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Autism Interventions
• Picture Exchange Communication System (PECS)
             • Pivotal Response Training
                   • Social Stories
            • Facilitated Communication
         • Structured Teaching (TEACCH)




                 Alyson Handler
                 SPED 655 OL
What is Picture Exchange
                          Communication System (PECS)?
• PECS is an augementive communication program that is designed to teach
  individuals with ASD or other disabilities who lack speech, to communicate
  in a social context
• Based on several studies, PECS can be used to develop verbal language and
  decrease tantrums and other odd behaviors.
• PECS teaches children to communicate through the use of pictures in
  exchange for wants/needs of items.
• There are six phases in PECS:
      – Phase I: includes three people in the room (the child, the
        facilitator, and the person who receives the message)The child learns
        how to exchange the picture for things they want.
      – Phase II: The facilitator tries to increase the students independence. It             YouTube video:
        increases the distances for the child and the adult                         http://www.youtube.com/watch?v=eT
      – Phase III: The child learns to select a picture from multiple picture                   zedhezar8
        choices
      – Phase IV: The child puts words and pictures together, creating
        sentences.
      – Phase V: The child answers questions using pictures
      – Phase VI: The child expands on these interactions and learns to
        comment
• http://www.iidc.indiana.edu/index.php?pageId=525
Picture Exchange Communication System (PECS): What Does Research
                                  Say?
    The Effectiveness of the Picture Exchange Communication System (PECS) for Children with Autism
                           Spectrum Disorder (ASD): A South African Pilot Study
• A mixed research design that included a quantitative component, a single-subject multiple baseline design across three
  behaviors that was repeated with two participants, and a qualitative component.
• This study examined the effectiveness of the Picture Exchange Communication System for children with ASD who lived
  in the culturally and linguistically diverse country of South Africa. In context, the aim of this research study was to see
  the effect that PECS has on the frequency of requesting and commenting behavior and the effect of PECS on the length
  of verbal utterances of two children who are diagnosed with ASD. The researchers hypothesized that there would be an
  increase in the frequency of requesting in the first phase, and an increase in the length of utterances in Phase IV. In
  addition, they hypothesized that there would be an increase in commenting during phase VI.
• Both of the participants were nine years old and attended separate classrooms at a special education school for children
  with autism.
• Data was collected in structured and unstructured settings during the pre-training, training, post-training and follow-up
  stages.
• The quantitative data visually showed that there was an increase in requesting behavior during the Phase I of the
  training. This increase was seen in the follow-up session. This data also showed that commenting behavior increased
  during Phase VI of the training, but only in the structured setting. In addition, there was an immediate increase in the
  mean length of utterances by one participant in both settings.
• Both participants demonstrated an increase in intentional communicative acts, including the use of requesting and the
  use of communication through the form of pictures.
• The results of this study confirmed the hypotheses and showed that PECS was effective in increasing desired
  communication goals and was consistent with the previous research.
• (Travis & Geiger, 2010)
Picture Exchange Communication System
          (PECS): What Does Research Say?
   Assessing Generalization of the Picture Exchange Communication System in Children with Autism

• This study examined PECS generalization after each phrase of PECS training. They assessed
  generalization by using a train and probe technique.

• The participants in the study were four boys children with autism. All of the boys attended the same
  after-school behavioral training program one day a week for two hours. They were ages 4, 5, 7 and 8.

• The PECS training was done in a workroom at their behavioral training program.

• Generalization sessions included: on a playground with a therapist, at home with the therapist, at home
  with the parents and at a convenience store with a stranger.

• The final results showed that all four of the boys demonstrated generalization of PECS at every setting
  and across people.

• Follow up probes were also assessed, and found that all four participates maintained PECS at follow-up.

• (Greenberg, Tomaino, & Charlop, 2012)
Picture Exchange Communication System
             (PECS): What Does Research Say?
    Social–Communicative Effects of the Picture Exchange Communication System (PECS) in Autism Spectrum Disorders
•   This study examines the usefulness of of PECS in treating social–communication impairments in autism.
•   The participants in this study were 18 preschool children with ASD. Each child was placed into an intervention group of
    either PECS or Conventional Language Therapy.
•   Each group received treatment for 30 minutes, three times a week for 6 monthes.
•   The results of this study showed that in the end, the PECS group showed significant improvement over the CLT group on
    the VABS social domain score.
•   In conclusion, the PECS intervention showed that it can be used to improve improve social–communicative skills in
    children with autism.
•   (Lerna, Esposito, Conson, Russo, and Massagli 2012)


                     Object Interest in Autism Spectrum Disorder: A Treatment Comparison
•     This study used a random controlled trial research design to compare two social communication treatments on the
      effect of object interest for children with autism.
•     There were 32 children in this study who were between the ages of 18-60 months.
•     The two social communication treatment groups that these children were randomly assigned to were the Picture
      Exchange Communication System (PECS) or the Responsive Education and Prelinguistic Milieu Teaching (RPMT)
      conditions.
•     Object interest was assessed in an unstructured play session with different toys, activities, adult, and location than
      they received during their treatment.
•     Results showed that the children in the RPMT treatment group demonstrated a greater increase in object interest, in
      comparison to those in the PECS group.
•     (McDuffie, Lieberman, & Yoder, 2012)
Picture Exchange Communication System
        (PECS) : What Does Research Say?
Brief Report: Randomized Test of the Efficacy of Picture Exchange Communication System
              on Highly Generalized Picture Exchanges in Children with ASD
• This study consisted of 36 children who were between the ages of 18 and 60 months. 33
   of these children had a diagnosis of autism and 3 children had a diagnosis of pervasive
   developmental disorder-not otherwise specified.
• These children were randomly placed into one of two treatment groups: Responsive
   Education and Prelinguistic Milieu Teaching or PECS.
• This study looks at the PECS teaching and its results used in a far-transfer measurement
   context for the picture exchange of children with ASD.
• The research design was claimed to have strong internal validity and found that children
   with autism who had PECS training were able to increase the number of picture
   exchanges then the children receiving the intervention in a far-transfer measurement.
• (Yoder & Lieberman, 2009)
What are Social Stories?
• Social stories are short stories that describes social
  cues and common responses in specific social
  situations. It is designed to helps individuals with ASD
  understand social situations.
• Social stories help children with autism understand
  other people’s perspectives (theory of mind).
• It uses four different sentence types: descriptive
  sentences, directive sentences, perspective sentences
  and affirmative sentences. Cooperative and control
  sentences can also be used to write a social story.
• Social stories focus on individualized goals/specific      http://www.youtube.com/watch?
  social needs and translates these goals into                        v=hhgZznTIf2E
  understandable steps.
• A Social Story has a ratio of 2 to 5 descriptive
  sentences for every directive sentence.
• http://www.educateautism.com/social-stories.html
Social Stories: What Does Research Say?

  Social Stories Interventions for Students with Autism Spectrum Disorders: A Meta-Analysis
• This study was conducted in order to determine if Social Stories were effective in decreasing
  disruptive behavior in children with autism.

• The study consisted of three children, ages 7 and 9. Each child had their own social story
  created for them which targeted a specific disruptive behavior. The three target behaviors
  were: using a loud voice in class, chair tipping, and cutting in lunch line. No other behavioral
  intervention has been used with these children.

• Using a single-subject multiple-baseline design across subjects, the students were observed
  three times a week after the social stories were implemented.

• After careful direct observation, this study concluded that each child’s targeted disruptive
  behavior was significantly reduced compared to their baseline performance.

• (Kokina & Kern, 2010)
Social Stories: What Does Research Say?
Comparing the Teaching Interaction Procedure                Differentiated Effects of Paper and Computer-
  to Social Stories for People with Autism                Assisted Social Stories on Inappropriate Behavior in
• This study used a parallel treatment design to                          Children with Autism
   compare social stories and the teaching interaction    • This study used a single-subject ABABCBC

   procedure in teaching social skills to 6 children        multicomponent reversal design to compare the use

   with autism.                                             of Social Stories in two formats, a paper format and a

• In this study, 18 social skills were taught using the     power point format. The social skill that this study

   social stories method and 18 social skills were          focused on was pushing others at recess and
   taught using the teaching interaction procedure.         transitions.

