Transcript The Use of Technology : Promote Independence and Social

The Use of Technology
To Promote Independence and Social
Acceptance in Adolescences with Autism
Preparing Adolescents for
Adult Life
Transforming Possibilities into Abilities
PAAL
Preparing Adolescents for
Adult Life
Transforming Possibilities into Abilities
A unique ABA driven, community
based transition program targeting
quality of life as the outcome in
preparing for adulthood
THE USE OF BLUETOOTH
TECHNOLOGY
TO PROMOTE INDEPENDENT
RESPONDING IN THE COMMUNITY :
REDUCING STIGMA OF PROMPTING
Gloria Satriale, Esq., BCABA, PAAL
Kaori Nepo, M.Ed., BCBA, PAAL
Emily Genter, B.S., PAAL
Avi Glickman, B.A., PAAL
Bluetooth

Replication of the study (Satriale,
Chance, & Nepo, 2007)
Complexity of Community based
instruction
 Level of prompting and proximity of
instructors
 Perception in the community-stigma
associated with overt and conspicuous
level of prompting
 Social inclusion/community education

Bluetooth

Purpose:
To promote independence and increase
community acceptance of adolescents
with autism by fading proximity from
instructors using Bluetooth technology
Bluetooth

Target Behaviors
Purchasing in the community
 locate items
 wait in line
 paying with a credit card
 Job tasks
 shredding paper
 clean waiting room
 clean bathroom

Bluetooth

Participants-purchase
A 13 years old male student with
moderate to severe autism
 A 16 years old male student with
moderate to severe autism
 A 18 years old female student with
moderate to severe autism

 Participants-job
A
tasks
18 years old female student with
moderate to severe autism
Bluetooth-purchase

Procedure:

Multiple baseline design across three
behaviors
• Locating items within the aisle of the
•
•
store
Waiting in line in order to purchase
the items
Pay for the items
Bluetooth-job tasks

Procedure:

Multiple baseline design across three tasks
• shredding papers (shredding,
•
•
changing trash bag)
cleaning waiting room (cleaning
tables and windows)
Cleaning bathrooms (cleaning
mirrors, sink, and toilet)
Bluetooth

Data collection
Number of prompts for each step of the
TA for purchasing and job tasks in the
community
 Distance between the student and the
instructor
 IOA

Bluetooth

Baseline:
Participants wore an activated Bluetooth
on the ear and kept the paired cell phone
in the pocket
 Participants used written/picture lists or
priming before walking in to the store
 Instructor provided only physical prompts
(partial and/or full) as needed to complete
the TA for purchasing or job tasks

Bluetooth

Interventions:
Participants wore an activated Bluetooth
on the ear and kept the paired cell phone
in the pocket or purse
 The instructor provided verbal prompts via
cell phone connected to the participants
 If the participants did not respond to the
2 verbal prompts, the instructor provided
light physical guidance
 The proximity of the instructor was
gradually increased

