Shaping the Use of Sign Language for Learners with Autism

Transcription

1 Shaping the Use of Sign Language for Learners with Autism Sharon Zamrin Dana Jones Lancaster Lebanon Intermediate Unit Preschool Special Education Program Welcome Introductions Audience Role of the Pennsylvania Verbal Behavior Project National Autism Conference State College, PA August 8, 8 Overview Communication is a key defining deficit for children with autism Often teaching language is a challenging process This presentation will address how sign language can be used as a way of helping students with autism improve their functional communication skills Verbal Antecedent Behavior Consequence Operant Mand Tact Intraverbal Echoic Motivative Operation (wants cookie) Sensory Stimuli (sees or smells cookie) Verbal stimulus (someone says: What do you eat? ) Verbal Stimulus (someone says cookie ) Verbal behavior (says cookie ) Verbal behavior (says cookie ) Verbal behavior (says cookie ) Verbal behavior: repeats all or part of antecedent (says cookie ) Direct (gets cookie) (gets praised, for instance) (gets praised, for instance) (gets praised, for instance) Skill Antecedent Behavior Consequence Imitation/ Point to point correspondence (a.k.a. Mimetic) Receptive Match to sample (person performs an action, etc.) Verbal stimulus ( touch the cookie, where is the cookie?, can you find the cookie?, give me the cookie, etc.) (presentation of stimuli) with point to point correspondence (person imitates same action) (child touches, points to, gives the cookie) (in presence of one stimuli, a second stimuli is selected with shared properties). Manded stimulus selection. (example: praise; you re right!, great job, high five, pat on back, etc.) (example: praise; you re right!, great job, high five, pat on back, etc.) (example: praise; you re right!, great job, high five, pat on back, etc.) SELECTING A RESPONSE FORM Behavior analysis stresses the importance of a clear, measurable definition of what response will be targeted for Select which communication behaviors will be shaped and strengthened through Communication response forms such as vocal talk, sign language or use of a communication device, will differ significantly in the muscles used by the speaker

2 Spoken Language Topography Based Verbal Behavior Vocal Signing Written Selection Based Verbal Behavior Picture exchange Touch talkers and other devices Communication board Most commonly used response form with wide community of skilled listeners Free from environmental support: no materials or devices needed Spoken language allows instruction across all verbal operants without confounds related to multiple control Difficult to prompt oral/vocal motor movements May be difficult to teach if the child does not have at least a minimum level of echoic repertoire (can begin repeating words or sounds) Sign Language Picture Exchange Systems Motor movements can be prompted and prompts faded Signs often resemble what they communicate (iconicity) Like speech, signing is a topographical system: each sign consists of distinct movements Free from environmental support: no materials or devices needed Sign language allows instruction across all verbal operants without confounds related to multiple control Sign language is a language and has a community of speakers and listeners Staff need specific training in sign language There may be a limited community of natural speakers of sign language Lack of a minimum level of motor imitation can hinder more rapid acquisition of signs Scanning and pointing are the same for each verbal relation thus making response acquisition less complex For picture exchange systems, contact between listener and speaker is more direct (requires some degree of physical proximity.) Can be easily prompted Does not require use of the vocal musculature system May be more easily acquired with individuals who have significant motor skill deficits Free from problems related to fidelity of sound production (i.e., articulation problems) Extensive preparation of communication materials Symbols and pictures are more abstract for advanced language User must carry materials therefore limiting situations and environments where it can be used Communication becomes more difficult as language is acquired Increasingly more complex visual discrimination skills Responses involve match to sample and therefore tacts and intraverbals are not pure operants Relatively slow responding and limits the flow of communication Complex response form required Communication is limited to the store of items available Picture Selection with Vocal Output Keyboarding These devices can be programmed to produce a full range of spoken communication Scanning and pointing are the same for each verbal relation thus making response acquisition less complex Can be easily prompted Does not require use of the vocal musculature system May be more easily acquired with individuals who have significant motor skill deficits Voice activated devices must be programmed Electronic devises may be prone to breaking or not working properly Device must be programmed to allow full range of words student can use Skilled speakers must become technology savvy (must be able to navigate programs on device) Complex response form required Responding is slow and limits the natural flow of communication User must carry device Requires complex visual discrimination skills These devices can be programmed to produce a full range of written or, if voice activated, spoken communication Does not require use of the vocal musculature system Allows production of novel responses that do not require specific programming Requires skilled keyboarding skills (refined motor movements) Response is slow compared to signing and spoken and limits the natural flow of communication Electronic devices may be prone to breaking or not working properly Requires user to carry device therefore limiting situations and environments where it can be used Requires increasingly more complex visual discrimination skills

