Education and Training in Developmental Disabilities - Division on ...
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<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Developmental</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
Focus<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with<br />
cognitive disabilities/mental retardati<strong>on</strong>, autism, <str<strong>on</strong>g>and</str<strong>on</strong>g> related disabilities<br />
Volume 44 Number 4 December 2009
December 2009 <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> Vol. 44, No. 4, pp. 433–588
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
The Journal of the <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>,<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>sult<str<strong>on</strong>g>in</str<strong>on</strong>g>g Editors<br />
Mart<str<strong>on</strong>g>in</str<strong>on</strong>g> 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 />
Carol<str<strong>on</strong>g>in</str<strong>on</strong>g>e Dunn<br />
Lise Fox<br />
David L. Gast<br />
Herbert Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
Robert Henders<strong>on</strong><br />
Carolyn Hughes<br />
Larry K. Irv<str<strong>on</strong>g>in</str<strong>on</strong>g><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. Ha<str<strong>on</strong>g>in</str<strong>on</strong>g>l<str<strong>on</strong>g>in</str<strong>on</strong>g>e<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. Westl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
John J. Wheeler<br />
Mark Wolery<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> is sent to all members of the <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> 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 />
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Gifted Children for publicati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> the m<strong>on</strong>thly pr<str<strong>on</strong>g>in</str<strong>on</strong>g>t <str<strong>on</strong>g>in</str<strong>on</strong>g>dex Current Index to Journals <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> the quarterly <str<strong>on</strong>g>in</str<strong>on</strong>g>dex, Excepti<strong>on</strong>al Child<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Resources.<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> Vol. 44, No. 4, December 2009, Copyright 2009 by the <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, 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> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><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 />
L<str<strong>on</strong>g>in</str<strong>on</strong>g>da Laz<br />
Nikki Murdick<br />
Robert S<str<strong>on</strong>g>and</str<strong>on</strong>g>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 />
C<strong>on</strong>ference Coord<str<strong>on</strong>g>in</str<strong>on</strong>g>ator<br />
C<str<strong>on</strong>g>in</str<strong>on</strong>g>dy Perras<br />
The purposes of this organizati<strong>on</strong> shall be to advance the educati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> welfare of pers<strong>on</strong>s with developmental disabilities, research <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
educati<strong>on</strong> of pers<strong>on</strong>s with developmental disabilities, competency of educators <str<strong>on</strong>g>in</str<strong>on</strong>g> this field, public underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g of developmental disabilities,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> legislati<strong>on</strong> needed to help accomplish these goals. The <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> shall encourage <str<strong>on</strong>g>and</str<strong>on</strong>g> promote professi<strong>on</strong>al growth, research, <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
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EDUCATION AND TRAINING IN DEVELOPMENTAL DISABILITIES (ISSN 1547-0350) (USPS 0168-5000) is published quarterly <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
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<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g><br />
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Editorial Policy<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> focuses <strong>on</strong> the educati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
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Manual of the American Psychological Associati<strong>on</strong> (Fifth Editi<strong>on</strong>, 2001).<br />
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3. Each manuscript must have a cover sheet giv<str<strong>on</strong>g>in</str<strong>on</strong>g>g the names <str<strong>on</strong>g>and</str<strong>on</strong>g> affiliati<strong>on</strong>s of all<br />
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5. Five copies of the manuscript al<strong>on</strong>g with a transmittal letter should be sent to the<br />
Editor: Stanley H. Zucker, Special <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Program, Box 875411, Ariz<strong>on</strong>a<br />
State University, Tempe, AZ 85287-5411.<br />
6. Up<strong>on</strong> receipt, each manuscript will be screened by the editor. Appropriate<br />
manuscripts will then be sent to c<strong>on</strong>sult<str<strong>on</strong>g>in</str<strong>on</strong>g>g editors. Pr<str<strong>on</strong>g>in</str<strong>on</strong>g>cipal authors will receive<br />
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VOLUME 44 NUMBER 4 DECEMBER 2009<br />
Functi<strong>on</strong>al Curriculum Models for Sec<strong>on</strong>dary Students with Mild Mental<br />
Impairment 435<br />
EMILY C. BOUCK<br />
Autism Spectrum Disorders <str<strong>on</strong>g>and</str<strong>on</strong>g> Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g Relati<strong>on</strong>ships: Research <str<strong>on</strong>g>and</str<strong>on</strong>g> Strategies 444<br />
JULIA F. BEYER<br />
Impacts of Family Support <str<strong>on</strong>g>in</str<strong>on</strong>g> Early Childhood Interventi<strong>on</strong> Research 453<br />
ANNA C. FRIEND, JEAN ANN SUMMERS, <str<strong>on</strong>g>and</str<strong>on</strong>g> ANN P. TURNBULL<br />
Differences Between Employees’ <str<strong>on</strong>g>and</str<strong>on</strong>g> Supervisors’ Evaluati<strong>on</strong>s of Work<br />
Performance <str<strong>on</strong>g>and</str<strong>on</strong>g> Support Needs 471<br />
KYLE BENNETT, MICHAEL FRAIN, MICHAEL P. BRADY, HOWARD ROSENBERG, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
TRICIA SURINAK<br />
Review of Interventi<strong>on</strong>s to Increase Functi<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> Symbolic Play <str<strong>on</strong>g>in</str<strong>on</strong>g> Children<br />
with Autism 481<br />
RUSSELL LANG, MARK O’REILLY, MANDY RISPOLI, KARRIE SHOGREN,<br />
WENDY MACHALICEK, JEFF SIGAFOOS, <str<strong>on</strong>g>and</str<strong>on</strong>g> APRIL REGESTER<br />
Acquisiti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> Generalizati<strong>on</strong> of Cha<str<strong>on</strong>g>in</str<strong>on</strong>g>ed Tasks Taught with Computer<br />
Based Video Instructi<strong>on</strong> to Children with Autism 493<br />
KEVIN M. AYRES, AMY MAGUIRE <str<strong>on</strong>g>and</str<strong>on</strong>g> DESIREE MCCLIMON<br />
Comparis<strong>on</strong> of Self, Other, <str<strong>on</strong>g>and</str<strong>on</strong>g> Subjective Video Models for Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Daily<br />
Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Skills to Individuals with <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> 509<br />
TONI VAN LAARHOVEN, LESLIE M. ZURITA, JESSE W. JOHNSON, KATIE M. GRIDER<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> KRISTIN L. GRIDER<br />
Parental Stress <str<strong>on</strong>g>and</str<strong>on</strong>g> Autism: Are There Useful Cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g Strategies? 523<br />
G. RICHMOND MANCIL, BRIAN A. BOYD, <str<strong>on</strong>g>and</str<strong>on</strong>g> PENA BEDESEM<br />
Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Organizati<strong>on</strong>al Skills to Children with High Functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g Autism <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Asperger’s Syndrome 538<br />
KIMBERLY POWERS DORMINY, DEANNA LUSCRE, <str<strong>on</strong>g>and</str<strong>on</strong>g> DAVID L. GAST<br />
Academic Achievement Profiles of Children with High Functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g Autism<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Asperger Syndrome: A Review of the Literature 551<br />
PEGGY J. SCHAEFER WHITBY <str<strong>on</strong>g>and</str<strong>on</strong>g> G. RICHMOND MANCIL<br />
A Method to Assess Work Task Preferences 561<br />
VIRGINIE COBIGO, DIANE MORIN, <str<strong>on</strong>g>and</str<strong>on</strong>g> YVES LACHAPELLE<br />
Fourth Grade Outcomes of Children with a Preschool History of<br />
<str<strong>on</strong>g>Developmental</str<strong>on</strong>g> Disability 573<br />
CHRISTINE E. F. DELGADO<br />
Index—Volume 44, 2009 580<br />
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<str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
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Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g students with moderate <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities to read: An experimental exam<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> of<br />
a comprehensive read<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. Jill H. Allor, Patricia Mathes, Kyle Roberts, Francesca J<strong>on</strong>es,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Tammi Champl<str<strong>on</strong>g>in</str<strong>on</strong>g>, Department of Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g, Annette Caldwell Simm<strong>on</strong>s School<br />
of <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> Human Development, Southern Methodist University, P.O. Box 750381, Dallas,<br />
TX 75275-0381.<br />
Friendships with peers with severe disabilities: American <str<strong>on</strong>g>and</str<strong>on</strong>g> Iranian sec<strong>on</strong>dary students’ ideas<br />
about be<str<strong>on</strong>g>in</str<strong>on</strong>g>g a friend. Mohsen Shokoohi-Yekta <str<strong>on</strong>g>and</str<strong>on</strong>g> Jo Hendricks<strong>on</strong>, The Department of Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g, N259 L<str<strong>on</strong>g>in</str<strong>on</strong>g>dquist Center, University of Iowa, Iowa City, IA 52242.<br />
Effects of c<strong>on</strong>stant time delay procedure <strong>on</strong> the Halliwick’s method of swimm<str<strong>on</strong>g>in</str<strong>on</strong>g>g rotati<strong>on</strong> skills for<br />
children with Autism. I˙lker Yılmaz, Ferman K<strong>on</strong>ukman, Benyam<str<strong>on</strong>g>in</str<strong>on</strong>g> Birkan, Arzu Özen, Mehmet<br />
Yanardag˘, <str<strong>on</strong>g>and</str<strong>on</strong>g> I˙lhan Çamursoy, The College at Brockport, State University of New York, Dept. of<br />
Physical <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> & Sports, Brockport, NY 14420-2989.<br />
Mild <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities: Legacies <str<strong>on</strong>g>and</str<strong>on</strong>g> trends <str<strong>on</strong>g>in</str<strong>on</strong>g> c<strong>on</strong>cepts <str<strong>on</strong>g>and</str<strong>on</strong>g> educati<strong>on</strong>al practices. Edward A.<br />
Polloway, Jacquel<str<strong>on</strong>g>in</str<strong>on</strong>g>e Lub<str<strong>on</strong>g>in</str<strong>on</strong>g>, J. David Smith, <str<strong>on</strong>g>and</str<strong>on</strong>g> James R. Patt<strong>on</strong>, Office of Graduate Studies <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Community Advancement, Lynchburg College, Lynchburg, VA 24501.<br />
Resp<strong>on</strong>se cards: An effective <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> for students with disabilities. Chann<strong>on</strong> Horn, Department<br />
of Special <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>, 229 Taylor <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Build<str<strong>on</strong>g>in</str<strong>on</strong>g>g, University of Kentucky, Lex<str<strong>on</strong>g>in</str<strong>on</strong>g>gt<strong>on</strong>, KY<br />
40506-0001.<br />
Characteristics <str<strong>on</strong>g>and</str<strong>on</strong>g> hypothesized functi<strong>on</strong>s of challeng<str<strong>on</strong>g>in</str<strong>on</strong>g>g behavior <str<strong>on</strong>g>in</str<strong>on</strong>g> a community-based sample.<br />
Anna Ingeborg Petursdottir, John W. Esch, Rachael A. Sautter, <str<strong>on</strong>g>and</str<strong>on</strong>g> Kelise K. Stewart, Department<br />
of Psychology, TCU Box 298920, Fort Worth, TX 76129.<br />
Use of self-model<str<strong>on</strong>g>in</str<strong>on</strong>g>g static-picture prompts via a h<str<strong>on</strong>g>and</str<strong>on</strong>g>held computer to facilitate self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the general educati<strong>on</strong> classroom. David F. Cihak, Rachel Wright, <str<strong>on</strong>g>and</str<strong>on</strong>g> Kev<str<strong>on</strong>g>in</str<strong>on</strong>g> M. Ayres, University<br />
of Tennessee, A412 Claxt<strong>on</strong> Complex, Knoxville, TN 37996-3442.<br />
L<strong>on</strong>g-term outcomes of services <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>clusive <str<strong>on</strong>g>and</str<strong>on</strong>g> self-c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs for sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with comparable<br />
significant disabilities. Diane Lea Ryndak, Terri Ward, S<str<strong>on</strong>g>and</str<strong>on</strong>g>ra Alper, Jill F. Storch, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Jennifer Wils<strong>on</strong> M<strong>on</strong>tgomery, University of Florida, Department of Special <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>, G315<br />
Norman Hall, PO Box 117050, Ga<str<strong>on</strong>g>in</str<strong>on</strong>g>esville, FL 32611-7050.<br />
Mercury <str<strong>on</strong>g>and</str<strong>on</strong>g> autism: A review. Jie Zhang <str<strong>on</strong>g>and</str<strong>on</strong>g> John J. Wheeler, <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> Human Development,<br />
SUNY Brockport, 350 New Campus Drive, Brockport, NY 14420.<br />
Practices <str<strong>on</strong>g>in</str<strong>on</strong>g> early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> for children with autism: A comparis<strong>on</strong> with Nati<strong>on</strong>al Research<br />
Council recommended practices. Robyn C<strong>on</strong>ley Downs <str<strong>on</strong>g>and</str<strong>on</strong>g> Andrew Downs, 2543 NW 118th Ter,<br />
Portl<str<strong>on</strong>g>and</str<strong>on</strong>g>, OR 97229.<br />
A collaborative approach to implement positive behavior support plans for children with problem<br />
behaviors: A comparis<strong>on</strong> of c<strong>on</strong>sultati<strong>on</strong> versus c<strong>on</strong>sultati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> feedback approach. Dilek Erbas,<br />
Erciyes Universitesi, Egitim Fakultesi, Ozel Egitim Bolumu, Kayseri, TURKEY.<br />
Exam<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g the effects of a social communicati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <strong>on</strong> the play behaviors of children<br />
with autism. Jennifer L<strong>on</strong>cola Walberg <str<strong>on</strong>g>and</str<strong>on</strong>g> Lesley A. Craig-Unkefer, DePaul University, School of<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>, 2320 North Kenmore, Chicago, IL 60614-3250.<br />
Address is supplied for author <str<strong>on</strong>g>in</str<strong>on</strong>g> boldface type.
Functi<strong>on</strong>al Curriculum Models for Sec<strong>on</strong>dary Students with<br />
Mild Mental Impairment<br />
Emily C. Bouck<br />
Purdue University<br />
Abstract: This paper analyzed 10 commercially available functi<strong>on</strong>al curriculum models designed for sec<strong>on</strong>dary<br />
students with mild-to-moderate mental impairment. The models were exam<str<strong>on</strong>g>in</str<strong>on</strong>g>ed with respect to the <str<strong>on</strong>g>in</str<strong>on</strong>g>clusi<strong>on</strong> of<br />
functi<strong>on</strong>al curriculum comp<strong>on</strong>ents, the doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s <str<strong>on</strong>g>and</str<strong>on</strong>g> subdoma<str<strong>on</strong>g>in</str<strong>on</strong>g>s of adulthood, the materials identified by the<br />
model to be used to deliver the curriculum, <str<strong>on</strong>g>and</str<strong>on</strong>g> the <str<strong>on</strong>g>in</str<strong>on</strong>g>corporati<strong>on</strong> of best practices for teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g. Results <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate<br />
that n<strong>on</strong>e of the models reviewed adequately addressed the needs of this populati<strong>on</strong> for learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of<br />
provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g a functi<strong>on</strong>al curriculum. Overall, the analysis suggests that more appropriate curriculum models<br />
need to be developed, such as <strong>on</strong>e that is designed to be balanced, comprehensive, <str<strong>on</strong>g>and</str<strong>on</strong>g> coherent for sec<strong>on</strong>dary<br />
students with mild mental impairment. In additi<strong>on</strong>, more research is needed <strong>on</strong> functi<strong>on</strong>al curricula, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the comp<strong>on</strong>ents of this approach.<br />
Follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g recent federal <str<strong>on</strong>g>and</str<strong>on</strong>g> state policies<br />
(i.e., No Child Left Beh<str<strong>on</strong>g>in</str<strong>on</strong>g>d [NCLB], 2002; Individuals<br />
with <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Act [IDEA],<br />
1997, 2004), the focus of special educati<strong>on</strong> has<br />
shifted from process to outcomes. It is now<br />
m<str<strong>on</strong>g>and</str<strong>on</strong>g>ated that teachers of students with disabilities<br />
be held accountable for their students’<br />
academic progress <str<strong>on</strong>g>and</str<strong>on</strong>g> outcomes.<br />
Thus, <str<strong>on</strong>g>in</str<strong>on</strong>g> this era of accountability <str<strong>on</strong>g>and</str<strong>on</strong>g> achievement,<br />
questi<strong>on</strong>s arise as to what should be the<br />
targeted outcomes for students with mild<br />
mental impairment <str<strong>on</strong>g>and</str<strong>on</strong>g> what educati<strong>on</strong>al programm<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
best meets their needs at the sec<strong>on</strong>dary<br />
level <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of successfully achiev<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
post-school outcomes (Bouck, 2004, 2007).<br />
This article advocates for the use of a functi<strong>on</strong>al<br />
curriculum for sec<strong>on</strong>dary students with<br />
mild mental impairment, yet discusses limitati<strong>on</strong>s<br />
that may be imposed through implementati<strong>on</strong><br />
of the functi<strong>on</strong>al curriculum models<br />
currently available. It discusses issues teachers<br />
need to c<strong>on</strong>sider if they use or are c<strong>on</strong>sider<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
a currently-available commercialized functi<strong>on</strong>al<br />
curriculum model.<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g this article should<br />
be addressed to Emily C. Bouck, 5146 BRNG Hall,<br />
Purdue University, 100 N. University St., West Lafayette,<br />
IN 47907. Email: bouck@purdue.edu<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, 2009, 44(4), 435–443<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
Functi<strong>on</strong>al Curriculum<br />
A functi<strong>on</strong>al curriculum is a curriculum designed<br />
to teach functi<strong>on</strong>al life skills, or <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
other words, the skills necessary to live, work,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> have fun <str<strong>on</strong>g>in</str<strong>on</strong>g> an <str<strong>on</strong>g>in</str<strong>on</strong>g>clusive community<br />
(Brown et al., 1979; Falvey, 1989; Snell &<br />
Browder, 1987). Comp<strong>on</strong>ents of a functi<strong>on</strong>al,<br />
or life management, curriculum are presumed<br />
to <str<strong>on</strong>g>in</str<strong>on</strong>g>clude the functi<strong>on</strong>al skills <str<strong>on</strong>g>and</str<strong>on</strong>g><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 liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g, f<str<strong>on</strong>g>in</str<strong>on</strong>g>ancial, <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
transportati<strong>on</strong>, social/relati<strong>on</strong>ships, <str<strong>on</strong>g>and</str<strong>on</strong>g> selfdeterm<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong><br />
(Patt<strong>on</strong>, Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>, & Jairrels,<br />
1997). A functi<strong>on</strong>al curriculum is utilized<br />
when students with disabilities are deemed to<br />
need assistance <str<strong>on</strong>g>in</str<strong>on</strong>g> the above-menti<strong>on</strong>ed critical<br />
life skills areas, <str<strong>on</strong>g>and</str<strong>on</strong>g> when the educati<strong>on</strong>al<br />
experiences these students are receiv<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
schools through the general educati<strong>on</strong> curriculum<br />
fails to reflect the skills necessary for<br />
their post-school success (Bouck, 2004; Retish,<br />
Hitch<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, Horvath, & Schmalle, 1991).<br />
While us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a functi<strong>on</strong>al curriculum to educate<br />
sec<strong>on</strong>dary students with mild mental<br />
impairment may be at odds with current federal<br />
policy (i.e., NCLB, 2002; IDEA, 2004)<br />
(Bouck, 2009), the c<strong>on</strong>cerns about the postschool<br />
success, or lack thereof, by this populati<strong>on</strong><br />
suggests that a curriculum focused <strong>on</strong><br />
social skills, f<str<strong>on</strong>g>in</str<strong>on</strong>g>ances, vocati<strong>on</strong>al skills, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Functi<strong>on</strong>al Curriculum Models / 435
other life skills may be what these students<br />
need (Patt<strong>on</strong>, Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>, & Bassett, 1997). This is<br />
especially so c<strong>on</strong>sider<str<strong>on</strong>g>in</str<strong>on</strong>g>g the lack of positive<br />
post-school outcomes for students with mild<br />
mental impairment. The populati<strong>on</strong> is traditi<strong>on</strong>ally<br />
associated with low employment rates,<br />
low <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g rates, <str<strong>on</strong>g>and</str<strong>on</strong>g> difficulty<br />
adjust<str<strong>on</strong>g>in</str<strong>on</strong>g>g to life after school (Blackorby &<br />
Wagner, 1996; Edgar & Polloway, 2004; Neubert,<br />
Mo<strong>on</strong>, & Grigal, 2004; Wagner, Newman,<br />
Cameto, & Lev<str<strong>on</strong>g>in</str<strong>on</strong>g>e, 2005). Although recent<br />
data have suggested improvement <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
some post-school outcomes for sec<strong>on</strong>dary students<br />
with mild mental impairment (i.e., decreased<br />
dropout rates, <str<strong>on</strong>g>in</str<strong>on</strong>g>creased employment<br />
rates, <str<strong>on</strong>g>in</str<strong>on</strong>g>creased rates of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g),<br />
an alternative, such as a functi<strong>on</strong>al curriculum,<br />
to provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g the general educati<strong>on</strong> curriculum,<br />
which is focused <strong>on</strong> prepar<str<strong>on</strong>g>in</str<strong>on</strong>g>g students<br />
for high-stakes tests <str<strong>on</strong>g>and</str<strong>on</strong>g> rigorous higher<br />
educati<strong>on</strong>, needs to be exam<str<strong>on</strong>g>in</str<strong>on</strong>g>ed for this<br />
populati<strong>on</strong> which has a statistically low postsec<strong>on</strong>dary<br />
educati<strong>on</strong> rate (13.4% <str<strong>on</strong>g>in</str<strong>on</strong>g> 2003) but<br />
potential for mean<str<strong>on</strong>g>in</str<strong>on</strong>g>gful post-school c<strong>on</strong>tributi<strong>on</strong>s<br />
outside of higher educati<strong>on</strong> (Wagner<br />
et al.).<br />
Although calls for the use of functi<strong>on</strong>al curriculum<br />
to educate sec<strong>on</strong>dary students with<br />
mild mental impairment have been made<br />
(Bouck, 2004; Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>, 1996; Dever & Knapczyk,<br />
1997), the field of special educati<strong>on</strong> has<br />
not given enough deliberati<strong>on</strong> to the curriculum<br />
models commercially available to implement<br />
such an approach. This study explored<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> reviewed commercially available functi<strong>on</strong>al<br />
curriculum models targeted towards educat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
sec<strong>on</strong>dary students with mild mental<br />
impairment (i.e., marketed towards students<br />
with “mild” to “moderate” disabilities). While<br />
students with mild mental impairment were<br />
the target populati<strong>on</strong>, the curriculum models<br />
exam<str<strong>on</strong>g>in</str<strong>on</strong>g>ed <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <strong>on</strong>es that were geared towards<br />
students with moderate disabilities,<br />
given the positi<strong>on</strong> that mild mental impairment<br />
is not a “mild” disability (see Polloway,<br />
2004). Specifically, this study sought to explore<br />
functi<strong>on</strong>al curriculum model opti<strong>on</strong>s<br />
that exist at the sec<strong>on</strong>dary level <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>sider<br />
if these models are appropriate <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of<br />
serv<str<strong>on</strong>g>in</str<strong>on</strong>g>g the needs of sec<strong>on</strong>dary students with<br />
mild mental impairment <str<strong>on</strong>g>and</str<strong>on</strong>g> support<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
teachers who elect to implement a particular<br />
model.<br />
Method<br />
Materials<br />
436 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Ten commercially available functi<strong>on</strong>al curriculum<br />
models were reviewed: The Syracuse<br />
Community-Reference Guide (Ford et al., 1989);<br />
Functi<strong>on</strong>al Independence Skills H<str<strong>on</strong>g>and</str<strong>on</strong>g>book (Killi<strong>on</strong>,<br />
2003); Impact: A Functi<strong>on</strong>al Curriculum<br />
H<str<strong>on</strong>g>and</str<strong>on</strong>g>book (Neel & Bill<str<strong>on</strong>g>in</str<strong>on</strong>g>gsley, 1989); Community-Based<br />
Curriculum (Falvey, 1989); Functi<strong>on</strong>al<br />
Curriculum for Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Students with <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
(Bender, Valletutti, Bagl<str<strong>on</strong>g>in</str<strong>on</strong>g>, & Hoffnung, 1996);<br />
Life Skills Instructi<strong>on</strong> for All Students with Special<br />
Needs (Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g> & Patt<strong>on</strong>, 1993); Functi<strong>on</strong>al Curriculum<br />
for Elementary, Middle, <str<strong>on</strong>g>and</str<strong>on</strong>g> Sec<strong>on</strong>dary<br />
Students with Special Needs (Wehman & Kregel,<br />
2004); Life Skills Activities for Sec<strong>on</strong>dary Students<br />
with Special Needs (Mannix, 1995); Adaptive<br />
Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Skills Curriculum (Anders<strong>on</strong>, Bru<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>ks,<br />
Morreau, & Gilman, 1991); <str<strong>on</strong>g>and</str<strong>on</strong>g> Everyday Life<br />
Skills (American Guidance Service, 2001).<br />
Brol<str<strong>on</strong>g>in</str<strong>on</strong>g>’s (2004) Life Centered Career <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g><br />
(LCCE) is menti<strong>on</strong>ed <str<strong>on</strong>g>in</str<strong>on</strong>g> this review, but is not<br />
evaluated as it represents a fundamentally different<br />
functi<strong>on</strong>al curriculum model <str<strong>on</strong>g>in</str<strong>on</strong>g> terms<br />
of cost, professi<strong>on</strong>al development opportunities,<br />
number of revisi<strong>on</strong>s, <str<strong>on</strong>g>and</str<strong>on</strong>g> endorsement by<br />
the Council for Excepti<strong>on</strong>al Children.<br />
Four charts were created or adapted by the<br />
researcher to analyze the commercially available<br />
functi<strong>on</strong>al curriculum models (all available<br />
from the author by request). The first<br />
chart (Chart A) was created by the researcher<br />
to analyze basic <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong>, such as the age<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> disability focus, research c<strong>on</strong>ducted <strong>on</strong><br />
the curriculum, resources available with the<br />
curriculum, number of revisi<strong>on</strong>s, <str<strong>on</strong>g>and</str<strong>on</strong>g> associated<br />
professi<strong>on</strong>al development opportunities<br />
available for teachers. It also focused <strong>on</strong> evidence<br />
of functi<strong>on</strong>al curriculum comp<strong>on</strong>ents,<br />
as def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed by Patt<strong>on</strong>, Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>, <str<strong>on</strong>g>and</str<strong>on</strong>g> Jairrels<br />
(1997), with<str<strong>on</strong>g>in</str<strong>on</strong>g> each model, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g: functi<strong>on</strong>al<br />
academics, vocati<strong>on</strong>al educati<strong>on</strong>, daily<br />
liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g, social/relati<strong>on</strong>ships, <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
community access or skills, transportati<strong>on</strong>,<br />
f<str<strong>on</strong>g>in</str<strong>on</strong>g>ancial, self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong>, leisure <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
recreati<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> communicati<strong>on</strong> skills. The<br />
sec<strong>on</strong>d chart (Chart B) was adapted from Mariage<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Patriarca’s (2002) review of “best<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g practices.” It identified the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
strategies offered <str<strong>on</strong>g>in</str<strong>on</strong>g> each model, such<br />
as the use of sequenc<str<strong>on</strong>g>in</str<strong>on</strong>g>g, drill <str<strong>on</strong>g>and</str<strong>on</strong>g> practice
eview, segmentati<strong>on</strong>, directed questi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> resp<strong>on</strong>ses, level of difficulty of tasks, technology,<br />
group<str<strong>on</strong>g>in</str<strong>on</strong>g>g of students (<str<strong>on</strong>g>in</str<strong>on</strong>g>dividually,<br />
pairs, small group, whole group), any supplement<br />
to teacher <str<strong>on</strong>g>and</str<strong>on</strong>g> peer <str<strong>on</strong>g>in</str<strong>on</strong>g>volvement, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
strategy cues.<br />
The third chart (Chart C) was adapted from<br />
Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> Patt<strong>on</strong>’s (1993) doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s <str<strong>on</strong>g>and</str<strong>on</strong>g> subdoma<str<strong>on</strong>g>in</str<strong>on</strong>g>s<br />
of adulthood. The curriculum models<br />
were analyzed for their <str<strong>on</strong>g>in</str<strong>on</strong>g>clusi<strong>on</strong> of Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Patt<strong>on</strong>’s six doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s of adulthood <str<strong>on</strong>g>and</str<strong>on</strong>g> 23<br />
subdoma<str<strong>on</strong>g>in</str<strong>on</strong>g>s. The six doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s of adulthood<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded: employment/educati<strong>on</strong>, home <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
family, leisure pursuits, pers<strong>on</strong>al resp<strong>on</strong>sibilities<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> relati<strong>on</strong>ships, community <str<strong>on</strong>g>in</str<strong>on</strong>g>volvement,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> physical/emoti<strong>on</strong>al health. The<br />
subdoma<str<strong>on</strong>g>in</str<strong>on</strong>g>s fell with<str<strong>on</strong>g>in</str<strong>on</strong>g> the six doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded aspects such as goal sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g, family<br />
life, general job skills, <str<strong>on</strong>g>and</str<strong>on</strong>g> travel. The fourth<br />
chart (Chart D) was based off of Hammill <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Bartel’s (1990) materials analysis, which had<br />
10 major secti<strong>on</strong>s: <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al areas <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
skills, scope <str<strong>on</strong>g>and</str<strong>on</strong>g> sequence; comp<strong>on</strong>ent parts<br />
of material; level of the material; quality; format;<br />
support materials; time requirements;<br />
field test <str<strong>on</strong>g>and</str<strong>on</strong>g> research data; bibliographic <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
price; <str<strong>on</strong>g>and</str<strong>on</strong>g> method, approach, or theoretical<br />
base.<br />
Procedure<br />
The functi<strong>on</strong>al curriculum models reviewed<br />
were first selected from a list of commercially<br />
available functi<strong>on</strong>al curriculum models identified<br />
by the Center for Innovati<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g><br />
(n.d.). Major publish<str<strong>on</strong>g>in</str<strong>on</strong>g>g companies were<br />
also explored for functi<strong>on</strong>al curriculum<br />
model materials. The complete list was narrowed<br />
by exclud<str<strong>on</strong>g>in</str<strong>on</strong>g>g any curriculum models<br />
that were deemed as not be<str<strong>on</strong>g>in</str<strong>on</strong>g>g comprehensive<br />
(i.e., <strong>on</strong>ly dealt with a specific functi<strong>on</strong>al area,<br />
such as self-care or self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong>), not<br />
geared towards sec<strong>on</strong>dary students, or were<br />
clearly focused <strong>on</strong> students with severe mental<br />
impairment or other severe disabilities.<br />
Data Analysis<br />
After select<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> purchas<str<strong>on</strong>g>in</str<strong>on</strong>g>g the functi<strong>on</strong>al<br />
curriculum models that met the criteria (i.e.,<br />
comprehensive, focused <strong>on</strong> sec<strong>on</strong>dary students<br />
with mild-to-moderate mental impairment),<br />
the models were then analyzed with<br />
respect to the charts previously discussed.<br />
Thus, the curriculum materials were reviewed,<br />
the charts completed, <str<strong>on</strong>g>and</str<strong>on</strong>g> then the functi<strong>on</strong>al<br />
curriculum models discussed <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of most<br />
comprehensive (i.e., covered most comp<strong>on</strong>ents)<br />
or “best value.” When analyz<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
models with respect to comp<strong>on</strong>ents covered,<br />
each curriculum model was given <strong>on</strong>e po<str<strong>on</strong>g>in</str<strong>on</strong>g>t if<br />
it fully addressed a comp<strong>on</strong>ent (e.g., vocati<strong>on</strong>al,<br />
social skills) <str<strong>on</strong>g>and</str<strong>on</strong>g> a half-po<str<strong>on</strong>g>in</str<strong>on</strong>g>t if they<br />
partially addressed a comp<strong>on</strong>ent, such as<br />
with<str<strong>on</strong>g>in</str<strong>on</strong>g> the comp<strong>on</strong>ent of transportati<strong>on</strong> if the<br />
model discussed walk<str<strong>on</strong>g>in</str<strong>on</strong>g>g safely with<str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
community, but not public transportati<strong>on</strong><br />
(Charts A <str<strong>on</strong>g>and</str<strong>on</strong>g> C). The other two charts<br />
(Charts B <str<strong>on</strong>g>and</str<strong>on</strong>g> D) were marked with respect to<br />
yes or no if they addressed comp<strong>on</strong>ents of<br />
best teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g or specific <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong>, such as<br />
hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g a research base or offer<str<strong>on</strong>g>in</str<strong>on</strong>g>g support<br />
materials.<br />
Results<br />
The 10 functi<strong>on</strong>al curriculum models exam<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
were all marketed towards sec<strong>on</strong>dary students<br />
with disabilities <str<strong>on</strong>g>and</str<strong>on</strong>g>, at a superficial<br />
analysis, could be c<strong>on</strong>sidered appropriate for<br />
use with students with mild mental impairment.<br />
All models addressed students with<br />
“mild” or “moderate” disabilities, although<br />
they used various term<str<strong>on</strong>g>in</str<strong>on</strong>g>ologies, such as developmental<br />
disabilities, moderate disabilities,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> special needs students. While the models<br />
supposedly focused <strong>on</strong> the same curriculum<br />
comp<strong>on</strong>ents (i.e., functi<strong>on</strong>al) <str<strong>on</strong>g>and</str<strong>on</strong>g> the same<br />
student populati<strong>on</strong>, they were quite divergent.<br />
For example, <str<strong>on</strong>g>in</str<strong>on</strong>g> price al<strong>on</strong>e, the curriculum<br />
models had a wide range (see Table 1). The<br />
lowest cost was $29.95 for Life Skills Instructi<strong>on</strong><br />
for All Students with <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> (Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g> & Patt<strong>on</strong>,<br />
1993) while the most expensive was Everyday<br />
Life Skills at $519.93 (American Guidance<br />
Service, 2001). Brol<str<strong>on</strong>g>in</str<strong>on</strong>g>’s (2004) Life Centered<br />
Career <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> (LCCE), which was not reviewed,<br />
was priced at $995. Five of the 10<br />
curriculum models were under $100, two<br />
more under $200, <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>on</strong>e was out of pr<str<strong>on</strong>g>in</str<strong>on</strong>g>t<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> no l<strong>on</strong>ger available for purchase from the<br />
publisher (i.e., Impact: A Functi<strong>on</strong>al Curriculum<br />
H<str<strong>on</strong>g>and</str<strong>on</strong>g>book, Neel & Bill<str<strong>on</strong>g>in</str<strong>on</strong>g>gsley, 1989).<br />
All the curriculum models addressed most<br />
aspects of a functi<strong>on</strong>al curriculum, as def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
by Patt<strong>on</strong>, Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>, <str<strong>on</strong>g>and</str<strong>on</strong>g> Jairrels (1997): Func-<br />
Functi<strong>on</strong>al Curriculum Models / 437
TABLE 1<br />
Functi<strong>on</strong>al Curriculum Models’ Price from Lowest to Highest<br />
Order Title Cost<br />
1 Life Skills Activities for Sec<strong>on</strong>dary Students with Special Needs $29.95<br />
2 Community-Based Curriculum $30.00<br />
3 Life Skills Instructi<strong>on</strong> for All Students with Special Needs $39.00<br />
4 Functi<strong>on</strong>al Curriculum for Elementary, Middle, <str<strong>on</strong>g>and</str<strong>on</strong>g> Sec<strong>on</strong>dary Age<br />
Students with Special Needs<br />
$52.00<br />
5 The Syracuse Community-Referenced Guide $59.00<br />
6 Functi<strong>on</strong>al Independence Skills H<str<strong>on</strong>g>and</str<strong>on</strong>g>book $62.00<br />
7 Everyday Life Skills (without extras) $114.97<br />
8 A Functi<strong>on</strong>al Curriculum for Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Students with <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> $125.00<br />
9 Adaptive Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Skills Curriculum $457.50<br />
10 Everyday Life Skills (with extras) $519.93<br />
11 Life Centered Career <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> $995.00<br />
Note. Impact: A Functi<strong>on</strong>al Curriculum H<str<strong>on</strong>g>and</str<strong>on</strong>g>book is out of pr<str<strong>on</strong>g>in</str<strong>on</strong>g>t.<br />
ti<strong>on</strong>al academics, vocati<strong>on</strong>al educati<strong>on</strong>, daily<br />
liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g, social/relati<strong>on</strong>ships, <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
community access or skills, transportati<strong>on</strong>,<br />
f<str<strong>on</strong>g>in</str<strong>on</strong>g>ancial, self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong>, leisure <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
recreati<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> communicati<strong>on</strong> skills (see Table<br />
2). Functi<strong>on</strong>al Curriculum for Elementary,<br />
Middle, <str<strong>on</strong>g>and</str<strong>on</strong>g> Sec<strong>on</strong>dary students with Special Needs<br />
(Wehman & Kregel, 2004) covered the greatest<br />
number of functi<strong>on</strong>al curriculum comp<strong>on</strong>ents<br />
with 9 of the 11 categories addressed,<br />
while Impact: A Functi<strong>on</strong>al Curriculum H<str<strong>on</strong>g>and</str<strong>on</strong>g>book<br />
(Neel & Bill<str<strong>on</strong>g>in</str<strong>on</strong>g>gsley, 1989) had the fewest with<br />
two skills covered completely <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>on</strong>e partially.<br />
The social/relati<strong>on</strong>ship skills compo-<br />
TABLE 2<br />
Functi<strong>on</strong>al Curriculum Models’ Comp<strong>on</strong>ents Covered (Most to Least)<br />
Order Title<br />
nent was at least partially addressed by all 10<br />
functi<strong>on</strong>al curriculum models. The next most<br />
addressed comp<strong>on</strong>ents <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded vocati<strong>on</strong>al<br />
educati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>in</str<strong>on</strong>g> which 9<br />
of the 10 reviewed curriculum models partially<br />
or totally addressed each comp<strong>on</strong>ent.<br />
Self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> was addressed <str<strong>on</strong>g>in</str<strong>on</strong>g> the fewest<br />
number of curriculum models (<strong>on</strong>ly five models<br />
partially or totally <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded it).<br />
Most of the curricular models exam<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
c<strong>on</strong>sisted of a s<str<strong>on</strong>g>in</str<strong>on</strong>g>gle book, although there<br />
were variati<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> the structure <str<strong>on</strong>g>and</str<strong>on</strong>g> purposes<br />
of these books. The few that offered additi<strong>on</strong>al<br />
resources bey<strong>on</strong>d the “teacher’s” guide<br />
#of<br />
comp<strong>on</strong>ents<br />
1 Functi<strong>on</strong>al Curriculum for Elementary, Middle, <str<strong>on</strong>g>and</str<strong>on</strong>g> Sec<strong>on</strong>dary Age<br />
Students with Special Needs<br />
10<br />
2 Life Skills Instructi<strong>on</strong> for All Students with Special Needs 9.5<br />
3 Community-Based Curriculum 9<br />
Functi<strong>on</strong>al Independence Skills H<str<strong>on</strong>g>and</str<strong>on</strong>g>book 9<br />
Life Skills Activities for Sec<strong>on</strong>dary Students with Special Needs 9<br />
6 The Syracuse Community-Referenced Guide 8.5<br />
7 A Functi<strong>on</strong>al Curriculum for Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Students with <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> 7<br />
8 Everyday Life Skills 6<br />
Adaptive Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Skills Curriculum 6<br />
9 Impact: A Functi<strong>on</strong>al Curriculum H<str<strong>on</strong>g>and</str<strong>on</strong>g>book 2.5<br />
438 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009
TABLE 3<br />
Functi<strong>on</strong>al Curriculum Models’ Adult Life Subdoma<str<strong>on</strong>g>in</str<strong>on</strong>g>s Covered (Most to Least)<br />
Order Title<br />
or editi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded assessment materials (i.e.,<br />
Functi<strong>on</strong>al Independence Skills H<str<strong>on</strong>g>and</str<strong>on</strong>g>book, Killi<strong>on</strong>,<br />
2003), CDs, or other workbooks (i.e., Everyday<br />
Life Skills, American Guidance Service, 2001).<br />
Few of the 10 curriculum models analyzed<br />
addressed any research c<strong>on</strong>ducted <strong>on</strong> the<br />
model or its implementati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> classrooms.<br />
Some curriculum models did provide research<br />
to support the <str<strong>on</strong>g>in</str<strong>on</strong>g>clusi<strong>on</strong> of specific curriculum<br />
comp<strong>on</strong>ents (i.e., The Syracuse Community-Referenced<br />
Guide, Ford et al., 1989 <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Community-Based Curriculum, Falvey, 1989), yet<br />
these tended to read more like textbooks.<br />
They had less emphasis <strong>on</strong> enabl<str<strong>on</strong>g>in</str<strong>on</strong>g>g teachers<br />
to implement the curriculum <str<strong>on</strong>g>in</str<strong>on</strong>g> the classroom<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> more of provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g research to support the<br />
comp<strong>on</strong>ents or c<strong>on</strong>cepts <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> their<br />
model. Furthermore, no curriculum model<br />
reviewed addressed any professi<strong>on</strong>al development<br />
opportunities for teachers <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g the particular model. Note: LCCE<br />
discusses professi<strong>on</strong>al development.<br />
Few of the analyzed functi<strong>on</strong>al curriculum<br />
models addressed the ideas <str<strong>on</strong>g>and</str<strong>on</strong>g> teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies<br />
found <str<strong>on</strong>g>in</str<strong>on</strong>g> the research <strong>on</strong> “best practices”<br />
(Mariage & Patriarca, 2002). For example,<br />
few gave explicit <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
philosophy towards implement<str<strong>on</strong>g>in</str<strong>on</strong>g>g the curriculum.<br />
The majority of the models were structured<br />
around pr<str<strong>on</strong>g>in</str<strong>on</strong>g>ciples of direct <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>,<br />
as opposed to c<strong>on</strong>structivist approaches (Swans<strong>on</strong>,<br />
2001). Furthermore, few of the models<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>volved technology, <str<strong>on</strong>g>and</str<strong>on</strong>g> most <strong>on</strong>ly implicitly<br />
addressed issues related to sequenc<str<strong>on</strong>g>in</str<strong>on</strong>g>g the ma-<br />
#of<br />
subdoma<str<strong>on</strong>g>in</str<strong>on</strong>g>s<br />
1 Life Skills Instructi<strong>on</strong> for All Students with Special Needs 23<br />
2 Functi<strong>on</strong>al Curriculum for Elementary, Middle, <str<strong>on</strong>g>and</str<strong>on</strong>g> Sec<strong>on</strong>dary Age<br />
Students with Special Needs<br />
17<br />
3 The Syracuse Community-Referenced Guide 15.5<br />
4 Everyday Life Skills 15<br />
5 Community-Based Instructi<strong>on</strong> 14<br />
6 Adaptive Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Skills Curriculum 12<br />
7 Life Skills Activities for Students with Special Needs 11.5<br />
8 A Functi<strong>on</strong>al Curriculum for Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Students with <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> 9.5<br />
9 Functi<strong>on</strong>al Independence Skills H<str<strong>on</strong>g>and</str<strong>on</strong>g>book 6<br />
10 Impact: A Functi<strong>on</strong>al Curriculum H<str<strong>on</strong>g>and</str<strong>on</strong>g>book .5<br />
terials, repetiti<strong>on</strong> of skills <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>cepts, segmentati<strong>on</strong>,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>troll<str<strong>on</strong>g>in</str<strong>on</strong>g>g for difficulty of<br />
dem<str<strong>on</strong>g>and</str<strong>on</strong>g>s of tasks.<br />
N<strong>on</strong>e of the curriculum models reviewed<br />
covered all of Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> Patt<strong>on</strong>’s (1993) six<br />
doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s of adulthood, aside from Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Patt<strong>on</strong>’s Life Skills Instructi<strong>on</strong> for All Students<br />
with Special Needs which covered 23 of the 23<br />
total subdoma<str<strong>on</strong>g>in</str<strong>on</strong>g>s. This particular curriculum<br />
model was structured around the doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> subdoma<str<strong>on</strong>g>in</str<strong>on</strong>g>s of adulthood <str<strong>on</strong>g>and</str<strong>on</strong>g> provided<br />
resources for materials for each of the subdoma<str<strong>on</strong>g>in</str<strong>on</strong>g>s.<br />
Although the rema<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g models covered<br />
many of the six doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s, the subdoma<str<strong>on</strong>g>in</str<strong>on</strong>g>s<br />
were addressed to vary<str<strong>on</strong>g>in</str<strong>on</strong>g>g degrees (see Table<br />
3). The adulthood doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s of home <str<strong>on</strong>g>and</str<strong>on</strong>g> family,<br />
leisure pursuits, <str<strong>on</strong>g>and</str<strong>on</strong>g> pers<strong>on</strong>al/resp<strong>on</strong>sibility<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> relati<strong>on</strong>ship were covered across most<br />
of the rema<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g n<str<strong>on</strong>g>in</str<strong>on</strong>g>e models. The curriculum<br />
model that addressed the fewest subdoma<str<strong>on</strong>g>in</str<strong>on</strong>g>s<br />
was Neel <str<strong>on</strong>g>and</str<strong>on</strong>g> Bill<str<strong>on</strong>g>in</str<strong>on</strong>g>gsley’s (1989) Impact:<br />
A Functi<strong>on</strong>al Curriculum H<str<strong>on</strong>g>and</str<strong>on</strong>g>book (.5 of<br />
23).<br />
In analyz<str<strong>on</strong>g>in</str<strong>on</strong>g>g the functi<strong>on</strong>al curriculum<br />
models with respect to the material analysis<br />
(Hammill & Bartel, 1990), the results showed<br />
that n<strong>on</strong>e of the models had an “appropriate”<br />
form for teachers. While the models c<strong>on</strong>sisted<br />
of different forms, n<strong>on</strong>e were assessed to be<br />
completely appropriate for teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g functi<strong>on</strong>al<br />
curriculum to sec<strong>on</strong>dary students with<br />
mild mental impairment. Some models placed<br />
too great a dem<str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>on</strong> teachers acquir<str<strong>on</strong>g>in</str<strong>on</strong>g>g or<br />
creat<str<strong>on</strong>g>in</str<strong>on</strong>g>g their own materials (i.e., Functi<strong>on</strong>al<br />
Functi<strong>on</strong>al Curriculum Models / 439
Life Skills Instructi<strong>on</strong> for All Students with Special<br />
Needs; Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g> & Patt<strong>on</strong>, 1993), others did not<br />
have enough applicati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> the curriculum,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> others were directed too much at teachers<br />
(i.e., references <str<strong>on</strong>g>and</str<strong>on</strong>g> citati<strong>on</strong>s) as opposed to<br />
activities or less<strong>on</strong>s for students (e.g., The Syracuse<br />
Community-Reference Guide; Ford et al.,<br />
1989).<br />
Other issues emerg<str<strong>on</strong>g>in</str<strong>on</strong>g>g from the material<br />
analysis were readability levels, student support<br />
materials, <str<strong>on</strong>g>and</str<strong>on</strong>g> teacher support. To beg<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
with, n<strong>on</strong>e of the curriculum models actually<br />
addressed the readability level of materials<br />
(Hammill & Bartel, 1990). While the curriculum<br />
models themselves were mostly directed<br />
to teachers, so readability level was not an<br />
issue, the few material pieces with<str<strong>on</strong>g>in</str<strong>on</strong>g> the curriculum<br />
that were geared towards students<br />
were assessed to be at a read<str<strong>on</strong>g>in</str<strong>on</strong>g>g level too high<br />
for the average student with mild mental impairment.<br />
In additi<strong>on</strong>, not all curriculum<br />
models had support materials or additi<strong>on</strong>al<br />
comp<strong>on</strong>ents, leav<str<strong>on</strong>g>in</str<strong>on</strong>g>g teachers hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g to create<br />
or f<str<strong>on</strong>g>in</str<strong>on</strong>g>d various comp<strong>on</strong>ents such as assessments<br />
or worksheets. The curriculum models<br />
also did not address teacher tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g or support<br />
for teachers dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g implementati<strong>on</strong> as<br />
the “teacher’s guide” or “teacher’s editi<strong>on</strong>”<br />
was the curriculum model itself. In general,<br />
the models did not c<strong>on</strong>sist of separate student<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> teacher editi<strong>on</strong>s, but rather there was<br />
<strong>on</strong>ly a teacher’s book (or guide or editi<strong>on</strong>),<br />
with <strong>on</strong>e excepti<strong>on</strong>, Everyday Life Skills (American<br />
Guidance Service, 2001).<br />
Discussi<strong>on</strong><br />
While each functi<strong>on</strong>al curriculum model had<br />
its strengths <str<strong>on</strong>g>and</str<strong>on</strong>g> weaknesses, n<strong>on</strong>e was all encompass<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> could be portrayed as a solid,<br />
complete functi<strong>on</strong>al curriculum model for<br />
sec<strong>on</strong>dary students with mild mental impairment,<br />
when exclud<str<strong>on</strong>g>in</str<strong>on</strong>g>g Brol<str<strong>on</strong>g>in</str<strong>on</strong>g>’s Life Centered<br />
Career <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> (2004) from evaluati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
c<strong>on</strong>siderati<strong>on</strong>. No <strong>on</strong>e model addressed all<br />
curricular areas as def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed by Patt<strong>on</strong>, Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Jairrels (1997). Furthermore, the vary<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
formats were challeng<str<strong>on</strong>g>in</str<strong>on</strong>g>g. Some read more<br />
like college textbooks than curriculum models,<br />
mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g implementati<strong>on</strong> difficult <str<strong>on</strong>g>in</str<strong>on</strong>g> a classroom<br />
(i.e., Community Based Curriculum,<br />
Falvey, 1989; The Syracuse Community-Referenced<br />
Guide, Ford et al., 1989). Others models were<br />
440 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
essentially a book of worksheets to give to<br />
students (i.e., Life Skills Activities for Students<br />
with Special Needs, Mannix, 1995), while some<br />
were reference books that told teachers about<br />
materials, books, <str<strong>on</strong>g>and</str<strong>on</strong>g> videos that could be<br />
used to “create” their own functi<strong>on</strong>al curriculum<br />
by compil<str<strong>on</strong>g>in</str<strong>on</strong>g>g materials from the identified<br />
multiple sources (i.e., Life Skills Instructi<strong>on</strong><br />
for all Students with Special Needs, Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g> &<br />
Patt<strong>on</strong>, 1993).<br />
The analysis also revealed vast differences <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
functi<strong>on</strong>al curriculum comp<strong>on</strong>ent coverage,<br />
ease of implementati<strong>on</strong>, accessibility of materials<br />
with students, <str<strong>on</strong>g>and</str<strong>on</strong>g> cost. For an educator<br />
look<str<strong>on</strong>g>in</str<strong>on</strong>g>g to implement a functi<strong>on</strong>al curriculum<br />
model, any of these issues could be a h<str<strong>on</strong>g>in</str<strong>on</strong>g>drance<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> implement<str<strong>on</strong>g>in</str<strong>on</strong>g>g a currently commercially<br />
available curriculum model. Practiti<strong>on</strong>ers<br />
must weigh compet<str<strong>on</strong>g>in</str<strong>on</strong>g>g dem<str<strong>on</strong>g>and</str<strong>on</strong>g>s, such as<br />
comprehensiveness versus expense, time to<br />
devote to teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g a functi<strong>on</strong>al curriculum<br />
with time needed for depth of the different<br />
comp<strong>on</strong>ents, <str<strong>on</strong>g>and</str<strong>on</strong>g> a scripted curriculum versus<br />
<strong>on</strong>e that <str<strong>on</strong>g>in</str<strong>on</strong>g>volves supplements <str<strong>on</strong>g>and</str<strong>on</strong>g> teacherc<strong>on</strong>structed<br />
materials. In essence, each curriculum<br />
model comes with trade-offs, whether<br />
those are cost or coverage, <str<strong>on</strong>g>and</str<strong>on</strong>g> teachers, <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
c<strong>on</strong>juncti<strong>on</strong> with other educators, must make<br />
decisi<strong>on</strong>s regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g the needs of their students<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> the resources of their program<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g>/or district.<br />
Thus, what appears miss<str<strong>on</strong>g>in</str<strong>on</strong>g>g from the collecti<strong>on</strong><br />
of functi<strong>on</strong>al curriculum models reviewed<br />
for sec<strong>on</strong>dary students with mild mental<br />
impairment is a comprehensive curriculum<br />
model that addresses all curriculum comp<strong>on</strong>ents<br />
(Patt<strong>on</strong>, Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>, & Jairrels, 1997), <str<strong>on</strong>g>in</str<strong>on</strong>g>volves<br />
community <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> as well as technology,<br />
is affordable, appeals to <str<strong>on</strong>g>and</str<strong>on</strong>g> supports<br />
students <str<strong>on</strong>g>and</str<strong>on</strong>g> teachers (i.e., engages students<br />
yet has easy implementati<strong>on</strong>), <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>siders<br />
best practices. The ideas <str<strong>on</strong>g>and</str<strong>on</strong>g> beliefs of the<br />
functi<strong>on</strong>al curriculum, much ab<str<strong>on</strong>g>and</str<strong>on</strong>g><strong>on</strong>ed for<br />
this populati<strong>on</strong> of students with mild mental<br />
impairment over recent years, deserves to be<br />
revisited <str<strong>on</strong>g>and</str<strong>on</strong>g> new models <str<strong>on</strong>g>and</str<strong>on</strong>g> materials created<br />
that represent a more comprehensive<br />
approach, address<str<strong>on</strong>g>in</str<strong>on</strong>g>g the needs of teachers<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> students (Bouck, 2004). These new functi<strong>on</strong>al<br />
curriculum models need to turn towards<br />
technology, utiliz<str<strong>on</strong>g>in</str<strong>on</strong>g>g practices, methods,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> less<strong>on</strong>s that <str<strong>on</strong>g>in</str<strong>on</strong>g>volve CD-ROMs <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
web-based <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al envir<strong>on</strong>ments to cap-
ture the attenti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> excitement of both<br />
students <str<strong>on</strong>g>and</str<strong>on</strong>g> teachers.<br />
The field needs to move towards provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
a balanced, comprehensive, coherent functi<strong>on</strong>al<br />
curriculum for this populati<strong>on</strong> of students<br />
at the sec<strong>on</strong>dary level (Bouck, 2008). A<br />
balanced, yet flexible, functi<strong>on</strong>al curriculum<br />
model would <str<strong>on</strong>g>in</str<strong>on</strong>g>clude utilizati<strong>on</strong> of different<br />
theories of learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> different pedagogical<br />
approaches (i.e., skills, cognitive apprenticeship,<br />
model<str<strong>on</strong>g>in</str<strong>on</strong>g>g, social mediati<strong>on</strong> direct <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>,<br />
etc.). It would balance the various<br />
comp<strong>on</strong>ents of a functi<strong>on</strong>al curriculum (e.g.,<br />
functi<strong>on</strong>al academics, community access, daily<br />
liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills, f<str<strong>on</strong>g>in</str<strong>on</strong>g>ancial, transportati<strong>on</strong>, leisure<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> recreati<strong>on</strong>, communicati<strong>on</strong>, self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong>,<br />
social skills, vocati<strong>on</strong>al educati<strong>on</strong>, <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills; Patt<strong>on</strong>, Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>, & Jairrels,<br />
1997). Furthermore, it would balance<br />
direct skills <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> with a cognitive apprenticeship,<br />
students as c<strong>on</strong>sumers with students<br />
as producers, <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>dividualizati<strong>on</strong> with<br />
community.<br />
A balanced approach to functi<strong>on</strong>al curriculum<br />
would resemble a balanced literacy approach;<br />
however, <str<strong>on</strong>g>in</str<strong>on</strong>g>stead of mov<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> a c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>uum<br />
from k<str<strong>on</strong>g>in</str<strong>on</strong>g>dergarten through 12 th grade<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> shift<str<strong>on</strong>g>in</str<strong>on</strong>g>g emphasis from “learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g to read”<br />
to “read<str<strong>on</strong>g>in</str<strong>on</strong>g>g to learn” (Duke, Bennett-<br />
Armistead, & Roberts, 2003; McCartney, 2004;<br />
Nati<strong>on</strong>al Center to Improve the Tools of <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>,<br />
1996), the shift <str<strong>on</strong>g>in</str<strong>on</strong>g> emphasis would<br />
occur with “learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g to functi<strong>on</strong>” (i.e., performance)<br />
to “functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g to learn” (i.e., cognitive<br />
apprenticeship) (see Figure 1) (Bouck,<br />
2008). The ascerta<str<strong>on</strong>g>in</str<strong>on</strong>g>ment of functi<strong>on</strong>al life<br />
skills needed for successful post-school outcomes<br />
would become a learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g process<br />
across students’ school careers with the goal of<br />
arm<str<strong>on</strong>g>in</str<strong>on</strong>g>g students with the skills <str<strong>on</strong>g>and</str<strong>on</strong>g> experiences<br />
necessary to be successful <str<strong>on</strong>g>in</str<strong>on</strong>g> life, much<br />
like what schools currently do for students go<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<strong>on</strong>to traditi<strong>on</strong>al post-sec<strong>on</strong>dary educati<strong>on</strong>.<br />
Limitati<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> Future Directi<strong>on</strong>s<br />
This study has some limitati<strong>on</strong>s. For <strong>on</strong>e, it<br />
represents <strong>on</strong>e researcher’s analysis of commercially<br />
available functi<strong>on</strong>al curriculum<br />
models geared towards sec<strong>on</strong>dary students<br />
with mild mental impairment. Thus, curriculum<br />
models may be miss<str<strong>on</strong>g>in</str<strong>on</strong>g>g that are not widely<br />
circulated or the researcher’s percepti<strong>on</strong>s may<br />
Figure 1. A balanced functi<strong>on</strong>al curriculum model.<br />
be biased. In additi<strong>on</strong>, this study does not<br />
attempt to elicit the op<str<strong>on</strong>g>in</str<strong>on</strong>g>i<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> perspectives<br />
of teachers, students, <str<strong>on</strong>g>and</str<strong>on</strong>g> parents as to the<br />
different functi<strong>on</strong>al curriculum models, but<br />
relies solely <strong>on</strong> the analysis of the written curriculum<br />
materials provided. This project also<br />
did not explore older, less known curriculum<br />
models such as Problem Solv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Activities for<br />
Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Skills (Luccas, Lenox, &<br />
Amey, 1982) or curricula geared to delivery by<br />
parents or <str<strong>on</strong>g>in</str<strong>on</strong>g> the home, such as Steps to Independence<br />
(Baker & Brightman, 2004).<br />
Future research should c<strong>on</strong>sider the perspectives<br />
of teachers, students, <str<strong>on</strong>g>and</str<strong>on</strong>g> parents <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
regards to functi<strong>on</strong>al curriculum models. Researchers<br />
should f<str<strong>on</strong>g>in</str<strong>on</strong>g>d ways to capture <str<strong>on</strong>g>and</str<strong>on</strong>g> express<br />
the op<str<strong>on</strong>g>in</str<strong>on</strong>g>i<strong>on</strong>s of these key stakeholders <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
regards to the most essential comp<strong>on</strong>ents of a<br />
functi<strong>on</strong>al curriculum model <str<strong>on</strong>g>and</str<strong>on</strong>g> delivery<br />
modes. Future research should also seek to<br />
create new functi<strong>on</strong>al curriculum models,<br />
draw<str<strong>on</strong>g>in</str<strong>on</strong>g>g up<strong>on</strong> technology, which has the potential<br />
of creat<str<strong>on</strong>g>in</str<strong>on</strong>g>g curricula that captures students’<br />
attenti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> present<str<strong>on</strong>g>in</str<strong>on</strong>g>g them with<br />
mean<str<strong>on</strong>g>in</str<strong>on</strong>g>gful learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g experiences <str<strong>on</strong>g>in</str<strong>on</strong>g> the community,<br />
school, home, <str<strong>on</strong>g>and</str<strong>on</strong>g> places of employment.<br />
Research <strong>on</strong> functi<strong>on</strong>al curricula for<br />
sec<strong>on</strong>dary students with mild mental impairment<br />
should extend bey<strong>on</strong>d just a review <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
analysis of functi<strong>on</strong>al curriculum models <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
recommendati<strong>on</strong>s for the creati<strong>on</strong> of new<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> alternative approaches. It should <str<strong>on</strong>g>in</str<strong>on</strong>g>clude<br />
the exam<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> of curricular impact <strong>on</strong> students’<br />
outcomes, such as employment, <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g, access to the community, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
social relati<strong>on</strong>ships.<br />
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Received: 19 June 2008<br />
Initial Acceptance: 19 August 2008<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>al Acceptance: 21 October 2008<br />
Functi<strong>on</strong>al Curriculum Models / 443
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, 2009, 44(4), 444–452<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
Autism Spectrum Disorders <str<strong>on</strong>g>and</str<strong>on</strong>g> Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g Relati<strong>on</strong>ships:<br />
Research <str<strong>on</strong>g>and</str<strong>on</strong>g> Strategies<br />
Julia F. Beyer<br />
Lynchburg College<br />
Abstract: Significant attenti<strong>on</strong> has been paid <str<strong>on</strong>g>in</str<strong>on</strong>g> the literature to sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships <str<strong>on</strong>g>and</str<strong>on</strong>g> the effects of birth<br />
order, family size, <str<strong>on</strong>g>and</str<strong>on</strong>g> gender <strong>on</strong> such relati<strong>on</strong>ships. Although these are important areas to study, there is<br />
relatively little research <strong>on</strong> the effects of autism spectrum disorders (ASD) <strong>on</strong> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships. The existent<br />
research identifies both positive <str<strong>on</strong>g>and</str<strong>on</strong>g> negative factors <str<strong>on</strong>g>in</str<strong>on</strong>g> such sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships. This paper analyzes the<br />
studies that are available <strong>on</strong> ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships, discusses f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, identifies implicati<strong>on</strong>s, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
makes recommendati<strong>on</strong>s for improv<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships when <strong>on</strong>e sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g has ASD.<br />
With<str<strong>on</strong>g>in</str<strong>on</strong>g> the family unit sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs share a unique<br />
relati<strong>on</strong>ship with <strong>on</strong>e another (Knott, Lewis,<br />
& Williams, 1995), typically last<str<strong>on</strong>g>in</str<strong>on</strong>g>g the l<strong>on</strong>gest<br />
am<strong>on</strong>g all human relati<strong>on</strong>ships (Orsm<strong>on</strong>d &<br />
Seltzer, 2007). Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
general populati<strong>on</strong> develop al<strong>on</strong>g a c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>uum<br />
throughout childhood, adolescence <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
adulthood (Dunn, Slomkowski, & Beardsall,<br />
1994) <str<strong>on</strong>g>and</str<strong>on</strong>g> typical sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships provide<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with experiences that “foster the development<br />
of emoti<strong>on</strong>al underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g, selfregulati<strong>on</strong>,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> a sense of bel<strong>on</strong>g<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> comfort”<br />
(Orsm<strong>on</strong>d & Seltzer, p. 313).<br />
A number of specific aspects of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships<br />
have been highlighted <str<strong>on</strong>g>in</str<strong>on</strong>g> the research.<br />
For example, Smith <str<strong>on</strong>g>and</str<strong>on</strong>g> Hart (2002) stated that<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships play a significant role <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
development of children’s underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>gs of<br />
others’ emoti<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> thoughts. Kam<str<strong>on</strong>g>in</str<strong>on</strong>g>sky <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Dewey (2001) reported that positive sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
relati<strong>on</strong>ships can be an important source of<br />
social development <str<strong>on</strong>g>and</str<strong>on</strong>g> self-worth <str<strong>on</strong>g>and</str<strong>on</strong>g> are associated<br />
with lower levels of c<strong>on</strong>duct disorders<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> l<strong>on</strong>el<str<strong>on</strong>g>in</str<strong>on</strong>g>ess <str<strong>on</strong>g>in</str<strong>on</strong>g> children. Further Foden<br />
(2007) stated <str<strong>on</strong>g>in</str<strong>on</strong>g>terplay between sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs profoundly<br />
affects <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals’ pers<strong>on</strong>alities <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
social <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual development. Howe,<br />
Petrakos, <str<strong>on</strong>g>and</str<strong>on</strong>g> R<str<strong>on</strong>g>in</str<strong>on</strong>g>aldi (1998) similarly found<br />
that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs who engage <str<strong>on</strong>g>in</str<strong>on</strong>g> frequent pretend<br />
play dem<strong>on</strong>strate a greater underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g of<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g this article should<br />
be addressed to Julia Beyer, 104 L<strong>on</strong>g Hill Lane,<br />
Chatham, NJ 07928.<br />
others’ emoti<strong>on</strong>s, are more likely to c<strong>on</strong>struct<br />
shared mean<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>in</str<strong>on</strong>g> play, <str<strong>on</strong>g>and</str<strong>on</strong>g> are more likely<br />
to develop c<strong>on</strong>flict management strategies. In<br />
additi<strong>on</strong>, El-Ghoroury <str<strong>on</strong>g>and</str<strong>on</strong>g> Romanczky (1999)<br />
reported that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs are important social<br />
agents for children with autism spectrum disorders<br />
(ASD), who often have severe deficits<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> social competence. As Reag<strong>on</strong> (2006) further<br />
noted, sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs are the most frequently<br />
available play partners.<br />
Thus, the questi<strong>on</strong> of how do autism spectrum<br />
disorders (ASD) affect sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships is important<br />
to answer because positive sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships<br />
can foster a better quality of life<br />
both <str<strong>on</strong>g>in</str<strong>on</strong>g> the present <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> the future, such as<br />
<strong>on</strong>ce parents may be unable to care for their<br />
child with ASD. This paper addresses factors<br />
that affect sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships, analyzes the<br />
impact of hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g a sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with ASD as compared<br />
to <strong>on</strong>e with other disabilities, discusses<br />
the f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> potential makes recommendati<strong>on</strong>s<br />
for improv<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships<br />
when <strong>on</strong>e sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g has ASD.<br />
Research <strong>on</strong> Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g Relati<strong>on</strong>ships<br />
Factors<br />
444 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
In additi<strong>on</strong> to the presence of a sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with a<br />
disability, there are many factors that have<br />
been identified that affect sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships.<br />
Kim, McHale, <str<strong>on</strong>g>and</str<strong>on</strong>g> Wayne (2006) reported<br />
<strong>on</strong> gender effects <strong>on</strong> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships;<br />
stat<str<strong>on</strong>g>in</str<strong>on</strong>g>g that girls tend to report more
affecti<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships than<br />
boys while Trev<str<strong>on</strong>g>in</str<strong>on</strong>g>o (1979) reported older<br />
brothers tend to be the least <str<strong>on</strong>g>in</str<strong>on</strong>g>volved with<br />
their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs. Further, Brody (1998) found<br />
positive parent-child relati<strong>on</strong>ships were c<strong>on</strong>nected<br />
to positive affect <str<strong>on</strong>g>and</str<strong>on</strong>g> pro-social behavior<br />
of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs. Moreover, Fielder <str<strong>on</strong>g>and</str<strong>on</strong>g> Simps<strong>on</strong><br />
(2006) reported that culture, traditi<strong>on</strong>s, <str<strong>on</strong>g>in</str<strong>on</strong>g>terests,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> envir<strong>on</strong>mental c<strong>on</strong>texts all have an<br />
effect <strong>on</strong> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships. The aim of this<br />
paper is to analyze the research about the<br />
impact of the presence of a disability, <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
particular ASD, <strong>on</strong> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships.<br />
ASD: Behavioral Barriers to the Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Relati<strong>on</strong>ship<br />
Foden (2007) stated that typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with ASD face the<br />
daunt<str<strong>on</strong>g>in</str<strong>on</strong>g>g task of form<str<strong>on</strong>g>in</str<strong>on</strong>g>g a healthy sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
b<strong>on</strong>d. Harris (2007) reported the nature of<br />
ASD makes it difficult for sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs who are<br />
n<strong>on</strong>-disabled to form satisfy<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships<br />
with their brother or sister with ASD. That is,<br />
the majority of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with ASD have<br />
cognitive limitati<strong>on</strong>s as well as social <str<strong>on</strong>g>and</str<strong>on</strong>g> behavioral<br />
characteristic that may present challenges<br />
to sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships (American Psychiatric<br />
Associati<strong>on</strong>, 2000). Such limitati<strong>on</strong>s<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> characteristics <str<strong>on</strong>g>in</str<strong>on</strong>g>clude deficits <str<strong>on</strong>g>in</str<strong>on</strong>g> underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the perspectives <str<strong>on</strong>g>and</str<strong>on</strong>g> emoti<strong>on</strong>s of<br />
others, lack of reciprocity <str<strong>on</strong>g>in</str<strong>on</strong>g> c<strong>on</strong>versati<strong>on</strong>s,<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>ability to seek out others for comfort, affecti<strong>on</strong>,<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>ability to <str<strong>on</strong>g>in</str<strong>on</strong>g>itiate play (Rutter & Schopler,<br />
1987), <str<strong>on</strong>g>and</str<strong>on</strong>g> troubl<str<strong>on</strong>g>in</str<strong>on</strong>g>g behaviors such as<br />
aggressi<strong>on</strong> (D<strong>on</strong>enberg & Baker, 1993). Further,<br />
Rivers <str<strong>on</strong>g>and</str<strong>on</strong>g> St<strong>on</strong>eman (2003) found <str<strong>on</strong>g>in</str<strong>on</strong>g> a<br />
study of 50 families with children with ASD<br />
that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs who are n<strong>on</strong>-disabled reported<br />
<strong>on</strong> a self-<str<strong>on</strong>g>in</str<strong>on</strong>g>ventory that they were often disturbed<br />
by their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs’ behaviors. Kam<str<strong>on</strong>g>in</str<strong>on</strong>g>sky<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Dewey (2001) hypothesized that the social<br />
deficits shown by <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with ASD<br />
causes their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships to be different<br />
from the relati<strong>on</strong>ships of other disorders<br />
such Down syndrome <str<strong>on</strong>g>and</str<strong>on</strong>g> no disorder.<br />
Comparis<strong>on</strong> to Other Groups<br />
To better underst<str<strong>on</strong>g>and</str<strong>on</strong>g> how ASD affects sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
relati<strong>on</strong>ships, it is helpful to <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigate studies<br />
that have compared relati<strong>on</strong>ships of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with ASD to sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>divid-<br />
uals with other disorders such as Down syndrome<br />
(DS), mental retardati<strong>on</strong> (MR), <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
developmental delay (DD), as well as sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
of typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals. In the succeed<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
secti<strong>on</strong>s attenti<strong>on</strong> is also given to<br />
prosocial behavior am<strong>on</strong>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, pride or<br />
embarrassment of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, c<strong>on</strong>flict between<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, c<strong>on</strong>cerns for sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, <str<strong>on</strong>g>and</str<strong>on</strong>g> cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
skills, (See, Table 1 for more <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> <strong>on</strong><br />
studies discussed below)<br />
Positive relati<strong>on</strong>ships. There have been studies<br />
that have found positive reports of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
relati<strong>on</strong>ships between typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with ASD. Rivers <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
St<strong>on</strong>eman (2003) studied 50 families of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with ASD ages 7–12 <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
reported ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ly positive feel<str<strong>on</strong>g>in</str<strong>on</strong>g>g about their<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships. Mascha <str<strong>on</strong>g>and</str<strong>on</strong>g> Boucher<br />
(2006) c<strong>on</strong>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> their qualitative study<br />
that most sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with ASD ages<br />
7-20 recalled positive experiences with their<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with ASD, stat<str<strong>on</strong>g>in</str<strong>on</strong>g>g they played outside,<br />
watched televisi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> had fun with their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs.<br />
Further, Foden (2007) reported that<br />
typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with ASD spoke of pride <str<strong>on</strong>g>in</str<strong>on</strong>g> teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g their<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with ASD. In additi<strong>on</strong>, Knott et al.<br />
(1995) reported that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with ASD typically “stage-manage” play with<br />
their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g. Knott et al. also found that <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
some cases sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with ASD did <str<strong>on</strong>g>in</str<strong>on</strong>g>itiate play<br />
with their typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g(s).<br />
Moreover, Fisman et al. (1996) <str<strong>on</strong>g>and</str<strong>on</strong>g> Kam<str<strong>on</strong>g>in</str<strong>on</strong>g>sky<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Dewey (2001) c<strong>on</strong>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> their study<br />
of 138 subjects that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of children with<br />
ASD reported less c<strong>on</strong>flict <str<strong>on</strong>g>and</str<strong>on</strong>g> greater warmth<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ship than sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of typically<br />
develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals. Orsm<strong>on</strong>d <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Seltzer (2007) reported sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with ASD were closer when the sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g had<br />
lower educati<strong>on</strong>al levels, lived closer to their<br />
brother or sister with ASD, used cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> when their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g had higher levels<br />
of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependence.<br />
Moreover, McHale et al. (1987) reported<br />
that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with ASD reported<br />
more positive sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships when they<br />
accepted their role as a family member, perceived<br />
m<str<strong>on</strong>g>in</str<strong>on</strong>g>imal parental favoritism, developed<br />
cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills, understood their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs’ disability,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> were not worried about the future<br />
of their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with ASD. Similarly, Orsm<strong>on</strong>d<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Seltzer (2007) found that the use of ef-<br />
ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g Relati<strong>on</strong>ships / 445
TABLE 1<br />
How do Autism Spectrum Disorders (ASD) Affect Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g Relati<strong>on</strong>ships?<br />
Outcomes: Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of Individuals<br />
w/ASD<br />
Citati<strong>on</strong>s N Comparis<strong>on</strong> group Measurement<br />
Reported significantly less positive<br />
experiences<br />
Parents & sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terviewed &<br />
completed the<br />
Eysenck Pers<strong>on</strong>ality<br />
Inventory<br />
Parent/caregiver &<br />
teacher <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewed<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
w/MR & n<strong>on</strong>disabled<br />
Reported less c<strong>on</strong>flict & greater<br />
warmth<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
w/w/out<br />
disability<br />
Spoke of pride teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g their<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs w/ASD<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewed<br />
& observati<strong>on</strong>al<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
w/DS & no<br />
Bagenholm &<br />
60 subjects b/w 5-20 years old<br />
Gillberg (1991)<br />
20 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs w/ASD<br />
20 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs w/MR<br />
20 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
w/out a disability<br />
Fisman et al.<br />
138 subjects<br />
(1996)<br />
46 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs w/ASD<br />
46 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs w/DS<br />
46 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
w/out a disability<br />
Foden (2007) Meta-analysis of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
outcomes<br />
disability<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g questi<strong>on</strong>naire Showed less close & warm<br />
relati<strong>on</strong>ships, slightly worse<br />
health, higher levels of<br />
depressive symptoms & less<br />
c<strong>on</strong>tacts<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g Relati<strong>on</strong>ship<br />
Characterized relati<strong>on</strong>ships by less<br />
Questi<strong>on</strong>er (SRQ)<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>timacy, prosocial behavior, &<br />
nurturance, & reported less<br />
c<strong>on</strong>flict<br />
Observed at home Engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> fewer bouts, imitated<br />
less, & staged managed play<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g Interviewed &<br />
Reported greater feel<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of<br />
observed at home<br />
embarrassment, & cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
strategies resulted <str<strong>on</strong>g>in</str<strong>on</strong>g> more<br />
positive feel<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, recalled<br />
positive feel<str<strong>on</strong>g>in</str<strong>on</strong>g>gs about play<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
outside, & watch<str<strong>on</strong>g>in</str<strong>on</strong>g>g tv<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
w/DS<br />
46 subjects<br />
284 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g w/DS<br />
176 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g w/ASD<br />
Hodapp & Urbano<br />
(2007)<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
w/DS & TD<br />
90 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs w/ASD<br />
b/w8&18<br />
Kam<str<strong>on</strong>g>in</str<strong>on</strong>g>sky & Dewey<br />
(2001)<br />
446 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Knott et al. (1995) 30 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g pairs Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
w/DS & LD<br />
Mascha & Boucher 14 subjects ages 7-20 from<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
(2006)<br />
families where there was a<br />
w/DS<br />
child diagnosed ASD
TABLE 1—(C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued)<br />
Outcomes: Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of Individuals w/<br />
ASD<br />
Citati<strong>on</strong>s N Comparis<strong>on</strong> group Measurement<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g questi<strong>on</strong>ers No differences <str<strong>on</strong>g>in</str<strong>on</strong>g> relati<strong>on</strong>ships<br />
b/w groups<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
w/MR & n<strong>on</strong>disabled<br />
90 subjects ages 6-15<br />
30 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g w/ASD<br />
30 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs w/MR<br />
30 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g w/out a<br />
disability<br />
154 subjects ages 21–56<br />
77 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs w/DS<br />
77 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g w/ASD<br />
McHale, Sloan &<br />
Simenss<strong>on</strong><br />
(1987)<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g questi<strong>on</strong>er Reported less positive affect,<br />
relati<strong>on</strong>ship w/parents<br />
impacted, development of<br />
cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies resulted <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
more positive feel<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, as did<br />
lower level of educati<strong>on</strong> &<br />
higher levels of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependence of<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
w/DS<br />
Osm<strong>on</strong>d & Seltzer<br />
(2007)<br />
their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Reported more positive<br />
relati<strong>on</strong>ships than parents did<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g Inventory<br />
Behavior (SIB) &<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g Relati<strong>on</strong>ship<br />
Questi<strong>on</strong>er (SRQ)<br />
No comparis<strong>on</strong><br />
group: normally<br />
develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs &<br />
parents views<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
w/DS & n<strong>on</strong>disabled<br />
50 families where there was a<br />
child diagnosed ASD<br />
Rivers & St<strong>on</strong>eman<br />
(2003)<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewed No differences <str<strong>on</strong>g>in</str<strong>on</strong>g> relati<strong>on</strong>ships<br />
b/w groups<br />
60 subjects ages 8–14<br />
20 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g w/ASD<br />
20 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g w/MR<br />
20 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs w/out<br />
a disability<br />
25 subjects ages 8-15 of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
w/ ASD or no disability<br />
Roeyers & Mycke<br />
(1995)<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewed Reported more aggressive<br />
behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g> the relati<strong>on</strong>ship<br />
Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs w/no<br />
disability<br />
Ross & Cuskelly<br />
(2006)<br />
ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g Relati<strong>on</strong>ships / 447
fective cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies results <str<strong>on</strong>g>in</str<strong>on</strong>g> more positive<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships between typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with ASD.<br />
Thus, positive relati<strong>on</strong>ships (Rivers & St<strong>on</strong>eman,<br />
2003; Mascha & Boucher, 2006; Foden,<br />
2007; Knott et al., 1995) <str<strong>on</strong>g>and</str<strong>on</strong>g> less c<strong>on</strong>flict (Fisman<br />
et al., 1996; Kam<str<strong>on</strong>g>in</str<strong>on</strong>g>sky & Dewey, 2001)<br />
have been reported by sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of a brother or<br />
sister with ASD. Further, effective cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies<br />
(McHale et al., 1986; Orsm<strong>on</strong>d & Seltzer,<br />
2007), m<str<strong>on</strong>g>in</str<strong>on</strong>g>imal perceived parental favoritism,<br />
underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g’s disability, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
little c<strong>on</strong>cern about futures of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with<br />
ASD were all found to c<strong>on</strong>tribute to positive<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships (McHale et al.).<br />
Negative relati<strong>on</strong>ships. Bagenholm <str<strong>on</strong>g>and</str<strong>on</strong>g> Gillberg<br />
(1991) c<strong>on</strong>ducted a study of 60 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
of children with ASD, DD, <str<strong>on</strong>g>and</str<strong>on</strong>g> children who<br />
are n<strong>on</strong>-disabled <str<strong>on</strong>g>and</str<strong>on</strong>g> their parents <str<strong>on</strong>g>and</str<strong>on</strong>g> found<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> parents of children with ASD reported<br />
less favorable attitudes towards their<br />
brother or sister with ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> significantly<br />
less positive experiences of their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g’s role<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the family. Further, sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> parents<br />
also reported problems with the destructive<br />
behavior of their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with ASD (Bagenholm<br />
& Gillberg). Similarly, Ross <str<strong>on</strong>g>and</str<strong>on</strong>g> Cuskelly<br />
(2006) reported that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of children with<br />
ASD ages 8–15 reported more aggressi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s.<br />
Further, Kam<str<strong>on</strong>g>in</str<strong>on</strong>g>sky <str<strong>on</strong>g>and</str<strong>on</strong>g> Dewey (2001) also<br />
reported differences between 90 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> other disabilities<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals ages<br />
8–18. That is, they found sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of a brother<br />
or sister with ASD reported <strong>on</strong> Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g Relati<strong>on</strong>ship<br />
Questi<strong>on</strong>er (SRQ) less <str<strong>on</strong>g>in</str<strong>on</strong>g>timacy, prosocial<br />
behavior, <str<strong>on</strong>g>in</str<strong>on</strong>g>itiated play <str<strong>on</strong>g>and</str<strong>on</strong>g> nurturance<br />
with their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g than sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with DS <str<strong>on</strong>g>and</str<strong>on</strong>g> of typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals.<br />
Knott et al. (1995) compared 30 sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
pairs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with DS <str<strong>on</strong>g>and</str<strong>on</strong>g> found that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with ASD spent less time with their<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g, reported hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g less close relati<strong>on</strong>ships<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>tact, <str<strong>on</strong>g>and</str<strong>on</strong>g> were more c<strong>on</strong>cerned<br />
about their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs’ future. Hodapp <str<strong>on</strong>g>and</str<strong>on</strong>g> Urbano<br />
(2007) c<strong>on</strong>ducted a study of 284 subjects<br />
of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with DS <str<strong>on</strong>g>and</str<strong>on</strong>g> 174 subjects of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
with ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> found sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with DS reported closer, warmer sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships<br />
than sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with<br />
ASD. Further, <str<strong>on</strong>g>in</str<strong>on</strong>g> a study of 154 subjects, Os-<br />
m<strong>on</strong>d <str<strong>on</strong>g>and</str<strong>on</strong>g> Seltzer (2007) c<strong>on</strong>cluded that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with ASD reported less<br />
c<strong>on</strong>tact <str<strong>on</strong>g>and</str<strong>on</strong>g> positive affect with their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
than sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with DS. They also<br />
found that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with ASD<br />
were more likely to report that their relati<strong>on</strong>ships<br />
with their parents had been impacted<br />
more than those with sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with DS. Mascha<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Boucher (2006) found <str<strong>on</strong>g>in</str<strong>on</strong>g> their study of<br />
14 subjects ages 7–20 that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with ASD reported greater feel<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of<br />
embarrassment than sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with DD or no disability.<br />
To c<strong>on</strong>clude, sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of a brother or sister<br />
with ASD have reported negative sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships<br />
such as less c<strong>on</strong>tact, less <str<strong>on</strong>g>in</str<strong>on</strong>g>timacy,<br />
less prosoical behavior <str<strong>on</strong>g>and</str<strong>on</strong>g> less <str<strong>on</strong>g>in</str<strong>on</strong>g>itiated play<br />
(Bagenholm & Gillberg, 1991; Hodapp &<br />
Urbano, 2007; Knott, et al., 1995; Orsm<strong>on</strong>d<br />
& Seltzer, 2007), worry about the future of<br />
their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with ASD (Knott et al.) c<strong>on</strong>cern<br />
about destructive behavior of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with ASD<br />
(Bagenbholm & Gillberg, 1991; Ross &<br />
Cuskelly, 2006; Rivers & St<strong>on</strong>eman, 2003),<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> embarrassment (Mascha & Boucher,<br />
2006).<br />
No differences. In c<strong>on</strong>trast to the above<br />
studies reported <strong>on</strong> which showed evidence of<br />
less positive relati<strong>on</strong>ships, Roeyers <str<strong>on</strong>g>and</str<strong>on</strong>g> Mycke<br />
(1995), <str<strong>on</strong>g>in</str<strong>on</strong>g> their study of 60 subjects ages 8–14,<br />
reported no differences between sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships<br />
of children with ASD when compared<br />
to sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of children with DS <str<strong>on</strong>g>and</str<strong>on</strong>g> no<br />
disability. Similarly, <str<strong>on</strong>g>in</str<strong>on</strong>g> a study of 90 subjects<br />
ages 6–15, McHale et al. (1987) found sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
of children with ASD, of children with MR,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> of typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g children reported<br />
no differences <str<strong>on</strong>g>in</str<strong>on</strong>g> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships.<br />
Strategies for Improv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Relati<strong>on</strong>ships<br />
448 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
The research f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs summarized above may<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dicate <str<strong>on</strong>g>in</str<strong>on</strong>g> part a negative impact of ASD <strong>on</strong><br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships. While there is noth<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
that can be d<strong>on</strong>e about the age, ord<str<strong>on</strong>g>in</str<strong>on</strong>g>al positi<strong>on</strong>,<br />
or degrees of ASD, there are strategies<br />
that can be implemented to facilitate more<br />
positive relati<strong>on</strong>ships between typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> their brother or sister with<br />
ASD. Strategies address<str<strong>on</strong>g>in</str<strong>on</strong>g>g four areas of c<strong>on</strong>cern<br />
are discussed below.