• The results of this study showed that the teaching      • The study participants consisted of three elementary
   interaction procedure was more successful in             aged students, two male and one female, all with
   producing higher levels of skill-specific steps.         autism. Each student had similar assessment results
• All participants met mastery criterion for all 18         and received their education in a general education
   social skills using the teaching interaction             setting.
   procedure, whereas all six participants only           • Results were slightly better using the Powerpoint
   mastered 4 of the 18 social skills using social          version and generalized to another setting using a
   stories.                                                 single verbal prompt.
• (Leaf et al., 2012)                                     • (Mancil, Haydon, & Whitby, 2009)
Social Stories: What Does Research
                       Say?
 Social Stories to Increase Verbal Initiation in Children with Autism and Asperger’s Disorder
• The purpose of this study was to determine if social stories had any effects on children’s
   verbal initiations and contigent responses to peers, when employed in school settings.
• There were four children who participated in this study. One child had a diagnosis of
   autism and the other three children were labeled with aspergers.
• This study was done in relation to a study done by Delano and Snell (2006). The major
   difference between their study and this study is that this current study was done in a
   natural school environment.
• The previous study done by Delano and Snell (2006) concluded that when used with
   students with ASD in isolation, social stories increased social enagement with peers.
   However, this study came up with a different conclusion, stating that there is limited
   support for the use of social stories in increasing social and communication behaviors in
   individuals with ASD.
• (Hanley-Hochdorfer, Bray, Kehle, & Elinoff, 2010)
Social Stories: What Does Research Say?
           A Social Stories Intervention Package with Students with Autism in Inclusive Classroom Settings
• This study examined the use of a Social Stories intervention package with two students with autism that
 were enrolled in a full-inclusion kindergarten classroom.
• Both participants were boys, Matt and Ted, with social communication problems. The target behaviors
 for Matt were inappropriate social interactions appropriate hand raising, and inappropriate vocalizations.
 Ted’s target behaviors were appropriate hand raising, appropriate social initiations, and inappropriate
 vocalizations.
• Data was taken using a frequency count. In addition, this study used a multiple probe design across
 behaviors as the research design.
• The results showed that Matt exhibited an immediate decrease in inappropriate social interaction
 behavior, an increase in hand raising, and reduction in his inappropriate vocalizations. Ted’s results
 showed that he showed an increase in hand raising and an increase in appropriate social initiations. The
 focus on Ted’s vocalizations was eliminated from the study due to the decrease in them before the study
 began.
• This intervention package showed that it does not require intensive supervision of the child’s behavior
 and can be useful in inclusive classroom environments.
• (Chan, & O’Reilly, 2008)
What is Pivotal Response Training (PRT)?
     Based on the principles of ABA

     Is a loosely structured, naturalistic intervention

     The pivotal behaviors that are central to PRT are:

        Responding to multiple cues and stimuli

        Increasing of child motivation

        Improving of self-management abilities

        Increasing self-initiations

    Can be used to improve
     language, social, behavioral, academic, and play skills in
     children with autism

    Child choice in choosing a stimulus is also part of PRT.

    Is used to promote generalization and maintenance of
                                                                        http://www.youtube.com/watch?v=M-
     taught skills.
                                                                      Lxx4Zf_Uo&playnext=1&list=PL2341238C7
                                                                           C13279F&feature=results_video
    http://autismlab.ucsd.edu/about/pivotal-response-training.shtml
PRT: What Does Research Say??
 Using Pivotal Response Training with Peers in Special Education to Facilitate Play in Two Children with Autism
• The participants in this study consisted of two students with autism. The treatment facilitators in this study
  consisted of five students/peers who were also receiving special education services.
• The purpose of this study was to evaluate the ability of peers in special education to implement pivotal
  response training to increase social interactions in the two students with autism.
• These peers were taught the strategies of using modeling, role-playing and feedback.
• The study showed that the students and peers had increased social interaction.
• The study also proved that peers can successful implement Pivotal Response Training methods to help their
  classmates with autism.
• (Kuhn, Bodkin, Devlin, & Doggett, 2008)

                     Pivotal Response Group Treatment Program for Parents of Children with Autism
• The purpose of this study was to show that parents can learn Pivotal Response Training in a group therapy format to
   use with their children with ASD, while showing increasing gains in their children’s language.
• The children with autism used in this study were between the ages of 2.0 and 6.11 years. A total of 17 families
   participated in this study.
• This study showed that the group format for training aprents to use the Pivotal Response method is benefitial in
   targeting language deficits in children with ASD. It showed that parents can effectively learn Pivotal Response Training
   in a group training format.
• (Minjarez, Williams, Mercier, & Hardan, 2011)
PRT: What Does Research Say?
    A Comparison of Video Modeling and Pivotal Response Training to Teach Pretend Play Skills to Children With Autism
                                                  Spectrum Disorder
•      This study compared the use of Video Modeling with the use of Pivotal Response Training in regards to the
       acquisition and generalization of scripted play verbalizations in the training and generalization stages of this skill.

•      Five children participated in this study. All five children had a diagnosis of autism spectrum disorder and had
       adequate language ability. The language ability of the children was similar to the language ability of typically
       developing children age two years.

•      All five children were exposed to Video Modeling and Pivotal Response Training, although the sequence to which
       children experience each intervention was randomly assigned.

•      Training took place inside a room at the children’s school. The generalization setting was the play area in each
       child’s classroom.

•      The results of the study showed that both Video Modeling and PRT can be used with children with autism who
       have sufficient language skills in order to increase their pretend play skills. However, the use of PRT showed a
       greater increase in the number of play actions during the training period and during the generalization
       environment than the use of Video Modeling.

•      (Lyndon, Healy, & Leader, 2011)
PRT: What Does Research Say?
      Child Demographics Associated With Outcomes in a Community-Based Pivotal Response Training Program
•   In contrast to previous studies, this study used a large sample of parents and children with autism. These parents
    and children were enrolled in an accelerated parent education program at a southern California children’s hospital.

•   In this program, parents were taught PRT and focused on increasing their children’s ability to facilitate play and
    increasing their children’s language skills.

•   The purpose of this study was to determine if PRT can be implemented effectively in a large-scale community based
    setting and to determine if specific child variables (gender, age and race) are associated with the outcomes.

•   158 families were included in the study sample. The children’s ages ranged from 24 months to 113 months. 83% of
    the children were boys and 17% were girls. 35% of the children were Hispanic, 27% were White, 19% were Asian, 4%
    were African American, 2% were Native American and 10% were other/unknown.

•   The Vineland Adaptive Behavior Scales was used in this study.

•   The results of this study showed that the PRT parent education program was effective in producing significant
    improvements in the areas of Communication, Daily Living Skills, Socialization, Motor Skills and Adaptive
    Behavior, regardless of specific child variables. The children who were ages 3 and under, showed the least
    impairment at intake and the most improvement from pre-post intervention.

•   (Baker-Ericzén, Stahmer, & Burns, 2007)
PRT: What Does Research Say?
                                Pivotal Response Teaching in the Classroom Setting
• This article contains an immense amount of information about what PRT is and how it is implemented in various
  settings. It includes a review of research studies that show the effectiveness of using PRT in teaching a variety of skills
  to students with autism.
• Based on the review of research, this article states that PRT is effective in teaching children with autism a variety skills
  such as: symbolic play, joint attention, sociodramatic play, peer social interaction, communication and self-initiations.
• Along with other interventions, PRT is proven to be effective in teaching communication; However, in comparison with
  other interventions, PRT is shown to be more effective in increasing verbalizations and language use. It is also
  effective in improving speech imitation, labeling, question asking, spontaneous speech, and conversational
  communication.
• This article claims that PRT was originally designed for use in parent education and in one on one settings.
  However, this article explains that PRT has been seen in many classrooms. They saw that in the Southern California
  region, more than 70% of 80 teachers that were surveyed actually used PRT inside their classroom.
• When the authors examined the use of PRT in the classrooms, the majority of teachers liked the use of PRT and found
  it to be effective. Although, these teachers also claimed that the use of PRT in the classroom is difficult when used in a
  group setting. The teachers said that it is important to understand ABA before implementing PRT and that data
  collecting and IEP goals were difficult to gather. Also, the teachers saw difficulties in implementing direct reinforcers
  and child choice in the classroom full of other children.
• The goals of the authors are to find a way to adapt PRT into the classroom in the future.
• (Stahmer, Suhrheinrich, Reed, Bolduc, & Schreibman, 2010)
What is Facilitated Communication (FC)?
• is a type of augmentative and alternative communication
  technique.
• Requires a communication partner, or a facilitator who
  supports the user.
• Supports include:
       Emotional support: through the use of encouragement
       Physical support: through the use of helping the user
          initiate typing, isolating the index finger, holding and
          stabilizing the arm, holding the arm to slow the pace or
          to help the user not hit the target more than once.
       Communicative support: through the use of
          feedback, prompts and cues to help the user stay
          focused.
• The goal of facilitated communication is for the user to               http://www.youtube.com/watch?v=Dq
  achieve independence in their typing.                                              hlv0UZUwY
• This method is controversial in its usage due to the skepticism
  in the authenticity of the user’s typing.
http://tash.org/breaking-the-barriers/about-facilitated-communication/
Facilitated Communication: What
                   Does Research Say?
  Brief Report: A Controlled Evaluation of Facilitated Communication Using Open-Ended and Fill-in Questions
• This study examines the use of facilitated communication with children with autism and whether the child is
  actually communicating authentically or if the child is influenced by the facilitator.
• There were four students who participated in this study. Each student was enrolled in a day school program in
  Arizona and had a diagnosis of autism. In addition, all four students have used facilitated communication for at
  least three months in the school with at least two facilitators.
• The study used a variety of stimuli cards: some cards were blank, some cards contained fill in the blank and
  some were short answer questions. The students were presented the cards with two different conditions. The
  first condition, the facilitator was aware of what was on the card and the second condition, the facilitator was
  unaware of the card.
• Between the four students, there were a total of 110 responses.
• The study showed that 95% of the questions were answered correctly when the facilitator knew what the
  questions were. Only 19% of the answers were answered correctly when the facilitator was unaware of the
  questions. 62% of the incorrect answers that were received when the facilitator was unaware of the cards were
  answers that were relevant to other questions and possible correct answers to those.
• The results of this study show that facilitators have influence over the user’s communication ability using the
  facilitated communication method.
• (Cabay, 1994)
Facilitated Communication: What Does Research
                       Say?
            Effectiveness of Facilitated Communication with Children and Youth with Autism
• This study was conducted in order to determine the effectiveness of using facilitated communication
 with children with autism.

