Autism: Three-word Phrases to Supported Conversations in 18 months
Presenter/Author: Nancy Horowitz Moilanen, M.A. CCC-SLP
Howard Memorial Hospital, Willits, CA
[email protected]
Course Purpose
To present a case study of an autistic male teen’s communication treatment program and
his treatment outcomes. This case study demonstrates the progressive changes occurring in
communication skills with the use of video-feedback using audio-video technology, digital
photography and a speech generating device with the output capacity of digitized recordings.
Evidence-based Treatment
The triad of evidence-based treatment in this case study is presented through an overview
of historical research, best practice decisions and sensitivity to; and incorporation of, the
patient’s values and interests.
Attendee Goals
1. Describe and discuss supported and independent audio-video feedback techniques
utilized in treatment.
2. Discuss patient’s sequential syntax development; including use of temporal and spatial
relationship vocabulary.
3. Describe role of customized, patient-created, digital icon library in patient’s speech and
language development
Discussion
An 18 y/o autistic male, initially presenting with perseverative and ritualistic language
patterns, accompanied with dysphonia, masters basic functional communication via treatment
utilizing both real-time, point-of-view video-feedback and immediate video-feedback for selfmodeling.
Treatment outcomes result in both the patient’s development of independent, highly
structured, declarative speech and language; and the ability to engage in short supported
conversations. Via use of point-of view virtual feedback, audio and video self-editing, selfmodeling, repetition and practice speaking with a monitor rather than a person; we witness
movement starting with the patient bolting perseverative repetitive words and stereo-typic
phrases across to phases of dependence on written scripts or memorized lines through his success
with short supported conversations.
The patient utilizes memorized syntactical structures as building blocks for his functional
self-generated speech. Mastering a speech-generating device, he has created a digital customized
icon library with embedded audio and video clips. The icons provide an appropriate frame of
reference from which he may imitate. Further, the icons serve for self-prompting and
storytelling, as well as, relaying personal information. A self-created linear digital filing system
assists him in storage and recall.
This icon library, using digital photography and videos, illustrates the patient’s
progressive highly structured language system. We see a continuum of vocal changes related to
message delivery, exploration with facial expression, ever-growing expressive vocabulary and
comprehension; and use of temporal and spatial relationships. An overview of this icon library
highlights the course.
Current Technology
With the release of the iPAD, 2010; an explosion appeared in the use of technology for teaching
communication skills across many language-disordered populations. This case study offers a
readily attainable speech and language treatment; utilizing current technology for delivering
supported and self-study techniques. The course demonstrates how existing research; and the
availability of developing standardized communication models for independent practice outside
of the therapy environment, can substantiate a treatment model of cost-efficiency. The course
further offers networking possibilities for clinicians to share treatment strategies for this
population related to communication development, speech generating devices, iPAD, video and
other technology.
Research
Within the field of autism, the effective use of video-feedback and computer technology
has been well-documented over the last decade. “There is growing support of efficacy of [this]
technology”, Goldsmith, et al., 2004. In 2005, Greenberg, D. and Buggey, T., demonstrated the
successes autistic children realize when they view edited video-clips of positive self-behavior.
The technique includes video self-modeling and video peer and/or adult modeling. These
children efficiently identify and incorporate newly learned behaviors when presented in videoclips which demonstrate their own and other’s point-of-view.
For autistic children, self-modeling has been shown to be an efficacious role model for
changing behavior. Seeing one’s own positive behavior reinforces the recurrence of that
behavior. Children have learned from raw video-feedback and highly sophisticated edited videos.
While the technology for raw video-feedback has been readily available to educators/clinicians
for many years; the technology to edit films capturing desired behaviors (i.e. video-modeling)
has been limited and time-consuming.
Other research comparing vivo modeling to video-modeling has demonstrated
significantly higher positive outcomes when utilizing video modeling, Charlop-Christy, 2000.
Studies have shown that the autistic child attends to a monitor better than a live model. Autistic
children lack the ability, during live social situations, to selectively identify, process and utilize
specific socially normed behaviors. The presentation of the targeted behavior on a video screen
defines the frame of reference from which to select the behavior. “They learn to memorize,
imitate, generalize or adapt targeted behaviors”, Hitchcock, Dowrick, and Prater, 2003;
Neumann, 2004.
