Student Description:

Z is a 15-year-old female and is in 10th grade. She has multiple disabilities (Trisomy 12, a seizure disorder, and sleep disorder), and receives Special Education services in a self-contained Functional Life Skills classroom at a public high school, community-based instructional settings, and adapted inclusion classes. She uses a wheelchair (though can walk short distances independently), eats through a g-tube, and uses a communication device (Vantage). Her receptive communication is a strength, as she seems to understand what staff members say to her and will select choices when they are presented to her that seem to accurately reflect her desires and what she is feeling. (For instance, they do not seem to be random choices, or always the last option, etc.) She appears to enjoy being around her peers, and will watch them, smiling and laughing, as they engage with each other. However, she does not currently interact with her peers as she does not have a way to do so. She would greatly benefit from receiving instruction on how to request assistance, initiate communication, and engage in social conversations.

Skill Sequence:

IEP Objective (12 months): When in an inclusive environment (such as the classroom, chorus, or an after-school club) with peers who are engaging socially and her Vantage device within reaching distance, Z will select the symbol that says “Come here please”. Once a peer has approached her, Z will select the symbol that indicates her intended purpose (“I want to talk”, “Can I join?”, or “I need help”), and engage in a conversation of at least three back-and-forth exchanges by scrolling through the pages of her AAC device and selecting the appropriate relevant symbols, on 5 naturally occurring daily opportunities across 10 consecutive school days.

Benchmark (2 months): When in an inclusive environment (such as the classroom, chorus, or an after-school club) with peers who are engaging socially and her Vantage device within reaching distance, Z will select the symbol that says “Come here please”. Once a peer has approached her, Z will scroll through her AAC device and select the symbol that indicates her intended purpose (“I want to talk”, “Can I join?”, or “I need help”), on 5 naturally occurring daily opportunities across 10 consecutive school days.

Benchmark (2 weeks): When in an inclusive environment (such as the classroom, chorus, or an after-school club) with peers who are engaging socially and her Vantage device within reaching distance, Z will select the symbol that says “Come here please”, on 5 naturally occurring daily opportunities across 10 consecutive school days.

In this skill sequence, the most basic skill of requesting a person of interest to come over will be taught first. Initially this will occur in opportunities set up by staff, and staff members will be the initial people to respond to her need. As her competency improves, peers will be gradually incorporated. It is occur in this order to ensure that her need gets met immediately, and the person of interest must know that they are to go over to her as soon as she hits the symbol.

After this skill is mastered, she will be taught to indicate her intended purpose, or why she called a person over. This may include things such as wanting to have a conversation, wanting to join in a game or activity that peers are playing nearby, or needing help with something.

Finally, she will be taught to have a conversation of three back-and-forth exchanges related to her intended purpose. The specifics of instruction for this final IEP objective would depend on which purpose she was addressing. For instance, if she wanted to engage in a social conversation, she would learn to use her device to select symbols related to a topic of interest or what is going on in the room. If she needed help with something, she would learn to locate the symbols that indicated what she needed help with that would allow her to get that need met.

Research Description/Rationale:

Reichle, J., Dropik, P. L., Alden-Anderson, E., & Haley, T. (2008). Teaching a young child with autism to request assistance conditionally: A preliminary study. American Journal of Speech-Language Pathology, 17, 231-240.

This study shows the effectiveness of teaching a young child with autism to request assistance using a most-to-least prompting technique. The student was taught to request help in completing three different tasks, with the level of assistance fading gradually as he became more independent in his ability to ask for help. This type of intervention is applicable to this instructional program, because Z can be taught to use her device to request that a peer or teacher come over to her when she wants to engage in a conversation. Since she currently does not independently use her Vantage device, she will initially have to receive intrusive prompting, such as full or partial-physical prompts, which will then be faded gradually as her ability to perform the skill improves.

Boesch, M. C., Wendt, O., Subramanian, A., & Hsu, N. (2012). Comparative efficacy of the picture exchange communication system (PECS) versus a speech-generating device: Effects on requesting skills. Research in Autism Spectrum Disorders, 7, 480-493.

