The broad goal of the proposed research is to examine the efficacy of the use of a picture communication system within the natural environment with caregivers and their young children with autism as a way to facilitate communication development [initiations and responses.] Investigation of this intervention approach will further clarify the caregivers' role as a facilitator in the use of visual supports for young children. Facilitating generalized use of caregiver strategies and pictures will enhance the caregiver's ability to support the child's communication development across daily routines and activities. The proposed research attempts to use a least-to-most picture prompting hierarchy to facilitate generalized use of pictures across daily routines. [Parents will begin with the least intrusive strategy (waiting) and progress to physical prompting if necessary to achieve the desired outcome.] Within identified routines, a picture symbol system will be used to teach young children how to initiate or respond by exchanging a picture for a desired item. In Year 01 an intervention study is proposed to evaluate the effectiveness of a least-to-most picture prompting hierarchy as a means to facilitate initiations and responses. A multiple baseline design across routines replicated across three children will be employed to evaluate an intervention that teaches picture symbol use to promote requesting in children with autism [and extensive training in the efficacy and use of augmentative devices for children] with moderate to severe communicative impairments. This study will serve as a basis for my dissertation study. In the second year of the project, four or more children with autism will participate in a multiple baseline design across routines and caregiver-child dyads to expand and evaluate any modifications to the picture prompting hierarchy as a result of study one. Child measures will focus on the frequency of initiations and responses and the communicative modality (gesture, vocal, verbal, and pictures). Caregiver outcomes will focus on the use of teaching strategies such as natural reinforcement, waiting, and verbal/physical prompts. Results from this study will have significant research and clinical implications if the findings support the efficacy of visual symbols to enhance the communication of young children with autism. Further evidence will be gathered to identify efficient and effective strategies for caregivers to use in their daily routines.
The specific aims of the proposed work are: 1: To investigate the extent to which the use of a picture communication system within daily routines facilitates requesting [initiations and responses] in young children with autism. 2: To investigate the extent to which the picture symbol communication is associated with gestures, vocalizations and verbalizations [and generalizes across routines.] 3: To investigate the caregivers' implementation of a least-to-most prompting/fading procedure using pictures and the extent to which it generalizes across routines. 4: To assess social validity via measures of family perceptions of the picture communication system therapy and its effects on child outcomes using a satisfaction survey.