• There were 18 children who participated in this study. Four students were in preschool, ten students
 were in elementary school, and four students were in secondary school. All students had a diagnosis of
 autism. The students’ teachers were the facilitators, in which they underwent a two day training on FC.

• The study was conducted in the students classrooms on a daily basis for 15 weeks.

• The results of the study showed that nine of the students were able to demonstrate potential in using FC
 for literacy and communication. This was shown by the ability of these students to write their name
 through the teachings of FC. They were also able to identify letters and numbers with at least 50%
 accuracy. But 5 out of the 9 were already able to do this prior to the study.

• Students were more accurate in their answers when the questions were known to the teachers.

• In the end, the study failed to validate the effectiveness of using FC with students with autism.

• (Simpson & Myles, 1995)
Facilitated Communication: What Does Research Say?
    Multiple Method Validation Study of Facilitated Communication: II. Individual Differences and Subgroup Results
•    This study used multiple methods to examine if there were individual variations in the usage of effectiveness of
     facilitated communication. Three of the methods were reported in this report. Each method varied in ways of The
     methods differed in three ways. One way was the extent in which the method was naturalistic vs. structured.
     Another way was the method of input(auditory, visual) and the third way was the type of response that was
     required (pointing to pictures, yes/no response, spelling).

•    There were 20 students from four classrooms of a regional program that participated in this study. 15 of the
     participants were male and 5 participants were female. There were 16 facilitators that were staff in the classrooms.

•    Three methods were used and data was collected after staff training and 6 weeks of using facilitated
     communication. Follow up data collection was collected after 7 months of FC use.

•    Results were not consistent among the three designs, as there were wide variations in students performance. The
     only consistent finding in this report was that there was little evidence/support for the validity of facilitated
     communication for the use as a communication tool. Some students showed an abdication pattern of responding
     was found for some students. These students were able to independently respond on tasks in an accurate manner
     without the use of FC. However, when FC was introduced and the facilitators did not know what was shown , the
     students became passive in their communication ability and their performance decreased.

•    (Bebko, Perry, & Bryson, 1996)
Facilitated Communication: What Does Research Say?
  Evaluating the Impact of Facilitated Communication on the Communicative Competence of Fourteen Students with
                                                      Autism
• This study evaluated the use of facilitated communication by students with autism.
• The participants in this study consisted of fourteen students with autism, who attended the Eden Institute in Princeton,
  New Jersey. The mean age of these participants was 10.5 years and eleven of the participants were male. The fourteen
  students were picked for this study based on their parents extreme interest in FC. Six of the participants communicated
  through their limited verbal skills, six of the participants used a type of an augmentative system/device, one student
  used manual signs to communicate and one student used simultaneous communication of signs and verbal
  approximations. Prior to this study, no student had used typing as a way to communicate. In addition, there were three
  facilitators.
• The researchers used a pretest-posttest design for this study. The pretest condition consisted of the use of the
  Expressive One-Word Picture Vocabulary Test Revised and a protocol of 30 questions. In order to eliminate the use of
  facilitator influence, the facilitators used headphones and could not see the questions being asked. Each participant
  received 10 weeks of instruction in FC. After the 10 weeks, the pretest was given again, but as the posttest.
• During the pretest, only one responder was able to answer a question correctly and many resisted the help of the
  facilitator. The instruction portion did not seem to increase the participants ability to communicate through FC. This
  was also shown in the posttest, which showed that the 10 weeks of instruction did not increase the participants ability
  to communicate through FC.
• This study confirms the previous quantitative studies that individuals who use FC are unable to communicate
  independently through the FC use of typing.
• (Bomba, O'Donnell, Markowitz, & Holmes, 1996)
Facilitated Communication: What Does Research Say?
          Brief Report: Degree of Facilitator Influence in Facilitated Communication as a Function of Facilitator
                                           Characteristics, Attitudes, and Beliefs
• The purpose of this study was to examine the degree of facilitator influence with the use of facilitated communication.
• This study included 20 students and 16 facilitators( 14 women and 2 men). These facilitators were actively working in
  four special education classrooms. They had not used facilitated communication in the past, but two of these
  facilitators attended a workshop on facilitated communication prior to this study. The nature of the study was
  explained to them prior. They also underwent a 2 day training workshop that introduced the facilitators about the
  beliefs and assumptions about FC, changing attitudes about people with autism, and the actual hands on usage and
  practice of FC.
• The researchers measured the facilitators attitude towards facilitated communication, their beliefs about students’
  competence, and facilitator influence.
• The results showed that the facilitators attitudes increased significantly towards the positive use of FC after the first
  day of training. Also, the measure of facilitator influence showed that when they saw the correct answer, the accuracy
  was a lot greater to when they did not see the correct answer. There was a strong correlation with attitude and
  amount of influence. The more positive the facilitators attitude towards FC, the greater amount of influence was seen.
• The two limitations in the study were: other variables that could have been responsible for facilitators influence was
  not measured (personality, optimism levels, etc.), and the generalizability of these facilitators to other facilitators. This
  study essentially proved that facilitated communication lacks validity.
• (Perry, Bryson, & Bebko, 1998)
What is Structured Teaching (TEACCH)
                    ?
                                                                http://www.youtube.com/watch?feature=pla
• TEACCH is based on the “culture of autism”, which                    yer_embedded&v=ddGLJ2r4rcw
  means to understand the characteristics and patterns
  of thinking of the individuals with autism using the
  intervention of structured teaching. It is highly
  dependent on structure, organization, visual
  information, and routines.
• The key elements of “Structured Teaching” include:
      A highly structured physical environment and
         development of visual boundaries
      Using visual supports to help students learn
         and process information
      Utilizes schedules and visual work systems
      Contains visually structured tasks
      It can be generalized in various settings

             http://www.autismspeaks.org/what-
autism/treatment/training-and-education-autistic-and-related-
            communication-handicapped-children
TEACCH: What Does Research Say?
    ABA Versus TEACCH: The Case for Defining and Validating Comprehensive Treatment Models in Autism
•     This study was based on a previous study done in 2008, by the same authors. For this study, they
      analyzed the results of a social validation survey to determine if those who support children with
      autism had a preference between ABA and the TEACCH approach to intervention.

•     In addition, this study examined the comprehensiveness of these two models in their use at public
      schools in comparison to the IDEAL Model functional catergories.

•     The results of the study showed that parents, teachers, and administrators did not show a preference
      for either intervention when the individual components of each model was rated. However, when
      validating the elements found in both models, these providers rated them to be valid when
      combined, then when they existed alone.