3 Considerations When Making Decisions in Selecting a Response Form The unique set of skills of the learner. The particular pattern of skill acquisition demonstrated by a student may be most easily identified through an analysis of a verbal behavior assessment protocol. The ease of use for the various response forms The degree to which the system allows development of a full range of verbal responses. The availability of instructional procedures to facilitate acquisition of verbal responses Considerations for Sign Language as a Response Form (Carbone, ) Obtain a sign manual or CD; take a signing course. Ensure that all people who interact regularly with the student are familiar with sign language Teach the first signs as mands Fade physical and gestural prompts when teaching signed mands. Ensure that the student has many opportunities to use signs for mands. Have data systems in place to count the frequency of signed mands and to record how many signed mands the student has acquired. Sign language training should be used in conjunction with echoic training and other procedures for teaching vocal responses. Teach signs across all the verbal operants. Student and Classroom Student Characteristics 6 year old boy with autism diagnosis In EI AS class second year (started January 6, years old) No previous services Primary focus of instruction is increasing verbal competence primarily for mands and tacts with ASL as primary response form When first enrolled almost no vocal behavior (silent when signing): non-vocal responder Long term goal to increase vocal responding Classroom Characteristics Year One VB Project class Dana Jones, Teacher; Robin Nice, SLP : pupil/teacher ratio ½ day class: ½ hours, days a week 6 students Adam: Initial Skill Pattern First ABLLS assessment completed March, 6: two months after beginning intervention Few cooperative behaviors; followed some directions to touch preferred items; either got desired items on his own or made requests with problem behavior (scream, etc) No imitation skills, no tacts, no intraverbals Frequent engagement in repetitive behaviors (moved items in a circular pattern) Little or no social initiation Initial Teaching Programs Approach behavior Increase cooperation Began mand training Early imitation training Some receptive skills Slow progress in first 6 to months

4 Initial Sign Language Instruction for Adam Identified items and activities Adam liked (informal; not many known reinforcers; limited interests) Staff learned these signs (Picture Plus Dictionary, McKinney, 997; Sign and Say Cards, Kaufman and Kaspar, 6) Staff paired model of these signs while freely delivering reinforcers; worked to increase approach behavior Introduced formal sign use training in mand frame (having him use signs to ask for what he wants, included prompt and prompt fading procedures.) Points to Remember When Teaching Early Signs Frequently pair model of sign and delivery of the reinforcer Use effective prompts and fade prompts as soon as possible Attend to the student s motivation! Selecting Targets for Early Mand Training with Signed Responses Chose items that are consumable, can be delivered multiple times in one session, and/or allow only short duration of contact Focus on teaching mands for items that the child consistently wants. Choose items that are easy to deliver Select words that are familiar to the child,. Consider signed words whose movements are easy to produce and easy to prompt Avoid selecting words that can be used to control multiple types of reinforcers (generalized mands). Possible Hierarchy for Prompts: Signed Mands Step Antecedent Behavior Consequence Child wants the ball (MO) Adult provides full hand over hand physical prompt for sign Child wants the ball (MO) Adult provides partial hand over hand physical prompt for sign (first step of prompt fade) Child wants the ball (MO) Adult prompts sign at wrist (partial physical prompt with fade) Signs ball Gets the ball Possible Hierarchy for Prompts: Signed Mands Step Antecedent Behavior Consequence Child wants the ball (MO) Adult prompts sign at elbow (partial physical prompt fade). Child wants the ball (MO) Adult moves hand toward child s arm but doesn t make contact (prompt fade) 6. Child wants the ball (MO) 7. Child wants the ball (MO) 8. Child wants the ball (MO) Signs ball Gets the ball Adam s Progress prior to September, 7 Motivated to request snacks Sign use was dependent on model prompt; not generalized Imitation became strong with verbal prompts (Sd was the model and telling him what to do) He probed through most imitation programs of ABLLS without formal teaching. Rate of mand and tact acquisition was slow.

