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Educati<strong>on</strong> <strong>and</strong><br />
Training<br />
in<br />
Developmental<br />
Disabilities<br />
Focusing <strong>on</strong> individuals with<br />
cognitive disabilities/mental retardati<strong>on</strong>, autism, <strong>and</strong> related disabilities<br />
Volume 43 Number 3 September 2008
September 2008 Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities Vol. 43, No. 3, pp. 277–408
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities<br />
The <str<strong>on</strong>g>Journal</str<strong>on</strong>g> of <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities,<br />
The Council for Excepti<strong>on</strong>al Children<br />
Editor: Stanley H. Zucker<br />
Ariz<strong>on</strong>a State University<br />
C<strong>on</strong>sulting Editors<br />
Martin Agran<br />
Reuben Altman<br />
Phillip J. Belfiore<br />
Shar<strong>on</strong> Borthwick-Duffy<br />
Michael P. Brady<br />
Fredda Brown<br />
Mary Lynne Calhoun<br />
Shar<strong>on</strong> F. Cramer<br />
Caroline Dunn<br />
Lise Fox<br />
David L. Gast<br />
Herbert Goldstein<br />
Robert Henders<strong>on</strong><br />
Carolyn Hughes<br />
Larry K. Irvin<br />
James V. Kahn<br />
H. Earle Knowlt<strong>on</strong><br />
Barry W. Lavay<br />
Rena Lewis<br />
Kathleen J. Marshall<br />
Editorial Assistant: Hannah H. Hainline<br />
Ariz<strong>on</strong>a State University<br />
John McD<strong>on</strong>nell<br />
Gale M. Morris<strong>on</strong><br />
Gabriel A. Nardi<br />
John Nietupski<br />
James R. Patt<strong>on</strong><br />
Edward A. Polloway<br />
Thomas G. Roberts<br />
Robert S. Rueda<br />
Diane L. Ryndak<br />
Edward J. Sabornie<br />
Laurence R. Sargent<br />
Gary M. Sasso<br />
Tom E. C. Smith<br />
Scott Sparks<br />
Fred Spo<strong>on</strong>er<br />
Robert Stodden<br />
Keith Storey<br />
David L. Westling<br />
John J. Wheeler<br />
Mark Wolery<br />
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities is sent to all members of <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities of The Council<br />
for Excepti<strong>on</strong>al Children. All <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> members must first be members of The Council for Excepti<strong>on</strong>al Children. <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> membership dues<br />
are $25.00 for regular members <strong>and</strong> $13.00 for full time students. Membership is <strong>on</strong> a yearly basis. All inquiries c<strong>on</strong>cerning membership,<br />
subscripti<strong>on</strong>, advertising, etc. should be sent to <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities, 1110 North Glebe Road, Arlingt<strong>on</strong>, VA 22201.<br />
Advertising rates are available up<strong>on</strong> request.<br />
Manuscripts should be typed, double spaced, <strong>and</strong> sent (five copies) to <str<strong>on</strong>g>the</str<strong>on</strong>g> Editor: Stanley H. Zucker, Special Educati<strong>on</strong> Program, Box<br />
872011, Ariz<strong>on</strong>a State University, Tempe, AZ 85287-2011. Each manuscript should have a cover sheet that gives <str<strong>on</strong>g>the</str<strong>on</strong>g> names, affiliati<strong>on</strong>s, <strong>and</strong><br />
complete addresses of all authors.<br />
Editing policies are based <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> Publicati<strong>on</strong> Manual, <str<strong>on</strong>g>the</str<strong>on</strong>g> American Psychological Associati<strong>on</strong>, 2001 revisi<strong>on</strong>. Additi<strong>on</strong>al informati<strong>on</strong> is<br />
provided <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> inside back cover. Any signed article is <str<strong>on</strong>g>the</str<strong>on</strong>g> pers<strong>on</strong>al expressi<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> author; likewise, any advertisement is <str<strong>on</strong>g>the</str<strong>on</strong>g> resp<strong>on</strong>sibility<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> advertiser. Nei<str<strong>on</strong>g>the</str<strong>on</strong>g>r necessarily carries <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> endorsement unless specifically set forth by adopted resoluti<strong>on</strong>.<br />
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities is abstracted <strong>and</strong> indexed in Psychological Abstracts, PsycINFO, e-psyche, Abstracts<br />
for Social Workers, Internati<strong>on</strong>al <str<strong>on</strong>g>Journal</str<strong>on</strong>g> of Rehabilitati<strong>on</strong> Research, Current C<strong>on</strong>tents/Social <strong>and</strong> Behavioral Sciences, Excerpta Medica,<br />
Social Sciences Citati<strong>on</strong> Index, Adolescent Mental Health Abstracts, Educati<strong>on</strong>al Administrati<strong>on</strong> Abstracts, Educati<strong>on</strong>al Research Abstracts,<br />
<strong>and</strong> Language <strong>and</strong> Language Behavior Abstracts. Additi<strong>on</strong>ally, it is annotated <strong>and</strong> indexed by <str<strong>on</strong>g>the</str<strong>on</strong>g> ERIC Clearinghouse <strong>on</strong> H<strong>and</strong>icapped <strong>and</strong><br />
Gifted Children for publicati<strong>on</strong> in <str<strong>on</strong>g>the</str<strong>on</strong>g> m<strong>on</strong>thly print index Current Index to <str<strong>on</strong>g>Journal</str<strong>on</strong>g>s in Educati<strong>on</strong> <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> quarterly index, Excepti<strong>on</strong>al Child<br />
Educati<strong>on</strong> Resources.<br />
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities Vol. 43, No. 3, September 2008, Copyright 2008 by <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental<br />
Disabilities, The Council for Excepti<strong>on</strong>al Children.<br />
<str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities<br />
The Council for Excepti<strong>on</strong>al Children<br />
Board of Directors<br />
Officers<br />
Past President Polly Parrish<br />
President J. David Smith<br />
President-Elect Emily Bouck<br />
Vice President Teresa Taber-Doughty<br />
Secretary T<strong>on</strong>i Merfeld<br />
Treasurer Gardner Umbarger<br />
Members<br />
Linda Laz<br />
Nikki Murdick<br />
Robert S<strong>and</strong>ies<strong>on</strong><br />
Angie St<strong>on</strong>e-MacD<strong>on</strong>ald (Student Governor)<br />
Dianne Zager<br />
Debora Wichmanowski<br />
Executive Director<br />
Tom E. C. Smith<br />
Publicati<strong>on</strong>s Chair<br />
Jack Hourcade<br />
Communicati<strong>on</strong>s Chair<br />
Darlene Perner<br />
The purposes of this organizati<strong>on</strong> shall be to advance <str<strong>on</strong>g>the</str<strong>on</strong>g> educati<strong>on</strong> <strong>and</strong> welfare of pers<strong>on</strong>s with developmental disabilities, research in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
educati<strong>on</strong> of pers<strong>on</strong>s with developmental disabilities, competency of educators in this field, public underst<strong>and</strong>ing of developmental disabilities,<br />
<strong>and</strong> legislati<strong>on</strong> needed to help accomplish <str<strong>on</strong>g>the</str<strong>on</strong>g>se goals. The <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> shall encourage <strong>and</strong> promote professi<strong>on</strong>al growth, research, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
disseminati<strong>on</strong> <strong>and</strong> utilizati<strong>on</strong> of research findings.<br />
EDUCATION AND TRAINING IN DEVELOPMENTAL DISABILITIES (ISSN 1547-0350) (USPS 0168-5000) is published quarterly in<br />
March, June, September, <strong>and</strong> December, by The Council for Excepti<strong>on</strong>al Children, <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities, 1110 North<br />
Glebe Road, Arlingt<strong>on</strong>, Virginia 22201-5704. Members’ dues to The Council for Excepti<strong>on</strong>al Children <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental<br />
Disabilities include $8.00 for subscripti<strong>on</strong> to EDUCATION AND TRAINING IN DEVELOPMENTAL DISABILITIES. Subscripti<strong>on</strong> to<br />
EDUCATION AND TRAINING IN DEVELOPMENTAL DISABILITIES is available without membership; Individual—U.S. $40.00 per<br />
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POSTMASTERS: Send address changes to EDUCATION AND TRAINING IN DEVELOPMENTAL DISABILITIES, 1110 North Glebe<br />
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Educati<strong>on</strong> <strong>and</strong> Training in Developmental<br />
Disabilities<br />
Editorial Policy<br />
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities focuses <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> educati<strong>on</strong> <strong>and</strong><br />
welfare of pers<strong>on</strong>s with developmental disabilities. ETDD invites research <strong>and</strong><br />
expository manuscripts <strong>and</strong> critical review of <str<strong>on</strong>g>the</str<strong>on</strong>g> literature. Major emphasis is <strong>on</strong><br />
identificati<strong>on</strong> <strong>and</strong> assessment, educati<strong>on</strong>al programming, characteristics, training<br />
of instructi<strong>on</strong>al pers<strong>on</strong>nel, habilitati<strong>on</strong>, preventi<strong>on</strong>, community underst<strong>and</strong>ing <strong>and</strong><br />
provisi<strong>on</strong>s, <strong>and</strong> legislati<strong>on</strong>.<br />
Each manuscript is evaluated an<strong>on</strong>ymously by three reviewers. Criteria for acceptance<br />
include <str<strong>on</strong>g>the</str<strong>on</strong>g> following: relevance, reader interest, quality, applicability,<br />
c<strong>on</strong>tributi<strong>on</strong> to <str<strong>on</strong>g>the</str<strong>on</strong>g> field, <strong>and</strong> ec<strong>on</strong>omy <strong>and</strong> smoothness of expressi<strong>on</strong>. The review<br />
process requires two to four m<strong>on</strong>ths.<br />
Viewpoints expressed are those of <str<strong>on</strong>g>the</str<strong>on</strong>g> authors <strong>and</strong> do not necessarily c<strong>on</strong>form to<br />
positi<strong>on</strong>s of <str<strong>on</strong>g>the</str<strong>on</strong>g> editors or of <str<strong>on</strong>g>the</str<strong>on</strong>g> officers of <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g>.<br />
Submissi<strong>on</strong> of Manuscripts<br />
1. Manuscript submissi<strong>on</strong> is a representati<strong>on</strong> that <str<strong>on</strong>g>the</str<strong>on</strong>g> manuscript is <str<strong>on</strong>g>the</str<strong>on</strong>g> author’s<br />
own work, has not been published, <strong>and</strong> is not currently under c<strong>on</strong>siderati<strong>on</strong> for<br />
publicati<strong>on</strong> elsewhere.<br />
2. Manuscripts must be prepared according to <str<strong>on</strong>g>the</str<strong>on</strong>g> recommendati<strong>on</strong>s in <str<strong>on</strong>g>the</str<strong>on</strong>g> Publicati<strong>on</strong><br />
Manual of <str<strong>on</strong>g>the</str<strong>on</strong>g> American Psychological Associati<strong>on</strong> (Fifth Editi<strong>on</strong>, 2001).<br />
Laser or high density dot printing are acceptable.<br />
3. Each manuscript must have a cover sheet giving <str<strong>on</strong>g>the</str<strong>on</strong>g> names <strong>and</strong> affiliati<strong>on</strong>s of all<br />
authors <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> address of <str<strong>on</strong>g>the</str<strong>on</strong>g> principal author.<br />
4. Graphs <strong>and</strong> figures should be originals or sharp, high quality photographic<br />
prints suitable, if necessary, for a 50% reducti<strong>on</strong> in size.<br />
5. Five copies of <str<strong>on</strong>g>the</str<strong>on</strong>g> manuscript al<strong>on</strong>g with a transmittal letter should be sent to <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
Editor: Stanley H. Zucker, Special Educati<strong>on</strong> Program, Box 872011, Ariz<strong>on</strong>a<br />
State University, Tempe, AZ 85287-2011.<br />
6. Up<strong>on</strong> receipt, each manuscript will be screened by <str<strong>on</strong>g>the</str<strong>on</strong>g> editor. Appropriate<br />
manuscripts will <str<strong>on</strong>g>the</str<strong>on</strong>g>n be sent to c<strong>on</strong>sulting editors. Principal authors will receive<br />
notificati<strong>on</strong> of receipt of manuscript.<br />
7. The Editor reserves <str<strong>on</strong>g>the</str<strong>on</strong>g> right to make minor editorial changes which do not<br />
materially affect <str<strong>on</strong>g>the</str<strong>on</strong>g> meaning of <str<strong>on</strong>g>the</str<strong>on</strong>g> text.<br />
8. Manuscripts are <str<strong>on</strong>g>the</str<strong>on</strong>g> property of ETDD for a minimum period of six m<strong>on</strong>ths. All<br />
articles accepted for publicati<strong>on</strong> are copyrighted in <str<strong>on</strong>g>the</str<strong>on</strong>g> name of <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong><br />
Developmental Disabilities.
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities<br />
VOLUME 43 NUMBER 3 SEPTEMBER 2008<br />
Self-Determinati<strong>on</strong> in Relati<strong>on</strong> to Having or Not Having a Legal Guardian:<br />
Case Studies of Two School-Aged Young Adults with Developmental<br />
Disabilities 279<br />
DOROTHY SQUATRITO MILLAR<br />
Factors Impacting <str<strong>on</strong>g>the</str<strong>on</strong>g> Enactment of a Functi<strong>on</strong>al Curriculum in Self-<br />
C<strong>on</strong>tained Cross-Categorical Programs 294<br />
EMILY C. BOUCK<br />
Thirty Year Review of Safety Skill Instructi<strong>on</strong> for Pers<strong>on</strong>s with Intellectual<br />
Disabilities 311<br />
LINDA C. MECHLING<br />
Enhancing Social <strong>and</strong> Transiti<strong>on</strong> Behaviors of Pers<strong>on</strong>s with <strong>Autism</strong> through<br />
Activity Schedules: A Review 324<br />
DEVENDER R. BANDA, <strong>and</strong> ERIC GRIMMETT<br />
Therapeutic Interventi<strong>on</strong>s in <str<strong>on</strong>g>the</str<strong>on</strong>g> Ne<str<strong>on</strong>g>the</str<strong>on</strong>g>rl<strong>and</strong>s <strong>and</strong> Belgium in Support of<br />
People with Profound Intellectual <strong>and</strong> Multiple Disabilities 334<br />
CARLA VLASKAMP, <strong>and</strong> HAN NAKKEN<br />
Systematic Instructi<strong>on</strong> for Social-Pragmatic Language Skills in Lunchroom<br />
Settings 342<br />
MAUREEN E. ANGELL, RITA L. BAILEY, <strong>and</strong> LAURA LARSON<br />
Combined Curricular Interventi<strong>on</strong> with Brief H<strong>and</strong>s Down to Decrease H<strong>and</strong><br />
Mouthing <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> Use of Arm Splints for a Young Boy with Profound<br />
Disabilities 360<br />
HELEN I. CANNELLA-MALONE, MARK F. O’REILLY, JEFF SIGAFOOS, <strong>and</strong> JEFFERY M. CHAN<br />
Effects of a Reciprocal Questi<strong>on</strong>ing Interventi<strong>on</strong> <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> Questi<strong>on</strong> Generati<strong>on</strong><br />
<strong>and</strong> Resp<strong>on</strong>ding of Children with <strong>Autism</strong> Spectrum Disorder 367<br />
KELLY WHALON, <strong>and</strong> MARY FRANCES HANLINE<br />
Discriminati<strong>on</strong> Skills Predict Effective Preference Assessment Methods for<br />
Adults with Developmental Disabilities 388<br />
MAY S. H. LEE, DUONG NGUYEN, C. T. YU, JENNIFER R. THORSTEINSSON,<br />
TOBY L. MARTIN, <strong>and</strong> GARRY L. MARTIN<br />
Teaching Test-taking Strategies to Improve <str<strong>on</strong>g>the</str<strong>on</strong>g> Academic Achievement of<br />
Students with Mild Mental Disabilities 397<br />
ALLISON G. KRETLOW, YA-YU LO, RICHARD B. WHITE, <strong>and</strong> LUANN JORDAN<br />
Manuscripts Accepted for Future Publicati<strong>on</strong> in Educati<strong>on</strong> <strong>and</strong> Training in<br />
Developmental Disabilities 278<br />
The <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities retains literary property rights <strong>on</strong> copyrighted articles. Up to 100<br />
copies of <str<strong>on</strong>g>the</str<strong>on</strong>g> articles in this journal may be reproduced for n<strong>on</strong>profit distributi<strong>on</strong> without permissi<strong>on</strong> from <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
publisher. All o<str<strong>on</strong>g>the</str<strong>on</strong>g>r forms of reproducti<strong>on</strong> require permissi<strong>on</strong> from <str<strong>on</strong>g>the</str<strong>on</strong>g> publisher.
Manuscripts Accepted for Future Publicati<strong>on</strong> in Educati<strong>on</strong><br />
<strong>and</strong> Training in Developmental Disabilities<br />
December 2008<br />
N<strong>on</strong>c<strong>on</strong>tingent escape access to self-reinforcement to increase task engagement for students with<br />
moderate to severe disabilities. David Cihak <strong>and</strong> Robert I. Gama, University of Tennessee, A412<br />
Claxt<strong>on</strong> Complex, Knoxville, TN 37996-3442.<br />
Individuals with intellectual <strong>and</strong> developmental disabilities in <str<strong>on</strong>g>the</str<strong>on</strong>g> criminal justice system <strong>and</strong><br />
implicati<strong>on</strong>s for transiti<strong>on</strong> planning. Tammy Smith, Edward A. Polloway, James R. Patt<strong>on</strong>, <strong>and</strong> Julia<br />
F. Beyer, Office of Graduate Studies, Lynchburg College, Lynchburg, VA 24501.<br />
Enhancing <str<strong>on</strong>g>the</str<strong>on</strong>g> job performance of employees with disabilities using <str<strong>on</strong>g>the</str<strong>on</strong>g> Self-Determined Career<br />
Development Model. Patricia Devlin, The University of Toledo, 2801 W. Bancroft Street, Mail Stop<br />
#106, Toledo, OH43606-7736.<br />
Effectiveness of discrete trial teaching with preschool students with developmental disabilities.<br />
Andrew Downs, Robyn C<strong>on</strong>ley Downs, Michelle Fossum, <strong>and</strong> Kathryn Rau, Department of Psychology,<br />
Central Washingt<strong>on</strong> University, 400 E. University Way, Ellensburg, WA 98926-7575.<br />
High tech cooking: A literature review of evolving technologies for teaching a functi<strong>on</strong>al skill.<br />
Linda C. Mechling, University of North Carolina Wilmingt<strong>on</strong>, 601 S. College Road, Wilmingt<strong>on</strong>,<br />
NC 28403-5940.<br />
Attitudes of Israeli teachers <strong>and</strong> paraprofesi<strong>on</strong>als towards <str<strong>on</strong>g>the</str<strong>on</strong>g> new definiti<strong>on</strong> of ID <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
willingness to cope with special educati<strong>on</strong> law changes. Hefziba Lifshitz, Shoshanna Nissim, <strong>and</strong><br />
Sara Cohen, Bar-Ilan University, School of Educati<strong>on</strong>, Ramat-Gan, 52900, ISRAEL.<br />
A distributive model of treatment acceptability. Stacy L. Carter, 4518 20th St., Lubbock, TX 79407.<br />
Staff variables that influence resp<strong>on</strong>ses to challenging behaviour of clients with intellectual<br />
disability: A review. Greet Lambrechts, Katja Petry, <strong>and</strong> Bea Maes, Katholieke Universiteit Leuven,<br />
Faculty of Psychology & Educati<strong>on</strong>al Sciences, Vesaliusstraat 2, B-3000 Leuven, BELGIUM.<br />
Using literacy-based behavioral interventi<strong>on</strong>s <strong>and</strong> social stories to improve work behavior in<br />
employees with developmental disabilities. Jessica Bucholz, Michael P. Brady, Mary Lou Duffy, Jack<br />
Scott, <strong>and</strong> Larry G. K<strong>on</strong>tosh, University of West Georgia, Department of Special Educati<strong>on</strong>, <strong>and</strong><br />
Speech-Language Pathology, Carrolt<strong>on</strong>, GA 30118-5140.<br />
Implementati<strong>on</strong> of a programme for students with profound intellectual <strong>and</strong> multiple disabilities<br />
in schools: Three case studies. Annemarie C. Tadema, Carla Vlaskamp, <strong>and</strong> Wied Ruijssenaars,<br />
University of Gr<strong>on</strong>ingen, Department of Special Educati<strong>on</strong>, Grote Rozenstraat 38, Gr<strong>on</strong>ingen,<br />
9712 TJ, The NETHERLANDS.<br />
Teaching grocery store purchasing skills to students with intellectual disabilities using a computerbased<br />
intructi<strong>on</strong> program. David L. Hansen <strong>and</strong> Robert L. Morgan, Department of Special<br />
Educati<strong>on</strong> <strong>and</strong> Rehabilitati<strong>on</strong>, Utah State University, 2865 Old Main Hill, Logan, UT 84322-2865.<br />
Caregiver-delivered home-based instructi<strong>on</strong> using simultaneous prompting for teaching home<br />
skills to individuals with developmental disabilities. Sema Batu, Anadolu Universitesi, Engelliler<br />
Arastirma Enstitusu, Eskisehir, 26470, TURKEY.<br />
Address is supplied for author in boldface type.
Self-Determinati<strong>on</strong> in Relati<strong>on</strong> to Having or Not Having a<br />
Legal Guardian: Case Studies of Two School-Aged Young<br />
Adults with Developmental Disabilities<br />
Dorothy Squatrito Millar<br />
Saginaw Valley State University<br />
Abstract: IDEA m<strong>and</strong>ates that all rights accorded to parents transfer to students when <str<strong>on</strong>g>the</str<strong>on</strong>g>y reach <str<strong>on</strong>g>the</str<strong>on</strong>g> age of<br />
majority, unless <str<strong>on</strong>g>the</str<strong>on</strong>g>ir competence is questi<strong>on</strong>ed. Using case studies, this research examined <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>cern that when<br />
competence is challenged, guardian appointments may occur, thus negatively impacting <str<strong>on</strong>g>the</str<strong>on</strong>g> self-determinati<strong>on</strong><br />
of school-aged young adults who have developmental disabilities. The assumpti<strong>on</strong> that a young adult who had<br />
a full legal guardian would exhibit fewer, if any, self-determinati<strong>on</strong> skills in comparis<strong>on</strong>s to a peer who did not<br />
have a legal guardian was investigated. Findings include (a) values, beliefs, <strong>and</strong> knowledge impact guardian<br />
roles, <strong>and</strong> (b) more research is needed to determine <str<strong>on</strong>g>the</str<strong>on</strong>g> impact IDEA age of majority <strong>and</strong> transfer of rights<br />
m<strong>and</strong>ates are having <strong>on</strong> families as well as school, law, <strong>and</strong> agency service providers’ interpretati<strong>on</strong>s <strong>and</strong><br />
acti<strong>on</strong>s.<br />
The importance of developing self-determinati<strong>on</strong><br />
related attributes in youth <strong>and</strong> young<br />
adults with disabilities is emphasized in legislati<strong>on</strong><br />
(e.g., IDEA; Rehabilitati<strong>on</strong> Act Amendments<br />
of 1992 <strong>and</strong> 1998), as well as in an<br />
abundance of literature (e.g, Algozzine, Browder,<br />
Karv<strong>on</strong>en, Test, & Wood, 2001; Test,<br />
Fowler, Brewer, & Wood, 2005). In additi<strong>on</strong>,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>re is a growing body of research which is<br />
providing evidence that self-determinati<strong>on</strong><br />
does positively impact employment outcomes<br />
(Wehmeyer & Palmer, 2003); post sec<strong>on</strong>dary<br />
educati<strong>on</strong> (Field, Sarver, & Shaw, 2003); <strong>and</strong><br />
overall quality of life (Wehmeyer & Schwartz,<br />
1997). Despite <str<strong>on</strong>g>the</str<strong>on</strong>g> efforts directed toward promoting<br />
<strong>and</strong> increasing self-determinati<strong>on</strong> of<br />
youth <strong>and</strong> young adults with disabilities such<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g>y can communicate <str<strong>on</strong>g>the</str<strong>on</strong>g>ir preferences,<br />
interests, <strong>and</strong> advocate for <str<strong>on</strong>g>the</str<strong>on</strong>g>mselves, little is<br />
known about how self-determinati<strong>on</strong> is being<br />
impacted at <str<strong>on</strong>g>the</str<strong>on</strong>g> time students reach <str<strong>on</strong>g>the</str<strong>on</strong>g> age of<br />
majority, <strong>and</strong> become legally resp<strong>on</strong>sible for<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir decisi<strong>on</strong>s <strong>and</strong> acti<strong>on</strong>s. When a student<br />
reaches <str<strong>on</strong>g>the</str<strong>on</strong>g> age of majority, IDEA m<strong>and</strong>ates<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cerning this article should<br />
be addressed to Dorothy Squatrito Millar, Saginaw<br />
Valley State University, College of Educati<strong>on</strong>, 7400<br />
Bay Road, University Center, MI 48710.<br />
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities, 2008, 43(3), 279–293<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities<br />
that all <str<strong>on</strong>g>the</str<strong>on</strong>g> rights accorded to <str<strong>on</strong>g>the</str<strong>on</strong>g> parents are<br />
to transfer to <str<strong>on</strong>g>the</str<strong>on</strong>g> student unless <str<strong>on</strong>g>the</str<strong>on</strong>g> student is<br />
determined to be incompetent by State law, or<br />
c<strong>on</strong>sidered unable to provide informed c<strong>on</strong>sent<br />
with respect to educati<strong>on</strong>al programming.<br />
When competence is in questi<strong>on</strong>, States<br />
are resp<strong>on</strong>sible for establishing procedures<br />
for appointing an individual (e.g., parent) to<br />
represent <str<strong>on</strong>g>the</str<strong>on</strong>g> educati<strong>on</strong>al interests of <str<strong>on</strong>g>the</str<strong>on</strong>g> student<br />
[614(d)(1)(A)VIII].<br />
To date, <str<strong>on</strong>g>the</str<strong>on</strong>g>re is no known investigati<strong>on</strong><br />
that examines <str<strong>on</strong>g>the</str<strong>on</strong>g> procedures States have established<br />
to address <str<strong>on</strong>g>the</str<strong>on</strong>g> m<strong>and</strong>ate, who is determining<br />
competence, how it is being determined,<br />
<strong>and</strong> what criteria is being used to<br />
determine it. C<strong>on</strong>cern has been raised that<br />
when students are reaching <str<strong>on</strong>g>the</str<strong>on</strong>g> age of majority,<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir competence is questi<strong>on</strong>ed,<br />
guardian appointments might be unnecessarily<br />
sought (Millar, 2007, 2003; Millar & Renzaglia,<br />
2002). As it applies to adults, guardianship<br />
is a process when a judge appoints<br />
some<strong>on</strong>e (a guardian) to make decisi<strong>on</strong>s for<br />
<strong>and</strong> h<strong>and</strong>le <str<strong>on</strong>g>the</str<strong>on</strong>g> affairs of ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r (a ward)<br />
who is believed “partially” or “totally” incompetent<br />
(Bulcroft, Kielkopf, & Tripp, 1991; Lisi,<br />
Burns, & Lussenden, 1994). Dependent <strong>on</strong> a<br />
court order, guardians can assume complete<br />
or limited c<strong>on</strong>trol over decisi<strong>on</strong>s related to <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
ward’s residence, educati<strong>on</strong>al services, voca-<br />
Self-Determinati<strong>on</strong> <strong>and</strong> Guardianship / 279
ti<strong>on</strong>al training, medical treatment, <strong>and</strong> participati<strong>on</strong><br />
in c<strong>on</strong>tracts (Lisi et al.).<br />
It is important to emphasize that legislati<strong>on</strong>,<br />
which is created by each state, has differing<br />
levels <strong>and</strong> scope of guardianship. It might be<br />
expected, <str<strong>on</strong>g>the</str<strong>on</strong>g>refore, that individuals who exhibit<br />
few if any self-determinati<strong>on</strong> skills would<br />
need a full (plenary) guardian to make <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
majority or all decisi<strong>on</strong>s for <str<strong>on</strong>g>the</str<strong>on</strong>g>ir ward, in<br />
c<strong>on</strong>trast to individuals displaying some selfdeterminati<strong>on</strong><br />
skills who would be appointed<br />
a limited guardian to make decisi<strong>on</strong>s <strong>on</strong> specific<br />
issues (e.g., financial decisi<strong>on</strong>s) (Stancliffe,<br />
Abery, Springborg, & Elkin, 2000). It<br />
may also be expected that an individual who<br />
does not need or have a guardian exhibits<br />
self-determinati<strong>on</strong> skills. Essentially, individuals<br />
who have a full or partial guardian could<br />
be perceived as having no or limited capability<br />
to provide informed c<strong>on</strong>sent or to exercise<br />
c<strong>on</strong>trol over <str<strong>on</strong>g>the</str<strong>on</strong>g>ir life in comparis<strong>on</strong> to pers<strong>on</strong>s<br />
without guardians (Abery & Stancliffe,<br />
1996).<br />
Interestingly, <str<strong>on</strong>g>the</str<strong>on</strong>g> research <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> extent to<br />
which guardian appointments impact self-determinati<strong>on</strong><br />
is limited, <strong>and</strong> in many instances<br />
dated. In <strong>on</strong>e topic related study, Lindsey <strong>and</strong><br />
Luckass<strong>on</strong> (1991) suggested that service providers<br />
frequently allowed or encouraged family<br />
members to make decisi<strong>on</strong>s as if <str<strong>on</strong>g>the</str<strong>on</strong>g>y were<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> guardian for an individual with a disability<br />
who did not legally have <strong>on</strong>e appointed. This<br />
suggests that some equate disability with incompetence<br />
<strong>and</strong> limited ability. In ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
study, Lindsey (1994) evaluated 69 adults, who<br />
had developmental disabilities capacity to give<br />
informed c<strong>on</strong>sent to community residential<br />
placements. In this study, it was found that<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>re were no significant differences regarding<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> ability to give informed c<strong>on</strong>sent between<br />
individuals who ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r had or did not<br />
have a court appointed guardian. This brings<br />
to questi<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> need of legal guardian appointments.<br />
In a more recent study, Stancliffe,<br />
et al. (2000) attempted to compare self-determinati<strong>on</strong><br />
competencies dem<strong>on</strong>strated by<br />
adults with disabilities by using results from<br />
self-determinati<strong>on</strong> related scales completed by<br />
residential agency care providers. Stancliffe et<br />
al. anticipated that adults with disabilities who<br />
had no guardian would be perceived as exhibiting<br />
more self-determinati<strong>on</strong> competencies<br />
<strong>and</strong> c<strong>on</strong>trol over <str<strong>on</strong>g>the</str<strong>on</strong>g>ir lives in comparis<strong>on</strong> to<br />
280 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir peers who had guardians. Findings revealed<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> level of pers<strong>on</strong>al c<strong>on</strong>trol exhibited<br />
by 76 adults (ages ranging between<br />
20.8 to 71.7, with <str<strong>on</strong>g>the</str<strong>on</strong>g> average age of 37.3, sd <br />
11.6; full IQ mean scores ranging from 42.3 to<br />
62.6) who did not have guardians were perceived<br />
by agency pers<strong>on</strong>nel as higher than<br />
those individuals who had ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r partial or full<br />
guardians. The authors c<strong>on</strong>cluded that <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
findings “provide objective evidence that individuals<br />
with less restrictive substitute decisi<strong>on</strong>making<br />
arrangements actually do exercise<br />
greater c<strong>on</strong>trol over <str<strong>on</strong>g>the</str<strong>on</strong>g>ir lives.” (p. 417).<br />
Given <str<strong>on</strong>g>the</str<strong>on</strong>g> findings of <str<strong>on</strong>g>the</str<strong>on</strong>g> studies noted above,<br />
it is clear that more research is necessary that<br />
examines <str<strong>on</strong>g>the</str<strong>on</strong>g> complexity of guardianship.<br />
Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r, when c<strong>on</strong>sidering IDEA, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
impact guardian appointments may or may<br />
not have <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> rights of individuals, it is clear<br />
that research in <str<strong>on</strong>g>the</str<strong>on</strong>g> area of guardianship <strong>and</strong><br />
its impact <strong>on</strong> self-determinati<strong>on</strong> is needed,<br />
particularly with respect to school-aged adults<br />
who have disabilities. Interestingly, <str<strong>on</strong>g>the</str<strong>on</strong>g> relati<strong>on</strong>ship<br />
has been rarely been examined.<br />
Within <str<strong>on</strong>g>the</str<strong>on</strong>g> last 10 years, Millar, <strong>and</strong> colleague,<br />
(Millar & Renzaglia, 2002; Millar, 2003) c<strong>on</strong>ducted<br />
studies that investigated guardianship<br />
in relati<strong>on</strong> to young adults who had developmental<br />
disabilities that were in <str<strong>on</strong>g>the</str<strong>on</strong>g> transiti<strong>on</strong><br />
phase of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir educati<strong>on</strong>. By reviewing over<br />
220 guardianship court files, it was found that<br />
guardians, as stated <strong>on</strong> court petiti<strong>on</strong> forms<br />
most often completed by parents, were<br />
needed because <str<strong>on</strong>g>the</str<strong>on</strong>g> student (a) reached <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
age of majority (18 years of age), <strong>and</strong> (b) had<br />
limited or no ability to make decisi<strong>on</strong>s. It was<br />
also found that <str<strong>on</strong>g>the</str<strong>on</strong>g> evidence used to “prove”<br />
“incompetence” was unclear, <strong>and</strong> that in<br />
100% of <str<strong>on</strong>g>the</str<strong>on</strong>g> cases a guardian (most often a<br />
parent) was appointed. Review of annual reports<br />
submitted to courts by guardians found<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> majority of wards’ “c<strong>on</strong>diti<strong>on</strong>s” of<br />
“having limited or no capacity to make decisi<strong>on</strong>s”<br />
reportedly remained unchanged following<br />
guardian appointments.<br />
In a related investigati<strong>on</strong>, Millar (2007)<br />
c<strong>on</strong>ducted focus groups with sec<strong>on</strong>dary special<br />
educati<strong>on</strong> teachers, parents (both who<br />
were legal guardians <strong>and</strong> who were not), <strong>and</strong><br />
young adults with disabilities (both who had<br />
legal guardians <strong>and</strong> who did not) to determine<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir knowledge of guardianship <strong>and</strong><br />
self-determinati<strong>on</strong>. It was learned that <str<strong>on</strong>g>the</str<strong>on</strong>g> par-
ticipants (a) believed <str<strong>on</strong>g>the</str<strong>on</strong>g>y exhibited/promoted<br />
self-determinati<strong>on</strong>; (b) did not recognize<br />
a disc<strong>on</strong>nect between self-determinati<strong>on</strong><br />
<strong>and</strong> guardianship; <strong>and</strong> (c) had limited underst<strong>and</strong>ing<br />
of guardianship <strong>and</strong> its alternatives.<br />
Ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r finding was that when asked how<br />
families first learned about guardianship, students<br />
<strong>and</strong> parents shared that it was at an IEP.<br />
They shared that a teacher asked “Do you<br />
have a guardian?” when it came to that secti<strong>on</strong><br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> IEP form. From that point, parents<br />
went to court because <str<strong>on</strong>g>the</str<strong>on</strong>g>y thought <str<strong>on</strong>g>the</str<strong>on</strong>g>y were<br />
supposed to do it <strong>and</strong> began <str<strong>on</strong>g>the</str<strong>on</strong>g> guardianship<br />
proceedings without truly underst<strong>and</strong>ing what<br />
guardian appointments entailed. Parents also<br />
reported that <str<strong>on</strong>g>the</str<strong>on</strong>g>y found it devastating to state<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir s<strong>on</strong> or daughter was incompetent to<br />
make decisi<strong>on</strong>s. In hindsight, <str<strong>on</strong>g>the</str<strong>on</strong>g>se parents<br />
questi<strong>on</strong>ed whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r a guardian was actually<br />
needed.<br />
Based <strong>on</strong> a review of guardianship <strong>and</strong> selfdeterminati<strong>on</strong><br />
literature, it was learned that<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>re has not been a study that addressed why<br />
some school-aged young adults with developmental<br />
disabilities do not have a guardian<br />
appointed, while o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs do. This current<br />
study, <str<strong>on</strong>g>the</str<strong>on</strong>g>refore, builds <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> previous work<br />
as it provides an underst<strong>and</strong>ing of <str<strong>on</strong>g>the</str<strong>on</strong>g> experiences<br />
students <strong>and</strong> families encounter at <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
time students with developmental disabilities<br />
reach <str<strong>on</strong>g>the</str<strong>on</strong>g> age of majority <strong>and</strong> guardianship is<br />
c<strong>on</strong>sidered. In a additi<strong>on</strong>, a purpose of this<br />
study was to examine why or why not parents<br />
elected to become guardians, as well as examine<br />
expectati<strong>on</strong>s that those with a full guardian<br />
were less likely to be self-determined <strong>and</strong><br />
experience pers<strong>on</strong>al c<strong>on</strong>trol than those with<br />
no guardian. Ultimately, it was hoped that<br />
through a case study approach, an in-depth<br />
view to guardianship <strong>and</strong> self-determinati<strong>on</strong><br />
would lead to increased awareness as to what<br />
guardianship is really about, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> extent to<br />
which a guardian impacts a young adult’s life.<br />
This is <str<strong>on</strong>g>the</str<strong>on</strong>g> first known study that explores how<br />
families, with young adults with similar educati<strong>on</strong>al<br />
experiences <strong>and</strong> special educati<strong>on</strong><br />
school labels, came to very different c<strong>on</strong>clusi<strong>on</strong>s<br />
about guardianship when <str<strong>on</strong>g>the</str<strong>on</strong>g>y attended<br />
an Individualized Educati<strong>on</strong> Program meeting<br />
(IEP) <strong>and</strong> it was time for <str<strong>on</strong>g>the</str<strong>on</strong>g> parents’<br />
rights to potentially transfer to <str<strong>on</strong>g>the</str<strong>on</strong>g>ir adult<br />
child.<br />
Method<br />
Participants <strong>and</strong> Settings<br />
Kevin <strong>and</strong> Jack, both 21 years of age, were<br />
purposively identified for this study as <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
both (a) had <str<strong>on</strong>g>the</str<strong>on</strong>g> special educati<strong>on</strong> eligibility<br />
label of “moderately cognitively impaired”<br />
based <strong>on</strong> results from IQ assessments, adaptive<br />
behavior scores, <strong>and</strong> <strong>on</strong>set of <str<strong>on</strong>g>the</str<strong>on</strong>g> disability;<br />
(b) were over <str<strong>on</strong>g>the</str<strong>on</strong>g> age of 18; (c) were<br />
eligible for services including vocati<strong>on</strong>al rehabilitati<strong>on</strong>,<br />
social security income, Medicaid,<br />
Department of Mental Health - Services of<br />
People with Developmental Disabilities<br />
(DMH); <strong>and</strong> (d) had high levels of parental<br />
involvement. One essential criteria was that<br />
<strong>on</strong>e individual (Jack) had a full (plenary)<br />
guardian, while <strong>on</strong>e (Kevin) did not.<br />
The two young men lived in <str<strong>on</strong>g>the</str<strong>on</strong>g> same community,<br />
attended <str<strong>on</strong>g>the</str<strong>on</strong>g> same high school, <strong>and</strong><br />
had <str<strong>on</strong>g>the</str<strong>on</strong>g> same teachers throughout most of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir schooling. Essentially, <str<strong>on</strong>g>the</str<strong>on</strong>g>se two young<br />
men had grown up toge<str<strong>on</strong>g>the</str<strong>on</strong>g>r, via <str<strong>on</strong>g>the</str<strong>on</strong>g>ir special<br />
educati<strong>on</strong>, since <str<strong>on</strong>g>the</str<strong>on</strong>g> age of four. The suburban<br />
community where Kevin <strong>and</strong> Jack lived<br />
had a populati<strong>on</strong> of over 40,000. The high<br />
school enrollment approximated 500, where<br />
90% of <str<strong>on</strong>g>the</str<strong>on</strong>g> student body was Caucasian. The<br />
school district had a solid reputati<strong>on</strong> for preparing<br />
students for college, <strong>and</strong> also had a<br />
reputati<strong>on</strong> across <str<strong>on</strong>g>the</str<strong>on</strong>g> regi<strong>on</strong> <strong>and</strong> state for promoting<br />
supported community living <strong>and</strong> job<br />
experiences for individuals who had developmental<br />
disabilities. The school’s curriculum<br />
emphasis was <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> exp<strong>and</strong>ed development<br />
of Kevin’s <strong>and</strong> Jack’s life skills (e.g., cooking,<br />
cleaning, m<strong>on</strong>ey use) <strong>and</strong> vocati<strong>on</strong>al training.<br />
Particular emphasis was placed <strong>on</strong> teaching<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>m to fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r develop <str<strong>on</strong>g>the</str<strong>on</strong>g>ir self-advocacy<br />
<strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r related self-determinati<strong>on</strong> skills. At<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> time <str<strong>on</strong>g>the</str<strong>on</strong>g> study began, both were in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
last year of public schooling where <str<strong>on</strong>g>the</str<strong>on</strong>g>y attended<br />
school for two to three hours a day,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>n were in <str<strong>on</strong>g>the</str<strong>on</strong>g> community – ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r working<br />
or recreating.<br />
Both young men, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir parents, had<br />
opportunities for becoming aware of <str<strong>on</strong>g>the</str<strong>on</strong>g> various<br />
transiti<strong>on</strong> services available during <strong>and</strong><br />
after high school graduati<strong>on</strong>. Opportunities<br />
to explore various jobs, opti<strong>on</strong>s, <strong>and</strong> agency<br />
services were available to Kevin <strong>and</strong> Jack, as<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y were for all students who received special<br />
Self-Determinati<strong>on</strong> <strong>and</strong> Guardianship / 281
educati<strong>on</strong> services. Despite <str<strong>on</strong>g>the</str<strong>on</strong>g>se similarities,<br />
each young man <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir parents resp<strong>on</strong>ded<br />
differently to <str<strong>on</strong>g>the</str<strong>on</strong>g> age of majority <strong>and</strong> transfer<br />
of rights issues. One family, Kevin’s, secured a<br />
house, obtained agency support, <strong>and</strong> were adamant<br />
that no legal guardian be appointed.<br />
Ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r family, Jack’s, chose a different path.<br />
By family choice, <str<strong>on</strong>g>the</str<strong>on</strong>g> young man had no<br />
agency services <strong>and</strong> lived with his parents, who<br />
were also his legal guardians.<br />
For Kevin, Mary his mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r shared <str<strong>on</strong>g>the</str<strong>on</strong>g> majority<br />
of informati<strong>on</strong> from <str<strong>on</strong>g>the</str<strong>on</strong>g> parental point<br />
of view. Although Kevin’s fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r was involved<br />
in his s<strong>on</strong>’s life, Mary stated “Oh, I can speak<br />
for him.” Mary was initially c<strong>on</strong>tacted by <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
district’s transiti<strong>on</strong> coordinator about <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
study, <str<strong>on</strong>g>the</str<strong>on</strong>g>n introduced to <str<strong>on</strong>g>the</str<strong>on</strong>g> author. Mary<br />
was immediately agreeable to participate in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> study <strong>and</strong> gave <str<strong>on</strong>g>the</str<strong>on</strong>g> author <str<strong>on</strong>g>the</str<strong>on</strong>g> names <strong>and</strong><br />
ph<strong>on</strong>e numbers of people to c<strong>on</strong>tact to set up<br />
times to meet with Kevin. A total of six individuals,<br />
in additi<strong>on</strong> to Kevin, were interviewed<br />
who included: Mary (his mom), his dad, <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> school Transiti<strong>on</strong> Coordinator. Kevin had<br />
a case manager through <str<strong>on</strong>g>the</str<strong>on</strong>g> Department of<br />
Mental Health - Services for People with Developmental<br />
Disabilities (DMH) whose job<br />
was to make sure Kevin had <str<strong>on</strong>g>the</str<strong>on</strong>g> supports he<br />
needed. The case manager, Tyler (Kevin’s<br />
pers<strong>on</strong>al care assistant funded by DMH), <strong>and</strong><br />
Sim<strong>on</strong> (Kevin’s job coach who’s positi<strong>on</strong> was<br />
funded in part by <str<strong>on</strong>g>the</str<strong>on</strong>g> school <strong>and</strong> vocati<strong>on</strong>al<br />
rehabilitati<strong>on</strong>) were also study participants.<br />
In Jack’s situati<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g> fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r granted <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
family participati<strong>on</strong> in <str<strong>on</strong>g>the</str<strong>on</strong>g> study, however,<br />
made it clear that both he <strong>and</strong> his wife would<br />
attend interviews toge<str<strong>on</strong>g>the</str<strong>on</strong>g>r. In all, four individuals,<br />
in additi<strong>on</strong> to Jack were interviewed: his<br />
mom, dad, employer, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> school transiti<strong>on</strong><br />
coordinator.<br />
The transiti<strong>on</strong> coordinator for <str<strong>on</strong>g>the</str<strong>on</strong>g> district<br />
was c<strong>on</strong>tacted by <str<strong>on</strong>g>the</str<strong>on</strong>g> author, following <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
advice of <str<strong>on</strong>g>the</str<strong>on</strong>g> district director of special educati<strong>on</strong>,<br />
<strong>and</strong> given <str<strong>on</strong>g>the</str<strong>on</strong>g> participant criteria, who<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>n helped identify participants. As a point<br />
of reference, <str<strong>on</strong>g>the</str<strong>on</strong>g> transiti<strong>on</strong> coordinator<br />
worked with <str<strong>on</strong>g>the</str<strong>on</strong>g> participants for a three year<br />
period, <strong>and</strong> had <str<strong>on</strong>g>the</str<strong>on</strong>g> resp<strong>on</strong>sibilities of being a<br />
teacher <strong>and</strong> work study coordinator. This individual<br />
was also resp<strong>on</strong>sible for arranging<br />
presentati<strong>on</strong>s throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> school year <strong>on</strong><br />
various topics, including social security, <strong>and</strong><br />
living arrangement opti<strong>on</strong>s.<br />
Data Collecti<strong>on</strong><br />
282 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Several methods <strong>and</strong> data sources were utilized<br />
to collect, elaborate <strong>and</strong> verify informati<strong>on</strong>.<br />
Main data collecti<strong>on</strong> methods were <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
use of open-ended <strong>and</strong> semi-structured interviews<br />
with participants (via teleph<strong>on</strong>e or in<br />
pers<strong>on</strong>) <strong>and</strong> <strong>on</strong>-site observati<strong>on</strong>s. Documents<br />
<strong>and</strong> records (e.g., Individualized Educati<strong>on</strong><br />
Programs, evaluati<strong>on</strong> reports, <strong>and</strong> student<br />
performance data provided by <str<strong>on</strong>g>the</str<strong>on</strong>g> transiti<strong>on</strong><br />
coordinator) were also reviewed.<br />
Based <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> recommendati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> transiti<strong>on</strong><br />
coordinator, <str<strong>on</strong>g>the</str<strong>on</strong>g> author c<strong>on</strong>ducted <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
first interviews with <str<strong>on</strong>g>the</str<strong>on</strong>g> parents by teleph<strong>on</strong>e.<br />
Initial ph<strong>on</strong>e calls to parents lasted no more<br />
than 30 minutes, during which <str<strong>on</strong>g>the</str<strong>on</strong>g> purpose of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> study was reiterated <strong>and</strong> arrangements for<br />
fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r interacti<strong>on</strong> were made. A request for<br />
background informati<strong>on</strong> was also made such<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> author could review documents related<br />
to health, school, employment <strong>and</strong> n<strong>on</strong>related<br />
school activities (e.g., recreati<strong>on</strong>/leisure,<br />
social activities). It was also shared by <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
author why <str<strong>on</strong>g>the</str<strong>on</strong>g>ir adult child was selected for<br />
participati<strong>on</strong>. Subsequent interviews lasted between<br />
30 minutes to 2 hours, <strong>and</strong> were tape<br />
recorded <strong>and</strong> transcribed for data analysis<br />
purposes by ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r <str<strong>on</strong>g>the</str<strong>on</strong>g> author or an assistant.<br />
Sample questi<strong>on</strong>s posed to parents, <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
participants, included: (a) what type of curriculum<br />
was emphasized at <str<strong>on</strong>g>the</str<strong>on</strong>g> school (e.g., life<br />
skills, academics, self-determinati<strong>on</strong> skills)?;<br />
(b) when did <str<strong>on</strong>g>the</str<strong>on</strong>g>y first learn about guardianship<br />
with regard to <str<strong>on</strong>g>the</str<strong>on</strong>g>ir s<strong>on</strong>?; (c) what experiences<br />
did <str<strong>on</strong>g>the</str<strong>on</strong>g>y have that related to guardianship?;<br />
<strong>and</strong> (d) what type of transiti<strong>on</strong><br />
informati<strong>on</strong> was provided by <str<strong>on</strong>g>the</str<strong>on</strong>g> schools, in<br />
particular to self-determinati<strong>on</strong>, guardianship,<br />
<strong>and</strong> guardianship alternatives? Throughout<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> study, questi<strong>on</strong>s were modified, <strong>and</strong><br />
resp<strong>on</strong>ses were clarified regarding <str<strong>on</strong>g>the</str<strong>on</strong>g> above<br />
noted topics.<br />
On-site observati<strong>on</strong>s occurred approximately<br />
two to seven times a m<strong>on</strong>th (ranging<br />
from <strong>on</strong>e to three hours per observati<strong>on</strong>) over<br />
a ten m<strong>on</strong>th period that began in late August<br />
(<str<strong>on</strong>g>the</str<strong>on</strong>g> beginning of a school calendar) <strong>and</strong><br />
ended in early July. Observati<strong>on</strong>s occurred at<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> young adults’ home, school, place of employment,<br />
<strong>and</strong> various community settings <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
young adults frequented (e.g., mall, community<br />
recreati<strong>on</strong> center, fast food restaurant).
Field notes were used to document <str<strong>on</strong>g>the</str<strong>on</strong>g> observati<strong>on</strong>s.<br />
During most observati<strong>on</strong>s, <str<strong>on</strong>g>the</str<strong>on</strong>g> author<br />
attempted to minimize impacting or influencing<br />
daily routines, <strong>and</strong> in most situati<strong>on</strong>s,<br />
stood or sat back from <str<strong>on</strong>g>the</str<strong>on</strong>g> student, having<br />
minimal direct interacti<strong>on</strong> with o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs. There<br />
were times, however, when <str<strong>on</strong>g>the</str<strong>on</strong>g> author did<br />
interact with <str<strong>on</strong>g>the</str<strong>on</strong>g> student <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r participants<br />
to clarify what was observed.<br />
Analysis<br />
Data analysis began immediately following <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
first interviews by reviewing <str<strong>on</strong>g>the</str<strong>on</strong>g> tape transcripts.<br />
Initially <str<strong>on</strong>g>the</str<strong>on</strong>g> framework, or outline, for<br />
determining <str<strong>on</strong>g>the</str<strong>on</strong>g>mes was <str<strong>on</strong>g>the</str<strong>on</strong>g> resp<strong>on</strong>ses to<br />
questi<strong>on</strong>s (e.g., when did you first learn about<br />
guardianship?). Specifically, under each questi<strong>on</strong><br />
that was used somewhat as a header, resp<strong>on</strong>ses<br />
were sorted <strong>and</strong> categorized first regarding<br />
Kevin <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>n Jack. Following<br />
transcript review, observati<strong>on</strong> field notes were<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>n added to <str<strong>on</strong>g>the</str<strong>on</strong>g> interview data. The author<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> assistant who transcribed interviews,<br />
separately reviewed at least 20% of r<strong>and</strong>omly<br />
selected passages <strong>and</strong> field notes to establish<br />
inter-coder reliability. Reliability was high<br />
(over 85%), however, after <str<strong>on</strong>g>the</str<strong>on</strong>g> additi<strong>on</strong> of<br />
field note observati<strong>on</strong>s, it was decided that <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
questi<strong>on</strong>/resp<strong>on</strong>se approach framework for<br />
determining <str<strong>on</strong>g>the</str<strong>on</strong>g>mes was not adequately reflecting<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> issues <str<strong>on</strong>g>the</str<strong>on</strong>g> students <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir parents<br />
encountered. That is, <str<strong>on</strong>g>the</str<strong>on</strong>g> framework<br />
seemed to fragment <str<strong>on</strong>g>the</str<strong>on</strong>g> findings. Therefore,<br />
individual case studies were created, with two<br />
main <str<strong>on</strong>g>the</str<strong>on</strong>g>mes, “Kevin: It takes a Village” <strong>and</strong><br />
“Jack: It takes a Family.” Documents (e.g.,<br />
school records) were used to c<strong>on</strong>firm <strong>and</strong> supplement<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> informati<strong>on</strong> collected during interviews<br />
<strong>and</strong> observati<strong>on</strong>s.<br />
The initial case studies were shared with <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
young men <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir parents (members<br />
checking) so that <str<strong>on</strong>g>the</str<strong>on</strong>g>y could review <strong>and</strong> c<strong>on</strong>firm<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> informati<strong>on</strong>. Following <str<strong>on</strong>g>the</str<strong>on</strong>g>ir review,<br />
<strong>and</strong> with little requested revisi<strong>on</strong> (nothing of<br />
c<strong>on</strong>tent, ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r grammatical c<strong>on</strong>cerns), <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
final case studies were completed. Prol<strong>on</strong>ged<br />
engagement in <str<strong>on</strong>g>the</str<strong>on</strong>g> envir<strong>on</strong>ments students frequented<br />
occurred, as did triangulati<strong>on</strong> of data<br />
<strong>and</strong> members checking <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> analysis of interviews<br />
<strong>and</strong> observati<strong>on</strong>al field notes, to ensure<br />
au<str<strong>on</strong>g>the</str<strong>on</strong>g>nticity <strong>and</strong> credibility (Bogdan &<br />
Bilken, 1998; Lincoln & Guba, 1985). In <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
subsequent secti<strong>on</strong>, each case study is presented.<br />
Kevin did not have a legal guardian,<br />
<strong>and</strong> Jack’s fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r was his legal guardian.<br />
Case Studies<br />
Kevin: It Takes a Village<br />
At <str<strong>on</strong>g>the</str<strong>on</strong>g> time <str<strong>on</strong>g>the</str<strong>on</strong>g> study began, Kevin was a 6 foot<br />
tall 21 year old Caucasian male who appeared<br />
physically fit. When he was born, <str<strong>on</strong>g>the</str<strong>on</strong>g>re were<br />
no apparent signs that he had a disability, <strong>and</strong><br />
it was not until <str<strong>on</strong>g>the</str<strong>on</strong>g> age of three that his parents<br />
noticed delays, <strong>and</strong> began an early interventi<strong>on</strong><br />
program sp<strong>on</strong>sored by <str<strong>on</strong>g>the</str<strong>on</strong>g> school district<br />
<strong>and</strong> family advocacy organizati<strong>on</strong>. By age<br />
nine, Kevin was found by a school psychologist<br />
to have an IQ <strong>and</strong> an adaptive behavior score<br />
that placed him in <str<strong>on</strong>g>the</str<strong>on</strong>g> “trainable mentally<br />
impaired” school category. As an adult, Kevin<br />
c<strong>on</strong>tinued to lack verbal communicati<strong>on</strong> skills<br />
that most same aged peers had, however, he<br />
did communicate his feelings verbally, as well<br />
as behaviorally. On occasi<strong>on</strong>, Kevin reportedly<br />
was “aggressive” <strong>and</strong> struck o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs. Such acti<strong>on</strong>s<br />
were interpreted by his parents, school<br />
pers<strong>on</strong>nel, <strong>and</strong> pers<strong>on</strong>al assistants as his way<br />
of communicating that he “does not like what<br />
was going <strong>on</strong>.” The transiti<strong>on</strong> coordinator<br />
stated “In a sense, his behavior shows his attempt<br />
to be self-determined.” Even with his<br />
limited verbal ability, he was able to underst<strong>and</strong><br />
questi<strong>on</strong>s <strong>and</strong> express resp<strong>on</strong>ses. On<br />
occasi<strong>on</strong> during observati<strong>on</strong>s, Kevin appeared<br />
sleepy, <strong>and</strong> according to his pers<strong>on</strong>al assistant<br />
this was “most likely due to his medicati<strong>on</strong>s”<br />
that were to help mediate his manic or aggressive<br />
behaviors.<br />
Home. Kevin lived in his own home that his<br />
parents, Mary <strong>and</strong> Joe, bought for him when<br />
he turned 18 years of age, while he was still<br />
enrolled in <str<strong>on</strong>g>the</str<strong>on</strong>g> public school system. “We used<br />
his m<strong>on</strong>ey - well what was to be his college<br />
m<strong>on</strong>ey - to buy <str<strong>on</strong>g>the</str<strong>on</strong>g> house.” His two bedroom<br />
house was selected such that it was within <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
city limits <strong>and</strong> near various retail <strong>and</strong> community<br />
opti<strong>on</strong>s. Kevin’s home was located near a<br />
community recreati<strong>on</strong> center where he<br />
walked (with support from his assistants) <strong>and</strong><br />
enjoyed playing basketball, swimming, <strong>and</strong><br />
taking karate less<strong>on</strong>s. Although he could take<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> public transportati<strong>on</strong> to various locales,<br />
his assistants often opted to drive him around.<br />
Self-Determinati<strong>on</strong> <strong>and</strong> Guardianship / 283
“Its easier for me to take him than wait for <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
bus” said <strong>on</strong>e assistant.<br />
Kevin depended <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> assistance from o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs<br />
to help him with cooking, cleaning, dressing<br />
<strong>and</strong> accomplishing many o<str<strong>on</strong>g>the</str<strong>on</strong>g>r daily living<br />
tasks. Pers<strong>on</strong>al assistants from community service<br />
agencies came in <strong>and</strong> out of Kevin’s home<br />
between 7:00 a.m. <strong>and</strong> 11:00 p.m. each day. A<br />
two-way intercom system was installed in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
home so that Kevin’s nightly acti<strong>on</strong>s could be<br />
m<strong>on</strong>itored from 11:00 p.m. until 7:00 a.m.<br />
That is, a pers<strong>on</strong> employed by a human service<br />
agency m<strong>on</strong>itored Kevin such that if he got<br />
out of bed, he would be reminded via a<br />
speaker to go back to his bedroom. Kevin<br />
received SSI (m<strong>on</strong>thly income via Social Security<br />
Administrati<strong>on</strong>) <strong>and</strong> Medicaid, <strong>and</strong> because<br />
of this, he was eligible for services from<br />
DMH, who took care of all <str<strong>on</strong>g>the</str<strong>on</strong>g> housecleaning,<br />
meal preparati<strong>on</strong>, shopping, err<strong>and</strong>s <strong>and</strong><br />
laundry. Support was also offered when it<br />
came to bathing, dressing, <strong>and</strong> taking medicati<strong>on</strong>.<br />
Work. Kevin’s jobs were mostly seas<strong>on</strong>al.<br />
During <str<strong>on</strong>g>the</str<strong>on</strong>g> fall <strong>and</strong> winter seas<strong>on</strong>s, he worked<br />
at <str<strong>on</strong>g>the</str<strong>on</strong>g> community center doing janitorial <strong>and</strong><br />
maintenance work. During <str<strong>on</strong>g>the</str<strong>on</strong>g> spring <strong>and</strong><br />
summer m<strong>on</strong>ths, he had a lawn maintenance<br />
<strong>and</strong> moving service in which he worked 20<br />
hours a week. Throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> year, he was<br />
scheduled to work at least 10 hours a week at<br />
a restaurant, clearing l<strong>and</strong>scape or shoveling<br />
snow. The school district, in partnership with<br />
vocati<strong>on</strong>al rehabilitati<strong>on</strong> services, sp<strong>on</strong>sored a<br />
job coach, which Kevin <strong>and</strong> his parents interviewed<br />
<strong>and</strong> helped hire.<br />
School. Prior to <str<strong>on</strong>g>the</str<strong>on</strong>g> afterno<strong>on</strong> work schedule,<br />
Kevin, under <str<strong>on</strong>g>the</str<strong>on</strong>g> supervisi<strong>on</strong> of his assistants,<br />
walked to school most mornings. For a<br />
two to three hour period at school, he worked<br />
<strong>on</strong> daily living activities (e.g., cooking, cleaning,<br />
recreating) in a simulated apartment, designed<br />
in a classroom. During <str<strong>on</strong>g>the</str<strong>on</strong>g> blocked<br />
time, Kevin had a semi-structured schedule<br />
where, during each half hour to 45 minute<br />
period, he was given a choice as to what he<br />
would like to do. As an example, between 9<br />
<strong>and</strong> 9:30 a.m., recreati<strong>on</strong> time, he could chose<br />
to play a card or board game. In additi<strong>on</strong> to<br />
learning games, an aim was for Kevin to fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
develop his social <strong>and</strong> self-determinati<strong>on</strong><br />
skills. Recreati<strong>on</strong> <strong>and</strong> social interacti<strong>on</strong> skills,<br />
like o<str<strong>on</strong>g>the</str<strong>on</strong>g>r daily living skills, were areas noted<br />
284 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
<strong>on</strong> Kevin’s IEP, <strong>and</strong> data were collected in an<br />
effort to m<strong>on</strong>itor his progress.<br />
Family values - no legal guardian appointed.<br />
Mary <strong>and</strong> Joe, both retired, visited with <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
s<strong>on</strong> regularly, at least <strong>on</strong>ce a week. Kevin<br />
fished <strong>and</strong> boated with his Dad <strong>and</strong> went to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> mall <strong>and</strong> restaurants with his Mom. His<br />
parents also stayed in close c<strong>on</strong>tact with<br />
Kevin’s assistants <strong>and</strong> m<strong>on</strong>itored his m<strong>on</strong>ey.<br />
His older bro<str<strong>on</strong>g>the</str<strong>on</strong>g>r by two years, Peter, did not<br />
live in <str<strong>on</strong>g>the</str<strong>on</strong>g> state, however, he kept in c<strong>on</strong>tact<br />
with Kevin. Two m<strong>on</strong>ths into <str<strong>on</strong>g>the</str<strong>on</strong>g> study, when<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> author ph<strong>on</strong>ed Mary to arrange an observati<strong>on</strong>,<br />
she quickly interjected:<br />
Boy do I have something to tell you about<br />
guardianship! We are at a ragged edge with<br />
this guardianship thing. I just got a ph<strong>on</strong>e<br />
call from <str<strong>on</strong>g>the</str<strong>on</strong>g> special educati<strong>on</strong> administrator.<br />
He said that Kevin was in an assault<br />
situati<strong>on</strong> at school. He told me he couldn’t<br />
tell me anything more because I was not<br />
Kevin’s legal guardian - that because Kevin<br />
was his own guardian, he could not disclose<br />
any details of what occurred – He also went<br />
<strong>on</strong> to say that Kevin would not underst<strong>and</strong> a<br />
report that detailed <str<strong>on</strong>g>the</str<strong>on</strong>g> situati<strong>on</strong> <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>refore<br />
would not give him <str<strong>on</strong>g>the</str<strong>on</strong>g> report ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r.<br />
This pers<strong>on</strong> had no right to make <str<strong>on</strong>g>the</str<strong>on</strong>g> determinati<strong>on</strong><br />
of Kevin’s competence.<br />
Mary volunteered regularly at a community<br />
family advocacy organizati<strong>on</strong> as a c<strong>on</strong>sultant<br />
to <strong>and</strong> an advocate for people with disabilities<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir family members with regard to special<br />
educati<strong>on</strong>, community agency c<strong>on</strong>necti<strong>on</strong>s,<br />
social security income <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r issues,<br />
including guardianship. Mary stated that she<br />
wanted Kevin, her s<strong>on</strong>, to remain an individual<br />
who maintained all of his basic rights.<br />
Through her associati<strong>on</strong> with <str<strong>on</strong>g>the</str<strong>on</strong>g> family advocacy<br />
organizati<strong>on</strong> <strong>and</strong> school sp<strong>on</strong>sored family<br />
transiti<strong>on</strong> topic nights, she learned that she<br />
could write a ‘letter of intent.’ A letter of<br />
intent is a document written by parents that<br />
describes <str<strong>on</strong>g>the</str<strong>on</strong>g> s<strong>on</strong>’s or daughter’s history, current<br />
status <strong>and</strong> hopes for <str<strong>on</strong>g>the</str<strong>on</strong>g> future<br />
(Pierangelo & Giuliani, 2004). Although <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
document is not a legal <strong>on</strong>e, judges <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
parties can refer to <str<strong>on</strong>g>the</str<strong>on</strong>g> letter for guidance in<br />
underst<strong>and</strong>ing <str<strong>on</strong>g>the</str<strong>on</strong>g> wishes of <str<strong>on</strong>g>the</str<strong>on</strong>g> parents in<br />
regard to <str<strong>on</strong>g>the</str<strong>on</strong>g>ir s<strong>on</strong> or daughter. C<strong>on</strong>tent areas<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> letter can vary: including religi<strong>on</strong>, sib-
ling informati<strong>on</strong>, medical history <strong>and</strong> care,<br />
recreati<strong>on</strong>/leisure activities, financial informati<strong>on</strong>,<br />
employment <strong>and</strong> educati<strong>on</strong>. The letter<br />
Kevin’s parents wrote stated that: (a) it was<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir intenti<strong>on</strong> that Kevin always be his own<br />
guardian; (b) if Kevin was ever involved with<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> court system in any way <strong>and</strong> his parents<br />
were unavailable, incapacitated, or deceased,<br />
he was to have <str<strong>on</strong>g>the</str<strong>on</strong>g> services of an attorney, not<br />
a court appointed attorney, working <strong>on</strong> his<br />
behalf; (c) ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r his parents or his trust would<br />
be resp<strong>on</strong>sible for <str<strong>on</strong>g>the</str<strong>on</strong>g> costs of an attorney,<br />
especially should <str<strong>on</strong>g>the</str<strong>on</strong>g>re be guardianship issues,<br />
<strong>and</strong> (d) if an extreme emergency a<br />
guardian is deemed necessary, his bro<str<strong>on</strong>g>the</str<strong>on</strong>g>r Peter<br />
was to be appointed, however, should he<br />
be deceased, an individual approved by <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
family advocacy organizati<strong>on</strong> [NAME OF OR-<br />
GANIZATION] was to be appointed.<br />
Clearly, Mary str<strong>on</strong>gly believed that Kevin<br />
should remain his own guardian. The letter of<br />
intent she <strong>and</strong> her husb<strong>and</strong> wrote was copied<br />
<strong>and</strong> presented to all family members <strong>and</strong> organizati<strong>on</strong>s<br />
(e.g., agency case managers,<br />
school pers<strong>on</strong>nel) Kevin worked with <strong>and</strong> was<br />
also posted <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> refrigerator in Kevin’s<br />
home for easy access. “No <strong>on</strong>e likes to be<br />
called or say that <str<strong>on</strong>g>the</str<strong>on</strong>g>y are dumb, incompetent<br />
or incapacitated” which is something that<br />
does occur at a guardianship appointment<br />
hearing. She indicated that <str<strong>on</strong>g>the</str<strong>on</strong>g>re are a number<br />
of ways in which Kevin, <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r people<br />
who have disabilities, can have <str<strong>on</strong>g>the</str<strong>on</strong>g> support<br />
needed when making decisi<strong>on</strong>s, without having<br />
a legal guardian appointed. The alternatives<br />
for Kevin included <str<strong>on</strong>g>the</str<strong>on</strong>g> support of his<br />
family, friends, <strong>and</strong> agency support pers<strong>on</strong>nel;<br />
utilizati<strong>on</strong> of pers<strong>on</strong>-centered planning; <strong>and</strong><br />
trusts. At <strong>on</strong>e time, his parents were his representative<br />
payee, however, <str<strong>on</strong>g>the</str<strong>on</strong>g>y opted to disc<strong>on</strong>tinue<br />
this as <str<strong>on</strong>g>the</str<strong>on</strong>g>y no l<strong>on</strong>ger wanted to<br />
write out reports regarding his finances.<br />
Guardian defined. To reiterate, having a<br />
guardian appointed means that an individual<br />
can no l<strong>on</strong>ger legally make decisi<strong>on</strong>s <strong>on</strong> his or<br />
her own behalf. Some<strong>on</strong>e else does <str<strong>on</strong>g>the</str<strong>on</strong>g> decisi<strong>on</strong><br />
making for <str<strong>on</strong>g>the</str<strong>on</strong>g>m. Kevin did not have a<br />
court appointed guardian. Because Kevin had<br />
difficulty verbally sharing informati<strong>on</strong>, observati<strong>on</strong>s<br />
across envir<strong>on</strong>ments occurred in order<br />
to get a sense of <str<strong>on</strong>g>the</str<strong>on</strong>g> decisi<strong>on</strong>s he made. At <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
school setting, it was clear that efforts were<br />
made for him to learn how to communicate<br />
his wishes. In o<str<strong>on</strong>g>the</str<strong>on</strong>g>r envir<strong>on</strong>ments, however,<br />
such efforts were not observed. Specifically,<br />
Kevin <strong>and</strong> Tyler (a pers<strong>on</strong>al assistant) were<br />
observed at Kevin’s home <strong>and</strong> at <str<strong>on</strong>g>the</str<strong>on</strong>g> food<br />
court in local mall, near a fast food restaurant.<br />
On a daily basis during breakfast at Kevin’s<br />
home Tyler made omelets <strong>and</strong> sausage for<br />
Kevin. Tyler was asked by <str<strong>on</strong>g>the</str<strong>on</strong>g> author if Kevin<br />
ever told him what he wanted to eat <strong>and</strong> if he<br />
ever helped prepare <str<strong>on</strong>g>the</str<strong>on</strong>g> food. It was observed<br />
in school that he was being taught how to<br />
prepare <strong>and</strong> cook simple foods (e.g., cereal<br />
<strong>and</strong> toast). Tyler shared “Well, I was a cook in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> service, <strong>and</strong> I like to cook, so I pretty much<br />
spoil him <strong>and</strong> make him things. Most of his<br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>r staff makes him oatmeal.” Kevin wiped<br />
his mouth with a napkin whenever Tyler told<br />
him to do so. After breakfast, Tyler placed<br />
clo<str<strong>on</strong>g>the</str<strong>on</strong>g>s <strong>on</strong> Kevin’s bed. Kevin was not observed<br />
picking out his clo<str<strong>on</strong>g>the</str<strong>on</strong>g>s nor asked what<br />
he would like to wear.<br />
Below is an example of <str<strong>on</strong>g>the</str<strong>on</strong>g> exchanges that<br />
occurred <strong>on</strong> Wednesday <strong>and</strong> Friday afterno<strong>on</strong>s,<br />
when Kevin <strong>and</strong> Tyler regularly went to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> local mall:<br />
Tyler. “What do you want for lunch Kevin?<br />
Do you want a hamburger? One or two?”<br />
Kevin raised two fingers to communicate<br />
his wishes.<br />
Tyler. “What do you want to drink? Milk<br />
or coke?”<br />
Kevin. “Coke.”<br />
Tyler. “No, let’s have milk. I’ll get you<br />
milk.”<br />
Tyler gave Kevin milk <strong>and</strong> himself a cola. Tyler<br />
indicated that he usually ordered Kevin’s food<br />
for him. At <strong>on</strong>e point, Tyler was asked by <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
author whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r Kevin ever ordered his own<br />
food <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> reply was “It is easier for me to<br />
do it.” Tyler shared that he worked with Kevin<br />
for “about 2 years”, <strong>and</strong> that he was just a few<br />
m<strong>on</strong>ths older than Kevin. Essentially, both<br />
men had <str<strong>on</strong>g>the</str<strong>on</strong>g> same build (tall, lean <strong>and</strong> fit)<br />
<strong>and</strong> dressed similarly.<br />
Tyler. “Kevin, take off your jacket” Kevin<br />
complied <strong>and</strong> took off <str<strong>on</strong>g>the</str<strong>on</strong>g> coat.<br />
Regularly, it was observed that Tyler arranged<br />
Kevin’s food <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> table. After a few bites of<br />
his fries, Kevin asked Tyler about students <strong>and</strong><br />
Self-Determinati<strong>on</strong> <strong>and</strong> Guardianship / 285
teachers that <str<strong>on</strong>g>the</str<strong>on</strong>g>y both knew at high school.<br />
Tyler shared that Kevin’s recall of all his classmates<br />
<strong>and</strong> teachers impressed him. Following<br />
some discussi<strong>on</strong>s about school, Tyler unwrapped<br />
Kevin’s cheeseburger. Kevin ate<br />
slowly, but interacted with both Tyler, <strong>and</strong> at<br />
times <str<strong>on</strong>g>the</str<strong>on</strong>g> author. When Tyler was d<strong>on</strong>e eating<br />
<strong>on</strong>e burger, he asked Kevin “Do you want your<br />
sec<strong>on</strong>d burger, or do you want to save it for<br />
later?” The resp<strong>on</strong>se was “I want some now.”<br />
Tyler, however, put <str<strong>on</strong>g>the</str<strong>on</strong>g> sec<strong>on</strong>d burger in his<br />
coat pocket <strong>and</strong> said “No. Let’s save it.” The<br />
turnover rate for working with Kevin ran between<br />
1 to 2 years. The l<strong>on</strong>gest time an attendant<br />
worked with Kevin was three years, <strong>on</strong> a<br />
part-time basis.<br />
Sim<strong>on</strong> was Kevin’s job coach. Similar to<br />
what was observed at <str<strong>on</strong>g>the</str<strong>on</strong>g> mall <strong>and</strong> at Kevin’s<br />
home, was also observed at <str<strong>on</strong>g>the</str<strong>on</strong>g> work place.<br />
Sim<strong>on</strong> got <str<strong>on</strong>g>the</str<strong>on</strong>g> supplies Kevin needed to use to<br />
vacuum, mop floors <strong>and</strong> clean tables. When<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> transiti<strong>on</strong> coordinator was <str<strong>on</strong>g>the</str<strong>on</strong>g> job coach,<br />
an effort was made to provide <str<strong>on</strong>g>the</str<strong>on</strong>g> least<br />
amount of intrusi<strong>on</strong> so that Kevin would become<br />
independent at <str<strong>on</strong>g>the</str<strong>on</strong>g> job site. Although<br />
Kevin did not ever become fully independent<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> majority of steps he needed to do <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
job, he was independent at getting his supplies.<br />
Kevin’s school job portfolio had a task<br />
analysis <strong>and</strong> data reflected Kevin’s areas of<br />
being independent. When asked, Sim<strong>on</strong> indicated<br />
that he was not c<strong>on</strong>cerned about <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
quality of Kevin’s work because he would go<br />
behind him <strong>and</strong> complete <str<strong>on</strong>g>the</str<strong>on</strong>g> tasks when<br />
needed.<br />
Mary indicated that <strong>on</strong> M<strong>on</strong>days <strong>and</strong> Thursdays<br />
from 1:00 p.m. to 3:00 p.m., her s<strong>on</strong> was<br />
scheduled to work at a restaurant to clean <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
l<strong>and</strong>scaping <strong>and</strong> pick up trash. When observati<strong>on</strong>s<br />
were arranged to meet at <str<strong>on</strong>g>the</str<strong>on</strong>g> worksite,<br />
Kevin <strong>and</strong> Sim<strong>on</strong> were at least 15 minutes late<br />
<strong>and</strong> <strong>on</strong> four occasi<strong>on</strong>s, Kevin did not show.<br />
Sim<strong>on</strong> indicated that he, not necessarily<br />
Kevin, did not care for that job <strong>and</strong> so <str<strong>on</strong>g>the</str<strong>on</strong>g>y did<br />
not go <str<strong>on</strong>g>the</str<strong>on</strong>g>re <strong>on</strong> a regular basis. Such informati<strong>on</strong><br />
was news to Mary when she asked how <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
observati<strong>on</strong>s were going. Mary worked with<br />
vocati<strong>on</strong>al rehabilitati<strong>on</strong> counselor, DMH<br />
case manager <strong>and</strong> transiti<strong>on</strong> coordinator to<br />
ensure that Sim<strong>on</strong> was helping Kevin become<br />
as independent as possible at <str<strong>on</strong>g>the</str<strong>on</strong>g> job sites.<br />
Jack: It Takes a Family<br />
286 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Jack, 21 years of age at <str<strong>on</strong>g>the</str<strong>on</strong>g> time <str<strong>on</strong>g>the</str<strong>on</strong>g> study<br />
began, <strong>and</strong> was planning to leave school at <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
end of <str<strong>on</strong>g>the</str<strong>on</strong>g> school year. He, like Kevin, began<br />
an early interventi<strong>on</strong> program at <str<strong>on</strong>g>the</str<strong>on</strong>g> age of<br />
three. In fact, both young men were in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
same early interventi<strong>on</strong> program class, had<br />
similar IQ <strong>and</strong> adaptive behavior scores <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> same special educati<strong>on</strong> school label. Unlike<br />
Kevin, Jack was noticeably small from <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
moment he was born. He was born two<br />
m<strong>on</strong>ths pre-mature, had a brain tumor, <strong>and</strong><br />
numerous medical scares throughout his life.<br />
He had a shunt initially placed when he was an<br />
infant. His parents could not recall <str<strong>on</strong>g>the</str<strong>on</strong>g> exact<br />
age of <str<strong>on</strong>g>the</str<strong>on</strong>g> first shunt, but <str<strong>on</strong>g>the</str<strong>on</strong>g>y could recall<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> shunt had to be replaced four times.<br />
Jack was also tube fed for <str<strong>on</strong>g>the</str<strong>on</strong>g> first year of his<br />
life.<br />
Jack could have stayed associated with <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
schools until <str<strong>on</strong>g>the</str<strong>on</strong>g> age of 26 (state law), but Jack<br />
<strong>and</strong> his parents opted that he leave earlier as<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y felt he was not “benefiting from <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum.”<br />
His mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r shared “It was decided<br />
to leave school because he isn’t progressing<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>re is no advantage to staying. He has<br />
reached his maximum at shopping, <strong>and</strong> all of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> things that <str<strong>on</strong>g>the</str<strong>on</strong>g> kids do. The <strong>on</strong>ly thing we<br />
think we will miss is <str<strong>on</strong>g>the</str<strong>on</strong>g> social part.” She<br />
shared that it would be difficult to keep her<br />
s<strong>on</strong> busy <strong>and</strong> that <str<strong>on</strong>g>the</str<strong>on</strong>g>y would try to get him to<br />
stay in c<strong>on</strong>tact with his friends, but that “it<br />
probably will be just too difficult.” They<br />
planned to keep him socially involved with<br />
family functi<strong>on</strong>s <strong>and</strong> activities.<br />
Jack was described by his parents, transiti<strong>on</strong><br />
coordinator, <strong>and</strong> his employer as being “some<strong>on</strong>e<br />
who is nice to be around as he is resp<strong>on</strong>sible”<br />
<strong>and</strong> “overall, a proper young gentlemen.”<br />
In terms of stature, Jack, a 21 year old<br />
bl<strong>on</strong>d hair, blue eyed man, was not quite four<br />
feet tall.<br />
Fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r. We love being around him. He’s<br />
very pleasant. We’re very fortunate that we<br />
have him <strong>and</strong> that he is small—people think<br />
of him younger than he is. We see some<br />
people who are h<strong>and</strong>icapped who d<strong>on</strong>’t<br />
look it, <strong>and</strong> it is harder for <str<strong>on</strong>g>the</str<strong>on</strong>g>m because<br />
people expect a lot from <str<strong>on</strong>g>the</str<strong>on</strong>g>m.<br />
Mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r. Jack is 21, but he is still my baby.
