the effectiveness of video prompting on teaching aquatic play skills for children with autism

47

Disability & Rehabilitation, 2013; 35(1): 47–56© 2013 Informa UK, Ltd.ISSN 0963-8288 print/ISSN 1464-5165 onlineDOI: 10.3109/09638288.2012.687030

Objective: To investigate the effectiveness of the video prompting procedure on teaching aquatic play skills and to determine the effects of aquatic exercise training on the motor performance of children with autism. Design: A multiple probe design across behaviours was used and replicated across subjects for the instructional part of this study. Pretest–posttest design was applied for the exercise training part of this study. Methods: Three children with autism were taught three aquatic play skills in a one-to-one training format. Aquatic play skills intervention and aquatic exercise training were performed separately throughout 12 weeks at three sessions per week, each lasting 1 h. The video prompting procedure was utilized for the instruction part of this study. Results: Video prompting was effective in teaching aquatic play skills to children with autism. In addition, aquatic exercise training increased the total motor performance scores of all the participants after 12 weeks. According to the social validity results, the families gave positive feedback about the learned skills and movement capabilities of their children. Conclusion: Aquatic play skills and swimming pools are favoured for children with autism. This attractive intervention is recommended as a means to extend knowledge of leisure skills and motor development of children with autism.

Keywords: Autism, aquatic play skills, motor performance, video prompting

Introduction

Although The American Psychiatric Association’s Diagnostic and Statistical Manual-IV, Text Revision (DSM-IV-TR) does not cover criteria related to incompetence on motor skills to help diagnose ASD, many studies have determined motor difficulties or delays for children with autism [1–6]. Participation in play, physical activity and sports contributes

to the development of motor skills and keeps children active. It is recommended for a healthy lifestyle that children should have moderate-intensity physical activity during school days [7]. However, delays or failures in developmental areas have a negative effect on engagement in social play, sports and physical activities with peers for children with ASD and this condition restricts the development of motor skills and level of physical activity [7–9].

The potentially useful effects of aquatic exercise are not only related to the improvement of motor performance and physical fitness, but also provide an opportunity for social integration, and facilitate language development and self-concept for children with special needs [10–12]. This type of exercise is utilized as an early intervention in educational settings [13–15]. Aquatic exercises, water play skills and swimming are favoured as an activity for children with ASD [13,14]. During a summer camp in 1943 run by Kanner, one of the children with ASD was taught to swim, and interest in aquatic activities, in mud play and water was observed. Many children with ASD displayed better performance in pool-based exercises and play skills than in land-based activities [13]. However, there are few studies in literature which have aimed to determine the effects of aquatic exercises and play

ReseaRch PaPeR

The effectiveness of video prompting on teaching aquatic play skills for children with autism

Mehmet Yanardag1, Nurgul akmanoglu1 & Ilker Yilmaz2

1Anadolu University, Research Institute for the Handicapped, Eskisehir, Turkey and 2Anadolu University, School of Physical Education and Sport, Eskisehir, Turkey

Correspondence: Mehmet Yanardag, PhD, Research Institute for the Handicapped, Anadolu University, Eskisehir, Turkey. Tel: 90 222 3350580-4987. Fax: 90 222 3352914. E-mail: [email protected]

Disability & Rehabilitation

2013

35

1

47

56

© 2013 Informa UK, Ltd.

10.3109/09638288.2012.687030

0963-8288

1464-5165

Video prompting and aquatic play skills

17April2012

• Video prompting may utilize to teach action-based motor tasks.

• Aquatic exercise training could be beneficial for improving movement difficulties of children with autism.

• Video-based instruction and swimming pool is rec-ommended to have alluring effects on children with special needs.

Implications for Rehabilitation

(Accepted April 2012)

M. Yanardag et al.

Dis

abil

Reh

abil

Dow

nloa

ded

from

info

rmah

ealth

care

.com

by

Ath

lone

Ins

titut

e of

Tec

hnol

ogy

on 1

0/06

/13

For

pers

onal

use

onl

y.

48 M. Yanardag et al.


skills on the physical and motor performance of children with ASD [12,16,17].

As these children have strong visual perception, several studies have reflected that visually based prompting systems are easily comprehended and effective for children with ASD. Children with ASD need external prompts to complete daily living tasks independently [18]. Utilizing video technology to teach daily living skills may cause substantial acquisition and maintenance of these skills and improve the quality of life and involvement in the community [19]. The number of studies in literature which are relevant to the teaching of daily living skills for developmental disabilities using video-based technology, has increased in recent years [20–25]. Two gen-eral procedures which can be applied to benefit from video technology are video model and video prompting. Video prompting consists of a video clip of one step of a task to show an individual and then giving that individual the opportunity to perform that step before the next step is shown [20].

