INDIVIDUAL TOPIC SEARCH STRATEGY (ITSS) GUIDELINES
PURPOSE
· The purpose of this initial paper is to briefly describe your search strategies when identifying an articles that pertain to an evidence-based practice topic of interest.
REQUIREMENTS/PREPARING THE PAPER
· Each student will sign-up for a group to formulate an evidence-based practice topic of interest
(My topic is Interventions to promote social interactions in children with autistic disorder spectrum)
· Each group will formulate research question using PICO format.
P: Children with autistic disorder
I: Play therapy
C: no therapy, no intervention
O: increase social behaviors
· Each group member will search, retrieve, and receive approval for 1 PRIMARY DATA ARTICLE to answer the group Research Question.
(I will attached the article for you to use my professor already approved it)
· Paper should include a Title and Reference pages.
· Page Length: 3-4 pages Excluding Title and Reference pages
· PAPER FORMAT
Clinical Question
Research Question- Describe problem
· Accurately and clearly states your research question using PICO format
· P: Children with autistic disorder
· I: Play therapy
· C: no therapy, no intervention
· O: increase social behaviors
Overview of the Problem- Overview/Significance of problem in terms of outcomes or statistics
· What statistics document this is a problem? (facts and figures)
Significance of the Problem-
· What statistic document this is a problem?
· What health outcomes result from this problem. Why should people be concerned about this problem?
Purpose of Paper:
The purpose of this paper is to describe search strategies to find evidence in supporting our groups PICO question.
Search Strategy
Search Terms
· List all terms used to search for your article (i.e. breast cancer, screening, mammography, intervention, assessment, influencing factors….etc.)
(I used autism, social behavior, and therapy)
Library Databases
· List Chamberlain library database used (i.e. EBSCO, Medline, OVID, PubMed….etc.)
· Google search engine is NOT the library database
(I used EBSCO)
Availability of Articles
· How many research articles were available to answer your research question?
· Provide numbers of articles, NOT just saying “plenty, sufficient, many…etc.
Refinement Decisions
· What decision(s) have changed from your original search strategies? (i.e. peer-review, within last 5 years, primary data article, full-text….etc.)
· As you did your search, what decisions did you make in refinement to get your required articles down to a reasonable number for review?
· What was your rationale for your decision to change from original search strategies?
Final Article
· Describe decisions you made to specifically select 1 PRIMARY DATA ARTICLE as relevant for answering your Research Question
Level of Evidence
Addresses Topic/Relevance to PICO
· Describe how article addresses the topic, purpose and key points
Evidence Level Pyramid
· Identify and describe the level of evidence based on Evidence Level/Hierarchy Pyramid
· Refers to Handout (Quick Guide to Designs in an Evidence Hierarchy)
Study Type
· Identify study type of article: Quantitative, Qualitative, or Mixed-Method Study
Format
§ Use of headings for each section
§ Use of APA format (7th edition)
ORIGINAL ARTICLE
The Effectiveness of Video Self-Modeling in Teaching Active Video Game Skills to Children with Autism Spectrum Disorder
Erkan Kurnaz1 & Mehmet Yanardag1
Published online: 24 March 2018 # Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Video self-modeling (VSM) is a teaching method in video-based ap- proaches for children with Autism Spectrum Disorder (ASD), who have a limited repertoire of leisure skills and tend towards sedentary behaviours. The aim of this study was to investigate the effectiveness of the video self-modeling procedure in teaching active video game skill to children with ASD. The study included 4 children with ASD aged 7 years, who participated in the study and were taught an active video game skill, consisting of multi-step skills (25), in a one-to-one training format in five sessions per week. A multiple probe design with probe conditions across subjects was used to analyse the effects of the VSM. The results of this study showed that VSM was effective in teaching active video game skills to children with ASD. The playing of the active video game was continued after the training process during maintenance and generalization probe sessions. In addition, the social validity data reflected positive results about acceptability of intervention, appropriateness of the goals, and importance of the outcomes. VSM could be utilized to teach motor imitation skills and increase the repertoire of leisure skills, and active video games are recommended to increase level of physical activity instead of non-active video games for children with ASD.
