbaseline averages for the skills taught usingnon-specific video-prompts, allowing him toshow steeper gains in his performance level.The skill that Chris had the most variabilitywith was setting the table, which was taughtusing non-specific video-prompts. The re-searcher noted that Chris (and others) strug-gled with this particular task due to steps 3and 4, that required the student to eitherknow directional terms (left and right) or im-itate the video model. Imitating the videomodel in this scenario was challenging, due tothe reversed image.

Nolan. Unlike Chris, Nolan had a slightlyhigher increase in mean level of performancefrom baseline to intervention using theindividualized video-prompts (individualized:66.7%, non-specific: 42%). This could againbe attributed to lower baseline averages forthe individualized skill set. One skill that No-lan did not reach 100% correct was sweepingthe floor. This skill was taught to Nolan usingnon-specific video-prompts. Nolan struggledwith two steps on this task, placing the shirt onthe table with the buttons facing up and but-toning the buttons. Although the teacher re-ported that Nolan had above average fine mo-tor skills, he often asked for help with thisstep. The inability to meet criterion on thistask was likely due to skills deficits (fine mo-tor), rather than the type of video-promptsbeing used. As Nolan watched the video forthis step, he understood what was being mod-eled in the video, but didn’t have the skill setto complete the step. The level of difficulty forthis task could have been too advanced forNolan.

Zack. Zack’s mean level of performancefrom baseline to intervention was almost thesame for individualized and non-specific vid-eo-prompts (individualized: 61.7%, non-spe-cific: 62.3%). Like Chris, the skill that Zackstruggled with the most was setting the table.

Zack never met 100% correct for this skill,which could be due to difficulty with direc-tional terms and concepts. Another reasonZack didn’t meet criterion could have beendue to his absences; Zack was absent two ofthe 10 intervention sessions.

Effects of Video Self-Prompting with ErrorCorrection Procedures

In addition to comparing individualized andnon-specific video-prompts, this study soughtto expand the research on video self-prompt-ing with error correction procedures. Limitedresearch exists on if students are able to con-trol the video-prompts themselves, instead of ateacher or researcher navigating through theprompts. All three participants in this studywere able to control the video-prompts, whichmirrors results previous research (Bereznak etal., 2012; Mechling et al., 2009; Payne et al.,2009).

Although students were able to navigate thevideo-prompts independently, they often re-quired external prompts to attend to the tech-nology. The researcher noted that all threestudents required several external prompts(i.e., watch the video) to focus on the videosduring the intervention phase. Van Laar-hoven and Van Laarhoven-Myers (2006) alsofound that participants required externalprompts to attend to the intervention packagethat included video-prompting. One explana-tion for the need for external prompts to usethe technology could be the setting of theintervention. Sessions were conducted in thestudents’ classroom to mimic daily instruc-tion, and classroom activities, peers, and ob-jects in the room often distracted students.Future studies should consider using a settingfree from distractions such as these until stu-dents become more proficient at self-prompt-ing. Receiving external prompts, although notdirected at the target skills themselves, de-creases the level of independence for the stu-dents.

Error correction procedures were used toensure that students learned to perform theskill correctly and did not practice the erroritself. Error corrections procedures have beenshown to improve skill acquisition (Cannella-Malone et al., 2011; Goodson et al., 2007). Inthis study, errors were interrupted and mod-


eled correctly throughout the intervention.Participants displayed a number of errors us-ing both the individualized and non-specificvideo-prompts. Some students struggled withcertain tasks (setting the table and sweepingthe floor), indicating that the level of diffi-culty may not have been equal.

One of the most challenging aspects of us-ing an adapted alternating treatments design(AATD) is the determination of skills of equaldifficulty (Wolery et al., 2009). Skills in thisstudy were selected due to the similar level ofdifficulty and number of steps required, buterror patterns indicate that some skills mayhave been too advanced. Future studies canuse one of the methods outlined by Woleryand colleagues (2009) to ensure behavior setsare equal in difficulty. These methods in-clude: experimental evaluation of the diffi-culty, select behaviors from pools of responseswhere norms exist, conduct a logical analysisof the difficulty of the responses and discrim-inations required, ask experts to rate thedifficulty, and evaluate participants’ perfor-mance on related behaviors. Adopting one ofthese methods may reduce the number oferrors shown by participants.

Maintenance

Another dimension of superiority when com-paring interventions is the extent of mainte-nance and generalization (Wolery et al.,2009). Only one student was able to performthe majority of target skills (five) at 2 and4-week post-intervention sessions without theuse of video-prompts. The other students wereonly able to reach 100% correct during thesesessions with the use of the video-prompts.The level of individualization of the video-prompts did not affect student performanceduring maintenance sessions, with all studentsdisplaying similar results for target skillsthat were taught using individualized video-prompts as those taught using non-specificvideo prompts. The need for the reintroduc-tion of the video-prompts for most studentsindicates that students were still prompt-de-pendent after the intervention phase.

Results on maintenance of target skills inthe video-prompting literature offers mixedresults. Some researchers have found that stu-dents were able to maintain the skills post-

intervention (Sigafoos et al., 2007; Van Laar-hoven & Van Laarhoven-Myers, 2010; VanLaarhoven et al., 2010). Others have foundsimilar results to this study, wherein studentswere unable to maintain skills without theuse of video-prompts (Bereznak et al., 2012;Mechling et al., 2009; Sigafoos et al., 2007).This could be due to the abrupt removal ofprompts without systematically fading the sup-port for students, the reinforcing nature ofusing the technology, or skill deficits. Futureresearch should consider systematic fadingmeasures for the videos or an introduction ofsupplementary visual supports.

Another possible barrier to maintenance ofthe target skills is the reinforcing nature of thetechnology. One student in this study (Chris)demonstrated that he was able to perform thetarget skills without video-prompts; however,he asked for the videos for every skill duringmaintenance sessions. This behavior couldshow that the act of watching the videos isreinforcing to the student, even after masteryof the steps has been achieved. Although in-formally addressed, Bereznak et al. (2012) re-ported that the participants demonstratedinterest in the portable technology used,“boasting” about using the iPhone to teachersand family members. This interest in thetechnology could make fading video-sup-ports challenging.

Social Validity

The classroom teacher was asked a series ofquestions about the acceptability of the goals,intervention, and outcomes of the study; sheresponded favorably to all three components.The level of individualization (individualizedvs. non-specific) required for students to besuccessful in learning skills using video-prompting has important implications for thefeasibility of the intervention. If students areable to acquire the target skill with the sameor similar results for both types of videos,teachers may be more likely to use the inter-vention. In addition to assessing teachers’ per-ceptions on the intervention, future researchshould include the attitudes and opinions ofstudents and peers.


Limitations

One limitation of this study is that two of thestudents had prior exposure to video self-prompting (Chris and Nolan). This previousexperience could have affected their perfor-mance navigating through the video-prompts.It should be noted, however, that Nolan per-formed similarly (in terms of number of ses-sions to meet 100% correct) to Zack, who hadno prior exposure to video-prompts.

Another threat to interval validity for thisdesign is multi-treatment interference due tocomparison of two interventions. This may betrue for this study because interventions wereadministered on the same day. Alternatingsessions by day and probing a control groupmay help minimize multi-treatment interfer-ence (Wolery et al., 2009).

Implications for Educators and Future Research

In an era where technological resources areaccessible in seconds, it is important that ed-ucators and researchers assess their efficiencyand effectiveness related to teaching neededskills. Research has shown video-prompting tobe an effective method for teaching a varietyof skills, including daily living skills. Wheninterpreting the results of these studies, how-ever, there are several considerations for bothteachers and researchers.

Teachers should consider the strengths andweaknesses of their students before beginningvideo-prompting methods. Video self-prompt-ing may also be best suited for students thatdon’t have trouble focusing on a task, as ex-ternal prompting was necessary to use tech-nology. Teachers also should consider theirstudents’ strengths and weaknesses when se-lecting the target skills that will be addressedusing video-prompts. Certain skill deficitssuch as fine motor delays may limit the resultsof the intervention.

Further research is needed on video self-prompting in a number of areas. Replicationstudies should be conducted to better under-stand the effects of individualized and non-specific video-prompts. In addition, more re-search is needed that examines maintenancetechniques and prompt-fading procedures.While this study and Mechling and colleagues(2013) both showed individualized video-

prompts to be slightly more effective, neitherstudy can identify which components of theindividualized study affected performance.Research should be conducted that isolatescomponents of the individualized video-prompts(e.g., setting, materials, model) to determineif certain components affect results more thanothers.

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Received: 19 October 2017Initial Acceptance: 19 December 2017Final Acceptance: 20 February 2018


Improvements in Proxy Individualized Education ProgramMeeting Participation among Latino Parents

Meghan M. Burke, Kristina Rios, andBrenda Lopez

University of Illinois at Urbana-Champaign

Marlene GarciaUniversity of Illinois at Chicago

Sandra MaganaUniversity of Texas at Austin

Abstract: Although expected to be equal partners in the special education process, parents of children withdisabilities often struggle to participate in individualized education program (IEP) meetings. Specifically,Latino parents of children with autism spectrum disorder (ASD) face systemic barriers occluding theirparticipation and advocacy in IEP meetings. In this study, 22 Latino parents of children with ASD participatedin an advocacy training. Before and after the advocacy training, participants read and responded to a proxyIEP transcript designed to gauge their participation and advocacy in IEP meetings. After completing theadvocacy training, participants demonstrated significant increases in the number of words used, turns taken,and appropriate, advocacy comments. Implications for research and practice are discussed.

The Individuals with Disabilities EducationAct (IDEA, 2004) encourages all families toactively participate in Individualized Educa-tion Program (IEP) meetings. Unfortunately,it seems that parents rarely participate in IEPmeetings. For example, in an examinationof the participation of IEP team members,Martin and colleagues (2006) used momen-tary time sampling to determine the intervalsin which parents spoke during IEP meetings.They reported that parents of children withdisabilities spoke in only 15% of the recordedintervals of the meetings. Although this studydid not disaggregate by race, other researchindicates that Latino families are less likely toparticipate in IEP meetings due to systemicbarriers. In a review of the literature aboutculturally and linguistically diverse (CLD) familiesincluding Latino families, Jung (2011) identi-fied several barriers to CLD parent participa-tion in IEP meetings, including lack of effortby the school to engage the family, negative

school attitudes toward CLD families, and dis-parate communication styles between theschool and the family. Notably, the lack ofparent participation does not mean that CLDfamilies are not interested in the education oftheir children. Instead, it seems that, com-pared to White families, CLD families aremore involved in planning for their childrenwith disabilities with the exception of school-based planning (e.g., transition planning;Geenen et al., 2001).

Advocacy programs tailored for Latino fam-ilies may enable families to participate in IEPmeetings and advocate for their children withdisabilities to receive appropriate services.Given the needs of parents of children withdisabilities, special education advocacy pro-grams are becoming increasingly commonacross the United States (Burke, 2013). How-ever, to date, there are few advocacy programsavailable in Spanish for Latino families (Co-hen, 2013). Specifically, few advocacy pro-grams exist for Latino parents of children withautism spectrum disorder (ASD) even thoughLatino families of children with ASD (versusother types of disabilities) may encountergreater difficulties in participating in IEPmeetings and Latino (versus White) familiesare more likely to lack information about ASD

Correspondence concerning this article should beaddressed to Meghan Burke, Department of SpecialEducation, 288 Education Building, 1310 S. 6th Street,University of Illinois at Urbana-Champaign, Cham-paign, IL 61820. E-mail: [email protected]


Improvements in Proxy Meetings / 393


and relevant services (Mercadante, Evans-Lacko, & Paula, 2009). The purpose of thispilot study was to examine responses to aproxy for participation and advocacy in IEPmeetings among Latino parents of childrenwith ASD who participated in an advocacyprogram. Specifically, we created an IEP tran-script (i.e., a proxy) that parents completed be-fore and after participating in an advocacy pro-gram. In the transcript, we asked parents toindicate where (if it all) they would commentduring IEP meetings and what their commentsor questions would be. Participation was definedbroadly as any type of communication in the IEPtranscript (Goldman & Burke, 2017); advocacywas defined as communication intended to acton behalf of the best interest of the child (Alper,Schloss, & Schloss, 1996).

Latino families face many barriers in thespecial education process. Hughes and col-leagues (2002) conducted a mixed methodsstudy with 44 Latino families to examine howthey perceived special education and their in-volvement in the school. Families reportedthat they did not have sufficient support dur-ing IEP meetings and lacked accessible infor-mation to understand their rights. In a similarstudy, Shapiro and colleagues (2004) con-ducted an interview study of 19 low-incomeLatina mothers about their relationships withthe educational and service delivery systems.Parents reported negative experiences withthe school because of limited availability of re-sources to understand the IEP process and lan-guage barriers. Reasons for little parent involve-ment could also relate to school perceptions.Indeed, parent participation may be minimalbecause schools report that Latino families arenot credible sources of information (Spann,Kohler, & Soenksen, 2003). Due to such barriersand biases, Latino families may be cautiousabout sharing their child’s personal informationwith educators (Cartledge et al, 2002).

Further barriers may relate to language. Forexample, most special education documentsare only available in English making it difficultfor Spanish-speaking parents to participatein IEP meetings and to advocate for theirchildren (Shapiro, Monzo, Rueda, Gomez, &Blacher, 2004). Having an interpreter at anIEP meeting may help increase parent partic-ipation and advocacy by overcoming the lan-guage barrier. However, an interpreter may

also introduce challenges. Latino families mayview the interpreter as an “alliance with theschool” (Harry, 1992, p. 182). As hired schoolpersonnel, the interpreter may have a vestedinterest in siding with the school making Latinofamilies feel distrustful about expressing theirconcerns. Perhaps because of such barriers, La-tino families are often relegated to listeningroles (Hughes, Valle-Riestra, & Arguelles, 2002).

Increasing Latino parent participation inIEP meetings is insufficient; it is also necessaryto increase parent advocacy during thesemeetings. IDEA has an expectation for par-ents to advocate (Harry, 2008). However, theexpectation of advocacy may conflict with afamily’s beliefs. Further, the expectation foradvocacy may not be met because of systemicbarriers. Latino parents may not be passivebut rather deliberative as they are trying tonavigate an unfamiliar system without beingconfrontational (Hatton & Correa, 2005). Assuch, some Latino parents may appear lessassertive and more reliant on the school tomake educational decisions (Olivos, 2009).Further, economic and cultural conditionsmay also contribute to less advocacy amongLatino families (Kummerer & Lopez-Reyna,2009). For example, Latino parents may lackneeded transportation to attend IEP meetings(Leiter & Krauss, 2004).

Given the low rates of parent participationin IEP meetings and systemic barriers to advo-cacy among Latino families, it is important tohave advocacy trainings to empower and edu-cate parents. In this pilot study, we examinedthe Latino Parent Leadership Support Project(LPLSP), a 36-hour advocacy training for La-tino families of children with ASD (Burke,Magana, Garcia & Mello, 2016). We examinedparent participation and advocacy in IEPmeetings via a proxy measure for an IEP meet-ing transcript using a single-arm design (i.e.,group design without a control group); par-ticipants completed the proxy before and af-ter participating in the LPLSP. Our researchquestions were two-pronged: (1) Using aproxy measure for parent participation, doesthe LPLSP increase the number of words usedand turns taken in IEP meetings of Latino,Spanish-speaking families of children withASD?; and (2) Using a proxy measure forparent advocacy, does the LPLSP increase theappropriate responses in IEP meetings of


Latino, Spanish-speaking families of childrenwith ASD?

Method

Participants

There were 22 participants in this study. Onaverage, participants were 37.71 years of age(SD � 5.56, ranging from 28 to 49 years ofage). Children of the participants were, onaverage, 8.32 years of age (SD � 4.15, rangingfrom 3 to 17 years of age). Inclusionary crite-ria required that the participants be: (1) La-tino, Spanish-speaking (but can also speakEnglish); (2) older than 18 years of age; (3)willing to participate in the 36-hour LPLSP;and (4) a family member of an individual withASD. The ASD diagnosis was confirmed by theSocial Communication Questionnaire (SCQ;Berument, Rutter, Lord, Pickles, & Bailey,1999). The SCQ is a 40 item, binary-scaledscreening instrument for ASD. The sensitivityand specificity of the SCQ have been provento accurately identify children with ASD(Chandler et al., 2007; Corsello et al., 2007).As indicated by the SCQ, all participants hadchildren who met the cutoff for an ASD diag-nosis. See Table 1 for descriptive informationabout the participants.

Recruitment

To recruit participants, we collaborated withseveral community-based organizations (CBOs)with reputations of serving Latino families ofchildren with ASD. By collaborating withCBOs, we ensured that the LPLSP and associ-ated research was relevant to the participants(Magana, 2000). For example, we collabo-rated with a support group which providedtraining, education, and support for 450 La-tino parents of children with ASD in the Chi-cagoland area. We also collaborated with aParent Training and Information Center.CBOs distributed flyers and e-blasts about theLPLSP. In addition, we distributed flyers andrecruitment e-mails to every church and clinicin the Chicagoland area. Information aboutthe LPLSP and associated study was also dis-seminated via Spanish media outlets (i.e.,newspapers, radio stations). Notably, the re-search coordinator (who was Latina and a

native Spanish speaker) was the primary per-son who conducted recruitment efforts andinteracted with participants.

To encourage interested individuals to par-ticipate in the LPLSP, several incentives wereoffered. For example, food was available ateach session. In addition, a small travel sti-pend ($24) was offered to each individualparticipant. The stipend was intended to helpcover travel and childcare fees. During the

TABLE 1

Participant Demographics

Characteristic % (n) or X (SD)

Type of ParticipantMother 86.4% (19)Father 13.6% (3)

Marital StatusMarried 59.1% (13)Not Married 22.7% (5)Living Together 18.2% (4)

Educational BackgroundSome high school 40.9% (9)High school graduate 40.9% (9)Some college 9.1% (2)College graduate 9.1% (2)

Household IncomeLess than $15,000 36.4% (8)Between $15–29,999 40.9% (9)Between $30–49,999 18.2% (4)Between $50–69,999 4.5% (1)

EthnicityMexican 95.5% (21)South American 4.5% (1)

Child GenderMale 81.8% (18)

Child Time Spent in GeneralEducation

0–20% 36.4% (8)20–40% 18.2% (4)41–60% 9.1% (2)61–80% 13.6% (3)81–100% 22.7% (5)

Spanish Proficiency*Speak in Spanish 3.61 (.61)Read in Spanish 3.56 (.62)Write in Spanish 3.22 (.88)

English ProficiencySpeak in English 1.50 (.86)Read in English 1.44 (.78)Write in English 1.33 (.49)

*Proficiency was rated on a four point Likert scaleranging from 1 (poor) to 4 (excellent).


LPLSP, prizes (i.e., premios) were offered toparticipants as incentives to attend and partic-ipate in the LPLSP. At the end of the LPLSP,the participants received a certificate and agraduation party was held.

