Videos With Integrated AAC Visual Scene Displays to Enhance Participation in Community and Vocational Activities: Pilot Case Study With an Adolescent With Autism Spectrum Disorder In order to maximize the positive outcomes of augmentative and alternative communication interventions, it is critical that interventions support the participation of individuals with complex communication needs within real-world interactions in their natural environments. A pilot case study was used to evaluate the effects of videos with integrated visual scene ... Article
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Article  |   November 15, 2017
Videos With Integrated AAC Visual Scene Displays to Enhance Participation in Community and Vocational Activities: Pilot Case Study With an Adolescent With Autism Spectrum Disorder
Author Affiliations & Notes
  • Tara O'Neill
    Department of Communication Sciences and Disorders, The Pennsylvania State University, State College, PA
  • Janice Light
    Department of Communication Sciences and Disorders, The Pennsylvania State University, State College, PA
  • David McNaughton
    Department of Educational and School Psychology, The Pennsylvania State University, State College, PA
  • Disclosures
    Disclosures ×
  • Financial: This project was supported, in part, by funding from the (a) Penn State AAC Leadership Project, a doctoral training grant funded by U.S. Department of Education grant #H325D110008 and (b) Rehabilitation Engineering Research Center on Augmentative and Alternative Communication (The RERC on AAC), funded by grant #90RE5017 from the National Institute on Disability, Independent Living, and Rehabilitation (NIDILRR) within the Administration for Community Living (ACL) of the U.S. Department of Health and Human Services (HHS).
    Financial: This project was supported, in part, by funding from the (a) Penn State AAC Leadership Project, a doctoral training grant funded by U.S. Department of Education grant #H325D110008 and (b) Rehabilitation Engineering Research Center on Augmentative and Alternative Communication (The RERC on AAC), funded by grant #90RE5017 from the National Institute on Disability, Independent Living, and Rehabilitation (NIDILRR) within the Administration for Community Living (ACL) of the U.S. Department of Health and Human Services (HHS).×
  • Nonfinancial: The results of this investigation were previously presented at the 2017 Pennsylvania Speech-Language-Hearing Association Convention.
    Nonfinancial: The results of this investigation were previously presented at the 2017 Pennsylvania Speech-Language-Hearing Association Convention.×
Article Information
Augmentative & Alternative Communication / Special Populations / Genetic & Congenital Disorders / Autism Spectrum / Part 2
Article   |   November 15, 2017
Videos With Integrated AAC Visual Scene Displays to Enhance Participation in Community and Vocational Activities: Pilot Case Study With an Adolescent With Autism Spectrum Disorder
Perspectives of the ASHA Special Interest Groups, November 2017, Vol. 2, 55-69. doi:10.1044/persp2.SIG12.55
History: Received April 5, 2017 , Revised August 4, 2017 , Accepted August 26, 2017
Perspectives of the ASHA Special Interest Groups, November 2017, Vol. 2, 55-69. doi:10.1044/persp2.SIG12.55
History: Received April 5, 2017; Revised August 4, 2017; Accepted August 26, 2017

In order to maximize the positive outcomes of augmentative and alternative communication interventions, it is critical that interventions support the participation of individuals with complex communication needs within real-world interactions in their natural environments. A pilot case study was used to evaluate the effects of videos with integrated visual scene displays (VSDs), displayed on a tablet-based application (app), on the percent of task steps completed independently within three community and vocational activities by an adolescent with autism spectrum disorder (ASD). The results indicated noticeable gains in independent task completion and communication across contexts while using the video VSD app after only a few intervention sessions. These results provide preliminary evidence that videos with integrated VSDs may serve as an effective means to maximize independent participation and communication for individuals with complex communication needs and ASD in real-world contexts. Ultimately, this assistive technology could reduce dependence on aides (e.g., job coaches, paraprofessionals) and create increased opportunities for employment and independent participation in meaningful community activities for individuals with complex communication needs.

Introduction
There is an expanding body of research evidence that clearly indicates that augmentative and alternative communication (AAC) interventions can support improved communication outcomes for individuals who experience complex communication needs (CCN) across a wide range of ages, needs, and disabilities (Light & McNaughton, 2015). Individuals with CCN experience significant limitations in communication functioning, and they are unable to use speech to meet their communication needs in all contexts with all communication partners. In order to maximize the positive outcomes of AAC interventions for individuals with CCN, it is critical that interventions are designed to support participation within real-world interactions in their natural environments. However, the majority of AAC research to date has focused on communication and participation within restricted settings. A review of recently published research in Augmentative and Alternative Communication revealed that only 42% of intervention research studies focused on participation within natural environments with everyday communication partners (Light & McNaughton, 2015). Clearly, investigations that support participation across a wide range of real-world contexts (e.g., home, school, work, community) are needed. The importance of participation has also been identified as a key component of the Who Health Organization's [WHO's] International Classification of Functioning, Disability, and Health (ICF; WHO, 2001; see also Pless & Granlund, 2012) .
Particularly, participation of individuals with CCN within community and vocational contexts deserves greater attention. According to the National Organization on Disability (2010), less than 21% of Americans with disabilities are employed. Among individuals with disabilities who experience CCN, the rate of employment has been reported to be even lower, at less than 5% (e.g., McNaughton & Bryen, 2002). The low proportion of employment among individuals who benefit from AAC likely is related to the lack of effective AAC supports to meet the functional demands of participation within community and vocational settings. There has been little research to inform the design of these AAC supports. In a meta-analysis investigating assistive technology use by individuals with intellectual disabilities, Wehmeyer, Palmer, Smith, Davies & Stock (2008)  found that almost 75% of individuals were evaluated in segregated, rather than community-based, settings. Additionally, a very small proportion of participants (1.8%) were evaluated within employment settings (Wehmeyer et al., 2008).
The lack of investigations on the use of AAC in real-world community and vocational settings may relate to the limitations of current AAC technologies as a means to support participation in these settings. Traditional AAC grid-based displays with isolated AAC symbols arranged in rows and columns depict language concepts outside of the meaningful communication contexts in which they occur. Alternatively, visual scene displays (VSDs) capture meaningful events within an individual's life in an integrated scene (i.e., photograph), with language concepts embedded as hotspots (i.e., portion of the display that can be selected or activated to result in speech output). The depiction of language concepts within a meaningful context reduces cognitive and linguistic demands (Light & McNaughton, 2012). Although investigations indicate that VSDs result in increases in communication for individuals with CCN (e.g., Beukelman, Hux, Dietz, McKelvey, & Weissling, 2015; Light & Drager, 2011), current AAC technologies support the integration of only static photo VSDs. These static VSDs do not capture the dynamic routines that require communication within real-world vocational and community activities. Light, McNaughton, and Jakobs (2014)  proposed the use of videos with integrated visual scene displays on a tablet-based AAC application (app) to facilitate participation and communication within daily activities:

Redesigning AAC apps to capture video of daily events and integrate communication VSDs within these videos may better support the participation and communication of individuals with complex communication needs. In theory, VSDs embedded within a video will be even more effective at facilitating participation and communication than static photo VSDs because video VSDs capture both the spatial and temporal contexts of activities and communication opportunities, thereby preserving the dynamic relationships and engagement cues found in real world interactions. Furthermore, automatic pausing of the video at key segues in the event marks the appropriate opportunity for participation and communication, and provides the necessary vocabulary within the VSD for the individual who uses AAC to fulfill the communication demands at that point. Apps that support videos with integrated VSDs capture the dynamic routines within the learner's life (e.g., school, work, community activities) and step the learner through the activities, one step at a time, fostering greater participation and communication. (Light et al., 2014, “Summary Statement”)

Research on Video Instruction Interventions
There is evidence that individuals with autism spectrum disorder (ASD) can benefit from video supports to promote participation in real-world contexts. Specifically, video modeling is an effective intervention to support completion of vocational, community-based tasks in learners with various disabilities including ASD (e.g., van Laarhoven, Winiarski, Blood, & Chan, 2012). Video modeling has its theoretical basis in social learning theory, and it is meant to support learning through observation, modeling, and imitation (Bandura, 1977). Video prompting is one form of video modeling in which a chained task is broken down into individual steps. Rather than watching the entire video, the individual watches each individual step of the task and is given a chance to perform that step before moving on the next step (Sigafoos et al., 2005). The presentation of information in small amounts allows for more effective and efficient processing and also reduces short-term memory demands (Minshew & Williams, 2008). Individuals with disabilities including ASD have experienced success with video prompting interventions within community-based vocational settings (e.g., Bereznak, Ayres, Mechling & Alexander, 2012; van Laarhoven, Johnson, van Laarhoven-Myers, Grider, & Grider, 2009). Despite the potential benefits of video modeling, there are some limitations of current apps for individuals with CCN. Many employment and community activities require communication by participants (Bryen, Potts, & Carey, 2007); however, current video modeling apps do not integrate communication supports into the video models of the activities.
Videos With Integrated Visual Scene Displays
Light et al. (2014)  proposed the use of videos with integrated visual scene displays (i.e., video VSDs) to support the participation and communication of individuals with CCN in daily activities. The use of videos with integrated VSDs capitalizes on evidence that: (1) video prompting interventions support learning of new skills by individuals with ASD; and (2) VSDs provide contextual support for communication within real-world contexts. Videos with integrated VSDs should harness the positive effects of both video prompting and VSDs by capturing the dynamic routines that support communication in real world vocational and community settings (Light et al., 2014).
The current investigation was a pilot case study that examined the use of videos with integrated VSDs on a tablet-based application (EasyVSD 1   software created by InvoTek, Inc.) to increase independent participation and communication of an adolescent with ASD in community and vocational activities. The question guiding the investigation was: Do videos with integrated VSDs on the EasyVSD application increase the percent of steps completed during community and vocational activities by an adolescent with ASD and CCN?
Methods
Design
The current investigation was a pilot case study that explored the effects of the video VSD app on participation in three real world contexts. The independent variable was the provision of the video VSD app containing videos with integrated VSDs and embedded hotspots and a least-to-most invasive prompting hierarchy to encourage use of the app. The dependent variable was the percent of task steps (including steps that involved communication) completed independently within each task. The pilot study was implemented during the extended school year summer program over a very limited time period. As a result, there was only time for a limited number of baseline and intervention observations, and there was not sufficient time to systematically stagger introduction of the independent variable across contexts. As a result, the study did not establish experimental control, and caution must be exercised in interpreting the results. However, given the lack of existing research on participation in real world contexts, the current investigation served as a pilot to explore the feasibility and efficacy of utilizing videos with integrated VSDs to support communication and participation within community and vocational settings.
Participant
One student with ASD participated in this case study. A pseudonym is used here to protect the privacy of the participant. At the start of the study, Lena was a 16-year-old teenager who participated in an inclusive high school program that supported students with autism. She typically used speech to communicate; however, she experienced CCN. In particular, she did not express a full range of communicative functions independently, and was dependent on prompting for functions such as commenting and interacting socially, especially during community and vocational activities. Her expressive communication was characterized by the use of ritualized phrases, delayed echolalia, and scripting. In addition, Lena was highly dependent on verbal prompting, gestural prompting, and modeling from teachers and job coaches to complete vocational and community tasks in real world contexts. She was reported to have functional literacy and comprehension skills that were slightly below grade level. Her hearing skills were within normal limits and her vision skills were corrected to within normal limits with glasses. She was considered a good candidate for the study by her teacher, job coaches, and parents due to difficulties with independent participation and communication in everyday community and workplace activities.
Settings and Tasks
The following criteria were used to select intervention tasks: (a) occurred within a meaningful community or vocational activity, (b) included a predictable series of steps, (c) included opportunities for communication, and (d) was not currently completed independently by Lena. The intervention tasks that met these criteria included: working at the print shop, using public transportation, and performing a shredding job. The print shop was a building outside of Lena's high school that was operated by the school district and provided work placements for high school students. Prior to the summer program, Lena had been working in the print shop one afternoon per week during the regular school year. A job coach attended this activity with Lena. Public transportation (i.e., bus riding) was part of the summer programming that supported students' participation in community experiences. At the time of the study, Lena had not taken public transportation since the previous summer. A job coach also accompanied Lena during this activity. The shredding job took place in the school office. The current investigation represented the first time that Lena had performed this particular task. During the intervention, there were no other environmental materials available beyond those that were typically a part of these tasks.
Task analyses for each task were developed by the first author after observing Lena's performance during one session within each context. A task analysis is a process in which a task is divided into small, manageable steps in order to evaluate and teach the skill or behavior (Cooper, 1987). Utilizing task analyses is an evidence-based practice for individuals with ASD (Wong et al., 2015). The task analyses were used to identify the steps to complete the tasks within each context, which included steps related to task completion as well as communication opportunities. See Table 1 for the task analyses within each intervention context.
Table 1. Task Analysis of Target Activities.
Task Analysis of Target Activities.×
Print shop job Public transportation Shredding job
1. Thank the van driver 1. Walk to the bus stop 1. Say goodbye to classmates
2. Exit the van 2. Look at the schedule for the time of the next bus 2. Exit the classroom and walk to the office
3. Greet job coach 3. Wait for the bus to arrive 3. Enter the office
4. Enter building and walk to the print shop 4. Get on the bus 4. Greet the secretaries
5. Get folder from the shelf 5. Greet the bus driver 5. Walk to the shredding room
6. Write date and time on sign in sheet 6. Give bus pass to the driver 6. Turn on the shredder
7. Return folder to the shelf 7. Walk to seat, sit down, and wait 7. Put papers through the slot
8. Get the die cuts from the shelf and bring to the table 8. Pull cord when stop is next 8. When the shredder stops, open the door and pull out the bag
9. Put paper on the die cut 9. Get up and walk to exit 9. Pick up scraps on the floor
10. Turn over the die cut and place in press 10. Thank the bus driver 10. Dump shredding bag into garbage can
11. Pull down the lever one time 11. Exit the bus 11. Slide bag into shredder
12. Slide out the block and remove the die cut 12. Close the shredder door
13. Recycle the paper scraps 13. Turn off the shredder and exit shredding room
14. Return the die cut to the shelf 14. Say goodbye to secretaries
15. Brush off the tables with the dust pan 15. Return to classroom
16. Get folder from the shelf 16. Enter classroom and greet classmates
17. Sign out with time and initials
18. Return folder to the shelf
19. Leave the print shop and walk outside
20. Say goodbye to job coach
21. Get on the van
22. Greet the van driver
Note. Steps that are in bold represent communication opportunities.
Note. Steps that are in bold represent communication opportunities.×
Table 1. Task Analysis of Target Activities.
Task Analysis of Target Activities.×
Print shop job Public transportation Shredding job
1. Thank the van driver 1. Walk to the bus stop 1. Say goodbye to classmates
2. Exit the van 2. Look at the schedule for the time of the next bus 2. Exit the classroom and walk to the office
3. Greet job coach 3. Wait for the bus to arrive 3. Enter the office
4. Enter building and walk to the print shop 4. Get on the bus 4. Greet the secretaries
5. Get folder from the shelf 5. Greet the bus driver 5. Walk to the shredding room
6. Write date and time on sign in sheet 6. Give bus pass to the driver 6. Turn on the shredder
7. Return folder to the shelf 7. Walk to seat, sit down, and wait 7. Put papers through the slot
8. Get the die cuts from the shelf and bring to the table 8. Pull cord when stop is next 8. When the shredder stops, open the door and pull out the bag
9. Put paper on the die cut 9. Get up and walk to exit 9. Pick up scraps on the floor
10. Turn over the die cut and place in press 10. Thank the bus driver 10. Dump shredding bag into garbage can
11. Pull down the lever one time 11. Exit the bus 11. Slide bag into shredder
12. Slide out the block and remove the die cut 12. Close the shredder door
13. Recycle the paper scraps 13. Turn off the shredder and exit shredding room
14. Return the die cut to the shelf 14. Say goodbye to secretaries
15. Brush off the tables with the dust pan 15. Return to classroom
16. Get folder from the shelf 16. Enter classroom and greet classmates
17. Sign out with time and initials
18. Return folder to the shelf
19. Leave the print shop and walk outside
20. Say goodbye to job coach
21. Get on the van
22. Greet the van driver
Note. Steps that are in bold represent communication opportunities.
Note. Steps that are in bold represent communication opportunities.×
×
Materials
Tablet and app
The tablet used for the intervention was a 12-inch Samsung Galaxy Note Pro 6® 2   that contained the EasyVSD app. Figure 1 provides a screenshot of the EasyVSD app from the bus riding context. The EasyVSD app supported the use of videos with integrated VSDs that filled almost the entire screen of the tablet, with the exception of the programming icons and menus positioned vertically on the left hand side of the screen. The icons served various programming functions, including: (1) capturing videos via the green and purple camera icons; (2) making hotspots and recording messages via the orange hotspot icon; (3) drawing via the blue pencil icon (not used in current investigation); and (4) playing and pausing videos via the pink play/pause icon. Below the programming icons, the app contained two menu bars positioned vertically. The menu bar on the left contained still VSDs (i.e., thumbnail representations) depicting the beginning of each step or video. The thumbnails on the left menu were used to navigate between video segments, and they were highlighted with a pink border to indicate the video currently playing. The menu bar on the right represented all of the still VSDs within the selected video segment. The still VSDs represented the junctures when video segments automatically stopped (i.e., at the completion of a step or when there was a communication opportunity) to provide the user with the opportunity to complete the step.
Figure 1.

