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Horn, Julie A.
Teaching functional skills to individuals with developmental disabilities using video prompting
h [electronic resource] /
by Julie A. Horn.
[Tampa, Fla] :
b University of South Florida,
Title from PDF of title page.
Document formatted into pages; contains 31 pages.
Thesis (M.A.)--University of South Florida, 2008.
Includes bibliographical references.
Text (Electronic thesis) in PDF format.
ABSTRACT: Because many individuals with developmental disabilities prefer to be as independent as possible, strategies need to be developed to teach them functional skills. Video prompting is a fairly new technology, in which a person learns to engage in a complex behavior by viewing steps of a task analysis on video. The steps are broken down so that the task is more manageable for the individual. The present study evaluated how many steps needed to be presented in the video model for the learner to acquire a functional skill. Three individuals between the ages of 17 and 29 and diagnosed with mental retardation were selected as participants. The target behaviors were to complete a 10 component laundry skill in a group home setting. Starting with viewing the entire task on video, the task was broken down into halves, then thirds, and so on until the individual performed all steps to criterion. A multiple baseline design was used to show the results of the video prompting procedure. The results showed that one individual learned the task with 5 steps in each video segment, another learned the task with the video broken into 4, 3, and 3 segments, and the final participant did not learn from video. For this participant, a least to most prompting procedure was effective.
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Co-advisor: Raymond G. Miltenberger, Ph.D.
Co-advisor: Timothy Weil, Ph.D.
Group home setting
Multiple opportunity method
x Applied Behavior Analysis
t USF Electronic Theses and Dissertations.
Teaching Functional Skills to Individuals with Developmental Disabilities Using Video Prompting by Julie A. Horn A thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts in Appl ied Behavior Analysis College of Graduate Studies University of South Florida Co-Major Professor: Raymond Miltenberger, Ph.D. Co-Major Professor: Timothy Weil, Ph.D. Shelley Clarke, M.A. Date of Approval: April 27, 2008 Keywords: mental retardation, group home setting, multiple opportunity method, video chunking, least-to-most prompting Copyright 2008, Julie A. Horn
i Table of Contents List of Figures ii Abstract iii Chapter One 1 Introduction 1 Chapter Two 8 Method 8 Participants and Settings 8 Materials 9 Target Behaviors and Data Collection 9 Interobserver Agreement 11 Treatment Integrity 11 Experimental Design and Procedure 12 Baseline 12 Intervention 1 12 Intervention 2 13 Intervention 3 13 Intervention 4 13 Intervention 5 14 Follow-up 14 Chapter Three 15 Results 15 Chapter Four Discussion 17 References 21 Appendices 27 Appendix A: Task Analysis for Washing Clothes in Washing Machine 28 Appendix B: Data Collection/Treatment Integrity Form 29 Appendix C: Data Collection Form for L east-to-Most Prompting 30
ii List of Figures Figure 1. Multiple Baseline Across Participants 16
iii Teaching Functional Skills to Individuals with Developmental Disabilities Usi ng Video Prompting Julie Horn ABSTRACT Because many individuals with developmental disabilities prefer to be as independent as possible, strategies need to be developed to teach them functional skills. Video prompting is a fairly new technology, in which a person learns to engage in a complex behavior by viewing steps of a task analysis on video. The steps are broken down so that the task is more manageable fo r the individual. The present study evaluated how many steps needed to be presented in th e video model for the learner to acquire a functional skill. Three individuals between the ages of 17 and 29 and diagnosed with mental retardation were selected as participants. The target behaviors were to complete a 10 component laundry skill in a group home se tting. Starting with viewing the entire task on video, the task was broken down into halves, then thirds, and so on until the individual performed all steps to criterion. A multiple baseline design was used to show the results of the video prompting procedure. The results showed that one individual learned the task with 5 steps in each video segment, another learned the task with the video broken into 4, 3, and 3 segments, and the final participant did not learn from video. For this participant, a least to most prompting procedure was effective.
