The effects of a treatment package in establishing independent academic work skills in children with autism.

The effects of a treatment package in establishing independent academic work skills in children with autism. Abstract The purpose of this study was to evaluate the effectiveness of atreatment package in producing independent work by three children withautism autism(ô`tĭzəm), developmental disability resulting from a neurological disorder that affects the normal functioning of the brain. It is characterized by the abnormal development of communication skills, social skills, and reasoning. with minimal supervision by an adult. The package included: (a)delayed reinforcement reinforcement/re��in��force��ment/ (-in-fors��ment) in behavioral science, the presentation of a stimulus following a response that increases the frequency of subsequent responses, whether positive to desirable events, or for on-task and on-schedule responding, (b) fadingof instructional prompts and of the instructor's presence, (c)unpredictable supervision, (d) response cost for off-task responding. Itwas found that the treatment package resulted in increased levels ofon-task and on-schedule responding during treatment for all threechildren with a supervising adult only occasionally present. Twochildren required minimal adult supervision in maintenance.Generalization gen��er��al��i��za��tionn.1. The act or an instance of generalizing.2. A principle, a statement, or an idea having general application. probes showed that the behavior of all three childrentransferred across both novel material and a novel setting in theabsence of adult supervision. Key words: Delayed reinforcement, fading supervision, responsecost, autism, independent skills, intervention package, unpredictablesupervision. ********** Numerous publications describe the variety of procedures that havebeen developed over decades to ameliorate a��mel��io��rate?tr. & intr.v. a��me��lio��rat��ed, a��me��lio��rat��ing, a��me��lio��ratesTo make or become better; improve. See Synonyms at improve.[Alteration of meliorate. the behavioral deficits and/orexcesses that are typically displayed by persons with autism. The mosteffective studies have taught precisely targeted behaviors in structurededucational settings (DeMyer, Hingtgen, & Jackson, 1981; Dunlap,Koegel, & O'Neil, 1985; Koegel, Rincover, & Egel, 1982).Despite these successes, learned behavior has not generalizeed to novelsettings and/or persisted once the treatment contingencies have beenwithdrawn (Dunlap & Johnson, 1985; Dunlap, Koegel, & Johnson,1987; Stahmer & Shreibman, 1992). Additionally, persons with autismfrequently do not independently initiate tasks or remain appropriatelyengaged with materials even though they may have displayed mastery ofthe specific tasks in structured settings (Dunlap & Plienis, 1988;Fowler, 1988; MacDuff, Krantz Krantz is the name of two persons: Kermit E Krantz Physician and inventor Grover Krantz Bigfoot researcher , & McClannahan, 1993; Sailor Person who navigates ships or assists in the conduct, maintenance, or service of ships.Sailors have historically received special treatment under the law because of the nature of their work. , Goetz,Anderson, Hunt, & Gee, 1988). The presence of a supervising adultwho wi ll prompt engagement continues to be a requirement for manypersons with autism to function in their environments (Dunlap &Johnston, 1985; Dunlap, Koegel, & Johnson, 1987; Stahmer &Shreibman, 1992). Furthermore, people with autism may also havedifficulty acquiring lengthy response sequences. Thus, even though achild with autism may have learned to complete a morning routine (e.g.,brush teeth, get dressed Verb 1. get dressed - put on clothes; "we had to dress quickly"; "dress the patient"; "Can the child dress by herself?"dressprimp, preen, dress, plume - dress or groom with elaborate care; "She likes to dress when going to the opera" , and go to breakfast), she may need prompts toinitiate each activity or each part of an activity (MacDuff, Krantz,& McClannahan, 1993). Again, successful completion of the sequencerequires monitoring from a supervising adult. Integration of persons with autism and developmental disabilitiesinto mainstream society continues to be a dominant priority in the fieldof education. Simply teaching children with autism a variety of skillsis not enough to prepare them for a functional life in society. Forinstance, it is important that persons with autism learn to displayalready acquired skills in the absence of a supervising adult. Krantzand McClannahan (1999) suggest that in order to program for integrationthe following six response classes should be addressed: (a) followingadults' instructions, (b) exhibiting generative gen��er��a��tiveadj.1. Having the ability to originate, produce, or procreate.2. Of or relating to the production of offspring.generativepertaining to reproduction. language, (c)emitting e��mit?tr.v. e��mit��ted, e��mit��ting, e��mits1. To give or send out (matter or energy): isotopes that emit radioactive particles; a stove emitting heat.2. a. low rates of inappropriate behavior, (d) sustaining engagement,(e) responding to temporally delayed consequences and (f) generalizingskills across settings. If children with autism are to share the sameexperiences as their nondisabled peers, it is imperative to identifyprocedures to successfully teach these skills to them. As mentioned earlier, typically, the removal of close supervision,whether in group or in individualized in��di��vid��u��al��ize?tr.v. in��di��vid��u��al��ized, in��di��vid��u��al��iz��ing, in��di��vid��u��al��iz��es1. To give individuality to.2. To consider or treat individually; particularize.3. settings, leads to the recurrence recurrence/re��cur��rence/ (-ker��ens) the return of symptoms after a remission.recur��rent re��cur��rencen.1. of stereotypic stereotypic/ster��eo��typ��ic/ (ster?e-o-tip��ik) having a fixed, unvarying form. and off-task behaviors and a decline in appropriate,productive responding (Dunlap & Johnson, 1985; Marholin &Steinman, 1977). One possible explanation for the failure of appropriateresponding to generalize generalize/gen��er��al��ize/ (-iz)1. to spread throughout the body, as when local disease becomes systemic.2. to form a general principle; to reason inductively. has been related to the strict stimulus control Stimulus controlWe refer to stimulus control when a discriminative stimulus changes the probability of a behavior (operant response). The discriminative stimulus comes to control behavior when it predicts something about the consequences of that behavior. that is typically established by structured training conditions(Billingsley & Romer This page is about the cartographic mechanism called a "Romer" or "Roamer"; for people named Romer see Romer (surname)A Romer or Roamer is a simple device for accurately plotting a grid reference on a map. , 1983; Snell Snell, George 1903-1996.American geneticist. He shared a 1980 Nobel Prize for discoveries concerning cell structure that enhanced understanding of the immunological system, resulting in higher success rates in organ transplantation. , 1983). According to according toprep.1. As stated or indicated by; on the authority of: according to historians.2. In keeping with: according to instructions.3. thishypothesis, the stimuli under which behavioral training is implementedacquire discriminative dis��crim��i��na��tive?adj.1. Drawing distinctions.2. Marked by or showing prejudice: discriminative hiring practices. characteristics and come to occasion appropriatebehavior because such stimuli may be associated with reinforcement oftargeted responses (Koegel & Rincover, 1977; Pierce &Schreibman, 1994). In contrast, the absence of such stimuli may serve tosignal the lack of controlling contingencies, thereby, resulting inbehavioral variation rather than reliable emission of the targetresponse (Corte, Wolf, & Locke, 1971; Marholin & Steinman, 1977;Risley, 1968). Thus, the departure of an instructor may result inincreased off-task behavior in a child with autism by virtue of thepredictable absence of contingencies for that period of time. To addressthese stimulus control considerations, some researchers have begun toinvestigate how the use of indistinguishable or unpredictablecontingencies as well as delayed contingencies can facilitategeneralization and maintenance of desirable behavior (Dunlap &Johnson, 1985; Dunlap, Koegel, & Johnson, 1987; Schwarz &Hawkins, 1970; Stokes Stokes, William 1804-1878.British physician. Known especially for his studies of diseases of the chest and heart, he expanded on the observations of John Cheyne in describing the breathing irregularity now known as Cheyne-Stokes respiration. & Baer, 1977). For instance, Dunlap andJohnson (1985) demonstrated that when an unpredictable schedule ofsupervision was used with three children with autism, on-task levelswere much higher during the therapist's absence than when apredictable supervision-schedule was used. Moreover, Dunlap, Koegel, andJohnson (1987) demonstrated that the therapist could be removed from thetreatment environment of three children with auti sm, although otheradults remained present. Also, the authors showed that appropriatebehavior could be successfully maintained in community settings, againin the presence of adults other than the experimenters, with infrequent in��fre��quent?adj.1. Not occurring regularly; occasional or rare: an infrequent guest.2. and delayed contingencies. In another study, MacDuff, Krantz, andMcClannahan (1993) taught children with autism to complete the steps ina complex task and to change tasks independently, by using photographiccues (i.e., albums depicting after-school activities) in combinationwith graduated guidance to increase on-task and on-schedule responding.With this two-component package, the authors taught four youths withautism to display sustained engagement and lengthy response chains, toindependently change activities, and to change activities in differentgroup home settings in the absence of immediate supervision and prompts.However, as with the Dunlap et al. study, in the MacDuff et al. studyadults other than the experimenter were present during intervention andgeneralization pro bes. Several researchers have demonstrated the effectiveness ofpictorial and/or textual cues, used alone or in combination with avariety of prompting/fading procedures and/or self-managementprocedures, in teaching persons with disabilities to initiate tasks.Thus far, however, research with pictorial/textual cues has focusedprimarily on adolescents or adults rather than younger children (Frank,Wacker Wacker may refer to: EMS Wacker http://i9.tinypic.com/4veeqvo.jpg http://i2.tinypic.com/5xrb2g0.jpg Wacker Drive Wacker process Sports VfB Admira Wacker M?dling Wacker Berlin Wacker Burghausen , Berg, & McMahon, 1985; Johnson & Cuvo, 1981; Krantz,MacDuff, & McClannahan, 1993; MacDuff, Krantz, & McClannahan,1993; Nietupski, Clancy, & Christiansen, 1984; Sowers, Verdi,Bourbeau, & Sheehan, 1985; Thinesen & Bryan, 1981; Wacker &Berg, 1983, 1984). Furthermore, intervention packages usingpictorial/textual cues typically have not attempted to investigateon-task and on-schedule responding in the absence of adult supervision.The purpose of this study was to investigate the effectiveness of atreatment package in producing independent work by three children withautism in the absence of a supervising adult . The package included: (a)delayed reinforcement for on-task and on-schedule responding, (b) fadingof instructional prompts and of the instructor's presence, (c)unpredictable supervision, and (d) contingent response cost for off-taskresponding. Method Participants The participants of this study were Zeb and David, who were 9, andCarl, who was 5 years old. All three children met the DSM 1. DSM - Data Structure Manager.An object-oriented language by J.E. Rumbaugh and M.E. Loomis of GE, similar to C++. It is used in implementation of CAD/CAE software. DSM is written in DSM and C and produces C as output. TV (APA (All Points Addressable) Refers to an array (bitmapped screen, matrix, etc.) in which all bits or cells can be individually manipulated. APA - Application Portability Architecture , 1994)criteria for the diagnosis of autism. The children's scores on thePeabody Picture Vocabulary Test The PPVT-III is an untimed, individual intelligence test, orally administered in 11 to 12 minutes or less. Extensively revised, this test measures an individual's receptive (hearing) vocabulary for Standard American English. ranged from 2.5 to 4.5 years (M = 3).Age equivalent scores on the Vineland Adaptive Behavior Scale a��dap��tive behavior scalen.A series of tests used to quantify the ability of mentally retarded and developmentally delayed individuals to live independently. were 4.11and 1.4 for David and Zeb respectively. No scores were obtained forCarl. Informed parental consent to participate in this study wasobtained for each participant. Zeb and David had been using activity schedules for up to sevenyears; Carl had been using activity schedules for approximately oneyear. All three children were proficient pro��fi��cient?adj.Having or marked by an advanced degree of competence, as in an art, vocation, profession, or branch of learning.n.An expert; an adept. schedule followers with