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ggey, Ph D sor/Siskin Chair of Excellence in Early Childhood l Education iversity of Tennessee Chattanooga/ Children’s Institute’s Center for Child and Family Studies [email protected] 15th International Conference on Autism, Intellectual Disability & Developmental Disabilities

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Use of VSM to teach children with autism.

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Tom Buggey, Ph DProfessor/Siskin Chair of Excellence in Early Childhood Special EducationThe University of Tennessee Chattanooga/Siskin Children’s Institute’s Center for Child and Family [email protected]

Tom Buggey, Ph DProfessor/Siskin Chair of Excellence in Early Childhood Special EducationThe University of Tennessee Chattanooga/Siskin Children’s Institute’s Center for Child and Family [email protected]

15th International Conference on Autism, Intellectual Disability & Developmental Disabilities

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VSM in 4 mins.VSM in 4 mins.

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Viewing Oneself - DefinitionsViewing Oneself - Definitions• Self-Observation: Viewing oneself performing at

present levels – good, bad, ugly – e.g. watching game films.

Mostly positive research findings; However, it has also been linked todecrease in self-efficacy/confidence.

I do not recommend this for kids withdisabilities except for rare Circumstances (and when you are absolutely certain a child’s ego can take it.)

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• Allowing people to view themselves performing a skill or task that is slightly beyond their present ability or exhibiting behavior that is more appropriate. = All positive.

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Two Forms of Self-ModelingTwo Forms of Self-Modeling

Dowrick, 1977Dowrick, 1977

• Positive Self-Review: Reinforcing already known skills to improve performance/ fluency

• Feedforward: Video of skills not yet learned. Introducing a new skill or behavior.

Laura WilkinsonGold medal Platform Diver

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Video Modeling FormatsVideo Modeling Formats• Peer/Adult - Easy to get typically developing kids to

serve as models. There are commercial versions that mainly focus on social skills:

Watch Me Learn@, Model Me Kids@, and Teach2Talk@

• Point-of-View - Activities are carried out from the viewer’s perspective by holding camera at eye level.

Hine & Wolery, 2006

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Born again as an Born again as an autism researcherautism researcher

• I was presenting in KY regarding the first study related to autism when someone asked me if I had read “Thinking in Pictures”

• I went home and read it… And that was that.

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And the rest is history. All studies since 1997 And the rest is history. All studies since 1997 have been with children on the spectrumhave been with children on the spectrum

“I THINK IN PICTURES. Words are like a second language to me. I translate both spoken and written words into full-color movies, complete with sound, which run like a VCR tape in my head. When somebody speaks to me, his words are instantly translated into pictures. Language-based thinkers often find this phenomenon difficult to understand, but in my job as an equipment designer for the livestock industry, visual thinking is a tremendous advantage. Visual thinking has enabled me to build entire systems in my imagination.”

Temple Grandin - from Thinking in Pictures

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• Bandura’s extensive research lends two findings related to self-modeling:

1. The best models are those closest to the viewer in all attributes Including ability.

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Bandura Bandura (con’t)(con’t)• 2. Self-efficacy = The person’s perception of their

ability is directly related to success.

Modeling for Children with Autism is problematic.

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Modeling-Children Modeling-Children with Autismwith Autism

Modeling requires:Attention to the model including eye-contact, interest, and proximity.Often children with autism will be actively avoiding eye-contact and moving away from potential models.Other humans as models are just problematic.

Also, limitations in social skills makes picking up on language pragmaticsespecially difficult – meaning is oftenLost.

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Why Video Modeling - Autism? Why Video Modeling - Autism?

“I THINK IN PICTURES. Words are like a second language to me. I translate both spoken and written words into full-color movies, complete with sound, which run like a VCR tape in my head. When somebody speaks to me, his words are instantly translated into pictures.

Temple Grandin - from Thinking in Pictures

Supported by research – (Bauman, 1999; Quill, 1997)

1. The Visual Learner

Temple has

changed!

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Why Video Modeling - Autism?Why Video Modeling - Autism?

2. Sustained attention/limits distractionsChildren with autism can watch TV for hours. Provides a focus that can be excessive. But it is a focus and extraneous sounds and movements do not grab attention as in other situations.