LPLSP

The LPLSP (Puente & Castillo, 2015) is a 36-hourtraining across nine sessions (i.e., 4 hours perweekly session). The purpose of the LPLSP isto enable family members of individuals withASD to become advocates for their own chil-dren as well as other families of children withdisabilities. The LPLSP was developed and fa-cilitated by two Latina parents of children withdisabilities; both parents worked at the ParentTraining and Information Center. The LPLSPhad an interactive format which includedsmall group activities, games, and role-playing.For example, the facilitators developed andused games (e.g., bingo) to teach special ed-ucation policy and advocacy to the partici-pants. The LPLSP also had a strong emphasison empowerment. For example, participantsprovided short presentations describing thepresent levels of performance and goals fortheir children. At the conclusion of the LPLSP,participants gathered in small groups to reportwhat they learned from the training. The LPLSPoccurred on weekday mornings in Chicago.

The content of the LPLSP included: specialeducation jargon, the roles and responsibili-ties of IEP team members, the needs and dis-ability of the child, ways to communicate thechild’s needs to the school, strategies to par-ticipate in IEP meetings, timelines for evalua-tions, and questions to ask school personnel.For example, regarding communication, par-ticipants were instructed that they could re-quest an interpreter and all materials in writ-ing (i.e., documentation) from the school. Inrelation to roles and responsibilities, the par-ticipants were taught that schools cannot de-mand that children take medication. Further,the participants learned how to access moreservices for their children with ASD. The em-phasis on accessing more services was basedon the premise that Latino (versus White)children with ASD receive significantly lessservices and have higher unmet service needs(Magana, Lopez, Aguinaga, & Morton, 2013).The LPLSP also highlighted ABA services as

the literature indicates that families, includingLatino families, of children with ASD strug-gled to receive ABA services from the school(Decker, 2012; Mueller & Carranza, 2011).

Treatment Fidelity

At each session, the research coordinator com-pleted a treatment fidelity checklist developedfor this project. Prior to the LPLSP, the firstauthor trained the research coordinator tocollect fidelity data. If a treatment componentwas given, the research coordinator checked“yes” on the checklist. The research coordina-tor collected treatment fidelity data for eachsession. For inter-rater reliability, the first au-thor also conducted treatment fidelity for77.78% (n � 7) of the sessions. Inter-rateragreement was 95.45%. Fidelity to the curric-ulum was 90.91%.

Measure

For this study, we created a proxy for an IEPmeeting transcript (hereafter referred to as“transcript”). The transcript was a case exam-ple of an IEP meeting. The transcript in-cluded a general education teacher, specialeducation teacher, case manager, and speechand language therapist. For families of chil-dren with ASD, most of the struggles with theschool relate to the receipt of applied behav-ior analysis (ABA) services (Cohen, 2012;Decker, 2012), and previous studies have in-dicated that Latino families of children withASD also want ABA services for their children(Burke & Sandman, 2015; Magana, Parish, &Son, 2015). Thus, the transcript focused onthe receipt of ABA services with the schoolrefusing to provide ABA to the child. The firstauthor developed the transcript based on theliterature (e.g., Decker, 2012; Magana et al.,2015) as well as her personal experiences asthe relative of someone with a disability andher professional experiences as a special edu-cation teacher and ABA therapist. Two attor-neys, six advocates, and six Latino parents ofchildren with ASD then reviewed the IEP tran-script. The first author incorporated their sug-gested changes. The transcript was pilotedwith two Latino parents of children with ASD;minor revisions were made.

Along with the transcript, the authors cre-


ated an answer key with expected advocacyresponses. These responses reflected advocacyactions to be taken during the IEP meeting.In total, there were 10 expected responsesthroughout the transcript. The expected re-sponses included: introducing one’s self as theparent; asking for the interpreter to be pres-ent; asking for summer services; requestingadditional services; stating that medication isnot a school decision; requesting a behavioralplan; requesting compensatory services; re-questing data from the school; requestingABA services, and requesting decisions in writ-ing. For example, one way to qualify for ex-tended school year services is by regressionand recoupment. When a student has the po-tential to regress over an extended period oftime and to take a long time to recoup theskills that were lost, the student may qualifyfor extended school year services. Thus, in theIEP transcript, when the teacher remarks thatthe child may regress over the break, the par-ent should request extended school year ser-vices. After creating the answer key, Latinoparents of children with ASD, advocates, andattorneys reviewed the answer key and madesmall corrections.

Procedure

This study was approved by the InstitutionalReview Board. It was important to ensure thatall of the materials and measures were accu-rately translated. Thus, all materials, includingthe IEP transcript, were translated in Spanishusing the translation/back translation method(Brislin, 1970). Three research assistants, allnative Spanish-speakers, translated the curricu-lar materials and measures that were not alreadyavailable in Spanish. All of the materials andmeasures were then back translated by nativeSpanish-speakers to ensure their accuracy.

Participants completed a demographicquestionnaire. After completing the demo-graphic questionnaire, participants were giventhe transcript. In the transcript, participantswere able to add comments, questions, orother text indicating where they would partic-ipate or advocate in an IEP meeting. Partici-pants completed the transcript before the firstLPLSP session (i.e., the pre-transcript) andagain after completing the last LPLSP session(i.e., the post-transcript). Notably, the pre-

and post-transcript was identical so that wecould gauge change using the same measure.

The participants were asked to write theirresponses in the transcript. Participants werealso told that, if they would not typically re-spond to the dialogue in the transcript, theycan leave the transcript blank (i.e., leave blankspace). Participants had ample space to writetheir responses throughout the transcript. Seethe Tables 2 and 3 for a copy of the transcriptin English and Spanish respectively.

Analyses

For the first research question, the first and thirdauthors independently counted the number ofresponses and words written for the pre and postIEP transcript of each participant. The authorshad the same counts of responses and words.Then, the first author conducted t-tests to deter-mine whether the pre/post IEP transcript hadsignificant differences. Effect sizes were calcu-lated using Cohen’s d. Consistent with this study,in a meta-analysis of parent involvement studies,Goldman and Burke (2017) found that previousstudies similarly defined parent participation bythe frequency of comments made by parents.

For the second research question, the secondand third author independently read the re-sponses and compared them to the answersheet. Individually, they recorded the correctresponses for each pre and post transcript.Then, the first author reviewed their responses,conducted kappas for reliability, and noted anydiscrepancies. For the pre IEP transcript, thekappa was .56. For the post IEP transcript,the kappa was .67. Thus, the kappas were in themoderate to substantial range (McHugh, 2012)indicating a high degree of agreement. For dis-crepant responses, the authors met to discussthe responses and came to an agreement.

Validity

To determine whether the IEP meeting tran-script would accurately reflect responses dur-ing an IEP meeting, we held a mock IEP meet-ing during the LPLSP. In this meeting, eachparticipant held a different role (i.e., specialeducation teacher, general education teacher,case manager). The mock IEP meeting washeld toward the beginning of the LPLSP so asto accurately reflect the responses of the par-


ticipants before they completed the LPLSP.Based upon field notes taken during theLPLSP, the responses of the participants mir-rored the IEP meeting responses before theycompleted the LPLSP.

Results

Words Used and Turns Taken

With large effect sizes, participants increasedtheir number of words in the IEP transcriptfrom 24.81 to 76.50 (p � .001). Specifically, 18participants increased their number of words,

two participants had the same number ofwords, and two participants had fewer words.Also, participants increased the number oftimes they would speak in an IEP meeting(i.e., responses or turns taken) from 1.86 to5.18 (p � .001). Specifically, 15 participantsincreased their turns taken, three participantshad no change, and four participants hadfewer turns taken. See Table 4.

Appropriate, Advocacy Responses

Participants demonstrated significant increases inthe number of appropriate responses with a

TABLE 2

IEP Meeting

Review the IEP meeting below. In the IEP meeting, there is a: regular education teacher, special educationteacher, case manager, and speech language therapist present. You are the parent of a child with autism.You are at the meeting to request applied behavior analysis (ABA) therapy for your child. Write in whereyou would participate in the meeting. Write the questions you would ask or the comments you wouldmake. This exercise has no right or wrong answers. Just think about the comments/questions you wouldstate during this dialogue. It is also fine if you wouldn’t say anything.

Case Manager (Irma): Welcome to the IEP meeting. We will go around and do introductions. My name isIrma. I am the case manager for the student.

Regular Education Teacher (Matiana): I am Matiana. I am the regular education teacher for this student.Special Education Teacher (Vanessa): I am Vanessa. I am the special education teacher for this student.Speech and Language Therapist (Linda): I am Linda. I am the speech and language therapist for this

student.Case manager (Irma): The student has been diagnosed with autism. The parent has requested that we hold

an IEP meeting to discuss whether applied behavior analysis (ABA) is an appropriate strategy for thisstudent. Vanessa (special education teacher), what do you think?

Special Education Teacher (Vanessa): I think that the student does not need ABA. The student is startingto make a little progress in math. I think the student will start to make progress in other classes. We didhave a setback when the student went on spring break and showed some regression (i.e., forgot what helearned). However, I think the student will be fine. The student will probably learn some things by theend of the school year. That being said, the student may forget those things over the summer break.

Case Manager (Irma): And Matiana (regular education teacher)? What do you think?Regular education Teacher (Matiana): I don’t think the student needs ABA either. I think the student just

needs more discipline at home. The student frequently engages in bad behavior in my classroom. Whenthe student does not want to do an assignment, the student will call me a name or yell at anotherstudent. So, then, I send the student to the principal’s office without doing the assignment. I think theparents need to provide more discipline at home. Maybe the parents should look into medication forhim as well. Medication could help with the behaviors.

Speech & Language Therapist (Linda): The student is improving his receptive and expressive language.The student is also doing well with his pragmatic language. Based upon my observations, the student ismaking progress. I see the student once a week in a group setting. I know the IEP says that the studentshould get speech therapy twice a week. However, I don’t have room on my caseload to see the studenttwice a week.

Case Manager: It seems that we are in agreement that the student does not need ABA therapy. Given howexpensive ABA therapy is, I am in agreement with the rest of the team that ABA is not necessary. Itseems that the student is making some progress. We will just continue with what we are doing. Anyquestions?


medium effect size (ES � .42). Out of 22 partic-ipants, 15 participants increased their numberof appropriate responses and seven participantsdemonstrated no change in their responses. Par-ticipants demonstrated the greatest increases ofappropriate responses for: requesting ABA ser-vices and requesting more services in general.Specifically, 12 participants made increases inrequesting ABA services and 11 participantsmade increases in receiving services in general.

For two responses, there were no increases incorrect answers; these responses included ask-ing for an interpreter and requesting theschool’s decision in writing.

Regarding requesting ABA services, in thepost-transcript, participants justified their re-quests by writing that ABA services would enabletheir children to forge educational progress. Forexample, Leticia, the mother of a 4-year-old son,Jeison, requested ABA services. She wrote:

TABLE 3

Junta de IEP

Repase la junta de IEP a continuacion. En la reunion del IEP, hay un(a): maestro/a de educacion regular,maestros/as de educacion especial, administrador/a de casos, y terapista de habla y lenguaje presente.Usted es el padre de un nino(a) con autismo. Esta en la reunion para solicitar terapia de analisis decomportamiento aplicado (ABA) para su hijo/a. Escriba donde usted participarıa en la reunion. Escribalas preguntas que usted preguntarıa o los comentarios que usted harıa. Este ejercicio no tiene respuestascorrectas o incorrectas. Solamente piense en los comentarios o preguntas que usted declararıa duranteeste dialogo. Tambien esta bien si usted no dice nada.

Administradora de Casos (Irma): Bienvenidos a la reunion del IEP. Iremos alrededor y haremosintroducciones. Mi nombre es Irma. Yo soy la administradora de casos para el estudiante.

Maestra de Educacion Regular (Matiana): Soy Matiana. Yo soy la maestra de educacion regular para esteestudiante.

Maestra de Educacion Especial (Vanessa): Soy Vanessa. Yo soy la maestra de educacion especial para esteestudiante.

Terapeuta del Habla y Lenguaje (Linda): Soy Linda. Yo soy la terapeuta del habla y lenguaje para esteestudiante.

Administradora de Casos (Irma): El estudiante ha sido diagnosticado con autismo. El padre ha solicitadoque tengamos una reunion de IEP para discutir si el analisis del comportamiento aplicado (ABA) es unaestrategia apropiada para este estudiante. Vanessa (maestra de educacion especial), ¿que te parece?

Maestra de Educacion Especial (Vanessa): Creo que el estudiante no necesita ABA. El estudiante ahempezando a hacer pocos avances en matematicas. Creo que el estudiante comenzara a avanzar en lasotras clases. Tuvimos una recaıda cuando el estudiante se fue de vacaciones de primavera y mostro ciertaregresion (olvido lo que aprendio). Sin embargo, creo que el estudiante va a estar bien. El estudianteprobablemente aprendera algunas cosas para el final del ano escolar. Dicho esto, el estudiante puedeolvidar esas cosas durante las vacaciones de verano.

Administradora de Casos (Irma): Y Matiana (maestra de educacion regular)? Que piensas?Maestra de educacion regular (Matiana): Yo no creo que el estudiante necesite ABA tampoco. Yo creo que

el alumno solo necesita mas disciplina en el hogar. El estudiante con frecuencia se involucra en malaconducta en mi salon de clases. Cuando el estudiante no quiere hacer una tarea, el estudiante mellamara un nombre o le grita a otro estudiante. Ası, entonces, yo mando al estudiante a la oficina deldirector sin hacer la tarea. Creo que los padres necesitan proveer mas disciplina en la casa. Tal vez lospadres deberan de tomar en cuenta medicamentos para el tambien. Los medicamentos pueden ayudarcon los comportamientos.

Terapeuta de Habla y Lenguaje (Linda): El estudiante esta mejorando su lenguaje receptivo y expresivo. Elestudiante tambien esta haciendo bien con su lenguaje pragmatico. Basado en mis observaciones, elestudiante esta progresando. Veo el estudiante una vez por semana en un ambiente de grupo. Se que elIEP dice que el estudiante debe recibir terapia del habla dos veces por semana. Sin embargo, no tengoespacio en mi carga de trabajo para ver al estudiante dos veces por semana.

Administradora de Casos (Irma): Parece que estamos de acuerdo en que el estudiante no necesita terapiaABA. Teniendo en cuenta lo caro que terapia de ABA es, estoy de acuerdo con el resto del equipo queABA no es necesario. Parece que el estudiante esta haciendo algunos progresos. Nosotros continuaremoscon lo que estamos haciendo. ¿Alguna pregunta(s)?


Como ustedes deben saber, el sistema de tera-pia ABA es una terapia estructurada y constante.Creo que mi hijo Jeison se verıa muy benefi-ciado de esta terapia. Por lo que insiste en queJeison deberıa recibir esta terapia.

As you probably already know, the systemof therapy, ABA is a very structured andconstant form of therapy. I think my son,Jeison, would benefit from this kind oftherapy. For this reason, I insist Jeisonshould receive this therapy.

Similarly, Franciso requested ABA services forhis 8-year-old son. In English and in responseto the school denying his son ABA services,Francisco wrote:

I do not agree with this decision and I donot think I will sign any paper until youreevaluate my child. I think that you are nottaking my opinion into account with respectto my child. You have not properly evalu-ated my child.

Eva, the mother of an 11-year-old daughter withASD, justified her request for services due thelack of progress of her daughter. Eva wrote:

Yo creo que mi hija sı necesita ABA terapiadado que no esta hacienda progreso.

I think my daughter needs ABA therapysince she is not making progress.

Regarding receiving more services in gen-eral, in the post-transcript, participants re-quested that the school provide other servicesto enable their children to make educationalprogress. For example, Brenda, the parent ofa 7-year-old son with ASD, wrote the followingin English:

I do not agree that ABA services and speechtherapy should be taken from my child. Canyou do a re-evaluation? I believe that my

child cannot be left without speech therapysince he could lose what he already learned.I do not agree that my child can stay withoutspeech therapy.

To a lesser extent, participants also increasedtheir number of correct responses with respectto stating their children should receive compen-satory services (n � 8), stating that servicesshould be provided by the school instead ofencouraging medication (n � 6), and statingthat the child needs a behavioral plan or servicesto address behavior (n � 5). Regarding com-pensatory services, in the post-transcript, eightparticipants wrote that their children were enti-tled to compensatory services in response to notreceiving the IEP-required number of speechtherapy minutes. For example, Leticia, in addi-tion to requesting ABA, also requested that theschool provide the needed speech services toher son, Jeison:

Entiendo que la carga de trabajo del per-sonal es mucha; sin embargo, lo que estaescrito en el IEP de Jeison refleja sus nece-sidades, y no solo lo que nos gustarıa que elrecibiera. Si mi hijo necesita este serviciodos veces por semana, es ese tiempo el quedebe de recibir. Por favor tenga la confianzade decirme en que puedo ayudar para queesto sea posible.

I understand that the workload of theschool personnel is heavy; however, what iswritten in Jeison’s IEP reflects his needs,and not what we would like for him to re-ceive. If my son needs these services twice aweek that is the amount of time my childshould be receiving them. Please, have theconfidence to tell me what I can help youwith in order to make this possible.

Regarding medication, parents reported thatthe school should provide services rather than

TABLE 4

Pre/Post Changes

Pre Post t p Effect Size (ES)

Number of Words 24.81 (38.18) 76.50 (54.09) �5.48 .001 1.10Number of Responses 1.86 (2.62) 5.18 (3.44) �5.08 .001 1.08Correct Responses .95 (1.43) 2.59 (2.03) �3.96 .001 .42


suggest medication. Notably, none of the par-ents stated that the school was not entitled torecommend medication. Gabriela, the parentof a 7-year-old daughter with ASD, wrote (inEnglish):

I disagree with that assumption. Again, shedoesn’t behave this way at home. Medica-tion is not an option I am going to lookinto. Medication is like putting a band-aidon the issue. Therapy can help better thanany med.

Also in the post-transcript, five participantsrequested that their children receive servicesor a plan to address problem behaviors. Forexample, Teresa, the parent of a 3-year-oldson, in English, wrote: “You mentioned prob-lems with my child’s behavior here at school.Then, what do you suggest to do to helphim?”.

Finally, in the post-transcript, five partici-pants introduced themselves at the beginningof the meeting, three participants requestedextended school year services, and three par-ents informally requested seeing school data.Regarding introductions, participants wrotetheir name and role at the beginning of theIEP meeting (e.g., “I am Teresa. The parent ofAdrian.”). Three parents requested educa-tional services over the summer. Rosa, theparent of a 4-year-old son, wrote:

Si cree que mi hijo tuvo una recaıda por noestar en la escuela. ¿Sugieren que vaya aescuela de verano?

I believe that my son relapsed because theschool is not giving services. Should he goto school in the summer?

Notably, participants did not use the term“extended school year services”; however, par-ticipants did often reference regression and,subsequently, requesting summer school ser-vices. Three parents also, informally, re-quested the data of the speech language ther-apist. For example, Silvia---the parent of a3-year-old---in English, wrote “Could you showme a chart of what level the child is on?”.Similarly, Francisco wrote “On what can youbase to say that my child has progressed?”. AnaMaria, the parent of a 10-year-old son, wrote,“I want to know what advances my child hasmade during therapy.”

Discussion

In summary, we examined parents’ participa-tion and advocacy responses to an IEP meet-ing transcript before and after participating inan advocacy training. There were two mainfindings. First, the majority of parents demon-strated greater IEP participation and morefrequent advocacy at the end of the advocacytraining. Other research has similarly docu-mented positive effects of advocacy trainingincluding increased knowledge and comfortwith advocacy skills (Burke et al., 2016) andempowerment (Magana et al., 2015).