Screenshot of the Video VSD App From the Bus Riding Context; It Depicts a VSD With an Embedded Hotspot (“Hello”) Used To Greet the Bus Driver. The VSD includes a text caption describing the required step.

 Screenshot of the Video VSD App From the Bus Riding Context; It Depicts a VSD With an Embedded Hotspot (“Hello”) Used To Greet the Bus Driver. The VSD includes a text caption describing the required step.
Figure 1.

Screenshot of the Video VSD App From the Bus Riding Context; It Depicts a VSD With an Embedded Hotspot (“Hello”) Used To Greet the Bus Driver. The VSD includes a text caption describing the required step.

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Lena followed these steps to operate the app: (1) press the play button, (2) watch the video segment portraying one step from the task analysis, (3) perform the step or fulfill the communication opportunity depicted in the segment, (4) select the thumbnail of the next video from the left menu, and (5) repeat steps 1–5 for each video segment to complete the entire task.
Videos with integrated VSDs
While the EasyVSD app supported capturing videos, video files used for the intervention were captured using a video recorder in order to support video editing (e.g., trimming, adding text). The videos were edited using Windows Movie Maker 3   before uploading them to the EasyVSD app. The videos contained self-models of Lena herself completing the tasks. Research suggests that using individuals as their own models may promote attention, increase self-efficacy, and reinforce the value of watching oneself be successful (Cihak & Schrader, 2008). Because Lena did not perform the tasks independently at the start of the study, videos of her performing each task with prompts were collected and then edited to eliminate or mute any prompts. The videos were trimmed in order to create video segments corresponding to steps identified within the task analyses for each context. Video segments were about 10 seconds in length on average and some combined several steps into logical chunks. These videos were then uploaded to the EasyVSD app. Hotspots to provide a means to fulfill communicative opportunities were added by the researcher, as indicated on the task analyses (see Table 1). Hotspots and embedded messages were added by: (1) pausing the video when there was an opportunity for communication, (2) selecting the orange hotspot button, (3) drawing the hotspot on the VSD, and (4) recording the communicative message. Wherever a hotspot was embedded, the video automatically paused and the hotspot appeared momentarily in order to highlight the communicative message. See Figure 1 for an example of a VSD with an embedded hotspot.
Procedures
The study included baseline and intervention phases. All of the sessions were conducted by the researcher (i.e., first author). The job coaches were instructed to allow the researcher to perform all prompting during task completion. Instruction started for all tasks within the same timeframe (i.e., within a 5-day period). Lena typically participated in 5 sessions per week, which included 1 session at the print shop, 2 sessions shredding, and 2 sessions riding the bus. Baseline and intervention sessions occurred over a 5-week period.
Baseline
Data were collected during target activities, as they typically occurred within her school program prior to the intervention, without the use of the video VSD app. Data were collected on the percent of steps completed independently by Lena within each context.
Intervention
The participant completed the tasks within each context with the use of the video VSD app. Prior to beginning each task, the participant reviewed the videos one time with the first author. No separate training phase was completed for operation of the app. When the app was introduced to the participant, the researcher instructed her, “Today you are going to use this tablet to help you with ___. First, we will watch a video of the steps.” Lena was engaged and attended to the videos. The experimenter provided the participant with gestural prompts (i.e., pointing to tablet) and verbal prompts (e.g., “press the play button”) to assist with navigation between the videos on the app and activation of the hotspots as needed. Additionally, the experimenter provided a short verbal description of each step as Lena watched (e.g., “Now you turn on the shredder”). Lena only required prompting during the video review for the first two to three sessions (some differences were observed across sessions), after which she demonstrated independent operation of the app.
During the intervention sessions, the participant was provided with access to the tablet with the video VSD app. After a general verbal prompt (e.g., “Time to work”), Lena followed the steps (listed in the Materials section) to operate the app during each activity. If Lena failed to complete a step independently within 5 seconds of the naturally occurring environmental stimulus, the interventionist moved through a least-to-most invasive prompting hierarchy. Least-to-most prompting hierarchies are advantageous because they provide an opportunity for learners to make unprompted responses to relevant stimuli every trial (Cooper, 1987). The prompting hierarchy consisted of the following set of cues for each step: (a) expectant delay (i.e., wait 5 seconds while looking at the participant expectantly), (b) gestural prompt (i.e., point towards the tablet), (c) model (i.e., model playing the video or activating the hotspot). If Lena made an error completing a step independently (i.e., performed the incorrect step, performed a step out of order), she was immediately provided with a model of the correct behavior to ensure that she did not practice “incorrect” behaviors (Light & Binger, 1998). The experimenter provided general verbal praise (e.g., Good job) during each activity that was not task-specific on a variable ratio reinforcement schedule.
Text captions that provided a short description of steps (e.g., “Get your folder from the shelf”) were added for the final two bus riding and shredding interventions and for the final print shop intervention. The text captions were added in order to determine if this additional support would aid with task completion and communication.
Procedural integrity
Procedural integrity was calculated for one intervention session within each of the three contexts (e.g., 3 out of 16 intervention sessions or 19% of intervention sessions). Procedural integrity was not calculated for the baseline sessions because this phase reflected the level of prompting Lena received prior to the intervention, without the video VSD app. A trained graduate student in communication sciences and disorders evaluated procedural integrity by watching videos of each session. For each step of the task analysis within each context, the trained graduate student indicated whether or not the researcher completed each of the following steps, as necessary: (1) provision of tablet with EasyVSD app, (2) expectant delay, (3) gestural prompt, and (4) model and corrective feedback if at any time an error was made. Procedural integrity was 93% on average across contexts (range 91–94%).
Measures and Data Analysis
The dependent variable measured was the percent of task steps completed independently. Steps referred to the both the behavioral task steps and communication opportunities that were identified within the task analysis (see Table 1). For example, the task analysis for the shredding job identified 16 steps, four of which constituted communication opportunities. The dependent variable was calculated by dividing the number of steps completed independently by the total number of steps (e.g., 16) and multiplying by 100.
Independent completion of a task step was operationally defined as completing the step within 5 seconds of the naturally occurring environmental stimulus with no direct prompting from a partner (i.e., gestural prompting, verbal prompting, modeling, or physical prompting). For the steps that involved communication opportunities, the step could be completed by touching the tablet to activate the hotspot and/or verbalizing the communication opportunity within 5 seconds of the hotspot appearing. It should be noted that the behavior or communication was coded as independent even if the participant prompted herself using the video VSDs on the tablet, provided she did so without any assistance or prompts from a partner. Data on the dependent variable were collected and coded by the first author post hoc through review of video tapes. The data were summarized for each session and graphed separately for each task in the order in which they were collected. The data were analyzed visually for changes in trend, slope, and variability to explore the effects of the video VSD app on independent communication and task completion (Kazdin, 2010).
Reliability
The same graduate student who evaluated procedural integrity was trained to code data for the dependent variable (i.e., percent of steps completed) by watching videos of the sessions. Reliability for data coding was conducted by computing interobserver agreement between the first author and the graduate student for 23% of baseline and intervention sessions across tasks (i.e., 5 out of 22 baseline and intervention sessions). Interobserver agreement was calculating by taking the number of agreements divided by the number of agreements plus disagreements and multiplying by 100. Interobserver agreement across sessions resulted in a mean score of 95% (range 89–100%).
Social Validation
Information on the social validity of the intervention was provided by Lena, her job coaches, her mother, and her classroom teacher. See Appendix A for a list of questions. Lena was asked yes/no questions regarding her satisfaction with the app and intervention. Her job coaches were asked informal questions about their overall satisfaction with the app, as well as suggestions for improvement. Both Lena's mother and classroom teacher watched pre- and post-intervention videos from her shredding job. Answers to social validity questions were recorded in real time.
Results
The data suggested that using videos with integrated VSDs on the EasyVSD app supported Lena in successful independent task completion and communication within real-world community and vocational tasks. The percent of steps performed independently within each context are represented in Figure 2. Changes in her performance were observed immediately upon introduction of the app; moreover, she required only a few intervention sessions to perform a range of meaningful community and vocational tasks more independently despite low levels of independence at baseline.
Figure 2.

Percent of Steps Completed Independently by Lena During Baseline and Intervention Across Three Contexts.

 Percent of Steps Completed Independently by Lena During Baseline and Intervention Across Three Contexts.
Figure 2.

Percent of Steps Completed Independently by Lena During Baseline and Intervention Across Three Contexts.