Teach play skills. Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs are the most frequently<br />
available play partners (Reag<strong>on</strong>,<br />
2006). One strategy for <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g positive <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s,<br />
prosocial behaviors, <str<strong>on</strong>g>and</str<strong>on</strong>g> play skills<br />
between sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs is to teach sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs a game<br />
that they can play together. Harris <str<strong>on</strong>g>and</str<strong>on</strong>g> Glasber<br />
(1994) suggested start<str<strong>on</strong>g>in</str<strong>on</strong>g>g with a simple<br />
skill such as roll<str<strong>on</strong>g>in</str<strong>on</strong>g>g a ball to each other or<br />
play<str<strong>on</strong>g>in</str<strong>on</strong>g>g catch <str<strong>on</strong>g>and</str<strong>on</strong>g> gradually <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
complexity of the skill as the sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs become<br />
more skillful <str<strong>on</strong>g>and</str<strong>on</strong>g> older, such as go<str<strong>on</strong>g>in</str<strong>on</strong>g>g for a jog<br />
or shoot<str<strong>on</strong>g>in</str<strong>on</strong>g>g baskets together. Further, older<br />
typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs might enjoy<br />
learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g specific teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills so they can be<br />
the “teacher” of play (Howl<str<strong>on</strong>g>in</str<strong>on</strong>g>, 1988) <str<strong>on</strong>g>and</str<strong>on</strong>g> research<br />
has shown that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of a brother or<br />
sister with ASD can effectively implement behavior<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s (Celiberti & Harris, 1993;<br />
Schreibman, O’Neill & Koegel, 1993).<br />
Develop cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills. As stated earlier,<br />
McHale et al. (1987) <str<strong>on</strong>g>and</str<strong>on</strong>g> Orsm<strong>on</strong>d <str<strong>on</strong>g>and</str<strong>on</strong>g> Seltzer<br />
(2007) reported that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of a brother or<br />
sister with ASD who had developed effective<br />
cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies reported more positive relati<strong>on</strong>ships.<br />
Thus, typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
need effective cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills <str<strong>on</strong>g>in</str<strong>on</strong>g> order to effectively<br />
deal with the challenges that come with<br />
hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g a sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with a disability <str<strong>on</strong>g>and</str<strong>on</strong>g> to develop<br />
a more positive relati<strong>on</strong>ship with their<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with ASD.<br />
Cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies can be developed by first<br />
encourag<str<strong>on</strong>g>in</str<strong>on</strong>g>g typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs to<br />
share how they are feel<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> any c<strong>on</strong>cerns<br />
they have for their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with ASD. That is, by<br />
encourag<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs to openly discuss their<br />
feel<str<strong>on</strong>g>in</str<strong>on</strong>g>g unnecessary distress can be avoided<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs can be reassured their feel<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
are natural.<br />
Sec<strong>on</strong>d, Glasberg (2000) stated these sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
often lack <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> or are mis<str<strong>on</strong>g>in</str<strong>on</strong>g>formed<br />
about their brother’s or sister’s disability<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> that approximately <strong>on</strong>e of every<br />
five sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs claim they never heard the sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g’s<br />
diagnostic term (autism), thus provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
them with accurate age appropriate <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong><br />
about ASD can enable them to cope<br />
both <str<strong>on</strong>g>in</str<strong>on</strong>g>trapers<strong>on</strong>ally <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terpers<strong>on</strong>ally by<br />
deal<str<strong>on</strong>g>in</str<strong>on</strong>g>g more effectively with their own curiosity<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> peers’ curiosity (Howl<str<strong>on</strong>g>in</str<strong>on</strong>g>, 1988; &<br />
McHale et al., 1986).<br />
Glasperg (2000) suggested when c<strong>on</strong>sider<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
how to expla<str<strong>on</strong>g>in</str<strong>on</strong>g> the disability to sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs it is<br />
important to first assess the sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g’s cognitive<br />
level <str<strong>on</strong>g>and</str<strong>on</strong>g> to then re-present <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong><br />
throughout the sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g’s development. Further,<br />
Harris <str<strong>on</strong>g>and</str<strong>on</strong>g> Glasberg (1994) stated that<br />
very young sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs will not benefit from a<br />
detailed discussi<strong>on</strong> of ASD, but they need to<br />
be reassured about their c<strong>on</strong>cerns. Smith, Polloway,<br />
Patt<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> Dowdy (2008) stated that as<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs get older they should be provided<br />
with <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g the disability,<br />
which can be found <str<strong>on</strong>g>in</str<strong>on</strong>g> books, magaz<str<strong>on</strong>g>in</str<strong>on</strong>g>es, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
journal articles. At the same time, however as<br />
noted by Fiedler, Simps<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> Clark (2005),<br />
adults should help sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with comprehensi<strong>on</strong><br />
for most <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> is often presented<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> a manner meant for adults. Further, Smith<br />
et al. stated that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs should be <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the educati<strong>on</strong> of their brother or sister with a<br />
disability because sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs who are not <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the educati<strong>on</strong> of their brother or<br />
sister with a disability may often feel isolated<br />
or guilt about caus<str<strong>on</strong>g>in</str<strong>on</strong>g>g the disability (Meyer,<br />
2001).<br />
Third, Rivers <str<strong>on</strong>g>and</str<strong>on</strong>g> St<strong>on</strong>eman (2003) hypothesized<br />
that access<str<strong>on</strong>g>in</str<strong>on</strong>g>g social support could<br />
shield the harmful effects of stressors <strong>on</strong> the<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ship. Therefore, encourag<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs to jo<str<strong>on</strong>g>in</str<strong>on</strong>g> support<br />
groups can allow them to meet others who are<br />
go<str<strong>on</strong>g>in</str<strong>on</strong>g>g through similar experiences, share their<br />
own experiences <str<strong>on</strong>g>and</str<strong>on</strong>g> realize they are not<br />
al<strong>on</strong>e.<br />
Private special time. Meyer (2001) reported<br />
that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of a brother or sister with a disability<br />
reported feel<str<strong>on</strong>g>in</str<strong>on</strong>g>gs or resentment when<br />
their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g became the focus of the family’s<br />
attenti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> when he or she was spoiled,<br />
overprotected, <str<strong>on</strong>g>and</str<strong>on</strong>g> allowed to engage <str<strong>on</strong>g>in</str<strong>on</strong>g> behaviors<br />
that were unacceptable if d<strong>on</strong>e by another<br />
family member. Thus, <str<strong>on</strong>g>in</str<strong>on</strong>g> order to reduce<br />
resentment, perceived parental favoritism,<br />
depressi<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>crease sensitivity <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>timacy<br />
of typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs towards<br />
their brother or sister with ASD, parents<br />
should purposefully set aside private special<br />
time to spend with their typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
child when the child can be the center of<br />
attenti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> feel like a valued member of the<br />
family (Harris & Glasberg, 1994). F<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g this<br />
time may not always be easy, but parents can,<br />
for example, spilt the time between each<br />
other, spend time with the child while do<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
err<str<strong>on</strong>g>and</str<strong>on</strong>g>s, enlist <str<strong>on</strong>g>in</str<strong>on</strong>g> support from other family<br />
members such as gr<str<strong>on</strong>g>and</str<strong>on</strong>g>parents, <str<strong>on</strong>g>and</str<strong>on</strong>g> use re-<br />
ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g Relati<strong>on</strong>ships / 449
spite care for the <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual with ASD (Howl<str<strong>on</strong>g>in</str<strong>on</strong>g>,<br />
1988).<br />
Avoid unnecessary emoti<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> physical pressure.<br />
Smith et al. (2008) stated that the sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
of a brother or sister with a disability<br />
often become sec<strong>on</strong>d parents <str<strong>on</strong>g>in</str<strong>on</strong>g> the areas of<br />
care <str<strong>on</strong>g>and</str<strong>on</strong>g> discipl<str<strong>on</strong>g>in</str<strong>on</strong>g>e. As menti<strong>on</strong>ed earlier<br />
Knott et al. (1995) reported that c<strong>on</strong>cerns<br />
about the future of the sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with ASD can<br />
lead to negative sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships. Thus,<br />
parents should be c<strong>on</strong>scious of not putt<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
too much resp<strong>on</strong>sibility <strong>on</strong> typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs for support for this puts unneeded<br />
stress up<strong>on</strong> them. More specifically, parents<br />
should plan for the possibly of future residential<br />
placements of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with ASD l<strong>on</strong>g before<br />
they become too old <str<strong>on</strong>g>and</str<strong>on</strong>g> typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs should be <str<strong>on</strong>g>in</str<strong>on</strong>g>volved <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
process, but not feel obligated for future care<br />
(Howl<str<strong>on</strong>g>in</str<strong>on</strong>g>, 1988).<br />
Future Research Areas<br />
The <str<strong>on</strong>g>in</str<strong>on</strong>g>c<strong>on</strong>sistencies that are reported <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
research regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g the effects of ASD <strong>on</strong> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
relati<strong>on</strong>ships (e.g., positive vs. negative<br />
relati<strong>on</strong>ships) seem <str<strong>on</strong>g>in</str<strong>on</strong>g>evitable because of <str<strong>on</strong>g>in</str<strong>on</strong>g>terven<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
variables such as the family envir<strong>on</strong>ment<br />
(e.g., ec<strong>on</strong>omic, educati<strong>on</strong>al status,<br />
number, age, <str<strong>on</strong>g>and</str<strong>on</strong>g> gender of children <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
family, presence or absence of stress <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
paternal relati<strong>on</strong>ship, development of cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
strategies, availability of social support) <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
the severity of the disorder of the child with<br />
ASD. However, the research literature does<br />
seem to show more negative impacts than positive<br />
impacts of hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g a sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with ASD<br />
when compared to hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g a sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with DS,<br />
DD, MR, or no disability (Bagenholm & Gillberg,<br />
1991; Hodapp & Urbano, 2007; Knott<br />
et al., 1995; Orsm<strong>on</strong>d & Seltzer, 2006; Ross &<br />
Cuskelly, 2006; Mascha & Boucher, 2006;<br />
Rivers & St<strong>on</strong>eman, 2003).<br />
Further, it appears that the majority of the<br />
studies <strong>on</strong> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with ASD<br />
group together sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs spann<str<strong>on</strong>g>in</str<strong>on</strong>g>g from the<br />
childhood to adolescence years, which may<br />
obscure the differences between these life<br />
stages. In additi<strong>on</strong>, the measurements most<br />
comm<strong>on</strong>ly used (e.g., self-reports) <str<strong>on</strong>g>in</str<strong>on</strong>g> most of<br />
the studies were dependent <strong>on</strong> the skills <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
development of the sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> parents <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
thus may not be reliable.<br />
450 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Given the status of the research f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
this area, it seems reas<strong>on</strong>able to c<strong>on</strong>clude it is<br />
not enough to just study the effects of ASD <strong>on</strong><br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships. Rather, future studies<br />
need to take a life course approach <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>sider<br />
the c<strong>on</strong>text of life stages <str<strong>on</strong>g>and</str<strong>on</strong>g> also to<br />
analyze <str<strong>on</strong>g>in</str<strong>on</strong>g> depth the effects of factors such as<br />
those discussed below.<br />
A first c<strong>on</strong>siderati<strong>on</strong> is the gender of the sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
with <str<strong>on</strong>g>and</str<strong>on</strong>g> without ASD, St<strong>on</strong>eman, Davis,<br />
Crapps, <str<strong>on</strong>g>and</str<strong>on</strong>g> Mal<strong>on</strong>e (1991) reported that<br />
older sisters with brother or sister with a disability<br />
had more care giv<str<strong>on</strong>g>in</str<strong>on</strong>g>g resp<strong>on</strong>sibilities<br />
than other sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs. Thus, it seems reas<strong>on</strong>able<br />
to ask is the sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ship <str<strong>on</strong>g>in</str<strong>on</strong>g> which <strong>on</strong>e<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g has a ASD more likely to be poor if the<br />
typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g is an older sister<br />
than if an older brother. Further, it may be<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terest<str<strong>on</strong>g>in</str<strong>on</strong>g>g to look <str<strong>on</strong>g>in</str<strong>on</strong>g>to how the relati<strong>on</strong>ship is<br />
affected if the sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs are of the same or<br />
opposite sex.<br />
A sec<strong>on</strong>d area for focus is age of the sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
with <str<strong>on</strong>g>and</str<strong>on</strong>g> without ASD. That is, future research<br />
should ask how the relati<strong>on</strong>ship is impacted if<br />
the typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g is older or<br />
younger than their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g with ASD. Brody,<br />
St<strong>on</strong>eman, Davis, <str<strong>on</strong>g>and</str<strong>on</strong>g> Crapps (1991) reported<br />
that older sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with mental retardati<strong>on</strong> can<br />
become closer with their younger typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g than if they did not have the<br />
disability, but little research is available <strong>on</strong> if<br />
this f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g would also be true of sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with<br />
ASD.<br />
Third, while it is well known that hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g a<br />
child with ASD can put stra<str<strong>on</strong>g>in</str<strong>on</strong>g> <strong>on</strong> the marital<br />
relati<strong>on</strong>ship, the questi<strong>on</strong> rema<str<strong>on</strong>g>in</str<strong>on</strong>g>s as whether<br />
this stra<str<strong>on</strong>g>in</str<strong>on</strong>g> carries over to sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships.<br />
That is, do sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs sense stress am<strong>on</strong>g parental<br />
relati<strong>on</strong>ships <str<strong>on</strong>g>and</str<strong>on</strong>g> if so are sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ship<br />
affected by negative or positive <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong><br />
am<strong>on</strong>g parents.<br />
Fourth, Trev<str<strong>on</strong>g>in</str<strong>on</strong>g>o (1979) reported that the<br />
larger the family the more the resp<strong>on</strong>sibilities<br />
for the child with a disability are dispersed<br />
am<strong>on</strong>g the family members. Thus, future research<br />
should address the affects of a larger<br />
family <strong>on</strong> relati<strong>on</strong>ships am<strong>on</strong>g typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> their brother of sister with<br />
ASD.<br />
A fifth c<strong>on</strong>cern is as menti<strong>on</strong>ed earlier cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
strategies have been found to have a positive<br />
effect <strong>on</strong> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships (McHale et al.,<br />
1986; Orsm<strong>on</strong>d & Seltzer, 2007), but strate-
gies that are the most <str<strong>on</strong>g>and</str<strong>on</strong>g> least effective for<br />
facilitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g positive relati<strong>on</strong>ships am<strong>on</strong>g typically<br />
develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> their brother or<br />
sister with ASD have not been widely documented;<br />
thus future research should address<br />
this issue.<br />
Another area of focus should be the socioec<strong>on</strong>omic<br />
status of the family. Seligmam (1983)<br />
reported that families with f<str<strong>on</strong>g>in</str<strong>on</strong>g>ancial security<br />
may experience greater difficulty meet<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
needs of their child with a disability because<br />
fewer resources are available to pay for services.<br />
Further research is needed to address<br />
whether relati<strong>on</strong>ships are more positive <str<strong>on</strong>g>in</str<strong>on</strong>g> affluent<br />
families.<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>ally, other factors that may be important<br />
are the effects of the severity of the disability,<br />
the family dynamic, <str<strong>on</strong>g>and</str<strong>on</strong>g> the cognitive abilities<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> educati<strong>on</strong>al levels of family <str<strong>on</strong>g>in</str<strong>on</strong>g>volvement.<br />
Moreover, most of the studies reported compared<br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with ASD to sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with DS<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> used <strong>on</strong>e type of assessment such as selfreports<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> this al<strong>on</strong>e is not sufficient enough<br />
to draw any clear c<strong>on</strong>clusi<strong>on</strong>s about sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
relati<strong>on</strong>ships. Thus comparis<strong>on</strong>s to other populati<strong>on</strong>s<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> other assessment method needs<br />
to be used al<strong>on</strong>g with self-reports (e.g., observati<strong>on</strong>s).<br />
Discussi<strong>on</strong><br />
The Centers for Disease C<strong>on</strong>trol <str<strong>on</strong>g>and</str<strong>on</strong>g> Preventi<strong>on</strong><br />
(CDC) (2007) released the latest prevalence<br />
figures for ASD of 1 <str<strong>on</strong>g>in</str<strong>on</strong>g> 150, which is up<br />
from the 1 <str<strong>on</strong>g>in</str<strong>on</strong>g> 166 figure reported by the CDC<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> 2004. C<strong>on</strong>sequently, it appears that hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
a brother or sister with ASD is becom<str<strong>on</strong>g>in</str<strong>on</strong>g>g more<br />
comm<strong>on</strong>. For children with ASD, a primary<br />
c<strong>on</strong>cern is the development of social competence<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> thus it seems more important than<br />
ever that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships be positive<br />
given that sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs are the most frequently<br />
available play partners (Reag<strong>on</strong>, 2006). As detailed<br />
earlier, positive support, effective cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
strategies, open discussi<strong>on</strong>, plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
sensitivity can facilitate more positive relati<strong>on</strong>ships<br />
between typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs with ASD.<br />
References<br />
American Psychiatric Associati<strong>on</strong>. (2000). Diagnostic<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> statistical manual of mental disorders (4 th ed.)<br />
Wash<str<strong>on</strong>g>in</str<strong>on</strong>g>gt<strong>on</strong>, DC.<br />
Bagenholm, A., & Gillberg, C. (1991). Psychosocial<br />
effects <strong>on</strong> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of children with autism <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
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Received: 10 July 2008<br />
Initial Acceptance: 14 September 2008<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>al Acceptance: 4 November 2008
Impacts of Family Support <str<strong>on</strong>g>in</str<strong>on</strong>g> Early Childhood<br />
Interventi<strong>on</strong> Research<br />
Anna C. Friend<br />
Pittsburg State University<br />
Jean Ann Summers <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Ann P. Turnbull<br />
University of Kansas<br />
Abstract: The purpose of this paper is to review <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e the types of family support that<br />
are reported <str<strong>on</strong>g>and</str<strong>on</strong>g> evaluated <str<strong>on</strong>g>in</str<strong>on</strong>g> early childhood. This review <str<strong>on</strong>g>in</str<strong>on</strong>g>cludes 26 articles evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g (a) parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
programs; (b) general family-centered practice models which offer comprehensive supports; (c) peer support;<br />
(d) two-generati<strong>on</strong> programs; <str<strong>on</strong>g>and</str<strong>on</strong>g> (e) respite care. In the article, we focus our discussi<strong>on</strong> <strong>on</strong>: (a) the def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s<br />
or descripti<strong>on</strong> of family support, (b) the family variables or impacts evaluated <str<strong>on</strong>g>and</str<strong>on</strong>g> their f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, <str<strong>on</strong>g>and</str<strong>on</strong>g> (c) the<br />
l<str<strong>on</strong>g>in</str<strong>on</strong>g>k between support <str<strong>on</strong>g>and</str<strong>on</strong>g> impacts to both the ECO outcomes <str<strong>on</strong>g>and</str<strong>on</strong>g> the family quality of life doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s. This review<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dicates a need for specific <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>sistent term<str<strong>on</strong>g>in</str<strong>on</strong>g>ology <str<strong>on</strong>g>in</str<strong>on</strong>g> def<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g family support <str<strong>on</strong>g>in</str<strong>on</strong>g> the early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> field.<br />
Further, a family support framework to guide future research to <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigate both l<strong>on</strong>g-term <str<strong>on</strong>g>and</str<strong>on</strong>g> short-term<br />
outcomes for families is warranted.<br />
Over the past decade, early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>ists<br />
have recognized that work<str<strong>on</strong>g>in</str<strong>on</strong>g>g with families <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
a broader scope by provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g supports to families<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> children impacts not <strong>on</strong>ly the child’s<br />
development, but the family’s ability to help<br />
the child grow <str<strong>on</strong>g>and</str<strong>on</strong>g> develop (Bailey et al.,<br />
1998; Bailey & Bruder, 2005; S<str<strong>on</strong>g>and</str<strong>on</strong>g>all, Hemmeter,<br />
Smith, & McLean, 2005). Further, the<br />
statutory underly<str<strong>on</strong>g>in</str<strong>on</strong>g>g premise of early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
services for children with disabilities is “to<br />
enhance the capacity of families to meet the<br />
special needs of their <str<strong>on</strong>g>in</str<strong>on</strong>g>fants <str<strong>on</strong>g>and</str<strong>on</strong>g> toddlers<br />
with disabilities” (Individuals with <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Act Amendments of 2004, Title I,<br />
Part C, Sec. 631(a)(4)), thus strengthen<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the role of the family as the primary caregiver.<br />
Family-centered practice is def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed us<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
two primary facets. The first facet is the partnerships<br />
that are developed between professi<strong>on</strong>als<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> parents that culm<str<strong>on</strong>g>in</str<strong>on</strong>g>ate <str<strong>on</strong>g>in</str<strong>on</strong>g> empower<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the family to make decisi<strong>on</strong>s for their<br />
child (Allen & Petr, 1996; Bailey et al., 1998;<br />
Mah<strong>on</strong>ey et al., 1999; Turnbull, Turbiville, &<br />
Turnbull, 2000). The sec<strong>on</strong>d facet specifies<br />
that the family itself is a recipient of supports<br />
for two reas<strong>on</strong>s: because it helps children<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g this article should<br />
be addressed to Anna Friend, 2900 West 51st Street,<br />
Westwood, KS 66205.<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, 2009, 44(4), 453–470<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
grow <str<strong>on</strong>g>and</str<strong>on</strong>g> learn <str<strong>on</strong>g>and</str<strong>on</strong>g> because families are impacted<br />
by their child’s disability <str<strong>on</strong>g>and</str<strong>on</strong>g> are <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
need of supports <str<strong>on</strong>g>in</str<strong>on</strong>g> their own right (Allen &<br />
Petr, 1996; Mah<strong>on</strong>ey et al., 1999; Post<strong>on</strong> et al.,<br />
2003). (We are us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the term, family support,<br />
to refer to assistance provided through formal<br />
systems (e.g., early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> programs)<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>formal networks (e.g., peer support).<br />
This article focuses <strong>on</strong> the nature of family<br />
support as c<strong>on</strong>trasted to the nature of partnerships<br />
between professi<strong>on</strong>als <str<strong>on</strong>g>and</str<strong>on</strong>g> parents).<br />
This sec<strong>on</strong>d facet of family-centered services is<br />
the focus of this paper.<br />
The family as a recipient of support has<br />
received less emphasis than the relati<strong>on</strong>ship<br />
facet of family-centered practice. In an analysis<br />
of early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> literature, family<br />
choice <str<strong>on</strong>g>and</str<strong>on</strong>g> family strengths perspectives have<br />
dom<str<strong>on</strong>g>in</str<strong>on</strong>g>ated the literature <str<strong>on</strong>g>in</str<strong>on</strong>g> comparis<strong>on</strong> with<br />
the delivery of support to the family (Epley,<br />
2006). In 25 articles, def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded the<br />
family as a unit of attenti<strong>on</strong> <strong>on</strong>ly 60% of the<br />
time; while 88% of the articles identified how<br />
to provide support to families, <strong>on</strong>ly 42% identified<br />
what types of support should be provided<br />
to families <str<strong>on</strong>g>in</str<strong>on</strong>g> early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. Although<br />
positi<strong>on</strong> papers <str<strong>on</strong>g>and</str<strong>on</strong>g> commentary have<br />
rema<str<strong>on</strong>g>in</str<strong>on</strong>g>ed str<strong>on</strong>g <str<strong>on</strong>g>in</str<strong>on</strong>g> advocat<str<strong>on</strong>g>in</str<strong>on</strong>g>g the importance<br />
of establish<str<strong>on</strong>g>in</str<strong>on</strong>g>g partnerships with families<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g empower<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>-<br />
Impacts of Family Support / 453
ships—the how of early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>—there<br />
has been relatively less emphasis <strong>on</strong> the whole<br />
family as a unit of attenti<strong>on</strong> (Epley), <str<strong>on</strong>g>and</str<strong>on</strong>g> more<br />
specifically, <strong>on</strong> the delivery of support to families<br />
to “enhance their capacity”, as the law<br />
puts it.<br />
An underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g of the types of support,<br />
both formal <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>formal, families receive is<br />
particularly important due to recent efforts to<br />
develop outcome measures related to children<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> families <str<strong>on</strong>g>in</str<strong>on</strong>g> early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
early childhood special educati<strong>on</strong>. In 2005,<br />
the Early Childhood Outcome (ECO) Center<br />
recommended five family outcomes that apply<br />
to early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> early childhood<br />
educati<strong>on</strong>. The ECO Center def<str<strong>on</strong>g>in</str<strong>on</strong>g>es family<br />
outcome as “a benefit experienced as a result<br />
of services received” (Bailey & Bruder, 2005).<br />
The five outcomes are (a) families underst<str<strong>on</strong>g>and</str<strong>on</strong>g><br />
their children’s strengths, abilities <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
special needs, (b) families know their rights<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> advocate effectively for their children,<br />
(c) families help their children learn <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
grow, (d) families have support systems, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
(e) families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g> access to desired<br />
services, programs, <str<strong>on</strong>g>and</str<strong>on</strong>g> activities <str<strong>on</strong>g>in</str<strong>on</strong>g> their community<br />
(Bailey et al., 2006).<br />
Another more l<strong>on</strong>g-term outcome of these<br />
specific ECO outcomes is family quality of<br />
life (Summers et al., 2005). Family quality of<br />
life is a c<strong>on</strong>diti<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> which family needs are<br />
be<str<strong>on</strong>g>in</str<strong>on</strong>g>g met, family members enjoy their life<br />
together <str<strong>on</strong>g>and</str<strong>on</strong>g> have an opportunity to participate<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the activities that are important to<br />
them (Park et al., 2003). Based <strong>on</strong> psychometric<br />
studies, family quality of life is comprised<br />
of five doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s: family <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>, parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g, physical/material wellbe<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> disability-related support (Hoffman,<br />
Marquis, Post<strong>on</strong>, Summers, & Turnbull,<br />
2006). The Beach Center <strong>on</strong> Disability def<str<strong>on</strong>g>in</str<strong>on</strong>g>es<br />
family outcomes as either positive or negative<br />
impacts that families may experience as a result<br />
of supports <str<strong>on</strong>g>and</str<strong>on</strong>g> services for themselves<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g>/or their children with disabilities (Mannan,<br />
Summer, Turnbull, & Post<strong>on</strong>, 2006)<br />
which can be measured us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the family quality<br />
of life doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s. However, <str<strong>on</strong>g>in</str<strong>on</strong>g> additi<strong>on</strong> to<br />
assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g family outcomes, it is critical to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
what specific support families are receiv<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> order to l<str<strong>on</strong>g>in</str<strong>on</strong>g>k those services to the<br />
proposed outcomes.<br />
An underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g of the specific services<br />
454 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
that are l<str<strong>on</strong>g>in</str<strong>on</strong>g>ked to family outcomes might be<br />
found <str<strong>on</strong>g>in</str<strong>on</strong>g> the Individuals with <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g><br />
Act (IDEA). Part C of IDEA governs<br />
the manner <str<strong>on</strong>g>in</str<strong>on</strong>g> which <str<strong>on</strong>g>in</str<strong>on</strong>g>fants <str<strong>on</strong>g>and</str<strong>on</strong>g> toddlers with<br />
disabilities <str<strong>on</strong>g>and</str<strong>on</strong>g> their families receive educati<strong>on</strong>al<br />
services from public agencies. Early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
services are def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed as “developmental<br />
services that are designed to meet the<br />
developmental needs of an <str<strong>on</strong>g>in</str<strong>on</strong>g>fant or toddler<br />
with a disability, as identified by the <str<strong>on</strong>g>in</str<strong>on</strong>g>dividualized<br />
family service plan team” (Individuals<br />
with <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Act Amendments<br />
of 2004, Title 20, Part C, Sec. 1432(4)(C)).<br />
The family support <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <strong>on</strong> the IFSP<br />
should promote physical, cognitive, communicati<strong>on</strong>,<br />
social/emoti<strong>on</strong>al, <str<strong>on</strong>g>and</str<strong>on</strong>g> adaptive development<br />
of the child. With<str<strong>on</strong>g>in</str<strong>on</strong>g> the statute, the<br />
follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g developmental services are listed:<br />
family tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g, counsel<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> home visits;<br />
special <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>; speech-language pathology<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> audiology services <str<strong>on</strong>g>and</str<strong>on</strong>g> sign language<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> cued sign language services; occupati<strong>on</strong>al<br />
therapy; physical therapy; psychological services;<br />
service coord<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> services; medical<br />
services <strong>on</strong>ly for diagnostic or evaluati<strong>on</strong> purposes;<br />
early identificati<strong>on</strong>, screen<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>and</str<strong>on</strong>g> assessment<br />
services; health services necessary to<br />
enable the <str<strong>on</strong>g>in</str<strong>on</strong>g>fant or toddler to benefit from<br />
the other early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> services; social<br />
work services; visi<strong>on</strong> services; assistive technology<br />
devices <str<strong>on</strong>g>and</str<strong>on</strong>g> assistive technology services;<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> transportati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> related costs that are<br />
necessary to enable an <str<strong>on</strong>g>in</str<strong>on</strong>g>fant or toddler <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
the <str<strong>on</strong>g>in</str<strong>on</strong>g>fant’s or toddler’s family to receive <strong>on</strong>e<br />
of these services (Individuals with <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Act Amendments of 2004, Title I,<br />
Part C, Sec. 1432(4)(E)).<br />
However, it is not clear just what this list of<br />
services means <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of what specific support<br />
is delivered to families, as opposed to<br />
child-oriented services. Further c<strong>on</strong>cern is<br />
raised by a review of data c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g types of<br />
family support <strong>on</strong> IFSPs. In review<str<strong>on</strong>g>in</str<strong>on</strong>g>g data<br />
reported by states regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g the number <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
percentage of early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> services reported<br />
<strong>on</strong> IFSPs for children ages 0–2 under<br />
Part C of IDEA, family support has been <strong>on</strong> a<br />
downward trend over the past decade (Danaher<br />
& Armijo, 2005). For example, family<br />
tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g, counsel<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> home visits; health<br />
services; medical services; respite care; social<br />
work services; <str<strong>on</strong>g>and</str<strong>on</strong>g> transportati<strong>on</strong> are early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
services that have decreased <str<strong>on</strong>g>in</str<strong>on</strong>g>
numbers as reported by IFSP data (Danaher &<br />
Armijo). The excepti<strong>on</strong>s to this appear to be<br />
services that are child-focused, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g occupati<strong>on</strong>al<br />
therapy, physical therapy, special<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> speech <str<strong>on</strong>g>and</str<strong>on</strong>g> language pathology,<br />
which are rema<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g c<strong>on</strong>sistent or <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> number (Danaher & Armijo).<br />
However, problems with this data set <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate<br />
that states <str<strong>on</strong>g>and</str<strong>on</strong>g> local programs may be def<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
these services differently, <str<strong>on</strong>g>and</str<strong>on</strong>g> family support<br />
may be occurr<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> the c<strong>on</strong>text of other def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
services (J. Hurth, pers<strong>on</strong>al communicati<strong>on</strong>,<br />
January 23, 2006). It is not clear whether<br />
these f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate an actual decl<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
emphasis or amounts of support provided to<br />
families. It is possible that early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>ists<br />
are serv<str<strong>on</strong>g>in</str<strong>on</strong>g>g families <str<strong>on</strong>g>in</str<strong>on</strong>g> a variety of ways that<br />
are not captured <str<strong>on</strong>g>in</str<strong>on</strong>g> the data. Also, it may be<br />
that def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s of family support are not c<strong>on</strong>sistent<br />
with the actual types of support families<br />
are receiv<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Another possible source of <str<strong>on</strong>g>in</str<strong>on</strong>g>sight <str<strong>on</strong>g>in</str<strong>on</strong>g>to the<br />
types of support families receive <str<strong>on</strong>g>in</str<strong>on</strong>g> the c<strong>on</strong>text<br />
of early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> might be found <str<strong>on</strong>g>in</str<strong>on</strong>g> literature<br />
describ<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g early childhood<br />
service models. Interventi<strong>on</strong> research<br />
may <str<strong>on</strong>g>in</str<strong>on</strong>g>clude descripti<strong>on</strong>s of types of family<br />
support <str<strong>on</strong>g>and</str<strong>on</strong>g> related outcomes of this support.<br />
The purpose of this paper is to focus <strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
research <str<strong>on</strong>g>and</str<strong>on</strong>g> evaluati<strong>on</strong> to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
the types of family support that are reported<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> evaluated <str<strong>on</strong>g>in</str<strong>on</strong>g> descripti<strong>on</strong>s of early childhood<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research. The specific questi<strong>on</strong>s<br />
guid<str<strong>on</strong>g>in</str<strong>on</strong>g>g this literature review were:<br />
1. What types of family-related support are<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> evaluati<strong>on</strong>s of early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
programs?<br />
2. How are families impacted by the provisi<strong>on</strong><br />
of family support?<br />
3. What specific family outcomes appear to<br />
be related to these family impacts?<br />
Method<br />
We c<strong>on</strong>ducted a literature search for <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
studies <str<strong>on</strong>g>in</str<strong>on</strong>g> the field of early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> early childhood, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g programs designed<br />
both specifically for families <str<strong>on</strong>g>and</str<strong>on</strong>g> children<br />
with disabilities <str<strong>on</strong>g>and</str<strong>on</strong>g> for families <str<strong>on</strong>g>and</str<strong>on</strong>g> children<br />
c<strong>on</strong>sidered “at risk” for disabilities (e.g.,<br />
programs serv<str<strong>on</strong>g>in</str<strong>on</strong>g>g low-<str<strong>on</strong>g>in</str<strong>on</strong>g>come families or adolescent<br />
parents). “At risk” children <str<strong>on</strong>g>and</str<strong>on</strong>g> fami-<br />
lies were <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> the populati<strong>on</strong> for this<br />
paper because there were a limited number of<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research articles devoted <strong>on</strong>ly to<br />
families <str<strong>on</strong>g>and</str<strong>on</strong>g> children with disabilities <str<strong>on</strong>g>in</str<strong>on</strong>g> early<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. Therefore, the <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigator exp<str<strong>on</strong>g>and</str<strong>on</strong>g>ed<br />
the search to <str<strong>on</strong>g>in</str<strong>on</strong>g>clude the “at risk”<br />
populati<strong>on</strong> to provide <str<strong>on</strong>g>in</str<strong>on</strong>g>sight <str<strong>on</strong>g>in</str<strong>on</strong>g>to more types<br />
of family-oriented services <str<strong>on</strong>g>in</str<strong>on</strong>g> the early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
field.<br />
The literature search used the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g descriptors<br />
to capture the populati<strong>on</strong> of <str<strong>on</strong>g>in</str<strong>on</strong>g>terest:<br />
early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, early childhood, preschool,<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>fant <str<strong>on</strong>g>and</str<strong>on</strong>g> toddlers, families <str<strong>on</strong>g>and</str<strong>on</strong>g> disabilities.<br />
The search <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g key words:<br />
family outcomes, family services <str<strong>on</strong>g>and</str<strong>on</strong>g> supports,<br />
family centered services, family <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>,<br />
parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g, parent to parent, parental<br />
stress, parental depressi<strong>on</strong>, parent educati<strong>on</strong>,<br />
respite care, rout<str<strong>on</strong>g>in</str<strong>on</strong>g>es-based <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>,<br />
home visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g, family counsel<str<strong>on</strong>g>in</str<strong>on</strong>g>g, relati<strong>on</strong>ship<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, advocacy, social supports, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
support groups. The search also <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded specific<br />
names of authors known as <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigators<br />
of family issues <str<strong>on</strong>g>in</str<strong>on</strong>g> the field, e.g., Bailey,<br />
Bruder, Dunst, McWilliam, Kaiser, Fewell, Mah<strong>on</strong>ey,<br />
Ramey, <str<strong>on</strong>g>and</str<strong>on</strong>g> S<str<strong>on</strong>g>in</str<strong>on</strong>g>ger. These key words,<br />
author names, <str<strong>on</strong>g>and</str<strong>on</strong>g> descriptors were used to<br />
search five primary databases: Psych-INFO,<br />
PubMed, ERIC, <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>al Abstracts, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Wils<strong>on</strong> Web. Further, we searched websites of<br />
specific nati<strong>on</strong>al organizati<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> the field of<br />
early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> to identify <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
studies. Those websites <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded Parents as<br />
Teachers (PAT), Early Childhood Outcomes<br />
C<strong>on</strong>sortium (ECO), <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> of Early Childhood<br />
(DEC), Office of Special <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g><br />
(OSEP), Adm<str<strong>on</strong>g>in</str<strong>on</strong>g>istrati<strong>on</strong> of Children <str<strong>on</strong>g>and</str<strong>on</strong>g> Families<br />
(ACF), Nati<strong>on</strong>al Early Childhood Technical<br />
Assistance Center (NECTAC), <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
Nati<strong>on</strong>al Associati<strong>on</strong> of Councils of <str<strong>on</strong>g>Developmental</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> (NACDD).<br />
Studies selected for this article were limited<br />
to those published with<str<strong>on</strong>g>in</str<strong>on</strong>g> the last decade from<br />
the date of the first search <str<strong>on</strong>g>in</str<strong>on</strong>g> 2005. Studies<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> this paper used r<str<strong>on</strong>g>and</str<strong>on</strong>g>omized c<strong>on</strong>trolled<br />
designs, meta-analyses, l<strong>on</strong>gitud<str<strong>on</strong>g>in</str<strong>on</strong>g>al<br />
designs, quasi-experimental designs, pilot<br />
studies, pretest/posttest experimental designs,<br />
path analysis, <str<strong>on</strong>g>and</str<strong>on</strong>g> correlati<strong>on</strong> designs.<br />
Literature reviews <str<strong>on</strong>g>and</str<strong>on</strong>g> meta-analyses were <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded,<br />
especially <str<strong>on</strong>g>in</str<strong>on</strong>g> the case of research evaluati<strong>on</strong>s<br />
with a very large literature base (such<br />
as home visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g programs). Studies that <str<strong>on</strong>g>in</str<strong>on</strong>g>ves-<br />
Impacts of Family Support / 455
tigated the effectiveness of commercially available<br />
programs <str<strong>on</strong>g>and</str<strong>on</strong>g> materials were excluded.<br />
Articles were collected from literature across<br />
all disability-related discipl<str<strong>on</strong>g>in</str<strong>on</strong>g>es, but did not<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>clude those studies narrowly focused <strong>on</strong> specific<br />
services listed <str<strong>on</strong>g>in</str<strong>on</strong>g> IDEA that are child focused,<br />
such as speech, OT, PT, special <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> assessment or diagnostic test<str<strong>on</strong>g>in</str<strong>on</strong>g>g. The<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> studies were restricted to families<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> children from the ages of birth to 8, with<br />
the excepti<strong>on</strong> of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> studies regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
respite care <str<strong>on</strong>g>and</str<strong>on</strong>g> peer support which<br />
reflect families <str<strong>on</strong>g>and</str<strong>on</strong>g> children with developmental<br />
disabilities of all ages. The reas<strong>on</strong> for<br />
this excepti<strong>on</strong> was that we were not able to<br />
locate studies <strong>on</strong> respite care or peer support<br />
that were focused <strong>on</strong> the early childhood age<br />
range. Some of the programs reviewed were<br />
evaluati<strong>on</strong>s that were specifically focused <strong>on</strong><br />
family support, e.g., respite care <str<strong>on</strong>g>and</str<strong>on</strong>g> peer supports<br />
(Parent to Parent); the majority, however,<br />
were general early childhood <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
that <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded some family support<br />
comp<strong>on</strong>ent <str<strong>on</strong>g>in</str<strong>on</strong>g> the c<strong>on</strong>text of provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
for children. S<str<strong>on</strong>g>in</str<strong>on</strong>g>ce the focus of this<br />
paper was to identify <str<strong>on</strong>g>and</str<strong>on</strong>g> def<str<strong>on</strong>g>in</str<strong>on</strong>g>e the types of<br />
support to families that are typically <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> such early childhood <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s, these<br />
studies were of particular <str<strong>on</strong>g>in</str<strong>on</strong>g>terest.<br />
The articles collected based <strong>on</strong> the above<br />
criteria were <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> the f<str<strong>on</strong>g>in</str<strong>on</strong>g>al review<br />
based up<strong>on</strong> three stipulati<strong>on</strong>s. First, the article<br />
needed to have specified a clear <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
or <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s related to the area of early<br />
childhood that was “tested” through an empirical<br />
research design. Sec<strong>on</strong>d, at least <strong>on</strong>e aspect<br />
of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> needed to target parents<br />
or family members. Third, the results of<br />
the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research needed a comp<strong>on</strong>ent<br />
of measurement regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g how the parents<br />
or family members resp<strong>on</strong>ded to the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> questi<strong>on</strong>. Based <strong>on</strong> all, we<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded a total of 26 articles <str<strong>on</strong>g>in</str<strong>on</strong>g> this review.<br />
Results<br />
Table 1 presents a synthesis of these 26 articles.<br />
The <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> studies reflect <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
models <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g studies of support<br />
for families that were part of evaluati<strong>on</strong>s of:<br />
(a) parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g programs; (b) general<br />
family-centered practice models which offer<br />
comprehensive support, which may <str<strong>on</strong>g>in</str<strong>on</strong>g>clude<br />
counsel<str<strong>on</strong>g>in</str<strong>on</strong>g>g, parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills, respite care,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g>/or support groups; (c) peer supports;<br />
(d) two- generati<strong>on</strong> programs; <str<strong>on</strong>g>and</str<strong>on</strong>g> (e) respite<br />
care. The follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g secti<strong>on</strong>s summarize the<br />
f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of this review related to each of these<br />
types of family support. The columns <str<strong>on</strong>g>in</str<strong>on</strong>g> Table<br />
1 describe the type of family support provided,<br />
a brief summary of results perta<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
to families, our judgment of the specific family<br />
outcomes represented <str<strong>on</strong>g>in</str<strong>on</strong>g> the study <str<strong>on</strong>g>in</str<strong>on</strong>g> terms<br />
of both ECO Center <str<strong>on</strong>g>and</str<strong>on</strong>g> FQOL family outcomes,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> the reference. Because of the<br />
focus <strong>on</strong> family support <str<strong>on</strong>g>in</str<strong>on</strong>g> this article, we<br />
omitted descripti<strong>on</strong>s of specific child measurements,<br />
results, <str<strong>on</strong>g>and</str<strong>on</strong>g> outcomes.<br />
In each of the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g secti<strong>on</strong>s we will<br />
discuss the three primary questi<strong>on</strong>s for this<br />
review: (a) the def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s or descripti<strong>on</strong>s of<br />
the types of support families receive, (b) the<br />
types of family variables or impacts <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the research or evaluati<strong>on</strong> design <str<strong>on</strong>g>and</str<strong>on</strong>g> their<br />
f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, <str<strong>on</strong>g>and</str<strong>on</strong>g> (c) a categorizati<strong>on</strong> of the l<str<strong>on</strong>g>in</str<strong>on</strong>g>k<br />
of these types of supports <str<strong>on</strong>g>and</str<strong>on</strong>g> impacts to both<br />
the ECO outcomes <str<strong>on</strong>g>and</str<strong>on</strong>g> the family quality of<br />
life (FQOL) doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s as <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated by the results<br />
of the evaluati<strong>on</strong>.<br />
Parent <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> Programs<br />
456 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g programs encompass <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
research that is specifically focused <strong>on</strong><br />
provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g to improve <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s<br />
between parents <str<strong>on</strong>g>and</str<strong>on</strong>g> their children. The<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> studies <str<strong>on</strong>g>in</str<strong>on</strong>g> Table 1 were focused<br />
<strong>on</strong> specific areas of parent educati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g>/or a<br />
specific populati<strong>on</strong>: family-<str<strong>on</strong>g>in</str<strong>on</strong>g>fant <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> home envir<strong>on</strong>ment (Bakermans-Kranenburg,<br />
van Ijzendoorn, & Bradley, 2005); father<br />
empowerment to improve parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g (Fagan &<br />
Stevens<strong>on</strong>, 2002); home-based parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
program <str<strong>on</strong>g>and</str<strong>on</strong>g> support group (Kucuker, 2006);<br />
skill-build<str<strong>on</strong>g>in</str<strong>on</strong>g>g groups to improve parental wellbe<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> family <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong> (Niccols & Mohamed,<br />
2000); parent management tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
to reduce behavior problems (Roberts, Mazzucchelli,<br />
Taylor, & Reid, 2003); Parents As<br />
Teachers programs (Wagner & Spiker, June<br />
2001); <str<strong>on</strong>g>and</str<strong>on</strong>g> deaf mentor program for parents<br />
to improve <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s with their children<br />
who are deaf (Watk<str<strong>on</strong>g>in</str<strong>on</strong>g>s, Pittman, & Walden,<br />
1998). Some of these <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s were offered<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the c<strong>on</strong>text of a home visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g model,<br />
while others were provided <str<strong>on</strong>g>in</str<strong>on</strong>g> group sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs.
TABLE 1<br />
Family Support Identified <str<strong>on</strong>g>in</str<strong>on</strong>g> the Interventi<strong>on</strong> Literature<br />
References/Support Identified Results Outcomes<br />
Bakermans-Kranenburg,<br />
M. J., van Ijzendoorn,<br />
M. H., & Bradley,<br />
R. H. (2005)<br />
Meta-analysis of early<br />
childhood <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
studies aimed at<br />
parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g or parentchild<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong> us<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the HOME assessment.<br />
(U.S. & <str<strong>on</strong>g>in</str<strong>on</strong>g>ternati<strong>on</strong>al)<br />
Fagan, J., & Stevens<strong>on</strong>,<br />
H. C. (2002)<br />
Parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g for<br />
fathers.<br />
Kucuker, S. (2006)<br />
Early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
program, to enhance<br />
the development of<br />
children with<br />
disabilities ages 0–4<br />
through a parent<br />
tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g program<br />
(Turkey)<br />
Niccols, A., & Mohamed, S.<br />
(2000)<br />
Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g skill build<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
group focused <strong>on</strong><br />
attachment theory for<br />
parents of <str<strong>on</strong>g>in</str<strong>on</strong>g>fants with<br />
developmental delays<br />
Type of <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> mode: Parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> programs<br />
1. Interventi<strong>on</strong>s with middle-class, n<strong>on</strong>adolescent<br />
parents reported higher effect<br />
sizes than <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s with low-SES or<br />
adolescent parents.<br />
2. Five to 16 home-based <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
sessi<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> a limited period were most<br />
effective.<br />
3. Interventi<strong>on</strong>s start<str<strong>on</strong>g>in</str<strong>on</strong>g>g when the child was<br />
older than 6 m<strong>on</strong>ths or started prenatally<br />
were more effective than <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
start<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> the first 6 m<strong>on</strong>ths of the<br />
child’s life.<br />
1. Resident fathers (those who live at home)<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g group reported<br />
significantly greater self-esteem at the end<br />
of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> comparis<strong>on</strong> to<br />
resident fathers <str<strong>on</strong>g>in</str<strong>on</strong>g> the c<strong>on</strong>trol group.<br />
2. Resident fathers <str<strong>on</strong>g>in</str<strong>on</strong>g> the parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
group showed significant improvement <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g satisfacti<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> comparis<strong>on</strong> to<br />
resident fathers <str<strong>on</strong>g>in</str<strong>on</strong>g> the c<strong>on</strong>trol group.<br />
3. All fathers <str<strong>on</strong>g>in</str<strong>on</strong>g> the parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g group<br />
made significantly greater ga<str<strong>on</strong>g>in</str<strong>on</strong>g>s than<br />
fathers <str<strong>on</strong>g>in</str<strong>on</strong>g> the c<strong>on</strong>trol group <str<strong>on</strong>g>in</str<strong>on</strong>g> their<br />
attitudes about facilitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g the teach<str<strong>on</strong>g>in</str<strong>on</strong>g>glearn<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
process for their child.<br />
1. The severity of depressi<strong>on</strong> scores for both<br />
mothers <str<strong>on</strong>g>and</str<strong>on</strong>g> fathers had decreased after<br />
participat<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> the early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
program with parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
2. There were no differences reported <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
parental stress scores.<br />
1. Parents <str<strong>on</strong>g>in</str<strong>on</strong>g> the skill-build<str<strong>on</strong>g>in</str<strong>on</strong>g>g group<br />
reported statistically significant lower<br />
levels of parent-child dysfuncti<strong>on</strong>al<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>, parental distress, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
depressi<strong>on</strong>.<br />
2. Parents <str<strong>on</strong>g>in</str<strong>on</strong>g> the comparis<strong>on</strong> groups showed<br />
a trend towards <str<strong>on</strong>g>in</str<strong>on</strong>g>creased depressi<strong>on</strong>.<br />
3. Parents <str<strong>on</strong>g>in</str<strong>on</strong>g> the skill-build<str<strong>on</strong>g>in</str<strong>on</strong>g>g group<br />
reported high satisfacti<strong>on</strong>, high<br />
effectiveness of the c<strong>on</strong>tent. <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>creased<br />
support from others.<br />
4. The majority of parents <str<strong>on</strong>g>in</str<strong>on</strong>g> the skillbuild<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
group (75%) chose c<strong>on</strong>sultati<strong>on</strong><br />
as their preferred follow-up service<br />
opti<strong>on</strong>.<br />
ECO outcomes<br />
● Families help their<br />
child learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
FQOL Outcomes<br />
● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
ECO outcomes<br />
● Families help their<br />
child learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
● Families have support<br />
systems<br />
FQOL Outcomes<br />
● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
ECO outcomes<br />
● Families help their<br />
child learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
● Families have support<br />
systems<br />
FQOL Outcomes<br />
● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
ECO outcomes<br />
● Families underst<str<strong>on</strong>g>and</str<strong>on</strong>g><br />
their child’s strengths,<br />
abilities <str<strong>on</strong>g>and</str<strong>on</strong>g> special<br />
needs<br />
● Families help their<br />
child learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
● Families have support<br />
systems<br />
FQOL Outcomes<br />
● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Impacts of Family Support / 457
TABLE 1—(C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued)<br />
References/Support Identified Results Outcomes<br />
Roberts, C. et al. (2003)<br />
Parent management<br />
tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g—review of<br />
studies for parents of<br />
preschool-aged<br />
children with<br />
developmental<br />
disabilities (U.S. &<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>ternati<strong>on</strong>al)<br />
Wagner, M., & Spiker, D.<br />
(June 2001)<br />
Evaluati<strong>on</strong> of Parents as<br />
Teachers (PAT)—<br />
home visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g model<br />
Watk<str<strong>on</strong>g>in</str<strong>on</strong>g>s, S. et al. (1998)<br />
Parent mentor groups<br />
1. Comprehensive early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> programs<br />
aimed at skill build<str<strong>on</strong>g>in</str<strong>on</strong>g>g through Applied<br />
Behavior Analysis, Parent Management<br />
<str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g>, <str<strong>on</strong>g>and</str<strong>on</strong>g> social learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g theory have<br />
dem<strong>on</strong>strated positive outcomes for build<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
competencies <str<strong>on</strong>g>and</str<strong>on</strong>g> reduc<str<strong>on</strong>g>in</str<strong>on</strong>g>g behavior problems.<br />
2. Studies us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a group <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> format of<br />
PMT <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated some positive effects <strong>on</strong> child<br />
behavior, parental stress, parental self-efficacy,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> marital satisfacti<strong>on</strong>.<br />
3. Studies with <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual families <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate some<br />
support for generalizati<strong>on</strong> of effects to other<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> behaviors.<br />
ECO outcomes<br />
● Families help their child<br />
learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
FQOL Outcomes<br />
● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
1. The very low <str<strong>on</strong>g>in</str<strong>on</strong>g>come group had more positive ECO outcomes<br />
effects than the moderate <str<strong>on</strong>g>in</str<strong>on</strong>g>come group <str<strong>on</strong>g>in</str<strong>on</strong>g> the ● Families help their child<br />
area of language <str<strong>on</strong>g>and</str<strong>on</strong>g> literacy promot<str<strong>on</strong>g>in</str<strong>on</strong>g>g learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
behaviors.<br />
FQOL Outcomes<br />
2. PAT families reported be<str<strong>on</strong>g>in</str<strong>on</strong>g>g happier tak<str<strong>on</strong>g>in</str<strong>on</strong>g>g ● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
care of their families.<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
3. After three years, PAT teen mothers had more<br />
knowledge, greater literacy promot<str<strong>on</strong>g>in</str<strong>on</strong>g>g behaviors<br />
<strong>on</strong> HOME, less reports of child maltreatment,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>creased positive home envir<strong>on</strong>ment<br />
compared to the c<strong>on</strong>trol group.<br />
1. Parents of the children <str<strong>on</strong>g>in</str<strong>on</strong>g> the deaf mentor ECO outcomes<br />
group reported that they understood what the ● Families underst<str<strong>on</strong>g>and</str<strong>on</strong>g> their<br />
child was communicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g to them a greater child’s strengths, abilities<br />
percentage of the time than parents <str<strong>on</strong>g>in</str<strong>on</strong>g> the <str<strong>on</strong>g>and</str<strong>on</strong>g> special needs<br />
c<strong>on</strong>trol group.<br />
FQOL Outcomes<br />
2. Parents <str<strong>on</strong>g>in</str<strong>on</strong>g> the deaf mentor group reported that ● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
their children understood them a greater ● Disability-related support<br />
percentage of the time than the parents of the<br />
c<strong>on</strong>trol group.<br />
3. Parents <str<strong>on</strong>g>in</str<strong>on</strong>g> the deaf mentor group reported less<br />
frustrati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>creased number of signs when<br />
communicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g with their child.<br />
4. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, parents <str<strong>on</strong>g>in</str<strong>on</strong>g> the deaf<br />
mentor group were observed <str<strong>on</strong>g>in</str<strong>on</strong>g> videotaped<br />
sessi<strong>on</strong>s to use more ASL.<br />
5. Parents <str<strong>on</strong>g>in</str<strong>on</strong>g> the deaf mentor group reported<br />
percepti<strong>on</strong>s more c<strong>on</strong>sistent with the deaf<br />
culture <str<strong>on</strong>g>and</str<strong>on</strong>g> deaf community.<br />
Type of <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> model: General family centered practice models—usually offer<str<strong>on</strong>g>in</str<strong>on</strong>g>g comprehensive support;<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cludes some programs that focus primarily <strong>on</strong> the child but <str<strong>on</strong>g>in</str<strong>on</strong>g>clude evaluati<strong>on</strong>s of impacts <strong>on</strong> families<br />
Dunst, C. J. et al. (2001) 1. Participati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> a larger variety of activity ECO outcomes<br />
Natural learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs was related to parents report<str<strong>on</strong>g>in</str<strong>on</strong>g>g that ● Families help their child<br />
envir<strong>on</strong>ments<br />
they engaged their children <str<strong>on</strong>g>in</str<strong>on</strong>g> more learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
activities.<br />
FQOL Outcomes<br />
2. The greater adopti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> use of the resp<strong>on</strong>sive ● Family <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong><br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g methods by parents, the more the<br />
children were observed <str<strong>on</strong>g>in</str<strong>on</strong>g>teract<str<strong>on</strong>g>in</str<strong>on</strong>g>g with adults.<br />
3. Greater adopti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> use of the resp<strong>on</strong>sive<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g methods by parents were related to<br />
enhanced positive child affect.<br />
● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
458 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009
TABLE 1—(C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued)<br />
References/Support Identified Results Outcomes<br />
Ericks<strong>on</strong>-Warfield, M. E. et<br />
al. (2000)<br />
Parent support groups<br />
Intensity of services<br />
provided to children<br />
Hendriks, A. H. C. et al.<br />
(2000)<br />
Family-directed<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> which may<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>clude family support<br />
groups, counsel<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
respite care (The<br />
Netherl<str<strong>on</strong>g>and</str<strong>on</strong>g>s)<br />
Kim, J. M. & Mah<strong>on</strong>ey, G.<br />
(2003)<br />
Impact of relati<strong>on</strong>shipfocused<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
<strong>on</strong> Korean mothers<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> their preschoolaged<br />
children with<br />
disabilities (Korea)<br />
Mah<strong>on</strong>ey, G., & Bella, J. M.<br />
Family-centered practice<br />
model <str<strong>on</strong>g>in</str<strong>on</strong>g>volv<str<strong>on</strong>g>in</str<strong>on</strong>g>g an<br />
array of family<br />
supports<br />
Mah<strong>on</strong>ey, G. & Perales, F.<br />
(2005)<br />
Relati<strong>on</strong>ship-focused<br />
early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>—two<br />
studies<br />
1. The greatest change between entry <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
discharge of EI was <str<strong>on</strong>g>in</str<strong>on</strong>g>creased social<br />
support networks, both formal <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formal.<br />
2. More <str<strong>on</strong>g>in</str<strong>on</strong>g>tense service (total hours of<br />
service) was significantly <str<strong>on</strong>g>and</str<strong>on</strong>g> positively<br />
correlated with <str<strong>on</strong>g>in</str<strong>on</strong>g>creased family cohesi<strong>on</strong>.<br />
3. More <str<strong>on</strong>g>in</str<strong>on</strong>g>tensive parent support group<br />
services <str<strong>on</strong>g>and</str<strong>on</strong>g> more <str<strong>on</strong>g>in</str<strong>on</strong>g>tensive child group<br />
services were significant predictors of<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>creased social support.<br />
4. The greater number of different services<br />
provided resulted <str<strong>on</strong>g>in</str<strong>on</strong>g> more parentreported<br />
ga<str<strong>on</strong>g>in</str<strong>on</strong>g>s <str<strong>on</strong>g>in</str<strong>on</strong>g> social support<br />
helpfulness.<br />
5. Maternal educati<strong>on</strong> impacted service<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tensity <str<strong>on</strong>g>and</str<strong>on</strong>g> comprehensiveness of<br />
services.<br />
1. On average, both mother <str<strong>on</strong>g>and</str<strong>on</strong>g> father<br />
perceived a positive change <str<strong>on</strong>g>in</str<strong>on</strong>g> well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
10 m<strong>on</strong>ths after participat<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
program.<br />
2. Mothers perceived a greater positive<br />
change <str<strong>on</strong>g>in</str<strong>on</strong>g> well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g than fathers.<br />
1. Mothers <str<strong>on</strong>g>in</str<strong>on</strong>g> the relati<strong>on</strong>ship-focused<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> group scored significantly<br />
higher <strong>on</strong> measures of resp<strong>on</strong>siveness,<br />
affect, <str<strong>on</strong>g>and</str<strong>on</strong>g> achievement orientati<strong>on</strong>.<br />
2. Overall, relati<strong>on</strong>ship-focused <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
reduced parental stress.<br />
1. There was no overall change <strong>on</strong> the<br />
Family Envir<strong>on</strong>ment Scales.<br />
2. There were marg<str<strong>on</strong>g>in</str<strong>on</strong>g>al changes <str<strong>on</strong>g>in</str<strong>on</strong>g> maternal<br />
stress.<br />
3. Although there was no overall change <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
maternal affective styles, enjoyment <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
expressiveness significantly decreased<br />
dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>.<br />
4. Approximately 45% of families reported<br />
receiv<str<strong>on</strong>g>in</str<strong>on</strong>g>g a comprehensive array of family<br />
services, which were characterized by<br />
extremely high levels of services related<br />
to their child’s development <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
moderate levels of services related to<br />
family-level c<strong>on</strong>cerns.<br />
1. Mothers who used resp<strong>on</strong>sive teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
made significant <str<strong>on</strong>g>in</str<strong>on</strong>g>creases <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
resp<strong>on</strong>siveness to their children.<br />
ECO outcomes<br />
● Families help their child<br />
learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
● Families have support<br />
systems<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs, <str<strong>on</strong>g>and</str<strong>on</strong>g> activities<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> their community<br />
FQOL Outcomes<br />
● Family <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong><br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Disability-related support<br />
ECO outcomes<br />
● Families have support<br />
systems<br />
FQOL Outcomes<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
ECO outcomes<br />
● Families help their child<br />
learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
FQOL Outcomes<br />
● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
ECO outcomes<br />
● Families help their child<br />
learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
● Families have support<br />
systems<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs, <str<strong>on</strong>g>and</str<strong>on</strong>g> activities<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> their community<br />
FQOL Outcomes<br />
● Family <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong><br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Disability-related support<br />
ECO outcomes<br />
● Families help their child<br />
learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
FQOL Outcomes<br />
● Family <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong><br />
● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Impacts of Family Support / 459
TABLE 1—(C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued)<br />
References/Support Identified Results Outcomes<br />
Trivette, C. M., Dunst, C. J.,<br />
Boyd, K., & Hamby,<br />
D. W. (1995)<br />
Family-centered services,<br />
us<str<strong>on</strong>g>in</str<strong>on</strong>g>g supports to help<br />
families access<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formal supports.<br />
A<str<strong>on</strong>g>in</str<strong>on</strong>g>bider, J. G. et al. (1998)<br />
Qualitative analysis of<br />
Parent to Parent<br />
programs through<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terviews with 24<br />
parents<br />
Ireys, H. T. et al. (1996)<br />
Social support<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> for<br />
mothers of children<br />
with Juvenile<br />
Rheumatoid Arthritis<br />
(ages 2–11). The social<br />
support <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
was a <strong>on</strong>e-to-<strong>on</strong>e<br />
mentor<str<strong>on</strong>g>in</str<strong>on</strong>g>g match of<br />
mothers of children<br />
with JRA.<br />
Rosenberg, S. A. et al.<br />
(2002)<br />
Comparis<strong>on</strong> of nurse<br />
home visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g model to<br />
home visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g model<br />
with tra<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
paraprofessi<strong>on</strong>als, who<br />
are all mothers of<br />
children with special<br />
health care needs<br />
1. Helpgivers from more family-centered<br />
programs who had more frequent c<strong>on</strong>tact<br />
with families reported more positive<br />
assessments of helpgiv<str<strong>on</strong>g>in</str<strong>on</strong>g>g practices.<br />
2. Participati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> family-centered programs<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> which parents had frequent c<strong>on</strong>tact with<br />
helpgivers us<str<strong>on</strong>g>in</str<strong>on</strong>g>g empower<str<strong>on</strong>g>in</str<strong>on</strong>g>g helpgiv<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
practices was associated with greater<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dicati<strong>on</strong> of pers<strong>on</strong>al c<strong>on</strong>trol.<br />
Type of <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> model: Peer support<br />
1. Parent to Parent support is particularly<br />
helpful when reliable allies have the four<br />
comp<strong>on</strong>ents: (a) perceived sameness,<br />
(b) comparable situati<strong>on</strong>s for learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
relevant skills <str<strong>on</strong>g>and</str<strong>on</strong>g> gather<str<strong>on</strong>g>in</str<strong>on</strong>g>g useful<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong>, (c) availability of support, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
(d) mutuality of support.<br />
2. Some parents did not f<str<strong>on</strong>g>in</str<strong>on</strong>g>d their experience<br />
with Parent to Parent to be helpful, but<br />
expressed belief <str<strong>on</strong>g>in</str<strong>on</strong>g> the value of parent<br />
c<strong>on</strong>necti<strong>on</strong>s.<br />
3. Barriers to unsuccessful matches <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
logistics <str<strong>on</strong>g>in</str<strong>on</strong>g> c<strong>on</strong>nect<str<strong>on</strong>g>in</str<strong>on</strong>g>g due to bus<str<strong>on</strong>g>in</str<strong>on</strong>g>ess, cost<br />
for ph<strong>on</strong>e bills, lost numbers, or negligent<br />
follow-up. Barriers also <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded differences<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> preferences <str<strong>on</strong>g>and</str<strong>on</strong>g> values regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g style, communicati<strong>on</strong> style,<br />
outlook <strong>on</strong> disability <str<strong>on</strong>g>and</str<strong>on</strong>g> future visi<strong>on</strong> for<br />
the children.<br />
1. The mothers receiv<str<strong>on</strong>g>in</str<strong>on</strong>g>g 1:1 mentor<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
reported a decrease <str<strong>on</strong>g>in</str<strong>on</strong>g> mental health<br />
symptoms compared to the c<strong>on</strong>trol group.<br />
Mental health symptoms <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
depressi<strong>on</strong>, anxiety, anger, <str<strong>on</strong>g>and</str<strong>on</strong>g> cognitive<br />
disturbance.<br />
2. The mothers receiv<str<strong>on</strong>g>in</str<strong>on</strong>g>g 1:1 mentor<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
reported greater improvements <strong>on</strong><br />
perceived availability of supports than those<br />
mothers <str<strong>on</strong>g>in</str<strong>on</strong>g> the c<strong>on</strong>trol group.<br />
1. Both groups believed the services they<br />
received were helpful. The families who<br />
received visits from the paraprofessi<strong>on</strong>als<br />
were significantly more positive about their<br />
experience.<br />
2. Families who received services from a<br />
paraprofessi<strong>on</strong>al <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated they learned<br />
more about how to obta<str<strong>on</strong>g>in</str<strong>on</strong>g> medical <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
therapy services than the nurse home<br />
visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g group.<br />
3. Both groups of mothers showed significant<br />
improvement <strong>on</strong> qualities of care giv<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> home envir<strong>on</strong>ment, as well as<br />
employment status.<br />
460 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
ECO outcomes<br />
● Families know their<br />
rights <str<strong>on</strong>g>and</str<strong>on</strong>g> advocate<br />
effectively for their<br />
children<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs, <str<strong>on</strong>g>and</str<strong>on</strong>g> activities<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> their community<br />
FQOL Outcomes<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Disability-related support<br />
ECO outcomes<br />
● Families have support<br />
systems<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs, <str<strong>on</strong>g>and</str<strong>on</strong>g> activities<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> their community<br />
FQOL Outcomes<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Disability-related support<br />
ECO outcomes<br />
● Families have support<br />
systems<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs, <str<strong>on</strong>g>and</str<strong>on</strong>g> activities<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> their community<br />
FQOL Outcomes<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Disability-related support<br />
ECO outcomes<br />
● Families underst<str<strong>on</strong>g>and</str<strong>on</strong>g> their<br />
child’s strengths, abilities<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> special needs<br />
● Families have support<br />
systems<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs, <str<strong>on</strong>g>and</str<strong>on</strong>g> activities<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> their community<br />
FQOL Outcomes<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Physical/material wellbe<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Disability-related support
TABLE 1—(C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued)<br />
References/Support Identified Results Outcomes<br />
S<str<strong>on</strong>g>in</str<strong>on</strong>g>ger, G. H. S. et al.<br />
(1999)<br />
Peer support<br />
Gomby, D. S. et al. (1999)<br />
Evaluati<strong>on</strong> of home<br />
visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g programs us<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
various models; most<br />
focused <strong>on</strong> provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
parent <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong>,<br />
but also provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
supports to parents<br />
Love, J. M. et al. (2002)<br />
Two-generati<strong>on</strong><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> model<br />
provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
comprehensive family<br />
supports for selfsufficiency<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> mental<br />
health; parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> child-oriented<br />
services. Some<br />
programs were home<br />
visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g models, others<br />
were center-based;<br />
most were<br />
comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong>.<br />
St. Pierre, R. G. et al.<br />
(1995)<br />
Two generati<strong>on</strong> service<br />
programs focus<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
simultaneously <strong>on</strong><br />
improv<str<strong>on</strong>g>in</str<strong>on</strong>g>g outcomes<br />
for families <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g supports<br />
(usually through<br />
parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g) for<br />
children.<br />
1. Parents who participated <str<strong>on</strong>g>in</str<strong>on</strong>g> Parent to Parent<br />
had positive percepti<strong>on</strong>s of their child <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
his or her impact <strong>on</strong> the family.<br />
2. Initial c<strong>on</strong>tacts <str<strong>on</strong>g>in</str<strong>on</strong>g> Parent to Parent were not<br />
associated with changes <str<strong>on</strong>g>in</str<strong>on</strong>g> parents’<br />
percepti<strong>on</strong>s of empowerment.<br />
3. Parents who participated <str<strong>on</strong>g>in</str<strong>on</strong>g> Parent to Parent<br />
made statistically greater progress than the<br />
c<strong>on</strong>trol group <str<strong>on</strong>g>in</str<strong>on</strong>g> gett<str<strong>on</strong>g>in</str<strong>on</strong>g>g help with their<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>itial problem.<br />
4. Eighty-n<str<strong>on</strong>g>in</str<strong>on</strong>g>e percent of the parents who<br />
participated <str<strong>on</strong>g>in</str<strong>on</strong>g> Parent to Parent rated it as<br />
helpful.<br />
Type of <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> model: Two-generati<strong>on</strong> programs<br />
1. Home-visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g programs may be associated<br />
with changes <str<strong>on</strong>g>in</str<strong>on</strong>g> some parent attitudes,<br />
though not necessarily their behaviors that<br />
are related to the preventi<strong>on</strong> of abuse <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
neglect.<br />
2. Home visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g may be beneficial <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
decreased child maltreatment, though<br />
evidence was primarily from self-report<br />
measures.<br />
3. Only Nurse Home Visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g Program found<br />
benefits <str<strong>on</strong>g>in</str<strong>on</strong>g> alter<str<strong>on</strong>g>in</str<strong>on</strong>g>g maternal life course for<br />
poor unmarried women. Women who had<br />
been home visited had fewer subsequent<br />
pregnancies <str<strong>on</strong>g>and</str<strong>on</strong>g> births, deferred their<br />
sec<strong>on</strong>d birth, spent fewer m<strong>on</strong>ths <strong>on</strong><br />
welfare, <str<strong>on</strong>g>and</str<strong>on</strong>g> had fewer problems result<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
from substance abuse <str<strong>on</strong>g>and</str<strong>on</strong>g> arrests than the<br />
c<strong>on</strong>trol group.<br />
1. Families <str<strong>on</strong>g>in</str<strong>on</strong>g> Early Head Start programs<br />
measured more positive impacts <strong>on</strong><br />
parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g behaviors, <str<strong>on</strong>g>and</str<strong>on</strong>g> support for<br />
parents’ emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
2. The programs led to lower levels of<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>sensitivity <str<strong>on</strong>g>and</str<strong>on</strong>g> hostile parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g behavior<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> the use of less punitive discipl<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
strategies.<br />
3. At age 3, there were no overall impacts <strong>on</strong><br />
measures of parent’s health or mental health<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> family functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
4. Overall, results showed c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued impacts<br />
<strong>on</strong> parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> educati<strong>on</strong> activities<br />
for families <str<strong>on</strong>g>in</str<strong>on</strong>g> the program compared to<br />
c<strong>on</strong>trol group families.<br />
1. Two-generati<strong>on</strong> programs <str<strong>on</strong>g>in</str<strong>on</strong>g>crease the rate<br />
of participati<strong>on</strong> for both children <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
parents <str<strong>on</strong>g>in</str<strong>on</strong>g> social <str<strong>on</strong>g>and</str<strong>on</strong>g> educati<strong>on</strong>al services.<br />
2. Two-generati<strong>on</strong> programs have positive<br />
effects <strong>on</strong> parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g time spent<br />
with child, parent teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills,<br />
expectati<strong>on</strong>s for child’s success, attitudes<br />
about child rear<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> parent-child<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s.<br />
3. Two-generati<strong>on</strong> programs have large positive<br />
effects <strong>on</strong> atta<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g a GED. There are no<br />
effects <strong>on</strong> mothers’ depressi<strong>on</strong> levels, selfesteem,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> social supports.<br />
4. There was a positive correlati<strong>on</strong> to the<br />
amount of participati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> GED<br />
atta<str<strong>on</strong>g>in</str<strong>on</strong>g>ment.<br />
ECO outcomes<br />
● Families have support<br />
systems<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs, <str<strong>on</strong>g>and</str<strong>on</strong>g> activities<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> their community<br />
FQOL Outcomes<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Disability-related support<br />
ECO Outcomes<br />
● Families help their child<br />
learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
● Families have support<br />
systems<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs <str<strong>on</strong>g>and</str<strong>on</strong>g> activities <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
their community<br />
FQOL Outcomes<br />
● Family <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong><br />
● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Physical/Material wellbe<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
ECO Outcomes<br />
● Families help their child<br />
learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
● Families have support<br />
systems<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs <str<strong>on</strong>g>and</str<strong>on</strong>g> activities <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
their community<br />
FQOL Outcomes<br />
● Family <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong><br />
● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Physical/Material well-<br />
be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
ECO Outcomes<br />
● Families help their child<br />
learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs <str<strong>on</strong>g>and</str<strong>on</strong>g> activities <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
their community<br />
FQOL Outcomes<br />
● Family <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong><br />
● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Physical/Material wellbe<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Impacts of Family Support / 461
TABLE 1—(C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued)<br />
References/Support Identified Results Outcomes<br />
Zeece, P. D. & Wang, A.<br />
(1998)<br />
Two-generati<strong>on</strong>al<br />
program-Head Start<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> the Family<br />
Empowerment Transiti<strong>on</strong><br />
Program<br />
Chan, J. B. & Sigafoos, J.<br />
(2001)<br />
Respite care<br />
Cowen, P. S. & Reed, D. A.<br />
(2002)<br />
Respite care<br />
Herman, S. E. & Marcenko,<br />
M. O. (1997)<br />
Respite care<br />
Only half of the articles <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> this secti<strong>on</strong><br />
of Table 1 were specific to families who<br />
have children with disabilities; the rema<str<strong>on</strong>g>in</str<strong>on</strong>g>der<br />
of the articles focused <strong>on</strong> “at-risk” children<br />
1. Over a three-year time span, parentcentered<br />
risk decreased for the participants<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the Head Start Family Empowerment<br />
Transiti<strong>on</strong> Program.<br />
2. There were no significant differences<br />
between the two groups regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g family<br />
ec<strong>on</strong>omic risk over time.<br />
Type of <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> model: Respite care<br />
1. The use of respite care was associated with<br />
reduced parental stress, especially for<br />
mothers, <str<strong>on</strong>g>in</str<strong>on</strong>g> the majority of families who<br />
have children with developmental<br />
disabilities.<br />
1. Reported parental stress scores (parentchild<br />
relati<strong>on</strong>ship) were significantly lower<br />
follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g respite care <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s.<br />
2. Follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g respite care <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, scores<br />
report<str<strong>on</strong>g>in</str<strong>on</strong>g>g parents’ percepti<strong>on</strong> of the child’s<br />
traits were significantly lower.<br />
1. Respite care use <str<strong>on</strong>g>in</str<strong>on</strong>g>directly effected parental<br />
depressi<strong>on</strong>. The quality of care <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
percepti<strong>on</strong> of time the parent has for<br />
themselves were mediat<str<strong>on</strong>g>in</str<strong>on</strong>g>g variables.<br />
462 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
ECO Outcomes<br />
● Families know their<br />
rights <str<strong>on</strong>g>and</str<strong>on</strong>g> advocate<br />
effectively for their<br />
children<br />
● Families help their child<br />
learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow<br />
● Families have support<br />
systems<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs <str<strong>on</strong>g>and</str<strong>on</strong>g> activities <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
their community<br />
FQOL Outcomes<br />
● Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
● Physical/Material wellbe<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
ECO Outcomes<br />
● Families have support<br />
systems<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs <str<strong>on</strong>g>and</str<strong>on</strong>g> activities <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
their community<br />
FQOL Outcomes<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
ECO Outcomes<br />
● Families have support<br />
systems<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs <str<strong>on</strong>g>and</str<strong>on</strong>g> activities <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
their community<br />
FQOL Outcomes<br />
● Family <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong><br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
ECO Outcomes<br />
● Families have support<br />
systems<br />
● Families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
access to desired services,<br />
programs <str<strong>on</strong>g>and</str<strong>on</strong>g> activities <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
their community<br />
FQOL Outcomes<br />
● Emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> families. Programs aimed at families of<br />
children with disabilities tended to use measures<br />
of maternal/parental stress or depressi<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> family <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>; the programs for
“at risk” children <str<strong>on</strong>g>and</str<strong>on</strong>g> families centered more<br />
<strong>on</strong> the acquisiti<strong>on</strong> of parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>volvement<br />
with their children.<br />
Effectiveness of parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g programs<br />
was typically measured <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of ga<str<strong>on</strong>g>in</str<strong>on</strong>g>s <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
child outcomes, e.g., <str<strong>on</strong>g>in</str<strong>on</strong>g> reducti<strong>on</strong>s of behavior<br />
problems or improved child language <str<strong>on</strong>g>and</str<strong>on</strong>g> literacy<br />
behaviors or other cognitive ga<str<strong>on</strong>g>in</str<strong>on</strong>g>s. Impacts<br />
<strong>on</strong> parents that were measured <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
the acquisiti<strong>on</strong> of parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills, parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
stress or depressi<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g satisfacti<strong>on</strong>.<br />
In the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> studies that also measured<br />
parents <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of depressi<strong>on</strong> or stress<br />
levels, parents reported reducti<strong>on</strong>s of these<br />
variables (Kucuker, 2006; Niccols & Mohamed,<br />
2000; Roberts et al., 2003). Last, a<br />
meta-analysis by Bakersman-Kranenburg, van<br />
Ijzendoorn <str<strong>on</strong>g>and</str<strong>on</strong>g> Bradley (2005) revealed that<br />
(a) middle-class, n<strong>on</strong>-adolescent parents benefited<br />
more from early childhood <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
than adolescent or low <str<strong>on</strong>g>in</str<strong>on</strong>g>come parents,<br />
(b) limited (between 5–16), home-based sessi<strong>on</strong>s<br />
were more effective than <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
with sessi<strong>on</strong>s number<str<strong>on</strong>g>in</str<strong>on</strong>g>g more than 16, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
(c) sessi<strong>on</strong>s for families with children either<br />
older than six m<strong>on</strong>ths or dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the prenatal<br />
stage were more effective than dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the first<br />
six m<strong>on</strong>ths of a child’s life.<br />
Based <strong>on</strong> the ECO Center family outcome<br />
def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s, we c<strong>on</strong>cluded that <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
that improve parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> reduce stress or<br />
depressi<strong>on</strong> are c<strong>on</strong>sistent with the ECO family<br />
outcomes of (a) families underst<str<strong>on</strong>g>and</str<strong>on</strong>g> their<br />
child’s strengths, abilities <str<strong>on</strong>g>and</str<strong>on</strong>g> special needs,<br />
(c) families help their children learn <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
grow, <str<strong>on</strong>g>and</str<strong>on</strong>g> (d) families have support systems.<br />
We also c<strong>on</strong>cluded that the primary area of<br />
Beach Center family quality of life doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s<br />
impacted by these programs was the Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Emoti<strong>on</strong>al Well-Be<str<strong>on</strong>g>in</str<strong>on</strong>g>g sub-scales.<br />
General Family-Centered Practice Models<br />
A number of <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigators have reported results<br />
of evaluati<strong>on</strong>s of early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> programs<br />
described as “family-centered” services.<br />
These programs may or may not provide<br />
service comp<strong>on</strong>ents specifically targeted to<br />
parents (e.g., parent support groups), but<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>vestigators describe the programs as familycentered<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the sense of develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g empower<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
partnerships with families <str<strong>on</strong>g>in</str<strong>on</strong>g> decisi<strong>on</strong>-<br />
mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> deliver<str<strong>on</strong>g>in</str<strong>on</strong>g>g services to children<br />
with disabilities (i.e., the how of familycentered<br />
practice). Evaluati<strong>on</strong>s of studies <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> this review <str<strong>on</strong>g>in</str<strong>on</strong>g>clude both those that<br />
identified specific supports provided to families<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> those that did not describe family<br />
support but did <str<strong>on</strong>g>in</str<strong>on</strong>g>clude family impact measures<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the evaluati<strong>on</strong> design.<br />
General family-centered practice models<br />
described <str<strong>on</strong>g>in</str<strong>on</strong>g> this secti<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded home visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
or center-based programs that provided a<br />
comp<strong>on</strong>ent of family support <str<strong>on</strong>g>and</str<strong>on</strong>g> collaborati<strong>on</strong><br />
(see Table 1). Families <str<strong>on</strong>g>in</str<strong>on</strong>g> these studies<br />
may have received a variety of types of family<br />
support depend<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> their <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual needs<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> preferences. These <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded counsel<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills, respite care, <str<strong>on</strong>g>and</str<strong>on</strong>g>/or support<br />
groups. Although the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s may have<br />
focused primarily <strong>on</strong> outcomes for children,<br />
the evaluati<strong>on</strong> of these programs also <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigated<br />
the impact <strong>on</strong> families. The general<br />
theme from this group of research studies<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dicates that early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> programs<br />
that provide general family-centered practices<br />
that focused <strong>on</strong> relati<strong>on</strong>ships between the parent<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> child positively impacted parent-child<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> improved family communicati<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> cohesi<strong>on</strong> (Dunst, Bruder, & Trivette,<br />
2001; Kim & Mah<strong>on</strong>ey, 2003; Mah<strong>on</strong>ey & Perales,<br />
2003; Mah<strong>on</strong>ey & Perales, 2005). Additi<strong>on</strong>ally,<br />
the parent’s use of resp<strong>on</strong>sive teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
methods (Dunst et al.) <str<strong>on</strong>g>and</str<strong>on</strong>g> participati<strong>on</strong><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> support groups improved parental emoti<strong>on</strong>al<br />
well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g (Ericks<strong>on</strong>-Warfield, Hauser-<br />
Cram, Krauss, Sh<strong>on</strong>koff, & Upshur, 2000; Mah<strong>on</strong>ey<br />
& Bella, 1998). Lastly, the child’s<br />
participati<strong>on</strong> or enrollment <str<strong>on</strong>g>in</str<strong>on</strong>g> an <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
program with different types of family support,<br />
which <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
counsel<str<strong>on</strong>g>in</str<strong>on</strong>g>g, positively impacted parental wellbe<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> family cohesi<strong>on</strong> (Hendriks, De<br />
Moor, Oud, & Savelberg, 2000).<br />
In comparis<strong>on</strong>s of the reported outcomes<br />
from these studies, we c<strong>on</strong>cluded that familycentered<br />
early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> programs that<br />
provided an array of family support achieved a<br />
number of the ECO outcomes for families.<br />
These <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded (c) families help their child<br />
grow <str<strong>on</strong>g>and</str<strong>on</strong>g> learn; (d) families have support systems;<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> (e) families have access to desired<br />
services, programs <str<strong>on</strong>g>and</str<strong>on</strong>g> activities <str<strong>on</strong>g>in</str<strong>on</strong>g> their community.<br />
With respect to family quality of life<br />
doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s, we c<strong>on</strong>cluded that the outcomes re-<br />
Impacts of Family Support / 463
ported were most relevant to Emoti<strong>on</strong>al Wellbe<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>and</str<strong>on</strong>g> Family Interacti<strong>on</strong>.<br />
Peer Support<br />
Peer support offers a way for people <str<strong>on</strong>g>in</str<strong>on</strong>g> similar<br />
circumstances to offer each other emoti<strong>on</strong>al<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong>al supports, as well as other<br />
self-help. For families of young children with<br />
disabilities or at-risk for disabilities, parents<br />
may be offered <strong>on</strong>e-to-<strong>on</strong>e peer support or<br />
parent support groups as a comp<strong>on</strong>ent of the<br />
overall early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> program. Support<br />
groups also may be offered for sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of a<br />
child with a disability or for other extended<br />
family members such as gr<str<strong>on</strong>g>and</str<strong>on</strong>g>parents. We<br />
were unable to f<str<strong>on</strong>g>in</str<strong>on</strong>g>d recent specific research<br />
focus<str<strong>on</strong>g>in</str<strong>on</strong>g>g exclusively <strong>on</strong> the impact of support<br />
groups <strong>on</strong> families, but there were overall evaluati<strong>on</strong>s<br />
of the general family-centered programs<br />
which <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded support groups, which<br />
were discussed above. In this secti<strong>on</strong>, we discuss<br />
two types of peer support models for<br />
which there is evaluati<strong>on</strong> research available,<br />
the Parent to Parent model (A<str<strong>on</strong>g>in</str<strong>on</strong>g>b<str<strong>on</strong>g>in</str<strong>on</strong>g>der et al.,<br />
1998; S<str<strong>on</strong>g>in</str<strong>on</strong>g>ger et al., 1999) <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>on</strong>e-to-<strong>on</strong>e peer<br />
mentor<str<strong>on</strong>g>in</str<strong>on</strong>g>g programs (Ireys, Sills, Kolodner, &<br />
Walsh, 1996; Rosenberg, Rob<str<strong>on</strong>g>in</str<strong>on</strong>g>s<strong>on</strong>, & Fryer,<br />
2002).<br />
Parent to Parent groups match tra<str<strong>on</strong>g>in</str<strong>on</strong>g>ed parents<br />
with parents who request assistance (A<str<strong>on</strong>g>in</str<strong>on</strong>g>b<str<strong>on</strong>g>in</str<strong>on</strong>g>der<br />
et al., 1998; S<str<strong>on</strong>g>in</str<strong>on</strong>g>ger et al., 1999). Parent<br />
to Parent organizati<strong>on</strong>s provide parents with<br />
c<strong>on</strong>necti<strong>on</strong> to resources <str<strong>on</strong>g>and</str<strong>on</strong>g> services <str<strong>on</strong>g>in</str<strong>on</strong>g> their<br />
community, emoti<strong>on</strong>al support, <str<strong>on</strong>g>and</str<strong>on</strong>g> practical<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> about car<str<strong>on</strong>g>in</str<strong>on</strong>g>g for a child with a<br />
disability (A<str<strong>on</strong>g>in</str<strong>on</strong>g>b<str<strong>on</strong>g>in</str<strong>on</strong>g>der et al.; S<str<strong>on</strong>g>in</str<strong>on</strong>g>ger et al.).<br />
S<str<strong>on</strong>g>in</str<strong>on</strong>g>ger et al. evaluated Parent to Parent mentor<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
programs <str<strong>on</strong>g>in</str<strong>on</strong>g> multiple sites across five<br />
states. As a smaller comp<strong>on</strong>ent of the larger<br />
study, A<str<strong>on</strong>g>in</str<strong>on</strong>g>b<str<strong>on</strong>g>in</str<strong>on</strong>g>der et al. c<strong>on</strong>ducted a qualitative<br />
evaluati<strong>on</strong> of Parent to Parent programs by<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terview<str<strong>on</strong>g>in</str<strong>on</strong>g>g 24 parents. The majority of the<br />
families participat<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> these two studies was<br />
Caucasian <str<strong>on</strong>g>and</str<strong>on</strong>g> married. The children with disabilities<br />
ranged <str<strong>on</strong>g>in</str<strong>on</strong>g> ages from <strong>on</strong>e to 16, with<br />
an average age of seven. The populati<strong>on</strong> for<br />
this group of studies was exp<str<strong>on</strong>g>and</str<strong>on</strong>g>ed to <str<strong>on</strong>g>in</str<strong>on</strong>g>clude<br />
children bey<strong>on</strong>d the age of eight, as we found<br />
no peer support <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> studies that focused<br />
exclusively <strong>on</strong> the early childhood populati<strong>on</strong>.<br />
The evaluati<strong>on</strong> studies of <strong>on</strong>e-to-<strong>on</strong>e peer<br />
464 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
mentor<str<strong>on</strong>g>in</str<strong>on</strong>g>g programs were similar <str<strong>on</strong>g>in</str<strong>on</strong>g> that mentor<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
services were provided by mothers,<br />
mothers of children with Juvenile Rheumatoid<br />
Arthritis (Ireys et al., 1996) or mothers of<br />
children with special needs (Rosenberg et al.,<br />
2002). The study by Rosenberg et al. evaluated<br />
home visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g services delivered to families<br />
c<strong>on</strong>sidered to be <str<strong>on</strong>g>in</str<strong>on</strong>g> an at-risk situati<strong>on</strong><br />
due to envir<strong>on</strong>mental or caregiv<str<strong>on</strong>g>in</str<strong>on</strong>g>g factors.<br />
The services were delivered by tra<str<strong>on</strong>g>in</str<strong>on</strong>g>ed paraprofessi<strong>on</strong>als<br />
who were all mothers of children<br />
with special needs <str<strong>on</strong>g>and</str<strong>on</strong>g> were recruited<br />
from the neighborhoods <str<strong>on</strong>g>in</str<strong>on</strong>g> which they provided<br />
services. The families received two<br />
visits per m<strong>on</strong>th <str<strong>on</strong>g>and</str<strong>on</strong>g> the visits focused <strong>on</strong><br />
build<str<strong>on</strong>g>in</str<strong>on</strong>g>g family strengths, identify<str<strong>on</strong>g>in</str<strong>on</strong>g>g needs,<br />
assist<str<strong>on</strong>g>in</str<strong>on</strong>g>g with access<str<strong>on</strong>g>in</str<strong>on</strong>g>g services <str<strong>on</strong>g>and</str<strong>on</strong>g> supports<br />
with<str<strong>on</strong>g>in</str<strong>on</strong>g> the community, <str<strong>on</strong>g>and</str<strong>on</strong>g> provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
a parent mentor to guide maternal care<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> home safety issues (Rosenberg et al.).<br />
The mentor<str<strong>on</strong>g>in</str<strong>on</strong>g>g program evaluated by Ireys<br />
et al. (1996) focused <strong>on</strong> enhanc<str<strong>on</strong>g>in</str<strong>on</strong>g>g three<br />
types of social support—<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong>al, affirmati<strong>on</strong>al,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> emoti<strong>on</strong>al support. Mothers<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> group were <str<strong>on</strong>g>in</str<strong>on</strong>g> c<strong>on</strong>tact<br />
with their peer mentor every two weeks via<br />
teleph<strong>on</strong>e, through home visits held every 6<br />
weeks, <str<strong>on</strong>g>and</str<strong>on</strong>g> at group events, such as picnics<br />
or group lunches (Ireys et al.).<br />
The multi-site Parent to Parent study reported<br />
that peer supports had a significant<br />
impact <strong>on</strong> attitudes regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g acceptance of<br />
family <str<strong>on</strong>g>and</str<strong>on</strong>g> disability; however, c<strong>on</strong>tacts with<br />
the organizati<strong>on</strong> did not change parents’ percepti<strong>on</strong><br />
of empowerment (S<str<strong>on</strong>g>in</str<strong>on</strong>g>ger et al., 1999).<br />
Further, successful matches were c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent<br />
up<strong>on</strong> equality <str<strong>on</strong>g>and</str<strong>on</strong>g> mutuality <str<strong>on</strong>g>in</str<strong>on</strong>g> their Parent to<br />
Parent relati<strong>on</strong>ships (A<str<strong>on</strong>g>in</str<strong>on</strong>g>b<str<strong>on</strong>g>in</str<strong>on</strong>g>der et al., 1998).<br />
The evaluati<strong>on</strong> of the home visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g model<br />
us<str<strong>on</strong>g>in</str<strong>on</strong>g>g peers as paraprofessi<strong>on</strong>als reported improvement<br />
for families <str<strong>on</strong>g>in</str<strong>on</strong>g> care giv<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills,<br />
home envir<strong>on</strong>ment, <str<strong>on</strong>g>and</str<strong>on</strong>g> employment status<br />
(Rosenberg et al., 2002). One-to-<strong>on</strong>e peer<br />
mentor<str<strong>on</strong>g>in</str<strong>on</strong>g>g also decreased the number of reported<br />
mental health symptoms mothers experienced<br />
(Ireys et al., 1996). Additi<strong>on</strong>ally,<br />
families who received support from other parents<br />
who have children with special needs<br />
made greater progress <str<strong>on</strong>g>in</str<strong>on</strong>g> gett<str<strong>on</strong>g>in</str<strong>on</strong>g>g help with<br />
their disability-related problems than parents<br />
did <strong>on</strong> their own (Ireys et al.; Rosenberg et al.;<br />
S<str<strong>on</strong>g>in</str<strong>on</strong>g>ger et al.). Overall, participants rated the
programs with peer support as helpful<br />
(Rosenberg et al.; S<str<strong>on</strong>g>in</str<strong>on</strong>g>ger et al.).<br />
In compar<str<strong>on</strong>g>in</str<strong>on</strong>g>g these f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs to def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s<br />
of the ECO Center family outcomes, we c<strong>on</strong>cluded<br />
that peer support programs typically<br />
offer families (a) <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> to underst<str<strong>on</strong>g>and</str<strong>on</strong>g><br />
their children’s strengths, abilities <str<strong>on</strong>g>and</str<strong>on</strong>g> special<br />
needs, (d) support systems, <str<strong>on</strong>g>and</str<strong>on</strong>g> (e) <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong><br />
to ga<str<strong>on</strong>g>in</str<strong>on</strong>g> access to desired services, programs,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> activities <str<strong>on</strong>g>in</str<strong>on</strong>g> their community. The<br />
outcomes reported <str<strong>on</strong>g>in</str<strong>on</strong>g> these peer support<br />
studies also appear to be relevant to the<br />
family quality of life doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s of Emoti<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Physical/Material Well-Be<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> Disability-<br />
Related Support.<br />
Two-Generati<strong>on</strong> Programs<br />
The term “two-generati<strong>on</strong> programs” arises<br />
from the theory that l<strong>on</strong>g-term improvements<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> outcomes for children from families with<br />
multiple challenges requires a comprehensive<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>tensive array of services that are focused<br />
simultaneously <strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s for the child<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>on</strong> supports for the family as a whole<br />