References
Bellini, S., Akullian, J., & Hopf, A. (2007). Increasing Social Engagement in Young Children with
Autism Spectrum Disorders Using Video Self-Modeling. School Psychology Review: Vol. 36, Issue No. 1.
Buggey, T. (2005). Video self-modeling applications with students with autism spectrum disorder
in a small private school setting. Focus on Autism and Other Developmental Disabilities, 20, 52-63.
Buggey, T. et.al, (1999). Training Responding Behaviors in Students with Autism: Using
Videotaped Self-Modeling. Journal of Positive Behavior Interventions, 4, 205-214.
Charlop-Christy, M.H., & Daneshvar, S. (2003). Using Video Modeling to Teach Perspective
Taking to Children with Autism. Journal of Positive Behavior Interventions: Vol. 5, Issue No. 1,pp.12-21.
Charlop-Christy, M.H., Le, L., & Freeman, K.A. (2000). A Comparison of Video Modeling with In
Vivo Modeling for Teaching Children with Autism. Journal of Autism and Developmental Disorders:
Volume 30, Issue No. 6, pp. 537-552.
Corbett, B.A. (2003). Video Modeling: A Window into the World of Autism. The Behavior Analyst
Today: Volume 4, Issue No. 3.
Corbett, B.A. & Abdullah, M. (2005) Video Modeling: Why Does It Work for Children with
Autism? Journal of Early and Intensive Behavior Intervention: Volume 2, Issue No. 1, pp.2-8.
D'Ateno, P., Mangiapanello, K., & Taylor, B. A. (2003). Using Video Modeling to Teach Complex
Play Sequences to a Preschooler with Autism. Journal of Positive Behavior Interventions: Volume 5, Issue
No. 1, pp. 5-11.
Goldsmith, T.R. & LeBlanc, L.A. (2004) Use of Technology in Interventions for Children with
Autism. Journal of Early and Intensive Behavioral Intervention:Volume 1, Issue No. 2, pp.166-178.
Hine, J.F. & Wolery, M. (2006). Using Point-of-View Video Modeling to Teach Play to
Preschoolers with Autism. Topics in Early Childhood Special Education: Vol. 26, Issue No. 2, pp.83–93.
Mc Coy, Kathleen; Hermansen, Emily. (Nov. 2007). Video modeling for individuals with autism: a
review of model types and effects. The Free Library by Farlex, www.thefreelibrary.com
Smith, C., Williamson, R. & Siegel-Robertson, J. (2005). Implementing Technology to Teach Social
Skills to Students with Multiple High-Incidence Disabilities. Unpublished University of Memphis research
study, 11.
Socialskillsbuilder.com. Video Modeling Research Overview. Web download (March 16, 2012).
Autism & Special Needs Software, www.socialskillsbuilder.com/articles/video-modeling-research.html
Steven, G. (2011). Unlock the Mystery. Autism Key. iPad Assist Those with Autism and Other
Special Needs. www.autismkey.com/ipad-for-autism/
Wert, B. Y., & Neisworth, J. T. (2003). Effects of Video Self-Modeling on Spontaneous Requesting
in Children with Autism. Journal of Positive Behavior Interventions: Volume 5, Issue No. 1, pp.30-34.
Whitlow, Crystal, Ph.D, University of Tennessee at Martin. Video Self-Modeling.
Retrieved from web, 3/1/12, www.search.asha.org
Williams, C., Wright, B., Callaghan, G., & Coughlan, B. (2002). Do Children with Autism Learn to
Read More Readily by Computer Assisted Instruction or Traditional Book Methods? Journal of Autism and
Developmental Disabilities, Volume 6, pp. 71-91.
Williams,S. Ph.D, SpeechPathology.com. (Nov 19, 2008). Wired for Success, Digital Games,
Simulations and Virtual Worlds for Language and Literacy Instruction. ASHA presentation.
Yoder, Paul, Ph.D., et.al., Are we Teaching Declaratives in Children with Developmental Delay or
Autism? (Nov., 2009). National Institute on Deafness and Other Communication Disorders.
Notes: