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Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
Education and training in autism and developmental disabilities
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  • 1. Education and Training in Autism and Developmental Disabilities Focusing on individuals with autism, intellectual disability and other developmental disabilities Volume 47 Number 2 DADD June 2012
  • 2. June 2012 Education and Training in Autism and Developmental Disabilities Vol. 47, No. 2, pp. 125–252
  • 3. Education and Training in Autism and Developmental Disabilities The Journal of the Division on Autism and Developmental Disabilities, The Council for Exceptional Children Editor: Stanley H. Zucker Editorial Assistant: Kathleen M. Corley Arizona State University Mary Lou Fulton Teachers College Arizona State University Mary Lou Fulton Teachers College Consulting Editors Martin Agran Reuben Altman Phillip J. Belfiore Sharon Borthwick-Duffy Michael P. Brady Fredda Brown Mary Lynne Calhoun Sharon F. Cramer Caroline Dunn Lise Fox David L. Gast Herbert Goldstein Juliet E. Hart Carolyn Hughes Larry K. Irvin James V. Kahn H. Earle Knowlton Barry W. Lavay Rena Lewis Kathleen J. Marshall John McDonnell Gale M. Morrison Gabriel A. Nardi John Nietupski James R. Patton Edward A. Polloway Thomas G. Roberts Robert S. Rueda Diane L. Ryndak Edward J. Sabornie Laurence R. Sargent Gary M. Sasso Tom E. C. Smith Scott Sparks Fred Spooner Robert Stodden Keith Storey David L. Westling John J. Wheeler Mark Wolery Education and Training in Autism and Developmental Disabilities is sent to all members of the Division on Autism and Developmental Disabilities of The Council for Exceptional Children. All Division members must first be members of The Council for Exceptional Children. Division membership dues are $30.00 for regular members and $15.00 for full time students. Membership is on a yearly basis. All inquiries concerning membership, subscription, advertising, etc. should be sent to the Division on Autism and Developmental Disabilities, 2900 Crystal Drive, Suite 1000, Arlington, VA 22202-3557. Advertising rates are available upon request. Manuscripts should be typed, double spaced, and sent (five copies) to the Editor: Stanley H. Zucker, Mary Lou Fulton Teachers College, Box 871811, Arizona State University, Tempe, AZ 85287-1811. Each manuscript should have a cover sheet that gives the names, affiliations, and complete addresses of all authors. Editing policies are based on the Publication Manual, the American Psychological Association, 2009 revision. Additional information is provided on the inside back cover. Any signed article is the personal expression of the author; likewise, any advertisement is the responsibility of the advertiser. Neither necessarily carries Division endorsement unless specifically set forth by adopted resolution. Education and Training in Autism and Developmental Disabilities is abstracted and indexed in Psychological Abstracts, PsycINFO, e-psyche, Abstracts for Social Workers, International Journal of Rehabilitation Research, Current Contents/Social and Behavioral Sciences, Excerpta Medica, Social Sciences Citation Index, Adolescent Mental Health Abstracts, Educational Administration Abstracts, Educational Research Abstracts, and Language and Language Behavior Abstracts. Additionally, it is annotated and indexed by the ERIC Clearinghouse on Handicapped and Gifted Children for publication in the monthly print index Current Index to Journals in Education and the quarterly index, Exceptional Child Education Resources. Education and Training in Autism and Developmental Disabilities Vol. 47, No. 2, June 2012, Copyright 2012 by the Division on Austim and Developmental Disabilities, The Council for Exceptional Children. Division on Autism and Developmental Disabilities The Council for Exceptional Children Board of Directors Officers Members Past President Emily Bouck President Teresa Taber-Doughty President-Elect Richard Gargiulo Vice President Nikki Murdick Secretary Toni Merfeld Treasurer Gardner Umbarger Debra Cote Mark Francis Robert Sandieson Jordan Shurr (Student Governor) Debora Wichmanowski Dianne Zager Executive Director Tom E. C. Smith Publications Chair Michael Wehmeyer Communications Chair Darlene Perner Conference Coordinator Cindy Perras The purposes of this organization shall be to advance the education and welfare of persons with autism and developmental disabilities, research in the education of persons with autism and developmental disabilities, competency of educators in this field, public understanding of autism and developmental disabilities, and legislation needed to help accomplish these goals. The Division shall encourage and promote professional growth, research, and the dissemination and utilization of research findings. EDUCATION AND TRAINING IN AUTISM AND DEVELOPMENTAL DISABILITIES (ISSN 2154-1647) (USPS 0168-5000) is published quarterly in March, June, September, and December, by The Council for Exceptional Children, Division on Autism and Developmental Disabilities, 2900 Crystal Drive, Suite 1000, Arlington, Virginia 22202-3557. Members’ dues to The Council for Exceptional Children Division on Developmental Disabilities include $8.00 for subscription to EDUCATION AND TRAINING IN AUTISM AND DEVELOPMENTAL DISABILITIES. Subscription to EDUCATION AND TRAINING IN AUTISM AND DEVELOPMENTAL DISABILITIES is available without membership; Individual—U.S. $60.00 per year; Canada, PUAS, and all other countries $44.00; Institutions—U.S. $195.00 per year; Canada, PUAS, and all other countries $199.50; single copy price is $30.00. U.S. Periodicals postage is paid at Arlington, Virginia 22204 and additional mailing offices. POSTMASTERS: Send address changes to EDUCATION AND TRAINING IN AUTISM AND DEVELOPMENTAL DISABILITIES, 2900 Crystal Drive, Suite 1000, Arlington, Virginia 22202-3557.
  • 4. Education and Training in Autism and Developmental Disabilities VOLUME 47 NUMBER 2 JUNE 2012 Documenting Impact of Educational Contexts on Long-Term Outcomes for Students with Significant Disabilities 127 DIANE LEA RYNDAK, SANDRA ALPER, CAROLYN HUGHES, and JOHN McDONNELL Functional Curriculum and Students with Mild Intellectual Disability: Exploring Postschool Outcomes through the NLTS2 139 EMILY C. BOUCK and GAURI JOSHI Effects of a Self-Monitoring Strategy on Independent Work Behavior of Students with Mild Intellectual Disability 154 JENNIFER COUGHLIN, KATHLEEN M. McCOY, AMY KENZER, SARUP R. MATHUR, and STANLEY H. ZUCKER Teaching Social Skills to Children with Autism Using the Cool versus Not Cool Procedure 165 JUSTIN B. LEAF, KATHLEEN H. TSUJI, BRANDY GRIGGS, ANDREW EDWARDS, MITCHELL TAUBMAN, JOHN McEACHIN, RONALD LEAF, and MISTY L. OPPENHEIM-LEAF The Picture Exchange Communication System (PECS): A Promising Method for Improving Communication Skills of Learners with Autism Spectrum Disorders 176 JENNIFER B. GANZ, RICHARD L. SIMPSON, and EMILY M. LUND Teacher Education in Autism Spectrum Disorders: A Potential Blueprint 187 ERIC SHYMAN Anxiety Levels in Students with Autism Spectrum Disorder Making the Transition from Primary to Secondary School 198 ELIZABETH F. HANNAH and KEITH J. TOPPING Effectiveness of an Essay Writing Strategy for Post-Secondary Students with Developmental Disabilities 210 SUZANNE WOODS-GROVES, WILLIAM J. THERRIEN, YOUJIA HUA, JO HENDRICKSON, JULIA SHAW, and CHARLES HUGHES Comparison of the Effects of Video Models With and Without Verbal Cueing on Task Completion by Young Adults With Moderate Intellectual Disability 223 LINDA C. MECHLING and TERRI S. COLLINS Mainstream Teachers’ Experiences of Communicating with Students with Multiple and Severe Disabilities 236 TANIA DE BORTOLI, SUSAN BALANDIN, PHIL FOREMAN, MICHAEL ARTHUR-KELLY, and BERNICE MATHISEN Manuscripts Accepted for Future Publication in Education and Training in Developmental Disabilities 126 The Division on Autism and Developmental Disabilities retains literary property rights on copyrighted articles. Up to 100 copies of the articles in this journal may be reproduced for nonprofit distribution without permission from the publisher. All other forms of reproduction require permission from the publisher.
  • 5. Manuscripts Accepted for Future Publication in Education and Training in Autism and Developmental Disabilities September 2012 Cognitive strategy instruction for functional mathematical skill: Effects for young adults with intellectual disability. Youjia Hua, Benjamin S. T. Morgan, Erica R. Kaldenberg, and Minkowan Goo, University of Iowa, College of Education, Department of Teaching and Learning, N256 Lindquist Center, Iowa City, IA 52242. Effects of a video model to teach students with moderate intellectual disability to use features of an iPhone. Kathryn Walser, Kevin M. Ayres, and Erika Foote, Department of Special Education, The University of Georgia, 516 Aderhold Hall, Athens, GA 30602-7153. Group delivered literacy-based behavioral interventions for children with intellectual disability. Dana Keeter and Jessica L. Bucholz, University of West Georgia, Department of CSI / Ed Annex 228, 1601 Maple Street, Carrollton, GA 30118. Grade-aligned math instruction for secondary students with moderate intellectual disability. Diane M. Browder, Bree Jimenez, and Katherine Trela, The University of North Carolina at Greensboro, Department of Specialized Education Services, 421 School of Education Building, Greensboro, NC 27402-6170. Two approaches to phonics instruction: Comparison of effects with children with significant cognitive disability. Elizabeth Finnegan, St. Thomas Aquinas College, 125 Route 340, Sparkill, NY 10976. Using video modeling to teach young children with autism developmentally-appropriate play and connected speech. Sarah Clifford Scheflen, Stephanny F. N. Freeman, and Tanya Paparella, ECPHP, UCLA, Dept. of Child Psychiatry, 77-447 Semel Institute for Neuroscience, 760 Westwood Plaza, Los Angeles, CA 90024-1759. Preparing children with developmental disabilities for life in the community: A Tanzanian perspective. Angela Stone-MacDonald, Department of Curriculum and Instruction, University of Massachusetts, Boston, College of Education and Human Development, 100 Morrissey Blvd., Boston, MA 02125-3393. Comparing the effects of video prompting with and without error correction on skill acquisition for students with intellectual disability. Helen I. Cannella-Malone, Joe E. Wheaton, Pei-Fang Wu, Christopher A. Tullis, and Ju Hee Park, The Ohio State University, A348 PAES Building, 305 W 17th Avenue, Columbus, OH 43210. A review of academic mathematics instruction for students with mild intellectual disability. Casey Hord and Emily C. Bouck, 6108A, BRNG Hall, Purdue University, 100 N. University St., West Lafayette, IN 47907. Comparing teacher-directed and computer-assisted constant time delay to teaching functional sight words for students with moderate intellectual disability. Mari Beth Coleman, Kevin J. Hurley, and David F. Cihak, University of Tennessee, A416 Jane and David Bailey Education Complex, 1122 Volunteer Boulevard, Knoxville, TN 37996-3442. Increasing comprehension for middle school students with moderate intellectual disability on age-appropriate texts. Jordan Shurr and Teresa Taber-Doughty, Purdue University, Dept. of Educational Studies, 100 N. University Street, West Lafayette, IN 47907-2098. Address is supplied for author in boldface type.
  • 6. Education and Training in Autism and Developmental Disabilities, 2012, 47(2), 127–138 © Division on Autism and Developmental Disabilities Documenting Impact of Educational Contexts on Long-Term Outcomes for Students with Significant Disabilities Diane Lea Ryndak Sandra Alper University of Florida University of Northern Iowa Carolyn Hughes John McDonnell Vanderbilt University University of Utah Abstract: Follow-up studies of students with significant disabilities consistently indicate poor post-school outcomes. Although existing research indicates that services in inclusive general education contexts can result in positive short-term outcomes for these individuals during their school years, there are few investigations of the lives of adults with significant disabilities who experienced inclusive education over extended periods of time. Considering the lack of longitudinal studies, it currently is difficult to determine whether young adults lead more successful lives relative to employment, residential situations, use of leisure time, and friendships and social networks, as a function of inclusive education. This paper focuses on issues faced when conducting research to document the impact of contexts on long-term outcomes for students with significant disabilities, especially when addressing relative effectiveness of services in inclusive general education contexts and more restrictive contexts. Recommendations for future research and related policy and funding are suggested. In these times of accountability, when state and federal legislatures are linking both financial support for schools and salaries for teachers and administrators to student outcomes, attention is being turned to the short- and long-term outcomes that are expected for students with disabilities. With increased access to the general curriculum and inclusive general education contexts, students with disabilities are expected to make adequate yearly progress and earn regular diplomas. For students with significant disabilities this trend is resulting in many positive changes (e.g., increased acquisition of general education content; inclusion in district and state accountability measures). It also is raising questions about the desired outcomes of educational services for this group of students, as well as the efficacy of various forms of curriculum content, instructional practices, and instruc- Correspondence concerning this article should be addressed to Diane Ryndak, School of Special Education, School Psychology, and Early Childhood Studies, PO Box 117050, University of Florida, Gainesville, FL 32611-7050. tional contexts that comprise their educational experiences. With the passage of the Education for All Handicapped Children Act (1975) the education system was mandated for the first time to provide educational services for students with significant disabilities (Federal Register, 1977). As these mandated services were implemented, schools struggled with articulating the purpose of education for this set of students, as well as the curriculum content and instructional practices that would lead to outcomes that reflected that purpose of education. As described in the literature from that period, schools initially provided services for students with significant disabilities based on the curriculum content provided for students without disabilities who were performing at the same developmental level, demonstrating the same developmental skills and milestones (Williams & Gotts, 1977). For the most part, however, this content was taught in settings that segregated students with significant disabilities from classmates who did not have disabilities and the contexts in which they received instruction (Brown et al., 1978). Some school districts, however, had opted Impact of Educational Contexts / 127
  • 7. to provide special education services for students with significant disabilities prior to the 1975 mandate. One of those districts began to articulate a purpose of education for this set of students, as well as study the long-term outcomes for their graduates (Van Deventer et al., 1981). The Madison (Wisconsin) Metropolitan Schools stated that the purpose of education for students with significant disabilities was to assist in maximizing their independent functioning in the heterogeneous society of adults without disabilities, including where and how those adults work, live, spend leisure time, and access the community. To determine if their services were meeting this goal, the district studied where their graduates with significant disabilities were spending day time hours. Initially the district found that only 2% of these graduates spent day time hours in a non-sheltered work place, while 98% spent day time hours in a sheltered work place or at home. Since these outcomes did not reflect the district’s stated purpose of education for these students, the district changed the curriculum content taught and the instructional practices implemented for their current students with significant disabilities. The changes focused on teaching naturally-occurring (i.e., functional) activities in naturally-occurring contexts (i.e., general education and community contexts) with same-age peers who did not have disabilities. Thus, the district changed both the curriculum content taught and the context in which instruction occurred. After six years of implementing these changes, the district found that 91% of the new graduates spent day time hours in a nonsheltered work place, while only 9% spent day time hours in a sheltered work place or at home. The district concluded that these longterm outcomes more closely reflected their purpose of education for their graduates with significant disabilities, and that long-term student outcomes had improved after these changes in the curriculum content taught and the context in which the students received instruction. Over the decades, numerous studies have been conducted to determine the long-term outcomes for students with disabilities (Wagner, Blackorby, Cameto, & Newman, 1993; Wagner, Newman, Cameto, Levin, & Garza, 2006). Unfortunately, the methodologies used 128 / for such studies have not provided outcome data specifically related to graduates with significant disabilities. For example, the use of data submitted to the U. S. Office of Education limits analysis to disability classification and percent of time in general education. Since federal disability classifications do not include “significant disabilities” or “severe disabilities,” outcomes for students with significant disabilities must be extrapolated from data on the existing categories, using prevalence data. In addition, the studies on longterm outcomes focus heavily on employment. For individuals with significant disabilities who have exited school services, however, the focus must go beyond employment and include overall quality of life, including residential situations, use of leisure time, access to the community, and social networks. The issues faced when studying longitudinal outcomes for students with significant disabilities are affected further by the call for research in special education to match the rigor of research in non-educational fields, resulting in a delineation of quality indicators for various methodologies (Cook, Landrum, Cook, & Tankersley, 2008; Odom et al., 2005). While describing the need for quality indicators, Odom and his colleagues stated: “Special education research, because of its complexity, may be the hardest of the hardest-to-do science. One feature of special education research that makes it more complex is the variability of the participants” (p. 139). We would argue further that, while this is the case for special education overall, it is even more evident when considering special education for students with significant disabilities. Both the low-incidence of significant disabilities and the numerous combinations of disabilities affecting the students comprising this group add to the complexity of the participants and the individualized services they require. The very nature of these complexities limits the field’s ability to use randomized trials, large-N studies, and norm-referenced assessments to study the long-term outcomes for students with significant disabilities. This article has four purposes. First, we discuss social validity and the role of social validation methodology in the study of long-term outcomes for students with significant disabilities. Second, we discuss the extent to which Education and Training in Autism and Developmental Disabilities-June 2012
  • 8. social validity is evident in research on services in inclusive general education contexts, and on the teaching of social skills in high schools. Third, we discuss the current status of research on inclusive education and post-school outcomes, and the extent to which that research is socially valid in representing longterm outcomes for individuals with significant disabilities in relation to their quality of life, including employment, residential situations, use of leisure time, access to the community, and social networks. Finally, we make recommendations for future research and funding support. Social Validity and Long-Term Outcomes for Students with Significant Disabilities Definition and rationale for social validation. The concept of social validity reaches far beyond the field of education. Perceptions of the usefulness and satisfaction with consumer products (e.g., automobiles, home appliances, banking and credit card practices) have been influential in business and manufacturing for years. In the field of medicine, there are controversies as to whether medical practices should be (a) standardized (i.e., quantified) by diagnosis and not altered by a physician’s clinical judgment based on patients’ characteristics, or (b) tailored by a physician to match the characteristics of individual patients and the contexts in which they live (Groopman, 2010). The concept of social validity was first introduced in education by Kazdin (1977) and Wolf (1978). In part, it was conceived as a response to early concerns about whether or not instructional practices based on applied behavior analysis, with its emphasis on operationally defined behaviors and methods of influencing the consequences of responses, were too controlling, unethical, or undesirable (Kennedy, 2005). Prior to the 1970s and the development of values such as normalization, many persons with significant disabilities were routinely institutionalized in congregate, segregated, and dehumanizing settings. “Education” largely consisted of meaningless and repetitive activities, such as putting puzzles together, sorting objects, or stuffing envelopes with blank pieces of papers. Research efforts often were focused on demonstrating that these individuals were capable of learning. Unfortunately, little emphasis was placed on the value and meaningfulness of the skills they were being taught; rather, more emphasis was placed on the assessment of a person’s disability than on the person’s demonstration of competence as validated by learning new and meaningful skills. More recently, however, the importance of documenting whether or not a particular educational intervention results in positive outcomes in reading, math, science, social, or employment skills within the context of school and community settings for all students has been recognized. Equally important are the reactions and perceptions of the intervention by persons in these settings. For students with significant disabilities, educational interventions involve teachers, students without disabilities, family members, administrators, and community members. Questions concerning the relevance of instructional content, instructional practices, and short- and long- term outcomes of instruction, as well as consumer satisfaction, are just as controversial today as they have been for decades. Social validation methodology was developed to better understand and interpret the larger social context in which instruction and learning occur. It represents an attempt to address the relevancy, effectiveness, usefulness, and appropriateness of curriculum content, instructional methods, education supports, and outcomes of instruction as perceived by various stakeholders in educational and other applied settings. Kennedy (2005) pointed out that social validity is not objective, precise, or quantifiable; rather it is a subjective concept. Perceptions of educational interventions change, therefore, relative to several variables, such as the priorities of different stakeholders, time, location, and social mores. Social validity is particularly important when attempting to evaluate the long-term outcomes for students with significant disabilities. For nearly four decades, the dismal outcomes of post-school follow-up studies of students with disabilities, and particularly those with significant disabilities, have indicated low rates of employment, dependence on family members or social welfare, few social contacts, and long periods of inactivity (see National Center on Disability and Social Security Administration, 2000). The results of these stud- Impact of Educational Contexts / 129
  • 9. ies raise serious concerns about the social validity of education for these students. Assessing social validity in education. Three basic approaches have evolved to estimate social validity in education: (a) subjective evaluation, (b) normative comparison, and (c) sustainability of results. Subjective evaluation involves the perceptions of instructional relevancy by some group or groups of stakeholders (Kazdin, 1977; Wolf, 1978). Students, family members, teachers, school administrators, or community members may be asked to rate the importance of instructional goals, methods, and outcomes. The advantage of subjective evaluation is that consumer input is gathered and valued. However, there are at least two disadvantages to this method. First, different sets of stakeholders, as well as individual people, have different perceptions of what is meaningful and relevant at any point in time (e.g., parents’ and teachers’ priorities for instructional objectives). Second, consumer perceptions of a particular intervention might be unrelated to positive outcomes, particularly long-term outcomes. Normative comparison, sometimes referred to as social comparison, involves comparing the performance of students with disabilities with some other reference group (e.g., sameage peers without disabilities) (Kazdin, 1977; Van Houten, 1979; Wolf, 1978). Normative comparison is always dependent on social standards. Compare, for example, federal or state mandated standardized age-normed tests versus teacher criteria for individualized student performance within a particular classroom, or differential expectations of employers. Normative comparison is based on criteria within a given context; however, a disadvantage centers on the question of whether or not meeting “average” standards is always advantageous for a particular individual. Using normative comparisons can minimize the appreciation of unique human differences and lead to expectations that all persons should be held to the same standard. Finally, questions linger as to what exactly would constitute an appropriate reference group for students with significant disabilities. Sustainability of results refers to the question of whether or not the outcomes of instruction are maintained over time (Kennedy, 2002). This approach to social validation is 130 / extremely important as we attempt to document the long-term efficacy of education in inclusive general education contexts. Clearly, studies have documented the short-tem effects of services in inclusive general education contexts (e.g., Alper & Ryndak, 1992; Fisher & Ryndak, 2001; Ryndak & Fisher, 2003). The disadvantage is that many behavioral changes are not maintained without sustained intervention. A host of intervening variables (e.g., different teachers, individual student characteristics, changing local standards, inconsistent support services) exacerbate the methodological difficulties of relating services in inclusive general education contexts to postschool outcomes for persons with significant disabilities (Ryndak, Ward, Alper, Montgomery, & Storch, 2010). Failure to apply social validation methodology. We argue that one factor contributing to the poor post-school outcomes characteristic of many adults with significant disabilities is the failure of special education policy makers and researchers to socially validate the prevailing high school curricula, instructional strategies, and service delivery models with respect to long-term outcomes. Studies indicate that those who have the most at stake with respect to the post-school outcomes of secondary curricula (e.g., parents, students, employers) often have little or no input into the curriculum goals, instructional procedures, and outcomes that comprise the content and delivery of high school programs for this population (e.g., Kolb & Hanley-Maxwell, 2003). Unless systems change agents systematically apply social validation methodology and solicit the views of participants most directly involved in the transition from school to adult life, and incorporate their perspectives into programmatic decisions, secondary curricula likely will fail to effectively address the participants’ long-term values, goals, and needs. To illustrate, employment and follow-up studies have indicated since the 1980s that the primary cause of people with disabilities lose their jobs is not because they cannot perform required tasks, but because of difficulty fitting in socially in the workplace (e.g., Brickey, Campbell, & Browning, 1985; Butterworth & Strauch, 1994; Chadsey, 2007; Greenspan & Shoultz, 1981; Kochany & Keller, 1981; Wehman, Hill, Goodall, Cleveland, & Pentecost, Education and Training in Autism and Developmental Disabilities-June 2012
  • 10. 1982). Social validation studies conducted in employment settings indicate that employers of people with disabilities have expectations for their employees on the job (e.g., interacting with co-workers at breaks, requesting and providing assistance, responding appropriately to constructive criticism) and that little tolerance exists for behaviors such as yelling, complaining, assaulting others, invading privacy, or interrupting meetings unannounced (e.g., Agran, Salzberg, & Martella, 1991; McConaughy, Stowitschek, Salzberg, & Peatross, 1989; Salzberg, Agran, & Lignurgaris/Kraft, 1986). At the same time, employers do not believe it is their job to teach expected social skills; rather, employers typically hold that employees with or without disabilities should enter employment with “job-ready” social skill repertoires so supervisors can focus on training requisite skills to maximize job performance (Butterworth & Strauch, 1994). We argue that if employers’ perspectives were heeded, a critical component of secondary programs for students with significant disabilities would be teaching socially validated social skills. However, doing so does not appear to be the case. For example, Guy, Sitlington, Larsen, and Frank’s (2009) statewide study revealed that employment training, in general, is limited in secondary education programs. Even when employment training is implemented, its main focus is teaching technical skills versus job-related social skills. Social Validity of Inclusive Education and Teaching Social Skills in High Schools Inclusive education in secondary general education classes and post-school outcomes. Research indicates that receiving services in inclusive secondary general education classes and demonstrating accepted social skills relate to postschool employment success for students with significant disabilities (e.g., Baer et al., 2003; Benz, Yovanoff, & Doren, 1997; Blackorby, Hancock, & Siegel, 1993; Heal & Rusch, 1995; Test et al., 2009; White & Weiner, 2004). A fundamental argument supporting the inclusion of high school students with significant disabilities in general education classes is that these students need access to their general education peers as models of expected social behavior (e.g., Alwell & Cobb, 2009; Naraian, 2010). Being educated in separate, segregated settings restricts opportunities to develop relationships and learn social skills needed for everyday life in school and adult life. On the other hand, interacting with their general education peers can promote acquisition of social skills when peers serve as models of expected behavior (e.g., Hughes et al., 2000). The logical place to teach social skills valued on the job and in adult life is in a student’s high school environment where an abundance of peers is found, who are competent in performing everyday social interactions. Indeed, studies show that general education peers can be effective teachers of appropriate social skills for students with significant disabilities, and that these skills can generalize to individuals and settings not associated with instruction (e.g., Hughes et al., 2004; Hughes et al., 2000; Hunt, Alwell, Goetz, & Sailor, 1990). Rather than wait until students are in a post-school employment setting, researchers, employers, parents, and others argue that social skills instruction should be provided in secondary curricula for students with intellectual and related disabilities (Kolb & Hanley-Maxwell, 2003). Considering that limited social skills is a characteristic of many students with intellectual disabilities (The AAIDD Ad Hoc Committee on Terminology and Classification, 2010), high schools must be responsible for teaching social skills to students with significant disabilities who have not yet acquired these critical skills. The fact that social skills instruction with peers is not occurring regularly in high school on a regular basis (Carter & Hughes, 2007) is a blatant failure to apply social validation methodology to the secondary curriculum in relation to long-term outcomes of students with significant disabilities. Social validation of teaching social skills: Parents’ perspectives. As discussed earlier, one method of social validation (i.e., subjective evaluation) includes querying stakeholders about their goals and expected short- and long-term outcomes for a proposed or ongoing program. Particularly as youth get closer to exiting school, there is a growing concern among parents to have their children learn social skills needed to get along on the job and in the community. Their collective concerns are an example of social validation: par- Impact of Educational Contexts / 131
  • 11. ents are saying that social skills are critical to success in adult society (e.g., Hughes, Brigham, & Cosgriff, 2010; Hughes, Killian, & Fischer, 1996). Parents report (a) wanting their high school-age children to learn to fit in socially by learning critical social skills, and (b) believing that classmates without disabilities can teach their children these skills (Hughes et al.). For example, upon hearing that his son could participate in a peer mentoring program at his high school, one father said, “It’s about time--we’ve needed this for so long.” He expressed how critical it was for his son to learn what is and is not appropriate behavior, both to promote relationships with peers and to learn what was expected on the job. One mother expressed concerns that her son was close to exiting high school but lacked socially appropriate skills required in the work place. She indicated that, “What we need now more than anything is social skills,” and that this was her top priority for her son’s participation in the peer mentoring program. She followed up by saying that society wants students to go on to be “card-carrying, tax-paying citizens” and in order to do so, it was critical that her son learn the social behaviors expected in adult life while he was still in high school. Despite parents’ strong views on the value of incorporating social skills instruction into the school day for their children with significant disabilities, rarely is their input sought on the content of secondary curricula and instructional activities (Kolb & Hanley-Maxwell, 2003). Further, unless instruction on social skills occurs, there is little likelihood that schools will provide the social interaction and opportunities to learn social skills that parents value, even when their children with significant disabilities have access to general education classmates (e.g., Carter, Hughes, Guth, & Copeland, 2005; Hughes, Carter, Hughes, Bradford, & Copeland, 2002). Unfortunately, observational studies show that instruction on social skills rarely occurs in general education high school contexts (Carter et al.), suggesting that parents’ perspectives and goals are not being incorporated into identifying relevant secondary curriculum content. Applying social validation methodology to high school curriculum. Parents, employers, and researchers are calling for opportunities for stu- 132 / dents with significant disabilities to learn the social skills needed for employment and other aspects of adult life from their classmates without disabilities while in high school. For this to occur, secondary curricula should be preparing students with significant disabilities for employment and other aspects of adult life. We argue that support should be provided by funding agencies (e.g., Institute of Education Sciences) to systematically conduct social validation research investigating the perspectives of critical stakeholders toward instruction on social interaction, and that these views be considered when identifying the secondary curriculum content for students with significant disabilities. Underutilization of social validity in educational research. The underutilization of social validity in educational research is related to the overarching questions of the purpose of education. In general education for students without disabilities, controversy exists over the desired outcomes of education. Should the goal of education be to develop well-rounded educated individuals with a broad base of knowledge, or to focus on job readiness for the global economy? Similar questions have been raised as to the purpose of inclusion in general education contexts. Should the primary emphasis of inclusion be the development of social skills and friendships, or should the emphasis be broadened to include readiness to work, live, and participate in the community? Our position is that both emphases are crucial. Incorporating the development of social skills and friendships into the purpose of education in general education contexts for students with significant disabilities need not jeopardize their development of skills needed for employment and living in the community. Unfortunately, disagreement on these questions compounds efforts to assess social validity. Finally, not all special education researchers are focused on the long-term goals of improving quality of life after school years. Many scholars, understandably, emphasize effective ways for students with disabilities to meet state standards for grade-level performance in math, reading, and science related to provisions of the No Child Left Behind Act. Few researchers have addressed the social validity Education and Training in Autism and Developmental Disabilities-June 2012
  • 12. of inclusion in general education contexts relative to post-school outcomes. Current Status of Research on Services in Inclusive Contexts and Post-School Outcomes While research examining inclusive education for students with significant disabilities has significantly increased over the last decade (Halvorsen & Neary, 2009; Ryndak & Alper, 2003), the primary dependent variables used in the majority of the research studies have focused on short-term social and educational outcomes. For example, in a research review on promoting social interactions between students with significant disabilities and their peers without disabilities, Carter and Hughes (2007) concluded that creating common social and educational experiences between students with and without disabilities results in increased acceptance of students with significant disabilities, increased frequency and quality of social interactions between peers, and the development of friendships during and after school hours (Carter & Hughes). However, they also point out that “In most research studies, the long-term effects of interventions have not been evaluated, highlighting the need for longitudinal evaluations that extend over the course of multiple semesters or school years” (p. 321). Similarly, Hunt and McDonnell (2007) examined research on strategies for supporting effective instruction to students with significant disabilities in general education classes. They concluded that a number of studentand classroom-based interventions have proven to be effective in promoting students’ acquisition of a variety of academic and functional skills. They also noted that a pervasive weakness in this research literature was a lack of attention by researchers to the generalization of skills to day-to-day activities, the maintenance of skills across time, and the longterm impacts on students’ overall quality of life. The intervention literature clearly documents that, as a field, we have effective strategies for increasing immediate social and educational outcomes for students with significant disabilities in general education classes. The assumption is that students’ participation in general education classes, and their improved social and education performance in these contexts, will lead to better outcomes and enhanced quality of life after they exit school. Unfortunately, the nature of the intervention studies completed to date simply do not yet allow for this conclusion. Some evidence supporting the long-term benefits of inclusive education can be found in studies that have examined the status of students after they leave school (Benz, Lindstrom, & Yovanoff, 2000; Benz et al., 1997; Heal, Khoju, & Rusch, 1997; Ryndak, Ward, Alper, Montgomery, & Storch, 2010; Ryndak, Ward, Alper, Storch, & Montgomery, 2010; Wagner et al., 1993; Wagner et al., 2006; White & Weiner, 2004). For example, White and Weiner conducted a correlational study examining the relationship between educational placement and community-based instruction on employment outcomes for 104 young adults with significant disabilities. One of the strongest predictors of paid, community employment for these students following school was the degree to which they were included in general education contexts with age-appropriate peers prior to graduation. In a retrospective qualitative study, Ryndak, Ward, Alper, Montgomery, and Storch (2010) examined the impact of inclusive education on two individuals with severe significant disabilities who attended the same self-contained class when they were 15 years of age. Data sources included: (a) observations at age 15 and 25; (b) interviews with the individuals with significant disabilities, family members, friends, and adult service providers; and (c) educational and adult services records. One of these individuals was identified as the “highest functioning” student in their class and the other was identified as the “lowest functioning” student. In subsequent school years the “highest functioning” student remained in self-contained classes while the “lowest functioning” student received services in general education classes. Three years after exiting the educational system the “lowest functioning” student consistently had been employed as a judicial system government employee, living in an apartment with weekly support for budgeting and independent functioning, and participating within an extensive social support network. In contrast, the “highest functioning” student had lost numerous jobs and Impact of Educational Contexts / 133
  • 13. at the time was working at a sheltered workshop, was living with family members, and had no social support network beyond family members. Finally, the National Longitudinal Transition Study (NLTS) I and the National Longitudinal Transition Study (NLTS) II funded by the U. S. Department of Education have also attempted to identify educational and school factors that influence post-school outcomes for students with disabilities. Findings from these studies also suggest that taking courses in the general education curriculum, especially vocational education courses, has a positive impact on students’ post-school outcomes (Wagner et al., 1993; Wagner et al, 2006). Although the available evidence suggests that inclusive education has a positive impact on post-school outcomes, most of the published research studies on post-school outcomes were not designed to specifically examine the relationship between students’ participation in general education classes and the general education curriculum, and their quality of life following school. Some of the limitations of the existing studies include: ● ● ● ● ● The primary dependent variables of postschool adjustment are overly focused on employment outcomes. Data on variables linked to individuals’ levels of independence, self-determination, community participation, depth and breadth of social networks, and overall satisfaction with quality of life are essentially nonexistent. Measures of the characteristics of services in inclusive general education contexts are broad (i.e., number of general education courses taken, amount of time in general education classes) and do not address the range, intensity, or quality of instruction that students receive in these contexts. The measures of academic performance and social connectedness are weak if they exist at all. Measures of student and family characteristics are broad and often don’t address variables that might influence student performance during school or access to resources after school (e.g., family income). The impacts of community characteristics (i.e., rural vs. urban; levels of unemploy- 134 / ● ● ● ment; affordable housing) are frequently not controlled for when drawing conclusions about students’ post-school outcomes. The type, intensity, and quality of community services and supports available to graduates are rarely controlled for when drawing conclusions about post-school outcomes. Measures of school and post-school experiences often are based on student and parent reports, or analysis of school or agency records, rather than direct observation. The number of students with significant disabilities, especially those with more significant disabilities, represents a small portion of the sample which prevents a comprehensive analysis of the features of students’ educational experiences that might impact post-school outcomes. What these limitations point out is that addressing the question of how inclusive education, and students’ access and progress in the general education curriculum, impact their post-school outcomes will require the implementation of one or more national longitudinal studies that systematically track the breadth, intensity, and quality of the participation of students with intellectual and developmental disabilities in general education classes and the general education curriculum throughout their school years and into adulthood. Discussion We have addressed some of the methodological issues in documenting post-school outcomes for students with significant disabilities. Specifically, we focused on the importance of social validity, the need for more emphasis during high school on social skills related to employment and other long-term outcomes, and the need for longitudinal studies focused on young adults with significant disabilities. Based on our review of the literature, the following recommendations for practitioners and researchers are offered. Recommendations for Increasing Emphasis on Social Validity First, there is a need for more consumer input during the school years about curriculum goals. Too often, general and special educa- Education and Training in Autism and Developmental Disabilities-June 2012
  • 14. tors, parents, and school administrators disagree. These issues are exacerbated by legislative mandates and the economy. Many times, issues involving post-school outcomes are simply not addressed until shortly before or after exiting school. In addition, there is a need for more student input into their own educational program based on their desires for the future. There is a great need to encourage teachers, students, family members, administrators, and researchers to think ahead and consider options for post-school options. Second, implications for teacher preparation should be reconsidered. General education teachers need to be better trained to adapt and accommodate curriculum for students with disabilities and recognize that not all students can or should meet the same performance criteria. Many higher education faculty in elementary and secondary general education are more focused on curriculum content of academic subjects rather than meeting individual needs of diverse learners. Most states mandate only a two to three credit hour course in meeting the needs of diverse learners for general education teacher licensure, and many of these courses focus primarily on students with mild disabilities. Unfortunately, student teachers all too often are trained in non-inclusive settings with little or no contact with students with significant disabilities. Ryndak and Alper (2003) developed a model for determining relevant curriculum content for a student with significant disabilities that blends relevant general education content and functional content. The primary advantage of this model is that it enables students with significant disabilities to remain in general education contexts and have access to the general curriculum while, at the same time, receive instruction that facilitates participation, as independently as possible, in context-based activities (e.g., in school, on the job, in other aspects of adult life in the community). This model relies on collaboration between special and general educators, as well as the students, their family members, and their social support network. Third, mastering the technical and social skills needed for successful post-school outcomes for students with significant disabilities is, in part, contingent on the context of in- struction. Instruction in the natural contexts in which skills typically are used is a priority in the education of secondary students with significant disabilities. Currently there are two variables that impact the instructional contexts for these students. First, many researchers, schools, and parents differentiate the context for instruction based on a student’s age; that is, through the age of 18 many students with significant disabilities receive instruction in the same contexts as their same-age peers who do not have disabilities. Thus, if there is a community-based employment training program for general education students in a high school, a student with significant disabilities might receive instruction on employment skills with those general education students in the same employment contexts. When general education students exit school services at age 18, students with significant disabilities would either receive community-based services (i.e., on the job, in residential situations, in the community-at-large) through age 22, or attend post-secondary education programs on university or college campuses. In contrast, some researchers, schools, and parents differentiate the context for instruction based on the curriculum content they choose for the student to learn. For instance, the emphasis of NCLB on meeting general education academic standards might result in maximizing students’ participation in academic contexts with their same-age peers in both secondary and post-secondary settings; emphasis on transitioning to adult life in the community might result in maximizing a student’s participation in community-based contexts (e.g., employment sites, residential situations). John Dewey held that a child is best prepared for life as an adult by being allowed to blend what is learned in school with life outside of school and experiencing that which has meaning in his/her life. The dilemma facing schools today is focusing on the individualized needs and future goals of a student with significant disabilities, and maximizing their educational experiences related to both general education content and their functional needs. Additionally, the education system must struggle with the concept that the effectiveness of education services for all students will not necessarily be based solely on standardized state and district assessments. Impact of Educational Contexts / 135
  • 15. Need for Longitudinal Studies Design and implementation of a comprehensive longitudinal study for students with significant disabilities would require a significant financial investment by the federal government and the participation of researchers from a number of disciplines. This effort would face a number of methodological challenges including obtaining a national representative sample; defining and quantifying the critical dimensions of education in inclusive general education contexts; obtaining reliable and valid measures of student learning and social adjustment during school; defining and quantifying meaningful post-school outcomes; and controlling for variation in school-based and post-school services. However, such an endeavor could have significant benefits in informing educational policy for this group of students for years to come. Given the current state of research on the impact of services in inclusive general education contexts, as well as the mandates in NCLB (2001) and IDEA (2004) on students’ access to and progress in the general curriculum, it would seem prudent to ascertain what elements of students’ participation in the general curriculum directly impacts their post-school outcomes. We need to know whether learning content from the general curriculum, learning social and functional skills that are linked directly to students’ post-school contexts and outcomes, participating in general education classes and activities, or all three make a difference in the effectiveness of students’ educational programs. We also need to know whether holding schools accountable only for short-term learning and social outcomes is having the intended impacts. We might find that if we really want to improve the quality of education for students with significant disabilities, then schools should instead be held responsible for whether students successfully transition into post-secondary education or employment, and participate fully in the social and cultural networks of the community. References AAIDD Ad Hoc Committee on Terminology and Classification (2010). Intellectual disability: Definition, classification, and systems of supports (11th ed.). 136 / Washington, DC: American Association on Intellectual and Developmental Disabilities. Agran, M., Salzberg, C. L., & Martella, R. C. (1991). Expectancy effects in social validation methodology: Are there differential expectations for employees with mental retardation? Research in Developmental Disabilities, 12, 425– 434. Alper, S., & Ryndak, D.L. (1992). Hey, don’t forget about us! Educating students with severe handicapping conditions in integrated elementary programs. Elementary School Administrators’ Journal, 92, 373–387. Alwell, M., & Cobb, B. (2009). Social and communicative interventions and transition outcomes for youth with disabilities: A systematic review. Career Development for Exceptional Individuals, 32, 94 –107. Baer, R., Flexer, R., Beck, S., Amstutz, N., Hoffmon, L., Brothers, J., & Zechman, C. (2003). A collaborative followup study on transition. Career Development for Exceptional Individuals, 26, 7–25. Benz, M. R., Lindstrom, L., & Yovanoff, P. (2000). Improving graduation and employment outcomes of students with disabilities: Predictive factors and student perspectives. Exceptional Children, 66, 509 –529. Benz, M. R., Yovanoff, P., & Doren, B. (1997). School-to-work components that predict postschool success for students with and without disabilities. Exceptional Children, 63, 151–165. Blackorby, J., Hancock, G. R., & Siegel, S. (1993). Human capital and structural explanations of postschool success for youth with disabilities: A latent variable exploration of the National Longitudinal Transition Study. Menlo Park, CA: SRI International. Brickey, M. P., Campbell, K. M., & Browning, L. J. (1985). A five-year follow-up of sheltered workshop employees placed in competitive jobs. Mental Retardation, 20, 67– 83. Brown, L., Branston, M. B., Hamre-Nietupski, S., Johnson, F., Wilcox, B., & Gruenewald, L. (1978). A rationale for comprehensive longitudinal interactions between severely handicapped students and nonhandicapped students and other citizens. American Association for the Education of the Severely and Profoundly Handicapped Review, 4, 3–14. Butterworth, J., & Strauch, J. D. (1994). The relationship between social competence and success in the competitive work place for persons with mental retardation. Education and Training in Mental Retardation and Developmental Disabilities, 29, 118 –133. Carter, E. W., & Hughes, C. (2007). Social interaction interventions: Promoting socially supported environments and teaching new skills. In S. L. Odom, R. H. Horner, M. E. Snell, & J. Blacher (Eds.), Handbook of developmental disabilities (pp. 310 –329). New York: The Guilford Press. Education and Training in Autism and Developmental Disabilities-June 2012
