Effects of Video Modeling, Prompting, Effects of Video Modeling, Prompting, and Reinforcement Strategies onand Reinforcement Strategies on

IIncreasing A Generalized Repertoire of ncreasing A Generalized Repertoire of Prosocial Behavior Prosocial Behavior

in Children with Autismin Children with Autism

Sharon A. Reeve, Ph.D., BCBA

Oct. 14, 2003

Presentation at Queens College

Importance of a DefinitionImportance of a Definition

Researchers have been inconsistent in defining prosocial behavior

We need to identify antecedent and consequential

stimuli to effectively define prosocial behavior

We can then treat it as a type of operant behavior and subsequently teach it (Novak, 1996)

Broad Definition of Broad Definition of Prosocial BehaviorProsocial Behavior

Any act intending to benefit another such as responses associated with helping, cooperating, sharing, care giving, taking turns, friendliness, affection, empathy, and/or sympathy– Distinction among categories is ambiguous

Observed in children of typical development as early as 1 ½ to 3 years of age– Children have been observed offering to help another

person who is injured by offering a toy or trying to comfort.

(Eisenberg & Fabes, 1998)

Prosocial Behavior is LearnedProsocial Behavior is Learned

Prosocial behavior is primarily learned by imitation of children of typical development– In contrast children with autism are unlikely to imitate one

engaging in prosocial behavior

Children of typical development are more likely to initiate prosocial behavior than children with autism. – Equally to children with disabilities and children of typical

development

Children with autism were still unlikely to imitate the prosocial behavior.

(Honig & McCarron, 1988)

Importance of Prosocial Importance of Prosocial Behavior in ChildrenBehavior in Children

Increased perception of social competence (Eisenberg, Fabes, Karbon, Mur phy, Wosinski, Polazzi, Carlo, & Juhnke, 1996; Peterson, Ridley-Johnson, & Carter, 1984). 

Increased frequency in engagement in positive social interactions with peers (Farver & Branstetter, 1994; Howes & Farver, 1987).

  Increased likelihood of having many close friends and a

best friend (Farver & Branstetter, 1994; Coie, Dodge, & Kupersmidt, 1990).

Negative Outcomes of Prosocial Behavior Negative Outcomes of Prosocial Behavior Deficit in Children with AutismDeficit in Children with Autism

Can be a source of frustration and distress to those who interact with a person with autism (Harris, Handleman, & Alessandri, 1990).

Parents, peers, and teachers may be discouraged from attempting to interact with the children (Lovaas, Koegel, Simmons, & Long 1973).

Further reduces the opportunities for learning (Lovaas, Koegel, Simmons, & Long, 1973).

Negative Outcomes of Prosocial Negative Outcomes of Prosocial Behavior Deficit in Children with AutismBehavior Deficit in Children with Autism

Unlikely to have friends or sustained interactions with peers (Sigman, 1998)

Perceived as less socially competent, whether valid or based on biased expectations (Center & Wascom, 1986)

Theories for Deficits in Theories for Deficits in Prosocial BehaviorProsocial Behavior

Lack “theory-of-mind” (Baron-Cohen et al., 1985)

Early deficit in imitation (Rogers & Pennington, 1991)

Result of an interaction between deficient innate structures that play a role in processing of emotional input and a lack of social experience (Bemporad et al., 1987)

Theories for Deficits in Theories for Deficits in Prosocial BehaviorProsocial Behavior

Various cognitive deficits (Gillberg, 1992)

Failure to discriminate and respond to social cues in environment (Morrison & Bellack, 1981)

Increasing Prosocial Behavior in Increasing Prosocial Behavior in Children with Autism Children with Autism

Under Specific Training Conditions Under Specific Training Conditions (No Generalization Measures)(No Generalization Measures)

Kohler, Strain, Hoyson, Davis, Donina, & Rapp (1995)– a comprehensive intervention increased

prosocial behavior between children with autism and their peers

 

Increasing Prosocial Behavior in Increasing Prosocial Behavior in Children with Autism Children with Autism

Under Specific Training Conditions Under Specific Training Conditions (No Generalization Measures)(No Generalization Measures)