1 Chapter One Introduction In society today many adults with devel opmental disabilities desire to live as independently as possible. They no longer want to depend on staff to provide services for them if they can learn to perform the sk ill on their own. For example, living more independently in an apartment may require the person to learn how to prepare meals, wash clothes, and maintain his or her hygiene. To be employed, the individual must learn skills such as answering the phone, washing dish es, bagging items, or mopping the floor. Unfortunately, some may have failed to ac quire the skills needed to live more independently in the community due to inad equate training approaches that are not matched to the level of support they need. A ttempts may have been made to teach daily living skills such as washing clothes, prepar ing a meal, or purchasing an item through the prompting hierarchy, in vivo modeling, or sel f-management procedures. The goal may have then been discontinued due to lack of progress even though the individual may have preferred to continue learning the skill. Instead of terminating a skill program, one may choose a different strategy that may better fit the persons support needs. One learning style that has been proven effective through several studies is video m odeling (Charlop-Christy & Daneshvar, 2005; Charlop & Milstein, 1989; DAteno, Ma ngiapanello, & Taylor, 2003; Haring, Kennedy, Adams, & Pitts-Conway, 1987; Hine and Wo lery, 2006; MacDonald, Clark, Garrigan, & Vangala, 2005; Nikopoulos & Keenan, 2003; Nikopoulos & Keenan, 2004; Reagan, Higbee, & Endicott, 2006; Rehfeldt, Dahm an,Young, Cherry, & Davis 2006; Taylor,
2 Levin, & Jasper, 1999). This procedure involves an individual view ing the target skill over video and then performing the skill to cr iterion immediately following the video. When the video has been create d, the participant is then instructed to watch the video in segments or in its entirety. On ce the individual is finished vi ewing the tape, he or she is then prompted to perform the same task in a similar setting. Sometimes other techniques are embedded into the procedure such as vari ous prompting hierarchies, feedback, time delay, and/or reinforcement (Ayres & La ngone, 2005; Bellini & A kullian, 2007; Delano, 2007). A number of studies have shown that video modeling technique s are an effective strategy for teaching skills such as persp ective taking (Charlop-Christy et al., 2005), purchasing skills (Nikopoulos & Keenan, 2003; Nikopoulos & Keenan, 2004), play skills (DAteno et al., 2003; MacDonald et al., 2005; Reagan et al., 2 006; Taylor et al., r, 1999), cooking skills (Rehfeldt et al., 2003) self-h elp skills (Shipley-Benamou, Lutzker, & Taubman, 2002; Norman, Collins, & Schuste r, 2001), and social skills (Charlop & Milstein, 1989) to individuals with developm ental disabilities. Rehfeldt et al. (2003) demonstrated this procedure when teaching m eal preparation skills. Three adults with moderate to severe mental reta rdation were chosen for the st udy. In this intervention, the participants watched a 2 min video and then were cued to perform the task. Praise was delivered for correct responding after each st ep completed. Findings showed that the video modeling technique was effective for teaching preparation of a simple meal. Sometimes watching the entire skill bei ng performed at once is too difficult for individuals with more severe developmental disabilities. These individuals may require the task to be broken down into steps that are more manageable. When a video model of a complex task is broken down into smaller units and each unit is view ed individually as a
3 cue for the behavior, the process is called video prompting. Sigafoos et al. (2005) demonstrated this strategy when teaching micr owave skills to three adults with moderate mental retardation. A 10-step task analys is was created for preparing popcorn in a microwave oven. The participants were then instructed to view each step of the task analysis and complete the step immediately af ter watching the segment. Each subsequent step of the task analysis was presented to the participant identically each time. No reinforcement was delivered for correct responding. Results showed that video prompting was an effective strategy for t eaching microwave skills to individuals with moderate mental retardation. One individual did not reach cr iterion. The author stated that popcorn may not have been reinforci ng due to refusal to eat popcorn at later presentations. The remaining two individuals maintained an 80% to 100% mastery of the skill even at the 10-week follow-up. Sigafoos et al., (2007) th en expanded on the previous study by demonstrating a procedure to fade the prompts that were required to obtain mastery of the skill. The participants were three adu lt men, ages between 27 and 33, all diagnosed with autism and mild to moderate mental retardation. The skill taught was dish washing which was made up of 10 steps in the task analysis. The pa rticipant viewed each step individually, and then the trainer prompted the individual to complete the step. To begin the fading procedure, the videos were combined into 3-st ep segments. The participant viewed a clip of three steps and then had the opportunity to complete the step. Af ter the participant had met criterion in this phase the videos were combined into 5-step segments and then one whole segment. The trainer did not use any ve rbal praise contingent on the participants performance, but did thank the participants fo r washing dishes at the end of each session.