The second finding was that while partici-pants made comments about advocacy ac-tions, their comments were more informaland less assertive than may be typical in advo-cacy (Burke & Goldman, 2017). For example,regarding medication, participants encour-aged the school to consider other optionsthan medication. However, a stronger advo-cacy response would be to state that IDEA2004 prohibits schools from mandating med-ication and, as such, medication should not besuggested by the school in an IEP meeting.The less assertive response about medicationmay be due to cultural differences about med-ication and treatment. Compared to other cul-tural groups, Latino families of children withASD are six times more likely to use non-traditional treatments (Levy, Mandell, Mer-har, Ittenbach & Pinto-Martin, 2003); thus, itcould also be that the reaction about medica-tion is related to cultural beliefs about treat-ment.

The more informal and less assertive re-sponses of the participants may be due toseveral, other reasons. For example, eventhough the participants attended an advocacytraining, there are still ongoing systemic issuesincluding a lack of cultural responsiveness inthe school (Klingner et al., 2005), inaccurateinterpreters (Hughes et al., 2002), absence ofdocuments in Spanish (Shapiro et al., 2004),and limited accessibility of resources aboutparent rights (Mercadente et al., 2009; Sha-piro et al., 2004). The lack of accessible re-sources may restrict the ability to use moreformal or precise language in IEP meetings.Further, the lack of participants requestinginterpreters and documentation from theschool may be due to believing interpreters


align with school (Harry, 1992) and beingunable to access documents written in English(Shapiro et al., 2004), respectively. Regardingthe latter, the participants reported that theyhad “poor” ability to read in English; withoutbeing able to access the information in theirlanguage, the participants may have decided itwas not worthwhile to request documentation.

Future Directions for Research

A next step for research is to confirm thefindings of this study. Specifically, it is neces-sary for researchers to actually observe andrecord IEP meetings to have an empirical un-derstanding of the participation and advocacyof Latino parents. Observational data of IEPmeetings would help document the participa-tion rates and advocacy actions of parents be-fore and after completing an advocacy train-ing. Also, by observing and recording IEPmeetings, future research can better assessother aspects of parent participation such asvolume, inflection, and type of responses(e.g., questions or statements). With observa-tions, researchers could also qualitatively ana-lyze the dialogue of IEP meetings to identifythemes. Along with the observations, it wouldalso be helpful to have social validity measuresto determine participant perspectives aboutthe LPLSP including the mode of the LPLSPand measures to gauge their participation andadvocacy in IEP meetings. By conducting ob-servations of IEP meetings, the type and fre-quency of parent participation and advocacycan be better understood.

Additionally, if future studies do use a proxyfor parent participation and advocacy in IEPmeetings, it is important to determine gener-alization and maintenance of effects. Specifi-cally, it is important to discern whether theincreases made in participation and advocacyby the participants generalize to actual IEPmeetings with the school. It is also importantto determine whether these effects maintainover time. Since this study had participantsimmediately conduct a proxy for parent par-ticipation and advocacy, it is unclear whetherthe effect on parent participation and advo-cacy would be sustained after time passedfrom the training.

Implications for Practice

Given that many parents want to be involvedin IEP meetings, practitioners may considerways to increase parent participation. Specifi-cally, teachers may be able to educate andempower families to increase their participa-tion in IEP meetings. Instead of placing theonus on parents to attend trainings, teachersmay be able to incorporate strategies to facil-itate parent participation. For example, Hold-ren and colleagues (2016) conducted a studywherein they trained pre-service special edu-cation teachers to facilitate parent participa-tion in IEP meetings by using actors and con-ducting simulated meetings. If teachers usedfamily-friendly strategies, parent participationmay increase.

In addition to school practitioners, coordi-nators of advocacy programs may consideridentifying and improving advocacy trainings.Although most participants demonstrated sig-nificant increases in the number of appropri-ate, advocacy responses, with respect to somecomments, participants did not make signifi-cant gains. For example, many participantsfailed to request to see the school’s data whichcould support whether a child needs addi-tional services. Advocacy trainings may needto include more content related to the impor-tance and potential use of data to make in-formed decisions. Using the LPLSP as an ex-ample, coordinators may consider trying toidentify and add different components to theLPLSP to make it more effective.

Limitations

This study has a few limitations that may haveimpacted the results. First, there was a smallsample size of 22 Latino parents of childrenwith ASD who volunteered to participate in a36-hr advocacy training. A larger sample sizemay provide greater power; also, this sample(given its nature of relying on volunteer par-ticipants who had the time to complete theLPLSP) may not represent all Latino families.An additional limitation relates to the tran-script proxy itself. We were not able to com-pare the proxy to actual participation in IEPmeetings. Observational methods would im-prove the rigor of a study about parent partic-ipation in IEP meetings. Also, although 10


potential correct responses could have beengiven in the transcript, at the post-transcript,participants averaged between two and threecorrect responses. Thus, additional trainingor support may be necessary to have a greaterincrease in the number of appropriate re-sponses. Finally, the proficiency (i.e., readingand writing ability) of participants may havelimit the accuracy of the IEP transcript mea-sure and the effectiveness of the LPLSP;future research should consider the issue oflanguage proficiency both in terms of mea-surement and the intervention.

In conclusion, this study has significant re-sults in increasing parent participation andadvocacy for parents of students with ASD andalso has important implications for researchand practice. Parent participation is impor-tant for student achievement; parent advocacyis important to enable children with ASD toobtain needed services. Researchers need tofind more ways to increase parent participa-tion and advocacy during IEP meetings forfamilies who are culturally and linguisticallydiverse.

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Effects of a Self-Management Intervention to ImproveBehaviors of a Child with Fetal Alcohol Spectrum Disorder

Megan M. GriffinWhitworth University

Susan R. CopelandUniversity of New Mexico

Abstract: Fetal alcohol spectrum disorder (FASD) is one of the most prevalent causes of developmental disability,impacting up to 2–5% of children in the United States. Yet, evidence-based treatments for individuals withFASD are notably limited, and individuals with this diagnosis have been very underrepresented in the empiricalbehavior analytic literature. The current study investigated the effects of an intervention package consisting ofself-monitoring and contingent reinforcement on the behavior of an 11-year-old Hispanic male with FASD. Theintervention had therapeutic effects on the participant’s independent task completion and arguing behavior.These results suggest the promise of behavior analytic interventions for individuals with FASD, and documentthe positive effects of this self-management intervention in particular. Implications for behavior analytic researchand practice among individuals with FASD are discussed.

According to the Centers for Disease Controland Prevention (n.d.), 2–5% of children inthe United States have fetal alcohol spectrumdisorder (FASD), a group of developmentaldisabilities causing a range of problems re-lated to physical, cognitive, and behavioraldevelopment. Many individuals with FASDare undiagnosed or misdiagnosed (Chasnoff,Wells, & King, 2015), making them a particu-larly underserved population of students intoday’s school systems. Individuals with FASDoften have difficulty completing tasks, inhibit-ing “impulsive” actions, and other adaptivebehaviors (Rasmussen, 2005). Due to theseand other issues, children with FASD are atrisk for a host of poor outcomes, includingdisrupted school experiences, problems re-lated to substance, and trouble with the law(Streissguth et al., 2004).

Reports in the literature note that somecaregivers consider “conventional behavioural

and learning approaches” to be inadequatefor addressing the support needs of individu-als with FASD in their care (Peadon, Rhys-Jones, Bower, & Elliott, 2009, p. 2). Reflectingthis, the research literature seems to focus ondeveloping and investigating interventionsthat are specific to individuals with FASD. AsFASD was identified relatively recently, withfetal alcohol syndrome officially documentedin the literature in the early 1970s, researchon interventions specific to this group of con-ditions is understandably small and limited(Peadon et al., 2009).

Impairments in attention and executive func-tioning are hallmark characteristics of FASD(Kodituwakku & Kodituwakku, 2014); as such,interventions that help children manage theirown behavior may be particularly beneficial forthis population. Within the field of applied be-havior analysis (ABA), self-management inter-ventions have been empirically validated withindividuals with disabilities (Cooper, Heron, &Heward, 2007). As one of the most researchedself-management interventions, self-monitoringhas been widely documented as a therapeuticstrategy with individuals impacted by various dis-abilities across a range of target behaviors, suchas completing academic tasks, engaging in socialbehaviors, following directions, and staying on-task (Bruhn, McDaniel, & Kreigh, 2015; Shef-field & Waller, 2010).

This work was funded by National Institutes ofHealth grant P50-AA022534. The authors would liketo thank the graduate students (Lauren Weiss andRolanda Maez) who worked on this project, as well asDr. Megan Martins, BCBA-D, who provided helpfulfeedback on earlier drafts of this manuscript. Corre-spondence concerning this article should be ad-dressed to Megan Griffin, School of Education,Whitworth University, Spokane, WA 99251. E-mail:[email protected]


Effects of a Self-Management Intervention / 405


Among school-age children, studies have beenconducted with individuals eligible for specialeducation under the labels autism spectrum dis-order (e.g., Koegel, Koegel, Hurley, & Frea,1992); emotional disturbance (e.g., Levendoski& Cartledge, 2000); intellectual disability (e.g.,Martella, Leonard, Marchand-Martella, &Agran, 1993); other health impairment (e.g.,Stahr, Cushing, Lane, & Fox, 2006); specificlearning disability (e.g., Harris, 1986); andspeech/language impairment (e.g., Stahr et al.,2006). Self-monitoring interventions have alsobeen found to be effective with participants hav-ing various specific conditions, such as Aspergersyndrome, attention deficit hyperactivity disor-der, and Down syndrome (Bruhn et al., 2015;Sheffield & Waller, 2010).

Though self-monitoring has been used suc-cessfully with participants with a wide range ofdisabilities and across various target behaviors,research including participants with FASD isnotably limited. To our knowledge, only twopublished studies on self-monitoring have in-cluded individuals identified with FASD (e.g.,Blood, Johnson, Ridenour, Simmons, & Crouch,2011; Lovett & Haring, 1989), with neitherdemonstrating a functional relationship be-tween the intervention and the dependentvariables. Thus, children with FASD have beenneglected in the self-monitoring literature,although their behavioral profiles make self-management a potentially effective strategyfor this population.

Self-monitoring is well established in theliterature, yet no empirical studies have docu-mented a functional relationship between thisstrategy and therapeutic behavior change inan individual diagnosed with FASD, despitethe relative prevalence of this condition. Thegoal of the current study was to address thisgap by documenting the effects of a self-mon-itoring intervention on the challenging behav-ior (argumentative statements) and desirablebehavior (independent task completion) of aparticipant with FASD.

Method

Participant and Setting

David was an 11-year-old Hispanic male diag-nosed with alcohol-related neurodevelopmen-tal disorder, one of the conditions included

under the broader umbrella term of FASD. Inaddition, David was diagnosed with attention-deficit hyperactivity disorder, oppositional de-fiant disorder, reactive attachment disorder,and specific learning disability. David receivedspecial education services in a self-containedclassroom for students with significant behav-ior support needs, and received behavior sup-ports for 2 hours a day. David was referred tothe study by faculty at a university-based FASDdiagnostic clinic.

The setting for this study was David’s home;sessions were conducted after school. Withinthis setting, David’s mother was always pres-ent. In addition to David, other children wereoften in the home, including David’s sistersand cousins. At times, other adult relatives werealso in the home. The two areas in the homewhere David spent most time during sessionswere his bedroom and the living room. Withinthe home, both English and Spanish were spo-ken.

Dependent Measures and Data Collection

Two dependent measures were selected be-cause of their frequency, and because theywere of great concern to David’s mother. Thefirst target behavior was completing choresand homework tasks. David’s mother reportedthat these tasks occasioned problem behaviorfrom David on a daily basis. The second targetbehavior was arguing with adults (primarilyhis mother); argumentative statements wereoften emitted in response to demands.

Target behavior: Task completion. Task com-pletion was defined as David independentlyand accurately performing assigned cleaningand homework tasks. The researchers opera-tionalized the tasks by interviewing David’smother; in the interview, she identified 10cleaning tasks and five homework tasks. Exam-ples included tasks David completed indepen-dently and to his mother’s specification (e.g.,reading aloud at an understandable pace andvolume for 20 minutes). Non-examples in-cluded tasks that were not completed inde-pendently or were not completed accurately(e.g., putting the comforter on top of his un-made bed, rather than making the bed to hismother’s specification).

Task completion was measured by directobservation of the behavior, or observation of


a permanent product (e.g., correctly madebed). The researchers used a checklist to re-cord whether tasks were completed indepen-dently and accurately. Task completion wasreported as a percentage of the total tasks in asession. In the event that a task on the check-list had already been completed prior to datacollection, that item was not included in thecalculation of percentage of tasks completed.

Target behavior: Argumentative statements.Argumentative statements were defined asstatements in which the participant re-sponded to an adult by (a) refusing, delayingcompliance with, or complaining about a de-mand; (b) directing the adult to leave himalone or to leave his belongings alone; (c)using inappropriate language; or (d) using anargumentative tone. Examples of refusing, de-laying compliance with, or complaining abouta demand included saying, “No” or “Later,Ma”; non-examples included saying, “I don’tknow how.” Examples of directing an adult toleave him alone or his belongings alone in-cluded saying, “Ma, stay out of my room,” or“You don’t need to look at my stuff”; non-examples included saying, “I don’t needhelp.” Examples of using inappropriate lan-guage included saying, “Oh my God, Ma”, orexpletives; non-examples included saying,“What the heck?” Finally, using an argumen-tative tone was operationalized as statementsin which David’s tone was sharp or rude; anargumentative tone did not include state-ments in which his tone was neutral, whiny, orjoking.

To collect data on argumentative state-ments, members of the research team usedevent recording. Observers recorded argu-mentative statements during each session;they also audio recorded the sessions withiPhones when practicable. A Spanish-speakingmember of the research team transcribed au-dio files and translated Spanish portions toEnglish. The research team reviewed the au-dio files and transcripts to recode sessions inorder to enhance accuracy. Rate of argumen-tative statements per minute was calculatedfor each session.

Intervention Development and Materials

We conducted a functional behavior assess-ment by interviewing David’s mother using

(a) a modified version of the Functional As-sessment Interview (O’Neill, Albin, Storey,Horner & Sprague, 2015), and (b) the Moti-vation Assessment Scale (MAS; Durand &Crimmins, 1988). We then interviewed Davidabout his behavior, as well as his likes anddislikes. Finally, two researchers collected ABCnarrative recording data on David’s behaviorover five days; 18 instances of argumentativestatements were observed. For the majority(11 of 18), the hypothesized function of thebehavior was to access attention. In severalinstances (7 of 18), the hypothesized functionwas escape from demands. Finally, David’smother’s responses to the MAS identified ac-cess to tangibles and escape as the two top-ranked results. Thus, we hypothesized thatDavid’s problem behavior was multiply main-tained by escape, attention, and tangibles.

We developed an intervention package toaddress these hypothesized functions. As de-scribed earlier, we interviewed David’s motherin order to create a task analysis of the clean-ing and homework tasks that she expectedhim to complete each day. Two laminatedchecklists (Cleaning and Homework) werecreated. Each list identified the task and in-cluded two columns: one for the participantto self-monitor task completion, and the otherfor an adult to indicate whether each task hadbeen completed independently and correctly.At the bottom of both lists, the contingencyfor receiving reinforcement was explained.David used the laminated lists, as well as aclipboard and dry-erase marker, to self-moni-tor his task completion.

To address the hypothesized function ofescape, David was able to earn free time aftercompleting tasks to criteria on both checklists;additionally, after the initial training phase,he was allowed to choose which checklist tocomplete first, and which to complete second.To address the hypothesized function of atten-tion, David was provided praise for task com-pletion and accuracy, as well as for the ab-sence of arguing. In addition, several of thetangible reinforcers were interactive games,through which he was able to access socialattention.

To identify potential tangible reinforcersfor David, we conducted a preference assess-ment (Cooper et al., 2007). Using open-endedquestions, we interviewed both David and his


mother individually about his preferences. Wealso conducted a naturalistic free-operant ob-servation, noting the activities and conversa-tion topics that David focused on most duringfree time. Based on these assessments, we ac-quired a variety of items that we expectedwould be reinforcing to him (e.g., checkers/chess set, soccer video game, model race car).We stored these reinforcers in a small con-tainer, along with a digital timer that was usedto time how long he was allowed access theitems.

Experimental Design and Procedure

We used a reversal design (ABAB), in whichfirst baseline data were collected (A). We thenconducted training and intervention (B).Next, we removed the intervention during re-versal (A). Finally, we implemented retrainingand reintroduced the intervention (B). Weused visual analysis to both determine when tochange phases, and to analyze the effects ofthe intervention.

Baseline. During baseline, David’s mothertold him to complete room-cleaning andhomework tasks (e.g., “Clean your room” or“Do your homework”). Other than the pres-ence of research team members collectingdata, baseline reflected the typical conditionsin the home.

Training. Using direct instruction andmodeling, a researcher taught David how to(a) complete each item on the checklist; (b)check off each item when completed; and (c)complete the items on the checklist in order.We also explicitly taught him the contingen-cies in effect for both checklists. For theCleaning Checklist, if he independently com-pleted 9 of 10 steps accurately and did notargue, then he received 15 minutes of freetime before starting tasks on the other check-list. For the Homework Checklist, if he inde-pendently completed 5 of 5 steps accuratelyand did not argue, then he was allowed toaccess a reinforcer from the container for 15minutes before starting tasks on the otherchecklist.

During training, a researcher providedprompts to David regarding the proceduresfor using the self-monitoring checklists, forcompleting the tasks accurately, and about thecontingencies in effect. He also received

praise and corrective feedback as needed. Af-ter he completed the tasks, David’s mothernoted on the checklists whether he had com-pleted them accurately (circling � on the list)or not (circling – on the list). If his perfor-mance met the criteria for the contingency inplace, he received the specified reinforcer. Ifhis performance did not meet the criteria,then a member of the research team told himthat he could try again next time.

Intervention. During intervention, David wasallowed to choose which checklist (Cleaningor Homework) to complete first. A researcheror David’s mother gave him the checklist andreminded him of the contingency written atthe bottom. After he reported that he wasfinished with all the tasks, David’s motherchecked each item as described previously inthe training section. If his performance metthe criteria, he received the specified rein-forcement; if not, he was directed to begin theother checklist and was reminded of the con-tingency in place. When finished, David’smother checked each item as described previ-ously. If his performance met the criteria, heaccessed the specified reinforcement.

Reversal. During the reversal sessions, wefollowed the same procedures as described inthe baseline sessions. To explain the with-drawal of the intervention to David and hismother, we stated that we wanted to observewhether David still needed the intervention inorder to complete the tasks and reduce hisarguing.

Retraining. During the retraining sessions,we reminded David to check off each item onthe checklist when completed, and to com-plete the items on the checklist in order untilall were completed. We provided prompts asneeded during the retraining sessions. Wealso provided praise and corrective feedbackas needed. If his performance met the criteriafor the contingency in place, he received thespecified reinforcer. If his performance didnot meet the criteria, then a member of theresearch team told him that he could try againnext time.