Kamps, Leonard, Vernon, Dugan, Delquadri, Gershon, Wade, & Folk (1992) – social skills training for students with autism

conducted concurrently with non-handicapped peers was an effective procedure for increasing:

frequency of social interactions amount of time engaged in prosocial behavior duration of each social interaction in children with autism

Increasing Prosocial Behavior in Increasing Prosocial Behavior in Children with AutismChildren with Autism

Under Specific Training Conditions Under Specific Training Conditions (With Generalization Measures) (With Generalization Measures)

Strain, Kerr, & Ragland (1979)– indicated that both intervention techniques increased each

child with autism’s prosocial behavior– Neither technique, however, produced increase in prosocial

behavior during generalization sessions Charlop & Walsh (1986)

– time-delay procedure was effective in teaching children with autism to respond with “I love (like) you” in response to a hug

– target behavior generalized across settings for all children, but across persons and settings for only one child

Increasing Prosocial Behavior in Increasing Prosocial Behavior in Children with AutismChildren with Autism

Under Specific Training Conditions Under Specific Training Conditions (With Generalization Measures) (With Generalization Measures)

Harris, Handleman, & Alessandri (1990)– Taught to offer assistance to a person who expressed

an inability to complete a task– adolescents given instructions as to how to help– all three adolescents showed an increase in their

offers of assistance as training progressed– generalization occurred across settings, people, and

situations during only a limited number of trials

Strategies that Increase Strategies that Increase GeneralizationGeneralization

Teaching multiple exemplars of target behavior using common stimuli (Balsam, 1988; Stokes & Baer, 1977)

 

Teaching generalized imitative repertoire (Harris et al., 1990; Poulson & Kymissis, 1988).

Use of video modeling (Charlop, Schreibman, & Tyron, 1983; Haring, Kennedy, Adams, & Pitts-Conway, 1987) 

Purpose of Present StudyPurpose of Present Study To determine extent to which children with autism

can learn to engage in both verbal and motor prosocial responses commonly labeled as helping

“Helping” was selected as prosocial response because it results in longer interactions than other prosocial responses

To determine extent to which helping responses generalized from training to novel situations in which there was an opportunity to engage in helping behavior

MethodMethod

Participants

Four children with autism (Irene, Tom, Eddie, and Nathan) who attended classes at Institute for Educational Achievement (IEA)

They ranged in age from 5-6 years

MethodMethod

Setting Most experimental sessions took place in small

classroom at IEA

Approximately once every two weeks, sessions were conducted in staff room at IEA

To assess occurrence of helping responses in a new setting, pre- and post-intervention measures were taken in children’s regular school classrooms at IEA

Definition of “Helping”Definition of “Helping”

Helping: a child with autism engaging in a problem-solving activity with an adult.

  For each problem-solving activity, three different

stimulus components were used to signal to the child that a specific helping response should be emitted: – non-verbal– verbal– affective discriminative stimuli

Eight Possible Experimenter-Eight Possible Experimenter-Defined Categories of HelpingDefined Categories of Helping

Cleaning Replacing Broken Materials  Picking up Objects  Sorting materials  Locating Objects Carrying Objects  Putting Items Away  Setting Up an Activity

Category StructureCategory Structure

Response Category

General Description

Nonverbal SD Verbal & Affective

SD

Verbal Response

(dependent measure)

Motor

Response

(dependent measure)

 

 

 

 

Cleaning

 

 

 

adult wipes messy

surfaces

1. Wiping a black board

  

2. Wiping a wipe-off board

 

3. Wiping a desk

  

4. Wiping a chair

 

5. Wiping a table (trained-category probe)

1. “Oh, time to clean the black board.”while shaking head

 2. “Boy, how did this get messy?” wrinkling brow

3. “Oops, I have to clean this desk.” while rolling eyes

 4. “Uh oh, what a dirty chair.” while signing

 5. “Wow, this table is messy.” while eyes wide

 

 

 

 

 

“May I help?”

 

1. Wiping a black board

  

2. Wiping a wipe off board

 

3. Wiping a desk

  

4. Wiping a chair

 

5. Wiping a table

Criterion that Defined a Mastery Criterion that Defined a Mastery Level of PerformanceLevel of Performance

Correct combined verbal and motor helping response on at least 94% (15/16) of the total number of training trials for four consecutive sessions. 

