signifiying and indicating the effectiveness of using activity schedules in teaching individuals...

SIGNIFIYING AND INDICATING THE EFFECTIVENESS OF USING ACTIVITY SCHEDULES IN TEACHING

INDIVIDUALS WITH AUTISM

PS 572 Language and Social Skills for Individuals with Autism

June 11, 2008

Christeen Z. Scarpa

OVERVIEW

This literature review investigates the effectiveness of using activity schedules to teach individuals with autism. There is an abundance of literature and empirical evidence showing the success of the effectiveness when using activity schedules to help facilitate learning.

Leisure time (tv), self help (brushing teeth), and independent skills (puzzles).

Activity Schedules have also shown to be effective in not only promoting new skills in individuals with autism, but also in decreasing depression and self-injurious behaviors.

Nevertheless, there is a lack of literature and empirical evidence available on the effectiveness of activity schedules in teaching language and social skills.

ORGANIZATION

DefinitionTypes of Activity SchedulesInclusion of all relevant articlesDiscussionsCritique of LiteratureComparison with criteria for EBPFuture Research

PSYCINFO

psycINFO served as a useful tool in obtaining several current studies included in this literature review. However, psycINFO only provided current studies that focused mainly on the use of computer based technology activity schedules when teaching learners with autism. Research shows that computer use itself Research shows that computer use itself is reinforcing (Kimball et. al. 2003 & Stromer, et. al. is reinforcing (Kimball et. al. 2003 & Stromer, et. al. 2006)2006)

Included studies were also obtained through Jaba

DEFINITION AND TYPES OF ACTIVITY SCHEDULES

““An activity schedule is a set of An activity schedule is a set of pictures or words that cues someone pictures or words that cues someone to engage in a sequence of activities” to engage in a sequence of activities”

(McClannahan & Krantz, 1999)(McClannahan & Krantz, 1999)

• TYPESTYPES• PHOTOGRAPHICPHOTOGRAPHIC• WRITTENWRITTEN• AUDIOAUDIO

INCLUSION OF ALL RELEVANT ARTICLES

According to the Journal of Applied Behavior Analysis (JABA) over 400 results of studies have been published.

Showing the effectiveness of encouraging already learned skills and promoting likelihood of new skills.

ARTICLES

Teaching Children with Autism to Use Photographic Activity Schedules: Maintenance and Generalization of Complex Response Chains (MacDuff et al., 1993), The Effects of Sequential Pictorial Cues, Self-Recording, and Praise on the Job Task Sequencing of Retarded Adults (Connis, Richard T., 1979)Programming Participation In Family Activities For Children with Autism: Parents Use of Photographic Activity Schedules (Krantz et al., 1993)Focused on skills such as increasing social initiations, disruptive behaviors, independent on-task and on-schedule behaviorsThe literature clearly shows significant improvement in the increase of above mentioned target skills and the decrease of non functional behaviors.

Teaching Children with Autism to Use Photographic Activity Schedules: Maintenance and Generalization of Complex

Response ChainsGregory S. MacDuff, Patricia J. Krantz, and Lynn E. McClannahan, 1993

Purpose: To increase on task and on-schedule behavior using a photographic activity scheduleImportance of purpose: Many individuals with autism lack functional skills that increase self-care, work, and leisure activities without use of verbal prompts. “People with autism have difficulty acquiring lengthy response chains” (MacDuff et. al. 1993)Setting: Their residence: Community based Teaching-Family Model group homeParticipants: Mike & Walter age 9, Steve age 11, and Roy age 14

• All: diagnosed with autism• History of disruptive and stereotypic behaviors• Severe language deficits• Dependent on verbal prompts to complete self help or leisure

activities



Measurement of behaviors (DV): Focus on On-Task behavior

• Data collected: if learners visually attended to work materials, looked at photographic schedules, engaged in play or work appropriately, change from one activity to another.

• On-Schedule: Data scored moment of attending, engagement in activity shown on page of activity schedule



Intervention: sessions- 60m durations and began upon instructor instructions

Baseline: no prompts

Inappropriate behavior ignored

No instructor present

Teaching use of pictoral schedules:

Teacher gave instructor and waited 10s for a response

If no response, teacher manually guided (always from behind) child to activity schedule

Graduated guidance was used to help complete activity schedule and activities

Prompts were faded, when child engaged in on-task behavior for 80% of sessions (MacDuff et. al. 1993)

Procedures replicable



A Multiple baseline was used.

A functional relationship was illustrated because

“With each application of teaching pictorial schedules, on-task immediately increased for all youths” (MacDuff et. al. 1993)

Interobserver Agreement: 30%, (preferred at 33%) calculated by dividing # of (on-task, nonoccurrence of on-task, and on-schedule) agreements by the # of agreement plus disagreements and × by 100%,

Mean of on-task = 96%, nonoccurrence of on-task = 95, and on-schedule = 99

Treatment Integrity was not assessed, a section of study could have been conducted to take data on the instructors or therapists, helping avoid any bias or objective conduct, and help insure all

teaching procedures are consistent and conducted well



Social Validity: no mention, other teachers or parents could have been asked to observe and fill out a questionnaire on student performance

Generalization: Teacher absent, 2 novel activities of 6 original replaced

Data scored: if learners visually attended to work materials, looked at photographic schedules, engaged in play or work appropriately, change from one activity to another.

