Purpose: Although many valid, reliable, and developmentally sensitive measures exist to monitor t... more Purpose: Although many valid, reliable, and developmentally sensitive measures exist to monitor the language gains of children who rely on spoken language to communicate, the same is not true for graphic symbol communicators. This study is a first step in developing such measures by examining the interobserver agreement (IOA) and within-observer agreement of 13 measures designed to monitor the language progress of children who use aided augmentative and alternative communication (AAC). These measures are based on the Graphic Symbol Utterance and Sentence Development Framework (Binger et al., 2020) and are hypothesized to capture various phases of graphic symbol communication. Method: Four graduate student observers coded 13 measures across 57 different play-based sessions of children with Down syndrome ages 3;0–5;11 (years;months). For IOA, sessions were coded by two different observers. For within-observer agreement, all sessions were recoded by the same coders. Corpus-level analys...
Education and training in autism and developmental disabilities, 2018
The purpose of this study was to evaluate the effects of different speech-generating device displ... more The purpose of this study was to evaluate the effects of different speech-generating device displays and vocabulary organizations on the acquisition of multi-step requesting responses in children with autism spectrum disorder (ASD). Four young children with ASD were taught to use an iPad application to make requests using both a taxonomically-organized grid display and a schematically organized visual scene display or hybrid. The conditions were compared using a multielement design. Time delay and least-to-most prompting were used to teach responses in both conditions. Three participants met mastery criterion for acquiring requests with the schematic display but did not meet criterion requesting with the taxonomic display. A fourth participant learned to make requests with both displays but showed generalization only with the schematic display. Error analyses indicated there were different types of errors made across conditions, which may suggest the need to tailor intervention meth...
Language, Speech, and Hearing Services in Schools, 2020
Purpose Children with autism spectrum disorder (ASD) and complex communication needs are increasi... more Purpose Children with autism spectrum disorder (ASD) and complex communication needs are increasingly taught to use tablet-based speech-generating devices (SGDs). An important issue in designing such interventions is the selection of an appropriate format for displaying vocabulary. The purpose of this study was to determine (a) whether young children with ASD can be taught to use different SGD vocabulary display formats and (b) whether there are differences across the formats on a range of secondary measures (e.g., preference and generalization). Method Five preschoolers with ASD (and prior experience with simpler aided augmentative and alternative communication) were taught to use grid and visual scene display SGDs during a play-based intervention. Acquisition of functional responding was assessed using a single-case experimental design. Secondary variables included error types, antecedents for communication, preference, and generalization. Results All participants increased their ...
Individuals with complex communication needs are likely to experience considerable difficulties a... more Individuals with complex communication needs are likely to experience considerable difficulties and challenges with everyday communication interactions due to limited use and understanding of natural speech. In this editorial, we review the nature of complex communication needs, describe the wide range of individuals who may experience such needs, and provide a brief history of behavioral approaches to addressing these needs. We also highlight the six papers in this special issue that contribute to the further understanding of the use of behavioral intervention approaches for addressing complex communication needs. These papers include one conceptual overview of aided augmentative and alternative communication (AAC) interventions for individuals with complex communication needs, four intervention studies addressing a range of communicative topographies (i.e., vocal speech, AAC, and a social messaging app), and one systematic review examining interventions that promote communicative ...
American Journal of Speech-Language Pathology, 2018
Purpose This article presents a systematic review that aimed to synthesize single-subject–design ... more Purpose This article presents a systematic review that aimed to synthesize single-subject–design studies that have examined naturalistic interventions for teaching the expressive use of speech-generating devices (SGDs) to children with complex communication needs. Specifically, this review describes what intervention strategies are most commonly applied in studies with positive effects and minimal methodological flaws and examines the populations and outcomes for which these strategies have been effective. Method A systematic approach was used to qualitatively code variables of interest to this review. Results were summarized via both visual analysis and effect size methods, and a certainty of evidence methodology was adopted to describe the quality of the evidence. Results Thirty-two unique studies met inclusion criteria, with 19 having consistent positive results and meeting minimum requirements for certainty of evidence. Although studies used a variety of titles to describe inter...
