Education and training in autism and developmental disabilities

Education andTraininginAutismandDevelopmentalDisabilities

Focusing on individuals withautism, intellectual disability and other developmental disabilities

Volume 47 Number 2DDDDAADD

June 2012

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Education and Training in Autism and Developmental DisabilitiesThe Journal of the Division on Autism and Developmental Disabilities,The Council for Exceptional Children

Editor: Stanley H. ZuckerArizona State UniversityMary Lou Fulton Teachers College

Editorial Assistant: Kathleen M. CorleyArizona State UniversityMary Lou Fulton Teachers College

Consulting EditorsMartin AgranReuben AltmanPhillip J. BelfioreSharon Borthwick-DuffyMichael P. BradyFredda BrownMary Lynne CalhounSharon F. CramerCaroline DunnLise Fox

David L. GastHerbert GoldsteinJuliet E. HartCarolyn HughesLarry K. IrvinJames V. KahnH. Earle KnowltonBarry W. LavayRena LewisKathleen J. Marshall

John McDonnellGale M. MorrisonGabriel A. NardiJohn NietupskiJames R. PattonEdward A. PollowayThomas G. RobertsRobert S. RuedaDiane L. RyndakEdward J. Sabornie

Laurence R. SargentGary M. SassoTom E. C. SmithScott SparksFred SpoonerRobert StoddenKeith StoreyDavid L. WestlingJohn J. WheelerMark Wolery

Education and Training in Autism and Developmental Disabilities is sent to all members of the Division on Autism and DevelopmentalDisabilities of The Council for Exceptional Children. All Division members must first be members of The Council for Exceptional Children.Division membership dues are $30.00 for regular members and $15.00 for full time students. Membership is on a yearly basis. All inquiriesconcerning membership, subscription, advertising, etc. should be sent to the Division on Autism and Developmental Disabilities, 2900 CrystalDrive, Suite 1000, Arlington, VA 22202-3557. Advertising rates are available upon request.

Manuscripts should be typed, double spaced, and sent (five copies) to the Editor: Stanley H. Zucker, Mary Lou Fulton Teachers College, Box871811, Arizona State University, Tempe, AZ 85287-1811. Each manuscript should have a cover sheet that gives the names, affiliations, andcomplete addresses of all authors.

Editing policies are based on the Publication Manual, the American Psychological Association, 2009 revision. Additional information isprovided on the inside back cover. Any signed article is the personal expression of the author; likewise, any advertisement is the responsibilityof the advertiser. Neither necessarily carries Division endorsement unless specifically set forth by adopted resolution.

Education and Training in Autism and Developmental Disabilities is abstracted and indexed in Psychological Abstracts, PsycINFO, e-psyche,Abstracts for Social Workers, International Journal of Rehabilitation Research, Current Contents/Social and Behavioral Sciences, ExcerptaMedica, Social Sciences Citation Index, Adolescent Mental Health Abstracts, Educational Administration Abstracts, Educational ResearchAbstracts, and Language and Language Behavior Abstracts. Additionally, it is annotated and indexed by the ERIC Clearinghouse onHandicapped and Gifted Children for publication in the monthly print index Current Index to Journals in Education and the quarterly index,Exceptional Child Education Resources.

Education and Training in Autism and Developmental Disabilities Vol. 47, No. 2, June 2012, Copyright 2012 by the Division on Austim andDevelopmental Disabilities, The Council for Exceptional Children.

Division on Autism and Developmental DisabilitiesThe Council for Exceptional Children

Board of DirectorsOfficers

Past President Emily BouckPresident Teresa Taber-DoughtyPresident-Elect Richard GargiuloVice President Nikki MurdickSecretary Toni MerfeldTreasurer Gardner Umbarger

Members

Debra CoteMark FrancisRobert SandiesonJordan Shurr (Student Governor)Debora WichmanowskiDianne Zager

Executive DirectorTom E. C. SmithPublications ChairMichael WehmeyerCommunications ChairDarlene PernerConference CoordinatorCindy Perras

The purposes of this organization shall be to advance the education and welfare of persons with autism and developmental disabilities, researchin the education of persons with autism and developmental disabilities, competency of educators in this field, public understanding of autismand developmental disabilities, and legislation needed to help accomplish these goals. The Division shall encourage and promote professionalgrowth, research, and the dissemination and utilization of research findings.

EDUCATION AND TRAINING IN AUTISM AND DEVELOPMENTAL DISABILITIES (ISSN 2154-1647) (USPS 0168-5000) is pub-lished quarterly in March, June, September, and December, by The Council for Exceptional Children, Division on Autism andDevelopmental Disabilities, 2900 Crystal Drive, Suite 1000, Arlington, Virginia 22202-3557. Members’ dues to The Council forExceptional Children Division on Developmental Disabilities include $8.00 for subscription to EDUCATION AND TRAINING INAUTISM AND DEVELOPMENTAL DISABILITIES. Subscription to EDUCATION AND TRAINING IN AUTISM AND DEVELOPMEN-TAL DISABILITIES is available without membership; Individual—U.S. $60.00 per year; Canada, PUAS, and all other countries $44.00;Institutions—U.S. $195.00 per year; Canada, PUAS, and all other countries $199.50; single copy price is $30.00. U.S. Periodicals postageis paid at Arlington, Virginia 22204 and additional mailing offices.

POSTMASTERS: Send address changes to EDUCATION AND TRAINING IN AUTISM AND DEVELOPMENTAL DISABILITIES,2900 Crystal Drive, Suite 1000, Arlington, Virginia 22202-3557.

Documenting Impact of Educational Contexts on Long-Term Outcomes forStudents with Significant Disabilities 127DIANE LEA RYNDAK, SANDRA ALPER, CAROLYN HUGHES, and JOHN McDONNELL

Functional Curriculum and Students with Mild Intellectual Disability:Exploring Postschool Outcomes through the NLTS2 139EMILY C. BOUCK and GAURI JOSHI

Effects of a Self-Monitoring Strategy on Independent Work Behavior ofStudents with Mild Intellectual Disability 154JENNIFER COUGHLIN, KATHLEEN M. McCOY, AMY KENZER, SARUP R. MATHUR,and STANLEY H. ZUCKER

Teaching Social Skills to Children with Autism Using the Cool versus NotCool Procedure 165JUSTIN B. LEAF, KATHLEEN H. TSUJI, BRANDY GRIGGS, ANDREW EDWARDS,MITCHELL TAUBMAN, JOHN McEACHIN, RONALD LEAF, andMISTY L. OPPENHEIM-LEAF

The Picture Exchange Communication System (PECS): A Promising Method forImproving Communication Skills of Learners with Autism Spectrum Disorders 176JENNIFER B. GANZ, RICHARD L. SIMPSON, and EMILY M. LUND

Teacher Education in Autism Spectrum Disorders: A Potential Blueprint 187ERIC SHYMAN

Anxiety Levels in Students with Autism Spectrum Disorder Making theTransition from Primary to Secondary School 198ELIZABETH F. HANNAH and KEITH J. TOPPING

Effectiveness of an Essay Writing Strategy for Post-Secondary Students withDevelopmental Disabilities 210SUZANNE WOODS-GROVES, WILLIAM J. THERRIEN, YOUJIA HUA, JO HENDRICKSON,JULIA SHAW, and CHARLES HUGHES

Comparison of the Effects of Video Models With and Without Verbal Cueingon Task Completion by Young Adults With Moderate Intellectual Disability 223LINDA C. MECHLING and TERRI S. COLLINS

Mainstream Teachers’ Experiences of Communicating with Students withMultiple and Severe Disabilities 236TANIA DE BORTOLI, SUSAN BALANDIN, PHIL FOREMAN, MICHAEL ARTHUR-KELLY,and BERNICE MATHISEN

Manuscripts Accepted for Future Publication in Education and Training inDevelopmental Disabilities 126

Education and Training in Autism and DevelopmentalDisabilities

VOLUME 47 NUMBER 2 JUNE 2012

The Division on Autism and Developmental Disabilities retains literary property rights on copyrighted articles. Upto 100 copies of the articles in this journal may be reproduced for nonprofit distribution without permission fromthe publisher. All other forms of reproduction require permission from the publisher.

Manuscripts Accepted for Future Publication in Educationand Training in Autism and Developmental Disabilities

September 2012

Cognitive strategy instruction for functional mathematical skill: Effects for young adults withintellectual disability. Youjia Hua, Benjamin S. T. Morgan, Erica R. Kaldenberg, and MinkowanGoo, University of Iowa, College of Education, Department of Teaching and Learning, N256Lindquist Center, Iowa City, IA 52242.

Effects of a video model to teach students with moderate intellectual disability to use features of aniPhone. Kathryn Walser, Kevin M. Ayres, and Erika Foote, Department of Special Education, TheUniversity of Georgia, 516 Aderhold Hall, Athens, GA 30602-7153.

Group delivered literacy-based behavioral interventions for children with intellectual disability.Dana Keeter and Jessica L. Bucholz, University of West Georgia, Department of CSI / Ed Annex228, 1601 Maple Street, Carrollton, GA 30118.

Grade-aligned math instruction for secondary students with moderate intellectual disability. DianeM. Browder, Bree Jimenez, and Katherine Trela, The University of North Carolina at Greensboro,Department of Specialized Education Services, 421 School of Education Building, Greensboro, NC27402-6170.

Two approaches to phonics instruction: Comparison of effects with children with significantcognitive disability. Elizabeth Finnegan, St. Thomas Aquinas College, 125 Route 340, Sparkill, NY10976.

Using video modeling to teach young children with autism developmentally-appropriate play andconnected speech. Sarah Clifford Scheflen, Stephanny F. N. Freeman, and Tanya Paparella,ECPHP, UCLA, Dept. of Child Psychiatry, 77-447 Semel Institute for Neuroscience, 760 WestwoodPlaza, Los Angeles, CA 90024-1759.

Preparing children with developmental disabilities for life in the community: A Tanzanian per-spective. Angela Stone-MacDonald, Department of Curriculum and Instruction, University ofMassachusetts, Boston, College of Education and Human Development, 100 Morrissey Blvd.,Boston, MA 02125-3393.

Comparing the effects of video prompting with and without error correction on skill acquisition forstudents with intellectual disability. Helen I. Cannella-Malone, Joe E. Wheaton, Pei-Fang Wu,Christopher A. Tullis, and Ju Hee Park, The Ohio State University, A348 PAES Building, 305 W17th Avenue, Columbus, OH 43210.

A review of academic mathematics instruction for students with mild intellectual disability. CaseyHord and Emily C. Bouck, 6108A, BRNG Hall, Purdue University, 100 N. University St., WestLafayette, IN 47907.

Comparing teacher-directed and computer-assisted constant time delay to teaching functionalsight words for students with moderate intellectual disability. Mari Beth Coleman, Kevin J. Hurley,and David F. Cihak, University of Tennessee, A416 Jane and David Bailey Education Complex, 1122Volunteer Boulevard, Knoxville, TN 37996-3442.

Increasing comprehension for middle school students with moderate intellectual disability onage-appropriate texts. Jordan Shurr and Teresa Taber-Doughty, Purdue University, Dept. ofEducational Studies, 100 N. University Street, West Lafayette, IN 47907-2098.

Address is supplied for author in boldface type.

Documenting Impact of Educational Contexts on Long-TermOutcomes for Students with Significant Disabilities

Diane Lea RyndakUniversity of Florida

Sandra AlperUniversity of Northern Iowa

Carolyn HughesVanderbilt University

John McDonnellUniversity of Utah

Abstract: Follow-up studies of students with significant disabilities consistently indicate poor post-schooloutcomes. Although existing research indicates that services in inclusive general education contexts can resultin positive short-term outcomes for these individuals during their school years, there are few investigations of thelives of adults with significant disabilities who experienced inclusive education over extended periods of time.Considering the lack of longitudinal studies, it currently is difficult to determine whether young adults lead moresuccessful lives relative to employment, residential situations, use of leisure time, and friendships and socialnetworks, as a function of inclusive education. This paper focuses on issues faced when conducting research todocument the impact of contexts on long-term outcomes for students with significant disabilities, especially whenaddressing relative effectiveness of services in inclusive general education contexts and more restrictive contexts.Recommendations for future research and related policy and funding are suggested.

In these times of accountability, when stateand federal legislatures are linking both finan-cial support for schools and salaries for teach-ers and administrators to student outcomes,attention is being turned to the short- andlong-term outcomes that are expected for stu-dents with disabilities. With increased accessto the general curriculum and inclusive gen-eral education contexts, students with disabil-ities are expected to make adequate yearlyprogress and earn regular diplomas. For stu-dents with significant disabilities this trend isresulting in many positive changes (e.g., in-creased acquisition of general education con-tent; inclusion in district and state account-ability measures). It also is raising questionsabout the desired outcomes of educationalservices for this group of students, as well asthe efficacy of various forms of curriculumcontent, instructional practices, and instruc-

tional contexts that comprise their educa-tional experiences.

With the passage of the Education for AllHandicapped Children Act (1975) the educa-tion system was mandated for the first time toprovide educational services for students withsignificant disabilities (Federal Register,1977). As these mandated services were imple-mented, schools struggled with articulatingthe purpose of education for this set of stu-dents, as well as the curriculum content andinstructional practices that would lead to out-comes that reflected that purpose of educa-tion. As described in the literature from thatperiod, schools initially provided services forstudents with significant disabilities based onthe curriculum content provided for studentswithout disabilities who were performing atthe same developmental level, demonstratingthe same developmental skills and milestones(Williams & Gotts, 1977). For the most part,however, this content was taught in settingsthat segregated students with significant dis-abilities from classmates who did not havedisabilities and the contexts in which they re-ceived instruction (Brown et al., 1978).

Some school districts, however, had opted

Correspondence concerning this article shouldbe addressed to Diane Ryndak, School of SpecialEducation, School Psychology, and Early ChildhoodStudies, PO Box 117050, University of Florida,Gainesville, FL 32611-7050.

Education and Training in Autism and Developmental Disabilities, 2012, 47(2), 127–138© Division on Autism and Developmental Disabilities

Impact of Educational Contexts / 127

to provide special education services for stu-dents with significant disabilities prior to the1975 mandate. One of those districts began toarticulate a purpose of education for this setof students, as well as study the long-termoutcomes for their graduates (Van Deventeret al., 1981). The Madison (Wisconsin) Met-ropolitan Schools stated that the purpose ofeducation for students with significant disabil-ities was to assist in maximizing their indepen-dent functioning in the heterogeneous societyof adults without disabilities, including whereand how those adults work, live, spend leisuretime, and access the community. To deter-mine if their services were meeting this goal,the district studied where their graduates withsignificant disabilities were spending day timehours. Initially the district found that only 2%of these graduates spent day time hours in anon-sheltered work place, while 98% spentday time hours in a sheltered work place or athome. Since these outcomes did not reflectthe district’s stated purpose of education forthese students, the district changed the curric-ulum content taught and the instructionalpractices implemented for their current stu-dents with significant disabilities. The changesfocused on teaching naturally-occurring (i.e.,functional) activities in naturally-occurringcontexts (i.e., general education and commu-nity contexts) with same-age peers who didnot have disabilities. Thus, the districtchanged both the curriculum content taughtand the context in which instruction oc-curred. After six years of implementing thesechanges, the district found that 91% of thenew graduates spent day time hours in a non-sheltered work place, while only 9% spent daytime hours in a sheltered work place or athome. The district concluded that these long-term outcomes more closely reflected theirpurpose of education for their graduates withsignificant disabilities, and that long-term stu-dent outcomes had improved after thesechanges in the curriculum content taught andthe context in which the students receivedinstruction.

Over the decades, numerous studies havebeen conducted to determine the long-termoutcomes for students with disabilities (Wag-ner, Blackorby, Cameto, & Newman, 1993;Wagner, Newman, Cameto, Levin, & Garza,2006). Unfortunately, the methodologies used

for such studies have not provided outcomedata specifically related to graduates with sig-nificant disabilities. For example, the use ofdata submitted to the U. S. Office of Educa-tion limits analysis to disability classificationand percent of time in general education.Since federal disability classifications do notinclude “significant disabilities” or “severe dis-abilities,” outcomes for students with signifi-cant disabilities must be extrapolated fromdata on the existing categories, using preva-lence data. In addition, the studies on long-term outcomes focus heavily on employment.For individuals with significant disabilitieswho have exited school services, however, thefocus must go beyond employment and in-clude overall quality of life, including residen-tial situations, use of leisure time, access to thecommunity, and social networks.

The issues faced when studying longitudinaloutcomes for students with significant disabil-ities are affected further by the call for re-search in special education to match the rigorof research in non-educational fields, result-ing in a delineation of quality indicators forvarious methodologies (Cook, Landrum,Cook, & Tankersley, 2008; Odom et al., 2005).While describing the need for quality indica-tors, Odom and his colleagues stated: “Specialeducation research, because of its complexity,may be the hardest of the hardest-to-do sci-ence. One feature of special education re-search that makes it more complex is the vari-ability of the participants” (p. 139). We wouldargue further that, while this is the case forspecial education overall, it is even more evi-dent when considering special education forstudents with significant disabilities. Both thelow-incidence of significant disabilities andthe numerous combinations of disabilities af-fecting the students comprising this groupadd to the complexity of the participants andthe individualized services they require. Thevery nature of these complexities limits thefield’s ability to use randomized trials, large-Nstudies, and norm-referenced assessments tostudy the long-term outcomes for studentswith significant disabilities.

This article has four purposes. First, we dis-cuss social validity and the role of social vali-dation methodology in the study of long-termoutcomes for students with significant disabil-ities. Second, we discuss the extent to which

128 / Education and Training in Autism and Developmental Disabilities-June 2012

social validity is evident in research on servicesin inclusive general education contexts, andon the teaching of social skills in high schools.Third, we discuss the current status of re-search on inclusive education and post-schooloutcomes, and the extent to which that re-search is socially valid in representing long-term outcomes for individuals with significantdisabilities in relation to their quality of life,including employment, residential situations,use of leisure time, access to the community,and social networks. Finally, we make recom-mendations for future research and fundingsupport.

Social Validity and Long-Term Outcomes forStudents with Significant Disabilities

Definition and rationale for social validation.The concept of social validity reaches far be-yond the field of education. Perceptions ofthe usefulness and satisfaction with consumerproducts (e.g., automobiles, home appliances,banking and credit card practices) have beeninfluential in business and manufacturing foryears. In the field of medicine, there are con-troversies as to whether medical practicesshould be (a) standardized (i.e., quantified)by diagnosis and not altered by a physician’sclinical judgment based on patients’ charac-teristics, or (b) tailored by a physician tomatch the characteristics of individual pa-tients and the contexts in which they live(Groopman, 2010).

The concept of social validity was first intro-duced in education by Kazdin (1977) andWolf (1978). In part, it was conceived as aresponse to early concerns about whether ornot instructional practices based on appliedbehavior analysis, with its emphasis on opera-tionally defined behaviors and methods of in-fluencing the consequences of responses,were too controlling, unethical, or undesir-able (Kennedy, 2005). Prior to the 1970s andthe development of values such as normaliza-tion, many persons with significant disabilitieswere routinely institutionalized in congregate,segregated, and dehumanizing settings. “Edu-cation” largely consisted of meaningless andrepetitive activities, such as putting puzzlestogether, sorting objects, or stuffing envelopeswith blank pieces of papers. Research effortsoften were focused on demonstrating thatthese individuals were capable of learning.

Unfortunately, little emphasis was placed onthe value and meaningfulness of the skills theywere being taught; rather, more emphasis wasplaced on the assessment of a person’s disabil-ity than on the person’s demonstration ofcompetence as validated by learning new andmeaningful skills.

More recently, however, the importance ofdocumenting whether or not a particular ed-ucational intervention results in positive out-comes in reading, math, science, social, oremployment skills within the context of schooland community settings for all students hasbeen recognized. Equally important are thereactions and perceptions of the interventionby persons in these settings. For students withsignificant disabilities, educational interven-tions involve teachers, students without dis-abilities, family members, administrators, andcommunity members. Questions concerningthe relevance of instructional content, instruc-tional practices, and short- and long- termoutcomes of instruction, as well as consumersatisfaction, are just as controversial today asthey have been for decades. Social validationmethodology was developed to better under-stand and interpret the larger social contextin which instruction and learning occur. Itrepresents an attempt to address the rele-vancy, effectiveness, usefulness, and appropri-ateness of curriculum content, instructionalmethods, education supports, and outcomesof instruction as perceived by various stake-holders in educational and other applied set-tings. Kennedy (2005) pointed out that socialvalidity is not objective, precise, or quantifi-able; rather it is a subjective concept. Percep-tions of educational interventions change,therefore, relative to several variables, such asthe priorities of different stakeholders, time,location, and social mores.

Social validity is particularly importantwhen attempting to evaluate the long-termoutcomes for students with significant disabil-ities. For nearly four decades, the dismal out-comes of post-school follow-up studies of stu-dents with disabilities, and particularly thosewith significant disabilities, have indicated lowrates of employment, dependence on familymembers or social welfare, few social contacts,and long periods of inactivity (see NationalCenter on Disability and Social Security Ad-ministration, 2000). The results of these stud-


ies raise serious concerns about the social va-lidity of education for these students.

Assessing social validity in education. Threebasic approaches have evolved to estimate so-cial validity in education: (a) subjective evalu-ation, (b) normative comparison, and (c) sus-tainability of results. Subjective evaluationinvolves the perceptions of instructional rele-vancy by some group or groups of stakehold-ers (Kazdin, 1977; Wolf, 1978). Students, fam-ily members, teachers, school administrators,or community members may be asked to ratethe importance of instructional goals, meth-ods, and outcomes. The advantage of subjec-tive evaluation is that consumer input is gath-ered and valued. However, there are at leasttwo disadvantages to this method. First, differ-ent sets of stakeholders, as well as individualpeople, have different perceptions of what ismeaningful and relevant at any point in time(e.g., parents’ and teachers’ priorities for in-structional objectives). Second, consumer per-ceptions of a particular intervention might beunrelated to positive outcomes, particularlylong-term outcomes.

Normative comparison, sometimes referredto as social comparison, involves comparingthe performance of students with disabilitieswith some other reference group (e.g., same-age peers without disabilities) (Kazdin, 1977;Van Houten, 1979; Wolf, 1978). Normativecomparison is always dependent on socialstandards. Compare, for example, federal orstate mandated standardized age-normed testsversus teacher criteria for individualized stu-dent performance within a particular class-room, or differential expectations of employ-ers. Normative comparison is based on criteriawithin a given context; however, a disadvan-tage centers on the question of whether or notmeeting “average” standards is always advan-tageous for a particular individual. Using nor-mative comparisons can minimize the appre-ciation of unique human differences and leadto expectations that all persons should be heldto the same standard. Finally, questions lingeras to what exactly would constitute an appro-priate reference group for students with sig-nificant disabilities.

Sustainability of results refers to the ques-tion of whether or not the outcomes of in-struction are maintained over time (Kennedy,2002). This approach to social validation is

extremely important as we attempt to docu-ment the long-term efficacy of education ininclusive general education contexts. Clearly,studies have documented the short-tem effectsof services in inclusive general education con-texts (e.g., Alper & Ryndak, 1992; Fisher &Ryndak, 2001; Ryndak & Fisher, 2003). Thedisadvantage is that many behavioral changesare not maintained without sustained inter-vention. A host of intervening variables (e.g.,different teachers, individual student charac-teristics, changing local standards, inconsis-tent support services) exacerbate the method-ological difficulties of relating services ininclusive general education contexts to post-school outcomes for persons with significantdisabilities (Ryndak, Ward, Alper, Montgom-ery, & Storch, 2010).

Failure to apply social validation methodology.We argue that one factor contributing to thepoor post-school outcomes characteristic ofmany adults with significant disabilities is thefailure of special education policy makers andresearchers to socially validate the prevailinghigh school curricula, instructional strategies,and service delivery models with respect tolong-term outcomes. Studies indicate thatthose who have the most at stake with respectto the post-school outcomes of secondary cur-ricula (e.g., parents, students, employers) of-ten have little or no input into the curriculumgoals, instructional procedures, and outcomesthat comprise the content and delivery of highschool programs for this population (e.g.,Kolb & Hanley-Maxwell, 2003). Unless systemschange agents systematically apply social vali-dation methodology and solicit the views ofparticipants most directly involved in the tran-sition from school to adult life, and incorpo-rate their perspectives into programmatic de-cisions, secondary curricula likely will fail toeffectively address the participants’ long-termvalues, goals, and needs.

To illustrate, employment and follow-upstudies have indicated since the 1980s that theprimary cause of people with disabilities losetheir jobs is not because they cannot performrequired tasks, but because of difficulty fittingin socially in the workplace (e.g., Brickey,Campbell, & Browning, 1985; Butterworth &Strauch, 1994; Chadsey, 2007; Greenspan &Shoultz, 1981; Kochany & Keller, 1981; Weh-man, Hill, Goodall, Cleveland, & Pentecost,


1982). Social validation studies conducted inemployment settings indicate that employersof people with disabilities have expectationsfor their employees on the job (e.g., interact-ing with co-workers at breaks, requesting andproviding assistance, responding appropri-ately to constructive criticism) and that littletolerance exists for behaviors such as yelling,complaining, assaulting others, invading pri-vacy, or interrupting meetings unannounced(e.g., Agran, Salzberg, & Martella, 1991; Mc-Conaughy, Stowitschek, Salzberg, & Peatross,1989; Salzberg, Agran, & Lignurgaris/Kraft,1986). At the same time, employers do notbelieve it is their job to teach expected socialskills; rather, employers typically hold that em-ployees with or without disabilities should en-ter employment with “job-ready” social skillrepertoires so supervisors can focus on train-ing requisite skills to maximize job perfor-mance (Butterworth & Strauch, 1994). We ar-gue that if employers’ perspectives wereheeded, a critical component of secondaryprograms for students with significant disabil-ities would be teaching socially validated socialskills. However, doing so does not appear tobe the case. For example, Guy, Sitlington,Larsen, and Frank’s (2009) statewide studyrevealed that employment training, in gen-eral, is limited in secondary education pro-grams. Even when employment training is im-plemented, its main focus is teachingtechnical skills versus job-related social skills.

Social Validity of Inclusive Education andTeaching Social Skills in High Schools

Inclusive education in secondary general educa-tion classes and post-school outcomes. Researchindicates that receiving services in inclusivesecondary general education classes and dem-onstrating accepted social skills relate to post-school employment success for students withsignificant disabilities (e.g., Baer et al., 2003;Benz, Yovanoff, & Doren, 1997; Blackorby,Hancock, & Siegel, 1993; Heal & Rusch, 1995;Test et al., 2009; White & Weiner, 2004). Afundamental argument supporting the inclu-sion of high school students with significantdisabilities in general education classes is thatthese students need access to their generaleducation peers as models of expected socialbehavior (e.g., Alwell & Cobb, 2009; Naraian,

2010). Being educated in separate, segregatedsettings restricts opportunities to develop re-lationships and learn social skills needed foreveryday life in school and adult life. On theother hand, interacting with their general ed-ucation peers can promote acquisition of so-cial skills when peers serve as models of ex-pected behavior (e.g., Hughes et al., 2000).

The logical place to teach social skills val-ued on the job and in adult life is in a stu-dent’s high school environment where anabundance of peers is found, who are com-petent in performing everyday social inter-actions. Indeed, studies show that general ed-ucation peers can be effective teachers ofappropriate social skills for students with sig-nificant disabilities, and that these skills cangeneralize to individuals and settings not as-sociated with instruction (e.g., Hughes et al.,2004; Hughes et al., 2000; Hunt, Alwell, Goetz,& Sailor, 1990). Rather than wait until stu-dents are in a post-school employment setting,researchers, employers, parents, and othersargue that social skills instruction should beprovided in secondary curricula for studentswith intellectual and related disabilities (Kolb& Hanley-Maxwell, 2003). Considering thatlimited social skills is a characteristic of manystudents with intellectual disabilities (TheAAIDD Ad Hoc Committee on Terminologyand Classification, 2010), high schools mustbe responsible for teaching social skills to stu-dents with significant disabilities who have notyet acquired these critical skills. The fact thatsocial skills instruction with peers is not occur-ring regularly in high school on a regular basis(Carter & Hughes, 2007) is a blatant failure toapply social validation methodology to the sec-ondary curriculum in relation to long-termoutcomes of students with significant disabili-ties.

Social validation of teaching social skills: Par-ents’ perspectives. As discussed earlier, onemethod of social validation (i.e., subjectiveevaluation) includes querying stakeholdersabout their goals and expected short- andlong-term outcomes for a proposed or ongo-ing program. Particularly as youth get closerto exiting school, there is a growing concernamong parents to have their children learnsocial skills needed to get along on the joband in the community. Their collective con-cerns are an example of social validation: par-


ents are saying that social skills are critical tosuccess in adult society (e.g., Hughes,Brigham, & Cosgriff, 2010; Hughes, Killian, &Fischer, 1996). Parents report (a) wantingtheir high school-age children to learn to fit insocially by learning critical social skills, and(b) believing that classmates without disabili-ties can teach their children these skills(Hughes et al.).

For example, upon hearing that his soncould participate in a peer mentoring pro-gram at his high school, one father said, “It’sabout time--we’ve needed this for so long.” Heexpressed how critical it was for his son tolearn what is and is not appropriate behavior,both to promote relationships with peers andto learn what was expected on the job. Onemother expressed concerns that her son wasclose to exiting high school but lacked sociallyappropriate skills required in the work place.She indicated that, “What we need now morethan anything is social skills,” and that this washer top priority for her son’s participation inthe peer mentoring program. She followed upby saying that society wants students to go onto be “card-carrying, tax-paying citizens” andin order to do so, it was critical that her sonlearn the social behaviors expected in adultlife while he was still in high school.

Despite parents’ strong views on the valueof incorporating social skills instruction intothe school day for their children with signifi-cant disabilities, rarely is their input sought onthe content of secondary curricula and in-structional activities (Kolb & Hanley-Maxwell,2003). Further, unless instruction on socialskills occurs, there is little likelihood thatschools will provide the social interaction andopportunities to learn social skills that parentsvalue, even when their children with signifi-cant disabilities have access to general educa-tion classmates (e.g., Carter, Hughes, Guth, &Copeland, 2005; Hughes, Carter, Hughes,Bradford, & Copeland, 2002). Unfortunately,observational studies show that instruction onsocial skills rarely occurs in general educationhigh school contexts (Carter et al.), suggest-ing that parents’ perspectives and goals arenot being incorporated into identifying rele-vant secondary curriculum content.

Applying social validation methodology to highschool curriculum. Parents, employers, and re-searchers are calling for opportunities for stu-

dents with significant disabilities to learn thesocial skills needed for employment and otheraspects of adult life from their classmates with-out disabilities while in high school. For this tooccur, secondary curricula should be prepar-ing students with significant disabilities foremployment and other aspects of adult life.We argue that support should be provided byfunding agencies (e.g., Institute of EducationSciences) to systematically conduct social val-idation research investigating the perspectivesof critical stakeholders toward instruction onsocial interaction, and that these views be con-sidered when identifying the secondary curric-ulum content for students with significant dis-abilities.

Underutilization of social validity in educationalresearch. The underutilization of social valid-ity in educational research is related to theoverarching questions of the purpose of edu-cation. In general education for students with-out disabilities, controversy exists over the de-sired outcomes of education. Should the goalof education be to develop well-rounded edu-cated individuals with a broad base of knowl-edge, or to focus on job readiness for theglobal economy? Similar questions have beenraised as to the purpose of inclusion in gen-eral education contexts. Should the primaryemphasis of inclusion be the development ofsocial skills and friendships, or should theemphasis be broadened to include readinessto work, live, and participate in the commu-nity? Our position is that both emphases arecrucial. Incorporating the development of so-cial skills and friendships into the purpose ofeducation in general education contexts forstudents with significant disabilities need notjeopardize their development of skills neededfor employment and living in the community.Unfortunately, disagreement on these ques-tions compounds efforts to assess socialvalidity.

Finally, not all special education research-ers are focused on the long-term goals of im-proving quality of life after school years. Manyscholars, understandably, emphasize effectiveways for students with disabilities to meet statestandards for grade-level performance inmath, reading, and science related to provi-sions of the No Child Left Behind Act. Fewresearchers have addressed the social validity


of inclusion in general education contexts rel-ative to post-school outcomes.

Current Status of Research on Services inInclusive Contexts and Post-School Outcomes

While research examining inclusive educationfor students with significant disabilities hassignificantly increased over the last decade(Halvorsen & Neary, 2009; Ryndak & Alper,2003), the primary dependent variables usedin the majority of the research studies havefocused on short-term social and educationaloutcomes. For example, in a research reviewon promoting social interactions between stu-dents with significant disabilities and theirpeers without disabilities, Carter and Hughes(2007) concluded that creating common so-cial and educational experiences between stu-dents with and without disabilities results inincreased acceptance of students with signifi-cant disabilities, increased frequency andquality of social interactions between peers,and the development of friendships duringand after school hours (Carter & Hughes).However, they also point out that “In mostresearch studies, the long-term effects of in-terventions have not been evaluated, high-lighting the need for longitudinal evaluationsthat extend over the course of multiple semes-ters or school years” (p. 321).

Similarly, Hunt and McDonnell (2007) ex-amined research on strategies for supportingeffective instruction to students with signifi-cant disabilities in general education classes.They concluded that a number of student-and classroom-based interventions haveproven to be effective in promoting students’acquisition of a variety of academic and func-tional skills. They also noted that a pervasiveweakness in this research literature was a lackof attention by researchers to the generaliza-tion of skills to day-to-day activities, the main-tenance of skills across time, and the long-term impacts on students’ overall quality oflife.

The intervention literature clearly docu-ments that, as a field, we have effective strate-gies for increasing immediate social and edu-cational outcomes for students with significantdisabilities in general education classes. Theassumption is that students’ participation ingeneral education classes, and their improved

social and education performance in thesecontexts, will lead to better outcomes and en-hanced quality of life after they exit school.Unfortunately, the nature of the interventionstudies completed to date simply do not yetallow for this conclusion.

Some evidence supporting the long-termbenefits of inclusive education can be foundin studies that have examined the status ofstudents after they leave school (Benz, Lind-strom, & Yovanoff, 2000; Benz et al., 1997;Heal, Khoju, & Rusch, 1997; Ryndak, Ward,Alper, Montgomery, & Storch, 2010; Ryndak,Ward, Alper, Storch, & Montgomery, 2010;Wagner et al., 1993; Wagner et al., 2006;White & Weiner, 2004). For example, Whiteand Weiner conducted a correlational studyexamining the relationship between educa-tional placement and community-based in-struction on employment outcomes for 104young adults with significant disabilities. Oneof the strongest predictors of paid, communityemployment for these students followingschool was the degree to which they wereincluded in general education contexts withage-appropriate peers prior to graduation.

In a retrospective qualitative study, Ryndak,Ward, Alper, Montgomery, and Storch (2010)examined the impact of inclusive educationon two individuals with severe significant dis-abilities who attended the same self-containedclass when they were 15 years of age. Datasources included: (a) observations at age 15and 25; (b) interviews with the individualswith significant disabilities, family members,friends, and adult service providers; and (c)educational and adult services records. One ofthese individuals was identified as the “highestfunctioning” student in their class and theother was identified as the “lowest function-ing” student. In subsequent school years the“highest functioning” student remained inself-contained classes while the “lowest func-tioning” student received services in generaleducation classes. Three years after exitingthe educational system the “lowest function-ing” student consistently had been employedas a judicial system government employee, liv-ing in an apartment with weekly support forbudgeting and independent functioning, andparticipating within an extensive social sup-port network. In contrast, the “highest func-tioning” student had lost numerous jobs and


at the time was working at a sheltered work-shop, was living with family members, and hadno social support network beyond familymembers.

Finally, the National Longitudinal Transi-tion Study (NLTS) I and the National Longi-tudinal Transition Study (NLTS) II funded bythe U. S. Department of Education have alsoattempted to identify educational and schoolfactors that influence post-school outcomesfor students with disabilities. Findings fromthese studies also suggest that taking coursesin the general education curriculum, espe-cially vocational education courses, has a pos-itive impact on students’ post-school out-comes (Wagner et al., 1993; Wagner et al,2006).

Although the available evidence suggeststhat inclusive education has a positive im-pact on post-school outcomes, most of thepublished research studies on post-school out-comes were not designed to specifically exam-ine the relationship between students’ partic-ipation in general education classes and thegeneral education curriculum, and their qual-ity of life following school. Some of the limi-tations of the existing studies include:

● The primary dependent variables of post-school adjustment are overly focused onemployment outcomes. Data on variableslinked to individuals’ levels of indepen-dence, self-determination, community par-ticipation, depth and breadth of social net-works, and overall satisfaction with qualityof life are essentially nonexistent.

● Measures of the characteristics of services ininclusive general education contexts arebroad (i.e., number of general educationcourses taken, amount of time in generaleducation classes) and do not address therange, intensity, or quality of instructionthat students receive in these contexts.

● The measures of academic performanceand social connectedness are weak if theyexist at all.

● Measures of student and family characteris-tics are broad and often don’t address vari-ables that might influence student perfor-mance during school or access to resourcesafter school (e.g., family income).

● The impacts of community characteristics(i.e., rural vs. urban; levels of unemploy-

ment; affordable housing) are frequentlynot controlled for when drawing conclu-sions about students’ post-school outcomes.

● The type, intensity, and quality of communityservices and supports available to graduatesare rarely controlled for when drawing con-clusions about post-school outcomes.

● Measures of school and post-school experi-ences often are based on student and par-ent reports, or analysis of school or agencyrecords, rather than direct observation.

● The number of students with significant dis-abilities, especially those with more signifi-cant disabilities, represents a small portionof the sample which prevents a comprehen-sive analysis of the features of students’ ed-ucational experiences that might impactpost-school outcomes.

What these limitations point out is thataddressing the question of how inclusive edu-cation, and students’ access and progress inthe general education curriculum, impacttheir post-school outcomes will require theimplementation of one or more national lon-gitudinal studies that systematically track thebreadth, intensity, and quality of the partici-pation of students with intellectual and devel-opmental disabilities in general educationclasses and the general education curriculumthroughout their school years and into adult-hood.

Discussion

We have addressed some of the methodolog-ical issues in documenting post-school out-comes for students with significant disabilities.Specifically, we focused on the importance ofsocial validity, the need for more emphasisduring high school on social skills related toemployment and other long-term outcomes,and the need for longitudinal studies focusedon young adults with significant disabilities.Based on our review of the literature, thefollowing recommendations for practitionersand researchers are offered.

Recommendations for Increasing Emphasis onSocial Validity

First, there is a need for more consumer inputduring the school years about curriculumgoals. Too often, general and special educa-


tors, parents, and school administrators dis-agree. These issues are exacerbated by legisla-tive mandates and the economy. Many times,issues involving post-school outcomes are sim-ply not addressed until shortly before or afterexiting school. In addition, there is a need formore student input into their own educa-tional program based on their desires for thefuture. There is a great need to encourageteachers, students, family members, adminis-trators, and researchers to think ahead andconsider options for post-school options.

Second, implications for teacher prepara-tion should be reconsidered. General educa-tion teachers need to be better trained toadapt and accommodate curriculum for stu-dents with disabilities and recognize that notall students can or should meet the same per-formance criteria. Many higher education fac-ulty in elementary and secondary general ed-ucation are more focused on curriculumcontent of academic subjects rather thanmeeting individual needs of diverse learners.Most states mandate only a two to three credithour course in meeting the needs of diverselearners for general education teacher licen-sure, and many of these courses focus primar-ily on students with mild disabilities. Unfortu-nately, student teachers all too often aretrained in non-inclusive settings with little orno contact with students with significant dis-abilities.

Ryndak and Alper (2003) developed amodel for determining relevant curriculumcontent for a student with significant disabili-ties that blends relevant general educationcontent and functional content. The primaryadvantage of this model is that it enables stu-dents with significant disabilities to remain ingeneral education contexts and have access tothe general curriculum while, at the sametime, receive instruction that facilitates partic-ipation, as independently as possible, in con-text-based activities (e.g., in school, on thejob, in other aspects of adult life in the com-munity). This model relies on collaborationbetween special and general educators, as wellas the students, their family members, andtheir social support network.

Third, mastering the technical and socialskills needed for successful post-school out-comes for students with significant disabilitiesis, in part, contingent on the context of in-

struction. Instruction in the natural contextsin which skills typically are used is a priority inthe education of secondary students with sig-nificant disabilities. Currently there are twovariables that impact the instructional con-texts for these students. First, many research-ers, schools, and parents differentiate the con-text for instruction based on a student’s age;that is, through the age of 18 many studentswith significant disabilities receive instructionin the same contexts as their same-age peerswho do not have disabilities. Thus, if there is acommunity-based employment training pro-gram for general education students in a highschool, a student with significant disabilitiesmight receive instruction on employmentskills with those general education students inthe same employment contexts. When generaleducation students exit school services at age18, students with significant disabilities wouldeither receive community-based services (i.e.,on the job, in residential situations, in thecommunity-at-large) through age 22, or at-tend post-secondary education programs onuniversity or college campuses.

In contrast, some researchers, schools, andparents differentiate the context for instruc-tion based on the curriculum content theychoose for the student to learn. For instance,the emphasis of NCLB on meeting generaleducation academic standards might result inmaximizing students’ participation in aca-demic contexts with their same-age peers inboth secondary and post-secondary settings;emphasis on transitioning to adult life in thecommunity might result in maximizing a stu-dent’s participation in community-based con-texts (e.g., employment sites, residential situ-ations). John Dewey held that a child is bestprepared for life as an adult by being allowedto blend what is learned in school with lifeoutside of school and experiencing that whichhas meaning in his/her life. The dilemmafacing schools today is focusing on the indi-vidualized needs and future goals of a studentwith significant disabilities, and maximizingtheir educational experiences related to bothgeneral education content and their func-tional needs. Additionally, the education sys-tem must struggle with the concept that theeffectiveness of education services for all stu-dents will not necessarily be based solely onstandardized state and district assessments.