4 The levels of correct responding remain ed at 80% to 100% throughout the video chunking procedure suggesting that the fadi ng procedure was effective strategy to decrease prompt dependency. Graves, Collins, and Shuster, (2005) also used video prompting to teach three individuals between ages 16 and 20 to prepar e food. These individuals were diagnosed with a moderate mental disability and one individual also had Down Syndrome. The skills selected were preparing macaroni and cheese in the microwave, ramen noodles on the stove, and peanut butter a nd jelly on the kitchen counter. Just as in the Sigafoos studies, the individuals watched th e entire task of the skill on video first. The participant then viewed only the first step, and was gi ven 20 seconds to complete the step to criterion. The difference between this study and the previous studies was the prompting strategies used if the partic ipant engaged in any incorrect responses. The trainer said, No, wait if you are not sure, within the 20 seconds. After the prompt, incorrect responses resulted in rewinding the video so that the partic ipant could ag ain watch the correct performance of the step. Then the pa rticipant was given the opportunity to finish the step, even if the correct response took l onger than 20 seconds. The trainer delivered verbal praise for correct responding during training sessions until the participants met 100% criterion for two consecutive days. Then verbal praise was thinned by the trainer delivering praise, on average, every 4 steps. Results show ed that the video prompting plus a constant time delay procedure was an effective strategy when teaching individuals with developmental disabilitie s food preparation skills. Another type of video modeling and/or vi deo prompting procedure is instructional video modeling (Alcantara, 1994; Norman et al., 2001; Shipley-Benamou et al., 2002).
5 This procedure involves the trai ner explaining to the participan ts what is expected before the intervention begins. One of the studies used this procedur e to teach daily living skills to children with Down Syndrome and Autism (Norman et al., 2001). The skills taught were cleaning sunglasses, putting on a wr ist watch, and zipping a jacket. Before presenting the video, the trainer describe d what would be viewed and what the participants were to do following the presenta tions of the video. The video started with reintroducing the instructions a nd then presenting the entire task. The instructions were again delivered on video and the participant vi ewed a model of only the first step. The tape froze and the participant was given the opp ortunity to perform the step. The results showed that video prompting was an effectiv e tool when teaching daily living skills to children with developmental disabilities. Also these skills maintained anywhere from 1 to 13 weeks, and skills generalized with diffe rent trainers. However, it is not clear what role the added instructions played in the acquisition of the skills. There are several advantages to using video modeling ove r other procedures when teaching skills to individuals with devel opmental disabilities. First, identical presentations of the skill will be guaranteed in each trial or session. If staff were required to physically model the behavi or, the model may not be performed in the same way every time. Different staff may perform the task or different materials may be used. Second, depending on the individual, one perspective of viewing the demons tration of the skill may be more effective then the other. For example, the individual may prefer to watch only the hands of another individual, or th e individual may benefit by watching a peer perform the skill instead of the staff or traine r. With video the person has already been taped to perform the skill each time. Also with video, one is able to zoom into the task at
6 hand which may help prevent distractions. Th is technique is esp ecially important for individuals with autism who te nd to focus on one detail rather than the whole picture. Third, using video modeling may also be cost -effective. Fewer staff are required to model the target behavior. This is especially true when th e target behavior is social interaction with other peers or staff. In order for individuals with developmental disabilities to learn functional skills that will lead to more independent living, st rategies must be developed that are less effortful and more cost-efficient. Also skills n eed to be generalized so that the individual will not only perform the skill in the current living environment but also in other living environments as they become more independe nt. If these individuals learn to perform skills of daily living simply by viewing vide o, the skills of imitating video models may then generalize to shows involving cooking, crafts, landscaping, or home dcor viewed on television. Little research has been conducted to determine the effectiveness of different variations of video prompting. One limitati on to the Sigafoos et al. (2007) study was not evaluating whether the participants could ha ve learned the skill to criterion merely by viewing the video of the entire task analyses. Other limita tions of the previous studies are that they involved primar ily children with autism a nd used primarily school or vocational program settings rather than reside ntial settings. The purpose of the present study was to expand on the Sigafoos et al. (2007) study and determine what levels of video chunking are required to teach indi viduals with develo pmental disabilities functional skills in a group home setting.