Keywords Autism . Video self-modeling . Active video game . Leisure skill . Physical activity
Autism spectrum disorder (ASD) is characterized by persistent deficits in social communi- cation and social interaction across multiple context, and restricted, repetitive patterns of
J Dev Phys Disabil (2018) 30:455–469 https://doi.org/10.1007/s10882-018-9596-y
* Mehmet Yanardag [email protected]
1 Research Institute for Individuals with Disability, Anadolu University, 26470 Eskisehir, Turkey
http://orcid.org/0000-0001-6058-1458
http://crossmark.crossref.org/dialog/?doi=10.1007/s10882-018-9596-y&domain=pdf
mailto:[email protected]
behaviour (DSM-5, American Psychiatric Association 2013). Individuals with ASD have difficulties in maintaining eye contact, sharing their interest and attention with each other, turn-taking during conversation, initiating-maintaining and terminating peer interaction, and using play skills to play games of pretend (Cardon 2015). Individuals with ASD had less physical activity level and lower motivates toward physical education than their peer (Pan et al. 2011; Savage et al. 2018), and the limited participation in physical activity was related to poor motor function (Baranek 2002) and needing extra prompts to initiate activity (Reid et al. 1991). Therefore, these characteristics of individuals with ASD could predispose them to engage in less physical activity (Reid 2005) and physical based leisure activities (Turygin and Matson 2014).
Leisure skills and activities have been taught to children with ASD so that they can enjoy free time. Leisure skills comprise the ability to identify, access, plan, and participate in activities, and the skills are important due to the positive effects on distress, coping skills, social involvement, social support, promoting appropriate re- sponses and psychological well-being (Chan et al. 2013; Garcia-Villamisar and Dattillo 2010). Leisure skills and activities include a solitary hobby (e.g. producing artwork), pleasurable activities (e.g. visiting tourist destinations), and attending concerts, exhibi- tions, movies, plays or playing video games (Turygin and Matson 2014; Blum-Dimaya et al. 2010). In recent years, active video games, or exergaming, has been utilized as a leisure activity for children and adolescents (Graf et al. 2009). It has more advantages than traditional video games that are played in a sitting position, in terms of preventing sedentary behaviours and providing opportunities for the children to increase their level of physical activity (Baranowski et al. 2008; Daley 2009; Foley and Maddison 2010). The video modeling has been utilized to teach novel leisure skills to children with ASD (Blum-Dimaya et al. 2010; Lee et al. 2017; Yanardag et al. 2013).
Video modeling involves the watching of video clips which provide a model for the child to imitate (Nikopoulos and Keenan 2006). The video modeling has been shown to be an evidence-based teaching strategy for children with ASD by the National Autism Center (NAC 2015). One procedure of the video modeling technology is video self- modeling (Buggey et al. 1999). Video self-modeling (VSM) is an intervention technique used to alter the frequency, quality and duration of the target behaviour or skill (Buggey 2009). A video is recorded the observer’s spontaneous behaviour over time in different contexts then editing the video to involve only the target behaviour or skills (Cihak and Schrader 2008; Collier-Meek et al. 2012). The concept of modeling was first introduced as a element of the social learning theory, which express that indivduals learn primarily through observing the behaviour or skill of those around them (Bandura 1997). VSM can be applied as positive self-review and feedforward to increase fluency of a skill or the acquisition of a new skill (Buggey 2005; Dowrick 2011). The positive self-review covers Bbetter^ form or episode among typical behaviours or skills in a task, and it has good results in the enhancement of the recently achieved skills (Dowrick 2011). Another procedure of the VSM is feedforward that an image of success is designed to show achievement beyond the individual’s current capability. The procedure facilitates remark- ably changes of target behaviour or skill and development of performance (Dowrick 2011). The effectiveness of VSM has been demonstrated across a variety of social (Buggey et al. 2016; Kabashi and Kaczmarek 2017; Liu et al. 2015), academic (Burton et al. 2013), vocational (Cihak and Schrader 2008), behaviour management (Nikopoulos and Panagiotopoulou 2015), and conversation skills (Sherer et al. 2001) for children with
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ASD. However, there have been no studies exploring the effect of VSM on teaching active video games as leisure skills for children with ASD.