(St. Pierre, Layzer, & Barnes, 1995). With respect<br />
to the family enhancement comp<strong>on</strong>ent<br />
of two-generati<strong>on</strong> programs, these services<br />
generally <str<strong>on</strong>g>in</str<strong>on</strong>g>volve the development of an <str<strong>on</strong>g>in</str<strong>on</strong>g>dividualized<br />
family support plan to help parents<br />
reach goals <str<strong>on</strong>g>in</str<strong>on</strong>g> educati<strong>on</strong> (e.g., complet<str<strong>on</strong>g>in</str<strong>on</strong>g>g a<br />
GED or learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g English), self-sufficiency,<br />
mental health (e.g., access<str<strong>on</strong>g>in</str<strong>on</strong>g>g substance abuse<br />
treatment or shelter from domestic violence),<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> health <str<strong>on</strong>g>and</str<strong>on</strong>g> nutriti<strong>on</strong>. A part of the child<br />
enhancement comp<strong>on</strong>ent of two-generati<strong>on</strong><br />
programs also typically <str<strong>on</strong>g>in</str<strong>on</strong>g>cludes parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong>, us<str<strong>on</strong>g>in</str<strong>on</strong>g>g group <str<strong>on</strong>g>and</str<strong>on</strong>g>/or<br />
home visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g approaches (Love et al., 2002).<br />
The desired outcomes of two-generati<strong>on</strong> programs<br />
are to produce improved cognitive <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
developmental functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> children, as<br />
well as <str<strong>on</strong>g>in</str<strong>on</strong>g>crease family functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> selfsufficiency<br />
(Love et al.), thus negat<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
effects of poverty <strong>on</strong> families.<br />
One article <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> Table 1 is a review<br />
of several two-generati<strong>on</strong> programs, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Avance, Child Family Resource Program,<br />
Comprehensive Child Development Program,<br />
Even Start, Head Start Family Service Centers<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> New Chance (St. Pierre et al., 1995). The<br />
sec<strong>on</strong>d article is a report of a l<strong>on</strong>gitud<str<strong>on</strong>g>in</str<strong>on</strong>g>al<br />
study of the impacts of Early Head Start <strong>on</strong><br />
children <str<strong>on</strong>g>and</str<strong>on</strong>g> families (Love et al., 2002). Also<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded is an evaluati<strong>on</strong> of five nati<strong>on</strong>al<br />
home visit<str<strong>on</strong>g>in</str<strong>on</strong>g>g models, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g Nurse Home<br />
Visitati<strong>on</strong> Program, Hawaii’s Healthy Start,<br />
Home Instructi<strong>on</strong> Program for Preschool<br />
Youngsters, Comprehensive Child Development<br />
Program, <str<strong>on</strong>g>and</str<strong>on</strong>g> Healthy Families America<br />
(Gomby, Culross, & Behrman, 1999). F<str<strong>on</strong>g>in</str<strong>on</strong>g>ally,<br />
Table 1 <str<strong>on</strong>g>in</str<strong>on</strong>g>cludes a review of an article evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the effects of Head Start plus a Family<br />
Empowerment Transiti<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g Program for atrisk<br />
children <str<strong>on</strong>g>and</str<strong>on</strong>g> their families (Zeece & Wang,<br />
1998). It is important to note that all of these<br />
studies <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded populati<strong>on</strong>s of at-risk children<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> families; n<strong>on</strong>e were specifically designed for<br />
families of children with disabilities.<br />
There was some c<strong>on</strong>troversy over the effects<br />
of two-generati<strong>on</strong> programs <strong>on</strong> children s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce<br />
the effect sizes of the programs reviewed by<br />
St. Pierre, Layzer, <str<strong>on</strong>g>and</str<strong>on</strong>g> Barnes (1995) were relatively<br />
small. The Early Head Start study found<br />
modest effect sizes for child outcomes that were<br />
susta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed until the age of three years (Love et<br />
al., 2002). Additi<strong>on</strong>ally, the Head Start plus<br />
Family Empowerment Transiti<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g Program<br />
decreased parent-centered risk (emoti<strong>on</strong>al/<br />
social issues) <str<strong>on</strong>g>and</str<strong>on</strong>g> improved child developmental<br />
outcomes over a three-year period<br />
(Zeece & Wang, 1998). With respect to impacts<br />
<strong>on</strong> families, the results are more c<strong>on</strong>sistent:<br />
These programs appeared to have a positive<br />
impact <strong>on</strong> parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g parentchild<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> reducti<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> negative<br />
discipl<str<strong>on</strong>g>in</str<strong>on</strong>g>e (Gomby et al., 1999; Love et al.;<br />
St. Pierre et al.). In additi<strong>on</strong>, two-generati<strong>on</strong><br />
programs appeared to have an impact <strong>on</strong><br />
improvements <str<strong>on</strong>g>in</str<strong>on</strong>g> parents’ educati<strong>on</strong>al atta<str<strong>on</strong>g>in</str<strong>on</strong>g>ments,<br />
but did not have significant effect <strong>on</strong><br />
parents’ health or mental health (St. Pierre<br />
et al.).<br />
In analyz<str<strong>on</strong>g>in</str<strong>on</strong>g>g the reported family outcomes<br />
of two-generati<strong>on</strong> programs <str<strong>on</strong>g>in</str<strong>on</strong>g> comparis<strong>on</strong> to<br />
the ECO Center family outcomes, we c<strong>on</strong>clude<br />
the results were potentially relevant to<br />
all five outcomes. However, given the variables<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> these studies, it appears that two-generati<strong>on</strong><br />
programs most often addressed the ECO outcomes<br />
of (b) families know their rights <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
advocate effectively for their children, (c) families<br />
help their child learn <str<strong>on</strong>g>and</str<strong>on</strong>g> grow, (d) families<br />
have support systems, <str<strong>on</strong>g>and</str<strong>on</strong>g> (e) families are able<br />
to ga<str<strong>on</strong>g>in</str<strong>on</strong>g> access to desired services, programs,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> activities <str<strong>on</strong>g>in</str<strong>on</strong>g> their community. Further,<br />
Impacts of Family Support / 465
comparis<strong>on</strong> of the reported results of these<br />
studies suggests that two-generati<strong>on</strong> programs<br />
may address family quality of life doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s of<br />
Family Interacti<strong>on</strong>, Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g, Emoti<strong>on</strong>al Well-<br />
Be<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> Physical/Material Well-Be<str<strong>on</strong>g>in</str<strong>on</strong>g>g of<br />
families.<br />
Respite Care<br />
Respite care services provide temporary child<br />
care <str<strong>on</strong>g>and</str<strong>on</strong>g> support to families with a child with<br />
a disability (Cowen & Reed, 2002). The use of<br />
respite care has been proposed as a way to<br />
reduce stress <str<strong>on</strong>g>and</str<strong>on</strong>g> depressi<strong>on</strong> for parents. In<br />
2002, respite care was <strong>on</strong>ly cited <strong>on</strong> IFSPs a<br />
total of 135 times for all Part C programs <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the 50 states, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g DC <str<strong>on</strong>g>and</str<strong>on</strong>g> Puerto Rico<br />
(Danaher & Armijo, 2005).<br />
Table 1 <str<strong>on</strong>g>in</str<strong>on</strong>g>cludes data <strong>on</strong> three articles that<br />
evaluated the impact of respite care <strong>on</strong> families.<br />
All studies focused <strong>on</strong> measur<str<strong>on</strong>g>in</str<strong>on</strong>g>g families’<br />
emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g stress <str<strong>on</strong>g>and</str<strong>on</strong>g> depressi<strong>on</strong><br />
levels. Unlike the other <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
models <str<strong>on</strong>g>in</str<strong>on</strong>g> this paper, we selected respite care<br />
studies that <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded families with children<br />
from ages two through 20, because we could<br />
f<str<strong>on</strong>g>in</str<strong>on</strong>g>d no evaluati<strong>on</strong>s of respite care focused<br />
specifically for young children with disabilities<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> their families. The populati<strong>on</strong> of these<br />
studies tended to be Caucasian, low-to-middle<br />
class families.<br />
Themes of results from these three articles<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dicate that utiliz<str<strong>on</strong>g>in</str<strong>on</strong>g>g respite care services reduced<br />
parental stress (Chan & Sigafoos, 2001;<br />
Cowen & Reed, 2002). The quality of the child<br />
care <str<strong>on</strong>g>and</str<strong>on</strong>g> the frequency by which parents’ utilized<br />
the service affected their level of depressi<strong>on</strong>;<br />
the higher the quality of care, the more<br />
often the services are used, which was associated<br />
with lower depressi<strong>on</strong> levels (Herman &<br />
Marcenko, 1997). All of these studies focused<br />
<strong>on</strong> short-term <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s (18 m<strong>on</strong>ths or<br />
less); more <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> is needed <strong>on</strong> the impact<br />
of l<strong>on</strong>g-term use of respite for families<br />
(Chan & Sigafoos).<br />
Based <strong>on</strong> these reported results, we c<strong>on</strong>clude<br />
that early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> programs provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
or referr<str<strong>on</strong>g>in</str<strong>on</strong>g>g families to respite care services<br />
may be relevant to the ECO Center<br />
family outcomes of: (d) families have support<br />
systems, <str<strong>on</strong>g>and</str<strong>on</strong>g> (e) families are able to ga<str<strong>on</strong>g>in</str<strong>on</strong>g> access<br />
to desired services, programs <str<strong>on</strong>g>and</str<strong>on</strong>g> activities<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> their community. With respect to family<br />
quality of life doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s, the reported results<br />
appear to be relevant to improved Family<br />
Emoti<strong>on</strong>al Well-Be<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Discussi<strong>on</strong><br />
Limitati<strong>on</strong>s<br />
There are some limitati<strong>on</strong>s to this review of<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research for family supports.<br />
First, there are evaluati<strong>on</strong>s of commercial programs<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> models that are aimed at improv<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
family outcomes that were excluded from<br />
our review. We chose to exclude commercially<br />
available curriculum or materials for early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce all Part C programs would<br />
not have the opportunity to pursue these programs.<br />
Also, the majority of the studies were<br />
aimed at mothers, thus limit<str<strong>on</strong>g>in</str<strong>on</strong>g>g generalizati<strong>on</strong>s<br />
of the f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs to the entire family unit.<br />
Research Implicati<strong>on</strong>s<br />
466 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
There are four research implicati<strong>on</strong>s to c<strong>on</strong>sider<br />
from the results of this literature review.<br />
They <str<strong>on</strong>g>in</str<strong>on</strong>g>clude (a) <str<strong>on</strong>g>in</str<strong>on</strong>g>c<strong>on</strong>sistent <str<strong>on</strong>g>and</str<strong>on</strong>g> loosely def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
term<str<strong>on</strong>g>in</str<strong>on</strong>g>ology <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research articles,<br />
(b) lack of family outcomes <str<strong>on</strong>g>and</str<strong>on</strong>g> measures<br />
tailored to families <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
research, (c) limited <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research<br />
target<str<strong>on</strong>g>in</str<strong>on</strong>g>g families <str<strong>on</strong>g>and</str<strong>on</strong>g> young children with<br />
disabilities, <str<strong>on</strong>g>and</str<strong>on</strong>g> (d) few evaluati<strong>on</strong>s specifically<br />
focused <strong>on</strong> family emoti<strong>on</strong>al supports.<br />
First, the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
this review measured outcomes for families<br />
us<str<strong>on</strong>g>in</str<strong>on</strong>g>g many different variables. Those variables<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded stress or depressi<strong>on</strong> levels,<br />
health benefits, abuse <str<strong>on</strong>g>and</str<strong>on</strong>g> pregnancy rates,<br />
home envir<strong>on</strong>ment, self-esteem, satisfacti<strong>on</strong>,<br />
attitudes, frustrati<strong>on</strong> levels, acceptance, negativity,<br />
parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g behavior, participati<strong>on</strong>, <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>,<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>come <str<strong>on</strong>g>and</str<strong>on</strong>g> employment levels, social<br />
supports, use of teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g practices, family cohesi<strong>on</strong>,<br />
percepti<strong>on</strong>s, affective styles, number<br />
of services received, resp<strong>on</strong>siveness, socializati<strong>on</strong>,<br />
helpgiv<str<strong>on</strong>g>in</str<strong>on</strong>g>g practices, <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>trol. The<br />
def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> model descripti<strong>on</strong>s to evaluate<br />
family support <str<strong>on</strong>g>and</str<strong>on</strong>g> outcomes <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
literature are not mutually exclusive; therefore,<br />
it is difficult to parcel out what aspect of<br />
the support is truly impact<str<strong>on</strong>g>in</str<strong>on</strong>g>g the family. For<br />
example, <str<strong>on</strong>g>in</str<strong>on</strong>g> this review the category of general<br />
family-centered practices had a variety of dif-
ferent <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s grouped together which<br />
made it difficult to del<str<strong>on</strong>g>in</str<strong>on</strong>g>eate the specific support<br />
that was be<str<strong>on</strong>g>in</str<strong>on</strong>g>g offered to families. Either<br />
the research or model descripti<strong>on</strong> was vague<br />
or the field of early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> has not<br />
clearly def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed the term<str<strong>on</strong>g>in</str<strong>on</strong>g>ology or def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s<br />
related to family support. Therefore, more<br />
specificity is needed <str<strong>on</strong>g>in</str<strong>on</strong>g> the term<str<strong>on</strong>g>in</str<strong>on</strong>g>ology <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s that the field uses to guide research<br />
<strong>on</strong> family support <str<strong>on</strong>g>and</str<strong>on</strong>g> outcomes.<br />
Sec<strong>on</strong>dly, the overlap <str<strong>on</strong>g>in</str<strong>on</strong>g> variables measured<br />
leads to c<strong>on</strong>fusi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terpret<str<strong>on</strong>g>in</str<strong>on</strong>g>g the outcomes<br />
for families. In this review, we attempted<br />
to categorize the results of each study<br />
accord<str<strong>on</strong>g>in</str<strong>on</strong>g>g to the ECO outcomes <str<strong>on</strong>g>and</str<strong>on</strong>g> Beach<br />
Center family quality of life doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s as a<br />
framework for discuss<str<strong>on</strong>g>in</str<strong>on</strong>g>g family support outcomes.<br />
A framework for the field <str<strong>on</strong>g>in</str<strong>on</strong>g> measur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
family outcomes, both short-term <str<strong>on</strong>g>and</str<strong>on</strong>g> l<strong>on</strong>gterm,<br />
is needed. To meet this goal, measurements<br />
with psychometric properties tailored<br />
to assess families’ outcomes are warranted.<br />
Further research <strong>on</strong> family support is needed<br />
that specifically measures both short-term <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
l<strong>on</strong>g-term family outcomes.<br />
The third research implicati<strong>on</strong> is the limited<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research target<str<strong>on</strong>g>in</str<strong>on</strong>g>g families<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> young children with disabilities. Because<br />
a primary purpose of this article was to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
how family support is def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed <str<strong>on</strong>g>and</str<strong>on</strong>g> delivered<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> studies, we broadened<br />
our search bey<strong>on</strong>d programs focused <strong>on</strong><br />
families of children with disabilities <str<strong>on</strong>g>in</str<strong>on</strong>g> order<br />
to <str<strong>on</strong>g>in</str<strong>on</strong>g>clude more types of family support <str<strong>on</strong>g>in</str<strong>on</strong>g> this<br />
analysis. This necessity <str<strong>on</strong>g>in</str<strong>on</strong>g> itself underscores<br />
the lack of emphasis <strong>on</strong> supports for families<br />
of children with disabilities. Only 18 of the 26<br />
articles <str<strong>on</strong>g>in</str<strong>on</strong>g> this paper evaluated <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
for this populati<strong>on</strong>. There were more <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
studies available that sampled general<br />
early childhood populati<strong>on</strong>s, especially <str<strong>on</strong>g>in</str<strong>on</strong>g> regard<br />
to parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g programs <str<strong>on</strong>g>and</str<strong>on</strong>g> twogenerati<strong>on</strong><br />
programs. In this article, <strong>on</strong>ly approximately<br />
half of the articles <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g programs category measured<br />
parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g aspects <str<strong>on</strong>g>in</str<strong>on</strong>g> relati<strong>on</strong> to families with<br />
children hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g disabilities. N<strong>on</strong>e of the studies<br />
evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g two-generati<strong>on</strong> programs sampled<br />
families <str<strong>on</strong>g>and</str<strong>on</strong>g> children with disabilities.<br />
The <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> these two areas is promis<str<strong>on</strong>g>in</str<strong>on</strong>g>g;<br />
however, the research needs to be extended<br />
to deliberately <str<strong>on</strong>g>in</str<strong>on</strong>g>clude families <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
children with disabilities.<br />
Another research implicati<strong>on</strong> from this review<br />
is the limited number of <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
research target<str<strong>on</strong>g>in</str<strong>on</strong>g>g families <str<strong>on</strong>g>and</str<strong>on</strong>g> young children<br />
with disabilities evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g family emoti<strong>on</strong>al<br />
support. One category of <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
models, peer support, exam<str<strong>on</strong>g>in</str<strong>on</strong>g>ed the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
research <strong>on</strong> emoti<strong>on</strong>al supports for families.<br />
Included were studies evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g Parent<br />
to Parent <str<strong>on</strong>g>and</str<strong>on</strong>g> peer mentor<str<strong>on</strong>g>in</str<strong>on</strong>g>g programs.<br />
There were no studies specifically evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
support groups as the primary <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
for families. Support groups were evaluated as<br />
part of more comprehensive <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the category of general family-centered services,<br />
therefore, mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g it difficult to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
the specific impact group supports had<br />
<strong>on</strong> families. Family emoti<strong>on</strong>al support would<br />
be an area for further research.<br />
Policy Implicati<strong>on</strong>s<br />
There are two policy implicati<strong>on</strong>s that have<br />
evolved from this literature review. They <str<strong>on</strong>g>in</str<strong>on</strong>g>clude<br />
(a) policy adopti<strong>on</strong> of an established set<br />
of family outcomes us<str<strong>on</strong>g>in</str<strong>on</strong>g>g specific def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s<br />
of family support <str<strong>on</strong>g>and</str<strong>on</strong>g> (b) policy adopti<strong>on</strong> of<br />
evidence-based family support <str<strong>on</strong>g>in</str<strong>on</strong>g> IDEA.<br />
First, policy must adopt an established set of<br />
family outcomes us<str<strong>on</strong>g>in</str<strong>on</strong>g>g specific def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
term<str<strong>on</strong>g>in</str<strong>on</strong>g>ology for family support. This paper<br />
has attempted to l<str<strong>on</strong>g>in</str<strong>on</strong>g>k family support <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
research with outcomes def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed by the<br />
ECO Center <str<strong>on</strong>g>and</str<strong>on</strong>g> the Beach Center family<br />
quality of life doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s. The goals developed<br />
by the ECO Center reflect short-term outcomes,<br />
though l<strong>on</strong>g-term impacts also need to<br />
be emphasized. L<strong>on</strong>g-term family outcomes<br />
are reflected <str<strong>on</strong>g>in</str<strong>on</strong>g> the Beach Center’s family<br />
quality of life doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s. A challenge to develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
an established set of family outcomes <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
policy is the overlap or lack of specificity <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
term<str<strong>on</strong>g>in</str<strong>on</strong>g>ology <str<strong>on</strong>g>and</str<strong>on</strong>g> def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s of family support.<br />
As previously recommended <str<strong>on</strong>g>in</str<strong>on</strong>g> this paper, research<br />
needs to del<str<strong>on</strong>g>in</str<strong>on</strong>g>eate the specific term<str<strong>on</strong>g>in</str<strong>on</strong>g>ology<br />
for def<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g family support. Once del<str<strong>on</strong>g>in</str<strong>on</strong>g>eated<br />
through research, the family support<br />
def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> terms need to be <str<strong>on</strong>g>in</str<strong>on</strong>g>corporated<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>to a framework for family outcomes. Further,<br />
a family outcome framework should be<br />
adopted <str<strong>on</strong>g>in</str<strong>on</strong>g>to federal policy, such as IDEA Part<br />
C <str<strong>on</strong>g>and</str<strong>on</strong>g> the DD Act.<br />
Sec<strong>on</strong>d, policy must adopt evidence-based<br />
family support <str<strong>on</strong>g>in</str<strong>on</strong>g> the next reauthorizati<strong>on</strong> of<br />
Impacts of Family Support / 467
IDEA. The <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
outcomes for families is limited <str<strong>on</strong>g>in</str<strong>on</strong>g> scope to<br />
<strong>on</strong>ly a few types of support outl<str<strong>on</strong>g>in</str<strong>on</strong>g>ed <str<strong>on</strong>g>in</str<strong>on</strong>g> IDEA.<br />
There is a gap between the types of supports<br />
stated <str<strong>on</strong>g>in</str<strong>on</strong>g> IDEA <str<strong>on</strong>g>and</str<strong>on</strong>g> evidence-based family support<br />
reviewed <str<strong>on</strong>g>in</str<strong>on</strong>g> this article. For example,<br />
IDEA does not require agencies to provide<br />
families with respite care, though the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
research <str<strong>on</strong>g>in</str<strong>on</strong>g>dicates respite care enhances<br />
the emoti<strong>on</strong>al well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g of families by<br />
decreas<str<strong>on</strong>g>in</str<strong>on</strong>g>g parents’ stress <str<strong>on</strong>g>and</str<strong>on</strong>g> depressi<strong>on</strong> levels.<br />
Similar positive outcomes for Parent to<br />
Parent <str<strong>on</strong>g>and</str<strong>on</strong>g> peer mentor<str<strong>on</strong>g>in</str<strong>on</strong>g>g programs were<br />
reported. Families reported receiv<str<strong>on</strong>g>in</str<strong>on</strong>g>g emoti<strong>on</strong>al<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong>al support from peers.<br />
In know<str<strong>on</strong>g>in</str<strong>on</strong>g>g the positive impacts respite care<br />
programs <str<strong>on</strong>g>and</str<strong>on</strong>g> peer support have <strong>on</strong> families,<br />
it would seem feasible to <str<strong>on</strong>g>in</str<strong>on</strong>g>clude these types of<br />
family support <str<strong>on</strong>g>in</str<strong>on</strong>g> the available services outl<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> IDEA under Part C <str<strong>on</strong>g>in</str<strong>on</strong>g> the next reauthorizati<strong>on</strong>.<br />
Policy should m<str<strong>on</strong>g>and</str<strong>on</strong>g>ate the types<br />
of family support that are empirically validated.<br />
Summary<br />
We have reviewed <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> studies that<br />
evaluated support for families which <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g programs, general family-centered<br />
practice models offer<str<strong>on</strong>g>in</str<strong>on</strong>g>g comprehensive<br />
family support, peer support, two-generati<strong>on</strong><br />
programs, <str<strong>on</strong>g>and</str<strong>on</strong>g> respite care. The majority of<br />
studies reviewed did not clearly def<str<strong>on</strong>g>in</str<strong>on</strong>g>e the<br />
specific support provided to families <str<strong>on</strong>g>and</str<strong>on</strong>g>,<br />
thus, it is not often clear just what the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
entailed. However, we are able to<br />
identify impacts <strong>on</strong> families of this support,<br />
both those that were specifically def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed (e.g.,<br />
respite care, peer supports) <str<strong>on</strong>g>and</str<strong>on</strong>g> those that<br />
were broadly comprehensive. Interventi<strong>on</strong> research<br />
suggests that parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g programs<br />
improved parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills <str<strong>on</strong>g>and</str<strong>on</strong>g> parent satisfacti<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> reduced parental stress (Niccols &<br />
Mohamed, 2000; Roberts et al., 2003). Additi<strong>on</strong>ally,<br />
general family-centered practice<br />
models offer<str<strong>on</strong>g>in</str<strong>on</strong>g>g an array of support improved<br />
overall family cohesi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> parental emoti<strong>on</strong>al<br />
well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g (Dunst et al., 2001; Ericks<strong>on</strong>-<br />
Warfield et al., 2000; Hendriks et al., 2000;<br />
Mah<strong>on</strong>ey & Bella, 1998). An evaluati<strong>on</strong> of<br />
peer supports <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated parental attitudes towards<br />
family <str<strong>on</strong>g>and</str<strong>on</strong>g> disability improved, but not<br />
parental empowerment (S<str<strong>on</strong>g>in</str<strong>on</strong>g>ger et al., 1999).<br />
Two-generati<strong>on</strong> programs positively impacted<br />
parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g (Gomby et al., 1999; Love et al.,<br />
2002) <str<strong>on</strong>g>and</str<strong>on</strong>g> improved parents’ educati<strong>on</strong>al atta<str<strong>on</strong>g>in</str<strong>on</strong>g>ments,<br />
but did not have significant effects<br />
<strong>on</strong> parental health or mental health (St.<br />
Pierre et al., 1995). F<str<strong>on</strong>g>in</str<strong>on</strong>g>ally, respite care has<br />
short-term effects of reduc<str<strong>on</strong>g>in</str<strong>on</strong>g>g parental stress<br />
(Chan & Sigafoos, 2001; Cowen & Reed,<br />
2002). The <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research reviewed <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
this article, overall, reported positive outcomes<br />
for families. Most often, the evaluati<strong>on</strong>s<br />
focused <strong>on</strong> child outcomes <str<strong>on</strong>g>and</str<strong>on</strong>g> family impacts<br />
were <str<strong>on</strong>g>in</str<strong>on</strong>g>cidental <str<strong>on</strong>g>in</str<strong>on</strong>g> the report<str<strong>on</strong>g>in</str<strong>on</strong>g>g of the f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
of the study. The outcomes for families<br />
could be characterized by the family quality of<br />
life doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s of family <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>, parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
emoti<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> physical/material well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> disability-related supports, as well as by<br />
the categories of family outcomes def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed by<br />
the ECO Center. In review<str<strong>on</strong>g>in</str<strong>on</strong>g>g the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
research, it is apparent that the implicati<strong>on</strong><br />
for the early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> field is to adopt<br />
c<strong>on</strong>sistent term<str<strong>on</strong>g>in</str<strong>on</strong>g>ology def<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g family support.<br />
Research <strong>on</strong> family support is also needed<br />
that specifically l<str<strong>on</strong>g>in</str<strong>on</strong>g>ks to family outcomes, thus<br />
guid<str<strong>on</strong>g>in</str<strong>on</strong>g>g future policy decisi<strong>on</strong>s for families <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
young children with disabilities.<br />
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Received: 23 April 2008<br />
Initial Acceptance: 25 June 2008<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>al Acceptance: 20 October 2008<br />
470 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009
Differences Between Employees’ <str<strong>on</strong>g>and</str<strong>on</strong>g> Supervisors’ Evaluati<strong>on</strong>s<br />
of Work Performance <str<strong>on</strong>g>and</str<strong>on</strong>g> Support Needs<br />
Kyle Bennett, Michael Fra<str<strong>on</strong>g>in</str<strong>on</strong>g>, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Michael P. Brady<br />
Florida Atlantic University<br />
Tricia Sur<str<strong>on</strong>g>in</str<strong>on</strong>g>ak<br />
Broward County Public Schools<br />
Howard Rosenberg<br />
Florida Internati<strong>on</strong>al University<br />
Abstract: Assessment systems are needed that are sensitive to employees’ work performance as well as their need<br />
for support, while <str<strong>on</strong>g>in</str<strong>on</strong>g>corporat<str<strong>on</strong>g>in</str<strong>on</strong>g>g the <str<strong>on</strong>g>in</str<strong>on</strong>g>put from both employees <str<strong>on</strong>g>and</str<strong>on</strong>g> their supervisors. This study exam<str<strong>on</strong>g>in</str<strong>on</strong>g>ed the<br />
corresp<strong>on</strong>dence of <strong>on</strong>e such evaluati<strong>on</strong> system, the Job Observati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> Behavior Scale (JOBS) <str<strong>on</strong>g>and</str<strong>on</strong>g> the JOBS:<br />
Opportunity for Self-Determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> (JOBS: OSD), to establish whether performance <str<strong>on</strong>g>and</str<strong>on</strong>g> support evaluati<strong>on</strong>s<br />
adm<str<strong>on</strong>g>in</str<strong>on</strong>g>istered by work supervisors would match self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ed percepti<strong>on</strong>s of the same variables by sheltered <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
supported employees with disabilities. Results showed that JOBS rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs established by supervisors did not<br />
corresp<strong>on</strong>d closely to employees’ self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ed rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs for any of the JOBS’ subscales (Work-Required Daily<br />
Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Activities, Work-Required Behavior, <str<strong>on</strong>g>and</str<strong>on</strong>g> Work-Required Job Duties). Results also showed that employees<br />
c<strong>on</strong>sistently overestimated their work performance <str<strong>on</strong>g>and</str<strong>on</strong>g> underestimated their support needs relative to supervisors’<br />
rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs. These results suggest that major discrepancies exist between supervisors’ <str<strong>on</strong>g>and</str<strong>on</strong>g> employees’ percepti<strong>on</strong>s of<br />
their work performance <str<strong>on</strong>g>and</str<strong>on</strong>g> support needs. These discrepancies may be important as job coaches, teachers,<br />
rehabilitati<strong>on</strong> professi<strong>on</strong>als, <str<strong>on</strong>g>and</str<strong>on</strong>g> employees <str<strong>on</strong>g>and</str<strong>on</strong>g> students with disabilities participate <str<strong>on</strong>g>in</str<strong>on</strong>g> employment preparati<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> transiti<strong>on</strong> plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
For most adults, employment is <str<strong>on</strong>g>in</str<strong>on</strong>g>tricately tied<br />
to culture <str<strong>on</strong>g>and</str<strong>on</strong>g> social values, <str<strong>on</strong>g>and</str<strong>on</strong>g> is central to<br />
the roles adults hold <str<strong>on</strong>g>in</str<strong>on</strong>g> their communities <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
with<str<strong>on</strong>g>in</str<strong>on</strong>g> their families. Because most people<br />
spend the majority of each day work<str<strong>on</strong>g>in</str<strong>on</strong>g>g, work<br />
is significant <str<strong>on</strong>g>in</str<strong>on</strong>g> how adults def<str<strong>on</strong>g>in</str<strong>on</strong>g>e themselves<br />
(Abrams, D<strong>on</strong>Aroma, & Karan, 1997; Grossi,<br />
Schaaf, Steigerwald, & Mank, 2002; Kolstoe,<br />
1961). For most adults, employment has pers<strong>on</strong>al<br />
benefits <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g self-c<strong>on</strong>fidence, directi<strong>on</strong>,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>creased life satisfacti<strong>on</strong> (Griff<str<strong>on</strong>g>in</str<strong>on</strong>g>,<br />
Rosenberg, Cheyney, & Greenberg, 1996;<br />
Sk<str<strong>on</strong>g>in</str<strong>on</strong>g>ner, 2003). Ec<strong>on</strong>omic benefits <str<strong>on</strong>g>in</str<strong>on</strong>g>clude<br />
the opportunity to shape <strong>on</strong>e’s own f<str<strong>on</strong>g>in</str<strong>on</strong>g>ancial<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependence <str<strong>on</strong>g>and</str<strong>on</strong>g> to decrease reliance <strong>on</strong><br />
families <str<strong>on</strong>g>and</str<strong>on</strong>g> others for ec<strong>on</strong>omic support (Anth<strong>on</strong>y,<br />
1994; Kim & Morn<str<strong>on</strong>g>in</str<strong>on</strong>g>gstar, 2005; Reisman<br />
& Reisman, 1993). Work also provides<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g this article should<br />
be addressed to Kyle Bennett, Florida Atlantic University,<br />
Department of Excepti<strong>on</strong>al Student <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>,<br />
777 Glades Road, Boca Rat<strong>on</strong>, Florida 33431.<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, 2009, 44(4), 471–480<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
social benefits <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g the opportunity to<br />
establish mean<str<strong>on</strong>g>in</str<strong>on</strong>g>gful relati<strong>on</strong>ships <str<strong>on</strong>g>and</str<strong>on</strong>g> the opportunity<br />
to c<strong>on</strong>tribute to <strong>on</strong>e’s community<br />
(Mancuso, 1990; Storey, 2002).<br />
Unfortunately, the benefits of work have yet<br />
to reach many <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with disabilities,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> community employment c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ues to be<br />
an elusive goal (Brady & Rosenberg, 2002a).<br />
For example, nearly 2/3 of adults with disabilities<br />
rema<str<strong>on</strong>g>in</str<strong>on</strong>g> unemployed or under-employed,<br />
or <strong>on</strong>ly have access to employment <str<strong>on</strong>g>in</str<strong>on</strong>g> sheltered<br />
workshops (Levy, Jessop, Rimmerman,<br />
Francis, & Levy, 1993; Murphy, Rogan, H<str<strong>on</strong>g>and</str<strong>on</strong>g>ley,<br />
K<str<strong>on</strong>g>in</str<strong>on</strong>g>caid, & Royce-Davis, 2002). Access to<br />
community employment is particularly troublesome<br />
for <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with more complex<br />
disabilities <str<strong>on</strong>g>and</str<strong>on</strong>g> behavior challenges (Hurlbutt<br />
& Chalmers, 2004; Mank, Cioffi, & Yovanoff,<br />
1998; McDermott, Mart<str<strong>on</strong>g>in</str<strong>on</strong>g>, & Butkus, 1999;<br />
Muller, Schuler, Burt<strong>on</strong>, & Yates, 2003).<br />
For community employment to be a successful<br />
outcome, many <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with disabilities<br />
require explicit <str<strong>on</strong>g>and</str<strong>on</strong>g> purposeful employment<br />
Evaluati<strong>on</strong>s of Work Performance <str<strong>on</strong>g>and</str<strong>on</strong>g> Support Needs / 471
<str<strong>on</strong>g>and</str<strong>on</strong>g> transiti<strong>on</strong> plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g. This <str<strong>on</strong>g>in</str<strong>on</strong>g>cludes active<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s to improve work performance<br />
(such as job coach<str<strong>on</strong>g>in</str<strong>on</strong>g>g) <str<strong>on</strong>g>and</str<strong>on</strong>g> attenti<strong>on</strong> to the<br />
design <str<strong>on</strong>g>and</str<strong>on</strong>g> delivery of work supports (Brady &<br />
Rosenberg, 2002a; Mancuso, 1990; Stodden,<br />
1998; Targett, Wehman, McK<str<strong>on</strong>g>in</str<strong>on</strong>g>ley, & Young,<br />
2004). In additi<strong>on</strong>, employment evaluati<strong>on</strong>s<br />
need to be sensitive to these two separate, but<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>ter-related dimensi<strong>on</strong>s. To date, evaluati<strong>on</strong>s<br />
of supported <str<strong>on</strong>g>and</str<strong>on</strong>g> sheltered employees have<br />
seldom been l<str<strong>on</strong>g>in</str<strong>on</strong>g>ked directly both to dem<strong>on</strong>strated<br />
work performance <str<strong>on</strong>g>and</str<strong>on</strong>g> employment support<br />
needs (Brady, Rosenberg, & Fra<str<strong>on</strong>g>in</str<strong>on</strong>g>, 2008).<br />
As important as it is to evaluate both of<br />
these employment dimensi<strong>on</strong>s (performance<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> support needs), it is equally important<br />
that employment evaluati<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g>clude the percepti<strong>on</strong>s<br />
of both employers <str<strong>on</strong>g>and</str<strong>on</strong>g> the employees<br />
themselves. In most community employment<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, work supervisors are most resp<strong>on</strong>sible<br />
for these evaluati<strong>on</strong>s; employment factors<br />
such as promoti<strong>on</strong>s, raises, <str<strong>on</strong>g>and</str<strong>on</strong>g> retenti<strong>on</strong> rely<br />
heavily <strong>on</strong> the percepti<strong>on</strong>s of performance by<br />
supervisors (Graffam, Sh<str<strong>on</strong>g>in</str<strong>on</strong>g>kfield, Smith, Polz<str<strong>on</strong>g>in</str<strong>on</strong>g>,<br />
2002; Hamilt<strong>on</strong> & Shumate, 2005; Krantz,<br />
1971). However, for <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with disabilities<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> other employment challenges, ga<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>put from employees directly is critical<br />
when mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g employment decisi<strong>on</strong>s (Brady et<br />
al., 2008; Lynn, Sumsi<strong>on</strong>, McWilliam, & Mac-<br />
K<str<strong>on</strong>g>in</str<strong>on</strong>g>n<strong>on</strong>, 2004; Wehman, 2006), particularly<br />
when plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s to promote job<br />
skills or develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g employment <str<strong>on</strong>g>and</str<strong>on</strong>g> transiti<strong>on</strong><br />
plans (Mart<str<strong>on</strong>g>in</str<strong>on</strong>g> & Huber Marshall, 1996;<br />
Menchetti & Garcia, 2003; Olney & Salom<strong>on</strong>e,<br />
1992; Rogan, Banks & Howard, 2000). Unfortunately,<br />
few employment evaluati<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g>clude<br />
self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> when establish<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
or support goals <str<strong>on</strong>g>and</str<strong>on</strong>g> transiti<strong>on</strong> plans<br />
for community employment (Thoma, Williams,<br />
& Davis, 2005; Wehmeyer & Schwartz,<br />
1997). Fewer still <str<strong>on</strong>g>in</str<strong>on</strong>g>clude both employer <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
employee percepti<strong>on</strong>s of work performance<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> support needs (Shaw, McMah<strong>on</strong>, Chan, &<br />
Hannold, 2004; Valenzuela & Mart<str<strong>on</strong>g>in</str<strong>on</strong>g>, 2005).<br />
If employment evaluati<strong>on</strong>s are go<str<strong>on</strong>g>in</str<strong>on</strong>g>g to be<br />
helpful <str<strong>on</strong>g>in</str<strong>on</strong>g> develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g employment <str<strong>on</strong>g>and</str<strong>on</strong>g> transiti<strong>on</strong><br />
plans for <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with disabilities,<br />
then assessment <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> is needed al<strong>on</strong>g<br />
all four of these dimensi<strong>on</strong>s. First, it is important<br />
to establish whether or not an employee’s<br />
work productivity matches the productivity of<br />
other employees without disabilities. This per-<br />
472 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
formance dimensi<strong>on</strong> is typically the focus of<br />
employer <str<strong>on</strong>g>and</str<strong>on</strong>g> supervisor evaluati<strong>on</strong>s (Hamilt<strong>on</strong><br />
& Shumate, 2005; Morgan & Alex<str<strong>on</strong>g>and</str<strong>on</strong>g>er,<br />
2005). Sec<strong>on</strong>d, for an employment evaluati<strong>on</strong><br />
to be useful <str<strong>on</strong>g>in</str<strong>on</strong>g> a supported employment c<strong>on</strong>text,<br />
it needs to <str<strong>on</strong>g>in</str<strong>on</strong>g>corporate <str<strong>on</strong>g>in</str<strong>on</strong>g>put <strong>on</strong> the type<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> level of support an employee uses to establish<br />
that level of performance (Rogan et<br />
al., 2000; Targett et al., 2004). Third, s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce<br />
employers are resp<strong>on</strong>sible for the c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued<br />
operati<strong>on</strong> of the bus<str<strong>on</strong>g>in</str<strong>on</strong>g>ess or enterprise, the<br />
evaluati<strong>on</strong> necessarily <str<strong>on</strong>g>in</str<strong>on</strong>g>cludes the employer’s<br />
percepti<strong>on</strong> of an employee’s performance<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> support needs (Graffam et al., 2002). F<str<strong>on</strong>g>in</str<strong>on</strong>g>ally,<br />
if transiti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> employment plans are<br />
to be developmental <str<strong>on</strong>g>in</str<strong>on</strong>g> nature – that is, the<br />
plans are to promote growth <str<strong>on</strong>g>and</str<strong>on</strong>g> opportunity<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> employees with disabilities – then evaluati<strong>on</strong>s<br />
must <str<strong>on</strong>g>in</str<strong>on</strong>g>clude employees’ own self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
perspectives of their performance <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
support needs (Brady et al., 2008).<br />
An evaluati<strong>on</strong> model that <str<strong>on</strong>g>in</str<strong>on</strong>g>corporates<br />
these four employment dimensi<strong>on</strong>s will provide<br />
important <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> when develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
transiti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> employment plans, <str<strong>on</strong>g>and</str<strong>on</strong>g> select<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
potential job roles, work placements, performance<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s, <str<strong>on</strong>g>and</str<strong>on</strong>g> support. The<br />
evaluati<strong>on</strong> data could establish, for example,<br />
that a supported employee’s work performance<br />
is not sufficient to ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g> c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued<br />
employment, <str<strong>on</strong>g>and</str<strong>on</strong>g> that some type of employment<br />
support (e.g., adapt<str<strong>on</strong>g>in</str<strong>on</strong>g>g materials or rout<str<strong>on</strong>g>in</str<strong>on</strong>g>es;<br />
restructur<str<strong>on</strong>g>in</str<strong>on</strong>g>g a complex job <str<strong>on</strong>g>in</str<strong>on</strong>g>to several<br />
s<str<strong>on</strong>g>in</str<strong>on</strong>g>gle tasks) is necessary to improve that performance.<br />
Numerous models of supported<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> sheltered employment exist that use evaluati<strong>on</strong><br />
data to make employment decisi<strong>on</strong>s<br />
such as this (Brady & Rosenberg, 2002a; Nisbet<br />
& Callahan, 1987; Olney & Salom<strong>on</strong>e,<br />
1992; Wehman, 1996). However, few models<br />
of assessment exist which <str<strong>on</strong>g>in</str<strong>on</strong>g>corporate both<br />
employee <str<strong>on</strong>g>and</str<strong>on</strong>g> employer percepti<strong>on</strong>s of performance<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> support, <str<strong>on</strong>g>and</str<strong>on</strong>g> the extent to<br />
which these different percepti<strong>on</strong>s corresp<strong>on</strong>d<br />
is relatively unknown.<br />
The purpose of the study was to <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigate<br />
the corresp<strong>on</strong>dence between employees’ <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
supervisors’ evaluati<strong>on</strong>s of work performance<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> support needs of people with disabilities<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> supported <str<strong>on</strong>g>and</str<strong>on</strong>g> sheltered employment. In<br />
areas where there was a lack of corresp<strong>on</strong>dence,<br />
we sought to establish the directi<strong>on</strong> of<br />
any differences (over-estimati<strong>on</strong>s or under-
estimati<strong>on</strong>s) of the two groups, <str<strong>on</strong>g>and</str<strong>on</strong>g> whether<br />
there were differences across the dimensi<strong>on</strong>s<br />
of performance vs. support.<br />
Method<br />
Participants <str<strong>on</strong>g>and</str<strong>on</strong>g> Sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
N<str<strong>on</strong>g>in</str<strong>on</strong>g>eteen employees with developmental disabilities<br />
(11 males <str<strong>on</strong>g>and</str<strong>on</strong>g> 8 females) participated<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> this study. Fifteen of the participants were<br />
diagnosed with a cognitive impairment, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
four were diagnosed with an autism spectrum<br />
disorder. All participated <str<strong>on</strong>g>in</str<strong>on</strong>g> supported (n <br />
14) or sheltered (n 5) employment programs.<br />
The employees ranged <str<strong>on</strong>g>in</str<strong>on</strong>g> age from 20<br />
years <str<strong>on</strong>g>and</str<strong>on</strong>g> 11 m<strong>on</strong>ths to 54 years <str<strong>on</strong>g>and</str<strong>on</strong>g> 3 m<strong>on</strong>ths<br />
(M 36 years, 4 m<strong>on</strong>ths). All <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals who<br />
gave c<strong>on</strong>sent participated <str<strong>on</strong>g>in</str<strong>on</strong>g> this study, <str<strong>on</strong>g>and</str<strong>on</strong>g> no<br />
compensati<strong>on</strong> was provided for participati<strong>on</strong>.<br />
All employees worked <strong>on</strong> a part-time basis,<br />
rang<str<strong>on</strong>g>in</str<strong>on</strong>g>g from 6 hours to 30 hours per week <strong>on</strong><br />
the job. Job tasks for the five sheltered employees<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded sort<str<strong>on</strong>g>in</str<strong>on</strong>g>g, collat<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>and</str<strong>on</strong>g> prepar<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
mail<str<strong>on</strong>g>in</str<strong>on</strong>g>gs for local bus<str<strong>on</strong>g>in</str<strong>on</strong>g>esses; job tasks<br />
for the 14 supported employees <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
child <str<strong>on</strong>g>and</str<strong>on</strong>g> animal care, custodial <str<strong>on</strong>g>and</str<strong>on</strong>g> kitchen<br />
duties, bagg<str<strong>on</strong>g>in</str<strong>on</strong>g>g groceries, <str<strong>on</strong>g>and</str<strong>on</strong>g> work<str<strong>on</strong>g>in</str<strong>on</strong>g>g as a<br />
cashier <str<strong>on</strong>g>and</str<strong>on</strong>g> office assistant. At the time of this<br />
study, employees had been <str<strong>on</strong>g>in</str<strong>on</strong>g> their job roles<br />
from 5 m<strong>on</strong>ths to 9 years (M 4 years, 1<br />
m<strong>on</strong>th).<br />
Dependent Measures<br />
The Job Observati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> Behavior Scale (JOBS)<br />
(Rosenberg & Brady, 2000) was used to gather<br />
supervisors’ evaluati<strong>on</strong>s of the employees;<br />
the Job Observati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> Behavior Scale: Opportunity<br />
for Self-Determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> (JOBS: OSD) (Brady,<br />
Rosenberg, & Fra<str<strong>on</strong>g>in</str<strong>on</strong>g>, 2006) was used to gather<br />
employees’ self-rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs. The two <str<strong>on</strong>g>in</str<strong>on</strong>g>struments<br />
comprise a system of evaluati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> which both<br />
external evaluators’ (supervisors, job coaches,<br />
teachers) rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> employees’ own self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs are used for employment<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g decisi<strong>on</strong>s. Both <str<strong>on</strong>g>in</str<strong>on</strong>g>struments target<br />
critical vocati<strong>on</strong>al behaviors <str<strong>on</strong>g>and</str<strong>on</strong>g> support<br />
needs of people <str<strong>on</strong>g>in</str<strong>on</strong>g> community employment<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs. The evaluati<strong>on</strong> assists employment<br />
professi<strong>on</strong>als to evaluate an <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual’s work<br />
performance <str<strong>on</strong>g>and</str<strong>on</strong>g> support needs, then to compare<br />
these results to the norms for other peo-<br />
ple who perform similar jobs <str<strong>on</strong>g>in</str<strong>on</strong>g> sheltered or<br />
supported employment. Validity, reliability,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> st<str<strong>on</strong>g>and</str<strong>on</strong>g>ardizati<strong>on</strong> data are available for<br />
three groups: sec<strong>on</strong>dary students with disabilities,<br />
adults <str<strong>on</strong>g>in</str<strong>on</strong>g> supported <str<strong>on</strong>g>and</str<strong>on</strong>g> sheltered work<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, <str<strong>on</strong>g>and</str<strong>on</strong>g> adults <str<strong>on</strong>g>in</str<strong>on</strong>g> entry level community<br />
jobs (Brady & Rosenberg, 2002b; Brady et al.,<br />
2008). Both JOBS <str<strong>on</strong>g>and</str<strong>on</strong>g> JOBS: OSD c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
same 30 items organized <str<strong>on</strong>g>in</str<strong>on</strong>g>to three subscales<br />
titled Work-Required Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Activities,<br />
Work-Required Behavior, <str<strong>on</strong>g>and</str<strong>on</strong>g> Work-Required<br />
Job Duties. The three subscales <str<strong>on</strong>g>and</str<strong>on</strong>g> a summary<br />
of items are found <str<strong>on</strong>g>in</str<strong>on</strong>g> Table 1.<br />
Although the scales <str<strong>on</strong>g>and</str<strong>on</strong>g> items are identical<br />
<strong>on</strong> both <str<strong>on</strong>g>in</str<strong>on</strong>g>struments, there are alternate<br />
phras<str<strong>on</strong>g>in</str<strong>on</strong>g>gs for the JOBS: OSD items for <str<strong>on</strong>g>in</str<strong>on</strong>g>stances<br />
when an employee has difficulty determ<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
what is be<str<strong>on</strong>g>in</str<strong>on</strong>g>g asked. In additi<strong>on</strong>, scor<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
protocols differ slightly for the JOBS <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
the JOBS: OSD. For each item <strong>on</strong> the JOBS, the<br />
supervisor rates each employee <strong>on</strong> the Quality<br />
of Performance, Type of Support needed, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
whether any Adaptive or Prosthetic Materials are<br />
needed. Quality of Job Performance is rated<br />
with a 5-po<str<strong>on</strong>g>in</str<strong>on</strong>g>t Likert-type scale with 5 <str<strong>on</strong>g>in</str<strong>on</strong>g>dicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
superior performance, 4 <str<strong>on</strong>g>in</str<strong>on</strong>g>dicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g above<br />
average performance, 3 <str<strong>on</strong>g>in</str<strong>on</strong>g>dicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g average<br />
performance, 2 <str<strong>on</strong>g>in</str<strong>on</strong>g>dicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g below average performance,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> 1 <str<strong>on</strong>g>in</str<strong>on</strong>g>dicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g performance<br />
which is not acceptable for competitive employment.<br />
The Type of Support is also rated<br />
<strong>on</strong> a 5-po<str<strong>on</strong>g>in</str<strong>on</strong>g>t scale with a rat<str<strong>on</strong>g>in</str<strong>on</strong>g>g of 5 mean<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
that no unique supervisi<strong>on</strong> or support is<br />
needed bey<strong>on</strong>d that provided to other workers.<br />
A rat<str<strong>on</strong>g>in</str<strong>on</strong>g>g of 4 <str<strong>on</strong>g>in</str<strong>on</strong>g>dicates that <str<strong>on</strong>g>in</str<strong>on</strong>g>termittent<br />
supervisi<strong>on</strong> is needed from a co-worker <str<strong>on</strong>g>and</str<strong>on</strong>g> a<br />
rat<str<strong>on</strong>g>in</str<strong>on</strong>g>g of 3 <str<strong>on</strong>g>in</str<strong>on</strong>g>dicates that <str<strong>on</strong>g>in</str<strong>on</strong>g>termittent supervisi<strong>on</strong><br />
is needed from the job coach or supervisor.<br />
Rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of 2 <str<strong>on</strong>g>and</str<strong>on</strong>g> 1 respectively <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate<br />
that supervisi<strong>on</strong> from the job coach or supervisor<br />
is needed either frequently or c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>uously.<br />
Because JOBS: OSD requires a self-assessment<br />
from <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with a wide range of<br />
cognitive <str<strong>on</strong>g>and</str<strong>on</strong>g> communicati<strong>on</strong> abilities, several<br />
alterati<strong>on</strong>s exist for the scor<str<strong>on</strong>g>in</str<strong>on</strong>g>g. First, each<br />
JOBS: OSD item is modified <str<strong>on</strong>g>in</str<strong>on</strong>g>to a self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong><br />
questi<strong>on</strong> format so that the <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong><br />
can be obta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed through a st<str<strong>on</strong>g>and</str<strong>on</strong>g>ardized <str<strong>on</strong>g>in</str<strong>on</strong>g>terview.<br />
This resp<strong>on</strong>se format requires that data<br />
be obta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed from <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual employees (an<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>ternal source of <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong>) rather than<br />
from work supervisors, job coaches, or reha-<br />
Evaluati<strong>on</strong>s of Work Performance <str<strong>on</strong>g>and</str<strong>on</strong>g> Support Needs / 473
TABLE 1<br />
Summary of JOBS <str<strong>on</strong>g>and</str<strong>on</strong>g> JOBS: OSD Items <str<strong>on</strong>g>and</str<strong>on</strong>g> Subscales<br />
bilitati<strong>on</strong> counselors (an external evaluati<strong>on</strong><br />
source). Sec<strong>on</strong>d, the scor<str<strong>on</strong>g>in</str<strong>on</strong>g>g protocol is simplified<br />
to a 3-po<str<strong>on</strong>g>in</str<strong>on</strong>g>t scale. For Quality of Performance<br />
rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, resp<strong>on</strong>dents report (a)<br />
“Yes”, (b) “Sometimes”, or (c) “No, not really”<br />
to the <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewer’s query about how well the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividual performs each item. For Type of<br />
Support rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs an <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewer asks resp<strong>on</strong>dents<br />
to select <strong>on</strong>e of three opti<strong>on</strong>s to <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate<br />
their need for support:<br />
“Can you do it by yourself?”<br />
“Can you do it with some help?”<br />
“Do you need a lot of help?”<br />
Procedure<br />
Subscale Number of items Item examples<br />
Work-Required Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g 13 Attendance; Punctuality; Pers<strong>on</strong>al Hygiene; Travel;<br />
Communicati<strong>on</strong>; M<strong>on</strong>ey; Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g; Math; Self<br />
Identificati<strong>on</strong>; Work & Pers<strong>on</strong>al Schedul<str<strong>on</strong>g>in</str<strong>on</strong>g>g;<br />
Work Facilities; Motivati<strong>on</strong><br />
Work-Required Behavior 8 Stress Tolerance; Interpers<strong>on</strong>al Work & Social<br />
Interacti<strong>on</strong>s; Changes <str<strong>on</strong>g>in</str<strong>on</strong>g> Rout<str<strong>on</strong>g>in</str<strong>on</strong>g>es; H<strong>on</strong>esty;<br />
Reacti<strong>on</strong> to Criticism; Work Initiative &<br />
Endurance<br />
Work-Required Job Duties 9 Quality & Quantity of Work; Speed of Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
New Tasks; Performance <strong>on</strong> Previously Learned<br />
& Multiple Tasks; Organizati<strong>on</strong> of Work Tasks;<br />
Safety; Cleanl<str<strong>on</strong>g>in</str<strong>on</strong>g>ess of Work Envir<strong>on</strong>ment<br />
For each employee, a work supervisor or job<br />
coach (hereafter referred to as supervisor)<br />
completed a JOBS record<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> scor<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
form. Each of the supervisors had worked directly<br />
with the employees previously, <str<strong>on</strong>g>and</str<strong>on</strong>g> had<br />
the knowledge necessary to complete the<br />
form. After the supervisors scored the <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals,<br />
the forms were returned to the <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigators<br />
for data entry <str<strong>on</strong>g>and</str<strong>on</strong>g> analysis. The <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigators<br />
tallied the total of po<str<strong>on</strong>g>in</str<strong>on</strong>g>ts scored for each<br />
of the three subscales (Work-Required Daily<br />
Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Activities, Work-Required Behavior,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Work-Required Job Duties) for Quality of<br />
Performance <str<strong>on</strong>g>and</str<strong>on</strong>g> Type of Support.<br />
Next, each employee was <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewed by<br />
<strong>on</strong>e of the authors to obta<str<strong>on</strong>g>in</str<strong>on</strong>g> the JOBS: OSD<br />
rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs. Interviews were c<strong>on</strong>ducted <str<strong>on</strong>g>in</str<strong>on</strong>g> a private<br />
area at the employees’ worksites. Supervisors<br />
were not present dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the <str<strong>on</strong>g>in</str<strong>on</strong>g>terviews. Employees<br />
were <str<strong>on</strong>g>in</str<strong>on</strong>g>formed of the answer choices<br />
prior to the <str<strong>on</strong>g>in</str<strong>on</strong>g>terview <str<strong>on</strong>g>and</str<strong>on</strong>g> items <str<strong>on</strong>g>and</str<strong>on</strong>g> answer<br />
choices were restated as needed. To adm<str<strong>on</strong>g>in</str<strong>on</strong>g>ister<br />
the JOBS: OSD, the <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewer read each<br />
item to the employee. The alternate phras<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
provided <str<strong>on</strong>g>in</str<strong>on</strong>g> the evaluati<strong>on</strong> protocol was provided<br />
if an employee needed clarificati<strong>on</strong> <strong>on</strong><br />
the <str<strong>on</strong>g>in</str<strong>on</strong>g>itial word<str<strong>on</strong>g>in</str<strong>on</strong>g>g of the item. The <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigators<br />
then totaled the scores for each of the<br />
three subscales for Quality of Performance<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Type of Support.<br />
Data Analysis<br />
474 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Data were h<str<strong>on</strong>g>and</str<strong>on</strong>g> scored by the lead author <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
then analyzed us<str<strong>on</strong>g>in</str<strong>on</strong>g>g SPSS 15.0. The means<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard deviati<strong>on</strong>s were computed for<br />
each of the subscales <str<strong>on</strong>g>and</str<strong>on</strong>g> for the overall scores<br />
for both JOBS <str<strong>on</strong>g>and</str<strong>on</strong>g> JOBS: OSD. Next, Pears<strong>on</strong><br />
product-moment correlati<strong>on</strong> coefficients were<br />
computed between the supervisors’ <str<strong>on</strong>g>and</str<strong>on</strong>g> employees’<br />
rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs for each subscale, as well as<br />
for the overall scores, to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e the degree<br />
of corresp<strong>on</strong>dence between the groups. A related<br />
samples t-test was used to study any difference<br />
between employees’ <str<strong>on</strong>g>and</str<strong>on</strong>g> supervisors’<br />
percepti<strong>on</strong>s <strong>on</strong> employees’ Quality of Performance<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Types of Support needs for each<br />
subscale for both JOBS <str<strong>on</strong>g>and</str<strong>on</strong>g> JOBS: OSD (Work-<br />
Required Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Activities, Work-Required<br />
Behavior, <str<strong>on</strong>g>and</str<strong>on</strong>g> Work-Required Job Duties).<br />
Prior to this analysis; however, scores<br />
were transformed to a st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard score <strong>on</strong> a
TABLE 2<br />
St<str<strong>on</strong>g>and</str<strong>on</strong>g>ardized Means, St<str<strong>on</strong>g>and</str<strong>on</strong>g>ard Deviati<strong>on</strong>s, <str<strong>on</strong>g>and</str<strong>on</strong>g> Correlati<strong>on</strong>s for Subscale <str<strong>on</strong>g>and</str<strong>on</strong>g> Overall Scores N 19 for<br />
Each Scale<br />
JOBS<br />
C<strong>on</strong>struct<br />
l<str<strong>on</strong>g>in</str<strong>on</strong>g>ear scale from 0-100, with 0 be<str<strong>on</strong>g>in</str<strong>on</strong>g>g the lowest<br />
score <str<strong>on</strong>g>and</str<strong>on</strong>g> 100 be<str<strong>on</strong>g>in</str<strong>on</strong>g>g the best possible score.<br />
The formula for this transformati<strong>on</strong> followed<br />
Holmes <str<strong>on</strong>g>and</str<strong>on</strong>g> Shea’s (1998) transformati<strong>on</strong> formula:<br />
Transformed St<str<strong>on</strong>g>and</str<strong>on</strong>g>ard Score (100 [Total<br />
Possible Score # of Items <strong>on</strong> Scale]) <br />
[Actual Score # of Items <strong>on</strong> Scale].<br />
For example, the raw Quality of Performance<br />
score for Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Activities for each employee<br />
was c<strong>on</strong>verted to a transformed st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard<br />
score <strong>on</strong> a l<str<strong>on</strong>g>in</str<strong>on</strong>g>ear scale as follows:<br />
Transformed St<str<strong>on</strong>g>and</str<strong>on</strong>g>ard Score for Quality of<br />
Performance for Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Activities <br />
(100 [65 13]) [Actual Participant<br />
Score 13].<br />
Us<str<strong>on</strong>g>in</str<strong>on</strong>g>g this formula, each employee’s JOBS <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
JOBS: OSD raw scores were transformed to a<br />
st<str<strong>on</strong>g>and</str<strong>on</strong>g>ardized score so that their rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs could<br />
be compared.<br />
Results<br />
Supervisor Employee<br />
Mean SD Mean SD<br />
N<str<strong>on</strong>g>in</str<strong>on</strong>g>eteen pairs of surveys were completed for<br />
a total of 38 surveys (19 JOBS; 19JOBS: OSD).<br />
Means <str<strong>on</strong>g>and</str<strong>on</strong>g> st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard deviati<strong>on</strong>s for each of the<br />
three subscales, <str<strong>on</strong>g>and</str<strong>on</strong>g> for overall scores for each<br />
Supervisor &<br />
employee correlati<strong>on</strong><br />
Work-Required Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Activities subscale<br />
QOP 76.5 15.9 83.0 12.0 .13<br />
TOS 80.1 16.1 74.5 18.8 .10<br />
Work-Required Behavior subscale<br />
QOP 68.7 19.8 87.5 12.0 .08<br />
TOS 70.5 18.5 80.9 15.4 .00<br />
Work-Required Job Duties subscale<br />
QOP 72.0 16.9 79.5 17.2 .19<br />
TOS 71.5 17.1 74.0 10.3 .15<br />
Total scores<br />
QOP 73.3 14.7 82.2 7.3 .09<br />
TOS 75.4 14.5 75.6 13.5 .12<br />
QOP Quality of Performance<br />
TOS Type of Support<br />
of the <str<strong>on</strong>g>in</str<strong>on</strong>g>struments are provided <str<strong>on</strong>g>in</str<strong>on</strong>g> Table 2.<br />
The means <str<strong>on</strong>g>and</str<strong>on</strong>g> st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard deviati<strong>on</strong>s for this<br />
sample were similar to the normative sample<br />
for both JOBS <str<strong>on</strong>g>and</str<strong>on</strong>g> JOBS: OSD (Brady et al.,<br />
2006; Rosenberg & Brady, 2000). For <str<strong>on</strong>g>in</str<strong>on</strong>g>stance,<br />
the raw scores for <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals <strong>on</strong> the JOBS:OSD<br />
Work Related Activities of Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g QOP<br />
scale <str<strong>on</strong>g>in</str<strong>on</strong>g> our sample was 34.6 (3.1); very similar<br />
to the normative sample of Brady et al. which<br />
found raw scores of 34.3 (4.1). (For more<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> <strong>on</strong> normative samples please refer<br />
to Brady & Rosenberg, 2002b, <str<strong>on</strong>g>and</str<strong>on</strong>g> Brady et<br />
al., 2008).<br />
Also seen <str<strong>on</strong>g>in</str<strong>on</strong>g> Table 2 are the Pears<strong>on</strong> product-moment<br />
correlati<strong>on</strong> coefficients between<br />
the two groups for each subscale. These coefficients<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dicated generally low correlati<strong>on</strong>s,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> three <str<strong>on</strong>g>in</str<strong>on</strong>g>stances (Quality of Performance<br />
rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs for both Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Activities<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Work-Required Behavior, <str<strong>on</strong>g>and</str<strong>on</strong>g> Type of<br />
Support scores for Work-Required Behavior)<br />
showed a reverse correlati<strong>on</strong>. That is, as employees’<br />
scores improved <strong>on</strong> JOBS: OSD, the<br />
supervisors’ scores for these employees decreased<br />
<strong>on</strong> JOBS. This trend was also seen <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
overall scores for both scales. The subscale<br />
correlati<strong>on</strong>s ranged from .13 to .19 Correlati<strong>on</strong><br />
coefficients for the overall scores were<br />
.09 for Quality of Performance <str<strong>on</strong>g>and</str<strong>on</strong>g> .12 for<br />
Evaluati<strong>on</strong>s of Work Performance <str<strong>on</strong>g>and</str<strong>on</strong>g> Support Needs / 475
TABLE 3<br />
Related Sample t-test Analysis Summary (N 38)<br />
Measures<br />
Mean difference<br />
Supervisor-employee<br />
Type of Support. These f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate that<br />
there was generally a very small correlati<strong>on</strong><br />
between the supervisors’ scores <str<strong>on</strong>g>and</str<strong>on</strong>g> the employees’<br />
scores of themselves. N<strong>on</strong>e of the<br />
correlati<strong>on</strong>s were statistically significant (p <br />
.05).<br />
Results of the related samples t-test compar<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
employees’ <str<strong>on</strong>g>and</str<strong>on</strong>g> supervisors’ percepti<strong>on</strong>s<br />
of the employees’ rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of their Quality of<br />
Performance <str<strong>on</strong>g>and</str<strong>on</strong>g> Type of Support needs for<br />
the three subscales are <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> Table 3.<br />
This table shows that significant differences<br />
exist between employees’ <str<strong>on</strong>g>and</str<strong>on</strong>g> supervisors’ rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the employees’ overall Quality of Performance<br />
scores, as well as <strong>on</strong> the Work-Required<br />
Behavior subscale.<br />
Given the small sample size <str<strong>on</strong>g>in</str<strong>on</strong>g> this study, the<br />
statistical power necessary to f<str<strong>on</strong>g>in</str<strong>on</strong>g>d a significant<br />
difference between the two sets of rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs was<br />
low; the power to f<str<strong>on</strong>g>in</str<strong>on</strong>g>d statistical significance at<br />
the .05 level, if it existed at a medium effect<br />
size was .69. Therefore, an alternate way of<br />
look<str<strong>on</strong>g>in</str<strong>on</strong>g>g at the results was also pursued. This<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>volved establish<str<strong>on</strong>g>in</str<strong>on</strong>g>g the effect sizes for the<br />
differences. Effect sizes present the differences<br />
between scores <str<strong>on</strong>g>in</str<strong>on</strong>g> st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard deviati<strong>on</strong><br />
terms [where the Difference (Mean of Supervisors’<br />
Scores – Mean of Employees’<br />
Scores/St<str<strong>on</strong>g>and</str<strong>on</strong>g>ard Deviati<strong>on</strong>)]. This allowed<br />
for more practical significance to be exam<str<strong>on</strong>g>in</str<strong>on</strong>g>ed.<br />
In social science research, Cohen (1988)<br />
95% c<strong>on</strong>fidence <str<strong>on</strong>g>in</str<strong>on</strong>g>terval<br />
Upper Lower t sig ES<br />
Quality of Performance<br />
Total Score 8.8 1.2 16.5 2.3 .02 .75<br />
DLA 6.4 2.7 15.6 1.4 .16 .46<br />
BEH 18.7 8.0 29.5 3.5 .001 1.18<br />
JD 2.5 1.7 16.9 .5 .66 .55<br />
Type of Support<br />
Total Score .2 9.0 9.4 .04 .97 .01<br />
DLA 5.6 17.1 5.9 .98 .33 .32<br />
BEH 10.4 .81 21.6 1.8 .07 .62<br />
JD 7.6 1.7 16.8 1.7 .11 .14<br />
DLA Work-Required Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Activities<br />
BEH Work-Required Behavior<br />
JD Work-Required Job Duties<br />
476 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dicated that the practical significance of the<br />
size of an effect should be compared to the<br />
follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g st<str<strong>on</strong>g>and</str<strong>on</strong>g>ards: (a) for a large effect, d<br />
.80; (b) for a medium effect, d .50; <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
(c) for a small effect, d .20. In this study,<br />
effect sizes show that employees rated themselves<br />
higher <str<strong>on</strong>g>in</str<strong>on</strong>g> every scale, but <strong>on</strong>e, when<br />
compared to their supervisors. Effect sizes<br />
ranged from a low of .14 (small effect) for the<br />
Type of Support for Work-Required Job Duties<br />
to a large effect size of 1.18 for the Quality<br />
of Performance Work-Required Behavior subscale.<br />
In all, five of the eight paired samples<br />
had effect sizes that would be c<strong>on</strong>sidered a<br />
medium to large effect; this <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded Quality<br />
of Performance for Work-Required Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Activities, Work-Required Behavior, Work-<br />
Required Job Duties subscales; the Total Quality<br />
of Performance rat<str<strong>on</strong>g>in</str<strong>on</strong>g>g; <str<strong>on</strong>g>and</str<strong>on</strong>g> the Type of<br />
Support rat<str<strong>on</strong>g>in</str<strong>on</strong>g>g for the Work-Required Behavior<br />
subscale. Two rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs fell <str<strong>on</strong>g>in</str<strong>on</strong>g> the small effect<br />
size range, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g the Type of Support<br />
rat<str<strong>on</strong>g>in</str<strong>on</strong>g>g for the work required Job Duties, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
the Type of Support rat<str<strong>on</strong>g>in</str<strong>on</strong>g>g for the Work-Required<br />
Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Activities subscale (.14 <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
.32, respectively). These f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate that<br />
supervisors’ rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs were approximately half<br />
of a st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard deviati<strong>on</strong> below employees’ selfdeterm<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs. Only the Type of Support<br />
overall rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs failed to show an effect. It is<br />
important to note that all comparis<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g>di-
cate effect size differences <str<strong>on</strong>g>in</str<strong>on</strong>g> the directi<strong>on</strong><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g that supervisors were always significantly<br />
lower <str<strong>on</strong>g>in</str<strong>on</strong>g> their percepti<strong>on</strong>s than employees,<br />
with <strong>on</strong>e excepti<strong>on</strong>. The Type of Support<br />
rat<str<strong>on</strong>g>in</str<strong>on</strong>g>g for the Work-Required Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Activities<br />
subscale was the <strong>on</strong>ly <strong>on</strong>e <str<strong>on</strong>g>in</str<strong>on</strong>g> which<br />
employers scored higher than employees.<br />
Discussi<strong>on</strong><br />
Overall, these results <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate that employees<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> their supervisors have a very different<br />
op<str<strong>on</strong>g>in</str<strong>on</strong>g>i<strong>on</strong> c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g the quality of work accomplished<br />
by employees with disabilities.<br />
S<str<strong>on</strong>g>in</str<strong>on</strong>g>ce the number of comparis<strong>on</strong> pairs was<br />
relatively small <str<strong>on</strong>g>in</str<strong>on</strong>g> this <str<strong>on</strong>g>in</str<strong>on</strong>g>itial study, significance<br />
levels are better addressed by effect<br />
sizes than statistical significance test<str<strong>on</strong>g>in</str<strong>on</strong>g>g. In this<br />
case, most of the pair comparis<strong>on</strong>s for the six<br />
subscales <str<strong>on</strong>g>and</str<strong>on</strong>g> two overall scores showed important<br />
differences between how supervisors<br />
rated employees <str<strong>on</strong>g>and</str<strong>on</strong>g> how employees rated<br />
themselves <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of Quality of Performance.<br />
There is a similar disc<strong>on</strong>nect <strong>on</strong> the<br />
Type of Support that is needed by employees<br />
to do their jobs, also dem<strong>on</strong>strated by the<br />
effect sizes. It may be that employees are overc<strong>on</strong>fident<br />
of their abilities, or employers<br />
might focus more <strong>on</strong> aspects of the job with<br />
which they are not satisfied. It also may be that<br />
employees with disabilities are unaware of<br />
how their work performance is judged by employers.<br />
Alternatively, it is possible that many<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with disabilities have <str<strong>on</strong>g>in</str<strong>on</strong>g>herent difficulty<br />
with skills associated with self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong><br />
(such as self-assessment) <str<strong>on</strong>g>and</str<strong>on</strong>g> may not<br />
be proficient <str<strong>on</strong>g>in</str<strong>on</strong>g> evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g their strengths <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
needs accurately. In <strong>on</strong>e study that supports<br />
this noti<strong>on</strong>, Wehmeyer <str<strong>on</strong>g>and</str<strong>on</strong>g> Schwartz (1998)<br />
reported that educati<strong>on</strong>al plans rarely targeted<br />
self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> skills for sec<strong>on</strong>dary<br />
students with cognitive impairments, <str<strong>on</strong>g>and</str<strong>on</strong>g> recommended<br />
that these skills be given priority<br />
for development. In the current study, it is<br />
important to note that the results (both the<br />
large effect sizes <str<strong>on</strong>g>and</str<strong>on</strong>g> the low correlati<strong>on</strong>s)<br />
show that employers rated the quality of performance<br />
differently <str<strong>on</strong>g>and</str<strong>on</strong>g> lower <str<strong>on</strong>g>in</str<strong>on</strong>g> most every<br />
category compared to employees.<br />
Overall <str<strong>on</strong>g>and</str<strong>on</strong>g> subscale scores <str<strong>on</strong>g>in</str<strong>on</strong>g> this study<br />
were very similar to the normed sample for<br />
JOBS: OSD <strong>on</strong> all of the Quality of Performance,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Type of Support measures. This<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dicates that <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of work performance,<br />
the employees <str<strong>on</strong>g>in</str<strong>on</strong>g> this study were similar (all<br />
scores well with<str<strong>on</strong>g>in</str<strong>on</strong>g> <strong>on</strong>e st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard deviati<strong>on</strong> of<br />
the normative group) to the sample <strong>on</strong> which<br />
this measure was normed. Although when<br />
compar<str<strong>on</strong>g>in</str<strong>on</strong>g>g this sample to others who were <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
work experience or supported employment<br />
(<str<strong>on</strong>g>in</str<strong>on</strong>g> the normed sample), the Type of Support<br />
scores for the Job-Related Duties subscale <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
the overall scores were somewhat higher for<br />
those <str<strong>on</strong>g>in</str<strong>on</strong>g> this study. Thus, it may be that this<br />
sample had slightly less work related support<br />
needs than those <str<strong>on</strong>g>in</str<strong>on</strong>g> the past sample.<br />
There are many uses for employment <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
transiti<strong>on</strong> assessments, particularly when assessment<br />
systems <str<strong>on</strong>g>in</str<strong>on</strong>g>corporate the multiple dimensi<strong>on</strong>s<br />
targeted <str<strong>on</strong>g>in</str<strong>on</strong>g> this study (productivity<br />
vs. support needs; employees’ vs. supervisors’<br />
percepti<strong>on</strong>s). The JOBS evaluati<strong>on</strong> system<br />
(Brady et al., 2006; Rosenberg & Brady, 2000)<br />
is <strong>on</strong>e such example, <str<strong>on</strong>g>and</str<strong>on</strong>g> this study <str<strong>on</strong>g>in</str<strong>on</strong>g>dicates<br />
a new area of use for such assessments. The<br />
discrepancy scores found <str<strong>on</strong>g>in</str<strong>on</strong>g> this study <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate<br />
that employers <str<strong>on</strong>g>and</str<strong>on</strong>g> employees disagreed<br />
about the quality of work <str<strong>on</strong>g>and</str<strong>on</strong>g> the support<br />
needs of entry-level workers with disabilities.<br />
While not know<str<strong>on</strong>g>in</str<strong>on</strong>g>g who was “right” <str<strong>on</strong>g>in</str<strong>on</strong>g> this<br />
debate, different theories emerge. It may be<br />
that employees with disabilities overestimate<br />
their ability level <str<strong>on</strong>g>and</str<strong>on</strong>g> need professi<strong>on</strong>als <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the field to give them h<strong>on</strong>est feedback c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
how their performance will be judged<br />
by future employers. One way of us<str<strong>on</strong>g>in</str<strong>on</strong>g>g JOBS to<br />
achieve this aim is to ask <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
early days of employment (or before be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
employed) to evaluate for themselves how<br />
other workers are do<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>and</str<strong>on</strong>g> then compare<br />
those rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs to their own self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs.<br />
An alternate explanati<strong>on</strong> for the discrepancy<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> scores could be employers underestimat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the skills of these employees. It may be<br />
that employers have prec<strong>on</strong>ceived ideas about<br />
how well employees with disabilities will perform<br />
<strong>on</strong> a job, <str<strong>on</strong>g>and</str<strong>on</strong>g> unknow<str<strong>on</strong>g>in</str<strong>on</strong>g>gly hold a rater<br />
bias when judg<str<strong>on</strong>g>in</str<strong>on</strong>g>g the quality of employees’<br />
work performance. It is also possible that the<br />
mere presence of a disability predisposes supervisors<br />
to watch these employees differently<br />
or more closely. It may be that any employee<br />
who is watched closely could obta<str<strong>on</strong>g>in</str<strong>on</strong>g> many suggesti<strong>on</strong>s<br />
from an employer <strong>on</strong> how to improve<br />
<strong>on</strong>e’s work. Employment professi<strong>on</strong>als can<br />
Evaluati<strong>on</strong>s of Work Performance <str<strong>on</strong>g>and</str<strong>on</strong>g> Support Needs / 477
share this <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> with employers, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
perhaps have them rate other very successful<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> marg<str<strong>on</strong>g>in</str<strong>on</strong>g>ally successful employees <strong>on</strong> the<br />
job. These rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs could be compared to the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividual with a disability to underst<str<strong>on</strong>g>and</str<strong>on</strong>g><br />
whether there is a need for improved performance,<br />
or whether the employee is perform<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
at an acceptable or normative rate.<br />
The different rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs obta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed by employees<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> supervisors can be used to identify<br />
changes needed for successful employment to<br />
be ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed. Employment professi<strong>on</strong>als, for<br />
example, could use these scores to create specific<br />
target goals based <strong>on</strong> these assessment<br />
scores. For <str<strong>on</strong>g>in</str<strong>on</strong>g>stance, if an employee reported<br />
that his or her job was c<strong>on</strong>ducted with a high<br />
degree of safety, but the supervisor reported<br />
that this <strong>on</strong>ly happens some of the time, the<br />
two can work with a job coach so that both<br />
underst<str<strong>on</strong>g>and</str<strong>on</strong>g> what c<strong>on</strong>stitutes safe job performance.<br />
They could then develop an <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
to reach that goal. Support <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
can be developed <str<strong>on</strong>g>in</str<strong>on</strong>g> a similar fashi<strong>on</strong>, with the<br />
goal of educat<str<strong>on</strong>g>in</str<strong>on</strong>g>g community employers<br />
about the types of supports that are available<br />
to help employees successfully perform their<br />
jobs. For <str<strong>on</strong>g>in</str<strong>on</strong>g>stance, if employees identify that<br />
they always need help to get back from breaks<br />
<strong>on</strong> time, the employment professi<strong>on</strong>al can discuss<br />
with the supervisor <str<strong>on</strong>g>and</str<strong>on</strong>g> employees the<br />
various ways to get the help needed to get<br />
back to work <strong>on</strong> time. For example, a coworker<br />
can be recruited to rem<str<strong>on</strong>g>in</str<strong>on</strong>g>d an employee<br />
when break time is over, or an alarm<br />
watch might be used as an adaptati<strong>on</strong> to rem<str<strong>on</strong>g>in</str<strong>on</strong>g>d<br />
an employee that it is time to return to<br />
work.<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>ally, employment professi<strong>on</strong>als can th<str<strong>on</strong>g>in</str<strong>on</strong>g>k<br />
about us<str<strong>on</strong>g>in</str<strong>on</strong>g>g supervisors’ <str<strong>on</strong>g>and</str<strong>on</strong>g> employees’<br />
scores <strong>on</strong> the JOBS system as a measure of<br />
when successful employment has been<br />
achieved. Currently, many people with disabilities<br />
<strong>on</strong>ly receive employment support <strong>on</strong> a<br />
temporary basis, <str<strong>on</strong>g>and</str<strong>on</strong>g> lose such support when a<br />
rehabilitati<strong>on</strong> counselor affirms that the employment<br />
status of the pers<strong>on</strong> is stable. This<br />
leads to many cases be<str<strong>on</strong>g>in</str<strong>on</strong>g>g closed before the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividual is <str<strong>on</strong>g>in</str<strong>on</strong>g> a successful l<strong>on</strong>g-term employment<br />
situati<strong>on</strong>. By <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g JOBS <str<strong>on</strong>g>and</str<strong>on</strong>g> JOBS:<br />
OSD rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>in</str<strong>on</strong>g>to an Individual Plan for Employment<br />
(IPE), these data could be used to<br />
determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e whether the <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual with a disability<br />
is stable <str<strong>on</strong>g>in</str<strong>on</strong>g> his or her work behavior,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> likely to c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ue success <strong>on</strong> the job (as<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dicated by m<str<strong>on</strong>g>in</str<strong>on</strong>g>imum performance scores,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> the support scores needed to ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
success). By <str<strong>on</strong>g>in</str<strong>on</strong>g>putt<str<strong>on</strong>g>in</str<strong>on</strong>g>g these criteria <str<strong>on</strong>g>in</str<strong>on</strong>g>to an<br />
IPE, employment professi<strong>on</strong>als can be more<br />
c<strong>on</strong>fident that employees are not los<str<strong>on</strong>g>in</str<strong>on</strong>g>g jobs<br />
due to <str<strong>on</strong>g>in</str<strong>on</strong>g>accurate percepti<strong>on</strong>s of work skills<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> premature term<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> of services (Mart<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
et al., 2006).<br />
Historically, people with disabilities have<br />
had difficulty obta<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g community<br />
employment (Brady & Rosenberg,<br />
2002a; Levy et al., 1993; Murphy et al., 2002).<br />
There are many factors that c<strong>on</strong>tribute to this<br />
situati<strong>on</strong>. These factors <str<strong>on</strong>g>in</str<strong>on</strong>g>clude provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
fad<str<strong>on</strong>g>in</str<strong>on</strong>g>g support (Rogan, Lueck<str<strong>on</strong>g>in</str<strong>on</strong>g>g, & Grossi,<br />
2007), fund<str<strong>on</strong>g>in</str<strong>on</strong>g>g for supported employment efforts<br />
(Rusch & Braddock, 2004), <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>tegrat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
employees with disabilities <str<strong>on</strong>g>in</str<strong>on</strong>g>to the culture<br />
of the workplace (Rogan, Callahan, Griff<str<strong>on</strong>g>in</str<strong>on</strong>g>, &<br />
Hammis, 2007). An additi<strong>on</strong>al variable that<br />
may impact the employment status of people<br />
with disabilities is the degree to which their<br />
self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ed evaluati<strong>on</strong>s of their own work<br />
performance <str<strong>on</strong>g>and</str<strong>on</strong>g> support needs corresp<strong>on</strong>d<br />
with those of their supervisors’ evaluati<strong>on</strong>s.<br />
Thus, it seems prudent for supervisors, employment<br />
professi<strong>on</strong>als, <str<strong>on</strong>g>and</str<strong>on</strong>g> related service<br />
providers to obta<str<strong>on</strong>g>in</str<strong>on</strong>g> the self-evaluati<strong>on</strong>s of employees<br />
with disabilities (see Brady et al., 2008;<br />
Lynn et al., 2004), <str<strong>on</strong>g>and</str<strong>on</strong>g> compare those evaluati<strong>on</strong>s<br />
to supervisors’ evaluati<strong>on</strong>s. In additi<strong>on</strong><br />
to learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g the employees’ perspective, such<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> may highlight any exist<str<strong>on</strong>g>in</str<strong>on</strong>g>g discrepancies<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> allow supervisors <str<strong>on</strong>g>and</str<strong>on</strong>g> employees<br />
to address these areas of c<strong>on</strong>cern prior to<br />
any changes to the <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual’s employment<br />
status.<br />
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255.<br />
Received: 19 March 2008<br />
Initial Acceptance: 17 May 2008<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>al Acceptance: 26 September 2008<br />
480 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009
Review of Interventi<strong>on</strong>s to Increase Functi<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> Symbolic<br />
Play <str<strong>on</strong>g>in</str<strong>on</strong>g> Children with Autism<br />
Russell Lang, Mark O’Reilly, M<str<strong>on</strong>g>and</str<strong>on</strong>g>y Rispoli, <str<strong>on</strong>g>and</str<strong>on</strong>g> Karrie Shogren<br />
The University of Texas at Aust<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
Wendy Machalicek<br />
Portl<str<strong>on</strong>g>and</str<strong>on</strong>g> State University<br />
April Regester<br />
University of California at Santa Barbara<br />
Jeff Sigafoos<br />
Victoria University of Well<str<strong>on</strong>g>in</str<strong>on</strong>g>gt<strong>on</strong><br />
Abstract: Play is widely acknowledged to be an <str<strong>on</strong>g>in</str<strong>on</strong>g>tegral part of human development <str<strong>on</strong>g>and</str<strong>on</strong>g> children with autism<br />
often experience substantial delays <str<strong>on</strong>g>in</str<strong>on</strong>g> the development of play behaviors. This review updates older reviews by<br />
cover<str<strong>on</strong>g>in</str<strong>on</strong>g>g the last 10 years of research target<str<strong>on</strong>g>in</str<strong>on</strong>g>g functi<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> symbolic play <str<strong>on</strong>g>in</str<strong>on</strong>g> children with autism. The review<br />
differs from other reviews c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g play by <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g all c<strong>on</strong>ceptual models <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> envir<strong>on</strong>ments,<br />
while also limit<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>clusi<strong>on</strong> to studies dem<strong>on</strong>strat<str<strong>on</strong>g>in</str<strong>on</strong>g>g experimental c<strong>on</strong>trol. Additi<strong>on</strong>ally, this is the first review<br />
of play studies to report results <str<strong>on</strong>g>in</str<strong>on</strong>g> quantifiable terms (e.g. PND). Studies are grouped <str<strong>on</strong>g>in</str<strong>on</strong>g>to two categories (i.e.<br />
studies of functi<strong>on</strong>al versus symbolic play). Three comp<strong>on</strong>ents (i.e. model<str<strong>on</strong>g>in</str<strong>on</strong>g>g, prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g with c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent<br />
re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement, <str<strong>on</strong>g>and</str<strong>on</strong>g> child directed or “naturalistic” <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>) appear related to successful play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s.<br />
The results of this review suggest that these comp<strong>on</strong>ents underlie the effectiveness of successful play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
for children with autism.<br />
Play is widely acknowledged to be an <str<strong>on</strong>g>in</str<strong>on</strong>g>tegral<br />
part of human development <str<strong>on</strong>g>and</str<strong>on</strong>g> a large percentage<br />
of typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g children’s<br />
time is spent engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> play (Boutot, Guenther,<br />
& Crozier, 2005; Sigelman & Rider,<br />
2006). As children develop, play serves <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>gly<br />
more complex <str<strong>on</strong>g>and</str<strong>on</strong>g> vital functi<strong>on</strong>s<br />
(Rutherford & Rogers, 2003; Williams, 2003).<br />
For example, play has been l<str<strong>on</strong>g>in</str<strong>on</strong>g>ked to the development<br />
of sensory process<str<strong>on</strong>g>in</str<strong>on</strong>g>g systems<br />
(Ruff, 1984), communicati<strong>on</strong> skills (Bakeman<br />
& Adams<strong>on</strong>, 1984, Toth, Muns<strong>on</strong>, Meltzoff, &<br />
Daws<strong>on</strong>, 2006), cogniti<strong>on</strong> (Piaget, 1962; Rutherford<br />
& Rogers, 2003; Vygotsky, 2000), <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
social <str<strong>on</strong>g>and</str<strong>on</strong>g> emoti<strong>on</strong>al <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s (Eriks<strong>on</strong>,<br />
1951). Delayed or abnormal development of<br />
The authors would like to thank the Eli <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Edythe L. Broad Center for Asperger’s Research at<br />
the Koegel Autism Center, University of California,<br />
Santa Barbara for their support. Corresp<strong>on</strong>dence<br />
c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g this article should be addressed to Russell<br />
Lang, Department of Special <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>, 1 University<br />
Stati<strong>on</strong> D5300, The University of Texas at<br />
Aust<str<strong>on</strong>g>in</str<strong>on</strong>g>, Aust<str<strong>on</strong>g>in</str<strong>on</strong>g>, TX 78712.<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, 2009, 44(4), 481–492<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
play behaviors can aversely affect an <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual<br />
across their lifespan (Sigelman & Rider, 2006)<br />
Children with autism <str<strong>on</strong>g>and</str<strong>on</strong>g> related developmental<br />
disabilities often experience substantial<br />
delays <str<strong>on</strong>g>in</str<strong>on</strong>g> the development of play behavior<br />
(Bar<strong>on</strong>-Cohen, 1987). In a l<strong>on</strong>gitud<str<strong>on</strong>g>in</str<strong>on</strong>g>al study,<br />
Sigafoos, Roberts-Pennell, <str<strong>on</strong>g>and</str<strong>on</strong>g> Graves (1999)<br />
reported that while other areas of adaptive<br />
behavior showed ga<str<strong>on</strong>g>in</str<strong>on</strong>g>s over a 3-year period,<br />
there was very little improvement <str<strong>on</strong>g>in</str<strong>on</strong>g> play<br />
am<strong>on</strong>g a sample of 13 preschool children with<br />
autism <str<strong>on</strong>g>and</str<strong>on</strong>g> related developmental disabilities.<br />
Even when matched with children accord<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
to mental age, children with autism engage <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
significantly more stereotypic <str<strong>on</strong>g>and</str<strong>on</strong>g> repetitive<br />
behaviors <str<strong>on</strong>g>and</str<strong>on</strong>g> fewer appropriate play behaviors<br />
(W<str<strong>on</strong>g>in</str<strong>on</strong>g>g, Gould, Yeates, & Brierley, 1977).<br />
Indeed, these deficits are central to the def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong><br />
of autism (DSM-IV; APA, 1994) <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
items related to play are <str<strong>on</strong>g>in</str<strong>on</strong>g>tegral comp<strong>on</strong>ents<br />
<strong>on</strong> autism diagnostic tools (e.g. Autism Diagnostic<br />
Observati<strong>on</strong> Schedule, Autism Diagnostic<br />
Interview). Deficits <str<strong>on</strong>g>in</str<strong>on</strong>g> play behavior can<br />
further exacerbate the social <str<strong>on</strong>g>and</str<strong>on</strong>g> communicati<strong>on</strong><br />
delays experienced by children with au-<br />
Review of Play Interventi<strong>on</strong>s / 481
tism <str<strong>on</strong>g>and</str<strong>on</strong>g> make play an important area for<br />
early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> (Jarrold, Boucher, & Smith,<br />
1993).<br />
Given that play deficits are prevalent, persistent,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> a core feature of autism, it is not<br />
surpris<str<strong>on</strong>g>in</str<strong>on</strong>g>g that a c<strong>on</strong>siderable amount of <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
research has focused <strong>on</strong> develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
successful procedures for teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g play<br />
skills to children with autism (Terpstra, Higg<str<strong>on</strong>g>in</str<strong>on</strong>g>s,<br />
& Pierce, 2002; Stahmer, Ingersol, &<br />
Carter, 2003). In additi<strong>on</strong> to <str<strong>on</strong>g>in</str<strong>on</strong>g>creases <str<strong>on</strong>g>in</str<strong>on</strong>g> diversity,<br />
flexibility, <str<strong>on</strong>g>and</str<strong>on</strong>g> sp<strong>on</strong>taneity of play<br />
skills, successful play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s have also<br />
been associated with improvements <str<strong>on</strong>g>in</str<strong>on</strong>g> socializati<strong>on</strong>,<br />
language, cogniti<strong>on</strong>, functi<strong>on</strong>al use of<br />
objects, motor skills, <str<strong>on</strong>g>and</str<strong>on</strong>g> exercise (Brown &<br />
Murray, 2001).<br />
In the current review, we aim to assist practiti<strong>on</strong>ers<br />
with implement<str<strong>on</strong>g>in</str<strong>on</strong>g>g evidence-based<br />
practice, by review<str<strong>on</strong>g>in</str<strong>on</strong>g>g research that has focused<br />
<strong>on</strong> teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g play to children with autism.<br />
This focus is important because children<br />
with autism are known to have more profound<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> global deficits <str<strong>on</strong>g>in</str<strong>on</strong>g> play (Boutot et al.,<br />
2005). In additi<strong>on</strong>, unlike previous reviews, we<br />
have aimed for a more <str<strong>on</strong>g>in</str<strong>on</strong>g>clusive <str<strong>on</strong>g>and</str<strong>on</strong>g> comprehensive<br />
review by <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g studies derived<br />
from a range of c<strong>on</strong>ceptual models (e.g. behaviorism,<br />
developmental, sensory <str<strong>on</strong>g>in</str<strong>on</strong>g>tegrati<strong>on</strong>)<br />
(cf. Luckett, Bundy, & Roberts, 2007;<br />
Stahmer et al., 2003), <str<strong>on</strong>g>and</str<strong>on</strong>g> sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs (e.g. school<br />
or home based <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s) (cf. Terpstra et<br />
al., 2002). To ensure the certa<str<strong>on</strong>g>in</str<strong>on</strong>g>ty of evidence,<br />
which is important for guid<str<strong>on</strong>g>in</str<strong>on</strong>g>g evidence-based<br />
practice (Schlosser & Sigafoos, 2007), we limited<br />
the current review to studies <str<strong>on</strong>g>in</str<strong>on</strong>g> which<br />
experimental c<strong>on</strong>trol was dem<strong>on</strong>strated <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
summarized results <str<strong>on</strong>g>in</str<strong>on</strong>g> quantifiable terms.<br />
Method<br />
Search Procedures <str<strong>on</strong>g>and</str<strong>on</strong>g> Selecti<strong>on</strong> Criteria<br />
Systematic computerized literature searches<br />
were c<strong>on</strong>ducted <strong>on</strong> two databases: the <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>al<br />
Resources Informati<strong>on</strong> Clear<str<strong>on</strong>g>in</str<strong>on</strong>g>g House<br />
(ERIC) <str<strong>on</strong>g>and</str<strong>on</strong>g> PsychINFO to identify research<br />
studies target<str<strong>on</strong>g>in</str<strong>on</strong>g>g play behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g> children<br />
with autism. The search was limited to English<br />
language journal articles published between<br />
1998 <str<strong>on</strong>g>and</str<strong>on</strong>g> July 2008. Comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> of the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
search terms were entered <str<strong>on</strong>g>in</str<strong>on</strong>g>to the<br />
keywords field: autism, autistic, symbolic play,<br />
sociodramatic play, functi<strong>on</strong>al play, object manipulati<strong>on</strong>,<br />
toy play, stereotypic play, leisure skills,<br />
games, <str<strong>on</strong>g>and</str<strong>on</strong>g> pretend. This <str<strong>on</strong>g>in</str<strong>on</strong>g>itial search resulted<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the identificati<strong>on</strong> of 425 studies. The titles<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> abstracts of these studies were then<br />
screened for general appropriateness. The<br />
reference lists from the result<str<strong>on</strong>g>in</str<strong>on</strong>g>g 65 studies<br />
were then h<str<strong>on</strong>g>and</str<strong>on</strong>g> searched for additi<strong>on</strong>al relevant<br />
studies lead<str<strong>on</strong>g>in</str<strong>on</strong>g>g to the identificati<strong>on</strong> of a<br />
total of 73 studies.<br />
These 73 studies were then <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded or excluded<br />
based <strong>on</strong> the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g criteria. To be<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded a study: (a) c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed participants<br />
ages 0 to 8 years old diagnosed with autism;<br />
(b) <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded the improvement <str<strong>on</strong>g>in</str<strong>on</strong>g> toy play as a<br />
dependent variable; <str<strong>on</strong>g>and</str<strong>on</strong>g> (c) experimental<br />
c<strong>on</strong>trol was dem<strong>on</strong>strated by means of s<str<strong>on</strong>g>in</str<strong>on</strong>g>glecase<br />
or c<strong>on</strong>trol-group experimental designs<br />
(Kennedy, 2005). Studies <str<strong>on</strong>g>in</str<strong>on</strong>g> which the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
procedures were not described <str<strong>on</strong>g>in</str<strong>on</strong>g> sufficient<br />
detail to enable replicati<strong>on</strong> or that did<br />
not dem<strong>on</strong>strate experimental c<strong>on</strong>trol were<br />
excluded (e.g. Bernard-Opitz, Ing, & K<strong>on</strong>g,<br />
2004). Also excluded were studies <str<strong>on</strong>g>in</str<strong>on</strong>g> which<br />
play was used as a c<strong>on</strong>text to <str<strong>on</strong>g>in</str<strong>on</strong>g>crease communicati<strong>on</strong><br />
or other social skills because the focus<br />
of these <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s was not <strong>on</strong> improv<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
play skills (e.g. Baker, Koegel & Koegel,<br />
1998; Bevill, Gast, Maguire, & Vail, 2001;<br />
Kohler, Anth<strong>on</strong>y, Steighner, & Hoys<strong>on</strong>, 2001;<br />
Krantz & McClannahan, 1998; L<strong>on</strong>cola &<br />
Craig-Unkefer, 2005; Shabani, Katz, Wilder,<br />
Beauchamp, Taylor, & Fisher, 2002). Studies<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> which the topography of the play behavior<br />
was unclear (e.g., “targeted play skill”) or did<br />
not require functi<strong>on</strong>al or symbolic play (provisi<strong>on</strong><br />
of sensory stimulati<strong>on</strong>) were also excluded<br />
(e.g. Ingersoll, Schreibman, & Tran,<br />
2003).<br />
Fifteen studies met the <str<strong>on</strong>g>in</str<strong>on</strong>g>clusi<strong>on</strong> criteria.<br />
These 15 studies <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded a total of 53 participants.<br />
Table 1 provides a summary of each<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded study.<br />
Cod<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> Summary of the Studies<br />
482 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
The 15 studies were coded us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a data sheet<br />
designed specifically for this review (available<br />
from the first author up<strong>on</strong> request). Every<br />
article was read <str<strong>on</strong>g>in</str<strong>on</strong>g> its entirety <str<strong>on</strong>g>and</str<strong>on</strong>g> pert<str<strong>on</strong>g>in</str<strong>on</strong>g>ent<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> was extracted <str<strong>on</strong>g>and</str<strong>on</strong>g> recorded <strong>on</strong><br />
the data sheet.<br />
Each study was classified <str<strong>on</strong>g>in</str<strong>on</strong>g>to <strong>on</strong>e of two
TABLE 1<br />
Studies Categorized <str<strong>on</strong>g>in</str<strong>on</strong>g>to Functi<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> Symbolic Play Behaviors, Lists Number of Participants,<br />
Independent <str<strong>on</strong>g>and</str<strong>on</strong>g> Dependent Variables, Experimental Design, <str<strong>on</strong>g>and</str<strong>on</strong>g> Results <str<strong>on</strong>g>in</str<strong>on</strong>g> Percent N<strong>on</strong>-overlapp<str<strong>on</strong>g>in</str<strong>on</strong>g>g Data<br />
(PND) or as Reported by Authors<br />
Citati<strong>on</strong> &<br />
Category<br />
I. Functi<strong>on</strong>al<br />
Play<br />
D’Ateno,<br />
Mangiapanello<br />
& Taylor<br />
(2003)<br />
Gillet & LeBlanc<br />
(2007)<br />
H<str<strong>on</strong>g>in</str<strong>on</strong>g>e & Wolery<br />
(2006)<br />
Hume & Odom<br />
(2007)<br />
Nuzzolo-<br />
Gomez,Le<strong>on</strong>ard,<br />
Ortiz,Rivera &<br />
Greer (2002)<br />
II. Symbolic Play<br />
Barry & Burlew<br />
(2004)<br />
Dauph<str<strong>on</strong>g>in</str<strong>on</strong>g>,<br />
K<str<strong>on</strong>g>in</str<strong>on</strong>g>ney &<br />
Stromer<br />
(2004)<br />
Ingersoll &<br />
Schreibman<br />
(2006)<br />
Kasari, Freeman<br />
& Paparella<br />
(2006)<br />
MacD<strong>on</strong>ald,<br />
Clark<br />
Garrigan &<br />
Vangala,<br />
(2005)<br />
n Independent<br />
Variables<br />
Experimental<br />
Design<br />
1 Video Model<str<strong>on</strong>g>in</str<strong>on</strong>g>g MBL* across<br />
toys<br />
3 Parentimplement<br />
Natural<br />
Language<br />
Paradigm<br />
2 Po<str<strong>on</strong>g>in</str<strong>on</strong>g>t-of-View<br />
Video<br />
Model<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
2 TEACHH<br />
developed<br />
Structured<br />
Work Systems<br />
3 Pair<str<strong>on</strong>g>in</str<strong>on</strong>g>g toy play<br />
with<br />
re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcer<br />
MBL across<br />
part a<br />
Multiple<br />
probe<br />
across play<br />
behaviors<br />
Reversal<br />
(ABAB)<br />
MBL across<br />
part<br />
2 Social Stories MBL across<br />
part<br />
1 Video Enhanced<br />
Activity<br />
Schedules &<br />
Matrix<br />
<str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g><br />
5 Reciprocal<br />
Imitati<strong>on</strong><br />
<str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g><br />
21 Comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
Behavioral<br />
Drill & Milieu<br />
Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Reversal &<br />
Comp<strong>on</strong>ent<br />
Analysis<br />
MBL across<br />
part &<br />
behaviors<br />
F Statistics <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
mixed<br />
effect<br />
regressi<strong>on</strong><br />
models<br />
2 Video Model<str<strong>on</strong>g>in</str<strong>on</strong>g>g Multiple<br />
probe<br />
across toys<br />
Dependent Variables & Results<br />
Modeled play behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M b PND c 87%<br />
(range, 60% to 100%)<br />
Novel play behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g>creased with some toys but not<br />
with others M b PND c 18% (range, 0% to 50%)<br />
Functi<strong>on</strong>al play <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M PND 93% (range, 80%<br />
to 100%)<br />
Stereotypy was not affected by <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> M PND <br />
0%<br />
Modeled play <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M PND 94% (range, 85% to<br />
100%)<br />
On task behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M PND 100%<br />
Teacher delivered prompts to play decreased M PND <br />
83.5% (range, 81% to 86%)<br />
Number of play materials utilized <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M PND <br />
100%<br />
Functi<strong>on</strong>al play <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M PND 55%<br />
Stereotypy decreased M PND 33% (range, 0 to<br />
100%) Note: variable rates of behavior <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e lowered PND Visual analysis of data<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dicates a more powerful positive effect<br />
Teacher delivered prompts to play decreased M PND <br />
97.25% (range, 94.5% to 100%)<br />
Symbolic play <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M PND 100%<br />
Modeled play behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g>creased<br />
Novel play behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g>creased Note: Data could not<br />
be c<strong>on</strong>verted <str<strong>on</strong>g>in</str<strong>on</strong>g>to PND, Results were positive for<br />
both variables.<br />
Total symbolic play <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M PND 29% (range,<br />
0 to 60%) Sp<strong>on</strong>taneous symbolic play <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M<br />
PND 27% (range, 0 to 63%) Note: 1 of the 5<br />
parts made no improvements <str<strong>on</strong>g>in</str<strong>on</strong>g> play skills<br />
Significant group x time <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>, play<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> group showed significantly greater<br />
improvements over time <str<strong>on</strong>g>in</str<strong>on</strong>g> both functi<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
symbolic play skills compared to a jo<str<strong>on</strong>g>in</str<strong>on</strong>g>t attenti<strong>on</strong><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> group <str<strong>on</strong>g>and</str<strong>on</strong>g> a no treatment c<strong>on</strong>trol<br />
group<br />
Modeled behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M PND 100%<br />
Novel play behaviors decreased Note: Only means<br />
were reported for novel play behaviors, therefore<br />
PND calculati<strong>on</strong> is not possible<br />
Review of Play Interventi<strong>on</strong>s / 483
TABLE 1—(C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued)<br />
Citati<strong>on</strong> &<br />
Category<br />
Morris<strong>on</strong>,<br />
Sa<str<strong>on</strong>g>in</str<strong>on</strong>g>ato,<br />
Benchaaban &<br />
Endo, (2002)<br />
Newman,<br />
Re<str<strong>on</strong>g>in</str<strong>on</strong>g>ecke &<br />
Me<str<strong>on</strong>g>in</str<strong>on</strong>g>berg,<br />
(2000)<br />
Paters<strong>on</strong> & Arco<br />
(2007)<br />
Reag<strong>on</strong>, Higbee<br />
& Endicott<br />
(2006)<br />
Zercher, Hunt,<br />
Schuler &<br />
Webster (2001)<br />
n Independent<br />
Variables<br />
4 Corresp<strong>on</strong>dence<br />
<str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g>,<br />
Activity<br />
Schedules<br />
2 Self<br />
Management<br />
Experimental<br />
Design<br />
MBL across<br />
part<br />
MBL across<br />
part<br />
possible categories accord<str<strong>on</strong>g>in</str<strong>on</strong>g>g to the type of<br />
play skill targeted for <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. The two<br />
categories of play skills were (a) functi<strong>on</strong>al<br />
play <str<strong>on</strong>g>and</str<strong>on</strong>g> (b) symbolic play (termed <str<strong>on</strong>g>in</str<strong>on</strong>g> some<br />
studies as “pretend play”, “sociodramatic play”<br />
or “imag<str<strong>on</strong>g>in</str<strong>on</strong>g>ative play”). A study was classified as<br />
functi<strong>on</strong>al play if the behavior targeted <str<strong>on</strong>g>in</str<strong>on</strong>g>volved<br />
use of a toy <str<strong>on</strong>g>in</str<strong>on</strong>g> a manner c<strong>on</strong>sistent with<br />
its <str<strong>on</strong>g>in</str<strong>on</strong>g>tended functi<strong>on</strong> preserv<str<strong>on</strong>g>in</str<strong>on</strong>g>g the unique<br />
physical properties of the toy. Examples of<br />
functi<strong>on</strong>al play <str<strong>on</strong>g>in</str<strong>on</strong>g>clude (a) plac<str<strong>on</strong>g>in</str<strong>on</strong>g>g puzzle<br />
pieces <str<strong>on</strong>g>in</str<strong>on</strong>g>to a puzzle, (b) us<str<strong>on</strong>g>in</str<strong>on</strong>g>g toy tools to<br />
build (c) str<str<strong>on</strong>g>in</str<strong>on</strong>g>g<str<strong>on</strong>g>in</str<strong>on</strong>g>g beads, (d) stirr<str<strong>on</strong>g>in</str<strong>on</strong>g>g a bowel<br />
with a spo<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> a toy cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g set (e) look<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
at a picture book. These studies are presented<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the first secti<strong>on</strong> of Table 1.<br />
A study was classified as symbolic play if the<br />
behavior targeted <str<strong>on</strong>g>in</str<strong>on</strong>g>volved any of the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
(a) use of <strong>on</strong>e object to st<str<strong>on</strong>g>and</str<strong>on</strong>g> for another<br />
object (e.g. a hairbrush used as a microph<strong>on</strong>e),<br />