International Journal of Developmental Disabilities, 2016
Objectives: For individuals with challenging behavior, antecedent interventions such as modifying... more Objectives: For individuals with challenging behavior, antecedent interventions such as modifying the motivation for the behavior have shown to be effective. In this study, we examined the effects of giving the participants the opportunity to continuously request tangible items (e.g. toys and activities) prior to instruction to determine if allowing them to satiate on the item would serve as an effective intervention to reduce challenging behavior maintained by access to the items. Method: Functional analyses identified that access to tangible items maintained the challenging behavior of four children with autism spectrum disorder. The children were then trained using Functional Communication Training (FCT) to request the items. Prior to 15 mins academic and/or functional skill instructional sessions, participants were exposed to either an FCT session and allowed to request the tangible items or did not receive an FCT session. The no FCT condition consisted of the child’s typically scheduled activities, without access to the preferred items maintaining challenging behavior for at least one hour prior to instruction. Following the FCT or no FCT conditions, we measured challenging behavior and academic engagement during 15-mins sessions of one-on-one instruction. Results: When instruction was preceded with FCT as a satiation intervention, we observed lower levels of challenging behavior and higher levels of academic engagement compared to no FCT conditions for two of four participants. Conclusion: Overall, the results of this study appear to support the use of FCT as a viable satiation procedure to reduce challenging behavior in instructional settings.
Five children with autism spectrum disorder (ASD) were taught to request preferred items using fo... more Five children with autism spectrum disorder (ASD) were taught to request preferred items using four different augmentative and alternative communication (AAC) displays on an iPad(®)-based speech-generating device (SGD). Acquisition was compared using multi-element designs. Displays included a symbol-based grid, a photo image with embedded hotspots, a hybrid (photo image with embedded hotspots and symbols), and a pop-up symbol grid. Three participants mastered requesting items from a field of four with at least three displays, and one mastered requesting items in a field of two. The fifth participant did not acquire requests in a field of preferred items. Individualized display effects were present, and the photo image appeared to have provided the most consistent advantages for three participants. Some errors were more or less common with specific displays and/or participants. The results have important implications for AAC assessment and implementation protocols.
This study aimed to teach individuals with autism spectrum disorder (ASD) and limited vocal speec... more This study aimed to teach individuals with autism spectrum disorder (ASD) and limited vocal speech to emit target vocalizations while using a speech-generating device (SGD). Of the 4 participants, 3 began emitting vocal word approximations with SGD responses after vocal instructional methods (delays, differential reinforcement, prompting) were introduced. Two participants met mastery criterion with a reinforcer delay and differential reinforcement, and 1 met criterion after fading an echoic model and prompt delay. For these participants, vocalizations initiated before speech outputs were shown to increase, and vocalizations generalized to a context in which the SGD was absent. The 4th participant showed high vocalization rates only when prompted. The results suggest that adding vocal instruction to an SGD-based intervention can increase vocalizations emitted along with SGD responses for some individuals with ASD.
This paper contains a review of eight studies that examined the views and knowledge base of admin... more This paper contains a review of eight studies that examined the views and knowledge base of administrators regarding intervention and instructional methods for students with autism spectrum disorders (ASDs). Administrators' views surrounding training and professional development in ASD instructional practices were also investigated. While administrators reported being knowledgeable about instructional practices, the need for a more formative evaluation of instructional knowledge combining self-report with observational methods of instructional knowledge was supported. Findings from the review point to added benefits to administrators when exposed to additional training in evidence-based practices for students with ASDs. Accordingly, administrators with a stronger knowledge of such practices may feel more prepared to act as instructional leaders. Research-to-practice gaps related to administrators' views and beliefs about interventions, utility of methods for different age gr...
Journal of Autism and Developmental Disorders, 2014
This review addresses the use of peer-mediated interventions (PMI) to improve the social interact... more This review addresses the use of peer-mediated interventions (PMI) to improve the social interaction skills of students with autism spectrum disorder (ASD) in inclusive settings. The purpose of this review is to (a) identify the characteristics and components of peer-mediated social interaction interventions, (b) evaluate the effectiveness of PMI by offering an analysis of intervention results and research design, and (c) suggest directions for future research. Overall, results suggest that PMI is a promising treatment for increasing social interaction in children, adolescents, and young adults with ASD in inclusive settings, with positive generalization, maintenance, and social validity outcomes. Findings also suggest that participant characteristics and the type of social deficit an individual exhibits are important considerations when choosing the optimal configuration of PMI strategies.