Home. Jack lived with his mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r <strong>and</strong> fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
in a home that was located just outside<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> city limits. Deer <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r wild life maneuvered<br />
through <str<strong>on</strong>g>the</str<strong>on</strong>g> family’s 30 acres of l<strong>and</strong>. In<br />
turn, <str<strong>on</strong>g>the</str<strong>on</strong>g> family, who had a l<strong>on</strong>g history in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
area, c<strong>on</strong>tinued to enjoy <str<strong>on</strong>g>the</str<strong>on</strong>g> animal activities.<br />
Although Jack <strong>and</strong> his parents attended presentati<strong>on</strong>s<br />
about living/housing opti<strong>on</strong>s that<br />
existed in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir community, <str<strong>on</strong>g>the</str<strong>on</strong>g>y were satisfied<br />
<strong>and</strong> comfortable with maintaining <str<strong>on</strong>g>the</str<strong>on</strong>g>ir living<br />
situati<strong>on</strong>. Jack indicated, as did his parents,<br />
that he was not in any rush to have a home<br />
away from his parents. Jack had his own room<br />
<strong>and</strong> spent time showing <str<strong>on</strong>g>the</str<strong>on</strong>g> author how he,<br />
with a little assistance from his mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r, redecorated<br />
it. He picked out <str<strong>on</strong>g>the</str<strong>on</strong>g> blinds <strong>and</strong> carpet.<br />
He bought himself a rocking chair <strong>and</strong> cabinets<br />
for his room. He proudly showed <str<strong>on</strong>g>the</str<strong>on</strong>g> golf<br />
clubs he purchased. He played golf <strong>and</strong> went<br />
fishing with his dad, who was retired. Interestingly,<br />
Jack had his driver’s permit <strong>and</strong> drove a<br />
car that had been accommodated by having<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> foot pedals extended so that his legs could<br />
c<strong>on</strong>trol <str<strong>on</strong>g>the</str<strong>on</strong>g> gas <strong>and</strong> brakes. When asked by <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
author “Can you tell me about how you<br />
learned to drive?” Jack’s resp<strong>on</strong>se was “I<br />
wanted to drive. My Dad said you gotta take a<br />
class. I took a class.” He drove himself to work<br />
“sometimes”, with his fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r by his side, <strong>and</strong> to<br />
a city that was about 20 minutes from where<br />
he lived. Surprisingly, given his calm demeanor,<br />
Jack’s taste in music was hard rock,<br />
which he listened to often. He had his own<br />
T.V., his own ph<strong>on</strong>e <strong>and</strong> he frequently took<br />
his parents out to lunch <strong>and</strong> dinner. His parents<br />
stated that Jack knew how to use his<br />
m<strong>on</strong>ey “cautiously <strong>and</strong> wisely.”<br />
Work. Jack had a part-time paying job at a<br />
nursing home that he could keep up<strong>on</strong> school<br />
completi<strong>on</strong>. His tasks involved providing fresh<br />
ice water to <str<strong>on</strong>g>the</str<strong>on</strong>g> residences <strong>and</strong> he reportedly<br />
liked it <str<strong>on</strong>g>the</str<strong>on</strong>g>re. Jack was observed at <str<strong>on</strong>g>the</str<strong>on</strong>g> nursing<br />
home at which he worked three times a week.<br />
No assistance from vocati<strong>on</strong>al rehabilitati<strong>on</strong><br />
services or a specialized job coach were<br />
needed, nor desired by Jack or his parents.<br />
Family values – a legal guardian appointed.<br />
When Jack was just about to turn 18, his parents<br />
filed a petiti<strong>on</strong> to become <str<strong>on</strong>g>the</str<strong>on</strong>g> legal<br />
guardian of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir s<strong>on</strong>. Jack’s fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r began <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
discussi<strong>on</strong>:<br />
One of <str<strong>on</strong>g>the</str<strong>on</strong>g> things you asked about was for<br />
us to talk about guardianship <strong>and</strong> I’ve been<br />
thinking. I think you can break it down into<br />
two areas: <strong>on</strong>e with <str<strong>on</strong>g>the</str<strong>on</strong>g> people who are<br />
more reliant <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> government <strong>and</strong> SSI;<br />
<strong>and</strong> maybe people that can make it <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
own <strong>and</strong> d<strong>on</strong>’t rely <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> government.<br />
When you look at <str<strong>on</strong>g>the</str<strong>on</strong>g> people who d<strong>on</strong>’t rely<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> government, such as ourselves, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
advantage we find with a guardianship is we<br />
have authority <strong>and</strong> can make changes in<br />
Jack’s yearly investments, <str<strong>on</strong>g>the</str<strong>on</strong>g> things that he<br />
does, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> things he buys. Now if you<br />
were not in <str<strong>on</strong>g>the</str<strong>on</strong>g> positi<strong>on</strong> that we are, I think<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> role of <str<strong>on</strong>g>the</str<strong>on</strong>g> guardian may change. Not<br />
sure exactly how. The difficulty that we have<br />
in trying to give you an assessment as to<br />
whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r guardianship is a good thing-is that<br />
we’ve never been challenged <strong>on</strong> anything or<br />
had any problems because we take care of<br />
things ourselves, so it is difficult to give you<br />
plusses <strong>and</strong> minuses.<br />
Unlike Kevin <strong>and</strong> his parents, Jack <strong>and</strong> his<br />
parents did not want any of <str<strong>on</strong>g>the</str<strong>on</strong>g> human service<br />
agencies involved in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir lives. They did not<br />
get SSI or Medicaid, <strong>and</strong> did not wish to have<br />
Jack surrounded by pers<strong>on</strong>al care attendants.<br />
“Taking care of Jack is <str<strong>on</strong>g>the</str<strong>on</strong>g> family’s resp<strong>on</strong>sibility.<br />
Not <str<strong>on</strong>g>the</str<strong>on</strong>g> governments, or any<strong>on</strong>e else’s.”<br />
When Jack’s parents were asked how <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
learned about guardianship, his fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r stated:<br />
Through <str<strong>on</strong>g>the</str<strong>on</strong>g> schools. It was through <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
transiti<strong>on</strong> coordinator that we found out.<br />
Something that I thought was most effective<br />
about <str<strong>on</strong>g>the</str<strong>on</strong>g> school program was <str<strong>on</strong>g>the</str<strong>on</strong>g> transiti<strong>on</strong><br />
coordinator gave <str<strong>on</strong>g>the</str<strong>on</strong>g> parents informati<strong>on</strong>.<br />
Then us, <str<strong>on</strong>g>the</str<strong>on</strong>g> parents, could decide what we<br />
want: to take care of ourselves; or try to<br />
share those resp<strong>on</strong>sibilities. The reas<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
flag went up for us about guardianship is<br />
because of <str<strong>on</strong>g>the</str<strong>on</strong>g> medical situati<strong>on</strong>. If we were<br />
in ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r city or state or something, <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
may not deliver medical attenti<strong>on</strong> to Jack.<br />
An attorney gave us advice <strong>on</strong>e way. My<br />
bro<str<strong>on</strong>g>the</str<strong>on</strong>g>r is also involved with a h<strong>and</strong>icapped<br />
child, as is our sister-in-law. They advised us<br />
against guardianship. We looked at it as<br />
what we felt what was best for our s<strong>on</strong>. But<br />
again, we d<strong>on</strong>’t really know <str<strong>on</strong>g>the</str<strong>on</strong>g> plusses <strong>and</strong><br />
minuses of it because we haven’t been challenged.<br />
We felt that we had to have <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
Self-Determinati<strong>on</strong> <strong>and</strong> Guardianship / 287
ability to make decisi<strong>on</strong>s in <str<strong>on</strong>g>the</str<strong>on</strong>g> medical area<br />
<strong>and</strong> investment area <strong>and</strong> just his general<br />
care. We felt much more qualified to make<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se decisi<strong>on</strong>s than to have <str<strong>on</strong>g>the</str<strong>on</strong>g> court make<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>m. While Karen (mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r) <strong>and</strong> I are both<br />
alive, we d<strong>on</strong>’t see any problems because<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> estate is very simple. In <str<strong>on</strong>g>the</str<strong>on</strong>g> future, <str<strong>on</strong>g>the</str<strong>on</strong>g>re<br />
may be some problems <strong>and</strong> I’m not sure<br />
how guardianship might fit in. When we did<br />
this we had as many questi<strong>on</strong>s not to do it as<br />
we did to do it. Since we have d<strong>on</strong>e it, we<br />
think it’s great because we haven’t had any<br />
problems. However, like I said before, we<br />
haven’t been challenged.<br />
Jack’s mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r indicated that <str<strong>on</strong>g>the</str<strong>on</strong>g> <strong>on</strong>ly down<br />
side to being a guardian was that <strong>on</strong>ce a year<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y had to submit a form with <str<strong>on</strong>g>the</str<strong>on</strong>g> court, a<br />
resp<strong>on</strong>sibility <str<strong>on</strong>g>the</str<strong>on</strong>g>y did not know about before<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y filed <str<strong>on</strong>g>the</str<strong>on</strong>g> petiti<strong>on</strong>. Both of Jack’s parents<br />
indicated that <str<strong>on</strong>g>the</str<strong>on</strong>g> report had to be d<strong>on</strong>e in a<br />
timely manner <strong>and</strong> that from <str<strong>on</strong>g>the</str<strong>on</strong>g>ir view point<br />
it was an extremely c<strong>on</strong>fusing form. For <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
first two years, <str<strong>on</strong>g>the</str<strong>on</strong>g>y had <str<strong>on</strong>g>the</str<strong>on</strong>g> report sent back to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>m three times, as it was not acceptable by<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> court.<br />
They just needed to know what you’ve spent<br />
<strong>on</strong> him in <str<strong>on</strong>g>the</str<strong>on</strong>g> last year, <strong>and</strong> let <str<strong>on</strong>g>the</str<strong>on</strong>g>m know<br />
if he’s comfortable. That part is extremely<br />
easy. Where we’ve had trouble is trying to<br />
rec<strong>on</strong>cile accounts from <strong>on</strong>e year to <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
next, <strong>and</strong> carrying things forward with <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
trust we have set up.<br />
Jack’s parents indicated that <str<strong>on</strong>g>the</str<strong>on</strong>g>y “felt bad<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> court had to come back” to <str<strong>on</strong>g>the</str<strong>on</strong>g>m to<br />
find out or have to ask for more informati<strong>on</strong><br />
as to <str<strong>on</strong>g>the</str<strong>on</strong>g> balance from <strong>on</strong>e year to <str<strong>on</strong>g>the</str<strong>on</strong>g> next.<br />
“We feel somewhat knowledgeable in this area<br />
seeing that we’ve been in business for a good<br />
part of our lives, involved with finance. We got<br />
thinking, if we’ve gotten in trouble with this,<br />
imagine <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r people.”<br />
Jack’s parents believe that “<str<strong>on</strong>g>the</str<strong>on</strong>g> Judge’s<br />
court has been simply outst<strong>and</strong>ing.” This is<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir experience:<br />
Author. You found an attorney that you felt<br />
comfortable to go through <str<strong>on</strong>g>the</str<strong>on</strong>g> process<br />
with?<br />
Mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r. Yes, we have our own attorney.<br />
Author. Can you tell me what happened<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> court?<br />
288 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r. Well it was fantastic. The judge<br />
got Jack up <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> judge’s bench <strong>and</strong> let<br />
him take <str<strong>on</strong>g>the</str<strong>on</strong>g> gavel. It was very pers<strong>on</strong>al. We<br />
know <str<strong>on</strong>g>the</str<strong>on</strong>g> Judge very well.<br />
Mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r. Jack sat with his attorney.<br />
Author. Separate from yours?<br />
Fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r. Yes. So we had our attorney <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>n ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r for Jack to make sure that he<br />
was defended. I think that was a good thing.<br />
We wanted to make sure that he was represented<br />
by some<strong>on</strong>e o<str<strong>on</strong>g>the</str<strong>on</strong>g>r than his guardian.<br />
I think it is required by <str<strong>on</strong>g>the</str<strong>on</strong>g> court. The attorney<br />
tried to help explain what he was<br />
getting into. If he was comfortable with us<br />
as guardians. Very deep questi<strong>on</strong>s.<br />
Mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r. Simple though. Jack would answer<br />
“yes” or “no.” It was a great experience<br />
for him . . . different though . . . in <str<strong>on</strong>g>the</str<strong>on</strong>g> attorney’s<br />
office, <strong>and</strong> in <str<strong>on</strong>g>the</str<strong>on</strong>g> court room.<br />
Author: Did Jack testify in court?<br />
Mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r. Not really. He just had to say “yes<br />
or no.” The questi<strong>on</strong>s were very simple. The<br />
judge has a very soft spot for children <strong>and</strong><br />
would probably treat any child very special.<br />
Jack’s fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r encouraged him to participate in<br />
c<strong>on</strong>versati<strong>on</strong>s. “Tell about when we went to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> Judge’s court. What happened <str<strong>on</strong>g>the</str<strong>on</strong>g>re? Remember<br />
when we went to <str<strong>on</strong>g>the</str<strong>on</strong>g> court room?”<br />
Jack said “Oh yeah, I met with my judge, <strong>and</strong><br />
he said what do you want me to do for you?<br />
And I said I want my Dad, <strong>and</strong> he said, court<br />
is adjourned <strong>and</strong> stuff like that.” To remember<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> details of what occurred three years<br />
ago was a challenge for Jack, but he did recall<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> main events. These parents <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir 21<br />
year old adult s<strong>on</strong> viewed <str<strong>on</strong>g>the</str<strong>on</strong>g>ir experience<br />
with <str<strong>on</strong>g>the</str<strong>on</strong>g> court as “positive.”<br />
Jack’s parents were asked whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r <str<strong>on</strong>g>the</str<strong>on</strong>g>y had<br />
thought about a backup guardian, because a<br />
court determined need for a guardian st<strong>and</strong>s<br />
over <str<strong>on</strong>g>the</str<strong>on</strong>g> ward, regardless if <str<strong>on</strong>g>the</str<strong>on</strong>g> guardian dies<br />
or decides to be relieved of guardianship duties<br />
<strong>and</strong> resp<strong>on</strong>sibilities. Jack’s mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r shared<br />
“He’s (<str<strong>on</strong>g>the</str<strong>on</strong>g> fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r) <str<strong>on</strong>g>the</str<strong>on</strong>g> guardian <strong>and</strong> I’m <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
backup. You really have to think l<strong>on</strong>g term.”<br />
The fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r added “What we’ve d<strong>on</strong>e is set that<br />
up with <str<strong>on</strong>g>the</str<strong>on</strong>g> trust. We have looked through<br />
that process so that 15-20 years from now, Jack<br />
would be taken care of . . . that’s why we had<br />
an attorney for him to make sure everything<br />
was set up. Regardless of what people told us<br />
not to do, we got everything set up. That’s why
we felt str<strong>on</strong>gly that we needed informati<strong>on</strong>.<br />
So that’s our view, <strong>and</strong> where we come from.”<br />
In additi<strong>on</strong> to <str<strong>on</strong>g>the</str<strong>on</strong>g> courts m<strong>on</strong>itoring yearly<br />
reports, Jack’s mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r shared that a court appointed<br />
social worker made annual visits to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir home.<br />
Mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r. A social worker comes to <str<strong>on</strong>g>the</str<strong>on</strong>g> door<br />
very unexpectedly, <strong>and</strong> comes <strong>and</strong> checks<br />
<strong>on</strong> Jack . . . without any call ahead.<br />
Fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r. Which I think is really, really neat.<br />
It is through <str<strong>on</strong>g>the</str<strong>on</strong>g> Judge’s court room, that’s<br />
how it’s d<strong>on</strong>e. I think it’s how <str<strong>on</strong>g>the</str<strong>on</strong>g> system is.<br />
It’s in <str<strong>on</strong>g>the</str<strong>on</strong>g> law. I think it’s written in <str<strong>on</strong>g>the</str<strong>on</strong>g>re<br />
but I d<strong>on</strong>’t think people ever do it. I think<br />
we have <strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g> very few judges who ever<br />
does this. The visits are very spotty, <str<strong>on</strong>g>the</str<strong>on</strong>g>re’s<br />
not a pattern to it.<br />
Mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r. Yeah, <str<strong>on</strong>g>the</str<strong>on</strong>g>re’s no pattern to it.<br />
You just have a knock at <str<strong>on</strong>g>the</str<strong>on</strong>g> door <strong>and</strong> I had<br />
a woman <strong>on</strong>e time <strong>and</strong> a man this last time.<br />
They just want to see Jack’s bedroom.<br />
Guardian defined? Jack, who legally had all<br />
his decisi<strong>on</strong>-making rights taken <strong>and</strong> given to<br />
his fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r, made decisi<strong>on</strong>s about preparing his<br />
work stati<strong>on</strong>, <strong>and</strong> deciding which patients at<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> nursing home needed water <strong>and</strong> who did<br />
not. The nursing home manager acknowledged<br />
his decisi<strong>on</strong> making ability <strong>and</strong> applauded<br />
it, frequently asking Jack to train<br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>r people. “He learned right away about<br />
who needed water <strong>and</strong> who did not. When he<br />
goes <strong>on</strong> vacati<strong>on</strong>, he makes sure that a substitute<br />
is trained <strong>and</strong> is scheduled to cover for<br />
him. He does this all <strong>on</strong> his own. No supports<br />
or reminders.”<br />
During observati<strong>on</strong>s, Jack not <strong>on</strong>ly decided<br />
what he would do at work, but directed <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
author as well. He said, “Put your coat <str<strong>on</strong>g>the</str<strong>on</strong>g>re,<br />
<strong>and</strong> follow me.” He told <str<strong>on</strong>g>the</str<strong>on</strong>g> author that “If<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>re is a yellow flag <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> room, I am not to<br />
go in <str<strong>on</strong>g>the</str<strong>on</strong>g>re because <str<strong>on</strong>g>the</str<strong>on</strong>g> pers<strong>on</strong> is sick. I just<br />
look in each room <strong>and</strong> check to see if some<strong>on</strong>e<br />
wants water.” Jack spoke to a few residents<br />
he stated that he liked to talk to. “I am patient<br />
with <str<strong>on</strong>g>the</str<strong>on</strong>g> people who think I am <str<strong>on</strong>g>the</str<strong>on</strong>g>ir s<strong>on</strong>.”<br />
When shopping at <str<strong>on</strong>g>the</str<strong>on</strong>g> mall, Jack walked<br />
side by side his parents <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>y engaged in<br />
causal c<strong>on</strong>versati<strong>on</strong>s.<br />
Fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r. He pays for all his things.<br />
Jack. I keep an eye <strong>on</strong> things <strong>and</strong> stuff like<br />
that.<br />
Mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r. He has a savings account.<br />
Jack. Yeah, a savings account <strong>and</strong> ah, if I<br />
d<strong>on</strong>’t know what to do with it (m<strong>on</strong>ey) I put<br />
it in <str<strong>on</strong>g>the</str<strong>on</strong>g> savings account <strong>and</strong> see how much<br />
I am saving.<br />
Fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r. How many dollars do you always<br />
keep in your wallet for going to Mc-<br />
D<strong>on</strong>ald’s?<br />
Jack. Oh, a couple dollars.<br />
Fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r. A little more than a couple<br />
(laughs).<br />
Mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r. Jack buys lunch for <str<strong>on</strong>g>the</str<strong>on</strong>g> family a<br />
lot.<br />
Jack. Yes, I do.<br />
Fa<str<strong>on</strong>g>the</str<strong>on</strong>g>r. At <str<strong>on</strong>g>the</str<strong>on</strong>g> nursing home, he is making<br />
$3,000 to $5,000 per year <strong>and</strong> after two<br />
years he has really built up his nest egg.<br />
Jack. I am making a lot of m<strong>on</strong>ey. Ah,<br />
sometimes, if I see a nice shirt I’ll buy it. I<br />
like looking in <str<strong>on</strong>g>the</str<strong>on</strong>g> mall store, to make sure<br />
stuffs a good deal.<br />
Discussi<strong>on</strong> <strong>and</strong> Implicati<strong>on</strong>s<br />
The importance of promoting self-determinati<strong>on</strong><br />
skills of youth <strong>and</strong> young adults with disabilities<br />
during <str<strong>on</strong>g>the</str<strong>on</strong>g> school years c<strong>on</strong>tinues to<br />
be emphasized in legislati<strong>on</strong>, literature, <strong>and</strong><br />
research. It has even been suggested that an<br />
indicator of special educati<strong>on</strong> services success<br />
can be measured by <str<strong>on</strong>g>the</str<strong>on</strong>g> extent to which students<br />
with disabilities are <str<strong>on</strong>g>the</str<strong>on</strong>g> guiding force of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir own lives (Agran, Blanchard, & Wehmeyer,<br />
2000). For youth who are about to<br />
become adults, it is imperative to underst<strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir family members’, values regarding<br />
self-determinati<strong>on</strong>. Grigal, Neubert,<br />
Mo<strong>on</strong>, <strong>and</strong> Graham (2003) stated “Undoubtedly<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> success of self-determinati<strong>on</strong> depends<br />
<strong>on</strong> parents’ views of its appropriateness <strong>and</strong><br />
desirability.” (p. 98). Although parent views<br />
are important, <str<strong>on</strong>g>the</str<strong>on</strong>g> success, as it was found in<br />
this study, depends heavily <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> values of<br />
educators, service providers, <strong>and</strong> members of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> judiciary (e.g., attorney, judge) who may<br />
work for <strong>and</strong> with families.<br />
IDEA m<strong>and</strong>ates that <strong>on</strong>ce students reach<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> age of majority, <str<strong>on</strong>g>the</str<strong>on</strong>g>y will assume <str<strong>on</strong>g>the</str<strong>on</strong>g> rights<br />
<strong>on</strong>ce accorded to <str<strong>on</strong>g>the</str<strong>on</strong>g>ir parents, unless <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
competence is in questi<strong>on</strong>. A c<strong>on</strong>cern was<br />
raised that if competence was challenged,<br />
guardian appointments may occur, thus negatively<br />
impacting <str<strong>on</strong>g>the</str<strong>on</strong>g> self-determinati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
Self-Determinati<strong>on</strong> <strong>and</strong> Guardianship / 289
young adult. In additi<strong>on</strong> to examining <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
impact of guardianship, it was anticipated that<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> young adults who participated in this study<br />
would affirm an assumpti<strong>on</strong> that a schoolaged<br />
young adult with developmental disability<br />
who had full legal guardian appointed<br />
would exhibit few, if any, self-determinati<strong>on</strong><br />
skills in comparis<strong>on</strong> to a peer who did not<br />
have a guardian. Surprisingly, this was not <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
case. As a result, <str<strong>on</strong>g>the</str<strong>on</strong>g> findings of <str<strong>on</strong>g>the</str<strong>on</strong>g>se case<br />
studies extend <str<strong>on</strong>g>the</str<strong>on</strong>g> research by providing <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
first examinati<strong>on</strong> of how guardians, legal or<br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>rwise, impact <str<strong>on</strong>g>the</str<strong>on</strong>g> self-determinati<strong>on</strong> opportunities<br />
for school-aged young adults with<br />
developmental disabilities.<br />
Despite <str<strong>on</strong>g>the</str<strong>on</strong>g> importance of family <strong>and</strong><br />
teacher efforts to promote self-determinati<strong>on</strong><br />
of young adults, o<str<strong>on</strong>g>the</str<strong>on</strong>g>r forces (e.g., school administrator,<br />
service providers) at times impeded<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>m, as was seen with Kevin. This finding<br />
that a teacher (transiti<strong>on</strong> coordinator)<br />
actively promoted <str<strong>on</strong>g>the</str<strong>on</strong>g> development of students’<br />
self-determinati<strong>on</strong> skills c<strong>on</strong>trasts <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
findings of <str<strong>on</strong>g>the</str<strong>on</strong>g> Wehmeyer, Agran, <strong>and</strong><br />
Hughes (2000) <strong>and</strong> Katsyannis, Zhang, Woodruff,<br />
<strong>and</strong> Dix<strong>on</strong> (2005) studies where teachers<br />
realized <str<strong>on</strong>g>the</str<strong>on</strong>g> importance of self-determinati<strong>on</strong><br />
skills, but did not necessarily teach <str<strong>on</strong>g>the</str<strong>on</strong>g>m. A<br />
c<strong>on</strong>cern raised in this study, ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r, is <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
disc<strong>on</strong>nect observed between <str<strong>on</strong>g>the</str<strong>on</strong>g> school administrator’s<br />
percepti<strong>on</strong> of Kevin’s competence<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> parents’ values <strong>and</strong> teacher’s<br />
role in helping <str<strong>on</strong>g>the</str<strong>on</strong>g> student dem<strong>on</strong>strate his<br />
abilities. It was almost as if <str<strong>on</strong>g>the</str<strong>on</strong>g> fact that Kevin<br />
had a developmental disability, <str<strong>on</strong>g>the</str<strong>on</strong>g> administrator<br />
assumed incompetence.<br />
Turnbull <strong>and</strong> Turnbull (2001) suggested<br />
that individuals with developmental disabilities<br />
most likely will require <strong>on</strong>going support<br />
from o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs to experience a quality life. Unfortunately,<br />
in this study it appeared that<br />
Kevin <strong>and</strong> his parents would be challenged<br />
with building alliances that would enable<br />
Kevin to be self-determined. Although <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
transiti<strong>on</strong> coordinator <strong>and</strong> families are applauded<br />
for teaching self-determinati<strong>on</strong> skills,<br />
a need exists to work <strong>on</strong> such skill development<br />
within a larger c<strong>on</strong>text, bey<strong>on</strong>d <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
school building. Teaching students self-determinati<strong>on</strong><br />
skills (e.g., making choices) is important,<br />
but perhaps more important is ensuring<br />
significant o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs, including pers<strong>on</strong>al<br />
assistants from community agencies, acknowl-<br />
290 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
edge <strong>and</strong> respect <str<strong>on</strong>g>the</str<strong>on</strong>g> students’ communicati<strong>on</strong>.<br />
It has been argued that individuals with<br />
disabilities have had limited influence over<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir lives <strong>and</strong> c<strong>on</strong>versely have had <str<strong>on</strong>g>the</str<strong>on</strong>g>ir lives<br />
unnecessarily c<strong>on</strong>trolled by o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs (Lisi et al.),<br />
<strong>and</strong> as a result, a cycle of dependency <strong>and</strong> less<br />
independence may be created. Kevin’s parents<br />
made substantial effort to establish envir<strong>on</strong>ments<br />
where <str<strong>on</strong>g>the</str<strong>on</strong>g>ir s<strong>on</strong> could express <strong>and</strong><br />
fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r develop his self-determinati<strong>on</strong> skills,<br />
however Kevin’s expressi<strong>on</strong>s were stifled, even<br />
in his own home. This finding is in c<strong>on</strong>trast to<br />
a study c<strong>on</strong>ducted by Wehmeyer, Kelchner,<br />
<strong>and</strong> Richards (1995) who found that adults<br />
with developmental disabilities who lived independently<br />
were more self-determined than<br />
individuals who lived in group homes. The<br />
findings from this study are more aligned with<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> results from <str<strong>on</strong>g>the</str<strong>on</strong>g> Wehmeyer <strong>and</strong> Metzler<br />
(1995) study were adults with developmental<br />
disabilities indicated that <str<strong>on</strong>g>the</str<strong>on</strong>g>y had limited<br />
c<strong>on</strong>trol over important life choices <strong>and</strong> decisi<strong>on</strong>s.<br />
Wehmeyer <strong>and</strong> Metzler c<strong>on</strong>cluded that<br />
people with developmental disabilities may be<br />
in envir<strong>on</strong>ments that are overly structured or<br />
protective <strong>and</strong> do not place emphasis <strong>on</strong> opportunities<br />
to make meaningful choices <strong>and</strong><br />
decisi<strong>on</strong>s <strong>and</strong> solve problems.<br />
This study has also brought to light that<br />
‘guardian’ may be interpreted in a variety of<br />
ways. If not having a guardian means an individual<br />
is living a life based <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir values,<br />
preferences, <strong>and</strong> choices without external<br />
forces, Kevin had a guardian, <strong>and</strong> in fact several<br />
– <str<strong>on</strong>g>the</str<strong>on</strong>g>y just were not court appointed.<br />
Many of <str<strong>on</strong>g>the</str<strong>on</strong>g> decisi<strong>on</strong>s he attempted to communicate<br />
(e.g., desire for a cola instead of<br />
milk), although not life critical, were not h<strong>on</strong>ored.<br />
For Jack, who had a legal guardian, it<br />
was clear to whom he interacted with that he<br />
made many decisi<strong>on</strong>s. Jack was exercising selfdeterminati<strong>on</strong>,<br />
even with <str<strong>on</strong>g>the</str<strong>on</strong>g> fact he had a<br />
legal guardian. The findings from this study<br />
for <strong>on</strong>e individual, Jack, suggest that guardian<br />
appointments may not impact <str<strong>on</strong>g>the</str<strong>on</strong>g> day to day<br />
decisi<strong>on</strong>-making of some individuals. His parents<br />
admitted that <str<strong>on</strong>g>the</str<strong>on</strong>g>y have not needed to<br />
use <str<strong>on</strong>g>the</str<strong>on</strong>g>ir legal authority, however, since <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
became legal guardians three years earlier. As<br />
a point of cauti<strong>on</strong>, Jack’s situati<strong>on</strong> may be<br />
excepti<strong>on</strong>al in that he had a family network to<br />
support him which c<strong>on</strong>trasts findings found in
literature, mostly to do with <str<strong>on</strong>g>the</str<strong>on</strong>g> elderly, where<br />
abuse <strong>and</strong> misuse of guardian powers were<br />
observed (Lisi et al., 1994).<br />
Jack’s situati<strong>on</strong> fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r reflects <str<strong>on</strong>g>the</str<strong>on</strong>g> finding<br />
of a study c<strong>on</strong>ducted by Stancliffe et al. (2000)<br />
who found that some adults with guardians<br />
displayed self-determinati<strong>on</strong> competencies<br />
that were as good or better than o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs who<br />
had not been assigned a guardian. The authors<br />
suggested that perhaps <str<strong>on</strong>g>the</str<strong>on</strong>g> self-determinati<strong>on</strong><br />
skills of some individuals steadily increased<br />
over time as a result of experiences.<br />
They also suggested that in <str<strong>on</strong>g>the</str<strong>on</strong>g>se situati<strong>on</strong>s<br />
courts should reevaluate guardian appointments<br />
or resp<strong>on</strong>sibilities, <strong>and</strong> cauti<strong>on</strong>ed that<br />
if too much time is taken to rec<strong>on</strong>sider guardian<br />
roles, <str<strong>on</strong>g>the</str<strong>on</strong>g>n a ward’s motivati<strong>on</strong> to exhibit<br />
self-determinati<strong>on</strong> may decrease, or potentially<br />
deteriorate. It is possible for individuals<br />
to petiti<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> court to modify or remove<br />
guardian appointments. An interesting finding<br />
about Jack’s situati<strong>on</strong> is that <str<strong>on</strong>g>the</str<strong>on</strong>g> parents<br />
were adamant about family taking care of family.<br />
Curiously, <str<strong>on</strong>g>the</str<strong>on</strong>g>y did not seem to view <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
court’s authority, annual reports <str<strong>on</strong>g>the</str<strong>on</strong>g>y had to<br />
submit to <str<strong>on</strong>g>the</str<strong>on</strong>g> judge, or social worker home<br />
visits as intrusi<strong>on</strong>s.<br />
It has been suggested that families need to<br />
have access to informati<strong>on</strong> to make informed<br />
choices regarding guardianship (Millar, 2003;<br />
Millar & Renzaglia, 2002). In additi<strong>on</strong> to this<br />
informati<strong>on</strong>, each family has to have individualized<br />
support <strong>and</strong> guidance by school pers<strong>on</strong>nel.<br />
Although Jack’s family believed <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
were informed, <str<strong>on</strong>g>the</str<strong>on</strong>g>y had at times inaccurate<br />
or incomplete informati<strong>on</strong>. For example,<br />
medical issues, a main reas<strong>on</strong> for filing a petiti<strong>on</strong><br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g>ir s<strong>on</strong>, may have sufficiently been<br />
taken care of in different ways (e.g., ‘next of<br />
kin,’ ‘power of attorney,’ ‘emergency/temporary<br />
guardianship). Alternatives could have<br />
been explored (see Millar, 2007 for potential<br />
alternatives), hence reducing <str<strong>on</strong>g>the</str<strong>on</strong>g> need for<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>m to write reports for <str<strong>on</strong>g>the</str<strong>on</strong>g> courts, <strong>and</strong> unnecessarily<br />
limiting <str<strong>on</strong>g>the</str<strong>on</strong>g>ir s<strong>on</strong>’s legal rights. Because<br />
legal issues can be c<strong>on</strong>fusing <strong>and</strong> complex,<br />
it is essential that members of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
judiciary (e.g., probate clerks who register<br />
guardian petiti<strong>on</strong>s, attorneys, judges) learn<br />
about self-determinati<strong>on</strong> initiatives <strong>and</strong> ways<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y too can support individuals with disabilities<br />
to remain aut<strong>on</strong>omous. Perhaps members<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> judiciary, ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r prior to or at <str<strong>on</strong>g>the</str<strong>on</strong>g> time<br />
a petiti<strong>on</strong> for guardianship is filed with <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
courts, can work with families to ensure <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
underst<strong>and</strong> what guardianship entails <strong>and</strong> its<br />
alternatives.<br />
Limitati<strong>on</strong>s <strong>and</strong> Future Research Ideas<br />
Although this study provides important new<br />
informati<strong>on</strong>, <strong>and</strong> used sound strategies for<br />
c<strong>on</strong>ducting quality case studies (e.g., prol<strong>on</strong>ged<br />
observati<strong>on</strong>s, members checking, triangulati<strong>on</strong><br />
of data), <str<strong>on</strong>g>the</str<strong>on</strong>g>re are limitati<strong>on</strong>s. For<br />
example, in <str<strong>on</strong>g>the</str<strong>on</strong>g> selecti<strong>on</strong> of participants, it is<br />
possible that <str<strong>on</strong>g>the</str<strong>on</strong>g>y are not representative of<br />
students in similar situati<strong>on</strong>s, hence restricting<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> ability to generalize <str<strong>on</strong>g>the</str<strong>on</strong>g> findings. A<br />
case study approach was used, however, because<br />
explorati<strong>on</strong> in this area of self-determinati<strong>on</strong><br />
in relati<strong>on</strong> to guardianship for young<br />
adults is new. It is anticipated that <str<strong>on</strong>g>the</str<strong>on</strong>g> less<strong>on</strong>s<br />
learned from this study will help with designing<br />
future research endeavors where larger<br />
numbers of individuals can have <str<strong>on</strong>g>the</str<strong>on</strong>g> opportunity<br />
to participate <strong>and</strong> have <str<strong>on</strong>g>the</str<strong>on</strong>g>ir voices heard.<br />
In additi<strong>on</strong>, this study has acted as a catalyst<br />
by raising several questi<strong>on</strong>s that could be addressed<br />
in future research initiatives. For example,<br />
how, if at all, has IDEA impacted <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
number of young adults having a guardian<br />
appointed? If a student’s competence is a c<strong>on</strong>cern,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>n to what extent are IEP present level<br />
of functi<strong>on</strong>al performance statements, goals,<br />
<strong>and</strong> objectives addressing this c<strong>on</strong>cern? When<br />
educators <strong>and</strong> service providers learn of<br />
guardian appointments, does <str<strong>on</strong>g>the</str<strong>on</strong>g>ir respect for<br />
<strong>and</strong> acti<strong>on</strong>s toward <str<strong>on</strong>g>the</str<strong>on</strong>g> individual with <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
disability change, <strong>and</strong> if so how? Ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
questi<strong>on</strong> to investigate is how prevalent is it<br />
that families petiti<strong>on</strong> courts at <str<strong>on</strong>g>the</str<strong>on</strong>g> time a student<br />
becomes of legal age? Does <str<strong>on</strong>g>the</str<strong>on</strong>g> awareness<br />
that a young adult with a disability who<br />
has been appointed a guardian lead to that<br />
individual becoming less likely to attempt to<br />
dem<strong>on</strong>strate self-determinati<strong>on</strong> attributes, or<br />
was Jack’s situati<strong>on</strong> an excepti<strong>on</strong>? O<str<strong>on</strong>g>the</str<strong>on</strong>g>r questi<strong>on</strong>s<br />
could relate to how often guardian appointments<br />
are modified or revoked if families<br />
realize that alternatives to guardian<br />
appointments can be used.<br />
Awhile ago Halpern (1994) wrote “if <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
transiti<strong>on</strong> process is to be successful, it must<br />
begin with helping students to gain a sense of<br />
empowerment with respect to <str<strong>on</strong>g>the</str<strong>on</strong>g>ir own tran-<br />
Self-Determinati<strong>on</strong> <strong>and</strong> Guardianship / 291
siti<strong>on</strong> planning.” (p. 118). Although <str<strong>on</strong>g>the</str<strong>on</strong>g>re has<br />
been improvement in supporting students in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir role during <str<strong>on</strong>g>the</str<strong>on</strong>g>ir pers<strong>on</strong>al transiti<strong>on</strong><br />
from school to post school envir<strong>on</strong>ments, it is<br />
essential that legislati<strong>on</strong>, school initiatives <strong>and</strong><br />
service supports, h<strong>on</strong>or <strong>and</strong> respect <str<strong>on</strong>g>the</str<strong>on</strong>g> individuals<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y serve, particularly if guardian appoints<br />
are a result of IDEA m<strong>and</strong>ate interpretati<strong>on</strong>s.<br />
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Received: 14 February 2007<br />
Initial Acceptance: 18 April 2007<br />
Final Acceptance: 14 July 2007<br />
Self-Determinati<strong>on</strong> <strong>and</strong> Guardianship / 293
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities, 2008, 43(3), 294–310<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities<br />
Factors Impacting <str<strong>on</strong>g>the</str<strong>on</strong>g> Enactment of a Functi<strong>on</strong>al Curriculum<br />
in Self-C<strong>on</strong>tained Cross-Categorical Programs<br />
Emily C. Bouck<br />
Purdue University<br />
Abstract: Factors relating to curriculum use in general educati<strong>on</strong> have been studied in c<strong>on</strong>siderable depth, yet<br />
little research has been c<strong>on</strong>ducted <strong>on</strong> what factors impact <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of curriculum in special educati<strong>on</strong>. This<br />
study specifically studied <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of a functi<strong>on</strong>al curriculum in two rural, self-c<strong>on</strong>tained, cross-categorical<br />
programs. The data revealed that it was <str<strong>on</strong>g>the</str<strong>on</strong>g> intersecti<strong>on</strong> <strong>and</strong> uni<strong>on</strong> of seven factors (policy/legislati<strong>on</strong>,<br />
community, school, teachers, paraprofessi<strong>on</strong>als, students, <strong>and</strong> curriculum materials) that shaped <str<strong>on</strong>g>the</str<strong>on</strong>g> enacted<br />
functi<strong>on</strong>al curriculum in both programs. The associati<strong>on</strong> between <str<strong>on</strong>g>the</str<strong>on</strong>g> factors <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
functi<strong>on</strong>al curriculum holds implicati<strong>on</strong>s for policy, research, <strong>and</strong> practice.<br />
“How we define curriculum makes a difference<br />
in how we think about it <strong>and</strong> how we<br />
plan it” (Morris<strong>on</strong>, 1993, p. 84). Little agreement<br />
exists am<strong>on</strong>g researchers or practiti<strong>on</strong>ers<br />
as to what c<strong>on</strong>stitutes curriculum, as it<br />
can refer to l<strong>on</strong>g-lasting educati<strong>on</strong>al programs,<br />
materials used in classrooms (i.e., textbooks),<br />
<strong>and</strong> experiences that students receive<br />
while in school (Morris<strong>on</strong>; Nolet & McLaughlin,<br />
2000). Although disagreement exists, it is<br />
understood that curriculum is complex <strong>and</strong><br />
reflects plans <strong>and</strong> activities that are to benefit<br />
students <strong>and</strong> help <str<strong>on</strong>g>the</str<strong>on</strong>g>m achieve specific goals<br />
(Nolet & McLaughlin).<br />
A curriculum is actually comprised of three<br />
comp<strong>on</strong>ents – <str<strong>on</strong>g>the</str<strong>on</strong>g> written (intended), enacted,<br />
<strong>and</strong> received curriculum. The written<br />
curriculum “is <str<strong>on</strong>g>the</str<strong>on</strong>g> official or adopted curriculum<br />
often c<strong>on</strong>tained in state or district policy”,<br />
<strong>and</strong> represents what students are expected to<br />
learn (Cuban, 1992; Nolet & McLaughlin,<br />
2000, p. 15). The enacted curriculum “is <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
operati<strong>on</strong>alizati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> intended curriculum”,<br />
<strong>and</strong> reflects <str<strong>on</strong>g>the</str<strong>on</strong>g> decisi<strong>on</strong>s a teacher<br />
This study represents <str<strong>on</strong>g>the</str<strong>on</strong>g> author’s doctoral dissertati<strong>on</strong>.<br />
She would like to thank her dissertati<strong>on</strong><br />
committee: Drs. Troy Mariage, Cindy Okolo, Carol<br />
Sue Englert, <strong>and</strong> S<strong>and</strong>ra Wilcox. Corresp<strong>on</strong>dence<br />
c<strong>on</strong>cerning this article should be addressed to Emily<br />
C. Bouck, Department of Educati<strong>on</strong>al Studies, Purdue<br />
University, 5146 BRNG Hall, 100 N. University,<br />
West Lafayette, Indiana 47907. E-mail: bouck@<br />
purdue.edu<br />
makes during implementati<strong>on</strong> (Nolet &<br />
McLaughlin, p. 16). It encompasses <str<strong>on</strong>g>the</str<strong>on</strong>g> formal<br />
<strong>and</strong> informal less<strong>on</strong>s <strong>and</strong> activities, as well<br />
as teachers’ behaviors, groupings, management<br />
strategies, beliefs, <strong>and</strong> comments (Cuban).<br />
The received curriculum “is what students<br />
actually learn as a result of being in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
classroom <strong>and</strong> interacting with <str<strong>on</strong>g>the</str<strong>on</strong>g> intended<br />
<strong>and</strong> taught curricula” (Nolet & McLaughlin,<br />
p. 17).<br />
Synder, Bolin, <strong>and</strong> Zumwalt (1992) exp<strong>and</strong>ed<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> definiti<strong>on</strong> of enacted curriculum<br />
to encompass a co-c<strong>on</strong>structi<strong>on</strong> of educati<strong>on</strong>al<br />
experiences by teachers <strong>and</strong> students. They<br />
suggested that an enacted curriculum is a<br />
transacti<strong>on</strong>al process where teachers <strong>and</strong> students<br />
interact, c<strong>on</strong>struct, <strong>and</strong> make meaning<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum <strong>and</strong> educati<strong>on</strong>al experiences<br />
within c<strong>on</strong>text. Yet, <str<strong>on</strong>g>the</str<strong>on</strong>g>ir exp<strong>and</strong>ed definiti<strong>on</strong><br />
may still be too narrow. This study<br />
proposes that <str<strong>on</strong>g>the</str<strong>on</strong>g> enacted curriculum is a<br />
transacti<strong>on</strong>al process, co-c<strong>on</strong>structed by teachers<br />
<strong>and</strong> students, <strong>and</strong> influenced by each<br />
<strong>on</strong>e’s history; <str<strong>on</strong>g>the</str<strong>on</strong>g> school; <str<strong>on</strong>g>the</str<strong>on</strong>g> communities in<br />
which <str<strong>on</strong>g>the</str<strong>on</strong>g> school, teachers, <strong>and</strong> students reside;<br />
instituti<strong>on</strong>al factors, such as federal <strong>and</strong><br />
state policies; <strong>and</strong> curriculum materials. This<br />
definiti<strong>on</strong> is depicted in Figure 1.<br />
Factors Impacting Curriculum<br />
294 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
According to Milner (2003) curriculum enactment<br />
<strong>and</strong> choice can be influenced by several
Figure 1. Proposed intersecti<strong>on</strong> of factors impacting<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of a functi<strong>on</strong>al curriculum.<br />
variables, including federal policies, state st<strong>and</strong>ards,<br />
school factors, <strong>and</strong> teacher factors.<br />
Morris<strong>on</strong> emphasized a sphere of influence<br />
<strong>on</strong> curriculum decisi<strong>on</strong> making c<strong>on</strong>sisting of<br />
society, legislati<strong>on</strong>/policy, <str<strong>on</strong>g>the</str<strong>on</strong>g> local school district,<br />
individual people, professi<strong>on</strong>al organizati<strong>on</strong>s,<br />
business/industry, foundati<strong>on</strong>s/agencies,<br />
teachers, textbooks, lobbying/special<br />
interest groups, <strong>and</strong> testing.<br />
Instituti<strong>on</strong>al policies <strong>and</strong> legislati<strong>on</strong>. Federal<br />
policies affect curriculum enactment within<br />
special educati<strong>on</strong>, such as No Child Left Behind<br />
(NCLB) (2002) <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> Individuals with Disabilities<br />
Educati<strong>on</strong> Act (IDEA) (1997, 2004).<br />
NCLB is built up<strong>on</strong> four pillars: str<strong>on</strong>ger accountability<br />
for results, more freedom for<br />
states <strong>and</strong> communities, encouraging <str<strong>on</strong>g>the</str<strong>on</strong>g> use<br />
of proven educati<strong>on</strong>al methods, <strong>and</strong> more<br />
choices for parents. This policy has led to a<br />
more rigorous general educati<strong>on</strong> curriculum<br />
<strong>and</strong> a presumed push towards using <str<strong>on</strong>g>the</str<strong>on</strong>g> general<br />
educati<strong>on</strong> curriculum for students with<br />
disabilities. Under NCLB teachers are to be<br />
held accountable for students’ progress <strong>on</strong><br />
state st<strong>and</strong>ards, suggesting that curricula must<br />
reflect teaching to <str<strong>on</strong>g>the</str<strong>on</strong>g> st<strong>and</strong>ards, or teaching<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> test (Karp, 2003; Patt<strong>on</strong>, Polloway, &<br />
Smith, 2000).<br />
The Individuals with Disabilities Educati<strong>on</strong> Improvement<br />
Act of 2004 is <str<strong>on</strong>g>the</str<strong>on</strong>g> reauthorizati<strong>on</strong> of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> Individuals with Disabilities Educati<strong>on</strong> Act,<br />
<strong>and</strong> reflects <str<strong>on</strong>g>the</str<strong>on</strong>g> government’s attempt to align<br />
IDEA ’97 with NCLB. It is focused <strong>on</strong> greater<br />
accountability <strong>and</strong> having highly qualified special<br />
educati<strong>on</strong> teachers in classrooms. IDEIA<br />
2004 has also been attributed to an increased<br />
focus <strong>on</strong> preparing students with disabilities<br />
for fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r educati<strong>on</strong>.<br />
Curriculum materials. Morris<strong>on</strong> (1993) discussed<br />
textbooks’ deterministic influence <strong>on</strong><br />
curriculum enactment, indicating that <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
tend to cater to <str<strong>on</strong>g>the</str<strong>on</strong>g> lowest ability students in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> classroom, ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r than <str<strong>on</strong>g>the</str<strong>on</strong>g> average or <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
more able students. Dyck <strong>and</strong> Pembert<strong>on</strong><br />
(2002) claimed that textbooks represent a<br />
central feature of curricula, particularly at <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
higher grades.<br />
School <strong>and</strong> community factors. Schools can<br />
influence curriculum through a district’s curriculum<br />
<strong>and</strong> philosophy, as well as <str<strong>on</strong>g>the</str<strong>on</strong>g> building’s<br />
climate (Milner, 2003; Waldrip & Giddings,<br />
1996). O<str<strong>on</strong>g>the</str<strong>on</strong>g>r school variables affecting<br />
curriculum are a school’s setting (rural, urban,<br />
<strong>and</strong> suburban) <strong>and</strong> size (see Bouck,<br />
2005; M<strong>on</strong>k & Haller, 1993). For example,<br />
rural schools are more likely to expose students<br />
to in-school jobs <strong>and</strong> work experience<br />
yet generally have fewer vocati<strong>on</strong>al educati<strong>on</strong>al<br />
choices (Baer et al., 2003; Huds<strong>on</strong> &<br />
Shafer, 2002). Research has suggested that<br />
rural schools are more likely to have crosscategorical<br />
programs than urban or suburban<br />
schools (Bouck, 2005). School size research<br />
shows similar results, with smaller schools offering<br />
fewer educati<strong>on</strong>al opportunities than<br />
larger schools (M<strong>on</strong>k & Haller, 1993).<br />
Teacher factors. Teachers shape how curriculum<br />
is enacted in classrooms (Milner, 2003).<br />
Remillard (1997) suggested that teachers play<br />
a more direct role than textbooks in <str<strong>on</strong>g>the</str<strong>on</strong>g> enacted<br />
curriculum as <str<strong>on</strong>g>the</str<strong>on</strong>g>y make <str<strong>on</strong>g>the</str<strong>on</strong>g> final decisi<strong>on</strong><br />
about what gets taught. Teachers’ pedagogical<br />
approaches, beliefs about course<br />
c<strong>on</strong>tent, knowledge about <str<strong>on</strong>g>the</str<strong>on</strong>g> community in<br />
which students live, c<strong>on</strong>tent knowledge, <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir own pers<strong>on</strong>al experiences all influence<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> delivery of curriculum (see Milner; Remillard<br />
& Bryans, 2003; Weiss, Pasley, Smith, Banilower,<br />
& Heck, 2003).<br />
Functi<strong>on</strong>al Curriculum<br />
While literature has explored <str<strong>on</strong>g>the</str<strong>on</strong>g>se factors in<br />
general educati<strong>on</strong> curricula, little has been<br />
Factors <strong>and</strong> Functi<strong>on</strong>al Curriculum / 295
studied in relati<strong>on</strong> to special educati<strong>on</strong>. Although<br />
special educati<strong>on</strong> has a range of<br />
curricula types (see Bigge, 1988; Sabornie &<br />
deBettencourt, 1997), this particular study<br />
chose to focus <strong>on</strong> functi<strong>on</strong>al curricula.<br />
Functi<strong>on</strong>al curriculum has lost favor <strong>and</strong><br />
declined in its use in practice due to recent<br />
federal policy pushing inclusi<strong>on</strong>, yet it still<br />
remains an important opti<strong>on</strong> for sec<strong>on</strong>dary<br />
students with disabilities (Bigge, Stump,<br />
Spagna, & Silberman, 1999; Patt<strong>on</strong>, Cr<strong>on</strong>in,<br />
& Bassett, 1997; Polloway, Patt<strong>on</strong>, Smith, &<br />
Roderique, 1991).<br />
Functi<strong>on</strong>al curricula represent curriculum<br />
models created to teach functi<strong>on</strong>al life skills,<br />
or in o<str<strong>on</strong>g>the</str<strong>on</strong>g>r words, <str<strong>on</strong>g>the</str<strong>on</strong>g> skills necessary to live,<br />
work, <strong>and</strong> have fun in an inclusive community<br />
(Brown et al., 1979; Falvey, 1989; Snell &<br />
Browder, 1987). Functi<strong>on</strong>al curricula resulted<br />
from <str<strong>on</strong>g>the</str<strong>on</strong>g> belief that what was occurring in<br />
schools failed to reflect <str<strong>on</strong>g>the</str<strong>on</strong>g> skills necessary for<br />
post-school success (Retish, Hitchings, Horvath,<br />
Schmalle, 1991). Comp<strong>on</strong>ents of a functi<strong>on</strong>al<br />
or life management curriculum supported<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> literature include <str<strong>on</strong>g>the</str<strong>on</strong>g> functi<strong>on</strong>al<br />
applicati<strong>on</strong>s of core subject areas (academics),<br />
vocati<strong>on</strong>al educati<strong>on</strong>, community access,<br />
daily living, financial, independent living,<br />
transportati<strong>on</strong>, social/relati<strong>on</strong>ships, <strong>and</strong> selfdeterminati<strong>on</strong><br />
(Patt<strong>on</strong>, Cr<strong>on</strong>in, & Jairrels,<br />
1997).<br />
In recogniti<strong>on</strong> that students with disabilities<br />
are not well prepared for adult life, <str<strong>on</strong>g>the</str<strong>on</strong>g>re has<br />
been a growing number of authors calling for<br />
implementati<strong>on</strong> of a functi<strong>on</strong>al curriculum<br />
(Bouck, 2004; Cr<strong>on</strong>in, 1996; Dever & Knapczyk,<br />
1997; Patt<strong>on</strong> et al., 2000). Unfortunately<br />
a functi<strong>on</strong>al curricula approach is an underresearched<br />
area in <str<strong>on</strong>g>the</str<strong>on</strong>g> field of sec<strong>on</strong>dary special<br />
educati<strong>on</strong>. This includes its comp<strong>on</strong>ents,<br />
enactment, <strong>and</strong> its influence <strong>on</strong> post-school<br />
outcomes. Although some researchers <strong>and</strong><br />
practiti<strong>on</strong>ers feel that a functi<strong>on</strong>al curriculum<br />
is <strong>on</strong>ly appropriate for students with severe<br />
disabilities (see Clark, 1994), o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs (e.g., Patt<strong>on</strong><br />
et al.) have argued that all students with<br />
disabilities need a functi<strong>on</strong>al curriculum, particularly<br />
at <str<strong>on</strong>g>the</str<strong>on</strong>g> sec<strong>on</strong>dary level. Billingsley <strong>and</strong><br />
Alberst<strong>on</strong> (1999) suggested that special educati<strong>on</strong><br />
students’ quality of life is dependent <strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> acquisiti<strong>on</strong> of functi<strong>on</strong>al skills.<br />
Research Study<br />
This research sought to underst<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> factors<br />
affecting <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of a functi<strong>on</strong>al<br />
curriculum in two rural sec<strong>on</strong>dary self-c<strong>on</strong>tained<br />
cross-categorical programs. This article<br />
represents <strong>on</strong>e aspect of a larger study of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
enactment of a functi<strong>on</strong>al curriculum in <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
two settings. The study sought to answer <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
questi<strong>on</strong>, what is <str<strong>on</strong>g>the</str<strong>on</strong>g> nature of <str<strong>on</strong>g>the</str<strong>on</strong>g> influence<br />
of factors <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of a functi<strong>on</strong>al<br />
curriculum when factors are hypo<str<strong>on</strong>g>the</str<strong>on</strong>g>sized as<br />
policy/legislati<strong>on</strong>, community, school, teachers,<br />
students, <strong>and</strong> curriculum materials?<br />
Factors influencing <str<strong>on</strong>g>the</str<strong>on</strong>g> implementati<strong>on</strong> of<br />
a functi<strong>on</strong>al curriculum in sec<strong>on</strong>dary special<br />
educati<strong>on</strong> classrooms are important to investigate<br />
as little current research exists <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
use of a functi<strong>on</strong>al curriculum at <str<strong>on</strong>g>the</str<strong>on</strong>g> sec<strong>on</strong>dary<br />
level for students with disabilities educated<br />
in cross-categorical programs. Yet, a functi<strong>on</strong>al<br />
curriculum represents an essential opti<strong>on</strong><br />
as it is not <strong>on</strong>ly used in practice but also<br />
desired by practiti<strong>on</strong>ers <strong>and</strong> parents. Research<br />
has shown that both groups have expressed<br />
c<strong>on</strong>cern that a functi<strong>on</strong>al curriculum will be<br />
replaced by a more academically focused curriculum<br />
without enough research <strong>on</strong> a functi<strong>on</strong>al<br />
approach to educating sec<strong>on</strong>dary students<br />
with disabilities (Bouck, 2004; Ols<strong>on</strong>,<br />
2004; Patt<strong>on</strong> et al., 2000). Finally, knowing<br />
how well sec<strong>on</strong>dary schools prepare students<br />
with disabilities for <str<strong>on</strong>g>the</str<strong>on</strong>g>ir life <strong>and</strong> work roles<br />
should be central to curriculum implementati<strong>on</strong>,<br />
particularly for sec<strong>on</strong>dary students with<br />
disabilities (Eisenman, 2001; Rabren, Dunn, &<br />
Chambers, 2002). However before <str<strong>on</strong>g>the</str<strong>on</strong>g> field<br />
can advocate for implementing a particular<br />
curriculum, research should be c<strong>on</strong>ducted to<br />
determine what <str<strong>on</strong>g>the</str<strong>on</strong>g> implementati<strong>on</strong> of different<br />
curricula opti<strong>on</strong>s look like in <str<strong>on</strong>g>the</str<strong>on</strong>g>se classrooms<br />
<strong>and</strong> also what factors affect that implementati<strong>on</strong>.<br />
This study undertakes this process<br />
for functi<strong>on</strong>al curricula.<br />
Method<br />
Participants<br />
296 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Teachers. One teacher from each of two<br />
districts participated in <str<strong>on</strong>g>the</str<strong>on</strong>g> project. Both<br />
teachers started <str<strong>on</strong>g>the</str<strong>on</strong>g>ir respective self-c<strong>on</strong>tained<br />
cross-categorical program <strong>and</strong> had been
teaching in each program for five years. One<br />
teacher, Paula, had been a n<strong>on</strong>-traditi<strong>on</strong>al<br />
teacher educati<strong>on</strong> student, returning to college<br />
for her teaching certificate after 25 years<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> business world. The o<str<strong>on</strong>g>the</str<strong>on</strong>g>r teacher, Katie,<br />
had been a traditi<strong>on</strong>al teacher educati<strong>on</strong><br />
c<strong>and</strong>idate. Katie had focused her preparati<strong>on</strong><br />
<strong>on</strong> sec<strong>on</strong>dary special educati<strong>on</strong> while Paula<br />
had prepared herself for elementary special<br />
educati<strong>on</strong>.<br />
Teachers were selected because <str<strong>on</strong>g>the</str<strong>on</strong>g>y both<br />
stated <str<strong>on</strong>g>the</str<strong>on</strong>g>y taught a functi<strong>on</strong>al curriculum to<br />
students educated in a cross-categorical selfc<strong>on</strong>tained<br />
sec<strong>on</strong>dary program, <str<strong>on</strong>g>the</str<strong>on</strong>g> study’s target<br />
populati<strong>on</strong>. Both teachers <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
schools were also located in <str<strong>on</strong>g>the</str<strong>on</strong>g> same county,<br />
which was an intenti<strong>on</strong>al decisi<strong>on</strong> to minimize<br />
factors related to county services as well as<br />
geographical variables. Finally, <str<strong>on</strong>g>the</str<strong>on</strong>g> schools<br />
were selected because <str<strong>on</strong>g>the</str<strong>on</strong>g>y were comparable<br />
in characteristics <strong>and</strong> each teacher was <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
<strong>on</strong>ly teacher in <str<strong>on</strong>g>the</str<strong>on</strong>g> school teaching a selfc<strong>on</strong>tained<br />
classroom, which differed from <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
resource room program at each school.<br />
Students. Seven of Katie’s 14 students participated<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> study (i.e., observati<strong>on</strong>s, interviews,<br />
<strong>and</strong> file reviews): <strong>on</strong>e senior, two juniors,<br />
two sophomores, <strong>and</strong> two freshmen.<br />
Three of <str<strong>on</strong>g>the</str<strong>on</strong>g> students were diagnosed as having<br />
a learning disability, two as having a cognitive<br />
impairment (mild), <strong>on</strong>e as Autistically<br />
impaired, <strong>and</strong> <strong>on</strong>e as o<str<strong>on</strong>g>the</str<strong>on</strong>g>rwise health impaired.<br />
The average IQ across <str<strong>on</strong>g>the</str<strong>on</strong>g> participating<br />
students was 77.6. One of Katie’s students<br />
was female, <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r six were male. Paula had<br />
eight of her nine students participate: <strong>on</strong>e<br />
senior, three juniors, <strong>and</strong> four freshmen. Four<br />
of her students were female <strong>and</strong> four male.<br />
The average IQ of Paula’s students was 68.5,<br />
<strong>and</strong> her students’ were diagnosed as a learning<br />
disability (3), having mild mental impairment<br />
(3), moderate mental impairment (1)<br />
<strong>and</strong> emoti<strong>on</strong>al impairment (1). All students in<br />
both classes had utilized special educati<strong>on</strong> services<br />
since early elementary; <str<strong>on</strong>g>the</str<strong>on</strong>g> majority attended<br />
each district’s pre-primary program<br />
(PPI, now known as early childhood developmental<br />
delay program).<br />
Paraprofessi<strong>on</strong>als. Each school had two<br />
paraprofessi<strong>on</strong>als that worked with students in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> program, although <str<strong>on</strong>g>the</str<strong>on</strong>g>y were not necessarily<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> room simultaneously. In River<br />
Bend High School, <strong>on</strong>e paraprofessi<strong>on</strong>al<br />
worked in <str<strong>on</strong>g>the</str<strong>on</strong>g> morning <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r worked<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> afterno<strong>on</strong>. In <str<strong>on</strong>g>the</str<strong>on</strong>g> sec<strong>on</strong>d school, Harborville,<br />
<strong>on</strong>e paraprofessi<strong>on</strong>al was assigned to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> program while <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r was assigned to<br />
two students in <str<strong>on</strong>g>the</str<strong>on</strong>g> program with <strong>Autism</strong> <strong>and</strong><br />
followed <str<strong>on</strong>g>the</str<strong>on</strong>g>m into general educati<strong>on</strong> classes.<br />
Each program also had a transiti<strong>on</strong>/job coach<br />
that served all of <str<strong>on</strong>g>the</str<strong>on</strong>g> students.<br />
Setting<br />
Two high schools in <str<strong>on</strong>g>the</str<strong>on</strong>g> state of Michigan<br />
were utilized for this project. One high school,<br />
Harborville, had a student count of 622 <strong>and</strong><br />
was located in a rural community. The school<br />
had a special educati<strong>on</strong> rate of 14.1% <strong>and</strong><br />
10.3% of its students were c<strong>on</strong>sidered ec<strong>on</strong>omically<br />
disadvantaged. The school was relatively<br />
racially <strong>and</strong> ethnically homogeneous<br />
(97.1% Caucasian) (St<strong>and</strong>ard & Poor’s,<br />
2004). Purposeful sampling was used to select<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> sec<strong>on</strong>d school, a rural school within <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
same county that also utilized a functi<strong>on</strong>al<br />
curriculum within <str<strong>on</strong>g>the</str<strong>on</strong>g>ir high school self-c<strong>on</strong>tained<br />
cross-categorical program. River Bend<br />
High School had a student count of 807,<br />
11.8% special educati<strong>on</strong> rate, <strong>and</strong> 16.9% of its<br />
populati<strong>on</strong> c<strong>on</strong>sidered ec<strong>on</strong>omically disadvantaged.<br />
It was also a relatively racially <strong>and</strong><br />
ethnically homogeneous school district (96%<br />
Caucasian) (St<strong>and</strong>ard & Poor’s).<br />
Procedure<br />
Data were collected through multiple means<br />
in an effort to triangulate (Stake, 1995). Classroom<br />
observati<strong>on</strong>s were performed <strong>and</strong> each<br />
site was observed for an entire school day two<br />
days a week for three m<strong>on</strong>ths (see Bogdan &<br />
Biklen, 2003). A total of 85 hours was spent at<br />
Harborville <strong>and</strong> 70 hours spent at River Bend.<br />
During <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom observati<strong>on</strong>s <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher<br />
took fieldnotes <strong>and</strong> observed <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
events within <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom. Decisi<strong>on</strong>s about<br />
what to observe <strong>and</strong> when were based <strong>on</strong> purposeful<br />
sampling (Patt<strong>on</strong>, 1980), such that<br />
observati<strong>on</strong>s were selected to present <str<strong>on</strong>g>the</str<strong>on</strong>g> most<br />
likely opportunity to underst<strong>and</strong> <strong>and</strong> gain insight<br />
into <str<strong>on</strong>g>the</str<strong>on</strong>g> case. For example, Fridays at<br />
River Bend were game or movie day. Thus,<br />
Friday was not selected as a c<strong>on</strong>sistent day to<br />
observe at River Bend High School. The researcher<br />
also worked with both teachers to<br />
Factors <strong>and</strong> Functi<strong>on</strong>al Curriculum / 297
avoid inservice days, exams, <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r such<br />
events. In general, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher observed<br />
every part of <str<strong>on</strong>g>the</str<strong>on</strong>g> school day for <str<strong>on</strong>g>the</str<strong>on</strong>g> students<br />
involved when she was present, including<br />
classroom activities, lunch, community-based<br />
instructi<strong>on</strong>, <strong>and</strong> work experiences.<br />
In additi<strong>on</strong> to classroom observati<strong>on</strong>s, document<br />
reviews were c<strong>on</strong>ducted. Students’<br />
CA-60 files were analyzed. Data was ga<str<strong>on</strong>g>the</str<strong>on</strong>g>red<br />
<strong>on</strong> students’ IQ, achievement test scores<br />
(reading <strong>and</strong> ma<str<strong>on</strong>g>the</str<strong>on</strong>g>matics), disability classificati<strong>on</strong>,<br />
years in special educati<strong>on</strong>, age, <strong>and</strong><br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>r pertinent informati<strong>on</strong>. Interviews were<br />
also c<strong>on</strong>ducted with <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers, students,<br />
<strong>and</strong> paraprofessi<strong>on</strong>als involved in <str<strong>on</strong>g>the</str<strong>on</strong>g> study.<br />
All were formally interviewed, in additi<strong>on</strong> to<br />
informal c<strong>on</strong>versati<strong>on</strong>s that occurred. Teachers<br />
were informally interviewed several times<br />
across <str<strong>on</strong>g>the</str<strong>on</strong>g> data collecti<strong>on</strong> period.<br />
Instruments<br />
A semi-structured interview protocol was followed<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers’ formal interview (protocol<br />
available up<strong>on</strong> request). It focused <strong>on</strong><br />
curriculum choice <strong>and</strong> underst<strong>and</strong>ing how<br />
curriculum became enacted as well as factors<br />
influencing <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum. Students’ formal<br />
interviews addressed <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
classes <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir ideal curriculum. Students<br />
were asked to resp<strong>on</strong>d to questi<strong>on</strong>s regarding<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir high school experience <strong>and</strong> what <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
were learning in <str<strong>on</strong>g>the</str<strong>on</strong>g> program (protocol available<br />
up<strong>on</strong> request). Paraprofessi<strong>on</strong>al formal<br />
interviews focused <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> program <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
perspectives (protocol available up<strong>on</strong> request).<br />
All interviews of participants were audiotaped,<br />
unless an individual requested that<br />
s/he not be recorded (1 student out of 15<br />
requested as such). The interview questi<strong>on</strong>naires<br />
were designed by <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher with<br />
feedback from colleagues <strong>and</strong> adjusted as<br />
needed during <str<strong>on</strong>g>the</str<strong>on</strong>g> research project.<br />
Role of <str<strong>on</strong>g>the</str<strong>on</strong>g> Researcher<br />
The role of <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher was that of a participant-observer.<br />
At <str<strong>on</strong>g>the</str<strong>on</strong>g> beginning <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher<br />
attempted to maintain more of an<br />
observer role. However, as observati<strong>on</strong>s c<strong>on</strong>tinued<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> role shifted to more of a participant.<br />
At different times <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher had to<br />
assist with instructi<strong>on</strong>al activities <strong>and</strong> inter-<br />
vene for behavioral reas<strong>on</strong>s. The more active<br />
participati<strong>on</strong> was at times sought by <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
teacher or students. It was also unsolicited as<br />
times, such as when student safety or <str<strong>on</strong>g>the</str<strong>on</strong>g> lack<br />
of instructi<strong>on</strong>al assistance to a struggling student<br />
necessitated involvement.<br />
Data Analysis<br />
298 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Data (interviews, field notes, researcher reflecti<strong>on</strong><br />
notes, <strong>and</strong> archival review notes) were<br />
read <strong>and</strong> re-read, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>n parsed al<strong>on</strong>g <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
research questi<strong>on</strong>, specifically noting <str<strong>on</strong>g>the</str<strong>on</strong>g> nature<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> influence of <str<strong>on</strong>g>the</str<strong>on</strong>g> pre-determined<br />
factors <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of functi<strong>on</strong>al curriculum:<br />
policy/ legislati<strong>on</strong>, community, school,<br />
teachers, students, <strong>and</strong> curriculum materials.<br />
Next, data were parsed by patterns that<br />
emerged. Data that supported or challenged<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> factors was color-coded <strong>and</strong>/or highlighted<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> hard-copy of <str<strong>on</strong>g>the</str<strong>on</strong>g> fieldnotes <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>n cut-<strong>and</strong>-pasted from <str<strong>on</strong>g>the</str<strong>on</strong>g> electr<strong>on</strong>ic versi<strong>on</strong><br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> fieldnotes into a working document<br />
of patterns <strong>and</strong> emerging <str<strong>on</strong>g>the</str<strong>on</strong>g>mes by<br />
factor.<br />
Data analysis began by organizing <str<strong>on</strong>g>the</str<strong>on</strong>g> hard<br />
copy of <str<strong>on</strong>g>the</str<strong>on</strong>g> fieldnotes, researcher reflective<br />
notes, <strong>and</strong> interviews in chr<strong>on</strong>ological order<br />
by school site. The researcher <str<strong>on</strong>g>the</str<strong>on</strong>g>n read each<br />
site’s hard-copy fieldnotes notebook <strong>and</strong><br />
noted patterns <strong>and</strong> any potential additi<strong>on</strong>s or<br />
deleti<strong>on</strong>s from <str<strong>on</strong>g>the</str<strong>on</strong>g> pre-determined factors.<br />
This process was repeated several times, both<br />
c<strong>on</strong>densing <strong>and</strong> exp<strong>and</strong>ing. Key <strong>and</strong>/or typical<br />
analytical vignettes were located within <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
data to support <str<strong>on</strong>g>the</str<strong>on</strong>g> asserti<strong>on</strong>s being made.<br />
Parsing <str<strong>on</strong>g>the</str<strong>on</strong>g> data by emerging patterns <strong>and</strong><br />
factors occurred for each school site separately<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>n comparis<strong>on</strong>s were made between<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> two sites. Overarching patterns were<br />
noted to cut across both field sites. The patterns<br />
under each major <str<strong>on</strong>g>the</str<strong>on</strong>g>me were <str<strong>on</strong>g>the</str<strong>on</strong>g>n organized<br />
with <str<strong>on</strong>g>the</str<strong>on</strong>g> analytical vignettes as well as<br />
any negative case analysis. While both cases<br />
had <str<strong>on</strong>g>the</str<strong>on</strong>g> same overarching factors, <str<strong>on</strong>g>the</str<strong>on</strong>g>y differed<br />
across <str<strong>on</strong>g>the</str<strong>on</strong>g> patterns.<br />
Triangulati<strong>on</strong> was sought am<strong>on</strong>g <str<strong>on</strong>g>the</str<strong>on</strong>g> multiple<br />
data sources (i.e., observati<strong>on</strong> fieldnotes,<br />
researcher reflective notes, <strong>and</strong> interviews).<br />
Observati<strong>on</strong>s formed <str<strong>on</strong>g>the</str<strong>on</strong>g> main source of fieldnotes<br />
<strong>and</strong> interviews were used to support or<br />
challenge what was observed in <str<strong>on</strong>g>the</str<strong>on</strong>g> classrooms.<br />
Archival or document reviews were
also used to support <strong>and</strong> challenge <str<strong>on</strong>g>the</str<strong>on</strong>g> data<br />
from both observati<strong>on</strong>s <strong>and</strong> interviews.<br />
Results<br />
Results indicated <str<strong>on</strong>g>the</str<strong>on</strong>g> pre-determined categories<br />
of policy/legislati<strong>on</strong>, community, school/<br />
school district, teachers, students, <strong>and</strong> curriculum<br />
materials affected <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment. The<br />
data also indicated that ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r factor influenced<br />
enactment, yet was not originally hypo<str<strong>on</strong>g>the</str<strong>on</strong>g>sized<br />
– paraprofessi<strong>on</strong>als. This factor<br />
emerged from <str<strong>on</strong>g>the</str<strong>on</strong>g> data as patterns <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>mes were explored. Although <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment<br />
of a functi<strong>on</strong>al curriculum in both sec<strong>on</strong>dary<br />
programs revealed that <str<strong>on</strong>g>the</str<strong>on</strong>g> hypo<str<strong>on</strong>g>the</str<strong>on</strong>g>sized<br />
factors were influential, <str<strong>on</strong>g>the</str<strong>on</strong>g>y were<br />
enacted in each program differently <strong>and</strong> had<br />
differential impact.<br />
Factors Influencing <str<strong>on</strong>g>the</str<strong>on</strong>g> Enactment of a<br />
Functi<strong>on</strong>al Curriculum<br />
Policy/legislati<strong>on</strong> factor. Policy <strong>and</strong> legislati<strong>on</strong><br />
were found to affect <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum enactment<br />
in both programs. One of <str<strong>on</strong>g>the</str<strong>on</strong>g> most<br />
poignant illustrati<strong>on</strong>s involved student assessments.<br />
In Michigan students take <str<strong>on</strong>g>the</str<strong>on</strong>g> Michigan<br />
Educati<strong>on</strong> Assessment Program (MEAP),<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> state’s general large scale assessment. Students<br />
in both programs qualified for <strong>on</strong>e of<br />
Michigan’s alternate assessments, <strong>and</strong> took<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> <strong>on</strong>e created for students with mild mental<br />
impairment or who functi<strong>on</strong>ed as such. This is<br />
in oppositi<strong>on</strong> to most o<str<strong>on</strong>g>the</str<strong>on</strong>g>r states in which<br />
alternate assessments have <strong>on</strong>ly been created<br />
for students with more severe impairments<br />
(see Alper & Mills, 2001; Kleinert & Thurlow,<br />
2001).<br />
Both teachers commented that <str<strong>on</strong>g>the</str<strong>on</strong>g>ir program<br />
planning needed to c<strong>on</strong>sider students’<br />
participati<strong>on</strong> in state assessments. Katie discussed<br />
rec<strong>on</strong>sidering her functi<strong>on</strong>al ma<str<strong>on</strong>g>the</str<strong>on</strong>g>matics<br />
class because fracti<strong>on</strong>s <strong>and</strong> graphs appeared<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> alternate assessment but were<br />
absent from her math curriculum. Katie stated<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> alternate assessment was “a lot more<br />
in-depth than <str<strong>on</strong>g>the</str<strong>on</strong>g> functi<strong>on</strong>al stuff I teach”<br />
(Interview, January 27, 2005). Katie felt some<br />
frustrati<strong>on</strong> towards <str<strong>on</strong>g>the</str<strong>on</strong>g> policymakers <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
state department of educati<strong>on</strong> as she perceived<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>m to devalue <str<strong>on</strong>g>the</str<strong>on</strong>g> functi<strong>on</strong>al nature<br />
of classrooms such as hers. She referenced her<br />
work with <str<strong>on</strong>g>the</str<strong>on</strong>g> state committee <strong>on</strong> creating this<br />
particular alternate assessment, saying “we<br />
tried to state <str<strong>on</strong>g>the</str<strong>on</strong>g> importance of what we do in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> classroom at <str<strong>on</strong>g>the</str<strong>on</strong>g> meetings” (Interview, January<br />
27, 2005). Paula also stressed <str<strong>on</strong>g>the</str<strong>on</strong>g> importance<br />
of state assessments, stating, “Oh yes . . .<br />
it is <strong>on</strong>e of those things driving what I do”<br />
(Interview, March 15, 2005).<br />
Yet, <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers implemented <str<strong>on</strong>g>the</str<strong>on</strong>g>ir versi<strong>on</strong><br />
of a functi<strong>on</strong>al curriculum without regard to<br />
policy or legislati<strong>on</strong>, suggesting that perhaps<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> value of this factor was given more “lipservice”<br />
than <str<strong>on</strong>g>the</str<strong>on</strong>g> role it really played. For example,<br />
when both teachers were questi<strong>on</strong>ed<br />
about <str<strong>on</strong>g>the</str<strong>on</strong>g> alternate state st<strong>and</strong>ards <str<strong>on</strong>g>the</str<strong>on</strong>g> alternate<br />
assessments were designed to align with<br />
both admitted that <str<strong>on</strong>g>the</str<strong>on</strong>g>y had not used <str<strong>on</strong>g>the</str<strong>on</strong>g>m to<br />
guide <str<strong>on</strong>g>the</str<strong>on</strong>g>ir planning. In resp<strong>on</strong>se to <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong><br />
regarding alternate state st<strong>and</strong>ards, Paula<br />
stated that she did “not have time yet to align<br />
those with my curriculum” (Observati<strong>on</strong>, January<br />
24, 2005) <strong>and</strong> Katie did not even possess<br />
a copy.<br />
Community factor. The community that<br />
both schools resided in provided influence<br />
over <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of a functi<strong>on</strong>al curriculum.<br />
One of <str<strong>on</strong>g>the</str<strong>on</strong>g> biggest influences was <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
locati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> community (i.e., rural), <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> school. The ruralness made transportati<strong>on</strong><br />
difficult <strong>and</strong> finding jobs for work experience<br />
more challenging. The lack of public transportati<strong>on</strong><br />
primarily limited students’ workbased<br />
experiences to in-school opti<strong>on</strong>s. The<br />
teachers repeatedly commented <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir frustrati<strong>on</strong><br />
with <str<strong>on</strong>g>the</str<strong>on</strong>g> transportati<strong>on</strong> <strong>and</strong> its role in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir educati<strong>on</strong>al programming, stating “The<br />
hardest part is transportati<strong>on</strong> ...Itishard to<br />
get students to places for work . . . to walk<br />
takes a good chunk of time” (Interview, February<br />
12, 2005) as well as “I think something<br />
that could make <str<strong>on</strong>g>the</str<strong>on</strong>g> class better is a large van<br />
or dial-a-ride. Transportati<strong>on</strong>. . . Getting out<br />
into <str<strong>on</strong>g>the</str<strong>on</strong>g> community is <strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g> weakest areas<br />
of my program” (Interview, June 12,<br />
2005).<br />
At <str<strong>on</strong>g>the</str<strong>on</strong>g> same time, community-based instructi<strong>on</strong><br />
opportunities illustrated <str<strong>on</strong>g>the</str<strong>on</strong>g> tolerance<br />
<strong>and</strong> acceptance of <str<strong>on</strong>g>the</str<strong>on</strong>g> programs <strong>and</strong> students<br />
within <str<strong>on</strong>g>the</str<strong>on</strong>g> community. Katie’s program was<br />
involved in multiple community-based instructi<strong>on</strong><br />
(CBI) experiences including doing inventory<br />
at <str<strong>on</strong>g>the</str<strong>on</strong>g> local hardware store, cleaning at an<br />
assistive living home, <strong>and</strong> painting buildings<br />
Factors <strong>and</strong> Functi<strong>on</strong>al Curriculum / 299
for <str<strong>on</strong>g>the</str<strong>on</strong>g> city parks <strong>and</strong> recreati<strong>on</strong> department.<br />
Marilyn, <str<strong>on</strong>g>the</str<strong>on</strong>g> school job coach, organized <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
CBI opportunities for <str<strong>on</strong>g>the</str<strong>on</strong>g> students. She discussed<br />
using a barter system to arrange <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
experiences, stating that knowing her pers<strong>on</strong>ally<br />
<strong>and</strong> using <str<strong>on</strong>g>the</str<strong>on</strong>g> facilities was helpful in getting<br />
businesses to agree to CBI opportunities<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g> students. Community businesses appeared<br />
to feel a c<strong>on</strong>necti<strong>on</strong> to program pers<strong>on</strong>nel<br />
<strong>and</strong> thus were more willing to provide<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> students work-based experiences.<br />
School <strong>and</strong> school district factor. One of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
major school factors impacting <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment<br />
of a functi<strong>on</strong>al curriculum involved <str<strong>on</strong>g>the</str<strong>on</strong>g> school<br />
<strong>and</strong> its locati<strong>on</strong> within <str<strong>on</strong>g>the</str<strong>on</strong>g> community. Both<br />
schools were situated in a part of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir rural<br />
communities that was away from <str<strong>on</strong>g>the</str<strong>on</strong>g> business<br />
district, making walking to work-based opportunities<br />
for students not possible. The locati<strong>on</strong><br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> school also made it difficult to drive<br />
students to a work-based experience. Thus,<br />
most work-based experiences for <str<strong>on</strong>g>the</str<strong>on</strong>g> majority<br />
of students occurred within <str<strong>on</strong>g>the</str<strong>on</strong>g> physical c<strong>on</strong>fines<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> school, such as working in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
school store or being an apprentice to a custodian.<br />
Transportati<strong>on</strong> was a large challenge,<br />
which Paula iterated in her statement “can’t<br />
get to downtown, get a good instructi<strong>on</strong>al<br />
work experience, <strong>and</strong> get back . . . in <str<strong>on</strong>g>the</str<strong>on</strong>g> middle<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> day” (Interview, March 29, 2006).<br />
Besides <str<strong>on</strong>g>the</str<strong>on</strong>g> school’s locati<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g> physical<br />
locati<strong>on</strong> of each classroom was an issue. It<br />
affected students’ social behavior, particularly<br />
between classes. Katie’s classroom was located<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> last hallway of <str<strong>on</strong>g>the</str<strong>on</strong>g> school, surrounded<br />
by o<str<strong>on</strong>g>the</str<strong>on</strong>g>r special educati<strong>on</strong> classrooms, which<br />
was significant since <str<strong>on</strong>g>the</str<strong>on</strong>g>se rooms housed most<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r peers that <str<strong>on</strong>g>the</str<strong>on</strong>g> students in Katie’s<br />
program socialized with outside <str<strong>on</strong>g>the</str<strong>on</strong>g> self-c<strong>on</strong>tained<br />
program. In c<strong>on</strong>trast, Paula’s program<br />
was surrounded by core c<strong>on</strong>tent classrooms.<br />
The influence of <str<strong>on</strong>g>the</str<strong>on</strong>g> physical locati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
classroom was evident in Paula’s program<br />
when <str<strong>on</strong>g>the</str<strong>on</strong>g> bell rang <strong>and</strong> she asked students to<br />
walk around <str<strong>on</strong>g>the</str<strong>on</strong>g> hallways. Her students preferred<br />
to stay within <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom during<br />
break between classes. Paula had to instruct<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>m every few classes to walk in <str<strong>on</strong>g>the</str<strong>on</strong>g> hallways,<br />
which was a signal to walk around, look peers<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> eyes, <strong>and</strong> say hello. The resistance of<br />
Paula’s students stood in c<strong>on</strong>trast to Katie’s<br />
students who practically bolted out <str<strong>on</strong>g>the</str<strong>on</strong>g> door<br />
when <str<strong>on</strong>g>the</str<strong>on</strong>g> bell rang <strong>and</strong> frequently stood<br />
300 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
around <str<strong>on</strong>g>the</str<strong>on</strong>g> door waiting for it to ring at <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
end of class.<br />
The actual features of <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom were<br />
also influential <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of a functi<strong>on</strong>al<br />
curriculum. When Harborville High<br />
School exp<strong>and</strong>ed, Katie’s program was moved<br />
from a small room to <strong>on</strong>e specifically designed<br />
for her program. The most important aspect<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> room was <str<strong>on</strong>g>the</str<strong>on</strong>g> kitchen, which was<br />
equipped with a refrigerator, a stove, <strong>and</strong> a<br />
sink. Katie also purchased o<str<strong>on</strong>g>the</str<strong>on</strong>g>r important<br />
kitchen necessities, such as dishes, a Kitchenaide,<br />
a griddle, <strong>and</strong> microwave. Having a<br />
kitchen enabled Katie <strong>and</strong> her students to<br />
enact daily living skills, such as cooking, within<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>fines of <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom. At least <strong>on</strong>ce a<br />
week, <str<strong>on</strong>g>the</str<strong>on</strong>g> students cooked during <str<strong>on</strong>g>the</str<strong>on</strong>g>ir life<br />
skills class as well as o<str<strong>on</strong>g>the</str<strong>on</strong>g>r times for special<br />
occasi<strong>on</strong>s, such as a student or staff member’s<br />
birthday.<br />
In c<strong>on</strong>trast, Paula’s classroom was actually<br />
two small offices combined to make a room.<br />
Paula’s classroom did not have kitchen or<br />
laundry facilities, over which she lamented.<br />
Paula discussed that she “would love to have<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> physical room that home ec does,” <strong>and</strong><br />
emphasized its laundry <strong>and</strong> kitchen spaces<br />
(Interview, March 15, 2005). Paula noted that<br />
she could use <str<strong>on</strong>g>the</str<strong>on</strong>g> facilities of <str<strong>on</strong>g>the</str<strong>on</strong>g> home ec<strong>on</strong>omics<br />
room, but she had not d<strong>on</strong>e so because<br />
she felt that <str<strong>on</strong>g>the</str<strong>on</strong>g> room bel<strong>on</strong>ged to <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
home ec<strong>on</strong>omics teacher saying, “It was her<br />
domain.” The importance Paula placed <strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se resources was evident when she discussed<br />
her ideal curriculum for her program,<br />
I would have to have a lot of equipment.<br />
The setting would take place in a mixture of<br />
reading center with couches <strong>and</strong> proper<br />
lighting, technology center where each student<br />
has access to user-friendly computers,<br />
<strong>and</strong> living center like a home ec<strong>on</strong>omic<br />
room. Just like home would be <strong>and</strong> a shop,<br />
where we would be using hammers, nails,<br />
<strong>and</strong> wood. All in <strong>on</strong>e place, we would have<br />
sewing machines, craft centers. That would<br />
be <str<strong>on</strong>g>the</str<strong>on</strong>g> setting <strong>and</strong> I could take it from <str<strong>on</strong>g>the</str<strong>on</strong>g>re.<br />
Access to <str<strong>on</strong>g>the</str<strong>on</strong>g> community as well, with good<br />
transportati<strong>on</strong>. And a job liais<strong>on</strong> to help<br />
me. I would teach what <str<strong>on</strong>g>the</str<strong>on</strong>g>y need to know<br />
here. And I would say <strong>on</strong>site learning lab,<br />
like school store (Interview, March 14,<br />
2005).
Despite Paula’s descripti<strong>on</strong> of an ideal curriculum,<br />
her students received little-to-no activities<br />
in daily living at school. Her life management<br />
class involved students reading a<br />
textbook, answering questi<strong>on</strong>s, <strong>and</strong> discussing<br />
topics, ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r than <str<strong>on</strong>g>the</str<strong>on</strong>g> h<strong>and</strong>s-<strong>on</strong> activities she<br />
talked about in interviews.<br />
Data also revealed an associati<strong>on</strong> between<br />
each school’s philosophy <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment<br />
of a functi<strong>on</strong>al curriculum. Yet, it was not <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
schools’ explicit philosophies “to make lifel<strong>on</strong>g<br />
learners out of <str<strong>on</strong>g>the</str<strong>on</strong>g>se kids <strong>and</strong> have <str<strong>on</strong>g>the</str<strong>on</strong>g>m<br />
participating in <str<strong>on</strong>g>the</str<strong>on</strong>g> community” (Interview,<br />
March 15, 2005) <strong>and</strong> “safety <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> importance<br />
to learn something new each day <strong>and</strong> to<br />
strive to better yourself everyday” (Interview,<br />
June 14, 2005) that were as relevant as <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
schools’ implicit philosophies.<br />
At Paula’s school, <str<strong>on</strong>g>the</str<strong>on</strong>g> office often asked her<br />
students to do things that were not asked of<br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>r students. One day <str<strong>on</strong>g>the</str<strong>on</strong>g> office called <strong>and</strong><br />
asked Paula if her students could stuff <strong>and</strong><br />
address envelopes <str<strong>on</strong>g>the</str<strong>on</strong>g> next day. Paula agreed<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> request, but expressed distress in her<br />
comment, “so much for my less<strong>on</strong> plans tomorrow”<br />
(Fieldnotes, January 28, 2005). In<br />
ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r instance, <str<strong>on</strong>g>the</str<strong>on</strong>g> principal stopped by<br />
Paula’s classroom <strong>and</strong> asked if her students<br />
would clean <str<strong>on</strong>g>the</str<strong>on</strong>g> outside of <str<strong>on</strong>g>the</str<strong>on</strong>g> school that day.<br />
Even though Paula felt that <str<strong>on</strong>g>the</str<strong>on</strong>g>re was some<br />
educati<strong>on</strong>al value to this activity in terms of<br />
work experience, as she designed it so students<br />
had a supervisor <strong>and</strong> were rewarded for<br />
hard work, she still felt trapped into doing this<br />
activity when asked by <str<strong>on</strong>g>the</str<strong>on</strong>g> principal, saying,<br />
“how could I say no to <str<strong>on</strong>g>the</str<strong>on</strong>g> principal, my boss?”<br />
(Fieldnotes, March 28, 2005). Paula’s interpretati<strong>on</strong><br />
of this situati<strong>on</strong> was evident when a<br />
student questi<strong>on</strong>ed <str<strong>on</strong>g>the</str<strong>on</strong>g> request <strong>and</strong> she clarified<br />
why her students take time out of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
school day to clean <str<strong>on</strong>g>the</str<strong>on</strong>g> school.<br />
Why we do it is that we have pride in our<br />
school. Sec<strong>on</strong>d reas<strong>on</strong> is that it helps our<br />
school look nice <strong>and</strong> helps our custodians.<br />
And in this class, like Mrs. Murphy’s class<br />
[middle school cross-categorical program<br />
teacher] we have more freedom. When <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
principal asks us to do something, he looks<br />
for some<strong>on</strong>e in <str<strong>on</strong>g>the</str<strong>on</strong>g> school who can get <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
job d<strong>on</strong>e (Fieldnotes, March 28, 2005).<br />
Paula c<strong>on</strong>tinued to explain to her students<br />
why <str<strong>on</strong>g>the</str<strong>on</strong>g>y picked up trash outside <str<strong>on</strong>g>the</str<strong>on</strong>g> school.<br />
We stop what we are doing <strong>and</strong> go do that.<br />
You might think golly <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r kids d<strong>on</strong>’t<br />
do this. But it gets hot in <str<strong>on</strong>g>the</str<strong>on</strong>g> school <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y are sitting <str<strong>on</strong>g>the</str<strong>on</strong>g>re doing <str<strong>on</strong>g>the</str<strong>on</strong>g>ir homework.<br />
And if you find m<strong>on</strong>ey, you get to<br />
keep it (Fieldnotes, March 28, 2005).<br />
Although office pers<strong>on</strong>nel did not ask Katie’s<br />
students to engage in work around <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
school, o<str<strong>on</strong>g>the</str<strong>on</strong>g>r school pers<strong>on</strong>nel interrupted<br />
Katie’s program <strong>and</strong> had students participate<br />
in n<strong>on</strong>-classroom work. Marilyn, <str<strong>on</strong>g>the</str<strong>on</strong>g> school<br />
job coach, asked Katie’s students to stuff registrati<strong>on</strong><br />
bags for a community 5K. Marilyn<br />
requested <strong>and</strong> Katie agreed that her students<br />
would take time from classroom activities to<br />
stuff <str<strong>on</strong>g>the</str<strong>on</strong>g> bags with running informati<strong>on</strong> <strong>and</strong><br />
free objects. Katie set aside time in two of her<br />
classes <strong>and</strong> indicated that if <str<strong>on</strong>g>the</str<strong>on</strong>g>re was still a lot<br />
to do her students could start first hour <strong>and</strong><br />
c<strong>on</strong>tinue throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> class periods until<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y were completed.<br />
Teacher factor. Although it seems intuitive<br />
that teachers affected <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of a functi<strong>on</strong>al<br />
curriculum, it is <str<strong>on</strong>g>the</str<strong>on</strong>g> intricacies of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
teacher factor that are worth discussing.<br />
Teachers were influential in terms of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
histories, preparati<strong>on</strong>, beliefs <strong>and</strong> philosophies,<br />
<strong>and</strong> expectati<strong>on</strong>s for students. Both<br />
teachers had created <str<strong>on</strong>g>the</str<strong>on</strong>g>ir programs. Paula<br />
started at River Bend five years ago, <str<strong>on</strong>g>the</str<strong>on</strong>g> year<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> program was started at <str<strong>on</strong>g>the</str<strong>on</strong>g> high school.<br />
She was given relative freedom over <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum<br />
to choose <str<strong>on</strong>g>the</str<strong>on</strong>g> classes that were included<br />
in her program <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>tent that<br />
would go into those classes. Katie assumed <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
role of <str<strong>on</strong>g>the</str<strong>on</strong>g> cross-categorical program teacher<br />
at Harborville <str<strong>on</strong>g>the</str<strong>on</strong>g> year after <str<strong>on</strong>g>the</str<strong>on</strong>g> program was<br />
started. However, <str<strong>on</strong>g>the</str<strong>on</strong>g> first teacher had d<strong>on</strong>e<br />
little to establish <str<strong>on</strong>g>the</str<strong>on</strong>g> program <strong>and</strong> Katie was<br />
able to choose <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum. Yet, she had<br />
restricti<strong>on</strong>s <strong>on</strong> her curriculum in that it was<br />
suppose to align with <str<strong>on</strong>g>the</str<strong>on</strong>g> state’s general educati<strong>on</strong><br />
benchmarks <strong>and</strong> guidelines.<br />
Teachers’ pre-service preparati<strong>on</strong> was influential.<br />
Both teachers attended <str<strong>on</strong>g>the</str<strong>on</strong>g> same midsized<br />
teacher preparati<strong>on</strong> university about<br />
four years apart, yet, <str<strong>on</strong>g>the</str<strong>on</strong>g>y had different<br />
teacher preparati<strong>on</strong> experiences. Katie focused<br />
her preparati<strong>on</strong> <strong>on</strong> sec<strong>on</strong>dary educati<strong>on</strong>,<br />
with a plan to teach at <str<strong>on</strong>g>the</str<strong>on</strong>g> high school<br />
level. Her field experiences occurred in high<br />
school programs, both resource <strong>and</strong> categori-<br />
Factors <strong>and</strong> Functi<strong>on</strong>al Curriculum / 301
cal. She also took a l<strong>on</strong>g term subbing positi<strong>on</strong><br />
at a nearby high school in a categorical<br />
program before she started teaching at Harborville.<br />
Paula, who returned to get her bachelor’s<br />
degree in educati<strong>on</strong> following 25 years<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> business world, planned <strong>on</strong> working in<br />
an elementary resource room program <strong>and</strong><br />
her pre-service teacher preparati<strong>on</strong> reflected<br />
this goal. Yet, she ended up working in a high<br />
school resource room for her first job. Although<br />
Paula referred to her high schoolers<br />
as, “not scary . . . same needs, just taller,” she<br />
seemed to sometimes struggle with <str<strong>on</strong>g>the</str<strong>on</strong>g> fact<br />
that her students were in high school with<br />
adolescent issues, needs, <strong>and</strong> desires (Interview,<br />
March 15, 2005). Paula’s elementary<br />
background filtered into <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom. She<br />
had a tendency to enact more traditi<strong>on</strong>al “elementary<br />
activities” <strong>and</strong> treat her students in a<br />
younger fashi<strong>on</strong>. For example, <strong>on</strong> Valentine’s<br />
Day she brought in a Valentine’s Day cake,<br />
Valentine’s Day pencils, <strong>and</strong> had her students<br />
engage in Valentine’s Day activities, including<br />
estimating <str<strong>on</strong>g>the</str<strong>on</strong>g> number of c<strong>and</strong>y hearts in a jar<br />
<strong>and</strong> a Valentine’s Day word search. Paula indicated<br />
that she had not used <str<strong>on</strong>g>the</str<strong>on</strong>g>se activities<br />
since her elementary field placement. Her students<br />
acknowledged her predispositi<strong>on</strong> towards<br />
elementary as well, remarking to her<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher <strong>on</strong> numerous occasi<strong>on</strong>s<br />
“we aren’t in kindergarten” or o<str<strong>on</strong>g>the</str<strong>on</strong>g>r similar<br />
statements.<br />
Teachers’ beliefs <strong>and</strong> philosophies, both explicit<br />
<strong>and</strong> implicit, were influential. Katie articulated<br />
her philosophy as giving “students an<br />
opportunity to find something <str<strong>on</strong>g>the</str<strong>on</strong>g>y can relate<br />
to <strong>and</strong> to teach <str<strong>on</strong>g>the</str<strong>on</strong>g>m <str<strong>on</strong>g>the</str<strong>on</strong>g> basics of respect.<br />
Having respect for o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs is probably <strong>on</strong>e of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> most important things for me” (Interview,<br />
June 14, 2005). However, Katie’s implicit philosophy<br />
involved a str<strong>on</strong>g devoti<strong>on</strong> to preparing<br />
students to be employable <strong>and</strong> to have<br />
success post-school in terms of employment<br />
<strong>and</strong> independent living. For example, Katie<br />
indicated that cooking was <strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g> most<br />
important curricular comp<strong>on</strong>ents for students,<br />
al<strong>on</strong>g with budgeting <strong>and</strong> basic reading<br />
for job applicati<strong>on</strong>s, descripti<strong>on</strong>s, <strong>and</strong> directi<strong>on</strong>s.<br />
Katie expected most of her students to seek<br />
employment after <str<strong>on</strong>g>the</str<strong>on</strong>g>y graduated <strong>and</strong> that became<br />
a focus of <str<strong>on</strong>g>the</str<strong>on</strong>g> program. She discussed<br />
getting students out into <str<strong>on</strong>g>the</str<strong>on</strong>g> community, al-<br />
302 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
lowing <str<strong>on</strong>g>the</str<strong>on</strong>g>m to see job opportunities, <strong>and</strong><br />
helping <str<strong>on</strong>g>the</str<strong>on</strong>g>m figure out what <str<strong>on</strong>g>the</str<strong>on</strong>g>y might like<br />
to do. She expected that <str<strong>on</strong>g>the</str<strong>on</strong>g> vast majority of<br />
her students could hold down jobs, stating<br />
“. . . maybe a little different, but all can work at<br />
something.” Katie believed her students could<br />
be successful in life, yet she knew her students<br />
would always carry a label with <str<strong>on</strong>g>the</str<strong>on</strong>g>m, commenting<br />
“stereotypes will always be <str<strong>on</strong>g>the</str<strong>on</strong>g>re.<br />
These kids will always be that special educati<strong>on</strong><br />
kid” (Interview, June 14, 2005).<br />
Paula stated that her philosophy was simple,<br />
“to help students reach <str<strong>on</strong>g>the</str<strong>on</strong>g>ir goals <strong>and</strong> make<br />
decisi<strong>on</strong>s” (Interview, March 15, 2005). Yet,<br />
she exhibited low expectati<strong>on</strong>s of some of her<br />
students. Paula stated that her students were,<br />
“really low functi<strong>on</strong>ing” <strong>and</strong> implied that<br />
some would not live independently. Similarly,<br />
she indicated that she felt all her students<br />
would qualify for <strong>on</strong>e of two after-high school<br />
programs organized for <str<strong>on</strong>g>the</str<strong>on</strong>g> local districts<br />
through <str<strong>on</strong>g>the</str<strong>on</strong>g> county intermediate school system.<br />
These programs were designed for students<br />
with moderate <strong>and</strong> severe disabilities<br />
who were in need of additi<strong>on</strong>al life skills for a<br />
greater chance of success post-school. Paula<br />
also expressed doubts about her students’ performance<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> alternate assessment designed<br />
for students with mild mental impairment,<br />
fearing it would be too difficult for her<br />
students; yet <str<strong>on</strong>g>the</str<strong>on</strong>g> majority of <str<strong>on</strong>g>the</str<strong>on</strong>g>m were students<br />
with learning disabilities or mild mental<br />
impairment.<br />
Paraprofessi<strong>on</strong>al factors. Although not originally<br />
hypo<str<strong>on</strong>g>the</str<strong>on</strong>g>sized as being a factor, paraprofessi<strong>on</strong>als<br />
were found to influence <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment<br />
of a functi<strong>on</strong>al curriculum. At times <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
paraprofessi<strong>on</strong>als acted as teachers <strong>and</strong> created<br />
activities, <strong>and</strong> at o<str<strong>on</strong>g>the</str<strong>on</strong>g>r times <str<strong>on</strong>g>the</str<strong>on</strong>g>ir roles<br />
were more of an “aide,” where <str<strong>on</strong>g>the</str<strong>on</strong>g>y performed<br />
duties such as making photocopies. The c<strong>on</strong>fusi<strong>on</strong><br />
over <str<strong>on</strong>g>the</str<strong>on</strong>g> role was evident in <str<strong>on</strong>g>the</str<strong>on</strong>g> discourse.<br />
One day Paula told <strong>on</strong>e of her paraprofessi<strong>on</strong>als,<br />
“You are a teacher. You are<br />
ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r teacher . . . you are <strong>on</strong>e of us” (Fieldnotes,<br />
February 15, 2005). Yet <str<strong>on</strong>g>the</str<strong>on</strong>g> paraprofessi<strong>on</strong>als<br />
did not always see it that way. One<br />
commented that she lacked power in <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom,<br />
stating, “I am just a parapro” (Fieldnotes,<br />
February 25, 2005). She indicated that<br />
she lacked power because she was not making<br />
decisi<strong>on</strong>s <strong>and</strong> she did not agree with decisi<strong>on</strong>s<br />
made.