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  • 17. sive settings. Upper Saddle River, NJ: Allyn and Bacon. Ryndak, D. L., & Fisher, D. (Eds.) (2003). The foundations of inclusive education: A compendium of articles on effective strategies to achieve inclusive education (2nd ed.). Baltimore: Paul H. Brookes. Ryndak, D. L.,Ward, T., Alper, S., Montgomery, J., & Storch, J. F. (2010). Long-term outcomes of services for two persons with significant disabilities with differing educational experiences: A qualitative consideration of the impact of education experiences. Education and Training in Autism and Development Disabilities, 45(3), 323–338). Ryndak, D. L., Ward, T., Alper, S., Storch, J. F., & Montgomery, J. (2010). Long-term outcomes of services in inclusive and self-contained settings for siblings with comparable significant disabilities. Education and Training in Autism and Developmental Disabilities, 45, 38 –53. Salzberg, C. L., Agran, M., & Lignugaris/Kraft, B. (1986). Behaviors that contribute to entry-level employment: A profile of five jobs. Applied Research in Mental Retardation, 7, 299 –314. Test, D. W., Mazzotti, V. L., Mustian, A. L., Fowler, C. H., Kortering, L., & Kohler, P. (2009). Evidenced-based secondary transition predictors for improving postschool outcomes for students with disabilities. Career Development for Exceptional Individuals, 32, 160 –181. Van Deventer, P., Yelinek, N., Brown, L., Schroeder, J., Loomis, R., & Gruenewald, L. (1981). A follow-up examination of severely handicapped graduates of the Madison Metropolitan School District from 1971–1978. In L. Brown, K. Baumgart, I. Pumpian, J. Nisbet, A. Ford, A. Donnellan, M. Sweet, R. Loomis, & J. Schroeder (Eds.), Educational programs for severely handicapped students, Vol. XI. Madison, WI: Madison Metropolitan School District. Van Houten, R. (1979). Social validation: The evo- 138 / lution of standards of competency for target behaviors. Journal of Applied Behavior Analysis, 12, 581–591. Wagner, M., Blackorby, J., Cameto, R., & Newman, L. (1993). What makes a difference? Influences on postschool outcomes of youth with disabilities. The third comprehensive report from the National Longitudinal Transition Study of Special Education Students. Menlo Park, CA: SRI International. Wagner, M., Newman, L., Cameto, R., Levine, P., & Garza, N. (2006). An overview of findings from the Wave 2 of the National Longitudinal Transition Study-2. Menlo Park, CA: SRI International. Retrieved June 24, 2009, from http://www.nlts2.org/reports/ 2006_08/nlts2_report_2006_08_complete.pdf Wehman, P., Hill, M., Goodall, P., Cleveland, V. B., & Pentecost, J. (1982). Job placements and follow-up of moderately and severely handicapped individuals after three years. Journal of the Association for the Severely Handicapped, 7, 5–15. White, J., & Weiner, J. S. (2004). Influence of least restrictive environment and community based training on integrated employment outcomes for transitioning students with severe disabilities. Journal of Vocational Rehabilitation, 21, 149 –156. Williams, W., & Gotts, E. A. (1977). Selected considerations on developing curriculum for severely handicapped students. In E. Sontag, J. Smith, & N. Certo (Eds), Educational programming for the severely and profoundly handicapped. Reston, VA: Council for Exceptional Children. Wolf, M. M. (1978). Social validity: The case for subjective measurement, or how applied behavior analysis is finding its heart. Journal of Applied Behavior Analysis, 11, 203–214. Received: 3 February 2011 Initial Acceptance: 6 April 2011 Final Acceptance: 25 May 2011 Education and Training in Autism and Developmental Disabilities-June 2012
  • 18. Education and Training in Autism and Developmental Disabilities, 2012, 47(2), 139 –153 © Division on Autism and Developmental Disabilities Functional Curriculum and Students with Mild Intellectual Disability: Exploring Postschool Outcomes through the NLTS2 Emily C. Bouck and Gauri Joshi Purdue University Abstract: While students with mild intellectual disability receive less attention in research, their educational programming is still important, including the curriculum they receive in school. This study analyzed the National Longitudinal Transition Study-2 (NLTS2) as to the curriculum students with mild intellectual disability received in high school as well as students’ postschool outcomes. Frequency distributions, cross tabulations and logistic regression were utilized to analyze secondary data from the NLTS2. Results indicated few students with mild intellectual disability received a functional curriculum and receipt of a functional curriculum did not influence postschool outcomes. The implications and future directions of these results are discussed. Students with mild intellectual disability once comprised the largest focus in special education and the category was often considered the foundation of the field (Bouck, 2007; Edgar, 1987; Polloway, 2006). But now it is a population in decline (Polloway), referred to by some as the forgotten generation (Fujiura, 2003). Students with mild intellectual disability are now often given other category labels, such as learning disabilities, and lumped into the category of high incidence disabilities or mild disabilities, despite not having mild needs (Polloway, 2004; Smith, 2006). The result of this melding is a loss of specific consideration for students with mild intellectual disability in terms of curriculum, instructional environments, and postschool outcomes (Polloway, 2004; 2005). In fact, Polloway (2004, 2005) wrote a eulogy for the field of mild intellectual disability and cited a lack of attention, research, and advocacy for this population of students and their educational needs. And yet, students with mild intellectual disability still exist and continue to have educational needs and concerns that need to be Correspondence concerning this article should be addressed to Emily C. Bouck, 5146 BRNG Hall, 100 N. University St., West Lafayette, IN 47907. Email: bouck@purdue.edu addressed in research and practice. Attention needs to be paid to this group of students’ educational services and their postschool outcomes. Mild intellectual disability is “characterized by significantly subaverage intellectual functioning, existing concurrently with related limitations in two or more of the following applicable adaptive skill areas: communication, self-care, home living, social skills, community use, self direction, health and safety, functional academics, leisure, and work” (Polloway, Patton, Smith, & Buck, 1997, p. 298). Historically and collectively, students with mild intellectual disability struggled with short attention spans and distractibility (Dunn, 1973; Kirk, 1972; Thomas, 1996; Zeaman & House, 1963, 1979). Other characteristics often associated with this population of students include difficulty transferring and generalizing information, inputting information into memory, and retrieving information from memory (Belmont, 1966; Dunn; Kirk; Spitz, 1973; Stephens, 1972; Thomas). In opposition to the aggregation of students with mild intellectual disability with other high incidence disability categories, Sabornie, Evans, and Cullinan (2006) suggested how students with mild intellectual disability were different from students with learning disabilities and emotional/behavior disorders in the domains of Functional Curriculum and Students with MID / 139
  • 19. IQ and academic achievement/skills (i.e., students with mild intellectual disability had lower IQs and lower academic achievement/ skills). Historically, students with mild intellectual disability have experienced poor postschool outcomes. Although aggregated, in the National Longitudinal Transition Study (NLTS), Blackorby and Wagner (1996) found only a 35% employment rate for students with intellectual disability. In 2009, from the National Longitudinal Transition Study 2 (NLTS2) Newman, Wagner, Cameto, and Knokey indicated only 31.0% of students were currently employed, although the data showed 51.8% had been employed sometime since they graduated from high school. Additionally, Newman et al. found only 14.1% of students with intellectual disability report living independently. For postsecondary institution attendance, Kaye (1997) reported 2.5% of students with intellectual disability participated in some form of postsecondary education; more recent data from the NLTS2 indicated an increase to 13% (Newman, 2005b). as a life skills curriculum, is designed to teach functional life skills, or in other words, the skills necessary to live, work, and have fun in an inclusive community (Bouck; Brown et al., 1979). A functional curriculum is presumed to include the functional skills and applications of core subject areas (academics), vocational education, community access, daily living, financial, independent living, transportation, social/relationships, and self-determination (Patton, Cronin, & Jairrels, 1997). A functional curriculum stems from the belief that the general academic curriculum fails to provide students with mild intellectual disability an opportunity to develop skills they will need to be successful postschool and they would not develop these skills unless explicitly taught (Bouck; Sitlington, Frank & Carson, 1993). Hence, a functional curriculum approach is characterized by the consideration of teaching students with mild intellectual disability the skills to help them be productive members of society, and support positive postschool outcomes. Postschool Outcomes Functional Curriculum Given the poor postschool outcomes, one needs to consider the educational programming students with mild intellectual disability receive. In a survey of one state, secondary special education teachers reported a range of curricular offerings for students with mild intellectual disability: 23.8% used a special education curriculum, 19% a functional curriculum, and 15.3% a general education curriculum; the remaining teachers used small frequencies of other models (e.g., lower grade level, vocational education, no curriculum) (Bouck, 2004a). Teachers in this study reported being unsatisfied with the educational programming for secondary students with mild intellectual disability and indicated one of the greatest improvement needs for their program was a more appropriate curriculum (Bouck). One curriculum advocated for secondary students with mild intellectual disability is a functional curriculum (Bouck, 2004b; Edgar, 1987; Kaiser & Abell, 1997; Patton, Cronin, Polloway, Hutchinson, & Robinson, 1989). A functional curriculum, sometimes referred to 140 / While a lack of research exists regarding the outcomes of a functional curriculum for secondary students with mild intellectual disability, research on a functional curriculum for students with disabilities in general suggests positive results. For example, Benz, Lindstrom, and Latta (1999) and Benz, Lindstrom, and Yovanoff (2000) indicated students with disabilities who participated in the Youth Transition Program, which involved life skills (i.e., vocational skills, including paid work experience; independent living skills; personalsocial skills; functional academics skills; and self-determination), experienced increased graduation rates, higher engagement in postsecondary outcomes of employment or education, and higher wages. In another study, Riches, Parmenter, Fegent, and Bailey (1993) surveyed students with disabilities in Australia who graduated from high school. They compared responses of students who participated in a transition project, in which the curriculum focused on vocational education, community access/living, functional academics, recreation and leisure, transportation and personal management, to those who did not Education and Training in Autism and Developmental Disabilities-June 2012
  • 20. participate in this program. One of the notable outcomes of this study was employment for the students in the transition program as Riches et al. found 89% students who participated in the program held at least one job after high school. Further, Phelps and HanleyMaxwell (1997) noted the value of a functional curriculum— operationally defined as the merger of academics and vocational education, suggesting it was one of two effective practices for students with disabilities when considering postschool outcomes related to work. Finally, Alwell and Cobb (2009), in a review of research on functional curriculum and outcomes of students with disabilities over two decades, suggested students benefited from receiving a functional curriculum but the research on functional curriculum primarily targeted students with more severe or low incidence disabilities. Yet, more than just curricula can impact students’ postschool outcomes. For example, Rabren, Dunn, and Chambers (2002), examining transition data from former students with disabilities in one state, found disability category, gender, school geography, and employment in school influenced students afterschool success or lack thereof. Baer et al. (2003) reported differential effect of in-school influences when considering postschool outcomes of employment and postsecondary education. They found participation in schoolsupported work experiences, vocational education, having a particular disability and being educated in a rural school were positive predictors of employment for students with disabilities after school, while attendance at a suburban school and participation in a general education settings positively correlated with postsecondary education attendance. And, from the National Longitudinal Transition Study data, Heal and Rusch (1995) reported male gender status and receiving life and academic skills as positive predictors of employment after school for students with disabilities. Research Project Currently there is a lack of attention to students with mild intellectual disability in research and practice (Bouck, 2007), which is unwarranted in these times of evidence-based practices and a focus on achievement and outcomes in federal policy (Bouck, & Flanagan, 2010; Individuals with Disabilities Education Improvement Act, 2004; No Child Left Behind, 2002). Further, there is a lack of current research connecting receipt of a functional curriculum to postschool outcomes for students with disabilities, particularly considering the often-overlooked population of students with mild intellectual disability. To address this gap in research, the authors sought to answer the following research questions: (a) to what extent are students with mild intellectual disabilities getting exposure to functional or life skills curriculum during their secondary education program?, (b) what are the immediate and long-term (i.e., more than 2 years) postschool outcomes for students with mild intellectual disability who receive a functional curriculum?, (c) how do the postschool outcomes of students with mild intellectual disability who receive a functional curriculum compare to those receiving other curriculum models?, and (d) what factors (i.e., curriculum, school geography) predict the ascertainment of more successful postschool outcomes (i.e., full-time employment, higher wages, independent living) for students with mild intellectual disability? Method This study used the National Longitudinal Transition Study-2 (NLTS2) database to explore students with mild intellectual disability, functional curriculum, and postschool outcomes (e.g., employment, postsecondary education, wages, and independent living) through a secondary analysis. We will discuss information regarding the participants and procedures used for this study and general information regarding the NLTS2, however, we invite readers to refer to reports and information from the NLTS2 website (http:// www.nlts2.org) and other published articles (Wagner, Kutash, Duchnowski, & Epstein, 2005) for additional information specific to the overall NLTS2 project. National Longitudinal Transition Study The National Longitudinal Transition Study (NLTS), funded by the Office of Special Ed- Functional Curriculum and Students with MID / 141
  • 21. ucation Programs and conducted by SRI International, focused on secondary students with disabilities receiving special education services (Wagner, Newman, Cameto, & Levine, 2005). It was a multiyear project, beginning in 1985, and sought to understand these students’ secondary education, transition to postschool, and outcomes postschool. Overall, the NLTS highlighted the poor postschool outcomes of students with disabilities and the need for change in areas of secondary education and transition (Blackorby & Wagner, 1996). The National Longitudinal Transition Study-2 (NLTS2) is the sequel to the NLTS. It is a government-sponsored project to document the “characteristics, experiences, and achievement of youth with disabilities” through its examination of issues of secondary education, transition, and postschool outcomes (Newman, 2005a). The NLTS2 represents a comprehensive 10-year project; data collection began during the 2000 –2001 academic year and the last wave of data completed during the 2008 –2009 academic year. The NLTS2 gathered data through multiple means: (a) parent and/or youth telephone interviews, (b) direct assessments of students, (c) teacher survey, (d) school program survey, (e) school information survey, and (f) student transcripts (SRI International, 2000b). The NLTS2 represents a two-stage sampling procedure (SRI International, 2000a; Wagner et al., 2005). First, Local Educational Agencies (LEA) and state-supported schools were randomly selected to participate. The selection was done in a stratified manner, to account for geographic region, student enrollment (i.e., enough respondents in each of the 12 possible disability categories at the secondary level), and wealth of LEA/community. From this, students between the ages of 13 and 16 and in at least seventh-grade receiving special education services within the selected LEAs and special schools were randomly selected to participate (SRI International, n.d). However, students were selected to ensure a 3.6% standard error in the disability categories with the highest frequency of students (i.e., learning disabilities, emotional/behavior disorders, intellectual disability, speech and language impairments, other health impairments, and hearing impairments) (SRI International; 142 / Wagner et al.). The sampling of students was also weighted towards older students (i.e., those aged 16 as compared to 13–15 year-olds) at the start of wave 1 (SRI International). Using the weighted design of the study, a total of 19,899,621 students receiving special education services from 12,435 LEAs participated in the NLTS2 study (SRI International). Participants Participants in this project were students from the NLTS2 study, meaning they were students 13–16 years of age in at least seventh-grade and receiving special education services in 2000. To be included in this secondary analysis, students from the NLTS2 database needed to meet the following criteria: (a) identified by school program as having a mild intellectual disability; (b) in school in wave 1 of data collection and out of school in wave 2, in school in wave 2 and out of school in wave 3, or in school in wave 3 and out in wave 4; and (c) receiving special education services while in school. While analyses were run on students who met these characteristics in the sample, all data reported are weighted using the weights provided in the NLTS2 database to represent the number of students in the population (see Javitz & Wagner, 2003; Wagner et al., 2005 for more information on weighting the data). Note, data with low unweighted counts have not been reported in this analysis. This secondary analysis of the NLTS2 involved 60,664 students with mild intellectual disability. The majority of students with mild intellectual disability identified their ethnicity as Caucasian (62.4%, SE 5.7), followed by African-American (30.5%, SE 5.5), Hispanic (4.5%, SE 2.7) and multiracial or other (2.1%, SE 1.7). The majority were male (66.1%, SE 4.8) and, of those who responded, the most frequently indicated family income (i.e., parent/guardians) was less than $25,000 per year. The average age of students in school was 17.2 while the average age for out of school for the postschool outcomes was 19.9, and 20.9 for the long-term postschool outcomes (i.e., more than two years out of school). Data Collection For this analysis, we pulled data from the first four waves of data collection (i.e., waves 1, 2, Education and Training in Autism and Developmental Disabilities-June 2012
  • 22. 3, and 4). The immediate outcomes reflect students who were out of school in wave 2, 3, or 4, while the “long term” outcomes reflect data of students who were out of school in either wave 3 or 4 and in school in waves 1 and 2 (i.e., out for more than two years). We utilized the Parent/Youth survey at each of the four waves, the School Characteristics survey completed at wave 1, and the Students’ School Program survey completed at waves 1 and 2. At wave 1, the Parent/Youth survey was a 60minute phone interview completed by the parents of the participating students. For waves 2, 3, and 4, students completed the 60-minute phone interview; parents completed it if the student was unable to do so. At all four waves, a mail survey was provided if a phone interview was not possible. The Parent/Youth survey focused on selected questions pertaining to student characteristics, household characteristics, nonschool factors, family involvement, academic and school experiences, personal/social issues, employment, citizenship, health, satisfactions, and behaviors (SRI International, 2000b). The teacher most familiar with the student’s overall school program completed the Students’ School Program survey. This survey was a mail survey and questions pertained to the school program, transition, special education services, state and district assessments, accommodations, provision of supports, performance, and parental involvement (SRI International, 2000b). Finally, school personnel, such as the principal, completed the School Characteristics survey. It was also a mail survey, which elicited information regarding the school and community, students, staff, programs, special education policies and practices, parental involvement, and background information (SRI International). Procedure For the purposes of this analysis, we focused on items from the multiple surveys that addressed our research questions. Specifically, we included items representing the curriculum focus in students’ special education classes (e.g., life skills, academic) as well as if they received life skills in school and where (e.g., special education setting, general education setting). We also used a variable from the database called “mental skills,” which was the sum of respondents’ assessment of the student’s ability to tell time on a clock with hands, read and understand common signs, count change and look up telephone numbers in a phonebook and use the telephone. Each skill was assessed on four point rating scale ranging from one (not at all well) to four (very well), resulting in a score ranging from 4 to 16. In terms of postschool outcomes, variables of interest included where students were living (i.e., independently vs. dependently), employment status, job type, wages received, and whether they attended postsecondary education (i.e., four-year college, two-year college, vocational/technical school). Other variables related to demographics of the students (i.e., disability, gender, ethnicity) and school (i.e., geographical location, size, services nearby). In addition to using the original NLTS2 variables, some variable categories were recoded. For instance, the variable related to type of student’s special education class originally had four values (see Table 1 for a list variables used in this study and their description). Since the focus of this project was on life skills, we recoded this variable into two categories: receipt of life skills and receipt of other (i.e., academic, basic academic, or study skills). Similarly, the independent living variable consisted of fifteen categories. These fifteen categories were recoded into three categories: lived independently (i.e., on his/her own, with a roommate or spouse, college dormitory, and military housing), and lived dependently (i.e., with his/her parents, with another relative, a group home or assisted living center, and a correctional facility/youth detention center). Finally, the wage variable was recoded from a continuous variable representing the hourly pay students received at their most current or recent job to a dichotomous variable, above or below minimum wage (i.e., $5.15 at the time of data collection). Data Analysis Statistical procedures such as frequency distributions, cross tabulations and logistic regression were utilized to analyze secondary data from the NLTS2. Specifically, to answer the first research question regarding exposure to Functional Curriculum and Students with MID / 143
  • 23. TABLE 1 Description of Variables used in Secondary Analysis Variables NLTS2 Variable ID Identification of students Disability Ethnicity ID Age npXCurAge Income npXk15Cat Gender Mental skills npXGendHdr npXG4_[a-d] Urbanicity wX_Urb3 Type of special education class nprXD9 Received life skills nprXA3h Instructional setting for life skills nprXA3h_(1-4) Independent living npXP1a_01_A6a_01-15‫ء‬ Postsecondary attendance npXS3a_S4a_S5a_D4a1_D4a2_D4a3 Currently employed Ever employed npXT7a_L7a_I2b npXT6a_L6a_I2a Above minimum wage Full time employment npXT8f1_T11f_L8f1_L11f_I3a‫ء‬ nprXD2a_09 npXEth_Recod npXT8c_T11c_L8c_L11c Description Randomized number assigned to each student Disability of student Ethnicity of each student (i.e., white; African American; Hispanic; Asian/ Pacific Islander; American Indian/ Alaska Native; multiple races/other) Student age at the time of data collection Family income categories (i.e., $25,000 or less; $25,001–$50,000; more than $50,000) Gender of each student (male, female) How well the student can tell time, read signs, count change and look up telephone numbers in a phonebook Geographical location of the student’s school (rural, suburban, or urban) Focus of the non vocational special education class (i.e., academic, life skills, basic academic skills, or study skills) Student received life skills, social skills instruction Instructional setting where student received life skills (general education, special education, individual instruction or community setting/different school) Independent living (i.e., living on own, with a roommate), dependent living (i.e., living with parents, in supportive environment), or other (i.e., homeless) Out-of-school student attended any type of postsecondary school (i.e., vocational, technical, two- year, or four-year college) Student has a paid job now If student worked for pay during the last 2 years Out-of-school student earns more than minimum wage($5.15) Out-of-school student has a full-time (Ն35 hours a week) or part-time job (Ͻ35 hours a week) Note: * Indicates a larger variable(s) was collapsed to created fewer categories and/or combine data. X indicates the Wave year (i.e., 1, 2). All in-school variables reflect variable name from wave 1 and all the postschool outcomes refer to variable names from wave 2. There may be slight changes in the variable ID’s from one wave to the next. 144 / Education and Training in Autism and Developmental Disabilities-June 2012
  • 24. a functional curriculum during school, frequency distributions were conducted on both responses to the curriculum in students’ special education class as well as the reported receipt of life skills in school. For the second and third research questions regarding postschool outcomes, we ran frequency distributions on the postschool outcome variables of interest (e.g., employment, independent living, postsecondary education attendance, wages). The frequency distributions of these variables were conducted for students with mild intellectual disability who received a functional curriculum and students with mild intellectual disability who received a different curriculum (non-functional curriculum). To compare the postschool outcomes of these two groups, an F test was conducted. Note, this F-test was provided with the NLTS2 dataset. Wagner, Newman, Cameto, Levine, and Marder (2007), suggested the F test can be used to identify the existence of statistically significant differences between groups rather than just merely looking at the differences between observed and expected frequencies. Finally, to answer research question four regarding what factors predict more successful postschool outcomes for students with mild intellectual disability a logistic regression was utilized. Logistic regression is used in a regression model for analyzing dichotomous variables (Peng, Lee, & Ingersoll, 2002). Binary categories (0 ϭ no and 1 ϭ yes) were created for all the six outcomes of interest (i.e., independent living, ever attended a postsecondary education institution, currently employed, ever employed, received above minimum wage, or working full time), for both immediate and long-term outcomes. Included in each logistic model were the following independent variables: curriculum (functional vs. non-functional), mental skills (sum of parental reporting of four skills on a scale of 1– 4 with a range of 4 –16), gender (male vs. female), family/parental income (Ͻ$25,000, $25,000 –$50,000, Ͼ$50,000), ethnicity (Caucasian, African-American, Hispanic, Asian, American Indian, Multi/Other), and school location (rural, urban, suburban). For each univariate logistical regression analysis, a Goodness of Fit test (i.e., G2 ϭ Ϫ2 [loglikehood(R) Ϫ loglikehood (F)], or in other words, the Ϫ2loglikehood of the re- duced model [i.e., without the variable of interest] minus the Ϫ2loglikehood of the full model) was conducted to determine if each particular variable should be included in the model. Note, the Goodness of Fit is compared to the ␹2 table with an alpha of .05 and appropriate degrees of freedom to determine whether or not to reject the null hypothesis (i.e., exclude the variable of interest). Thus, the full model with all six predictors was conducted for each of the six dependent variables for both immediate and long-term outcomes. Then, each predictor was removed individually to assess its significance to the model. Results Given the nature of survey and interview data, responses to questions were not available for every individual. Also, not all questions were answered with the same frequency as individual responses may not have been gathered because a particular question was not asked (i.e., skip logic was imposed) or because the respondent chose not to answer the question. Hence, data are reported out of the number who responded to the question rather than the number of the complete dataset (i.e., 60,664 for students with mild intellectual disability). Exposure to Functional Curriculum Functional curriculum was reported as the curricular focus of students’ non-vocational special education class for approximately onefifth of the students with mild intellectual disability (17.5%, SE 3.8). For the majority of the students with mild intellectual disability, academic skills was the main focus (60.1%, SE 5.4), followed by basic academic skills (19.2%, SE 4.0). Outside of a functional curriculum, almost 75% students with mild intellectual disability received life skills, including social skills, at school (74.3%, SE 4.1). The majority of those who indicated where they received life skills (N ϭ 45,086), reported it was in a special education setting (76.7%, SE 5.9), followed by a general education setting (13.1%, SE 4.7), community setting (6.5%, SE 3.4), and then multiple settings (2.2%, SE 1.0). Students who received a functional curriculum were not different from students who Functional Curriculum and Students with MID / 145
  • 25. TABLE 2 Immediate Postschool Outcomes for Students with Mild Intellectual Disability by Curricula Received Functional Curriculum Non-Functional Curriculum Postschool Outcomes N % SE N % SE Independent living Postsecondary attendance Currently employed Ever employed Above minimum wage Full-time employment 8,879 9,112 6,257 6,772 4,669 — 8.7 12.6 64.0 71.5 56.9 — 5.4 7.2 12.9 10.5 17.4 — 41,545 39,612 34,324 37,430 16,832 18,690 13.8 27.1 45.0 62.3 85.1 38.7 4.5 5.4 7.6 6.7 7.2 9.5 Note: The percent is based on those in each category who responded to the question (i.e., some individuals did not have responses to every question). Ever employed refers to whether students were employed any time after they left high school. Currently employed refer to whether students were employed currently when they responded to the interview/survey. The wage variable was calculated based on current or most recent wages of participating youth, in case students were currently unemployed. Minimum wage was $5.15 at the time of data collection. Postsecondary attendance includes attendance at vocational school, two-year college, or four-year college. Please also note data with low unweighted count are not reported (i.e., represented by dashes in the table). received a non-functional curriculum in school in terms of parent assessed “mental skills.” The average mental skills of students with mild intellectual disability who received a functional curriculum were 10.6 (SE 0.6), while students who received a non-functional curriculum (i.e., academic skills, basic academic skills or study skills) averaged 11.8 (SE 0.3). These differences were not found to be statistically significantly different (p Ͼ .05). Among the students who received a non-functional curriculum, students who received a study skills curriculum averaged the highest mental skills (15.1, SE 0.6), followed by those who received an academic skills curriculum (12.0, SE 0.5) and a basic academic skills curriculum (10.9, SE 0.8). Postschool Outcomes Less than 10% of students with mild intellectual disability who received a functional curriculum lived independently after exiting school (8.7%, SE 5.4) (see Table 2 for the percent, standard error, and population size for each postschool outcome). For students who received a non-functional curriculum just over 10% reported living independently (13.8%, SE 4.5). While the majority of students with mild intellectual disability reported 146 / they experienced paid employment, (71.5%, SE 10.5 for those who received a functional curriculum and 62.3%, SE 6.7 for those who received a non-functional curriculum), a larger percentage of students who received a functional curriculum indicated they were currently employed (64.0%, SE 12.9 vs. 45.0%, SE 7.6). Regardless of in-school curricular focus, the majority of students with mild intellectual disability earned more than the minimum wage, which was $5.15 at the time of data collection. Specifically, 56.9% (SE 17.4) of those who received a functional curriculum and 85.1% (SE 7.2) of those who received a non-functional curriculum earned more than $5.15 per hour. In the final postschool outcome examined, 12.6% (SE 7.2) of students who received a functional curriculum attended any postsecondary educational institution (i.e., business/vocational/technical, twoyear, or four-year college) since leaving high school. This rate more than doubled for students who received a non-functional curriculum (27.1%, SE 5.4). In terms of differences in postschool outcomes between students with mild intellectual disability who received a functional curriculum and those who received a non-functional curriculum, no statistically significant differences existed for any outcome (p Ͼ .05). Education and Training in Autism and Developmental Disabilities-June 2012
  • 26. TABLE 3 Long term Postschool Outcomes for Students with Mild Intellectual Disability by Curricula Received Functional Curriculum Non-Functional Curriculum Postschool Outcomes N % SE N % SE Independent living Postsecondary attendance Currently employed Ever employed Above minimum wage Full-Time Employment — 4,295 3,687 3,806 1,634 — — 21.5 40.4 49.7 95.4 — — 12.8 17.9 23.1 3.1 — 15,273 16,348 13,766 16,348 7,468 8,823 19.4 25.6 43.9 54.0 96.2 78.7 8.6 9.5 11.1 10.1 3.0 12.9 Note: The percent is based on those in each category who responded to the question (i.e., some individuals did not have responses to every question). Ever employed refers to whether students were employed any time after they left high school. Currently employed refer to whether students were employed currently when they responded to the interview/survey. The wage variable was calculated based on current or most recent wages of participating youth, in case students were currently unemployed. Minimum wage was $5.15 at the time of data collection. Postsecondary attendance includes attendance at vocational school, two-year college, or four-year college. Please also note data with low unweighted count are not reported (i.e., represented by dashes in the table). “Long Term” Postschool Outcomes In terms of “long-term” postschool outcomes (i.e., more than two years after participants left school), more students with mild intellectual disability who received a non-functional curriculum responded as having ever experienced paid employment as compared to those who received a functional curriculum in school (54.0%, SE 10.1 vs. 49.7%, SE 23.1) (see Table 3). A similar frequency of respondents in both curricular categories reported they were currently employed (non-functional: 43.9%, SE 11.1; functional: 40.4%, SE 17.9). In terms of wages received, almost all students who received a non-functional or a functional curriculum in school reported they earned more than minimum wage (96.2%, SE 3.0 vs. 95.4%, SE 3.1 respectively). Finally, a slightly higher frequency of students with mild intellectual disability who received a non-functional curriculum attended postsecondary institutions as compared to those who received a functional curriculum (25.6%, SE 9.5 vs. 21.5%, SE 12.8). Similar to the examination of differences in frequencies for the immediate postschool outcomes, none of the long-term postschool outcomes examined for students who received a non-functional curriculum were statistically significantly different than those of students who received a functional curriculum (p Ͼ .05). Experiences Predicting Success The logistic regression analyzing the six immediate postschool outcomes represented by binary dependent variables (i.e., independent living, currently employed, ever employed, ever attended a postsecondary institution, above minimum wage, and full time work) resulted in receipt of a functional curriculum not being a statistically significant predictor for any outcome (p Ͼ .05). Thus, receipt of a functional curriculum versus a non-functional curriculum was not a factor influencing students’ postschool outcomes. In fact, none of the factors examined (curriculum, mental skills, gender, family income, ethnicity, and school location) were predictors for the immediate postschool outcomes of students with mild intellectual disability (p Ͼ .05). Similar results were found for the six long-term postschool outcomes, with the exception of the dependent variables “currently employed” and “ever attended a postsecondary institution.” Gender was a statistically significant predictor for being currently employed, with males more likely to be employed at the time Functional Curriculum and Students with MID / 147
  • 27. of the interview (3.23 times more likely to be currently employed). Income was a statistically significant predictor for the long-term outcome “ever attended a postsecondary institution,” with students who attended a postsecondary institution more likely to report higher incomes. Discussion This study was a secondary analysis of the NLTS2 data focusing on issues of a functional curriculum for high school students with mild intellectual disability. Specifically, we analyzed receipt of a functional curriculum in school by students with mild intellectual disability, the postschool outcomes (i.e., independent living, employment, postsecondary attendance) of students with mild intellectual disability, and the relationship between curricular focus in school and postschool outcomes for this population. The results reveal three main findings for students with mild intellectual disability: (a) a low frequency receive a functional curriculum as their curricular focus in special education, (b) some positive postschool outcomes were found, but there is still work to be done to improve success, and (c) receipt of a functional curriculum in school does not impact students’ postschool outcomes. The most significant result may be the lack of impact of receipt of a functional curriculum on postschool outcomes for students with mild intellectual disability. The lack of influence was apparent with the logistic regression analysis, as the binary variable of curriculum (i.e., functional or non-functional) was not a predictor in any of the postschool outcome models (i.e., independent living, ever attended a postsecondary education institution, currently employed, ever employed, above minimum wage, or working full time), and this was for both immediate postschool outcomes as well as long-term postschool outcomes. Hence, whether a student with mild intellectual disability received a functional curriculum in school or a non-functional curriculum (i.e., academics, basic academics, study skills), it did not impact his or her postschool outcomes. The lack of impact of curriculum was also supported by the lack of statistically significant differences between curricular focus in frequency of postschool 148 / outcomes for students with mild intellectual disability (refer to Tables 2 and 3). Despite the lack of statistical significance regarding receipt of a functional curriculum and postschool outcomes, we cannot conclude students with mild intellectual disability (a) do not benefit from receiving a functional curriculum or (b) should not be provided with a functional curriculum. The results need to be interpreted in light of the limitations with the secondary analysis. For example, the survey, from which the variable representing the curricular focus of students’ non-vocational special education class, did not include questions that might shed additional light on understanding the issues surrounding curriculum and postschool outcomes for students with mild intellectual disability. The survey asked about the curriculum in students’ nonvocational special education class (i.e., academics, basic academics, study skills, or life skills) but did not provide information regarding how much functional curriculum students receive (i.e., number of classes, hours a week). Perhaps differences depend on the amount and/or frequency with which students with mild intellectual disability received a functional curriculum, but this could not be ascertained from the data. Related, the survey did not ask about the nature of the functional curriculum and Bouck (2009) suggested different models for functional curriculum exist and that not all address aspects of a functional curriculum with equal attention or a focus towards the unique needs of students with mild intellectual disability. It is worth noting that the results of this analysis were not consistent with previous research suggesting a relationship between receipt of functional curriculum and positive postschool outcomes for students with disabilities in general (Benz et al., 1999; Benz et al., 2000; Heal & Rusch, 1995; Phelps & HanleyMaxwell, 1997; Riches et al., 1993). In fact, no factors examined were found to impact the immediate postschool outcomes of students with mild intellectual disability, which also conflicts with previous research (Baer et al., 2003; Rabren et al., 2002) except gender, which was influential in the long-term outcomes of “currently employed” and income for “attending postsecondary education.” While the previous research focused on stu- Education and Training in Autism and Developmental Disabilities-June 2012
  • 28. dents with disabilities in general or an aggregation of disability categories (e.g., mild), this research focused exclusively on students whose primary disability classification was mild intellectual disability. Perhaps there is something qualitatively and quantitatively different about students with mild intellectual disability with respect to postschool outcomes and the factors impacting their outcomes (e.g., curriculum, school location, income, gender). Note, students with mild intellectual disability had lower mental skills (functional curriculum—10.6 and non functional curriculum—11.8) than students with learning disabilities (14.1), emotional behavior disorders (14.5), and all other disability categories other than multiple disabilities (9.8) (Wagner, Cameto, & Newman, 2003). Students with mild intellectual disability perhaps face challenges to postschool outcomes that are different from other disability populations and these challenges may not be overcome by curricular focus, whatever that may be. For example, in comparing the outcomes from the NLTS2 of students with mild intellectual disability to the outcomes of student with learning disabilities and emotional disabilities (two common categories mild intellectual disability is aggregated within research; Edgar, 1987; Jones, 1996), 26.1% of students with mild intellectual disability attended a postsecondary institution (regardless of curriculum) as compared to 34% of students with emotional/behavior disorders and 47.3% of students with learning disabilities (Newman et al., 2009). Similarly, 49.1% of students with mild intellectual disability were employed postschool as compared to 63.6% of students with learning disabilities (42.3% for students with emotional/behavior disorders). Finally, 12.1% of students with mild intellectual disability are living independently as compared to 21.5% of students with emotional/ behavioral disorders and 28.8% of students with learning disabilities (Newman et al.). Although receipt of a functional curriculum did not result in students having statistically better postschool outcomes (i.e., higher rates of independent living, higher rates of employment, etc.), it also did not result in them experiencing lower postschool outcomes, statistically speaking. Thus, a functional curriculum remains a viable option to consider. Yet, the results indicated less than one-fifth of students with mild intellectual disability reported receiving a functional curriculum in school. While the low frequency may not be surprising today, given the focus on the general education curriculum and participation in general large-scale assessments following No Child Left Behind (NCLB, 2002) and the Individuals with Disabilities Education Improvement Act (IDEA, 2004), the data on in-school curricular focus predate the impact of NCLB and IDEA on education. The relatively small frequency reporting a functional curriculum is aligned with the reported decrease in attention on a functional curriculum in the 1990s (Nietupski, Hamre-Nietupski, Curtin, & Shrikanth, 1997). Further, the data align with survey data from a single state study regarding the frequency of curricular focus for high school students with mild intellectual disability—19.0% (Bouck, 2004a). Implications for Practice The results of this study hold implications for practice. The results suggest the need to focus on issues of transition for secondary students with mild intellectual disability and particularly targeting areas of postschool success, such as independent living. There is a need to focus on what students with mild intellectual disability plan on doing after high school and how practitioners can help them achieve those goals, including curriculum choices. The results also suggest that as a field we need to engage in deeper discussion around the curriculum students are receiving. Although the results indicate receiving a functional curriculum did not predict better postschool outcomes, it also did not “hurt” the students (i.e., lower postschool outcomes). Yet lacking from this analysis is the social validity of teachers, parents, and student regarding curricular implementation. This analysis did not address what key stakeholders feel students should be receiving as a curriculum and what they see as beneficial to post school success. Student and parents may find value in a functional curriculum not captured by outcomes; previous research suggested parents express concerns about the lack of acquisition of functional life skills by their child with a disability (Love & Malian 1997; Olson, 2004). Functional Curriculum and Students with MID / 149
  • 29. Limitations and Future Directions Several limitations apply to this analysis. First, this is a secondary analysis of the NLTS2 data and hence experiences the limitations of the original design, which includes the self-reported nature of surveys. Related, missing data existed for the secondary analysis— both in terms of responses to some of the questions for all who participated in the study (i.e., respondents elected not to answer or skip logic was imposed so a question was never asked to respondents), as well as attrition occurred throughout the waves of data collection. The attrition is evident when examining the “longterm” postschool outcomes. Whereas over 6,000 students with mild intellectual disability who received a functional curriculum in school responded to employment outcome questions (i.e., ever and currently employed), only around 3,000 responded to the “longterm” employment questions. Although the “long-term” outcomes drew from only two waves of data (i.e., waves 3 and 4), this does not completely explain the smaller n. Those who responded to the “long-term” employment questions appeared to be those who were not as successful, as the ever employed frequency went from 71.5% to 49.8%. This suggests individuals with more successful outcomes might have been less likely to respond to the survey and this may be related to the design of the NLTS2. The “long-term” outcomes may need to be interpreted with caution. Another limitation pertained to the phrasing of questions and the lack of control during secondary analyses. For example, there was a differentiation in questions between receiving a functional curriculum in a special education class and receiving life skills. Further, when inquiring about receipt of life skills, the question was phrased to be life skills, including social skills. While social skills are a component of life skills they are not the heart of life skills (e.g., skills for students to be successful in life or independent). It was assumed more students with disabilities receive social skills than life skills, and hence the variable inquiring about receipt of life skills in general was difficult to use. We could not be certain if students received life skills or just social skills. Additionally, the lack of statistically significant 150 / results for the variable of interest—functional curriculum— could be viewed as a limitation. However, we choose to view it as an important finding warranting further consideration. Finally, the lack of significant predictors for the logistic regression models is problematic and suggests additional research is needed to understand what factors do impact the postschool outcomes of students with mild intellectual disability, given the lack of effect of curriculum, mental skills, and standard demographic variables. Future research should continue to explore the impact of curricula on the postschool outcomes and in-school experiences for students with mild intellectual disability as well as secondary students with other types of disabilities (e.g., learning disabilities, moderate/severe intellectual disability). Although this analysis suggested a lack of statistical differences in the postschool outcomes for students who received a particular curricular focus as well as the curriculum received variable was not a factor predicting outcomes in the logistic regression, the impact of curriculum still warrants further examination. For example, what really constitutes a functional curricular approach or a basic academics approach? A teacher most knowledgeable with the students’ program indicated the curricular focus, but the nuances of the curricular approach were not explored in the NLTS2 survey. Further research should understand and characterize curricular approaches as well as the relationship between experiencing a particular curricular focus and postschool outcomes. Related, research should examine what factors do impact the postschool outcomes of students with mild intellectual disability, given the lack of predictive relationship of the variables examined in this analysis. Additionally, future research should analyze the in-school experiences of secondary students with mild intellectual disability in greater depth. The majority of reports and research studies from the NLTS2 aggregate students with mild intellectual disability with students with moderate/severe disabilities (Newman et al., 2009; Yu, Newman, & Wagner, 2009), which does a disservice to understanding the education of this population of students. Much research in general aggregates students with mild intellectual disability with Education and Training in Autism and Developmental Disabilities-June 2012
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  • 32. Longitudinal Transition Study: Study designs and implications for children and youth with emotional disturbance. Journal of Emotional and Behavioral Disorders, 13(1), 23– 41. Wagner, M., Newman, L., Cameto, R., & Levine, P. (2005). Changes Over Time in the Early Postschool Outcomes of Youth with Disabilities. A Report of Findings from the National Longitudinal Transition Study (NLTS) and the National Longitudinal Transition Study-2 (NLTS2). Menlo Park, CA: SRI International. Retrieved October 9, 2009, from http:// www.nlts2.org/reports/2005_06/nlts2_report_ 2005_06_complete.pdf Wagner, M., Newman, L., Cameto, R., Levine, P., & Marder, C. (2007). Perceptions and expectations of youth with disabilities. A special topic report of findings from the National Longitudinal Transition Study-2 (NLTS2) (NCSER 2007–3006). Menlo Park, CA: SRI International. Retrieved from http://ies.ed. gov/ncser/pdf/20073006.pdf Yu, J., Newman, L., & Wagner, M. (2009). Secondary school experiences and academic performance of students with mental retardation. Menlo Park, CA: SRI International. Retrieved March 31, 2010 from http:// www.nlts2.org/fact_sheets/nlts2_fact_sheet_ 2009_07.pdf Zeaman, D., & House, B. J. (1963). The role of attention in retardate discrimination learning. In N. R. Ellis (Ed.), Handbook of mental deficiency: Psychological theory and research (pp. 159 –223). Hillsdale, NJ: Erlbaum. Zeaman, D., & House, B. J. (1979). A review of attention theory. In N. R. Ellis (Ed.), Handbook of mental deficiency: Psychological theory and research (pp. 63–120). Hillsdale, NJ: Erlbaum. Received: 24 March 2011 Initial Acceptance: 20 May 2011 Final Acceptance: 15 July 2011 Functional Curriculum and Students with MID / 153