7 Chapter 2 Method Participants and Settings The participants were thr ee adults, between the ages of 17 and 29. Four other participants started th e study but their participation was terminated when they completed the laundry task without assistance during base line. The participants were chosen using the following criteria: they had a support plan goal to increase skills of daily living; could attend to a video independently; were 17 year s of age or older; had a developmental disability; were ambulatory; and had adequa te motor coordination with their hands to accomplish all steps independently. Training and assessments were conducted in the laundry room in the group home where the i ndividuals lived. Sessions lasted up to 15 minutes and no more than 2 se ssions were conducted daily. Brian was a 29-year-old man diagnosed w ith autism and mental retardation. He also has a history of hearing impairment. In terviews from staff showed that Mark could read and use some ASL signs. Medications he was taking at the time of the study were Paroxetine for depression, Depakote for mood stabilizer, Desmopressin for enuresis, Benztropine for tremors, and Trazedone for sl eep disturbance. His support plan goal stated that Mark would like to be more inde pendent in his home skills. During the day he attended an Adult Day Training program for si x hours, five days a week. One functional skill that Brian was observed completing in the home was preparing coffee in a coffee machine.
8 Davey was a 17-year-old boy diagnosed with Attention Deficit Hyperactivity Disorder. He could use 1 to 2 word phras es to communicate. He had a history of Gastroesophageal Reflux Disease. Prescribed medications include Risperdal for problem behavior, Adderall for ADHD, Amphetami ne salts for ADHD, Chlordiazepoxide for problem behavior, and Ranitidine for food alle rgy. Daveys support plan stated that he would like to do more things for himself. He attended an excep tional center during the day. Functional skills that Davey was observed completing while in the home included wiping the table, mopping and sweeping the floor, and making his bed. Sarah was a 25-year-old women diagnos ed with autism, me ntal retardation, hypothyroidism, anemia, and behavior disord er. She used some ASL signs and a Dynavox to communicate. A Dynavox is a co mputer device with pictures. When a person touches a picture on the screen an audi ble voice says what the picture represents. This device helps those who are nonverbal or difficult to understand communicate their wants and needs. At the time of the study, Sarah was taking Nexium for elevated H. Pylori, Synthroid for hypothyroidism, Zelnorm to relieve constipati on, Valporic acid for a mood stabilizer, Depo-Provera for hormone bala nce, Risperdal for an anti-psychotic, and Lexapro for anxiety. Her support plan goal stated she would like to in crease her self-care skills, learn job skills, and ha ve a meaningful day activity. Sarah attended an Adult Day Training Program five day a weeks, six hours each day. Functional skills that Sarah was observed doing while in the group home were toileting and washing her hands. Materials Materials used were a video camera to crea te the videos and to tape the sessions. A laptop was used for the participants to vi ew the video of the target skill on a DVD.
9 The video included the entire task analysis, and then the task analysis divided into halves, thirds, quarters, and so on until each step wa s shown individually. The video displayed the skill from the perspective of the particip ant. In other words, only the hands of the model were seen when most of the steps of the skill was performed on the video. Other materials included laundry supplies such as the washing machine, detergent, fabric softener, and the clothes the participant was to wash. Target Behaviors and Data Collection Laundry skills were the target behaviors investigated in this study. The steps completed correctly in the task analysis we re the dependent measure. See Appendix A for the task analysis of the laundry skills. Da ta were collected on each step in the task analysis using the multiple opportunity met hod in which the participant was presented with the SD for each step in the sequence regardle ss of whether the previous step was completed correctly. If the step was not completed or completed incorrectly by the participant, the trainer complete d the step so that the next SD was present. The participant was distracted so he or she did not see the trainer perform the step. In each phase, for a step to be counted as correct, it must be star ted within 5 seconds of the trainer delivering the cue to start the task. Data were collect ed at least 3 times per week. The time was decided because the participants typically ha d their clothes washes every two to three days weekly. First and second year stude nts from the Applied Behavior Analysis Masters Program were chosen as research assi stants. They assisted as trainer and data collector across sessions. An assessment session began with the tr ainer directing the participant into the laundry room. A basket of clothes was pres ent on the floor in front of the washing