The paraprofessi<strong>on</strong>als at Harborville, Whitney<br />
<strong>and</strong> Brenda, positively affected <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment<br />
of curriculum in Harborville as <str<strong>on</strong>g>the</str<strong>on</strong>g>y assisted<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>structi<strong>on</strong> of curriculum within<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> program. This occurred when Katie was<br />
present <strong>and</strong> when she was absent, as evident in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> following vignette.<br />
It is third hour. Katie is not in <str<strong>on</strong>g>the</str<strong>on</strong>g> class. She<br />
is at an IEP, which started during 1 st hour.<br />
The students have entered <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> bell has rung. The students are<br />
sitting <strong>and</strong> st<strong>and</strong>ing around talking. Brenda<br />
<strong>and</strong> Whitney are st<strong>and</strong>ing around as well.<br />
Katie has not left anything for less<strong>on</strong> plans<br />
for third hour as she thought she would be<br />
back from <str<strong>on</strong>g>the</str<strong>on</strong>g> IEP. Whitney speaks up. She<br />
tells <str<strong>on</strong>g>the</str<strong>on</strong>g> students to get a newspaper, pick<br />
an article, read it, write at least four sentences<br />
<strong>on</strong> it, <strong>and</strong> be prepared to read what<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y wrote in fr<strong>on</strong>t of <str<strong>on</strong>g>the</str<strong>on</strong>g> class. The students<br />
grab a newspaper <strong>and</strong> start to work (Fieldnotes,<br />
February 14, 2005).<br />
Whitney c<strong>on</strong>structed <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum when Katie<br />
was absent <strong>and</strong> no curriculum was prearranged.<br />
When Katie returned to <str<strong>on</strong>g>the</str<strong>on</strong>g> class,<br />
she saw <str<strong>on</strong>g>the</str<strong>on</strong>g> directi<strong>on</strong>s <strong>and</strong> told <str<strong>on</strong>g>the</str<strong>on</strong>g> students<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y needed to be prepared to share <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
article with <str<strong>on</strong>g>the</str<strong>on</strong>g> class; thus, supporting <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum<br />
enacted by Whitney.<br />
However, at o<str<strong>on</strong>g>the</str<strong>on</strong>g>r times, <str<strong>on</strong>g>the</str<strong>on</strong>g> paraprofessi<strong>on</strong>als<br />
gave students misleading, incorrect, or<br />
biased informati<strong>on</strong> when c<strong>on</strong>structing or assisting<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>structi<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum,<br />
such as telling students <str<strong>on</strong>g>the</str<strong>on</strong>g> Geneva C<strong>on</strong>venti<strong>on</strong><br />
did not apply to Iraqi insurgents, ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
time stating that people in India <strong>and</strong> China<br />
ate food made from blood, <strong>and</strong> often shutting<br />
down student comments that differed from<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir own beliefs.<br />
The paraprofessi<strong>on</strong>als in Paula’s program<br />
were assigned to be with students in general<br />
educati<strong>on</strong> classes <strong>and</strong>/or to help students in<br />
Paula’s room. Paula described <str<strong>on</strong>g>the</str<strong>on</strong>g>ir role as,<br />
“to be <str<strong>on</strong>g>the</str<strong>on</strong>g> students’ aide in general educati<strong>on</strong><br />
classes, but when in my room, it is to help <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
students in here” (Interview, March 15, 2005).<br />
At times, <str<strong>on</strong>g>the</str<strong>on</strong>g>y were also resp<strong>on</strong>sible for leading<br />
instructi<strong>on</strong>. This allowed Paula to do o<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
things, such as grade or talk with an individual<br />
student. For example, Laura frequently led<br />
instructi<strong>on</strong> in Paula’s history class. Paula<br />
would typically tell Laura what she wanted <strong>and</strong><br />
Laura would enact <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum, while<br />
Paula graded student work.<br />
Student factor. The impact of <str<strong>on</strong>g>the</str<strong>on</strong>g> students<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum was commented<br />
<strong>on</strong> by <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers. Paula stated, “Everything<br />
I do [in my program] is driven by<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>m [<str<strong>on</strong>g>the</str<strong>on</strong>g> students]” (Interview, February 22,<br />
2005). Students’ pers<strong>on</strong>al <strong>and</strong> school histories<br />
influenced curriculum enactment <strong>and</strong> were<br />
largely tied to being in special educati<strong>on</strong>. Students<br />
may have been in general educati<strong>on</strong><br />
classes in elementary school, but <str<strong>on</strong>g>the</str<strong>on</strong>g>y were<br />
placed in pull-out programs by middle school;<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>se experiences in middle school impacted<br />
what took place in high school. Katie,<br />
her students, <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r school pers<strong>on</strong>nel<br />
shared that students were asked to do little in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> self-c<strong>on</strong>tained middle school program in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> Harborville District. Thus, when <str<strong>on</strong>g>the</str<strong>on</strong>g> students<br />
came to high school <str<strong>on</strong>g>the</str<strong>on</strong>g>y had little motivati<strong>on</strong>,<br />
which she saw as <strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g> largest<br />
impediments to <str<strong>on</strong>g>the</str<strong>on</strong>g> positive enactment of a<br />
functi<strong>on</strong>al curriculum. For example, Adam<br />
stated that “high school is better than middle<br />
school, <str<strong>on</strong>g>the</str<strong>on</strong>g>re are more opportunities” (Interview,<br />
February 4, 2005). Sara echoed similar<br />
sentiments, saying that middle school did not<br />
help her as all <str<strong>on</strong>g>the</str<strong>on</strong>g>y did was play games <strong>and</strong> she<br />
was not happy nor did she learn anything.<br />
Brenda, a paraprofessi<strong>on</strong>al, supported <str<strong>on</strong>g>the</str<strong>on</strong>g> students’<br />
beliefs regarding <str<strong>on</strong>g>the</str<strong>on</strong>g> middle school<br />
program <strong>and</strong> its impact <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> high school<br />
program, stating, “Forget that <str<strong>on</strong>g>the</str<strong>on</strong>g>y are ruining<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se kids during <str<strong>on</strong>g>the</str<strong>on</strong>g> middle school year. The<br />
kids hate school over <str<strong>on</strong>g>the</str<strong>on</strong>g>re because <str<strong>on</strong>g>the</str<strong>on</strong>g>y d<strong>on</strong>’t<br />
do anything” (Interview, February 24, 2005).<br />
Paula also expressed frustrati<strong>on</strong> over her<br />
students’ middle school experiences <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
impact of <str<strong>on</strong>g>the</str<strong>on</strong>g> program <strong>on</strong> her own cross-categorical<br />
program. Her frustrati<strong>on</strong> existed with<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> teacher. Paula explained that <strong>on</strong>ce she<br />
selected curriculum materials (i.e., textbooks),<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> middle school teacher selected<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> same textbooks. She felt that this negatively<br />
affected her curriculum <strong>and</strong> program as<br />
students would be forced to possibly learn <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
same material twice.<br />
Students’ pers<strong>on</strong>al histories were also important.<br />
Many students came from single parent<br />
homes, lived with o<str<strong>on</strong>g>the</str<strong>on</strong>g>r family members<br />
or in foster care. Katie discussed how some of<br />
her students could be successful if <str<strong>on</strong>g>the</str<strong>on</strong>g>y were<br />
Factors <strong>and</strong> Functi<strong>on</strong>al Curriculum / 303
able to break away from <str<strong>on</strong>g>the</str<strong>on</strong>g>ir families, that<br />
some of her students were <str<strong>on</strong>g>the</str<strong>on</strong>g> glue that held<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir families toge<str<strong>on</strong>g>the</str<strong>on</strong>g>r <strong>and</strong> that <str<strong>on</strong>g>the</str<strong>on</strong>g>y might<br />
forever need to come home <strong>and</strong> “bail <str<strong>on</strong>g>the</str<strong>on</strong>g>m<br />
out.” Yet, o<str<strong>on</strong>g>the</str<strong>on</strong>g>r students were held back from<br />
independence out of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir parents’ fear that<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y might <str<strong>on</strong>g>the</str<strong>on</strong>g>n leave <str<strong>on</strong>g>the</str<strong>on</strong>g>m. Katie implied<br />
that she incorporated independent skills into<br />
her curriculum through her use of budgeting<br />
<strong>and</strong> daily living skills. Katie felt that her students<br />
would benefit greatly from having a<br />
school social worker in <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom <strong>on</strong> a<br />
daily basis. She expressed that her students<br />
had a lot of family issues that needed resolving<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> assistance a school social worker<br />
could provide an important part of curriculum<br />
enactment.<br />
Students’ certificati<strong>on</strong> or level of functi<strong>on</strong>ing<br />
was also influential. Both teachers spoke<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir students’ functi<strong>on</strong>ing levels with regards<br />
to academic abilities <strong>and</strong> skills. Paula<br />
indicated that her current students were at<br />
higher levels than her past students, that her<br />
previous students had lower reading abilities<br />
<strong>and</strong> were generally lower in cognitive ability.<br />
As a result of her percepti<strong>on</strong> that this group of<br />
students had “higher abilities,” Paula c<strong>on</strong>templated<br />
adding some different (<strong>and</strong> new)<br />
things to her program. Katie commented <strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> opposite, as she felt her current students<br />
were at a lower ability level that her previous<br />
groups, <strong>and</strong> that <str<strong>on</strong>g>the</str<strong>on</strong>g>ir behavior was worse.<br />
Katie stated that, “when you have more behavior<br />
problems <strong>and</strong> self-esteem issues, it impacts<br />
it [curriculum enactment]. It absorbs more of<br />
your time.” Katie also menti<strong>on</strong>ed that her current<br />
group of students had less interest in<br />
cooking, so <str<strong>on</strong>g>the</str<strong>on</strong>g>y did not do it as much because<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> students complained <strong>and</strong> generally<br />
seemed not to get much out of <str<strong>on</strong>g>the</str<strong>on</strong>g> experience.<br />
Curriculum materials factor. Nei<str<strong>on</strong>g>the</str<strong>on</strong>g>r program<br />
employed a commercially-available a<br />
functi<strong>on</strong>al curriculum model, but instead <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
teachers created <str<strong>on</strong>g>the</str<strong>on</strong>g>irs through a piece-meal<br />
approach. The motto was to use whatever was<br />
available <strong>and</strong> “be flexible.” As a result of Katie’s<br />
<strong>and</strong> Paula’s “piece-mealing,” <str<strong>on</strong>g>the</str<strong>on</strong>g>ir functi<strong>on</strong>al<br />
curriculum c<strong>on</strong>sisted of purchased materials,<br />
borrowed materials, created materials<br />
<strong>and</strong> photocopied materials. Many of Katie’s<br />
materials were photocopies of workbooks,<br />
novels, <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r materials. She explained<br />
304 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
that photocopies were used because she did<br />
not have resources to secure curriculum materials.<br />
The program was given $800 when it<br />
was started <strong>and</strong> it had not received any additi<strong>on</strong>al<br />
funding. To purchase any additi<strong>on</strong>al<br />
materials, such as kitchen equipment, novels,<br />
<strong>and</strong> workbooks, Katie used m<strong>on</strong>ey made from<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> school store that her class ran.<br />
Paula explained that <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum materials<br />
in her program were “piece-mealed” because<br />
of a lack of appropriate materials available<br />
for her cross-categorical program. Paula<br />
expressed frustrati<strong>on</strong> because <str<strong>on</strong>g>the</str<strong>on</strong>g> reading<br />
level of materials was often above those of her<br />
students, stating “most stuff is designed for<br />
students with learning disabilities. Their reading<br />
levels [her students] are low, as low as 2.3,<br />
but generally between 3 <strong>and</strong> 4” (Fieldnotes,<br />
January 28, 2005). She indicated that <str<strong>on</strong>g>the</str<strong>on</strong>g> special<br />
educati<strong>on</strong> director at her district encouraged<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> use of research-based materials,<br />
which she could not find any for <str<strong>on</strong>g>the</str<strong>on</strong>g> populati<strong>on</strong><br />
she taught. The lack of an appropriate<br />
functi<strong>on</strong>al curriculum was supported by <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
researcher’s review of functi<strong>on</strong>al curricula<br />
models. Despite that many exist, few were designed<br />
for this populati<strong>on</strong> – students with mild<br />
mental impairment <strong>and</strong> learning disabilities.<br />
Most models were designed for students with<br />
moderate or severe mental impairment, such<br />
as The Syracuse community-referenced guide <strong>and</strong><br />
Impact: A functi<strong>on</strong>al curriculum h<strong>and</strong>book (Ford<br />
et al. 1989; Neel & Billingsley, 1989). Ones<br />
that focused <strong>on</strong> students with high incidence<br />
disabilities were designed as workbooks that<br />
students filled out ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r than providing applicati<strong>on</strong><br />
of functi<strong>on</strong>al curricula comp<strong>on</strong>ents,<br />
such as Life skills activities for sec<strong>on</strong>dary students<br />
with special needs (Mannix, 1995).<br />
When Katie started teaching in <str<strong>on</strong>g>the</str<strong>on</strong>g> program,<br />
she found <str<strong>on</strong>g>the</str<strong>on</strong>g> Life Centered Career Educati<strong>on</strong><br />
(Brolin, 1997) as <str<strong>on</strong>g>the</str<strong>on</strong>g> <strong>on</strong>ly formal model<br />
available. She referred to <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum that<br />
she developed <strong>and</strong> enacted in terms of “taking<br />
different things <strong>and</strong> piecing <str<strong>on</strong>g>the</str<strong>on</strong>g>m toge<str<strong>on</strong>g>the</str<strong>on</strong>g>r”<br />
(Interview, January 27, 2005). Katie talked<br />
about <str<strong>on</strong>g>the</str<strong>on</strong>g> varying abilities of students in her<br />
room <strong>and</strong> that a range of curricular materials<br />
would be helpful because students come in at<br />
different levels <strong>and</strong> have different interests.<br />
The lack of a “formal” curriculum model in<br />
Katie’s program was noted by <str<strong>on</strong>g>the</str<strong>on</strong>g> paraprofessi<strong>on</strong>al<br />
Brenda, “I d<strong>on</strong>’t underst<strong>and</strong> what <str<strong>on</strong>g>the</str<strong>on</strong>g>
Figure 2. Resultant intersecti<strong>on</strong> of factors impacting<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of a functi<strong>on</strong>al curriculum.<br />
curriculum is up here” (Interview, February<br />
24, 2005). Brenda stated that in her previous<br />
aid positi<strong>on</strong>s (at <str<strong>on</strong>g>the</str<strong>on</strong>g> elementary level), <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
curriculum was sequential <strong>and</strong> progressive,<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>refore “every<strong>on</strong>e knew what was expected<br />
<strong>and</strong> what to expect” (Interview, February<br />
24, 2005). She c<strong>on</strong>trasted this to Katie’s<br />
program, saying that she had “never seen anything”<br />
<strong>and</strong> that she does “not know where to<br />
go” in terms of helping <str<strong>on</strong>g>the</str<strong>on</strong>g> students <strong>and</strong> moving<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>m forward.<br />
Discussi<strong>on</strong><br />
The nature of <str<strong>on</strong>g>the</str<strong>on</strong>g> impact of factors <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
enactment of a functi<strong>on</strong>al curriculum in <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
two cross-categorical self-c<strong>on</strong>tained sec<strong>on</strong>dary<br />
special educati<strong>on</strong> programs could be discussed<br />
as a c<strong>on</strong>juncted process. It was <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
intersecti<strong>on</strong> <strong>and</strong> uni<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> seven factors<br />
that created <str<strong>on</strong>g>the</str<strong>on</strong>g> enacted curriculum, illustrated<br />
graphically in Figure 2. It was not <strong>on</strong>e<br />
factor, or even all factors working singularly,<br />
but <str<strong>on</strong>g>the</str<strong>on</strong>g> uni<strong>on</strong> <strong>and</strong> intersecti<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> different<br />
factors that enacted <str<strong>on</strong>g>the</str<strong>on</strong>g> functi<strong>on</strong>al curriculum<br />
in both programs, for better or worse. Both<br />
Katie <strong>and</strong> Paula would likely have enacted<br />
different versi<strong>on</strong>s of a functi<strong>on</strong>al curriculum if<br />
factors had been different.<br />
This study raises c<strong>on</strong>cerns about use of<br />
functi<strong>on</strong>al curricula in light of current federal<br />
policy <strong>and</strong> legislati<strong>on</strong>. The teachers involved<br />
in this study referenced <str<strong>on</strong>g>the</str<strong>on</strong>g> increasing role of<br />
policy <strong>and</strong> legislati<strong>on</strong> with respect to <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
functi<strong>on</strong>al curriculum enactment, particularly<br />
citing <str<strong>on</strong>g>the</str<strong>on</strong>g> pressure towards academics <strong>and</strong> increased<br />
rigor. Yet <str<strong>on</strong>g>the</str<strong>on</strong>g>se teachers were in a<br />
unique positi<strong>on</strong> in that Michigan is <strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
few states that has more than <strong>on</strong>e alternate<br />
assessment, <strong>and</strong> <strong>on</strong>e created specifically for<br />
students with mild mental impairment or<br />
those who functi<strong>on</strong>al as such (i.e., students<br />
educated in self-c<strong>on</strong>tained cross-categorical<br />
programs). The state test supposedly focused<br />
<strong>on</strong> functi<strong>on</strong>al independence; yet, <str<strong>on</strong>g>the</str<strong>on</strong>g>se two<br />
teachers were still c<strong>on</strong>cerned <strong>and</strong> commended<br />
how <str<strong>on</strong>g>the</str<strong>on</strong>g>y felt <str<strong>on</strong>g>the</str<strong>on</strong>g> alternate assessments<br />
did not truly value <str<strong>on</strong>g>the</str<strong>on</strong>g> functi<strong>on</strong>al curriculum<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir students were receiving.<br />
The questi<strong>on</strong> of using a functi<strong>on</strong>al curriculum<br />
may be a bigger issue in o<str<strong>on</strong>g>the</str<strong>on</strong>g>r states. If<br />
states do not have alternate assessments designed<br />
for this populati<strong>on</strong> than most likely <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
students would be tested using <str<strong>on</strong>g>the</str<strong>on</strong>g> general<br />
large scale state assessment. For students in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se programs, whose average grade level<br />
equivalency in reading was 3.3 <strong>and</strong> in math<br />
was 3.6, it would mean taking an assessment at<br />
least six years developmentally ahead of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
learning. Unfortunately, although a functi<strong>on</strong>al<br />
curriculum holds much potential for<br />
educating sec<strong>on</strong>dary students with disabilities<br />
<strong>and</strong> preparing <str<strong>on</strong>g>the</str<strong>on</strong>g>m for post-school success, it<br />
is not designed to close a learning gap this<br />
large <strong>and</strong> thus is not likely to be supported as<br />
a curriculum opti<strong>on</strong> in today’s push towards<br />
passing state tests. Teachers <strong>and</strong> schools are<br />
being forced to decide if <str<strong>on</strong>g>the</str<strong>on</strong>g>y will educate<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir students with a functi<strong>on</strong>al curriculum to<br />
prepare <str<strong>on</strong>g>the</str<strong>on</strong>g>m for daily living, work, <strong>and</strong> independent<br />
living after school or if <str<strong>on</strong>g>the</str<strong>on</strong>g>y will prepare<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>m to hopefully, somehow, pass a general<br />
large-scale state assessment.<br />
Regardless if states have <strong>on</strong>e test for all<br />
students or alternate assessment for special<br />
needs students, all special educati<strong>on</strong> teachers<br />
will be faced with <str<strong>on</strong>g>the</str<strong>on</strong>g> challenge of teaching to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> test. Teaching to <str<strong>on</strong>g>the</str<strong>on</strong>g> test has been cited as<br />
negatively affecting students’ educati<strong>on</strong>. Peha<br />
(2005) stated that teaching to <str<strong>on</strong>g>the</str<strong>on</strong>g> test resulted<br />
in less teaching to students <strong>and</strong> less real learning.<br />
If teachers like Katie <strong>and</strong> Paula feel pressure<br />
to have <str<strong>on</strong>g>the</str<strong>on</strong>g>ir students pass <str<strong>on</strong>g>the</str<strong>on</strong>g> alternate<br />
assessment, or <str<strong>on</strong>g>the</str<strong>on</strong>g> general large-scale state as-<br />
Factors <strong>and</strong> Functi<strong>on</strong>al Curriculum / 305
sessment, <strong>and</strong> alter <str<strong>on</strong>g>the</str<strong>on</strong>g>ir curriculum to focus<br />
more <strong>on</strong> teaching to <str<strong>on</strong>g>the</str<strong>on</strong>g> test, <strong>on</strong>e has to questi<strong>on</strong><br />
what will be cut from <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum.<br />
Perhaps <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum will have less focus <strong>on</strong><br />
functi<strong>on</strong>al skills, such as daily living <strong>and</strong> social<br />
skills as, for example, Michigan’s alternate assessment<br />
focuses <strong>on</strong> ma<str<strong>on</strong>g>the</str<strong>on</strong>g>matics, literacy,<br />
<strong>and</strong> vocati<strong>on</strong>al skills. What about <str<strong>on</strong>g>the</str<strong>on</strong>g> au<str<strong>on</strong>g>the</str<strong>on</strong>g>ntic<br />
activities within <strong>and</strong> outside of school that<br />
have benefited <str<strong>on</strong>g>the</str<strong>on</strong>g>se students? Unless high<br />
stake assessments are expansive enough to<br />
capture many of <str<strong>on</strong>g>the</str<strong>on</strong>g> performative experiences<br />
students should engage in, <str<strong>on</strong>g>the</str<strong>on</strong>g>re is a risk that<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se could be dropped from <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum,<br />
fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r narrowing what counts as valued<br />
learning <strong>and</strong> a narrowed focus <strong>on</strong> curriculum<br />
that disperses informati<strong>on</strong> which can be measured<br />
<strong>on</strong> paper <strong>and</strong> pencil tests, <strong>and</strong> usually<br />
multiple choice tests at that.<br />
The seven factors identified in this study as<br />
influencing curricula enactment may be more<br />
pr<strong>on</strong>ounced in special educati<strong>on</strong> than general<br />
educati<strong>on</strong>, as general educati<strong>on</strong> teachers typically<br />
use a formal, commercially-available curriculum,<br />
published by <str<strong>on</strong>g>the</str<strong>on</strong>g> likes of Prentice<br />
Hall, Glencoe/McGraw-Hill, <strong>and</strong> Houghlin-<br />
Mifflin. Special educati<strong>on</strong> is more acurricular,<br />
particularly so for <str<strong>on</strong>g>the</str<strong>on</strong>g> populati<strong>on</strong> of students<br />
with high incidence disabilities educated in a<br />
self-c<strong>on</strong>tained cross-categorical program, envir<strong>on</strong>ments<br />
where debates occur over what curriculum<br />
is most appropriate.<br />
The lack of a formal commercially-available<br />
curriculum model may be <str<strong>on</strong>g>the</str<strong>on</strong>g> very reas<strong>on</strong> that<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> identified factors were so pr<strong>on</strong>ounced in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of a functi<strong>on</strong>al curriculum for<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> students in this study. The few models that<br />
exist for students with high incidence disabilities<br />
are designed like worksheets <strong>and</strong> offer<br />
little applicati<strong>on</strong>. Hence, teachers are left to<br />
piece-meal <strong>and</strong> c<strong>on</strong>struct <str<strong>on</strong>g>the</str<strong>on</strong>g>ir functi<strong>on</strong>al curriculum<br />
from a variety of sources, which are<br />
dependent <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir community <strong>and</strong> school<br />
resources as well as <str<strong>on</strong>g>the</str<strong>on</strong>g>ir own pedagogical<br />
approach.<br />
The influence of <str<strong>on</strong>g>the</str<strong>on</strong>g> factors <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment<br />
was evident through <str<strong>on</strong>g>the</str<strong>on</strong>g> impact that<br />
school <strong>and</strong> community resources played. For<br />
example, a comp<strong>on</strong>ent of a functi<strong>on</strong>al curriculum<br />
can be learning to use multiple forms of<br />
transportati<strong>on</strong>, yet public transportati<strong>on</strong> is often<br />
n<strong>on</strong>existent in rural settings, such as <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
two schools in this research. Similarly, a func-<br />
306 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
ti<strong>on</strong>al curriculum typically involves a community<br />
access <strong>and</strong>/or skills comp<strong>on</strong>ent, which<br />
can be achieved through community-based instructi<strong>on</strong>.<br />
However, utilizati<strong>on</strong> of communitybased<br />
instructi<strong>on</strong> (CBI) opportunities requires<br />
businesses or agencies in which to<br />
c<strong>on</strong>duct <str<strong>on</strong>g>the</str<strong>on</strong>g> CBI, as well as transportati<strong>on</strong> to<br />
<strong>and</strong> from <str<strong>on</strong>g>the</str<strong>on</strong>g> site. A rural setting with few<br />
transportati<strong>on</strong> opti<strong>on</strong>s <strong>and</strong> few businesses fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
exasperates <str<strong>on</strong>g>the</str<strong>on</strong>g> situati<strong>on</strong>, leading to experiences<br />
being restricted to <str<strong>on</strong>g>the</str<strong>on</strong>g> school. This<br />
is what happened in Katie’s <strong>and</strong> Paula’s program,<br />
where much of <str<strong>on</strong>g>the</str<strong>on</strong>g> students’ work experience<br />
was gained in-school through working<br />
at <str<strong>on</strong>g>the</str<strong>on</strong>g> school store or cleaning <str<strong>on</strong>g>the</str<strong>on</strong>g> school.<br />
Al<strong>on</strong>g similar lines, both teachers’ educati<strong>on</strong>al<br />
programming was influenced by <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
resources available in <str<strong>on</strong>g>the</str<strong>on</strong>g> schools, particularly<br />
resources that supported <str<strong>on</strong>g>the</str<strong>on</strong>g> teaching of functi<strong>on</strong>al<br />
curricula comp<strong>on</strong>ents. The resources<br />
(or lack of) within a school, such as materials<br />
<strong>and</strong> equipment necessary for engaging in<br />
daily living skills <strong>and</strong>/or vocati<strong>on</strong>al educati<strong>on</strong>,<br />
raises questi<strong>on</strong>s about <str<strong>on</strong>g>the</str<strong>on</strong>g> ability to adequately<br />
provide this curriculum. How can teachers tell<br />
parents, students, <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r educators <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
are providing a functi<strong>on</strong>al curriculum if <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
lack in-school (i.e., a kitchen) <strong>and</strong> out-ofschool<br />
(i.e., work experiences, CBI) resources<br />
to satisfactorily deliver <str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum? Just as<br />
teachers <strong>and</strong> parents expect, <strong>and</strong> dem<strong>and</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
appropriate resources be made available for<br />
students to learn ma<str<strong>on</strong>g>the</str<strong>on</strong>g>matics, ec<strong>on</strong>omics,<br />
<strong>and</strong> physics, so should <str<strong>on</strong>g>the</str<strong>on</strong>g> necessary resources<br />
be available to enact a functi<strong>on</strong>al curriculum.<br />
This c<strong>on</strong>siderati<strong>on</strong>, al<strong>on</strong>g with o<str<strong>on</strong>g>the</str<strong>on</strong>g>r data<br />
from <str<strong>on</strong>g>the</str<strong>on</strong>g> study, suggests that a functi<strong>on</strong>al curriculum<br />
is viewed as an inferior approach.<br />
The educati<strong>on</strong> <strong>and</strong>/or curriculum occurring<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g>se programs were not being valued.<br />
In fact <str<strong>on</strong>g>the</str<strong>on</strong>g> educati<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>se students received<br />
was devalued, as school pers<strong>on</strong>nel placed tasks<br />
such as cleaning <strong>and</strong> stuffing envelopes or<br />
bags before <str<strong>on</strong>g>the</str<strong>on</strong>g> intended curriculum. Students<br />
who are educated in self-c<strong>on</strong>tained<br />
cross-categorical programs have just as much<br />
right to learn, <strong>and</strong> to learn what is appropriate<br />
<strong>and</strong> what will benefit <str<strong>on</strong>g>the</str<strong>on</strong>g>m in terms of postschool<br />
outcomes. Although <str<strong>on</strong>g>the</str<strong>on</strong>g> activities<br />
school pers<strong>on</strong>nel asked <str<strong>on</strong>g>the</str<strong>on</strong>g> students to do<br />
(i.e., stuffing envelopes, cleaning <str<strong>on</strong>g>the</str<strong>on</strong>g> school,<br />
stuffing bags) might have had some c<strong>on</strong>necti<strong>on</strong><br />
to vocati<strong>on</strong>al experiences <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r
learning opportunities relevant to a functi<strong>on</strong>al<br />
curriculum, <str<strong>on</strong>g>the</str<strong>on</strong>g>y were not designed in<br />
this capacity. Instead <str<strong>on</strong>g>the</str<strong>on</strong>g>se activities were used<br />
to assist staff or serve as time-fillers. Ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
than dem<strong>on</strong>strating <str<strong>on</strong>g>the</str<strong>on</strong>g> many functi<strong>on</strong>al curriculum<br />
learning opportunities that could occur<br />
naturally within a school, <str<strong>on</strong>g>the</str<strong>on</strong>g> data suggested<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g>se students, <str<strong>on</strong>g>the</str<strong>on</strong>g>ir educati<strong>on</strong>al<br />
programming, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir learning were valued<br />
less than o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs.<br />
The lack of formal curriculum materials fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
suggests that perhaps a comprehensive,<br />
flexible, balanced functi<strong>on</strong>al curriculum heuristic<br />
needs to be developed for <str<strong>on</strong>g>the</str<strong>on</strong>g> populati<strong>on</strong><br />
within <str<strong>on</strong>g>the</str<strong>on</strong>g>se programs. The words of a<br />
paraprofessi<strong>on</strong>als working in <strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g>se programs<br />
summarized it best when it came to <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
enacted curriculum, “I d<strong>on</strong>’t underst<strong>and</strong> what<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> curriculum is . . .”. A proposed balanced,<br />
yet flexible, functi<strong>on</strong>al curriculum heuristic<br />
would include utilizati<strong>on</strong> of different learning<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ories <strong>and</strong> pedagogical approaches (i.e.,<br />
skills, cognitive apprenticeship, modeling, social<br />
mediati<strong>on</strong> direct instructi<strong>on</strong>, etc.). It<br />
would attempt to balance <str<strong>on</strong>g>the</str<strong>on</strong>g> various comp<strong>on</strong>ents<br />
of a functi<strong>on</strong>al curriculum (e.g., functi<strong>on</strong>al<br />
academics, community access, daily living<br />
skills, financial, transportati<strong>on</strong>, leisure <strong>and</strong><br />
recreati<strong>on</strong>, communicati<strong>on</strong>, self-determinati<strong>on</strong>,<br />
social skills, vocati<strong>on</strong>al educati<strong>on</strong>, independent<br />
living skills) as well as direct skills<br />
instructi<strong>on</strong> with a cognitive apprenticeship,<br />
students as c<strong>on</strong>sumers with students as producers,<br />
<strong>and</strong> individualizati<strong>on</strong> with community.<br />
A balanced approach to a functi<strong>on</strong>al curriculum<br />
would resemble a balanced literacy approach<br />
(see Duke, Bennett-Armistead, & Roberts,<br />
2003), moving <strong>on</strong> a c<strong>on</strong>tinuum, with<br />
shifting emphasis from “learning to functi<strong>on</strong>”<br />
(i.e., performance) to “functi<strong>on</strong>ing to learn”<br />
(i.e., cognitive apprenticeship), which is represented<br />
graphically in Figure 3. The balanced<br />
approach distributes expertise across<br />
multiple individuals <strong>and</strong> activities, to avoid<br />
self-c<strong>on</strong>tained cross-categorical teachers having<br />
to be all. Although a balanced a functi<strong>on</strong>al<br />
curriculum heuristic is suggested, it must be<br />
flexible enough to address various factors.<br />
This heuristic must be flexible to work within<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>fines of various community <strong>and</strong> school<br />
variables as well as fluid enough to address<br />
what students bring to <str<strong>on</strong>g>the</str<strong>on</strong>g> program <strong>and</strong> how<br />
Figure 3. A balanced a functi<strong>on</strong>al curriculum heuristic.<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> compositi<strong>on</strong> of students will impact <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
enactment <strong>and</strong> curricular decisi<strong>on</strong>-making.<br />
Although <str<strong>on</strong>g>the</str<strong>on</strong>g> data analysis was approached<br />
with an apriori lens in terms of factors, because<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> researcher approached it with an<br />
open mind <strong>and</strong> looked for evidence to support<br />
<strong>and</strong> challenge <str<strong>on</strong>g>the</str<strong>on</strong>g>se factors, ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r factor<br />
was found – paraprofessi<strong>on</strong>als. It is likely<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> role of paraprofessi<strong>on</strong>als was not acknowledged<br />
because <str<strong>on</strong>g>the</str<strong>on</strong>g> limited literature <strong>on</strong><br />
factors influencing an enacted curriculum<br />
came from general educati<strong>on</strong>, in which paraprofessi<strong>on</strong>als<br />
play less of a role, if present at<br />
all. Paraprofessi<strong>on</strong>als added benefits <strong>and</strong> limitati<strong>on</strong>s<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment of a functi<strong>on</strong>al curriculum.<br />
One major challenge for paraprofessi<strong>on</strong>als<br />
involved c<strong>on</strong>fusi<strong>on</strong> over <str<strong>on</strong>g>the</str<strong>on</strong>g>ir role. At<br />
times <str<strong>on</strong>g>the</str<strong>on</strong>g>y were treated <strong>and</strong> given privileges as<br />
a teacher <strong>and</strong> at times that of a secretary or<br />
assistant, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>se two distinct roles hold implicati<strong>on</strong>s<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g> educati<strong>on</strong> of students.<br />
One major c<strong>on</strong>tenti<strong>on</strong> when discussing<br />
paraprofessi<strong>on</strong>als <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir impact involves<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> fact that <str<strong>on</strong>g>the</str<strong>on</strong>g>y are often instructing or<br />
teaching some of <str<strong>on</strong>g>the</str<strong>on</strong>g> most vulnerable students<br />
in schools. Research has suggested that some<br />
paraprofessi<strong>on</strong>als spend almost 50% of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
time providing individual instructi<strong>on</strong> to students<br />
without a teacher present (Ashbaker &<br />
Morgan, 2001). Some students have been<br />
found to receive as much of 80% of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
instructi<strong>on</strong> from a paraprofessi<strong>on</strong>al, ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
than a certified teacher (Ashbaker & Morgan).<br />
Thus, our students who may be most in<br />
need of a highly ”qualified” teacher’s assistance<br />
are fur<str<strong>on</strong>g>the</str<strong>on</strong>g>st away (i.e., sec<strong>on</strong>dary students<br />
educated in self-c<strong>on</strong>tained cross-categorical<br />
programs) <strong>and</strong> being educated by<br />
paraprofessi<strong>on</strong>als – individuals who may not<br />
have a college degree <strong>and</strong> potentially little<br />
training in teaching or working with children.<br />
Factors <strong>and</strong> Functi<strong>on</strong>al Curriculum / 307
Limitati<strong>on</strong>s<br />
This study presented several limitati<strong>on</strong>s. One<br />
limitati<strong>on</strong> involved <str<strong>on</strong>g>the</str<strong>on</strong>g> cases, as <str<strong>on</strong>g>the</str<strong>on</strong>g> study c<strong>on</strong>sisted<br />
of two programs, <strong>and</strong> hence generalizability<br />
is limited. Ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r limitati<strong>on</strong> is that <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
two cases were observed for a bounded period<br />
of time, although <str<strong>on</strong>g>the</str<strong>on</strong>g> data did become saturated<br />
prior to ending observati<strong>on</strong>s. Additi<strong>on</strong>ally,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> cases were not observed for <str<strong>on</strong>g>the</str<strong>on</strong>g> same<br />
amount of time. More hours of observati<strong>on</strong><br />
were recorded at Harborville High School in<br />
Katie’s program than at River Bend High<br />
School in Paula’s room. This resulted from<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> teacher at River Bend getting sick, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
school having snow days, <strong>and</strong> students being<br />
away <strong>on</strong> field trips.<br />
Limitati<strong>on</strong>s also arose in <str<strong>on</strong>g>the</str<strong>on</strong>g> data collecti<strong>on</strong>.<br />
Not every student in both programs returned<br />
approved parental c<strong>on</strong>sent forms, <strong>and</strong>/or<br />
gave student assent. The enactment of a functi<strong>on</strong>al<br />
curriculum in <str<strong>on</strong>g>the</str<strong>on</strong>g> programs was left to<br />
be understood by <strong>on</strong>ly those students for<br />
whom c<strong>on</strong>sent was granted. Little is known<br />
regarding <str<strong>on</strong>g>the</str<strong>on</strong>g> students for whom c<strong>on</strong>sent was<br />
not obtained, in terms of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir pers<strong>on</strong>al <strong>and</strong><br />
school data as well as <str<strong>on</strong>g>the</str<strong>on</strong>g>ir perspective of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
enactment of a functi<strong>on</strong>al curriculum. A limitati<strong>on</strong><br />
also existed with <str<strong>on</strong>g>the</str<strong>on</strong>g> student interviews.<br />
Some students had difficulty underst<strong>and</strong>ing<br />
some of <str<strong>on</strong>g>the</str<strong>on</strong>g> interview questi<strong>on</strong>s. Even when<br />
students appeared to underst<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong>s,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir resp<strong>on</strong>ses c<strong>on</strong>sisted of a few words<br />
ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r than expansi<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir thoughts.<br />
Future Directi<strong>on</strong>s<br />
Research needs to c<strong>on</strong>tinue to explore not<br />
<strong>on</strong>ly <str<strong>on</strong>g>the</str<strong>on</strong>g> relati<strong>on</strong>ship between factors <strong>and</strong> a<br />
functi<strong>on</strong>al curriculum, but between factors<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> influence of curriculum in special<br />
educati<strong>on</strong> in general. The field needs to better<br />
underst<strong>and</strong> what is occurring curriculumwise<br />
in its service-delivery opti<strong>on</strong>s as well as<br />
what factors are affecting <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment. Future<br />
research should examine <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment<br />
of a functi<strong>on</strong>al curriculum given o<str<strong>on</strong>g>the</str<strong>on</strong>g>r factors,<br />
such as urban or suburban self-c<strong>on</strong>tained<br />
cross-categorical programs. It should also examine<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> enactment with o<str<strong>on</strong>g>the</str<strong>on</strong>g>r types of service<br />
delivery models, such as resource rooms<br />
<strong>and</strong> general educati<strong>on</strong> classes, if applicable.<br />
As this study was limited to functi<strong>on</strong>al curric-<br />
ulum models that were “piece-mealed” by <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
teachers, as opposed to formal commercially<br />
available functi<strong>on</strong>al curricula, research needs<br />
to be undertaken to underst<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment<br />
of commercially available functi<strong>on</strong>al<br />
curricula as well.<br />
Exploring <str<strong>on</strong>g>the</str<strong>on</strong>g> enactment with different<br />
teacher characteristics may also lead to underst<strong>and</strong>ing.<br />
The role of teacher preparati<strong>on</strong> <strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> enactment was under-explored in this<br />
study <strong>and</strong> additi<strong>on</strong>al research is needed regarding<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> impact of preservice educati<strong>on</strong><br />
<strong>and</strong> experience <strong>on</strong> inservice acti<strong>on</strong>s <strong>and</strong> decisi<strong>on</strong>s.<br />
Variati<strong>on</strong>s in o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs factors should also<br />
be analyzed, such as studying enactment<br />
across categorical versus cross-categorical programs<br />
or <str<strong>on</strong>g>the</str<strong>on</strong>g> influence of <str<strong>on</strong>g>the</str<strong>on</strong>g> lack of paraprofessi<strong>on</strong>als.<br />
Given <str<strong>on</strong>g>the</str<strong>on</strong>g> factors that were found<br />
to be influential in this study, <str<strong>on</strong>g>the</str<strong>on</strong>g> next step is<br />
to manipulate <str<strong>on</strong>g>the</str<strong>on</strong>g> factors <strong>and</strong> study <str<strong>on</strong>g>the</str<strong>on</strong>g> relati<strong>on</strong>ship<br />
between <str<strong>on</strong>g>the</str<strong>on</strong>g> intersecti<strong>on</strong> <strong>and</strong> uni<strong>on</strong><br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> various factors <strong>and</strong> students’ in-school<br />
<strong>and</strong> post-school success, such as employment,<br />
independent living, <strong>and</strong> life satisfacti<strong>on</strong>.<br />
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classroom: A study of k-12 ma<str<strong>on</strong>g>the</str<strong>on</strong>g>matics <strong>and</strong> science<br />
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inside<str<strong>on</strong>g>the</str<strong>on</strong>g>classroom/reports/looking/complete.pdf<br />
Received: 4 January 2007<br />
Initial Acceptance: 1 March 2007<br />
Final Acceptance: 22 May 2007<br />
310 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008
Thirty Year Review of Safety Skill Instructi<strong>on</strong> for Pers<strong>on</strong>s<br />
with Intellectual Disabilities<br />
Linda C. Mechling<br />
University of North Carolina Wilmingt<strong>on</strong><br />
Abstract: This review syn<str<strong>on</strong>g>the</str<strong>on</strong>g>sizes <str<strong>on</strong>g>the</str<strong>on</strong>g> empirical literature (1976–2006) focusing <strong>on</strong> teaching pers<strong>on</strong>al safety<br />
skills to pers<strong>on</strong>s with intellectual disabilities. Thirty-six investigati<strong>on</strong>s were identified which provided informati<strong>on</strong><br />
<strong>on</strong> six areas of instructi<strong>on</strong>: (a) pedestrian/street crossing safety; (b) home accident preventi<strong>on</strong>; (c)<br />
applicati<strong>on</strong> of first aid (including identificati<strong>on</strong> <strong>and</strong> reporting of illnesses); (d) resp<strong>on</strong>se to lures or advancements<br />
of strangers; (e) fire safety; <strong>and</strong> (f) emergency use of teleph<strong>on</strong>es. Implicati<strong>on</strong>s for instructi<strong>on</strong> <strong>and</strong> future<br />
research are discussed based <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> results of <str<strong>on</strong>g>the</str<strong>on</strong>g> review.<br />
Deinstituti<strong>on</strong>alizati<strong>on</strong> <strong>and</strong> desegregati<strong>on</strong> in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> early 1960’s initiated <str<strong>on</strong>g>the</str<strong>on</strong>g> need to prepare<br />
pers<strong>on</strong>s with disabilities to functi<strong>on</strong> in less<br />
supervised <strong>and</strong> sheltered envir<strong>on</strong>ments (Marchetti,<br />
McCartney, Drain, Hooper, & Dix<br />
(1983). Today focus c<strong>on</strong>tinues <strong>on</strong> providing<br />
inclusive opportunities for pers<strong>on</strong>s with disabilities,<br />
requiring instructi<strong>on</strong> of skills in preparati<strong>on</strong><br />
of integrati<strong>on</strong> into communities. By<br />
nature of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir disabilities, pers<strong>on</strong>s may lack<br />
judgment <strong>and</strong> skills to recognize, avoid, or<br />
escape dangerous situati<strong>on</strong>s <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> communicati<strong>on</strong><br />
skills to report situati<strong>on</strong>s or crimes<br />
against <str<strong>on</strong>g>the</str<strong>on</strong>g>m (Mazzucchelli, 2001; Wils<strong>on</strong>,<br />
Seaman, & Nettelbeck, 1996). They may also<br />
be more dependent <strong>on</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs for physical <strong>and</strong><br />
psychological needs <strong>and</strong> support across envir<strong>on</strong>ments<br />
(Mats<strong>on</strong>, 1984; Taber, Alberto,<br />
Hughes, & Seltzer, 2002). This dependence<br />
<strong>and</strong> lack of skills often cause <str<strong>on</strong>g>the</str<strong>on</strong>g>m to be compliant<br />
<strong>and</strong> passive towards o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs, which may<br />
leave <str<strong>on</strong>g>the</str<strong>on</strong>g>m susceptible to victimizati<strong>on</strong> (Mats<strong>on</strong>).<br />
Moving from supervised to semi-independent<br />
or independent living arrangements <strong>and</strong><br />
from sheltered to competitive work envir<strong>on</strong>ments<br />
require planning <strong>and</strong> programming for<br />
attainment of increased independence. An increase<br />
in independence results in decreased<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cerning this article should<br />
be addressed to Linda C. Mechling, University of<br />
North Carolina Wilmingt<strong>on</strong>, 601 S. College Road,<br />
Wilmingt<strong>on</strong>, NC 28403-5940.<br />
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities, 2008, 43(3), 311–323<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities<br />
dependency <strong>on</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs. Less supervisi<strong>on</strong> <strong>and</strong><br />
support from adults <strong>and</strong> transiti<strong>on</strong>ing from<br />
protected envir<strong>on</strong>ments may lead to an increased<br />
exposure to risk <strong>and</strong> unsafe situati<strong>on</strong>s.<br />
Wils<strong>on</strong> <strong>and</strong> Brewer (1992) report a significantly<br />
higher risk of criminal victimizati<strong>on</strong>,<br />
including pers<strong>on</strong>al <strong>and</strong> property offenses,<br />
am<strong>on</strong>g pers<strong>on</strong>s with intellectual disabilities<br />
<strong>and</strong> that this risk increases for those living<br />
al<strong>on</strong>e or with some<strong>on</strong>e else with a disability.<br />
Yet, in spite of <str<strong>on</strong>g>the</str<strong>on</strong>g>se difficult c<strong>on</strong>cerns, reas<strong>on</strong>able<br />
risk is a necessary part of normal life<br />
(MacEachr<strong>on</strong> & Janicki, 1983). The right to<br />
experience normal risk taking is necessary for<br />
human growth <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> development of human<br />
dignity (MacEachr<strong>on</strong> & Janicki), <str<strong>on</strong>g>the</str<strong>on</strong>g>refor,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>re is a need to provide opportunities<br />
for increased independence <strong>and</strong> to teach<br />
skills that minimize risk.<br />
Pers<strong>on</strong>al safety skill instructi<strong>on</strong> is c<strong>on</strong>sidered<br />
by many as being as important as teaching<br />
communicati<strong>on</strong>, motor, <strong>and</strong> social skills to<br />
pers<strong>on</strong>s with disabilities (Collins, Wolery, &<br />
Gast, 1991). Safety goals are being included<br />
for students receiving transiti<strong>on</strong> planning services<br />
through <str<strong>on</strong>g>the</str<strong>on</strong>g>ir Individualized Educati<strong>on</strong><br />
Program (IEP) while teachers seek ways to<br />
teach strategies <strong>and</strong> skills to increase pers<strong>on</strong>al<br />
safety through awareness of safe <strong>and</strong> unsafe<br />
situati<strong>on</strong>s <strong>and</strong> underst<strong>and</strong>ing how to take appropriate<br />
acti<strong>on</strong>s in dangerous situati<strong>on</strong>s<br />
(Collins et al.).<br />
The focus of this review is <str<strong>on</strong>g>the</str<strong>on</strong>g> syn<str<strong>on</strong>g>the</str<strong>on</strong>g>sis of<br />
research available <strong>on</strong> teaching pers<strong>on</strong>al safety<br />
Safety Skill Instructi<strong>on</strong> / 311
skills to pers<strong>on</strong>s with disabilities. Clees <strong>and</strong><br />
Gast (1994) defined social safety skills as verbal<br />
or n<strong>on</strong>verbal behaviors which may be primarily<br />
preventative or reacti<strong>on</strong>ary. Preventative<br />
measures serve to avoid potentially<br />
dangerous situati<strong>on</strong>s before <str<strong>on</strong>g>the</str<strong>on</strong>g>y occur while<br />
reacti<strong>on</strong>ary measures allow escape from or terminati<strong>on</strong><br />
of presently occurring situati<strong>on</strong>s. This<br />
review included studies that focus <strong>on</strong> ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
preventative or reacti<strong>on</strong>ary pers<strong>on</strong>al safety<br />
skills.<br />
Method<br />
The period of review extended over 30 years<br />
(1976-2006). Although a review of this extent<br />
risks inclusi<strong>on</strong> of methods that are outdated, it<br />
also helps to assure <str<strong>on</strong>g>the</str<strong>on</strong>g> inclusi<strong>on</strong> of effective<br />
strategies that may not have been c<strong>on</strong>ducted<br />
in recent years. An electr<strong>on</strong>ic search of ERIC<br />
included <str<strong>on</strong>g>the</str<strong>on</strong>g> keywords: safety skills, safety,<br />
safety instructi<strong>on</strong>, fire safety, pedestrian skills,<br />
street crossing, teleph<strong>on</strong>e skills, first aid, accident<br />
preventi<strong>on</strong>, lures of strangers, crime preventi<strong>on</strong>,<br />
child abducti<strong>on</strong>, <strong>and</strong> molestati<strong>on</strong>. An<br />
ancestral search was <str<strong>on</strong>g>the</str<strong>on</strong>g>n c<strong>on</strong>ducted of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
table of c<strong>on</strong>tents of <str<strong>on</strong>g>the</str<strong>on</strong>g> following journals:<br />
American <str<strong>on</strong>g>Journal</str<strong>on</strong>g> of Mental Retardati<strong>on</strong>, Behavior<br />
Modificati<strong>on</strong>, Excepti<strong>on</strong>ality, Educati<strong>on</strong> <strong>and</strong><br />
Training in Developmental Disabilities, Excepti<strong>on</strong>al<br />
Children, Focus <strong>on</strong> <strong>Autism</strong> <strong>and</strong> O<str<strong>on</strong>g>the</str<strong>on</strong>g>r Developmental<br />
Disabilities, Focus <strong>on</strong> Excepti<strong>on</strong>al Children,<br />
<str<strong>on</strong>g>Journal</str<strong>on</strong>g> of Applied Behavior Analysis, <str<strong>on</strong>g>Journal</str<strong>on</strong>g> of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
Associati<strong>on</strong> for Pers<strong>on</strong>s with Severe Disabilities,<br />
<str<strong>on</strong>g>Journal</str<strong>on</strong>g> of <strong>Autism</strong> <strong>and</strong> Developmental Disabilities,<br />
<str<strong>on</strong>g>Journal</str<strong>on</strong>g> of Developmental <strong>and</strong> Physical Disabilities,<br />
<str<strong>on</strong>g>Journal</str<strong>on</strong>g> of Early Interventi<strong>on</strong>, <str<strong>on</strong>g>Journal</str<strong>on</strong>g> of Special<br />
Educati<strong>on</strong>, <str<strong>on</strong>g>Journal</str<strong>on</strong>g> of Special Educati<strong>on</strong> Technology,<br />
Mental Retardati<strong>on</strong>, Remedial <strong>and</strong> Special Educati<strong>on</strong>,<br />
Research <strong>and</strong> Practice for Pers<strong>on</strong>s with<br />
Severe Disabilities, Topics in Early Childhood Special<br />
Educati<strong>on</strong>, followed by a manual search of<br />
all reference lists of identified articles. In order<br />
to be included in <str<strong>on</strong>g>the</str<strong>on</strong>g> review, studies met<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> following criteria:<br />
1. Use of experimental design<br />
2. Publicati<strong>on</strong> in peer-reviewed journal<br />
3. Evaluati<strong>on</strong> of safety skill instructi<strong>on</strong><br />
4. Participants were diagnosed with an intellectual<br />
disability<br />
5. Article published in English<br />
Results<br />
Thirty six studies (Table 1) <strong>and</strong> two literature<br />
reviews were identified. Both literature reviews<br />
focused <strong>on</strong> abducti<strong>on</strong> preventi<strong>on</strong>. The<br />
review by Bevill <strong>and</strong> Gast (1998) narrowed its<br />
focus to young children, <str<strong>on</strong>g>the</str<strong>on</strong>g> lures of strangers,<br />
<strong>and</strong> sexual abuse while <str<strong>on</strong>g>the</str<strong>on</strong>g> Miltenberger <strong>and</strong><br />
Olsen (1996) review included research with<br />
children without disabilities <strong>and</strong> adults with<br />
intellectual disabilities. While some of <str<strong>on</strong>g>the</str<strong>on</strong>g> 36<br />
studies evaluated multiple skills, each addressed<br />
at least <strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g> following pers<strong>on</strong>al<br />
safety skills: (a) pedestrian/street crossing<br />
safety (7); (b) home accident preventi<strong>on</strong> (6);<br />
(c) applicati<strong>on</strong> of first aid (including identificati<strong>on</strong><br />
<strong>and</strong> reporting of illnesses (7); (d) resp<strong>on</strong>se<br />
to lures or advancements of strangers<br />
(6); (e) fire safety (6); <strong>and</strong> (f) emergency use<br />
of teleph<strong>on</strong>es (5).<br />
Pedestrian/Street Crossing Safety<br />
312 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
While <str<strong>on</strong>g>the</str<strong>on</strong>g> inability to safely move around<br />
<strong>on</strong>e’s community can hinder independence, a<br />
single error while crossing a street can have<br />
crucial c<strong>on</strong>sequences (Mats<strong>on</strong>, 1980a). Community<br />
pedestrian movement <strong>and</strong> street crossing<br />
were addressed in eight identified studies.<br />
Am<strong>on</strong>g <str<strong>on</strong>g>the</str<strong>on</strong>g> skills taught were: proper sidewalk<br />
behavior (ie. walk <strong>on</strong> right side, do not bump<br />
into pedestrians) (Mats<strong>on</strong>); recogniti<strong>on</strong> of intersecti<strong>on</strong>s<br />
(Mats<strong>on</strong>); crossing streets with<br />
stop signs (look in both directi<strong>on</strong>s; use of<br />
crosswalks) (Horner, J<strong>on</strong>es, & Williams, 1985;<br />
Vogelsburg & Rusch, 1979); crossing streets<br />
with traffic lights (Horner et al.; Page, Iwata, &<br />
Neef, 1976); <strong>and</strong> crossing unc<strong>on</strong>trolled streets<br />
(Branham, Collins, Schuster, & Kleinert,<br />
1999; Horner et al.) <strong>and</strong> parking lots (Spears,<br />
Rusch, York, & Lilly, 1981).<br />
Three of <str<strong>on</strong>g>the</str<strong>on</strong>g> studies c<strong>on</strong>ducted all sessi<strong>on</strong>s<br />
with community streets (Horner et al. (1985;<br />
Spears et al., 1981; Vogelsburg & Rusch,<br />
1979). Two of <str<strong>on</strong>g>the</str<strong>on</strong>g> studies (Mats<strong>on</strong>, 1980a;<br />
Page et al., 1976) used <strong>on</strong>ly simulated instructi<strong>on</strong>,<br />
<strong>and</strong> three studies (Branham et al., 1999;<br />
Collins, Stins<strong>on</strong>, & L<strong>and</strong>, 1993; Marchetti et<br />
al., 1983) used both simulati<strong>on</strong> <strong>and</strong> community<br />
instructi<strong>on</strong>. Results of <str<strong>on</strong>g>the</str<strong>on</strong>g> Collins et al.<br />
study indicated that teaching first in simulati<strong>on</strong><br />
did not facilitate or inhibit later instructi<strong>on</strong><br />
within <str<strong>on</strong>g>the</str<strong>on</strong>g> community. Branham et al.
TABLE 1<br />
Safety Skill Studies<br />
Reference Participants Safety Skill Setting/Simulati<strong>on</strong> Design Results Generalizati<strong>on</strong> Maintenance<br />
Novel settings No report<br />
All formats effective.<br />
Classroom CBI<br />
more efficient<br />
Multiple probe across<br />
behaviors<br />
Pedestrian Classroom CBI,<br />
Video Model CBI,<br />
Classroom Video<br />
n 3<br />
CA 14–20yrs<br />
Moderate ID<br />
Branham, Collins,<br />
Schuster, & Kleinert<br />
(1999)<br />
8wk<br />
generalizati<strong>on</strong><br />
to follow-up<br />
2 of 3 pairs<br />
generalized<br />
home &<br />
school playground<br />
after<br />
2 wks.<br />
Generalizati<strong>on</strong><br />
reported for<br />
real injuries -<br />
2 students<br />
Generazati<strong>on</strong> to<br />
playground<br />
& children’s<br />
homes<br />
School <strong>and</strong><br />
community<br />
settings<br />
Students learned to<br />
seek help through<br />
direct instructi<strong>on</strong> &<br />
observati<strong>on</strong>al<br />
learning<br />
Multiple probe across 3<br />
pairs of students<br />
Model CBI<br />
Simulati<strong>on</strong>, school<br />
bathroom<br />
First Aid, seek adult<br />
assistance<br />
n 6<br />
CA pre-school<br />
Mild ID<br />
Moderate ID<br />
Christensen, Lignugaris/<br />
Kraft, & Fiechtl (1996)<br />
100%<br />
maintenance<br />
after 1<br />
m<strong>on</strong>th<br />
Maintained<br />
Time period<br />
not provided<br />
1 week, mixed<br />
results<br />
Rapid increase in<br />
performance using<br />
social modeling<br />
Multiple baseline<br />
across students<br />
Simulati<strong>on</strong>, social<br />
modeling, kitchen<br />
area of classroom<br />
First Aid, seek adult<br />
assistance<br />
CTD effective in<br />
teaching reading of<br />
Multiple probe across<br />
participants<br />
Read words <strong>on</strong> product<br />
labels (classroom)<br />
Product warning<br />
labels<br />
words<br />
Mixed results 1 participant<br />
c<strong>on</strong>sistently<br />
generalized<br />
Students learned Words <strong>on</strong><br />
target words <strong>and</strong> actual<br />
some incidental <strong>and</strong> products<br />
observati<strong>on</strong>al words<br />
No significant<br />
Community<br />
difference across streets & pay<br />
two c<strong>on</strong>diti<strong>on</strong>s ph<strong>on</strong>es<br />
Parents performed Performance<br />
child-care, home measured at<br />
safety skills using parents’<br />
checklist task<br />
homes<br />
analysis<br />
Each group achieved Some use of<br />
gains in 6 social skill skills across<br />
areas<br />
peer<br />
“c<strong>on</strong>federate”<br />
Acquisiti<strong>on</strong> in<br />
Failure to<br />
simulati<strong>on</strong><br />
generalize<br />
until training<br />
in vivo<br />
Multiple probe across<br />
participants<br />
CTD using multiple<br />
exemplars in vivo<br />
Resp<strong>on</strong>se to lures of<br />
strangers<br />
Maintained 2<br />
wks<br />
Read words <strong>on</strong> flash<br />
cards.<br />
Product Warning<br />
Labels Incidental<br />
learning of<br />
definiti<strong>on</strong>s<br />
Pedestrian, Pay<br />
ph<strong>on</strong>e<br />
Christensen, March<strong>and</strong>- n 4<br />
Martella, Martella, CA pre-school<br />
Fiechtl, & Christensen Developmental<br />
(1993)<br />
delays<br />
Collins, & Griffen (1996) n 4<br />
CA 8–11yrs<br />
Moderate ID<br />
Collins, Schuster, & n 3<br />
Nels<strong>on</strong> (1992)<br />
CA 38–48yrs<br />
Severe ID<br />
Collins, & Stins<strong>on</strong> (1994– n 4<br />
1995)<br />
CA 16–20yrs<br />
Moderate ID<br />
Maintained 1<br />
m<strong>on</strong>th<br />
Multiple probe across<br />
word pairs,<br />
replicated across<br />
participants<br />
Adapted multiple<br />
probe across<br />
participants<br />
Multiple baseline<br />
across participants<br />
In vivo vs Simulati<strong>on</strong> <br />
In vivo<br />
n 4<br />
CA 15–19yrs<br />
Moderate ID<br />
Collins, Stins<strong>on</strong>, & L<strong>and</strong><br />
(1993)<br />
No report<br />
Self-instructi<strong>on</strong> with<br />
audiovisual child<br />
care manuals<br />
Home accident<br />
preventi<strong>on</strong><br />
Feldman, & Case (1999) n 10<br />
CA 23–37yrs<br />
Mild ID<br />
No report<br />
Multiple baseline<br />
across groups<br />
Adapted board game<br />
<strong>and</strong> verbal resp<strong>on</strong>se<br />
Resp<strong>on</strong>se to sexual<br />
advancements<br />
n 6<br />
CA 24–26yrs<br />
Mild, Moderate<br />
ID<br />
n 4<br />
CA preschool<br />
Developmental<br />
delays<br />
Foxx, McMorrow, Storey,<br />
& Rogers (1984)<br />
Maintained 2–4<br />
wks after in<br />
vivo training<br />
Multiple probe across<br />
subjects<br />
CTD, multiple<br />
examples, simulated<br />
preschool setting<br />
Resp<strong>on</strong>se to lures of<br />
strangers<br />
Gast, Collins, Wolery, &<br />
J<strong>on</strong>es (1993)<br />
Safety Skill Instructi<strong>on</strong> / 313
TABLE 1—(C<strong>on</strong>tinued)<br />
Reference Participants Safety Skill Setting/Simulati<strong>on</strong> Design Results Generalizati<strong>on</strong> Maintenance<br />
Mixed results<br />
across<br />
injuries 8–12<br />
wks<br />
Maintained 10–<br />
50 days<br />
Peers without<br />
disabilities<br />
All students reached<br />
criteria<br />
Multiple probe across<br />
behaviors replicated<br />
across participants<br />
First aid Simulated injuries using<br />
costume make-up<br />
Gast, & Winterling (1992) n 4<br />
CA 17–21yrs<br />
Moderate ID<br />
Performance<br />
measured<br />
from 2nd<br />
bedroom<br />
All students learned to<br />
exit home<br />
Multiple baseline across<br />
participants<br />
Fire Safety Bedrooms at home.<br />
Blow dryer for heat,<br />
heating pad <strong>on</strong> door,<br />
picture of smoke,<br />
house fire alarm<br />
Safe resp<strong>on</strong>se to Curriculum using<br />
situati<strong>on</strong>s of modeling, rehearsal,<br />
abducti<strong>on</strong> & feedback, & praise<br />
sexual abuse<br />
Haney, & J<strong>on</strong>es (1982) n 4<br />
CA 12–16yrs<br />
Moderate to<br />
Severe ID<br />
N<strong>on</strong>e reported Maintenance of<br />
skills for 7 of<br />
8 subjects, 6<br />
Effective for 7 of 8<br />
students<br />
Modified multiple<br />
baseline across<br />
subjects<br />
n 8<br />
CA 22–45yrs<br />
Mild ID<br />
Haseltine, & Miltenberger<br />
(1990)<br />
m<strong>on</strong>ths<br />
No report<br />
Generalizati<strong>on</strong><br />
to n<strong>on</strong>trained<br />
streets<br />
General case<br />
programming<br />
effective in teaching<br />
crossing of trained &<br />
n<strong>on</strong>-trained streets<br />
Verbal acquisiti<strong>on</strong> 83–<br />
100% of facts<br />
Pedestrian Community streets Multiple baseline across<br />
participants<br />
n 3<br />
CA 12–53yrs<br />
Moderate to<br />
Severe ID<br />
Horner, J<strong>on</strong>es, & Williams<br />
(1985)<br />
No report<br />
No report for<br />
safety facts<br />
No report Maintained 2<br />
wks<br />
Multiple probe across<br />
behaviors, replicated<br />
across participants<br />
Multiple baseline across<br />
participants<br />
Safety facts N<strong>on</strong>-target feedback<br />
statements, classroom<br />
instructi<strong>on</strong><br />
Fire safety Simulated bedroom at<br />
school<br />
“significant<br />
improvements” in<br />
overt behaviors <strong>and</strong><br />
self-report of safety<br />
skills<br />
“High level” of mastery<br />
of skills across<br />
daytime <strong>and</strong><br />
nighttime scenarios<br />
J<strong>on</strong>es, & Collins (1997) n 3<br />
CA 31–45yrs<br />
Moderate ID<br />
J<strong>on</strong>es, Kazdin, & Haney n 5<br />
(1981)<br />
CA 8–9yrs Mild<br />
ID, no disability<br />
No report Maintained 5–8<br />
m<strong>on</strong>ths<br />
Multiple baseline across<br />
participants<br />
J<strong>on</strong>es, & Thornt<strong>on</strong> (1987) n 4<br />
CA 30–55yrs<br />
Mild, Moderate<br />
ID<br />
314 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
No report Maintained 3<br />
m<strong>on</strong>ths for 2<br />
students<br />
“Significant<br />
improvements in fire<br />
safety resp<strong>on</strong>se for 3<br />
of 4 participants<br />
Multiple baseline across<br />
participants<br />
Fire safety Tape recordings of<br />
alarms, blow dryer for<br />
heat, picture of fires,<br />
taught in apartment<br />
of participants<br />
Fire safety Fire drill in residential<br />
dormitory, tape<br />
recordings of fire<br />
alarms & crackling<br />
fires, blow dryer for<br />
heat<br />
Fire safety Tape recording of<br />
school fire alarm, exit<br />
from 3rd floor of<br />
dormitory<br />
n 4<br />
CA 17–19yrs<br />
Blind Mild ID,<br />
n 1<br />
J<strong>on</strong>es, Van Hasselt, &<br />
Siss<strong>on</strong> (1984)<br />
No report<br />
Generalizati<strong>on</strong><br />
to night time<br />
fire drill<br />
All participants<br />
mastered sequence<br />
for exiting building<br />
Multiple baseline across<br />
participants<br />
n 8<br />
CA 10–19yrs<br />
Blind<br />
J<strong>on</strong>es, Siss<strong>on</strong>, & Van<br />
Hasselt (1984)
TABLE 1—(C<strong>on</strong>tinued)<br />
Reference Participants Safety Skill Setting/Simulati<strong>on</strong> Design Results Generalizati<strong>on</strong> Maintenance<br />
Maintained 66<br />
wks<br />
Self-injuries,<br />
injuries of<br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs, across<br />
natural home<br />
envir<strong>on</strong>ments<br />
N<strong>on</strong>trained No report<br />
injuries of<br />
self <strong>and</strong><br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs<br />
In vivo more effective Novel settings No report<br />
Completi<strong>on</strong> of skills<br />
with puppets<br />
Multiple baseline across<br />
behaviors, replicated<br />
across participants<br />
First aid Ketchup, red pen marks<br />
<strong>on</strong> puppets<br />
n 4<br />
CA 7–11yrs<br />
EBD<br />
March<strong>and</strong>-Martella, &<br />
Martella (1990)<br />
Acquisiti<strong>on</strong> <strong>and</strong><br />
performance of skills<br />
<strong>on</strong> self <strong>and</strong> puppets<br />
Multiple baseline across<br />
participants<br />
First aid Manufactured simulated<br />
injuries, puppets<br />
n 4<br />
CA 6–12yrs<br />
Mild, Moderate<br />
ID, EBD<br />
n 18<br />
CA 19–59yrs<br />
Moderate ID<br />
March<strong>and</strong>-Martella,<br />
Martella, Christensen,<br />
Agran, & Young (1992)<br />
Multiple comparis<strong>on</strong><br />
using Tukey HSD<br />
Pedestrian Classroom scaled<br />
Model vs in vivo<br />
Marchetti, McCartney,<br />
Drain, Hooper, & Dix<br />
No report<br />
Community<br />
streets<br />
Classroom simulati<strong>on</strong><br />
more effective than<br />
scaled model<br />
Duncan’s Multiple<br />
Range Test<br />
Pedestrian Scaled model,<br />
Simulati<strong>on</strong> <strong>on</strong><br />
hospital grounds<br />
Discussi<strong>on</strong> & modeling<br />
not effective until<br />
role playing<br />
introduced<br />
Multiple baseline across<br />
subjects<br />
Fire safety, Discussi<strong>on</strong>, model, role<br />
play in classroom<br />
(1983)<br />
Mats<strong>on</strong> (1980a) n 30<br />
CA 21–55yrs<br />
Moderate,<br />
Severe ID<br />
Mats<strong>on</strong> (1980b) n 5<br />
CA 25–37yrs<br />
Moderate ID<br />
No Maintained 7<br />
generalizati<strong>on</strong> m<strong>on</strong>ths<br />
to actual<br />
emergency<br />
situati<strong>on</strong>s<br />
Maintained 4<br />
wks<br />
N<strong>on</strong>e reported No report<br />
Increase in protective<br />
behaviors<br />
First aid Multiple baseline across<br />
behaviors<br />
Protective behaviors Discussi<strong>on</strong>, model, role 2 2 repeated<br />
play at center using measures ANOVA<br />
“Feel Safe” program<br />
in a group format<br />
Self-treatment of Simulated photographic Multiple baseline across<br />
cold symptoms scenarios<br />
4 classificati<strong>on</strong>s of<br />
colds<br />
Mazzucchelli, (2001) n 20<br />
CA 31–37yrs<br />
Mild ID<br />
N<strong>on</strong>e reported Decrease in<br />
performance<br />
at 1 m<strong>on</strong>th<br />
until<br />
retraining<br />
Some<br />
Most skills<br />
generalizati<strong>on</strong> maintained<br />
to untaught 1-m<strong>on</strong>th<br />
hazards<br />
Acquisiti<strong>on</strong> of treatment<br />
of different cold<br />
types<br />
O’Reilly, & Cuvo (1989) n 1<br />
CA 44yrs<br />
TBI<br />
Anoxic<br />
Checklist effective in<br />
increasing resp<strong>on</strong>se<br />
to most hazards. Task<br />
analysis resulted in<br />
remediati<strong>on</strong> of skills<br />
not acquired through<br />
checklist<br />
Scaled model effective<br />
in teaching street<br />
crossing in natural<br />
envir<strong>on</strong>ment<br />
Variati<strong>on</strong> of multiple<br />
probe across rooms<br />
& participants<br />
Written checklist & task<br />
analysis<br />
Home accident<br />
preventi<strong>on</strong><br />
encephalopathy<br />
n 4<br />
CA 18–20yrs<br />
TBI<br />
O’Reilly, Green, &<br />
Braunling-McMorrow<br />
(1990)<br />
Maintained 2–6<br />
wks<br />
Community<br />
streets<br />
Pedestrian Scaled model Multiple baseline across<br />
behaviors <strong>and</strong><br />
participants<br />
n 5<br />
CA 16–25yrs<br />
Mild, Moderate<br />
ID<br />
Page, Iwata, & Neef<br />
(1976)<br />
Safety Skill Instructi<strong>on</strong> / 315
TABLE 1—(C<strong>on</strong>tinued)<br />
Reference Participants Safety Skill Setting/Simulati<strong>on</strong> Design Results Generalizati<strong>on</strong> Maintenance<br />
Maintained 1–2<br />
wks<br />
Generalizati<strong>on</strong><br />
to untaught<br />
numbers<br />
Acquisiti<strong>on</strong> of dialing<br />
<strong>and</strong> giving<br />
informati<strong>on</strong><br />
Multiple baseline across<br />
behaviors <strong>and</strong><br />
participants<br />
Photo scenarios, picture<br />
ph<strong>on</strong>e directory, in<br />
classroom<br />
Emergency<br />
teleph<strong>on</strong>e calls<br />
N<strong>on</strong>e reported No report<br />
Significant increases for<br />
all participants<br />
Newman-Keuls test for<br />
comparis<strong>on</strong> of means<br />
Disc<strong>on</strong>nected ph<strong>on</strong>es,<br />
cards with ph<strong>on</strong>e<br />
numbers<br />
Emergency<br />
teleph<strong>on</strong>e calls<br />
Independent behavior N<strong>on</strong>e reported No report<br />
attributed to pacing<br />
prompts<br />
Acquisiti<strong>on</strong> of all tasks N<strong>on</strong>e reported Maintained 6–<br />
12 wks<br />
Multiple baseline <strong>and</strong><br />
reversal design across<br />
behaviors<br />
Multiple baseline across<br />
behaviors<br />
Pedestrian Parking lot of residental<br />
facility<br />
Simulated injuries (i.e.<br />
betadine), inoperable<br />
teleph<strong>on</strong>es<br />
First Aid,<br />
Emergency ph<strong>on</strong>e<br />
calls<br />
No report<br />
Multiple probe across<br />
groups<br />
Cell ph<strong>on</strong>e use in<br />
classroom role play<br />
Emergency cell<br />
ph<strong>on</strong>e calls<br />
Risley, & Cuvo (1980) n 3<br />
CA 26–52yrs<br />
Mild, Moderate<br />
ID<br />
Smith, & Meyers (1979) n 60<br />
CA 42–49yrs<br />
Moderate to<br />
Profound ID<br />
Spears, Rusch, York, & n 1<br />
Lilly (1981)<br />
CA 12yrs<br />
Severe ID<br />
Spo<strong>on</strong>er, Stem, & Test n 3<br />
(1989)<br />
CA emergency<br />
Moderate<br />
ID<br />
Taber, Alberto, Hughes, & n 14<br />
seltzer (2002)<br />
CA 11–14yrs<br />
Moderate ID<br />
No report<br />
Generalizati<strong>on</strong><br />
to community<br />
settings &<br />
ph<strong>on</strong>e<br />
numbers<br />
Generalizati<strong>on</strong><br />
to untrained<br />
intersecti<strong>on</strong>s<br />
Acquisiti<strong>on</strong> of cell<br />
ph<strong>on</strong>e use: dialing<br />
number from index<br />
card & give<br />
informati<strong>on</strong><br />
Instructi<strong>on</strong>al feedback<br />
effective in teaching<br />
approach & walk<br />
behaviors. Repeated<br />
practice required to<br />
teach “looking”<br />
behavior<br />
Improvement for 6 of 7<br />
students<br />
Pedestrian Community intersecti<strong>on</strong>s Multiple baseline across<br />
subjects with a partial<br />
sequential reversal<br />
n 3<br />
CA 17–21yrs<br />
Severe, Profound<br />
ID<br />
Vogelsburg, & Rusch<br />
(1979)<br />
316 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Maintained 14<br />
days for 6 of<br />
7 students<br />
Generalizati<strong>on</strong><br />
to novel<br />
situati<strong>on</strong>s &<br />
abductors for<br />
6of7<br />
students<br />
Modified multiple<br />
probe interrupted<br />
time series across<br />
groups<br />
Classroom, school playground<br />
Resp<strong>on</strong>se to lures of<br />
strangers<br />
n 7<br />
CA 6–8yrs<br />
Moderate,<br />
Severe ID<br />
Wats<strong>on</strong>, Bain, &<br />
Hought<strong>on</strong> (1992)<br />
N<strong>on</strong>e reported Maintained 1<br />
wk. Mixed<br />
data 1 m<strong>on</strong>th<br />
Treatment package<br />
effective in teaching<br />
safe h<strong>and</strong>ling of<br />
materials<br />
Multiple probe across<br />
participants,<br />
replicated across<br />
tasks<br />
Simulated plastic<br />
materials, glass<br />
materials<br />
H<strong>and</strong>ling broken<br />
materials (plates,<br />
glasses)<br />
n 3<br />
CA 17–21yrs<br />
Moderate ID<br />
Winterling, Gast, Wolery,<br />
& Farmer (1992)
found differences <strong>on</strong>ly in efficiency data (favoring<br />
classroom simulati<strong>on</strong> plus communitybased<br />
instructi<strong>on</strong> over videotape modeling<br />
used with community-based instructi<strong>on</strong> <strong>and</strong><br />
videotape modeling used with simulati<strong>on</strong> <strong>and</strong><br />
community-based instructi<strong>on</strong>). In c<strong>on</strong>trast,<br />
Marchetti et al. found significant differences<br />
in favor of community training over a classroom<br />
simulati<strong>on</strong> using a small scaled model of<br />
streets <strong>and</strong> moving dolls through intersecti<strong>on</strong>s.<br />
Home Accident Preventi<strong>on</strong><br />
Measures against home accidents <strong>and</strong> injuries<br />
was <str<strong>on</strong>g>the</str<strong>on</strong>g> focus of five identified studies with<br />
results indicating that pers<strong>on</strong> with disabilities<br />
can learn to both prevent <strong>and</strong> h<strong>and</strong>le accidents<br />
within <str<strong>on</strong>g>the</str<strong>on</strong>g> home by following precauti<strong>on</strong>ary<br />
measures. Written checklists of task<br />
analysis were effective in increasing appropriate<br />
preventi<strong>on</strong> of potential in-home hazards<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> bathroom, kitchen, living room <strong>and</strong><br />
bedroom in <str<strong>on</strong>g>the</str<strong>on</strong>g> study by O’Reilly, Green, <strong>and</strong><br />
Braunling-McMorrow (1990). Task analysis included<br />
informati<strong>on</strong> <strong>on</strong> such skills as: proper<br />
positi<strong>on</strong>ing of electric space heaters, use of<br />
hair dryers in <str<strong>on</strong>g>the</str<strong>on</strong>g> bathroom, disposal of outdated<br />
medicati<strong>on</strong>s, <strong>and</strong> bathtub safety. In a<br />
sec<strong>on</strong>d study, J<strong>on</strong>es <strong>and</strong> Collins (1997) presented<br />
safety facts (<str<strong>on</strong>g>the</str<strong>on</strong>g> popcorn popper is hot<br />
<strong>and</strong> could burn you) as n<strong>on</strong>-target informati<strong>on</strong><br />
in instructive feedback statements during<br />
microwave cooking. Although students were<br />
required to answer questi<strong>on</strong>s <strong>and</strong> state safety<br />
facts, measures of safe performance of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
facts were not included in <str<strong>on</strong>g>the</str<strong>on</strong>g> study.<br />
In two similar studies, Collins <strong>and</strong> Stins<strong>on</strong><br />
(1994–1995) taught students to read product<br />
warning labels (i.e. liquid bleach) while Collins<br />
<strong>and</strong> Griffen (1996) taught students to<br />
read labels <strong>and</strong> resp<strong>on</strong>d safely by putting unsafe<br />
products <strong>on</strong> a shelf or h<strong>and</strong>ing <str<strong>on</strong>g>the</str<strong>on</strong>g>m to<br />
an adult.<br />
Using self-instructi<strong>on</strong>al, audiovisual childcare<br />
manuals, Feldman <strong>and</strong> Case (1999)<br />
taught parents with intellectual disabilities to<br />
prevent <str<strong>on</strong>g>the</str<strong>on</strong>g>ir children from being victims to<br />
home accidents by proper storage <strong>and</strong> h<strong>and</strong>ling<br />
of matererials (i.e. glass, electrical appliances,<br />
<strong>and</strong> sharp objects). The <strong>on</strong>ly reactive<br />
study was c<strong>on</strong>ducted by Winterling, Gast, Wolery,<br />
<strong>and</strong> Farmer (1992) who taught students<br />
with disabilities to remove <strong>and</strong> discard broken<br />
materials (plates, glasses) from a sink, countertop,<br />
<strong>and</strong> floor using simulated (plastic) <strong>and</strong><br />
glass materials.<br />
First Aid<br />
Research has also supported <str<strong>on</strong>g>the</str<strong>on</strong>g> ability of pers<strong>on</strong>s<br />
with disabilities to learn <strong>and</strong> apply minor<br />
first aid procedures. O’Reilly <strong>and</strong> Cuvo (1989)<br />
evaluated written task analysis <strong>and</strong> picture<br />
cues depicting cold symptoms (i.e. runny<br />
nose) to teach identificati<strong>on</strong>, m<strong>on</strong>itoring, reporting,<br />
<strong>and</strong> self-administrati<strong>on</strong> of medicati<strong>on</strong>s<br />
for symptoms of illness.<br />
Students have also been taught to: administer<br />
first aid for choking (Spo<strong>on</strong>er, Stem, &<br />
Test, 1989); treat minor burns (March<strong>and</strong>-<br />
Martella & Martella, 1990); treat minor<br />
wounds (i.e. wash, dry, apply b<strong>and</strong>ages)<br />
(March<strong>and</strong>-Martella et al., 1990; March<strong>and</strong>-<br />
Martella, Martella, Christensen, Agran, &<br />
Young, 1992; Mats<strong>on</strong>, 1980b; Spo<strong>on</strong>er et al.);<br />
<strong>and</strong> apply first aid to an insect bite (Gast &<br />
Winterling, 1992). Studies by Christensen,<br />
Lignugaris/Kraft, <strong>and</strong> Fiechtl (1996) <strong>and</strong><br />
Christensen, March<strong>and</strong>-Martella, Martella,<br />
Fiechtl, <strong>and</strong> Christensen (1993) found that<br />
even preschool children were able to learn to<br />
report simulated injuries to an adult through<br />
direct instructi<strong>on</strong> <strong>and</strong> observati<strong>on</strong>al learning.<br />
Procedures have included: (a) model <strong>and</strong><br />
practice <strong>on</strong> self (Gast & Winterling, 1992.;<br />
Spo<strong>on</strong>er et al. 1989); (b) practice <strong>on</strong> puppets<br />
(March<strong>and</strong>-Martella & Martella, 1990); <strong>and</strong><br />
(c) model <strong>and</strong> practice <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> instructor<br />
(Spo<strong>on</strong>er et al.). Simulated materials were<br />
used in each of <str<strong>on</strong>g>the</str<strong>on</strong>g> studies treating minor<br />
cuts, burns, <strong>and</strong> insect bites. These ranged<br />
from using: ketchup (March<strong>and</strong>-Martella &<br />
Martella, 1990) <strong>and</strong> betadine (Spo<strong>on</strong>er et al.)<br />
to simulate blood; costume makeup (Gast et<br />
al.), <strong>and</strong> manufactured simulated injuries<br />
used in first aid training (Christensen et al.,<br />
1993; 1996; March<strong>and</strong>-Martella et al., 1992).<br />
Two studies evaluated students’ abilities to<br />
generalize first aid skills to actual injuries to<br />
follow-up procedures. Christensen et al.<br />
(1996) reported that two of six preschoolers<br />
were able to perform some of <str<strong>on</strong>g>the</str<strong>on</strong>g> first aid<br />
procedures (i.e. covering cut <strong>and</strong> locating a<br />
parent) while March<strong>and</strong>-Martella <strong>and</strong> Martella<br />
(1990) report that three of four partici-<br />
Safety Skill Instructi<strong>on</strong> / 317
pants were reported by <str<strong>on</strong>g>the</str<strong>on</strong>g>ir parents to have<br />
b<strong>and</strong>aged real-life injuries of siblings <strong>and</strong><br />
treating self-injuries.<br />
Abducti<strong>on</strong>/Lures of Strangers/Sexual Abuse<br />
Due to <str<strong>on</strong>g>the</str<strong>on</strong>g>ir disabilities, children <strong>and</strong> adults<br />
may lack social skills, intellectual ability, <strong>and</strong><br />
judgment, making it easier to coerce <str<strong>on</strong>g>the</str<strong>on</strong>g>m<br />
into dangerous situati<strong>on</strong>s (Mats<strong>on</strong>, 1984). Pers<strong>on</strong>s<br />
with disabilities may have poorer interpers<strong>on</strong>al<br />
competence (i.e. resp<strong>on</strong>se to some<strong>on</strong>e<br />
asking for m<strong>on</strong>ey) which may impede<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir ability to decide appropriate behaviors<br />
<strong>and</strong> leave <str<strong>on</strong>g>the</str<strong>on</strong>g>m vulnerable (Wils<strong>on</strong> et al.,<br />
1996).<br />
The ability to “Just say ‘no’ <strong>and</strong> walk away”<br />
in resp<strong>on</strong>se to c<strong>on</strong>fr<strong>on</strong>tati<strong>on</strong>, behaviors, or<br />
pers<strong>on</strong>s that pose harm to pers<strong>on</strong>s with disabilities<br />
is a strategy that has effectively been<br />
taught to pers<strong>on</strong>s with disabilities (Collins,<br />
Hall, Rankin, & Brans<strong>on</strong>, 1999). Research focus<br />
has been <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> instructi<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g>se protective<br />
skills to both adults (Collins, Schuster,<br />
& Nels<strong>on</strong>, 1992; Haseltine & Miltenberger,<br />
1990; Mazzucchelli, 2001) <strong>and</strong> young children<br />
(Gast, Collins, Wolery, & J<strong>on</strong>es, 1993; Wats<strong>on</strong>,<br />
Bain, & Hought<strong>on</strong>, 1992). When teaching<br />
protective behaviors to adults, procedures<br />
have included: a) curriculums which follow a<br />
model of discussi<strong>on</strong>, modeling, <strong>and</strong> role playing<br />
(Haseltine, & Miltenberger, 1990; Mazzucchelli,<br />
2001); b) use of a specially designed<br />
card deck <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> table game Sorry to teach<br />
social/sexual behaviors including appropriate<br />
resp<strong>on</strong>se to strangers’ advancements (Foxx,<br />
McMorrow, Storey, & Rogers, 1984); <strong>and</strong> c)<br />
c<strong>on</strong>stant time delay with multiple teaching<br />
exemplars taught in vivo (Collins et al., 1992).<br />
Procedures used with children also included<br />
use of c<strong>on</strong>stant time delay with multiple exemplars<br />
of strangers, lures, <strong>and</strong> sites (Gast et<br />
al.) <strong>and</strong> use of guided questi<strong>on</strong>s, slide pictures<br />
of known/unknown pers<strong>on</strong>s, <strong>and</strong> role playing<br />
(Wats<strong>on</strong> et al.). Both studies taught children<br />
to say, “No”, “walk” away, <strong>and</strong> “tell” a familiar<br />
adult.<br />
Although results of <str<strong>on</strong>g>the</str<strong>on</strong>g> studies are encouraging,<br />
mixed results for generalizati<strong>on</strong> of behaviors<br />
to untaught settings is c<strong>on</strong>cerning.<br />
Self-protective behaviors against potentially<br />
harmful behaviors of o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs should be safely<br />
used across a range of settings that may be<br />
experienced by both adults <strong>and</strong> young children<br />
with disabilities.<br />
Fire Safety<br />
Development of safety skills in resp<strong>on</strong>se to<br />
potential fires received research attenti<strong>on</strong> during<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> 1980s. Although such fire emergencies<br />
are rare, <str<strong>on</strong>g>the</str<strong>on</strong>g> devastating effects when <str<strong>on</strong>g>the</str<strong>on</strong>g>y do<br />
occur present <str<strong>on</strong>g>the</str<strong>on</strong>g> need for teaching both preventi<strong>on</strong><br />
<strong>and</strong> reacti<strong>on</strong> to <str<strong>on</strong>g>the</str<strong>on</strong>g>se emergency situati<strong>on</strong>s.<br />
Due to <str<strong>on</strong>g>the</str<strong>on</strong>g>ir cognitive delays, some<br />
pers<strong>on</strong>s with intellectual disabilities may experience<br />
increased risk of being victims of home<br />
fires (J<strong>on</strong>es & Thornt<strong>on</strong>, 1987). Measures for<br />
preventing fires were addressed under <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
previously reviewed studies of “home accident<br />
preventi<strong>on</strong>”. Studies reporting fires are reviewed<br />
under “emergency teleph<strong>on</strong>e skills”. In<br />
this secti<strong>on</strong>, recogniti<strong>on</strong> of fires <strong>and</strong> teaching<br />
emergency evacuati<strong>on</strong> skills are presented.<br />
These skills have all been taught in simulated<br />
envir<strong>on</strong>ments including: classrooms (J<strong>on</strong>es,<br />
Kazdin, & Haney, 1981; Mats<strong>on</strong>, 1980b); dormitory<br />
rooms (J<strong>on</strong>es, Van Hasselt, & Siss<strong>on</strong>,<br />
1984; J<strong>on</strong>es, Siss<strong>on</strong>, & Hasselt, 1984), family<br />
homes (Haney & J<strong>on</strong>es, 1982); <strong>and</strong> participants’<br />
apartments (J<strong>on</strong>es & Thornt<strong>on</strong>, 1987).<br />
In each study reviewed, instructors primarily<br />
used discussi<strong>on</strong>, modeling, <strong>and</strong> behavioral rehearsal<br />
to teach a series of steps in a task<br />
analysis for: crawling, checking doorknobs for<br />
heat, opening windows, <strong>and</strong> exiting buildings.<br />
Simulati<strong>on</strong>s varied, but included: tape recording<br />
of house fire alarms, heating pads to heat<br />
doorknobs, blow dryers to blow hot air into a<br />
room, <strong>and</strong> pictures of fire <strong>and</strong> smoke (Haney<br />
& J<strong>on</strong>es; J<strong>on</strong>es & Thornt<strong>on</strong>).<br />
Although it is understood that generalizati<strong>on</strong><br />
to real home fires will hopefully be n<strong>on</strong>existent,<br />
n<strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g> reviewed studies taught<br />
fire safety or measured generalizati<strong>on</strong> using<br />
small, yet c<strong>on</strong>tained, fires. Additi<strong>on</strong>ally, no<br />
studies evaluated extinguishing comm<strong>on</strong><br />
kitchen fires or use of a fire extinguisher.<br />
Emergency Teleph<strong>on</strong>e Skills<br />
318 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
In additi<strong>on</strong> to learning to use a teleph<strong>on</strong>e<br />
(Horner, Williams, & Steveley, 1987; Smith &<br />
Meyers, 1979; Test, Spo<strong>on</strong>er, Keul, & Grossi,<br />
1990), making emergency teleph<strong>on</strong>e calls to<br />
obtain assistance is c<strong>on</strong>sidered an important
skill for integrating pers<strong>on</strong>s with disabilities<br />
into community settings (Risley & Cuvo,<br />
1980). Students have been taught to use home<br />
teleph<strong>on</strong>es to dial 911 <strong>and</strong> give relevant informati<strong>on</strong><br />
(Risley & Cuvo; Spo<strong>on</strong>er et al., 1989);<br />
dial <str<strong>on</strong>g>the</str<strong>on</strong>g> operator <strong>and</strong> report a fire (Smith &<br />
Meyers, 1979); use public pay ph<strong>on</strong>es to call<br />
home when lost in <str<strong>on</strong>g>the</str<strong>on</strong>g> community (Collins et<br />
al., 1993), <strong>and</strong> to use a cell ph<strong>on</strong>e to call for<br />
assistance when lost (Taber et al., 2002).<br />
Skills have been taught in simulati<strong>on</strong> using<br />
pictorial scenarios (room <strong>on</strong> fire) (Risley &<br />
Cuvo, 1980); mock cardboard boxes as ph<strong>on</strong>e<br />
booths (Collins et al., 1993); <strong>and</strong> disc<strong>on</strong>nected<br />
teleph<strong>on</strong>es (Smith & Meyers, 1979;<br />
Spo<strong>on</strong>er et al., 1989). Additi<strong>on</strong>al aids have<br />
been used in <str<strong>on</strong>g>the</str<strong>on</strong>g> form of a modified ph<strong>on</strong>e<br />
directory with picture cues (Risley & Cuvo)<br />
<strong>and</strong> index cards with printed ph<strong>on</strong>e numbers<br />
(Smith & Meyers; Taber et al. 2002).<br />
N<strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g> current studies evaluated use of<br />
pre-programmed or picture ph<strong>on</strong>es nor was<br />
valuable informati<strong>on</strong> obtained through follow-up<br />
sessi<strong>on</strong>s to determine if students could<br />
use <str<strong>on</strong>g>the</str<strong>on</strong>g> skills during an actually emergency<br />
situati<strong>on</strong> to give informati<strong>on</strong> to obtain help.<br />
Discussi<strong>on</strong> <strong>and</strong> Recommendati<strong>on</strong>s for Future<br />
Research <strong>and</strong> Practice<br />
All 36 identified studies reported some degree<br />
of success in teaching pers<strong>on</strong>al safety skills to<br />
pers<strong>on</strong>s with mild to severe disabilities. A<br />
number of instructi<strong>on</strong>al strategies (most relying<br />
<strong>on</strong> simulati<strong>on</strong>) were identified. Although<br />
results of <str<strong>on</strong>g>the</str<strong>on</strong>g> studies are positive, a number of<br />
issues remain that need to be addressed in<br />
future research <strong>and</strong> practice. These issues primarily<br />
address: procedures for teaching pers<strong>on</strong>al<br />
safety skills; measures of generalizati<strong>on</strong><br />
to novel situati<strong>on</strong>s; <strong>and</strong> maintenance of critical<br />
skills over time. Examinati<strong>on</strong> of each of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se issues is provided below.<br />
Instructi<strong>on</strong>al Procedures<br />
In order to be functi<strong>on</strong>al, safety skills must be<br />
performed c<strong>on</strong>sistently at high criteria levels<br />
or result in pers<strong>on</strong>al injury or even death (Collins,<br />
1992). Two re-occurring issues found in<br />
this review of <str<strong>on</strong>g>the</str<strong>on</strong>g> literature were where <strong>and</strong> how<br />
to safely teach <str<strong>on</strong>g>the</str<strong>on</strong>g>se skills while providing examples<br />
which closely resemble actual situa-<br />
ti<strong>on</strong>s in which <str<strong>on</strong>g>the</str<strong>on</strong>g>y will be needed. Results of<br />
this review were c<strong>on</strong>sistent with those of<br />
Miltenberger <strong>and</strong> Olsen (1996) <strong>and</strong> Bevill <strong>and</strong><br />
Gast (1998) which found behavioral skills<br />
training (BST) using verbal <strong>and</strong> visual instructi<strong>on</strong>,<br />
modeling, rehearsal, praise, <strong>and</strong> feedback<br />
to be effective in teaching safety related<br />
skills. The key comp<strong>on</strong>ent appears to be inclusi<strong>on</strong><br />
of behavioral performance of skills.<br />
Mats<strong>on</strong> (1980b) found that discussi<strong>on</strong> al<strong>on</strong>e<br />
was not effective in teaching fire safety skills<br />
<strong>and</strong> that student performance showed minimal<br />
improvement until role playing was<br />
added. Although completed with children<br />
without disabilities, Peters<strong>on</strong> (1984) found<br />
similar results: reading manuals <strong>and</strong> discussing<br />
correct behaviors were not effective until<br />
explicit behavioral training was included in<br />
teaching home safety skills such as answering<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> door, treating a cut, reacti<strong>on</strong> to a fire, <strong>and</strong><br />
safely preparing a snack. Care should <str<strong>on</strong>g>the</str<strong>on</strong>g>refore<br />
be taken to follow recommended practices<br />
that students with disabilities actually perform<br />
or physically practice <str<strong>on</strong>g>the</str<strong>on</strong>g> skills <str<strong>on</strong>g>the</str<strong>on</strong>g>y will<br />
be required to use. Instructors should also<br />
take care to match strategies to <str<strong>on</strong>g>the</str<strong>on</strong>g> intellectual<br />
abilities of students. A limitati<strong>on</strong> with role<br />
playing is <str<strong>on</strong>g>the</str<strong>on</strong>g> ability to c<strong>on</strong>ceptualize what is<br />
“pretended”. Mats<strong>on</strong> (1980b) found that<br />
when pers<strong>on</strong>s with moderate disabilities were<br />
asked to “role play” fire escape scenarios a<br />
typical resp<strong>on</strong>se was, “<str<strong>on</strong>g>the</str<strong>on</strong>g>re is no fire”.<br />
Simulati<strong>on</strong>s. There seems to be no argument<br />
that c<strong>on</strong>ducting instructi<strong>on</strong> in natural<br />
envir<strong>on</strong>ments where pers<strong>on</strong>s will be residing<br />
<strong>and</strong> using safety skills, needs to be included<br />
whenever feasible when teaching safety skills.<br />
Limited funds <strong>and</strong> scheduling issues are<br />
am<strong>on</strong>g <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>straints that may prohibit programs<br />
from c<strong>on</strong>ducting <str<strong>on</strong>g>the</str<strong>on</strong>g> majority of instructi<strong>on</strong>al<br />
sessi<strong>on</strong>s within community-based<br />
settings. Limited teaching trials are also a c<strong>on</strong>cern<br />
when teaching in natural envir<strong>on</strong>ments.<br />
Teaching skills such as riding a bus or ordering<br />
at a fast food restaurant prohibit much<br />
needed repetiti<strong>on</strong> when instructi<strong>on</strong> is limited<br />
to <strong>on</strong>e teaching trial (unless more than <strong>on</strong>e<br />
trip is made a day, more than <strong>on</strong>e meal is<br />
ordered, or <str<strong>on</strong>g>the</str<strong>on</strong>g> pers<strong>on</strong> orders for some<strong>on</strong>e<br />
else). Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r, issues arise when teaching<br />
safety skills such as first aid when an injury<br />
rarely happens in real life. It is not feasible to<br />
wait for a natural event or injury to occur<br />
Safety Skill Instructi<strong>on</strong> / 319
efore beginning instructi<strong>on</strong> (Christensen et<br />
al., 1996). Simulated instructi<strong>on</strong> is <strong>on</strong>e alternative<br />
for providing teaching examples when<br />
care is taken to provide multiple examples<br />
which replicate functi<strong>on</strong>al c<strong>on</strong>texts in which<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y will be used (Horner, McD<strong>on</strong>ell, & Bellamy,<br />
1986).<br />
Simulati<strong>on</strong>s increase opportunities for<br />
training trials <strong>and</strong> increase <str<strong>on</strong>g>the</str<strong>on</strong>g> number of<br />
trials that can be presented during <strong>on</strong>e sessi<strong>on</strong>.<br />
The difficulty identified in <str<strong>on</strong>g>the</str<strong>on</strong>g> reviewed<br />
studies is providing realistic teaching examples<br />
that will promote generalizati<strong>on</strong> to real<br />
life situati<strong>on</strong>s. While <str<strong>on</strong>g>the</str<strong>on</strong>g> majority of <str<strong>on</strong>g>the</str<strong>on</strong>g> reviewed<br />
studies support use of simulati<strong>on</strong>s,<br />
some studies reported limited results when<br />
attempting to simulate real life scenarios. For<br />
example, Mats<strong>on</strong> (1980a) provided classroom<br />
instructi<strong>on</strong> using a scale model of intersecti<strong>on</strong>s<br />
with small dolls representing “pedestrians”<br />
that were moved by students. Results indicate<br />
that inclusi<strong>on</strong> of simulated street<br />
crossing <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> hospital grounds were more<br />
effective than <str<strong>on</strong>g>the</str<strong>on</strong>g> scaled model when generalizati<strong>on</strong><br />
was measured in community settings.<br />
Marchetti et al. (1983) likewise found community<br />
training more effective than a scale model<br />
when teaching pedestrian skills. Collins et al.<br />
(1993) found little effects of simulated classroom<br />
instructi<strong>on</strong> presented prior to in vivo<br />
instructi<strong>on</strong> when compared to in vivo instructi<strong>on</strong><br />
al<strong>on</strong>e. Gast et al. (1993) reported that<br />
students failed to generalize safe resp<strong>on</strong>ses to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> lures of strangers until taught in vivo.<br />
An important c<strong>on</strong>siderati<strong>on</strong> when designing<br />
instructi<strong>on</strong>al programs may be <str<strong>on</strong>g>the</str<strong>on</strong>g> features<br />
of stimuli <strong>and</strong> how readily <str<strong>on</strong>g>the</str<strong>on</strong>g>y can be<br />
simulated. Instructors may find representati<strong>on</strong><br />
of realistic injuries, using artificial blisters<br />
or au<str<strong>on</strong>g>the</str<strong>on</strong>g>ntic blood, (March<strong>and</strong>-Martell &<br />
Martella, 1990) to be more realistic than attempts<br />
to create a dangerous household fire<br />
or a busy intersecti<strong>on</strong>. Ethical issues must also<br />
be c<strong>on</strong>sidered when c<strong>on</strong>ducting safety research.<br />
Fear tactics or threatening pers<strong>on</strong>al<br />
harm are unacceptable <strong>and</strong> will not pass a<br />
review board when planning for students to<br />
resp<strong>on</strong>d to situati<strong>on</strong>s such as child abducti<strong>on</strong>.<br />
Setting actual fires or crossing busy intersecti<strong>on</strong>s<br />
may pose danger bey<strong>on</strong>d <str<strong>on</strong>g>the</str<strong>on</strong>g> scope of<br />
ethical research, yet how do teachers teach <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
natural c<strong>on</strong>sequences of potentially dangerous<br />
scenarios (Collins, 1992)? Collins suggests<br />
320 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
reading of newspaper articles or watching televisi<strong>on</strong><br />
to witness aversive c<strong>on</strong>sequences. Video<br />
technology is ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r possible means for providing<br />
realistic examples of difficult to represent<br />
stimuli. Video technology includes video<br />
modeling—watching o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs perform a skill<br />
<strong>and</strong> completing <str<strong>on</strong>g>the</str<strong>on</strong>g> skill later <strong>and</strong> video<br />
prompting—watching a video segment <strong>and</strong><br />
immediately performing a physical resp<strong>on</strong>se<br />
before advancing to <str<strong>on</strong>g>the</str<strong>on</strong>g> next segment. A number<br />
of skills have been taught to students with<br />
disabilities using video instructi<strong>on</strong> (Mechling,<br />
2005), <strong>and</strong> video technology has been used to<br />
teach students without disabilities to resp<strong>on</strong>d<br />
safely to potential abductors (Caroll-Rowan &<br />
Miltenberger, 1994; Poche, Yoder, & Miltenberger,<br />
1988), yet, Branham et al. (1999) was<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> <strong>on</strong>ly identified study which included videotapes<br />
to teach safety skills to students with<br />
disabilities. Video technology appears to address<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> need for: repeated practice; sufficient<br />
teaching trials; over learning of skills;<br />
<strong>and</strong> presenting dangerous or emergency scenarios<br />
that occur infrequently (Cless & Gast,<br />
1994; Mazzucchelli, 2001). Collins, Wolery,<br />
<strong>and</strong> Gast (1992) fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r identify individualizati<strong>on</strong><br />
as an important comp<strong>on</strong>ent when teaching<br />
safety skills to students with disabilities.<br />
Video instructi<strong>on</strong> can provide examples to<br />
meet <str<strong>on</strong>g>the</str<strong>on</strong>g> specific safety skill needs of each<br />
student (i.e. video tape of <str<strong>on</strong>g>the</str<strong>on</strong>g> student’s<br />
kitchen at home). Use of video technology<br />
shows promise in providing real-life examples<br />
of dangerous or difficult to simulate examples,<br />
yet remains a relatively unexplored area<br />
when teaching safety skills to pers<strong>on</strong>s with<br />
disabilities.<br />
Measures of Generalizati<strong>on</strong> <strong>and</strong> Maintenance<br />
In general, while studies evaluating safety<br />
skills do not support <str<strong>on</strong>g>the</str<strong>on</strong>g> use of simulati<strong>on</strong><br />
over community-based instructi<strong>on</strong>, difficulties<br />
of providing instructi<strong>on</strong> solely in community<br />
settings is recognized. In order to be functi<strong>on</strong>al,<br />
safety skills must be generalized across<br />
settings <strong>and</strong> situati<strong>on</strong>s where <str<strong>on</strong>g>the</str<strong>on</strong>g>y will be required,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>refore programs need to at least<br />
evaluate generalizati<strong>on</strong> in natural settings<br />
even if <str<strong>on</strong>g>the</str<strong>on</strong>g> majority of instructi<strong>on</strong> has occurred<br />
in simulati<strong>on</strong> (Bevil & Gast, 1998; Gast<br />
et al., 1993; Hasselt<strong>on</strong> & Miltenberger, 1990).<br />
Evaluati<strong>on</strong> of actual emergency situati<strong>on</strong>s (i.e.
