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Combining Interventions for ASD

Article: Effect of Video Modeling on the Instructional Efficiency of Simultaneous Prompting Among Preschoolers with Autism Spectrum Disorder. By Genc-Tosun and Kurt. In Education and Training in Autism and Developmental Disabilities, 2017, 52(3).

The world of ASD intervention research is hot right now. I have talked in past posts about video modeling (VM). VM is a good intervention for teaching discrete and complex skills and behaviors to ASD individuals. You make videos of people, or have the kids make videos of themselves doing the activity or behavior you want the ASD person to learn, and then have them watch the video until they can do the behavior independently. Simultaneous Prompting (SP) is another intervention. The person teaching the skill will tell the ASD person what they want them to do (e.g., put peanut butter on the knife) and then immediately prompt them to do the behavior. SP is also called "errorless learning". In behaviorism, if you can avoid learning the wrong thing (errors), you do not have to unlearn those wrong things, and can focus exclusively on the right things. It is apparently an efficient and effective way to teach a new behavior. I have never seen SP performed, so be skeptical of my description.

The research question asked was whether or not they could increase the speed and accuracy of ASD individuals in learning new self-help behaviors by combining these two interventions. Both work well independently, perhaps they work even better together. The results suggest that is not the case. Again, both interventions are somewhat equally effective, but combining them did not yield results that were even better.

Why would researchers be interested in this question? Is consumer, capitalistic culture (bigger, better!) making its way into science? These interventions for teaching basic self-help and independent living skills (e.g., teaching a 6-year-old ASD child to make a PB&J) can require multiple sessions and considerable amount of time from a highly skilled therapist. To give you some context, one of the children in the study took about 43 minutes to learn to make a sandwich correctly about half the times he tried. This 43 minutes was split over 22 sessions. 22 sessions! After about session 2 I would question if this kid is ever going to get it (I can be impatient and reactive). This is an incredible investment of time and resource, but no one is saying it is not worth it. Instead, researchers are looking for efficiencies and even more effective means to teach these skills.

There are, of course, many more things to say about this article, and other research like that represented here. I am going to restate a theory I had, however, regarding the development of social and independent living skills, like those mentioned in this article. I suspect much of the fault in learning (and why these interventions do work, despite being painstaking) has to do with attention. Both VM and SP have, at their core, methods of directing and sustaining one's attention on the specific behavior that must be learned. It almost feels Socratic in a way. The skill is within the child, they just need help revealing the behavior.

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