10 machine. The trainer then delivered the cu e, (Name), wash the clothes. The participant had the opportunity to perform each st ep correctly. For example, the first step was to open the door of the washer. If the st ep was completed correctly the trainer waited for the following step to be performed. Afte r every third, sixth, and tenth step performed, the trainer stated (Name), thanks for pa rticipating. If the step was performed incorrectly the trainer, as unobtrusively as possible, opened the door which provided the SD for the next step to be performed. To get the participants attention back to the washer, the trainer prompted the participant by sa ying, (Name), finish washing the clothes, giving the participant the opportuni ty to perform the remaining st eps in the task analysis. This way participant had the opportunity to pe rform all steps in the task analysis. Interobserver Agreement Videotaping of the assessment sessions occu rred for all sessions. An independent observer viewed the videos for interobser ver agreement. Agreements divided by agreements plus disagreement on the ten steps of the task analysis determined the percentage of agreements for the target behavior. Mean overall agreement across participants was 97%. Brians mean agreem ent score was 98% (range, 90% to 100%). Daveys mean agreement score was 95%, (range, 80% to 100%) and Sarahs mean agreement score was 97% (range, 90% to 100%). Experimental Design and Procedure A multiple baseline design was used to evaluate the video prompting procedure. After the participants or their guardians signed the consent forms, the participant was involved in baseline assessments of th e laundry skills. Following baseline, the
11 participants participated in the video prom pting training phases. Fo llow-up sessions were completed 2 weeks after the training sessions. Baseline. The trainer instructed each participant to complete the task analysis of the skill and assessed the skill using the multiple opportunity method. At minimum the trainer conducted three sessions before begi nning training. Because Brian was hearing impaired, a piece of paper which stated, Brian wash the clothes, was presented as a cue to start performing the skill, and a piece of paper was presented after every third, sixth, and tenth step which stated, Bri an, thanks for participating. Intervention 1. The trainer instructed the participant to stand by the washing machine with a basket of clothes on the floor. The trainer then delivered the cue either verbally or on a piece of paper which stated (Name), watch the video. The video was viewed on a laptop. Each participant was inst ructed to watch a shor t video no longer than 20 seconds. The video displayed the entire task analysis of the skill. At the end of the video segment, the cue, (Name), wash the cl othes, was delivered. The participant then had the opportunity to perform the skill to criterion. After every third, sixth, and tenth step, the trainer stated, (Name), thanks for participating which was generally contingent on participating but not on any particular st ep completed. This was used to rule out positive reinforcement as a variable which may also have led to skill acquisition. Praise was also written on paper for Brian. If any step was not completed or completed incorrectly, the trainer comple ted the step as unobtrusively as possible. To get the participants attention back to the washer, the trainer prompted th e participant by saying or showing on paper, (Name), finish washi ng the clothes, and gave the participant the opportunity to perform the remaining steps in the task analysis. This way the participant
12 had the opportunity to complete the next ste p. The following steps were performed in the same manner until the entire task analysis was finished. If the part icipant did not perform all steps in the task for two consecutive sessi ons (the training crit erion) the participant advanced to the next intervention. Intervention 2. This phase was performed only if the participant did not meet criterion in the first phase. All procedures were the same except the steps were divided into 5-step segments. The participant viewed the task of only the firs t five steps on video. The cue was delivered and then the individual had the opportunity to complete the task. Then the following 5 steps were shown on vi deo and the participant had the opportunity to complete the task. Intervention 3. This phase was implemented only if the participant did not meet criterion in intervention 2. A ll procedures were the same ex cept the steps were divided into 3 and 4 step segments. The first 4 steps were shown and then the following segments had 3 steps. Intervention 4. This phase was implemented only if the participant did not meet criterion in Intervention 3. All procedures were identical except the segments were divided into 2 steps. Intervention 5. This phase was implemented if the individual did not meet criterion in Intervention 4. All procedures were identical except each step was viewed individually or in 1-step segments. Intervention 6. For Brian only, an additional intervention was added which was run identical to Intervention 5 with the addition of the wr itten cue on the video. Each step on video showed the trainer showing the card with the written cue to the participant.
13 Intervention 7 Least-to-m ost prompting procedure. Because Brian did not perform to criterion using the video prompti ng procedure, a procedure was added so that he could benefit from the study. At the start of each session a piece of paper was held up which stated, Brian, wash the clothes If no responding occurred or incorrect responding occurred, the trainer pointed to the next step. If still no responding occurred, a light touch prompt was deliv ered. The trainer tapped Bria ns hand and then pointed to the next step to be performed. If still no response, the trainer us ed physical assistance (hand over hand assistance). The trainer t ook Brians hand and physically performed the step with him. For example, if the dial need ed to be turned the trainer put her hand over Brians hand and turned the dial to the de signated spot. Praise which stated, Brian, thanks for participating was delivered after all steps were completed to not interrupt the chain of steps. Follow-up. Two weeks following the training se ssions, follow-up occurred in the group home where the individual lived which was the same as the baseline and training setting. Assessments were identical to baseline.