•     (Callahan, Shukla-Mehta, Magee, & Wie, 2010)
TEACCH: What Does Research Say?
                   Special Education Versus Inclusive Education: The Role of the TEACCH Program
• This study was conducted for over three years at the Oasi Institute. This study examined the effectiveness of
    three educational approaches for children with autism with severe mental retardation.
• The first approach implemented TEACCH in a residential center. The second implemented TEACCH at home
    and at a mainstream school after a specific parent psychoeducational training (Referred to as the natural
    setting). The third implemented a non-specific approach using inclusive education in a mainstream school.
• 34 male children with autism and severe mental retardation participated in this research study and they were
    enrolled in one of the three settings. Thirteen boys were enrolled in the natural setting TEACCH program, 11
    boys were in the residential program and 10 boys in the inclusive non-specific education approach program.
•   Each child was assessed twice, with a three-year interval between evaluations, using the PEP-R and the VABS
    assessments.
• This study was based on the previous notion that TEACCH was not able to be used in an inclusive setting.
    However, this study proved that TEACCH is not only an effective approach but it showed to be an inclusive
    value. If used in an inclusive setting, the TEACCH approach would strengthen the inclusive educational setting
    for children with autism.
• (Panerai et al., 2009)
TEACCH: What Does Research Say?
 Brief Report: Application of the TEACCH Program on Chinese Pre-School Children with Autism––Does Culture Make a
                                                    Difference?
• This study was conducted in Hong Kong in order to examine the usefulness of the TEACCH program with Chinese
  preschool students.
• For this study, the researchers used a experimental group and a control group. There were 18 children in the
  experimental group. These children were between the ages of 3-5 and 17 of the children were male. They were chosen
  randomly from the 63 preschool students with autism who are studying in the Heep Hong Society. The control group
  consisted of 16 children between the same ages. These children were recruited from the Preschool Parent Association.
  There were 12 boys and 4 girls in this group.
• This study was a longitudinal study that spanned for 12 months. All the participants were assessed before the study, at
  6 months into the study and after 12 months. Children in the experimental group received TEACCH training for 7 h a
  day for 12 months. The control group received a variation of training, but none of them received TEACCH related
  training.
• The instrument that was used to measure the participants changes in the various learning domains was the
  Developmental Scale of the validated Chinese version of PEP-R. In addition, the The Merrill-Palmer Scale of Mental
  Test and the Hong Kong Based Adaptive Behavioral Scales were used to measure the participants cognitive and social
  adaptive functioning.
• At posttest, the results showed the participants who received the TEACCH training (the experimental group) showed
  more improvement than those in the control group. This study showed that the TEACCH program is effective for
  working with children with autism.
• (Tsang, Shek, Lam, Tang, & Cheung, 2007)
TEACCH: What Does Research Say?
           Effects of Structured Teaching on the Behavior of Young Children With Disabilities
•   The aim of this study was to add to the previous research on structured teaching by extending its effects onto
    engagement, task completion, stereotypic behavior and escape attempts with preschoolers with disabilities. The
    other aim of this study was to examine the use of graduated guidance when teaching children how to use the
    structured work systems. This research report contained two studies.
•   The participants in the first study consisted of two children, Gabriel and Jacob. Both children were between the
    ages of 24-50 months, and diagnosed with autism. This study used an A-B-A-B withdrawal design. The children
    behaviors that were measured were: engagement, task completion, stereotypic behavior and escape attempt.
•   The 2nd study involved a girl who was 46 months in age and diagnosed with autism. A multiple baseline across
    stimuli design was used for this study. The same behaviors were measured as the 1st study.
•   For the 1st study, during the baseline, the children were given 3 tasks to do, without guidance or structure. For the
    2nd study, the girl had to complete three interlocking puzzles. Graduated guidance was used to teach the children
    the work systems. The intervention included a structured work system, and was seen to produce an increase in
    the engagement of the activity.. It was also shown to increase the speed and accuracy of the completion of the
    task. There were decreases in stereotypic behavior and escape attempts.
•   The use of graduated guidance resulted in every child independently using the work systems in the end.
•   (Bennett, Reichow, & Wolery, 2011)
TEACCH: What Does Research Say?
    Promoting Task Accuracy and Independence in Students with Autism Across Educational Setting Through the Use of
                                              Individual Work Systems
•     This study examined an individual work systems impact on task accuracy and the level of adult prompting across
      educational settings.

•     The participants in this study were three male students with autism who were in the first grade. Each student
      received the majority of their education in a self-contained classroom for students with moderate to severe
      disabilities. The participants received the intervention inside their special education classroom.

•     A multiple-probe-across-participants design was used in this study. Accuracy was measured in this study by the
      amount of steps that the students were able to complete correctly on an assigned task. Teacher prompts were any
      physical, verbal, gestural and proximal cues that were given by the instructional staff to the student.

•     The results of this study showed an increase in task accuracy and a decrease in teacher prompt in all students. In
      addition, these students were able to demonstrate these results among both the special education setting and
      general education setting. A one month follow up probe showed that these results remained in effect after the
      study was over.

•     (Hume, Plavnick and Odom, 2012)
REFERENCES
Bebko, J., Perry, A., & Bryson, S. (1996). Multiple method validation study of facilitated communication: II. Individual
     differences and subgroup results. Journal Of Autism & Developmental Disorders, 26(1), 19-42

Bennett, K. , Reichow, B. , & Wolery, M. (2011). Effects of structured teaching on the behavior of young children with
     disabilities. Focus on Autism and Other Developmental Disabilities, 26(3), 143-152.

Bomba, C., O'Donnell, L., Markowitz, C., & Holmes, D. (1996). Evaluating the impact of facilitated communication on the
    communicative competence of fourteen students with autism. Journal Of Autism & Developmental Disorders,
    26(1), 43-58. Retrieved from http://web.ebscohost.com.libproxy.csun.edu

Baker-Ericzén, M., Stahmer, A., & Burns, A. (2007). Child demographics associated with outcomes in a community-based
      pivotal response training program. Journal Of Positive Behavior Interventions, 9(1), 52-60

Cabay, M. (1994). A controlled evaluation of facilitated communication using open-ended and fill-in questions. Journal of
      Autism and Developmental Disorders, 24(4), 517-527. doi: 10.1007/BF02172132

Callahan, K., Shukla-Mehta, S., Magee, S., & Wie, M. (2010). ABA versus TEACCH: the case for defining and validating
      comprehensive treatment models in autism. Journal of Autism and Developmental Disorders, 40(1), 74-88.
      doi: 10.1007/s10803-009-0834-0

Chan, J. M., & O'Reilly, M.,F. (2008). A social stories(tm) intervention package for students with autism in inclusive
      classroom settings. Journal of Applied Behavior Analysis, 41(3), 405-9.

Greenberg, A., Tomaino, M., & Charlop, H. (2012). Assessing generalization of the picture exchange communication
     system in children with autism. Journal of Developmental and Physical Disabilities, 24(6), 539-558.
     doi: 10.1007s10882-012-9288-y

Hanley-Hochdorfer, K. , Bray, M. , Kehle, T. , & Elinoff, M. (2010). Social stories to increase verbal initiation in children with
     autism and asperger's disorder. School Psychology Review, 39(3), 484-492
Hume, K., Plavnick, J., & Odom, S. L., (2012). Promoting task accuracy and independence in students with autism across
     educational setting through the use of individual work systems. Journal of Autism and Developmental Disorders,
     42(10), 2084-2099. DOI: 10.1007/s10803-012-1457-4

Kokina, A., & Kern, L. (2010). Social story[tm] interventions for students with autism spectrum disorders : A meta-
      analysis. Journal of autism and developmental disorders, 40(7), 812-826. doi: 10.1007/s10803-009-0931-0

Kuhn, L. R., Bodkin, A. E., Devlin, S. D., & Doggett, R. (2008). Using Pivotal Response Training with Peers in Special
      Education to Facilitate Play in Two Children with Autism. Education and Training In Developmental Disabilities,
      43(1), 37-45. Retrieved from http://web.ebscohost.com.libproxy.csun.edu/

Leaf, J. B., Oppenheim-Leaf, M. L., Call, N. A., Sheldon, J. B., Sherman, J., Taubman, M., . . Leaf, R. (2012). Comparing the
        teaching interaction procedure to social stories for people with autism. Journal of Applied Behavior Analysis, 45(2),
        281-298. doi: 10.1901/jaba.2012.45-281

Lerna, A., Esposito, D., Conson, M., Russo, L. and Massagli, A. (2012), Social–communicative effects of the Picture
      Exchange Communication System (PECS) in Autism Spectrum Disorders. International Journal of Language &
      Communication Disorders, 47: 609–617. doi: 10.1111/j.1460-6984.2012.00172.x

Lyndon, H., Healy, O., & Leader, G. (2011) A comparison of Video Modeling and Pivotal Response Training to teach pretend
play skills to children with Autism Spectrum Disorder. Research in Autism Spectrum Disorders, 5(2), 872-884
Mancil, G. R., Haydon, T., & Whitby, P. (2009). Differentiated effects of paper and computer-assisted social stories on
       inappropriate behavior in children with autism. Focus on Autism and Other Developmental Disabilities, 24(4),
       205-215. doi: 10.1177/1088357609347324

McDuffie, A., Lieberman,R., & Yoder, P. (2012). Object interest in autism spectrum disorder : A treatment comparison.
     Autism, 16(4), 398-405. doi: 10.1177/1362361309360983
Minjarez, M., Williams, S., Mercier, E., & Hardan, A. (2011). Pivotal response group treatment program for parents of
      children with autism. Journal Of Autism and Developmental Disorders, 41(1), 92-101.       doi10.1007s10803-010-
1027-6

Panerai, S., Zingale, M., Trubia, G., Finocchiaro, M., Zuccarello, R., Ferri, R., & Elia, M. (2009). Special education versus
     inclusive education: the role of the TEACCH program. Journal of Autism and Developmental Disorders, 39(6),
     874-882. doi:10.1007/s10803-009-0696-5

Perry, A., Bryson, S., & Bebko, J. (1998). Brief report: degree of facilitator influence in facilitated communication as a
       function of facilitator characteristics, attitudes, and beliefs. Journal Of Autism & Developmental Disorders, 28(1),
       87-90.
Simpson, R. L., & Myles, B. (1995). Effectiveness of facilitated communication with children and youth with autism. Journal
       of Special Education, 28(4), 424.