Reintroduction of intervention. Proceduresduring the reintroduction phase followed thesame procedures as described for the inter-vention sessions. The only difference was thatmembers of the research team supported Da-vid’s mother or aunt to implement the inter-


vention, rather than the researchers imple-menting it (as had been the case duringintervention sessions).

Procedural Fidelity

To document procedural fidelity, an indepen-dent observer recorded whether the 10 stepscomprising the intervention had been com-pleted. To calculate fidelity, the number ofcorrectly completed components was dividedby the total number of components, and mul-tiplied by 100. Fidelity data were collected forat least 33% of sessions in all training andintervention phases. During the final interven-tion phase, in which the intervention was re-introduced and conducted by David’s motheror aunt, fidelity data were collected for 83% ofsessions.

For sessions in which a member of the re-search team implemented the intervention(e.g., during training, intervention, and re-training phases), procedural fidelity was100%. During the final intervention phase, inwhich the intervention was reintroduced andconducted by the participant’s mother oraunt, fidelity data ranged from 57–100%, witha mean of 76%. Across all sessions, fidelitydata ranged from 57–100%, with a mean of86%.

Interobserver Agreement (IOA)

For both dependent variables, IOA was calcu-lated using total agreement IOA (e.g., smallercount divided by larger count, multiplied by100; Kennedy, 2005). We calculated IOA for atleast 33% of sessions per phase, with the ex-ception of baseline; lack of IOA data in base-line was an oversight. To address this limita-tion, we collected higher levels of IOA inremaining sessions (41% for argumentativestatements, and 53% for task completion).Overall, we calculated IOA on task completionfor 45% of sessions; IOA ranged from 93–100% (M � 98%). For argumentative state-ments, two research team members indepen-dently coded the audio files and transcriptsfor a given session. If agreement fell below75%, the coders reviewed differences andcame to consensus about a decision rule. Wecalculated IOA on argumentative statements

for 35% of sessions; IOA ranged from 75–100% (M � 88%).

Pre/Post-Test and Social Validity Measures

We administered the Eyberg Child Behavior In-ventory (ECBI; Burns & Patterson, 1990) toDavid’s mother both before the study beganand after its conclusion. The ECBI is a stan-dardized 36-item parent-report measure ofthe number of challenging behaviors exhib-ited by the child, and the intensity (e.g., fre-quency) of each challenging behavior (ratedon a Likert-type scale, 1 � the problem neveroccurs, 7 � the problem always occurs). Aresearcher interviewed David’s mother pri-vately using the ECBI and manually recordedher answers.

At the end of the study, we conducted socialvalidity interviews with David and his motherindividually. The interviews consisted of eightquestions developed for this study. Examplesof questions we asked David’s mother in-cluded, “After participating in this study, haveyou noticed any difference in your child’s be-havior? If so, what have you noticed?” Exam-ples of questions we asked David were, “Whatdid you like about learning some new ways toact/behave? What did you not like aboutlearning some new ways to act/behave?”

Results

Task Completion

David’s task completion data and mean phaselines are displayed in Figure 1. During base-line, the average percentage of task comple-tion was 46.33% (range, 31% to 55%). Thelevel of task completion increased sharply dur-ing training sessions, with David accuratelycompleting an average of 97.67% of tasks(range, 93% to 100%). This high level contin-ued during intervention, in which his taskcompletion was 100% for three consecutivesessions. During the reversal phase, David’saverage level of task completion fell to 50%(range, 33% to 67%), a level comparable tohis baseline data. As compared to the base-line and reversal phases, there was a cleardifference in level of task completion duringtraining and intervention. No data points


overlapped between baseline/reversal andtraining/intervention.

During the retraining sessions, David’s taskcompletion increased to a mean of 76%(range, 50% to 92%), showing more variabilityand lower levels of correct task completion thanthe initial training sessions. During the finalphase when the intervention was reintroduced,his task completion data stabilized at 100% forfour consecutive sessions. One data point (firstsession of reintroduction) was not included inthis analysis (see Figure 1). Because the proce-dures implemented by David’s mother in thissession differed significantly from the recom-mended intervention (e.g., use of an overcorrec-tion procedure), we separated this session fromthe others, and did not include it in our dataanalysis for this phase.

Overall, David’s task completion increasedimmediately from baseline to training/inter-

vention. During reversal, his task completiondecreased immediately, and closely resembledthe baseline data in terms of level and variabil-ity. During retraining, his task completion re-mained variable, but did increase from rever-sal (an average of 50%) to an average of 76%.His task completion stabilized at 100% for thelast four sessions of the study. Though theretraining sessions showed some variability,only one data point overlapped with the base-line/reversal data. Thus, these data documentone demonstration of effect, followed by tworeversals.

Argumentative Statements

David’s rate of argumentative statements andmean phase lines are displayed in Figure 2.During baseline, the average rate was 0.17statements per minute (range, 0.06 to 0.31);

Figure 1. Percentage of independent task completion data and mean phase lines across conditions.

Figure 2. Rate of argumentative statements per minute and mean phase lines across conditions.


these data showed an increasing trend. Hisrate of arguing decreased during training ses-sions to an average of 0.10 per minute (range,0.05 to 0.20), with a decreasing trend. Thistrend continued during intervention, inwhich his rate of arguing decreased to .03 perminute on average (range, 0 to 0.09). Duringreversal, his rate of arguing exceeded the datain baseline, with an average of 0.26 statementsper minute (range, 0.11 to 0.35). During re-training sessions, David’s rate of argumenta-tive statements decreased to an average of 0.06per minute (range, 0 to 0.17), and remainedat an average of 0.06 during the final phase ofthe study (range, 0 to 0.20). As noted in theprior section, we did not include the first datapoint in reintroduction because the proce-dures used by David’s mother differed signif-icantly from the recommended intervention.

David’s rate of arguing showed more vari-ability than the data on his task completion;typically the first data point in each phasediffered from the other data in the phase,showing a slightly delayed behavioral responseto the changing contingencies. Although changeswere not immediate in each phase, and there-fore produced overlapping data betweenphases, overall we observed countertherapeu-tic trends and higher rates of arguing duringbaseline and reversal (averages of 0.17 and0.26, respectively). In contrast, we noted ther-apeutic trends and lower rates of arguing dur-ing the initial training/intervention phases(average of 0.07) and the retraining/reintro-duction of intervention (average of 0.06).Thus, baseline and reversal sessions producedarguing at a rate over double and triple that ofthe mean rates observed when the interven-tion contingencies were in effect. As with thetask completion data, the data on David’s ar-gumentative statements document one dem-onstration of effect, followed by two reversals.

Pre/Post-Test and Social Validity Measures

David’s mother’s responses to the ECBI pre-test produced a score of 26 (out of 36), rep-resenting the number of behaviors she identifiedas a problem (Burns & Patterson, 1990). Onthe post-test, her responses produced a scoreof 24, indicating a slight decrease in the num-ber of behavior problems. Both pre- and post-test scores were well above the clinical cutoff

of 11 for this measure. David’s mother’s pre-test responses on the ECBI produced a scoreof 186 (out of 252 possible), representing theintensity of the behavior problems (e.g., fre-quency). On the post-test, her responses pro-duced a score of 120, showing a marked de-crease from pre- to post-test reports. The post-test score fell slightly below the clinical cutoffof 127 for this measure.

In the social validity interviews, David andhis mother both reported that his behaviorhad improved after participating in the study.Both also reported that the interventionhelped them to learn strategies that they willcontinue to use. Finally, they both reportedthat David’s motivation to clean his room hadincreased; his mother stated, “Now he isproud of keeping his room clean.” David com-mented, “I like having a clean room. Before itwas gross and messy.”

Finally, both David and his mother notedimprovements in their communication. Hismother reported, “Now it’s easier for me tocommunicate with [him]. He understandsyou better. He understands what you wanthim to do.” She also stated, “Now he is moremature. Now he is more respectful of me.”Likewise, David said, “My mom is more hum-ble and nice. She used to be aggressive whenshe told me to clean my room, and now sheasks more nicely.”

Discussion

The data from this study document a func-tional relationship between the interventionand both (a) completion of cleaning andhomework tasks, and (b) argumentative state-ments. The intervention addressed the multi-ple functions that were hypothesized to main-tain David’s behavior. Completion of hisroom-cleaning routine to the specified criteriaand without arguing resulted in 15 minutes offree time (e.g., escape from demands). Com-pletion of his homework tasks to the specifiedcriteria and without arguing resulted in 15minutes of access to reinforcers in the con-tainer; in every instance, he chose to playcheckers, thereby accessing both the game(e.g., tangible) and attention from the otherperson playing.

Further, the social validity data documentedvia multiple measures that the participant and


his mother considered both the goals andresults of the study to be important. Thoughnot explicitly a goal of this investigation, Davidreported that his mother communicated withhim in a more respectful way after participat-ing in the study. They also both reported thatthe procedures were acceptable. This is nota-ble because David’s mother initially expressedreluctance to give him “rewards,” and in ourobservation, relied more on punishment pro-cedures (e.g., response-cost, reprimands). De-spite her initial hesitance, after we explainedour rationale for the intervention, David’smother agreed to try it. After the study ended,she did not express reservations about thereinforcement procedures during the socialvalidity interview or during other conversa-tions with the researchers.

The reasons that David’s mother relied onpunishment may relate to parenting modelswithin her family and culture; her attributionsabout David’s challenging behavior; instruc-tions she received from professionals; her his-tory of negative reinforcement for using pun-ishment strategies; or likely some combinationof these factors. Future studies are needed toexamine how these factors affect parents’ ac-ceptance and implementation of reinforce-ment-based strategies, and behavior analyticinterventions more broadly. Such studiescould provide a basis for refining parent train-ing in order to strengthen the social validity ofbehavior analytic interventions among con-sumers, including those from culturally andlinguistically diverse backgrounds.

Though an important contribution to theliterature, we must note several limitations ofthe current study. First, we did not collect IOAduring baseline; we compensated for this byexceeding the traditional criteria of 33% ofsessions for IOA for both dependent variablesfor the remaining sessions. Second, IOA forargumentative statements for two sessions fellslightly below the traditional standard of 80%agreement (e.g., 75% and 78%). Given thecomplexity of the verbal behavior beingcoded, and the complexity of the environ-ment (e.g., multiple individuals speaking at atime, in English and Spanish, as well as otherbackground noise), we considered theseslightly lower levels of IOA to be acceptable(Kennedy, 2005).

Third, as in most applied studies, we were

not able to control for all extraneous variableswithin and outside the setting. David’s motherwas a caregiver for multiple children in herextended family, and the number of childrenin the home could vary widely from session tosession. The children required varying levelsof her attention, and engaged in differentactivities from day to day, producing a variablebackdrop for the current study. Further, ex-ternal events (e.g., related to the health ofseveral family members) occurred over thecourse of the study and we were unable toaccount for these incidents and the ways theyaffected David and his family.

Relatedly, when David’s mother reintro-duced the intervention in the last phase, sheused an overcorrection procedure that wasnot included in our intervention package. Be-cause this procedure deviated so greatly fromthe recommended intervention, we did notinclude it in our analysis of the data for thisphase. It is notable, however, that this proce-dure produced high rates of argumentativestatements from David, as well as a decrease inhis task completion from the prior session. Insome ways, then, this unanticipated eventserved as a natural experiment documentingthe countertherapeutic effects of this type ofprocedure for David.

A final limitation relates to the lack of for-mal maintenance and generalization data.Based on feedback from David’s mother, con-tinued data collection would have decreasedthe acceptability of the study. However, in thesocial validity interview, she reported that herintention was to continue using the interven-tion strategies. In an informal follow-up con-versation approximately one year after thestudy’s completion, she reported that Davidwas continuing to keep his room clean to hersatisfaction. In the social validity interview im-mediately after the study, she also reportedher generalization of the use of contingentreinforcement to promote untrained behav-iors. For example, she described how she hadasked David to do a chore not on his checklist;after completing it, he was allowed to playoutside with friends in the neighborhood. Fi-nally, during the last session David’s aunt im-plemented the intervention, demonstratinggeneralization to a degree. During this ses-sion, he completed 100% of the assigned taskscorrectly and independently; he also did not


make any argumentative statements in thissession.

This study has shown the promise of behav-ior analytic self-management strategies to im-prove the behavior of a child with FASDwithin the complex context of his home. Likefamilies of children with other types of devel-opmental disabilities, families of children withFASD face challenges in meeting their aca-demic, social and behavioral needs. They alsoface pronounced challenges in accessing ser-vices for their children. A family seeking ser-vices for a child with FASD will likely experi-ence limited community and social supportsand encounter professionals who are not fa-miliar with FASD (Paley & O’Connor, 2011).In our observation, they will also likely interactwith professionals who do not identify behav-ior analytic interventions as appropriate forchildren with FASD, and insurance companiesthat do not cover behavior analytic services fortheir children.

This study is an important step in demon-strating the effects of behavior analytic inter-ventions for children with FASD. More studiesare needed to document behavior analysis asan evidence-based technology for this highlyunderserved, at-risk population. Given the ex-traordinarily limited literature on this popula-tion to date, more home-based investigationsare warranted. Future research should alsoextend this work by investigating the applica-tions of self-management strategies amongchildren with FASD within school settings. Bygrowing the evidence base, our field can bet-ter disseminate effective behavioral strategiesto the families of children with FASD and theprofessionals who serve them.

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Received: 19 October 2017Initial Acceptance: 19 December 2017Final Acceptance: 28 January 2018


Investigating Components, Benefits, and Barriers ofImplementing Community-Based Vocational Instruction for

Students with Intellectual Disability in Saudi Arabia

Hussain A. AlmalkyPrince Sattam bin Abdulaziz University

Abstract: Special education teachers’ perceptions towards community-based vocational instruction (CBVI) arecritical for effective implementation of related activities for students with intellectual disability (ID). This paperexamines special education teachers’ perceptions towards CBVI in preparing secondary students with ID forpostschool employment in Saudi Arabia. A web-based survey was used for data collection. The survey wasdistributed to the population of special education teachers in public high schools in Riyadh city, Saudi Arabia.Based on the survey results, this study examines educators’ perceptions about the components, the benefits, andthe barriers to implementing CBVI. The results indicate that teachers are generally confident about theimportance of CBVI components and show positive perceptions toward the benefits of implementing CBVI.Additionally, the results reveal some barriers to implementing CBVI in Saudi Arabia. Implications andrecommendations are also discussed.

The purpose of this study was to examinespecial education teachers’ perceptions to-ward the components, the benefits, and thebarriers to the implementation of community-based vocational instruction (CBVI) to pre-pare students with intellectual disability (ID)for postschool employment. Special educationin Saudi Arabia is still being developed, par-ticularly for students with ID (Al-Ajmi, 2006).Investigating teachers’ perceptions about CBVIcould increase awareness of this approach,which could increase the likelihood it wouldbe implemented. Additionally, gathering in-formation about CBVI could increase teacherstraining (pre-service and/or in-service) aboutdeveloping and providing CBVI activities.

Individuals with special needs in Saudi Ara-bia did not receive special education beforethe year 1958. In that year, the first institutefor blindness was established (Alhano, 2006).After that initiative, students with ID began toreceive special education services when the

first institute for them was opened in 1972(Al-Hoshan, 2009). The increased services inspecial education in Saudi Arabia have im-proved the education of students with disabil-ities (Al-Ajmi, 2006). Regulations were estab-lished in order to provide human rights thatensure free and appropriate services for allstudents with disabilities. As a result, Saudischools have incorporated inclusion for stu-dents with ID as in self-contained classroomssince 1991 (Almalky, 2008). However, althoughthere is an improvement, it is very slow. Con-sequently, most of the regulations regardingstudents with disabilities were passed in thelast two decades, and even some of these lawshave yet to be applied (Alquraini, 2011).

Postsecondary Transition

Special education services in Saudi highschools provide an Individualized EducationProgram (IEP) for each student with ID,which focuses on academic, social, and com-munication skills. However, transition plan-ning and services are not clearly consideredin students’ IEPs (Alnahdi, 2012). Teachersshould educate their students with ID on jobsites to facilitate an easier transition from ac-ademic life to employment (White & Weiner,

Correspondence concerning this article shouldbe addressed to Hussain A. Almalky, Special Educa-tion Department, School of Education, Prince Sat-tam bin Abdulaziz University, Al-Kharj, SAUDIARABIA. E-mail: [email protected]


Community-Based Vocational Instruction / 415


2004). Despite this, high schools in Saudi arestill not including job training in students’community environment, thereby not prepar-ing the students for their adult life (Alhossan& Trainor, 2015; Almanea, 1997). It is essen-tial that they have a connection with the com-munity so that they can stay aware of the op-portunities, which are not available in theclassrooms (White & Weiner, 2004). Afterhigh school, the students with ID has access toonly certain training that are offered in voca-tional centers which are usually a shelteredworkshop meant for students with disabilities.However, this option is also not readily avail-able (Elsheikh & Alqurashi, 2013).

Since Saudi schools do not include transi-tion planning and transition services in thestudents’ IEPs, transition research from theUS will be used in this study. In addition tothat reason, the transition is still a new con-cept in Saudi Arabia, thus, the research ontransition for students with ID is limited inSaudi Arabia. Besides, numerous Saudi schol-ars are trained in the US and then importedsome of these ideas. The imported ideas thathave been successful include, implementingIEPs, integrating students with ID in publicschools, and providing related services. How-ever, in Saudi Arabia, students with ID are notconnected to the community environment,which offers a rich experience that studentscannot get it in their classrooms. When com-pared to the US, Saudi government statisticsindicate lower quality of life, higher unem-ployment rates, and lower wages if employed,for people with ID (Ministry of Economy andPlanning, 2014).

In contrast, in the US, the transition planneeds to be included in students’ IEPs. Tran-sition planning is used to help students withdisabilities move smoothly from school topostschool life. The Individuals with Disabili-ties Education Act (2004) requires that transi-tion planning and services begin when astudent reaches 16 years of age or younger(Schwartz, Mactavish, & Lutfiyya, 2006). How-ever, most research suggests starting transitionplanning at age 14 or earlier if appropriate.Furthermore, some states and previous ver-sions of IDEA required transition planning byage 14 (Cameto, Levine, & Wagner, 2004).

IDEA (2004) defines a transition plan asa coordinated set of strategies and activities

based on the student’s strengths, needs, inter-ests, and preferences that help the student inachieving postsecondary objectives related totraining, education, employment and inde-pendent living. IDEA requires that studentstake part in transition planning and decision-making about their lives, working with theirparents, teachers, and community service pro-viders to support achieving their goals. Faci-litating transition services among studentsensure that they have a successful transitionfrom academic life to postsecondary educa-tion, employment, vocational training and in-dependent living. Research also supports thefact stating that there is a positive relationshipbetween transition planning in secondaryschools and transition outcomes (Phelps &Hanley-Maxwell, 1997; Test, Mazzotti et al.,2009; Trainor, 2008; Wehman, 2006).

Vocational Education

According to The Career and Technical Edu-cation Act (2006), vocational education maybe defined as the programs that are focusedon providing individuals the technical and ac-ademic knowledge along with the necessaryskills that make them ready for further studiesor employment, which may be paid or unpaid.For vocational training to be successful, itshould have these components: (a) a trainingand employment setting providing a real feel,(b) job analysis, (c) correct job placement, (d)proper assessment and instructions, (e) sup-port during transition and (f) effective super-vision (Inge, Wehman, & Dymond, 2005).These training programs can be in differentfields such as trade and industry, agriculture,consumer sciences, family, or technology ed-ucation (Scott & Sarkees-Wircenski, 2004).