Bluetooth
Bluetooth Results
Participant 1-Purchase
Bluetooth-Results
Locate Items (Participant 1)
# of p
distance
35
14
30
Frequency
25
10
20
8
15
6
4
10
2
5
0
0
0
5
10
15
Session
20
25
Distance (ft)
12
Bluetooth-results
Wait (participant 1)
# of p
distance
35
14
30
25
Frequncy
10
20
8
15
6
4
10
2
5
0
0
0
5
10
15
Session
20
25
Distance (ft)
12
Bluetooth-results
Purchase (participant 1)
# of p
distance
35
14
30
Frequency
25
10
20
8
15
6
4
10
2
5
0
0
0
5
10
15
Session
20
25
Distance (ft)
12
Locate Items (Participant 1)
# of p
distance
40
30
10
20
5
10
0
Distance
(ft)
Frequency
15
0
0
5
10
15
20
25
Session
Wait (participant 1)
40
30
10
20
5
10
0
Distance
(ft)
Frequncy
15
0
0
5
10
Session
15
20
25
Purchase (participant 1)
40
30
10
20
5
10
0
0
0
5
10
15
Session
20
25
Distance
(ft)
Frequency
15
Bluetooth Results
Participant 2-Purchase
Bluetooth-results
Locate Items (participant 2)
# of prompts
distance
50
14
45
Frequency
40
35
10
30
8
25
6
20
15
4
10
2
5
0
0
0
5
10
15
20
sessions
25
30
35
Distance (ft)
12
Bluetooth-results
Wait (Participant 2)
# of prompts
distance
40
14
Frequency
30
10
25
8
20
6
15
4
10
2
5
0
0
0
5
10
15
20
sessions
25
30
35
Distance (ft)
35
12
Bluetooth-results
Purchase (participant 2)
# of prompts
distance
14
40
12
35
Freqeuncy
25
8
20
6
15
4
10
2
5
0
0
0
5
10
15
20
sessions
25
30
35
Distance (ft)
30
10
Locate Items (participant 2)
# of prompts
distance
50
40
10
Distance
(ft)
Frequency
15
30
20
5
10
0
0
0
5
10
15
20
25
30
35
sessions
Wait (Participant 2)
# of prompts
distance
40
30
10
Distance
(ft)
Frequency
15
20
5
10
0
0
0
5
10
15
20
25
30
35
sessions
Purchase (participant 2)
# of prompts
distance
40
30
10
20
5
10
0
0
0
5
10
15
20
sessions
25
30
35
Distance (ft)
Freqeuncy
15
Bluetooth-video
Bluetooth Results
Participant 3-Purchase
Bluetooth-results
Locate Items (Participant 3)
# of prompts
distance
25
40
35
30
25
15
20
10
15
10
5
5
0
0
0
5
10
15
20
Session
25
30
35
40
Distance (ft)
Frequency
20
Bluetooth-results
Wait (participants 3)
# of prompts
distance
25
35
30
Frequency
25
15
20
15
10
10
5
5
0
0
0
5
10
15
20
Session
25
30
35
40
Distance (ft)
20
Bluetooth-results
Purchase (participants 3)
# of prompts
distance
25
35
Frequency
25
15
20
15
10
10
5
5
0
0
0
5
10
15
20
Session
25
30
35
40
Distance (ft)
30
20
Locate Items (Participant 3)
# of prompts
distance
25
40
30
15
20
10
10
5
0
0
0
5
10
15
20
Session
25
30
Wait (participants 3)
35
40
# of prompts
distance
25
40
20
30
15
20
10
10
5
0
Distance
(ft)
Frequency
Distance
(ft)
Frequency
20
0
0
5
10
15
20
25
30
35
40
Session
# of prompts
distance
25
40
20
30
15
20
10
5
10
0
0
0
5
10
15
20
Session
25
30
35
40
Distance (ft)
Frequency
Purchase (participants 3)
Bluetooth Results
Participant 3-Job Tasks
Bluetooth-results
Waiting Room
distance
25
25
20
20
15
15
10
10
5
5
0
0
0
2
4
6
8
Session
10
12
14
Distance (ft)
Frequency
# of p
Bluetooth-results
Shredding
distance
40
40
35
35
30
30
25
25
20
20
15
15
10
10
5
5
0
0
0
2
4
6
8
Session
10
12
14
Distance (ft)
Frequency
# of p
Bluetooth-results
Bathroom
# of p
distance
30
25
20
Frequency
20
15
15
10
10
5
5
0
0
0
2
4
6
8
Session
10
12
14
Distance (ft)
25
Waiting Room
# of p
distance
40
30
20
20
10
10
0
Distance
(ft)
Frequency
30
0
0
2
4
6
Session
8
10
Shredding
12
14
# of p
distance
40
30
20
20
10
10
0
0
0
2
4
6
Session
8
10
Bathroom
12
# of p
14
distance
30
40
30
20
20
10
10
0
0
0
2
4
6
Session
8
10
12
14
Distance
(ft)
Frequency
Distance
(ft)
Frequency
30
Bluetooth-Limitation
Require receptive language and level of
compliance-pre-teaching
 Sensitivity to Bluetooth-desensitization
program
 Prompt dependency
 Length of line may have affected data
 Prompts from cashier may have
affected data