Need for Longitudinal Studies

Design and implementation of a comprehen-sive longitudinal study for students with signif-icant disabilities would require a significantfinancial investment by the federal govern-ment and the participation of researchersfrom a number of disciplines. This effortwould face a number of methodological chal-lenges including obtaining a national repre-sentative sample; defining and quantifying thecritical dimensions of education in inclusivegeneral education contexts; obtaining reliableand valid measures of student learning andsocial adjustment during school; defining andquantifying meaningful post-school outcomes;and controlling for variation in school-basedand post-school services. However, such anendeavor could have significant benefits ininforming educational policy for this group ofstudents for years to come.

Given the current state of research on theimpact of services in inclusive general educa-tion contexts, as well as the mandates in NCLB(2001) and IDEA (2004) on students’ accessto and progress in the general curriculum, itwould seem prudent to ascertain what ele-ments of students’ participation in the generalcurriculum directly impacts their post-schooloutcomes. We need to know whether learningcontent from the general curriculum, learn-ing social and functional skills that are linkeddirectly to students’ post-school contexts andoutcomes, participating in general educationclasses and activities, or all three make a dif-ference in the effectiveness of students’ edu-cational programs. We also need to knowwhether holding schools accountable only forshort-term learning and social outcomes ishaving the intended impacts. We might findthat if we really want to improve the quality ofeducation for students with significant disabil-ities, then schools should instead be held re-sponsible for whether students successfullytransition into post-secondary education oremployment, and participate fully in the socialand cultural networks of the community.

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Received: 3 February 2011Initial Acceptance: 6 April 2011Final Acceptance: 25 May 2011


Functional Curriculum and Students with Mild IntellectualDisability: Exploring Postschool Outcomes through the

NLTS2

Emily C. Bouck and Gauri JoshiPurdue University

Abstract: While students with mild intellectual disability receive less attention in research, their educationalprogramming is still important, including the curriculum they receive in school. This study analyzed theNational Longitudinal Transition Study-2 (NLTS2) as to the curriculum students with mild intellectualdisability received in high school as well as students’ postschool outcomes. Frequency distributions, crosstabulations and logistic regression were utilized to analyze secondary data from the NLTS2. Results indicatedfew students with mild intellectual disability received a functional curriculum and receipt of a functionalcurriculum did not influence postschool outcomes. The implications and future directions of these results arediscussed.

Students with mild intellectual disability oncecomprised the largest focus in special educa-tion and the category was often consideredthe foundation of the field (Bouck, 2007; Ed-gar, 1987; Polloway, 2006). But now it is apopulation in decline (Polloway), referred toby some as the forgotten generation (Fujiura,2003). Students with mild intellectual disabil-ity are now often given other category labels,such as learning disabilities, and lumped intothe category of high incidence disabilities ormild disabilities, despite not having mildneeds (Polloway, 2004; Smith, 2006). The re-sult of this melding is a loss of specific consid-eration for students with mild intellectual dis-ability in terms of curriculum, instructionalenvironments, and postschool outcomes (Pol-loway, 2004; 2005). In fact, Polloway (2004,2005) wrote a eulogy for the field of mildintellectual disability and cited a lack of atten-tion, research, and advocacy for this popula-tion of students and their educational needs.And yet, students with mild intellectual dis-ability still exist and continue to have educa-tional needs and concerns that need to be

addressed in research and practice. Attentionneeds to be paid to this group of students’educational services and their postschool out-comes.

Mild intellectual disability is “characterizedby significantly subaverage intellectual func-tioning, existing concurrently with relatedlimitations in two or more of the followingapplicable adaptive skill areas: communica-tion, self-care, home living, social skills, com-munity use, self direction, health and safety,functional academics, leisure, and work” (Pol-loway, Patton, Smith, & Buck, 1997, p. 298).Historically and collectively, students withmild intellectual disability struggled with shortattention spans and distractibility (Dunn,1973; Kirk, 1972; Thomas, 1996; Zeaman &House, 1963, 1979). Other characteristics of-ten associated with this population of studentsinclude difficulty transferring and generaliz-ing information, inputting information intomemory, and retrieving information frommemory (Belmont, 1966; Dunn; Kirk; Spitz,1973; Stephens, 1972; Thomas). In oppositionto the aggregation of students with mild intel-lectual disability with other high incidencedisability categories, Sabornie, Evans, and Cul-linan (2006) suggested how students withmild intellectual disability were different fromstudents with learning disabilities and emo-tional/behavior disorders in the domains of

Correspondence concerning this article shouldbe addressed to Emily C. Bouck, 5146 BRNG Hall,100 N. University St., West Lafayette, IN 47907.Email: [email protected]


Functional Curriculum and Students with MID / 139

IQ and academic achievement/skills (i.e., stu-dents with mild intellectual disability hadlower IQs and lower academic achievement/skills).

Historically, students with mild intellectualdisability have experienced poor postschooloutcomes. Although aggregated, in the Na-tional Longitudinal Transition Study (NLTS),Blackorby and Wagner (1996) found only a35% employment rate for students with intel-lectual disability. In 2009, from the NationalLongitudinal Transition Study 2 (NLTS2)Newman, Wagner, Cameto, and Knokey indi-cated only 31.0% of students were currentlyemployed, although the data showed 51.8%had been employed sometime since they grad-uated from high school. Additionally, New-man et al. found only 14.1% of students withintellectual disability report living indepen-dently. For postsecondary institution atten-dance, Kaye (1997) reported 2.5% of studentswith intellectual disability participated insome form of postsecondary education; morerecent data from the NLTS2 indicated an in-crease to 13% (Newman, 2005b).

Functional Curriculum

Given the poor postschool outcomes, oneneeds to consider the educational program-ming students with mild intellectual disabilityreceive. In a survey of one state, secondaryspecial education teachers reported a range ofcurricular offerings for students with mild in-tellectual disability: 23.8% used a special edu-cation curriculum, 19% a functional curricu-lum, and 15.3% a general educationcurriculum; the remaining teachers usedsmall frequencies of other models (e.g., lowergrade level, vocational education, no curricu-lum) (Bouck, 2004a). Teachers in this studyreported being unsatisfied with the educa-tional programming for secondary studentswith mild intellectual disability and indicatedone of the greatest improvement needs fortheir program was a more appropriate curric-ulum (Bouck).

One curriculum advocated for secondarystudents with mild intellectual disability is afunctional curriculum (Bouck, 2004b; Edgar,1987; Kaiser & Abell, 1997; Patton, Cronin,Polloway, Hutchinson, & Robinson, 1989). Afunctional curriculum, sometimes referred to

as a life skills curriculum, is designed to teachfunctional life skills, or in other words, theskills necessary to live, work, and have fun inan inclusive community (Bouck; Brown et al.,1979). A functional curriculum is presumed toinclude the functional skills and applicationsof core subject areas (academics), vocationaleducation, community access, daily living, fi-nancial, independent living, transportation,social/relationships, and self-determination(Patton, Cronin, & Jairrels, 1997). A func-tional curriculum stems from the belief thatthe general academic curriculum fails to pro-vide students with mild intellectual disabilityan opportunity to develop skills they will needto be successful postschool and they would notdevelop these skills unless explicitly taught(Bouck; Sitlington, Frank & Carson, 1993).Hence, a functional curriculum approach ischaracterized by the consideration of teachingstudents with mild intellectual disability theskills to help them be productive members ofsociety, and support positive postschool out-comes.

Postschool Outcomes

While a lack of research exists regarding theoutcomes of a functional curriculum for sec-ondary students with mild intellectual disabil-ity, research on a functional curriculum forstudents with disabilities in general suggestspositive results. For example, Benz, Lind-strom, and Latta (1999) and Benz, Lindstrom,and Yovanoff (2000) indicated students withdisabilities who participated in the YouthTransition Program, which involved life skills(i.e., vocational skills, including paid work ex-perience; independent living skills; personal-social skills; functional academics skills; andself-determination), experienced increasedgraduation rates, higher engagement in post-secondary outcomes of employment or educa-tion, and higher wages. In another study,Riches, Parmenter, Fegent, and Bailey (1993)surveyed students with disabilities in Australiawho graduated from high school. They com-pared responses of students who participatedin a transition project, in which the curricu-lum focused on vocational education, commu-nity access/living, functional academics, rec-reation and leisure, transportation andpersonal management, to those who did not


participate in this program. One of the nota-ble outcomes of this study was employmentfor the students in the transition program asRiches et al. found 89% students who partici-pated in the program held at least one jobafter high school. Further, Phelps and Hanley-Maxwell (1997) noted the value of a func-tional curriculum—operationally defined asthe merger of academics and vocational edu-cation, suggesting it was one of two effectivepractices for students with disabilities whenconsidering postschool outcomes related towork. Finally, Alwell and Cobb (2009), in areview of research on functional curriculumand outcomes of students with disabilities overtwo decades, suggested students benefitedfrom receiving a functional curriculum butthe research on functional curriculum primar-ily targeted students with more severe or lowincidence disabilities.

Yet, more than just curricula can impactstudents’ postschool outcomes. For example,Rabren, Dunn, and Chambers (2002), exam-ining transition data from former studentswith disabilities in one state, found disabilitycategory, gender, school geography, and em-ployment in school influenced students after-school success or lack thereof. Baer et al.(2003) reported differential effect of in-schoolinfluences when considering postschool out-comes of employment and postsecondary ed-ucation. They found participation in school-supported work experiences, vocationaleducation, having a particular disability andbeing educated in a rural school were positivepredictors of employment for students withdisabilities after school, while attendance at asuburban school and participation in a gen-eral education settings positively correlatedwith postsecondary education attendance.And, from the National Longitudinal Transi-tion Study data, Heal and Rusch (1995) re-ported male gender status and receiving lifeand academic skills as positive predictors ofemployment after school for students with dis-abilities.

Research Project

Currently there is a lack of attention to stu-dents with mild intellectual disability in re-search and practice (Bouck, 2007), which isunwarranted in these times of evidence-based

practices and a focus on achievement and out-comes in federal policy (Bouck, & Flanagan,2010; Individuals with Disabilities EducationImprovement Act, 2004; No Child Left Be-hind, 2002). Further, there is a lack of currentresearch connecting receipt of a functionalcurriculum to postschool outcomes for stu-dents with disabilities, particularly consideringthe often-overlooked population of studentswith mild intellectual disability. To addressthis gap in research, the authors sought toanswer the following research questions: (a)to what extent are students with mild intellec-tual disabilities getting exposure to functionalor life skills curriculum during their second-ary education program?, (b) what are the im-mediate and long-term (i.e., more than 2years) postschool outcomes for students withmild intellectual disability who receive a func-tional curriculum?, (c) how do the postschooloutcomes of students with mild intellectualdisability who receive a functional curriculumcompare to those receiving other curriculummodels?, and (d) what factors (i.e., curricu-lum, school geography) predict the ascertain-ment of more successful postschool outcomes(i.e., full-time employment, higher wages, in-dependent living) for students with mild intel-lectual disability?

Method

This study used the National LongitudinalTransition Study-2 (NLTS2) database to ex-plore students with mild intellectual disability,functional curriculum, and postschool out-comes (e.g., employment, postsecondary edu-cation, wages, and independent living)through a secondary analysis. We will discussinformation regarding the participants andprocedures used for this study and generalinformation regarding the NLTS2, however,we invite readers to refer to reports and infor-mation from the NLTS2 website (http://www.nlts2.org) and other published articles(Wagner, Kutash, Duchnowski, & Epstein,2005) for additional information specific tothe overall NLTS2 project.

National Longitudinal Transition Study

The National Longitudinal Transition Study(NLTS), funded by the Office of Special Ed-


ucation Programs and conducted by SRI In-ternational, focused on secondary studentswith disabilities receiving special educationservices (Wagner, Newman, Cameto, &Levine, 2005). It was a multiyear project, be-ginning in 1985, and sought to understandthese students’ secondary education, transi-tion to postschool, and outcomes postschool.Overall, the NLTS highlighted the poor post-school outcomes of students with disabilitiesand the need for change in areas of secondaryeducation and transition (Blackorby & Wag-ner, 1996).

The National Longitudinal TransitionStudy-2 (NLTS2) is the sequel to the NLTS. Itis a government-sponsored project to docu-ment the “characteristics, experiences, andachievement of youth with disabilities”through its examination of issues of secondaryeducation, transition, and postschool out-comes (Newman, 2005a). The NLTS2 repre-sents a comprehensive 10-year project; datacollection began during the 2000–2001 aca-demic year and the last wave of data com-pleted during the 2008–2009 academic year.The NLTS2 gathered data through multiplemeans: (a) parent and/or youth telephoneinterviews, (b) direct assessments of students,(c) teacher survey, (d) school program survey,(e) school information survey, and (f) studenttranscripts (SRI International, 2000b).

The NLTS2 represents a two-stage samplingprocedure (SRI International, 2000a; Wagneret al., 2005). First, Local Educational Agencies(LEA) and state-supported schools were ran-domly selected to participate. The selectionwas done in a stratified manner, to account forgeographic region, student enrollment (i.e.,enough respondents in each of the 12 possibledisability categories at the secondary level),and wealth of LEA/community. From this,students between the ages of 13 and 16 and inat least seventh-grade receiving special educa-tion services within the selected LEAs and spe-cial schools were randomly selected to partic-ipate (SRI International, n.d). However,students were selected to ensure a 3.6% stan-dard error in the disability categories with thehighest frequency of students (i.e., learningdisabilities, emotional/behavior disorders, in-tellectual disability, speech and language im-pairments, other health impairments, andhearing impairments) (SRI International;

Wagner et al.). The sampling of students wasalso weighted towards older students (i.e.,those aged 16 as compared to 13–15 year-olds)at the start of wave 1 (SRI International). Us-ing the weighted design of the study, a total of19,899,621 students receiving special educa-tion services from 12,435 LEAs participated inthe NLTS2 study (SRI International).

Participants

Participants in this project were students fromthe NLTS2 study, meaning they were students13–16 years of age in at least seventh-gradeand receiving special education services in2000. To be included in this secondary analy-sis, students from the NLTS2 database neededto meet the following criteria: (a) identifiedby school program as having a mild intellec-tual disability; (b) in school in wave 1 of datacollection and out of school in wave 2, inschool in wave 2 and out of school in wave 3,or in school in wave 3 and out in wave 4; and(c) receiving special education services whilein school. While analyses were run on studentswho met these characteristics in the sample,all data reported are weighted using theweights provided in the NLTS2 database torepresent the number of students in the pop-ulation (see Javitz & Wagner, 2003; Wagner etal., 2005 for more information on weightingthe data). Note, data with low unweightedcounts have not been reported in this analysis.

This secondary analysis of the NLTS2 in-volved 60,664 students with mild intellectualdisability. The majority of students with mildintellectual disability identified their ethnicityas Caucasian (62.4%, SE 5.7), followed by Af-rican-American (30.5%, SE 5.5), Hispanic(4.5%, SE 2.7) and multiracial or other (2.1%,SE 1.7). The majority were male (66.1%, SE4.8) and, of those who responded, the mostfrequently indicated family income (i.e., par-ent/guardians) was less than $25,000 per year.The average age of students in school was 17.2while the average age for out of school for thepostschool outcomes was 19.9, and 20.9 forthe long-term postschool outcomes (i.e., morethan two years out of school).

Data Collection

For this analysis, we pulled data from the firstfour waves of data collection (i.e., waves 1, 2,


3, and 4). The immediate outcomes reflectstudents who were out of school in wave 2, 3,or 4, while the “long term” outcomes reflectdata of students who were out of school ineither wave 3 or 4 and in school in waves 1 and2 (i.e., out for more than two years). We uti-lized the Parent/Youth survey at each of thefour waves, the School Characteristics surveycompleted at wave 1, and the Students’ SchoolProgram survey completed at waves 1 and 2.At wave 1, the Parent/Youth survey was a 60-minute phone interview completed by the par-ents of the participating students. For waves 2,3, and 4, students completed the 60-minutephone interview; parents completed it if thestudent was unable to do so. At all four waves,a mail survey was provided if a phone inter-view was not possible. The Parent/Youth sur-vey focused on selected questions pertainingto student characteristics, household charac-teristics, nonschool factors, family involve-ment, academic and school experiences, per-sonal/social issues, employment, citizenship,health, satisfactions, and behaviors (SRI Inter-national, 2000b).

The teacher most familiar with the student’soverall school program completed the Stu-dents’ School Program survey. This survey wasa mail survey and questions pertained to theschool program, transition, special educationservices, state and district assessments, accom-modations, provision of supports, perfor-mance, and parental involvement (SRI Inter-national, 2000b). Finally, school personnel,such as the principal, completed the SchoolCharacteristics survey. It was also a mail sur-vey, which elicited information regarding theschool and community, students, staff, pro-grams, special education policies and prac-tices, parental involvement, and backgroundinformation (SRI International).

Procedure

For the purposes of this analysis, we focusedon items from the multiple surveys that ad-dressed our research questions. Specifically,we included items representing the curricu-lum focus in students’ special educationclasses (e.g., life skills, academic) as well as ifthey received life skills in school and where(e.g., special education setting, general edu-cation setting). We also used a variable from

the database called “mental skills,” which wasthe sum of respondents’ assessment of thestudent’s ability to tell time on a clock withhands, read and understand common signs,count change and look up telephone num-bers in a phonebook and use the telephone.Each skill was assessed on four point ratingscale ranging from one (not at all well) to four(very well), resulting in a score ranging from 4to 16. In terms of postschool outcomes, vari-ables of interest included where students wereliving (i.e., independently vs. dependently),employment status, job type, wages received,and whether they attended postsecondary ed-ucation (i.e., four-year college, two-year col-lege, vocational/technical school). Other vari-ables related to demographics of the students(i.e., disability, gender, ethnicity) and school(i.e., geographical location, size, servicesnearby).

In addition to using the original NLTS2variables, some variable categories were re-coded. For instance, the variable related totype of student’s special education class orig-inally had four values (see Table 1 for a listvariables used in this study and their descrip-tion). Since the focus of this project was onlife skills, we recoded this variable into twocategories: receipt of life skills and receipt ofother (i.e., academic, basic academic, or studyskills). Similarly, the independent living vari-able consisted of fifteen categories. These fif-teen categories were recoded into three cate-gories: lived independently (i.e., on his/herown, with a roommate or spouse, college dor-mitory, and military housing), and lived de-pendently (i.e., with his/her parents, with an-other relative, a group home or assisted livingcenter, and a correctional facility/youth de-tention center). Finally, the wage variable wasrecoded from a continuous variable represent-ing the hourly pay students received at theirmost current or recent job to a dichotomousvariable, above or below minimum wage (i.e.,$5.15 at the time of data collection).

Data Analysis

Statistical procedures such as frequency distri-butions, cross tabulations and logistic regres-sion were utilized to analyze secondary datafrom the NLTS2. Specifically, to answer thefirst research question regarding exposure to


TABLE 1

Description of Variables used in Secondary Analysis

Variables NLTS2 Variable ID Description

Identification ofstudents

ID Randomized number assigned to eachstudent

Disability nprXD2a_09 Disability of studentEthnicity npXEth_Recod Ethnicity of each student (i.e., white;

African American; Hispanic; Asian/Pacific Islander; American Indian/Alaska Native; multiple races/other)

Age npXCurAge Student age at the time of datacollection

Income npXk15Cat Family income categories (i.e., $25,000or less; $25,001–$50,000; more than$50,000)

Gender npXGendHdr Gender of each student (male, female)Mental skills npXG4_[a-d] How well the student can tell time,

read signs, count change and lookup telephone numbers in aphonebook

Urbanicity wX_Urb3 Geographical location of the student’sschool (rural, suburban, or urban)

Type of specialeducation class

nprXD9 Focus of the non vocational specialeducation class (i.e., academic, lifeskills, basic academic skills, or studyskills)

Received life skills nprXA3h Student received life skills, social skillsinstruction

Instructional settingfor life skills

nprXA3h_(1-4) Instructional setting where studentreceived life skills (generaleducation, special education,individual instruction or communitysetting/different school)

Independent living npXP1a_01_A6a_01-15� Independent living (i.e., living on own,with a roommate), dependent living(i.e., living with parents, insupportive environment), or other(i.e., homeless)

Postsecondaryattendance

npXS3a_S4a_S5a_D4a1_D4a2_D4a3 Out-of-school student attended anytype of postsecondary school (i.e.,vocational, technical, two- year, orfour-year college)

Currently employed npXT7a_L7a_I2b Student has a paid job nowEver employed npXT6a_L6a_I2a If student worked for pay during the

last 2 yearsAbove minimum

wagenpXT8f1_T11f_L8f1_L11f_I3a� Out-of-school student earns more than

minimum wage($5.15)Full time

employmentnpXT8c_T11c_L8c_L11c Out-of-school student has a full-time

(�35 hours a week) or part-time job(�35 hours a week)

Note: * Indicates a larger variable(s) was collapsed to created fewer categories and/or combine data. Xindicates the Wave year (i.e., 1, 2). All in-school variables reflect variable name from wave 1 and all thepostschool outcomes refer to variable names from wave 2. There may be slight changes in the variable ID’s fromone wave to the next.


a functional curriculum during school, fre-quency distributions were conducted on bothresponses to the curriculum in students’ spe-cial education class as well as the reportedreceipt of life skills in school.

For the second and third research questionsregarding postschool outcomes, we ran fre-quency distributions on the postschool out-come variables of interest (e.g., employment,independent living, postsecondary educationattendance, wages). The frequency distribu-tions of these variables were conducted forstudents with mild intellectual disability whoreceived a functional curriculum and studentswith mild intellectual disability who received adifferent curriculum (non-functional curricu-lum). To compare the postschool outcomes ofthese two groups, an F test was conducted.Note, this F-test was provided with the NLTS2dataset. Wagner, Newman, Cameto, Levine,and Marder (2007), suggested the F test canbe used to identify the existence of statisticallysignificant differences between groups ratherthan just merely looking at the differencesbetween observed and expected frequencies.

Finally, to answer research question fourregarding what factors predict more success-ful postschool outcomes for students withmild intellectual disability a logistic regressionwas utilized. Logistic regression is used in aregression model for analyzing dichotomousvariables (Peng, Lee, & Ingersoll, 2002). Bi-nary categories (0 � no and 1 � yes) werecreated for all the six outcomes of interest(i.e., independent living, ever attended a post-secondary education institution, currently em-ployed, ever employed, received above mini-mum wage, or working full time), for bothimmediate and long-term outcomes. Includedin each logistic model were the following in-dependent variables: curriculum (functionalvs. non-functional), mental skills (sum of pa-rental reporting of four skills on a scale of 1–4with a range of 4–16), gender (male vs. fe-male), family/parental income (�$25,000,$25,000–$50,000, �$50,000), ethnicity (Cau-casian, African-American, Hispanic, Asian,American Indian, Multi/Other), and schoollocation (rural, urban, suburban).

For each univariate logistical regressionanalysis, a Goodness of Fit test (i.e., G2 � �2[loglikehood(R) � loglikehood (F)], or inother words, the �2loglikehood of the re-

duced model [i.e., without the variable of in-terest] minus the �2loglikehood of the fullmodel) was conducted to determine if eachparticular variable should be included in themodel. Note, the Goodness of Fit is comparedto the �2 table with an alpha of .05 and appro-priate degrees of freedom to determinewhether or not to reject the null hypothesis(i.e., exclude the variable of interest). Thus,the full model with all six predictors was con-ducted for each of the six dependent variablesfor both immediate and long-term outcomes.Then, each predictor was removed individu-ally to assess its significance to the model.

Results

Given the nature of survey and interview data,responses to questions were not available forevery individual. Also, not all questions wereanswered with the same frequency as individ-ual responses may not have been gatheredbecause a particular question was not asked(i.e., skip logic was imposed) or because therespondent chose not to answer the question.Hence, data are reported out of the numberwho responded to the question rather thanthe number of the complete dataset (i.e.,60,664 for students with mild intellectual dis-ability).

Exposure to Functional Curriculum

Functional curriculum was reported as thecurricular focus of students’ non-vocationalspecial education class for approximately one-fifth of the students with mild intellectual dis-ability (17.5%, SE 3.8). For the majority of thestudents with mild intellectual disability, aca-demic skills was the main focus (60.1%, SE5.4), followed by basic academic skills (19.2%,SE 4.0). Outside of a functional curriculum,almost 75% students with mild intellectual dis-ability received life skills, including socialskills, at school (74.3%, SE 4.1). The majorityof those who indicated where they receivedlife skills (N � 45,086), reported it was in aspecial education setting (76.7%, SE 5.9), fol-lowed by a general education setting (13.1%,SE 4.7), community setting (6.5%, SE 3.4),and then multiple settings (2.2%, SE 1.0).

Students who received a functional curricu-lum were not different from students who


received a non-functional curriculum inschool in terms of parent assessed “mentalskills.” The average mental skills of studentswith mild intellectual disability who received afunctional curriculum were 10.6 (SE 0.6),while students who received a non-functionalcurriculum (i.e., academic skills, basic aca-demic skills or study skills) averaged 11.8 (SE0.3). These differences were not found to bestatistically significantly different (p � .05).Among the students who received a non-func-tional curriculum, students who received astudy skills curriculum averaged the highestmental skills (15.1, SE 0.6), followed by thosewho received an academic skills curriculum(12.0, SE 0.5) and a basic academic skills cur-riculum (10.9, SE 0.8).

Postschool Outcomes

Less than 10% of students with mild intellec-tual disability who received a functional cur-riculum lived independently after exitingschool (8.7%, SE 5.4) (see Table 2 for thepercent, standard error, and population sizefor each postschool outcome). For studentswho received a non-functional curriculum justover 10% reported living independently(13.8%, SE 4.5). While the majority of stu-dents with mild intellectual disability reported

they experienced paid employment, (71.5%,SE 10.5 for those who received a functionalcurriculum and 62.3%, SE 6.7 for those whoreceived a non-functional curriculum), alarger percentage of students who received afunctional curriculum indicated they werecurrently employed (64.0%, SE 12.9 vs. 45.0%,SE 7.6). Regardless of in-school curricular fo-cus, the majority of students with mild intel-lectual disability earned more than the mini-mum wage, which was $5.15 at the time of datacollection. Specifically, 56.9% (SE 17.4) ofthose who received a functional curriculumand 85.1% (SE 7.2) of those who received anon-functional curriculum earned more than$5.15 per hour. In the final postschool out-come examined, 12.6% (SE 7.2) of studentswho received a functional curriculum at-tended any postsecondary educational institu-tion (i.e., business/vocational/technical, two-year, or four-year college) since leaving highschool. This rate more than doubled for stu-dents who received a non-functional curricu-lum (27.1%, SE 5.4). In terms of differences inpostschool outcomes between students withmild intellectual disability who received afunctional curriculum and those who receiveda non-functional curriculum, no statisticallysignificant differences existed for any out-come (p � .05).

TABLE 2

Immediate Postschool Outcomes for Students with Mild Intellectual Disability by Curricula Received

Postschool Outcomes

Functional Curriculum Non-Functional Curriculum

N % SE N % SE

Independent living 8,879 8.7 5.4 41,545 13.8 4.5Postsecondary attendance 9,112 12.6 7.2 39,612 27.1 5.4Currently employed 6,257 64.0 12.9 34,324 45.0 7.6Ever employed 6,772 71.5 10.5 37,430 62.3 6.7Above minimum wage 4,669 56.9 17.4 16,832 85.1 7.2Full-time employment — — — 18,690 38.7 9.5

Note: The percent is based on those in each category who responded to the question (i.e., some individualsdid not have responses to every question). Ever employed refers to whether students were employed any timeafter they left high school. Currently employed refer to whether students were employed currently when theyresponded to the interview/survey. The wage variable was calculated based on current or most recent wages ofparticipating youth, in case students were currently unemployed. Minimum wage was $5.15 at the time of datacollection. Postsecondary attendance includes attendance at vocational school, two-year college, or four-yearcollege. Please also note data with low unweighted count are not reported (i.e., represented by dashes in thetable).


“Long Term” Postschool Outcomes

In terms of “long-term” postschool outcomes(i.e., more than two years after participantsleft school), more students with mild intellec-tual disability who received a non-functionalcurriculum responded as having ever experi-enced paid employment as compared to thosewho received a functional curriculum inschool (54.0%, SE 10.1 vs. 49.7%, SE 23.1) (seeTable 3). A similar frequency of respondentsin both curricular categories reported theywere currently employed (non-functional:43.9%, SE 11.1; functional: 40.4%, SE 17.9). Interms of wages received, almost all studentswho received a non-functional or a functionalcurriculum in school reported they earnedmore than minimum wage (96.2%, SE 3.0 vs.95.4%, SE 3.1 respectively). Finally, a slightlyhigher frequency of students with mild intel-lectual disability who received a non-func-tional curriculum attended postsecondary in-stitutions as compared to those who received afunctional curriculum (25.6%, SE 9.5 vs.21.5%, SE 12.8). Similar to the examination ofdifferences in frequencies for the immediatepostschool outcomes, none of the long-termpostschool outcomes examined for studentswho received a non-functional curriculumwere statistically significantly different than

those of students who received a functionalcurriculum (p � .05).

Experiences Predicting Success

The logistic regression analyzing the six im-mediate postschool outcomes represented bybinary dependent variables (i.e., independentliving, currently employed, ever employed,ever attended a postsecondary institution,above minimum wage, and full time work)resulted in receipt of a functional curriculumnot being a statistically significant predictorfor any outcome (p � .05). Thus, receipt of afunctional curriculum versus a non-functionalcurriculum was not a factor influencing stu-dents’ postschool outcomes. In fact, none ofthe factors examined (curriculum, mentalskills, gender, family income, ethnicity, andschool location) were predictors for the im-mediate postschool outcomes of students withmild intellectual disability (p � .05). Similarresults were found for the six long-term post-school outcomes, with the exception of thedependent variables “currently employed”and “ever attended a postsecondary institu-tion.” Gender was a statistically significant pre-dictor for being currently employed, withmales more likely to be employed at the time

TABLE 3

Long term Postschool Outcomes for Students with Mild Intellectual Disability by Curricula Received

Postschool Outcomes

Functional Curriculum Non-Functional Curriculum

N % SE N % SE

Independent living — — — 15,273 19.4 8.6Postsecondary attendance 4,295 21.5 12.8 16,348 25.6 9.5Currently employed 3,687 40.4 17.9 13,766 43.9 11.1Ever employed 3,806 49.7 23.1 16,348 54.0 10.1Above minimum wage 1,634 95.4 3.1 7,468 96.2 3.0Full-Time Employment — — — 8,823 78.7 12.9

Note: The percent is based on those in each category who responded to the question (i.e., some individualsdid not have responses to every question). Ever employed refers to whether students were employed any timeafter they left high school. Currently employed refer to whether students were employed currently when theyresponded to the interview/survey. The wage variable was calculated based on current or most recent wages ofparticipating youth, in case students were currently unemployed. Minimum wage was $5.15 at the time of datacollection. Postsecondary attendance includes attendance at vocational school, two-year college, or four-yearcollege. Please also note data with low unweighted count are not reported (i.e., represented by dashes in thetable).


of the interview (3.23 times more likely to becurrently employed). Income was a statisticallysignificant predictor for the long-term out-come “ever attended a postsecondary institu-tion,” with students who attended a postsec-ondary institution more likely to report higherincomes.

Discussion

This study was a secondary analysis of theNLTS2 data focusing on issues of a functionalcurriculum for high school students with mildintellectual disability. Specifically, we analyzedreceipt of a functional curriculum in school bystudents with mild intellectual disability, thepostschool outcomes (i.e., independent living,employment, postsecondary attendance) ofstudents with mild intellectual disability, andthe relationship between curricular focus inschool and postschool outcomes for this pop-ulation. The results reveal three main findingsfor students with mild intellectual disability:(a) a low frequency receive a functional cur-riculum as their curricular focus in specialeducation, (b) some positive postschool out-comes were found, but there is still work to bedone to improve success, and (c) receipt of afunctional curriculum in school does not im-pact students’ postschool outcomes.

The most significant result may be the lackof impact of receipt of a functional curricu-lum on postschool outcomes for students withmild intellectual disability. The lack of influ-ence was apparent with the logistic regressionanalysis, as the binary variable of curriculum(i.e., functional or non-functional) was not apredictor in any of the postschool outcomemodels (i.e., independent living, ever at-tended a postsecondary education institution,currently employed, ever employed, aboveminimum wage, or working full time), andthis was for both immediate postschool out-comes as well as long-term postschool out-comes. Hence, whether a student with mildintellectual disability received a functionalcurriculum in school or a non-functional cur-riculum (i.e., academics, basic academics,study skills), it did not impact his or her post-school outcomes. The lack of impact of cur-riculum was also supported by the lack ofstatistically significant differences betweencurricular focus in frequency of postschool

outcomes for students with mild intellectualdisability (refer to Tables 2 and 3).

Despite the lack of statistical significanceregarding receipt of a functional curriculumand postschool outcomes, we cannot con-clude students with mild intellectual disability(a) do not benefit from receiving a functionalcurriculum or (b) should not be providedwith a functional curriculum. The results needto be interpreted in light of the limitationswith the secondary analysis. For example, thesurvey, from which the variable representingthe curricular focus of students’ non-voca-tional special education class, did not includequestions that might shed additional light onunderstanding the issues surrounding curric-ulum and postschool outcomes for studentswith mild intellectual disability. The surveyasked about the curriculum in students’ non-vocational special education class (i.e., aca-demics, basic academics, study skills, or lifeskills) but did not provide information regard-ing how much functional curriculum studentsreceive (i.e., number of classes, hours a week).Perhaps differences depend on the amountand/or frequency with which students withmild intellectual disability received a func-tional curriculum, but this could not be ascer-tained from the data. Related, the survey didnot ask about the nature of the functionalcurriculum and Bouck (2009) suggested dif-ferent models for functional curriculum existand that not all address aspects of a functionalcurriculum with equal attention or a focustowards the unique needs of students withmild intellectual disability.

It is worth noting that the results of thisanalysis were not consistent with previous re-search suggesting a relationship between re-ceipt of functional curriculum and positivepostschool outcomes for students with disabil-ities in general (Benz et al., 1999; Benz et al.,2000; Heal & Rusch, 1995; Phelps & Hanley-Maxwell, 1997; Riches et al., 1993). In fact, nofactors examined were found to impact theimmediate postschool outcomes of studentswith mild intellectual disability, which alsoconflicts with previous research (Baer et al.,2003; Rabren et al., 2002) except gender,which was influential in the long-term out-comes of “currently employed” and incomefor “attending postsecondary education.”While the previous research focused on stu-


dents with disabilities in general or an aggre-gation of disability categories (e.g., mild), thisresearch focused exclusively on studentswhose primary disability classification wasmild intellectual disability. Perhaps there issomething qualitatively and quantitatively dif-ferent about students with mild intellectualdisability with respect to postschool outcomesand the factors impacting their outcomes(e.g., curriculum, school location, income,gender). Note, students with mild intellectualdisability had lower mental skills (functionalcurriculum—10.6 and non functional curric-ulum—11.8) than students with learning dis-abilities (14.1), emotional behavior disorders(14.5), and all other disability categories otherthan multiple disabilities (9.8) (Wagner, Ca-meto, & Newman, 2003).

Students with mild intellectual disabilityperhaps face challenges to postschool out-comes that are different from other disabilitypopulations and these challenges may not beovercome by curricular focus, whatever thatmay be. For example, in comparing the out-comes from the NLTS2 of students with mildintellectual disability to the outcomes of stu-dent with learning disabilities and emotionaldisabilities (two common categories mild in-tellectual disability is aggregated within re-search; Edgar, 1987; Jones, 1996), 26.1% ofstudents with mild intellectual disability at-tended a postsecondary institution (regardlessof curriculum) as compared to 34% of stu-dents with emotional/behavior disorders and47.3% of students with learning disabilities(Newman et al., 2009). Similarly, 49.1% ofstudents with mild intellectual disability wereemployed postschool as compared to 63.6% ofstudents with learning disabilities (42.3% forstudents with emotional/behavior disorders).Finally, 12.1% of students with mild intellec-tual disability are living independently as com-pared to 21.5% of students with emotional/behavioral disorders and 28.8% of studentswith learning disabilities (Newman et al.).

Although receipt of a functional curriculumdid not result in students having statisticallybetter postschool outcomes (i.e., higher ratesof independent living, higher rates of employ-ment, etc.), it also did not result in themexperiencing lower postschool outcomes, sta-tistically speaking. Thus, a functional curricu-lum remains a viable option to consider. Yet,

the results indicated less than one-fifth of stu-dents with mild intellectual disability reportedreceiving a functional curriculum in school.While the low frequency may not be surprisingtoday, given the focus on the general educa-tion curriculum and participation in generallarge-scale assessments following No ChildLeft Behind (NCLB, 2002) and the Individu-als with Disabilities Education ImprovementAct (IDEA, 2004), the data on in-school cur-ricular focus predate the impact of NCLB andIDEA on education. The relatively small fre-quency reporting a functional curriculum isaligned with the reported decrease in atten-tion on a functional curriculum in the 1990s(Nietupski, Hamre-Nietupski, Curtin, & Shri-kanth, 1997). Further, the data align with sur-vey data from a single state study regardingthe frequency of curricular focus for highschool students with mild intellectual disabil-ity—19.0% (Bouck, 2004a).

Implications for Practice

The results of this study hold implications forpractice. The results suggest the need to focuson issues of transition for secondary studentswith mild intellectual disability and particu-larly targeting areas of postschool success,such as independent living. There is a need tofocus on what students with mild intellectualdisability plan on doing after high school andhow practitioners can help them achievethose goals, including curriculum choices.The results also suggest that as a field we needto engage in deeper discussion around thecurriculum students are receiving. Althoughthe results indicate receiving a functional cur-riculum did not predict better postschool out-comes, it also did not “hurt” the students (i.e.,lower postschool outcomes). Yet lacking fromthis analysis is the social validity of teachers,parents, and student regarding curricular im-plementation. This analysis did not addresswhat key stakeholders feel students should bereceiving as a curriculum and what they see asbeneficial to post school success. Student andparents may find value in a functional curric-ulum not captured by outcomes; previous re-search suggested parents express concernsabout the lack of acquisition of functional lifeskills by their child with a disability (Love &Malian 1997; Olson, 2004).


Limitations and Future Directions

Several limitations apply to this analysis. First,this is a secondary analysis of the NLTS2 dataand hence experiences the limitations of theoriginal design, which includes the self-re-ported nature of surveys. Related, missingdata existed for the secondary analysis—bothin terms of responses to some of the questionsfor all who participated in the study (i.e., re-spondents elected not to answer or skip logicwas imposed so a question was never asked torespondents), as well as attrition occurredthroughout the waves of data collection. Theattrition is evident when examining the “long-term” postschool outcomes. Whereas over6,000 students with mild intellectual disabilitywho received a functional curriculum inschool responded to employment outcomequestions (i.e., ever and currently employed),only around 3,000 responded to the “long-term” employment questions. Although the“long-term” outcomes drew from only twowaves of data (i.e., waves 3 and 4), this doesnot completely explain the smaller n. Thosewho responded to the “long-term” employ-ment questions appeared to be those whowere not as successful, as the ever employedfrequency went from 71.5% to 49.8%. Thissuggests individuals with more successful out-comes might have been less likely to respondto the survey and this may be related to thedesign of the NLTS2. The “long-term” out-comes may need to be interpreted with cau-tion.

Another limitation pertained to the phras-ing of questions and the lack of control duringsecondary analyses. For example, there was adifferentiation in questions between receivinga functional curriculum in a special educationclass and receiving life skills. Further, wheninquiring about receipt of life skills, the ques-tion was phrased to be life skills, includingsocial skills. While social skills are a compo-nent of life skills they are not the heart of lifeskills (e.g., skills for students to be successfulin life or independent). It was assumed morestudents with disabilities receive social skillsthan life skills, and hence the variable inquir-ing about receipt of life skills in general wasdifficult to use. We could not be certain ifstudents received life skills or just social skills.Additionally, the lack of statistically significant

results for the variable of interest—functionalcurriculum—could be viewed as a limitation.However, we choose to view it as an importantfinding warranting further consideration. Fi-nally, the lack of significant predictors for thelogistic regression models is problematic andsuggests additional research is needed to un-derstand what factors do impact the post-school outcomes of students with mild intel-lectual disability, given the lack of effect ofcurriculum, mental skills, and standard demo-graphic variables.

Future research should continue to explorethe impact of curricula on the postschool out-comes and in-school experiences for studentswith mild intellectual disability as well as sec-ondary students with other types of disabilities(e.g., learning disabilities, moderate/severeintellectual disability). Although this analysissuggested a lack of statistical differences in thepostschool outcomes for students who re-ceived a particular curricular focus as well asthe curriculum received variable was not afactor predicting outcomes in the logistic re-gression, the impact of curriculum still war-rants further examination. For example, whatreally constitutes a functional curricular ap-proach or a basic academics approach? Ateacher most knowledgeable with the stu-dents’ program indicated the curricular focus,but the nuances of the curricular approachwere not explored in the NLTS2 survey. Fur-ther research should understand and charac-terize curricular approaches as well as the re-lationship between experiencing a particularcurricular focus and postschool outcomes. Re-lated, research should examine what factorsdo impact the postschool outcomes of stu-dents with mild intellectual disability, giventhe lack of predictive relationship of the vari-ables examined in this analysis.

