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A Comparison of On-Task Behavior in Person-Directed VS. AAC-Directed Apraxia Therapy for Children with Autism Spectrum Disorder By: Jeanna Probst Eastern.

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Presentation on theme: "A Comparison of On-Task Behavior in Person-Directed VS. AAC-Directed Apraxia Therapy for Children with Autism Spectrum Disorder By: Jeanna Probst Eastern."— Presentation transcript:

1 A Comparison of On-Task Behavior in Person-Directed VS. AAC-Directed Apraxia Therapy for Children with Autism Spectrum Disorder By: Jeanna Probst Eastern Illinois University

2 Introduction: Autism Spectrum Disorder (ASD) Deficits in 3 areas: ◦ Social Interaction ◦ Language & Communication ◦ Repetitive & Restricted Interests (Routine) Sensory Processing Deficits Joint Attention Deficits

3 Developmental Apraxia of Speech (DAS) Neurological disorder Difficulty sequencing movements needed to produce a clear and precise sound or utterance (Darley, Aronson & Brown, 1975; Hall, Jordan, & Robin, 2007; Tombin, Morris & Spriestersbach, 2000) “sensory integration dysfunction, which interferes with planning and executing an unfamiliar task” (Marshalla, 1994, 1995; Darley et al., 1975; Hall et al., 2007) Often associated with ASD

4 Joint Attention Schertz & Odom, (2004) define joint attention as, “coordinating attention to an event or object with another individual, sharing interest and social engagement, and showing an understanding that the partner is sharing the same focus”(p. 42). Language delays in ASD mainly due to deficit in the area of Joint Attention

5 Augmentative and Alternative Communication “Augmentative and alternative communication refers to the field or area of clinical, educational, and research practice to improve, temporarily or permanently, the communication skills of individuals with little or no functional speech and/or writing” (American Speech-Language-Hearing Association, 2002). Augmentative: augment existing speech abilities Alternative: providing a substitute for ineffective speech Facilitates natural speech  Consistent model  Immediate reinforcement AAC devices are often used with ASD & DAS  Helps the AAC users acquire functional communication and develop expressive language

6 ASD - DAS - AAC Commonalities in ASD & DAS: ◦ Neurological Disorder ◦ Routine ◦ Sensory Processing Deficits ◦ Joint Attention Deficits ◦ AAC provides a consistent model and routine ◦ Limited research that looks at joint attention in a person-directed model versus an AAC- directed model

7 Purpose and Research Question Limited research in area of AAC and ASD with DAS Purpose: compare on-task behavior in person-directed apraxia therapy to AAC- directed apraxia therapy in individuals diagnosed with ASD who also have apraxia of speech. Is there a difference in the length of on-task behavior when using a person-directed stimulus mode versus AAC-directed stimulus mode for individuals with co-morbid ADS and DAS?

8 Subjects SubjectGenderAgeDisorderAAC System Participant 1Female6ASD/DASDynavox V Participant 2Female6ASD/DASDynavox MT4 Participant 3Male8ASD/DASDynavox V max

9 Methodology Rapid alternating subject treatment design Randomly presented with stimuli (IV: AAC- directed & Person-directed) ◦ 5 minutes over 22 sessions AAC Device: Mercury II by Assistive Technology Inc., the Dyanvox IV, and the Dynavox V max Clinician: CDS graduate student, who was blind to the dependent variables Oral Motor Activities ◦ Blow, Kiss, Raspberry, Pat Mouth, Click Tongue, /p/, /b/, /m/

10 Video Clips Person-Directed ◦ Shows apraxia at work AAC-Directed ◦ Imitation of one of the oral motor behaviors

11 Dependent Variables Dependent VariableDescription Leave Work AreaThe subject left the identified work area (where the clinician or AAC system was). Disruptive BehaviorThe subject displayed behaviors that were physically or verbally disruptive and were used to block out the stimulus: closing eyes, screaming, attention focused on sensory items (e.g., string), physical disruptions (e.g., hugging). No Eye ContactThe subject was within the defined work area and interacting with the stimulus, but no sustained eye contact with the stimulus or clinician was present. On-Task BehaviorThe subject was interacting with the stimuli or clinician within the work area.