ABSTRACT This chapter provides a selective overview of the use of assistive technology used to su... more ABSTRACT This chapter provides a selective overview of the use of assistive technology used to support persons with diverse abilities who engage in problem behavior. By it is nature this is a very broad topic and incorporates a wide array of populations and assistive technologies strategies. The chapter begins with a description and definition of problem behavior. Next is an overview of the characteristics of the populations that have received assistive technology interventions to treat problem behavior. This overview of population characteristics will enhance the reader’s understanding of the nature of problem behavior and also provide a deeper understanding of the rationale for the use of various assistive technologies in the following section of the chapter. The next section of the chapter provides a selective overview of the assistive technologies used to manage problem behavior. Assistive technology strategies will be divided into two general categories—those that focus on (a) antecedent cue or self-control strategies (enhancing stimulus control of adaptive behavior and/or teaching persons to monitor their own behavior) and (b) consequence strategies (providing consequences contingent upon problem behavior or teaching persons to use appropriate communication to access desired consequences). The final section provides an overview of the clinical and academic implications of the use of assistive technologies to support persons with behavior problems.
Studies that have compared different communication systems for individuals with developmental dis... more Studies that have compared different communication systems for individuals with developmental disabilities were systematically reviewed in an effort to provide information useful for clinical decision making and directions for future research. Specifically, 28 studies that compared (a) non-electronic picture systems to speech generating devices, (b) aided AAC (e.g. picture exchange systems and SGDs) to unaided AAC systems (manual sign), or (c) AAC to speech-language interventions were included in this review. Dependent variables forming the basis for comparison included: (a) effectiveness (e.g. acquisition of systems and/or rate of use), (b) efficiency or rate of skill acquisition (c) participants' preference for systems, (d) occurrence of vocalizations and problem behavior, and (e) generalization across communication partners, settings, and time (i.e. maintenance). Results suggest that clear and consistent differences between communication systems are rare, precluding definitive statements regarding a universal best approach for all people with developmental disabilities. Instead, findings of this review support the consideration of an individual's existing skills, goals and preferences as part of the process of selecting an approach to communication.
Purpose: Although many valid, reliable, and developmentally sensitive measures exist to monitor t... more Purpose: Although many valid, reliable, and developmentally sensitive measures exist to monitor the language gains of children who rely on spoken language to communicate, the same is not true for graphic symbol communicators. This study is a first step in developing such measures by examining the interobserver agreement (IOA) and within-observer agreement of 13 measures designed to monitor the language progress of children who use aided augmentative and alternative communication (AAC). These measures are based on the Graphic Symbol Utterance and Sentence Development Framework (Binger et al., 2020) and are hypothesized to capture various phases of graphic symbol communication. Method: Four graduate student observers coded 13 measures across 57 different play-based sessions of children with Down syndrome ages 3;0–5;11 (years;months). For IOA, sessions were coded by two different observers. For within-observer agreement, all sessions were recoded by the same coders. Corpus-level analys...
Education and training in autism and developmental disabilities, 2018
The purpose of this study was to evaluate the effects of different speech-generating device displ... more The purpose of this study was to evaluate the effects of different speech-generating device displays and vocabulary organizations on the acquisition of multi-step requesting responses in children with autism spectrum disorder (ASD). Four young children with ASD were taught to use an iPad application to make requests using both a taxonomically-organized grid display and a schematically organized visual scene display or hybrid. The conditions were compared using a multielement design. Time delay and least-to-most prompting were used to teach responses in both conditions. Three participants met mastery criterion for acquiring requests with the schematic display but did not meet criterion requesting with the taxonomic display. A fourth participant learned to make requests with both displays but showed generalization only with the schematic display. Error analyses indicated there were different types of errors made across conditions, which may suggest the need to tailor intervention meth...
Language, Speech, and Hearing Services in Schools, 2020
Purpose Children with autism spectrum disorder (ASD) and complex communication needs are increasi... more Purpose Children with autism spectrum disorder (ASD) and complex communication needs are increasingly taught to use tablet-based speech-generating devices (SGDs). An important issue in designing such interventions is the selection of an appropriate format for displaying vocabulary. The purpose of this study was to determine (a) whether young children with ASD can be taught to use different SGD vocabulary display formats and (b) whether there are differences across the formats on a range of secondary measures (e.g., preference and generalization). Method Five preschoolers with ASD (and prior experience with simpler aided augmentative and alternative communication) were taught to use grid and visual scene display SGDs during a play-based intervention. Acquisition of functional responding was assessed using a single-case experimental design. Secondary variables included error types, antecedents for communication, preference, and generalization. Results All participants increased their ...