The diagnostic features of ASD generally may affect the repertoire of leisure skills and activities, and these children may have difficulty learning a novel skill through observation or imitation of their friends or other individuals. Therefore, children with ASD may need assistance or receive prompt for exploring and learning novel leisure options (Coyne et al. 2011). The purpose of this study was to answer the following research questions: 1. Will the use of VSM procedure be effective in teaching active video game skills to four children with ASD? 2. Will these participants display the skills during the maintenance and generalization phases? 3. Will the intervention study has high social validity?
Methods
Participants
The study involved 3 boys and 1 girl with ASD, aged 7 years. Before the study, written informed parental consent and verbal approval were obtained from all the parents of the participants in compliance with the Declaration of Helsinki. The names of the partic- ipants have been substituted with pseudonyms for the study. Approval for the study was granted by the Ethics Committee of the university with research proposal number 10819–2015. To be able to teach the active video game skills using the VSM proce- dure, some prerequisite skills were identified before the intervention: (a) ability to follow visual and verbal prompts for at least 5 min, (b) ability to watch a video on the television (TV) or tablet for at least 3 min, (c) ability to imitate motor skills, and (d), watching images on the screen. All the participants met these criteria.
Sena was a 7-year old girl with ASD. She had been included in an inclusion program for primary school, and was also receiving both individual special education (two sessions a week) and group-based special education. She had difficulty in social integration and communication skills. She had learned the basic concepts (colour, shape, etc.) and numbers. Her parents reported that she preferred watching TV or playing games on a tablet when she had leisure time, and her weekly routine did not involve a regular physical education program.
Ata was a 7-year old boy with ASD. He had been included in a special education class in a primary school, and was also receiving both individual special education (two sessions a week) and group-based special education. He had difficulty in social integration and communication skills. He had learned the basic concepts (colour, shape, etc.) and was able to count 1–30. His parents reported that he preferred playing games on his tablet and was not involved in a regular physical education program.
Uğur was a 7-year old boy with ASD. He was receiving both individual special education (two sessions a week) and group-based special education (five sessions a week) in a developmental support centre. He could count 1–10 and had learned the concepts of colour and shapes. His leisure time was only composed of watching TV. He had difficulty in social integration and communication skills.
Ersen was a 7-year old boy with ASD. He had been included in a special education class in a primary school, and was also receiving both individual special education (two sessions a week) and group-based special education. He had difficulty in social
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integration and communication skills. He could reply to simple questions and show numbers (1–10) when it was demanded. His parents reported that he had not any physical activity or program in his leisure time. None of the participants had any experience of the VSM procedure and they had not any experience or knowledge about active video game skills.
Trainers
The first author conducted the video preparation and intervention phases of the research process. The second author carried out other tasks such as data collection, recording, analysis, and preparing the manuscript. Both authors have experience of video model- ing, single subject design, teaching, active video games, and children with ASD.
Setting
All instructional, probes, maintenance and generalization sessions were conducted in a research laboratory of the research institute for individuals with disabilities. All sessions were carried out in a one-to-one format, as five sessions a week in the laboratory, which was 14 m long, 10 m wide, and covered in an acoustic material.
Materials
A digital camera (Canon 7D Mark II DSLR) and video camera (Sony HandyCam) were used to record the target behaviours of each participant, and a laptop was used to upload and edit the video images. Movie maker software (Microsoft) and other softwares (Adobe Premiere CC, Sony Vegas Pro 11, Adobe Audition CC) were used to process the images. For the playing of the active video game by the participants, a games console (Microsoft XBOX 360), game (Microsoft XBOX Adventures) and Led TV (Samsung) were used in the study. Finally, a flash memory stick, data collections forms, a writing pad, and pencil were used to collect data.
Dependent Variable
The main purpose of the study was to determine the effects of VSM on the acquisition of active video game skills, called BMicrosoft XBOX Adventures^ in children with ASD. Thus, the target skill was described in detail (Table 1) to be able to reach a consensus on meeting the criteria and interobserver agreement. The applicability of the task analyses of the target skill was tested before the intervention phase by four individuals of a different age, gender, and education profile.