Categories for Each ChildCategories for Each Child

 Irene

 

 Tom  Eddie Nathan

 

Trained

Categories

Locating

Carrying

Putting Away

Setting Up

Cleaning

Replacing

Picking Up

Sorting

Putting Away

Setting Up

Cleaning

Replacing

Picking Up

 Sorting

Locating

Carrying

Non-trained

Categories

(Probes)

Cleaning

Replacing

Locating

Carrying

Picking Up

 Sorting

Putting Away

Setting Up

Assignment of Trials (for Tom)Assignment of Trials (for Tom)Category Non-Verbal Stimuli for

Training Trials

Within Category

Probe Trials

Cleaning Wiping:

1. backboard 2. wipe-off 3. Desk 4. Chair

Wiping:

1. Table

Replacing Broken Materials

Replacing broken or torn

5. Paintbrushes 6. Forks 7. Pencils 8. Crayons

Replacing:

2. Paper

Picking up Objects

Picking up:

9. Paper clips 10. Money 11. LM 12. Pict cards

Picking up

3 Comp Disks

Sorting Materials Sorting:

13. Scissors/glue 14. markers 15. sticks 16. Utensils

Sorting

4. paper/brush

Across-Category

Probe Trials

Locate Objects Locating

5. Puzzle piece

Carry Objects Carrying

6. See & says

Baseline & Treatment TrialsBaseline & Treatment Trials

Baseline– Both training and probe trials presented– Neither trial type associated with treatment or

reinforcement– Token reinforcement and verbal praise provided only for

on-task behavior

Treatment– Both training and probe trials presented– Training trials associated with treatment– Probe trials not associated with treatment

Teaching ProcedureTeaching ProcedurePresentation of Live Discriminative Stimuli

(non-verbal & verbal)

Incorrect Verbal and/or Motor Response by child

Presentation of Video Model

Re-presentation of Live Discriminative Stimuli

Incorrect Verbal and/or Motor Response by child

Presentation of Motor and/or Verbal Prompts

Re-presentation of Live Discriminative Stimuli

Correct Verbal and Motor Responses by child

Reinforcement (token + praise)

Non-Helping Verbal and Non-Non-Helping Verbal and Non-Verbal Discriminative StimuliVerbal Discriminative Stimuli

Non-Verbal Verbal

Holding a Mr. Potato Head Oh, what a cool potato head!

Holding up a marker Boy, isn’t this a great marker?

Holding up a toy train Wow, don’t you love this train?

Holding up scissors Wow, these are neat scissors?

Holding up potato chips Oh, I love potato chips!

Holding up a book Hey, this is a great book!

Holding up an etch-a sketch Boy, this is a tine etch-a-sketch!

Holding up an oreo Hey, don’t you love oreos?

Holding up a puzzle Oh, this is a cool puzzle!

Holding up a toy car Wow, check out this cool toy!

Additional Strategies Used to Additional Strategies Used to Promote GeneralizationPromote Generalization

Treatment sessions were conducted once every eight sessions in the staff room (not the typical experimental session room)

Treatment sessions were conducted once every 10 sessions by a secondary experimenter (not the primary experimenter)

Pre- and Post-Intervention MeasuresPre- and Post-Intervention Measures

For each child, three pre-intervention sessions were conducted before treatment was introduced. 

Three post-intervention sessions were conducted after all participants had achieved mastery criterion

Counterbalanced Assignment of Counterbalanced Assignment of Additional CategoriesAdditional Categories

Tom Nathan Irene Eddie

Trained Categories

Cleaning

Replacing

Picking

Sorting

Picking

Sorting

Locating

Carrying

Locating

Carrying

Putting away

Setting up

Putting away

Setting up

Cleaning

Replacing

Non-Trained

Categories (Probes)

Locating

Carrying

Putting away

Setting up

Cleaning

Replacing

Picking

Sorting

Novel Categories (Pre/Post

Tests)

Putting away

Setting up

Cleaning

Replacing

Picking

Sorting

Locating

Carrying

Pre- and Post-Intervention MeasuresPre- and Post-Intervention Measures Measures 1-3

– Combination of novel trials, probe trials, and training trial types  

– Conducted in the child’s regular school classroom with their regular school instructor.  

