using video modeling to teach pretend play to children with autism

Behavioral Interventions

Behav. Intervent. 20: 225–238 (2005)

Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/bin.197

USING VIDEOMODELING TO TEACHPRETENDPLAY TO CHILDRENWITH AUTISM

Rebecca MacDonald*, Michelle Clark, Elizabeth Garrigan and Madhuri Vangala

The New England Center for Children, Southborough, MA, USA

Children with autism often fail to develop the rich repertoires of pretend play seen in typically

developing children. Video modeling is a teaching methodology that has been shown to produce rapid

acquisition of a variety of skills in children with autism. The purpose of the present study was to use

video modeling to teach thematic pretend play skills to two preschool children with autism. Scripted

play scenarios involving up to 17 verbalizations and 15 play actions by toy figurines were videotaped

using adult models. A multiple probe design within child across play sets was used to demonstrate

experimental control. Children were shown the video model two times and no further prompting or

reinforcement was delivered during training. Results indicated that both children acquired the sequences

of scripted verbalizations and play actions quickly and maintained this performance during follow-up

probes. These findings are discussed as they relate to types of play and the development of extended play

repertoires in young children with autism. Copyright # 2005 John Wiley & Sons, Ltd.

INTRODUCTION

Pretend play is a social skill that emerges early in typically developing children

and is thought to contribute to the social and language development of young

children. In play children act out what they know about the world around them. Play

emerges in a developmental sequence for typically developing children (Lifter,

2000), progressing from simple toy manipulation, such as cause and effect toys to

more advanced symbolic play with action figures or characters. In children with

autism, play is often characterized by repetitive behaviors and a lack of symbolic

quality (Lifter, 2000).

Video modeling is a teaching procedure that has been shown to effectively teach a

variety of skills to children with autism, including: generalize purchasing skills

Copyright # 2005 John Wiley & Sons, Ltd.

*Correspondence to: Rebecca MacDonald, Ph.D., The New England Center for Children, 33 Turnpike Road,Southborough, MA 01772, USA. E-mail: [email protected]

(Haring, Kennedy, Adams, & Pitts-Conway, 1987), daily living skills (Rehfeld,

Dahman, Young, Cherry, & Davis, 2003; Shipley-Benamou, Lutzker, & Taubman,

2002), conversational skills (Charlop & Milstein, 1989; Charlop-Christy, Lee, &

Freeman, 2000; Sherer et al., 2001), and perspective taking (Charlop-Christy, Lee, &

Daneshvar, 2003; LeBlanc et al., 2003). Video modeling is emerging as an effective

instructional technique to teach play skills to children with autism. Charlop-Christy

et al. (2000) taught children to play games like tag, Red Rover, and card games.

Video modeling has been used to increase play statements during play with siblings

Taylor, Levin, and Jasper (1999) and to teach children to initiate play with others

(Nikopoulos & Keenan, 2003, 2004). D’Ateno, Mangiapanello, and Taylor (2003)

found that they could establish complex pretend play sequences involving both verbal

and motor responses.

Video modeling typically involves presenting a videotaped sample of models

engaged in a specific series of scripted actions and/or verbalizations. The videotaped

model is shown two or three times (Charlop & Milstein, 1989; Charlop et al.,

2000) and then the individual is directed to perform the scripted behaviors. Video

modeling has produced more rapid acquisition and greater generalization than in vivo

modeling (Charlop-Christy et al., 2000) and a number of studies have shown that

prompting and reinforcement were not necessary for acquisition to occur (Charlop-

Christy et al., 2000; D’Ateno et al., 2003).

The purpose of the present study was to extend the D’Ateno et al. (2003) study by

teaching children with autism to engage in long sequences of play, which included

verbal narration and motor actions with toy play sets that had figurines and objects.

This type of play, which Lifter (2000) suggests is a later developing play skill,

requires the child to move figurines as if they were capable of specific actions (e.g.,

making the figurine hold the telescope and look through it) rather than acting on the

materials (e.g., pretending to drink tea) as in the D’Ateno et al. (2003) study. Play

scripts were developed based on observing typically developing children playing

with three commercially available play sets. Phrases and themes from the typically

developing children’s play were used in the play scripts developed for video

modeling instruction. These scripts were then video taped and used to teach play

skills to two children diagnosed with an autism spectrum disorder.

