Evaluating Video Self‐Modeling to Teach Medication Safety Skills to Children With Autism

Behavioral skills training (BST) was combined with in-situ training to teach young children to solicit help when they become lost from a caregiver at a store. Three children were taught to approach a cashier, tell the cashier their name, and inform the cashier that they are lost. A multiple baseline design across participants was used to evaluate the effects of training. One of the three participants successfully met the criterion with the BST + in situ training treatment package alone, and the other two participants required an incentive to meet the criterion. All participants maintained the safety skill at follow-up evaluations. DESCRIPTORS: behavioral skills training, early childhood, in-situ training, lost child, safety, social skills training ********** A missing or lost child is defined as "when the child's whereabouts are unknown to the primary caregiver, resulting in the caregiver being alarmed for at least 1 hour" (U.S. Department of Justice, 2002). In a recent parent survey, it was reported that 90% of families have lost a young child in a public place, and that 20% of families have lost a child more than once. Although the vast majority of these children are reunited with their family, being lost may expose a child to other dangers such as abduction and accidents (U.S. Department of Justice, 2002). The frequency with which children become lost and the potential dangers involved in separation make it important to teach safety skills in situations in which children might become separated from a caregiver. Behavior analysts have taught safety skills to children using behavioral skills training (BST). For example, researchers have evaluated the use of BST to teach gun play prevention skills (Himle, Miltenberger, Flessner, and Gatheridge, 2004; Miltenberger et al., 2004; Miltenberger, et al., 2005) and abduction prevention skills (Johnson et al., 2005; Johnson et al., 2006). BST typically consists of instructions, modeling, rehearsal, and praise or corrective feedback. Participants who do not perform the safety skill to criterion during the assessment sessions often receive "in situ" training. In situ training involves teaching the skill in the natural environment. For example, in situ training in the context of what to do when finding a firearm consists of a therapist entering the room, pointing out the firearm, and conducting a training session "in the moment" (Miltenberger et al., 2004). Some research (e.g., Himle et al., 2004; Johnson et al., 2006; Miltenberger et al., 2004) has shown that BST alone is ineffective for some participants; an in situ training component is often needed to meet the mastery criterion (see Miltenberger (2008) for a review of BST and situations in which in situ training is necessary in the context of firearm injury prevention). Although there have been several studies focusing on teaching safety skills to children, few have focused on teaching children to seek assistance when lost from caregivers in a store or public place. Taber, Alberto, Seltzer, and Hughes (2003) taught six teenagers with moderate disabilities to use a cell phone when separated from a caregiver. Taylor, Hughes and Richard (2004) taught teenagers with autism to seek assistance when lost through the use of a pager and a communication card. No research, however, has focused on using BST and in-situ training to teach young, typically developing children to solicit help when separated from caregivers in public. In the current study, BST and in-situ training were used to teach these skills. Method Participants and Settings Participants were recruited via flyers posted at a private school. In order to participate, children had to be between the ages of 4 and 6 and have no medical or developmental disability. In addition, their caregivers had to have reliable transportation. Three typically developing children and their caregivers participated. …

This study investigated the effects of behavioral skills training (BST) with video modeling and in situ training on workplace conversational skills of four transition-age students with autism enrolled in a U.S. community-based internship program. Intervention sessions began with BST, which included direct instruction, video modeling, conversational practice, and feedback on practice performance, and concluded with in situ training, during which participants conversed with coworkers in their internship settings. Data were collected on participants’ accuracy in conversing with coworkers through mock conversations and in situ trials in internship settings. Findings demonstrated a functional relation between the implementation of the intervention package and increases in skill accuracy on in situ trials for all participants. Substantive improvements in participants’ mock conversation scores within training settings were also noted. Findings highlight the importance of in situ training and how video modeling can be incorporated within a BST instructional sequence.

This chapter describes behavioral approaches to teaching community living skills to people with intellectual and developmental disabilities. Community living skills are essential for promoting independence and autonomy. After identifying relevant skills for the individual, the next step is to conduct a task analysis that identifies the sequence of component behaviors of the skills to be taught. A variety of approaches can be used to teach community living skills including, prompting strategies, computer simulation, behavioral skills training (BST), simulated environments, video modeling, video prompting, and picture prompting strategies. Each of these approaches is described and research evaluating each of these approaches is presented. The chapter concludes with step-by-step guidelines for teaching community living skills to people with intellectual and developmental disabilities

The purpose of this study was to evaluate the effects of video self‐modeling (VSM) for teaching gun safety skills to five children with developmental disabilities. In situ assessments were conducted across all phases. Following baseline, participants were filmed engaging in the safety skills and then viewed the video of their performance. If a participant did not engage in the safety skills following VSM, they participated in in situ training (IST). The results showed that one participant engaged in the safety skills after participating in filming, three participants engaged in the skills after viewing the self‐modeling video, and one participant engaged in the skills following IST. The results are consistent with research showing the effectiveness of VSM for teaching other skills to children with disabilities.