Individuals with complex communication needs are likely to experience considerable difficulties a... more Individuals with complex communication needs are likely to experience considerable difficulties and challenges with everyday communication interactions due to limited use and understanding of natural speech. In this editorial, we review the nature of complex communication needs, describe the wide range of individuals who may experience such needs, and provide a brief history of behavioral approaches to addressing these needs. We also highlight the six papers in this special issue that contribute to the further understanding of the use of behavioral intervention approaches for addressing complex communication needs. These papers include one conceptual overview of aided augmentative and alternative communication (AAC) interventions for individuals with complex communication needs, four intervention studies addressing a range of communicative topographies (i.e., vocal speech, AAC, and a social messaging app), and one systematic review examining interventions that promote communicative ...
American Journal of Speech-Language Pathology, 2018
Purpose This article presents a systematic review that aimed to synthesize single-subject–design ... more Purpose This article presents a systematic review that aimed to synthesize single-subject–design studies that have examined naturalistic interventions for teaching the expressive use of speech-generating devices (SGDs) to children with complex communication needs. Specifically, this review describes what intervention strategies are most commonly applied in studies with positive effects and minimal methodological flaws and examines the populations and outcomes for which these strategies have been effective. Method A systematic approach was used to qualitatively code variables of interest to this review. Results were summarized via both visual analysis and effect size methods, and a certainty of evidence methodology was adopted to describe the quality of the evidence. Results Thirty-two unique studies met inclusion criteria, with 19 having consistent positive results and meeting minimum requirements for certainty of evidence. Although studies used a variety of titles to describe inter...
International Journal of Developmental Disabilities, 2016
Objectives: For individuals with challenging behavior, antecedent interventions such as modifying... more Objectives: For individuals with challenging behavior, antecedent interventions such as modifying the motivation for the behavior have shown to be effective. In this study, we examined the effects of giving the participants the opportunity to continuously request tangible items (e.g. toys and activities) prior to instruction to determine if allowing them to satiate on the item would serve as an effective intervention to reduce challenging behavior maintained by access to the items. Method: Functional analyses identified that access to tangible items maintained the challenging behavior of four children with autism spectrum disorder. The children were then trained using Functional Communication Training (FCT) to request the items. Prior to 15 mins academic and/or functional skill instructional sessions, participants were exposed to either an FCT session and allowed to request the tangible items or did not receive an FCT session. The no FCT condition consisted of the child’s typically scheduled activities, without access to the preferred items maintaining challenging behavior for at least one hour prior to instruction. Following the FCT or no FCT conditions, we measured challenging behavior and academic engagement during 15-mins sessions of one-on-one instruction. Results: When instruction was preceded with FCT as a satiation intervention, we observed lower levels of challenging behavior and higher levels of academic engagement compared to no FCT conditions for two of four participants. Conclusion: Overall, the results of this study appear to support the use of FCT as a viable satiation procedure to reduce challenging behavior in instructional settings.
Five children with autism spectrum disorder (ASD) were taught to request preferred items using fo... more Five children with autism spectrum disorder (ASD) were taught to request preferred items using four different augmentative and alternative communication (AAC) displays on an iPad(®)-based speech-generating device (SGD). Acquisition was compared using multi-element designs. Displays included a symbol-based grid, a photo image with embedded hotspots, a hybrid (photo image with embedded hotspots and symbols), and a pop-up symbol grid. Three participants mastered requesting items from a field of four with at least three displays, and one mastered requesting items in a field of two. The fifth participant did not acquire requests in a field of preferred items. Individualized display effects were present, and the photo image appeared to have provided the most consistent advantages for three participants. Some errors were more or less common with specific displays and/or participants. The results have important implications for AAC assessment and implementation protocols.