  • 33. Education and Training in Autism and Developmental Disabilities, 2012, 47(2), 154 –164 © Division on Autism and Developmental Disabilities Effects of a Self-Monitoring Strategy on Independent Work Behavior of Students with Mild Intellectual Disability Jennifer Coughlin, Kathleen M. McCoy, Amy Kenzer, Sarup R. Mathur, and Stanley H. Zucker Arizona State University Abstract: This study evaluated the effectiveness of a self-monitoring strategy on independent work behavior. The three subjects were in first grade, seven years old, identified with mild intellectual disability (MID), and had an Individualized Education Plan (IEP) with targeted functional academic and behavior goals. The purpose of this study was to investigate the effect of a self-monitoring strategy on on-task independent work behavior and task completion. A multiple baseline across subjects design was used. Data were collected using a frequency count of off-task behavior. The self-monitoring strategy was found to be successful with all subjects in the study. Overall, the subjects demonstrated a decrease in off-task behavior during independent work time after the intervention was introduced. Implications are discussed. Off-task behavior can negatively impact the success of people with disabilities in various settings, including work, school, and other areas of community involvement. In one observation of a work program site, participants with disabilities spent 70% of observed time engaging in off-task behavior (Parsons, Rollyson, & Reid, 2004). Remaining on-task during independent work time at school is a struggle for many students. Staying on-task can be even more difficult for students with disabilities. Students with disabilities can be distracted by other stimuli in the environment or frustrated by the level of difficulty of the task they are expected to complete independently resulting in off-task behavior during independent work time. Behaviors that are irrelevant to the current academic task are considered off-task, taking such forms as distracting other students, attempting to gain the attention of instructors, sitting idly, leaving the designated work space, engaging in self-stimulatory behavior, or engaging in destructive behavior (Gickling & Armstrong, 1978). When many students with Correspondence concerning this article should be addressed to Kathleen M. McCoy, Mary Lou Fulton Teachers College, Arizona State University, 1050 S. Forest Ave., PO Box 871811, Tempe, AZ 85287-1811. E-mail: Kathleen.McCoy@asu.edu 154 / disabilities are prompted to return to the academic task, often an increase in off-task behaviors is observed (Saunders, McEntee, & Saunders, 2005). Two contributing factors related to off-task behavior during independent work time are difficulty of material and level of details in instruction. Independent work that includes 90% known material enhances the duration of on-task behavior (Burns & Dean, 2005). Students, who are given general instructions, rather than specific instructions, are more likely to engage in off-task behavior. Giving specific and descriptive instructions to a student increases the frequency of task completion (Bouxsein, Tiger, & Fisher, 2008). Students with intellectual disability (ID) struggle to understand and identify the functions of their behavior (Crawley, Lynch, & Vannest, 2006). As a result of cognitive disability, students with ID typically experience interference with the ability to self-manage. Students with ID or other cognitive disability also can benefit from instruction which teaches specific self-management strategies to increase on-task behavior. Lack of self-management skills inhibits students with ID from appropriate independent functioning and integration into the community (Selznick & Savage, 2000). Hume and Odom define independent functioning as “on-task engagement in an ac- Education and Training in Autism and Developmental Disabilities-June 2012
  • 34. tivity in the absence of adult prompting” (2007, p. 1166). Conversely, learning to selfmanage behavior can effectively enhance independent functioning in the home, school and community. Classroom goals for students that include working independently, self-managing behaviors, and finding motivation in natural consequences are important (Hume & Odom, 2007). Remaining on-task during independent work time is a critical component of student success in the classroom. Students who demonstrate on-task behavior during independent work time may also be able to generalize this skill to other academic areas. To maintain high standards for all students, including students with ID and other disabilities, all students would benefit from instruction which facilitates their ability to engage in on-task behaviors during independent work time. When learners are independently engaged in on task behaviors, more instructional time is freed for the teacher as well. While students work independently on-task, teachers have opportunity to work one-on-one with a student, assess a student, or pull a small group of students for more intense instruction. Self-Management A self-monitoring strategy that successfully increases on-task behavior during independent work time would benefit the individual students, teacher, and entire classroom. Classroom goals for students that include working independently, self-managing behaviors, and finding motivation in natural consequences are important (Hume & Odom, 2007). In the classroom, when a student selfmanages, the teacher is able to spend more time focusing on instruction. According to Koegel, Harrower, and Koegel (1999), one way to increase independent work is to teach students self-management strategies. Mitchem and Young (2001) created a class-wide peerassisted self-management program in a classroom setting. They found that after training the students were able to self-manage. Teacher and students found the program valuable in improving classroom climate, and the program was successfully generalized to other classrooms. Self-control and self-management interven- tions have many benefits. Self-management strategies are effective beyond the classroom setting in teaching daily living skills (Hume & Odom, 2007). Society values independent actions. Students who self-manage are more likely to behave independently and appropriately without adult supervision. Finally, selfmanagement encourages more natural behavior changes than relying on external influences (Lane, Menzies, Bruhn, & Crnobori, 2011; O’Leary & Dubey, 1979). Students who self-manage have higher achievements in the classroom and feel a sense of satisfaction toward their work (Lapan, Kardash, & Turner, 2002). Rosenbaum and Drabman (1979) emphasize the importance of instructing students to self-manage effectively. Self-Monitoring One self-management strategy is self-monitoring (O’Reilly et al., 2002). Self-monitoring is a component of Positive Behavioral Intervention (Ganz, 2008). Self-monitoring occurs when students pay attention to a specific behavior, record the occurrences of the target behavior, and reward themselves for improvements (Ganz, 2008; Soares, Vannest, & Harrison, 2009). Used independently, self-monitoring can be effective in changing target behavior (Mace & West, 1986). Self-monitoring, however, is most effective when coupled with either self-evaluation or positive reinforcement (Mitchem & Young, 2001). Selfreinforcement is effective when used alone, but is far more effective when added to other procedures (O’Leary & Dubey, 1979). With appropriate training, students become capable of self-monitoring in natural settings. Ganz and Sigafoos (2005) researched the effect of self-monitoring in a vocational setting with adults with both ID and autism. They found that this strategy increased both independent work and verbal requests. Self-monitoring is also effective in decreasing self-injurious behavior and tantruming in students with autism. Self-monitoring is appropriate for the classroom because not only is responsibility placed in the hands of the students, but also the amount of direct contact with the teacher decreases (Soares et al., 2009). Self-monitoring strategies have been effectively utilized with a single student with Self-Monitoring Strategy / 155
  • 35. mild ID (Crawley et al., 2006), with students with emotional disabilities (Mooney, Epstein, Reid, & Nelson, 2003), across multiple classroom settings (O’Reilly et al., 2002), and with adolescent students with brain injury in math class (Selznick & Savage, 2000). The question remains to be answered if these findings can be replicated to a classroom of students with mild ID. Although research has shown that self-management strategies are effective in reducing inappropriate behaviors, self-management strategies have not been broadly researched in students who demonstrate both inappropriate, off-task behaviors and have cognitive disabilities (Crawley et al., 2006). Self-monitoring is both easy to implement and rewarding for teachers. Students are interested in participating in self-monitoring because they see the potential rewards. Teachers often have easy access in their classrooms to necessary materials effective for self-monitoring instruction. Minimal training is required for teachers to acquire skills to implement self-monitoring in a classroom (Ganz, 2008). Instructors must verify that the student can correctly implement the self-monitoring strategy (O’Leary & Dubey, 1979). Mace and West (1986) suggest that further research in selfmonitoring include reinforcement contingent on appropriate implementation of the selfmonitoring intervention. Additionally, instructors should make clear the relationship between the self-monitoring intervention, age appropriate material and resultant consequences. Based on the work of Ganz, Cook, and EarlesVoolrath (2007) and Rankin and Reid (1995), a sequence of steps is recommended to effectively implement self-monitoring in a classroom. First, the instructor selects a target behavior and operationally defines the behavior. Second, the instructor and student discuss the purpose and benefits of self-monitoring and reinforcements available. Third, the instructor determines a method to measure the target behavior and collects baseline data. Fourth, the instructor determines an age-appropriate way for the student to self-monitor. Additionally, a criterion for reinforcement is determined based on baseline data. This criterion should be set initially so that the student frequently receives reinforcement for self-monitoring. Reinforcement fades as the 156 / student increases appropriate self-monitoring. Fifth, the instructor teaches the student to self-monitor, using role playing and modeling. Sixth, using scaffolding, the instructor and student begin to self-monitor. Crucial to this process is that the student receives the reinforcement each time (s)he reaches a given criterion. Reinforcement validates the use of self-monitoring for the student. The instructor should continue to monitor periodically the student’s self-monitoring. Once a student effectively self-monitors a behavior, the student can learn to self-monitor additional target behaviors. The use of self-management strategies can help students with mild ID take ownership of their behavior. One type of selfmanagement is self-monitoring. When students self-monitor, they identify a behavior, record occurrences, and reinforce improvements. Self-monitoring is most effective when used with positive reinforcement. The purpose of the study was to examine the effect of a self-monitoring strategy on independent work behavior in students with identified mild ID being instructed in a selfcontained setting. A self-monitoring intervention was implemented to determine its effects on on-task independent work behavior. Method Participants Three children participated in this study. Each was seven years old, identified with MID, and had a current IEP with functional academic and/or behavior goals. Each participant received special education services from the researcher in a self-contained setting for primary students with MID. Sally, subject one, is a seven-year-old female with an intelligence quotient (IQ) of 64 as measured by the Pictoral Test of Intelligence, Second Edition (PTI-II). She frequently rushes through work without regard to detail. She wants to be the first student to finish any given assignment. Rather than taking responsibility for herself, she focuses on other students’ behavior and task completion. She requires constant verbal prompts to stay on task. She responds to verbal reinforcement and recognition of her achievements. Elise, subject two, is a seven-year-old female Education and Training in Autism and Developmental Disabilities-June 2012
  • 36. with an IQ of 62 as measured by the Developmental Profile, Second Edition (DP-II). She is easily distracted by her peers and surroundings. She frequently leaves her seat, engages the teacher or her peers in conversation, and manipulates classroom supplies. She requires frequent verbal prompts to stay on task, as well as reinforcement for completing work. Jose, subject three, is a seven-year-old male with an IQ of 64 as measured by the PTI-II. He frequently zones out during independent work time. He engages in conversations with peers and questions the teacher. When given a task, he waits for individualized instruction before beginning the task. He requires prompts to return to the task. He responds well to verbal and visual reinforcement. Design A multiple baseline across subjects design was used in this research. Baseline data were collected for at least five days for each subject followed by the treatment and independent work phases. The dependent variable in this research was on-task behavior. On-task behavior was operationally defined as engaging in a designated academic task for more than 180 consecutive seconds. On-task behavior included staying in the designated work area, using designated work utensils, and working independently. On-task behavior did not include leaving designated work area, sitting in designated work area idly, talking to other students or adults, engaging in self-stimulatory behavior, or engaging in destructive behavior. Frequency count was used to collect data for off-task behaviors during independent work sessions. The researcher kept track of the frequency of off-task behaviors, noting each occurrence during each session. Duration recording was also used to show the duration of each subject’s independent work session. The researcher collected the start and completion time for each subject’s independent work. The independent variable in this research was the self-monitoring intervention program. This program incorporates the use of a visual cue to prompt subjects to self-monitor their progress on work completed during a designated independent work time. Figure 1 shows an example of the visual prompt. Reliability Both the researcher and a paraprofessional in the classroom collected data throughout the study. The paraprofessional in the classroom was trained on the operational definitions of target behaviors and data collection methods. The researcher and paraprofessional simultaneously collected data two days out of each week. Both observers collected data for 40% of total sessions. Total count inter-observer agreement between the two observers for the study was calculated at 96.9%. The paraprofessional had a copy of the instruction script and observed instruction during the instruction phase. As the researcher instructed the subjects, the paraprofessional verified that the researcher followed the appropriate steps necessary to effectively implement the treatment thus maintaining fidelity to treatment. Materials The following materials were used to implement the intervention. Subjects self-monitored progress on a self-monitoring chart (Figure 1). The researcher used a script to instruct subjects during the treatment (Table 1). A visual cue to self-monitor was placed on all independent work. This cue was a one-inch picture of a cartoon character, selected by each subject individually in a multiple-stimulus procedure without replacement preference assessment. Sally and Elise selected a Dora the Explorer cue. Jose selected a SpongeBob Squarepants cue. See an example of this cue on the self-monitoring chart in Figure 1. Setting The study was conducted in the subjects’ selfcontained classroom, during regular school hours. Independent work sessions occurred every day from 8:50 A.M.–9:10 A.M. Instruction occurred from 10:15 A.M.–10:45 A.M. The class consisted of eight students in first and second grades, one teacher, and two paraprofessionals. The researcher instructed these students daily and knew each student’s individual needs and motivators. Self-Monitoring Strategy / 157
  • 37. Figure 1. Example of self-monitoring charts for Phases 1– 4. Procedure Baseline data were collected for at least five sessions or until a stable trend was established. A stable trend was defined as an increase of ten or more off-task behavior occurrences in a minimum of three sessions. Following baseline, subjects were taught the self-monitoring intervention. The three subjects selected were unable to begin an independent work task and remain on-task for the duration of the independent work session, which occurred daily from 8:50 A.M.–9:10 A.M. Each subject was given the intervention of a visual cue to self-monitor during completion of independent work. In the study, subjects were shown a visual cue to self-monitor behavior during independent work time. This cue was a one-inch picture of either SpongeBob Squarepants or Dora the Explorer. This visual cue appeared at the end of a line of work. Independent work varied by subject, but the format was the same. Each worksheet had five tasks to complete (count a set of items, find and circle a designated letter, count money, etc.) All work was at the independent or 95% 158 / accuracy level of difficulty. Each subject’s work had embedded visual cues to self-monitor, while working independently, at the end of each task. The visual cue, a one-inch cartoon picture, was placed at the end of each line of work. The visual cue to self-monitor varied by subject interest but in no other way. A multiple-stimulus procedure without replacement preference assessment was given to each subject to determine the most motivating cue (Leon & Iwata, 1996). The first set of independent work had five visual cues, one after every line of work. After the subjects successfully completed independent work for three consecutive sessions and improved on-task behavior, they moved to the second set of independent work. This set had three visual cues, one after every other line. The following set of independent work had two visual cues. In the final set of independent work, one visual cue was found at the end of the worksheet. Phase one of the intervention included instruction. During instruction, the researcher used a script to instruct the subjects how to Education and Training in Autism and Developmental Disabilities-June 2012
  • 38. TABLE 1 Instruction Script 1. Tell: you are going to learn how to self-monitor while you work. 2. Show: self-monitor visual cue. 3. Tell: this picture (of Dora the Explorer/SpongeBob Squarepants) shows me that it is time to stop working and self-monitor. 4. Show: self-monitoring chart. 5. Tell: when I self-monitor, I put a sticker on this chart. 6. Tell: when you see Dora the Explorer/SpongeBob Squarepants, I stop working and put a sticker on my chart. 7. Tell: after I put a sticker on my chart, I go back to my work. 8. Tell: watch me. 9. Show: work on a problem. 10. Tell: I am doing my work. 11. Show: see the self-monitor cue. 12. Tell: I see Dora the Explorer/SpongeBob Squarepants. It is time to give myself a sticker. 13. Show: stop work; take a sticker and place it on the self-monitoring chart. 14. Tell: I am putting a sticker here because I have finished some work. 15. Show: go back to the worksheet and start next problem. 16. Tell: after I put a sticker on my chart, it is time to work. 17. Tell: now let practice together. 18. Walk through steps 10–17 with the student self-monitoring. 19. Tell: now show me how you self-monitor. 20. Watch student walk through steps 10–17 independently; prompt when necessary. self-monitor. The researcher defined the terms self-monitoring and self-monitoring chart. The researcher instructed and modeled the following procedure: complete a task on the worksheet, identify the visual cue to selfmonitor, take a sticker and place it on the self-monitoring chart, and complete the next task on the worksheet. All work and self-monitoring chart completion was to be done independently, without additional verbal cues. The self-monitoring chart corresponded to the subject’s visual cue and charted on-task behavior during independent work time by gradually indicating completion of work. Subjects paused from the independent work to add a sticker for reinforcement to their individualized self-monitoring charts. This chart tracked the subjects’ ability to remain on-task while working independently. The researcher instructed the subject to complete all tasks on the worksheet and self-monitor using the visual cue and self-monitoring chart until the self-monitoring chart was full of stickers. A chart full of stickers indicated the completion of the independent work. Following direct instruction, the researcher and subject worked together to complete two tasks on the work- sheet. Finally, the researcher watched the subject complete two tasks on the worksheet independently. Following day one of instruction, each subject was given an opportunity to complete independent work using the self-monitoring strategy. If the subject successfully completed the independent work using the self-monitoring chart, (s)he did not receive further instruction. If the subject did not successfully and independently complete the work using the self-monitoring chart, the researcher instructed the subject a second time. Once the subject completed the independent work and self-monitoring chart, (s)he turned in the self-monitoring chart to the teacher. If the subject had successfully completed the independent work and self-monitoring chart, the subject received reinforcement specifically valuable to the student (computer time, coloring a picture, completing a puzzle, etc.) Sally preferred computer time, Elise, blocks, and Jose, puzzles. Although each subject had reinforcement preferences, they were able to choose from a menu of reinforcers. After three days of successful completion of Self-Monitoring Strategy / 159
  • 39. independent work using the self-monitoring chart, the subject advanced to phase two of the intervention. In phase two, the frequency of visual cues decreased from five to three. After three days of successful completion in phase two, the subject advanced to phase three of the intervention. In phase three, the frequency of visual cues decreased from three to two. Finally, after three days of successful completion in phase three, the subject advanced to phase four of the intervention. In phase four, the frequency of visual cues decreased from two to one. Each time a subject moved from one phase to another, the selfmonitoring chart changed to correspond to the number of cues on the independent work. When moving through the intervention phases, the third day of successful independent work completion could not occur on a Monday. It was unknown if the subject would effectively remember the intervention after two weekend days of not practicing. Therefore, if the third day of successful independent work completion occurred on a Monday, then the subject would complete independent work at the same phase on Tuesday. If successful for a fourth day, the subject would advance to the next phase. Results Figure 2 titled “Sally” displays data collected over a six and a half week period for Sally, Elise, and Joe. Sally was taught the self-monitoring intervention to use during independent work time. The graph displays both the frequency of off-task behavior during independent work time and the amount of time it took Sally to complete the independent work. During the first six days of baseline, Sally was given independent work to complete during the independent work session, without any further support or instruction. During instruction, Sally was taught the self-monitoring strategy. The researcher taught her the intervention, they practiced the intervention together, and the researcher observed Sally attempt the intervention independently. After Sally demonstrated an understanding of the intervention, she began using the self-monitoring strategy independently during the independent work session. During baseline, Sally averaged 5.6 occurrences of off-task behavior. Af- 160 / ter learning the self-monitoring strategy, Sally averaged 1.1 occurrences of off-task behavior. At the beginning of intervention, Sally spent more time completing independent work than during baseline. After day 13 of the study, Sally’s completion time decreased by more than four minutes. Baseline data were collected for Elise for 11 days. After the first day of instruction, Elise was not able to accurately complete the selfmonitoring chart. Therefore, she received a second day of instruction. Following the second day of instruction, Elise was able to accurately use the self-monitoring strategy while completing independent work. The researcher instructed Elise in the same way Sally was instructed. During baseline, Elise averaged 7.5 occurrences of off-task behavior. After learning the self-monitoring strategy, Elise averaged 1.8 occurrences of off-task behavior. Throughout the duration of the study, Elise’s completion time decreased by over four minutes. Baseline data were collected for Jose for 16 days. The researcher followed the same procedure in teaching Jose the self-monitoring strategy as used with Sally and Elise. During baseline, Jose averaged 5.3 occurrences of offtask behavior. After learning the self-monitoring strategy, Jose averaged .6 occurrences of off-task behavior. Throughout the duration of the study, Jose’s completion time decreased by over six minutes. Within this study, the use of a self-monitoring strategy successfully decreased occurrences of off-task behavior during independent work time. All three subjects demonstrated a decrease in occurrences of off-task behavior during independent work time. Additionally, Elise and Jose spent less time working on independent work after learning the self-monitoring strategy. As Sally learned the self-monitoring strategy, her completion time increased, but as she familiarized herself with the strategy, her completion time decreased. Discussion The purpose of this study was to determine the effect of a self-monitoring strategy on independent work behavior. Specifically, the study investigated occurrences of off-task be- Education and Training in Autism and Developmental Disabilities-June 2012
  • 40. Figure 2. Results for Sally, Elise, and Jose. havior and completion time of independent work with three students, with identified MID and IEPs with functional academic and behav- ior goals. Results of the study indicate that a self-monitoring strategy, in which students track progress while completing independent Self-Monitoring Strategy / 161
  • 41. work, effectively decreased the occurrences of off-task behavior. Additionally, in all three subjects, the intervention decreased independent work completion time. Sally was enthusiastic to learn the self-monitoring strategy, specifically to use the selfmonitoring chart while completing independent work. She quickly learned how to use the strategy and effectively used it independently after one day of instruction. Data collected on Sally indicate that the self-monitoring strategy effectively decreased the frequency of off-task behavior. Although not by a significant amount, the strategy decreased her completion time. Using the self-monitoring strategy encouraged her to remain focused while completing independent work. She took pride in maintaining responsibility for her work. During the first day of instruction, Elise quickly learned the self-monitoring strategy. She was able to demonstrate understanding of the strategy during the instruction session, but then next day was not successful at implementing the strategy independently. Therefore, the researcher instructed her in a second instruction session. On the second day of using the strategy during the independent work session, she was able to successfully self-monitor independently. Data collected for Elise indicate that the self-monitoring strategy effectively decreased the frequency of off-task behavior. Additionally, the strategy decreased her completion time. Elise celebrated to herself each time she successfully self-monitored during independent work time. As she turned in her independent work and self-monitoring chart, she would say aloud to herself, “You did it Elise” (or another similar phrase). During baseline, Jose demonstrated a high frequency of off-task behavior. He quickly learned the self-monitoring strategy. He effectively used the strategy to self-monitor during independent work time the first day following instruction. Data collected for Jose indicate that the self-monitoring strategy significantly decreased the frequency of off-task behavior. Additionally, the strategy significantly decreased his completion time. Jose quickly realized that the less time he spent on independent work, the more time he could spend with a self chosen reinforcement. 162 / Implications for Education Findings in this study suggest that the use of a self-monitoring strategy helps to decrease the frequency of off-task behavior. These off-task behaviors include any behaviors irrelevant to the academic task (Gickling & Armstrong, 1978). Additionally, the strategy decreases the completion time of independent work. This strategy incorporates specific and descriptive instruction, which enhances task completion (Bouxsein et al., 2008). The research found the self-monitoring strategy to work with early elementary students with identified MID. Teaching students to self-manage behavior gives students the responsibility of owning their behavior choices. This enhances the students’ independent functioning. Additionally, it enables further integration into the community at large (Hume & Odom, 2007; Selznick & Savage, 2000). As students self-manage, they gain confidence in their abilities both in the classroom and community (Lapan et al., 2002). This strategy could be taught to an entire class. A teacher could implement this selfmonitoring strategy in a classroom with minimal training (Ganz, 2008). An independent work session in which students work on-task for the duration of the session would allow a teacher to work one-on-one with a student, assess an individual or small group, or work with a small group of students for remedial instruction, without interruption. Additionally, students could generalize this strategy to other academic tasks, as they complete work independently or in small groups, during various instruction times in a school day. Based on the results of this study, when students self-monitor behavior while completing independent work, they have less frequent occurrences of off-task behavior. When students have less frequent occurrences of offtask behavior, the teacher can spend less time redirecting and instructing the whole group of students. This provides the teacher more time to work with other students, either oneon-one or in a small group, without interruptions. Limitations This study may have threats to both internal and external validity. Maturation is a potential Education and Training in Autism and Developmental Disabilities-June 2012
  • 42. threat to internal validity. All three subjects are in critical learning stages and physical and emotional maturation may have contributed to their on-task behavior improvement. Further research on older students with MID or other cognitive disability could eliminate this threat. Selection is another potential threat to internal validity. Each subject was systematically selected. A potential threat to external validity is reactive arrangements, otherwise known as the Hawthorne effect. The subjects were aware of their participation in the study. Therefore, this acknowledgement of participation may have affected their performance during independent work time, using the self-monitoring strategy (Salkind, 2006). Future Research This study could be replicated on older students with identified MID, as well as students with other disabilities in both self-contained settings and resource settings, as long as their behavior needs are similar to the subjects used in this study. Future research may find that some populations of students need more cues to self-monitor than other populations. Also, further research could determine this strategy’s effectiveness among various populations of students and during various academic tasks. Summary This study examined the use of a self-monitoring strategy during independent work time, and its effect on on-task behavior and completion time. A multiple-baseline across subjects design was used for the three subjects who participated in the study. Results of occurrences of off-task behavior in three subjects were analyzed to determine the effect of the intervention on on-task behavior. Examination of the data provided results indicating that the use of a self-monitoring strategy during independent work time decreased both occurrences of off-task behavior and completion time. After learning the self-monitoring strategy, all three subjects were able to effectively implement the strategy during independent work sessions. References Bouxsein, K. J., Tiger, J. H., & Fisher, W. W. (2008). A comparison of general and specific instructions to promote task engagement and completion by a young man with Asperger syndrome. Journal of Applied Behavior Analysis, 41, 113–116. Burns, M. K., & Dean, V. J. (2005). Effect of drill ratios on recall and on-task behavior for children with learning and attention difficulties. Journal of Instructional Psychology, 32, 118 –126. Crawley, S. H., Lynch, P., & Vannest, K. (2006). The use of self-monitoring to reduce off-task behavior and cross-correlation examination of weekends and absences as an antecedent to off-task behavior. Child & Family Behavior Therapy, 28, 29 – 48. DeLeon, I. G., & Iwata, B.A. (1996). Evaluation of a multiple-stimulus presentation format for assessing reinforcer preferences. Journal of Applied Behavior Analysis, 29, 519 –533. Ganz, J. B. (2008). Self-monitoring across age and ability levels: Teaching students to implement their own positive behavioral interventions. Preventing School Failure, 53, 39 – 48. Ganz, J. B., Cook, K. E., & Earles-Vollrath, T. L. (2007). A grab-bag of strategies for children with mild communication deficits. Intervention in School and Clinic, 42, 179 –187. Ganz, J. B., & Sigafoos, J. (2005). Self-monitoring: Are young adults with MR and autism able to utilize cognitive strategies independently? Education and Training in Developmental Disabilities, 40, 24 –33. Gickling, E. E., & Armstrong. D. L. (1978). Levels of instructional difficulty as related to on-task behavior, task completion, and comprehension. Journal of Learning Disabilities, 11, 559 –566. Hume, K., & Odom, S. (2007). Effects of an individual work system on the independent functioning of students with autism. Journal of Autism and Developmental Disorders, 37, 1166 –1180. Koegel, L. K., Harrower, J. K., & Koegel, R. L. (1999). Support for children with developmental disabilities in full inclusion classrooms through self-management. Journal of Positive Behavior Interventions, 1, 26 –34. Lane, K. L., Menzies, H., Bruhn, A., & Crnobori, M. (2011). Managing challenging behaviors in schools: Research-based strategies that work. New York, NY: Guilford Press. Lapan, R. T., Kardash, C. M., & Turner, S. (2002). Empowering students to become self-regulated learners. Professional School Counseling, 5, 257–265. Mace, F., & West, B. (1986). Unresolved theoretical issues in self-management: Implications for research and practice. Professional School Psychology, 1(3), 149 –163. Mitchem, K. J., & Young, R. (2001). Adapting self- Self-Monitoring Strategy / 163
  • 43. management programs for classwide use: Acceptability, feasibility, and effectiveness. Remedial and Special Education, 22, 75– 88. Mooney, P., Epstein, M. H., Reid, R., & Nelson, J. R. (2003). Status of and trends in academic intervention research for students with emotional disturbance. Remedial and Special Education, 24, 273– 287. O’Leary, S., & Dubey, D. (1979). Applications of self-control procedures by children: A review. Journal of Applied Behavior Analysis, 12, 449 – 465. O’Rielly, M., Tiernan, R., Lancioni, G., Lacey, C., Hillery, J., & Gardiner, M. (2002). Use of selfmonitoring and delayed feedback to increase ontask behavior in a post-institutionalized child within regular classroom settings. Education and Treatment of Children, 25, 91–102. Parsons, M. B., Rollyson, J. H., & Reid, D. H. (2004). Improving day-treatment services for adults with severe disabilities: A norm-referenced application of outcome management. Journal of Applied Behavior Analysis, 37, 365–377. Rankin, J. L., & Reid, R. (1995). The SM rap: Or here’s the rap on self-monitoring. Intervention in School and Clinic, 30, 181–188. 164 / Rosenbaum, M. S., & Drabman, R. S. (1979). Selfcontrol training in the classroom: A review and critique. Journal of Applied Behavior Analysis, 12, 467– 485. Salkind, N. (2006). Exploring research. Upper Saddle River, NJ: Pearson Education, Inc. Saunders, R. R., McEntee, J. E., & Saunders, M. D. (2005). Interaction of reinforcement schedules, a behavioral prosthesis, and work-related behavior in adults with mental retardation. Journal of Applied Behavior Analysis, 38, 163–176. Selznick, L., & Savage, R. (2000). Using self-monitoring procedures to increase on-task behavior with three adolescent boys with brain injury. Behavioral Interventions, 15, 243–260 Soares, D. A., Vannest, K. J., & Harrison, J. (2009). Computer aided self-monitoring to increase academic production and reduce self-injurious behavior in a child with autism. Behavioral Interventions, 24, 171–183. Received: 14 December 2010 Initial Acceptance: 1 March 2011 Final Acceptance: 28 June 2011 Education and Training in Autism and Developmental Disabilities-June 2012
  • 44. Education and Training in Autism and Developmental Disabilities, 2012, 47(2), 165–175 © Division on Autism and Developmental Disabilities Teaching Social Skills to Children with Autism Using the Cool versus Not Cool Procedure Justin B. Leaf, Kathleen H. Tsuji, Brandy Griggs, Andrew Edwards, Mitchell Taubman, John McEachin, Ronald Leaf, and Misty L. Oppenheim-Leaf Autism Partnership and Behavior Therapy and Learning Center Abstract: This study evaluated the effects of the cool versus not cool procedure for teaching three children diagnosed with an autism spectrum disorder eight social skills. The cool versus not cool procedure is a social discrimination program used to increase children’s ability to display appropriate social behaviors. In this study, the cool versus not cool procedure consisted of the participants observing the researcher demonstrating a social behavior either appropriately or inappropriately, followed by the participants discriminating whether the researcher demonstration was “cool” (appropriate) or “not cool” (inappropriate). For some social skills the participants role-played the social behavior following the researcher demonstration. Results indicated that participants reached mastery criterion on 50% of targeted social skills with the researcher demonstration and on an additional 37.5% of targeted social skills with researcher demonstrations plus role-plays. Only one participant on one social skill (12.5%) was unable to reach mastery criterion although performance increased from baseline. Several behavior interventions have been implemented to increase the social behavior of children diagnosed with an autism spectrum disorder (ASD). These interventions have included: video modeling (e.g., Apple, Billingsley, & Schwartz, 2005, Charlop-Christy, Le, & Freeman, 2000), the teaching interaction procedure (e.g., Leaf et al., 2009; Leaf, Dotson, Oppenheim, Sheldon, & Sherman, 2010), discrete trial teaching (e.g., Leaf & McEachin, 1999; Lovaas, 1981, 1987), social stories (e.g., Theimann & Goldstein, 2001), and behavioral skills training (e.g., Stewart, Carr, & LeBlanc, 2007). Researchers have shown that these interventions can not only improve the social behavior of individuals diagnosed with an autism spectrum disorder but The researchers wish to thank Shelli Infield, Julie Stiglich, and Cliff Anderson for their continuous help throughout the project. We also wish to thank the staff of Autism Partnership, the families of Autism Partnership, and the children involved in this study. Correspondence concerning this article should be addressed to Justin B. Leaf, Autism Partnership, 200 Marina Drive, Seal Beach, CA 90740. E-mail: Jblautpar@aol.com can also improve their overall quality of life (e.g., Bauminger & Kasari, 2000; Ladd, Birch, & Buhs, 1999; Stewart, Barnard, Pearson, Hasan, & O’Brien, 2006). A common component of several of the above mentioned social skills interventions is the teacher demonstrating the appropriate behavior for the learner and/or the learner role-playing the appropriate social behavior with the teacher. For example, in video-modeling, the learner watches a videotape of oneself, a peer, or the teacher demonstrating the appropriate social behavior prior to practicing the social behavior with the teacher. Charlop and Milstein (1989) evaluated the effects of video modeling for increasing conversational scripts for three young children diagnosed with autism. In this study, two adults modeled the appropriate conversational scripts, the learner watched a videotape of that model, and then the participant practiced the conversational scripts with the researcher. Charlop and Milstein utilized a multiple baseline design across the three participants and within participants across two different conversational scripts, to evaluate the effects of the video-modeling procedure. Results of the Cool versus Not Cool Procedure / 165
  • 45. study indicated that all participants were able to learn conversational scripts directly taught to them, maintained the conversational scripts during maintenance probes conducted 15months after intervention, and generalized their conversational skills to different untrained conversational scripts. Teacher demonstration and participant role-plays are also an important component of behavioral skills training (e.g., Stewart et al., 2007). In behavioral skills training the teacher labels the social behavior, describes how to perform the task analyzed steps of the social behavior, then models the social behavior prior to having the learner role-play the same behavior, followed by positive feedback for correct modeling of the targeted behavior. Hanley, Heal, Tiger, and Ingvarsson (2007) evaluated a class-wide pre-school teaching program that used behavioral skills training to decrease problem behavior and increase preschool life skills (e.g., responding to their name) for 16 preschool children. The behavioral skills training consisted of the researchers modeling the appropriate pre-school life skill to the participants and then the participants demonstrating that skill. The researchers utilized a multiple probe design to evaluate the program. Results indicated that participants were able to reduce their problem behaviors by 74% and were able to learn the different preschool life skills that were directly taught to them. The teaching interaction procedure is identical to behavioral skills training except for the addition of rationales. Rationales include reasons why the learner should engage in the social behavior and, sometimes, cues and characteristics for when the learner should engage in the social behavior. Like behavioral skills training, teacher demonstration and role-playing are a critical component of the teaching interaction procedure. Leaf and colleagues (2010) implemented the teaching interaction procedure in a group setting for five young children diagnosed with ASD. In this study, the researchers taught four different social skills (i.e., showing appreciation, giving a compliment, making an empathetic statement, and changing the game) to each of the five participants. The researchers demonstrated appropriate and inappropriate exam- 166 / ples of each of the four social skills within the teaching interaction. Following the teacher demonstration, the researchers asked the participants to identify whether the social skill had been modeled appropriately or inappropriately and why the demonstration was appropriate or inappropriate. Next, the participants had the opportunity to role-play the social skill the appropriate way. Leaf and colleagues utilized a multiple probe design across skills and replicated across participants; the results showed that participants were able to learn and generalize the four social skills taught to them with the teaching interaction procedure. Another procedure that utilizes teacher demonstration and can include participant role-play is the cool versus not cool procedure (Taubman, Leaf, & McEachin, 2011). The cool versus not cool procedure is a social discrimination program used to teach children and adolescents to discriminate between appropriate (“cool”) and inappropriate (“not cool”) social behaviors. During the cool versus not cool procedure a teacher demonstrates either a socially appropriate behavior (e.g., raising hand to gain teacher’s attention) or a socially inappropriate behavior (e.g., yelling out to gain teacher’s attention) and asks the learner to state whether the demonstrated behavior was “cool” (socially appropriate) or “not cool” (socially inappropriate). This is followed by the teacher asking the learner why that demonstration was “cool” or “not cool” and the teacher providing feedback to the learner for correct discrimination. After the teacher is done demonstrating the social skill, the learner typically has the opportunity to role-play the social skill appropriately followed by the teacher providing feedback for correctly role-playing the targeted social behavior. Although the cool versus not cool procedure is similar to the above described behavioral interventions, there are variations. The cool versus not cool procedure varies from behavioral skills training and the teaching interaction procedure in that it does not provide a description of the behavior, a rationale of why the learner should engage in the behavior, and does not provide cues and characteristics about when the learner should display the appropriate social behavior. The cool versus not cool procedure varies from prior Education and Training in Autism and Developmental Disabilities-June 2012
  • 46. research on video modeling in that all demonstrations are done in vivo, and that cool versus not cool involves discrimination training and not merely the modeling of appropriate alternatives. The cool versus not cool procedure has been clinically implemented with numerous children and adolescents diagnosed with ASD (Taubman et al., 2011); however, to date, there has been no empirical investigation on its effectiveness. Additionally, it is not known how effective the cool versus not cool procedure would be with just the teacher demonstration alone, without the addition of the learner role-play. The purpose of the current study was twofold: (1) to conduct the first empirical evaluation of the cool versus not cool discrimination procedure to children diagnosed with ASD and (2) to evaluate if children can learn a variety of social skills utilizing the cool versus not cool discrimination procedure alone or if it would additionally require implementation of role-play for the participants to learn the various social skills. Autistic Disorder. Donald had a Wechsler Preschool and Primary Scales of IntelligenceThird Edition Full Scale IQ score of 88, a Vineland Adaptive Score of 77, a SSRS-P standard score of 104 (61st percentile), and a SSRS-T stand score of 102 (55th percentile). Donald received 35 hours of behavioral intervention per week and attended a general education classroom with supports. Setting The researchers conducted all research sessions in a room at a private behavioral agency’s clinic in Southern California. The agency provides behavior intervention services to children and adolescents diagnosed with ASD. The room contained toys, chairs, and other educational materials. Participants participated in research anywhere from one to five days per week. Each experimental session lasted approximately 60 min including probes and teaching. Skills Taught Method Participants Dante was a 9-year-old boy diagnosed with Autistic Disorder. Dante had a Wechsler Intelligence Scale for Children IV (WISC IV) Intelligence Quotient (IQ) score of 80, a Vineland Adaptive Composite Behavior Score of 90, a Social Skills Rating Score-Parent (SSRS-P) standard score of 116 (82nd percentile), and a Social Skills Rating Score-Teacher (SSRS-T) standard score of 105 (63rd percentile). Dante received 30 hours of behavioral intervention per week which included supporting him in his general education classroom. Marc was an 8-year-old boy diagnosed with Autistic Disorder. Marc had a WISC IV Full IQ Score of 127, a Vineland Adaptive Score of 105, a Social Skills Improvement System (SSiS) Rating Scale (Parent) standard score of 93 (30th percentile), and a SSiS-Teacher standard score of 81 (10th percentile). Marc received 8.5 hours of behavioral intervention a week and attended general education classroom with supports. Donald was a 4-year-old boy diagnosed with The researchers identified areas of social deficit for each participant by asking the participant’s clinical supervisor what social skills needed to be taught and through direct observations of the participant. The researchers identified two to three targets for each participant and either task analyzed the social skills into smaller behavioral components or operationally defined the skills. Table 1 provides information for each of the social skills taught to the three participants. Measurement The researchers measured each of the eight social skills during naturalistic probes. During naturalistic probes, the researchers simply engaged in a behavior that set the occasion for the participant to display one of the target social skills. For example, when measuring the social skill of changing the conversation when a person gets bored the researcher and participant would engage in a conversation and at some point the researcher would appear to be bored (e.g., looking away or looking at his or her watch) and see if the participant would change the conversation. The researchers did Cool versus Not Cool Procedure / 167
  • 47. TABLE 1. Skills Taught Participant Dante Skill Taught Interrupting Marc Donald Wait for a break, say excuse me, state person’s name, say sorry for interrupting, state what they needed to say, and walk away. Changing the game Asked to play a different game when the other person looked bored, asked the person what new game they wanted to play, agreed to play it, got the materials needed, play the game, and refrain from any negative or rude comments. Appropriate Made a general greeting statement, stated the person’s name, and asked a greetings personal inquiring question. Interrupting Wait for a break, say excuse me, state person’s name, say sorry for interrupting, state what they needed to say, and walk away. Joint attention Stop engaging in preferred activity, look towards the person who made the comment, look in the direction the comment is being direct too, make a positive comment about what the other person was doing. Changing the Changed the topic when the other person looked bored by making a conversation comment about a different topic, wait for the person to respond, make a second comment about the new topic, wait for the person to respond. Abduction Say no to the strangers request to go with them, make a statement that prevention they do not know the person, did not follow the stranger, restate they will not go with the stranger, walk away from the stranger, tell the teacher about what just occurred. Eye contact The participant looked at the conversational partner in the eye or face at the 10 second interval. not prime, prompt, reinforce, or provide consequences to the participants during naturalistic probes. For the social skills that were task analyzed (i.e., interrupting appropriately, joint attention, changing the conversation, abduction avoidance, and changing the game), the participants had one opportunity to display the social skill per naturalistic probe. During the naturalistic probe, the researchers recorded whether the participant engaged or did not engage in each of the components of the task analysis for each skill. For the social skill of appropriate greetings, Dante had five different opportunities to display the social skill during the naturalistic probe. During each one of these opportunities the researchers scored if Dante displayed the skill correctly or incorrectly. For Donald’s target of maintaining eye contact, a 10 s momentary time sampling procedure was implemented. During this probe the researcher engaged in a two-minute conversation and at the end of each 10 s interval the researcher scored if Donald was making eye contact. The re- 168 Operational Definition / searchers set mastery criterion for each of the social skills at 80% or above of the behavioral steps, opportunities, or intervals for three consecutive naturalistic probes. Experimental Design and General Procedure To evaluate the effectiveness of the cool versus not cool procedure, the researchers implemented a multiple baseline design across social skills and replicated it across participants. The research consisted of four distinct phases: an initial baseline, intervention, maintenance, and a booster session condition. Initial baseline condition. An initial baseline condition occurred prior to the teaching of any of the social skills for each participant. Each session in this condition began with the researcher implementing naturalistic probes for each of the social skills. The order of the naturalistic probes was randomly determined ahead of time. After all naturalistic probes were conducted, the participant resumed ongoing activity in his regular setting; an hour later the researcher pulled the participant out Education and Training in Autism and Developmental Disabilities-June 2012