Unfortunately, it is a rarity that Saudischools implement these programs for stu-dents with ID (Alnahdi, 2013). As per theresearch conducted in the US, vocational ed-ucation is one of the most integral compo-nents for the students with ID and should bemade a part of all the special education pro-grams run for secondary education (Harvey,1998; Inge et al., 2005; Trainor, Carter, Ow-ens, & Swedeen, 2008). Additionally, variousstudies have also indicated that it acts a strongpredictor of the employment opportunitiesfor the students with ID (Baer, Daviso, Flexer,


Queen, & Meindl, 2011; Benz, Lindstrom, &Yovanoff, 2000; Doren, & Benz, 1998; Test,Mazzotti et al., 2009). It is observed that stu-dents who have attended vocational trainingduring high school tend to have better wageearnings, higher working hours as comparedto those who do not attend (Harvey, 1998;Rabren, Dunn, & Chambers, 2002).

Based on these evidence, it is argued in theresearch that if the vocational training espe-cially CBVI, is implemented, it will preparethe Saudi students with ID for the job skillswhich are required for job search and main-tenance (Masters, Mori, & Mori, 1993; Weh-man, 2006). The conceptual framework, forthis study, is derived from the human capitaltheory, which indicates that an individual in-vestment is expected to increase one’s abilityto make improvements in one’s quality of life(Becker, 1993). As per the theory, acquiringmore skills make an individual rich in humancapital and therefore increases the employ-ment opportunities, production and potentialincome for him (Blackorby, Hancock & Sie-gel, 1993).

Community-Based Vocational Instruction

CBVI includes training roles, events and inte-grated settings in the work of students to de-velop their employment skills and awarenesstowards the career (Kim & Dymond, 2010).Educators have realized that the skills learnedin schools cannot be generalized to commu-nity workplaces that led to providing voca-tional instruction in community environments,which became one of the best transition prac-tices for the students with ID (Test, Fowler etal., 2009). As the implementation of voca-tional training has proved to be successful, it isconsidered as one of the prominent CBVIstrategies for job seeking and maintaining (Ci-mera, 2010; Wehman, 2006). According toChan and Chadsy (2006), employment en-gagement and preparing students with ID isnecessary, as it can encourage independentliving and integration of work in a community.

Various studies indicate that to improve ca-reer awareness and skills development, stu-dents should take different jobs and narrowthem to determine the final work that theywant to pursue in the final years of study (Ren-zaglia, Hutchins, Dymond, & Sheldon, 2008;

Test, Aspel, & Everson, 2006; Wehman, 2006).CBVI includes work experience, which may bepaid or unpaid and may vary from volunteerto competitive employment. Paid and short-term experiences may include job shadowingand unpaid long-term experiences may in-clude internships. Students with ID canbroaden their work experiences with theseopportunities either before or after their grad-uation (Donell & Hardman, 2010; Renzagliaet al., 2008; White & Weiner, 2004).

CBVI helps in the advancement of school,reduce the possibilities of student dropout,and improves outcomes for students with dis-abilities after school (Benz, Yovanoff, & Do-ren, 1997). The literature also indicates thatCBVI help students with ID in the develop-ment of vocational competencies, social skills,and employment behaviors. Schools withCBVI have assisted students with ID in findingemployment opportunities as per their strengthsand achievements (Benz, Lindstrom, Unruh,& Waintrup, 2004; Langone, Langone, &McLaughlin, 2000; Wehman & Revell, 1997).These schools have also helped in connectingstudents with the community environmentsfor accessing other services too which helpthem in getting better employment opportu-nities (Nuehring, 2003).

For connecting CBVI to the evidence base,the literature provided by Test, Mazzotti, et al.(2009) and Test, Fowler, et al. (2009) empha-sizes the application of real work environ-ments. The studies indicate that students whowere a part of CBVI in natural environmentspossessed better chances of getting jobs postschool. Furthermore, students had jobs dur-ing the school were likely to have paid employ-ment after graduating as compared to volun-teer work and unpaid jobs. Parmenter (2011)researched CBVI and reflected that with thehelp of individualized supervision in the work-place culture offered to students with ID, itcontributes to their professional develop-ment. Additionally, students who participatedin teamwork, built relationships with otheragencies, mastered managing their time, andselected jobs that fit their strengths. The liter-ature provides that CBVI is an effective ap-proach as it allows students with the opportu-nities to develop skills, acquire knowledge,and apply them in actual settings. Differentstudies have identified the correlation be-


tween competitive employment outcomes andsecondary school work experience (Benz etal., 2004; Collet-Klingenberg, 1998; Inge et al.,2005; Lindstrom & Benz, 2002; Rabren et al.,2002; West, Wehman, & Wehman, 2005).

Perceptions of Teachers toward CBVI

The perceptions of special education teachersregarding CBVI are important to develop ef-fective programs. Langone et al. (2000) statedthat teachers with positive perceptions regard-ing CBVI are in a better position to developeffective CBVI activities. In addition to this,the teachers who took a part in CBVI indi-cated positive attitudes as they were able todesign community-based activities that had apositive impact on the self-worth, success, andfeelings of the students. Agran, Snow, andSwaner (1999) found that teachers considerCBVI to be essential for preparing studentswith ID for the life after school. The research-ers concluded that teachers believe CBVI tohave various benefits for the students with ID,such as to enhance social interactions, inde-pendence, promote learning skills, and gener-alizing the educational skills across differentsettings. The teachers considered administra-tive support to be the key factor in effectivecommunity programs.

This depicts the significance of examiningthe perceptions of special education teachersabout CBVI and its relationship with the post-school employment outcomes. Therefore, thefocus of the researcher was to find out if CBVIcan be successful in Saudi Arabia, as it is suc-cessful in the US. It is crucial to determinewhether the same benefits will be available forthe students in Saudi Arabia which are avail-able to students in the US. These may be inthe form of better employment opportunities,higher wages, more working hours and betterlife. Thus, this study focuses on identifying theperceptions of special education teachers to-wards implementation of CBVI in Saudi Arabiato determine the extent to which the interven-tion can be transferred. In this respect, the fol-lowing research questions are developed:

1. Given a definition of CBVI, what are theperceptions of Saudi special educationteachers toward the essential compo-nents of CBVI?

2. What are the perceptions of Saudi spe-cial education teachers regarding the po-tential benefits of implementing CBVI attheir schools?

3. What are the perceptions of Saudi spe-cial education teachers regarding the po-tential barriers of implementing CBVI attheir schools?

4. What are the possible differences in theperceptions of female and male specialeducation teachers towards implement-ing CBVI?

Method

This study used a survey to collect data re-garding the perceptions of special educationteachers toward the implementation of CBVIin high schools. These perceptions were gath-ered to help students with ID for preparingfor work after high school through the imple-mentation of CBVI programs. The rationalefor using survey methodology was that thetechnique was effective in obtaining the atti-tudes and perceptions of participants and un-derstanding it (Couper, 2008). Additionally, itwas feasible to cover a wide base of respon-dents at a low cost, in short duration, andfrom a distance (Tourangeau, Rips, & Rasin-ski, 2000).

Instrument Development

The researcher used a survey developed in theU.S. context as it was conducted on a similarpopulation dealt with similar issues regardingusing CBVI to prepare students during highschool for employment. The survey was devel-oped by Kim and Dymond (2010) basis onthe literature review conducted on the topicof CBVI. The researcher made necessarychanges in the survey to make it suitable in thecontext of Saudi Arabia.

The survey was divided into four sections,section 1 aimed at gathering the demographicinformation of the participants. Section 2measured participants’ perceptions about theimportance of different components of CBVIidentified in the literature. Section 3 assessedparticipants’ perceptions about the potentialbenefits of CBVI in the Saudi Arabian context,


and Section 4 gathered participants’ percep-tions concerning potential barriers to imple-mentation of CBVI in the context of SaudiArabia. The survey used a linear and numeric6-point Likert-type scale, which included la-beled anchors as the rating mechanism forSections 2 - 4 (e.g., 1 � not important to6 � very important; 1 � not a benefit to 6 �extreme benefit; 1 � not a barrier to 6 �extreme barrier; Kim & Dymond, 2010).

Validity and Reliability

Validity. The final English version of thesurvey was reviewed by a content expert intransition for youth with disabilities. Then, theresearcher translated the survey into Arabic,and a native Arabic speaker, who is also anexpert in transition, reviewed the translationfrom English to Arabic of that version of thesurvey. Additionally, two faculty members atKing Saud University in Riyadh reviewed theArabic version of the survey to determine thecontent validity, the accuracy of the items andits relevance, and the survey design. Then thefaculty members translated the survey back toEnglish. Utilizing this back-translation tech-nique (Khalaila, 2013), a comparison of thetranslation from Arabic to English was madewith the original English survey, and someminor changes were made to the Arabic sur-vey after this procedure. To find the consis-tency in the survey, it was then given to fivespecial education teachers working in themiddle schools in Saudi Arabia. The re-searcher tested this survey with these partici-pants as they were teachers in the middleschool. They also did not belong to any focalgroup that was a part of this study. Basedon their suggestions, necessary changes weremade in the survey, which were minor in na-ture.

Reliability. The researcher used Cronbach’salpha coefficient to measure internal reliabil-ity of the Arabic version of the survey (Cola-darci, Cobb, Minium, & Clarke, 2004). Aftercalculating the items consistency across thesections of the survey, the total score of thecoefficient alpha was high (97%) indicatinghigh reliability. The coefficient alpha for thesurvey’s sections---namely, the components(16 items) was .97, the benefits (13 items) was.96, and the barriers (16 items) was .93.

Sampling Procedures and Sample

The sample for this study included the specialeducation teachers working in all the publichigh schools that offer programs for the stu-dents with ID in Riyadh. The schools thatoffered the programs amounted to 18 highschools and all these schools were includedfor the purpose of this study.

Data Collection

After obtaining the IRB approval, and the Ed-ucation Department consent in Saudi Arabia,the web-based surveys were distributed tothe targeted population of special educationteachers via emails. The online survey toolQualtrics (www.qualtrics.com) was used. Alink to the survey was emailed to the partici-pants. The first page of the survey explainedthe survey’s purpose, its confidentiality, poten-tial risks associated with participation, and theduration of the survey. A voluntary consentstatement was also provided. Three reminderswere emailed weekly to the participants beforethe close of the survey.

Data Analysis

After exporting the data in the form of Excelsheets, the data were entered into a statisticalsoftware program (SPSS). Descriptive statisti-cal calculations were made which includedstandard deviations (SD), frequencies, means,the coefficient of variation (CV), and percent-ages. The researcher used the means (M) forcomparing the differences in the perceptionsof participants about the components, bene-fits and the barriers. Additionally, the re-searcher calculated the coefficient of variationfor measuring the consistency of the partici-pants’ answers for each item in the survey. Anindependent sample t-test was used to deter-mine if there was a statistically significant in-fluence by gender on special education teach-ers’ perceptions of the components, benefitsof and barriers to CBVI. More informationcan be found in the results section below.

Results

The current study investigated teachers’ per-ceptions about CBVI. This section presents


http://www.qualtrics.com

the results in the following order: (a) re-sponse rate, (b) participants’ demographiccharacteristics, (d) components of CBVI, (e)benefits of implementing CBVI, and (f) barri-ers to implementing CBVI.

Response Rate

The targeted population consisted of 108 spe-cial education teachers. A total of 86 partici-pated. Responses from five of the 86 partici-pants were excluded because they did notcomplete the survey. Data from 81 completedsurveys were analyzed. Participant demo-graphics are described in Table 1.

Components of CBVI

The overall mean for the importance of thecomponents of CBVI was high (M � 4.71) ona 6-point Likert-type scale range as depictedin Table 2. The means of the componentsranged from 3.93 to 5.00, and standard devi-ations ranged from 1.36 to 1.61. The differ-ence between the highest and lowest mean

TABLE 1

Participants’ Demographic Characteristics

Characteristics n %

Experience1 to 5 18 22.26 to 10 15 18.511 to 20 27 33.3More than 20 21 25.9

CertificateBachelor 51 63Master’s 27 33.3Ph.D. 3 3.7

MajorSpecial education 57 70.4Other majors with Special

education certificate9 11.1

Other majors 15 18.5Gender

Male 45 55.6Female 36 44.4

Experience with CBVIYes 33 40.7No 48 59.3

TABLE 2

Means and Standard Deviations and Coefficients of Variation for Components of CBVI

The Importance of Components of CBVI M SD CV Rank

Develop IEP goals for CBVI collaboratively with a team (e.g. parents, students,special education teachers, job-coordinator, etc

5.00 1.36 0.27 1

Offer opportunities for students to perform a variety of job tasks 4.93 1.41 0.28 2Choose CBVI sites that reflect local labor market needs 4.93 1.41 0.28 2Provide students with CBVI more than 2 times a week 4.89 1.42 0.29 4Provide experiences that reflect the specific job demands of the local business 4.96 1.44 0.29 5Keep a portfolio documenting students’ CBVI experiences 4.96 1.49 0.30 6Provide students with a variety of work experiences 4.72 1.50 0.31 7Provide CBVI based on the needs of students (not the needs of the business) 4.55 1.45 0.31 8Provide students with choices of work experiences 4.74 1.51 0.32 9Provide students with opportunities to interact with employees without disabilities 4.69 1.56 0.33 10Supplement CBVI with classroom- based instruction (e.g. simulation) 4.72 1.58 0.33 11Use systematic instructional procedures (e.g. job analysis) 4.62 1.55 0.33 12Provide classroom-based instruction (e.g. simulation) prior to community

placement4.78 1.61 0.33 13

Provide instruction and/or supervision (i.e. by the school or business) duringCBVI at all times

4.41 1.49 0.33 14

Assess students’ generalization of skills across CBVI sites 4.44 1.51 0.34 15Provide CBVI to heterogeneous groups of students at the same time 3.93 1.54 0.39 16Overall mean and standard deviation and coefficient of variation 4.71 1.22 0.25

Note. M � Mean; SD � standard deviation; CV � coefficient of variation.


was 1.07, which is negligible because of a highmean of all components (Coladarci et al.,2004). That indicates special education teach-ers believed the components of CBVI werevery important. The high degrees of signifi-cance of the components reveal positive per-ceptions regarding the CBVI in general. Therate of the standard deviation (SD � 1.22)illustrates a good consistency with the sampleanswers. As Table 2 shows, teachers ranked“developing IEP goals for CBVI collaborativelywith a team (e.g. parents, students, specialeducation teachers, job-coordinator, etc.,” asthe most important component. With a meanof 5.00 and the standard deviation of 1.36; itwas the most consistent answer of the partic-ipants than the rest of other componentswhere the coefficient variation (CV) was 0.27.The sample ranked “providing CBVI to heter-ogeneous groups of students at the same time”as the least important component, with amean 3.93, and a standard deviation of 1.54.The coefficient of variation in this componentwas 0.39, which indicates the variation of thesample perceptions toward this componentwas less homogeneous than the other percep-tions in the rest of components.

Benefits of Implementing CBVI

The overall mean of the benefits of CBVI wasvery high (M � 5.13) on a 6-point Likert-typescale as shown in Table 3. The means of thebenefits ranged from 4.39 to 5.39, and stan-dard deviations ranged from 0.99 to 1.55. Thedifference between the highest and lowestmean was 1.14, which is a small discrepancyindicating a high level of value to these bene-fits of CBVI according to the sample percep-tions. The value of the standard deviation was1.04, which depicts a little variance betweenthe sample answers. The statement “increas-ing the likelihood that students will maintain ajob after graduation” was ranked first amongthe benefits, with a mean of 5.39 and a stan-dard deviation of 0.99. This item demon-strated the most homogeneous participantperception compared to the rest of the bene-fits where the coefficient of variation was0.184. The statement “decreasing high schooldrop-out rate” was the last important benefitin rank with a mean of 4.79, and standarddeviation of 1.55 indicating the variation ofthe sample perceptions toward the impor-tance of this benefit was less homogeneousthan the rest of the perceptions in other ben-

TABLE 3

Means and Standard Deviations and Coefficients of Variation for Benefits of CBVI

The Benefits of CBVI M SD CV Rank

Increases the likelihood that students will maintain a job aftergraduation

5.39 0.99 0.18 1

Help students learn specific job skills 5.31 1.08 0.20 2Assists students in identifying vocational goals 5.17 1.08 0.20 3Help students learn job task skills (e.g., production rate, work product

quality, etc.)5.13 1.09 0.21 4

Increases students’ self-determination 5.17 1.16 0.22 5Help students learn work behaviors (e.g., attendance, punctuality,

hygiene etc.)5.24 1.26 0.24 6

Increases the likelihood that students will obtain paid employment 5.13 1.26 0.24 7Provides opportunities for interactions with co-worker without disabilities 5.17 1.27 0.24 8Prepares students for post-school life 5.17 1.29 0.25 9Identifies student’s employment interests 5.03 1.30 0.26 10Promotes generalization of skills across settings 4.86 1.26 0.26 11Increases students’ independence 5.13 1.36 0.26 12Decreases high school drop-out rate 4.79 1.55 0.32 13Overall mean and standard deviation and coefficient of variation 5.13 1.04 0.20



efits where the coefficient of variation was0.32.

Barriers to Implementing CBVI

The overall mean of the third dimension,which is the barriers of implementing CBVI inSaudi Arabia, was high (M � 4.66) on a6-point Likert-type scale. The means of thebarriers ranged from 4.31 to 5.07, and stan-dard deviations ranged from 0.91 to 1.59. Thedisparity between the highest and lowest meanis 0.76, which is a small variation depicting ahigh consistency in the sample perceptions ofthe significance to these barriers. A good con-sistency with the sample answers was based onthe rate of the standard deviation 0.91. Asshown in Table 4, special education teachersranked “lacking of administrative support” asthe first barrier with a mean of 5.07 and thestandard deviation of 0.91. This barrier wasthe most homogeneous compared to otherbarriers, and the coefficient of variation was0.18. The barrier “not enough staff” was in thelast rank with a mean of 4.44, and the stan-dard deviation of 1.59 indicating a small vari-ation about the significance of this barrier,and the perceptions about it were less homo-

geneous than the rest of the perceptions ofother barriers where the coefficient of varia-tion was 0.35.

An independent sample t-test was used todetermine if the “Gender” had a statisticallysignificant influence on special educationteachers’ perceptions of the components, thebenefits, and barriers regarding implement-ing CBVI. There were non-significant differ-ences between perceptions of male andfemale teachers toward the importance ofcomponents of CBVI (t � �0.988, p � 0.34),and the value of t was non-significant (p �0.34 � 0.05. Furthermore, there were alsonon-significant differences between percep-tions of male and female teachers toward thebenefits of CBVI (t � �0.538, p � 0.596), andthe value of t was non-significant (p � 0.596 �0.05). Finally, there were non-significant differ-ences between perceptions of male and femaleteachers toward the barriers of implementingCBVI (t � �0.035, p � 0.97), and the value of twas non-significant (p � 0.97 � 0.05).