treatment of a burn) may take several m<strong>on</strong>ths<br />
to occur, but appears necessary when measuring<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of procedures to teach<br />
preventative or reacti<strong>on</strong>ary skills to real life<br />
events. Following procedures of March<strong>and</strong>-Martella<br />
<strong>and</strong> Martella (1990) researchers<br />
<strong>and</strong> practiti<strong>on</strong>ers may need to rely <strong>on</strong> follow-up<br />
reports from parents of participants to<br />
assess performance when real injuries occur.<br />
Given <str<strong>on</strong>g>the</str<strong>on</strong>g> critical nature of <str<strong>on</strong>g>the</str<strong>on</strong>g> skills being<br />
taught <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> ability to use <str<strong>on</strong>g>the</str<strong>on</strong>g>m over an<br />
extended period of time, <str<strong>on</strong>g>the</str<strong>on</strong>g> importance of<br />
maintenance measures is apparent. A difficulty<br />
addressed in <str<strong>on</strong>g>the</str<strong>on</strong>g> literature is how to<br />
maintain skills that are seldom needed or<br />
practiced. Collins (1992) suggests that this issue<br />
is similar to renewing a first aid certificate<br />
or c<strong>on</strong>ducting fire drills <strong>and</strong> that retraining or<br />
follow-up is needed. Spo<strong>on</strong>er et al. (1989)<br />
recommend retraining at periodic intervals<br />
similar to refresher CPR courses for pers<strong>on</strong>s<br />
without disabilities. Winterling et al. (1992)<br />
fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r recommend that pers<strong>on</strong>s in <str<strong>on</strong>g>the</str<strong>on</strong>g> student’s<br />
natural envir<strong>on</strong>ment should be made<br />
aware of his/her competencies in performing<br />
safety skills so that <str<strong>on</strong>g>the</str<strong>on</strong>g>y can reinforce use <strong>and</strong><br />
provide additi<strong>on</strong>al training.<br />
Summary<br />
Results show that pers<strong>on</strong>s with disabilities<br />
have <str<strong>on</strong>g>the</str<strong>on</strong>g> ability to learn to react to <strong>and</strong> prevent<br />
potential emergencies when presented<br />
with systematic, behavioral approaches to instructi<strong>on</strong>.<br />
A number of preferred instructi<strong>on</strong>al<br />
strategies were identified in additi<strong>on</strong> to future<br />
challenges to researchers <strong>and</strong> practiti<strong>on</strong>ers.<br />
Increased independence <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> freedom to<br />
make decisi<strong>on</strong>s about <strong>on</strong>e’s own life come<br />
with additi<strong>on</strong>al risks. It is important that pers<strong>on</strong>s<br />
with disabilities learn to recognize, prevent,<br />
<strong>and</strong> react to potential emergencies <strong>and</strong><br />
unsafe situati<strong>on</strong>s in order to promote human<br />
dignity through <str<strong>on</strong>g>the</str<strong>on</strong>g> right to experience risk.<br />
It is of interest to note that of <str<strong>on</strong>g>the</str<strong>on</strong>g> 36 studies<br />
identified, <strong>on</strong>ly two were c<strong>on</strong>ducted after <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
year 2000. The thrust in <str<strong>on</strong>g>the</str<strong>on</strong>g> area of safety skill<br />
research appears to have occurred in <str<strong>on</strong>g>the</str<strong>on</strong>g> 80’s<br />
(38.9% of identified studies) <strong>and</strong> 90’s (47.2%<br />
of identified studies). Perhaps, due to technology<br />
advancements <strong>and</strong> increased availability<br />
of assisitive technology in recent years, special<br />
educati<strong>on</strong> <strong>and</strong> related fields should revisit this<br />
line of research as it relates to new <strong>and</strong> innovative<br />
technologies. Evaluati<strong>on</strong> of technologies<br />
for: tracking <strong>and</strong> locating pers<strong>on</strong>s <strong>and</strong><br />
destinati<strong>on</strong>s; wireless communicati<strong>on</strong>; alerting<br />
devices; <strong>and</strong> virtual envir<strong>on</strong>ments for simulati<strong>on</strong>,<br />
offer new opportunities to teach <strong>and</strong><br />
provide safety informati<strong>on</strong> to pers<strong>on</strong>s with disabilities.<br />
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Received: 4 January 2007<br />
Initial Acceptance: 1 March 2007<br />
Final Acceptance: 6 June 2007<br />
Safety Skill Instructi<strong>on</strong> / 323
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities, 2008, 43(3), 324–333<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities<br />
Enhancing Social <strong>and</strong> Transiti<strong>on</strong> Behaviors of Pers<strong>on</strong>s with<br />
<strong>Autism</strong> through Activity Schedules: A Review<br />
Devender R. B<strong>and</strong>a <strong>and</strong> Eric Grimmett<br />
Texas Tech University<br />
Abstract: Thirteen studies were reviewed that were c<strong>on</strong>ducted using activity schedules with pers<strong>on</strong>s with autism<br />
to improve social interacti<strong>on</strong> skills <strong>and</strong> decrease problem behaviors. Results across studies indicate that activity<br />
schedules enhanced social interacti<strong>on</strong>s <strong>and</strong> <strong>on</strong>-task <strong>and</strong> transiti<strong>on</strong> behaviors. Also, investigators in some studies<br />
used activity schedules to decrease students’ tantrums <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r problem behaviors during transiti<strong>on</strong>s.<br />
Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>rmore, researchers in several studies that reported generalizati<strong>on</strong> indicated that behaviors learned through<br />
activity schedules generalized across settings <strong>and</strong> pers<strong>on</strong>s. Implicati<strong>on</strong>s for practiti<strong>on</strong>ers <strong>and</strong> for future<br />
researchers are discussed.<br />
Individuals with autism often have difficulty<br />
with social interacti<strong>on</strong>s <strong>and</strong> communicati<strong>on</strong>.<br />
In additi<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g>se pers<strong>on</strong>s may display deficits<br />
in life skills <strong>and</strong>/or exhibit problem behaviors<br />
including stereotypic behaviors, self-injurious<br />
behaviors, hyper- or hyposensitivity to sound,<br />
taste, smell, etc. (Scheuermann & Webber,<br />
2002; Scott, Clark, & Brady, 2000). A majority<br />
of pers<strong>on</strong>s with autism have difficulties with<br />
social skills, particularly making eye c<strong>on</strong>tact,<br />
recognizing social cues, <strong>and</strong> participating in<br />
turn taking activities (Jamies<strong>on</strong>, 2004). Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>rmore,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y may display unusual characteristics<br />
such as resistance to change, ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
within <str<strong>on</strong>g>the</str<strong>on</strong>g>ir envir<strong>on</strong>ment or within <str<strong>on</strong>g>the</str<strong>on</strong>g>ir daily<br />
activities (e.g., American Psychiatric Associati<strong>on</strong>,<br />
2000; Schreibman, Whalen, & Stahmer,<br />
2000). Issues with routine changes <strong>and</strong> transiti<strong>on</strong>s<br />
can particularly be problematic resulting<br />
in atypical behaviors such as heightened verbal<br />
<strong>and</strong> physical aggressi<strong>on</strong>, tantrums, n<strong>on</strong>compliance,<br />
self-injury, etc. (Schreibman et<br />
al.). Difficulty with transiti<strong>on</strong>s between <strong>and</strong><br />
within activities can limit <str<strong>on</strong>g>the</str<strong>on</strong>g> pers<strong>on</strong>’s ability<br />
to navigate different envir<strong>on</strong>ments without<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> adult supervisi<strong>on</strong> <strong>and</strong> guidance (e.g., For-<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cerning this article should<br />
be addressed to Devender B<strong>and</strong>a, Department of<br />
Educati<strong>on</strong>al Psychology <strong>and</strong> Leadership, College of<br />
Educati<strong>on</strong>, PO Box 41701, Texas Tech University,<br />
Lubbock, TX 79416. Email: devender.b<strong>and</strong>a@<br />
ttu.edu<br />
324 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
est, Horner, Lewis-Palmer, & Todd, 2004;<br />
Scheuermann & Webber; Schreibman et al.).<br />
Because of this, individuals with autism often<br />
develop dependence <strong>on</strong> adult caregivers to<br />
provide support to learn new skills, <strong>and</strong> to stay<br />
<strong>on</strong>-task <strong>and</strong> <strong>on</strong>-schedule throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> activities<br />
at school, home, <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r community<br />
settings (Heflin & Alaimo, 2007; Scheuermann<br />
& Webber). Thus, <str<strong>on</strong>g>the</str<strong>on</strong>g> challenge for<br />
parents <strong>and</strong> teachers is to decrease <str<strong>on</strong>g>the</str<strong>on</strong>g> dependence<br />
<strong>on</strong> adults <strong>and</strong> to increase <str<strong>on</strong>g>the</str<strong>on</strong>g> pers<strong>on</strong>’s<br />
independence in daily living, communicati<strong>on</strong>,<br />
socializati<strong>on</strong>, <strong>and</strong> vocati<strong>on</strong>al skills.<br />
Researchers have used visual supports (e.g.,<br />
pictures, videos, activity schedules) to improve<br />
various behaviors of pers<strong>on</strong>s with mental retardati<strong>on</strong><br />
including transiti<strong>on</strong>s during vocati<strong>on</strong>al<br />
activities <strong>and</strong> teaching daily living skills<br />
(e.g., Anders<strong>on</strong>, Sherman, Sheld<strong>on</strong>, & Mc-<br />
Adam, 1997; Morgan & Salzberg, 1992;<br />
Wacker, Berg, Berrie, & Swatta, 1985). Investigators<br />
in recent years have also identified<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se visual supports, particularly <str<strong>on</strong>g>the</str<strong>on</strong>g> activity<br />
schedules as a promising educati<strong>on</strong>al strategy<br />
for pers<strong>on</strong>s with autism (e.g., Scheuermann &<br />
Webber, 2002; We<str<strong>on</strong>g>the</str<strong>on</strong>g>rby & Prizant, 2000). In<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> early nineties, investigators in three studies<br />
(Krantz & McClannahan, 1993; Krantz,<br />
MacDuff, & McClannahan 1993; <strong>and</strong> Mac-<br />
Duff, Krantz, & McClannahan, 1993) c<strong>on</strong>ducted<br />
initial investigati<strong>on</strong>s using activity<br />
schedules <strong>and</strong> found that <str<strong>on</strong>g>the</str<strong>on</strong>g>se strategies have<br />
increased social initiati<strong>on</strong>s, increased <strong>on</strong>-task
<strong>and</strong> <strong>on</strong>-schedule behavior <strong>and</strong> decreased disruptive<br />
behaviors in children with autism.<br />
These initial studies <strong>and</strong> numerous o<str<strong>on</strong>g>the</str<strong>on</strong>g>r investigati<strong>on</strong>s<br />
that followed <str<strong>on</strong>g>the</str<strong>on</strong>g>m have used activity<br />
schedules to teach various daily living,<br />
social, <strong>and</strong> transiti<strong>on</strong> behaviors to pers<strong>on</strong>s<br />
with autism.<br />
An activity schedule is a string of photographs,<br />
images or drawings of daily routines<br />
that are sequentially arranged <strong>on</strong> a display<br />
(e.g., wall, computer, folder, desk) for <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
targeted student to follow. These visual supports<br />
can be a single picture used as a prompting<br />
device, or multiple picture symbols formatted<br />
in a sequence. The activity schedule<br />
can be used between routines, such as moving<br />
from a classroom to a physical educati<strong>on</strong> setting,<br />
or within <str<strong>on</strong>g>the</str<strong>on</strong>g> student’s daily routines,<br />
such as moving from shaving to brushing<br />
teeth during a hygiene activity. Activity schedules<br />
not <strong>on</strong>ly improved transiti<strong>on</strong> or daily living<br />
skills but have also shown promise in enhancing<br />
social behaviors, social initiati<strong>on</strong>, <strong>and</strong><br />
social interacti<strong>on</strong> in students with autism<br />
(Heflin & Alaimo, 2007; Scheuermann &<br />
Webber, 2002). Changes that are to occur<br />
within <str<strong>on</strong>g>the</str<strong>on</strong>g> anticipated daily activities can be<br />
reflected <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> activity schedule, allowing<br />
increased time for <str<strong>on</strong>g>the</str<strong>on</strong>g> child to enhance participati<strong>on</strong><br />
in existing routines or to transiti<strong>on</strong><br />
to a new activity (Jamies<strong>on</strong>, 2004). Activity<br />
schedules may be helpful for pers<strong>on</strong>s with<br />
autism due to several possible explanati<strong>on</strong>s.<br />
Individuals with autism may have difficulty<br />
processing auditory informati<strong>on</strong>, instead resp<strong>on</strong>ding<br />
to visual input as <str<strong>on</strong>g>the</str<strong>on</strong>g>ir primary<br />
source of informati<strong>on</strong> (Quill, 1995). Also, <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
often prefer objects over people, <strong>and</strong> when<br />
observing ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r pers<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>y tend to focus<br />
<strong>on</strong> physical features ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r than attending to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> pers<strong>on</strong> as a whole (Heflin & Alaimo,<br />
2007). Visual support systems may prompt students<br />
with autism to perform a specific acti<strong>on</strong>,<br />
anything from <str<strong>on</strong>g>the</str<strong>on</strong>g> next step in a sequenced<br />
activity to transiti<strong>on</strong>ing to <str<strong>on</strong>g>the</str<strong>on</strong>g> next class in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir schedule. In additi<strong>on</strong>, visual systems may<br />
provide predictability <strong>and</strong> c<strong>on</strong>crete steps that<br />
need to be completed within a daily schedule<br />
(e.g., classroom transiti<strong>on</strong>s) or within a single<br />
activity (e.g., brushing).<br />
Although numerous investigators have used<br />
activity schedules with pers<strong>on</strong>s with autism,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>re has been no comprehensive review of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se studies. Recently, however, Stromer,<br />
Kimball, Kinney, <strong>and</strong> Taylor (2006) examined<br />
several studies that used activity schedules for<br />
pers<strong>on</strong>s with autism. In <str<strong>on</strong>g>the</str<strong>on</strong>g>ir article, Stromer<br />
et al. briefly referred to activity schedule studies<br />
<strong>and</strong> presented a case study that addressed<br />
computer technology as a way to build <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
existing techniques of activity schedules. It is<br />
crucial for practiti<strong>on</strong>ers <strong>and</strong> researchers to<br />
know <str<strong>on</strong>g>the</str<strong>on</strong>g> current status of activity schedules in<br />
terms of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir effectiveness <strong>and</strong> directi<strong>on</strong>s for<br />
practice <strong>and</strong> future research. Thus, <str<strong>on</strong>g>the</str<strong>on</strong>g> current<br />
review seeks to comprehensively analyze<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> studies that utilized activity schedules with<br />
individuals with autism. Specifically, <str<strong>on</strong>g>the</str<strong>on</strong>g> following<br />
research questi<strong>on</strong>s were answered in<br />
this study: a) Are activity schedules effective<br />
with pers<strong>on</strong>s with autism to enhance appropriate<br />
behaviors <strong>and</strong>/or to decrease inappropriate<br />
behaviors? b) Can <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of activity<br />
schedules be generalized to o<str<strong>on</strong>g>the</str<strong>on</strong>g>r activities,<br />
pers<strong>on</strong>s, or settings? <strong>and</strong>, c) Are activity schedules<br />
socially valid interventi<strong>on</strong>s?<br />
Method<br />
We c<strong>on</strong>ducted a computer search using ERIC<br />
<strong>and</strong> PsycInfo. The key words used to search<br />
databases included autism, Asperger, activity<br />
schedule, picture schedule, <strong>and</strong> photographic schedule.<br />
Study inclusi<strong>on</strong> was c<strong>on</strong>tingent up<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
following parameters: a) <str<strong>on</strong>g>the</str<strong>on</strong>g> study was c<strong>on</strong>ducted<br />
with individuals with autism, b) <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
study involved some form of activity or picture<br />
schedule as an interventi<strong>on</strong>, c) <str<strong>on</strong>g>the</str<strong>on</strong>g> study was<br />
data based, <strong>and</strong> d) <str<strong>on</strong>g>the</str<strong>on</strong>g> study was published in<br />
a peer-reviewed journal. Thirteen studies met<br />
selecti<strong>on</strong> criteria. One study had a mixed<br />
group that c<strong>on</strong>tained children who were not<br />
diagnosed with autism (Hall, McClannahan, &<br />
Krantz, 1995). In this case, <strong>on</strong>ly <str<strong>on</strong>g>the</str<strong>on</strong>g> participant<br />
with autism was included in this review.<br />
Ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r study was excluded from final analysis<br />
because <str<strong>on</strong>g>the</str<strong>on</strong>g> data was not presented in an<br />
interpretable graph form (Kimball, Kinney,<br />
Taylor, & Stromer, 2004). Finally, an ancestral<br />
search from selected studies did not reveal any<br />
fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r articles that met <str<strong>on</strong>g>the</str<strong>on</strong>g> study parameters.<br />
All research studies that met <str<strong>on</strong>g>the</str<strong>on</strong>g> inclusi<strong>on</strong><br />
criteria were reviewed <strong>and</strong> analyzed to answer<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> research questi<strong>on</strong>s posed in this study.<br />
Table 1 shows <str<strong>on</strong>g>the</str<strong>on</strong>g> summery of activity sched-<br />
Activity Schedules <strong>and</strong> <strong>Autism</strong> / 325
TABLE 1<br />
Summary of Activity Schedule Studies with Students with <strong>Autism</strong><br />
Author(s)<br />
Bryan & Gast<br />
(2000)<br />
Dauphin et al.<br />
(2004)<br />
Dettmer et al.<br />
(2000)<br />
Dooley et al.<br />
(2001)<br />
Halletal.<br />
(1995)<br />
Krantz et al.<br />
(1993)<br />
Krantz &<br />
McClannahan<br />
(1998)<br />
MacDuff et al.<br />
(1993)<br />
Massey &<br />
Wheeler<br />
(2000)<br />
Participants<br />
Age/Disability<br />
1. 8y, autism<br />
2. 8y, autism<br />
3. 7y, autism<br />
4. 8y, autism<br />
Target<br />
Behavior(s)<br />
For all<br />
participants:<br />
increase <strong>on</strong>-task<br />
<strong>and</strong> <strong>on</strong>schedule<br />
behavior<br />
1. 3y, autism increase<br />
sociodramatic<br />
play, <strong>on</strong>schedule<br />
behavior<br />
1. 7y, autism<br />
2. 5y, autism<br />
For all<br />
participants:<br />
decrease<br />
transiti<strong>on</strong><br />
time<br />
1. 3y, autism decrease<br />
tantrum<br />
behavior<br />
1. 7y, autism decrease<br />
transiti<strong>on</strong><br />
time<br />
1. 8y, autism<br />
2. 6y, autism<br />
3. 7y, autism<br />
1. 5y, autism<br />
2. 4y, autism<br />
3. 4y, autism<br />
1. 9y, autism<br />
2. 9y, autism<br />
3. 11y, autism<br />
4. 14y, autism<br />
For all<br />
participants:<br />
increase social<br />
initiati<strong>on</strong>,<br />
decrease<br />
disruptive<br />
behavior<br />
For all<br />
participants:<br />
increase<br />
participati<strong>on</strong><br />
in social<br />
exchanges<br />
For all<br />
participants:<br />
increase <strong>on</strong>-task<br />
<strong>and</strong> <strong>on</strong>schedule<br />
behavior<br />
1. 4y, autism increase <strong>on</strong>-task<br />
behavior,<br />
decrease<br />
problem<br />
transiti<strong>on</strong>s<br />
Type of<br />
Schedule(s)<br />
line drawings <strong>on</strong>e picture<br />
per page<br />
in photo<br />
album<br />
computer/<br />
video,<br />
photographic<br />
Mode of<br />
Presentati<strong>on</strong> Design(s) Results<br />
computer<br />
with<br />
embedded<br />
video<br />
clips,<br />
ABAB<br />
withdrawal<br />
design<br />
matrix<br />
training<br />
For all<br />
participants:<br />
increased<br />
independent<br />
<strong>on</strong>-task <strong>and</strong><br />
<strong>on</strong>-schedule<br />
behavior<br />
learned social<br />
scripts,<br />
increased<br />
<strong>on</strong>-schedule<br />
behavior<br />
line drawings<br />
notebook<br />
Velcro ABCB decreased<br />
strips, reversal latency<br />
photo design time,<br />
album,<br />
decreased<br />
note<br />
physical<br />
cards<br />
removals<br />
line drawings PECS-based A-BC-B decreased<br />
schedule<br />
problem<br />
board<br />
behavior<br />
photographs photo multiple increased<br />
album, 1 baseline indepen-<br />
photo<br />
dent<br />
per page<br />
transiti<strong>on</strong>s<br />
photographs three ring multiple For all<br />
binders baseline participants:<br />
with <strong>on</strong>e across increased<br />
photograph participants social<br />
per page<br />
engagement,<br />
decreased<br />
disrupti<strong>on</strong><br />
photographs notebook multiple For all<br />
paired with with <strong>on</strong>e baseline participants:<br />
textual cues photo across increased<br />
per page participants social<br />
engagement<br />
photographs three ring<br />
binder<br />
with <strong>on</strong>e<br />
photograph<br />
per page<br />
photographs photo<br />
placed<br />
<strong>on</strong> a<br />
folder<br />
326 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
multiple<br />
baseline<br />
across<br />
participants<br />
multiple<br />
baseline<br />
across<br />
activities<br />
For all<br />
participants:<br />
increased<br />
engagement,<br />
independent<br />
transiti<strong>on</strong>s<br />
increased task<br />
engagement,<br />
transiti<strong>on</strong>s<br />
easier
TABLE 1—(C<strong>on</strong>tinued)<br />
Author(s)<br />
Morris<strong>on</strong> et al.<br />
(2002)<br />
Pierce et al.<br />
(1994)<br />
Schmit et al.<br />
(2000)<br />
Watanabe et al.<br />
(2003)<br />
ule studies c<strong>on</strong>ducted with pers<strong>on</strong>s with autism.<br />
Results<br />
Participants<br />
Age/Disability<br />
1. 4y, autism<br />
2. 5y, autism<br />
3. 3y, autism<br />
4. 6y, autism<br />
1. 8y, autism<br />
2. 9y, autism<br />
3. 6y, autism<br />
Demographic Characteristics<br />
Target<br />
Behavior(s)<br />
For all<br />
participants:<br />
develop<br />
independent<br />
play skills<br />
For all<br />
participants:<br />
develop<br />
independent<br />
daily living<br />
skills<br />
1. 6y, autism decrease<br />
tantrums<br />
during<br />
transiti<strong>on</strong>s<br />
1. 22y, autism<br />
2. 40y, autism<br />
3. 30y, autism<br />
For all<br />
participants:<br />
increase<br />
independence<br />
during work<br />
routines<br />
Participants. A total of 28 children <strong>and</strong><br />
three adults participated in <str<strong>on</strong>g>the</str<strong>on</strong>g> 13 studies. All<br />
children were 14 or younger, <strong>and</strong> 25 were boys<br />
<strong>and</strong> three were girls. The three adult participants<br />
were all men from <str<strong>on</strong>g>the</str<strong>on</strong>g> age of 22 to 40.<br />
Ages of all participants ranged from three<br />
years to 40 years, with an average age of 8.8<br />
years. The average age for <str<strong>on</strong>g>the</str<strong>on</strong>g> children al<strong>on</strong>e<br />
was 6.53 years. The median age of all participants<br />
was seven years. All of <str<strong>on</strong>g>the</str<strong>on</strong>g> participants<br />
had been diagnosed with autism.<br />
Setting <strong>and</strong> trainers. The majority of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
studies (7 of 13) were c<strong>on</strong>ducted in a classroom<br />
setting by psychologists, teachers,<br />
<strong>and</strong>/or graduate assistants. Four of seven studies<br />
took place in <str<strong>on</strong>g>the</str<strong>on</strong>g> general educati<strong>on</strong> classroom<br />
while three o<str<strong>on</strong>g>the</str<strong>on</strong>g>r studies were c<strong>on</strong>ducted<br />
in self-c<strong>on</strong>tained classrooms. Four of<br />
Type of<br />
Schedule(s)<br />
photographs clipboard<br />
with<br />
Velcro,<br />
photos in<br />
envelope<br />
<strong>on</strong> back<br />
photographs photo book<br />
with <strong>on</strong>e<br />
photo<br />
per page<br />
photographs photo<br />
presented<br />
in fr<strong>on</strong>t<br />
text schedule<br />
sheet<br />
Mode of<br />
Presentati<strong>on</strong> Design(s) Results<br />
of face<br />
Schedule<br />
sheet<br />
with list<br />
of nine<br />
activities<br />
multiple<br />
baseline<br />
across<br />
participants<br />
multiple<br />
baseline<br />
probe<br />
design<br />
across<br />
behaviors<br />
multiple<br />
baseline<br />
across<br />
settings<br />
multiple<br />
baseline<br />
across<br />
participants<br />
For all<br />
participants:<br />
<strong>on</strong>-task <strong>and</strong><br />
<strong>on</strong>-schedule<br />
play<br />
behavior<br />
increased<br />
For all<br />
participants:<br />
increase in<br />
<strong>on</strong>-task daily<br />
living skills<br />
reduced<br />
tantrums,<br />
increased<br />
transiti<strong>on</strong>s<br />
For all<br />
participants:<br />
significant<br />
increase in<br />
time <strong>on</strong><br />
task<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> 13 studies were c<strong>on</strong>ducted in <str<strong>on</strong>g>the</str<strong>on</strong>g> home<br />
setting (Dauphin, Kinney, & Stromer, 2004;<br />
Dettmer, Simps<strong>on</strong>, Myles, & Ganz, 2000;<br />
Krantz et al., 1993; Pierce & Schreibman,<br />
1994). One of <str<strong>on</strong>g>the</str<strong>on</strong>g> three home-based studies<br />
also included a participant who engaged in<br />
community outings as part of <str<strong>on</strong>g>the</str<strong>on</strong>g> study (Dettmer<br />
et al.), <strong>and</strong> ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r study included two<br />
participants trained at home <strong>and</strong> <strong>on</strong>e in a<br />
clinical setting (Pierce & Schreibman). One of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> studies was c<strong>on</strong>ducted in a group home<br />
setting (MacDuff et al., 1993). The study with<br />
adult participants took place in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir adult<br />
services program building (Watanabe & Sturmey,<br />
2003).<br />
Target behaviors. Researchers in a majority<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> studies enhanced social behaviors in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> participants through <str<strong>on</strong>g>the</str<strong>on</strong>g> use of some form<br />
of activity schedule (i.e., photographic, line<br />
drawings, video models, computer, text). Researchers<br />
in three studies specifically targeted<br />
increasing social exchanges <strong>and</strong> initiati<strong>on</strong>s<br />
(Dauphin et al., 2004; Krantz & McClannahan,<br />
1998; Krantz et al., 1993). Researchers in<br />
two studies focused <strong>on</strong> decreasing tantrum<br />
Activity Schedules <strong>and</strong> <strong>Autism</strong> / 327
ehaviors such as hitting, kicking, biting, crying,<br />
<strong>and</strong> screaming in <str<strong>on</strong>g>the</str<strong>on</strong>g> participant (Dooley,<br />
Wilczenski, & Torem, 2001; Schmit, Alper, Raschke,<br />
& Ryndak, 2000). Also, researchers in<br />
four additi<strong>on</strong>al studies targeted problem behaviors<br />
during transiti<strong>on</strong>s while attempting to<br />
increase <strong>on</strong>-task <strong>and</strong> <strong>on</strong>-schedule behavior between<br />
activities (Bryan & Gast, 2000; Dettmer<br />
et al., 2000; MacDuff et al., 1993; Massey &<br />
Wheeler, 2000). Researchers in <strong>on</strong>e study utilized<br />
photographs to teach independent daily<br />
living skills to three young children with autism<br />
(Pierce & Schreibman, 1994), while ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
study focused <strong>on</strong> increasing independent play<br />
skills (Morris<strong>on</strong>, Sainato, Benchaaban, & Endo,<br />
2002). Similarly, <str<strong>on</strong>g>the</str<strong>on</strong>g> remaining two studies<br />
both focused <strong>on</strong> enhancing participati<strong>on</strong> <strong>and</strong><br />
independence within daily activities, <strong>on</strong>e<br />
within <str<strong>on</strong>g>the</str<strong>on</strong>g> work <strong>and</strong> writing routines of adults<br />
with autism (Watanabe & Sturmey, 2003),<br />
while <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r study targeted decreased time<br />
for a young boy with autism to transiti<strong>on</strong> from<br />
a group activity to working independently<br />
(Hall et al., 1995).<br />
Effectiveness of Activity Schedules<br />
The activity schedules utilized by <str<strong>on</strong>g>the</str<strong>on</strong>g> researchers<br />
were shown to be effective interventi<strong>on</strong>s<br />
with all 31 individuals with autism. The current<br />
review indicated that <str<strong>on</strong>g>the</str<strong>on</strong>g> activity schedules<br />
utilized by <str<strong>on</strong>g>the</str<strong>on</strong>g> researchers increased various<br />
behaviors in a number of skill areas.<br />
These behaviors included enhancing social interacti<strong>on</strong>s,<br />
transiti<strong>on</strong>s, <strong>and</strong> <strong>on</strong>-task behaviors,<br />
<strong>and</strong> decreasing disruptive behaviors.<br />
Researchers targeting social interacti<strong>on</strong>s focused<br />
<strong>on</strong> increasing social exchanges <strong>and</strong> social<br />
initiati<strong>on</strong> in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir study participants (Dauphin<br />
et al., 2004; Krantz et al., 1993; Krantz &<br />
McClannahan, 1998). For example, Dauphin<br />
et al. utilized a combinati<strong>on</strong> of matrix training<br />
<strong>and</strong> video clips <strong>on</strong> computer to effectively<br />
teach sociodramatic play to <str<strong>on</strong>g>the</str<strong>on</strong>g> single participant<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir study. Results indicated that <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
child learned new play activities following <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
introducti<strong>on</strong> of a computer generated activity<br />
schedule into his daily routines. The o<str<strong>on</strong>g>the</str<strong>on</strong>g>r two<br />
studies addressing social interacti<strong>on</strong> skills<br />
used photographs as <str<strong>on</strong>g>the</str<strong>on</strong>g> primary symbol system<br />
within <str<strong>on</strong>g>the</str<strong>on</strong>g> activity schedules. Krantz et al.<br />
utilized three-ring binders with <strong>on</strong>e photograph<br />
to a page to increase participati<strong>on</strong> in<br />
328 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
social exchanges in all three of <str<strong>on</strong>g>the</str<strong>on</strong>g> children<br />
with autism participating in <str<strong>on</strong>g>the</str<strong>on</strong>g> study. Results<br />
revealed that <str<strong>on</strong>g>the</str<strong>on</strong>g> introducti<strong>on</strong> of activity<br />
schedules not <strong>on</strong>ly increased social engagement<br />
<strong>and</strong> initiati<strong>on</strong> in <str<strong>on</strong>g>the</str<strong>on</strong>g> participants, but<br />
also decreased disruptive behaviors. These researchers<br />
used <str<strong>on</strong>g>the</str<strong>on</strong>g> same mode of presentati<strong>on</strong><br />
to increase social initiati<strong>on</strong> in three children<br />
with autism five years later (Krantz & McClannahan);<br />
employing a script-fading procedure,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> researchers were again showed an increase<br />
in social exchanges.<br />
Researchers in several studies focused <strong>on</strong><br />
interventi<strong>on</strong>s addressing transiti<strong>on</strong>s, particularly<br />
<strong>on</strong>-schedule <strong>and</strong> <strong>on</strong>-task behaviors <strong>and</strong><br />
decreasing tantrums (Bryan & Gast, 2000;<br />
Dettmer et al., 2000; Dooley et al., 2001;<br />
Schmitt et al., 2000; Massey & Wheeler, 2000).<br />
For instance, Bryan <strong>and</strong> Gast enhanced <strong>on</strong>task<br />
behaviors in four children with autism by<br />
utilizing a photo album with <strong>on</strong>e line drawing<br />
per page when transiti<strong>on</strong>ing between activities<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom. These researchers reported<br />
that all of <str<strong>on</strong>g>the</str<strong>on</strong>g> participants not <strong>on</strong>ly were able<br />
to learn to use an activity schedule quickly but<br />
also were able to use <str<strong>on</strong>g>the</str<strong>on</strong>g> activity schedule<br />
independently to stay <strong>on</strong>-task in <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom.<br />
In a similar study, Dettmer et al. also<br />
employed line drawings in both a photo album<br />
<strong>and</strong> <strong>on</strong> a sequence strip to ease transiti<strong>on</strong>s<br />
<strong>and</strong> to decrease transiti<strong>on</strong> time in two<br />
young children with autism, both at home <strong>and</strong><br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> community. Results indicated a decrease<br />
in transiti<strong>on</strong> time in both of <str<strong>on</strong>g>the</str<strong>on</strong>g> participants,<br />
<strong>and</strong> <strong>on</strong>e participant also began to initiate<br />
verbal communicati<strong>on</strong> by commenting<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> activities displayed <strong>on</strong> his schedule.<br />
One study (Dooley et al., 2001) used <str<strong>on</strong>g>the</str<strong>on</strong>g> Picture<br />
Exchange Communicati<strong>on</strong> System<br />
(PECS; B<strong>on</strong>dy & Frost, 1993) <strong>and</strong> a schedule<br />
board with a single participant to decrease<br />
tantrum behavior during transiti<strong>on</strong>s. Results<br />
indicated a decrease in tantrum behaviors<br />
al<strong>on</strong>g with a corresp<strong>on</strong>ding increase in compliance.<br />
In ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r study, Schmit et al. also<br />
targeted tantrum behaviors during transiti<strong>on</strong>s<br />
using photos with a child, with results showing<br />
a decrease in tantrum behavior in three separate<br />
transiti<strong>on</strong> settings. Massey <strong>and</strong> Wheeler<br />
used a simplified activity schedule with a single<br />
photograph placed <strong>on</strong> a folder to increase<br />
<strong>on</strong>-task behavior <strong>and</strong> decrease problems during<br />
transiti<strong>on</strong>s (e.g., n<strong>on</strong>compliance, tan-
trums, aggressi<strong>on</strong>) in a four-year-old child<br />
with autism.<br />
Self-determinati<strong>on</strong> for <str<strong>on</strong>g>the</str<strong>on</strong>g> participants was<br />
an important element in many of <str<strong>on</strong>g>the</str<strong>on</strong>g> studies,<br />
<strong>and</strong> researchers in four studies targeted independence<br />
as a central goal of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir research<br />
(Hall et al., 1995; MacDuff et al., 1993; Morris<strong>on</strong><br />
et al., 2002; Pierce et al., 1995; Watanabe<br />
& Sturmey, 2003). Hall et al. used a photo<br />
album with <strong>on</strong>e photo per page to increase<br />
participati<strong>on</strong> <strong>and</strong> independence in a 7-yearold<br />
boy with autism during transiti<strong>on</strong>s from<br />
group work to independent writing; <str<strong>on</strong>g>the</str<strong>on</strong>g> participant’s<br />
dependence <strong>on</strong> adult prompts also<br />
decreased during <str<strong>on</strong>g>the</str<strong>on</strong>g> study. MacDuff et al.<br />
also utilized <strong>on</strong>e photograph per page in a<br />
three-ring binder to both decrease dependence<br />
<strong>on</strong> prompting <strong>and</strong> to decrease disruptive<br />
behaviors in a number of recreati<strong>on</strong>al <strong>and</strong><br />
daily living tasks for four children with autism<br />
living in a group home. In this study, stimulus<br />
c<strong>on</strong>trol was transferred from adult verbal<br />
prompts to <str<strong>on</strong>g>the</str<strong>on</strong>g> photographs incorporated in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> activity schedule. In ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r study, Morris<strong>on</strong><br />
et al. used photographs <strong>and</strong> a clipboard to<br />
successfully develop independent play skills in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> four children participating in <str<strong>on</strong>g>the</str<strong>on</strong>g> study. A<br />
similar study by Pierce et al. used a photo<br />
album with a photo to a page to teach morning<br />
daily living skills (e.g., getting dressed,<br />
setting <str<strong>on</strong>g>the</str<strong>on</strong>g> table, making lunch) to three adolescents<br />
with autism. The single study with<br />
adult participants with high functi<strong>on</strong>ing autism<br />
also focused <strong>on</strong> increasing independence<br />
using a text based schedule sheet during daily<br />
vocati<strong>on</strong>al training activities (Watanabe &<br />
Sturmey). Results showed increased <strong>on</strong>-task<br />
participati<strong>on</strong> in hygiene checks, job searches,<br />
<strong>and</strong> letter writing in all three participants.<br />
Comp<strong>on</strong>ents of Activity Schedules<br />
Activity schedules have several shared comp<strong>on</strong>ents:<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> use of visuals, modes of presentati<strong>on</strong>,<br />
<strong>and</strong> training strategies. Visual supports<br />
including photographs were by far <str<strong>on</strong>g>the</str<strong>on</strong>g> most<br />
comm<strong>on</strong> element, <strong>and</strong> nine of <str<strong>on</strong>g>the</str<strong>on</strong>g> 13 studies<br />
utilized photographs in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir activity schedule<br />
interventi<strong>on</strong>s. These nine studies included 20<br />
participants. This use of photography proved<br />
to be an effective strategy, with nine of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
participants in <str<strong>on</strong>g>the</str<strong>on</strong>g>se studies showing a marked<br />
improvement in <str<strong>on</strong>g>the</str<strong>on</strong>g> targeted behavior. The<br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>r 11 participants using photographic activity<br />
schedules also showed a moderate improvement.<br />
The remaining four studies used<br />
alternate forms of visual supports (Bryan &<br />
Gast, 2000; Dettmer et al., 2000; Dooley et al.,<br />
2001; Watanabe & Sturmey, 2003). While <strong>on</strong>ly<br />
two studies utilized line drawings as <str<strong>on</strong>g>the</str<strong>on</strong>g> picture<br />
symbol within activity schedules, <str<strong>on</strong>g>the</str<strong>on</strong>g> total<br />
six participants in <str<strong>on</strong>g>the</str<strong>on</strong>g>se studies showed<br />
marked improvement in <str<strong>on</strong>g>the</str<strong>on</strong>g> targeted behavior<br />
(Bryan & Gast; Dettmer et al.). The <strong>on</strong>e<br />
study that used PECS for its activity schedule<br />
<strong>on</strong>ly showed moderate improvement in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
single participant (Dooley et al.). In c<strong>on</strong>trast,<br />
Watanabe <strong>and</strong> Sturmey were <str<strong>on</strong>g>the</str<strong>on</strong>g> <strong>on</strong>ly investigators<br />
who used text without any picture support<br />
to increase task participati<strong>on</strong> in three<br />
adults with autism.<br />
The mode of presentati<strong>on</strong> for each activity<br />
schedule was particularly significant, with<br />
seven of <str<strong>on</strong>g>the</str<strong>on</strong>g> 13 studies utilizing some form of<br />
folder or picture album with <strong>on</strong>e symbol<br />
mounted in <str<strong>on</strong>g>the</str<strong>on</strong>g> center of each page (e.g.,<br />
Bryan & Gast, 2000; Dettmer et al., 2000; Hall<br />
et al., 1995; Krantz et al., 1993). Within <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
seven studies, 15 participants showed a<br />
marked improvement in <str<strong>on</strong>g>the</str<strong>on</strong>g> targeted behaviors<br />
during <str<strong>on</strong>g>the</str<strong>on</strong>g> activity schedule interventi<strong>on</strong><br />
phase, while six additi<strong>on</strong>al participants improving<br />
to a lesser degree. A close comparis<strong>on</strong><br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r studies included in <str<strong>on</strong>g>the</str<strong>on</strong>g> analysis<br />
fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r indicated that <strong>on</strong>e picture per page<br />
folder system as <str<strong>on</strong>g>the</str<strong>on</strong>g> most effective schedule<br />
format for individuals with autism.<br />
Generalizati<strong>on</strong><br />
Researchers in six of 13 studies reported generalizati<strong>on</strong><br />
of activity schedule skills across settings<br />
(Dettmer et al., 2000; Dooley et al., 2001;<br />
Krantz & McClannahan, 1998; Krantz et al.,<br />
1993; MacDuff et al., 1993; Pierce & Schreibman,<br />
1994). Dooley et al. reported <str<strong>on</strong>g>the</str<strong>on</strong>g>ir participant<br />
successfully generalized appropriate<br />
transiti<strong>on</strong> behaviors across activities for <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
remainder of <str<strong>on</strong>g>the</str<strong>on</strong>g> school year through <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>tinued<br />
use of <str<strong>on</strong>g>the</str<strong>on</strong>g> activity schedule. Similarly,<br />
Krantz et al. reported that behavior changes<br />
resulting from <str<strong>on</strong>g>the</str<strong>on</strong>g> introducti<strong>on</strong> of an activity<br />
schedule within daily routines were maintained<br />
for extended periods of up to 10<br />
m<strong>on</strong>ths in three participants with autism.<br />
Krantz <strong>and</strong> McClannahan also reported that<br />
Activity Schedules <strong>and</strong> <strong>Autism</strong> / 329
all <str<strong>on</strong>g>the</str<strong>on</strong>g> participants in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir study were able to<br />
generalize <str<strong>on</strong>g>the</str<strong>on</strong>g>ir newly learned social initiati<strong>on</strong>s<br />
across trainers. Likewise, participants in<br />
MacDuff et al. were able to follow new unfamiliar<br />
activity schedules without any additi<strong>on</strong>al<br />
training. Pierce <strong>and</strong> Schreibman also<br />
reported generalizati<strong>on</strong> across settings <strong>and</strong><br />
tasks with little additi<strong>on</strong>al training, with <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
participants learning new tasks at a faster rate<br />
<strong>on</strong>ce <str<strong>on</strong>g>the</str<strong>on</strong>g> initial training period was completed.<br />
On a more anecdotal note, <str<strong>on</strong>g>the</str<strong>on</strong>g> mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
in <strong>on</strong>e additi<strong>on</strong>al study (Dettmer et al.) reported<br />
utilizing activity schedules with her<br />
child across settings that resulted in a steady<br />
reducti<strong>on</strong> of latency time between activities.<br />
Social Validity<br />
Researchers in five of <str<strong>on</strong>g>the</str<strong>on</strong>g> 13 studies reported<br />
social validati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> by teachers<br />
<strong>and</strong> parents (Bryan & Gast, 2000; Hall et<br />
al., 1995; Massey & Wheeler, 2000; Morris<strong>on</strong><br />
et al., 2002; Schmit et al., 2000). Bryan <strong>and</strong><br />
Gast utilized a Likert scale to collect <str<strong>on</strong>g>the</str<strong>on</strong>g> opini<strong>on</strong>s<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers <strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r professi<strong>on</strong>als<br />
who worked with <str<strong>on</strong>g>the</str<strong>on</strong>g> participants <strong>and</strong> found<br />
that all resp<strong>on</strong>dents felt that picture symbols<br />
would be a useful management tool for all<br />
children in increasing <strong>on</strong>-task <strong>and</strong> <strong>on</strong>-schedule<br />
behavior. Hall et al. administered a poststudy<br />
questi<strong>on</strong>naire to <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers, teachers’<br />
aides, <strong>and</strong> integrati<strong>on</strong> coordinator involved in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> study <strong>and</strong> all surveyed expressed satisfacti<strong>on</strong><br />
with <str<strong>on</strong>g>the</str<strong>on</strong>g> program <strong>and</strong> felt it was a valuable<br />
tool for increasing independent transiti<strong>on</strong>s<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> participant. Likewise, Massey <strong>and</strong><br />
Wheeler developed <strong>and</strong> administered a social<br />
validity scale to <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers, mo<str<strong>on</strong>g>the</str<strong>on</strong>g>rs <strong>and</strong> behavior<br />
c<strong>on</strong>sultant of <str<strong>on</strong>g>the</str<strong>on</strong>g> participants, <strong>and</strong><br />
found a similar satisfacti<strong>on</strong> with <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>,<br />
c<strong>on</strong>cluding that it was an effective <strong>and</strong><br />
beneficial interventi<strong>on</strong> for decreasing problem<br />
transiti<strong>on</strong>s in <str<strong>on</strong>g>the</str<strong>on</strong>g> participant. Similarly,<br />
Morris<strong>on</strong> et al. employed a checklist with<br />
three early interventi<strong>on</strong> teachers to determine<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> social validity of <str<strong>on</strong>g>the</str<strong>on</strong>g> study, <strong>and</strong> all three<br />
teachers reported that <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong><br />
seemed effective in improving play behavior<br />
of preschoolers with autism. The parents of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> participants in this study also reported<br />
important positive behavior changes in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
children following <str<strong>on</strong>g>the</str<strong>on</strong>g> study. Finally, Schmit et<br />
al. utilized both social comparis<strong>on</strong> <strong>and</strong> subjec-<br />
tive evaluati<strong>on</strong> to assess for social validity, c<strong>on</strong>cluding<br />
that reducing tantrum behavior<br />
meant meaningful growth for <str<strong>on</strong>g>the</str<strong>on</strong>g>ir participant.<br />
Discussi<strong>on</strong><br />
330 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Of <str<strong>on</strong>g>the</str<strong>on</strong>g> 13 studies reviewed, all revealed significant<br />
benefits to utilizing activity schedules in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> instructi<strong>on</strong> of individuals with autism. Researchers<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> majority of <str<strong>on</strong>g>the</str<strong>on</strong>g> studies focused<br />
<strong>on</strong> teaching new social <strong>and</strong> <strong>on</strong>-task behaviors<br />
<strong>and</strong> transiti<strong>on</strong> skills. Also, researchers<br />
in some studies successfully decreased tantrum<br />
behaviors in children with autism during<br />
transiti<strong>on</strong>s. Investigators in less than half of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> studies reviewed have examined generalizati<strong>on</strong><br />
<strong>and</strong> social validity indicating that fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
research in <str<strong>on</strong>g>the</str<strong>on</strong>g>se areas is necessary to<br />
support <str<strong>on</strong>g>the</str<strong>on</strong>g> wide use <strong>and</strong> benefits of activity<br />
schedules for pers<strong>on</strong>s with autism.<br />
Results shown in <str<strong>on</strong>g>the</str<strong>on</strong>g>se studies str<strong>on</strong>gly suggest<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> use of activity schedules with<br />
pers<strong>on</strong>s with autism can lead to an increase in<br />
several behaviors. There may be several explanati<strong>on</strong>s<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g> improvement seen in <str<strong>on</strong>g>the</str<strong>on</strong>g> participants.<br />
Activity schedules may have provided<br />
a predictable pattern of expected<br />
behaviors (Bryan & Gast, 2000; Schreibman et<br />
al., 2000) in <str<strong>on</strong>g>the</str<strong>on</strong>g> form of task analysis (e.g.,<br />
breaking skills into small comp<strong>on</strong>ents for each<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> participants). Research supports <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
assumpti<strong>on</strong> that pers<strong>on</strong>s with autism <strong>and</strong><br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>r developmental disabilities (e.g., mental<br />
retardati<strong>on</strong>) resp<strong>on</strong>d better when behaviors<br />
are predictable <strong>and</strong> presented sequentially in<br />
a step-by-step manner (e.g., Heflin & Simps<strong>on</strong>,<br />
1998; Quill, 1995; Simps<strong>on</strong>, 2005). Also,<br />
each picture in <str<strong>on</strong>g>the</str<strong>on</strong>g> activity schedule may have<br />
served as a discriminative stimulus (S D )orcue<br />
for initiating <str<strong>on</strong>g>the</str<strong>on</strong>g> next behavior in <str<strong>on</strong>g>the</str<strong>on</strong>g> schedule/activity.<br />
Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>rmore, it is also highly<br />
probable that <str<strong>on</strong>g>the</str<strong>on</strong>g> activity schedules served as<br />
visual prompts for <str<strong>on</strong>g>the</str<strong>on</strong>g> participants leading to<br />
a completi<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> target behavior(s). In general,<br />
visual prompts are helpful for all pers<strong>on</strong>s,<br />
with <strong>and</strong> without disabilities. For example,<br />
traffic or road signs <strong>and</strong> visual directi<strong>on</strong>s are<br />
helpful for all of us. Specifically, <str<strong>on</strong>g>the</str<strong>on</strong>g> research<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> use of c<strong>on</strong>crete visual supports/<br />
prompts for pers<strong>on</strong>s with autism indicates that<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y resp<strong>on</strong>d better when activities are presented<br />
through visual prompts or pictures
(Quill, 1995). Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>rmore, <str<strong>on</strong>g>the</str<strong>on</strong>g> majority of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> investigators in <str<strong>on</strong>g>the</str<strong>on</strong>g>se studies used some<br />
form of teaching through modeling <strong>and</strong>/or<br />
prompting. It is unknown whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r activity<br />
schedules al<strong>on</strong>e in <str<strong>on</strong>g>the</str<strong>on</strong>g> absence of supplementary<br />
instructi<strong>on</strong> or prompts are helpful in acquiring<br />
necessary behaviors. Future research<br />
should explore <str<strong>on</strong>g>the</str<strong>on</strong>g> role of instructi<strong>on</strong> when<br />
using activity schedules to teach various behaviors<br />
to pers<strong>on</strong>s with autism. Some progress<br />
towards <str<strong>on</strong>g>the</str<strong>on</strong>g> targeted behavior was made by<br />
every participant in each of <str<strong>on</strong>g>the</str<strong>on</strong>g> studies. However,<br />
due to <str<strong>on</strong>g>the</str<strong>on</strong>g> wide variance in picture types<br />
(e.g., photographs, line drawings, PECS) used<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g>se studies, c<strong>on</strong>clusi<strong>on</strong>s cannot be drawn<br />
as to <str<strong>on</strong>g>the</str<strong>on</strong>g> comparative effectiveness of <str<strong>on</strong>g>the</str<strong>on</strong>g> different<br />
types of pictures. Thus, future research<br />
should also investigate <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of different<br />
picture types (e.g., line drawings vs. photographs)<br />
<strong>and</strong> sizes. In additi<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g> mode of<br />
presentati<strong>on</strong> seems to be a critical comp<strong>on</strong>ent<br />
of activity schedules. For instance, using a<br />
binder or folder with <strong>on</strong>e page per picture<br />
seems to be more useful for students with<br />
autism in <str<strong>on</strong>g>the</str<strong>on</strong>g>se studies. It is possible that <strong>on</strong>e<br />
picture per page may have provided a better<br />
visual clarity <strong>and</strong> specificity for some participants.<br />
It is unclear from this review whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
<strong>on</strong>e mode of presentati<strong>on</strong> is superior over <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>r mode(s) because no comparative research<br />
in this area has been c<strong>on</strong>ducted. Future<br />
research is warranted to study <str<strong>on</strong>g>the</str<strong>on</strong>g> effects<br />
of different presentati<strong>on</strong>s <strong>on</strong> a variety of behaviors<br />
in students with autism.<br />
Finally, results of generalizati<strong>on</strong> indicate<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of activity schedules can be<br />
generalized to o<str<strong>on</strong>g>the</str<strong>on</strong>g>r settings, activities, <strong>and</strong><br />
pers<strong>on</strong>s. The participants may have been successful<br />
generalizing behaviors due to programming<br />
comm<strong>on</strong> stimuli - use of similar<br />
pictures in <str<strong>on</strong>g>the</str<strong>on</strong>g> activity schedules that are presented<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> child’s natural envir<strong>on</strong>ment<br />
(Cooper, Her<strong>on</strong>, & Heward, 2007). Also, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
participants may have generalized behaviors<br />
learned through activity schedules due to natural<br />
reinforcement c<strong>on</strong>tingencies or through<br />
varied reinforcement schedules. Although<br />
generalizati<strong>on</strong> results are promising, <strong>on</strong>ly less<br />
than half of <str<strong>on</strong>g>the</str<strong>on</strong>g> studies reported data <strong>on</strong> generalizati<strong>on</strong>,<br />
indicating that more research is<br />
necessary in this area. Specifically, future research<br />
should be focused <strong>on</strong> generalizati<strong>on</strong><br />
effects of activity schedules to new behaviors.<br />
Implicati<strong>on</strong>s for Practice<br />
Several implicati<strong>on</strong>s could be drawn for practiti<strong>on</strong>ers<br />
from this review. First, activity schedules<br />
are easy to develop <strong>and</strong> can be used with<br />
different routines <strong>and</strong> in different settings<br />
(e.g., school, home, work, <strong>and</strong> play) for pers<strong>on</strong>s<br />
with autism. Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>rmore, this method<br />
could be used by educators to teach any activity<br />
that can be broken into sequential steps,<br />
from educati<strong>on</strong>al games to cooking activities.<br />
This review also suggests that each step of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
activity or skill would simply have to be represented<br />
by some form of picture symbol representing<br />
that step, <strong>and</strong> a manner of display<br />
(e.g., folder, wall, computer, <strong>and</strong> desk). In<br />
additi<strong>on</strong>, it is evident from <str<strong>on</strong>g>the</str<strong>on</strong>g>se studies that<br />
practiti<strong>on</strong>ers need to teach <str<strong>on</strong>g>the</str<strong>on</strong>g> student with<br />
autism to use or follow <str<strong>on</strong>g>the</str<strong>on</strong>g> activity schedule<br />
with a range of prompts based <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> student’s<br />
needs. Without explicit teaching <strong>and</strong><br />
use of prompts, activity schedules al<strong>on</strong>e may<br />
not be sufficient to improve behaviors.<br />
In summary, <str<strong>on</strong>g>the</str<strong>on</strong>g> reviewed studies support<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> use of activity schedules as an effective<br />
interventi<strong>on</strong> strategy for modifying various social,<br />
daily living, <strong>on</strong>-task, <strong>and</strong> transiti<strong>on</strong> behaviors<br />
in pers<strong>on</strong>s with autism. Also, <str<strong>on</strong>g>the</str<strong>on</strong>g> review<br />
indicates that <str<strong>on</strong>g>the</str<strong>on</strong>g> use of activity schedules may<br />
decrease problem behaviors during transiti<strong>on</strong>s.<br />
More studies are needed to fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r assess<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of activity schedule systems<br />
in pers<strong>on</strong>s with o<str<strong>on</strong>g>the</str<strong>on</strong>g>r types of autism<br />
spectrum disorders, particularly those diagnosed<br />
with Asperger’s syndrome. Future research<br />
with activity schedules should identify<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> most effective comp<strong>on</strong>ents of <str<strong>on</strong>g>the</str<strong>on</strong>g> technique,<br />
including types of pictures, displays,<br />
<strong>and</strong> size. Finally, future research should c<strong>on</strong>tinue<br />
to investigate <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of activity<br />
schedules <strong>on</strong> generalizati<strong>on</strong> <strong>and</strong> social validity.<br />
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Received: 22 January 2007<br />
Initial Acceptance: 26 March 2007<br />
Final Acceptance: 5 June 2007<br />
Activity Schedules <strong>and</strong> <strong>Autism</strong> / 333
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities, 2008, 43(3), 334–341<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities<br />
Therapeutic Interventi<strong>on</strong>s in <str<strong>on</strong>g>the</str<strong>on</strong>g> Ne<str<strong>on</strong>g>the</str<strong>on</strong>g>rl<strong>and</strong>s <strong>and</strong> Belgium in<br />
Support of People with Profound Intellectual <strong>and</strong><br />
Multiple Disabilities<br />
Carla Vlaskamp <strong>and</strong> Han Nakken<br />
University of Gr<strong>on</strong>ingen<br />
Abstract: For several reas<strong>on</strong>s, people with profound <strong>and</strong> multiple disabilities may be offered a variety of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s. Thus far, researchers have shown a limited interest in providing an empirical base<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g>se interventi<strong>on</strong>s. Research is needed <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g>oretical rati<strong>on</strong>ale (if any), <str<strong>on</strong>g>the</str<strong>on</strong>g> supposed ‘modus oper<strong>and</strong>i’<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> claimed benefits of <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s. As a first step, this paper offers an overview of <str<strong>on</strong>g>the</str<strong>on</strong>g> use of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se interventi<strong>on</strong>s. A total of 48 settings in <str<strong>on</strong>g>the</str<strong>on</strong>g> Ne<str<strong>on</strong>g>the</str<strong>on</strong>g>rl<strong>and</strong>s <strong>and</strong> Belgium were included in this study. Results<br />
show that some interventi<strong>on</strong>s are very frequently used, with Snoezelen, Sensory Integrative Therapy, Equine<br />
Therapy, Basic Stimulati<strong>on</strong> <strong>and</strong> Aroma<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy being <str<strong>on</strong>g>the</str<strong>on</strong>g> most comm<strong>on</strong>. Only <strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g>se five has been subjected<br />
to a number of carefully designed studies. Nearly a third of all <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s currently in use are not<br />
clinically evaluated. Of those that are evaluated, more than half are <strong>on</strong>ly evaluated m<strong>on</strong>thly or even less<br />
frequently. The article ends with a call for an effective research strategy to separate interventi<strong>on</strong>s that are<br />
beneficial to people with PIMD from those that are unsubstantiated.<br />
In <str<strong>on</strong>g>the</str<strong>on</strong>g> support of people with profound intellectual<br />
<strong>and</strong> multiple disabilities (PIMD), practiti<strong>on</strong>ers<br />
in centers for special educati<strong>on</strong>, day<br />
services centers <strong>and</strong> residential facilities use a<br />
series of <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s that aim to<br />
achieve a broad spectrum of claimed effects,<br />
ranging from ‘feeling good’ <strong>and</strong> ‘restoring a<br />
natural balance’ to developmental effects <strong>and</strong><br />
regaining functi<strong>on</strong>s. These interventi<strong>on</strong>s or<br />
procedures are generally not carried out by<br />
medical staff but by direct support staff members<br />
or <str<strong>on</strong>g>the</str<strong>on</strong>g>rapists (such as physio<str<strong>on</strong>g>the</str<strong>on</strong>g>rapists or<br />
speech <str<strong>on</strong>g>the</str<strong>on</strong>g>rapists). In practice-oriented journals,<br />
popular magazines <strong>and</strong> <strong>on</strong> televisi<strong>on</strong> <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> internet, a large range of <str<strong>on</strong>g>the</str<strong>on</strong>g>se interventi<strong>on</strong>s<br />
or <str<strong>on</strong>g>the</str<strong>on</strong>g>rapies are documented. They may<br />
claim ‘to cure’, such as Gentle Teaching, for<br />
example, which promises to cure self-injurious<br />
behavior by using unc<strong>on</strong>diti<strong>on</strong>al acceptance<br />
<strong>and</strong> a gentle touch. They may promise impor-<br />
The authors would like to thank prof. dr J.H.<br />
Hogg for his comments <strong>on</strong> a previous versi<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
manuscript. Corresp<strong>on</strong>dence c<strong>on</strong>cerning this article<br />
should be addressed to Carla Vlaskamp, Department<br />
of Health Care Psychology, University of Gr<strong>on</strong>ingen,<br />
Grote Rozenstraat 38, 9712 TJ Gr<strong>on</strong>ingen,<br />
The NETHERLANDS. Email: c.vlaskamp@rug.nl<br />
334 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
tant sounding but vague benefits, such as<br />
Therapeutic Touch, which states that <str<strong>on</strong>g>the</str<strong>on</strong>g>re is<br />
‘a natural human potential which can be actualized<br />
through <str<strong>on</strong>g>the</str<strong>on</strong>g> intent to help or enhance<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> recipients’ own ability to support<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>mselves towards wholeness,’ or ‘Dolphin<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy’ which states that ‘swimming with dolphins<br />
makes children with special needs learn<br />
up to four times faster <strong>and</strong> more intensively.’<br />
These kinds of interventi<strong>on</strong>s are used<br />
throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> human services area, <strong>and</strong><br />
while no area or enterprise has been immune<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> phenomen<strong>on</strong> of unsubstantiated <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s, <str<strong>on</strong>g>the</str<strong>on</strong>g> field of profound<br />
<strong>and</strong> multiple disabilities appears to be particularly<br />
vulnerable. This may be due to several<br />
reas<strong>on</strong>s. Firstly, <str<strong>on</strong>g>the</str<strong>on</strong>g>re is <str<strong>on</strong>g>the</str<strong>on</strong>g> size <strong>and</strong> complexity<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> disabilities of those with PIMD. In<br />
additi<strong>on</strong> to <str<strong>on</strong>g>the</str<strong>on</strong>g>ir profound intellectual <strong>and</strong><br />
severe or profound motor disabilities, individuals<br />
with PIMD also have a high prevalence of<br />
sensory disability (Nakken & Vlaskamp, 2006;<br />
Schrojenstein, Lantman-de Valk et al., 1997;<br />
Van Splunder, Stilma, Bernsen, Arentz, &<br />
Evenhuis, 2003). Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>rmore, as well as <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
impairments, people with PIMD have an overall<br />
risk of developing medical complicati<strong>on</strong>s<br />
<strong>and</strong> almost all require regularly administered
medicati<strong>on</strong>, for example antic<strong>on</strong>vulsant<br />
drugs, sleep medicati<strong>on</strong>, medicati<strong>on</strong> to prevent<br />
reflux <strong>and</strong> sedatives (Hogg, 1992; Kapell<br />
et al., 1998; Zijlstra & Vlaskamp, 2005). This<br />
category of people thus forms a physically very<br />
vulnerable group with a heavy or total dependence<br />
<strong>on</strong> pers<strong>on</strong>al assistance for everyday<br />
tasks. This puts a strain <strong>on</strong> all those who provide<br />
support. Sec<strong>on</strong>dly, those with PIMD obtain<br />
services from several kinds of professi<strong>on</strong>als<br />
with different vocati<strong>on</strong>al backgrounds,<br />
using various <str<strong>on</strong>g>the</str<strong>on</strong>g>oretical frameworks <strong>and</strong><br />
ideas. Within all of <str<strong>on</strong>g>the</str<strong>on</strong>g> different professi<strong>on</strong>s it<br />
is possible to find <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s<br />
that may seem to be ‘worth a try’. We lack a<br />
traditi<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s that are<br />
specifically designed <strong>and</strong> developed for people<br />
with PIMD. Most <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s<br />
that are offered to this category of people are<br />
originally designed <strong>and</strong> developed for those<br />
with less severe disabilities, <strong>and</strong> have in some<br />
cases been ‘modified’ by practiti<strong>on</strong>ers to fit<br />
this specific category. Thirdly, <str<strong>on</strong>g>the</str<strong>on</strong>g> size <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
complexity of disabilities will provoke feelings<br />
of insecurity relating to <str<strong>on</strong>g>the</str<strong>on</strong>g> educati<strong>on</strong>al <strong>and</strong><br />
support goals that are operative. These feelings<br />
of insecurity may render parents <strong>and</strong> professi<strong>on</strong>als<br />
powerless, <strong>and</strong> leave <str<strong>on</strong>g>the</str<strong>on</strong>g>m with a<br />
str<strong>on</strong>g urge to explore whatever possibilities<br />
are placed before <str<strong>on</strong>g>the</str<strong>on</strong>g>m.<br />
The evidence base supporting <str<strong>on</strong>g>the</str<strong>on</strong>g>se types of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong> is limited as far as<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir use for people with PIMD is c<strong>on</strong>cerned.<br />
However, even if <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
interventi<strong>on</strong>s is unproven, this does not automatically<br />
mean that <str<strong>on</strong>g>the</str<strong>on</strong>g>y are inherently good<br />
or bad. N<strong>on</strong>e<str<strong>on</strong>g>the</str<strong>on</strong>g>less, <str<strong>on</strong>g>the</str<strong>on</strong>g>re are forms of <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong> or <str<strong>on</strong>g>the</str<strong>on</strong>g>rapies which may<br />
be likely to cause harm, ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r directly, for<br />
example a child subjected to passive training<br />
activities for hours a day, or indirectly, for<br />
example if applying <str<strong>on</strong>g>the</str<strong>on</strong>g> procedure keeps <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
pers<strong>on</strong> with PIMD from effective treatment or<br />
from more pleasurable activities. Such <str<strong>on</strong>g>the</str<strong>on</strong>g>rapies<br />
could also raise <str<strong>on</strong>g>the</str<strong>on</strong>g> hopes of parents by<br />
c<strong>on</strong>tinually promising an improvement in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
child’s c<strong>on</strong>diti<strong>on</strong>, a promise that may not be<br />
fulfilled.<br />
Many of <str<strong>on</strong>g>the</str<strong>on</strong>g>se <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s are<br />
adopted by well-meaning professi<strong>on</strong>als or parents<br />
who do not have <str<strong>on</strong>g>the</str<strong>on</strong>g> background, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
skills, or <str<strong>on</strong>g>the</str<strong>on</strong>g> inclinati<strong>on</strong> to investigate <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
treatments (Jacobs<strong>on</strong>, Foxx, & Mulick, 2005).<br />
Researchers have shown limited interest in<br />
delivering such a supporting base of evidence.<br />
This might be because studying <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g>se <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s for individuals<br />
with PIMD is time-c<strong>on</strong>suming <strong>and</strong><br />
methodologically complicated. Thus far, <strong>on</strong>ly<br />
a limited amount of scientific literature documenting<br />
both <str<strong>on</strong>g>the</str<strong>on</strong>g> inefficacy <strong>and</strong> efficacy of<br />
some of <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s for people<br />
with PIMD is available (for example, Lindsay,<br />
Black, Broxholme, Pitcaithly, & Hornsby,<br />
2001; Mount & Cavet, 1995; Vlaskamp, de<br />
Geeter, Huijsmans, & Smit, 2003; Hogg,<br />
Cavet, Lambe, & Smeddle, 2001; Smith,<br />
Mruzek, & Mozingo, 2005; Kaplan, Clopt<strong>on</strong>,<br />
Kaplan, Messbauer, & McPhers<strong>on</strong>, 2006; van<br />
der Putten, Vlaskamp, Reynders, & Nakken,<br />
2005a, 2005b).<br />
Research is needed <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g>oretical rati<strong>on</strong>ale<br />
(if any), <str<strong>on</strong>g>the</str<strong>on</strong>g> supposed ‘modus oper<strong>and</strong>i’<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> claimed benefits of <str<strong>on</strong>g>the</str<strong>on</strong>g>se <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s. As a first step, we need an overview<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>s actually in use at<br />
present.<br />
Method<br />
Participants <strong>and</strong> Setting<br />
Ten Dutch organizati<strong>on</strong>s <strong>and</strong> nine organizati<strong>on</strong>s<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> Flemish-speaking part of Belgium<br />
participated in this study. The facilities were<br />
r<strong>and</strong>omly chosen <strong>and</strong> evenly spread throughout<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> Ne<str<strong>on</strong>g>the</str<strong>on</strong>g>rl<strong>and</strong>s <strong>and</strong> Fl<strong>and</strong>ers. Each facility<br />
offers support to people with PIMD in multiple<br />
settings, such as residential care, day<br />
services <strong>and</strong> educati<strong>on</strong>al centers. Except for<br />
four special educati<strong>on</strong>al centers who <strong>on</strong>ly provide<br />
support for children with PIMD, all facilities<br />
offer services to a diverse populati<strong>on</strong> of<br />
those with intellectual disabilities. A total of 48<br />
settings were included in this study: 23 residential<br />
care units, 13 day services, 11 special<br />
educati<strong>on</strong>al centers <strong>and</strong> <strong>on</strong>e respite care<br />
home. The 23 residential care units provided<br />
for 1007 people with PIMD, <str<strong>on</strong>g>the</str<strong>on</strong>g> 13 day services<br />
settings provided for 342 people. The special<br />
educati<strong>on</strong>al centers provided informati<strong>on</strong> <strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir populati<strong>on</strong> of 162 children with PIMD,<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> respite care home <strong>on</strong> six children with<br />
PIMD.<br />
Therapeutic Interventi<strong>on</strong>s / 335
Instruments<br />
A questi<strong>on</strong>naire with four semi-structured<br />
questi<strong>on</strong>s <strong>and</strong> <strong>on</strong>e open questi<strong>on</strong> was developed.<br />
The semi-structured questi<strong>on</strong>s focused<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> use of a particular interventi<strong>on</strong> for<br />
people with PIMD, <strong>and</strong> asked how many clients<br />
were offered this interventi<strong>on</strong> (less than<br />
30 clients in intervals of two <strong>and</strong> from 30<br />
<strong>on</strong>wards in tens) if it had been used. We subsequently<br />
asked if (<strong>and</strong> if so, how often) <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
effect of this interventi<strong>on</strong> was evaluated in<br />
writing. The open questi<strong>on</strong> asked which interventi<strong>on</strong>s<br />
not included in <str<strong>on</strong>g>the</str<strong>on</strong>g> list were also<br />
used in <str<strong>on</strong>g>the</str<strong>on</strong>g> specific setting. A manual was<br />
included which explained how to complete<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong>naire.<br />
Procedure<br />
Firstly, an inventory of interventi<strong>on</strong>s that were<br />
frequently recommended to practiti<strong>on</strong>ers in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> Ne<str<strong>on</strong>g>the</str<strong>on</strong>g>rl<strong>and</strong>s <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> Flemish-speaking<br />
part of Belgium was made. This overview was<br />
based <strong>on</strong> informati<strong>on</strong> in practice-oriented<br />
journals <strong>and</strong> internet sites that target professi<strong>on</strong>als<br />
involved in <str<strong>on</strong>g>the</str<strong>on</strong>g> support of people with<br />
profound intellectual disabilities. From this<br />
list, which c<strong>on</strong>tained 23 interventi<strong>on</strong>s, seven<br />
were omitted as <str<strong>on</strong>g>the</str<strong>on</strong>g>y were primarily designed<br />
for use by parents at home (such as Brain Net<br />
<strong>and</strong> Saito Therapy) or dem<strong>and</strong>ed specific situati<strong>on</strong>s<br />
<strong>and</strong> funding (such as Dolphin <str<strong>on</strong>g>the</str<strong>on</strong>g>rapy).<br />
Subsequently, <str<strong>on</strong>g>the</str<strong>on</strong>g> researchers asked health<br />
care psychologists to cooperate in ga<str<strong>on</strong>g>the</str<strong>on</strong>g>ring<br />
data. In <str<strong>on</strong>g>the</str<strong>on</strong>g> Dutch c<strong>on</strong>text, researchers informed<br />
health care psychologists working in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> field by teleph<strong>on</strong>e, explaining <str<strong>on</strong>g>the</str<strong>on</strong>g> aim of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> study <strong>and</strong> asking about <str<strong>on</strong>g>the</str<strong>on</strong>g>ir willingness to<br />
complete a questi<strong>on</strong>naire. In Belgium, health<br />
care psychologists working with those with<br />
PIMD were asked <str<strong>on</strong>g>the</str<strong>on</strong>g> same questi<strong>on</strong> during<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir biannual meeting. The questi<strong>on</strong>naire<br />
was mailed to those who c<strong>on</strong>sented. The list<br />
c<strong>on</strong>sisted of 16 interventi<strong>on</strong>s: Aroma<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy<br />
(Diego, J<strong>on</strong>es, & Field, 1998), Basic Stimulati<strong>on</strong><br />
(Fröhlich, 1991), CranioSacral Therapy<br />
(Upledger & Vredevoogd, 1983), Discrete<br />
Trial Training (Lovaas, 1987), Gentle Teaching<br />
(McGee, 1992), Hapt<strong>on</strong>omy (Veldman,<br />
2003), Equine Therapy/Hippo<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy (I<strong>on</strong>atamamishvili,<br />
Tsverava, Loriya, Sheshaberidze,<br />
& Rukhadze, 2004), Mobility Opportunities<br />
Via Educati<strong>on</strong> (Bidabe & Lollar, 1990), Shantala<br />
Massage (Leboyer, 1987), Sensory Integrative<br />
Therapy (Ayers, 1972), Sherborne Developmental<br />
Movement (Loots & Malschaert,<br />
1999), Snoezelen (Hulsegge & Verheul,<br />
1987), Tibetan Cymbals (Jansen, 1990), Therapeutic<br />
Touch (Courcey, 2001), Touch for<br />
Health (Thie, 2005) <strong>and</strong> Watsu Therapy<br />
(Dull, 1997).<br />
Only half of <str<strong>on</strong>g>the</str<strong>on</strong>g> facilities resp<strong>on</strong>ded before<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> due date. Two weeks after <str<strong>on</strong>g>the</str<strong>on</strong>g> due date<br />
researchers sent a reminder <strong>and</strong> most resp<strong>on</strong>ded<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>reafter, with <str<strong>on</strong>g>the</str<strong>on</strong>g> excepti<strong>on</strong> of<br />
three psychologists who could not be c<strong>on</strong>tacted<br />
even after several attempts, <strong>and</strong> a fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
three that were no l<strong>on</strong>ger willing to participate<br />
due to lack of time. Data were<br />
analyzed using descriptive measures.<br />
Results<br />
336 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
All facilities that participated use at least <strong>on</strong>e<br />
(as was <str<strong>on</strong>g>the</str<strong>on</strong>g> case in two facilities) or more (with<br />
a maximum of eleven in <strong>on</strong>e facility) <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s, with <str<strong>on</strong>g>the</str<strong>on</strong>g> excepti<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
respite care home. In this setting, n<strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s from our list is used<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>refore it is excluded from <str<strong>on</strong>g>the</str<strong>on</strong>g> results.<br />
Two <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s, Mobility Opportunities<br />
via Educati<strong>on</strong> <strong>and</strong> Touch for<br />
Health, were not menti<strong>on</strong>ed at all by <str<strong>on</strong>g>the</str<strong>on</strong>g> resp<strong>on</strong>dents<br />
<strong>and</strong> are also excluded from <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
tables. In Table 1, <str<strong>on</strong>g>the</str<strong>on</strong>g> number <strong>and</strong> percentage<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> use of <str<strong>on</strong>g>the</str<strong>on</strong>g>se interventi<strong>on</strong>s in 47 settings<br />
are given. The table shows that some <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s are <strong>on</strong>ly offered in a limited<br />
number of settings. O<str<strong>on</strong>g>the</str<strong>on</strong>g>rs, such as<br />
Snoezelen <strong>and</strong> Sensory Integrative Therapy<br />
are offered in more than half of <str<strong>on</strong>g>the</str<strong>on</strong>g> participating<br />
settings. Snoezelen is used in 87.2%<br />
<strong>and</strong> is by far <str<strong>on</strong>g>the</str<strong>on</strong>g> most popular interventi<strong>on</strong>.<br />
Some <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s are offered<br />
to a large number of clients in each setting.<br />
Gentle Teaching <strong>and</strong> Snoezelen are offered to<br />
a high number of clients at least <strong>on</strong>ce a week<br />
(120129 <strong>and</strong> 100109, respectively). O<str<strong>on</strong>g>the</str<strong>on</strong>g>rs,<br />
for example Discrete Trial Training, CranioSacral<br />
Therapy, <strong>and</strong> Therapeutic Touch<br />
are not offered to more than six clients per<br />
setting. Table 2 shows <str<strong>on</strong>g>the</str<strong>on</strong>g> ranges between <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
least number <strong>and</strong> highest number of clients
TABLE 1<br />
Number of Facilities That Use Therapeutic Interventi<strong>on</strong>s<br />
that are offered a specific interventi<strong>on</strong> at least<br />
<strong>on</strong>ce a week in a specific setting.<br />
We also inquired whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s were evaluated <strong>and</strong> if so, at what<br />
point. Table 3 shows that 65.3% of <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s used are clinically evalu-<br />
Residential Units Day Services Special Educati<strong>on</strong> Total<br />
NL<br />
(N 14)<br />
B<br />
(N 9)<br />
NL<br />
(N 11)<br />
B<br />
(N 2)<br />
NL<br />
(N 6)<br />
B<br />
(N 5)<br />
NL B<br />
(N 47)<br />
NL B<br />
(%)<br />
Aroma<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy 3 5 3 1 3 15 31.9<br />
Basic Stimulati<strong>on</strong> 3 7 2 1 2 5 19 40.4<br />
CranioSacral Therapy 1 1 2 4.3<br />
Discrete Trial 1 1 2 4.3<br />
Training<br />
Gentle Teaching 2 1 2 1 2 8 17.0<br />
Hapt<strong>on</strong>omy 5 1 1 8 17.0<br />
Equine Therapy 6 4 7 1 3 21 44.7<br />
S.I.T. 8 2 6 6 2 24 51.1<br />
Shantala Massage 1 5 3 2 3 14 29.8<br />
Sherborne 6 2 1 4 13 27.7<br />
Snoezelen 9 9 11 2 5 5 41 87.2<br />
Therapeutic Touch 1 1 2 4.3<br />
Tibetan Cymbals 2 2 5 1 1 11 23.4<br />
Watsu Therapy 3 3 6.4<br />
TABLE 2<br />
ated in writing, but in <strong>on</strong>ly 39.8% of <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
cases does <str<strong>on</strong>g>the</str<strong>on</strong>g> evaluati<strong>on</strong> follow directly after<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>, or <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> same day. Ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
3.5% of cases are evaluated weekly, <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
56.6 % being evaluated less frequently (ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
m<strong>on</strong>thly, annually or even less often). The<br />
Ranges (Lowest-Highest) in Number of Clients Receiving Therapeutic Interventi<strong>on</strong>s<br />
Number of<br />
Settings Providing<br />
Treatment Form<br />
Least Number of<br />
Clients<br />
(Number of Settings)<br />
Highest Number of<br />
Clients<br />
(Number of Settings)<br />
Aroma<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy 15 1–3 (2) 60–69 (1)<br />
Basic Stimulati<strong>on</strong> 19 1–3 (2) 60–69 (1)<br />
CranioSacral Therapy 2 4–6 (1) 4–6 (1)<br />
Discrete Trial Training 2 1–3 (1) 1–3 (1)<br />
Gentle Teaching 8 1–3 (4) 120–129 (1)<br />
Hapt<strong>on</strong>omy 8 4–6 (1) 13–15 (1)<br />
Equine Therapy 21 1–3 (3) 28–30 (1)<br />
S.I.T 24 1–3 (2) 10–12 (2)<br />
Shantala Massage 14 1–3 (4) 40–49 (1)<br />
Sherborne 13 1–3 (3) 16–18 (1)<br />
Snoezelen 41 1–3 (7) 100–109 (1)<br />
Therapeutic Touch 2 1–3 (1) 4–6 (1)<br />
Tibetan Cymbals 11 1–3 (2) 16–18 (1)<br />
Watsu Therapy 3 1–3 (1) 10–12 (2)<br />
Therapeutic Interventi<strong>on</strong>s / 337
TABLE 3<br />
Clinical Evaluati<strong>on</strong> of Therapeutic Interventi<strong>on</strong>s<br />
table also shows that <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong> with regard<br />
to evaluati<strong>on</strong> was not answered in a small<br />
number of cases.<br />
In additi<strong>on</strong> to <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s<br />
provided by <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong>naire, facilities menti<strong>on</strong>ed<br />
ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r 21 used in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir own daily<br />
practice. These range from <strong>on</strong>e that was<br />
adapted from existing <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s<br />
(a combinati<strong>on</strong> of Hapt<strong>on</strong>omy <strong>and</strong> Sensory<br />
Integrative Therapy) to 15 that were ‘self<br />
invented’ (for example, an interventi<strong>on</strong> called<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> ‘Spoil Room’) <strong>and</strong> 7 existing <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s that were not included in our<br />
questi<strong>on</strong>naire. With <str<strong>on</strong>g>the</str<strong>on</strong>g> excepti<strong>on</strong> of two: foot<br />
reflex <str<strong>on</strong>g>the</str<strong>on</strong>g>rapy, which was menti<strong>on</strong>ed twice,<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> Halliwick c<strong>on</strong>cept (a method of motor<br />
rehabilitati<strong>on</strong> in water, Lambeck & Stanat,<br />
2000), which was menti<strong>on</strong>ed five times, <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>r <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s are <strong>on</strong>ly menti<strong>on</strong>ed<br />
by <strong>on</strong>e resp<strong>on</strong>dent.<br />
C<strong>on</strong>clusi<strong>on</strong> <strong>and</strong> Discussi<strong>on</strong><br />
Evaluated Directly<br />
Our research included 16 <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s<br />
of which 14 were used in <str<strong>on</strong>g>the</str<strong>on</strong>g> participating<br />
facilities. Some are ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r frequently<br />
used in Dutch <strong>and</strong> Flemish practice, with<br />
Snoezelen, Sensory Integrative Therapy,<br />
Equine Therapy, Basic Stimulati<strong>on</strong> <strong>and</strong> Aroma<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy<br />
being most frequently used. However,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> applicati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g>se interventi<strong>on</strong>s<br />
End of<br />
Day Weekly O<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
Not<br />
Evaluated Missing<br />
Aroma<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy (15) 9 3 3 3 4 2<br />
Basic Stimulati<strong>on</strong> (19) 17 4 1 12 2<br />
CranioSacral Ther. (2) 2<br />
Discrete Trial Train. (2) 1 1 1<br />
Gentle Teaching (8) 2 1 1 6<br />
Hapt<strong>on</strong>omy (8) 5 1 2 2 2 1<br />
Equine Therapy (21) 9 3 1 5 8 4<br />
SIT (24) 22 3 1 2 16 2<br />
Shantala Massage (14) 8 3 1 4 6<br />
Sherborne (13) 9 2 2 5 4<br />
Snoezelen (41) 21 2 7 12 20<br />
Therapeutic Touch (2) 2 2<br />
Tibetan Cymbals (11) 6 2 1 1 2 3 2<br />
Watsu Therapy (3) 2 2 1<br />
338 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
without feedback <strong>on</strong> effectiveness occurs too<br />
often. Nearly a third of all <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s<br />
used are not evaluated in writing at<br />
all. Of those that are evaluated in practice,<br />
more than half are <strong>on</strong>ly evaluated m<strong>on</strong>thly or<br />
even less often.<br />
Our study has several limitati<strong>on</strong>s with respect<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> estimated use of <str<strong>on</strong>g>the</str<strong>on</strong>g>se <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s. Firstly, we obtained informati<strong>on</strong><br />
from <strong>on</strong>e member of staff <strong>on</strong>ly, which<br />
may lead to an under or overestimati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
use of <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s. However,<br />
our resp<strong>on</strong>dents were all able to provide an<br />
expert judgment, given <str<strong>on</strong>g>the</str<strong>on</strong>g>ir positi<strong>on</strong> within<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir organizati<strong>on</strong> <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir specialist interest<br />
in people with PIMD. Sec<strong>on</strong>dly, no explicit<br />
rules were given for <str<strong>on</strong>g>the</str<strong>on</strong>g> use of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>.<br />
This left <str<strong>on</strong>g>the</str<strong>on</strong>g> resp<strong>on</strong>dents room for interpretati<strong>on</strong>.<br />
It may very well be that in <strong>on</strong>e<br />
setting <str<strong>on</strong>g>the</str<strong>on</strong>g> burning of incense in <str<strong>on</strong>g>the</str<strong>on</strong>g> residential<br />
care unit is understood as ‘aroma<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy’<br />
for 10 people while in ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r setting staff use<br />
specific oils or scents for clients in individual<br />
sessi<strong>on</strong>s. The possibility of different interpretati<strong>on</strong>s<br />
might have led to a bias in <str<strong>on</strong>g>the</str<strong>on</strong>g> results<br />
of this study.<br />
As for <str<strong>on</strong>g>the</str<strong>on</strong>g> five most popular <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s, <strong>on</strong>ly <strong>on</strong>e has been subjected to<br />
a number of carefully designed studies,<br />
namely ‘Snoezelen.’ Research has been undertaken<br />
with respect to <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of
Snoezelen <strong>on</strong> a variety of behaviors, such as<br />
changes in affect, challenging behavior, relaxati<strong>on</strong>,<br />
behavior states <strong>and</strong> interacti<strong>on</strong>s (for<br />
example, Ashby, Lindsay, Pitcaithly, Broxholme<br />
& Geelen, 1995; Lindsay et al., 2001;<br />
Mount & Cavet, 1995; Vlaskamp et al., 2003).<br />
Some studies show positive outcomes, especially<br />
with regard to relaxati<strong>on</strong>, but several<br />
show negative results, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>re is little evidence<br />
<strong>on</strong> which to base any generalizati<strong>on</strong>s<br />
(Hogg et al., 2001).<br />
Aroma<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy has also been subjected to<br />
research, but to far less an extent than<br />
Snoezelen. Lindsay et al. (2001) showed that<br />
aroma<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy has a limited effect <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> communicati<strong>on</strong><br />