Additionally, future research should analyzethe in-school experiences of secondary stu-dents with mild intellectual disability ingreater depth. The majority of reports andresearch studies from the NLTS2 aggregatestudents with mild intellectual disability withstudents with moderate/severe disabilities(Newman et al., 2009; Yu, Newman, & Wag-ner, 2009), which does a disservice to under-standing the education of this population ofstudents. Much research in general aggregatesstudents with mild intellectual disability with


other high incidence disabilities and refers tothe grouping as students with mild disabilities(Edgar, 1987; Jones, 1996; Polloway, 2004;Smith, 2006). Seldom do we know about theeducation of student with mild intellectualdisability.

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Received: 24 March 2011Initial Acceptance: 20 May 2011Final Acceptance: 15 July 2011


Effects of a Self-Monitoring Strategy on Independent WorkBehavior of Students with Mild Intellectual Disability

Jennifer Coughlin, Kathleen M. McCoy, Amy Kenzer,Sarup R. Mathur, and Stanley H. Zucker

Arizona State University

Abstract: This study evaluated the effectiveness of a self-monitoring strategy on independent work behavior. Thethree subjects were in first grade, seven years old, identified with mild intellectual disability (MID), and had anIndividualized Education Plan (IEP) with targeted functional academic and behavior goals. The purpose ofthis study was to investigate the effect of a self-monitoring strategy on on-task independent work behavior andtask completion. A multiple baseline across subjects design was used. Data were collected using a frequency countof off-task behavior. The self-monitoring strategy was found to be successful with all subjects in the study.Overall, the subjects demonstrated a decrease in off-task behavior during independent work time after theintervention was introduced. Implications are discussed.

Off-task behavior can negatively impact thesuccess of people with disabilities in varioussettings, including work, school, and otherareas of community involvement. In one ob-servation of a work program site, participantswith disabilities spent 70% of observed timeengaging in off-task behavior (Parsons, Rolly-son, & Reid, 2004). Remaining on-task duringindependent work time at school is a strugglefor many students. Staying on-task can be evenmore difficult for students with disabilities.Students with disabilities can be distracted byother stimuli in the environment or frustratedby the level of difficulty of the task they areexpected to complete independently resultingin off-task behavior during independent worktime.

Behaviors that are irrelevant to the currentacademic task are considered off-task, takingsuch forms as distracting other students, at-tempting to gain the attention of instructors,sitting idly, leaving the designated work space,engaging in self-stimulatory behavior, or en-gaging in destructive behavior (Gickling &Armstrong, 1978). When many students with

disabilities are prompted to return to the ac-ademic task, often an increase in off-task be-haviors is observed (Saunders, McEntee, &Saunders, 2005).

Two contributing factors related to off-taskbehavior during independent work time aredifficulty of material and level of details ininstruction. Independent work that includes90% known material enhances the duration ofon-task behavior (Burns & Dean, 2005). Stu-dents, who are given general instructions,rather than specific instructions, are morelikely to engage in off-task behavior. Givingspecific and descriptive instructions to a stu-dent increases the frequency of task comple-tion (Bouxsein, Tiger, & Fisher, 2008).

Students with intellectual disability (ID)struggle to understand and identify the func-tions of their behavior (Crawley, Lynch, &Vannest, 2006). As a result of cognitive dis-ability, students with ID typically experienceinterference with the ability to self-manage.Students with ID or other cognitive disabilityalso can benefit from instruction which teachesspecific self-management strategies to increaseon-task behavior. Lack of self-managementskills inhibits students with ID from appro-priate independent functioning and integra-tion into the community (Selznick & Savage,2000). Hume and Odom define independentfunctioning as “on-task engagement in an ac-

Correspondence concerning this article shouldbe addressed to Kathleen M. McCoy, Mary LouFulton Teachers College, Arizona State University,1050 S. Forest Ave., PO Box 871811, Tempe, AZ85287-1811. E-mail: [email protected]



tivity in the absence of adult prompting”(2007, p. 1166). Conversely, learning to self-manage behavior can effectively enhance in-dependent functioning in the home, schooland community. Classroom goals for studentsthat include working independently, self-man-aging behaviors, and finding motivation innatural consequences are important (Hume &Odom, 2007).

Remaining on-task during independentwork time is a critical component of studentsuccess in the classroom. Students who dem-onstrate on-task behavior during independentwork time may also be able to generalize thisskill to other academic areas. To maintainhigh standards for all students, including stu-dents with ID and other disabilities, all stu-dents would benefit from instruction whichfacilitates their ability to engage in on-taskbehaviors during independent work time.When learners are independently engaged inon task behaviors, more instructional time isfreed for the teacher as well. While studentswork independently on-task, teachers have op-portunity to work one-on-one with a student,assess a student, or pull a small group of stu-dents for more intense instruction.

Self-Management

A self-monitoring strategy that successfully in-creases on-task behavior during independentwork time would benefit the individual stu-dents, teacher, and entire classroom.

Classroom goals for students that includeworking independently, self-managing behav-iors, and finding motivation in natural conse-quences are important (Hume & Odom,2007). In the classroom, when a student self-manages, the teacher is able to spend moretime focusing on instruction. According toKoegel, Harrower, and Koegel (1999), oneway to increase independent work is to teachstudents self-management strategies. Mitchemand Young (2001) created a class-wide peer-assisted self-management program in a class-room setting. They found that after trainingthe students were able to self-manage.Teacher and students found the programvaluable in improving classroom climate, andthe program was successfully generalized toother classrooms.

Self-control and self-management interven-

tions have many benefits. Self-managementstrategies are effective beyond the classroomsetting in teaching daily living skills (Hume &Odom, 2007). Society values independent ac-tions. Students who self-manage are morelikely to behave independently and appropri-ately without adult supervision. Finally, self-management encourages more natural behav-ior changes than relying on externalinfluences (Lane, Menzies, Bruhn, & Crno-bori, 2011; O’Leary & Dubey, 1979). Studentswho self-manage have higher achievements inthe classroom and feel a sense of satisfactiontoward their work (Lapan, Kardash, & Turner,2002). Rosenbaum and Drabman (1979) em-phasize the importance of instructing studentsto self-manage effectively.

Self-Monitoring

One self-management strategy is self-monitor-ing (O’Reilly et al., 2002). Self-monitoring is acomponent of Positive Behavioral Interven-tion (Ganz, 2008). Self-monitoring occurswhen students pay attention to a specific be-havior, record the occurrences of the targetbehavior, and reward themselves for improve-ments (Ganz, 2008; Soares, Vannest, & Harri-son, 2009). Used independently, self-monitor-ing can be effective in changing targetbehavior (Mace & West, 1986). Self-monitor-ing, however, is most effective when coupledwith either self-evaluation or positive rein-forcement (Mitchem & Young, 2001). Self-reinforcement is effective when used alone,but is far more effective when added to otherprocedures (O’Leary & Dubey, 1979). Withappropriate training, students become capa-ble of self-monitoring in natural settings. Ganzand Sigafoos (2005) researched the effect ofself-monitoring in a vocational setting withadults with both ID and autism. They foundthat this strategy increased both independentwork and verbal requests.

Self-monitoring is also effective in decreas-ing self-injurious behavior and tantruming instudents with autism. Self-monitoring is ap-propriate for the classroom because not onlyis responsibility placed in the hands of thestudents, but also the amount of direct contactwith the teacher decreases (Soares et al.,2009). Self-monitoring strategies have beeneffectively utilized with a single student with

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mild ID (Crawley et al., 2006), with studentswith emotional disabilities (Mooney, Epstein,Reid, & Nelson, 2003), across multiple class-room settings (O’Reilly et al., 2002), and withadolescent students with brain injury in mathclass (Selznick & Savage, 2000). The questionremains to be answered if these findings canbe replicated to a classroom of students withmild ID. Although research has shown thatself-management strategies are effective in re-ducing inappropriate behaviors, self-manage-ment strategies have not been broadly re-searched in students who demonstrate bothinappropriate, off-task behaviors and havecognitive disabilities (Crawley et al., 2006).

Self-monitoring is both easy to implementand rewarding for teachers. Students are in-terested in participating in self-monitoring be-cause they see the potential rewards. Teachersoften have easy access in their classrooms tonecessary materials effective for self-monitor-ing instruction. Minimal training is requiredfor teachers to acquire skills to implementself-monitoring in a classroom (Ganz, 2008).Instructors must verify that the student cancorrectly implement the self-monitoring strat-egy (O’Leary & Dubey, 1979). Mace and West(1986) suggest that further research in self-monitoring include reinforcement contingenton appropriate implementation of the self-monitoring intervention. Additionally, in-structors should make clear the relationshipbetween the self-monitoring intervention, ageappropriate material and resultant conse-quences.

Based on the work of Ganz, Cook, and Earles-Voolrath (2007) and Rankin and Reid (1995),a sequence of steps is recommended to effec-tively implement self-monitoring in a class-room. First, the instructor selects a target be-havior and operationally defines the behavior.Second, the instructor and student discuss thepurpose and benefits of self-monitoring andreinforcements available. Third, the instruc-tor determines a method to measure the tar-get behavior and collects baseline data.Fourth, the instructor determines an age-ap-propriate way for the student to self-monitor.Additionally, a criterion for reinforcement isdetermined based on baseline data. This cri-terion should be set initially so that the stu-dent frequently receives reinforcement forself-monitoring. Reinforcement fades as the

student increases appropriate self-monitoring.Fifth, the instructor teaches the student toself-monitor, using role playing and modeling.Sixth, using scaffolding, the instructor andstudent begin to self-monitor. Crucial to thisprocess is that the student receives the rein-forcement each time (s)he reaches a givencriterion. Reinforcement validates the use ofself-monitoring for the student. The instruc-tor should continue to monitor periodicallythe student’s self-monitoring. Once a studenteffectively self-monitors a behavior, the stu-dent can learn to self-monitor additional tar-get behaviors. The use of self-managementstrategies can help students with mild ID takeownership of their behavior. One type of self-management is self-monitoring. When stu-dents self-monitor, they identify a behavior,record occurrences, and reinforce improve-ments. Self-monitoring is most effective whenused with positive reinforcement.

The purpose of the study was to examinethe effect of a self-monitoring strategy on in-dependent work behavior in students withidentified mild ID being instructed in a self-contained setting. A self-monitoring interven-tion was implemented to determine its effectson on-task independent work behavior.

Method

Participants

Three children participated in this study.Each was seven years old, identified with MID,and had a current IEP with functional aca-demic and/or behavior goals. Each partici-pant received special education services fromthe researcher in a self-contained setting forprimary students with MID.

Sally, subject one, is a seven-year-old femalewith an intelligence quotient (IQ) of 64 asmeasured by the Pictoral Test of Intelligence,Second Edition (PTI-II). She frequentlyrushes through work without regard to detail.She wants to be the first student to finish anygiven assignment. Rather than taking respon-sibility for herself, she focuses on other stu-dents’ behavior and task completion. She re-quires constant verbal prompts to stay on task.She responds to verbal reinforcement and rec-ognition of her achievements.

Elise, subject two, is a seven-year-old female


with an IQ of 62 as measured by the Develop-mental Profile, Second Edition (DP-II). She iseasily distracted by her peers and surround-ings. She frequently leaves her seat, engagesthe teacher or her peers in conversation, andmanipulates classroom supplies. She requiresfrequent verbal prompts to stay on task, as wellas reinforcement for completing work.

Jose, subject three, is a seven-year-old malewith an IQ of 64 as measured by the PTI-II. Hefrequently zones out during independentwork time. He engages in conversations withpeers and questions the teacher. When given atask, he waits for individualized instructionbefore beginning the task. He requiresprompts to return to the task. He respondswell to verbal and visual reinforcement.

Design

A multiple baseline across subjects design wasused in this research. Baseline data were col-lected for at least five days for each subjectfollowed by the treatment and independentwork phases.

The dependent variable in this research wason-task behavior. On-task behavior was opera-tionally defined as engaging in a designatedacademic task for more than 180 consecutiveseconds. On-task behavior included staying inthe designated work area, using designatedwork utensils, and working independently.On-task behavior did not include leaving des-ignated work area, sitting in designated workarea idly, talking to other students or adults,engaging in self-stimulatory behavior, or en-gaging in destructive behavior. Frequencycount was used to collect data for off-task be-haviors during independent work sessions.The researcher kept track of the frequency ofoff-task behaviors, noting each occurrenceduring each session. Duration recording wasalso used to show the duration of each sub-ject’s independent work session. The re-searcher collected the start and completiontime for each subject’s independent work.

The independent variable in this researchwas the self-monitoring intervention program.This program incorporates the use of a visualcue to prompt subjects to self-monitor theirprogress on work completed during a desig-nated independent work time. Figure 1 showsan example of the visual prompt.

Reliability

Both the researcher and a paraprofessional inthe classroom collected data throughout thestudy. The paraprofessional in the classroomwas trained on the operational definitions oftarget behaviors and data collection methods.The researcher and paraprofessional simulta-neously collected data two days out of eachweek. Both observers collected data for 40%of total sessions. Total count inter-observeragreement between the two observers for thestudy was calculated at 96.9%.

The paraprofessional had a copy of the in-struction script and observed instruction dur-ing the instruction phase. As the researcherinstructed the subjects, the paraprofessionalverified that the researcher followed the ap-propriate steps necessary to effectively imple-ment the treatment thus maintaining fidelityto treatment.

Materials

The following materials were used to imple-ment the intervention. Subjects self-moni-tored progress on a self-monitoring chart (Fig-ure 1). The researcher used a script to instructsubjects during the treatment (Table 1). Avisual cue to self-monitor was placed on allindependent work. This cue was a one-inchpicture of a cartoon character, selected byeach subject individually in a multiple-stimu-lus procedure without replacement prefer-ence assessment. Sally and Elise selected aDora the Explorer cue. Jose selected aSpongeBob Squarepants cue. See an exampleof this cue on the self-monitoring chart inFigure 1.

Setting

The study was conducted in the subjects’ self-contained classroom, during regular schoolhours. Independent work sessions occurredevery day from 8:50 A.M.–9:10 A.M. Instruc-tion occurred from 10:15 A.M.–10:45 A.M.The class consisted of eight students in firstand second grades, one teacher, and two para-professionals. The researcher instructed thesestudents daily and knew each student’s indi-vidual needs and motivators.


Procedure

Baseline data were collected for at least fivesessions or until a stable trend was established.A stable trend was defined as an increase often or more off-task behavior occurrences in aminimum of three sessions. Following base-line, subjects were taught the self-monitoringintervention. The three subjects selected wereunable to begin an independent work taskand remain on-task for the duration of theindependent work session, which occurreddaily from 8:50 A.M.–9:10 A.M. Each subjectwas given the intervention of a visual cue toself-monitor during completion of indepen-dent work. In the study, subjects were shown avisual cue to self-monitor behavior during in-dependent work time. This cue was a one-inchpicture of either SpongeBob Squarepants orDora the Explorer. This visual cue appeared atthe end of a line of work.

Independent work varied by subject, but theformat was the same. Each worksheet had fivetasks to complete (count a set of items, findand circle a designated letter, count money,etc.) All work was at the independent or 95%

accuracy level of difficulty. Each subject’s workhad embedded visual cues to self-monitor,while working independently, at the end ofeach task. The visual cue, a one-inch cartoonpicture, was placed at the end of each line ofwork. The visual cue to self-monitor varied bysubject interest but in no other way. A multi-ple-stimulus procedure without replacementpreference assessment was given to each sub-ject to determine the most motivating cue(Leon & Iwata, 1996).

The first set of independent work had fivevisual cues, one after every line of work. Afterthe subjects successfully completed indepen-dent work for three consecutive sessions andimproved on-task behavior, they moved to thesecond set of independent work. This set hadthree visual cues, one after every other line.The following set of independent work hadtwo visual cues. In the final set of independentwork, one visual cue was found at the end ofthe worksheet.

Phase one of the intervention included in-struction. During instruction, the researcherused a script to instruct the subjects how to

Figure 1. Example of self-monitoring charts for Phases 1–4.


self-monitor. The researcher defined theterms self-monitoring and self-monitoringchart. The researcher instructed and modeledthe following procedure: complete a task onthe worksheet, identify the visual cue to self-monitor, take a sticker and place it on theself-monitoring chart, and complete the nexttask on the worksheet. All work and self-mon-itoring chart completion was to be done inde-pendently, without additional verbal cues.

The self-monitoring chart corresponded tothe subject’s visual cue and charted on-taskbehavior during independent work time bygradually indicating completion of work. Sub-jects paused from the independent work toadd a sticker for reinforcement to their indi-vidualized self-monitoring charts. This charttracked the subjects’ ability to remain on-taskwhile working independently. The researcherinstructed the subject to complete all tasks onthe worksheet and self-monitor using the vi-sual cue and self-monitoring chart until theself-monitoring chart was full of stickers. Achart full of stickers indicated the completionof the independent work. Following direct in-struction, the researcher and subject workedtogether to complete two tasks on the work-

sheet. Finally, the researcher watched the sub-ject complete two tasks on the worksheet in-dependently.

Following day one of instruction, each sub-ject was given an opportunity to complete in-dependent work using the self-monitoringstrategy. If the subject successfully completedthe independent work using the self-monitor-ing chart, (s)he did not receive further in-struction. If the subject did not successfullyand independently complete the work usingthe self-monitoring chart, the researcher in-structed the subject a second time.

Once the subject completed the indepen-dent work and self-monitoring chart, (s)heturned in the self-monitoring chart to theteacher. If the subject had successfully com-pleted the independent work and self-moni-toring chart, the subject received reinforce-ment specifically valuable to the student(computer time, coloring a picture, complet-ing a puzzle, etc.) Sally preferred computertime, Elise, blocks, and Jose, puzzles. Al-though each subject had reinforcement pref-erences, they were able to choose from amenu of reinforcers.

After three days of successful completion of

TABLE 1

Instruction Script

1. Tell: you are going to learn how to self-monitor while you work.2. Show: self-monitor visual cue.3. Tell: this picture (of Dora the Explorer/SpongeBob Squarepants) shows me that it is time to stop

working and self-monitor.4. Show: self-monitoring chart.5. Tell: when I self-monitor, I put a sticker on this chart.6. Tell: when you see Dora the Explorer/SpongeBob Squarepants, I stop working and put a sticker on my

chart.7. Tell: after I put a sticker on my chart, I go back to my work.8. Tell: watch me.9. Show: work on a problem.

10. Tell: I am doing my work.11. Show: see the self-monitor cue.12. Tell: I see Dora the Explorer/SpongeBob Squarepants. It is time to give myself a sticker.13. Show: stop work; take a sticker and place it on the self-monitoring chart.14. Tell: I am putting a sticker here because I have finished some work.15. Show: go back to the worksheet and start next problem.16. Tell: after I put a sticker on my chart, it is time to work.17. Tell: now let practice together.18. Walk through steps 10–17 with the student self-monitoring.19. Tell: now show me how you self-monitor.20. Watch student walk through steps 10–17 independently; prompt when necessary.


independent work using the self-monitoringchart, the subject advanced to phase two ofthe intervention. In phase two, the frequencyof visual cues decreased from five to three.After three days of successful completion inphase two, the subject advanced to phasethree of the intervention. In phase three, thefrequency of visual cues decreased from threeto two. Finally, after three days of successfulcompletion in phase three, the subject ad-vanced to phase four of the intervention. Inphase four, the frequency of visual cues de-creased from two to one. Each time a subjectmoved from one phase to another, the self-monitoring chart changed to correspond tothe number of cues on the independent work.When moving through the interventionphases, the third day of successful indepen-dent work completion could not occur on aMonday. It was unknown if the subject wouldeffectively remember the intervention aftertwo weekend days of not practicing. There-fore, if the third day of successful indepen-dent work completion occurred on a Monday,then the subject would complete independentwork at the same phase on Tuesday. If success-ful for a fourth day, the subject would advanceto the next phase.

Results

Figure 2 titled “Sally” displays data collectedover a six and a half week period for Sally,Elise, and Joe. Sally was taught the self-moni-toring intervention to use during indepen-dent work time. The graph displays both thefrequency of off-task behavior during inde-pendent work time and the amount of time ittook Sally to complete the independent work.During the first six days of baseline, Sally wasgiven independent work to complete duringthe independent work session, without anyfurther support or instruction. During instruc-tion, Sally was taught the self-monitoring strat-egy. The researcher taught her the interven-tion, they practiced the intervention together,and the researcher observed Sally attempt theintervention independently. After Sally dem-onstrated an understanding of the interven-tion, she began using the self-monitoringstrategy independently during the indepen-dent work session. During baseline, Sally aver-aged 5.6 occurrences of off-task behavior. Af-

ter learning the self-monitoring strategy, Sallyaveraged 1.1 occurrences of off-task behavior.At the beginning of intervention, Sally spentmore time completing independent workthan during baseline. After day 13 of thestudy, Sally’s completion time decreased bymore than four minutes.

Baseline data were collected for Elise for 11days. After the first day of instruction, Elisewas not able to accurately complete the self-monitoring chart. Therefore, she received asecond day of instruction. Following the sec-ond day of instruction, Elise was able to accu-rately use the self-monitoring strategy whilecompleting independent work. The re-searcher instructed Elise in the same way Sallywas instructed. During baseline, Elise aver-aged 7.5 occurrences of off-task behavior. Af-ter learning the self-monitoring strategy, Eliseaveraged 1.8 occurrences of off-task behavior.Throughout the duration of the study, Elise’scompletion time decreased by over four min-utes.

Baseline data were collected for Jose for 16days. The researcher followed the same pro-cedure in teaching Jose the self-monitoringstrategy as used with Sally and Elise. Duringbaseline, Jose averaged 5.3 occurrences of off-task behavior. After learning the self-monitor-ing strategy, Jose averaged .6 occurrences ofoff-task behavior. Throughout the duration ofthe study, Jose’s completion time decreased byover six minutes.

Within this study, the use of a self-monitor-ing strategy successfully decreased occur-rences of off-task behavior during indepen-dent work time. All three subjectsdemonstrated a decrease in occurrences ofoff-task behavior during independent worktime. Additionally, Elise and Jose spent lesstime working on independent work afterlearning the self-monitoring strategy. As Sallylearned the self-monitoring strategy, her com-pletion time increased, but as she familiarizedherself with the strategy, her completion timedecreased.

Discussion

The purpose of this study was to determinethe effect of a self-monitoring strategy on in-dependent work behavior. Specifically, thestudy investigated occurrences of off-task be-


havior and completion time of independentwork with three students, with identified MIDand IEPs with functional academic and behav-

ior goals. Results of the study indicate that aself-monitoring strategy, in which studentstrack progress while completing independent

Figure 2. Results for Sally, Elise, and Jose.


work, effectively decreased the occurrences ofoff-task behavior. Additionally, in all threesubjects, the intervention decreased indepen-dent work completion time.

Sally was enthusiastic to learn the self-mon-itoring strategy, specifically to use the self-monitoring chart while completing indepen-dent work. She quickly learned how to use thestrategy and effectively used it independentlyafter one day of instruction. Data collected onSally indicate that the self-monitoring strategyeffectively decreased the frequency of off-taskbehavior. Although not by a significantamount, the strategy decreased her comple-tion time. Using the self-monitoring strategyencouraged her to remain focused while com-pleting independent work. She took pride inmaintaining responsibility for her work.

During the first day of instruction, Elisequickly learned the self-monitoring strategy.She was able to demonstrate understanding ofthe strategy during the instruction session, butthen next day was not successful at imple-menting the strategy independently. There-fore, the researcher instructed her in a secondinstruction session. On the second day of us-ing the strategy during the independent worksession, she was able to successfully self-moni-tor independently. Data collected for Elise in-dicate that the self-monitoring strategy effec-tively decreased the frequency of off-taskbehavior. Additionally, the strategy decreasedher completion time. Elise celebrated to her-self each time she successfully self-monitoredduring independent work time. As she turnedin her independent work and self-monitoringchart, she would say aloud to herself, “You didit Elise” (or another similar phrase).

During baseline, Jose demonstrated a highfrequency of off-task behavior. He quicklylearned the self-monitoring strategy. He effec-tively used the strategy to self-monitor duringindependent work time the first day followinginstruction. Data collected for Jose indicatethat the self-monitoring strategy significantlydecreased the frequency of off-task behavior.Additionally, the strategy significantly de-creased his completion time. Jose quickly re-alized that the less time he spent on indepen-dent work, the more time he could spend witha self chosen reinforcement.

Implications for Education

Findings in this study suggest that the use of aself-monitoring strategy helps to decrease thefrequency of off-task behavior. These off-taskbehaviors include any behaviors irrelevant tothe academic task (Gickling & Armstrong,1978). Additionally, the strategy decreases thecompletion time of independent work. Thisstrategy incorporates specific and descriptiveinstruction, which enhances task completion(Bouxsein et al., 2008). The research foundthe self-monitoring strategy to work with earlyelementary students with identified MID.

Teaching students to self-manage behaviorgives students the responsibility of owningtheir behavior choices. This enhances the stu-dents’ independent functioning. Additionally,it enables further integration into the commu-nity at large (Hume & Odom, 2007; Selznick& Savage, 2000). As students self-manage, theygain confidence in their abilities both in theclassroom and community (Lapan et al.,2002).

This strategy could be taught to an entireclass. A teacher could implement this self-monitoring strategy in a classroom with mini-mal training (Ganz, 2008). An independentwork session in which students work on-taskfor the duration of the session would allow ateacher to work one-on-one with a student,assess an individual or small group, or workwith a small group of students for remedialinstruction, without interruption. Addition-ally, students could generalize this strategy toother academic tasks, as they complete workindependently or in small groups, during var-ious instruction times in a school day.

Based on the results of this study, whenstudents self-monitor behavior while complet-ing independent work, they have less frequentoccurrences of off-task behavior. When stu-dents have less frequent occurrences of off-task behavior, the teacher can spend less timeredirecting and instructing the whole groupof students. This provides the teacher moretime to work with other students, either one-on-one or in a small group, without interrup-tions.

Limitations

This study may have threats to both internaland external validity. Maturation is a potential


threat to internal validity. All three subjectsare in critical learning stages and physical andemotional maturation may have contributedto their on-task behavior improvement. Fur-ther research on older students with MID orother cognitive disability could eliminate thisthreat. Selection is another potential threat tointernal validity. Each subject was systemati-cally selected.

A potential threat to external validity is re-active arrangements, otherwise known as theHawthorne effect. The subjects were aware oftheir participation in the study. Therefore,this acknowledgement of participation mayhave affected their performance during inde-pendent work time, using the self-monitoringstrategy (Salkind, 2006).

Future Research

This study could be replicated on older stu-dents with identified MID, as well as studentswith other disabilities in both self-containedsettings and resource settings, as long as theirbehavior needs are similar to the subjects usedin this study. Future research may find thatsome populations of students need more cuesto self-monitor than other populations. Also,further research could determine this strate-gy’s effectiveness among various populationsof students and during various academic tasks.

Summary

This study examined the use of a self-monitor-ing strategy during independent work time,and its effect on on-task behavior and comple-tion time. A multiple-baseline across subjectsdesign was used for the three subjects whoparticipated in the study. Results of occur-rences of off-task behavior in three subjectswere analyzed to determine the effect of theintervention on on-task behavior. Examina-tion of the data provided results indicatingthat the use of a self-monitoring strategy dur-ing independent work time decreased bothoccurrences of off-task behavior and comple-tion time. After learning the self-monitoringstrategy, all three subjects were able to effec-tively implement the strategy during indepen-dent work sessions.

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Received: 14 December 2010Initial Acceptance: 1 March 2011Final Acceptance: 28 June 2011


Teaching Social Skills to Children with Autism Using the Coolversus Not Cool Procedure

Justin B. Leaf, Kathleen H. Tsuji, Brandy Griggs, Andrew Edwards,Mitchell Taubman, John McEachin, Ronald Leaf, and

Misty L. Oppenheim-LeafAutism Partnership and Behavior Therapy and Learning Center

Abstract: This study evaluated the effects of the cool versus not cool procedure for teaching three childrendiagnosed with an autism spectrum disorder eight social skills. The cool versus not cool procedure is a socialdiscrimination program used to increase children’s ability to display appropriate social behaviors. In this study,the cool versus not cool procedure consisted of the participants observing the researcher demonstrating a socialbehavior either appropriately or inappropriately, followed by the participants discriminating whether theresearcher demonstration was “cool” (appropriate) or “not cool” (inappropriate). For some social skills theparticipants role-played the social behavior following the researcher demonstration. Results indicated thatparticipants reached mastery criterion on 50% of targeted social skills with the researcher demonstration andon an additional 37.5% of targeted social skills with researcher demonstrations plus role-plays. Only oneparticipant on one social skill (12.5%) was unable to reach mastery criterion although performance increasedfrom baseline.

Several behavior interventions have been im-plemented to increase the social behavior ofchildren diagnosed with an autism spectrumdisorder (ASD). These interventions have in-cluded: video modeling (e.g., Apple, Bil-lingsley, & Schwartz, 2005, Charlop-Christy,Le, & Freeman, 2000), the teaching interac-tion procedure (e.g., Leaf et al., 2009; Leaf,Dotson, Oppenheim, Sheldon, & Sherman,2010), discrete trial teaching (e.g., Leaf &McEachin, 1999; Lovaas, 1981, 1987), socialstories (e.g., Theimann & Goldstein, 2001),and behavioral skills training (e.g., Stewart,Carr, & LeBlanc, 2007). Researchers haveshown that these interventions can not onlyimprove the social behavior of individuals di-agnosed with an autism spectrum disorder but

can also improve their overall quality of life(e.g., Bauminger & Kasari, 2000; Ladd, Birch,& Buhs, 1999; Stewart, Barnard, Pearson,Hasan, & O’Brien, 2006).

A common component of several of theabove mentioned social skills interventions isthe teacher demonstrating the appropriatebehavior for the learner and/or the learnerrole-playing the appropriate social behaviorwith the teacher. For example, in video-mod-eling, the learner watches a videotape of one-self, a peer, or the teacher demonstrating theappropriate social behavior prior to practicingthe social behavior with the teacher. Charlopand Milstein (1989) evaluated the effects ofvideo modeling for increasing conversationalscripts for three young children diagnosedwith autism. In this study, two adults modeledthe appropriate conversational scripts, thelearner watched a videotape of that model,and then the participant practiced the conver-sational scripts with the researcher. Charlopand Milstein utilized a multiple baseline de-sign across the three participants and withinparticipants across two different conversa-tional scripts, to evaluate the effects of thevideo-modeling procedure. Results of the

The researchers wish to thank Shelli Infield, JulieStiglich, and Cliff Anderson for their continuoushelp throughout the project. We also wish to thankthe staff of Autism Partnership, the families of Au-tism Partnership, and the children involved in thisstudy. Correspondence concerning this articleshould be addressed to Justin B. Leaf, Autism Part-nership, 200 Marina Drive, Seal Beach, CA 90740.E-mail: [email protected]


Cool versus Not Cool Procedure / 165

study indicated that all participants were ableto learn conversational scripts directly taughtto them, maintained the conversational scriptsduring maintenance probes conducted 15-months after intervention, and generalizedtheir conversational skills to different un-trained conversational scripts.

Teacher demonstration and participantrole-plays are also an important component ofbehavioral skills training (e.g., Stewart et al.,2007). In behavioral skills training the teacherlabels the social behavior, describes how toperform the task analyzed steps of the socialbehavior, then models the social behaviorprior to having the learner role-play the samebehavior, followed by positive feedback forcorrect modeling of the targeted behavior.Hanley, Heal, Tiger, and Ingvarsson (2007)evaluated a class-wide pre-school teaching pro-gram that used behavioral skills training todecrease problem behavior and increase pre-school life skills (e.g., responding to theirname) for 16 preschool children. The behav-ioral skills training consisted of the research-ers modeling the appropriate pre-school lifeskill to the participants and then the partici-pants demonstrating that skill. The research-ers utilized a multiple probe design to evalu-ate the program. Results indicated thatparticipants were able to reduce their prob-lem behaviors by 74% and were able to learnthe different preschool life skills that weredirectly taught to them.

The teaching interaction procedure is iden-tical to behavioral skills training except for theaddition of rationales. Rationales include rea-sons why the learner should engage in thesocial behavior and, sometimes, cues andcharacteristics for when the learner shouldengage in the social behavior. Like behavioralskills training, teacher demonstration androle-playing are a critical component of theteaching interaction procedure. Leaf and col-leagues (2010) implemented the teaching in-teraction procedure in a group setting for fiveyoung children diagnosed with ASD. In thisstudy, the researchers taught four differentsocial skills (i.e., showing appreciation, givinga compliment, making an empathetic state-ment, and changing the game) to each ofthe five participants. The researchers demon-strated appropriate and inappropriate exam-

ples of each of the four social skills within theteaching interaction. Following the teacherdemonstration, the researchers asked the par-ticipants to identify whether the social skillhad been modeled appropriately or inappro-priately and why the demonstration was ap-propriate or inappropriate. Next, the partici-pants had the opportunity to role-play thesocial skill the appropriate way. Leaf and col-leagues utilized a multiple probe design acrossskills and replicated across participants; theresults showed that participants were able tolearn and generalize the four social skillstaught to them with the teaching interactionprocedure.

Another procedure that utilizes teacherdemonstration and can include participantrole-play is the cool versus not cool procedure(Taubman, Leaf, & McEachin, 2011). Thecool versus not cool procedure is a social dis-crimination program used to teach childrenand adolescents to discriminate between ap-propriate (“cool”) and inappropriate (“notcool”) social behaviors. During the cool versusnot cool procedure a teacher demonstrateseither a socially appropriate behavior (e.g.,raising hand to gain teacher’s attention) or asocially inappropriate behavior (e.g., yellingout to gain teacher’s attention) and asks thelearner to state whether the demonstrated be-havior was “cool” (socially appropriate) or“not cool” (socially inappropriate). This is fol-lowed by the teacher asking the learner whythat demonstration was “cool” or “not cool”and the teacher providing feedback to thelearner for correct discrimination. After theteacher is done demonstrating the social skill,the learner typically has the opportunity torole-play the social skill appropriately followedby the teacher providing feedback for correctlyrole-playing the targeted social behavior.

Although the cool versus not cool proce-dure is similar to the above described behav-ioral interventions, there are variations. Thecool versus not cool procedure varies frombehavioral skills training and the teaching in-teraction procedure in that it does not pro-vide a description of the behavior, a rationaleof why the learner should engage in the be-havior, and does not provide cues and char-acteristics about when the learner should dis-play the appropriate social behavior. The coolversus not cool procedure varies from prior


research on video modeling in that all dem-onstrations are done in vivo, and that coolversus not cool involves discrimination train-ing and not merely the modeling of appropri-ate alternatives.

The cool versus not cool procedure hasbeen clinically implemented with numerouschildren and adolescents diagnosed with ASD(Taubman et al., 2011); however, to date,there has been no empirical investigation onits effectiveness. Additionally, it is not knownhow effective the cool versus not cool proce-dure would be with just the teacher demon-stration alone, without the addition of thelearner role-play. The purpose of the currentstudy was twofold: (1) to conduct the firstempirical evaluation of the cool versus notcool discrimination procedure to children di-agnosed with ASD and (2) to evaluate if chil-dren can learn a variety of social skills utilizingthe cool versus not cool discrimination proce-dure alone or if it would additionally requireimplementation of role-play for the partici-pants to learn the various social skills.

Method

Participants

Dante was a 9-year-old boy diagnosed withAutistic Disorder. Dante had a Wechsler Intel-ligence Scale for Children IV (WISC IV) In-telligence Quotient (IQ) score of 80, aVineland Adaptive Composite Behavior Scoreof 90, a Social Skills Rating Score-Parent(SSRS-P) standard score of 116 (82nd percen-tile), and a Social Skills Rating Score-Teacher(SSRS-T) standard score of 105 (63rd percen-tile). Dante received 30 hours of behavioralintervention per week which included sup-porting him in his general education class-room.

Marc was an 8-year-old boy diagnosed withAutistic Disorder. Marc had a WISC IV Full IQScore of 127, a Vineland Adaptive Score of105, a Social Skills Improvement System(SSiS) Rating Scale (Parent) standard score of93 (30th percentile), and a SSiS-Teacher stan-dard score of 81 (10th percentile). Marc re-ceived 8.5 hours of behavioral intervention aweek and attended general education class-room with supports.

Donald was a 4-year-old boy diagnosed with

Autistic Disorder. Donald had a Wechsler Pre-school and Primary Scales of Intelligence-Third Edition Full Scale IQ score of 88, aVineland Adaptive Score of 77, a SSRS-P stan-dard score of 104 (61st percentile), and aSSRS-T stand score of 102 (55th percentile).Donald received 35 hours of behavioral inter-vention per week and attended a general ed-ucation classroom with supports.

Setting

The researchers conducted all research ses-sions in a room at a private behavioral agen-cy’s clinic in Southern California. The agencyprovides behavior intervention services tochildren and adolescents diagnosed withASD. The room contained toys, chairs, andother educational materials. Participants par-ticipated in research anywhere from one tofive days per week. Each experimental sessionlasted approximately 60 min including probesand teaching.

Skills Taught

The researchers identified areas of social def-icit for each participant by asking the partici-pant’s clinical supervisor what social skillsneeded to be taught and through direct ob-servations of the participant. The researchersidentified two to three targets for each partic-ipant and either task analyzed the social skillsinto smaller behavioral components or oper-ationally defined the skills. Table 1 providesinformation for each of the social skills taughtto the three participants.

Measurement

The researchers measured each of the eightsocial skills during naturalistic probes. Duringnaturalistic probes, the researchers simply en-gaged in a behavior that set the occasion forthe participant to display one of the targetsocial skills. For example, when measuring thesocial skill of changing the conversation whena person gets bored the researcher and par-ticipant would engage in a conversation and atsome point the researcher would appear to bebored (e.g., looking away or looking at his orher watch) and see if the participant wouldchange the conversation. The researchers did


not prime, prompt, reinforce, or provide con-sequences to the participants during natural-istic probes.

For the social skills that were task analyzed(i.e., interrupting appropriately, joint atten-tion, changing the conversation, abductionavoidance, and changing the game), the par-ticipants had one opportunity to display thesocial skill per naturalistic probe. During thenaturalistic probe, the researchers recordedwhether the participant engaged or did notengage in each of the components of the taskanalysis for each skill.

For the social skill of appropriate greetings,Dante had five different opportunities to dis-play the social skill during the naturalisticprobe. During each one of these opportuni-ties the researchers scored if Dante displayedthe skill correctly or incorrectly. For Donald’starget of maintaining eye contact, a 10 s mo-mentary time sampling procedure was imple-mented. During this probe the researcher en-gaged in a two-minute conversation and at theend of each 10 s interval the researcher scoredif Donald was making eye contact. The re-

searchers set mastery criterion for each of thesocial skills at 80% or above of the behavioralsteps, opportunities, or intervals for three con-secutive naturalistic probes.

Experimental Design and General Procedure

To evaluate the effectiveness of the cool versusnot cool procedure, the researchers imple-mented a multiple baseline design across so-cial skills and replicated it across participants.The research consisted of four distinct phases:an initial baseline, intervention, maintenance,and a booster session condition.

Initial baseline condition. An initial baselinecondition occurred prior to the teaching ofany of the social skills for each participant.Each session in this condition began with theresearcher implementing naturalistic probesfor each of the social skills. The order of thenaturalistic probes was randomly determinedahead of time. After all naturalistic probeswere conducted, the participant resumed on-going activity in his regular setting; an hourlater the researcher pulled the participant out

TABLE 1.

Skills Taught

Participant Skill Taught Operational Definition

Dante Interrupting Wait for a break, say excuse me, state person’s name, say sorry forinterrupting, state what they needed to say, and walk away.

Changing the game Asked to play a different game when the other person looked bored, askedthe person what new game they wanted to play, agreed to play it, got thematerials needed, play the game, and refrain from any negative or rudecomments.

Appropriategreetings

Made a general greeting statement, stated the person’s name, and asked apersonal inquiring question.

Marc Interrupting Wait for a break, say excuse me, state person’s name, say sorry forinterrupting, state what they needed to say, and walk away.

Joint attention Stop engaging in preferred activity, look towards the person who made thecomment, look in the direction the comment is being direct too, make apositive comment about what the other person was doing.

Changing theconversation

Changed the topic when the other person looked bored by making acomment about a different topic, wait for the person to respond, make asecond comment about the new topic, wait for the person to respond.

Donald Abductionprevention

Say no to the strangers request to go with them, make a statement thatthey do not know the person, did not follow the stranger, restate theywill not go with the stranger, walk away from the stranger, tell theteacher about what just occurred.

Eye contact The participant looked at the conversational partner in the eye or face atthe 10 second interval.


of his regular setting and probed all of thesocial skills again.

Intervention condition. During the interven-tion condition, the researchers taught one ofthe social skills while the other two social skillswere either in the baseline or maintenancecondition. Each research session began withthe researcher implementing naturalisticprobes for the social skill that was in the in-tervention condition, the social skill(s) in thebaseline condition, and during some researchsessions the social skill(s) that were in main-tenance. The order of the naturalistic probeswas randomly determined ahead of time. Ashort break (5 to 30 min) followed the natu-ralistic probes. After the break, the researcherimplemented the cool versus not cool proce-dure (described below) for the skill currentlyin intervention. Following the implementa-tion of the cool versus not cool procedure, theresearcher placed the participant back in hisregular setting. During most days, at least anhour after the cool versus not cool procedurewas implemented, the researcher again pulledthe participant out of his regular setting andimplemented naturalistic probes for the skillin the intervention condition, the skills in thebaseline condition, and, during some re-search sessions, skill(s) that were in mainte-nance. The second set of naturalistic probeswas occasionally not conducted due to dailyscheduling issues.