5 Program Development in Fall of 7 Taught all signs in imitation first (Sd= do this Transferred accurately imitated signs to an intraverbal (SD= sign ) Then used intraverbal signed response as a prompt to teach mands and tacts. Steps: Imitation to Intraverbal to Mand Sequence In imitation program teach motions of sign Transfer Sd to sign (IV prompt) along with imitative model Transfer imitative response to Intraverbal response: Sign (Prompt, transfer trial, distracter, check) Use Intraverbal sign to prompt mand in condition when MO is present. (aside: this was also done for tacts) Video clips of procedure Mand Acquisition 6 Adam Mastered Mands.8 December 6 to August 7.6 September 7 to January 8 Number mastered Rate per Month # of Mastered Mands Dec-6 Feb-7 Apr-7 Jun-7 Aug-7 Oct-7 Dec-7 Feb-8 Apr-8 Date

6 Adam - Tacts July 7Aug 7 Sept 7 Oct 7 Nov 7 Dec 8 Jan # of Mastered Tacts per Month 8 Feb 8 Mar 8 Apr Month Initiating Vocal Response Training Video clips of Adam using signs As Adam acquired more facility at language an increase in his attempts to vocalize was noted (prior to September of 7 his rate of differentiated vocalization was low: dash ) Since he was vocalizing more, we began to teach vocal responding but did so systematically. Sign language was central to the process. Background on Sign to Vocal Procedure Dr. Vince Carbone lists ways to shape vocal responding in non-vocal students Stimulus-stimulus pairing: (pair vocal model with delivery of Sr+) Automatic Reinforcement Procedure Differential Sr+ of vocal with signers Echoic training (Kaufman procedures) For Adam of of these procedures (no ARP) have been used SLP Robin Nice consults on selection of targets/articulation sequence Current Programming Use of stimulus-stimulus pairing is primary intervention: informal shaping of vocal responses We also differentially reinforced reasonably accurate attempts to vocalize in mand frame More formal use of the differential procedure has been used. 6