Stahmer, A. C., Suhrheinrich, J., Reed, S., Bolduc, C., & Schreibman, L. (2010). Pivotal Response Teaching in the Classroom
     Setting. Preventing School Failure, 54(4), 265-274. doi:10.1080/10459881003800743

Tsang, S., Shek, D., Lam, L., Tang, F., & Cheung, P. (2007). Brief report: application of the TEACCH program on Chinese pre-
      school children with autism -- does culture make a difference?. Journal Of Autism and Developmental
Disorders, 37(2), 390-396. DOI 10.1007/s10803-006-0199-6

Travis, J., & Geiger, M. (2010). The Effectiveness of the Picture Exchange Communication System (PECS) for Children with
       Autism Spectrum Disorder: A South African Pilot Study. Child Language Teaching and Therapy, 26(1), 39-59.
       doi: 10.1177/0265659009349971

Yoder, P., & Lieberman, R. (2010). Brief report: Randomized test of the efficacy of Picture Exchange Communication
      System on highly generalized picture exchanges in children with ASD. Journal Of Autism & Developmental Disorders,
      40(5), 629-632. doi:10.1007/s10803-009-0897-y
Comments
• Professional quality staff development PP!
• Great research and references!
• Wonderful effort 200/200

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Autism Powerpoint

  • 1. Autism Interventions • Picture Exchange Communication System (PECS) • Pivotal Response Training • Social Stories • Facilitated Communication • Structured Teaching (TEACCH) Alyson Handler SPED 655 OL
  • 2. What is Picture Exchange Communication System (PECS)? • PECS is an augementive communication program that is designed to teach individuals with ASD or other disabilities who lack speech, to communicate in a social context • Based on several studies, PECS can be used to develop verbal language and decrease tantrums and other odd behaviors. • PECS teaches children to communicate through the use of pictures in exchange for wants/needs of items. • There are six phases in PECS: – Phase I: includes three people in the room (the child, the facilitator, and the person who receives the message)The child learns how to exchange the picture for things they want. – Phase II: The facilitator tries to increase the students independence. It YouTube video: increases the distances for the child and the adult http://www.youtube.com/watch?v=eT – Phase III: The child learns to select a picture from multiple picture zedhezar8 choices – Phase IV: The child puts words and pictures together, creating sentences. – Phase V: The child answers questions using pictures – Phase VI: The child expands on these interactions and learns to comment • http://www.iidc.indiana.edu/index.php?pageId=525
  • 3. Picture Exchange Communication System (PECS): What Does Research Say? The Effectiveness of the Picture Exchange Communication System (PECS) for Children with Autism Spectrum Disorder (ASD): A South African Pilot Study • A mixed research design that included a quantitative component, a single-subject multiple baseline design across three behaviors that was repeated with two participants, and a qualitative component. • This study examined the effectiveness of the Picture Exchange Communication System for children with ASD who lived in the culturally and linguistically diverse country of South Africa. In context, the aim of this research study was to see the effect that PECS has on the frequency of requesting and commenting behavior and the effect of PECS on the length of verbal utterances of two children who are diagnosed with ASD. The researchers hypothesized that there would be an increase in the frequency of requesting in the first phase, and an increase in the length of utterances in Phase IV. In addition, they hypothesized that there would be an increase in commenting during phase VI. • Both of the participants were nine years old and attended separate classrooms at a special education school for children with autism. • Data was collected in structured and unstructured settings during the pre-training, training, post-training and follow-up stages. • The quantitative data visually showed that there was an increase in requesting behavior during the Phase I of the training. This increase was seen in the follow-up session. This data also showed that commenting behavior increased during Phase VI of the training, but only in the structured setting. In addition, there was an immediate increase in the mean length of utterances by one participant in both settings. • Both participants demonstrated an increase in intentional communicative acts, including the use of requesting and the use of communication through the form of pictures. • The results of this study confirmed the hypotheses and showed that PECS was effective in increasing desired communication goals and was consistent with the previous research. • (Travis & Geiger, 2010)
  • 4. Picture Exchange Communication System (PECS): What Does Research Say? Assessing Generalization of the Picture Exchange Communication System in Children with Autism • This study examined PECS generalization after each phrase of PECS training. They assessed generalization by using a train and probe technique. • The participants in the study were four boys children with autism. All of the boys attended the same after-school behavioral training program one day a week for two hours. They were ages 4, 5, 7 and 8. • The PECS training was done in a workroom at their behavioral training program. • Generalization sessions included: on a playground with a therapist, at home with the therapist, at home with the parents and at a convenience store with a stranger. • The final results showed that all four of the boys demonstrated generalization of PECS at every setting and across people. • Follow up probes were also assessed, and found that all four participates maintained PECS at follow-up. • (Greenberg, Tomaino, & Charlop, 2012)
  • 5. Picture Exchange Communication System (PECS): What Does Research Say? Social–Communicative Effects of the Picture Exchange Communication System (PECS) in Autism Spectrum Disorders • This study examines the usefulness of of PECS in treating social–communication impairments in autism. • The participants in this study were 18 preschool children with ASD. Each child was placed into an intervention group of either PECS or Conventional Language Therapy. • Each group received treatment for 30 minutes, three times a week for 6 monthes. • The results of this study showed that in the end, the PECS group showed significant improvement over the CLT group on the VABS social domain score. • In conclusion, the PECS intervention showed that it can be used to improve improve social–communicative skills in children with autism. • (Lerna, Esposito, Conson, Russo, and Massagli 2012) Object Interest in Autism Spectrum Disorder: A Treatment Comparison • This study used a random controlled trial research design to compare two social communication treatments on the effect of object interest for children with autism. • There were 32 children in this study who were between the ages of 18-60 months. • The two social communication treatment groups that these children were randomly assigned to were the Picture Exchange Communication System (PECS) or the Responsive Education and Prelinguistic Milieu Teaching (RPMT) conditions. • Object interest was assessed in an unstructured play session with different toys, activities, adult, and location than they received during their treatment. • Results showed that the children in the RPMT treatment group demonstrated a greater increase in object interest, in comparison to those in the PECS group. • (McDuffie, Lieberman, & Yoder, 2012)
  • 6. Picture Exchange Communication System (PECS) : What Does Research Say? Brief Report: Randomized Test of the Efficacy of Picture Exchange Communication System on Highly Generalized Picture Exchanges in Children with ASD • This study consisted of 36 children who were between the ages of 18 and 60 months. 33 of these children had a diagnosis of autism and 3 children had a diagnosis of pervasive developmental disorder-not otherwise specified. • These children were randomly placed into one of two treatment groups: Responsive Education and Prelinguistic Milieu Teaching or PECS. • This study looks at the PECS teaching and its results used in a far-transfer measurement context for the picture exchange of children with ASD. • The research design was claimed to have strong internal validity and found that children with autism who had PECS training were able to increase the number of picture exchanges then the children receiving the intervention in a far-transfer measurement. • (Yoder & Lieberman, 2009)
  • 7. What are Social Stories? • Social stories are short stories that describes social cues and common responses in specific social situations. It is designed to helps individuals with ASD understand social situations. • Social stories help children with autism understand other people’s perspectives (theory of mind). • It uses four different sentence types: descriptive sentences, directive sentences, perspective sentences and affirmative sentences. Cooperative and control sentences can also be used to write a social story. • Social stories focus on individualized goals/specific http://www.youtube.com/watch? social needs and translates these goals into v=hhgZznTIf2E understandable steps. • A Social Story has a ratio of 2 to 5 descriptive sentences for every directive sentence. • http://www.educateautism.com/social-stories.html
  • 8. Social Stories: What Does Research Say? Social Stories Interventions for Students with Autism Spectrum Disorders: A Meta-Analysis • This study was conducted in order to determine if Social Stories were effective in decreasing disruptive behavior in children with autism. • The study consisted of three children, ages 7 and 9. Each child had their own social story created for them which targeted a specific disruptive behavior. The three target behaviors were: using a loud voice in class, chair tipping, and cutting in lunch line. No other behavioral intervention has been used with these children. • Using a single-subject multiple-baseline design across subjects, the students were observed three times a week after the social stories were implemented. • After careful direct observation, this study concluded that each child’s targeted disruptive behavior was significantly reduced compared to their baseline performance. • (Kokina & Kern, 2010)
  • 9. Social Stories: What Does Research Say? Comparing the Teaching Interaction Procedure Differentiated Effects of Paper and Computer- to Social Stories for People with Autism Assisted Social Stories on Inappropriate Behavior in • This study used a parallel treatment design to Children with Autism compare social stories and the teaching interaction • This study used a single-subject ABABCBC procedure in teaching social skills to 6 children multicomponent reversal design to compare the use with autism. of Social Stories in two formats, a paper format and a • In this study, 18 social skills were taught using the power point format. The social skill that this study social stories method and 18 social skills were focused on was pushing others at recess and taught using the teaching interaction procedure. transitions. • The results of this study showed that the teaching • The study participants consisted of three elementary interaction procedure was more successful in aged students, two male and one female, all with producing higher levels of skill-specific steps. autism. Each student had similar assessment results • All participants met mastery criterion for all 18 and received their education in a general education social skills using the teaching interaction setting. procedure, whereas all six participants only • Results were slightly better using the Powerpoint mastered 4 of the 18 social skills using social version and generalized to another setting using a stories. single verbal prompt. • (Leaf et al., 2012) • (Mancil, Haydon, & Whitby, 2009)