Discussion

The results of this study indicated that specialeducation teachers in Riyadh recognize the

TABLE 4

Means and Standard Deviations and Coefficients of Variation CBVI

The Barriers of Implementing CBVI M SD CV Rank

Lack of administrative support 5.07 0.91 0.18 1Employers are not ready to cooperate with schools 4.96 1.23 0.24 2Lack of cooperation between schools and other related agencies 5.00 1.27 0.25 3Liability concerns 4.69 1.19 0.25 4Lack of work opportunities for students with disabilities in the community 4.96 1.28 0.25 5Pressure to focus students with disabilities in the academic curriculum 4.69 1.24 0.26 6Challenges to aligning standards-based content and vocational goals 4.58 1.23 0.26 7Students’ challenging behaviors 4.31 1.16 0.27 8Severity of students’ disabilities 4.65 1.30 0.28 9Limited personal experience implementing CBVI 4.72 1.34 0.28 10Lack of preparation time 4.44 1.28 0.28 11Lack of funding 4.86 1.45 0.29 12Lack of transportation 4.51 1.40 0.31 13Safety concerns 4.31 1.34 0.31 14Parental concerns 4.37 1.46 0.33 15Not enough staff 4.44 1.59 0.35 16Overall mean and standard deviation and coefficient of variation 4.66 0.91 0.19



potential importance of the components andthe benefits of CBVI. They also were awareof challenges and barriers of implementingCBVI for students with ID. Special educationteachers think that CBVI has to incorporatevarious essential components to be an effi-cient approach for training students with IDfor employment. Teachers ranked differentcomponents such as creating CBVI’s goalswith a team as the most important. Addition-ally, they state that it is vital to provide oppor-tunities for students with ID to do a variety oftasks for different jobs. This result agrees withTest, Fowler, et al. (2009) study, which sup-ports preparing students with ID for variousjobs. It was not clear why special educationteachers ranked providing instruction and/orsupervision (i.e. by the school or business)during CBVI at all times as one of the leastimportant components. Instruction and/orsupervision are essential components of CBVI.The students with ID need the instructionand/or supervision to learn job skills andfunction effectively. Several studies recom-mend supervision and natural support inthe integrated work environments (Luecking,Cuozzo, & Buchanan, 2006). Even thoughteachers ranked some components lower,those components are still important becausethey have a high average mean which is in linewith some studies’ findings (Kim & Dymond,2010; Lindstrom & Benz, 2002).

Teachers in high school confirm that theimplementation of CBVI drives to positivepostschool outcomes such as more likely thatstudents with ID will find and maintain a job.This result is consistent with Lindstrom andBenz (2002) and Collet-Klingenberg (1998)findings, both of which revealed that workexperience in high school is a vital compo-nent in assisting students with transition towork after secondary school. Special educa-tion teachers also think that CBVI supportsstudents with ID to equip with needed em-ployment skills, find postschool employment,and reach independent living, which agreedwith Parmenter’s (2011) findings.

In this study, educators ranked major barri-ers to implementing CBVI, such as a lack ofadministrative support, lack of preparationtime, and lack of cooperation between schoolsand other related agencies, and employers.These were consistent with Sarkees-Wircenski

and Scott’s (1995) findings, but inconsistentwith the findings of Kim and Dymond (2010),who investigated secondary special educationteachers (N � 68) in Illinois, and found dif-ferent ranking of major barriers, such as: notenough staff, requirements of the No ChildLeft Behind Act (NCLB), and lack of funding.This inconsistency in the results of the currentstudy and Kim and Dymond study may refer tothe different way of funding schools betweenthe two countries. In Saudi Arabia, the gov-ernment provides equal funding for all schoolbased students while in the US, federal, state,and local revenue provide varying funding fordifferent schools. Teachers believe that thecommunity has been not supportive with theimplementation of CBVI. Employers are stillnot ready to cooperate with schools. Educa-tors have not received a sufficient level of staffdevelopment. Local universities do not offerprograms that teach CBVI for current specialeducation teachers or students training to bespecial education teachers. Alnahdi (2013)concluded that special education teachersfelt unequipped with adequate skills to planand provide transition services. Additionally,Althabet (2002) pointed out that there wereno university courses about transition servicesin the special education program at King SaudUniversity. Furthermore, the legislation inSaudi Arabia does not require the involve-ment of other agencies in providing employ-ment training for students with ID duringhigh school. This pressures special educationteachers to concentrate only on teaching aca-demic skills and do not provide CBVI for theirstudents. Lastly, educators conclude thatimplementing CBVI more likely to take toomuch time from the academic instruction inthe classroom.

The current study revealed that there was anon-significant difference in the perceptionsof female and male special education teachersconcerning components, benefits, and barri-ers of CBVI. This may indicate two things, firstthat the special education teachers do notconsider CBVI to be an important componentand second, the female and male teachershave positive perceptions about the CBVI dueto its better understanding of the studentswith ID.


Limitations of the Study

Throughout conducting the study in Riyadhthere were various challenges in carrying outthis investigation. Therefore, there were vari-ous limitations. One of the limitations wasinvolving participants from only one city. Thatprecludes the generalization of the study re-sults. Secondly, only public high schools wereselected; thus, there was not enough represen-tation of various institutions across Riyadh,which resulted in an unequal number of par-ticipants among special education teachers.The third problem encountered was the factthat the definition of CBVI that was providedin the survey was broad (Kim & Dymond,2010). This may have led to a situationwhereby many participants may have citedhaving experience in CBVI than if a narrowerdefinition had been provided. CBVI was notimplemented at all schools in Riyadh. Thus, itwas not clear that teachers understood CBVIfrom the definition that was provided in thesurvey and from the items under the dimen-sions in the survey, which are the importanceof components, the benefits, and the barriers.This study is based on a survey conducted onspecial education teachers in Riyadh; thus,those respondents’ perceptions were based onSaudi Arabian culture, legislation and educa-tion systems, which reflect only the challengeseducators face in their social setting.

Implications for Practice

One of the significant implications of thisstudy is for the schools, government and otherrelated agencies to include the CBVI pro-grams in student IEPs. It is necessary that it iseffectively implemented so that the studentscan be prepared for the postschool employ-ment. Southward and Kyzar (2017) empha-sized that on the job experiences should befocused by the educators for the overall devel-opment of the students, which should includeinternships, shadowing, apprenticeships, co-operative education, and nonpaying observa-tion. It is also required that the governmentshould adopt certain legislative policies whichrequire employers to provide training to thestudents with ID. This will ensure that whileworking in real life environment, they aremade more job-ready and have a better quality

of life. Another significant implication is forthe schools to create new positions for special-ists in schools for professional developmentsuch as transition and CBVI specialists (Lueck-ing et al., 2006). These implications will helpin increasing the employment opportunitiesfor students with ID and will enhance theirintegration in the community thereby provid-ing a better quality of life.

Future Research

As the present study focuses only on the Ri-yadh city, it is recommended that for the fu-ture studies, a similar study is conducted on anational level. Additionally, it is also recom-mended that unlike the current study, whichis focused on determining the perceptionsof special education teachers, another studyshould be conducted for determining admin-istrators’ perceptions for the implementationof CBVI. Another area which needs an addi-tional inquiry is the push for accountability, asexpressed in the legislation and CBVI (Rabrenet al. 2002). Future studies should also beconducted to study CBVI as an interventionstudy to determine the impact of CBVI onemployment success after completion of highschool. Lastly, the future studies should alsofocus on determining the role of family mem-bers and school-based staff in guiding andinfluencing the decisions taken by the stu-dents with ID concerning employment (Lind-strom, Doren, Metheny, Johnson, & Zane,2007). Test, Mazzotti, et al. (2009) illustratethat students who have proper occupationalguidance from family members and schoolstaff are likely to have successful transitions tojobs and are capable of keeping their job po-sitions for a longer time.

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Participation in Related Services and Behavioral, Social, andAdaptive Symptom Presentation in Young Children with

Autism Spectrum Disorder

Stephanny F. N. Freeman, Tanya Paparella, Joanne J. Kim, Fiona Whelan,Gerhard Hellemann, and Steven Forness

University of California, Los Angeles

Abstract: Children with autism spectrum disorder (ASD) tend to receive several related services during their earlyschool years. In this study, we followed 70 preschoolers with ASD and used parent reports to document theintensity of these services over a 4-year period, in relation to children’s outcomes in three domains. Whilebehavioral difficulties improved, social skills and adaptive abilities in children with ASD tended to remainimpaired across development. We found that very young children with ASD received behavioral servicesregardless of need and overall standardized measures of behavioral difficulties showed improvement over 4 years.Further, over time, behavioral services were correlated to children’s needs. Standardized measures of social skillsimproved significantly but scores remained impaired and services specific to this skill area were few. Adaptiveabilities remained significantly impaired however, and adaptive services were very few, with little relationshipto abilities over time.

In 2001, the National Research Council (NRC)published Educating Children with Autism call-ing for interventions prioritizing language, so-cial skills, cognitive development, problembehaviors, and academic skills. They state, “Ef-fective services will and should vary consider-ably across individual children, depending ona child’s age, cognitive and language levels,behavioral needs, and family priorities” (Lord& McGee, 2001, p. 220). They recommendeda minimum of 25 hours per week, 12 monthsof the year with a particular emphasis on earlyintervention. During early school years, in ad-dition to schooling, services may be providedthrough young children’s Individual Educa-

tion Programs (IEPs) while others may beobtained by parents through private fundsor health care coverage (Young, Ruble, &McGrew, 2009).

The NRC report summarized research oneffective interventions, and subsequent re-search has focused on identifying ingredientsof therapeutic interventions that maximizeoutcomes for young children with autismspectrum disorder (ASD) in such areas asautistic behaviors, cognitive skills, languageskills, and social skills. Meta-analytic reviewsof comprehensive intervention programs foryoung children with ASD, for example, sug-gest relatively broad gains across these areaswith considerable interactions between thesegains and individual child characteristics suchas symptom severity, initial IQ, and age atintervention entry (Eldevik et al., 2009; Makry-gianni & Reed, 2010; Virues-Ortega, 2010).

What remains concerning, however, is thatadaptive behavior was not specifically includedin the NRC report as a priority and yet adap-tive behavior scores for children with ASDconsistently seem to fall one to two standarddeviations below average, even in childrenwith average intelligence (Lee & Park, 2007).Further, adaptive behavior has not readily

Tremendous gratitude is extended to all the fam-ilies who gave their valuable time to participate inthe present project. We are incredibly grateful toMegan Micheletti for tireless data entry. Thank youalso to Angela Nam and Yanzhen Chen for reliabil-ity and administrative help. Correspondence con-cerning this article should be addressed to Stepha-nny Freeman, University of California, Los Angeles,Department of Child Psychiatry, 78-243B Semel Insti-tute for Neuroscience & Human Behavior, UCLA, 760Westwood Plaza, Los Angeles, CA 90024-1759. E-mail:[email protected]




been used as an intervention outcome mea-sure at least as compared to other outcomes;and, when it has, post-intervention adaptivescores tend to remain quite low (Sainato et al.,2015). For example, Eldevik et al., (2009) re-viewed eight studies and found, after treat-ment, a mean adaptive behavior compositescore of only 61.9 or more than two standarddeviations below the mean. More recent stud-ies on young children with ASD focus on iden-tifying the moderators and mediators of gainsin adaptive behaviors. Baghdadli et al., (2012)examined trajectories in adaptive behaviorfrom preschool into adolescence and foundthat “important deficits remain in adaptiveabilities” (p. 1322) but that one-third of theirsample with higher cognitive abilities andmore hours of intervention during follow updid make significant improvements. Indeed,cognitive (IQ) and language abilities are reli-able moderators of adaptive behavior out-comes (Anderson, Oti, Lord, & Welch, 2009;Hedvall et al., 2014; Szatmari et al., 2012) buttype and intensity of therapeutic services re-main less well established (Scahill et al., 2016).

It is not altogether clear what therapeuticservices young children with ASD actually re-ceive in community settings through the ele-mentary grades. Some studies have attemptedto collect such data but are limited to hoursof intensive behavior therapy and not to abroader spectrum of therapeutic services (Es-tes et al., 2015); others are limited only tospecial education services (Wei et al., 2014).More comprehensive surveys have been con-ducted on child and family access to a widerange of related services and generally suggestthat those most often used are speech/language therapy, behavior therapies, occupa-tional therapy, and social skills training (Ru-ble & McGrew, 2007; Thomas, Ellis, McLau-rin, Daniels, & Morrissey, 2007; Thomas,Morrissey, & McLaurin, 2007; Young et al.,2009). These studies also suggest that thenorm is for families to use many services atonce, often in clusters related to specific de-velopmental or behavioral needs. It is impor-tant to note, however, that these studies werebased on broad cross-sectional and not longi-tudinal data and that parents reported verylittle that could be considered related to dailyliving or adaptive skill targets.

In the present study, we therefore sought

first to understand the current state of thera-peutic services in a cohort of preschoolersover a 4-year period and then to examine therelationship of service provision to standard-ized scores in three domains of development(behavioral difficulties, social skills, and adap-tive abilities). Although multiple services havebeen studied we chose the four most fre-quently used from the service literature notedabove, and then added adaptive skills therapyas the fifth, since it was of particular interest.The sample of families originated in a short-term (3-month) intensive partial-day hospital-ization program for young children with ASD.The families that accessed the program werepro-active, highly engaged, and, as part of theprogram, were given extensive training on ac-cessing community resources. The programitself was located in a middle to upper classcommunity in one of the largest metropolitancities in the US where depth, breadth, andvariety of programs are significantly moreavailable than in smaller cities. Taken to-gether, these families were such that, if theservices were available, they were generallyable to access them given that they presum-ably had the skills and the resources, as well asthe potential availability of therapeutic ser-vices. In other words, in a best-case scenario, wesought to understand 1) what therapeutic ser-vices could be obtained over a 4-year periodafter completing a brief but intensive thera-peutic intervention for young children withASD, and 2) how these services related tofunctioning. This study thus investigated threepredictor variables (initial abilities at programentry, intervention intensity as it varied overthe 4-year period, and change over time invarious services provided) on standardizedoutcome measures of behavioral difficulties,social skills, and adaptive abilities.

Method

Participants

Participants all were within 2–6 years of age(24–81 months) at Time 1 (mean inmonths � 48.4, SD � 14.9) and 6–11 years ofage (69–135 months) at Time 2 (mean inmonths � 96.4, SD � 21.1). This providedboth a longitudinal and a cross-sectional viewover a 10-year period. The fact that they all

Services and Symptom Presentation / 429

participated in the intensive program was aconstant in regard to baseline assessments. Allchildren were assessed in person at Time 1 butthen parent/provider questionnaires weremailed at Time 2. Report of services was thusretrospective.

Materials and Procedure

A packet of questionnaires was mailed to 328families who had once participated in anintensive short-term treatment program be-tween the years of 2008 and 2014. The treat-ment program is for children with ASD. Allchildren, prior to entering the treatment pro-gram, had an established diagnosis by a stateRegional Center psychologist or a private psy-chologist using the Autism Diagnostic Obser-vation Schedule (Lord, Rutter, Dilavore, &Risi, 2008). Children are referred to the pro-gram for intensive, comprehensive, interdisci-plinary treatment. Enrollment is on a firstcome first serve basis with only the ASD diag-nosis as criteria. Four months after the initialmailing, new packets were re-mailed to non-responders. Of the original 328 packets, 56were returned due to incorrect addresses.Thus, 272 families potentially received thepacket. Of these families, a total of 70 (25.7%)returned at least one questionnaire and thedemographic form, reflecting an acceptableresponse rate for complex questionnaires de-livered by mail in academic studies (Baruch,1999; Sahlqvist et al., 2011). Note that familydemographics indicated a relatively well-to-do

profile including family income and caregi-ver’s highest level of education (Table 1).

Time 1 (Initial). At program admission, allchildren were assessed using one of two devel-opmentally appropriate measures of cogni-tion: the Wechsler Preschool and PrimaryScales of Intelligence (WPPSI-III; Wechsler,2002) or the Mullen Scales of Early Learning(MSEL; Mullen, 1995) both yielding a com-posite mental age. Parents were administeredthe Vineland II Adaptive Behavior Scales(VABSII; Sparrow, Cicchetti, & Balla, 2005)to identify both adaptive and social skillstrengths and weaknesses using the subscalescores for these domains. We limited our anal-yses to these two domain scores and not theglobal score intentionally so as not to includelanguage and motor skills. Parents also com-pleted the ASEBA Child Behavior Checklist(CBCL; Achenbach & Rescorla, 2001) to ex-amine behavioral difficulties. The UniversityHuman Subjects Protection Committee ap-proved the data collection protocol, and par-ents signed informed consent to have theirdata used for research purposes.

Time 2 (Follow-up). A mean of approxi-mately 48 months later, parents were mailedpackets containing a brief introductory letter,a consent form, self-addressed stamped enve-lope, and four questionnaires/instruments.The University Human Subjects ProtectionCommittee approved this time point question-naire study and parents returned informedconsent forms to have their data used for re-search purposes. No incentives were providedto complete the forms. The first was a demo-

TABLE 1

Caregiver Demographics by Number and Percentage (N � 70)

ResponderIncome

(in 10,000) EthnicityHighest Levelof Education

Mother 58 (83%) 30–40 2 (3%) African Am 2 (3%) High school 1 (1%)Father 9 (13%) 40–50 3 (4%) Asian Am 8 (11%) Some college 10 (14%)Other 2 (3%) 50–60 2 (3%) Caucasian/White 55 (79%) Completed college 24 (34%)NR 1 (1%) 60–80 5 (7%) Hispanic 5 (7%) Graduate/professional 34 (49%)

80–100 6 (9%) Other 0 NR 1 (1%)�100 47 (67%)NR 5 (7%)

NR � no response.


graphic questionnaire that also included alog for parents to inventory year-by-year theirchild’s past and current services (“ServiceHistory Inventory”). Parents followed theprompt, “My child received services relatedto. . .” the following: occupational therapy,speech therapy, physical therapy, social skillsdevelopment, adaptive daily living skills/self-help skills, interfering/maladaptive behaviors.Table 2 provides the language and examplesused to define each category in the inventory.

The second was the Adaptive Behavior As-sessment System Second Edition (ABASII,Harrison & Oakland, 2003) where again wefocused on the two subscale scores of practicalreasoning and social skills. The ABASII man-ual contains specific validation studies demon-strating concurrency between the VABSIIand the ABASII. The correlation between theGeneral Adaptive Composite (GAC) on theABASII and the VABSII Adaptive BehaviorComposite was .75 (Community-UniversityPartnership for the Study of Children, Youth,and Families, 2011). Further, Kenworthy et al(2010) identified the ABASII as comparableand informative in relationship to the VABS intheir study while Lopata (2013) found that theVABSII and the ABASII yielded scores that didnot significantly differ for adaptive social skillsand showed similar patterns of deficits overallacross the sample. The third instrument was

the CBCL (Achenbach & Rescorla, 2001) andthe fourth was the Social ResponsivenessScale-2 (SRS2; Constantino & Gruber, 2007).

