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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 />

Activity Schedules <strong>and</strong> <strong>Autism</strong> / 329

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