14 Chapter 3 Results The results of this study showed that 2 of the 3 participants learned how to wash clothes in a washing machine with the use of the video prompting procedure alone. Sarah acquired the skill by watching 5 steps at a tim e (Intervention 2). Davey acquired the skill by Intervention 3, watching 3 and 4 steps at a ti me. Brian required video prompting plus least-to-most prompting to complete the steps independently. Figure 1 shows the results. Davey scored 40% or lower in baseline The first intervention, watching the entire video, increased responding at firs t, but then responding dropped over three assessments to 20%. At Intervention 2, hi s performance increased to 100% but then leveled off to 80%. When the Interventi on 3 was introduced, criterion was met in 4 sessions. At the two week follow-up, Davey scored 80% Sarah also completed 40% or less of the steps in baseline. At Intervention 1, responding increased but eventually dropped to 20%. At Intervention 2, responding again increased immediately, and criteri on was met at the sixth session in the Intervention. At the two week follow-up, Sarah scored 100%. Brian did not respond during baseline or dur ing any of the Interventions involving the video prompting procedure. Least-to -most prompting was added and responding increased to 80%. Two week follow-up ha s yet to be completed for Brian. To evaluate treatment integrity, all tr aining sessions were videotaped and the researcher recorded the percentage of tr aining behaviors completed correctly by the trainer. The following training behaviors were recorded: the trainer had the participant
15 standing beside the washing machine before the video was viewed; the trainer delivered the cue before the segment of the step or st eps was viewed by vide o; the trainer again cued for the participant to perform the step or steps that he or she had previously viewed; the trainer gave the participant 5 seconds to st art performing the skill; the trainer praised the participant for correct res ponding; and the trainer completed the step as unobtrusively as possible if required. Scoring took place fo r each segment viewed on video. The mean score for treatment integrity during each partic ipants sessions were as follows: sessions for Brian, 99.9%: sessions for Davey, 98%; a nd sessions for Sarah 99%. Interobserver agreement was also collected which resulted in a mean of 100% for Brian, 98% (range, 95% to 100%) for Davey, and 99% (95% to 100%) for Sarah.
16 Figure 1. Multiple Baseline Design showing percentage of steps completed independently by each participant. 0 10 20 30 40 50 60 70 80 90 100 DaveyF/U 0 10 20 30 40 50 60 70 80 90 100BLInt 1Int 2Int 3 Int 4Int 5Int 7BrianInt 6 0 10 20 30 40 50 60 70 80 90 100 12345678910111213141516171819202122232425 SessionsSarah F/U Percentage of Steps Completed Independently
17 Chapter 4 Discussion Overall, the results of the study showed that different leve ls of video chunking were needed for different individuals. Davey required the steps to be broken down into 3 and 4 steps before he could perform the ski ll 100% of the time for 2 consecutive sessions. Sarah only needed the steps to be broken down into 5-step segments. Brian needed the least-to-most prompting to start performing the skills. The findings expand on the Sigafoos et al. (2007) study by showing that each person does not need to view each step indivi dually to perform the skill to criterion. Some may be able to view the whole video. Others may be able to perform the skills with seeing 5 steps at a time, and others may need the steps to be broken down even further. Unfortunately, it is not possible to know in advance whic h level of chunking will be needed with a particular individual. In this study, the most efficient method was tried first (whole video) followed by increasingly less efficient strategies (halves of the video, then thirds, and so forth). In this way, it could be determined which level was necessary for the particular individual s involved in the study. This approach is one way to determine the most efficient level of video chunking necessary for an individual to benefit from video modeling of complex skills. Criterion was not met in follow-up for Da vey for a couple reasons. First, the steps missed were putting the detergent in to the washer and putting the cap on the detergent. Because Davey attempted to put more than one capful of detergent into the washer, the step of putting the detergent into the washer was scored as incorrect. After
18 distracting and presenting the Sd for the next step, Davey cont inued to put more detergent into the cap. Only after distr acting again and presenting the Sd, which was the cap on the detergent, did Davey then continue with th e following steps independently. The possible reason for the incorrect response may have been that the Sd for putting detergent in the washer and putting the cap on the detergent were exactly the same. This may have led to some confusion. Also Davey did have a hi story of repetitive be haviors, and pouring more than one capful of detergent may have be en an instance of repetitive behavior. The present study used a laptop to display the steps of the ski ll. The use of a laptop to show the video may have been an advantage or a disadvantage, depending on the individual involved. It may have been an advantage because the participant was standing in front of the washer when the vi deo was