adultsupervision. All three children had severe language deficits; theydisplayed high rates of echolalia echolalia/echo��la��lia/ (ek?o-la��le-ah) stereotyped repetition of another person's words and phrases. ech��o��la��li��an.1. , vocal noise, noncontextual speech,and limited spontaneous language. All three children remained on-taskand on-schedule, with irregular performance, in the presence ofsupervising adults, but engaged in stereotypy stereotypy/ster��eo��ty��py/ (ster��e-o-ti?pe) persistent repetition or sameness of acts, ideas, or words. ster��e��o��ty��pyn.1. The maintenance of one attitude for a long period. (e.g., verbal and motoric)in the absence of adults. All participants had acquired picture objectcorrespondence prior to the study, had past experience with monetaryreinforcement systems, such as token boards, and were accustomed totokens embedded Inserted into. See embedded system. in their schedules. Settings and Tasks Sessions took place in a 3 x 4 m classroom with no windowsexcluding the one-way mirror that was built in the door. The room wasfurnished fur��nish?tr.v. fur��nished, fur��nish��ing, fur��nish��es1. To equip with what is needed, especially to provide furniture for.2. with a desk, a chair, and a long table. The activities werearranged in folders on the long table in the order indicated by theschedule. No other children were present in the classroom. Schedulesconsisted of a 7 x 9 inch black binder binder:see combine. An earlier Microsoft Office workbook file that let users combine related documents from different Office applications. The documents could be viewed, saved, opened, e-mailed and printed as a group. that held 7 to 16 pages. Atextual cue indicating which activity was next (e.g., "Math,""Spelling," "Coloring") was displayed on every otherpage while a penny was embedded on the remaining pages. The activitiesselected had been included in the participants' past activityschedules and had been mastered by the participants, sometimes as longas a year ago. These activities were currently used in maintenanceschedules that the children used at home or at school when they hadcompleted their current schedules. Some examples of activities were:completing math worksheets, completing a puzzle, coloring a picture, andlistening to music while l ooking at a photo album. Dependent Variables A 15-s partial interval recording procedure was used tosuccessively record all the dependent variables. The observers checked abox to indicate the occurrence or non-occurrence of each variable. On/Off-task responding. On-task was recorded if the participant wasvisually attending to play or work materials, looking at his activityschedule, and manipulating play or work materials appropriately (i.e.,as they were designed to be used), or moving from one scheduled activityto another. Off-task was scored if the participant used materials in amanner other than that for which they were designed, manipulated but didnot visually attend to the materials, engaged in inappropriate behavior(e.g. aggression, tantrums, stereotypies), or did not engage inactivities or use materials On/Off schedule responding. On-schedule was recorded if theparticipant was engaged in the activity depicted de��pict?tr.v. de��pict��ed, de��pict��ing, de��picts1. To represent in a picture or sculpture.2. To represent in words; describe. See Synonyms at represent. on the page to whichhis activity schedule was open. Off-schedule was scored if theparticipant was engaged in an activity other than what was depicted onhis activity schedule. Independent Variables As with the dependent variables, a 15s partial interval recordingprocedure was used to simultaneously record the independent variables,Independent variables consisted of a package including: (a) manualprompts (verbal and gestural prompts were also recorded for purposes oftreatment integrity), (b) presence of the instructor, (c)contingent/delayed reinforcement, and (d) response cost. The observerschecked a box to indicate the occurrence or non-occurrence of eachvariable. Manual prompts. All physical contact between the teacher and theparticipants, designed to assist the participants in the completion of atask, was scored as a manual prompt. Examples of such prompts arephysically guiding the participant to pick up materials or to turn thepage via hand-over-hand prompts and light touches such as those that mayoccur during fading graduated guidance. Verbal prompts. Verbal prompts included instructions such as"Do your work," "Work nicely," "Look at yourwork" and any other verbal statement directing the participants tobe engaged. Gestural prompts. Gestural prompts included all pointing,motioning, or nodding toward children or materials, as well as pointingto specific toys or photographs that represent the next task in asequence. Thus, nonspecific nonspecific/non��spe��cif��ic/ (non?spi-sif��ik)1. not due to any single known cause.2. not directed against a particular agent, but rather having a general effect.nonspecific1. and specific gestures (e.g., pointing to achild or pointing to the last piece to be placed in the puzzle) werescored as gestural prompts. Presence of the instructor. The instructor was scored as present inall those instances in which she was in the room. She was also scored aspresent when she entered the room for 3 s on a random schedule toobserve the participants, as was the case during the later steps intreatment and during maintenance. Once the instructor's presencewas faded to outside the room, the time-delay schedule was implementedinitially by entries that were predictable (e.g., every 1 min, 2 min, 3min) and subsequently by entries that were unpredictable (e.g., enteringrandomly every 2-5 and every 3-5 min). Contingent/delayed consequences. Self-administration of pennies bythe participants was scored as a contingent reward. The exchange ofpennies for preferred items or activities at the end of the session wasscored as delayed reward. Response-cost. The instructor implemented response cost via removalof all acquired pennies if the participants were off-task for 3 s ormore and manually prompted the participants to start the schedule over. Sessions. Sessions were 15 min long in duration. Data werecollected on both dependent and independent variables In mathematics, an independent variable is any of the arguments, i.e. "inputs", to a function. These are contrasted with the dependent variable, which is the value, i.e. the "output", of the function. for the durationof the session. No more than two sessions per child were run on anygiven day. On those occasions where two sessions were conducted a 30 minbreak between sessions was reliably observed. This study