This study aimed to determine whether using PECS or a speech-generating device would be more effective in teaching students to make a request. Participants included three students who received instruction through a multiple baseline design (across participants). Both interventions began with physical prompts, and were faded as the students’ skill levels became more independent. The results showed that both PECS and an SGD are effective materials to use when teaching students to make a request. These results also support the effectiveness of beginning with more intrusive prompts and then fading them as the skill competency improves. This kind of prompting technique will be used with Z during skill instruction.

Description of AAC System/Materials:

Z will use her Vantage device for this instructional program. A Vantage is a high-tech AAC device that allows the user to scroll through different pages to select desired symbols. When the symbols are selected, a voice outputs the word or phrase associated with the symbol. Z currently owns and uses a Vantage, so she will be receiving instruction with materials that are familiar to her. Although she does not currently use the device very often, implementing this instruction will encourage her to use the device more frequently and also teach her that using it to communicate will allow her to get her wants and needs met more accurately and efficiently.

Baseline Data:

Date Trial 1 Trial 2 Trial 3 Trial 4 Trial 511/14/13 - - - - -11/15/13 - - - - -

Independent Requests

11/13/0

9

11/15/0

9

11/17/0

9

11/19/0

9

11/21/0

9

11/23/0

9

11/25/0

9

11/27/0

90

1

2

3

4

5

Number of Independent RequestsAimline

Context for Instruction:

Instruction will take place during naturally occurring opportunities throughout Z’s school day. For instance, inclusive classroom environments or after-school clubs where peers without disabilities are present are appropriate places that instruction could occur. Initially, teachers and staff will be the individuals who will respond to Z’s request, to ensure that the instruction is effective. Her peers will then receive training so that they are able to participate and so Z is able to communicate with a wider variety of individuals.

Program Objective:

When in an inclusive environment (such as the classroom, chorus, or an after-school club) with peers who are engaging socially and her Vantage device within reaching distance, Z will select the symbol that says “Come here please”, on 5 naturally occurring daily opportunities across 10 consecutive school days.

Rationale:

This skill was chosen because Z clearly shows an interest in her peers and a desire to engage with them. Observation data indicated that when her peers were talking, laughing, and engaging in social interactions in close proximity to Z, she was almost always watching them, smiling, and laughing. She looked as though she wanted to be a part of it. However, she currently does not interact with her peers, and does not consistently or independently use her Vantage device. Learning this skill will significantly increase her engagement with peers as well as teach her to use her AAC device more effectively.

Assessment Procedures:

Assessment will take place during naturally occurring opportunities during the school day, when Z is in an environment with peers who are engaging socially. Assessment procedures should occur as follows:

1. Make sure that Z’s Vantage device is placed within reaching distance either on her wheelchair tray or the table in front of her, depending on the context or activity in the environment.

2. Do not provide assistance or any type of prompt to Z.3. As Z watches her peers engage, observe whether she selects the symbol that says

“Come here please.”4. For each opportunity where Z selects the correct symbol, mark a plus on the data

sheet. For each opportunity where Z does not select the correct symbol, mark a minus on the data sheet.

Sample Data Sheet:

Date Trial 1 Trial 2 Trial 3 Trial 4 Trial 5(+/-) (+/-) (+/-) (+/-) (+/-)

Assessment Schedule:

Baseline will be taken across three days, or until the data are consistent. Once baseline data have been taken and instruction has begun, Z will be assessed every three days on five naturally occurring opportunities. Instruction will occur on 10 opportunities throughout the day, so the ratio of instruction to assessment will be 3:1.

Instructional Procedures:

Instruction will take place during naturally occurring opportunities throughout the day. Initially, opportunities will be created and occur with teachers, and once Z begins to show improvement in her ability to complete the skill, peers will be gradually included. The purpose of this is to ensure that as soon as Z hits the symbol that says “Come here please”, the individual will immediately come over to her. Instruction will occur in environments where social interaction is taking place, such as in inclusive classrooms, chorus, transitions between activities, or at after-school clubs. Instructional procedures should occur using a most-to-least prompting technique as follows:

1. Make sure that Z’s Vantage device is placed within reaching distance either on her wheelchair tray or the table in front of her, depending on the context or activity in the environment.