Target outcome measures. Behavioral Difficul-ties were assessed using the CBCL at bothTime 1 and Time 2. The scores are expressedas T-Scores (70 and above � clinical, 65–69 �borderline, 50–64 � nonclinical). Social Skillswere assessed using the Social Skills Sub-domain of the VABSII (VABS-SO) at Time 1and the ABAS Social Skills Subdomain (ABAS-SO) at Time 2. These measures are expressedas standard scores (Mean � 100, SD � 15).The SRS from Time 2 was used to validate theABAS Social Skills subdomain at Time 2 sincethe SRS could not be given at Time 1 as mostparticipants were too young for the age range.The SRS and ABAS Social Skills Subdomainwere very highly correlated (R2 � .778, p �.001) at Time 2. Adaptive Abilities were assessedusing the Daily Living Skills subdomain of theVABSII (VABS-DLS) at Time 1 and the ABASPractical Skills (ABAS-PR) score at Time 2.The measures are also expressed in this studyas Standard Scores (Mean � 100, SD � 15).

Contributing variables. Hours of therapeu-tic services targeted towards improving behav-ioral difficulties, social skills, adaptive abilities,speech and language, and occupational ther-apy skills were obtained through the ServiceHistory form at each age. For behavioral

TABLE 2

Service History Definitions and Examples

Type of Service Brief Definition and Example

Occupational Therapy Offered in school, clinic, or home setting. OT focuses on finemotor skills, gross motor skills, sensory and neuromuscular, andstrengthening.

Speech Therapy Offered in school, clinic, or home setting. ST focuses on speech,language, and pragmatic skills.

Physical Therapy Offered in school, clinic, or home setting. PT focuses generally onmobility and functional ability.

Social Skills Usually offered in a clinic or through your in home behavioralservices. Some skills include but are not limited to turn taking,sharing, or play.

Adaptive Daily Living Skills/Self-Help Offered in school or home/community setting. Examples ofADLS include toileting, dressing, clearing the table, using thetelephone, going to the store, etc.

Interfering/Maladaptive Behaviors Behavior Therapy at Home and/or at School: Focus on home orschool behavioral concerns. Can include any specific teachingstyles, e.g., DTT, PRT.


and adaptive therapy, the families categorizedtheir hours per week using the following scale:0 � 0 hours, 1 � 1–5 hours, 2 � 6–10 hours,3 � 11–15 hours, 4 � 16–20 hours, 5 � 20�hours. For social skills, speech and language,and occupational therapy, parents specifiedthe total number of minutes they received perweek. Since speech and language therapy in-cludes a focus on pragmatic communication,we examined those services as well as socialskill services in relation to social skills. Addi-tionally, occupational therapy often focuseson daily living skills; and thus we examinedthose services, as well as adaptive services, inrelation to adaptive abilities.

Statistical analysis. Pearson correlationswere conducted to examine the relationshipbetween hours of service (behavioral, social,and adaptive) and standardized scores atTime 1 and Time 2. Generalized linear mixedmodels (GLMM) were used to examine rela-tionships over time. GLMM with a main effectof time and subject level random interceptsand slopes were used to model the longitudi-nal trajectories of different services (behav-ioral, adaptive, social skills, speech therapy,and occupational therapy). GLMM accountsfor correlations between repeated measureswithin subjects and utilizes all available obser-vations from each subject. Outcome measureswere collected at Time 1 and Time 2, and notat each time point. Thus, in order to study theassociation between change over time in theservices and skills at Time 1 and Time 2, weregressed the predicted services slopes from

the GLMMs on the baseline measures andthen on outcome measures (behavioral, socialand adaptive).

Results

Differences in Symptomology from Initialto Follow Up

Using two-group dependent sample t-tests, the70 responders were examined at Time 2 com-pared to Time 1 symptom presentation ont-scores (CBCL) and standard scores (VABSIIand ABAS) for each of the corresponding tar-get domains (behavioral, social, adaptive). Inall three domains, there was a significant dif-ference between Time 1 and 2 (Table 3). Be-havioral difficulties improved from a sub-clinical to a non-clinical range. Social skillsimproved but remained at two standard devi-ations below the mean, and adaptive abilitiesworsened from slightly above two to well be-low two standard deviations from the mean.

Services

Figure 1 shows the average hours of serviceper week over time for behavioral and adap-tive services. Both are presented by “category”of hours, as noted in the methods section. Ascan be seen, behavioral therapy peaked ataround 10 hours per week between the ages of3 and 6. Adaptive therapy remained under5 hours per week across the age range. Figure2 shows the average minutes per week over

TABLE 3

Initial (Time 1) and Follow Up (Time 2) Mean and Standard Deviation Scores by Three Domains(Behavioral, Social, and Adaptive)

Time 1 Time 2 T Score

Behavioral Difficultiesa 65.0 (10.2) 58.0 (9.62) 3.97***Social Skillsb 70.0 (11.4) 76.0 (17.9) 3.33***Adaptive Abilitiesb 73.5 (13.2) 64.5 (18.1) 3.85***

*** p � .001.aCBCL Child Behavior Checklist; T50-T64 � within normal limits, T65-T69 � subclinical, T70 and above �

clinical.bVABS at Time 1 Vineland Adaptive Behavior Scales, Subscales: DLS � Daily Living Skills, SO � Social Skills;

(M � 100, SD�15).bABAS at Time 2 Adaptive Behavior Assessment System Subscales: PR � Practical Skills, SO � Social Skills;

(M � 100, SD � 15).


time for social skills, occupational, and speechtherapy. Speech and occupational therapy fol-lowed similar trends and, again, peaked be-tween 3 and 6 years of age. Social skills therapybegan to be prominent around age 8 andspeech therapy also showed a slight increase.The sample at age 11 is n � 3, none of whomappeared to have received behavioral or occu-pational therapy.

Correlations at Time 1

We examined the relationship between ser-vice hours and symptom presentation at Time1. The amount of services each child wasreceiving for behavior, social skills, adaptiveabilities, speech and language, or occupa-tional therapy at Time 1 did not correlatesignificantly with the corresponding Time 1symptom presentation in the three domains.Further, mental age at Time 1 did not signif-

icantly contribute to any of the models orcorrelate to the variables.

Predictors of Service Provision

Behavioral difficulties. The GLMM showedthat Time 1 CBCL was not related to the slopeof behavioral service provision but it was atTime 2 CBCL (F(1, 66) � 3.66, p � .06, R2 �.05). Using the � � .004 and the intercept �.3we can interpret the slope. For the averagechild in this sample who had a Time 2 CBCLof 58, their service hours decreased by .07categories per year or approximately 3.5 hoursper week after 10 years. For a child scoring twostandard deviations above the mean, their ser-vice hours increased by .01 categories per yearhalf an hour per week after 10 years. Finally,for a child scoring two standard deviationsbelow the mean their service hours decreased

0

1

2

3

4

2 3 4 5 6 7 8 9 10 11

Hou

r Cat

egor

y/5

Hou

r Ran

ge

Age In Years

Behavior Therapy

Adaptive Skills Therapy

Figure 1. Distribution of behavior and adaptive skills therapy by category of hours per week. The y-axisrepresents the hours of services reported per week using the following categories 0 � 0 hours, 1 �1–5 hours, 2 � 5–10 hours, 3 � 10–15 hours, 4 � 15–20 hours.

0

20

40

60

80

100

120

140

2 3 4 5 6 7 8 9 10 11

Min

utes

per

Wee

k

Age in Years

Social Skills Therapy Speech Therapy Occupa�onal Therapy

Figure 2. Distribution of social skills, speech, and occupational therapy in minutes per week. The y-axisrepresents the minutes of services reported per week.


by .14 categories per year or approximately 7.2hours per week after 10 years.

Social skills: Social skill services or speech andlanguage services. Time 1 VABS-SO and Time2 ABAS-SO were not related to the slopeof Social Skill Services. However, Time 1 symp-tom presentation on the VABS-SO was re-lated to Time 1 speech therapy services(F(1,69)�6.89, p � .01 R2 �.10) in that moreimpaired symptom presentation receivedmore speech services. Further, Time 2 symp-tom presentation on the ABAS-SO was relatedto the slope of speech services (F(1, 68) �9.19, p � .01, R2 �.12). Using the � � �.2,intercept � 13.1, for the average child in thisstudy with an ABAS of 76, speech therapyservices decreased by 2.9 minutes per weekper year or, after 10 years speech therapy,would have decreased by 29 minutes per week.For a child with an ABAS score two standarddeviation above the mean, their speech ther-apy service hours decreased by 10.9 minutesper week or would decrease by 109 minutesper week after 10 years. Finally, a child with ascore of two standard deviations below themean would have their speech therapy hoursincreased by 4.6 minutes per week per year orby 46 minutes per week after 10 years.

Adaptive abilities: Adaptive services or occupa-tional therapy services. At Time 2, childrenwith lower standard scores in adaptive abilitieshad more occupational therapy services (R2 ��.27, p � .05); however, neither Time 1VABS-DLS or Time 2 ABAS-PR was related tothe slope of either Adaptive Services or Occu-pational Therapy Services.

Discussion

This study investigated the relationship of ser-vice provision with symptom presentation attwo different time points (Time 1 � Initial;Time 2 � Follow-up) spanning a four-yeartime period across a 10-year age range. Ourlongitudinal findings differ somewhat fromcross-sectional data on such services that sug-gested that breadth of services tended to peakat 5–8 years of age (Thomas, Ellis et al., 2007).There was a steady decline for behavioral ther-apy in our study during these years and asomewhat higher intensity of social skillsand speech therapy in the preschool years.Our longitudinal data also allowed us to ex-

amine three predictor variables (initial abili-ties, change over time of service provision,and intensity of hours of outcome services) onstandardized outcome measures of behavioraldifficulties, social skills, and adaptive abilities,as noted below.

First, taken in perspective, the group as awhole improved significantly in their behav-ioral presentation, and this appeared unrelatedto initial mental age. More specifically how-ever, as predicted, initial behavioral serviceswere not correlated to initial CBCL scores.Young children with autism were receivingintensive behavioral interventions in the pre-school period regardless of the severity oftheir behavioral difficulties. When examiningthe pattern of behavioral services over time bythe slope of their service change, unexpect-edly but not surprisingly, over the end of thepreschool years through early elementaryyears, the group increased hours of servicesslightly over time. This was not related to im-provements they may or may not have beenmaking in behavioral symptoms. Cross-sec-tional data suggested that caregivers rated be-havioral therapy as the most effective of themany services they received which also seemedto be verified by child outcome data (Ruble &McGrew, 2007). In our study, however, therewas a strong trend for children with worseningsymptom presentation to receive a larger in-crease in behavioral therapy hours, as indi-cated by the high correlation at follow-up inhours of service with the severity of their be-havioral impairments.

Social skills showed an improvement overtime but remained impaired at outcome. So-cial skill services seemed to be available acrossthe age range and showed a trend towardsincreases in services as the children aged.Symptom presentation was more strongly re-lated, however, to speech and language ser-vices. Parents and practitioners seem to beaccessing speech and language therapy as aresponse to difficulties in social skills but whythis should be the case is not readily apparentfrom our data. The possibility is that prag-matic language skills may be contributing togains in social skills as suggested by cross-sectional findings that only about a quarter offamilies seemed to access social skills therapywhile over 80% accessed speech and languagetherapy (Thomas, Morrisey et al., 2007).


A broad examination of adaptive abilitiesshows that overall, children with ASD are wors-ening in their symptom presentation. Further,consistently across the age range in this study,the service hours that target these critical skillsare extremely low. Finally, there was no signif-icant relationship between adaptive therapyservices and adaptive abilities scores; but,there was a slight relationship between adap-tive abilities and occupational therapy ser-vices. Occupational therapy minutes werequite low, generally less than an hour perweek and tended to decline over time, consis-tent with cross-sectional research suggestingthat nearly two-thirds of families access occu-pational therapy (Thomas, Morrissey et al.,2007) but this service only ranked sixth out ofnine services rated for effectiveness (Ruble &McGrew, 2007).

The findings in this study, taken together,may help to provide a preliminary picture ofservice provision for young children with ASDin a resource-rich environment where accessand availability seem to be strong and sus-tained behavioral interventions are being im-plemented. While not presuming any assump-tions about quality or type of interventionpackage, children who are receiving 6 to 15hours per week of behavioral intervention atan early age for a period of 3 to 4 years andwho are then generally sustaining some ser-vice, if needed, show significant improve-ments in behavioral symptomology. For socialskills, families seem to be relying somewhatmore on speech therapy, and this appears tobe yielding some improvements. Clearly moreis needed, since their outcome standardscores remained below one standard devia-tion. The access of social skill therapy seemsnot to be enough; thus, outcomes are notstrong. Finally, in the adaptive domain, thereare few targeted services and virtually no im-provements. Indeed, declines in this area re-main consistent with prior literature, but theprovision of occupational therapy services inthis area deserves more study.

This study had several limitations. The sam-ple was a convenience sample and thus, issuesof sampling bias were present and acknowl-edged as a limitation; nonetheless, these bi-ases contributed to our understanding. Orga-nized, pro-active, participating, well-educatedfamilies were likely accessing all that could be

available for their children. This particularsample was the target but it is acknowledgedthat the study then assumed that those whodid not answer the follow-up questionnairesor did not participate in the treatment pro-gram at Time 1 were thus not accessingbroader or more comprehensive services. Asecond limitation relates to the Service His-tory form. Although the form did not name aparticular service delivery style (e.g., ABA) butinstead focused parents on the targets of theservices (e.g., “services related to interfering/maladaptive behaviors”), it is possible thatsome parents did not rate social and adaptiveskills because they felt they were embedded intheir “ABA” services. We recognize that thiscould under-represent adaptive and socialskill assistance but we specifically asked forservices related to a particular content arearather than a specific service provider to helpbring attention to those target domains. Fi-nally, this study does rely on retrospective re-ports of families, which may have somewhatlimited validity. Although a limitation, a num-ber of studies have shown that parents arereliable reporters in a variety of circum-stances. For example, parents of younger chil-dren show relatively accurate report of healthcare service (Kosa, Alpert, & Haggerty, 1967),and the more severe the health condition themore accurate the report (Daly, Lindgren, &Giebink, 1994). Parents with higher educa-tional levels seem to provide more accuratereports than lower educational level house-holds (Hawe et al., 1991). It should also benoted that “substantial beyond chance agree-ment” was found between maternal recall ofmedical records and actual medical records(D’Souza-Vazirani, Minkovitz, & Strobino,2005). Further, one could argue that thestudy targets the absence of a critical area ofneed; and, even when prompted, if the par-ents couldn’t recall any or very little helpwithin the social and adaptive domains overthe past 4 years, it may likely be the result ofthese services not being readily available.

Although this study has a relatively smallsample with seemingly limited generalizabil-ity, it nonetheless suggests intriguing possibil-ities for future research that might further ourunderstanding of effective interventions tar-geting adaptive and social skill development.An examination of another subset of children


between the ages of 10 and 16 would be usefulto determine if the relationship between wors-ening symptom presentation and increasesin behavioral therapy continues into adoles-cence, if continued low levels of adaptive ther-apies correlate with adaptive scores, and ifother therapies can be increased (occupa-tional and speech) to provide additionalenrichment and skill training for these under-represented areas. As for professional prac-tice, more careful attention to adaptive skills,both as a focus for more targeted adaptive skilltraining as well as a focus within behavioraland occupational therapies, might be war-ranted, especially given the generally pooroutcomes reported for adaptive skills of rela-tively young children with ASD.

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AUTHORS

Akmanoglu, Nurgul. See Karabekir, EsinPektas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363

Alkhanji, Rufaida. See Spencer, Vicky G . . . . 33

Almalky, Hussain A. Investigating compo-nents, benefits, and barriers of implementingcommunity-based vocational instruction forstudents with intellectual disability in SaudiArabia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415

Alqahtani, Saeed S. See Woods-Groves, Su-zanne . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311

Ayres, Kevin M. See Shepley, Sally B . . . . . . . 264

Balint-Langel, Kinga. See Woods-Groves, Su-zanne . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311

Banda, Devender R. See Hart, Stephanie L . . . 160

Barnett, Juliet. Systematic review of evidence-based interventions in science for studentswith autism spectrum disorders . . . . . . . . . . 128

Barrio, Brenda L. See Kelley, Jane E . . . . . . . . . 115

Black, Marie. See Solis, Michael . . . . . . . . . . . 287

Boccumini, Erica. See Root, Jenny . . . . . . . . . 325

Bondy, Alexis H. Effects of response cards onstudents with autism spectrum disorder orintellectual disability . . . . . . . . . . . . . . . . . . . . . 59

Bouck, Emily C. Exploring post-school out-comes across time out of school for studentswith autism spectrum disorder . . . . . . . . . . . 253

Brady, Michael P. See Hall, Kalynn . . . . . . . . . 299

Brando-Subis, Christina. See Kelley, Jane E . 115

Brosh, Chelsi R. High-probability request se-quence: An evidence-based practice for in-dividuals with autism spectrum disorder . . . 276

Burke, Meghan M. Improvements in proxy in-dividualized education program meeting par-ticipation among Latino parents . . . . . . . . . . 393

Cagliani, Rachel. See Shepley, Sally B . . . . . . 264

Cardon, Teresa A. See Kelley, Jane E . . . . . . 115

Chang, Chia-Jui. Applying secondary-tier-group-based video modeling to teach chil-dren with developmental disabilities to com-municate using an iPad . . . . . . . . . . . . . . . . . 209

Cohen, Annamarie. Use of visual supports toincrease task independence in students withsevere disabilities in inclusive educationalsettings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

Copeland, Susan R. See Griffin, Megan M . . . . 405

Demchak, MaryAnn. See Cohen, Annamarie . . . 84

Diegelmann, Karen M. Effects of a self-moni-toring checklist as a component of the self-directed IEP . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Downey, Angelica. See Hall, Kalynn . . . . . . . . 299

El Zein, Farah. See Solis, Michael . . . . . . . . . . 287

Ferguson, Raechal. See Gevarter, Cindy . . . . 222

Fisher, Kim W. See Barnett, Juliet . . . . . . . . . . 128

Fisher, Kimberly W. See Ruppar, Andrea . . . . 192

Fisher, Larry B. See Brosh, Chelsi R . . . . . . . . 276

Flores, Margaret M. See Head, Cynthia . . . . . 176

Forness, Steven. See Freeman, StephannyF. N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 428

Frankel, Ashleigh J. See Barnett, Juliet . . . . . 128

Freeman, Stephanny F. N. Participation in re-lated services and behavioral, social, andadaptive symptom presentation in youngchildren with autism spectrum disorder . . . . 428

Garcia, Marlene. See Burke, Meghan M . . . . 393

Gevarter, Cindy. Comparison of schematicand taxonomic speech generating devicesfor children with ASD . . . . . . . . . . . . . . . . . . . 222

Gine, Climent. See Raley, Sheida K . . . . . . . . 353

Griffin, Megan M. Effects of a self-managementintervention to improve behaviors of a childwith fetal alcohol spectrum disorder . . . . . . . . 405

Grigal, Meg. See Shogren, Karrie A . . . . . . . . 146

Hall, Kalynn. Comparing different delivery modesfor literacy-based behavioral interventions dur-ing employment training for college studentswith developmental disabilities . . . . . . . . . . . . 299

Hart, Stephanie L. Examining the effects ofpeer mediation on the social skills of stu-dents with autism spectrum disorder as com-pared to their peers . . . . . . . . . . . . . . . . . . . . . 160