  • 48. of his regular setting and probed all of the social skills again. Intervention condition. During the intervention condition, the researchers taught one of the social skills while the other two social skills were either in the baseline or maintenance condition. Each research session began with the researcher implementing naturalistic probes for the social skill that was in the intervention condition, the social skill(s) in the baseline condition, and during some research sessions the social skill(s) that were in maintenance. The order of the naturalistic probes was randomly determined ahead of time. A short break (5 to 30 min) followed the naturalistic probes. After the break, the researcher implemented the cool versus not cool procedure (described below) for the skill currently in intervention. Following the implementation of the cool versus not cool procedure, the researcher placed the participant back in his regular setting. During most days, at least an hour after the cool versus not cool procedure was implemented, the researcher again pulled the participant out of his regular setting and implemented naturalistic probes for the skill in the intervention condition, the skills in the baseline condition, and, during some research sessions, skill(s) that were in maintenance. The second set of naturalistic probes was occasionally not conducted due to daily scheduling issues. Maintenance condition. Once a participant reached mastery criterion on a given social skill the researchers placed that social skill into maintenance. Once a skill was put on maintenance the researchers randomly probed the skill during various research sessions and the skill did not receive further intervention. Booster session condition. The researchers implemented booster sessions for targeted skills that participants had reached mastery criterion during teaching or were displaying an average accuracy of 50% or less during maintenance. These skills were then placed in the booster condition. During booster sessions the researchers implemented naturalistic probes for each of the skills placed in the booster condition. If the participant displayed the social skill correctly during the naturalistic probe the researchers provided social praise to the participant. If the participant displayed the social skill incorrectly during the naturalistic probe the researchers provided corrective feedback and implemented the cool versus not cool procedure. Teaching Procedures Cool versus not cool discrimination procedure (teacher demonstration only). The teaching procedure consisted of six total teaching trials (three trials of the appropriate behavior and three trials of the inappropriate behavior). The order of each trial was randomly determined ahead of time. A trial began with the researcher demonstrating either the appropriate behavior or the inappropriate behavior. For example, if the researcher was demonstrating the appropriate version of changing the conversation when someone is bored, the researcher would talk to another teacher about a certain topic (e.g., shopping) and once that other teacher appeared bored (e.g., sighing, looking away, looking at his or her watch) the researcher would make a statement or ask a question about another unrelated topic (e.g., baseball). If, however, the researcher was demonstrating the inappropriate version, the researcher would continue talking about the original topic (e.g., shopping) even after the other teacher gave a signal (e.g., sighing, looking away, looking at his or her watch) that he or she was bored. After the researcher demonstrated the behavior she asked the participant if the demonstration was “cool” (appropriate) or “not cool” (not appropriate). If the participant answered correctly the researcher provided social praise; however, if the participant answered incorrectly the researcher provided corrective feedback. Next, the researcher asked the participant why the demonstration was either “cool” or “not cool.” If the participant answered correctly the researcher provided praise to the participant. If, however, the participant answered incorrectly the teacher provided corrective feedback and told the participant why the demonstration was appropriate or inappropriate. Cool versus not cool procedure (teacher demonstration plus participant role-play). If after 10 naturalistic probes the participant had not reached mastery criterion or did not have a score of 80% or above on the 10th naturalistic Cool versus Not Cool Procedure / 169
  • 49. probe, the researchers implemented the cool versus not cool discrimination procedure plus role-playing. This phase was identical to the cool versus not cool procedure (described above) with one major addition, the participant role-playing the appropriate social behavior. After the six trials of researcher demonstration the participant role-played the social behavior. The role-plays consisted of the researcher telling the participant that it was his turn to practice the skill the “cool” way. Next, the researcher would engage in a behavior that set the occasion for the participant to display the social skill (similar to naturalistic probes). After the participant role-played the behavior the researcher asked the participant if they displayed the skill “cool” or “not cool” and why the performance was “cool” or “not cool.” If the participant role-played and answered the questions correctly, the researcher provided social praise. If the participant roleplayed incorrectly but answered the questions correctly, the researcher praised the participant for answering the questions correctly but had the participant role-play the behavior again. If the participant role-played incorrectly and answered the questions incorrectly the researcher provided corrective feedback and provided further explanation on why the demonstration was “cool” or “not cool.” Participants role-played until they were able to correctly role-play the behavior on two consecutive trials. Participants were never asked to role play an inappropriate version. Reliability and Treatment Fidelity The researcher scored participant behavior during all research sessions. A second researcher independently scored participant behaviors via videotape on 26% of naturalistic probes across the eight social skills. Interobserver agreement was calculated by totaling the number of times observers agreed on the scoring of each skill step or occurrence of the behavior divided by the total number of agreements and disagreements on scoring each skill step or occurrence of the behavior. This was converted to a percentage of agreement per each skill. Percentage agreement across all naturalistic probes was 96% (range, 71– 100%). To assess treatment fidelity, an independent 170 / observer recorded planned researcher behaviors during 25% of time when the researcher was implementing the teaching procedure. Planned researcher behaviors during the cool versus not cool procedure were the teacher: (a) demonstrating the behavior appropriately for three trials; (b) demonstrating the behavior inappropriately for three trials; (c) having the participant state whether the demonstration was “cool” or “not cool” during every trial; (d) having the participant state why the behavior was “cool” or “not cool”; and (e) having the participant role-play the social behavior when applicable. The independent observer scored that the researchers implemented the procedure correctly 100% of the time. Results Across the three participants a total of eight social skills were taught with the cool versus not cool procedure. Across the three participants, mastery criterion (i.e., 80% correct during three consecutive naturalistic probe sessions) was reached for 50% of the skills taught using the cool versus not cool procedure with teacher demonstration only and 37.5% of the social skills using the cool versus not cool procedure with role-plays. Only one social skill, for one participant, did not reach mastery criterion. Figures 1 to 3 show these results. Dante reached mastery criterion for two social skills (i.e., interrupting appropriately and changing the game when someone was bored) with the cool versus not cool discrimination procedure alone and reached mastery criterion for one social skill (appropriate greetings) using the discrimination procedure plus role-plays (see Figure 1). Prior to intervention, Dante displayed an average of 0%, 0%, and 5.3% for interrupting appropriately, changing the game when someone was bored, and greetings, respectively. Dante reached mastery criterion in 11 naturalistic probes, 3 naturalistic probes, and 24 naturalistic probes for interrupting appropriately, changing the game when someone was bored, and greetings, respectively. During the assessment of maintenance on naturalistic probes, Dante maintained an average of 21%, 85%, and 60% of steps for interrupting, changing the game, and greetings, respectively. Since Dante’s Education and Training in Autism and Developmental Disabilities-June 2012
  • 50. Figure 1. Skills Taught to Dante. maintenance of interrupting appropriately was below 50%, a booster condition was implemented. Marc reached mastery criterion for one social skill, interrupting appropriately, with the cool versus not cool discrimination procedure alone and reached mastery criterion for two skills, joint attention and changing the conversation when someone was bored, using the discrimination procedure plus role-plays (see Figure 2). Prior to intervention, Marc displayed an average of 0%, 5%, and 2% for interrupting appropriately, joint attention, and changing the conversation when someone was bored, respectively. Marc reached mastery criterion in 13 naturalistic probes, 25 naturalistic probes, and 15 naturalistic probes for interrupting appropriately, joint attention, and changing the conversation when bored, respectively. During the assessment of maintenance on naturalistic probes, Marc correctly performed an average of 50%, 75%, and 100% of steps for interrupting, joint attention, and changing the conversation when someone was bored, respectively. Since no skill dropped below Cool versus Not Cool Procedure / 171
  • 51. Figure 2. Skills Taught to Marc. 50% the booster condition was not implemented for Marc. Donald reached mastery criterion for one social skill, abduction avoidance, with the cool versus not cool discrimination procedure alone and did not reach mastery criterion for the other social skill, eye contact, even after the role-playing was implemented (see Figure 3). Although Donald did not reach mastery criterion for eye contact, he did increase his 172 / ability to display eye contact during naturalistic probes from an average of 18.7% during baseline to an average of 31% and 57.5% during the cool versus not cool discrimination procedure alone and the cool versus not cool discrimination procedure plus role-plays, respectively. Prior to intervention, Donald displayed an average of 0% for abduction avoidance. Donald reached mastery criterion in 12 naturalistic probes for that skill. During the Education and Training in Autism and Developmental Disabilities-June 2012
  • 52. Figure 3. Skills Taught to Donald. assessment of maintenance, on naturalistic probes, Donald maintained 72% and 63% of steps for abduction avoidance and eye contact respectively. Since the mastered skill did not fall below 50% during maintenance, the booster condition was not implemented for Donald. Discussion Results of this study indicated that participants were able to reach mastery criterion on four out of eight social skills with the cool versus not cool procedure. Participants required role-playing to reach mastery criterion for an additional three social skills targets, one participant, Donald, was unable to reach mastery criterion on one of his targets, even after role-playing was implemented. Thus, participants reached mastery criterion on 50% of the targeted social skills with the cool versus not cool procedure alone and participants reached mastery criterion on an additional 37.5% of social skills with the addition of roleplaying. Results of the study have several implications pertaining to instruction in the social area for children with ASD. Results of the study indicate that the cool versus not cool procedure may be an effective procedure when teaching social discrimination to children with ASD. The three social skills targets (i.e., interrupting, abduction prevention, and changing the game) that did reach mastery criterion with the cool versus not cool discrimination procedure alone were targets that required the participants to merely make a social discrimination such as “Is this person a stranger?”, “Is this person bored?”, or “Is this an appropriate time to interrupt?” as opposed Cool versus Not Cool Procedure / 173
  • 53. to learning multi-step social interaction skills. Conversely, with the majority of those skills that did require multi-step interactional competencies (e.g. greetings and joint attention), the study illustrated that the combination cool versus not cool and role play procedure may be effective for teaching those skills. Despite the positive findings in this study there were still limitations. One limitation of this study is the time it took participants to reach mastery criterion. Across all eight social skills it took participants a range of 3 to 24 probes to reach mastery criterion. However, conducting probes twice during a research session resulted in numerous probes being conducted prior to a skill reaching mastery and fewer teaching sessions being conducted. Additionally, the cool versus not cool procedure does fall in the range of efficiency of several other commonly implemented social skills interventions including: the teaching interaction procedure (e.g., Leaf et al., 2009, 2010), social stories (Kokina & Kern, 2010), and script fading (e.g., Stevenson, Krantz, & McClannahan, 2000). A second limitation of this study is that one participant did not reach mastery criterion on one of his skills. Although this participant did not reach mastery criterion on one skill, this is also seen in other behavioral interventions (e.g., social stories and the teaching interaction procedure) (e.g., Kokina & Kern, 2010; Leaf et al., 2010). Future researchers should continue to evaluate the cool versus not cool procedure to determine the parameters of its effectiveness. Even with the limitations of the current study there are several reasons why clinicians may choose to implement the cool versus not cool procedure. For one, the cool versus not cool procedure provides the learner the opportunity to observe both a correct demonstration and incorrect demonstration of the desired social skill. Having the learner observe the teacher demonstrating such contrasting alternatives may be beneficial as it allows the learner to view how he or she should display the desired behavior and how he or she may be displaying the social skill. This can be very helpful when the learner is not displaying the subtle nuances of a social skill. A second reason why clinicians may choose to implement cool versus not cool is the flex- 174 / ibility of the procedure. In this study the researchers implemented the cool versus not cool with teacher demonstration alone for some skills and both teacher demonstration and participant role-play for other social skills; these are only two ways that the procedure can be implemented. Clinicians can implement the procedure as a matching program, a receptive program, or by having peers demonstrate the behavior. A third reason why clinicians may choose to implement the cool versus not cool procedure is that it requires little to no materials to set up prior to teaching, unlike social stories, which require the clinician to write a story and create a book prior to intervention, or video-modeling, which requires the clinician to create videotapes prior to intervention. Though certainly involving planning, the cool versus not cool procedure does not requires such extensive material development prior to teaching. Therefore, clinicians can implement the cool versus not cool procedure spontaneously. Finally, clinicians can implement the cool versus not cool procedure prior to using other behavioral interventions (e.g., the teaching interaction procedure, video modeling, behavioral skills training) for social skills that need to be taught. If the skill entails a straightforward social discrimination, then there may be no need to implement the more labor intensive procedures. If, however, the learner is not able to learn the skill with just the cool versus not cool procedure, for example, with a multistep interactional skill, then the cool versus not cool procedure may help expedite learning with the other behavioral interventions. Future researchers should evaluate whether implementation of the cool versus not cool procedure prior to the implementation of other behavioral interventions accelerates learning. Research should also examine if the cool versus not cool procedure alone is effective in addressing social skill needs beyond social discriminations. This study found that the cool versus not cool procedure alone and in combination with role play was an effective intervention for improving the social behaviors of three young children diagnosed with ASD. Future researchers should continue to evaluate this procedure to determine how effective it is for other children and adolescents diagnosed Education and Training in Autism and Developmental Disabilities-June 2012
  • 54. with ASD, how effective it is when implemented in various instructional formats, the use of the combined demonstration and role play procedures with social interactional skills of a complexity greater than those examined in this study, and how effective, efficient, and preferred cool versus not cool is when compared to other commonly implemented social skills interventions (e.g., social stories, video modeling, script fading). In doing so clinicians may have a new effective procedure to implement when teaching social skills to children and adolescents diagnosed with ASD. References Apple, A. L., Billingsley, F., & Schwartz, I. S. (2005). Effects of video modeling alone and with selfmanagement on compliment-giving behaviors of children with high-functioning ASD. Journal of Positive Behavior Interventions, 7, 33– 46. Bauminger, N., & Kasari, C. (2000). Loneliness and friendship in high-functioning children with autism. Child Development, 71, 447– 456. Charlop, M. H. & Milstein, J. P. (1989). Teaching autistic children conversational speech using video modeling. Journal of Applied Behavior Analysis, 22, 275–285. Charlop-Christy, M. H., Le, L., & Freeman, K. A. (2000). A comparison of video modeling with in vivo modeling for teaching children with autism. Journal of Autism and Developmental Disorders, 30, 537–552. Hanley, G. P., Heal, N. A., Tiger, J. H., & Ingvarsson, E. T. (2007). Evaluation of a classwide teaching program for developing preschool life skills. Journal of Applied Behavior Analysis, 40, 277–300. Kokina, A., & Kern, L. (2010). Social story intervention for students with autism spectrum disorders: A meta-analysis. Journal of Autism and Developmental Disorders, 40, 812– 816. Ladd, G.W. Birch, S. H., & Buhs, E. S. (1999). Children social and scholastic lives in kindergarten: Related spheres of influence? Child Development, 70, 1373–1400. Leaf, J. B., Dotson, W., Oppenheim, M. L., Sheldon, J. B., & Sherman, J. A. (2010). The effectiveness of group teaching interactions for young children with a pervasive developmental disorder. Research in Autism Spectrum Disorders, 4, 186 –198. Leaf, J. B., Taubman, M., Bloomfield, S., Palos-Rafuse, L. I., McEachin, J. J., Leaf, R. B. & Oppenheim, M. L. (2009). Increasing social skills and prosocial behavior for three children diagnosed with autism through the use of a teaching package. Research in Autism Spectrum Disorder, 3, 275– 289. Leaf, R., & McEachin, J. (1999) A work in progress. New York, NY: DRL Books, LLC. Lovaas, I. O. (1981). Teaching developmentally disabled children: The me book. Austin, TX: Pro-Ed. Lovaas, O. I. (1987). Behavioral treatment and normal education and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3–9. Stewart, M. E., Barnard, L., Pearson, J., Hasan, R., & O’Brien, G. (2006). Presentation of depression in autism and asperger syndrome: A review. Autism, 10, 103–116. Stewart, K. K., Carr, J. E., & LeBlanc, L. A. (2007). Evaluation of family-implemented behavioral skills training for teaching social skills to a child with Asperger’s disorder. Clinical Case Studies, 6, 252–262. Stevenson, C. L., Krantz, P. J., & McClannahan, L. E. (2000). Social interaction skills for Children with autism: A script-fading procedure for nonreaders. Behavioral Interventions, 15, 1–20. Taubman, M., Leaf, R., & McEachin, J. (2011). Crafting Connections: Contemporary Applied Behavior Analysis for Enriching the Social Lives of Persons with Autism Spectrum Disorder. New York, NY: DRL Books, LLC. Thiemann, K. S., & Goldstein, H. (2001). Social stories, written text cues, and video feedback, effects on social communication of children with autism. Journal of Applied Behavior Analysis, 34, 425– 446. Received: 17 February 2011 Initial Acceptance: 15 April 2011 Final Acceptance: 17 May 2011 Cool versus Not Cool Procedure / 175
  • 55. Education and Training in Autism and Developmental Disabilities, 2012, 47(2), 176 –186 © Division on Autism and Developmental Disabilities The Picture Exchange Communication System (PECS): A Promising Method for Improving Communication Skills of Learners with Autism Spectrum Disorders Jennifer B. Ganz Richard L. Simpson Texas A&M University University of Kansas Emily M. Lund Texas A&M University Abstract: Children and youth with autism spectrum disorders (ASD) and other developmental delays frequently experience deficits in functional communication. Identifying and using suitable communication enhancement and augmentative and alternative communication supports is essential to achievement of positive outcomes for these learners. This article discusses the use of the Picture Exchange Communication System (PECS), a commonly used and utilitarian AAC system for children and youth who lack sufficient functional communication skills. Particular attention is given to practitioners’ use of this promising tool. The Picture Exchange Communication System (PECS; Frost & Bondy, 1994, 2002) is an icon-based form of augmentative and alternative communication (AAC). While the system is appropriate for use with a variety of individuals with communication deficits and disorders, it has most commonly been used with children with autism spectrum disorders (ASD; Magiati & Howlin, 2003; Tincani, Crozier, & Alazetta, 2006). PECS was developed in 1986 by Bondy and Frost and is currently marketed and hosted by Pyramid Educational Consultants, Inc. Since its development, PECS has received considerable attention in peerreviewed literature and has generally been shown to be relatively useful promising practice in promoting functional communication in individuals with moderate to severe disabilities (Flippin, Reszak, & Watson, 2010). Description of PECS Materials One attractive feature of PECS is that it requires relatively few materials, all of which can Correspondence concerning this article should be addressed to Jennifer Ganz: Texas A&M University, Department of Educational Psychology, 4225 TAMU, College Station, TX 77843-4225. Email: jeniganz@tamu.edu 176 / be created or obtained at relatively low cost (Ogletree, Oren, & Fischer, 2007). As the name implies, a key feature of PECS is the picture cards, which contain pictures, also referred to as icons, that represent objects (e.g., ball, computer, cookie), people (e.g., Mom, Dad), or activities (e.g., hug, draw). The icons can be made using a computer graphics program or actual photographs and should be fastened with Velcro® on the back. This will allow the icons to be stored on a Velcro® communication picture board or book, from which the child will be able to select the icons of appropriate or desired items, people, or activities. Additionally, PECS materials include several sentence stems (e.g., “I HEAR,” “I SEE,” “I WANT”), which can be combined with icons to form phrases and sentences in later stages of training and should also be affixed to the communication picture board or book with Velcro®. PECS’ format has several advantages (Ogletree et. al, 2007; Yoder & Stone, 2006). Because PECS requires few materials, the system can easily travel with the child to multiple locations, thus increasing the potential for training and generalization across multiple settings. Also, icons can easily be created to correspond to items in the user’s environment, allowing for specific tailoring to his or Education and Training in Autism and Developmental Disabilities-June 2012
  • 56. her settings or preferences. Finally, the “lowtech” nature of the PECS materials eliminates the issues of technological failure and greatly reduces the probability and cost of the materials being damaged or lost. Credentials and Training for PECS Trainers Official PECS training workshops are offered by Pyramid Educational Consultants, Inc. (http://www.pecsusa.com/training.php), including basic and advanced levels. Basic training is designed for individuals seeking certification as a “PECS Certified Implementer,” allowing them to implement the PECS intervention with an assured level of competency. Within two years of attending a basic PECS workshop, the prospective implementer must submit evidence of competency in the areas of: (a) implementation of PECS in each of the six phases, (b) error correction, (c) implementation of PECS during functional activities, (d) writing PECS instructional lessons for clients, (e) data collection within the phases of PECS, and (f) writing summaries of PECS implementation. Practitioners must also pass a written exam covering accurate PECS practice. After passing the exam and demonstrating competency in all six areas, individuals are granted certification, renewable every three years. Advanced PECS implementers may chose to pursue PECS supervisor training through Pyramid Educational Consultants, Inc. (http:// www.pecsusa.com/training.php). According to the company, this training is reserved for experienced implementers who have not only shown knowledge and skills in implementing PECS properly in all six phases but have also demonstrated the ability to critique PECS instructors in a positive and constructive manner. Individuals who qualify as PECS supervisors may not offer PECS training workshops or other formal training but may advise and critique co-workers who have undergone basic PECS implementation training on best implementation practices for PECS and may offer basic information on PECS to other professionals. Suitability for PECS PECS is designed for people who lack an effective system of functional communication (Frost & Bondy, 2002). It is typically not needed or used by individuals who have high verbal functioning, such as those with Asperger syndrome or high functioning autism (Simpson & Myles, 2011). While people with higher functioning variants of ASD, such as Asperger syndrome, have communication and language difficulties, such as understanding metaphors or figures of speech, or have difficulties mastering the social aspects of communication, their communication deficits are usually not severe enough to require PECS or other AAC systems and are most effectively addressed through other types of intervention (Wetherby & Prizant, 2005). Assessing suitability. Pyramid Educational Consultants, Inc. does not publish an official measure to assess suitability for PECS but broadly states that the system may be useful for individuals who (a) lack a method of functional communication that allows them to adequately express their needs and wants, (b) have trouble making their communication understood by others, (c) have a functional communication system that is not adequate in its ability to convey needs and wants, or (d) lack a communication system that allows spontaneous expressive communication across a variety of settings (http://www.pecsusa.com). It is clear that relatively little is known about student characteristics that make them the best candidates for PECS. However, a recent review of PECS methodology and outcomes by Flippin and colleagues (2010) suggested that children who have relatively poor joint attention (e.g., have difficulty sharing interest in an object with another person) and relatively strong interest and tendencies to search out and explore a variety of objects in their environment but relatively limited motor imitation skills have the best outcomes relative to PECS use. Additionally, existing measures that assess functional communication may be useful when determining an individual’s suitability for PECS. These supplemental measures can either be part of a formal, structured evaluation or informal assessments, such as parentor proxy-report checklists. Informal evaluation measures may include the Assessment of Social and Communication Skills for Children with Autism (Quill, Bracken, & Fair, 2000) or Verbal Behavior Milestones Assessment and Placement Program (VB–MAPP; Sundberg, 2008). Examples Picture Exchange Communication System / 177
  • 57. of more formal, complex assessment include the Test of Early Language Development (Hresko, Reid, & Hammill, 1999) and the Brigance Diagnostic Inventory of Early Development (Brigance, 2004). The primary purpose of these measures in relation to PECS is to determine if the child in question would benefit from an AAC system to improve functional communication and should be interpreted with professional judgment, combining assessment results with observation (Flippin et al., 2010; Ogletree, 2008; Ogletree et al., 2007; Yoder & Stone, 2006). As the name implies, PECS is a visual form of AAC. The visual nature of PECS may be beneficial when working with children with ASD, as there is some evidence that people on the autism spectrum may be highly visual learners (Schopler, Mesibov & Hearsey, 1995). Accordingly, visually-based AAC systems are often seen as the most effective and preferred choice when working with individuals with ASD (Mirenda, 2001; National Research Council, 2001). PECS symbols are both concrete and static in nature, appealing to the common preference of individuals with ASD for consistent, explicit objects and ideas (Heflin & Alaimo, 2007; Ogletree, 2008). Most icons have a one-to-one correspondence with an object, person, or activity, thus reducing confusion common to many forms of communication wherein abstract interpretations and variable meanings exist. Furthermore, the icons themselves are consistent in appearance and meaning, further reducing linguistic ambiguity and allowing for recognition instead of recall (Heflin & Alaimo). Considerations regarding multiple disabilities. While the visual nature of PECS presents several advantages relative to use with individuals with ASD, the visual focus of PECS may make it a poor choice for people with both ASD and blindness or severe low vision, unless modifications are made (Lund & Troha, 2008). PECS has been used effectively with a blind clinician through the addition of Braille tags to the picture cards (Charlop, Malmberg, & Berquist, 2008). Of course such a modification with a blind or low vision PECS-user would require that the user read and comprehend Braille. Lund and Troha (2008) investigated the use of PECS with three adolescents with both 178 / autism and severe visual impairment or blindness. Tactile symbols were used as an accommodation, and verbal prompts, which are not typically used in PECS training, were applied if the communication partner deemed them necessary. All three participants showed varying degrees of increased functional communication with PECS over the course of the intervention. Only one of the participants was able to show proficiency— defined as correct independent response rate of 80% or higher in two separate trials—at each of the first three stages of PECS. Lund and Troha speculated that this may be due to the time-limited nature of the study— each participant received only 30 sessions of PECS—and noted that the participants’ rates of improvement were similar to those seen in children without co-occurring visual impairment. It appears the use of tactile symbols may be an effective way to modify PECS for use by those with co-occurring ASD and severe visual impairments. PECS also requires some degree of proficient motor functioning (Bondy & Frost, 1994; Frost & Bondy, 1994). The user must be able to pick up, carry, and hand the icon cards as needed. In later stages of training, the user must be able to align icons and sentence stems closely enough to demonstrate their association (e.g., show that the “I SEE” sentence string and the “ball” icon are connected). If necessary, modifications, such as creating larger or thicker icons and sentence stems, can be made to increase the ease of use for children with limited fine and gross motor function due to physical impairments or muscle weakness (Bondy & Frost). PECS may be a viable alternative for individuals who lack the fine motor coordination necessary for sign language or typing-based AAC systems (Ogletree & Oren, 2006). The highly visual nature of PECS also makes it good choice for individuals with ASD and co-occurring hearing impairment or Deafness (Tincani, 2004). Furthermore, PECS attempts to model natural language development through the use of icons and thus does not assume or require the capacity for expressive spoken language (Bondy & Frost, 2001). Additionally, PECS can be used in conjunction with American Sign Language or another signing system or spoken language, depending on the needs, abilities, and preferences of Education and Training in Autism and Developmental Disabilities-June 2012
  • 58. the user and his or her support system (Tincani). Considerations for English Language Learners. Relatively little research has been conducted regarding special education and AAC for children who are also English Language Learners (ELL; Simpson & Ganz, in press). However, current recommendations for the general population of ELL students hold that education should involve both English and the child’s first or familial language, if possible, with a preferred emphasis on the language spoken at home (Donovan & Cross, 2002). PECS may be a particularly useful AAC system to use with this population, as the visual nature of the icons transcends language barriers (Simpson & Ganz, in press). Thus, a child from a Spanish-language home who has been trained in PECS could use the same set of icons with his or her English-speaking teacher at school and with his or her parents at home. Words and phrases may be translated into both languages, perhaps allowing the child to use one set at home and another set at school. If verbal prompts are used, the prompts could be given in both languages until the user is able to respond appropriately to prompts in both languages. Alternately, the parents or teacher may decide to pursue training in only one language for the sake of simplicity (Simpson & Ganz). Given both the lack of literature on this topic and the highly personal nature of linguistic identity, the decision of what language or languages to use for verbal prompts or icons should be mutually decided by the parents and trainers prior to the start of PECS training. Use of PECS with adolescents. A vast majority of the existent studies of PECS have focused on young children, as they are more likely to lack an established AAC system and be receiving intensive intervention services (Lancioni et al., 2007). However, older children and adolescents who lack adequate functional communication skills, whether verbal or with another form of ACC, may still benefit from PECS training (Simpson & Ganz, in press). Functional communication is vital in increasing an individual’s ability to live independently, and a lack of functional communication skills may increase the rate of challenging behaviors, thus impacting the individual’s ability to gain and maintain employment and participate in other independent living tasks (Koegel, Koegel, Shoshan, & McNerney, 1999; Prizant, Wetherby, & Rydell, 2000). Thus, PECS would have high social validity if it could increase functional communication in a way that decreased problem behaviors and increased capacity for independent living. The handful of studies (Charlop-Christy, Carpenter, Le, LeBlanc, & Kellet, 2002; Ganz, Sigafoos, Simpson, & Cook, 2008; Lund & Troha, 2008; Tincani et al., 2006) that have examined the use of PECS in older children and adolescents have shown promising results, although two of these studies (Ganz, Sigafoos, et al., 2008; Lund & Troha, 2008) made substantial modification to the standard PECS training procedures. Further research is necessary in order to better understand the utility and limitations of PECS in this population. Theoretical Grounding of PECS and Implications for Practice PECS utilizes a behavioral training system, based on the theories of B. F. Skinner and colleagues (e.g., Skinner, 1957) and of applied behavioral analysis (Baer, Wolf & Risley, 1968; Cooper, Heron, & Heward, 2007). Unlike some other communication instructional programs for people with ASD, however, PECS relies primarily on direct reinforcement, similar to the direct reinforcement that occurs during typical language development (Frost & Bondy, 1994). For example, if a child gives his or her communicative partner a “ball” icon, he or she is then given access to a ball, thus strengthening the association between the icon and the corresponding, reinforcing object. This differs from other communication training techniques where the user may be rewarded with a third, unrelated item (e.g., the therapist says, “touch ball,” and the student touches the “ball” picture and is a given a cookie as a reward; DeBoer, 2007). The use of direct reinforcement leads to clearer associations between icons and objects or actions and mimics the naturally occurring reinforcement of verbal speech in typicallydeveloping children (Bondy & Frost, 2001). For this reason, it is important that a child’s preferred reinforcers, such as certain types of toys or specific foods, are identified prior to the start of PECS training and that corre- Picture Exchange Communication System / 179
  • 59. sponding icons are created. Reinforcers can be identified through simply observing the user in his or her environment (Bondy & Frost) or through systematic recording and comparison of the user’s responses to several potential reinforcers (Frost & Bondy, 1994). Phases of PECS Training Bondy and Frost (2001) conceptualized PECS training as occurring in six phases, with the opportunity for additional training. Each phase becomes increasingly complex and demands greater expressive and/or receptive communication skills from the user. For this reason, it is recommended that the phases be completed in order, and that the next phase should be tackled only when the user achieves an adequate ratio of correct responses during two or more separate trials or days. This ratio can be set by the treatment team, although 80% minimum accuracy rates are commonly used in the literature (e.g., Lund & Troha, 2008; Bondy & Frost, 1994). The six phases of PECS training are generally designed to correspond to typical communication development. The descriptions below are provided for informational purposes and are not intended to replace formal PECS training. Phase 1: Initial Communication Training The first phase of PECS teaches the user that icons can be used as communication tools (Frost & Bondy, 1994, 2002). In this phase, the user is shown a preferred reinforcer by a communication partner; most students instinctively try to reach for the reinforcer. When this happens, a second instructor, the prompter, places the appropriate icon in the user’s hand and guides the learner’s hand to the communication partner’s hand. When the user drops the icon into the communicative partner’s open hand, the user should immediately be allowed to have access to the reinforcer for a brief period of time. If verbal communication is also being modeled, the communicative partner can name the reinforcer as the user releases the icon into his or her hand. In order to prevent satiation, the reinforcer should be promptly and gently taken away from the user after a few seconds (Frost & 180 / Bondy, 1994, 2002). The process should then be repeated until the user consistently and independently hands the communication partner the icon in order to receive access to the reinforcer, as determined by the pre-set correct response ratio. The prompter’s guidance and assistance in picking up the icon and reaching towards the communication should fade over trials, and the communication partner’s open handed prompt may change to a close-handed one as the user demonstrates an understanding of the association between giving the communication partner the icon and access to the reinforcer. This process should be repeated with other icons, in various settings, and with various communicative partners in order to build the user’s vocabulary in anticipation for the item and icon discrimination training that occurs in phase three and to promote skill generalization. Phase 2: Retrieval and Delivery of Icons In phase two, the child is taught to independently retrieve icons and deliver them to a communication partner who is not immediately available (Frost & Bondy, 1994, 2002). For example, in this stage, a child may be taught to retrieve an icon placed a few feet away from him or her and then deliver it to a communication partner in an adjacent room in order to gain access to the desired item, as represented by the icon. Frost and Bondy (2002) hold that this type of training encourages spontaneous communication by demonstrating to the child that communication that requires effort on the part of the child can still lead to the desired results. Additionally, phase two may be used to teach a child the important of persistence when communicating wants or needs. For example, the learner may have to learn to give an item to a communication partner who initially has his or her back turned. These skills can be conceptualized as analogous to a speaking child learning that he or she must increase the volume of his or her voice when trying to speak with someone who is a greater distance away (Frost & Bondy, 2002). The amount of effort and persistence required of the learner should be gradually increased throughout phase two. This is also the phase in which a child should start learn- Education and Training in Autism and Developmental Disabilities-June 2012
  • 60. ing to retrieve icons for desired objects from his or her communication book or board. look through multiple pages of the communication book in order to locate a particular icon (Bondy & Frost, 2001). Phase 3: Icon and Item Discrimination In phase three, the child learns that presenting his or her communication partner with different icons will result in different consequences and thus learns to discriminate between icons and to select the icon for a desired object from a group of other icon choices (Frost & Bondy, 1994, 2002). This phase begins with presenting the child with two icons based on the results of the pretreatment preference assessment. One icon should represent a highly desired item while the other icon should represent a much less desired item. If the child picks the less desired icon, he or she should be given that item by the communication partner, and, when the child shows disinterest in it, a follow-up teaching procedure that demonstrates or prompts choosing the icon for the desired item should occur. If the child does indeed initially present his or her communication partner with the icon of the desired item, this should be reinforced with both access to said item and social reinforcement of the selection, such as verbal praise (Bondy & Frost, 2001). After the child has mastered discrimination between the more desired and the less desired item, he or she should then be given a choice between two icons representing items of equally high desirability that are both in the child’s immediate environment (Frost & Bondy, 1994, 2002). After he or she exchanges an icon, the communication partner should prompt the child to “take it,” being sure to use a pronoun instead of naming the item. If the child attempts to access the item corresponding with the icon he or she selected, he or she should then be granted brief access to the item. If the child attempts to access another item, however, the communication partner should block him or her from obtaining access to any item except the one represented by the previously selected icon, then use an error correction procedure. Once the child has mastered this level of discrimination with two icons, the number of icons and items presented should be increased, until the child can discriminate between five or six icons of appropriately equivalent desirability and even Phase 4: Phrases Phase four begins the next major phase of PECS training, in which the child is taught to combine sentence strips with icons in order to form requests (e.g., “I WANT” sentence strip plus the icon for “ball” in order to request the ball; Frost & Bondy, 1994, 2002). Because they are naturally reinforcing, requests are taught first, with the child learning to combine the “I WANT” sentence strip with an icon for the desired item. The child should be taught to give the “sentence” to the communication partner, who should than respond by verbalizing the sentence—for example, saying “I WANT the ball” when the child exchanges a communication board with the “I WANT” sentence strip and ball icon—and giving the child access to the requested item (Bondy & Frost, 2001). Learning to communicate requests via sentence strips may help compensate for the non-verbal deficits of some children with ASD, such as lacking the tendency to point to or reach for a desired item (Bondy & Frost). Phase 5: Answering Questions In phase five, the child learns to answer verbal questions posed by the communication partner through the use of sentence strips and icons (Bondy & Frost, 2001; Frost & Bondy, 1994, 2002). The communication partner helps the child learn the association between specific questions and appropriate responses by asking the question (e.g., “What do you want?”) and then physically prompting the child to use the appropriate sentence strip (e.g., “I WANT”) in response and giving the child access to the desired icon after her or she exchanges the responding phrase. Eventually, the child should independently access the sentence strip and respond with no other prompting than the question itself. As with the request training in phase four, this process is naturally reinforcing and thus should be learned relatively quickly (Bondy & Frost, 2001). Picture Exchange Communication System / 181
  • 61. Phase 6: Commenting In the final formal phase of PECS training the child is taught to use sentence strips such as “I SEE” and “I HEAR” to comment on his or her environment (Bondy & Frost, 2001). Unlike the other stages of PECS, the reinforcement in this phase is indirect—the child receives only social reinforcement for his or her correct responses, not actual access to a desired item itself. This allows comments to be clearly distinguished from commands, as taught in phase four, and also makes reinforcing appropriate responses more difficult than in previous stages (Bondy & Frost). Bondy and Frost emphasize the importance of having the child spontaneously comment in situations where a typically developing child would also comment, such as situations where there is something unusual in the child’s environment or when he or she is asked a question like “What do you see,” “What do you hear,” or “What do you have?” Additional Uses for PECS Training Once the six formal phases of PECS are mastered, the child can be taught additional icon vocabulary and words forms, such as learning to understand and apply adjectives (Frost & Bondy, 1994, 2002). For example, a child may learn to identify and discriminate between different colors of candy. He or she can then use PECS adjective icons to ask specifically for a preferred color of candy (e.g., “I WANT” sentence strip ϩ “blue” icon ϩ “candy” icon) or to comment on his or her environment (“I SEE” sentence strip ϩ “big” icon ϩ “dog” icon) in greater detail. Similarly, the child can be taught to use icons to express other common needs and wants, such as the need to “take a break” from a frustrating or over-stimulating activity, thereby increasing the utility of his or her functional communication. Icons for situations, objects, and people specific or new to a user’s learning environment can be continually created and taught as needed in order to provide the fullest possible range of functional communication. Case Example Assessment. Alex was a five year-old girl diagnosed with autism. She had complex communication needs and did not speak; previous attempts had been made to teach her sign 182 / language, but she struggled with adequately imitating many of the signs used by her parents and teacher, Mr. Gutierrez. Following the speech therapist, Ms. Lorrie’s, formal assessment of Alex’s functional communication skills, it was concluded that she would be a good candidate for PECS. A preference assessment conducted prior to the implementation of training revealed that hats and toy cars were preferred objects for Alex while blocks and picture books were less desired objects. Phase One. In phase one, Mr. Gutierrez put a hat on his head, an icon of a hat was placed on the table in front of Alex, and when Alex reached to take the hat off of Mr. Gutierrez’s head, she was prompted by Ms. Lorrie, to give the icon to the teacher. Giving Mr. Gutierrez the hat icon earned Alex access to a favorite hat for 10 seconds before the hat was gently taken away, and a new trial began. Several other icons, with preferred items pictured, were presented, one at a time, throughout phase one instruction. After seven prompted trials Alex began to independently pick up and exchange the icons. When she achieved 90% accuracy over ten trials in one day, for requesting 25 different items in three settings (i.e., classroom, cafeteria, home), a decision was made to move to phase two. Phase Two. In phase two, Alex was required to go to her communication board— which only contained the hat icon at this time—retrieve it and bring it to Ms. Lorrie, who was sitting on the other side of the room with her back turned. After Alex achieved 90% accuracy on a set of 10 trials that followed 20 prompted trials Ms. Lorrie moved to an adjacent room, and Alex was required to carry the icon to the other room and exchange the icon in order to gain another 10 seconds of access to her favored hat. Additional school personnel were added as communicative partners and more icons were added to Alex’s repertoire in this phase. She achieved perfect accuracy over 10 trials thus completing phase two. Phase Three. In phase three, Alex was presented with her communication book, which now included both the icon for hat and an icon for blocks. After Alex handed the blocks icon to Mr. Guitierrez, Alex was handed the blocks and began to cry. He then guided Alex’s hand to the hat icon and prompted her to Education and Training in Autism and Developmental Disabilities-June 2012
  • 62. give it to him, an act that was reinforced by patting Alex’s shoulder, her preferred form of social reinforcement. Over subsequent trials, Alex began to consistently select and present only the icon that corresponded with the preferred item, granting her 10 seconds of access for each exchange. Once Alex achieved 90% accuracy over ten trials, the non-preferred icons were replaced with the preferred item icons, and Alex was only given access to the item that corresponded with the icon she presented. After she met the pre-established benchmark of 90% accuracy in reaching for the correct item, more icons were presented in an array for discrimination. At the end of phase three training Alex could reliably discriminate between and select specific icons when presented with up to seven icons distributed over three pages of communication book. Phases Four and Five. After Alex met the 90% accuracy criterion for the 10-item discrimination task in phase three, the training team moved on phase four. Alex was prompted to combine the sentence strip “I WANT” with an icon for a preferred object (e.g., hat, cookie, cars) on her communication book. When she presented the sentence strip and icon in the correct order to her communication partner, the communication partner read the sentence “I WANT [icon]” and then gave Alex brief access to that the object represented by the icon. Alex mastered this stage quickly, suggesting that it was highly naturally reinforcing for her. The treatment team observed similarly good success in stage five, when Alex quickly associated the question “What do you want?” as a prompt to present her sentence strip with a phrase asking for a desired object to her communication partner. Phase Six. Phase six was initially more difficult. When Alex correctly used the “I SEE” sentence strip with the cars icon and received only verbal praise instead of access to the cars, she began to cry. The use of the “I SEE” sentence strip in connection with icons of other, less reinforcing items in the immediate environment was repeated several times and was both rewarded with verbal praise, pats on the arm, and prompted with the question, “What do you see?” These were alternated with “What do you want” trials to maintain high rates of reinforcement. After 20 “What do you see” trials, Alex no longer responded poorly to only receiving verbal praise for correctly commenting, and the use of the prompting question and “I SEE” sentence strip was then modeled in situations where unusual or unexpected objects were present. Alex began to comment spontaneously on the presence of some of the unusual objects and received verbal affirmation from Mr. Gutierrez for doing so. After commenting on the “I SEE” strip was mastered with 90% correct responding, similar training was done with other sentence strips, including “I HEAR” and “I HAVE.” The use of these strips was combined with a corresponding prompting question (e.g., “What do you hear?” or “What do you have?”). Mastery of these sentence strips generally occurred at a faster rate than seen with the initial commenting training, indicating there was some degree of generalization of the broad idea and purpose of commenting. Further Use. Following the completion of phase six of PECS training, Alex has continued to increase her vocabulary of icons and sentence strips and thus her functional communication skills across all areas of her life. Alex experiences problems with over-stimulation when in noisy or crowded environments; since learning to request a “break” by using the appropriate PECS icons, her rate of challenging behavior due to over-stimulation has markedly decreased. This suggests that PECS provided Alex with a more socially acceptable way to communicate her need for temporary escape in certain situations and demonstrates a potential secondary benefit of increasing functional communication via PECS. Data Tracking As mentioned previously, all decisions regarding progression through the PECS should be data-based (Bondy & Frost, 2001; Frost & Bondy, 1994, 2002). Therefore, it is vital that PECS implementers maintain clear and accurate records of independent responses made by the user. Additionally, it may be beneficial to track data on other outcomes or co-occurring phenomena. For instance, a frequently occurring question regarding PECS is whether the training increases verbal as well as iconbased communication. While early reports by Picture Exchange Communication System / 183
  • 63. the creators of PECS (Bondy & Frost, 1994) suggested that PECS training frequently lead to increased speech, more recent evidence on the topic is mixed (Flippin et al., 2010; Ganz, Simpson, & Corbin-Newsome, 2008). Increased verbal communication does seem to occur in some users (Ganz & Simpson, 2004) but this phenomenon does not appear to be either universal or consistent in nature (Ganz, Simpson, et al., 2008). Nevertheless, it may prove helpful to track verbal communication that occurs during or after PECS training in individual users in order to better assess the entirety of the impact of PECS training on functional communication skills and speech. Similarly, it may be useful to track the incidence of challenging behavior before, during, and following PECS training, as increased functional communication may result in a decrease in challenging or problem behaviors (Charlop-Christy et al., 2002). Finally, it may also be helpful to monitor the degree to which functional communication with PECS generalizes across contexts (Ganz, Sigafoos, et al., 2008). In addition to providing valuable information on individual users, collecting PECSrelated outcome data on challenging behavior, verbal expression, and generalization may help address several standing research questions regarding the broader utility of PECS. Summary and Discussion PECS is a form of AAC designed to increase functional communication among individuals with ASD and other developmental disabilities that have significant communication deficits (Frost & Bondy, 1994, 2002). It is a visuallybased AAC system (Mirenda, 2001) and employs direct reinforcement of expressive and receptive communication and other behavioral principles. Users are trained to communicate via icons and sentence strips and PECS uses low-cost materials that are relatively simple to create (Frost & Bondy, 1994, 2002). PECS training occurs in a structured sequence designed to parallel the phases of typical communication and language development. Over the course of training, users are taught to (a) associate icons with their representative items; (b) give an icon to a communicative partner in order to gain access to a desired item; (c) seek out the appropriate icon and travel to a 184 / communicative partner to achieve the item; (d) discriminate between multiple icons in order to obtain a preferred item; (e) use phrases to express wants and describe the environment; (f) answer questions and respond to commands; and (g) learn and use descriptors to discriminate between similar items. Areas Requiring Further Clarification and Investigation In general, PECS has been shown to be effective at increasing functional communication in children with ASD and related disorders (e.g., Flippin et al., 2010; Ganz, 2007). However, relatively little is known about its efficacy in older children, adolescents, and adults. Additionally, more research needs to be conducted regarding best practices for using PECS with children who have other disabilities or functional impairments in additional to ASD and children who are non-English language learners or come from otherwise linguistically diverse backgrounds. Future research should examine the effects of modifying the PECS materials for individuals with disabilities and the relative effectiveness of conducting PECS training in English, the user’s familial language, or both languages. Finally identifying the characteristics of students that make them the best candidates for positive outcomes for PECS intervention is essential. Such research could help guide the creation of best practices for working with individuals who require PECS or another form of augmentative or alternative communication. Additionally, future research should examine the effects of PECS training on secondary outcomes, including verbal expression, challenging behavior, and academics. By better understanding the broader effects of increasing functional communication through PECS, we can better detect situations where the intervention may result in important, socially valid secondary gains. Similarly, additional data on the generalization of functional communication across multiple settings could aid in our understanding of when and how PECS can be used in an individual’s daily life and in what situations applying PECS becomes difficult. Education and Training in Autism and Developmental Disabilities-June 2012