METHOD

Participants

Two boys, ages 4 and 7 years old, who had a diagnosis of Pervasive Developmental

Disorder—Autism, participated in this study. Andrew was a 4-year-old boy who had

226 R. MacDonald et al.

Copyright # 2005 John Wiley & Sons, Ltd. Behav. Intervent. 20: 225–238 (2005)

recently begun early intensive behavioral intervention. He used short intelligible

sentences to request and comment on events in his environment. James was a 7-year-

old boy who communicated using full sentences but required prompting to initiate

requests. Both boys were enrolled in an intensive behavioral preschool program that

offered 5 days a week and 6 h a day of individualized programming. Andrew was

integrated into a typical preschool classroom for 1 h a day with the support of a

one-to-one therapist. James was integrated into a local kindergarten classroom five

mornings a week, also with the support of a therapist. He spent his afternoons in the

specialized preschool program. Andrew and James both had generalized imitation

and were able to learn through observation of others. They had limited repertoires of

pretend play and the play they did exhibit was repetitive with no story line or theme.

Both had prior experience of using video modeling teaching procedures, and showed

sustained attention to the video modeled instruction.

Setting

Play skills training sessions were conducted in an area within each child’s

specialized preschool classroom. The classrooms contained small cubby areas

around the perimeter of the room with a large table in the center of the room. Play

sessions were conducted at this large table and the video model was presented in a

separate area in the classroom where there was a TV with a VCR. Sessions were run

daily. All sessions were videotaped for later scoring.

Materials

Three play sets were used to teach pretend play. The play sets included a town,

a ship, and a house. Scripts were developed for each play set. Each play set had a base

structure and seven characters or objects that were all used in the video modeling

scripts.

Town

The town base structure had a building with a garage door that opened. The

characters included a girl, a cat, a fire man, and a pilot. The additional objects

included a helicopter, a swing, and a fire engine.

Ship

The ship base had stairs, a steering wheel, and a crows nest. The characters

included a pirate, a sailor, a captain, and a dog. The objects included a treasure box, a

cannon, and a telescope.

Video modeling to teach pretend play 227


House

The house consisted of a kitchen with a door that opened, a living room, and a

bedroom. The characters included a mother, a boy, and a dog. The additional objects

included a bed, a table, and two chairs.

Scripts were recorded on a VHS-C camcorder and shown on a Portable TV with a

1300 screen and a VCR player. The TV/VCR was placed on a table separate from the

area in which the child would play with the toy set.

Independent Variable

Specific play scripts were developed for each set of materials. These scripts were

based on a story about a pretend event using the characters and the materials for each

play set. The scripts required the child to hold each character, and speak for that

character. In addition, the script involved having the characters manipulate the

materials, for example, having the fireman get into the fire truck and drive the truck,

or having the sailor look through the telescope. Each script had a sequence of

approximately 16 verbalizations and 14 coordinated actions.

An adult was videotaped acting out the sequence of pretend play. This video model

was shown to the child two times consecutively. Immediately after viewing the video

modeling script, the examiner gave the cue ‘It’s time to play’ and the child was given

four minutes to play with the materials, while the examiner stood directly behind the

child. No reinforcement or prompting was given by the examiner during training or

probe sessions.

Dependent Measures

The participant’s responses were scored from videotapes subsequent to each

session. The number of scripted verbalizations and play actions were scored for all

sessions. The verbalizations ranged from single words to phrases of three to five

words in length. A sample script used to teach play with the house is shown in

Appendix A. The number of unscripted play actions was also scored for all baseline

and probe sessions.

Scripted Verbalizations

Verbalizations were defined as vocal statements that matched the statement of the

video model. In addition, statements that were similar to the modeled response but

not identical were also scored. This included the substitution or omission of a word.

For example, the child said ‘Bringing the treasure box’ rather than ‘carrying the

treasure box.’



Scripted Play Actions

Scripted actions were defined as motor responses that matched the actions of the

video model and resulted in the same change in the environment as seen in the model.

A play action was only scored if the complete sequence of play was performed. For

example, swinging in the swing was only scored if the character was put in the swing

and then pushed back and forth.