Video prompting has been used effectively for children with ASD and intellectual disabilities to teach washing dishes [25], using a microwave oven [24], daily living skills [21] and laundry skills [26]. However, there have been no studies inves-tigating the effect of video prompting on teaching aquatic play skills in the swimming pool for children with ASD. Therefore, the purpose of this study was to examine the effectiveness of video prompting procedure on teaching aquatic play skills, and to determine the effect of aquatic exercise training on the motor performance of children with ASD.

Methods

ParticipantsThe study comprised two boys and one girl with autism, aged 6–8 years. Before the study, written informed parental consent and verbal assent were obtained from all the participants’ par-ents in compliance with the Declaration of Helsinki. The names of participants were given pseudonymously in the study. Some prerequisite conditions were established before the study for the participants who were to be taught three aquatic play skills using video prompting: (i) ability to following verbal prompts, (ii) ability to imitate motor skills, (iii) ability to watch a video on the screen for at least 2 min, (iv) absence of any physical dysfunction or health condition (open wound on the body), (v) no hypersensitivity to water and (vi) ability to have toilet control. All the participants met these criteria.

Berat was an 8-year-old boy with autism. He had been included in an early special-education program when he was 4–5 years old. At the time of this study he was attending second grade in a state school, and receiving individual special-educa-tion services twice a week. Berat could read, write and perform simple mathematics, but he needed the additional courses. He had difficulty in social interaction and communication skills. He did not have any experience with a video prompting procedure.

Sacit was a 6-year-old boy with autism. He had been included in an early special-education program, since he was 4 years old. At the time of this study he was receiving both individual special education (twice a week) and group educa-tion (five times a week). He had difficulty in social interaction,

academic and communication skills. He had learned the con-cept of colour, shapes and matching skills. He did not have any experience with a video prompting procedure.

Sumru was a 6-year-old girl with autism. She had been included in an early special-education program, since she was 4 years old. At the time of this study she was receiving indi-vidual special education (twice a week) and group education (five times a week), and she also attended kindergarten with peers. She had difficulty in social interaction, language and communication skills. She had learned the concept of colour, shapes and numbers from 1 to 9. She did not have any experi-ence with a video prompting procedure.

PeerA peer was included to be a model for the video prompts, which were to be watched by the participants in this study. The selected peer was a 6-year-old boy with autism, who was attending an inclusion program. Video records of the target aquatic play skills were prepared with the peer in a swimming pool before the teaching process. Arranged video segments for each step of the aquatic play skills were watched by two academic staff in the spe-cial-education area to determine the validity of the video clips. They approved the content as suitable for teaching purposes.

TrainersThe intervention sessions were applied by three researchers. All researchers had PhD degrees in special education and physiotherapy. They had prior research experience of at least 7 years. In addition, three exercise specialists participated to conduct the aquatic exercise training.

SettingsAll instructional, probe, maintenance and generalization ses-sions occurred at the Anadolu University indoor swimming pool; dimensions 15.5 × 6 m. The swimming pool was divided into two parts with a mattress. One part of the pool was used to carry out the teaching process and the other part was used to perform the aquatic exercises training. While teaching play skills to a child in the instruction part of the pool, the other children participated in the exercise training with exercise specialists in the activity part of the pool. All sessions were administered in a one-to-one format for 12 weeks, three times a week, between 08:00 and 09:00. There was also a writing board at the side of the swimming pool. The indoor gym of the University was used to perform movement tests before and after the 12-week aquatic exercise training.

Task and materialsAll researchers independently developed a task analysis, and then they got together to review the task analyses by performing these skills (kangaroo, cycling and snake) again. Some modifications and adaptations were made. The task analyses for the three aquatic play skills are shown in Table I. Each step of these task analyses was filmed as a video clip using a digital camera (Sony XR155 Full HD). The clips were arranged from the participants’ perspective. Each aquatic play skill covered three steps, so three separate video clips were filmed. Each clip displayed only one step of the task and lasted

Dis

abil

Reh

abil

Dow

nloa

ded

from

info

rmah

ealth

care

.com

by

Ath

lone

Ins

titut

e of

Tec

hnol

ogy

on 1

0/06

/13

For

pers

onal

use

onl

y.