levels of those with PIMD. While<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>re is a growing body of research <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
practice of aroma<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy, <str<strong>on</strong>g>the</str<strong>on</strong>g>re are <strong>on</strong>ly a few<br />
empirical studies <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of it (Maddock-Jennings<br />
& Wilkins<strong>on</strong>, 2004), <strong>and</strong> n<strong>on</strong>e<br />
with specific regard to people with PIMD.<br />
We did find two studies that have been c<strong>on</strong>ducted<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of Sensory Integrative<br />
Therapy (SIT) for people with PIMD.<br />
One study by Brody, Thomas, Brody <strong>and</strong><br />
Kucherawy (1977) used a well-established research<br />
design (for example, r<strong>and</strong>om assignment,<br />
use of interventi<strong>on</strong> manual <strong>and</strong> validated<br />
outcome measures) <strong>and</strong> found no<br />
significant difference between <str<strong>on</strong>g>the</str<strong>on</strong>g> SIT group<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>trol group. In <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r study by<br />
Close, Carpenter <strong>and</strong> Cibiri (1986), no r<strong>and</strong>om<br />
assignment, no interventi<strong>on</strong> manual <strong>and</strong><br />
no validated outcome measures were used.<br />
They showed that <str<strong>on</strong>g>the</str<strong>on</strong>g> SIT group improved<br />
more than <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>trol group. Smith et al.<br />
(2005), in an overview of research (or <str<strong>on</strong>g>the</str<strong>on</strong>g> lack<br />
of it) <strong>on</strong> SIT, stress <str<strong>on</strong>g>the</str<strong>on</strong>g> need for research<br />
support in <str<strong>on</strong>g>the</str<strong>on</strong>g> future.<br />
The influence of Equine Therapy <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
motor <strong>and</strong> social-emoti<strong>on</strong>al behavior of children<br />
with disabilities has been examined in<br />
several studies, but n<strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g>se studies is<br />
related to <str<strong>on</strong>g>the</str<strong>on</strong>g> populati<strong>on</strong> of children with<br />
PIMD. In <str<strong>on</strong>g>the</str<strong>on</strong>g>ir literature review, Rol<strong>and</strong>elli<br />
<strong>and</strong> Dunst (2003) stated that most of <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
studies report benefits, but methodological<br />
<strong>and</strong> procedural problems raise questi<strong>on</strong>s<br />
about <str<strong>on</strong>g>the</str<strong>on</strong>g> efficacy of <str<strong>on</strong>g>the</str<strong>on</strong>g> practice.<br />
Finally, Basic Stimulati<strong>on</strong> has not been subjected<br />
to research, although some of <str<strong>on</strong>g>the</str<strong>on</strong>g> underlying<br />
principles have been examined. This<br />
is viewed by its creator as an indirect argument<br />
in support of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> (Bienstein &<br />
Fröhlich, 2003). Apparently, <str<strong>on</strong>g>the</str<strong>on</strong>g> scientific underpinning<br />
proving <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
frequently used <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s<br />
does not have priority. It also seems that if<br />
results <strong>and</strong> outcomes of research do not c<strong>on</strong>form<br />
to prevailing beliefs, such results <strong>and</strong><br />
outcomes are easily overlooked.<br />
The use of ineffective <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s<br />
is costly, not <strong>on</strong>ly in terms of raising false<br />
hopes or running <str<strong>on</strong>g>the</str<strong>on</strong>g> risk of injuring <str<strong>on</strong>g>the</str<strong>on</strong>g> pers<strong>on</strong><br />
with PIMD, but also in m<strong>on</strong>etary terms.<br />
Quite a number of <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s,<br />
especially some of those based <strong>on</strong> refuted<br />
models of human behavior such as Therapeutic<br />
Touch, start with training sessi<strong>on</strong>s or workshops<br />
for those who will apply <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>.<br />
These training sessi<strong>on</strong>s or workshops are<br />
not cheap. Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>rmore, some of <str<strong>on</strong>g>the</str<strong>on</strong>g>se <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s use expensive equipment,<br />
while o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs are not costly in terms of<br />
material but are costly in terms of time. As a<br />
result of <str<strong>on</strong>g>the</str<strong>on</strong>g> lack of research, <str<strong>on</strong>g>the</str<strong>on</strong>g> expenditure<br />
by services <strong>on</strong> such <str<strong>on</strong>g>the</str<strong>on</strong>g>rapies may not be based<br />
<strong>on</strong> rati<strong>on</strong>al decisi<strong>on</strong>s, <strong>and</strong> could actually c<strong>on</strong>flict<br />
with <strong>and</strong> undermine <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of<br />
support. The lack of ‘evidence-based’ <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s for people with PIMD<br />
makes services vulnerable: if services are unable<br />
to dem<strong>on</strong>strate <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
care, <str<strong>on</strong>g>the</str<strong>on</strong>g> willingness of those who are resp<strong>on</strong>sible<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g> actual costs (such as health insurers,<br />
or local systems providing financial assistance)<br />
will decrease or decline.<br />
Studying <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s<br />
for individuals with PIMD is timec<strong>on</strong>suming<br />
<strong>and</strong> methodologically complicated.<br />
Therefore we need an efficient<br />
research strategy to separate <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s that are actually beneficial to<br />
people with PIMD from those that are that are<br />
damaging, or have no effect at all but do<br />
c<strong>on</strong>sume time <strong>and</strong> m<strong>on</strong>ey. A logical starting<br />
point would be an investigati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s that are used most frequently.<br />
Ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r approach could be to examine <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
type of claim that is made. It can be argued<br />
that a claim that feelings of wellbeing or relaxati<strong>on</strong><br />
improvement is of little c<strong>on</strong>cern relative<br />
to a claim for restored functi<strong>on</strong>s or for<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> stimulati<strong>on</strong> of cognitive or motor development.<br />
The str<strong>on</strong>ger <str<strong>on</strong>g>the</str<strong>on</strong>g> claim, <str<strong>on</strong>g>the</str<strong>on</strong>g> more reas<strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>re is to determine whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r or not this<br />
Therapeutic Interventi<strong>on</strong>s / 339
claim is truthful. If a claim for <str<strong>on</strong>g>the</str<strong>on</strong>g> restorati<strong>on</strong><br />
of functi<strong>on</strong>s is made, at least two thorough<br />
between-group design experiments should be<br />
expected. With more modest claims, a series<br />
of single-case experiments (preferably with a<br />
waiting-list c<strong>on</strong>trol group) would be sufficient.<br />
It is also possible that <str<strong>on</strong>g>the</str<strong>on</strong>g> positive anecdotal<br />
evidence for some of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>s relates<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> social-emoti<strong>on</strong>al interacti<strong>on</strong>s between<br />
staff <strong>and</strong> service users – regardless of <str<strong>on</strong>g>the</str<strong>on</strong>g> materials<br />
or ‘treatment’. Therefore ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r interesting<br />
area for research could be <str<strong>on</strong>g>the</str<strong>on</strong>g> study<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> interacti<strong>on</strong>s that occur while applying<br />
treatments such as Shantala Massage,<br />
Snoezelen, Therapeutic Touch or Hapt<strong>on</strong>omy.<br />
In some of <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s<br />
that are used, an ‘approach’ is stated <strong>and</strong><br />
no clear directi<strong>on</strong>s, for example, a manual or<br />
guidelines for its use, are given. The availability<br />
of a manual or guidelines for <str<strong>on</strong>g>the</str<strong>on</strong>g> use of an<br />
interventi<strong>on</strong> is necessary for evaluati<strong>on</strong>. The<br />
lack of such guidelines means that a well-designed<br />
evaluati<strong>on</strong> study will be impossible.<br />
The above-menti<strong>on</strong>ed research efforts must<br />
be accompanied by fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r discussi<strong>on</strong> about<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> treatment forms used specifically by parents<br />
ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r within <str<strong>on</strong>g>the</str<strong>on</strong>g> home (such as Brain<br />
Net) or outside (such as hyperbaric oxygen<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy). This does not mean that <str<strong>on</strong>g>the</str<strong>on</strong>g>se types<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong> should be advised<br />
against in all cases. We need to be open to new<br />
ideas as well as to ideas that still lack scientific<br />
underpinning, but <str<strong>on</strong>g>the</str<strong>on</strong>g> rhetoric about <str<strong>on</strong>g>the</str<strong>on</strong>g> suitability<br />
<strong>and</strong> possible efficacy of <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s<br />
that are new or have not been<br />
validated must be replaced by empirical studies<br />
<strong>and</strong> an analysis of <str<strong>on</strong>g>the</str<strong>on</strong>g> functi<strong>on</strong>al role of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
interventi<strong>on</strong> in <str<strong>on</strong>g>the</str<strong>on</strong>g> measured outcome.<br />
Thereby, we can differentiate between wellintended<br />
but ungrounded <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s that<br />
are effective <strong>and</strong> beneficial <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>refore may<br />
provide sound ‘treatment’ opti<strong>on</strong>s for people<br />
with PIMD.<br />
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Received: 25 October 2006<br />
Initial Acceptance: 8 January 2007<br />
Final Acceptance: 1 May 2007<br />
Therapeutic Interventi<strong>on</strong>s / 341
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities, 2008, 43(3), 342–359<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities<br />
Systematic Instructi<strong>on</strong> for Social-Pragmatic Language Skills in<br />
Lunchroom Settings<br />
Maureen E. Angell, Rita L. Bailey, <strong>and</strong> Laura Lars<strong>on</strong><br />
Illinois State University<br />
Abstract: This study involved <str<strong>on</strong>g>the</str<strong>on</strong>g> extensi<strong>on</strong> <strong>and</strong> adaptati<strong>on</strong> of systematic instructi<strong>on</strong>al procedures suggested by<br />
Light <strong>and</strong> Binger (1998) to increase <str<strong>on</strong>g>the</str<strong>on</strong>g> social-pragmatic language skills of five high school students with<br />
moderate cognitive disabilities. Within a single-subject multiple probe research design, we also assessed<br />
interventi<strong>on</strong> effects <strong>on</strong> two skills targeted by classroom teachers. The three primary target behaviors were taking<br />
obligatory turns, taking n<strong>on</strong>obligatory turns, <strong>and</strong> asking partner-focused questi<strong>on</strong>s. The two sec<strong>on</strong>dary target<br />
behaviors were c<strong>on</strong>versing with appropriate eye c<strong>on</strong>tact <strong>and</strong> using appropriate t<strong>on</strong>e of voice in c<strong>on</strong>versati<strong>on</strong>al<br />
speech. Overall, results showed positive effects of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> <strong>on</strong> participants’ skills with some variability in<br />
student performance in generalizati<strong>on</strong> (lunchroom) settings. Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r research <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of various systematic<br />
instructi<strong>on</strong>al strategies <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> social-pragmatic skills of individuals with various disabilities in multiple settings<br />
is recommended.<br />
Students with disabilities, particularly those requiring<br />
augmentative <strong>and</strong> alternative communicati<strong>on</strong><br />
(AAC) systems, often have difficulty<br />
participating in social communicati<strong>on</strong> exhanges<br />
(Furick, 2003; Hatt<strong>on</strong>, 1998). Successful<br />
communicati<strong>on</strong> exchanges in social envir<strong>on</strong>ments<br />
involve competent use of language,<br />
or pragmatic language skills. Pragmatic language<br />
skills have been described as <str<strong>on</strong>g>the</str<strong>on</strong>g> use of<br />
communicati<strong>on</strong> to carry out communicati<strong>on</strong><br />
interacti<strong>on</strong>s in a social envir<strong>on</strong>ment (Levins<strong>on</strong>,<br />
1983). Pragmatics has been defined as<br />
“rules for using language c<strong>on</strong>textually for social<br />
purposes” (Beukelman & Mirenda, 1998,<br />
p. 332). Knowledge <strong>and</strong> skills related to interpreting<br />
<strong>and</strong> sending appropriate n<strong>on</strong>verbal<br />
messages (i.e., eye c<strong>on</strong>tact, facial expressi<strong>on</strong>s,<br />
<strong>and</strong> body language) are also required for competent<br />
use of pragmatic language. Development<br />
<strong>and</strong> use of appropriate social <strong>and</strong> pragmatic<br />
language skills is important to<br />
maximizing <str<strong>on</strong>g>the</str<strong>on</strong>g> quality of life of students with<br />
intellectual disabilities. Appropriate communicati<strong>on</strong><br />
interacti<strong>on</strong>s am<strong>on</strong>g peers with <strong>and</strong><br />
Corresp<strong>on</strong>dence c<strong>on</strong>cerning this article should<br />
be addressed to Maureen E. Angell, Illinois State<br />
University, Department of Special Educati<strong>on</strong>, Campus<br />
Box 5910, Normal, IL 61790-5910.<br />
342 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
without disabilities are important for developing<br />
meaningful relati<strong>on</strong>ships.<br />
Unfortunately, students with intellectual<br />
disabilities often experience difficulties in interacting<br />
successfully with peers (DeGeorge,<br />
1998). According to <str<strong>on</strong>g>the</str<strong>on</strong>g> Nati<strong>on</strong>al Joint Committee<br />
<strong>on</strong> Learning Disabilities (1998), people<br />
with intellectual disabilities often dem<strong>on</strong>strate<br />
problems in self-regulatory behaviors, social<br />
percepti<strong>on</strong>s, <strong>and</strong> social <strong>and</strong> pragmatic interacti<strong>on</strong>s.<br />
The development of appropriate sociorelati<strong>on</strong>al<br />
skills plays a key role in <str<strong>on</strong>g>the</str<strong>on</strong>g> development<br />
of communicative competence<br />
(Light, Binger, Agate, & Ramsay, 1999). This<br />
may be a particularly important skill for<br />
school-age children, as behavior <strong>and</strong> communicati<strong>on</strong><br />
patterns developed during <str<strong>on</strong>g>the</str<strong>on</strong>g> school<br />
years may impact students’ ability to form <strong>and</strong><br />
maintain relati<strong>on</strong>ships <strong>and</strong> friendships for a<br />
lifetime.<br />
Making friends is a natural result of human<br />
interacti<strong>on</strong> that involves many complex verbal<br />
<strong>and</strong> n<strong>on</strong>verbal transacti<strong>on</strong>s (DeGeorge,<br />
1998). Impaired development of social <strong>and</strong><br />
pragmatic language skills may negatively affect<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> forging of friendships between students<br />
with <strong>and</strong> without disabilities. Typical interacti<strong>on</strong>s<br />
between peers with <strong>and</strong> without disabilities<br />
have been reported as ‘asymmetrical’<br />
with more of <str<strong>on</strong>g>the</str<strong>on</strong>g> communicati<strong>on</strong> resp<strong>on</strong>sibil-
ity being <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> communicati<strong>on</strong> partner without<br />
disabilities (Ratcliff & Cress, 1998). Individuals<br />
with disabilities have also been<br />
reported to experience more frequent communicati<strong>on</strong><br />
breakdowns <strong>and</strong> greater difficulty<br />
in using communicati<strong>on</strong> repair strategies than<br />
peers without disabilities (Fishman, Timler, &<br />
Yoder, 1985; Kraat, 1985). These social <strong>and</strong><br />
pragmatic language difficulties can be detrimental<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> social success of students with<br />
communicati<strong>on</strong> impairments.<br />
During school days, a greater number of<br />
opportunities for naturalistic social interacti<strong>on</strong>s<br />
often occur during traditi<strong>on</strong>ally n<strong>on</strong>academic<br />
times such as recess <strong>and</strong> lunch. School<br />
lunchtimes are typically social times, when students<br />
typically interact while c<strong>on</strong>suming <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
meals. Unstructured, naturalistic communicati<strong>on</strong><br />
times may pose a greater challenge for<br />
students with impaired social <strong>and</strong> pragmatic<br />
language skills than more structured academic<br />
settings (Beukelman, & Mirenda,<br />
1998). Yet, <str<strong>on</strong>g>the</str<strong>on</strong>g>se naturalistic social times may<br />
also provide w<strong>on</strong>derful opportunities for<br />
learning <strong>and</strong> generalizing social <strong>and</strong> pragmatic<br />
language skills.<br />
Often, students with impaired social <strong>and</strong><br />
pragmatic skills require additi<strong>on</strong>al support to<br />
develop <str<strong>on</strong>g>the</str<strong>on</strong>g>se important language skills. Interacti<strong>on</strong><br />
patterns between students with disabilities<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir peers in inclusive settings have<br />
been well-researched (e.g., Chadsey-Rusch,<br />
1990; Evans, Salisbury, Palombaro, Berryman,<br />
& Hollowood; 1992; Hanline, 1993; Hughes,<br />
1999; Mu, Siegel, & Allinder, 2000). Collectively,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> research has dem<strong>on</strong>strated that although<br />
students with disabilities <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
peers may be in physical proximity to <strong>on</strong>e<br />
ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r, limited social interacti<strong>on</strong> occurs between<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>m without direct programming or<br />
supports by interventi<strong>on</strong>ists.<br />
Many students with disabilities exhibit inappropriate<br />
pragmatic behaviors that may prevent<br />
social interacti<strong>on</strong>. There is evidence that<br />
social interacti<strong>on</strong> between students with disabilities<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir peers benefit from structured<br />
facilitati<strong>on</strong> techniques that enhance<br />
communicati<strong>on</strong> interacti<strong>on</strong>s <strong>and</strong> relati<strong>on</strong>ships.<br />
In additi<strong>on</strong> to promoting social gains,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> research suggests that interventi<strong>on</strong> strategies<br />
can also have academic benefits for students<br />
with disabilities (e.g., Brown & Holvoet,<br />
1982; Haring, Breen, Pitts-C<strong>on</strong>way, Lee, &<br />
Gaylord-Ross, 1987; Kamps, Locke, Delquadri,<br />
& Hall, 1989; McD<strong>on</strong>nell, Mathot-Buckner, &<br />
Thors<strong>on</strong>, 2001; Strain, Kerr, & Ragl<strong>and</strong>,<br />
1979). McGee, Almeida, Sulzer-Azaroff, <strong>and</strong><br />
Feldman (1992) evaluated <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of peer<br />
incidental teaching as a strategy for increasing<br />
reciprocal peer interacti<strong>on</strong>s in students with<br />
disabilities that adversely affected <str<strong>on</strong>g>the</str<strong>on</strong>g>ir pragmatic<br />
communicati<strong>on</strong> skills. While gains were<br />
made in number <strong>and</strong> quality of communicati<strong>on</strong><br />
interacti<strong>on</strong>s in an academic setting in this<br />
study, <str<strong>on</strong>g>the</str<strong>on</strong>g>se gains did not generalize to school<br />
mealtimes.<br />
Use of systematic instructi<strong>on</strong> has been<br />
shown to be effective in facilitating skills acquisiti<strong>on</strong><br />
for students with disabilities. One<br />
such program (Light & Binger, 1998) was designed<br />
specifically to enhance communicative<br />
competence for youths with disabilities across<br />
multiple pragmatic-social communicati<strong>on</strong> areas.<br />
This program describes systematic instructi<strong>on</strong>al<br />
procedures for teaching students who<br />
use AAC systems how to use introducti<strong>on</strong> strategies,<br />
improve communicati<strong>on</strong> turn-taking,<br />
<strong>and</strong> increase <str<strong>on</strong>g>the</str<strong>on</strong>g>ir use of partner-focused<br />
questi<strong>on</strong>s. The program also includes a descripti<strong>on</strong><br />
of how instructi<strong>on</strong>al procedures can<br />
be adapted to specifically teach specific communicati<strong>on</strong><br />
skills.<br />
Light’s <strong>and</strong> Binger’s (1998) program has<br />
been used effectively with multiple groups of<br />
individuals who use AAC systems (e.g., Light,<br />
Binger, Agate, et al., 1999; Light, Binger, Dilg,<br />
et al., 1996). This program has been used<br />
successfully across several academic settings.<br />
However, generalizati<strong>on</strong> of classroom-based<br />
systematic instructi<strong>on</strong>al programs in specific<br />
pragmatic language <strong>and</strong> social skills development<br />
have not been evaluated in less structured<br />
school social settings such as school<br />
lunchrooms.<br />
The purpose of this investigati<strong>on</strong> was to<br />
evaluate <str<strong>on</strong>g>the</str<strong>on</strong>g> applicati<strong>on</strong> of a classroom-based<br />
systematic instructi<strong>on</strong>al program <strong>on</strong> five identified<br />
social <strong>and</strong> pragmatic language skills in a<br />
high school lunchroom envir<strong>on</strong>ment. Specifically,<br />
we adapted Light’s <strong>and</strong> Binger’s (1998)<br />
classroom-based systematic instructi<strong>on</strong> program<br />
to increase our participants’ use of partner-focused<br />
questi<strong>on</strong>s, obligatory turn-taking,<br />
n<strong>on</strong>-obligatory turn-taking, appropriate eye<br />
c<strong>on</strong>tact, <strong>and</strong> appropriate t<strong>on</strong>e of voice.<br />
Social-Pragmatic Language Skills Instructi<strong>on</strong> / 343
TABLE 1<br />
Participants’ Demographic Informati<strong>on</strong><br />
Participant Age Gender Primary Diagnosis<br />
Method<br />
Participants<br />
Five high school students, all from <str<strong>on</strong>g>the</str<strong>on</strong>g> same<br />
special educati<strong>on</strong> program, participated in<br />
this study. These students were between 15<br />
<strong>and</strong> 19 years of age. Each had been identified<br />
with moderate cognitive disabilities. Categories<br />
of cognitive disability were established in<br />
compliance with <str<strong>on</strong>g>the</str<strong>on</strong>g> criteria stated in <str<strong>on</strong>g>the</str<strong>on</strong>g> Individuals<br />
with Disabilities Educati<strong>on</strong>s Act (P.L.<br />
105–117). Licensed psychologists <strong>and</strong> students’<br />
eligibility teams had determined <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
students’ classificati<strong>on</strong> via appropriate measures<br />
of general intellectual functi<strong>on</strong>ing <strong>and</strong><br />
adaptive behavior. Each participant primarily<br />
used oral speech as his or her primary communicati<strong>on</strong><br />
mode, but all participants also c<strong>on</strong>sistently<br />
used AAC systems to augment speech<br />
<strong>and</strong> language use at school. These AAC supports<br />
included c<strong>on</strong>sistent use of pers<strong>on</strong>al <strong>and</strong> classroom<br />
visual strategies or aids such as visual<br />
schedules, visual behavior programs, social stories,<br />
communicati<strong>on</strong> boards, sentence completi<strong>on</strong><br />
aids, <strong>and</strong> classroom rules <strong>and</strong> instructi<strong>on</strong>s<br />
(Downing, 1999; Gray & Gar<strong>and</strong>, 1993; Hodgd<strong>on</strong>,<br />
1995). Special educati<strong>on</strong> teachers <strong>and</strong>/or<br />
general educati<strong>on</strong> classroom pers<strong>on</strong>nel identified<br />
participants as having difficulty using appropriate<br />
pragmatic-social communicati<strong>on</strong> skills in<br />
social educati<strong>on</strong> settings. All participants had at<br />
least <strong>on</strong>e Individualized Educati<strong>on</strong> Program<br />
(IEP) goal that suggested deficits in social <strong>and</strong><br />
pragmatic language skills. See Table 1 for participant<br />
demographic characteristics.<br />
Primary Mode of<br />
Communicati<strong>on</strong> Primary AAC Support<br />
Bob 17 Male Fragile-X Verbal Visual strategies <strong>and</strong> supports<br />
TJ 18 Male Mental <strong>and</strong> Cognitive<br />
Impairment<br />
Verbal Visual strategies <strong>and</strong> supports<br />
Devin 19 Male TBI-Cognitive<br />
Verbal Communicati<strong>on</strong> boards/pages<br />
Impairment<br />
Visual supports<br />
Eric 15 Male Down syndrome Verbal Visual strategies <strong>and</strong> supports<br />
Jen 19 Female Cognitive<br />
Impairment<br />
Verbal Visual strategies <strong>and</strong> supports<br />
* Names have been changed to protect c<strong>on</strong>fidentiality<br />
344 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Bob. Bob was a 17-year-old male diagnosed<br />
with Fragile-X syndrome. His primary mode of<br />
communicati<strong>on</strong> with peers <strong>and</strong> teaching staff<br />
was oral speech. His verbal communicati<strong>on</strong><br />
was augmented with pictorial representati<strong>on</strong>s<br />
of items or ideas (i.e., visual strategies) in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
classroom as needed. Bob appeared to have<br />
adequate functi<strong>on</strong>al vocabulary <strong>and</strong> sentence<br />
structure in structured classroom routines. He<br />
initiated <strong>and</strong> resp<strong>on</strong>ded to communicati<strong>on</strong>,<br />
although approximately 80% of his communicati<strong>on</strong><br />
c<strong>on</strong>sisted of resp<strong>on</strong>ses. Bob participated<br />
in structured academic activities <strong>and</strong><br />
frequently took his communicati<strong>on</strong> turns in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se structured educati<strong>on</strong>al settings.<br />
Occasi<strong>on</strong>ally, breakdowns in communicati<strong>on</strong><br />
exchanges were observed when Bob was<br />
in group/classroom situati<strong>on</strong>s. For example,<br />
when he verbally resp<strong>on</strong>ded to questi<strong>on</strong>s from<br />
teaching staff, he often did not make eye c<strong>on</strong>tact,<br />
turned his body away from his communicati<strong>on</strong><br />
partner, <strong>and</strong> used an inappropriately<br />
high pitch <strong>and</strong> sarcastic t<strong>on</strong>e of voice. During<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se times, his sentence length also became<br />
notably reduced. Bob’s Speech-Language Pathologist<br />
(SLP) had instituted a visual prompting<br />
AAC system that c<strong>on</strong>sisted of pictorial<br />
prompts with printed words for each academic<br />
less<strong>on</strong> that functi<strong>on</strong>ed as a sentence<br />
completi<strong>on</strong> strip. The purpose of this system<br />
was to facilitate l<strong>on</strong>ger verbal utterances, but<br />
Bob did not use it without verbal reminders<br />
from teaching staff. Therefore, Bob’s sp<strong>on</strong>taneous<br />
communicati<strong>on</strong> interacti<strong>on</strong>s were often<br />
limited to <strong>on</strong>e- or two-word phrases <strong>and</strong> two
communicati<strong>on</strong> turns (i.e., initiati<strong>on</strong> <strong>and</strong> resp<strong>on</strong>se).<br />
Bob did not use socially appropriate<br />
gestures o<str<strong>on</strong>g>the</str<strong>on</strong>g>r than greetings (i.e., saying “excuse<br />
me”) in appropriate situati<strong>on</strong>s <strong>and</strong> he<br />
appeared to have extreme difficulty reading<br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs’ n<strong>on</strong>verbal or gestural communicati<strong>on</strong>.<br />
His t<strong>on</strong>e of voice was judged as typically inappropriate<br />
<strong>and</strong> characterized by teaching staff<br />
<strong>and</strong> graduate student observers as sarcastic or<br />
negative in most interacti<strong>on</strong>s.<br />
Pragmatic <strong>and</strong> social communicati<strong>on</strong> goals<br />
found in Bob’s IEP included (a) improving<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> ability to read 10 specific n<strong>on</strong>verbal body<br />
gestures <strong>and</strong> explain what <str<strong>on</strong>g>the</str<strong>on</strong>g>y mean, (b) saying<br />
“excuse me” <strong>and</strong> using o<str<strong>on</strong>g>the</str<strong>on</strong>g>r socially appropriate<br />
phrases in a variety of social situati<strong>on</strong>s,<br />
(c) increasing successful use of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
visual sentence completi<strong>on</strong> system to create<br />
l<strong>on</strong>ger utterances, <strong>and</strong> (d) using correct body<br />
orientati<strong>on</strong> when c<strong>on</strong>versing.<br />
TJ. TJ was an 18-year-old male with a moderate<br />
cognitive disability of unknown origin.<br />
His primary mode of communicati<strong>on</strong> was oral<br />
speech. His verbal communicati<strong>on</strong> was augmented<br />
with pictorial representati<strong>on</strong>s of items<br />
or ideas (i.e., visual strategies) in <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom<br />
as needed as well as <str<strong>on</strong>g>the</str<strong>on</strong>g> use of a laminated<br />
page depicting his behavior management<br />
program. This laminated page was used<br />
across school settings. TJ had functi<strong>on</strong>al oral<br />
communicati<strong>on</strong> skills in structured academic<br />
c<strong>on</strong>texts. When his speech was intelligible, he<br />
was able to carry <strong>on</strong> a c<strong>on</strong>versati<strong>on</strong> <strong>and</strong> c<strong>on</strong>vey<br />
<strong>and</strong> receive basic messages successfully. Unfortunately,<br />
his articulati<strong>on</strong> was c<strong>on</strong>sistently<br />
poor, which decreased his intelligibility in<br />
most situati<strong>on</strong>s. TJ did not maintain appropriate<br />
eye c<strong>on</strong>tact when communicating with<br />
peers <strong>and</strong> teaching staff. He habitually spoke<br />
with low intensity <strong>and</strong> his t<strong>on</strong>e of voice was<br />
often judged sarcastic in nature by <str<strong>on</strong>g>the</str<strong>on</strong>g> teaching<br />
staff. TJ’s pragmatic <strong>and</strong> social communicati<strong>on</strong><br />
goals listed in his IEP included (a)<br />
identifying visual cues given by a listener that<br />
indicated a lack of intelligibility <strong>and</strong> self-correcting<br />
those errors, (b) using appropriate<br />
social phrases <strong>and</strong> greetings depending <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
situati<strong>on</strong>, <strong>and</strong> (c) identifying appropriate resp<strong>on</strong>ses<br />
for given situati<strong>on</strong>s.<br />
Devin. Devin was a 19-year-old male with<br />
cognitive impairment due to traumatic brain<br />
injury that occurred in early childhood. His<br />
primary mode of communicati<strong>on</strong> was oral<br />
speech. Devin typically communicated with<br />
staff <strong>and</strong> peers using single <strong>and</strong> multi-word<br />
utterances. He was moderately intelligible in<br />
familiar c<strong>on</strong>texts. To augment his communicati<strong>on</strong>,<br />
Devin utilized communicati<strong>on</strong> boards<br />
that appeared to also functi<strong>on</strong> as a tool for<br />
learning new vocabulary <strong>and</strong> sentence structure.<br />
He sp<strong>on</strong>taneously used several pre-made<br />
communicati<strong>on</strong> boards in classroom activities.<br />
Devin required prompting from teaching staff<br />
to use a visual communicati<strong>on</strong> system that was<br />
intended to cue him to use l<strong>on</strong>ger utterances.<br />
In less structured social settings, Devin c<strong>on</strong>sistently<br />
produced loud speech. During interacti<strong>on</strong>s,<br />
he repeated multiple times any words<br />
or phrases that he appeared to find funny. He<br />
often laughed out loud after producing loud,<br />
repetitious speech. He also c<strong>on</strong>sistently chose<br />
to leave classroom group activities <strong>and</strong> return<br />
to his desk without warning <strong>and</strong> c<strong>on</strong>sistently<br />
required a verbal or visual cue to remind him<br />
to ask permissi<strong>on</strong> to leave a group activity.<br />
Devin did not maintain appropriate eye c<strong>on</strong>tact<br />
during communicati<strong>on</strong> interacti<strong>on</strong>s with<br />
peers or school pers<strong>on</strong>nel. Although no visual<br />
deficits were noted in his case history, Devin<br />
typically oriented his face toward his communicati<strong>on</strong><br />
partner but his eyes appeared to look<br />
toward <str<strong>on</strong>g>the</str<strong>on</strong>g> floor. His t<strong>on</strong>e of voice was observed<br />
to be appropriate during <str<strong>on</strong>g>the</str<strong>on</strong>g> majority<br />
of classroom time, but occasi<strong>on</strong>ally he used a<br />
loud vocal t<strong>on</strong>e which appeared to functi<strong>on</strong> as<br />
a way to entertain his peers. Devin’s t<strong>on</strong>e of<br />
voice was characterized as sounding angry<br />
when he was asked to rejoin group activities<br />
after he had moved away from <str<strong>on</strong>g>the</str<strong>on</strong>g>m. Devin’s<br />
IEP goals related to social <strong>and</strong> pragmatic language<br />
included (a) attempting to correctly<br />
re-pr<strong>on</strong>ounce words when listeners appeared<br />
to misunderst<strong>and</strong>, (b) using a communicati<strong>on</strong><br />
board to create l<strong>on</strong>ger sentences, (c) asking<br />
“May I...”toleave his chair to get materials<br />
or leave work space, <strong>and</strong> (d) reducing <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
number of repetiti<strong>on</strong>s of silly phrases <strong>and</strong><br />
jokes in sp<strong>on</strong>taneous c<strong>on</strong>versati<strong>on</strong>s.<br />
Eric. Eric was a 15-year-old male diagnosed<br />
with Down syndrome. Initial classroom <strong>and</strong><br />
mealtime observati<strong>on</strong>s yielded <str<strong>on</strong>g>the</str<strong>on</strong>g> following<br />
summary of findings: Eric’s primary mode of<br />
communicati<strong>on</strong> was oral speech, augmented<br />
with communicati<strong>on</strong> books <strong>and</strong> visual strategies<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom. He had moderate difficulty<br />
making his wants <strong>and</strong> needs understood<br />
Social-Pragmatic Language Skills Instructi<strong>on</strong> / 345
verbally due to largely unintelligible speech.<br />
He was judged unintelligible by unfamiliar<br />
listeners <strong>and</strong> by familiar listeners in unfamiliar<br />
c<strong>on</strong>texts. Eric’s eye c<strong>on</strong>tact was limited during<br />
initial observati<strong>on</strong>s. When he spoke about a<br />
topic that he initiated, he tended to maintain<br />
appropriate eye c<strong>on</strong>tact. Eye c<strong>on</strong>tact was inc<strong>on</strong>sistent<br />
when communicati<strong>on</strong> interacti<strong>on</strong>s<br />
were initiated by o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs. Eric’s t<strong>on</strong>e of voice<br />
tended to sound m<strong>on</strong>ot<strong>on</strong>ous with limited inflecti<strong>on</strong>.<br />
His IEP communicati<strong>on</strong> goals related<br />
to social <strong>and</strong> pragmatic language included (a)<br />
maintaining appropriate eye c<strong>on</strong>tact with<br />
communicati<strong>on</strong> partners, (b) using a communicati<strong>on</strong><br />
book as needed to clarify or exp<strong>and</strong><br />
his utterances when misunderstood by communicati<strong>on</strong><br />
partners, <strong>and</strong> (c) making requests<br />
to unfamiliar individuals following a verbal<br />
plus visual model in community-based activities.<br />
Jen. Jen was a 19-year-old female diagnosed<br />
with moderate cognitive impairment of<br />
unknown origin. Jen’s primary mode of communicati<strong>on</strong><br />
was oral speech. Her verbal communicati<strong>on</strong><br />
was augmented with pictorial representati<strong>on</strong>s<br />
of items or ideas (i.e., visual<br />
strategies) in <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom as needed. She<br />
spoke in sentences with mostly well-formed<br />
grammatical structures <strong>and</strong> had a large functi<strong>on</strong>al<br />
vocabulary. She appeared to underst<strong>and</strong><br />
most social c<strong>on</strong>versati<strong>on</strong> rules in roleplaying<br />
situati<strong>on</strong>s, but had difficulty following<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se rules in typical c<strong>on</strong>versati<strong>on</strong>. During<br />
communicati<strong>on</strong> interacti<strong>on</strong>s she tended to<br />
talk quietly <strong>and</strong> keep her head down without<br />
making appropriate eye c<strong>on</strong>tact with communicati<strong>on</strong><br />
partners. Jen often made comments<br />
about events or o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs’ acti<strong>on</strong>s that could be<br />
characterized as inappropriate or rude. These<br />
comments appeared to interfere with communicati<strong>on</strong><br />
maintenance. Jen did not maintain<br />
appropriate eye c<strong>on</strong>tact with peers or teaching<br />
staff during initial observati<strong>on</strong>s. Her t<strong>on</strong>e of<br />
voice was described by a member of <str<strong>on</strong>g>the</str<strong>on</strong>g> teaching<br />
staff as “negative <strong>and</strong> sarcastic.” Jen’s<br />
laughing at inappropriate times was also c<strong>on</strong>sistently<br />
noted in initial observati<strong>on</strong>s. Her IEP<br />
goals related to social <strong>and</strong> pragmatic language<br />
included (a) using correct volume during<br />
classroom activities, (b) lifting her head up to<br />
look at <str<strong>on</strong>g>the</str<strong>on</strong>g> pers<strong>on</strong> talking to her, <strong>and</strong> (c)<br />
c<strong>on</strong>trolling her excitement by reducing <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
frequency of exaggerated arm moti<strong>on</strong>s <strong>and</strong><br />
inappropriate laughing episodes.<br />
Research Design <strong>and</strong> Procedure<br />
346 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
We employed a single-subject multiple probe<br />
design across three target social <strong>and</strong> pragmatic<br />
language skills <strong>and</strong> replicated across five<br />
students. Within <str<strong>on</strong>g>the</str<strong>on</strong>g> multiple probe design,<br />
we also assessed effects of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> (a<br />
systematic teaching strategy) <strong>on</strong> two skills that<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> classroom teachers asked <str<strong>on</strong>g>the</str<strong>on</strong>g> research<br />
team to address. The three primary target behaviors<br />
were taking obligatory turns, taking<br />
n<strong>on</strong>obligatory turns, <strong>and</strong> asking partner-focused<br />
questi<strong>on</strong>s. The two sec<strong>on</strong>dary target behaviors<br />
were c<strong>on</strong>versing with appropriate eye<br />
c<strong>on</strong>tact <strong>and</strong> using appropriate t<strong>on</strong>e of voice in<br />
c<strong>on</strong>versati<strong>on</strong>al speech. According to subjective<br />
informati<strong>on</strong> provided by teaching staff<br />
<strong>and</strong> recorded baseline data, <str<strong>on</strong>g>the</str<strong>on</strong>g>se were deficient<br />
skill areas for all participants.<br />
Prior to initiati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> project, graduate<br />
students in a Department of Speech Pathology<br />
<strong>and</strong> Audiology in a midwestern university<br />
were trained in data collecti<strong>on</strong>, systematic instructi<strong>on</strong><br />
methods, <strong>and</strong> role-playing strategies<br />
by members of <str<strong>on</strong>g>the</str<strong>on</strong>g> research team. Graduate<br />
students were instructed to initiate a total of<br />
15 scripted interacti<strong>on</strong> opportunities <strong>and</strong> discretely<br />
document participant resp<strong>on</strong>ses <strong>and</strong><br />
interacti<strong>on</strong>s related to <str<strong>on</strong>g>the</str<strong>on</strong>g> five targeted social<br />
<strong>and</strong> pragmatic communicati<strong>on</strong> skills. Graduate<br />
students were asked to participate as communicati<strong>on</strong><br />
partners <strong>and</strong> resp<strong>on</strong>d as naturalistically<br />
as possible to any communicati<strong>on</strong><br />
attempts made by study participants. They<br />
were fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r instructed in two levels of structured<br />
cues to facilitate participants’ use of<br />
target skills. They were instructed to refrain<br />
from providing additi<strong>on</strong>al verbal or n<strong>on</strong>verbal<br />
communicati<strong>on</strong> facilitati<strong>on</strong> cues. Observati<strong>on</strong><br />
of role-playing scenarios between graduate<br />
students by members of <str<strong>on</strong>g>the</str<strong>on</strong>g> research team was<br />
used to determine training efficacy prior to<br />
initiating <str<strong>on</strong>g>the</str<strong>on</strong>g> project. Training activities c<strong>on</strong>tinued<br />
until all graduate students dem<strong>on</strong>strated<br />
accuracy in project procedures, data<br />
collecti<strong>on</strong>, <strong>and</strong> systematic instructi<strong>on</strong> methods.
Definiti<strong>on</strong>s of Target Behaviors <strong>and</strong> Resp<strong>on</strong>ses<br />
Obligatory turns were defined as turns that<br />
follow a partner’s direct questi<strong>on</strong>s. We defined<br />
n<strong>on</strong>obligatory turns as turns that follow<br />
a partner’s comment or statement or turns<br />
that start a c<strong>on</strong>versati<strong>on</strong>. Taking turns frequently<br />
during interacti<strong>on</strong>s, including those<br />
that are obligatory <strong>and</strong> those that are not<br />
obligatory, is <strong>on</strong>e way for individuals to let<br />
partners know that <str<strong>on</strong>g>the</str<strong>on</strong>g>y are interested <strong>and</strong><br />
involved in <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>versati<strong>on</strong> <strong>and</strong> that <str<strong>on</strong>g>the</str<strong>on</strong>g>y are<br />
competent communicators. Partner-focused<br />
questi<strong>on</strong>s are questi<strong>on</strong>s that individuals ask<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir communicati<strong>on</strong> partners about <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
thoughts, feelings, <strong>and</strong> experiences (Light &<br />
Binger, 1998). Appropriate eye c<strong>on</strong>tact was<br />
defined as SLP graduate student judgment<br />
that a participant’s eye c<strong>on</strong>tact was adequate<br />
to assist <str<strong>on</strong>g>the</str<strong>on</strong>g> participant in c<strong>on</strong>veying his/her<br />
message. Similarly, appropriate t<strong>on</strong>e of voice<br />
was defined as graduate SLP student judgment<br />
that a participant’s t<strong>on</strong>e of voice was<br />
appropriate for <str<strong>on</strong>g>the</str<strong>on</strong>g> resp<strong>on</strong>se, comment, or<br />
questi<strong>on</strong> that was made. Use of an appropriate<br />
t<strong>on</strong>e of voice was scored as correct when t<strong>on</strong>e<br />
of voice was appropriate, whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r or not obligatory<br />
turns, n<strong>on</strong>obligatory resp<strong>on</strong>ses, <strong>and</strong><br />
partner-focused questi<strong>on</strong>s were used correctly.<br />
No resp<strong>on</strong>se was scored as inappropriate t<strong>on</strong>e<br />
of voice. Graduate students used <str<strong>on</strong>g>the</str<strong>on</strong>g> same<br />
probes during each lunchtime data collecti<strong>on</strong><br />
sessi<strong>on</strong>. (See Figure 1 for probe statements or<br />
questi<strong>on</strong>s). Slight variati<strong>on</strong>s in stimulus cues<br />
were listed to allow graduate students to modify<br />
stimulus cues for participants’ unique situati<strong>on</strong>s<br />
<strong>and</strong> in an attempt to keep c<strong>on</strong>versati<strong>on</strong>s<br />
as naturalistic as possible.<br />
Baseline c<strong>on</strong>diti<strong>on</strong> (A). During <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline<br />
c<strong>on</strong>diti<strong>on</strong> (A) within <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>text of <str<strong>on</strong>g>the</str<strong>on</strong>g> multiple<br />
probe design, graduate SLP students observed,<br />
documented, <strong>and</strong> graphically displayed<br />
baseline student performance data for<br />
five specific pragmatic-social communicati<strong>on</strong><br />
behaviors across a minimum of three lunchtime<br />
sessi<strong>on</strong>s per participant. During baseline<br />
observati<strong>on</strong>s, graduate students sat next to or<br />
across from high school student participants.<br />
Interventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong> (B). During <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong> (B), participants engaged<br />
in two c<strong>on</strong>secutive 20-minute systematic group<br />
instructi<strong>on</strong>al sessi<strong>on</strong>s (<strong>on</strong>e instructi<strong>on</strong>al sessi<strong>on</strong><br />
per week) for each of <str<strong>on</strong>g>the</str<strong>on</strong>g> three identified<br />
target social <strong>and</strong> pragmatic language skills<br />
(use of obligatory resp<strong>on</strong>ses, use of n<strong>on</strong>-obligatory<br />
resp<strong>on</strong>ses, <strong>and</strong> asking partner-focused<br />
questi<strong>on</strong>s). These sessi<strong>on</strong>s were led by <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
third author, a graduate SLP student. Instructi<strong>on</strong><br />
targeting use of appropriate eye c<strong>on</strong>tact<br />
<strong>and</strong> t<strong>on</strong>e of voice was introduced <strong>and</strong> reinforced<br />
as a part of every instructi<strong>on</strong>al sessi<strong>on</strong>.<br />
Group instructi<strong>on</strong> was followed by 20-25 minutes<br />
of structured individualized role-play sessi<strong>on</strong>s<br />
provided by individual graduate students,<br />
each assigned to work with a single high<br />
school participant for <str<strong>on</strong>g>the</str<strong>on</strong>g> durati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
project. In order to promote generalizati<strong>on</strong> of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> skill to more naturalistic communicati<strong>on</strong><br />
envir<strong>on</strong>ments, role-playing sessi<strong>on</strong>s were<br />
structured to target <str<strong>on</strong>g>the</str<strong>on</strong>g> social <strong>and</strong> language<br />
skill taught during <str<strong>on</strong>g>the</str<strong>on</strong>g> group instructi<strong>on</strong>al sessi<strong>on</strong>.<br />
To c<strong>on</strong>duct generalizati<strong>on</strong> probes during<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong> (B), graduate students<br />
sat with participants during two lunch<br />
periods per week. Graduate students <strong>and</strong> high<br />
school participants remained paired throughout<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> study to ensure procedural reliability<br />
<strong>and</strong> c<strong>on</strong>sistency across all c<strong>on</strong>diti<strong>on</strong>s. During<br />
each lunchtime sessi<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g> graduate SLP students<br />
initiated 15 scripted communicati<strong>on</strong> opportunities<br />
specifically designed to assess individual<br />
participants’ dem<strong>on</strong>strati<strong>on</strong> of target<br />
social <strong>and</strong> pragmatic language skills taught<br />
during <str<strong>on</strong>g>the</str<strong>on</strong>g> previous instructi<strong>on</strong>al sessi<strong>on</strong>(s)<br />
(see Figure 1). Use of appropriate eye c<strong>on</strong>tact<br />
<strong>and</strong> t<strong>on</strong>e of voice were evaluated in each of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> 15 interacti<strong>on</strong> opportunities. Graduate<br />
students verbally reinforced appropriate use<br />
of social <strong>and</strong> pragmatic language skills targeted<br />
during <str<strong>on</strong>g>the</str<strong>on</strong>g> previous instructi<strong>on</strong>al sessi<strong>on</strong> as <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
documented high school participants’ resp<strong>on</strong>ses<br />
to all 15 stimulus communicati<strong>on</strong> opportunities.<br />
If a participant did not accurately<br />
resp<strong>on</strong>d to an initial opportunity (natural cue),<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> graduate student provided <strong>on</strong>e or two additi<strong>on</strong>al<br />
predetermined levels of prompts designed<br />
to elicit <str<strong>on</strong>g>the</str<strong>on</strong>g> correct resp<strong>on</strong>se. This leveled<br />
prompting system was a simplified versi<strong>on</strong><br />
of Light’s <strong>and</strong> Binger’s (1998) original fourlevel<br />
prompting system. The first prompt c<strong>on</strong>sisted<br />
of an expectant look al<strong>on</strong>g with a repeated<br />
stimulus statement or questi<strong>on</strong>. If this<br />
prompt elicited an appropriate resp<strong>on</strong>se, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
graduate student verbally reinforced <str<strong>on</strong>g>the</str<strong>on</strong>g> high<br />
school student for emitting a correct re-<br />
Social-Pragmatic Language Skills Instructi<strong>on</strong> / 347
sp<strong>on</strong>se, but recorded <str<strong>on</strong>g>the</str<strong>on</strong>g> resp<strong>on</strong>se as incorrect.<br />
If a correct resp<strong>on</strong>se was not elicited with<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> expectant look with repeated stimulus<br />
Figure 1. Probe statements or questi<strong>on</strong>s.<br />
348 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
cue, <str<strong>on</strong>g>the</str<strong>on</strong>g> graduate student modeled <str<strong>on</strong>g>the</str<strong>on</strong>g> correct<br />
resp<strong>on</strong>se for <str<strong>on</strong>g>the</str<strong>on</strong>g> participant. If <str<strong>on</strong>g>the</str<strong>on</strong>g> participant<br />
emitted a correct resp<strong>on</strong>se, <str<strong>on</strong>g>the</str<strong>on</strong>g> graduate
student gave <str<strong>on</strong>g>the</str<strong>on</strong>g> participant positive verbal<br />
reinforcement but recorded <str<strong>on</strong>g>the</str<strong>on</strong>g> initial resp<strong>on</strong>se<br />
as incorrect. Correct resp<strong>on</strong>ses were<br />
recorded <strong>on</strong>ly when participants resp<strong>on</strong>ded<br />
accurately with a natural stimulus cue.<br />
A slightly different prompting system was<br />
used to facilitate appropriate eye c<strong>on</strong>tact <strong>and</strong><br />
t<strong>on</strong>e of voice. The first level prompt remained<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> same, c<strong>on</strong>sisting of an expectant look <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> repetiti<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> stimulus cue. The sec<strong>on</strong>d<br />
level prompt c<strong>on</strong>sisted of pointing to a pictorial<br />
prompt. The first pictorial prompt depicted<br />
a pair of open eyes to prompt <str<strong>on</strong>g>the</str<strong>on</strong>g> participant<br />
to make eye c<strong>on</strong>tact with <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
communicati<strong>on</strong> partner. The graduate student<br />
pointed to <str<strong>on</strong>g>the</str<strong>on</strong>g> picture <strong>and</strong> repeated <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
original stimulus cue, indicating that <str<strong>on</strong>g>the</str<strong>on</strong>g> participant<br />
should resp<strong>on</strong>d again, but with appropriate<br />
eye c<strong>on</strong>tact. The pictorial prompt depicting<br />
use of appropriate voice was a picture<br />
of a face, with an arrow pointing toward <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
mouth <strong>and</strong> throat to facilitate use of appropriate<br />
t<strong>on</strong>e of voice. Participants’ instructi<strong>on</strong> during<br />
each group instructi<strong>on</strong>al <strong>and</strong> individual<br />
role-playing sessi<strong>on</strong> included <str<strong>on</strong>g>the</str<strong>on</strong>g> use of <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
prompting systems, so <str<strong>on</strong>g>the</str<strong>on</strong>g>y were familiar with<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> meaning both pictorial prompts.<br />
When a participant reached his/her predetermined<br />
performance criteri<strong>on</strong> for <strong>on</strong>e target<br />
pragmatic-social communicati<strong>on</strong> skill, instructi<strong>on</strong><br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g> subsequent target skill was<br />
taught during <str<strong>on</strong>g>the</str<strong>on</strong>g> next individual porti<strong>on</strong> of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> instructi<strong>on</strong>al sessi<strong>on</strong>, following <str<strong>on</strong>g>the</str<strong>on</strong>g> roleplaying<br />
activity. The research team made an a<br />
priori decisi<strong>on</strong> to disc<strong>on</strong>tinue target skill instructi<strong>on</strong><br />
if a participant did not reach <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
predetermined performance criteri<strong>on</strong> within<br />
four probe sessi<strong>on</strong>s. In this case, <str<strong>on</strong>g>the</str<strong>on</strong>g> team<br />
began instructi<strong>on</strong> for <str<strong>on</strong>g>the</str<strong>on</strong>g> student’s next identified<br />
target skill.<br />
Generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong> (A'). During <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
maintenance (A') c<strong>on</strong>diti<strong>on</strong>, graduate students<br />
c<strong>on</strong>tinued to initiate <str<strong>on</strong>g>the</str<strong>on</strong>g> 15 pragmatic<br />
<strong>and</strong> social language communicati<strong>on</strong> opportunities,<br />
delivered without <str<strong>on</strong>g>the</str<strong>on</strong>g> leveled prompting<br />
system or verbal positive reinforcement.<br />
When <str<strong>on</strong>g>the</str<strong>on</strong>g> (A') c<strong>on</strong>diti<strong>on</strong> was initiated for a<br />
previously targeted social <strong>and</strong> pragmatic language<br />
skill, a new social <strong>and</strong> pragmatic language<br />
skill was systematically taught during<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> instructi<strong>on</strong>al sessi<strong>on</strong>s. Data <strong>on</strong> student resp<strong>on</strong>ses<br />
for all five target areas were collected<br />
during each sessi<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> (A') c<strong>on</strong>diti<strong>on</strong>.<br />
Setting<br />
All instructi<strong>on</strong>al sessi<strong>on</strong>s <strong>and</strong> collecti<strong>on</strong> of participants’<br />
performance data <strong>and</strong> graduate students’<br />
procedural reliability occurred within a<br />
single high school. Instructi<strong>on</strong>al sessi<strong>on</strong>s took<br />
place in a single classroom <strong>on</strong>e morning per<br />
week <strong>and</strong> data collecti<strong>on</strong> for students’ performance<br />
took place in <str<strong>on</strong>g>the</str<strong>on</strong>g> high school lunchroom<br />
two days per week. Graduate students<br />
sat with <str<strong>on</strong>g>the</str<strong>on</strong>g> same assigned participant during<br />
all instructi<strong>on</strong>al <strong>and</strong> data collecti<strong>on</strong> sessi<strong>on</strong>s.<br />
Interrater Performance <strong>and</strong> Procedural Reliability<br />
Participant performance data <strong>and</strong> graduate<br />
student procedural reliability data were collected<br />
by additi<strong>on</strong>al graduate SLP students<br />
trained as interraters. These interraters were<br />
not o<str<strong>on</strong>g>the</str<strong>on</strong>g>rwise involved in <str<strong>on</strong>g>the</str<strong>on</strong>g> investigati<strong>on</strong>.<br />
One research team member trained <str<strong>on</strong>g>the</str<strong>on</strong>g>se students<br />
in scoring interventi<strong>on</strong>ists’ procedures<br />
<strong>and</strong> participant resp<strong>on</strong>ses. During lunchtime<br />
data collecti<strong>on</strong> sessi<strong>on</strong>s, interraters sat close<br />
enough to <str<strong>on</strong>g>the</str<strong>on</strong>g> high school participants <strong>and</strong><br />
graduate SLP communicati<strong>on</strong> partners to<br />
hear communicati<strong>on</strong> exchanges. They did not<br />
make eye c<strong>on</strong>tact or engage ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r <str<strong>on</strong>g>the</str<strong>on</strong>g> graduate<br />
student or participant in c<strong>on</strong>versati<strong>on</strong>;<br />
however, <str<strong>on</strong>g>the</str<strong>on</strong>g>y were instructed to resp<strong>on</strong>d appropriately<br />
to communicati<strong>on</strong> attempts initiated<br />
by participants.<br />
Results<br />
Overall results indicated that <str<strong>on</strong>g>the</str<strong>on</strong>g> group systematic<br />
instructi<strong>on</strong>al strategy involving individualized<br />
role playing was effective in improving<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> social-pragmatic skills of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
participants. Generalizati<strong>on</strong> probes in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
high school lunchroom revealed variable results<br />
across participants. See Figures 2 to 6 for<br />
graphic displays of individual participants’<br />
performance data. These figures show data for<br />
three primary target behaviors <strong>and</strong> sec<strong>on</strong>dary<br />
behaviors assessed within <str<strong>on</strong>g>the</str<strong>on</strong>g> single-subject<br />
multiple probe design. Experimental c<strong>on</strong>trol<br />
was established as all participants dem<strong>on</strong>strated<br />
a change in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir target behaviors <strong>on</strong>ly<br />
when <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was applied to each<br />
behavior within <str<strong>on</strong>g>the</str<strong>on</strong>g> multiple probe design.<br />
Social-Pragmatic Language Skills Instructi<strong>on</strong> / 349
Bob’s Performance Data Related to Primary Target<br />
Behaviors<br />
As shown in Figure 2, Bob used obligatory<br />
turns appropriately with a mean of 44% during<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> baseline c<strong>on</strong>diti<strong>on</strong> (A). During C<strong>on</strong>diti<strong>on</strong><br />
B, Bob’s mean use of obligatory turns<br />
was measured at 45%, a mean increase of 1%.<br />
With generalizati<strong>on</strong> probes (A'), Bob’s use of<br />
obligatory turns increased to a mean 71% of<br />
opportunities. A total mean increase of 27%<br />
in use of obligatory turns was measured from<br />
baseline through generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s.<br />
Baseline data for Bob’s use of n<strong>on</strong>obligatory<br />
turns was measured at a mean 38%. During<br />
C<strong>on</strong>diti<strong>on</strong> B, Bob’s mean appropriate use of<br />
n<strong>on</strong>obligatory turns was measured at 70%.<br />
During <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong> (A'), Bob<br />
decreased his use of n<strong>on</strong>obligatory turns at a<br />
mean 2%, resulting in a mean use of 62%. A<br />
total mean increase of 24% in use of appropriate<br />
n<strong>on</strong>obligatory turns was measured from<br />
baseline through generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s.<br />
Bob used appropriate partner-focused questi<strong>on</strong>s<br />
in a mean 31% of opportunities during<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> baseline c<strong>on</strong>diti<strong>on</strong> (A). This mean increased<br />
to 35% during <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong><br />
(B). Bob’s mean use of appropriate<br />
partner-focused questi<strong>on</strong>s increased during<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong> (A') c<strong>on</strong>diti<strong>on</strong> to a mean<br />
40% of opportunities. This resulted in a mean<br />
9% increase from baseline through generalizati<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong>s.<br />
Bob’s Performance Data Related to Eye C<strong>on</strong>tact<br />
<strong>and</strong> T<strong>on</strong>e of Voice<br />
Bob’s mean percentage gain of appropriate<br />
eye c<strong>on</strong>tact from <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline through generalizati<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong>s was 6% with opportunities<br />
for taking obligatory turns <strong>and</strong> 13% with<br />
opportunities for taking n<strong>on</strong>obligatory turns.<br />
His percentage of appropriate eye c<strong>on</strong>tact decreased<br />
2% with opportunities for asking partner-focused<br />
questi<strong>on</strong>s from baseline through<br />
generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s.<br />
Bob’s use of appropriate t<strong>on</strong>e of voice with<br />
opportunities for taking obligatory turns decreased<br />
by 9% throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> program. With<br />
opportunities for taking n<strong>on</strong>obligatory turns,<br />
Bob dem<strong>on</strong>strated no mean increase in his use<br />
of appropriate t<strong>on</strong>e of voice from baseline<br />
through generalizati<strong>on</strong>, although he increased<br />
350 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
performance <strong>on</strong> this behavior during <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong>. Bob also dem<strong>on</strong>strated a<br />
mean decrease of 15% in his use of appropriate<br />
t<strong>on</strong>e of voice from baseline through generalizati<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong>s with opportunities for asking<br />
partner-focused questi<strong>on</strong>s.<br />
TJ’s Performance Data Related to Primary Target<br />
Behavior<br />
During C<strong>on</strong>diti<strong>on</strong> A, TJ exhibited use of appropriate<br />
obligatory turns at a mean rate of<br />
84% of opportunities. This mean decreased<br />
during C<strong>on</strong>diti<strong>on</strong> B to a rate of 70%. In C<strong>on</strong>diti<strong>on</strong><br />
A', TJ’s mean use of appropriate obligatory<br />
turns occurred at a mean 98% of opportunities.<br />
This resulted in a total mean increase<br />
of 14% from <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline through generalizati<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong>s. See Figure 3 for TJ’s performance<br />
data.<br />
TJ’s mean use of appropriate n<strong>on</strong>obligatory<br />
turns in <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline c<strong>on</strong>diti<strong>on</strong> (A) occurred<br />
at a mean rate of 58% of opportunities. During<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> instructi<strong>on</strong>al c<strong>on</strong>diti<strong>on</strong> (B), this mean<br />
rate increased to 70%. In <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong> (A') his mean use of appropriate<br />
n<strong>on</strong>obligatory turns occurred at a rate of 86%<br />
of opportunities, resulting in a total mean<br />
increase of 28%.<br />
In <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline c<strong>on</strong>diti<strong>on</strong> (A), TJ’s use of<br />
appropriate partner-focused questi<strong>on</strong>s occurred<br />
at a mean rate of 22%. This mean<br />
increased to 53% during <str<strong>on</strong>g>the</str<strong>on</strong>g> instructi<strong>on</strong>al<br />
c<strong>on</strong>diti<strong>on</strong> (B). In <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong><br />
(A'), TJ’s mean use of appropriate partnerfocused<br />
questi<strong>on</strong>s occurred at a rate of 35% of<br />
opportunities with a total mean increase of<br />
13% across all c<strong>on</strong>diti<strong>on</strong>s.<br />
TJ’s Performance Data Related to Eye C<strong>on</strong>tact <strong>and</strong><br />
T<strong>on</strong>e of Voice<br />
Figure 3 shows TJ’s performance data across<br />
c<strong>on</strong>diti<strong>on</strong>s for eye c<strong>on</strong>tact <strong>and</strong> t<strong>on</strong>e of voice.<br />
With opportunities for taking obligatory<br />
turns, TJ dem<strong>on</strong>strated a total mean increase<br />
of 41% in <str<strong>on</strong>g>the</str<strong>on</strong>g> use of appropriate eye c<strong>on</strong>tact.<br />
He increased appropriate eye c<strong>on</strong>tact by a<br />
mean 50% across c<strong>on</strong>diti<strong>on</strong>s with opportunities<br />
for taking n<strong>on</strong>obligatory turns. With opportunities<br />
for asking partner-focused questi<strong>on</strong>s,<br />
TJ’s mean use of appropriate eye
Figure 2. Bob’s performance data.<br />
Social-Pragmatic Language Skills Instructi<strong>on</strong> / 351
Figure 3. TJ’s performance data.<br />
352 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008
c<strong>on</strong>tact increased 41% from baseline through<br />
generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s.<br />
TJ’s use of appropriate t<strong>on</strong>e of voice increased<br />
64% throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> program with<br />
opportunities for taking obligatory turns.<br />
With opportunities for taking n<strong>on</strong>obligatory<br />
turns, TJ dem<strong>on</strong>strated a mean increase of<br />
73% use of appropriate t<strong>on</strong>e of voice across all<br />
c<strong>on</strong>diti<strong>on</strong>s. TJ’s mean use of appropriate t<strong>on</strong>e<br />
of voice increased a mean 53% across c<strong>on</strong>diti<strong>on</strong>s<br />
as measured within his program related<br />
to asking partner-focused questi<strong>on</strong>s.<br />
Devin’s Performance Data Related to Primary<br />
Target Behaviors<br />
As shown in Figure 4, baseline data revealed<br />
Devin’s mean use of obligatory turns at 16% of<br />
opportunities. His mean use of appropriate<br />
obligatory turns increased to a mean 40% during<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> instructi<strong>on</strong>al c<strong>on</strong>diti<strong>on</strong> <strong>and</strong> his obligatory<br />
turn-taking dramatically increased to a<br />
mean 80% of opportunities in <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong>. An overall 64% increase in<br />
Devin’s mean use of obligatory turns was recorded<br />
from baseline through generalizati<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong>s.<br />
Baseline (A) data for Devin’s n<strong>on</strong>obligatory<br />
turn-taking showed a mean rate of 49% of<br />
opportunities. His mean n<strong>on</strong>obligatory turntaking<br />
decreased 4% during <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong> (B), but increased to a mean 84%<br />
of opportunities during <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong> (A'). This represents a mean 35%<br />
increase from baseline through generalizati<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong>s for Devin’s n<strong>on</strong>obligatory turn-taking.<br />
Devin’s mean use of partner-focused questi<strong>on</strong>s<br />
during <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline c<strong>on</strong>diti<strong>on</strong> was measured<br />
at 25% of opportunities. During <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
interventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>, his use of partner-focused<br />
questi<strong>on</strong>s increased to a mean 35% of<br />
opportunities. However, Devin’s mean use of<br />
partner-focused questi<strong>on</strong>s decreased to 28%<br />
of opportunities during <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong> (A'). This represented an overall<br />
mean 3% increase for Devin’s use of partnerfocused<br />
questi<strong>on</strong>s.<br />
Devin’s Performance Data Related to Eye C<strong>on</strong>tact<br />
<strong>and</strong> T<strong>on</strong>e of Voice<br />
Figure 4 also shows Devin’s performance data<br />
related to appropriate eye c<strong>on</strong>tact <strong>and</strong> t<strong>on</strong>e of<br />
voice within c<strong>on</strong>versati<strong>on</strong>s. Given opportunities<br />
for taking obligatory turns, Devin dem<strong>on</strong>strated<br />
a total increase of 55% mean use of<br />
appropriate eye c<strong>on</strong>tact from <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline<br />
c<strong>on</strong>diti<strong>on</strong> (A) through <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong><br />
(A'). Throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> program, he also<br />
showed a mean increase of 49% in his use of<br />
appropriate eye c<strong>on</strong>tact during opportunities<br />
for taking n<strong>on</strong>obligatory turns but he dem<strong>on</strong>strated<br />
an overall mean 1% decrease in his use<br />
of appropriate eye c<strong>on</strong>tact during opportunities<br />
for asking partner-focused questi<strong>on</strong>s.<br />
Devin’s mean use of appropriate t<strong>on</strong>e of<br />
voice increased by 70% from <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline<br />
through generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s within opportunities<br />
for taking obligatory turns <strong>and</strong> increased<br />
by 54% within opportunities for taking<br />
n<strong>on</strong>obligatory turns. Within opportunities<br />
for asking partner-focused questi<strong>on</strong>s, Devin<br />
dem<strong>on</strong>strated an overall increase of 9% for<br />
mean use of appropriate t<strong>on</strong>e of voice<br />
throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> program. See Figure 4 for<br />
Devin’s t<strong>on</strong>e of voice data.<br />
Eric’s Performance Data Related to Primary<br />
Target Behaviors<br />
Baseline data indicate that Eric took obligatory<br />
turns during 72% of opportunities provided<br />
during lunchtime c<strong>on</strong>versati<strong>on</strong>s. During<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>, Eric’s mean use of<br />
obligatory turns increased to 95% of opportunities.<br />
This mean rate decreased to 82% during<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>, representing<br />
a total mean increase of 10% from baseline<br />
through generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s, as shown<br />
in Figure 5.<br />
Eric’s rate of taking n<strong>on</strong>obligatory turns was<br />
measured at a mean 53% of opportunities<br />
during C<strong>on</strong>diti<strong>on</strong> A. During C<strong>on</strong>diti<strong>on</strong> B, his<br />
mean use of appropriate n<strong>on</strong>obligatory turns<br />
increased to a rate of 60% of opportunities.<br />
Eric’s mean use of appropriate n<strong>on</strong>obligatory<br />
turns was measured at a mean 69% during<br />
C<strong>on</strong>diti<strong>on</strong> A'. As seen in Figure 5, Eric increased<br />
his use of n<strong>on</strong>obligatory turns by a<br />
mean 16% from C<strong>on</strong>diti<strong>on</strong> A through C<strong>on</strong>diti<strong>on</strong><br />
A'.<br />
During <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline phase, Eric’s asking of<br />
appropriate partner-focused questi<strong>on</strong>s during<br />
lunchtime c<strong>on</strong>versati<strong>on</strong>s was measured at a<br />
mean rate of 40% of opportunities he had.<br />
During <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>, this mean<br />
Social-Pragmatic Language Skills Instructi<strong>on</strong> / 353
Figure 4. Devin’s performance data.<br />
354 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008
Figure 5. Eric’s performance data.<br />
Social-Pragmatic Language Skills Instructi<strong>on</strong> / 355
decreased to 15%. In <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>,<br />
Eric asked appropriate partner-focused<br />
questi<strong>on</strong>s at a mean rate of 44% of opportunities.<br />
This represented a mean increase of<br />
4% from <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline c<strong>on</strong>diti<strong>on</strong> through <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>.<br />
Eric’s Performance Data Related to Eye C<strong>on</strong>tact<br />
<strong>and</strong> T<strong>on</strong>e of Voice<br />
Eric dem<strong>on</strong>strated a total mean increase of<br />
17% occurred from baseline c<strong>on</strong>diti<strong>on</strong> (A) to<br />
generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong> (A') for mean use of<br />
appropriate eye c<strong>on</strong>tact with opportunities for<br />
taking obligatory turns. With opportunities<br />
for taking n<strong>on</strong>obligatory turns, Eric’s use of<br />
appropriate eye c<strong>on</strong>tact increased a total<br />
mean 11% across <str<strong>on</strong>g>the</str<strong>on</strong>g> three study c<strong>on</strong>diti<strong>on</strong>s.<br />
As seen in Figure 5, a total 24% mean increase<br />
in Eric’s use of appropriate eye c<strong>on</strong>tact occurred<br />
from C<strong>on</strong>diti<strong>on</strong> A through C<strong>on</strong>diti<strong>on</strong><br />
A' with opportunities for asking partner-focused<br />
questi<strong>on</strong>s.<br />
Figure 5 also shows a total mean 17% increase<br />
in Eric’s use of appropriate t<strong>on</strong>e of<br />
voice with opportunities for taking obligatory<br />
turns from <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline c<strong>on</strong>diti<strong>on</strong> through <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>. Eric increased his<br />
use of appropriate t<strong>on</strong>e of voice by 12% across<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> three study c<strong>on</strong>diti<strong>on</strong>s with opportunities<br />
for taking n<strong>on</strong>obligatory turns. A total mean<br />
increase of 20% for Eric’s use of appropriate<br />
t<strong>on</strong>e of voice was noted with opportunities for<br />
asking partner-focused questi<strong>on</strong>s from baseline<br />
through generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s.<br />
Jen’s Performance Data Related to Primary Target<br />
Behavior<br />
As indicated in Figure 6, Jen took appropriate<br />
obligatory turns at a mean appropriately 64%<br />
during <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline c<strong>on</strong>diti<strong>on</strong> (A). During <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
interventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong> (B), her mean rate of<br />
obligatory turn-taking increased to 80%. During<br />
generalizati<strong>on</strong> probes, Jen appropriately<br />
took obligatory turns during 99% of opportunities<br />
provided. Results indicate an accelerating<br />
trend in Jen’s appropriate resp<strong>on</strong>ses when<br />
given opportunities for taking obligatory<br />
turns.<br />
Baseline data for Jen’s n<strong>on</strong>obligatory turntaking<br />
revealed a mean usage of 76%. During<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>, her mean appro-<br />
priate use of n<strong>on</strong>obligatory turns was measured<br />
at 95% of opportunities. Generalizati<strong>on</strong><br />
data showed a slight decrease in n<strong>on</strong>obligatory<br />
turn usage, with a mean of 93% appropriate<br />
resp<strong>on</strong>ding during <str<strong>on</strong>g>the</str<strong>on</strong>g> A' c<strong>on</strong>diti<strong>on</strong>.<br />
Baseline data for Jen’s use of partner-focused<br />
questi<strong>on</strong>s revealed a mean of 34% of<br />
opportunities. A mean of 30% was recorded<br />
during <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong> for her use<br />
of partner-focused questi<strong>on</strong>s. Evaluati<strong>on</strong> of<br />
generalizati<strong>on</strong> of use of partner-focused questi<strong>on</strong>s<br />
found a decrease in Jen’s use of appropriate<br />
partner-focused questi<strong>on</strong>s. A mean appropriate<br />
use of 12% was recorded in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>.<br />
Jen’s Performance Data Related to Eye C<strong>on</strong>tact<br />
<strong>and</strong> T<strong>on</strong>e of Voice<br />
Jen dem<strong>on</strong>strated a mean 54% increase from<br />
baseline (A) to generalizati<strong>on</strong> (A') for use of<br />
appropriate eye c<strong>on</strong>tact during opportunities<br />
for taking obligatory turns. A 35% mean increase<br />
of appropriate eye c<strong>on</strong>tact occurred<br />
across all c<strong>on</strong>diti<strong>on</strong>s during opportunities for<br />
making n<strong>on</strong>obligatory turns. With opportunities<br />
for asking partner-focused questi<strong>on</strong>s, Jen<br />
increased appropriate eye c<strong>on</strong>tact by 48%<br />
from baseline through generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s.<br />
Jen increased her use of appropriate t<strong>on</strong>e of<br />
voice by a mean 30% from baseline through<br />
generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s with opportunities<br />
for taking obligatory turns. She showed a 25%<br />
mean increase in her use of appropriate t<strong>on</strong>e<br />
of voice across all c<strong>on</strong>diti<strong>on</strong>s with opportunities<br />
for taking n<strong>on</strong>obligatory turns. Data also<br />
revealed a mean 21% increase in Jen’s use of<br />
appropriate t<strong>on</strong>e of voice from baseline<br />
through generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s.<br />
Reliability Data<br />
356 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Performance reliability data were collected<br />
during approximately 20% of all sessi<strong>on</strong>s<br />
across all c<strong>on</strong>diti<strong>on</strong>s. Trained graduate students<br />
who were not involved in <str<strong>on</strong>g>the</str<strong>on</strong>g> investigati<strong>on</strong><br />
previously collected interrater data. Overall<br />
interobserver agreement for participant<br />
performance data ranged from 94-100% (M <br />
95.1).<br />
Performance reliability data for Eric were<br />
collected during five out of 22 (22.7%) ses-
Figure 6. Jen’s performance data.<br />
Social-Pragmatic Language Skills Instructi<strong>on</strong> / 357
si<strong>on</strong>s. The mean interobserver agreement rate<br />
for Eric’s performance was 95.2%. Reliability<br />
data for Devin were collected for five out of 22<br />
(22.7%) sessi<strong>on</strong>s. The mean interobserver reliability<br />
rate for Devin’s performance was<br />
95.2%. Performance reliability data for TJ<br />
were collected for four out of 18 (22%) sessi<strong>on</strong>s<br />
<strong>and</strong> revealed a mean interobserver rate<br />
of 97%. Performance reliability data for Jen<br />
were ga<str<strong>on</strong>g>the</str<strong>on</strong>g>red for four out of 22 (18%) sessi<strong>on</strong>s<br />
<strong>and</strong> mean interobserver agreement was<br />
calculated at 94%. Interobserver reliability<br />
data for Bob were collected for four out of 22<br />
(18%) sessi<strong>on</strong>s <strong>and</strong> showed a mean interobserver<br />
agreement rate of 94%.<br />
Data related to procedural reliability were<br />
also collected for approximately 20% of all<br />
sessi<strong>on</strong>s. Independent raters documented<br />
whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r or not graduate students used an attenti<strong>on</strong>al<br />
cue prior to initiating a facilitating<br />
comment or questi<strong>on</strong>, perceived naturalness<br />
of c<strong>on</strong>versati<strong>on</strong>s, use of predetermined cueing<br />
levels, <strong>and</strong> use of positive reinforcement during<br />
interventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s. Results indicated<br />
an overall procedural reliability rating of 96%<br />
across all graduate students. This percentage<br />
indicated an acceptable level of procedural<br />
reliability.<br />
Discussi<strong>on</strong><br />
This study’s results indicate an overall functi<strong>on</strong>al<br />
relati<strong>on</strong>ship between a systematic instructi<strong>on</strong>al<br />
approach <strong>and</strong> increased socialpragmatic<br />
skills for high school students with<br />
moderate cognitive disabilities. Specifically,<br />
participants generally increased <str<strong>on</strong>g>the</str<strong>on</strong>g>ir skills related<br />
to taking obligatory turns, taking n<strong>on</strong>obligatory<br />
turns, asking partner-focused questi<strong>on</strong>s,<br />
using appropriate eye c<strong>on</strong>tact, <strong>and</strong><br />
using appropriate t<strong>on</strong>e of voice. While some<br />
performance variability was indicated, general<br />
improvement was documented in multiple areas<br />
for all participants. Individual learning<br />
<strong>and</strong> pers<strong>on</strong>ality characteristics as well as naturally<br />
occurring distracti<strong>on</strong>s in <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong><br />
setting may have c<strong>on</strong>tributed to this variability.<br />
This study also shows that high school<br />
lunchroom envir<strong>on</strong>ments may serve as naturalistic<br />
settings for facilitating <strong>and</strong> assessing<br />
students’ generalizati<strong>on</strong> of pragmatic-social<br />
language skills. Our results extend <str<strong>on</strong>g>the</str<strong>on</strong>g> find-<br />
ings of McGee <strong>and</strong> colleagues (1992) who<br />
found that peer incidental teaching resulted<br />
in gains by students with disabilities in reciprocal<br />
peer communicative interacti<strong>on</strong>s in an<br />
academic setting but that <str<strong>on</strong>g>the</str<strong>on</strong>g>se skills did not<br />
generalize to school mealtimes. Strategies for<br />
promoting pragmatic-social skills in naturalistic<br />
settings need to be fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r investigated.<br />
We recommend more research investigating<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of various systematic instructi<strong>on</strong>al<br />
strategies <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> social-pragmatic<br />
skills of students of varying ages <strong>and</strong> ability<br />
levels. The current study c<strong>on</strong>tributes to <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
literature base that supports structured facilitati<strong>on</strong><br />
techniques that enhance communicati<strong>on</strong><br />
interacti<strong>on</strong>s <strong>and</strong> relati<strong>on</strong>ships between<br />
students with disabilities <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir peers. However,<br />
we recommend enhancing <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizability<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> current study’s findings by implementing<br />
similar systematic instructi<strong>on</strong>al<br />
procedures to o<str<strong>on</strong>g>the</str<strong>on</strong>g>r populati<strong>on</strong>s <strong>and</strong> settings<br />
such as community-based <strong>and</strong> vocati<strong>on</strong>al educati<strong>on</strong>al<br />
sites. For example, extending <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
findings of Ingersoll, Dvortcsak, Whalen, <strong>and</strong><br />
Sikora (2005) <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of developmental<br />
social-pragmatic language interventi<strong>on</strong><br />
approaches bey<strong>on</strong>d children with autism<br />
spectrum disorders may encourage more research-based<br />
practice in sp<strong>on</strong>taneous speech<br />
<strong>and</strong> communicative interacti<strong>on</strong>s between<br />
peers with <strong>and</strong> without disabilities in naturalistic<br />
envir<strong>on</strong>ments.<br />
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<strong>and</strong> Developmental Disorders, 9, 41–54.<br />
Received: 22 January 2007<br />
Initial Acceptance: 20 March 2007<br />
Final Acceptance: 1 June 2007<br />
Social-Pragmatic Language Skills Instructi<strong>on</strong> / 359
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities, 2008, 43(3), 360–366<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities<br />
Combined Curricular Interventi<strong>on</strong> with Brief H<strong>and</strong>s Down to<br />
Decrease H<strong>and</strong> Mouthing <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> Use of Arm Splints for a<br />
Young Boy with Profound Disabilities<br />
Helen I. Cannella-Mal<strong>on</strong>e<br />
The Ohio State University<br />
Mark F. O’Reilly<br />
The University of Texas at Austin<br />
Jeff Sigafoos<br />
Victoria University of Wellingt<strong>on</strong><br />
Jeffery M. Chan<br />
The University of Texas at Austin<br />
Abstract: H<strong>and</strong> mouthing is highly prevalent in individuals with severe to profound developmental disabilities.<br />
Frequent h<strong>and</strong> mouthing may interfere with appropriate resp<strong>on</strong>ding, have negative health impacts, <strong>and</strong> result<br />
in restrictive interventi<strong>on</strong>s, such as <str<strong>on</strong>g>the</str<strong>on</strong>g> applicati<strong>on</strong> of arm splints, to prevent this challenging behavior. The<br />
c<strong>on</strong>tinuous applicati<strong>on</strong> of arm splints can have negative health outcomes <strong>and</strong> can interfere with daily activities.<br />
The purpose of this study was to replace arm splints with appropriate curricular activities in a 10-year-old boy<br />
with profound disabilities. An interventi<strong>on</strong> package involving <str<strong>on</strong>g>the</str<strong>on</strong>g> provisi<strong>on</strong> of curricular activities <strong>and</strong> a brief<br />
h<strong>and</strong>s down procedure was evaluated using a combined alternating treatments <strong>and</strong> reversal design across<br />
several hours of <str<strong>on</strong>g>the</str<strong>on</strong>g> school day to dem<strong>on</strong>strate <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> reducti<strong>on</strong> of h<strong>and</strong><br />
mouthing. The interventi<strong>on</strong> was successfully implemented across several hours of <str<strong>on</strong>g>the</str<strong>on</strong>g> student’s school day within<br />
his natural school envir<strong>on</strong>ments. Limitati<strong>on</strong>s, implicati<strong>on</strong>s, <strong>and</strong> directi<strong>on</strong>s for future research are discussed.<br />
The prevalence of h<strong>and</strong> mouthing, a form of<br />
stereotypic behavior, has been estimated to<br />
occur in up to 16% of individuals with severe<br />
to profound disabilities (Rast & Jack, 1992).<br />
H<strong>and</strong> mouthing can be detrimental to an individual’s<br />
health, adaptive behavior, <strong>and</strong> social<br />
functi<strong>on</strong>ing (Pelios, Morren, Tesch, & Axelrod,<br />
1999; Wallace, Iwata, Zhou, & Goff,<br />
1999), because it can lead to tissue damage,<br />
hematoma, salivary dermatitis, scarring, <strong>and</strong><br />
skin breakage (Ball, Campbell, & Barkemeyer,<br />
1980; Fisher, Piazza, Bowman, Hanley, & Adelinis,<br />
1997; Luiselli, 1989). It can also interfere<br />
with participati<strong>on</strong> in daily educati<strong>on</strong>al<br />
<strong>and</strong> living activities, because <str<strong>on</strong>g>the</str<strong>on</strong>g> individual’s<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cerning this article should<br />
be addressed to Helen I. Cannella-Mal<strong>on</strong>e, The<br />
Ohio State University, PAES Building, Room A348,<br />
305W17 th Avenue, Columbus, OH 43210. Email:<br />
mal<strong>on</strong>e.175@osu.edu<br />
360 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
h<strong>and</strong>s are c<strong>on</strong>sistently in his or her mouth<br />
(McClure, Moss, McPeters, & Kirkpatrick,<br />
1986). Additi<strong>on</strong>ally, it is c<strong>on</strong>sidered to be socially<br />
maladaptive because of <str<strong>on</strong>g>the</str<strong>on</strong>g> repulsive<br />
sights <strong>and</strong> smells it produces (Real<strong>on</strong>, Favell,<br />
& Cacace, 1995).<br />
A variety of interventi<strong>on</strong>s have been used to<br />
reduce <str<strong>on</strong>g>the</str<strong>on</strong>g> occurrence of h<strong>and</strong> mouthing in<br />
individuals with severe to profound disabilities,<br />
including overcorrecti<strong>on</strong> (Foxx & Azrin,<br />
1973), c<strong>on</strong>tingent sensory reinforcement<br />
(Barmann, 1980; Case-Holden & Hupp,<br />
1989), differential reinforcement of o<str<strong>on</strong>g>the</str<strong>on</strong>g>r behaviors<br />
(Favell, McGimsey, & Schell, 1982; Mc-<br />
Clure et al., 1986), differential reinforcement<br />
in combinati<strong>on</strong> with punishment (Lockwood<br />
& Williams, 1994; Mazaleski, Iwata, Rodgers,<br />
Vollmer, & Zarc<strong>on</strong>e, 1994; Minness, 1980),<br />
envir<strong>on</strong>mental enrichment (Real<strong>on</strong> et al.,<br />
1995), <strong>and</strong> resp<strong>on</strong>se restricti<strong>on</strong> via mechanical<br />
restraint, such as arm splints (Ball et al.,<br />
1980; Luiselli & Waldstein, 1994).
