Communication Partners for Individuals with Autism: Promoting Skill Development through Video Self-Modeling

1. Communication Partners for Individuals with Autism: Promoting Skill Development through Video Self-Modeling ISAAC 2012 July 31, 2012 Joanne M Cafiero

2. Video-Modeling & Video Self-Modeling in Communication Partnerships • Research & rationale for Video Modeling and Video Self-modeling • Features of effective communication partnerships for individuals with ASD • Action Research • Procedures for teaching effective communication partnerships • Case studies in VM and VSM JM Cafiero, 2012

3. Video Self-Modeling • Learning from our own positive behaviors • Military and sports venues used videos for teaching (as far back as 1950-1960) • Self-observation (positive & negative) mixed results • Editing video to show only positive behaviors JM Cafiero, 2012

4. VSM has been used Successfully with the Following Populations/Disorders/Issues Problem Behaviors Academic Engagement Impulsivity Adaptive Behavior/Daily Living Skills Athletic Performance Reading Fluency and Comprehension Math Achievement Articulation Disorders Selective Mutism Autism (behavior, social skills, communication) Phobias/Anxiety (Speaking, Social, etc.) JM Cafiero, 2012

5. Bandura, Social Learning Theory and VSM • The more similar a person is to the model he/she is watching the more closely attends to the model • Best models were usually slightly more skilled than the observer • Individuals are more likely to perform a skill if they are confident they can do it. • In later writings, Bandura called “self-modeling” the purest social learning model. JM Cafiero, 2012

6. Video Self-Modeling • Provides scaffolding for a new skill • Builds self-efficacy • May build confidence as much as teach specific skills JM Cafiero, 2012

7. Mirror Neurons • Brain mirrors movement it sees • Watching & doing: same neurons are firing • Impacts motor planning • Translates what we see so we can relate it to the world • Ties us to the actions and feelings of our fellow human beings: empathy • Place in our brain where job is to live in other’s head JM Cafiero, 2012

8. Video Self-Modeling (VSM) • Intervention where observers are shown videotapes of themselves successfully engaging in an activity. • Ensures that model has similar attributes and ability. • Independent and efficacious performance is facilitated via positive self-review. (Bellini, Akullian, & Hopf, 2007) JM Cafiero, 2012

9. VSM for Promoting Skill Development in communication partnerships: rationale & strategies • Skill & commitment define success • Augmented input strategies critical • Training requires instilling a new ‘belief system’ • Modeling, practice with feedback (PwF); monitoring checklist, readings • VSM integrated into training package JM Cafiero, 2012

10. Study on VM/VSM with Autism Practitioners(Robinson, 2011) • “Teaching Para-professionals to Implement PRT in Inclusive School Settings Using Brief Video Feedback Training Package” • Training package was effective and efficient in training para-pros in implementation of PRT • Social communication of students with autism also improved. JM Cafiero, 2012

11. Research on Language Development • Interactive: Vygotsky (a more skilled peer scaffolds input) • Co-construction of messages (Jean Berko-Gleason) • Birth of a word (TED Talk: Deb Roy) • Implications of new Mirror Neuron research • Watching & doing activates same neurons JM Cafiero, 2012

12. Research in Language Development Jean Berko Gleason (BU, psycholinguist, Interactionist • Brain/language development occurs in relationships with language stimulators • Learning language is a “cooperative event” with cognitive & emotional underpinnings • Children learn language from adults and adults from children • “We do not wait for language to unfold, we are unfolding with the child.” (Gleason) JM Cafiero, 2012

13. The Social Framework of Communication from Vygotsky • Children learn first through socially mediated interactions from a more knowledgeable peer • Children need socially mediated experiences with people who are better communicators than they are • Communication is by nature, interactive • Children co-construct their communication with their communication partners JM Cafiero, 2012

14. The Blossoming of a Speech Form Deb Roy (MIT, engineer) • Multiple cameras in home to chronicle language development of his son • Coded & graphed ¼ million words and interactions • Found caregiver language dipped in complexity with the birth of each word (MLU dips then rises) • The environment (ie. communication partners) is learning from the child • Creation of tight feedback loop • http://www.youtube.com/watch?v=VwgkT34g61w JM Cafiero, 2012

15. Good communication partnerships with AAC mirror theory & research in social, language & neuroscience

16. The Augmented Input Strategies • Mother Tongue Method • 2nd Language = Visual Language • Receptive Language Intervention • Total Immersion • Mirrors Typical Language Development • Robust Vocabularies • Gateway to Literacy: symbols, text JM Cafiero, 2012

17. Augmented Input Strategies • (Drager, Postal, et.al. 2006; Acheson, 2006; Cafiero, 1995, 2001, 2005; Romski & Sevcik, 1996, 2006, 2009; Dexter, 1998; ; Goossens’, Crain & Elder,1992) • Augmented Input facilitated • Increased language • Increased MLU • Increased type/token ratio • Increased initiations • Increased personal investment of speaking partner JM Cafiero, 2012

18. Why are communication partners of individuals with ASD & CCN so silent? • Ownership of AAC tool • Typical language development • Intermittent speech • Not understanding the nature of ASD in terms of speech • Architecture of the AAC tool JM Cafiero, 2012

