News and Knowledge

OAR-funded researcher Laura C. Chezan, Ph.D., BCBA-D., an assistant professor of special education at Old Dominion University in Norfolk, Va., conducted a study in 2015 to test the use of an intervention that teaches children with ASD and language delays to wait to receive something they request.

Numerous studies have demonstrated the effectiveness of functional communication training to establish socially acceptable communication for children who have little or no functional speech. However, many children with autism spectrum disorder (ASD) who learn to request access to something they want through functional communication training make requests at higher rates than their caregivers can reasonably fulfill. For that reason, it’s important to teach children who use functional communication to wait for a response when one is not immediately given.

Two young children, both boys, one age 5 and the other 6, participated in this study. The five-year-old used an electronic communication device to ask for items or activities. The six-year-old was non-vocal and used gestures, picture symbols, and sign language to ask for items or activities.

Methodology

The therapists who worked with the boys used a visual timer to let the children know that the item they were asking for was either available (the timer showed a green light) or not (the timer showed a red light). The color of the timer automatically changed when a predetermined amount of time elapsed.

In the first phase of the study, the therapists taught the children to ask for something they liked when the timer was green and not to ask if it was red. The therapist placed the item in the child’s sight but out of his reach and made the communication system available to the child. Then, the therapist turned on the green light. If the child asked for the item, the therapist pointed to the green light and said “green” while immediately giving the item to the child. The therapist allowed the child to eat the item chosen if it was food or to play with the chosen toy for a predetermined amount of time.

After the time elapsed and the timer turned red, the therapist removed the toy from the child’s reach but not out of sight. If the child asked for the item during this time, the therapist pointed to the red light, said “red,” and did not give the item to the child. The therapist did not engage in an alternative activity with the child and did not respond to problem behavior.

The therapists gradually increased the length of time the item was unavailable while decreasing the amount of time the item was available.

In the next phase, the therapists allowed the children to choose an alternate activity — either a work task or a leisure activity — during the time the timer’s light was red. If the child selected an activity within six seconds, the therapist immediately provided that activity. The child was allowed to engage in the activity as long as the light was red. If the child did not select an activity within six seconds, the therapist removed the choices and allowed the child to wait without engaging in any activity.

To be able to function effectively during natural routines, each child was eventually required to wait a specific period of time when the item was not available. The duration was 10 minutes for the five-year-old and five minutes for the six-year-old. Prior to each training session, the therapist placed an item in the child’s sight but out of reach and made the communication system available to the child. Then, the therapist began the session by turning on the red light of the timer and presenting the child with a choice of two alternate activities.

Each phase of the intervention consisted of four intervention sessions per day five days per week over a two-month period.

Results

Eight weeks after the intervention ended, Dr. Chezan and her team conducted a session to determine whether the children continued to use waiting skills. Both children used waiting skills during that session.

The study results suggested that an individual with autism can learn waiting skills when a preferred item or activity is not immediately available. A parent can provide a choice of alternative items during periods when a preferred item or activity is not available to reduce the likelihood of high-rate requests displayed by a child with ASD. A teacher can implement this intervention in applied settings to teach waiting skills with fidelity.