Browsing by Author "Stevens, Michelle"

Background Children with neurodevelopmental disorders often present with little or no speech. Augmentative and alternative communication (AAC) aims to promote functional communication using non‐speech modes, but it might also influence natural speech production. Method To investigate this possibility, we provided AAC intervention to two boys with neurodevelopmental disorders and severe communication impairment. Intervention focused on teaching the boys to use a tablet computer‐based speech‐generating device (SGD) to request preferred stimuli. During SGD intervention, both boys began to utter relevant single words. In an effort to induce more speech, and investigate the relation between SGD availability and natural speech production, the SGD was removed during some requesting opportunities. Results With intervention, both participants learned to use the SGD to request preferred stimuli. After learning to use the SGD, both participants began to respond more frequently with natural speech when the SGD was removed. Conclusion The results suggest that a rehabilitation program involving initial SGD intervention, followed by subsequent withdrawal of the SGD, might increase the frequency of natural speech production in some children with neurodevelopmental disorders. This effect could be an example of response generalization.

iPads® have been successfully used as speech-generating devices (SGD) for children with ASD and limited speech, but little research has investigated the use of iPads to enhance academic skills, such as picture/word matching. In the present study, a student with ASD received intervention to teach picture and word matching using an iPad-based SGD as the response mode. A multiple baseline across matching tasks design was used to evaluate the effects of a graduated guidance prompting procedure and differential reinforcement on correct matching across four matching tasks (i.e., picture to picture, word to picture, picture to word, and word to word). With intervention, the student showed increased correct matching across all four combinations, suggesting that picture and word matching with an iPad-based SGD can be successfully taught using graduated guidance and differential reinforcement. This approach might have relevance for teaching a range of academic/literacy skills to students with ASD who present with limited or no speech. While the use of new technologies to teach students with autism spectrum disorder (ASD) and related developmental disabilities (DD) is not a new concept, recent developments in mobile technologies, such as iPods® and iPads®, have been promoted through anecdotal reports and by the media as transforming teaching and learning for these students (Knight et al. 2013). As a result, there have been calls for researchers to provide empirical evidence that supports/refutes these claims. Indeed, two relevant reviews of the current literature have found an emerging research-base for the use of iPods/iPads in teaching programs for students with ASD/DD (Kagohara et al. 2013; Stephenson and Limbrick 2013). These reviews identified research conducted across various domains of learning, including: (a) academic, (b) communication, (c) employment, (d) leisure, and (e) transitioning across school settings. iPods/iPads have also been used as a platform to deliver self-prompting, such as through video-modeling (e.g., Alexander et al. 2013; Hart and Whalon 2012; Jowett et al. 2012) and to present interventions based on Social Stories™ (e.g., Vandermeer et al. 2013). To date, most research has investigated the utility of using iPods/iPads as speech-generating devices (SGD) to support the communication development of individuals with ASD/DD (e.g., Flores et al. 2012; McNaughton and Light 2013; van der Meer et al. 2013). Another emerging line of research has been to evaluate the effects of traditional (therapist implemented pencil/paper) versus iPad-assisted interventions to reduce challenging behavior and support academic engagement/task completion (e.g., Lee et al. 2013; Neely et al. 2013; O'Malley et al. 2014). Despite the growing literature on the use of iPods/iPads in interventions for individuals with ASD/DD, there are few studies investigating the use of these new technologies to teach specific academic skills (e.g., Kagohara et al. 2012a). Given this gap in the literature, there would seem to be some value in investigating the use of iPods/iPads for interventions targeting academic skills, such as literacy and numeracy (Knight et al. 2013; Stephenson and Limbrick 2013), given that the acquisition of such skills is an important aim of education/rehabilitation of persons with ASD and other DD (Pituch et al. 2010). Students with ASD/DD appear to require systematic instruction to support their communication/language, social, and academic progress (Lang et al. 2010; Lovaas 2003). It would therefore seem critical that such technology-based interventions use well-established instructional strategies, such as time-delay, response prompting, and differential reinforcement (Duker et al. 2004). Early language development and specifically vocabulary acquisition are of importance to both pre-literacy and literacy skills (Stoner et al. 2011). One strategy used to enhance vocabulary acquisition involves picture naming activities. A teacher might show a student a picture of an animal (e.g., a cow) and ask what it is. The student would respond by verbally naming the picture (e.g., It’s a cow), which is typically followed by praise (e.g., Yes, correct). Incorrect- or non-responses (e.g., It’s a pig) might be followed by error correction and prompts (e.g., Not quite, it is a cow. Say cow). Kagohara and colleagues (2012b) highlighted that students with ASD/DD who also have severe communication impairment are often excluded from such activities because they are not able to respond using intelligible speech. To overcome this barrier, they used an iPod-based SGD (Study 1) and iPad-based SGD (Study 2) as the response mode to teach picture naming. In their study, two participants were shown pictures and asked What do you see? Or What is this?. The students were taught to select the corresponding (but not identical) icon from the SGD screen to produce relevant voice-output (e.g., “It’s a penguin.”). This matching skill requires a type of conditional discrimination, specifically a non-identity matching-to-sample task (Reichle et al. 1991) because the training stimuli (pictures) and response form (icons on the screen of the SGD) are similar, but not identical. While Kagohara and colleagues identified that this skill is inherently different from typical picture naming tasks, where the training stimuli are unlike the response form (speaking the name of the picture), they suggested that it is nonetheless a useful approach to enable students with severe communication impairment to learn new vocabulary and participate in such academic/literacy building activities. There is a need for additional studies using sound research designs to implement technology-based interventions that target academic skills for students with ASD/DD (Knight et al. 2013; Pennington 2010). Therefore, the purpose of the present study was to extend previous research by using a single-case experimental design (Kennedy 2005) to assess whether the same systematic instructional strategies to teach picture naming/matching with an iPad-based SGD as the response mode (Kagohara et al. 2012b), can also be used to teach word to picture, picture to word, and word to word matching. We aimed to demonstrate effective procedures for teaching such skills to a student with ASD/DD who required the use of an alternative response mode due to severe communication impairment. Such a demonstration is important because targeting both picture and word matching has relevance to a range of academic/literacy skills and the technology may enable such students to participate in academic/literacy skills instruction that they might otherwise be excluded from.

