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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 />
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