Rebecca Feathers, University of Tennessee   A Comparison of Universal versus Classroom-Specific Visual Activity Supports to Improve Transitional Behaviors for Preschool Children with Autism Rebecca Feathers, University of Tennessee

Review of the Literature Preschool transitioning Autism Transitioning with autism Using visual supports for students with autism Research questions

Pre-K Transitioning Why is transition important? Reduced transition time = more instructional time More instructional time = more time to be actively engaged in learning activities How do we improve transitions? Structure/classroom management Scheduling (Bryan & Gast, 2000)

How do we improve transitions? Structure/Classroom management Should be well planned and explicitly taught Children should know what is expected of them Structured routine=decrease in # of inappropriate behaviors and less transition time Scheduling Visual supports can ultimately promote more independent transitions (Ostrosky & Colleagues, 2003)

Visual Supports Who do they benefit? A variety of students Information processing How are they implemented? Classroom Schedules Individual schedules PECS Picture cues Who were they used for in this study? Preschoolers with autism

Autism Defined A neurological disorder of development that causes information processing differences affecting children’s ability to understand and use language to interact and communicate with people, relate to those around them in typical ways, respond to sensory stimuli, and learn in the same ways as normally developing peers Students do not automatically discriminate cues in their environment that are needed to function independently (Quill, 1997)

Autism Communication/Language barriers Behavioral patterns are combined with severe receptive and expressive language impairments Deficits in recall memory Frustration, confusion May engage in inappropriate behaviors if they cannot communicate their wants and needs effectively Teachers need to find alternative ways to relay information (Quill, 1997)

Autism The need for routine Research suggests that children with autism benefit from the use of visual prompts Implementation of picture systems within preschool classrooms Teachers can aid in the increase of on-task behaviors during most all activities performed during the school day (Banda & colleagues, 2009)

Transitioning with Autism Strategies for reducing transition difficulties Choice making, preferred activities, and reinforcing appropriate behaviors The need for visual supports Most often used Information processing difficulties Picture cues/activity schedules may help reduce or eliminate the need for students to rely on adults to provide assistance and clarification during scheduled and unscheduled changes

Using Visual Supports for Students with Autism How can we make this effective? Consistency Students will more likely be able to progress through their day with minimal behavioral problems Teachers should follow the same highly structured schedule every day Students with autism like to engage in the same tasks throughout the week; therefore, it is crucial that teachers implement such practices

Using Visual Supports for Students with Autism Organization of time Students can organize their time in a way that helps support their daily routines Understanding expectations in the classroom Eliminates confusion (ex. What are we doing next?) Promoting independence Main goal Several strategies that support smooth transitions between activities verbal cues and reminders before transitions nonverbal cues/prompts positive feedback after transitions (Dettmer & colleagues, 2000)

Building and Implementing Activity Schedules 12 Steps from Banda and colleagues, 2009 1. Identify and define target transition behaviors 2. Collect baseline data on problem behavior 3. Choose a between-activity or within-activity schedule (see next slide) 4. Chose a mode of presentation 5. Choose a medium for the activity schedule 6. Chose a location for the schedule

Schedule Types Between-Activity Schedule Within-Activity Schedule

Cont’d 7. Train the student to use the schedule 8. Collect intervention data 9. Add new pictures or words 10. Fade prompts 11. Fade the prominence of the activity schedule 12. Promote generalization across settings

Benefits Transition behaviors Communication skills Progressing successfully between steps in an activity Progressing successfully between activities Communication skills Scripted and unscripted verbal interactions

Benefits cont’d Daily living skills Academics Inappropriate Behaviors Vocational training Independent dressing Meal preparation Academics Increased on-task behavior Inappropriate Behaviors Reducing tantrum behaviors Reducing noncompliance (Banda & colleagues, 2009)

Research Questions How do visual supports promote more independent transitions in preschool children with autism? Which visual supports work best? Does it matter which types of visuals are used as long as a system is taught? What is the social acceptability of using a universal picture schedule compared to a classroom-specific visual schedule to increase independent transitioning for children with autism in a preschool classroom?

Methods Participants Materials Settings Variables Data collection Research design Procedures

Participants 2 males, 5 years of age (Michael & Ryan) Both students were identified as having Autism Spectrum Disorder Both nonverbal Both had been observed having difficulty during transitional times Had previously used visual supports in different preschool programs, as well as in the home The goal of implementing a visual support system with these students was to promote more independent transition behaviors

Materials A variety of materials were used to provide the participants with differing options of visual supports to aid them in the transitioning process Universal visuals Boardmaker ™ program, laminator, Velcro In color Classroom-specific visuals Digital camera, laminator, Velcro