Unscripted Play Actions

Unscripted actions were scored as two separate types of responses. Unscripted

verbalizations were not scored because they almost never occurred. Unscripted play

included the same actions as seen in the video model but completed with a different

character. For example, in the video model the captain steers the ship but the child has

the sailor steer the ship. Unscripted play also included a play action that was not

modeled in the video script but that was appropriate to the context of the toy. For

example, falling off the ship and swimming in the water. These behaviors were scored

using a data sheet that had a variety of possible play actions that were not part of the

script, developed for each play set.

Experimental Design

A multiple probe design within child across play sets was used to establish

experimental control. The play sets were taught in the same order for each child

starting with the town, then the ship, and finally the house. Each participant was

required to perform at mastery on scripted verbalizations and scripted play actions

before training could begin on the next play set. Probes (see below) were conducted

prior to the introduction of training for each play set, and then again subsequent to

acquisition of a new play set.

Procedures

Baseline

During baseline sessions the toy base structure was placed on the table in front

of the child and the characters and objects were placed to the left of the structure.

The child was seated on a chair at the table and given the instruction ‘It’s time to

play.’ The child was then given 4 min to play with the toys. The experimenter stood

just behind the child, and did not give any additional instructions or physical cues.

If the child tried to leave the area before the 4 min, they were redirected back to

the play set.



Training

During training sessions the child was brought to the TV/VCR and shown the

video model play script two times. The child was then immediately directed to the

play materials and told ‘It’s time to play.’ As in baseline, the child was given 4 min to

play with the toys while the experimenter stood behind the child. No prompts or

reinforcement were delivered by the experimenter during training. Training sessions

continued until the child demonstrated mastery criterion of 80% accuracy on all

actions and verbalizations.

Mastery Probes

Subsequent to reaching mastery criterion with the video present, probes were

conducted without the video. During these probe sessions the child was presented

with the toy set and given the instruction to play. Probe sessions were identical to

baseline sessions. If the child demonstrated 80% accuracy on all actions and

verbalizations without the video they met mastery criteria for that play set and

training could then began on a new set of materials.

Follow-Up Probes

Once mastery criteria were met on a toy set, follow-up probes were conducted on

any of the previously mastered scripts. These probe sessions were identical to

baseline sessions.

Interobserver Agreement

Interobserver agreement was calculated in 40% of sessions for

scripted verbalizations and actions. The interobserver agreement was calculated by

taking the number of agreements, divided by the number of agreements plus

disagreements and multiplying by 100. Interobserver agreement for play actions

was 97% (range, 93–100%) for the town script, 99% (range, 93–100%) for the ship

script, and 96% (range, 88–100%) for the house script. Interobserver agreement

for play verbalizations was 90% (range, 73–100%) for the town script, 96% (range,

80–100%) for the ship script, and 99% (range, 94–100%) for the house script.

Interobserver agreement was calculated for unscripted actions in 33% of the probe

sessions. The mean agreement for scripted actions with different characters was 96%

(range, 79–100%), and mean agreement for unscripted actions was 98% (range,

87–100%).



RESULTS

Scripted behaviors for Andrew are shown in Figure 1. Andrew showed low levels

of scripted verbalizations during baseline across all three play sets. Following video

modeling training, scripted verbalizations for the town script increased from a

baseline level of 0.33 verbalizations per session (range, 0–1) to a level of 13 (of 15)

verbalizations on mastery probes (range, 12–14). Scripted verbalizations for the ship

script increased from a baseline level of 0.5 verbalizations per session (range, 0–2) to

a level of 16 (of 16) verbalizations during the mastery probe session. Scripted

verbalizations for the house script increased from a baseline level of 0.5

verbalizations per session (range, 0–2) to a level of 16.5 (of 17) verbalizations on

mastery probes (range, 16–17).

Andrew also showed low levels of scripted play actions during baseline across all

three play sets. Following video modeling training, scripted actions for the town

script increased from a baseline level of 4.3 actions per session (range, 2–6) to

mastery level of 13 (of 16) actions on mastery probe sessions (range, 12–14). Scripted

actions for the ship script increased from a baseline level of 4.3 actions per session

(range, 2–6) to a level of 11 (of 14) actions during the mastery probe. Scripted actions

for the house script increased from a baseline level of 4.3 actions per session (range,

4–5) to mastery level of 13 (of 16) actions on mastery probes. Performance on

scripted verbalizations and actions decreased slightly during follow-up probes for

both the town and ship scripts but returned to mastery levels after one training session

(indicated by solid points on graph).