This study aimed to teach individuals with autism spectrum disorder (ASD) and limited vocal speec... more This study aimed to teach individuals with autism spectrum disorder (ASD) and limited vocal speech to emit target vocalizations while using a speech-generating device (SGD). Of the 4 participants, 3 began emitting vocal word approximations with SGD responses after vocal instructional methods (delays, differential reinforcement, prompting) were introduced. Two participants met mastery criterion with a reinforcer delay and differential reinforcement, and 1 met criterion after fading an echoic model and prompt delay. For these participants, vocalizations initiated before speech outputs were shown to increase, and vocalizations generalized to a context in which the SGD was absent. The 4th participant showed high vocalization rates only when prompted. The results suggest that adding vocal instruction to an SGD-based intervention can increase vocalizations emitted along with SGD responses for some individuals with ASD.
This paper contains a review of eight studies that examined the views and knowledge base of admin... more This paper contains a review of eight studies that examined the views and knowledge base of administrators regarding intervention and instructional methods for students with autism spectrum disorders (ASDs). Administrators' views surrounding training and professional development in ASD instructional practices were also investigated. While administrators reported being knowledgeable about instructional practices, the need for a more formative evaluation of instructional knowledge combining self-report with observational methods of instructional knowledge was supported. Findings from the review point to added benefits to administrators when exposed to additional training in evidence-based practices for students with ASDs. Accordingly, administrators with a stronger knowledge of such practices may feel more prepared to act as instructional leaders. Research-to-practice gaps related to administrators' views and beliefs about interventions, utility of methods for different age gr...
Journal of Autism and Developmental Disorders, 2014
This review addresses the use of peer-mediated interventions (PMI) to improve the social interact... more This review addresses the use of peer-mediated interventions (PMI) to improve the social interaction skills of students with autism spectrum disorder (ASD) in inclusive settings. The purpose of this review is to (a) identify the characteristics and components of peer-mediated social interaction interventions, (b) evaluate the effectiveness of PMI by offering an analysis of intervention results and research design, and (c) suggest directions for future research. Overall, results suggest that PMI is a promising treatment for increasing social interaction in children, adolescents, and young adults with ASD in inclusive settings, with positive generalization, maintenance, and social validity outcomes. Findings also suggest that participant characteristics and the type of social deficit an individual exhibits are important considerations when choosing the optimal configuration of PMI strategies.
ABSTRACT This chapter provides a selective overview of the use of assistive technology used to su... more ABSTRACT This chapter provides a selective overview of the use of assistive technology used to support persons with diverse abilities who engage in problem behavior. By it is nature this is a very broad topic and incorporates a wide array of populations and assistive technologies strategies. The chapter begins with a description and definition of problem behavior. Next is an overview of the characteristics of the populations that have received assistive technology interventions to treat problem behavior. This overview of population characteristics will enhance the reader’s understanding of the nature of problem behavior and also provide a deeper understanding of the rationale for the use of various assistive technologies in the following section of the chapter. The next section of the chapter provides a selective overview of the assistive technologies used to manage problem behavior. Assistive technology strategies will be divided into two general categories—those that focus on (a) antecedent cue or self-control strategies (enhancing stimulus control of adaptive behavior and/or teaching persons to monitor their own behavior) and (b) consequence strategies (providing consequences contingent upon problem behavior or teaching persons to use appropriate communication to access desired consequences). The final section provides an overview of the clinical and academic implications of the use of assistive technologies to support persons with behavior problems.
Studies that have compared different communication systems for individuals with developmental dis... more Studies that have compared different communication systems for individuals with developmental disabilities were systematically reviewed in an effort to provide information useful for clinical decision making and directions for future research. Specifically, 28 studies that compared (a) non-electronic picture systems to speech generating devices, (b) aided AAC (e.g. picture exchange systems and SGDs) to unaided AAC systems (manual sign), or (c) AAC to speech-language interventions were included in this review. Dependent variables forming the basis for comparison included: (a) effectiveness (e.g. acquisition of systems and/or rate of use), (b) efficiency or rate of skill acquisition (c) participants' preference for systems, (d) occurrence of vocalizations and problem behavior, and (e) generalization across communication partners, settings, and time (i.e. maintenance). Results suggest that clear and consistent differences between communication systems are rare, precluding definitive statements regarding a universal best approach for all people with developmental disabilities. Instead, findings of this review support the consideration of an individual's existing skills, goals and preferences as part of the process of selecting an approach to communication.
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Papers by Cindy Gevarter