7 Differential Reinforcement of Vocal Responding with Signed Mands Fairly complicated procedure Procedure likely has high probability of treatment drift or misinterpretation (note: minor revisions of procedural checklist occurred -8-8) Procedure required significant staff training: verbal review; model; role play practice; procedural checklist; performance based feedback) Review of Carbone/Kasper Guidelines for Differential Sr+ of Vocal Responding with Signed Mands Select strong signed mands When sign occurs, momentarily withhold Say the name of the reinforcer up to three times with a one second pause between each presentation Reinforce immediately delivering the item if an approximation is produced Reinforce after the third presentation, even if an approximation does not occur Procedural Integrity Checklist Adam: Differential Reinforcement of Vocal Responding with Signed Mands Instructor name: IOA check? yes no (with: ) Date:.Did you make sure all mand items are present during the session? Yes No.Did you have a variety of mand items available? Yes No. Did you confirm that an MO is in place for teaching items? Yes No. Did you check to be certain which mand items should be run as differential of vocal responding? Yes No. Did you have the word shells available? Yes No 6. Did you intersperse trials for items that are sign only for which we are not running the differential procedure? Yes No 7. Are you clear on the exact pronunciation of each word shell? Yes No 8. Did you hold up the item and get a clear an accurate sign response first? Yes No 9. If Adam responds with the target vocal response, did you reinforce immediately with greater quantity of reinforcer (better?) Yes No.If the target vocalization is not said immediately, did you present up to three times before reinforcing (but presentation with target response)? Yes No. Did you record data on the last level of word shell consistently emitted on first trial? Yes No. Did you remember to keep the sign strong? Yes No. Did you say the adult form when delivering the reinforcer? Yes No IOA on the Procedural Checklist Initial Version //7 8 of agree: 7% (TH &JK) /7/8 8 of agree: 7% (BC &SZ) /8/8 9 of agree: 8% (JW&MM) Post revision and training: /8/8 of agree: 8 % (JW&SZ) //8 of agree: 9% (TH&JK) //8 of agree: 9% (BC&JK) Date /7 /8 /9 / / BLOCK.Bah.bahk.bwahk X X.bu -lahk BALL. Bah. Bah -all. Ball X X X X COOKIE. U* X. U* -E X X X. Tu -tu. Tu -e. Tu -te 6. Ku -e 7. Ke -ke 8. ku -ke 9. Cookie JUICE. doo X X X. oos. doot. Doos. Joot 6. Juice YOGURT NoMO NoMo. Yo X. Yo -uh X X. Yo -u*t. Yo -ert. Yo -dert 6. Yogurt Initial Progress Data on Vocal Responding /8/8 Data from session: (note that data is taken only on highest level of performance Target Item Ball Block Juice yogurt cookie Highest Level reached in Session Ball No MO doo yo u 7

8 Considerations in developing procedure Signed mands for use in vocal training must be strong Need to continue broadening of Adam s repertoire through Imitation to Intraverbal to mand and tact sequence Ball ball bah all bah Yogurt Yogurt Yo- dert Yo- ert Yo u*t (pronounced as u in put ) Yo Cookie Cookie Ku-ke Ku-e Tu-te Tu-e Tu-tu U*-e U Juice Cookie Current Vocal Progress Block Series Yogurt Adam has continued to progress in acquiring signed responses for mands and tacts and some intraverbals Vocal progress has been slow Only one word mastered to criteria ball His rate of emitting vocal approximations has increased and has become more diversified (backpack = bah pah ) while signing. 8