Maintenance condition. Once a participantreached mastery criterion on a given socialskill the researchers placed that social skillinto maintenance. Once a skill was put onmaintenance the researchers randomlyprobed the skill during various research ses-sions and the skill did not receive furtherintervention.

Booster session condition. The researchersimplemented booster sessions for targetedskills that participants had reached masterycriterion during teaching or were displayingan average accuracy of 50% or less duringmaintenance. These skills were then placed inthe booster condition. During booster ses-sions the researchers implemented naturalis-tic probes for each of the skills placed in thebooster condition. If the participant displayedthe social skill correctly during the naturalisticprobe the researchers provided social praiseto the participant. If the participant displayed

the social skill incorrectly during the natural-istic probe the researchers provided correctivefeedback and implemented the cool versusnot cool procedure.

Teaching Procedures

Cool versus not cool discrimination procedure(teacher demonstration only). The teaching pro-cedure consisted of six total teaching trials(three trials of the appropriate behavior andthree trials of the inappropriate behavior).The order of each trial was randomly deter-mined ahead of time. A trial began with theresearcher demonstrating either the appropri-ate behavior or the inappropriate behavior.For example, if the researcher was demon-strating the appropriate version of changingthe conversation when someone is bored, theresearcher would talk to another teacherabout a certain topic (e.g., shopping) andonce that other teacher appeared bored (e.g.,sighing, looking away, looking at his or herwatch) the researcher would make a state-ment or ask a question about another unre-lated topic (e.g., baseball). If, however, theresearcher was demonstrating the inappropri-ate version, the researcher would continuetalking about the original topic (e.g., shop-ping) even after the other teacher gave a sig-nal (e.g., sighing, looking away, looking at hisor her watch) that he or she was bored.

After the researcher demonstrated the be-havior she asked the participant if the demon-stration was “cool” (appropriate) or “not cool”(not appropriate). If the participant answeredcorrectly the researcher provided socialpraise; however, if the participant answeredincorrectly the researcher provided correctivefeedback. Next, the researcher asked the par-ticipant why the demonstration was either“cool” or “not cool.” If the participant an-swered correctly the researcher providedpraise to the participant. If, however, the par-ticipant answered incorrectly the teacher pro-vided corrective feedback and told the partic-ipant why the demonstration was appropriateor inappropriate.

Cool versus not cool procedure (teacher demon-stration plus participant role-play). If after 10naturalistic probes the participant had notreached mastery criterion or did not have ascore of 80% or above on the 10th naturalistic


probe, the researchers implemented the coolversus not cool discrimination procedure plusrole-playing. This phase was identical to thecool versus not cool procedure (describedabove) with one major addition, the partici-pant role-playing the appropriate social be-havior. After the six trials of researcher dem-onstration the participant role-played thesocial behavior. The role-plays consisted of theresearcher telling the participant that it washis turn to practice the skill the “cool” way.Next, the researcher would engage in a behav-ior that set the occasion for the participant todisplay the social skill (similar to naturalisticprobes). After the participant role-played thebehavior the researcher asked the participantif they displayed the skill “cool” or “not cool”and why the performance was “cool” or “notcool.” If the participant role-played and an-swered the questions correctly, the researcherprovided social praise. If the participant role-played incorrectly but answered the questionscorrectly, the researcher praised the partici-pant for answering the questions correctly buthad the participant role-play the behavioragain. If the participant role-played incor-rectly and answered the questions incorrectlythe researcher provided corrective feedbackand provided further explanation on why thedemonstration was “cool” or “not cool.” Par-ticipants role-played until they were able tocorrectly role-play the behavior on two consec-utive trials. Participants were never asked torole play an inappropriate version.

Reliability and Treatment Fidelity

The researcher scored participant behaviorduring all research sessions. A second re-searcher independently scored participant be-haviors via videotape on 26% of naturalisticprobes across the eight social skills. Interob-server agreement was calculated by totalingthe number of times observers agreed on thescoring of each skill step or occurrence of thebehavior divided by the total number of agree-ments and disagreements on scoring eachskill step or occurrence of the behavior. Thiswas converted to a percentage of agreementper each skill. Percentage agreement acrossall naturalistic probes was 96% (range, 71–100%).

To assess treatment fidelity, an independent

observer recorded planned researcher behav-iors during 25% of time when the researcherwas implementing the teaching procedure.Planned researcher behaviors during the coolversus not cool procedure were the teacher:(a) demonstrating the behavior appropriatelyfor three trials; (b) demonstrating the behav-ior inappropriately for three trials; (c) havingthe participant state whether the demonstra-tion was “cool” or “not cool” during every trial;(d) having the participant state why the be-havior was “cool” or “not cool”; and (e) havingthe participant role-play the social behaviorwhen applicable. The independent observerscored that the researchers implemented theprocedure correctly 100% of the time.

Results

Across the three participants a total of eightsocial skills were taught with the cool versusnot cool procedure. Across the three partici-pants, mastery criterion (i.e., 80% correct dur-ing three consecutive naturalistic probe ses-sions) was reached for 50% of the skills taughtusing the cool versus not cool procedure withteacher demonstration only and 37.5% of thesocial skills using the cool versus not coolprocedure with role-plays. Only one socialskill, for one participant, did not reach mas-tery criterion. Figures 1 to 3 show these re-sults.

Dante reached mastery criterion for two so-cial skills (i.e., interrupting appropriately andchanging the game when someone was bored)with the cool versus not cool discriminationprocedure alone and reached mastery crite-rion for one social skill (appropriate greet-ings) using the discrimination procedure plusrole-plays (see Figure 1). Prior to intervention,Dante displayed an average of 0%, 0%, and5.3% for interrupting appropriately, changingthe game when someone was bored, andgreetings, respectively. Dante reached masterycriterion in 11 naturalistic probes, 3 naturalis-tic probes, and 24 naturalistic probes for in-terrupting appropriately, changing the gamewhen someone was bored, and greetings, re-spectively. During the assessment of mainte-nance on naturalistic probes, Dante main-tained an average of 21%, 85%, and 60% ofsteps for interrupting, changing the game,and greetings, respectively. Since Dante’s


maintenance of interrupting appropriatelywas below 50%, a booster condition was im-plemented.

Marc reached mastery criterion for onesocial skill, interrupting appropriately, withthe cool versus not cool discrimination pro-cedure alone and reached mastery criterionfor two skills, joint attention and changingthe conversation when someone was bored,using the discrimination procedure plusrole-plays (see Figure 2). Prior to interven-tion, Marc displayed an average of 0%, 5%,and 2% for interrupting appropriately, joint

attention, and changing the conversationwhen someone was bored, respectively. Marcreached mastery criterion in 13 naturalisticprobes, 25 naturalistic probes, and 15 natu-ralistic probes for interrupting appropri-ately, joint attention, and changing the con-versation when bored, respectively. Duringthe assessment of maintenance on natural-istic probes, Marc correctly performed anaverage of 50%, 75%, and 100% of steps forinterrupting, joint attention, and changingthe conversation when someone was bored,respectively. Since no skill dropped below

Figure 1. Skills Taught to Dante.


50% the booster condition was not imple-mented for Marc.

Donald reached mastery criterion for onesocial skill, abduction avoidance, with the coolversus not cool discrimination procedurealone and did not reach mastery criterion forthe other social skill, eye contact, even afterthe role-playing was implemented (see Figure3). Although Donald did not reach masterycriterion for eye contact, he did increase his

ability to display eye contact during naturalis-tic probes from an average of 18.7% duringbaseline to an average of 31% and 57.5% dur-ing the cool versus not cool discriminationprocedure alone and the cool versus not cooldiscrimination procedure plus role-plays, re-spectively. Prior to intervention, Donald dis-played an average of 0% for abduction avoid-ance. Donald reached mastery criterion in 12naturalistic probes for that skill. During the

Figure 2. Skills Taught to Marc.


assessment of maintenance, on naturalisticprobes, Donald maintained 72% and 63% ofsteps for abduction avoidance and eye contactrespectively. Since the mastered skill did notfall below 50% during maintenance, thebooster condition was not implemented forDonald.

Discussion

Results of this study indicated that partici-pants were able to reach mastery criterion onfour out of eight social skills with the coolversus not cool procedure. Participants re-quired role-playing to reach mastery criterionfor an additional three social skills targets, oneparticipant, Donald, was unable to reach mas-tery criterion on one of his targets, even afterrole-playing was implemented. Thus, partici-pants reached mastery criterion on 50% of the

targeted social skills with the cool versus notcool procedure alone and participantsreached mastery criterion on an additional37.5% of social skills with the addition of role-playing.

Results of the study have several implica-tions pertaining to instruction in the socialarea for children with ASD. Results of thestudy indicate that the cool versus not coolprocedure may be an effective procedurewhen teaching social discrimination to chil-dren with ASD. The three social skills targets(i.e., interrupting, abduction prevention, andchanging the game) that did reach masterycriterion with the cool versus not cool discrim-ination procedure alone were targets that re-quired the participants to merely make a so-cial discrimination such as “Is this person astranger?”, “Is this person bored?”, or “Is thisan appropriate time to interrupt?” as opposed

Figure 3. Skills Taught to Donald.


to learning multi-step social interaction skills.Conversely, with the majority of those skillsthat did require multi-step interactional com-petencies (e.g. greetings and joint attention),the study illustrated that the combination coolversus not cool and role play procedure maybe effective for teaching those skills.

Despite the positive findings in this studythere were still limitations. One limitation ofthis study is the time it took participants toreach mastery criterion. Across all eight socialskills it took participants a range of 3 to 24probes to reach mastery criterion. However,conducting probes twice during a researchsession resulted in numerous probes beingconducted prior to a skill reaching masteryand fewer teaching sessions being conducted.Additionally, the cool versus not cool proce-dure does fall in the range of efficiency ofseveral other commonly implemented socialskills interventions including: the teaching in-teraction procedure (e.g., Leaf et al., 2009,2010), social stories (Kokina & Kern, 2010),and script fading (e.g., Stevenson, Krantz, &McClannahan, 2000).

A second limitation of this study is that oneparticipant did not reach mastery criterion onone of his skills. Although this participant didnot reach mastery criterion on one skill, this isalso seen in other behavioral interventions(e.g., social stories and the teaching interac-tion procedure) (e.g., Kokina & Kern, 2010;Leaf et al., 2010). Future researchers shouldcontinue to evaluate the cool versus not coolprocedure to determine the parameters of itseffectiveness.

Even with the limitations of the currentstudy there are several reasons why cliniciansmay choose to implement the cool versus notcool procedure. For one, the cool versus notcool procedure provides the learner the op-portunity to observe both a correct demon-stration and incorrect demonstration of thedesired social skill. Having the learner observethe teacher demonstrating such contrastingalternatives may be beneficial as it allows thelearner to view how he or she should displaythe desired behavior and how he or she maybe displaying the social skill. This can be veryhelpful when the learner is not displaying thesubtle nuances of a social skill.

A second reason why clinicians may chooseto implement cool versus not cool is the flex-

ibility of the procedure. In this study the re-searchers implemented the cool versus notcool with teacher demonstration alone forsome skills and both teacher demonstrationand participant role-play for other social skills;these are only two ways that the procedure canbe implemented. Clinicians can implementthe procedure as a matching program, a re-ceptive program, or by having peers demon-strate the behavior.

A third reason why clinicians may choose toimplement the cool versus not cool procedureis that it requires little to no materials to set upprior to teaching, unlike social stories, whichrequire the clinician to write a story and createa book prior to intervention, or video-model-ing, which requires the clinician to create vid-eotapes prior to intervention. Though cer-tainly involving planning, the cool versus notcool procedure does not requires such exten-sive material development prior to teaching.Therefore, clinicians can implement the coolversus not cool procedure spontaneously.

Finally, clinicians can implement the coolversus not cool procedure prior to using otherbehavioral interventions (e.g., the teaching in-teraction procedure, video modeling, behav-ioral skills training) for social skills that needto be taught. If the skill entails a straightfor-ward social discrimination, then there may beno need to implement the more labor inten-sive procedures. If, however, the learner is notable to learn the skill with just the cool versusnot cool procedure, for example, with a multi-step interactional skill, then the cool versusnot cool procedure may help expedite learn-ing with the other behavioral interventions.Future researchers should evaluate whetherimplementation of the cool versus not coolprocedure prior to the implementation ofother behavioral interventions accelerateslearning. Research should also examine if thecool versus not cool procedure alone is effec-tive in addressing social skill needs beyondsocial discriminations.

This study found that the cool versus notcool procedure alone and in combinationwith role play was an effective intervention forimproving the social behaviors of three youngchildren diagnosed with ASD. Future re-searchers should continue to evaluate thisprocedure to determine how effective it is forother children and adolescents diagnosed


with ASD, how effective it is when imple-mented in various instructional formats, theuse of the combined demonstration and roleplay procedures with social interactional skillsof a complexity greater than those examinedin this study, and how effective, efficient, andpreferred cool versus not cool is when com-pared to other commonly implemented socialskills interventions (e.g., social stories, videomodeling, script fading). In doing so clini-cians may have a new effective procedure toimplement when teaching social skills to chil-dren and adolescents diagnosed with ASD.

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The Picture Exchange Communication System (PECS): APromising Method for Improving Communication Skills of

Learners with Autism Spectrum Disorders

Jennifer B. GanzTexas A&M University

Richard L. SimpsonUniversity of Kansas

Emily M. LundTexas A&M University

Abstract: Children and youth with autism spectrum disorders (ASD) and other developmental delays frequentlyexperience deficits in functional communication. Identifying and using suitable communication enhancementand augmentative and alternative communication supports is essential to achievement of positive outcomes forthese learners. This article discusses the use of the Picture Exchange Communication System (PECS), acommonly used and utilitarian AAC system for children and youth who lack sufficient functional communi-cation skills. Particular attention is given to practitioners’ use of this promising tool.

The Picture Exchange Communication Sys-tem (PECS; Frost & Bondy, 1994, 2002) is anicon-based form of augmentative and alterna-tive communication (AAC). While the systemis appropriate for use with a variety of individ-uals with communication deficits and disor-ders, it has most commonly been used withchildren with autism spectrum disorders(ASD; Magiati & Howlin, 2003; Tincani, Cro-zier, & Alazetta, 2006). PECS was developed in1986 by Bondy and Frost and is currently mar-keted and hosted by Pyramid EducationalConsultants, Inc. Since its development, PECShas received considerable attention in peer-reviewed literature and has generally beenshown to be relatively useful promising prac-tice in promoting functional communicationin individuals with moderate to severe disabil-ities (Flippin, Reszak, & Watson, 2010).

Description of PECS Materials

One attractive feature of PECS is that it re-quires relatively few materials, all of which can

be created or obtained at relatively low cost(Ogletree, Oren, & Fischer, 2007). As thename implies, a key feature of PECS is thepicture cards, which contain pictures, also re-ferred to as icons, that represent objects (e.g.,ball, computer, cookie), people (e.g., Mom,Dad), or activities (e.g., hug, draw). The iconscan be made using a computer graphics pro-gram or actual photographs and should befastened with Velcro® on the back. This willallow the icons to be stored on a Velcro®communication picture board or book, fromwhich the child will be able to select the iconsof appropriate or desired items, people, oractivities. Additionally, PECS materials in-clude several sentence stems (e.g., “I HEAR,”“I SEE,” “I WANT”), which can be combinedwith icons to form phrases and sentences inlater stages of training and should also beaffixed to the communication picture boardor book with Velcro®.

PECS’ format has several advantages (Ogle-tree et. al, 2007; Yoder & Stone, 2006). Be-cause PECS requires few materials, the systemcan easily travel with the child to multiplelocations, thus increasing the potential fortraining and generalization across multiplesettings. Also, icons can easily be created tocorrespond to items in the user’s environ-ment, allowing for specific tailoring to his or

Correspondence concerning this article shouldbe addressed to Jennifer Ganz: Texas A&M Univer-sity, Department of Educational Psychology, 4225TAMU, College Station, TX 77843-4225. Email:[email protected]



her settings or preferences. Finally, the “low-tech” nature of the PECS materials eliminatesthe issues of technological failure and greatlyreduces the probability and cost of the mate-rials being damaged or lost.

Credentials and Training for PECS Trainers

Official PECS training workshops are offeredby Pyramid Educational Consultants, Inc.(http://www.pecsusa.com/training.php), in-cluding basic and advanced levels. Basic train-ing is designed for individuals seeking certifi-cation as a “PECS Certified Implementer,”allowing them to implement the PECS inter-vention with an assured level of competency.Within two years of attending a basic PECSworkshop, the prospective implementer mustsubmit evidence of competency in the areasof: (a) implementation of PECS in each of thesix phases, (b) error correction, (c) imple-mentation of PECS during functional activi-ties, (d) writing PECS instructional lessons forclients, (e) data collection within the phasesof PECS, and (f) writing summaries of PECSimplementation. Practitioners must also pass awritten exam covering accurate PECS prac-tice. After passing the exam and demonstrat-ing competency in all six areas, individuals aregranted certification, renewable every threeyears.

Advanced PECS implementers may chose topursue PECS supervisor training through Pyr-amid Educational Consultants, Inc. (http://www.pecsusa.com/training.php). Accordingto the company, this training is reserved forexperienced implementers who have not onlyshown knowledge and skills in implementingPECS properly in all six phases but have alsodemonstrated the ability to critique PECS in-structors in a positive and constructive man-ner. Individuals who qualify as PECS supervi-sors may not offer PECS training workshops orother formal training but may advise and cri-tique co-workers who have undergone basicPECS implementation training on best imple-mentation practices for PECS and may offerbasic information on PECS to other profes-sionals.

Suitability for PECS

PECS is designed for people who lack an ef-fective system of functional communication

(Frost & Bondy, 2002). It is typically notneeded or used by individuals who have highverbal functioning, such as those withAsperger syndrome or high functioning au-tism (Simpson & Myles, 2011). While peoplewith higher functioning variants of ASD, suchas Asperger syndrome, have communicationand language difficulties, such as understand-ing metaphors or figures of speech, or havedifficulties mastering the social aspects ofcommunication, their communication deficitsare usually not severe enough to require PECSor other AAC systems and are most effectivelyaddressed through other types of intervention(Wetherby & Prizant, 2005).

Assessing suitability. Pyramid EducationalConsultants, Inc. does not publish an officialmeasure to assess suitability for PECS butbroadly states that the system may be usefulfor individuals who (a) lack a method of func-tional communication that allows them to ad-equately express their needs and wants, (b)have trouble making their communication un-derstood by others, (c) have a functional com-munication system that is not adequate in itsability to convey needs and wants, or (d) lacka communication system that allows spontane-ous expressive communication across a varietyof settings (http://www.pecsusa.com). It isclear that relatively little is known about stu-dent characteristics that make them the bestcandidates for PECS. However, a recent reviewof PECS methodology and outcomes by Flip-pin and colleagues (2010) suggested that chil-dren who have relatively poor joint attention(e.g., have difficulty sharing interest in an ob-ject with another person) and relatively stronginterest and tendencies to search out and ex-plore a variety of objects in their environmentbut relatively limited motor imitation skillshave the best outcomes relative to PECS use.

Additionally, existing measures that assessfunctional communication may be usefulwhen determining an individual’s suitabilityfor PECS. These supplemental measures caneither be part of a formal, structured evalua-tion or informal assessments, such as parent-or proxy-report checklists. Informal evalua-tion measures may include the Assessment ofSocial and Communication Skills for Children withAutism (Quill, Bracken, & Fair, 2000) or VerbalBehavior Milestones Assessment and Placement Pro-gram (VB–MAPP; Sundberg, 2008). Examples

Picture Exchange Communication System / 177

of more formal, complex assessment includethe Test of Early Language Development (Hresko,Reid, & Hammill, 1999) and the Brigance Di-agnostic Inventory of Early Development (Brig-ance, 2004). The primary purpose of thesemeasures in relation to PECS is to determineif the child in question would benefit from anAAC system to improve functional communi-cation and should be interpreted with profes-sional judgment, combining assessment re-sults with observation (Flippin et al., 2010;Ogletree, 2008; Ogletree et al., 2007; Yoder &Stone, 2006).

As the name implies, PECS is a visual formof AAC. The visual nature of PECS may bebeneficial when working with children withASD, as there is some evidence that people onthe autism spectrum may be highly visuallearners (Schopler, Mesibov & Hearsey,1995). Accordingly, visually-based AAC sys-tems are often seen as the most effective andpreferred choice when working with individu-als with ASD (Mirenda, 2001; National Re-search Council, 2001). PECS symbols are bothconcrete and static in nature, appealing to thecommon preference of individuals with ASDfor consistent, explicit objects and ideas (He-flin & Alaimo, 2007; Ogletree, 2008). Mosticons have a one-to-one correspondence withan object, person, or activity, thus reducingconfusion common to many forms of commu-nication wherein abstract interpretations andvariable meanings exist. Furthermore, theicons themselves are consistent in appearanceand meaning, further reducing linguistic am-biguity and allowing for recognition instead ofrecall (Heflin & Alaimo).

Considerations regarding multiple disabilities.While the visual nature of PECS presents sev-eral advantages relative to use with individualswith ASD, the visual focus of PECS may makeit a poor choice for people with both ASD andblindness or severe low vision, unless modifi-cations are made (Lund & Troha, 2008).PECS has been used effectively with a blindclinician through the addition of Braille tagsto the picture cards (Charlop, Malmberg, &Berquist, 2008). Of course such a modifica-tion with a blind or low vision PECS-userwould require that the user read and compre-hend Braille.

Lund and Troha (2008) investigated theuse of PECS with three adolescents with both

autism and severe visual impairment or blind-ness. Tactile symbols were used as an accom-modation, and verbal prompts, which are nottypically used in PECS training, were appliedif the communication partner deemed themnecessary. All three participants showed vary-ing degrees of increased functional communi-cation with PECS over the course of the inter-vention. Only one of the participants was ableto show proficiency—defined as correct inde-pendent response rate of 80% or higher intwo separate trials—at each of the first threestages of PECS. Lund and Troha speculatedthat this may be due to the time-limited natureof the study—each participant received only30 sessions of PECS—and noted that the par-ticipants’ rates of improvement were similar tothose seen in children without co-occurringvisual impairment. It appears the use of tactilesymbols may be an effective way to modifyPECS for use by those with co-occurring ASDand severe visual impairments.

PECS also requires some degree of profi-cient motor functioning (Bondy & Frost,1994; Frost & Bondy, 1994). The user must beable to pick up, carry, and hand the icon cardsas needed. In later stages of training, the usermust be able to align icons and sentence stemsclosely enough to demonstrate their associa-tion (e.g., show that the “I SEE” sentencestring and the “ball” icon are connected). Ifnecessary, modifications, such as creatinglarger or thicker icons and sentence stems,can be made to increase the ease of use forchildren with limited fine and gross motorfunction due to physical impairments or mus-cle weakness (Bondy & Frost). PECS may be aviable alternative for individuals who lack thefine motor coordination necessary for signlanguage or typing-based AAC systems (Ogle-tree & Oren, 2006).

The highly visual nature of PECS also makesit good choice for individuals with ASD andco-occurring hearing impairment or Deafness(Tincani, 2004). Furthermore, PECS attemptsto model natural language developmentthrough the use of icons and thus does notassume or require the capacity for expressivespoken language (Bondy & Frost, 2001). Ad-ditionally, PECS can be used in conjunctionwith American Sign Language or anothersigning system or spoken language, depend-ing on the needs, abilities, and preferences of


the user and his or her support system (Tin-cani).

Considerations for English Language Learners.Relatively little research has been conductedregarding special education and AAC for chil-dren who are also English Language Learners(ELL; Simpson & Ganz, in press). However,current recommendations for the generalpopulation of ELL students hold that educa-tion should involve both English and thechild’s first or familial language, if possible,with a preferred emphasis on the languagespoken at home (Donovan & Cross, 2002).

PECS may be a particularly useful AAC sys-tem to use with this population, as the visualnature of the icons transcends language bar-riers (Simpson & Ganz, in press). Thus, achild from a Spanish-language home who hasbeen trained in PECS could use the same setof icons with his or her English-speakingteacher at school and with his or her parentsat home. Words and phrases may be translatedinto both languages, perhaps allowing thechild to use one set at home and another set atschool. If verbal prompts are used, theprompts could be given in both languagesuntil the user is able to respond appropriatelyto prompts in both languages. Alternately, theparents or teacher may decide to pursue train-ing in only one language for the sake of sim-plicity (Simpson & Ganz). Given both the lackof literature on this topic and the highly per-sonal nature of linguistic identity, the decisionof what language or languages to use for ver-bal prompts or icons should be mutually de-cided by the parents and trainers prior to thestart of PECS training.

Use of PECS with adolescents. A vast majorityof the existent studies of PECS have focusedon young children, as they are more likely tolack an established AAC system and be receiv-ing intensive intervention services (Lancioniet al., 2007). However, older children andadolescents who lack adequate functionalcommunication skills, whether verbal or withanother form of ACC, may still benefit fromPECS training (Simpson & Ganz, in press).Functional communication is vital in increas-ing an individual’s ability to live indepen-dently, and a lack of functional communica-tion skills may increase the rate of challengingbehaviors, thus impacting the individual’sability to gain and maintain employment and

participate in other independent living tasks(Koegel, Koegel, Shoshan, & McNerney, 1999;Prizant, Wetherby, & Rydell, 2000). Thus,PECS would have high social validity if it couldincrease functional communication in a waythat decreased problem behaviors and in-creased capacity for independent living. Thehandful of studies (Charlop-Christy, Carpen-ter, Le, LeBlanc, & Kellet, 2002; Ganz, Siga-foos, Simpson, & Cook, 2008; Lund & Troha,2008; Tincani et al., 2006) that have examinedthe use of PECS in older children and adoles-cents have shown promising results, althoughtwo of these studies (Ganz, Sigafoos, et al.,2008; Lund & Troha, 2008) made substantialmodification to the standard PECS trainingprocedures. Further research is necessary inorder to better understand the utility and lim-itations of PECS in this population.

Theoretical Grounding of PECS and Implicationsfor Practice

PECS utilizes a behavioral training system,based on the theories of B. F. Skinner andcolleagues (e.g., Skinner, 1957) and of ap-plied behavioral analysis (Baer, Wolf & Risley,1968; Cooper, Heron, & Heward, 2007). Un-like some other communication instructionalprograms for people with ASD, however,PECS relies primarily on direct reinforce-ment, similar to the direct reinforcement thatoccurs during typical language development(Frost & Bondy, 1994). For example, if a childgives his or her communicative partner a“ball” icon, he or she is then given access to aball, thus strengthening the association be-tween the icon and the corresponding, rein-forcing object. This differs from other com-munication training techniques where theuser may be rewarded with a third, unrelateditem (e.g., the therapist says, “touch ball,” andthe student touches the “ball” picture and is agiven a cookie as a reward; DeBoer, 2007).

The use of direct reinforcement leads toclearer associations between icons and objectsor actions and mimics the naturally occurringreinforcement of verbal speech in typically-developing children (Bondy & Frost, 2001).For this reason, it is important that a child’spreferred reinforcers, such as certain types oftoys or specific foods, are identified prior tothe start of PECS training and that corre-


sponding icons are created. Reinforcers canbe identified through simply observing theuser in his or her environment (Bondy &Frost) or through systematic recording andcomparison of the user’s responses to severalpotential reinforcers (Frost & Bondy, 1994).

Phases of PECS Training

Bondy and Frost (2001) conceptualized PECStraining as occurring in six phases, with theopportunity for additional training. Eachphase becomes increasingly complex and de-mands greater expressive and/or receptivecommunication skills from the user. For thisreason, it is recommended that the phases becompleted in order, and that the next phaseshould be tackled only when the user achievesan adequate ratio of correct responses duringtwo or more separate trials or days. This ratiocan be set by the treatment team, although80% minimum accuracy rates are commonlyused in the literature (e.g., Lund & Troha,2008; Bondy & Frost, 1994). The six phases ofPECS training are generally designed to cor-respond to typical communication develop-ment. The descriptions below are provided forinformational purposes and are not intendedto replace formal PECS training.

Phase 1: Initial Communication Training

The first phase of PECS teaches the user thaticons can be used as communication tools(Frost & Bondy, 1994, 2002). In this phase,the user is shown a preferred reinforcer by acommunication partner; most students in-stinctively try to reach for the reinforcer.When this happens, a second instructor, theprompter, places the appropriate icon in theuser’s hand and guides the learner’s hand tothe communication partner’s hand. When theuser drops the icon into the communicativepartner’s open hand, the user should imme-diately be allowed to have access to the rein-forcer for a brief period of time. If verbalcommunication is also being modeled, thecommunicative partner can name the rein-forcer as the user releases the icon into his orher hand.

In order to prevent satiation, the reinforcershould be promptly and gently taken awayfrom the user after a few seconds (Frost &

Bondy, 1994, 2002). The process should thenbe repeated until the user consistently andindependently hands the communicationpartner the icon in order to receive access tothe reinforcer, as determined by the pre-setcorrect response ratio. The prompter’s guid-ance and assistance in picking up the icon andreaching towards the communication shouldfade over trials, and the communication part-ner’s open handed prompt may change to aclose-handed one as the user demonstrates anunderstanding of the association between giv-ing the communication partner the icon andaccess to the reinforcer. This process shouldbe repeated with other icons, in various set-tings, and with various communicative part-ners in order to build the user’s vocabulary inanticipation for the item and icon discrimina-tion training that occurs in phase three and topromote skill generalization.

Phase 2: Retrieval and Delivery of Icons

In phase two, the child is taught to indepen-dently retrieve icons and deliver them to acommunication partner who is not immedi-ately available (Frost & Bondy, 1994, 2002).For example, in this stage, a child may betaught to retrieve an icon placed a few feetaway from him or her and then deliver it to acommunication partner in an adjacent roomin order to gain access to the desired item, asrepresented by the icon. Frost and Bondy(2002) hold that this type of training encour-ages spontaneous communication by demon-strating to the child that communication thatrequires effort on the part of the child can stilllead to the desired results. Additionally, phasetwo may be used to teach a child the impor-tant of persistence when communicatingwants or needs. For example, the learner mayhave to learn to give an item to a communi-cation partner who initially has his or her backturned. These skills can be conceptualized asanalogous to a speaking child learning that heor she must increase the volume of his or hervoice when trying to speak with someone whois a greater distance away (Frost & Bondy,2002). The amount of effort and persistencerequired of the learner should be graduallyincreased throughout phase two. This is alsothe phase in which a child should start learn-


ing to retrieve icons for desired objects fromhis or her communication book or board.

Phase 3: Icon and Item Discrimination

In phase three, the child learns that present-ing his or her communication partner withdifferent icons will result in different conse-quences and thus learns to discriminate be-tween icons and to select the icon for a de-sired object from a group of other iconchoices (Frost & Bondy, 1994, 2002). Thisphase begins with presenting the child withtwo icons based on the results of the pre-treatment preference assessment. One iconshould represent a highly desired item whilethe other icon should represent a much lessdesired item. If the child picks the less desiredicon, he or she should be given that item bythe communication partner, and, when thechild shows disinterest in it, a follow-up teach-ing procedure that demonstrates or promptschoosing the icon for the desired item shouldoccur. If the child does indeed initially pres-ent his or her communication partner withthe icon of the desired item, this should bereinforced with both access to said item andsocial reinforcement of the selection, such asverbal praise (Bondy & Frost, 2001).

After the child has mastered discriminationbetween the more desired and the less desireditem, he or she should then be given a choicebetween two icons representing items ofequally high desirability that are both in thechild’s immediate environment (Frost &Bondy, 1994, 2002). After he or she exchangesan icon, the communication partner shouldprompt the child to “take it,” being sure to usea pronoun instead of naming the item. If thechild attempts to access the item correspond-ing with the icon he or she selected, he or sheshould then be granted brief access to theitem. If the child attempts to access anotheritem, however, the communication partnershould block him or her from obtaining ac-cess to any item except the one represented bythe previously selected icon, then use an errorcorrection procedure. Once the child hasmastered this level of discrimination with twoicons, the number of icons and items pre-sented should be increased, until the childcan discriminate between five or six icons ofappropriately equivalent desirability and even

look through multiple pages of the communi-cation book in order to locate a particularicon (Bondy & Frost, 2001).

Phase 4: Phrases

Phase four begins the next major phase ofPECS training, in which the child is taught tocombine sentence strips with icons in order toform requests (e.g., “I WANT” sentence stripplus the icon for “ball” in order to request theball; Frost & Bondy, 1994, 2002). Because theyare naturally reinforcing, requests are taughtfirst, with the child learning to combine the “IWANT” sentence strip with an icon for thedesired item. The child should be taught togive the “sentence” to the communicationpartner, who should than respond by verbal-izing the sentence—for example, saying “IWANT the ball” when the child exchanges acommunication board with the “I WANT” sen-tence strip and ball icon—and giving the childaccess to the requested item (Bondy & Frost,2001). Learning to communicate requests viasentence strips may help compensate for thenon-verbal deficits of some children with ASD,such as lacking the tendency to point to orreach for a desired item (Bondy & Frost).

Phase 5: Answering Questions

In phase five, the child learns to answer verbalquestions posed by the communication part-ner through the use of sentence strips andicons (Bondy & Frost, 2001; Frost & Bondy,1994, 2002). The communication partnerhelps the child learn the association betweenspecific questions and appropriate responsesby asking the question (e.g., “What do youwant?”) and then physically prompting thechild to use the appropriate sentence strip(e.g., “I WANT”) in response and giving thechild access to the desired icon after her orshe exchanges the responding phrase. Even-tually, the child should independently accessthe sentence strip and respond with no otherprompting than the question itself. As withthe request training in phase four, this processis naturally reinforcing and thus should belearned relatively quickly (Bondy & Frost,2001).


Phase 6: CommentingIn the final formal phase of PECS training thechild is taught to use sentence strips such as “ISEE” and “I HEAR” to comment on his or herenvironment (Bondy & Frost, 2001). Unlikethe other stages of PECS, the reinforcementin this phase is indirect—the child receivesonly social reinforcement for his or her cor-rect responses, not actual access to a desireditem itself. This allows comments to be clearlydistinguished from commands, as taught inphase four, and also makes reinforcing appro-priate responses more difficult than in previ-ous stages (Bondy & Frost). Bondy and Frostemphasize the importance of having the childspontaneously comment in situations where atypically developing child would also com-ment, such as situations where there is some-thing unusual in the child’s environment orwhen he or she is asked a question like “Whatdo you see,” “What do you hear,” or “What doyou have?”

Additional Uses for PECS TrainingOnce the six formal phases of PECS are mas-tered, the child can be taught additional iconvocabulary and words forms, such as learningto understand and apply adjectives (Frost &Bondy, 1994, 2002). For example, a child maylearn to identify and discriminate between dif-ferent colors of candy. He or she can then usePECS adjective icons to ask specifically for apreferred color of candy (e.g., “I WANT” sen-tence strip � “blue” icon � “candy” icon) orto comment on his or her environment (“ISEE” sentence strip � “big” icon � “dog”icon) in greater detail. Similarly, the child canbe taught to use icons to express other com-mon needs and wants, such as the need to“take a break” from a frustrating or over-stim-ulating activity, thereby increasing the utilityof his or her functional communication. Iconsfor situations, objects, and people specific ornew to a user’s learning environment can becontinually created and taught as needed inorder to provide the fullest possible range offunctional communication.

Case ExampleAssessment. Alex was a five year-old girl di-

agnosed with autism. She had complex com-munication needs and did not speak; previousattempts had been made to teach her sign

language, but she struggled with adequatelyimitating many of the signs used by her par-ents and teacher, Mr. Gutierrez. Following thespeech therapist, Ms. Lorrie’s, formal assess-ment of Alex’s functional communicationskills, it was concluded that she would be agood candidate for PECS. A preference assess-ment conducted prior to the implementationof training revealed that hats and toy cars werepreferred objects for Alex while blocks andpicture books were less desired objects.

Phase One. In phase one, Mr. Gutierrez puta hat on his head, an icon of a hat was placedon the table in front of Alex, and when Alexreached to take the hat off of Mr. Gutierrez’shead, she was prompted by Ms. Lorrie, to givethe icon to the teacher. Giving Mr. Gutierrezthe hat icon earned Alex access to a favoritehat for 10 seconds before the hat was gentlytaken away, and a new trial began. Severalother icons, with preferred items pictured,were presented, one at a time, throughoutphase one instruction. After seven promptedtrials Alex began to independently pick upand exchange the icons. When she achieved90% accuracy over ten trials in one day, forrequesting 25 different items in three settings(i.e., classroom, cafeteria, home), a decisionwas made to move to phase two.

Phase Two. In phase two, Alex was re-quired to go to her communication board—which only contained the hat icon at thistime—retrieve it and bring it to Ms. Lorrie,who was sitting on the other side of the roomwith her back turned. After Alex achieved90% accuracy on a set of 10 trials that followed20 prompted trials Ms. Lorrie moved to anadjacent room, and Alex was required to carrythe icon to the other room and exchange theicon in order to gain another 10 seconds ofaccess to her favored hat. Additional schoolpersonnel were added as communicative part-ners and more icons were added to Alex’srepertoire in this phase. She achieved perfectaccuracy over 10 trials thus completing phasetwo.

Phase Three. In phase three, Alex was pre-sented with her communication book, whichnow included both the icon for hat and anicon for blocks. After Alex handed the blocksicon to Mr. Guitierrez, Alex was handed theblocks and began to cry. He then guided Al-ex’s hand to the hat icon and prompted her to


give it to him, an act that was reinforced bypatting Alex’s shoulder, her preferred form ofsocial reinforcement. Over subsequent trials,Alex began to consistently select and presentonly the icon that corresponded with the pre-ferred item, granting her 10 seconds of accessfor each exchange. Once Alex achieved 90%accuracy over ten trials, the non-preferredicons were replaced with the preferred itemicons, and Alex was only given access to theitem that corresponded with the icon she pre-sented. After she met the pre-establishedbenchmark of 90% accuracy in reaching forthe correct item, more icons were presentedin an array for discrimination. At the end ofphase three training Alex could reliably dis-criminate between and select specific iconswhen presented with up to seven icons distrib-uted over three pages of communicationbook.

Phases Four and Five. After Alex met the90% accuracy criterion for the 10-item dis-crimination task in phase three, the trainingteam moved on phase four. Alex wasprompted to combine the sentence strip “IWANT” with an icon for a preferred object(e.g., hat, cookie, cars) on her communica-tion book. When she presented the sentencestrip and icon in the correct order to hercommunication partner, the communicationpartner read the sentence “I WANT [icon]”and then gave Alex brief access to that theobject represented by the icon. Alex masteredthis stage quickly, suggesting that it was highlynaturally reinforcing for her. The treatmentteam observed similarly good success in stagefive, when Alex quickly associated the ques-tion “What do you want?” as a prompt topresent her sentence strip with a phrase ask-ing for a desired object to her communicationpartner.

Phase Six. Phase six was initially more dif-ficult. When Alex correctly used the “I SEE”sentence strip with the cars icon and receivedonly verbal praise instead of access to the cars,she began to cry. The use of the “I SEE”sentence strip in connection with icons ofother, less reinforcing items in the immediateenvironment was repeated several times andwas both rewarded with verbal praise, pats onthe arm, and prompted with the question,“What do you see?” These were alternatedwith “What do you want” trials to maintain

high rates of reinforcement. After 20 “Whatdo you see” trials, Alex no longer respondedpoorly to only receiving verbal praise for cor-rectly commenting, and the use of theprompting question and “I SEE” sentencestrip was then modeled in situations whereunusual or unexpected objects were present.Alex began to comment spontaneously on thepresence of some of the unusual objects andreceived verbal affirmation from Mr. Gutier-rez for doing so. After commenting on the “ISEE” strip was mastered with 90% correct re-sponding, similar training was done withother sentence strips, including “I HEAR” and“I HAVE.” The use of these strips was com-bined with a corresponding prompting ques-tion (e.g., “What do you hear?” or “What doyou have?”). Mastery of these sentence stripsgenerally occurred at a faster rate than seenwith the initial commenting training, indicat-ing there was some degree of generalization ofthe broad idea and purpose of commenting.

Further Use. Following the completion ofphase six of PECS training, Alex has contin-ued to increase her vocabulary of icons andsentence strips and thus her functional com-munication skills across all areas of her life.Alex experiences problems with over-stimula-tion when in noisy or crowded environments;since learning to request a “break” by usingthe appropriate PECS icons, her rate of chal-lenging behavior due to over-stimulation hasmarkedly decreased. This suggests that PECSprovided Alex with a more socially acceptableway to communicate her need for temporaryescape in certain situations and demonstratesa potential secondary benefit of increasingfunctional communication via PECS.

Data Tracking

As mentioned previously, all decisions regard-ing progression through the PECS should bedata-based (Bondy & Frost, 2001; Frost &Bondy, 1994, 2002). Therefore, it is vital thatPECS implementers maintain clear and accu-rate records of independent responses madeby the user. Additionally, it may be beneficialto track data on other outcomes or co-occur-ring phenomena. For instance, a frequentlyoccurring question regarding PECS is whetherthe training increases verbal as well as icon-based communication. While early reports by


the creators of PECS (Bondy & Frost, 1994)suggested that PECS training frequently leadto increased speech, more recent evidence onthe topic is mixed (Flippin et al., 2010; Ganz,Simpson, & Corbin-Newsome, 2008). In-creased verbal communication does seem tooccur in some users (Ganz & Simpson, 2004)but this phenomenon does not appear to beeither universal or consistent in nature (Ganz,Simpson, et al., 2008). Nevertheless, it mayprove helpful to track verbal communicationthat occurs during or after PECS training inindividual users in order to better assess theentirety of the impact of PECS training onfunctional communication skills and speech.