began inJanuary and ran until the end of the academic year that is until August.The experimenters did not systematically manipulate the number ofsessions conducted per day. Rather, this was a function of studentabsenteeism and/or time restrictions for the completion of the project. Interobserver Agreement Interobserver agreement data were collected in vivo through atwo-way mirror two-way mirrorn.See one-way mirror. built into the door of the classroom. The two observerswho stood outside the door simultaneously but independently scored datacued by a tape-recorded signal. Interobserver agreement data wereobtained for the dependent variables on 30% or more of sessions acrossall conditions. An agreement was scored when both observers recordedon-task and on-schedule as occurring at the end of an interval or as notoccurring. Interval-by-interval percentage interobserver agreement wascalculated by dividing the number of agreements by the number ofagreements plus disagreements and multiplying by 100 % (Cooper, Heron,& Heward, 1987). Mean interobserver agreement for all dependentvariables was above 98 % (range = 98-100 %). Treatment Integrity-Independent Variables Treatment integrity consisted of operationally defining theindependent variables and of direct observation of those variablesthroughout the study to ensure that the procedure was implemented in themanner in which it was intended. Levels of treatment integrity werecalculated in the same manner as discussed in Interobserver Agreement.Mean interobserver agreement for all six independent variables wasscored at 98 % or higher (range = 98-100 %). Procedures Experimental Design A multiple probe design (Homer & Baer, 1978) acrossparticipants was used to assess the effects of the treatment packageacross all conditions (e.g., baseline, treatment, resequencing,maintenance, and generalization). Experimental Conditions All experimental conditions occurred in the same classroomexcluding the generalization probes across rooms. All sessions in eachcondition lasted 15 min. Baseline. During this condition, the teacher escorted theparticipant to a classroom in which the activity schedule and therequired materials to complete the tasks were located. The teacherdelivered the instruction "Do your schedule" and left theroom. The teacher returned to the classroom after 15 min had elapsed e��lapse?intr.v. e��lapsed, e��laps��ing, e��laps��esTo slip by; pass: Weeks elapsed before we could start renovating.n. andannounced: "Doing your schedule is over." Treatment. The treatment package consisted of several steps. (a) Manual prompts: the teacher manually prompted high rates ofon-task and on-schedule behavior via graduated guidance. Graduatedguidance required that manual prompts be faded via spatial fading andshadowing. According to this procedure, the teacher initially usedhand-overhand prompts to direct the participant. As the participantbecame increasingly more independent with the task, the teachergradually changed the location of manual prompts from the hands, to thewrists, the elbows, and finally the shoulders. Once the participantdemonstrated independent responding with the task at this level ofprompting, the teacher gradually began to fade proximity until she wasoutside the room; (b) Instructor's presence: when 80% of the intervals or betterhad been scored for on-task and on-schedule for two consecutive sessionsand response-cost had not been implemented, the teacher's presencewas faded to the next step. Fading occurred via shadowing theparticipant to gradually increasing physical distance until theinstructor was outside the room. Steps in fading the instructor'sproximity were the following: (step 0) shadowing the student at adistance less than 5 inches, (step 1) shadowing the student at 6 inches,(step 2) shadowing the student at 12 inches, (step 3) shadowing thestudent at 18 inches, (step 4) shadowing the student at 24 inches orstanding by the door, and (step 5) standing by the door with the doorhalf open. Once outside the room, the teacher reentered the classroomfor approximately 2 s according to a time-delay schedule, observed thechild and exited without saying anything to the participant. Steps inthe time-delay schedule were the following: (step 6) entering the roomevery 1 min, (step 7) entering every 2 min, (step 8) entering every 3min, (step 9) entering randomly every 2-5 minutes, (step 10) enteringrandomly every 3-5 minutes. The criterion for moving to the next levelof fading was 80% of the intervals scored for on-task and on-schedule inthe absence of response-cost for two consecutive sessions; (c) Contingent/delayed reinforcement: immediate rewards consistedof pennies embedded on separate pages between activities in the activityschedule. During intervention if the child administered a penny withoutfirst completing the work the instructor would manually prompt the childto return the penny and follow the correct sequence. At the end of thesession, pennies were exchanged for preferred snacks or activities; (d) Response cost: when off-task behavior and/or stereotypyoccurred for a minimum of 3 s, the teacher immediately implementedresponse-cost by removing all acquired coins from the token board andmanually guiding the participants to start the schedule from thebeginning. When off-task responding and/or stereotypy occurred duringthose sessions in which the teacher's presence had been faded fromthe classroom, the teacher would reenter re��en��teralso re-en��ter ?v. re��en��tered, re��en��ter��ing, re��en��tersv.tr.1. To enter or come in to again.2. To record again on a list or ledger.v.intr. the room, implement theresponse cost procedure, manually prompt the participant to start theschedule over and leave the room. Resequencing. As each participant demonstrated stable levels (i.e.,80% or more of the intervals scored) of on-task and on-scheduleresponding, the activities in the schedule, excluding the first pagewere resequenced according to a table of random numbers. Prompting wasdelivered according to the specifications in the treatment section. Thepurpose of this condition was to evaluate whether the participants hadacquired a generalized repertoire of schedule following or whether theywere simply following a memorized sequence of activities. Maintenance. In maintenance the teacher checked on the student onceper session, at the first to 14th minutes assigned randomly. The teacherwas present in the room for no longer than 2s. Generalization. Generalization was assessed across (a) novelstimuli that were cued by the activity schedule and (b) a novel setting.Probes were conducted across novel materials and settings pre- andpost-treatment as well as during