The dependent measure was the percentage of steps completed correctly on task analysis for the Microsoft XBOX Adventures. A correct step was scored when the participants independently completed the step as defined in Table 1. An incorrect step was scored when the participants did not perform the step as defined or did not respond within five second. Percentage of steps completed correctly was determined as the number of correct steps was divided by the total number of steps in the task analysis and multiplied by 100% for each participant.
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Experimental Design and Procedure
To determine the effects of VSM on the acquisition of active video game skills in children with ASD, a multiple probe design with probe conditions across subjects was used in the study (Kazdin 2011). The research process involved the following steps: the first baseline, the second baseline (after making video sessions), intervention (instruction) sessions, maintenance and generalization sessions (Goh and Bambara 2013). The dependent variable of the research was defined as the percentage of the correctly performed steps of the active video game skill.
Probe Sessions
Baseline probe sessions were conducted as the first baseline and second baseline. The purpose of the first baseline probe was to determine the independence level of the
Table 1 Task analyses for active video game skill
1. Participant takes the TV remote control from the table.
2. Participant pushes the red button of the remote control to switch the TVon.
3. Participant replaces the remote control on the table.
4. Participant pushes the button on the game console to switch the console on.
5. Participant pushes the button on the CD driver of the console to switch the driver on.
6. Participant turns on the CD box of the game.
7. Participant takes the game CD from the box.
8. Participant places the CD in the CD driver with the picture side uppermost.
9. Participant pushes the button on the CD driver of the console to switch the driver off.
10. Participant walks to the play area marked by yellow tape on the ground.
11. Participant follows some directions on the TV screen for one minute.
12. Participant waits five seconds to adjust the player position.
13. Participant elevates (300) the left arm to the side and waits five seconds when a line character shows on the TV screen.
14. Participant brings the hand symbol to the start symbol on the screen using his/her hands and waits for five seconds.
15. Participant follows the task directions on the screen for one minute.
16. Participant initiates active video game by jumping when the video character is seen on the screen.
17. Participant plays the active video game by imitating the video character’s movements (jump, tilt to the right and tilt to the left)
18. Participant elevates (300) the left arm to the side and waits five seconds to exit from the active video game.
19. Participant pushes the button on the CD driver of the console to switch the driver on.
20. Participant takes the game CD from the box.
21. Participant puts the game CD into the box.
22. Participant pushes the button on the game console to switch the console off.
23. Participant takes the TV remote control from the table.
24. Participant pushes the red button of the remote control to switch the TVoff.
25. Participant replaces the remote control on the table.
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participants for the target skill; three baseline sessions were conducted on three consecutive days. The purpose of the second baseline probe was to determine any incidental learning during making the video clips (Goh and Bambara 2013). A single opportunity procedure was used during the baseline and daily probe sessions. The procedures for the baseline sessions were (a) providing a verbal cue to gain the participant’s attention, (b) the participant was then asked to perform the skill, (c) five seconds were allowed for the participant to initiate the skill, (d) If the participant displayed the correct behaviour, the performance was recorded as plus (+) for that target skill, (e) If the participant performed an incorrect response, the performance was recorded as a minus (−), and the assessment was terminated (Brown and Snell 2000). After the probe procedure, praise was delivered at the end of the probe regardless of the participant’s performance.
Similarly, daily and full probe sessions were conducted exactly as the baseline sessions. The daily probe session was performed to determine the current per- formance of the participant to decide whether to stop the intervention process. The daily probe session was useful to observe when the criterion of the target skill had been reached. The daily probe sessions were regulated as one trial after each intervention session, and were maintained until a participant showed 100% correct performance in three consecutive daily probe sessions for the target skills. Full probe sessions were conducted before the intervention, and after reaching the criterion of the target skill (it was determined by the daily probe sessions), and were continued until a stable response had been demonstrated in at least three consecutive sessions. The full probe sessions were terminated after collecting the full probe data from the last participant.
