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By: Jeanna Probst Eastern Illinois University jrprobst@eiu

A Comparison of On-Task Behavior in Person-Directed VS. AAC-Directed Apraxia Therapy for Children with Autism Spectrum Disorder. By: Jeanna Probst Eastern Illinois University jrprobst@eiu.edu. Introduction: Autism Spectrum Disorder (ASD). Deficits in 3 areas: Social Interaction

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By: Jeanna Probst Eastern Illinois University jrprobst@eiu

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  1. A Comparison of On-Task Behavior in Person-Directed VS. AAC-Directed Apraxia Therapy for Children with Autism Spectrum Disorder By: JeannaProbst Eastern Illinois University jrprobst@eiu.edu

  2. Introduction:Autism Spectrum Disorder (ASD) • Deficits in 3 areas: • Social Interaction • Language & Communication • Repetitive & Restricted Interests (Routine) • Sensory Processing Deficits • Joint Attention Deficits

  3. Developmental Apraxia of Speech (DAS) • Neurological disorder • Difficulty sequencing movements needed to produce a clear and precise sound or utterance (Darley, Aronson & Brown, 1975; Hall, Jordan, & Robin, 2007; Tombin, Morris & Spriestersbach, 2000) • “sensory integration dysfunction, which interferes with planning and executing an unfamiliar task” (Marshalla, 1994, 1995; Darley et al., 1975; Hall et al., 2007) • Often associated with ASD

  4. Joint Attention • Schertz & Odom, (2004) define joint attention as, “coordinating attention to an event or object with another individual, sharing interest and social engagement, and showing an understanding that the partner is sharing the same focus”(p. 42). • Language delays in ASD mainly due to deficit in the area of Joint Attention

  5. Augmentative and Alternative Communication • “Augmentative and alternative communication refers to the field or area of clinical, educational, and research practice to improve, temporarily or permanently, the communication skills of individuals with little or no functional speech and/or writing” (American Speech-Language-Hearing Association, 2002). • Augmentative: augment existing speech abilities • Alternative: providing a substitute for ineffective speech • Facilitates natural speech • Consistent model • Immediate reinforcement • AAC devices are often used with ASD & DAS • Helps the AAC users acquire functional communication and develop expressive language

  6. ASD - DAS - AAC • Commonalities in ASD & DAS: • Neurological Disorder • Routine • Sensory Processing Deficits • Joint Attention Deficits • AAC provides a consistent model and routine • Limited research that looks at joint attention in a person-directed model versus an AAC-directed model

  7. Purpose and Research Question • Limited research in area of AAC and ASD with DAS • Purpose: compare on-task behavior in person-directed apraxia therapy to AAC- directed apraxia therapy in individuals diagnosed with ASD who also have apraxia of speech. • Is there a difference in the length of on-task behavior when using a person-directed stimulus mode versus AAC-directed stimulus mode for individuals with co-morbid ADS and DAS?

  8. Subjects

  9. Methodology • Rapid alternating subject treatment design • Randomly presented with stimuli (IV: AAC-directed & Person-directed) • 5 minutes over 22 sessions • AAC Device: Mercury II by Assistive Technology Inc., the Dyanvox IV, and the Dynavox V max • Clinician: CDS graduate student, who was blind to the dependent variables • Oral Motor Activities • Blow, Kiss, Raspberry, Pat Mouth, Click Tongue, /p/, /b/, /m/

  10. Video Clips • Person-Directed • Shows apraxia at work • AAC-Directed • Imitation of one of the oral motor behaviors

  11. Dependent Variables

  12. Data Recording Sheet

  13. Results: Overall • Multivariate Analysis of Variance (MANOVA) • Overall significant difference, F(4,57)=5.8; p=.001 • Higher occurrence of Disruptive Behavior and No Eye Contact in Condition 1 (Person-Directed) than Condition 2 (AAC-Directed) • Disruptive Behavior (p=.034) • No Eye Contact (p=.001)

  14. Results: Overall *significant difference

  15. Results: On-Task Behavior Person-Directed 97.7%, AAC-Directed 96% Person-Directed 94.9%, AAC-Directed 98.9% Person-Directed 84%, AAC-Directed 97% • Overall On-Task: • Person-Directed: 92.4% • AAC-Directed: 97.6% • Both IV: 95% • AAC significantly higher than Person-Directed (p=.001)

  16. Results: No Eye Contact No Eye Contact: Person-Directed: 33.9% AAC-Directed: 19% Overall: 26% P=.001 Person-Directed 38.6%, AAC-Directed 10% Person-Directed 27.7%, AAC-Directed 33.5% Person-Directed 37.8%, AAC-Directed 11.5%

  17. Results: Disruptive Behavior Person-Directed 44.8%, AAC-Directed 41% Disruptive Behavior: Person-Directed: 41.5% AAC-Directed: 27% Overall: 34% P=.034 Person-Directed 41%, AAC-Directed 28.9% Person-Directed 38.9%, AAC-Directed 11%

  18. Results: Leave Work Area Person-Directed 3%, AAC-Directed 9.5% Leave Work Area: Person-Directed: 3.4% AAC-Directed: 3.7% Overall: 3.6% Person-Directed 4.1%, AAC-Directed 0% Person-Directed 2.7%, AAC-Directed 1.5%

  19. Discussion • Variables to account for results • ASD is an individual disorder • AAC was more routine orientation; PD involved more variability • Disruptive behaviors • Clear focus with AAC • PD provided a richer multimodality learning experience compared to the AAC device with flat 2-dimensional picture and auditory feedback

  20. Discussion • Strengths • Routine Design • Limited time frame • Focused/Controlled sensory input • Limitations • Small subject size • Technology Difficulties

  21. Discussion • Future Research • Broader Sample (different severity levels of ASD and DAS) • Lower and higher emerging level of AAC users • Evaluate emerging imitation in Person-Directed vs. AAC-Directed conditions • Evaluate if either of these conditions help develop joint attention • Use of a video model instead of a static picture on the AAC device • Replication to determine generalization of the present study

  22. References American Speech-Language-Hearing Association (2002). Augmentative and Alternative Communication: Knowledge and Skills for Service Delivery. [Knowledge and Skills]. Available from http://www.asha.org/policy Darley, F. L., Aronson, A. E., Brown, J. R. (1975). Motor Speech Disorders. W. B. Saunders Company. Hall, P. K., Jordan, L. S., & Robin, D. A. (2007). Developmental Apraxia of Speech: Theory and Clinical Practice (2nd ed.). PRO-ED Inc. Marshalla, P. (1994). The non-verbal apraxic child: speech-language techniques. 1-19. Marshalla, P. (1995). Developmental apraxia of speech: facilitating vocal and verbal expression. Speech Dynamics Incorporated, 1-25. Schertz, H. H. & Odom, S. L. (2004). Joint attention and early intervention with autism: a conceptual framework and promising approaches. Journal of Early  Intervention, 21, 1, 42-54. Tombin, J. B., Morris, H., & Spriestersbach, D.C. (2000). Diagnosis in Speech- Language Pathology (2nd ed.). Singular Publishing Group, Inc.

  23. Any Questions?

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