maintenance for two of the threeparticipants. During probes the teacher did not enter the room after theinitial instruction and no prompts were delivered. If the studentcompleted the activity schedule without engaging in off-task respondingfor 3s or more, he was allowed to choose a reward. Results Dependent Variables Figure 1 displays levels of on-task and on-schedule performance forthe three participants across the baseline, treatment, resequencing, andmaintenance conditions. During baseline Zeb was almost never scoredon-task or on-schedule. His mean performance was 0.25% for both on-taskand on-schedule (range = 0-2% for both). David and Carl displayed considerable variability in performanceduring baseline measures for both on-task and on-schedule respondingacross sessions. Mean performance for David during baseline was 63%on-task (range = 0-98%) and 55% on-schedule (range 0-98%). Meanperformance for Carl during baseline was 9 % on-task (range = 0-33%) and3% on-schedule (range = 0-17%). During treatment, mean on-task performance for all three childrenranged between 95% and 99%. Specifically, Zeb's mean on-task andon-schedule performance was 99% (on-task and on-schedule range =85-100%). Mean on-task performance for David during treatment was 98%(range = 92-100%) of the intervals scored while his mean on-scheduleperformance was 97% (range 92-100%). Finally, Carl was scored on-taskfor 97% of the intervals (range 87-100%) during treatment whileon-schedule was scored for 96% of the intervals (range = 80-100%). During resequencing of photographs and the maintenance condition,all three participants continued to display high and stable rates ofon-task and on-schedule performances. As shown in Figure 1, Zeb'smean performance for on-task during resequencing was 98% (range =97-100%) while his mean on-schedule performance was scored at 96 %(range = 87-100%). David's mean performance during resequencing was97% for on-task responding and 96% for on-schedule responding (range =90-100% for both on-task and on-schedule). Carl's mean on-taskperformance during resequencing was 97% for both on-task and on-schedule(on-task range = 87-100%; on-schedule range = 80-100%). Levels of on-task and on-schedule responding during maintenance canbe seen in Figure 1. Mean performance for Zeb was scored at 99% for bothon-task and on-schedule responding (range = 97-100%). Duringmaintenance, David's performance for both on-task and on-schedulewas scored at 98% (range = 98-100% for both on-task and on-schedule). Nomaintenance data are available for Carl because the academic year ended. Figure 2 displays levels of on-task and on-schedule respondingduring generalization probes conducted with the same material but in adifferent room across baseline, treatment and maintenance conditions forall three children. In baseline Zeb was never on-task or on-schedule. Intreatment he was scored on-task and on-schedule during 99% of theintervals scored (range = 97-100% for both on-task and on-schedule). Inmaintenance Zeb was scored on-task for 92% of the intervals andon-schedule for 91% of the intervals scored (range = 82-98% for on-task;78-98% for on-schedule). During generalization probes across a novel setting, David'smean on-task and on-schedule performances in baseline were 73% and 41%respectively (range = 57-92% for on-task and 21-77% for on-schedule).Generalization probes conducted while David was David Was (born David Weiss, 26 October 1952, Detroit) is, with his stage-brother Don Was, the founder of the influential 1980s pop group, Was (Not Was).Reviewed by The New York Times still in treatment showthat his mean score for on-task was 85% of the intervals scored (range =70-100%) and for on-schedule 83% of the intervals scored (range=63-100%). Generalization probes across a novel setting showed thatDavid's mean performance for both on-task and on-schedule inmaintenance was 99% (range = 98-100% for both). Carl's mean on-task and on-schedule performances in baseline,during generalization probes across a novel setting were scored at 0.8%and 0.3% respectively (on-task range = 0-3% and on-schedule range=0-2%). Generalization probes across a novel setting show thatCarl's mean score for on-task and on-schedule was 47% of theintervals scored while in treatment (range = 0-95%). When looking atindividual data points, however, it can be noted that the first two datapoints in treatment were at 0% for both on-task and on-scheduleresponding while the last two data points were at 95 and 93% for on-taskand at 72% and 92% for on-schedule responding. It is clear thatresponding for both on-task and on-schedule increased in the laterstages of treatment. No maintenance data are available for Carl. Figure 3 displays levels of on-task and on-schedule respondingduring generalization probes across novel material but in the originalinstructional setting. During these probes, Zeb was never scored on-taskor on-schedule while in baseline. During generalization probes acrossnovel material, Zeb's mean score for on-task and on-schedule was100% of the intervals scored while in treatment. Generalization probesacross novel material conducted during maintenance show that his meanscore for both on-task and on-schedule was 93% of the intervals (range =85-100% for both). David's mean on-task performance in baseline duringgeneralization probes across novel material was 82% (range = 70-93%),while his mean on-schedule performance was scored at 56% (range =32-80%). Generalization probes across novel material conducted intreatment indicated that David's mean score for on-task was 95 % ofthe intervals scored (range = 87-100%). while his mean on-schedule scorewas 94% (range = 83-100%). Similarly, generalization probes across novelmaterial during maintenance show that David's mean score foron-task was 98% and for on-schedule was 97% of the intervals scoredduring maintenance (on-task range = 97-98%). During generalization probes of novel material, Carl's meanperformance for on-task in baseline was scored at 9% (range = 0-25%)while his mean on-schedule performance was scored at 3% (range = 1-5%).Generalization probes for novel material conducted during treatmentindicate that Carl's mean scores for both on-task and on-schedulewas 49% of the intervals scored (on-task and on-schedule range = 8-93%).Upon examination of individual data points collected during treatment inthe generalization across novel material condition, it can be noticedthat his scores were higher in the later stages of treatment. Forinstance, the first two data points for both on-task and on-schedulewere scored at 2 and 8% while the last two data points in treatment foron-task and on-schedule were scored at 