Although in-vivo behavioral skills training (BST) is often effective, it may be too resource-intensive for organizations that rely on volunteers. Alternatives to in-vivo BST include video models or interactive computer training (ICT), but the utility of these procedures for training volunteers remains largely unknown. We used a randomized control trial to teach multiple skills to new volunteers at a therapeutic riding center. A total of 60 volunteers were assigned to one of three groups using block randomization. Depending on group assignment, volunteers received instructions and modeling through in-vivo interactions, a video model, or ICT. All volunteers completed in-vivo role plays with feedback. Skills were measured by unblinded observers during role plays. There were no statistically significant differences in accuracy of role-play performance between volunteers in the in-vivo BST and ICT groups, but both outperformed the video-model group. The ICT and video model required statistically significantly less time from a live instructor than did in-vivo training. Thus, although in-vivo BST remains best practice, ICT may be a viable alternative when training resources are limited.

Previous research has demonstrated the efficacy of behavioral skills training (BST) and in situ training (IST) for teaching children to protect themselves. However, BST may be resource intensive and difficult to implement on a large scale. We evaluated a computerized version of BST (CBST) to teach safety skills and determined the extent to which safety skills generalized across different dangers. In Study 1, 11 children learned, via CBST and IST, to respond safely when asked to leave with a stranger. In Studies 2 and 3, IST was implemented with 16 children for 1 or 2 dangers after exposure to CBST for 3 dangers. Participants correctly self-protected from dangers after CBST and IST, and performance generalized to similar dangers for which participants did not receive IST. CBST may be an acceptable substitute for BST when combined with IST to improve efficiency and maintain efficacy in a comprehensive safety skills program.

ABSTRACTThe present study used behavior skills training (BST) to teach three adult participants to implement a video modeling intervention aimed at teaching social skills to adults with autism spectrum disorder (ASD). During baseline trials, participants were given access to written instructions before role-play with two actors (who simulated a quiet conversation) and one confederate (who played the role of an adult with ASD). During treatment, participants were given a video model with voice-over instruction depicting how to implement the video modeling intervention to teach social skills, repeated roleplay trials, and feedback following their performance. All participant scores (percentage of steps correctly implemented in each session) increased from baseline to treatment, and generalization was demonstrated with an actual consumer diagnosed with ASD. Additionally, after training participants to use a video model to teach one social skill, there was generalization to teaching as many as three additional novel social skills. Participants showed maintenance of skills during a treatment study that involved training adult clients with ASD to engage in the social skills.

This chapter discusses research on teaching safety skills to children to prevent gunplay. Gunplay by children results in hundreds of accidental deaths and injuries each year. The chapter starts with a discussion of assessment and concludes that in situ assessment is the only valid approach to assessment of safety skills. The chapter then discusses two approaches to training safety skills: an informational approach and an active learning approach. The active learning approach, including behavioral skills training and in situ training, is the only effective approach to training safety skills. The chapter concludes with a discussion of training implemented by peers, parents, and simulation in order to increase the accessibility of training.

Research shows that behavioral skills training (BST) and in situ training (IST) are effective interventions for teaching safety skills to children. In addition, the efficiency of these interventions can be increased when parents, teachers, or peers are taught to implement them. The purpose of this study was to replicate Novotny et al. (2020) and evaluate a web‐based program for teaching parents to conduct BST to teach safety skills to prevent gunplay. We randomly assigned 18 children to the parent‐conducted BST group or a control group and evaluated the intervention in a posttest only control group design. Children in the control group or treatment group who did not score a three in the in situ assessment (do not touch, get away, and tell an adult) received IST from their parents and were assessed again. Results showed that safety skill scores were statistically significantly higher in the treatment group than in the control group. Furthermore, there was a statistically significant increase in safety skills scores following IST for children who received it.

BackgroundViolence in the healthcare workplace has been a global concern for over two decades, with a high prevalence of violence towards healthcare workers reported. Workplace violence has become a healthcare quality indicator and embedded in quality improvement initiatives of many healthcare organizations. The Centre for Addiction and Mental Health (CAMH), Canada’s largest mental health hospital, provides all clinical staff with mandated staff safety training for self-protection and team-control skills. These skills are to be used as a last resort when a patient is at imminent risk of harm to self or others. The purpose of this study is to compare the effectiveness of two training methods of this mandated staff safety training for workplace violence in a large psychiatric hospital setting.MethodsUsing a pragmatic randomized control trial design, this study compares two approaches to teaching safety skills CAMH’s training-as-usual (TAU) using the 3D approach (description, demonstration and doing) and behavioural skills training (BST), from the field of applied behaviour analysis, using instruction, modeling, practice and feedback loop. Staff were assessed on three outcome measures (competency, mastery and confidence), across three time points: before training (baseline), immediately after training (post-training) and one month later (follow-up). This study was registered with the ISRCTN registry on 06/09/2023 (ISRCTN18133140).ResultsWith a sample size of 99 new staff, results indicate that BST was significantly better than TAU in improving observed performance of self-protection and team-control skills. Both methods were associated with improved skills and confidence. However, there was a decrease in skill performance levels at the one-month follow-up for both methods, with BST remaining higher than TAU scores across all three time points. The impact of training improved staff confidence in both training methods and remained high across all three time points.ConclusionsThe study findings suggest that BST is more effective than TAU in improving safety skills among healthcare workers. However, the retention of skills over time remains a concern, and therefore a single training session without on-the-job-feedback or booster sessions based on objective assessments of skill may not be sufficient. Further research is needed to confirm and expand upon these findings in different settings.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12913-024-10994-1.