Making Video Sessions
VSM clips were prepared after the first baseline sessions. For this purpose, video images were recorded while demonstrating the steps of the skill to all the participants. The recording speed of the videos was 18–135 mm. A Canon 7D Mark II DSLR camera and Sony HandyCam video camera and tripod were used in these sessions. Researchers, participants and ancillary staff were involved in these sessions. The participants were shown the steps of the target skill by the ancillary staff. A partial physical prompt was delivered by the staff to the participants to display some steps of the skill during the video recordings. To prevent possible an incidental learning, complex step sequences and different video recording angles were used during the sessions. Each step of the skill was recorded by two video cameras placed at different angles, and then these recordings were converted to form the VSM clip, which was used in the intervention phase of the research. The VSM clip was evaluated for validity by two special education experts. As a result of the expert evaluation, the VSM clip was specified as valid and understandable for the intervention process. The average duration of the video clip recording sessions for each participant was calculated as 15 h. It has been stated in literature that the length of the VSM clip in intervention sessions should not be longer than 5 min (Nikopoulos and Keenan 2006). In this study, the average length of the VSM clip was 3 min 25 s (range: 3 min 10 s – 3 min 45 s).
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Intervention Sessions
The VSM process for the active video game skill was initiated when the steady-state data was obtained after the second baseline probe session. The intervention sessions were performed as follows: (a) The researcher delivered an attentional cue (Bare you ready to watch a video clip?^) to the participant to focus on the task. The researcher provided verbal praise (Bwonderful^) if the participant replied verbally or with a sign. (b) The researcher and participant sat side by side at a table, and the participant watched the self-modeling video clip on a tablet. After watching the clip, the researcher asked, Bthe video has finished, would you like to watch it again?^ and waited for five seconds. If the participant wanted to watch the video clip again, the researcher provided the opportunity of watching it twice more. While watching the video clip, researcher did not give any information about the images to the participant. When the participant turned away from the screen, the researcher delivered a verbal prompt (Bwatch the video^) to maintain attention on watching the video clip. When the participant watched the video clip, the researcher provided verbal praise (Bwell done^). (c) The researcher and participant moved to the corner of the laboratory where the game console and TV were placed in order to perform the active video game immediately after watching the VSM clip. (d) The researcher provided an attentional cue (Bare you ready to play the video game?^) to the participant to focus on the task. (e). The researcher provided task direction (Bplay^) if the participant replied verbally or with a sign. The researcher delivered verbal reinforcement (Bwell done, bravo^) when the participant performed correctly the steps of the active video game skill. An intervention session was termi- nated if a participant performed an incorrect response or gave no response for five seconds. Two trials were performed for the target skill in every intervention session, and a one-hour break was given between the two trials.
Maintenance and Generalization Sessions
Maintenance sessions were implemented one, two, and four weeks after the participants met the instructional criterion, which was to display independent performance for the target skill. Maintenance sessions were performed in a similar manner to the probe sessions. Generalization across settings was evaluated by pre-post-test design. This was applied as a probe session before the intervention process and after the participants had reached the criteria for the active video game skill.
Data Collection and Analysis
Four types of data were collected during the study including effectiveness, mainte- nance, generalization, social validity and reliability data. Effectiveness, maintenance, and generalization data were collected via recording data of children’ correct and incorrect responses for the target skill and calculated the percentage of correct re- sponses. The collected data of effectiveness, maintenance and generalization phases was analysed graphically.
The reliability data was collected as interobserver agreement and procedural reli- ability from 30% of all the experimental sessions. Interobserver agreement was calcu- lated using the point-by-point method with a formula of the number of agreements
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divided by the number of agreements plus disagreements multiplied by 100 (Kazdin 2011). Interobserver agreement data were collected in full probe, daily probe, inter- vention, maintenance and generalization sessions for each participant. Procedural reliability (independent variable) was calculated by dividing the number of observed researcher behaviours by the number of planned researcher behaviours multiplied by 100 (Kazdin 2011). The researcher’s behaviours were observed as follows: (1) record- ing the video clip, (2) providing the attentional cue before watching the video clip, (3) delivering the self-modeling video images, (4) providing prompting/reinforcement while watching the video, (5) preparing materials, (6) providing the attentional cue before delivering task direction, (7) providing task direction, (8) delivering reinforce- ment after performing the task, (9) delivering verbal praise for collaboration.