(b) appears to use someth<str<strong>on</strong>g>in</str<strong>on</strong>g>g that is<br />
not present (e.g. strums an imag<str<strong>on</strong>g>in</str<strong>on</strong>g>ary guitar),<br />
(c) uses a toy figure as if it were capable of<br />
perform<str<strong>on</strong>g>in</str<strong>on</strong>g>g acti<strong>on</strong>s (e.g. makes a teddy bear<br />
dance <str<strong>on</strong>g>and</str<strong>on</strong>g> s<str<strong>on</strong>g>in</str<strong>on</strong>g>g), (d) uses a toy as a prop (e.g.<br />
Dependent Variables & Results<br />
On task symbolic play <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M PND 100%<br />
Variability of play <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M PND 91.5% (range,<br />
90% to 93%)<br />
2 Video Model<str<strong>on</strong>g>in</str<strong>on</strong>g>g Reversal Appropriate play <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M PND 100%<br />
embedded Stereotypy decreased M PND 100%<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>to a MLB<br />
across toys<br />
1 Video Model<str<strong>on</strong>g>in</str<strong>on</strong>g>g MBL across<br />
play<br />
2 Integrated Play<br />
Therapy<br />
scenarios<br />
MBL across<br />
part<br />
* Multiple basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
a<br />
Participants<br />
b<br />
Mean<br />
c<br />
Percent N<strong>on</strong>-Overlapp<str<strong>on</strong>g>in</str<strong>on</strong>g>g Data<br />
Italics denote the name of the dependent variable<br />
484 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Model behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M PND 100% Note: Only<br />
1 basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e data po<str<strong>on</strong>g>in</str<strong>on</strong>g>t<br />
Symbolic play <str<strong>on</strong>g>in</str<strong>on</strong>g>creased M PND 72% (range, 50%<br />
to 94%)<br />
a book becomes a ramp for a car), or (e)<br />
adopts a role or pers<strong>on</strong>a that does not bel<strong>on</strong>g<br />
to the child (e.g. acts as if they are a parent,<br />
teacher, or super hero). When a study targeted<br />
both functi<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> symbolic play, that<br />
study was classified as symbolic because symbolic<br />
play is c<strong>on</strong>sidered to be more advanced.<br />
These studies are presented <str<strong>on</strong>g>in</str<strong>on</strong>g> the sec<strong>on</strong>d<br />
secti<strong>on</strong> of Table 1.<br />
For each study <str<strong>on</strong>g>in</str<strong>on</strong>g> the review, Table 1 summarizes<br />
the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g variables: (a) number of<br />
participants (b) <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent variable <str<strong>on</strong>g>in</str<strong>on</strong>g>tended<br />
to <str<strong>on</strong>g>in</str<strong>on</strong>g>crease play skills (c) experimental<br />
design <str<strong>on</strong>g>and</str<strong>on</strong>g> (d) effectiveness of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g play behaviors. Other dependent<br />
variables that are not directly related<br />
to play are not listed (e.g. language <str<strong>on</strong>g>and</str<strong>on</strong>g> social<br />
skills). Interventi<strong>on</strong> effectiveness is reported<br />
as either percentage of n<strong>on</strong>-overlapp<str<strong>on</strong>g>in</str<strong>on</strong>g>g data<br />
(PND), the statistical f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs reported by the<br />
author (e.g. Kasari et al., 2006), or when basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
data prevented the use of PND, the authors’<br />
visual analysis of the results are reported<br />
(e.g. Dauph<str<strong>on</strong>g>in</str<strong>on</strong>g> et al., 2004).<br />
PND is <strong>on</strong>e method of synthesiz<str<strong>on</strong>g>in</str<strong>on</strong>g>g s<str<strong>on</strong>g>in</str<strong>on</strong>g>gle
subject data (Scruggs & Mastropieri, 1998). A<br />
higher PND suggests that the participant’s behavior<br />
changed <str<strong>on</strong>g>in</str<strong>on</strong>g> the desired directi<strong>on</strong> (i.e.<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>creased or decreased) dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g or follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. A lower PND suggests that the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> may have failed to change behavior<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the desired directi<strong>on</strong>. While several<br />
other methods for synthesiz<str<strong>on</strong>g>in</str<strong>on</strong>g>g s<str<strong>on</strong>g>in</str<strong>on</strong>g>gle subject<br />
data exist (e.g. St<str<strong>on</strong>g>and</str<strong>on</strong>g>ard Mean Difference,<br />
Percentage Reducti<strong>on</strong> Measure) a recent review<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> empirical comparis<strong>on</strong> of these methods<br />
found c<strong>on</strong>sistent results across methods<br />
(Olive & Smith, 2005). Therefore, PND was<br />
chosen for its simplicity.<br />
To calculate PND for behavior reducti<strong>on</strong>,<br />
the lowest basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e data po<str<strong>on</strong>g>in</str<strong>on</strong>g>t is identified.<br />
Next, the data po<str<strong>on</strong>g>in</str<strong>on</strong>g>ts <str<strong>on</strong>g>in</str<strong>on</strong>g> the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
phase that fall below the lowest basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e po<str<strong>on</strong>g>in</str<strong>on</strong>g>t<br />
are counted. This number is then divided by<br />
the total number of data po<str<strong>on</strong>g>in</str<strong>on</strong>g>ts <str<strong>on</strong>g>in</str<strong>on</strong>g> the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
phase (data po<str<strong>on</strong>g>in</str<strong>on</strong>g>ts below lowest basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
po<str<strong>on</strong>g>in</str<strong>on</strong>g>t data po<str<strong>on</strong>g>in</str<strong>on</strong>g>ts equal to <str<strong>on</strong>g>and</str<strong>on</strong>g> above<br />
lowest basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e po<str<strong>on</strong>g>in</str<strong>on</strong>g>t). The quotient is then<br />
c<strong>on</strong>verted to a percentage by multiply<str<strong>on</strong>g>in</str<strong>on</strong>g>g by<br />
100%. For behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g> which an <str<strong>on</strong>g>in</str<strong>on</strong>g>crease is<br />
desired, the highest basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e po<str<strong>on</strong>g>in</str<strong>on</strong>g>t is identified<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> identical calculati<strong>on</strong>s are made; except<br />
that the number of <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> data<br />
po<str<strong>on</strong>g>in</str<strong>on</strong>g>ts above (<str<strong>on</strong>g>in</str<strong>on</strong>g>stead of below) the highest<br />
basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e po<str<strong>on</strong>g>in</str<strong>on</strong>g>t is used as the divisor. PND cannot<br />
be calculated when a zero quantity is <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e of reducti<strong>on</strong> studies or a maximum<br />
possible quantity is found <str<strong>on</strong>g>in</str<strong>on</strong>g> behavior<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>crease studies (Olive & Smith, 2005). When<br />
a design c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>s more than <strong>on</strong>e basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
phase (e.g. an ABAB design), the lowest or<br />
highest basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e po<str<strong>on</strong>g>in</str<strong>on</strong>g>t was identified across all<br />
basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e phases.<br />
When s<str<strong>on</strong>g>in</str<strong>on</strong>g>gle subject data cannot be c<strong>on</strong>verted<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>to PND, due to the presence of an<br />
extreme basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e po<str<strong>on</strong>g>in</str<strong>on</strong>g>t, the methodology<br />
used by Machalicek et al. (2008) was used to<br />
describe results as positive, negative, or mixed.<br />
“Positive” meant that all the participants experienced<br />
some improvement from basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e levels<br />
dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g or follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. “Mixed”<br />
meant that, although <strong>on</strong>e or more participants<br />
experienced some improvement, <strong>on</strong>e or<br />
more participants did not. “Negative” meant<br />
that no participants <str<strong>on</strong>g>in</str<strong>on</strong>g> the study benefited<br />
from the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. No study <str<strong>on</strong>g>in</str<strong>on</strong>g> this review<br />
reported negative f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs.<br />
This review is organized <str<strong>on</strong>g>in</str<strong>on</strong>g>to three secti<strong>on</strong>s:<br />
(a) results, (b) discussi<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> (c) future research.<br />
The results secti<strong>on</strong> presents an overview<br />
of the studies with<str<strong>on</strong>g>in</str<strong>on</strong>g> each category (i.e.<br />
functi<strong>on</strong>al or symbolic play) <str<strong>on</strong>g>and</str<strong>on</strong>g> two studies<br />
are discussed <str<strong>on</strong>g>in</str<strong>on</strong>g> detail to illustrate the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
that typify the category. The discussi<strong>on</strong><br />
secti<strong>on</strong> evaluates the reviewed studies towards<br />
identify<str<strong>on</strong>g>in</str<strong>on</strong>g>g comm<strong>on</strong> comp<strong>on</strong>ents of<br />
successful play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s. The f<str<strong>on</strong>g>in</str<strong>on</strong>g>al secti<strong>on</strong><br />
highlights possible areas of future research.<br />
Results<br />
Increas<str<strong>on</strong>g>in</str<strong>on</strong>g>g Functi<strong>on</strong>al Play<br />
Five studies (n 11 participants) evaluated<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s designed to <str<strong>on</strong>g>in</str<strong>on</strong>g>crease the functi<strong>on</strong>al<br />
play skills of children with autism<br />
(D’Ateno, Mangiapanello & Taylor, 2003; Gillet<br />
& Leblanc, 2007; H<str<strong>on</strong>g>in</str<strong>on</strong>g>e & Wolery, 2006;<br />
Hume & Odom, 2007; Nuzzolo-Gomez, Le<strong>on</strong>ard,<br />
Ortiz, Rivera & Greer, 2002). Two of<br />
these studies evaluated the use of video model<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
(D’Ateno et al., 2003; H<str<strong>on</strong>g>in</str<strong>on</strong>g>e & Wolery,<br />
2006). Other <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent variables <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
natural language paradigm (Gillett & LeBlanc,<br />
2007), structured work systems (Hume &<br />
Odom, 2007), <str<strong>on</strong>g>and</str<strong>on</strong>g> pair<str<strong>on</strong>g>in</str<strong>on</strong>g>g (Nuzzolo-Gomez et<br />
al., 2002). Dependent variables, other than<br />
functi<strong>on</strong>al play <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded, stereotypy (Gillett &<br />
LeBlanc, 2007; Nuzzolo-Gomez et al., 2002)<br />
verbal communicati<strong>on</strong> variables (D’Ateno et<br />
al., 2003; Gillett & LeBlanc, 2007), off task<br />
behavior (Hume & Odom, 2007), <str<strong>on</strong>g>and</str<strong>on</strong>g> teacher<br />
delivered prompts (Hume & Odom, 2007).<br />
All of these studies used s<str<strong>on</strong>g>in</str<strong>on</strong>g>gle-case experimental<br />
designs (e.g., ABAB reversal design,<br />
multiple-basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e), The three studies that assessed<br />
social validity reported that parents <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
educators found the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s to be successful,<br />
acceptable, <str<strong>on</strong>g>and</str<strong>on</strong>g> target<str<strong>on</strong>g>in</str<strong>on</strong>g>g important<br />
skills (Gillett & LeBlanc, 2007; H<str<strong>on</strong>g>in</str<strong>on</strong>g>e & Wolery,<br />
2006; Hume & Odom, 2007). Ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance<br />
data was collected <str<strong>on</strong>g>in</str<strong>on</strong>g> two studies. Acquired<br />
play skills were ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed at 1 m<strong>on</strong>th (Hume<br />
& Odom, 2007) <str<strong>on</strong>g>and</str<strong>on</strong>g> 2 m<strong>on</strong>ths (H<str<strong>on</strong>g>in</str<strong>on</strong>g>e & Wolery,<br />
2006). Generalizati<strong>on</strong> of newly acquired<br />
play skills to new toys <str<strong>on</strong>g>and</str<strong>on</strong>g> sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs was reported<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> <strong>on</strong>e study (H<str<strong>on</strong>g>in</str<strong>on</strong>g>e & Wolery, 2006).<br />
Across all the functi<strong>on</strong>al play studies, the<br />
mean PND for <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g functi<strong>on</strong>al play skills<br />
was 88% (range, 60% to 100%). This <str<strong>on</strong>g>in</str<strong>on</strong>g>dicates<br />
that participants improved more than the best<br />
Review of Play Interventi<strong>on</strong>s / 485
asel<str<strong>on</strong>g>in</str<strong>on</strong>g>e po<str<strong>on</strong>g>in</str<strong>on</strong>g>t across 88% of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> post <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> sessi<strong>on</strong>s, <strong>on</strong> average.<br />
H<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>and</str<strong>on</strong>g> Wolery (2006) evaluated the effects<br />
of video model<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g toy-play<br />
skills of two children with autism (ages 30<br />
m<strong>on</strong>ths <str<strong>on</strong>g>and</str<strong>on</strong>g> 43 m<strong>on</strong>ths). The first targeted<br />
play skill <str<strong>on</strong>g>in</str<strong>on</strong>g>volved us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a toy garden<str<strong>on</strong>g>in</str<strong>on</strong>g>g set to<br />
dig holes, put soil <str<strong>on</strong>g>in</str<strong>on</strong>g>to empty pots, <str<strong>on</strong>g>and</str<strong>on</strong>g> plant<br />
toy flowers. The sec<strong>on</strong>d play skill <str<strong>on</strong>g>in</str<strong>on</strong>g>volved us<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
a toy cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g to set the table <str<strong>on</strong>g>and</str<strong>on</strong>g> perform<br />
cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g moti<strong>on</strong>s with the toys (e.g. stir a<br />
bowel). Po<str<strong>on</strong>g>in</str<strong>on</strong>g>t-of-view video model tapes were<br />
made by hold<str<strong>on</strong>g>in</str<strong>on</strong>g>g the camera at the child’s eye<br />
level without <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g any people <str<strong>on</strong>g>in</str<strong>on</strong>g> the camera<br />
shot. This camera angle was used to show<br />
the envir<strong>on</strong>ment as the child would see it if<br />
they were perform<str<strong>on</strong>g>in</str<strong>on</strong>g>g the targeted behaviors.<br />
The effects of po<str<strong>on</strong>g>in</str<strong>on</strong>g>t-of view video model<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
were evaluated <str<strong>on</strong>g>in</str<strong>on</strong>g> a multiple probe design<br />
across both participants <str<strong>on</strong>g>and</str<strong>on</strong>g> both sets of toys.<br />
The <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> was effective at <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the participants’ engagement <str<strong>on</strong>g>in</str<strong>on</strong>g> the modeled<br />
behaviors (M PND 94% range, 85% to<br />
100%).<br />
H<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>and</str<strong>on</strong>g> Wolery also collected generalizati<strong>on</strong>,<br />
social validity, <str<strong>on</strong>g>and</str<strong>on</strong>g> ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance data.<br />
Generalizati<strong>on</strong> probes showed mixed results.<br />
Both children dem<strong>on</strong>strated the ability to generalize<br />
to new play materials but <strong>on</strong>ly <strong>on</strong>e<br />
participant generalized to a sec<strong>on</strong>d envir<strong>on</strong>ment.<br />
Social validity was evaluated by a group<br />
of 10 graduate students for each participant.<br />
Graduate students watched pre/post tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
videos <str<strong>on</strong>g>and</str<strong>on</strong>g> rated the children’s play behaviors<br />
<strong>on</strong> a 5 po<str<strong>on</strong>g>in</str<strong>on</strong>g>t Likert Scale. Raters c<strong>on</strong>cluded<br />
that <str<strong>on</strong>g>in</str<strong>on</strong>g> the post-tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g videos children were<br />
more engaged, used multiple acti<strong>on</strong>s/materials,<br />
played appropriately, enjoyed the activity,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> needed less help than dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
videos. Ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance data shows that the participants<br />
still engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> the modeled behaviors<br />
two m<strong>on</strong>ths after the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> had<br />
ceased.<br />
Gillett <str<strong>on</strong>g>and</str<strong>on</strong>g> LeBlanc (2007) evaluated the<br />
effects of a natural language paradigm (NLP)<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, implemented by participants’<br />
parents, <strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g the appropriate play<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> decreas<str<strong>on</strong>g>in</str<strong>on</strong>g>g the <str<strong>on</strong>g>in</str<strong>on</strong>g>appropriate play of<br />
three children with autism between the ages<br />
of 4 <str<strong>on</strong>g>and</str<strong>on</strong>g> 5 years old. Appropriate play was<br />
def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed as “us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the toy <str<strong>on</strong>g>in</str<strong>on</strong>g> the manner it was<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tended”. Inappropriate play <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded “use<br />
of the toy <str<strong>on</strong>g>in</str<strong>on</strong>g> a stereotyped manner”. The mod-<br />
ified NLP procedures used <str<strong>on</strong>g>in</str<strong>on</strong>g> this study c<strong>on</strong>sisted<br />
of six steps; (a) display<str<strong>on</strong>g>in</str<strong>on</strong>g>g three toys to<br />
the child, (b) prevent<str<strong>on</strong>g>in</str<strong>on</strong>g>g access to these toys,<br />
(c) provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g an acti<strong>on</strong> model for 5s <str<strong>on</strong>g>and</str<strong>on</strong>g> then<br />
a vocal model, (d) re<str<strong>on</strong>g>in</str<strong>on</strong>g>forc<str<strong>on</strong>g>in</str<strong>on</strong>g>g appropriate<br />
child resp<strong>on</strong>ses with access to the selected toy,<br />
(e) repetiti<strong>on</strong> with a novel modeled play behavior,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> (f) c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued play model<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
throughout sessi<strong>on</strong>s. A multiple basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
across participants was used to evaluate the<br />
effects <strong>on</strong> appropriate <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>appropriate play<br />
behaviors. Results showed that all 3 parents<br />
learned to correctly implement the NLP <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> that while appropriate play <str<strong>on</strong>g>in</str<strong>on</strong>g>creased<br />
(M PND 93% range: 80% to 100%)<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> that levels of <str<strong>on</strong>g>in</str<strong>on</strong>g>appropriate play (i.e. challeng<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
behavior or stereotypy) rema<str<strong>on</strong>g>in</str<strong>on</strong>g>ed the<br />
same from basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e to <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> (PND <br />
0%) suggest<str<strong>on</strong>g>in</str<strong>on</strong>g>g no reducti<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>appropriate<br />
play. Social validity data was collected via written<br />
questi<strong>on</strong>naire from 2 of the 3 parents who<br />
found the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> to be “very useful”,<br />
“very easy”, <str<strong>on</strong>g>and</str<strong>on</strong>g> “very helpful”.<br />
Increas<str<strong>on</strong>g>in</str<strong>on</strong>g>g Symbolic Play<br />
486 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Ten studies, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g a total of 42 participants<br />
(21 from Kasari et al., 2006), evaluated<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s designed to <str<strong>on</strong>g>in</str<strong>on</strong>g>crease the symbolic<br />
play skills of children with autism (Barry<br />
& Burlew, 2004; Dauph<str<strong>on</strong>g>in</str<strong>on</strong>g> et al., 2004; Ingersoll<br />
& Schreibman, 2006; Kasrai et al., 2006;<br />
McD<strong>on</strong>ald, Clark, Garrigan & Vangala, 2005;<br />
Morris<strong>on</strong>, Sa<str<strong>on</strong>g>in</str<strong>on</strong>g>ato, Benchaaban & Endo, 2002;<br />
Newman, Re<str<strong>on</strong>g>in</str<strong>on</strong>g>ecke & Me<str<strong>on</strong>g>in</str<strong>on</strong>g>berg, 2000; Paters<strong>on</strong><br />
& Arco, 2007; Reag<strong>on</strong>, Higbee & Endicott,<br />
2006; Zercher, Hunt, Schuler & Webster,<br />
2001). Three of these studies evaluated some<br />
form of video model<str<strong>on</strong>g>in</str<strong>on</strong>g>g (MacD<strong>on</strong>ald et al.,<br />
2005; Paters<strong>on</strong> & Arco, 2007; Reag<strong>on</strong> et al.,<br />
2006). Other <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent variables <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
Social Stories TM (Barry & Burlew, 2004), activity<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> matrix tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g (Dauph<str<strong>on</strong>g>in</str<strong>on</strong>g> et al.,<br />
2004), reciprocal imitati<strong>on</strong> tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g (Ingersoll<br />
& Schreibman, 2006), behavioral drill <str<strong>on</strong>g>and</str<strong>on</strong>g> milieu<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g (Kasari et al., 2006), activity<br />
schedules (Morris<strong>on</strong> et al., 2002), self management<br />
(Newman et al., 2000), <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>tegrated<br />
play therapy (Zercher et al., 2001).<br />
Dependent variables, other than symbolic<br />
play, <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded stereotypy (Paters<strong>on</strong> & Arco,<br />
2007), off-task behavior (Morris<strong>on</strong> et al.,<br />
2002), <str<strong>on</strong>g>and</str<strong>on</strong>g> teacher delivered prompts (Barry
& Burlew, 2004). All studies, with the excepti<strong>on</strong><br />
of Kasari <str<strong>on</strong>g>and</str<strong>on</strong>g> colleagues (2006), used<br />
s<str<strong>on</strong>g>in</str<strong>on</strong>g>gle subject designs. Kasari <str<strong>on</strong>g>and</str<strong>on</strong>g> colleagues<br />
(2006) utilized a group design. The mean<br />
PND across the symbolic play studies that used<br />
s<str<strong>on</strong>g>in</str<strong>on</strong>g>gle subject designs was 86% (range, 27% to<br />
100%). This <str<strong>on</strong>g>in</str<strong>on</strong>g>dicates that, <strong>on</strong> average, participants<br />
improved symbolic play skills more<br />
than the best basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e po<str<strong>on</strong>g>in</str<strong>on</strong>g>t across 86% of the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> post <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> sessi<strong>on</strong>s.<br />
The five studies that assessed social validity<br />
reported that parents <str<strong>on</strong>g>and</str<strong>on</strong>g> educators found<br />
the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s to be successful, acceptable,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> target<str<strong>on</strong>g>in</str<strong>on</strong>g>g important skills (Barry & Burlew,<br />
2004; Ingersoll & Schreibman, 2006; Morris<strong>on</strong><br />
et al., 2002; Paters<strong>on</strong> & Arco, 2007; Reag<strong>on</strong><br />
et al., 2006; Zercher et al., 2001).<br />
Ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance data was collected <str<strong>on</strong>g>in</str<strong>on</strong>g> four studies.<br />
Acquired play skills were ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed at 1<br />
week (Paters<strong>on</strong> & Arco, 2007), 1 m<strong>on</strong>th (Ingersoll<br />
& Schreibman, 2006; Newman et al.,<br />
2000) <str<strong>on</strong>g>and</str<strong>on</strong>g> 2 m<strong>on</strong>ths (McD<strong>on</strong>ald et al., 2005).<br />
Generalizati<strong>on</strong> of new play skills to (a) new<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs was reported <str<strong>on</strong>g>in</str<strong>on</strong>g> two studies (Barry &<br />
Burlew, 2004; Ingersoll & Schreibman, 2006),<br />
(b) new toys <str<strong>on</strong>g>in</str<strong>on</strong>g> two studies (Ingersoll & Schreibman,<br />
2006; Paters<strong>on</strong> & Arco, 2007), (c) new<br />
play partners <str<strong>on</strong>g>in</str<strong>on</strong>g> three studies (Ingersoll &<br />
Schreibman, 2006; Kasari et al., 2006; Reag<strong>on</strong><br />
et al., 2006) <str<strong>on</strong>g>and</str<strong>on</strong>g> to (d) new comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong>s of<br />
play behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g> <strong>on</strong>e study (Dauph<str<strong>on</strong>g>in</str<strong>on</strong>g> et al.,<br />
2004).<br />
Ingersoll <str<strong>on</strong>g>and</str<strong>on</strong>g> Schreibman (2006) evaluated<br />
the effects of a naturalistic behavioral <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
<strong>on</strong> the language, imitati<strong>on</strong>, jo<str<strong>on</strong>g>in</str<strong>on</strong>g>t attenti<strong>on</strong>,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> pretend (i.e. symbolic) play skills<br />
of five children with autism. Naturalistic behavioral<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s are a hybrid of behavioral<br />
techniques (e.g. prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g, shap<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement) <str<strong>on</strong>g>and</str<strong>on</strong>g> child lead<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g procedures (e.g. <str<strong>on</strong>g>in</str<strong>on</strong>g>cidental teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
milieu teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g, pivotal resp<strong>on</strong>se tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g).<br />
The <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> used <str<strong>on</strong>g>in</str<strong>on</strong>g> this study c<strong>on</strong>sisted<br />
of five phases. In the first phase, the therapist<br />
used the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g two strategies (a) c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent<br />
imitati<strong>on</strong> (<str<strong>on</strong>g>in</str<strong>on</strong>g> which the therapist imitated<br />
the child’s acti<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> language) <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
(b) l<str<strong>on</strong>g>in</str<strong>on</strong>g>guistic mapp<str<strong>on</strong>g>in</str<strong>on</strong>g>g (<str<strong>on</strong>g>in</str<strong>on</strong>g> which the therapist<br />
provided a verbal descripti<strong>on</strong> of the acti<strong>on</strong>s of<br />
the child). In the sec<strong>on</strong>d phase, requests for<br />
the child to imitate the therapist were <str<strong>on</strong>g>in</str<strong>on</strong>g>terspersed<br />
with the therapist’s c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent imitati<strong>on</strong><br />
of the child. For example, the therapist<br />
would move the toy <str<strong>on</strong>g>in</str<strong>on</strong>g> the same manner as the<br />
child for several repetiti<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> would then<br />
prompt the child to imitate the therapist’s<br />
novel movement with the toy. In the third<br />
phase, more novel <str<strong>on</strong>g>and</str<strong>on</strong>g> familiar movements<br />
were modeled with familiar toys. In the fourth<br />
phase, novel <str<strong>on</strong>g>and</str<strong>on</strong>g> familiar movements were<br />
aga<str<strong>on</strong>g>in</str<strong>on</strong>g> modeled with the same toy <str<strong>on</strong>g>and</str<strong>on</strong>g> familiar<br />
movements were modeled with novel toys. In<br />
the f<str<strong>on</strong>g>in</str<strong>on</strong>g>al phase, novel movements were modeled<br />
with novel toys. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g each phase systematic<br />
prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g for the modeled behavior<br />
was used <str<strong>on</strong>g>and</str<strong>on</strong>g> re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement <str<strong>on</strong>g>in</str<strong>on</strong>g> the form of<br />
praise was given c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent <strong>on</strong> the child’s imitati<strong>on</strong><br />
of the play behavior. Each phase lasted<br />
2 weeks.<br />
A s<str<strong>on</strong>g>in</str<strong>on</strong>g>gle-subject multiple-basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e design<br />
across participants (Kennedy, 2005) was used<br />
to evaluate the effects of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>.<br />
Symbolic play was def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed <str<strong>on</strong>g>in</str<strong>on</strong>g> two ways (a) total<br />
pretend play (“child performs a dist<str<strong>on</strong>g>in</str<strong>on</strong>g>ct acti<strong>on</strong><br />
with m<str<strong>on</strong>g>in</str<strong>on</strong>g>iature objects, directs a pretend acti<strong>on</strong><br />
towards self, adult or <str<strong>on</strong>g>in</str<strong>on</strong>g>animate object,<br />
uses object as if it were another object, attributes<br />
properties to an object which it does<br />
not have or refers to an object that is not<br />
present”) <str<strong>on</strong>g>and</str<strong>on</strong>g> (b) sp<strong>on</strong>taneous pretend play<br />
(child performs a pretend play scheme that is<br />
not imitative of a therapists movements with<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the last 30 s). Average total pretend play <str<strong>on</strong>g>in</str<strong>on</strong>g>creased<br />
(Mean PND 29 %, range 0 to 60%).<br />
Average sp<strong>on</strong>taneous pretend play <str<strong>on</strong>g>in</str<strong>on</strong>g>creased<br />
(Mean PND 29%, range 0 to 90%). However,<br />
the overall results were mixed because 1<br />
out of the 4 participants did not have any<br />
ga<str<strong>on</strong>g>in</str<strong>on</strong>g>s <str<strong>on</strong>g>in</str<strong>on</strong>g> play behaviors.<br />
Newman, Re<str<strong>on</strong>g>in</str<strong>on</strong>g>ecke, <str<strong>on</strong>g>and</str<strong>on</strong>g> Me<str<strong>on</strong>g>in</str<strong>on</strong>g>berg (2000)<br />
implemented a self-management <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
designed to <str<strong>on</strong>g>in</str<strong>on</strong>g>crease the variability of play<br />
behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g> 3 children with autism. The selfmanagement<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> c<strong>on</strong>sisted of first<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g the participants to take a penny follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
novel play resp<strong>on</strong>ses by provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g verbal<br />
prompts <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent social praise. The<br />
pennies were traded <str<strong>on</strong>g>in</str<strong>on</strong>g> for re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcers follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the play sessi<strong>on</strong>s. Once the participants<br />
learned to collect the penny follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g novel<br />
play behaviors the therapist stopped provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the verbal prompts <str<strong>on</strong>g>and</str<strong>on</strong>g> praise.<br />
A s<str<strong>on</strong>g>in</str<strong>on</strong>g>gle-subject multiple-basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e design<br />
across participants (Kennedy, 2005) was used<br />
to evaluate the effects of the self-management<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. All three participants learned to<br />
Review of Play Interventi<strong>on</strong>s / 487
engage <str<strong>on</strong>g>in</str<strong>on</strong>g> a variety of novel play behaviors.<br />
Average number of different play behaviors<br />
per sessi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>creased (M PND 94 %, range<br />
90% to 95%). Follow-up data, collected 1<br />
m<strong>on</strong>th after the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> had been removed,<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dicated that the participants c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued<br />
to engage <str<strong>on</strong>g>in</str<strong>on</strong>g> less repetitive <str<strong>on</strong>g>and</str<strong>on</strong>g> more<br />
dynamic topographies of play.<br />
Discussi<strong>on</strong><br />
Identificati<strong>on</strong> of Comm<strong>on</strong> Comp<strong>on</strong>ents of<br />
Successful Play Interventi<strong>on</strong>s<br />
The most comm<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> comp<strong>on</strong>ent<br />
found <str<strong>on</strong>g>in</str<strong>on</strong>g> studies target<str<strong>on</strong>g>in</str<strong>on</strong>g>g both functi<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
symbolic play is model<str<strong>on</strong>g>in</str<strong>on</strong>g>g of appropriate play<br />
behavior. Model<str<strong>on</strong>g>in</str<strong>on</strong>g>g was a comp<strong>on</strong>ent <str<strong>on</strong>g>in</str<strong>on</strong>g> 3 of<br />
the 5 functi<strong>on</strong>al play studies <str<strong>on</strong>g>and</str<strong>on</strong>g> 8 of the 10<br />
symbolic play studies. Model<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>volves the<br />
participant attend<str<strong>on</strong>g>in</str<strong>on</strong>g>g to another pers<strong>on</strong> (<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
vivo or <strong>on</strong> film) engag<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> the targeted behavior.<br />
Model<str<strong>on</strong>g>in</str<strong>on</strong>g>g has been shown to be effective<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g many complex skills to children<br />
with autism, such as c<strong>on</strong>versati<strong>on</strong>al<br />
speech (Charlop & Milste<str<strong>on</strong>g>in</str<strong>on</strong>g>, 1989) <str<strong>on</strong>g>and</str<strong>on</strong>g> perspective<br />
tak<str<strong>on</strong>g>in</str<strong>on</strong>g>g (Charlop & Daneshvar, 2003).<br />
Model<str<strong>on</strong>g>in</str<strong>on</strong>g>g has been identified <str<strong>on</strong>g>in</str<strong>on</strong>g> other reviews<br />
as a promis<str<strong>on</strong>g>in</str<strong>on</strong>g>g practice for <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g the play<br />
behaviors of children with autism (Stahmer et<br />
al., 2003). This review provides additi<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
quantifiable support for this asserti<strong>on</strong>.<br />
Given the evidence support<str<strong>on</strong>g>in</str<strong>on</strong>g>g the use of<br />
model<str<strong>on</strong>g>in</str<strong>on</strong>g>g to teach children with autism functi<strong>on</strong>al<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> symbolic play, it would seem that<br />
model<str<strong>on</strong>g>in</str<strong>on</strong>g>g is an important <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al strategy<br />
for teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g play. However, the use of<br />
model<str<strong>on</strong>g>in</str<strong>on</strong>g>g to <str<strong>on</strong>g>in</str<strong>on</strong>g>crease play behaviors has been<br />
criticized by some researchers who reas<strong>on</strong> that<br />
imitative behaviors may not be true forms of<br />
play because they lack sp<strong>on</strong>taneity (e.g. Luckett<br />
et al., 2007). This c<strong>on</strong>cern is compounded<br />
when the model<str<strong>on</strong>g>in</str<strong>on</strong>g>g also <str<strong>on</strong>g>in</str<strong>on</strong>g>volves some form of<br />
vicarious re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement (i.e., the observer witnesses<br />
the model receive re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement for<br />
their behavior) (B<str<strong>on</strong>g>and</str<strong>on</strong>g>ura, 1965) because<br />
many feel play should be <str<strong>on</strong>g>in</str<strong>on</strong>g>ternally motivated<br />
(Luckett et al., 2007).<br />
H<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>and</str<strong>on</strong>g> Wolery (2006) offer several reas<strong>on</strong>s<br />
for target<str<strong>on</strong>g>in</str<strong>on</strong>g>g modeled acti<strong>on</strong>s as dependent<br />
variables <str<strong>on</strong>g>in</str<strong>on</strong>g> a play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. First, an<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>crease <str<strong>on</strong>g>in</str<strong>on</strong>g> appropriate play behaviors (even if<br />
imitative) may reduce stereotypic or challeng-<br />
488 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>g behaviors. Sec<strong>on</strong>d, an <str<strong>on</strong>g>in</str<strong>on</strong>g>crease <str<strong>on</strong>g>in</str<strong>on</strong>g> recognizable<br />
behaviors should also <str<strong>on</strong>g>in</str<strong>on</strong>g>crease the<br />
number of appropriate behaviors <strong>on</strong> which an<br />
adult can comment. This leads to an <str<strong>on</strong>g>in</str<strong>on</strong>g>crease<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> opportunities for language <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>.<br />
Third, an <str<strong>on</strong>g>in</str<strong>on</strong>g>crease <str<strong>on</strong>g>in</str<strong>on</strong>g> modeled behavior<br />
should reduce apparent differences between<br />
the child with autism <str<strong>on</strong>g>and</str<strong>on</strong>g> his typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
classmates: potentially allow<str<strong>on</strong>g>in</str<strong>on</strong>g>g for an<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>creased opportunity for <str<strong>on</strong>g>in</str<strong>on</strong>g>clusi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> social<br />
activities.<br />
The next most comm<strong>on</strong> comp<strong>on</strong>ent used <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
both functi<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> symbolic play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
was systematic prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent<br />
re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement of the target behavior.<br />
The comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> of prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement<br />
was used <str<strong>on</strong>g>in</str<strong>on</strong>g> 2 of the 5 functi<strong>on</strong>al play<br />
studies <str<strong>on</strong>g>and</str<strong>on</strong>g> 7 of the 10 symbolic play studies.<br />
Prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement were implemented<br />
both from a discrete trail <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
format (e.g. Kasari et al., 2006) <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
from a child directed <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al format<br />
(e.g. Ingersoll & Schreibman, 2006).<br />
Prompts are behaviors provided by the<br />
teacher or parent that <str<strong>on</strong>g>in</str<strong>on</strong>g>crease the likelihood<br />
that the participant will engage <str<strong>on</strong>g>in</str<strong>on</strong>g> the desired<br />
behavior. Prompts vary from highly <str<strong>on</strong>g>in</str<strong>on</strong>g>trusive<br />
(e.g. physically guid<str<strong>on</strong>g>in</str<strong>on</strong>g>g the participants h<str<strong>on</strong>g>and</str<strong>on</strong>g><br />
to manipulate the toy appropriately) to very<br />
covert (e.g. the teacher uses her eye gaze to<br />
signal to the participant what item is used next<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the play sequence). All studies <str<strong>on</strong>g>in</str<strong>on</strong>g> which<br />
prompts were used employed a least-to-most<br />
prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g hierarchy. In this system the least<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>trusive prompt is used first <str<strong>on</strong>g>and</str<strong>on</strong>g> more direct<br />
prompts are used <strong>on</strong>ly when the lesser<br />
prompts fail to produce the desired behavior.<br />
C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement was used <str<strong>on</strong>g>in</str<strong>on</strong>g> all of<br />
the studies that <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g. C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent<br />
re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement <str<strong>on</strong>g>in</str<strong>on</strong>g>volves provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
participant with a reward (pleasant c<strong>on</strong>sequence)<br />
follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g the occurrence of the target<br />
behavior. A re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcer can come <str<strong>on</strong>g>in</str<strong>on</strong>g> many<br />
forms, for example, preferred edible items<br />
(e.g. H<str<strong>on</strong>g>in</str<strong>on</strong>g>e & Wolery, 2006) or praise from an<br />
adult (e.g. Barry & Burlew, 2004). When a<br />
behavior is re<str<strong>on</strong>g>in</str<strong>on</strong>g>forced it is more likely to occur<br />
aga<str<strong>on</strong>g>in</str<strong>on</strong>g>.<br />
Some have suggested that approaches that<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>volve external re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement (re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement<br />
delivered from the envir<strong>on</strong>ment) do not<br />
teach “play” but <str<strong>on</strong>g>in</str<strong>on</strong>g>stead teach a child to<br />
merely appear to be play<str<strong>on</strong>g>in</str<strong>on</strong>g>g (e.g. Luckett et
al., 2007) because play is <str<strong>on</strong>g>in</str<strong>on</strong>g>ternally motivated<br />
(Garvey, 1991; Wolfberg, 2003). Several studies<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> this review that utilize c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement<br />
also collected ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance data. In<br />
these <str<strong>on</strong>g>in</str<strong>on</strong>g>stances, re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement was used <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>itial teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g of play behaviors, but was then<br />
withdrawn when the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> phase<br />
ended. The participants <str<strong>on</strong>g>in</str<strong>on</strong>g> these studies c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued<br />
to engage <str<strong>on</strong>g>in</str<strong>on</strong>g> the new play behaviors for<br />
as l<strong>on</strong>g as two m<strong>on</strong>ths without programmed<br />
external re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement (e.g. H<str<strong>on</strong>g>in</str<strong>on</strong>g>e & Wolery,<br />
2006; Ingersoll & Schriebman, 2006). While<br />
the numbers of participants <str<strong>on</strong>g>in</str<strong>on</strong>g> each of these<br />
studies are limited, it does suggest play behaviors<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>itially paired with external re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcers<br />
may become “<str<strong>on</strong>g>in</str<strong>on</strong>g>ternally re<str<strong>on</strong>g>in</str<strong>on</strong>g>forc<str<strong>on</strong>g>in</str<strong>on</strong>g>g” over<br />
time (Nuzzolo-Gomez et al., 2002).<br />
Another comm<strong>on</strong> strategy used <str<strong>on</strong>g>in</str<strong>on</strong>g> both<br />
functi<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> symbolic play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s was<br />
child directed or “naturalistic” <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>. Interventi<strong>on</strong>s<br />
c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g this comp<strong>on</strong>ent <str<strong>on</strong>g>in</str<strong>on</strong>g>volved<br />
attend<str<strong>on</strong>g>in</str<strong>on</strong>g>g to the participant’s focus,<br />
imitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g the participant’s play behaviors,<br />
identify<str<strong>on</strong>g>in</str<strong>on</strong>g>g toys the participant prefers for use<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>duct<str<strong>on</strong>g>in</str<strong>on</strong>g>g the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> a natural play sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g (e.g. <strong>on</strong> the<br />
floor as opposed to seated at a desk). Naturalistic<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> is an <str<strong>on</strong>g>in</str<strong>on</strong>g>tegral part of the Natural<br />
Language Paradigm (Gillett & Leblanc,<br />
2007), Reciprocal Imitati<strong>on</strong> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> (Ingersoll<br />
& Schreibman, 2006), Milieu Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
(Kasari et al., 2006), <str<strong>on</strong>g>and</str<strong>on</strong>g> Integrated Play Therapy<br />
(Zercher et al., 2001).<br />
Kasari et al. (2006) evaluated a play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
c<strong>on</strong>sist<str<strong>on</strong>g>in</str<strong>on</strong>g>g of all three of the above<br />
identified comp<strong>on</strong>ents (i.e. model<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g with c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> naturalistic teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g) <str<strong>on</strong>g>in</str<strong>on</strong>g> a rigorous experimental<br />
design. Specifically, Kasari et al. r<str<strong>on</strong>g>and</str<strong>on</strong>g>omly<br />
assigned 58 children with autism between<br />
3 <str<strong>on</strong>g>and</str<strong>on</strong>g> 4 years old to a play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
group (n 21), a jo<str<strong>on</strong>g>in</str<strong>on</strong>g>t attenti<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
group (n 20), or a no treatment c<strong>on</strong>trol<br />
group (n 17). The impact <strong>on</strong> play skills<br />
(<str<strong>on</strong>g>and</str<strong>on</strong>g> jo<str<strong>on</strong>g>in</str<strong>on</strong>g>t attenti<strong>on</strong>, although <strong>on</strong>ly the result<br />
related to play will be discussed <str<strong>on</strong>g>in</str<strong>on</strong>g> this review)<br />
were then compared across the three groups.<br />
The symbolic play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> c<strong>on</strong>sisted of<br />
model<str<strong>on</strong>g>in</str<strong>on</strong>g>g, systematic prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> re<str<strong>on</strong>g>in</str<strong>on</strong>g>forc<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
of play skills followed by milieu teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
The Milieu teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g comp<strong>on</strong>ent of the same<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> c<strong>on</strong>sisted of (a) follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
child’s lead <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terest <str<strong>on</strong>g>in</str<strong>on</strong>g> activities, (b) talk-<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>g about what the child was do<str<strong>on</strong>g>in</str<strong>on</strong>g>g, (c) repeat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
back what the child said <str<strong>on</strong>g>and</str<strong>on</strong>g> exp<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<strong>on</strong> it, (d) stay<str<strong>on</strong>g>in</str<strong>on</strong>g>g close <str<strong>on</strong>g>in</str<strong>on</strong>g> proximity <str<strong>on</strong>g>and</str<strong>on</strong>g> mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
eye c<strong>on</strong>tact, <str<strong>on</strong>g>and</str<strong>on</strong>g> (e) mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g envir<strong>on</strong>mental<br />
adjustments designed to encourage<br />
engagement. While all three groups dem<strong>on</strong>strated<br />
improvements <str<strong>on</strong>g>in</str<strong>on</strong>g> play over time, the<br />
group that received the play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
showed significantly more diverse types of play<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> a greater overall play level over time compared<br />
to both the jo<str<strong>on</strong>g>in</str<strong>on</strong>g>t attenti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> the c<strong>on</strong>trol<br />
group. Thus the play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> produced<br />
significantly more types of symbolic<br />
play <str<strong>on</strong>g>and</str<strong>on</strong>g> greater overall play than either the<br />
jo<str<strong>on</strong>g>in</str<strong>on</strong>g>t attenti<strong>on</strong> or the c<strong>on</strong>trol group.<br />
Despite c<strong>on</strong>cerns that the nature of play<br />
precludes the use of external motivators (re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement),<br />
prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>and</str<strong>on</strong>g> modeled examples,<br />
no recent research has been c<strong>on</strong>ducted<br />
without us<str<strong>on</strong>g>in</str<strong>on</strong>g>g these comp<strong>on</strong>ents <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
some manner to teach play skills to children<br />
with autism. However, recent research does<br />
suggest that these comp<strong>on</strong>ents may <str<strong>on</strong>g>in</str<strong>on</strong>g> some<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>stances be best used with<str<strong>on</strong>g>in</str<strong>on</strong>g> a child-directed<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al format <str<strong>on</strong>g>and</str<strong>on</strong>g> with<str<strong>on</strong>g>in</str<strong>on</strong>g> natural envir<strong>on</strong>ments<br />
(e.g. <strong>on</strong> the floor as opposed to<br />
seated at a desk). Additi<strong>on</strong>ally, there seems to<br />
be little difference <str<strong>on</strong>g>in</str<strong>on</strong>g> the manner <str<strong>on</strong>g>in</str<strong>on</strong>g> which<br />
functi<strong>on</strong>al play <str<strong>on</strong>g>and</str<strong>on</strong>g> symbolic play are taught.<br />
Therefore, when design<str<strong>on</strong>g>in</str<strong>on</strong>g>g any play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>,<br />
practiti<strong>on</strong>ers should str<strong>on</strong>gly c<strong>on</strong>sider <str<strong>on</strong>g>in</str<strong>on</strong>g>corporat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the three comm<strong>on</strong> comp<strong>on</strong>ents<br />
of play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s reviewed above.<br />
Future Research<br />
A number of <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s to teach functi<strong>on</strong>al<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> symbolic play behaviors to children with<br />
autism have been exam<str<strong>on</strong>g>in</str<strong>on</strong>g>ed <str<strong>on</strong>g>in</str<strong>on</strong>g> the literature.<br />
This review suggests that the most comm<strong>on</strong>ly<br />
used strategies are model<str<strong>on</strong>g>in</str<strong>on</strong>g>g, systematic<br />
prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g with c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> naturalistic teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g procedures. Several<br />
research questi<strong>on</strong>s have emerged from this<br />
review.<br />
First, no research identified <str<strong>on</strong>g>in</str<strong>on</strong>g> this review or<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> past reviews attempts to isolate the effects of<br />
any <strong>on</strong>e s<str<strong>on</strong>g>in</str<strong>on</strong>g>gle comp<strong>on</strong>ent with<str<strong>on</strong>g>in</str<strong>on</strong>g> a multi-comp<strong>on</strong>ent<br />
play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. H<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>and</str<strong>on</strong>g> Wolery<br />
(2006) evaluated the effects of video model<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
without any additi<strong>on</strong>al prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g or re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement.<br />
However, <strong>on</strong>ly <strong>on</strong>e of the two participants<br />
improved. The sec<strong>on</strong>d participant<br />
Review of Play Interventi<strong>on</strong>s / 489
did not improve until c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gent re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement<br />
was added (i.e. small edible given follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
occurrence of the modeled behavior).<br />
Such an example dem<strong>on</strong>strates the necessity<br />
of a better underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g of how to <str<strong>on</strong>g>in</str<strong>on</strong>g>itially<br />
design these <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> order to be most<br />
efficient <str<strong>on</strong>g>and</str<strong>on</strong>g> effective. Future research could<br />
be c<strong>on</strong>ducted <str<strong>on</strong>g>in</str<strong>on</strong>g> which comm<strong>on</strong> comp<strong>on</strong>ents<br />
are systematically evaluated <str<strong>on</strong>g>in</str<strong>on</strong>g>dividually <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
then <str<strong>on</strong>g>in</str<strong>on</strong>g> t<str<strong>on</strong>g>and</str<strong>on</strong>g>em <str<strong>on</strong>g>in</str<strong>on</strong>g> order to identify the most<br />
effective <str<strong>on</strong>g>and</str<strong>on</strong>g> parsim<strong>on</strong>ious play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
tailored to the specific characteristics of the<br />
child.<br />
Sec<strong>on</strong>d, many researchers <str<strong>on</strong>g>and</str<strong>on</strong>g> practiti<strong>on</strong>ers<br />
report that stereotypic behavior (e.g. rock<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
sp<str<strong>on</strong>g>in</str<strong>on</strong>g>n<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> mouth<str<strong>on</strong>g>in</str<strong>on</strong>g>g toys) often <str<strong>on</strong>g>in</str<strong>on</strong>g>terferes<br />
with attempts to teach play skills (Baker, 2000;<br />
H<strong>on</strong>ey, Leekam, Turner, McC<strong>on</strong>achie, 2007;<br />
Koegel, Firest<strong>on</strong>e, Kramme, & Dunlap; 1974).<br />
Block<str<strong>on</strong>g>in</str<strong>on</strong>g>g or restrict<str<strong>on</strong>g>in</str<strong>on</strong>g>g these stereotypic behaviors<br />
may elicit challeng<str<strong>on</strong>g>in</str<strong>on</strong>g>g behavior (e.g.<br />
tantrum, aggressi<strong>on</strong>, self <str<strong>on</strong>g>in</str<strong>on</strong>g>jury) (Green &<br />
Striefel, 1988) further complicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s.<br />
Several of the reviewed studies address<br />
this issue by collect<str<strong>on</strong>g>in</str<strong>on</strong>g>g data regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
challeng<str<strong>on</strong>g>in</str<strong>on</strong>g>g behavior <str<strong>on</strong>g>and</str<strong>on</strong>g> stereotypy while<br />
evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s designed to <str<strong>on</strong>g>in</str<strong>on</strong>g>crease<br />
play skills (e.g. Gillett & LeBlanc, 2007; Hume<br />
& Odom, 2007; Paters<strong>on</strong> & Arco, 2007).<br />
Results of these studies suggest that a negative<br />
correlati<strong>on</strong> between stereotypy <str<strong>on</strong>g>and</str<strong>on</strong>g> play<br />
skills may exist for some children. Evidence of<br />
such a relati<strong>on</strong>ship is also suggested when an<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> designed to decrease challeng<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
behaviors also occasi<strong>on</strong>s an <str<strong>on</strong>g>in</str<strong>on</strong>g>crease <str<strong>on</strong>g>in</str<strong>on</strong>g> appropriate<br />
play behaviors (e.g. Koegel et al., 1974).<br />
When <str<strong>on</strong>g>in</str<strong>on</strong>g>appropriate behavior decreases follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
a successful play <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, the exact<br />
mechanism of acti<strong>on</strong> for the decrease is<br />
often not apparent bey<strong>on</strong>d the asserti<strong>on</strong> that<br />
the more time spent play<str<strong>on</strong>g>in</str<strong>on</strong>g>g appropriately<br />
leaves less time available dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the sessi<strong>on</strong> for<br />
challeng<str<strong>on</strong>g>in</str<strong>on</strong>g>g behavior <str<strong>on</strong>g>and</str<strong>on</strong>g> stereotypy. However,<br />
this is not always the case. For example,<br />
Gillett <str<strong>on</strong>g>and</str<strong>on</strong>g> LeBlanc (2007) successfully <str<strong>on</strong>g>in</str<strong>on</strong>g>creased<br />
play behaviors, but found no difference<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> challeng<str<strong>on</strong>g>in</str<strong>on</strong>g>g behavior <str<strong>on</strong>g>and</str<strong>on</strong>g> stereotypy<br />
between basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. Such an<br />
example highlights the need for future research<br />
c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g the relati<strong>on</strong>ship between<br />
stereotypy, challeng<str<strong>on</strong>g>in</str<strong>on</strong>g>g behavior, <str<strong>on</strong>g>and</str<strong>on</strong>g> play <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
children with autism.<br />
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through peer supported play. Autism, 5,<br />
374–398.<br />
Received:14 May 2008<br />
Initial Acceptance: 8 July 2008<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>al Acceptance: 2 October 2008<br />
492 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009
Acquisiti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> Generalizati<strong>on</strong> of Cha<str<strong>on</strong>g>in</str<strong>on</strong>g>ed Tasks Taught with<br />
Computer Based Video Instructi<strong>on</strong> to Children with Autism<br />
Kev<str<strong>on</strong>g>in</str<strong>on</strong>g> M. Ayres<br />
The University of Georgia<br />
Amy Maguire <str<strong>on</strong>g>and</str<strong>on</strong>g> Desiree McClim<strong>on</strong><br />
S<str<strong>on</strong>g>and</str<strong>on</strong>g>box Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g Co.<br />
Abstract: Three elementary aged students with autism participated <str<strong>on</strong>g>in</str<strong>on</strong>g> an evaluati<strong>on</strong> of computer based video<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> that targeted functi<strong>on</strong>al life skills. The effects of the software were analyzed <str<strong>on</strong>g>in</str<strong>on</strong>g> the c<strong>on</strong>text of a<br />
multiple probe design across <str<strong>on</strong>g>and</str<strong>on</strong>g> replicated across participants. This study represents a departure from more<br />
traditi<strong>on</strong>al video based <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> for <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with autism because it comb<str<strong>on</strong>g>in</str<strong>on</strong>g>es video model<str<strong>on</strong>g>in</str<strong>on</strong>g>g as well as<br />
computer based simulati<strong>on</strong> tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> absence of any <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>. All <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> took place <strong>on</strong> the<br />
computer <str<strong>on</strong>g>and</str<strong>on</strong>g> student’s performance <str<strong>on</strong>g>in</str<strong>on</strong>g> vivo was the primary dependent measure. The participants each<br />
mastered all the skills they were taught via the computer <str<strong>on</strong>g>and</str<strong>on</strong>g> generalized this to the natural envir<strong>on</strong>ment. They<br />
ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed the skills after a two-week follow up.<br />
Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g functi<strong>on</strong>al life skills is the cornerst<strong>on</strong>e<br />
of many Individualized <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Plans<br />
for students with autism. A focus <strong>on</strong> functi<strong>on</strong>al<br />
skill <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> allows students the opportunity<br />
to learn valuable skills that lead to greater<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependence <str<strong>on</strong>g>and</str<strong>on</strong>g> aut<strong>on</strong>omy (Brown, 1979).<br />
One of the key features of special educati<strong>on</strong><br />
services is the ability of educators <str<strong>on</strong>g>and</str<strong>on</strong>g> parents<br />
to focus <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> curriculum <strong>on</strong> those<br />
areas where a student needs the greatest<br />
amount of assistance to <str<strong>on</strong>g>in</str<strong>on</strong>g>crease their <str<strong>on</strong>g>in</str<strong>on</strong>g>dependence.<br />
In the classroom, prov<str<strong>on</strong>g>in</str<strong>on</strong>g>g student<br />
with frequent enough practice, sufficient<br />
guided repetiti<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> opportunities to use a<br />
wide range of materials to promote generalizati<strong>on</strong><br />
can be a challenge when a teacher has<br />
a group of learners with heterogeneous needs<br />
who all require <str<strong>on</strong>g>in</str<strong>on</strong>g>tensive <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>. One soluti<strong>on</strong><br />
to this logistical challenge is to staff<br />
more paraprofessi<strong>on</strong>als or teacher’s aides <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the classroom to provide more <str<strong>on</strong>g>in</str<strong>on</strong>g>dividualized<br />
attenti<strong>on</strong> to students. Another soluti<strong>on</strong> is to<br />
plan ways for students to <str<strong>on</strong>g>in</str<strong>on</strong>g>dependently engage<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g activities that do not require<br />
direct teacher supervisi<strong>on</strong>.<br />
Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g activities centered <strong>on</strong> functi<strong>on</strong>al<br />
skills <str<strong>on</strong>g>and</str<strong>on</strong>g> supported by video or computer<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g this article should<br />
be addressed to Kev<str<strong>on</strong>g>in</str<strong>on</strong>g> Ayres, University of Georgia,<br />
College of <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>, Department of Special <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>,<br />
537 Aderhold Hall, Athens, GA 30602-7153.<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, 2009, 44(4), 493–508<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
based video <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> (CBVI) have a small<br />
but grow<str<strong>on</strong>g>in</str<strong>on</strong>g>g body of literature support <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
may be <strong>on</strong>e way to address students’ needs for<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividualized <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>. The use of CBVI<br />
takes many forms but relies heavily <strong>on</strong> the<br />
grow<str<strong>on</strong>g>in</str<strong>on</strong>g>g body of evidence that suggests video<br />
can be a powerful teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g tool (Ayres &<br />
Lang<strong>on</strong>e, 2005). For example, Charlop-<br />
Christy, Le, <str<strong>on</strong>g>and</str<strong>on</strong>g> Freeman (2000) used video<br />
model<str<strong>on</strong>g>in</str<strong>on</strong>g>g to effectively teach hygiene skills<br />
(am<strong>on</strong>g other pre-academic <str<strong>on</strong>g>and</str<strong>on</strong>g> social skils).<br />
Alberto, Cihak, <str<strong>on</strong>g>and</str<strong>on</strong>g> Gama (2005) used video<br />
as an <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al tool to teach the use of an<br />
ATM mach<str<strong>on</strong>g>in</str<strong>on</strong>g>e to middle school aged students.<br />
Similarly, Sigafoos et al. (2005) employed<br />
video model<str<strong>on</strong>g>in</str<strong>on</strong>g>g to teach microwave<br />
use to adults with developmental disabilities.<br />
Even when students are taught to access video<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependently (<strong>on</strong> video tape or DVD), adult<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong> is still <str<strong>on</strong>g>in</str<strong>on</strong>g>tegral to the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>.<br />
The role of the adult may not be as a teacher<br />
per se, but their role is important to the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
arrangement because they often<br />
set up the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g for the video or<br />
aide the student <str<strong>on</strong>g>in</str<strong>on</strong>g> mov<str<strong>on</strong>g>in</str<strong>on</strong>g>g from video to <str<strong>on</strong>g>in</str<strong>on</strong>g>vivo<br />
practice.<br />
CBVI allows greater student <str<strong>on</strong>g>in</str<strong>on</strong>g>dependence<br />
dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al activities because the<br />
video <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s are mediated by computer<br />
which provides prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g (often <str<strong>on</strong>g>in</str<strong>on</strong>g> the form<br />
of video) <str<strong>on</strong>g>and</str<strong>on</strong>g> an opportunity for the student<br />
to practice aspects of the target behavior. In<br />
Computer Based Video Instructi<strong>on</strong> / 493
this way, the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> becomes more of an<br />
active simulati<strong>on</strong>. In 2004, Simps<strong>on</strong>, Lang<strong>on</strong>e,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Ayres used CBVI to effectively deliver social<br />
skills <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> to young students with<br />
autism <str<strong>on</strong>g>in</str<strong>on</strong>g> teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g the students to appropriately<br />
engage <str<strong>on</strong>g>in</str<strong>on</strong>g> social protocols like turn tak<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> wait<str<strong>on</strong>g>in</str<strong>on</strong>g>g for a turn. Mechl<str<strong>on</strong>g>in</str<strong>on</strong>g>g, Pridgen,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Cr<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g> (2005) used CBVI to teach verbal<br />
resp<strong>on</strong>ses to questi<strong>on</strong>s that a student would<br />
encounter <str<strong>on</strong>g>in</str<strong>on</strong>g> fast food restaurant. This particular<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> required teacher <str<strong>on</strong>g>in</str<strong>on</strong>g>volvement<br />
(prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> error correcti<strong>on</strong>) however,<br />
it provides an example of how as<br />
technology improves, there is greater potential<br />
for students to engage <str<strong>on</strong>g>in</str<strong>on</strong>g> more <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g activities. In 2007, Mechl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Ortega-Hurnd<strong>on</strong> used CBVI to teach<br />
three complex cha<str<strong>on</strong>g>in</str<strong>on</strong>g>ed tasks to young adults<br />
with developmental disabilities. Similar to the<br />
methodology used <str<strong>on</strong>g>in</str<strong>on</strong>g> Mechl<str<strong>on</strong>g>in</str<strong>on</strong>g>g et al. (2005),<br />
computer c<strong>on</strong>trolled the delivery of video <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
the teacher assisted with prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g. Ayres,<br />
Lang<strong>on</strong>e, Bo<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> Norman (2006) used<br />
CBVI to teach purchas<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills to middle<br />
school aged students with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities.<br />
In this case, all <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
were delivered by the computer <str<strong>on</strong>g>and</str<strong>on</strong>g> students<br />
worked <str<strong>on</strong>g>in</str<strong>on</strong>g>dependently dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g this<br />
porti<strong>on</strong> of <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>. Participants still engaged<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> related purchas<str<strong>on</strong>g>in</str<strong>on</strong>g>g skill <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong><br />
with a teacher though. Mitchell, Pars<strong>on</strong>s, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Leanoard (2007) present <strong>on</strong>e of the most<br />
technologically advanced examples of comb<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
video <str<strong>on</strong>g>and</str<strong>on</strong>g> computer <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong> for<br />
students with autism. They used a virtual reality<br />
envir<strong>on</strong>ment to <str<strong>on</strong>g>in</str<strong>on</strong>g>struct teenaged students<br />
how to <str<strong>on</strong>g>in</str<strong>on</strong>g>teract <str<strong>on</strong>g>in</str<strong>on</strong>g> a café (order food, sit at a<br />
table etc). In the cases listed above, teachers<br />
were an <str<strong>on</strong>g>in</str<strong>on</strong>g>tegral part of facilitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g the <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s<br />
of the student with the technology <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
video. With <strong>on</strong>e of the potential values of<br />
CBVI be<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent student usage, further<br />
efforts are needed to exam<str<strong>on</strong>g>in</str<strong>on</strong>g>e how students<br />
can engage <str<strong>on</strong>g>in</str<strong>on</strong>g> technology based <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong><br />
with their teachers play<str<strong>on</strong>g>in</str<strong>on</strong>g>g a more limited<br />
role.<br />
The current study focused <strong>on</strong> teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
cha<str<strong>on</strong>g>in</str<strong>on</strong>g>ed tasks with CBVI without direct<br />
teacher support. Advances <str<strong>on</strong>g>in</str<strong>on</strong>g> technology have<br />
revoluti<strong>on</strong>ized the types of simulati<strong>on</strong>s that<br />
can be used to supplement or augment <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>.<br />
Tak<str<strong>on</strong>g>in</str<strong>on</strong>g>g note of that, Brown<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
White, Nave, <str<strong>on</strong>g>and</str<strong>on</strong>g> Bark<str<strong>on</strong>g>in</str<strong>on</strong>g>s (1986) cauti<strong>on</strong>ed<br />
about the importance of similarities of stimuli<br />
between natural <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>trived tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g envir<strong>on</strong>ments,<br />
researchers have c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued to look<br />
for ways to improve simulati<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> various<br />
ways. For example, Cihak, Alberto, Kessler,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Taber (2004) documented the superior<br />
efficiency of comb<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> with<br />
simulati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> over <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo or simulated<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> al<strong>on</strong>e for teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g fax mach<str<strong>on</strong>g>in</str<strong>on</strong>g>e,<br />
ATM, debit mach<str<strong>on</strong>g>in</str<strong>on</strong>g>e, <str<strong>on</strong>g>and</str<strong>on</strong>g> copy mach<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
use. This implies that students benefit<br />
greatly from the repeated practice <str<strong>on</strong>g>and</str<strong>on</strong>g> extensi<strong>on</strong><br />
that simulati<strong>on</strong> tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g affords but they<br />
also need the <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> to ensure efficient<br />
generalizati<strong>on</strong>.<br />
This <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigati<strong>on</strong> was built around the rati<strong>on</strong>ale<br />
that CBVI is a powerful <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
that can present students a range of multiple<br />
exemplars <str<strong>on</strong>g>and</str<strong>on</strong>g> provide <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> feedback. Further, if students are able<br />
to engage <str<strong>on</strong>g>in</str<strong>on</strong>g> a behavior that is topographically<br />
related to the criteri<strong>on</strong> behavior (the behavior<br />
expected <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo), the behavior may generalize<br />
to the natural envir<strong>on</strong>ment without additi<strong>on</strong>al<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>. This would allow<br />
teachers the ability to provide <str<strong>on</strong>g>in</str<strong>on</strong>g>dividualize<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al opportunities to students for<br />
functi<strong>on</strong>al skills while maximiz<str<strong>on</strong>g>in</str<strong>on</strong>g>g time <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
reduc<str<strong>on</strong>g>in</str<strong>on</strong>g>g cost <strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al materials (e.g.<br />
food, c<strong>on</strong>sumable products) or travel (to appropriate<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo locati<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> the community<br />
or school).<br />
The fundamental research questi<strong>on</strong> addressed<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> this <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigati<strong>on</strong> is whether students<br />
acquire a functi<strong>on</strong>al skill (mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g soup,<br />
mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich <str<strong>on</strong>g>and</str<strong>on</strong>g> sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the table) us<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
CBVI <str<strong>on</strong>g>and</str<strong>on</strong>g> then generalize this skill to an<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g without additi<strong>on</strong>al <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>.<br />
Method<br />
Participants<br />
494 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
This study was approved by school system,<br />
private, <str<strong>on</strong>g>and</str<strong>on</strong>g> university IRBs. Three participants<br />
were recruited through the local school<br />
system as well with the assistance of the Autism<br />
Society of America <str<strong>on</strong>g>in</str<strong>on</strong>g> a medium sized southern<br />
city to take part <str<strong>on</strong>g>in</str<strong>on</strong>g> this study. All three<br />
participants were diagnosed with autism by<br />
the TEACCH program <str<strong>on</strong>g>in</str<strong>on</strong>g> North Carol<str<strong>on</strong>g>in</str<strong>on</strong>g>a <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
had autism special educati<strong>on</strong> eligibilities. In<br />
additi<strong>on</strong> to hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g autism, participants also
had to: c<strong>on</strong>sent to participate, have parental<br />
permissi<strong>on</strong> to participate, be elementary<br />
school aged, have sufficient f<str<strong>on</strong>g>in</str<strong>on</strong>g>e motor skills<br />
to complete the target tasks, use a mouse to<br />
move the cursor <str<strong>on</strong>g>and</str<strong>on</strong>g> click <strong>on</strong> ic<strong>on</strong>s, <str<strong>on</strong>g>and</str<strong>on</strong>g> attend<br />
to a computer screen for at least 10<br />
m<str<strong>on</strong>g>in</str<strong>on</strong>g>utes. Lastly, all potential participants were<br />
screened <str<strong>on</strong>g>and</str<strong>on</strong>g> to be <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> this study,<br />
students had to be perform<str<strong>on</strong>g>in</str<strong>on</strong>g>g below 60%<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependent (averaged across skills) <strong>on</strong> the<br />
tasks targeted by <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. This liberal criteri<strong>on</strong><br />
meant that <strong>on</strong>e student (Stephen) was<br />
allowed to participate despite dem<strong>on</strong>strat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
above 60% <str<strong>on</strong>g>in</str<strong>on</strong>g>dependence for <strong>on</strong>e of the target<br />
skills.<br />
Depend<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> the school system, different<br />
st<str<strong>on</strong>g>and</str<strong>on</strong>g>ardized test <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> was available to<br />
the researchers <str<strong>on</strong>g>and</str<strong>on</strong>g> not all exist<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong><br />
was made available. Therefore cauti<strong>on</strong> is<br />
warranted relative to the generality of f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
to others with autism diagnoses. In the descripti<strong>on</strong>s<br />
below we have attempted to detail<br />
as much as possible about the students. The<br />
first student, Stephan was a 9 year 2 m<strong>on</strong>th old<br />
male student who enjoyed us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the computer.<br />
He showed stereotypical behavior when<br />
excited or after successfully complet<str<strong>on</strong>g>in</str<strong>on</strong>g>g tasks<br />
by flapp<str<strong>on</strong>g>in</str<strong>on</strong>g>g his h<str<strong>on</strong>g>and</str<strong>on</strong>g>s <str<strong>on</strong>g>and</str<strong>on</strong>g> rock<str<strong>on</strong>g>in</str<strong>on</strong>g>g. School<br />
records <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated that Stephen was perform<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
significantly below grade level <str<strong>on</strong>g>in</str<strong>on</strong>g> academic<br />
areas <str<strong>on</strong>g>and</str<strong>on</strong>g> that he exhibited characteristics of<br />
ADHD. The sec<strong>on</strong>d student, Natalie, was 9<br />
years <str<strong>on</strong>g>and</str<strong>on</strong>g> 6 m<strong>on</strong>ths old at the beg<str<strong>on</strong>g>in</str<strong>on</strong>g>n<str<strong>on</strong>g>in</str<strong>on</strong>g>g of<br />
the study. She had difficulty pay<str<strong>on</strong>g>in</str<strong>on</strong>g>g attenti<strong>on</strong><br />
to task for l<strong>on</strong>g periods of time <str<strong>on</strong>g>and</str<strong>on</strong>g> she was<br />
especially distracted by other student behavior<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> noises. The Bayley Scales of Infant Development<br />
II (Bayley, 1993) <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated that she<br />
had an IQ of 53. Her adaptive behavior was<br />
evaluated with the V<str<strong>on</strong>g>in</str<strong>on</strong>g>el<str<strong>on</strong>g>and</str<strong>on</strong>g> Adaptive Behavior<br />
Scales (Sparrow, Balla, & Cicchetti, 1984),<br />
which showed st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard scores of 43 for daily<br />
liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g, 52 for socializati<strong>on</strong>, 55 for communicati<strong>on</strong><br />
with a composite of 55. Like Stephan, she<br />
was highly distractible <str<strong>on</strong>g>and</str<strong>on</strong>g> would occasi<strong>on</strong>ally<br />
walk away from <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probes. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
game, she wore headph<strong>on</strong>es to reduce distracti<strong>on</strong>s.<br />
The third student, Ray, was a quiet, soft<br />
spoken 7 year 7 m<strong>on</strong>th old boy who would<br />
resp<strong>on</strong>d to greet<str<strong>on</strong>g>in</str<strong>on</strong>g>gs verbally but <strong>on</strong>ly after<br />
be<str<strong>on</strong>g>in</str<strong>on</strong>g>g rem<str<strong>on</strong>g>in</str<strong>on</strong>g>ded. He was very sensitive to sensory<br />
simulati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> gagged if he got mustard<br />
or may<strong>on</strong>naise <strong>on</strong> his f<str<strong>on</strong>g>in</str<strong>on</strong>g>gers dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g test<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Ray would exhibit signs of frustrati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> anxiety<br />
(wh<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g, mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g faces, <str<strong>on</strong>g>and</str<strong>on</strong>g> not resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g)<br />
when presented with difficult tasks. He<br />
enjoyed us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the computer <str<strong>on</strong>g>and</str<strong>on</strong>g> could turn<br />
<strong>on</strong> the computer <str<strong>on</strong>g>and</str<strong>on</strong>g> log <str<strong>on</strong>g>in</str<strong>on</strong>g> to his favorite<br />
games. He had a history of refus<str<strong>on</strong>g>in</str<strong>on</strong>g>g to resp<strong>on</strong>d<br />
to st<str<strong>on</strong>g>and</str<strong>on</strong>g>ardized assessment tests. The<br />
<strong>on</strong>ly test scores available for Ray were from the<br />
Preschool Language Scale 3 rd Editi<strong>on</strong> (Zimmerman,<br />
Ste<str<strong>on</strong>g>in</str<strong>on</strong>g>er, & P<strong>on</strong>d, 1992) that showed<br />
st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard scores of 68 for auditory comprehensi<strong>on</strong>,<br />
52 for expressive communicati<strong>on</strong> with a<br />
composite score of 56 for language.<br />
Sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> Instructi<strong>on</strong>al Arrangement<br />
The study took place <str<strong>on</strong>g>in</str<strong>on</strong>g> multiple locati<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded both home <str<strong>on</strong>g>and</str<strong>on</strong>g> classroom envir<strong>on</strong>ments.<br />
Ray received CBVI <str<strong>on</strong>g>in</str<strong>on</strong>g> his home <strong>on</strong> a<br />
W<str<strong>on</strong>g>in</str<strong>on</strong>g>dows computer. Natalie <str<strong>on</strong>g>and</str<strong>on</strong>g> Stephen received<br />
CBVI <str<strong>on</strong>g>in</str<strong>on</strong>g> their respective classrooms <strong>on</strong><br />
a Mac laptop with an attached mouse. In-vivo<br />
probes took place <str<strong>on</strong>g>in</str<strong>on</strong>g> the school for Natalie<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Stephen <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> the home for Ray.<br />
The arrangement of CBVI sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>vivo<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g for Ray was <str<strong>on</strong>g>in</str<strong>on</strong>g> his home kitchen<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> d<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g room. For Natalie <str<strong>on</strong>g>and</str<strong>on</strong>g> Stephen<br />
CBVI <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g were <str<strong>on</strong>g>in</str<strong>on</strong>g> different areas<br />
of their schools <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g at the classroom<br />
snack area (all 3 skills), <str<strong>on</strong>g>in</str<strong>on</strong>g> the cafeteria (all 3<br />
skills), <str<strong>on</strong>g>and</str<strong>on</strong>g> at a picnic table outside (s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the table).<br />
Materials<br />
Materials for the <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probes varied depend<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<strong>on</strong> the task. For prepar<str<strong>on</strong>g>in</str<strong>on</strong>g>g soup, students<br />
were provided an <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual serv<str<strong>on</strong>g>in</str<strong>on</strong>g>g sized 8oz<br />
microwavable c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>er of soup (Campbell’s<br />
or Progresso <str<strong>on</strong>g>and</str<strong>on</strong>g> different k<str<strong>on</strong>g>in</str<strong>on</strong>g>ds such as<br />
chicken <str<strong>on</strong>g>and</str<strong>on</strong>g> stars, vegetable, etc.) situated approximately<br />
1 ft from a microwave. Each c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>er<br />
had a metal lid (with sharp edges) that<br />
was removed prior to <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>. For mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
s<str<strong>on</strong>g>and</str<strong>on</strong>g>wiches, students were provided a cafeteria<br />
tray with two slices of bread, meat (turkey,<br />
chicken, bologna, or salami), cheese (Swiss,<br />
American, baby Swiss, or provol<strong>on</strong>e), <str<strong>on</strong>g>and</str<strong>on</strong>g> a<br />
c<strong>on</strong>diment (may<strong>on</strong>naise or mustard) <str<strong>on</strong>g>in</str<strong>on</strong>g> a preopened<br />
s<str<strong>on</strong>g>in</str<strong>on</strong>g>gle serv<str<strong>on</strong>g>in</str<strong>on</strong>g>g package. These materials<br />
were situated <strong>on</strong> a tray to the left of the<br />
food preparati<strong>on</strong> area. After <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
<strong>on</strong>ce students dem<strong>on</strong>strated mastery of mak-<br />
Computer Based Video Instructi<strong>on</strong> / 495
<str<strong>on</strong>g>in</str<strong>on</strong>g>g a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich, a full bottle of the c<strong>on</strong>diments<br />
was used from which students would have to<br />
squeeze an appropriate amount. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
a pre-opened package was used to reduce<br />
the chance that f<str<strong>on</strong>g>in</str<strong>on</strong>g>e motor difficulty would<br />
prevent the student from open<str<strong>on</strong>g>in</str<strong>on</strong>g>g the package<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> not complet<str<strong>on</strong>g>in</str<strong>on</strong>g>g the task. F<str<strong>on</strong>g>in</str<strong>on</strong>g>ally, for<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the table, students’ materials were positi<strong>on</strong>ed<br />
to the left of the child <str<strong>on</strong>g>in</str<strong>on</strong>g> r<str<strong>on</strong>g>and</str<strong>on</strong>g>om<br />
order. Materials <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded with a plate, fork,<br />
spo<strong>on</strong>, knife, napk<str<strong>on</strong>g>in</str<strong>on</strong>g>, <str<strong>on</strong>g>and</str<strong>on</strong>g> cup. The specific<br />
materials varied but <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded paper, plastic,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> ceramic plates; plastic <str<strong>on</strong>g>and</str<strong>on</strong>g> metal flatware;<br />
cloth <str<strong>on</strong>g>and</str<strong>on</strong>g> paper napk<str<strong>on</strong>g>in</str<strong>on</strong>g>s (folded <str<strong>on</strong>g>in</str<strong>on</strong>g> triangles<br />
or rectangles; <str<strong>on</strong>g>and</str<strong>on</strong>g> glass, Styrofoam <str<strong>on</strong>g>and</str<strong>on</strong>g> plastic<br />
cups.<br />
Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g CBVI, students sat at a computer<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> used a two butt<strong>on</strong> mouse to <str<strong>on</strong>g>in</str<strong>on</strong>g>teract with<br />
the software program called I Can!- Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Community Skills (S<str<strong>on</strong>g>and</str<strong>on</strong>g>box Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Company, unpublished) software was developed<br />
by S<str<strong>on</strong>g>and</str<strong>on</strong>g>box Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g Company (owned<br />
by the sec<strong>on</strong>d <str<strong>on</strong>g>and</str<strong>on</strong>g> third authors). The software<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded video models <str<strong>on</strong>g>and</str<strong>on</strong>g> required the<br />
student to manipulate images <strong>on</strong> the screen<br />
that simulated the natural envir<strong>on</strong>ment. The<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al procedures <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong> are<br />
detailed <str<strong>on</strong>g>in</str<strong>on</strong>g> the procedures secti<strong>on</strong>.<br />
The images that the student saw dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
CBVI c<strong>on</strong>sisted of video images filmed from a<br />
1 st pers<strong>on</strong> perspective (c.f. Ayres & Lang<strong>on</strong>e,<br />
2007) which are depicted <str<strong>on</strong>g>in</str<strong>on</strong>g> the left column of<br />
Figure 1. Videos showed a narrated step-bystep<br />
walk-through of each target skill. Items<br />
used <str<strong>on</strong>g>in</str<strong>on</strong>g> the film<str<strong>on</strong>g>in</str<strong>on</strong>g>g mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
two different types of bread (wheat<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> white), two types of cheese (Swiss <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
cheddar), two c<strong>on</strong>diments (mustard <str<strong>on</strong>g>and</str<strong>on</strong>g> may<strong>on</strong>naise)<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> two types of meat (turkey <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
bologna). The video for mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g soup used<br />
two different but similar microwaves <str<strong>on</strong>g>and</str<strong>on</strong>g> three<br />
different types of soup. The materials filmed<br />
for the table sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g sequences <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded white<br />
ceramic <str<strong>on</strong>g>and</str<strong>on</strong>g> white Styrofoam plates, plastic<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> sta<str<strong>on</strong>g>in</str<strong>on</strong>g>less steel silverware, a white Styrofoam<br />
cup <str<strong>on</strong>g>and</str<strong>on</strong>g> a blue plastic cup, <str<strong>on</strong>g>and</str<strong>on</strong>g> white<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> orange napk<str<strong>on</strong>g>in</str<strong>on</strong>g>s. These were comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ed <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
various comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong>s for each skill to produce<br />
five video examples of each task be<str<strong>on</strong>g>in</str<strong>on</strong>g>g completed.<br />
The l<strong>on</strong>gest video was 1:10 m<str<strong>on</strong>g>in</str<strong>on</strong>g>utes<br />
(sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the table). The average video length<br />
was 50s.<br />
In additi<strong>on</strong> to video models, students saw<br />
496 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
professi<strong>on</strong>ally illustrated materials designed to<br />
mirror the stimuli they depicted <str<strong>on</strong>g>in</str<strong>on</strong>g> the videos<br />
(see right column of Figure 1). These materials<br />
(e.g. a slice of bread) were drawn to facilitate<br />
programm<str<strong>on</strong>g>in</str<strong>on</strong>g>g the computer game <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
allow the programmers maximal c<strong>on</strong>trol over<br />
manipulat<str<strong>on</strong>g>in</str<strong>on</strong>g>g movement of the images. Every<br />
video image had an illustrated counterpart<br />
that was used dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the <str<strong>on</strong>g>in</str<strong>on</strong>g>teractive <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
porti<strong>on</strong> of the program. The students<br />
manipulated these materials to mirror <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo<br />
acti<strong>on</strong>s. This will be described <str<strong>on</strong>g>in</str<strong>on</strong>g> the procedures<br />
secti<strong>on</strong>.<br />
Resp<strong>on</strong>se Def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s<br />
In-vivo. All three target behaviors were<br />
task analyzed (see Table 1) <str<strong>on</strong>g>and</str<strong>on</strong>g> dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo<br />
probes, students were presented the task <str<strong>on</strong>g>in</str<strong>on</strong>g> a<br />
total task format (Alberto & Troutman, 2003)<br />
whereby they had the opportunity to resp<strong>on</strong>d<br />
correctly or <str<strong>on</strong>g>in</str<strong>on</strong>g>correctly for each <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual<br />
step of the task analysis regardless of whether<br />
or not they correctly resp<strong>on</strong>ded to earlier<br />
steps of the task analysis. A correct resp<strong>on</strong>se<br />
occurred when a student began the resp<strong>on</strong>se<br />
with<str<strong>on</strong>g>in</str<strong>on</strong>g> 5s of the task directi<strong>on</strong> (e.g. “Please set<br />
the table) or with<str<strong>on</strong>g>in</str<strong>on</strong>g> 5s of complet<str<strong>on</strong>g>in</str<strong>on</strong>g>g the previous<br />
step (e.g. beg<str<strong>on</strong>g>in</str<strong>on</strong>g>n<str<strong>on</strong>g>in</str<strong>on</strong>g>g to place a piece of<br />
meat <strong>on</strong> a slice of bread with <str<strong>on</strong>g>in</str<strong>on</strong>g> 5s of plac<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the bread <strong>on</strong> the plate) <str<strong>on</strong>g>and</str<strong>on</strong>g> the student the<br />
student had to complete the step with<str<strong>on</strong>g>in</str<strong>on</strong>g> 5s of<br />
start<str<strong>on</strong>g>in</str<strong>on</strong>g>g the step. Any other resp<strong>on</strong>se was<br />
scored as <str<strong>on</strong>g>in</str<strong>on</strong>g>correct. This <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded not beg<str<strong>on</strong>g>in</str<strong>on</strong>g>n<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
a resp<strong>on</strong>se so<strong>on</strong> enough after the task<br />
request or previous step completi<strong>on</strong> (latency<br />
error or no resp<strong>on</strong>se), fail<str<strong>on</strong>g>in</str<strong>on</strong>g>g to complete the<br />
step with<str<strong>on</strong>g>in</str<strong>on</strong>g> 5s of beg<str<strong>on</strong>g>in</str<strong>on</strong>g>n<str<strong>on</strong>g>in</str<strong>on</strong>g>g the step (durati<strong>on</strong><br />
error), or engag<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> a topographically <str<strong>on</strong>g>in</str<strong>on</strong>g>correct<br />
behavior given the step <strong>on</strong> the task analysis<br />
(topography error).<br />
In cases where the student made any error<br />
(latency, durati<strong>on</strong>, topography), the researcher<br />
stopped the student, blocked the student’s<br />
view of the task materials, <str<strong>on</strong>g>and</str<strong>on</strong>g> corrected<br />
or completed the step without allow<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the student to see what was be<str<strong>on</strong>g>in</str<strong>on</strong>g>g d<strong>on</strong>e. The<br />
rati<strong>on</strong>ale beh<str<strong>on</strong>g>in</str<strong>on</strong>g>d this procedure was two fold.<br />
First, the step was completed or corrected to<br />
allow the student the opportunity to resp<strong>on</strong>d<br />
correctly to subsequent steps of the task analysis<br />
rather than term<str<strong>on</strong>g>in</str<strong>on</strong>g>at<str<strong>on</strong>g>in</str<strong>on</strong>g>g the sessi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
scor<str<strong>on</strong>g>in</str<strong>on</strong>g>g all steps after the error as <str<strong>on</strong>g>in</str<strong>on</strong>g>correct.
Figure 1. Screen captures of the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al software. Images <strong>on</strong> the left side show screen images of the<br />
video models. Images <strong>on</strong> the right column show clips of different parts of the <str<strong>on</strong>g>in</str<strong>on</strong>g>teractive software.<br />
Sec<strong>on</strong>d, the completi<strong>on</strong> of <strong>on</strong>e step <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
arrangement of the stimuli are the S D for the<br />
subsequent steps; therefore, <str<strong>on</strong>g>in</str<strong>on</strong>g> order to evaluate<br />
student knowledge of the subsequent<br />
steps, the stimuli had to be properly placed.<br />
This total task presentati<strong>on</strong> provides a c<strong>on</strong>servative<br />
estimate of basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e behavior because it<br />
allows measurement of student performance<br />
<strong>on</strong> all steps.<br />
It is important to note the difference <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
latency parameters between <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo <str<strong>on</strong>g>and</str<strong>on</strong>g> CBVI.<br />
With <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo the latency for a correct resp<strong>on</strong>se<br />
was 5s whereas <strong>on</strong> the computer, the latency<br />
for resp<strong>on</strong>ses (<str<strong>on</strong>g>and</str<strong>on</strong>g> prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g) was set at 10s.<br />
Computer Based Video Instructi<strong>on</strong> / 497
TABLE 1<br />
Task Analysis of Target Skills<br />
Sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the Table Mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g Soup Mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g a S<str<strong>on</strong>g>and</str<strong>on</strong>g>wich<br />
1. Pick up the plate 1. Open the microwave 1. Pick up a piece of bread<br />
2. Put the plate <strong>on</strong> the mat 2. Get the soup 2. Put the bread <strong>on</strong> the plate<br />
3. Pick up the napk<str<strong>on</strong>g>in</str<strong>on</strong>g> 3. Put the soup <str<strong>on</strong>g>in</str<strong>on</strong>g> the microwave 3. Pick up the c<strong>on</strong>diment<br />
4. Put the napk<str<strong>on</strong>g>in</str<strong>on</strong>g> to the left of 4. Close the microwave door 4. Spread the c<strong>on</strong>diment <strong>on</strong> the<br />
the plate<br />
5. Press “Stop/Clear”<br />
bread<br />
5. Pick up the fork<br />
6. Press “Time”<br />
5. Put the package <str<strong>on</strong>g>in</str<strong>on</strong>g> the trash<br />
6. Put the fork <strong>on</strong> the napk<str<strong>on</strong>g>in</str<strong>on</strong>g> 7. Press “1”<br />
6. Pick up the meat<br />
7. Pick up the knife<br />
8. Press “3”<br />
7. Put the meat <strong>on</strong> the c<strong>on</strong>diment<br />
8. Put the knife to the right of 9. Press “0”<br />
8. Pick up the cheese<br />
the plate<br />
10. Press “Start”<br />
9. Put the cheese <strong>on</strong> the meat<br />
9. Pick up the so<strong>on</strong><br />
10. Pick up the bread<br />
10. Put the spo<strong>on</strong> to the right of<br />
the knife<br />
11. Pick up the cup<br />
12. Put the cup to above the knife<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> spo<strong>on</strong><br />
11. Put the bread <strong>on</strong> the cheese<br />
This was a functi<strong>on</strong> of software cod<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> this<br />
prototype where coord<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> of the programm<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
to allow record<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> multiple “events”<br />
to take place simultaneously <strong>on</strong> the computer<br />
made a 5s latency too short for student resp<strong>on</strong>se.<br />
Based <strong>on</strong> our pilot test<str<strong>on</strong>g>in</str<strong>on</strong>g>g with a 5s<br />
latency, students did not have a reas<strong>on</strong>able<br />
amount of time to identify the appropriate<br />
target to “click” <str<strong>on</strong>g>and</str<strong>on</strong>g> then <str<strong>on</strong>g>in</str<strong>on</strong>g>itiate mov<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
mouse toward the target. We found that 10s<br />
allowed a much more reas<strong>on</strong>able time.<br />
Computer Based Video Instructi<strong>on</strong>. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
CBVI, four resp<strong>on</strong>ses were scored. Independent<br />
correct resp<strong>on</strong>ses were scored if the student<br />
completed the correct step of the task<br />
analysis with<str<strong>on</strong>g>in</str<strong>on</strong>g> 10s of the task directi<strong>on</strong> (for<br />
the <str<strong>on</strong>g>in</str<strong>on</strong>g>itial step) or with<str<strong>on</strong>g>in</str<strong>on</strong>g> 10s of complet<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the previous step. Prompted corrects were<br />
scored when students did not resp<strong>on</strong>d with<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
10s of the task directi<strong>on</strong> or completi<strong>on</strong> of the<br />
previous step but resp<strong>on</strong>ded correctly after<br />
the computer delivered a prompt. Three types<br />
of prompted corrects were possible: verbal,<br />
verbal plus model, verbal plus stimulus<br />
prompt. To have a prompted correct that was<br />
verbal plus model or verbal plus stimulus<br />
prompt the student would have to have not<br />
resp<strong>on</strong>ded at all to the less <str<strong>on</strong>g>in</str<strong>on</strong>g>trusive levels of<br />
prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g. These prompt levels <str<strong>on</strong>g>and</str<strong>on</strong>g> their applicati<strong>on</strong><br />
are def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed below <str<strong>on</strong>g>in</str<strong>on</strong>g> the secti<strong>on</strong> detail<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al methodology. Only<br />
498 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependent corrects were counted toward<br />
meet<str<strong>on</strong>g>in</str<strong>on</strong>g>g the mastery criteria. The program<br />
recorded resp<strong>on</strong>ses <str<strong>on</strong>g>and</str<strong>on</strong>g> reported the total<br />
percent <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct after the student<br />
completed the sessi<strong>on</strong>.<br />
General Procedures<br />
In-vivo probes. Students were brought to<br />
the test<str<strong>on</strong>g>in</str<strong>on</strong>g>g area (part of the classroom, school<br />
kitchen, or home kitchen), <strong>on</strong>e of the researchers<br />
(sec<strong>on</strong>d author) po<str<strong>on</strong>g>in</str<strong>on</strong>g>ted at the materials<br />
for the task <str<strong>on</strong>g>and</str<strong>on</strong>g> gave the task directi<strong>on</strong><br />
(e.g. “Make the soup”). Students were allowed<br />
5s to beg<str<strong>on</strong>g>in</str<strong>on</strong>g> the resp<strong>on</strong>se. If they failed to<br />
beg<str<strong>on</strong>g>in</str<strong>on</strong>g> the resp<strong>on</strong>se, the researcher shielded<br />
the student from view<str<strong>on</strong>g>in</str<strong>on</strong>g>g the correct resp<strong>on</strong>se<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> completed the step <strong>on</strong> the task analysis<br />
for the student <str<strong>on</strong>g>and</str<strong>on</strong>g> then repeated the task<br />
directi<strong>on</strong>. This was an attempt to prevent the<br />
student from acquir<str<strong>on</strong>g>in</str<strong>on</strong>g>g the skill by watch<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the researcher model the resp<strong>on</strong>se. In some<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>stances, this shield<str<strong>on</strong>g>in</str<strong>on</strong>g>g would not wholly<br />
keep the participant from see<str<strong>on</strong>g>in</str<strong>on</strong>g>g what occurred.<br />
For example, several steps of the task<br />
analyses required the student to pick up an<br />
object. In these <str<strong>on</strong>g>in</str<strong>on</strong>g>stances, the researcher would<br />
place her body or clipboard between the student<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> the materials, pick up the correct<br />
material <str<strong>on</strong>g>and</str<strong>on</strong>g> place it <str<strong>on</strong>g>in</str<strong>on</strong>g> the student’s h<str<strong>on</strong>g>and</str<strong>on</strong>g>.<br />
If students resp<strong>on</strong>ded <str<strong>on</strong>g>in</str<strong>on</strong>g>correctly or ex-
ceeded the allowable durati<strong>on</strong> for the resp<strong>on</strong>se,<br />
the researcher <str<strong>on</strong>g>in</str<strong>on</strong>g>terrupted the resp<strong>on</strong>se,<br />
placed the materials <str<strong>on</strong>g>in</str<strong>on</strong>g> the correct<br />
place for the next step of the task sequence<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> repeated the task directi<strong>on</strong>. We believed<br />
that these efforts were the most prudent way<br />
to allow students a complete opportunity to<br />
dem<strong>on</strong>strate how to perform as many steps of<br />
the task analysis as possible while recogniz<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the risk that students might “learn” from the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> of the researcher. After students<br />
completed the entire task, they were allowed<br />
to c<strong>on</strong>sume whatever food they made if they<br />
wanted. Sessi<strong>on</strong>s for <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual skills lasted approximately<br />
10 m<str<strong>on</strong>g>in</str<strong>on</strong>g> (shorter <strong>on</strong>ce students<br />
mastered the skills) <str<strong>on</strong>g>and</str<strong>on</strong>g> all three skills were<br />
probed <str<strong>on</strong>g>in</str<strong>on</strong>g> successi<strong>on</strong> <strong>on</strong> the same day.<br />
CBVI procedures. Pilot test<str<strong>on</strong>g>in</str<strong>on</strong>g>g of the software<br />
with other students with autism revealed<br />
that the computer <str<strong>on</strong>g>in</str<strong>on</strong>g>terface was <str<strong>on</strong>g>in</str<strong>on</strong>g>tuitive <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
that the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> the program (e.g.<br />
“Now we are go<str<strong>on</strong>g>in</str<strong>on</strong>g>g to watch a video, when the<br />
video f<str<strong>on</strong>g>in</str<strong>on</strong>g>ishes press the arrow butt<strong>on</strong>”; or<br />
“Now it is your turn, use the mouse to<br />
______.”) were sufficient to tra<str<strong>on</strong>g>in</str<strong>on</strong>g> students to<br />
use the software. Because of this previous test<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
no additi<strong>on</strong>al tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g was planned or<br />
needed. The teacher or parent assisted the<br />
student with logg<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>to the computer program.<br />
Once <str<strong>on</strong>g>in</str<strong>on</strong>g> the program, the student<br />
viewed two narrated video models of the target<br />
task be<str<strong>on</strong>g>in</str<strong>on</strong>g>g completed. After the first video<br />
ended, the sec<strong>on</strong>d video exemplar played. Figure<br />
1 shows screen captures of videos for each<br />
skill <str<strong>on</strong>g>in</str<strong>on</strong>g> the left h<str<strong>on</strong>g>and</str<strong>on</strong>g> column.<br />
Once the student completed view<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
video models, the program asked them to<br />
complete the skill <str<strong>on</strong>g>in</str<strong>on</strong>g> a computer simulati<strong>on</strong>.<br />
Figure 1 shows screen captures of the <str<strong>on</strong>g>in</str<strong>on</strong>g>teractive<br />
simulati<strong>on</strong> screens for each task. The computer<br />
displayed an image of all materials <strong>on</strong><br />
the screen <str<strong>on</strong>g>and</str<strong>on</strong>g> then issued a task directi<strong>on</strong><br />
(e.g. “Make a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich”). Students resp<strong>on</strong>ded<br />
by us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the mouse to click <strong>on</strong> items, move<br />
items across the screen, <str<strong>on</strong>g>and</str<strong>on</strong>g> then click <strong>on</strong><br />
locati<strong>on</strong>s to drop or place items. For example,<br />
part of the <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo task analysis for mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g a<br />
s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich c<strong>on</strong>sisted of these steps: pick up the<br />
bread, place the bread <strong>on</strong> the plate, pick up<br />
the meat, place the meat <strong>on</strong> the bread. On the<br />
computer, these steps were identical. The student<br />
had to click <strong>on</strong> the bread to pick it up,<br />
move the bread to the place, <str<strong>on</strong>g>and</str<strong>on</strong>g> place the<br />
bread <strong>on</strong> the plate by click<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> the plate.<br />
The click<str<strong>on</strong>g>in</str<strong>on</strong>g>g resp<strong>on</strong>se <strong>on</strong> the bread to pick it<br />
up was <strong>on</strong>e step of the TA <str<strong>on</strong>g>and</str<strong>on</strong>g> then click<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the plate to place the bread <strong>on</strong> the plate was<br />
another step of the TA. Each of these was<br />
prompted as needed <str<strong>on</strong>g>in</str<strong>on</strong>g> a modified system of<br />
least prompts (SLP) <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al arrangement<br />
(Wolery, Ault, & Doyle, 1992).<br />
Students were allowed 10s to resp<strong>on</strong>d us<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the mouse, if they did not resp<strong>on</strong>d, or began<br />
an <str<strong>on</strong>g>in</str<strong>on</strong>g>correct resp<strong>on</strong>se (e.g. clicked <strong>on</strong> the<br />
wr<strong>on</strong>g item to pick up), the computer stopped<br />
them <str<strong>on</strong>g>and</str<strong>on</strong>g> delivered the next level <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
prompt hierarchy. The SLP procedure c<strong>on</strong>sisted<br />
of levels:<br />
1. Independent: student beg<str<strong>on</strong>g>in</str<strong>on</strong>g>s a resp<strong>on</strong>se<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> f<str<strong>on</strong>g>in</str<strong>on</strong>g>ishes the resp<strong>on</strong>se with<str<strong>on</strong>g>in</str<strong>on</strong>g> 10s of the<br />
previous step or task directi<strong>on</strong>.<br />
2. Verbal: computer provides an auditory resp<strong>on</strong>se<br />
prompt tell<str<strong>on</strong>g>in</str<strong>on</strong>g>g the student what to<br />
do (e.g. “Put the bread <strong>on</strong> the plate”).<br />
3. Model prompt: computer shows a visual<br />
resp<strong>on</strong>se prompt <str<strong>on</strong>g>in</str<strong>on</strong>g> the form of a video<br />
model where a live actor completes the<br />
step (identical to the pre-sessi<strong>on</strong> video<br />
models). The middle image <str<strong>on</strong>g>in</str<strong>on</strong>g> the right<br />
column of figure <strong>on</strong>e displays the model<br />
prompt be<str<strong>on</strong>g>in</str<strong>on</strong>g>g delivered.<br />
4. Stimulus Prompt: analogous to a “partial<br />
physical” prompt <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of level of <str<strong>on</strong>g>in</str<strong>on</strong>g>trusi<strong>on</strong>,<br />
the stimulus prompt created a bright<br />
yellow “halo” <strong>on</strong> the locati<strong>on</strong> where the<br />
student needed to click. The image <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
top right of Figure 1 shows the spo<strong>on</strong> be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
highlighted.<br />
5. “Full Physical”: the computer c<strong>on</strong>trolled<br />
the images <strong>on</strong> the screen <str<strong>on</strong>g>and</str<strong>on</strong>g> completed<br />
the step for the student.<br />
If students resp<strong>on</strong>ded correctly before any<br />
prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g was required, the resp<strong>on</strong>se for that<br />
step of the TA was scored as <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent. If<br />
the student did not resp<strong>on</strong>d until after a<br />
prompt, the highest level of prompt required<br />
for the student to resp<strong>on</strong>d correctly was<br />
scored. If the student made an error, the computer<br />
prompted them <str<strong>on</strong>g>and</str<strong>on</strong>g> allowed them to<br />
complete the step, the resp<strong>on</strong>se was scored<br />
based <strong>on</strong> the highest level of prompt required<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> a noti<strong>on</strong> was made that the student made<br />
an error <strong>on</strong> that step before complet<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
step. All sessi<strong>on</strong>s were scored <str<strong>on</strong>g>and</str<strong>on</strong>g> recorded by<br />
the computer.<br />
Computer Based Video Instructi<strong>on</strong> / 499
No programmed re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement was provided<br />
for correct resp<strong>on</strong>ses dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g CBVI. A<br />
re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcer game was available n<strong>on</strong>-c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>gently<br />
<strong>on</strong> student performance after the student<br />
completed the simulati<strong>on</strong>. A teacher, or<br />
a parent (for Ray <str<strong>on</strong>g>in</str<strong>on</strong>g> the home), supervised all<br />
CBVI sessi<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> did not provide any feedback<br />
to the student. They were present <strong>on</strong>ly to<br />
m<strong>on</strong>itor the performance of the computer<br />
program <str<strong>on</strong>g>and</str<strong>on</strong>g> to keep students <strong>on</strong> task. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the course of the study, students generally<br />
displayed eagerness to work <strong>on</strong> the program<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> no attenti<strong>on</strong> problems were noted. Students<br />
usually engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> two sessi<strong>on</strong>s per day<br />
with each sessi<strong>on</strong> last<str<strong>on</strong>g>in</str<strong>on</strong>g>g approximately 5 m<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
total. Inter-sessi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>tervals varied based <strong>on</strong><br />
school <str<strong>on</strong>g>and</str<strong>on</strong>g> home schedules.<br />
Experimental Design<br />
CBVI was evaluated <str<strong>on</strong>g>in</str<strong>on</strong>g> the c<strong>on</strong>text of a multiple<br />
probe design across behaviors <str<strong>on</strong>g>and</str<strong>on</strong>g> replicated<br />
across students. The sequence of target<br />
behaviors was counterbalanced across participants.<br />
Pre/post <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probes were used to<br />
evaluate generalizati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> were the pr<str<strong>on</strong>g>in</str<strong>on</strong>g>ciple<br />
measure of <str<strong>on</strong>g>in</str<strong>on</strong>g>terest. Pre/Interventi<strong>on</strong> probes<br />
functi<strong>on</strong>ed as the basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e measure. All students<br />
were evaluated <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo <strong>on</strong> all target skills<br />
prior to receiv<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> <strong>on</strong> the computer.<br />
Once their data were stable across at<br />
least three sessi<strong>on</strong>s, each student began computer-based<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <strong>on</strong> their first skill.<br />
Once a student resp<strong>on</strong>ded <str<strong>on</strong>g>in</str<strong>on</strong>g>dependently to<br />
90% or more of the steps of the task analysis<br />
dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g CBVI for his or her target skill <strong>on</strong> at<br />
least three occasi<strong>on</strong>s (c<strong>on</strong>secutive sessi<strong>on</strong>s at<br />
90% were not required), the researcher tested<br />
for generalizati<strong>on</strong> with <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probes <strong>on</strong> all<br />
skills <str<strong>on</strong>g>and</str<strong>on</strong>g> the student began <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <strong>on</strong><br />
their next skill. This c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued until each student<br />
had received <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <strong>on</strong> all target<br />
skills. The criteri<strong>on</strong> for mov<str<strong>on</strong>g>in</str<strong>on</strong>g>g to <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo test<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
was set at 90% <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent <strong>on</strong> three separate<br />
occasi<strong>on</strong>s for multiple reas<strong>on</strong>s. First, we<br />
wanted to evaluate <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo performance as<br />
so<strong>on</strong> as possible but yet allow adequate acquisiti<strong>on</strong><br />
time <strong>on</strong> the computer <str<strong>on</strong>g>and</str<strong>on</strong>g> sec<strong>on</strong>d we<br />
wanted students to have an opportunity to<br />
engage <str<strong>on</strong>g>in</str<strong>on</strong>g> all skills (if possible) as quickly as<br />