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  • 66. Education and Training in Autism and Developmental Disabilities, 2012, 47(2), 187–197 © Division on Autism and Developmental Disabilities Teacher Education in Autism Spectrum Disorders: A Potential Blueprint Eric Shyman Dowling College Abstract: With evidence indicating the increase in the diagnosis of autism, as well as the complexity of working with individuals with Autism Spectrum Disorders (ASD), providing effective teacher education and training programs specializing in ASD has become an educational necessity. This article seeks to outline necessary components of a comprehensive teacher education program specializing in teaching individuals with ASD. By contextualizing the needs of a teacher preparation in ASD, better and more focused research can be conducted in determining effectiveness and comprehensiveness of such programs. While accepted figures remain debated, it is virtually inarguable that individuals with Autism Spectrum Disorder (ASD) have become a more common presence in public schools within the last several years (Safran, 2008). With the impending reauthorizations of both the Elementary and Secondary Education Act (ESEA) and the Individuals with Disabilities Education Act (IDEA), legislation will undoubtedly continue to mandate efforts toward inclusive education (Simpson, de Boer-Ott, & Smith-Myles, 2003). Because individuals with ASD present with complex behavioral, social, and linguistic patterns necessitating specialized educational needs, in-service teachers must become better prepared to meet such challenges. According to the National Research Council (2001), which provided the last available data set, teachers have been shown to lack expertise in the area of ASD, and no data since then have indicated that this phenomenon has significantly changed. This lack of expertise has created a formidable challenge for schools, obligating them to better meet the diverse and complex needs of individuals with ASD. Further complicating the situation, little research is available elucidating effective and appropriate designs for teacher preparation programs special- Correspondence concerning this article should be addressed to Eric Shyman, Dowling College, Department of Special Education, 150 Idle Hour Blvd., Oakdale, NY 11769. E-mail: shymane@dowling.edu izing in ASD. While some efforts have been made, standards for attaining the status of a Highly Qualified Teacher (HQT) for individuals with ASD remain unofficial and untested (Scheurmann, Webber, Boutot, & Goodwin, 2003). If standards and accountability measures are to be appropriately applied in the process of improving teacher quality, it is incumbent upon faculties of education to lead the way in defining, measuring and improving the preparation of quality teachers (McArdle, 2010). For these reasons, it is important that professional discourse and scientific research begin to focus on contributing to an evidencebased framework for teacher preparation programs in ASD. Most importantly, however, the field must be an active contributor to this research by designing and implementing such programs based on such discourse in order to prepare teachers who specialize in ASD. Best Practices in Educating Individuals with Autism Among the more zealous debates in the field of special education is the issue of what educational methodologies are most effective and most promising and how such conclusions should be drawn. Clear paradigmatic factions exist in the field of ASD and there is a considerable lack of agreement with regard to the strategies and methods that are most effective for individuals with ASD (Reichow, Volkmar, & Ciccheti, 2007; Simpson, 2008). Teacher Education in Autism Spectrum Disorders / 187
  • 67. What naturally follows from the teacher education perspective is the need to determine which issues and methodologies should be included in a teacher preparation program in ASD (Hess, Morrier, Heflin, & Ivey, 2008; Scheurmann et al., 2003; Simpson, 2007). The question of whether only established evidence-based methodologies should be discussed or whether programs should also include a discussion of methodologies with less evidence basis remains unresolved. As stated by Simpson (2008): the lack of practical information and welldesigned guidelines that professionals and families can use to identify the most suitable, effective, and utilitarian methods from among the countless available interventions and treatments . . . only serves to intensify and further polarize variable opinions and perspectives concerning autism” (p. 3). While many in the field will readily and confidently deem the methods of teaching falling under the umbrella of Applied Behavior Analysis (ABA) as being representative of best practice or, at least, the most clearly evidenced practice, this conclusion may be premature and confounded by various methodological considerations including low sample sizes, lack of fidelity of implementation measures between research and practice, and questionable methods of data analysis techniques, making it dubious to consider such approaches as the only approach worthy of inclusion in a teacher preparation program (Gresham, 2009; Parker, Vannest, & Brown, 2009; Ximenes, Manalov, Solonas, & Quera., 2009). The difficulty of contextualizing what ABA is in the context of an “intervention” protocol further complicates the validity of claiming it as an evidence-based practice in and of itself. As clarified by Dillinburger (2011), ABA is often erroneously characterized as an ASD treatment. As per Simpson’s (2008) point, teacher preparation programs in ASD may be a viable starting point for an examination and evaluation of various treatment and educational programs in terms of its existing and/or emerging research support. In a study by Hess et al. (2008) a sample of teachers in Georgia were examined to determine the types of methodologies being used 188 / for educating individuals with ASD. An analysis of data from 185 teachers reporting on 226 children indicated that a majority of the programs utilized a variety of treatments, some of which are not supported by evidence. These findings indicate that though there is a general push for evidence-based practice, parents and professionals are still willing to explore and implement methodologies that lack empirical support. Use of a variety of intervention programs is further supported by Simpson (2008) and McLennan, Huculak, and Sheehan (2008). Scheurmann et al. (2003) raise serious objections to the notion that any unidimensional approach should or could be considered best practice. Referencing the idea of “single theory training” the authors contend that no research has convincingly substantiated claims of the supremacy of one methodology over another. Additionally, single theory training approaches are likely to erroneously assume that all students can and will respond to one approach, deeming it the only necessary approach to promote. While there is a substantial body of research supporting behaviorally based interventions (such as those characterized under the umbrella of ABA), the research has not provided any peremptory evidence that behavioral treatment is comparatively more effective than other approaches. Accepting a single theory approach may limit teachers’ recognition that all children are different and may respond to different approaches. As an alternative, the authors suggest that teachers should pay more attention to students’ individual needs rather than fitting a paradigm to their diagnosis and classification (Scheurmann et al., 2003). From a teacher education perspective, Scheurmann et al. (2003) also provide a valuable perspective suggesting that if teachers are trained in only one methodology they will be unable to make educated comparisons as to which methodologies fit individual student needs best and, furthermore, which methodologies appear to be more comparatively effective for different individuals. Therefore, consistent use of one programmatic approach in lieu of another may be more indicative of lacking multiple teaching skill sets rather than a true belief in or evidence for the validity and integrity of the teaching method being used. Education and Training in Autism and Developmental Disabilities-June 2012
  • 68. More concerning, rigidity in teaching may ultimately be detrimental to student progress, especially if students transition between settings that utilize different methods stymieing continuity in programming or growth. Therefore, it is important for teachers to become exposed to, understand, and implement different modes and theories of teaching in order to ensure that the most appropriate means of service delivery is being provided to individuals (Lovaas, 1996; Scheurmann & Webber, 2002). The Council for Exceptional Children (CEC) validates the perspective that “. . .the rationale for having different research methodologies in special education is based on the current conceptualization of research in education and the complexity of special education as a field” (Odom et al., 2005, p. 138). As such, it is imperative that teacher preparation programs be mindful of presupposing evidence basis for any discussed methodologies, as well as taking care to espouse particular paradigms as superior to others if there is not a true foundation to do so. Issues in Teacher Preparation in Autism While ASD has become an unprecedented commonality in schools, the field of teacher preparation with specific focus on ASD is in its infancy. Scheurmann et al. (2003) suggest some trends in teacher preparation for ASD that need to be addressed. First, much teacher preparation in ASD focuses on reactive strategies, or those that are implemented after a behavioral problem or crisis has already occurred. In such cases, training is often focused on methodology or consultation based support centered on ABA, risking the same aforementioned issues. Secondly, college or university based programs are likely to focus on general certification as dictated by local education agency standards, lacking any specialization in particular areas of the field. Though typically accepted by states as a viable credential for teaching in any setting in the certification area, certification does not necessarily mean qualification, thus perpetuating the presence of teachers lacking specific expertise in educating individuals with ASD. Further supported by Simpson (2008), while there are many treatments available for individuals with ASD that clearly lack supporting evidence, there are treatment approaches that have emerging evidence, warranting further study. This idea supports the notion put forth by Scheurmann et al. (2003) that single theory approaches do not meet the progressive and individualized needs of the field in its current state. What hampers the issue significantly, however, is the drastic lack of research in the area of both frameworks for teacher preparation in autism as well as the evidencebased effectiveness of those programs. Guidelines for Teacher Preparation Programs in ASD In light of these issues, this paper proposes a potential framework for designing teacher preparation programs specializing in ASD. Balancing overall teaching standards with the specialized needs in training for individuals with autism is a necessary consideration. This section will outline three major sets of standards that are necessary to consider. The National Board for Professional Teaching Standards (NBPTS) (2002) outlines five core areas in teacher preparation: 1) Teachers are committed to students and their learning 2) Teachers know the subjects they teach and how to teach those subjects to students 3) Teachers are responsible for managing and monitoring student learning 4) Teachers think systematically about their practice and learn from experience 5) Teachers are members of learning communities It is important to note that each of these standards are further subdivided into more detailed performance indicators. While these areas of expertise and practice are important to teaching in general, it has been well-established that individuals with ASD have specific needs that warrant specific types of training and knowledge (Hess et al., 2008; Scheurmann et al., 2003; Simpson, 2007). Therefore, more specified guidelines are needed to sat- Teacher Education in Autism Spectrum Disorders / 189
  • 69. isfy a well-suited framework for a teacher education program specializing in ASD. Scheurmann et al. (2003) offers a list of competency areas proposed as central components to a comprehensive teacher education program in ASD. The categories have been condensed and summarized for the sake of organization: 1) Knowledge of the disorder 2) Parent involvement 3) Theoretical underpinnings of instructional approaches (multiple approaches) 4) Teaching language and communication, social competencies, adaptive behaviors and transitions 5) Classroom structure 6) Behavior management 7) Special issues (to fluctuate with the field) Adding to the framework, CEC proposed additional teacher standards for quality teaching in ASD/Developmental Disabilities. Again, a condensed and summarized version of the parameters is: 1) Foundations (including models, theories, laws/policies, history, definitions, trends in practice) 2) Development and characteristics of learners (typical/atypical human growth, environmental/cultural effects, medical issues, speech, language, and communication) 3) Individual learning differences (effects of the condition, differences in skill acquisition, impact of theory of mind/ cognitive functioning, behavioral difficulty) 4) Instructional strategies (evidencebased practices, specialized curriculum design, transitions, academic learning, positive behavioral supports) 5) Learning environments/social interactions (classroom management theories, teacher attitudes, cultural sensitivity, realistic expectations, supports for integration) 6) Language (retention of cultural values of individual, language/communication enhancement, repair/avoidance of miscommunication) 7) Instructional planning (theories/re- 190 / search in curriculum development, technology, paraeducator roles, accommodation/modification, selection of content) 8) Assessment (basic terminology, legal provisions, uses/limitations of assessment, administering nonbiased assessments, record-keeping, conducting FBAs) 9) Professional and ethical practice/collaboration (teacher biases, professional development, high standards of competence and integrity, cultural sensitivity, working effectively with interdisciplinary/multidisciplinary professionals) Framework for Course Offerings Characteristics of Individuals with ASD * Course and fieldwork content in this area of specialization is designed to meet NBPTS 1 and 2, Scheurmann 1 and 7, and CEC 1, 2, 3, 8 and 9. The purpose of ensuring a comprehensive coverage of characteristics of individuals with ASD is important for any program attempting a specialization. Providing such a foundation will ensure that the enrollees can be provided a deeper understanding of more specialized and advanced materials from a common basis. Furthermore, course content should be based firmly in the most current available research which reports changes, variations, and multiple perspectives of such characteristics. Therefore, it is essential that such issues be contextualized within a common information base. Characteristics of individuals should be framed in two contexts: those outlined in the Diagnostic and Statistical Manual of the American Psychiatric Association (current version) and those outlined in the peer-reviewed research. In addition to coursework focusing on characteristics of ASD, a practicum and/or observation component should be mandated for all students, during which the student observes and/or works directly with multiple individuals with ASD, as well as produce written reports on their observations and clinical experiences. Providing these two pillars of understanding the characteristics of individuals Education and Training in Autism and Developmental Disabilities-June 2012
  • 70. with ASD will satisfy both a clinical and practical experiential base. Coursework in this area should be presented from a comprehensive and multidisciplinary perspective by providing access to research from the areas of education, psychology, and diagnostic practice, as well as medical fields such as neurobiology, genetics, and biology. Understanding of Current Research and Evidence Basis of Methodological Approaches in ASD * Course and fieldwork content in this area of specialization is designed to meet NBPTS 4 and 5, Scheurmann 3 and 7, and CEC 1, 4, and 9. The importance of framing a teacher education around an evidence-basis is a necessity for all teacher education programs. Since ASD is a disorder that is poorly understood in terms of etiology, presentation, and treatment, utilizing a framework of evidence-basis is essential. However, in order to truly frame a teacher education program around evidencebased practices, the concept itself must be defined in a workable and applicable fashion. A sound definition of evidence-based practices is one that reflects a combination of the American Psychological Association (APA) and the Council for Exceptional Children (CEC), both relevant agencies of authority for such a program. APA states that EBP is based on the integration of the best available research coupled with clinical expertise in the context of patient characteristics, culture, and preferences (APA, 2002). CEC offers a definition of evidence-based practice specific to special education: An evidence-based special education professional practice is a strategy or intervention designed for use by special educators and intended to support the education of individuals with exceptional learning needs (bold in original text). CEC includes in this definition specified configurations of individual strategies and interventions. Complex configurations of variables in which the efficacy of each of the variables has been studied separately are sometimes considered a practice. Whenever a complex configuration of strategies and interventions is proposed as a practice, the evidence for the configuration should be established as such, i.e. with all the variables in the given configuration, not in isolation. (Council for Exceptional Children, 2008, p. 8) CEC further delineates three categories of Professional Practice Evidence-Base: (1) Positive Effects Evidence-Base; (2) Mixed Effects Evidence Base (Potentially Positive Evidence Base, Mixed Effects Evidence Base, No Discernable Effects Evidence Base); and (3) Negative Effects Evidence-Base). Additionally, CEC put forth a contextual model similar to that of APA with three main concepts: (1) Family and Cultural Values; (2) Professional Skill and Wisdom; and (3) Professional Practice Evidence Base. Evaluating the available research is central to determining evidence-basis and, therefore, central to the ability of enrollees to accurately evaluate methodologies. As such, the quality standards for research will also be adopted from APA and CEC, both of which validate the concept that evidence-basis can be drawn from a variety of research methodologies and disciplines including randomized clinical trials, experimental designs, quasi-experimental designs, single-subject design, and correlation designs (APA, 2002; CEC, 2008; Odom et al., 2005). Two additional concepts are essential to truly determining evidence-basis: treatment fidelity (or fidelity of implementation) and the modes and mechanisms of empirically supported treatment (Kazdin, 2007). According to Grehsam (2009), treatment integrity refers to the extent to which treatments or interventions are delivered or prescribed as intended. Of further importance is that the practitioners who are implementing such practices in the field as evidence-based practices are doing so in the same manner as the research was initially gathered- that is, the practice being implemented reflects the method(s) used in the studies that vetted them. Failure to achieve treatment integrity will result in a practice unreflective of that which was evidenced. Similarly, Kazdin’s (2007) admonition that legitimately establishing a “treatment” as “evidencebased” is not a matter of simply “studying it” across some variables and circumstances or publishing even a wealth of articles, but is dependent on a very precise and rigorous methodology that determines whether or not Teacher Education in Autism Spectrum Disorders / 191
  • 71. it can qualify as EBP. This idea will be central in the evaluation process of the enrollees. Multidisciplinary/Comprehensive Approaches to Methodologies in ASD * Course and fieldwork content in this area of specialization focuses on multidisciplinary approaches and its evaluation in the context of supporting research meets the standards of NBPTS 4 and 5, Scheurmann 3, and CEC 1, 4, 7, and 9. * Course and fieldwork content in this area of specialization focuses on language and communication development in this comprehensive context meets the NBPTS 2, Scheuermann 1, 2, 4, and 7, and CEC 1, 2, 3, 4, 6, and 7. Because research clearly indicates that no methodology can or should be deemed as superior, not espousing a particular paradigmatic framework for the education and treatment of individuals with ASD is a cornerstone of a teacher education program specializing in ASD (NRC, 2001; Simpson, 2008; Task Force on Autism, 2001). Therefore, programs should provide discussion and discourse on a comprehensive set of available approaches toward educating individuals with autism, holding each of them to the standards outlined for EBP and allowing enrollees to determine how well the practice is established in evidence. Dawson and Osterling (1997) reported on a comprehensive analysis from which they were able to delineate six common elements among the most widely used approaches for individuals with ASD: (1) specialized curriculum content, (2) highly supportive teaching environments and generalization strategies, (3) predictability and routine, (4) a functional approach to challenging behaviors, (5) transition support from the previous school environment, and (6) family involvement. Therefore, while the specific philosophies or nomenclatures of particular approaches may differ, there appear to be far more commonalities in both goals and procedures that are often regarded. Along the same lines, because teachers are likely to play an assistive role to parents in the decision making process, it is important that they be made aware of as many potential possibilities of treatments in which families may become interested, and be as 192 / well-versed as possible in order to provide sound, evidence-based advice to their clients. This section will be divided into multiple categories of approach type, using the main paradigm under which the approach can be classified: (1) behaviorally based; (2) relationship/ social based; (3) language based; (4) technology based; (5) sensory based and; (6) medicallybased. It is imperative to note, however, that this is being done for the sake of organization only, and is no way indicative of clinical categories. Furthermore, in almost all cases, as noted by Dawson and Osterling (1997), there are several characteristics that are shared between the approaches, and none is independent of another. In these cases, the same examples will be used in multiple sections. Behaviorally based approaches. Most, if not all, methodologies of educating individuals with ASD have some level of behavioral basis to it. Because behavioral challenges are central to the characteristics of individuals with ASD, this is an imperative component to any effective methodology. As aforementioned, Dillinburger (2011) correctly emphasizes that Applied Behavior Analysis (ABA) is not a form of autism treatment, but rather a methodological approach that predates the diagnosis or application to individuals with ASD. Furthermore, Schreibman (2007) goes so far as to say ABA is not a teaching methodology at all, but rather a research methodology. However, it is important to note that the principles of ABA (e.g., functional assessment and application of consequential events in the form of reinforcement and punishment and the emphasis on those behaviors that can be operationally defined) are commonly applied to educational approaches to individuals with ASD, and are often used as being synonymous with an autism treatment. The specific methodologies discussed in teacher education programs that employ behaviorally based principles are: Discrete Trial Instruction (DTI) (Smith, 2001), incidental teaching (Charlop-Kristy & Carpenter, 2000), Positive Behavior Supports (PBS) (Carr et al., 2002), Pivotal Response Training (PRT) (Koegel, Carter, & Koegel, 2003; Koegel, Koegel, Harrower, & Carter, 1999), Picture Exchange Communication System (PECS) (Bondy & Frost, 1994), Treatment and Education of Autistic and Communication Handicapped Children (TEACCH) (Schopler, Mesibov, & Hearsey, 1995), Learning Experiences: An Alter- Education and Training in Autism and Developmental Disabilities-June 2012
  • 72. native Program for Preschoolers and Parents (LEAP) (Strain & Hoyson, 2000), and Social Communication/Emotional Regulation/Transactional Support (SCERTS) (Wetherby & Prizant, 2000) Relationship-based/emotional-based approaches. An alternative (or perhaps complementary) approach to the behavioral model for understanding and educating individuals with ASD comes from a perspective that regards the challenges in ASD from a relational standpoint, positing that individuals with ASD lack the ability to initiate and foster appropriate emotional relationships with other individuals. From this perspective, stereotypical behavior is not seen as something to be “corrected” reactively, but suggest that environments should be set up to nurture normal (or as close to normal as possible) social interactions in order to foster brain development from the younger ages. From this perspective, behavioral approaches are effective in changing behaviors after such maladaptive behaviors have already been identified, but does not sufficiently account for the development of individuals in the younger stages before deficits have been so well-established (and perhaps engrained in habit). Furthermore, relationship-based approaches are likely to criticize behaviorally-based approaches as being hyperfocused on observable behaviors only, whereas there may be just as much validity in nurturing those concepts that cannot be as readily operational such as emotions and thoughts. Such approaches in this category are Developmental Individual Difference Relatonaship Model (DIR)/ FloorTime (Greenspan & Wieder, 2006), Relationship Development Intervention (RDI) (Gutstein & Sheely, 2004), Social Communication/Emotional Regulation/ Transactional Support (SCERTS) (Wetherby & Prizant, 2000) and SonRise (Kaufman, 1994). Language/communication based approaches. Because language and communication challenges is a central issue in ASD, a substantial amount of coursework must be dedicated to processes of natural and typical language development as well as potential differences in language development for individuals with ASD. Comprehensive theories of typical language development (e.g., Bloom & Lahey, 1978; Hauser, Chomsky, & Fitch, 2002; Skinner, 1957), theo- ries of how language development is different in communication disorders and ASD specifically (Hummel & Prizant, 2010; Siegel, 1997; Prizant, 2003) and specific methodologies that approach intervention from a language and communication based perspective should be explored. A sample of methodologies for inclusion are Applied Verbal Behavior (AVB) (Sundberg & Michael, 2001), Facilitated Communciation (FC) (Biklen, 1993), Social Stories (Gray, 2000), PECS (Bondy & Frost, 1994), incidental teaching (Charlop-Kristy & Carpenter, 2000), and Scripting (Krantz & McClanahan, 1998), Social Communication/Emotional Regulation/Transactional Support (SCERTS) (Wetherby & Prizant, 2000), and Augmentative and Alternative Communication (AAC) (Mirenda, 2003). Technology based approaches. With the seemingly incessant advancements of technology becoming more applicable in school environments, focusing attention on such advancements with respect to methodological approaches for individuals with ASD is becoming increasingly important. Methodologies involving less sophisticated technological means such as video modeling (Bellini & Akuillan, 2007; Shukla-Mehta, Miller, & Callahan, 2010) should be targeted, as well as more involved technologies such as augmentative and alternative communication (AAC) (Mirenda, 2003), PDA applications, and interactive whiteboards (Goldsmith & LeBlanc, 2005). Sensory-based approaches. Some theorists contend that sensory perception problems are essential to understanding the behavior and treatment of individuals with ASD. From this perspective, the behaviors associated with autism (especially those that are seen as stereotypical or self-stimulatory) may be less connected to functions of behavior and more related to an inability to integrate sensory stimuli from the environment in an appropriate way, resulting in overstimulation. Therefore, if methodologies focus on enhancing sensory processing and integration, reduction in behaviors resulting from overstimulation may be observed. The most common application of this theory is Sensory Integration Therapy (SIT) (Carte, Morrison, Sublett, Uemera, & Setrakian, 1984; Snider & Rodriguez, 1993); however other methodologies are also em- Teacher Education in Autism Spectrum Disorders / 193
  • 73. ployed in the same vein such as Higashi/Daily Life Therapy (Quill, Gurry, & Larkin, 1989). Medically-based approaches. As various fields in medical science also explore ASD from a variety of perspectives, exposing enrollees to various medically-based approaches is imperative. Approaches such as brain mapping (McAlonan et al., 2005), chelation therapy (Sinha, Silove, & Williams, 2006), secretin therapy (Chez et al., 2000), and vitamin therapy (Wong & Smith, 2006) should be explored, especially since such approaches may continue to be appealing to parents. Assessment and Monitoring of Teacher Performance Post-Graduate While teacher education programs within colleges and universities can closely control the information and assessment techniques applied within their curriculum, the true measure of a teacher preparation program comes in the effectiveness of the teachers such programs produce. Therefore, it is an imperative component of any teacher education program to determine a means of monitoring and assessing the job placement, job performance, and student outcome of those teachers who have completed the program. This task can be challenging, however, it is incumbent upon the facilitators of such programs to determine the overall clinical and practical worth of the programs. Methods such as direct evaluation of accurate implementation (Lerman, Vondran, Ajdisim, & Kuhn, 2004), self-assessment (Grey, Honan, McLean, & Daly, 2005), ecobehavioral assessment (Roberson, Woolsey, Seabrooks, & Williams, 2004), as well as novel and new approaches developed by the teacher education programs should be explored. Inclusive Education for Individuals with ASD With both the Elementary and Secondary Education Act (ESEA) and the Individuals with Disabilities Education Act (IDEA) mandating that the field increase inclusive opportunities for all students, teacher education programs must pay particular attention to issues involving the successful inclusion of individuals with ASD. As defined by Ferguson (1995) inclusion is defined as: 194 / a unified system of public education that incorporates all children. . .as active, fully participating members of the school community; that views diversity as the norm; and that ensures a high-quality education for each student by providing meaningful curriculum, effective teaching, and necessary supports for each student” (p. 286). Approaching inclusion from the well-established perspective that successful inclusive education should be implemented in the context of a “needs-based approach” (Lynch & Irvine, 2009), the program will emphasize the central ideas of the needs of individuals with ASD as indicated by the research. Lipsky and Gartner (1997) identified seven essential elements of successful inclusion: (1) Visionary leadership; (2) collaboration; (3) support for staff and students; (4) effective parental involvement; (5) refocused use of assessment; (6) appropriate levels of funding; and (7) curricular adaptation and effective instructional practices. Expanding on these findings, Lynch and Irvine (2009) suggest four similar elements that are essential specifically for the effective inclusion of individuals with ASD: (1) instructional practices that are specific to suit individual strengths and challenges of individuals; (2) student and staff supports including classroom structure and environments, routines and schedules, and resources for dealing with challenging behaviors; (3) multidisciplinary, multisite collaboration which employs a combination of expertise, approaches, and perspectives to ensure programs do not become overly paradigmatic; (4) family involvement to help the facilitation of generalization and maintenance of skills and consistency of responses and content. Teacher education programs specializing in individuals with ASD need meet these guidelines. Such programs can do so by focusing on a variety of approaches and perspectives from which ASD can be both characterized and framed as well as a multidisciplinary approach to educational and treatment methods. Content focusing on family issues, including presentations by families of individuals with ASD, as well as ASD specific issues can provide a comprehensive handling of ASD, allowing for well-prepared and well-informed teachers that can take an active and qualified Education and Training in Autism and Developmental Disabilities-June 2012
  • 74. role in increasing inclusive opportunities for their students with ASD. Overarching Issues in Teacher Education Because preparing teachers in specialized areas cannot be entirely separated from general teacher education programs, designing such programs with close attention to overarching issues in teacher education is essential. Programs specializing in ASD must frame the concept of teacher education beyond simply standards and assessments to gauge mastery, but instead use a multi-faceted definition including experiential, practical, and philosophical knowledge of and engagement with the real and pertinent issues in the field of educating individuals with ASD. Three tiers of comprehensive teacher education are offered by McArdle (2010): (1) what teachers need to know and do to become quality teachers (e.g., discipline and content knowledge, curricular knowledge, pedagogical knowledge, and knowledge of self and culture); (2) the current climate of accountability measures and standards; and (3) the visibility of learning, or a shared sense of the whole task, purpose, or goal of education. By focusing on specific characteristics of ASD, comprehensive and multidisciplinary approaches, and opportunities for self-evaluation, as well as a focus on EBP and discussion of the purposes of teaching, this program clearly meets these guidelines as comprehensive program of teacher education. As teacher education is fostered by learning from research as well as collaboratively, provision of information must not rely strictly on discrete presentations of methodologies, but also offer and foster multidimensional, interactive, and experiential activities that provide direct engagement and application of these methodologies (Lieberman & Pointer Mace, 2008). As such, the enrollees should be provided with a program that extends beyond reinforcing simply a “culture of compliance” but an engagement with a curriculum that allows learning through practice, meaning, community, and identity, as well as an opportunity to learn with experienced and degreed professionals with a wealth of knowledge, expertise, and experience (Lieberman & Pointer Mace, 2008). Conclusion Since the needs of individuals with ASD are so specialized, research seems clear that specific teacher training protocols must exist for teachers working with ASD (National Research Council, 2001; Scheuermann et al., 2003; Simpson, 2008). However, there appears to be a lack of available comprehensive teacher education programs in ASD. Furthermore, the teacher education programs that do exist appears to adopt and rely on single theory approaches, which does not seem to be a prudent or potentially effective framework (Reichow et al., 2007; Scheurmann et al., 2003; Simpson, 2008). In attempt to contribute to the discourse on teacher preparation in ASD, as well as propose a framework that is to be implemented for such a purpose, this article outlined major areas that should be included in a teacher preparation program in ASD based on the available research. References American Psychological Association. (2002). Criteria for evaluating treatment guidelines. American Psychologist, 57, 1052–1059. Bellini, S., & Akullian, J. (2007). A meta-analysis of video modeling and video self-modeling interventions for children and adolescents with Autism Spectrum Disorders. Exceptional Children, 73, 264 – 287. Biklen, D. (1993). Communication unbound: How facilitated communication is challenging traditional views of autism and ability/disability. New York: Teachers College Press. Bloom, L., & Lahey, M. (1978). Language development and language disorders. Somerset, NJ: John Wiley & Sons, Inc. Bondy, A., & Frost, L. (1994). The picture exchange communication system. Focus on Autism and Other Developmental Disabilities, 9, 1–19. Carr, E. G., Dunlap, G., Horner, R. H., Koegel, R. L., Turnbull, A., Sailor, W., . . . Fox, L. (2002). Positive behavior support: Evolution of an applied science. Journal of Positive Behavioral Interventions, 4, 4 –16. Carte, E., Morrison, D., Sublett, J., Uemera, A., & Setrakian, W. (1984). A trial of specific neurodevelopmental therapy for the remediation of learning disabilities. Journal of Developmental & Behavior Pediatrics, 5, 189 –194. Charlop-Kristy, M. H., & Carpenter, M. H. (2000). Modified incidental teaching sessions: A procedure for parents to increase spontaneous speech Teacher Education in Autism Spectrum Disorders / 195
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  • 77. Education and Training in Autism and Developmental Disabilities, 2012, 47(2), 198 –209 © Division on Autism and Developmental Disabilities Anxiety Levels in Students with Autism Spectrum Disorder Making the Transition from Primary to Secondary School Elizabeth F. Hannah and Keith J. Topping University of Dundee Abstract: The anxiety levels of students with autism spectrum disorder (ASD) over the period of transition from primary to secondary school are investigated. A repeated measures design and an adapted version of a self-report measure, the Spence Children’s Anxiety Scale (SCAS), are used to compare the anxiety levels of eight students before and after the transfer. Analysis at the individual level of the sub-scale scores using the adapted SCAS against the standardised norms in two studies involving community samples reveals a mixed picture. These findings suggest that individual differences are a significant feature. Limitations of the research and possible avenues for future research are considered. Implications for supporting students with ASD in schools are outlined. Having Autism Spectrum Disorder (ASD) is considered to be a lifelong developmental disability which has a pervasive impact on how an individual makes sense of the world and interacts with other people. The term Autism Spectrum Disorder is used in this paper to embrace a range of diagnostic labels including classical autism, atypical autism and Asperger’s Syndrome. Wing and Gould, in their 1979 Camberwell (London) study into the prevalence of autism in children with special needs, identified children who did not fit with previous conceptualizations of autism as described originally by Kanner in 1943 (Kanner, 1943; Wing & Gould, 1979). They proposed a broader spectrum of conditions, hence autism spectrum, and coined the term triad of impairments to refer to impairments in social interaction, communication and imagination (Wing, 1993). The term triad of impairments is now generally recognized by clinicians and researchers and forms the basis for the two major diagnostic systems for ASD in current use, namely the International Classification of Diseases 10th edition (ICD-10) (WHO, 1993) Correspondence concerning this article should be addressed to Elizabeth Hannah, University of Dundee, School of Education, Social Work & Community Education, College of Arts and Social Sciences, Carnelley, Nethergate, Dundee, DD1 4HN, Scotland, UK. E-mail: e.hannah@dundee.ac.uk 198 / and the Diagnostic and Statistical Manual 4th edition (DSM-IV; American Psychiatric Association, 2000). Enhanced anxiety levels in individuals with ASD are a recognized clinical feature that may result from a range of factors such as an individual’s difficulty in dealing with social situations due to social interaction and communication impairments; problems coping with changes in the environment and hence the need for routine; and responses to sensory experiences (Attwood, 1998; Howlin, 1998). A perceived link between an individual’s difficulty in coping with change and insistence on maintenance of routines and levels of anxiety has been of interest to writers and researchers in this field for many years. In his original study in 1943, Kanner suggested that the core features of ‘early infantile autism,’ including routines, were anxiety driven (Kanner, 1943). More recently, Kuusikko et al. (2008) suggested that stereotyped routines and rituals are a way of easing anxiety symptoms; Gillott, Furniss, and Walter (2001) proposed that changes in routine can result in raised anxiety levels and that ritualistic behaviours are a coping mechanism for such heightened emotional states. However, questions have been raised by some researchers as to whether such behavioural features can be considered to be true symptoms of anxiety or simply expressions of pervasive developmental disorder (PDD) Education and Training in Autism and Developmental Disabilities-June 2012
  • 78. symptoms (Kim, Szatmari, Bryson, Streiner, & Wilson, 2000). This appears to be a question of differential diagnosis. Whether this has implications in terms of the interventions employed to support children and young people in school and in the community is unclear. Within the past 10 years there have been a few empirical investigations into the anxiety levels of children and young people with ASD. These studies can be differentiated into those which have employed measures to compare the anxiety levels of individuals with ASD with community samples (Kim et al., 2000; Kuusikko et al., 2008) and those which have employed cross-sectional designs to compare matched groups (Gillott et al., 2001; Green, Gilchrist, Burton, & Cox, 2000). Overall, these studies provide evidence of raised anxiety levels in children and young people with ASD. Kim et al. (2000) report on the prevalence and correlates of anxiety and mood problems amongst 9 to 14 year old children with Asperger Syndrome (AS) and high functioning autism (HFA). Employing a modified version of the Ontario-Child Health Study Revised (OCHS-R) questionnaire completed by parents, AS and HFA children were found to have a greater rate of anxiety and depression problems compared with the standardized community sample. One of the acknowledged limitations of this study was the difficulty in differentiating between true symptoms of anxiety and depression, as reported by parents, and those of pervasive developmental disorder (PDD). Kuusikko et al. (2008) address this limitation through employing revised measures which excluded items which overlapped with criteria associated with HFA and AS symptoms. They examined social anxiety symptoms in children and adolescents with AS and HFA using children’s self-report measures of social phobia and anxiety (Social Phobia and Anxiety Inventory for Children) and social anxiety (Social Anxiety Scale for Children Revised). Parental ratings of the children’s observed internalizing symptoms were measured using the Child Behavior Checklist. The children and adolescents scored higher on all measures compared with a community based control sample. Gillott et al. (2001) compared the anxiety levels of three matched groups of children (aged 8 to 14 years) (although it should be noted that they were not matched for IQ): normally developing, high functioning autism (HFA), and specific language impairments. Employing two self–report measures of anxiety (Spence Children’s Anxiety Scale (SCAS); Social Worries Questionnaires (SWQ)), the children with HFA obtained higher mean total scores and scores in four of the six subscales compared with the comparison groups. Green et al. (2000) compared the psychosocial functioning of a group of adolescent boys with AS with a matched group of males with a diagnosis of conduct disorder (CD). However, unlike Gillott et al. they did not include a control group of normally developing adolescents. Subject and informant interview measures were employed to assess social and psychiatric functioning. The researchers found that the AS group had poorer social functioning and more severe difficulties in interpersonal functioning than the CD group. In terms of psychiatric functioning, the AS group, in the subject interview measure, displayed significantly greater levels of anxiety related symptoms. It is generally recognized that individuals with ASD experience more difficulties coping with routine changes than individuals in the general population. This has been attributed to impairment in imagination resulting in ritualistic behaviour and insistence on routines (Wing, 1992; Wing, 1993). The conceptualization of transitions being of a micro-nature (e.g. moving between activities) or a macronature (e.g. moving between schools) (Attwood, 1998) is helpful to our understanding of children’s difficulties with transitions in an educational context and the role played by anxiety during this process. Although there will be individual differences in levels of response to change, it appears reasonable to propose that changes of a macro-nature are likely to lead to higher levels of anxiety. It is generally accepted that students with ASD require additional support to help them cope with the day to day changes within classroom and school environments. Typical approaches include the use of visual supports (e.g. visual timetables, visual cues, photographs); calming activities; support with personal organisation of belongings and materials; and appointing a classroom buddy (Larkey, 2005). Furthermore, it has been pro- Anxiety and Transition / 199
  • 79. posed that transitions of a macro-nature, such as moving between one school and another should carefully be managed through such strategies as additional visits to the new school, transition planning meetings, and information for students and parents (Attwood, 1998; Carter, Clark, Cushing, & Kennedy, 2005; Ennis & Manns, 2004). Heightened levels of anxiety which such changes may engender will have a variable impact on a student’s psychological response and social functioning. Knowledge of an individual’s experience and response will inform the strategies adopted by parents and professionals. For students in the general population, there is evidence that following transfer to secondary school, levels of anxiety and stress are a short-term feature during the first months (Graham & Hill, 2003; Tobbell, 2003). Furthermore, there appears to be some evidence that these levels decrease for the majority of students during their first year at secondary school. Lohaus, Ev Elben, Ball, and Klein-Hessling (2004) attribute this decrease to the relaxing effects of the summer vacation. In contrast, there appear to be no published studies exploring the anxiety levels of students with ASD during this transition. The present study aims to inform our understanding of factors impacting the anxiety levels in children with ASD. It is acknowledged that the findings should be considered preliminary in nature given the small sample size and the reliance on a self-report measure. However, it is argued that the findings will provide the basis for future research and have relevance for educational practices. Research Questions 1. How do the self-reported anxiety levels of a sample of students with ASD compare with those of the standardised sample prior to the transfer to secondary school? 2. How do the self-reported anxiety levels of a sample of students with ASD compare with those of the standardised sample following the transfer to secondary school? 3. How do the self-reported anxiety levels of a sample of students with ASD prior to the transfer to secondary school compare with those of the same students following transfer? 200 / It was predicted, based on previous studies, that students with ASD would have higher levels of anxiety compared with the general student population. Furthermore, if students with ASD follow a similar pattern to the general student population (Lohaus et al., 2004), it was predicted that they would experience heightened feelings of anxiety prior to the move and a reduction in anxiety levels following the transfer. Method Participants and Setting Setting. This study took place in a large, inner city in Scotland which in 2007 had an estimated population of 581,940 (General Register Office for Scotland, 2008). The city faces challenges due to the levels of deprivation within its locality, with 49% of the 5% most deprived areas (data zones) and 31% of the 15% most deprived areas in Scotland (Scottish Government, 2009). Participants. For the wider investigation, of which this study formed a part, a sample of students was purposively selected. The population comprised all students with a diagnosis of ASD in their final year at mainstream primary schools in the south side of the city who could transfer to mainstream secondary schools in the authority. The sampling frame was drawn up using the knowledge of educational psychologists (EPs) employed by the local authority serving this geographical area. A potential drawback of this method was its reliance on full and accurate returns. Other sources of information, such as speech and language therapy records, provided a crosschecking mechanism improving the reliability of this method. The inclusion criteria were that the students should have a diagnosis of ASD; be in their final year of education in a mainstream primary school; and that transfer to a mainstream secondary school was anticipated. Nine male students participated in the wider study, all of whom had a diagnosis of Asperger Syndrome (considered to fall within the parameters of ASD). The absence of females in the sample is not surprising. In terms of gender balance, prevalence levels (male to female) range from 4.7: 1 to 10.3: 1 Education and Training in Autism and Developmental Disabilities-June 2012
  • 80. TABLE 1 Details of participants Student No. Age at Start of study Diagnosis Primary School Placement Secondary School Placement 1 11 years 8 months Asperger syndrome Mainstream primary 2 11 years 3 months Asperger syndrome Mainstream primary 3 4 5 12 years 2 months 11 years 6 months 11 years 10 months Mainstream primary Mainstream primary Mainstream primary 6 7 8 12 years 4 months 12 years 1 month 11 years 5 months Asperger syndrome Asperger syndrome Asperger syndrome Tourette syndrome Asperger syndrome Asperger syndrome Asperger syndrome (Howlin, 1998). In addition, one student had a diagnosis of Tourette syndrome. Participants’ ages at commencement of the study ranged from 11 years 3 months to 12 years 4 months (M ϭ 11 years 8.9 months; SD ϭ 4.6 months). There was minimal attrition over the period of the investigation reflecting the levels of engagement. Due to parental disengagement after completion of the six-week transition programme, data at two time points were not available for one of the participating students. Data for the other eight students are reported here. Details of participants by gender, age at commencement of the study, diagnosis and school provision are provided in Table 1. Measure An adapted version of the Spence Children’s Anxiety Scale (SCAS; Spence, 1997) was employed. The original version comprises six sub-scales, namely, panic attack and agoraphobia (PAA), separation anxiety (SA), physical injury fears (PI), social phobia (SP), obsessive compulsive (OC) and generalized anxiety disorder/overanxious disorder (GAD) based on six of the DSM-IV categories of anxiety disorders (Yule, 1997). It has 45 items comprising 38 anxiety items, six filler items and one open-ended item. The filler and open-ended items are not scored. There is a 4-point scale response set (never, Mainstream primary Mainstream primary Mainstream primary Secondary communication support unit Secondary communication support unit Mainstream secondary Mainstream secondary Mainstream secondary Mainstream secondary Mainstream secondary Secondary communication support unit sometimes, often, and always) for each item, scored 0 to 3. Using a large community sample of Australian children aged 8 to 12 years, Spence (1998) reports high internal reliability for the SCAS with a co-efficient alpha of 0.92 and a Guttman split-half reliability of 0.90. Internal consistency of the sub-scales ranged from 0.60 to 0.82. Test-retest reliability on a sub-sample for the total score over a six month time period was 0.60 and for the sub-scales 0.45 to 0.57. Convergent and discriminant validity were assessed using a range of other measures. A Pearson product-moment correlation of 0.71 was found between SCAS total scores and the Revised Children’s Manifest Anxiety Scale (RCMAS) total scores and a range of 0.50 to 0.61 between the SCAS sub-scales and RCMAS total scores. In contrast, there was no supporting evidence for convergent validity using a parent reported measure, namely the internalizing sub-scale of the Child Behaviour Checklist (CBCL). The SCAS has been found to have discriminatory properties between two groups of clinically diagnosed children (social phobia and co-morbid social-separation anxiety) and a non-clinical control group. The present study used an adapted version of the SCAS incorporating the 4 sub-scales (PAA, SA, PI, and OC) which were found to discriminate the HFA children from the other two matched groups in the Gillott et al. (2001) study. The final version comprised 26 items, Anxiety and Transition / 201