Video prompting and aquatic play skills 49


from 6 to 30 s, with an average duration of 11 s. Each clip also included a vocal task direction demonstrating the actions as synchronous. These video clips were shown to the participants from a Vista-based laptop, and Windows Media PlayerTM

software was utilized to show the video clips on the screen. The dimensions of the laptop screen were 34.5 × 19.5 cm. In addition to the video recorder and laptop, data collection forms, a writing board, CD and pencil were employed in the teaching procedures. The Movement ABC motor test battery was also utilized to evaluate the motor profile of the participants.

Screen procedure for target behavioursThe main aim of the study was to teach aquatic play skills to chil-dren with autism. These play skills are essential for adaptation to water, and form the first phase of the Halliwick method of teach-ing swimming [27]. Therefore, the aquatic play skills of kangaroo, cycling and snake were selected from this method for children with autism, who had no pool experience and could not swim.

Experimental designIn order to determine the effectiveness of the video prompting on teaching three aquatic play skills for children with autism, a mul-tiple probe design across behaviours was used and was replicated across the subjects in this study. A multiple probe design across behaviours is an experimental model, which examines the effec-tiveness of an independent variable on three behaviours [28,29].

Independent variablesIn order to teach the three aquatic play skills, a video prompt-ing procedure was used in this study, and the effectiveness of the procedure on these tasks in the pool setting was exam-ined. This teaching process was conducted in three sessions per week, and one teaching session for each day. In addition to teaching aquatic play skills, aquatic exercise training was per-formed throughout 12 weeks to determine the effects on the motor performance of the children with autism. The aquatic exercise training program comprised the following; walking around the outside of the pool as a warm-up (2 min), walking in the pool (5 min), down walking in the pool (2 min), run-ning in the pool (5 min), throwing a ball at a target in the pool

(5 min), splashing water (5 min), collecting a small sponge from the water and putting it in a box at the edge of the pool (5 min).

Dependent measureThe dependent variable of this study was the percentage of cor-rect steps in the three aquatic play skills according to the task analysis in Table I. To be scored as independent, the first step (i.e. turn his back to the trainer) had to be completed within 8 s of the initial instruction (e.g. do the cycling play in the water). All subsequent steps had to be initiated and completed within 8 s. During intervention, steps completed within 8 s of watch-ing the video clip for that step were scored as correct.

Probe sessionsFull probe and intermittent probe sessions were regulated for this study. A full probe session consisted of the instructor’s task request (play kangaroo!) and the participant’s response. The instructor did not provide any help or prompt during the probe conditions. Full probe sessions were conducted before the inter-vention, and after reaching the criterion of the target play skills, and were continued until a stable response had been demon-strated in at least three successive sessions. One trial was per-formed for each target play skill during one full probe session.

An intermittent probe session was conducted to deter-mine the current performance of the participant in order to decide whether to terminate the intervention process, so it was helpful to observe when the criterion of the target play skill was reached. If the participant displayed 100% correct performance in three successive intermittent probe sessions for a play skill, then the intervention sessions were termi-nated. One intermittent probe session was arranged after two successive intervention sessions. Similar to the full probe ses-sions, one trial was performed for each target play skill in an intermittent probe session, and it was carried out without any external help or prompt.

Intervention sessionsIn order to watch the video prompts during the instruction, the laptop was placed on a platform at the edge of the swimming pool. When the participants entered the swimming pool, they were directed to the activity part of the pool, and one participant was taken to the instruction part of the pool. While the participant and the researcher were lined up in the pool with the laptop in full view, another researcher used a remote control to present the video clips. Three trials were performed for each step of a target play skill in every intervention session. Video prompting consisted of a video clip of one step of a task shown to the participant and then that participant was given the opportunity to perform that step before being shown the next step. After a participant had completed the first step of the task 100% correctly, the second step video prompting instruction was started. Before presenting the second step video clip, the first step video clip was watched and the task direction was delivered to provide chain integrity along the steps. When the participant responded correctly to the first step, the researcher began to instruct for the second step of the task. If the participant did not meet the criteria for the first

Table I. Task analyses for aquatic kangaroo, cycling and snake play skills.Skills Steps in the task analysesKangaroo 1. Participant turns his/her body to instructor

2. Participant holds hands of the instructor3. Participant jumps like a kangaroo inside of the pool

with instructorCycling 1. Participant turns his back to instructor

2. Instructor holds waist of the participant and raise in the water

3. Participant moves his legs forward like pedalling a bicycle

Snake 1. Participant goes back of the instructor2. Participant holds from instructor’s shoulders with

both hands3. Participant follows instructor 20 meters within the

water

Dis

abil

Reh

abil

Dow

nloa

ded

from

info

rmah

ealth

care

.com

by

Ath

lone

Ins

titut

e of

Tec

hnol

ogy

on 1

0/06

/13

For

pers

onal

use

onl

y.



step of the task, the researcher delivered the video prompts for three trials of the first step of the task again.