• On-Schedule: Data scored moment of attending, engagement in activity shown on page of activity schedule

• Mean: 99% for all students

• Maintenance: Last 5 sessions, no prompts

• Data collection same as generalization

• Except for Steve, all participants average at 99%



Results?

Was their analysis data appropriate?

Were findings in agreement with previous research?



Results: “Clinical data indicated that the participants learned to do a variety of recreational and home-living tasks” (MacDuff et. al. 1993)

Yes, appropriate

Yes, their findings where in agreement to previous research, having activity schedules increase likelihood of leisure, self-help, and independent skills.

However, perhaps further research can investigate social initiations and language skills in individuals with autism

The Effects of Sequential Pictorial Cues, Self-Recording, and Praise on the Job Task Sequencing

of Retarded Adults (Connis, Richard T., 1979)

Purpose: Using picture cues on independent task changes of four mentally retarded adults. (Connis, 1979)

Importance of purpose: Little research has been shown on the use of visual cues to instruct the mentally retarded individuals

Participants: Alice 24 yrs old, IQ of 50 on Wechsler Adult Intelligence Scale (WAIS) Bill 22 yrs old, IQ of 35 on Stanford-Binet Intelligence Scale, Chuck, 24 yrs old, WAIS IQ of 43, and Doug, 21 yrs. Old WAIS IQ of 48.

Setting: Vocational training program in University of Washington Campus

Measurement of Behavior (DV): Focus on Independent task change. “…beginning the correct assigned task without directives or instruction (Connis, 1979). Data recorded: correct if when task ended, learner correctly changed tasks

The Effects of Sequential Pictorial Cues, Self-Recording, and Praise on the Job Task Sequencing of Retarded Adults (Connis,

Richard T., 1979)

Intervention: Direction was given to begin task

Picture-cue training: managing changing tasks with photographs

Photographs represented task in a controlled sequence

Photos taped with a small blank paper underneath them on a visible wall in learner’s work domain

Instructions were given at beginning of work day of photographic use: walk to photos, look at correct photo, mark “X” on blank paper beneath photo, begin task presented in photo within a 40 sec time duration

Verbal feedback given periodically 9 (Connis, 1979)

Procedures replicable


Richard T., 1979)

Multiple Baseline Design was used.“The results indicate the effectiveness of pictorial cues and self-recording in increasing and maintaining independent task-change behavior.” (Connis, 1979)Functional Relationship showed that after intervention, target behaviors increased.Interobserver Agreement: 20% (not enough) dividing # of task-change agreements by the number of agreements + disagreements × 100%Mean of 98.9% for Alice, 100% for Bill, 97.8% for Chuck, and 98.5% for Doug

Treatment Integrity: No mention, a section of study could have been conducted to take data on the instructors or therapists, helping avoid any bias or objective conduct, and help insure all teaching procedures are consistent and conducted well


Richard T., 1979)

Social Validity: not assessed, novel teachers could have been asked to observe and fill out a questionnaire on student performance

Generalization: Learners not required to use photographs and self-recording system

Correct change of tasks without any cues, independent task change was recorded.

Maintenance: High levels of independent task change was measured.

Self-recording mean average of 98% across all students


Richard T., 1979)

Results?




Richard T., 1979)

“The results indicate the effectiveness of pictorial cues and self-recording in increasing and maintaining independent task change behavior” (Connis, 1979)

Yes, appropriate

Not much research have been conducted in finding for the use of visual cues to instruct the mentally retarded individuals

However, Learner’s memorized the task sequence and were no However, Learner’s memorized the task sequence and were no

longer guided by the photographic cues.longer guided by the photographic cues.

Programming Participation In Family Activities For Children with Autism: Parents Use of Photographic Activity Schedules Patricia J. Krantz, Michael T. MacDuff, and Lynn E. McClannahan, 1993

Purpose: Parents helping their children follow a photographic activity schedule showing different home living tasks

Importance of Purpose: “Many parents report that their youngsters with autism do not participate in family life … limiting their opportunities to undertake routine household tasks, to attend to other children, or to pursue community activities” (Krantz et al. 1993)

Participants: Jack, 8 yrs old., Jay, 6 yrs. Old, Miles, 7 yrs. Old

All had autism

All had pre-teaching to photographic activity schedules

Setting: private residence

Programming Participation In Family Activities For Children with Autism: Parents Use of Photographic Activity Schedules Patricia Patricia J. Krantz, Michael T. MacDuff, and Lynn E. McClannahan, 1993

Measurement of behaviors (DV): Focus on Engagement

Data collected: if learners visually attended to work materials, looked at photographic schedules, engaged in play or work appropriately, change from one activity to another.