Similarly, it may be useful to track the inci-dence of challenging behavior before, during,and following PECS training, as increasedfunctional communication may result in a de-crease in challenging or problem behaviors(Charlop-Christy et al., 2002). Finally, it mayalso be helpful to monitor the degree to whichfunctional communication with PECS gener-alizes across contexts (Ganz, Sigafoos, et al.,2008). In addition to providing valuable infor-mation on individual users, collecting PECS-related outcome data on challenging behav-ior, verbal expression, and generalization mayhelp address several standing research ques-tions regarding the broader utility of PECS.

Summary and Discussion

PECS is a form of AAC designed to increasefunctional communication among individualswith ASD and other developmental disabilitiesthat have significant communication deficits(Frost & Bondy, 1994, 2002). It is a visually-based AAC system (Mirenda, 2001) and em-ploys direct reinforcement of expressive andreceptive communication and other behav-ioral principles. Users are trained to commu-nicate via icons and sentence strips and PECSuses low-cost materials that are relatively sim-ple to create (Frost & Bondy, 1994, 2002).PECS training occurs in a structured sequencedesigned to parallel the phases of typical com-munication and language development. Overthe course of training, users are taught to (a)associate icons with their representative items;(b) give an icon to a communicative partnerin order to gain access to a desired item; (c)seek out the appropriate icon and travel to a

communicative partner to achieve the item;(d) discriminate between multiple icons inorder to obtain a preferred item; (e) usephrases to express wants and describe the en-vironment; (f) answer questions and respondto commands; and (g) learn and use descrip-tors to discriminate between similar items.

Areas Requiring Further Clarification andInvestigation

In general, PECS has been shown to be effec-tive at increasing functional communicationin children with ASD and related disorders(e.g., Flippin et al., 2010; Ganz, 2007). How-ever, relatively little is known about its efficacyin older children, adolescents, and adults. Ad-ditionally, more research needs to be con-ducted regarding best practices for usingPECS with children who have other disabilitiesor functional impairments in additional toASD and children who are non-English lan-guage learners or come from otherwise lin-guistically diverse backgrounds. Future re-search should examine the effects ofmodifying the PECS materials for individualswith disabilities and the relative effectivenessof conducting PECS training in English, theuser’s familial language, or both languages.Finally identifying the characteristics of stu-dents that make them the best candidates forpositive outcomes for PECS intervention isessential. Such research could help guide thecreation of best practices for working withindividuals who require PECS or anotherform of augmentative or alternative commu-nication.

Additionally, future research should exam-ine the effects of PECS training on secondaryoutcomes, including verbal expression, chal-lenging behavior, and academics. By betterunderstanding the broader effects of increas-ing functional communication through PECS,we can better detect situations where the in-tervention may result in important, sociallyvalid secondary gains. Similarly, additionaldata on the generalization of functional com-munication across multiple settings could aidin our understanding of when and how PECScan be used in an individual’s daily life and inwhat situations applying PECS becomes diffi-cult.


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Received: 3 March 2011Initial Acceptance: 6 May 2011Final Acceptance: 5 August 2011


Teacher Education in Autism Spectrum Disorders: APotential Blueprint

Eric ShymanDowling College

Abstract: With evidence indicating the increase in the diagnosis of autism, as well as the complexity of workingwith individuals with Autism Spectrum Disorders (ASD), providing effective teacher education and trainingprograms specializing in ASD has become an educational necessity. This article seeks to outline necessarycomponents of a comprehensive teacher education program specializing in teaching individuals with ASD. Bycontextualizing the needs of a teacher preparation in ASD, better and more focused research can be conductedin determining effectiveness and comprehensiveness of such programs.

While accepted figures remain debated, it isvirtually inarguable that individuals with Au-tism Spectrum Disorder (ASD) have become amore common presence in public schoolswithin the last several years (Safran, 2008).With the impending reauthorizations of boththe Elementary and Secondary Education Act(ESEA) and the Individuals with DisabilitiesEducation Act (IDEA), legislation will un-doubtedly continue to mandate efforts towardinclusive education (Simpson, de Boer-Ott, &Smith-Myles, 2003). Because individuals withASD present with complex behavioral, social,and linguistic patterns necessitating special-ized educational needs, in-service teachersmust become better prepared to meet suchchallenges.

According to the National Research Council(2001), which provided the last available dataset, teachers have been shown to lack expertisein the area of ASD, and no data since then haveindicated that this phenomenon has signifi-cantly changed. This lack of expertise has cre-ated a formidable challenge for schools, obli-gating them to better meet the diverse andcomplex needs of individuals with ASD. Furthercomplicating the situation, little research is avail-able elucidating effective and appropriate de-signs for teacher preparation programs special-

izing in ASD. While some efforts have beenmade, standards for attaining the status of aHighly Qualified Teacher (HQT) for individu-als with ASD remain unofficial and untested(Scheurmann, Webber, Boutot, & Goodwin,2003). If standards and accountability measuresare to be appropriately applied in the process ofimproving teacher quality, it is incumbent uponfaculties of education to lead the way in defin-ing, measuring and improving the preparationof quality teachers (McArdle, 2010).

For these reasons, it is important that pro-fessional discourse and scientific research be-gin to focus on contributing to an evidence-based framework for teacher preparationprograms in ASD. Most importantly, however,the field must be an active contributor to thisresearch by designing and implementing suchprograms based on such discourse in order toprepare teachers who specialize in ASD.

Best Practices in Educating Individuals withAutism

Among the more zealous debates in the fieldof special education is the issue of what edu-cational methodologies are most effective andmost promising and how such conclusionsshould be drawn. Clear paradigmatic factionsexist in the field of ASD and there is a con-siderable lack of agreement with regard tothe strategies and methods that are most ef-fective for individuals with ASD (Reichow,Volkmar, & Ciccheti, 2007; Simpson, 2008).

Correspondence concerning this article shouldbe addressed to Eric Shyman, Dowling College, De-partment of Special Education, 150 Idle Hour Blvd.,Oakdale, NY 11769. E-mail: [email protected]


Teacher Education in Autism Spectrum Disorders / 187

What naturally follows from the teacher edu-cation perspective is the need to determinewhich issues and methodologies should beincluded in a teacher preparation program inASD (Hess, Morrier, Heflin, & Ivey, 2008;Scheurmann et al., 2003; Simpson, 2007). Thequestion of whether only established evi-dence-based methodologies should be dis-cussed or whether programs should also in-clude a discussion of methodologies with lessevidence basis remains unresolved. As statedby Simpson (2008):

the lack of practical information and well-designed guidelines that professionals andfamilies can use to identify the most suit-able, effective, and utilitarian methods fromamong the countless available interventionsand treatments . . . only serves to intensifyand further polarize variable opinions andperspectives concerning autism” (p. 3).

While many in the field will readily andconfidently deem the methods of teachingfalling under the umbrella of Applied Behav-ior Analysis (ABA) as being representative ofbest practice or, at least, the most clearly evi-denced practice, this conclusion may be pre-mature and confounded by various method-ological considerations including low samplesizes, lack of fidelity of implementation mea-sures between research and practice, andquestionable methods of data analysis tech-niques, making it dubious to consider suchapproaches as the only approach worthy ofinclusion in a teacher preparation program(Gresham, 2009; Parker, Vannest, & Brown,2009; Ximenes, Manalov, Solonas, & Quera.,2009). The difficulty of contextualizing whatABA is in the context of an “intervention”protocol further complicates the validity ofclaiming it as an evidence-based practice inand of itself. As clarified by Dillinburger(2011), ABA is often erroneously character-ized as an ASD treatment. As per Simpson’s(2008) point, teacher preparation programsin ASD may be a viable starting point for anexamination and evaluation of various treat-ment and educational programs in terms of itsexisting and/or emerging research support.

In a study by Hess et al. (2008) a sample ofteachers in Georgia were examined to deter-mine the types of methodologies being used

for educating individuals with ASD. An analy-sis of data from 185 teachers reporting on 226children indicated that a majority of the pro-grams utilized a variety of treatments, some ofwhich are not supported by evidence. Thesefindings indicate that though there is a gen-eral push for evidence-based practice, parentsand professionals are still willing to exploreand implement methodologies that lack em-pirical support. Use of a variety of interven-tion programs is further supported by Simp-son (2008) and McLennan, Huculak, andSheehan (2008).

Scheurmann et al. (2003) raise serious ob-jections to the notion that any unidimensionalapproach should or could be considered bestpractice. Referencing the idea of “single the-ory training” the authors contend that no re-search has convincingly substantiated claimsof the supremacy of one methodology overanother. Additionally, single theory trainingapproaches are likely to erroneously assumethat all students can and will respond to oneapproach, deeming it the only necessary ap-proach to promote. While there is a substan-tial body of research supporting behaviorallybased interventions (such as those character-ized under the umbrella of ABA), the researchhas not provided any peremptory evidencethat behavioral treatment is comparativelymore effective than other approaches. Accept-ing a single theory approach may limit teach-ers’ recognition that all children are differentand may respond to different approaches. Asan alternative, the authors suggest that teach-ers should pay more attention to students’individual needs rather than fitting a para-digm to their diagnosis and classification(Scheurmann et al., 2003).

From a teacher education perspective,Scheurmann et al. (2003) also provide a valu-able perspective suggesting that if teachers aretrained in only one methodology they will beunable to make educated comparisons as towhich methodologies fit individual studentneeds best and, furthermore, which method-ologies appear to be more comparatively ef-fective for different individuals. Therefore,consistent use of one programmatic approachin lieu of another may be more indicative oflacking multiple teaching skill sets rather thana true belief in or evidence for the validity andintegrity of the teaching method being used.


More concerning, rigidity in teaching may ul-timately be detrimental to student progress,especially if students transition between set-tings that utilize different methods stymieingcontinuity in programming or growth. There-fore, it is important for teachers to becomeexposed to, understand, and implement dif-ferent modes and theories of teaching in or-der to ensure that the most appropriatemeans of service delivery is being provided toindividuals (Lovaas, 1996; Scheurmann &Webber, 2002).

Issues in Teacher Preparation in Autism

While ASD has become an unprecedentedcommonality in schools, the field of teacherpreparation with specific focus on ASD is in itsinfancy. Scheurmann et al. (2003) suggestsome trends in teacher preparation for ASDthat need to be addressed. First, much teacherpreparation in ASD focuses on reactive strat-egies, or those that are implemented after abehavioral problem or crisis has already oc-curred. In such cases, training is often focusedon methodology or consultation based sup-port centered on ABA, risking the same afore-mentioned issues. Secondly, college or univer-sity based programs are likely to focus ongeneral certification as dictated by local edu-cation agency standards, lacking any special-ization in particular areas of the field. Thoughtypically accepted by states as a viable creden-tial for teaching in any setting in the certifica-tion area, certification does not necessarilymean qualification, thus perpetuating thepresence of teachers lacking specific expertisein educating individuals with ASD.

Further supported by Simpson (2008),while there are many treatments available forindividuals with ASD that clearly lack support-ing evidence, there are treatment approachesthat have emerging evidence, warranting fur-ther study. This idea supports the notion putforth by Scheurmann et al. (2003) that singletheory approaches do not meet the progres-sive and individualized needs of the field in itscurrent state. What hampers the issue signifi-cantly, however, is the drastic lack of researchin the area of both frameworks for teacherpreparation in autism as well as the evidence-based effectiveness of those programs.

The Council for Exceptional Children(CEC) validates the perspective that “. . .therationale for having different research meth-odologies in special education is based on thecurrent conceptualization of research in edu-cation and the complexity of special educa-tion as a field” (Odom et al., 2005, p. 138). Assuch, it is imperative that teacher preparationprograms be mindful of presupposing evi-dence basis for any discussed methodologies,as well as taking care to espouse particularparadigms as superior to others if there is nota true foundation to do so.

Guidelines for Teacher PreparationPrograms in ASD

In light of these issues, this paper proposes apotential framework for designing teacherpreparation programs specializing in ASD.Balancing overall teaching standards with thespecialized needs in training for individualswith autism is a necessary consideration. Thissection will outline three major sets of stan-dards that are necessary to consider.

The National Board for Professional Teach-ing Standards (NBPTS) (2002) outlines fivecore areas in teacher preparation:

1) Teachers are committed to studentsand their learning

2) Teachers know the subjects they teachand how to teach those subjects to stu-dents

3) Teachers are responsible for managingand monitoring student learning

4) Teachers think systematically abouttheir practice and learn from experi-ence

5) Teachers are members of learningcommunities

It is important to note that each of thesestandards are further subdivided into moredetailed performance indicators. While theseareas of expertise and practice are importantto teaching in general, it has been well-estab-lished that individuals with ASD have specificneeds that warrant specific types of trainingand knowledge (Hess et al., 2008; Scheur-mann et al., 2003; Simpson, 2007). Therefore,more specified guidelines are needed to sat-


isfy a well-suited framework for a teacher ed-ucation program specializing in ASD.

Scheurmann et al. (2003) offers a list ofcompetency areas proposed as central compo-nents to a comprehensive teacher educationprogram in ASD. The categories have beencondensed and summarized for the sake oforganization:

1) Knowledge of the disorder2) Parent involvement3) Theoretical underpinnings of instruc-

tional approaches (multiple approaches)4) Teaching language and communica-

tion, social competencies, adaptive be-haviors and transitions

5) Classroom structure6) Behavior management7) Special issues (to fluctuate with the

field)

Adding to the framework, CEC proposed ad-ditional teacher standards for quality teachingin ASD/Developmental Disabilities. Again, acondensed and summarized version of the pa-rameters is:

1) Foundations (including models, theo-ries, laws/policies, history, definitions,trends in practice)

2) Development and characteristics oflearners (typical/atypical human growth,environmental/cultural effects, medicalissues, speech, language, and communi-cation)

3) Individual learning differences (effectsof the condition, differences in skillacquisition, impact of theory of mind/cognitive functioning, behavioral diffi-culty)

4) Instructional strategies (evidence-based practices, specialized curriculumdesign, transitions, academic learning,positive behavioral supports)

5) Learning environments/social interac-tions (classroom management theories,teacher attitudes, cultural sensitivity,realistic expectations, supports for inte-gration)

6) Language (retention of cultural valuesof individual, language/communica-tion enhancement, repair/avoidanceof miscommunication)

7) Instructional planning (theories/re-

search in curriculum development,technology, paraeducator roles, accom-modation/modification, selection ofcontent)

8) Assessment (basic terminology, legalprovisions, uses/limitations of assess-ment, administering nonbiased assess-ments, record-keeping, conductingFBAs)

9) Professional and ethical practice/col-laboration (teacher biases, professionaldevelopment, high standards of com-petence and integrity, cultural sensitiv-ity, working effectively with interdisci-plinary/multidisciplinaryprofessionals)

Framework for Course Offerings

Characteristics of Individuals with ASD

* Course and fieldwork content in this area ofspecialization is designed to meet NBPTS 1and 2, Scheurmann 1 and 7, and CEC 1, 2, 3,8 and 9.

The purpose of ensuring a comprehensivecoverage of characteristics of individuals withASD is important for any program attemptinga specialization. Providing such a foundationwill ensure that the enrollees can be provideda deeper understanding of more specializedand advanced materials from a common basis.Furthermore, course content should be basedfirmly in the most current available researchwhich reports changes, variations, and multi-ple perspectives of such characteristics. There-fore, it is essential that such issues be contex-tualized within a common information base.

Characteristics of individuals should beframed in two contexts: those outlined in theDiagnostic and Statistical Manual of the Amer-ican Psychiatric Association (current version)and those outlined in the peer-reviewed re-search. In addition to coursework focusing oncharacteristics of ASD, a practicum and/orobservation component should be mandatedfor all students, during which the student ob-serves and/or works directly with multiple in-dividuals with ASD, as well as produce writtenreports on their observations and clinical ex-periences. Providing these two pillars of un-derstanding the characteristics of individuals


with ASD will satisfy both a clinical and prac-tical experiential base.

Coursework in this area should be presentedfrom a comprehensive and multidisciplinaryperspective by providing access to research fromthe areas of education, psychology, and diagnos-tic practice, as well as medical fields such asneurobiology, genetics, and biology.

Understanding of Current Research and EvidenceBasis of Methodological Approaches in ASD

* Course and fieldwork content in this area ofspecialization is designed to meet NBPTS 4and 5, Scheurmann 3 and 7, and CEC 1, 4,and 9.

The importance of framing a teacher edu-cation around an evidence-basis is a necessityfor all teacher education programs. Since ASDis a disorder that is poorly understood interms of etiology, presentation, and treat-ment, utilizing a framework of evidence-basisis essential. However, in order to truly frame ateacher education program around evidence-based practices, the concept itself must bedefined in a workable and applicable fashion.A sound definition of evidence-based prac-tices is one that reflects a combination of theAmerican Psychological Association (APA)and the Council for Exceptional Children(CEC), both relevant agencies of authority forsuch a program.

APA states that EBP is based on the integra-tion of the best available research coupledwith clinical expertise in the context of patientcharacteristics, culture, and preferences(APA, 2002). CEC offers a definition of evi-dence-based practice specific to special educa-tion:

An evidence-based special education profes-sional practice is a strategy or interventiondesigned for use by special educators andintended to support the education of indi-viduals with exceptional learning needs(bold in original text). CEC includes in thisdefinition specified configurations of indi-vidual strategies and interventions. Com-plex configurations of variables in whichthe efficacy of each of the variables has beenstudied separately are sometimes consid-ered a practice. Whenever a complex con-figuration of strategies and interventions is

proposed as a practice, the evidence for theconfiguration should be established as such,i.e. with all the variables in the given con-figuration, not in isolation. (Council for Ex-ceptional Children, 2008, p. 8)

CEC further delineates three categories ofProfessional Practice Evidence-Base: (1) PositiveEffects Evidence-Base; (2) Mixed Effects Evi-dence Base (Potentially Positive Evidence Base,Mixed Effects Evidence Base, No DiscernableEffects Evidence Base); and (3) Negative EffectsEvidence-Base). Additionally, CEC put forth acontextual model similar to that of APA withthree main concepts: (1) Family and CulturalValues; (2) Professional Skill and Wisdom; and(3) Professional Practice Evidence Base.

Evaluating the available research is central todetermining evidence-basis and, therefore, cen-tral to the ability of enrollees to accurately eval-uate methodologies. As such, the quality stan-dards for research will also be adopted fromAPA and CEC, both of which validate the con-cept that evidence-basis can be drawn from avariety of research methodologies and disci-plines including randomized clinical trials, ex-perimental designs, quasi-experimental designs,single-subject design, and correlation designs(APA, 2002; CEC, 2008; Odom et al., 2005).

Two additional concepts are essential totruly determining evidence-basis: treatment fi-delity (or fidelity of implementation) and themodes and mechanisms of empirically sup-ported treatment (Kazdin, 2007). Accordingto Grehsam (2009), treatment integrity refersto the extent to which treatments or interven-tions are delivered or prescribed as intended.Of further importance is that the practitionerswho are implementing such practices in thefield as evidence-based practices are doing soin the same manner as the research was ini-tially gathered- that is, the practice being im-plemented reflects the method(s) used in thestudies that vetted them. Failure to achievetreatment integrity will result in a practiceunreflective of that which was evidenced. Sim-ilarly, Kazdin’s (2007) admonition that legiti-mately establishing a “treatment” as “evidence-based” is not a matter of simply “studying it”across some variables and circumstances orpublishing even a wealth of articles, but isdependent on a very precise and rigorousmethodology that determines whether or not


it can qualify as EBP. This idea will be centralin the evaluation process of the enrollees.

Multidisciplinary/Comprehensive Approaches toMethodologies in ASD

* Course and fieldwork content in this area ofspecialization focuses on multidisciplinary ap-proaches and its evaluation in the context ofsupporting research meets the standards ofNBPTS 4 and 5, Scheurmann 3, and CEC 1, 4,7, and 9.

* Course and fieldwork content in this areaof specialization focuses on language andcommunication development in this compre-hensive context meets the NBPTS 2, Scheuer-mann 1, 2, 4, and 7, and CEC 1, 2, 3, 4, 6, and7.

Because research clearly indicates that nomethodology can or should be deemed assuperior, not espousing a particular paradig-matic framework for the education and treat-ment of individuals with ASD is a cornerstoneof a teacher education program specializingin ASD (NRC, 2001; Simpson, 2008; TaskForce on Autism, 2001). Therefore, programsshould provide discussion and discourse on acomprehensive set of available approaches to-ward educating individuals with autism, hold-ing each of them to the standards outlined forEBP and allowing enrollees to determine howwell the practice is established in evidence.Dawson and Osterling (1997) reported on acomprehensive analysis from which they wereable to delineate six common elementsamong the most widely used approaches forindividuals with ASD: (1) specialized curricu-lum content, (2) highly supportive teachingenvironments and generalization strategies,(3) predictability and routine, (4) a functionalapproach to challenging behaviors, (5) transi-tion support from the previous school envi-ronment, and (6) family involvement. There-fore, while the specific philosophies ornomenclatures of particular approaches maydiffer, there appear to be far more common-alities in both goals and procedures that areoften regarded. Along the same lines, becauseteachers are likely to play an assistive role toparents in the decision making process, it isimportant that they be made aware of as manypotential possibilities of treatments in whichfamilies may become interested, and be as

well-versed as possible in order to providesound, evidence-based advice to their clients.

This section will be divided into multiple cat-egories of approach type, using the main para-digm under which the approach can be classi-fied: (1) behaviorally based; (2) relationship/social based; (3) language based; (4) technologybased; (5) sensory based and; (6) medically-based. It is imperative to note, however, that thisis being done for the sake of organization only,and is no way indicative of clinical categories.Furthermore, in almost all cases, as noted byDawson and Osterling (1997), there are severalcharacteristics that are shared between the ap-proaches, and none is independent of another.In these cases, the same examples will be used inmultiple sections.

Behaviorally based approaches. Most, if notall, methodologies of educating individuals withASD have some level of behavioral basis to it.Because behavioral challenges are central to thecharacteristics of individuals with ASD, this is animperative component to any effective method-ology. As aforementioned, Dillinburger (2011)correctly emphasizes that Applied BehaviorAnalysis (ABA) is not a form of autism treat-ment, but rather a methodological approachthat predates the diagnosis or application toindividuals with ASD. Furthermore, Schreibman(2007) goes so far as to say ABA is not a teachingmethodology at all, but rather a research meth-odology. However, it is important to note thatthe principles of ABA (e.g., functional assess-ment and application of consequential events inthe form of reinforcement and punishment andthe emphasis on those behaviors that can beoperationally defined) are commonly applied toeducational approaches to individuals with ASD,and are often used as being synonymous with anautism treatment. The specific methodologiesdiscussed in teacher education programs thatemploy behaviorally based principles are: Dis-crete Trial Instruction (DTI) (Smith, 2001), in-cidental teaching (Charlop-Kristy & Carpenter,2000), Positive Behavior Supports (PBS) (Carret al., 2002), Pivotal Response Training (PRT)(Koegel, Carter, & Koegel, 2003; Koegel, Koe-gel, Harrower, & Carter, 1999), Picture Ex-change Communication System (PECS) (Bondy& Frost, 1994), Treatment and Education ofAutistic and Communication HandicappedChildren (TEACCH) (Schopler, Mesibov, &Hearsey, 1995), Learning Experiences: An Alter-


native Program for Preschoolers and Parents(LEAP) (Strain & Hoyson, 2000), and SocialCommunication/Emotional Regulation/Trans-actional Support (SCERTS) (Wetherby & Pri-zant, 2000)

Relationship-based/emotional-based approaches.An alternative (or perhaps complementary)approach to the behavioral model for under-standing and educating individuals with ASDcomes from a perspective that regards thechallenges in ASD from a relational stand-point, positing that individuals with ASD lackthe ability to initiate and foster appropriateemotional relationships with other individu-als. From this perspective, stereotypical behav-ior is not seen as something to be “corrected”reactively, but suggest that environmentsshould be set up to nurture normal (or asclose to normal as possible) social interactionsin order to foster brain development from theyounger ages. From this perspective, behav-ioral approaches are effective in changing be-haviors after such maladaptive behaviors havealready been identified, but does not suffi-ciently account for the development of indi-viduals in the younger stages before deficitshave been so well-established (and perhapsengrained in habit). Furthermore, relation-ship-based approaches are likely to criticizebehaviorally-based approaches as being hyper-focused on observable behaviors only, whereasthere may be just as much validity in nurturingthose concepts that cannot be as readily oper-ational such as emotions and thoughts. Suchapproaches in this category are Developmen-tal Individual Difference Relatonaship Model(DIR)/ FloorTime (Greenspan & Wieder,2006), Relationship Development Interven-tion (RDI) (Gutstein & Sheely, 2004), SocialCommunication/Emotional Regulation/Transactional Support (SCERTS) (Wetherby& Prizant, 2000) and SonRise (Kaufman,1994).

Language/communication based approaches.Because language and communication chal-lenges is a central issue in ASD, a substantialamount of coursework must be dedicated toprocesses of natural and typical language devel-opment as well as potential differences in lan-guage development for individuals with ASD.Comprehensive theories of typical language de-velopment (e.g., Bloom & Lahey, 1978; Hauser,Chomsky, & Fitch, 2002; Skinner, 1957), theo-

ries of how language development is different incommunication disorders and ASD specifically(Hummel & Prizant, 2010; Siegel, 1997; Prizant,2003) and specific methodologies that ap-proach intervention from a language and com-munication based perspective should be ex-plored. A sample of methodologies for inclusionare Applied Verbal Behavior (AVB) (Sundberg& Michael, 2001), Facilitated Communciation(FC) (Biklen, 1993), Social Stories (Gray, 2000),PECS (Bondy & Frost, 1994), incidental teach-ing (Charlop-Kristy & Carpenter, 2000), andScripting (Krantz & McClanahan, 1998), SocialCommunication/Emotional Regulation/Trans-actional Support (SCERTS) (Wetherby & Pri-zant, 2000), and Augmentative and AlternativeCommunication (AAC) (Mirenda, 2003).

Technology based approaches. With theseemingly incessant advancements of tech-nology becoming more applicable in schoolenvironments, focusing attention on suchadvancements with respect to methodologi-cal approaches for individuals with ASD isbecoming increasingly important. Method-ologies involving less sophisticated techno-logical means such as video modeling(Bellini & Akuillan, 2007; Shukla-Mehta,Miller, & Callahan, 2010) should be tar-geted, as well as more involved technologiessuch as augmentative and alternative com-munication (AAC) (Mirenda, 2003), PDAapplications, and interactive whiteboards(Goldsmith & LeBlanc, 2005).

Sensory-based approaches. Some theoristscontend that sensory perception problems areessential to understanding the behavior andtreatment of individuals with ASD. From thisperspective, the behaviors associated with au-tism (especially those that are seen as stereo-typical or self-stimulatory) may be less con-nected to functions of behavior and morerelated to an inability to integrate sensorystimuli from the environment in an appropri-ate way, resulting in overstimulation. There-fore, if methodologies focus on enhancingsensory processing and integration, reductionin behaviors resulting from overstimulationmay be observed. The most common applica-tion of this theory is Sensory Integration Ther-apy (SIT) (Carte, Morrison, Sublett, Uemera,& Setrakian, 1984; Snider & Rodriguez, 1993);however other methodologies are also em-


ployed in the same vein such as Higashi/DailyLife Therapy (Quill, Gurry, & Larkin, 1989).

Medically-based approaches. As various fieldsin medical science also explore ASD from avariety of perspectives, exposing enrollees tovarious medically-based approaches is imper-ative. Approaches such as brain mapping(McAlonan et al., 2005), chelation therapy(Sinha, Silove, & Williams, 2006), secretintherapy (Chez et al., 2000), and vitamin ther-apy (Wong & Smith, 2006) should be ex-plored, especially since such approaches maycontinue to be appealing to parents.

Assessment and Monitoring of TeacherPerformance Post-Graduate

While teacher education programs within col-leges and universities can closely control theinformation and assessment techniques ap-plied within their curriculum, the true mea-sure of a teacher preparation program comesin the effectiveness of the teachers such pro-grams produce. Therefore, it is an imperativecomponent of any teacher education programto determine a means of monitoring and as-sessing the job placement, job performance,and student outcome of those teachers whohave completed the program. This task can bechallenging, however, it is incumbent uponthe facilitators of such programs to determinethe overall clinical and practical worth of theprograms. Methods such as direct evaluationof accurate implementation (Lerman, Von-dran, Ajdisim, & Kuhn, 2004), self-assessment(Grey, Honan, McLean, & Daly, 2005), ecobe-havioral assessment (Roberson, Woolsey, Sea-brooks, & Williams, 2004), as well as novel andnew approaches developed by the teacher ed-ucation programs should be explored.

Inclusive Education for Individuals with ASD

With both the Elementary and Secondary Ed-ucation Act (ESEA) and the Individuals withDisabilities Education Act (IDEA) mandatingthat the field increase inclusive opportunitiesfor all students, teacher education programsmust pay particular attention to issues involv-ing the successful inclusion of individuals withASD. As defined by Ferguson (1995) inclusionis defined as:

a unified system of public education thatincorporates all children. . .as active, fullyparticipating members of the school com-munity; that views diversity as the norm; andthat ensures a high-quality education foreach student by providing meaningful cur-riculum, effective teaching, and necessarysupports for each student” (p. 286).

Approaching inclusion from the well-estab-lished perspective that successful inclusive ed-ucation should be implemented in the con-text of a “needs-based approach” (Lynch &Irvine, 2009), the program will emphasize thecentral ideas of the needs of individuals withASD as indicated by the research.

Lipsky and Gartner (1997) identified sevenessential elements of successful inclusion: (1)Visionary leadership; (2) collaboration; (3)support for staff and students; (4) effectiveparental involvement; (5) refocused use ofassessment; (6) appropriate levels of funding;and (7) curricular adaptation and effectiveinstructional practices. Expanding on thesefindings, Lynch and Irvine (2009) suggestfour similar elements that are essential specif-ically for the effective inclusion of individualswith ASD: (1) instructional practices that arespecific to suit individual strengths and chal-lenges of individuals; (2) student and staffsupports including classroom structure andenvironments, routines and schedules, and re-sources for dealing with challenging behav-iors; (3) multidisciplinary, multisite collabora-tion which employs a combination ofexpertise, approaches, and perspectives to en-sure programs do not become overly paradig-matic; (4) family involvement to help the fa-cilitation of generalization and maintenanceof skills and consistency of responses and con-tent. Teacher education programs specializ-ing in individuals with ASD need meet theseguidelines. Such programs can do so by focus-ing on a variety of approaches and perspec-tives from which ASD can be both character-ized and framed as well as a multidisciplinaryapproach to educational and treatment meth-ods. Content focusing on family issues, includ-ing presentations by families of individualswith ASD, as well as ASD specific issues canprovide a comprehensive handling of ASD,allowing for well-prepared and well-informedteachers that can take an active and qualified


role in increasing inclusive opportunities fortheir students with ASD.

Overarching Issues in Teacher Education

Because preparing teachers in specialized ar-eas cannot be entirely separated from generalteacher education programs, designing suchprograms with close attention to overarchingissues in teacher education is essential. Pro-grams specializing in ASD must frame the con-cept of teacher education beyond simply stan-dards and assessments to gauge mastery, butinstead use a multi-faceted definition includ-ing experiential, practical, and philosophicalknowledge of and engagement with the realand pertinent issues in the field of educatingindividuals with ASD.

Three tiers of comprehensive teacher edu-cation are offered by McArdle (2010): (1)what teachers need to know and do to becomequality teachers (e.g., discipline and contentknowledge, curricular knowledge, pedagogi-cal knowledge, and knowledge of self and cul-ture); (2) the current climate of accountabil-ity measures and standards; and (3) thevisibility of learning, or a shared sense of thewhole task, purpose, or goal of education. Byfocusing on specific characteristics of ASD,comprehensive and multidisciplinary ap-proaches, and opportunities for self-evalua-tion, as well as a focus on EBP and discussionof the purposes of teaching, this programclearly meets these guidelines as comprehen-sive program of teacher education.

As teacher education is fostered by learningfrom research as well as collaboratively, provi-sion of information must not rely strictly ondiscrete presentations of methodologies, butalso offer and foster multidimensional, inter-active, and experiential activities that providedirect engagement and application of thesemethodologies (Lieberman & Pointer Mace,2008). As such, the enrollees should be pro-vided with a program that extends beyondreinforcing simply a “culture of compliance”but an engagement with a curriculum thatallows learning through practice, meaning,community, and identity, as well as an op-portunity to learn with experienced and de-greed professionals with a wealth of knowl-edge, expertise, and experience (Lieberman& Pointer Mace, 2008).

Conclusion

Since the needs of individuals with ASD are sospecialized, research seems clear that specificteacher training protocols must exist forteachers working with ASD (National Re-search Council, 2001; Scheuermann et al.,2003; Simpson, 2008). However, there ap-pears to be a lack of available comprehensiveteacher education programs in ASD. Further-more, the teacher education programs that doexist appears to adopt and rely on single the-ory approaches, which does not seem to be aprudent or potentially effective framework(Reichow et al., 2007; Scheurmann et al.,2003; Simpson, 2008). In attempt to contrib-ute to the discourse on teacher preparation inASD, as well as propose a framework that is tobe implemented for such a purpose, this arti-cle outlined major areas that should be in-cluded in a teacher preparation program inASD based on the available research.

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Received: 4 May 2011Initial Acceptance: 9 July 2011Final Acceptance: 25 August 2011


Anxiety Levels in Students with Autism Spectrum DisorderMaking the Transition from Primary to Secondary School

Elizabeth F. Hannah and Keith J. ToppingUniversity of Dundee

Abstract: The anxiety levels of students with autism spectrum disorder (ASD) over the period of transition fromprimary to secondary school are investigated. A repeated measures design and an adapted version of a self-reportmeasure, the Spence Children’s Anxiety Scale (SCAS), are used to compare the anxiety levels of eight studentsbefore and after the transfer. Analysis at the individual level of the sub-scale scores using the adapted SCASagainst the standardised norms in two studies involving community samples reveals a mixed picture. Thesefindings suggest that individual differences are a significant feature. Limitations of the research and possibleavenues for future research are considered. Implications for supporting students with ASD in schools areoutlined.

Having Autism Spectrum Disorder (ASD) isconsidered to be a lifelong developmental dis-ability which has a pervasive impact on how anindividual makes sense of the world and inter-acts with other people. The term Autism Spec-trum Disorder is used in this paper to embracea range of diagnostic labels including classicalautism, atypical autism and Asperger’s Syn-drome. Wing and Gould, in their 1979 Cam-berwell (London) study into the prevalence ofautism in children with special needs, identi-fied children who did not fit with previousconceptualizations of autism as describedoriginally by Kanner in 1943 (Kanner, 1943;Wing & Gould, 1979). They proposed abroader spectrum of conditions, hence autismspectrum, and coined the term triad of impair-ments to refer to impairments in social inter-action, communication and imagination(Wing, 1993). The term triad of impairments isnow generally recognized by clinicians andresearchers and forms the basis for the twomajor diagnostic systems for ASD in currentuse, namely the International Classification ofDiseases 10th edition (ICD-10) (WHO, 1993)

and the Diagnostic and Statistical Manual 4thedition (DSM-IV; American Psychiatric Associ-ation, 2000).

Enhanced anxiety levels in individuals withASD are a recognized clinical feature that mayresult from a range of factors such as an indi-vidual’s difficulty in dealing with social situa-tions due to social interaction and communi-cation impairments; problems coping withchanges in the environment and hence theneed for routine; and responses to sensoryexperiences (Attwood, 1998; Howlin, 1998). Aperceived link between an individual’s diffi-culty in coping with change and insistence onmaintenance of routines and levels of anxietyhas been of interest to writers and researchersin this field for many years. In his originalstudy in 1943, Kanner suggested that the corefeatures of ‘early infantile autism,’ includingroutines, were anxiety driven (Kanner, 1943).More recently, Kuusikko et al. (2008) sug-gested that stereotyped routines and ritualsare a way of easing anxiety symptoms; Gillott,Furniss, and Walter (2001) proposed thatchanges in routine can result in raised anxietylevels and that ritualistic behaviours are a cop-ing mechanism for such heightened emo-tional states. However, questions have beenraised by some researchers as to whether suchbehavioural features can be considered to betrue symptoms of anxiety or simply expressionsof pervasive developmental disorder (PDD)

Correspondence concerning this article shouldbe addressed to Elizabeth Hannah, University ofDundee, School of Education, Social Work & Com-munity Education, College of Arts and Social Sci-ences, Carnelley, Nethergate, Dundee, DD1 4HN,Scotland, UK. E-mail: [email protected]



symptoms (Kim, Szatmari, Bryson, Streiner, &Wilson, 2000). This appears to be a questionof differential diagnosis. Whether this has im-plications in terms of the interventions em-ployed to support children and young peoplein school and in the community is unclear.

Within the past 10 years there have been afew empirical investigations into the anxietylevels of children and young people with ASD.These studies can be differentiated into thosewhich have employed measures to comparethe anxiety levels of individuals with ASD withcommunity samples (Kim et al., 2000;Kuusikko et al., 2008) and those which haveemployed cross-sectional designs to comparematched groups (Gillott et al., 2001; Green,Gilchrist, Burton, & Cox, 2000). Overall, thesestudies provide evidence of raised anxiety lev-els in children and young people with ASD.

Kim et al. (2000) report on the prevalenceand correlates of anxiety and mood problemsamongst 9 to 14 year old children withAsperger Syndrome (AS) and high function-ing autism (HFA). Employing a modified ver-sion of the Ontario-Child Health Study Re-vised (OCHS-R) questionnaire completed byparents, AS and HFA children were found tohave a greater rate of anxiety and depressionproblems compared with the standardizedcommunity sample. One of the acknowledgedlimitations of this study was the difficulty indifferentiating between true symptoms of anx-iety and depression, as reported by parents,and those of pervasive developmental disor-der (PDD). Kuusikko et al. (2008) address thislimitation through employing revised mea-sures which excluded items which overlappedwith criteria associated with HFA and ASsymptoms. They examined social anxietysymptoms in children and adolescents with ASand HFA using children’s self-report measuresof social phobia and anxiety (Social Phobiaand Anxiety Inventory for Children) and so-cial anxiety (Social Anxiety Scale for ChildrenRevised). Parental ratings of the children’sobserved internalizing symptoms were mea-sured using the Child Behavior Checklist. Thechildren and adolescents scored higher on allmeasures compared with a community basedcontrol sample.

Gillott et al. (2001) compared the anxietylevels of three matched groups of children(aged 8 to 14 years) (although it should be

noted that they were not matched for IQ):normally developing, high functioning autism(HFA), and specific language impairments.Employing two self–report measures of anxi-ety (Spence Children’s Anxiety Scale (SCAS);Social Worries Questionnaires (SWQ)), thechildren with HFA obtained higher mean to-tal scores and scores in four of the six sub-scales compared with the comparison groups.Green et al. (2000) compared the psychoso-cial functioning of a group of adolescent boyswith AS with a matched group of males with adiagnosis of conduct disorder (CD). However,unlike Gillott et al. they did not include acontrol group of normally developing adoles-cents. Subject and informant interview mea-sures were employed to assess social and psy-chiatric functioning. The researchers foundthat the AS group had poorer social function-ing and more severe difficulties in interper-sonal functioning than the CD group. Interms of psychiatric functioning, the ASgroup, in the subject interview measure, dis-played significantly greater levels of anxietyrelated symptoms.

It is generally recognized that individualswith ASD experience more difficulties copingwith routine changes than individuals in thegeneral population. This has been attributedto impairment in imagination resulting in rit-ualistic behaviour and insistence on routines(Wing, 1992; Wing, 1993). The conceptualiza-tion of transitions being of a micro-nature(e.g. moving between activities) or a macro-nature (e.g. moving between schools) (Att-wood, 1998) is helpful to our understandingof children’s difficulties with transitions in aneducational context and the role played byanxiety during this process. Although therewill be individual differences in levels of re-sponse to change, it appears reasonable topropose that changes of a macro-nature arelikely to lead to higher levels of anxiety.

It is generally accepted that students withASD require additional support to help themcope with the day to day changes within class-room and school environments. Typical ap-proaches include the use of visual supports(e.g. visual timetables, visual cues, photo-graphs); calming activities; support with per-sonal organisation of belongings and materi-als; and appointing a classroom buddy(Larkey, 2005). Furthermore, it has been pro-

Anxiety and Transition / 199

posed that transitions of a macro-nature, suchas moving between one school and anothershould carefully be managed through suchstrategies as additional visits to the new school,transition planning meetings, and informa-tion for students and parents (Attwood, 1998;Carter, Clark, Cushing, & Kennedy, 2005; En-nis & Manns, 2004). Heightened levels of anx-iety which such changes may engender willhave a variable impact on a student’s psycho-logical response and social functioning.Knowledge of an individual’s experience andresponse will inform the strategies adopted byparents and professionals.

For students in the general population,there is evidence that following transfer tosecondary school, levels of anxiety and stressare a short-term feature during the firstmonths (Graham & Hill, 2003; Tobbell,2003). Furthermore, there appears to be someevidence that these levels decrease for themajority of students during their first year atsecondary school. Lohaus, Ev Elben, Ball, andKlein-Hessling (2004) attribute this decreaseto the relaxing effects of the summer vacation.

In contrast, there appear to be no pub-lished studies exploring the anxiety levels ofstudents with ASD during this transition. Thepresent study aims to inform our understand-ing of factors impacting the anxiety levels inchildren with ASD. It is acknowledged that thefindings should be considered preliminary innature given the small sample size and thereliance on a self-report measure. However, itis argued that the findings will provide thebasis for future research and have relevancefor educational practices.

Research Questions

1. How do the self-reported anxiety levels ofa sample of students with ASD comparewith those of the standardised sampleprior to the transfer to secondary school?