viewed. At times the participants looked at the materials viewed in the video a nd then looked at the same materials in the environment. For example, when Sarah sa w the detergent being taken down from the shelf in the video, she then looked up at th e detergent on the shelf in the laundry room. Sarah also may have responded better to the laptop because she has used a Dynavox communication device in the past. At times she touched materials on the screen of the laptop as she would touch the screen of he r Dynavox. A disadvantage of using a laptop may have been that a participant had not view ed a video on laptop in the past and thus it may not have had stimulus control over the individuals behavior. Although one criterion for inclusion into the study was that the pa rticipants could attend to a video, it was not determined in advance whether they could at tend to a video presented via laptop.. Davey had been observed playing video games on a computer and watchi ng movies on TV but not on a laptop. Brian was observed only watching shows on the TV.
19 There were several limitations to the study. One was dealing effectively with Brians hearing impairment. Because Bria n was hearing impaired, another strategy besides a vocal delivery of the cue was needed to deliver the cue to begin washing clothes or to watch the video. Staff and managers st ated that Brian could read. Therefore, the trainer used a card with the cue in writing. Although Brian used ASL signs to spell the letters on the card, he did not perform any of the steps in the washing task after being cued with the card. Even when using the least-to-most prompting strategy, responding did not occur until the trainer us ed a gestural prompt for the first step, suggesting that the verbal prompt (delivered in writ ing) did not exert stimulus cont rol over his behavior. It is possible that Brian could not r ead the words on the cue card. Using ASL signs to deliver the cue may have been more effective in getting the corr ect response. Using the multiple opportunity method assessment of the behaviors in the washing clothes task gave the participant an opportunity to perform each step even if the previous step was performed incorrectly or not at all. It is also po ssible that this method inadvertently assisted in teaching laundry sk ills because the learner saw the outcome of every step as the SD for the following step. For exampl e, when the participant did not open the cap of the detergent, the data collect or distracted the part icipant and the trainer then took the detergent off the shelf, opened the cap and set the detergent on the edge of the washer. When the participant was cued to finish washing the clothes, the presence of the open bottle of detergent si tting on the washer may have signaled the next step. The presence of the open detergent over repeated sessions may have been enough to signal to the participant that something should be done wi th the detergent. Alternatively seeing the
20 open bottle of detergent may have made the pa rticipant more likely to open the lid to the detergent in the next assessment. There are a number of areas for future research. One idea is to show the entire skill on video over a large number of sessions to determine if the repetition of watching the video leads to skill acquisition. When Sarah and Davey viewed the first chunk of skills in the video segment, the following se gments were sometimes not needed because they performed the following steps indepe ndently without needing to watch the remainder of the steps on video. It would al so be interesting to study if only the steps that were missed previously needed to be s hown to acquire the skill. Another area for future research would be to add a preferred video segment for the participants to watch before viewing the skill. Wa tching a preferred video may ha ve gotten the participant to view the video more closely, with the possibili ty that acquisition of the skill would occur quicker. Another area for future research would be to conduct a comparison of the efficiency of video modeling or video prompti ng to the use of most to least or least to most prompting strategies. It ma y be that the use of video is no more efficient than more standard prompting strategies. Future research should try to answer th is question. In this study, follow-up was conducted 2 weeks after tr aining. Sarah maintained the skill at 100%, but Davey decreased to 80%. Futu re research should look at measuring maintenance over longer periods of time to de termine if the video prompting procedure was sufficient to teach a functional skill which maintains over months. In conclusion, this study extends previous research evaluating video prompting to teach a functional skill to individuals with de velopmental disabilities. Some individuals may learn skills using video prompting better th an others. All individuals may not need
21 to view each step individually to acquire the sk ill. Overall, it is important to view each person individually to determine what procedure will be most effective and efficient for that person. This procedure should be consider ed if the person can attend to and imitate the actions in a video. Furthermore, it should be considered when the focus is on skill acquisition rather than compliance training as video prompting or modeling does not seem particularly useful as an intervention for individuals who refuse to complete a task.