The use of arm splints has been successful<br />
at eliminating h<strong>and</strong> mouthing by preventing<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> individual from being able to move his or<br />
her h<strong>and</strong>s to <str<strong>on</strong>g>the</str<strong>on</strong>g> mouth. While effective as a<br />
preventative strategy, <str<strong>on</strong>g>the</str<strong>on</strong>g> use of arm splints<br />
has several potential disadvantages, including<br />
possible negative impacts <strong>on</strong> health, adaptive<br />
behavior, <strong>and</strong> social functi<strong>on</strong>ing of pers<strong>on</strong>s<br />
who wear <str<strong>on</strong>g>the</str<strong>on</strong>g>m (Fisher et al., 1997; Luiselli,<br />
1989). Additi<strong>on</strong>ally, researchers have found<br />
that l<strong>on</strong>g-term wearing of arm splints can<br />
cause health problems such as b<strong>on</strong>e demineralizati<strong>on</strong>,<br />
shortening of tend<strong>on</strong>s, muscle atrophy,<br />
arrested motor development, c<strong>on</strong>tractures,<br />
<strong>and</strong> restricted circulati<strong>on</strong> (Fisher et al.;<br />
Oliver, Murphy, Hall, Arr<strong>on</strong>, & Leggett,<br />
2003). These findings cast doubt <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> ethical<br />
aspects of <str<strong>on</strong>g>the</str<strong>on</strong>g> l<strong>on</strong>g-term use of arm splints<br />
for reducing h<strong>and</strong> mouthing in individuals<br />
with severe to profound disabilities.<br />
Due to <str<strong>on</strong>g>the</str<strong>on</strong>g> ethical issues raised by <str<strong>on</strong>g>the</str<strong>on</strong>g> use of<br />
arm splints as a preventative interventi<strong>on</strong>, it is<br />
important to examine o<str<strong>on</strong>g>the</str<strong>on</strong>g>r antecedent interventi<strong>on</strong>s<br />
that can be implemented to prevent<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> occurrence of h<strong>and</strong> mouthing. Several<br />
studies have investigated <str<strong>on</strong>g>the</str<strong>on</strong>g> use of various<br />
forms of envir<strong>on</strong>mental enrichment to prevent<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> occurrence of h<strong>and</strong> mouthing. For<br />
example, Vollmer, Marcus, <strong>and</strong> LeBlanc<br />
(1994) provided three individuals with severe<br />
disabilities who engaged in h<strong>and</strong> mouthing<br />
<strong>and</strong> h<strong>and</strong> biting access to an array of highly<br />
preferred stimuli <strong>and</strong> noted decreases in challenging<br />
behavior <strong>and</strong> increases in appropriate<br />
behavior across 10 min sessi<strong>on</strong>s. For <strong>on</strong>e participant,<br />
explicit reinforcement of appropriate<br />
behaviors <strong>and</strong> a brief (5 s) time out was<br />
required. Real<strong>on</strong> et al. (1995) found reducti<strong>on</strong>s<br />
in h<strong>and</strong> mouthing when preferred toys<br />
were c<strong>on</strong>sistently made available to <strong>on</strong>e participant<br />
with profound mental retardati<strong>on</strong><br />
across 5 min sessi<strong>on</strong>s.<br />
Although interventi<strong>on</strong>s have been successful<br />
at reducing challenging behavior, <str<strong>on</strong>g>the</str<strong>on</strong>g>y often<br />
<strong>on</strong>ly examine <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of an interventi<strong>on</strong><br />
over a short period of time (e.g., 10<br />
min) <strong>and</strong> within <strong>on</strong>ly <strong>on</strong>e envir<strong>on</strong>ment. One<br />
purpose of <str<strong>on</strong>g>the</str<strong>on</strong>g> present study was to evaluate<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> effects of an interventi<strong>on</strong> package for<br />
eliminating <str<strong>on</strong>g>the</str<strong>on</strong>g> use of arm splints in a boy with<br />
profound disabilities who had a l<strong>on</strong>g history of<br />
wearing arm splints to prevent h<strong>and</strong> mouthing.<br />
The interventi<strong>on</strong> package included <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
provisi<strong>on</strong> of curricular activities <strong>and</strong> a brief<br />
h<strong>and</strong>s down procedure. A sec<strong>on</strong>d purpose of<br />
this study was to examine <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> across <str<strong>on</strong>g>the</str<strong>on</strong>g> student’s entire<br />
school day in his natural envir<strong>on</strong>ments.<br />
Method<br />
Participant, Settings, <strong>and</strong> Materials<br />
Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w was a 10-year-old, Caucasian boy with<br />
profound mental retardati<strong>on</strong>, cerebral palsy,<br />
<strong>and</strong> hydrocephalus. He did not speak or use<br />
any alternative form of symbolic communicati<strong>on</strong>.<br />
At <str<strong>on</strong>g>the</str<strong>on</strong>g> beginning of this study, Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w<br />
would resp<strong>on</strong>d to <strong>on</strong>e-sentence requests, such<br />
as “Push <str<strong>on</strong>g>the</str<strong>on</strong>g> switch to tell me you’re here”. By<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> time <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was implemented,<br />
he had been taught by his classroom teacher<br />
to resp<strong>on</strong>d to <strong>on</strong>e-sentence requests by pointing<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> correct answer or his choice when<br />
presented with an array of items <strong>and</strong>/or photographs.<br />
He was n<strong>on</strong>-ambulatory <strong>and</strong> spent<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> majority of his school day seated in a<br />
wheel chair or <strong>on</strong> a bean bag or mat <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
floor. Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w was completely dependent <strong>on</strong><br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs for all of his daily functi<strong>on</strong>ing (e.g.,<br />
toileting, feeding, washing, etc.). He attended<br />
a functi<strong>on</strong>al life skills classroom at a school for<br />
individuals with severe to profound developmental<br />
disabilities. When he engaged in h<strong>and</strong><br />
mouthing, his teachers would give him <strong>on</strong>e<br />
verbal warning. After <str<strong>on</strong>g>the</str<strong>on</strong>g> warning, he would<br />
often stop h<strong>and</strong> mouthing for approximately<br />
30 s while looking at <str<strong>on</strong>g>the</str<strong>on</strong>g> teacher, <str<strong>on</strong>g>the</str<strong>on</strong>g>n begin<br />
h<strong>and</strong> mouthing again if no fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r directi<strong>on</strong><br />
or engagement was provided. If he c<strong>on</strong>tinued<br />
to engage in h<strong>and</strong> mouthing, his teachers<br />
would put arm splints <strong>on</strong> both arms. Once <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
arm splints were placed <strong>on</strong> Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w, <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
were generally not removed until <str<strong>on</strong>g>the</str<strong>on</strong>g> end of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> school day when he left <str<strong>on</strong>g>the</str<strong>on</strong>g> school.<br />
All interventi<strong>on</strong> sessi<strong>on</strong>s were c<strong>on</strong>ducted in<br />
Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w’s natural school envir<strong>on</strong>ments,<br />
which included his classroom, <str<strong>on</strong>g>the</str<strong>on</strong>g> library, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
gymnasium, <strong>and</strong> an outdoor playground. Materials<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g> curricular activities included<br />
picture books, n<strong>on</strong>-interlocking puzzles, <strong>and</strong><br />
various pieces of gym equipment, such as<br />
balls.<br />
Combined Curricular Interventi<strong>on</strong> / 361
Target Behavior<br />
H<strong>and</strong> mouthing was defined as <str<strong>on</strong>g>the</str<strong>on</strong>g> inserti<strong>on</strong><br />
of any part of <str<strong>on</strong>g>the</str<strong>on</strong>g> h<strong>and</strong> into <str<strong>on</strong>g>the</str<strong>on</strong>g> mouth or <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
protrusi<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> t<strong>on</strong>gue out of <str<strong>on</strong>g>the</str<strong>on</strong>g> mouth<br />
<strong>on</strong>to <str<strong>on</strong>g>the</str<strong>on</strong>g> h<strong>and</strong>. For a new occurrence of h<strong>and</strong><br />
mouthing to be recorded, Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w’s h<strong>and</strong><br />
had to be completely removed from his<br />
mouth <str<strong>on</strong>g>the</str<strong>on</strong>g>n reinserted or <str<strong>on</strong>g>the</str<strong>on</strong>g> t<strong>on</strong>gue completely<br />
removed from <str<strong>on</strong>g>the</str<strong>on</strong>g> h<strong>and</strong> <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>n reapplied<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> h<strong>and</strong>.<br />
Data Collecti<strong>on</strong> <strong>and</strong> Interobserver Agreement<br />
Data were collected in real time using a scatterplot<br />
data collecti<strong>on</strong> system (Touchette,<br />
MacD<strong>on</strong>ald, & Langer, 1985). Data were collected<br />
during two different time blocks during<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> day. Time Block A (i.e., 11:30–1:00) was<br />
broken into six 15 min intervals, <strong>and</strong> Time<br />
Block B (i.e., 1:00–2:45) was broken into<br />
seven 15 min intervals. During each interval,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> occurrence of h<strong>and</strong> mouthing was indicated<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g> first three occurrences for ease<br />
of data collecti<strong>on</strong> <strong>and</strong> interpretati<strong>on</strong><br />
(Touchette et al.). Therefore, h<strong>and</strong> mouthing<br />
could be scored 18 times in Time Block A <strong>and</strong><br />
21 times in Time Block B.<br />
To determine inter-observer agreement,<br />
two observers (i.e., <str<strong>on</strong>g>the</str<strong>on</strong>g> first author <strong>and</strong> a graduate<br />
student) independently scored data <strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> target behavior for at least 30% of all<br />
sessi<strong>on</strong>s. Data from <str<strong>on</strong>g>the</str<strong>on</strong>g> two observers were<br />
compared for agreements <strong>and</strong> disagreements.<br />
An agreement was scored if both observers<br />
recorded <str<strong>on</strong>g>the</str<strong>on</strong>g> occurrence or n<strong>on</strong>-occurrence<br />
of h<strong>and</strong> mouthing within each 15 min interval.<br />
In <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>, an agreement was<br />
scored if each observer recorded <str<strong>on</strong>g>the</str<strong>on</strong>g> same<br />
number of occurrences of h<strong>and</strong> mouthing<br />
within each 15 min interval. Any discrepancy<br />
between <str<strong>on</strong>g>the</str<strong>on</strong>g> two observers was counted as a<br />
disagreement. Interobserver agreement <strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> dependent measure was calculated <strong>on</strong> an<br />
interval-by-interval basis using <str<strong>on</strong>g>the</str<strong>on</strong>g> formula:<br />
Agreements/(Disagreements Agreements)<br />
100%. Inter-observer agreement data were<br />
collected for 33% of <str<strong>on</strong>g>the</str<strong>on</strong>g> sessi<strong>on</strong>s <strong>and</strong> overall<br />
agreement was calculated to be 96.7% (range<br />
83.3–100%).<br />
Experimental Design<br />
A combinati<strong>on</strong> reversal <strong>and</strong> alternating treatments<br />
design across two time blocks was used<br />
(Kazdin, 1982). During Time Block A, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
reversal design utilized an ABAB reversal pattern,<br />
while Time Block B utilized a n<strong>on</strong>-reversal<br />
ABC pattern.<br />
Interventi<strong>on</strong><br />
362 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
During baseline, Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w’s arm splints were<br />
removed <strong>and</strong> occurrences of h<strong>and</strong> mouthing<br />
were recorded within his natural settings (e.g.,<br />
classroom, gymnasium, library, etc.). His<br />
teachers were asked to do what <str<strong>on</strong>g>the</str<strong>on</strong>g>y would<br />
normally do, but were asked not to put his<br />
arm splints <strong>on</strong>. The first author sat in a corner<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> room <strong>and</strong> observed Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w. During<br />
each 15 min interval, <str<strong>on</strong>g>the</str<strong>on</strong>g> first three occurrences<br />
of h<strong>and</strong> mouthing were recorded <strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> scatterplot data sheet. Once three occurrences<br />
of h<strong>and</strong> mouthing occurred in an interval,<br />
no fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r data were collected during<br />
that interval, <strong>and</strong> data recording resumed at<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> beginning of <str<strong>on</strong>g>the</str<strong>on</strong>g> next 15 min interval.<br />
Baseline data were collected from 11:30 a.m.<br />
to 2:45 p.m. (i.e., Time Blocks A <strong>and</strong> B). During<br />
most baseline sessi<strong>on</strong>s, Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w was<br />
placed in a bean bag or <strong>on</strong> a mat <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> floor<br />
<strong>and</strong> provided ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r free access to <str<strong>on</strong>g>the</str<strong>on</strong>g> televisi<strong>on</strong><br />
or switch activated access to <str<strong>on</strong>g>the</str<strong>on</strong>g> radio or<br />
a book <strong>on</strong> tape. Very little interacti<strong>on</strong> typically<br />
occurred with Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w.<br />
The interventi<strong>on</strong> c<strong>on</strong>sisted of <str<strong>on</strong>g>the</str<strong>on</strong>g> provisi<strong>on</strong><br />
of curricular activities <strong>and</strong> a brief h<strong>and</strong>s down<br />
procedure. During interventi<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g> first author<br />
placed curricular materials within Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w’s<br />
reach <strong>and</strong> waited 10 s for him to initiate<br />
appropriate engagement with <str<strong>on</strong>g>the</str<strong>on</strong>g> materials. If<br />
he did not engage in <str<strong>on</strong>g>the</str<strong>on</strong>g> activity within 10 s, a<br />
least-to-most prompting hierarchy was used to<br />
prompt engagement. Specifically, <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g>rapist<br />
would first provide a verbal prompt (e.g.,<br />
“Ok Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w, let’s work <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> puzzle.”), <str<strong>on</strong>g>the</str<strong>on</strong>g>n<br />
a gestural prompt (e.g., pointing to <str<strong>on</strong>g>the</str<strong>on</strong>g> puzzle),<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>n a model prompt (e.g., placing <strong>on</strong>e<br />
puzzle piece in place), <strong>and</strong> finally a physical<br />
prompt (e.g., guiding his h<strong>and</strong> to pick up <strong>and</strong><br />
place a puzzle piece). Curricular activities presented<br />
to Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w included reading books to<br />
him while he turned <str<strong>on</strong>g>the</str<strong>on</strong>g> pages, having him<br />
complete his choice of n<strong>on</strong>-interlocking puz-
Figure 1. Interventi<strong>on</strong> results for Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w across Time Blocks A <strong>and</strong> B.<br />
zles, going for walks while he pushed himself<br />
in his wheelchair, <strong>and</strong> playing games in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
gymnasium. Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w was provided a choice of<br />
what activity he wanted to engage in by showing<br />
him <str<strong>on</strong>g>the</str<strong>on</strong>g> activities in an array of photographs<br />
<strong>and</strong> having him point to <str<strong>on</strong>g>the</str<strong>on</strong>g> activity he<br />
wanted. All activities were part of his individualized<br />
educati<strong>on</strong>al plan.<br />
When <str<strong>on</strong>g>the</str<strong>on</strong>g> class engaged in group activities,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> first author provided <strong>on</strong>e-<strong>on</strong>-<strong>on</strong>e assistance<br />
to Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w as needed within <str<strong>on</strong>g>the</str<strong>on</strong>g> group<br />
setting. When <str<strong>on</strong>g>the</str<strong>on</strong>g> class engaged in center activities,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> first author provided Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w with<br />
an array of curricular activities to choose from<br />
<strong>and</strong> followed <str<strong>on</strong>g>the</str<strong>on</strong>g> previously described procedures.<br />
If Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w engaged in h<strong>and</strong> mouthing,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> first author immediately removed Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w’s<br />
from his mouth, said “h<strong>and</strong>s down”,<br />
<strong>and</strong> held his h<strong>and</strong>s in his lap for 10 s. Following<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> 10 s, Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w was prompted to engage<br />
with <str<strong>on</strong>g>the</str<strong>on</strong>g> curricular materials.<br />
In <str<strong>on</strong>g>the</str<strong>on</strong>g> reversal back to baseline in Time<br />
Block B, <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers began to interact with<br />
Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w in a manner different than in all<br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>r baseline phases. Therefore, this phase<br />
was relabeled as <str<strong>on</strong>g>the</str<strong>on</strong>g> teacher interventi<strong>on</strong>. Dur-<br />
ing this phase, <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom teacher <strong>and</strong> her<br />
teaching assistants began to include Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w<br />
in regular small group (SG) <strong>and</strong> <strong>on</strong>e-to-<strong>on</strong>e<br />
(1:1) instructi<strong>on</strong>, which <str<strong>on</strong>g>the</str<strong>on</strong>g>y had not d<strong>on</strong>e in<br />
any of <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r baseline sessi<strong>on</strong>s. While <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
teachers did provide curricular activities, <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
did not implement <str<strong>on</strong>g>the</str<strong>on</strong>g> brief h<strong>and</strong>s down procedure.<br />
Additi<strong>on</strong>ally, he was not placed in a<br />
beanbag or <strong>on</strong> a mat during this phase, <strong>and</strong> he<br />
was no l<strong>on</strong>ger given free access to <str<strong>on</strong>g>the</str<strong>on</strong>g> televisi<strong>on</strong><br />
or switch-activated access to <str<strong>on</strong>g>the</str<strong>on</strong>g> radio or<br />
books <strong>on</strong> tape. During 10 of <str<strong>on</strong>g>the</str<strong>on</strong>g> 31 intervals,<br />
Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w was given an independent task <strong>and</strong><br />
was not engaged with <str<strong>on</strong>g>the</str<strong>on</strong>g> teacher, her assistants,<br />
or his peers. The teachers shifted <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
instructi<strong>on</strong> independently <strong>and</strong> without<br />
prompting from <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher. As in all o<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
baseline c<strong>on</strong>diti<strong>on</strong>s, <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers did not apply<br />
Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w’s splints, even when he did engage<br />
in h<strong>and</strong> mouthing.<br />
Results<br />
Figure 1 shows <str<strong>on</strong>g>the</str<strong>on</strong>g> number of occurrences<br />
(up to three per interval) of h<strong>and</strong> mouthing<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g> two time blocks in which daily sessi<strong>on</strong>s<br />
Combined Curricular Interventi<strong>on</strong> / 363
were c<strong>on</strong>ducted. During <str<strong>on</strong>g>the</str<strong>on</strong>g> initial baseline<br />
phase in Time Block A (sessi<strong>on</strong>s 1–12), Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w<br />
engaged in h<strong>and</strong> mouthing an average<br />
of 11.4 times (range 2–18) per sessi<strong>on</strong>. When<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was introduced in Time<br />
Block A (sessi<strong>on</strong>s 13–15), occurrences of h<strong>and</strong><br />
mouthing decreased dramatically to 0–2 occurrences.<br />
Up<strong>on</strong> a return to baseline (sessi<strong>on</strong>s<br />
16–18), h<strong>and</strong> mouthing increased to an average<br />
of 13.7 times (range 6–18) per sessi<strong>on</strong>. In<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> final return to interventi<strong>on</strong> (sessi<strong>on</strong>s 19–<br />
21), h<strong>and</strong> mouthing did not occur <strong>on</strong>ce over<br />
three sessi<strong>on</strong>s.<br />
During <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline phase in Time Block B<br />
(sessi<strong>on</strong>s 1–6), h<strong>and</strong> mouthing occurred an<br />
average of 9 times (range 6–15) per sessi<strong>on</strong>.<br />
When <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was implemented (sessi<strong>on</strong>s<br />
7–12), an immediate decrease in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
occurrence of h<strong>and</strong> mouthing to an average<br />
of 1.3 times (range 0–2) per sessi<strong>on</strong> was observed.<br />
When <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was removed in<br />
sessi<strong>on</strong> 13 <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers began to intervene,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> average occurrence of h<strong>and</strong> mouthing<br />
increased to an average of 5.8 times<br />
(range 3–9) per sessi<strong>on</strong> in <str<strong>on</strong>g>the</str<strong>on</strong>g> remaining five<br />
sessi<strong>on</strong>s. During this last phase in Time Block<br />
B, Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w was out of <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom (na) for<br />
four full sessi<strong>on</strong>s <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> final 15 min interval<br />
for all but <str<strong>on</strong>g>the</str<strong>on</strong>g> first sessi<strong>on</strong>.<br />
Discussi<strong>on</strong><br />
By prompting engagement with curricular materials<br />
<strong>and</strong> implementing a brief h<strong>and</strong>s down<br />
procedure, we were able to remove Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w’s<br />
arm splints <strong>and</strong> maintain low levels of h<strong>and</strong><br />
mouthing across a two hour <strong>and</strong> forty five<br />
minute period in several school envir<strong>on</strong>ments.<br />
Because Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w was not in arm<br />
splints <strong>and</strong> was provided with curricular activities,<br />
he engaged in higher levels of appropriate<br />
behavior. Additi<strong>on</strong>ally, with no training,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> teachers in <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom began to independently<br />
implement <str<strong>on</strong>g>the</str<strong>on</strong>g> curricular comp<strong>on</strong>ent<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> successfully during<br />
Time Block B.<br />
While <str<strong>on</strong>g>the</str<strong>on</strong>g>se results are promising, several<br />
issues should be c<strong>on</strong>sidered. First, we were<br />
<strong>on</strong>ly able to complete this study with <strong>on</strong>e participant.<br />
Although this interventi<strong>on</strong> was successful<br />
with our participant, it is not known if<br />
this procedure would have similar effects with<br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>r students. This study should <str<strong>on</strong>g>the</str<strong>on</strong>g>refore be<br />
364 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
replicated within natural c<strong>on</strong>texts with o<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
participants who have severe to profound disabilities<br />
<strong>and</strong> engage in h<strong>and</strong> mouthing.<br />
A sec<strong>on</strong>d c<strong>on</strong>siderati<strong>on</strong> is that <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong><br />
utilized both a curricular interventi<strong>on</strong><br />
<strong>and</strong> a brief h<strong>and</strong>s down comp<strong>on</strong>ent. One<br />
might argue that, even though both procedures<br />
were in effect, <str<strong>on</strong>g>the</str<strong>on</strong>g> decrease in h<strong>and</strong><br />
mouthing might have been due to <strong>on</strong>ly <strong>on</strong>e<br />
comp<strong>on</strong>ent of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> (i.e., curricular<br />
interventi<strong>on</strong> or brief h<strong>and</strong>s down). Based<br />
<strong>on</strong> all of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> data in both Time<br />
Blocks A <strong>and</strong> B, <str<strong>on</strong>g>the</str<strong>on</strong>g> use of <str<strong>on</strong>g>the</str<strong>on</strong>g> brief h<strong>and</strong>s<br />
down procedure was <strong>on</strong>ly utilized in 10% of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> intervals, <strong>and</strong> implemented<br />
<strong>on</strong>ly 14 times out of 234 possible opportunities.<br />
This might suggest that <str<strong>on</strong>g>the</str<strong>on</strong>g> brief h<strong>and</strong>s<br />
down comp<strong>on</strong>ent of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> could<br />
naturally be faded out as h<strong>and</strong> mouthing c<strong>on</strong>tinued<br />
to decrease. This data also suggests that<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> curricular interventi<strong>on</strong> had a significant<br />
impact <strong>on</strong> h<strong>and</strong> mouthing, as 85% of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
intervals in <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> phases had no<br />
occurrences of h<strong>and</strong> mouthing.<br />
On <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r h<strong>and</strong>, when <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers implemented<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> without <str<strong>on</strong>g>the</str<strong>on</strong>g> brief<br />
h<strong>and</strong>s down comp<strong>on</strong>ent, <str<strong>on</strong>g>the</str<strong>on</strong>g> decrease in h<strong>and</strong><br />
mouthing was not as significant as during interventi<strong>on</strong><br />
sessi<strong>on</strong>s c<strong>on</strong>ducted by <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher.<br />
One reas<strong>on</strong> for <str<strong>on</strong>g>the</str<strong>on</strong>g> decreased effectiveness<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> teacher interventi<strong>on</strong> might be<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers did not implement <str<strong>on</strong>g>the</str<strong>on</strong>g> brief<br />
h<strong>and</strong>s down comp<strong>on</strong>ent. A sec<strong>on</strong>d reas<strong>on</strong> may<br />
be due to <str<strong>on</strong>g>the</str<strong>on</strong>g> fact that <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers were not<br />
trained to implement any comp<strong>on</strong>ent of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
interventi<strong>on</strong>, but simply began to include Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w<br />
in curricular activities. The data do indicate<br />
that when <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers were working with<br />
Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w, he <strong>on</strong>ly engaged in h<strong>and</strong> mouthing<br />
four times out of 63 possible opportunities,<br />
which is an average of less than <strong>on</strong>e occurrence<br />
per sessi<strong>on</strong>. This might suggest that by<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> time <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers began to independently<br />
implement <str<strong>on</strong>g>the</str<strong>on</strong>g> curricular aspect of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> brief h<strong>and</strong>s down procedure was<br />
no l<strong>on</strong>ger necessary. A final reas<strong>on</strong> for <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
increased occurrence during <str<strong>on</strong>g>the</str<strong>on</strong>g> teacher interventi<strong>on</strong><br />
might be that Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w was more<br />
likely to engage in high levels of h<strong>and</strong> mouthing<br />
when given independent tasks that did not<br />
involve any engagement with an adult. Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w<br />
was given such tasks in 10 of <str<strong>on</strong>g>the</str<strong>on</strong>g> 31<br />
teacher interventi<strong>on</strong> sessi<strong>on</strong>s. In <str<strong>on</strong>g>the</str<strong>on</strong>g>se 10 ses-
si<strong>on</strong>s, he engaged in h<strong>and</strong> mouthing an average<br />
of 83% of <str<strong>on</strong>g>the</str<strong>on</strong>g> time, which indicates that<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> teachers were able to implement <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong><br />
effectively when working with Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w,<br />
but that independent seatwork led to a<br />
return to baseline levels of h<strong>and</strong> mouthing.<br />
The above data suggests ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r limitati<strong>on</strong><br />
to this study in that we did not address times<br />
when Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w would be given independent<br />
tasks to complete. During <str<strong>on</strong>g>the</str<strong>on</strong>g> majority of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
baseline c<strong>on</strong>diti<strong>on</strong>s, Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w was allowed free<br />
access to televisi<strong>on</strong> or switch activated access<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> radio or books <strong>on</strong> tape. During <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
times, his h<strong>and</strong> mouthing occurred at high<br />
rates. Although we were able to reduce his<br />
h<strong>and</strong> mouthing by incorporating significantly<br />
more activity into his day, it may not be possible,<br />
or beneficial, for a student to have no<br />
independent or free time during <str<strong>on</strong>g>the</str<strong>on</strong>g> day. It is<br />
possible that a traditi<strong>on</strong>al use of envir<strong>on</strong>mental<br />
enrichment using items that would keep<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> h<strong>and</strong>s occupied would be effective during<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se independent times during <str<strong>on</strong>g>the</str<strong>on</strong>g> day. Future<br />
research should examine <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness<br />
of targeting challenging behavior within<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>text of group work, <strong>on</strong>e-<strong>on</strong>-<strong>on</strong>e work,<br />
<strong>and</strong> independent work.<br />
Ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r limitati<strong>on</strong> to this study is that <str<strong>on</strong>g>the</str<strong>on</strong>g>re<br />
was no clear reversal in Time Block B. This<br />
likely occurred because <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers began<br />
including Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w in <str<strong>on</strong>g>the</str<strong>on</strong>g> small group <strong>and</strong><br />
<strong>on</strong>e-<strong>on</strong>-<strong>on</strong>e activities in Time Block B, which<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y did not do during Time Block A. The<br />
teacher interventi<strong>on</strong> phase in Time Block B<br />
did indicate an increase in h<strong>and</strong> mouthing<br />
from an average of 1.3 times per sessi<strong>on</strong> in<br />
interventi<strong>on</strong> to an average of 5.8 times per<br />
sessi<strong>on</strong> in <str<strong>on</strong>g>the</str<strong>on</strong>g> teacher interventi<strong>on</strong>, though<br />
this was a decrease from <str<strong>on</strong>g>the</str<strong>on</strong>g> initial baseline<br />
phase (average 9 times per sessi<strong>on</strong>). The possible<br />
reas<strong>on</strong>s for this data were explained<br />
above. Although <str<strong>on</strong>g>the</str<strong>on</strong>g> independent change in<br />
teacher behavior did reduce <str<strong>on</strong>g>the</str<strong>on</strong>g> level of experimental<br />
c<strong>on</strong>trol in Time Block B, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
change in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir behavior was meaningful for<br />
Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w <strong>and</strong> we did not want to instruct <str<strong>on</strong>g>the</str<strong>on</strong>g>m<br />
to disc<strong>on</strong>tinue <str<strong>on</strong>g>the</str<strong>on</strong>g>ir change. Additi<strong>on</strong>ally, a<br />
very clear reversal was seen in Time Block A,<br />
suggesting that <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was effective<br />
for Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w.<br />
Two final c<strong>on</strong>siderati<strong>on</strong>s are that, due to<br />
time c<strong>on</strong>straints, we were unable to collect<br />
maintenance data within Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w’s classroom<br />
with his teachers to examine whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r <str<strong>on</strong>g>the</str<strong>on</strong>g> reduced<br />
levels of h<strong>and</strong> mouthing would maintain<br />
over time as well as determine if <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
teachers would be able to maintain <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>.<br />
We were also unable to transfer <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
role of data collecti<strong>on</strong> to <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers during<br />
this study, so it is not known if <str<strong>on</strong>g>the</str<strong>on</strong>g>y would be<br />
able to both implement <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> <strong>and</strong><br />
maintain accurate data collecti<strong>on</strong>. However,<br />
because we used a scatterplot to collect <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
data, teachers would <strong>on</strong>ly need to collect data<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> first three occurrences of a behavior<br />
during an interval, ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r than <strong>on</strong> each occurrence<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> behavior. Research should also<br />
c<strong>on</strong>sider <str<strong>on</strong>g>the</str<strong>on</strong>g> use of scatterplot data collecti<strong>on</strong><br />
in natural envir<strong>on</strong>ments to m<strong>on</strong>itor <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness<br />
of interventi<strong>on</strong>s across <str<strong>on</strong>g>the</str<strong>on</strong>g> entire day.<br />
While some might c<strong>on</strong>sider <str<strong>on</strong>g>the</str<strong>on</strong>g> use of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
scatterplot as a limitati<strong>on</strong> because it is less<br />
sensitive to behavior change than interval recording,<br />
this method is more amenable to<br />
collecting data over <str<strong>on</strong>g>the</str<strong>on</strong>g> course of several<br />
hours <strong>and</strong> is likely to be more feasible for<br />
teachers to implement than 10 s interval recording<br />
systems. Additi<strong>on</strong>ally, in Time Block<br />
A especially, clear changes in behavior were<br />
observed from baseline to interventi<strong>on</strong><br />
phases. Finally, using scatterplot data, we were<br />
able to examine <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong><br />
across several hours, ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r than over<br />
10 min sessi<strong>on</strong>s, which enhances <str<strong>on</strong>g>the</str<strong>on</strong>g> social<br />
validity of this study.<br />
While a clear reversal was not observed in<br />
Time Block B, <str<strong>on</strong>g>the</str<strong>on</strong>g>re are several advantages to<br />
this study that compensate for <str<strong>on</strong>g>the</str<strong>on</strong>g> reduced<br />
level of experimental c<strong>on</strong>trol. First, because<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was c<strong>on</strong>ducted within Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w’s<br />
natural envir<strong>on</strong>ments, he was able to<br />
remain in his classroom <strong>and</strong> participate in<br />
activities with his peers. In line with that, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
teachers were able to observe <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong><br />
being implemented <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> changes in Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w’s<br />
behavior. Although <str<strong>on</strong>g>the</str<strong>on</strong>g> teachers were<br />
never trained to implement <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y independently began implementing <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
curricular interventi<strong>on</strong> with Mat<str<strong>on</strong>g>the</str<strong>on</strong>g>w in Time<br />
Block B, suggesting that <str<strong>on</strong>g>the</str<strong>on</strong>g> ease of implementing<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was such that it<br />
could be implemented within <str<strong>on</strong>g>the</str<strong>on</strong>g> natural c<strong>on</strong>text<br />
of a classroom. Future research should<br />
c<strong>on</strong>tinue to examine <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of interventi<strong>on</strong>s<br />
implemented by teachers <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
Combined Curricular Interventi<strong>on</strong> / 365
assistants within <str<strong>on</strong>g>the</str<strong>on</strong>g> natural c<strong>on</strong>texts of a participant’s<br />
daily schedule.<br />
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Received: 14 February 2007<br />
Initial Acceptance: 12 April 2007<br />
Final Acceptance: 6 June 2007<br />
366 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008
Effects of a Reciprocal Questi<strong>on</strong>ing Interventi<strong>on</strong> <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
Questi<strong>on</strong> Generati<strong>on</strong> <strong>and</strong> Resp<strong>on</strong>ding of Children with<br />
<strong>Autism</strong> Spectrum Disorder<br />
Kelly Whal<strong>on</strong><br />
The College of William <strong>and</strong> Mary<br />
Mary Frances Hanline<br />
Florida State University<br />
Abstract: A multiple baseline design across participants was used to investigate <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of reciprocal<br />
questi<strong>on</strong>ing strategy instructi<strong>on</strong> delivered in cooperative pairs <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong> generati<strong>on</strong> <strong>and</strong> resp<strong>on</strong>ding of<br />
children with autism spectrum disorder. Three children with autism spectrum disorder <strong>and</strong> nine general<br />
educati<strong>on</strong> peers participated in <str<strong>on</strong>g>the</str<strong>on</strong>g> study. Following interventi<strong>on</strong>, children with autism increased frequency of<br />
questi<strong>on</strong> generati<strong>on</strong> <strong>and</strong> resp<strong>on</strong>ding using a story map framework. Social validity data indicated children with<br />
autism spectrum disorder <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir general educati<strong>on</strong> peers found <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> helpful, <strong>and</strong> parents<br />
perceived a change in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir child’s reading <strong>and</strong> language skills.<br />
“Learning to read builds <strong>on</strong> cognitive, linguistic,<br />
<strong>and</strong> social skills that have developed from<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> earliest age” (Rayner, Foorman, Perfetti,<br />
Pesetsky, & Seidenberg, 2001, p. 34). Basic to<br />
reading development is a child’s proficiency<br />
in language (Rayner et al.). For children with<br />
autism spectrum disorder (ASD), however,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> reliance <strong>on</strong> language development to facilitate<br />
reading skills is problematic, as children<br />
with ASD typically experience difficulty<br />
in acquiring <str<strong>on</strong>g>the</str<strong>on</strong>g> linguistic skills needed for<br />
effective reading (Myles et al., 2002; Norbury<br />
& Bishop, 2002). Because of <str<strong>on</strong>g>the</str<strong>on</strong>g> variability in<br />
acquisiti<strong>on</strong> of cognitive, linguistic <strong>and</strong> social<br />
skills, it is likely that learning to read will<br />
present a range of challenges for children<br />
with ASD.<br />
In comparis<strong>on</strong> to typically developing<br />
peers, children with autism generally acquire<br />
speech late, <strong>and</strong> “a substantial minority” fail to<br />
develop fluent speech by adolescence or<br />
adulthood (Lord & Paul, 1997, p. 204). Children<br />
with ASD that develop speech, typically<br />
dem<strong>on</strong>strate good mechanics of language<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cerning this article should<br />
be addressed to Kelly Whal<strong>on</strong>, The College of William<br />
<strong>and</strong> Mary, P.O. Box 8795, Williamsburg, VA<br />
23187-8795. Email: kjwhal@wm.edu<br />
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities, 2008, 43(3), 367–387<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities<br />
(Minshew, Goldstein, & Siegel, 1995) with accurate<br />
articulati<strong>on</strong>, <strong>and</strong> ph<strong>on</strong>ological development<br />
similar to that of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir general educati<strong>on</strong><br />
peers (Tager-Flusberg, Paul, & Lord, 2005),<br />
yet have difficulty with more complex syntax<br />
<strong>and</strong> semantics as well as pragmatic aspects of<br />
language (Tager-Flusberg & Joesph, 2003).<br />
Some children with ASD appear to <strong>on</strong>ly have<br />
difficulties with social aspects of language<br />
ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r than syntactic or semantic difficulties,<br />
<strong>and</strong> o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs may make gains in social aspects of<br />
language but c<strong>on</strong>tinue to have limited spoken<br />
language (Tager-Flusberg et al.).<br />
The scale of difficulties children with ASD<br />
experience with language can potentially impact<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> reading process. Evidence suggests<br />
that we can <strong>on</strong>ly comprehend text to <str<strong>on</strong>g>the</str<strong>on</strong>g> degree<br />
we comprehend language (Rayner et al.,<br />
2001). Although many children with ASD can<br />
develop average or better decoding skills,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se decoding strengths generally accompany<br />
problems with reading comprehensi<strong>on</strong><br />
(Frith, 2003; Mayes & Calho<strong>on</strong>, 2003a; 2003b;<br />
Calho<strong>on</strong>, 2001; Lord & Paul, 1997; Minshew,<br />
Goldstein, Taylor, & Seigel, 1994; Nati<strong>on</strong>,<br />
Clarke, Wright, & Williams, 2006); however,<br />
extreme variability has been noted in reading<br />
development across <str<strong>on</strong>g>the</str<strong>on</strong>g> autism spectrum (Nati<strong>on</strong><br />
et al., 2006). Despite variability in reading<br />
Reciprocal Questi<strong>on</strong>ing / 367
ability, studies have c<strong>on</strong>sistently shown that<br />
students with ASD frequently have difficulty<br />
comprehending text (Mayes & Calhoun,<br />
2003a; 2003b; Nati<strong>on</strong> et al.; Minshew et al.;<br />
Wahlberg & Magliano, 2004).<br />
Promoting Reading Skills of Learners with <strong>Autism</strong><br />
Research regarding how to promote effective<br />
reading skills am<strong>on</strong>g children with ASD is<br />
minimal. Although <str<strong>on</strong>g>the</str<strong>on</strong>g> research targeting<br />
reading development is limited, children with<br />
ASD with varying levels of language <strong>and</strong> cognitive<br />
ability have successfully developed reading<br />
skills following <str<strong>on</strong>g>the</str<strong>on</strong>g> implementati<strong>on</strong> of a<br />
variety of interventi<strong>on</strong> methods including behavioral<br />
(Rosenbaum & Breiling, 1976), cooperative<br />
learning/peer tutoring (Kamps, Barbetta,<br />
Le<strong>on</strong>ard, & Delquadri, 1994; Kamps,<br />
Le<strong>on</strong>ard, Potucek, & Garris<strong>on</strong>-Harrell, 1995),<br />
incidental teaching (McGee, Krantz, & Mc-<br />
Clannahan, 1986), computer assisted instructi<strong>on</strong><br />
(Heiman, Nels<strong>on</strong>, Tjus, & Gillberg, 1995;<br />
Tjus, Heimann, & Nels<strong>on</strong>, 1998; Williams,<br />
Wright, Callaghan, & Coughlan, 2002), <strong>and</strong><br />
anaphoric cuing (O’C<strong>on</strong>nor & Klein, 2004).<br />
Many of <str<strong>on</strong>g>the</str<strong>on</strong>g> studies focused <strong>on</strong> sight word<br />
identificati<strong>on</strong> (Heiman et al.; McGee et al.;<br />
Rosenbaum & Breiling, 1976; Tjus et al.; Williams<br />
et al.), two targeted reading comprehensi<strong>on</strong><br />
(Kamps et al.; O’C<strong>on</strong>nor & Klein,), <strong>and</strong><br />
<strong>on</strong>e reading fluency (Kamps et al., 1994).<br />
Reading comprehensi<strong>on</strong>. This scarce literature<br />
base of reading interventi<strong>on</strong> studies c<strong>on</strong>sists<br />
of <strong>on</strong>ly two studies emphasizing reading<br />
comprehensi<strong>on</strong> (Kamps et al., 1995;<br />
O’C<strong>on</strong>nor & Klein, 2004). Kamps <strong>and</strong> colleagues<br />
targeted <str<strong>on</strong>g>the</str<strong>on</strong>g> reading comprehensi<strong>on</strong><br />
skills of <strong>on</strong>e child identified as having “high<br />
functi<strong>on</strong>ing autism” <strong>and</strong> two children with autism<br />
<strong>and</strong> a moderate cognitive disability al<strong>on</strong>g<br />
with <str<strong>on</strong>g>the</str<strong>on</strong>g>ir general educati<strong>on</strong> peers in an in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
c<strong>on</strong>text of cooperative groups (Kamps et al.).<br />
Classroom instructi<strong>on</strong> included direct instructi<strong>on</strong><br />
of vocabulary, story c<strong>on</strong>cepts, main idea,<br />
sequencing, <strong>and</strong> story mapping. In <str<strong>on</strong>g>the</str<strong>on</strong>g> cooperative<br />
learning c<strong>on</strong>diti<strong>on</strong>, groups of four students,<br />
<strong>on</strong>e with ASD, completed 3 activities:<br />
(1) a peer tutoring of vocabulary words, (2)<br />
resp<strong>on</strong>ding to wh comprehensi<strong>on</strong> questi<strong>on</strong>s<br />
following reading, (3) comprehensi<strong>on</strong> game<br />
of characters, <strong>and</strong> facts from stories read in<br />
class. All participants, including general edu-<br />
368 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
cati<strong>on</strong> peers, showed increased levels of academic<br />
engagement <strong>and</strong> social interacti<strong>on</strong> following<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>, but <str<strong>on</strong>g>the</str<strong>on</strong>g> authors<br />
reported greater variability in reading results<br />
associated with <str<strong>on</strong>g>the</str<strong>on</strong>g> participant’s level of cognitive<br />
ability. Distinctly, participants described<br />
by <str<strong>on</strong>g>the</str<strong>on</strong>g> authors as having autism <strong>and</strong> a moderate<br />
cognitive disability did not produce as<br />
many gains in <str<strong>on</strong>g>the</str<strong>on</strong>g> area of reading comprehensi<strong>on</strong><br />
as <str<strong>on</strong>g>the</str<strong>on</strong>g> student described as having high<br />
functi<strong>on</strong>ing autism <strong>and</strong> general educati<strong>on</strong><br />
counterparts.<br />
The sec<strong>on</strong>d study focused <strong>on</strong> increasing<br />
reading comprehensi<strong>on</strong> of children with ASD<br />
(O’C<strong>on</strong>nor et al., 2004) through <str<strong>on</strong>g>the</str<strong>on</strong>g> use of<br />
procedural facilitati<strong>on</strong>. Procedural facilitati<strong>on</strong><br />
c<strong>on</strong>sisted of four different c<strong>on</strong>diti<strong>on</strong>s in which<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> researcher provided prompting to facilitate<br />
processes needed for comprehensi<strong>on</strong> during<br />
reading. That is, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher set up <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
task/materials to facilitate <str<strong>on</strong>g>the</str<strong>on</strong>g> processes<br />
needed to comprehend <str<strong>on</strong>g>the</str<strong>on</strong>g> text. Specifically,<br />
participants were asked to read 5 stories aloud<br />
in 4 c<strong>on</strong>diti<strong>on</strong>s: (1) <strong>on</strong>e in a prereading c<strong>on</strong>diti<strong>on</strong>,<br />
(2) <strong>on</strong>e in an anaphoric cuing c<strong>on</strong>diti<strong>on</strong>,<br />
(3) <strong>on</strong>e in a cloze c<strong>on</strong>diti<strong>on</strong>, <strong>and</strong> (4) two<br />
in a c<strong>on</strong>trol c<strong>on</strong>diti<strong>on</strong>. Following each c<strong>on</strong>diti<strong>on</strong>,<br />
a researcher made test c<strong>on</strong>sisting of 12<br />
items that included free retelling, identifying<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> main idea, generating a title, detecting<br />
inc<strong>on</strong>gruous sentences from <str<strong>on</strong>g>the</str<strong>on</strong>g> story, inference<br />
why <strong>and</strong> how questi<strong>on</strong>s, <strong>and</strong> factual who,<br />
what, where, when questi<strong>on</strong>s was administered.<br />
Following <str<strong>on</strong>g>the</str<strong>on</strong>g> anaphoric cuing c<strong>on</strong>diti<strong>on</strong>,<br />
performance <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> comprehensi<strong>on</strong><br />
measure of more than half of <str<strong>on</strong>g>the</str<strong>on</strong>g> participants<br />
resulted in medium effect size gains, whereas<br />
gains from prereading questi<strong>on</strong>s <strong>and</strong> cloze<br />
c<strong>on</strong>diti<strong>on</strong>s were not statistically significant.<br />
Also, in both <str<strong>on</strong>g>the</str<strong>on</strong>g> anaphoric cuing <strong>and</strong> cloze<br />
c<strong>on</strong>diti<strong>on</strong>s <str<strong>on</strong>g>the</str<strong>on</strong>g> participants completed <str<strong>on</strong>g>the</str<strong>on</strong>g> task<br />
with approximately 80% accuracy, but <strong>on</strong>ly<br />
anaphoric cueing facilitated comprehensi<strong>on</strong><br />
of text.<br />
The purpose of this study is to extend <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
research base <strong>on</strong> reading comprehensi<strong>on</strong> of<br />
children with ASD to include direct comprehensi<strong>on</strong><br />
strategy instructi<strong>on</strong>. The Nati<strong>on</strong>al<br />
Reading Panel (NPR) acknowledged that<br />
within comprehensi<strong>on</strong> research, “<str<strong>on</strong>g>the</str<strong>on</strong>g> str<strong>on</strong>gest<br />
scientific evidence was found for <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness<br />
of asking readers to generate questi<strong>on</strong>s<br />
during reading” (NICHD, 2000, pp.
4-45). Because <str<strong>on</strong>g>the</str<strong>on</strong>g> No Child Left Behind Act<br />
(NCLB, 2002) calls for evidence-based strategies<br />
identified by <str<strong>on</strong>g>the</str<strong>on</strong>g> NRP to teach reading<br />
<strong>and</strong> children with disabilities have access to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> general educati<strong>on</strong> curriculum through<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> Individuals with Disabilities Educati<strong>on</strong> Act<br />
(IDEA) (34. C.F.R. & 300.26(b)(3)(ii), research<br />
<strong>on</strong> how to facilitate <str<strong>on</strong>g>the</str<strong>on</strong>g> learning of<br />
children with ASD using strategies appropriate<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g> general populati<strong>on</strong> is needed.<br />
In a review of <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong> generati<strong>on</strong> literature,<br />
Rosenshine, Meister, <strong>and</strong> Chapman<br />
(1996) determined that studies providing procedural<br />
checklists, visual cues, signal words<br />
<strong>and</strong> generic questi<strong>on</strong>s or questi<strong>on</strong> stems as<br />
prompts produced positive effects (Rosenshine<br />
et al.). These are strategies deemed effective<br />
for teaching a variety of skills. Specifically,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> use of visuals (Krantz, MacDuff, &<br />
McClannahan, 1993; MacDuff, Krantz, & Mc-<br />
Clannahan, 1993; Pierce & Schreibman,<br />
1994), scripts (Krantz & McClannahan, 1993,<br />
1998; Mats<strong>on</strong>, Sevin, Box, Francis, & Sevin,<br />
1993; Sarokoff, Taylor, & Pouls<strong>on</strong>, 2001;<br />
Stevens<strong>on</strong>, Krantz, & McClannahan, 2000),<br />
<strong>and</strong> self-m<strong>on</strong>itoring (Koegel & Frea, 1993;<br />
Koegel, Koegel, Hurley, & Frea, 1992; Mancina,<br />
Tankersley, Kamps, Kravits, & Parrett,<br />
2000) have been effective in increasing independence,<br />
social communicati<strong>on</strong>, <strong>and</strong> prosocial<br />
behaviors of children with ASD.<br />
The availability of self-m<strong>on</strong>itoring, visuals,<br />
<strong>and</strong> scripts during reading comprehensi<strong>on</strong> instructi<strong>on</strong><br />
may elicit gains in reading achievement<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g> general educati<strong>on</strong> populati<strong>on</strong>,<br />
children with effective decoding but limited<br />
comprehensi<strong>on</strong> skills, <strong>and</strong> potentially children<br />
with ASD. Hence, it is not surprising that<br />
researchers have encouraged teachers of children<br />
with ASD to use visual cues <strong>and</strong> checklists<br />
to augment receptive <strong>and</strong> expressive communicati<strong>on</strong><br />
(Mirenda & Eriks<strong>on</strong>, 2000; Quill,<br />
1995) <strong>and</strong> promote independence (Koegel,<br />
Koegel, & Parks, 1995; Quill). What remains<br />
unclear is whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r <str<strong>on</strong>g>the</str<strong>on</strong>g> use of <str<strong>on</strong>g>the</str<strong>on</strong>g>se instructi<strong>on</strong>al<br />
practices will prove successful in interventi<strong>on</strong>s<br />
focusing <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> reading comprehensi<strong>on</strong><br />
of children with ASD.<br />
In this study, we used an adapted guided<br />
reciprocal questi<strong>on</strong>ing interventi<strong>on</strong> (See<br />
King, 1994; King & Rosenshine, 1993) coupled<br />
with self-m<strong>on</strong>itoring <strong>and</strong> visual cues to<br />
teach children with ASD to ask <strong>and</strong> resp<strong>on</strong>d to<br />
questi<strong>on</strong>s using a story map framework while<br />
taking turns reading with a general educati<strong>on</strong><br />
peer. The following research questi<strong>on</strong>s were<br />
addressed.<br />
Questi<strong>on</strong> 1: What is <str<strong>on</strong>g>the</str<strong>on</strong>g> functi<strong>on</strong>al relati<strong>on</strong>ship<br />
between guided reciprocal questi<strong>on</strong>ing<br />
strategy instructi<strong>on</strong> delivered in cooperative<br />
pairs <strong>and</strong> questi<strong>on</strong> generati<strong>on</strong><br />
<strong>and</strong> resp<strong>on</strong>ding of children with autism<br />
spectrum disorder?<br />
Questi<strong>on</strong> 2: To what extent are children<br />
with autism spectrum disorder, general educati<strong>on</strong><br />
peers, <strong>and</strong> parents of children with<br />
autism satisfied with <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>?<br />
Method<br />
Participants<br />
Three elementary aged boys with ASD (as defined<br />
by <str<strong>on</strong>g>the</str<strong>on</strong>g> DSM IV) participated in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
study. They were administered <str<strong>on</strong>g>the</str<strong>on</strong>g> Peabody<br />
Picture Vocabulary Test-III (PPVT-III), <str<strong>on</strong>g>the</str<strong>on</strong>g> Expressive<br />
One-Word Picture Vocabulary Test<br />
(EOWPVT), <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> Oral Reading Fluency<br />
(ORF) <strong>and</strong> Retell Fluency (RF) subtests of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
Dynamic Indicators of Basic Early Literacy<br />
(DIBELS) prior to initiati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> study. Table<br />
1 presents <str<strong>on</strong>g>the</str<strong>on</strong>g> results of this testing al<strong>on</strong>g<br />
with IQ scores taken from participant cumulative<br />
folders.<br />
Scores of all three participants <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> PPVT-<br />
III were at least <strong>on</strong>e st<strong>and</strong>ard deviati<strong>on</strong> below<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> mean, indicating difficulty with receptive<br />
vocabulary. Scores <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> EOWPVT were<br />
greater than <strong>on</strong>e st<strong>and</strong>ard deviati<strong>on</strong> below <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
mean for two participants, dem<strong>on</strong>strating difficulty<br />
with both receptive <strong>and</strong> expressive language,<br />
<strong>and</strong> in <str<strong>on</strong>g>the</str<strong>on</strong>g> average range for <str<strong>on</strong>g>the</str<strong>on</strong>g> <strong>on</strong>e<br />
participant indicating a discrepancy between<br />
receptive <strong>and</strong> expressive language. In additi<strong>on</strong>,<br />
participants were administered <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
DIBELS ORF subtest paired with <str<strong>on</strong>g>the</str<strong>on</strong>g> RF<br />
subtest. The RF is c<strong>on</strong>sidered a “comprehensi<strong>on</strong><br />
check” to determine whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r <str<strong>on</strong>g>the</str<strong>on</strong>g> ORF<br />
score reflects overall reading proficiency to<br />
include comprehensi<strong>on</strong>. The RF score should<br />
be approximately half of <str<strong>on</strong>g>the</str<strong>on</strong>g> ORF score to be<br />
c<strong>on</strong>sidered a good indicator of overall reading<br />
ability. Scores of participating students with<br />
ASD were c<strong>on</strong>siderably less than half <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
Reciprocal Questi<strong>on</strong>ing / 369
TABLE 1<br />
Participants’ Test Scores<br />
PPVT-III EOWPVT ORF 1<br />
ORF scores suggesting a reading comprehensi<strong>on</strong><br />
c<strong>on</strong>cern (Good & Kaminski, 2003).<br />
Austin. Austin was 7 years 5 m<strong>on</strong>ths old at<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> <strong>on</strong>set of <str<strong>on</strong>g>the</str<strong>on</strong>g> study. He is an Asian/Hispanic<br />
male with Asperger syndrome. Austin<br />
received his reading instructi<strong>on</strong> in a self-c<strong>on</strong>tained<br />
classroom setting. In a review of his<br />
cumulative folder, Austin’s reported strengths<br />
included determining relati<strong>on</strong>ships between<br />
abstract figures, as well as detecting patterns.<br />
He has greater difficulty with tasks that involve<br />
defining words <strong>and</strong> stating similarities between<br />
words. On <str<strong>on</strong>g>the</str<strong>on</strong>g> Differential Ability Scales<br />
(DAS), Austin received a general c<strong>on</strong>ceptual<br />
ability score of 101. His score <strong>on</strong> n<strong>on</strong>verbal<br />
reas<strong>on</strong>ing subtests was significantly higher at<br />
133 than his verbal reas<strong>on</strong>ing score, 73. Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r,<br />
Austin’s scores <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> PPVT-III was over<br />
<strong>on</strong>e st<strong>and</strong>ard deviati<strong>on</strong> below <str<strong>on</strong>g>the</str<strong>on</strong>g> mean, 83,<br />
yet his score <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> EOWPVT was in <str<strong>on</strong>g>the</str<strong>on</strong>g> average<br />
range for his chr<strong>on</strong>ological age, 92, indicating<br />
a discrepancy between expressive <strong>and</strong><br />
receptive language. On <str<strong>on</strong>g>the</str<strong>on</strong>g> ORF subtest, Austin<br />
read 78 words per minute, which is above<br />
benchmark for his age (i.e., 40 words per<br />
minute). Yet, <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> RF subtest when asked to<br />
tell about what he just read, his retell c<strong>on</strong>sisted<br />
of five words related to <str<strong>on</strong>g>the</str<strong>on</strong>g> story.<br />
Barry. When <str<strong>on</strong>g>the</str<strong>on</strong>g> study began, Barry was 8<br />
years 7 m<strong>on</strong>ths old. Barry is a Hispanic male<br />
with autism. He received reading instructi<strong>on</strong><br />
in both his self-c<strong>on</strong>tained <strong>and</strong> mainstream settings.<br />
His reported IQ score in his cumulative<br />
folder of 112 was obtained from <str<strong>on</strong>g>the</str<strong>on</strong>g> Leiter-R<br />
test of n<strong>on</strong>verbal intelligence, <strong>and</strong> is c<strong>on</strong>sidered<br />
average for his chr<strong>on</strong>ological age. On<br />
language measures, Barry’s scores were suggestive<br />
of difficulty with both expressive <strong>and</strong><br />
receptive language. Specifically, Barry’s performance<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> EOWPVT was over <strong>on</strong>e stan-<br />
RF 2<br />
IQ Score<br />
Austin 83 92 78 5 101<br />
Barry 70 78 87 3 112<br />
Chris 76 68 66 0 92<br />
1 Reported in words per minute<br />
2 Reported in words related to <str<strong>on</strong>g>the</str<strong>on</strong>g> story<br />
370 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
dard deviati<strong>on</strong> below <str<strong>on</strong>g>the</str<strong>on</strong>g> mean, <strong>and</strong> his score<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> PPVT-III was two st<strong>and</strong>ard deviati<strong>on</strong>s<br />
below <str<strong>on</strong>g>the</str<strong>on</strong>g> mean for his age. On <str<strong>on</strong>g>the</str<strong>on</strong>g> DIBELS<br />
ORF subtest, Barry read 87 words per minute,<br />
just below <str<strong>on</strong>g>the</str<strong>on</strong>g> 2 nd grade benchmark of 90<br />
words; however, <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> RF subtest he was able<br />
to retell three words related to <str<strong>on</strong>g>the</str<strong>on</strong>g> story.<br />
Chris. Chris was 7 years 8 m<strong>on</strong>ths at pretesting.<br />
He is a Caucasian male with pervasive<br />
developmental disorder. He receives his reading<br />
instructi<strong>on</strong> in both a self-c<strong>on</strong>tained <strong>and</strong><br />
mainstream classroom setting. On <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
Leiter-R n<strong>on</strong>verbal intelligence test, Chris received<br />
an IQ score of 92, an average score for<br />
his age. Strengths noted in his cumulative<br />
folder included performance <strong>on</strong> visual matching<br />
tasks, <strong>and</strong> his ability to discriminate informati<strong>on</strong><br />
<strong>and</strong> complete c<strong>on</strong>crete tasks. On<br />
preliminary descriptive measures, Chris dem<strong>on</strong>strated<br />
difficulty <strong>on</strong> both expressive <strong>and</strong><br />
receptive assessments. Chris scored more than<br />
<strong>on</strong>e st<strong>and</strong>ard deviati<strong>on</strong> below <str<strong>on</strong>g>the</str<strong>on</strong>g> mean <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
PPVT-III, <strong>and</strong> greater than two st<strong>and</strong>ard deviati<strong>on</strong>s<br />
below <str<strong>on</strong>g>the</str<strong>on</strong>g> mean <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> EOWPVT. On<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> DIBELS ORF subtest, Chris read 66 words<br />
per minute, which is below <str<strong>on</strong>g>the</str<strong>on</strong>g> 2 nd grade<br />
benchmark of 90 words a minute. When asked<br />
to tell everything he remembered about what<br />
he read <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> RF subtest, Chris did not resp<strong>on</strong>d.<br />
Nine general educati<strong>on</strong> peers participated<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> study. Peers attended <str<strong>on</strong>g>the</str<strong>on</strong>g> same school<br />
<strong>and</strong> grade level as <str<strong>on</strong>g>the</str<strong>on</strong>g> student with ASD, <strong>and</strong><br />
were students with whom <str<strong>on</strong>g>the</str<strong>on</strong>g> children with<br />
ASD had <str<strong>on</strong>g>the</str<strong>on</strong>g> opportunity to interact during a<br />
typical school day. General educati<strong>on</strong> students<br />
were recruited because of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir effective interpers<strong>on</strong>al<br />
skills as determined by each participant’s<br />
mainstream teacher.
TABLE 2<br />
Codes of Student Questi<strong>on</strong> Generati<strong>on</strong> <strong>and</strong> Resp<strong>on</strong>ding<br />
Setting<br />
Code Code Definiti<strong>on</strong> Subcategories <strong>and</strong> Subcategory Definiti<strong>on</strong><br />
Student Generated<br />
Questi<strong>on</strong><br />
All three students with ASD received <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
educati<strong>on</strong> in a self-c<strong>on</strong>tained special educati<strong>on</strong><br />
classroom. Each participant was mainstreamed<br />
in a general educati<strong>on</strong> classroom<br />
setting for at least <strong>on</strong>e class, approximately 60<br />
minutes each day. The interventi<strong>on</strong> occurred<br />
in a small room located outside <str<strong>on</strong>g>the</str<strong>on</strong>g> general<br />
<strong>and</strong> special educati<strong>on</strong> classrooms. The classroom<br />
was used for parent pick-up <strong>and</strong> dropoff,<br />
occupati<strong>on</strong>al <str<strong>on</strong>g>the</str<strong>on</strong>g>rapy, special area activities,<br />
etc. The setting was familiar to all<br />
participants with ASD.<br />
Experimental Design<br />
A student generated<br />
questi<strong>on</strong> directed<br />
toward peer<br />
Student Resp<strong>on</strong>ses Any communicative<br />
act in resp<strong>on</strong>se to a<br />
peer questi<strong>on</strong> that<br />
is unprompted<br />
A single-subject multiple baseline design<br />
across participants was employed to clearly<br />
establish <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> <strong>on</strong><br />
each participant’s ability to generate <strong>and</strong> resp<strong>on</strong>d<br />
to questi<strong>on</strong>s related to a reading selecti<strong>on</strong>.<br />
Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r, <str<strong>on</strong>g>the</str<strong>on</strong>g> multiple baseline design is<br />
well-suited to <str<strong>on</strong>g>the</str<strong>on</strong>g> practical requirements of<br />
applied research <strong>and</strong> does not require <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
Related: A questi<strong>on</strong> in direct reference to <str<strong>on</strong>g>the</str<strong>on</strong>g> story<br />
that c<strong>on</strong>tains a questi<strong>on</strong> word (who, what, when,<br />
where, why, how) <strong>and</strong> an element of <str<strong>on</strong>g>the</str<strong>on</strong>g> story<br />
(character, setting, event, problem, soluti<strong>on</strong>)<br />
Unrelated: A questi<strong>on</strong> c<strong>on</strong>taining an appropriate<br />
questi<strong>on</strong> word <strong>and</strong> informati<strong>on</strong> unrelated to <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
story<br />
Prompted: A related questi<strong>on</strong> formed following a<br />
researcher prompt (i.e., verbal prompt,<br />
modeling, or corrective feedback)<br />
Unprompted: A related questi<strong>on</strong> formed without a<br />
preceding researcher prompt (i.e., verbal<br />
prompt, modeling, or corrective feedback)<br />
Related resp<strong>on</strong>se: Any communicati<strong>on</strong> act directly<br />
related to <str<strong>on</strong>g>the</str<strong>on</strong>g> story in resp<strong>on</strong>se to a questi<strong>on</strong> that<br />
does not follow corrective feedback/modeling<br />
from <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher<br />
Unrelated resp<strong>on</strong>se: Any communicati<strong>on</strong> act unrelated<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> story in resp<strong>on</strong>se to a questi<strong>on</strong><br />
Echoic: Any imitati<strong>on</strong> of an utterance in resp<strong>on</strong>se to<br />
a questi<strong>on</strong><br />
withdrawal of interventi<strong>on</strong> procedures (Neuman<br />
& McCormick, 1995).<br />
Dependent Measures<br />
To formulate a questi<strong>on</strong> about text, <str<strong>on</strong>g>the</str<strong>on</strong>g> reader<br />
must process <str<strong>on</strong>g>the</str<strong>on</strong>g> informati<strong>on</strong> read <strong>and</strong> create<br />
a questi<strong>on</strong> that reflects c<strong>on</strong>tent (Palinscsar &<br />
Brown, 1984; Rosenshine et al., 1996; Slavin,<br />
Hurley, & Chamberlain, 2003). Forming questi<strong>on</strong>s<br />
in direct relati<strong>on</strong> to c<strong>on</strong>tent requires <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
resp<strong>on</strong>der to interpret meaning from <str<strong>on</strong>g>the</str<strong>on</strong>g> text<br />
(Palinscsar & Brown). Questi<strong>on</strong> generati<strong>on</strong><br />
has also dem<strong>on</strong>strated improvements in student<br />
ability to resp<strong>on</strong>d to questi<strong>on</strong>s focusing<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> main idea (NICHD, 2000). Therefore,<br />
dependent measures focused <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> participants’<br />
ability to generate <strong>and</strong> resp<strong>on</strong>d to questi<strong>on</strong>s<br />
related to <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>tent of reading material.<br />
The frequency of student-generated<br />
questi<strong>on</strong>s was coded as related or unrelated to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> book <strong>and</strong> as prompted or unprompted.<br />
Table 2 provides a descripti<strong>on</strong> of each of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
codes.<br />
Reciprocal Questi<strong>on</strong>ing / 371
Data Collecti<strong>on</strong><br />
All sessi<strong>on</strong>s were videotaped using a digital<br />
camcorder <strong>and</strong> downloaded to a computer for<br />
analysis. The researcher transcribed, <str<strong>on</strong>g>the</str<strong>on</strong>g>n<br />
coded <strong>and</strong> graphed <str<strong>on</strong>g>the</str<strong>on</strong>g> data to include <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
frequency of student generated questi<strong>on</strong>s <strong>and</strong><br />
resp<strong>on</strong>ses, <strong>and</strong> researcher prompting.<br />
Procedure<br />
Pre-Baseline. A 2-sessi<strong>on</strong> pre-baseline phase<br />
was included to determine <str<strong>on</strong>g>the</str<strong>on</strong>g> impact of preinstructi<strong>on</strong><br />
procedures <strong>on</strong> participant questi<strong>on</strong><br />
generati<strong>on</strong> <strong>and</strong> resp<strong>on</strong>ding. In pre-baseline,<br />
each child with ASD <strong>and</strong> <strong>on</strong>e general educati<strong>on</strong><br />
peer took turns reading a storybook aloud. One<br />
book was read each sessi<strong>on</strong> of pre-baseline, taking<br />
approximately 20 minutes. The general educati<strong>on</strong><br />
peer was selected r<strong>and</strong>omly each day<br />
from a c<strong>on</strong>sistent group of three general educati<strong>on</strong><br />
peers for each child with ASD. Before reading,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> researcher prompted <str<strong>on</strong>g>the</str<strong>on</strong>g> students to ask<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir friend questi<strong>on</strong>s, “It is time to read with<br />
your friend. Remember to ask each o<str<strong>on</strong>g>the</str<strong>on</strong>g>r questi<strong>on</strong>s<br />
while you read.” The researcher provided<br />
no guidance or prompts related to questi<strong>on</strong><br />
generati<strong>on</strong>.<br />
Figure 1. Story cards<br />
372 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Elements of a story instructi<strong>on</strong>. Elements of a<br />
story instructi<strong>on</strong> occurred after pre-baseline<br />
<strong>and</strong> seven school days prior to baseline. This<br />
instructi<strong>on</strong> ensured that participants had a<br />
preliminary underst<strong>and</strong>ing of <str<strong>on</strong>g>the</str<strong>on</strong>g> setting,<br />
characters, events, problem <strong>and</strong> soluti<strong>on</strong> of a<br />
story. To be eligible to begin baseline, students<br />
were required to accurately match 80%<br />
of note cards to <str<strong>on</strong>g>the</str<strong>on</strong>g> appropriate element of a<br />
story card. All students met criteria by <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
sec<strong>on</strong>d day of instructi<strong>on</strong>. Details <strong>on</strong> teaching<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> elements of a story follow.<br />
During <str<strong>on</strong>g>the</str<strong>on</strong>g> first day, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher taught<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> elements of a story to each child with ASD<br />
in a group with three general educati<strong>on</strong> peers.<br />
The researcher reviewed <str<strong>on</strong>g>the</str<strong>on</strong>g> elements of a<br />
story (i.e., setting, characters, event, problem<br />
<strong>and</strong> soluti<strong>on</strong>) using <str<strong>on</strong>g>the</str<strong>on</strong>g> familiar story, Goldilocks<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> Three Bears. Participants were<br />
asked questi<strong>on</strong>s about each element using <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
tag board materials <strong>and</strong> story cards shown in<br />
Figure 1. Table 3 includes examples of questi<strong>on</strong>s<br />
related to each story element. If students<br />
had difficulty answering any of <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong>s,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> researcher modeled looking up <str<strong>on</strong>g>the</str<strong>on</strong>g> answer<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> storybook.<br />
Next, each participant was given five note-
TABLE 3<br />
Examples of Elements of a Story Questi<strong>on</strong>s<br />
Element Questi<strong>on</strong><br />
Setting Generic Questi<strong>on</strong>: “Where does <str<strong>on</strong>g>the</str<strong>on</strong>g> story take place?”<br />
More specific: “Where do <str<strong>on</strong>g>the</str<strong>on</strong>g> 3 bears live?”<br />
Characters Generic Questi<strong>on</strong>: “Who are <str<strong>on</strong>g>the</str<strong>on</strong>g> characters in <str<strong>on</strong>g>the</str<strong>on</strong>g> story?”<br />
More specific: “Who went into <str<strong>on</strong>g>the</str<strong>on</strong>g> 3 bears house without permissi<strong>on</strong>?”<br />
Event Generic Questi<strong>on</strong>: “What does <str<strong>on</strong>g>the</str<strong>on</strong>g> character do in <str<strong>on</strong>g>the</str<strong>on</strong>g> story?”<br />
More specific: “What did Goldilocks do when she got in <str<strong>on</strong>g>the</str<strong>on</strong>g> 3 bears house?<br />
Problem Generic Questi<strong>on</strong>: “What is <str<strong>on</strong>g>the</str<strong>on</strong>g> problem in <str<strong>on</strong>g>the</str<strong>on</strong>g> story?”<br />
More specific: “What did Goldilocks do to <str<strong>on</strong>g>the</str<strong>on</strong>g> bears house?”<br />
Soluti<strong>on</strong> Generic Questi<strong>on</strong>: “How does <str<strong>on</strong>g>the</str<strong>on</strong>g> character solve <str<strong>on</strong>g>the</str<strong>on</strong>g> problem?<br />
More specific: “What did Goldilocks do when <str<strong>on</strong>g>the</str<strong>on</strong>g> bears came home?”<br />
cards with statements specific to <strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
elements of a story from Goldilocks <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
Three Bears. With assistance from <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher,<br />
students matched <str<strong>on</strong>g>the</str<strong>on</strong>g> notecards with<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> appropriate element by placing <str<strong>on</strong>g>the</str<strong>on</strong>g> Velcro<br />
notecard <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> tagboard. For example, “Goldilocks”<br />
is placed next to <str<strong>on</strong>g>the</str<strong>on</strong>g> characters story<br />
card <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> tag board, <strong>and</strong> “Goldilocks tasted<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> porridge” next to <str<strong>on</strong>g>the</str<strong>on</strong>g> events card. After all<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> notecards were placed <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> tagboard,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> researcher <strong>and</strong> students reviewed <str<strong>on</strong>g>the</str<strong>on</strong>g> story<br />
elements.<br />
On <str<strong>on</strong>g>the</str<strong>on</strong>g> sec<strong>on</strong>d day, using <str<strong>on</strong>g>the</str<strong>on</strong>g> note cards from<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> previous less<strong>on</strong> <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> tag board story<br />
cards shown in Figure 1, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher asked<br />
students to independently match <str<strong>on</strong>g>the</str<strong>on</strong>g> note<br />
card <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> tag board next to <str<strong>on</strong>g>the</str<strong>on</strong>g> appropriate<br />
element of a story card. Following <str<strong>on</strong>g>the</str<strong>on</strong>g> review,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> researcher read Cloudy with a Chance of<br />
Meatballs to <str<strong>on</strong>g>the</str<strong>on</strong>g> students. Each student had a<br />
copy of <str<strong>on</strong>g>the</str<strong>on</strong>g> story, his or her own story cards<br />
c<strong>on</strong>taining <str<strong>on</strong>g>the</str<strong>on</strong>g> element of a story, a small<br />
individual tag board/story board <strong>and</strong> 10 note<br />
cards with statements specific to each of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
elements of <str<strong>on</strong>g>the</str<strong>on</strong>g> story read. The researcher<br />
asked students to match <str<strong>on</strong>g>the</str<strong>on</strong>g>ir notecards to <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
appropriate element of a story <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir own<br />
tagboard. During <str<strong>on</strong>g>the</str<strong>on</strong>g> task, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher provided<br />
corrective feedback. For example, if a<br />
student placed a note card describing <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
problem <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> tag board next to event, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
researcher asked <str<strong>on</strong>g>the</str<strong>on</strong>g> student to look at <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
story card. Then, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher read <str<strong>on</strong>g>the</str<strong>on</strong>g> generic<br />
questi<strong>on</strong> <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> story card: “What does<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> character do in <str<strong>on</strong>g>the</str<strong>on</strong>g> story?” “On your note<br />
card it says that <str<strong>on</strong>g>the</str<strong>on</strong>g> food falling from <str<strong>on</strong>g>the</str<strong>on</strong>g> sky is<br />
too large <strong>and</strong> destroying <str<strong>on</strong>g>the</str<strong>on</strong>g> town of Chew<strong>and</strong>swallow.”<br />
“Is that something <str<strong>on</strong>g>the</str<strong>on</strong>g> character<br />
did in <str<strong>on</strong>g>the</str<strong>on</strong>g> story?” “Let’s look at <str<strong>on</strong>g>the</str<strong>on</strong>g> problem<br />
card.” “It says, What is <str<strong>on</strong>g>the</str<strong>on</strong>g> problem in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
story?” “If <str<strong>on</strong>g>the</str<strong>on</strong>g> food is destroying <str<strong>on</strong>g>the</str<strong>on</strong>g> town, is<br />
that a problem?”<br />
SCORE instructi<strong>on</strong>. The SCORE curriculum<br />
was introduced after elements of a story<br />
instructi<strong>on</strong> <strong>and</strong> <strong>on</strong>e week prior to baseline.<br />
Each day for <strong>on</strong>e week, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher provided<br />
direct instructi<strong>on</strong> of cooperative behaviors<br />
using <str<strong>on</strong>g>the</str<strong>on</strong>g> SCORE curriculum with each<br />
participant <strong>and</strong> 3 general educati<strong>on</strong> cooperative<br />
partners in small groups of 4 students<br />
(Vern<strong>on</strong>, Schumaker, & Deshler, 1996). This<br />
curriculum has been used successfully in previous<br />
studies teaching academic c<strong>on</strong>tent to<br />
students with ASD in cooperative groups (Dugan,<br />
Kamps, & Le<strong>on</strong>ard, 1995; Kamps et al.,<br />
1995; 2002). SCORE includes <str<strong>on</strong>g>the</str<strong>on</strong>g> following<br />
cooperative learning behaviors: Share ideas,<br />
Compliment o<str<strong>on</strong>g>the</str<strong>on</strong>g>rs, Offer help or encouragement,<br />
Recommend changes nicely, <strong>and</strong> Exercise<br />
self-c<strong>on</strong>trol. At <str<strong>on</strong>g>the</str<strong>on</strong>g> end of each less<strong>on</strong>,<br />
students applied <str<strong>on</strong>g>the</str<strong>on</strong>g> skill during role play.<br />
After <str<strong>on</strong>g>the</str<strong>on</strong>g> role play sessi<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher <strong>and</strong><br />
students discussed examples of skill applicati<strong>on</strong>.<br />
To reach criteri<strong>on</strong>, all students defined<br />
<strong>and</strong> provided an example of <str<strong>on</strong>g>the</str<strong>on</strong>g> skill at <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
end of <str<strong>on</strong>g>the</str<strong>on</strong>g> less<strong>on</strong> <strong>and</strong> each c<strong>on</strong>secutive less<strong>on</strong><br />
until <str<strong>on</strong>g>the</str<strong>on</strong>g> SCORE curriculum ended. Less<strong>on</strong>s<br />
lasted approximately 30 minutes each day.<br />
Baseline. Baseline c<strong>on</strong>diti<strong>on</strong>s were <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
same as pre-baseline except that baseline followed<br />
Elements of a Story <strong>and</strong> SCORE instructi<strong>on</strong>.<br />
That is, each child with ASD <strong>and</strong> <strong>on</strong>e<br />
Reciprocal Questi<strong>on</strong>ing / 373
general educati<strong>on</strong> peer took turns reading<br />
<strong>on</strong>e storybook aloud during each sessi<strong>on</strong>. Before<br />
reading, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher prompted <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
students to ask <str<strong>on</strong>g>the</str<strong>on</strong>g>ir friend questi<strong>on</strong>s, “It is<br />
time to read with your friend. Remember to<br />
ask each o<str<strong>on</strong>g>the</str<strong>on</strong>g>r questi<strong>on</strong>s while you read.” The<br />
researcher provided no guidance or prompts<br />
related to questi<strong>on</strong> generati<strong>on</strong>. Also, throughout<br />
baseline, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher provided students<br />
with stickers <strong>on</strong> a SCORE chart as cooperative<br />
behaviors were observed.<br />
Interventi<strong>on</strong>. On <str<strong>on</strong>g>the</str<strong>on</strong>g> first day of <str<strong>on</strong>g>the</str<strong>on</strong>g> cooperative<br />
pairs interventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher<br />
r<strong>and</strong>omly assigned <str<strong>on</strong>g>the</str<strong>on</strong>g> child with<br />
ASD to <strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g> three typical peers participating<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> study. On each successive day,<br />
general educati<strong>on</strong> participants were rotated.<br />
Participants had access to <str<strong>on</strong>g>the</str<strong>on</strong>g> following materials:<br />
(a) copies of a storybook from Marc<br />
Brown’s Author series for each participant,<br />
(b) laminated self-m<strong>on</strong>itoring checklist <strong>and</strong><br />
vis-à-vis pen, (c) story cards c<strong>on</strong>taining elements<br />
of a story, corresp<strong>on</strong>ding picture, <strong>and</strong><br />
generic questi<strong>on</strong> (d) questi<strong>on</strong> word cards<br />
(i.e., who, what, when, where, why <strong>and</strong> how),<br />
<strong>and</strong> (e) a manipulative velcro storyboard (see<br />
Figures 1-3). Also, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher c<strong>on</strong>tinued to<br />
provide students with stickers <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> SCORE<br />
chart after students dem<strong>on</strong>strated a behavior<br />
c<strong>on</strong>sistent with <str<strong>on</strong>g>the</str<strong>on</strong>g> SCORE curriculum. Sessi<strong>on</strong>s<br />
took place four days a week for approximately<br />
40 minutes.<br />
The researcher began instructi<strong>on</strong> by verbally<br />
“walking” <str<strong>on</strong>g>the</str<strong>on</strong>g> students through each<br />
mental process used to c<strong>on</strong>struct a questi<strong>on</strong><br />
during reading. When generating a questi<strong>on</strong>,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> researcher placed <str<strong>on</strong>g>the</str<strong>on</strong>g> story card illustrating<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> relevant element of a story <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
Velcro storyboard followed by <str<strong>on</strong>g>the</str<strong>on</strong>g> appropriate<br />
questi<strong>on</strong> card (see Figure 3). After reading<br />
four pages of <str<strong>on</strong>g>the</str<strong>on</strong>g> book, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher asked<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> children, “Who wants to ask a questi<strong>on</strong>?”<br />
At that point, questi<strong>on</strong>ing was alternated between<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> two children <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher.<br />
The following is a detailed descripti<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
initial interventi<strong>on</strong> sessi<strong>on</strong> as it distinctly related<br />
to reciprocal questi<strong>on</strong>ing (i.e., <str<strong>on</strong>g>the</str<strong>on</strong>g> During<br />
Reading step <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> checklist in Figure 2).<br />
1. The researcher explained: “Good questi<strong>on</strong>s<br />
start with a questi<strong>on</strong> word such as<br />
who, what, when, where, why, <strong>and</strong> how.<br />
Also, a good questi<strong>on</strong> asks about important<br />
374 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
elements of <str<strong>on</strong>g>the</str<strong>on</strong>g> story such as, setting, characters,<br />
events, a problem, or a soluti<strong>on</strong>”<br />
while pointing to <str<strong>on</strong>g>the</str<strong>on</strong>g> story cards shown in<br />
Figure 1. The researcher <str<strong>on</strong>g>the</str<strong>on</strong>g>n read <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
generic questi<strong>on</strong> from story cards aloud.<br />
2. The researcher presented <str<strong>on</strong>g>the</str<strong>on</strong>g> story cards<br />
c<strong>on</strong>taining <str<strong>on</strong>g>the</str<strong>on</strong>g> elements of a story, corresp<strong>on</strong>ding<br />
picture <strong>and</strong> generic questi<strong>on</strong>s as<br />
well <str<strong>on</strong>g>the</str<strong>on</strong>g> removable questi<strong>on</strong> words (See<br />
Figure 3).<br />
3. The researcher read <str<strong>on</strong>g>the</str<strong>on</strong>g> story, stopping to<br />
ask questi<strong>on</strong>s before turning each page.<br />
4. The researcher asked questi<strong>on</strong>s by picking<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong> word, looking at <str<strong>on</strong>g>the</str<strong>on</strong>g> book,<br />
<strong>and</strong> restating what was read. For example,<br />
“I just found out what Arthur has for homework,<br />
so I can ask a questi<strong>on</strong> about an event<br />
because it is something <str<strong>on</strong>g>the</str<strong>on</strong>g> character has to<br />
do [<str<strong>on</strong>g>the</str<strong>on</strong>g> researcher placed <str<strong>on</strong>g>the</str<strong>on</strong>g> event card<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> storyboard] (see Figure 3). Because<br />
I want to ask about ‘what’ Arthur has for<br />
homework, I will start my questi<strong>on</strong> with<br />
‘what’ [researcher placed <str<strong>on</strong>g>the</str<strong>on</strong>g> what card <strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> storyboard]. So, my questi<strong>on</strong> is ‘What<br />
does Arthur have for homework?’” Or, if<br />
restating what was read would lead to a<br />
resp<strong>on</strong>se, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher made a generic<br />
statement followed by a questi<strong>on</strong> such as<br />
“Wow, Arthur has a problem. What is<br />
Arthur’s problem?” Table 4 provides examples<br />
of researcher dialogue related to all<br />
five elements of a story including questi<strong>on</strong>s,<br />
questi<strong>on</strong> words, <strong>and</strong> think aloud discussi<strong>on</strong>s.<br />
5. The researcher directed <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong> (generated<br />
in step 4 immediately above) to <strong>on</strong>e<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> students. If <str<strong>on</strong>g>the</str<strong>on</strong>g> student resp<strong>on</strong>ded to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong> correctly, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher<br />
praised <str<strong>on</strong>g>the</str<strong>on</strong>g> student. If <str<strong>on</strong>g>the</str<strong>on</strong>g> student resp<strong>on</strong>ded<br />
incorrectly, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher provided<br />
corrective feedback by putting <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
student’s resp<strong>on</strong>se in c<strong>on</strong>text <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>n<br />
modeling <str<strong>on</strong>g>the</str<strong>on</strong>g> appropriate answer by locating<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> answer in <str<strong>on</strong>g>the</str<strong>on</strong>g> text. If <str<strong>on</strong>g>the</str<strong>on</strong>g> student<br />
failed to resp<strong>on</strong>d in five sec<strong>on</strong>ds or repeated<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher rephrased<br />
for clarity or used restated using<br />
binary choice. If <str<strong>on</strong>g>the</str<strong>on</strong>g> student did not resp<strong>on</strong>d<br />
or resp<strong>on</strong>ded inappropriately, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
researcher provided corrective feedback<br />
<strong>and</strong> put <str<strong>on</strong>g>the</str<strong>on</strong>g> resp<strong>on</strong>se in c<strong>on</strong>text, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>n<br />
explained <str<strong>on</strong>g>the</str<strong>on</strong>g> correct answer. The scaffolding<br />
procedures are outlined in Table 5.