Social validity data was collected to determine the parents’ opinions about study. In order to gather data from parents, social validity questionnaire form was developed. The form consisted of 6 closed questions (1. Do you think that the active video game skills which was taught in this research is important for your child? 2. Do you think that the active video game skill which was taught in this research will contribute to repertoire of the leisure skill of your child? 3. Do you satisfy to participate in the study that was taught active video game skills to your child by using video self modeling? 4. Do you think that your child learned the leisure skill? 5. Do you intend to buy an active video game console so that your child can maintain active video game skill during his/ her leisure time in home? 6. Would you consider re-joining a new intervention study that aims to teach a novel skill to your child by using VSM?) and two open ended questions (1. Would you describe the parts of the study that you approve? 2. Would you describe the parts of the study that you disapprove?). Parents were asked to write the answer of the questions under the items. The social validity forms were provided in closed envelopes to the parents and they were asked to reply and send the answers back in closed envelopes to the researchers. Answers of these questions were analysed descriptively.
Results
Interobserver Agreement and Procedural Reliability
Interobserver agreement data revealed that both researchers agreed on the participants’ performance during the first baseline probe session, second baseline probe session, daily probe session, full probe session, maintenance and generalization sessions, and it was calculated as 100% for all participants. Procedural reliability was calculated, and the researcher performed the above-mentioned procedures at 92% (range: 88–100%) for all participants.
The Effects of the Video Self-Modeling on the Active Video Game Skill
Figure 1 shows the effectiveness data as performance of the participants in the active video game skill during baseline, intervention, maintenance, and generalization
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FB MVS SB I FBS1 I FBS2 I FBS3 I FBS4 M P
er ce
nt o
f c or
re ct
r es
po ns
es
Sessions
Fig. 1 Percent of correct responses in video play skill for all participants. FB: First baseline SB: Second baseline MVS: Making video sessions I: Intervention sessions FPS: Full probe session M: Maintenance
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sessions. Each data point shows the percentage of correct responses during the sessions. As seen in Fig. 1, Sena displayed 0% performance for the active video game skill in the first and second baseline probe sessions. She showed an increase in the percentage of independent skill when VSM was provided, and she reached the acquisition criterion of 100% in the third intervention session. When she showed 100% performance in three consecutive sessions, the intervention sessions were terminated. The researcher con- ducted five sessions and ten trials in the intervention phase. She maintained the performance (100%) during all full probe and follow-up sessions. She also displayed 100% performance for the active video game skill when the generalization sessions were evaluated.
As seen in Fig. 1, Ata displayed 0% performance for the active video game skill in the first and second baseline probe sessions. He showed an increase in the percentage of independent skill when VSM was provided, and he reached the acquisition criterion of 100% in the fourth intervention session. When he showed 100% performance in three consecutive sessions, the intervention sessions were terminated. The researcher con- ducted six sessions and twelve trials in the intervention phase. He maintained the performance (100%) during all full probe and follow-up sessions. He also displayed 100% performance for the active video game skill when the generalization sessions were evaluated.
As seen in Fig. 1, Ugur displayed 16% performance for the active video game skill in the first and second baseline probe sessions. He showed an increase in the percentage of independent skill when VSM was provided, and he reached the acquisition criterion of 100% in the sixth intervention session. When he showed 100% performance in three consecutive sessions, the intervention sessions were terminated. The researcher con- ducted eight sessions and sixteen trials in the intervention phase. He maintained the performance (100%) during all full probe and follow-up sessions. He also displayed 100% performance for the active video game skill when the generalization sessions were evaluated.
As seen in Fig. 1, Ersen displayed 0% performance for the active video game skill in the first and second baseline probe sessions. He showed an increase in the percentage of independent skill when VSM was provided, and he reached the acquisition criterion of 100% in the sixth intervention session. When he showed 100% performance in three consecutive sessions, the intervention sessions were terminated. The researcher con- ducted six sessions and twelve trials in the intervention phase. He maintained the performance (100%) during all full probe and follow-up sessions. He also displayed 100% performance for the active video game skill when the generalization sessions were evaluated.