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29 Appendix A.: Task Analysis for Washing Clothes in a Washing Machine Steps in the Task Analysis 1. Turn dial to setting for regular wash. 2. Pull dial to start running water 3. Open the door 4. Take off cap of detergent 5. Pour detergent into cap 6. Pour detergent into washer 7. Put cap back on detergent 8. Put clothes in washer 9. Close door 10. Put detergent away
30 Appendix B: Data Collection/Treatment Integrity Form Video Prompting to Teach Laundry Skills: Data Collection/Treatment Integrity Form Name of Participant:_______________________ Staff recording data:__________________ Date of Sessi on:___________________________ Session #:___________ Instructions: Circle a + or - to record a step being perfo rmed correct or incorrect. Writ e a number in each box under ord er of steps to record what order the participant performed t he steps. Circle Y, N, or N/A to record whether these procedures were perfo rmed correctly by the trainer Participant is standing in front of the washing machine before the video is viewed Circle one: Y N N/A Steps in Task Analysis Performed Correctly or Incorrectly: Circle one Order of Steps (Place # in each box) Deliver praise (Name Thanks for participating) Circle one in each box Trainer delivers cue before part. views the video (Name watch the video) Circle one in each box After viewing the video clip(s), the trainer cues for part. to perform step(s) Circle one in each box Uses multiple opportunity method (distract, perform step, state, Name finished washing clothes) Circle one in each box Trainer gives part. 5 seconds to start performing each step Circle one in each box 1. Turn dial to normal load. + No praise Y N N/A Y N N/A Y N N/A Y N N/A 2. Pull dial to star t + No praise Y N N/A Y N N/A Y N N/A Y N N/A 3. Open washer door + Y N Y N N/A Y N N/A Y N N/A Y N N/A 4. Take cap off detergent + No praise Y N N/A Y N N/A Y N N/A Y N N/A 5. Pour detergent into cap + No praise Y N N/A Y N N/A Y N N/A Y N N/A 6. Pour detergent into was her + Y N Y N N/A Y N N/A Y N N/A Y N N/A 7. Put cap on detergent + No praise Y N N/A Y N N/A Y N N/A Y N N/A 8. Put detergent on shel f + No praise Y N N/A Y N N/A Y N N/A Y N N/A 9. Put clothes in washer + No praise Y N N/A Y N N/A Y N N/A Y N N/A 10. Shut door of washer + Y N Y N N/A Y N N/A Y N N/A Y N N/A
31 Appendix C: Data Collection/Treatment Integrit y Form for Least-to-Most Prompting Procedure Video Prompting to Teach Laundry Skills: Data Collection/Treatment Integrity Form Name of Participant:_____ Brian __________ Staff recording data:__________________ Date of Session:______________________ Session #:__ ________________________ Instructions: Circle a I, G , L or P to record the level of prompti ng needed to perform the step correctly. Write a nu mber in each box under order of steps to record what order t he participant performed the steps. Circle Y , N, or N/A to record whether the se procedures were performed correctly by the trainer. Deliv er praise after each step. Remember to to use least-to-most prompting as necess ary Steps in Task Analysis Performed at what level of prompting: Circle one Order of Steps (Place # in each box) Deliver praise (Name Thanks for participating) Circle one in each box Trainer gives part. 5 seconds to start performing each step Circle one in each box 1. Turn dial to normal load. I G L P No praise Y N N/A 2. Pull dial to start I G L P No praise Y N N/A 3. Open washer door I G L P No praise Y N N/A 4. Take cap off detergent I G L P No praise Y N N/A 5. Pour detergent into cap I G L P No praise Y N N/A 6. Pour detergent into washer I G L P No praise Y N N/A 7. Put cap on detergent I G L P No praise Y N N/A 8. Put detergent on shelf I G L P No praise Y N N/A 9. Put clothes in washer I G L P No praise Y N N/A 10. Shut door of washer I G L P Y N Y N N/A Key : I=Independent G=Gesture prompts needed L=Light Touch prompts P=Physical prompts(hand over hand assistance)