Systematic Review and Meta-Analysis of Stimulus-Stimulus Pairings to Increase Vocalizations in Children with Language Delays: 2015-2024.

Stimulus-stimulus pairing (SSP) is a procedure used to increase vocalizations in children with significant language delays. However, results from studies that have examined the effectiveness of SSP have been discrepant. The following review of the literature summarizes the results from 13 experiments published between 1996 and 2014 that used this procedure with children with language delays. Studies were analyzed across various participant and procedural variables, and an effect size estimate (nonoverlap of all pairs) was calculated for a portion of the participants in the studies reviewed. Results indicated an overall moderate intervention effect for SSP of speech sounds. Recommendations are provided for future researchers about information to report and potential avenues for future studies.

Greer &. Ross (2007): Verbal Behavior Analysis: Inducing and Expanding New Verbal Capabilities in Children with Language Delays Language impairments affect 7% of preschool children (Ziegler, 2005). Some of these children will catch up to their peers, but many will continue to have problems at school age. For example, Paul (2000) found that 16% of children with expressive language delays at age 2 continued to present with language impairments at the age of 7. Additionally there is evidence that early problems with oral language are related to later problems with the development of literacy skills (Bartlett, et al., 2002). Moreover, when language impairments accompany developmental disabilities (e.g., autism, mental retardation), they are likely to remain a life-long challenge. Professionals from a variety of disciplines have developed approaches to language intervention over the past 80 years (Paul, 2007). Within that context, behavioral approaches have emerged among the most effective, especially for teaching children with autism and related disabilities (Goldstein & Hockenberry, 1991). Traditionally, behavioral approaches emphasized modeling, imitation, systematic prompting, differential reinforcement and discrete trial instruction as a primary instructional format (e.g., Lovaas, 1981). However, more recently the behavioral framework has been expanded to include an emphasis on functional analysis and especially Skinner's (1957) functional analysis of verbal behavior. Additionally, natural environmental teaching (NET) strategies (e.g., incidental teaching, mand-model) were added to the repertoire of important instructional formats, and a review of recent studies supports the effectiveness of these formats (Petersen, 2006 for children with language delays. Skinner (1957) originally developed the verbal behavior model to account for the continuity between operant behavior and language. Others are responsible for applying the model to language instruction (e.g., Sundberg & Partington, 1998; Greer & Ross, 2007). These applications have gradually come to be known as the verbal behavior (VB) approach. Carr and Firth (2005) recently reviewed the published literature on VB practices and pointed to the need for additional research. We believe that his call for research has been addressed in part by Greer and Ross's (2007) book: Verbal Behavior Analysis: Inducing and Expanding New Verbal Capabilities in Children with Language Delays. This book represents the culmination of considerable research, practice, and critical thinking by a Greer and his colleagues (e.g., Greer & Keohane, 2006; Greer, Keohane, & Healy, 2002; Tsai, & Greer, 2006). It addresses many interesting and important questions about the verbal behavior approach, and it offers an evidence-based framework for best practices in behavioral language intervention, including detailed information about assessment, instructional strategies, and procedures for evaluating treatment efficacy. It is highly engaging and conveys complex theoretical information in a clear and reader-friendly style. It is an excellent source of information for students planning a career in communicative disorders, for behavior analysts who wish to enhance their understanding of Skinner's verbal behavior framework, for parents of children with communicative disorders, and for professionals in the fields of developmental disabilities and early intervention. An important feature of this book is that it includes an empirical account of verbal behavior development, and it t may be the first comprehensive account of language development that incorporates Skinner's (1957) verbal behavior model. It describes a developmental trajectory marked by developmental cusps (Rosales-Ruiz & Baer, 1966; Bosh & Hixson, 2004). In some linguistic and cognitive accounts of language development, stages of language growth have been attributed to neurological factors such as a language acquisition device (e. …

The research literature has revealed mixed outcomes on various procedures for increasing vocalizations and echoic responding in persons with disabilities (Miguel, Carr, & Michael The Analysis of Verbal Behavior, 18, 3-13, 2002; Stock, Schulze, & Mirenda The Analysis of Verbal Behavior, 24, 123-133, 2008). We examined the efficacy of an assessment procedure for identifying the most effective echoic teaching procedure to six students diagnosed autism spectrum disorder (ASD) and other developmental delays. The assessment procedure included a within-participant comparison of vocal imitation training (VIT), stimulus-stimulus pairing (SSP), and a mand-model procedure (MM). A functional analysis of the responses was conducted to determine whether responding was functionally an echoic or a mand. The results indicated that the assessment was effective in identifying a teaching procedure for five out of the six participants and that responding was established under echoic control. These outcomes support the efficacy of this assessment procedure for identifying effective echoic teaching procedures.

Much has been said about B. F. Skinner's analysis of verbal behavior. This commentary specifically focuses on the functional independence of B. F. Skinner's verbal operants. While researchers have long been interested in this topic, the research literature on this topic has produced mixed results; it has shown that the verbal operants may be both functionally independent and functionally interdependent. This commentary considers the conceptual and applied implications of these mixed findings. The distinction between constructs and events is highlighted, with specific attention to how this distinction relates to the consideration of the verbal operants in behavior analysis. The value of further research on the functional independence of the verbal operants is considered, as well as the type of research studies that might be useful toward developing interventions for individuals with language delays. Copyright © 2016 John Wiley & Sons, Ltd.

This issue offers seven reports of experiments, two reviews of the literature, and a book review. The lead article by Dunst et al. provides our readers with two analyses of the of response contingent child learning for profoundly disabled participants and their parents. This is interesting and important work that places both children and their parents at the center of the stage. The research also suggests potential behavioral developmental analyses that might be done with typically developing children. Most of all the paper identifies what can and should be done with individuals with profound disabilities, but often is not done. Three of the research reports address contemporary topics in verbal behavior analysis. Each of these analyses incorporates the listener role and the intercept of the speaker and listener. The papers provide protocols that lead the induction of new verbal developmental capabilities, or cusps, that have been identified in recent research in verbal behavior (Greer & Ross, 2007). The intensive tact procedure (Pereira-Delgado and Oblak) replicates and extends findings of the effectiveness of this procedure in expanding non-instructional social verbal interactions by preschoolers with language delays and shows how to induce social verbal behavior without having to wait for incidental opportunities. Specifically, the protocol shows how to provide the prerequisites that allow children to be affected by contact with verbal opportunities when they could not be affected by those opportunities before the intervention. The intensive tact procedure builds generalized reinforcement effect for the emission of tacts. Tacts are the critical foundation for the unfolding of more advanced verbal capabilities and socialization (e.g., naming and conversational units). Until children have the naming capability and are fluent readers the only way that they can acquire tacts is through direct instruction. Once they have naming they can acquire tacts indirectly and that is the capability that Speckman-Collins, Park, and Greer address in the test of the effect of acquiring auditory matching on the listener component of naming. The auditory matching protocol described by Speckman-Collins et al. expands prior work where auditory matching led to either first instances of echoics or exact echoics. In their study, the authors found that the auditory matching protocol resulted in the listener half of naming in children with limited speaker repertoires. Naming was also found to be a collateral outcome of systematic training in observational learning in the Rothstein and Gautreaux paper. Helou, Lai, and Sterkin report new data on the effect of writer immersion on functional writing, particularly the editing aspect of functional writing. Editing is an expanded listener capability. Their work adds to the growing evidence of the utility of the findings from verbal behavior analysis for curriculum objective to reach effective writing to children and youth with and without disabilities. Three of the research reports involve the induction or expansion of observational learning repertories and the manner in which tutoring taps the benefits of observational learning for tutors. Observational contact with contingencies is a critical repertoire. It is a repertoire that is often deficit or missing in some students; however recent work shows how it can be induced or expanded. Research in behavior analysis is currently addressing observational learning with renewed vigor and the result of this work is both surprising and promising (Greer, Singer-Dudek, & Gautreaux, 2006). One of the more promising efforts is the treatment of observational learning as a dependent variable rather that the traditional treatment of it as an independent variable. For too long we have ignored the importance of analyses of how we learn from indirect contact with contingencies of instruction or social interaction and the relation of higher order classes to certain types of observational learning that is key to social behavior. …