Measures 4-6 – Combination of novel trials, probe trials, and training

trial types– Conducted in the child’s regular school classroom by the

primary experimenter  Measure 7

– Used trials from the two novel categories– Conducted in the experimental setting by the primary

experimenter

Social Validity MeasuresSocial Validity Measures Measure 1

– Used to assess increase in each child’s prosocial behavior from baseline to treatment.

– Undergraduate raters were asked: “In which of the two video-taped episodes (the first or the second) did the

child appear to engage in more prosocial behavior?” 

Measure 2– Used to assess whether the prosocial behavior emitted by the

children in this study was similar to the behavior emitted by their age-matched peers.

– Undergraduate raters were asked: “Was appropriate prosocial behavior used by this child?”

Interobserver AgreementInterobserver Agreement

Obtained for the percentage of trials that contained a correct or incorrect helping response for each child.  

Obtained for the frequency of occasions in which each child emitted a helping response during non-helping episodes.  

Obtained for the accuracy of presentation of the nonverbal, verbal, and affective discriminative stimuli for all trial types across all experimental conditions and children.

Percentage of Trials in Which Video Presentation Percentage of Trials in Which Video Presentation Occasioned a Correct Helping Response on Subsequent Occasioned a Correct Helping Response on Subsequent

Presentation of the Discriminative StimuliPresentation of the Discriminative Stimuli

Treatment Session

1 2 3 4 5 6 7 8 9 10

Irene 46 50 - 100 100 100 - - 100 100

Tom 67 80 33 75 0 - 75 50 - 100

Eddie 40 100 0 100 - 100 - - - 100

Nathan 67 75 83 100 50 - - - - 100

Note: dashes indicate a child emitted no errors during that session

Total Number of Occasions in Which Each ChildTotal Number of Occasions in Which Each Child  Engaged in a Non-Contextual Helping ResponseEngaged in a Non-Contextual Helping Response

Baseline

Sessions

1-5

Treatment Sessions

1-5

Treatment Sessions

6-10

Irene 0 8 0

Tom 0 9 1

Eddie 0 9 0

Nathan 0 12 2

Mean Percentage of Correct Mean Percentage of Correct Helping Responses Collapsed Across All Seven Post-Helping Responses Collapsed Across All Seven Post-

Intervention MeasuresIntervention Measures

1 2 3

Irene 100.0 100.0 100.0

Tom 94.7 97.4 94.7

Eddie 97.4 97.4 97.4

Nathan 97.4 94.7 94.7

Number of Sessions Required to Achieve a Mastery Number of Sessions Required to Achieve a Mastery Level of Performance During Untrained-category Level of Performance During Untrained-category Probe Trials and Trained-Category Probe TrialsProbe Trials and Trained-Category Probe Trials

Child Trained-category Probes

Untrained-category Probe

Irene 7 4

Tom 6 9

Eddie 9 5

Nathan 9 4

Mean 7.7 5.5

Results of Social Validity Results of Social Validity MeasuresMeasures

Measure 1– indicated that the children with autism’s

responses in treatment episodes were more helpful than those in baseline episodes

Measure 2– indicated no difference between prosocial

behavior of the children with autism and age-matched peers of typical development

ConclusionsConclusions

Results of present study suggest that social programs for children with autism should include training in prosocial behavior

Systematic application of video modeling, prompting, and reinforcement taught children to use both motor and verbal helping responses in training and novel situations

 

ConclusionsConclusions

Children demonstrated a generalized repertoire of helping behavior as evidenced by emitting appropriate helping behavior in presence of novel verbal and nonverbal discriminative stimuli drawn from novel categories of helping

Benefits When a Child with Autism Benefits When a Child with Autism Engages in Prosocial BehaviorEngages in Prosocial Behavior

Children who engage in prosocial behavior tend to be viewed by adults as more socially competent (Eisenberg et al., 1996; Peterson, Ridley-Johnson, & Carter, 1984).

  An adult may be more likely to interact with the

child with autism who engages in prosocial behavior (Charlop & Walsh, 1986; Harris et al., 1990).