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In the print shop context, Lena independently completed 15% of the steps during baseline. By the third and final intervention session, the percent of steps completed independently reached 75% (i.e., +60% of steps completed from baseline). During the final intervention session, Lena was observed to benefit from the text captions, which she read aloud as a means of self-prompting.
Within the bus riding activity, Lena independently completed 22% of the steps on average during the three baseline sessions. She participated in eight intervention sessions in this context. By the final intervention session, her percent correct for independent task completion was 100% (i.e., +78% of steps completed from average baseline performance).
In the shredding job, Lena independently completed 10% of the steps independently on average during the two baseline sessions. She immediately increased to 70% independently upon the introduction of the video VSD app. She participated in five intervention sessions within this context. Lena's percent correct for independent task completion by the final intervention session was 100% (i.e., +90% of steps completed from average performance during baseline).
Social Validity Results
Lena reported that she liked using the app and that it helped her to do her jobs, ride the bus, and talk with other people. She reported that she liked it more with the text captions than without and that she would like to use the app in the future. Lena's job coaches reported that, overall, the app was beneficial to help Lena remember the steps of the tasks and to know what to expect. One job coach felt that using the tablet could be stressful in high pressure situations that require doing multiple things in a short time period (e.g., getting on the bus, greeting the bus driver, and handing over the ticket). Lena's mother and classroom teacher viewed pre- and post-intervention video clips. Both reported that Lena performed more independently and communicated more effectively when using the app. When watching the intervention video, her mother commented, “Maybe she could use the app in other jobs in the future.”
Discussion
Results of this study suggested that the introduction of the EasyVSD app with VSDs integrated within videos was associated with an increase in the percent of steps completed independently across three meaningful, real-world tasks. Lena reached 100% independence by the final intervention session in two of the three activities (i.e., shredding and bus riding) in a very short period of time (i.e., 5–8 intervention sessions). The notable increase in independent performance in a short time frame suggested that the EasyVSD app was an effective tool to increase both task completion and effective communication within real-world contexts. Although previous studies have evaluated the use of video self-prompting during community-based activities by individuals with ASD (e.g., Bereznak et al., 2012; van Laarhoven et al., 2012), this study was the first to investigate the use of technology to support both independent participation and effective expressive communication within real-world contexts.
It should be noted that Lena was independent in the sense that she did not require support or prompting from a job coach or aide in order to complete the tasks. She continued to benefit from the tablet to self-prompt performance and communication. Her independence with the support of the tablet as a self-prompting tool has significant implications for the development of self-determination (McNaughton & Beukelman, 2010). Additionally, this type of independence may increase cost effectiveness, by reducing staffing needs.
A number of factors may have contributed to the effectiveness of this intervention. The intervention seamlessly infused several evidence-based practices for individuals with ASD and CCN: (1) VSDs that depicted vocabulary within meaningful contexts, (2) video self-prompting to support independent task completion, (3) task analysis to break complex tasks into manageable units, (4) videos with automatic pauses (i.e., time delay) after each step to prompt completion of the required step and VSDs with briefly highlighted hotspot(s) to prompt communication as required, and (5) least-to-most prompting to allow multiple opportunities for independent use of the tablet. Another reason for the effectiveness of the intervention may be that it allowed Lena to respond to relevant aspects of the environment independently, without direct prompting from adults. Often, learners with ASD become prompt-dependent, meaning that they respond to prompts rather than cues in the environment that should evoke a target behavior (MacDuff, Krantz, & McClannahan, 2001). The videos with integrated VSDs and embedded hotspots likely provided Lena with a visual support that allowed her to independently respond to meaningful cues within the environment, decreasing her prompt dependence. For example, prior to the intervention, Lena consistently required verbal prompting to greet others (e.g., “Say hi to the bus driver”). Using the video VSD app, the hotspot that appeared provided a visual cue to support Lena in greeting others appropriately, without direct verbal prompting from an aide or job coach.
Another important consideration of the current investigation was the use of text captions. Because the introduction of the text captions in the intervention was not controlled, it was unclear whether their addition to the video VSD app benefitted or detracted from the success of the intervention. In the print shop context, Lena appeared to benefit from the text captions as a means of self-prompting, and the data reflected an increase in independent performance upon the introduction of the captions. In the other two contexts (i.e., bus riding and shredding), a slight decrease in the percent of steps independently completed was noted upon introduction of the text captions, followed by an increase in the final intervention session. Text captions could be advantageous for individuals with relative strengths in literacy because they provide a support for comprehension (in addition to the video) to aid in task completion (see Reagon, Higbee, & Endicott, 2007). Alternatively, it is possible that the additional cognitive demand of reading text captions could detract from the intervention. Previous research has indicated that individuals with developmental disabilities can benefit from videos that include text captions (e.g., Norman, Collins, & Schuster, 2001); however, there has been limited research directly comparing video interventions with and without text captions. This warrants future research.
A final important consideration is the types of communication opportunities targeted within the intervention. Opportunities for greetings, dismissal, and social etiquette were targeted, rather than other functions such as social closeness or information sharing (Light, 1988). This reflected the expectations of the tasks included within the intervention. Particularly, the tasks did not require that Lydia engage in socializing or sharing information with others. Therefore, the communication opportunities targeted were ecologically valid given the expectations of the tasks. However, given the narrow range of communicative functions targeted, the ability to evaluate the impact of the app on communication outcomes was somewhat limited.