Several studies have demonstrated effects of stimulus-stimulus pairing (SSP) on children's vocalizations, but numerous treatment failures have also been reported. The present study attempted to isolate procedural variables related to failures of SSP to condition speech sounds as reinforcers. Three boys diagnosed with autism-spectrum disorders participated. Phase 1 was designed to assess SSP effects on production of auditory stimuli via button pressing. When SSP failed to produce a preference for the target stimulus, we instituted a series of procedural manipulations intended to address potential reasons for failure. One participant preferred the target stimulus when given the opportunity to select preferred items for pairing prior to each session, but a subsequent reversal attempt produced ambiguous results. Two participants showed no consistent preference in Phase 1 and underwent a within-session reinforcer evaluation in Phase 2, in which alternative controlling variables were demonstrated by delivering preferred stimuli contingent on button pressing.

We tested the effects of an intensive tact instruction procedure on the emission of verbal operants in non-instructional settings by three preschool students with developmental delays. The participants were selected because they emitted low numbers pure verbal operants in non-instructional settings throughout the school day. Specifically, we measured the number of pure mands and tacts emitted during probes in the non-instructional settings. During the intensive tact procedure, the participants received an additional 100 tacts above their average number of daily learn units. In a delayed multiple probe design, we found the intensive tact instruction was effective in increasing the number of pure mands and tacts emitted in the non-instructional settings by all three of the participants in the study. Keywords: Tacts, Mands, Learn units. ********** The development of a fluent speaker repertoire is critical for young children with language delays. Students with a fluent speaker repertoire use an extensive vocabulary across settings and overtime, extrapolate new vocabulary based on existing vocabulary and are reinforced naturally by communicative behavior (Hart & Risley, 1996). Furthermore, students who function as speakers can govern consequences in the presence of listeners in their environment by using another individual to mediate the contingencies (Greer, 2002). Deficits in the development of a speaker repertoire may be attributed to native or environmental factors. The latter was demonstrated by Hart & Risley (1995) who found a correlation between SES and vocabulary growth, where 3 year-old children from families categorized as low SES had acquired approximately half the vocabulary compared with children from higher SES or professional families. These findings were attributed to overall language interactions between parents and their children, in which parents of high SES used a vocabulary of over 2000 different words versus 1000 words used by parents of low SES. Additionally, the low SES children experienced infrequent opportunities for interactions, which placed these children at risk for failure in future languagelearning opportunities. Students present with deficits in their speaker repertoire often receive intense behavioral interventions provide opportunities for compensation. This instruction involves teaching the vocal operants-- mands and tacts. According to Skinner's analysis of verbal behavior (1957), mands and tacts are two of the functional relations in terms of their controlling antecedent and consequent events. Children typically learn tacts through direct instruction, naming or via observation if the student has an observational learning repertoire. The term tact, is derived from contact with one's own environment, and can represent aspects of an individuals' environment across all five senses: taste, smell, sound, touch and sight (Greer & Ross, 2006). More specifically, a tact is a vocal verbal operant is under non-verbal control and is reinforced by a generalized reinforcer (Skinner, 1957; Becker, 1989). In this case a generalized reinforcer would be the attention of another person. For example, a child may emit the tact with a vocal response car in the presence of an actual and the child's mother may respond that is a red car. In this case the mother's response functioned to reinforce the child's initial tact. This then increases the likelihood the child would emit further tacts in the future. Skinner (1957) differentiated between two different types of tacts; pure and intraverbal tacts, where an intraverbal or impure tact occurs under multiple controlling antecedents, which are both verbal and physical. At times during direct instruction students are required to emit impure tacts where the teacher points to a stimulus and as part of the antecedent and may ask What is it? Typically, children are learning the form and the correspondence between the stimulus and the word during instruction under the antecedent control of both a verbal stimulus and a nonverbal stimulus. …