93 and 92%. The academic yearended before maintenance data for Carl could be collected. During baseline manual, verbal, and gestural prompts, theinstructor's presence, use of reinforcement, and response cost wasnever scored for any of the three participants. Percentages of theinstructor's presence, use of reinforcement, and response costacross all conditions can be seen in Table 1. Manual prompts can be seenon Figure 1 across the remaining conditions. Discussion This study demonstrated that the intervention package resulted inhigher levels of on-task and on-schedule responding for all threeparticipants. These high levels of responding were accomplished with asupervising adult present only for brief and intermittent intermittent/in��ter��mit��tent/ (-mit��ent) marked by alternating periods of activity and inactivity. in��ter��mit��tentadj.1. Stopping and starting at intervals.2. periods duringthe later sessions in treatment and during the maintenance phase.Generalization probes showed that the behavioral gains of all threechildren transferred across both novel material and a novel setting inthe complete absence of a supervising adult. Furthermore, both on-taskand on-schedule responding maintained at high rates, that is above 80 %,with minimal adult supervision over the course of seven weeks for Zeband four weeks for Daniel as indicated by the maintenance data. It isimportant to note that neither the instructor nor any other adult waspresent during the generalization probes, while during maintenance theteacher was present no more than 2s for the duration of the session.This point distinguishes the present study from other studies in whichan adult was always present in the room with the children. Overall response gains, as indicated by comparing baseline totreatment and maintenance measures, were substantial. With eachapplication of teaching the schedule, on-task and on-scheduleperformance increased for all children while the presence of theinstructor and the frequency of manual prompts and response-cost weregradually decreased. Individual data points for Carl indicated that hisperformance increased considerably in the later stages of treatmentacross both generalization conditions. Therefore, although Carl did notreach criterion on all his sessions, a considerable increase in hison-task and on-schedule responding was noted. An interesting observation was made regarding the number ofsessions required across children to fade the instructor'sproximity and to complete the time-delay schedule. Specifically, whencomparing the number of sessions required to fade the proximity of theinstructor to the number of sessions required to complete the time-delayschedule, it was observed that Carl required far more sessions to meetcriterion during the delay schedule. Carl's performance during thegeneralization probes further supports this point since his performancedid not meet criterion until the later sessions. It is expected,however, that responding across a novel setting and novel material wouldbe delayed until responding in the treatment condition was reliable. Inother words Adv. 1. in other words - otherwise stated; "in other words, we are broke"put differently , Carl's initial lack of generalized responding acrossmaterials and location may have been due to the fact that generalizationprobes for him were conducted much closer to the initiation of treatmentas compared to David and Zeb. Specifically, Carl's first generalization probe across both materials and location was conductedupon completion of his third session in treatment. Zeb's firstgeneralization probe, on the other hand, was conducted at the end oftreatment and David's first generalization probe was conducted uponcompletion of session 11 in treatment. Providing David and Zeb with moretreatment sessions prior to probing for generalization may have beenresponsible for their performance meeting criterion within fewersessions both with the instructor's proximity faded to the door, aswell as with the time-delay schedule. Additionally, the noted disparity dis��par��i��ty?n. pl. dis��par��i��ties1. The condition or fact of being unequal, as in age, rank, or degree; difference: "narrow the economic disparities among regions and industries"between Carl and the other two children may be compounded by the factthat Carl was the youngest of the three and had the least experience infollowing activity schedules. Furthermore, it is more likely that Davidand Zeb, due to their schooling, have had more incidental Contingent upon or pertaining to something that is more important; that which is necessary, appertaining to, or depending upon another known as the principal.Under Workers' Compensation statutes, a risk is deemed incidental to employment when it is related to whatever a experienceswith unpredictable supervision and response cost in their classrooms andtheir homes. Thus, prior experience with natural co ntingencies for thetwo older children, although not systematic enough to produce reliablechanges in responding, may have played a role in facilitating higher andreliable rates of responding more quickly once implementedsystematically. Interestingly, during baseline Carl, who had only one year ofexperience in schedule following and Zeb, who had seven years ofexperience spent almost the entire 15-mm period engaging in vocal andmotor stereotypy. Additionally David, who had seven years of experiencein following activity schedules, during baseline only occasionallyengaged in schedule following. Furthermore, his performance was sovariable that ultimately his responding was unreliable (e.g., 10 of the16 points collected in baseline were scored below criterion for bothon-task and on-schedule responding). Interestingly, David's on-taskresponding was higher than his on-schedule responding. Duringobservations, it was noted that David would select activities andsometimes complete them out of sequence, rather than follow the sequenceindicated by the schedule. The reduction of variability in hisresponding once the treatment was implemented indicates that theprocedure was effective in establishing a reliable schedule followingrepertoire. A lthough, David's preference for certain activities isnot a problem per se, eventually, his ability to participate in societyas a productive member will in part depend on his ability to follow awork schedule. During resequencing, two participants erred on the first activityin the new sequence. While collecting data, the observers noted that theparticipants attempted to complete the sequence in the originalschedule, indicating that the children may have been following afamiliar routine rather than responding to the textual stimuli