Hart, Debra. See Shogren, Karrie A . . . . . . . . 146

Head, Cynthia. Effects of direct instruction onreading comprehension for individuals withautism or developmental disabilities . . . . . . 176

Hellemann, Gerhard. See Freeman, Stepha-nny F. N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 428

Henning, Bonnie. See Root, Jenny . . . . . . . . . 325

Invernizzi, Marcia. See Solis, Michael . . . . . . . 287

INDEX—VOLUME 53, 2018


Jameson, J. Matt. See Reisen, Tim. . . . . . . . . 100

Karabekir, Esin Pektas. Effectiveness of videomodeling presented via Smartboard forteaching social response behavior to chil-dren with autism . . . . . . . . . . . . . . . . . . . . . . . . 363

Karal, Muhammed A. Social story effective-ness on social interaction for students withautism: A review of the literature . . . . . . . . 44

Kearney, Kelly. See Hall, Kalynn . . . . . . . . . . . 299

Kelley, Jane E. DSM-5 autism spectrum disor-der symptomology in award-winning narra-tive fiction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

Kern, Amanda. See Woods-Groves, Suzanne . 311

Khamsi, Sheida. See Shogren, Karrie A . . . . . 146

Kim, Joanne J. See Freeman, Stephanny F. N . 428

Kim, Yu-Ri. See Park, Inhwan . . . . . . . . . . . . . . 343

Kuhn, Michelle. See Gevarter, Cindy . . . . . . . 222

Lee, Saeun. See Kelley, Jane E . . . . . . . . . . . . 115

Lopez, Brenda. See Burke, Meghan M . . . . . . 393

Lovelace, Temple S. Experiences of AfricanAmerican mothers of sons with autism spec-trum disorder: Lessons for improving servicedelivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Magana, Sandra. See Burke, Meghan M . . . . 393

Meadan, Hedda. See Pearson, Jamie Nicole . . 17

Miller, Alexandra. See Solis, Michael . . . . . . . 287

Monaco, Sarah Domire. Comparison of individ-ualized and non-specific video-prompts toteach daily living skills to students with au-tism spectrum disorders . . . . . . . . . . . . . . . . . 378

Mumbardo-Adam, Cristina. See Raley, SheidaK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353

O’Reilly, Mark F. See Gevarter, Cindy . . . . . . . 222

Olson, Amy Jo. See Ruppar, Andrea . . . . . . . 192

Orlando, Ann-Marie. See Ruppar, Andrea . . . 192

Paparella, Tanya. See Freeman, StephannyF. N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 428

Park, Inhwan. Effects of TEACCH structuredteaching on independent work skills amongindividuals with severe disabilities . . . . . . . . 343

Park, Jiyoon. See Bouck, Emily C . . . . . . . . . . 253

Pearson, Jamie Nicole. African American par-ents perceptions of diagnoses and services forchildren with autism . . . . . . . . . . . . . . . . . . . . . 17

Raley, Sheida K. Curricula to teach skills as-sociated with self-determination: A review ofexisting research . . . . . . . . . . . . . . . . . . . . . . . 353

Reisen, Tim. Comparison of prompting proce-dures to teach work tasks to transition-agedstudents with disabilities . . . . . . . . . . . . . . . 100

Rios, Kristina. See Burke, Meghan M . . . . . . . 393

Robertson, Rachel E. See Lovelace, Temple S . 3

Root, Jenny. Teaching students with autismand intellectual disability to solve algebraicword problems . . . . . . . . . . . . . . . . . . . . . . . 325

Ruppar, Andrea. Exposure to literacy for stu-dents eligible for the alternate assessment . . 192

Sammarco, Nicolette. See Gevarter, Cindy . . . . 222

Schultz, Tia R. See Winchell, Brooke N . . . . . 243

Shaw, Leslie A. See Shogren, Karrie A . . . . . . 146

Shepley, Sally B. Effects of self-mediatedvideo modeling compared to video self-prompting for adolescents with intellectualdisability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264

Shippen, Margaret E. See Head, Cynthia . . . 176

Shogren, Karrie A. Predictors of self-determi-nation in postsecondary education for stu-dents with intellectual and developmentaldisabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146

Shogren, Karrie A. See Raley, Sheida K . . . . 353

Sigafoos, Jeff. See Gevarter, Cindy . . . . . . . . . 222

Simo-Pinatella, David. See Raley, Sheida K . . . 353

Smith, Frank A. See Shogren, Karrie A . . . . . . 146

Smith, Katharine. See Kelley, Jane E . . . . . . . 115

Solis, Michael. Word study intervention for stu-dents with ASD: A multiple baseline study ofdata-based individualization . . . . . . . . . . . . . . 287

Spencer, Vicky G. Response interruption andredirection (RIRD) as a behavioral interven-tion for vocal stereotypy . . . . . . . . . . . . . . . . . 33

Sreckovic, Melissa A. See Winchell, Brooke N . 243

Tamayo, Sareska. See Lovelace, Temple S . . 3

Test, David W. See Brosh, Chelsi R . . . . . . . . 276

Test, David W. See Diegelmann, Karen M . . . 73

Therrien, William J. See Solis, Michael . . . . . . 287

Tincani, Matt. See Bondy, Alexis H . . . . . . . . . 59

Wang, Hui-Ting. See Chang, Chia-Jui . . . . . . 209

Watkins, Laci. See Gevarter, Cindy . . . . . . . . . . 222

Wehmeyer, Michael L. See Shogren, Karrie A . 146

Whelan, Fiona. See Freeman, Stephanny F. N . 428

Whiteside, Erinn. See Shepley, Sally B . . . . . . 264

Winchell, Brooke N. Preventing bullying andpromoting friendship for students with ASD:Looking back to move forward . . . . . . . . . . . 243

Wolfe, Pamela S. See Karal, Muhammed A . . 44

Wolfe, Pamela. See Monaco, Sarah Domire . 378

Wood, Charles L. See Brosh, Chelsi R . . . . . . 276

Woods-Groves, Suzanne. Electronic essaywriting with postsecondary students with in-tellectual and developmental disabilities . . . 311

Index–Volume 53, 2018 / 439

TITLES

African American parents perceptions of diagno-ses and services for children with autism. Ja-mie Nicole Pearson and Hedda Meadan . . . 17

Applying secondary-tier-group-based videomodeling to teach children with developmentaldisabilities to communicate using an iPad.Chia-Jui Chang and Hui-Ting Wang . . . . . . . 209

Comparing different delivery modes for literacy-based behavioral interventions during employ-ment training for college students with devel-opmental disabilities. Kalynn Hall, Michael P.Brady, Kelly Kearney, and Angelica Downey . 299

Comparison of individualized and non-specificvideo-prompts to teach daily living skills to stu-dents with autism spectrum disorders. SarahDomire Monaco and Pamela Wolfe . . . . . . . . 378

Comparison of prompting procedures to teachwork tasks to transition-aged students with dis-abilities. Tim Reisen and J. Matt Jameson . . 100

Comparison of schematic and taxonomicspeech generating devices for children withASD. Cindy Gevarter, Mark F. O’Reilly, Ni-colette Sammarco, Raechal Ferguson, LaciWatkins, Michelle Kuhn, and Jeff Sigafoos . 222

Curricula to teach skills associated with self-determination: A review of existing research.Sheida K. Raley, Cristina Mumbardo-Adam,Karrie A. Shogren, David Simo-Pinatella,and Climent Gine . . . . . . . . . . . . . . . . . . . . . . . 353

DSM-5 autism spectrum disorder symptomol-ogy in award-winning narrative fiction. JaneE. Kelley, Brenda L. Barrio, Teresa A. Car-don, Christina Brando-Subis, Saeun Lee,and Katharine Smith . . . . . . . . . . . . . . . . . . . . 115

Effectiveness of video modeling presented viaSmartboard for teaching social response be-havior to children with autism. Esin PektasKarabekir and Nurgul Akmanoglu . . . . . . . . 363

Effects of a self-management intervention toimprove behaviors of a child with fetal alco-hol spectrum disorder. Megan M. Griffin andSusan R. Copeland . . . . . . . . . . . . . . . . . . . . 405

Effects of a self-monitoring checklist as a com-ponent of the self-directed IEP. Karen M.Diegelmann and David W. Test . . . . . . . . . . 73

Effects of direct instruction on reading compre-hension for individuals with autism or develop-mental disabilities. Cynthia Head, Margaret M.Flores, and Margaret E. Shippen . . . . . . . . . 176

Effects of response cards on students with au-tism spectrum disorder or intellectual disability.Alexis H. Bondy and Matt Tincani . . . . . . . . . 59

Effects of self-mediated video modeling com-pared to video self-prompting for adoles-cents with intellectual disability. Sally B. She-pley, Kevin M. Ayres, Rachel Cagliani, andErinn Whiteside . . . . . . . . . . . . . . . . . . . . . . . . 264

Effects of TEACCH structured teaching on in-dependent work skills among individualswith severe disabilities. Inhwan Park andYu-Ri Kim . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 343

Electronic essay writing with postsecondarystudents with intellectual and developmentaldisabilities. Suzanne Woods-Groves, SaeedS. Alqahtani, Kinga Balint-Langel, andAmanda Kern . . . . . . . . . . . . . . . . . . . . . . . . . 311

Examining the effects of peer mediation on thesocial skills of students with autism spectrumdisorder as compared to their peers. Steph-anie L. Hart and Devender R. Banda . . . . . 160

Experiences of African American mothers ofsons with autism spectrum disorder: Les-sons for improving service delivery. TempleS. Lovelace, Rachel E. Robertson, andSareska Tamayo . . . . . . . . . . . . . . . . . . . . . . . 3

Exploring post-school outcomes across time outof school for students with autism spectrumdisorder. Emily C. Bouck and Jiyoon Park . . 253

Exposure to literacy for students eligible for thealternate assessment. Andrea Ruppar, Kim-berly W. Fisher, Amy Jo Olson, and Ann-Marie Orlando . . . . . . . . . . . . . . . . . . . . . . . . . 192

High-probability request sequence: An evi-dence-based practice for individuals with au-tism spectrum disorder. Chelsi R. Brosh,Larry B. Fisher, Charles L. Wood, and DavidW. Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276

Improvements in proxy individualized educa-tion program meeting participation amongLatino parents. Meghan M. Burke, KristinaRios, Brenda Lopez, Marlene Garcia, andSandra Magana . . . . . . . . . . . . . . . . . . . . . . . 393

Investigating components, benefits, and barriersof implementing community-based vocationalinstruction for students with intellectual disabil-ity in Saudi Arabia. Hussain A. Almalky . . . . . 415

Participation in related services and behavioral,social, and adaptive symptom presentation inyoung children with autism spectrum disorder.Stephanny F. N. Freeman, Tanya Paparella,Joanne J. Kim, Fiona Whelan, Gerhard Helle-mann, and Steven Forness . . . . . . . . . . . . . . . 428

Predictors of self-determination in postsecond-ary education for students with intellectualand developmental disabilities. Karrie A.Shogren, Michael L. Wehmeyer, Leslie A.Shaw, Meg Grigal, Debra Hart, Frank A.Smith, and Sheida Khamsi . . . . . . . . . . . . . . 146

Preventing bullying and promoting friendshipfor students with ASD: Looking back to moveforward. Brooke N. Winchell, Melissa A.Sreckovic, and Tia R. Schultz . . . . . . . . . . . 243

Response interruption and redirection (RIRD) asa behavioral intervention for vocal stereotypy.Vicky G. Spencer and Rufaida Alkhanji . . . . . 33


Social story effectiveness on social interaction forstudents with autism: A review of the literature.Muhammed A. Karal and Pamela S. Wolfe . . . 44

Systematic review of evidence-based interven-tions in science for students with autismspectrum disorders. Juliet Barnett, AshleighJ. Frankel, and Kim W. Fisher . . . . . . . . . . . . 128

Teaching students with autism and intellectual dis-ability to solve algebraic word problems. JennyRoot, Bonnie Henning, and Erica Boccumini . . 325

Use of visual supports to increase task inde-pendence in students with severe disabilitiesin inclusive educational settings. AnnamarieCohen and MaryAnn Demchak . . . . . . . . . . 84

Word study intervention for students with ASD:A multiple baseline study of data-based in-dividualization. Michael Solis, Farah El Zein,Marie Black, Alexandra Miller, William J.Therrien, and Marcia Invernizzi . . . . . . . . . . 287

Index–Volume 53, 2018 / 441

Juliet E. Hart Barnett and Kelly J. Whalon, Editors2014

The eighth volume of the CEC Division on Autism and Developmental Disabilities’Prism series, Friendship 101 focuses on building social competence, friendshipmaking, and recreation and leisure skills among students with autism spectrumdisorder and other developmental disabilities. Chapters in this evidence-based, user-friendly guide address the needs of students in different developmental periods (frompre-K through young adulthood), providing teachers, parents, faculty and teachereducators with tools and strategies for enhancing the social skill development of thesechildren and youth. Presented through an ecological perspective, together thesechapters emphasize building social competence within and across school, home, andcommunity contexts.

Available from CEC Publicationshttps://www.cec.sped.org/Publications

Edited by L. Lynn Stansberry Brusnahan, Robert A. Stodden, and Stanley H. Zucker. 2018. 149 pages. ISBN 978-0-86586-535-3. #P6296.

The transition from high school to adulthood is challenging for many young people, and often particularly difficult for those with disabilities. Transition To Adulthood: Work, Community, and Educational Success provides a blueprint for supporting youth with disabilities in achieving their postsecondary goals in a variety of adult settings – education and training, employment, and the community. This publication of the Council for Exceptional Children’s Division on Autism and Developmental Disabilities is the latest in its successful Prism series (Prism 11) and covers a wide range of topics, from assessing students’ interests and abilities to fine-tuning their education plans and goals, ensuring that students with disabilities are included in a variety of settings, and building community relationships to ensure their continuing inclusion. It provides a valuable resource for transition personnel, special and general educators, and special education administrators at the school and state level, as well as adult service professionals. With eight chapters written by 20 authors, Transition to Adulthood covers the breadth of research delineating best practices and proven instructional strategies for ensuring that students with disabilities reach their full potential and achieve their goals.

Visit the CEC online catalog at pubs.cec.sped.org to order this book. The direct link to the book listing is http://pubs.cec.sped.org/p6296/

Statement of Ownership, Management, and Circulation (Act of August 12, 1970, Section 3685 Title 39, United States Code)

1. Publication Title: EDUCATION AND TRAINING IN AUTISM AND DEVELOPMENTAL DISABILITIES. 2. Publication Number: 0016-8500. 3. Filing Date: September 24, 2018. 4. Issue Frequency: Quarterly in March, June, September, and December. 5. No. of Issues Published Annually: 4. 6. Annual Subscription Price: $100 domestic; $104 foreign; $249 institution; $254 foreign. 7. Complete Mailing Address of Known Office of Publication: The Council for Exceptional Children, 2900 Crystal Drive, Suite 100, Arlington, Virginia 22202-3556, Contact Person; Jose Maquen, Telephone; 703-264-9445. 8. Complete Mailing Address of Headquarters or General Business Offices of the Publisher: The Council for Exceptional Children, 2900 Crystal Drive, Suite 100, Arlington, Virginia 22202-3556. 9. Full Names and Complete Mailing Addresses of Publisher and Editor: Publisher—The Council for Exceptional Children, 2900 Crystal Drive, Suite 100, Arlington, Virginia 22202-3556; Editor—Dr. Stanley H. Zucker, Farmer 402, Arizona State University, PO Box 871811, Tempe, AZ 85287-1811; Managing Editor—Dr. Stanley H. Zucker, Farmer 402, Arizona State University, PO Box 871811, Tempe, AZ 85287-1811. 10. Owner: Division on Autism and Developmental Disabilities, Council for Exceptional Children, 2900 Crystal Drive, Suite 100, Arlington, Virginia 22202-3556, no stockholders. 11. Known Bondholders, Mortgagees, and Others: Not applicable. 12. Tax Status: The purpose, function, and nonprofit status of this organization and the exempt status for Federal Income Tax purposes have not changed during the preceding 12 months. 13. Publication Name: EDUCATION AND TRAINING IN AUTISM AND DEVELOPMENTAL DISABILITIES. 14. Issue Date for Circulation Data Below: 09/01/ 2018. 15. Extent and nature of circulation:

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2. Mail subscription C. Total paid circulation D. Free distribution by mail; samples, complimentary, and

other free copies E. Free distribution outside the mail; carriers or other means F. Total free distribution G. Total distribution H. Copies not distributed

1. Office use, left-over, unaccounted, spoiled after printing 2. Returns from news agents

I. Total J. Percent paid and/or requested circulation

Average no. copies ea. issue

for past 12 mos.

2,612

55

2,396 2,451

25

0 25 2,476

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16. Electronic Copy Circulation: Not applicable.

17. This statement of ownership will be printed in the VOL. 53 #4 (12/01/2018 issue of this publication. 18. Signature and Title:

Teresa Doughty Executive Director September 24, 2018

Education and Training in Autism andDevelopmental Disabilities

Editorial Policy

Education and Training in Autism and Developmental Disabilities focuses on theeducation and welfare of persons with autism and developmental disabilities.ETADD invites research and expository manuscripts and critical review of theliterature. Major emphasis is on identification and assessment, educational pro-gramming, characteristics, training of instructional personnel, habilitation, preven-tion, community understanding and provisions, and legislation.

Each manuscript is evaluated anonymously by three reviewers. Criteria for ac-ceptance include the following: relevance, reader interest, quality, applicability,contribution to the field, and economy and smoothness of expression. The reviewprocess requires two to four months.

Viewpoints expressed are those of the authors and do not necessarily conform topositions of the editors or of the officers of the Division.

Submission of Manuscripts

1. Manuscript submission is a representation that the manuscript is the author’sown work, has not been published, and is not currently under consideration forpublication elsewhere.

2. Manuscripts must be prepared according to the recommendations in thePublication Manual of the American Psychological Association (Sixth Edition,2009).

3. Each manuscript must have a cover sheet giving the names and affiliations ofall authors and the address of the principal author.

4. Research studies, including experimental (group and single-subject methodol-ogies), quasi-experimental, surveys, and qualitative designs should be no morethan 20–30 typewritten, double-spaced pages, including references, tables,figures, and an abstract.

5. Graphs and figures should be originals or sharp, high quality photographicprints suitable, if necessary, for a 50% reduction in size.

6. Three copies of the manuscript along with a transmittal letter should be sent tothe Editor: Stanley H. Zucker, Mary Lou Fulton Teachers College, Box 871811,Arizona State University, Tempe, AZ 85287-1811.

7. Upon receipt, each manuscript will be screened by the editor. Appropriatemanuscripts will then be sent to consulting editors. Principal authors willreceive notification of receipt of manuscript.

8. The Editor reserves the right to make minor editorial changes which do notmaterially affect the meaning of the text.

9. Manuscripts are the property of ETADD for a minimum period of six months.All articles accepted for publication are copyrighted in the name of theDivision on Autism and Developmental Disabilities.

10. Please describe subjects (or any other references to persons with disabilities)with a people first orientation. Also, use the term �intellectual disability�(singular) to replace any previous term used to describe the population ofstudents with significant limitations in intellectual functioning and adaptivebehavior as manifested in the developmental period.

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