Visuals Universal Classroom-specific

Variables Dependent Duration between activities How long it took to get from one activity to another (circle to blue table, circle to red table, circle to kitchen, etc.) # of inappropriate behaviors Counted when a student did not respond to the first verbal and visual support within 10 seconds of it being given. Counted when another prompt was given if student still was not responding Counted when student transitioned to incorrect area Counted when the student did not match visual to larger visual and immediately sit in seat

Variables Independent Variation of schedules Providing students with two different types of visual supports in order to determine which work more efficiently Universal pictures and classroom-specific pictures

Setting Urban public elementary school Midsize city grades K-5, around 700 students attending 23% free and reduced lunch

Setting Preschool special education classroom 1 special education teacher, 1 teaching assistant, 1 interning teacher 4 and 5 years of age 7 students: 5 students with autism, 2 students with Down Syndrome Self contained Mostly non-verbal

Data Collection Data sheets # of inappropriate behaviors Included student name, type of visual, specific transition, duration, # of inappropriate behaviors # of inappropriate behaviors Frequency count Duration between transitions Stop watch

# of inappropriate behaviors Data Collection Student:____________________ Visual Type:_________________ Transition Duration # of inappropriate behaviors Circle-Blue-Circle Circle-Red-Circle Circle-Kitchen-Circle

Research Design Alternating Treatments Design Used when a person wants to determine which strategy or intervention is more effective and/or more efficient. Treatments were sufficiently different from each other and the students discriminated between them. (Alberto & Troutman, 2006) For 5 days, both students were given universal visuals during certain transition times For another 5 days, both students were given classroom-specific visuals during certain transition times

Procedures Baseline Collected by noting the amount of time it took students to transition between activities Began with only 1 verbal prompt, informing the student where to go exactly, then adding more verbal/nonverbal/physical prompts as needed Collected by calculating the number of inappropriate behaviors during transition times No visual supports provided

Procedures Visual Intervention Providing a variation of visual supports to the participants To decrease inappropriate behaviors and duration during activity-to-activity transition times 2 types of visuals: Universal Boardmaker™ Classroom-specific

Visuals Universal Classroom-specific

Procedures Maintenance Period of 3 days to assure that one type of visual was continuing to be effective Problematic behavior and transition times were decreasing Universal pictures were continued to be used Why?

Social Validity Which visuals did the students prefer? Which visuals did the teachers prefer? Which visuals were easier to access/easier to construct?

Results Michael Ryan Overview

Total Duration in Seconds Baseline Universal Classroom-Specific Maintenance (Universal) Average: 2 min 26 sec Average: 8 min 13 sec Days Figure 1. Michael-Universal vs. Classroom Specific-Duration

Total # of Inappropriate Behaviors Baseline Universal Classroom-Specific Maintenance (Universal) Total # of Inappropriate Behaviors Average: 9 Average: 8 Average: 9 Days Figure 2. Michael-Universal vs. Classroom Specific-Duration

Total Duration in Seconds Baseline Universal Classroom-Specific Maintenance (Universal) Total Duration in Seconds Average: 2 min 43 sec Average: 2 min 41 sec Average: 8 min 41 sec Days Figure 3. Ryan-Universal vs. Classroom Specific- Duration

Total # of Inappropriate Behaviors Baseline Universal Classroom-Specific Maintenance (Universal) Total # of Inappropriate Behaviors Average: 7 Average: 6 Average: 8 Average: 17 Days Figure 4. Ryan-Universal vs. Classroom Specific-Inappropriate Behaviors

Results Both interventions were successful Problematic behavior and transition times decreased Students had no preference in the specific visual presented to them Universal Boardmaker™ visuals: Transition time as well as inappropriate behavior decreased compared to the baseline phase Classroom-specific visuals: Transition time and inappropriate behaviors decreased compared to baseline phase

Discussion Did the interventions meet the ultimate goal? How was the study unique? Implications for special/general educators Limitations Further research

Discussion Did the interventions meet the ultimate goal? Visuals improve transitioning within preschool classrooms for children with autism Both were effective in meeting the ultimate goal Reducing transition time and the # of inappropriate behaviors between activities

Discussion How was the study unique? Supported previous picture prompt within-activity schedule studies Most other research did not go into depth of which visuals (e.g., pictures, photos, line-drawings) were more effective

Discussion Implications for special/general educators: Should consider the use of visuals and/or visual schedules Not only for children with autism Become familiar with each child and their learning style Tailor to their wants and needs by the use of visuals if such children are unable to respond both expressively and receptively

Discussion Limitations: # of participants Only consisted of two participants Difficult to analyze the results for a comparison of other students on the autism spectrum More participants may yield different results

Discussion Further Research: Could be used similarly with other populations of students with disabilities Could be conducted in other settings, such as the home, to see if one could acquire differing results

Conclusion Overall, this study proved to be beneficial in many ways: Met the ultimate goal of increasing transition independence Results yielded positive outcomes Not restricted to just one type of visual Both proved to be efficient Could be used in further research

Thank you Questions ?