3. No social obligations Videos place no social pressure on the child, whereas human interaction does. Real people – avoidance; Same people on-screen – no avoidance. (a plus for all forms of video modeling.)

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Three Prerequisites for MAX Results Three Prerequisites for MAX Results

MaybeMaybe

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Self-recognitionSelf-recognition• Onset 14-18 mos.

• We test for this by reversingviewfinder on camcorder and looking for reaction. The “sticking out the tongue

test”.

Side note:- The only child in a 1-2 yr old preschool room who acted for

camera = little boy with Down Syndrome.- The only child under 4 where we had success = 2 ½ yr old

girl with DS who sat and watched herself adoringly.

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3 Components of a VSM 3 Components of a VSM moviemovie

• 1. Positively label the behavior - helps child discern the target behavior. “Here’s Tony talking nicely with his friends!” We usually follow this with cheering/clapping.

• 2. Self-modeling - Child behaving/performing well.

• 3. Reinforcement at end/re-label behavior - “Nice playing, Tony!”

• Other possible elements: Self-talk/congratulations; internal narration (could be distracting); background music (ambient-mood enhancing).

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FilmingFilming

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How to Capture Footage for How to Capture Footage for

Feedforward VideosFeedforward Videos• Imitation – Great for language. Have children

imitate advanced language skills. Keep one step ahead of morphological development.

• Role Play – Fun! Act out behaviors in full Hollywood fashion. Get a director’s chair and clacker.

• Capture Rare Behaviors – Used with children who are not responsive. Camera keeps rolling.

Include child and family in planning when possible

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Cut and paste wordsCut and paste words

Mav. Age 3.0 Apraxia Lang Dev. 23-24 mos.Stuttering

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Social skills/transitions/eatingSocial skills/transitions/eating

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Make filming a fun Make filming a fun experienceexperience

Keeping with the positive nature of VSM, make filming as fun as possible.

1.Involve child and family in planning when appropriate2.Role play = play it up. You can role play too.3.Emphasize that the child will be the STAR of a movie.

I’m amazed at how many young children get the idea of “movieproducer = clacker, beret, director’s chair, and stage commands.

THUS, make the filming a learning experience, too. If you are doing role-playOr imitation it IS instruction.

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Planning: StoryboardingPlanning: Storyboarding• Identify the target/replacement behavior

(something measurable/observable).

• Determine best method for capturing the behavior.

• Determine video scenes.o Task-analyze the target or replacement behavior. o Each step becomes a scene.o Or, each trigger of negative behavior becomes a scene.

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SampleSample Storyboard StoryboardMorning RoutineMorning Routine

*Drawn freehand with child and family assistance

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Tantrum StoryboardTantrum StoryboardSelf-talk may compliment VSMSelf-talk may compliment VSM

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Food AversionFood Aversion

Reluctant eatersReluctant eaters• 1. Set up camera during lunch or snack and film child eating.

• 2. Edit film by selecting exemplars of desired behavior and chain them together.

If the behavior is to eat specific food, take footage of the food and pair it with video of the child putting spoon to mouth (Cheating).

If the behavior is spoon-to-mouth, try peer modeling or point of view. You could also cheat by doing close-ups of peers’ mouths paired with appropriate antecedent behavior by your child.

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EditingEditing

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Editing: In-Camera EditingEditing: In-Camera EditingCamcorder to VCR or DVD Player ArrangementCamcorder to VCR or DVD Player Arrangement

• Make a copy of the original tape and save it. Do all editing from the copy.• If you want to add an intro and ending (recommended), you can just state the behavior

(“Let’s listen to John talking nicely!”) at the start of the tape while covering the lens. You can also prepare a poster stating the behavior and/or praising the observer, e.g. “John is a Super Star!” “Here’s John talking nicely!!” Just talk while taping the poster.

*It is very important to use “pause” instead of “stop.” This will give you smooth transitions. If you press stop, it creates a second or so of static between segments.

1. Connect2. Have VCR on “play”, “record”, & Pause

3. Scan the footage in camcorder until you find what you want on your video.

4. Camcorder press “play” and “pause”5. Release both “pause” buttons to record and press “pause” buttons again when your scene is ended.

