Greetings: Video Social Stories via ipad for Children with Autism. Kathryn Young, B.S. Pamela Smith Ph.D, CCC-SLP

Transcription

1 Greetings: Video Social Stories via ipad for Children with Autism Kathryn Young, B.S. Pamela Smith Ph.D, CCC-SLP

2 Disclosure Statement Yes, I have financial or nonfinancial relationships relevant to the content of the presentation. Jessica S. and Stephen R. Kozloff Undergraduate Research Scholarship (Bloomsburg University of Pennsylvania).

3 What is Autism? Autism Spectrum Disorder (ASD) A spectrum of disorders Rett Syndrome Autistic Disorder Aspergers Pervasive Developmental Disorder Pervasive Developmental Disorder-Not Otherwise Specified Affects 1 in 110 children (CDC,2010) Broad definition Better efforts of diagnosis

4 DSM-V Change in criteria for diagnosis of ASD in new manual to be released in Asperger s Syndrome excluded. Social Communication Disorder is proposed; describes many of the social and language issues of those with ASD. ASD needs to be ruled out first.

5 Red Flags of ASD Difficulty expressing wants/needs Failure to use verbal gestures and/or facial expressions Little or no eye contact Non-responsiveness to verbal cues Difficulty interacting with others Severe to pervasive communication impairments (Autism Society, 2008; American Psychiatric Association, 2000; Murray, Ruble, Willis & Molloy, 2009; Crozier & Tincani, 2005; Hanley-Hochdorfer, Bray, Kehle & Elinoff, 2010).

6 Diagnosis Assessment of: Development of spoken language Inability to initiate or sustain a conversation with others Stereotyped and repetitive use of language Idiosyncratic language Lack of social imitative appropriate play (DSM-IV, 1994).

7 Role of Speech-Language Pathologist Pragmatics The language skills of communication; social How we organize our thoughts into utterances to communicate appropriately Overall therapy goal is to use pragmatics to become accepted, contributable members of society. Social Stories

8 What are Social Stories? Carol Gray Used to increase appropriate social behaviors in children with ASD. Allow for a transfer of stimulus in an individualized manner. Visual, situation-specific and explicit information. Teach relevant components of a given social situation in the story. Modifications

9 Social Story Structure Three types of sentences Descriptive Perspective Directive Ratio. Reading comprehension levels and child s inability to fully understand the complexity. (Crozier & Tincani, 2005; Gray, 2010, Crozier & Sileo, 2005; Hanley-Hochdorfer et al., 2010; Delano & Snell, 2006; Quirmbach, Lincoln, Feinber-Gizzo, Ingersoll, Andrew, 2008).

10 Guidelines of a Social Story Introduction, body and conclusion. Answer wh questions. Written from student s perspective. State behaviors positively. Geared towards individual s abilities and incorporates student s interests.

11 Research says Most successful when implemented in a private, individualized setting. (Adams et al., 2004; Scattone et al., 2006; Crozier & Tincani, 2005; Ozdemir, 2008). Focus on elementary and middle school children. (Delano & Snell, 2006; Crozier & Tincani, 2005; Scattone et al., 2006; Ozdemir, 2008). Picture incorporation into written Social Story. Pictures should only be permitted where they do not distract the child and do not restrict his or her ability to generalize the principle beyond the depicted situation (Ozdemir, 2008). Behavior is often not entirely extinguished. Positive social interactions.

12 Technology s role Combats limitations. Portability. Apple ipod Apple ipad Increased freedom for teachers and staff. Eliminates obtrusiveness of adult presence. Increased accessibility and affordability.

13 Video self-modeling and Social Stories Allows for incorporations of person s point of view. Visually comprehend material. Attend to one stimulus at a time. Combination of interventions allow for extra time to practice skills. Controlled and structured learning environment. (Ayres & Cihak, 2010; Charlop et al., 2010; Maione & Mirenda, 2006).

