Author: Raj Brij
Brij, Raj, 2019 Effects of visual supports with and without systematic instruction on the acquisition of daily living skills for students with autism spectrum disorder and intellectual disability, Flinders University, College of Education, Psychology and Social Work
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Ensuring students with autism spectrum disorder (ASD) and intellectual disability (ID) receive evidence-based instruction as part of their schooling curriculum is pivotal for ensuring lifelong potential is maximised. Much research exists that highlights the benefits of visual supports for teaching students with ASD and ID; however much of this research includes additional forms of instruction calling for a need to validate if visual supports in isolation truly is an appropriate evidence-based practice or whether a combination of visual supports plus systematic instruction is a more effective pedagogical approach.
This study investigated the effect of visual supports plus systematic instruction in comparison to visual supports in isolation on the acquisition of daily living skills for students with ASD and ID. Eight students with a diagnosis of ASD and ID, aged between 6.8 to 14.10 years old from two South Australian special school settings participated in the study. Using a novel multiple-baseline comparative-intervention (Ferron & Levin, 2014) design, participants were randomly paired into four units, assigned an intervention within their pair (i.e., within a pair, one participant receiving visual supports plus systematic instruction and the other receiving visual supports in isolation), and a pair intervention start point. Across a cumulative total of 22 sessions, all participants were engaged in baseline (5-8 sessions), intervention (12-15 sessions) and maintenance phases (2 sessions). Four participants in the visual supports plus systematic instruction condition received graduated guidance plus system of least prompts in addition to visual supports mapped to their visual comprehension ability to target a parent-selected daily living skill. Meanwhile, the four participants in the visual supports in isolation condition received only sequences of visual supports matched to their visual comprehension level to teach their parent-selected daily living skill. To socially validate the study data, teachers and teacher aides were engaged in a social validation questionnaire.
Data collected as part of the multiple-baseline comparative-intervention design were analysed using the Excel Package of Randomization Tests (version 3.1; Levin, Evmenova, & Gafurov, 2014) while social validation data was analysed thematically. Results revealed that visual supports plus systematic instruction was significantly effective (p = 0.04) with effect size ranging from medium to large in increasing the percentage of independent steps completed in a daily living skill for all four participants in the visual supports plus systematic instruction condition. In the visual supports condition, out of the four participants, only one participant’s percentage of independent steps in daily living skills improved. Effect sizes for three participants in the visual supports in isolation condition were negative to small, however one participant demonstrated a large effect size and positive change being able to complete his targeted daily living skill. Analysis of significance for the visual supports only condition revealed an overall statistically significant improvement (p = 0.04), however when one participant’s data was removed, overall statistical significance for the visual supports only condition was not achieved (p = 0.08). Social validation data revealed that educators rated the visual supports plus systematic instruction condition as more effective than the visual supports in isolation condition.
The results from this study indicate that visual supports in isolation is a comparatively less effective approach to teaching daily living skills compared to visual supports plus systematic instruction, although individual variation does exist. The implications of avoiding the presumptions that students with ASD and ID are predisposed to learning visually without the mediating effect of systematic instruction are highlighted. In addition, the repercussions for teacher education, classroom practice, school leadership and policy direction regarding the importance of understanding which components of evidence-based practice are most useful in classroom contexts are discussed.
Keywords: autism spectrum disorders (ASD), intellectual disability (ID), visual supports, systematic instruction, daily living skills
Subject: Disability Studies thesis
Thesis type: Doctor of Philosophy
Completed: 2019
School: College of Education, Psychology and Social Work
Supervisor: Dr. Julie McMillan