experimentally possible <str<strong>on</strong>g>and</str<strong>on</strong>g> us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a 90% criteri<strong>on</strong><br />
seemed like a reas<strong>on</strong>able compromise.<br />
Reliability<br />
500 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
The primary observer scored student resp<strong>on</strong>ses<br />
dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probes. All <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo<br />
sessi<strong>on</strong>s were video taped to allow for collecti<strong>on</strong><br />
of reliability <str<strong>on</strong>g>and</str<strong>on</strong>g> procedural fidelity data.<br />
Interobserver agreement (IOA) data were<br />
gathered for student resp<strong>on</strong>ses as well as procedural<br />
fidelity. For <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo sessi<strong>on</strong>s, data were<br />
collected by an observer <str<strong>on</strong>g>in</str<strong>on</strong>g> real time. A sec<strong>on</strong>d<br />
observer viewed video of at least 20% sessi<strong>on</strong>s<br />
for each student (mean of 27.69% of all sessi<strong>on</strong>s)<br />
<strong>on</strong> each skill before <str<strong>on</strong>g>and</str<strong>on</strong>g> after <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> scored student behavior as well as<br />
procedural fidelity. IOA was calculated by divid<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the number of agreements <strong>on</strong> student<br />
resp<strong>on</strong>ses by the sum of the agreements <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
disagreements <str<strong>on</strong>g>and</str<strong>on</strong>g> this number was multiplied<br />
by 100. Interobserver agreement for<br />
these averaged 98% with a range of 96.2-<br />
100%. The disagreements <strong>on</strong> student performance<br />
were always a matter of differences <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
count<str<strong>on</strong>g>in</str<strong>on</strong>g>g resp<strong>on</strong>se time. For example, <strong>on</strong>e observer<br />
saw the student beg<str<strong>on</strong>g>in</str<strong>on</strong>g> the resp<strong>on</strong>se<br />
with<str<strong>on</strong>g>in</str<strong>on</strong>g> the specified time frame where as the<br />
other observer scored the behavior as <str<strong>on</strong>g>in</str<strong>on</strong>g>correct<br />
because the behavior was <strong>on</strong> started<br />
with<str<strong>on</strong>g>in</str<strong>on</strong>g> the allotted time.<br />
Procedural fidelity was calculated by scor<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
researcher behavior for all critical steps of the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probe <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>. These <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded 1)<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g out the appropriate materials, 2) provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the student with a verbal <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> to<br />
beg<str<strong>on</strong>g>in</str<strong>on</strong>g> the target task. Then for each step of<br />
the task analysis, the researchers behavior was<br />
scored for whether they 3) resp<strong>on</strong>ded correctly<br />
to the student acti<strong>on</strong> whether they had<br />
to <str<strong>on</strong>g>in</str<strong>on</strong>g>terrupt an <str<strong>on</strong>g>in</str<strong>on</strong>g>correct resp<strong>on</strong>se or allow the<br />
participant to c<strong>on</strong>diti<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> 4) whether or<br />
not they adhered to the latency limit before<br />
mov<str<strong>on</strong>g>in</str<strong>on</strong>g>g the student to the next step. Because<br />
these last two comp<strong>on</strong>ents were scored for<br />
each step of the task analysis, the total number<br />
of steps varied based <strong>on</strong> the skill. The number<br />
of correctly performed researcher resp<strong>on</strong>ses<br />
was divided by the sum of appropriate <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>appropriate resp<strong>on</strong>ses <str<strong>on</strong>g>and</str<strong>on</strong>g> multiplied by<br />
100. Procedural fidelity was 96.6%, calculated<br />
by divid<str<strong>on</strong>g>in</str<strong>on</strong>g>g the total number of procedural<br />
steps followed by the total number of procedural<br />
steps scripted to be followed <str<strong>on</strong>g>and</str<strong>on</strong>g> then<br />
multiply<str<strong>on</strong>g>in</str<strong>on</strong>g>g by 100. The procedural steps that<br />
were not followed were always related to la-
tency <str<strong>on</strong>g>in</str<strong>on</strong>g>tervals <str<strong>on</strong>g>and</str<strong>on</strong>g> the researcher allow<str<strong>on</strong>g>in</str<strong>on</strong>g>g 1-2<br />
additi<strong>on</strong>al sec<strong>on</strong>ds for a student to <str<strong>on</strong>g>in</str<strong>on</strong>g>itiate a<br />
resp<strong>on</strong>se.<br />
Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, the computer collected<br />
all data <strong>on</strong> student resp<strong>on</strong>ses. Prior to<br />
deploy<str<strong>on</strong>g>in</str<strong>on</strong>g>g the program, it was extensively<br />
tested <str<strong>on</strong>g>and</str<strong>on</strong>g> reviewed by the software development<br />
team <str<strong>on</strong>g>and</str<strong>on</strong>g> the researchers. No procedural<br />
or scor<str<strong>on</strong>g>in</str<strong>on</strong>g>g errors were reported dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
this evaluati<strong>on</strong>. The teacher, researcher or<br />
parent completed a protocol checklist after<br />
each sessi<strong>on</strong> to record any irregularities <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
computer functi<strong>on</strong> dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. However,<br />
with this prototype software, the program<br />
did not log <str<strong>on</strong>g>and</str<strong>on</strong>g> save student data for<br />
each sessi<strong>on</strong> keyed to students’ names <str<strong>on</strong>g>and</str<strong>on</strong>g> dates.<br />
Results<br />
Figures 2 through 4 show student performance<br />
data for <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probes. All students<br />
dem<strong>on</strong>strated improvement dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo<br />
probes follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g mastery of the target skill <strong>on</strong><br />
the computer. The percent of n<strong>on</strong>-overlapp<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
data (PND) from pre-<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> to<br />
post-<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo for Stephan <str<strong>on</strong>g>and</str<strong>on</strong>g> Ray<br />
was 0% for all skills. The PND for Natalie was<br />
16% for mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich <str<strong>on</strong>g>and</str<strong>on</strong>g> 0% <strong>on</strong> sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the table.<br />
Stephen<br />
Stephen showed low levels of accurate resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probes for sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
table with a mean percentage correct of 11%<br />
(See Figure 2). After he reached criteri<strong>on</strong> <strong>on</strong><br />
the computer simulati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> six sessi<strong>on</strong>s, he<br />
scored 100% correct <strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probes for<br />
three c<strong>on</strong>secutive sessi<strong>on</strong>s after which his performance<br />
dipped slightly to 92% correct before<br />
rebound<str<strong>on</strong>g>in</str<strong>on</strong>g>g to 100% <str<strong>on</strong>g>and</str<strong>on</strong>g> back to 92%.<br />
Two weeks after <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> he resp<strong>on</strong>ded at<br />
100% correct for three c<strong>on</strong>secutive sessi<strong>on</strong>s.<br />
Stephen dem<strong>on</strong>strated slightly higher abilities<br />
with mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich. Prior to CBVI, he<br />
averaged 65% of steps correct. Once he met<br />
the 90% criteria <str<strong>on</strong>g>in</str<strong>on</strong>g> CBVI <str<strong>on</strong>g>in</str<strong>on</strong>g> 11 sessi<strong>on</strong>s, he<br />
dem<strong>on</strong>strated complete <str<strong>on</strong>g>in</str<strong>on</strong>g>dependence dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probes <str<strong>on</strong>g>and</str<strong>on</strong>g> ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed 100% accuracy<br />
at a two week follow up probe. With micro-wav<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
soup, he showed stable resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo prior to <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> where his mean<br />
performance was 39% correct. In ten sessi<strong>on</strong>s<br />
of CBVI he met criteri<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> generalized his<br />
performance to <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probes where he resp<strong>on</strong>ded<br />
correctly for 100% of the steps across<br />
three sessi<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> then ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed at 90%<br />
correct at a two week follow up.<br />
Natalie<br />
Natalie’s first skill was mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich.<br />
Prior to <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, she resp<strong>on</strong>ded at low<br />
levels averag<str<strong>on</strong>g>in</str<strong>on</strong>g>g 34% correct (See Figure 3).<br />
The <strong>on</strong>ly step she c<strong>on</strong>sistently got correct was<br />
putt<str<strong>on</strong>g>in</str<strong>on</strong>g>g the f<str<strong>on</strong>g>in</str<strong>on</strong>g>al piece of bread <strong>on</strong> the s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich.<br />
After she <str<strong>on</strong>g>in</str<strong>on</strong>g>itially met criteria <strong>on</strong> CBVI<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> n<str<strong>on</strong>g>in</str<strong>on</strong>g>e sessi<strong>on</strong>s, she dem<strong>on</strong>strated higher <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
performance <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo by resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
correctly for but was not complet<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
task <str<strong>on</strong>g>in</str<strong>on</strong>g>dependently. The decisi<strong>on</strong> was made to<br />
return to <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> until she met criteri<strong>on</strong><br />
aga<str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> she also received probes <strong>on</strong> the<br />
rema<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g skills <str<strong>on</strong>g>and</str<strong>on</strong>g> began <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <strong>on</strong><br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the table. Once Natalie reached criteri<strong>on</strong><br />
<strong>on</strong> mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich for the sec<strong>on</strong>d<br />
time (eight additi<strong>on</strong>al sessi<strong>on</strong>s) she was<br />
probed <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo aga<str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> showed more c<strong>on</strong>sistently<br />
high performance than previous <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo<br />
probes but she was not resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g at 100%.<br />
Aga<str<strong>on</strong>g>in</str<strong>on</strong>g> she returned to <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> for four<br />
sessi<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> then back to <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo where she<br />
aga<str<strong>on</strong>g>in</str<strong>on</strong>g> resp<strong>on</strong>ded better than dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
but not at 100%. She c<strong>on</strong>sistently <str<strong>on</strong>g>and</str<strong>on</strong>g> correctly<br />
resp<strong>on</strong>ded for the f<str<strong>on</strong>g>in</str<strong>on</strong>g>al four steps of the<br />
task analysis. Her errors were always with the<br />
first four steps. For sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the table, Natalie’s<br />
performance was low <str<strong>on</strong>g>and</str<strong>on</strong>g> stable with a mean<br />
of 19% <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probes.<br />
Her errors were <str<strong>on</strong>g>in</str<strong>on</strong>g>c<strong>on</strong>sistent across sessi<strong>on</strong>s.<br />
Up<strong>on</strong> beg<str<strong>on</strong>g>in</str<strong>on</strong>g>n<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, she resp<strong>on</strong>ded<br />
slowly at first <str<strong>on</strong>g>and</str<strong>on</strong>g> ultimately required 20 CBVI<br />
sessi<strong>on</strong>s to meet criteri<strong>on</strong>. She engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> <strong>on</strong>e<br />
additi<strong>on</strong>al CBVI sessi<strong>on</strong> bey<strong>on</strong>d criteria. In<br />
post <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> (<str<strong>on</strong>g>and</str<strong>on</strong>g> ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance probes)<br />
she generalized her performance to the natural<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g with a mean of 79% of steps correct.<br />
Natalie did not have enough time to beg<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
CBVI for mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g soup because the school year<br />
ended, however, her performance data rema<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
low <str<strong>on</strong>g>and</str<strong>on</strong>g> stable throughout the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>.<br />
Ray<br />
The evaluati<strong>on</strong> of performance with the software<br />
was <str<strong>on</strong>g>in</str<strong>on</strong>g>tended to be c<strong>on</strong>ducted <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
Computer Based Video Instructi<strong>on</strong> / 501
Figure 2. Resp<strong>on</strong>se data for Stephen. Closed circles represent resp<strong>on</strong>ses <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo <str<strong>on</strong>g>and</str<strong>on</strong>g> open circles represent<br />
resp<strong>on</strong>ses <strong>on</strong> the computer.<br />
c<strong>on</strong>text of a multiple probe design (like with<br />
Stephen <str<strong>on</strong>g>and</str<strong>on</strong>g> Natalie), however, it was discovered<br />
through the sessi<strong>on</strong> logs <strong>on</strong> Ray’s computer<br />
that he likely ga<str<strong>on</strong>g>in</str<strong>on</strong>g>ed access to all three<br />
502 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al programs prior to dem<strong>on</strong>strat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
mastery <strong>on</strong> the first skill. In additi<strong>on</strong>, reviews<br />
of the logs revealed that Ray accessed<br />
the program three additi<strong>on</strong>al times for his
Figure 3. Resp<strong>on</strong>se data for Natalie. Closed circles represent resp<strong>on</strong>ses <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo <str<strong>on</strong>g>and</str<strong>on</strong>g> open circles represent<br />
resp<strong>on</strong>ses <strong>on</strong> the computer.<br />
first skill (microwav<str<strong>on</strong>g>in</str<strong>on</strong>g>g soup) after he had<br />
dem<strong>on</strong>strated mastery. Therefore his graph<br />
(see Figure 4) essentially reflects three c<strong>on</strong>-<br />
current AB designs because we believed this<br />
would be the most c<strong>on</strong>servative way to present<br />
his data because he could not have access the<br />
Computer Based Video Instructi<strong>on</strong> / 503
Figure 4. Resp<strong>on</strong>se data for Ray. Closed circles represent resp<strong>on</strong>ses <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo <str<strong>on</strong>g>and</str<strong>on</strong>g> open circles represent<br />
resp<strong>on</strong>ses <strong>on</strong> the computer.<br />
software until after he completed <str<strong>on</strong>g>in</str<strong>on</strong>g>itial basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
test<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo. After he saw how to log<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>to the software dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the first sessi<strong>on</strong>, he<br />
could then have accessed the program at any<br />
time <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>on</strong> multiple times dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the same<br />
day. His data are displayed as if he accessed<br />
504 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
the software for all skills immediately after<br />
hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g access to it.<br />
Ray showed low levels of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent performance<br />
for micro-wav<str<strong>on</strong>g>in</str<strong>on</strong>g>g soup with a mean<br />
of 23% correct dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g pre-<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
probes. Ray required 19 CBVI sessi<strong>on</strong>s to mas-
ter micro-wav<str<strong>on</strong>g>in</str<strong>on</strong>g>g soup after which he dem<strong>on</strong>strated<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependent performance dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
first six post <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probes. After<br />
11 sessi<strong>on</strong>s <strong>on</strong> CBVI for mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g soup, Ray’s<br />
performance had stagnated, he was probed<br />
for his performance <strong>on</strong> the rema<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g skills,<br />
with the <str<strong>on</strong>g>in</str<strong>on</strong>g>tenti<strong>on</strong> of beg<str<strong>on</strong>g>in</str<strong>on</strong>g>n<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
<strong>on</strong> sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the table. At this time, because of<br />
the high degree of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent performance,<br />
it was discovered that Ray had accessed the<br />
rema<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g skills <strong>on</strong> the computer. The computer<br />
tracked his activity however <str<strong>on</strong>g>and</str<strong>on</strong>g> this<br />
showed that after 11 sessi<strong>on</strong>s of access<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
CBVI for sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the table, <str<strong>on</strong>g>and</str<strong>on</strong>g> 10 for mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich, Ray had achieved mastery <strong>on</strong> the<br />
computer. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g pre-<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> probes for<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the table, Ray had averaged 11% correct<br />
resp<strong>on</strong>ses <str<strong>on</strong>g>and</str<strong>on</strong>g> dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g post <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
he dem<strong>on</strong>strated a mean of 93%; achiev<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
100% accuracy dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g several sessi<strong>on</strong>s. Ray’s<br />
pre-<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> ability to make a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich<br />
was higher relative to the other target skills.<br />
His pre-<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> performance ranged<br />
from 36 to 73% correct with a mean of 58%.<br />
He averaged 93% correct dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g post <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
with several sessi<strong>on</strong>s at 100% correct.<br />
Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo probes, Ray would regularly<br />
repeat the verbal prompts from the software<br />
verbatim.<br />
Social Validity<br />
A social validity survey was given to parents,<br />
teachers, teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g assistants, speech therapists,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> occupati<strong>on</strong>al therapists work<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
with the participants. Half of the surveys returned<br />
were from parents, <str<strong>on</strong>g>and</str<strong>on</strong>g> half were from<br />
service providers. A 5-po<str<strong>on</strong>g>in</str<strong>on</strong>g>t Likert Scale was<br />
used (1 str<strong>on</strong>gly disagree; 5 str<strong>on</strong>gly<br />
agree) for <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals to resp<strong>on</strong>d to attitud<str<strong>on</strong>g>in</str<strong>on</strong>g>al<br />
questi<strong>on</strong>s about the goals <str<strong>on</strong>g>and</str<strong>on</strong>g> procedures<br />
of the study. Parents <str<strong>on</strong>g>and</str<strong>on</strong>g> professi<strong>on</strong>als felt<br />
elementary school rather than pre-school,<br />
middle school, or high school was the time to<br />
learn these skills (4.4 average). Parents <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
professi<strong>on</strong>als would use a versi<strong>on</strong> of this game<br />
to teach other functi<strong>on</strong>al skills for <str<strong>on</strong>g>in</str<strong>on</strong>g>dependence,<br />
work, or leisure (4.8, 4.4, <str<strong>on</strong>g>and</str<strong>on</strong>g> 4.6 average,<br />
respectively). Professi<strong>on</strong>als were asked additi<strong>on</strong>al<br />
questi<strong>on</strong>s about the game but <strong>on</strong>ly<br />
four resp<strong>on</strong>ses out of the six surveys were<br />
completed s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce they were not <str<strong>on</strong>g>in</str<strong>on</strong>g>volved <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
us<str<strong>on</strong>g>in</str<strong>on</strong>g>g this <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>. Overall, professi<strong>on</strong>als<br />
felt the students enjoyed the game (average<br />
4.8), but they did not feel it reduced the time<br />
they would spend teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich,<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the table, or us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a microwave<br />
(2.5, 2.8, 2.5, respectively).<br />
Judg<str<strong>on</strong>g>in</str<strong>on</strong>g>g the social validity of the study outcomes<br />
came from <str<strong>on</strong>g>in</str<strong>on</strong>g>formal feedback from<br />
parents. One saw their child microwave someth<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> set the table. Another reported that<br />
their child used the microwave <str<strong>on</strong>g>and</str<strong>on</strong>g> made a<br />
s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich. One saw the child complete all of<br />
the skills. The parents were not asked to <str<strong>on</strong>g>in</str<strong>on</strong>g>volve<br />
the children <str<strong>on</strong>g>in</str<strong>on</strong>g> these skills at home so<br />
they were not directly tested <str<strong>on</strong>g>in</str<strong>on</strong>g> this envir<strong>on</strong>ment.<br />
In an email <strong>on</strong>e parent wrote, “he has<br />
talked about sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the table s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce then. He<br />
told me just last night that I was putt<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
napk<str<strong>on</strong>g>in</str<strong>on</strong>g>s <strong>on</strong> the wr<strong>on</strong>g side of the plate.” Anecdotal<br />
reports from parents <str<strong>on</strong>g>and</str<strong>on</strong>g> teachers as<br />
well as observati<strong>on</strong>s of students c<strong>on</strong>firmed<br />
that they enjoyed us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the game. All participants<br />
wanted to work <strong>on</strong> the game <str<strong>on</strong>g>and</str<strong>on</strong>g> all<br />
participants tried to access the other skills <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the game before they mastered the target<br />
skills <strong>on</strong> which they were work<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Discussi<strong>on</strong><br />
To c<strong>on</strong>sider us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a computer game to teach a<br />
functi<strong>on</strong>al life skill, seems, <strong>on</strong> the surface,<br />
impractical <str<strong>on</strong>g>and</str<strong>on</strong>g> counter<str<strong>on</strong>g>in</str<strong>on</strong>g>tuitive. Results of<br />
this study dem<strong>on</strong>strated that it can be accomplished<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> that the student will generalize<br />
the skill to the natural envir<strong>on</strong>ment. This begs<br />
the questi<strong>on</strong> as to why <strong>on</strong>e would use computer<br />
technology to teach these skills when<br />
they might be best taught <str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
natural materials.<br />
Us<str<strong>on</strong>g>in</str<strong>on</strong>g>g technology to teach functi<strong>on</strong>al skills<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> this way has dist<str<strong>on</strong>g>in</str<strong>on</strong>g>ct advantages that are<br />
important c<strong>on</strong>siderati<strong>on</strong>s for <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>.<br />
First, technology is “recyclable” <str<strong>on</strong>g>in</str<strong>on</strong>g> that <strong>on</strong>ce<br />
the less<strong>on</strong> is developed (scheduled, program,<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividualized), the teacher does not have to<br />
prepare for the less<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> the same way every<br />
time. Similarly, with a less<strong>on</strong> that is tightly<br />
structured <str<strong>on</strong>g>and</str<strong>on</strong>g> delivered reliably through<br />
technology, the teacher does not have to<br />
worry about procedural variati<strong>on</strong>s that other<br />
staff may <str<strong>on</strong>g>in</str<strong>on</strong>g>troduce as a child is acquir<str<strong>on</strong>g>in</str<strong>on</strong>g>g a<br />
skill. For example, if a teacher is teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g a<br />
student to wash clothes <str<strong>on</strong>g>in</str<strong>on</strong>g> a wash<str<strong>on</strong>g>in</str<strong>on</strong>g>g mach<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> teaches the student to load the clothes,<br />
Computer Based Video Instructi<strong>on</strong> / 505
turn <strong>on</strong> the water, wait for the water to reach<br />
the top, <str<strong>on</strong>g>and</str<strong>on</strong>g> then put <str<strong>on</strong>g>in</str<strong>on</strong>g> the powdered detergent<br />
but another professi<strong>on</strong>al is teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
student to turn the water <strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> the wash<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
mach<str<strong>on</strong>g>in</str<strong>on</strong>g>e, put <str<strong>on</strong>g>in</str<strong>on</strong>g> the soap <str<strong>on</strong>g>and</str<strong>on</strong>g> then load the<br />
clothes, the student may fail to acquire the<br />
skill as quickly as he or she would have if they<br />
were <str<strong>on</strong>g>in</str<strong>on</strong>g>itially taught a s<str<strong>on</strong>g>in</str<strong>on</strong>g>gle correct way to<br />
complete the task.<br />
Bey<strong>on</strong>d the computer’s ability to deliver<br />
c<strong>on</strong>sistent <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> ad nauseum, it also provides<br />
the opportunity for <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
The teacher is freed to work 1:1 or <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
small groups with other students; perhaps<br />
other students who are try<str<strong>on</strong>g>in</str<strong>on</strong>g>g to generalize<br />
what they learned <strong>on</strong> the computer. In terms<br />
of generalizati<strong>on</strong>, computer <str<strong>on</strong>g>and</str<strong>on</strong>g> video technology<br />
allow for a wide range of examples to<br />
be <str<strong>on</strong>g>in</str<strong>on</strong>g>serted <str<strong>on</strong>g>in</str<strong>on</strong>g>to a less<strong>on</strong> bey<strong>on</strong>d what a<br />
teacher could reas<strong>on</strong>ably assemble for use <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the classroom. For example, <str<strong>on</strong>g>in</str<strong>on</strong>g> the current<br />
study, five different place sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong>s<br />
were used to teach sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the table <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
these were depicted <str<strong>on</strong>g>in</str<strong>on</strong>g> different sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
<strong>on</strong> different tables. Technology can br<str<strong>on</strong>g>in</str<strong>on</strong>g>g that<br />
all <str<strong>on</strong>g>in</str<strong>on</strong>g>to <strong>on</strong>e place <str<strong>on</strong>g>and</str<strong>on</strong>g> allow the teacher to<br />
c<strong>on</strong>trol the degree of variability <str<strong>on</strong>g>in</str<strong>on</strong>g> an attempt<br />
to prompt stimulus generalizati<strong>on</strong>. If this sort<br />
of technology proves to be successful <str<strong>on</strong>g>in</str<strong>on</strong>g> replicati<strong>on</strong>s,<br />
it is reas<strong>on</strong>able to assume, if adopted,<br />
students would be able to spend more time <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the community work<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> social skill related<br />
tasks that are more difficult to program <strong>on</strong> a<br />
computer <str<strong>on</strong>g>and</str<strong>on</strong>g> less time focused <strong>on</strong> repeated<br />
trials of functi<strong>on</strong>al skills.<br />
Limitati<strong>on</strong>s<br />
This study attempted to c<strong>on</strong>trol for threats to<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>ternal validity by us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a multiple probe design<br />
across behaviors <str<strong>on</strong>g>and</str<strong>on</strong>g> then replicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g that<br />
across participants. The logistics of this design<br />
made it difficult for <strong>on</strong>e of the students, Natalie,<br />
to complete all of her target skills; yet,<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tra <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>tersubject replicati<strong>on</strong> of effect<br />
were still dem<strong>on</strong>strated. More narrowly, to <str<strong>on</strong>g>in</str<strong>on</strong>g>terpret<br />
these results, <strong>on</strong>e must be cautious of<br />
the accelerat<str<strong>on</strong>g>in</str<strong>on</strong>g>g basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e data for Natalie <strong>on</strong><br />
mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich <str<strong>on</strong>g>and</str<strong>on</strong>g>, to a lesser extent <strong>on</strong><br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g the table. Ray also exhibited some variable<br />
data with some basel<str<strong>on</strong>g>in</str<strong>on</strong>g>es show<str<strong>on</strong>g>in</str<strong>on</strong>g>g slight<br />
accelerati<strong>on</strong>s.<br />
In terms of research design, Stephen’s re-<br />
506 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
sults document the most c<strong>on</strong>v<str<strong>on</strong>g>in</str<strong>on</strong>g>c<str<strong>on</strong>g>in</str<strong>on</strong>g>g evidence<br />
that the software was an effective <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
tool with three dem<strong>on</strong>strati<strong>on</strong>s of effect. To a<br />
lesser extent, Natalie’s mastery of two of the<br />
skills she had time to do show promise. Ray’s<br />
results have to be approached with the greatest<br />
cauti<strong>on</strong> s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce the three AB designs, though<br />
illustrat<str<strong>on</strong>g>in</str<strong>on</strong>g>g acquisiti<strong>on</strong>, fail to achieve the experimental<br />
c<strong>on</strong>trol offered by the evaluati<strong>on</strong><br />
<strong>on</strong> Stephen’s data. However, Ray’s violati<strong>on</strong> of<br />
the procedural protocols <str<strong>on</strong>g>and</str<strong>on</strong>g> access<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills<br />
that were to rema<str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e may yield <strong>on</strong>e<br />
of the most valuable f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of the study.<br />
Ray’s explorati<strong>on</strong> of the software <str<strong>on</strong>g>and</str<strong>on</strong>g> eagerness<br />
to engage with the activities may have led<br />
to him learn the target skills (the experimental<br />
design does not permit this c<strong>on</strong>clusi<strong>on</strong> to<br />
be drawn though) <str<strong>on</strong>g>and</str<strong>on</strong>g> be motivati<strong>on</strong>al but<br />
bey<strong>on</strong>d this, his <str<strong>on</strong>g>in</str<strong>on</strong>g>itiative dem<strong>on</strong>strates the<br />
ease with which systematically designed software<br />
can be used by a student without a great<br />
deal of adult supervisi<strong>on</strong>. The design could<br />
have been tightened more by requir<str<strong>on</strong>g>in</str<strong>on</strong>g>g a criteri<strong>on</strong><br />
level of 90% or 100% over three c<strong>on</strong>secutive<br />
sessi<strong>on</strong>s rather than three sessi<strong>on</strong>s.<br />
Admittedly, the decisi<strong>on</strong> to use the more relaxed<br />
criteria (90% <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent or better<br />
across three sessi<strong>on</strong>s) was <strong>on</strong>e of expedience<br />
than experimental rigor but the results still<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dicated that <strong>on</strong>ce students were able to meet<br />
the criteria, they were able to generalize the<br />
skill to the natural envir<strong>on</strong>ment.<br />
Other limitati<strong>on</strong>s that impact the external<br />
validity of this study <str<strong>on</strong>g>in</str<strong>on</strong>g>clude the availability of<br />
the software to teachers. Currently this study<br />
evaluated proprietary software to answer research<br />
questi<strong>on</strong>s about the possibility of teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
functi<strong>on</strong>al skills with CBVI. However, <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the future, when such software is more widely<br />
available, teaches will be able to <str<strong>on</strong>g>in</str<strong>on</strong>g>corporate<br />
this <str<strong>on</strong>g>in</str<strong>on</strong>g>to their <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>. Until that time, this<br />
study does dem<strong>on</strong>strate that <str<strong>on</strong>g>in</str<strong>on</strong>g>teractive CBVI<br />
can lead to positive outcomes <str<strong>on</strong>g>and</str<strong>on</strong>g> teachers<br />
can <str<strong>on</strong>g>in</str<strong>on</strong>g>corporate some of these techniques <str<strong>on</strong>g>in</str<strong>on</strong>g>to<br />
simple author<str<strong>on</strong>g>in</str<strong>on</strong>g>g tools like IntelliStudio <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
even PowerPo<str<strong>on</strong>g>in</str<strong>on</strong>g>t.<br />
Another limitati<strong>on</strong> that should be c<strong>on</strong>sidered<br />
is that, from an <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al st<str<strong>on</strong>g>and</str<strong>on</strong>g>po<str<strong>on</strong>g>in</str<strong>on</strong>g>t,<br />
strictly def<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g the order of steps for mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich may seem arbitrary <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> some<br />
ways limits the generality of these results. In<br />
other words, <strong>on</strong>e can make a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich by<br />
plac<str<strong>on</strong>g>in</str<strong>on</strong>g>g a slice of bread <strong>on</strong> a plate, then meat,
then c<strong>on</strong>diments, then cheese <str<strong>on</strong>g>and</str<strong>on</strong>g> then the<br />
last slice of bread. This is certa<str<strong>on</strong>g>in</str<strong>on</strong>g>ly a socially<br />
valid way to c<strong>on</strong>struct a s<str<strong>on</strong>g>and</str<strong>on</strong>g>wich. However,<br />
for the purposes of this study, we were <str<strong>on</strong>g>in</str<strong>on</strong>g>terested<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g whether such tight stimulus<br />
c<strong>on</strong>trol could be achieved <strong>on</strong> the computer<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> then generalized to the natural<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g. Therefore the sequence of all steps <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
all skills became critical. One should note that<br />
no student, regardless of sequenc<str<strong>on</strong>g>in</str<strong>on</strong>g>g preference<br />
was able to perform any of the skills <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e to the same level of mastery that they<br />
did follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. While sequence errors<br />
were evident dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g pre-<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
probes, many of the student errors were latency<br />
or durati<strong>on</strong> errors. This <str<strong>on</strong>g>in</str<strong>on</strong>g>dicates that<br />
they would not have been able to perform the<br />
skills fluently if at all without <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>.<br />
Lastly, had the software been able to track<br />
daily student data by sessi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> step <str<strong>on</strong>g>and</str<strong>on</strong>g> log<br />
that <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong>, we may have been able to<br />
make data based decisi<strong>on</strong>s that could have led<br />
to faster acquisiti<strong>on</strong>.<br />
Future Directi<strong>on</strong>s<br />
While this study dem<strong>on</strong>strated the impact of<br />
CBVI <strong>on</strong> the acquisiti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> generalizati<strong>on</strong> of<br />
functi<strong>on</strong>al skills for three students with autism,<br />
future <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigati<strong>on</strong>s could c<strong>on</strong>sider a<br />
broader range of skills. With<str<strong>on</strong>g>in</str<strong>on</strong>g> CBVI, no c<strong>on</strong>sistent<br />
evidence base exists for what prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
strategy is the best. For example, Mechl<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Ortega-Hurnd<strong>on</strong> (2007) used a c<strong>on</strong>stant<br />
time delay <str<strong>on</strong>g>and</str<strong>on</strong>g> this study used a modified<br />
system of least prompts. Future research can<br />
exam<str<strong>on</strong>g>in</str<strong>on</strong>g>e the relative efficiency of these two<br />
procedures with<str<strong>on</strong>g>in</str<strong>on</strong>g> the delivery model of CBVI.<br />
Further research is also warranted for the evaluati<strong>on</strong><br />
of how students <str<strong>on</strong>g>in</str<strong>on</strong>g>teract with the software.<br />
This study required to students to complete<br />
mouse click<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> mov<str<strong>on</strong>g>in</str<strong>on</strong>g>g operati<strong>on</strong>s<br />
that were mirrored <strong>on</strong> the screen as genu<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
movement. With new <str<strong>on</strong>g>in</str<strong>on</strong>g>put computer devices<br />
becom<str<strong>on</strong>g>in</str<strong>on</strong>g>g available (e.g. N<str<strong>on</strong>g>in</str<strong>on</strong>g>tendo Wii) that<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>expensively allow a user to <str<strong>on</strong>g>in</str<strong>on</strong>g>teract with a<br />
game us<str<strong>on</strong>g>in</str<strong>on</strong>g>g gross <str<strong>on</strong>g>and</str<strong>on</strong>g> f<str<strong>on</strong>g>in</str<strong>on</strong>g>e motor movements<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> topographically similar ways <strong>on</strong>e would use<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo, the possibility of allow<str<strong>on</strong>g>in</str<strong>on</strong>g>g a student to<br />
actually rehearse the motor movements required<br />
for a task <str<strong>on</strong>g>in</str<strong>on</strong>g>creases <str<strong>on</strong>g>and</str<strong>on</strong>g> may impact<br />
acquisiti<strong>on</strong>.<br />
Us<str<strong>on</strong>g>in</str<strong>on</strong>g>g technology to teach, specifically,<br />
CBVI, is not substitute for teacher directed<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>-vivo <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>. However, if researchers are<br />
able to c<strong>on</strong>sistently document the efficacy of<br />
CBVI to teach generalized functi<strong>on</strong>al skills to<br />
students with autism <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities,<br />
these can become powerful supplements<br />
to traditi<strong>on</strong>al <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> all the classroom<br />
teacher greater freedom to spend <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual<br />
time with students.<br />
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to six adolescents with autistic spectrum disorder.<br />
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Received: 19 June 2008<br />
Initial Acceptance: 23 August 2008<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>al Acceptance: 15 December 2008<br />
508 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009
Comparis<strong>on</strong> of Self, Other, <str<strong>on</strong>g>and</str<strong>on</strong>g> Subjective Video Models for<br />
Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Daily Liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Skills to Individuals with<br />
<str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
T<strong>on</strong>i Van Laarhoven, Leslie M. Zurita, Jesse W. Johns<strong>on</strong>, Katie M. Grider,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Krist<str<strong>on</strong>g>in</str<strong>on</strong>g> L. Grider<br />
Northern Ill<str<strong>on</strong>g>in</str<strong>on</strong>g>ois University<br />
Abstract: This study compared the effectiveness of self-, other-, <str<strong>on</strong>g>and</str<strong>on</strong>g> subjective- video models <strong>on</strong> teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g daily<br />
liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills to three <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with developmental disabilities. Results <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated that all c<strong>on</strong>diti<strong>on</strong>s were<br />
effective <str<strong>on</strong>g>in</str<strong>on</strong>g> promot<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> both <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> generalizati<strong>on</strong> sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> that<br />
the effects ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed over time. Two of the three participants engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> more <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
when they were taught skills with the other model c<strong>on</strong>diti<strong>on</strong>, while the other participant engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> more<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependent resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> the target skill when the subjective model c<strong>on</strong>diti<strong>on</strong> was the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al procedure.<br />
However, there were significant differences between the model types when time needed to create the stimulus<br />
materials was c<strong>on</strong>sidered. Creati<strong>on</strong> of self-model<str<strong>on</strong>g>in</str<strong>on</strong>g>g materials required almost twice as much time as the other<str<strong>on</strong>g>and</str<strong>on</strong>g><br />
subjective-model<str<strong>on</strong>g>in</str<strong>on</strong>g>g materials, which made self-models less cost effective <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of teacher time <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
outcomes.<br />
Video <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> is c<strong>on</strong>sidered a “promis<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
practice” for teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g a variety of skills such as<br />
cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g, clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g, spell<str<strong>on</strong>g>in</str<strong>on</strong>g>g, social skills, communicati<strong>on</strong>,<br />
as well as other life skills to <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with developmental disabilities. It <str<strong>on</strong>g>in</str<strong>on</strong>g>volves<br />
show<str<strong>on</strong>g>in</str<strong>on</strong>g>g learners a video of a model<br />
(i.e., self, peer, expert, or “first pers<strong>on</strong> viewpo<str<strong>on</strong>g>in</str<strong>on</strong>g>t”)<br />
perform<str<strong>on</strong>g>in</str<strong>on</strong>g>g a skill or skill sequence.<br />
Typically, these videos are viewed either <strong>on</strong> a<br />
televisi<strong>on</strong> or computer prior to task engagement<br />
(video model<str<strong>on</strong>g>in</str<strong>on</strong>g>g) <str<strong>on</strong>g>and</str<strong>on</strong>g> the learner is expected<br />
to perform the skill shortly after view<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the video. To date, researchers who have<br />
studied video-based <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> have dem<strong>on</strong>strated<br />
that it usually results <str<strong>on</strong>g>in</str<strong>on</strong>g> faster skill acquisiti<strong>on</strong><br />
<strong>on</strong> the part of the learners <str<strong>on</strong>g>and</str<strong>on</strong>g> that<br />
the skills can often generalize to untra<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs (Ayres & Lang<strong>on</strong>e, 2005; Hitchock,<br />
Dowrick, & Prater, 2003; Mechl<str<strong>on</strong>g>in</str<strong>on</strong>g>g, 2005).<br />
Although video <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> appears to be a<br />
very effective <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al tool, there are<br />
many variables associated with video <str<strong>on</strong>g>in</str<strong>on</strong>g>struc-<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g this article should<br />
be addressed to T<strong>on</strong>i Van Laarhoven, Department<br />
of Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g & Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g, Northern Ill<str<strong>on</strong>g>in</str<strong>on</strong>g>ois University,<br />
Dekalb, IL 60115-2854.<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, 2009, 44(4), 509–522<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
ti<strong>on</strong> that need to be evaluated to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
how it can be more efficient <str<strong>on</strong>g>and</str<strong>on</strong>g> effective for<br />
the learners as well as the educators who will<br />
be resp<strong>on</strong>sible for creati<strong>on</strong> of the materials.<br />
Research is needed to <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigate the comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong>s<br />
of variables that will result <str<strong>on</strong>g>in</str<strong>on</strong>g> the most<br />
effective <str<strong>on</strong>g>and</str<strong>on</strong>g> efficient implementati<strong>on</strong> package<br />
for video-based <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> (Cihak, Alberto,<br />
Kessler, Taber-Doughty, & Gama,<br />
2006).<br />
Type of Model (self, other, subjective)<br />
One of the variables associated with video<br />
model<str<strong>on</strong>g>in</str<strong>on</strong>g>g that is <str<strong>on</strong>g>in</str<strong>on</strong>g> need of further study <str<strong>on</strong>g>in</str<strong>on</strong>g>volves<br />
the type of model that is depicted <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
video sequences. Some researchers have used<br />
self models (Buggey, 2005), peer models<br />
(Har<str<strong>on</strong>g>in</str<strong>on</strong>g>g, Kennedy, Adams, & Pitts-C<strong>on</strong>way,<br />
1987; Lasater & Brady, 1995), adult models<br />
(Alcantara, 1994; Charlop & Milste<str<strong>on</strong>g>in</str<strong>on</strong>g>, 1989),<br />
first pers<strong>on</strong> or “subjective viewpo<str<strong>on</strong>g>in</str<strong>on</strong>g>t” (where<br />
video is shown from the perspective of the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividual perform<str<strong>on</strong>g>in</str<strong>on</strong>g>g the task) (Schreibman,<br />
Whalen, & Stahmer, 2000), or a comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong><br />
of models (Morgan & Salzberg, 1992; Van<br />
Laarhoven & Van Laarhoven-Myers, 2006; Van<br />
Laarhoven, Van Laarhoven-Myers, & Zurita,<br />
Comparis<strong>on</strong> of Self, Other, <str<strong>on</strong>g>and</str<strong>on</strong>g> Subjective Video Models / 509
2007). Although all of these <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigati<strong>on</strong>s resulted<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> improved performance, it is unclear<br />
whether or not <strong>on</strong>e type of model would be<br />
better than the others or if <strong>on</strong>e type of model<br />
would be more effective for a particular type<br />
of skill (e.g., social versus academic skill).<br />
Self-model<str<strong>on</strong>g>in</str<strong>on</strong>g>g. Video self-model<str<strong>on</strong>g>in</str<strong>on</strong>g>g (VSM)<br />
is a technique that allows learners to observe<br />
themselves engag<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> positive performances<br />
of a target behavior <str<strong>on</strong>g>and</str<strong>on</strong>g> has been used to<br />
teach skills such as math (Schunk & Hans<strong>on</strong>,<br />
1989), language (Buggey, 1995; 2005), <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
social skills (Buggey, 2005; L<strong>on</strong>necker, Brady,<br />
McPhers<strong>on</strong>, & Hawk<str<strong>on</strong>g>in</str<strong>on</strong>g>s, 1994). Video selfmodel<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
is thought to be effective because<br />
the learners can view themselves successfully<br />
perform<str<strong>on</strong>g>in</str<strong>on</strong>g>g a skill that may be difficult. By<br />
view<str<strong>on</strong>g>in</str<strong>on</strong>g>g their own successful performances,<br />
the learners are thought to be more <str<strong>on</strong>g>in</str<strong>on</strong>g>terested<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> more c<strong>on</strong>fident <str<strong>on</strong>g>in</str<strong>on</strong>g> their abilities. The <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
materials are developed by either<br />
prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g the <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual to perform the task<br />
dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g tap<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> edit<str<strong>on</strong>g>in</str<strong>on</strong>g>g out the “prompter”,<br />
or by videotap<str<strong>on</strong>g>in</str<strong>on</strong>g>g the learner over a period of<br />
time <str<strong>on</strong>g>and</str<strong>on</strong>g> us<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong>ly the footage that shows the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividual perform<str<strong>on</strong>g>in</str<strong>on</strong>g>g the skill successfully.<br />
The drawback to this type of model is the time<br />
required to create the stimulus materials (videos).<br />
Because the learners serve as their own<br />
models, a great deal of time must be spent<br />
edit<str<strong>on</strong>g>in</str<strong>on</strong>g>g out the prompter or edit<str<strong>on</strong>g>in</str<strong>on</strong>g>g footage<br />
that has been videotaped over an extended<br />
period of time.<br />
Other models. Several researchers have used<br />
models other than the learner to dem<strong>on</strong>strate<br />
skills, or to serve as models <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
videos. Most cite the work of B<str<strong>on</strong>g>and</str<strong>on</strong>g>ura (1977)<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> his Social Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g Theory, which describes<br />
how humans can learn from observ<str<strong>on</strong>g>in</str<strong>on</strong>g>g others<br />
engag<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> behaviors <str<strong>on</strong>g>and</str<strong>on</strong>g> by observ<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
c<strong>on</strong>sequences that follow. Based <strong>on</strong> this work,<br />
other models (typically adults) <str<strong>on</strong>g>and</str<strong>on</strong>g> peer models<br />
have also been used with video-based <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>.<br />
Some researchers have followed the<br />
work of B<str<strong>on</strong>g>and</str<strong>on</strong>g>ura (1969) <str<strong>on</strong>g>and</str<strong>on</strong>g> have suggested<br />
that the most effective “other” models are<br />
those who share comm<strong>on</strong> features with the<br />
learners (e.g., age, gender) <str<strong>on</strong>g>and</str<strong>on</strong>g> have chosen<br />
peers to serve as <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al models. Peer<br />
models have been used to <str<strong>on</strong>g>in</str<strong>on</strong>g>struct pers<strong>on</strong>s <strong>on</strong><br />
community skills (Branham, Coll<str<strong>on</strong>g>in</str<strong>on</strong>g>s, Schuster,<br />
& Kle<str<strong>on</strong>g>in</str<strong>on</strong>g>ert, 1999; Har<str<strong>on</strong>g>in</str<strong>on</strong>g>g et al., 1987), vocati<strong>on</strong>al<br />
skills (Mart<str<strong>on</strong>g>in</str<strong>on</strong>g>, Mithaug, & Frazier,<br />
510 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
1992), social skills (Nikopoulos & Keenan,<br />
2004), <str<strong>on</strong>g>and</str<strong>on</strong>g> cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills (Bidwell & Rehfeldt,<br />
2004; Rehfeldt, Dahman, Young, Cherry, &<br />
Davis, 2003). Videos us<str<strong>on</strong>g>in</str<strong>on</strong>g>g models of other<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals <str<strong>on</strong>g>in</str<strong>on</strong>g>stead of peer models have been<br />
used for a variety of skills <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g social <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
communicati<strong>on</strong> skills (Charlop & Milste<str<strong>on</strong>g>in</str<strong>on</strong>g>,<br />
1989; Charlop-Christy, Le, & Freeman, 2000;<br />
C<strong>on</strong>yers, et al., 2004; LeBlanc, et al., 2003),<br />
daily liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills (Van Laarhoven & Van Laarhoven-Myers,<br />
2006), <str<strong>on</strong>g>and</str<strong>on</strong>g> community skills (Alcantara,<br />
1994; Ayers & Lang<strong>on</strong>e, 2002). Typically,<br />
the use of other models requires less<br />
time for material creati<strong>on</strong> because the models<br />
that are depicted usually have the skills of<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terest <str<strong>on</strong>g>in</str<strong>on</strong>g> their repertoire <str<strong>on</strong>g>and</str<strong>on</strong>g> less edit<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
time is required. However, depend<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> the<br />
age <str<strong>on</strong>g>and</str<strong>on</strong>g>/or cognitive level of the models, peer<br />
model<str<strong>on</strong>g>in</str<strong>on</strong>g>g can require more time than that of<br />
adult models. On the other h<str<strong>on</strong>g>and</str<strong>on</strong>g>, it would<br />
probably require less time than is required for<br />
the creati<strong>on</strong> of video self models. In <strong>on</strong>e of the<br />
very few comparative studies that exist with<br />
video-based <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>, Sherer, et al., (2001),<br />
compared video self-model<str<strong>on</strong>g>in</str<strong>on</strong>g>g with other<br />
models to teach c<strong>on</strong>versati<strong>on</strong> skills to five children<br />
with autism. Results <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated that, although<br />
there was some variability am<strong>on</strong>g participants,<br />
both c<strong>on</strong>diti<strong>on</strong>s were equally<br />
effective <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of percentage correct engagement<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> rate of acquisiti<strong>on</strong>.<br />
Subjective models. Another approach that<br />
m<str<strong>on</strong>g>in</str<strong>on</strong>g>imizes the need for extensive edit<str<strong>on</strong>g>in</str<strong>on</strong>g>g is the<br />
use of subjective viewpo<str<strong>on</strong>g>in</str<strong>on</strong>g>t models or firstpers<strong>on</strong><br />
perspective models. With this approach,<br />
the learner watches the video as if<br />
they were complet<str<strong>on</strong>g>in</str<strong>on</strong>g>g the task themselves.<br />
Typically, there is no model present, but<br />
rather, learners watch a video that shows what<br />
it would look like if they were complet<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
task. Subjective models have been used for<br />
video <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> of various skills, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
self help skills (Norman, Coll<str<strong>on</strong>g>in</str<strong>on</strong>g>s, & Schuster,<br />
2001), daily liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills (Shipley-Benamou,<br />
Lutzker, & Taubman, 2002), behavior regulati<strong>on</strong>/transiti<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
from <strong>on</strong>e activity to the<br />
next (Schreibman, et al., 2000), <str<strong>on</strong>g>and</str<strong>on</strong>g> cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
skills (Graves, Coll<str<strong>on</strong>g>in</str<strong>on</strong>g>s, Schuster, & Kle<str<strong>on</strong>g>in</str<strong>on</strong>g>ert,<br />
2005). In a comparative study, Ayres <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Lang<strong>on</strong>e (2007) compared first-pers<strong>on</strong> (subjective)<br />
models with third-pers<strong>on</strong> (other)<br />
models <str<strong>on</strong>g>and</str<strong>on</strong>g> found that although there was
some variability am<strong>on</strong>g participants related to<br />
efficiency, both models were equally effective.<br />
Although different types of models have<br />
been used to teach various skills, several questi<strong>on</strong>s<br />
still rema<str<strong>on</strong>g>in</str<strong>on</strong>g> unanswered <str<strong>on</strong>g>in</str<strong>on</strong>g> the research<br />
literature. For example, is <strong>on</strong>e type of model<br />
(self, other, subjective) more c<strong>on</strong>ducive or<br />
more effective <str<strong>on</strong>g>and</str<strong>on</strong>g> efficient for teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g specific<br />
types of skills to <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with disabilities?<br />
And, are any of the model types more<br />
cost effective <str<strong>on</strong>g>in</str<strong>on</strong>g> relati<strong>on</strong> to teacher requirements<br />
(time needed to create materials) <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
student outcomes (e.g., time <str<strong>on</strong>g>and</str<strong>on</strong>g> number of<br />
sessi<strong>on</strong>s to criteri<strong>on</strong>; growth between pre- <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
post-measures)?<br />
The purpose of this study was to compare<br />
different types of models depicted with<str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sequences to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e if there<br />
were differences regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g the effectiveness of<br />
each model. Cost benefit or “efficiency analyses”<br />
were c<strong>on</strong>ducted <str<strong>on</strong>g>in</str<strong>on</strong>g> order to assess the<br />
practical utility of each video-based procedure.<br />
These “costs” were compared to the accrued<br />
benefit to the participants as measured<br />
by the relative effectiveness of each c<strong>on</strong>diti<strong>on</strong>.<br />
Method<br />
Participant Selecti<strong>on</strong><br />
Participants were recruited from high school<br />
programs located <str<strong>on</strong>g>in</str<strong>on</strong>g> the suburbs of Chicago.<br />
To recruit, a descripti<strong>on</strong> of the study was emailed<br />
to teachers <str<strong>on</strong>g>in</str<strong>on</strong>g> several school districts.<br />
Of those who resp<strong>on</strong>ded, a follow-up questi<strong>on</strong>naire<br />
was sent to: 1) identify specific skills<br />
for <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>, 2) determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e availability of the<br />
participant, <str<strong>on</strong>g>and</str<strong>on</strong>g> 3) obta<str<strong>on</strong>g>in</str<strong>on</strong>g> pers<strong>on</strong>al <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong><br />
for the participant to obta<str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>formed<br />
c<strong>on</strong>sent <str<strong>on</strong>g>and</str<strong>on</strong>g> assent. Participants were then selected<br />
from the pool of resp<strong>on</strong>dents based <strong>on</strong><br />
similarity of IQ scores, skills requir<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> scores <strong>on</strong> pretests.<br />
Participants<br />
Two females <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>on</strong>e male with moderate<br />
disabilities (IQ range 35–55) between the ages<br />
of 12–17 participated. All participants came<br />
from homes where Spanish was the primary<br />
language, all had similar skills requir<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> all were functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g with<str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
moderate range of mental retardati<strong>on</strong>.<br />
Pablo was a 17-year-old high school student<br />
with Down syndrome who functi<strong>on</strong>ed <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
moderate range of mental retardati<strong>on</strong>. His<br />
full-scale IQ score <strong>on</strong> the WAIS-III (Wechsler,<br />
1997) was 40. He received special educati<strong>on</strong><br />
services <str<strong>on</strong>g>in</str<strong>on</strong>g> a self-c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed classroom to meet<br />
his <str<strong>on</strong>g>in</str<strong>on</strong>g>dividualized needs. He was also <str<strong>on</strong>g>in</str<strong>on</strong>g>volved<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> a vocati<strong>on</strong>al tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g program <str<strong>on</strong>g>and</str<strong>on</strong>g> worked<br />
<strong>on</strong> skills such as item assembly, wash<str<strong>on</strong>g>in</str<strong>on</strong>g>g tables<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> chairs, <str<strong>on</strong>g>and</str<strong>on</strong>g> also worked <strong>on</strong> functi<strong>on</strong>al<br />
academic skills such as m<strong>on</strong>ey h<str<strong>on</strong>g>and</str<strong>on</strong>g>l<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
read<str<strong>on</strong>g>in</str<strong>on</strong>g>g. He generally required direct <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> practice/repetiti<strong>on</strong> to acquire or atta<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
new <str<strong>on</strong>g>and</str<strong>on</strong>g>/or difficult skills <str<strong>on</strong>g>and</str<strong>on</strong>g> prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
to stay <strong>on</strong> task. Behaviorally, Pablo was fairly<br />
even tempered, but did have a tendency to<br />
exhibit n<strong>on</strong>-compliant behaviors when asked<br />
to complete tasks that were outside of his normal<br />
rout<str<strong>on</strong>g>in</str<strong>on</strong>g>e, were unfamiliar, or n<strong>on</strong>-preferred.<br />
Alanna was a 15-year-old female who functi<strong>on</strong>ed<br />
with<str<strong>on</strong>g>in</str<strong>on</strong>g> the moderate range of mental<br />
retardati<strong>on</strong>. Her full-scale IQ score <strong>on</strong> the<br />
Leiter Internati<strong>on</strong>al Performance Scale-Revised<br />
(Roid & Miller, 1997) was 30. She received<br />
special educati<strong>on</strong> services <str<strong>on</strong>g>in</str<strong>on</strong>g> a selfc<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
classroom where she practiced<br />
academic skills, basic domestic skills such as<br />
cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>and</str<strong>on</strong>g> vocati<strong>on</strong>al skills<br />
such as gather<str<strong>on</strong>g>in</str<strong>on</strong>g>g recycl<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> sort<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
assembl<str<strong>on</strong>g>in</str<strong>on</strong>g>g piece work. Alanna was quite distractible<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> required cue<str<strong>on</strong>g>in</str<strong>on</strong>g>g, prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
redirecti<strong>on</strong> to focus <strong>on</strong> the task <str<strong>on</strong>g>in</str<strong>on</strong>g> which she<br />
was engaged, <str<strong>on</strong>g>and</str<strong>on</strong>g> also needed a great deal of<br />
repetiti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> direct <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> to acquire<br />
new skills.<br />
Breanne was a 12-year-old girl who was functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
with<str<strong>on</strong>g>in</str<strong>on</strong>g> the moderate range of mental<br />
retardati<strong>on</strong>. Although her files <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated that<br />
the Stanford-B<str<strong>on</strong>g>in</str<strong>on</strong>g>et-Fourth Editi<strong>on</strong> (Thorndike,<br />
Hagen, & Sattler, 1986) was adm<str<strong>on</strong>g>in</str<strong>on</strong>g>istered<br />
several years prior to her participati<strong>on</strong><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the study, there was no IQ score listed.<br />
However, the report <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated that she was<br />
functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g with<str<strong>on</strong>g>in</str<strong>on</strong>g> the moderate range. Breanne<br />
received special educati<strong>on</strong> services <str<strong>on</strong>g>in</str<strong>on</strong>g> a<br />
self-c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed classroom where she was work<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<strong>on</strong> functi<strong>on</strong>al academic skills such as read<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
sight words, tell<str<strong>on</strong>g>in</str<strong>on</strong>g>g time, count<str<strong>on</strong>g>in</str<strong>on</strong>g>g m<strong>on</strong>ey,<br />
as well as daily liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> pre-vocati<strong>on</strong>al skills.<br />
She had a very pleasant pers<strong>on</strong>ality <str<strong>on</strong>g>and</str<strong>on</strong>g> was<br />
will<str<strong>on</strong>g>in</str<strong>on</strong>g>g to work hard <strong>on</strong> whatever task she was<br />
Comparis<strong>on</strong> of Self, Other, <str<strong>on</strong>g>and</str<strong>on</strong>g> Subjective Video Models / 511
given. She frequently praised her own work as<br />
well as the work of others (e.g., “you did it”)!<br />
Sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Instructi<strong>on</strong>al sessi<strong>on</strong>s were c<strong>on</strong>ducted <str<strong>on</strong>g>in</str<strong>on</strong>g> three<br />
different areas <str<strong>on</strong>g>in</str<strong>on</strong>g> the school. Cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g hot<br />
dogs was d<strong>on</strong>e <str<strong>on</strong>g>in</str<strong>on</strong>g> a café <str<strong>on</strong>g>in</str<strong>on</strong>g> the school. It was a<br />
large room that had two l-shaped kitchenettes<br />
<strong>on</strong> <strong>on</strong>e wall <str<strong>on</strong>g>and</str<strong>on</strong>g> then l<strong>on</strong>g rectangular tables<br />
or circular-shaped tables spread throughout<br />
the rema<str<strong>on</strong>g>in</str<strong>on</strong>g>der of the room. The room appeared<br />
to have been used as a home ec<strong>on</strong>omics<br />
room <str<strong>on</strong>g>in</str<strong>on</strong>g> the past. Clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g a s<str<strong>on</strong>g>in</str<strong>on</strong>g>k was d<strong>on</strong>e<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> a bathroom that was located <str<strong>on</strong>g>in</str<strong>on</strong>g> a “mock<br />
house” that was <str<strong>on</strong>g>in</str<strong>on</strong>g> the school, <str<strong>on</strong>g>and</str<strong>on</strong>g> chang<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
batteries was d<strong>on</strong>e at a d<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g table that was<br />
c<strong>on</strong>nected to the mock house. Once participants<br />
met criteri<strong>on</strong> (80% <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct<br />
resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g for three c<strong>on</strong>secutive sessi<strong>on</strong>s),<br />
they were assessed <strong>on</strong> their ability to<br />
generalize the skill to novel envir<strong>on</strong>ments<br />
(sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs other than those used dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>)<br />
while us<str<strong>on</strong>g>in</str<strong>on</strong>g>g different stimulus materials<br />
than were used dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sessi<strong>on</strong>s<br />
(e.g., different microwaves, br<str<strong>on</strong>g>and</str<strong>on</strong>g>s of hot<br />
dogs, cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g equipment, battery-operated<br />
devices, <str<strong>on</strong>g>and</str<strong>on</strong>g> clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g supplies). The generalizati<strong>on</strong><br />
sessi<strong>on</strong>s for cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g hot dogs were<br />
c<strong>on</strong>ducted <str<strong>on</strong>g>in</str<strong>on</strong>g> the mock house kitchen, clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the s<str<strong>on</strong>g>in</str<strong>on</strong>g>k was d<strong>on</strong>e <str<strong>on</strong>g>in</str<strong>on</strong>g> a bathroom that was<br />
c<strong>on</strong>nected to a classroom, <str<strong>on</strong>g>and</str<strong>on</strong>g> chang<str<strong>on</strong>g>in</str<strong>on</strong>g>g batteries<br />
was d<strong>on</strong>e at a table <str<strong>on</strong>g>in</str<strong>on</strong>g> the café.<br />
Instructi<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> Generalizati<strong>on</strong> Stimulus<br />
Materials<br />
All video-based materials were developed <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs where <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sessi<strong>on</strong>s took<br />
place. In additi<strong>on</strong>, participants used a different<br />
set of materials <str<strong>on</strong>g>in</str<strong>on</strong>g> the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sessi<strong>on</strong>s<br />
than were used <str<strong>on</strong>g>in</str<strong>on</strong>g> the generalizati<strong>on</strong><br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs. For example, Oscar Mayer hot dogs,<br />
Jewel br<str<strong>on</strong>g>and</str<strong>on</strong>g> buns, a black oven mitt, blackh<str<strong>on</strong>g>and</str<strong>on</strong>g>led<br />
silverware, a blue plate, <str<strong>on</strong>g>and</str<strong>on</strong>g> a microwave<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> refrigerator located <str<strong>on</strong>g>in</str<strong>on</strong>g> the café were<br />
used for <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sessi<strong>on</strong>s for cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g hot<br />
dogs. Ekrich hot dogs, W<strong>on</strong>der hot dog buns,<br />
a green oven mitt, green-h<str<strong>on</strong>g>and</str<strong>on</strong>g>led silverware, a<br />
green plate <str<strong>on</strong>g>and</str<strong>on</strong>g> different microwaves <str<strong>on</strong>g>and</str<strong>on</strong>g> refrigerator<br />
located <str<strong>on</strong>g>in</str<strong>on</strong>g> the mock house were<br />
used for generalizati<strong>on</strong> sessi<strong>on</strong>s. For the battery<br />
tasks, different battery operated devices<br />
were used <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al (i.e., Roomba wall<br />
unit with D-sized batteries) versus generalizati<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong>s (i.e., Tetris h<str<strong>on</strong>g>and</str<strong>on</strong>g>held game<br />
with AA-sized batteries). The batteries differed<br />
by br<str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> size, as did the types of<br />
screwdrivers that were used. Similarly, clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
buckets that held different br<str<strong>on</strong>g>and</str<strong>on</strong>g>s/colors<br />
of clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g supplies (i.e., p<str<strong>on</strong>g>in</str<strong>on</strong>g>k sp<strong>on</strong>ge, Fantastik<br />
cleaner, white bucket) were used <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
mock house bathroom for <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sessi<strong>on</strong>s<br />
while a different colored bucket <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g supplies were used to clean <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
generalizati<strong>on</strong> sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g (bathroom off of a classroom).<br />
Skills Selected for Instructi<strong>on</strong><br />
512 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Each participant was taught three different<br />
skills (<strong>on</strong>e per <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al c<strong>on</strong>diti<strong>on</strong>). The<br />
targeted skills fell with<str<strong>on</strong>g>in</str<strong>on</strong>g> the domestic or daily<br />
liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g doma<str<strong>on</strong>g>in</str<strong>on</strong>g>, however, each student was<br />
taught skill sequences from three different<br />
sub-doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s with<str<strong>on</strong>g>in</str<strong>on</strong>g> the domestic realm (i.e.,<br />
cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g, clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g, ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance) to ensure<br />
that the resp<strong>on</strong>ses across the skill sequences<br />
were mutually exclusive <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent of<br />
<strong>on</strong>e another. These skills <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g a<br />
microwave hot dog, clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g a bathroom s<str<strong>on</strong>g>in</str<strong>on</strong>g>k,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a screwdriver <str<strong>on</strong>g>and</str<strong>on</strong>g> chang<str<strong>on</strong>g>in</str<strong>on</strong>g>g batteries<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> different devices (i.e., a Roomba wall<br />
unit <str<strong>on</strong>g>and</str<strong>on</strong>g> a h<str<strong>on</strong>g>and</str<strong>on</strong>g>held game).<br />
C<strong>on</strong>troll<str<strong>on</strong>g>in</str<strong>on</strong>g>g for Task Difficulty <str<strong>on</strong>g>and</str<strong>on</strong>g> Practice<br />
Effects<br />
Once several skills were identified for possible<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>clusi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> the study, task analyses were written<br />
for each sequence <str<strong>on</strong>g>and</str<strong>on</strong>g> four different<br />
teachers who had been teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g for at least<br />
two years rated them accord<str<strong>on</strong>g>in</str<strong>on</strong>g>g to complexity<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> difficulty (easy, moderately difficult, &<br />
difficult). They then ranked skills with<str<strong>on</strong>g>in</str<strong>on</strong>g> each<br />
difficulty level to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e which skills were<br />
equivalent <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of complexity. Results of<br />
the rat<str<strong>on</strong>g>in</str<strong>on</strong>g>gs were used as a guide for determ<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
skills to be targeted for <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>. In<br />
additi<strong>on</strong>, participants’ pretest scores were<br />
used to equate the skills. In order to c<strong>on</strong>trol<br />
for participant skill level prior to <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>,<br />
the scores for <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al pretests <str<strong>on</strong>g>and</str<strong>on</strong>g> generalizati<strong>on</strong><br />
pretests were averaged <str<strong>on</strong>g>and</str<strong>on</strong>g> ranked.<br />
Each participant’s task with the highest score<br />
was r<str<strong>on</strong>g>and</str<strong>on</strong>g>omly assigned to <strong>on</strong>e of the three
TABLE 1<br />
Task Assignment Across Type of Model <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Participant<br />
Participant Self Subjective Other<br />
Pablo Hot dog Clean s<str<strong>on</strong>g>in</str<strong>on</strong>g>k Batteries<br />
Alanna Batteries Hot dog Clean s<str<strong>on</strong>g>in</str<strong>on</strong>g>k<br />
Breanne Clean s<str<strong>on</strong>g>in</str<strong>on</strong>g>k Batteries Hot dog<br />
different c<strong>on</strong>diti<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> the tasks with the<br />
lowest scores were assigned to three different<br />
c<strong>on</strong>diti<strong>on</strong>s when possible. To c<strong>on</strong>trol for practice<br />
effects, all participants were videotaped<br />
engag<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> all three of the tasks prior to<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>. This was d<strong>on</strong>e to reduce the likelihood<br />
that practice would improve their performance<br />
with<str<strong>on</strong>g>in</str<strong>on</strong>g> the self model c<strong>on</strong>diti<strong>on</strong>.<br />
Design<br />
The design for this study was a with<str<strong>on</strong>g>in</str<strong>on</strong>g>-subject<br />
adapted alternat<str<strong>on</strong>g>in</str<strong>on</strong>g>g treatments design (Wolery,<br />
Bailey, & Sugai, 1988). It differs from the<br />
alternat<str<strong>on</strong>g>in</str<strong>on</strong>g>g treatments design <str<strong>on</strong>g>in</str<strong>on</strong>g> that the treatments<br />
are applied to different but equally difficult,<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependent behaviors/skills, whereas,<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the alternat<str<strong>on</strong>g>in</str<strong>on</strong>g>g treatments design, the treatments<br />
are applied to the same behavior/skill.<br />
With this design, two or more treatment c<strong>on</strong>diti<strong>on</strong>s<br />
are <str<strong>on</strong>g>in</str<strong>on</strong>g>troduced <str<strong>on</strong>g>in</str<strong>on</strong>g> a rapidly alternat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
fashi<strong>on</strong> with the order of presentati<strong>on</strong> be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
r<str<strong>on</strong>g>and</str<strong>on</strong>g>omized. Each participant was taught a<br />
different skill with<str<strong>on</strong>g>in</str<strong>on</strong>g> each c<strong>on</strong>diti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
skills were counter-balanced across c<strong>on</strong>diti<strong>on</strong>s<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> subjects to c<strong>on</strong>trol for task difficulty. The<br />
skills were assigned as <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated <str<strong>on</strong>g>in</str<strong>on</strong>g> Table 1.<br />
Independent Variables<br />
C<strong>on</strong>diti<strong>on</strong> 1: Self Model. Participants viewed<br />
a video-based multimedia sequence of themselves<br />
engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> the skill prior to task engagement.<br />
C<strong>on</strong>diti<strong>on</strong> 2: Subjective Model. Participants<br />
viewed a video-based multimedia sequence<br />
that was created as if they were perform<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
skill sequence (i.e., what it would look like<br />
from a first pers<strong>on</strong> perspective).<br />
C<strong>on</strong>diti<strong>on</strong> 3: Other Model. Participants<br />
viewed a video-based multimedia sequence of<br />
another pers<strong>on</strong> (an adult female) engag<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
skill sequence prior to task engagement.<br />
Instructi<strong>on</strong>al Materials<br />
The lead author/experimenter, who is an<br />
adult female, served as the model for both the<br />
“other” <str<strong>on</strong>g>and</str<strong>on</strong>g> “subjective” c<strong>on</strong>diti<strong>on</strong>s, <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
participants served as their own models dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the “self-model” c<strong>on</strong>diti<strong>on</strong>s. Video segments<br />
were shot <str<strong>on</strong>g>in</str<strong>on</strong>g> the sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs where <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong><br />
took place. For the “other” c<strong>on</strong>diti<strong>on</strong>, a<br />
comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> of wide angle (full view of the<br />
model) <str<strong>on</strong>g>and</str<strong>on</strong>g> a few zoom shots (show<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
arm of the model reach<str<strong>on</strong>g>in</str<strong>on</strong>g>g for hot dogs) were<br />
used. When the subjective model was created,<br />
the videographer placed the camera <strong>on</strong> the<br />
lead author’s shoulder while she performed<br />
the task. The result<str<strong>on</strong>g>in</str<strong>on</strong>g>g materials showed the<br />
task be<str<strong>on</strong>g>in</str<strong>on</strong>g>g completed from a first pers<strong>on</strong> perspective<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> usually <strong>on</strong>ly the h<str<strong>on</strong>g>and</str<strong>on</strong>g>s of the<br />
experimenter were shown. For the “self” models,<br />
each participant was videotaped engag<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the skill sequence <str<strong>on</strong>g>and</str<strong>on</strong>g> the prompter<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g>/or mistakes were edited out of the video.<br />
Aga<str<strong>on</strong>g>in</str<strong>on</strong>g>, to m<str<strong>on</strong>g>in</str<strong>on</strong>g>imize practice effects for the<br />
self-model c<strong>on</strong>diti<strong>on</strong>s, all participants were<br />
videotaped engag<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> all three skill sequences;<br />
however, <strong>on</strong>ly <strong>on</strong>e self-model video was<br />
used for each participant dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the study.<br />
Skill sequences (e.g. mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g a microwave<br />
hot dog) were broken <str<strong>on</strong>g>in</str<strong>on</strong>g>to short video segments<br />
(for each step). Photos of the most<br />
salient feature of the steps (e.g., a still of water<br />
be<str<strong>on</strong>g>in</str<strong>on</strong>g>g squeezed from a sp<strong>on</strong>ge) were<br />
“grabbed” out of the video <str<strong>on</strong>g>and</str<strong>on</strong>g> placed at the<br />
beg<str<strong>on</strong>g>in</str<strong>on</strong>g>n<str<strong>on</strong>g>in</str<strong>on</strong>g>g of each video segment. Each video<br />
segment, or each step of the task was edited<br />
us<str<strong>on</strong>g>in</str<strong>on</strong>g>g P<str<strong>on</strong>g>in</str<strong>on</strong>g>nacle Studio 10.1 (P<str<strong>on</strong>g>in</str<strong>on</strong>g>nacle Systems,<br />
2005) <str<strong>on</strong>g>and</str<strong>on</strong>g> saved as a separate file <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
then later placed <strong>on</strong> a PowerPo<str<strong>on</strong>g>in</str<strong>on</strong>g>t, 2003<br />
presentati<strong>on</strong>. Each slide <str<strong>on</strong>g>in</str<strong>on</strong>g> the PowerPo<str<strong>on</strong>g>in</str<strong>on</strong>g>t<br />
had written directi<strong>on</strong>s for each step <strong>on</strong> the top<br />
of the screen, the “grabbed” photo visible <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the middle of the screen, <str<strong>on</strong>g>and</str<strong>on</strong>g> narrati<strong>on</strong> that<br />
described the step to be completed. The slide<br />
show was set so that the participants had to<br />
move the cursor to the photo <str<strong>on</strong>g>and</str<strong>on</strong>g> use a mouse<br />
click to view the video <str<strong>on</strong>g>and</str<strong>on</strong>g> a mouse click <strong>on</strong> a<br />
hyperl<str<strong>on</strong>g>in</str<strong>on</strong>g>ked “next” butt<strong>on</strong> <strong>on</strong> the bottom<br />
right of the screen to advance to the next<br />
slide. Please refer to Figure 1 for an example<br />
screenshot.<br />
Comparis<strong>on</strong> of Self, Other, <str<strong>on</strong>g>and</str<strong>on</strong>g> Subjective Video Models / 513
Figure 1. Screen shot of PowerPo<str<strong>on</strong>g>in</str<strong>on</strong>g>t Slide with<br />
Embedded Video File.<br />
Instructi<strong>on</strong>al Sessi<strong>on</strong>s<br />
Video model<str<strong>on</strong>g>in</str<strong>on</strong>g>g, or view<str<strong>on</strong>g>in</str<strong>on</strong>g>g the video-based<br />
sequence prior to task engagement, was used<br />
for all of the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sessi<strong>on</strong>s. Participants<br />
sat at a large d<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g table <str<strong>on</strong>g>in</str<strong>on</strong>g> the mock<br />
house <str<strong>on</strong>g>in</str<strong>on</strong>g> the school <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>dependently navigated<br />
through the PowerPo<str<strong>on</strong>g>in</str<strong>on</strong>g>t presentati<strong>on</strong><br />
that was loaded <strong>on</strong> a laptop computer. Once<br />
participants viewed the video sequences, they<br />
then immediately engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
task.<br />
<str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> Participants to Use Technology/photos<br />
Prior to engag<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sessi<strong>on</strong>s,<br />
each participant was taught to operate the<br />
laptop <str<strong>on</strong>g>and</str<strong>on</strong>g> to navigate through the Power-<br />
Po<str<strong>on</strong>g>in</str<strong>on</strong>g>t presentati<strong>on</strong> (i.e., us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a mouse click<br />
to view the video segment <str<strong>on</strong>g>and</str<strong>on</strong>g> advance to the<br />
next slide) <str<strong>on</strong>g>in</str<strong>on</strong>g>dependently for two c<strong>on</strong>secutive<br />
sessi<strong>on</strong>s before they engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
sessi<strong>on</strong>s.<br />
Data Collecti<strong>on</strong> Procedures<br />
Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g pre/post-test<str<strong>on</strong>g>in</str<strong>on</strong>g>g, acquisiti<strong>on</strong> phases,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> generalizati<strong>on</strong> test<str<strong>on</strong>g>in</str<strong>on</strong>g>g, task analytic data<br />
were collected with correct <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>correct performance<br />
be<str<strong>on</strong>g>in</str<strong>on</strong>g>g reported <strong>on</strong> each step of the<br />
skill sequence. A ‘’ was recorded for <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
correct resp<strong>on</strong>ses, a ‘A’was recorded<br />
for <str<strong>on</strong>g>in</str<strong>on</strong>g>correct attempts, an ‘N-’ was recorded<br />
for no attempt, <str<strong>on</strong>g>and</str<strong>on</strong>g> an ‘S-’ was<br />
recorded for a sequence error. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g acquisiti<strong>on</strong><br />
phases, data were also collected <strong>on</strong><br />
514 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
prompt levels <str<strong>on</strong>g>and</str<strong>on</strong>g> a ‘√’ was recorded for each<br />
prompt given at each step (with a maximum<br />
of two per step). To obta<str<strong>on</strong>g>in</str<strong>on</strong>g> data <strong>on</strong> prompt<br />
levels, a two-level prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g hierarchy was<br />
used. In the event of an error or no attempt<br />
with<str<strong>on</strong>g>in</str<strong>on</strong>g> 5 sec<strong>on</strong>ds of the natural discrim<str<strong>on</strong>g>in</str<strong>on</strong>g>ative<br />
stimulus, participants were given a verbal<br />
prompt to resp<strong>on</strong>d. If the verbal prompt was<br />
not sufficient to prompt a correct resp<strong>on</strong>se, a<br />
gestural or physical prompt was provided (depend<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<strong>on</strong> what was necessary for the particular<br />
step) to ensure correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Dependent Measures<br />
Percentage of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>ses.<br />
Participants were assessed <strong>on</strong> how <str<strong>on</strong>g>in</str<strong>on</strong>g>dependently<br />
they performed the skills selected for<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> prior to engag<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
sequences (pretest), dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong><br />
(acquisiti<strong>on</strong>), <str<strong>on</strong>g>and</str<strong>on</strong>g> follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> (posttest).<br />
The score was determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ed by divid<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the number of steps with <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
by the total number of steps <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
skill sequence <str<strong>on</strong>g>and</str<strong>on</strong>g> multiply<str<strong>on</strong>g>in</str<strong>on</strong>g>g by 100. Pre/<br />
post tests differed from <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sessi<strong>on</strong>s<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> that participants were expected to perform<br />
the skill <str<strong>on</strong>g>in</str<strong>on</strong>g> the tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g/generalizati<strong>on</strong> envir<strong>on</strong>ment<br />
without video models. In additi<strong>on</strong>,<br />
no prompts were delivered dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g test<str<strong>on</strong>g>in</str<strong>on</strong>g>g. If<br />
participants made errors dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the test<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
phases, the experimenter asked them to turn<br />
away or close their eyes as the step with the<br />
error was completed for them. Post-tests were<br />
c<strong>on</strong>ducted <str<strong>on</strong>g>in</str<strong>on</strong>g> the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong>e or<br />
two days after participants met criteri<strong>on</strong> <strong>on</strong> all<br />
three tasks <str<strong>on</strong>g>and</str<strong>on</strong>g> the generalizati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance<br />
post-tests were c<strong>on</strong>ducted 1- <str<strong>on</strong>g>and</str<strong>on</strong>g> 6weeks<br />
follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g (<str<strong>on</strong>g>in</str<strong>on</strong>g> envir<strong>on</strong>ments<br />
that were different than the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g).<br />
Percentage of prompts. Participants were assessed<br />
<strong>on</strong> the number of external prompts<br />
they needed to complete the skill sequence<br />
dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g acquisiti<strong>on</strong> phases of the study. The<br />
score was determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ed by divid<str<strong>on</strong>g>in</str<strong>on</strong>g>g the number<br />
of prompts given by the total number of<br />
prompts possible (i.e., two per step) <str<strong>on</strong>g>and</str<strong>on</strong>g> multiply<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
by 100.<br />
Number of sessi<strong>on</strong>s to reach criteri<strong>on</strong>. The acquisiti<strong>on</strong><br />
criteria for each skill sequence was a<br />
score of 80% <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>ses<br />
or higher for three c<strong>on</strong>secutive sessi<strong>on</strong>s. The
number of <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sessi<strong>on</strong>s required for<br />
the participant to reach criteri<strong>on</strong> was counted<br />
to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e if any of the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al c<strong>on</strong>diti<strong>on</strong>s<br />
resulted <str<strong>on</strong>g>in</str<strong>on</strong>g> faster acquisiti<strong>on</strong>.<br />
Percentage of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>ses <strong>on</strong><br />
measures of generalizati<strong>on</strong>. Prior to <str<strong>on</strong>g>and</str<strong>on</strong>g> follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> (at 1- & 6-weeks), participants<br />
performed the skill <str<strong>on</strong>g>in</str<strong>on</strong>g> novel envir<strong>on</strong>ments<br />
without video materials or prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g to obta<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e levels <str<strong>on</strong>g>and</str<strong>on</strong>g> to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e if their<br />
skills generalized to untra<str<strong>on</strong>g>in</str<strong>on</strong>g>ed envir<strong>on</strong>ments<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> stimulus materials follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>.<br />
Efficiency measures. An efficiency score was<br />
computed by c<strong>on</strong>sider<str<strong>on</strong>g>in</str<strong>on</strong>g>g the ratio of each<br />
participant’s growth (from pre-test to posttest)<br />
to the measured ”cost“ of m<str<strong>on</strong>g>in</str<strong>on</strong>g>utes required<br />
to create <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al materials [i.e.,<br />
(posttest-pretest)/(m<str<strong>on</strong>g>in</str<strong>on</strong>g>utes of preparati<strong>on</strong>)].<br />
To determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e the number of m<str<strong>on</strong>g>in</str<strong>on</strong>g>utes of preparati<strong>on</strong>,<br />
a stop-watch was used to calculate the<br />
number of m<str<strong>on</strong>g>in</str<strong>on</strong>g>utes to videotape, capture the<br />
video, edit the video, <str<strong>on</strong>g>and</str<strong>on</strong>g> to prepare the video-based<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sequences.<br />
Data Analysis<br />
Experimental c<strong>on</strong>trol was determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ed primarily<br />
through visual <str<strong>on</strong>g>in</str<strong>on</strong>g>specti<strong>on</strong> of the data <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
through comparis<strong>on</strong>s of means for each c<strong>on</strong>diti<strong>on</strong>.<br />
With the adapted alternat<str<strong>on</strong>g>in</str<strong>on</strong>g>g treatments<br />
design, experimental c<strong>on</strong>trol is dem<strong>on</strong>strated<br />
by a c<strong>on</strong>sistent level <str<strong>on</strong>g>and</str<strong>on</strong>g>/or trend<br />
difference between the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s (Wolery<br />
et al., 1988). At a quick glance, <strong>on</strong>e can determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
if <strong>on</strong>e <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> is better than the<br />
other if there is little or no overlap between<br />
the data paths. In additi<strong>on</strong>, although basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
measures are not necessary with the alternat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
treatments design, the pre/post scores for<br />
each c<strong>on</strong>diti<strong>on</strong> were also compared.<br />
Reliability<br />
Additi<strong>on</strong>al authors c<strong>on</strong>ducted reliability sessi<strong>on</strong>s<br />
for 28% of all sessi<strong>on</strong>s (<str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g pre/<br />
post-tests <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al sequences). The<br />
percentage agreement <str<strong>on</strong>g>in</str<strong>on</strong>g>dex (i.e., number of<br />
agreements divided by number of agreements<br />
plus disagreements <str<strong>on</strong>g>and</str<strong>on</strong>g> multiplied by 100)<br />
was used to calculate <str<strong>on</strong>g>in</str<strong>on</strong>g>terobserver agreement.<br />
Agreement for <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>ses<br />
averaged 98% (range 93–100).<br />
Agreement for Instructi<strong>on</strong>al prompts across<br />
sessi<strong>on</strong>s resulted <str<strong>on</strong>g>in</str<strong>on</strong>g> a mean score of 95%<br />
(range 83–100). In additi<strong>on</strong>, the sec<strong>on</strong>d<br />
observer collected procedural reliability data<br />
(Bill<str<strong>on</strong>g>in</str<strong>on</strong>g>gsley, White, & Muns<strong>on</strong>, 1980). These<br />
measures <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g: a) check<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
to ensure that the correct c<strong>on</strong>diti<strong>on</strong> was be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
applied to the <str<strong>on</strong>g>in</str<strong>on</strong>g>tended task for each participant,<br />
b) check<str<strong>on</strong>g>in</str<strong>on</strong>g>g to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e if the order of<br />
tasks were presented as stated <str<strong>on</strong>g>in</str<strong>on</strong>g> the research<br />
protocol, c) check<str<strong>on</strong>g>in</str<strong>on</strong>g>g to make sure that the<br />
correct stimulus materials were used, <str<strong>on</strong>g>and</str<strong>on</strong>g> d)<br />
that the prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g hierarchy was delivered as<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tended. Reliability was calculated by divid<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
number of correct measures by the total<br />
number of assessed variables <str<strong>on</strong>g>and</str<strong>on</strong>g> multiply<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
by 100. Procedural reliability agreement averaged<br />
100%.<br />
Results<br />
All of the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al procedures were effective<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g>/or decreas<str<strong>on</strong>g>in</str<strong>on</strong>g>g prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g acquisiti<strong>on</strong><br />
for all participants, however, some differential<br />
effects were observed between the c<strong>on</strong>diti<strong>on</strong>s.<br />
Percentage of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>ses.<br />
When the percentage of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct<br />
resp<strong>on</strong>ses were measured across c<strong>on</strong>diti<strong>on</strong>s/<br />
tasks, the data clearly <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated that all c<strong>on</strong>diti<strong>on</strong>s<br />
or models were effective <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependent resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g for all participants.<br />
Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g acquisiti<strong>on</strong>, Pablo <str<strong>on</strong>g>and</str<strong>on</strong>g> Breanne engaged<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> more <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g acquisiti<strong>on</strong> with the “other” model<br />
c<strong>on</strong>diti<strong>on</strong> while Alanna engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> more <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the “subjective”<br />
model c<strong>on</strong>diti<strong>on</strong> (see Figure 2).<br />
Pablo engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> more <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct<br />
resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g when the “other” model c<strong>on</strong>diti<strong>on</strong><br />
was used (M 87) followed by “self”<br />
model (M 81) <str<strong>on</strong>g>and</str<strong>on</strong>g> “subjective” model (M <br />
73). Breanne also had higher <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g when the “other” model<br />
was used (M 90) followed by the “subjective”<br />
model (M 84) <str<strong>on</strong>g>and</str<strong>on</strong>g> then “self” model<br />
(M 71). Alanna engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> more <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g when the “subjective”<br />
model was presented (M 88) followed by<br />
“self” model (M 69) <str<strong>on</strong>g>and</str<strong>on</strong>g> “other” model<br />
(M 66).<br />
Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g post-test phases, participants no<br />
l<strong>on</strong>ger viewed the videos prior to task engage-<br />
Comparis<strong>on</strong> of Self, Other, <str<strong>on</strong>g>and</str<strong>on</strong>g> Subjective Video Models / 515
Figure 2. Percentage of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g across phases <str<strong>on</strong>g>and</str<strong>on</strong>g> participants.<br />
516 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009
ment. This was d<strong>on</strong>e to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e if the participants<br />
improved their <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct<br />
resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g without video-based supports.<br />
They were tested us<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al materials<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the <str<strong>on</strong>g>in</str<strong>on</strong>g>itial post-test <strong>on</strong>e or two days after<br />
reach<str<strong>on</strong>g>in</str<strong>on</strong>g>g criteri<strong>on</strong> <strong>on</strong> all three tasks. They<br />
were then given a generalizati<strong>on</strong> post-test <strong>on</strong>e<br />
week later <str<strong>on</strong>g>and</str<strong>on</strong>g> aga<str<strong>on</strong>g>in</str<strong>on</strong>g> at six weeks after reach<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
criteri<strong>on</strong>.<br />
When post-test data were analyzed, Pablo<br />
c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued to engage <str<strong>on</strong>g>in</str<strong>on</strong>g> more <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g with the task he was taught<br />
us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the “other” video model dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> generalizati<strong>on</strong> post-tests <str<strong>on</strong>g>and</str<strong>on</strong>g> these<br />
effects ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed over a 6-week period of<br />
time. Although Breanne also c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued to<br />
have more <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
with the “other” model c<strong>on</strong>diti<strong>on</strong> as measured<br />
by the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al post-tests, she had more<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g with the<br />
“subjective” model c<strong>on</strong>diti<strong>on</strong> when generalizati<strong>on</strong><br />
was measured with the generalizati<strong>on</strong><br />
post-test. However, this was not ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> she performed better with the “other”<br />
model c<strong>on</strong>diti<strong>on</strong> at the 6-week ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance<br />
post-test. Alanna c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued to engage <str<strong>on</strong>g>in</str<strong>on</strong>g> more<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g when the<br />
“subjective” model was used as the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
method <str<strong>on</strong>g>and</str<strong>on</strong>g> these skills also generalized<br />
to other sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> materials <str<strong>on</strong>g>and</str<strong>on</strong>g> were<br />
ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed over time.<br />
Although every attempt was made to identify<br />
tasks of equal difficulty <str<strong>on</strong>g>and</str<strong>on</strong>g> to account for<br />
skill level prior to <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>, the clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
s<str<strong>on</strong>g>in</str<strong>on</strong>g>k task appeared to be the most difficult for<br />
all participants regardless of c<strong>on</strong>diti<strong>on</strong>. However,<br />
each participant engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> that task<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> the tasks were counter-balanced across all<br />
three model<str<strong>on</strong>g>in</str<strong>on</strong>g>g c<strong>on</strong>diti<strong>on</strong>s. When the mean<br />
scores of participants were comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ed accord<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
to the type of model, the “subjective”<br />
model c<strong>on</strong>diti<strong>on</strong> was associated with the highest<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
acquisiti<strong>on</strong> (M 82) followed closely by the<br />
“other” model c<strong>on</strong>diti<strong>on</strong> (M 81) <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
“self” model c<strong>on</strong>diti<strong>on</strong> (M 74) (see Figure<br />
3). When the mean scores of participants were<br />
comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ed across c<strong>on</strong>diti<strong>on</strong>s dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
post-tests, the “other” model c<strong>on</strong>diti<strong>on</strong><br />
was associated with the highest <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g (M 98) followed by the<br />
“subjective” model c<strong>on</strong>diti<strong>on</strong> (M 95) <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
the “self” model c<strong>on</strong>diti<strong>on</strong> (M 88). Similar<br />
Figure 3. Mean percentages of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct<br />
resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g across phases <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>diti<strong>on</strong>s.<br />
results were found with the <strong>on</strong>e-week generalizati<strong>on</strong><br />
post-tests with the “other” model c<strong>on</strong>diti<strong>on</strong><br />
be<str<strong>on</strong>g>in</str<strong>on</strong>g>g associated with the highest scores<br />
(M 92) followed by the “subjective” model<br />
c<strong>on</strong>diti<strong>on</strong> (M 90) <str<strong>on</strong>g>and</str<strong>on</strong>g> the “self” model c<strong>on</strong>diti<strong>on</strong><br />
(M 86). At the 6-wk test, the “subjective”<br />
model c<strong>on</strong>diti<strong>on</strong> had the highest mean<br />
scores (M 90) while the “other” <str<strong>on</strong>g>and</str<strong>on</strong>g> “self”<br />
model c<strong>on</strong>diti<strong>on</strong>s were not far beh<str<strong>on</strong>g>in</str<strong>on</strong>g>d (M <br />
88). Overall, it appears that all three of the<br />
model<str<strong>on</strong>g>in</str<strong>on</strong>g>g c<strong>on</strong>diti<strong>on</strong>s resulted <str<strong>on</strong>g>in</str<strong>on</strong>g> relatively<br />
high percentages of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
across all phases of the study. The<br />
“other” <str<strong>on</strong>g>and</str<strong>on</strong>g> “subjective” model c<strong>on</strong>diti<strong>on</strong>s<br />
were associated with slightly higher percentages<br />
of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
both acquisiti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> generalizati<strong>on</strong>, while<br />
all three c<strong>on</strong>diti<strong>on</strong>s appeared to be somewhat<br />
similar <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance.<br />
Percentage of prompts. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
sessi<strong>on</strong>s, if the participants made errors, a twostep<br />
error correcti<strong>on</strong> prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g sequence was<br />
provided if necessary. Follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g errors, participants<br />
were first given a verbal prompt to perform<br />
the step. If they resp<strong>on</strong>ded correctly, no<br />
additi<strong>on</strong>al prompts were given. If the participants<br />
made another error, a c<strong>on</strong>troll<str<strong>on</strong>g>in</str<strong>on</strong>g>g model<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
or physical prompt was delivered to ensure<br />
correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g. As was expected,<br />
participants received fewer prompts <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
c<strong>on</strong>diti<strong>on</strong>s where they had the most <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g. Pablo <str<strong>on</strong>g>and</str<strong>on</strong>g> Breanne<br />
received the fewest prompts when the “other”<br />
model c<strong>on</strong>diti<strong>on</strong> was used while Alanna received<br />
the fewest percentage of prompts when<br />
the “subjective” model was used. When the<br />
mean scores were comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ed across participants,<br />
the “other” model was associated with<br />
Comparis<strong>on</strong> of Self, Other, <str<strong>on</strong>g>and</str<strong>on</strong>g> Subjective Video Models / 517
the fewest external prompts (M 11), followed<br />
by the “subjective” model (M 13) <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
“self” models (M 16) (see Figure 4).<br />
Number of sessi<strong>on</strong>s to criteri<strong>on</strong>. To determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
if any of the model<str<strong>on</strong>g>in</str<strong>on</strong>g>g c<strong>on</strong>diti<strong>on</strong>s were more<br />
efficient than the others, the number of sessi<strong>on</strong>s<br />
to reach criteri<strong>on</strong> (i.e., three c<strong>on</strong>secutive<br />
sessi<strong>on</strong>s with 80% or higher <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct<br />
resp<strong>on</strong>ses) was also analyzed. Alanna <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Breanne reached criteri<strong>on</strong> more quickly when<br />
the “subjective” model was presented, while<br />
Pablo reached criteri<strong>on</strong> more quickly when<br />
the “other” model was used. When the mean<br />
number of sessi<strong>on</strong>s were comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ed across participants<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> model<str<strong>on</strong>g>in</str<strong>on</strong>g>g c<strong>on</strong>diti<strong>on</strong>s, the “subjective”<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> “other” model c<strong>on</strong>diti<strong>on</strong>s required<br />
an average of 9.33 sessi<strong>on</strong>s to criteri<strong>on</strong><br />
while the “self” model c<strong>on</strong>diti<strong>on</strong> required an<br />
average of 11.33 sessi<strong>on</strong>s to criteri<strong>on</strong> (see Figure<br />
5).<br />
Efficiency measures. In order to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
which of the procedures was more cost effective,<br />
an efficiency score was calculated by c<strong>on</strong>sider<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the ratio of each participant’s growth<br />
(from pre-test to post-test) to the measured<br />
“cost” or m<str<strong>on</strong>g>in</str<strong>on</strong>g>utes that were required to prepare<br />
the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al materials. This score<br />
was calculated to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e if <strong>on</strong>e type of<br />
model would be more efficient than the others<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> terms of teacher/caregiver time to create<br />
the materials <str<strong>on</strong>g>and</str<strong>on</strong>g> to measure the practical<br />
utility of each procedure. Results <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated<br />
that the “other” model c<strong>on</strong>diti<strong>on</strong> was more<br />
cost effective for two of the participants while<br />
the “subjective” model c<strong>on</strong>diti<strong>on</strong> was more<br />
cost effective for the third participant. With<br />
the excepti<strong>on</strong> of Pablo, the “self” models were<br />
the least efficient of the models (see Figure 6).<br />
When the efficiency scores were comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
across participants, the “other” model c<strong>on</strong>diti<strong>on</strong><br />
was the most efficient (M 1.25), followed<br />
by the “subjective” model c<strong>on</strong>diti<strong>on</strong><br />
(M 1.17), <str<strong>on</strong>g>and</str<strong>on</strong>g> f<str<strong>on</strong>g>in</str<strong>on</strong>g>ally the “self” model c<strong>on</strong>diti<strong>on</strong><br />
(M .61). In essence, each m<str<strong>on</strong>g>in</str<strong>on</strong>g>ute of<br />
time spent creat<str<strong>on</strong>g>in</str<strong>on</strong>g>g the materials “bought” an<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>crease of 1.25 percentage po<str<strong>on</strong>g>in</str<strong>on</strong>g>ts from preto<br />
post-test scores for the “other” model, 1.17<br />
percentage po<str<strong>on</strong>g>in</str<strong>on</strong>g>ts for the “subjective” model,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> .61 percentage po<str<strong>on</strong>g>in</str<strong>on</strong>g>ts for the “self”<br />
model, <str<strong>on</strong>g>in</str<strong>on</strong>g>dicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g that the other <str<strong>on</strong>g>and</str<strong>on</strong>g> subjective<br />
models were almost twice as efficient as<br />
the self models.<br />
Discussi<strong>on</strong><br />
518 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
In summary, all three of the video models<br />
were effective at <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct<br />
resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g for all three participants.<br />
When means were comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ed across c<strong>on</strong>diti<strong>on</strong>s,<br />
the “other” <str<strong>on</strong>g>and</str<strong>on</strong>g> “subjective” models appeared<br />
to be more effective <str<strong>on</strong>g>and</str<strong>on</strong>g> efficient than<br />
“self” models across all of the dependent measures.<br />
The “other” model c<strong>on</strong>diti<strong>on</strong> was associated<br />
with somewhat higher scores <str<strong>on</strong>g>in</str<strong>on</strong>g> terms<br />
of <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g for two of<br />
the participants for acquisiti<strong>on</strong>, ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> generalizati<strong>on</strong>, while the other participant<br />
performed better dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g acquisiti<strong>on</strong>,<br />
ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance, <str<strong>on</strong>g>and</str<strong>on</strong>g> generalizati<strong>on</strong> when the<br />
“subjective” model was used. Fewer external<br />
prompts were also used for two of the participants<br />
when the “other” model c<strong>on</strong>diti<strong>on</strong> was<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> place while the third participant required<br />
fewer external prompts when the “subjective”<br />
model c<strong>on</strong>diti<strong>on</strong> was <str<strong>on</strong>g>in</str<strong>on</strong>g> place. When the number<br />
of sessi<strong>on</strong>s to reach criteri<strong>on</strong> were evaluated,<br />
two of the participants met criteri<strong>on</strong><br />
faster when the “subjective” model was presented<br />
while the third participant met criteri<strong>on</strong><br />
faster when the “other” model c<strong>on</strong>diti<strong>on</strong><br />
was <str<strong>on</strong>g>in</str<strong>on</strong>g> place. In additi<strong>on</strong>, both the “other” <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
“subjective” models were far more efficient<br />
than “self” models when the time to create the<br />
materials were c<strong>on</strong>sidered <str<strong>on</strong>g>in</str<strong>on</strong>g> relati<strong>on</strong> to the<br />
amount of growth under each c<strong>on</strong>diti<strong>on</strong>.<br />
Self models appeared to be the least effective<br />
of all the model types across the different<br />
dependent measures, <str<strong>on</strong>g>in</str<strong>on</strong>g> particular, when the<br />
efficiency scores were calculated. Because the<br />
participants served as their own models <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
were not adept at perform<str<strong>on</strong>g>in</str<strong>on</strong>g>g the skill sequences,<br />
the videotap<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> edit<str<strong>on</strong>g>in</str<strong>on</strong>g>g necessary<br />
for the development of the “self” model<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
materials required far more time than the<br />
“other” <str<strong>on</strong>g>and</str<strong>on</strong>g> “subjective” models, thus mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
it less efficient. This is an important f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
especially c<strong>on</strong>sider<str<strong>on</strong>g>in</str<strong>on</strong>g>g that a frequent criticism<br />
of video-based <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> is that the time<br />
to create the materials is a shortcom<str<strong>on</strong>g>in</str<strong>on</strong>g>g that<br />
prevents its widespread use <str<strong>on</strong>g>in</str<strong>on</strong>g> applied sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs.<br />
To reduce this limitati<strong>on</strong>, it makes sense to<br />
use models that are more efficient <str<strong>on</strong>g>and</str<strong>on</strong>g> cost<br />
effective <str<strong>on</strong>g>and</str<strong>on</strong>g> perhaps us<str<strong>on</strong>g>in</str<strong>on</strong>g>g “other” or “subjective”<br />
models when teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g functi<strong>on</strong>al<br />
skills is the most logical <str<strong>on</strong>g>and</str<strong>on</strong>g> practical approach.<br />