9 Sign Language Resources Kaspar, T.S., & Kaufman, N. (6). K&K Sign and Say: shaping verbal language for individuals with Autism and other developmental challenges. Gaylord, MI: Northern Speech Services. Michigan State University (). Communication Technology Laboratory (Website). Your Dictionary.com (996-8) Website Gallaudet University Press, (). Signs of Life. ISBN Valli, C., Editor. (6). The Gallaudet Dictionary of American Sign. Gallaudet University Press. ISBN Riekoff, L.L. (987). The Joy of Signing, Second Edition. Gospel Publishing House. ISBN- 88 Mckinney, V. (997). The Picture Plus Dictionary. Butte Publications, Inc.: Hillsboro, OR. ISBN References Attanascio, V., Carbone, V.J., Delany, L., Zecchin, G., & Sweeney-Kerwin, E.J. (6). Increasing vocalizations of children with autism using sign language and mand training. Paper presented at the New York State Association for behavior Analysis, Verona, NY. Barrera, R.D., Lobato-Barrera, D., & Sulzer-Azaroff (98). A simultaneous treatment comparison of three expressive language training programs with a mute autistic child. Journal of Autism and Developmental Disorders,, -7. Barrera, R.D., & Sulzer-Azaroff (98). An alternating treatment comparison of oral and total communication training programs with echolalic autistic children. Journal of Applied Behavior Analysis, 6, Barrett, R.P., & Sisson, L.A., (987). Use of the alternating treatments design as a strategy for empirically determining language training approaches with mentally retarded children. Research in Developmental Disabilities, 8, -. Carbone, V.J., Lewis, L., Sweeney-Kerwin, E.J., Dixon, J., Louden, R., & Quinn, s. (6) A comparison of two approaches for teaching VB functions: Total communication vs. vocal-alone. Journal of Speech and Language Pathology and Applied Behavior Analysis,, 8-9. Carr, E. (979). Teaching autistic children to use sign language: some research issues. Journal of Autism and Developmental Disorders, 9, -9. Bennett, D. L., Gast, D. L., Wolery, M., & Schuster, J. (986). Time delay and system of least prompts: A comparison in teaching manual sign production. Education and Training of the Mentally Retarded, June, 7-9. Carr, E.G., & Kologinsky, E. (98). Acquisition of sign language by autistic children using a time delay procedure. Journal of Applied Behavioral Analysis, 6, 97-. Charlop-Christy, M., Carpenter, M. L., LeBlanc, L. A., & Kellet, K. (). Using the picture exchange communication system (PECS) with children with autism: Assessment of PECS acquisition, speech, social-communicative behavior, and problem behavior. Journal of Applied Behavior Analysis,, -. Charlop, M. H., Schreibman, L., & Thibodeau, M. G. (98). Increasing spontaneous verbal responding in autistic children using a time delay procedure. Journal of Applied Behavioral Analysis, 8, -66. Charlop, M. H. & Trasowech, J. E. (99). Increasing autistic children s daily spontaneous speech. Journal of Applied Behavioral Analysis,, Halle, J. W., Baer, D. M., & Spradline, J. E. (98). Teacher s generalized use of delay as a stimulus control procedure to increase language use in handicapped children. Journal of Applied Behavioral Analysis,, Halle, J.W., Marshall, A.M., & Spradlin, J.E. (979). Time delay: A technique to increase languae use and facilitate generalization in retarded children. Journal of Applied behavior Analysis,, -9. Ingemmey, R. & Houten, R.V. (99). Using time delay to promote spontaneous speech in an autistic child. Journal of Applied Behavior Analysis,, Kaspar, T.S., & Kaufman, N. (6). K&K Sign and Say: shaping verbal language for individuals with Autism and other developmental challenges. Gaylord, MI: Northern Speech Services. Kaufman, N. (99). Kaufman Speech Praxis Test for Children. Detroit: Wayne State University Press. Kaufman, N. (998). Speech Prxis Treatment Kit for Children. Gaylord, MI: Northern Speech Services. Mirenda, P. (). Toward functional augmentative and alternative communication for students with autism: Manual signs, graphic symbols, and voice output communication aids, Language, Speech, and Hearing Services in Schools,, -6. Mirenda, P., & Erickson, K. A.. (). Augmentative communication and literacy. In Wetherby, A. M., & Prizant, B. M. (Eds.), Autism spectrum disorders v 9 (pp. -67). Baltimore: Paul. H. Brookes. Ross, D.E. & Greer,R. D. () Generalized imitation and the mand: inducing first instances of speech in young children with autism. Research in Developmental Disabilities. () 8-7 Sundberg, M.L., Endicott, K,& Eidenheer,P. () Using Intraverbal prompts to establish tacts for children with autism. The Analysis of Verbal behavior 7, Tincani, M. (). Comparing picture exchange communication system and sign language training with children with autism. Focus on Autism and Other Developmental Disabilities, 9, -6. Yoder, P., & Layton, T. (989). Speech following sign language training in autistic children with minimal verbal language. Journal of Autism and Developmental Disorders, 8, 7-9. Young, J.M., Kranz, P.J., McClannahan,L.E., and Poulson, C.L. (99). Generalized imitation and response class formation in children with autism. Journal of Applied Behavior Analysis 7 (): Acknowledgments This presentation would not have been possible without the hard work and unending dedication of following people: Mike Miklos -our VB Project consultant and Behavior Analyst from Pattan Janine Wagg, Joyce Kaczinski, and Barb Curry - our classroom staff, who work with Adam and other children with autism, and love every minute of it! 9