Social Validity Results
Social validity questionnaire forms were obtained from parents after the intervention process. Six closed and two open ended questions were asked to parents in order to determine the social validity data of the study. In the first closed question, all parents stated that playing active video game skills was important for their child. In the second closed question, all parents mentioned that the skill will contribute their repertoire of the leisure skills because they need some alternative skills during at home to occupy actively himself/herself. In the third closed question, all parents stated that they pleased
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to engage in this study owing to the target skills to create opportunities to play with peers. In the fourth closed question, all parents affirmed that all children learned the new leisure skill. In the fifth closed question, three parents stated that active video game console is needed because of maintaining the skill in the home and would buy it, whereas the forth parent told that it was not suitable for their economic condition. In the sixth closed question, all parents replied affirmatively because they liked the self modeling video clips instead of peer modeling, and their children are needed to grow the skill repertoire by providing not only regular school activities, but also other opportunities such as the research study. In the first open ended question, parents mentioned that they liked the VSM and the video clips could be used for home and school activities. Parents also stated that if the active video game skills could be applied as a leisure skill at home, it would be useful increasing the level of physical activity for their children, who had tended to have an inactive lifestyle for various reasons. In the second open ended question, parents mentioned that there was not any part they disliked in the study.
Discussion
The aim of this research study was to evaluate the effectiveness of VSM in teaching active video game skills to children with ASD. The findings of the study showed that the VSM was effective when teaching active video game skills to the four children with ASD. The effects of the VSM conditions showed a similar performance across participants. All the participants achieved criterion performance between 5 and 6 sessions, except for Ugur, who needed 8 sessions for the criteria. In order to prevent an incidental learning after making video clip session, second baseline was conducted and the first three data points in second baseline were similar to the data obtained in first baseline, and VSM intervention sessions were implemented. The rapid acquisition of the active video game skills recorded in the current study is consistent with previous findings (Bellini et al. 2007; Litras et al. 2010) on the effects of VSM. To the best of our knowledge, there is no previous study in literature which has aimed to teach a leisure skill, Bactive video game skills^ using VSM. All studies aimed to focus on diagnostic symptoms of the ASD such as behaviour, social and communication skills (Burton et al. 2013; Kabashi and Kaczmarek 2017; Liu et al. 2015; Nikopoulos and Panagiotopoulou 2015; Sherer et al. 2001). The current study focused on non- diagnostic skills such as leisure because of their limited activity repertoire and partic- ipation (Little et al. 2014). Therefore, the results of the study contribute the literature in terms of utilizing VSM to teach active game skills to the children with ASD, who are needed to prevent physical inactivity especially on home settings. The results of the current study support the finding of other studies that have utilized VSM to teach other chaining skills to children with ASD (Burton et al. 2013; Cihak and Schrader 2008; Liu et al. 2015; Wert and Neisworth 2003). When VSM studies were examined, it can be seen that multiple baseline (Bellini et al. 2007; Boudreau and Harvey 2013; Buggey 2005, 2012; Buggey et al. 2011, 1999; Burton et al. 2013; Cihak and Schrader 2008; Delano 2007; Hart and Whalon 2012; Lang et al. 2009; Litras et al. 2010; Liu et al. 2015; Mechling 2011; Nikopoulos and Panagiotopoulou 2015; Wert and Neisworth 2003; Williamson et al. 2013) and comparison models (Marcus and Wilder 2009;
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Sherer et al. 2001) have been used as experimental designs, but all of these studies conducted one baseline probe condition. The single baseline probe condition could be a disadvantage in terms of making video clip sessions, which can lead to an incidental learning on participants, and influences data of the intervention sessions because video images were recorded while demonstrating the steps of the skill to all the participants for making the VSM clips. Therefore, probe conditions are needed post video produc- tion as the pre video production, and some studies in literature were conducted with two baseline probe conditions before the intervention sessions (Goh and Bambara 2013; Litras et al. 2010; Nikopoulos and Panagiotopoulou 2015). In the present study, two baseline probe conditions were also conducted before and after the video recording sessions in order to determine a possible change in the dependent variable. The possible incidental learning on the participants after the making video clip sessions was not seen in the current study as the other studies. Therefore, the present study can be considered to have made a contribution to literature with the experimental design.