  • 81. there being no filler items or an open-ended item. The 4-point scale response set (never, sometimes, often, and always) was retained. Cronbach alpha coefficients in the current study, with the Spence, Barrett, and Turner (2003) figures in brackets, were: PAA .72 (.80); SA .53 (.71); PI .75 (.60); and OC .66 (.75). Cronbach alpha values are sensitive to the number of items in the scale and it is not uncommon to get figures as low as .5 for short scales with less than 10 items (Pallant, 2007). In that context, it is argued that the reduction from 45 to 26 items could account for the lower levels in three of the sub-scales and that the obtained figures are acceptable. the first author’s presence and clarification provided if required. For one student, an attempted home visit and follow-up written communication proved unsuccessful and it was decided to exclude this participant from this element of the research. An identical version of the questionnaire was utilised at the follow-up point. The first author visited the students at their homes during the period late February to early April of their first year in secondary school. Written instructions on the questionnaire were supplemented, where necessary, by verbal explanation. If required, reading assistance was provided. Procedure In terms of ethical considerations, the first author was bound by the British Psychological Society and affiliated university codes of practice for research on human participants. All participants were advised of the voluntary nature of participation and informed consent was sought through written and verbal means. Paper data was stored in a locked filing cabinet and electronic data was stored and retrieved through a password protected computer. Issues of confidentiality and anonymity in reports of the research were communicated to all participants. The adapted SCAS was administered at two time points, namely, immediately prior to the move to secondary school, and approximately 6 months following the transfer. Questionnaires were sent to the students’ parents in May with a cover letter providing informed consent. Parents were advised to allow their child to complete the questionnaire as far as possible independently, although they could provide assistance for clarification purposes. Despite this guidance, it is acknowledged there was no control of the actual administration and parents could have inadvertently influenced their children’s responses impacting on the reliability of the data. Questionnaires were completed over the period from early June to mid July prior to the students starting secondary school in late August. Five questionnaires were returned by parents using the postal service and home visits were arranged for the remaining four students. Questionnaires were completed in 202 / Data Analysis For each of the 26 items in the SCAS (amended), respondents were asked to tick one of four possible responses. Responses were allocated a score ranging from 0 to 3. For the purposes of analysis, it has been assumed that the measurement scale furnished ordinal data. The quantitative data was subjected to descriptive and inferential analyses using SPSS. The Wilcoxon Signed Rank (WSR) test was employed to compare the scores on each of the 26 items at time points 1 and 2. SCAS sub-scale scores for the respondents were compared to those of the standardization sample (Spence et al., 2003). Respondents’ ages at each time point were calculated with figures rounded down to the nearest whole number. At time point one, five students were aged 11 years and three students aged 12 years. At time point two, six students were 12 years and two students aged 13 years. There is evidence that self-reported anxiety levels decrease with age (Spence, 1997). To address this, norms from a study involving a sample of thirteen and fourteen year old adolescents from Brisbane, Australia (Spence et al.) were used for the two students who were aged thirteen at time point two. Spence et al. note that combined norms for thirteen and fourteen year olds were lower than those for 12 year olds (Spence, cited in Spence et al.) providing further evidence of “a continued decrease in self-reported anxiety scores with increasing age” (p. 621). Education and Training in Autism and Developmental Disabilities-June 2012
  • 82. TABLE 2 Descriptive Statistics of the Panic Attack and Agoraphobia Sub-scale SDb Time point 1 M Time point 2 SDb Time point 2 Effect Size Item na M Time point 1 I suddenly feel as if I can’t breath when there is no reason for this I suddenly start to tremble or shake when there is no reason for this I feel scared if I have to travel in the car or in a bus or train I am afraid of being in crowded places All of a sudden I feel really scared for no reason at all I suddenly become dizzy or faint when there is no reason for this My heart suddenly starts to beat too quickly for no reason I worry that I will suddenly get a scared feeling when there is nothing to be afraid of I am afraid of being in small closed places 8 .13 .354 .25 .463 .339 8 .38 .518 .25 .463 .251 8 .25 .463 .25 .463 0 8 .38 .744 .38 .518 0 8 .38 .518 0 .000 .734 8 .13 .354 0 .000 .367 8 .25 .463 .38 .518 .281 8 .38 .518 .38 .518 0 8 .63 .744 .50 .535 .175 a b number standard deviation Results Group SCAS Sub-scale Scores Eight students completed the anxiety questionnaire at both time points. Group means and standard deviations for the sub-scale items are outlined (see Tables 2- 5). Within-subjects analyses at the group level for the four subscales indicated that few of the sub-scale items had reached statistical significance. Given the small sample size with the increased likelihood of type II errors, it was decided to calculate effect sizes using Cohen’s d (Cohen, Manion, & Morrison, 2007). Clark-Carter (2004) states that it is possible to calculate an effect size for a within-subjects design which allows relative comparison with effect size in a between-subjects design. Cohen et al. provide guidance for interpretation of the statistic Cohen’s d as follows: 0 – 0.20 ϭ weak effect; 0.21– 0.50 ϭ modest effect; 0.51–1.00 ϭ moderate effect; and Ͼ1.00 ϭ strong effect. There were changes in the predicted direction as reflected in a decrease in the scores for four of the nine items in the Panic Attack and Agoraphobia (PAA) sub-scale. Of these four items, there was a moderate effect size for time for one item (All of a sudden I feel really scared for no reason at all; d ϭ 0.734) and a modest effect size for two items (I suddenly start to tremble or shake when there is no reason for this; d ϭ 0.251); I suddenly became dizzy or faint when there is no reason for this; d ϭ 0.367). However, it should be noted that in two items the scores Anxiety and Transition / 203
  • 83. TABLE 3 Descriptive Statistics of the Separation Anxiety Sub-scale SDb Time point 1 M Time point 2 SDb Time point 2 Effect Size Item na M Time point 1 I would feel afraid of being on my own at home I worry about being away from my parents I worry that something awful will happen to someone in my family I feel scared if I sleep on my own I have trouble going to school in the mornings because I feel nervous or afraid I would feel scared if I had to stay away from home overnight 8 1.00 .926 .63 .518 .405 8 1.25 .707 .75 .463 .707 8 1.38 .744 1.50 .756 .161 7 .14 .378 .14 .378 0 8 .38 .744 .50 1.069 .161 8 .50 .756 .38 .518 .159 a b number standard deviation increased. There was a decrease in three of the six items in the Separation Anxiety (SA) sub-scale with a moderate effect size in one item (I worry about being away from my parents; d ϭ 0.707)) and a modest effect size in another (I would feel afraid of being on my own at home; d ϭ 0.405). There was a decrease in two of the six items in the Obsessive-compulsive (OC) sub-scale each showing a modest effect size (I can’t seem to get bad or silly thoughts out of my head; d ϭ 0.383); I have to think of special thoughts (like numbers or words) to stop bad things from happening; d ϭ 0.259). However, in three items the scores increased. Finally, there was an increase in the score for one of the five items in the Physical Injury Fears (PI) sub-scale although this had a weak effect size. In contrast, the scores in three items increased at time point two, two showing a modest effect size and one a strong effect size. 204 / Individual SCAS Sub-Scale Scores Given the apparent variability in the direction of change using group aggregated scores in the four sub-scales, it was decided to conduct an analysis at the individual level. The total sub-scale scores for each of the four sub-scales were calculated at both time points. It was decided to use normative means of the community sample for comparative purposes such that it would be possible to determine whether an individual had a significantly higher or lower score than the norm. Given the age of the respondents over the period of the study, it was necessary to use the standardized norms from two studies, the original study (Spence, 1997) and one involving older children (Spence et al., 2003). For the purposes of this study, a score of more than one standard deviation from the standardised mean was defined as substantial (see Table 6). Education and Training in Autism and Developmental Disabilities-June 2012
  • 84. TABLE 4 Descriptive Statistics of the Obsessive Compulsive Sub-scale SDb Time Point 1 M Time Point 2 SDb Time Point 2 Effect Size Item na M Time Point 1 I have to keep checking that I have done things right I can’t seem to get bad or silly thoughts out of my head I have to think of special thoughts I have to do same things over and over again I get bothered by bad or silly thoughts or pictures in my mind I have to do some things in just the right way to stop bad things happening 8 1.25 .707 1.50 .926 .354 8 1.13 .991 .75 .707 .383 8 .25 .463 .13 .354 .259 8 1.13 1.246 1.00 .756 .104 7 .29 .488 .75 .707 .943 9 .25 .707 .57 .787 .453 a b number standard deviation Five out of eight respondents had substantial scores in one sub-scale at time point one and this reduced to four respondents at time point two. Looking at trends in the four sub-scales, one respondent had a substantial score at time point one in the PAA sub-scale. At time point two, this score had reduced to within one standard deviation of the mean. In the SA sub-scale, two respondents had substantial scores at time point one. Both figures were lower at time point two with only one remaining substantial. For the OC sub-scale, one respondent had a substantial score at time point TABLE 5 Descriptive Statistics of the Physical Injury Fears Sub-scale SDb Time Point 1 M Time Point 2 SDb Time Point 2 Effect Size Item na M Time Point 1 I am scared of the dark I am scared of dogs I am scared of going to the doctor or dentist I am scared of being in high places or lifts I am scared of insects or spiders 8 8 8 .63 .13 .50 .916 .354 .535 .63 .50 .63 .744 .756 .518 0 1.045 .243 7 1.14 .900 1.00 .756 .156 8 .63 .744 .87 .835 .323 a b number standard deviation Anxiety and Transition / 205
  • 85. TABLE 6 Descriptive Statistics of Individual Sub-scale Scores: SCAS Respondent 1 2 3 4 5 6 7 8 PAA ascore time point 1 2 6 6* 2 0 1 0 6 3.70 4.32 1 3.70 4.32 3 2.45 3.17 5 3.70 4.32 3 3.70 4.32 1 2.45 3.17 2 2.45 3.17 0 3.70 4.32 4 2.45 3.17 2 2.45 3.17 11 prorated* 3.78 2.98 7* 1.95 3.20 4 2.45 3.17 3 2.45 3.17 3 1.95 3.20 8* 2.45 3.17 3 2.45 3.17 5 3.00 2.55 2 3.78 2.98 4 3.78 2.98 4 3.00 2.55 5 3.78 2.98 4 3.00 2.55 7 prorated 5.90 3.86 3 1.83 2.29 5 3.00 2.55 2 3.00 2.55 3 3.00 2.55 4 prorated 1.83 2.29 2 3.00 2.55 4 3.00 2.55 10* 5.39 4.02 7 prorated* 3.22 2.86 3 5.90 3.86 3 5.90 3.86 7 5.39 4.02 3 5.39 4.02 7 5.90 3.86 5 5.39 4.02 8* 5.39 4.02 3 3.22 2.86 1 5.39 4.02 1 5.39 4.02 1 2.94 2.55 5* 3.32 2.65 6* 3.32 2.65 6* 2.94 2.55 0 2.94 2.55 1 3.32 2.65 2 1.86 2.22 2.94 2.55 2.94 2.55 1.86 2.22 2.94 2.55 2.94 2.55 PAA score time point 2 SA b score time point 1 SA score time point 2 OC c score time point 1 OC score time point 2 3.78 2.98 2 3.00 2.55 2 5.90 3.86 3 PI score time point 2 3.32 2.65 4 5.39 4.02 5 prorated 3.32 2.65 5 2.94 2.55 PId score time point 1 5.39 4.02 2 2.94 2.55 a panic attack and agoraphobia separation anxiety c obsessive compulsive d physical injury fears e non-emboldened and non-italicized figures represent raw scores f emboldened figures represent the means from other studies (Spence, 1997; Spence et al., 2003) g emboldened and italicized figures represent the standard deviations from other studies (Spence, 1997; Spence et al., 2003) h an asterisk indicates that the score is more than one standard deviation above the mean i where there are missing data, figures have been pro-rated utilising available data b one but this ceased to be the case at time point two. However, another respondent’s score increased at time point two reaching a substantial level. Finally, in the PI sub-scale, one respondent had a substantial score at time point one. In contrast, at time point two, three of the respondents had substantial scores. 206 / Discussion Using the individual SCAS sub-scale scores, prior to the transfer to secondary school five of the eight students had substantial scores in one sub-scale of the adapted SCAS compared with standardised norms in a community sam- Education and Training in Autism and Developmental Disabilities-June 2012
  • 86. ple. Previous studies have found higher levels of anxiety in children and adolescents with HFA and AS compared with those in community samples or a matched comparison group of normally developing children (Gillott et al., 2001; Kim et al., 2000; Kuusikko et al., 2008). Following the transfer, half of the students had substantial scores in at least one sub-scale compared with a community sample. These findings are in the same general direction as previous studies but conclusions should be tempered by the absence of consistency across all students in the sample and across all four sub-scales. Two methods of analysis were employed to look at changes in anxiety levels over the transition period. The findings from the initial analysis, which focused on comparison of group mean scores for each of the 26 scale items, were not conclusive. The second analysis, which looked at individual scores across the four sub-scales, revealed some interesting trends. Between the two time points, there was evidence of a decrease in anxiety levels in two of the sub-scales (PAA, and SA); a mixed picture in the OC sub-scale with one individual evidencing a decrease and another individual an increase in levels; and an increase in the PI sub-scale (three individuals had substantial scores at time point two compared with one at time point one). It should be noted that a few researchers have expressed concerns about the internal consistency of the PI sub-scale (Muris, Merckelbach, Ollendick, King, & Bogie, 2002). However, the majority view of the research community is that the PI sub-scale should be retained as a measurement of an important dimension of anxiety in children and adolescents (Nauta, 2005; Spence et al., 2003). Overall, these findings provide quite a mixed picture across the four sub-scales. It appears that there are individual differences in anxiety levels as students transition to a new school. This finding could be attributed to the small sample failing to identify a general pattern. One limitation of the methodology in this study was the reliance on one data source, a self-report questionnaire, which has not been standardized on a UK sample and has no established validity for children with autism (Gillott et al., 2003). Concerns have been raised by some researchers about the ability of children with ASD to complete self-report measures (Sofronoff, Attwood, & Hinton, 2005). However, countering those concerns, there is some evidence that children with ASD are able to “self- reflect using structured questionnaires” (Knott, Dunlop, & Mackay, 2006, p. 616) and that the “general skills of insight and emotional self-reporting increase with age in children and adolescents” (Kuusikko et al., 2008, p. 1707). Another limitation of the methodology was the researcher’s acceptance of the children’s diagnoses without reassessment. This paper reports on what appears to be the first study which has explored anxiety levels in children with ASD as they make the transition from primary to secondary school. Further studies, involving larger samples, are indicated. Furthermore, longitudinal research designs which would enable tracking of anxiety levels over a longer time period and at various time points would provide greater insight into changes over time. Kuusikko et al. (2008), utilising two different self-report measures of social anxiety, found that “children with HFA/AS reported an increase in social anxiety as they grew older, whereas typically developing children reported a decrease in social and evaluative anxiety as they grew older” (p. 1706). It would be of interest to explore whether other forms of anxiety increase with time in children with ASD. In typically developing children, levels of anxiety decrease by age (Spence et al., 2003). Utilization of an equivalent parent questionnaire (SCAS-P; Nauta, Scholing, Rapee, Abbott, Spence, & Waters, 2004) would enable triangulation with student data. Finally, it would be valuable to further investigate factors which could explain the individual differences which were a feature of this study. Notwithstanding the identified limitations and preliminary nature of this study, some implications for educational policy and practice are indicated. It is recommended that teachers and related professionals should take cognizance of individual variability in anxiety levels and responses to moving schools. As part of the assessment approach, they should consider using standardised measures, such as the SCAS, and employing a range of support strategies, such as induction days, orientation visits, familiarity with timetables, maps of the Anxiety and Transition / 207
  • 87. school, meeting school staff and other pupils, and a buddy system. In addition, the use of relaxation techniques should be considered as part of an overall support package. The provision of support for parents and other family members is another area worth pursuing. Finally, referral to other professionals for the treatment of anxiety symptoms may be indicated as there is evidence that young people with HFA and AS respond to treatments such as cognitive psychotherapy (Kuusikko et al., 2008). References American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders, 4th ed. (DSM-IV-TR). Washington, D.C.: American Psychiatric Press. Attwood, T. (1998). Asperger’s syndrome: A guide for parents and professionals. London: Jessica Kingsley Publishers. Carter, E. W., Clark, N. M., Cushing, L. S., & Kennedy, C. H. (2005). Moving from elementary to middle school: Supporting a smooth transition for students with severe disabilities. Teaching Exceptional Children, 37(3), 8 –14. Clark-Carter, D. (2004). Quantitative psychological research. Hove, England: Psychology Press. Cohen, L., Manion, L., & Morrison, K. (2007). Research methods in education (6th ed.). London: Routledge. Ennis, D., & Manns, C. (2004). Breaking down barriers to learning: practical strategies for achieving successful transition for students with autism and Asperger syndrome. Surrey Children’s Service. Retrieved from National Autistic Society website: http:// www.nas.org.uk/ General Register Office for Scotland. (2008). Scotland’s population 2007: The register general’s annual review of demographic trends. 153rd edition. Retrieved from General Register Office for Scotland website: http://www.gro-scotland.gov.uk/ Gillott, A., Furniss, F., & Walter, A. (2001). Anxiety in high functioning children with autism. Autism, 5, 277–286. Retrieved from http://aut.sagepub. com/ Graham, C., & Hill, M. (2003). Spotlight 89: Negotiating the transition to secondary school. University of Glasgow, SCRE Centre. Green, J., Gilchrist, A., Burton, D., & Cox, A. (2000). Social and psychiatric functioning in adolescents with Asperger Syndrome compared with conduct disorder. Journal of Autism and Developmental Disorders, 30, 279 –293. Retrieved from http://www.springer.com/psychology/ 208 / childϩ%26ϩschoolϩpsychology/journal/ 10803 Howlin, P. (1998). Children with autism and Asperger syndrome: A guide for practitioners and carers. Chichester, England: John Wiley & Sons. Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217-250. Retrieved from http://affect.media.mit.edu/Rgrads/ Articles/pdfs/Kanner-1943-OrigPaper.pdf Kim, J. A., Szatmari, P., Bryson, S. E., Streiner, D. L., & Wilson, F. J. (2000). The prevalence of anxiety and mood problems among children with autism and Asperger Syndrome. Autism, 4 (2), 117–132. Retrieved from http://aut.sagepub.com/ Knott, F., Dunlop, A., & Mackay, T. (2006). Living with ASD: How do children and their parents assess their difficulties with social interaction and understanding? Autism, 10, 609 – 617. doi: 10.1177/1362361306068510 Kuusikko, S, Pollock-Wurman, R., Jussila, K., Carter, A. S., Matilla, M-L, Ebeling, H., . . . Moilanen, I. (2008). Social anxiety in high functioning children and adolescents with autism and Asperger Syndrome, Journal of Autism and Developmental Disorders, 38, 1697-1709. doi:10.1007/s10803-0080555-9 Larkey, S. (2005). Making it a success: Practical strategies and worksheets for teaching students with autism spectrum disorder. London: Jessica Kingsley. Lohaus, A., Ev Elben, C., Ball, J., & Klein-Hessling, J. (2004). School transition from elementary to secondary school: changes in psychological adjustment. Educational Psychology, 24, 161–173. doi: 10.1080/0144341032000160128 Muris, P., Merckelbach, H., Ollendick, T., King, N., & Bogie, N. (2002). Three traditional and three new child anxiety questionnaires: Their reliability and validity in a normal adolescent sample. Behaviour Research and Therapy, 40, 753-772. Retrieved from http://journals.elsevier.com/00057967/behaviourresearch-and-therapy/ Nauta, M. H. (2005). Anxiety disorders in children and adolescents: assessment, cognitive behavioural therapy and predictors of treatment outcome (Doctoral dissertation). Retrieved from http://dissertations.ub. rug.nl/FILES/faculties/ppsw/2005/m.h.nauta/ thesis.pdf Nauta, M.H., Scholing, A., Rapee, R. M., Abbott, M., Spence, S. H., & Waters, A. (2004). A parentreport measure of children’s anxiety: psychometric properties and comparison with child-report in a clinic and normal sample. Behaviour Research and Therapy, 42, 813– 839. doi:10.1016/S00057967(03)00200-6 Pallant, J. (2007). SPSS survival manual (3rd ed.). Maidenhead, England: Open University Press. Scottish Government (2009). Scottish index of multiple deprivation 2009 general report. Retrieved Education and Training in Autism and Developmental Disabilities-June 2012
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  • 89. Education and Training in Autism and Developmental Disabilities, 2012, 47(2), 210 –222 © Division on Autism and Developmental Disabilities Effectiveness of an Essay Writing Strategy for Post-Secondary Students with Developmental Disabilities Suzanne Woods-Groves, William J. Therrien, Youjia Hua, Jo M. Hendrickson, and Julia W. Shaw Charles A. Hughes The Pennsylvania State University University of Iowa Abstract: This study examined the effectiveness of the ANSWER Strategy (Hughes, Schumaker, & Deshler, 2005) in improving the essay composition skills of post-secondary students with developmental disabilities. The six-step strategy incorporated analyzing essay prompts, creating an outline, generating an essay response, and reviewing the answer. The students (N ϭ 16) were assigned via a stratified random sample method to treatment or control groups. A pre- and post-test design was employed and the results were evaluated using a strategy scoring rubric. Statistically significant differences were found between the post-tests in favor of the treatment group related to their knowledge of the ANSWER strategy and the use of the strategy steps. Overall, the results indicated that the ANSWER strategy holds promise as an effective writing intervention for individuals with developmental disabilities in post-secondary settings. Mercer, Mercer, and Pullen (2011) described written expression as the “highest forms of communication” that emulates one’s ability to comprehend, develop concepts, and abstraction (p. 359). Polloway (2009) noted the principal goal of writing instruction is to cultivate individuals who can communicate effectively. The process of constructing a coherent and effective written passage is multi-faceted and requires one to identify, synthesize, and sequence ideas (Englert et al., 2009). One of the most complicated skills for individuals with and without disabilities to acquire is the art of written expression. The 2007 National Assessment of Educational Progress (NAEP) writing assessment revealed that only 33 percent of eighth- and twelfth-grade students assessed The research reported herein was supported in part by the Office of Postsecondary Education (OPE), U.S. Department of Education, through Grant P407A100030 to The University of Iowa. The opinions expressed are those of the authors and do not represent views of the OPE or the U.S. Department of Education. Correspondence concerning this article should be addressed to Suzanne WoodsGroves, Department of Teaching and Learning, 246 Lindquist Center North, University of Iowa, Iowa City, IA 52242-1529. Email suzanne-woodsgroves@uiowa.edu 210 / were considered proficient writers (SalahuDin, Persky, & Miller, 2008). For individuals with disabilities, difficulties with written expression that emerge during their elementary school years continue to persist throughout their lifetimes unless effective interventions are employed. As the Individuals with Disabilities Education Improvement Act (IDEA; 2004) has evolved so too has the implementation of special education services across K-12 public schools and post-secondary settings (Stodden & Whelley, 2004; Zaft, Hart, & Zimbrich, 2004). Traditionally, individuals with developmental disabilities received special education services in public school settings until the age of 21 or 22 (Grigal, Neubert, & Moon, 2001; Zaft, et al.). New opportunities are now burgeoning for individuals with developmental disabilities and their families as inclusive post-secondary college programs are being established (Grigal, Neubert, Moon, 2002; Hall, Kleinert, & Kearns, 2000; Weir, 2004). A comparison between the National Longitudinal Transition Study (NLTS) and the (NLTS-2) revealed that in 2005, 28 percent of youths with intellectual disabilities attended post-secondary programs compared to 8 percent in 1990 (Newman et al., 2010). As post-secondary programs Education and Training in Autism and Developmental Disabilities-June 2012
  • 90. emerge for individuals with developmental disabilities, so does the opportunity to address difficulties in written expression with strategic academic instruction. One type of writing that is particularly difficult for individuals with and without disabilities is expository writing. An individual’s personal knowledge of a topic is the basis from which writing begins and as such, it is incumbent upon the writer to develop strategies for acquiring and organizing content knowledge. Englert et al. (2009) noted that if students cannot identify, synthesize, and organize expository ideas they will experience problems understanding and constructing expository text. Englert and colleagues examined the ability of seventh grade students with and without disabilities to read science and social studies content and highlight main ideas, take notes, and construct expository reports. Overall neither group (students with disabilities or those without disabilities) was deemed to be “highly proficient” in the employment of learning strategies (Englert et al., p. 147). The students with disabilities lacked knowledge of how to effectively organize, classify, and label expository ideas. In addition, the students also experienced trouble selecting main ideas within connected text. Skills critical for expository writing include goal setting, planning, sentence development, and editing. Hayes and Flower (1987) asserted that writing is goal directed. The authors deconstructed the writing process to reveal that writing goals are hierarchal in nature and are generated through the employment of planning, sentence creation, and revision. In the planning stage one must not only have content knowledge of the subject at hand, but also construct a composition that fits the “situation and the audience” (Hayes & Flower, p. 21). Graham and Harris (2009) reiterated the importance of planning and revising and noted that skilled writers commonly employ these strategic behaviors while students with disabilities and less proficient writers do not routinely use these strategies when writing. Students with disabilities frequently exhibit problems within the area of written expression (De La Paz, 1999; Graham & Harris; Guzel-Ozmen, 2006; Lane et al., 2009; Schumaker & Deshler, 2009). These difficulties manifest themselves in a myriad of ways that include problems with acquiring and accessing content knowledge, planning, sentence construction, and revising (Englert et al., 2009; Deshler & Schumaker, 1986; Graham & Harris, 2003; Hallenbeck, 2002; Harris, Graham, & Mason, 2003; Schumaker & Deshler, 2009). In an attempt to identify components in written expression instruction that have been effective, Gersten and Baker (2001) conducted a meta-analysis of 13 studies that examined writing instruction for students with learning disabilities. The authors purported that effective comprehensive writing instruction should incorporate the following: (a) explicit teaching of each step of the writing process, (b) the components of different writing genres, and (c) the delivery of explicit feedback from teachers or peers to students (Gersten & Baker). In addition, Schumaker and Deshler (2009) cautioned that efficient writing instruction for individuals with disabilities should include explicit instruction, numerous opportunities for learners to acquire mastery on each skill, and immediate feedback. Deshler and Schumaker (1986) designed a series of learning strategies that incorporated aspects of the following: (a) a pre-test of students’ skill knowledge, (b) a description of the strategy, (c) modeling and practice, (d) students selfprompting to use the strategy, (e) a post-test, and (f) instruction for the generalization of skills. Writing strategies that embody combinations of the aforementioned elements of instruction have yielded favorable results when employed with students with writing problems, learning disabilities, behavior disorders, intellectual disabilities, Asperger’s Disorder, and attention deficit hyperactivity disorder (De La Paz, 1999; Delano, 2007; Englert, Raphael, & Anderson, 1992; Graham & Harris, 2003, 2009; Guzel-Ozmen, 2006; Hallenbeck, 2002; Harris, Graham, & Mason, 2003; Lane et al., 2009; Schumaker & Deshler, 2009). One area that has not been extensively explored is the use of strategic instruction within the area of written expression for individuals with developmental disabilities in post-secondary settings. Students in post-secondary settings are often required to express information through classroom discussions, writing, and taking tests (Schumaker & Deshler); however, Essay Writing Strategy / 211
  • 91. there is a dearth of documented strategies for promoting written expression with this age group. The Essay Test-Taking Strategy (Hughes et al., 2005) was designed to facilitate the essay composition skills of students’ responses to essay-type questions on content area tests. The strategy consists of a series of sequenced cognitive and behavioral steps within which the learner advances through using self-instruction (Schumaker & Deshler, 2009). Specifically, the strategy employs the use of the acronym ANSWER and consists of the following six steps: (a) Analyze the action words in an essay question, (b) Notice the requirements of the question, (c) Set up an outline, (d) Work in the details of the outline, (e) Engineer an answer, and (f) Review the answer (Hughes et al.). Therrien, Hughes, Kapelski, and Mokhtari (2009) investigated the effectiveness of the ANSWER strategy with seventh- and eighthgraders with learning disabilities and students without disabilities. The results revealed a significant difference in the post-test scores in the areas of strategy use, content, and organization for students in the experimental group in comparison to the control group. Students’ post-test strategy rubric scores in the experimental group yielded an effect size of d ϭ 1.69. Cohen (1988) classified effect sizes of Ͻ .2 as small, Ͻ .5 as medium, and Ͼ.8 as large. Subsequently, an effect size of d ϭ 1.69 would be considered large. The purpose of our study was to investigate the effectiveness of the Essay Test-Taking Strategy on essay responses written by postsecondary students with developmental disabilities. The following questions were investigated: 1. Can post-secondary students with developmental disabilities acquire and apply a six-step writing strategy designed to improve the quality of their expository essays? 2. Will there be a difference in the ability of the students to acquire and apply the strategy specific components of the essay strategy and the components of the strategy that pertain to generalization? 212 / Method Participants The sample was comprised of 16 students; including five (31%) females and 11 (69%) males who attended a two-year post-secondary certificate program designed for individuals with developmental disabilities at a university in the Midwest. The participants ranged in age from 19 to 23 years with a mean of 21 years, 7 months, (SD ϭ 1.23). With regard to ethnicity, 15 (94%) were White, while one (6%) was Latino. Four (25%) individuals were from rural areas; 11 (69%) were from urban areas; and one (6%) was from a suburban area. With regard to diagnostic categories, five (31%) were diagnosed with autism, one (6%) with a non-verbal learning disorder, six (38%) with a mild intellectual disability, one (6%) with a traumatic brain injury, two (13%) with a severe learning disability, and one (6%) with Asperger’s Disorder. For 14 of the participants IQ levels (M ϭ 100, SD ϭ 15) standard scores ranged from 61 to 98, (Mdn ϭ 70); IQ scores were not reported for two participants. The students were administered a pre-test. A series of ANOVAs indicated no significant difference on pre-test scores between control and treatment group students. See Table 1 for scores on pre-tests, effect size differences between treatment and control (Cohen’s d), and ANOVA comparisons. Materials The directions and materials supplied in the Essay Test-Taking Strategy (Hughes et al., 2005) manual were used to implement the intervention. Several supplemental materials were provided to the students. Graphic organizers were created in order to supplement daily lessons. Students were also given highlighters and were instructed to highlight important elements in the materials provided throughout the daily lessons. In addition, each student had a folder that included his or her progress graph, completed practice exercises, and materials for the lesson for the day. A copy of the ANSWER strategy mnemonic was attached to the front of each of the students’ folders. See Figure 1 for an example of a graphic organizer used in the study. Education and Training in Autism and Developmental Disabilities-June 2012
  • 92. TABLE 1 Strategy Scoring Rubric Overall and Components Pre-test Scores Overall Stategy Scoring Rubric Rubric Components Rubric Rubric sections aligned with strategy specific components (1-4) Treatment group Control group Effect size difference (Cohen’s d) ANOVA Comparison 1.275* (.29) 1.244* (.21) 0.12 Rubric sections aligned with essay general components (5-6) .0000* .0000* 1.275* (.29) 1.244* (.21) 0.12 F(1,15) ϭ 0.06, p ϭ .807 F(1,15) ϭ 0.06, p ϭ .807 Note: *Denotes mean values. Standard deviations provided in parentheses. We used the pre- and post-test essay prompts from Therrien et al. (2009), which emulated essay prompt questions from statewide assessments. The authors noted that because the intent was to appraise writing ability not background knowledge, the prompts were constructed to require critical thinking and not extensive content knowledge (Therrien et al.). The pre-test prompt was as follows: Inventions are all around us. Think of an invention that has been especially helpful or harmful to people. Write an essay that gives at least 3 reasons why the invention was helpful or harmful. The post-test essay prompt was as follows: Your school newspaper is printing a series of articles about heroes and heroines. Write about someone who is a hero or heroine to you. That person may be someone you know, someone you have read about, a celebrity, or a historical figure. Explain at least 3 reasons why you believe this person is someone to admire. Design and Procedure Design. A 2-level (treatment or control) single factor, pre/post experimental design, was used to examine the effect of the intervention on students’ essay responses. A stratified random assignment method was employed to place students either in treatment or control groups using a random digits number chart. The students were rank ordered using their reported reading grade levels obtained from their student records. We used a random digits number chart and paired each participant to the next closest reading score. Student pairs were then randomly assigned to treatment or control groups. Intervention. The ANSWER strategy (Hughes et al., 2005) consists of systematic instruction delivered in an explicit fashion in order to teach students a multi-step approach to effectively answer essay prompts. In order to progress to subsequent lessons, students are required to demonstrate skill mastery. The ANSWER strategy includes the following six steps: (a) Analyze the action words in an essay question, (b) Notice the requirements of the question, (c) Set up an outline, (d) Work in the details of the outline, (e) Engineer an answer, and (f) Review the answer (Hughes et al., 2005). Table 2 contains a detailed description of the ANSWER strategy steps. Daily instruction closely followed the lesson guidelines provided in the Essay Test-Taking Strategy instructor’s manual. The instructor supplemented the daily lessons with graphic organizers. In contrast to the Therrien et al. 2009 study, the students’ goals were to create essay responses that consisted of one or two paragraphs instead of multi-paragraph (two or more paragraph) essays. Implementation of the ANSWER strategy employed the following elements of instruction. After the first day when the strategy was introduced, each subsequent day began with a review of the previous lesson(s). New information was presented Essay Writing Strategy / 213
  • 93. Figure 1. Sample Graphic Organizer for Lessons Four and Five. through a process of describing the strategy steps, modeling and demonstrating the steps through think-aloud procedures, the use of graphic organizers, and frequent teacher-student interactions designed to probe for un- 214 / derstanding and promote elaboration. Guided practice incorporated the use of graphic organizers and corrective feedback, and information covered during the lesson was reviewed. These instructional activities in- Education and Training in Autism and Developmental Disabilities-June 2012
  • 94. TABLE 2 Six-Step ANSWER Strategy (adapted from Therrien et al. 2009) A N S W E R Analyze the action words in the question. This step requires students to read the question carefully and underline the key action words once. Notice the requirements of the question. Here students mark key essay requirements by underlining them twice and change the question into their own words. Set up an outline. This step requires students to list the main ideas of their essay within an outline format. Work in details. Here students add important details to the outline that they plan to include in their essay. Engineer your answer. This step requires students to write the essay including an introductory sentence, detailed sentences about each of the main ideas in their outline, and to include a summary sentence(s). Review your answer. Here students check that all parts of the question were answered and edit their essay. cluded recommended components of effective writing instruction and were comparable to those employed in previous strategy instruction for students with disabilities (Gersten & Baker, 2001; Graham & Harris, 2003; Schumaker & Deshler, 2009; Therrien et al.). Table 3 provides an overview of the daily lessons. The second and third author conducted the fidelity data collection. Fidelity data were collected for 100% of the intervention sessions and consisted of checking off lesson steps that were completed or not completed. Treatment group intervention. An equal number of students were assigned to the treatment and control groups with each group consisting of eight students. The intervention was conducted in six sessions with three sessions occurring every other day, three days a week, for two weeks. Each session was a 30-min period during the students’ instructional time. The students in the experimental group received the intervention together in a group setting. The instructor held a master’s degree in special education and was a certified teacher. The instructor was trained to implement the strategy by the second author after carefully reviewing the instructional manual (Hughes et al., 2005). Control group intervention. During the ANSWER intervention, students in the control group participated in typically planned instructional activities. Dependent variables. Students’ pre- and post-test essays were evaluated using a strategy scoring rubric designed to evaluate stu- dents’ essays based on the implementation of the specific steps and sub-steps detailed in the ANSWER strategy (Therrien et al., 2009). The strategy scoring rubric used in this study was a modified version of the rubric Therrien et al. employed in 2009. Modifications included the following, in “Step Five: Engineer Your Answer” of the strategy scoring rubric the guidelines were modified to include the question, “Was there an Introductory Sentence?” instead of asking, “Was there an Introductory Paragraph?” Subsequently, the next question, “Did the Introductory Paragraph contain a rephrase of the question?” was modified to ask “Did the Introductory Sentence contain a rephrase of the question?” The revised strategy scoring rubric is depictedin Figure 2. The strategy scoring rubric was divided into “strategy specific components” (Steps 1 – 4) and “essay general components” (Steps 5 – 6). The strategy specific components evaluated if students analyzed the action words, noticed the requirements, set up an outline, and worked in the details. Students could earn 0 to 4 points for the strategy specific components. The essay general components evaluated if the students engineered an answer, and reviewed or revised the answer. Students could earn 0 to 2 points for the essay general components. The strategy scoring rubric yielded a total raw score derived by summing the scores from Steps 1 – 6 which represented the total number of strategy steps that were com- Essay Writing Strategy / 215
  • 95. TABLE 3 The ANSWER Strategy Lesson Activities (adapted from Therrien et al. 2009). Lesson Lesson Activities 1 The ANSWER strategy was introduced and the students were asked to write a statement indicating that they would commit to learning the strategy. 2 The intent of this lesson was to identify current strategies that the students used when they constructed essays. The first two steps of the strategy, which involved analyzing the question, were introduced. We supplemented the lesson with graphic organizers. Students were given a sample essay topic and asked to write a short essay answer. Then the steps of analyzing the action words and noticing the requirements were taught. Students completed these two steps with the sample essay question and revised their answers based on feedback. The students also completed an assessment worksheet. Their answers were checked for the demonstration of mastery. 3 In this lesson, the first two steps of the strategy were reviewed. The next two steps of the strategy, which involved creating an outline, were introduced. A new sample essay question was provided and, as a group, the students analyzed the action words and noticed the requirements. A graphic organizer was used for this lesson. The group discussed several different topic ideas for the essay. The students were taught the steps for creating an outline and practiced creating an outline for the sample essay question. The students completed a worksheet where they were asked to create an outline for one of the three topics on the page. Their answers were checked for the demonstration of mastery. 4 In this lesson, the four steps of the strategy were reviewed with the aid of a graphic organizer. The steps for creating an outline were discussed in depth. Next, the steps for writing an answer were taught. A graphic organizer was provided to the students. Students were given sample essay questions and were asked to analyze the question and construct their own outline. The last two steps focused on the types of paragraphs and sentences that can be used in an essay. The students were instructed to use their outline as a guide to writing an essay. The students checked their essay answer by referring to their outline. They also edited their answer for punctuation and spelling errors. The students’ answers were checked for the demonstration of mastery. 5 For this lesson, students verbally practiced the six steps of the strategy using a graphic organizer as their guide. A rapid fire questioning technique was used. 6 The intent of this lesson was to have students independently practice using the entire strategy. An advance organizer was provided for this lesson. The instructor first briefly reviewed the ANSWER strategy. Then the students were given a new essay question and were asked to engage in the entire strategy on their own. Students’ answers were check for the demonstration of mastery. Total time Supplemental Features 180 min Supplemental materials included the use of graphic organizers, highlighters, and having the 3 hrs ANSWER mnemonic attached to the front of the students’ folders. Total instructional time for the strategy across all six lessons was approximately 3 hrs. pleted. Conceptually, the strategy specific components (Steps 1 – 4) examined the application of the planning and goal setting part of the ANSWER strategy. The essay general components (Steps 5 – 6) were a generalization measure that evaluated if essay responses were topic specific, included an introductory sentence, incorporated detailed sentences aligned with the outline, and contained a summary sentence. 216 / Data collection. The pre-test essay was administered the week prior to program implementation and the post-test was administered the week after program completion. Two graduate students in the College of Education evaluated the essays. The graduate students had extensive experience administering and evaluating assessments. In addition, training was Education and Training in Autism and Developmental Disabilities-June 2012
  • 96. Figure 2. Strategy Scoring Rubric. This rubric was modified from the original Strategy Specific Rubric employed by Therrien et al. (2009). * Denotes items that were modified from the Therrien et al. original Strategy Specific Rubric. provided by the first and second authors where the raters were introduced to the components of the strategy rubric. The raters practiced using the strategy rubric to evaluate examples of essay prompts and answers. The raters were not aware of the AN- SWER study. They were not involved in data collection nor were they aware that the essay responses they were evaluating were preand post-test results. Therefore the raters were blind to what the intervention was, who was in the treatment and control groups, Essay Writing Strategy / 217
  • 97. and which essay was the pre-test and posttest. Procedure. The study employed the following sequence. First students (N ϭ 16) were assigned via a stratified random sampling method to the treatment or control group. Next the pre-test essay prompts were administered. Then students in the treatment group received instruction in the ANSWER Strategy over a two-week period while students in the control group attended their regularly scheduled activities. Next the post-test essay prompts were administered to students in the treatment (n ϭ 8) and control (n ϭ 8) group students. The preand post-test essays were then evaluated by the graduate student raters using the strategy scoring rubric. Results Treatment Integrity and Inter-Rater Reliability Treatment integrity checklists containing the essential instructional components for each lesson were used to collect data for all (i.e., 100%) sessions. An overall integrity percentage of 99% was obtained with a range per observation between 97–100%. Final rubric scores for pre and post-test measures were calculated by averaging the two rater scores. Correlations between rater scores were calculated for all measures and averaged r ϭ .987. Strategy Scoring Rubric Students’ post-test scores including effect size (ES) differences on the strategy scoring rubric are summarized in Table 3. Students in the treatment group scored an average of 3.706 on the post-test compared to 0.925 for students in the control group. ANCOVA results using pre-test scores as the covariate indicated that this result (d ϭ 2.63) was statistically significant F(1, 14) ϭ 27.07, p Ͻ .0001. To ascertain what might account for the difference in the post-test, the strategy scoring rubric was broken down into two parts. Rubric steps one through four were examined as strategy specific components while rubric steps five and six were examined as essay general compo- 218 / nents. The strategy scoring rubric is depicted in Figure 2. An examination of the strategy specific aspects revealed that none of the students utilized any of the strategies on the pre-test and that students in the treatment group earned approximately 60% of the points on the posttest compared to 0% for control. This difference was statistically significant and yielded a large effect size (d ϭ 4.68). When the essay general component aspects were examined, there was no statistically significant difference between conditions however the effect size was moderate (d ϭ .40) (Cohen, 1988). Students’ post-test scores including effect size (ES) differences on the strategy specific aspects and the essay general component aspects are summarized in Table 4. Discussion The ANSWER strategy (Hughes et al., 2005) holds promise in improving the essay composition skills of post-secondary students with developmental disabilities. The present study investigated the effectiveness of the ANSWER strategy with post-secondary young adults with developmental disabilities. The results of this study indicated that the students in the treatment group improved their essay test-taking skills after a total of approximately 3 hrs of instruction (distributed across six 30 min lessons). The following research questions were posed. Could the students acquire and apply the ANSWER strategy? Would there be differences in how the students mastered the strategy aspects verses the generalization aspects of the ANSWER strategy? The results of this study indicated that students in the treatment group significantly out-performed the control group when post-test results were compared. The large effect size of d ϭ 2.63 indicated that the students in the treatment group were able to acquire and apply the ANSWER strategy. Next, the students’ acquisition and application of the specific strategy steps were examined. A comparison of the post-test strategy specific components scores (Steps 1– 4) indicated that students in the treatment group significantly out-performed those in the control group yielding a large effect size of d ϭ Education and Training in Autism and Developmental Disabilities-June 2012
  • 98. TABLE 4 Post-test Scores for Strategy Scoring Rubric Components Strategy Scoring Rubric Components Overall strategy scoring rubric Treatment group Control group Effect size difference (Cohen’s d) ANCOVA Comparison Rubric sections aligned with strategy specific components (1-4) Rubric sections aligned with essay general components (5-6) 3.706* (1.43) 0.925* (.42) 2.63 2.500* (.76) .0000* 4.68 1.206* (.90) 0.925* (.42) .40 F(1, 14) ϭ 27.07 p Ͻ .0001 F(1,14) ϭ 87.50 p ϭ .0001 F(1,14) ϭ 0.57 p ϭ .463 Note:* Denotes mean values. Standard deviations provided in parentheses. 4.68. When the post-test essay general components scores were compared there was no statistically significant difference between conditions. However the effect size in favor of the treatment group was d ϭ .40 which indicated a promising trend. Implications for Practice When the students’ individual pre-test essays in the treatment and control groups were examined a pattern emerged. None of the essay responses exhibited any evidence of planning or goal setting through the incorporation of outlines or pre-planning notes. Many of the essays consisted of a series of disjointed sentences devoid of an introductory sentence or summary sentence. Hayes and Flower (1987) described this characteristic as “knowledgetelling” where the writer’s goal is to produce a written product that includes any information pertinent to the topic at hand (p. 22). The writer may list all of his or her topical factual knowledge but will not couch or organize his or her written response to fit the audience or situation (Hayes & Flower). In contrast, following the ANSWER strategy intervention, students in the treatment group constructed post-test essays that did include planning strategies and that incorporated strategy specific steps. The majority of the students in the treatment group read and analyzed the essay prompt. They also developed an outline indicating that the students incorporated pre-planning and goal setting before they constructed their essays. When one examines the generalization aspects of the posttest responses, five out of eight (63%) students in the treatment group constructed essay responses that exhibited the mechanics of expository writing such as the inclusion of an introductory sentence, constructing one’s written response in an organized sequential manner, and ending one’s essay response with a conclusion or summary sentence(s). Even though the results for the generalization component of the strategy were not statistically significant, it did appear that the majority of the students in the treatment group applied aspects of the strategy when they created their essays. Only one out of eight students (13%) in the control group constructed a post-test essay response that contained an introductory sentence. No responses contained a conclusion or summary sentence. The control groups’ post-test essays were comparable to the pretest essay responses for both groups (treatment and control). Subsequently when one examines the post-test essay responses of the treatment group it is evident that this brief (3hr) intervention had a positive impact upon the quality of the students’ post-test essay responses. Limitations and Future Research There were several limitations with regard to this study. First, the components of the ANSWER strategy that addressed the actual Essay Writing Strategy / 219
