Behavioral intervention for autistic children focuses on building many skills in a short amount of time through individualized programming. That goal requires effective and efficient teaching strategies, such as prompting, which promotes the acquisition and independence of skills. However, not all prompts are effective for all learners.
In her OAR-funded 2021 study, “Stimulus Prompts in Tablet-based Instruction: An Assessment with Children with Autism,” Haven Niland, who was then pursuing a doctorate in health services research with a concentration in behavior analysis at the University of North Texas, used assessment-based instruction to identify effective and efficient stimulus prompts to teach matching skills to autistic children. Stimulus prompts are signs or signals that are used for a limited amount of time to signal the learner to complete a task.
Niland recruited five children between the ages of 3 and 6 from the University of North Texas Autism Center to participate. The children were recommended for the study because they needed to learn picture-picture or word-picture matching skills, and effective and efficient prompts were needed to teach those skills. Niland used tablet-based instruction to reduce practical barriers to using stimulus prompts.
She and her research team designed and conducted an assessment to determine whether the children could use tablet-based instruction. The assessment evaluated their ability to master matching tasks when a tablet showed images and played audio. The children completed the assessment during their individual instruction time while enrolled in behavioral intervention services.
After reviewing 50 of the top free and paid children’s apps and games in the Apple and Google Play stores, Haven chose the most common stimulus prompts found in those apps and games – motion and pointing – to evaluate in her study.
Only three of the five children participated in the prompt assessment due to treatment circumstances. In order to compare the efficacy and efficiency of the stimulus prompts, Niland alternated treatment for each teaching condition, assigning unique learning targets. Teaching included three conditions.
All images and words were presented on a tablet using Microsoft PowerPoint. Niland presented the tablet on the table in front of the child and swiped through the slides to present matching trials with embedded prompts for the child to match a picture to a picture or a word to picture. The prompts were introduced immediately at first and then faded to give the child a chance to respond on their own. A child was considered to have mastered the prompt with 100% correct responses in two consecutive sessions.
The outcomes of this study are informative for clinical programming for participants and other children for whom stimulus prompts and tablet-based instruction may be appropriate.
Tablet-readiness assessment: The tablet-readiness assessment indicated that all of the children could participate in tablet-based instruction that involves previously mastered matching tasks. Four of the five children mastered the tablet-readiness assessment without additional instruction, and one mastered the assessment with additional training.
The same assessment and component skills training program could be used by practitioners who are considering using tablet-based instruction. More evaluation is needed to determine whether success with this assessment is indicative of success with learning new or different (e.g., labeling) skills on the tablet. Identification and dissemination of the skills that a child needs in order to benefit from tablet-based instruction could help practitioners explore options for more children to learn on tablets.
Prompt assessment: Two of the three children who participated in the prompt assessment learned matching tasks with response prompts (e.g., pointing, modeling) and printed picture flashcards. Of those two, one did not learn the targets in the stimulus-prompt assessment, even with additional modifications. The other participant did respond correctly with error correction. Extra-stimulus prompts resulted in more consistently accurate responses. The third participant had just begun the prompt assessment, as of the final report to OAR.
Other practitioners may use this assessment methodology to evaluate stimulus prompts for their learners. The lack of acquisition with the initial prompt-fading procedure indicates that future assessments should consider modifying this procedure and consider other modifications depending on their learner’s error patterns. If stimulus prompts are found to be effective for any participant, this study will provide data to suggest ones that may be effective for other learners or similar programs and create the possibility for them to be implemented feasibly in applied practice.
Sherri Alms is the freelance editor of The OARacle, a role she took on in 2007. She has been a freelance writer and editor for more than 20 years.
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