Background Many children with autism spectrum disorder (ASD) have limited or absent speech and might therefore benefit from learning to use a speech‐generating device (SGD). The purpose of this study was to evaluate a procedure aimed at teaching three children with ASD to use an iPad®‐based SGD to make a general request for access to toys, then make a specific request for one of two toys, and then communicate a thank‐you response after receiving the requested toy. Method A multiple‐baseline across participants design was used to determine whether systematic instruction involving least‐to‐most‐prompting, time delay, error correction, and reinforcement was effective in teaching the three children to engage in this requesting and social communication sequence. Generalization and follow‐up probes were conducted for two of the three participants. Results With intervention, all three children showed improvement in performing the communication sequence. This improvement was maintained with an unfamiliar communication partner and during the follow‐up sessions. Conclusion With systematic instruction, children with ASD and severe communication impairment can learn to use an iPad‐based SGD to complete multi‐step communication sequences that involve requesting and social communication functions.

Autism spectrum disorder is characterized by social and communication impairment, but some children appear to have relative strength in areas such as reading printed words. The present study involved two children with limited expressive communication skills, but relatively stronger reading ability. Based on this existing strength, we evaluated a textual prompting procedure for teaching the children to produce multiword spoken requests. The effect of providing textual prompts on production of multiword requests was evaluated in an ABAB design. The results showed that multiword requests increased when textual prompts were provided and decreased when the prompts were removed. In subsequent phases, the textual prompts were successfully faded by gradually making the printed text lighter and lighter until eventually the prompts were eliminated altogether. We conclude that identification of children’s strengths may assist in identifying effective prompting procedures that could then be used in teaching functional communication skills.