In additi<strong>on</strong>, us<str<strong>on</strong>g>in</str<strong>on</strong>g>g video-based mate-
Figure 4. Percentage of prompts across participants <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>diti<strong>on</strong>s.<br />
Comparis<strong>on</strong> of Self, Other, <str<strong>on</strong>g>and</str<strong>on</strong>g> Subjective Video Models / 519
Figure 5. Number of sessi<strong>on</strong>s to criteri<strong>on</strong> across<br />
participants <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>diti<strong>on</strong>s.<br />
rials that present “other” <str<strong>on</strong>g>and</str<strong>on</strong>g> “subjective”<br />
models has the added advantage of be<str<strong>on</strong>g>in</str<strong>on</strong>g>g used<br />
across learners whereas “self” models do not.<br />
In additi<strong>on</strong> to be<str<strong>on</strong>g>in</str<strong>on</strong>g>g less efficient <str<strong>on</strong>g>in</str<strong>on</strong>g> terms<br />
of the time required to create the <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al<br />
materials, “self” models also resulted <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
lower scores when <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
was analyzed across participants.<br />
One surpris<str<strong>on</strong>g>in</str<strong>on</strong>g>g outcome of this study was that<br />
the participants seemed to resp<strong>on</strong>d somewhat<br />
differently when they viewed the “self” models<br />
versus the “other” or “subjective” models. Although<br />
they were excited to see themselves <strong>on</strong><br />
the computer <str<strong>on</strong>g>and</str<strong>on</strong>g> would often say th<str<strong>on</strong>g>in</str<strong>on</strong>g>gs like,<br />
“Look! That’s me!”, they also often commented<br />
<strong>on</strong> th<str<strong>on</strong>g>in</str<strong>on</strong>g>gs that were unrelated to the<br />
task. For <str<strong>on</strong>g>in</str<strong>on</strong>g>stance, Pablo frequently po<str<strong>on</strong>g>in</str<strong>on</strong>g>ted<br />
out the bruise <strong>on</strong> his arm <str<strong>on</strong>g>in</str<strong>on</strong>g> the hot dog video<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> then wanted to discuss how he got it from<br />
fight<str<strong>on</strong>g>in</str<strong>on</strong>g>g with his brother. Alanna <str<strong>on</strong>g>and</str<strong>on</strong>g> Breanne<br />
frequently commented <strong>on</strong> the clothes they<br />
were wear<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> the video (e.g., “That’s my<br />
favorite shirt”, “I’m wear<str<strong>on</strong>g>in</str<strong>on</strong>g>g that same outfit<br />
today!”) <str<strong>on</strong>g>and</str<strong>on</strong>g> they all seemed to attend more to<br />
the irrelevant stimuli that were present <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
“self” model videos rather than the task that<br />
Figure 6. Efficiency measures across participants<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>diti<strong>on</strong>s.<br />
520 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
was be<str<strong>on</strong>g>in</str<strong>on</strong>g>g presented. A possible explanati<strong>on</strong><br />
for the lower mean scores with <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g with the self model<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
tasks might be attributed to the fact that the<br />
participants were “star struck” <str<strong>on</strong>g>and</str<strong>on</strong>g> were attend<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
to themselves or what they were wear<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the videos rather than the task that was<br />
be<str<strong>on</strong>g>in</str<strong>on</strong>g>g presented.<br />
Although all of the video models appeared<br />
to be effective, <strong>on</strong>e limitati<strong>on</strong> to the study is<br />
that the participants performed less well when<br />
they were clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g the s<str<strong>on</strong>g>in</str<strong>on</strong>g>k. This was def<str<strong>on</strong>g>in</str<strong>on</strong>g>itely<br />
a n<strong>on</strong>-preferred task for all of the participants<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> it appeared to be somewhat<br />
more difficult than the other tasks regardless<br />
of the type of model that was used. Pablo <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Alanna, <str<strong>on</strong>g>in</str<strong>on</strong>g> particular, did not like clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
s<str<strong>on</strong>g>in</str<strong>on</strong>g>k <str<strong>on</strong>g>and</str<strong>on</strong>g> often verbalized their displeasure<br />
with hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g to clean it. Pablo often engaged <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
avoidance behaviors dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the task (e.g., pretend<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
to dry his h<str<strong>on</strong>g>and</str<strong>on</strong>g>s <strong>on</strong> the heat<str<strong>on</strong>g>in</str<strong>on</strong>g>g vents;<br />
frequently adjust<str<strong>on</strong>g>in</str<strong>on</strong>g>g the bl<str<strong>on</strong>g>in</str<strong>on</strong>g>ds <strong>on</strong> the bathroom<br />
w<str<strong>on</strong>g>in</str<strong>on</strong>g>dow to obta<str<strong>on</strong>g>in</str<strong>on</strong>g> the best light; repeatedly<br />
wr<str<strong>on</strong>g>in</str<strong>on</strong>g>g<str<strong>on</strong>g>in</str<strong>on</strong>g>g the sp<strong>on</strong>ge with exaggerated<br />
force), <str<strong>on</strong>g>and</str<strong>on</strong>g> although his antics were quite<br />
amus<str<strong>on</strong>g>in</str<strong>on</strong>g>g at times, prompts often needed to be<br />
delivered to get him to complete the next step<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the task sequence <str<strong>on</strong>g>and</str<strong>on</strong>g> this resulted <str<strong>on</strong>g>in</str<strong>on</strong>g> fewer<br />
steps with <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent correct resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Alanna also would throw the sp<strong>on</strong>ge <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
s<str<strong>on</strong>g>in</str<strong>on</strong>g>k after she completed a few steps <str<strong>on</strong>g>and</str<strong>on</strong>g> would<br />
declare that she “was d<strong>on</strong>e”. In additi<strong>on</strong>, the<br />
clean<str<strong>on</strong>g>in</str<strong>on</strong>g>g task was probably more difficult because<br />
the stimulus/resp<strong>on</strong>se relati<strong>on</strong>ships<br />
were less clear than with the other tasks. For<br />
example, <strong>on</strong>ce the hot dog was <str<strong>on</strong>g>in</str<strong>on</strong>g> the microwave,<br />
it was more clear that the next resp<strong>on</strong>se<br />
would be to set the timer, whereas, after wip<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the <str<strong>on</strong>g>in</str<strong>on</strong>g>side of the s<str<strong>on</strong>g>in</str<strong>on</strong>g>k, the next step was<br />
not as obvious. However, all of the participants<br />
were required to engage <str<strong>on</strong>g>in</str<strong>on</strong>g> this task <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
each model type was represented. By comb<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the means across dependent measures it<br />
was possible to identify the differential effects<br />
of each of the model<str<strong>on</strong>g>in</str<strong>on</strong>g>g c<strong>on</strong>diti<strong>on</strong>s.<br />
Although all the video models <str<strong>on</strong>g>in</str<strong>on</strong>g>creased<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependent resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g across tasks, they<br />
were used <str<strong>on</strong>g>in</str<strong>on</strong>g> c<strong>on</strong>juncti<strong>on</strong> with a two step<br />
prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g sequence. As a result of us<str<strong>on</strong>g>in</str<strong>on</strong>g>g this<br />
comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong>, it cannot be stated that the<br />
video model<str<strong>on</strong>g>in</str<strong>on</strong>g>g procedures al<strong>on</strong>e were resp<strong>on</strong>sible<br />
for the changes <str<strong>on</strong>g>in</str<strong>on</strong>g> student resp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Future research might be directed at <str<strong>on</strong>g>in</str<strong>on</strong>g>-
vestigat<str<strong>on</strong>g>in</str<strong>on</strong>g>g use of the video sequences <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
isolati<strong>on</strong> rather than <str<strong>on</strong>g>in</str<strong>on</strong>g> c<strong>on</strong>juncti<strong>on</strong> with a<br />
prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g system (e.g., system of least<br />
prompts) or with<str<strong>on</strong>g>in</str<strong>on</strong>g> the c<strong>on</strong>text of fad<str<strong>on</strong>g>in</str<strong>on</strong>g>g approaches<br />
(gradually fad<str<strong>on</strong>g>in</str<strong>on</strong>g>g out video models).<br />
Research <strong>on</strong> video-based <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> to date<br />
has <str<strong>on</strong>g>in</str<strong>on</strong>g>volved the use of different types of models<br />
to teach a broad range of skills; however,<br />
several questi<strong>on</strong>s still rema<str<strong>on</strong>g>in</str<strong>on</strong>g> unanswered <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the research literature. For example, is <strong>on</strong>e<br />
type of model (self, other, subjective) more<br />
c<strong>on</strong>ducive or more effective <str<strong>on</strong>g>and</str<strong>on</strong>g> efficient for<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g specific types of skills to <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with disabilities? Are different skill categories<br />
(academic/cognitive, social/communicative,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> behavioral/self-regulatory skills), more<br />
c<strong>on</strong>ducive to specific types of models when<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with disabilities? And, depend<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<strong>on</strong> the type of skill that is taught, are<br />
any of the model types more cost effective <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
relati<strong>on</strong> to teacher requirements (time<br />
needed to create materials) <str<strong>on</strong>g>and</str<strong>on</strong>g> student outcomes<br />
(e.g., time <str<strong>on</strong>g>and</str<strong>on</strong>g> number of sessi<strong>on</strong>s to<br />
criteri<strong>on</strong>; rate of acquisiti<strong>on</strong>)? Future research<br />
should focus <strong>on</strong> answer<str<strong>on</strong>g>in</str<strong>on</strong>g>g these questi<strong>on</strong>s, as<br />
well as others, to ensure that the most efficient<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> effective models are used to improve the<br />
practicality <str<strong>on</strong>g>and</str<strong>on</strong>g> efficacy of video-based <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong><br />
across different types of tasks <str<strong>on</strong>g>and</str<strong>on</strong>g> populati<strong>on</strong>s.<br />
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behavior analysis with excepti<strong>on</strong>al students. Needham,<br />
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Received: 14 May 2008<br />
Initial Acceptance: 12 July 2008<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>al Acceptance: 12 November 2008<br />
522 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009
Parental Stress <str<strong>on</strong>g>and</str<strong>on</strong>g> Autism:<br />
Are There Useful Cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g Strategies?<br />
G. Richm<strong>on</strong>d Mancil<br />
University of Louisville<br />
Pena Bedesem<br />
University of Central Florida<br />
Brian A. Boyd<br />
University of North Carol<str<strong>on</strong>g>in</str<strong>on</strong>g>a at Chapel Hill<br />
Abstract: Accord<str<strong>on</strong>g>in</str<strong>on</strong>g>g to previous researchers, parents of children diagnosed with Autism Spectrum Disorders<br />
(ASD) c<strong>on</strong>sistently report more stress than parents of typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g children or children with other<br />
developmental disorders (e.g., Down syndrome). This has peaked <str<strong>on</strong>g>in</str<strong>on</strong>g>terest <str<strong>on</strong>g>in</str<strong>on</strong>g> the field <str<strong>on</strong>g>in</str<strong>on</strong>g> a related area, that<br />
be<str<strong>on</strong>g>in</str<strong>on</strong>g>g, identify<str<strong>on</strong>g>in</str<strong>on</strong>g>g the cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies parents use to deal with the stressors of rear<str<strong>on</strong>g>in</str<strong>on</strong>g>g a child <strong>on</strong> the autism<br />
spectrum. The available literature <strong>on</strong> cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies primarily has focused <strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>terview<str<strong>on</strong>g>in</str<strong>on</strong>g>g parents to f<str<strong>on</strong>g>in</str<strong>on</strong>g>d out<br />
what strategies they currently use <str<strong>on</strong>g>and</str<strong>on</strong>g> if these are effective, which has resulted <str<strong>on</strong>g>in</str<strong>on</strong>g> mixed f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs. A selected<br />
synthesis of the stress literature perta<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g to cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies is provided to highlight the high levels of reported<br />
stress already experienced by families of children with ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> what strategies the parents report aid them <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g with the stress. This literature review is presented for two purposes: (a) highlight relevant f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
methodological issues with current research, <str<strong>on</strong>g>and</str<strong>on</strong>g> (b) discuss implicati<strong>on</strong>s for researchers <str<strong>on</strong>g>and</str<strong>on</strong>g> practiti<strong>on</strong>ers<br />
work<str<strong>on</strong>g>in</str<strong>on</strong>g>g with children with ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> their families who exhibit <str<strong>on</strong>g>in</str<strong>on</strong>g>creased levels of stress.<br />
Accord<str<strong>on</strong>g>in</str<strong>on</strong>g>g to previous researchers, parents of<br />
children diagnosed with Autism Spectrum Disorders<br />
(ASD) c<strong>on</strong>sistently report more stress<br />
than parents of typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g children<br />
(Dys<strong>on</strong>, 1993; Wolf, Noh, Fisman, & Speechley,<br />
1989) <str<strong>on</strong>g>and</str<strong>on</strong>g> children with other developmental<br />
disorders (e.g., Down syndrome)<br />
(Boyd, 2002; S<str<strong>on</strong>g>and</str<strong>on</strong>g>ers & Morgan, 1997). Further,<br />
parents of children with ASD report<br />
more symptoms of anxiety <str<strong>on</strong>g>and</str<strong>on</strong>g> marital dissatisfacti<strong>on</strong><br />
than parents of children with other<br />
types of disabilities (Dunn, Burb<str<strong>on</strong>g>in</str<strong>on</strong>g>e, Boers, &<br />
Dunn, 2001; Holroyd & McArthur, 1976; K<strong>on</strong>stantareas<br />
& Homatidis, 1989). Researchers<br />
purport that the treatment of children with<br />
ASD may be compromised when parents are<br />
experienc<str<strong>on</strong>g>in</str<strong>on</strong>g>g overwhelm<str<strong>on</strong>g>in</str<strong>on</strong>g>g levels of stress,<br />
exhibit<str<strong>on</strong>g>in</str<strong>on</strong>g>g symptoms of psychopathology<br />
(e.g., anxiety, depressi<strong>on</strong>), or hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g difficulty<br />
liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g with <str<strong>on</strong>g>and</str<strong>on</strong>g> rear<str<strong>on</strong>g>in</str<strong>on</strong>g>g their child with ASD<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g this article should<br />
be addressed to G. Richm<strong>on</strong>d Mancil, Kentucky<br />
Austism <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> Center, College of <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Human Development, University of Louisville, Louisville,<br />
KY 40292. Email: rich.mancil@louisville.edu<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, 2009, 44(4), 523–537<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
(Robb<str<strong>on</strong>g>in</str<strong>on</strong>g>s, Dunlap, & Plienis, 1991). Thus, effective<br />
treatments for this populati<strong>on</strong> must<br />
provide support to parents as well as their<br />
children. However, little is known about cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
strategies parents employ to effectively<br />
deal with these various stressors or how to<br />
design effective parental educati<strong>on</strong> programs<br />
to combat perceived stressors.<br />
The available literature <strong>on</strong> cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies<br />
for parents of children with autism primarily<br />
has focused <strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>terview<str<strong>on</strong>g>in</str<strong>on</strong>g>g parents to f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<br />
out what strategies they currently use <str<strong>on</strong>g>and</str<strong>on</strong>g> if<br />
these are effective. Previous researchers have<br />
found that parents used a variety of strategies<br />
to cope with stressors related to hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g a child<br />
with autism. Parents noted that professi<strong>on</strong>al<br />
services (D<strong>on</strong>ovan, 1988) <str<strong>on</strong>g>and</str<strong>on</strong>g> spousal support<br />
(Higg<str<strong>on</strong>g>in</str<strong>on</strong>g>s, Bailey, & Pearce, 2005) are effective<br />
cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies. Others have reported that<br />
plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g appropriate resp<strong>on</strong>ses to challeng<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
behavior (e.g., if the child tantrums, I will<br />
ignore the behavior) <str<strong>on</strong>g>and</str<strong>on</strong>g> keep<str<strong>on</strong>g>in</str<strong>on</strong>g>g children<br />
with ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> comorbid behavior challenges<br />
separated from sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs also helps (Gray,<br />
2003). Still others have noted that extended<br />
family support <str<strong>on</strong>g>and</str<strong>on</strong>g> social withdrawal decrease<br />
Stress <str<strong>on</strong>g>and</str<strong>on</strong>g> Autism / 523
stress (1994). The parents expla<str<strong>on</strong>g>in</str<strong>on</strong>g>ed it was<br />
easier to keep to themselves <str<strong>on</strong>g>and</str<strong>on</strong>g> avoid embarrass<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cidents (e.g., tantrum) that results <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
stares <str<strong>on</strong>g>and</str<strong>on</strong>g> comments from others. Given the<br />
variety of cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies reported by parents,<br />
it is not surpris<str<strong>on</strong>g>in</str<strong>on</strong>g>g that c<strong>on</strong>flict<str<strong>on</strong>g>in</str<strong>on</strong>g>g research<br />
f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs exist. For example, Erguner-<br />
Tek<str<strong>on</strong>g>in</str<strong>on</strong>g>alp <str<strong>on</strong>g>and</str<strong>on</strong>g> Akkok (2004) found social<br />
support was not an effective cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategy<br />
for parents of children with autism. In c<strong>on</strong>trast,<br />
the sample of parents <str<strong>on</strong>g>in</str<strong>on</strong>g> the study by<br />
Dunn et al. (2001) reported that social supports<br />
were effective cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g mechanisms for<br />
deal<str<strong>on</strong>g>in</str<strong>on</strong>g>g with the daily stress of rear<str<strong>on</strong>g>in</str<strong>on</strong>g>g a child<br />
with autism. These discrepancies may be related<br />
to the differences between studies,<br />
which <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded socio-ec<strong>on</strong>omic status, parent<br />
occupati<strong>on</strong>, parent educati<strong>on</strong>, age of child,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> severity of the child. However, the researchers<br />
did not provide any data expla<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
possible reas<strong>on</strong>s for differences. In additi<strong>on</strong> to<br />
c<strong>on</strong>flict<str<strong>on</strong>g>in</str<strong>on</strong>g>g f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, some of the strategies<br />
parents report as effective may <strong>on</strong>ly be provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
short term soluti<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> although temporarily<br />
effective may have unanticipated l<strong>on</strong>gterm<br />
outcomes. For example, the parents who<br />
keep children separated from sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> use<br />
social withdrawal as a means to cope may experience<br />
decreased levels of stress at first;<br />
however, this approach <strong>on</strong>ly temporarily displaces<br />
the problem, result<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> stress later<br />
that may be much worse <str<strong>on</strong>g>in</str<strong>on</strong>g> severity (Beck,<br />
1995). In additi<strong>on</strong>, the separati<strong>on</strong> from sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> social withdrawal may <str<strong>on</strong>g>in</str<strong>on</strong>g>hibit improvement<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the social communicative behaviors<br />
of their children with ASD (Quill,<br />
1995).<br />
Although the aforementi<strong>on</strong>ed researchers<br />
have questi<strong>on</strong>ed parents regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g what cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
strategies they f<str<strong>on</strong>g>in</str<strong>on</strong>g>d effective for deal<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
with stressors related to rear<str<strong>on</strong>g>in</str<strong>on</strong>g>g a child with<br />
ASD, there is sparse research <strong>on</strong> design<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
educati<strong>on</strong>al or counsel<str<strong>on</strong>g>in</str<strong>on</strong>g>g programs to help<br />
parents cope with these various stressors.<br />
Some research has exam<str<strong>on</strong>g>in</str<strong>on</strong>g>ed the correlati<strong>on</strong><br />
between child, parent, <str<strong>on</strong>g>and</str<strong>on</strong>g> envir<strong>on</strong>mental<br />
characteristics <str<strong>on</strong>g>and</str<strong>on</strong>g> that of parent stress<br />
(Bishop, Richler, Ca<str<strong>on</strong>g>in</str<strong>on</strong>g>, & Lord, 2007; Mash &<br />
Johnst<strong>on</strong>, 1990). Mash <str<strong>on</strong>g>and</str<strong>on</strong>g> Johnst<strong>on</strong>’s f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
suggest that child characteristics are the<br />
primary c<strong>on</strong>tributor to parent-child stress <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
families of hyperactive children. In additi<strong>on</strong>,<br />
they found that parental cogniti<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g>fluence<br />
parent behavior, which then can effect the<br />
parents’ relati<strong>on</strong>ships with their children.<br />
However, this has not been c<strong>on</strong>nected to educati<strong>on</strong>al<br />
or counsel<str<strong>on</strong>g>in</str<strong>on</strong>g>g services for parents of<br />
children <strong>on</strong> the autism spectrum.<br />
In summary, researchers have noted elevated<br />
stress levels <str<strong>on</strong>g>in</str<strong>on</strong>g> parents of children with<br />
ASD s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce the 1970s (Lilly, 1977) <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
need to address the problem, but much less<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> is known about effective cop<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
strategies. Therefore, the purpose of this paper<br />
is to (a) review the literature <strong>on</strong> cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
strategies parents of children with ASD use to<br />
deal with various stressors, <str<strong>on</strong>g>and</str<strong>on</strong>g> (b) discuss<br />
implicati<strong>on</strong>s for researchers <str<strong>on</strong>g>and</str<strong>on</strong>g> practiti<strong>on</strong>ers<br />
work<str<strong>on</strong>g>in</str<strong>on</strong>g>g with children with ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> their<br />
families who exhibit <str<strong>on</strong>g>in</str<strong>on</strong>g>creased levels of stress.<br />
Method<br />
524 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
The literature review c<strong>on</strong>ducted <strong>on</strong> cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
strategies for parents of children with ASD<br />
began with a search of electr<strong>on</strong>ic databases<br />
(ERIC, <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>, PsycINFO, <str<strong>on</strong>g>and</str<strong>on</strong>g> Academic<br />
Search Premier) us<str<strong>on</strong>g>in</str<strong>on</strong>g>g various comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong>s<br />
of the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g keywords: autism, autism<br />
spectrum disorders, aspergers syndrome, pervasive<br />
developmental disabilities, children,<br />
cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies, family, mothers, fathers,<br />
parents, sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, <str<strong>on</strong>g>and</str<strong>on</strong>g> stress. Follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
electr<strong>on</strong>ic data base search, a h<str<strong>on</strong>g>and</str<strong>on</strong>g> search was<br />
c<strong>on</strong>ducted of the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g journals: American<br />
Journal of Mental Retardati<strong>on</strong>, Journal of<br />
Autism <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> Disorders, Family<br />
Process, Journal of Abnormal Child Psychology,<br />
American Journal of Mental Deficiency,<br />
Community Mental Health Journal, <str<strong>on</strong>g>and</str<strong>on</strong>g> Focus<br />
<strong>on</strong> Autism <str<strong>on</strong>g>and</str<strong>on</strong>g> Other <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>.<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>ally, after review<str<strong>on</strong>g>in</str<strong>on</strong>g>g the retrieved articles,<br />
an ancestral search was c<strong>on</strong>ducted.<br />
These searches produced <str<strong>on</strong>g>in</str<strong>on</strong>g> excess of 50 articles,<br />
19 of which met the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g predeterm<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>clusi<strong>on</strong> criteria: (a) reported empirical<br />
f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs or a summary of those f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
<strong>on</strong> familial stress <str<strong>on</strong>g>and</str<strong>on</strong>g> cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies to help<br />
reduce stress, (b) focus of study was families<br />
with children who have a diagnosis of ASD,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> (c) published <str<strong>on</strong>g>in</str<strong>on</strong>g> a peer-reviewed journal.<br />
The 19 articles that met the criteria were<br />
reviewed to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e what cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies<br />
were effective for parents of children with<br />
ASD. Particularly, the studies were analyzed to
determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e the characteristics of parents, children,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> major f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs across studies.<br />
Results<br />
Characteristics of Study Participants<br />
Parent characteristics. As outl<str<strong>on</strong>g>in</str<strong>on</strong>g>ed <str<strong>on</strong>g>in</str<strong>on</strong>g> Table<br />
1, there were 594 parents across studies. The<br />
majority of researchers reported the mean<br />
chr<strong>on</strong>ological age of parents by gender. In<br />
additi<strong>on</strong>, most studies <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded the educati<strong>on</strong><br />
level of parents, with <strong>on</strong>ly a few <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
additi<strong>on</strong>al <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> <strong>on</strong> the number of children<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the household. The reported ages of<br />
mothers across studies ranged from 25 to 67<br />
years, with the mean ages rang<str<strong>on</strong>g>in</str<strong>on</strong>g>g from 32.46<br />
to 42.4 years (see Table 1). Similarly, the reported<br />
ages of fathers across studies ranged 25<br />
to 67 years, with the mean ages rang<str<strong>on</strong>g>in</str<strong>on</strong>g>g from<br />
35.12 to 43.44 years.<br />
Parents’ educati<strong>on</strong> levels differed with<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> across studies. The educati<strong>on</strong> levels of<br />
parents ranged from the completi<strong>on</strong> of some<br />
high school to the atta<str<strong>on</strong>g>in</str<strong>on</strong>g>ment of a doctoral<br />
degree (both mothers <str<strong>on</strong>g>and</str<strong>on</strong>g> fathers). For example,<br />
the study by Dunn et al. (2001) c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
participants with partial high school, high<br />
school, partial college, college, <str<strong>on</strong>g>and</str<strong>on</strong>g> graduate<br />
school, with the majority hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g partial college<br />
or greater. In c<strong>on</strong>trast, 22 out of 33<br />
(66.7%) of the participants <str<strong>on</strong>g>in</str<strong>on</strong>g> Gray’s (1994)<br />
study had a high school educati<strong>on</strong> or less. As<br />
shown <str<strong>on</strong>g>in</str<strong>on</strong>g> Table 1, the majority of mothers <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
each of the 11 (out of 19) studies with reported<br />
educati<strong>on</strong> levels completed high<br />
school <str<strong>on</strong>g>and</str<strong>on</strong>g>/or attended college. Similarly, the<br />
majority of the reported fathers’ educati<strong>on</strong><br />
levels <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated the completi<strong>on</strong> of high school<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> the attendance <str<strong>on</strong>g>and</str<strong>on</strong>g>/or completi<strong>on</strong> of a<br />
college degree.<br />
In c<strong>on</strong>trast to the reports of chr<strong>on</strong>ological<br />
ages <str<strong>on</strong>g>and</str<strong>on</strong>g> educati<strong>on</strong> level of parents, <strong>on</strong>ly 7 of<br />
the 19 studies reported the number of children<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the household. Of the few studies that<br />
reported number of children, the number of<br />
children <str<strong>on</strong>g>in</str<strong>on</strong>g> the household ranged from <strong>on</strong>e to<br />
eight. Future researchers may want to <str<strong>on</strong>g>in</str<strong>on</strong>g>clude<br />
data <strong>on</strong> the number of people, both children<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> adults, <str<strong>on</strong>g>in</str<strong>on</strong>g> the household as it may be<br />
related to parental stress levels.<br />
Child characteristics. Similar to parent characteristics,<br />
child characteristics varied with<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> across studies (see Table 2). The chr<strong>on</strong>ological<br />
age of children ranged from 13<br />
m<strong>on</strong>ths to 26 years, with the mean ages across<br />
studies rang<str<strong>on</strong>g>in</str<strong>on</strong>g>g from 28.35 m<strong>on</strong>ths to 15.2<br />
years. The study samples of children ranged <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
size from 3 to 141. Only two of the articles<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded the mental age or I.Q. of the children.<br />
D<strong>on</strong>ovan (1988) reported an I.Q. range<br />
of eight to 83, <str<strong>on</strong>g>and</str<strong>on</strong>g> these data were collected<br />
from <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent agencies that had previously<br />
served the children. Rodrigue, Morgan,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Geffken (1990) reported a mean mental<br />
age of 2.82 years, with a mean chr<strong>on</strong>ological<br />
age of 10.71 years, accord<str<strong>on</strong>g>in</str<strong>on</strong>g>g to the V<str<strong>on</strong>g>in</str<strong>on</strong>g>el<str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Adaptive Behavior Scale. All children <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the literature review were diagnosed<br />
with an autism spectrum disorder; however,<br />
some articles did <str<strong>on</strong>g>in</str<strong>on</strong>g>clude <strong>on</strong>ly children with<br />
other disabilities (these articles were not <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the table or the overall literature<br />
review). The researchers did not describe the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>struments that were used to c<strong>on</strong>firm the<br />
child’s diagnosis. The majority of diagnoses<br />
were recorded from cumulative folders of the<br />
children. No studies reported the grade level<br />
or academic measures <strong>on</strong> the children. Further,<br />
<strong>on</strong>ly six of the 18 studies reported severity<br />
of symptoms or level of symptomology of<br />
the children. The researchers noted that the<br />
more severe the symptoms <str<strong>on</strong>g>and</str<strong>on</strong>g> challeng<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
behaviors were <str<strong>on</strong>g>in</str<strong>on</strong>g> the children, the more<br />
stress parents reported (Baker-Ericzen, Brookman-Frazee,<br />
& Stahmer, 2005; Feldman &<br />
Werner, 2002; Hast<str<strong>on</strong>g>in</str<strong>on</strong>g>gs & Johns<strong>on</strong>, 2001; Higg<str<strong>on</strong>g>in</str<strong>on</strong>g>s<br />
et al., 2005; Pakenham, Sohr<strong>on</strong>off, &<br />
Samios, 2004; Tunali & Power, 2002).<br />
Major F<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
Researchers have used different <str<strong>on</strong>g>in</str<strong>on</strong>g>struments<br />
to measure parental stress levels across the<br />
studies. They also noted several types of stress<br />
affected parents. Further, researchers noted<br />
that parents used various strategies to cope with<br />
the stress, some more effective than others.<br />
Instruments. Researchers used a variety of<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>struments to measure stress. Several researchers<br />
utilized stress measures previously<br />
developed, studied, <str<strong>on</strong>g>and</str<strong>on</strong>g> psychometrically validated<br />
for reliability. For example, Pakenham<br />
et al. (2004) used several tested <str<strong>on</strong>g>in</str<strong>on</strong>g>struments<br />
such as the COPE (Carver, Scheier, & We<str<strong>on</strong>g>in</str<strong>on</strong>g>traub,<br />
1989) <str<strong>on</strong>g>and</str<strong>on</strong>g> the Parental Self-Efficacy<br />
Stress <str<strong>on</strong>g>and</str<strong>on</strong>g> Autism / 525
TABLE 1<br />
Characteristics of the Parents<br />
Age of<br />
Father* Mother’s <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Father’s <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
Age of<br />
Mother*<br />
Study N<br />
NR<br />
HS (7%)<br />
Some College (48%)<br />
College (19%)<br />
Graduate (30%)<br />
HS (7%)<br />
Some College (56%)<br />
College (22%)<br />
Graduate (14%)<br />
M 35.12<br />
(SD 5.41)<br />
64 M 32.46<br />
(SD 3.36)<br />
Baker-Ericzen,<br />
Brookman-Frazee,<br />
& Stahmer 2005<br />
D<strong>on</strong>ovan 1988 36 M 41.7 N/A N/R N/R M 1.81<br />
Dunn, Burb<str<strong>on</strong>g>in</str<strong>on</strong>g>e,<br />
58 M 36.84 (SD 9.21) - both Partial HS (3%)<br />
N/R<br />
Bowers, &<br />
High School Graduate (21%)<br />
Tantleff-Dunn<br />
Partial College (30%)<br />
2001<br />
College Graduate (33%)<br />
Partial or Completed Graduate<br />
School (13%)<br />
Erguner-Tek<str<strong>on</strong>g>in</str<strong>on</strong>g>alp, & 10 M 42.40 (SD 7.02) - both N/R N/R<br />
Akkok 2004<br />
Feldman & Werner 18 (EG) M 39.05 M 42.17 HS Graduate (n 8)<br />
HS Graduate (n 6)<br />
N/R<br />
2002<br />
18 (CG) (SD 10.36) (SD 7.58) Community College Diploma Community College Diploma<br />
(EG)<br />
(EG)<br />
(n 4)<br />
(n 0)<br />
M 39.5 M 42.13 University Graduate (n 0) (EG) University Graduate (n 2) (EG)<br />
(SD 10.36) (SD 12.45) HS Graduate (n 6)<br />
HS Graduate (n 7)<br />
(CG)<br />
(CG) CC Diploma (n 5)<br />
CC Diploma (n 3)<br />
University Graduate (n 2) (CG) University Graduate (n 2) (CG)<br />
Gray 1994 33 N/R N/R HS <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> or Less (66.7%) N/R<br />
Gray 2003 53 N/R N/R N/R N/R N/R<br />
Hast<str<strong>on</strong>g>in</str<strong>on</strong>g>gs & Brown 46 M 41.04 M 43.50 College (15.3%) College (25%) N/R<br />
2002<br />
(SD 5.00) (SD 5.06)<br />
Hast<str<strong>on</strong>g>in</str<strong>on</strong>g>gs & Johns<strong>on</strong> 141 M 37.41 (SD 4.87) - both College (45.4%) M1.22%<br />
2001<br />
(SD0.80)<br />
Hast<str<strong>on</strong>g>in</str<strong>on</strong>g>gs et al. 2005 135 M 37.75 M 40.76 College (27%) College (37%) N/R<br />
(SD 5.00) (SD 5.14)<br />
Higg<str<strong>on</strong>g>in</str<strong>on</strong>g>s, Bailey & 52 N/R N/R N/R N/R N/R<br />
Pearce 2005<br />
526 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009
Table 1—(C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued)<br />
Age of<br />
Father* Mother’s <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Father’s <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
Age of<br />
Mother*<br />
Study N<br />
Hutt<strong>on</strong> & Car<strong>on</strong> 21 N/R N/R N/R N/R N/R<br />
2005<br />
Leyser & Dekel 1991 82 M 34.16 M 36.46 N/R Bible School Graduate (84%) M 5.74<br />
(SD 6.72) (SD 7.88)<br />
(SD 2.82)<br />
Luther, Canham, & 18 N/R N/R N/R N/R M 2.3<br />
Curet<strong>on</strong> 2005<br />
Pakenham,<br />
59 M 40.99 M 43.44 HS (47%)<br />
HS (50%)<br />
M 2.51<br />
Sofr<strong>on</strong>off, &<br />
(SD 5.03) (SD 3.79) College (53%)<br />
College (50%)<br />
(SD .97)<br />
Samios 2004<br />
(Mother)<br />
M 2.25<br />
(SD .71)<br />
(Father)<br />
Rodrigue, Morgan, 20 M 38.75 N/R N/R N/R Most had two<br />
& Geffken 1990<br />
St<strong>on</strong>eman &<br />
67 M 33 M 36 Some HS (9%)<br />
Some HS (15%)<br />
M 2.3<br />
Gavidia-Payne<br />
(SD 6.01) (SD 7.26) HS Graduate (30%)<br />
HS Graduate (24%)<br />
2006<br />
Some College (27%)<br />
Some College (24%)<br />
College Graduate (27%)<br />
College Graduate (22%)<br />
Masters/Doctoral Degree (7%) Masters/Doctoral Degree (13%)<br />
Tarakeshwar &<br />
45 N/R N/R HS Graduate (15.6%)<br />
N/R<br />
Pargament 2001<br />
Some College (37.8%)<br />
BS Degree (24.4%)<br />
Some Graduate School (8.9%)<br />
Graduate Degree (13.3%)<br />
Tunali & Power 58 N/R N/R Some College (n 48) N/R Most had two<br />
2002<br />
(n 30)<br />
Note. M mean; SD st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard deviati<strong>on</strong>; N/R not reported; N/A not applicable; EG experimental group; CG c<strong>on</strong>trol group; HS high school; BS <br />
bachelors degree; CC community college; *Age is <str<strong>on</strong>g>in</str<strong>on</strong>g> years unless otherwise notated.<br />
Stress <str<strong>on</strong>g>and</str<strong>on</strong>g> Autism / 527
TABLE 2<br />
Characteristics of Children<br />
Study N Chr<strong>on</strong>ological Age* MA* Diagnosis<br />
Baker-Ericzen, Brookman-Frazee,<br />
& Stahmer 2005<br />
37 M 28.35 m<strong>on</strong>ths N/R Autism<br />
D<strong>on</strong>ovan 1988 22 M 14.3 8–83 Autism<br />
Dunn, Burb<str<strong>on</strong>g>in</str<strong>on</strong>g>e, Bowers, &<br />
Tantleff-Dunn 2001<br />
N/R M 7.47 (SD 3.31) N/R Autism<br />
Erguner-Tek<str<strong>on</strong>g>in</str<strong>on</strong>g>alp, & Akkok 2004 10 M 15.2 (SD 1.93) N/R Autism<br />
Feldman & Werner 2002 5 (EG) M 11.33 (SD 3.56) (EG)<br />
N/R Autism<br />
6 (CG) M 10.76 (SD 5.38) (CG)<br />
Gray 1994 N/R Range 6-12 N/R Autism<br />
Gray 2003 32 Median 12 (5-26) N/R Autism<br />
Hast<str<strong>on</strong>g>in</str<strong>on</strong>g>gs & Brown 2002 46 M 12.15 (SD 2.49) N/R Autism<br />
Hast<str<strong>on</strong>g>in</str<strong>on</strong>g>gs & Johns<strong>on</strong> 2001 141 M 4.98 (SD 1.50) N/R Autism<br />
Hast<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, Kovshoff, Brown, Ward,<br />
Esp<str<strong>on</strong>g>in</str<strong>on</strong>g>osa, & Rem<str<strong>on</strong>g>in</str<strong>on</strong>g>gt<strong>on</strong> 2005<br />
51 M 24.5 (SD 4.40) N/R Autism<br />
Higg<str<strong>on</strong>g>in</str<strong>on</strong>g>s, Bailey & Pearce 2005 58 M 10.8 N/R ASD<br />
Hutt<strong>on</strong> & Car<strong>on</strong> 2005 21 Range 3-16 N/R Autism<br />
Leyser & Dekel 1991 3 M 6.84 (SD 2.36) N/R Autism<br />
Luther, Canham, & Curet<strong>on</strong> 2005 21 Range 5-13 N/R Autism<br />
Pakenham, Sofr<strong>on</strong>off, & Samios 59 M 10.77 (SD .98) (Mother) N/R AS<br />
2004<br />
M 10.67 (SD 1.15) (Father)<br />
Rodrigue, Morgan, & Geffken<br />
1990<br />
20 M 10.71 M 2.82 Autism<br />
St<strong>on</strong>eman & Gavidia-Payne 2006 3 M 45 m<strong>on</strong>ths (13-72 m<strong>on</strong>ths) N/R Autism<br />
Tarakeshwar & Pargament 2001 45 Range 4-24 N/R Autism<br />
Tunali & Power 2002 29 M 9.7 (SD 2.4) N/R Autism<br />
Note. M mean; SD st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard deviati<strong>on</strong>; N/R not reported; N/A not applicable; EG experimental<br />
group; CG c<strong>on</strong>trol group; MA mental age; ASD autism spectrum disorder; AS asperger syndrome;<br />
*Age is <str<strong>on</strong>g>in</str<strong>on</strong>g> years unless otherwise notated.<br />
Scale (Sofr<strong>on</strong>off & Farbotko, 2002). In c<strong>on</strong>trast,<br />
a few researchers solely relied <strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>terviews<br />
developed for their particular studies.<br />
(see Gray 1994, 2003 as an example). As<br />
shown <str<strong>on</strong>g>in</str<strong>on</strong>g> Table 3, four research teams used a<br />
comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> of formal <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>formal stress<br />
measures (Hast<str<strong>on</strong>g>in</str<strong>on</strong>g>gs & Brown, 2002; Luther,<br />
Canham, & Curek<strong>on</strong>, 2005; Tarakeshwar &<br />
Pargament, 2001; Tunali & Power, 2002).<br />
The <str<strong>on</strong>g>in</str<strong>on</strong>g>strument types <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded scales, questi<strong>on</strong>naires,<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terviews, <str<strong>on</strong>g>in</str<strong>on</strong>g>ventories, checklists,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> stress <str<strong>on</strong>g>in</str<strong>on</strong>g>dexes. As shown <str<strong>on</strong>g>in</str<strong>on</strong>g> Table 3, the<br />
most comm<strong>on</strong> of these <str<strong>on</strong>g>in</str<strong>on</strong>g>struments used<br />
across the identified studies were the Hospital<br />
Anxiety <str<strong>on</strong>g>and</str<strong>on</strong>g> Depressi<strong>on</strong> Scale (Zigm<strong>on</strong>d &<br />
Snaith, 1983; 2 out of 19) <str<strong>on</strong>g>and</str<strong>on</strong>g> versi<strong>on</strong>s of the<br />
COPE (6 out of 19). These were the <strong>on</strong>ly<br />
comm<strong>on</strong>alities <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>struments across studies<br />
other than several researchers who used <str<strong>on</strong>g>in</str<strong>on</strong>g>terviews<br />
developed for their respective studies.<br />
528 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Stress <str<strong>on</strong>g>and</str<strong>on</strong>g> other psychological factors. Research<br />
teams discovered numerous types of<br />
stress reported by parents of children with<br />
ASD. The types of stress (<str<strong>on</strong>g>and</str<strong>on</strong>g> other psychological<br />
factors) comm<strong>on</strong>ly identified by the<br />
researchers were child related stress (e.g., acceptability,<br />
hyperactivity), depressi<strong>on</strong>, anxiety,<br />
frustrati<strong>on</strong>, social isolati<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> spousal relati<strong>on</strong>ship<br />
problems (see Table 3). Although<br />
the researchers listed these stresses with<str<strong>on</strong>g>in</str<strong>on</strong>g> separate<br />
categories, they are not necessarily mutually<br />
exclusive. For example, <strong>on</strong>e parent<br />
noted that the social isolati<strong>on</strong> she felt made<br />
her more anxious <str<strong>on</strong>g>and</str<strong>on</strong>g> frustrated (Feldman &<br />
Werner, 2002).<br />
Stress reducti<strong>on</strong> strategies. Across studies,<br />
there was no <strong>on</strong>e strategy found to be successful<br />
for reduc<str<strong>on</strong>g>in</str<strong>on</strong>g>g parental stress. While<br />
some studies found similar results, others c<strong>on</strong>trasted<br />
their f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs. D<strong>on</strong>ovan (1988) found
TABLE 3<br />
Major F<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
Stress Reducti<strong>on</strong> Strategies<br />
Effective Ineffective<br />
Study Instrument(s) Types of Stress<br />
N/R<br />
Children with autism were<br />
enrolled <str<strong>on</strong>g>in</str<strong>on</strong>g> an <str<strong>on</strong>g>in</str<strong>on</strong>g>clusi<strong>on</strong><br />
childcare program.<br />
Mothers showed significant<br />
reducti<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> child-related<br />
stress <strong>on</strong>ly.<br />
There were no significant<br />
reducti<strong>on</strong>s for fathers.<br />
Child-related stress<br />
(adaptability, acceptability,<br />
dem<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>gness, mood,<br />
distractiblitiy/hyperactivity,<br />
re<str<strong>on</strong>g>in</str<strong>on</strong>g>forces parent)<br />
Parent-related stress<br />
(depressi<strong>on</strong>, attachment,<br />
restricti<strong>on</strong> of role, sense of<br />
competence, social<br />
isolati<strong>on</strong>, relati<strong>on</strong>ship with<br />
The Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g Stress Index (PSI),<br />
Child Doma<str<strong>on</strong>g>in</str<strong>on</strong>g> subscales, Parent<br />
Doma<str<strong>on</strong>g>in</str<strong>on</strong>g> subscales<br />
Baker-Ericzen,<br />
Brookman-Frazee, &<br />
Stahmer 2005<br />
Optimistic def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong> of the<br />
situati<strong>on</strong>.<br />
Mobilizati<strong>on</strong> of family resources.<br />
Ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance <str<strong>on</strong>g>and</str<strong>on</strong>g> improvement of<br />
their own psychological well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
spouse, parent health)<br />
General (e.g., f<str<strong>on</strong>g>in</str<strong>on</strong>g>ances) Reliance up<strong>on</strong> professi<strong>on</strong>al<br />
resources <str<strong>on</strong>g>and</str<strong>on</strong>g> programs<br />
outside the family.<br />
D<strong>on</strong>ovan 1988 The Questi<strong>on</strong>naire <strong>on</strong> Resources<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Stress-Revised (QRS), The<br />
Locke-Wallace Marital<br />
Adjustment Scale-Short Form,<br />
The Cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g Health Inventory<br />
Escape-avoidance<br />
Distanc<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
External locus of c<strong>on</strong>trol<br />
Positive reappraisal<br />
C<strong>on</strong>fr<strong>on</strong>tive cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Seek social support<br />
Depressi<strong>on</strong><br />
Social Isolati<strong>on</strong><br />
Spousal Relati<strong>on</strong>ship<br />
Problems<br />
for Parents, Form D<br />
The Inventory of Socially<br />
Supportive Behaviors, Ways of<br />
Cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g Questi<strong>on</strong>naire-Revised,<br />
PSI, Internal-External Locus of<br />
C<strong>on</strong>trol Scale, Life Experiences<br />
Survey<br />
QRS, Cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g Strategy Indicator,<br />
Beck Hopelessness Scale<br />
Interviews<br />
Dunn, Burb<str<strong>on</strong>g>in</str<strong>on</strong>g>e,<br />
Bowers, & Tantleff-<br />
Dunn 2001<br />
Child related stress N/R Cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g Skills <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> Program:<br />
- Underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g stress <str<strong>on</strong>g>and</str<strong>on</strong>g> cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
- General cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies<br />
- Problem solv<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
- Relaxati<strong>on</strong> tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
- Positive th<str<strong>on</strong>g>in</str<strong>on</strong>g>k<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
- Social support<br />
Erguner-Tek<str<strong>on</strong>g>in</str<strong>on</strong>g>alp, &<br />
Akkok 2004<br />
Stress <str<strong>on</strong>g>and</str<strong>on</strong>g> Autism / 529
TABLE 3—(C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued)<br />
Stress Reducti<strong>on</strong> Strategies<br />
Effective Ineffective<br />
Study Instrument(s) Types of Stress<br />
N/R<br />
Child related stress Behavior Parent <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> (BPT)<br />
is a full service, which <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
a comprehensive functi<strong>on</strong>al<br />
assessment, a treatment plan,<br />
parent tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>and</str<strong>on</strong>g> weekly<br />
home visits.<br />
The experimental group c<strong>on</strong>sisted<br />
of families that graduated from<br />
BPT with<str<strong>on</strong>g>in</str<strong>on</strong>g> the last 5 years.<br />
Child Behavior Management<br />
Survey (CBMS), QRS-SF, Beck<br />
Depressi<strong>on</strong> Inventory (BDI),<br />
Interpers<strong>on</strong>al Support Evaluati<strong>on</strong><br />
List (ISEL), Family Quality of<br />
Life Questi<strong>on</strong>naire<br />
Feldman &<br />
Werner 2002<br />
N/R<br />
N/R<br />
Self-efficacy was not a<br />
mediat<str<strong>on</strong>g>in</str<strong>on</strong>g>g variable <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
father’s anxiety or<br />
depressi<strong>on</strong><br />
Gray 1994 Interviews (Researcher Developed) General Use of treatment services<br />
Family support<br />
Religi<strong>on</strong><br />
Social withdrawal<br />
Individualism<br />
Other<br />
Gray 2003 Semi-Structured Interviews<br />
Frustrati<strong>on</strong> Plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g appropriate resp<strong>on</strong>ses<br />
(Researcher Developed)<br />
Tak<str<strong>on</strong>g>in</str<strong>on</strong>g>g th<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <strong>on</strong>e day at a time<br />
Work<str<strong>on</strong>g>in</str<strong>on</strong>g>g with their child as a<br />
participant <str<strong>on</strong>g>in</str<strong>on</strong>g> their therapeutic<br />
regimen<br />
Keep<str<strong>on</strong>g>in</str<strong>on</strong>g>g their autistic child<br />
separated from their sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
Talk<str<strong>on</strong>g>in</str<strong>on</strong>g>g to friends <str<strong>on</strong>g>and</str<strong>on</strong>g> family<br />
Spousal support<br />
Religious cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Hast<str<strong>on</strong>g>in</str<strong>on</strong>g>gs & Brown Teacher Report versi<strong>on</strong> of the<br />
Anxiety<br />
Self-efficacy was a mediat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
2002<br />
<str<strong>on</strong>g>Developmental</str<strong>on</strong>g> Behavior<br />
Depressi<strong>on</strong><br />
variable <str<strong>on</strong>g>in</str<strong>on</strong>g> mother’s anxiety <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Checklist Parent Questi<strong>on</strong>naire<br />
depressi<strong>on</strong><br />
(Researcher Developed),<br />
Hospital Anxiety <str<strong>on</strong>g>and</str<strong>on</strong>g> Depressi<strong>on</strong><br />
Scale<br />
530 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009
TABLE 3—(C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued)<br />
Stress Reducti<strong>on</strong> Strategies<br />
Effective Ineffective<br />
Study Instrument(s) Types of Stress<br />
N/R<br />
Adaptive cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies<br />
Informal social support sources<br />
Beliefs about the efficacy of the<br />
Depressi<strong>on</strong><br />
Parent <str<strong>on</strong>g>and</str<strong>on</strong>g> Family Problems<br />
Pessimism<br />
Autism Behavior Checklist, QRS,<br />
Family Support Scale, Family<br />
Cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g Strategies<br />
Hast<str<strong>on</strong>g>in</str<strong>on</strong>g>gs & Johns<strong>on</strong><br />
2001<br />
Avoidance cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
Positive refram<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Religious cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Depressi<strong>on</strong><br />
Mental Health Problems<br />
N/R<br />
Spousal support<br />
Optimism<br />
Positive self-esteem<br />
Physical<br />
Emoti<strong>on</strong>al<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>ancial<br />
Marital relati<strong>on</strong>ship stress<br />
N/R<br />
Hast<str<strong>on</strong>g>in</str<strong>on</strong>g>gs et al. 2005 Brief-Cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g Orientati<strong>on</strong>s to<br />
Problems Experienced Scale<br />
(COPE), Hospital Anxiety <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Depressi<strong>on</strong> Scale<br />
Higg<str<strong>on</strong>g>in</str<strong>on</strong>g>s, Bailey &<br />
Demographic questi<strong>on</strong>naire,<br />
Pearce 2005<br />
Family Adaptability <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Cohesi<strong>on</strong> Evaluati<strong>on</strong> Scales<br />
(FACES II), Quality Marriage<br />
Index (QMI), Rosenberg Self-<br />
Esteem Scale, Cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g Health<br />
Inventory for Patients (CHIP)<br />
Hutt<strong>on</strong> & Car<strong>on</strong> 2005 Parent Interview (Researcher<br />
Developed)<br />
N/R<br />
Stress <strong>on</strong> marriage<br />
Adapt<str<strong>on</strong>g>in</str<strong>on</strong>g>g family schedules<br />
Safety c<strong>on</strong>cerns<br />
Structure <str<strong>on</strong>g>in</str<strong>on</strong>g> the home<br />
Fear of children with autism<br />
hurt<str<strong>on</strong>g>in</str<strong>on</strong>g>g themselves or<br />
others<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>ancial status<br />
Close c<strong>on</strong>tact with family<br />
Lack of community support members<br />
Seek<str<strong>on</strong>g>in</str<strong>on</strong>g>g advice <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong><br />
from health care<br />
professi<strong>on</strong>als<br />
Spiritual guidance<br />
General Parent support groups<br />
Refram<str<strong>on</strong>g>in</str<strong>on</strong>g>g (percepti<strong>on</strong> of<br />
stressful experience)<br />
Social support<br />
Avoidance<br />
Leyser & Dekel 1991 Parent Interview (Researcher<br />
Developed)<br />
Spiritual support<br />
Full-COPES, Demographic<br />
questi<strong>on</strong>naire (Researcher<br />
Developed)<br />
Luther, Canham, &<br />
Curet<strong>on</strong> 2005<br />
Stress <str<strong>on</strong>g>and</str<strong>on</strong>g> Autism / 531
TABLE 3—(C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued)<br />
Stress Reducti<strong>on</strong> Strategies<br />
Effective Ineffective<br />
Study Instrument(s) Types of Stress<br />
N/R<br />
Benefit f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategy (positive<br />
pers<strong>on</strong>ality change)<br />
Sense mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategy<br />
(underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g ASD)<br />
Depressi<strong>on</strong><br />
Anxiety<br />
Emoti<strong>on</strong>al stress<br />
Demographic questi<strong>on</strong>naire<br />
(Researcher Developed), The<br />
Childhood Asperger Syndrome<br />
Test (CAST), ABCX, Eyberg<br />
Child Behaviour Inventory<br />
(ECBI), Modified versi<strong>on</strong> of the<br />
Social Readjustment Rat<str<strong>on</strong>g>in</str<strong>on</strong>g>g Scale<br />
(SRRS), Brief Social support<br />
Questi<strong>on</strong>naire, Parental Stress <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the Management of Asperger<br />
Syndrome Scale, Parental Self-<br />
Efficacy Scale, COPE, Short<br />
Versi<strong>on</strong> of the Depressi<strong>on</strong><br />
Anxiety Stress Scale (DASS21),<br />
Social Adjustment Self-report<br />
Questi<strong>on</strong>naire (SAS-SR),<br />
Parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g Sense of Competence<br />
Scale, Ways of Cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g Scale,<br />
Marital Adjustment Scale,<br />
FACES, Impact-<strong>on</strong>-Family Scale,<br />
Mother-child <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong><br />
(videotaped sessi<strong>on</strong>), Social<br />
Support Questi<strong>on</strong>naire<br />
32-item Dyadic Adjustment Scale,<br />
Hassles <str<strong>on</strong>g>and</str<strong>on</strong>g> Uplifts Scale, COPE<br />
Pakenham, Sofr<strong>on</strong>off,<br />
& Samios 2004<br />
Self-blame<br />
Informati<strong>on</strong> seek<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Wish-fulfill<str<strong>on</strong>g>in</str<strong>on</strong>g>g fantasy<br />
Frustrati<strong>on</strong><br />
Anxiety<br />
Tenseness<br />
Rodrigue, Morgan, &<br />
Geffken 1990<br />
532 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Problem-focused strategies<br />
were not related to better<br />
family adjustments for<br />
mothers.<br />
Problem-focused strategies<br />
were not effective for<br />
mothers or fathers with<br />
daily hassles.<br />
Problem-focused strategies were<br />
related to better family<br />
adjustment for fathers.<br />
Family adjustment<br />
Daily Hassles<br />
St<strong>on</strong>eman & Gavidia<br />
2006
TABLE 3—(C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued)<br />
Stress Reducti<strong>on</strong> Strategies<br />
Effective Ineffective<br />
Study Instrument(s) Types of Stress<br />
N/R Negative Religious Cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g Strategies<br />
(God as unhelpful <str<strong>on</strong>g>in</str<strong>on</strong>g> parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
their child, percepti<strong>on</strong> of religious<br />
experiences as aversive to the<br />
cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g process, <str<strong>on</strong>g>and</str<strong>on</strong>g> feel<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of<br />
punishment or hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g doubts about<br />
the benevolence of God)<br />
Positive Religious Cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g Strategies<br />
(be<str<strong>on</strong>g>in</str<strong>on</strong>g>g part of God’s plan, an<br />
Depressi<strong>on</strong><br />
Anxiety<br />
Center for Epidemiological<br />
Research-Depressed Mood Scale,<br />
State-Trait Anxiety Inventory,<br />
Stress-Related Growth Scale,<br />
Brief COPE Semi structured<br />
Interviews (Researcher<br />
Developed)<br />
Tarakeshwar &<br />
Pargament 2001<br />
opportunity for spiritual growth)<br />
N/R<br />
N/R Placed less emphasis <strong>on</strong> their<br />
careers <str<strong>on</strong>g>and</str<strong>on</strong>g> more <strong>on</strong> their<br />
parental role<br />
Engaged <str<strong>on</strong>g>in</str<strong>on</strong>g> more leisure<br />
activities with extended family<br />
members<br />
Placed less emphasis <strong>on</strong> others’<br />
op<str<strong>on</strong>g>in</str<strong>on</strong>g>i<strong>on</strong>s about their child’s<br />
behavior<br />
Placed more emphasis <strong>on</strong><br />
spousal support <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
parental role <str<strong>on</strong>g>in</str<strong>on</strong>g> their<br />
discussi<strong>on</strong>s of marriage<br />
Experienced more ambiguity <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
their child’s behavior<br />
Showed a tendency toward a<br />
greater overall tolerance of<br />
ambiguity<br />
Tunali & Power 2002 Semi structured Interviews<br />
(Researcher Developed), Home/<br />
Career Questi<strong>on</strong>naire Revised<br />
Scale for Ambiguity Tolerance<br />
(AT-20), Self-Rat<str<strong>on</strong>g>in</str<strong>on</strong>g>g Depressi<strong>on</strong><br />
Scale, Short-Marital Adjustment<br />
Test (SMAT)<br />
Note. M mean; SD st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard deviati<strong>on</strong>; N/R not reported; N/A not applicable.<br />
Stress <str<strong>on</strong>g>and</str<strong>on</strong>g> Autism / 533
that parents who relied <strong>on</strong> professi<strong>on</strong>al resources<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> programs outside the family experienced<br />
decreased levels of stress. They further<br />
discovered that hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g an optimistic<br />
def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong> of the situati<strong>on</strong>, mobilizati<strong>on</strong> of<br />
family, <str<strong>on</strong>g>and</str<strong>on</strong>g> ma<str<strong>on</strong>g>in</str<strong>on</strong>g>tenance <str<strong>on</strong>g>and</str<strong>on</strong>g> improvement of<br />
their own psychological well-be<str<strong>on</strong>g>in</str<strong>on</strong>g>g were not<br />
identified as effective for decreas<str<strong>on</strong>g>in</str<strong>on</strong>g>g stress.<br />
Families <str<strong>on</strong>g>in</str<strong>on</strong>g> a study c<strong>on</strong>ducted by Luther et al.<br />
(2005) effectively coped with stress through<br />
parent support groups <str<strong>on</strong>g>and</str<strong>on</strong>g> social support.<br />
However, those researchers did not f<str<strong>on</strong>g>in</str<strong>on</strong>g>d spiritual<br />
support to be effective, which is <str<strong>on</strong>g>in</str<strong>on</strong>g> c<strong>on</strong>trast<br />
to families <str<strong>on</strong>g>in</str<strong>on</strong>g> the studies by Leyser <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Dekel (1991) <str<strong>on</strong>g>and</str<strong>on</strong>g> Gray (1994). Further, several<br />
parents across studies noted that spousal<br />
support helped them cope with stress (Gray,<br />
2003; Higg<str<strong>on</strong>g>in</str<strong>on</strong>g>s et al., 2005); yet, spousal relati<strong>on</strong>ship<br />
problems was a comm<strong>on</strong> type of<br />
stress experienced by some parents (Baker-<br />
Ericzen et al., 2005; Dunn et al., 2001; Hutt<strong>on</strong><br />
& Car<strong>on</strong>, 2005).<br />
Discussi<strong>on</strong><br />
Researchers who study familial stress f<str<strong>on</strong>g>in</str<strong>on</strong>g>d that<br />
parents of children with ASD are at an <str<strong>on</strong>g>in</str<strong>on</strong>g>creased<br />
risk for high stress levels <str<strong>on</strong>g>in</str<strong>on</strong>g> comparis<strong>on</strong><br />
to parents of children with other developmental<br />
disorders or typically develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
children. The exact source of their stress is<br />
undeterm<str<strong>on</strong>g>in</str<strong>on</strong>g>ed, but may be attributed to difficulty<br />
f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g an accurate diagnosis, deal<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
with characteristics of the child, <str<strong>on</strong>g>and</str<strong>on</strong>g> access<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
social support (Dunn et al., 2001). Further,<br />
the anxiety related to rais<str<strong>on</strong>g>in</str<strong>on</strong>g>g ag<str<strong>on</strong>g>in</str<strong>on</strong>g>g children<br />
with disabilities <str<strong>on</strong>g>in</str<strong>on</strong>g>creases over time as does the<br />
vulnerability to disrupti<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>formal supports<br />
(White & Hast<str<strong>on</strong>g>in</str<strong>on</strong>g>gs, 2004). Thus, professi<strong>on</strong>als<br />
need to provide educati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> support<br />
services early <str<strong>on</strong>g>and</str<strong>on</strong>g> l<strong>on</strong>gitud<str<strong>on</strong>g>in</str<strong>on</strong>g>ally.<br />
The perceived parental stress associated<br />
with rear<str<strong>on</strong>g>in</str<strong>on</strong>g>g a child with ASD is a c<strong>on</strong>sistent<br />
f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g (Feldman & Werner, 2002; Gray,<br />
2003; Hutt<strong>on</strong> & Car<strong>on</strong>, 2005). If a parent is<br />
c<strong>on</strong>currently experienc<str<strong>on</strong>g>in</str<strong>on</strong>g>g high levels of stress<br />
because of the recent diagnosis of the child,<br />
then the service provider may be <str<strong>on</strong>g>in</str<strong>on</strong>g>advertently<br />
add<str<strong>on</strong>g>in</str<strong>on</strong>g>g an additi<strong>on</strong>al stressor. Access to formal<br />
(e.g., parent support groups) <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>formal<br />
sources (e.g., family, friends) of social support<br />
can provide a cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g mechanism for<br />
534 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
families of children with autism (Boyd, 2002).<br />
In a review of the literature <strong>on</strong> the social<br />
support needs of mothers of children with<br />
autism, Boyd found that c<strong>on</strong>tact with supportive<br />
family members <str<strong>on</strong>g>and</str<strong>on</strong>g> parents of other children<br />
with autism decreased parental stress. It<br />
is important to note that high levels of parental<br />
stress are associated with an <str<strong>on</strong>g>in</str<strong>on</strong>g>creased likelihood<br />
that the child with autism will be<br />
placed out-of-home (Raif & Rimmerman,<br />
1993). Unfortunately for parents, as the age of<br />
their child <str<strong>on</strong>g>in</str<strong>on</strong>g>creases, their number of support<br />
opti<strong>on</strong>s often decreases. In a follow-up study<br />
of 31 Australian parents c<strong>on</strong>ducted ten years<br />
after the orig<str<strong>on</strong>g>in</str<strong>on</strong>g>al, Gray (2002) found that as<br />
children with autism aged, the number of<br />
treatment <str<strong>on</strong>g>and</str<strong>on</strong>g> support opti<strong>on</strong>s for them reduced.<br />
In additi<strong>on</strong>, M<str<strong>on</strong>g>in</str<strong>on</strong>g>nes <str<strong>on</strong>g>and</str<strong>on</strong>g> Woodford<br />
(2005) found that 65% of parents reported<br />
age-related change adversely affected their<br />
life. For example, as parents aged, they worried<br />
more about lack of services for an older<br />
child with ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> future guardianship of<br />
their child with ASD. Although levels of parental<br />
stress related to such areas as diagnosis<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> tend to subside overtime<br />
(Gray, 2002), parents’ feel<str<strong>on</strong>g>in</str<strong>on</strong>g>gs of anxiety<br />
about their children’s future come to the forefr<strong>on</strong>t.<br />
Obviously, parents need c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued access<br />
to treatment services <str<strong>on</strong>g>and</str<strong>on</strong>g> residential<br />
placement opti<strong>on</strong>s for their ag<str<strong>on</strong>g>in</str<strong>on</strong>g>g children.<br />
Hopefully, this will help to avoid the feel<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
of “pessimism about their child’s future”<br />
S<str<strong>on</strong>g>and</str<strong>on</strong>g>ers <str<strong>on</strong>g>and</str<strong>on</strong>g> Morgan (1997) found am<strong>on</strong>g<br />
parents of children with ASD <str<strong>on</strong>g>and</str<strong>on</strong>g> Down syndrome.<br />
Parents of children with ASD also report<br />
less <str<strong>on</strong>g>in</str<strong>on</strong>g>volvement <str<strong>on</strong>g>in</str<strong>on</strong>g> recreati<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
sport<str<strong>on</strong>g>in</str<strong>on</strong>g>g activities, which may c<strong>on</strong>tribute to<br />
social isolati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> subsequently higher stress<br />
levels. Provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g parents respite care services<br />
for their children or <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> <strong>on</strong> programs<br />
that provide modificati<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> accommodati<strong>on</strong>s<br />
for <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with disabilities may allow<br />
parents to participate <str<strong>on</strong>g>in</str<strong>on</strong>g> more leisure-type activities<br />
to help them cope, which has been reported<br />
to be an effective cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategy for<br />
several parents (Dunn et al., 2001; Luther et al.,<br />
2005). M<str<strong>on</strong>g>in</str<strong>on</strong>g>nes <str<strong>on</strong>g>and</str<strong>on</strong>g> Woodford (2005) found that<br />
the two greatest c<strong>on</strong>cerns of parents with children<br />
with ASD were limited access to parent<br />
support groups <str<strong>on</strong>g>and</str<strong>on</strong>g> parent educati<strong>on</strong>.
Implicati<strong>on</strong>s for Practiti<strong>on</strong>ers <str<strong>on</strong>g>and</str<strong>on</strong>g> Researchers<br />
In the field of educati<strong>on</strong>, our roles as service<br />
providers are sometimes blurred as we offer<br />
counsel<str<strong>on</strong>g>in</str<strong>on</strong>g>g, friendship, <str<strong>on</strong>g>and</str<strong>on</strong>g> support to the<br />
family who has a child with disabilities. Although<br />
these services typically are performed<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> an effort to provide family-centered support,<br />
practiti<strong>on</strong>ers can cross the l<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>in</str<strong>on</strong>g>to unfamiliar<br />
territory, which may lead to ill-c<strong>on</strong>ceived<br />
advice be<str<strong>on</strong>g>in</str<strong>on</strong>g>g given <str<strong>on</strong>g>and</str<strong>on</strong>g> or to the<br />
estrangement of the parent-provider relati<strong>on</strong>ship.<br />
One mother’s brief account of her<br />
child’s diagnostic evaluati<strong>on</strong> provides such an<br />
example: “Well, the speech therapist came out<br />
of the room <str<strong>on</strong>g>and</str<strong>on</strong>g> just flat out told me that<br />
Matthew had autism, <str<strong>on</strong>g>and</str<strong>on</strong>g> I was floored by that,<br />
but then she proceeded to say that there was a<br />
50/50 chance that the baby I was carry<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
would have autism too” (pers<strong>on</strong>al communicati<strong>on</strong>,<br />
1999). Thus, co<str<strong>on</strong>g>in</str<strong>on</strong>g>cid<str<strong>on</strong>g>in</str<strong>on</strong>g>g with <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
for children with ASD, it is imperative<br />
for practiti<strong>on</strong>ers <str<strong>on</strong>g>and</str<strong>on</strong>g> researchers to (a) help<br />
parents cope with stress, <str<strong>on</strong>g>and</str<strong>on</strong>g> (b) exam<str<strong>on</strong>g>in</str<strong>on</strong>g>e opti<strong>on</strong>s<br />
for ag<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with ASD.<br />
Address Parental Stress<br />
Researchers need to exam<str<strong>on</strong>g>in</str<strong>on</strong>g>e the various cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
strategies identified <str<strong>on</strong>g>in</str<strong>on</strong>g> this review <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
other literature <str<strong>on</strong>g>and</str<strong>on</strong>g> determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e what strategies<br />
work best for various types of parents. The<br />
research also should match the appropriate<br />
strategies to parents with similar characteristics<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e the effects <strong>on</strong> parental<br />
stress. For example, researchers may exam<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
the impact of parental educati<strong>on</strong> level or socioec<strong>on</strong>omic<br />
status <strong>on</strong> the reported parental<br />
stress <str<strong>on</strong>g>and</str<strong>on</strong>g>/or strategies that are effective. In<br />
additi<strong>on</strong>, future research may exam<str<strong>on</strong>g>in</str<strong>on</strong>g>e how<br />
cultural or l<str<strong>on</strong>g>in</str<strong>on</strong>g>guistic diversity affect parental<br />
stress <str<strong>on</strong>g>and</str<strong>on</strong>g>/or cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies that are effective.<br />
For example, are parents for whom English<br />
is not their first language more stressed<br />
because of limited access to support groups or<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> provided <str<strong>on</strong>g>in</str<strong>on</strong>g> their first (or native)<br />
language? However, to do this research, researchers<br />
may need more uniformity <str<strong>on</strong>g>in</str<strong>on</strong>g> measures<br />
used to measure stress <str<strong>on</strong>g>in</str<strong>on</strong>g> parents. When<br />
the cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies are identified <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
matched to particular stressors <str<strong>on</strong>g>and</str<strong>on</strong>g> parental<br />
characteristics <str<strong>on</strong>g>in</str<strong>on</strong>g> the research, practiti<strong>on</strong>ers<br />
may then teach parents to use the strategies<br />
that best align to their particular situati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
characteristics.<br />
Practiti<strong>on</strong>ers also could help strengthen <str<strong>on</strong>g>in</str<strong>on</strong>g>formal<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> formal sources of support for parents.<br />
For example, practiti<strong>on</strong>ers could provide<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> <strong>on</strong> counsel<str<strong>on</strong>g>in</str<strong>on</strong>g>g services for the<br />
family or marriage counsel<str<strong>on</strong>g>in</str<strong>on</strong>g>g. However, practiti<strong>on</strong>ers<br />
should be careful about immediately<br />
assum<str<strong>on</strong>g>in</str<strong>on</strong>g>g couples need <str<strong>on</strong>g>in</str<strong>on</strong>g>tensive marriage<br />
counsel<str<strong>on</strong>g>in</str<strong>on</strong>g>g. In additi<strong>on</strong>, practiti<strong>on</strong>ers could<br />
identify programs such as ‘parent night out’<br />
where organizati<strong>on</strong>s provide care for children<br />
with ASD so couples can focus <strong>on</strong> strengthen<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
their relati<strong>on</strong>ships.<br />
Opti<strong>on</strong>s<br />
Another area under researched that is related<br />
to stress of parents of children with ASD, particularly<br />
to those of ag<str<strong>on</strong>g>in</str<strong>on</strong>g>g children, is treatment<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> opti<strong>on</strong>s for older <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals <strong>on</strong> the<br />
autism spectrum. For example, what do parents<br />
do who have ag<str<strong>on</strong>g>in</str<strong>on</strong>g>g children with lower<br />
functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g autism? Currently, there is little to<br />
no research with this sub-populati<strong>on</strong>. Also,<br />
parents need to know service opti<strong>on</strong>s that may<br />
help them plan for transiti<strong>on</strong>s to work or postsec<strong>on</strong>dary<br />
placements. These opti<strong>on</strong>s may <str<strong>on</strong>g>in</str<strong>on</strong>g>clude<br />
such services as vocati<strong>on</strong>al rehab, private<br />
organizati<strong>on</strong>s that provide tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g, a<br />
university that has support programs for <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with ASD. Provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g parents with these<br />
supports <str<strong>on</strong>g>and</str<strong>on</strong>g> opti<strong>on</strong>s may help alleviate some<br />
stress.<br />
C<strong>on</strong>clusi<strong>on</strong><br />
In summary, the reported parental stress associated<br />
with rear<str<strong>on</strong>g>in</str<strong>on</strong>g>g a child with autism is a<br />
c<strong>on</strong>sistent f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g (Feldman & Werner, 2002;<br />
Gray, 2003; Hutt<strong>on</strong> & Car<strong>on</strong>, 2005). As a result<br />
of this f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g, a number of researchers<br />
have begun to identify cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies parents<br />
employ to cope with the stressors of rear<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
a child with ASD. The research <str<strong>on</strong>g>in</str<strong>on</strong>g> this area<br />
has not been c<strong>on</strong>sistent. Across studies identified<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the current literature review, there was<br />
no <strong>on</strong>e strategy found to be successful for<br />
reduc<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g>/or cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g with parental stress.<br />
Future research teams should exam<str<strong>on</strong>g>in</str<strong>on</strong>g>e the<br />
various cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies identified <str<strong>on</strong>g>in</str<strong>on</strong>g> this review<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> other literature <str<strong>on</strong>g>and</str<strong>on</strong>g> determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e what<br />
strategies work best for various types of par-<br />
Stress <str<strong>on</strong>g>and</str<strong>on</strong>g> Autism / 535
ents. Research also should match the appropriate<br />
strategies to parents with similar characteristics<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e the effects <strong>on</strong><br />
parental stress.<br />
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St<strong>on</strong>eman, Z., & Gavidia-Payne, S. (2006). Marital<br />
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with severe <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities. Journal of Applied<br />
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(1989). Brief report: Psychological effects of parent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
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166<br />
Zigm<strong>on</strong>d A. S., & Snaith R. P., (1983): The hospital<br />
anxiety <str<strong>on</strong>g>and</str<strong>on</strong>g> depressi<strong>on</strong> scale. Acta Psychiatr Sc<str<strong>on</strong>g>and</str<strong>on</strong>g>,<br />
67, 361–70.<br />
Received: 26 March 2008<br />
Initial Acceptance: 1 June 2008<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>al Acceptance: 15 November 2008<br />
Stress <str<strong>on</strong>g>and</str<strong>on</strong>g> Autism / 537
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, 2009, 44(4), 538–550<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Organizati<strong>on</strong>al Skills to Children with High<br />
Functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g Autism <str<strong>on</strong>g>and</str<strong>on</strong>g> Asperger’s Syndrome<br />
Kimberly Powers Dorm<str<strong>on</strong>g>in</str<strong>on</strong>g>y, Deanna Luscre, <str<strong>on</strong>g>and</str<strong>on</strong>g> David L. Gast<br />
University of Georgia<br />
Abstract: A multiple basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e design across participants was used to evaluate the effectiveness of a file box system<br />
plus self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> the organizati<strong>on</strong>al skills of four fourth <str<strong>on</strong>g>and</str<strong>on</strong>g> fifth grade students with high functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
autism (HFA) <str<strong>on</strong>g>and</str<strong>on</strong>g> Asperger’s Syndrome (AS). Instructi<strong>on</strong> took place <str<strong>on</strong>g>in</str<strong>on</strong>g> general educati<strong>on</strong> classrooms <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
c<strong>on</strong>sisted of teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g students to arrange academic materials (worksheets, note pages, study guides etc.) <str<strong>on</strong>g>in</str<strong>on</strong>g> a<br />
portable file box with hang<str<strong>on</strong>g>in</str<strong>on</strong>g>g folders. Students were also taught to self-m<strong>on</strong>itor their accuracy. The percentage<br />
of correctly filed items <str<strong>on</strong>g>and</str<strong>on</strong>g> the number of sec<strong>on</strong>ds it took students’ to retrieve requested items were the dependent<br />
variables assessed across c<strong>on</strong>diti<strong>on</strong>s. Results showed that the percentage of correctly filed items <str<strong>on</strong>g>in</str<strong>on</strong>g>creased <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
number of sec<strong>on</strong>ds required to locate specific items decreased with the use of the file system box. These f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
dem<strong>on</strong>strate how a simple n<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>vasive <str<strong>on</strong>g>and</str<strong>on</strong>g> affordable classroom modificati<strong>on</strong> can improve performance of<br />
children with HFA <str<strong>on</strong>g>and</str<strong>on</strong>g> AS <str<strong>on</strong>g>in</str<strong>on</strong>g> general educati<strong>on</strong> classrooms.<br />
Autistic disorder (AD) is a neurodevelopmental<br />
disability with vary<str<strong>on</strong>g>in</str<strong>on</strong>g>g degrees of qualitative<br />
impairments <str<strong>on</strong>g>in</str<strong>on</strong>g> social <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> communicati<strong>on</strong>,<br />
stereotypic repetitive <str<strong>on</strong>g>in</str<strong>on</strong>g>terests or behaviors,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> delays <str<strong>on</strong>g>in</str<strong>on</strong>g> social <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>, communicative<br />
language or play (American<br />
Psychiatric Associati<strong>on</strong>, 2000). Children with<br />
Asperger’s Syndrome (AS) subsume the social<br />
impairment of AD, but reta<str<strong>on</strong>g>in</str<strong>on</strong>g> an <str<strong>on</strong>g>in</str<strong>on</strong>g>terest <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
others, whom they distance by their socially<br />
odd behaviors (Elder, Cater<str<strong>on</strong>g>in</str<strong>on</strong>g>o, Chao, Shacknai,<br />
& De Sim<strong>on</strong>e, 2006). Circumscribed <str<strong>on</strong>g>in</str<strong>on</strong>g>terests<br />
are present as <str<strong>on</strong>g>in</str<strong>on</strong>g> AS, but often are<br />
c<strong>on</strong>f<str<strong>on</strong>g>in</str<strong>on</strong>g>ed to amass<str<strong>on</strong>g>in</str<strong>on</strong>g>g large amounts of <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong><br />
about a specific topic (Tantam, 1991).<br />
Unlike AD, speech develops normally <str<strong>on</strong>g>in</str<strong>on</strong>g> children<br />
with AS, but n<strong>on</strong>verbal pragmatic abnormalities<br />
make social c<strong>on</strong>versati<strong>on</strong>s pedantic<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> unproductive (Asperger, 1991). Absent<br />
from diagnostic criteria, yet prom<str<strong>on</strong>g>in</str<strong>on</strong>g>ent <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
both autism <str<strong>on</strong>g>and</str<strong>on</strong>g> Asperger syndrome (Penn<str<strong>on</strong>g>in</str<strong>on</strong>g>gt<strong>on</strong>,<br />
Bennetto, McAlcer, & Roberts, 1996)<br />
are difficulty with <str<strong>on</strong>g>in</str<strong>on</strong>g>hibiti<strong>on</strong>, <str<strong>on</strong>g>in</str<strong>on</strong>g>itiati<strong>on</strong>, attenti<strong>on</strong>,<br />
flexibility, <str<strong>on</strong>g>and</str<strong>on</strong>g> self regulati<strong>on</strong>, comm<strong>on</strong>ly<br />
associated with the “organizati<strong>on</strong>al aspect of<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g this article should<br />
be addressed to Deanna Luscre, 3250 Brown<br />
Thrasher Trace, Cumm<str<strong>on</strong>g>in</str<strong>on</strong>g>g, GA 30041.<br />
538 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
executive functi<strong>on</strong>” (Killiani, Moore, Rehbe<str<strong>on</strong>g>in</str<strong>on</strong>g>,<br />
& Moss, 2005).<br />
Executive functi<strong>on</strong>s are “bra<str<strong>on</strong>g>in</str<strong>on</strong>g>-based skills”<br />
(p. 817) that beg<str<strong>on</strong>g>in</str<strong>on</strong>g> to develop <str<strong>on</strong>g>in</str<strong>on</strong>g> the first years<br />
of life (Griffith, Penn<str<strong>on</strong>g>in</str<strong>on</strong>g>gt<strong>on</strong>, Wehner, & Rogers,<br />
1999) <str<strong>on</strong>g>and</str<strong>on</strong>g> result <str<strong>on</strong>g>in</str<strong>on</strong>g> “the ability to ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
an appropriate problem-solv<str<strong>on</strong>g>in</str<strong>on</strong>g>g set for atta<str<strong>on</strong>g>in</str<strong>on</strong>g>ment<br />
of a future goal” (Welsh & Penn<str<strong>on</strong>g>in</str<strong>on</strong>g>gt<strong>on</strong><br />
(1988, p.201). Children with autism spectrum<br />
disorders (ASD) have c<strong>on</strong>sistently dem<strong>on</strong>strated<br />
impaired executive functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g deficits<br />
<strong>on</strong> tests that measure plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>in</str<strong>on</strong>g>hibit<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
pre-potent resp<strong>on</strong>ses, <str<strong>on</strong>g>and</str<strong>on</strong>g> mental flexibility<br />
(Hill, 2003). Deficiencies <str<strong>on</strong>g>in</str<strong>on</strong>g> executive functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
may be primary cognitive deficits <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
autism (Oz<strong>on</strong>off & Jensen, 1999).<br />
Although more positive outcomes are associated<br />
with AS than AD (Kl<str<strong>on</strong>g>in</str<strong>on</strong>g>, Sparrow, Marans,<br />
Carter, & Volkmar, 2000), both disorders<br />
result <str<strong>on</strong>g>in</str<strong>on</strong>g> classroom performance deficits.<br />
Neuropsychological profiles of children with<br />
AS, which <str<strong>on</strong>g>in</str<strong>on</strong>g>clude deficits <str<strong>on</strong>g>in</str<strong>on</strong>g> f<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>and</str<strong>on</strong>g> gross<br />
motor skills, visual motor <str<strong>on</strong>g>in</str<strong>on</strong>g>tegrati<strong>on</strong>, visual<br />
spatial percepti<strong>on</strong>, n<strong>on</strong>verbal c<strong>on</strong>cept formati<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> visual memory, are c<strong>on</strong>sistent with<br />
n<strong>on</strong>verbal learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g disabilities (Kl<str<strong>on</strong>g>in</str<strong>on</strong>g>, McPartl<str<strong>on</strong>g>and</str<strong>on</strong>g>,<br />
& Volkmar, 2005, p. 103). <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>al<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s (e.g., develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g visual-spatial<br />
organizati<strong>on</strong>al skills) used for children with<br />
high functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g autism (HFA), Asperger’s
Syndrome (AS), <str<strong>on</strong>g>and</str<strong>on</strong>g> n<strong>on</strong>verbal learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g disabilities<br />
(NLD) are often <str<strong>on</strong>g>in</str<strong>on</strong>g>terchangeable<br />
(Hooper & Bundy, 1998).<br />
Students with HFA <str<strong>on</strong>g>and</str<strong>on</strong>g> AS, are <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>gly<br />
return<str<strong>on</strong>g>in</str<strong>on</strong>g>g to general educati<strong>on</strong> classrooms<br />
from pull-out programs (T<str<strong>on</strong>g>in</str<strong>on</strong>g>cani, 2007; Simps<strong>on</strong>,<br />
2004). A summary objective when teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
students with disabilities <str<strong>on</strong>g>in</str<strong>on</strong>g> a general educati<strong>on</strong><br />
classroom is to provide them with<br />
skills to become <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent learners. Children<br />
with HFA or AS often depend <strong>on</strong> adults<br />
for complet<str<strong>on</strong>g>in</str<strong>on</strong>g>g assignments, transiti<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g between<br />
activities, <str<strong>on</strong>g>and</str<strong>on</strong>g> stay<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong>-task (Bryan &<br />
Gast, 2000; Giangreco, Edelman, Luiselli, &<br />
MacFarl<str<strong>on</strong>g>and</str<strong>on</strong>g>, 1997). Once adult support is provided<br />
they frequently learn to rely <strong>on</strong> support<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the future. Young, Simps<strong>on</strong>, Myles, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Kamps (1997) reported that when paraprofessi<strong>on</strong>als<br />
were more than 2 feet from assigned<br />
students with autism, greater <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong> occurred<br />
with the general educati<strong>on</strong> classroom<br />
teacher. In order to reduce reliance <strong>on</strong> adults<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> prompt dependency students with ASD<br />
need to be taught how to <str<strong>on</strong>g>in</str<strong>on</strong>g>dependently access<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> (Simps<strong>on</strong>, 2001, 2004).<br />
Students with ASD comm<strong>on</strong>ly experience<br />
difficulty organiz<str<strong>on</strong>g>in</str<strong>on</strong>g>g their thoughts <str<strong>on</strong>g>and</str<strong>on</strong>g> process<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
auditory stimuli. When teachers, students,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> educati<strong>on</strong>al pers<strong>on</strong>nel can enter a<br />
classroom <str<strong>on</strong>g>and</str<strong>on</strong>g> underst<str<strong>on</strong>g>and</str<strong>on</strong>g> classroom expectati<strong>on</strong>s,<br />
structure is <str<strong>on</strong>g>in</str<strong>on</strong>g> place (Iovann<strong>on</strong>e, Dunlap,<br />
Huber, & K<str<strong>on</strong>g>in</str<strong>on</strong>g>caid, 2003). Visual supports<br />
for children with autism compensate for difficulties<br />
they experience <str<strong>on</strong>g>in</str<strong>on</strong>g> attenti<strong>on</strong>, auditory<br />
process<str<strong>on</strong>g>in</str<strong>on</strong>g>g, sequenc<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>and</str<strong>on</strong>g> organizati<strong>on</strong><br />
(Hodgd<strong>on</strong>, 1995). These supports serve as visual<br />
cues that <str<strong>on</strong>g>in</str<strong>on</strong>g>crease compliance by rem<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
students of behaviors they are expected to<br />
exhibit (Odom et al., 2003). When correctly<br />
implemented, visual supports can help children<br />
with ASD sequence daily events, organize<br />
their envir<strong>on</strong>ment, <str<strong>on</strong>g>and</str<strong>on</strong>g> prepare for transiti<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
to another activity (Quill, 1995; Hodgd<strong>on</strong>,<br />
1995). Structured teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> envir<strong>on</strong>mental<br />
modificati<strong>on</strong>s will <str<strong>on</strong>g>in</str<strong>on</strong>g>crease the child’s <str<strong>on</strong>g>in</str<strong>on</strong>g>dependence<br />
by mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g the envir<strong>on</strong>ment <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
its expectati<strong>on</strong>s more underst<str<strong>on</strong>g>and</str<strong>on</strong>g>able (Mesibov,<br />
Shea, & Schopler, 2005, chap. 4).<br />
Organizati<strong>on</strong> is a fundamental pr<str<strong>on</strong>g>in</str<strong>on</strong>g>ciple of<br />
structure that supports the acquisiti<strong>on</strong> of language,<br />
appropriate behavior, social <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> academic goals (Iovann<strong>on</strong>e et al.,<br />
2003). Visual organizati<strong>on</strong>al supports, such as<br />
picture schedules or work systems are visual<br />
strategies c<strong>on</strong>sidered as st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard for many<br />
children with autism (Prizant & Wetherby,<br />
2005; Odom et al., 2003). Children with autism<br />
frequently have difficulty organiz<str<strong>on</strong>g>in</str<strong>on</strong>g>g pers<strong>on</strong>al<br />
bel<strong>on</strong>g<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> school related materials<br />
(Arick, Krug, Fullert<strong>on</strong>, Loos, & Falco, 2005).<br />
A recent <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigati<strong>on</strong> of the needs of college<br />
students with ASD emphasized that for student<br />
success there is a need for organizati<strong>on</strong>al<br />
strategies, due to executive functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g deficits,<br />
(Adre<strong>on</strong> & Durocher, 2007). The earlier<br />
students <strong>on</strong> the autism spectrum are taught<br />
organizati<strong>on</strong>al strategies the greater the likelihood<br />
they will succeed <str<strong>on</strong>g>in</str<strong>on</strong>g> their educati<strong>on</strong>al,<br />
vocati<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> pers<strong>on</strong>al pursuits.<br />
Visual schedules have been shown to be<br />
effective <str<strong>on</strong>g>in</str<strong>on</strong>g> help<str<strong>on</strong>g>in</str<strong>on</strong>g>g students with ASD organize<br />
their daily activities. They have also been<br />
shown to be effective <str<strong>on</strong>g>in</str<strong>on</strong>g> teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g students to<br />
transiti<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>dependently, thus reduc<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
need for adult prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g. Dettmer, Simps<strong>on</strong>,<br />
Myles, <str<strong>on</strong>g>and</str<strong>on</strong>g> Ganz (2000), for example, taught<br />
two elementary aged boys with autism to follow<br />
a portable schedule of daily activities assembled<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> a photo album. This resulted <str<strong>on</strong>g>in</str<strong>on</strong>g> a<br />
substantial decrease <str<strong>on</strong>g>in</str<strong>on</strong>g> prompts delivered by<br />
the teacher <str<strong>on</strong>g>and</str<strong>on</strong>g> a reducti<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> the time it took<br />
students to resp<strong>on</strong>d to adult <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>s at<br />
home <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> the community. Visual activity<br />
schedules have also been successful <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the <strong>on</strong>-task <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>on</strong>-schedule behaviors of<br />
elementary students with ASD (Bryan & Gast,<br />
2000). Stromer, Kimball, K<str<strong>on</strong>g>in</str<strong>on</strong>g>ney, <str<strong>on</strong>g>and</str<strong>on</strong>g> Taylor<br />
(2006) dem<strong>on</strong>strated how activity schedules,<br />
presented <strong>on</strong> a computer, could enhance students’<br />
ability to use multiple cues <str<strong>on</strong>g>and</str<strong>on</strong>g> then<br />
generalize <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> to the classroom envir<strong>on</strong>ment.<br />
They admitted, however, that computers<br />
were more expensive, more time c<strong>on</strong>sum<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> less portable than simple visual<br />
activity schedules.<br />
Self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g has also been shown to be<br />
an effective strategy for <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
performance by children with ASD.<br />
Shearer, Kohler, Buchan, <str<strong>on</strong>g>and</str<strong>on</strong>g> McCullough<br />
(1996) taught three preschoolers to m<strong>on</strong>itor<br />
their activity engagement <str<strong>on</strong>g>and</str<strong>on</strong>g> social <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong><br />
by mov<str<strong>on</strong>g>in</str<strong>on</strong>g>g beads to <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate a completed<br />
social exchange, a self-management skill as<br />
efficient as prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g by an adult. Students<br />
who learn self-regulati<strong>on</strong> strategies require<br />
less support from peers <str<strong>on</strong>g>and</str<strong>on</strong>g> adults, <str<strong>on</strong>g>and</str<strong>on</strong>g> are<br />
Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Organizati<strong>on</strong>al Skills / 539
viewed by others as hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g greater learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
potential than previously dem<strong>on</strong>strated (Wehmeyer,<br />
Yeager, Bold<str<strong>on</strong>g>in</str<strong>on</strong>g>g, Agran, & Hughes,<br />
2003). Shimabukuro, Prater, Jenk<str<strong>on</strong>g>in</str<strong>on</strong>g>s, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Edelen-Smith (1999) <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigated the effects<br />
of self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> the academic performance<br />
of students with learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g disabilities.<br />
Results were <str<strong>on</strong>g>in</str<strong>on</strong>g>creased academic productivity,<br />
accuracy, <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>on</strong>-task behavior dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent<br />
work. Ga<str<strong>on</strong>g>in</str<strong>on</strong>g>s <str<strong>on</strong>g>in</str<strong>on</strong>g> productivity were<br />
greater than ga<str<strong>on</strong>g>in</str<strong>on</strong>g>s <str<strong>on</strong>g>in</str<strong>on</strong>g> accuracy, but an improvement<br />
was seen <str<strong>on</strong>g>in</str<strong>on</strong>g> both areas <strong>on</strong>ce students<br />
learned the self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g procedure<br />
(Shimabukuro et al., 1999).<br />
Self-evaluati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> the form of goal sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> self-graph<str<strong>on</strong>g>in</str<strong>on</strong>g>g the number of daily homework<br />
assignments completed, resulted <str<strong>on</strong>g>in</str<strong>on</strong>g> enhanced<br />
homework completi<strong>on</strong> for middle<br />
school students with learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g disabilities<br />
(Trammel & Schloss 1994). A seventeen year<br />
old boy with AS <str<strong>on</strong>g>in</str<strong>on</strong>g>creased <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent homework<br />
assignment record<str<strong>on</strong>g>in</str<strong>on</strong>g>g across academic<br />
subjects through the use of a pers<strong>on</strong>al digital<br />
assistant (Myles, Fergus<strong>on</strong>, & Hagiwara, 2007).<br />
Results suggest that teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g students with<br />
HFA <str<strong>on</strong>g>and</str<strong>on</strong>g> AS to self-m<strong>on</strong>itor their academic<br />
behaviors is a useful skill throughout their<br />
educati<strong>on</strong>.<br />
Effective organizati<strong>on</strong>al strategies are required<br />
for success <str<strong>on</strong>g>in</str<strong>on</strong>g> all educati<strong>on</strong>al sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
regardless of level. Elementary age students<br />
with ASD, for example, need to learn how to<br />
retrieve books, notebooks, papers etc. from an<br />
array of materials, when requested to do so,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> they need to do so <str<strong>on</strong>g>in</str<strong>on</strong>g> a reas<strong>on</strong>able<br />
amount of time. This requires that that they<br />
learn an effective <str<strong>on</strong>g>and</str<strong>on</strong>g> efficient strategy that<br />
doesn’t call undue attenti<strong>on</strong> to their executive<br />
functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g deficits. By the time students transiti<strong>on</strong><br />
to middle school, particularly if they are<br />
fully <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> the general educati<strong>on</strong> program,<br />
they are expected to <str<strong>on</strong>g>in</str<strong>on</strong>g>dependently organize<br />
their school materials <str<strong>on</strong>g>and</str<strong>on</strong>g> locate items<br />
with<str<strong>on</strong>g>in</str<strong>on</strong>g> a reas<strong>on</strong>able time period. With this<br />
objective <str<strong>on</strong>g>in</str<strong>on</strong>g> m<str<strong>on</strong>g>in</str<strong>on</strong>g>d, the current study was designed<br />
to answer the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g questi<strong>on</strong>s: Will<br />
elementary age children with HFA <str<strong>on</strong>g>and</str<strong>on</strong>g> AS, a)<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>crease the percentage of items correctly<br />
filed across a school day, <str<strong>on</strong>g>and</str<strong>on</strong>g> b) decrease the<br />
number of sec<strong>on</strong>ds needed to retrieve a requested<br />
item when us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a file box organizati<strong>on</strong>al<br />
system?<br />
Method<br />
Participants<br />
540 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Four Caucasian male students attend<str<strong>on</strong>g>in</str<strong>on</strong>g>g a<br />
public school <str<strong>on</strong>g>in</str<strong>on</strong>g> a large metropolitan city <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
rang<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> ages 9 years 4 m<strong>on</strong>ths to 10 years 3<br />
m<strong>on</strong>ths participated <str<strong>on</strong>g>in</str<strong>on</strong>g> this study.<br />
All students met Georgia eligibility requirements<br />
for autism which were characteristics<br />
impact<str<strong>on</strong>g>in</str<strong>on</strong>g>g (1) developmental rates <str<strong>on</strong>g>and</str<strong>on</strong>g> sequences,<br />
(2) social <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> participati<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> (3) verbal <str<strong>on</strong>g>and</str<strong>on</strong>g> n<strong>on</strong>-verbal communicati<strong>on</strong><br />
result<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> an adverse effect <strong>on</strong> a<br />
student’s educati<strong>on</strong>al performance (Georgia<br />
Department of <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>, 2008a). Three of<br />
the students were eligible for special educati<strong>on</strong><br />
services under Georgia autism eligibility<br />
criteria because of behaviors associated with<br />
Asperger’s Syndrome (AS). Georgia autism eligibility<br />
can apply to students with other<br />
DSM-IV spectrum disorders <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g Asperger’s<br />
syndrome (Georgia Department of <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>,<br />
2008b). One student received Georgia<br />
autism eligibility based <strong>on</strong> characteristics associated<br />
with high functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g autism. Table 1<br />
presents diagnostic <str<strong>on</strong>g>and</str<strong>on</strong>g> related <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong>.<br />
All students were <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded full time <str<strong>on</strong>g>in</str<strong>on</strong>g> a general<br />
educati<strong>on</strong> classroom <str<strong>on</strong>g>and</str<strong>on</strong>g> received support<br />
services from the special educati<strong>on</strong><br />
teacher or a paraprofessi<strong>on</strong>al two to five hours<br />
per day. The rema<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g time <str<strong>on</strong>g>in</str<strong>on</strong>g> the general<br />
educati<strong>on</strong> classroom was spent without special<br />
support.<br />
Evan received autism support five hours per<br />
day <str<strong>on</strong>g>in</str<strong>on</strong>g> the general educati<strong>on</strong> fourth grade<br />
classroom <str<strong>on</strong>g>and</str<strong>on</strong>g> attended the gifted educati<strong>on</strong><br />
program for four hours per week. Although<br />
Evan had an above average cognitive ability,<br />
his lack of organizati<strong>on</strong>al skills adversely affected<br />
his performance <str<strong>on</strong>g>in</str<strong>on</strong>g> the classroom. He<br />
completed assignments accurately <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
quickly, but put them <str<strong>on</strong>g>in</str<strong>on</strong>g> his desk where they<br />
were forgotten, lost or thrown away before<br />
they were turned <str<strong>on</strong>g>in</str<strong>on</strong>g> to teachers to be graded.<br />
Ben, a fifth grader, received two <str<strong>on</strong>g>and</str<strong>on</strong>g> a half<br />
hours of special educati<strong>on</strong> support per day <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the general educati<strong>on</strong> classroom. Despite an<br />
average full scale IQ, Ben had difficulty organiz<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
his school materials. Due to a deficit <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
fluency, he did not f<str<strong>on</strong>g>in</str<strong>on</strong>g>ish work <str<strong>on</strong>g>in</str<strong>on</strong>g> the time<br />
allotted <str<strong>on</strong>g>and</str<strong>on</strong>g> was expected to complete it at<br />
a later time. He often put unf<str<strong>on</strong>g>in</str<strong>on</strong>g>ished assign-
TABLE 1<br />
Descripti<strong>on</strong> of Participants<br />
St<str<strong>on</strong>g>and</str<strong>on</strong>g>ardized Achievement<br />
Scores<br />
Autism<br />
Eligibility SPED Support WISC-IV*<br />
Participants Grade Age<br />
WJ-III** :<br />
Oral Expressi<strong>on</strong>: 108<br />
Broad Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g: 114<br />
Academic Skills: 122<br />
Academic Knowledge: 110<br />
WJ-III**:<br />
Oral language: 117<br />
Story Recall: 144<br />
Academic Fluency: 77<br />
Writ<str<strong>on</strong>g>in</str<strong>on</strong>g>g fluency: 83<br />
Applied Problems: 105<br />
WJ-III**:<br />
Broad read<str<strong>on</strong>g>in</str<strong>on</strong>g>g: 99<br />
Basic read<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills: 110<br />
Academic skills: 100<br />
Academic fluency: 102<br />
K-TEA***:<br />
Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g Decod<str<strong>on</strong>g>in</str<strong>on</strong>g>g: 98<br />
Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g Comprehensi<strong>on</strong>: 88<br />
Full Scale: 120<br />
Verbal: 102<br />
Perceptual<br />
Reas<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g: 135<br />
5 hrs autism per day<br />
4 hrs gifted per wk<br />
Asperger<br />
Syndrome<br />
Evan fifth 9 years 4<br />
m<strong>on</strong>ths<br />
2.5 hrs autism per day Full Scale: 100<br />
Verbal: 119<br />
Perceptual<br />
Reas<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g: 100<br />
Asperger<br />
Syndrome<br />
Ben fifth 10 years 3<br />
m<strong>on</strong>ths<br />
Autism 3 hrs. autism per day No Full Scale IQ<br />
Available<br />
Jake fourth 9 years 10<br />
m<strong>on</strong>ths<br />
5.5 hrs. autism per day Full Scale: 86<br />
Verbal: 110<br />
Perceptual<br />
Reas<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g: 84<br />
Asperger<br />
Syndrome<br />
Patrick fourth 9 years 11<br />
m<strong>on</strong>ths<br />
* WISC-IV Wechsler Intelligence Scale for Children-Fourth Editi<strong>on</strong> (Wechsler, 2004).<br />
** WJ-III Woodcock Johns<strong>on</strong> III (Woodcock, McGrew & Mather, 2000).<br />
*** K-TEA Kaufman Test of <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>al Achievement (Kaufman & Kaufman, 1985).<br />
Special <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> support from autism program was not <strong>on</strong>e/<strong>on</strong>e, but shared with other students with autism placed <str<strong>on</strong>g>in</str<strong>on</strong>g> the regular educati<strong>on</strong> classroom.<br />
Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Organizati<strong>on</strong>al Skills / 541
ments <str<strong>on</strong>g>in</str<strong>on</strong>g> his desk, under books, or with other<br />
assignments <str<strong>on</strong>g>and</str<strong>on</strong>g> forgot or lost them. Fail<str<strong>on</strong>g>in</str<strong>on</strong>g>g to<br />
complete or turn <str<strong>on</strong>g>in</str<strong>on</strong>g> assignments negatively<br />
affected Ben’s grades.<br />
Jake received three hours of special educati<strong>on</strong><br />
support per day <str<strong>on</strong>g>in</str<strong>on</strong>g> the general educati<strong>on</strong><br />
classroom. Although Jake completed gradelevel<br />
assignments rapidly <str<strong>on</strong>g>and</str<strong>on</strong>g> accurately, he<br />
did not put them <str<strong>on</strong>g>in</str<strong>on</strong>g> the appropriate folder,<br />
but put them <str<strong>on</strong>g>in</str<strong>on</strong>g> his desk where they became<br />
lost <str<strong>on</strong>g>and</str<strong>on</strong>g> subsequently were not turned <str<strong>on</strong>g>in</str<strong>on</strong>g> to be<br />
graded. Jake needed to improve his ability to<br />
file completed work <str<strong>on</strong>g>in</str<strong>on</strong>g> the classroom. Jake<br />
had deficits <str<strong>on</strong>g>in</str<strong>on</strong>g> gross/f<str<strong>on</strong>g>in</str<strong>on</strong>g>e motor abilities, preservative/stereotypical<br />
behaviors, <str<strong>on</strong>g>and</str<strong>on</strong>g> delays<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> pragmatic language.<br />
Patrick received five <str<strong>on</strong>g>and</str<strong>on</strong>g> a half hours of<br />
special educati<strong>on</strong> support per day <str<strong>on</strong>g>in</str<strong>on</strong>g> the general<br />
educati<strong>on</strong> classroom where his performance<br />
was <str<strong>on</strong>g>in</str<strong>on</strong>g> the “low average” range. Three<br />
of these hours were provided <str<strong>on</strong>g>in</str<strong>on</strong>g> a <strong>on</strong>e-<strong>on</strong>-<strong>on</strong>e<br />
arrangement <str<strong>on</strong>g>in</str<strong>on</strong>g> the general educati<strong>on</strong> classroom<br />
from the special educator or paraprofessi<strong>on</strong>al.<br />
Support was provided to help<br />
Patrick complete his assignments <str<strong>on</strong>g>and</str<strong>on</strong>g> submit<br />
them to the appropriate teacher <str<strong>on</strong>g>in</str<strong>on</strong>g> a timely<br />
manner. Patrick f<str<strong>on</strong>g>in</str<strong>on</strong>g>ished assignments <str<strong>on</strong>g>and</str<strong>on</strong>g>,<br />
like other participants, put them <str<strong>on</strong>g>in</str<strong>on</strong>g> his desk or<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>side unrelated books <str<strong>on</strong>g>and</str<strong>on</strong>g> when asked was<br />
unable to f<str<strong>on</strong>g>in</str<strong>on</strong>g>d them result<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> a zero grade.<br />
Prior to the study all participants were assisted<br />
by the special educati<strong>on</strong> teacher or<br />
paraprofessi<strong>on</strong>al to retrieve <str<strong>on</strong>g>and</str<strong>on</strong>g> organize required<br />
materials. Over time, it became evident<br />
that for these students to become successful<br />
learners, <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent fil<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> retriev<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
strategies needed to be learned. Participants’<br />
IEPs <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded goals to improve organizati<strong>on</strong>al<br />
skills. N<strong>on</strong>e of the participants had previous<br />
experience with the file box system to organize<br />
class materials, but did have experience<br />
with visual strategies, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g activity schedules<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> behavioral prompts (e.g., posted<br />
classroom rules, h<str<strong>on</strong>g>and</str<strong>on</strong>g> gestures etc.). No other<br />
organizati<strong>on</strong>al strategies had been attempted<br />
with students.<br />
Students were selected for participati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the study because of their full <str<strong>on</strong>g>in</str<strong>on</strong>g>clusi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
general educati<strong>on</strong> classroom, with the expectati<strong>on</strong><br />
that they could perform at grade level,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> their organizati<strong>on</strong>al skill deficits that negatively<br />
impacted their progress. All students<br />
had good attendance records hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g missed<br />
six or fewer school days the previous year.<br />
Parents signed c<strong>on</strong>sent forms <str<strong>on</strong>g>and</str<strong>on</strong>g> students<br />
signed assent forms prior to the start of the<br />
study.<br />
Sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>and</str<strong>on</strong>g> Arrangements<br />
Basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s were<br />
c<strong>on</strong>ducted <str<strong>on</strong>g>in</str<strong>on</strong>g> three general educati<strong>on</strong> classrooms<br />
(two fourth grade classes <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>on</strong>e fifth<br />
grade class) throughout the school day. Generalizati<strong>on</strong><br />
assessments were adm<str<strong>on</strong>g>in</str<strong>on</strong>g>istered <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
students’ homes by parents. Classroom arrangements<br />
were similar <str<strong>on</strong>g>in</str<strong>on</strong>g> each of the classrooms.<br />
Student desks were arranged <str<strong>on</strong>g>in</str<strong>on</strong>g> clusters<br />
of five to six desks. Participants did not sit<br />
at the same cluster. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> each<br />
student had his fil<str<strong>on</strong>g>in</str<strong>on</strong>g>g box sitt<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> the floor<br />
beside his desk for easy access. Most of the<br />
academic <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> took place at a dry erase<br />
board <strong>on</strong> the fr<strong>on</strong>t wall of each classroom that<br />
was easily visible to all students. The daily<br />
schedule was posted <strong>on</strong> the fr<strong>on</strong>t wall of the<br />
classroom. Students also had a copy of their<br />
daily schedules at their desks. The general<br />
educati<strong>on</strong> teacher <str<strong>on</strong>g>and</str<strong>on</strong>g> special educati<strong>on</strong><br />
teacher collaborated <str<strong>on</strong>g>in</str<strong>on</strong>g> classroom <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> provided assistance to students as needed.<br />
The special educati<strong>on</strong> teacher <str<strong>on</strong>g>and</str<strong>on</strong>g> first author<br />
was the primary <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigator <str<strong>on</strong>g>in</str<strong>on</strong>g> this study.<br />
Materials<br />
542 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e c<strong>on</strong>diti<strong>on</strong>, seven two-pocketed<br />
9½ <str<strong>on</strong>g>in</str<strong>on</strong>g> 12 <str<strong>on</strong>g>in</str<strong>on</strong>g> card stock weight file<br />
folders were available to students for organiz<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
materials. These file folders were to be<br />
stored <str<strong>on</strong>g>in</str<strong>on</strong>g> students’ desks. Student organizati<strong>on</strong>al<br />
materials used dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded a 14 <str<strong>on</strong>g>in</str<strong>on</strong>g> 9<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> 11 <str<strong>on</strong>g>in</str<strong>on</strong>g> plastic file box, seven 9½ <str<strong>on</strong>g>in</str<strong>on</strong>g> 12 <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
green hang<str<strong>on</strong>g>in</str<strong>on</strong>g>g file folders with ½ <str<strong>on</strong>g>in</str<strong>on</strong>g> 2<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
labels, <str<strong>on</strong>g>and</str<strong>on</strong>g> an 8 <str<strong>on</strong>g>in</str<strong>on</strong>g> 5 <str<strong>on</strong>g>in</str<strong>on</strong>g> plastic pencil box. A<br />
label was attached to the top of each folder<br />
identify<str<strong>on</strong>g>in</str<strong>on</strong>g>g the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g curricular c<strong>on</strong>tent<br />
areas: math, read<str<strong>on</strong>g>in</str<strong>on</strong>g>g, grammar, spell<str<strong>on</strong>g>in</str<strong>on</strong>g>g, social<br />
studies, <str<strong>on</strong>g>and</str<strong>on</strong>g> science. The seventh folder<br />
was designated for 8½<str<strong>on</strong>g>in</str<strong>on</strong>g> 11 <str<strong>on</strong>g>in</str<strong>on</strong>g> wide ruled<br />
notebook paper. These materials were to be<br />
used by students to place all assignments related<br />
to each of the curricular c<strong>on</strong>tent areas <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the appropriate folder <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> the file box.<br />
Students’ self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g charts were divided
<str<strong>on</strong>g>in</str<strong>on</strong>g>to seven columns, <strong>on</strong>e for the date <str<strong>on</strong>g>and</str<strong>on</strong>g> <strong>on</strong>e<br />
for each curricular c<strong>on</strong>tent area sequenced to<br />
follow the student’s daily schedule. In the<br />
home sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g, neither the file box nor the<br />
self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g chart was used by parents. Students<br />
brought home the file folder for the<br />
curriculum c<strong>on</strong>tent area <str<strong>on</strong>g>in</str<strong>on</strong>g> which they had<br />
homework.<br />
Dependent Variables<br />
The dependent variables <str<strong>on</strong>g>in</str<strong>on</strong>g> this study were: a)<br />
percentage of papers, notes, h<str<strong>on</strong>g>and</str<strong>on</strong>g>outs, study<br />
guides, books, <str<strong>on</strong>g>and</str<strong>on</strong>g> workbooks filed <str<strong>on</strong>g>in</str<strong>on</strong>g> the appropriate<br />