Figure 2. Self-m<strong>on</strong>itoring checklist<br />
Reciprocal Questi<strong>on</strong>ing / 375
6. After <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher asked three questi<strong>on</strong>s<br />
(as outlined in step 4 above), she verbally<br />
prompted a participant to ask a questi<strong>on</strong>:<br />
“Who would like to ask a questi<strong>on</strong>?”<br />
If <str<strong>on</strong>g>the</str<strong>on</strong>g> student did not ask a questi<strong>on</strong> in<br />
five sec<strong>on</strong>ds, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher provided a<br />
verbal prompt: “What did we learn about<br />
<strong>on</strong> this page?” Did we just learn about a<br />
character or an event?”<br />
If <str<strong>on</strong>g>the</str<strong>on</strong>g> student failed to ask a questi<strong>on</strong> in<br />
5 sec<strong>on</strong>ds, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher modeled questi<strong>on</strong><br />
generati<strong>on</strong>.<br />
7. The researcher <strong>and</strong> participants rotated<br />
around <str<strong>on</strong>g>the</str<strong>on</strong>g> table asking each o<str<strong>on</strong>g>the</str<strong>on</strong>g>r questi<strong>on</strong>s<br />
during this initial sessi<strong>on</strong>.<br />
After sessi<strong>on</strong> 2, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher no l<strong>on</strong>ger<br />
generated questi<strong>on</strong>s with participants <strong>and</strong><br />
provided scaffolding to include verbal<br />
prompting, modeling <strong>and</strong> corrective feedback<br />
as needed (see Table 5). Scaffolding was used<br />
when children with ASD <strong>and</strong>/or <str<strong>on</strong>g>the</str<strong>on</strong>g>ir general<br />
educati<strong>on</strong> peers had difficulty forming/re-<br />
Figure 3. Reciprocal questi<strong>on</strong>ing materials<br />
sp<strong>on</strong>ding to questi<strong>on</strong>s. Students had access to<br />
all needed materials during each sessi<strong>on</strong>, including<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> self- m<strong>on</strong>itoring checklist (Figure<br />
2).<br />
Interrater Reliability<br />
376 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
A special educati<strong>on</strong> graduate student was<br />
taught to code student <strong>and</strong> researcher behavior<br />
for reliability purposes. To learn coding<br />
procedures, <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher <strong>and</strong> student assistant<br />
watched videotapes taken during a pilot<br />
study of storybook reading using <str<strong>on</strong>g>the</str<strong>on</strong>g> same<br />
procedure but in a <strong>on</strong>e-to-<strong>on</strong>e situati<strong>on</strong> with a<br />
researcher <strong>and</strong> student. The graduate student<br />
<strong>and</strong> researcher watched <str<strong>on</strong>g>the</str<strong>on</strong>g> videos <strong>and</strong> coded<br />
researcher <strong>and</strong> student behaviors until 80%<br />
agreement was reached for three out of five<br />
c<strong>on</strong>secutive coding sessi<strong>on</strong>s. Agreement was<br />
reached by sessi<strong>on</strong> 3. At this time, <str<strong>on</strong>g>the</str<strong>on</strong>g> graduate<br />
student began coding interventi<strong>on</strong> data<br />
for reliability.<br />
Interrater reliability was calculated by divid-
TABLE 4<br />
Example Questi<strong>on</strong> Words, Think Aloud Procedures, <strong>and</strong> Questi<strong>on</strong>s<br />
Story<br />
Element<br />
Questi<strong>on</strong><br />
Word Think Aloud Questi<strong>on</strong><br />
Setting Where “I just learned something new about <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
setting.” I am going to ask a questi<strong>on</strong><br />
using ‘where’ because ‘where’ is a good<br />
questi<strong>on</strong> word when asking about<br />
setting.”<br />
Character Who “We just found out about a character.<br />
‘Who’ is a good questi<strong>on</strong> word when<br />
asking a character questi<strong>on</strong>.”<br />
Event Why “We found out that Arthur did something.<br />
He borrowed books from <str<strong>on</strong>g>the</str<strong>on</strong>g> Brain. So<br />
I can ask a questi<strong>on</strong> about an event.”<br />
Problem Why “Oh, Arthur is not sleeping well. I am<br />
going to ask a questi<strong>on</strong> about <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
problem using why.”<br />
Soluti<strong>on</strong> What “We just found out that Mr. Ratburn<br />
helped solve Arthur’s problem. I am<br />
going to ask a questi<strong>on</strong> about <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
soluti<strong>on</strong>, using what.”<br />
ing <str<strong>on</strong>g>the</str<strong>on</strong>g> number of agreements by <str<strong>on</strong>g>the</str<strong>on</strong>g> number<br />
of agreements plus disagreements <strong>and</strong> multiplying<br />
by 100. In additi<strong>on</strong>, a Kappa coefficient<br />
was calculated. Interrater reliability was assessed<br />
for 30% of all collected student data.<br />
Reliability of prompted <strong>and</strong> unprompted student<br />
generated questi<strong>on</strong>s was 85% with a<br />
Kappa value of .62, c<strong>on</strong>sidered “good” agreement<br />
(Cooper & Hedges, 1994). Reliability of<br />
unprompted <strong>and</strong> prompted student resp<strong>on</strong>ses<br />
was 90% with a Kappa value of .68, also c<strong>on</strong>sidered<br />
“good” agreement (Cooper &<br />
Hedges).<br />
Data Analysis<br />
To gain a better underst<strong>and</strong>ing of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong><br />
effects <strong>on</strong> individual performance, all<br />
data obtained are presented graphically (Pars<strong>on</strong>s<strong>on</strong><br />
& Baer, 1992). The data were graphed<br />
<strong>and</strong> visually inspected by investigating <str<strong>on</strong>g>the</str<strong>on</strong>g> degree<br />
as well as variability of change to determine<br />
interventi<strong>on</strong> effects (Barlow & Hersen,<br />
1984; Kamil, 1995).<br />
Treatment Fidelity<br />
A graduate student coded a r<strong>and</strong>omly selected<br />
30% of all interventi<strong>on</strong> <strong>and</strong> baseline sessi<strong>on</strong>s<br />
“Where did Arthur have<br />
his pet business?”<br />
“Who is helping Arthur<br />
write his story?”<br />
“Why did Arthur borrow<br />
books from <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
Brain?”<br />
“Why is Arthur not<br />
sleeping well?”<br />
“What did Mr. Ratburn<br />
do to help Arthur<br />
solve his problem?”<br />
to document <str<strong>on</strong>g>the</str<strong>on</strong>g> specified interventi<strong>on</strong> procedures<br />
(see procedures secti<strong>on</strong> for a descripti<strong>on</strong>).<br />
Data collecti<strong>on</strong> c<strong>on</strong>sisted of frequency<br />
counts of researcher prompting, instructi<strong>on</strong>al<br />
steps completed, <strong>and</strong> presence of needed materials.<br />
The researcher adhered to procedures<br />
during all baseline <strong>and</strong> interventi<strong>on</strong> segments<br />
viewed 100% of <str<strong>on</strong>g>the</str<strong>on</strong>g> time. Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r, appropriate<br />
materials were presented in 100% of all baseline<br />
sessi<strong>on</strong>s, <strong>and</strong> 92% of <str<strong>on</strong>g>the</str<strong>on</strong>g> time during<br />
interventi<strong>on</strong>.<br />
Results<br />
Visual inspecti<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> data (presented in<br />
Figures 4 <strong>and</strong> 5) reveals a functi<strong>on</strong>al relati<strong>on</strong>ship<br />
between <str<strong>on</strong>g>the</str<strong>on</strong>g> implementati<strong>on</strong> of a reciprocal<br />
questi<strong>on</strong>ing interventi<strong>on</strong> delivered in cooperative<br />
pairs <strong>and</strong> questi<strong>on</strong> generati<strong>on</strong> <strong>and</strong><br />
resp<strong>on</strong>ding of <str<strong>on</strong>g>the</str<strong>on</strong>g> three children with ASD.<br />
That is, <strong>on</strong>ce interventi<strong>on</strong> began, all three<br />
children increased frequency of unprompted<br />
questi<strong>on</strong> generati<strong>on</strong> <strong>and</strong> resp<strong>on</strong>ding during<br />
reading.<br />
Questi<strong>on</strong> Generati<strong>on</strong><br />
Figure 4 illustrates <str<strong>on</strong>g>the</str<strong>on</strong>g> frequency of unprompted<br />
<strong>and</strong> prompted questi<strong>on</strong>s generated<br />
Reciprocal Questi<strong>on</strong>ing / 377
TABLE 5<br />
Researcher Scaffolding Procedure<br />
Teacher Prompt Situati<strong>on</strong> Definiti<strong>on</strong><br />
Verbal Prompt ● Child fails to initiate a questi<strong>on</strong> Questi<strong>on</strong><br />
● Child asks for help ● “What does your checklist tell you to do?”<br />
● Child repeats a generic questi<strong>on</strong> ● “What is a good questi<strong>on</strong> word when<br />
● Child repeatedly asks a questi<strong>on</strong> asking a character questi<strong>on</strong>?”<br />
about <str<strong>on</strong>g>the</str<strong>on</strong>g> same element of a ● “What elements of <str<strong>on</strong>g>the</str<strong>on</strong>g> story did you just<br />
story<br />
read about?”<br />
● Child does not resp<strong>on</strong>d to a peer<br />
questi<strong>on</strong><br />
by all three participants with ASD. Because<br />
participants did not ask any questi<strong>on</strong>s unrelated<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> story, <str<strong>on</strong>g>the</str<strong>on</strong>g> graph c<strong>on</strong>sists of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
frequency of unprompted versus prompted<br />
questi<strong>on</strong> generati<strong>on</strong> <strong>on</strong>ly. The change in frequency<br />
of unprompted questi<strong>on</strong> generati<strong>on</strong><br />
was immediate for Austin <strong>and</strong> Barry. Chris<br />
also showed an increase in <str<strong>on</strong>g>the</str<strong>on</strong>g> number of<br />
unprompted questi<strong>on</strong>s asked, but with greater<br />
variability. The frequency of unprompted<br />
questi<strong>on</strong>s increased from 0–1 at baseline to a<br />
range of 1–6, 1–4, <strong>and</strong> 0–4 during interventi<strong>on</strong><br />
for Austin, Barry, <strong>and</strong> Chris respectively.<br />
Prompting decreased as children began generating<br />
questi<strong>on</strong>s independently.<br />
As dem<strong>on</strong>strated in Table 6, unprompted<br />
<strong>and</strong> prompted questi<strong>on</strong> generati<strong>on</strong> was not<br />
● “What did you just read about?”<br />
Comment<br />
● “D<strong>on</strong>’t forget to follow your checklist.”<br />
● “Remember to make your questi<strong>on</strong> about<br />
something you just read.”<br />
● “Try to ask a questi<strong>on</strong> about .”<br />
Modeling Child Generated Questi<strong>on</strong> The teacher models how to ask an<br />
● Child does not resp<strong>on</strong>d to a appropriate questi<strong>on</strong> by:<br />
verbal prompt ● placing <str<strong>on</strong>g>the</str<strong>on</strong>g> appropriate story <strong>and</strong> word<br />
● After corrective feedback<br />
card <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> storyboard<br />
following a child generated ● asking a questi<strong>on</strong> directly related to <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
questi<strong>on</strong><br />
element of <str<strong>on</strong>g>the</str<strong>on</strong>g> story identified <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
story card<br />
Corrective Feedback Child Resp<strong>on</strong>se<br />
● The teacher uses <str<strong>on</strong>g>the</str<strong>on</strong>g> child’s resp<strong>on</strong>se in<br />
● Child gives an incorrect<br />
c<strong>on</strong>text, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>n provides <str<strong>on</strong>g>the</str<strong>on</strong>g> correct<br />
resp<strong>on</strong>se to a questi<strong>on</strong><br />
resp<strong>on</strong>se<br />
● Child asks an unclear or<br />
● The teacher explains why <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong><br />
inappropriate questi<strong>on</strong><br />
does not ask something about <str<strong>on</strong>g>the</str<strong>on</strong>g> chosen<br />
Child Generated Questi<strong>on</strong><br />
part of <str<strong>on</strong>g>the</str<strong>on</strong>g> story <str<strong>on</strong>g>the</str<strong>on</strong>g>n, models an<br />
● Child asks an unclear or<br />
appropriate questi<strong>on</strong><br />
inappropriate questi<strong>on</strong><br />
● The teacher explains why <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong><br />
● Child gives an incorrect<br />
does not ask something about <str<strong>on</strong>g>the</str<strong>on</strong>g> chosen<br />
resp<strong>on</strong>se to a questi<strong>on</strong><br />
part of <str<strong>on</strong>g>the</str<strong>on</strong>g> story <str<strong>on</strong>g>the</str<strong>on</strong>g>n, models an<br />
appropriate questi<strong>on</strong><br />
378 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
c<strong>on</strong>sistent am<strong>on</strong>g children with ASD, yet <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
were representative of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir general educati<strong>on</strong><br />
peers. Similarities am<strong>on</strong>g individual children<br />
with ASD <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir general educati<strong>on</strong> counterparts<br />
were observed in <str<strong>on</strong>g>the</str<strong>on</strong>g> percentage of<br />
unprompted questi<strong>on</strong>s posed.<br />
Austin. The proporti<strong>on</strong> of unprompted versus<br />
prompted questi<strong>on</strong>s was high for Austin<br />
when generating questi<strong>on</strong>s related to characters,<br />
but lower when generating questi<strong>on</strong>s pertaining<br />
to an event or problem (see Table 6).<br />
The c<strong>on</strong>tent of initial questi<strong>on</strong>s generated by<br />
Austin were generic, reflective of questi<strong>on</strong>s<br />
printed <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> storycards, <strong>and</strong> primarily focused<br />
<strong>on</strong> characters <strong>and</strong> setting. Over time,<br />
Austin began asking more specific questi<strong>on</strong>s<br />
that went bey<strong>on</strong>d character <strong>and</strong> setting iden-
Figure 4. Frequency of prompted <strong>and</strong> unprompted student generated questi<strong>on</strong>s by children with autism<br />
spectrum disorder<br />
tificati<strong>on</strong> to interpretati<strong>on</strong> of events, problems,<br />
<strong>and</strong> soluti<strong>on</strong>s. For example, in beginning<br />
sessi<strong>on</strong>s, Austin asked <str<strong>on</strong>g>the</str<strong>on</strong>g> following,<br />
“Where are <str<strong>on</strong>g>the</str<strong>on</strong>g>y going?”; “Who is Arthur telling<br />
to go away?” In later sessi<strong>on</strong>s, Austin’s<br />
unprompted questi<strong>on</strong>s were specific <strong>and</strong><br />
clearly stated, “Why does Arthur have to clean<br />
up his room before mommy gets home?”;<br />
“What did Arthur <strong>and</strong> Buster fight about?”<br />
Barry. Barry posed few character <strong>and</strong> setting<br />
questi<strong>on</strong>s, <strong>and</strong> needed higher levels of<br />
prompting when questi<strong>on</strong>s targeted an event<br />
as opposed to o<str<strong>on</strong>g>the</str<strong>on</strong>g>r story elements (see Table<br />
6). Unlike o<str<strong>on</strong>g>the</str<strong>on</strong>g>r participants with ASD, Barry<br />
effectively asked “why” questi<strong>on</strong>s throughout<br />
interventi<strong>on</strong>, which most often reflected <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
problem in <str<strong>on</strong>g>the</str<strong>on</strong>g> story. However, during initial<br />
sessi<strong>on</strong>s, Barry started <str<strong>on</strong>g>the</str<strong>on</strong>g> majority of his questi<strong>on</strong>s<br />
using <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong> word “why.” Later, he<br />
effectively asked a range of questi<strong>on</strong>s using<br />
questi<strong>on</strong> words o<str<strong>on</strong>g>the</str<strong>on</strong>g>r than “why” (e.g., “What<br />
did Arthur’s puppy do?”; “What happened to<br />
Reciprocal Questi<strong>on</strong>ing / 379
TABLE 6<br />
Questi<strong>on</strong> Generati<strong>on</strong> by Element of a Story<br />
Participants<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> computer?”). By <str<strong>on</strong>g>the</str<strong>on</strong>g> end of interventi<strong>on</strong>,<br />
Barry used a number of questi<strong>on</strong> words, <strong>and</strong><br />
<strong>on</strong>ly received prompting when questi<strong>on</strong>s did<br />
not reflect <str<strong>on</strong>g>the</str<strong>on</strong>g> element of a story.<br />
Chris. In comparis<strong>on</strong> to o<str<strong>on</strong>g>the</str<strong>on</strong>g>r children with<br />
ASD, Chris dem<strong>on</strong>strated <str<strong>on</strong>g>the</str<strong>on</strong>g> highest percentage<br />
of unprompted questi<strong>on</strong>s when asking<br />
about a problem <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> lowest percentage<br />
when asking about characters <strong>and</strong> events (see<br />
Table 6). Chris’s difficulty forming character<br />
questi<strong>on</strong>s was a result of using “who” <strong>and</strong><br />
“what” questi<strong>on</strong> words interchangeably, “Who<br />
is mommy doing?” Chris relied primarily <strong>on</strong><br />
modeling to ask a questi<strong>on</strong> during beginning<br />
sessi<strong>on</strong>s. By sessi<strong>on</strong> 6, he was c<strong>on</strong>sistently asking<br />
more unprompted than prompted questi<strong>on</strong>s<br />
during reading. During initial sessi<strong>on</strong>s,<br />
Chris used a lot of self-talk, “I can ask an<br />
element. Setting is an element.” By <str<strong>on</strong>g>the</str<strong>on</strong>g> end of<br />
sessi<strong>on</strong> 5, Chris asked his first specific problem<br />
questi<strong>on</strong>, “Why did Muffy trip <str<strong>on</strong>g>the</str<strong>on</strong>g> brain?”<br />
Throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>, Chris progressively<br />
asked more specific questi<strong>on</strong>s reflecting<br />
story c<strong>on</strong>tent, “Why is <str<strong>on</strong>g>the</str<strong>on</strong>g>ir house all messy?”<br />
Self-talk remained prominent, but instances<br />
of failing to ask a questi<strong>on</strong> decreased steadily<br />
after sessi<strong>on</strong> eight. At <str<strong>on</strong>g>the</str<strong>on</strong>g> end of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>,<br />
Chris c<strong>on</strong>tinued to use “who” <strong>and</strong> “what”<br />
questi<strong>on</strong> words interchangeably.<br />
Unprompted Resp<strong>on</strong>ses<br />
Characters Setting Event Problem Soluti<strong>on</strong> Totals<br />
UP P UP P UP P UP P UP P UP P<br />
Figure 5 shows <str<strong>on</strong>g>the</str<strong>on</strong>g> frequency of unprompted<br />
resp<strong>on</strong>ses by each child. Immediately after interventi<strong>on</strong><br />
began, general educati<strong>on</strong> peers increased<br />
questi<strong>on</strong> generati<strong>on</strong>. Because <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong><br />
involved reciprocal questi<strong>on</strong>ing,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> resp<strong>on</strong>ses of <str<strong>on</strong>g>the</str<strong>on</strong>g> children with ASD were<br />
Total #<br />
Generated<br />
Cole 11 2 12 1 16 8 4 6 0 2 43 19 62<br />
Cole’s Ps 23 2 2 2 6 13 6 8 0 1 36 26 63<br />
Dean 1 1 1 2 9 6 17 4 0 4 28 17 45<br />
Dean’s Ps 3 2 5 0 12 14 7 4 1 0 28 20 48<br />
Nate 3 7 3 1 13 9 9 3 1 5 29 25 54<br />
Nate’s Ps 6 5 7 2 13 7 15 5 0 0 30 30 60<br />
380 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
highly dependent <strong>on</strong> questi<strong>on</strong>s posed by general<br />
educati<strong>on</strong> peers. That is, all three children<br />
with ASD show a general pattern of increased<br />
unprompted resp<strong>on</strong>ses with an<br />
increase in <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong>s posed by peers, although<br />
with individual variati<strong>on</strong>s in relati<strong>on</strong><br />
to c<strong>on</strong>sistency. The number of times participants<br />
with ASD resp<strong>on</strong>ded to questi<strong>on</strong>s generated<br />
by peers without prompting ranged<br />
from 2–6, 1–6 <strong>and</strong> 1–5 for Austin, Barry <strong>and</strong><br />
Chris respectively.<br />
Participants with ASD <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir general educati<strong>on</strong><br />
peers had <str<strong>on</strong>g>the</str<strong>on</strong>g> opportunity to resp<strong>on</strong>d<br />
to a variety of questi<strong>on</strong>s focusing <strong>on</strong> each of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> 5 elements of a story (see Table 7). The<br />
proporti<strong>on</strong> of unprompted versus prompted<br />
resp<strong>on</strong>ses was variable. Participants with ASD<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir peers received <str<strong>on</strong>g>the</str<strong>on</strong>g> least amount of<br />
prompting when resp<strong>on</strong>ding to character <strong>and</strong><br />
setting questi<strong>on</strong>s. Resp<strong>on</strong>ses to problem questi<strong>on</strong>s<br />
showed greater variability. Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r, soluti<strong>on</strong><br />
questi<strong>on</strong>s were asked very infrequently by<br />
participants, making it difficult to note any<br />
patterns in resp<strong>on</strong>ding behavior. Very few participants<br />
failed to resp<strong>on</strong>d or resp<strong>on</strong>ded with<br />
“I d<strong>on</strong>’t know.”<br />
Questi<strong>on</strong>s that required a resp<strong>on</strong>se bey<strong>on</strong>d<br />
text recall required prompting more often<br />
than resp<strong>on</strong>ses directly found in text. That is,<br />
if a resp<strong>on</strong>se required interpretati<strong>on</strong> of a character’s<br />
behavior or summarizing a character’s<br />
acti<strong>on</strong>s or events, <str<strong>on</strong>g>the</str<strong>on</strong>g> need for prompting increased.<br />
For example, in <str<strong>on</strong>g>the</str<strong>on</strong>g> story Arthur Goes<br />
to Camp, Rocky (<str<strong>on</strong>g>the</str<strong>on</strong>g> boy’s camp counselor) is<br />
yelling at <str<strong>on</strong>g>the</str<strong>on</strong>g> boys about <str<strong>on</strong>g>the</str<strong>on</strong>g>ir physical shape.<br />
Earlier in <str<strong>on</strong>g>the</str<strong>on</strong>g> story, references were made<br />
about sporting competiti<strong>on</strong>s between <str<strong>on</strong>g>the</str<strong>on</strong>g> boys<br />
<strong>and</strong> girls camps, <strong>and</strong> Rocky is yelling at <str<strong>on</strong>g>the</str<strong>on</strong>g>
Figure 5. Frequency of unprompted student resp<strong>on</strong>ses by children with autism spectrum disorder by<br />
frequency of peer generated questi<strong>on</strong>s<br />
boys about getting in better shape. One participant<br />
asked, “Why is Rocky being so mean<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> boys?” To answer this questi<strong>on</strong>, first, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
student must interpret Rocky’s behavior as<br />
“mean.” Then, <str<strong>on</strong>g>the</str<strong>on</strong>g> participant has to link<br />
Rocky’s pushing <str<strong>on</strong>g>the</str<strong>on</strong>g> boys to get into better<br />
shape as a reflecti<strong>on</strong> of his desire to win <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
competiti<strong>on</strong>. This takes summarizing informati<strong>on</strong><br />
from within text <strong>and</strong> linking it to what <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
participant already knows about competiti<strong>on</strong>.<br />
Social Validity<br />
Social validity data were collected including<br />
interviews with parents of children with ASD,<br />
interviews of children with ASD, <strong>and</strong> interviews<br />
with 8 of 9 participating general educati<strong>on</strong><br />
peers. Parents were interviewed regarding<br />
degree of change noticed in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir child’s<br />
reading <strong>and</strong> social behavior, <strong>and</strong> whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r or<br />
not <str<strong>on</strong>g>the</str<strong>on</strong>g>y felt <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was important<br />
Reciprocal Questi<strong>on</strong>ing / 381
TABLE 7<br />
Unprompted <strong>and</strong> Prompted Resp<strong>on</strong>ses by Element of a Story<br />
Participants<br />
Characters Setting Event Problem Soluti<strong>on</strong> Totals<br />
UP P UP P UP P UP P UP P UP P<br />
Cole 24 1 3 1 14 5 8 6 1 0 50 13 63<br />
Cole’s P’s 11 3 11 2 20 5 4 4 2 0 48 14 62<br />
Dean 4 1 5 0 18 8 6 5 0 1 33 15 48<br />
Dean’s P’s 1 0 2 1 15 4 15 5 1 1 34 11 45<br />
Nate 9 2 8 1 15 5 9 11 0 0 41 19 60<br />
Nate’s P’s 5 0 3 1 18 5 14 1 6 1 48 6 54<br />
<strong>and</strong> necessary for <str<strong>on</strong>g>the</str<strong>on</strong>g>ir child. Later, parents<br />
were shown a video of <str<strong>on</strong>g>the</str<strong>on</strong>g> first interventi<strong>on</strong><br />
sessi<strong>on</strong> followed by a video of <str<strong>on</strong>g>the</str<strong>on</strong>g> last sessi<strong>on</strong>,<br />
<strong>and</strong> were asked to describe any changes in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir child’s reading <strong>and</strong> language skills. Children<br />
with ASD <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir general educati<strong>on</strong><br />
peers were interviewed separately. Questi<strong>on</strong>s<br />
pertained to usefulness of <str<strong>on</strong>g>the</str<strong>on</strong>g> reading interventi<strong>on</strong>.<br />
Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r, children were asked about<br />
relati<strong>on</strong>ships established with <str<strong>on</strong>g>the</str<strong>on</strong>g>ir reading<br />
partners during interventi<strong>on</strong>.<br />
All participants with ASD stated <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong><br />
helped <str<strong>on</strong>g>the</str<strong>on</strong>g>m underst<strong>and</strong> what <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
read. Barry <strong>and</strong> Austin reported <str<strong>on</strong>g>the</str<strong>on</strong>g>y still ask<br />
questi<strong>on</strong>s when <str<strong>on</strong>g>the</str<strong>on</strong>g>y read. When asked what<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y liked best about <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>, Austin<br />
focused <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> books <strong>and</strong> reading with peers,<br />
Barry reported a preference for working with<br />
<strong>on</strong>e peer, <strong>and</strong> Chris enjoyed using <str<strong>on</strong>g>the</str<strong>on</strong>g> checklist.<br />
Austin described positive attributes of all<br />
three of his peers, <strong>and</strong> Barry favored <strong>on</strong>e peer<br />
he thought of as “cool.”<br />
All general educati<strong>on</strong> peers indicated <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
interventi<strong>on</strong> was helpful, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>y enjoyed<br />
participating. General educati<strong>on</strong> participants<br />
stated <str<strong>on</strong>g>the</str<strong>on</strong>g>y learned new words (n 3) <strong>and</strong><br />
how to ask questi<strong>on</strong>s (n 3). Also, <strong>on</strong>e participant<br />
noted she was able to take time to<br />
read, ano<str<strong>on</strong>g>the</str<strong>on</strong>g>r menti<strong>on</strong>ed feeling encouraged<br />
to read more, <strong>and</strong> a third thought <str<strong>on</strong>g>the</str<strong>on</strong>g> book<br />
helped him learn. Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r, six participants<br />
reported <str<strong>on</strong>g>the</str<strong>on</strong>g>y c<strong>on</strong>tinued to ask questi<strong>on</strong>s<br />
when reading <strong>and</strong> reported <str<strong>on</strong>g>the</str<strong>on</strong>g>y talked to <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
children with ASD more often. When asked<br />
what <str<strong>on</strong>g>the</str<strong>on</strong>g>y thought of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir peers with ASD, all<br />
communicated differences in percepti<strong>on</strong>. For<br />
example, <strong>on</strong>e of Austin’s peers stated that before<br />
interventi<strong>on</strong> he found Austin “a little<br />
382 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Total #<br />
Posed<br />
weird,” but after interventi<strong>on</strong> he thought of<br />
Austin as “a good friend.” Similarly, <strong>on</strong>e of<br />
Chris’s peers believed Chris was “a nice pers<strong>on</strong>”<br />
prior to interventi<strong>on</strong>, <strong>and</strong> after she c<strong>on</strong>sidered<br />
him “nice” <strong>and</strong> “smart.” In fact she<br />
stated: “. . . he didn’t really need my help at all<br />
because he was really smart.” Overall, six of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> seven peers would participate in <str<strong>on</strong>g>the</str<strong>on</strong>g> reading<br />
interventi<strong>on</strong> again, <strong>and</strong> <strong>on</strong>e indicated he<br />
might.<br />
Parents of children with ASD were shown a<br />
video of <str<strong>on</strong>g>the</str<strong>on</strong>g> first interventi<strong>on</strong> sessi<strong>on</strong> followed<br />
by a video of <str<strong>on</strong>g>the</str<strong>on</strong>g> last sessi<strong>on</strong> <strong>and</strong> were <str<strong>on</strong>g>the</str<strong>on</strong>g>n<br />
asked to describe any changes in her child’s<br />
reading <strong>and</strong> language skills from <str<strong>on</strong>g>the</str<strong>on</strong>g> first to<br />
last sessi<strong>on</strong>. Austin’s mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r reported improvement<br />
in Austin’s questi<strong>on</strong> formati<strong>on</strong> <strong>and</strong><br />
attenti<strong>on</strong> while reading. Barry’s parents <strong>and</strong><br />
Chris’s mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r acknowledged a positive gain<br />
in reading fluency including rate, accuracy<br />
<strong>and</strong>/or expressi<strong>on</strong>. Chris’s mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r noted<br />
forming questi<strong>on</strong>s remained difficult for him<br />
<strong>and</strong> stated he had trouble “. . . coming up with<br />
words.” Austin’s mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r <strong>and</strong> Barry’s parents<br />
observed a decrease in <str<strong>on</strong>g>the</str<strong>on</strong>g> level of prompting<br />
prior to <strong>and</strong> following interventi<strong>on</strong> while<br />
Chris’s mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r noticed less prompting related<br />
to initiati<strong>on</strong> of a questi<strong>on</strong>.<br />
Overall, Austin <strong>and</strong> Chris’s mo<str<strong>on</strong>g>the</str<strong>on</strong>g>rs, as well<br />
as Barry’s parents, agreed that <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong><br />
was valuable. Austin’s mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r <strong>and</strong> Barry’s<br />
parents suggested <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was important<br />
for both reading <strong>and</strong> language. Moreover,<br />
Barry’s parents indicated it improved<br />
Barry’s “c<strong>on</strong>versati<strong>on</strong>al skills.” Chris’s mo<str<strong>on</strong>g>the</str<strong>on</strong>g>r<br />
valued <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> because Chris no<br />
l<strong>on</strong>ger resp<strong>on</strong>ded to questi<strong>on</strong>s with “I d<strong>on</strong>’t<br />
know.” Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r, all interviewees would like
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir children to participate in a similar interventi<strong>on</strong><br />
again.<br />
Discussi<strong>on</strong><br />
The purpose of this study was to determine<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> effect of a reciprocal questi<strong>on</strong>ing comprehensi<strong>on</strong><br />
strategy delivered in <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>text of<br />
cooperative pairs <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong> generati<strong>on</strong><br />
<strong>and</strong> resp<strong>on</strong>ding of three children with ASD.<br />
All children with ASD were able to learn <strong>and</strong><br />
effectively utilize a questi<strong>on</strong> generati<strong>on</strong> strategy<br />
<strong>and</strong> increased frequency of questi<strong>on</strong> generati<strong>on</strong><br />
<strong>and</strong> resp<strong>on</strong>ding during reading. In<br />
additi<strong>on</strong>, social validity data documented that<br />
both children with <strong>and</strong> without ASD enjoyed<br />
participating in <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> <strong>and</strong> thought<br />
it beneficial. Parents of all three children with<br />
ASD also felt <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was important<br />
<strong>and</strong> had a positive effect <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir child.<br />
Individual Variati<strong>on</strong> in Questi<strong>on</strong> Generati<strong>on</strong><br />
Immediate <strong>and</strong> c<strong>on</strong>sistent gains experienced<br />
by Austin may be representative of his language<br />
ability. On descriptive receptive/expressive<br />
language measures, Austin scored<br />
higher than his peers with ASD. Yet, he dem<strong>on</strong>strated<br />
a discrepancy between scores, scoring<br />
higher <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> expressive than receptive<br />
language measure, not uncomm<strong>on</strong> for children<br />
with Asperger syndrome (Tantum,<br />
2000). It is possible that Austin had less trouble<br />
forming questi<strong>on</strong>s initially, resulting in his<br />
ability to focus his attenti<strong>on</strong> <strong>on</strong> meaning, i.e.,<br />
c<strong>on</strong>tent related to <str<strong>on</strong>g>the</str<strong>on</strong>g> story ra<str<strong>on</strong>g>the</str<strong>on</strong>g>r than <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
mechanics of questi<strong>on</strong> formati<strong>on</strong>.<br />
In c<strong>on</strong>trast to Austin, Barry <strong>and</strong> Chris<br />
scored at least <strong>on</strong>e st<strong>and</strong>ard deviati<strong>on</strong> below<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> mean <strong>on</strong> both expressive <strong>and</strong> receptive<br />
language measures given prior to interventi<strong>on</strong>.<br />
During beginning interventi<strong>on</strong> sessi<strong>on</strong>s,<br />
Barry <strong>and</strong> Chris had greater difficulty forming<br />
questi<strong>on</strong>s, attending more to <str<strong>on</strong>g>the</str<strong>on</strong>g> form <strong>and</strong><br />
functi<strong>on</strong> of questi<strong>on</strong> generati<strong>on</strong>. From <str<strong>on</strong>g>the</str<strong>on</strong>g> <strong>on</strong>set<br />
of interventi<strong>on</strong>, Barry was able to generate<br />
‘why’ questi<strong>on</strong>s effectively, but had greater<br />
difficulty posing questi<strong>on</strong>s with an alternate<br />
questi<strong>on</strong> word. For example, “Elements of a<br />
story, because Arthur is doing something in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> story.” Similar to Barry, Chris also had<br />
trouble forming questi<strong>on</strong>s during beginning<br />
sessi<strong>on</strong>s, “I can ask an element. Setting is an<br />
element.” This is c<strong>on</strong>sistent with <str<strong>on</strong>g>the</str<strong>on</strong>g> research<br />
<strong>on</strong> language development of children with<br />
ASD, that is, many children with ASD have<br />
difficulty underst<strong>and</strong>ing how to use language<br />
to obtain a specific goal (We<str<strong>on</strong>g>the</str<strong>on</strong>g>rby, 1986).<br />
Over <str<strong>on</strong>g>the</str<strong>on</strong>g> course of interventi<strong>on</strong>, Barry began<br />
forming questi<strong>on</strong>s using various questi<strong>on</strong><br />
words, <strong>and</strong> Chris began generating c<strong>on</strong>tent<br />
specific questi<strong>on</strong>s. Therefore, initial interventi<strong>on</strong><br />
effects may reflect an expansi<strong>on</strong> in communicative<br />
functi<strong>on</strong> for Barry <strong>and</strong> Chris, specifically,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> functi<strong>on</strong> of asking <strong>and</strong><br />
resp<strong>on</strong>ding to questi<strong>on</strong>s interactively during<br />
reading.<br />
Gestalt Learning<br />
Children with autism often begin using language<br />
by imitating vocalizati<strong>on</strong>s. As children<br />
with ASD use <str<strong>on</strong>g>the</str<strong>on</strong>g>se vocalizati<strong>on</strong>s in c<strong>on</strong>text,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y begin to underst<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir meaning <strong>and</strong><br />
functi<strong>on</strong>. As a result, more inventive language<br />
emerges as imitative, rigid vocalizati<strong>on</strong>s decrease<br />
(Schuler, Prizant, & We<str<strong>on</strong>g>the</str<strong>on</strong>g>rby, 1997).<br />
This pattern of language development has<br />
been described as a Gestalt learning style<br />
(We<str<strong>on</strong>g>the</str<strong>on</strong>g>rby, Prizant, & Schuler, 2000). The Gestalt<br />
learning style has been explained as<br />
learning in chunks. When applied to language<br />
development, <str<strong>on</strong>g>the</str<strong>on</strong>g> child interprets a chunk of<br />
language as meaning associated with <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>text<br />
in which it was originally heard or<br />
learned. Initially, chunks of language are repeated<br />
with little comprehensi<strong>on</strong> of functi<strong>on</strong>,<br />
sometimes taking <strong>on</strong> unc<strong>on</strong>venti<strong>on</strong>al forms of<br />
language. As <str<strong>on</strong>g>the</str<strong>on</strong>g> child begins to underst<strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> functi<strong>on</strong> or intent to a greater extent,<br />
he/she begins pers<strong>on</strong>alizing vocalizati<strong>on</strong>s by<br />
modifying repeated phrases. Through experience<br />
using <strong>and</strong> modifying <str<strong>on</strong>g>the</str<strong>on</strong>g>se phrases, more<br />
sp<strong>on</strong>taneous speech occurs (We<str<strong>on</strong>g>the</str<strong>on</strong>g>rby et al.).<br />
Both Austin <strong>and</strong> Chris used story cards to<br />
build questi<strong>on</strong>s during initial sessi<strong>on</strong>s, “What<br />
is <str<strong>on</strong>g>the</str<strong>on</strong>g> problem in <str<strong>on</strong>g>the</str<strong>on</strong>g> story?”; “What is <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
character doing in <str<strong>on</strong>g>the</str<strong>on</strong>g> story?” Later, both participants<br />
became more flexible with questi<strong>on</strong><br />
generati<strong>on</strong>. For example, Austin asked, “What<br />
is Mrs. McGrady, Fern <strong>and</strong> Binky doing?” <strong>and</strong><br />
Chris, “Why did Muffy trip <str<strong>on</strong>g>the</str<strong>on</strong>g> brain?” The<br />
initial success of using <str<strong>on</strong>g>the</str<strong>on</strong>g> story card to form a<br />
questi<strong>on</strong> could be a reflecti<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> gestalt<br />
learning style associated with autism. That is,<br />
participants began using <str<strong>on</strong>g>the</str<strong>on</strong>g> direct model,<br />
Reciprocal Questi<strong>on</strong>ing / 383
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>n modified questi<strong>on</strong>s to fit <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>text<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> story, becoming more creative with<br />
questi<strong>on</strong> generati<strong>on</strong>.<br />
Similarly, Barry initially generated questi<strong>on</strong>s<br />
using <strong>on</strong>ly ‘why.’ This heavy reliance <strong>on</strong><br />
‘why’ questi<strong>on</strong>s during beginning sessi<strong>on</strong>s<br />
may signify familiarity with <str<strong>on</strong>g>the</str<strong>on</strong>g> form <strong>and</strong> functi<strong>on</strong><br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g>se questi<strong>on</strong>s. It is c<strong>on</strong>ceivable that<br />
as Barry became more comfortable with <strong>and</strong><br />
began to comprehend <str<strong>on</strong>g>the</str<strong>on</strong>g> purpose <strong>and</strong> functi<strong>on</strong><br />
of generating questi<strong>on</strong>s during reading,<br />
his creativity with questi<strong>on</strong> formati<strong>on</strong> increased<br />
by exp<strong>and</strong>ing questi<strong>on</strong> word use (i.e.,<br />
who, how, what). Also, all three participants<br />
increased <str<strong>on</strong>g>the</str<strong>on</strong>g> frequency of unprompted resp<strong>on</strong>ses<br />
bey<strong>on</strong>d answering using informati<strong>on</strong><br />
directly stated in text or immediate recall to<br />
interpretati<strong>on</strong> of events within text.<br />
Results Indicative of Age<br />
All participants with autism as well as <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
general educati<strong>on</strong> peers received variable levels<br />
of prompting when questi<strong>on</strong>s required interpretati<strong>on</strong><br />
of text bey<strong>on</strong>d factual informati<strong>on</strong>.<br />
If <str<strong>on</strong>g>the</str<strong>on</strong>g> participant had to summarize<br />
informati<strong>on</strong> from <str<strong>on</strong>g>the</str<strong>on</strong>g> text or use prior knowledge<br />
or experience to generate or resp<strong>on</strong>d,<br />
instances of prompting were greater. For example,<br />
both children with ASD <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir general<br />
educati<strong>on</strong> peers had more difficulty with<br />
questi<strong>on</strong>s <strong>and</strong>/or resp<strong>on</strong>ses reflecting a problem<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> story. To generate <strong>and</strong>/or resp<strong>on</strong>d to<br />
a questi<strong>on</strong> c<strong>on</strong>cerning a problem, <strong>on</strong>e has to<br />
summarize <strong>and</strong> interpret what was read as a<br />
problem for <str<strong>on</strong>g>the</str<strong>on</strong>g> character(s) in <str<strong>on</strong>g>the</str<strong>on</strong>g> story often<br />
sequencing <strong>and</strong> summarizing informati<strong>on</strong> from<br />
within text, <strong>and</strong> linking it to what <str<strong>on</strong>g>the</str<strong>on</strong>g> participant<br />
already knows about <str<strong>on</strong>g>the</str<strong>on</strong>g> topic read.<br />
Although lower levels of prompting were<br />
recorded for all participants over <str<strong>on</strong>g>the</str<strong>on</strong>g> course<br />
of interventi<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g> abstract nature of <str<strong>on</strong>g>the</str<strong>on</strong>g> task<br />
may account for existence of prompting at <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
end of interventi<strong>on</strong>. The ability to independently<br />
participate in higher order processing<br />
activities that involve abstract thought differs<br />
by age. During middle childhood years (ages<br />
6-10) children have more limited capacity for<br />
abstract thought, <strong>and</strong> generally require <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
assistance of c<strong>on</strong>crete materials <strong>and</strong>/or adult<br />
scaffolding to participate in activities that require<br />
abstract processing (Devitt & Ormrod,<br />
2002). Therefore, developmentally all partici-<br />
pating children to varying degrees needed<br />
c<strong>on</strong>crete supports as well as researcher<br />
prompting. C<strong>on</strong>sequently, <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> established<br />
a truly reciprocal relati<strong>on</strong>ship in<br />
which students with ASD learned al<strong>on</strong>gside<br />
typically developing peers.<br />
Typically, questi<strong>on</strong> generati<strong>on</strong> strategies including<br />
reciprocal teaching are used for students<br />
in third grade through adult years (Rosenshine<br />
& Meister, 1994; Rosenshine, et al., 1996).<br />
This does not mean that questi<strong>on</strong> generati<strong>on</strong> is<br />
not an important strategy for students in early<br />
elementary grades. Children as young as kindergarten<br />
have increased <str<strong>on</strong>g>the</str<strong>on</strong>g> quality of questi<strong>on</strong>ing<br />
related to story comprehensi<strong>on</strong> (Glaubman,<br />
Glaubman, & Ofir, 1997). Moreover, research<br />
suggests that students reading/comprehending<br />
<strong>on</strong> grade level by third grade will not necessarily<br />
comprehend <strong>on</strong> grade level in future grades,<br />
indicating a need for explicit, systematic comprehensi<strong>on</strong><br />
instructi<strong>on</strong> beginning in primary<br />
grades (Snow, 2002). Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r, results from this<br />
study indicate that students began to generate<br />
more questi<strong>on</strong>s that required resp<strong>on</strong>dents to<br />
summarize informati<strong>on</strong> from within text <strong>and</strong><br />
link it to independent knowledge <strong>and</strong> experiences.<br />
Over time increased experiences in generating<br />
<strong>and</strong> resp<strong>on</strong>ding to such questi<strong>on</strong>s may<br />
increase <str<strong>on</strong>g>the</str<strong>on</strong>g> student’s ability to independently<br />
resp<strong>on</strong>d to like questi<strong>on</strong>s (Palincsar & Brown,<br />
1984).<br />
Results of this study suggest that direct comprehensi<strong>on</strong><br />
strategy instructi<strong>on</strong> in <str<strong>on</strong>g>the</str<strong>on</strong>g> form of<br />
reciprocal questi<strong>on</strong>ing interventi<strong>on</strong> has <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
potential to be a powerful tool for increasing<br />
questi<strong>on</strong> generati<strong>on</strong> <strong>and</strong> resp<strong>on</strong>ding of children<br />
with ASD during <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>text of storybook<br />
reading with peers. Results also show<br />
that both <str<strong>on</strong>g>the</str<strong>on</strong>g> children with ASD <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
general educati<strong>on</strong> peers learned a new strategy<br />
simultaneously. Therefore, children with<br />
ASD can learn reading comprehensi<strong>on</strong> strategies<br />
suggested by NRP al<strong>on</strong>gside <str<strong>on</strong>g>the</str<strong>on</strong>g>ir typical<br />
peers with <str<strong>on</strong>g>the</str<strong>on</strong>g> typical peers also benefiting<br />
from <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>. Both <str<strong>on</strong>g>the</str<strong>on</strong>g> children with<br />
<strong>and</strong> without ASD enjoyed learning toge<str<strong>on</strong>g>the</str<strong>on</strong>g>r,<br />
<strong>and</strong>, as such, <str<strong>on</strong>g>the</str<strong>on</strong>g> integrated setting may increase<br />
motivati<strong>on</strong> for learning.<br />
Limitati<strong>on</strong>s<br />
384 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Results of <str<strong>on</strong>g>the</str<strong>on</strong>g> study, however, should be interpreted<br />
with cauti<strong>on</strong>. The small sample size
<strong>and</strong> lack of r<strong>and</strong>om selecti<strong>on</strong> makes it impossible<br />
to generalize <str<strong>on</strong>g>the</str<strong>on</strong>g> results to o<str<strong>on</strong>g>the</str<strong>on</strong>g>r children.<br />
Also, in a multiple baseline design it is<br />
preferred to vary <str<strong>on</strong>g>the</str<strong>on</strong>g> length of <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline<br />
c<strong>on</strong>diti<strong>on</strong> across participants (Cooper, Her<strong>on</strong>,<br />
& Heward, 1987). Although baseline sessi<strong>on</strong>s<br />
were lagged between participants <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
number of days spent in <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline c<strong>on</strong>diti<strong>on</strong><br />
varied, <str<strong>on</strong>g>the</str<strong>on</strong>g> number of baseline sessi<strong>on</strong>s<br />
was three for all participants. However, data<br />
revealed stable or descending baseline behavior<br />
across all participants. Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r, because<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> proposed study incorporates a treatment<br />
package, when a change in behavior occurs, it<br />
is difficult to determine if <str<strong>on</strong>g>the</str<strong>on</strong>g> entire package<br />
or a comp<strong>on</strong>ent of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> impacted<br />
that change.<br />
Implicati<strong>on</strong>s for Practice <strong>and</strong> Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r Research<br />
Research replicating <str<strong>on</strong>g>the</str<strong>on</strong>g> present study <strong>and</strong><br />
examining <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of direct comprehensi<strong>on</strong><br />
strategy instructi<strong>on</strong> <strong>on</strong> reading comprehensi<strong>on</strong><br />
is needed. Not <strong>on</strong>ly should <str<strong>on</strong>g>the</str<strong>on</strong>g> effects<br />
of reciprocal questi<strong>on</strong>ing interventi<strong>on</strong> <strong>on</strong><br />
reading comprehensi<strong>on</strong> be studied, but <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
effects of o<str<strong>on</strong>g>the</str<strong>on</strong>g>r NRP strategies <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> reading<br />
comprehensi<strong>on</strong> of learners with ASD should<br />
be researched. Outcomes of teaching students<br />
with ASD with <str<strong>on</strong>g>the</str<strong>on</strong>g>ir typical peers should be<br />
c<strong>on</strong>ducted. Studies should assess <str<strong>on</strong>g>the</str<strong>on</strong>g> l<strong>on</strong>gitudinal<br />
impact of reading comprehensi<strong>on</strong> interventi<strong>on</strong>s<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong> of reading<br />
comprehensi<strong>on</strong> skills to o<str<strong>on</strong>g>the</str<strong>on</strong>g>r areas of development<br />
(i.e., expressive, receptive, social communicati<strong>on</strong>,<br />
<strong>and</strong> cognitive development), to<br />
comprehensi<strong>on</strong> in curriculum c<strong>on</strong>tent areas,<br />
<strong>and</strong> to performance <strong>on</strong> questi<strong>on</strong> <strong>and</strong> answer<br />
assessments. Also, future studies should investigate<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> amount <strong>and</strong> intensity of instructi<strong>on</strong><br />
required for children with ASD to increase<br />
<strong>and</strong> maintain reading comprehensi<strong>on</strong> abilities.<br />
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Received: 22 January 2007<br />
Initial Acceptance: 18 March 2007<br />
Final Acceptance: 20 June 2007<br />
Reciprocal Questi<strong>on</strong>ing / 387
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities, 2008, 43(3), 388–396<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities<br />
Discriminati<strong>on</strong> Skills Predict Effective Preference Assessment<br />
Methods for Adults with Developmental Disabilities<br />
May S. H. Lee, Du<strong>on</strong>g Nguyen, C. T. Yu, Jennifer R. Thorsteinss<strong>on</strong>,<br />
Toby L. Martin, <strong>and</strong> Garry L. Martin<br />
University of Manitoba <strong>and</strong> St. Amant Research Centre<br />
Abstract: We examined <str<strong>on</strong>g>the</str<strong>on</strong>g> relati<strong>on</strong>ship between three discriminati<strong>on</strong> skills (visual, visual matching-to-sample,<br />
<strong>and</strong> auditory-visual) <strong>and</strong> four stimulus modalities (object, picture, spoken, <strong>and</strong> video) in assessing preferences<br />
of leisure activities for 7 adults with developmental disabilities. Three discriminati<strong>on</strong> skills were measured using<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> Assessment of Basic Learning Abilities Test. Three participants mastered a visual discriminati<strong>on</strong> task, but<br />
not visual matching-to-sample <strong>and</strong> auditory-visual discriminati<strong>on</strong>s; two participants mastered visual <strong>and</strong><br />
visual matching-to-sample discriminati<strong>on</strong>s, but not auditory-visual discriminati<strong>on</strong>, <strong>and</strong> two participants<br />
showed all three discriminati<strong>on</strong>s. The most <strong>and</strong> least preferred activities, identified through paired-stimulus<br />
preference assessment using objects, were presented to each participant in each of <str<strong>on</strong>g>the</str<strong>on</strong>g> four modalities using a<br />
reversal design. The results showed that (1) participants with visual discriminati<strong>on</strong> al<strong>on</strong>e showed a preference<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g>ir preferred activities in <str<strong>on</strong>g>the</str<strong>on</strong>g> object modality <strong>on</strong>ly; (2) those with visual <strong>and</strong> visual matching-to-sample<br />
discriminati<strong>on</strong>s, but not auditory-visual discriminati<strong>on</strong>, showed a preference for <str<strong>on</strong>g>the</str<strong>on</strong>g>ir preferred activities in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
object but not in <str<strong>on</strong>g>the</str<strong>on</strong>g> spoken modality, <strong>and</strong> mixed results in <str<strong>on</strong>g>the</str<strong>on</strong>g> pictorial <strong>and</strong> video modalities; <strong>and</strong> (3) those with<br />
all three discriminati<strong>on</strong>s showed a preference for <str<strong>on</strong>g>the</str<strong>on</strong>g>ir preferred activities in all four modalities. These results<br />
provide partial replicati<strong>on</strong>s of previous findings <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> relati<strong>on</strong>ship between discriminati<strong>on</strong>s <strong>and</strong> object,<br />
pictorial, <strong>and</strong> spoken modalities, <strong>and</strong> extend previous research to include video stimuli.<br />
Preference assessments are important tools<br />
for educators <strong>and</strong> caregivers who work with<br />
individuals with developmental disabilities.<br />
Educators <strong>and</strong> caregivers can use preference<br />
assessments to identify reinforcers that can be<br />
used to streng<str<strong>on</strong>g>the</str<strong>on</strong>g>n adaptive skills of individuals<br />
with developmental disabilities during<br />
training programs (Green et al., 1988; Logan<br />
et al., 2001; Pace, Ivancic, Edwards, Iwata, &<br />
Page, 1985). Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>rmore, allowing individuals<br />
with developmental disabilities to make<br />
choices c<strong>on</strong>tributes to <str<strong>on</strong>g>the</str<strong>on</strong>g>ir quality of life<br />
We thank <str<strong>on</strong>g>the</str<strong>on</strong>g> participants for <str<strong>on</strong>g>the</str<strong>on</strong>g>ir cooperati<strong>on</strong><br />
throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> study, <strong>and</strong> Leah Enns, Sara Spevack,<br />
Aynsley Verbeke, Kerri Walters, <strong>and</strong> Georgina<br />
Johnst<strong>on</strong> for <str<strong>on</strong>g>the</str<strong>on</strong>g>ir assistance with reliability assessments.<br />
This research was supported by grant<br />
MOP77604 from <str<strong>on</strong>g>the</str<strong>on</strong>g> Canadian Institutes of Health<br />
Research. Corresp<strong>on</strong>dence c<strong>on</strong>cerning this article<br />
should be addressed to C. T. Yu, 440 River Road,<br />
Winnipeg, Manitoba, Canada R2M 3Z9. Email:<br />
yu@stamant.mb.ca. Or Garry Martin, 129 St. Paul’s<br />
College, 70 Dysart Road, Winnipeg, Manitoba, Canada,<br />
R3T 2M6. Email: gmartin@cc.umanitoba.ca<br />
388 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
(Hughes, Hwang, Kim, Eisenman, & Killian,<br />
1995; Stock, Davies, Secor, & Wehmeyer,<br />
2003).<br />
Preference assessment effectiveness (i.e.,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir ability to distinguish high preference<br />
items from less preferred items) depends both<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> presentati<strong>on</strong> modality of <str<strong>on</strong>g>the</str<strong>on</strong>g> items or<br />
activities used, <strong>and</strong> <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> discriminati<strong>on</strong> skills<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> individuals whose preferences are assessed.<br />
C<strong>on</strong>yers et al. (2002), for example,<br />
measured visual, visual matching-to-sample,<br />
<strong>and</strong> auditory-visual discriminati<strong>on</strong> skills of<br />
nine pers<strong>on</strong>s with mental retardati<strong>on</strong> using<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> Assessment of Basic Learning Abilities (ABLA)<br />
Test (Kerr, Meyers<strong>on</strong>, & Flora, 1977; Martin &<br />
Yu, 2000). In <str<strong>on</strong>g>the</str<strong>on</strong>g>ir first experiment with food<br />
items, <str<strong>on</strong>g>the</str<strong>on</strong>g>y found that (a) all three participants<br />
who passed <str<strong>on</strong>g>the</str<strong>on</strong>g> visual discriminati<strong>on</strong><br />
assessment, but failed both <str<strong>on</strong>g>the</str<strong>on</strong>g> visual matching-to-sample<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> auditory-visual discriminati<strong>on</strong><br />
assessments <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> ABLA test could<br />
c<strong>on</strong>sistently select <str<strong>on</strong>g>the</str<strong>on</strong>g>ir most preferred item<br />
in object preference assessment but not in<br />
picture or verbal preference assessments; (b)
all three participants who passed both visual<br />
<strong>and</strong> visual matching-to-sample discriminati<strong>on</strong><br />
assessments, but failed <str<strong>on</strong>g>the</str<strong>on</strong>g> auditory-visual discriminati<strong>on</strong><br />
assessment <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> ABLA test<br />
could c<strong>on</strong>sistently select <str<strong>on</strong>g>the</str<strong>on</strong>g>ir most preferred<br />
item in both object <strong>and</strong> picture preference<br />
assessments but not when <str<strong>on</strong>g>the</str<strong>on</strong>g> choices were<br />
spoken; <strong>and</strong> (c) all three participants who<br />
passed <str<strong>on</strong>g>the</str<strong>on</strong>g> visual, visual matching-to-sample,<br />
<strong>and</strong> auditory-visual discriminati<strong>on</strong> assessments<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> ABLA test could c<strong>on</strong>sistently select<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir most preferred item in all three modalities.<br />
In <str<strong>on</strong>g>the</str<strong>on</strong>g> sec<strong>on</strong>d experiment when n<strong>on</strong>food<br />
items were presented, C<strong>on</strong>yers et al. observed<br />
similar results for seven of <str<strong>on</strong>g>the</str<strong>on</strong>g> nine<br />
participants with mixed results obtained for<br />
two participants with visual <strong>and</strong> visual matching-to-sample<br />
discriminati<strong>on</strong>s.<br />
Schwartzman, Yu, <strong>and</strong> Martin (2003) replicated<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> results of C<strong>on</strong>yers et al. (2002) using<br />
food items with six adults with developmental<br />
disabilities, <strong>and</strong> Clevenger <strong>and</strong> Graff (2005)<br />
showed that object-to-picture <strong>and</strong> picture-toobject<br />
matching skills might be prerequisite<br />
skills for making c<strong>on</strong>sistent choices in preference<br />
assessments involving pictures of food<br />
items. In additi<strong>on</strong>, de Vries et al. (2005) systematically<br />
replicated <str<strong>on</strong>g>the</str<strong>on</strong>g> procedures of C<strong>on</strong>yers<br />
et al. using leisure activities with pers<strong>on</strong>s<br />
with developmental disabilities. They found<br />
that eight of <str<strong>on</strong>g>the</str<strong>on</strong>g> nine participants in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
study showed a preference for <str<strong>on</strong>g>the</str<strong>on</strong>g>ir preferred<br />
activities in two-choice preference assessments<br />
when stimulus modalities “matched” <str<strong>on</strong>g>the</str<strong>on</strong>g>ir discriminati<strong>on</strong><br />
skills. Most recently, Reyer <strong>and</strong><br />
Sturmey (2006) also partially replicated <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
procedures of C<strong>on</strong>yers et al. using work tasks<br />
with adults with developmental disabilities<br />
<strong>and</strong> intellectual disability. These studies underscore<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> importance of matching stimulus<br />
modalities used in preference assessments to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> discriminati<strong>on</strong> skills of individuals.<br />
However, many leisure activities <strong>and</strong> work<br />
tasks are protracted <strong>and</strong> involve multiple stimuli<br />
that may be impractical or impossible to<br />
present in object or pictorial modalities. Object<br />
<strong>and</strong> pictorial presentati<strong>on</strong>s are relatively<br />
static <strong>and</strong> may not adequately present <str<strong>on</strong>g>the</str<strong>on</strong>g> various<br />
aspects of an activity. Moreover, <str<strong>on</strong>g>the</str<strong>on</strong>g> stimuli<br />
captured by object <strong>and</strong> pictorial presentati<strong>on</strong>s<br />
may not be <str<strong>on</strong>g>the</str<strong>on</strong>g> reinforcing aspects of an<br />
activity for <str<strong>on</strong>g>the</str<strong>on</strong>g> individual. It may be possible to<br />
overcome <str<strong>on</strong>g>the</str<strong>on</strong>g>se limitati<strong>on</strong>s by using video presentati<strong>on</strong>s.<br />
Recent studies have investigated <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness<br />
of video presentati<strong>on</strong> in identifying<br />
job preferences for individuals with developmental<br />
disabilities. For example, Ellerd, Morgan,<br />
<strong>and</strong> Salzberg (2002) measured <str<strong>on</strong>g>the</str<strong>on</strong>g> job<br />
preferences of four verbal adults with developmental<br />
disabilities. They provided five job<br />
opti<strong>on</strong>s via video presentati<strong>on</strong>s using singlestimulus<br />
<strong>and</strong> paired-stimulus presentati<strong>on</strong><br />
procedures in <str<strong>on</strong>g>the</str<strong>on</strong>g> first <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> sec<strong>on</strong>d preference<br />
assessments respectively for each participant.<br />
Ellerd et al. observed differential preferences<br />
for all participants; however, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
assessment using paired-stimulus presentati<strong>on</strong><br />
procedure was more sensitive in identifying a<br />
preference hierarchy than <str<strong>on</strong>g>the</str<strong>on</strong>g> single-stimulus<br />
presentati<strong>on</strong> procedure. Stock et al. (2003)<br />
examined <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of a computerbased<br />
job preference assessment of 25 adults<br />
with intellectual disabilities. In <str<strong>on</strong>g>the</str<strong>on</strong>g> assessment,<br />
participants engaged in a self-paced computer<br />
program in which <str<strong>on</strong>g>the</str<strong>on</strong>g>y were allowed to watch<br />
videos representing different job opti<strong>on</strong>s <strong>and</strong><br />
were allowed to make choices am<strong>on</strong>g <str<strong>on</strong>g>the</str<strong>on</strong>g> twochoice<br />
presentati<strong>on</strong> trials. Results indicated<br />
that in general, job preferences identified by<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> computer-based preference assessment<br />
were positively correlated to <str<strong>on</strong>g>the</str<strong>on</strong>g> preferences<br />
predicted by <str<strong>on</strong>g>the</str<strong>on</strong>g> educators <strong>and</strong> agency professi<strong>on</strong>als<br />
who relied <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> participants’ previous<br />
assessment results <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir past experience<br />
with <str<strong>on</strong>g>the</str<strong>on</strong>g> participants. The same<br />
educators <strong>and</strong> agency professi<strong>on</strong>als agreed<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> computer-based job preference assessment<br />
was more effective than <str<strong>on</strong>g>the</str<strong>on</strong>g> most<br />
popular job assessment tools in <str<strong>on</strong>g>the</str<strong>on</strong>g> existing<br />
job placement system (e.g., Career Decisi<strong>on</strong><br />
Maker). Stock et al. explained that because<br />
video presentati<strong>on</strong> provided more informati<strong>on</strong><br />
about jobs than picture <strong>and</strong> verbal presentati<strong>on</strong>s,<br />
individuals had a better underst<strong>and</strong>ing<br />
am<strong>on</strong>g job opti<strong>on</strong>s before making<br />
any decisi<strong>on</strong>. The functi<strong>on</strong>ing levels of participants<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> above studies were not reported<br />
although <str<strong>on</strong>g>the</str<strong>on</strong>g>y appeared to be relatively high<br />
functi<strong>on</strong>ing. Individuals in <str<strong>on</strong>g>the</str<strong>on</strong>g> Ellerd et al.<br />
study were verbal <strong>and</strong> those in <str<strong>on</strong>g>the</str<strong>on</strong>g> Stock et al.<br />
study were able to follow instructi<strong>on</strong>s to interact<br />
with <str<strong>on</strong>g>the</str<strong>on</strong>g> computer program. It is unclear<br />
whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r individuals with more severe disabilities,<br />
with no speech or auditory discrimina-<br />
Discriminati<strong>on</strong> Skills / 389
TABLE 1<br />
Participant Characteristics<br />
Participant Sex Age Diagnosis Communicati<strong>on</strong> Skills<br />
ti<strong>on</strong>s, could resp<strong>on</strong>d to video stimuli in preference<br />
assessments.<br />
C<strong>on</strong>sidering <str<strong>on</strong>g>the</str<strong>on</strong>g> relati<strong>on</strong>ship between discriminati<strong>on</strong><br />
skills <strong>and</strong> stimulus modalities<br />
used in preference assessments reported in<br />
previous research, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> potential of video<br />
presentati<strong>on</strong>s in presenting protracted activities,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> purpose of this study was to systematically<br />
replicate previous research <strong>on</strong> discriminati<strong>on</strong><br />
skills <strong>and</strong> object, pictorial, <strong>and</strong> spoken<br />
stimuli in assessing preferences for leisure activities,<br />
<strong>and</strong> to include video presentati<strong>on</strong> as<br />
<strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g> stimulus modalities.<br />
Method<br />
Participants <strong>and</strong> Setting<br />
Participants were seven adults recruited from<br />
River Road Place of St. Amant, a residential<br />
<strong>and</strong> community resource facility for pers<strong>on</strong>s<br />
with developmental disabilities. They were selected<br />
based <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir ABLA assessments c<strong>on</strong>ducted<br />
at <str<strong>on</strong>g>the</str<strong>on</strong>g> beginning of <str<strong>on</strong>g>the</str<strong>on</strong>g> study. The<br />
ABLA assessment procedures can be found in<br />
C<strong>on</strong>yers et al. (2002), de Vries et al. (2005),<br />
<strong>and</strong> Martin <strong>and</strong> Yu (2000). Participants 1, 2,<br />
<strong>and</strong> 3 passed <str<strong>on</strong>g>the</str<strong>on</strong>g> visual discriminati<strong>on</strong> task<br />
(referred to as Level 3 <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> ABLA test) but<br />
failed both <str<strong>on</strong>g>the</str<strong>on</strong>g> visual matching-to-sample<br />
(Level 4) <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> auditory-visual discriminati<strong>on</strong>s<br />
(Level 6). Participants 4 <strong>and</strong> 5 passed<br />
both Levels 3 <strong>and</strong> 4, but failed Level 6. Participants<br />
6 <strong>and</strong> 7 passed all three levels. Characteristics<br />
for each participant were obtained<br />
from <str<strong>on</strong>g>the</str<strong>on</strong>g>ir health records <strong>and</strong> are provided in<br />
Table 1.<br />
All sessi<strong>on</strong>s were c<strong>on</strong>ducted in a small quiet<br />
room with minimal distracti<strong>on</strong>s. The experimenter<br />
sat across a table from <str<strong>on</strong>g>the</str<strong>on</strong>g> participant<br />
during each sessi<strong>on</strong>, <strong>and</strong> an observer attended<br />
some of <str<strong>on</strong>g>the</str<strong>on</strong>g> sessi<strong>on</strong>s to c<strong>on</strong>duct reliability<br />
checks.<br />
Research Design<br />
ABLA Levels<br />
Passed*<br />
1 F 41 Severe developmental<br />
disabilities<br />
N<strong>on</strong>e 3<br />
2 F 39 Profound developmental<br />
disabilities<br />
N<strong>on</strong>e 3<br />
3 M 33 <strong>Autism</strong> N<strong>on</strong>e 3<br />
4 F 37 Severe developmental<br />
disabilities<br />
N<strong>on</strong>e 3 <strong>and</strong> 4<br />
5 M 49 Severe developmental Little speech; socially<br />
3 <strong>and</strong> 4<br />
disabilities<br />
resp<strong>on</strong>sive<br />
6 F 41 Severe developmental Little speech; difficult to 3, 4, <strong>and</strong> 6<br />
disabilities<br />
underst<strong>and</strong><br />
7 F 50 Moderate developmental Little or no recognizable 3, 4, <strong>and</strong> 6<br />
disabilities<br />
speech; underst<strong>and</strong>s<br />
simple instructi<strong>on</strong>s<br />
<strong>and</strong> questi<strong>on</strong>s<br />
* Level 3 visual discriminati<strong>on</strong>, Level 4 quasi-identity visual matching-to-sample discriminati<strong>on</strong>, Level<br />
6 auditory-visual discriminati<strong>on</strong>.<br />
390 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Each participant received an initial preference<br />
assessment using actual objects to identify<br />
his or her most preferred <strong>and</strong> least preferred<br />
leisure activities. Next, <str<strong>on</strong>g>the</str<strong>on</strong>g> most <strong>and</strong><br />
least preferred leisure activities were presented<br />
in four modalities (object, picture,<br />
video, <strong>and</strong> spoken) using a replicati<strong>on</strong> design,<br />
with each modality assessed at least twice.
