Lending a Hand: Teaching Children with Autism to Give Assistance

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Lending a HandTeaching Children with Autismto
Give Assistance

• Summary of Reeve Reeve et al 2007

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Definition of Autism

• Autism is a neurological disorder that affects a
  person's ability to
• a) communicate (impairments in speech and
  language development)
• b) form relationships (qualitative impairment
  in social skills and interactions with
  others)
• c) respond appropriately to the environment
  (sensitivity to stimulation and repetitive
  patterns of behavior, interests, and activities)
• Onset typically before the age of three, which
  makes early and accurate diagnosis very
  important.
• May affect as many as 1/150-200 individuals

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Social Impairments of Autism

• Many children with autism exhibit severe and
  persistent deficits in social behavior
  (Baron-Cohen, Leslie, Frith, 1985 Rutter,
  1978 Volkmar, Carter, Sparrow, Cicchetti,
  1993 Wing, 1988). Examples include
• inappropriate affect (emotional displays)
• absent or delayed social smile
• absent or delayed eye contact
• social isolation
• failing to initiate to peers and/or adults
• pro-social behavior (see next slide)

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Definition of Prosocial Behavior

• Any act intending to benefit another, such as
  responses associated with
• helping
• cooperating
• sharing
• turn-taking
• exhibiting empathy, and/or sympathy
• Observed in children of typical development as
  early as 1 ½ to 3 years of age (but often absent
  in children with autism)
•  
• (Eisenberg Fabes, 1998 Rheingold Hay, 1980)

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Negative Outcomes of Prosocial Behavior Deficit

• Parents, peers, and teachers may be discouraged
  from attempting to interact with the child
• In fact, peers often reject children who exhibit
  low levels of prosocial behavior (Vitaro, Gagnon,
  Tremblay, 1990)
• Further reduces the opportunities for learning
  (Lovaas, Koegel, Simmons, Long, 1973).

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Positive Outcomes of Prosocial Behavior
Proficiency

•  Children who engage in appropriate prosocial
  behavior
• (a) tend to be viewed by adults as more socially
  competent (Eisenberg, Fabes, Karbon, Murphy,
  Wosinski, Polazzi, Carlo, Juhnke, 1996
  Peterson, Ridley-Johnson, Carter, 1984)
• (b) are more likely to frequently engage in
  positive and cooperative social interactions with
  peers (Dunn Munn, 1986 Farver Branstetter,
  1994)
• (c) are more likely to have strong peer
  friendships (Coie, Dodge, Kupersmidt, 1990
  Farver Branstetter, 1994)

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Prior Research to Teach Prosocial Behavior to
Children with Autism

• A number of studies have taught prosocial
  behavior but the behavior failed to generalize
  beyond teaching conditions, or showed minimal
  generalization (Charlop Walsh, 1986 Harris,
  Handleman, Alessandri, 1990 Kamps, Leonard,
  Vernon, Dugan, Delquadri, Gershon, Wade, Folk,
  1992 Kohler, Strain, Hoyson, Davis, Donina,
  Rapp, 1995 Strain, Kerr, Ragland, 1979)
• Strategies included instruction, peer models, a
  small number of examples, and reinforcement
• Failure to generalize reduces functionality of
  the skill

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Purpose of the Present Study

• To determine the extent to which children with
  autism can learn to engage in prosocial
  responses, in this case, behavior commonly
  labeled as helping.
• To determine the extent to which helping
  responses generalize from training to novel
  situations in which there is an opportunity to
  engage in helping behavior.

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Strategies to Increase Learning

• Increasing salience of stimuli
• Use of prompting
• Use of reinforcement
• Use of correction procedure

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Strategies to Increase Generalization

• Use of video modeling
• (Charlop, Schreibman, Tyron, 1983 Haring,
  Kennedy, Adams, Pitts-Conway, 1987)
• Teaching multiple exemplars of the target
  behavior using common stimuli
• (Stokes Baer, 1977)

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Participants Settings

• Four children with autism (Irene, Tom, Eddie, and
  Nathan) who attended classes at the Institute for
  Educational Achievement (IEA).
• Most experimental sessions took place in a small
  classroom at IEA. Approximately once every week,
  sessions were conducted in the staff room at IEA.

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Categories of Helping

• Cleaning
• Replacing Broken Materials
• Picking Up Objects
• Sorting Materials
• Locating Objects
• Carrying Objects
• Putting Items Away
• Setting Up an Activity

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Category Structure
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Categories for Each Child
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Assignment of Trials (for Tom)
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Baseline Treatment Trials

• Baseline
• Both training and probe trials presented
• Neither trial type associated with treatment or
  reinforcement
• Token reinforcement and verbal praise provided
  only for on-task behavior
• Treatment
• Both training and probe trials presented
• Training trials associated with treatment
• Probe trials not associated with treatment

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Error-Correction Procedure

• Presentation of Live Discriminative Stimuli
• (non-verbal verbal)
• ?
• Incorrect Verbal and/or Motor Response by child
• ?
• Presentation of Video Model
• ?
• Re-presentation of Live Discriminative Stimuli
• ?
• Incorrect Verbal and/or Motor Response by child
• ?
• Presentation of Motor and/or Verbal Prompts
• ?
• Re-presentation of Live Discriminative Stimuli
• ?
• Correct Verbal and Motor Responses by child
• ?
• Reinforcement
• (token praise)

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Additional Strategies Used to Promote
Generalization

• Treatment sessions were conducted once every
  eight sessions in the staff room (not the typical
  experimental session room)
• Treatment sessions were conducted once every 10
  sessions by a secondary experimenter (not the
  primary experimenter)

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Pre- and Post-Intervention Measures

• For each child, three pre-intervention sessions
  were conducted before treatment was introduced.
• Three post-intervention sessions were conducted
  after all participants had achieved mastery
  criterion.
•  
• Combination of novel trials, probe trials, and
  training trial types
• Conducted in the childs regular school classroom
  (not the experimental setting) with their regular
  school instructor (not the experimenter).

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Mean Percentage of Correct Helping Responses
Across Pre- and Post-Intervention
Measures(Combination of Trial Types in Childs
Regular Classroom with their Regular Instructor)
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Conclusions

• Systematic application of multiple exemplar
  training using video modeling, prompting, and
  reinforcement taught children to use helping
  responses in training and novel situations
• Children demonstrated a generalized repertoire of
  helping behavior. They responded with appropriate
  helping behavior in the presence of
  discriminative stimuli from novel trials, from
  novel categories of helping, in novel settings,
  and in the presence of novel persons.
• Programs for children with autism should include
  training in prosocial behavior. Such training
  should lead to increased opportunities for
  learning.

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Percentage of Trials in Which Video Presentation
Occasioned a Correct Helping Response on
Subsequent Presentation of the Discriminative
Stimuli