Clinical Implications
This study suggests that videos with integrated VSDs provide a means to seamlessly infuse video prompting and communication in order to increase participation and communication for individuals with ASD and CCN in real world contexts. Video VSDs have the potential to increase independence and decrease reliance on prompting from staff (e.g., job coaches) for individuals with CCN. This type of app may create increased opportunities for employment and independent participation in meaningful community activities. Additionally, it is possible that once an individual is taught to use video VSDs within several contexts, their use may be applied across a wide range of settings and skills to support greater participation and independence. While not examined in the current study, it is possible that the use of videos could be faded as proficiency in task performance and independent communication increases.
Given the effectiveness of the videos with integrated VSDs in the current investigation, clinicians may benefit from incorporating similar technology in intervention with individuals who have ASD and CCN. Technology that incorporates videos with integrated VSDs is currently under development. 1   In the meantime, there are several methods clinicians may utilize to achieve similar results. For example, clinicians can use apps that incorporate still VSDs (e.g., GoTalk NOW 4 , SnapScene 5 ). The still VSDs could depict each step of a multi-component task and include hotspots when necessary to allow the individual to communicate effectively within the tasks. Alternatively, clinicians could utilize a video prompting app (e.g., iModeling 6 , InPromptu 7 ) in combination with a learner's existing AAC system.
Limitations and Future Research Directions
This pilot case study makes a contribution to the field by investigating an innovative app designed to increase the participation and communication of an individual with ASD and CCN in employment and community activities, a significantly under-researched topic. However, despite the contribution of this case study to the field, there are a number of limitations that readers should consider in interpreting the results. The current study did not use an experimental design. Therefore, one cannot say with certainty that a functional relation existed between the independent variable and the dependent variable (Kazdin, 2010). However, given the notable gains in performance across 3 real world contexts, it seems likely that these gains can be attributed to the introduction of the video VSD technology.
Another limitation is that generalization of the results is limited due to the inclusion of only one participant. Although Lena had no prior experience using the video VSD app, she did have experience using other technologies independently. It is possible that more training on the use of the app would be required for learners with less developed technology skills. Furthermore, maintenance and generalization data could not be collected, as Lena did not consistently participate in shredding and bus riding during the regular school year. Although she did continue to work in the print shop, a scheduling conflict prevented further data collection in this context. A final limitation is that a limited sample of intervention sessions were evaluated for procedural integrity.
Future experimental research with increased numbers of learners of various diagnoses and skill levels across multiple contexts is needed to provide additional information regarding the effects of videos with integrated VSDs on participation and communication within real world contexts for individuals with CCN. This research should include maintenance and generalization phases in order to evaluate the long-term effectiveness and generalizability of skills. There are several additional avenues for future research. First, future investigations may investigate “chunking” of videos into longer segments as learners increase proficiency. Second, future investigations may benefit from evaluating outcomes related to communication separately from outcomes related to task completion. Third, the use of video VSDs to support communicative functions in addition to social etiquette and greetings/dismissals, such as exchanging information, may be examined. Third, future research is necessary to determine if text captions within video VSDs are beneficial, and for whom they may be beneficial. Finally, future research should consider other applications of the video VSD app to enhance participation and communication of individuals with CCN (e.g., as a video schedule to support successful transitions between activities, as a shared context to promote social interaction, etc.).
Conclusion
This is the first investigation that has evaluated the combination of video instruction and VSDs to support participation and communication within real-world settings. Moving forward, it is critical that AAC research and practice target participation of individuals with CCN within meaningful, real-world tasks. The current investigation suggests that videos with integrated VSDs may serve as an effective tool to support meaningful, independent participation and communication of learners with ASD within vocational and community activities, while reducing reliance on prompting from adults. This may allow individuals with CCN to have greater access to employment opportunities, meaningful participation in society, and ultimately higher quality of life.
References
Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.
Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.×
Bereznak, S., Ayres, K. M., Mechling, L. C., & Alexander, J. L. (2012). Video self-prompting and mobile technology to increase daily living and vocational independence for students with autism spectrum disorders. Journal of Developmental and Physical Disabilities, 24, 269–285. https://doi.org/10.1007/s10882-012-9270-8 [Article]
Bereznak, S., Ayres, K. M., Mechling, L. C., & Alexander, J. L. (2012). Video self-prompting and mobile technology to increase daily living and vocational independence for students with autism spectrum disorders. Journal of Developmental and Physical Disabilities, 24, 269–285. https://doi.org/10.1007/s10882-012-9270-8 [Article] ×
Beukelman, D. R., Hux, K., Dietz, A., McKelvey, M., & Weissling, K. (2015). Using visual scene displays as communication support options for people with chronic, severe aphasia: A summary of AAC research and future research directions. Augmentative and Alternative Communication, 31, 234–245. https://doi.org/10.3109/07434618.2015.1052152 [Article] [PubMed]
Beukelman, D. R., Hux, K., Dietz, A., McKelvey, M., & Weissling, K. (2015). Using visual scene displays as communication support options for people with chronic, severe aphasia: A summary of AAC research and future research directions. Augmentative and Alternative Communication, 31, 234–245. https://doi.org/10.3109/07434618.2015.1052152 [Article] [PubMed]×
Bryen, D. N., Potts, B. B., & Carey, A. C. (2007). So you want to work? What employers say about job skills, recruitment and hiring employees who rely on AAC. Augmentative and Alternative Communication, 23, 126–139. https://doi.org/10.1080/07434610600991175 [Article] [PubMed]
Bryen, D. N., Potts, B. B., & Carey, A. C. (2007). So you want to work? What employers say about job skills, recruitment and hiring employees who rely on AAC. Augmentative and Alternative Communication, 23, 126–139. https://doi.org/10.1080/07434610600991175 [Article] [PubMed]×
