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ISAAC, 2012 Joanne M. Cafiero Cynthia Pearl

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1 ISAAC, 2012 Joanne M. Cafiero Cynthia Pearl
Facilitating Pretend Play Skills for Youngsters with Autism through Literacy-Based Interventions ISAAC, 2012 Joanne M. Cafiero Cynthia Pearl

2 Rationale for Project High engagement in repeated readings using adapted literature Absence or low levels of pretend play Absence or low levels of interactive play Prior Action Research on Pretend Play with Preschoolers with ASD

3 Facilitating Pretend Play through Literacy Interventions
Environments: self-contained ASD program in general education environment Home Inclusion opportunities: in Specials, Recess and planned activities with typical peers Partnership with teacher, family and consultant Action Research Model

4 Action Research Research conducted within the environment that results will be utilized Goals, research questions taken from IEP or questions of practitioners Can be messy and evolving Utilizes qualitative and quantitative measurements Facilitates immediate implementation of results

5 Why is Pretend Play Important?
Play is the “work” of childhood Presumes perspective taking Skills correlate with language development Evolves from solitary to parallel to interactive in typical children

6 Why is literacy important?
Visual medium targets strengths. Current research dictates that providing opportunity facilitates literacy learning. Literacy and AAC are inextricably entwined. Reading and writing can segue into functional communication.

7 Teaching Pretend Play Scripts to Pre-K students with ASD Through Adapted Literature (Cafiero, Manthey-Silvio& Pearl, 2007; Cafiero & Pearl, 2009) Collected language samples from typical kids Developed adapted literature (text above; adapted text below) from sample Read book in group reading for 3 weeks Videotaped independent unprompted play for baseline and 5 intervention probes In watching typical kids play it was apparent in both video observations that the kids “became the driver” of the car. Joanne M. Cafiero PhD, 2011

8 It’s Time to Play with My Toy Cars by Cindy Pearl

9 Pretend Play: Time to Get Gas
Book read in group instruction. Each student had his/her own book. Related Balanced Literacy activities with target words & sentences daily. Videotaped baseline, intervention and 3 probes of individual students Data taken from videotapes

10 Pretend-play Behaviors: Gas Station: Actions
Putting man in car Driving to gas pump Putting in nozzle; filling up Leaving gas station Joanne M. Cafiero PhD, 2010

11 Pretend-play Behaviors: Gas Station: Scripts
“This is my car” “Uh-oh, I’m out of gas.” “I’m putting in gas.” “I’m putting in more gas” “Gas is finished, bye-bye.” Joanne M. Cafiero PhD, 2010

12 Joanne M. Cafiero PhD, 2010

13 Joanne M. Cafiero PhD, 2010

14 Integrated Literacy Activities Using Balanced Literacy Model
Word Study Using Target Words Word building Phonics Phonemic awareness Writing Using Target Words Sentence building Close writing activities Self-Selected Reading Books made available for independent reading Comprehension built in through play acting with the nouns & verbs in real play


16 Thematic Curricular Unit: Car Wash
Math Counting cars Color identification Matching PCS (PCS-PCS; PCS-word; word-word) Patterning with target words Communication Requesting play items Using target language in play Fine Motor Cutting, pasting Using pencils Manipulating Gross Motor Car play Riding car play Technology Interactive vocabulary on P2G Word match & other technology games. Socialization Appropriate toy play in inclusive environments

17 Results: Teaching Pretend Play Through Adapted Literature
Qualitative: “crystal clear” speech and spontaneous generating of appropriate language. Longer periods of engaging in targeted pretend play behaviors Fewer off-task and stereotypic and self-stimulatory behaviors Maintained play and language at 18 month probe Joanne M. Cafiero PhD, 2011

18 Pretend Play Skill Maintenance: 1.5 years later
Students maintained play scheme skills without book; more skills with book present Students who learned scripts (Baby to Bed) maintained the non-linguistics (lullabye, “shhh”, kiss good night) Students independently requested to play and generalized to novel objects & environments

19 New Findings: 3 years later
Students from original study requested opportunities to pretend play with targeted items when given the opportunity. Target students maintained 20-40% of scripts and 100% of actions Target students selected Pretend Play activity as highly preferred reinforcer


21 Facilitating Pretend Play Toy Cars: Phase 2
Primary Autism Class Implemented intervention with modeling and literature Did not include robust literacy extension activities Baseline & 3 Video Probes

22 Identifying Specific Play Behaviors
Observed typically developing kids engaging in the targeted pretend play Pretend play included concrete figures, objects Charted actions and scripts Took photos of identified actions Created literature using photos and scripts

23 Pretend Play Skill Acquisition

24 Observations Increases in play actions
No Increases in play language (scripts) Demonstrated interest in play schemes when others were engaged with it. More interest in interactive play than in previous pilot study with younger CWA

25 Pretend Play in the home: My Restaurant
Restaurant theme selected from favorite pretend play activity of two typical brothers, 8-9 years old Videotape of Restaurant play; actions & scripts identified Selected 10 of most appropriate actions & scripts for book Photographed boys engaged in activity for book: excluded adults and prompts


27 Pretend Play: Teddy & Kenneth
Twin boys, 9 years old, Dx ASD Non-verbal & limited speakers Participated in structured literacy program in school Majority of play time is solitary screen time (iPad, TV, videos) Engaged parents Read story 2x/day Played restaurant 1x/day Family is venturing out to visit restaurants for the first time.



30 My Restaurant Parents and caregiver read story 2x day
Once with props; acting it out Once without Limited related literacy activities around target vocabulary (sentence building) Weekly coaching and videotaped probes

31 My Restaurant

32 Bethany is a customer in My Restaurant

33 Hi. Welcome to My Restaurant.

34 Here is your menu.

35 Bethany reads the menu.

36 Can I take your order?

37 What do you like to drink? Bethany says “I want some water, please.”

38 Here is your drink.

39 What would you like to eat?
Bethany says: “I’d like a pizza”.

40 Here is your pizza.

41 Bethany eats her pizza.

42 Here is your check.

43 Bethany pays the check.

44 I put the money in my pocket.

45 Thank you, please come back.

46 The End

47 My Restaurant: Measuring Outcomes
Simple data collection method Weighted prompts for coding % independence 3 fully independent 2 Gestural prompt 1 Verbal prompt 0 No response Observations of activity around theme noted anecdotally

48 My Restaurant Actions Scripts Greets customer
“Hi, Welcome to My Restaurant” Gives menu to customer “Here is your menu” Takes order “Can I take your order” Brings drink “What would you like to drink?” Brings pizza “What would you like to eat?” Waits for customer to finish eating Brings check “Here is your check.” Takes money Puts in pocket “Thank you, Please come back.”

49 % Independence in Pretend Play: Kenneth

50 % Independence in Pretend Play: Teddy

51 Results: Increases in % independence in actions
Increases in % independence using scripts More novel pretend play around toy foods Increased engagement with play partners Increases in independent performance of play actions and scripts with book present

52 What We Learned: Data collection should represent smaller increments of performance Applying gentle pressure by putting hand on shoulder breaks autistic inertia in some children Total package (story, word study, cross curricular activities) total immersion may be the factor that defines greater levels of Pretend Play skill acquisition

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