Programming Participation In Family Activities For Children with Autism: Parents Use of Photographic Activity Schedules Patricia

Patricia J. Krantz, Michael T. MacDuff, and Lynn E. McClannahan, 1993

Intervention: modeling to parents how to use graduated guidance to teach use of photographic activity schedule Parents used their own strategies to care for the child with autism. (Krantz et al. 1993)Jack’s parents received 74 hrs of trainingJay’s parents received 90 hrs of trainingMile’s parents received 53 hrs of trainingSupervision and feedback given

These procedures are difficult to replicable



Multiple baseline ABC

Functional Relationship showed that after intervention, target behaviors increased.

Interobserver Agreement: assessed at 60% (enough), unclear on method of calculation.

Mean ranged form 79%-100%

Treatment Integrity: No mention, a section of study could have been conducted to take data on the instructors or therapists, helping avoid any bias or objective conduct, and help insure all teaching procedures are consistent and conducted well.

Social Validity: No mention, Independent observer could have assessed performance of parents



Generalization: No mention, intervention could have been implemented across novel settings and people.

Maintenance: data was collected, however, not much information regarding maintenance measurment

Observation sessions occurred daily during baseline and weekly during teaching and the first 2 to 3 weeks of maintenance. (Krantz et. al. 1993)



Results?





“Literature shows increases in engagement and decreases in disruptive behavior when parents taught their children to follow photographic activity schedules” (Krantz et al. 1993)

Yes, their data was appropriate

Yes

Pre-training may have assisted these children’s rapid behavior change

Example of Activity Schedule

Activity Schedule

CRITIQUE OF LITERATURE

Teaching Children with Autism to Use Photographic Activity Schedules: Maintenance and Generalization of Complex Response Chains (MacDuff et al., 1993),No resistance to manual guidance was recorded (could there have been tantrums?)After intervention, off-task was sometimes scored, Learner’s were not observed whether engagement in novel activities other than those depicted in activity schedules occurred.Little manual prompts given, perhaps of previously learned skills

CRITIQUE OF LITERATURE Cont’d

The Effects of Sequential Pictorial Cues, Self-Recording, and Praise on the Job Task Sequencing of Retarded Adults (Connis, Richard T., 1979)

Social Validity and Treatment Integrity were not assessed, therefore, any type of bias may be possible and social observations or assessment was not measured

“Future research may suggest that complete withdrawal of the package does not indicate clear response maintenance…and generalization programming” (Connis, 1979)

CRITIQUE OF LITERATURE Cont’d

Programming Participation In Family Activities For Children with Autism: Parents Use of Photographic Activity Schedules (Krantz et al., 1993)

Social Validity and Treatment Integrity were not assessed, therefore, any type of bias may be possible and social observations or assessment was not measured.

Generalization not mentioned and weak depiction of maintenance procedures

“Pre-training in the treatment setting may have facilitated these children’s rapid behavior change at home” (Krantz et al. 1993)

.

Comparison with Criteria for Evidence Based Practice

All literature conducted by a team of experts

All Peer-reviewed

Not all included treatment integrity, social validity, generalization, and no/weak maintenance procedures

All literature have interventions with important supporting evidence

No harm produced

Further research identified

ASSESSMENT AND FUTURE RESEARCH

The development of activity schedules began with the use of sequential picture cues to teach independence and on task behavior the mental retardation population. Autism professionals developed the use of picture cues and implemented them into activity schedules, having activity schedules a vital and efficient teaching tool. Peer reviewed literature research demonstrates that activity schedules are effective resources to teach various skills.Nevertheless, published research on activity schedules, particularly on their use for teaching social and language skills, is needed.Future research should examine different ways of teaching language and social skills through the use of many models of activity schedules.

References

Connis, R.T. (1979). The effects of sequential pictorial cues, self-recording, and praise on the job task sequencing of retarded adults. The Journal of Applied Behavior Analysis, 12, 355-361.

* Kimball, J.W., Kinney, E.M., Taylor, B.A., & Stromer, R. (2003). Lights, camera, action! Council for Exceptional Children, 36, 40-45.

Krantz, P. J., MacDuff, M. T., & McClannahan, L. E. (1993). Programming participation in family activities for children with autism: Parents' use of photographic activity schedules. Journal of Applied Behavior Analysis, 26(1), 137-138.

MacDuff, G.S., Krantz, P.J., & McClannahan, L.E. (1993). Teaching children with autism to use photographic activity schedules: Maintenance and generalization of complex response chains. The Journal of Applied Behavior Analysis, 26, 89-97.

McClannahan, L.E., & Krantz, P.J. (1999). Activity schedules for children with autism. Bethesda, MD: Woodbine.

* Stromer, R., Kimball, J.W., Kinney, E. M., & Taylor, B.A. (2006). Activity schedules, computer technology, and teaching children with autism spectrum disorder. Focus on Autism and Other Developmental Disabilities, 21, 14-24.

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