The development of a vocal mand repertoire is often delayed or deficient in children with an autism spectrum disorder. Utilizing caregivers as behavior change agents to address this core deficit may be advantageous as more learning opportunities can be incorporated in daily routines. A plethora of literature exists on teaching caregivers to promote communication with their children; however, many of these studies use behavioral skills training that can be resource-intensive. This study evaluated the effectiveness of video modeling with voice-over and on-screen text, without researcher mediation, as an alternative to behavioral skills training for teaching caregivers to teach vocal mands to their 2- to 5-year-old children with an autism spectrum disorder. The video model described mand training with an echoic prompt (Greer & Ross, 2008; Kodak & Clements, 2009), using a mnemonic (POWER: Play, Offer, Wait, Encourage, and Reinforce). Results of our nonconcurrent multiple baseline design across three dyads indicates that video modeling was effective in increasing all three caregivers' mand training fidelity, and this correlated to small increases in independent mands with some of the child participants when training occurred less than 1 hr per week. We discuss implications for practice and areas for future research.

There are a number of different safety threats that children face in their lives. One infrequent, but highly dangerous situation a child can face is finding a firearm. Hundreds of children are injured or killed by firearms each year. Fortunately, behavioral skills training (BST) and in situ training (IST) are effective approaches for teaching a number of different skills, including safety skills. The purpose of this study was to evaluate a teaching package for preschool teachers to learn to conduct BST to teach safety skills. Following teacher-implemented BST, the experimenter completed in situ training and supplemental instructions. A multiple baseline across subjects design was used to evaluate the effectiveness of this teaching package implemented by the teacher and experimenter with five preschoolers. Five children demonstrated the skills following IST and additional reinforcement or time out. The use of additional reinforcement, as well as treatment fidelity are discussed.

Children have been taught to demonstrate a safety response when they encounter a dangerous stimulus using behavioral skills training (BST). However, little research has evaluated the usefulness of BST to teach safety skills to children with autism spectrum disorder (ASD). In the current study, we evaluated BST to establish a generalized repertoire of safety skills in children with ASD. Three categories of safety skills were identified and multiple exemplars were taught to program for generalization to stimuli and settings not associated with training. The 3 participants demonstrated an appropriate safety response after BST training across trained and untrained exemplars and settings. Additionally, responding to trained exemplars maintained up to four weeks following training. High levels of social validity were also found. These results suggest BST is a viable training approach for training individuals with ASD to demonstrate safety skills and results are discussed in light of previous studies.

The purpose of this study was to investigate the effect of a behavioral skills training involving written teaching, modeling, role-play, and feedback for performance accuracy and maintenance of discrete-trial teaching(DTT) procedures to three parents of children with developmental disabilities. Three parents of children with developmental disabilities were trained to implement discrete-trial teaching through behavioral skills training. A multiple baseline across participants design was used, consisting baseline, written instruction, modeling, role-play, feedback, and maintenance phases. The results demonstrated that behavioral skills training has improved the accuracy of DTT and maintained. Two participated parents reached mastery levels of correct implementation at the feedback phase. The results indicated that behavioral skills training could be an effective training method for parents of children with developmental disabilities.

In the following study 12 preschool students diagnosed with an autism spectrum disorder were assessed for 10 potential pre-requisite skills for video modeling performance. The purpose of the study was determined which skills were necessary for children to learn though video modeling. In the first Experiment it was found that 8 of the 12 students demonstrated mastery of all assessed skills including video modeling. The four students who did not demonstrate learning through video modeling, also did not demonstrate successive discrimination skills. Experiment 2 tested to see if teaching these skills (i.e. delayed imitation, delayed matching), would produce learning through video modeling. Participants with average video modeling scores of 50% or higher showed improved learning through video modeling after mastering delayed matching, while students scoring 25% or less on video modeling assessments, were considered to have no change in video modeling performance. The results suggested that delayed matching and delayed imitation may be prerequisite skills for learning through video modeling, and that training successive discriminations to students with video modeling scores of 50% or higher will improve learning through video modeling performance. Future research is warranted on the role of successive discriminations on learning through video modeling, as well as the overall academic and social development of children diagnosed with developmental disabilities.