TABLE 2<br />
Leisure Activities Used in <str<strong>on</strong>g>the</str<strong>on</strong>g> Preference Assessments<br />
Leisure Activity Stimuli Presented During a Trial<br />
Coloring Cray<strong>on</strong>s <strong>and</strong> coloring book<br />
Doing a puzzle 3-pieces<br />
Listening to music Tape recorder with pop music<br />
Painting Paint, paint brush, paper, <strong>and</strong> water<br />
Playing cards Deck of playing cards<br />
Playing with a light toy Rattle-shaped light toy called “Meteor Storm” about 20 cm<br />
tall<br />
Playing with object-sound<br />
related toy<br />
A cow-shaped plastic toy<br />
Playing with a velcro-ball Tennis ball wrapped with velcro <strong>and</strong> two rackets with velcro<br />
<strong>on</strong> <strong>on</strong>e side<br />
Playing with a carpentry set Mini tool kit<br />
Playing with a toy car A miniature sport car about 6 cm l<strong>on</strong>g<br />
Playing with a xyloph<strong>on</strong>e A miniature xyloph<strong>on</strong>e (24 cm 11 cm)<br />
Reading magazines Three types of magazines<br />
Shaking a rattle Rattle<br />
Touching a lighting ball Plasma lighting ball about 33 cm tall<br />
Turning <strong>on</strong> <strong>and</strong> off a fan that<br />
lights up<br />
Battery operated h<strong>and</strong>-held fan<br />
Washing <strong>and</strong> applying loti<strong>on</strong> to<br />
h<strong>and</strong>s<br />
H<strong>and</strong> soap, sp<strong>on</strong>ge, water <strong>and</strong> h<strong>and</strong> loti<strong>on</strong><br />
Watering plants Plastic plants <strong>and</strong> watering can<br />
Initial Object Preference Assessment<br />
Six activities were identified for each participant<br />
based <strong>on</strong> recommendati<strong>on</strong>s from <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
participant’s caregivers <strong>and</strong> <strong>on</strong> practical c<strong>on</strong>siderati<strong>on</strong>s<br />
in presenting <strong>and</strong> performing <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
activities during sessi<strong>on</strong>s. Table 2 lists all <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
leisure activities used <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> object stimuli<br />
presented <strong>on</strong> each trial.<br />
A paired-stimulus presentati<strong>on</strong> procedure<br />
was used (Fisher et al., 1992; Piazza, Fisher,<br />
Hagopian, Bowman, & Toole, 1996). Each<br />
stimulus was paired with every o<str<strong>on</strong>g>the</str<strong>on</strong>g>r stimulus<br />
twice, totaling 30 trials. Order <strong>and</strong> positi<strong>on</strong>s of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> stimuli were counterbalanced across trials.<br />
Trials were spread across two to four sessi<strong>on</strong>s<br />
depending <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> participant’s level of functi<strong>on</strong>ing.<br />
On each trial, <str<strong>on</strong>g>the</str<strong>on</strong>g> experimenter presented<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> objects representing <str<strong>on</strong>g>the</str<strong>on</strong>g> two leisure<br />
activities c<strong>on</strong>currently <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> table.<br />
Verbal prompts <strong>and</strong> gestures were provided to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> participant to attend to each stimulus. The<br />
experimenter <str<strong>on</strong>g>the</str<strong>on</strong>g>n asked <str<strong>on</strong>g>the</str<strong>on</strong>g> participant to<br />
“pick <strong>on</strong>e”. Once <str<strong>on</strong>g>the</str<strong>on</strong>g> participant made an<br />
approach resp<strong>on</strong>se (touching or pointing to a<br />
stimulus), <str<strong>on</strong>g>the</str<strong>on</strong>g> n<strong>on</strong>-selected stimulus was removed<br />
immediately, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> participant was<br />
allowed to engage in <str<strong>on</strong>g>the</str<strong>on</strong>g> chosen activity for<br />
approximate 30 s. If <str<strong>on</strong>g>the</str<strong>on</strong>g> participant tried to<br />
approach both stimuli or did not choose an<br />
activity after 10 s, <str<strong>on</strong>g>the</str<strong>on</strong>g> trial was repeated.<br />
At <str<strong>on</strong>g>the</str<strong>on</strong>g> end of <str<strong>on</strong>g>the</str<strong>on</strong>g> assessment, <str<strong>on</strong>g>the</str<strong>on</strong>g> preference<br />
measure for a stimulus was calculated by<br />
dividing <str<strong>on</strong>g>the</str<strong>on</strong>g> number of trials in which that<br />
stimulus was chosen by <str<strong>on</strong>g>the</str<strong>on</strong>g> total number of<br />
trials that particular stimulus was available<br />
during <str<strong>on</strong>g>the</str<strong>on</strong>g> assessment, multiplied by 100%.<br />
The most <strong>and</strong> least frequently preferred stimuli<br />
were used in <str<strong>on</strong>g>the</str<strong>on</strong>g> next phase (see Table 3).<br />
Stimulus Modalities <strong>and</strong> Presentati<strong>on</strong> Procedures<br />
Four stimulus modalities were evaluated in a<br />
replicati<strong>on</strong> design. Presentati<strong>on</strong>s using objects<br />
(O) were given to each participant during <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
first phase, followed by presentati<strong>on</strong>s using<br />
pictorial (P), video (V), <strong>and</strong> spoken (S) stimuli<br />
in subsequent phases. The order for P, V,<br />
<strong>and</strong> S phases was r<strong>and</strong>omized <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> four<br />
Discriminati<strong>on</strong> Skills / 391
TABLE 3<br />
Percentage of Trials that <str<strong>on</strong>g>the</str<strong>on</strong>g> Most <strong>and</strong> Least Frequently Preferred Activities Were Chosen for Each<br />
Participant During <str<strong>on</strong>g>the</str<strong>on</strong>g> Initial Object Preference Assessment<br />
Participant<br />
Most Frequently Chosen<br />
Activity % Least Frequently Chosen Activity %<br />
1 Touching a lighting ball 70 Watering plants 10<br />
2 Playing with a velcro-ball 70 Watering plants 20<br />
3 Playing with a toy car 70 Coloring 20<br />
4 Watering plants 70 Listening to music 40<br />
5 Playing with a carpentry set 80 Playing with a velcro-ball 20<br />
6 Playing with a light toy 100 Coloring 20<br />
7 Playing with a light toy 70 Washing <strong>and</strong> applying loti<strong>on</strong> to h<strong>and</strong>s 30<br />
phases were <str<strong>on</strong>g>the</str<strong>on</strong>g>n repeated for each participant.<br />
Additi<strong>on</strong>al replicati<strong>on</strong>s were c<strong>on</strong>ducted<br />
for three participants because <str<strong>on</strong>g>the</str<strong>on</strong>g>ir results<br />
were varied across phases <strong>and</strong> inc<strong>on</strong>sistent<br />
with our predicti<strong>on</strong>s. In all modalities, activities<br />
were presented using a paired-stimulus<br />
procedure, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> most <strong>and</strong> least preferred<br />
leisure activities identified during <str<strong>on</strong>g>the</str<strong>on</strong>g> initial<br />
object preference assessment were used <strong>on</strong><br />
each trial. Each phase c<strong>on</strong>sisted of two sessi<strong>on</strong>s,<br />
with six trials per sessi<strong>on</strong>. The left-right<br />
positi<strong>on</strong>s of <str<strong>on</strong>g>the</str<strong>on</strong>g> two leisure activities were<br />
counterbalanced across trials within each<br />
phase.<br />
Object presentati<strong>on</strong>. During <str<strong>on</strong>g>the</str<strong>on</strong>g> object<br />
phase, <str<strong>on</strong>g>the</str<strong>on</strong>g> presentati<strong>on</strong> procedures were <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
same as in <str<strong>on</strong>g>the</str<strong>on</strong>g> initial object preference assessment<br />
except that <strong>on</strong>ly two items, representing<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> most <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> least preferred activities were<br />
used.<br />
Pictorial presentati<strong>on</strong>. During <str<strong>on</strong>g>the</str<strong>on</strong>g> pictorial<br />
phase, <str<strong>on</strong>g>the</str<strong>on</strong>g> presentati<strong>on</strong> procedures were similar<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> object phase except colored pictures<br />
(22 cm 27 cm) of <str<strong>on</strong>g>the</str<strong>on</strong>g> object stimuli<br />
were shown <strong>on</strong> each trial. At <str<strong>on</strong>g>the</str<strong>on</strong>g> beginning of<br />
each trial, <str<strong>on</strong>g>the</str<strong>on</strong>g> two colored pictures were<br />
placed, side by side, face down <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> table in<br />
fr<strong>on</strong>t of <str<strong>on</strong>g>the</str<strong>on</strong>g> participant. The experimenter<br />
held up <str<strong>on</strong>g>the</str<strong>on</strong>g> picture <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> left to <str<strong>on</strong>g>the</str<strong>on</strong>g> participant’s<br />
eye level <strong>and</strong> said, “look”. Once <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
participant looked at <str<strong>on</strong>g>the</str<strong>on</strong>g> picture, <str<strong>on</strong>g>the</str<strong>on</strong>g> experimenter<br />
placed <str<strong>on</strong>g>the</str<strong>on</strong>g> picture <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> table faced<br />
down, <strong>and</strong> repeated <str<strong>on</strong>g>the</str<strong>on</strong>g> procedure for <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
picture <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> right. The experimenter <str<strong>on</strong>g>the</str<strong>on</strong>g>n<br />
held up both pictures simultaneously <strong>and</strong><br />
asked <str<strong>on</strong>g>the</str<strong>on</strong>g> participant to “pick <strong>on</strong>e”. After <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
participant made a selecti<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g> pictures<br />
392 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
were removed <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> chosen activity was provided<br />
immediately to <str<strong>on</strong>g>the</str<strong>on</strong>g> participant for 30 s.<br />
Video presentati<strong>on</strong>. During <str<strong>on</strong>g>the</str<strong>on</strong>g> video phase,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> presentati<strong>on</strong> procedures were similar to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> picture phase except that video clips of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> leisure activities were presented instead of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> colored pictures. On each trial, <str<strong>on</strong>g>the</str<strong>on</strong>g> experimenter<br />
first presented <str<strong>on</strong>g>the</str<strong>on</strong>g> video for <str<strong>on</strong>g>the</str<strong>on</strong>g> activity<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> left side of a 43 cm m<strong>on</strong>itor while<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> right side was blank, <strong>and</strong> asked <str<strong>on</strong>g>the</str<strong>on</strong>g> participant<br />
to look at <str<strong>on</strong>g>the</str<strong>on</strong>g> video, while pointing to<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> video. Once <str<strong>on</strong>g>the</str<strong>on</strong>g> participant looked at <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
video, <str<strong>on</strong>g>the</str<strong>on</strong>g> experimenter repeated <str<strong>on</strong>g>the</str<strong>on</strong>g> procedure<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g> activity <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> right side of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
m<strong>on</strong>itor. Then, <str<strong>on</strong>g>the</str<strong>on</strong>g> experimenter played both<br />
videos simultaneously <strong>and</strong> asked <str<strong>on</strong>g>the</str<strong>on</strong>g> participant<br />
to “pick <strong>on</strong>e”. Once <str<strong>on</strong>g>the</str<strong>on</strong>g> participant<br />
pointed to <strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g> two videos, <str<strong>on</strong>g>the</str<strong>on</strong>g> experimenter<br />
turned off <str<strong>on</strong>g>the</str<strong>on</strong>g> computer screen <strong>and</strong><br />
provided <str<strong>on</strong>g>the</str<strong>on</strong>g> chosen activity to <str<strong>on</strong>g>the</str<strong>on</strong>g> participant<br />
for 30 s. The sound was turned off for all video<br />
presentati<strong>on</strong>s.<br />
Spoken presentati<strong>on</strong>. During <str<strong>on</strong>g>the</str<strong>on</strong>g> spoken<br />
phase, <str<strong>on</strong>g>the</str<strong>on</strong>g> presentati<strong>on</strong> procedures were <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
same as in <str<strong>on</strong>g>the</str<strong>on</strong>g> picture phase except that two<br />
sheets of white paper were used instead of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
pictures <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> experimenter stated <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
names of <str<strong>on</strong>g>the</str<strong>on</strong>g> activities. At <str<strong>on</strong>g>the</str<strong>on</strong>g> beginning of<br />
each trial, <str<strong>on</strong>g>the</str<strong>on</strong>g> experimenter held up <str<strong>on</strong>g>the</str<strong>on</strong>g> paper<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> left of <str<strong>on</strong>g>the</str<strong>on</strong>g> participant’s eye level,<br />
stated <str<strong>on</strong>g>the</str<strong>on</strong>g> name of <str<strong>on</strong>g>the</str<strong>on</strong>g> activity in a neutral<br />
t<strong>on</strong>e, <strong>and</strong> put <str<strong>on</strong>g>the</str<strong>on</strong>g> paper back <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> table.<br />
This was repeated with <str<strong>on</strong>g>the</str<strong>on</strong>g> paper/activity <strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> right. Then, <str<strong>on</strong>g>the</str<strong>on</strong>g> experimenter held up<br />
both papers <strong>and</strong> asked <str<strong>on</strong>g>the</str<strong>on</strong>g> participant to “pick<br />
<strong>on</strong>e”. After <str<strong>on</strong>g>the</str<strong>on</strong>g> participant made an approach<br />
resp<strong>on</strong>se (e.g., pointing to <str<strong>on</strong>g>the</str<strong>on</strong>g> paper), both
papers were removed <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> activity that corresp<strong>on</strong>ded<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> selected paper was provided<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> participant for 30 s.<br />
Reliability Assessments<br />
ABLA discriminati<strong>on</strong> assessment. Interobserver<br />
reliability checks were c<strong>on</strong>ducted <strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> initial ABLA discriminati<strong>on</strong> assessments<br />
for all participants. The experimenter <strong>and</strong> an<br />
observer independently recorded <str<strong>on</strong>g>the</str<strong>on</strong>g> participant’s<br />
resp<strong>on</strong>se <strong>on</strong> each trial during <str<strong>on</strong>g>the</str<strong>on</strong>g> assessment.<br />
Agreement <strong>on</strong> a trial was defined as<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> experimenter <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> observer both recording<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> same resp<strong>on</strong>se; o<str<strong>on</strong>g>the</str<strong>on</strong>g>rwise, it was<br />
c<strong>on</strong>sidered a disagreement. Percent agreement<br />
for each discriminati<strong>on</strong> task was calculated<br />
by dividing <str<strong>on</strong>g>the</str<strong>on</strong>g> number of agreements<br />
by <str<strong>on</strong>g>the</str<strong>on</strong>g> number of agreements plus disagreements,<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>n multiplying by 100% (Martin<br />
& Pear, 2007). Percent agreement was 100%<br />
for all participants.<br />
The observer also c<strong>on</strong>ducted procedural integrity<br />
checks using a pre-defined checklist,<br />
which included whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r <str<strong>on</strong>g>the</str<strong>on</strong>g> testing materials<br />
were placed in <str<strong>on</strong>g>the</str<strong>on</strong>g> correct positi<strong>on</strong>s, verbal<br />
instructi<strong>on</strong>s were provided correctly, correcti<strong>on</strong><br />
procedures were c<strong>on</strong>ducted properly following<br />
an incorrect resp<strong>on</strong>se, <strong>and</strong> reinforcers<br />
were given immediately following a correct<br />
resp<strong>on</strong>se. A trial was scored as correctly delivered<br />
if no errors were made. Procedural integrity<br />
was 100% for all participants.<br />
Initial object preference assessment. Interobserver<br />
reliability checks were c<strong>on</strong>ducted for<br />
each participant <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> percentage of trials<br />
observed by a sec<strong>on</strong>d observer ranged from<br />
23% to 100% across participants. The experimenter<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> observer recorded <str<strong>on</strong>g>the</str<strong>on</strong>g> participant’s<br />
selecti<strong>on</strong> <strong>on</strong> each trial. The mean percent<br />
agreement across participants was 99%,<br />
with a range of 86% to 100%.<br />
Procedural integrity checks for preference<br />
assessment were also c<strong>on</strong>ducted for each participant<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> percentage of trials observed<br />
by a sec<strong>on</strong>d observer ranged from 23% to<br />
100% across participants. On each trial, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
observer recorded whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r <str<strong>on</strong>g>the</str<strong>on</strong>g> correct stimuli<br />
were presented <strong>and</strong> in <str<strong>on</strong>g>the</str<strong>on</strong>g> correct positi<strong>on</strong>s,<br />
whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r correct verbal cues were provided,<br />
<strong>and</strong> whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>sequence was delivered<br />
properly following a selecti<strong>on</strong>. A trial was<br />
scored as correct if no errors occurred. The<br />
mean percentage of trials delivered correctly<br />
across participants was 100%.<br />
Stimulus modalities presentati<strong>on</strong>. Interobserver<br />
reliability checks were c<strong>on</strong>ducted for<br />
each participant <strong>and</strong> for each modality. The<br />
percentage of sessi<strong>on</strong>s observed ranged from<br />
25% to 100% across participants. A trial was<br />
scored as an agreement <strong>on</strong>ly if both <str<strong>on</strong>g>the</str<strong>on</strong>g> experimenter<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> observer recorded <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
same resp<strong>on</strong>se. The mean percent agreement<br />
across sessi<strong>on</strong>s <strong>and</strong> participants was 99%, with<br />
a range of 96% to 100%.<br />
Procedural integrity checks were also performed<br />
for each participant <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> percentage<br />
of sessi<strong>on</strong>s observed ranged from 25% to<br />
100% across participants. Each trial was<br />
scored using a checklist similar to <str<strong>on</strong>g>the</str<strong>on</strong>g> <strong>on</strong>e<br />
used described above for preference assessment.<br />
A trial was c<strong>on</strong>sidered correctly delivered<br />
if all <str<strong>on</strong>g>the</str<strong>on</strong>g> steps <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> checklist were<br />
performed correctly. The mean percentage of<br />
trials delivered correctly across sessi<strong>on</strong>s <strong>and</strong><br />
participants was 99%, ranging from 99% to<br />
100%.<br />
Results<br />
Figure 1 shows <str<strong>on</strong>g>the</str<strong>on</strong>g> percentage of trials that<br />
each participant chose <str<strong>on</strong>g>the</str<strong>on</strong>g>ir most preferred<br />
leisure activity for each presentati<strong>on</strong> method.<br />
The top three graphs show <str<strong>on</strong>g>the</str<strong>on</strong>g> results of Participants<br />
1 through 3, who passed <str<strong>on</strong>g>the</str<strong>on</strong>g> visual<br />
discriminati<strong>on</strong> assessment (Level 3) but failed<br />
both visual matching-to-sample (Level 4) <strong>and</strong><br />
auditory-visual (Level 6) discriminati<strong>on</strong>s <strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> ABLA Test. During object presentati<strong>on</strong><br />
phases, <str<strong>on</strong>g>the</str<strong>on</strong>g> participants selected <str<strong>on</strong>g>the</str<strong>on</strong>g>ir most<br />
preferred leisure activity <strong>on</strong> an average of 97%<br />
across phases (range 92% to 100%). During<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> pictorial presentati<strong>on</strong> phases, <str<strong>on</strong>g>the</str<strong>on</strong>g> average<br />
was 57% (range 50% to 67%), which is approximately<br />
chance level in a two-choice arrangement.<br />
During <str<strong>on</strong>g>the</str<strong>on</strong>g> video presentati<strong>on</strong><br />
phases, <str<strong>on</strong>g>the</str<strong>on</strong>g> average was 49% (range 8% to<br />
67%). Except for <str<strong>on</strong>g>the</str<strong>on</strong>g> first video phase for<br />
Participant 1, who showed a low preference<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g> high preference activity (8%), preference<br />
levels for <str<strong>on</strong>g>the</str<strong>on</strong>g> preferred activity during<br />
subsequent phases <strong>and</strong> for <str<strong>on</strong>g>the</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r participants<br />
were approximately chance level. During<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> spoken presentati<strong>on</strong> phases, preference<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g> preferred activity averaged 47%<br />
(range 33% to 58%).<br />
Discriminati<strong>on</strong> Skills / 393
Figure 1. Percentage of trials that <str<strong>on</strong>g>the</str<strong>on</strong>g> most preferred leisure activity was chosen during object (O), pictorial<br />
(P), video (V), <strong>and</strong> spoken (S) presentati<strong>on</strong> phases for each participant. Participants at Level 3<br />
passed <strong>on</strong>ly <str<strong>on</strong>g>the</str<strong>on</strong>g> visual discriminati<strong>on</strong>, participants at Level 4 passed both visual <strong>and</strong> visual matchingto-sample<br />
discriminati<strong>on</strong>s, <strong>and</strong> participants at Level 6 passed visual, visual matching-to-sample, <strong>and</strong><br />
auditory-visual discriminati<strong>on</strong>s.<br />
Results of Participants 4 <strong>and</strong> 5, who passed<br />
both visual <strong>and</strong> visual matching-to-sample discriminati<strong>on</strong><br />
assessments, but failed <str<strong>on</strong>g>the</str<strong>on</strong>g> auditory-visual<br />
discriminati<strong>on</strong> assessment <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
ABLA Test, are shown in <str<strong>on</strong>g>the</str<strong>on</strong>g> sec<strong>on</strong>d row of<br />
394 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Figure 1. During object presentati<strong>on</strong> phases,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> two participants selected <str<strong>on</strong>g>the</str<strong>on</strong>g>ir most preferred<br />
leisure activity <strong>on</strong> an average of 80%<br />
across phases (range 75% to 100%). During<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> pictorial presentati<strong>on</strong> phases, <str<strong>on</strong>g>the</str<strong>on</strong>g> average
was 68% (range 42% to 83%). In <str<strong>on</strong>g>the</str<strong>on</strong>g> video<br />
presentati<strong>on</strong> phases, <str<strong>on</strong>g>the</str<strong>on</strong>g> average was 62%<br />
(range 33% to 83%). Lastly, in <str<strong>on</strong>g>the</str<strong>on</strong>g> spoken<br />
phases, <str<strong>on</strong>g>the</str<strong>on</strong>g> average was 50% (range 42% to<br />
58%).<br />
Participants 6 <strong>and</strong> 7 passed <str<strong>on</strong>g>the</str<strong>on</strong>g> visual, visual<br />
matching-to-sample, <strong>and</strong> auditory-visual discriminati<strong>on</strong><br />
assessments <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> ABLA Test.<br />
They selected <str<strong>on</strong>g>the</str<strong>on</strong>g>ir preferred activity <strong>on</strong> all<br />
trials (100%) during object, pictorial, <strong>and</strong><br />
video phases, <strong>and</strong> <strong>on</strong> an average of 85% of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
spoken phase trials (range 83% to 92%).<br />
Discussi<strong>on</strong><br />
C<strong>on</strong>cerning <str<strong>on</strong>g>the</str<strong>on</strong>g> object, pictorial, <strong>and</strong> spoken<br />
modalities, <str<strong>on</strong>g>the</str<strong>on</strong>g> results replicate <str<strong>on</strong>g>the</str<strong>on</strong>g> findings of<br />
previous research except for <str<strong>on</strong>g>the</str<strong>on</strong>g> pictorial modality<br />
with Participant 5. First, we anticipated<br />
that Level 3 participants would select <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
preferred activity more frequently during object<br />
phases, but at approximately chance level<br />
during pictorial <strong>and</strong> spoken phases. This was<br />
c<strong>on</strong>firmed. Sec<strong>on</strong>d, we anticipated that Level<br />
4 participants would select <str<strong>on</strong>g>the</str<strong>on</strong>g>ir preferred activity<br />
more frequently during object <strong>and</strong> pictorial<br />
phases, but at approximately chance<br />
level during spoken phases. This was c<strong>on</strong>firmed<br />
except for <str<strong>on</strong>g>the</str<strong>on</strong>g> pictorial modality with<br />
Participant 5. His preference toward <str<strong>on</strong>g>the</str<strong>on</strong>g> preferred<br />
leisure activity was inc<strong>on</strong>sistent during<br />
pictorial phases. He selected his preferred activity<br />
<strong>on</strong> an average of 63% across phases.<br />
Participant 5 did not select his preferred activity<br />
during object phases as frequently as<br />
o<str<strong>on</strong>g>the</str<strong>on</strong>g>r participants (i.e., <strong>on</strong> an average of 75%<br />
across phases vs. <strong>on</strong> an average of 96% across<br />
phases for o<str<strong>on</strong>g>the</str<strong>on</strong>g>r participants). This suggests<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> activity was not as str<strong>on</strong>gly preferred<br />
<strong>and</strong> this may have c<strong>on</strong>tributed to <str<strong>on</strong>g>the</str<strong>on</strong>g> mixed<br />
results. Overall, Participant 4 selected her preferred<br />
leisure activity during pictorial phases<br />
more frequently even though her preference<br />
toward <str<strong>on</strong>g>the</str<strong>on</strong>g> preferred activity was inc<strong>on</strong>sistent<br />
across phases <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> effect is small (i.e., <strong>on</strong><br />
an average of 75% across phases). Third, we<br />
anticipated that <str<strong>on</strong>g>the</str<strong>on</strong>g> Level 6 participants would<br />
select <str<strong>on</strong>g>the</str<strong>on</strong>g>ir preferred activity more frequently<br />
during all three stimulus modalities. This was<br />
c<strong>on</strong>firmed in all modalities. Except for Participant<br />
5’s performance in <str<strong>on</strong>g>the</str<strong>on</strong>g> pictorial modality,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se results are c<strong>on</strong>sistent with previous<br />
findings (e.g., C<strong>on</strong>yers et al., 2002; de Vries et<br />
al., 2005).<br />
The present study extends previous research<br />
by examining <str<strong>on</strong>g>the</str<strong>on</strong>g> use of video presentati<strong>on</strong>s<br />
in preference assessments with pers<strong>on</strong>s<br />
with severe <strong>and</strong> profound developmental disabilities.<br />
During video presentati<strong>on</strong>s, all participants<br />
at Level 3 did not show a preference<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g>ir preferred over <str<strong>on</strong>g>the</str<strong>on</strong>g> less preferred activities,<br />
while both participants at Level 6<br />
chose <str<strong>on</strong>g>the</str<strong>on</strong>g>ir preferred activities c<strong>on</strong>sistently.<br />
The two participants at Level 4 showed mixed<br />
results, with Participant 4 choosing her preferred<br />
activity more frequently than <str<strong>on</strong>g>the</str<strong>on</strong>g> less<br />
preferred activity even though her performance<br />
was inc<strong>on</strong>sistent across phases, whereas<br />
Participant 5 did not. Given <str<strong>on</strong>g>the</str<strong>on</strong>g> small number<br />
of participants, <str<strong>on</strong>g>the</str<strong>on</strong>g>se results should be interpreted<br />
cautiously. Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>r research with additi<strong>on</strong>al<br />
participants, especially at Level 4, is<br />
needed. However, if <str<strong>on</strong>g>the</str<strong>on</strong>g> present results are<br />
generalizable, it suggests that quasi-identity<br />
matching performance involving 3-dimensi<strong>on</strong>al<br />
objects (<str<strong>on</strong>g>the</str<strong>on</strong>g> ABLA Level 4 discriminati<strong>on</strong>)<br />
may not predict a pers<strong>on</strong>’s ability to<br />
c<strong>on</strong>sistently select his/her preferred activity<br />
using video presentati<strong>on</strong>.<br />
Research is needed to examine <str<strong>on</strong>g>the</str<strong>on</strong>g> relative<br />
importance of <str<strong>on</strong>g>the</str<strong>on</strong>g> visual <strong>and</strong> auditory comp<strong>on</strong>ents<br />
of video presentati<strong>on</strong>s. In this study, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
video clips were presented without sound because<br />
we speculated that sounds associated<br />
with <str<strong>on</strong>g>the</str<strong>on</strong>g> two videos presented c<strong>on</strong>currently<br />
might have been c<strong>on</strong>fusing to <str<strong>on</strong>g>the</str<strong>on</strong>g> participants,<br />
especially those who had not passed <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
auditory-visual discriminati<strong>on</strong> (Level 6) <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
ABLA Test. However, sounds <strong>and</strong> visual stimuli<br />
associated with different activities usually<br />
occur as a compound stimulus in <str<strong>on</strong>g>the</str<strong>on</strong>g> natural<br />
envir<strong>on</strong>ment <strong>and</strong> <strong>on</strong>e is often exposed to multiple<br />
stimuli simultaneously. For <str<strong>on</strong>g>the</str<strong>on</strong>g> Level 4<br />
participants, who had failed to perform <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
ABLA Level 6 auditory-visual discriminati<strong>on</strong>, it<br />
is quite possible that <str<strong>on</strong>g>the</str<strong>on</strong>g>y may be able to discriminate<br />
some n<strong>on</strong>-speech sounds. Therefore,<br />
distinctive sounds accompanying different<br />
activities might facilitate video<br />
discriminati<strong>on</strong>s even for participants who<br />
have not dem<strong>on</strong>strated <str<strong>on</strong>g>the</str<strong>on</strong>g> ABLA Level 6 discriminati<strong>on</strong>.<br />
Alternatives to c<strong>on</strong>current presentati<strong>on</strong>s<br />
of videos with sound, such as successive<br />
presentati<strong>on</strong>s, may help to reduce<br />
potential interference.<br />
Discriminati<strong>on</strong> Skills / 395
Research <strong>on</strong> video presentati<strong>on</strong> in preference<br />
assessment has been limited for pers<strong>on</strong>s<br />
with severe developmental disabilities, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
relati<strong>on</strong>ship between discriminati<strong>on</strong> skills <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of <str<strong>on</strong>g>the</str<strong>on</strong>g> video presentati<strong>on</strong> in<br />
preference assessments has been unexplored.<br />
The potential of video presentati<strong>on</strong> appears to<br />
lie in its ability to present complex activities<br />
more accurately (Ellerd et al., 2002; Stock et<br />
al., 2003). It is possible that individuals with<br />
severe developmental disabilities who have<br />
difficulties resp<strong>on</strong>ding to pictorial <strong>and</strong> spoken<br />
stimuli in preference assessments could resp<strong>on</strong>d<br />
to or learn to resp<strong>on</strong>d to video presentati<strong>on</strong>s<br />
more readily. Thus, future research is<br />
much needed to examine <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>diti<strong>on</strong>s under<br />
which video presentati<strong>on</strong> will be most effective<br />
(relative to o<str<strong>on</strong>g>the</str<strong>on</strong>g>r modalities) <strong>and</strong> to<br />
develop effective procedures to teach individuals<br />
to indicate <str<strong>on</strong>g>the</str<strong>on</strong>g>ir preferences by resp<strong>on</strong>ding<br />
to video presentati<strong>on</strong>s.<br />
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R. C., Brittain, D. P., & Gardner, S. M. (1988).<br />
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Hughes, C., Hwang, B., Kim, J. H., Eisenman, L. T.,<br />
& Killian, D. J. (1995). Quality of life in applied<br />
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Daniel, J., & Rawls, J. (2001). Preferences <strong>and</strong><br />
reinforcers for students with profound multiple<br />
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<strong>and</strong> Physical Disabilities, 13, 97–122.<br />
Martin, G. L., & Pear, J. (2007). Behavior modificati<strong>on</strong>:<br />
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B. A., & Page, T. J. (1985). Assessment of stimulus<br />
preference <strong>and</strong> reinforcer value with profoundly<br />
retarded individuals. <str<strong>on</strong>g>Journal</str<strong>on</strong>g> of Applied Behavior<br />
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L. G., & Toole, L. T. (1996). Using a choice<br />
assessment to predict reinforcer effectiveness.<br />
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of Basic Learning Abilities (ABLA) Test predicts<br />
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with developmental disabilities. <str<strong>on</strong>g>Journal</str<strong>on</strong>g> of Intellectual<br />
Disability Research, 50, 404–409.<br />
Schwartzman, L., Yu, C. T., & Martin, G. L. (2003).<br />
Choice resp<strong>on</strong>ding as a functi<strong>on</strong> of choice presentati<strong>on</strong><br />
method <strong>and</strong> level of preference in pers<strong>on</strong>s<br />
with developmental disabilities. Internati<strong>on</strong>al<br />
<str<strong>on</strong>g>Journal</str<strong>on</strong>g> of Disability, Community, <strong>and</strong> Rehabilitati<strong>on</strong>,<br />
1(3), Article 3. Retrieved March 15, 2003, from<br />
http://www.ijdcr.ca/ VOL01_03_CAN/ articles/<br />
schwartzman.shtml<br />
Stock, S. E., Davies, D. K., Secor, R. R., & Wehmeyer,<br />
M. L. (2003). Self-directed career preference selecti<strong>on</strong><br />
for individuals with intellectual disabilities:<br />
Using computer technology to enhance selfdeterminati<strong>on</strong>.<br />
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19, 95–103.<br />
Received: 15 November 2006<br />
Initial Acceptance: 2 February 2007<br />
Final Acceptance: 14 May 2007<br />
396 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008
Teaching Test-taking Strategies to Improve <str<strong>on</strong>g>the</str<strong>on</strong>g> Academic<br />
Achievement of Students with Mild Mental Disabilities<br />
Allis<strong>on</strong> G. Kretlow, Ya-yu Lo, Richard B. White, <strong>and</strong> LuAnn Jordan<br />
University of North Carolina at Charlotte<br />
Abstract: This study examined <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of teaching a test-taking strategy to 4 fourth- <strong>and</strong> fifth-grade students<br />
with mild mental disabilities <strong>on</strong> reading <strong>and</strong> math achievement. The interventi<strong>on</strong> c<strong>on</strong>sisted of a direct <strong>and</strong><br />
explicit instructi<strong>on</strong>al method using a mnem<strong>on</strong>ic strategy. The participants’ acquisiti<strong>on</strong> <strong>and</strong> applicati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
test-taking strategy <strong>on</strong> reading <strong>and</strong> math probes were evaluated using a multiple probe across participants<br />
design. All participants dem<strong>on</strong>strated <str<strong>on</strong>g>the</str<strong>on</strong>g> ability to apply <str<strong>on</strong>g>the</str<strong>on</strong>g> strategy <strong>on</strong> probes during <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>, 2-week<br />
maintenance, <strong>and</strong> generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s. Significant gains in achievement were observed for all participants.<br />
Implicati<strong>on</strong>s of teaching test-taking strategies to students with mild to moderate mental disabilities were<br />
discussed.<br />
As achievement accountability measures c<strong>on</strong>tinue<br />
to increase in <str<strong>on</strong>g>the</str<strong>on</strong>g> public educati<strong>on</strong> system,<br />
so do <str<strong>on</strong>g>the</str<strong>on</strong>g> expectati<strong>on</strong>s for students with<br />
disabilities. Current legislati<strong>on</strong> enforces <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
need for students with disabilities to have access<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> general educati<strong>on</strong> curriculum, <strong>and</strong><br />
in turn for states to assess those students<br />
through st<strong>and</strong>ardized achievement measures.<br />
The No Child Left Behind Act (NCLB) of<br />
2001 requires that all students in grades three<br />
through eight take state-wide achievement<br />
tests in reading <strong>and</strong> math (Goertz & Duffy,<br />
2003). The NCLB Act in combinati<strong>on</strong> with <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
amendments to <str<strong>on</strong>g>the</str<strong>on</strong>g> Individuals with Disabilities<br />
Educati<strong>on</strong> Improvement Act (IDEIA,<br />
2004), which states that all students must be<br />
included in state <strong>and</strong> district assessments,<br />
present challenges of test-taking to students<br />
with disabilities (Washburn-Moses, 2003).<br />
The performance of students with disabilities<br />
<strong>on</strong> st<strong>and</strong>ardized achievement tests is at<br />
least, in part, resp<strong>on</strong>sible for states attaining<br />
what <str<strong>on</strong>g>the</str<strong>on</strong>g> federal government outlined in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
NCLB Act as Adequately Yearly Progress<br />
(AYP). To meet AYP, schools must attain goals<br />
related to achievement for certain targeted<br />
groups of students, including students with<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cerning this article should<br />
be addressed to Allis<strong>on</strong> G. Kretlow, 11027 Heritage<br />
Green Drive, Cornelius, NC 28031. Email:<br />
awgraves@uncc.edu<br />
Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities, 2008, 43(3), 397–408<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities<br />
disabilities. As a result, performance <strong>on</strong> st<strong>and</strong>ardized<br />
achievement tests has high stakes for<br />
students with disabilities. Additi<strong>on</strong>ally, school<br />
districts may use test scores of students with<br />
disabilities to decide placement, grade level<br />
promoti<strong>on</strong>, or to determine whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r or not a<br />
student graduates (Heubert & Hauser, 1999).<br />
By <str<strong>on</strong>g>the</str<strong>on</strong>g> nature of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir disabilities, many students<br />
in special educati<strong>on</strong> programs have difficulty<br />
dem<strong>on</strong>strating knowledge through<br />
st<strong>and</strong>ardized achievement tests. Specifically,<br />
students with disabilities have difficulty with<br />
cognitive <strong>and</strong> metacognitive task dem<strong>and</strong>s.<br />
They often need help to approach a learning<br />
activity (such as test taking), <strong>and</strong> require systematic<br />
methods of training to acquire thinking<br />
skills (Henley, Ramsey, & Algozzine,<br />
2005). Students with disabilities also often<br />
have difficulty organizing informati<strong>on</strong> <strong>and</strong> resp<strong>on</strong>ding<br />
to complex questi<strong>on</strong>s. For example,<br />
a student with a learning disability may have<br />
c<strong>on</strong>tent knowledge (e.g., in math or science),<br />
but have difficulty dem<strong>on</strong>strating <str<strong>on</strong>g>the</str<strong>on</strong>g> knowledge<br />
in a st<strong>and</strong>ardized format. In o<str<strong>on</strong>g>the</str<strong>on</strong>g>r words,<br />
students’ lack of test taking skills may appear<br />
as academic deficiencies (Scruggs & Marsing,<br />
1988).<br />
In many states, students with learning disabilities<br />
(LD) <strong>and</strong> emoti<strong>on</strong>al <strong>and</strong> behavioral<br />
disabilities (EBD) have l<strong>on</strong>g been participating<br />
in st<strong>and</strong>ardized achievement tests with or<br />
without modificati<strong>on</strong>s <strong>and</strong> accommodati<strong>on</strong>s.<br />
Teaching Test-taking Strategies / 397
However, in accordance with <str<strong>on</strong>g>the</str<strong>on</strong>g> NCLB Act,<br />
more states now require students with mild<br />
mental disabilities to participate in state-wide<br />
testing programs. Many students with mild<br />
mental disabilities have traditi<strong>on</strong>ally been<br />
placed in more restrictive, separate settings<br />
(Henley et al., 2006) which may have led to<br />
less access to <str<strong>on</strong>g>the</str<strong>on</strong>g> general curriculum, <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>refore less exposure to st<strong>and</strong>ardized test<br />
formats or test-taking strategies typically used<br />
in general educati<strong>on</strong> classrooms.<br />
Prior research has shown <str<strong>on</strong>g>the</str<strong>on</strong>g> importance<br />
<strong>and</strong> effectiveness of teaching test-taking strategies<br />
to students with <strong>and</strong> without disabilities.<br />
Studies c<strong>on</strong>ducted with general educati<strong>on</strong> students<br />
dem<strong>on</strong>strate that students benefit from<br />
test-taking instructi<strong>on</strong> that includes training<br />
<strong>on</strong> test formats, reas<strong>on</strong>ing <strong>and</strong> deducti<strong>on</strong><br />
strategies, time management, practice, <strong>and</strong><br />
coaching (Beidel, Turner, & Taylor-Ferreira,<br />
1999; Bunting & Mo<strong>on</strong>ey, 2001; Kenny &<br />
Faunce, 2004; Towns & Robins<strong>on</strong>, 1993). Additi<strong>on</strong>ally,<br />
several research studies have found<br />
that students with LD (Lee & Alley, 1981;<br />
Scruggs, Mastropieri, & Tolfa-Veit, 1986; Winnery<br />
& Fuchs, 1993) <strong>and</strong> EBD (Hughes &<br />
Deshler, 1993; Scruggs & Marsing, 1988) outperformed<br />
students in c<strong>on</strong>trol groups in<br />
achievement <strong>on</strong> c<strong>on</strong>tent areas after being<br />
taught test-taking strategies.<br />
One effective approach for applying testtaking<br />
strategies is <str<strong>on</strong>g>the</str<strong>on</strong>g> use of mnem<strong>on</strong>ic learning,<br />
which has shown its efficacy in improving<br />
testing-taking skills <strong>and</strong> achievement of students<br />
with high incidence disabilities such as<br />
LD <strong>and</strong> EBD (Hughes & Deshler, 1993;<br />
Hughes & Schumaker, 1991; Mas<strong>on</strong>, Snyder,<br />
Sukhram, & Kedem, 2006; Scanl<strong>on</strong>, 2002;<br />
Wehrung-Schaffner & Sap<strong>on</strong>a, 1990). For example,<br />
Hughes <strong>and</strong> Schumaker taught a mnem<strong>on</strong>ic<br />
test-taking strategy to 6 seventh <strong>and</strong><br />
eighth graders with LD. Students were taught<br />
a sequence of cognitive <strong>and</strong> behavioral testtaking<br />
strategy steps using a first-letter mnem<strong>on</strong>ic<br />
device (i.e., PIRATES: Prepare to succeed,<br />
Inspect <str<strong>on</strong>g>the</str<strong>on</strong>g> instructi<strong>on</strong>s, Read,<br />
remember, <strong>and</strong> reduce, Answer or ab<strong>and</strong><strong>on</strong>,<br />
Turn back, Estimate, Survey). Using a multiple<br />
probe across participants design, <str<strong>on</strong>g>the</str<strong>on</strong>g> authors<br />
measured <str<strong>on</strong>g>the</str<strong>on</strong>g> percent of items correct<br />
<strong>on</strong> 10 probes designed to measure students’<br />
use of <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy. All students<br />
scored at or above mastery criteri<strong>on</strong> <strong>on</strong> all<br />
398 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
probe tests <strong>and</strong> maintained <str<strong>on</strong>g>the</str<strong>on</strong>g>ir mastery of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy after 3 to 11 weeks.<br />
Additi<strong>on</strong>ally, <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong> data showed<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g> students improved <str<strong>on</strong>g>the</str<strong>on</strong>g>ir performance<br />
<strong>on</strong> regular class tests by an average of 14%<br />
after <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong> was implemented. Similar<br />
results were observed in a systematically<br />
replicated study with 6 seventh- <strong>and</strong> eighthgrade<br />
students with EBD (Hughes & Deshler,<br />
1993).<br />
Empirical evidence supporting <str<strong>on</strong>g>the</str<strong>on</strong>g> efficacy<br />
of mnem<strong>on</strong>ic strategy-based instructi<strong>on</strong> for<br />
students with mental disabilities is relatively<br />
limited. Morin <strong>and</strong> Miller (1998) delivered<br />
mnem<strong>on</strong>ic strategy instructi<strong>on</strong> to teach multiplicati<strong>on</strong><br />
facts <strong>and</strong> word problems to three<br />
7 th -grade students with mental disabilities.<br />
Students were first instructed how to compute<br />
multiplicati<strong>on</strong> facts, <str<strong>on</strong>g>the</str<strong>on</strong>g>n were taught to use<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> mnem<strong>on</strong>ic DRAW (Discover <str<strong>on</strong>g>the</str<strong>on</strong>g> sign,<br />
Read <str<strong>on</strong>g>the</str<strong>on</strong>g> problem, Answer, Write <str<strong>on</strong>g>the</str<strong>on</strong>g> answer)<br />
to complete multiplicati<strong>on</strong> word problems.<br />
Using a multiple baseline across subjects design,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> authors evaluated students’ performance<br />
<strong>on</strong> 21 probes <strong>and</strong> reported that all<br />
students achieved mastery <strong>on</strong> all except four<br />
probes. Similarly, Mastropieri <strong>and</strong> Scruggs<br />
(1994) used mnem<strong>on</strong>ic strategies to teach science<br />
<strong>and</strong> social studies c<strong>on</strong>tent to students<br />
with mild mental disabilities who had not mastered<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>cepts after various methods of<br />
instructi<strong>on</strong> (e.g., textbook materials, outlining,<br />
computer programs) from <str<strong>on</strong>g>the</str<strong>on</strong>g> special educati<strong>on</strong><br />
teacher. Instructi<strong>on</strong> <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> mnem<strong>on</strong>ic<br />
devices greatly improved all students’<br />
mastery in naming state capitals <strong>and</strong> body<br />
parts.<br />
Despite <str<strong>on</strong>g>the</str<strong>on</strong>g> positive outcomes of mnem<strong>on</strong>ic-based<br />
instructi<strong>on</strong> <strong>on</strong> test-taking strategies<br />
for students with <strong>and</strong> without disabilities, research<br />
is limited in two areas. First, <str<strong>on</strong>g>the</str<strong>on</strong>g> majority<br />
of studies c<strong>on</strong>tained teaching test-taking<br />
strategies to students with high incidence disabilities<br />
with limited evidence supporting <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
effects of strategy instructi<strong>on</strong> for students with<br />
mental disabilities. As <str<strong>on</strong>g>the</str<strong>on</strong>g> dem<strong>and</strong> of including<br />
students with mental disabilities in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
state-wide <strong>and</strong> district-wide assessments increases,<br />
so does <str<strong>on</strong>g>the</str<strong>on</strong>g> need for strategy instructi<strong>on</strong><br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g>se students. Sec<strong>on</strong>d, scarce research<br />
addressed test-taking instructi<strong>on</strong> with<br />
elementary aged students. In order to prepare<br />
students for l<strong>on</strong>g-term st<strong>and</strong>ardized test tak-
ing experiences beginning at <str<strong>on</strong>g>the</str<strong>on</strong>g> elementary<br />
level, it is warranted to provide students with<br />
skills in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir early schooling. The purpose of<br />
this study was, <str<strong>on</strong>g>the</str<strong>on</strong>g>refore, to address <str<strong>on</strong>g>the</str<strong>on</strong>g>se issues<br />
by examining <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of direct <strong>and</strong><br />
explicit mnem<strong>on</strong>ic test-taking strategy instructi<strong>on</strong><br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> reading <strong>and</strong> math achievement<br />
test scores of students with mild mental disabilities<br />
in grades four <strong>and</strong> five. Measurements<br />
were taken to evaluate <str<strong>on</strong>g>the</str<strong>on</strong>g> degree to<br />
which <str<strong>on</strong>g>the</str<strong>on</strong>g> participants applied <str<strong>on</strong>g>the</str<strong>on</strong>g> taught<br />
strategies to tests <strong>and</strong> improved <str<strong>on</strong>g>the</str<strong>on</strong>g>ir achievement<br />
test scores, both <strong>on</strong> practice probes <strong>and</strong><br />
regular classroom tests.<br />
Method<br />
Participants<br />
Four students with mild mental disabilities<br />
in grades four <strong>and</strong> five participated in this<br />
study. All participants had an IQ score falling<br />
between 60 <strong>and</strong> 72 <strong>on</strong> previously administered<br />
Weschler Intelligence Scales for Children<br />
(Weschler, 1991), which qualified <str<strong>on</strong>g>the</str<strong>on</strong>g>m for<br />
special educati<strong>on</strong> in <str<strong>on</strong>g>the</str<strong>on</strong>g> educable mental<br />
disability (EMD) category based <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> state<br />
guidelines. The participants’ achievement<br />
scores in reading <strong>and</strong> math were at least two<br />
grade levels behind <str<strong>on</strong>g>the</str<strong>on</strong>g>ir peers without disabilities<br />
<strong>on</strong> previously administered Woodcock<br />
Johns<strong>on</strong> Test of Achievement (Woodcock,<br />
McGrew, & Ma<str<strong>on</strong>g>the</str<strong>on</strong>g>r, 1977) <strong>and</strong> various classroom-based<br />
assessments including <str<strong>on</strong>g>the</str<strong>on</strong>g> Brigance<br />
Diagnostic Comprehensive Inventory of Basic<br />
Skills-Revised (Brigance, 1999) <strong>and</strong> Corrective<br />
Reading assessments (Englemann, Hanner, &<br />
Johns<strong>on</strong>, 1999).<br />
Br<strong>and</strong>y was a 10-year-old female student in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> fifth grade. She exhibited delays in cognitive<br />
ability, academic ability, <strong>and</strong> adaptive behavior<br />
when compared to her same age peers.<br />
She had a full scale IQ of 69, with relative<br />
strengths in memory <strong>and</strong> perceptual reas<strong>on</strong>ing.<br />
Br<strong>and</strong>y dem<strong>on</strong>strated basic reading skills<br />
<strong>on</strong> an upper first grade level <strong>and</strong> reading comprehensi<strong>on</strong><br />
skills <strong>on</strong> a mid-first grade level.<br />
Her math <strong>and</strong> writing skills were <strong>on</strong> an upper<br />
sec<strong>on</strong>d grade level. Testing accommodati<strong>on</strong>s<br />
<strong>on</strong> Br<strong>and</strong>y’s Individualized Educati<strong>on</strong> Program<br />
(IEP) included testing in a separate setting,<br />
read aloud for math, reading aloud to<br />
self for reading passages, <strong>and</strong> multiple test<br />
sessi<strong>on</strong>s.<br />
John was a 10-year-old male student in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
fifth grade. He exhibited delays in cogniti<strong>on</strong>,<br />
academics, <strong>and</strong> adaptive behavior, <strong>and</strong> was<br />
diagnosed with Attenti<strong>on</strong>-Deficit/Hyperactivity<br />
Disorder (ADHD). John received medicati<strong>on</strong><br />
for his ADHD; however, he c<strong>on</strong>tinued to<br />
experience significant difficulty with focusing,<br />
<strong>and</strong> dem<strong>on</strong>strated frequent impulsive behaviors<br />
throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> study. John had a full<br />
scale IQ of 61, with a relative strength in verbal<br />
comprehensi<strong>on</strong>. John read <strong>and</strong> comprehended<br />
<strong>on</strong> a late first grade level, <strong>and</strong> his<br />
math <strong>and</strong> writing skills were <strong>on</strong> a late sec<strong>on</strong>d<br />
grade level, as measured by <str<strong>on</strong>g>the</str<strong>on</strong>g> Woodcock Johns<strong>on</strong><br />
Test of Achievement. John received speech<br />
language <str<strong>on</strong>g>the</str<strong>on</strong>g>rapy for articulati<strong>on</strong> delays. Testing<br />
accommodati<strong>on</strong>s <strong>on</strong> John’s IEP included<br />
testing in a separate setting, read aloud for<br />
math, student reads aloud to self for reading,<br />
extended time, <strong>and</strong> multiple test sessi<strong>on</strong>s.<br />
Sarah was a 9-year-old female in <str<strong>on</strong>g>the</str<strong>on</strong>g> fourth<br />
grade. She exhibited significant delays in cognitive<br />
ability, academic skills, <strong>and</strong> adaptive behavior.<br />
Sarah’s last psycho-educati<strong>on</strong>al evaluati<strong>on</strong><br />
was completed in preschool, in which she<br />
dem<strong>on</strong>strated a general cognitive ability score<br />
of 71, with relatively higher n<strong>on</strong>-verbal skills.<br />
Based <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> preschool evaluati<strong>on</strong>, her academic<br />
skills were <strong>on</strong> a kindergarten level.<br />
However, Sarah’s teacher reported that based<br />
<strong>on</strong> curriculum based measurement, Sarah’s<br />
reading skills were <strong>on</strong> an upper sec<strong>on</strong>d grade<br />
level, math skills <strong>on</strong> a lower first grade level,<br />
<strong>and</strong> writing skills <strong>on</strong> a lower sec<strong>on</strong>d grade<br />
level. Sarah received speech language <str<strong>on</strong>g>the</str<strong>on</strong>g>rapy<br />
for articulati<strong>on</strong> delays. Testing accommodati<strong>on</strong>s<br />
<strong>on</strong> Sarah’s IEP included testing in a<br />
separate setting, read aloud for math, student<br />
reads aloud to self for reading, extended time,<br />
<strong>and</strong> multiple test sessi<strong>on</strong>s.<br />
Amy was a 9-year-old female in <str<strong>on</strong>g>the</str<strong>on</strong>g> fourth<br />
grade. Amy was diagnosed with Velo-Cardial<br />
Facial Syndrome (VCFS), which is a genetic<br />
disorder associated with cleft palate, heart<br />
problems, speech delays, <strong>and</strong> learning difficulties.<br />
On a previous evaluati<strong>on</strong>, Amy exhibited<br />
significant delays in cogniti<strong>on</strong>, academics, <strong>and</strong><br />
adaptive behavior, with a full scale IQ of 71,<br />
making her eligible for special educati<strong>on</strong> as<br />
EMD. However, during <str<strong>on</strong>g>the</str<strong>on</strong>g> course of <str<strong>on</strong>g>the</str<strong>on</strong>g> study<br />
Amy completed a required triennial compre-<br />
Teaching Test-taking Strategies / 399
hensive evaluati<strong>on</strong>, in which her category was<br />
changed from EMD to O<str<strong>on</strong>g>the</str<strong>on</strong>g>r Health Impaired<br />
(OHI) due to <str<strong>on</strong>g>the</str<strong>on</strong>g> impact of VCFS <strong>on</strong> her<br />
learning. On <str<strong>on</strong>g>the</str<strong>on</strong>g> current evaluati<strong>on</strong>, Amy<br />
dem<strong>on</strong>strated a full-scale IQ of 77, reading<br />
scores <strong>on</strong> an upper sec<strong>on</strong>d grade level, <strong>and</strong><br />
math <strong>and</strong> writing scores <strong>on</strong> a lower sec<strong>on</strong>d<br />
grade level. Due to <str<strong>on</strong>g>the</str<strong>on</strong>g> VCFS, Amy dem<strong>on</strong>strates<br />
significant speech <strong>and</strong> language impairments.<br />
Her speech is often unintelligible;<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>refore she uses a combinati<strong>on</strong> of c<strong>on</strong>venti<strong>on</strong>al<br />
speech <strong>and</strong> assistive technology to communicate.<br />
She used both speaking <strong>and</strong> a computer<br />
to interact with <str<strong>on</strong>g>the</str<strong>on</strong>g> researcher during<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> study. Testing accommodati<strong>on</strong>s <strong>on</strong> Amy’s<br />
IEP included testing in a separate setting, extended<br />
time, read aloud for math, student<br />
reads aloud to self for reading, <strong>and</strong> multiple<br />
test sessi<strong>on</strong>s.<br />
Setting<br />
The setting was a self-c<strong>on</strong>tained classroom<br />
(grades three to five) for students with mild to<br />
moderate disabilities. All students in <str<strong>on</strong>g>the</str<strong>on</strong>g> class<br />
functi<strong>on</strong>ed significantly below <str<strong>on</strong>g>the</str<strong>on</strong>g>ir peers in<br />
academics, intellectual ability, <strong>and</strong> adaptive<br />
skills. The classroom housed <strong>on</strong>e special educati<strong>on</strong><br />
teacher, <strong>on</strong>e classroom teacher assistant,<br />
<strong>and</strong> eight students. Classroom instructi<strong>on</strong><br />
focused <strong>on</strong> each student’s IEP goals <strong>and</strong><br />
objectives <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir instructi<strong>on</strong>al level al<strong>on</strong>g<br />
with <str<strong>on</strong>g>the</str<strong>on</strong>g> state curriculum st<strong>and</strong>ards in reading,<br />
math, <strong>and</strong> writing.<br />
Experimenter<br />
The primary experimenter, trainer, <strong>and</strong> data<br />
collector (first author) for this study was a<br />
graduate student <strong>and</strong> excepti<strong>on</strong>al children<br />
program specialist in a rural school district.<br />
The experimenter had been previously<br />
trained in learning strategy instructi<strong>on</strong> <strong>and</strong><br />
taught learning strategies to students with various<br />
high incidence disabilities during her two<br />
years of classroom teaching experience.<br />
Data Collecti<strong>on</strong> Procedures<br />
Dependent variables. Two dependent variables<br />
were measured in <str<strong>on</strong>g>the</str<strong>on</strong>g> study. The first<br />
dependent variable was <str<strong>on</strong>g>the</str<strong>on</strong>g> student achievement<br />
scores <strong>on</strong> reading <strong>and</strong> math multiple<br />
400 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
choice probes (i.e., achievement probes), as<br />
measured by <str<strong>on</strong>g>the</str<strong>on</strong>g> percentage of items answered<br />
correctly <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> probes. Each probe<br />
had 20 items organized into four secti<strong>on</strong>s: (a)<br />
reading words, (b) reading <strong>and</strong> answering<br />
questi<strong>on</strong>s, (c) math problems, <strong>and</strong> (d) math<br />
word problems. The secti<strong>on</strong> <strong>on</strong> reading words<br />
included fill-in-<str<strong>on</strong>g>the</str<strong>on</strong>g>-blank items in which <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
students read sentences <str<strong>on</strong>g>the</str<strong>on</strong>g>n supplied <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
missing word from four choices (e.g., “Every<br />
night I go to bed at a _____ time. My parents<br />
say that getting enough rest is very important.<br />
(a) certain, (b) several, (c) circus, (d) sure”).<br />
The reading <strong>and</strong> answering questi<strong>on</strong>s secti<strong>on</strong><br />
included a passage followed by literal <strong>and</strong><br />
n<strong>on</strong>-literal comprehensi<strong>on</strong> questi<strong>on</strong>s. The<br />
math problems secti<strong>on</strong> included computati<strong>on</strong><br />
problems <strong>and</strong> numerati<strong>on</strong> tasks (e.g., place<br />
value, numbers in st<strong>and</strong>ard form) <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
final secti<strong>on</strong>, math word problems, included<br />
applied math problems involving various<br />
math skills (e.g., geometric shapes, interpreting<br />
tables <strong>and</strong> graphs). Each secti<strong>on</strong> had five<br />
questi<strong>on</strong>s. For each questi<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g> participants<br />
were to choose <str<strong>on</strong>g>the</str<strong>on</strong>g> most appropriate answer<br />
from a choice of four. The first author c<strong>on</strong>structed<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> probe items in <str<strong>on</strong>g>the</str<strong>on</strong>g> reading words,<br />
math problems, <strong>and</strong> math word problems secti<strong>on</strong>s<br />
of each probe by adapting practice endof-grade<br />
exams items provided by <str<strong>on</strong>g>the</str<strong>on</strong>g> state.<br />
Passages in <str<strong>on</strong>g>the</str<strong>on</strong>g> reading <strong>and</strong> answering questi<strong>on</strong>s<br />
secti<strong>on</strong> of each probe were taken from<br />
five practice st<strong>and</strong>ardized tests (Coan, 2003)<br />
used by <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom teacher. The test items<br />
represented skills taught throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> reading<br />
<strong>and</strong> math curriculum <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> state’s St<strong>and</strong>ard<br />
Course of Study for each participant’s<br />
specified grade level. Probes were administered<br />
individually. The first author scored<br />
each student’s probe up<strong>on</strong> completi<strong>on</strong>.<br />
The sec<strong>on</strong>d dependent variable was <str<strong>on</strong>g>the</str<strong>on</strong>g> percent<br />
of steps applied correctly <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> pretest,<br />
five c<strong>on</strong>trolled practice tests, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> posttest,<br />
designed to measure students’ correct use of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy, as well as additi<strong>on</strong>al<br />
five advanced practice tests (i.e., achievement<br />
probes). The pretest, c<strong>on</strong>trolled practice tests,<br />
<strong>and</strong> posttest were directly retrieved from The<br />
Test Taking Strategy instructor’s manual<br />
(Deshler, Hughes, Mercer, & Schumaker,<br />
1993). Each of <str<strong>on</strong>g>the</str<strong>on</strong>g> tests had four secti<strong>on</strong>s<br />
comprised of true/false items, multiple choice<br />
questi<strong>on</strong>s, fill-in-<str<strong>on</strong>g>the</str<strong>on</strong>g>-blank items, <strong>and</strong> <strong>on</strong>e
short essay questi<strong>on</strong>. Items were ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r easy to<br />
answer (used to determine students’ deducti<strong>on</strong><br />
strategies, e.g., “In school, most students<br />
sit at: (a) a lounge chair, (b) a couch, (c) a<br />
desk, (d) a rocking chair”) or fictitious (used<br />
to determine students’ estimating strategies,<br />
e.g., “During <str<strong>on</strong>g>the</str<strong>on</strong>g> neoplenic period, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
wea<str<strong>on</strong>g>the</str<strong>on</strong>g>r was (a) often unpredictable, (b)<br />
never cold, (c) always below freezing, (d)<br />
mostly temperate”). Using a checklist provided<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> manual, <str<strong>on</strong>g>the</str<strong>on</strong>g> experimenter sat<br />
next to each student <strong>and</strong> placed a check next<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> steps of <str<strong>on</strong>g>the</str<strong>on</strong>g> strategy <str<strong>on</strong>g>the</str<strong>on</strong>g> student completed<br />
correctly. Percent of <str<strong>on</strong>g>the</str<strong>on</strong>g> strategy steps<br />
applied correctly was calculated for each student.<br />
Interobserver agreement. To establish interobserver<br />
agreement, <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom special educati<strong>on</strong><br />
teacher <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> first author both<br />
scored 30% of <str<strong>on</strong>g>the</str<strong>on</strong>g> probes across c<strong>on</strong>diti<strong>on</strong>s<br />
for each student. The two scorers’ recordings<br />
were compared item by item. The percentage<br />
of agreement was calculated by dividing <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
number of agreements by <str<strong>on</strong>g>the</str<strong>on</strong>g> number of<br />
agreements plus disagreements <strong>and</strong> multiplying<br />
by 100. Interobserver reliability was found<br />
to be 100% <strong>on</strong> all selected probes.<br />
Procedural reliability. To ensure procedural<br />
reliability, <str<strong>on</strong>g>the</str<strong>on</strong>g> special educati<strong>on</strong> teacher observed<br />
30% of <str<strong>on</strong>g>the</str<strong>on</strong>g> instructi<strong>on</strong>al sessi<strong>on</strong>s. The<br />
teacher determined <str<strong>on</strong>g>the</str<strong>on</strong>g> accuracy with which<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> first author implemented <str<strong>on</strong>g>the</str<strong>on</strong>g> strategy by<br />
completing a procedural checklist to determine<br />
if <str<strong>on</strong>g>the</str<strong>on</strong>g> instructor (a) followed <str<strong>on</strong>g>the</str<strong>on</strong>g> script,<br />
(b) followed <str<strong>on</strong>g>the</str<strong>on</strong>g> instructi<strong>on</strong>al sequence outlined<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> strategy, <strong>and</strong> (c) gave adequate<br />
repetiti<strong>on</strong> <strong>and</strong> corrective feedback as outlined<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> procedures. The teacher was provided<br />
with a copy of <str<strong>on</strong>g>the</str<strong>on</strong>g> Test-Taking Strategy manual<br />
to follow during <str<strong>on</strong>g>the</str<strong>on</strong>g> observed sessi<strong>on</strong>s.<br />
Procedural reliability for each sessi<strong>on</strong> was calculated<br />
by dividing <str<strong>on</strong>g>the</str<strong>on</strong>g> number of procedural<br />
items followed correctly by <str<strong>on</strong>g>the</str<strong>on</strong>g> total number<br />
of procedural items to be observed (i.e., 7)<br />
<strong>and</strong> multiplying by 100. Procedural reliability<br />
was assessed to be at 100%.<br />
Social validity data. Social validity data were<br />
collected before <str<strong>on</strong>g>the</str<strong>on</strong>g> study began <strong>and</strong> again<br />
after <str<strong>on</strong>g>the</str<strong>on</strong>g> study was completed to measure <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
social importance of teaching test-taking strategies<br />
to students with mental disabilities <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> perceived outcomes of <str<strong>on</strong>g>the</str<strong>on</strong>g> instructi<strong>on</strong>. Using<br />
a c<strong>on</strong>sumer satisfacti<strong>on</strong> questi<strong>on</strong>naire,<br />
parents of <str<strong>on</strong>g>the</str<strong>on</strong>g> participants, <str<strong>on</strong>g>the</str<strong>on</strong>g> classroom special<br />
educati<strong>on</strong> teacher, <strong>and</strong> <strong>on</strong>e general educati<strong>on</strong><br />
teacher provided <str<strong>on</strong>g>the</str<strong>on</strong>g>ir resp<strong>on</strong>ses.<br />
Experimental Design <strong>and</strong> Procedures<br />
The experimental design was a single-subject<br />
multiple probe across participants design<br />
(Tawney & Gast, 1984). The initial baseline<br />
lasted a minimum of three sessi<strong>on</strong>s for all<br />
participants, or until baseline was stable. The<br />
training began with Br<strong>and</strong>y first, with <str<strong>on</strong>g>the</str<strong>on</strong>g> remaining<br />
participants in <str<strong>on</strong>g>the</str<strong>on</strong>g> baseline c<strong>on</strong>diti<strong>on</strong>,<br />
during which a probe was given to each<br />
participant weekly. When Br<strong>and</strong>y dem<strong>on</strong>strated<br />
80% accuracy <strong>on</strong> two c<strong>on</strong>secutive<br />
probes during post-training, <str<strong>on</strong>g>the</str<strong>on</strong>g> training was<br />
introduced to John. The same criteri<strong>on</strong> applied<br />
to Sarah <strong>and</strong> Amy in <str<strong>on</strong>g>the</str<strong>on</strong>g> subsequent<br />
order.<br />
Baseline. During baseline, no test-taking<br />
strategies were taught. The participants received<br />
regular instructi<strong>on</strong> in reading <strong>and</strong><br />
math in <str<strong>on</strong>g>the</str<strong>on</strong>g> self-c<strong>on</strong>tained classroom. The participants<br />
were given achievement probes to<br />
complete daily for at least three days or until<br />
baseline was stable. The probes were administered<br />
individually by <str<strong>on</strong>g>the</str<strong>on</strong>g> first author in a separate<br />
setting (various quiet locati<strong>on</strong>s available<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g> school). Students were given an unlimited<br />
amount of time to complete <str<strong>on</strong>g>the</str<strong>on</strong>g> probes.<br />
Participants received all modificati<strong>on</strong>s listed<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir IEPs, including read aloud for <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
math problems, reading aloud to <str<strong>on</strong>g>the</str<strong>on</strong>g>mselves<br />
during reading passages, <strong>and</strong> extended time.<br />
Interventi<strong>on</strong>. The instructi<strong>on</strong>al procedures<br />
were developed based <strong>on</strong> The Test Taking Strategy<br />
by Deshler <strong>and</strong> colleagues (Deshler et al.,<br />
1993) <strong>and</strong> c<strong>on</strong>sisted of nine stages (see Table<br />
1). Each participant received 12 instructi<strong>on</strong>al<br />
sessi<strong>on</strong>s, each lasting approximately 20 min.<br />
In <str<strong>on</strong>g>the</str<strong>on</strong>g> first stage, participants were given <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
pretest. Due to <str<strong>on</strong>g>the</str<strong>on</strong>g> advanced reading level of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> pretest <strong>and</strong> participants’ IEP modificati<strong>on</strong>s,<br />
all questi<strong>on</strong>s were read aloud. The first<br />
author scored <str<strong>on</strong>g>the</str<strong>on</strong>g> pretests, <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>n gave individual<br />
feedback <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> pretest to each participant.<br />
Participants <str<strong>on</strong>g>the</str<strong>on</strong>g>n each wrote a goal<br />
stating what <str<strong>on</strong>g>the</str<strong>on</strong>g>y wanted to learn <strong>and</strong> how<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>y would improve by using <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking<br />
strategy. In stage two <str<strong>on</strong>g>the</str<strong>on</strong>g> first author described<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> purpose<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy to participants.<br />
Teaching Test-taking Strategies / 401
TABLE 1<br />
Instructi<strong>on</strong>al Stages<br />
Stages Descripti<strong>on</strong><br />
1. Pretest Students take pretest measuring strategy use.<br />
2. Describe Instructor gives purpose <strong>and</strong> rati<strong>on</strong>ale for strategy <strong>and</strong> briefly<br />
previews each step.<br />
3. Model Instructor directly <strong>and</strong> explicitly models each step of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
PIRATES strategy.<br />
4. Verbal rehearsal Instructor leads students in verbal repetiti<strong>on</strong> of each step <strong>and</strong><br />
sub-step of <str<strong>on</strong>g>the</str<strong>on</strong>g> strategy to aid memorizati<strong>on</strong> <strong>and</strong> acquisiti<strong>on</strong>.<br />
5. C<strong>on</strong>trolled practice Students apply strategy to practice tests designed to measure<br />
strategy use.<br />
6. Advanced practice <strong>and</strong><br />
Students apply strategy to “real” tests.<br />
feedback<br />
7. Posttest Students take posttest measuring strategy use.<br />
8. Maintenance Instructor evaluates whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r students have maintained strategy<br />
use at <str<strong>on</strong>g>the</str<strong>on</strong>g> end of 2-week post training <strong>on</strong> tests designed to<br />
measure strategy use.<br />
9. Generalizati<strong>on</strong> Instructor teaches students to generalize strategy to o<str<strong>on</strong>g>the</str<strong>on</strong>g>r settings<br />
(e.g., different subjects or courses).<br />
In stage three participants were trained to<br />
apply <str<strong>on</strong>g>the</str<strong>on</strong>g> “PIRATES” first letter mnem<strong>on</strong>ic<br />
test-taking strategy as listed below:<br />
The first author modeled each step of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
strategy <strong>on</strong> a sample test while enlisting a cognitive<br />
think aloud strategy. First, students were<br />
instructed to write <str<strong>on</strong>g>the</str<strong>on</strong>g> acr<strong>on</strong>ym “PIRATES” <strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> fr<strong>on</strong>t top of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir test page. Then, in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
“P” step of PIRATES, “Prepare to Succeed”,<br />
students were taught to write <str<strong>on</strong>g>the</str<strong>on</strong>g>ir names <strong>on</strong><br />
each page of <str<strong>on</strong>g>the</str<strong>on</strong>g> test <strong>and</strong> count <str<strong>on</strong>g>the</str<strong>on</strong>g> number of<br />
secti<strong>on</strong>s <strong>and</strong> types of questi<strong>on</strong>s <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> test.<br />
Next, students learned to order <str<strong>on</strong>g>the</str<strong>on</strong>g> secti<strong>on</strong>s of<br />
a test by level of difficulty to help <str<strong>on</strong>g>the</str<strong>on</strong>g>m determine<br />
where to start <strong>on</strong> a test. Participants were<br />
shown how to begin working <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> test by<br />
starting with <str<strong>on</strong>g>the</str<strong>on</strong>g> secti<strong>on</strong> determined by <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
test-taker to be easiest (See Figure 1).<br />
In step two of PIRATES, participants were<br />
trained to “Inspect <str<strong>on</strong>g>the</str<strong>on</strong>g> Instructi<strong>on</strong>s” by reading<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> directi<strong>on</strong>s <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> test <strong>and</strong> underlining<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> words that tell <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taker what to do. In<br />
step three, participants learned to “Read, Remember,<br />
<strong>and</strong> Reduce” by reading each test<br />
item <strong>and</strong> eliminating answer choices that were<br />
clearly incorrect. In step four, “Answer or<br />
Ab<strong>and</strong><strong>on</strong>,” <str<strong>on</strong>g>the</str<strong>on</strong>g> participants were trained to<br />
answer <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong> if <str<strong>on</strong>g>the</str<strong>on</strong>g>y were sure of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
answer, or ab<strong>and</strong><strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> questi<strong>on</strong> if <str<strong>on</strong>g>the</str<strong>on</strong>g>y were<br />
unsure of <str<strong>on</strong>g>the</str<strong>on</strong>g> answer. Participants learned to<br />
402 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
mark ab<strong>and</strong><strong>on</strong>ed items with a symbol (e.g., a<br />
star). Participants were taught to repeat all<br />
previous steps for all remaining test items in<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> secti<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>y were working <strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g>n to go<br />
<strong>on</strong> to <str<strong>on</strong>g>the</str<strong>on</strong>g> secti<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>y indicated to complete<br />
next (based <strong>on</strong> order of difficulty). Participants<br />
were instructed to again “Inspect <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
Instructi<strong>on</strong>s” for <str<strong>on</strong>g>the</str<strong>on</strong>g> next secti<strong>on</strong> <strong>and</strong> c<strong>on</strong>tinue<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> strategy for <str<strong>on</strong>g>the</str<strong>on</strong>g> remaining secti<strong>on</strong>s<br />
<strong>and</strong> test items. In step five, “Turn Back,” participants<br />
were trained to return to <str<strong>on</strong>g>the</str<strong>on</strong>g> beginning<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> test, locate <str<strong>on</strong>g>the</str<strong>on</strong>g> symbol for ab<strong>and</strong><strong>on</strong>ed<br />
items, <strong>and</strong> ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r answer, or “Estimate.”<br />
Participants learned several estimating techniques<br />
including: avoiding absolute words,<br />
choosing <str<strong>on</strong>g>the</str<strong>on</strong>g> l<strong>on</strong>gest answer, <strong>and</strong> estimating<br />
similar choices. In <str<strong>on</strong>g>the</str<strong>on</strong>g> last step, “Survey,” participants<br />
were instructed to look over all <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
test items to make sure <str<strong>on</strong>g>the</str<strong>on</strong>g>y had answered<br />
each item, but not to change any answers<br />
unless <str<strong>on</strong>g>the</str<strong>on</strong>g>y were certain it was incorrect.<br />
During stage four, verbal rehearsal, participants<br />
repeated each step <strong>and</strong> sub-step of PI-<br />
RATES using flash cards <strong>and</strong> fading prompts<br />
until <str<strong>on</strong>g>the</str<strong>on</strong>g>y memorized it <strong>and</strong> had been individually<br />
checked for mastery using <str<strong>on</strong>g>the</str<strong>on</strong>g> checklist<br />
provided in <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking instructor’s manual.<br />
When participants reached 90% mastery<br />
<strong>on</strong> memorizati<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g>y proceeded to stage five<br />
of instructi<strong>on</strong>, which involved participants’ ap-
plicati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy to c<strong>on</strong>trolled<br />
practice tests. The first author scored <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>trolled<br />
practice tests <strong>and</strong> provided individual<br />
feedback to participants. Steps of <str<strong>on</strong>g>the</str<strong>on</strong>g> strategy<br />
were re-taught after each test if <str<strong>on</strong>g>the</str<strong>on</strong>g> participant<br />
failed to reach a 90% mastery level. Once participants<br />
reached 90% mastery <strong>on</strong> <strong>on</strong>e c<strong>on</strong>trolled<br />
practice test, <str<strong>on</strong>g>the</str<strong>on</strong>g> training ended <strong>and</strong> participants<br />
proceeded to stage six.<br />
In stage six, advanced practice <strong>and</strong> feedback,<br />
participants applied <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy<br />
to five achievement probes. Once a participant<br />
completed all five probes, <str<strong>on</strong>g>the</str<strong>on</strong>g>y<br />
completed <str<strong>on</strong>g>the</str<strong>on</strong>g> posttest (i.e., stage seven). During<br />
stage eight, <str<strong>on</strong>g>the</str<strong>on</strong>g> participants were evaluated<br />
at <str<strong>on</strong>g>the</str<strong>on</strong>g> end of 2-week post training to<br />
determine if <str<strong>on</strong>g>the</str<strong>on</strong>g>y maintained <str<strong>on</strong>g>the</str<strong>on</strong>g> use of strategy.<br />
During stage nine, <str<strong>on</strong>g>the</str<strong>on</strong>g> participants were<br />
taught to apply <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy to a<br />
variety of regular classroom tests.<br />
Figure 1. “PIRATES” mnem<strong>on</strong>ic test-taking strategy.<br />
Generalizati<strong>on</strong> probes. Generalizati<strong>on</strong> included<br />
an examinati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> participants’<br />
use of <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
achievement <strong>on</strong> regular classroom tests. During<br />
generalizati<strong>on</strong>, <str<strong>on</strong>g>the</str<strong>on</strong>g> special educati<strong>on</strong><br />
teacher administered two regular classroom<br />
reading <strong>and</strong> math tests. The first author<br />
scored <str<strong>on</strong>g>the</str<strong>on</strong>g> regular classroom tests <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
participant’s use of <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy.<br />
Maintenance. Maintenance included <strong>on</strong>e<br />
additi<strong>on</strong>al achievement probe which was administered<br />
two weeks after each participant<br />
completed <str<strong>on</strong>g>the</str<strong>on</strong>g> training.<br />
Results<br />
The interventi<strong>on</strong> of teaching <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking<br />
strategies was effective for all students in that<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> instructi<strong>on</strong> increased <str<strong>on</strong>g>the</str<strong>on</strong>g> percent correct<br />
Teaching Test-taking Strategies / 403
TABLE 2<br />
Percent Correct <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> Acquisiti<strong>on</strong> <strong>and</strong> Applicati<strong>on</strong> of Test-taking Strategies<br />
by at least 10 points for each participant <strong>on</strong><br />
both <str<strong>on</strong>g>the</str<strong>on</strong>g> tests measuring strategy applicati<strong>on</strong><br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> probes measuring achievement. All<br />
students reached 80% mastery <strong>on</strong> achievement<br />
probes <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> tests designed to measure<br />
test-taking applicati<strong>on</strong>.<br />
Strategy Applicati<strong>on</strong><br />
Test Br<strong>and</strong>y John Sarah Amy<br />
Pretest 19 40 28 27<br />
Training<br />
C<strong>on</strong>trolled Practice 1 83 86 88 89<br />
C<strong>on</strong>trolled Practice 2 75 92 72 85<br />
C<strong>on</strong>trolled Practice 3 81 – 86 79<br />
C<strong>on</strong>trolled Practice 4 86 – 92 81<br />
C<strong>on</strong>trolled Practice 5 93 – – 90<br />
Post-training (with feedback)<br />
Advanced Practice 1 100 100 86 79<br />
Advanced Practice 2 93 100 71 93<br />
Advanced Practice 3 93 100 93 93<br />
Advanced Practice 4 93 100 86 93<br />
Advanced Practice 5 93 100 86 83<br />
Posttest 90 92 86 85<br />
Post-training (without feedback)<br />
Maintenance 93 86 86 86<br />
Generalizati<strong>on</strong> 1 86 58 55 83<br />
Generalizati<strong>on</strong> 2 86 86 80 80<br />
Results <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking applicati<strong>on</strong> showed<br />
that Br<strong>and</strong>y <strong>and</strong> John both memorized <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
steps of <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy as dem<strong>on</strong>strated<br />
by verbal repetiti<strong>on</strong> in <strong>on</strong>ly two attempts.<br />
Sarah <strong>and</strong> Amy had some difficulty<br />
memorizing <str<strong>on</strong>g>the</str<strong>on</strong>g> steps of <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy,<br />
taking <str<strong>on</strong>g>the</str<strong>on</strong>g>m five <strong>and</strong> six attempts, respectively,<br />
to verbally repeat <str<strong>on</strong>g>the</str<strong>on</strong>g> strategy correctly.<br />
Both Sarah <strong>and</strong> Amy had lower verbal ability<br />
scores <strong>on</strong> previous evaluati<strong>on</strong>s am<strong>on</strong>g all participants,<br />
thus it is possible that <str<strong>on</strong>g>the</str<strong>on</strong>g>ir difficulty<br />
memorizing <strong>and</strong> repeating <str<strong>on</strong>g>the</str<strong>on</strong>g> strategy could<br />
be attributed to <str<strong>on</strong>g>the</str<strong>on</strong>g> lower verbal ability.<br />
Data were also collected to determine <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
level of accuracy with which each participant<br />
applied <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy prior to training,<br />
during training, <strong>and</strong> post training, as<br />
measured by percent correct <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> pretest,<br />
c<strong>on</strong>trolled practice tests, advanced practice<br />
tests, <strong>and</strong> posttest. All participants reached<br />
mastery of 80% correct during c<strong>on</strong>trolled<br />
practice <strong>and</strong> advanced practice, <strong>and</strong> dem<strong>on</strong>strated<br />
significant gains from pretest to posttest<br />
in <str<strong>on</strong>g>the</str<strong>on</strong>g>ir test-taking ability. Results are presented<br />
in Table 2.<br />
Achievement Probes<br />
404 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
Achievement probes results (see Figure 2)<br />
also support <str<strong>on</strong>g>the</str<strong>on</strong>g> effectiveness of <str<strong>on</strong>g>the</str<strong>on</strong>g> interventi<strong>on</strong>.<br />
Br<strong>and</strong>y obtained a mean percent score of<br />
55 (range 50–60) <strong>on</strong> achievement probes during<br />
baseline <strong>and</strong> a mean percent score of 77.4<br />
(range 55–90) during post-training sessi<strong>on</strong>s.<br />
Her lowest score, at 55 percent during <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
sec<strong>on</strong>d post-training sessi<strong>on</strong>, could be attributed<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> level of reading difficulty of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
probe. The first author observed her having<br />
difficulty reading <str<strong>on</strong>g>the</str<strong>on</strong>g> passages in <str<strong>on</strong>g>the</str<strong>on</strong>g> probe<br />
which negatively impacted her score, <strong>and</strong> adjusted<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> subsequent probes to match her<br />
instructi<strong>on</strong>al reading level. John obtained a<br />
mean percent score of 55 (range 55–65) <strong>on</strong><br />
baseline probes <strong>and</strong> improved his score to<br />
82.4 (range 80–84) during post-training. Similarly,<br />
Sarah <strong>and</strong> Amy dem<strong>on</strong>strated substantial<br />
improvements <strong>on</strong> achievement probes,<br />
from a mean percent score of 45.5 (range<br />
35–55) <strong>and</strong> 49.1 (range 30–65), respectively,
Figure 2. Percent correct <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> achievement probes.<br />
Teaching Test-taking Strategies / 405
during baseline to a mean percent score of<br />
77.8 (range 60–85) <strong>and</strong> 84.4 (range 70–100),<br />
respectively, during post-training. All participants<br />
maintained a minimum of 80% correct<br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> maintenance achievement probe two<br />
weeks after <str<strong>on</strong>g>the</str<strong>on</strong>g> training was terminated.<br />
Generalizati<strong>on</strong> data <strong>on</strong> achievement probes<br />
showed much variability for all participants.<br />
Specifically, Br<strong>and</strong>y scored a mean percent of<br />
56 (range 33–73), John 66.3 (range 44–80),<br />
Sarah 57.5 (range 40–75), <strong>and</strong> Amy 64 (range<br />
53–75) <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir regular classroom tests.<br />
Social Validity Data<br />
Parents <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> special educati<strong>on</strong> teacher of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> participants felt that students with mental<br />
disabilities were not prepared to take tests <strong>and</strong><br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g>y ei<str<strong>on</strong>g>the</str<strong>on</strong>g>r had no or <strong>on</strong>ly limited knowledge<br />
of test formats, while <str<strong>on</strong>g>the</str<strong>on</strong>g> general educati<strong>on</strong><br />
teacher felt that students with mental<br />
disabilities were somewhat prepared to take<br />
tests <strong>and</strong> had some knowledge of test formats.<br />
All of <str<strong>on</strong>g>the</str<strong>on</strong>g> resp<strong>on</strong>dents felt that students with<br />
mental disabilities would benefit from testtaking<br />
strategy instructi<strong>on</strong>. Regarding <str<strong>on</strong>g>the</str<strong>on</strong>g> perceived<br />
outcomes, all resp<strong>on</strong>dents agreed that<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> participants were more prepared to take<br />
tests after being taught <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy.<br />
Discussi<strong>on</strong><br />
To extend current research <strong>and</strong> practice limitati<strong>on</strong><br />
<strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> use of test-taking strategies with<br />
elementary-age students with mental disabilities,<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> primary purpose of this study was to<br />
examine <str<strong>on</strong>g>the</str<strong>on</strong>g> effects of teaching a direct <strong>and</strong><br />
explicit test-taking strategy <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> reading <strong>and</strong><br />
math achievement of students with mild mental<br />
disabilities in grades four <strong>and</strong> five.<br />
All participants dem<strong>on</strong>strated <str<strong>on</strong>g>the</str<strong>on</strong>g> ability to<br />
acquire <strong>and</strong> apply a comprehensive, mnem<strong>on</strong>ic<br />
test-taking strategy. Specifically, <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
participants required five or fewer c<strong>on</strong>trolled<br />
practices during training to reach a 90% mastery<br />
criteri<strong>on</strong> <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir use of test-taking strategies.<br />
All participants achieved a minimum<br />
level of 80% criteri<strong>on</strong> <strong>on</strong> all five advanced<br />
practices during post training, with <str<strong>on</strong>g>the</str<strong>on</strong>g> excepti<strong>on</strong><br />
of Sarah <strong>and</strong> Amy for whom feedback was<br />
provided <strong>on</strong>ly <strong>on</strong>ce when <str<strong>on</strong>g>the</str<strong>on</strong>g>y failed to reach<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> criteri<strong>on</strong> (i.e., Advanced Practice 2 for<br />
Sarah <strong>and</strong> Advanced Practice 1 for Amy). Ad-<br />
406 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
diti<strong>on</strong>ally, all participants maintained <str<strong>on</strong>g>the</str<strong>on</strong>g>ir acquisiti<strong>on</strong><br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
posttest, 2-week maintenance assessment, <strong>and</strong><br />
two generalizati<strong>on</strong> measurements of regular<br />
classroom tests. These results are c<strong>on</strong>sistent<br />
with previous research in two ways. First, students<br />
with mild mental disabilities effectively<br />
learned <strong>and</strong> applied <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy<br />
through use of <str<strong>on</strong>g>the</str<strong>on</strong>g> nine-stage instructi<strong>on</strong>al<br />
sequence found in o<str<strong>on</strong>g>the</str<strong>on</strong>g>r learning strategy research<br />
with students with LD or EBD (Ellis,<br />
Deshler, Lenz, Schumaker, & Clark, 1991;<br />
Hughes & Deshler, 1993; Hughes & Schumaker,<br />
1991; Morin & Miller, 1998). Thus,<br />
this study provides additi<strong>on</strong>al support to <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
efficacy <strong>and</strong> usefulness of teaching mnem<strong>on</strong>ic<br />
test-taking strategies for students with disabilities.<br />
Sec<strong>on</strong>d, <str<strong>on</strong>g>the</str<strong>on</strong>g> results support previous research<br />
in that students with disabilities not<br />
<strong>on</strong>ly can apply a test-taking strategy to tests,<br />
but also can maintain <str<strong>on</strong>g>the</str<strong>on</strong>g> skill over time <strong>and</strong><br />
generalize use of <str<strong>on</strong>g>the</str<strong>on</strong>g> strategy to o<str<strong>on</strong>g>the</str<strong>on</strong>g>r testtaking<br />
situati<strong>on</strong>s (Hughes & Deshler, 1993;<br />
Hughes & Schumaker, 1991).<br />
Results <strong>on</strong> participants’ achievement<br />
probes dem<strong>on</strong>strated a functi<strong>on</strong>al relati<strong>on</strong>ship<br />
between <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy instructi<strong>on</strong><br />
<strong>and</strong> percent correct <strong>on</strong> math <strong>and</strong> reading<br />
achievement tests. During baseline, Br<strong>and</strong>y<br />
<strong>and</strong> Sarah received 60% correct or lower <strong>on</strong><br />
all of <str<strong>on</strong>g>the</str<strong>on</strong>g> achievement probes while John <strong>and</strong><br />
Amy scored 70% correct or lower <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
achievement probes. During post training <strong>and</strong><br />
2-week maintenance c<strong>on</strong>diti<strong>on</strong>s, all participants<br />
scored higher than <str<strong>on</strong>g>the</str<strong>on</strong>g>ir baseline performance<br />
<strong>on</strong> all of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir five achievement<br />
probes, with <str<strong>on</strong>g>the</str<strong>on</strong>g> excepti<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> sec<strong>on</strong>d data<br />
point for Br<strong>and</strong>y. Therefore, an experimental<br />
c<strong>on</strong>trol was apparent in this study, supporting<br />
previous research <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> efficacy of test-taking<br />
instructi<strong>on</strong> in improving students’ achievement<br />
scores (Beidel et al., 1999; Bunting &<br />
Mo<strong>on</strong>ey, 2001; Kenny & Faunce, 2004; Lee &<br />
Alley, 1981; Scruggs et al., 1986; Scruggs &<br />
Marsing, 1988; Towns & Robins<strong>on</strong>, 1993; Winnery<br />
& Fuchs, 1993) <strong>and</strong> maintaining positive<br />
achievement outcomes over time (Hughes &<br />
Deshler, 1993; Hughes & Schumaker, 1991).<br />
However, <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong> data for <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
achievement probes were inc<strong>on</strong>clusive. Although<br />
all participants improved <str<strong>on</strong>g>the</str<strong>on</strong>g> mean<br />
percent correct <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong> achievement<br />
probes by 1% to 15% compared to <str<strong>on</strong>g>the</str<strong>on</strong>g>
aseline probes, data were highly variable <strong>and</strong><br />
an experimental c<strong>on</strong>trol was not achieved due<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> lack of generalizati<strong>on</strong> data prior to <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
interventi<strong>on</strong>. The low <strong>and</strong> variable generalizati<strong>on</strong><br />
achievement scores may result from <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
participants’ academic skill levels. Specifically,<br />
all participants applied <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy<br />
with a high level of accuracy to <str<strong>on</strong>g>the</str<strong>on</strong>g> generalizati<strong>on</strong><br />
probes, however <str<strong>on</strong>g>the</str<strong>on</strong>g>y sometimes had<br />
low overall scores because <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>tent knowledge<br />
was too difficult or unfamiliar, or <str<strong>on</strong>g>the</str<strong>on</strong>g> test<br />
materials were not matched to <str<strong>on</strong>g>the</str<strong>on</strong>g>ir instructi<strong>on</strong>al<br />
reading levels. It is important to note<br />
that a test-taking strategy is not intended to<br />
compensate for gaps in c<strong>on</strong>tent knowledge or<br />
reading ability. This may explain why <str<strong>on</strong>g>the</str<strong>on</strong>g> participants<br />
did not generalize <str<strong>on</strong>g>the</str<strong>on</strong>g>ir achievement<br />
outcomes to regular classroom tests, a finding<br />
inc<strong>on</strong>sistent with previous research c<strong>on</strong>ducted<br />
with students who have high incidence disabilities<br />
(Hughes & Deshler, 1993; Hughes &<br />
Schumaker, 1991; Lee & Alley, 1981). Future<br />
research is warranted to develop strategies in<br />
promoting generalizati<strong>on</strong> across types of<br />
achievement tests <strong>and</strong> to develop appropriate<br />
tests measuring general educati<strong>on</strong> c<strong>on</strong>tent<br />
with lower reading levels.<br />
Some limitati<strong>on</strong>s were noted in this study.<br />
First, a large porti<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy<br />
training used in <str<strong>on</strong>g>the</str<strong>on</strong>g> current study relied<br />
heavily <strong>on</strong> print. Although modificati<strong>on</strong>s were<br />
made to <str<strong>on</strong>g>the</str<strong>on</strong>g> materials, <strong>and</strong> accommodati<strong>on</strong>s<br />
were given during <str<strong>on</strong>g>the</str<strong>on</strong>g> sessi<strong>on</strong>s, participants’<br />
success was still somewhat c<strong>on</strong>tingent up<strong>on</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>ir reading ability. In order for <str<strong>on</strong>g>the</str<strong>on</strong>g> testtaking<br />
strategy to be most effective, <str<strong>on</strong>g>the</str<strong>on</strong>g> training<br />
materials should be matched to <str<strong>on</strong>g>the</str<strong>on</strong>g> participants’<br />
instructi<strong>on</strong>al reading level. The<br />
materials developed by Deshler <strong>and</strong> colleagues<br />
(1993) were intended to be used with<br />
adolescents with LD, thus <str<strong>on</strong>g>the</str<strong>on</strong>g> reading levels<br />
were too difficult for elementary students with<br />
mild mental disabilities. Because <str<strong>on</strong>g>the</str<strong>on</strong>g> participants<br />
benefited from <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>tent of <str<strong>on</strong>g>the</str<strong>on</strong>g> strategy,<br />
it would be beneficial for <str<strong>on</strong>g>the</str<strong>on</strong>g> reading<br />
level of <str<strong>on</strong>g>the</str<strong>on</strong>g> training materials to be modified<br />
for elementary students. Future research<br />
should include using <str<strong>on</strong>g>the</str<strong>on</strong>g> same procedures,<br />
but with lower level readability. Sec<strong>on</strong>d, generalizati<strong>on</strong><br />
data were <strong>on</strong>ly available post interventi<strong>on</strong><br />
<strong>and</strong> were not measured during baseline<br />
or training, making it difficult to evaluate<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> extent to which <str<strong>on</strong>g>the</str<strong>on</strong>g> participants general-<br />
ized positive achievement outcomes to regular<br />
classroom tests. Future research is needed to<br />
more systematically collect <strong>and</strong> evaluate generalizati<strong>on</strong><br />
data throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> course of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
study. Finally, during <str<strong>on</strong>g>the</str<strong>on</strong>g> course of <str<strong>on</strong>g>the</str<strong>on</strong>g> study,<br />
Amy changed eligibility categories from Educable<br />
Mentally Disabled to O<str<strong>on</strong>g>the</str<strong>on</strong>g>r Health Impaired.<br />
Although her IQ score was still in <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
borderline range, it is possible that she performed<br />
better than o<str<strong>on</strong>g>the</str<strong>on</strong>g>r participants due to a<br />
higher cognitive ability level, making her results<br />
difficult to compare to those of students<br />
with EMD.<br />
Despite <str<strong>on</strong>g>the</str<strong>on</strong>g> limitati<strong>on</strong>s, this study offers important<br />
research <strong>and</strong> practice implicati<strong>on</strong>s.<br />
The No Child Left Behind Act of 2001 <strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
Individuals with Disabilities Educati<strong>on</strong> Improvement<br />
Act (2004) state that students with<br />
mild mental disabilities must be exposed to<br />
<strong>and</strong> assessed <strong>on</strong> general curriculum grade appropriate<br />
st<strong>and</strong>ards. States most often assess<br />
students’ achievement through <str<strong>on</strong>g>the</str<strong>on</strong>g> use of<br />
st<strong>and</strong>ardized tests, thus it is critical that students<br />
with mild mental disabilities c<strong>on</strong>tinue to<br />
be taught direct <strong>and</strong> explicit test-taking strategies.<br />
This study dem<strong>on</strong>strates that students<br />
who are identified as having mild mental disabilities<br />
can be taught effectively a comprehensive<br />
test-taking strategy which may c<strong>on</strong>sequently<br />
improve achievement. Teachers <strong>and</strong><br />
educators working with students with mild<br />
mental disabilities may utilize test-taking strategy<br />
instructi<strong>on</strong> as a promising <strong>and</strong> valid<br />
method for improving students’ test-taking<br />
skills <strong>and</strong> academic achievement. In additi<strong>on</strong>,<br />
this study points to <str<strong>on</strong>g>the</str<strong>on</strong>g> need for modificati<strong>on</strong>s<br />
in teaching students with mild mental disabilities<br />
who have lower academic skills <strong>and</strong> more<br />
reading delays. Participants in this study received<br />
instructi<strong>on</strong> in a <strong>on</strong>e-<strong>on</strong>-<strong>on</strong>e setting,<br />
with direct instructi<strong>on</strong>, verbal rehearsal, cue<br />
cards <strong>and</strong> fading prompts used as instructi<strong>on</strong>al<br />
methods to teach <str<strong>on</strong>g>the</str<strong>on</strong>g> test-taking strategy.<br />
Complex wording in <str<strong>on</strong>g>the</str<strong>on</strong>g> training materials<br />
was simplified or read aloud to students. If<br />
students with mild mental disabilities are to be<br />
held accountable through high stakes, st<strong>and</strong>ardized<br />
achievement testing, appropriate<br />
modificati<strong>on</strong>s must be made to allow <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
students to fully dem<strong>on</strong>strate <str<strong>on</strong>g>the</str<strong>on</strong>g>ir competence.<br />
Similarly, it is vital that appropriate<br />
training <strong>and</strong> test materials are developed so<br />
that <str<strong>on</strong>g>the</str<strong>on</strong>g>y match to students’ instructi<strong>on</strong>al<br />
Teaching Test-taking Strategies / 407
eading levels for <str<strong>on</strong>g>the</str<strong>on</strong>g> maximum outcomes. In<br />
short, with carefully designed instructi<strong>on</strong> <strong>and</strong><br />
appropriate test materials, students with mild<br />
mental disabilities can be supported to successfully<br />
participate <strong>and</strong> dem<strong>on</strong>strate <str<strong>on</strong>g>the</str<strong>on</strong>g>ir<br />
learning in st<strong>and</strong>ardized assessments.<br />
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Received: 15 November 2006<br />
Initial Acceptance: 5 February 2007<br />
Final Acceptance: 21 June 2007<br />
408 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008