Maintenance and generalization sessionsMaintenance sessions were conducted 1, 2 and 4 weeks after the participants met the criteria. Maintenance sessions were conducted in an identical manner to probe sessions except reinforcement was delivered after the session when the par-ticipants had completed the trials correctly. Generalization across settings was examined by pre-post test design. It was conducted as a probe session before intervention and after the participants had reached the criteria in the target play skills. A swimming pool of a community-based fitness club was used for the generalization probe session.

Motor performance measurement sessionsThe effects of the aquatic exercise training on motor per-formance for children with autism were examined by pre-post test design. Motor performance measurement sessions were conducted in an indoor gym of Anadolu University. Movement ABC-2 was utilized to determine the level of motor performance of the participants before and after 12-weeks aquatic exercise training [30]. The test battery measures the three basic motor skills of manual dexterity, aiming and catching and balance. In order to evaluate these basic skills, several tasks were performed both on a table and the floor. Manual dexterity was measured by posting coins, threading beads and drawing a trail. Aiming and Catching was evalu-ated by catching a beanbag and throwing a beanbag onto a mat. Balance motor skill was measured by one-leg balance, walking with heels raised and jumping on mats. According to the test manual of the Movement-ABC-2, standard total scores of the participants were determined for all motor skills before and after the aquatic exercise training [30].

Data collectionThe instruction part of this study collected three types of data; effectiveness, reliability and social validity. In addition, the motor performance of the participants was measured before and after the aquatic exercise training. Effectiveness data were collected by correct and incorrect performance being reported at each step of the skill sequence, and the percentage of independent correct responses in the intermittent probe sessions was calculated. Social validity data was collected to determine whether the findings met the purpose of this study. An informal questionnaire, developed by the researchers, was sent to the parents of the participants in a sealed envelope.

Reliability dataInterobserver agreement and procedural reliability data were collected during at least 30% of all the experimental sessions. Reliability data of this study were collected and calculated by an assistant professor with experience of using response-prompting procedure and errorless teaching strategies.

Interobserver agreementInterobserver agreement was calculated using the point-by-point method with a formula of the number of agreements divided by

the number of agreements plus disagreements multiplied by 100 [31]. The data were collected in full probe, intermittent probe, intervention, maintenance and generalization sessions for each participant. The results of this study showed that the interob-server agreement was calculated as 100% for all participants.

Procedural reliabilityIndependent variable (procedural) reliability was calculated by dividing the number of observed teacher behaviours by the number of planned teacher behaviours multiplied by 100 [28]. The researchers’ behaviours were observed as follows: (i) preparing to teach materials, (ii) drawing attention to watch the video, (iii) delivering video prompts, (iv) giving an appro-priate response to the participant for watching the video, (v) drawing attention before performing tasks, (vi) deliver-ing task direction, (vii) waiting for the 4 s response interval, (viii) giving an appropriate response and (ix) reinforcement for collaboration of the participants. The results of the proce-dural reliability data indicated that it was mean value 95.66% (range: 86.66–100%) for Berat, 96.33% (range: 86.66–100%) for Sacit and 98.19% (range: 93.33–100%) for Sumru.

Results

Figures 1, 2 and 3 show the percentage of steps completed cor-rectly for kangaroo, cycling and snake play skills, participants and sessions. The results reflected that video prompting was effective in performing independent aquatic play skills in the swimming pool for the three participants.

Video prompting process for BeratAt baseline, Berat displayed 0% of the steps correctly in the first three sessions for kangaroo, cycling and snake play skills. When the video prompting was delivered in session 4, Berat displayed an immediate increase in the percentage of steps completed correctly, and he reached the acquisition criterion (100% in three successive sessions) of 100% after four sessions in all play skills (see Figure 1). In order to reach the criteria, 36 trials were conducted for Berat, and the total duration of the instruction, and intermittent probe sessions were 27 min 23 s and 06 min 02 s, respectively. He showed incorrect responses of 8.3% in all intermittent probe sessions.

Video prompting process for SacitAt baseline, Sacit displayed 0% of the steps correctly in the first three sessions for the three play skills. When the video prompting was delivered in session 4, Sacit showed an imme-diate increase in the percentage of steps completed correctly, and he reached the acquisition criterion of 100% after four sessions in all play skills (see Figure 2). In order to reach the criteria, 36 trials were conducted for Sacit, and the total dura-tion of the instruction, and intermittent probe sessions were 28 min 27 s and 06 min 34 s, respectively. He showed incor-rect responses of 11.1% in all intermittent probe sessions.