Cihak, D. F., & Schrader, L. (2008). Does the model matter? Comparing video self-modeling and video adult modeling for task acquisition and maintenance by adolescents with autism spectrum disorders. Journal of Special Education Technology, 23, 9–20. https://doi.org/10.1177/016264340802300302 [Article]
Cihak, D. F., & Schrader, L. (2008). Does the model matter? Comparing video self-modeling and video adult modeling for task acquisition and maintenance by adolescents with autism spectrum disorders. Journal of Special Education Technology, 23, 9–20. https://doi.org/10.1177/016264340802300302 [Article] ×
Cooper, J. O. (1987). Stimulus control. In Cooper, J. O., Heron, T. E., & Heward, W. L. (Eds.), Applied behavior analysis (pp. 299–326). Columbus, OH: Merrill.
Cooper, J. O. (1987). Stimulus control. In Cooper, J. O., Heron, T. E., & Heward, W. L. (Eds.), Applied behavior analysis (pp. 299–326). Columbus, OH: Merrill.×
Kazdin, A. E. (2010). Single-case research designs: Methods for clinical and applied settings (2nd ed.). New York, NY: Oxford University Press.
Kazdin, A. E. (2010). Single-case research designs: Methods for clinical and applied settings (2nd ed.). New York, NY: Oxford University Press.×
Light, J. (1988). Interaction involving individuals using augmentative and alternative communication systems: State of the art and future directions. Augmentative and Alternative Communication, 4, 66–82. https://doi.org/10.1080/07434618812331274657 [Article]
Light, J. (1988). Interaction involving individuals using augmentative and alternative communication systems: State of the art and future directions. Augmentative and Alternative Communication, 4, 66–82. https://doi.org/10.1080/07434618812331274657 [Article] ×
Light, J. C., & Binger, C. (1998). Building communicative competence with individuals who use augmentative and alternative communication. Baltimore, MD: Paul H. Brookes.
Light, J. C., & Binger, C. (1998). Building communicative competence with individuals who use augmentative and alternative communication. Baltimore, MD: Paul H. Brookes.×
Light, J., & Drager, K. (2011). Early intervention for young children with autism, cerebral palsy, Down syndrome, and other disabilities. Retrieved from https://aackids.psu.edu
Light, J., & Drager, K. (2011). Early intervention for young children with autism, cerebral palsy, Down syndrome, and other disabilities. Retrieved from https://aackids.psu.edu ×
Light, J., & McNaughton, D. (2012). Supporting the communication, language, and literacy development of children with complex communication needs: State of the science and future research priorities. Assistive Technology, 24, 34–44. https://doi.org/10.1080/10400435.2011.648717 [Article]
Light, J., & McNaughton, D. (2012). Supporting the communication, language, and literacy development of children with complex communication needs: State of the science and future research priorities. Assistive Technology, 24, 34–44. https://doi.org/10.1080/10400435.2011.648717 [Article] ×
Light, J., & McNaughton, D. (2015). Designing AAC research and intervention to improve outcomes for individuals with complex communication needs. Augmentative and Alternative Communication, 31, 85–96. https://doi.org/10.3109/07434618.2015.1036458 [Article] [PubMed]
Light, J., & McNaughton, D. (2015). Designing AAC research and intervention to improve outcomes for individuals with complex communication needs. Augmentative and Alternative Communication, 31, 85–96. https://doi.org/10.3109/07434618.2015.1036458 [Article] [PubMed]×
Light, J., McNaughton, D., & Jakobs, T. (2014). Developing AAC technology to support interactive video visual scene displays. RERC on AAC: Rehabilitation Engineering Research Center on Augmentative and Alternative Communication. Retrieved from https://rerc-aac.psu.edu/development/d2-developing-aac-technology-to-support-interactive-video-visual-scene-displays/
Light, J., McNaughton, D., & Jakobs, T. (2014). Developing AAC technology to support interactive video visual scene displays. RERC on AAC: Rehabilitation Engineering Research Center on Augmentative and Alternative Communication. Retrieved from https://rerc-aac.psu.edu/development/d2-developing-aac-technology-to-support-interactive-video-visual-scene-displays/ ×
MacDuff, G. S., Krantz, P. J., & McClannahan, L. E. (2001). Prompts and prompt-fading strategies for people with autism. In Maurice, C., Green, G., & Fox, R. M. (Eds.), Making a difference: Behavioral intervention for autism. Austin, TX: PRO-Ed.
MacDuff, G. S., Krantz, P. J., & McClannahan, L. E. (2001). Prompts and prompt-fading strategies for people with autism. In Maurice, C., Green, G., & Fox, R. M. (Eds.), Making a difference: Behavioral intervention for autism. Austin, TX: PRO-Ed.×
McNaughton, D. B., & Beukelman, D. R. (2010). Transition strategies for adolescents and young adults who use AAC. Baltimore, MD: Paul H. Brookes.
McNaughton, D. B., & Beukelman, D. R. (2010). Transition strategies for adolescents and young adults who use AAC. Baltimore, MD: Paul H. Brookes.×
McNaughton, D., & Bryen, D. N. (2002). Enhancing participation in employment through AAC technologies. Assistive Technology, 14, 58–70. https://doi.org/10.1080/10400435.2002.10132055 [Article] [PubMed]
McNaughton, D., & Bryen, D. N. (2002). Enhancing participation in employment through AAC technologies. Assistive Technology, 14, 58–70. https://doi.org/10.1080/10400435.2002.10132055 [Article] [PubMed]×
Minshew, N., & Williams, D. (2008). Brain–behavior connections in autism. In Buron, K. & Wolfberg, P. (Eds.), Learners on the autism spectrum: Preparing highly qualified educators (pp. 55–82). Shawnee Mission, KS: Autism Asperger Publishing Company.
Minshew, N., & Williams, D. (2008). Brain–behavior connections in autism. In Buron, K. & Wolfberg, P. (Eds.), Learners on the autism spectrum: Preparing highly qualified educators (pp. 55–82). Shawnee Mission, KS: Autism Asperger Publishing Company.×
National Organization on Disability. (2010). Survey of Americans with disabilities. Retrieved from http://www.2010disabilitysurveys.org/pdfs/surveyresults.pdf
National Organization on Disability. (2010). Survey of Americans with disabilities. Retrieved from http://www.2010disabilitysurveys.org/pdfs/surveyresults.pdf ×
Norman, J. M., Collins, B. C., & Schuster, J. W. (2001). Using an instructional package including video technology to teach self-help skills to elementary students with mental disabilities. Journal of Special Education Technology, 16, 5–18. https://doi.org/10.1177/016264340101600301 [Article]
Norman, J. M., Collins, B. C., & Schuster, J. W. (2001). Using an instructional package including video technology to teach self-help skills to elementary students with mental disabilities. Journal of Special Education Technology, 16, 5–18. https://doi.org/10.1177/016264340101600301 [Article] ×
Pless, M., & Granlund, M. (2012). Implementation of the international classification of functioning, disability and health (ICF) and the ICF children and youth version (ICF-CY) within the context of augmentative and alternative communication. Augmentative and Alternative communication, 28, 11–20. https://doi.org/10.3109/07434618.2011.654263 [Article] [PubMed]