Benefits When a Child with Autism Benefits When a Child with Autism Engages in Prosocial BehaviorEngages in Prosocial Behavior

Increased social interactions provided for child with autism may result in additional access to social reinforcement (Lovaas et al., 1973; Lovaas, 1981)

 Engagement in prosocial behavior may

lessen deficits in social behavior prevalent in diagnosis of autism (Wing, 1988)

Future Areas of ResearchFuture Areas of Research Define most efficient way to teach a generalized

repertoire of helping behavior

Use more natural teaching paradigms, such as incidental teaching (Hart & Risley, 1975), to further facilitate generalization of prosocial behavior from training to novel situations

Identify minimum levels of prerequisite skills that children with autism need to emit before they are able to consistently engage in prosocial behavior

Future Areas of ResearchFuture Areas of Research

  Determine whether early intervention efforts for

children with autism that include prosocial behavior training with peers would produce a generalized imitative repertoire of prosocial behavior

Should include follow-up training and maintenance of newly acquired prosocial behavior emitted by children with autism

Social Skills: ProSocial Social Skills: ProSocial BehaviorBehavior

Examples of skill acquisition programs – Helping– Perspective taking

““Helping”Helping”

Skill Domain: Social & Peer Interaction Skills Category: ProSocial BehaviorOperational Definition:

– Within 5 seconds of the discriminative stimuli (SD) Johnny says “Can I help”AND engages in a problem-solving activity with another person . Examples of problem-solving activities are further defined as teaching sets.

– Data are collected minimally weekly and are summarized as percentage of opportunities in which Johnny effectively engaged in a helping response

– During data collection, no prompts are used.

““Helping”Helping”

Teaching Sets with Specific response definitions – Cleaning

The child places a cloth in contact with a surface and engages in either back-and-forth or circular arm movements until the adult stops making that same motion.

– Replacing Broken Materials – Picking up Objects – Sorting materials – Locating Objects– Carrying Objects – Putting Items Away – Setting Up an Activity

““Helping”Helping”

Discriminative Stimulus: – Non-verbal: various motor movements

depending on the set– Verbal: exclamation– Affective: facial expression

Criterion for Advancement: – Engaging in helping on at least 90% of the

opportunities for two consecutive sessions.

““Helping”Helping”

ResponsResponse e

CategorCategoryy

General General DescriptiDescripti

onon

Nonverbal Nonverbal SSDD

Verbal & Verbal & AffectiveAffective

SSDD

Verbal Verbal ResponseResponse

(depend(dependent ent

measuremeasure))

Motor Motor

ResponseResponse

(depende(dependent nt

measure)measure)

  

  

  

  

CleaningCleaning

  

  

  

adult adult wipes wipes messy messy

surfaces surfaces

1. Wiping a 1. Wiping a black boardblack board

    

2. Wiping a 2. Wiping a wipe-off wipe-off boardboard

  

3. Wiping a 3. Wiping a desk desk

    

4. Wiping a 4. Wiping a chair chair

  

5. Wiping a 5. Wiping a tabletable (trained-(trained-category category probe)probe)

1. “1. “OhOh, time to , time to clean the black clean the black board.”while board.”while shaking headshaking head

  2. “2. “BoyBoy, how , how did this get did this get messy?” messy?” wrinkling browwrinkling brow

3. “3. “OopsOops, I , I have to clean have to clean this desk.” this desk.” while rolling while rolling eyeseyes

  4. “4. “Uh ohUh oh, , what a dirty what a dirty chair.” while chair.” while signingsigning

  5. “5. “WowWow, this , this table is messy.” table is messy.” while eyes widewhile eyes wide

  

  

  

  

  

““Can I Can I help?”help?”

““Want Want some some help?”help?”

““How How about about some some

help?”  help?”  

1. Wiping a 1. Wiping a black board black board

    

2. Wiping a 2. Wiping a wipe off wipe off boardboard

  

3. Wiping a 3. Wiping a desk desk

    

4. Wiping a 4. Wiping a chairchair

  

5. Wiping a 5. Wiping a table table

““Helping”: Helping”: Teaching ProcedureTeaching ProcedurePresentation of Live Discriminative Stimuli

(non-verbal, verbal affective)

Incorrect Verbal and/or Motor Response by child

Presentation of Video Model

Re-presentation of Live Discriminative Stimuli

Incorrect Verbal and/or Motor Response by child

Presentation of Motor and/or Verbal Prompts

Re-presentation of Live Discriminative Stimuli

Correct Verbal and Motor Responses by child

Reinforcement (token + praise)

““Helping”Helping”

Generalization: – Generalization of helping across stimuli is programmed

by teaching multiple exemplars of helping scenarios within a category (e.g., cleaning multiple surfaces) and across category (e.g., cleaning, picking up, carrying).