in theschedule. One prompt per participant was sufficient to establish the newsequence. When the schedule was resequenced to its original order duringthe maintenance condition and during the generalization probes, theparticipants did not require any additional prompts to follow theoriginal sequence. This indicates that the textual cues were establishedas discriminative stimuli and that the children were not merely engagingin familiar routines. Learning to respond to textual cues in adiscriminated fashion can be a very important skill that presents bothimmediate and future gains. For younger children it may facilitategeneralization to novel schedules and settings whereas for youths andadults with autism it may increase engagement in vocational tasks andfacilitate the acquisition and maintenance of complex sequences. Because the intervention used in this study was a treatment packageconsisting of a number of different variables that were implementedsimultaneously, it is impossible to identify which specific variableswere responsible for the behavioral gains. Nevertheless, this studyclearly demonstrated that children with autism could maintain high andconstant levels of both on-task and on-schedule responding cued via anactivity schedule. Furthermore, these levels of responding were achievedwith minimal adult supervision during the intervention and maintenancephases and with no supervision during the generalization probes.Previous studies investigating the impact of activity schedules, delayschedules, prompt fading, and unpredictable supervision as independentvariables did not attempt to assess responding in the absence of alladults (Dunlap & Johnson, 1985; Dunlap, Koegel, & Johnson, 1987;Krantz, MacDuff, & McClannahan, 1993, MacDuff, Krantz, &McClannahan, 1993; Pierce & Schreibman, 1994). In these studies, adults other than the experimenter were present during the implementationof the intervention and during the probes. As mentioned earlier thiscould be a confounding variable A confounding variable (also confounding factor, lurking variable, a confound, or confounder) is an extraneous variable in a statistical or research model that should have been experimentally controlled, but was not. since "adults" as a classcould have acquired discriminative qualities for access toreinforcement. In the present study we conducted all sessions in anisolated classroom in the absence of other children and adults unlessotherwise specified by the intervention. We established increased levelsof on-task and on-schedule responding with adults only occasionallypresent. For instance in the maintenance condition, the adult waspresent only once for as little as 2 sec throughout the 15 min session.Similar findings were demonstrated by the generalization probes with noadult supervision. Several additional components might have contributed to the successof the intervention package. For instance, the systematic fading ofinstructional prompts and fading the instructor's presence may haveresulted in transfer of stimulus control to the schedule and thematerials. Additionally, establishing unpredictable supervision may havecontributed to the reduction of off-task responding and stereotypyduring these conditions as well as during the generalization probes. Thelow levels of off-task responding and stereotypy indicate that althoughresponse cost had never been implemented during the generalizationprobes, the possibility for the instructor to enter the room andimplement the procedure at any time existed. Clinical data that were available from the children's centerbased program indicated that in the past reinforcement contingenciesalone were not sufficient to eliminate off-task responding andstereotypy in the absence of an instructor. Therefore, we programmed theimplementation of response cost for these responses. Future researchmight investigate whether reinforcing desirable behavior andconcurrently punishing undesirable behavior are both necessary toproduce desirable and lasting behavioral change in the absence ofcontinuous adult supervision while simultaneously eliminating off-taskresponding and stereotypy. Another point that requires furtherinvestigation involves the effectiveness of delaying consequences,specifically response cost, in producing lasting behavioral change. Forexample, although we arranged for reinforcement to be contingent viasell-delivery of tokens, access to the reinforcer reinforcer/re��in��forc��er/ (-in-for��ser) any stimulus that produces reinforcement, a positive r. being a desirable event strengthening responses preceding its occurrence and a negative r. was delayed until theend of the 15-min session. Response-cost, however, was implementedcontingent on Adj. 1. contingent on - determined by conditions or circumstances that follow; "arms sales contingent on the approval of congress"contingent upon, dependant on, dependant upon, dependent on, dependent upon, depending on, contingent e ach and every occurrence of off-task responding. Itwould be important to assess the effectiveness of the interventionpackage when response-cost was faded to the end of the session.Successfully fading response cost would accomplish two things. First, itwould add testament to the value of the intervention package because itwould signify sig��ni��fy?v. sig��ni��fied, sig��ni��fy��ing, sig��ni��fiesv.tr.1. To denote; mean.2. To make known, as with a sign or word: signify one's intent. that behavior is under the control of more naturalistic nat��u��ral��is��tic?adj.1. Imitating or producing the effect or appearance of nature.2. Of or in accordance with the doctrines of naturalism. contingencies. Second, it would increase the practical value of theintervention package because the need for continuous observation todetermine whether response cost should be contingently implemented ornot would be eliminated. Bringing behavior under the control of naturalistic contingenciesis important in ensuring children's inclusion in typical settings.This is especially true since the inappropriate behavior of childrenwith autism is not always observed in the process of occurring anddelayed punishment is often not effective in reducing such behavior. Oneway to assess the effectiveness of noncontingent and delayedimplementation of response cost would be to collect data onon-task/schedule and off-task/schedule responding during an extendedmaintenance phase. Such a phase would be engineered to simulate simulate - simulation thenatural environment in which children are observed engaging ininappropriate behavior that would be consequated occasionally at a laterpoint in time (delayed punishment). It would be interesting to comparerates of