It has been reported in literature that VSM has been used to teach different skills such as academic (Burton et al. 2013), social (Buggey 2012; Litras et al. 2010), employment (Goh and Bambara 2013), behaviour (Buggey et al. 1999), and functional play (Lee et al. 2017) skills. Research on the acquisition of the leisure skill in individuals with ASD is less common than research on the other skills (Burgess and Gutstein 2007). Leisure activities facilitates participation, psychological well-being and physical activ- ities for people (Turygin and Matson 2014), but the leisure activities could be difficult for individuals with ASD owing to their poses deficits such as self management, motor and social skills, so they may need additional assistance and prompting to actively participation (Pan et al. 2011). Physical leisure activities in individuals with ASD have been recommended for decreasing stereotyped behaviours, increasing on-task behav- iours, and improving motor skills (Turygin and Matson 2014). The present study aimed to determine the effectiveness of the VSM on a leisure skill such as the the active video game skill to children with ASD. Active video game skills require the player to participate in whole body movements to interact within a virtual world, can increase time of being physically active, increase energy expenditure, and could provide oppor- tunity for enjoyment (Gao et al. 2013; Sun 2015). Therefore, the study has extended the literature by focusing on a leisure skill beyond the existing skill groups.
According to the social validity data, which were obtained from families after the intervention process, parents had positive opinions about acceptability of intervention, goals and outcomes such as achieving independence and increasing level of physical activity in the home based leisure skill. When previous studies that have used video self-modeling were examined, only three studies (Bellini et al. 2007; Cihak and Schrader 2008; Boudreau and Harvey 2013) collected social validity data. Therefore, the present study has made a contribution to literature in terms of increasing the social validity data for the VSM. Children with ASD tend to prefer screen-based activities in a sitting position and could be candidates for a sedentary life style (Must et al. 2014), so the social validity data were essential to provide implications to researchers, clinicians (physiotherapists etc.), teachers (special education and physical education etc.) and parents for encouragement of active video game skills instead of classic video games played while sitting. Thus, activity-based video game skills could be implemented into their home routine as leisure skills instead of classic video games for children with ASD. VSM can be utilized to teach leisure skills such as active video games that
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involve motor imitation and movement skills for children with ASD, but the VSM procedure should be provided with two baseline probe conditions to observe a possible incidental learning on the participants after the making video clip session (Goh and Bambara 2013; Litras et al. 2010).
There were some limitations to the present study. First, only four children with ASD were included in the study. Second, one target skill was used as the dependent variable. The length time to produce the VSM clip was the third limitation of the current study, and so the production time for VMS videos could be easily reduced and created (Schaeffer et al. 2016) by minimizing the devices and editing programs in the future studies. Fourth, formal assessment approach was not utilized to determine the partic- ipants’ repertoires in the study, so the future studies could use form for the individual’s repertoire level. Additional research should explore the effects of VSM on more participants and other active video game skills, which aim to increase the level of physical activity for children with ASD. In addition, other forms of video-based technology such as video model should be conducted to teach leisure skills and compared to the VSM in terms of effectiveness and efficiency. There is need to conduct new studies aiming to determine the effectiveness of VSM on various leisure skills to children with ASD. Finally, future studies should measure the level of physical activity and energy expenditure before and after teaching leisure skills to children with ASD.
Acknowledgements The authors wish to thank all participants and their parents for engaging in this study. The manuscript has been adapted from the master thesis of the first author, and the corresponding author was the thesis author’s advisor. The authors are grateful to Caroline Walker for proofreading the manuscript.
Compliance with Ethical Standards
Funding This research was supported by a Grant from Anadolu University Fund (Project No: 1502E079).
Ethical Approval All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Approval for the study was granted by the Ethics Committee of the university with research proposal number 10819–2015.
Informed Consent Written informed parental consent and verbal approval were obtained from all the parents of the participants in compliance with the Declaration of Helsinki.
Conflict of Interest The author(s) declared no conflict of interests with respect to the authorship and/or publication of this article.
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The Effectiveness of Video Self-Modeling in Teaching Active Video Game Skills to Children with Autism Spectrum Disorder
Abstract
Methods
Participants
Trainers
Setting
Materials
Dependent Variable
Experimental Design and Procedure
Probe Sessions
Making Video Sessions
Intervention Sessions
Maintenance and Generalization Sessions
Data Collection and Analysis
Results
Interobserver Agreement and Procedural Reliability
The Effects of the Video Self-Modeling on the Active Video Game Skill
Social Validity Results
Discussion
References
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