Scripted behaviors for James are shown in Figure 2. James showed low levels of

scripted verbalizations during baseline across all three play sets. Following video

modeling training, scripted verbalizations for the town script increased from a

baseline level of zero verbalizations per session to mastery level of 15 verbalizations

on mastery probes. Scripted verbalizations for the ship script increased from a

baseline level of 1.2 verbalizations per session (range, 0–2) to a level of 16

verbalizations on mastery probes. Scripted verbalizations for the house script

increased from a baseline level of 1.3 verbalizations per session (range, 0–3) to a

level of 17 verbalizations on mastery probes.

James showed low levels of scripted play actions during baseline across all three play

sets. Following video modeling training, scripted actions for the town script increased

from a baseline level of 3 actions per session to a level of 13.5 actions on mastery probes

(range, 13–14). Scripted actions for the ship script increased from a baseline level of

2.3 actions per session (range, 1–4) to a level of 13.5 actions on mastery probes (range,

13–14). Scripted actions for the house script increased from a baseline level of 1.8

actions per session (range, 1–5) to a level of 16 actions on mastery probes. Performance

on scripted verbalizations and actions was maintained during follow-up probes.



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Figure 1. Number of scripted verbalizations and scripted actions demonstrated by Andrew with thetown, ship, and house.



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Figure 2. Number of scripted verbalizations and scripted actions demonstrated by James with the town,ship, and house.



Unscripted play actions for Andrew are shown in Figure 3. The bar graph shows

only play actions during baseline, mastery probes and follow-up probes for each play

set. The mean number of scripted play actions is indicated by the solid area on the

bottom of each bar, followed by the mean number of scripted actions completed with

different characters (the checkered area) and the number of unscripted play actions

(the shaded area). During baseline James exhibited few scripted actions with different

characters across play sets. He exhibited six unscripted actions with the town and few

or none with the other play sets. After video modeling training he exhibited some

scripted actions with different characters with all three play sets and a mean of 11

unscripted actions with the house.

Unscripted play actions for James are shown in Figure 4. During baseline James

exhibited an average of 2.6 scripted actions with different characters on the town but

none with the other two play sets. He exhibited an average of 2.3 unscripted actions

with the town, 2.8 with the ship, and 7.3 with the house. After video modeling

training he exhibited only scripted actions with all three play sets.

DISCUSSION

Video modeling produced extended sequences of scripted play for these two

children who did not have well-developed repertoires of play prior to intervention. The

results show that video modeling was an effective procedure for increasing scripted

play across three commercially available play sets. Both children exhibited rapid

acquisition of verbalizations and play actions, and maintained this performance over

time. These acquired chains of play included up to 17 actions with verbalizations

embedded into the play scenarios. The scripts were acquired in five to seven sessions

without the use of response prompting, or experimenter-delivered reinforcement.

In the present study, the targeted play involved the manipulation of characters to

act out a story about an event. Lifter (2000) in her Developmental Play Assessment

describes pretend play as relating objects to one’s self and acting on those objects in a

pretend manner (e.g., child looks through a telescope) or as a child extending familiar

actions to dolls (e.g., puts telescope to dolls eye). She proposes that relating objects to

one’s self is an earlier developing form of play relative to doll as agent pretend play

where the child moves figurines as if they were capable of specific actions (e.g.,

having figurine hold telescope and look through it). The children in this study quickly

learned to use a character to perform a pretend action on the available materials as

modeled in the play script. In addition, they learned to hold onto the character and

talk for that character. The use of figurines requires that the child engage in more

complex social behavior, similar to that required in perspective taking, an area of skill

deficit for many children with autism (Knoll & Charman, 2000; LeBlanc et al., 2003).



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Teaching this type of play using video modeling may be one strategy to foster

prespective taking in these children. The present study is an extension of the D’Ateno

et al. (2003) study in which video modeling was used to teach a child to play with

materials in a manner similar to Lifter’s earlier form of pretend play involving the

child acting on the objects directly.