responding over time in this condition to rates of respondingmaintained by continuous and immediate aversive aversive/aver��sive/ (ah-ver��siv) characterized by or giving rise to avoidance; noxious. a��ver��siveadj. consequences. Finally,another important point to be examined is whether high rates of on-taskand on-schedule responding would be maintained in a classroom typesetting with the use of this intervention package. Dunlap, Koegel, Johnson, and O'Neil (1987) in their studysuccessfully faded both reinforcing and punishing consequences that wereinitially delivered contingently (e.g., praise and reprimands) to theend of the session. The authors concluded that systematic fading ofreprimands was necessary to increase the durability of appropriateresponding. It should be noted, however, that the presence of variousadults other than the experimenter mall conditions throughout this studymight have confounded the outcome. In contrast to the Dunlap et al.study, the present study seems to provide some evidence that durablebehavior can be produced without delaying the implementation of responsecost. For instance, in the present study all three children showedincreased levels of on-task and on-schedule responding during bothgeneralization probes across novel material and novel settings. In fact,response-cost was never delivered during generalization probes.Additionally, two of the children showed increased responding du ringmaintenance, without the need for fading response-cost. Similarly,during maintenance response-cost was never implemented on Zeb'sresponding and it was implemented rarely (0.7 % of the intervals scored)for David's off-task responding. A more prolonged pro��long?tr.v. pro��longed, pro��long��ing, pro��longs1. To lengthen in duration; protract.2. To lengthen in extent. maintenance phasein the present study, however, across all three children would have beenhelpful in further supporting this argument. Many researchers have criticized the employment of packages arguingthat use of multiple elements as an independent variable makes itimpossible to specify relationships between dependent and independentvariables (Michael, 1980). At times, however, a scientist/practitionermay choose to use a package, when it is expected that it is more likelyto produce a desirable outcome for the participant rather than anintervention that is more analytic (Azrin, 1977). The argument in favorof packages is based on the philosophy that focus should be directed tooutcome. Thus, the development of methods that maximize speed ofacquisition and increase the number of persons who may benefitrepresents a worthy endeavor. This argument has direct implicationsregarding the present study. The importance of identifying effective means of teaching personswith autism to work independently is indisputable. Yet only a limitednumber of studies was identified that investigate the effects ofcomponents similar to the ones used in the current intervention.Furthermore, most of these studies were conducted with adults. Finally,in all of the studies identified, a supervising adult was always presentin the room with the participants. This could have been a confoundingvariable with respect to conclusions regarding performance in theabsence of a supervising adult. The present study has provided someevidence that young children with autism can produce high rates ofon-task and on-schedule responding in the absence of a supervising adultand maintain such rates over time with minimal adult supervision. Itremains the burden of experimenters/practitioners to extend thesefindings to additional children and variable settings as well as toinvestigate whether all the components used in the present study a renecessary to replicate rep��li��catev.1. To duplicate, copy, reproduce, or repeat.2. To reproduce or make an exact copy or copies of genetic material, a cell, or an organism.n.A repetition of an experiment or a procedure. these outcomes. [FIGURE 1 OMITTED] [FIGURE 2 OMITTED] [FIGURE 3 OMITTED]Table 1Mean percentages of intervals scored for the instructor's presence,delivery of reinforcers, and implementation of response cost (RC) acrossbaseline, treatment, resequencing, and maintenance conditions. ParticipantsConditionsBaseline Zeb David CarlInstructor Present 0% 0% 0%Reinforcers 0% 0% 0%RC 0% 0% 0%TreatmentInstructor Present 67% 56% 44%Reinforcers 8% 10% 6%RC 1% 0.65% 2.5%ResequencingInstructor Present 7% 14% 9%Reinforcers 10% 10% 7%RC 0.6% 7% 0.5%MaintenanceInstructor Present 2% 2% --Reinforcers 10% 11% --RC 0% 0% -- References American Psychiatric psy��chi��at��ricadj.Of or relating to psychiatry.psychiatricadjective Pertaining to psychiatry, mental disorders Association. (1994). Diagnostic andstatistical manual of mental disorders Diagnostic and Statistical Manual of Mental Disorders/Di��ag��nos��tic and Sta��tis��ti��cal Man��u��al of Men��tal Dis��or��ders/ (DSM) a categorical system of classification of mental disorders, published by the American Psychiatric Association, that delineates objective (4th ed.). Washington, DC:Author. Azrin, N. H. (1977). A strategy for applied research: Learningbased but outcome oriented o��ri��ent?n.1. 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The use of sequential picturecues in the initiation and maintenance of grooming behaviors withmentally retarded adults. Mental Retardation mental retardation,below average level of intellectual functioning, usually defined by an IQ of below 70 to 75, combined with limitations in the skills necessary for daily living. , 19, 247-250. Wacker, D. P., & Berg, W. K. (1983). Effects of picture promptson the acquisition of complex vocational tasks by mentally retardedadolescents. Journal of Applied Behavior Analysis, 16, 417-433. Wacker, D. P., & Berg, W. K. (1984). Training adolescents withsevere handicaps to set up job tasks independently using pictureprompts. Analysis and Intervention in Developmental Disabilities, 4,353-365. Address Correspondence to: Lillian Pelios, Bancroft CARES, BancroftNeurohealth, 201 S. Kings Highway, Cherry Hill Cherry Hill,township (1990 pop. 69,319), Camden co., W central N.J.; name was changed from Delaware township to Cherry Hill in 1961. Largely residential, Cherry Hill has been marked by great development and housing growth, especially since the 1970s. , NJ 08304, Phone: (856)216-8090, Fax: (856) 216-9240, E-mail: lpelios@bnh.org Authors' Note: We extend our appreciation to Pat J. Krantz andLynn E. McClannahan who facilitated the completion of this study. Wealso thank Meg MacDuff, who served as the teacher. Her enthusiasm forresearch and her excellent skills as a teacher made it so much easier tocomplete this project.