Video prompting process for SumruAt baseline, Sumru showed 0% of the steps correctly in the first three sessions for the three play skills. When the video

Dis

abil

Reh

abil

Dow

nloa

ded

from

info

rmah

ealth

care

.com

by

Ath

lone

Ins

titut

e of

Tec

hnol

ogy

on 1

0/06

/13

For

pers

onal

use

onl

y.



prompting was delivered in session 4, Sumru showed an immediate increase in the percentage of steps completed correctly, and she reached the acquisition criterion of 100% after four sessions in all play skills (see Figure 3). In order to reach the criteria, 36 trials were performed for Sumru, and the total duration of the instruction, and intermittent probe sessions were 31 min 31 s and 07 min 25 s, respectively. She

showed incorrect responses of 22.2% in all intermittent probe sessions.

Exercise training process for participantsTo examine the effects of the 12-week aquatic exercise train-ing on motor performance of the participants, several tasks were applied before and after study. The results of the data

Figure 1. Percent correct responses for Berat during full probe, instructional, maintenance and generalization probe sessions.

Dis

abil

Reh

abil

Dow

nloa

ded

from

info

rmah

ealth

care

.com

by

Ath

lone

Ins

titut

e of

Tec

hnol

ogy

on 1

0/06

/13

For

pers

onal

use

onl

y.



indicated that test scores for motor performance increased in all participants after training (see Table II).

Discussion

The main purpose of this study was to determine the effec-tiveness of video prompting on aquatic play skills for children

with autism. In addition, motor performance data was col-lected to examine the effects of the aquatic exercise training before and after the study. The findings of this study showed that all participants increased their correct target skills with video prompting, and maintained their successful aquatic play skills during the first, second and fourth weeks of the

Figure 2. Percent correct responses for Sacit during full probe, instructional, maintenance and generalization probe sessions.

Dis

abil

Reh

abil

Dow

nloa

ded

from

info

rmah

ealth

care

.com

by

Ath

lone

Ins

titut

e of

Tec

hnol

ogy

on 1

0/06

/13

For

pers

onal

use

onl

y.



maintenance, and generalization phases. Moreover, aquatic exercise training improved the motor performance scores for the three participants after 12 weeks.

Video-based instruction has been shown to be effective for teaching action-based tasks such as walking, running and jumping for children with developmental disabilities, owing to the mobility of video records [32]. In our study, video

prompting was preferred to teach the kangaroo, cycling and snake play skills, which are action-based tasks, for children with autism. There are no studies in literature which examine the effectiveness of video prompting on teaching play skills in a swimming pool setting. However, many studies have been carried out to examine the effects of video prompting on daily life skills [20–22,24,25,33,34], vocational skills for

Figure 3. Percent correct responses for Sumru during full probe, instructional, maintenance and generalization probe sessions.

Dis

abil

Reh

abil

Dow

nloa

ded

from

info

rmah

ealth

care

.com

by

Ath

lone

Ins

titut

e of

Tec

hnol

ogy

on 1

0/06

/13

For

pers

onal

use

onl

y.



employment [35] and self-aiding skills [36]. These studies have shown that video prompting is effective in teaching the aforementioned skills. After delivering the video prompts during the intervention sessions of this study, the participants increased their performance and met the criteria just at the beginning of the intervention process. Moreover, the three participants displayed a lower incorrect response rate dur-ing intermittent probe sessions, and none of them displayed a wrong response during intervention sessions. Consistent with findings in literature, this study demonstrated that video prompting was an effective means of teaching and main-taining chained aquatic play tasks (e.g. kangaroo, snake and cycling) to children with autism.

Physical activity and sport are essential to improve social integration and communication skills, decrease inappropri-ate behaviours and enhance motor skills, but this subject area has been ignored in literature [37]. A few studies have focused on examining the effects of teaching strategies on sports and exercise drills. One study aimed to teach kangaroo, snake and cycling play skills in a pool setting to children with autism using a constant time delay procedure. The findings of that study demonstrated that all participants reached the criteria after 12–13 teaching sessions, and the duration of the teach-ing sessions was recorded as between 21 and 31 min [15]. The effectiveness data of the study was similar to the results of our study in terms of the duration and number of teaching sessions.