2. How do the self-reported anxiety levels ofa sample of students with ASD comparewith those of the standardised sample fol-lowing the transfer to secondary school?

3. How do the self-reported anxiety levels ofa sample of students with ASD prior to thetransfer to secondary school compare withthose of the same students following trans-fer?

It was predicted, based on previous studies,that students with ASD would have higherlevels of anxiety compared with the generalstudent population. Furthermore, if studentswith ASD follow a similar pattern to the gen-eral student population (Lohaus et al., 2004),it was predicted that they would experienceheightened feelings of anxiety prior to themove and a reduction in anxiety levels follow-ing the transfer.

Method

Participants and Setting

Setting. This study took place in a large,inner city in Scotland which in 2007 had anestimated population of 581,940 (GeneralRegister Office for Scotland, 2008). The cityfaces challenges due to the levels of depriva-tion within its locality, with 49% of the 5%most deprived areas (data zones) and 31% ofthe 15% most deprived areas in Scotland(Scottish Government, 2009).

Participants. For the wider investigation, ofwhich this study formed a part, a sample ofstudents was purposively selected. The popu-lation comprised all students with a diagnosisof ASD in their final year at mainstream pri-mary schools in the south side of the city whocould transfer to mainstream secondaryschools in the authority. The sampling framewas drawn up using the knowledge of educa-tional psychologists (EPs) employed by thelocal authority serving this geographical area.A potential drawback of this method was itsreliance on full and accurate returns. Othersources of information, such as speech andlanguage therapy records, provided a cross-checking mechanism improving the reliabilityof this method. The inclusion criteria werethat the students should have a diagnosis ofASD; be in their final year of education in amainstream primary school; and that transferto a mainstream secondary school was antici-pated.

Nine male students participated in thewider study, all of whom had a diagnosis ofAsperger Syndrome (considered to fallwithin the parameters of ASD). The absenceof females in the sample is not surprising. Interms of gender balance, prevalence levels(male to female) range from 4.7: 1 to 10.3: 1


(Howlin, 1998). In addition, one studenthad a diagnosis of Tourette syndrome. Par-ticipants’ ages at commencement of thestudy ranged from 11 years 3 months to 12years 4 months (M � 11 years 8.9 months;SD � 4.6 months). There was minimal attri-tion over the period of the investigationreflecting the levels of engagement. Due toparental disengagement after completion ofthe six-week transition programme, data attwo time points were not available for one ofthe participating students. Data for theother eight students are reported here. De-tails of participants by gender, age at com-mencement of the study, diagnosis andschool provision are provided in Table 1.

Measure

An adapted version of the Spence Children’sAnxiety Scale (SCAS; Spence, 1997) was em-ployed. The original version comprises sixsub-scales, namely, panic attack and agoraphobia(PAA), separation anxiety (SA), physical injuryfears (PI), social phobia (SP), obsessive compulsive(OC) and generalized anxiety disorder/overanx-ious disorder (GAD) based on six of the DSM-IVcategories of anxiety disorders (Yule, 1997). Ithas 45 items comprising 38 anxiety items, sixfiller items and one open-ended item. Thefiller and open-ended items are not scored.There is a 4-point scale response set (never,

sometimes, often, and always) for each item,scored 0 to 3.

Using a large community sample of Austra-lian children aged 8 to 12 years, Spence(1998) reports high internal reliability for theSCAS with a co-efficient alpha of 0.92 and aGuttman split-half reliability of 0.90. Internalconsistency of the sub-scales ranged from 0.60to 0.82. Test-retest reliability on a sub-samplefor the total score over a six month time pe-riod was 0.60 and for the sub-scales 0.45 to0.57. Convergent and discriminant validitywere assessed using a range of other measures.A Pearson product-moment correlation of0.71 was found between SCAS total scores andthe Revised Children’s Manifest Anxiety Scale(RCMAS) total scores and a range of 0.50 to0.61 between the SCAS sub-scales and RCMAStotal scores. In contrast, there was no support-ing evidence for convergent validity using aparent reported measure, namely the inter-nalizing sub-scale of the Child BehaviourChecklist (CBCL). The SCAS has been foundto have discriminatory properties between twogroups of clinically diagnosed children (socialphobia and co-morbid social-separation anxiety)and a non-clinical control group.

The present study used an adapted versionof the SCAS incorporating the 4 sub-scales(PAA, SA, PI, and OC) which were found todiscriminate the HFA children from the othertwo matched groups in the Gillott et al. (2001)study. The final version comprised 26 items,

TABLE 1

Details of participants

StudentNo. Age at Start of study Diagnosis

Primary SchoolPlacement Secondary School Placement

1 11 years 8 months Asperger syndrome Mainstream primary Secondary communicationsupport unit

2 11 years 3 months Asperger syndrome Mainstream primary Secondary communicationsupport unit

3 12 years 2 months Asperger syndrome Mainstream primary Mainstream secondary4 11 years 6 months Asperger syndrome Mainstream primary Mainstream secondary5 11 years 10 months Asperger syndrome

Tourette syndromeMainstream primary Mainstream secondary

6 12 years 4 months Asperger syndrome Mainstream primary Mainstream secondary7 12 years 1 month Asperger syndrome Mainstream primary Mainstream secondary8 11 years 5 months Asperger syndrome Mainstream primary Secondary communication

support unit


there being no filler items or an open-endeditem. The 4-point scale response set (never,sometimes, often, and always) was retained.Cronbach alpha coefficients in the currentstudy, with the Spence, Barrett, and Turner(2003) figures in brackets, were: PAA .72(.80); SA .53 (.71); PI .75 (.60); and OC .66(.75). Cronbach alpha values are sensitive tothe number of items in the scale and it is notuncommon to get figures as low as .5 for shortscales with less than 10 items (Pallant, 2007).In that context, it is argued that the reductionfrom 45 to 26 items could account for thelower levels in three of the sub-scales and thatthe obtained figures are acceptable.

Procedure

In terms of ethical considerations, the firstauthor was bound by the British PsychologicalSociety and affiliated university codes of prac-tice for research on human participants. Allparticipants were advised of the voluntary na-ture of participation and informed consentwas sought through written and verbal means.Paper data was stored in a locked filing cabi-net and electronic data was stored and re-trieved through a password protected com-puter. Issues of confidentiality and anonymityin reports of the research were communicatedto all participants.

The adapted SCAS was administered at twotime points, namely, immediately prior to themove to secondary school, and approximately6 months following the transfer. Question-naires were sent to the students’ parents inMay with a cover letter providing informedconsent. Parents were advised to allow theirchild to complete the questionnaire as far aspossible independently, although they couldprovide assistance for clarification purposes.Despite this guidance, it is acknowledgedthere was no control of the actual administra-tion and parents could have inadvertently in-fluenced their children’s responses impactingon the reliability of the data.

Questionnaires were completed over theperiod from early June to mid July prior to thestudents starting secondary school in late Au-gust. Five questionnaires were returned byparents using the postal service and homevisits were arranged for the remaining fourstudents. Questionnaires were completed in

the first author’s presence and clarificationprovided if required. For one student, an at-tempted home visit and follow-up writtencommunication proved unsuccessful and itwas decided to exclude this participant fromthis element of the research.

An identical version of the questionnairewas utilised at the follow-up point. The firstauthor visited the students at their homes dur-ing the period late February to early April oftheir first year in secondary school. Writteninstructions on the questionnaire were supple-mented, where necessary, by verbal explana-tion. If required, reading assistance was pro-vided.

Data Analysis

For each of the 26 items in the SCAS(amended), respondents were asked to tickone of four possible responses. Responseswere allocated a score ranging from 0 to 3. Forthe purposes of analysis, it has been assumedthat the measurement scale furnished ordinaldata. The quantitative data was subjected todescriptive and inferential analyses usingSPSS. The Wilcoxon Signed Rank (WSR) testwas employed to compare the scores on eachof the 26 items at time points 1 and 2.

SCAS sub-scale scores for the respondentswere compared to those of the standardiza-tion sample (Spence et al., 2003). Respon-dents’ ages at each time point were calculatedwith figures rounded down to the nearestwhole number. At time point one, five stu-dents were aged 11 years and three studentsaged 12 years. At time point two, six studentswere 12 years and two students aged 13 years.There is evidence that self-reported anxietylevels decrease with age (Spence, 1997). Toaddress this, norms from a study involving asample of thirteen and fourteen year old ad-olescents from Brisbane, Australia (Spence etal.) were used for the two students who wereaged thirteen at time point two. Spence et al.note that combined norms for thirteen andfourteen year olds were lower than those for12 year olds (Spence, cited in Spence et al.)providing further evidence of “a continueddecrease in self-reported anxiety scores withincreasing age” (p. 621).


Results

Group SCAS Sub-scale Scores

Eight students completed the anxiety ques-tionnaire at both time points. Group meansand standard deviations for the sub-scale itemsare outlined (see Tables 2- 5). Within-subjectsanalyses at the group level for the four sub-scales indicated that few of the sub-scale itemshad reached statistical significance. Given thesmall sample size with the increased likeli-hood of type II errors, it was decided to cal-culate effect sizes using Cohen’s d (Cohen,Manion, & Morrison, 2007). Clark-Carter(2004) states that it is possible to calculate aneffect size for a within-subjects design whichallows relative comparison with effect size in a

between-subjects design. Cohen et al. provideguidance for interpretation of the statistic Co-hen’s d as follows: 0–0.20 � weak effect; 0.21–0.50 � modest effect; 0.51–1.00 � moderateeffect; and �1.00 � strong effect.

There were changes in the predicted direc-tion as reflected in a decrease in the scores forfour of the nine items in the Panic Attack andAgoraphobia (PAA) sub-scale. Of these fouritems, there was a moderate effect size fortime for one item (All of a sudden I feel reallyscared for no reason at all; d � 0.734) and amodest effect size for two items (I suddenly startto tremble or shake when there is no reason for this;d � 0.251); I suddenly became dizzy or faint whenthere is no reason for this; d � 0.367). However,it should be noted that in two items the scores

TABLE 2

Descriptive Statistics of the Panic Attack and Agoraphobia Sub-scale

Item naM Timepoint 1

SDb

Timepoint 1

M Timepoint 2

SDb

Timepoint 2

EffectSize

I suddenly feel as if I can’tbreath when there is noreason for this

8 .13 .354 .25 .463 .339

I suddenly start to trembleor shake when there isno reason for this

8 .38 .518 .25 .463 .251

I feel scared if I have totravel in the car or in abus or train

8 .25 .463 .25 .463 0

I am afraid of being incrowded places

8 .38 .744 .38 .518 0

All of a sudden I feelreally scared for noreason at all

8 .38 .518 0 .000 .734

I suddenly become dizzyor faint when there isno reason for this

8 .13 .354 0 .000 .367

My heart suddenly startsto beat too quickly forno reason

8 .25 .463 .38 .518 .281

I worry that I will suddenlyget a scared feelingwhen there is nothingto be afraid of

8 .38 .518 .38 .518 0

I am afraid of being insmall closed places

8 .63 .744 .50 .535 .175

a numberb standard deviation


increased. There was a decrease in three ofthe six items in the Separation Anxiety (SA)sub-scale with a moderate effect size in oneitem (I worry about being away from my parents;d � 0.707)) and a modest effect size in an-other (I would feel afraid of being on my own athome; d � 0.405). There was a decrease in twoof the six items in the Obsessive-compulsive (OC)sub-scale each showing a modest effect size (Ican’t seem to get bad or silly thoughts out of myhead; d � 0.383); I have to think of specialthoughts (like numbers or words) to stop bad thingsfrom happening; d � 0.259). However, in threeitems the scores increased. Finally, there wasan increase in the score for one of the fiveitems in the Physical Injury Fears (PI) sub-scalealthough this had a weak effect size. In con-trast, the scores in three items increased attime point two, two showing a modest effectsize and one a strong effect size.

Individual SCAS Sub-Scale Scores

Given the apparent variability in the directionof change using group aggregated scores inthe four sub-scales, it was decided to conductan analysis at the individual level. The totalsub-scale scores for each of the four sub-scaleswere calculated at both time points. It wasdecided to use normative means of the com-munity sample for comparative purposes suchthat it would be possible to determinewhether an individual had a significantlyhigher or lower score than the norm. Giventhe age of the respondents over the period ofthe study, it was necessary to use the standard-ized norms from two studies, the originalstudy (Spence, 1997) and one involving olderchildren (Spence et al., 2003). For the pur-poses of this study, a score of more than onestandard deviation from the standardisedmean was defined as substantial (see Table 6).

TABLE 3

Descriptive Statistics of the Separation Anxiety Sub-scale

Item naM Timepoint 1

SDb

Timepoint 1

M Timepoint 2

SDb

Timepoint 2

EffectSize

I would feel afraidof being on myown at home

8 1.00 .926 .63 .518 .405

I worry aboutbeing away frommy parents

8 1.25 .707 .75 .463 .707

I worry thatsomething awfulwill happen tosomeone in myfamily

8 1.38 .744 1.50 .756 .161

I feel scared if Isleep on my own

7 .14 .378 .14 .378 0

I have troublegoing to schoolin the morningsbecause I feelnervous or afraid

8 .38 .744 .50 1.069 .161

I would feel scaredif I had to stayaway from homeovernight

8 .50 .756 .38 .518 .159



Five out of eight respondents had substantialscores in one sub-scale at time point one and thisreduced to four respondents at time point two.Looking at trends in the four sub-scales, one re-spondent had a substantial score at time point onein the PAA sub-scale. At time point two, this score

had reduced to within one standard deviation ofthe mean. In the SA sub-scale, two respondentshad substantial scores at time point one. Bothfigures were lower at time point two with only oneremaining substantial. For the OC sub-scale, onerespondent had a substantial score at time point

TABLE 4

Descriptive Statistics of the Obsessive Compulsive Sub-scale

Item naM TimePoint 1

SDb

TimePoint 1

M TimePoint 2

SDb

TimePoint 2

EffectSize

I have to keep checkingthat I have donethings right

8 1.25 .707 1.50 .926 .354

I can’t seem to get bador silly thoughts outof my head

8 1.13 .991 .75 .707 .383

I have to think ofspecial thoughts

8 .25 .463 .13 .354 .259

I have to do samethings over and overagain

8 1.13 1.246 1.00 .756 .104

I get bothered by bador silly thoughts orpictures in my mind

7 .29 .488 .75 .707 .943

I have to do somethings in just theright way to stop badthings happening

9 .25 .707 .57 .787 .453


TABLE 5

Descriptive Statistics of the Physical Injury Fears Sub-scale

Item naM TimePoint 1

SDb

TimePoint 1

MTime

Point 2

SDb

TimePoint 2

EffectSize

I am scared of the dark 8 .63 .916 .63 .744 0I am scared of dogs 8 .13 .354 .50 .756 1.045I am scared of going to

the doctor or dentist8 .50 .535 .63 .518 .243

I am scared of being inhigh places or lifts

7 1.14 .900 1.00 .756 .156

I am scared of insectsor spiders

8 .63 .744 .87 .835 .323



one but this ceased to be the case at time pointtwo. However, another respondent’s score in-creased at time point two reaching a substantiallevel. Finally, in the PI sub-scale, one respondenthad a substantial score at time point one. In con-trast, at time point two, three of the respondentshad substantial scores.

Discussion

Using the individual SCAS sub-scale scores,prior to the transfer to secondary school fiveof the eight students had substantial scores inone sub-scale of the adapted SCAS comparedwith standardised norms in a community sam-

TABLE 6

Descriptive Statistics of Individual Sub-scale Scores: SCAS

Respondent 1 2 3 4 5 6 7 8

PAA ascore timepoint 1

2 6 6* 2 0 1 0 6

3.70 3.70 2.45 3.70 3.70 2.45 2.45 3.704.32 4.32 3.17 4.32 4.32 3.17 3.17 4.32

PAA score timepoint 2

1 3 5 3 1 2 0 4

2.45 2.45 1.95 2.45 2.45 1.95 2.45 2.453.17 3.17 3.20 3.17 3.17 3.20 3.17 3.17

SA b score timepoint 1

2 11 pro-rated*

4 3 3 8* 3 5

3.78 3.78 3.00 3.78 3.78 3.00 3.00 3.782.98 2.98 2.55 2.98 2.98 2.55 2.55 2.98

SA score timepoint 2

2 7 * 2 4 4 4 pro-rated

5 4

3.00 3.00 1.83 3.00 3.00 1.83 3.00 3.002.55 2.55 2.29 2.55 2.55 2.29 2.55 2.55

OC c score timepoint 1

2 7 pro-rated

5 2 3 2 4 10*

5.90 5.90 5.39 5.90 5.90 5.39 5.39 5.903.86 3.86 4.02 3.86 3.86 4.02 4.02 3.86

OC score timepoint 2

3 3 7 pro-rated*

3 7 3 7 5

5.39 5.39 3.22 5.39 5.39 3.22 5.39 5.394.02 4.02 2.86 4.02 4.02 2.86 4.02 4.02

PId score timepoint 1

2 5 pro-rated

3 8* 3 1 1 1

3.32 3.32 2.94 3.32 3.32 2.94 2.94 3.322.65 2.65 2.55 2.65 2.65 2.55 2.55 2.65

PI score timepoint 2

4 5 5* 6* 6* 0 1 2

2.94 2.94 1.86 2.94 2.94 1.86 2.94 2.942.55 2.55 2.22 2.55 2.55 2.22 2.55 2.55

a panic attack and agoraphobiab separation anxietyc obsessive compulsived physical injury fearse non-emboldened and non-italicized figures represent raw scoresf emboldened figures represent the means from other studies (Spence, 1997; Spence et al., 2003)g emboldened and italicized figures represent the standard deviations from other studies (Spence, 1997;

Spence et al., 2003)h an asterisk indicates that the score is more than one standard deviation above the meani where there are missing data, figures have been pro-rated utilising available data


ple. Previous studies have found higher levelsof anxiety in children and adolescents withHFA and AS compared with those in commu-nity samples or a matched comparison groupof normally developing children (Gillott et al.,2001; Kim et al., 2000; Kuusikko et al., 2008).Following the transfer, half of the studentshad substantial scores in at least one sub-scalecompared with a community sample. Thesefindings are in the same general direction asprevious studies but conclusions should betempered by the absence of consistency acrossall students in the sample and across all foursub-scales.

Two methods of analysis were employed tolook at changes in anxiety levels over the tran-sition period. The findings from the initialanalysis, which focused on comparison ofgroup mean scores for each of the 26 scaleitems, were not conclusive. The second analy-sis, which looked at individual scores acrossthe four sub-scales, revealed some interestingtrends. Between the two time points, there wasevidence of a decrease in anxiety levels in twoof the sub-scales (PAA, and SA); a mixed pic-ture in the OC sub-scale with one individualevidencing a decrease and another individualan increase in levels; and an increase in the PIsub-scale (three individuals had substantialscores at time point two compared with one attime point one). It should be noted that a fewresearchers have expressed concerns aboutthe internal consistency of the PI sub-scale(Muris, Merckelbach, Ollendick, King, & Bo-gie, 2002). However, the majority view of theresearch community is that the PI sub-scaleshould be retained as a measurement of animportant dimension of anxiety in childrenand adolescents (Nauta, 2005; Spence et al.,2003). Overall, these findings provide quite amixed picture across the four sub-scales. Itappears that there are individual differencesin anxiety levels as students transition to a newschool. This finding could be attributed to thesmall sample failing to identify a general pat-tern.

One limitation of the methodology in thisstudy was the reliance on one data source, aself-report questionnaire, which has not beenstandardized on a UK sample and has no es-tablished validity for children with autism(Gillott et al., 2003). Concerns have beenraised by some researchers about the ability of

children with ASD to complete self-reportmeasures (Sofronoff, Attwood, & Hinton,2005). However, countering those concerns,there is some evidence that children with ASDare able to “self- reflect using structured ques-tionnaires” (Knott, Dunlop, & Mackay, 2006,p. 616) and that the “general skills of insightand emotional self-reporting increase with agein children and adolescents” (Kuusikko et al.,2008, p. 1707). Another limitation of themethodology was the researcher’s acceptanceof the children’s diagnoses without reassess-ment.

This paper reports on what appears to bethe first study which has explored anxiety lev-els in children with ASD as they make thetransition from primary to secondary school.Further studies, involving larger samples, areindicated. Furthermore, longitudinal researchdesigns which would enable tracking of anxi-ety levels over a longer time period and atvarious time points would provide greater in-sight into changes over time. Kuusikko et al.(2008), utilising two different self-report mea-sures of social anxiety, found that “childrenwith HFA/AS reported an increase in socialanxiety as they grew older, whereas typicallydeveloping children reported a decrease insocial and evaluative anxiety as they grewolder” (p. 1706). It would be of interest toexplore whether other forms of anxiety in-crease with time in children with ASD. Intypically developing children, levels of anxietydecrease by age (Spence et al., 2003). Utiliza-tion of an equivalent parent questionnaire(SCAS-P; Nauta, Scholing, Rapee, Abbott,Spence, & Waters, 2004) would enable trian-gulation with student data. Finally, it would bevaluable to further investigate factors whichcould explain the individual differences whichwere a feature of this study.

Notwithstanding the identified limitationsand preliminary nature of this study, someimplications for educational policy and prac-tice are indicated. It is recommended thatteachers and related professionals should takecognizance of individual variability in anxietylevels and responses to moving schools. Aspart of the assessment approach, they shouldconsider using standardised measures, such asthe SCAS, and employing a range of supportstrategies, such as induction days, orientationvisits, familiarity with timetables, maps of the


school, meeting school staff and other pupils,and a buddy system. In addition, the use ofrelaxation techniques should be considered aspart of an overall support package. The pro-vision of support for parents and other familymembers is another area worth pursuing. Fi-nally, referral to other professionals for thetreatment of anxiety symptoms may be indi-cated as there is evidence that young peoplewith HFA and AS respond to treatments suchas cognitive psychotherapy (Kuusikko et al.,2008).

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Received: 20 April 2011Initial Acceptance: 28 June 2011Final Acceptance: 25 August 2011


Effectiveness of an Essay Writing Strategy for Post-SecondaryStudents with Developmental Disabilities

Suzanne Woods-Groves,William J. Therrien, Youjia Hua,

Jo M. Hendrickson, and Julia W. ShawUniversity of Iowa

Charles A. HughesThe Pennsylvania State University

Abstract: This study examined the effectiveness of the ANSWER Strategy (Hughes, Schumaker, & Deshler,2005) in improving the essay composition skills of post-secondary students with developmental disabilities. Thesix-step strategy incorporated analyzing essay prompts, creating an outline, generating an essay response, andreviewing the answer. The students (N � 16) were assigned via a stratified random sample method to treatmentor control groups. A pre- and post-test design was employed and the results were evaluated using a strategyscoring rubric. Statistically significant differences were found between the post-tests in favor of the treatmentgroup related to their knowledge of the ANSWER strategy and the use of the strategy steps. Overall, the resultsindicated that the ANSWER strategy holds promise as an effective writing intervention for individuals withdevelopmental disabilities in post-secondary settings.

Mercer, Mercer, and Pullen (2011) describedwritten expression as the “highest forms ofcommunication” that emulates one’s ability tocomprehend, develop concepts, and abstrac-tion (p. 359). Polloway (2009) noted the prin-cipal goal of writing instruction is to cultivateindividuals who can communicate effectively.The process of constructing a coherent andeffective written passage is multi-faceted andrequires one to identify, synthesize, and se-quence ideas (Englert et al., 2009). One of themost complicated skills for individuals withand without disabilities to acquire is the art ofwritten expression. The 2007 National Assess-ment of Educational Progress (NAEP) writingassessment revealed that only 33 percent ofeighth- and twelfth-grade students assessed

were considered proficient writers (Salahu-Din, Persky, & Miller, 2008).

For individuals with disabilities, difficultieswith written expression that emerge duringtheir elementary school years continue to per-sist throughout their lifetimes unless effectiveinterventions are employed. As the Individualswith Disabilities Education Improvement Act(IDEA; 2004) has evolved so too has the im-plementation of special education servicesacross K-12 public schools and post-secondarysettings (Stodden & Whelley, 2004; Zaft, Hart,& Zimbrich, 2004). Traditionally, individualswith developmental disabilities received spe-cial education services in public school set-tings until the age of 21 or 22 (Grigal, Neu-bert, & Moon, 2001; Zaft, et al.). Newopportunities are now burgeoning for individ-uals with developmental disabilities and theirfamilies as inclusive post-secondary collegeprograms are being established (Grigal, Neu-bert, Moon, 2002; Hall, Kleinert, & Kearns,2000; Weir, 2004). A comparison between theNational Longitudinal Transition Study(NLTS) and the (NLTS-2) revealed that in2005, 28 percent of youths with intellectualdisabilities attended post-secondary programscompared to 8 percent in 1990 (Newman etal., 2010). As post-secondary programs

The research reported herein was supported inpart by the Office of Postsecondary Education(OPE), U.S. Department of Education, throughGrant P407A100030 to The University of Iowa. Theopinions expressed are those of the authors and donot represent views of the OPE or the U.S. Depart-ment of Education. Correspondence concerningthis article should be addressed to Suzanne Woods-Groves, Department of Teaching and Learning, 246Lindquist Center North, University of Iowa, IowaCity, IA 52242-1529. Email [email protected]



emerge for individuals with developmentaldisabilities, so does the opportunity to addressdifficulties in written expression with strategicacademic instruction.

One type of writing that is particularly dif-ficult for individuals with and without disabil-ities is expository writing. An individual’s per-sonal knowledge of a topic is the basis fromwhich writing begins and as such, it is incum-bent upon the writer to develop strategies foracquiring and organizing content knowledge.Englert et al. (2009) noted that if studentscannot identify, synthesize, and organize ex-pository ideas they will experience problemsunderstanding and constructing expositorytext. Englert and colleagues examined theability of seventh grade students with andwithout disabilities to read science and socialstudies content and highlight main ideas, takenotes, and construct expository reports. Over-all neither group (students with disabilities orthose without disabilities) was deemed to be“highly proficient” in the employment oflearning strategies (Englert et al., p. 147). Thestudents with disabilities lacked knowledge ofhow to effectively organize, classify, and labelexpository ideas. In addition, the students alsoexperienced trouble selecting main ideaswithin connected text.

Skills critical for expository writing includegoal setting, planning, sentence development,and editing. Hayes and Flower (1987) assertedthat writing is goal directed. The authors de-constructed the writing process to reveal thatwriting goals are hierarchal in nature and aregenerated through the employment of plan-ning, sentence creation, and revision. In theplanning stage one must not only have con-tent knowledge of the subject at hand, but alsoconstruct a composition that fits the “situationand the audience” (Hayes & Flower, p. 21).

Graham and Harris (2009) reiterated theimportance of planning and revising andnoted that skilled writers commonly employthese strategic behaviors while students withdisabilities and less proficient writers do notroutinely use these strategies when writing.Students with disabilities frequently exhibitproblems within the area of written expres-sion (De La Paz, 1999; Graham & Harris; Gu-zel-Ozmen, 2006; Lane et al., 2009; Schu-maker & Deshler, 2009). These difficultiesmanifest themselves in a myriad of ways that

include problems with acquiring and access-ing content knowledge, planning, sentenceconstruction, and revising (Englert et al.,2009; Deshler & Schumaker, 1986; Graham &Harris, 2003; Hallenbeck, 2002; Harris, Gra-ham, & Mason, 2003; Schumaker & Deshler,2009).

In an attempt to identify components inwritten expression instruction that have beeneffective, Gersten and Baker (2001) con-ducted a meta-analysis of 13 studies that ex-amined writing instruction for students withlearning disabilities. The authors purportedthat effective comprehensive writing instruc-tion should incorporate the following: (a) ex-plicit teaching of each step of the writing pro-cess, (b) the components of different writinggenres, and (c) the delivery of explicit feed-back from teachers or peers to students (Ger-sten & Baker). In addition, Schumaker andDeshler (2009) cautioned that efficient writ-ing instruction for individuals with disabilitiesshould include explicit instruction, numerousopportunities for learners to acquire masteryon each skill, and immediate feedback. Desh-ler and Schumaker (1986) designed a series oflearning strategies that incorporated aspectsof the following: (a) a pre-test of students’ skillknowledge, (b) a description of the strategy,(c) modeling and practice, (d) students self-prompting to use the strategy, (e) a post-test,and (f) instruction for the generalization ofskills.

Writing strategies that embody combina-tions of the aforementioned elements of in-struction have yielded favorable results whenemployed with students with writing prob-lems, learning disabilities, behavior disorders,intellectual disabilities, Asperger’s Disorder,and attention deficit hyperactivity disorder(De La Paz, 1999; Delano, 2007; Englert, Ra-phael, & Anderson, 1992; Graham & Harris,2003, 2009; Guzel-Ozmen, 2006; Hallenbeck,2002; Harris, Graham, & Mason, 2003; Lane etal., 2009; Schumaker & Deshler, 2009). Onearea that has not been extensively explored isthe use of strategic instruction within the areaof written expression for individuals with de-velopmental disabilities in post-secondary set-tings. Students in post-secondary settings areoften required to express informationthrough classroom discussions, writing, andtaking tests (Schumaker & Deshler); however,

Essay Writing Strategy / 211

there is a dearth of documented strategies forpromoting written expression with this agegroup.

The Essay Test-Taking Strategy (Hughes etal., 2005) was designed to facilitate the essaycomposition skills of students’ responses toessay-type questions on content area tests. Thestrategy consists of a series of sequenced cog-nitive and behavioral steps within which thelearner advances through using self-instruc-tion (Schumaker & Deshler, 2009). Specifi-cally, the strategy employs the use of the acro-nym ANSWER and consists of the following sixsteps: (a) Analyze the action words in an essayquestion, (b) Notice the requirements of thequestion, (c) Set up an outline, (d) Work inthe details of the outline, (e) Engineer ananswer, and (f) Review the answer (Hughes etal.).

Therrien, Hughes, Kapelski, and Mokhtari(2009) investigated the effectiveness of theANSWER strategy with seventh- and eighth-graders with learning disabilities and studentswithout disabilities. The results revealed a sig-nificant difference in the post-test scores inthe areas of strategy use, content, and organi-zation for students in the experimental groupin comparison to the control group. Students’post-test strategy rubric scores in the experi-mental group yielded an effect size of d �1.69. Cohen (1988) classified effect sizes of �.2 as small, � .5 as medium, and �.8 as large.Subsequently, an effect size of d � 1.69 wouldbe considered large.

The purpose of our study was to investigatethe effectiveness of the Essay Test-TakingStrategy on essay responses written by post-secondary students with developmental dis-abilities.The following questions were investigated:

1. Can post-secondary students with devel-opmental disabilities acquire and applya six-step writing strategy designed toimprove the quality of their expositoryessays?

2. Will there be a difference in the abilityof the students to acquire and apply thestrategy specific components of the es-say strategy and the components of thestrategy that pertain to generalization?

Method

Participants

The sample was comprised of 16 students;including five (31%) females and 11 (69%)males who attended a two-year post-secondarycertificate program designed for individualswith developmental disabilities at a universityin the Midwest. The participants ranged inage from 19 to 23 years with a mean of 21years, 7 months, (SD � 1.23). With regard toethnicity, 15 (94%) were White, while one(6%) was Latino. Four (25%) individuals werefrom rural areas; 11 (69%) were from urbanareas; and one (6%) was from a suburbanarea. With regard to diagnostic categories, five(31%) were diagnosed with autism, one (6%)with a non-verbal learning disorder, six (38%)with a mild intellectual disability, one (6%)with a traumatic brain injury, two (13%) witha severe learning disability, and one (6%) withAsperger’s Disorder. For 14 of the participantsIQ levels (M � 100, SD � 15) standard scoresranged from 61 to 98, (Mdn � 70); IQ scoreswere not reported for two participants.

The students were administered a pre-test.A series of ANOVAs indicated no significantdifference on pre-test scores between controland treatment group students. See Table 1 forscores on pre-tests, effect size differences be-tween treatment and control (Cohen’s d), andANOVA comparisons.

Materials

The directions and materials supplied in theEssay Test-Taking Strategy (Hughes et al.,2005) manual were used to implement theintervention. Several supplemental materialswere provided to the students. Graphic orga-nizers were created in order to supplementdaily lessons. Students were also given high-lighters and were instructed to highlight im-portant elements in the materials providedthroughout the daily lessons. In addition,each student had a folder that included his orher progress graph, completed practice exer-cises, and materials for the lesson for the day.A copy of the ANSWER strategy mnemonicwas attached to the front of each of the stu-dents’ folders. See Figure 1 for an example ofa graphic organizer used in the study.


We used the pre- and post-test essayprompts from Therrien et al. (2009), whichemulated essay prompt questions from state-wide assessments. The authors noted that be-cause the intent was to appraise writing abilitynot background knowledge, the prompts wereconstructed to require critical thinking andnot extensive content knowledge (Therrien etal.). The pre-test prompt was as follows: Inven-tions are all around us. Think of an invention thathas been especially helpful or harmful to people.Write an essay that gives at least 3 reasons why theinvention was helpful or harmful. The post-testessay prompt was as follows: Your school news-paper is printing a series of articles about heroes andheroines. Write about someone who is a hero orheroine to you. That person may be someone youknow, someone you have read about, a celebrity, or ahistorical figure. Explain at least 3 reasons why youbelieve this person is someone to admire.

Design and Procedure

Design. A 2-level (treatment or control)single factor, pre/post experimental design,was used to examine the effect of the inter-vention on students’ essay responses. A strati-fied random assignment method was em-ployed to place students either in treatment orcontrol groups using a random digits numberchart. The students were rank ordered usingtheir reported reading grade levels obtainedfrom their student records. We used a random

digits number chart and paired each partici-pant to the next closest reading score. Studentpairs were then randomly assigned to treat-ment or control groups.

Intervention. The ANSWER strategy(Hughes et al., 2005) consists of systematicinstruction delivered in an explicit fashion inorder to teach students a multi-step approachto effectively answer essay prompts. In orderto progress to subsequent lessons, students arerequired to demonstrate skill mastery. TheANSWER strategy includes the following sixsteps: (a) Analyze the action words in an essayquestion, (b) Notice the requirements of thequestion, (c) Set up an outline, (d) Work inthe details of the outline, (e) Engineer ananswer, and (f) Review the answer (Hughes etal., 2005). Table 2 contains a detailed descrip-tion of the ANSWER strategy steps.

Daily instruction closely followed the lessonguidelines provided in the Essay Test-TakingStrategy instructor’s manual. The instructorsupplemented the daily lessons with graphicorganizers. In contrast to the Therrien et al.2009 study, the students’ goals were to createessay responses that consisted of one or twoparagraphs instead of multi-paragraph (two ormore paragraph) essays. Implementation ofthe ANSWER strategy employed the followingelements of instruction. After the first daywhen the strategy was introduced, each subse-quent day began with a review of the previouslesson(s). New information was presented

TABLE 1

Strategy Scoring Rubric Overall and Components Pre-test Scores

Overall Stategy ScoringRubric Rubric Components Rubric

Rubric sectionsaligned with

strategy specificcomponents (1-4)

Rubric sections alignedwith essay generalcomponents (5-6)

Treatment group 1.275* (.29) .0000* 1.275* (.29)Control group 1.244* (.21) .0000* 1.244* (.21)Effect size difference

(Cohen’s d)0.12 0.12

ANOVAComparison

F(1,15) � 0.06,p � .807

F(1,15) � 0.06,p � .807

Note: *Denotes mean values. Standard deviations provided in parentheses.


through a process of describing the strategysteps, modeling and demonstrating the stepsthrough think-aloud procedures, the use ofgraphic organizers, and frequent teacher-stu-dent interactions designed to probe for un-

derstanding and promote elaboration.Guided practice incorporated the use ofgraphic organizers and corrective feedback,and information covered during the lessonwas reviewed. These instructional activities in-

Figure 1. Sample Graphic Organizer for Lessons Four and Five.


cluded recommended components of effec-tive writing instruction and were comparableto those employed in previous strategy instruc-tion for students with disabilities (Gersten &Baker, 2001; Graham & Harris, 2003; Schu-maker & Deshler, 2009; Therrien et al.). Table3 provides an overview of the daily lessons.

The second and third author conducted thefidelity data collection. Fidelity data were col-lected for 100% of the intervention sessionsand consisted of checking off lesson steps thatwere completed or not completed.

Treatment group intervention. An equalnumber of students were assigned to the treat-ment and control groups with each groupconsisting of eight students. The interventionwas conducted in six sessions with three ses-sions occurring every other day, three days aweek, for two weeks. Each session was a 30-minperiod during the students’ instructionaltime. The students in the experimental groupreceived the intervention together in a groupsetting. The instructor held a master’s degreein special education and was a certifiedteacher. The instructor was trained to imple-ment the strategy by the second author aftercarefully reviewing the instructional manual(Hughes et al., 2005).

Control group intervention. During the AN-SWER intervention, students in the controlgroup participated in typically planned in-structional activities.

Dependent variables. Students’ pre- andpost-test essays were evaluated using a strat-egy scoring rubric designed to evaluate stu-

dents’ essays based on the implementationof the specific steps and sub-steps detailed inthe ANSWER strategy (Therrien et al.,2009). The strategy scoring rubric used inthis study was a modified version of the ru-bric Therrien et al. employed in 2009. Mod-ifications included the following, in “StepFive: Engineer Your Answer” of the strategyscoring rubric the guidelines were modifiedto include the question, “Was there an In-troductory Sentence?” instead of asking,“Was there an Introductory Paragraph?”Subsequently, the next question, “Did theIntroductory Paragraph contain a rephraseof the question?” was modified to ask “Didthe Introductory Sentence contain a re-phrase of the question?” The revised strat-egy scoring rubric is depictedin Figure 2.

The strategy scoring rubric was divided into“strategy specific components” (Steps 1 – 4)and “essay general components” (Steps 5 – 6).The strategy specific components evaluated ifstudents analyzed the action words, noticedthe requirements, set up an outline, andworked in the details. Students could earn 0 to4 points for the strategy specific components.The essay general components evaluated ifthe students engineered an answer, and re-viewed or revised the answer. Students couldearn 0 to 2 points for the essay general com-ponents.

The strategy scoring rubric yielded a totalraw score derived by summing the scoresfrom Steps 1 – 6 which represented the totalnumber of strategy steps that were com-

TABLE 2

Six-Step ANSWER Strategy (adapted from Therrien et al. 2009)

A Analyze the action words in the question. This step requires students to read the question carefullyand underline the key action words once.

N Notice the requirements of the question. Here students mark key essay requirements byunderlining them twice and change the question into their own words.

S Set up an outline. This step requires students to list the main ideas of their essay within an outlineformat.

W Work in details. Here students add important details to the outline that they plan to include intheir essay.

E Engineer your answer. This step requires students to write the essay including an introductorysentence, detailed sentences about each of the main ideas in their outline, and to include asummary sentence(s).

R Review your answer. Here students check that all parts of the question were answered and edittheir essay.


pleted. Conceptually, the strategy specificcomponents (Steps 1 – 4) examined theapplication of the planning and goal settingpart of the ANSWER strategy. The essay gen-eral components (Steps 5 – 6) were a gen-eralization measure that evaluated if essayresponses were topic specific, included anintroductory sentence, incorporated de-tailed sentences aligned with the outline,and contained a summary sentence.

Data collection.

The pre-test essay was administered theweek prior to program implementation andthe post-test was administered the week afterprogram completion. Two graduate stu-dents in the College of Education evaluatedthe essays. The graduate students had exten-sive experience administering and evaluat-ing assessments. In addition, training was

TABLE 3

The ANSWER Strategy Lesson Activities (adapted from Therrien et al. 2009).

Lesson Lesson Activities

1 The ANSWER strategy was introduced and the students were asked to write a statementindicating that they would commit to learning the strategy.

2 The intent of this lesson was to identify current strategies that the students used when theyconstructed essays. The first two steps of the strategy, which involved analyzing the question,were introduced. We supplemented the lesson with graphic organizers. Students were given asample essay topic and asked to write a short essay answer. Then the steps of analyzing theaction words and noticing the requirements were taught. Students completed these two stepswith the sample essay question and revised their answers based on feedback. The students alsocompleted an assessment worksheet. Their answers were checked for the demonstration ofmastery.

3 In this lesson, the first two steps of the strategy were reviewed. The next two steps of the strategy,which involved creating an outline, were introduced. A new sample essay question wasprovided and, as a group, the students analyzed the action words and noticed therequirements. A graphic organizer was used for this lesson. The group discussed severaldifferent topic ideas for the essay. The students were taught the steps for creating an outlineand practiced creating an outline for the sample essay question. The students completed aworksheet where they were asked to create an outline for one of the three topics on the page.Their answers were checked for the demonstration of mastery.

4 In this lesson, the four steps of the strategy were reviewed with the aid of a graphic organizer.The steps for creating an outline were discussed in depth. Next, the steps for writing ananswer were taught. A graphic organizer was provided to the students. Students were givensample essay questions and were asked to analyze the question and construct their ownoutline. The last two steps focused on the types of paragraphs and sentences that can be usedin an essay. The students were instructed to use their outline as a guide to writing an essay.The students checked their essay answer by referring to their outline. They also edited theiranswer for punctuation and spelling errors. The students’ answers were checked for thedemonstration of mastery.

5 For this lesson, students verbally practiced the six steps of the strategy using a graphic organizeras their guide. A rapid fire questioning technique was used.

6 The intent of this lesson was to have students independently practice using the entire strategy.An advance organizer was provided for this lesson. The instructor first briefly reviewed theANSWER strategy. Then the students were given a new essay question and were asked toengage in the entire strategy on their own. Students’ answers were check for thedemonstration of mastery.