2. Observe Z as her peers engage socially around her, and notice as Z watches them and appears interested in engaging with them or having a conversation.

3. Using a hand-under-hand physical prompt, guide Z’s hand to select the symbol on her AAC device that says “Come here please”, while giving the verbal direction “Tell him/her to come over here if you want to talk.” Use this level of assistance for 10 opportunities each day for the first three days of instruction.

4. Beginning on the fourth day of instruction, use a partial-physical prompt to guide Z’s hand to select the symbol on her AAC device that says “Come here please”, while giving the verbal direction “Tell him/her to come over here if you want to talk.” Use this level of assistance for 10 opportunities each day for two days of instruction.

5. Beginning on the sixth day of instruction, use a direct verbal prompt to prompt Z to engage with her peers by giving the verbal direction “Tell him/her to

come over here if you want to talk.” Use this level of assistance for 10 opportunities each day for three days of instruction.

6. Beginning on the ninth day of instruction, use a gesture prompt by pointing at Z’s Vantage device and then looking over at her peers.

7. If at any point during instruction Z begins to make an error, provide a partial-physical prompt to guide her hand as error correction.

Reinforcement:

Initially, Z will receive verbal/social praise for each opportunity where she accurately completes the skill. As the prompt levels begin to become less intrusive and Z becomes more independent at completing the skill, reinforcement will be faded gradually. During partial-physical prompting, praise will be provided for every other correct opportunity. During direct verbal and gesture prompting, praise will be provided for every third correct opportunity. Reinforcement will be kept at that level until mastery.

Consideration of Preferences:

Although verbal praise will be provided as reinforcement, instruction will take place in environments that incorporate several of Z’s interests and preferred activities. For example, all opportunities will occur in social environments, some of which will likely include leisure activities. Z especially enjoys dancing, music, and drawing, so it is important that environments or after-school activities that involve these be considered when choosing where to implement instruction. If Z receives instruction in environments that incorporate her interests and preferred activities, she will likely be more willing and excited to interact with her peers who are engaging in these kinds of activities.

Generalization Plan:

To encourage Z to engage with a variety of individuals, instruction will occur in multiple environments. For example, she will receive instruction in inclusive academic environments, during chorus, at lunchtime, and at after-school activities that she is involved in. Initially, Z will receive instruction solely with teachers and staff members who are trained, so that she will receive immediate reinforcement when she hits the correct symbol. As soon as the Vantage device says “Come here please”, it is critical that the person of interest comes over to her immediately so that she is able to develop the association between touching that symbol and getting her needs met. As her skill level improves, students will be trained so that a wider variety of peers can participate. These considerations will allow Z to more easily generalize this skill across a variety of different environments and with a variety of teachers and peers. If she begins to over-generalize the skill, such as requesting “Come here please” almost constantly or at a very high frequency, delay for reinforcement will occur. She will still get her need met, but the

person of interest may say something such as “Just a minute, let me finish this and I’ll be right there.”

Maintenance:

This skill will be naturally maintained because Z will participate in a variety of environments with peers in which social engagement regularly occurs. Once the skill has been mastered, Z will be able to independently use her AAC device to request that a teacher or peer come over to her when she wants to have a conversation. However, maintenance will be tested every other week using the program’s assessment procedures.

References:

Boesch, M. C., Wendt, O., Subramanian, A., & Hsu, N. (2012). Comparative efficacy of the picture exchange communication system (PECS) versus a speech-generating device: Effects on requesting skills. Research in Autism Spectrum Disorders, 7, 480-493.

Reichle, J., Dropik, P. L., Alden-Anderson, E., & Haley, T. (2008). Teaching a young child with autism to request assistance conditionally: A preliminary study. American Journal of Speech-Language Pathology, 17, 231-240.