  • 99. construction of an essay prompt response did not yield significant effects when the treatment and control groups were compared. As previously mentioned, the “essay general components” rubric scores represented a generalization measure. In addition it is important to note that the essay general components rubric section consisted of only two items. Therefore it is difficult due to the truncated nature of the scale to reach a statistically significant difference. However the effect size of d ϭ .40 was impressive considering the truncated nature of the generalization measure, and the fact that the raters were unaware of the ANSWER strategy that was taught to the students. Although the six-steps of the strategy were taught to mastery through modeling, feedback, and daily practice tests, perhaps more individualized instruction was needed for generalized responding. Each student could have had individualized goals in order to supplement instruction. A second limitation is the length of the intervention. Extended instruction might help to ascertain if the students are able to generalize the strategy. The third limitation was the fact that due to time constraints, we were not able to determine whether the students who had been taught the strategy were actually generalizing the strategy in their other classes. Finally, we were not able to administer a maintenance test. Future studies should continue to investigate the use of this strategy with individuals with developmental disabilities who are enrolled in post-secondary settings. Several points should be addressed in future investigations. The ANSWER strategy intervention could be extended beyond teaching students to mastery and include the administration of multiple probes to assess mastery and over learning. Each student could have individualized essay writing goals that are tied to individual student outcomes. Future studies should also build in opportunities for students to practice answering essay test questions in novel settings and include maintenance tests to determine if the students are continuing to use the strategy over time. 220 / Conclusion In 2009, Penner-Williams, Smith, and Gartin noted the importance of written expression in the lives of adults. The authors asserted that adults must master written language skills not only to communicate with others but also to be gainfully employed. Adults frequently participate in written forms of communication such as writing notes for themselves (PennerWilliams et al.) and communicating via email, blogs, tweets, and so on. If difficulties in written expression are not reconciled at some stage in an individual’s development then one remains at a disadvantage and cannot become fully engaged in his or her adult environment. The inception of post-secondary programs for individuals with developmental disabilities involves the development and implementation of unique curricula that emboldens individuals with developmental disabilities with the capacity to access the components of college life (e.g. academics, employment preparation, community life). Academics are an important component to college life and as such there is a need for evidence-based strategies. In the present study, we investigated the effectiveness of the ANSWER strategy in improving the essay composition skills of postsecondary students with developmental disabilities. We proposed that if students applied the six steps of the strategy they would produce comprehensive and organized essay prompt responses. We concluded that the post-secondary students with developmental disabilities who were taught the ANSWER strategy were able to learn the strategy; however, they may need additional structured support outside of instructional settings to ensure that they utilize the strategy effectively in novel settings. The ANSWER strategy holds considerable promise as an effective strategy for use in inclusive settings at the post-secondary level. It is our hope that this study will stimulate additional data based research in order to identify evidence-based practices that are effective for individuals with developmental disabilities who are enrolled in post-secondary settings. References De La Paz, S. (1999). Self-regulated strategy instruction in regular education settings: Improving out- Education and Training in Autism and Developmental Disabilities-June 2012
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  • 101. Therrien, W. J., Hughes, C. A., Kapelski, C., & Mokhtari, K. (2009). Effectiveness of a test-taking strategy on achievement in essay tests for students with learning disabilities. Journal of Learning Disabilities, 42, 14 –23 doi: 10.1177/ 0022219408326218 Weir, C. (2004). Person-centered and collaborative supports for college success. Education and Training in Developmental Disabilities, 39, 67–73. 222 / Zaft, C., Hart, D., & Zimbrich, K. (2004). College career connection: A study of youth with intellectual disabilities and the impact of postsecondary education. Education and Training in Developmental Disabilities, 39, 45–53. Received: 13 April 2011 Initial Acceptance: 7 June 2011 Final Acceptance: 22 July 2011 Education and Training in Autism and Developmental Disabilities-June 2012
  • 102. Education and Training in Autism and Developmental Disabilities, 2012, 47(2), 223–235 © Division on Autism and Developmental Disabilities Comparison of the Effects of Video Models With and Without Verbal Cueing on Task Completion by Young Adults With Moderate Intellectual Disability Linda C. Mechling and Terri S. Collins University of North Carolina Wilmington Abstract: This study compared the effects of video models with and without verbal cuing (voice over) on the completion of fine motor cooking related tasks by four young adults with moderate intellectual disability. The effects of the two modeling conditions were compared using an adapted alternating treatments design with an extended baseline, comparison, final treatment, and best treatment condition. Results indicated that video modeling with verbal cuing was more effective for three of the four students when evaluating independent correct performance of task steps. Video technology, used to increase learning and to promote independence in students with disabilities, continues to receive positive support in the research literature with a growing amount of attention being devoted to its evaluation (Rayner, Denholm, & Sigafoos, 2009). While the use of video technology has been shown to improve the learning and independent functioning levels of students with developmental and intellectual disability and those with a diagnosis of autism spectrum disorders (ASD), questions still remain concerning which individual components or combinations of these components contributes to its effectiveness (Ayres & Langone, 2007; Rayner et al.). Isolation of different variables through comparative studies has been recommended in order to determine which characteristics are most effective when using video technology (Ayres & Langone). Among the variables of interest when using video instruction is the use of verbal cues/ prompts/directions being delivered while a student is watching a video recording (Rayner et al., 2009). These verbal cues are frequently used along with the visual demonstration of Correspondence concerning this article should be addressed to Linda C. Mechling, University of North Carolina Wilmington, Department of Education of Young Children and Special Education, 601 S. College Road, Wilmington, NC 28404-5940. how to complete a task or component steps of a task. When creating the video model or prompt, these verbal cues are referred to as “voice-overs” in which the person recording the video (operating the digital video camera) or the person performing the task (video model) verbally provides directions or descriptions of how to complete the task (i.e., “put the skillet on the stove”) while demonstrating this step on the video recording. Voice-over has been included in a number of studies which have effectively used video models (presentation of an entire task via video followed by a student performing the task) (Mechling, Gast, & Gustafson, 2009; Mechling & O’Brien, 2010; Taber-Doughty, Patton, & Brennan, 2008; Van Laarhoven, Van Laarhoven-Myers, & Zurita, 2007) and video prompts (presentation of a component step or cluster of steps followed by a student performing the individual step) (Cannella-Malone et al., 2006; Grice & Blampied, 1994; Mechling, Gast, & Fields, 2008; Mechling, Gast, & Seid, 2009; Norman, Collins, & Schuster, 2001; Sigafoos et al., 2005; Van Laarhoven, Johnson, Van Laarhoven-Myers, Grider, & Grider, 2009;Van Laarhoven, Kraus, Karpman, Nizzi, & Valentino, 2010) to teach functional skills. Likewise, no verbal cues or voice-over features have been effectively used with video modeling (Alcantara, 1994; Ayres & Langone, 2007; Cihak, Fahrenkrog, Ayres, & Smith, Effects of Video Models / 223
  • 103. TABLE 1 Student characteristics, treatment and tasks Age Student Pair 1 Coleman Lionel Pair 2 Neville Wanda Diagnoses IQ Adaptive Behavior Verbal Cues No Verbal Cues 22yrs 1m 20yrs 10m Moderate ID Moderate ID 52* Not available 45** 55** Set 2 Set 2 Set 1 Set 1 21yrs 19yrs 7m Moderate ID Moderate ID 39*** 44*** 39** 58** Set 1 Set 1 Set 2 Set 2 * Kaufman Brief Intelligence Test (K-BIT) ** Vineland Adaptive Behavior Scales *** Stanford-Binet Intelligence Scale (4th ed) 2010; Mechling & Gast, 2003; Murzynski & Bourret, 2007; Shipley-Benamou, Lutzker, & Taubman, 2002) and video prompting (Mechling & Seid, 2011) to teach functional skills to persons with ASD and moderate intellectual disability. It therefore remains unclear whether or not the inclusion of a verbal description is a critical component for task completion. Of particular interest is whether these cues are necessary for students with ASD and other intellectual disability who tend to be strong visual learners and weaker in the area of auditory learning (Quill, 1995). Results of a recent comparison study by West (2008) supports the theory that students with ASD are stronger visual learners. In that study it was found that three of four young students with ASD more effectively and efficiently transferred stimulus control from the instructor providing assistance to picture cues compared to verbal cues when prompting the functional skills of setting the table and setting up an art project. In addition to not being necessary for persons who are stronger visual learners, it may even be possible these verbal cues could be distracting to some students with a diagnosis of ASD or intellectual disability as they attempt to visually focus on the video model. The current study is in response to the recommendation of Rayner et al. (2009) who suggested that components of video modeling and video prompting, such as voice-overs and video perspectives, be further evaluated in the research. The purpose of this study was to evaluate performance of students with moder- 224 / ate intellectual disability on completion of fine motor, cooking related tasks when video models included verbal cues (voice-over) compared to completion of fine motor, cooking related tasks when the video models contained no verbal cues. Method Participants Four students with a diagnosis of moderate intellectual disability participated in the study. Students were enrolled in a local school system transition program for young adults and ranged in ages from 19 to 22 years (Table 1). Students were imitative and screened earlier for fine motor skills such as turning, pulling, and cutting. All students had experience with computer based instruction and Wanda was a participant in a previous study evaluating the effects video models on a small PDA screen (Mechling & Gustafson, 2009). Coleman was a 22 year, 1 month old male diagnosed with a moderate intellectual disability [IQ 52, Kaufman Brief Intelligence Test (K-BIT): Kaufman & Kaufman, 1990; Adaptive Behavior Composite Score 45, Vineland Adaptive Behavior Scales: Sparrow, Balla, & Cicchetti, 1984)]. Coleman communicated in complete sentences although he frequently replied with one or two word responses. He was more expressive when interacting with peers and when describing preferred activities (i.e., dancing, landscaping equipment). He was able to read and follow a daily agenda, Education and Training in Autism and Developmental Disabilities-June 2012
  • 104. read functional words for meal preparation, restaurant menus, and grocery aisle signs. He could write legibly and complete basic information on job applications. He needed to increase his ability to write in small spaces and write his name in cursive. He was able to shop from a written list with assistance for less familiar items. He recognized coins and could count different combinations except quarters plus dimes. He could also count dollar bills to $50, but needed to learn to transition when counting from 59 to 60, 69 to 70 and so forth. He was able to read a calendar for information and used a personal calendar for time management. He rode the city bus and could locate three stops independently. He was independent in caring for his personal needs with some reminders to do so. He could prepare simple boxed meals in a microwave and his needs included use of additional kitchen appliances and planning and preparing a variety of meals. Lionel was a 20 year, 10 month old male diagnosed with a moderate intellectual disability. His IQ test score was unattainable on the Stanford-Binet Intelligence Scales–Fourth Edition (Thorndike, Hagan, & Sattler, 1986). At age 5 years he obtained an age equivalence score of 13 months on the Bayley Scales of Infant Development (Bayley, 1993). His Adaptive Behavior Composite Score was 55 on the Vineland Adaptive Behavior Scales (Sparrow et al., 1984). He used single words and word approximations to communicate. He often said, “I don’t know” in response to questions. He was reported to be very quiet and did not initiate telling persons of his needs. He also used pictures to facilitate his expressive communication. He rarely made eye contact and frequently closed his eyes when spoken to or presented with a request. He could identify 19 words found on fast food menus and used a communication wallet with the words to order his meals when out in the community. He could also identify 26 community signs and point to information on his identification card when asked his name, address, and phone number. He could orally identify pictures of common grocery items and used a picture list to shop. His needs included navigation of aisles in the store and to continue work on survival reading skills. He could write eight of the ten letters of his first and last name. He could rote count and count objects up to five. He needed to increase his numeral identification skills and to use the skills functionally for tasks such as telling time with a digital watch and clock. He was learning to pay for purchases using large bills and to locate bus stops. He required physical assistance with his personal care needs including bathing and brushing his teeth and his needs included increasing his independent living skills. He walked slowly which presented difficulty when crossing streets and walking in the community. He could complete some household chores such as emptying a dishwasher, emptying the trashcan, and clearing the table. His needs included preparation of snacks and simple meals when supervised. Neville was a 21 year old male diagnosed with a moderate intellectual disability (IQ 39 Stanford-Binet Intelligence Scales–Fourth Edition: Thorndike et al., 1986; Adaptive Behavior Composite Score 39; Vineland Adaptive Behavior Scales: Sparrow et al., 1984). Neville communicated with one word and short phrases in both Spanish and English and he had a diagnosis of disfluency. His English was better understood in context and by those familiar with him. He was described as being easily distracted, inattentive, and impulsive. He also became easily irritated when other students touched him or looked at him and displayed non-compliant and aggressive behaviors in addition to saying inappropriate words and comments. He was able to identify approximately 15 survival signs in addition to recognition of menu words and logos. His needs included increasing his recognition of functional words and signs in the community. He could trace letters and circle pictures to indicate answers on a page, but was unable to write independently. He could rote count up to 10, but did not recognize numerals. He enjoyed cleaning and volunteered to assist with such tasks in his classroom. He was attentive and concerned about his appearance (i.e., became upset if his clothes became soiled) and often wore a tie to school. He was able to care for his dressing needs, but required assistance with brushing his teeth and shaving. His needs further included crossing streets safely, entering and exiting a city bus, locating items on shelves when directed to the correct aisle, and paying for purchases using a large bill. He Effects of Video Models / 225
  • 105. could follow a picture schedule and was working on obtaining ingredients to prepare recipes using picture cues. His needs also included operation of small appliances such as can openers and cutting utensils and preparing simple meal items. Wanda was a 19 year, 7 month old female diagnosed with a moderate intellectual disability (IQ 44, Stanford-Binet Intelligence Scales–Fourth Edition: Thorndike et al., 1986; Adaptive Behavior Composite Score 58, Vineland Adaptive Behavior Scales: Sparrow et al., 1984). Wanda was able to communicate in complete sentences and use “slang” and current vocabulary used by her peers. She was able to read sight words and community signs and words and use text functionally (i.e., read menu words and order at restaurants). She could write her personal information and basic two and three letter words. She was able to use her spelling skills to compose grocery lists. She used a calculator to complete simple addition and subtraction problems for budgeting purposes. She could tell time on the hour and half hour and could use the skill for time management (i.e., arriving at a destination at a specific time). She was working on increasing her ability to independently cross streets with traffic lights. She was working on counting coin and dollar combinations to $20 and used the next dollar strategy for making purchases. Her needs included identifying the amount of a purchase by looking at the monitor or cash register. She was able to care for all of her personal care needs and enjoyed shopping for clothing. Her needs included sorting and independently washing and drying clothing. She could follow simple recipes with pictures and words using a microwave, stove, and oven. Her needs included increasing her ability to plan and prepare meals. Tasks, Materials, Equipment, and Settings Fifteen cooking related tasks were used in the study: five for use with video models with verbal cues, five for use with video models without verbal cues, and five for use as the control set. Eight of the tasks used in the comparison sets were selected from those used in the studies by Mechling and Gustafson (2008, 2009) which compared picture and video prompts on task completion by students with moderate 226 / intellectual disability and those with autism spectrum disorders. In those studies the tasks were paired across two sets by task similarity so that tasks assigned to each procedure required relatively equal skills. This procedure was used to select two additional tasks (set digital timer and spray the loaf pan) for the comparison sets and the five tasks used for the control set (Table 2). The two tasks for using measuring cups were also adapted from the Mechling and Gustafson procedures so that water was poured from a plastic container rather than a sink. Color coded stickers were placed on the vegetable peeler and cheese grater to cue students where to hold the equipment and different colored measuring cups were used to represent different sizes for measuring amounts of water. No other adaptations were made to the cooking materials and equipment. Prior to the start of the study students were assigned to one set for video modeling with verbal cuing and the alternate set for video modeling with no sound (Table 1). Tasks ranged from 2 to 6 steps per task (Table 2). Video recordings were made using a Cannon ZR 830 digital video camcorder and edited using Windows Movie Maker. Each video was then inserted onto a separate PowerPoint slide and saved by set. Three different PowerPoint programs were made for each set in order to present the video models in different orders. Each set of 5 tasks (with and without verbal cueing) were displayed on a Dell Latitude ϫ 300 laptop computer with an 11in. screen. Video models were made using an adult model completing each task. Models were made by using close up angles of the adult’s hands completing the task. Verbal cues (voice-over) corresponding to the task (i.e., “put in”) were inserted while making the video recordings by the person operating the digital camera. During video modeling without verbal cueing the volume on the laptop was turned to mute. The duration of the videos ranged from 9s to 28s. During video modeling sessions, the laptop was placed on a desk in front of the student and the cooking related materials from all sets were placed to the right and left of the laptop. Materials were placed in the same location across sessions (i.e., cooking timers and measuring cups placed to the right of the laptop). The inves- Education and Training in Autism and Developmental Disabilities-June 2012
  • 106. Effects of Video Models / 227 Set 2 Snap off ends of asparagus 1. Select asparagus 2. Snap off end of 1 asparagus 3. Snap off end of 2nd asparagus 4. Snap off end of 3rd asparagus 5. Stop Measure 1/8 cup water from container 1. Select correct measuring cup 2. Pour water to top of rim 3. Stop Grease loaf pan with stick of butter 1. Rub 1st side of pan 2. Rub 2nd side of pan 3. Rub 3rd side of pan 4. Rub 4th side of pan 5. Rub bottom of pan 6. Stop Grate block of cheese with hand grater 1. Select correct tool 2. Place cheese on grating side, red dot up 3. Rub cheese on grate 1 time 4. Rub cheese on grate 2nd time 5. Rub cheese on grate 3rd time 6. Stop Cut off each end of celery with knife 1. Select knife 2. Select celery 3. Cut off one end of celery 4. Cut off opposite end of celery 5. Stop Measure 1/3 cup water from container 1. Select correct measuring cup 2. Pour water to top of rim 3. Stop Spray loaf pan with cooking spray 1. Spray 1st side of pan 2. Spray 2nd side of pan 3. Spray 3rd side of pan 4. Spray 4th side of pan 5. Spray bottom of pan 6. Stop Set digital timer to 3 minutes 1. Select correct timer 2. Touch “M” 1 time 3. Touch “M” 2nd time 4. Touch “M” 3rd time 5. Stop Peel carrot with vegetable peeler 1. Select correct tool 2. Hold handle with blue dot up 3. Place carrot on flat side 4. Pull peeler across carrot 1 time 5. Pull peeler across carrot 2nd time 6. Pull peeler across carrot 3rd time 7. Stop Set dial timer to 5 minutes 1. Select correct timer 2. Turn timer to 5 3. Stop on 5 Set 1 Tasks and task steps TABLE 2 Set second digital timer to 5 minutes 1. Select correct timer 2. Touch “seconds” 1 time 3. Touch “seconds” 2nd time 4. Touch “seconds” 3rd time 5. Touch “seconds” 4th time 6. Touch “seconds” 5th time 7. Stop Cut green beans in half 1. Select knife 2. Select green beans 3. Cut 1st green bean in half 4. Cut 2nd green bean in half 5. Cut 3rd green bean in half 6. Stop Measure 1 cup water from container 1. Select correct measuring cup 2. Pour water to top of rim 3. Stop Flour loaf pan 1. Sprinkle flour with spoon on 1st side of pan 2. Sprinkle 2nd side of pan 3. Sprinkle 3rd side of pan 4. Sprinkle 4th side of pan 5. Sprinkle bottom of pan 6. Stop Slice block of cheese with cheese slicer 1. Select correct tool 2. Place slicer on cheese 3. Pull across 1 time 4. Pull across 2nd time 5. Pull across 3rd time 6. Stop Control Set
  • 107. tigator sat to the right of the student and when present the reliability data collector sat to the right and behind the student and investigator. Experimental Design The study used an adapted alternating treatments design (AATD) with baseline, comparison, and final treatment conditions to compare the effects of video modeling with and without verbal cuing on the completion of fine motor cooking related tasks with four students (Wolery, Gast, & Hammond, 2010). The dependent variable was the percent of cooking related tasks completed independently. The two treatments were applied to different, functionally independent tasks, equated for response difficulty (Table 2) (Holcombe, Wolery, & Gast, 1994). Experimental conditions included baseline, with a verbal task direction (i.e., “Cut the celery”) being given for each of the three sets, followed by video modeling with and without verbal cueing and continuation of the control set (comparison condition). A final treatment condition was then applied to the control set followed by a final best treatment condition in which the superior treatment (video modeling with verbal cues) was applied to the tasks which did not receive verbal cuing during the comparison condition. Sessions were conducted individually across all conditions and video models with and without verbal cues were counter-balanced across tasks and students to control for task difficulty (Table 1). The two sets of tasks were counterbalanced across two pairs of two students with moderate intellectual disability so that Set 1 was presented to one pair of students using video models with verbal cues and the second pair to students using video models without verbal cues (vice versa for Set 2). Counterbalancing the interventions within sessions was used to minimize the possibility of sequencing effects. The baseline condition served to demonstrate student performance on the 15 tasks without video modeling and equivalence of performance on the two sets (Sindelar, Rosenberg, & Wilson, 1985). Inclusion of the control set, its intermittent measurement during the comparison condition, and the final treatment condition were included to assess possi- 228 / ble multiple treatment interference (threat to internal validity), the effects of history and maturation, and to provide intra-subject replication. The final best treatment condition served to detect multitreatment effects by evaluating the best treatment (video modeling with verbal cues) in isolation and to determine if providing the superior treatment to the alternate set (video modeling with no verbal cues) would produce any change in performance. Response Measurement and Data Collection Data were collected individually across all sessions and conditions on the number of task steps completed independently correct by each of the four students. Students’ performance on each task step was recorded as correct or incorrect. Students were provided 3s to initiate each task after watching the video model or receiving the task direction (baseline) and 1min to complete all steps of the task. Incorrect performance was recorded for failure to complete a step correctly within 1min. No instructor prompts were provided during baseline or comparison sessions in order to evaluate the isolated effects of using video models with and without voice-over. Baseline Procedures During baseline, each student was presented with the opportunity to attempt completion of each task independently. Each student’s ability to complete the 15 fine motor cooking related tasks was evaluated over three baseline sessions or until data stabilized prior to the use of video modeling (Wolery et al., 2010). Each session consisted of one trial per task and consisted of delivery of a task direction (i.e., “Grate the cheese”) followed by a 3s allotment for the student to initiate the task and 1 min. to complete the task steps. All three sets of materials were placed on the table to avoid process of elimination through use of target items (Mechling & Gustafson, 2008; 2009). Students received nonspecific verbal praise on the average of every third task (VR3) for general attending, attempts to perform tasks, and correct responses. Tasks were presented in blocks by set, however the order of the blocks varied across sessions. Education and Training in Autism and Developmental Disabilities-June 2012
  • 108. Video Modeling, with and without Verbal Cueing (Voice-Over) Procedures At the beginning of each session students sat in front of the laptop computer and the instructor delivered a task direction identical to the ones used during baseline and advanced the PowerPoint program to the first slide which delivered the video model. Each session consisted of one trial for each of the five fine motor cooking related tasks with voice-over and one trial for each of the five fine motor cooking related tasks without voice-over. Trials were presented in blocks by set. Sets were counterbalanced across days. The student was given 3s to initiate each task and 1min to complete the task steps. Failure to initiate the task, failure to complete the task steps in 1min., or incorrect performance of the task steps within 1min, resulted in the instructor presenting the next video model. Reinforcement was delivered identically to the baseline condition. The control set was conducted in the same manner using only verbal task directions and was presented intermittently throughout the comparison condition. Video modeling procedures continued for a minimum of six sessions or until data stabilized (no change in the number of task steps performed correctly) on two consecutive sessions across both procedures or until 100% correct performance was achieved on a set. Final Treatment Procedures Upon completion of the comparison condition, the fine motor cooking related tasks from the control set received video modeling with the superior treatment (verbal cuing) for 3 sessions. Procedures were identical to those used in the video modeling comparison condition except only the control set of tasks was evaluated using video modeling with verbal cues. Best Treatment Procedures Following the Final Treatment condition the Best Treatment condition served to evaluate possible multitreatment effects by applying the superior video treatment alone and measuring its effectiveness with the alternate set of tasks (Holcombe et al., 1994). During the Best Treatment condition, the single more effective intervention (video modeling with verbal cues) was applied to the alternate set for three sessions and procedures were identical to those used during video modeling comparison condition. Reliability During the study, the first author conducted all baseline and video modeling sessions and the second author collected reliability data. Reliability data on the dependent measure was collected on 33% of all baseline, video modeling comparison, final treatment, and best treatment sessions. Interobserver agreement was calculated by dividing the number of agreements on each step by the number of agreements plus disagreements and multiplying by 100. Mean interobserver agreement across all sessions was 98.9% (range ϭ 95.7– 100). The reliability data collector also collected procedural fidelity data on independent variables which included: (a) instructor delivering the general task directions; (b) instructor presenting the correct video model or control set; (c) all materials present on the table; (d) waiting the appropriate amount of time for task initiation; (e) waiting for the appropriate amount of time for completion of task steps; (e) no delivery of prompts or cues; and (f) delivery of reinforcement. Reliability was calculated by dividing the number of correct variables by the total number of assessed variables and multiplying by 100 (Billingsley, White, & Munson, 1980). Mean procedural fidelity agreement was 99.8% (range ϭ 98.6 – 100). All instructor procedural errors occurred in the category of not providing any prompts or cues. The instructor pointed to the screen one time when the student was distracted and replayed the video model on four occasions when the student was distracted or did not wait for the video to completely play. These were interpreted as providing a prompt. Social Validity At the conclusion of the study, results were shared with the classroom teachers (n ϭ 3 ) and they were asked if they thought it would Effects of Video Models / 229
  • 109. be easier to develop video modeling programs with or without voice-over, what types of video modeling they would prefer to use, and whether they thought that video modeling would be an effective tool in their classrooms. Results The combined scores across the four participants showed a difference in performance in favor of video modeling with verbal cues: mean ϭ 72.8% correct with verbal cues; mean ϭ 61.8% correct without verbal cues. The percentage of task steps completed correctly for each set of five cooking related tasks, by individual students across each condition, is presented in Figures 1 and 2. Baseline data for each student remained low across the three sets of tasks prior to the comparison condition. Coleman was the only student who was able to complete more than 13% of task steps within one session. He consistently completed 21.1% of the five tasks assigned to the video modeling with verbal cue set. When video modeling with and without verbal cues was introduced in the comparison phase, Wanda and Coleman’s performance improved considerably when using video models with verbal cues. Their performance also showed improvement when using video models without verbal cues although the level of change was not as abrupt. Coleman reached 100% accuracy with the verbal cue set on his second session and Wanda likewise reached 100% accuracy when using video models with verbal cues on her fourth instructional session. Overall, Wanda’s mean performance was 91.3% correct when using video modeling with verbal cuing and 75.4% correct without verbal cuing. Coleman’s mean performance was 98.3% when using video modeling with verbal cuing and 71.3% without verbal cuing. During the Best Treatment condition, when verbal cuing was applied to the alternate set of tasks that did not receive verbal cuing during the comparison condition, Coleman’s performance remained high (discounting any multitreatment effects on performance during the Comparison condition) and he was able to complete 100% of the task steps. He was unable to complete one step (stopping while grating the cheese) before delivery of the video model with verbal cuing. During the 230 / Best Treatment condition Wanda’s performance also remained high and she completed two additional steps (stopping while grating the cheese and rubbing one side of the loaf pan). Although Lionel and Neville showed improved performance with the introduction of video modeling, the change was not as abrupt and each experienced a gradual change in his level of performance. Lionel was able to complete up to 60.9% of the task steps using video modeling with verbal cuing on his last two sessions and Neville’s best performance was 52.2% correct when no verbal cuing was provided. Overall Lionel’s mean performance when using video modeling with verbal cuing was 52.7% correct and 46.4% correct when using video modeling without verbal cuing. He also experienced overlapping data paths during the Comparison condition. Neville was the only participant whose mean performance was greater when using video without verbal cuing (48.6%) compared to video modeling with verbal cuing (32.6%). During the Best Treatment condition, introduction of verbal cues had no effect on Lionel’s performance with the set of tasks that did not receive verbal cuing during the comparison phase and Neville completed one additional step on the first session and then reverted back to his previous level of performance on the tasks. Final Treatment Performance when completing the control set tasks remained low throughout the Baseline and Comparison condition although Coleman completed up to 40% of the five task steps prior to introduction of video modeling with verbal cues. The other three students were unable to complete more than 8% of the task steps prior to introduction of video modeling. When video models with verbal cues were added to the set during the Final Treatment condition, all participants showed an improvement in performance therefore strengthening the internal validity of the study. Social Validity All three teachers reported that they felt it would be easier to develop voice over video Education and Training in Autism and Developmental Disabilities-June 2012
  • 110. Figure 1. Percentage of steps performed independently correct by Coleman and Lionel across all conditions. Open circles represent video with verbal cues; open squares represent video without verbal cues; open triangles represent the control set. Open squares in the Best Treatment condition represent application of verbal cues to the set of tasks not receiving verbal cues during the Comparison condition. Effects of Video Models / 231
  • 111. Figure 2. Percentage of steps performed independently correct by Neville and Wanda across all conditions. Open circles represent video with verbal cues; open squares represent video without verbal cues; open triangles represent the control set. Open squares in the Best Treatment condition represent application of verbal cues to the set of tasks not receiving verbal cues during the Comparison condition. 232 / Education and Training in Autism and Developmental Disabilities-June 2012
  • 112. recordings, that they preferred to use video modeling with voice over recordings, and that they thought video with voice over recordings would be more effective when teaching their students. Discussion The purpose of this study was to compare the effects of video modeling with and without verbal cuing (voice over) on the completion of cooking related task steps by four young adults with moderate intellectual disability. Effectiveness was measured by comparing the individual and combined percentages of task steps completed independently. Both video interventions were effective in increasing independent completion of task steps across all four participants, but video modeling with verbal cues seemed to be more effective for three of the participants. Neville was the only participant who completed more task steps correctly when using video modeling without verbal cues. Additionally, when verbal cues were introduced to this set during the Final Treatment condition, he completed one additional step correctly, but he was unable to maintain that level of performance over the next two sessions. Similarly, although Lionel completed a higher percentage of task steps with verbal cues, the addition of verbal cues during the Final Treatment condition produced no change in his performance. These individual outcomes demonstrate that individual differences in student characteristics, including ability level, may play an important role in determining components of video instruction that may be more critical to some learners. Nick and Lionel each exhibited lower cognitive abilities than Wanda and Coleman. Further, it appears that certain task requirements involving variables such as amounts of time (i.e., stir for 10s, wait 1 min) or number of repetitions (i.e., grate 3 times, cut 4 beans) may be better represented by video models which include verbal cues. In the current study Coleman and Wanda were unsuccessful in completing the steps involving number of repetitions (grate the cheese 3 times, grate the carrot 3 times) until the verbal cue (“one, two, three, stop”) was added during the Best Treatment condition. Although the current study is a preliminary attempt to isolate components of video technology, a recognized limitation of the study is the number of participants and that each had a diagnosis of moderate intellectual disability. This limits the generalizability to other students with moderate intellectual disability and other disability groups such as those with autism spectrum disorders. Further, different results may occur when verbal cuing is examined with younger students. Another question raised by the results of the study concerns task requirements. The fine motor cooking related tasks in this study were evaluated and matched across sets based on level of difficulty. In addition, sets were counterbalanced across video modeling interventions and pairs of students (Table 1) to control for effects of task difficulty. Table 3 provides an analysis of the percentage of errors committed across each task by the four participants. Results indicate that the tasks were matched across the two sets by relatively similar levels of difficulty; however some pairs (types of tasks) presented more difficulty to students. Coating the loaf pan accounted for 29.5% of the errors followed by use of tools to grate the cheese and carrots (27.8%) and setting a digital and analog timer (23.7%). Cutting and snapping off the ends of the celery and asparagus (15.9%) and measuring liquids (1.2%) resulted in the least amount of committed errors. These results have implications for further research examining components of video modeling in relationship to types of tasks with differing motor and/or cognitive challenges. Although there is an increasing amount of information supporting use of video technology as an instructional tool for persons with disabilities, researchers are just beginning to address the isolation of video variables in order to determine which components are most effective with different learners. This study was an early attempt to determine the extent to which verbal cuing is a critical component for delivering instruction through video technology. While the results suggest its importance with young adults with moderate intellectual disability, much more research is needed in this area. Effects of Video Models / 233
  • 113. TABLE 3 Error analysis. Percentage of errors across participants for each fine motor cooking related task Set 1 Percent Error Set 2 Percent Error Spray loaf pan with cooking spray Grate block of cheese with hand grater Set digital timer to 3 minutes Cut off each end of celery with knife Measure 1/3 cup water from container 14.5 14.5 12.7 9.2 0 Grease loaf pan with stick of butter Peel carrot with vegetable peeler Set dial timer to 5 minutes Snap off ends of asparagus Measure 1/8 cup water from container 15 13.3 11.0 8.7 1.2 References Alcantara, P. R. (1994). Effects of videotape instructional package on purchasing skills of children with autism. Exceptional Children, 61, 40 –55. Ayres, K. M., & Langone, J. (2007). A comparison of video modeling perspectives for students with autism. Journal of Special Education Technology, 22(2), 15–30. Bayley, N. (1993). Bayley scales of infant development (BSID). New York: Psychological Corp. Billingsley, F. F., White, O. R., & Munson, R. (1980). Procedural reliability: A rational and an example. Behavioral Assessment, 2, 229 –241. Cannella-Malone H., Sigafoos, J., O’Reilly, M., De La Cruz, B., Edrisinha, C., & Lancioni, G. E. (2006). Comparing video prompting to video modeling for teaching. Education and Training in Developmental Disabilities, 41, 344 –356. Cihak, D., Fahrenkrog, C., Ayres, K. M., & Smith, C. (2010). The use of video modeling via a video iPod and a system of least prompts to improve transitional behaviors for students with autism spectrum disorders in the general education classroom. Journal of Behavioral Interventions, 12, 103–115. Holcombe, A., Wolery, M., & Gast, D. L. (1994). Comparative single-subject research: Description of designs and discussion of problems. Topics in Early Childhood Special Education, 14, 119 –145. Kaufman, A. S., & Kaufman, N. L. (1990). Kaufman brief intelligence test. Circle Pines, MN: American Guidance Service. Le Grice, B., & Blampied, N. M. (1994). Teaching pupils with intellectual disability to operate educational technology using video prompting. Education and Training in Mental Retardation and Developmental Disabilities, 29, 321–330. Mechling, L. C., & Gast, D. L. (2003). Multimedia instruction to teach grocery store location: A study of generalization. Education and Training in Mental Retardation and Developmental Disabilities, 38, 62–76. Mechling, L. C., Gast, D. L., & Fields, E. (2008). Evaluation of a portable DVD player as a self- 234 / prompting device to teach cooking tasks to young adults with moderate intellectual disabilities. The Journal of Special Education, 42, 179 –190. Mechling, L. C., Gast, D. L., & Gustafson, M. (2009). Use of video modeling to teach extinguishing of cooking related fires to young adults with moderate intellectual disabilities Education and Training in Developmental Disabilities, 44, 67–79. Mechling, L. C., Gast, D. L., & Seid, N. H. (2009). Using a personal digital assistant to increase independent task completion by students with autism spectrum disorder. Journal of Autism and Developmental Disorders, 39, 1420 –1434. Mechling, L. C., & Gustafson, M. (2008). Comparison of static picture and video prompting on the performance of cooking related tasks by students with autism. Journal of Special Education Technology, 23(3), 31– 45. Mechling, L. C., & Gustafson, M. (2009). Comparison of the effects of static picture and video prompting on completion of cooking related tasks by students with moderate intellectual disabilities. Exceptionality, 17, 103–116. Mechling, L. C., & O’Brien, E. (2010). Computerbased video instruction to teach students with intellectual disabilities to use public bus transportation. Education and Training in Autism and Developmental Disabilities, 45, 230 –242. Mechling, L. C., & Seid, N. H. (2011). Use of a hand-held personal digital assistant (PDA) to selfprompt pedestrian travel by young adults with moderate intellectual disabilities. Education and Training in Developmental Disabilities, 46, 220 –237. Murzynski, N. T., & Bourret, J. C. (2007). Combining video modeling and least-to-most prompting for establishing response chains. Behavioral Interventions, 22, 147–152. Norman, J. M., Collins, B. C., & Schuster, J. W. (2001). Using an instructional package including video technology to teach self-help skills to elementary students with mental disabilities. Journal of Special Education Technology, 16(3), 5–18. Quill, K. A. (1995). Visually cued instruction for Education and Training in Autism and Developmental Disabilities-June 2012
  • 114. children with autism and pervasive developmental disorders. Focus on Autistic Behavior, 10, 10 –20. Rayner, C., Denholm, C., & Sigafoos, J. (2009). Video-based intervention for individuals with autism: Key questions that remain unanswered. Research in Autism Spectrum Disorders, 3, 291–303. Richards, S. B., Taylor, R. L., Ramasamy, R., & Richards, R. Y. (1999). Single subject research: Applications in educational and clinical settings. San Diego, CA: Singular Publishing Group, Inc. Shipley-Benamou, R., Lutzker, J. R., & Taubman, M. (2002). Teaching daily living skills to children with autism through instructional video modeling. Journal of Positive Behavior Interventions, 4, 165–175. Sigaofoos, J., O’Reilly, M., Cannella, H., Upadhyaya, M., Edrisinha, C., Lancioni, G. E., . . . Young, D. (2005). Computer-presented video prompting for teaching microwave oven use to three adults with developmental disabilities. Journal of Behavioral Education, 14, 189 –201. Sindelar, P. T., Rosenberg, M. S., & Wilson, R. J. (1985). An adapted alternating treatments design for instructional research. Education and Treatment of Children, 8, 67–76. Sparrow, S. S., Balla, D. A., & Cicchetti, D. V. (1984). Vineland Adaptive Behavior Scales. Cirelc Pines, MNL American Guidance Service. Taber-Doughty, T., Patton, S. E., & Brennan, S. (2008). Simultaneous and delayed video modeling: An examination of system effectiveness and student preferences. Journal of Special Education Technology, 23(1), 1–18. Thorndike, R. L., Hagan, E. P., & Sattler, J. M. (1986). Stanford-Binet Intelligence Scale. Itasca, IL: Riverside Publishing. Van Laarhoven, T., Johnson, J. W., Van LarrhovenMyers, T., Grider, K. L., & Grider, K. M. (2009). The effectiveness of using a video iPod as a prompting device in employment settings. Journal of Behavioral Education, 18, 119 –141. Van Laarhoven, T., Kraus, E., Karpman, K., Nizzi, R., & Valentino, J. (2010). A comparison of picture and video prompts to teach daily living skills to individuals with autism. Focus on Autism and Other Developmental Disabilities, 25, 195–208. Van Laarhoven, T., Van Laarhoven-Myers, T., & Zurita, L. M. (2007). The effectiveness of using a Pocket PC as a video modeling and feedback device for individuals with developmental disabilities in vocational settings. Assistive Technology Outcomes and Benefits, 14(1), 28 – 45. West, E. A. (2008). Effects of verbal cues versus pictorial cues on the transfer of stimulus control for children with autism. Focus on Autism and Other Developmental Disabilities, 23, 229 –241. Wolery, M., Gast, D. L., & Hammond, D. (2010). Comparative intervention design. In Gast, D. L. (Ed.), Single subject research methodology in behavioral sciences. New York, NY: Routledge. Received: 24 February 2011 Initial Acceptance: 21 April 2011 Final Acceptance: 25 May 2011 Effects of Video Models / 235
  • 115. Education and Training in Autism and Developmental Disabilities, 2012, 47(2), 236 –252 © Division on Autism and Developmental Disabilities Mainstream Teachers’ Experiences of Communicating with Students with Multiple and Severe Disabilities Tania De Bortoli Susan Balandin The University of Newcastle Molde University College, Norway Phil Foreman and Michael Arthur-Kelly Bernice Mathisen La Trobe University The University of Newcastle Abstract: The aim of this study was to explore regular teachers’ perceptions and experiences of supports and obstacles to communicative interactions for students with multiple and severe disabilities (MSD). Five teachers of students with MSD participated in two in-depth interviews. Interview transcripts were analysed using content analysis. Transcripts were coded into categories, which were then grouped to yield content themes. Participants identified a broad range of themes, including: the complex needs of students with MSD, teachers’ training and experience, communication education for teachers, the presence of peers without disabilities, the mainstream classroom, other staff in the school context, resources, infrastructure, the culture, size and geographical location of the school, the home context, support from specialist personnel outside the school, including collaboration with speech-language pathologists, the role of government departments, and broader societal factors. There are complex, systemic influences on access to communicative interactions for students with MSD in mainstream school settings. Inadequate systemic supports restrict communicative interactions between students with MSD and their teachers and peers without disabilities, and limit the involvement of students with MSD in mainstream classroom activities. Further research is required with teachers of students with MSD to substantiate these preliminary findings. Access to communicative interactions is important for the educational participation and social inclusion of students with multiple and severe disabilities (MSD) (Calculator & Black, 2009; Downing, 2006). For several decades, however, researchers have reported low frequencies of communicative interaction for these students at school (Arthur, 2003; De Bortoli et al., 2010). Until recently, little research has examined potential reasons for the low frequencies of communicative interactions and there is limited understanding about their persistence, particularly between teachers and students with MSD (De Bortoli et al.). Our recently reported research suggests that supports and barriers to communicative interactions for these students in segregated Correspondence concerning this article should be addressed to Tania De Bortoli, School of Education, The University of Newcastle, Callaghan, AUSTRALIA. E-mail: Tania.Debortoli@uon.edu.au 236 / classrooms (i.e., special schools and support units) are complex and systemic (De Bortoli, T., Arthur-Kelly, M., Foreman, P., Balandin, S., & Mathisen, B., 2011). In the past 20 years, researchers have suggested that the presence of peers without disabilities in mainstream school settings may offer a more favourable context for enhancing the frequency of communicative interactions for students with MSD (Arthur-Kelly, Foreman, Bennett, & Pascoe, 2008; Calculator, 2009; Houghton, Bronicki, & Guess, 1987; Siegel-Causey & Bashinski, 1997). Further, the potential benefits of mainstream settings for students with severe disabilities have been well documented (Carter, Hughes, Guth, & Copeland, 2005; Downing, 2001, 2006; Hunt, Soto, Maier, & Doering, 2003; Kent-Walsh, & Light, 2003; Soto, Muller, Hunt, & Goetz, 2001). Researchers have investigated the level of engagement and frequency of communication for students with severe disability and MSD in Education and Training in Autism and Developmental Disabilities-June 2012
  • 116. both primary and high school settings. However, research with primary-aged students with MSD in mainstream classrooms has produced mixed results. Foreman, Arthur-Kelly, Pascoe, and Smyth King (2004) found that students with MSD spent more time involved in communicative interactions in mainstream classrooms than in segregated classrooms. In contrast, Helmstetter, Curry, Brennan, and Sampson-Saul (1998) identified that students were more actively engaged in segregated classrooms, and that in mainstream classrooms, they were most actively engaged when interacting on a one-to-one basis with a teachers’ aide (TA). Researchers have claimed also that students with severe disabilities in mainstream high schools continue to have limited engagement in classrooms activities and that the frequency of communicative interactions remains low (Carter & Hughes, 2006; Carter et al.; Downing, 2006; Hughes et al., 2002). Given that school may be an optimal place to acquire and practise communication skills, there is a need to better understand how to support students with MSD to leave the education system having realised their potential as communicators (Downing). There appears to be a consensus among researchers that, although there may be increased opportunities for communicative interactions in mainstream school settings, physical placement alone is not sufficient to ensure increased access to communicative interactions for students with intellectual or physical disabilities (Calculator, 2009; Cutts & Sigafoos, 2001; Downing, 2006; Hughes et al., 2002; Kent-Walsh & Light, 2003). Indeed, researchers have concluded that there may be a range of complex factors, including contextual factors, influencing the communication of students with MSD in mainstream school settings (Arthur-Kelly et al., 2008; Cutts & Sigafoos; De Bortoli et al., 2010; Helmstetter et al., 1998). Despite mixed research results regarding frequencies of communication opportunities for students with MSD in mainstream classrooms, to date there has been limited research with teachers exploring the factors potentially influencing such opportunities (Arthur-Kelly et al., 2008; Carter & Hughes, 2006; De Bortoli et al., 2011; McNally, Cole, & Waugh, 2001). Most research investigating the involvement of students with severe disabilities in mainstream classrooms has been conducted in large metropolitan schools (Carter et al., 2005; Cutts & Sigafoos, 2001). This is despite reports from families in rural areas that they wish their child with a significant disability to attend the local school in order to have the opportunity to interact with other children in the community (Calculator, 2009; Downing, 2006). The aim of the present study was to explore teachers’ perceptions and experiences of factors that influence the communicative interactions of students with MSD in mainstream school settings in rural areas. Method Participants Participants were recruited through the state education system. The first author contacted disability support services staff within two district/area offices, who forwarded the names of schools including students with MSD in mainstream classrooms. The first author then contacted 11 schools by telephone. Following discussion with executive teachers, six schools were deemed not eligible for the study because they did not have a student with MSD enrolled. No successful contact was made with two schools. Three schools were deemed eligible and five teachers from these schools volunteered to participate in the study. All participants currently taught one student in a mainstream classroom who had MSD. MSD was defined as having a severe intellectual disability, and a range of impairments that may include physical and sensory impairments (Foreman & Arthur, 2002). All five teachers worked in mainstream public schools in rural areas. Teachers ranged in years of teaching experience from 5–30 years. Two of the teachers had not previously encountered students with disabilities, while the other three teachers had some previous experience working with students with a range of disabilities. The pseudonym, school setting, and years of teaching experience of the participants are summarised in Table 1. Procedure Each teacher participated in two in-depth interviews lasting 45–120 minutes. In the first Mainstream Teachers’ Experiences with Students with MSD / 237