6. Repeat

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Camcorder to ComputerCamcorder to Computer

iMovie@ iMovie HD@

MovieMaker@

1. Connect Camcorder2. Cut and paste3. Click and drag

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Video downloads to here

Cut & Paste to timeline

Bells & whistlesAlso Cut & Paste

Editing window: 2 markers can be dragged to highlight anything you want cut - press delete - it’s gone.

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My preferred methodMy preferred method• Camcorder to Imovie HD (mac-based) to DVD

Or iPad

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iPad = camcorder, iPad = camcorder, editing, viewing in one editing, viewing in one

package.package.

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““Cheating” Cheating” (special effects/stunt doubles)(special effects/stunt doubles)• We can use editing to depict events that never happened.1. Tommy wouldn’t slide, but we got him to sit with peer at the

top + short clip of him at the bottom of slide + clip of 2 peers coming down clipped at the waist. = He’s sliding.

2. Tommy pushing a truck down a sidewalk + peer pushing truck back at same spot = two children playing.

3. Eating: We used a video of a close-up of a peer’s mouth when inserting spoon with food and paired this with a clip of a child manipulating silverware at lunch….

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More trickeration – for More trickeration – for a good causea good cause

• Tantrums – Child can’t role-play = film a triggering event scenario & cut to a scene of the child behaving well.

• Eating – Using spoon. Place spoon in child’s hand. Use best footage of spoon in proximity to food. Use close up of peer’s mouth and Spoon.

• Washing hands – footage of peer washing/drying hands sandwiched between scenes of child entering and leaving washroom.

• We’ve used peer voices overlaid on the child’s video. Can the child self-recognize own voice???

• Sliding – footage at child at top of slide and at bottom. In between = footage of a peer sliding with only lower half showing.

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ViewingViewing

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• Bottom line = It doesn’t seem to matter.

• You could try video priming = showing the video immediately prior to when the behavior is likely to occur. = before lunch and snack for eating. Socialization prior to center time, etc.

• We typically show the videos at a time that causes the least disruption and provides an opportunity to have the child watch in an environment as free of distractions as possible.

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PrimingPriming

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One firm rule:One firm rule:

• Do Not Make Comments!

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The Yin-Yang of Working with The Yin-Yang of Working with

Preschoolers with ASDPreschoolers with ASD• Over the past 2 yrs. we have worked with 14 children

6 of whom were four, 4 were three, 4 were 2 1/2.

• All of the four yr olds made nice gains in either social skills, language, or eating. Three of these could fit into that “magical” category.

• Not one of the three yr olds showed any gain.

• Age? Maybe, but we showed the videos to the children after they turned four and still nothing??

• Age-inappropriate behavior – social interactions????

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However, The MN Preschool However, The MN Preschool

ProjectProjectChild Age

Yrs/mosBehavior Baseline VSM Maintenance

Jess 2-1 Switch activation 12.4 secs 2.6 secs 2.4 secs

Nevin 2-6 Crying during diaper change

Cried 20 of 21 events

0 crying 0 crying

Nolan 2 -7 Word use. Longer utterances

12 words 41 words + 5 3-word sentences

-

Yaquin 2-9 Spoon to mouth/20 mins.

1 21.12 20

Abe 2-10 Signs/words 2 signs w/ prompts only.

Rare one-word utterances

Using 2 signs spontaneously + 3

word combo.

-

1Aho 2-10 Use of signs and new words

5 signs – 0 words 14 new signs17 words

-

Gideon 2-10 Putting backpack and coat in cubby

0/4 w/out cues

 

2/9w/out cues  

-

Eijah 3-0 Audible words per 1/2hr

0 5.33  

Nolan 3-7 Self-advocates 0 60% 60%

“ “   Express needs 25% 75% 70%

  3-9 Pedaling trike/non-refusal

0/0 100% /100% 100% /100%

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Peter 3-9 Food variety - - No increase

“ “   Good transitions 0 3/4 3/4

Ron 3-10 Off-task 27 events per day 8 per day 7 per day

Lucille 3-10 On floor, kicking during transition

6 per day 1 per day - no kicking

>1 per day - no kicking

Emma 3-11 Words heard/20 mins.

4.33 4 -

“ “   1HandwashCheck-ins/ prompts

89 secs-63.17 4 secs.4.6

-

Tevon 4 School departure (“goodbye” to bus)

5.33mins. 2.50 mins. 2.50 mins

Jerome 4-0 Sitting in grp 0 5 mins. 6 mins.

Lawrence 4.1 Screaming 8.6 10.8 -

Emily 4-2 Hands to self/line 30% 80% 80%

Jason 4-4 Heel/toe walking 0 55% 65%

“ “   Stairs 0 75% 80%

Isaac  

4-6 Time on task /promptsWalking to room from lib

6 secs/31.67

97.86 secs/ 1.43 -

“ “ “   Gym transitions/prompts

2.5 secs/8.33

133.85 secs/1.15

 

“ “ “   Bathroom transition/prompts

18.3 secs/15.67

205.38 secs/2.85

 

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CaveatsCaveats1. Never go too far beyond the child’s developmental

level. Make sure it’s doable.2. Always have full disclosure and informed consent

including disposition of video when intervention is over. Peers too.

3. You can prompt as must as you want during filming, but do not get pushy during viewing. Never say things like, “Look how good you are doing there!” or “See, you can do it.” Let the videos speak for themselves.

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A Recent Thought:A Recent Thought:• What happens when the targeted behavior is

physically unpleasant for the child (albeit not so with typical peers)?

• Can socializing, handling a spoon, or even eating some food be truly aversive and thus inappropriate?

• Raises ethical question, but a practical question too = Can VSM overcome biology?

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Visual SchedulesVisual SchedulesA very simple form of self-modelingA very simple form of self-modeling

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Sometimes: a bit of “magic”Time getting ready for school

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Tantrums: Duration Seven-year-olds with mild autism

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Eating lunch: Six-year-old with moderate autism

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VSM goes commercialVSM goes commercial• I phone app Therad – embeds short clips of

appropriate behavior into big-screen movies??? $14.99. I would bet that this doesn’t work well and could backfire????

• Pollymovies@ – Alaska - $1400 for training and support.

Think of how much money you saved today.

This one is amazing:iPad app = INNERVOICE AAC+VSM for $2.99

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The FutureThe Future• Laura Casey – Look at Me Now@

• Virtual Reality

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Possible ApplicationsPossible ApplicationsAdd Your ownAdd Your own

• Attention Disorders• Depression• Aggressive / disruptive behaviors• Stuttering• Elective Mutism• Responding behaviors - Students with autism• Motor Problems - “Shirley”• Language development• School to community transition (job interviews, task

performance…)• Cognitive skill training• Parenting skills• Literacy - phonemic awareness/letter recognition/oral reading• And, if you want to make millions, think about the application in

sports where mental imagery is so important.

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ResourcesResourcesWebsites:• http://siskinvsm.org - mine: videos, presentations, and articles.• http://depts.washington.edu/pdacent/archive/videometa.pdf - Bellini & Akullian’s 2007

meta-analysis of SM studies.• http://www.creating-futures.org/ Peter Dowrick’s site at the U of Hawai’i Manoa. Video

Futures and ACE Reading• Look at Me Now@ http://lookatmenow.org/ - Commercial self-

Modeling site.

Commercial Peer-modeling sites:• http://www.modelmekids.com/• http://www.socialskillbuilder.com/• http://www.watchmelearn.com/Books:• http://www.woodbinehouse.com/main.asp_Q_product_id_E_978-1-890627-88-1_A_.as

p My Book

• URL was too long - Video modelling and behaviour analysis: a guide for teaching social skills ... By Christos Nikopoulos, Michael Keenan

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Limitations of VSM UseLimitations of VSM Use

• Little is known for certain (lots of evidence though), but:1. Age. There must be a lower limit with child characteristics

being a determining factor (cognitive skills, interest in video, self-recognition and excitement, other).

2. Cognitive development: Problematic with children with concurrent mental retardation.

3. Interest/attention: If children show little interest in the video or cannot sustain interest while watching, it probably won’t work.

However, it still may be worth a try. Worst case scenario = You end up with a nice, positive video of the child. There have been no reports of negative consequences.

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These studies are those found in which VSM was a primary intervention or was compared to another method. Studies where VSM was part of a package were not included.