Pless, M., & Granlund, M. (2012). Implementation of the international classification of functioning, disability and health (ICF) and the ICF children and youth version (ICF-CY) within the context of augmentative and alternative communication. Augmentative and Alternative communication, 28, 11–20. https://doi.org/10.3109/07434618.2011.654263 [Article] [PubMed]×
Reagon, K. A., Higbee, T. S., & Endicott, K. (2007). Using video instruction procedures with and without embedded text to teach object labeling to preschoolers with autism: A preliminary investigation. Journal of Special Education Technology, 22, 13–20. https://doi.org/10.1177/016264340702200102 [Article]
Reagon, K. A., Higbee, T. S., & Endicott, K. (2007). Using video instruction procedures with and without embedded text to teach object labeling to preschoolers with autism: A preliminary investigation. Journal of Special Education Technology, 22, 13–20. https://doi.org/10.1177/016264340702200102 [Article] ×
Sigafoos, J., O'Reilly, M., Cannella, H., Upadhyaya, M., Edrisinha, C., Lancioni, G. E. , … Young, D. (2005). Computer-presented video prompting for teaching microwave oven use to three adults with developmental disabilities. Journal of Behavioral Education, 14, 189–201. https://doi.org/10.1007/s10864-005-6297-2 [Article]
Sigafoos, J., O'Reilly, M., Cannella, H., Upadhyaya, M., Edrisinha, C., Lancioni, G. E. , … Young, D. (2005). Computer-presented video prompting for teaching microwave oven use to three adults with developmental disabilities. Journal of Behavioral Education, 14, 189–201. https://doi.org/10.1007/s10864-005-6297-2 [Article] ×
van Laarhoven, T., Johnson, J. W., van Laarhoven-Myers, T., Grider, K. L., & Grider, K. M. (2009). The effectiveness of using a video iPod as a prompting device in employment settings. Journal of Behavioral Education, 18, 119–141. https://doi.org/10.1007/s10864-009-9077-6 [Article]
van Laarhoven, T., Johnson, J. W., van Laarhoven-Myers, T., Grider, K. L., & Grider, K. M. (2009). The effectiveness of using a video iPod as a prompting device in employment settings. Journal of Behavioral Education, 18, 119–141. https://doi.org/10.1007/s10864-009-9077-6 [Article] ×
van Laarhoven, T., Winiarski, L., Blood, E., & Chan, J. M. (2012). Maintaining vocational skills of individuals with autism and developmental disabilities through video modeling. Education and Training in Autism and Developmental Disabilities, 447–461.
van Laarhoven, T., Winiarski, L., Blood, E., & Chan, J. M. (2012). Maintaining vocational skills of individuals with autism and developmental disabilities through video modeling. Education and Training in Autism and Developmental Disabilities, 447–461.×
Wehmeyer, M. L., Palmer, S. B., Smith, S. J., Davies, D. K., & Stock, S. (2008). The efficacy of technology use by people with intellectual disability: A single-subject design meta-analysis. Journal of Special Education Technology, 23, 21–30. https://doi.org/10.1177/016264340802300303 [Article]
Wehmeyer, M. L., Palmer, S. B., Smith, S. J., Davies, D. K., & Stock, S. (2008). The efficacy of technology use by people with intellectual disability: A single-subject design meta-analysis. Journal of Special Education Technology, 23, 21–30. https://doi.org/10.1177/016264340802300303 [Article] ×
Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., Kucharczyk, S. , … Schultz, T. R. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45, 1951–1966. https://doi.org/10.1007/s10803-014-2351-z [Article] [PubMed]
Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., Kucharczyk, S. , … Schultz, T. R. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45, 1951–1966. https://doi.org/10.1007/s10803-014-2351-z [Article] [PubMed]×
World Health Organization. (2001). International classification of functioning, disability, and health (ICF). Geneva, Switzerland: Author.
World Health Organization. (2001). International classification of functioning, disability, and health (ICF). Geneva, Switzerland: Author.×
Appendix A.
Social Validity Questions
Questions for learner Questions for job coaches Questions for mother and teacher (following video review)
• Did you like using the app? • Do you think Lena enjoyed using the app? Why or why not? • In which video do you think Lena demonstrated greater independence? How could you tell?
• Do you think that the app helped you at the print shop? • Do you think that the app helped Lena to perform vocational and community tasks? Why or why not? • In which video do you think Lena communicated more effectively? How could you tell?
• Do you think that the app helped you during shredding? • Do you think the text descriptions were helpful? Why or why not?
• Do you think the app helped you to ride the bus? • What suggestions do you have to improve the app or intervention?
• Did you like the app better with text or without?
• Would you like to use the app for other jobs in the future?
Questions for learner Questions for job coaches Questions for mother and teacher (following video review)
• Did you like using the app? • Do you think Lena enjoyed using the app? Why or why not? • In which video do you think Lena demonstrated greater independence? How could you tell?
• Do you think that the app helped you at the print shop? • Do you think that the app helped Lena to perform vocational and community tasks? Why or why not? • In which video do you think Lena communicated more effectively? How could you tell?
• Do you think that the app helped you during shredding? • Do you think the text descriptions were helpful? Why or why not?
• Do you think the app helped you to ride the bus? • What suggestions do you have to improve the app or intervention?
• Did you like the app better with text or without?
• Would you like to use the app for other jobs in the future?
×
Footnotes
1 EasyVSD is an AAC application created by InvoTek, Inc. This technology will be available for purchase in the future. http://www.invotek.org/
EasyVSD is an AAC application created by InvoTek, Inc. This technology will be available for purchase in the future. http://www.invotek.org/ ×
2 Samsung Galaxy Note Pro 6® is an Android tablet computer, developed by Samsung Electronics. www.samsung.com
Samsung Galaxy Note Pro 6® is an Android tablet computer, developed by Samsung Electronics. www.samsung.com ×
3 Movie Maker is a video editing software application created by Windows. http://www.windows-movie-maker.org/
Movie Maker is a video editing software application created by Windows. http://www.windows-movie-maker.org/ ×
4 GoTalk NOW is an AAC application created by Attainment Company https://www.attainmentcompany.com/gotalk-now
GoTalk NOW is an AAC application created by Attainment Company https://www.attainmentcompany.com/gotalk-now ×
5 Snap Scene is a an AAC application created by Tobii Dynavox http://mytobiidynavox.com/Store/SnapScene
Snap Scene is a an AAC application created by Tobii Dynavox http://mytobiidynavox.com/Store/SnapScene ×
6 iModeling is a video modeling app created by Autism SA. https://itunes.apple.com/au/app/imodeling/id457539171?mt=8
iModeling is a video modeling app created by Autism SA. https://itunes.apple.com/au/app/imodeling/id457539171?mt=8 ×
7 InPromptu is a video prompting app created by the special education department at Ohio State University. https://itunes.apple.com/us/app/inpromptu/id473450377?mt=8
InPromptu is a video prompting app created by the special education department at Ohio State University. https://itunes.apple.com/us/app/inpromptu/id473450377?mt=8 ×
Figure 1.