A limitation of this study was that although scripted play was acquired, unscripted

play did not emerge. Both children had some unscripted play prior to video modeling

instruction; however, this play was characterized by repetitive isolated play actions

that were not related to any type of thematic play, for example, repeatedly having a

character go up and down the stairs on the ship. After training, one child performed

some scripted actions with other characters, while the other child performed only the

scripted actions and repeated this script until the 4 min play period was over. The lack

of unscripted play is concerning; however, children with autism have very limited

repertoires of play, and increasing play in any manner is significant. While video

modeling is an effective and efficient strategy for teaching sequences of play, future

research should focus on strategies to systematically increase unscripted but

contextually appropriate play in children with autism.

REFERENCES

Charlop, M. H., & Milstein, J. P. (1989). Teaching autistic children conversational speech using video

modeling. Journal of Applied Behavior Analysis, 22, 275–285.

Charlop-Christy, M. H., Le, L., & Daneshvar, S. (2003). Using video modeling to teach perspective

taking to children with autism. Journal of Positive Behavior Interventions, 5, 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 AutismandDevelopmentalDisorders, 30, 537–552.

D’Ateno, P., Mangiapanello, K., & Taylor, B. (2003). Using video modeling to teach complex play

sequences to preschooler with autism. Journal of Positive Behavior Interventions, 5, 5–11.

Haring, T. G., Kennedy, C. H., Adams, M. J., & Pitts-Conway, V. (1987). Teaching generalization of

purchasing skills across community settings to autistic youth using videotape modeling. Journal of

Applied Behavior Analysis, 19, 159–171.

Knoll, M., & Charman, T. (2000). Teaching false belief and visual perspective taking skills in your

children: Can a theory of mind be trained?. Child Study Journal, 30, 273–304.

LeBlanc, L., Coates, M., Daneshvar, S., Charlop-Christy, M., Morris, C., & Lancaster, B. (2003). Using

video modeling and reinforcement to teach perspective-taking skills to children with autism. Journal

of Applied Behavior Analysis, 36, 253–257.

Lifter, K. (2000). Linking assessment to intervention for children with developmental disabilities or

at-risk for developmental delay: The Development Play Assessment (DPA) Instrument. In K. Gitlin-

Weiner, A. Sandgrund, & C. Schaefer (Eds.), Play diagnosis and assessment (2nd edn, pp. 228–261).

New York: Wiley.

Nikopoulos, C. K., & Keenan, M. (2003). Promoting social initiations in children with autism using

video modeling. Behavioral Interventions, 18, 87–108.



Nikopoulos, C. K., & Keenana, M. (2004). Effects of video modeling on social initiations by children

with autism. Journal of Applied Behavior Analysis, 37, 93–96.

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preparation skill to adults with severe and mental retardation using video modeling. Behavioral

Intervention, 18, 209–218.

Sherer, M., Pierce, K. L., Paredes, S., Kisacky, K. L., Ingersoll, B., & Schreibman, L. (2001). Enhancing

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Shipley-Benamou, R., Lutzker, J., & Taubman, M. (2002). Teaching daily living skills to children with

autism through instructional video modeling. Journal of Positive Behavior Interventions, 4(3), 165–175.

Sherer, M., Pierce, K. L., Paredes, S., Kisacky, K. L., Ingersoll, B., & Schreibman, L. (2001). Enhancing

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APPENDIX A

Video Modeling House Script

Objects Actions Verbalizations

Mom Mom walks to refrigerator ‘I’m the mommy’‘I’m cooking dinner’

Son Son lays down in bed ‘I’m Bobby’‘I’m taking a nap’

Bed Son and Bed are placed upstairs in bedroomDog Dog goes to door ‘Woof-Woof’Mom Mom goes to door ‘Go out and play’Dog Dog goes through door and walks around houseTable Mom goes to tableChair Mom sits down in chair ‘Time to eat’Son Son gets out of bed ‘Okay Mom’Table Son goes to tableMom ‘Let the dog in, please’

Son goes to door ‘Buster, come’Dog ‘He’s not here’Mom Mom goes to door ‘Let’s go find him’

Mom and son walk through doorSon ‘Where is Buster?’Mom Mom and son walking around ‘We’ll find him’

‘Buster, come’DogSon Son runs to dog ‘There’s Buster’Mom ‘Now let’s go home’

Mom, son and dog go inside house.Total 16 17



using video modeling to teach pretend play to children with autism

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