Communication Partners for Individuals with Autism: Promoting Skill Development

through Video Self-Modeling

ISAAC 2012July 31, 2012

Joanne M Cafiero

JM Cafiero, 2012

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

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

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

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

Video Self-Modeling

• Provides scaffolding for a new skill • Builds self-efficacy• May build confidence as much as

teach specific skills

JM Cafiero, 2012

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

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

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

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

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

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

JM Cafiero, 2012

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

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

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

JM Cafiero, 2012

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

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

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

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

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

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

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

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

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

JM Cafiero, 2012

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

JM Cafiero, 2012

NAL/PRT Fidelity of Implementation LS

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JM Cafiero, 2012

Lexical Variety & Responsivity in NAL/PRT Interventions with Low-Tech AAC (L&A)

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lexical varietyResponsivity

JM Cafiero, 2012

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

JM Cafiero, 2012

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

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

Communication Partnership Fidelity Weekly Data Probes

Baseline Probe 1 Probe 2 Probe 3 Probe 4 Probe 5 Probe 60%

5%

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JM Cafiero, 2012

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

MLU & Use of Aided Language Tools

Directive Vocab Interactive Vocab0

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Comm PartStudent

JM Cafiero, 2012

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

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

Fidelity of Implementation of CP Checklist: Amanda & Annie

Probe 1 Probe 2 Probe 3 Probe 40%

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JM Cafiero, 2012

Aided Input of Communication Partner & Output of Student with ASD

Probe 1 Probe 2 Probe 3 Probe 40

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Comm PartPartner with ASD/CCN

JM Cafiero, 2012

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

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.