Total time Supplemental Features180 min

3 hrsSupplemental materials included the use of graphic organizers, highlighters, and having the

ANSWER mnemonic attached to the front of the students’ folders. Total instructional time forthe strategy across all six lessons was approximately 3 hrs.


provided by the first and second authorswhere the raters were introduced to thecomponents of the strategy rubric. The rat-ers practiced using the strategy rubric toevaluate examples of essay prompts and an-swers. The raters were not aware of the AN-

SWER study. They were not involved in datacollection nor were they aware that the essayresponses they were evaluating were pre-and post-test results. Therefore the raterswere blind to what the intervention was, whowas in the treatment and control groups,

Figure 2. Strategy Scoring Rubric. This rubric was modified from the original Strategy Specific Rubricemployed by Therrien et al. (2009). * Denotes items that were modified from the Therrien et al.original Strategy Specific Rubric.


and which essay was the pre-test and post-test.

Procedure.

The study employed the following sequence.First students (N � 16) were assigned via astratified random sampling method to thetreatment or control group. Next the pre-testessay prompts were administered. Then stu-dents in the treatment group received instruc-tion in the ANSWER Strategy over a two-weekperiod while students in the control groupattended their regularly scheduled activities.Next the post-test essay prompts were admin-istered to students in the treatment (n � 8)and control (n � 8) group students. The pre-and post-test essays were then evaluated by thegraduate student raters using the strategy scor-ing rubric.

Results

Treatment Integrity and Inter-Rater Reliability

Treatment integrity checklists containing theessential instructional components for eachlesson were used to collect data for all (i.e.,100%) sessions. An overall integrity percent-age of 99% was obtained with a range perobservation between 97–100%. Final rubricscores for pre and post-test measures werecalculated by averaging the two rater scores.Correlations between rater scores were calcu-lated for all measures and averaged r � .987.

Strategy Scoring Rubric

Students’ post-test scores including effect size(ES) differences on the strategy scoring rubricare summarized in Table 3. Students in thetreatment group scored an average of 3.706on the post-test compared to 0.925 for stu-dents in the control group. ANCOVA resultsusing pre-test scores as the covariate indicatedthat this result (d � 2.63) was statistically sig-nificant F(1, 14) � 27.07, p � .0001. To ascer-tain what might account for the difference inthe post-test, the strategy scoring rubric wasbroken down into two parts. Rubric steps onethrough four were examined as strategy spe-cific components while rubric steps five andsix were examined as essay general compo-

nents. The strategy scoring rubric is depictedin Figure 2.

An examination of the strategy specific as-pects revealed that none of the students uti-lized any of the strategies on the pre-test andthat students in the treatment group earnedapproximately 60% of the points on the post-test compared to 0% for control. This differ-ence was statistically significant and yielded alarge effect size (d � 4.68). When the essaygeneral component aspects were examined,there was no statistically significant differencebetween conditions however the effect sizewas moderate (d � .40) (Cohen, 1988). Stu-dents’ post-test scores including effect size(ES) differences on the strategy specific as-pects and the essay general component as-pects are summarized in Table 4.

Discussion

The ANSWER strategy (Hughes et al., 2005)holds promise in improving the essay com-position skills of post-secondary studentswith developmental disabilities. The presentstudy investigated the effectiveness of theANSWER strategy with post-secondaryyoung adults with developmental disabili-ties. The results of this study indicated thatthe students in the treatment group im-proved their essay test-taking skills after atotal of approximately 3 hrs of instruction(distributed across six 30 min lessons). Thefollowing research questions were posed.Could the students acquire and apply theANSWER strategy? Would there be differ-ences in how the students mastered thestrategy aspects verses the generalization as-pects of the ANSWER strategy? The resultsof this study indicated that students in thetreatment group significantly out-performedthe control group when post-test resultswere compared. The large effect size of d �2.63 indicated that the students in the treat-ment group were able to acquire and applythe ANSWER strategy.

Next, the students’ acquisition and applica-tion of the specific strategy steps were exam-ined. A comparison of the post-test strategyspecific components scores (Steps 1–4) indi-cated that students in the treatment groupsignificantly out-performed those in the con-trol group yielding a large effect size of d �


4.68. When the post-test essay general compo-nents scores were compared there was no sta-tistically significant difference between condi-tions. However the effect size in favor of thetreatment group was d � .40 which indicateda promising trend.

Implications for Practice

When the students’ individual pre-test essaysin the treatment and control groups were ex-amined a pattern emerged. None of the essayresponses exhibited any evidence of planningor goal setting through the incorporation ofoutlines or pre-planning notes. Many of theessays consisted of a series of disjointed sen-tences devoid of an introductory sentence orsummary sentence. Hayes and Flower (1987)described this characteristic as “knowledge-telling” where the writer’s goal is to produce awritten product that includes any informationpertinent to the topic at hand (p. 22). Thewriter may list all of his or her topical factualknowledge but will not couch or organize hisor her written response to fit the audience orsituation (Hayes & Flower).

In contrast, following the ANSWER strategyintervention, students in the treatment groupconstructed post-test essays that did includeplanning strategies and that incorporatedstrategy specific steps. The majority of the stu-dents in the treatment group read and ana-lyzed the essay prompt. They also developedan outline indicating that the students incor-porated pre-planning and goal setting before

they constructed their essays. When one ex-amines the generalization aspects of the post-test responses, five out of eight (63%) stu-dents in the treatment group constructedessay responses that exhibited the mechanicsof expository writing such as the inclusion ofan introductory sentence, constructing one’swritten response in an organized sequentialmanner, and ending one’s essay response witha conclusion or summary sentence(s). Eventhough the results for the generalization com-ponent of the strategy were not statisticallysignificant, it did appear that the majority ofthe students in the treatment group appliedaspects of the strategy when they created theiressays.

Only one out of eight students (13%) in thecontrol group constructed a post-test essay re-sponse that contained an introductory sen-tence. No responses contained a conclusionor summary sentence. The control groups’post-test essays were comparable to the pre-test essay responses for both groups (treat-ment and control). Subsequently when oneexamines the post-test essay responses of thetreatment group it is evident that this brief(3hr) intervention had a positive impact uponthe quality of the students’ post-test essay re-sponses.

Limitations and Future Research

There were several limitations with regardto this study. First, the components of theANSWER strategy that addressed the actual

TABLE 4

Post-test Scores for Strategy Scoring Rubric Components

Strategy Scoring Rubric Components

Overall strategy scoringrubric

Rubric sections alignedwith strategy specific

components (1-4)

Rubric sections alignedwith essay generalcomponents (5-6)

Treatment group 3.706* (1.43) 2.500* (.76) 1.206* (.90)Control group 0.925* (.42) .0000* 0.925* (.42)Effect size difference

(Cohen’s d)2.63 4.68 .40

ANCOVAComparison

F(1, 14) � 27.07p � .0001

F(1,14) � 87.50p � .0001

F(1,14) � 0.57p � .463

Note:* Denotes mean values. Standard deviations provided in parentheses.


construction of an essay prompt responsedid not yield significant effects when thetreatment and control groups were com-pared. As previously mentioned, the “essaygeneral components” rubric scores repre-sented a generalization measure. In addi-tion it is important to note that the essaygeneral components rubric section con-sisted of only two items. Therefore it is dif-ficult due to the truncated nature of thescale to reach a statistically significant differ-ence. However the effect size of d � .40 wasimpressive considering the truncated natureof the generalization measure, and the factthat the raters were unaware of the AN-SWER strategy that was taught to the stu-dents. Although the six-steps of the strategywere taught to mastery through modeling,feedback, and daily practice tests, perhapsmore individualized instruction was neededfor generalized responding. Each studentcould have had individualized goals in orderto supplement instruction.

A second limitation is the length of theintervention. Extended instruction mighthelp to ascertain if the students are able togeneralize the strategy. The third limitationwas the fact that due to time constraints, wewere not able to determine whether the stu-dents who had been taught the strategy wereactually generalizing the strategy in theirother classes. Finally, we were not able to ad-minister a maintenance test.

Future studies should continue to investi-gate the use of this strategy with individualswith developmental disabilities who are en-rolled in post-secondary settings. Severalpoints should be addressed in future inves-tigations. The ANSWER strategy interven-tion could be extended beyond teaching stu-dents to mastery and include theadministration of multiple probes to assessmastery and over learning. Each studentcould have individualized essay writing goalsthat are tied to individual student outcomes.Future studies should also build in opportu-nities for students to practice answering es-say test questions in novel settings and in-clude maintenance tests to determine if thestudents are continuing to use the strategyover time.

Conclusion

In 2009, Penner-Williams, Smith, and Gartinnoted the importance of written expression inthe lives of adults. The authors asserted thatadults must master written language skills notonly to communicate with others but also tobe gainfully employed. Adults frequently par-ticipate in written forms of communicationsuch as writing notes for themselves (Penner-Williams et al.) and communicating via email,blogs, tweets, and so on. If difficulties in writ-ten expression are not reconciled at somestage in an individual’s development then oneremains at a disadvantage and cannot becomefully engaged in his or her adult environment.The inception of post-secondary programs forindividuals with developmental disabilities in-volves the development and implementationof unique curricula that emboldens individu-als with developmental disabilities with thecapacity to access the components of collegelife (e.g. academics, employment preparation,community life). Academics are an importantcomponent to college life and as such there isa need for evidence-based strategies.

In the present study, we investigated theeffectiveness of the ANSWER strategy in im-proving the essay composition skills of post-secondary students with developmental dis-abilities. We proposed that if students appliedthe six steps of the strategy they would pro-duce comprehensive and organized essayprompt responses. We concluded that thepost-secondary students with developmentaldisabilities who were taught the ANSWERstrategy were able to learn the strategy; how-ever, they may need additional structured sup-port outside of instructional settings to ensurethat they utilize the strategy effectively innovel settings. The ANSWER strategy holdsconsiderable promise as an effective strategyfor use in inclusive settings at the post-second-ary level. It is our hope that this study willstimulate additional data based research inorder to identify evidence-based practices thatare effective for individuals with developmen-tal disabilities who are enrolled in post-sec-ondary settings.

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Received: 13 April 2011Initial Acceptance: 7 June 2011Final Acceptance: 22 July 2011


Comparison of the Effects of Video Models With and WithoutVerbal Cueing on Task Completion by Young Adults With

Moderate Intellectual Disability

Linda C. Mechling and Terri S. CollinsUniversity of North Carolina Wilmington

Abstract: This study compared the effects of video models with and without verbal cuing (voice over) on thecompletion of fine motor cooking related tasks by four young adults with moderate intellectual disability. Theeffects of the two modeling conditions were compared using an adapted alternating treatments design with anextended baseline, comparison, final treatment, and best treatment condition. Results indicated that videomodeling with verbal cuing was more effective for three of the four students when evaluating independent correctperformance of task steps.

Video technology, used to increase learningand to promote independence in studentswith disabilities, continues to receive positivesupport in the research literature with a grow-ing amount of attention being devoted to itsevaluation (Rayner, Denholm, & Sigafoos,2009). While the use of video technology hasbeen shown to improve the learning and in-dependent functioning levels of students withdevelopmental and intellectual disability andthose with a diagnosis of autism spectrum dis-orders (ASD), questions still remain concern-ing which individual components or combina-tions of these components contributes to itseffectiveness (Ayres & Langone, 2007; Rayneret al.). Isolation of different variables throughcomparative studies has been recommendedin order to determine which characteristicsare most effective when using video technol-ogy (Ayres & Langone).

Among the variables of interest when usingvideo instruction is the use of verbal cues/prompts/directions being delivered while astudent is watching a video recording (Rayneret al., 2009). These verbal cues are frequentlyused along with the visual demonstration of

how to complete a task or component steps ofa task. When creating the video model orprompt, these verbal cues are referred to as“voice-overs” in which the person recordingthe video (operating the digital video camera)or the person performing the task (videomodel) verbally provides directions or de-scriptions of how to complete the task (i.e.,“put the skillet on the stove”) while demon-strating this step on the video recording.Voice-over has been included in a number ofstudies which have effectively used video mod-els (presentation of an entire task via videofollowed by a student performing the task)(Mechling, Gast, & Gustafson, 2009; Mechling& O’Brien, 2010; Taber-Doughty, Patton, &Brennan, 2008; Van Laarhoven, Van Laar-hoven-Myers, & Zurita, 2007) and videoprompts (presentation of a component stepor cluster of steps followed by a student per-forming the individual step) (Cannella-Ma-lone et al., 2006; Grice & Blampied, 1994;Mechling, Gast, & Fields, 2008; Mechling,Gast, & Seid, 2009; Norman, Collins, & Schus-ter, 2001; Sigafoos et al., 2005; Van Laar-hoven, Johnson, Van Laarhoven-Myers,Grider, & Grider, 2009;Van Laarhoven, Kraus,Karpman, Nizzi, & Valentino, 2010) to teachfunctional skills.

Likewise, no verbal cues or voice-over fea-tures have been effectively used with videomodeling (Alcantara, 1994; Ayres & Langone,2007; Cihak, Fahrenkrog, Ayres, & Smith,

Correspondence concerning this article shouldbe addressed to Linda C. Mechling, University ofNorth Carolina Wilmington, Department of Educa-tion of Young Children and Special Education, 601S. College Road, Wilmington, NC 28404-5940.


Effects of Video Models / 223

2010; Mechling & Gast, 2003; Murzynski &Bourret, 2007; Shipley-Benamou, Lutzker, &Taubman, 2002) and video prompting(Mechling & Seid, 2011) to teach functionalskills to persons with ASD and moderate intel-lectual disability. It therefore remains unclearwhether or not the inclusion of a verbal de-scription is a critical component for task com-pletion. Of particular interest is whether thesecues are necessary for students with ASD andother intellectual disability who tend to bestrong visual learners and weaker in the areaof auditory learning (Quill, 1995). Results of arecent comparison study by West (2008) sup-ports the theory that students with ASD arestronger visual learners. In that study it wasfound that three of four young students withASD more effectively and efficiently trans-ferred stimulus control from the instructorproviding assistance to picture cues comparedto verbal cues when prompting the functionalskills of setting the table and setting up an artproject. In addition to not being necessary forpersons who are stronger visual learners, itmay even be possible these verbal cues couldbe distracting to some students with a diagno-sis of ASD or intellectual disability as theyattempt to visually focus on the video model.

The current study is in response to the rec-ommendation of Rayner et al. (2009) whosuggested that components of video modelingand video prompting, such as voice-overs andvideo perspectives, be further evaluated in theresearch. The purpose of this study was toevaluate performance of students with moder-

ate intellectual disability on completion offine motor, cooking related tasks when videomodels included verbal cues (voice-over) com-pared to completion of fine motor, cookingrelated tasks when the video models con-tained no verbal cues.

Method

Participants

Four students with a diagnosis of moderateintellectual disability participated in the study.Students were enrolled in a local school sys-tem transition program for young adults andranged in ages from 19 to 22 years (Table 1).Students were imitative and screened earlierfor fine motor skills such as turning, pulling,and cutting. All students had experience withcomputer based instruction and Wanda was aparticipant in a previous study evaluating theeffects video models on a small PDA screen(Mechling & Gustafson, 2009).

Coleman was a 22 year, 1 month old malediagnosed with a moderate intellectual dis-ability [IQ 52, Kaufman Brief Intelligence Test(K-BIT): Kaufman & Kaufman, 1990; AdaptiveBehavior Composite Score 45, Vineland Adap-tive Behavior Scales: Sparrow, Balla, & Cic-chetti, 1984)]. Coleman communicated incomplete sentences although he frequentlyreplied with one or two word responses. Hewas more expressive when interacting withpeers and when describing preferred activities(i.e., dancing, landscaping equipment). Hewas able to read and follow a daily agenda,

TABLE 1

Student characteristics, treatment and tasks

Student Age Diagnoses IQ Adaptive Behavior Verbal CuesNo Verbal

Cues

Pair 1Coleman 22yrs 1m Moderate ID 52* 45** Set 2 Set 1Lionel 20yrs 10m Moderate ID Not available 55** Set 2 Set 1Pair 2Neville 21yrs Moderate ID 39*** 39** Set 1 Set 2Wanda 19yrs 7m Moderate ID 44*** 58** Set 1 Set 2

* Kaufman Brief Intelligence Test (K-BIT)** Vineland Adaptive Behavior Scales*** Stanford-Binet Intelligence Scale (4th ed)


read functional words for meal preparation,restaurant menus, and grocery aisle signs. Hecould write legibly and complete basic infor-mation on job applications. He needed toincrease his ability to write in small spaces andwrite his name in cursive. He was able to shopfrom a written list with assistance for less fa-miliar items. He recognized coins and couldcount different combinations except quartersplus dimes. He could also count dollar bills to$50, but needed to learn to transition whencounting from 59 to 60, 69 to 70 and so forth.He was able to read a calendar for informa-tion and used a personal calendar for timemanagement. He rode the city bus and couldlocate three stops independently. He was in-dependent in caring for his personal needswith some reminders to do so. He could pre-pare simple boxed meals in a microwave andhis needs included use of additional kitchenappliances and planning and preparing a va-riety of meals.

Lionel was a 20 year, 10 month old malediagnosed with a moderate intellectual dis-ability. His IQ test score was unattainable onthe Stanford-Binet Intelligence Scales–FourthEdition (Thorndike, Hagan, & Sattler, 1986).At age 5 years he obtained an age equivalencescore of 13 months on the Bayley Scales ofInfant Development (Bayley, 1993). His Adap-tive Behavior Composite Score was 55 on theVineland Adaptive Behavior Scales (Sparrowet al., 1984). He used single words and wordapproximations to communicate. He oftensaid, “I don’t know” in response to questions.He was reported to be very quiet and did notinitiate telling persons of his needs. He alsoused pictures to facilitate his expressive com-munication. He rarely made eye contact andfrequently closed his eyes when spoken to orpresented with a request. He could identify 19words found on fast food menus and used acommunication wallet with the words to orderhis meals when out in the community. Hecould also identify 26 community signs andpoint to information on his identification cardwhen asked his name, address, and phonenumber. He could orally identify pictures ofcommon grocery items and used a picture listto shop. His needs included navigation ofaisles in the store and to continue work onsurvival reading skills. He could write eight ofthe ten letters of his first and last name. He

could rote count and count objects up to five.He needed to increase his numeral identifica-tion skills and to use the skills functionally fortasks such as telling time with a digital watchand clock. He was learning to pay for pur-chases using large bills and to locate bus stops.He required physical assistance with his per-sonal care needs including bathing and brush-ing his teeth and his needs included increas-ing his independent living skills. He walkedslowly which presented difficulty when cross-ing streets and walking in the community. Hecould complete some household chores suchas emptying a dishwasher, emptying the trash-can, and clearing the table. His needs in-cluded preparation of snacks and simplemeals when supervised.

Neville was a 21 year old male diagnosedwith a moderate intellectual disability (IQ 39Stanford-Binet Intelligence Scales–FourthEdition: Thorndike et al., 1986; Adaptive Be-havior Composite Score 39; Vineland Adap-tive Behavior Scales: Sparrow et al., 1984).Neville communicated with one word andshort phrases in both Spanish and English andhe had a diagnosis of disfluency. His Englishwas better understood in context and by thosefamiliar with him. He was described as beingeasily distracted, inattentive, and impulsive.He also became easily irritated when otherstudents touched him or looked at him anddisplayed non-compliant and aggressive be-haviors in addition to saying inappropriatewords and comments. He was able to identifyapproximately 15 survival signs in addition torecognition of menu words and logos. Hisneeds included increasing his recognition offunctional words and signs in the community.He could trace letters and circle pictures toindicate answers on a page, but was unable towrite independently. He could rote count upto 10, but did not recognize numerals. Heenjoyed cleaning and volunteered to assistwith such tasks in his classroom. He was atten-tive and concerned about his appearance (i.e.,became upset if his clothes became soiled)and often wore a tie to school. He was able tocare for his dressing needs, but required assis-tance with brushing his teeth and shaving. Hisneeds further included crossing streets safely,entering and exiting a city bus, locating itemson shelves when directed to the correct aisle,and paying for purchases using a large bill. He


could follow a picture schedule and was work-ing on obtaining ingredients to prepare reci-pes using picture cues. His needs also in-cluded operation of small appliances such ascan openers and cutting utensils and prepar-ing simple meal items.

Wanda was a 19 year, 7 month old femalediagnosed with a moderate intellectual dis-ability (IQ 44, Stanford-Binet IntelligenceScales–Fourth Edition: Thorndike et al., 1986;Adaptive Behavior Composite Score 58,Vineland Adaptive Behavior Scales: Sparrowet al., 1984). Wanda was able to communicatein complete sentences and use “slang” andcurrent vocabulary used by her peers. She wasable to read sight words and community signsand words and use text functionally (i.e., readmenu words and order at restaurants). Shecould write her personal information and ba-sic two and three letter words. She was able touse her spelling skills to compose grocery lists.She used a calculator to complete simple ad-dition and subtraction problems for budget-ing purposes. She could tell time on the hourand half hour and could use the skill for timemanagement (i.e., arriving at a destination ata specific time). She was working on increas-ing her ability to independently cross streetswith traffic lights. She was working on count-ing coin and dollar combinations to $20 andused the next dollar strategy for making pur-chases. Her needs included identifying theamount of a purchase by looking at the mon-itor or cash register. She was able to care forall of her personal care needs and enjoyedshopping for clothing. Her needs includedsorting and independently washing and dry-ing clothing. She could follow simple recipeswith pictures and words using a microwave,stove, and oven. Her needs included increas-ing her ability to plan and prepare meals.

Tasks, Materials, Equipment, and Settings

Fifteen cooking related tasks were used in thestudy: five for use with video models with ver-bal cues, five for use with video models with-out verbal cues, and five for use as the controlset. Eight of the tasks used in the comparisonsets were selected from those used in the stud-ies by Mechling and Gustafson (2008, 2009)which compared picture and video promptson task completion by students with moderate

intellectual disability and those with autismspectrum disorders. In those studies the taskswere paired across two sets by task similarity sothat tasks assigned to each procedure re-quired relatively equal skills. This procedurewas used to select two additional tasks (setdigital timer and spray the loaf pan) for thecomparison sets and the five tasks used for thecontrol set (Table 2). The two tasks for usingmeasuring cups were also adapted from theMechling and Gustafson procedures so thatwater was poured from a plastic containerrather than a sink. Color coded stickers wereplaced on the vegetable peeler and cheesegrater to cue students where to hold theequipment and different colored measuringcups were used to represent different sizes formeasuring amounts of water. No other adap-tations were made to the cooking materialsand equipment. Prior to the start of the studystudents were assigned to one set for videomodeling with verbal cuing and the alternateset for video modeling with no sound (Table1). Tasks ranged from 2 to 6 steps per task(Table 2).

Video recordings were made using a Can-non ZR 830 digital video camcorder and ed-ited using Windows Movie Maker. Each videowas then inserted onto a separate PowerPointslide and saved by set. Three different Power-Point programs were made for each set inorder to present the video models in differentorders. Each set of 5 tasks (with and withoutverbal cueing) were displayed on a Dell Lati-tude � 300 laptop computer with an 11in.screen. Video models were made using anadult model completing each task. Modelswere made by using close up angles of theadult’s hands completing the task. Verbal cues(voice-over) corresponding to the task (i.e.,“put in”) were inserted while making thevideo recordings by the person operating thedigital camera. During video modeling with-out verbal cueing the volume on the laptopwas turned to mute. The duration of the vid-eos ranged from 9s to 28s. During video mod-eling sessions, the laptop was placed on a deskin front of the student and the cooking re-lated materials from all sets were placed to theright and left of the laptop. Materials wereplaced in the same location across sessions(i.e., cooking timers and measuring cupsplaced to the right of the laptop). The inves-


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tigator sat to the right of the student and whenpresent the reliability data collector sat to theright and behind the student and investigator.

Experimental Design

The study used an adapted alternating treat-ments design (AATD) with baseline, compar-ison, and final treatment conditions to com-pare the effects of video modeling with andwithout verbal cuing on the completion offine motor cooking related tasks with fourstudents (Wolery, Gast, & Hammond, 2010).The dependent variable was the percent ofcooking related tasks completed indepen-dently. The two treatments were applied todifferent, functionally independent tasks,equated for response difficulty (Table 2)(Holcombe, Wolery, & Gast, 1994). Experi-mental conditions included baseline, with averbal task direction (i.e., “Cut the celery”)being given for each of the three sets, followedby video modeling with and without verbalcueing and continuation of the control set(comparison condition). A final treatmentcondition was then applied to the control setfollowed by a final best treatment condition inwhich the superior treatment (video model-ing with verbal cues) was applied to the taskswhich did not receive verbal cuing during thecomparison condition.

Sessions were conducted individually acrossall conditions and video models with and with-out verbal cues were counter-balanced acrosstasks and students to control for task difficulty(Table 1). The two sets of tasks were counter-balanced across two pairs of two students withmoderate intellectual disability so that Set 1was presented to one pair of students usingvideo models with verbal cues and the secondpair to students using video models withoutverbal cues (vice versa for Set 2). Counterbal-ancing the interventions within sessions wasused to minimize the possibility of sequencingeffects.

The baseline condition served to demon-strate student performance on the 15 taskswithout video modeling and equivalence ofperformance on the two sets (Sindelar, Rosen-berg, & Wilson, 1985). Inclusion of the con-trol set, its intermittent measurement duringthe comparison condition, and the final treat-ment condition were included to assess possi-

ble multiple treatment interference (threat tointernal validity), the effects of history andmaturation, and to provide intra-subject rep-lication. The final best treatment conditionserved to detect multitreatment effects by eval-uating the best treatment (video modelingwith verbal cues) in isolation and to deter-mine if providing the superior treatment tothe alternate set (video modeling with no ver-bal cues) would produce any change in per-formance.

Response Measurement and Data Collection

Data were collected individually across all ses-sions and conditions on the number of tasksteps completed independently correct byeach of the four students. Students’ perfor-mance on each task step was recorded as cor-rect or incorrect. Students were provided 3s toinitiate each task after watching the videomodel or receiving the task direction (base-line) and 1min to complete all steps of thetask. Incorrect performance was recorded forfailure to complete a step correctly within1min. No instructor prompts were providedduring baseline or comparison sessions in or-der to evaluate the isolated effects of usingvideo models with and without voice-over.

Baseline Procedures

During baseline, each student was presentedwith the opportunity to attempt completion ofeach task independently. Each student’s abil-ity to complete the 15 fine motor cookingrelated tasks was evaluated over three baselinesessions or until data stabilized prior to theuse of video modeling (Wolery et al., 2010).Each session consisted of one trial per taskand consisted of delivery of a task direction(i.e., “Grate the cheese”) followed by a 3sallotment for the student to initiate the taskand 1 min. to complete the task steps. Allthree sets of materials were placed on thetable to avoid process of elimination throughuse of target items (Mechling & Gustafson,2008; 2009). Students received nonspecificverbal praise on the average of every third task(VR3) for general attending, attempts to per-form tasks, and correct responses. Tasks werepresented in blocks by set, however the orderof the blocks varied across sessions.


Video Modeling, with and without Verbal Cueing(Voice-Over) Procedures

At the beginning of each session students satin front of the laptop computer and the in-structor delivered a task direction identical tothe ones used during baseline and advancedthe PowerPoint program to the first slidewhich delivered the video model. Each sessionconsisted of one trial for each of the five finemotor cooking related tasks with voice-overand one trial for each of the five fine motorcooking related tasks without voice-over. Tri-als were presented in blocks by set. Sets werecounterbalanced across days. The student wasgiven 3s to initiate each task and 1min tocomplete the task steps. Failure to initiate thetask, failure to complete the task steps in1min., or incorrect performance of the tasksteps within 1min, resulted in the instructorpresenting the next video model. Reinforce-ment was delivered identically to the baselinecondition. The control set was conducted inthe same manner using only verbal task direc-tions and was presented intermittentlythroughout the comparison condition. Videomodeling procedures continued for a mini-mum of six sessions or until data stabilized(no change in the number of task steps per-formed correctly) on two consecutive sessionsacross both procedures or until 100% correctperformance was achieved on a set.

Final Treatment Procedures

Upon completion of the comparison condi-tion, the fine motor cooking related tasksfrom the control set received video modelingwith the superior treatment (verbal cuing) for3 sessions. Procedures were identical to thoseused in the video modeling comparison con-dition except only the control set of tasks wasevaluated using video modeling with verbalcues.

Best Treatment Procedures

Following the Final Treatment condition theBest Treatment condition served to evaluatepossible multitreatment effects by applyingthe superior video treatment alone and mea-suring its effectiveness with the alternate set oftasks (Holcombe et al., 1994). During the Best

Treatment condition, the single more effec-tive intervention (video modeling with verbalcues) was applied to the alternate set for threesessions and procedures were identical tothose used during video modeling compari-son condition.

Reliability

During the study, the first author conductedall baseline and video modeling sessions andthe second author collected reliability data.Reliability data on the dependent measurewas collected on 33% of all baseline, videomodeling comparison, final treatment, andbest treatment sessions. Interobserver agree-ment was calculated by dividing the numberof agreements on each step by the number ofagreements plus disagreements and multiply-ing by 100. Mean interobserver agreementacross all sessions was 98.9% (range � 95.7–100).

The reliability data collector also collectedprocedural fidelity data on independent vari-ables which included: (a) instructor deliveringthe general task directions; (b) instructor pre-senting the correct video model or control set;(c) all materials present on the table; (d) wait-ing the appropriate amount of time for taskinitiation; (e) waiting for the appropriateamount of time for completion of task steps;(e) no delivery of prompts or cues; and (f)delivery of reinforcement. Reliability was cal-culated by dividing the number of correctvariables by the total number of assessed vari-ables and multiplying by 100 (Billingsley,White, & Munson, 1980). Mean proceduralfidelity agreement was 99.8% (range � 98.6–100). All instructor procedural errors oc-curred in the category of not providing anyprompts or cues. The instructor pointed tothe screen one time when the student wasdistracted and replayed the video model onfour occasions when the student was dis-tracted or did not wait for the video to com-pletely play. These were interpreted as provid-ing a prompt.

Social Validity

At the conclusion of the study, results wereshared with the classroom teachers (n � 3 )and they were asked if they thought it would


be easier to develop video modeling programswith or without voice-over, what types of videomodeling they would prefer to use, andwhether they thought that video modelingwould be an effective tool in their classrooms.

Results

The combined scores across the four partici-pants showed a difference in performance infavor of video modeling with verbal cues:mean � 72.8% correct with verbal cues;mean � 61.8% correct without verbal cues.The percentage of task steps completed cor-rectly for each set of five cooking related tasks,by individual students across each condition,is presented in Figures 1 and 2. Baseline datafor each student remained low across thethree sets of tasks prior to the comparisoncondition. Coleman was the only student whowas able to complete more than 13% of tasksteps within one session. He consistently com-pleted 21.1% of the five tasks assigned to thevideo modeling with verbal cue set.

When video modeling with and without ver-bal cues was introduced in the comparisonphase, Wanda and Coleman’s performanceimproved considerably when using videomodels with verbal cues. Their performancealso showed improvement when using videomodels without verbal cues although the levelof change was not as abrupt. Colemanreached 100% accuracy with the verbal cue seton his second session and Wanda likewisereached 100% accuracy when using videomodels with verbal cues on her fourth instruc-tional session. Overall, Wanda’s mean perfor-mance was 91.3% correct when using videomodeling with verbal cuing and 75.4% correctwithout verbal cuing. Coleman’s mean perfor-mance was 98.3% when using video modelingwith verbal cuing and 71.3% without verbalcuing. During the Best Treatment condition,when verbal cuing was applied to the alternateset of tasks that did not receive verbal cuingduring the comparison condition, Coleman’sperformance remained high (discounting anymultitreatment effects on performance dur-ing the Comparison condition) and he wasable to complete 100% of the task steps. Hewas unable to complete one step (stoppingwhile grating the cheese) before delivery ofthe video model with verbal cuing. During the

Best Treatment condition Wanda’s perfor-mance also remained high and she completedtwo additional steps (stopping while gratingthe cheese and rubbing one side of the loafpan).

Although Lionel and Neville showed im-proved performance with the introduction ofvideo modeling, the change was not as abruptand each experienced a gradual change in hislevel of performance. Lionel was able to com-plete up to 60.9% of the task steps using videomodeling with verbal cuing on his last twosessions and Neville’s best performance was52.2% correct when no verbal cuing was pro-vided. Overall Lionel’s mean performancewhen using video modeling with verbal cuingwas 52.7% correct and 46.4% correct whenusing video modeling without verbal cuing.He also experienced overlapping data pathsduring the Comparison condition. Neville wasthe only participant whose mean performancewas greater when using video without verbalcuing (48.6%) compared to video modelingwith verbal cuing (32.6%). During the BestTreatment condition, introduction of verbalcues had no effect on Lionel’s performancewith the set of tasks that did not receive verbalcuing during the comparison phase and Nev-ille completed one additional step on the firstsession and then reverted back to his previouslevel of performance on the tasks.

Final Treatment

Performance when completing the control settasks remained low throughout the Baselineand Comparison condition although Cole-man completed up to 40% of the five tasksteps prior to introduction of video modelingwith verbal cues. The other three studentswere unable to complete more than 8% of thetask steps prior to introduction of video mod-eling. When video models with verbal cueswere added to the set during the Final Treat-ment condition, all participants showed animprovement in performance thereforestrengthening the internal validity of thestudy.

Social Validity

All three teachers reported that they felt itwould be easier to develop voice over video


Figure 1. Percentage of steps performed independently correct by Coleman and Lionel across all conditions.Open circles represent video with verbal cues; open squares represent video without verbal cues;open triangles represent the control set. Open squares in the Best Treatment condition representapplication of verbal cues to the set of tasks not receiving verbal cues during the Comparisoncondition.


Figure 2. Percentage of steps performed independently correct by Neville and Wanda across all conditions.Open circles represent video with verbal cues; open squares represent video without verbal cues;open triangles represent the control set. Open squares in the Best Treatment condition representapplication of verbal cues to the set of tasks not receiving verbal cues during the Comparisoncondition.


recordings, that they preferred to use videomodeling with voice over recordings, and thatthey thought video with voice over recordingswould be more effective when teaching theirstudents.

Discussion

The purpose of this study was to comparethe effects of video modeling with and with-out verbal cuing (voice over) on the com-pletion of cooking related task steps by fouryoung adults with moderate intellectualdisability. Effectiveness was measured bycomparing the individual and combinedpercentages of task steps completed inde-pendently. Both video interventions were ef-fective in increasing independent comple-tion of task steps across all four participants,but video modeling with verbal cues seemedto be more effective for three of the partic-ipants. Neville was the only participant whocompleted more task steps correctly whenusing video modeling without verbal cues.Additionally, when verbal cues were intro-duced to this set during the Final Treatmentcondition, he completed one additional stepcorrectly, but he was unable to maintain thatlevel of performance over the next two ses-sions. Similarly, although Lionel completeda higher percentage of task steps with verbalcues, the addition of verbal cues during theFinal Treatment condition produced nochange in his performance. These individ-ual outcomes demonstrate that individualdifferences in student characteristics, in-cluding ability level, may play an importantrole in determining components of videoinstruction that may be more critical tosome learners. Nick and Lionel each exhib-ited lower cognitive abilities than Wandaand Coleman.

Further, it appears that certain task require-ments involving variables such as amounts oftime (i.e., stir for 10s, wait 1 min) or numberof repetitions (i.e., grate 3 times, cut 4 beans)may be better represented by video modelswhich include verbal cues. In the currentstudy Coleman and Wanda were unsuccessfulin completing the steps involving number ofrepetitions (grate the cheese 3 times, grate thecarrot 3 times) until the verbal cue (“one, two,

three, stop”) was added during the Best Treat-ment condition.

Although the current study is a preliminaryattempt to isolate components of video tech-nology, a recognized limitation of the study isthe number of participants and that each hada diagnosis of moderate intellectual disability.This limits the generalizability to other stu-dents with moderate intellectual disability andother disability groups such as those with au-tism spectrum disorders. Further, different re-sults may occur when verbal cuing is exam-ined with younger students.

Another question raised by the results ofthe study concerns task requirements. Thefine motor cooking related tasks in this studywere evaluated and matched across sets basedon level of difficulty. In addition, sets werecounterbalanced across video modeling inter-ventions and pairs of students (Table 1) tocontrol for effects of task difficulty. Table 3provides an analysis of the percentage of er-rors committed across each task by the fourparticipants. Results indicate that the taskswere matched across the two sets by relativelysimilar levels of difficulty; however some pairs(types of tasks) presented more difficulty tostudents. Coating the loaf pan accounted for29.5% of the errors followed by use of tools tograte the cheese and carrots (27.8%) and set-ting a digital and analog timer (23.7%). Cut-ting and snapping off the ends of the celeryand asparagus (15.9%) and measuring liquids(1.2%) resulted in the least amount of com-mitted errors. These results have implicationsfor further research examining componentsof video modeling in relationship to types oftasks with differing motor and/or cognitivechallenges.

Although there is an increasing amount ofinformation supporting use of video technol-ogy as an instructional tool for persons withdisabilities, researchers are just beginning toaddress the isolation of video variables in or-der to determine which components are mosteffective with different learners. This studywas an early attempt to determine the extentto which verbal cuing is a critical componentfor delivering instruction through video tech-nology. While the results suggest its impor-tance with young adults with moderate intel-lectual disability, much more research isneeded in this area.


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TABLE 3

Error analysis. Percentage of errors across participants for each fine motor cooking related task

Set 1 Percent Error Set 2 Percent Error

Spray loaf pan with cooking spray 14.5 Grease loaf pan with stick of butter 15Grate block of cheese with hand grater 14.5 Peel carrot with vegetable peeler 13.3Set digital timer to 3 minutes 12.7 Set dial timer to 5 minutes 11.0Cut off each end of celery with knife 9.2 Snap off ends of asparagus 8.7Measure 1/3 cup water from container 0 Measure 1/8 cup water from container 1.2


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Mainstream Teachers’ Experiences of Communicating withStudents with Multiple and Severe Disabilities

Tania De BortoliThe University of Newcastle

Susan BalandinMolde University College, Norway

Phil Foreman andMichael Arthur-Kelly

The University of Newcastle

Bernice MathisenLa Trobe University

Abstract: The aim of this study was to explore regular teachers’ perceptions and experiences of supports andobstacles to communicative interactions for students with multiple and severe disabilities (MSD). Five teachersof students with MSD participated in two in-depth interviews. Interview transcripts were analysed using contentanalysis. Transcripts were coded into categories, which were then grouped to yield content themes. Participantsidentified a broad range of themes, including: the complex needs of students with MSD, teachers’ training andexperience, communication education for teachers, the presence of peers without disabilities, the mainstreamclassroom, other staff in the school context, resources, infrastructure, the culture, size and geographical locationof the school, the home context, support from specialist personnel outside the school, including collaboration withspeech-language pathologists, the role of government departments, and broader societal factors. There arecomplex, systemic influences on access to communicative interactions for students with MSD in mainstreamschool settings. Inadequate systemic supports restrict communicative interactions between students with MSDand their teachers and peers without disabilities, and limit the involvement of students with MSD inmainstream classroom activities. Further research is required with teachers of students with MSD to substantiatethese preliminary findings.

Access to communicative interactions is im-portant for the educational participation andsocial inclusion of students with multiple andsevere disabilities (MSD) (Calculator & Black,2009; Downing, 2006). For several decades,however, researchers have reported low fre-quencies of communicative interaction forthese students at school (Arthur, 2003; DeBortoli et al., 2010). Until recently, little re-search has examined potential reasons for thelow frequencies of communicative interac-tions and there is limited understandingabout their persistence, particularly betweenteachers and students with MSD (De Bortoli etal.). Our recently reported research suggeststhat supports and barriers to communicativeinteractions for these students in segregated

classrooms (i.e., special schools and supportunits) are complex and systemic (De Bortoli,T., Arthur-Kelly, M., Foreman, P., Balandin,S., & Mathisen, B., 2011).

In the past 20 years, researchers have sug-gested that the presence of peers without dis-abilities in mainstream school settings mayoffer a more favourable context for enhancingthe frequency of communicative interactionsfor students with MSD (Arthur-Kelly, Fore-man, Bennett, & Pascoe, 2008; Calculator,2009; Houghton, Bronicki, & Guess, 1987; Sie-gel-Causey & Bashinski, 1997). Further, thepotential benefits of mainstream settings forstudents with severe disabilities have been welldocumented (Carter, Hughes, Guth, & Cope-land, 2005; Downing, 2001, 2006; Hunt, Soto,Maier, & Doering, 2003; Kent-Walsh, & Light,2003; Soto, Muller, Hunt, & Goetz, 2001).Researchers have investigated the level of en-gagement and frequency of communicationfor students with severe disability and MSD in

Correspondence concerning this article shouldbe addressed to Tania De Bortoli, School of Educa-tion, The University of Newcastle, Callaghan, AUS-TRALIA. E-mail: [email protected]



both primary and high school settings. How-ever, research with primary-aged students withMSD in mainstream classrooms has producedmixed results. Foreman, Arthur-Kelly, Pascoe,and Smyth King (2004) found that studentswith MSD spent more time involved in com-municative interactions in mainstream class-rooms than in segregated classrooms. In con-trast, Helmstetter, Curry, Brennan, andSampson-Saul (1998) identified that studentswere more actively engaged in segregatedclassrooms, and that in mainstream class-rooms, they were most actively engaged wheninteracting on a one-to-one basis with a teach-ers’ aide (TA). Researchers have claimed alsothat students with severe disabilities in main-stream high schools continue to have limitedengagement in classrooms activities and thatthe frequency of communicative interactionsremains low (Carter & Hughes, 2006; Carteret al.; Downing, 2006; Hughes et al., 2002).Given that school may be an optimal place toacquire and practise communication skills,there is a need to better understand how tosupport students with MSD to leave the edu-cation system having realised their potential ascommunicators (Downing).