12 Data Recording Sheet

13 Results: Overall Multivariate Analysis of Variance (MANOVA) Overall significant difference, F(4,57)=5.8; p=.001 ◦ Higher occurrence of Disruptive Behavior and No Eye Contact in Condition 1 (Person- Directed) than Condition 2 (AAC-Directed) ◦ Disruptive Behavior (p=.034) ◦ No Eye Contact (p=.001)

14 Results: Overall ConditionOn-TaskLeave Work Area No Eye Contact Disruptive Behavior 1-Person- Directed Mean.92.03.32*.42* Standard Deviation. Number of Data Points Collected 30 2-AAC- Directed Mean.98.03.17*.28* Standard Deviation. Number of Data Points Collected 32 *significant difference

15 Results: On-Task Behavior Overall On-Task: Person-Directed: 92.4% AAC-Directed: 97.6% Both IV: 95% AAC significantly higher than Person-Directed (p=.001) Person-Directed 97.7%, AAC-Directed 96% Person-Directed 84%, AAC-Directed 97% Person-Directed 94.9%, AAC-Directed 98.9%

16 Results: No Eye Contact No Eye Contact: Person-Directed: 33.9% AAC-Directed: 19% Overall: 26% P=.001 Person-Directed 38.6%, AAC-Directed 10% Person-Directed 37.8%, AAC-Directed 11.5% Person-Directed 27.7%, AAC-Directed 33.5%

17 Results: Disruptive Behavior Disruptive Behavior: Person-Directed: 41.5% AAC-Directed: 27% Overall: 34% P=.034 Person-Directed 44.8%, AAC-Directed 41% Person-Directed 38.9%, AAC-Directed 11% Person-Directed 41%, AAC-Directed 28.9%

18 Results: Leave Work Area Leave Work Area: Person-Directed: 3.4% AAC-Directed: 3.7% Overall: 3.6% Person-Directed 3%, AAC-Directed 9.5% Person-Directed 2.7%, AAC-Directed 1.5% Person-Directed 4.1%, AAC-Directed 0%

19 Discussion Variables to account for results ◦ ASD is an individual disorder ◦ AAC was more routine orientation; PD involved more variability  Disruptive behaviors ◦ Clear focus with AAC ◦ PD provided a richer multimodality learning experience compared to the AAC device with flat 2-dimensional picture and auditory feedback

20 Discussion Strengths  Routine Design  Limited time frame  Focused/Controlled sensory input Limitations  Small subject size  Technology Difficulties

21 Discussion Future Research ◦ Broader Sample (different severity levels of ASD and DAS)  Lower and higher emerging level of AAC users ◦ Evaluate emerging imitation in Person-Directed vs. AAC- Directed conditions ◦ Evaluate if either of these conditions help develop joint attention ◦ Use of a video model instead of a static picture on the AAC device ◦ Replication to determine generalization of the present study

22 References American Speech-Language-Hearing Association (2002). Augmentative and Alternative Communication: Knowledge and Skills for Service Delivery. [Knowledge and Skills]. Available from Darley, F. L., Aronson, A. E., Brown, J. R. (1975). Motor Speech Disorders. W. B. Saunders Company. Hall, P. K., Jordan, L. S., & Robin, D. A. (2007). Developmental Apraxia of Speech: Theory and Clinical Practice (2 nd ed.). PRO-ED Inc. Marshalla, P. (1994). The non-verbal apraxic child: speech-language techniques. 1-19. Marshalla, P. (1995). Developmental apraxia of speech: facilitating vocal and verbal expression. Speech Dynamics Incorporated, 1-25. Schertz, H. H. & Odom, S. L. (2004). Joint attention and early intervention with autism: a conceptual framework and promising approaches. Journal of Early Intervention, 21, 1, 42-54. Tombin, J. B., Morris, H., & Spriestersbach, D.C. (2000). Diagnosis in Speech- Language Pathology (2 nd ed.). Singular Publishing Group, Inc.


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