Using the Procedural Knowledge
Profile© to Establish Effective
Communication
Howard C. Shane
Sharon Weiss - Kapp
Rebecca Cordeiro
This work is supported in part by:
•The RERC on Communication Enhancement
under grants #H133E980026 (1998-2003) and
# H133E030018 (2003-2008). www.aacrerc.com
•
The Monarch School for Children with
Autism, Shaker Heights, Ohio.
American Speech Language
Hearing Association
November 18, 2006
Purposes
PKP
•Overview Procedural Knowledge Profile
(PKP)
•Rationale for its development
•Provide intervention suggestions based on
Procedural Knowledge Profile
1. Evaluates ability to interact effectively
within an environment and
2. Demonstrates knowledge of the function
of the objects contained within the
environment
Linguistic
Procedural
Knowledge
• Difficulty with “
simple
language concepts (e.g.,
verbs, prepositions,
pronouns)
• Difficulty with language
acquisition despite
exposure and instruction
• Strong operational
competence
• Imitation skills often poor
in contrast to strong
observational skills
• Skills often learned
without instruction
• More complex learning
may require some
additional language input
PKP
Does the content of the
PKP help explain disparity
between measured ability
and perceived capacity?
These distinctions may help explain why persons with ASD
may appear more competent than standardized tests often reveal
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Clinically relevant aspects
•Procedural knowledge evolves through
non-verbal relationship with objects
•Procedural knowledge is obtained
through observation of predictable and
repeated goal oriented routines
Clinically relevant aspects
•Spoken language is not required but
sometimes assists in the comprehension of
the function of objects in a natural setting
•Procedural understanding is the foundation
for mapping language (symbols) to concepts
already within the individual’
s repertoire
•Helps identify three clinical sub-groups
Contemporary Treatments
and Relationship to PKP
Comprehension
Comprehension is …“
the essence of language”
(Savage-Rumbaugh & Lewin, 1994)
•Children with ASD have weakness in declarative
knowledge (concept formation)
•Children with ASD have strength in procedural
knowledge (knowledge for doing things)
(Goldstein, Minshew, & Siegel 1994)
•Comprehension….as the power that fuels
expression (Twachtman - Cullen, 1997)
Theory of Human Cultural Learning
(Vygotsky; Tomasello, Kruger and
Ratner)
Language development is dependent on:
•A cultural context that structures events for
a child
•Child’
s capacity to learn from this cultural
structuring
Developmental Pragmatics
• DP movement developed in the late
1970’
s and early 1980s. Promoted the
view that:
Social context of naturally occurring routines
was considered of primary importance in
language development
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Developmental Pragmatics
Child was viewed as an active participant in
learning and a social participant rather than
under the agenda and control of a teacher with
a specific reinforcement schedule and variety
of instructional variables
“
[J]oint attention, early language skills, and
imitation are core deficits that are the
hallmarks of the disorder, and are
predictive of longer-term outcome in
language, adaptive behaviors, and
academic skills.
Committee on Educational Interventions for Children with Autism, National Academy
Page 44.
Natural Language Paradigm
Applied Behavioral Analysis
Natural child-centered routines that recur in
everyday life with family and peers as a
primary intervention context (Koegel &
Johnson, 1989: Scheibner & Pierce, 1983)
Rationale for highly repetitive non-contextual
approach:
•Children with ASD could not learn in natural
environments because of extreme learning and
attentional problems
•Natural environments do not provide practice
opportunities and systematic reinforcement
(Lovaas 1981)
“There is now a large body of empirical support for more
contemporary behavioral approaches using naturalistic
teaching methods that demonstrate efficacy for teaching not
only speech and language, but also communication. ….include
natural language paradigms (Koegel et al., 1987), incidental teaching (Hart, 1985;
McGee et al., 1985; McGee et al., 1999), time delay and milieu intervention (Charlop
et al., 1985; Charlop and Trasowech, 1991; Hwang and Hughes, 2000; Kaiser, 1993;
Kaiser et al., 1992), and pivotal response training (Koegel, 1995; Koegel et al., 1998).