Bluetooth-Future Consideration




Replication on various skills across a
greater number of individual and
settings
Combination with other technology
devices to fade proximity further
Investigation on social validity on stigma
associated with close proximity of
instructors
Dyads/triads instructions with Bluetooth
technology
THE USE OF AUDITORY
PROMPTS VIA MP4 PLAYER AND
IPOD ™
TO PROMOTE INDEPENDENT
ENGAGEMENT IN LEISURE/EXERCISE
ROUTINES
Avi Glickman, B.A., PAAL
Gloria Satriale, Esq., BCABA, PAAL
Kaori Nepo, M.Ed., BCBA, PAAL
Emily Genter, B.S., PAAL
MP4 player/ IPod ™

Community Based Instruction
Shaping/Chaining/Prompts
 Perception in the community
 Materials for organization and
independence


Alternative Interventions with
technology
Improved portability
 Less stigmatizing-community inclusion

MP4 player/ IPod ™

Purpose:
To facilitate independence and reduce stigma
associated with the close proximity of
instructors, the use of physical prompts, and
the need to carry adaptive material including
a timer, visual schedule, and pen during their
workout routines at the local fitness center.
MP4 player/ IPod ™

Participants:
1.
2.
3.
A 17 years old male student with
moderate to severe autism
A 18 years old male student with
moderate to severe autism
A 21 years old female student with
moderate to severe autism
MP4 player/ IPod ™

Procedure


Multiple baseline design with reversal
(ABAB) across participants
*ABCB for participant 3
Behaviors:

Following workout routines
 locating
equipment
 setting machine
 complete the exercise

Affect
MP4 player/ IPod ™

Data Collection:
Type and number of prompts required to
follow the TA for workout routines
 affect of students during the routines
(5 point scale:
)

MP4 player/ IPod ™

Baseline:
Participants wore the MP4 player watch or
IPod and earphones/headphones
connected to the device
 Use written schedule and a portable timer
to follow the workout schedule (checking
schedule, setting a timer,
 Partial and/full physical prompts were
provided as needed

MP4 player/ IPod

Intervention:
Participants wore the MP4 player watch or
IPod with earphones or headphones
connected to the device
 Verbal directions combined with highly
preferred music were given via MP4 player
or IPod
 Partial/full physical prompts were provided
as needed

Mp4 Player/ IPod™

Example of audio.
MP4 Player/IPod ™
Workout with MP4 Player (participant 1)
Percentage of Independent Completion
Baseline
MP4
w/o MP4
100
90
80
70
60
50
40
winter break
30
20
10
0
Sessions
MP4
MP4 player/ IPod ™
Workout with MP4 Player (participant 2)
Percentage of Independent Completion
w/o
100
90
80
70
winter break
60
50
40
30
20
Baseline
MP4 Player
10
0
Session
MP4
Percentage of Independent
Completion
Workout with MP4 Player (participant 1)
100
90
80
70
60
50
40
30
20
10
0
Baseline
MP4
MP4
w/o MP4
winter break
Sessions
Percentage of Independent
Completion
Workout with MP4 Player (participant 2)
100
90
80
70
60
50
40
30
20
10
0
w/o
winter break
Baseline
MP4 Player
Session
MP4
MP4 player/ IPod ™
Workout with IPod (participant 3)
CD player
w/o
IPOD
I POD/new routines
Percentage of Independent Completion
100
90
80
winter break
70
60
50
40
30
20
10
week off
0
session
IPOD
MP4 player/ IPod ™
Affect (Workout)
16
14
12
Frequency
10
without watch
8
with watch
6
4
2
0
1
2
3
4
5
MP4 player/ IPod ™
Affect (Workout)
6
Frequency
5
4
with watch
3
without watch
2
1
0
1
2
3
4
5
MP4 player-video
MP4 player/ IPod ™

