ERIC EJ910163: Increasing the Vocal Responses of Children with Autism and Developmental Disabilities Using Manual Sign Mand Training and Prompt Delay

2010·0.22 MB·English

by  ERIC

JOURNALOFAPPLIEDBEHAVIORANALYSIS 2010, 43, 705–709 NUMBER4 (WINTER2010)
INCREASING THE VOCAL RESPONSES OF CHILDREN
WITH AUTISM AND DEVELOPMENTAL DISABILITIES USING
MANUAL SIGN MAND TRAINING AND PROMPT DELAY
VINCENT J. CARBONE AND EMILY J. SWEENEY-KERWIN
CARBONECLINIC
VIVIAN ATTANASIO
VERBALBEHAVIORINSTITUTE
AND
TAMARA KASPER
CENTERFORAUTISMTREATMENT
Thepurposeofthisstudywastodeterminetheeffectofmanualsignmandtrainingcombined
with prompt delay and vocal prompting on the production of vocal responses in nonvocal
children with developmental disabilities. A multiple baseline design across participants verified
the effectiveness of this intervention. All participants showed increases in vocal responses
followingthe implementation ofthe independent variables.
Keywords: autism, mand,manual sign language, promptdelay, vocalresponding
_______________________________________________________________________________
Although the goal of many language training that manual sign language may facilitate the
programs is to develop vocal verbal behavior, development of vocal responding, but these
this can sometimes be a long and difficult effects may be limited to those children who
process. In addition, the absence of vocal verbal have already developed at least a modest vocal
behavior leaves minimally vocal children with- imitation repertoire and may not produce the
outaneffectiveformofcommunication.Several same effect for children who do not already
studies have provided empirical support for the emit a variety of vocal responses (see Schlosser
use of manual sign manding in producing a & Wendt for a review). Additional procedures,
functional communication repertoire in the conducted in combination with the teaching of
absence of effective vocal verbal behavior manual sign language, may therefore be neces-
repertoires for children with developmental sary to facilitate vocal responding.
disabilities (see Schlosser & Wendt, 2008, for Prompt-delay procedures, used in combina-
areview;Gregory,DeLeon,&Richman,2009). tion with alternative forms of communication
A limited body of research has also suggested and mand training, have been demonstrated to
increase the vocal verbal behavior repertoires of
We thank the parents of the participants for their
children with developmental disabilities (e.g.,
support and cooperation. Portions of this paper were
Tincani, 2004; Tincani, Crozier, & Alazetta,
presented at the annual meeting of the New York State
Association for Behavior Analysis, Saratoga Springs, 2006). For example, Tincani et al. found a
November, 2005, and the annual meeting of the differentially higher percentage of vocal re-
Association for Behavior Analysis International, Atlanta,
sponses when prompt delay was used in
Georgia,May, 2006.
Correspondence concerning this article should be combination with mand training using the
addressed to Vincent J. Carbone, Carbone Clinic, 614 picture exchange communication system
CorporateWay,ValleyCottage,NewYork10989(e-mail:
(PECS) compared to when mands were rein-
[email protected]).
doi:10.1901/jaba.2010.43-705 forced immediately after the exchange of the
705
706 VINCENT J. CARBONE et al.
picture symbol. The results of this and similar manual sign during the 5-s prompt delay.
studies indicate that the use of various prompt- Prompted vocal responses included any vocal
delay procedures in combination with alterna- responses that occurred after a vocal prompt.
tive communication systems and mand training
may be effective in increasing vocal responses Recording and Calculation of
Interobserver Agreement
for nonvocal individuals with developmental
disabilities. The purpose of this study was to The participants’ instructors served as the
replicate previous findings related to prompt response recorders for the dependent variables.
delay and vocal prompting while teaching an Additional instructors were trained to record
alternativefunctionalcommunicationrepertoire observations of the dependent variables simul-
using manual sign language. taneously but independently for the purpose of
determining interobserver agreement. A long
table separated the data recorders to ensure
METHOD
independence of the recordings. During each
Participants and Setting trial, the instructor recorded data on the item
The participants attended a private, publicly manded, the prompt level necessary to evoke
funded school serving mostly children with the manual sign mand, and the occurrence of
developmental disabilities. Only children who any prompted or unprompted vocal responses.
failed to demonstrate a consistent or functional They recorded vocal responses by writing the
vocal responding repertoire participated in the phonetic spelling of each vocal response. The
study. Tony was a 4-year-old boy with autism. datarecordedbytheprimaryobserverwerethen
He manded for 15 items with manual signs compared to those of the secondary observer.
without physical or gestural prompts when a Interobserver agreement was calculated by
desireditem waspresent andthemotivationfor dividing agreements by agreements plus dis-
theitemwasstrong.Ralphwasa4-year-oldboy agreements and converting the ratio to a
withDownsyndrome.Hemandedfor10items percentage. Interobserver agreement was con-
with manual signs without physical or gestural ductedfor30%ofallsessions.Meanagreement
prompts when a desired item was present and was 99% (range, 96% to 100%).
the motivation for the item was strong. Nick
was a 6-year-old boy with autism. He had a Design and Procedure
weakmanualsignmandrepertoireandrequired A multiplebaselinedesign acrossparticipants
partial physical prompts or full physical verified the effectiveness of the independent
prompts to produce signs. The instructor variables (Baer, Wolf, & Risley, 1968).
conducted all sessions in each participant’s General procedure. The instructor selected six
classroom. targetmanditemsforeach participantbasedon
apreexperimentalassessmentthatindicatedthat