  • 10. Social Stories: What Does Research Say? Social Stories to Increase Verbal Initiation in Children with Autism and Asperger’s Disorder • The purpose of this study was to determine if social stories had any effects on children’s verbal initiations and contigent responses to peers, when employed in school settings. • There were four children who participated in this study. One child had a diagnosis of autism and the other three children were labeled with aspergers. • This study was done in relation to a study done by Delano and Snell (2006). The major difference between their study and this study is that this current study was done in a natural school environment. • The previous study done by Delano and Snell (2006) concluded that when used with students with ASD in isolation, social stories increased social enagement with peers. However, this study came up with a different conclusion, stating that there is limited support for the use of social stories in increasing social and communication behaviors in individuals with ASD. • (Hanley-Hochdorfer, Bray, Kehle, & Elinoff, 2010)
  • 11. Social Stories: What Does Research Say? A Social Stories Intervention Package with Students with Autism in Inclusive Classroom Settings • This study examined the use of a Social Stories intervention package with two students with autism that were enrolled in a full-inclusion kindergarten classroom. • Both participants were boys, Matt and Ted, with social communication problems. The target behaviors for Matt were inappropriate social interactions appropriate hand raising, and inappropriate vocalizations. Ted’s target behaviors were appropriate hand raising, appropriate social initiations, and inappropriate vocalizations. • Data was taken using a frequency count. In addition, this study used a multiple probe design across behaviors as the research design. • The results showed that Matt exhibited an immediate decrease in inappropriate social interaction behavior, an increase in hand raising, and reduction in his inappropriate vocalizations. Ted’s results showed that he showed an increase in hand raising and an increase in appropriate social initiations. The focus on Ted’s vocalizations was eliminated from the study due to the decrease in them before the study began. • This intervention package showed that it does not require intensive supervision of the child’s behavior and can be useful in inclusive classroom environments. • (Chan, & O’Reilly, 2008)
  • 12. What is Pivotal Response Training (PRT)?  Based on the principles of ABA  Is a loosely structured, naturalistic intervention  The pivotal behaviors that are central to PRT are:  Responding to multiple cues and stimuli  Increasing of child motivation  Improving of self-management abilities  Increasing self-initiations  Can be used to improve language, social, behavioral, academic, and play skills in children with autism  Child choice in choosing a stimulus is also part of PRT.  Is used to promote generalization and maintenance of http://www.youtube.com/watch?v=M- taught skills. Lxx4Zf_Uo&playnext=1&list=PL2341238C7 C13279F&feature=results_video http://autismlab.ucsd.edu/about/pivotal-response-training.shtml
  • 13. PRT: What Does Research Say?? Using Pivotal Response Training with Peers in Special Education to Facilitate Play in Two Children with Autism • The participants in this study consisted of two students with autism. The treatment facilitators in this study consisted of five students/peers who were also receiving special education services. • The purpose of this study was to evaluate the ability of peers in special education to implement pivotal response training to increase social interactions in the two students with autism. • These peers were taught the strategies of using modeling, role-playing and feedback. • The study showed that the students and peers had increased social interaction. • The study also proved that peers can successful implement Pivotal Response Training methods to help their classmates with autism. • (Kuhn, Bodkin, Devlin, & Doggett, 2008) Pivotal Response Group Treatment Program for Parents of Children with Autism • The purpose of this study was to show that parents can learn Pivotal Response Training in a group therapy format to use with their children with ASD, while showing increasing gains in their children’s language. • The children with autism used in this study were between the ages of 2.0 and 6.11 years. A total of 17 families participated in this study. • This study showed that the group format for training aprents to use the Pivotal Response method is benefitial in targeting language deficits in children with ASD. It showed that parents can effectively learn Pivotal Response Training in a group training format. • (Minjarez, Williams, Mercier, & Hardan, 2011)
  • 14. PRT: What Does Research Say? A Comparison of Video Modeling and Pivotal Response Training to Teach Pretend Play Skills to Children With Autism Spectrum Disorder • This study compared the use of Video Modeling with the use of Pivotal Response Training in regards to the acquisition and generalization of scripted play verbalizations in the training and generalization stages of this skill. • Five children participated in this study. All five children had a diagnosis of autism spectrum disorder and had adequate language ability. The language ability of the children was similar to the language ability of typically developing children age two years. • All five children were exposed to Video Modeling and Pivotal Response Training, although the sequence to which children experience each intervention was randomly assigned. • Training took place inside a room at the children’s school. The generalization setting was the play area in each child’s classroom. • The results of the study showed that both Video Modeling and PRT can be used with children with autism who have sufficient language skills in order to increase their pretend play skills. However, the use of PRT showed a greater increase in the number of play actions during the training period and during the generalization environment than the use of Video Modeling. • (Lyndon, Healy, & Leader, 2011)
  • 15. PRT: What Does Research Say? Child Demographics Associated With Outcomes in a Community-Based Pivotal Response Training Program • In contrast to previous studies, this study used a large sample of parents and children with autism. These parents and children were enrolled in an accelerated parent education program at a southern California children’s hospital. • In this program, parents were taught PRT and focused on increasing their children’s ability to facilitate play and increasing their children’s language skills. • The purpose of this study was to determine if PRT can be implemented effectively in a large-scale community based setting and to determine if specific child variables (gender, age and race) are associated with the outcomes. • 158 families were included in the study sample. The children’s ages ranged from 24 months to 113 months. 83% of the children were boys and 17% were girls. 35% of the children were Hispanic, 27% were White, 19% were Asian, 4% were African American, 2% were Native American and 10% were other/unknown. • The Vineland Adaptive Behavior Scales was used in this study. • The results of this study showed that the PRT parent education program was effective in producing significant improvements in the areas of Communication, Daily Living Skills, Socialization, Motor Skills and Adaptive Behavior, regardless of specific child variables. The children who were ages 3 and under, showed the least impairment at intake and the most improvement from pre-post intervention. • (Baker-Ericzén, Stahmer, & Burns, 2007)
  • 16. PRT: What Does Research Say? Pivotal Response Teaching in the Classroom Setting • This article contains an immense amount of information about what PRT is and how it is implemented in various settings. It includes a review of research studies that show the effectiveness of using PRT in teaching a variety of skills to students with autism. • Based on the review of research, this article states that PRT is effective in teaching children with autism a variety skills such as: symbolic play, joint attention, sociodramatic play, peer social interaction, communication and self-initiations. • Along with other interventions, PRT is proven to be effective in teaching communication; However, in comparison with other interventions, PRT is shown to be more effective in increasing verbalizations and language use. It is also effective in improving speech imitation, labeling, question asking, spontaneous speech, and conversational communication. • This article claims that PRT was originally designed for use in parent education and in one on one settings. However, this article explains that PRT has been seen in many classrooms. They saw that in the Southern California region, more than 70% of 80 teachers that were surveyed actually used PRT inside their classroom. • When the authors examined the use of PRT in the classrooms, the majority of teachers liked the use of PRT and found it to be effective. Although, these teachers also claimed that the use of PRT in the classroom is difficult when used in a group setting. The teachers said that it is important to understand ABA before implementing PRT and that data collecting and IEP goals were difficult to gather. Also, the teachers saw difficulties in implementing direct reinforcers and child choice in the classroom full of other children. • The goals of the authors are to find a way to adapt PRT into the classroom in the future. • (Stahmer, Suhrheinrich, Reed, Bolduc, & Schreibman, 2010)
  • 17. What is Facilitated Communication (FC)? • is a type of augmentative and alternative communication technique. • Requires a communication partner, or a facilitator who supports the user. • Supports include:  Emotional support: through the use of encouragement  Physical support: through the use of helping the user initiate typing, isolating the index finger, holding and stabilizing the arm, holding the arm to slow the pace or to help the user not hit the target more than once.  Communicative support: through the use of feedback, prompts and cues to help the user stay focused. • The goal of facilitated communication is for the user to http://www.youtube.com/watch?v=Dq achieve independence in their typing. hlv0UZUwY • This method is controversial in its usage due to the skepticism in the authenticity of the user’s typing. http://tash.org/breaking-the-barriers/about-facilitated-communication/
  • 18. Facilitated Communication: What Does Research Say? Brief Report: A Controlled Evaluation of Facilitated Communication Using Open-Ended and Fill-in Questions • This study examines the use of facilitated communication with children with autism and whether the child is actually communicating authentically or if the child is influenced by the facilitator. • There were four students who participated in this study. Each student was enrolled in a day school program in Arizona and had a diagnosis of autism. In addition, all four students have used facilitated communication for at least three months in the school with at least two facilitators. • The study used a variety of stimuli cards: some cards were blank, some cards contained fill in the blank and some were short answer questions. The students were presented the cards with two different conditions. The first condition, the facilitator was aware of what was on the card and the second condition, the facilitator was unaware of the card. • Between the four students, there were a total of 110 responses. • The study showed that 95% of the questions were answered correctly when the facilitator knew what the questions were. Only 19% of the answers were answered correctly when the facilitator was unaware of the questions. 62% of the incorrect answers that were received when the facilitator was unaware of the cards were answers that were relevant to other questions and possible correct answers to those. • The results of this study show that facilitators have influence over the user’s communication ability using the facilitated communication method. • (Cabay, 1994)
  • 19. Facilitated Communication: What Does Research Say? Effectiveness of Facilitated Communication with Children and Youth with Autism • This study was conducted in order to determine the effectiveness of using facilitated communication with children with autism. • There were 18 children who participated in this study. Four students were in preschool, ten students were in elementary school, and four students were in secondary school. All students had a diagnosis of autism. The students’ teachers were the facilitators, in which they underwent a two day training on FC. • The study was conducted in the students classrooms on a daily basis for 15 weeks. • The results of the study showed that nine of the students were able to demonstrate potential in using FC for literacy and communication. This was shown by the ability of these students to write their name through the teachings of FC. They were also able to identify letters and numbers with at least 50% accuracy. But 5 out of the 9 were already able to do this prior to the study. • Students were more accurate in their answers when the questions were known to the teachers. • In the end, the study failed to validate the effectiveness of using FC with students with autism. • (Simpson & Myles, 1995)
  • 20. Facilitated Communication: What Does Research Say? Multiple Method Validation Study of Facilitated Communication: II. Individual Differences and Subgroup Results • This study used multiple methods to examine if there were individual variations in the usage of effectiveness of facilitated communication. Three of the methods were reported in this report. Each method varied in ways of The methods differed in three ways. One way was the extent in which the method was naturalistic vs. structured. Another way was the method of input(auditory, visual) and the third way was the type of response that was required (pointing to pictures, yes/no response, spelling). • There were 20 students from four classrooms of a regional program that participated in this study. 15 of the participants were male and 5 participants were female. There were 16 facilitators that were staff in the classrooms. • Three methods were used and data was collected after staff training and 6 weeks of using facilitated communication. Follow up data collection was collected after 7 months of FC use. • Results were not consistent among the three designs, as there were wide variations in students performance. The only consistent finding in this report was that there was little evidence/support for the validity of facilitated communication for the use as a communication tool. Some students showed an abdication pattern of responding was found for some students. These students were able to independently respond on tasks in an accurate manner without the use of FC. However, when FC was introduced and the facilitators did not know what was shown , the students became passive in their communication ability and their performance decreased. • (Bebko, Perry, & Bryson, 1996)
  • 21. Facilitated Communication: What Does Research Say? Evaluating the Impact of Facilitated Communication on the Communicative Competence of Fourteen Students with Autism • This study evaluated the use of facilitated communication by students with autism. • The participants in this study consisted of fourteen students with autism, who attended the Eden Institute in Princeton, New Jersey. The mean age of these participants was 10.5 years and eleven of the participants were male. The fourteen students were picked for this study based on their parents extreme interest in FC. Six of the participants communicated through their limited verbal skills, six of the participants used a type of an augmentative system/device, one student used manual signs to communicate and one student used simultaneous communication of signs and verbal approximations. Prior to this study, no student had used typing as a way to communicate. In addition, there were three facilitators. • The researchers used a pretest-posttest design for this study. The pretest condition consisted of the use of the Expressive One-Word Picture Vocabulary Test Revised and a protocol of 30 questions. In order to eliminate the use of facilitator influence, the facilitators used headphones and could not see the questions being asked. Each participant received 10 weeks of instruction in FC. After the 10 weeks, the pretest was given again, but as the posttest. • During the pretest, only one responder was able to answer a question correctly and many resisted the help of the facilitator. The instruction portion did not seem to increase the participants ability to communicate through FC. This was also shown in the posttest, which showed that the 10 weeks of instruction did not increase the participants ability to communicate through FC. • This study confirms the previous quantitative studies that individuals who use FC are unable to communicate independently through the FC use of typing. • (Bomba, O'Donnell, Markowitz, & Holmes, 1996)
  • 22. Facilitated Communication: What Does Research Say? Brief Report: Degree of Facilitator Influence in Facilitated Communication as a Function of Facilitator Characteristics, Attitudes, and Beliefs • The purpose of this study was to examine the degree of facilitator influence with the use of facilitated communication. • This study included 20 students and 16 facilitators( 14 women and 2 men). These facilitators were actively working in four special education classrooms. They had not used facilitated communication in the past, but two of these facilitators attended a workshop on facilitated communication prior to this study. The nature of the study was explained to them prior. They also underwent a 2 day training workshop that introduced the facilitators about the beliefs and assumptions about FC, changing attitudes about people with autism, and the actual hands on usage and practice of FC. • The researchers measured the facilitators attitude towards facilitated communication, their beliefs about students’ competence, and facilitator influence. • The results showed that the facilitators attitudes increased significantly towards the positive use of FC after the first day of training. Also, the measure of facilitator influence showed that when they saw the correct answer, the accuracy was a lot greater to when they did not see the correct answer. There was a strong correlation with attitude and amount of influence. The more positive the facilitators attitude towards FC, the greater amount of influence was seen. • The two limitations in the study were: other variables that could have been responsible for facilitators influence was not measured (personality, optimism levels, etc.), and the generalizability of these facilitators to other facilitators. This study essentially proved that facilitated communication lacks validity. • (Perry, Bryson, & Bebko, 1998)
  • 23. What is Structured Teaching (TEACCH) ? http://www.youtube.com/watch?feature=pla • TEACCH is based on the “culture of autism”, which yer_embedded&v=ddGLJ2r4rcw means to understand the characteristics and patterns of thinking of the individuals with autism using the intervention of structured teaching. It is highly dependent on structure, organization, visual information, and routines. • The key elements of “Structured Teaching” include:  A highly structured physical environment and development of visual boundaries  Using visual supports to help students learn and process information  Utilizes schedules and visual work systems  Contains visually structured tasks  It can be generalized in various settings http://www.autismspeaks.org/what- autism/treatment/training-and-education-autistic-and-related- communication-handicapped-children
  • 24. TEACCH: What Does Research Say? ABA Versus TEACCH: The Case for Defining and Validating Comprehensive Treatment Models in Autism • This study was based on a previous study done in 2008, by the same authors. For this study, they analyzed the results of a social validation survey to determine if those who support children with autism had a preference between ABA and the TEACCH approach to intervention. • In addition, this study examined the comprehensiveness of these two models in their use at public schools in comparison to the IDEAL Model functional catergories. • The results of the study showed that parents, teachers, and administrators did not show a preference for either intervention when the individual components of each model was rated. However, when validating the elements found in both models, these providers rated them to be valid when combined, then when they existed alone. • (Callahan, Shukla-Mehta, Magee, & Wie, 2010)
  • 25. TEACCH: What Does Research Say? Special Education Versus Inclusive Education: The Role of the TEACCH Program • This study was conducted for over three years at the Oasi Institute. This study examined the effectiveness of three educational approaches for children with autism with severe mental retardation. • The first approach implemented TEACCH in a residential center. The second implemented TEACCH at home and at a mainstream school after a specific parent psychoeducational training (Referred to as the natural setting). The third implemented a non-specific approach using inclusive education in a mainstream school. • 34 male children with autism and severe mental retardation participated in this research study and they were enrolled in one of the three settings. Thirteen boys were enrolled in the natural setting TEACCH program, 11 boys were in the residential program and 10 boys in the inclusive non-specific education approach program. • Each child was assessed twice, with a three-year interval between evaluations, using the PEP-R and the VABS assessments. • This study was based on the previous notion that TEACCH was not able to be used in an inclusive setting. However, this study proved that TEACCH is not only an effective approach but it showed to be an inclusive value. If used in an inclusive setting, the TEACCH approach would strengthen the inclusive educational setting for children with autism. • (Panerai et al., 2009)