These approaches use systematic teaching trials that have several common active
ingredients: they are initiated by the child and focus on the child’
s interest; they are
interspersed and embedded in the natural environment; and they use natural
reinforcers that follow what the child is trying to communicate. Only a few studies,
all using single-subject designs, have compared traditional discrete trial with
naturalistic behavioral approaches. These studies have reported that naturalistic
approaches are more effective at leading to generalization of language gains to
natural contexts (Koegel et al., 1998; Koegel et al., 1992; McGee et al., 1985).”
Applied Behavioral Analysis
Imitation and matching are primary
learning channels
Committee on Educational Interventions for Children with Autism,
p.53.
3
Floor time
Especially relevant is the suggestion to
follow the child’
s lead –typically occurs
in natural environment
Evidence from
Observational Learning
Influences to what has become
PKP
•Lack / Limited spoken language
comprehension
•Our growing interest in Observation Learning
•Clinical encounters reveal relative strength especially in relationship to language profile
•Too limiting to restrict instruction to discrete
trial, table top, scripted instruction, etc
•Wanted to maximize strength of acquiring
information and skills into a clinically practical
approach
Our Current Thinking
Observational
Learning
Live or Video Model
Imitation
Concrete
Non-symbolic
“What you see is what you get.”
Bobo Doll, Model and Child
Symbolic
Instruction
Non-Imitation
Abstract
Symbolic
“Don’
t do what I do, do what I say.”
Evidence from ESM Interest
Typical Findings
Bandura & Walters, 1963
•88% of children imitated the
model’
s aggressive behaviors.
•40% of same children repeated
these behaviors 8 months later.
Key Point
Children imitated novel behaviors
• With high frequency & precision
• Without any reinforcements,
prompts or instructions
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Survey
Electronic Screen Media for Persons
with Autism Spectrum Disorders –Shane & Albert
(ASHA –2005 & submitted for Publication)
•Quantification of television and computer use
•Instructional potential of medium
–Extent of interaction
–Nature of interaction
•Distributed Survey Design
– N = 89
–Drawn from families having children
(preschool to 12 years) on the autism spectrum
MAIN FINDINGS
MAIN FINDINGS
•More time with media than other activities.
•Considerable “operational
competence”, but not equal to typical
children.
•Prefer animated characters, but need to explore
actual preference by individual.
•Deferred vocal imitation occurs frequently.
•Families change viewing habits to
accommodate child on autism spectrum.
Fundamental Question
•Prefer characters in media over commercial
products.
•Motor imitation and copying reported.
Can the recognized high level of interest in OL
and ESM, be harnessed and used as an
essential and effective method of instruction?
We submit PKP can be used to as a way to
improve instruction. It takes advantage of
naturally occurring opportunities as well as
knowledge / skills the child has acquired by
observation with or without adult directed
training.
PKP
•Functional
•Naturalistic
•Map language onto "existing" capacity
Interpretation of the
Procedural Knowledge ProfileGeneral Guidelines
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Ability to Perform Procedural
Functions
•Determine which concepts are known and
are ready for symbols to be mapped to
•Determine which concepts need to be
explicitly taught
Ability to Perform Procedural
Functions in a Goal-oriented
Sequence
•Determine if student can/cannot maintain
a representation of the goal (working
memory)
•Determine if student can/cannot maintain
a representation of the goal and plan and
carry out the necessary steps to
accomplish it
Ability to Perform Procedural
Functions Across Multiple
Environments
•Determine if procedural concepts are only
associated with specific tasks
•Determine if procedural concepts are
generalized to related tasks in multiple
settings
Pre-symbolic/Symbolic
Understanding
Level of assist needed
Pre-symbolic:
•Physical/reenactment
Symbolic:
•Gestural
•Verbal
•Graphic
•Print
Level 1 Student Profile
Student Sub-Groups
PKP Analysis
•No evidence of procedural understanding
•All procedural functions are prompted by
“
Adult Directed- Physical Assist”
•All procedural concepts need to be
explicitly taught
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Associated Behaviors
•May not attend to environment or others
within his/her environment
•May not understand relevance of
procedures and routines to him or herself
•May not understand that two behaviors
“
match”e.g., “
I can do what you are
doing”
.