Response Definition the participants frequently declared motivation
The dependent variable measured in the for the items (e.g., reached for the item or
study was the occurrence of unprompted and looked at it). The items included edible items,
prompted vocal responses (including speech toys,andmovies.Sessionswereconductedtwice
sounds, word approximations, or adult word per day and consisted of 50 trials during which
forms). Unprompted vocal responses included the target items were presented in a random
any vocal responses emitted simultaneously rotation. Each trial began with the instructor
with the manual sign, simultaneously with a holding a desired item at the participant’s eye
gestural or physical prompt necessary to evoke level to signal the availability of reinforcement.
the manual sign, or after the emission of a Iftheparticipantdidnotdeclaremotivationfor
INCREASING VOCAL RESPONSES 707
theitem within 5 s, theinstructor withdrewthe began. During the 5-s delay, if the participant
item and presented the next item in the emitted any vocal response, it resulted in
rotation. If the participant declared motivation delivery of the manded item immediately. If
for the item (e.g., looked at it or reached for it) the participant did not vocalize during the
butdidnotemitamanualsignmandwithin5s prompt delay, the instructor said the name of
or signed incorrectly, the instructor initiated a the desired item as a vocal prompt and waited
promptsequenceforthemanualsignthatbegan 2 s for a response. If a vocal response occurred
withagesturalprompt.Ifagesturalpromptwas within 2 s, the instructor delivered the desired
not effective in evoking the manual sign, the item. If no vocal response occurred, the
instructor provided a physical prompt 2 s later. instructor re-presented the vocal prompt two
The reinforcement period lasted for 30 s for additional times. The instructor delivered the
activities or until the item was consumed for manded item immediately after the occurrence
edible reinforcers. If the participant had refused of a vocal response following any of the vocal
to take the putative reinforcer after declaring prompts. If no vocal response occurred, the
motivation and emitting the manual sign, the instructor delivered the desired item at the end
instructorwouldhavewithdrawntheitem.This of the sequence of presentations of three vocal
never occurred during the study. If the prompts.
participant did not declare motivation and
signed for something other than the item
RESULTS AND DISCUSSION
displayed, the instructor withdrew the item
and displayed the next item in the rotation. If Figure 1 displays the effects of prompt delay
the participant emitted only a vocal response and vocal prompts on the number of vocal
without a manual sign, the instructor did not responses across baseline and treatment condi-
deliver the reinforcer and initiated the prompt tions for the three participants. The pattern of
sequenceforthemanualsign.Thisensuredthat responding across participants verifies the
vocal responses that would not control the effectiveness of the treatment methods for all
behavior of a listener (e.g., speech sounds) were participants. The treatment produced an in-
notstrengthenedindependentofamanualsign, crease in the number of vocal responses that
which was necessary for functional communi- accompanied the manual sign mands for all
cation. participants. Tony’s mean responding showed a
Baseline. During this condition, if the threefold increase in unprompted vocal re-
participant declared motivation for an item sponding resulting from the prompt-delay
and emitted the target manual sign mand procedure with additional vocal responses
within 5 s of the item’s presentation, the resulting from vocal prompts. Both Ralph’s
instructor delivered the item immediately while and Nick’s manual sign mands were accompa-
saying the name of the item. nied by very few vocal responses during
Prompt delay and vocal prompt. During the baseline, but demonstrated substantial increases
prompt-delay and vocal prompt condition, in unprompted vocalizations during treatment.
when the participant demonstrated motivation The greater benefit to Tony may have been the
for the item and signed, the instructor did not result of his more complex prebaseline vocal
immediatelydeliverthereinforcer;instead,a5-s repertoire.
prompt delay occurred. If the participant The findings of this study support the
emittedasoundwithoutthesign,theinstructor conclusion that prompt delay and vocal
implemented the prompt sequence for the prompting can be implemented with manual
manual sign and then the 5-s prompt delay sign language to produce an increase in vocal
708 VINCENT J. CARBONE et al.
Figure1. Thefrequencyofmanualsignmandsaccompaniedbypromptedandunpromptedvocalresponsespersession.
INCREASING VOCAL RESPONSES 709
responses in children with developmental the fact that there was no measurement of the
disabilities who emit few vocal responses. This response outside the experimental session and
study did not support concerns that manual the small number of participants included in
sign language may suppress vocal responses in the study. Another possible limitation includes
minimally vocal children with developmental the time interval per opportunity difference
disabilities. Moreover, the combination of between baseline and intervention. However, it
manual sign language and vocal responses is highly unlikely that participants would have
increasedthelikelihoodthattheverbalbehavior vocalized after receiving the reinforcer during
of the children in this study would effectively baseline. Collectively, these findings add to a
control the behavior of a listener. For example, growing literature that supports behavior-ana-
some listener behavior may come under better lytic methods for teaching vocal verbal skills to
control of the manual sign, and others may children with disabilities.
respond more effectively to the vocalization.
Further,anincreaseinvocalizationsprovidesan
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Final acceptanceMarch 4,2010
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