  • 117. TABLE 1 Characteristics of participants Participant Gender Age (years) Years of teaching experience Type of teaching experience Primary and secondary Primary and secondary Primary Betty F 55ϩ 30 Dora F 55ϩ 30 Naomi F 36-45 15 Phoebe F 20-35 6 Primary Nigel M 20-35 5 Secondary Educational setting Location Training background Central school Rural DipEd Central school Rural DipEd Small Rural mainstream public Small Rural mainstream public Central Rural school B.Ed. B.Ed B.Ed Fϭfemale, Mϭmale, DipEd ϭ Diploma of Education, B.Ed. ϭ Bachelor of Education. interview, participants were invited to talk about their perceptions and experiences of supports and obstacles to access to communication for the student with MSD. Four openended questions, developed from a review of the literature, were used to guide the interview (see Table 2). Each participant was then sent a copy of their transcript including the initial coding for content themes. The second interview was conducted during the following school term (3 to 10 weeks after the first interview). In the second interview, participants were invited to: (a) change and/or elaborate on issues discussed in the first interview, and (b) provide feedback on the researcher’s interpretations (Eisenhart & Howe, 1992; Freeman, M., de Marrais, K., Preissle, J., Roulston, K., & St. Pierre, E., 2007). Interviews were audio-taped for later analysis, with the participants’ consent. Transcription and Management of Data The first author transcribed the interviews as soon as possible after interviews were conducted. All identifying information was removed from transcripts. Pseudonyms replaced participants’ names, and general descriptors (e.g., student, teacher, school, place) were 238 / used in place of proper nouns to ensure confidentiality. Analysis and Verification The transcripts of the first interviews were subjected to an analysis of content themes (Coffey & Atkinson, 1996; Creswell, 2008; Richards, 2005; Tesch, 1990). Text segments were coded for the topic discussed and assigned to categories. Categories were derived partly from previous research (De Bortoli et al., 2011), with some categories not used and new categories added according to the topics discussed by the participants in this study. Categories occurring at the same systemic level (De Bortoli et al), or within the same context (e.g., school setting, government department), were grouped together to yield the content themes. Qualitative data analysis software (NVivo 8, QSR International) was used to assist in data management. Only two participants attended second interviews due to work commitments at the end of the school year. However, all participants provided verification of their transcripts and interpretations of themes, either by writing on their transcripts (nϭ5) and/or by discussion in the second interview (nϭ2). In addition, an Education and Training in Autism and Developmental Disabilities-June 2012
  • 118. TABLE 2 Interview outline The following is the general interview format for the initial interview with teachers. The format of the indepth interview has been chosen to allow participants to discuss their experiences of communicating with their students with multiple and severe disabilities openly and without interruption. The interviews will be conversational in style and the number of questions kept to a minimum. The following questions will be used as a guide only. 1. Demographic information ⅙ What type of setting do you work in? ⅙ How many years experience have you had working with students with severe and multiple disabilities? You may find it helpful to think of particular students when answering these questions. 2. Communicating with students with severe, multiple disabilities ⅙ What is it like to communicate with your student(s)? ⅙ What do you think is important about communication for your students? 3. Supports ⅙ Can you tell me what supports or has a positive affect on your communication with your student(s)? ⅙ What do you think could help make communication easier? 4. Training ⅙ Have you had any communication training? If so, how would you evaluate it? ⅙ What sort of communication training do you think would be valuable to you? 5. Obstacles ⅙ What factors have a negative impact on your communication with your student(s)? Topic areas will be introduced with the natural flow of conversation. It may be unnecessary to introduce a topic or ask a question if the participant has already addressed it. Therefore, these topic areas are merely a guide and not a set interview regime. independent person, a research assistant with experience in qualitative research, coded randomly-selected transcripts for two of the five participants (40%) into content themes. She was given instructions for coding that included definitions of the coding categories and then independently coded the transcripts without any discussion with the main investigator. Subsequent analysis compared the coding of transcripts into categories by the independent person with those noted by the first author, yielding an inter-coder reliability rating of 92%. Results Findings are presented as the six main themes that emerged from the participants’ experiences. These are summarised in Table 3, with categories and examples of supports and obstacles discussed by participants. careers and had no previous experience with students with MSD. The other three participants had 15–30 years experience and had previously taught one student with MSD. Participants described communicating with students with MSD as “difficult” (Phoebe, Nigel, Naomi), “overwhelming” (Phoebe), “frustrating” (Betty, Dora), and “daunting” (Dora). Nigel said: “I find it difficult because apart from the greeting you’re left a little bit lost as to where to go from there. It’s a bit hard to prolong an interaction or a conversation of any manner.” Yet the teachers also reported some positive experiences and feelings. Betty said: “[Student] makes my day when he smiles at me, it’s wonderful.” The supports and obstacles to communication identified by participants are outlined below. Individuals: Teacher and Student Teachers’ Experiences Communicating with Students with MSD Two of the participants in this group (Phoebe and Nigel) were in the early stages of their Participants initially identified obstacles to communicating associated with both the student’s characteristics, and their own characteristics. The more experienced teachers also Mainstream Teachers’ Experiences with Students with MSD / 239
  • 119. TABLE 3 Themes, sub-themes and examples of supports and obstacles discussed by participants Themes IndividualsTeacher and student Categories Student characteristics Teacher characteristics Communication education for teachers Formal education and courses Mentoring Practical experience Internet Visiting other schools Support people The school context Supports Peers without disabilities The mainstream classroom Other staff in the school context Complex communication needs. Existing skills, knowledge and Limited training, knowledge and experience experience. Limited pre-service and continuing education. Limited opportunities. Working with students with disability. Access to information in rural schools. Observing communication practises. Giving teachers skills and knowledge. Communication opportunities. Positive attitudes. Teachers’ aides. Resources and the physical environment School culture Home context Close contact for exchange of information. Visiting specialist teachers Government department/ agencies Accessible physical environment. Facilitating communication skills; student, teacher, peers. Programming for activities. Speech pathologists and other therapists State education system Small, rural schools provide supportive atmosphere. 240 / Limited opportunities for collegiality. Principal provides limited support to teacher. Difficulty accessing resources, assistive technology. Difficulty meeting learning and communication needs. Difficult for small, rural schools to access support. Family not capable of supporting the child’s communication. Reduced support. Limited support for students without hearing impairment. Limited collaboration with teacher. Integration officer supports school with resources. Other departments and agencies Societal factors Limited interaction at high school. Difficulties programming and communicating in group situation. Collegiality: meeting with other teachers. Principal supports teachers. Other people outside the school Obstacles Positive community attitudes. Local school promotes social inclusion. Difficulties obtaining funding, specialist staff and support for networking. Limited access to speech pathology services. Inconsistent service to schools. Social exclusion in mainstream school. Segregated activities outside school. Education and Training in Autism and Developmental Disabilities-June 2012
  • 120. identified some supports associated with their own characteristics. Student characteristics. Participants identified the complex communication needs of their student with MSD as an obstacle to establishing communication. They perceived that communication was difficult because of their student’s limited responsiveness and spontaneity. Betty said: “With a typical student you are able to get some feedback and therefore know that your message has been understood. Sometimes with [student] we may get no visual signs whatsoever, not even facial movement.” Participants reported difficulty interpreting students’ idiosyncratic forms of communication. Nigel said: “He can’t communicate verbally so actions and eye contact are the biggest things. I’m only taking a guess or a stab at what it is that he’s trying to project.” Three participants perceived that their student may be pre-intentional. Phoebe noted: “I don’t know if [student] has intent to communicate, that’s the hard part. We can put him in situations to foster communication but I don’t know if the intent is there, if he actually wants to communicate.” Four participants also observed that communicating with their student with MSD required increased effort and time on their part, because of the need for one-toone interaction. Participants then emphasised their lack of skills and knowledge to interact with students with such complex communication needs. Teacher characteristics. Participants reported that their lack of training, knowledge and experience was a major obstacle to establishing communication with students with MSD. Phoebe said: “I’m not trained and I don’t understand how it [communication] works with a child with severe, multiple disabilities and minimal communication.” Naomi noted, however, that the experience, skills and knowledge she had acquired at a previous school, teaching children with a variety of additional needs, supported her to communicate with her current student with MSD. She had undertaken training in sign language, and said “so I could actually communicate with them that way.” Following on from discussion of their own characteristics, participants talked about the importance of communication education. Communication Education for Teachers Formal education and courses. The participants reported a general lack of training for teaching and communicating with their student with MSD. They noted limited relevant content in their pre-service teacher education and limited continuing communication education. Nigel said: We’ve very much been told to try and interact with the student as best we can but I haven’t had any kind of special education training or any specific professional development regarding how to cope with a student that’s at this level. It has been very much on-the-job training, a bit of trial and error. Participants perceived a need to attend external courses to help them acquire some skills and strategies for communicating with students with MSD. Mentoring. The early career teachers, in particular, perceived the potential value of regular opportunities for mentoring, for personal support and guidance with programming However, they reported limited opportunities for such experiences. Phoebe said: “As far as mentoring goes, it’s quite difficult to find someone that’s willing to support you.” In the absence of formal education and mentoring, Nigel described some of his experiences of “on-the-job training.” Practical experience. Nigel described the benefits of spending time with another student at the school who had a hearing impairment. He said: “I’ve found that a very big learning experience in terms of understanding her communication needs. It gave me more insight into working with the more severely disabled student that we have here at the school.” Participants noted other ways they could be supported to learn how to communicate with students with MSD. These included using the internet, visiting other schools, and support people coming into the school. Internet. Naomi reported that access to the internet at her school enabled her to research the communication needs of children with disability. She perceived this as an important resource for teachers in rural areas. Mainstream Teachers’ Experiences with Students with MSD / 241
  • 121. Visiting other schools. Participants also commented that observing practices in other schools, particularly special schools, would be helpful. Phoebe said: “[We] are going to another school to see what they are doing there for these students with multiple disabilities and severe language delays, and how the teachers there communicate with them, to see that we’re on the right track.” The role of support people. Finally, participants perceived that support people, from outside the school, had a role in imparting skills and knowledge about how to communicate with students with MSD. Naomi said: When the children come through they bring their entourage of OTs and speechies. The itinerant support people are making sure that as a beginning teacher you’re getting that information. That’s basically how I learned. So really those support people are crucial. Regardless of their level of experience or access to training, however, participants talked about receiving limited support. Naomi noted that while this support is crucial for beginning teachers it had been “dwindling away.” She said: Particularly for a beginning teacher, to be faced with a student with multiple and severe disabilities, it’s essential to have support. If I was a beginning teacher I would say that I would be struggling because I wouldn’t know where to go with this child. Participants talked about obstacles, and supports, they encountered in the contexts of the classroom and school. These are presented in the next theme. The role of support people from outside the school will be presented in the following theme. Classroom and School Contexts Participants perceived that a number of issues influenced access to communicative interactions for the student with MSD. These included: (a) peers without disability, (b) the mainstream classroom, (c) other staff in the school, (d) resources and the physical environment, and (e) the culture of their school. 242 / Peers without disability. Participants reported that the other students generally held positive attitudes toward their peer with MSD. The two participants in primary classrooms perceived that the student with MSD had opportunities for communication, because of the presence of peers as potential communication partners. Phoebe said: I think him just being here is a great opportunity for communication because he’s getting to interact. The other kids want to hold his hand, they want to speak to him, they want to sit beside him. His being in the mainstream setting just provides him with other students that want to talk to him and that want to be his friend. Participants at the secondary school level, however, reported minimal interaction between the student with MSD and other students, despite students’ positive attitudes. Nigel said: There’s not a lot of interaction between the mainstream students and him [student with MSD]. None of the other students seem to want to even attempt the “high fives,” a big communication tool. So, there is that divide in that respect. Nigel perceived that, like the staff, the other students found it difficult to communicate with the student with MSD. He said: “It is very difficult for other students to even relate with [student]. If teachers find that difficult then what chance does a student have?” The mainstream classroom. Participants noted a number of barriers to communication associated with the mainstream classroom. Participants reported both awareness that their student with MSD needed more time, and a concern about allocating their time and effort equitably among all their students, to ensure delivery of the curriculum, particularly at the high school level. Participants also reported difficulty communicating with the student with MSD in the group situation and programming to involve him in classroom activities. They perceived that the student with MSD could be “disruptive” (Naomi) for them and the other students. Phoebe said “We encourage him to make noises to communicate but it’s awfully difficult to be teaching when Education and Training in Autism and Developmental Disabilities-June 2012
  • 122. you’ve got someone yelling in the background.” Other staff in the school context. Participants talked about the perceived role of teacher’s aides, the principal, and collegiality in supporting or hindering access to communication for students with MSD. Participants spoke about the importance of having a teachers’ aide (TA) in the classroom to facilitate communication, and work one-to-one with the student with MSD on their individual education plan (IEP). Naomi said: “With more severe children we do that more through the teacher’s aide and using that aide to set them up with communication skills. You need that space where he’s just with his aide working on his own program.” However, Phoebe reported limited opportunities during the school day to communicate with her TA about the student’s progress and goals. Participants also spoke about the role of opportunities to meet with other teachers, in supporting them to communicate with their student with MSD. Three participants reported that dialogue between teachers supported positive attitudes and a consistent approach to communicating with the student with MSD. Betty commented that: “It’s been a communication for staff actually” to take a consistent approach to using high fives with their student. Phoebe, however, reported almost no opportunities for collegiality. She was the only teacher at her school who had a student with MSD in her classroom. She said: I’ve found that there’s no one else in the same situation as me. There’s no one with my lack of training that has a student with multiple and severe disabilities in their classroom that can speak on a de-briefing level. Participants also reported varying experiences of support from their principal. Phoebe said: “I don’t feel that I get support from the principal.” Other participants reported that their principal managed the students with disabilities at their school, provided informal problem-solving with them, and arranged a speaker to attend a staff meeting prior to the student with MSD arriving. Resources and the physical environment. In addition to the role of other people in the school context, participants talked about the infrastructure of their school, and the need for more resources. Betty, Dora and Nigel described changes made to the physical environment of their school to enable the student with MSD to participate in classes with his peers. These included use of downstairs classrooms, installation of ramps, and acquisition of desks to accommodate wheelchairs. Nigel reported that changes were made to the use of particular rooms and areas in the school, so that the student had dedicated spaces for sleep and mealtimes. However, participants reported difficulty acquiring, or lack of knowledge about resources to support the student’s participation in classroom activities and opportunities for communication. Naomi said: “We haven’t really been offered any equipment here and we’re making do as we go.” Nigel reported that his student with MSD had recently acquired an assistive technology device. However he also said: “I don’t know a lot about it, the teacher’s aide knows more about it.” The school culture. In addition to these specific issues, participants shared their perceptions of their school culture. They discussed the school’s ability to cater for the needs of students with MSD, and the impact of its size and geographical location. Even participants in the same school had different perceptions about their school’s ability to cater for the needs of students with MSD. Betty and Dora commented that their school had a history of accommodating students with disabilities, in terms of enabling access in the physical environment. Betty said: I think it’s a culture within our school because I remember twenty years ago, we had students that would have been at [special school] then. We had a fellow in a wheel chair and it was no big deal. We just changed our timetable for him every year so that he never had to go upstairs. So I think we’ve had it in our community, in our school community for quite some time. Nigel, however, expressed the view that, while it was “fantastic” to be able to accommodate the student with MSD, staff had fears about how to interact with him. He noted that staff attitudes had become more positive: “I think Mainstream Teachers’ Experiences with Students with MSD / 243
  • 123. change has been the biggest fear for many of us, including myself, but as times gone on I think it’s been more accepted.” Nevertheless, he expressed uncertainty about the school’s ability to cater for the educational and communication needs of the student with MSD, and recommended that more be done “to make it more worthwhile for those children that are coming.” Participants also noted supports and obstacles associated with small, rural schools. Four participants perceived that the emotionally supportive culture of their school was due to it being a small, rural school. Naomi said: “It’s really a family environment in a small school. Everyone’s accepting of our little person and really nurturing and encouraging.” Betty perceived that there was a “sense of community within the school.” The perceived disadvantage of small, rural schools, however, was greater difficulty accessing support from the state system and professionals outside the school. Naomi said: “I think we find it a little bit difficult to access support being in a smaller school rather than being in a larger school where there are more of those sorts of children.” Teachers’ perceptions and experiences of other people outside the school is the next theme. Other People outside the School Participants talked about the role of people outside the school. These included parents of their student with MSD and professionals in their district/region, such as visiting specialist teachers and speech pathologists. Home context. Participants reported varying experiences of contact with their student’s parents. Three participants reported having close contact, via phone and communication book. Dora said: “A lot of the communication is through the parents for the kids. So we work with them. [Communicating with the student] is hard.” They reported that the communication book was not being used to communicate with the student with MSD. Two participants noted that not all families were capable of supporting their child’s communication development. Phoebe described limited support from the family for enhancing her student’s skills: “I feel that I don’t get much support from the home environment. It 244 / isn’t particularly an opportune environment. I don’t think they are particularly concerned with fostering [student’s] development. It frustrates me. That’s a big obstacle.” Participants perceived that parents had an important role in accessing support, for example, speech pathologists, both before students start school and throughout their school years. Naomi said: “Some parents are maybe not as diligent in looking for that help before school. If we are trying to access that support later on then it’s perhaps a little more limited.” Visiting specialist teacher. The two participants in primary schools spoke about the ways that an itinerant teacher for hearing (ISTH) provided support. These included facilitating the communication skills of the student with MSD, the teacher and the other students in the class. Phoebe said: “With access to their support, we are trying to teach him to communicate using his eyes and using simple Makaton signs. So they are our alternative forms of communication.” Naomi added: “The itinerant support people set you up for making sure that you’re going to be able to communicate well, that you’re able to sign to them to communicate to them.” She also said: We use the support teacher to work with all of the children so she could sign to the children as well. That way we’re all on the same wave length in being able to communicate with each other. That was really important. Participants also reported that the ISTH supported them with programming to involve the student with MSD in activities and create opportunities for communication. Naomi said: “Every chance I get with my support teacher we’re programming.” However, Naomi reported that this support “has just dwindled away. Now we might see our support teacher once every couple of weeks. Those support people are crucial.” The participants in a high school noted that an ISTH comes to their school to support a student who has a hearing impairment. However, they noted that their student with MSD was not receiving similar support. Nigel said: “I’m not certain whether there’s that kind of facility with the more severely disabled male student that we have. I may be unaware of it.” Education and Training in Autism and Developmental Disabilities-June 2012
  • 124. Speech pathologist and other therapists. In contrast to her supportive experience with an ISTH, Phoebe described her negative experience of visits from a speech pathologist and other therapists that were unhelpful. She said: The very first day of school, seven people from [Non Government Organisation] knocked on my classroom door and started speaking about Big Mack switches, and augmented communication systems . . . I was just so overwhelmed by these people telling me what I must do. I was actually told: “You need to do more, and this was the very first day of meeting this little person.” She also reported not being involved because the speech pathologist did not arrange appropriate times with her to visit the school. She said: “So since having [student] at school we’ve had three speech visits that really I felt I got nothing from. These visits happen outside the classroom while I’m teaching.” Apart from participants’ comments about the individual professionals that they worked with, they also talked about factors associated with government departments. This is the next theme. Government Departments: State Education System Teachers talked about supports and obstacles associated with both the state education system and other government departments and agencies responsible for providing speech pathology services. The integration officer. Participants working at the central school reported receiving weekly visits from an integration officer “because there are quite a few special needs children here” (Dora). Dora said: “She talks to the teachers to see if there are any special resources that the child may need to help with their learning. If we need a laptop she can get that from district office.” Participants perceived the integration officer’s presence as helpful, even though she had limited time at the school. Difficulty obtaining support. Having previously also worked in a central school, Naomi perceived, however, that there was less support from the state system for students with MSD in smaller schools. Phoebe reported that her requests for support seemed to “fall on deaf ears.” Despite positive reports about the ISTH and integration officer, participants talked about difficulties obtaining funding, support from specialist staff, and support for networking with other teachers of students with MSD in mainstream classes. Difficulty obtaining funding. Participants reported difficulty obtaining funding through the state system for resources to support their student’s participation in activities and opportunities for communication. Phoebe said: “I pushed and pushed and pushed. It’s taken a term and a half to get $400 worth of funding to buy some developmental toys and resources for him.” However, she also described resorting to purchasing resources with her personal money, for which she had not been reimbursed. Betty perceived that staff had to “fight,” not only to obtain resources, but also for additional staffing in the classroom. Limited specialist staff. Participants perceived that there were limited avenues for accessing specialist support through the state system, for students with MSD in the mainstream setting. Phoebe said: When I first filled out the access request form, “hearing” was the only box that [student] fitted into. It was the only box that I could tick for him and I thought “I need some support. I’m just going to try.” Nigel perceived that there was a scarcity of such staff. He said: “If you brought someone in [here], are you taking resources from elsewhere. It’s a finite resource pool.” Isolation of mainstream teachers of students with MSD. Participants talked about being on their own, both personally and professionally. Phoebe said: “When you do try to have a personal relationship with some of the people higher up in integration and in special ed, it’s like they don’t want to talk to you about how you’re feeling.” Betty commented that the integration officer’s visits were not enough support for individual teachers. She noted the need for the state system to provide opportunities for networking with other teachers of students with MSD in mainstream settings: So that we can look at all the different strategies, share all the resources that are out there. We all do our own thing. There doesn’t seem to be on a departmental level Mainstream Teachers’ Experiences with Students with MSD / 245
  • 125. enough co-operation, co-ordination. We could do it a hell of a lot better. Participants also made comments about lack of support associated with other departments and agencies. ences of the broader community on the student’s access to communication in the mainstream school setting are presented in the final theme. Societal Factors: Social Inclusion Other Departments and Agencies Participants spoke about the limited and inconsistent provision of speech pathology services to students with MSD at their schools. Limited services to schools. Participants perceived that it was difficult to access speech pathology services in the school setting, and that when provided input was brief. Phoebe said: “You have to jump through so many hoops to get it, or it costs extra and the family just can’t accommodate that.” Phoebe’s student had received three school visits over six months. The student was now on a waiting list for further support. Nigel, Betty and Dora reported that no speech pathologists come to their school, and perceived that this service was not accessible for the high school. Betty said: “I think if we could get it we would have accessed it by now but I know that certainly doesn’t come in through high school.” Nevertheless, participants unanimously stated that speech pathologists could support them to communicate with the student in the classroom. Inconsistent provision of services to schools. Naomi compared the provision of speech pathology services to students with MSD at different schools. She reported that at the central school where she had taught kindergarten previously: “We had a lot more support for that student. We had occupational therapy. We had speech pathology that came with him and stayed with him.” In contrast, she reported receiving no service at her current small, primary school, and added: “I’m not sure why there would be a difference because that was a rural school as well.” However, as previously mentioned, she perceived greater difficulty accessing a speech pathology service at a small school than a larger school. Naomi, Betty and Dora stated that it was up to parents to arrange a speech pathology service. Dora said: “I think that’s just something that parents do off their own bat.” Participants’ perceptions about the influ- 246 / Finally, participants expressed different views about the extent to which social inclusion occurred at their school and in the broader community. Four participants perceived that their local communities were accepting of young people with MSD and their attendance at the local school. They believed that it was important for the student with MSD to participate in activities and not be segregated. Betty perceived that the student with MSD was “included in just the same way [as other students],” and noted that: “If they’re [students with MSD] set apart and appear that they are very different and you don’t get to interact with them” then communicative interactions are much less likely to happen. One participant had different views, however, about social inclusion. Nigel perceived that the student with MSD was not being socially included. He therefore had doubts about the benefits of the mainstream school setting for this student: “The family want the child to be at the local school which is understandable but whether it’s necessarily to his maximum benefit is questionable.” Nigel commented that the special school in the area would better cater for the needs of the student with MSD. He said: “We do have a special education school in the area and that’s already sort of set up, it’s got a program like that.” He noted that apart from the lack of interaction between the student with MSD and other students at school, this student attended segregated activities outside school as well. Discussion Participants Identified a Broad Range of Factors The findings of the present study support previous research (De Bortoli et al., 2011; Kent-Walsh & Light, 2003; Soto et al., 2001), and suggest that supports and obstacles influencing the communication of students with Education and Training in Autism and Developmental Disabilities-June 2012
  • 126. Figure 1. Systemic factors influencing the communicative interactions of students with MSD in mainstream school. MSD in mainstream schools are complex and systemic. These are represented in Figure 1. Participants’ Difficulties Communicating with Students Given their limited training and experience, participants had difficulty interacting with students with such complex communication needs. These issues are represented in the innermost circles of Figure 1. These findings are consistent with previous research with mainstream teachers including students with severe disabilities and students who use AAC (Carter & Hughes, 2006; Kent-Walsh & Light, 2003; Smith, 2000; Soto et al., 2001). This factor was compounded by few opportunities for continuing professional development and limited supports at a number of contextual levels, such as mentoring, networking with other mainstream teachers, specialist support people, and external courses. In Figure 1 communication education crosses a number of levels. This situation existed despite claims by researchers that teachers need a high level of professional development support to include students with severe and multiple disabilities (McNally et al., 2001). Classroom Context Involvement in classroom activities. Participants’ difficulties engaging students with MSD in classroom activities may have been due to an interaction between their limited training and experience teaching these students, and Mainstream Teachers’ Experiences with Students with MSD / 247
  • 127. instructional practices in mainstream classrooms, such as whole-group activities. This appeared to be particularly true in high school classrooms with lecture-style instructional practices and focus on curricular content. Reliance on TA. Participants’ consequent reliance on a TA to mediate communication and work individually with the student with MSD may have further limited the students’ involvement and communicative interactions in the mainstream classroom (Carter & Hughes, 2006; Carter et al., 2005). While the support of a TA in the classroom was crucial for these participants, it may nevertheless have contributed to the social isolation of the student with MSD, a phenomenon discussed by other researchers (Carter & Hughes, 2006; Downing, 2006; Kent-Walsh & Light, 2003). Peers without disability. The findings also suggest that there was limited realisation of the potential opportunities for communication offered by the presence of peers without disabilities. While the primary-aged students were perceived to be naturally interactive (also reported by Bentley, 2008), participants did not report perceived quantity or nature of communicative interactions between students. In the high school setting, the presence of peers as potential communication partners reportedly did not translate into interactions, consistent with previous research (Carter & Hughes, 2005). The findings suggest that the presence of peers without disabilities as potential communication partners may have interacted with other contextual factors. Instructional practices and peers are represented in the next circle in Figure 1. Teachers’ aides are included in the following outer circle representing the school context/culture along with other influencing factors at this level. School Context/Culture Findings suggest that the cultures of schools varied in terms of support for facilitating communicative interactions for their students with MSD. These varied from lack of support and isolation, to supportive school environments. Parents have also reported experiencing differences between schools in the support provided to include their child with a disability (Kluth, Bliken, English-Sand, & Smukler, 2007). 248 / In the present study, a supportive school culture enabled participants to meet and develop a school-wide goal for their student with MSD of using high fives for greeting, a goal documented in the literature as socially valid and age-appropriate (Calculator & Black, 2009; Downing, 2001, 2006). However, as one of the teachers commented, this communication goal was very limited, a view supported by researchers who have stated that students with MSD may rely on a limited number of communication modes and therefore be limited in the messages that they can convey (Calculator, 2009; Downing, 2006). Therefore, the findings suggest that this supportive school culture, which also reportedly helped participants transform their initial fears into more positive perceptions, was not sufficient to ensure communicative interactions for the student with MSD. The factor of change, which was perceived to occur or need to occur at the personal level, in the school context and in organisational service provision, is represented in Figure 1 by a wedge that crosses these levels. Geographical Area The infrequent communicative interactions reported may have been influenced by limited specialist support services in the schools. Participants perceived that the rural location of their schools meant they received minimal support from specialist teachers and speech pathologists, as represented in the next circle in Figure 1. It may also have made access to professional development more difficult. Limited specialist support services may have presented a barrier to communicative interactions for the student with MSD because teachers, TAs and peers without disability appeared to receive limited support for learning how to communicate with the student. Researchers state that teachers and peers without disability need to be taught how to: (a) recognise and respond to the idiosyncratic forms of communication of students with MSD, and (b) use AAC systems to have communicative interactions with them (Calculator, 2009; Copley & Ziviani, 2004; Downing, 2006; McMillan, 2008). Further, research suggests that even minimal teaching of peers facilitates interac- Education and Training in Autism and Developmental Disabilities-June 2012
  • 128. tion (Carter & Hughes, 2006; Carter, Cushing, Clark & Kennedy, 2005; Downing, 2006). Limited specialist support services may also have presented a barrier to involving the student with MSD in classroom activities because participants received limited support for programming, a support recommended in the best practice literature (Calculator, 2009; Calculator & Black, 2009; Hunt et al., 2003). While participants in primary school environments relied on visits from a specialist teacher for programming, and teaching students some signs to communicate with the student with MSD, their comments suggest that this support was not sufficient, and that support from speech pathologists was also needed. The findings also suggest variable co-operation between schools and the families of students with MSD. Even though parents reportedly wanted their child with MSD to attend the local school, it is not known whether their expectations were met. Limited specialist support may also have presented a barrier to the collaboration required to facilitate consistent approaches to communication across contexts (Calculator & Black, 2009; Downing, 2006; Hunt et al., 2003). Teachers at the high school, for example, used a communication book with parents but did not use it with the student to facilitate participation in the classroom and conversations with peers (as discussed by Downing, 2001, 2006). Government Departments and Other Organisations Findings suggest there are other issues that have implications for service delivery at a departmental/organisational level, as represented in the next circle in Figure 1. The finding that some teachers were only able to access a specialist teacher because their student with MSD had a hearing impairment suggests limited avenues for teachers to access specialist support services through the state education system. The findings also suggest that speech pathology services operated under a model of few visits during which the student was withdrawn from the classroom, teacher and peers. Conflicts between the time required, and the time available or provided, to meet the communication and learning needs of students with MSD is represented by a wedge in Figure 1 that crosses a number of levels. Limited to teaching the student with MSD communication skills, this model, therefore, was not supportive of facilitating communicative interactions in the classroom and school contexts. It appears that some participants were not even making service requests, suggesting that organisations providing speech pathology services may need to provide schools with information about accessing this service. Discourses about Social Inclusion The existence of different views amongst teachers in the same school about the ability to support communicative interactions for students with MSD in their local, rural school suggests that there are different discourses operating simultaneously. This level of influencing factors is represented in the outermost circle of Figure 1. These discourses may both be influenced by the interactions between factors discussed above, and influence access to communication for students with MSD in mainstream settings. The parents in Kluth et al.’s (2007) study also reported the influences of different districts’ and schools’ discourses and cultures on the social inclusion of their children with disabilities. The finding that teachers perceived limited philosophical and practical support from the education system for socially including students with MSD may reflect a broader social discourse while at the same time influencing the views of individual teachers. The findings of this study suggest the existence of the following discourses: (a) students with MSD have the right to attend their local school and not be separated from peers; (b) resources are scarce and it is not cost effective to provide the supports needed for students with MSD in mainstream schools; (c) if students with MSD attend the local school they have to fit in with little additional support to accommodate them (also reported by the parents in Kluth et al.’s (2007) study); and (d) the needs of students with MSD are not always met in the local mainstream school and it is in the best interests of some students to have segregated education. Researchers have speculated that teachers doubt the benefits for students with severe disabilities of attending a Mainstream Teachers’ Experiences with Students with MSD / 249
  • 129. mainstream classroom in the neighbourhood school, because the barriers overshadow the potential benefits, and that there would be greater benefits for such students in segregated settings (Carter & Hughes, 2006; Downing, 2006; Smith, 2000). The perpetuation of some of these discourses may continue to limit opportunities for communicative interaction for students with MSD. Perhaps because of the difficulties establishing communication in the school setting, none of these teachers spoke about preparing the student to communicate in the broader community, as discussed by Calculator and Black (2009). The findings suggest that, without supports, students with MSD can still be segregated, with limited opportunities for interaction at school and more broadly in their local community. Limitations and Future Research This was a small study incorporating the views of five teachers in three rural schools. Certainly, the results do not reflect the views of other teachers of students with MSD in mainstream school settings. Further research is needed with other teachers of students with MSD in mainstream schools in a broader geographical area in order to substantiate the claims of the participants of this study. The findings of this study have implications for: (a) how the culture of a school influences the communicative interactions of students with MSD, and (b) speech pathology service delivery. The importance of collaboration and teamwork also suggests that further research involving potential team members, such as speech pathologists, other health professionals, parents, specialist teachers and peers without disability is required. Further observational research is also required to document what actually happens in mainstream classrooms between teachers, students with MSD, and their peers. This research would contribute further insight regarding a model for enhancing the communicative interactions of students with MSD in mainstream school settings. Conclusion: Supports and Obstacles may be Systemic The findings of this study offer new insights into the supports and obstacles that impact 250 / teachers in rural schools in their communicative interactions with students with MSD in mainstream classes. The participants’ perceptions suggest that the supports and obstacles for communicative interactions, and engagement in the classroom are complex and systemic. The findings therefore also suggest that a model for enhancing access to communicative interactions for students with MSD in rural, mainstream schools may also need to be complex and systemic. This may include the following recommendations: (a) support for individual teachers, such as mentoring, opportunities for gaining experience with students with disability at university, regular opportunities for networking with other teachers and visiting other schools, accessing courses using technologies, and collaboration with specialist support staff; (b) specialist support services into schools to support teachers, TAs and peers without disability to learn how to communicate with the student, involve him/her in class activities, set up peer support arrangements, facilitate collaborative teaming involving families, set up AAC systems, and build up the school culture in terms of communication practices and resources; (c) further investigation of service provision for students with MSD in rural areas, (d) government departments and other organisations continue developing policies and practices for building the social inclusion capacities of rural mainstream schools thereby reducing the isolation of teachers and families; and (e) a continuing dialogue about social discourses around mainstream educational settings and students with MSD that may be influencing their access to communicative interactions. References Arthur, M. (2003). Socio-communicative variables and behaviour states in students with profound and multiple disabilities: Descriptive data from school settings. Education and Training in Developmental Disabilities, 38, 200 –219. Arthur-Kelly, M., Foreman, P., Bennet, D., & Pascoe, S. (2008). Interaction, inclusion and students with profound and multiple disabilities: Towards an agenda for research and practice. Journal of Research in Special Education Needs, 8, 161–168. Bentley, J. K. C. (2008). Lessons from the 1%: Children with labels of severe disabilities and their Education and Training in Autism and Developmental Disabilities-June 2012
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  • 131. communication. Augmentative and Alternative Communication, 19, 104 –124. Kluth, P., Bliken, D., English-Sand, P., & Smukler, D. (2007). Going away to school: Stories of families who move to seek inclusive educational experiences for their children with disabilities. Journal of Disability Policy Studies, 18, 43–56. McMillan, J. (2008). Teachers make it happen: From professional development to integration of augmentative and alternative communication technologies in the classroom. Australasian Journal of Special Education, 32, 199 –211. McNally, R. D., Cole, P. G., & Waugh, R. F. (2001). Regular teachers’ attitudes to the need for additional classroom support for the inclusion of students with intellectual disabilities. Journal of Intellectual and Developmental Disability, 26, 257–273. QSR International, Pty Ltd. (2009). NVivo 8. QSR International, Pty Ltd. www.qsrinternational.com 252 / Richards, L. (2005). Handling qualitative data: A practical guide (pp. 67–103). London: Sage. Smith, M. G. (2000). Secondary teachers’ perceptions toward inclusion of students with severe disabilities. NASSP Bulletin, 84, 54 – 60. Siegel-Causey, E., & Bashinski, S. M. (1997) Enhancing initial communication and responsiveness of learners with multiple disabilities: A Tri-Focus framework for partners. Focus on Autism and Other Developmental Disabilities, 12, 105–120. Soto, G., Muller, E., Hunt, P., & Goetz, L. (2001). Critical issues in the inclusion of students who use augmentative and alternative communication: An educational team perspective. Augmentative and Alternative Communication, 17, 62–72. Tesch, R. (1990). Qualitative research: Analytic types and software tools. Lewes, Falmer Press, 113– 46. Received: 30 March 2011 Initial Acceptance: 27 May 2011 Final Acceptance: 30 July 2011 Education and Training in Autism and Developmental Disabilities-June 2012
  • 132. Education and Training in Autism and Developmental Disabilities Editorial Policy Education and Training in Autism and Developmental Disabilities focuses on the education and welfare of persons with autism and developmental disabilities. ETADD invites research and expository manuscripts and critical review of the literature. Major emphasis is on identification and assessment, educational programming, characteristics, training of instructional personnel, habilitation, prevention, community understanding and provisions, and legislation. Each manuscript is evaluated anonymously by three reviewers. Criteria for acceptance include the following: relevance, reader interest, quality, applicability, contribution to the field, and economy and smoothness of expression. The review process requires two to four months. Viewpoints expressed are those of the authors and do not necessarily conform to positions of the editors or of the officers of the Division. Submission of Manuscripts 1. Manuscript submission is a representation that the manuscript is the author’s own work, has not been published, and is not currently under consideration for publication elsewhere. 2. Manuscripts must be prepared according to the recommendations in the Publication Manual of the American Psychological Association (Sixth Edition, 2009). 3. Each manuscript must have a cover sheet giving the names and affiliations of all authors and the address of the principal author. 4. Graphs and figures should be originals or sharp, high quality photographic prints suitable, if necessary, for a 50% reduction in size. 5. Five copies of the manuscript along with a transmittal letter should be sent to the Editor: Stanley H. Zucker, Mary Lou Fulton Teachers College, Box 871811, Arizona State University, Tempe, AZ 85287-1811. 6. Upon receipt, each manuscript will be screened by the editor. Appropriate manuscripts will then be sent to consulting editors. Principal authors will receive notification of receipt of manuscript. 7. The Editor reserves the right to make minor editorial changes which do not materially affect the meaning of the text. 8. Manuscripts are the property of ETADD for a minimum period of six months. All articles accepted for publication are copyrighted in the name of the Division on Autism and Developmental Disabilities. 9. Please describe subjects (or any other references to persons with disabilities) with a people first orientation. Also, use the term Љintellectual disabilityЉ (singular) to replace any previous term used to describe the population of students with significant limitations in intellectual functioning and adaptive behavior as manifested in the developmental period.
  • 133. Call for Papers 14th International Conference on Autism, Intellectual Disability & Developmental Disabilities Research to Practice January 23 - 25, 2013 Kona, Hawaii CEC’s Division on Autism and Developmental Disabilities (DADD) is hosting the 14th International Conference, which is both research and practitioner-focused. DADD welcomes the submission of innovative, evidence-based proposals within the following topical areas: Autism Spectrum Disorder Assistive & Adaptive Technology IBI & Other Interventions Intellectual Disability Mental Health/Dual Diagnosis Multiple Disabilities Paraprofessionals Parental Engagement/Advocacy Post-Secondary Transition Proposals (submitted in Word) should include the following information: Presenter name(s), affiliation, contact information (including e-mail) Session title, abstract (50 word maximum), and summary (300 word maximum), three learner outcomes, and information as to how the proposal addresses diversity Session format – poster session, lecture, or panel presentation Please submit proposals to: Cindy Perras, Conference Coordinator cindy.perras@cogeco.ca www.daddcec.org Submission Deadline: June 15, 2012

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