19. Communication Partnerships: AAC/ASD • Why important? • Investment of speaking partner • Belief in the competence of the person with ASD/CCN • Understanding the architecture of the AAC tool • Social Learning • Bandura • Mirror Neurons • Typical language development • Social constructs of language • Gleason, Vygotsky. • Birth of a word • Deb Roy JM Cafiero, 2012

20. What is required of the Communication Partner in Aided Language Strategies? • Active participation • Knowledge of vocabulary • Knowledge of navigation procedures • Knowledge of the architecture of the tool or device • Modeling of language with device • Stimulating and expanding language development by understanding the zone of proximal development in their partner JM Cafiero, 2012

21. Action Research • Conducted in school or clinical environments • Is qualitative & quantitative • Can be fluid & untidy • Research questions arise from IEP and/or natural questions arising from the everyday. • Interventionist integral to the research • Research shared with colleagues • Results of research applied immediately JM Cafiero, 2012

22. Procedures for VM & VSM • Select observable, measurable targets • Take baseline on the targets • Write a script or task analysis for target • Record • Edit video; remove prompts & errors • Keep video short, simple, targeted, positive • Collect data on performance of targets JM Cafiero, 2012

23. Hypothesis: Video Self-Modeling is More Effective than Traditional Techniques for Teaching Communication Partnerships • Condition A: Practice with Feedback, written critiques, Fidelity Checklist Review • Condition B: Video Modeling & Self-Modeling • Original Study: Alternating treatments ABAB • Current Study: A/B single subject design with 4 communication partner pairs • New Variable introduced (C): adding or promoting the use of interactive vocabulary to existing AAC tools JM Cafiero, 2012

24. Fidelity of Implementation: Communication Partnerships • Select, prepare, reinforcing materials & AAC • Get partner’s attention/refocus • Use expectant delay • Model with AAC • Acknowledge, reinforce all attempts with AAC • Shape, Expand with AAC • Withhold target for language • Note positive affect of both partners JM Cafiero, 2012

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26. Case Study: Selena & Adam • 6 years old, Dx ASD, limited speaker • 1st year teacher; eager to learn • Selected activity; created simple language board • Baseline:Fidelity of Implementation – Selena & Adam’s 1st session • Written feedback provided after each session • “living” intervention: Vocabulary adjusted to support more complex language • 3 intervention probes coded JM Cafiero, 2012

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28. NAL/PRT Fidelity of Implementation LS JM Cafiero, 2012

29. Lexical Variety & Responsivity in NAL/PRT Interventions with Low-Tech AAC (L&A) JM Cafiero, 2012

30. Selena & Adam: Results • Increase in Selena’s fidelity of implementation of NAL/PRT • Increase in Adam’s responsivity • Increase in Type-Token Ratio (variety of words Adam used) • Consistent high scores on 5 point affect scale (Koegel & Egel, 1979) (measures interest, happiness and behavior) JM Cafiero, 2012

31. Case Study: Melissa & Gabe • Melissa • SEIA with degree • Highly motivated • Gabe • 12 years old; 6th grade • Special ASD program within general MS • Limited Speaker JM Cafiero, 2012

32. Case Study: Melissa & Gabe • Intervention 1 • Communication Partner Checklist • Practice with Feedback (PwF) • Readings on Communication Partnerships & ASD • On-the-spot feedback • Intervention 2: • VSM (3-10 second clips of features defined in checklist) • Adding more robust, interactive vocabulary JM Cafiero, 2012

33. Communication Partnership Fidelity Weekly Data Probes JM Cafiero, 2012

34. The Need for Robust Vocabularies • Mirrors normal language development • Presumes competence • Provides vehicle for more fluid interactions • Provides vehicle for more communicative exchanges JM Cafiero, 2012

35. MLU & Use of Aided Language Tools JM Cafiero, 2012

36. Qualitative Results • Structured predictable activities with hands-on components facilitated most engagement. • Communication Partners provided more input when vocabulary was more robust & more interactive. • VSM was effective but enhanced communication tools were critical. • Increased MLU & equal exchanges. JM Cafiero, 2012

37. Case Study: Amanda & Annie • Middle School Self-contained w/in general education setting • High staff to student ratio • Amanda: SEIA with degree in Marketing; high interest in Special Education; motivated • Annie: 14 years old, functionally non-verbal; severe in terms of showing what she knows JM Cafiero, 2012

38. Fidelity of Implementation of CP Checklist: Amanda & Annie JM Cafiero, 2012

39. Aided Input of Communication Partner & Output of Student with ASD JM Cafiero, 2012

40. Limitations of Study • Targeting VSM as more effective was difficult • Obtaining positive models for VSM early on was difficult • Hawthorne Effect may have been at play • Positive carry-over effect of treatments on each other • (Barlow & Herson) • Skill Acquisition is not a linear process JM Cafiero, 2012

41. Conclusions • Investment & skill of communication partners essential. • Robust vocabularies may increase exchanges. • Total training package of PwF, written feedback, assigned readings and VSM improved partnership skills. JM Cafiero, 2012