folder for each curriculum area <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
b) number of sec<strong>on</strong>ds it took a student to<br />
retrieve a requested item. Each classroom had<br />
1-2 items to be filed per curriculum area each<br />
day, result<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> 6-12 items that should be<br />
filed daily. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the generalizati<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>,<br />
the number of completed homework assignments<br />
placed <str<strong>on</strong>g>in</str<strong>on</strong>g> the correct file folder was<br />
recorded up<strong>on</strong> the student’s return to school.<br />
Retrieval time was recorded by count<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
number of sec<strong>on</strong>ds it took a student to locate<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> submit a requested item. These data were<br />
collected <strong>on</strong> the average of every three days<br />
across all c<strong>on</strong>diti<strong>on</strong>s with a m<str<strong>on</strong>g>in</str<strong>on</strong>g>imum of three<br />
days <str<strong>on</strong>g>in</str<strong>on</strong>g> any <strong>on</strong>e c<strong>on</strong>diti<strong>on</strong>.<br />
Experimental Design<br />
A multiple basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e design across participants<br />
was used to evaluate the effectiveness of the<br />
file box organizati<strong>on</strong>al system. Initially basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
data were collected <strong>on</strong> all four students’<br />
fil<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> item retrieval behaviors dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
same time period. Once basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e data were<br />
stable for a m<str<strong>on</strong>g>in</str<strong>on</strong>g>imum of three days, the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
(file box) c<strong>on</strong>diti<strong>on</strong> was <str<strong>on</strong>g>in</str<strong>on</strong>g>troduced to<br />
the first student, while the other students rema<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e (file folder) c<strong>on</strong>diti<strong>on</strong>.<br />
Once the first student’s data reached criteri<strong>on</strong>,<br />
the file box system was <str<strong>on</strong>g>in</str<strong>on</strong>g>troduced to the<br />
sec<strong>on</strong>d student, <str<strong>on</strong>g>and</str<strong>on</strong>g> so <strong>on</strong> until all students<br />
were <str<strong>on</strong>g>in</str<strong>on</strong>g>troduced to the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. Experimental<br />
c<strong>on</strong>trol would be dem<strong>on</strong>strated with<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the c<strong>on</strong>text of a multiple basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e design<br />
across participants if: a) stable basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e levels<br />
were ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed for each participant prior to<br />
the <str<strong>on</strong>g>in</str<strong>on</strong>g>troducti<strong>on</strong> of the file box system; b) the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>troducti<strong>on</strong> of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> was systematically<br />
staggered across participants; c) up<strong>on</strong><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>troducti<strong>on</strong> of <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, not before,<br />
there was an immediate <str<strong>on</strong>g>in</str<strong>on</strong>g>crease <str<strong>on</strong>g>in</str<strong>on</strong>g> the percentage<br />
of items filed correctly <str<strong>on</strong>g>and</str<strong>on</strong>g> a c<strong>on</strong>comitant<br />
decrease <str<strong>on</strong>g>in</str<strong>on</strong>g> the number of sec<strong>on</strong>ds it<br />
took a student to retrieve requested items; <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
d) this effect was replicated across each of the<br />
four participants (i.e., <str<strong>on</strong>g>in</str<strong>on</strong>g>ter-subject direct replicati<strong>on</strong>)<br />
(Kennedy, 2005).<br />
General Procedure<br />
To assure students understood what was expected<br />
of them, the special educati<strong>on</strong> teacher<br />
approached each student before first period<br />
class, waited for eye c<strong>on</strong>tact, <str<strong>on</strong>g>and</str<strong>on</strong>g> then delivered<br />
the prime, “D<strong>on</strong>’t forget to keep your<br />
materials organized today”. Student file folders<br />
(basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e c<strong>on</strong>diti<strong>on</strong>) <str<strong>on</strong>g>and</str<strong>on</strong>g> file boxes (<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong>) were checked 5 days a<br />
week at the end of the school day prior to<br />
dismissal. The teacher <str<strong>on</strong>g>and</str<strong>on</strong>g> student spent 5-10<br />
m<str<strong>on</strong>g>in</str<strong>on</strong>g> check<str<strong>on</strong>g>in</str<strong>on</strong>g>g whether study guides, notes,<br />
textbooks, h<str<strong>on</strong>g>and</str<strong>on</strong>g>outs, worksheets etc. were<br />
filed correctly. No re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement system was<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> place for fil<str<strong>on</strong>g>in</str<strong>on</strong>g>g or retriev<str<strong>on</strong>g>in</str<strong>on</strong>g>g items dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e or <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s.<br />
Procedure<br />
Basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e c<strong>on</strong>diti<strong>on</strong>. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e c<strong>on</strong>diti<strong>on</strong>,<br />
data were collected <strong>on</strong> students’ fil<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
skills, us<str<strong>on</strong>g>in</str<strong>on</strong>g>g manila file folders, <str<strong>on</strong>g>and</str<strong>on</strong>g> without<br />
the use of the file box system <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. At<br />
the beg<str<strong>on</strong>g>in</str<strong>on</strong>g>n<str<strong>on</strong>g>in</str<strong>on</strong>g>g of each school day, the special<br />
educati<strong>on</strong> teacher delivered the verbal prime,<br />
“D<strong>on</strong>’t forget to keep your desk organized<br />
today.” At the end of each academic period,<br />
students were expected to place unf<str<strong>on</strong>g>in</str<strong>on</strong>g>ished<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> completed work, notes, h<str<strong>on</strong>g>and</str<strong>on</strong>g>outs etc. <str<strong>on</strong>g>in</str<strong>on</strong>g>to<br />
<strong>on</strong>e of two pockets <str<strong>on</strong>g>in</str<strong>on</strong>g> their file folder for the<br />
appropriate curricular area. At the end of the<br />
school day, the teacher checked student folders<br />
for the number of appropriately filed<br />
items, <str<strong>on</strong>g>and</str<strong>on</strong>g> when <str<strong>on</strong>g>in</str<strong>on</strong>g>correct, <str<strong>on</strong>g>in</str<strong>on</strong>g>structed students<br />
to put items “<str<strong>on</strong>g>in</str<strong>on</strong>g> the correct folder.” No re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement<br />
was provided for correctly fil<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
items.<br />
File box system c<strong>on</strong>diti<strong>on</strong>. On the first day of<br />
the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong> when students<br />
were to use the file box system, the special<br />
educati<strong>on</strong> teacher taught participants how to<br />
use the file box system <str<strong>on</strong>g>and</str<strong>on</strong>g> self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
chart. Individual tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g was c<strong>on</strong>ducted dur-<br />
Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Organizati<strong>on</strong>al Skills / 543
<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong>e 10-15 m<str<strong>on</strong>g>in</str<strong>on</strong>g> sessi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> the general educati<strong>on</strong><br />
classroom at the beg<str<strong>on</strong>g>in</str<strong>on</strong>g>n<str<strong>on</strong>g>in</str<strong>on</strong>g>g of the first<br />
school day. The teacher placed curriculum<br />
folders <str<strong>on</strong>g>in</str<strong>on</strong>g> the file box <strong>on</strong> the floor beside each<br />
participant’s desk <str<strong>on</strong>g>and</str<strong>on</strong>g> arranged them <str<strong>on</strong>g>in</str<strong>on</strong>g> sequential<br />
order follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g the classroom daily<br />
schedule. The student was <str<strong>on</strong>g>in</str<strong>on</strong>g>structed to remove<br />
everyth<str<strong>on</strong>g>in</str<strong>on</strong>g>g from his desk <str<strong>on</strong>g>and</str<strong>on</strong>g> to file each<br />
paper <str<strong>on</strong>g>and</str<strong>on</strong>g> textbook <str<strong>on</strong>g>in</str<strong>on</strong>g> its appropriate folder<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>side the file box. Once all items <str<strong>on</strong>g>in</str<strong>on</strong>g> the students’<br />
desk were filed correctly, the student’s<br />
desk was turned 180 degrees so that he could<br />
not put any work or materials <str<strong>on</strong>g>in</str<strong>on</strong>g>side the desk.<br />
The student was then taught to self-m<strong>on</strong>itor<br />
his fil<str<strong>on</strong>g>in</str<strong>on</strong>g>g resp<strong>on</strong>ses <strong>on</strong> a daily organizati<strong>on</strong>al<br />
chart by circl<str<strong>on</strong>g>in</str<strong>on</strong>g>g “” if all items were filed<br />
correctly, or “” when misfiled.<br />
Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, students were rem<str<strong>on</strong>g>in</str<strong>on</strong>g>ded<br />
at the beg<str<strong>on</strong>g>in</str<strong>on</strong>g>n<str<strong>on</strong>g>in</str<strong>on</strong>g>g of the day “D<strong>on</strong>’t<br />
forget to keep your desk organized today.”<br />
They were expected to <str<strong>on</strong>g>in</str<strong>on</strong>g>dependently file<br />
their curricular materials throughout the day.<br />
At the end of each academic period as <str<strong>on</strong>g>in</str<strong>on</strong>g>structed<br />
dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g, students looked <str<strong>on</strong>g>in</str<strong>on</strong>g>to<br />
their file box, organized their materials, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
then <str<strong>on</strong>g>and</str<strong>on</strong>g> circled or – if their items for that<br />
subject were organized. At the end of the<br />
school day, the special educati<strong>on</strong> teacher entered<br />
the general educati<strong>on</strong> classroom, <str<strong>on</strong>g>and</str<strong>on</strong>g> as<br />
the student observed, she recorded the number<br />
of correctly <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>correctly filed items <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the student’s file box. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>,<br />
participants were rated <strong>on</strong> how accurately they<br />
placed materials <str<strong>on</strong>g>in</str<strong>on</strong>g> the fil<str<strong>on</strong>g>in</str<strong>on</strong>g>g box, <str<strong>on</strong>g>and</str<strong>on</strong>g> how<br />
l<strong>on</strong>g it took them to file specific academic<br />
materials.<br />
The percentage of correctly filed items was<br />
calculated <str<strong>on</strong>g>and</str<strong>on</strong>g> the data graphed. Durati<strong>on</strong><br />
per occurrence data <strong>on</strong> the length of time it<br />
took for the student to locate <str<strong>on</strong>g>and</str<strong>on</strong>g> h<str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
teacher a specific requested item from his file<br />
box were collected <strong>on</strong> the average of <strong>on</strong>ce<br />
every three days at a different time of day. As<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e c<strong>on</strong>diti<strong>on</strong> no adult prompts, correcti<strong>on</strong>s,<br />
or re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcers were delivered dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>.<br />
Reliability<br />
The paraprofessi<strong>on</strong>al support<str<strong>on</strong>g>in</str<strong>on</strong>g>g students <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the general educati<strong>on</strong> classroom collected reliability<br />
data 20% of all sessi<strong>on</strong>s across both<br />
c<strong>on</strong>diti<strong>on</strong>s for all students <strong>on</strong> the number of<br />
544 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
correctly filed items. A m<str<strong>on</strong>g>in</str<strong>on</strong>g>imum <strong>on</strong>e reliability<br />
check was made per c<strong>on</strong>diti<strong>on</strong>. Durati<strong>on</strong><br />
per occurrence reliability data was collected<br />
<strong>on</strong> 20% of all sessi<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> at least <strong>on</strong>ce per<br />
c<strong>on</strong>diti<strong>on</strong> for each student. Interobserver reliability<br />
data were calculated us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the po<str<strong>on</strong>g>in</str<strong>on</strong>g>tby-po<str<strong>on</strong>g>in</str<strong>on</strong>g>t<br />
method <str<strong>on</strong>g>in</str<strong>on</strong>g> which the number of<br />
agreements were divided by the number of<br />
agreements plus disagreements <str<strong>on</strong>g>and</str<strong>on</strong>g> multiplied<br />
by 100 (Cooper, Her<strong>on</strong>, & Heward,<br />
2007). Overall mean <str<strong>on</strong>g>in</str<strong>on</strong>g>terobserver agreement<br />
was 97.3% (92.8%-100%).<br />
Procedural reliability checks <strong>on</strong> teacher behaviors<br />
(deliver<str<strong>on</strong>g>in</str<strong>on</strong>g>g the daily prime, “D<strong>on</strong>’t forget<br />
to keep your desk/box organized”; no<br />
adult prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>; no re<str<strong>on</strong>g>in</str<strong>on</strong>g>forcement<br />
for correct fil<str<strong>on</strong>g>in</str<strong>on</strong>g>g) occurred <str<strong>on</strong>g>in</str<strong>on</strong>g> 20%<br />
of all sessi<strong>on</strong>s across both c<strong>on</strong>diti<strong>on</strong>s for all<br />
students. Procedural reliability was calculated<br />
by divid<str<strong>on</strong>g>in</str<strong>on</strong>g>g the number of correct adult behaviors<br />
by the number of planned behaviors<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> multiply<str<strong>on</strong>g>in</str<strong>on</strong>g>g by 100 (Bill<str<strong>on</strong>g>in</str<strong>on</strong>g>gsley, White, &<br />
Muns<strong>on</strong>, 1980). The mean accuracy for classroom<br />
adults follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g prescribed procedures<br />
was 94.6% (89.2%-100%).<br />
Results<br />
Effectiveness data. Figure 1 presents the<br />
percentage of items filed correctly across basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
(file folder) <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> (file box<br />
system plus self m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g) c<strong>on</strong>diti<strong>on</strong>s. As<br />
shown for each of the four students, after a<br />
stable basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e was established <str<strong>on</strong>g>and</str<strong>on</strong>g> up<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>troducti<strong>on</strong><br />
of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, there was an<br />
immediate <str<strong>on</strong>g>in</str<strong>on</strong>g>crease <str<strong>on</strong>g>in</str<strong>on</strong>g> the percentage of daily<br />
assignments filed correctly, not before. Figure<br />
2 summarizes the percent of items filed correctly<br />
for each participant <str<strong>on</strong>g>in</str<strong>on</strong>g> basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>and</str<strong>on</strong>g> file<br />
box c<strong>on</strong>diti<strong>on</strong>s, <str<strong>on</strong>g>in</str<strong>on</strong>g> a bar graph. Summary data<br />
show that the four students filed between 45%<br />
71% of items correctly dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
c<strong>on</strong>diti<strong>on</strong> (Jake M 72%, 71%–73%; Ben<br />
M 55.7%, 50%–62%; Evan M 56.7%,<br />
50%–73%; Patrick M 53.75%, 45%–67%),<br />
while dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong> they<br />
filed between 70%–100% of items correctly<br />
(Jake M 97.96%, 80%–100%; Ben M <br />
95.9%, 80%–100%; Evan M 94.6%, 75%–<br />
100%; Patrick M 88.75%, 70%–100%). Substantial<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>creases <str<strong>on</strong>g>in</str<strong>on</strong>g> the percentage of items<br />
filed correctly were replicated across students<br />
<strong>on</strong>ly up<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>troducti<strong>on</strong> of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>
Figure 1. Percentage of correctly filed items <str<strong>on</strong>g>in</str<strong>on</strong>g> basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>and</str<strong>on</strong>g> file box paired with self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Organizati<strong>on</strong>al Skills / 545
Figure 2. Percentage of correctly filed items for<br />
each participant dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>and</str<strong>on</strong>g> file<br />
box c<strong>on</strong>diti<strong>on</strong>.<br />
c<strong>on</strong>diti<strong>on</strong>. Percentage of N<strong>on</strong>overlapp<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Data (PND) across basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e trend <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong> was 100% for all students,<br />
further show<str<strong>on</strong>g>in</str<strong>on</strong>g>g the effectiveness of the file<br />
box system plus self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Efficiency data. Figure 3 presents students’<br />
mean number of sec<strong>on</strong>ds to retrieve teacher<br />
requested items across basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
c<strong>on</strong>diti<strong>on</strong>s. These data show an immediate<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> susta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed decrease <str<strong>on</strong>g>in</str<strong>on</strong>g> retrieval time<br />
durati<strong>on</strong> for all four students up<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>troducti<strong>on</strong><br />
of the file box organizati<strong>on</strong>al system. For<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividual participants mean durati<strong>on</strong> from<br />
basel<str<strong>on</strong>g>in</str<strong>on</strong>g>e to <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> c<strong>on</strong>diti<strong>on</strong>s decreased<br />
as follows: Jake, M 42.3s (R 40s-45s) to<br />
12.75s (R 10s-20s); Ben, M 46.5s (R36s-<br />
57s) to 13.6 (R 10s-26s); Evan, 45.8s (R <br />
36s-53s) to 17.25s (R 10s-28s); Patrick, 54s<br />
(R 50s-66s) to 17.31s (R 15s-20s). The net<br />
mean improvement <str<strong>on</strong>g>in</str<strong>on</strong>g> durati<strong>on</strong> retrieval time<br />
was 29.55s for Jake, 32.9s for Ben, 28.55s for<br />
Evan, <str<strong>on</strong>g>and</str<strong>on</strong>g> 36.63s for Patrick. The PND for<br />
durati<strong>on</strong> retrieval time was 100% for all four<br />
participants<br />
Social validity data. General educati<strong>on</strong><br />
teachers rated participants’ organizati<strong>on</strong>al<br />
skills pre <str<strong>on</strong>g>and</str<strong>on</strong>g> post <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> saw an<br />
improvement <str<strong>on</strong>g>in</str<strong>on</strong>g> classroom performance of<br />
the students when they began us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the fil<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
system. Students turned their work <str<strong>on</strong>g>in</str<strong>on</strong>g> <strong>on</strong> time<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> did not ask for extra copies of assignments<br />
as often as they had before us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
fil<str<strong>on</strong>g>in</str<strong>on</strong>g>g system. When students were assigned<br />
homework <str<strong>on</strong>g>in</str<strong>on</strong>g> different subject areas, they<br />
pulled corresp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g file folders from the file<br />
box <str<strong>on</strong>g>and</str<strong>on</strong>g> placed them <str<strong>on</strong>g>in</str<strong>on</strong>g>to their backpack.<br />
Parents reported that <strong>on</strong>ce the fil<str<strong>on</strong>g>in</str<strong>on</strong>g>g system<br />
began, their child did not have as many miss<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
assignments that had to be re-d<strong>on</strong>e; how-<br />
ever, better fil<str<strong>on</strong>g>in</str<strong>on</strong>g>g at school did not result <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
improved organizati<strong>on</strong> of school papers at<br />
home.<br />
Discussi<strong>on</strong><br />
546 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Results of this study dem<strong>on</strong>strate that a simple<br />
file box system paired with self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g is a<br />
more effective <str<strong>on</strong>g>and</str<strong>on</strong>g> efficient organizati<strong>on</strong>al approach<br />
than a traditi<strong>on</strong>al file folder approach<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> which students’ store their academic assignments<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> materials <str<strong>on</strong>g>in</str<strong>on</strong>g>side their desks. Students,<br />
all of whom were diagnosed with ASD,<br />
learned how to use the file box system <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g chart with<str<strong>on</strong>g>in</str<strong>on</strong>g> <strong>on</strong>e 10-15 m<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g sessi<strong>on</strong> <strong>on</strong> <strong>on</strong>e day. An immediate<br />
improvement <str<strong>on</strong>g>in</str<strong>on</strong>g> a) percentage of items correctly<br />
filed <str<strong>on</strong>g>and</str<strong>on</strong>g> b) number of sec<strong>on</strong>ds to retrieve<br />
an item requested by their teacher was<br />
observed for all four students. Students with<br />
HFA <str<strong>on</strong>g>and</str<strong>on</strong>g> AS, as well as other students (learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
disabilities, <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities) who<br />
have difficulties organiz<str<strong>on</strong>g>in</str<strong>on</strong>g>g their school materials<br />
may benefit from this simple <str<strong>on</strong>g>and</str<strong>on</strong>g> affordable<br />
organizati<strong>on</strong>al system for keep<str<strong>on</strong>g>in</str<strong>on</strong>g>g track<br />
of their notes, worksheets, assignments, books,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> materials kept at their desks. The file box<br />
system allowed students to locate their work<br />
more quickly when asked <str<strong>on</strong>g>and</str<strong>on</strong>g> it decreased the<br />
frequency of their comments related to frustrati<strong>on</strong><br />
when classroom materials could not be<br />
found. Locat<str<strong>on</strong>g>in</str<strong>on</strong>g>g assignments so they can be<br />
turned <str<strong>on</strong>g>in</str<strong>on</strong>g> <strong>on</strong> time can positively impact classroom<br />
performance <str<strong>on</strong>g>and</str<strong>on</strong>g> grades.<br />
Self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g charts <str<strong>on</strong>g>in</str<strong>on</strong>g> the current study<br />
served as visual rem<str<strong>on</strong>g>in</str<strong>on</strong>g>ders to keep their file<br />
boxes organized. Unlike Bryan <str<strong>on</strong>g>and</str<strong>on</strong>g> Gast<br />
(2000), <str<strong>on</strong>g>in</str<strong>on</strong>g> which graduated guidance was used<br />
to teach students with HFA <str<strong>on</strong>g>and</str<strong>on</strong>g> AS to use<br />
visual activity schedules, the current <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigati<strong>on</strong><br />
required <strong>on</strong>ly <strong>on</strong>e 10-15 m<str<strong>on</strong>g>in</str<strong>on</strong>g> sessi<strong>on</strong> to<br />
teach students how to use both the file box<br />
system <str<strong>on</strong>g>and</str<strong>on</strong>g> self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g chart. Systematic<br />
prompt fad<str<strong>on</strong>g>in</str<strong>on</strong>g>g was not required. If systematic<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> often time c<strong>on</strong>sum<str<strong>on</strong>g>in</str<strong>on</strong>g>g prompt fad<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
strategies are not required, they should not be<br />
used. Teachers <str<strong>on</strong>g>and</str<strong>on</strong>g> therapists need to assess<br />
students’ need for assistance prior to select<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
a teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategy. As <str<strong>on</strong>g>in</str<strong>on</strong>g> the case of participants<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> this study, all of whom were imitative,<br />
a simple adult model plus verbal descripti<strong>on</strong><br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g approach was effective <str<strong>on</strong>g>in</str<strong>on</strong>g> teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
how to use the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>. Prompt depen-
Figure 3. Number of sec<strong>on</strong>ds it took students to locate specific items.<br />
dency is not uncomm<strong>on</strong> am<strong>on</strong>g children <strong>on</strong><br />
the autism spectrum <str<strong>on</strong>g>and</str<strong>on</strong>g>, as described by Giangreco,<br />
et al. (1997) <str<strong>on</strong>g>and</str<strong>on</strong>g> Young et al. (1996)<br />
difficult to change <strong>on</strong>ce established. As dem<strong>on</strong>strated<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> this study a simple visual teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
strategy (model<str<strong>on</strong>g>in</str<strong>on</strong>g>g) <str<strong>on</strong>g>and</str<strong>on</strong>g> simple visual organi-<br />
zati<strong>on</strong>al system (file box) plus self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
immediately elim<str<strong>on</strong>g>in</str<strong>on</strong>g>ated the need for adult assistance<br />
to help students organize their class<br />
materials.<br />
A strength of this <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigati<strong>on</strong> is that it the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> was designed <str<strong>on</strong>g>and</str<strong>on</strong>g> implemented<br />
Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g Organizati<strong>on</strong>al Skills / 547
y a special educati<strong>on</strong> teacher, <str<strong>on</strong>g>in</str<strong>on</strong>g> a public<br />
school, serv<str<strong>on</strong>g>in</str<strong>on</strong>g>g n<str<strong>on</strong>g>in</str<strong>on</strong>g>e children with ASD <str<strong>on</strong>g>in</str<strong>on</strong>g> a<br />
collaborative arrangement with<str<strong>on</strong>g>in</str<strong>on</strong>g> general educati<strong>on</strong><br />
classrooms. Because of this the ecological<br />
validity of the f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs is <str<strong>on</strong>g>in</str<strong>on</strong>g>creased. As<br />
previously menti<strong>on</strong>ed the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> was<br />
low cost both <str<strong>on</strong>g>in</str<strong>on</strong>g> teacher time expenditure <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
material costs. There were, however, limitati<strong>on</strong>s<br />
to the study to which we recommend<br />
procedural changes. First, reliability data were<br />
not collected <strong>on</strong> the number of sec<strong>on</strong>ds it<br />
took students to retrieve items requested by<br />
the teacher. This was an unfortunate oversight<br />
that requires that retrieval time durati<strong>on</strong> f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
be viewed as tentative. These data should<br />
be taken a m<str<strong>on</strong>g>in</str<strong>on</strong>g>imum of 20% of all sessi<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
which data were collected <str<strong>on</strong>g>and</str<strong>on</strong>g> reported <str<strong>on</strong>g>and</str<strong>on</strong>g> at<br />
least <strong>on</strong>ce <str<strong>on</strong>g>in</str<strong>on</strong>g> each c<strong>on</strong>diti<strong>on</strong>. Sec<strong>on</strong>d, social<br />
data were not collected from student participants.<br />
Although effective, the use of a plastic<br />
file box may have been embarrass<str<strong>on</strong>g>in</str<strong>on</strong>g>g for students<br />
to use s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce they are not comm<strong>on</strong>ly used<br />
by “typical” peers <str<strong>on</strong>g>in</str<strong>on</strong>g> general educati<strong>on</strong> classrooms.<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>ally, it rema<str<strong>on</strong>g>in</str<strong>on</strong>g>s to be determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
whether or not students would c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ue to<br />
use the file box system over a prol<strong>on</strong>ged period<br />
without prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Future research should address generalizati<strong>on</strong><br />
of f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs to other sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs (home, vocati<strong>on</strong>al<br />
etc.) <str<strong>on</strong>g>and</str<strong>on</strong>g> other populati<strong>on</strong>s who exhibit<br />
executive functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g deficits that impede<br />
their academic performance. Students with<br />
AS have been shown to benefit from visual<br />
supports to underst<str<strong>on</strong>g>and</str<strong>on</strong>g> auditory-based <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong><br />
(Griswold, Barnhill, Myles, Hagiwara,<br />
& Simps<strong>on</strong>, 2002). The file box system<br />
could decrease the amount of time required<br />
to complete homework assignments if it were<br />
used at home as well as at school. If parents<br />
were to use a similar file system at home to<br />
help organize their child’s home rout<str<strong>on</strong>g>in</str<strong>on</strong>g>es,<br />
their reliance <strong>on</strong> auditory prompts to get their<br />
s<strong>on</strong> to complete assigned chores may be decreased.<br />
It would be useful to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e if the<br />
file box system plus self-m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g would be<br />
effective for students <strong>on</strong> the spectrum when<br />
complet<str<strong>on</strong>g>in</str<strong>on</strong>g>g l<strong>on</strong>g term school projects. Also,<br />
studies <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigat<str<strong>on</strong>g>in</str<strong>on</strong>g>g whether the file box system<br />
could be modified to assist students with<br />
locker <str<strong>on</strong>g>and</str<strong>on</strong>g> book bag organizati<strong>on</strong> are warranted.<br />
Although the current study targeted<br />
elementary age students, older students with<br />
HFA <str<strong>on</strong>g>and</str<strong>on</strong>g> AS who attend middle <str<strong>on</strong>g>and</str<strong>on</strong>g> high<br />
schools may benefit from a similar organizati<strong>on</strong>al<br />
system, tak<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>to c<strong>on</strong>siderati<strong>on</strong> the<br />
age appropriateness of materials, due to the<br />
complexity, variety <str<strong>on</strong>g>and</str<strong>on</strong>g> quantity of their assignments.<br />
In spite of study limitati<strong>on</strong>s, this <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigati<strong>on</strong><br />
adds to the applied research literature<br />
related to the remediati<strong>on</strong> of executive functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
skill deficits exhibited by children with<br />
ASD. The <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> was effective <str<strong>on</strong>g>and</str<strong>on</strong>g> efficient,<br />
as well as affordable, <str<strong>on</strong>g>and</str<strong>on</strong>g> warrants c<strong>on</strong>siderati<strong>on</strong><br />
by teachers <str<strong>on</strong>g>and</str<strong>on</strong>g> others work<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
with <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals special needs.<br />
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Received: 14 May 2008<br />
Initial Acceptance: 16 July 2008<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>al Acceptance: 17 October 2008<br />
550 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009
Academic Achievement Profiles of Children with High<br />
Functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g Autism <str<strong>on</strong>g>and</str<strong>on</strong>g> Asperger Syndrome: A Review of the<br />
Literature<br />
Peggy J. Schaefer Whitby<br />
University of Central Florida<br />
G. Richm<strong>on</strong>d Mancil<br />
Western Kentucky University<br />
Abstract: High functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g autism (HFA) <str<strong>on</strong>g>and</str<strong>on</strong>g> Asperger syndrome (AS) are foremost social disorders (Church,<br />
Alisanski, & Amanullah, 2000; Myles & Simps<strong>on</strong>, 2001) yet many students with HFA/AS experience<br />
difficulties with academic functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g. Educators report difficulties <str<strong>on</strong>g>in</str<strong>on</strong>g> teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> identify<str<strong>on</strong>g>in</str<strong>on</strong>g>g appropriate<br />
educati<strong>on</strong>al <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s for children with HFA/AS. Research <str<strong>on</strong>g>in</str<strong>on</strong>g> the area of academic achievement of children<br />
with HFA/AS is <str<strong>on</strong>g>in</str<strong>on</strong>g> the stage of <str<strong>on</strong>g>in</str<strong>on</strong>g>fancy <str<strong>on</strong>g>and</str<strong>on</strong>g> more research is needed (Prior, 2003). To address the need for<br />
development of appropriate academic <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s, several research studies have been c<strong>on</strong>ducted to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
the academic achievement profile of children with AS/ HFA (Barnhill, Hagiwara, Smith Myles, & Simps<strong>on</strong>,<br />
2000; Mayes & Calhoun, 2003a, 2003b, 2008; Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g>, M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew, & Siegel, 1994; Griswold, Barnhill,<br />
Smith Myles, Hagiwara, & Simps<strong>on</strong>, 2002; M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew, Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g>, Taylor, & Siegel, 1994). This article<br />
provides a synthesis of the literature <strong>on</strong> the academic achievement of students with HFA/AS from 1981 to the<br />
present to help determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e if an academic profile for students with HFA/AS emerges.<br />
While there is no exact populati<strong>on</strong> study, <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the United States of America, there are an<br />
estimated 560,000 of children between the<br />
ages of 0-21 with an autism spectrum disorder<br />
(Center for Disease C<strong>on</strong>trol, 2007). This number<br />
is expected to <str<strong>on</strong>g>in</str<strong>on</strong>g>crease as approximately 1<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> 150 children are be<str<strong>on</strong>g>in</str<strong>on</strong>g>g diagnosed with an<br />
autism spectrum disorder (ASD). One of the<br />
reas<strong>on</strong>s for the <str<strong>on</strong>g>in</str<strong>on</strong>g>crease <str<strong>on</strong>g>in</str<strong>on</strong>g> children with an<br />
autism spectrum disorder is due to better assessment<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> broaden<str<strong>on</strong>g>in</str<strong>on</strong>g>g of the diagnostic<br />
criteria (Rutter, 2005). It is estimated that<br />
between 48% of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals diagnosed with<br />
autism spectrum disorders have IQs below 70<br />
(Bertr<str<strong>on</strong>g>and</str<strong>on</strong>g>, Mars, & Boyle, 2001) leav<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
other 52% of people diagnosed with autism<br />
spectrum disorders <str<strong>on</strong>g>in</str<strong>on</strong>g> the high functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
range. Further, as early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> methods<br />
are identified <str<strong>on</strong>g>and</str<strong>on</strong>g> successfully impact the lives<br />
of children with autism spectrum disorders,<br />
academic goals are atta<str<strong>on</strong>g>in</str<strong>on</strong>g>able (O’C<strong>on</strong>nor &<br />
Kle<str<strong>on</strong>g>in</str<strong>on</strong>g>, 2004).<br />
Corresp<strong>on</strong>dence c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g this article should<br />
be addressed to Peggy J. Schaefer Whitby, University<br />
of Central Florida, 1407 Cather<str<strong>on</strong>g>in</str<strong>on</strong>g>e Street, Orl<str<strong>on</strong>g>and</str<strong>on</strong>g>o,<br />
FL 32801.<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, 2009, 44(4), 551–560<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
Children with autism <str<strong>on</strong>g>in</str<strong>on</strong>g> the high-functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
range are often referred to as hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g high<br />
functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g autism (HFA) or Asperger syndrome<br />
(AS). AS was re-<str<strong>on</strong>g>in</str<strong>on</strong>g>troduced by W<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
1981 (W<str<strong>on</strong>g>in</str<strong>on</strong>g>g, 1981). W<str<strong>on</strong>g>in</str<strong>on</strong>g>g’s 1981 def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong> of<br />
AS was the same as autistic disorder as def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
by the DSM-IV TR, except W<str<strong>on</strong>g>in</str<strong>on</strong>g>g described<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with AS as hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g better social language<br />
skills (Prior, 2003). AS is listed as <strong>on</strong>e of<br />
the five pervasive developmental disorders <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the DSM-IV TR (2000). The criteria listed <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the DSM-IV TR is different than previous c<strong>on</strong>ceptualizati<strong>on</strong>s<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> research (Prior, 2003). Because<br />
of the discrepancy <str<strong>on</strong>g>in</str<strong>on</strong>g> the AS diagnostic<br />
criteria, many authors use their own def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong><br />
of AS <str<strong>on</strong>g>in</str<strong>on</strong>g> research studies, mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g it very<br />
difficult to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e a useable def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
compare data across research studies (Schoplar,<br />
1998). Furthermore, the validity of AS as a<br />
dist<str<strong>on</strong>g>in</str<strong>on</strong>g>ct disorder accord<str<strong>on</strong>g>in</str<strong>on</strong>g>g to the DSM-IV TR<br />
is questi<strong>on</strong>able as many research studies <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate<br />
that <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with AS meet criteria for<br />
both AS <str<strong>on</strong>g>and</str<strong>on</strong>g> autism (Prior, 2003).<br />
As a result of the discrepancies, there has<br />
been much debate regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g the diagnostic<br />
differences between HFA <str<strong>on</strong>g>and</str<strong>on</strong>g> AS. Many experts<br />
now suggest that AS is high functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
autism (Oz<strong>on</strong>off, South & Miller, 2000; Prior<br />
Academic Achievement of Children with HFA <str<strong>on</strong>g>and</str<strong>on</strong>g> AS / 551
et al., 1998; W<str<strong>on</strong>g>in</str<strong>on</strong>g>g, 1998). While studies have<br />
documented differences between HFA <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
AS, these studies did not c<strong>on</strong>trol for differences<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>telligence quotients <str<strong>on</strong>g>and</str<strong>on</strong>g> cognitive<br />
functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g levels (Prior, 2003). Studies c<strong>on</strong>troll<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
for IQ have documented no significant<br />
difference <str<strong>on</strong>g>in</str<strong>on</strong>g> HFA <str<strong>on</strong>g>and</str<strong>on</strong>g> AS (Prior, 2003).<br />
Thus, for purposes of this literature review,<br />
subjects will <str<strong>on</strong>g>in</str<strong>on</strong>g>clude both <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with<br />
HFA <str<strong>on</strong>g>and</str<strong>on</strong>g>/or AS as def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed by an IQ of 70 or<br />
greater.<br />
Academic achievement becomes <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>gly<br />
important as the number of children <strong>on</strong><br />
the autism spectrum served <str<strong>on</strong>g>in</str<strong>on</strong>g> the general<br />
educati<strong>on</strong> sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>creases. Accord<str<strong>on</strong>g>in</str<strong>on</strong>g>g to the<br />
Twenty-seventh Annual Report to C<strong>on</strong>gress,<br />
27% of children with autism spend less than<br />
21% of the day outside of the general educati<strong>on</strong><br />
sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g. Fifty-<strong>on</strong>e percent of children with<br />
autism graduated with a st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard diploma,<br />
twenty three percent of children with autism<br />
plan to attend college, <str<strong>on</strong>g>and</str<strong>on</strong>g> 17.6% dropped<br />
out of school (Wagner, Newman, Cameto, &<br />
Lev<str<strong>on</strong>g>in</str<strong>on</strong>g>e, 2006). As more children are diagnosed<br />
with autism <str<strong>on</strong>g>and</str<strong>on</strong>g> expected to meet the<br />
same academic st<str<strong>on</strong>g>and</str<strong>on</strong>g>ards of their neuro-typical<br />
peers, there is a dem<str<strong>on</strong>g>and</str<strong>on</strong>g> for <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong><br />
strategies that will enable children with<br />
HFA/AS to perform academically.<br />
Academic performance will enable <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with HFA/AS to attend college <str<strong>on</strong>g>and</str<strong>on</strong>g> obta<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
mean<str<strong>on</strong>g>in</str<strong>on</strong>g>gful employment. Although <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with HFA/AS have the <str<strong>on</strong>g>in</str<strong>on</strong>g>telligence as<br />
measured by IQ, to compete they need appropriate<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> accommodati<strong>on</strong>s to<br />
reach their full potential (Smith Myles, 2005).<br />
This is critical as Temple Gr<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g> suggests<br />
that <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with HFA/AS need to become<br />
specialized <str<strong>on</strong>g>in</str<strong>on</strong>g> a field so that people are will<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
to pay for their unique skill <str<strong>on</strong>g>and</str<strong>on</strong>g> overlook the<br />
social skill deficits (Gr<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>, Duffy, & Atwood,<br />
2004). Gr<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>’s comment suggests that academic<br />
functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> specialized skill development<br />
may be as important as social skills<br />
tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g for <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with HFA/AS. If <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with HFA/AS lose the opportunity to<br />
attend college because of poor academic performance<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> school, they may not obta<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
mean<str<strong>on</strong>g>in</str<strong>on</strong>g>gful employment. Mean<str<strong>on</strong>g>in</str<strong>on</strong>g>gful employment<br />
also may provide <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with<br />
HFA/AS access to people who have similar<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terests <str<strong>on</strong>g>and</str<strong>on</strong>g> allow social <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s to de-<br />
velop. The lack of mean<str<strong>on</strong>g>in</str<strong>on</strong>g>gful employment,<br />
therefore, may cause further isolati<strong>on</strong> for <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with HFA/AS.<br />
To accomplish these academic goals, <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong><br />
<strong>on</strong> academic functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g is needed to<br />
develop a foundati<strong>on</strong> for underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
academic achievement strengths <str<strong>on</strong>g>and</str<strong>on</strong>g> weaknesses<br />
of students with HFA/ AS (Griswold et<br />
al., 2002). Once a foundati<strong>on</strong> of academic<br />
functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g is established, educati<strong>on</strong>al <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> best practices can be identified.<br />
To address the need for development of appropriate<br />
academic <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s, several research<br />
studies have been c<strong>on</strong>ducted to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
the academic achievement profile of<br />
children with AS or HFA (Dickers<strong>on</strong> Mayes, &<br />
Calhoun, 2003a, 2003b, 2008; Barnhill et al.,<br />
2000; Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g> et al., 1994; Griswold et al.,<br />
2002; M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew et al., 1994). Thus, the purpose<br />
of this review is to provide a synthesis of<br />
the literature <strong>on</strong> the academic achievement of<br />
students with high functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g autism <str<strong>on</strong>g>and</str<strong>on</strong>g> Asperger<br />
syndrome to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e if an overall<br />
academic achievement profile emerges. First,<br />
analysis of the characteristics of the participants,<br />
the research design <str<strong>on</strong>g>and</str<strong>on</strong>g> the major f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
across studies is provided. Sec<strong>on</strong>d, an<br />
overall summary of an academic achievement<br />
profile for <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with HFA/AS based<br />
up<strong>on</strong> the articles is presented. F<str<strong>on</strong>g>in</str<strong>on</strong>g>ally, implicati<strong>on</strong>s<br />
for practiti<strong>on</strong>ers <str<strong>on</strong>g>and</str<strong>on</strong>g> researchers are<br />
provided.<br />
Method<br />
552 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
The literature review c<strong>on</strong>sisted of searches of<br />
academic search premier, ERIC, Middle Search Premier,<br />
Primary Search, PsychARTICLES, Psych<br />
INFO <str<strong>on</strong>g>and</str<strong>on</strong>g> Pubmed us<str<strong>on</strong>g>in</str<strong>on</strong>g>g various comb<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong>s<br />
of the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g terms: Asperger syndrome,<br />
autism, high functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g autism, educati<strong>on</strong>,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> academic achievement. Then a h<str<strong>on</strong>g>and</str<strong>on</strong>g><br />
search was c<strong>on</strong>ducted of the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g journals<br />
cover<str<strong>on</strong>g>in</str<strong>on</strong>g>g the time span from 1981 to<br />
present: The Journal of Autism <str<strong>on</strong>g>and</str<strong>on</strong>g> Other <str<strong>on</strong>g>Developmental</str<strong>on</strong>g><br />
Disorders, Focus <strong>on</strong> Autism <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, <str<strong>on</strong>g>and</str<strong>on</strong>g> The Journal of Cl<str<strong>on</strong>g>in</str<strong>on</strong>g>ical<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Experimental Neuropsychology. The year<br />
1981 was chosen because W<str<strong>on</strong>g>in</str<strong>on</strong>g>g re<str<strong>on</strong>g>in</str<strong>on</strong>g>troduced<br />
AS <str<strong>on</strong>g>in</str<strong>on</strong>g> that year <str<strong>on</strong>g>and</str<strong>on</strong>g> the debate over HFA/AS<br />
subtype differentiati<strong>on</strong> began. F<str<strong>on</strong>g>in</str<strong>on</strong>g>ally, after review<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the retrieved articles an archival
TABLE 1<br />
Characteristics of Subjects<br />
Diagnostician <str<strong>on</strong>g>and</str<strong>on</strong>g> Assessment<br />
Tool<br />
ASD Subtypes<br />
Cognitive Level Gender<br />
Study N CA<br />
Dickers<strong>on</strong> Mayes & Calhoun, 2003a n 116 3 to 15 years old Autism 82% male DSM-IV<br />
Mean 6.7 Low 1Q 80 18% female Psychologist<br />
High IQ 80 Child Psychiatrist<br />
Dickers<strong>on</strong> Mayes & Calhoun, 2003b n 164 3 to 15 years old Autism 77% male DSM-IV<br />
Mean 5.9 Low 1Q 80 23% female Psychologist<br />
High IQ 80 Child Psychiatrist<br />
Dickers<strong>on</strong> Mayes & Calhoun, 2008 n 54 6 to 14 years old HFA 89% male DSM-IV<br />
Psychologist, c<strong>on</strong>firmatory<br />
diagnosis by psychiatrist,<br />
psychologist, pediatric<br />
neurologist, or pediatrician<br />
Checklist for Autism <str<strong>on</strong>g>in</str<strong>on</strong>g> Young<br />
Children Pediatric Behavior<br />
Mean 8.2 IQ70 11% female Scale Cl<str<strong>on</strong>g>in</str<strong>on</strong>g>ical Observati<strong>on</strong><br />
Two groups:<br />
13 or 14<br />
Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g>, M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew, & Siegel, 1994 n 64<br />
years old Autism 100 % male DSM-IV<br />
n 46 Mean 16.11 IQ 80 0% females ADI<br />
matched c<strong>on</strong>trols ADOS<br />
Griswold, Barnhill, Smith Myles,<br />
Hagiwara, & Simps<strong>on</strong>, 2002 n 21 6 to 17 years old AS/HFA 100 % male DSM-IV<br />
IQ Full Scale<br />
Physician, Psychiatrist, or<br />
psychologist<br />
66-144 0 % female<br />
Mean: 10.0<br />
DSM-IV<br />
ADI<br />
ADOS<br />
100% male<br />
0% female<br />
Autism<br />
IQ70<br />
Median age:14<br />
years old<br />
n 54<br />
n 41 matched<br />
c<strong>on</strong>trols<br />
M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew, Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g>, Taylor, &<br />
Siegel, 1994<br />
Note. DSM-IVDiagnostic <str<strong>on</strong>g>and</str<strong>on</strong>g> Statistical Manual Fourth Editi<strong>on</strong>; ADIAutism Diagnostic Inventory; ADOSAutism Diagnostic Observati<strong>on</strong> Scale<br />
Academic Achievement of Children with HFA <str<strong>on</strong>g>and</str<strong>on</strong>g> AS / 553
TABLE 2<br />
Research Design<br />
Study Research Questi<strong>on</strong><br />
Dickers<strong>on</strong> Mayes &<br />
Calhoun, 2003a<br />
Dickers<strong>on</strong> Mayes &<br />
Calhoun, 2003b<br />
Dickers<strong>on</strong> Mayes &<br />
Calhoun, 2008<br />
Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g>, M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew,<br />
& Siegel, 1994<br />
Griswold, Barnhill,<br />
Smith Myles,<br />
Hagiwara, &<br />
Simps<strong>on</strong>, 2002<br />
M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew, Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g>,<br />
Taylor, & Siegel,<br />
1994<br />
Del<str<strong>on</strong>g>in</str<strong>on</strong>g>eate strengths<br />
& weaknesses to<br />
determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e a<br />
difference as a<br />
functi<strong>on</strong> of age<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> IQ.<br />
To underst<str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
differences <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
ability based<br />
up<strong>on</strong> age <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
IQ.<br />
To determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e if<br />
neuropsychological<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
profiles emerge<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> to compare<br />
f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs from<br />
the WISC III<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> WIAT <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
previous<br />
research<br />
To <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigate age<br />
differences <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the academic<br />
profile of people<br />
with HFA as<br />
compared to<br />
neurotypical<br />
c<strong>on</strong>trols<br />
What are the<br />
academic<br />
characteristics of<br />
youth with AS?<br />
To <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigate the<br />
differences <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
academic ability<br />
between HFA<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>trols.<br />
search was c<strong>on</strong>ducted. This search resulted <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
five research studies where academic achievement<br />
profiles of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with AS were the<br />
primary area assessed. Criteria for <str<strong>on</strong>g>in</str<strong>on</strong>g>clusi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the review were: subjects were diagnosed with<br />
HFA/AS, an experimental or quasi-experi-<br />
Type of Assessment<br />
Instrument Tests Statistical Analysis<br />
Intelligence<br />
Academic<br />
Achievement<br />
Intelligence<br />
N<strong>on</strong>-verbal<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>telligence<br />
Visual Motor<br />
Achievement<br />
Intelligence<br />
Academic<br />
Achievement<br />
Academic<br />
Achievement<br />
Achievement<br />
Problem Solv<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Stanford B<str<strong>on</strong>g>in</str<strong>on</strong>g>et IV<br />
WISC –III<br />
<str<strong>on</strong>g>Developmental</str<strong>on</strong>g> Test<br />
of Visual Motor<br />
Integrati<strong>on</strong><br />
WIAT<br />
WJ Tests of<br />
Achievement<br />
Bayley Mental Scale<br />
Stanford B<str<strong>on</strong>g>in</str<strong>on</strong>g>et<br />
Test of Visual<br />
motor<br />
Integrati<strong>on</strong><br />
Leiter Internati<strong>on</strong>al<br />
performance<br />
scale<br />
Test of N<strong>on</strong>verbal<br />
Intelligence<br />
WIAT<br />
WJ Tests of<br />
Achievement<br />
WISC-IV<br />
WIAT-II<br />
Detroit Tests of<br />
Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g-2<br />
Woodcock Johns<strong>on</strong><br />
Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g Mastery<br />
tests-R<br />
Kaufman Test of<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>al<br />
Achievement<br />
WIAT<br />
TOPS-R<br />
TOPS-A<br />
Achievement Detroit Tests of<br />
Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g-2<br />
Woodcock Johns<strong>on</strong><br />
Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g Mastery<br />
tests-R<br />
Kaufman Test of<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>al<br />
Achievement<br />
t tests with a<br />
B<strong>on</strong>ferr<strong>on</strong>i<br />
correcti<strong>on</strong><br />
Pears<strong>on</strong> Correlati<strong>on</strong><br />
Coefficients<br />
Pears<strong>on</strong> Correlati<strong>on</strong><br />
Coefficients<br />
t tests<br />
t Tests<br />
Cohen’s d effect size<br />
ANOVA<br />
B<strong>on</strong>ferr<strong>on</strong>i t tests<br />
Pears<strong>on</strong> Correlati<strong>on</strong><br />
Stepwise L<str<strong>on</strong>g>in</str<strong>on</strong>g>ear<br />
Regressi<strong>on</strong><br />
ANOVA<br />
Friedman Two Way<br />
analysis of Variance<br />
Post Hoc<br />
Comparis<strong>on</strong>s<br />
Independent Group t<br />
tests<br />
Note. WISC-IIIWeschler Intelligence Scale for Children; WIATWeschler Individual Achievement Tests;<br />
TOPS-RTest of Oral Problem Solv<str<strong>on</strong>g>in</str<strong>on</strong>g>g Revised; TOPS-ATest of Oral Problem Solv<str<strong>on</strong>g>in</str<strong>on</strong>g>g for Adolescents<br />
554 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
mental design was employed, <str<strong>on</strong>g>and</str<strong>on</strong>g> the study<br />
used a norm referenced achievement battery<br />
to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e achievement level. For each<br />
study, characteristics of subjects, research design<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> major f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs were identified. The<br />
data is presented <str<strong>on</strong>g>in</str<strong>on</strong>g> Tables 1, 2, <str<strong>on</strong>g>and</str<strong>on</strong>g> 3.
TABLE 3<br />
Major F<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>in</str<strong>on</strong>g> Academic Achievement (HFA)<br />
Study Profile strengths Profile Weaknesses Academic Implicati<strong>on</strong>s Research Questi<strong>on</strong> Answer<br />
Dickers<strong>on</strong> Mayes &<br />
Calhoun, 2003a<br />
Dickers<strong>on</strong> Mayes &<br />
Calhoun, 2003b<br />
Dickers<strong>on</strong> Mayes &<br />
Calhoun, 2008<br />
Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g>,<br />
M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew, &<br />
Siegel, 1994<br />
Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g, math &<br />
writ<str<strong>on</strong>g>in</str<strong>on</strong>g>g were <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
average range<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g><br />
commensurate<br />
with IQ<br />
Math read<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> spell<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
correlated with<br />
IQ<br />
Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Math were<br />
commensurate<br />
with IQ.<br />
Verbal <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Visual<br />
Reas<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Young Group:<br />
Decod<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
Rote<br />
Mechanical<br />
Functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
Normal<br />
performance<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> early years<br />
Graphomotor<br />
Writ<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Attenti<strong>on</strong><br />
Comprehensi<strong>on</strong>:<br />
social language<br />
& reas<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
7% qualified for<br />
read<str<strong>on</strong>g>in</str<strong>on</strong>g>g SLD<br />
22% qualified for<br />
math SLD<br />
63% qualified for<br />
writ<str<strong>on</strong>g>in</str<strong>on</strong>g>g SLD<br />
Academic <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
may need to focus<br />
<strong>on</strong> attenti<strong>on</strong>,<br />
language, social<br />
skills, writ<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
graphomotor skills<br />
Written expressi<strong>on</strong> Use visual strength<br />
while bypass<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
writ<str<strong>on</strong>g>in</str<strong>on</strong>g>g weaknesses<br />
N<strong>on</strong>-verbal <str<strong>on</strong>g>and</str<strong>on</strong>g> verbal<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>telligence gap<br />
closed between the<br />
age of 9-10.<br />
Therefore, early<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> should<br />
focus <strong>on</strong> verbal<br />
Written Expressi<strong>on</strong><br />
Attenti<strong>on</strong><br />
Process<str<strong>on</strong>g>in</str<strong>on</strong>g>g Speed<br />
Language<br />
comprehensi<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> social<br />
reas<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Complex<br />
process<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
across doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s<br />
Comprehensi<strong>on</strong><br />
Oral directi<strong>on</strong>s<br />
L<str<strong>on</strong>g>in</str<strong>on</strong>g>guistically<br />
Complex material<br />
weakness<br />
17% qualified for math<br />
learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g disability<br />
63% qualified for a<br />
writ<str<strong>on</strong>g>in</str<strong>on</strong>g>g learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
disability<br />
37% qualified for a<br />
read<str<strong>on</strong>g>in</str<strong>on</strong>g>g learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
disability<br />
Teach to the child’s<br />
verbal <str<strong>on</strong>g>and</str<strong>on</strong>g> visual<br />
reas<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g skills while<br />
compensat<str<strong>on</strong>g>in</str<strong>on</strong>g>g for<br />
the writ<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
attenti<strong>on</strong>, process<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
speed, language <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
social reas<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
weaknesses<br />
People with HFA may<br />
perform as well or<br />
better than peers <strong>on</strong><br />
many age-normed<br />
tasks until a certa<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
grade level, bey<strong>on</strong>d<br />
which they do<br />
substantially less well<br />
The research del<str<strong>on</strong>g>in</str<strong>on</strong>g>eates<br />
the strengths <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
weakness of children<br />
with HFA. The<br />
research suggests that<br />
there is a difference<br />
based <strong>on</strong> IQ <str<strong>on</strong>g>and</str<strong>on</strong>g> age.<br />
IQ <str<strong>on</strong>g>in</str<strong>on</strong>g>creased up to the<br />
age of eight<br />
The WISC-IV <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
WIAT-II appear to be<br />
an improved<br />
assessment<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>strument for<br />
children with HFA<br />
FSIQ was the best<br />
predictor of academic<br />
achievement<br />
Profile emerged:<br />
deficits <str<strong>on</strong>g>in</str<strong>on</strong>g> attenti<strong>on</strong>,<br />
graphomotor, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
process<str<strong>on</strong>g>in</str<strong>on</strong>g>g speed;<br />
strengths <str<strong>on</strong>g>in</str<strong>on</strong>g> verbal<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> visual reas<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Three l<strong>on</strong>gitud<str<strong>on</strong>g>in</str<strong>on</strong>g>al age<br />
patterns emerged:<br />
1. Some academic<br />
skills rema<str<strong>on</strong>g>in</str<strong>on</strong>g> at or<br />
above average levels<br />
2. Underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> perform<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
l<str<strong>on</strong>g>in</str<strong>on</strong>g>guistically complex<br />
materials were deficit<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> both age groups<br />
3. Normal<br />
performance <str<strong>on</strong>g>in</str<strong>on</strong>g> early<br />
years but does not<br />
ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g> over time<br />
Academic Achievement of Children with HFA <str<strong>on</strong>g>and</str<strong>on</strong>g> AS / 555
TABLE 3—(C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued)<br />
Results<br />
Study Profile strengths Profile Weaknesses Academic Implicati<strong>on</strong>s Research Questi<strong>on</strong> Answer<br />
Griswold, Barnhill,<br />
Smith Myles,<br />
Hagiwara, &<br />
Simps<strong>on</strong>, 2002<br />
M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew,<br />
Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g>, Taylor,<br />
& Siegel, 1994<br />
Basic Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Oral Expressi<strong>on</strong><br />
Average<br />
Language<br />
Composite<br />
Basic ability to<br />
read, spell <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
perform<br />
mathematical<br />
calculati<strong>on</strong>s<br />
Characteristics of Study Participants<br />
Numerical<br />
Operati<strong>on</strong>s<br />
Listen<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Comprehensi<strong>on</strong><br />
Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Comprehensi<strong>on</strong><br />
Written Expressi<strong>on</strong><br />
Problem Solv<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Lowest subtests <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
arithmetic <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
comprehensi<strong>on</strong><br />
Impaired<br />
comprehensi<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terpretive<br />
skills of<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
text<br />
The majority of the researchers presented<br />
gender, chr<strong>on</strong>ological age, autism spectrum<br />
disorder diagnosis subtype with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual<br />
functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g level, <str<strong>on</strong>g>and</str<strong>on</strong>g> diagnostic <str<strong>on</strong>g>in</str<strong>on</strong>g>strument<br />
(See Table 1). Eighty eight percent of the<br />
subjects were male, which is a slightly higher<br />
representati<strong>on</strong> of males than the populati<strong>on</strong><br />
as ASD is four times more likely to occur <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
males than females (Center for Disease C<strong>on</strong>trol,<br />
2007).<br />
For most studies, participants ranged from<br />
3–17 years old with a mean of 10.5 years <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
chr<strong>on</strong>ological age. Two studies reported a median<br />
age of 14 <str<strong>on</strong>g>and</str<strong>on</strong>g> divide the group <str<strong>on</strong>g>in</str<strong>on</strong>g>to two<br />
categories: studies with participants under 14<br />
years old or above 14 years old. The purpose<br />
of the divisi<strong>on</strong> of the group was to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
if age differences appeared to impact academic<br />
achievement.<br />
ASD diagnosis <str<strong>on</strong>g>and</str<strong>on</strong>g> level of <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
was reported for every study. Most<br />
studies <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded pers<strong>on</strong>s with HFA/AS <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
had an IQ of greater than 80. Several studies<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>cluded pers<strong>on</strong>s with ASD who had IQ’s of<br />
Huge Range of<br />
functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g, know<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
that a child has AS<br />
has little value to the<br />
teacher<br />
Teachers need the<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividual item<br />
analysis of these tests<br />
to build the IEP<br />
Build student portfolios<br />
paired with formal<br />
assessment<br />
Perform rote tasks <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>voke simple<br />
associative processes<br />
The use of global<br />
scores to assess<br />
academic functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> read<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
mathematics may fail<br />
to identify deficits<br />
less than 80, however, the data was used for<br />
comparis<strong>on</strong> to the group of pers<strong>on</strong>s with IQs<br />
above 80. One study classified pers<strong>on</strong>s with<br />
HFA as hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g IQ levels above 70. In the study<br />
that <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded pers<strong>on</strong>s with AS <strong>on</strong>ly, it was<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terest<str<strong>on</strong>g>in</str<strong>on</strong>g>g to note that after the Weschler<br />
Intelligence Scale for Children was adm<str<strong>on</strong>g>in</str<strong>on</strong>g>istered,<br />
it was revealed that the subjects IQ<br />
ranged from 66 to 144.<br />
All subjects met criteria for HFA/AS based<br />
up<strong>on</strong> the DSM-IV-TR. Two studies used the<br />
Autism Diagnostic Inventory (ADI) <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
Autism Diagnostic Observati<strong>on</strong> Scale (ADOS)<br />
to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e if the DSM-IV TR criteri<strong>on</strong> were<br />
met. All but two of the studies reported diagnosis<br />
that was determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ed by a psychologist,<br />
psychiatrist or a physician. The two studies<br />
that did not report the pers<strong>on</strong> mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
diagnosis were authored <str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>ducted by<br />
pers<strong>on</strong>s with the credentials to make the cl<str<strong>on</strong>g>in</str<strong>on</strong>g>ical<br />
diagnosis.<br />
Research Design<br />
556 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Profile emerged,<br />
however, <str<strong>on</strong>g>in</str<strong>on</strong>g>-depth<br />
assessments may be<br />
needed to identify<br />
weaknesses <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
portfolio assessments<br />
are needed to<br />
determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e student<br />
needs.<br />
There is a profile that is<br />
different than neurotypical<br />
peers<br />
While the research questi<strong>on</strong> for each study<br />
varied slightly, the majority of the research<br />
studies focused <strong>on</strong> underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g the achieve-
ment or ability of students with HFA/AS or<br />
underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g the underly<str<strong>on</strong>g>in</str<strong>on</strong>g>g achievement or<br />
ability so that <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s could be developed<br />
(See Table 2). One study <str<strong>on</strong>g>in</str<strong>on</strong>g>vestigated<br />
the relati<strong>on</strong>ship between age <str<strong>on</strong>g>and</str<strong>on</strong>g> IQ with academic<br />
achievement <str<strong>on</strong>g>in</str<strong>on</strong>g> order to ga<str<strong>on</strong>g>in</str<strong>on</strong>g> a better<br />
underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> needs of<br />
students as the progress through school. Two<br />
of the studies used age <str<strong>on</strong>g>and</str<strong>on</strong>g> IQ matched c<strong>on</strong>trols<br />
groups, two research studies compared<br />
scores based up<strong>on</strong> discrepancy from IQ <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
between age groups <str<strong>on</strong>g>and</str<strong>on</strong>g> two research studies<br />
compared subtests with verbal, performance<br />
or full scale IQ.<br />
The ma<str<strong>on</strong>g>in</str<strong>on</strong>g> focus of each study was academic<br />
achievement. However, some studies <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>struments other than academic achievement<br />
assessments to help ascerta<str<strong>on</strong>g>in</str<strong>on</strong>g> ability profiles<br />
or strengths <str<strong>on</strong>g>and</str<strong>on</strong>g> deficits as it relates to<br />
school. Each study, except <strong>on</strong>e, <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded an<br />
IQ test <str<strong>on</strong>g>in</str<strong>on</strong>g> the data collecti<strong>on</strong> process. Many of<br />
the additi<strong>on</strong>al assessment <str<strong>on</strong>g>in</str<strong>on</strong>g>struments measured<br />
areas that are c<strong>on</strong>sidered weaknesses <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
HFA/AS, such as visual motor process<str<strong>on</strong>g>in</str<strong>on</strong>g>g, motor<br />
coord<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> problem solv<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Data analysis varied for the studies. Several<br />
studies used <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent t tests for group<br />
comparis<strong>on</strong>s as well as dependent t tests to<br />
compare discrepancy between IQ <str<strong>on</strong>g>and</str<strong>on</strong>g> various<br />
subtests. Correlati<strong>on</strong> coefficients were used <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
two studies to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e the relati<strong>on</strong>ship between<br />
two variables. Two-way analysis of variance<br />
also was used to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e the differences<br />
between two or more variables.<br />
Major F<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
Overall f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate that read<str<strong>on</strong>g>in</str<strong>on</strong>g>g, math<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> writ<str<strong>on</strong>g>in</str<strong>on</strong>g>g were commensurate with IQ<br />
(Dickers<strong>on</strong> Mayes & Calhoun., 2003a; Dickers<strong>on</strong><br />
Mayes & Calhoun., 2008) <str<strong>on</strong>g>and</str<strong>on</strong>g> that basic<br />
read<str<strong>on</strong>g>in</str<strong>on</strong>g>g, encod<str<strong>on</strong>g>in</str<strong>on</strong>g>g, rote skills <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong><br />
was <str<strong>on</strong>g>in</str<strong>on</strong>g>tact (See Table 3) (Mayes & Calhoun,<br />
2003a; Dickers<strong>on</strong> Mayes & Calhoun., 2003b,<br />
Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g> et al., 1994; Griswold et al., 2002;<br />
M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew et al., 1994). Accord<str<strong>on</strong>g>in</str<strong>on</strong>g>g to this review,<br />
weaknesses for children with HFA/AS lie<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the area of writ<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g graphomotor<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> organizati<strong>on</strong>al skills, attenti<strong>on</strong>, complex<br />
process<str<strong>on</strong>g>in</str<strong>on</strong>g>g across doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g problem<br />
solv<str<strong>on</strong>g>in</str<strong>on</strong>g>g, numerical operati<strong>on</strong>s, listen<str<strong>on</strong>g>in</str<strong>on</strong>g>g comprehensi<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> read<str<strong>on</strong>g>in</str<strong>on</strong>g>g comprehensi<strong>on</strong><br />
(Barnhill et al, 2000; Mayes & Calhoun, 2003a,<br />
2003b, 2008; Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g>, et al., 1994; Griswold<br />
et al., 2002; M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew et al., 1994). The lowest<br />
subtests areas were <str<strong>on</strong>g>in</str<strong>on</strong>g> arithmetic <str<strong>on</strong>g>and</str<strong>on</strong>g> comprehensi<strong>on</strong><br />
(M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew et al.).<br />
Furthermore, it appears that IQ <str<strong>on</strong>g>in</str<strong>on</strong>g>creases<br />
up to the age of eight (Mayes & Calhoun,<br />
2003b). Children below the age of eight had<br />
weaker verbal skills. The n<strong>on</strong>-verbal <str<strong>on</strong>g>and</str<strong>on</strong>g> verbal<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>telligence gap closed between the age of<br />
9-10, suggest<str<strong>on</strong>g>in</str<strong>on</strong>g>g that <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s prior to the<br />
age of eight focus <strong>on</strong> verbal skill acquisiti<strong>on</strong>.<br />
Individuals with HFA/AS may perform as well<br />
or better than peers <strong>on</strong> many age-normed<br />
tasks until a certa<str<strong>on</strong>g>in</str<strong>on</strong>g> grade level, bey<strong>on</strong>d which<br />
they do substantially less well (Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g> et al.,<br />
1994). The use of global scores to assess academic<br />
functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> read<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> mathematics<br />
may fail to identify deficits (M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew et al.,<br />
1994).<br />
Discussi<strong>on</strong><br />
Overall, the review of the literature suggests<br />
that <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with HFA/AS present with a<br />
general profile of academic functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g. Individuals<br />
with HFA/AS have deficits <str<strong>on</strong>g>in</str<strong>on</strong>g> the areas<br />
of comprehensi<strong>on</strong>, written expressi<strong>on</strong>, graphomotor<br />
skills, l<str<strong>on</strong>g>in</str<strong>on</strong>g>guistically complex materials,<br />
complex process<str<strong>on</strong>g>in</str<strong>on</strong>g>g across all doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
problem solv<str<strong>on</strong>g>in</str<strong>on</strong>g>g. The deficits <str<strong>on</strong>g>in</str<strong>on</strong>g> academic<br />
functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g may not become apparent until<br />
learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g moves from rote tasks to abstract,<br />
c<strong>on</strong>ceptual learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g (Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g> et al., 1994).<br />
Deficits may result <str<strong>on</strong>g>in</str<strong>on</strong>g> academic difficulties <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
read<str<strong>on</strong>g>in</str<strong>on</strong>g>g, writ<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> mathematics. Proper assessment<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> analysis of subtest doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s is<br />
needed to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e the strengths <str<strong>on</strong>g>and</str<strong>on</strong>g> weaknesses<br />
of a student with HFA/AS as the disorder<br />
present a range of functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
The academic profile <str<strong>on</strong>g>in</str<strong>on</strong>g> read<str<strong>on</strong>g>in</str<strong>on</strong>g>g suggests that<br />
basic read<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> decod<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills are <str<strong>on</strong>g>in</str<strong>on</strong>g>tact for<br />
students with HFA/AS. Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g ability is commensurate<br />
with IQ up to around age 8. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the early years, students perform at or above<br />
their peers <strong>on</strong> read<str<strong>on</strong>g>in</str<strong>on</strong>g>g tasks. After age eight,<br />
read<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> focuses more <strong>on</strong> comprehensi<strong>on</strong><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g abstract c<strong>on</strong>cepts such as<br />
ma<str<strong>on</strong>g>in</str<strong>on</strong>g> ideas, <str<strong>on</strong>g>in</str<strong>on</strong>g>ferences <str<strong>on</strong>g>and</str<strong>on</strong>g> causes/effect. Material<br />
becomes less explicit which may expla<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the decrease <str<strong>on</strong>g>in</str<strong>on</strong>g> read<str<strong>on</strong>g>in</str<strong>on</strong>g>g ability when com-<br />
Academic Achievement of Children with HFA <str<strong>on</strong>g>and</str<strong>on</strong>g> AS / 557
pared to neuro-typical peers. Comprehensi<strong>on</strong><br />
deficits are an area identified as part of the<br />
academic profile <str<strong>on</strong>g>in</str<strong>on</strong>g> HFA/AS. Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g comprehensi<strong>on</strong><br />
due to the critical th<str<strong>on</strong>g>in</str<strong>on</strong>g>k<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
verbal reas<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g comp<strong>on</strong>ents also may be impacted<br />
by the theory of m<str<strong>on</strong>g>in</str<strong>on</strong>g>d <str<strong>on</strong>g>and</str<strong>on</strong>g> attenti<strong>on</strong><br />
deficits (Griswold et al., 2002).<br />
Writ<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Both written expressi<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> graphomotor<br />
skills are identified as weaknesses for students<br />
with HFA/AS. Graphomotor skill deficits may<br />
be caused by motor coord<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> difficulties.<br />
Written expressi<strong>on</strong> may be impacted by the<br />
organizati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> attenti<strong>on</strong> deficits. Sixty percent<br />
of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with HFA/AS also have<br />
writ<str<strong>on</strong>g>in</str<strong>on</strong>g>g learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g disabilities (Mayes & Calhoun,<br />
2003a, 2008).<br />
Mathematics<br />
Review of the literature suggests that children<br />
with HFA/AS have average mathematical abilities.<br />
Computati<strong>on</strong>al skills appear to be <str<strong>on</strong>g>in</str<strong>on</strong>g>tact<br />
for this populati<strong>on</strong>. However, complex problem<br />
solv<str<strong>on</strong>g>in</str<strong>on</strong>g>g with<str<strong>on</strong>g>in</str<strong>on</strong>g> this doma<str<strong>on</strong>g>in</str<strong>on</strong>g> impacts applied<br />
mathematical ability. Organizati<strong>on</strong>al<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> attenti<strong>on</strong> skills may also impact multiple<br />
step problem solv<str<strong>on</strong>g>in</str<strong>on</strong>g>g. Read<str<strong>on</strong>g>in</str<strong>on</strong>g>g comprehensi<strong>on</strong><br />
deficits may also impact grade level word<br />
problems. Deficit areas other than mathematical<br />
computati<strong>on</strong> may account for the significant<br />
difference between average to above average<br />
IQ <str<strong>on</strong>g>and</str<strong>on</strong>g> average mathematical ability<br />
f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs. Dickers<strong>on</strong> Mayes <str<strong>on</strong>g>and</str<strong>on</strong>g> Calhoun<br />
(2003a, 2008) report that 23% of the students<br />
with HFA/AS meet criteria for a mathematics<br />
learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g disability.<br />
Implicati<strong>on</strong>s for Practiti<strong>on</strong>ers<br />
The review of the literature suggests that there<br />
is an academic profile of students with<br />
HFA/AS (Mayes & Calhoun, 2003a 2003b;<br />
Barnhill et al., 2000; Goldste<str<strong>on</strong>g>in</str<strong>on</strong>g> et al., 1994;<br />
Griswold et al., 2002; M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew et al., 1994).<br />
The value of know<str<strong>on</strong>g>in</str<strong>on</strong>g>g the profile allows for a<br />
basic underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g of how to teach children<br />
with HFA/AS (Griswold et al.). However, what<br />
is true for the group may not be true for each<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividual (Mayes & Calhoun, 2003a). Given<br />
the heterogeneous nature of the disorder, a<br />
huge range of functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g across students<br />
may exist. Know<str<strong>on</strong>g>in</str<strong>on</strong>g>g that a child has HFA/AS<br />
may be little value to the teacher. The use of<br />
global scores to assess academic functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> read<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> mathematics may fail to identify<br />
deficits (M<str<strong>on</strong>g>in</str<strong>on</strong>g>shew et al.) Therefore, It is<br />
important to look at the whole child as well as<br />
item analysis of subtest performances to guide<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dividual <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s (Griswold et al.).<br />
Teachers need the <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual subtest analysis<br />
of assessments to build <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual educati<strong>on</strong><br />
plans. For example, know<str<strong>on</strong>g>in</str<strong>on</strong>g>g that a student<br />
with HFA/AS scores <str<strong>on</strong>g>in</str<strong>on</strong>g> the 95 th percentile <strong>on</strong><br />
overall academic skills <strong>on</strong> the Woodcock Johns<strong>on</strong><br />
Tests of Achievement is less important<br />
then know<str<strong>on</strong>g>in</str<strong>on</strong>g>g that the student scored <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
47 th percentile rank<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> read<str<strong>on</strong>g>in</str<strong>on</strong>g>g comprehensi<strong>on</strong><br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> the 76 th percentile rank<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
applied problems. The subtest scores allow a<br />
teacher to create an educati<strong>on</strong>al plan based<br />
up<strong>on</strong> the support needs of the student as well<br />
as the strengths of the student that a teacher<br />
can build up<strong>on</strong>. Build<str<strong>on</strong>g>in</str<strong>on</strong>g>g student portfolios<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> pair<str<strong>on</strong>g>in</str<strong>on</strong>g>g the <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> with formal assessment<br />
may give a teacher the best <str<strong>on</strong>g>in</str<strong>on</strong>g>dicati<strong>on</strong><br />
of academic functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g (Griswold et al.).<br />
Once a teacher has developed an underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
of the specific needs of the student, then<br />
he/she must have access to research-based<br />
practices to address the student’s academic<br />
needs.<br />
In additi<strong>on</strong>, practiti<strong>on</strong>ers can educate parents<br />
so they do not become frustrated with a<br />
perceived decl<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>in</str<strong>on</strong>g> academic functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
when tasks become more c<strong>on</strong>ceptual. Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
this process, it is important for teachers to<br />
communicate effectively. This will <str<strong>on</strong>g>in</str<strong>on</strong>g>volve<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g the parents about the new areas <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the academics <str<strong>on</strong>g>and</str<strong>on</strong>g> strategies that may be beneficial.<br />
Further, the teachers should expla<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the tests to the parents <str<strong>on</strong>g>in</str<strong>on</strong>g> terms that are underst<str<strong>on</strong>g>and</str<strong>on</strong>g>able<br />
(i.e., m<str<strong>on</strong>g>in</str<strong>on</strong>g>us the professi<strong>on</strong>al jarg<strong>on</strong>).<br />
Implicati<strong>on</strong>s for Researchers<br />
558 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
As aforementi<strong>on</strong>ed, researched-based academic<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s for this populati<strong>on</strong> of students<br />
are sparse (Simps<strong>on</strong>, 2005). S<str<strong>on</strong>g>in</str<strong>on</strong>g>ce teachers<br />
typically are not tra<str<strong>on</strong>g>in</str<strong>on</strong>g>ed <str<strong>on</strong>g>in</str<strong>on</strong>g> research-based<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s for their students with HFA/ AS<br />
(Smith Myles, 2005), they often rely <strong>on</strong> strategies<br />
researched with children with learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g
disabilities yet children with HFA/AS may<br />
need further accommodati<strong>on</strong>s (Adre<strong>on</strong> & Durocher,<br />
2007). The effectiveness of the learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
disability <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s, when used for<br />
children with HFA/AS, has not been adequately<br />
assessed. Researchers could beg<str<strong>on</strong>g>in</str<strong>on</strong>g> to<br />
explore the effectiveness of these <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
with the HFA/ AS populati<strong>on</strong>. When<br />
do<str<strong>on</strong>g>in</str<strong>on</strong>g>g this, research could test learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> meta-cognitive strategies that have<br />
proved successful for learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g disabilities <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e the necessary adaptati<strong>on</strong>s to meet<br />
the unique cognitive <str<strong>on</strong>g>and</str<strong>on</strong>g> academic needs of<br />
children with HFA/AS. By develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies<br />
that remediate or support the c<strong>on</strong>ceptual<br />
learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g of <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with HFA/AS as their<br />
needs change dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g adolescences, quality of<br />
life outcomes may be improved by successful<br />
performance school that may lead to successful<br />
post-sec<strong>on</strong>dary educati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> mean<str<strong>on</strong>g>in</str<strong>on</strong>g>gful<br />
employment. In additi<strong>on</strong>, researchers should<br />
beg<str<strong>on</strong>g>in</str<strong>on</strong>g> extend<str<strong>on</strong>g>in</str<strong>on</strong>g>g the researched based practices<br />
that have proved successful <str<strong>on</strong>g>in</str<strong>on</strong>g> remediat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the social <str<strong>on</strong>g>and</str<strong>on</strong>g> communicative deficits to<br />
the classroom sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
C<strong>on</strong>clusi<strong>on</strong>s<br />
In summary, children with HFA/AS have the<br />
potential to become highly productive, c<strong>on</strong>tribut<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
members of society <str<strong>on</strong>g>and</str<strong>on</strong>g> can develop<br />
their specific skills so they are admired <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
hired for their talent (Gr<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>, Duffy, & Atwood,<br />
2004). Students with HFA/AS need to<br />
ga<str<strong>on</strong>g>in</str<strong>on</strong>g> skill <str<strong>on</strong>g>in</str<strong>on</strong>g> all academic areas <str<strong>on</strong>g>in</str<strong>on</strong>g> order to<br />
graduate with a st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard diploma, obta<str<strong>on</strong>g>in</str<strong>on</strong>g> satisfactory<br />
SAT or ACT scores <str<strong>on</strong>g>and</str<strong>on</strong>g> become admitted<br />
to college. However, research <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
area of academic achievement of children<br />
with HFA/AS is <str<strong>on</strong>g>in</str<strong>on</strong>g> the stage of <str<strong>on</strong>g>in</str<strong>on</strong>g>fancy; result<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> teachers often hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g to use strategies<br />
researched with <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g disabilities.<br />
Future research teams should evaluate<br />
the effectiveness <str<strong>on</strong>g>and</str<strong>on</strong>g> efficiency of these<br />
strategies with <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with HFA/AS.<br />
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(pp. 11–28). New York: Plenum.<br />
Received: 19 June 2008<br />
Initial Acceptance: 22 August 2008<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>al Acceptance: 12 January 2009<br />
560 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009
A Method to Assess Work Task Preferences<br />
Virg<str<strong>on</strong>g>in</str<strong>on</strong>g>ie Cobigo<br />
Queen’s University<br />
Yves Lachapelle<br />
Université du Québec à Trois-Rivières<br />
Diane Mor<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
Université du Québec à M<strong>on</strong>tréal<br />
Abstract: Pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability may encounter difficulties <str<strong>on</strong>g>in</str<strong>on</strong>g> mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g choices <str<strong>on</strong>g>and</str<strong>on</strong>g> express<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
preferences because of restricted communicati<strong>on</strong> skills or a tendency to acquiesce. In additi<strong>on</strong>, many studies<br />
provide evidence that these pers<strong>on</strong>s have less opportunity to make choices <str<strong>on</strong>g>and</str<strong>on</strong>g> express their preferences. The aim<br />
of this study was to c<strong>on</strong>duct a field test of an <str<strong>on</strong>g>in</str<strong>on</strong>g>novative method to assess vocati<strong>on</strong>al preferences us<str<strong>on</strong>g>in</str<strong>on</strong>g>g choice<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> task completi<strong>on</strong> observati<strong>on</strong>s. Sixteen educators were tra<str<strong>on</strong>g>in</str<strong>on</strong>g>ed to use this method. They were recruited through<br />
local developmental disability agencies specializ<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> services for pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
Prov<str<strong>on</strong>g>in</str<strong>on</strong>g>ce of Quebec (Canada). N<str<strong>on</strong>g>in</str<strong>on</strong>g>eteen pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability were assessed. Occurrences of four<br />
types of behaviors (choice, refusal, positive emoti<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> off-task behaviors), as well as length of time spent<br />
work<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> the task, were computed to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e levels of preferences. Interviews were c<strong>on</strong>ducted with the<br />
educators to collect their percepti<strong>on</strong>s regard<str<strong>on</strong>g>in</str<strong>on</strong>g>g the effectiveness <str<strong>on</strong>g>and</str<strong>on</strong>g> usefulness of the method as a measure of its<br />
value <str<strong>on</strong>g>in</str<strong>on</strong>g> use. Results suggest that this method is useful to assess vocati<strong>on</strong>al preferences with pers<strong>on</strong>s with<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability. Interviews c<strong>on</strong>ducted with educators reveal a high satisfacti<strong>on</strong> with the method.<br />
Vocati<strong>on</strong>al preferences assessment should rely <strong>on</strong> frequency of choices, as other behaviors previously c<strong>on</strong>sidered<br />
as express<str<strong>on</strong>g>in</str<strong>on</strong>g>g preferences are not reliable. This study also provides further evidence that proxy op<str<strong>on</strong>g>in</str<strong>on</strong>g>i<strong>on</strong>s may<br />
differ from <strong>on</strong>e’s actual preferences.<br />
The aim of support<str<strong>on</strong>g>in</str<strong>on</strong>g>g pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual<br />
disability is to provide them with a good<br />
quality of life, as well as self-determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ed life<br />
outcomes. Current legislati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> policies uphold<br />
these major objectives <str<strong>on</strong>g>and</str<strong>on</strong>g> recommend<br />
that professi<strong>on</strong>als <str<strong>on</strong>g>and</str<strong>on</strong>g> caregivers take the preferences<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> pers<strong>on</strong>al goals of these pers<strong>on</strong>s<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>to account when mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g decisi<strong>on</strong>s c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
their lives. Recently, assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g choices <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
preferences, which are def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed as repeated<br />
This research was funded with doctoral grants<br />
from the C<strong>on</strong>sortium nati<strong>on</strong>al de recherche sur<br />
l’<str<strong>on</strong>g>in</str<strong>on</strong>g>tégrati<strong>on</strong> sociale (Nati<strong>on</strong>al c<strong>on</strong>sortium <strong>on</strong> social<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tegrati<strong>on</strong>, www.cnris.org), the F<strong>on</strong>ds de recherche<br />
québécois sur la société et la culture (Society <str<strong>on</strong>g>and</str<strong>on</strong>g> culture<br />
research Quebec funds, www.fqrsc.gouv.qc.ca) <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
the Quebec chapter of the American Associati<strong>on</strong> <strong>on</strong><br />
Intellectual <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> (www.<br />
aaidd.org). Corresp<strong>on</strong>dence c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g this article<br />
should be addressed to Virg<str<strong>on</strong>g>in</str<strong>on</strong>g>ie Cobigo, Queen’s<br />
University, Department of Community Health <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Epidemiology, 21 Arch Street, Abramsky Hall, 3rd<br />
Floor, K<str<strong>on</strong>g>in</str<strong>on</strong>g>gst<strong>on</strong>, ON K7L 3N6, CANADA. Email:<br />
virg<str<strong>on</strong>g>in</str<strong>on</strong>g>ie.cobigo@gmail.com<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, 2009, 44(4), 561–572<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
choices of a same opti<strong>on</strong>, was highlighted as<br />
<strong>on</strong>e of the ma<str<strong>on</strong>g>in</str<strong>on</strong>g> relevant research doma<str<strong>on</strong>g>in</str<strong>on</strong>g>s<br />
(Emers<strong>on</strong>, Hatt<strong>on</strong>, Thomps<strong>on</strong>, & Parmenter,<br />
2004). Direct measures of preferences are<br />
necessary s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce preferences expressed by the<br />
pers<strong>on</strong> him- or herself may differ from those<br />
hypothesized by proxies, especially if the latter<br />
rely <strong>on</strong> subjective <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> (Perry & Felce,<br />
2002; Reid, Evers<strong>on</strong>, & Green, 1999; Stancliffe,<br />
1995). However, all direct measures may<br />
not be suitable for every pers<strong>on</strong> with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual<br />
disability. Questi<strong>on</strong>naires <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terviews<br />
may be <str<strong>on</strong>g>in</str<strong>on</strong>g>effective with pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual<br />
disability because of limitati<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> their<br />
receptive or expressive communicati<strong>on</strong> skills<br />
(Camer<strong>on</strong> & Murphy, 2002). Pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual<br />
disability also have a tendency to<br />
acquiesce <strong>on</strong> yes-say<str<strong>on</strong>g>in</str<strong>on</strong>g>g questi<strong>on</strong>s or to choose<br />
the sec<strong>on</strong>d of two parallel either/or questi<strong>on</strong>s<br />
(F<str<strong>on</strong>g>in</str<strong>on</strong>g>lay & Ly<strong>on</strong>s, 2002; Perry & Felce, 2002).<br />
Cognitive limitati<strong>on</strong>s are other important barriers<br />
to expressi<strong>on</strong> of preferences, particularly<br />
<strong>on</strong> complex abstract issues (Perry, 2004). C<strong>on</strong>sequently,<br />
pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability<br />
Assessment of Work Task Preferences / 561
may benefit from direct observati<strong>on</strong> while<br />
they are manipulat<str<strong>on</strong>g>in</str<strong>on</strong>g>g or c<strong>on</strong>sum<str<strong>on</strong>g>in</str<strong>on</strong>g>g opti<strong>on</strong>s<br />
presented dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g a valid preference assessment<br />
procedure. Pictorial presentati<strong>on</strong>s us<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
still pictures or videos are likely to compromise<br />
preferences assessment as they may be<br />
too abstract, given an <str<strong>on</strong>g>in</str<strong>on</strong>g>dividual’s cognitive<br />
skills. Most of the studies <strong>on</strong> direct observati<strong>on</strong><br />
assessment methods describe assessment<br />
of preferences for tangible stimuli (edibles,<br />
sensory activity, etc). Further research is<br />
needed to implement direct observati<strong>on</strong><br />
methods for assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g more symbolic objects<br />
that represent important life outcomes, such<br />
as vocati<strong>on</strong>al activities (Cobigo, Mor<str<strong>on</strong>g>in</str<strong>on</strong>g>, &<br />
Lachapelle, 2007; Hatt<strong>on</strong>, 2004; Hughes, Pitk<str<strong>on</strong>g>in</str<strong>on</strong>g>,<br />
& Lorden, 1998; Lohrmann-O’Rourke &<br />
Browder, 1998). This study aims to present<br />
field test results of a method to assess vocati<strong>on</strong>al<br />
preferences us<str<strong>on</strong>g>in</str<strong>on</strong>g>g direct observati<strong>on</strong><br />
while a pers<strong>on</strong> selects an opti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> works <strong>on</strong><br />
the corresp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g task. Furthermore, it assesses<br />
the value <str<strong>on</strong>g>in</str<strong>on</strong>g> use of the assessment<br />
method by <str<strong>on</strong>g>in</str<strong>on</strong>g>terview<str<strong>on</strong>g>in</str<strong>on</strong>g>g the 16 job coaches<br />
who c<strong>on</strong>ducted assessment <strong>on</strong> 19 pers<strong>on</strong>s with<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability.<br />
Method<br />
Participants<br />
Sixteen job coaches (all women) were recruited<br />
through four local developmental disability<br />
agencies that provide public services to<br />
pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability <str<strong>on</strong>g>in</str<strong>on</strong>g> the Prov<str<strong>on</strong>g>in</str<strong>on</strong>g>ce<br />
of Quebec (Canada). Fourteen had a<br />
college or university degree. Fourteen of them<br />
had worked with pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability<br />
for at least 10 years. They assessed work<br />
task preferences for n<str<strong>on</strong>g>in</str<strong>on</strong>g>eteen pers<strong>on</strong>s with<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability (8 women, 11 men) who<br />
encountered difficulties express<str<strong>on</strong>g>in</str<strong>on</strong>g>g their preferences<br />
verbally. The evaluated pers<strong>on</strong>s were<br />
between 23 to 58 years old (mean 35). Their<br />
levels of adaptive behaviors were assessed us<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the Échelle québécoise des comportements adaptatifs<br />
(Quebec Adaptive Behavior Scale; Maurice,<br />
Mor<str<strong>on</strong>g>in</str<strong>on</strong>g>, Tassé, Garc<str<strong>on</strong>g>in</str<strong>on</strong>g>, & Vaillant, 1997)<br />
which is a reliable French <str<strong>on</strong>g>in</str<strong>on</strong>g>strument to assess<br />
adaptive behaviors of pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual<br />
disability aged 3 years <str<strong>on</strong>g>and</str<strong>on</strong>g> older. It gives reliable<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> comparable descripti<strong>on</strong>s of the participants,<br />
us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a global score which describes<br />
the general adaptive skills of each participant.<br />
562 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
It also provides seven partial scores, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
communicati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> vocati<strong>on</strong>al skills levels.<br />
These two scores provided <str<strong>on</strong>g>in</str<strong>on</strong>g>terest<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong><br />
<strong>on</strong> the participants’ functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
terms of the research goals. The computed<br />
global scores <str<strong>on</strong>g>in</str<strong>on</strong>g>dicated that all the evaluated<br />
pers<strong>on</strong>s had a severe to profound deficit <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
their adaptive skills, except for <strong>on</strong>e who had a<br />
mild deficit (participant 14). Their deficits <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
communicati<strong>on</strong> skills were severe to profound,<br />
except for <strong>on</strong>e who was reported as<br />
hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g a mild deficit (participant 16). All were<br />
assessed as hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g important limitati<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> express<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
or underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g complex language.<br />
One had no deficit <str<strong>on</strong>g>in</str<strong>on</strong>g> his vocati<strong>on</strong>al skills<br />
(participant 14), five had a mild deficit (participants<br />
3, 4, 6, 7, 15), seven a moderate<br />
deficit, <str<strong>on</strong>g>and</str<strong>on</strong>g> six a severe to profound deficit <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
their vocati<strong>on</strong>al skills. Most of them received<br />
c<strong>on</strong>stant supervisi<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> had held the same<br />
job for more than a year. Work sett<str<strong>on</strong>g>in</str<strong>on</strong>g>gs were<br />
diverse: participants worked <str<strong>on</strong>g>in</str<strong>on</strong>g> schools, stores<br />
or community centers. C<strong>on</strong>sequently, work<br />
tasks presented dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the assessment were<br />
different from <strong>on</strong>e participant to another (for<br />
example, sort<str<strong>on</strong>g>in</str<strong>on</strong>g>g clothes, count<str<strong>on</strong>g>in</str<strong>on</strong>g>g 100 screws<br />
with a caliber, putt<str<strong>on</strong>g>in</str<strong>on</strong>g>g price stickers <strong>on</strong> products,<br />
shredd<str<strong>on</strong>g>in</str<strong>on</strong>g>g paper, etc.). Three of them<br />
were <str<strong>on</strong>g>in</str<strong>on</strong>g> an assessment period to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
which job best suited them. Twelve had known<br />
the evaluator for at least a year, <str<strong>on</strong>g>and</str<strong>on</strong>g> six had<br />
got to know her with<str<strong>on</strong>g>in</str<strong>on</strong>g> the last six m<strong>on</strong>ths.<br />
They all had weekly c<strong>on</strong>tact with the evaluators,<br />
except for <strong>on</strong>e who saw his or her evaluator<br />
<strong>on</strong>ce a m<strong>on</strong>th.<br />
Research Design<br />
A work task preference assessment method<br />
was designed follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g an <str<strong>on</strong>g>in</str<strong>on</strong>g>tegrative review<br />
(Jacks<strong>on</strong>, 1989) of studies assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g vocati<strong>on</strong>al<br />
preferences <str<strong>on</strong>g>in</str<strong>on</strong>g> pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability<br />
or evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g the reliability of such assessment<br />
methods (Cobigo, Mor<str<strong>on</strong>g>in</str<strong>on</strong>g> et al.,<br />
2007). This review allowed the researcher to<br />
make decisi<strong>on</strong>s <strong>on</strong> stimuli presented, assessment<br />
c<strong>on</strong>text <str<strong>on</strong>g>and</str<strong>on</strong>g> procedure, as well as behaviors<br />
to observe <str<strong>on</strong>g>and</str<strong>on</strong>g> to design a valid <str<strong>on</strong>g>and</str<strong>on</strong>g> reliable<br />
method to assess vocati<strong>on</strong>al preferences<br />
with pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability. The<br />
designed method was then validated by five<br />
experts <str<strong>on</strong>g>in</str<strong>on</strong>g> the <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability field, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
pre-experimentati<strong>on</strong> was c<strong>on</strong>ducted with two<br />
job coaches (Cobigo, Lachapelle, & Mor<str<strong>on</strong>g>in</str<strong>on</strong>g>,
2007). The 16 job coaches who agreed to participate<br />
were tra<str<strong>on</strong>g>in</str<strong>on</strong>g>ed to c<strong>on</strong>duct work task<br />
preference assessment us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the method designed<br />
by the researcher. They chose <strong>on</strong>e or<br />
two pers<strong>on</strong>s they wished to assess. Job coaches<br />
chose four tasks that existed at each pers<strong>on</strong>’s<br />
work sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g. If necessary, the pers<strong>on</strong> was<br />
tra<str<strong>on</strong>g>in</str<strong>on</strong>g>ed beforeh<str<strong>on</strong>g>and</str<strong>on</strong>g> to know which behaviors<br />
were needed to complete a task.<br />
Dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the assessment, two choices were<br />
presented simultaneously us<str<strong>on</strong>g>in</str<strong>on</strong>g>g tangible objects<br />
normally required to complete the tasks.<br />
Pictograms were used with two participants<br />
(participants 6 <str<strong>on</strong>g>and</str<strong>on</strong>g> 14) as they already communicate<br />
us<str<strong>on</strong>g>in</str<strong>on</strong>g>g images at the job site. Objects<br />
or pictograms were presented at an equal distance<br />
from the pers<strong>on</strong>, so he could reach both<br />
of them. The evaluator asked the pers<strong>on</strong> to<br />
pick <strong>on</strong>e of the objects, without nam<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
corresp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g activities. The evaluator recorded<br />
selecti<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> refusals <strong>on</strong> an observati<strong>on</strong><br />
grid. Selecti<strong>on</strong> was def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed as po<str<strong>on</strong>g>in</str<strong>on</strong>g>t<str<strong>on</strong>g>in</str<strong>on</strong>g>g to<br />
an object, touch<str<strong>on</strong>g>in</str<strong>on</strong>g>g it or nam<str<strong>on</strong>g>in</str<strong>on</strong>g>g the activity it<br />
represented. The pers<strong>on</strong> be<str<strong>on</strong>g>in</str<strong>on</strong>g>g evaluated was<br />
allowed to change his choice with<str<strong>on</strong>g>in</str<strong>on</strong>g> a fivesec<strong>on</strong>d<br />
period, <str<strong>on</strong>g>in</str<strong>on</strong>g> which case the sec<strong>on</strong>d<br />
choice was c<strong>on</strong>sidered as selected. Refusals<br />
were def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed as throw<str<strong>on</strong>g>in</str<strong>on</strong>g>g an object away,<br />
push<str<strong>on</strong>g>in</str<strong>on</strong>g>g it away, or refus<str<strong>on</strong>g>in</str<strong>on</strong>g>g to choose <strong>on</strong>e of<br />
the opti<strong>on</strong>s. If both opti<strong>on</strong>s were refused, the<br />
pair of objects was removed <str<strong>on</strong>g>and</str<strong>on</strong>g> the next pair<br />
was presented. Once a choice was recorded,<br />
the pers<strong>on</strong> be<str<strong>on</strong>g>in</str<strong>on</strong>g>g evaluated was prompted to<br />
work <strong>on</strong> the selected task with<str<strong>on</strong>g>in</str<strong>on</strong>g> a threem<str<strong>on</strong>g>in</str<strong>on</strong>g>ute<br />
period. The evaluator used a chr<strong>on</strong>ometer<br />
to assess the length of time spent<br />
work<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> the task <str<strong>on</strong>g>in</str<strong>on</strong>g> the three-m<str<strong>on</strong>g>in</str<strong>on</strong>g>ute period.<br />
The evaluator also recorded off-task behaviors<br />
which were what the pers<strong>on</strong> did when<br />
the chr<strong>on</strong>ometer was off (off-task behaviors).<br />
The evaluator also observed positive emoti<strong>on</strong>al<br />
behaviors such as smil<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> laugh<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
as well as idiosyncratic vocalizati<strong>on</strong>s or gestures<br />
express<str<strong>on</strong>g>in</str<strong>on</strong>g>g pleasure. A timer rang when<br />
the three m<str<strong>on</strong>g>in</str<strong>on</strong>g>utes were up. The task was removed<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> the sec<strong>on</strong>d pair of choices was<br />
presented follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g the same procedure. The<br />
sequences of the pairs were predeterm<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
r<str<strong>on</strong>g>and</str<strong>on</strong>g>omly, as well as alternat<str<strong>on</strong>g>in</str<strong>on</strong>g>g object presentati<strong>on</strong><br />
side (right <str<strong>on</strong>g>and</str<strong>on</strong>g> left). In a sessi<strong>on</strong>, all<br />
possible pairs had to be presented. In this<br />
study, four tasks were presented, so six pairs<br />
were possible. Evaluators were provided with<br />
observati<strong>on</strong> grids that <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong><br />
about sequences <str<strong>on</strong>g>in</str<strong>on</strong>g> pair presentati<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> alternat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
right-left positi<strong>on</strong>s. Seven sessi<strong>on</strong>s<br />
were c<strong>on</strong>ducted <str<strong>on</strong>g>in</str<strong>on</strong>g> an eight-week maximum<br />
period. Research assistants observed 30% of<br />
the assessment sessi<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> order to c<strong>on</strong>duct<br />
reliability checks. The first two sessi<strong>on</strong>s were<br />
not <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> the assessment results, as they<br />
were designed for mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g any necessary adjustments<br />
to the set-up, <str<strong>on</strong>g>and</str<strong>on</strong>g> for acqua<str<strong>on</strong>g>in</str<strong>on</strong>g>t<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
both the evaluator <str<strong>on</strong>g>and</str<strong>on</strong>g> the pers<strong>on</strong> be<str<strong>on</strong>g>in</str<strong>on</strong>g>g evaluated<br />
with the assessment procedure. For the<br />
behaviors recorded dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g sessi<strong>on</strong>s three to<br />
seven, the evaluator computed percentages of<br />
choice <str<strong>on</strong>g>and</str<strong>on</strong>g> refusal for each task. Percentages<br />
of off-task <str<strong>on</strong>g>and</str<strong>on</strong>g> positive emoti<strong>on</strong>al behaviors<br />
were calculated <strong>on</strong> the number of choices for<br />
each task. The evaluator also calculated the<br />
mean durati<strong>on</strong> of <strong>on</strong>-task behavior <str<strong>on</strong>g>in</str<strong>on</strong>g> a threem<str<strong>on</strong>g>in</str<strong>on</strong>g>ute<br />
period. This provided a profile of the<br />
most <str<strong>on</strong>g>and</str<strong>on</strong>g> least preferred activities am<strong>on</strong>g the<br />
four tasks presented. In c<strong>on</strong>cordance with<br />
previous research (Lanci<strong>on</strong>i, O’Reilly, Campod<strong>on</strong>ico,<br />
& Mant<str<strong>on</strong>g>in</str<strong>on</strong>g>i, 1998a; Lanci<strong>on</strong>i, O’Reilly,<br />
Campod<strong>on</strong>ico, & Mant<str<strong>on</strong>g>in</str<strong>on</strong>g>i, 1998b; Pars<strong>on</strong>s,<br />
Reid, & Green, 1998; Reid, Pars<strong>on</strong>s, & Green,<br />
1998), we expected that the most preferred<br />
activities were chosen over 70% of the time<br />
they were presented, they had the l<strong>on</strong>gest durati<strong>on</strong><br />
of <strong>on</strong>-task behaviors, the highest frequency<br />
of positive emoti<strong>on</strong>al behaviors, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
the lowest frequency of off-task behaviors. In<br />
c<strong>on</strong>trast, a least-preferred activity is expected<br />
to be chosen less than 50% of the time it was<br />
presented; to have the highest frequency of<br />
off-task behaviors, the lowest durati<strong>on</strong> of <strong>on</strong>task<br />
behaviors <str<strong>on</strong>g>and</str<strong>on</strong>g> lowest frequency of positive<br />
emoti<strong>on</strong>al behaviors. For each participant,<br />
tasks were classified from most to least preferred<br />
us<str<strong>on</strong>g>in</str<strong>on</strong>g>g frequencies of choice. We analyzed<br />
if levels of preferences have an impact<br />
<strong>on</strong> emoti<strong>on</strong>al <str<strong>on</strong>g>and</str<strong>on</strong>g> off-task behavior frequencies,<br />
us<str<strong>on</strong>g>in</str<strong>on</strong>g>g repeated measures ANOVA.<br />
Once the assessment was f<str<strong>on</strong>g>in</str<strong>on</strong>g>ished, a research<br />
assistant c<strong>on</strong>ducted a semi-structured<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terview with each job coach to collect data<br />
<strong>on</strong> her percepti<strong>on</strong>s of the assessment method.<br />
Interviews were designed follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g the utilizati<strong>on</strong>-focused<br />
assessment approach (Patt<strong>on</strong>,<br />
1997) to assess the method’s value <str<strong>on</strong>g>in</str<strong>on</strong>g> use. It<br />
could be def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed as the value of an <str<strong>on</strong>g>in</str<strong>on</strong>g>strument<br />
or a product <str<strong>on</strong>g>in</str<strong>on</strong>g> relati<strong>on</strong> to its users’ needs <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
use c<strong>on</strong>diti<strong>on</strong>s. Thus, <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewers were tra<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
Assessment of Work Task Preferences / 563
to follow an <str<strong>on</strong>g>in</str<strong>on</strong>g>terview guide that listed specific<br />
questi<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> topics to be covered. Interview<br />
themes were: 1. general percepti<strong>on</strong>s of the<br />
method used; 2. facilitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g factors observed; 3.<br />
barriers encountered; 4. assessment outcomes;<br />
5. assessment of the expected <str<strong>on</strong>g>and</str<strong>on</strong>g> unexpected<br />
outcomes; <str<strong>on</strong>g>and</str<strong>on</strong>g> 6. percepti<strong>on</strong>s of the advantages<br />
of the method. Interviews lasted about 30 to 60<br />