– Generalization across stimuli is assessed by probing Johnny’s helping skills in the presence of within and across category exemplars not associated with teaching.

– Generalization across instructors and settings is programmed by conducting teaching across multiple instructors and settings and is assessed in novel settings and with novel instructors.

““Helping”Helping”

Maintenance: – Johnny’s helping responses will be maintained

throughout his day as various opportunities to help occur in the natural environment.

Inter-Observer Agreement: – Inter-observer agreement data are collected monthly

and calculated by using the formula:

Number of Agreements X 100 = IOA

Number of Agreements + Disagreements

““Perspective Taking”Perspective Taking”Skill Domain: Social & Peer Interaction Skills Category: ProSocial BehaviorOperational Definition:

– Observing the behavior of another person and responding according to the private thoughts the person might experience in that situation (e.g., saying “that’s too bad” upon seeing a person break a toy)

– Within 5 seconds of the discriminative stimuli (SD) Johnny says a contextually relevant statement AND emits an appropriate motor response. Examples of statements are further defined as teaching sets.

– Data are collected minimally weekly and are summarized as percentage of opportunities in which Johnny effectively engaged in perspective taking

– During data collection, no prompts are used.

““Perspective Taking”Perspective Taking”

Teaching Sets with Specific response definitions

1. excitement

2. pain

3. frustration

““Perspective Taking”Perspective Taking”Discriminative Stimulus:

– Non-verbal: various motor movements depending on the set

– Verbal: exclamation

Criterion for Advancement: – Engaging in helping on at least 90% of the

opportunities for two consecutive sessions.

““Perspective TakingPerspective Taking

Response Response CategoryCategory

Nonverbal SDNonverbal SD Verbal SDVerbal SD Verbal Verbal ResponseResponse

Motor Motor ResponResponsese

ExcitemenExcitementt

Showing cool toyShowing cool toy

Completing modelCompleting model

Holding up mateiralsHolding up mateirals

““look at look at this”this”

““I did it”I did it”

““I found it”I found it”

““can I can I see?”see?”

““Let me Let me see”see”

““Show Show me”me”

Hand Hand on on chestchest

PainPain Bumping arm on chairBumping arm on chair

Sitting downSitting down

Waving handWaving hand

““ouch”ouch”

““I don’t feel I don’t feel good”good”

““oh, ah”oh, ah”

““Are you Are you ok?”ok?”

““Are you Are you alright”alright”

““It’s ok”It’s ok”

Pat Pat armarm

FrustratioFrustrationn

Holding up broken lego Holding up broken lego modelmodel

Trying to put shape in Trying to put shape in sortersorter

Trying to remove lid Trying to remove lid from boxfrom box

““I broke it”I broke it”

““I can’t do I can’t do it”it”

““It’s stuck”It’s stuck”

““I can I can help”help”

““let me let me try”try”

““Want Want some some help”help”

Hold Hold out out handhand

““Perspective Taking”: Perspective Taking”: Teaching ProcedureTeaching Procedure

Presentation of Discriminative Stimuli

(non-verbal & verbal )

Incorrect Verbal and/or Motor Response by child

Presentation of Audio and Manual Prompts

Re-presentation of Live Discriminative Stimuli

Correct Verbal and Motor Responses by child

Reinforcement (token + praise)

““Perspective TakingPerspective Taking Generalization:

– Generalization of perspective taking across stimuli is programmed by teaching multiple exemplars of perspective taking scenarios within a category (e.g., different ways to show excitement) and across category (e.g., excitement, sadness)

– Generalization across stimuli is assessed by probing Johnny’s perspective taking skills in the presence of within and across category exemplars not associated with teaching.

– Generalization across instructors and settings is programmed by conducting teaching across multiple instructors and settings and is assessed in novel settings and with novel instructors.

““Perspective Taking”Perspective Taking”

Maintenance: – Johnny’s perspective taking will be maintained

throughout his day as various opportunities occur in the natural environment.

Inter-Observer Agreement: – Inter-observer agreement data are collected monthly

and calculated by using the formula: Number of Agreements X 100 = IOA Number of Agreements + Disagreements