The current study replicated an enhanced stimulus-stimulus pairing (SSP) procedure used by Esch et al. (Journal of Applied Behavior Analysis 42: 42-225, 2009) for increasing vocalizations in children with autism. The enhanced SSP procedure consisted of pairing target vocalizations with high-preference items, interspersed target and nontarget trials, an observing response, and the presentation of the vocalizations in "motherese" speech. Results showed substantial increases in target vocalizations above baseline levels and above nontarget vocalizations for two of three participants.

Effects of a stimulus-stimulus pairing procedure on the subsequent acquisition of mand operants were investigated. An attempt was made to shape novel sounds that emerged through the pairing procedure into a mand. Six children, aged two to five years, with moderate to severe language and communication delays, participated. Two conditions were used following the pairing condition: postpairing and direct reinforcement. The emergence of mands was compared across these conditions. An additional analysis was made of the relation between participants' baseline verbal repertoires and the effects of the pairing and the emergence of mands. Results indicate the possibility of stimulus control from a stimulus-stimulus pairing to mand as shown in two of the participants who had demonstrated high rates of vocal play and low to no verbal repertoire prior to this study. Target vocal sounds during postpairing and direct reinforcement condition remained at zero to low levels for participants with high verbal repertoire and little vocal play, warranting future studies on relations between the pre-existing verbal repertoire and the effectiveness of stimulus-stimulus pairing.

Stimulus-stimulus pairing (SSP) is a procedure used by behavior analysis practitioners that capitalizes on respondent conditioning processes to elicit vocalizations. These procedures usually are implemented only after other, more customary methods (e.g., standard echoic training via modeling) have been exhausted. Unfortunately, SSP itself has mixed research support, probably because certain as-yet-unidentified procedural variations are more effective than others. Even when SSP produces (or increases) vocalizations, its effects can be short-lived. Although specific features of SSP differ across published accounts, fundamental characteristics include presentation of a vocal stimulus proximal with presentation of a preferred item. In the present article, we draw parallels between SSP procedures and autoshaping, review factors shown to affect autoshaping, and interpret autoshaping research for suggested SSP tests and applications. We then call for extended use and reporting of SSP in behavior-analytic treatments. Finally, three bridges created by this article are identified: basic-applied, respondent-operant, and behavior analysis with other sciences.

Recent reviews of behavior analytic journals suggest that participant demographics are inadequately described. These reviews have been limited to brief periods across several journals, emphasized specific variables (e.g., socioeconomic status), or only included specific populations. The current scoping review included all published articles in The Analysis of Verbal Behavior from 1982-2020. Six demographic variables were coded for 1888 participants across 226 articles. Despite small sample sizes (i.e., fewer than six participants in 62.3% of studies), only age (85.4%) and gender identity (71.6%) were reported for the majority of participants. Socioeconomic status, race/ethnicity, and primary language were reported for fewer than 20% of participants. Over time, the number of demographic variables reported showed a slight increasing trend, although considerable variability was observed across years. These findings suggest that editors and reviewers must consider what constitutes acceptable participant characterization. Researchers might also be emboldened to extend their work to populations currently underrepresented in the journal.