m<str<strong>on</strong>g>in</str<strong>on</strong>g>utes. Research assistants transcribed audiotaped<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terviews, <str<strong>on</strong>g>and</str<strong>on</strong>g> an <str<strong>on</strong>g>in</str<strong>on</strong>g>dependent assistant<br />
checked all the transcripts.<br />
Qualitative data were analyzed <str<strong>on</strong>g>in</str<strong>on</strong>g> six recommended<br />
steps to prevent bias <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terpretati<strong>on</strong><br />
(L’Écuyer, 1990; Miles & Huberman, 1994;<br />
2003). First, the experimenter read transcripts<br />
twice to get an overall underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g of the<br />
material. Transcripts were cut <str<strong>on</strong>g>in</str<strong>on</strong>g>to mean<str<strong>on</strong>g>in</str<strong>on</strong>g>gful<br />
segments. Each passage was categorized us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a<br />
grid of codes. This grid was developed accord<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
to <str<strong>on</strong>g>in</str<strong>on</strong>g>terview themes <str<strong>on</strong>g>and</str<strong>on</strong>g> study goals. Two<br />
assistants tried this grid with 30% of the transcripts<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> made comments to enhance its reliability.<br />
The experimenter then analyzed the material<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> assigned a code to each secti<strong>on</strong><br />
follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g the modified grid. Two other assistants<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>dependently analyzed 30% of the transcripts<br />
us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the same grid to check <str<strong>on</strong>g>in</str<strong>on</strong>g>ter-coder<br />
agreement. The grid c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed 29 codes <str<strong>on</strong>g>in</str<strong>on</strong>g> six<br />
categories (general percepti<strong>on</strong>s, facilitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g factors,<br />
barriers encountered, assessment outcomes,<br />
other <str<strong>on</strong>g>in</str<strong>on</strong>g>struments to assess preferences<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> how to enhance the assessment method)<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> these are described <str<strong>on</strong>g>in</str<strong>on</strong>g> Table 1. Descriptive<br />
analyses were c<strong>on</strong>ducted to describe the experience<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> percepti<strong>on</strong>s of participants <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of<br />
the above-menti<strong>on</strong>ed themes.<br />
Results<br />
Preference Assessment<br />
The percentage of <str<strong>on</strong>g>in</str<strong>on</strong>g>ter-observer agreement<br />
was estimated by divid<str<strong>on</strong>g>in</str<strong>on</strong>g>g the number of<br />
agreements by the number of agreements plus<br />
disagreements <str<strong>on</strong>g>and</str<strong>on</strong>g> multiply<str<strong>on</strong>g>in</str<strong>on</strong>g>g by 100%. Inter-observer<br />
agreement ranged between 73%<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> 100%, depend<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> the participants,<br />
with overall <str<strong>on</strong>g>in</str<strong>on</strong>g>ter-observer agreement be<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
85%. Inter-observer agreement also varied depend<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<strong>on</strong> the k<str<strong>on</strong>g>in</str<strong>on</strong>g>d of behaviors recorded.<br />
Agreement was lower for positive emoti<strong>on</strong>al<br />
behaviors (71%) which are discrete <str<strong>on</strong>g>and</str<strong>on</strong>g> sometimes<br />
idiosyncratic. Furthermore, evaluators<br />
may have wr<strong>on</strong>gly recorded participant char-<br />
564 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
acteristics, such as attentiveness or degree of<br />
c<strong>on</strong>centrati<strong>on</strong>, as positive emoti<strong>on</strong>al behaviors.<br />
These observati<strong>on</strong> errors were corrected before<br />
calculat<str<strong>on</strong>g>in</str<strong>on</strong>g>g frequencies of emoti<strong>on</strong>al behaviors.<br />
Other agreements ranged from 82% (off-task<br />
behaviors) to 98% (selecti<strong>on</strong>). However, the offtask<br />
behavior category was misunderstood by<br />
several observers who recorded off-task behaviors<br />
even if the pers<strong>on</strong> be<str<strong>on</strong>g>in</str<strong>on</strong>g>g evaluated did not<br />
stop work<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> the task. Once these errors<br />
were corrected, <str<strong>on</strong>g>in</str<strong>on</strong>g>ter-observer agreement <strong>on</strong><br />
off-task behaviors was 88%.<br />
Overall, results show that most preferred<br />
work tasks could be evaluated for 12 participants<br />
out of 19. Figures 1 <str<strong>on</strong>g>and</str<strong>on</strong>g> 2 show assessment<br />
results for each participant. Results vary<br />
c<strong>on</strong>siderably am<strong>on</strong>g participants. The percentages<br />
of choices clearly dem<strong>on</strong>strate the<br />
most-preferred <str<strong>on</strong>g>and</str<strong>on</strong>g> less-preferred work tasks<br />
for the majority of participants. However, no<br />
obvious preference profile could be dem<strong>on</strong>strated<br />
for participants 2, 6, 14 <str<strong>on</strong>g>and</str<strong>on</strong>g> 18 as<br />
frequencies of choice were equivalent for all<br />
the four tasks (around 40% <str<strong>on</strong>g>and</str<strong>on</strong>g> 60%). Participants<br />
11 <str<strong>on</strong>g>and</str<strong>on</strong>g> 12 dem<strong>on</strong>strated no most-preferred<br />
activity, but frequencies of choice for<br />
moderately-preferred <str<strong>on</strong>g>and</str<strong>on</strong>g> n<strong>on</strong>-preferred activities<br />
vary between 27% <str<strong>on</strong>g>and</str<strong>on</strong>g> 67%. The percentages<br />
of choices were not reliable for participant<br />
10. Throughout the assessment, he<br />
chose the left-positi<strong>on</strong>ed stimulus. Experimenters<br />
were careful not to present the same<br />
stimulus always <strong>on</strong> the right or left side, but<br />
did not equally balance right <str<strong>on</strong>g>and</str<strong>on</strong>g> left positi<strong>on</strong>s<br />
for each task. Task 1 was presented 80%<br />
of the time <strong>on</strong> the left side.<br />
Only four participants exhibited refusals<br />
dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the assessment. Frequency of refusals<br />
for participant 12 should be <str<strong>on</strong>g>in</str<strong>on</strong>g>terpreted with<br />
cauti<strong>on</strong> s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce refusals were hard to dist<str<strong>on</strong>g>in</str<strong>on</strong>g>guish<br />
from his epileptic symptoms. Participant<br />
5 exhibited refusals with two tasks that he<br />
selected at least 80% of the time they were<br />
presented. However, each task was <strong>on</strong>ly refused<br />
<strong>on</strong>ce. It is <str<strong>on</strong>g>in</str<strong>on</strong>g>terest<str<strong>on</strong>g>in</str<strong>on</strong>g>g to note that participant<br />
5 is diagnosed with a pervasive developmental<br />
disorder. Participants 7 <str<strong>on</strong>g>and</str<strong>on</strong>g> 14<br />
exhibited refusals with moderately-preferred<br />
tasks. No refusal was exhibited with n<strong>on</strong>-preferred<br />
activities.<br />
Only four participants did not exhibit offtask<br />
behaviors dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the assessment. N<strong>on</strong>etheless,<br />
no c<strong>on</strong>cordance was observed be-
TABLE 1<br />
Qualitative Analysis Grid<br />
Categories Codes<br />
General percepti<strong>on</strong>s a) Satisfacti<strong>on</strong><br />
b) Dissatisfacti<strong>on</strong><br />
c) Reluctance<br />
d) Pers<strong>on</strong>s who could benefit from the assessment<br />
e) Professi<strong>on</strong>als who could use the method.<br />
Facilitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g factors a) Related to the assessment c<strong>on</strong>text<br />
b) Related to the evaluated pers<strong>on</strong>’s characteristics<br />
c) Related to the assessment method itself<br />
d) Related to the tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g received <strong>on</strong> the assessment<br />
method<br />
e) Related to the evaluator’s professi<strong>on</strong>al tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
experience<br />
f) Other facilitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g factors.<br />
Barriers encountered a) Related to the assessment c<strong>on</strong>text<br />
b) Related to the evaluated pers<strong>on</strong>’s characteristics<br />
c) Related to the assessment method itself<br />
d) Related to the tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g received <strong>on</strong> the assessment<br />
method<br />
e) Related to the evaluator’s professi<strong>on</strong>al tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
experience<br />
f) Other barriers encountered.<br />
Assessment outcomes a) Knowledge of the evaluated pers<strong>on</strong>’s preferences<br />
b) Agreement between assessed preferences <str<strong>on</strong>g>and</str<strong>on</strong>g> preferences<br />
assumed by the evaluator before the assessment<br />
c) Lack of agreement between assessed <str<strong>on</strong>g>and</str<strong>on</strong>g> assumed<br />
preferences<br />
d) Knowledge of work<str<strong>on</strong>g>in</str<strong>on</strong>g>g c<strong>on</strong>diti<strong>on</strong> preferences<br />
e) Plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g vocati<strong>on</strong>al activities<br />
f) Other outcomes.<br />
Other <str<strong>on</strong>g>in</str<strong>on</strong>g>struments to assess preferences a) Validated <str<strong>on</strong>g>in</str<strong>on</strong>g>strument<br />
b) Informal tool<br />
c) No other tool known<br />
How to enhance the assessment method a) Suggesti<strong>on</strong>s for enhanc<str<strong>on</strong>g>in</str<strong>on</strong>g>g the assessment method<br />
b) Expressi<strong>on</strong> of no possible improvements<br />
c) Expressi<strong>on</strong> of no known improvements<br />
tween the frequency of choices <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
frequency of off-task behaviors. Repeated<br />
measures ANOVA were n<strong>on</strong> significant (p <br />
0.05), suggest<str<strong>on</strong>g>in</str<strong>on</strong>g>g that there is no impact of the<br />
level of preference <strong>on</strong> the frequency of offtask<br />
behaviors. Off-task behaviors were exhibited<br />
with most-preferred as well as less-preferred<br />
activities. For example, participant 9<br />
exhibited off-task behaviors while complet<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
his two most-preferred tasks, but n<strong>on</strong>e<br />
with his less-preferred <strong>on</strong>es. Participant 13<br />
exhibited off-task behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g> almost 100%<br />
of the observati<strong>on</strong> periods. The length of<br />
time spent work<str<strong>on</strong>g>in</str<strong>on</strong>g>g <strong>on</strong> the task was also<br />
recorded but is not reported <str<strong>on</strong>g>in</str<strong>on</strong>g> this article<br />
because no significant difference between<br />
tasks <str<strong>on</strong>g>and</str<strong>on</strong>g> participants is clearly dem<strong>on</strong>strated.<br />
All the computed means are above<br />
two m<str<strong>on</strong>g>in</str<strong>on</strong>g>utes <strong>on</strong> a three-m<str<strong>on</strong>g>in</str<strong>on</strong>g>ute period <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
are not c<strong>on</strong>gruent with other behaviors recorded.<br />
Most of the time, positive emoti<strong>on</strong>al behaviors<br />
were exhibited while complet<str<strong>on</strong>g>in</str<strong>on</strong>g>g a task that<br />
was selected over 70% of the time it was presented.<br />
However, positive emoti<strong>on</strong>al behaviors<br />
were also exhibited with less-preferred <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
n<strong>on</strong>-preferred tasks. Repeated measures<br />
ANOVA were not significant (p 0.05). Fre-<br />
Assessment of Work Task Preferences / 565
quency of positive emoti<strong>on</strong>al behaviors did not<br />
vary proporti<strong>on</strong>ally to frequency of choices.<br />
Utilizati<strong>on</strong>-focused Assessment<br />
Codes utilized to analyze transcripts of <str<strong>on</strong>g>in</str<strong>on</strong>g>terviews<br />
with the job coaches were divided <str<strong>on</strong>g>in</str<strong>on</strong>g> 6<br />
categories: 1. general percepti<strong>on</strong>s of <str<strong>on</strong>g>in</str<strong>on</strong>g>terview-<br />
Figure 1. Assessment results by participant.<br />
566 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
ees c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g the assessment method, 2. facilitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
factors <str<strong>on</strong>g>in</str<strong>on</strong>g> the implementati<strong>on</strong> of the<br />
method, 3. barriers encountered, 4. appreciati<strong>on</strong><br />
of the assessment outcomes, 5. other tools<br />
to assess vocati<strong>on</strong>al preferences known by <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees,<br />
6. recommendati<strong>on</strong>s to enhance<br />
the assessment method. To facilitate readers’
comprehensi<strong>on</strong>, results for both category 2<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> 3 will be presented <str<strong>on</strong>g>in</str<strong>on</strong>g> the same paragraph.<br />
General Percepti<strong>on</strong>s<br />
All <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees expressed their appreciati<strong>on</strong> of<br />
the method <str<strong>on</strong>g>and</str<strong>on</strong>g> recommended its use s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce<br />
they need such assessment methods to enhance<br />
observati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g of their clients.<br />
They found the method pleasant <str<strong>on</strong>g>and</str<strong>on</strong>g> easy to<br />
use. However, three of them were dissatisfied<br />
with the assessment results which they qualified<br />
as <str<strong>on</strong>g>in</str<strong>on</strong>g>sufficient or unclear. These three job<br />
coaches respectively assessed participants 10, 12<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> 13, <str<strong>on</strong>g>and</str<strong>on</strong>g> 17. Participant 10 is the pers<strong>on</strong> who<br />
chose all objects presented <strong>on</strong> his left. Results<br />
for participants 12, 13 <str<strong>on</strong>g>and</str<strong>on</strong>g> 17 are ambiguous<br />
because of a lack of c<strong>on</strong>gruence am<strong>on</strong>g behaviors<br />
observed. Only <strong>on</strong>e job coach declared that<br />
she was not <str<strong>on</strong>g>in</str<strong>on</strong>g>terested <str<strong>on</strong>g>in</str<strong>on</strong>g> us<str<strong>on</strong>g>in</str<strong>on</strong>g>g the assessment<br />
method s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce she was already aware of her clients’<br />
preferences before the assessment. However,<br />
she thought that young job coaches could<br />
f<str<strong>on</strong>g>in</str<strong>on</strong>g>d the method useful. Accord<str<strong>on</strong>g>in</str<strong>on</strong>g>g to the <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees,<br />
the method could be used by various<br />
types of professi<strong>on</strong>als, irrespective of their academic<br />
background, s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce it is easy to implement.<br />
Job coaches <str<strong>on</strong>g>and</str<strong>on</strong>g> psychologists were the most<br />
comm<strong>on</strong> professi<strong>on</strong>al categories cited. Two <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees<br />
also recommended that school professi<strong>on</strong>als<br />
use this method to help students discover<br />
their vocati<strong>on</strong>al orientati<strong>on</strong>. Furthermore,<br />
some <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees thought that the method<br />
could be useful for assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>terests for leisure<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> home tasks. Interviewees highlighted the<br />
usefulness of this method for assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g the preferences<br />
of pers<strong>on</strong>s who have limited communicati<strong>on</strong><br />
skills, especially those who have not been<br />
tra<str<strong>on</strong>g>in</str<strong>on</strong>g>ed to communicate us<str<strong>on</strong>g>in</str<strong>on</strong>g>g alternative communicati<strong>on</strong><br />
means (signs, pictograms, etc.).<br />
Most of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees added that pers<strong>on</strong>s<br />
with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities may have difficulty<br />
express<str<strong>on</strong>g>in</str<strong>on</strong>g>g their preferences because of a tendency<br />
to acquiesce with or to please their caregivers,<br />
even if they have no major communicati<strong>on</strong><br />
limitati<strong>on</strong>s. Pers<strong>on</strong>s with or without<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability may benefit from this<br />
method if they have language, auditory or visual<br />
difficulties. Several <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees said that the<br />
method is useful for quickly identify<str<strong>on</strong>g>in</str<strong>on</strong>g>g a new<br />
client’s preferences <str<strong>on</strong>g>in</str<strong>on</strong>g> order to plan his vocati<strong>on</strong>al<br />
orientati<strong>on</strong>. Twelve <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees were re-<br />
luctant to use the assessment method. They<br />
feared that they would not have enough time to<br />
c<strong>on</strong>duct the assessment, they would be disturbed<br />
by other clients, the pers<strong>on</strong> be<str<strong>on</strong>g>in</str<strong>on</strong>g>g evaluated<br />
would not cooperate, or the method would<br />
be too complicated. All of their fears disappeared<br />
when they used the method.<br />
Facilitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g Factors <str<strong>on</strong>g>and</str<strong>on</strong>g> Barriers Encountered<br />
More than 80% of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees identified<br />
c<strong>on</strong>textual factors as c<strong>on</strong>diti<strong>on</strong>s that would<br />
facilitate implementati<strong>on</strong> of the method, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
75% found that c<strong>on</strong>textual factors could be<br />
barriers to its use (see Figure 3). The assessment<br />
c<strong>on</strong>text seems to be an important issue<br />
to c<strong>on</strong>sider when evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g the effectiveness<br />
of the method. Job coaches could choose to<br />
either c<strong>on</strong>duct the assessment <str<strong>on</strong>g>in</str<strong>on</strong>g> the natural<br />
work sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g or <str<strong>on</strong>g>in</str<strong>on</strong>g> a separate room <str<strong>on</strong>g>in</str<strong>on</strong>g> a <strong>on</strong>e<strong>on</strong>-<strong>on</strong>e<br />
situati<strong>on</strong> with the pers<strong>on</strong> be<str<strong>on</strong>g>in</str<strong>on</strong>g>g evaluated.<br />
Those who chose to c<strong>on</strong>duct the assessment<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> a separate room identified this factor<br />
as a facilitator. Natural work c<strong>on</strong>diti<strong>on</strong>s make<br />
the assessment more difficult s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce other clients<br />
may need attenti<strong>on</strong> or some<strong>on</strong>e could<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terrupt a sessi<strong>on</strong>. The pers<strong>on</strong> be<str<strong>on</strong>g>in</str<strong>on</strong>g>g evaluated<br />
is also more distracted because of <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s<br />
with peers. If the assessment is c<strong>on</strong>ducted<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> a natural work sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees<br />
recommended that a colleague take over from<br />
them <str<strong>on</strong>g>and</str<strong>on</strong>g> that tasks be assigned to the other<br />
clients so they will not disturb the assessment.<br />
They also recommended choos<str<strong>on</strong>g>in</str<strong>on</strong>g>g an appropriate<br />
time for c<strong>on</strong>duct<str<strong>on</strong>g>in</str<strong>on</strong>g>g a sessi<strong>on</strong>. Most of<br />
them chose times when some clients were absent,<br />
or when there was no rush <str<strong>on</strong>g>in</str<strong>on</strong>g> the producti<strong>on</strong><br />
schedule, etc. Other c<strong>on</strong>textual factors<br />
identified as facilitators or barriers had an<br />
impact <strong>on</strong> the client’s motivati<strong>on</strong> to complete<br />
the task. For example, it is necessary to prepare<br />
enough material to last the entire sessi<strong>on</strong>.<br />
When material was <str<strong>on</strong>g>in</str<strong>on</strong>g>sufficient <str<strong>on</strong>g>and</str<strong>on</strong>g> the evaluated<br />
pers<strong>on</strong> completed the task before the three<br />
m<str<strong>on</strong>g>in</str<strong>on</strong>g>utes were over, the evaluator had to undo<br />
the work already completed <str<strong>on</strong>g>and</str<strong>on</strong>g> then prompt<br />
the client to redo the same task. Interviewees<br />
observed a lack of <str<strong>on</strong>g>in</str<strong>on</strong>g>terest <str<strong>on</strong>g>in</str<strong>on</strong>g> their clients for<br />
redo<str<strong>on</strong>g>in</str<strong>on</strong>g>g a task they had already d<strong>on</strong>e. A soluti<strong>on</strong><br />
could be hav<str<strong>on</strong>g>in</str<strong>on</strong>g>g separate work stati<strong>on</strong>s for each<br />
task <str<strong>on</strong>g>and</str<strong>on</strong>g> prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g the client to walk toward the<br />
corresp<strong>on</strong>d<str<strong>on</strong>g>in</str<strong>on</strong>g>g work stati<strong>on</strong> after his choice.<br />
This would also reduce the time needed to pre-<br />
Assessment of Work Task Preferences / 567
pare the material dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g a sessi<strong>on</strong>. A similar<br />
impact <strong>on</strong> the client’s motivati<strong>on</strong> to choose <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
complete a task could be the sequence of work<br />
tasks he had completed before the assessment.<br />
He could be pr<strong>on</strong>e to choos<str<strong>on</strong>g>in</str<strong>on</strong>g>g different tasks<br />
from those he had already d<strong>on</strong>e.<br />
Figure 2. Assessment results by participant.<br />
568 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
More than 80% of <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees listed characteristics<br />
of the pers<strong>on</strong> be<str<strong>on</strong>g>in</str<strong>on</strong>g>g evaluated as<br />
facilitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g c<strong>on</strong>diti<strong>on</strong>s: his cooperati<strong>on</strong> dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the assessment <str<strong>on</strong>g>and</str<strong>on</strong>g> his c<strong>on</strong>centrati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> attenti<strong>on</strong><br />
skills. On the other h<str<strong>on</strong>g>and</str<strong>on</strong>g>, 56% of<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees described pers<strong>on</strong>al characteris-
Figure 3. Facilitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g factors <str<strong>on</strong>g>and</str<strong>on</strong>g> barriers encountered by job coaches.<br />
tics as barriers, especially dual diagnoses that<br />
could <str<strong>on</strong>g>in</str<strong>on</strong>g>terfere with the assessment, such as<br />
pervasive developmental disorders or mental<br />
health disorders.<br />
In accordance with the general positive percepti<strong>on</strong><br />
expressed by <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees, most of<br />
the factors related to the method were c<strong>on</strong>sidered<br />
to be facilitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g c<strong>on</strong>diti<strong>on</strong>s. N<str<strong>on</strong>g>in</str<strong>on</strong>g>ety-four<br />
percent of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees appreciated the flexibility<br />
of the method which allowed for <str<strong>on</strong>g>in</str<strong>on</strong>g>terrupti<strong>on</strong>s<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> provided choice of an appropriate<br />
time to c<strong>on</strong>duct a sessi<strong>on</strong>, the length of<br />
time needed, <str<strong>on</strong>g>and</str<strong>on</strong>g> the first two tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g sessi<strong>on</strong>s.<br />
Seventy-five percent of <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees<br />
identified barriers related to the method itself.<br />
Some behaviors to be observed were too<br />
ambiguous or difficult to observe. Calculat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
the results was also c<strong>on</strong>sidered to be difficult.<br />
Some job coaches thought that the method<br />
restricted the choice of tasks to be assessed.<br />
For example, they would have liked to <str<strong>on</strong>g>in</str<strong>on</strong>g>clude<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the assessment tasks that were unknown to<br />
the client.<br />
<str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> the method seems to be an<br />
important facilitat<str<strong>on</strong>g>in</str<strong>on</strong>g>g factor. Interviewees<br />
highlighted the importance of the supervisi<strong>on</strong><br />
given by a research assistant <str<strong>on</strong>g>and</str<strong>on</strong>g> the experimenter<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> choos<str<strong>on</strong>g>in</str<strong>on</strong>g>g the tasks <str<strong>on</strong>g>and</str<strong>on</strong>g> prepar<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
Assessment of Work Task Preferences / 569
the material dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the first two sessi<strong>on</strong>s. They<br />
also found the document describ<str<strong>on</strong>g>in</str<strong>on</strong>g>g the<br />
method, which they received dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
to be very useful. However, some clients<br />
were distracted by the presence of the research<br />
assistant dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the assessment. Professi<strong>on</strong>al<br />
experience <str<strong>on</strong>g>and</str<strong>on</strong>g> academic background,<br />
as well as an <strong>on</strong>go<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ship with the<br />
client, were c<strong>on</strong>sidered to be assets <str<strong>on</strong>g>in</str<strong>on</strong>g> observ<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>terpret<str<strong>on</strong>g>in</str<strong>on</strong>g>g behavior. They facilitate<br />
the recogniti<strong>on</strong> of undesirable variables that<br />
could <str<strong>on</strong>g>in</str<strong>on</strong>g>terfere with the assessment.<br />
Assessment Outcomes<br />
Twelve job coaches reported a lack of c<strong>on</strong>cordance<br />
between preferences assessed <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
preferences they had hypothesized before the<br />
assessment. Eleven <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees found preference<br />
assessment useful for plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g vocati<strong>on</strong>al<br />
activities best suited to clients. Twelve<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees reported unexpected outcomes.<br />
The assessment allowed them to stop <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
th<str<strong>on</strong>g>in</str<strong>on</strong>g>k about their clients, the number of tasks<br />
they were able to do, <str<strong>on</strong>g>and</str<strong>on</strong>g> the c<strong>on</strong>cordance<br />
between client preferences <str<strong>on</strong>g>and</str<strong>on</strong>g> task plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Another important outcome was the significant<br />
impact <strong>on</strong> the quality of life of clients as<br />
the method helps job coaches <str<strong>on</strong>g>in</str<strong>on</strong>g>troduce<br />
choices <strong>on</strong> a daily basis <str<strong>on</strong>g>and</str<strong>on</strong>g> plan preferred<br />
vocati<strong>on</strong>al activities. Furthermore, some job<br />
coaches felt that this experience enhanced<br />
their competencies <str<strong>on</strong>g>in</str<strong>on</strong>g> observ<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
their clients.<br />
Other Preference Assessment Tools<br />
Forty-four percent of <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees did not<br />
know of other tools for assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g work task<br />
preferences. Forty-four percent cited the Inventaire<br />
visuel des <str<strong>on</strong>g>in</str<strong>on</strong>g>térêts professi<strong>on</strong>nel (Dup<strong>on</strong>t,<br />
G<str<strong>on</strong>g>in</str<strong>on</strong>g>gras, & Tétreau, 2000) which is an <str<strong>on</strong>g>in</str<strong>on</strong>g>strument<br />
for assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g vocati<strong>on</strong>al <str<strong>on</strong>g>in</str<strong>on</strong>g>terests us<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
80 pictures of work areas. They described its<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>adequacies for assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g the work task preferences<br />
of pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability<br />
s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce it is not c<strong>on</strong>crete enough for some of<br />
them. Some pers<strong>on</strong>s with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability<br />
lack the necessary language <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>sight skills<br />
that are required for assessments which use<br />
pictures. One <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewee also menti<strong>on</strong>ed a<br />
computerized assessment tool. C<strong>on</strong>sequently,<br />
job coaches tend to assess vocati<strong>on</strong>al prefer-<br />
ences by giv<str<strong>on</strong>g>in</str<strong>on</strong>g>g choices that are embedded <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the client’s rout<str<strong>on</strong>g>in</str<strong>on</strong>g>e.<br />
How Can the Assessment Method Be Enhanced?<br />
Thirteen <str<strong>on</strong>g>in</str<strong>on</strong>g>terviewees suggested enhancements<br />
to the method. They recommended<br />
more c<strong>on</strong>crete <str<strong>on</strong>g>and</str<strong>on</strong>g> detailed def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s of behaviors<br />
to observe s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce some were ambiguous.<br />
They also suggested decreas<str<strong>on</strong>g>in</str<strong>on</strong>g>g the time<br />
needed for the evaluati<strong>on</strong>, for example, by<br />
hold<str<strong>on</strong>g>in</str<strong>on</strong>g>g 4 to 5 sessi<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g>stead of 7. They<br />
asked that a way be found to make calculati<strong>on</strong><br />
of the results easier. Furthermore, they suggested<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tegrat<str<strong>on</strong>g>in</str<strong>on</strong>g>g the assessment <str<strong>on</strong>g>in</str<strong>on</strong>g>to a more<br />
complete assessment program that would <str<strong>on</strong>g>in</str<strong>on</strong>g>clude<br />
more tasks, <str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g tasks unknown to<br />
the client. The assessment should help to estimate<br />
performance <strong>on</strong> the tasks <str<strong>on</strong>g>and</str<strong>on</strong>g> the <str<strong>on</strong>g>in</str<strong>on</strong>g>fluence<br />
of variables such as diversity versus<br />
repetiti<strong>on</strong> of the tasks or <str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s with<br />
peers <strong>on</strong> the expressed preferences. A more<br />
detailed assessment would be helpful <str<strong>on</strong>g>in</str<strong>on</strong>g> plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
a client’s vocati<strong>on</strong>al orientati<strong>on</strong>, which is<br />
more useful than just know<str<strong>on</strong>g>in</str<strong>on</strong>g>g which tasks are<br />
preferred.<br />
Discussi<strong>on</strong><br />
570 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
This study provides further evidence of the<br />
behaviors which should be c<strong>on</strong>sidered when<br />
assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g or def<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g choices <str<strong>on</strong>g>and</str<strong>on</strong>g> preferences.<br />
It is also a first attempt to assess the value <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
use of a work task preference assessment. Its<br />
important f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs will help to provide job<br />
coaches with an effective tool for assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
preferences. This k<str<strong>on</strong>g>in</str<strong>on</strong>g>d of program evaluati<strong>on</strong><br />
is of particular <str<strong>on</strong>g>in</str<strong>on</strong>g>terest as it assesses the adequacy<br />
between a product <str<strong>on</strong>g>and</str<strong>on</strong>g> its users’ needs.<br />
It also provides important <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> <strong>on</strong> how<br />
to enhance the product to best suited its users’<br />
competencies <str<strong>on</strong>g>and</str<strong>on</strong>g> work habits. As a c<strong>on</strong>sequence,<br />
this approach is a useful l<str<strong>on</strong>g>in</str<strong>on</strong>g>k between<br />
research <str<strong>on</strong>g>and</str<strong>on</strong>g> practice as it could help to transfer<br />
research results <str<strong>on</strong>g>in</str<strong>on</strong>g>to practice. Results from<br />
this study suggest that the assessment method<br />
resp<strong>on</strong>ds to diverse needs expressed by job<br />
coaches, especially c<strong>on</strong>sider<str<strong>on</strong>g>in</str<strong>on</strong>g>g the lack of <str<strong>on</strong>g>in</str<strong>on</strong>g>strument<br />
to assess vocati<strong>on</strong>al preferences. In<br />
additi<strong>on</strong>, an important difference between exist<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>struments <str<strong>on</strong>g>and</str<strong>on</strong>g> this assessment method<br />
is that it assesses preferences for tasks available<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the pers<strong>on</strong>’s work envir<strong>on</strong>ment. Exist<str<strong>on</strong>g>in</str<strong>on</strong>g>g
<str<strong>on</strong>g>in</str<strong>on</strong>g>struments rely <strong>on</strong> a st<str<strong>on</strong>g>and</str<strong>on</strong>g>ard set of tasks that<br />
captures important dimensi<strong>on</strong>s of vocati<strong>on</strong>al<br />
tasks. However, some of these predeterm<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
tasks are not always available for the pers<strong>on</strong><br />
be<str<strong>on</strong>g>in</str<strong>on</strong>g>g assessed <str<strong>on</strong>g>and</str<strong>on</strong>g>, c<strong>on</strong>sequently, are not useful<br />
for vocati<strong>on</strong>al plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Most of the participants expressed preferences<br />
by select<str<strong>on</strong>g>in</str<strong>on</strong>g>g objects or pictograms represent<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
work tasks. This study supports previous<br />
studies which <str<strong>on</strong>g>in</str<strong>on</strong>g>dicate that selecti<strong>on</strong><br />
behaviors are reliable <str<strong>on</strong>g>in</str<strong>on</strong>g>dicators for assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
preferences (Mithaug & Hanawalt, 1978;<br />
Mithaug & Mar, 1980; Pars<strong>on</strong>s et al., 1998;<br />
Reid et al., 1998). Few refusals were observed<br />
dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g the assessment, <str<strong>on</strong>g>and</str<strong>on</strong>g> they were not c<strong>on</strong>sistent<br />
with frequency of choice. We could<br />
w<strong>on</strong>der if the tendency to acquiescence <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
social desirability had an impact <strong>on</strong> the frequency<br />
of refusals. On-task <str<strong>on</strong>g>and</str<strong>on</strong>g> off-task behaviors<br />
appeared to be unreliable <str<strong>on</strong>g>in</str<strong>on</strong>g>dicators for<br />
assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g preferences. C<strong>on</strong>tradictory results<br />
have been published with regards to these<br />
behaviors (Hatt<strong>on</strong>, 2004; Worsdell, Iwata, &<br />
Wallace, 2002), but we could hypothesize that<br />
task engagement <str<strong>on</strong>g>in</str<strong>on</strong>g>creases <str<strong>on</strong>g>in</str<strong>on</strong>g> c<strong>on</strong>diti<strong>on</strong>s<br />
where there is choice, but not necessarily with<br />
preferred tasks. Positive emoti<strong>on</strong>al behaviors<br />
are also <str<strong>on</strong>g>in</str<strong>on</strong>g>c<strong>on</strong>sistent <str<strong>on</strong>g>in</str<strong>on</strong>g> assessment sessi<strong>on</strong>s.<br />
Previous research argues that pers<strong>on</strong>s with<br />
greater communicati<strong>on</strong> limitati<strong>on</strong>s are likely<br />
to exhibit more emoti<strong>on</strong>al behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g> order<br />
to communicate their preferences (Campbell<br />
& Fletcher, 1993). In this study, all participants<br />
had important communicati<strong>on</strong> limitati<strong>on</strong>s<br />
but they did not all exhibit emoti<strong>on</strong>al<br />
behavior. Furthermore, evaluators observed<br />
the impact of c<strong>on</strong>textual variables (for example,<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>teracti<strong>on</strong>s with a peer) <strong>on</strong> the occurrence<br />
of positive emoti<strong>on</strong>al behaviors. C<strong>on</strong>sequently,<br />
preference assessment should rely <strong>on</strong><br />
frequency of choices def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed as physical selecti<strong>on</strong><br />
of an opti<strong>on</strong>. Task engagement <str<strong>on</strong>g>and</str<strong>on</strong>g> positive<br />
emoti<strong>on</strong>al behaviors are useful for gather<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> <strong>on</strong> the <str<strong>on</strong>g>in</str<strong>on</strong>g>fluence of<br />
c<strong>on</strong>textual factors which are important variables<br />
to c<strong>on</strong>sider when plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g vocati<strong>on</strong>al<br />
tasks that best suit the pers<strong>on</strong>. Further research<br />
is needed to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e which pers<strong>on</strong>al<br />
or c<strong>on</strong>textual factors have an impact <strong>on</strong> the<br />
reliability <str<strong>on</strong>g>and</str<strong>on</strong>g> efficiency of the assessment<br />
method. Experimental or quasi-experimental<br />
designs should be used to accurately assess the<br />
impact of c<strong>on</strong>textual <str<strong>on</strong>g>and</str<strong>on</strong>g> pers<strong>on</strong>al variables.<br />
Interviewees gave useful suggesti<strong>on</strong>s <strong>on</strong> how<br />
to identify the variables to target. Their comments<br />
also highlighted the importance of<br />
tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g. Evaluators should be tra<str<strong>on</strong>g>in</str<strong>on</strong>g>ed to observe<br />
relevant behaviors <str<strong>on</strong>g>in</str<strong>on</strong>g> order to assess<br />
preferences. This tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g should <str<strong>on</strong>g>in</str<strong>on</strong>g>clude operati<strong>on</strong>al<br />
def<str<strong>on</strong>g>in</str<strong>on</strong>g>iti<strong>on</strong>s of behaviors to avoid c<strong>on</strong>fusi<strong>on</strong><br />
with pers<strong>on</strong>al characteristics or pers<strong>on</strong>al<br />
judgment, such as attentiveness or<br />
degree of c<strong>on</strong>centrati<strong>on</strong>. Supervisi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
first sessi<strong>on</strong>s also seems to be appreciated by<br />
the evaluators <str<strong>on</strong>g>and</str<strong>on</strong>g> could <str<strong>on</strong>g>in</str<strong>on</strong>g>crease reliability of<br />
the method. Interviewees <str<strong>on</strong>g>in</str<strong>on</strong>g>sisted <strong>on</strong> the need<br />
to make the assessment easier <str<strong>on</strong>g>and</str<strong>on</strong>g> quicker.<br />
Multiple stimuli without replacement method<br />
(MSWO) is currently c<strong>on</strong>sidered to be the<br />
easiest <str<strong>on</strong>g>and</str<strong>on</strong>g> quickest assessment procedure<br />
(Hagopian, L<strong>on</strong>g, & Rush, 2004). It c<strong>on</strong>sists<br />
<strong>on</strong> the simultaneous presentati<strong>on</strong> of all possible<br />
pairs as opposed to the pair presentati<strong>on</strong>.<br />
Once a stimulus chosen, it is not presented<br />
aga<str<strong>on</strong>g>in</str<strong>on</strong>g> to the pers<strong>on</strong> be<str<strong>on</strong>g>in</str<strong>on</strong>g>g assessed. However,<br />
no research has assessed reliability of MSWO<br />
for assess<str<strong>on</strong>g>in</str<strong>on</strong>g>g work tasks preferences. Further<br />
research is still needed to extend f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
from previous studies <strong>on</strong> the assessment of<br />
tangible stimuli preferences to vocati<strong>on</strong>al activity<br />
preferences. The results of this study<br />
support the idea that the preference assessment<br />
method could be embedded <str<strong>on</strong>g>in</str<strong>on</strong>g>to rout<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
staff practice. Future research will help to<br />
identify c<strong>on</strong>diti<strong>on</strong>s for its use <str<strong>on</strong>g>and</str<strong>on</strong>g> its reliability<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> validity. To c<strong>on</strong>clude, this study provides<br />
additi<strong>on</strong>al evidence that proxies are not always<br />
reliable when determ<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g a pers<strong>on</strong>’s<br />
preferences, s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce the preferences attributed<br />
by proxies may differ from those assessed us<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
direct measures.<br />
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Received: 10 July 2008<br />
Initial Acceptance: 21 September 2008<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>al Acceptance: 15 November 2008
Fourth Grade Outcomes of Children with a Preschool History<br />
of <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> Disability<br />
Christ<str<strong>on</strong>g>in</str<strong>on</strong>g>e E. F. Delgado<br />
University of Miami<br />
Abstract: Special educati<strong>on</strong> outcomes were evaluated for 3,608 children (2,513 males) with a preschool history<br />
of developmental disability. Sixty-six percent of the children had an identified disability <str<strong>on</strong>g>in</str<strong>on</strong>g> fourth grade. The<br />
percentage of children with a disability at outcome varied across preschool disability categories from 54% to<br />
96%. The c<strong>on</strong>sistency of classificati<strong>on</strong> at preschool <str<strong>on</strong>g>and</str<strong>on</strong>g> outcome was relatively high for children with tra<str<strong>on</strong>g>in</str<strong>on</strong>g>able<br />
mental h<str<strong>on</strong>g>and</str<strong>on</strong>g>icap/profound mental h<str<strong>on</strong>g>and</str<strong>on</strong>g>icap (TMH/PMH), emoti<strong>on</strong>al h<str<strong>on</strong>g>and</str<strong>on</strong>g>icap/severe emoti<strong>on</strong>al disturbance<br />
(EH/SED), specific learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g disability (SLD), <str<strong>on</strong>g>and</str<strong>on</strong>g> autism (AT) <str<strong>on</strong>g>and</str<strong>on</strong>g> lower for children with educable<br />
mental h<str<strong>on</strong>g>and</str<strong>on</strong>g>icap (EMH), speech <str<strong>on</strong>g>and</str<strong>on</strong>g>/or language impairment (SI/LI), <str<strong>on</strong>g>and</str<strong>on</strong>g> developmental delay (DD).<br />
Underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g the nature <str<strong>on</strong>g>and</str<strong>on</strong>g> course of developmental disabilities can <str<strong>on</strong>g>in</str<strong>on</strong>g>form early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> services,<br />
service plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g, <str<strong>on</strong>g>and</str<strong>on</strong>g> resource management.<br />
Underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g the nature <str<strong>on</strong>g>and</str<strong>on</strong>g> course of developmental<br />
disabilities over time is both theoretically<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> cl<str<strong>on</strong>g>in</str<strong>on</strong>g>ically important. One way<br />
to improve our knowledge of developmental<br />
disabilities is to l<strong>on</strong>gitud<str<strong>on</strong>g>in</str<strong>on</strong>g>ally m<strong>on</strong>itor<br />
special educati<strong>on</strong> placement. Awareness of<br />
the future special educati<strong>on</strong> placement of<br />
preschoolers with disabilities can <str<strong>on</strong>g>in</str<strong>on</strong>g>form<br />
early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> services, service plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> resource management. Research <str<strong>on</strong>g>in</str<strong>on</strong>g> this<br />
area, however, has been largely limited to<br />
This research was supported by the Children’s<br />
Registry <str<strong>on</strong>g>and</str<strong>on</strong>g> Informati<strong>on</strong> System (CHRIS) <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
FDLRS-UM, a specialized university center of the<br />
Florida Diagnostic <str<strong>on</strong>g>and</str<strong>on</strong>g> Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g Resources System.<br />
Both CHRIS <str<strong>on</strong>g>and</str<strong>on</strong>g> FDLRS-UM are special projects<br />
funded by the State of Florida, Department of <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g>,<br />
Bureau of Excepti<strong>on</strong>al <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> Student<br />
Services (BEESS). CHRIS is funded through<br />
federal assistance under the Individuals with <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Act (IDEA), Part B <str<strong>on</strong>g>and</str<strong>on</strong>g> general<br />
revenue sources. FDLRS-UM is funded from general<br />
revenue sources. The support of the Florida Department<br />
of <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> for provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g the records is<br />
gratefully acknowledged. The authors would also<br />
like to thank Olga Camacho <str<strong>on</strong>g>and</str<strong>on</strong>g> Ant<strong>on</strong>io G<strong>on</strong>zalez<br />
for their assistance <str<strong>on</strong>g>in</str<strong>on</strong>g> prepar<str<strong>on</strong>g>in</str<strong>on</strong>g>g the dataset. Corresp<strong>on</strong>dence<br />
c<strong>on</strong>cern<str<strong>on</strong>g>in</str<strong>on</strong>g>g this article should be<br />
addressed to Christ<str<strong>on</strong>g>in</str<strong>on</strong>g>e Delgado, Department of<br />
Psychology, University of Miami, PO Box 248185,<br />
Coral Gables, Florida, 33124-0751. Email: cdelgado<br />
@umiami.edu<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>, 2009, 44(4), 573–579<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
preschoolers with developmental delay <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
speech-language impairments.<br />
<str<strong>on</strong>g>Developmental</str<strong>on</strong>g> delay is an eligibility category<br />
that is <strong>on</strong>ly applicable to young children.<br />
As children mature, they must be identified<br />
with a more traditi<strong>on</strong>al disability to rema<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
eligible for special educati<strong>on</strong> services. The majority<br />
of preschool children identified with<br />
developmental delay enter special educati<strong>on</strong><br />
programs <str<strong>on</strong>g>in</str<strong>on</strong>g> elementary school (Bernheimer,<br />
Keogh, & Coots, 1993; Dale, Jenk<str<strong>on</strong>g>in</str<strong>on</strong>g>s, Mills, &<br />
Cole, 2005; Delgado, Vagi, & Scott, 2006;<br />
Keogh, Coots, & Bernheimer, 1996; Mills,<br />
Dale, Cole, & Jenk<str<strong>on</strong>g>in</str<strong>on</strong>g>s, 1995). The most comm<strong>on</strong><br />
disability reclassificati<strong>on</strong>s for children<br />
with DD are learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g h<str<strong>on</strong>g>and</str<strong>on</strong>g>icaps, speech <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
language h<str<strong>on</strong>g>and</str<strong>on</strong>g>icaps, <str<strong>on</strong>g>and</str<strong>on</strong>g> mild mental retardati<strong>on</strong><br />
(Bernheimer et al.; Delgado et al.; Keogh<br />
et al.).<br />
Preschool speech-language disorders are associated<br />
with language <str<strong>on</strong>g>and</str<strong>on</strong>g> academic difficulties<br />
that persist throughout childhood <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
adolescence (Aram, Ekelman, & Nati<strong>on</strong>, 1984;<br />
Beitchman, Wils<strong>on</strong>, Brownlie, Walters, & Lancee,<br />
1996b; Johns<strong>on</strong> et al., 1999; Silva, McGee,<br />
& Williams, 1983; Stothard, Snowl<str<strong>on</strong>g>in</str<strong>on</strong>g>g, Bishop,<br />
Chipchase, & Kaplan, 1998; Young et al.,<br />
2002). A l<str<strong>on</strong>g>in</str<strong>on</strong>g>k between early speech-language<br />
impairments <str<strong>on</strong>g>and</str<strong>on</strong>g> later learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> read<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
disabilities has been well established (Catts,<br />
1993; Leitão & Fletcher, 2004; Paul, 2000;<br />
<str<strong>on</strong>g>Developmental</str<strong>on</strong>g> Disability Outcome / 573
Silva et al., 1983; Silva, Williams, & McGee,<br />
1987; Stothard et al.; Young et al.). Preschool<br />
speech-language impairments are also associated<br />
with later behavior problems (Beitchman<br />
et al., 1996a; Silva et al., 1987).<br />
The l<strong>on</strong>g-term m<strong>on</strong>itor<str<strong>on</strong>g>in</str<strong>on</strong>g>g of preschool<br />
children with speech-language impairments<br />
has “helped speech-language pathologists to<br />
evaluate l<strong>on</strong>g-term prognoses, set realistic goals,<br />
develop suitable service models, <str<strong>on</strong>g>and</str<strong>on</strong>g> advocate<br />
appropriate social policies” (Johns<strong>on</strong> et al.,<br />
1999, p. 744). Similar benefits would be expected<br />
for the track<str<strong>on</strong>g>in</str<strong>on</strong>g>g of special educati<strong>on</strong><br />
placements for young children with other disabilities.<br />
This study utilizes extant statewide<br />
datasets to exp<str<strong>on</strong>g>and</str<strong>on</strong>g> our knowledge of the subsequent<br />
educati<strong>on</strong>al outcomes of preschool<br />
children with developmental disabilities.<br />
Method<br />
Database Integrati<strong>on</strong><br />
Data from the Children’s Registry <str<strong>on</strong>g>and</str<strong>on</strong>g> Informati<strong>on</strong><br />
System (CHRIS) database were <str<strong>on</strong>g>in</str<strong>on</strong>g>tegrated<br />
with Florida Department of <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g><br />
public school records. Preschool disability status<br />
was obta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed from CHRIS. CHRIS is a<br />
statewide database developed at the University<br />
of Miami <str<strong>on</strong>g>in</str<strong>on</strong>g> 1990 <str<strong>on</strong>g>in</str<strong>on</strong>g> resp<strong>on</strong>se to the need to<br />
track children who receive services under<br />
IDEA, Part B. The CHRIS database c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>s<br />
referral, screen<str<strong>on</strong>g>in</str<strong>on</strong>g>g, evaluati<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> eligibility<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> for preschool children throughout<br />
Florida. The data c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed <str<strong>on</strong>g>in</str<strong>on</strong>g> CHRIS<br />
provide the Florida Department of <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g><br />
with a means of document<str<strong>on</strong>g>in</str<strong>on</strong>g>g Child F<str<strong>on</strong>g>in</str<strong>on</strong>g>d efforts<br />
to locate, evaluate, <str<strong>on</strong>g>and</str<strong>on</strong>g> provide necessary<br />
services to at-risk preschool-aged children.<br />
Outcome disability status was obta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed from<br />
the Florida Department of <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> public<br />
school record database. This database c<strong>on</strong>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>s<br />
educati<strong>on</strong>al <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> (<str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g primary<br />
excepti<strong>on</strong>ality) for all children attend<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
a Florida public school.<br />
Database <str<strong>on</strong>g>in</str<strong>on</strong>g>tegrati<strong>on</strong> was accomplished us<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
automated data l<str<strong>on</strong>g>in</str<strong>on</strong>g>kage techniques whereby a<br />
child’s unique record was identified <str<strong>on</strong>g>in</str<strong>on</strong>g> each<br />
database <str<strong>on</strong>g>and</str<strong>on</strong>g> jo<str<strong>on</strong>g>in</str<strong>on</strong>g>ed across datasets to establish<br />
<strong>on</strong>e record. This data l<str<strong>on</strong>g>in</str<strong>on</strong>g>kage method was<br />
based <strong>on</strong> previously established techniques<br />
(Boussy & Scott, 1993; Newcombe, 1988; Redden,<br />
Mulvihill, Wall<str<strong>on</strong>g>and</str<strong>on</strong>g>er, & Hov<str<strong>on</strong>g>in</str<strong>on</strong>g>ga, 2000).<br />
Records were l<str<strong>on</strong>g>in</str<strong>on</strong>g>ked based <strong>on</strong> an exact match<br />
of a child’s last name, first name, gender, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
date of birth. If any of the match<str<strong>on</strong>g>in</str<strong>on</strong>g>g variables<br />
differed, the pair was c<strong>on</strong>sidered a n<strong>on</strong>-match<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> was not <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> the l<str<strong>on</strong>g>in</str<strong>on</strong>g>ked sample. All<br />
identify<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> was removed immediately<br />
follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g the automated data l<str<strong>on</strong>g>in</str<strong>on</strong>g>kage<br />
process <str<strong>on</strong>g>and</str<strong>on</strong>g> prior to data analysis to ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
c<strong>on</strong>fidentiality.<br />
Diagnostic Criteria<br />
Preschool disability status was def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed as the<br />
primary excepti<strong>on</strong>ality listed <str<strong>on</strong>g>in</str<strong>on</strong>g> the CHRIS<br />
database. Outcome disability status was def<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
as the primary excepti<strong>on</strong>ality listed <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
the Florida public school record database. Primary<br />
excepti<strong>on</strong>ality determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong> at both<br />
time po<str<strong>on</strong>g>in</str<strong>on</strong>g>ts was based <strong>on</strong> the criteria specified<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the Florida Statutes <str<strong>on</strong>g>and</str<strong>on</strong>g> State Board of<br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Rules (2001). Criteria for eligibility<br />
vary by disability but typically <str<strong>on</strong>g>in</str<strong>on</strong>g>volve the review<br />
of st<str<strong>on</strong>g>and</str<strong>on</strong>g>ardized assessments <str<strong>on</strong>g>and</str<strong>on</strong>g> other<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> (e.g., parent report or observati<strong>on</strong>s).<br />
All eligibility determ<str<strong>on</strong>g>in</str<strong>on</strong>g>ati<strong>on</strong>s were<br />
made at an eligibility staff<str<strong>on</strong>g>in</str<strong>on</strong>g>g meet<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
were based <strong>on</strong> Florida Statute.<br />
Sample<br />
574 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
The sample c<strong>on</strong>sisted of 3,608 children (2,513<br />
males). The racial/ethnic distributi<strong>on</strong> of the<br />
children was 59% White, 27% Black, 12% Hispanic,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> 2% Other. The children were<br />
identified with <strong>on</strong>e of the follow<str<strong>on</strong>g>in</str<strong>on</strong>g>g developmental<br />
disabilities as a preschooler: autism<br />
(AT), developmental delay (DD), emoti<strong>on</strong>al<br />
h<str<strong>on</strong>g>and</str<strong>on</strong>g>icap or severe emoti<strong>on</strong>al disturbance<br />
(EH/SED), educable mental h<str<strong>on</strong>g>and</str<strong>on</strong>g>icap (EMH),<br />
speech <str<strong>on</strong>g>and</str<strong>on</strong>g>/or language impairment (SI/LI),<br />
specific learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g disability (SLD), tra<str<strong>on</strong>g>in</str<strong>on</strong>g>able<br />
mental h<str<strong>on</strong>g>and</str<strong>on</strong>g>icap or profound mental h<str<strong>on</strong>g>and</str<strong>on</strong>g>icap<br />
(TMH/PMH). All children were between<br />
the ages of 2 years, 6 m<strong>on</strong>ths <str<strong>on</strong>g>and</str<strong>on</strong>g> 5 years at<br />
preschool diagnosis (average age 3 years, 11<br />
m<strong>on</strong>ths).<br />
The children also attended fourth grade at<br />
a Florida public school. Outcome disability<br />
classificati<strong>on</strong> opti<strong>on</strong>s were identical to those<br />
for preschool children with the excepti<strong>on</strong> of<br />
DD. Per Florida law, to rema<str<strong>on</strong>g>in</str<strong>on</strong>g> eligible for<br />
special educati<strong>on</strong> services, all children with a<br />
DD classificati<strong>on</strong> must be reclassified with a
TABLE 1<br />
Preschool disability classificati<strong>on</strong> by fourth grade disability classificati<strong>on</strong> (number of children)<br />
traditi<strong>on</strong>al disability category by the age of 6<br />
years (Florida Statutes, 2001). Preschool children<br />
with all other disability classificati<strong>on</strong>s<br />
studied could ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g> the same classificati<strong>on</strong><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> elementary school. At outcome, some children<br />
had primary excepti<strong>on</strong>ality classificati<strong>on</strong>s<br />
that were not <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> the preschool<br />
sample. These disabilities <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded orthopedically<br />
impaired, deaf or hard of hear<str<strong>on</strong>g>in</str<strong>on</strong>g>g, visually<br />
impaired, gifted, hospital/homebound,<br />
traumatic bra<str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>jured, <str<strong>on</strong>g>and</str<strong>on</strong>g> other health impaired<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> were c<strong>on</strong>sidered “Other” for analysis<br />
purposes.<br />
Results<br />
Overall results are presented <str<strong>on</strong>g>in</str<strong>on</strong>g> Table 1. Results<br />
which follow represent a prospective look<br />
at outcomes for preschoolers with developmental<br />
disabilities. It is also possible to exam<str<strong>on</strong>g>in</str<strong>on</strong>g>e<br />
the results retrospectively, look<str<strong>on</strong>g>in</str<strong>on</strong>g>g from<br />
outcome back to preschool. These results will<br />
not be discussed but can be <str<strong>on</strong>g>in</str<strong>on</strong>g>terpreted from<br />
Table 1.<br />
Sixty-six percent of children with a preschool<br />
history of developmental disability<br />
were identified with a disability <str<strong>on</strong>g>in</str<strong>on</strong>g> fourth<br />
grade. The percentage of children with a disability<br />
at both the preschool <str<strong>on</strong>g>and</str<strong>on</strong>g> fourth grade<br />
time po<str<strong>on</strong>g>in</str<strong>on</strong>g>ts varied across preschool disability<br />
categories: 54% for SI/LI, 77% for DD, 84%<br />
for EH/SED, 85% for SLD, 93% for EMH,<br />
95% for TMH/PMH, <str<strong>on</strong>g>and</str<strong>on</strong>g> 96% for AT.<br />
The distributi<strong>on</strong> of outcome disability classificati<strong>on</strong>s<br />
by preschool disability classificati<strong>on</strong><br />
Fourth Grade Disability<br />
Preschool Disability SI/LI SLD EMH EH/SED TMH/PMH AT Other N<strong>on</strong>e Total<br />
SI/LI 437 371 46 82 9 18 134 948 2,045<br />
SLD 12 132 12 16 6 4 10 34 226<br />
EMH 5 24 89 5 26 8 7 12 176<br />
EH/SED 3 17 0 66 0 6 4 18 114<br />
TMH/PMH 0 1 12 0 60 14 7 5 99<br />
AT 2 3 2 0 4 81 2 4 98<br />
DD 83 233 133 69 36 48 52 196 850<br />
Total 542 781 294 238 141 179 216 1217 3,608<br />
are displayed <str<strong>on</strong>g>in</str<strong>on</strong>g> Figure 1. Children without an<br />
identified disability at outcome were not <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> this figure to improve visual clarity.<br />
Therefore, the denom<str<strong>on</strong>g>in</str<strong>on</strong>g>ator for the percentages<br />
provided <str<strong>on</strong>g>in</str<strong>on</strong>g> the figure <str<strong>on</strong>g>and</str<strong>on</strong>g> referenced<br />
below was the number of children with a disability<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> preschool who also had a disability at<br />
outcome. The highest rates of c<strong>on</strong>sistency of<br />
classificati<strong>on</strong> were identified for children with<br />
AT. Eighty-seven percent of children identified<br />
with AT <str<strong>on</strong>g>in</str<strong>on</strong>g> preschool were also classified<br />
as AT <str<strong>on</strong>g>in</str<strong>on</strong>g> fourth grade. C<strong>on</strong>sistency of classificati<strong>on</strong><br />
rates for the other disabilities studied<br />
were 70% for SLD, 69% for EH/SED, 64% for<br />
TMH/PMH, 54% for EMH, <str<strong>on</strong>g>and</str<strong>on</strong>g> 40% for<br />
SI/LI. In Florida, DD is not available as a<br />
disability classificati<strong>on</strong> for children over the<br />
age of 5, <str<strong>on</strong>g>and</str<strong>on</strong>g> therefore, children with a preschool<br />
diagnosis of DD could not ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
same disability classificati<strong>on</strong> at outcome.<br />
The nature of changes <str<strong>on</strong>g>in</str<strong>on</strong>g> classificati<strong>on</strong> from<br />
preschool to fourth grade outcome are presented<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> Figure 1. Preschool children with<br />
DD, SI/LI, <str<strong>on</strong>g>and</str<strong>on</strong>g> EMH were the most likely to<br />
have been reclassified with another disability.<br />
For preschool children with DD who had a<br />
disability at outcome, SLD (35%) <str<strong>on</strong>g>and</str<strong>on</strong>g> EMH<br />
(20%) were the most comm<strong>on</strong> outcome classificati<strong>on</strong>s.<br />
Over <strong>on</strong>e-third (34%) of preschool<br />
children with SI/LI who had a disability at<br />
outcome were reclassified as SLD. Preschool<br />
children with EMH who had a disability at<br />
outcome were most comm<strong>on</strong>ly reclassified as<br />
TMH/PMH (16%) or SLD (15%).<br />
<str<strong>on</strong>g>Developmental</str<strong>on</strong>g> Disability Outcome / 575
Figure 1. Distributi<strong>on</strong> of outcome disabilities by preschool disability classificati<strong>on</strong>. For visual clarity, <strong>on</strong>ly children<br />
with an outcome disability are <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> the pie charts. Children identified with a disability <str<strong>on</strong>g>in</str<strong>on</strong>g> preschool<br />
who were not identified with a disability <str<strong>on</strong>g>in</str<strong>on</strong>g> 4th grade are not <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded <str<strong>on</strong>g>in</str<strong>on</strong>g> this figure. AT autism,<br />
SLD specific learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g disability, EH/SED emoti<strong>on</strong>al h<str<strong>on</strong>g>and</str<strong>on</strong>g>icap/severe emoti<strong>on</strong>al disturbance,<br />
TMH/PMH tra<str<strong>on</strong>g>in</str<strong>on</strong>g>able mental h<str<strong>on</strong>g>and</str<strong>on</strong>g>icap/profound mental h<str<strong>on</strong>g>and</str<strong>on</strong>g>icap, EMH educable mental h<str<strong>on</strong>g>and</str<strong>on</strong>g>icap,<br />
SI/LI speech <str<strong>on</strong>g>and</str<strong>on</strong>g>/or language impairment, DD developmental delay.<br />
576 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009
Discussi<strong>on</strong><br />
The use of extant datasets enabled the l<strong>on</strong>gitud<str<strong>on</strong>g>in</str<strong>on</strong>g>al<br />
track<str<strong>on</strong>g>in</str<strong>on</strong>g>g of over 3,600 children with a<br />
preschool history of developmental disability.<br />
Results of the study c<strong>on</strong>cur with exist<str<strong>on</strong>g>in</str<strong>on</strong>g>g research<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> DD <str<strong>on</strong>g>and</str<strong>on</strong>g> SI/LI <str<strong>on</strong>g>and</str<strong>on</strong>g> exp<str<strong>on</strong>g>and</str<strong>on</strong>g> our underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
of the l<strong>on</strong>g-term special educati<strong>on</strong><br />
outcomes of children with AT, EH/SED,<br />
EMH, SLD, <str<strong>on</strong>g>and</str<strong>on</strong>g> TMH/PMH.<br />
Early identificati<strong>on</strong> efforts are, for the most<br />
part, identify<str<strong>on</strong>g>in</str<strong>on</strong>g>g children who will c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ue to<br />
meet criteria for special educati<strong>on</strong> services.<br />
The majority of children identified with a disability<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> preschool were also identified with<br />
a disability at outcome. With the excepti<strong>on</strong> of<br />
preschool children with SI/LI, over threefourths<br />
of preschool children with a disability<br />
c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued to have a disability at outcome. The<br />
greatest percentages were seen for the more<br />
severe disabilities, AT (96%) <str<strong>on</strong>g>and</str<strong>on</strong>g> TMH/PMH<br />
(95%); however, the rate for EMH (93%) was<br />
also high. Although the reas<strong>on</strong> some children<br />
with a disability at preschool were not identified<br />
with a disability at outcome cannot be<br />
identified <str<strong>on</strong>g>in</str<strong>on</strong>g> this study, the potential role of<br />
early <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> efforts should be the focus<br />
of future research.<br />
Although the majority of children c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued<br />
to meet criteria for special educati<strong>on</strong> services,<br />
specific disability classificati<strong>on</strong>s often<br />
changed. C<strong>on</strong>sistency of classificati<strong>on</strong> varied<br />
quite a bit across preschool disability categories.<br />
DD is unique <str<strong>on</strong>g>in</str<strong>on</strong>g> that preschool children<br />
identified as DD were not able to ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g><br />
that classificati<strong>on</strong> at outcome. Per Florida law,<br />
all children with a preschool diagnosis of DD<br />
who c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued <str<strong>on</strong>g>in</str<strong>on</strong>g> special educati<strong>on</strong> were reclassified<br />
with a traditi<strong>on</strong>al disability by 4th<br />
grade. The majority (77%) of children identified<br />
with DD <str<strong>on</strong>g>in</str<strong>on</strong>g> preschool rema<str<strong>on</strong>g>in</str<strong>on</strong>g>ed <str<strong>on</strong>g>in</str<strong>on</strong>g> special<br />
educati<strong>on</strong> at outcome. The most comm<strong>on</strong><br />
outcome disability classificati<strong>on</strong>s for preschool<br />
children with DD were SLD (35%),<br />
EMH (20%), <str<strong>on</strong>g>and</str<strong>on</strong>g> SI/LI (13%). These f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs<br />
are c<strong>on</strong>sistent with previous research<br />
(Bernheimer et al., 1993; Dale et al., 2005;<br />
Delgado et al., 2006; Keogh et al., 1996; Mills<br />
et al., 1995).<br />
Preschool classificati<strong>on</strong>s of SI/LI <str<strong>on</strong>g>and</str<strong>on</strong>g> EMH<br />
were associated with the greatest <str<strong>on</strong>g>in</str<strong>on</strong>g>c<strong>on</strong>sistencies<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> disability classificati<strong>on</strong> at outcome.<br />
Children identified with SI/LI as preschoolers<br />
showed the lowest rates of c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued special<br />
educati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> fourth grade (54%). Of those<br />
children identified with SI/LI <str<strong>on</strong>g>in</str<strong>on</strong>g> preschool<br />
who had a disability at outcome, 40% ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
the SI/LI classificati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> 34% were<br />
classified as SLD at outcome. The change <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
classificati<strong>on</strong> from SI/LI to SLD is c<strong>on</strong>sistent<br />
with previous research <str<strong>on</strong>g>in</str<strong>on</strong>g>dicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g that many<br />
children with SI/LI <str<strong>on</strong>g>in</str<strong>on</strong>g> preschool or k<str<strong>on</strong>g>in</str<strong>on</strong>g>dergarten<br />
dem<strong>on</strong>strate learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g>/or read<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
disabilities at later ages (Catts, 1993; Stothard<br />
et al., 1998). Preschool speech <str<strong>on</strong>g>and</str<strong>on</strong>g> language<br />
impairments have also been associated with<br />
later behavior problems <str<strong>on</strong>g>and</str<strong>on</strong>g> mild mental retardati<strong>on</strong><br />
(Aram et al., 1984; Beitchman et al.,<br />
1996a; Silva et al., 1987). These associati<strong>on</strong>s<br />
were identified <str<strong>on</strong>g>in</str<strong>on</strong>g> the present study with 7% of<br />
children with SI/LI <str<strong>on</strong>g>in</str<strong>on</strong>g> preschool who had a<br />
disability at outcome identified with EH/SED<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> 4% identified with EMH at outcome.<br />
Interest<str<strong>on</strong>g>in</str<strong>on</strong>g>gly, preschool children with EMH<br />
had <strong>on</strong>e of the highest rates of c<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ued<br />
special educati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> fourth grade (93%); however,<br />
<strong>on</strong>ly a little over half of the children who<br />
had a disability at outcome ma<str<strong>on</strong>g>in</str<strong>on</strong>g>ta<str<strong>on</strong>g>in</str<strong>on</strong>g>ed the<br />
EMH classificati<strong>on</strong>. The rema<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g children<br />
were reclassified as TMH/PMH (16%), SLD<br />
(15%), AT (5%), Other (4%), EH/SED (3%),<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> SI/LI (3%). Although these children were<br />
identified early, changes <str<strong>on</strong>g>in</str<strong>on</strong>g> classificati<strong>on</strong> were<br />
comm<strong>on</strong>. Additi<strong>on</strong>al research is required to<br />
more fully underst<str<strong>on</strong>g>and</str<strong>on</strong>g> the nature of the deficits<br />
of preschool children identified with<br />
EMH <str<strong>on</strong>g>and</str<strong>on</strong>g> the reas<strong>on</strong>s for reclassificati<strong>on</strong>.<br />
Such research would <str<strong>on</strong>g>in</str<strong>on</strong>g>form <str<strong>on</strong>g>and</str<strong>on</strong>g> potentially<br />
improve early identificati<strong>on</strong> practices for<br />
EMH.<br />
For the rema<str<strong>on</strong>g>in</str<strong>on</strong>g>der of the disabilities studied,<br />
c<strong>on</strong>sistency between preschool <str<strong>on</strong>g>and</str<strong>on</strong>g> outcome<br />
classificati<strong>on</strong>s was quite high, 64% for<br />
TMH/PMH, 69% for EH/SED, 70% for SLD,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> 87% for AT. The high c<strong>on</strong>sistency <str<strong>on</strong>g>in</str<strong>on</strong>g> classificati<strong>on</strong><br />
for children with AT is not surpris<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
as expressi<strong>on</strong> of autism symptoms is c<strong>on</strong>sidered<br />
to be very stable (Eaves & Ho, 1996).<br />
Although this study provides a foundati<strong>on</strong><br />
from which to build, it is important that future<br />
work exam<str<strong>on</strong>g>in</str<strong>on</strong>g>e changes <str<strong>on</strong>g>in</str<strong>on</strong>g> classificati<strong>on</strong> status<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> more detail to better determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e which children<br />
will leave special educati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> which<br />
will stay as well as to determ<str<strong>on</strong>g>in</str<strong>on</strong>g>e the factors that<br />
result <str<strong>on</strong>g>in</str<strong>on</strong>g> changes <str<strong>on</strong>g>in</str<strong>on</strong>g> disability classificati<strong>on</strong>s.<br />
<str<strong>on</strong>g>Developmental</str<strong>on</strong>g> Disability Outcome / 577
Although the use of large, extant databases<br />
enables the track<str<strong>on</strong>g>in</str<strong>on</strong>g>g of large numbers of children,<br />
this method of research lacks important<br />
detail. Primary excepti<strong>on</strong>ality <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> was<br />
available, but other <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> that undoubtedly<br />
plays a key role <str<strong>on</strong>g>in</str<strong>on</strong>g> outcomes for children<br />
with disabilities was unavailable. Additi<strong>on</strong>al research<br />
is needed to exam<str<strong>on</strong>g>in</str<strong>on</strong>g>e other factors important<br />
to disability outcome such as severity<br />
of impairment, exact nature of the impairment,<br />
IQ, sec<strong>on</strong>dary impairments, <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
wide range of parent, family, <str<strong>on</strong>g>and</str<strong>on</strong>g> child factors<br />
that could <str<strong>on</strong>g>in</str<strong>on</strong>g>fluence child outcomes (Beitchman<br />
et al., 1996b; Catts, 1993; Eaves & Ho,<br />
1996; O’Brien, 2001).<br />
A better underst<str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g of the future disabilities<br />
that children are likely to be assigned<br />
has numerous benefits. This <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> can<br />
assist school systems with plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> manag<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
resources <str<strong>on</strong>g>in</str<strong>on</strong>g> order to provide services to<br />
these children. It can also <str<strong>on</strong>g>in</str<strong>on</strong>g>form early identificati<strong>on</strong><br />
practices, prognostic accuracy, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
the nature of the <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s provided to<br />
these children, further improv<str<strong>on</strong>g>in</str<strong>on</strong>g>g outcomes.<br />
In additi<strong>on</strong>, such <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> can assist cl<str<strong>on</strong>g>in</str<strong>on</strong>g>icians<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> mak<str<strong>on</strong>g>in</str<strong>on</strong>g>g realistic plans, anticipat<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
probable or possible difficulties, develop<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
balanced expectati<strong>on</strong>s, <str<strong>on</strong>g>and</str<strong>on</strong>g> relay<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong><br />
to parents.<br />
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Young, A. R., Beitchman, J. H., Johns<strong>on</strong>, C., Douglas,<br />
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sample of early identified language impaired <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
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Psychiatry, 43, 635–645.<br />
Received: 14 May 2008<br />
Initial Acceptance: 21 July 2008<br />
F<str<strong>on</strong>g>in</str<strong>on</strong>g>al Acceptance: 15 December 2008<br />
<str<strong>on</strong>g>Developmental</str<strong>on</strong>g> Disability Outcome / 579
INDEX—VOLUME 44, 2009<br />
AUTHORS<br />
Allor, Jill. Research-based techniques for<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g early read<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills to students with<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities .................. 356<br />
Andrews, Al<strong>on</strong>zo. See Machalicek, Wendy . 207<br />
Anto<str<strong>on</strong>g>in</str<strong>on</strong>g>e, Karen. See Polloway, Edward A . . . 14<br />
Ant<strong>on</strong>ucci, Massimo. See Machalicek, Wendy 207<br />
Ayres, Kev<str<strong>on</strong>g>in</str<strong>on</strong>g>. Acquisiti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> generalizati<strong>on</strong> of<br />
cha<str<strong>on</strong>g>in</str<strong>on</strong>g>ed tasks taught with computer based<br />
video <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> to children with autism .. 493<br />
Baker, Joshua N. See Mims, Pamela J ..... 409<br />
B<str<strong>on</strong>g>and</str<strong>on</strong>g>a, Devender R. See Dogoe, Maud .... 177<br />
Bassette, Laura. See Bouck, Emily C. ...... 367<br />
Bedesem, Pena. See Mancil, G. Richm<strong>on</strong>d . 523<br />
Bennett, Kyle. It all depends <strong>on</strong> where you<br />
st<str<strong>on</strong>g>and</str<strong>on</strong>g>: Differences between employee’s <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
supervisor’s evaluati<strong>on</strong>s of work performance<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> support needs .............. 471<br />
Beyer, Julia. Autism spectrum disorders <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships .................... 444<br />
Blanks, A. Brooke. Multiculturalism, religi<strong>on</strong>,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> disability: Implicati<strong>on</strong>s for special educati<strong>on</strong><br />
practiti<strong>on</strong>ers ..................... 295<br />
Bouck, Emily C. Functi<strong>on</strong>al curriculum models<br />
for sec<strong>on</strong>dary students with mild mental impairment<br />
.............................. 435<br />
Bouck, Emily C. No Child Left Beh<str<strong>on</strong>g>in</str<strong>on</strong>g>d, the Individuals<br />
with <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g> <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Act <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
functi<strong>on</strong>al curricula: A c<strong>on</strong>flict of <str<strong>on</strong>g>in</str<strong>on</strong>g>terest? . 3<br />
Bouck, Emily C. Pentop computers as tools for<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g multiplicati<strong>on</strong> to students with mild<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities .................. 367<br />
Boyd, Brian A. See Mancil, G. Richm<strong>on</strong>d . . . 523<br />
Brady, Michael P. See Bennett, Kyle ....... 471<br />
Browder, Diane. See Mims, Pamela J ...... 409<br />
Campbell, L<str<strong>on</strong>g>in</str<strong>on</strong>g>dsay. See Schwartzman, Lisa<br />
J.V. .................................. 271<br />
Carter, Stacy L. See Wheeler, John ........ 187<br />
Carter, Stacy L. Treatment of pica us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a pica<br />
exchange procedure with <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g resp<strong>on</strong>se<br />
effort .......................... 143<br />
Cavkaytar, Atilla. Effectiveness of Parent <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Therapist Collaborati<strong>on</strong> Program (PTCP) for<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g self-care <str<strong>on</strong>g>and</str<strong>on</strong>g> domestic skills to <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with autism ................... 381<br />
580 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Cavkaytar, Atilla. See Ozcan, Nihal ........ 237<br />
Champl<str<strong>on</strong>g>in</str<strong>on</strong>g>, Tammi. See Allor, Jill ........... 356<br />
Chan, Jeffrey M. See Machalicek, Wendy . . 207<br />
Cheatham, Jennifer P. See Allor, Jill ....... 356<br />
Chitiyo, Morgan. See Wheeler, John ....... 187<br />
Cobigo, Virg<str<strong>on</strong>g>in</str<strong>on</strong>g>ie. Field test of a method to assess<br />
work task preferences ............. 561<br />
Coll<str<strong>on</strong>g>in</str<strong>on</strong>g>s, Belva C. See J<strong>on</strong>es, Karen L. ...... 127<br />
Danbrook, Matthew. See Schwartzman, Lisa<br />
J.V. .................................. 271<br />
Davis, T<strong>on</strong>ya. See Machalicek, Wendy ..... 207<br />
Delgado, Christ<str<strong>on</strong>g>in</str<strong>on</strong>g>e E. F. Fourth grade outcomes<br />
of children with a preschool history of<br />
developmental disability ................ 573<br />
Didden, Robert. See Machalicek, Wendy . . . 207<br />
Dogoe, Maud. Review of recent research us<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
c<strong>on</strong>stant time delay to teach cha<str<strong>on</strong>g>in</str<strong>on</strong>g>ed<br />
tasks to pers<strong>on</strong>s with developmental disabilities<br />
.................................. 177<br />
Dorm<str<strong>on</strong>g>in</str<strong>on</strong>g>y, Kimberly Powers. Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g organizati<strong>on</strong>al<br />
skills to children with high functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
autism <str<strong>on</strong>g>and</str<strong>on</strong>g> asperger’s syndrome ..... 538<br />
Dyches, T<str<strong>on</strong>g>in</str<strong>on</strong>g>a Taylor. Juvenile literature <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
portrayal of developmental disabilities .... 304<br />
Eisenman, Laura. Sec<strong>on</strong>dary <str<strong>on</strong>g>and</str<strong>on</strong>g> postsec<strong>on</strong>dary<br />
community activities of youth with significant<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities ............. 168<br />
Elmensdorp, Shar<strong>on</strong>. See Ruef, Mike ...... 343<br />
Ersoy, Gulhan. Effects of antecedent prompt<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> test procedure <strong>on</strong> teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g simulated<br />
menstrual care skills to females with developmental<br />
disabilities .................... 54<br />
Feldman, Maurice. See Schwartzman, Lisa<br />
J.V. .................................. 271<br />
Flanagan, Sara M. See Bouck, Emily C. .... 367<br />
Flexer, Robert W. See Kre<str<strong>on</strong>g>in</str<strong>on</strong>g>er, Janice ...... 280<br />
Flores, Mararet M. Effects of direct <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong><br />
<strong>on</strong> the read<str<strong>on</strong>g>in</str<strong>on</strong>g>g comprehensi<strong>on</strong> of students<br />
with autism <str<strong>on</strong>g>and</str<strong>on</strong>g> developmental disabilities . 39<br />
Fox, Robert. A community-based accomodati<strong>on</strong><br />
program for adults with autism <str<strong>on</strong>g>and</str<strong>on</strong>g> mental<br />
retardati<strong>on</strong> ......................... 118<br />
Fra<str<strong>on</strong>g>in</str<strong>on</strong>g>, Michael. See Bennett, Kyle .......... 471<br />
Fridel, Sara. See Lifshitz, Hefziba .......... 196
Friend, Anna. Impacts of family support <str<strong>on</strong>g>in</str<strong>on</strong>g> early<br />
childhood <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research .......... 453<br />
Ganz, Jennifer B. See Flores, Mararet M. . . . 39<br />
Gast, David L. See Dorm<str<strong>on</strong>g>in</str<strong>on</strong>g>y, Kimberly Powers 538<br />
Gast, David L. See Mechl<str<strong>on</strong>g>in</str<strong>on</strong>g>g, L<str<strong>on</strong>g>in</str<strong>on</strong>g>da C. ..... 67<br />
Geiman, Allis<strong>on</strong>. See Eisenman, Laura ..... 168<br />
Glaubman, Rivka. See Lifshitz, Hefziba ..... 196<br />
Graetz, Janet E. Decreas<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>appropriate behaviors<br />
for adolescents with autism spectrum<br />
disorder us<str<strong>on</strong>g>in</str<strong>on</strong>g>g modified social stories . 91<br />
Grider, Katie M. See Van Laarhoven, T<strong>on</strong>i . . 509<br />
Grider, Krist<str<strong>on</strong>g>in</str<strong>on</strong>g> L. See Van Laarhoven, T<strong>on</strong>i . . 509<br />
Gustafs<strong>on</strong>, Melissa R. See Mechl<str<strong>on</strong>g>in</str<strong>on</strong>g>g, L<str<strong>on</strong>g>in</str<strong>on</strong>g>da C. 67<br />
Hagiwara, Mayumi. See Meadan, Hedda . . . 421<br />
Harris, Kathleen C. See Ruef, Mike ........ 343<br />
Herold, Julie. See Meadan, Hedda ........ 421<br />
Hoekstra, Sarah. See Meadan, Hedda ..... 421<br />
Holtz, Casey A. See Fox, Robert .......... 118<br />
Huang, Ann. See Wheeler, John ........... 187<br />
Johns<strong>on</strong>, Jesse W. See Van Laarhoven, T<strong>on</strong>i . 509<br />
J<strong>on</strong>es, Karen L. Present<str<strong>on</strong>g>in</str<strong>on</strong>g>g cha<str<strong>on</strong>g>in</str<strong>on</strong>g>ed <str<strong>on</strong>g>and</str<strong>on</strong>g> discrete<br />
tasks as n<strong>on</strong>targeted <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> when<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g discrete academic skills through<br />
small group <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> ................. 127<br />
Kane, Martha T. See Rao, Shaila .......... 244<br />
Kircaali-Iftar, G<strong>on</strong>ul. See Ersoy, Gulhan .... 54<br />
Kle<str<strong>on</strong>g>in</str<strong>on</strong>g>ert, Harold. See J<strong>on</strong>es, Karen L. ...... 127<br />
Kre<str<strong>on</strong>g>in</str<strong>on</strong>g>er, Janice. Assessment of leisure preferences<br />
for students with severe developmental<br />
disabilities <str<strong>on</strong>g>and</str<strong>on</strong>g> communicati<strong>on</strong> difficulties 280<br />
Lachapelle, Yves. See Cobigo, Virg<str<strong>on</strong>g>in</str<strong>on</strong>g>ie .... 561<br />
Lanci<strong>on</strong>i, Giulio. See Machalicek, Wendy . . . 207<br />
Lang, Russell. See Machalicek, Wendy .... 207<br />
Lang, Russell. Review of teacher <str<strong>on</strong>g>in</str<strong>on</strong>g>volvement<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> the applied <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research for children<br />
with autism spectrum disorders ...... 481<br />
Langthorne, Paul. See Machalicek, Wendy . 207<br />
Lee, Angel. See Mims, Pamela J. .......... 409<br />
Lee, EunJung. Effects of <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al rubrics<br />
<strong>on</strong> class engagement behaviors <str<strong>on</strong>g>and</str<strong>on</strong>g> the<br />
achievement of less<strong>on</strong> objectives by students<br />
with mild mental retardati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> their<br />
typical peers .......................... 396<br />
Lee, SoHyun. See Lee, EunJung .......... 396<br />
Le<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>ger, Melissa. See Dyches, T<str<strong>on</strong>g>in</str<strong>on</strong>g>a Taylor . 304<br />
Liaups<str<strong>on</strong>g>in</str<strong>on</strong>g>, Carl. See Underwood, Martha .... 25<br />
Lifshitz, Hefziba. Why do <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual<br />
disability turn to religi<strong>on</strong>: A comparis<strong>on</strong><br />
between adolescents <str<strong>on</strong>g>and</str<strong>on</strong>g> adults ..... 196<br />
Lub<str<strong>on</strong>g>in</str<strong>on</strong>g>, Jaquel<str<strong>on</strong>g>in</str<strong>on</strong>g>e. See Polloway, Edward A. . 14<br />
Luscre, Deanna. See Dorm<str<strong>on</strong>g>in</str<strong>on</strong>g>y, Kimberly Powers<br />
................................... 538<br />
Machalicek, Wendy. See Lang, Russell .... 481<br />
Machalicek, Wendy. Us<str<strong>on</strong>g>in</str<strong>on</strong>g>g videoc<strong>on</strong>ferenc<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
to c<strong>on</strong>duct functi<strong>on</strong>al analysis of challeng<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
behavior <str<strong>on</strong>g>and</str<strong>on</strong>g> develop classroom support<br />
plans for students with autism ........... 207<br />
Maguire, Amy. See Ayres, Kev<str<strong>on</strong>g>in</str<strong>on</strong>g> ..........<br />
Mallow, Lynette. See Rao, Shaila .......... 80<br />
Mancil, G. Richm<strong>on</strong>d. Milieu therapy as a communicati<strong>on</strong><br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>: A review of the literature<br />
related to children with autism spectrum<br />
disorder .......................... 105<br />
Mancil, G. Richm<strong>on</strong>d. See Schaefer Whitby,<br />
Peggy J. .............................. 551<br />
Mancil, G. Richm<strong>on</strong>d. Parental stress <str<strong>on</strong>g>and</str<strong>on</strong>g> autism:<br />
Are there useful cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies ... 523<br />
Manser, Samantha. See Meadan, Hedda . . . 421<br />
Mart<str<strong>on</strong>g>in</str<strong>on</strong>g>, Garry L. See Schwartzman, Lisa J. V.<br />
....................................... 271<br />
Mastropieri, Margo A. See Graetz, Janet E. . 91<br />
Mathes, Patricia. See Allor, Jill ............ 356<br />
Mayt<strong>on</strong>, Michael R. See Wheeler, John ..... 187<br />
McClim<strong>on</strong>, Desiree. See Ayres, Kev<str<strong>on</strong>g>in</str<strong>on</strong>g> ...... 493<br />
Meadan, Hedda. Evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g the acceptability<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> effectiveness of family assessment portfolios<br />
................................. 421<br />
Mechl<str<strong>on</strong>g>in</str<strong>on</strong>g>g, L<str<strong>on</strong>g>in</str<strong>on</strong>g>da C. Comparis<strong>on</strong> of selfprompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
of cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills via picture-based<br />
cookbooks <str<strong>on</strong>g>and</str<strong>on</strong>g> video recipes ............ 218<br />
Mechl<str<strong>on</strong>g>in</str<strong>on</strong>g>g, L<str<strong>on</strong>g>in</str<strong>on</strong>g>da C. Use of video model<str<strong>on</strong>g>in</str<strong>on</strong>g>g to<br />
teach ext<str<strong>on</strong>g>in</str<strong>on</strong>g>guish<str<strong>on</strong>g>in</str<strong>on</strong>g>g of cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g related fires<br />
to <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with moderate <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities<br />
............................... 67<br />
Menendez, Anth<strong>on</strong>y L. See Wheeler, John . . 187<br />
Millar, Dorothy Squatrito. Comparis<strong>on</strong> of transiti<strong>on</strong>-related<br />
IEP c<strong>on</strong>tent for young adults<br />
with disabilities who do or do not have a<br />
legal guardian ......................... 151<br />
Mims, Pamela J. Increas<str<strong>on</strong>g>in</str<strong>on</strong>g>g comprehensi<strong>on</strong> of<br />
students with significant <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> visual impairments dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g shared<br />
stories ................................ 409<br />
Moist, Amie M. See Fox, Robert ........... 118<br />
Mor<str<strong>on</strong>g>in</str<strong>on</strong>g>, Diane. See Cobigo, Virg<str<strong>on</strong>g>in</str<strong>on</strong>g>ie ........ 561<br />
Nefdt, Nicolette. See Ruef, Mike ........... 343<br />
O’Reilly, Mark. See Lang, Russell .......... 481<br />
Openden, Daniel. See Ruef, Mike ......... 343<br />
O’Reilly, Mark. See Machalicek, Wendy .... 207<br />
Ozcan, Nihal. Parents as teachers: Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
parents how to teach toilet skills to their children<br />
with autism <str<strong>on</strong>g>and</str<strong>on</strong>g> mental retardati<strong>on</strong> .. 237<br />
Parette, Howard P. Assistive technology user<br />
group perspectives of early childhood professi<strong>on</strong>als<br />
............................. 257<br />
Patt<strong>on</strong>, James R. See Polloway, Edward A. . 14<br />
Perner, Darlene E. See Zucker, Stanley H. . . 291<br />
Index, Volume 44 / 581
Perras, C<str<strong>on</strong>g>in</str<strong>on</strong>g>dy. See Zucker, Stanley H. ..... 291<br />
Perr<str<strong>on</strong>g>in</str<strong>on</strong>g>gt<strong>on</strong>, Carol. See Eisenman, Laura .... 168<br />
Pollard, Elena. See Cavkaytar, Atilla ....... 381<br />
Polloway, Edward A. State guidel<str<strong>on</strong>g>in</str<strong>on</strong>g>es for mental<br />
retardati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> developmental disabilities:<br />
A revisitati<strong>on</strong> of previous analyses <str<strong>on</strong>g>in</str<strong>on</strong>g><br />
light of changes <str<strong>on</strong>g>in</str<strong>on</strong>g> the field ............. 14<br />
Prater, Mary Anne. See Dyches, T<str<strong>on</strong>g>in</str<strong>on</strong>g>a Taylor . 304<br />
Rao, Shaila. Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g students with cognitive<br />
impairment cha<str<strong>on</strong>g>in</str<strong>on</strong>g>ed mathematical task of<br />
decimal subtracti<strong>on</strong> us<str<strong>on</strong>g>in</str<strong>on</strong>g>g simultaneous<br />
prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g ............................. 244<br />
Rao, Shaila. Us<str<strong>on</strong>g>in</str<strong>on</strong>g>g simultaneous prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
procedure to promote recall of multiplicati<strong>on</strong><br />
facts by middle school students with cognitive<br />
impairment. ....................... 80<br />
Regester, April. See Lang, Russell ......... 481<br />
Rispoli, M<str<strong>on</strong>g>and</str<strong>on</strong>g>y. See Lang, Russell ......... 481<br />
Rispoli, M<str<strong>on</strong>g>and</str<strong>on</strong>g>y. See Machalicek, Wendy . . . 207<br />
Rob<str<strong>on</strong>g>in</str<strong>on</strong>g>s<strong>on</strong>, Suzanne. See Ruef, Mike ....... 343<br />
Rosenberg, Howard. See Bennett, Kyle .... 471<br />
Ruef, Mike. Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g by do<str<strong>on</strong>g>in</str<strong>on</strong>g>g: A collaborative<br />
model for tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g teacher-c<str<strong>on</strong>g>and</str<strong>on</strong>g>idate graduate<br />
students <str<strong>on</strong>g>in</str<strong>on</strong>g> Autism .................. 343<br />
Schaefer Whitby, Peggy J. Academic achievement<br />
profiles of children with high functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
autism <str<strong>on</strong>g>and</str<strong>on</strong>g> Asperger Syndrome: A review<br />
of the literature ................... 551<br />
Schuster, John W. See J<strong>on</strong>es, Karen L. .... 127<br />
Schwartzman, Lisa J. V. Predict<str<strong>on</strong>g>in</str<strong>on</strong>g>g the learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
ability of children with autism: The assessment<br />
of basic learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g abilities test versus<br />
parents’ predicti<strong>on</strong>s ................ 271<br />
Scruggs, Thomas E. See Graetz, Janet E. . . 91<br />
Shogren, Karrie. See Lang, Russell ........ 481<br />
Shogren, Karrie. See Machalicek, Wendy . . . 207<br />
Sigafoos, Jeff. See Lang, Russell .......... 481<br />
Sigafoos, Jeff. See Machalicek, Wendy .... 207<br />
Smith, J. David. See Blanks, A. Brooke ..... 295<br />
Smith, J. David. See Polloway, Edward A. . . 14<br />
Smith, J. David. See Zucker, Stanley H. .... 291<br />
Spillane, Anne. See Wang, Peishi .......... 318<br />
Spo<strong>on</strong>er, Fred. See Mims, Pamela J. ....... 409<br />
Stephens, Er<str<strong>on</strong>g>in</str<strong>on</strong>g>. See Mechl<str<strong>on</strong>g>in</str<strong>on</strong>g>g, L<str<strong>on</strong>g>in</str<strong>on</strong>g>da C. .... 218<br />
St<strong>on</strong>er, Julia B. See Parette, Howard P. .... 257<br />
Summers, Jean Ann. See Friend, Anna ..... 453<br />
Sur<str<strong>on</strong>g>in</str<strong>on</strong>g>ak, Tricia. See Bennett, Kyle .......... 471<br />
Szwed, Kathryn. See Bouck, Emily C. ...... 367<br />
Taber-Doughty, Teresa. See Bouck, Emily C.<br />
....................................... 367<br />
Tanverdi, Annie. See Eisenman, Laura ..... 168<br />
Tek<str<strong>on</strong>g>in</str<strong>on</strong>g>-Iftar, Elif. See Ersoy, Gulhan ......... 54<br />
Thomps<strong>on</strong>, James R. See Meadan, Hedda . 421<br />
582 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Turnbull, Ann P. See Friend, Anna ......... 453<br />
Umbreit, John. See Underwood, Martha .... 25<br />
Underwood, Martha. Efficacy of a systematic<br />
process for design<str<strong>on</strong>g>in</str<strong>on</strong>g>g functi<strong>on</strong>-based <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
for adults <str<strong>on</strong>g>in</str<strong>on</strong>g> a community sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g .<br />
Van Laarhoven, T<strong>on</strong>i. Comparis<strong>on</strong> of self,<br />
25<br />
other, <str<strong>on</strong>g>and</str<strong>on</strong>g> subjective video models for<br />
teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g daily liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills to <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with<br />
developmental disabilities ............... 509<br />
Vause, Tricia. See Schwartzman, Lisa J. V. . 271<br />
Wang, Peishi. Evidence-based social skills <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s<br />
for children with autism: A metaanalysis<br />
.............................. 318<br />
Watts, Emily H. See Parette, Howard P. .... 257<br />
Weiss, Izhak. ............................ 196<br />
Wheeler, John. An assessment of treatment<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>tegrity <str<strong>on</strong>g>in</str<strong>on</strong>g> behavioral <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> studies<br />
c<strong>on</strong>ducted with pers<strong>on</strong>s with mental retardati<strong>on</strong><br />
.................................. 187<br />
Yu, C. T. See Schwartzman, Lisa J. V. ...... 271<br />
Zucker, Stanley H. Best practices <str<strong>on</strong>g>in</str<strong>on</strong>g> cognitive<br />
disabilities/mental retardati<strong>on</strong>, autism, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
related disabilities ...................... 291<br />
Zurita, Leslie M. See Van Laarhoven, T<strong>on</strong>i . . 509<br />
TITLES<br />
A community-based accomodati<strong>on</strong> program<br />
for adults with autism <str<strong>on</strong>g>and</str<strong>on</strong>g> mental retardati<strong>on</strong>.<br />
Robert Fox, Casey A. Holtz, <str<strong>on</strong>g>and</str<strong>on</strong>g> Amie<br />
M. Moist .............................. 118<br />
Academic achievement profiles of children with<br />
high functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g autism <str<strong>on</strong>g>and</str<strong>on</strong>g> Asperger Syndrome:<br />
A review of the literature. Peggy J.<br />
Schaefer Whitby <str<strong>on</strong>g>and</str<strong>on</strong>g> G. Richm<strong>on</strong>d Mancil . 551<br />
Acquisiti<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> generalizati<strong>on</strong> of cha<str<strong>on</strong>g>in</str<strong>on</strong>g>ed tasks<br />
taught with computer based video <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong><br />
to children with autism. Kev<str<strong>on</strong>g>in</str<strong>on</strong>g> Ayres, Amy<br />
Maguire, <str<strong>on</strong>g>and</str<strong>on</strong>g> Desiree McClim<strong>on</strong> ........ 493<br />
An assessment of treatment <str<strong>on</strong>g>in</str<strong>on</strong>g>tegrity <str<strong>on</strong>g>in</str<strong>on</strong>g> behavioral<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> studies c<strong>on</strong>ducted with pers<strong>on</strong>s<br />
with mental retardati<strong>on</strong>. John Wheeler,<br />
Michael R. Mayt<strong>on</strong>, Stacy L. Carter, Morgan<br />
Chitiyo, Anth<strong>on</strong>y L. Menendez, <str<strong>on</strong>g>and</str<strong>on</strong>g> Ann<br />
Huang ................................ 187<br />
Assessment of leisure preferences for students<br />
with severe developmental disabilities<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> communicati<strong>on</strong> difficulties. Janice<br />
Kre<str<strong>on</strong>g>in</str<strong>on</strong>g>er <str<strong>on</strong>g>and</str<strong>on</strong>g> Robert W. Flexer ........... 280<br />
Assistive technology user group perspectives<br />
of early childhood professi<strong>on</strong>als. Howard P.<br />
Parette, Julia B. St<strong>on</strong>er, <str<strong>on</strong>g>and</str<strong>on</strong>g> Emily H. Watts 257<br />
Autism spectrum disorders <str<strong>on</strong>g>and</str<strong>on</strong>g> sibl<str<strong>on</strong>g>in</str<strong>on</strong>g>g relati<strong>on</strong>ships.<br />
Julia Beyer ...................... 444<br />
Best practices <str<strong>on</strong>g>in</str<strong>on</strong>g> cognitive disabilities/mental<br />
retardati<strong>on</strong>, autism, <str<strong>on</strong>g>and</str<strong>on</strong>g> related disabilities.<br />
Stanley H. Zucker, C<str<strong>on</strong>g>in</str<strong>on</strong>g>dy Perras, Darlene E.<br />
Perner, <str<strong>on</strong>g>and</str<strong>on</strong>g> J. David Smith ............. 291
Comparis<strong>on</strong> of self, other, <str<strong>on</strong>g>and</str<strong>on</strong>g> subjective video<br />
models for teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g daily liv<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills to <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals<br />
with developmental disabilities. T<strong>on</strong>i<br />
Van Laarhoven, Leslie M. Zurita, Jesse W.<br />
Johns<strong>on</strong>, Katie M. Grider, <str<strong>on</strong>g>and</str<strong>on</strong>g> Krist<str<strong>on</strong>g>in</str<strong>on</strong>g> L.<br />
Grider ................................ 509<br />
Comparis<strong>on</strong> of self-prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g of cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills<br />
via picture-based cookbooks <str<strong>on</strong>g>and</str<strong>on</strong>g> video recipes.<br />
L<str<strong>on</strong>g>in</str<strong>on</strong>g>da C. Mechl<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>and</str<strong>on</strong>g> Er<str<strong>on</strong>g>in</str<strong>on</strong>g> Stephens<br />
....................................... 218<br />
Comparis<strong>on</strong> of transiti<strong>on</strong>-related IEP c<strong>on</strong>tent<br />
for young adults with disabilities who do or<br />
do not have a legal guardian. Dorothy Squatrito<br />
Millar ............................. 151<br />
Decreas<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g>appropriate behaviors for adolescents<br />
with autism spectrum disorder us<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
modified social stories. Janet E. Graetz,<br />
Margo A. Mastropieri, <str<strong>on</strong>g>and</str<strong>on</strong>g> Thomas E.<br />
Scruggs .............................. 91<br />
Effectiveness of Parent <str<strong>on</strong>g>and</str<strong>on</strong>g> Therapist Collaborati<strong>on</strong><br />
Program (PTCP) for teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g selfcare<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> domestic skills to <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with<br />
autism. Atilla Cavkaytar <str<strong>on</strong>g>and</str<strong>on</strong>g> Elena Pollard . 381<br />
Effects of antecedent prompt <str<strong>on</strong>g>and</str<strong>on</strong>g> test procedure<br />
<strong>on</strong> teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g simulated menstrual care<br />
skills to females with developmental disabilities.<br />
Gulhan Ersoy, Elif Tek<str<strong>on</strong>g>in</str<strong>on</strong>g>-Iftar, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
G<strong>on</strong>ul Kircaali-Iftar ..................... 54<br />
Effects of direct <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong> <strong>on</strong> the read<str<strong>on</strong>g>in</str<strong>on</strong>g>g comprehensi<strong>on</strong><br />
of students with autism <str<strong>on</strong>g>and</str<strong>on</strong>g> developmental<br />
disabilities. Mararet M. Flores<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Jennifer B. Ganz .................. 39<br />
Effects of <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>al rubrics <strong>on</strong> class engagement<br />
behaviors <str<strong>on</strong>g>and</str<strong>on</strong>g> the achievement of<br />
less<strong>on</strong> objectives by students with mild mental<br />
retardati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> their typical peers. Eun-<br />
Jung Lee <str<strong>on</strong>g>and</str<strong>on</strong>g> SoHyun Lee ............. 396<br />
Efficacy of a systematic process for design<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
functi<strong>on</strong>-based <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s for adults <str<strong>on</strong>g>in</str<strong>on</strong>g> a<br />
community sett<str<strong>on</strong>g>in</str<strong>on</strong>g>g. Martha Underwood,<br />
John Umbreit, <str<strong>on</strong>g>and</str<strong>on</strong>g> Carl Liaups<str<strong>on</strong>g>in</str<strong>on</strong>g> ........ 25<br />
Evaluat<str<strong>on</strong>g>in</str<strong>on</strong>g>g the acceptability <str<strong>on</strong>g>and</str<strong>on</strong>g> effectiveness<br />
of family assessment portfolios. Hedda<br />
Meadan, James R. Thomps<strong>on</strong>, Mayumi<br />
Hagiwara, Julie Herold, Sarah Hoekstra,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Samantha Manser ................. 421<br />
Evidence-based social skills <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>s for<br />
children with autism: A meta-analysis. Peishi<br />
Wang <str<strong>on</strong>g>and</str<strong>on</strong>g> Anne Spillane ............... 318<br />
Field test of a method to assess work task<br />
preferences. Virg<str<strong>on</strong>g>in</str<strong>on</strong>g>ie Cobigo, Diane Mor<str<strong>on</strong>g>in</str<strong>on</strong>g>,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Yves Lachapelle ................... 561<br />
Fourth grade outcomes of children with a preschool<br />
history of developmental disability.<br />
Christ<str<strong>on</strong>g>in</str<strong>on</strong>g>e E. F. Delgado ................. 573<br />
Functi<strong>on</strong>al curriculum models for sec<strong>on</strong>dary<br />
students with mild mental mpairment. Emily<br />
C. Bouck ............................. 435<br />
Impacts of family support <str<strong>on</strong>g>in</str<strong>on</strong>g> early childhood<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research. Anna Friend, Jean<br />
Ann Summers, <str<strong>on</strong>g>and</str<strong>on</strong>g> Ann P. Turnbull ...... 453<br />
Increas<str<strong>on</strong>g>in</str<strong>on</strong>g>g comprehensi<strong>on</strong> of students with<br />
significant <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities <str<strong>on</strong>g>and</str<strong>on</strong>g> visual<br />
impairments dur<str<strong>on</strong>g>in</str<strong>on</strong>g>g shared stories. Pamela<br />
J. Mims, Diane Browder, Joshua N. Baker,<br />
Angel Lee, <str<strong>on</strong>g>and</str<strong>on</strong>g> Fred Spo<strong>on</strong>er ........... 409<br />
It all depends <strong>on</strong> where you st<str<strong>on</strong>g>and</str<strong>on</strong>g>: Differences<br />
between employee’s <str<strong>on</strong>g>and</str<strong>on</strong>g> supervisor’s evaluati<strong>on</strong>s<br />
of work performance <str<strong>on</strong>g>and</str<strong>on</strong>g> support<br />
needs. Kyle Bennett, Michael Fra<str<strong>on</strong>g>in</str<strong>on</strong>g>, Michael<br />
P. Brady, Howard Rosenberg, <str<strong>on</strong>g>and</str<strong>on</strong>g> Tricia<br />
Sur<str<strong>on</strong>g>in</str<strong>on</strong>g>ak ............................... 471<br />
Juvenile literature <str<strong>on</strong>g>and</str<strong>on</strong>g> the portrayal of developmental<br />
disabilities. T<str<strong>on</strong>g>in</str<strong>on</strong>g>a Taylor Dyches,<br />
Mary Anne Prater, <str<strong>on</strong>g>and</str<strong>on</strong>g> Melissa Le<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>ger . 304<br />
Learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g by do<str<strong>on</strong>g>in</str<strong>on</strong>g>g: A collaborative model for<br />
tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g teacher-c<str<strong>on</strong>g>and</str<strong>on</strong>g>idate graduate students<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g> Autism. Mike Ruef, Nicolette Nefdt,<br />
Daniel Openden, Shar<strong>on</strong> Elmensdorp, Kathleen<br />
C. Harris, <str<strong>on</strong>g>and</str<strong>on</strong>g> Suzanne Rob<str<strong>on</strong>g>in</str<strong>on</strong>g>s<strong>on</strong> . . . 343<br />
Milieu therapy as a communicati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong>:<br />
A review of the literature related to children<br />
with autism spectrum disorder. G. Richm<strong>on</strong>d<br />
Mancil .......................... 105<br />
Multiculturalism, religi<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> disability: Implicati<strong>on</strong>s<br />
for special educati<strong>on</strong> practiti<strong>on</strong>ers.<br />
A. Brooke Blanks <str<strong>on</strong>g>and</str<strong>on</strong>g> J. David Smith .... 295<br />
No Child Left Beh<str<strong>on</strong>g>in</str<strong>on</strong>g>d, the Individuals with <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g><br />
<str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> Act <str<strong>on</strong>g>and</str<strong>on</strong>g> functi<strong>on</strong>al curricula:<br />
A c<strong>on</strong>flict of <str<strong>on</strong>g>in</str<strong>on</strong>g>terest?. Emily C. Bouck . 3<br />
Parental stress <str<strong>on</strong>g>and</str<strong>on</strong>g> autism: Are there useful<br />
cop<str<strong>on</strong>g>in</str<strong>on</strong>g>g strategies. G. Richm<strong>on</strong>d Mancil,<br />
Brian A. Boyd, <str<strong>on</strong>g>and</str<strong>on</strong>g> Pena Bedesem ...... 523<br />
Parents as teachers: Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g parents how to<br />
teach toilet skills to their children with autism<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> mental retardati<strong>on</strong>. Nihal Ozcan <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
Atilla Cavkaytar ........................ 237<br />
Pentop computers as tools for teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g multiplicati<strong>on</strong><br />
to students with mild <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual<br />
disabilities. Emily C. Bouck, Laura Bassette,<br />
Teresa Taber-Doughty, Sara M. Flanagan,<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Kathryn Szwed .................... 367<br />
Predict<str<strong>on</strong>g>in</str<strong>on</strong>g>g the learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g ability of children with<br />
autism: The assessment of basic learn<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
abilities test versus parents’ predicti<strong>on</strong>s. Lisa<br />
J. V. Schwartzman, Tricia Vause, Garry L.<br />
Mart<str<strong>on</strong>g>in</str<strong>on</strong>g>, C. T. Yu, L<str<strong>on</strong>g>in</str<strong>on</strong>g>dsay Campbell, Matthew<br />
Danbrook, <str<strong>on</strong>g>and</str<strong>on</strong>g> Maurice Feldman . . . 271<br />
Present<str<strong>on</strong>g>in</str<strong>on</strong>g>g cha<str<strong>on</strong>g>in</str<strong>on</strong>g>ed <str<strong>on</strong>g>and</str<strong>on</strong>g> discrete tasks as n<strong>on</strong>targeted<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> when teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g discrete<br />
academic skills through small group <str<strong>on</strong>g>in</str<strong>on</strong>g>structi<strong>on</strong>.<br />
Karen L. J<strong>on</strong>es, Belva C. Coll<str<strong>on</strong>g>in</str<strong>on</strong>g>s, Johm<br />
W. Schuster, <str<strong>on</strong>g>and</str<strong>on</strong>g> Harold Kle<str<strong>on</strong>g>in</str<strong>on</strong>g>ert ........ 127<br />
Research-based techniques for teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g early<br />
read<str<strong>on</strong>g>in</str<strong>on</strong>g>g skills to students with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual<br />
disabilities. Jill Allor, Patricia Mathes, Tammi<br />
Champl<str<strong>on</strong>g>in</str<strong>on</strong>g>, <str<strong>on</strong>g>and</str<strong>on</strong>g> Jennifer P. Cheatham .... 356<br />
Index, Volume 44 / 583
Review of recent research us<str<strong>on</strong>g>in</str<strong>on</strong>g>g c<strong>on</strong>stant time<br />
delay to teach cha<str<strong>on</strong>g>in</str<strong>on</strong>g>ed tasks to pers<strong>on</strong>s with<br />
developmental disabilities. Maud Dogoe<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> Devender R. B<str<strong>on</strong>g>and</str<strong>on</strong>g>a ................ 177<br />
Review of teacher <str<strong>on</strong>g>in</str<strong>on</strong>g>volvement <str<strong>on</strong>g>in</str<strong>on</strong>g> the applied<br />
<str<strong>on</strong>g>in</str<strong>on</strong>g>terventi<strong>on</strong> research for children with autism<br />
spectrum disorders. Russell Lang,<br />
Wendy Machalicek, Mark O’Reilly, Jeff Sigafoos,<br />
M<str<strong>on</strong>g>and</str<strong>on</strong>g>y Rispoli, Karrie Shogren, <str<strong>on</strong>g>and</str<strong>on</strong>g><br />
April Regester ......................... 481<br />
Sec<strong>on</strong>dary <str<strong>on</strong>g>and</str<strong>on</strong>g> postsec<strong>on</strong>dary community activities<br />
of youth with significant <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual<br />
disabilities. Laura Eisenman, Annie Tanverdi,<br />
Carol Perr<str<strong>on</strong>g>in</str<strong>on</strong>g>gt<strong>on</strong>, <str<strong>on</strong>g>and</str<strong>on</strong>g> Allis<strong>on</strong> Geiman 168<br />
State guidel<str<strong>on</strong>g>in</str<strong>on</strong>g>es for mental retardati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> developmental<br />
disabilities: A revisitati<strong>on</strong> of previous<br />
analyses <str<strong>on</strong>g>in</str<strong>on</strong>g> light of changes <str<strong>on</strong>g>in</str<strong>on</strong>g> the<br />
field. Edward A. Polloway, James R. Patt<strong>on</strong>,<br />
J. David Smith, Jaquel<str<strong>on</strong>g>in</str<strong>on</strong>g>e Lub<str<strong>on</strong>g>in</str<strong>on</strong>g>, <str<strong>on</strong>g>and</str<strong>on</strong>g> Karen<br />
Anto<str<strong>on</strong>g>in</str<strong>on</strong>g>e ............................... 14<br />
Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g organizati<strong>on</strong>al skills to children with<br />
high functi<strong>on</strong><str<strong>on</strong>g>in</str<strong>on</strong>g>g autism <str<strong>on</strong>g>and</str<strong>on</strong>g> asperger’s syndrome.<br />
Kimberly Powers Dorm<str<strong>on</strong>g>in</str<strong>on</strong>g>y, Deanna<br />
Luscre, <str<strong>on</strong>g>and</str<strong>on</strong>g> David L. Gast .............. 538<br />
Teach<str<strong>on</strong>g>in</str<strong>on</strong>g>g students with cognitive impairment<br />
cha<str<strong>on</strong>g>in</str<strong>on</strong>g>ed mathematical task of decimal subtracti<strong>on</strong><br />
us<str<strong>on</strong>g>in</str<strong>on</strong>g>g simultaneous prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g.<br />
Shaila Rao <str<strong>on</strong>g>and</str<strong>on</strong>g> Martha T. Kane ......... 244<br />
584 / <str<strong>on</strong>g>Educati<strong>on</strong></str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>Tra<str<strong>on</strong>g>in</str<strong>on</strong>g><str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Developmental</str<strong>on</strong>g> <str<strong>on</strong>g>Disabilities</str<strong>on</strong>g>-December 2009<br />
Treatment of pica us<str<strong>on</strong>g>in</str<strong>on</strong>g>g a pica exchange procedure<br />
with <str<strong>on</strong>g>in</str<strong>on</strong>g>creas<str<strong>on</strong>g>in</str<strong>on</strong>g>g resp<strong>on</strong>se effort.<br />
Stacy L. Carter ........................ 143<br />
Use of video model<str<strong>on</strong>g>in</str<strong>on</strong>g>g to teach ext<str<strong>on</strong>g>in</str<strong>on</strong>g>guish<str<strong>on</strong>g>in</str<strong>on</strong>g>g<br />
of cook<str<strong>on</strong>g>in</str<strong>on</strong>g>g related fires to <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with<br />
moderate <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disabilities. L<str<strong>on</strong>g>in</str<strong>on</strong>g>da C.<br />
Mechl<str<strong>on</strong>g>in</str<strong>on</strong>g>g, David L. Gast, <str<strong>on</strong>g>and</str<strong>on</strong>g> Melissa R.<br />
Gustafs<strong>on</strong> ............................ 67<br />
Us<str<strong>on</strong>g>in</str<strong>on</strong>g>g simultaneous prompt<str<strong>on</strong>g>in</str<strong>on</strong>g>g procedure to<br />
promote recall of multiplicati<strong>on</strong> facts by middle<br />
school students with cognitive impairment.<br />
Shaila Rao <str<strong>on</strong>g>and</str<strong>on</strong>g> Lynette Mallow .... 80<br />
Us<str<strong>on</strong>g>in</str<strong>on</strong>g>g videoc<strong>on</strong>ferenc<str<strong>on</strong>g>in</str<strong>on</strong>g>g to c<strong>on</strong>duct functi<strong>on</strong>al<br />
analysis of challeng<str<strong>on</strong>g>in</str<strong>on</strong>g>g behavior <str<strong>on</strong>g>and</str<strong>on</strong>g> develop<br />
classroom support plans for students<br />
with autism. Wendy Machalicek, Mark<br />
O’Reilly, Jeffrey M. Chan, Russell Lang,<br />
M<str<strong>on</strong>g>and</str<strong>on</strong>g>y Rispoli, T<strong>on</strong>ya Davis, Karrie<br />
Shogren, Jeff Sigafoos, Giulio Lanci<strong>on</strong>i,<br />
Massimo Ant<strong>on</strong>ucci, Paul Langthorne,<br />
Al<strong>on</strong>zo Andrews, <str<strong>on</strong>g>and</str<strong>on</strong>g> Robert Didden .... 207<br />
Why do <str<strong>on</strong>g>in</str<strong>on</strong>g>dividuals with <str<strong>on</strong>g>in</str<strong>on</strong>g>tellectual disability<br />
turn to religi<strong>on</strong>: A comparis<strong>on</strong> between adolescents<br />
<str<strong>on</strong>g>and</str<strong>on</strong>g> adults. Hefziba Lifshitz, Izhak<br />
Weiss, Sara Fridel, <str<strong>on</strong>g>and</str<strong>on</strong>g> Rivka Glaubman . 196