Screenshot of the Video VSD App From the Bus Riding Context; It Depicts a VSD With an Embedded Hotspot (“Hello”) Used To Greet the Bus Driver. The VSD includes a text caption describing the required step.

 Screenshot of the Video VSD App From the Bus Riding Context; It Depicts a VSD With an Embedded Hotspot (“Hello”) Used To Greet the Bus Driver. The VSD includes a text caption describing the required step.
Figure 1.

Screenshot of the Video VSD App From the Bus Riding Context; It Depicts a VSD With an Embedded Hotspot (“Hello”) Used To Greet the Bus Driver. The VSD includes a text caption describing the required step.

×
Figure 2.

Percent of Steps Completed Independently by Lena During Baseline and Intervention Across Three Contexts.

 Percent of Steps Completed Independently by Lena During Baseline and Intervention Across Three Contexts.
Figure 2.

Percent of Steps Completed Independently by Lena During Baseline and Intervention Across Three Contexts.

×
Table 1. Task Analysis of Target Activities.
Task Analysis of Target Activities.×
Print shop job Public transportation Shredding job
1. Thank the van driver 1. Walk to the bus stop 1. Say goodbye to classmates
2. Exit the van 2. Look at the schedule for the time of the next bus 2. Exit the classroom and walk to the office
3. Greet job coach 3. Wait for the bus to arrive 3. Enter the office
4. Enter building and walk to the print shop 4. Get on the bus 4. Greet the secretaries
5. Get folder from the shelf 5. Greet the bus driver 5. Walk to the shredding room
6. Write date and time on sign in sheet 6. Give bus pass to the driver 6. Turn on the shredder
7. Return folder to the shelf 7. Walk to seat, sit down, and wait 7. Put papers through the slot
8. Get the die cuts from the shelf and bring to the table 8. Pull cord when stop is next 8. When the shredder stops, open the door and pull out the bag
9. Put paper on the die cut 9. Get up and walk to exit 9. Pick up scraps on the floor
10. Turn over the die cut and place in press 10. Thank the bus driver 10. Dump shredding bag into garbage can
11. Pull down the lever one time 11. Exit the bus 11. Slide bag into shredder
12. Slide out the block and remove the die cut 12. Close the shredder door
13. Recycle the paper scraps 13. Turn off the shredder and exit shredding room
14. Return the die cut to the shelf 14. Say goodbye to secretaries
15. Brush off the tables with the dust pan 15. Return to classroom
16. Get folder from the shelf 16. Enter classroom and greet classmates
17. Sign out with time and initials
18. Return folder to the shelf
19. Leave the print shop and walk outside
20. Say goodbye to job coach
21. Get on the van
22. Greet the van driver
Note. Steps that are in bold represent communication opportunities.
Note. Steps that are in bold represent communication opportunities.×
Table 1. Task Analysis of Target Activities.
Task Analysis of Target Activities.×
Print shop job Public transportation Shredding job
1. Thank the van driver 1. Walk to the bus stop 1. Say goodbye to classmates
2. Exit the van 2. Look at the schedule for the time of the next bus 2. Exit the classroom and walk to the office
3. Greet job coach 3. Wait for the bus to arrive 3. Enter the office
4. Enter building and walk to the print shop 4. Get on the bus 4. Greet the secretaries
5. Get folder from the shelf 5. Greet the bus driver 5. Walk to the shredding room
6. Write date and time on sign in sheet 6. Give bus pass to the driver 6. Turn on the shredder
7. Return folder to the shelf 7. Walk to seat, sit down, and wait 7. Put papers through the slot
8. Get the die cuts from the shelf and bring to the table 8. Pull cord when stop is next 8. When the shredder stops, open the door and pull out the bag
9. Put paper on the die cut 9. Get up and walk to exit 9. Pick up scraps on the floor
10. Turn over the die cut and place in press 10. Thank the bus driver 10. Dump shredding bag into garbage can
11. Pull down the lever one time 11. Exit the bus 11. Slide bag into shredder
12. Slide out the block and remove the die cut 12. Close the shredder door
13. Recycle the paper scraps 13. Turn off the shredder and exit shredding room
14. Return the die cut to the shelf 14. Say goodbye to secretaries
15. Brush off the tables with the dust pan 15. Return to classroom
16. Get folder from the shelf 16. Enter classroom and greet classmates
17. Sign out with time and initials
18. Return folder to the shelf
19. Leave the print shop and walk outside
20. Say goodbye to job coach
21. Get on the van
22. Greet the van driver
Note. Steps that are in bold represent communication opportunities.
Note. Steps that are in bold represent communication opportunities.×
×
Questions for learner Questions for job coaches Questions for mother and teacher (following video review)
• Did you like using the app? • Do you think Lena enjoyed using the app? Why or why not? • In which video do you think Lena demonstrated greater independence? How could you tell?
• Do you think that the app helped you at the print shop? • Do you think that the app helped Lena to perform vocational and community tasks? Why or why not? • In which video do you think Lena communicated more effectively? How could you tell?
• Do you think that the app helped you during shredding? • Do you think the text descriptions were helpful? Why or why not?
• Do you think the app helped you to ride the bus? • What suggestions do you have to improve the app or intervention?
• Did you like the app better with text or without?
• Would you like to use the app for other jobs in the future?
Questions for learner Questions for job coaches Questions for mother and teacher (following video review)
• Did you like using the app? • Do you think Lena enjoyed using the app? Why or why not? • In which video do you think Lena demonstrated greater independence? How could you tell?
• Do you think that the app helped you at the print shop? • Do you think that the app helped Lena to perform vocational and community tasks? Why or why not? • In which video do you think Lena communicated more effectively? How could you tell?
• Do you think that the app helped you during shredding? • Do you think the text descriptions were helpful? Why or why not?
• Do you think the app helped you to ride the bus? • What suggestions do you have to improve the app or intervention?
• Did you like the app better with text or without?
• Would you like to use the app for other jobs in the future?
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We've Changed Our Publication Model...
The 19 individual SIG Perspectives publications have been relaunched as the new, all-in-one Perspectives of the ASHA Special Interest Groups.