The parent questionnaires were delivered to evaluate the social validity of this study following the intervention. The findings of the social validity data indicated that the parents liked the use of the video prompting system, and they would like to benefit from this procedure on academic skills in school settings for their children. Moreover, they expressed that this study was essential for teaching swimming skills in the future, and they wanted to participate in a new study, which aims to improve the ability of sport and leisure skills for children with autism. The social validity results for video prompting instruction of this study were parallel to other studies, which have examined the social validity of video prompting interventions [22,23,35].

The procedural reliability measurements of this study showed that researchers applied the video prompting pro-cedure consistently between 86.6 and 100%. In literature, it is recommended that procedural reliability at a minimum of 80%, and above 90% is highly regarded [29]. It can be con-cluded that the researchers carried out the video prompting procedures effectively to teach aquatic play skills in the swim-ming pool for children with autism.

Another aim of this study was to examine the effects of the aquatic exercise training on motor performance. In order to determine the motor profile of the participants, The Movement ABC-2 test battery was applied before and after the 12-week exercise interventions [30]. Manual dexterity, aiming and catching and balance tests were measured, and the standard total score for each participant was calculated. Before the study, the total scores recorded were 40 for Berat, 41 for Sacit and 43 for Sumru. After the 12-week aquatic exer-cise training, the total scores for motor performance were 63 for Berat, 75 for Sacit and 74 for Sumru. In addition to teach-ing and performing aquatic play skills, the aquatic exercise training was conducted separately in a one-to-one training format. According to the test manual of Movement ABC-2, a total score up to and including 56 is described as “signifi-cant movement difficulty,” between 57 and 67 inclusive for the total score is identified as “risk of having movement dif-ficulty; monitoring required,” and any score above 67 for the total score is specified as “no movement difficulty detected” [30]. Therefore, the three participants displayed poor motor performance before the study. After the aquatic exercise train-ing, three participants improved their motor test scores, and decreased movement difficulties. However, the test scores suggested that Berat should be followed to monitor move-ment difficulties.

Although there is no diagnostic criterion for motor dif-ficulties of children with autism, several studies have shown that they displayed delay or difficulties in gross and fine motor skills [4,38], motor coordination [39], motor imitation skills [40] and hand and balance skills [41,42]. Therefore, there is a need for various exercise training covering motor coordina-tion such as walking, balance and arm functions [43]. Aquatic exercises have been found to be effective in resolving these failures [12,16]. However, there have not been enough studies, and few case reports exist in literature. One study reported the effects of aquatic exercise training on motor performance in a child with autism. Before and after 10 weeks of swimming training, walking performance, muscle strength and balance (open/closed) was evaluated. All measurements improved after 10 weeks training in the pool [12]. In another study which investigated the effects of aquatic exercise training on motor performance for a child with Rett syndrome, fine motor skills and balance skills improved after 8 weeks [16]. Participating in exercise training not only improves move-ment difficulties, but also enriches the leisure skills repertoire of the children with autism, and provides an opportunity for social integration.

The present study has two important contributions to lit-erature: (i) Support of the literature that video prompting is an effective method to teach action-based skills to children with autism. (ii) Extending literature from daily living and self-aiding skills to play skills, as previous research has focused on teaching daily living skills and pre-employment skills by video prompting. This study is the first research attempt to determine the effectiveness of video prompting on aquatic play skills in a community swimming pool setting for children with autism. The findings of this study show that video prompting is effec-tive in teaching aquatic play skills for children with autism.

Table II. Motor tests scores of the participants before and after training.Berat Sacit Sumru

Before After Before After Before AfterManual

dexterity12 16 7 20 13 17

Aiming and catching

10 16 17 29 11 23

Balance 18 31 17 26 19 34Total test

score40 63 41 75 43 74

Dis

abil

Reh

abil

Dow

nloa

ded

from

info

rmah

ealth

care

.com

by

Ath

lone

Ins

titut

e of

Tec

hnol

ogy

on 1

0/06

/13

For

pers

onal

use

onl

y.



However, a limitation of the present study is the number of participants. Three children with autism were included in the study. Another limitation of the study is the aquatic play skills. Additional research should investigate the effects of video prompting on more complex chained aquatic skills such as the basic phases of swimming administered by parents, physical education teachers and preservice educators. Other forms of video-based instruction should be conducted to teach simple play skills on land such as bowling, boccia, darts, frisbee and compared in terms of effectiveness and efficiency using hand-held devices.

Conclusion

This study provided an opinion on the use of video prompt-ing to teach play skills in a swimming pool setting for chil-dren with autism. The instructional data showed that video prompting was effective in teaching action-based motor tasks such as aquatic play skills. In addition, the 12-week aquatic exercise training improved the motor performance of the par-ticipants. This study enabled an extension to the repertory of leisure skills, enhanced motor skills and provided an oppor-tunity for social integration in a community-based sports set-ting for children with autism.