  • 26. TEACCH: What Does Research Say? Brief Report: Application of the TEACCH Program on Chinese Pre-School Children with Autism––Does Culture Make a Difference? • This study was conducted in Hong Kong in order to examine the usefulness of the TEACCH program with Chinese preschool students. • For this study, the researchers used a experimental group and a control group. There were 18 children in the experimental group. These children were between the ages of 3-5 and 17 of the children were male. They were chosen randomly from the 63 preschool students with autism who are studying in the Heep Hong Society. The control group consisted of 16 children between the same ages. These children were recruited from the Preschool Parent Association. There were 12 boys and 4 girls in this group. • This study was a longitudinal study that spanned for 12 months. All the participants were assessed before the study, at 6 months into the study and after 12 months. Children in the experimental group received TEACCH training for 7 h a day for 12 months. The control group received a variation of training, but none of them received TEACCH related training. • The instrument that was used to measure the participants changes in the various learning domains was the Developmental Scale of the validated Chinese version of PEP-R. In addition, the The Merrill-Palmer Scale of Mental Test and the Hong Kong Based Adaptive Behavioral Scales were used to measure the participants cognitive and social adaptive functioning. • At posttest, the results showed the participants who received the TEACCH training (the experimental group) showed more improvement than those in the control group. This study showed that the TEACCH program is effective for working with children with autism. • (Tsang, Shek, Lam, Tang, & Cheung, 2007)
  • 27. TEACCH: What Does Research Say? Effects of Structured Teaching on the Behavior of Young Children With Disabilities • The aim of this study was to add to the previous research on structured teaching by extending its effects onto engagement, task completion, stereotypic behavior and escape attempts with preschoolers with disabilities. The other aim of this study was to examine the use of graduated guidance when teaching children how to use the structured work systems. This research report contained two studies. • The participants in the first study consisted of two children, Gabriel and Jacob. Both children were between the ages of 24-50 months, and diagnosed with autism. This study used an A-B-A-B withdrawal design. The children behaviors that were measured were: engagement, task completion, stereotypic behavior and escape attempt. • The 2nd study involved a girl who was 46 months in age and diagnosed with autism. A multiple baseline across stimuli design was used for this study. The same behaviors were measured as the 1st study. • For the 1st study, during the baseline, the children were given 3 tasks to do, without guidance or structure. For the 2nd study, the girl had to complete three interlocking puzzles. Graduated guidance was used to teach the children the work systems. The intervention included a structured work system, and was seen to produce an increase in the engagement of the activity.. It was also shown to increase the speed and accuracy of the completion of the task. There were decreases in stereotypic behavior and escape attempts. • The use of graduated guidance resulted in every child independently using the work systems in the end. • (Bennett, Reichow, & Wolery, 2011)
  • 28. TEACCH: What Does Research Say? Promoting Task Accuracy and Independence in Students with Autism Across Educational Setting Through the Use of Individual Work Systems • This study examined an individual work systems impact on task accuracy and the level of adult prompting across educational settings. • The participants in this study were three male students with autism who were in the first grade. Each student received the majority of their education in a self-contained classroom for students with moderate to severe disabilities. The participants received the intervention inside their special education classroom. • A multiple-probe-across-participants design was used in this study. Accuracy was measured in this study by the amount of steps that the students were able to complete correctly on an assigned task. Teacher prompts were any physical, verbal, gestural and proximal cues that were given by the instructional staff to the student. • The results of this study showed an increase in task accuracy and a decrease in teacher prompt in all students. In addition, these students were able to demonstrate these results among both the special education setting and general education setting. A one month follow up probe showed that these results remained in effect after the study was over. • (Hume, Plavnick and Odom, 2012)
  • 29. REFERENCES Bebko, J., Perry, A., & Bryson, S. (1996). Multiple method validation study of facilitated communication: II. Individual differences and subgroup results. Journal Of Autism & Developmental Disorders, 26(1), 19-42 Bennett, K. , Reichow, B. , & Wolery, M. (2011). Effects of structured teaching on the behavior of young children with disabilities. Focus on Autism and Other Developmental Disabilities, 26(3), 143-152. Bomba, C., O'Donnell, L., Markowitz, C., & Holmes, D. (1996). Evaluating the impact of facilitated communication on the communicative competence of fourteen students with autism. Journal Of Autism & Developmental Disorders, 26(1), 43-58. Retrieved from http://web.ebscohost.com.libproxy.csun.edu Baker-Ericzén, M., Stahmer, A., & Burns, A. (2007). Child demographics associated with outcomes in a community-based pivotal response training program. Journal Of Positive Behavior Interventions, 9(1), 52-60 Cabay, M. (1994). A controlled evaluation of facilitated communication using open-ended and fill-in questions. Journal of Autism and Developmental Disorders, 24(4), 517-527. doi: 10.1007/BF02172132 Callahan, K., Shukla-Mehta, S., Magee, S., & Wie, M. (2010). ABA versus TEACCH: the case for defining and validating comprehensive treatment models in autism. Journal of Autism and Developmental Disorders, 40(1), 74-88. doi: 10.1007/s10803-009-0834-0 Chan, J. M., & O'Reilly, M.,F. (2008). A social stories(tm) intervention package for students with autism in inclusive classroom settings. Journal of Applied Behavior Analysis, 41(3), 405-9. Greenberg, A., Tomaino, M., & Charlop, H. (2012). Assessing generalization of the picture exchange communication system in children with autism. Journal of Developmental and Physical Disabilities, 24(6), 539-558. doi: 10.1007s10882-012-9288-y Hanley-Hochdorfer, K. , Bray, M. , Kehle, T. , & Elinoff, M. (2010). Social stories to increase verbal initiation in children with autism and asperger's disorder. School Psychology Review, 39(3), 484-492
  • 30. Hume, K., Plavnick, J., & Odom, S. L., (2012). Promoting task accuracy and independence in students with autism across educational setting through the use of individual work systems. Journal of Autism and Developmental Disorders, 42(10), 2084-2099. DOI: 10.1007/s10803-012-1457-4 Kokina, A., & Kern, L. (2010). Social story[tm] interventions for students with autism spectrum disorders : A meta- analysis. Journal of autism and developmental disorders, 40(7), 812-826. doi: 10.1007/s10803-009-0931-0 Kuhn, L. R., Bodkin, A. E., Devlin, S. D., & Doggett, R. (2008). Using Pivotal Response Training with Peers in Special Education to Facilitate Play in Two Children with Autism. Education and Training In Developmental Disabilities, 43(1), 37-45. Retrieved from http://web.ebscohost.com.libproxy.csun.edu/ Leaf, J. B., Oppenheim-Leaf, M. L., Call, N. A., Sheldon, J. B., Sherman, J., Taubman, M., . . Leaf, R. (2012). Comparing the teaching interaction procedure to social stories for people with autism. Journal of Applied Behavior Analysis, 45(2), 281-298. doi: 10.1901/jaba.2012.45-281 Lerna, A., Esposito, D., Conson, M., Russo, L. and Massagli, A. (2012), Social–communicative effects of the Picture Exchange Communication System (PECS) in Autism Spectrum Disorders. International Journal of Language & Communication Disorders, 47: 609–617. doi: 10.1111/j.1460-6984.2012.00172.x Lyndon, H., Healy, O., & Leader, G. (2011) A comparison of Video Modeling and Pivotal Response Training to teach pretend play skills to children with Autism Spectrum Disorder. Research in Autism Spectrum Disorders, 5(2), 872-884 Mancil, G. R., Haydon, T., & Whitby, P. (2009). Differentiated effects of paper and computer-assisted social stories on inappropriate behavior in children with autism. Focus on Autism and Other Developmental Disabilities, 24(4), 205-215. doi: 10.1177/1088357609347324 McDuffie, A., Lieberman,R., & Yoder, P. (2012). Object interest in autism spectrum disorder : A treatment comparison. Autism, 16(4), 398-405. doi: 10.1177/1362361309360983
  • 31. Minjarez, M., Williams, S., Mercier, E., & Hardan, A. (2011). Pivotal response group treatment program for parents of children with autism. Journal Of Autism and Developmental Disorders, 41(1), 92-101. doi10.1007s10803-010- 1027-6 Panerai, S., Zingale, M., Trubia, G., Finocchiaro, M., Zuccarello, R., Ferri, R., & Elia, M. (2009). Special education versus inclusive education: the role of the TEACCH program. Journal of Autism and Developmental Disorders, 39(6), 874-882. doi:10.1007/s10803-009-0696-5 Perry, A., Bryson, S., & Bebko, J. (1998). Brief report: degree of facilitator influence in facilitated communication as a function of facilitator characteristics, attitudes, and beliefs. Journal Of Autism & Developmental Disorders, 28(1), 87-90. Simpson, R. L., & Myles, B. (1995). Effectiveness of facilitated communication with children and youth with autism. Journal of Special Education, 28(4), 424. Stahmer, A. C., Suhrheinrich, J., Reed, S., Bolduc, C., & Schreibman, L. (2010). Pivotal Response Teaching in the Classroom Setting. Preventing School Failure, 54(4), 265-274. doi:10.1080/10459881003800743 Tsang, S., Shek, D., Lam, L., Tang, F., & Cheung, P. (2007). Brief report: application of the TEACCH program on Chinese pre- school children with autism -- does culture make a difference?. Journal Of Autism and Developmental Disorders, 37(2), 390-396. DOI 10.1007/s10803-006-0199-6 Travis, J., & Geiger, M. (2010). The Effectiveness of the Picture Exchange Communication System (PECS) for Children with Autism Spectrum Disorder: A South African Pilot Study. Child Language Teaching and Therapy, 26(1), 39-59. doi: 10.1177/0265659009349971 Yoder, P., & Lieberman, R. (2010). Brief report: Randomized test of the efficacy of Picture Exchange Communication System on highly generalized picture exchanges in children with ASD. Journal Of Autism & Developmental Disorders, 40(5), 629-632. doi:10.1007/s10803-009-0897-y
  • 32. Comments • Professional quality staff development PP! • Great research and references! • Wonderful effort 200/200