Acquisition of Play Actions and Vocabulary Using Different Speech-generating
Displays for one Child with Autism
Recent literature reviews suggest that speech-generating device (SGD)
interventions for individuals with autism spectrum disorder and developmental
disabilities often focus primarily on requesting (Alzrayer, Banda, & Koul, 2014;
Kagohara et al., 2013). Additionally, research has primarily explored the use of gridbased SGD displays (Alzrayer, Banda, & Koul, 2014; Kagohara et al., 2013). It has
been suggested that visual scene displays (VSDs) may be advantageous for individuals
with autism (Drager et al., 2004; Shane et al., 2012). Given their ability to present
vocabulary in highly contextual manners, VSDs might be particularly appropriate for
teaching play related vocabulary. Previous research involving individuals with
developmental disabilities has shown positive effects of incorporating SGDs into playbased interventions, but these studies did not examine VSDs and had limited data
supporting the relationship between the play vocabulary emitted and play action emitted
(see for example Binger & Light, 2007; Iacono & Duncam, 1995; Taylor & Iacono,
2003). The purpose of this study was, therefore, to compare the effects of incorporating
either a VSD or grid-based SGD (both created using the AutisMate app on an iPad®based SGD) into a play-based intervention teaching both play actions and associated
vocabulary to a 5 year old child with autism and limited vocal speech.
An alternating treatments design was utilized to assess the effects of the SGD
formats. A free operant preference assessment was utilized to select a playset that the
participant preferred. The same playset (i.e., ocean mat), was used for both conditions
(VSD and grid), but the available play items and associated actions and vocabulary
differed by condition (e.g., seahorse was assigned to one condition, and starfish to
another). There were five play items (each with an associated target action and
vocabulary) allocated to each condition, with one highly preferred item being allocated
to both conditions, four items allocated to the VSD, and four different items allocated to
the grid.
During baseline structured trials, the playset was present, but the SGD was not. The
participant was given one play item from the condition at a time and told to “show me
how to play”. There were two trials with each item, resulting in 10 trials per session. The
structured baseline sessions were conducted three times with each condition, and the
use of target play actions and play vocabulary (i.e., via vocalization) was recorded. The
participant showed low levels of target actions and vocabulary during structured trials
(i.e., 0 to 10% of trials). A free play probe consisting of 2.5 minutes of free access to the
playset and items for a condition was conducted for each condition during baseline. The
participant had low levels of target actions or vocabulary us in both conditions (i.e.,
frequencies of zero to one) and primarily engaged in self-stimulatory behaviors.
During intervention structured sessions, the playset and the SGD (with the given
display for a condition) were present and the participant was given one play item from
the condition at a time and told to “show me how to play”. There were two trials with
each item, resulting in 10 trials per session. Time delay and least-to-most prompt
hierarchies were used to teach target actions (e.g., spin the starfish) and the activation
of an associated vocal-output hotspot (e.g., “Starfish whirl!”) using either the VSD or the
grid. Appropriate target actions and vocabulary use (via SGD or vocalization) were
recorded and reinforced with social attention and free access to the play items. Free
play probes (2.5 minutes of free access to the play set and items for that condition)
were conducted following every two structured sessions. During free play probes a
transcript detailing target actions and both target and non-targeted communication acts
was created. Via coding, it was determined whether target communication acts occurred
in proximity to (i.e., immediately before or after) the associated target action (i.e.,
considered to be a “matched” target communicative act.
During final intervention sessions the participant used target actions and vocabulary
words in 100% of trials, and increased his use of targeted actions and matched target
vocabulary during free play probes. During structured sessions, the communication
responses were initially acquired more rapidly with the VSD, but mastery criterion (three
sessions at 80% for both actions and vocabulary) was also met with the grid. The
procedures were replicated with a novel playset, and the participant acquired
vocabulary and actions in both conditions at a similar rate.
The results suggest that for one participant with ASD, the use of either a VSD or a
grid-based SGD combined with prompting and reinforcement, were both successful for
increasing the use of targeted play actions and associated vocabulary. It should be
noted that this participant had prior experience with both grid and VSD SGDs for
requesting skills. Although he did not have a strong repertoire of functional play skills
with a variety of toys, he had strong imitative skills, and responded well to social
reinforcement. As a pilot study with one participant, this study cannot determine whether
the intervention would be effective for additional participants with different
characteristics. It does, however, suggest potential benefits of incorporating an SGD
into a play-based intervention and suggests the need for further research evaluating the
use of a variety of SGD formats in play-based interventions.
The authors disclose they have no financial or other interest in objects or entities
mentioned in this paper.
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