Declaration of Interest: This research was supported by a Grant from Anadolu University Fund (Project No: 1001E17). Authors are grateful to Caroline Jane Walker for her proof-reading support for the present manuscript.

References 1. American Psychiatric Association. Diagnostic and statistical manual

of mental disorders: text revision. 4th ed. Washington, DC: American Psychiatric Association; 2000.

2. Ming X, Brimacombe M, Wagner GC. Prevalence of motor impairment in autism spectrum disorders. Brain Dev 2007;29:565–570.

3. Piek JP, Dyck MJ. Sensory-motor deficits in children with developmen-tal coordination disorder, attention deficit hyperactivity disorder and autistic disorder. Hum Mov Sci 2004;23:475–488.

4. Provost B, Lopez BR, Heimerl S. A comparison of motor delays in young children: autism spectrum disorder, developmental delay, and develop-mental concerns. J Autism Dev Disord 2007;37:321–328.

5. Staples KL, Reid G. Fundamental movement skills and autism spectrum disorders. J Autism Dev Disord 2010;40:209–217.

6. Yu-Pan C, Tsai CL, Chu CH. Fundamental movement skills in children diagnosed with autism spectrum disorders and attention deficit hyper-activity disorder. J Autism Dev Disord 2009;39:1694–1705.

7. Yu-Pan C. Objectively measured physical activity between chil-dren with autism spectrum disorders and children without disabili-ties during inclusive recess settings in Taiwan. J Autism Dev Disord 2008;38:1292–1301.

8. Reid G. Understanding physical activity in youths with autism spectrum disorders. Palaestra 2005;21:6–7.

9. Sandt DDR, Frey GC. Comparison of physical activity levels between children with and without autistic spectrum disorders. Adap Phys Activ Quar 2005;22:146–159.

10. Koury JM. Aquatic therapy programming. Illinois: Human Kinetics; 1996.

11. Winnick JP. Adapted physical education and sport. Illinois: Human Kinetics; 2000.

12. Yilmaz I, Yanarda M, Birkan B, Bumin G. Effects of swimming train-ing on physical fitness and water orientation in autism. Pediatr Int 2004;46:624–626.

13. Killian JK, Joyce-Petrovich RA, Menna L, Arena S. Measuring water orientation and beginner swim skills of autistic individuals. Adap Phys Activ Quar 1984;1:287–295.

14. Prupas A, Harvey WJ, Benjamin J. Early intervention aquatics, a pro-gram for children with autism and their families. J Phys Educ Recre Dance 2006;77:46–51.

15. Yılmaz I, Birkan B, Konukman F, Erkan M. Using a constant time delay procedure to teach aquatic play skills to children with autism. Educ Train Dev Disabil 2005;40:171–182.

16. Bumin G, Uyanik M, Yilmaz I, Kayihan H, Topçu M. Hydrotherapy for Rett syndrome. J Rehabil Med 2003;35:44–45.

17. Fragala-Pinkham M, Haley SM, O’Neil ME. Group aquatic aero-bic exercise for children with disabilities. Dev Med Child Neurol 2008;50:822–827.

18. Johnston S, Nelson C, Evans J, Palazolo K. The use of visual supports in teaching young children with autism spectrum disorder to initiate interactions. Augment Alter Comm 2003;19:86–103.

19. Parmenter TR. Quality of life as a concept and measurable entity. Soc Indicat Res 1994;33:9–46.

20. Canella-Malone HI, Fleming C, Chung YC, Wheeler GM, Basbagill, AR, Singh AH. Teaching Daily living skills to seven individuals with severe intellectual disabilities: A comparison of video prompting to video mod-eling. J Pos Behav Interv 2011;13:44–153.

21. Canella-Malone H, Sigafoos J, O’Reilly M, De la Cruz B, Edrisinha C, Lancioni GE. Comparing video prompting to video modeling for teach-ing daily living skills to six adults with developmental disabilities. Educ Train Dev Disabil 2006;41:344–356.

22. Laarhoven VT, Kraus E, Karpman K, Nizzi R, Valentino J. A comparison of picture and video prompts to teach daily living skills to children with autism. Foc Autism Oth Dev Disabil 2010;25:195–208.

23. Mechling LC, Gast DL, Seid NH. Evaluation of a personal digital assis-tant as a self-prompting device for increasing multi-step task completion by students with moderate intellectual disabilities. Educ Train Autism Dev Disabil 2010;45:422–439.