•May not understand the task requirements
Diagnostic Intervention
Contextual Activities-Procedural
Understanding
Level –Pre-symbolic (reenactment)
Video-based
• Student reviews video tape of a specific procedural step
in a routine to observe salient aspects of performing the
targeted procedural step
In Vivo
• Student is provided with repeated physical assists in
performing the specific, targeted procedural step within a
routine
Table Top Activities –Vocabulary Development
;
Vocabulary selection is always derived from noun and, verb,
preposition lists associated with the procedural routines
Vocabulary Development cont’
d
Level-Symbolic
Level- Pre-symbolic/Symbolic
•Matching (identity match)
•Student matches identical representations
of noun items that are the recipient of
procedural functions, found within a
specific environment. (Refer to Vocabulary
lists).
• Student matches noun items (as above) to multiple
examples of nouns that are not identical but are at the
same level of representation
Level-Schematic
• Student matches noun items (as above) to those same
items pictured within a scene cue of a specific
environment, e.g., picture of a refrigerator to the
refrigerator in the kitchen scene cue
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Associated Behaviors
Level 2 Student Profile
PKP Analysis
• Primarily ‘
Adult Directed”procedural skill acquisition
• Level of prompts are at the symbolic level, e.g.,
conventional gestures, visuals, spoken language,
written language
• Concepts that are understood through procedural
performance--either task specific or across settings--are
identified
• Concepts that need to be explicitly taught are identified
• Level of ability to perform a goal-oriented sequence of
procedural functions is evaluated
Individual may have difficulty in following areas:
•Attending to task
•Initiating
•Maintaining representation of the end goal of the
task (working memory)
•Planning steps needed to complete a sequence
•Processing temporal information (concepts of
beginning, middle, end)
•Understanding symbolic representation
•Connecting relational aspects of language
Contextual Activities- Procedural
Understanding: Sequencing
Level-Symbolic/Schematic
Diagnostic Intervention
Video Based
• Student reviews video of a procedural sequence
• Screen shots (scene cues) are taken as a visual support
to trigger retrieval of each step in the procedural
sequence
In Vivo
• Student uses the scene cues that are placed in a leftright array to perform the procedural sequence
• Prompts are either conventional gestures, visual or
spoken assists
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Table Top Activities: Sequencing
Level-Symbolic/Schematic
•Student matches individual scenes to the order
of the multi-step sequenced array
•Student sequences the scenes without the
support of the multi-step visual sequenced array
•Student completes a sequence that is missing
either the first or last scene in the array
Table Top Activities: Vocabulary
Development
Level 3 Student Profile
PKP Analysis
Level--Symbolic/Schematic
•Student matches symbols to the elements in the
scene, (e.g., picture of actor to picture of actor in
the environment, picture of refrigerator to picture
of refrigerator within the scene)
•Student sorts noun vocabulary by category (e.g.,
various examples of faucets for kitchen
environment)
•Student sorts noun vocabulary by environment
•Primarily ‘
Child Acquired’
procedural skill
acquisition
•Prompts (conventional gesture, visual or
spoken) needed only to alert student to initiate
sequence
•Procedural skills cross over to multiple
environments
Associated Behaviors
•May have attention difficulties
•May have difficulty recognizing the relevance of
the task to the present situation
•May have difficulty perceiving similarity of
established routines in novel settings
•May have difficulty with symbolic representation
•May have difficulty in relational aspects of
language
Diagnostic Intervention
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Contextual Activities- Procedural
Understanding: Sequencing
Level-Symbolic/Schematic
Video based
• Student reviews video of a procedural sequence
In Vivo
• Screen shots (scene cues) are taken as a visual support to
trigger retrieval of each step in the procedural sequence
• Student independently refers to the scene cues as a memory
aid to recall the next behavioral chunk that needs to be
recalled and performed
• Student begins to successfully initiate sequences after long
delays by taking advantage of scene cues to help remember
the correct number and order of procedural steps
Table Top Activities-Vocabulary
Development
•Student interprets action symbols linking actor
and recipient of the action after repeated
rehearsal of the procedural function with the
visual support of a scene cue
•Student acts out the scene using element cues
•Student interprets locative prepositions that are
embedded with action verbs after repeated
rehearsal of the procedural function with the
visual support of a scene cue
•Student acts out new procedural routines using
elements arranged in novel sequences
Benefits of PKP
•Identifies student sub-groups
•Identifies pre-symbolic/symbolic
understanding
•Identifies appropriate level of
representation
•Identifies relevant vocabulary for
instruction
•Facilitates analytical language processing
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