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Figure 2. Ari: Percentage of trials during which he requested following a verbal model, requested independently, and used word approximations. follow-up for set 3, Ari used word approximations during 80% of the trials. Overall IRD for Ari’s use of word approximations was 1.00, 90% CI [0.75, 1.00], p .000. This intervention had large effects for word approximations for Ari. Discussion Both participants made progress in targeted behaviors, one in independent requests and the other in use of word approximations. Jo- siah rapidly began imitating the correct names and eventually began to spontaneously use the correct names. Following implementation in sets 2 and 3, Josiah rapidly began to independently request the items he was requesting. During generalization probes with a new communicative partner, he used the requests, though at a lower rate for set 2. At follow-up, Josiah maintained the use of correct and independent requests, though at lower rates than during intervention phases. While Josiah did use some word approximations, his artic- Multi-Component Communication Intervention / 603
ulation was generally clear and he was able to correctly pronounce the names for the items most of the time. Ari also made sufficient progress during intervention, however, he had some difficulties with articulation and used word approximations more frequently than requests, either following a verbal model or independently. Ari did quickly meet criterion for word approximations for all sets and was able to get his message across. Further, he generalized use of the word approximations to a new communicative partner at high rates and maintained the use of the word approximations during follow-up. While, preferably, Ari would have increased in spontaneous communication during intervention, an increase in imitated verbalizations often precedes spontaneous communication in individuals with ASD and is a positive indicator of language development (Carpenter & Tomasello, 2000). Though we did not collect data on the independent use of word approximations, we did anecdotally note that, during the last sessions of intervention for each set, Ari began using word approximations without requiring an immediate verbal model. The implications of this study indicate that it may be possible to improve imitated or spontaneous speech skills in some students with autism with less costly and less intensive intervention packages, such as a combination of NCR and verbal modeling. One question that remains is what types of students would be most likely to respond to such interventions and which would require more intensive interventions. Considering the results of this study, it may be that children with higher rates of spontaneous communication skills, including nonconventional and less sophisticated skills (e.g., grabbing, reaching), and those who initially respond to others’ initiations more frequently (e.g., responding to their name) may more easily respond to simpler interventions. Further, younger students and those with more complicated health issues and those with more severe scores on diagnostic instruments may require more intensive and costly interventions. NCR has been shown to decrease mouthing behaviors (Carr et al., 2002), reduce aggressive and self-injurious behaviors (Lalli et al., 1995). There is little research in which NCR has been used to increase communication. Therefore, the current study extended the line of research on the use of a treatment package, which included NCR and communication instruction, to increase communication behaviors (i.e., Marcus & Vollmer, 1996; Mildon et al., 2004). This intervention package incorporated Tucker et al.’s (1998) recommendations to fade initially high rates of reinforcement to lower rates and to combine NCR with educational interventions. Further, this study evaluated a modification on how NCR is typically implemented. This study has some limitations. First, due to the implementation of this study during the summer, follow-up data was collected only once, three weeks following the cessation of intervention. It is not possible to assess the long term outcomes of this intervention without the collection of maintenance data several months following the cessation of intervention. Further, the researchers did not systematically collect data on the independent use of word approximations. Though the researchers noted anecdotally that Ari began using independent word approximations near the end of intervention, it would have been useful to determine the extent to which he did so. Clearly, many children with ASD will require far more intensive communication interventions. Another limitation is the use of intervention conditions when measuring generalization and follow up. Without a true return to baseline conditions, it is unclear whether or not Josiah and Ari would continue to make independent requests without continued training, though they did demonstrate use of previously learned skills with minimal instruction. A final limitation is the use of a multielement intervention; because we always combined NCR with verbal modeling, it may be the case that modeling alone would have been sufficient and that NCR was irrelevant. Without investigating each component separately, we are unable to make the case that the combined intervention is necessary. The current study included a small sample of children and was an initial demonstration of the combination of naturalistic teaching and NCR. Further replication is needed to generalize the results and refine the procedures. Future research is needed with children with varied characteristics, within differ- 604 / Education and Training in Autism and Developmental Disabilities-December 2011
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Education and Training in Autism an
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March 2012 Manuscripts Accepted for
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new line of research, the review ho
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TABLE 1—(Continued) Overview of H
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TABLE 1—(Continued) Overview of H
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Figure 1. MP3 Player (Model: SM-320
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Figure 3. Sony-Ericsson K800. Retri
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computer with three middle school s
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Figure 6. Video iPod. Apple, Inc. h
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example, in contrast to previous st
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using public transportation. Device
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accessible software to increase ind
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(14.3%), a unique curriculum (13.8%
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TABLE 1 Student Characteristics Stu
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eos” was highlighted. Students th
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ment was 100% for baseline and main
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Figure 3. Percentage of independent
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how to program and operate the equi
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Individuals with Disabilities Educa
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TABLE 1 Video Prompting Studies Con
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TABLE 1—(Continued) Video Prompti
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Length of video clips. Researchers
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to learn three cooking tasks. Resul
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Van Laarhoven and Van Laarhoven-Mye
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Dogoe, M., & Banda, D. R. (2009). R
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TABLE 1 Summary of Demographic and
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TABLE 2 Summary of Outcome Variable
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with students in preschool (Akmanog
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with MoID acquiring some of their p
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Vocational task. To date one study
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ed; thereby adding to the amount of
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Retardation and Developmental Disab
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TABLE 1 Student Demographic Informa
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Figure 1. Example of the mini-poste
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Experimental Design This study empl
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Page 149 and 150: Copeland, S. R. (2002). See citatio
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Page 157 and 158: Mastropieri, M. A. (2009). See cita
Page 159 and 160: 262. Noyes, D. A., & Sax, C. L. (20
Page 161 and 162: Rispoli, M. (2009). See citation #1
Page 163 and 164: Sparks, S. (2010). See citation #87
Page 165 and 166: Vlaskamp, C. (2008). See citation #
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