24. Sigafos J, O’Reilly M, Cannella H, Upadhyaya M, Edrisinha C, Lancioni GE, Hundley A, Andrews A, Garver C, Young D. Computer-presented video prompting for teaching microwave oven use to three adults with developmental disabilities. J Behav Educ 2005;14:189–201.

25. Sigafos J, O’Reilly M, Cannella H, Edrisinha C, De La Cruz B, Upadhyaya M, Lancioni GE, Hundley A, Andrews A, Garver C, Young D. Evaluation of a video prompting and fading procedure for teaching dish washing skills to adult with developmental disabilities. J Behav Educ 2007;14:189–201.

26. Horn JA, Miltenberger RG, Weil T, Mowery J, Con M, Sams L. Teaching laundry skills to individuals with developmental disabilities using video prompting. Intern J Behav Cons Ther 2008;4:279–286.

27. Martin J. The Halliwick Method. Physiotherapy 1981;67:288–291. 28. Tekin-İftar E, Kırcaali-İftar G. Özel eğitimde yanlışsız öğretim yön-

temleri (Errorless learning procedures in special education). 2nd ed. Ankara: Nobel Yayın Dağıtım; 2006.

29. Wolery M, Bailey DB, Sugai GM. Effective teaching: Principles and pro-cedures of applied behavior analysis with exceptional students. Boston: Allyn & Bacon;1988.

30. Henderson SE, Sugden DA, Barnett AL. Movement assessment battery for children-2. 2nd ed. London: Pearson; 2007.

31. Kennedy CH. Single-case designs for educational research. Boston: Pearson Education; 2005.

32. Stephens WE, Ludy IE. Action-concept learning in retarded children using photographic slides, motion pictures, sequences, and live demon-strations. Am J Ment Defic 1975;80:277–280.

33. Graves TB, Collins BC, Schuster JW, Kleinert H. Using video prompting to teach cooking skills to secondary students with moderate disabilities. Educ Train Dev Disabil 2005;40:34–46.

34. Mechling LC, Gustafson M. Comparison of the effects of static pic-ture and video prompting on completion of cooking related tasks by students with moderate intellectual disabilities. Exceptionally 2009;17:103–116.

35. Laarhoven VT, Johnson JW, Laarhoven-Myers VT, Grider KL, Grider KM. The effectiveness of using a video ipod as a prompting device in employment settings. J Behav Educ 2009;18:119–141.

36. Norman JM, Collins BC, Schuster JW. Using an instructional package including video technology to teach self-help skills to elementary stu-dents with mental disabilities. J Spec Educ Tech 2001;16:5–18.

37. Todd T, Reid G. Increasing physical activity in individuals with autism. Foc Autism Oth Dev Disabil 2006;21:167–176.

38. Dewey D, Cantell M, Crawford SG. Motor and gestural performance in children with autism spectrum disorders, developmental coordi-nation disorder, and/or attention deficit hyperactivity disorder. J Int Neuropsychol Soc 2007;13:246–256.

Dis

abil

Reh

abil

Dow

nloa

ded

from

info

rmah

ealth

care

.com

by

Ath

lone

Ins

titut

e of

Tec

hnol

ogy

on 1

0/06

/13

For

pers

onal

use

onl

y.



39. Dyck MJ, Piek JP, Hay D, Smith L, Hallmayer J. Are abilities abnormally interdependent in children with autism? J Clin Child Adolesc Psychol 2006;35:20–33.

40. Vanvuchelen M, Roeyers H, De Weerdt W. Nature of motor imitation problems in school-aged boys with autism: a motor or a cognitive prob-lem? Autism 2007;11:225–240.

41. Green D, Baird G, Barnett AL, Henderson L, Huber J, Henderson SE. The severity and nature of motor impairment in Asperger’s syndrome:

a comparison with specific developmental disorder of motor function. J Child Psychol Psychiatry 2002;43:655–668.

42. Manjiviona J, Prior M. Comparison of Asperger syndrome and high-functioning autistic children on a test of motor impairment. J Autism Dev Disord 1995;25:23–39.

43. Fournier KA, Hass CJ, Naik SK, Lodha N, Cauraugh JH. Motor coor-dination in autism spectrum disorders: a synthesis and meta-analysis. J Autism Dev Disord 2010;40:1227–1240.

Dis

abil

Reh

abil

Dow

nloa

ded

from

info

rmah

ealth

care

.com

by

Ath

lone

Ins

titut

e of

Tec

hnol

ogy

on 1

0/06

/13

For

pers

onal

use

onl

y.

the effectiveness of video prompting on teaching aquatic play skills for children with autism

Documents