There appears to be a consensus amongresearchers that, although there may be in-creased opportunities for communicative in-teractions in mainstream school settings, phys-ical placement alone is not sufficient to ensureincreased access to communicative interac-tions for students with intellectual or physicaldisabilities (Calculator, 2009; Cutts & Siga-foos, 2001; Downing, 2006; Hughes et al.,2002; Kent-Walsh & Light, 2003). Indeed, re-searchers have concluded that there may be arange of complex factors, including contex-tual factors, influencing the communicationof students with MSD in mainstream schoolsettings (Arthur-Kelly et al., 2008; Cutts & Si-gafoos; De Bortoli et al., 2010; Helmstetter etal., 1998).

Despite mixed research results regardingfrequencies of communication opportunitiesfor students with MSD in mainstream class-rooms, to date there has been limited re-search with teachers exploring the factors po-tentially influencing such opportunities(Arthur-Kelly et al., 2008; Carter & Hughes,2006; De Bortoli et al., 2011; McNally, Cole, &Waugh, 2001). Most research investigating the

involvement of students with severe disabili-ties in mainstream classrooms has been con-ducted in large metropolitan schools (Carteret al., 2005; Cutts & Sigafoos, 2001). This isdespite reports from families in rural areasthat they wish their child with a significantdisability to attend the local school in order tohave the opportunity to interact with otherchildren in the community (Calculator, 2009;Downing, 2006). The aim of the present studywas to explore teachers’ perceptions and ex-periences of factors that influence the com-municative interactions of students with MSDin mainstream school settings in rural areas.

Method

Participants

Participants were recruited through the stateeducation system. The first author contacteddisability support services staff within two dis-trict/area offices, who forwarded the names ofschools including students with MSD in main-stream classrooms. The first author then con-tacted 11 schools by telephone. Following dis-cussion with executive teachers, six schoolswere deemed not eligible for the study be-cause they did not have a student with MSDenrolled. No successful contact was made withtwo schools. Three schools were deemed eli-gible and five teachers from these schools vol-unteered to participate in the study. All par-ticipants currently taught one student in amainstream classroom who had MSD. MSDwas defined as having a severe intellectualdisability, and a range of impairments thatmay include physical and sensory impairments(Foreman & Arthur, 2002). All five teachersworked in mainstream public schools in ruralareas. Teachers ranged in years of teachingexperience from 5–30 years. Two of the teach-ers had not previously encountered studentswith disabilities, while the other three teach-ers had some previous experience workingwith students with a range of disabilities. Thepseudonym, school setting, and years of teach-ing experience of the participants are sum-marised in Table 1.

Procedure

Each teacher participated in two in-depth in-terviews lasting 45–120 minutes. In the first

Mainstream Teachers’ Experiences with Students with MSD / 237

interview, participants were invited to talkabout their perceptions and experiences ofsupports and obstacles to access to communi-cation for the student with MSD. Four open-ended questions, developed from a review ofthe literature, were used to guide the inter-view (see Table 2). Each participant was thensent a copy of their transcript including theinitial coding for content themes. The secondinterview was conducted during the followingschool term (3 to 10 weeks after the first in-terview). In the second interview, participantswere invited to: (a) change and/or elaborateon issues discussed in the first interview, and(b) provide feedback on the researcher’s in-terpretations (Eisenhart & Howe, 1992; Free-man, M., de Marrais, K., Preissle, J., Roulston,K., & St. Pierre, E., 2007). Interviews wereaudio-taped for later analysis, with the partic-ipants’ consent.

Transcription and Management of Data

The first author transcribed the interviews assoon as possible after interviews were con-ducted. All identifying information was re-moved from transcripts. Pseudonyms replacedparticipants’ names, and general descriptors(e.g., student, teacher, school, place) were

used in place of proper nouns to ensure con-fidentiality.

Analysis and Verification

The transcripts of the first interviews weresubjected to an analysis of content themes(Coffey & Atkinson, 1996; Creswell, 2008;Richards, 2005; Tesch, 1990). Text segmentswere coded for the topic discussed and as-signed to categories. Categories were derivedpartly from previous research (De Bortoli etal., 2011), with some categories not used andnew categories added according to the topicsdiscussed by the participants in this study.Categories occurring at the same systemiclevel (De Bortoli et al), or within the samecontext (e.g., school setting, government de-partment), were grouped together to yield thecontent themes. Qualitative data analysis soft-ware (NVivo 8, QSR International) was usedto assist in data management.

Only two participants attended second in-terviews due to work commitments at the endof the school year. However, all participantsprovided verification of their transcripts andinterpretations of themes, either by writing ontheir transcripts (n�5) and/or by discussionin the second interview (n�2). In addition, an

TABLE 1

Characteristics of participants

Participant GenderAge

(years)

Years ofteaching

experience

Type ofteaching

experienceEducational

setting LocationTraining

background

Betty F 55� 30 Primaryandsecondary

Centralschool

Rural DipEd

Dora F 55� 30 Primaryandsecondary

Centralschool

Rural DipEd

Naomi F 36-45 15 Primary Smallmainstreampublic

Rural B.Ed.

Phoebe F 20-35 6 Primary Smallmainstreampublic

Rural B.Ed

Nigel M 20-35 5 Secondary Centralschool

Rural B.Ed

F�female, M�male, DipEd � Diploma of Education, B.Ed. � Bachelor of Education.


independent person, a research assistant withexperience in qualitative research, coded ran-domly-selected transcripts for two of the fiveparticipants (40%) into content themes. Shewas given instructions for coding that in-cluded definitions of the coding categoriesand then independently coded the transcriptswithout any discussion with the main investi-gator. Subsequent analysis compared the cod-ing of transcripts into categories by the inde-pendent person with those noted by the firstauthor, yielding an inter-coder reliability rat-ing of 92%.

Results

Findings are presented as the six main themesthat emerged from the participants’ experi-ences. These are summarised in Table 3, withcategories and examples of supports and ob-stacles discussed by participants.

Teachers’ Experiences Communicating withStudents with MSD

Two of the participants in this group (Phoebeand Nigel) were in the early stages of their

careers and had no previous experience withstudents with MSD. The other three partici-pants had 15–30 years experience and hadpreviously taught one student with MSD. Par-ticipants described communicating with stu-dents with MSD as “difficult” (Phoebe, Nigel,Naomi), “overwhelming” (Phoebe), “frustrat-ing” (Betty, Dora), and “daunting” (Dora).Nigel said: “I find it difficult because apartfrom the greeting you’re left a little bit lost asto where to go from there. It’s a bit hard toprolong an interaction or a conversation ofany manner.” Yet the teachers also reportedsome positive experiences and feelings. Bettysaid: “[Student] makes my day when he smilesat me, it’s wonderful.” The supports and ob-stacles to communication identified by partic-ipants are outlined below.

Individuals: Teacher and Student

Participants initially identified obstacles tocommunicating associated with both the stu-dent’s characteristics, and their own charac-teristics. The more experienced teachers also

TABLE 2

Interview outline

The following is the general interview format for the initial interview with teachers. The format of the in-depth interview has been chosen to allow participants to discuss their experiences of communicatingwith their students with multiple and severe disabilities openly and without interruption. Theinterviews will be conversational in style and the number of questions kept to a minimum. Thefollowing questions will be used as a guide only.

1. Demographic information� What type of setting do you work in?� How many years experience have you had working with students with severe and multiple disabilities?

You may find it helpful to think of particular students when answering these questions.2. Communicating with students with severe, multiple disabilities

� What is it like to communicate with your student(s)?� What do you think is important about communication for your students?

3. Supports� Can you tell me what supports or has a positive affect on your communication with your student(s)?� What do you think could help make communication easier?

4. Training� Have you had any communication training? If so, how would you evaluate it?� What sort of communication training do you think would be valuable to you?

5. Obstacles� What factors have a negative impact on your communication with your student(s)?

Topic areas will be introduced with the natural flow of conversation. It may be unnecessary to introduce atopic or ask a question if the participant has already addressed it. Therefore, these topic areas aremerely a guide and not a set interview regime.


TABLE 3

Themes, sub-themes and examples of supports and obstacles discussed by participants

Themes Categories Supports Obstacles

Individuals-Teacher andstudent

Student characteristics Complex communication needs.

Teacher characteristics Existing skills, knowledge andexperience.

Limited training, knowledge and experience

Communicationeducation forteachers

Formal education andcourses

Limited pre-service and continuingeducation.

Mentoring Limited opportunities.Practical experience Working with students with

disability.Internet Access to information in

rural schools.Visiting other schools Observing communication

practises.Support people Giving teachers skills and

knowledge.The school

contextPeers without

disabilitiesCommunication oppor-

tunities. Positive attitudes.Limited interaction at high school.

The mainstreamclassroom

Difficulties programming andcommunicating in group situation.

Other staff in theschool context

Teachers’ aides.

Collegiality: meeting withother teachers.

Limited opportunities for collegiality.

Principal supports teachers. Principal provides limited support toteacher.

Resources and thephysicalenvironment

Accessible physicalenvironment.

Difficulty accessing resources, assistivetechnology.

School culture Small, rural schools providesupportive atmosphere.

Difficulty meeting learning andcommunication needs. Difficult for small,rural schools to access support.

Other peopleoutside theschool

Home context Close contact for exchangeof information.

Family not capable of supporting the child’scommunication.

Visiting specialistteachers

Facilitating communicationskills; student, teacher,peers. Programming foractivities.

Reduced support. Limited support forstudents without hearing impairment.

Speech pathologistsand other therapists

Limited collaboration with teacher.

Governmentdepartment/agencies

State education system Integration officer supportsschool with resources.

Difficulties obtaining funding, specialist staffand support for networking.

Other departmentsand agencies

Limited access to speech pathology services.Inconsistent service to schools.

Societal factors Positive community attitudes.Local school promotessocial inclusion.

Social exclusion in mainstream school.Segregated activities outside school.


identified some supports associated with theirown characteristics.

Student characteristics. Participants identi-fied the complex communication needs oftheir student with MSD as an obstacle to es-tablishing communication. They perceivedthat communication was difficult because oftheir student’s limited responsiveness andspontaneity. Betty said: “With a typical studentyou are able to get some feedback and there-fore know that your message has been under-stood. Sometimes with [student] we may getno visual signs whatsoever, not even facialmovement.”

Participants reported difficulty interpretingstudents’ idiosyncratic forms of communica-tion. Nigel said: “He can’t communicate ver-bally so actions and eye contact are the biggestthings. I’m only taking a guess or a stab atwhat it is that he’s trying to project.” Threeparticipants perceived that their student maybe pre-intentional. Phoebe noted: “I don’tknow if [student] has intent to communicate,that’s the hard part. We can put him in situa-tions to foster communication but I don’tknow if the intent is there, if he actually wantsto communicate.” Four participants also ob-served that communicating with their studentwith MSD required increased effort and timeon their part, because of the need for one-to-one interaction. Participants then emphasisedtheir lack of skills and knowledge to interactwith students with such complex communica-tion needs.

Teacher characteristics. Participants re-ported that their lack of training, knowledgeand experience was a major obstacle to estab-lishing communication with students withMSD. Phoebe said: “I’m not trained and Idon’t understand how it [communication]works with a child with severe, multiple dis-abilities and minimal communication.”

Naomi noted, however, that the experience,skills and knowledge she had acquired at aprevious school, teaching children with a va-riety of additional needs, supported her tocommunicate with her current student withMSD. She had undertaken training in signlanguage, and said “so I could actually com-municate with them that way.” Following onfrom discussion of their own characteristics,participants talked about the importance ofcommunication education.

Communication Education for Teachers

Formal education and courses. The partici-pants reported a general lack of training forteaching and communicating with their stu-dent with MSD. They noted limited relevantcontent in their pre-service teacher educationand limited continuing communication edu-cation. Nigel said:

We’ve very much been told to try and inter-act with the student as best we can but Ihaven’t had any kind of special educationtraining or any specific professional devel-opment regarding how to cope with a stu-dent that’s at this level. It has been verymuch on-the-job training, a bit of trial anderror.

Participants perceived a need to attend exter-nal courses to help them acquire some skillsand strategies for communicating with stu-dents with MSD.

Mentoring. The early career teachers, inparticular, perceived the potential value ofregular opportunities for mentoring, for per-sonal support and guidance with program-ming However, they reported limited oppor-tunities for such experiences. Phoebe said: “Asfar as mentoring goes, it’s quite difficult tofind someone that’s willing to support you.” Inthe absence of formal education and mentor-ing, Nigel described some of his experiencesof “on-the-job training.”

Practical experience. Nigel described thebenefits of spending time with another stu-dent at the school who had a hearing impair-ment. He said: “I’ve found that a very biglearning experience in terms of understand-ing her communication needs. It gave memore insight into working with the more se-verely disabled student that we have here atthe school.” Participants noted other waysthey could be supported to learn how to com-municate with students with MSD. These in-cluded using the internet, visiting otherschools, and support people coming into theschool.

Internet. Naomi reported that access to theinternet at her school enabled her to researchthe communication needs of children withdisability. She perceived this as an importantresource for teachers in rural areas.


Visiting other schools. Participants also com-mented that observing practices in otherschools, particularly special schools, would behelpful. Phoebe said: “[We] are going to an-other school to see what they are doing therefor these students with multiple disabilitiesand severe language delays, and how theteachers there communicate with them, to seethat we’re on the right track.”

The role of support people. Finally, partici-pants perceived that support people, fromoutside the school, had a role in impartingskills and knowledge about how to communi-cate with students with MSD. Naomi said:

When the children come through theybring their entourage of OTs andspeechies. The itinerant support people aremaking sure that as a beginning teacheryou’re getting that information. That’s ba-sically how I learned. So really those sup-port people are crucial.

Regardless of their level of experience oraccess to training, however, participantstalked about receiving limited support. Naominoted that while this support is crucial forbeginning teachers it had been “dwindlingaway.” She said:

Particularly for a beginning teacher, to befaced with a student with multiple and se-vere disabilities, it’s essential to have sup-port. If I was a beginning teacher I wouldsay that I would be struggling because Iwouldn’t know where to go with this child.

Participants talked about obstacles, and sup-ports, they encountered in the contexts of theclassroom and school. These are presented inthe next theme. The role of support peoplefrom outside the school will be presented inthe following theme.

Classroom and School Contexts

Participants perceived that a number of issuesinfluenced access to communicative interac-tions for the student with MSD. These in-cluded: (a) peers without disability, (b) themainstream classroom, (c) other staff in theschool, (d) resources and the physical envi-ronment, and (e) the culture of their school.

Peers without disability. Participants re-ported that the other students generally heldpositive attitudes toward their peer with MSD.The two participants in primary classroomsperceived that the student with MSD had op-portunities for communication, because ofthe presence of peers as potential communi-cation partners. Phoebe said:

I think him just being here is a great oppor-tunity for communication because he’s get-ting to interact. The other kids want to holdhis hand, they want to speak to him, theywant to sit beside him. His being in themainstream setting just provides him withother students that want to talk to him andthat want to be his friend.

Participants at the secondary school level,however, reported minimal interaction be-tween the student with MSD and other stu-dents, despite students’ positive attitudes. Ni-gel said:

There’s not a lot of interaction between themainstream students and him [student withMSD]. None of the other students seem towant to even attempt the “high fives,” a bigcommunication tool. So, there is that dividein that respect.

Nigel perceived that, like the staff, the otherstudents found it difficult to communicatewith the student with MSD. He said: “It is verydifficult for other students to even relate with[student]. If teachers find that difficult thenwhat chance does a student have?”

The mainstream classroom. Participantsnoted a number of barriers to communicationassociated with the mainstream classroom.Participants reported both awareness thattheir student with MSD needed more time,and a concern about allocating their time andeffort equitably among all their students, toensure delivery of the curriculum, particularlyat the high school level. Participants also re-ported difficulty communicating with the stu-dent with MSD in the group situation andprogramming to involve him in classroom ac-tivities. They perceived that the student withMSD could be “disruptive” (Naomi) for themand the other students. Phoebe said “We en-courage him to make noises to communicatebut it’s awfully difficult to be teaching when


you’ve got someone yelling in the back-ground.”

Other staff in the school context. Participantstalked about the perceived role of teacher’saides, the principal, and collegiality in sup-porting or hindering access to communica-tion for students with MSD. Participants spokeabout the importance of having a teachers’aide (TA) in the classroom to facilitate com-munication, and work one-to-one with the stu-dent with MSD on their individual educationplan (IEP). Naomi said: “With more severechildren we do that more through the teach-er’s aide and using that aide to set them upwith communication skills. You need thatspace where he’s just with his aide working onhis own program.” However, Phoebe reportedlimited opportunities during the school day tocommunicate with her TA about the student’sprogress and goals.

Participants also spoke about the role ofopportunities to meet with other teachers, insupporting them to communicate with theirstudent with MSD. Three participants re-ported that dialogue between teachers sup-ported positive attitudes and a consistent ap-proach to communicating with the studentwith MSD. Betty commented that: “It’s been acommunication for staff actually” to take aconsistent approach to using high fives withtheir student. Phoebe, however, reported al-most no opportunities for collegiality. She wasthe only teacher at her school who had astudent with MSD in her classroom. She said:

I’ve found that there’s no one else in thesame situation as me. There’s no one withmy lack of training that has a student withmultiple and severe disabilities in theirclassroom that can speak on a de-briefinglevel.

Participants also reported varying experi-ences of support from their principal. Phoebesaid: “I don’t feel that I get support from theprincipal.” Other participants reported thattheir principal managed the students with dis-abilities at their school, provided informalproblem-solving with them, and arranged aspeaker to attend a staff meeting prior to thestudent with MSD arriving.

Resources and the physical environment. In ad-dition to the role of other people in the

school context, participants talked about theinfrastructure of their school, and the needfor more resources. Betty, Dora and Nigeldescribed changes made to the physical envi-ronment of their school to enable the studentwith MSD to participate in classes with hispeers. These included use of downstairs class-rooms, installation of ramps, and acquisitionof desks to accommodate wheelchairs. Nigelreported that changes were made to the use ofparticular rooms and areas in the school, sothat the student had dedicated spaces forsleep and mealtimes.

However, participants reported difficulty ac-quiring, or lack of knowledge about resourcesto support the student’s participation in class-room activities and opportunities for commu-nication. Naomi said: “We haven’t really beenoffered any equipment here and we’re mak-ing do as we go.” Nigel reported that his stu-dent with MSD had recently acquired an assis-tive technology device. However he also said:“I don’t know a lot about it, the teacher’s aideknows more about it.”

The school culture. In addition to these spe-cific issues, participants shared their percep-tions of their school culture. They discussedthe school’s ability to cater for the needs ofstudents with MSD, and the impact of its sizeand geographical location. Even participantsin the same school had different perceptionsabout their school’s ability to cater for theneeds of students with MSD. Betty and Doracommented that their school had a history ofaccommodating students with disabilities, interms of enabling access in the physical envi-ronment. Betty said:

I think it’s a culture within our school be-cause I remember twenty years ago, we hadstudents that would have been at [specialschool] then. We had a fellow in a wheelchair and it was no big deal. We justchanged our timetable for him every year sothat he never had to go upstairs. So I thinkwe’ve had it in our community, in ourschool community for quite some time.

Nigel, however, expressed the view that, whileit was “fantastic” to be able to accommodatethe student with MSD, staff had fears abouthow to interact with him. He noted that staffattitudes had become more positive: “I think


change has been the biggest fear for many ofus, including myself, but as times gone on Ithink it’s been more accepted.” Nevertheless,he expressed uncertainty about the school’sability to cater for the educational and com-munication needs of the student with MSD,and recommended that more be done “tomake it more worthwhile for those childrenthat are coming.”

Participants also noted supports and obsta-cles associated with small, rural schools. Fourparticipants perceived that the emotionallysupportive culture of their school was due to itbeing a small, rural school. Naomi said: “It’sreally a family environment in a small school.Everyone’s accepting of our little person andreally nurturing and encouraging.” Betty per-ceived that there was a “sense of communitywithin the school.”

The perceived disadvantage of small, ruralschools, however, was greater difficulty access-ing support from the state system and profes-sionals outside the school. Naomi said: “Ithink we find it a little bit difficult to accesssupport being in a smaller school rather thanbeing in a larger school where there are moreof those sorts of children.” Teachers’ percep-tions and experiences of other people outsidethe school is the next theme.

Other People outside the School

Participants talked about the role of peopleoutside the school. These included parents oftheir student with MSD and professionals intheir district/region, such as visiting specialistteachers and speech pathologists.

Home context. Participants reported varyingexperiences of contact with their student’sparents. Three participants reported havingclose contact, via phone and communicationbook. Dora said: “A lot of the communicationis through the parents for the kids. So we workwith them. [Communicating with the student]is hard.” They reported that the communica-tion book was not being used to communicatewith the student with MSD.

Two participants noted that not all familieswere capable of supporting their child’s com-munication development. Phoebe describedlimited support from the family for enhancingher student’s skills: “I feel that I don’t getmuch support from the home environment. It

isn’t particularly an opportune environment. Idon’t think they are particularly concernedwith fostering [student’s] development. Itfrustrates me. That’s a big obstacle.”

Participants perceived that parents had animportant role in accessing support, for exam-ple, speech pathologists, both before studentsstart school and throughout their schoolyears. Naomi said: “Some parents are maybenot as diligent in looking for that help beforeschool. If we are trying to access that supportlater on then it’s perhaps a little more lim-ited.”

Visiting specialist teacher. The two partici-pants in primary schools spoke about the waysthat an itinerant teacher for hearing (ISTH)provided support. These included facilitatingthe communication skills of the student withMSD, the teacher and the other students inthe class. Phoebe said: “With access to theirsupport, we are trying to teach him to com-municate using his eyes and using simpleMakaton signs. So they are our alternativeforms of communication.” Naomi added:“The itinerant support people set you up formaking sure that you’re going to be able tocommunicate well, that you’re able to sign tothem to communicate to them.” She also said:

We use the support teacher to work with allof the children so she could sign to thechildren as well. That way we’re all on thesame wave length in being able to commu-nicate with each other. That was really im-portant.

Participants also reported that the ISTH sup-ported them with programming to involve thestudent with MSD in activities and create op-portunities for communication. Naomi said:“Every chance I get with my support teacherwe’re programming.”

However, Naomi reported that this support“has just dwindled away. Now we might seeour support teacher once every couple ofweeks. Those support people are crucial.” Theparticipants in a high school noted that anISTH comes to their school to support a stu-dent who has a hearing impairment. However,they noted that their student with MSD wasnot receiving similar support. Nigel said: “I’mnot certain whether there’s that kind of facil-ity with the more severely disabled male stu-dent that we have. I may be unaware of it.”


Speech pathologist and other therapists. Incontrast to her supportive experience with anISTH, Phoebe described her negative experi-ence of visits from a speech pathologist andother therapists that were unhelpful. She said:

The very first day of school, seven peoplefrom [Non Government Organisation]knocked on my classroom door and startedspeaking about Big Mack switches, and aug-mented communication systems . . . I wasjust so overwhelmed by these people tellingme what I must do. I was actually told: “Youneed to do more, and this was the very firstday of meeting this little person.”

She also reported not being involved becausethe speech pathologist did not arrange appro-priate times with her to visit the school. Shesaid: “So since having [student] at schoolwe’ve had three speech visits that really I felt Igot nothing from. These visits happen outsidethe classroom while I’m teaching.” Apart fromparticipants’ comments about the individualprofessionals that they worked with, they alsotalked about factors associated with govern-ment departments. This is the next theme.

Government Departments: State Education System

Teachers talked about supports and obstaclesassociated with both the state education sys-tem and other government departments andagencies responsible for providing speech pa-thology services.

The integration officer. Participants workingat the central school reported receivingweekly visits from an integration officer “be-cause there are quite a few special needs chil-dren here” (Dora). Dora said: “She talks to theteachers to see if there are any special re-sources that the child may need to help withtheir learning. If we need a laptop she can getthat from district office.” Participants per-ceived the integration officer’s presence ashelpful, even though she had limited time atthe school.

Difficulty obtaining support. Having previ-ously also worked in a central school, Naomiperceived, however, that there was less sup-port from the state system for students withMSD in smaller schools. Phoebe reported thather requests for support seemed to “fall on

deaf ears.” Despite positive reports about theISTH and integration officer, participantstalked about difficulties obtaining funding,support from specialist staff, and support fornetworking with other teachers of studentswith MSD in mainstream classes.

Difficulty obtaining funding. Participants re-ported difficulty obtaining funding throughthe state system for resources to support theirstudent’s participation in activities and oppor-tunities for communication. Phoebe said: “Ipushed and pushed and pushed. It’s taken aterm and a half to get $400 worth of fundingto buy some developmental toys and resourcesfor him.” However, she also described resort-ing to purchasing resources with her personalmoney, for which she had not been reim-bursed. Betty perceived that staff had to“fight,” not only to obtain resources, but alsofor additional staffing in the classroom.

Limited specialist staff. Participants per-ceived that there were limited avenues foraccessing specialist support through the statesystem, for students with MSD in the main-stream setting. Phoebe said:

When I first filled out the access requestform, “hearing” was the only box that [stu-dent] fitted into. It was the only box that Icould tick for him and I thought “I needsome support. I’m just going to try.”

Nigel perceived that there was a scarcity ofsuch staff. He said: “If you brought someonein [here], are you taking resources from else-where. It’s a finite resource pool.”

Isolation of mainstream teachers of students withMSD. Participants talked about being ontheir own, both personally and professionally.Phoebe said: “When you do try to have a per-sonal relationship with some of the peoplehigher up in integration and in special ed, it’slike they don’t want to talk to you about howyou’re feeling.” Betty commented that the in-tegration officer’s visits were not enough sup-port for individual teachers. She noted theneed for the state system to provide opportu-nities for networking with other teachers ofstudents with MSD in mainstream settings:

So that we can look at all the different strat-egies, share all the resources that are outthere. We all do our own thing. Theredoesn’t seem to be on a departmental level


enough co-operation, co-ordination. Wecould do it a hell of a lot better.

Participants also made comments about lackof support associated with other departmentsand agencies.

Other Departments and Agencies

Participants spoke about the limited and in-consistent provision of speech pathology ser-vices to students with MSD at their schools.

Limited services to schools. Participants per-ceived that it was difficult to access speechpathology services in the school setting, andthat when provided input was brief. Phoebesaid: “You have to jump through so manyhoops to get it, or it costs extra and the familyjust can’t accommodate that.” Phoebe’s stu-dent had received three school visits over sixmonths. The student was now on a waiting listfor further support.

Nigel, Betty and Dora reported that nospeech pathologists come to their school, andperceived that this service was not accessiblefor the high school. Betty said: “I think if wecould get it we would have accessed it by nowbut I know that certainly doesn’t come inthrough high school.” Nevertheless, partici-pants unanimously stated that speech pathol-ogists could support them to communicatewith the student in the classroom.

Inconsistent provision of services to schools.Naomi compared the provision of speech pa-thology services to students with MSD at dif-ferent schools. She reported that at the cen-tral school where she had taught kindergartenpreviously: “We had a lot more support forthat student. We had occupational therapy.We had speech pathology that came with himand stayed with him.” In contrast, she re-ported receiving no service at her currentsmall, primary school, and added: “I’m notsure why there would be a difference becausethat was a rural school as well.” However, aspreviously mentioned, she perceived greaterdifficulty accessing a speech pathology serviceat a small school than a larger school. Naomi,Betty and Dora stated that it was up to parentsto arrange a speech pathology service. Dorasaid: “I think that’s just something that par-ents do off their own bat.”

Participants’ perceptions about the influ-

ences of the broader community on the stu-dent’s access to communication in the main-stream school setting are presented in thefinal theme.

Societal Factors: Social Inclusion

Finally, participants expressed different viewsabout the extent to which social inclusion oc-curred at their school and in the broadercommunity. Four participants perceived thattheir local communities were accepting ofyoung people with MSD and their attendanceat the local school. They believed that it wasimportant for the student with MSD to partic-ipate in activities and not be segregated. Bettyperceived that the student with MSD was “in-cluded in just the same way [as other stu-dents],” and noted that: “If they’re [studentswith MSD] set apart and appear that they arevery different and you don’t get to interactwith them” then communicative interactionsare much less likely to happen.

One participant had different views, how-ever, about social inclusion. Nigel perceivedthat the student with MSD was not being so-cially included. He therefore had doubtsabout the benefits of the mainstream schoolsetting for this student: “The family want thechild to be at the local school which is under-standable but whether it’s necessarily to hismaximum benefit is questionable.” Nigel com-mented that the special school in the areawould better cater for the needs of the studentwith MSD. He said: “We do have a specialeducation school in the area and that’s al-ready sort of set up, it’s got a program likethat.” He noted that apart from the lack ofinteraction between the student with MSDand other students at school, this student at-tended segregated activities outside school aswell.

Discussion

Participants Identified a Broad Range of Factors

The findings of the present study supportprevious research (De Bortoli et al., 2011;Kent-Walsh & Light, 2003; Soto et al., 2001),and suggest that supports and obstacles influ-encing the communication of students with


MSD in mainstream schools are complex andsystemic. These are represented in Figure 1.

Participants’ Difficulties Communicating withStudents

Given their limited training and experience,participants had difficulty interacting with stu-dents with such complex communicationneeds. These issues are represented in theinnermost circles of Figure 1. These findingsare consistent with previous research withmainstream teachers including students withsevere disabilities and students who use AAC(Carter & Hughes, 2006; Kent-Walsh & Light,2003; Smith, 2000; Soto et al., 2001). Thisfactor was compounded by few opportunitiesfor continuing professional development and

limited supports at a number of contextuallevels, such as mentoring, networking withother mainstream teachers, specialist supportpeople, and external courses. In Figure 1 com-munication education crosses a number of lev-els. This situation existed despite claims byresearchers that teachers need a high level ofprofessional development support to includestudents with severe and multiple disabilities(McNally et al., 2001).

Classroom Context

Involvement in classroom activities. Partici-pants’ difficulties engaging students with MSDin classroom activities may have been due toan interaction between their limited trainingand experience teaching these students, and

Figure 1. Systemic factors influencing the communicative interactions of students with MSD in mainstreamschool.


instructional practices in mainstream class-rooms, such as whole-group activities. This ap-peared to be particularly true in high schoolclassrooms with lecture-style instructionalpractices and focus on curricular content.

Reliance on TA. Participants’ consequentreliance on a TA to mediate communicationand work individually with the student withMSD may have further limited the students’involvement and communicative interactionsin the mainstream classroom (Carter &Hughes, 2006; Carter et al., 2005). While thesupport of a TA in the classroom was crucialfor these participants, it may nevertheless havecontributed to the social isolation of the stu-dent with MSD, a phenomenon discussed byother researchers (Carter & Hughes, 2006;Downing, 2006; Kent-Walsh & Light, 2003).

Peers without disability. The findings alsosuggest that there was limited realisation ofthe potential opportunities for communica-tion offered by the presence of peers withoutdisabilities. While the primary-aged studentswere perceived to be naturally interactive(also reported by Bentley, 2008), participantsdid not report perceived quantity or nature ofcommunicative interactions between students.In the high school setting, the presence ofpeers as potential communication partners re-portedly did not translate into interactions,consistent with previous research (Carter &Hughes, 2005). The findings suggest that thepresence of peers without disabilities as poten-tial communication partners may have inter-acted with other contextual factors. Instruc-tional practices and peers are represented in thenext circle in Figure 1. Teachers’ aides are in-cluded in the following outer circle represent-ing the school context/culture along with otherinfluencing factors at this level.

School Context/Culture

Findings suggest that the cultures of schoolsvaried in terms of support for facilitating com-municative interactions for their students withMSD. These varied from lack of support andisolation, to supportive school environments.Parents have also reported experiencing dif-ferences between schools in the support pro-vided to include their child with a disability(Kluth, Bliken, English-Sand, & Smukler,2007).

In the present study, a supportive schoolculture enabled participants to meet and de-velop a school-wide goal for their student withMSD of using high fives for greeting, a goaldocumented in the literature as socially validand age-appropriate (Calculator & Black,2009; Downing, 2001, 2006). However, as oneof the teachers commented, this communica-tion goal was very limited, a view supported byresearchers who have stated that students withMSD may rely on a limited number of com-munication modes and therefore be limited inthe messages that they can convey (Calculator,2009; Downing, 2006). Therefore, the find-ings suggest that this supportive school cul-ture, which also reportedly helped partici-pants transform their initial fears into morepositive perceptions, was not sufficient to en-sure communicative interactions for the stu-dent with MSD. The factor of change, whichwas perceived to occur or need to occur at thepersonal level, in the school context and inorganisational service provision, is repre-sented in Figure 1 by a wedge that crossesthese levels.

Geographical Area

The infrequent communicative interactionsreported may have been influenced by limitedspecialist support services in the schools. Par-ticipants perceived that the rural location oftheir schools meant they received minimalsupport from specialist teachers and speechpathologists, as represented in the next circlein Figure 1. It may also have made access toprofessional development more difficult.

Limited specialist support services may havepresented a barrier to communicative interac-tions for the student with MSD because teach-ers, TAs and peers without disability appearedto receive limited support for learning how tocommunicate with the student. Researchersstate that teachers and peers without disabilityneed to be taught how to: (a) recognise andrespond to the idiosyncratic forms of commu-nication of students with MSD, and (b) useAAC systems to have communicative interac-tions with them (Calculator, 2009; Copley &Ziviani, 2004; Downing, 2006; McMillan,2008). Further, research suggests that evenminimal teaching of peers facilitates interac-


tion (Carter & Hughes, 2006; Carter, Cushing,Clark & Kennedy, 2005; Downing, 2006).

Limited specialist support services may alsohave presented a barrier to involving the stu-dent with MSD in classroom activities becauseparticipants received limited support for pro-gramming, a support recommended in thebest practice literature (Calculator, 2009; Cal-culator & Black, 2009; Hunt et al., 2003).While participants in primary school environ-ments relied on visits from a specialist teacherfor programming, and teaching studentssome signs to communicate with the studentwith MSD, their comments suggest that thissupport was not sufficient, and that supportfrom speech pathologists was also needed.

The findings also suggest variable co-opera-tion between schools and the families of stu-dents with MSD. Even though parents report-edly wanted their child with MSD to attendthe local school, it is not known whether theirexpectations were met. Limited specialist sup-port may also have presented a barrier to thecollaboration required to facilitate consistentapproaches to communication across contexts(Calculator & Black, 2009; Downing, 2006;Hunt et al., 2003). Teachers at the highschool, for example, used a communicationbook with parents but did not use it with thestudent to facilitate participation in the class-room and conversations with peers (as dis-cussed by Downing, 2001, 2006).

Government Departments and OtherOrganisations

Findings suggest there are other issues thathave implications for service delivery at a de-partmental/organisational level, as repre-sented in the next circle in Figure 1. Thefinding that some teachers were only able toaccess a specialist teacher because their stu-dent with MSD had a hearing impairmentsuggests limited avenues for teachers to accessspecialist support services through the stateeducation system. The findings also suggestthat speech pathology services operated undera model of few visits during which the studentwas withdrawn from the classroom, teacherand peers. Conflicts between the time re-quired, and the time available or provided, tomeet the communication and learning needsof students with MSD is represented by a

wedge in Figure 1 that crosses a number oflevels. Limited to teaching the student withMSD communication skills, this model, there-fore, was not supportive of facilitating commu-nicative interactions in the classroom andschool contexts. It appears that some partici-pants were not even making service requests,suggesting that organisations providingspeech pathology services may need to pro-vide schools with information about accessingthis service.

Discourses about Social Inclusion

The existence of different views amongstteachers in the same school about the abilityto support communicative interactions for stu-dents with MSD in their local, rural schoolsuggests that there are different discoursesoperating simultaneously. This level of influ-encing factors is represented in the outermostcircle of Figure 1. These discourses may bothbe influenced by the interactions between fac-tors discussed above, and influence access tocommunication for students with MSD inmainstream settings. The parents in Kluth etal.’s (2007) study also reported the influencesof different districts’ and schools’ discoursesand cultures on the social inclusion of theirchildren with disabilities. The finding thatteachers perceived limited philosophical andpractical support from the education systemfor socially including students with MSD mayreflect a broader social discourse while at thesame time influencing the views of individualteachers.

The findings of this study suggest the exis-tence of the following discourses: (a) studentswith MSD have the right to attend their localschool and not be separated from peers; (b)resources are scarce and it is not cost effectiveto provide the supports needed for studentswith MSD in mainstream schools; (c) if stu-dents with MSD attend the local school theyhave to fit in with little additional support toaccommodate them (also reported by the par-ents in Kluth et al.’s (2007) study); and (d)the needs of students with MSD are not alwaysmet in the local mainstream school and it is inthe best interests of some students to havesegregated education. Researchers have spec-ulated that teachers doubt the benefits forstudents with severe disabilities of attending a


mainstream classroom in the neighbourhoodschool, because the barriers overshadow thepotential benefits, and that there would begreater benefits for such students in segre-gated settings (Carter & Hughes, 2006; Down-ing, 2006; Smith, 2000). The perpetuation ofsome of these discourses may continue to limitopportunities for communicative interactionfor students with MSD. Perhaps because of thedifficulties establishing communication in theschool setting, none of these teachers spokeabout preparing the student to communicatein the broader community, as discussed byCalculator and Black (2009). The findingssuggest that, without supports, students withMSD can still be segregated, with limited op-portunities for interaction at school and morebroadly in their local community.

Limitations and Future Research

This was a small study incorporating the viewsof five teachers in three rural schools. Cer-tainly, the results do not reflect the views ofother teachers of students with MSD in main-stream school settings. Further research isneeded with other teachers of students withMSD in mainstream schools in a broader geo-graphical area in order to substantiate theclaims of the participants of this study. Thefindings of this study have implications for:(a) how the culture of a school influences thecommunicative interactions of students withMSD, and (b) speech pathology service deliv-ery. The importance of collaboration andteamwork also suggests that further researchinvolving potential team members, such asspeech pathologists, other health profession-als, parents, specialist teachers and peers with-out disability is required. Further observa-tional research is also required to documentwhat actually happens in mainstream class-rooms between teachers, students with MSD,and their peers. This research would contrib-ute further insight regarding a model for en-hancing the communicative interactions ofstudents with MSD in mainstream school set-tings.

Conclusion: Supports and Obstacles may beSystemic

The findings of this study offer new insightsinto the supports and obstacles that impact

teachers in rural schools in their communica-tive interactions with students with MSD inmainstream classes. The participants’ percep-tions suggest that the supports and obstaclesfor communicative interactions, and engage-ment in the classroom are complex and sys-temic. The findings therefore also suggest thata model for enhancing access to communica-tive interactions for students with MSD in ru-ral, mainstream schools may also need to becomplex and systemic. This may include thefollowing recommendations: (a) support forindividual teachers, such as mentoring, oppor-tunities for gaining experience with studentswith disability at university, regular opportuni-ties for networking with other teachers andvisiting other schools, accessing courses usingtechnologies, and collaboration with specialistsupport staff; (b) specialist support servicesinto schools to support teachers, TAs andpeers without disability to learn how to com-municate with the student, involve him/her inclass activities, set up peer support arrange-ments, facilitate collaborative teaming involv-ing families, set up AAC systems, and build upthe school culture in terms of communicationpractices and resources; (c) further investiga-tion of service provision for students withMSD in rural areas, (d) government depart-ments and other organisations continue devel-oping policies and practices for building thesocial inclusion capacities of rural mainstreamschools thereby reducing the isolation ofteachers and families; and (e) a continuingdialogue about social discourses around main-stream educational settings and students withMSD that may be influencing their access tocommunicative interactions.

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Received: 30 March 2011Initial Acceptance: 27 May 2011Final Acceptance: 30 July 2011


Education and Training in Autism andDevelopmental Disabilities

Editorial Policy

Education and Training in Autism and Developmental Disabilities focuses on theeducation and welfare of persons with autism and developmental disabilities.ETADD invites research and expository manuscripts and critical review of theliterature. Major emphasis is on identification and assessment, educational pro-gramming, characteristics, training of instructional personnel, habilitation, preven-tion, community understanding and provisions, and legislation.

Each manuscript is evaluated anonymously by three reviewers. Criteria for ac-ceptance include the following: relevance, reader interest, quality, applicability,contribution to the field, and economy and smoothness of expression. The reviewprocess requires two to four months.

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9. Please describe subjects (or any other references to persons with disabilities)with a people first orientation. Also, use the term �intellectual disability� (sin-gular) to replace any previous term used to describe the population of studentswith significant limitations in intellectual functioning and adaptive behavior asmanifested in the developmental period.

Call for Papers

114th International

Conference on Autism,

Intellectual Disability &

Developmental Disabilities

Research to Practice January 23 - 25, 2013

Kona, Hawaii

CEC’s Division on Autism and Developmental Disabilities (DADD) is hosting the 14th International Conference, which is both research and practitioner-focused. DADD welcomes the submission of innovative, evidence-based proposals within the following topical areas:

AAutism Spectrum Disorder MMultiple Disabilities AAssistive & Adaptive Technology PParaprofessionals IIBI & Other Interventions PParental Engagement/Advocacy IIntellectual Disability PPost--SSecondary MMental Health/Dual Diagnosis TTransition

PProposals (submitted in Word) should include the following information:

Presenter name(s), affiliation, contact information (including e-mail) Session title, abstract (50 word maximum), and summary (300 word maximum),

three learner outcomes, and information as to how the proposal addresses diversity Session format – poster session, lecture, or panel presentation

Please submit proposals to: Cindy Perras, Conference Coordinator

[email protected] www.daddcec.org

Submission Deadline: June 15, 2012