CHELSEA VANDERWOUDE EXAMINING THE EFFECTS OF A MIRROR ON IMITATION SKILLS IN CHILDREN WITH AUTISM

Western Michigan University Psychology Department Lee Honors College Thesis Defense Spring 2013

SPECIAL THANKS

AGENDA Brief Overview Current Treatments Proposed Treatment Research Questions of the Current Study Independent and Dependent Variables Methodology Risks and Benefits to Potential Participants Questions

BRIEF OVERVIEW Children with autism show difficulty in imitation skills (Freitag, kleser, & Gontardf, 2006; Rogers Bennetto, McEvoy, & Pennigton, 1996) Typically developing children can imitate at six- weeks old (Meltzoff, 1995) Those with autism struggle with imitation as infants, adolescents, and adults (Killen & Uzgiris, 1981; Hobson & Lee, 1999)

BRIEF OVERVIEW Imitation is important in the developmental process (Meltzoff & Moore, 1998; Piaget, 1962; Rogers, Cook, & Meryl, 2005) Children without imitation skills also have difficulty forming communication skills (Ingersoll, 2008) Empirically supported treatments are needed

CURRENT TREATMENTS Discrete Trial Training (Gena, Krantz, McClannahan & Poulson, 1996) Reciprocal Imitation Training (Warren, Yoder, Gazdag, & Kim, 1993) Video Modeling (Charlop-Christy, Loc, & Freeman, 2001) Video Self Modeling and Point of View Video Modeling (Cotter, 2010)

CURRENT TREATMENTS Weaknesses Difficult Time Consuming Expensive Classroom Adaptability

PROPOSED TREATMENT The use of a mirror for imitation skills Would provide several benefits over current treatments Has not been studied before Used by other fields

RESEARCH QUESTIONS Will a mirror increase imitation skills for children with autism? Can we establish empirical support for a new intervention measure? Can we provide empirical evidence for the use of a mirror?

INDEPENDENT AND DEPENDENT VARIABLES Independent Variable Mirror Dependent Variable The correct trials of imitative behaviors. Imitation is defined as: the match between the behavior of the investigator and the behavior of the participant, within 5 seconds of the model

METHODOLOGY: CODING BEHAVIORS All behaviors will have three possible codes Incorrect Attempt (IA) No Response (NR) Correct Response (CR)

METHODOLOGY: INCLUSION Between ages of two and 10 years old Diagnosis of any Autism Spectrum Disorder Difficulty in imitation skills With little to no improvement when using current treatments Exclusion: severe self-injurious behaviors and/or severe problem behaviors

METHODOLOGY: RECRUITMENT Allegan, Summit Pointe, Kalamazoo Autism Center (KAC), and Woodsedge Learning Center Kalamazoo/Battle Creek Autism Society 20 potential participants Brief Screening

METHODOLOGY: INFORMED CONSENT Child’s school or home Will provide an overview of the study, the methods, potential risks, and benefits of their children’s participation. Assent Protocol

METHODOLOGY: ASSESSMENT Semi-Structured Imitation Assessment Measure (SSIAM) Assesses imitation skills across a range of behaviors Administered before, during and after the intervention The first assessment will be administered after the informed consent is obtained

METHODOLOGY: ATTENDING PROCEDURES Participants are required to have attending skills for the study Must be able to “look at me” and “look at that” e.g., the researcher and mirror Will be assessed in the first session prior to the SSIAM Researchers will teach participants to attend if they are unable to do so

METHODOLOGY: PROMPTING Least to most prompting hierarchy according to past research protocols (Libby, Weiss, Bancroft, & Ahearn, 2008) If the child does not engage in the targeted behavior the next prompt will be given Prompts will not be provided in the assessment

METHODOLOGY: PROMPTING Order of prompting Independent Partial prompt Full prompt

METHODOLOGY: BASELINE Discrete trial training Will have child attend to researcher, then ask to engage in a behavior Prompted behaviors: touch nose, pat head, and touch ears Five trials for each behavior, each session for a total of 15 scored behaviors in all baseline sessions All behaviors will be scored as: no response, incorrect attempt or correct response

METHODOLOGY: BASELINE Example of a correct response “Michael, Do this!” Discriminative Stimulus Response Correct Response Outcome Access to preferred item

METHODOLOGY: BASELINE Example of an incorrect response Discriminative Stimulus Response Outcome “Michael, Do this!” Incorrect Response Partial Prompt

METHODOLOGY: INTERVENTION Identical to baseline procedures, with the exception of a full length swivel mirror Researcher will sit behind child, with mirror in front him/her Will have child attend to the mirror, then ask to engage in a behavior The model will be provided when child is attending to the mirror

METHODOLOGY: INTERVENTION Example of a correct response “Michael, Do this!” Discriminative Stimulus Response Correct Response Outcome Access to preferred item

METHODOLOGY: INTERVENTION Example of an incorrect response Discriminative Stimulus Response Outcome “Michael, Do this!” Incorrect Response Partial Prompt

Discriminative Stimulus Correct Response Incorrect Response Reinforcement Partial Prompt Correct Response Incorrect Response Verbal Praise Blocked Response Full Prompt Verbal Praise Prompting Flowchart

METHODOLOGY: RESEARCH DESIGN Multiple baseline across participants All participants will begin in baseline with three behaviors (touch shoulders, touch head, and arms extended) Participants will enter the treatment phase, after it has been determined that there is no change in the DV using DTT solely The study will end when all participants have met mastery criteria for all behaviors

REINFORCEMENT A preference assessment will be conducted prior to each session to determine the preferred item for that session If the participant correctly imitates the behavior the investigator will immediately provide access to the preferred item to the child for 20 s and verbal praise. Preferred items will only be provided on CR codes. Verbal praise will be provided for all prompted responses

METHODOLOGY: SOCIAL VALIDITY Participant’s preference of treatments Discrete Trial Training Discrete Trial Training with a Mirror Teachers/parents confidence in running sessions independently Will be shown a video of sessions Asking other fields How often do you use mirrors as a supplemental stimulus to your sessions?

METHODOLOGY: DURATION AND LOCATION Each session will have 15 trials 5 trials for each behavior No session will last longer than 45 minutes Including assessment sessions Parents/teachers will determine the setting for sessions

METHODOLOGY: DATA ANALYSIS Visual inspection of the graphs for changes in data Magnitude Trends Level Percentage of correct responses

METHODOLOGY: DATA ANALYSIS Hypothetical Data

RISKS AND BENEFITS TO POTENTIAL PARTICIPANTS Risks Potential Distress e.g., frustration Length and time of study Benefits Possible increase participants’ imitation skills Behaviors in the study Potential generalized imitation skills May increase communication skills as a result Will provide possible evidence for an adaptable treatment

THANK YOU! QUESTIONS?