14 Purpose Examine whether using video Social Stories that specifically model a desired, appropriate behavior will increase the likelihood of the behavior occurring. Examine if children with Autism Spectrum Disorder could increase the consistency and frequency in which desired behavior occurs across contexts.

15 Methods Three elementary-age students Diagnosed with ASD Individualized Education Program in place Sunbury, Pennsylvania Participants met the following criteria: Diagnosed with ASD by physician or school psychologist Have an IEP goal designed to increase the child s use of social greeting Current use of inappropriate communication strategies to greet Have no documented hearing, vision, or fine motor impairments No tactile defensive behaviors (headphones) Written consent from parent(s), legal guardian(s) and teacher

16 Target behavior clipped using still shots of student engaging in appropriate behavior. Personalized videos One minute and twenty-four seconds Video downloaded onto Apple ipad

17 Experimental Design Multiple-baseline design across participants (ABAB design) A: no intervention/removal of intervention 10 consecutive school days B: Social Story/video intervention 15 consecutive school days Four contexts Bus Snack Lunch Dismissal

18 Coding

19 Social Validity Intervention Rating Profile-15 Martens & Witt, question Likert-type rating scale ranging from 1 (strongly disagree) to 6 (strongly agree) Ratings higher than 52.5 reflect a high degree of acceptability VonBrock & Elliott, 1987

20 Student 1

21 Demonstrated a high success rate as well as steady progress across all consecutive phases of intervention. Maintained a relatively high amount of successful attempts at communication when transitioning from intervention to baseline phases. Demonstrated most competencies viewing the video in the beginning of the day (bus) with a mean number of 3.7 desired behaviors. Demonstrated the least number of desired competencies at snack with a mean number of 1.1 desired behaviors.

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25 Student continues to respond to greets at the times of the day in which the intervention was implemented. Teacher reports to be working with student to carry the skill over to different times of the day. Initiates greeting 3/5 mornings Expansion

26 Student 2

27 Significant behavior problems unrelated to study. Demonstrated the highest amount of success in terms of engaging in the desired behavior in the last week of the study. Most success engaging in the desired behavior at dismissal time with a mean average of 3.9 behaviors. Least amount of success engaging in appropriate greetings during snack with a mean average of 0.9 behaviors.

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31 Student left IU classroom for a residential facility. Reported student continues to respond to greetings at all times of the day. Initiates greeting with another individual on an average of 5 times per week.

32 Student 3

33 Presented with much success at the end of intervention. Steady improvement in the number of desired behaviors demonstrated resulting in the highest number of appropriate behaviors. Maintained a relatively high number of desired behaviors between transitions of intervention phases. Most successful during dismissal time with a mean number of desired behaviors of 3.8. Second most successful context with a mean number of 3.1 desired behaviors occurred when the child got off the bus in the morning.

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37 Student continues to respond to greetings 50% of the time. If no response, needs multiple verbal prompts to respond. Continues to ask to watch the Social Story during the school day.

38 Social Validity Teacher indicated intervention was acceptable. Score was 81/90 indicating a score of agree or strongly agree across all items. I would suggest the use of this intervention to other teachers. The child s problem behavior is severe enough to warrant use of this intervention. I would be willing to use this intervention in the classroom setting. This intervention would be appropriate for a variety of children. This intervention is consistent with those I have used in classroom settings. I liked the procedures used in this intervention.

39 Conclusions All three students showed improvements across all phases of the intervention. Students improved their behavior in regards to greeting across all four contexts: bus, snack, lunch and dismissal. Teacher noted all students initiated greeting by waving, making eye contact as well as a few verbal responses. Study successfully taught students with ASD a new skill that they prior did not utilize in multiple contextual environments. Visual and auditory component combination.

40 Limitations Small sample size. Ceiling effect. Teacher s use of positive reinforcements may have had an effect on outcome. High level of motivation and prior exposure. Technology in the classroom. Future research is warranted. Requests. Conversation starters.

41 Thank you!