Evidence-Based Strategies to Address Deficient Repertoires in Young Children with Autism

Coyne & AssociatesEducational Corporation

ABAI Phoenix 2009

Facilitation of an Echoic Repertoire

Christine Dausch Essex, SLPSally D. Moore, MA BCBA

Len Levin, PhDNicola Bogie, MA

Celia Newkirk, MA

Introduction

A primary goal for children with Autism receiving EIBI is to establish a system of communication

EIBI curricula emphasize development of listener and speaker repertoires (i.e. following instructions, identification, manding, tacting, etc.)

Included in EIBI curricula is a “standard” method for establishing an echoic repertoireReinforce spontaneous vocalizationsGain stimulus control over vocalizations via Vocal

Imitation or mand trainingShape approximations

Introduction Continued

Some alternative methods have been utilized to try and establish an echoic repertoire when “standard” methods are unsuccessful

What happens when attempts to establish an echoic repertoire are unsuccessfulProgram focus is shifted to non-vocal modalities of

communication (eg. PECS)Referrals are made to other providers (Speech-

Language Pathologists)

Introduction Continued

Due to the nature of vocal targets, it is often impossible to directly evoke the correct response following the delivery of the SD

Traditional prompting and prompt fading techniques are not applicable to most vocal responses

There is little empirical literature addressing how to proceed with children who display severely deficient to no vocal repertoire

Collaboration

Behavior Analysts are trained HOW to teach by utilizing the 3 term contingency: S->R->S

Speech-Language Pathologists are trained WHAT to teach (i.e. developmental sequence of phonemes, speech/oral motor development).

Collaboration Continued

This collaborative model relies equally on the principles of Behavior Analysis and behavior change and the science of speech/oral motor development

In our opinion, the protocols and procedures cultivated from this model could not have been developed by behavior analysts or speech-language pathologists working individually

Characteristics of Participants

Limited babbling/spontaneous vocalizations

No obvious difficulty with non-vocal imitation

Lack of progress with vocal imitation targets

Utilizing PECS as primary mode of communication

Diagnosis of autism

Ages 2-3

Method-Participant 1

Oral Motor Imitation with Objects

Introduced targets that would act as a bridge to production of specific phonemesExample: Wipe mouth with washcloth-bridge to /m/

Target List 1Blow train whistleWipe mouth with washclothChantBlow harmonicaLick lollipopRaspberry Lips

Oral Motor Imitation with Objects

Target List 2Blow train whistle /h/Wipe mouth with washcloth /m/Chant /a/Blow harmonica /h/Lick lollipop tongue controlRaspberry Lips /p/ and /b/

Teaching stepsTargets were introduced in groups of 2-3Each target was presented in block trials of 5Mastery Criterion-90% over 2 days, 80% over 3 days

Vocal Imitation

Sounds targeted through Oral Motor Imitation with objects were introduced in vocal imitation in block trials of 5

Anecdotally, the OMI program increased visual regard for the Interventionist’s mouth when modeling vocal Imitation targets

Additional targets were introduced that were not specifically targeted through the OMI program

Echoic to Mand

Mastered vocal Imitation targets were introduced as manding targets

3 targets were introduced simultaneously

Format as in Greer & Ross 2008

Method-Participant 2

Non Vocal ImitationPreviously taught targets were re-taught requiring a

response that more accurately mimics the SD

A variety of new gross motor & action with objects targets were introduced incorporating finer discrimination

Teaching Steps Imitation targets were introduced 1 or 2 at a timeErrorless -> Error CorrectionMastery Criterion-90% over 2 days, 80% over 3 days

Increasing accuracy with less complex behavior chains (i.e. non-vocal imitation) would lead to the acquisition of imitation with complex behavior chains (i.e. vocal imitation)

Vocal Imitation

Vocal imitation targets were reintroduced after several targets were mastered in the revised NVI

Targets were selected based on a developmental sequence of phoneme acquisition

Teaching StepsTarget sounds were presented in block trials of 5Each target sound was presented between 25- 50 trials

per sessionMastery Criterion-90% over 2 days or 80% over 3 daysMastered targets were presented in random rotation

Echoic to Mands & Tacts

After mastery was achieved with various vowel and consonant vowel combinations in vocal imitation, targets were shifted to functional language programming

Mand and Tact targets were introduced in the Echoic to Mand/Echoic to Tact format as described by Greer & Ross

Mastered Targets to Date

Mands Read DVD Book Bubble Flip

Tacts Dog Horse Sheep Hat Shoe Bed Waffle Apple Papa Tito Abu Tita Aba

Discussion

We made the Discriminative Stimulus more salient via the use of objects and minor discriminations with motor imitationParticipant 1-through pairing actions with objects with

vocal targetsParticipant 2-through fine discrimination with non-vocal

imitation targets

Ongoing collaboration led to better and better refinements of the proceduresWithin the procedures continual problem solving was

utilizedWhen acquisition was not present sometimes it was a

teaching issue and sometimes it was a speech issue

Discussion Continued

Future DirectionsCollect experimental data to support our hypothesisEstablish a “profile” to determine which procedure

will be most effective with which children