Limitations
Require receptive language and level of
compliance
 Sensitivity to earphones/headphones
 Sensitivity to the watch
 Preference on music
 Initial intensive teaching
 Time consuming to program the watch or
IPod

MP4 player/ IPod ™

Future implications
Replication on various skills (c.f. cooking,
job tasks…) across settings
 Replication across greater number of
participants
 Further research on affects and music
across various skills (c.f. attention,
fluency, duration)
 Combination with other modes (c.f.
pictorial, textual)

THE USE OF VIDEO
MODELING
TO PROMOTE INDEPENDENCE IN SELF
CARING SKILLS OF ADOLESCENTS WITH
AUTISM
Kaori Nepo, M.Ed., BCBA, PAAL
Gloria Satriale, Esq., BCABA, PAAL
Emily Genter, B.S., PAAL
Avi Glickman, B.A., PAAL
Video Modeling
History:
Promising effectiveness of “video
modeling/video prompting” through
research studies (e.g. Bellini, 2007)

Social skills (Kimball, Kinney, Tayler, & Stromer, 2004)
 Complex play sequences (D’Ateno, Mangiapanello, &

Tayler, 2003)
Social language (Maione & Ayres, 2004)
 Perspective taking (Charlop-Christy & Daneshvar, 2003)
 Life skills (sigafoos et al, 2005, 2007)

Video Modeling

Variation in Video Modeling
 Variation in latency and frequency
 Variation in models (c.f. VM, VSM,
point of view models)
 Variation in instructions with video
modeling (c.f. chaining, leastmost/most-least prompting, shaping)
 Video prompting
Video Modeling
Benefit
 Rapid acquisition of skills
 Effective for both verbal and motor
responses
 Effective for NT population and people
with learning difficulties
 Fade one on one instructions
 Consistency of sequence/duration
Video Modeling

Technology-improved portability
MP4 player
 MP4 player Watch
 Portable DVD player
 Digital Picture frames
 PDA devices
 Cell phones (c.f. I Phone)
 IPODTM

Video Modeling

Adolescents Application:
To teach life skills to improve
independence and to increase social
acceptance
Domestic skills
 Self care skills
 Daily living skills
 Job tasks

Video Modeling

Purpose:
To improve independence of adolescents
with autism during showering and hygiene
routines using video modeling via digital
picture frames and portable DVD players
Video Modeling

Target Behaviors/Skills
Showering
 Brushing Teeth


Research Design


Multiple baseline across participants
Data collection

Number of prompts
VIDEO MODELING
SHOWERING
Video Modeling-Showering

Participants
A 17 years old female student diagnosed
with moderate to severe autism
 A 18 years old male student diagnosed
with moderate to severe autism

Video Modeling-showering

Baseline
Priming
 Textual (with pictorial for participant 1)
prompts for showering routines
 Partial and/or full physical prompts as
needed
 Verbal/social praise for
attempt/completion of the steps
 Delayed reinforcers upon completion of all
TA

Video Modeling-showering

Baseline Behaviors
Participant 1: required prompts to
complete all steps of the TA for washing
body parts
 Participant 2: required prompts to
complete all steps of the TA for washing
body parts

Video Modeling-showering

Interventions
Priming
 Video Modeling-visual prompts (VM/ VSM)
 Full/Partial prompts from behind
 Gestural prompts to attend to Video
 Systematic prompt fading
 Social praise for attempt/ completion of
the steps
 Delayed reinforcers upon completion of all
TA

Video Modeling-showering
VM-showering (participant 2)
100
Baseline
Percentage of Independent Completion
90
Video Modeling
80
70
60
50
40
30
20
10
0
0
2
4
6
8
session
10
12
14
16
Video Modeling-showering
VM –Showering (participant 2)
Percentage of Independent Completion
100
90
80
70
60
50
40
30
20
10
0
0
2
4
6
8
10
Session
12
14
16
18
100
Percentage of Independent
Completion
VM-showering (participant 2)
Baseline
Video Modeling
90
80
70
60
50
40
30
20
10
0
0
2
4
6
8
10
12
14
16
18
session
VM –Showering (participant 2)
Percentage of Independent
Completion
100
90
80
70
60
50
40
30
20
10
0
0
2
4
6
8
10
Session
12
14
16
18
VIDEO MODELING
TOOTH BRUSHING
Video Modeling-Tooth Brushing

Participants:
1.
2.
3.
A 16 years old female student with
moderate to severe autism
A 18 years old male student with
moderate to severe autism
A 13 years old male student with
moderate to severe autism
Video Modeling-Tooth Brushing

Baseline
Priming
 Textual (with pictorial for participant 1)
prompts for showering routines
 Partial and/or full physical prompts as
needed
 Verbal/social praise for
attempt/completion of the steps
 Delayed reinforcers upon completion of all
TA

Video Modeling-Tooth Brushing

Interventions
Priming
 Video Modeling-visual prompts
 Full/Partial prompts from behind
 Gestural prompts to attend to Video
 Systematic prompt fading
 Social praise for attempt/ completion of
the steps
 Delayed reinforcers upon completion of all
TA

Video Modeling-Tooth Brushing
Video Modeling-Tooth Brushing

Baseline Behaviors:
Participant 1: bite and suck on the tooth
brush
 Participant 2: 2 seconds of brushing,
starring the mirror, or bite the tooth brush
 Participant 3: starring the mirror and
required repeated prompts to start the
first step (up to 17 prompts)

Video Modeling-Tooth Brushing
Video Modeling-Tooth Brushing

Result
Participant 1: slow and steady
improvement on independent completion
of the TA
 Participant 2: significant improvement on
independent completion of the TA
 Participant 3:significant improvement on
independent completion of the TA

Video Modeling-results
Brush Teeth (participant 1)
Percentage of Independent Completion
100
90
80
70
60
50
40
30
20
10
0
0
5
10
15
20
Session
25
30
35
40
Video Modeling-results
Brush Teeth (participant 2)
Percentage of Independent Completion
70
60
50
40
30
20
Baseline
Video Modeling (VM)
10
0
0
2
4
6
8
10
Sessions
12
14
16
18
Video Modeling-results
Brush Teeth (participant 3)
VM
100
w/o
VM
Baseline
90
80
Percentage
70
60
50
40
30
20
Video Modeling (VM)
10
VM
0
0
10
20
30
Session
40
50
60
Percentage of
Independent Completion
Brush Teeth (participant 1)
Baseline
100
Video Modeling (VM)
80
60
40
20
0
0
5
10
15
20
25
30
35
40
Percentage
Percentage of
Independent Completion
Session
100
Brush Teeth (participant 2)
Baseline
VM
80
60
40
20
0
0
5
10
15
20
25
30
35
40
Sessions
w/o
VM
VM
100
80
60
40
20
0
w/o
VM
(participant 3)
Baseline
VM
VM
0
5
10
15
20
25
Session
30
35
40
45
50
Video Modeling-Tooth Brushing
Limitation
Time consuming
 Requires imitation skills/ visual
processing and motor coordination:
pre-teaching
 Requires sustained attention
 Requires level of compliance
 Fading prompts

Future Consideration





Oral motor imitation
Combination with auditory prompts
Further replication on daily living skills (c.f.
cooking) and job tasks across greater
number of students
Combine with other teaching procedure (c.f.
chaining)
Portability with MP4 player and other
technology devices for tremendous
possibilities
Web: www.researchautism.org
Peter F. Gerhardt, Ed.D., OAR
Web: MECAAutims.org
Gloria Satriale, Esq., BCABA, PAAL
[email protected]
Kaori G. Nepo, M.Ed., BCBA, PAAL
[email protected]
Avi Glickman, B.A., PAAL
[email protected]
Emily Genter, B.S., PAAL
[email protected]