Introduction In 1957, Skinner expanded the contention that individuals act on the environment and included the notion that individuals act in two distinct ways: namely on the environment and upon others. It is the action of individuals on others he considered under the umbrella of verbal behavior (1). In his 1957 analysis, Skinner provided a framework for understanding verbal behavior. According to Skinner, one understands verbal behavior when we predict the occurrence of specific instances and produce or control such behavior by altering the conditions under which it occurs (pg. 3). It is this prediction and control of verbal behavior that will allow us to not only understand communication disorders but also inform the way in which treatments are developed and implemented to overcome such deficits. Speech and language disorders (i.e., disorder related to verbal behavior) refer to problems in communication and related areas and are among the most common disabilities in the United States (US) (Van Dyke & Holte, 2003). Speech disorders are characterized as an impairment of the articulation of fluency, speech sounds, and/or voice; whereas language disorders are characterized as an impairment in comprehension and/or use of spoken, written, or other symbol systems involving either the form, content, or function (American Speech and Hearing Association, 1993). According to the U. S. Department of Education (2004) of the six million plus students served in the public schools' special education programs in 2002, over a million (21.6%) received services for speech and language disorders. However, this is likely to represent an underestimation of actual prevalence of speech and language disorders given that it does not include children who have speech and language delays secondary to other conditions or children who have not started formal education. Moreover, according to the National Institute of Mental Health (NIMH), one of the most concerning disorders faced by parents of children in America is Autism Spectrum Disorder, which is characterized by a significant impairment in social interactions and communication (Strock, 2004). These delays not only represent an important area of human development (i.e., ability to communicate), but research has also documented that children with speech and language delays demonstrate persistent impairments in developmental and functional skills in school not limited to language (Fox, Dodd, & Howard, 2002). In addition, children with speech and language delays have also been shown to experience long-term problems affecting learning, school achievement, and behavior (Laing et al., 2002; Chaimay, Thinkhamrop, & Thinkhamrop, 2006). In fact, problem behaviors are more prevalent among children with language delays than typically developing children (Willinger et al., 2003). Given the prevalence of speech and language delays as well as the comorbid issues related to academic and behavioral achievement, it is not surprising that communication (i.e., verbal behavior) in and of itself is a pressing area in need of evaluation. More specially, a comprehensive analysis of how we can predict and control verbal behavior related to speech and language delays is warranted. Skinner (1957) provided a theoretical analysis of verbal behavior wherein a number of different functional relations were described in terms of their controlling antecedent and consequent events (e.g., tacts, mands, intraverbals, autolitics, echoic, and textual) in an attempt to provide a framework for the predication and control of said behavior. Much research has been subsequently conducted to elucidate these relations. Thus, the intent of this article is to expand upon Skinner's analysis by synthesizing the current research and to provide a detailed analysis regarding the functional relations related to one specific form of verbal behavior, the mand. More specifically, to elucidate the variables related to teaching individuals to mand. …

Sixteen children with language delays and their mothers were studied to identify the types of child utterances mothers were most likely to expand. Eight of these children had Down's syndrome (DS), while the other eight were pairwise-matched for mean length of utterance (MLU) and did not have DS, but were language delayed. Twenty-minute mother-child free-play sessions were videotaped and transcribed. Trained observers coded utterances for child intelligibility, child utterance length, adult expansions and adult non-expansions. Sequential analysis results indicated that mothers of children with DS were more likely to expand partially intelligible multi-word utterances than to expand fully intelligible multi-word utterances. The opposite pattern occurred in the dyads without DS. Single-word utterances were least likely to be expanded in both groups. The implications of the results for language intervention and future research are discussed.

Recently there has been an increased interest in Skinner's (1957) Verbal Behavior, most notably among parents of with seeking to reverse and correct devastation of condition. The current commentary suggests that with of Skinner's analysis and subsequent application in clinical treatment that analyst's have a responsibility to properly educate community about history of analysis of verbal and to adequately train people who conduct protocols using Skinner's analysis or suffer lessons of past. ********** Recently there has been an increased interest in Skinner's 1957 Verbal Behavior. This is a long awaited change among those of us who have studied Skinner's work and have long believed in validity of his analysis. Much of new interest in this body of work has come about due to application of Skinner's analysis by Sundberg and Partington with who have autism. This work is outlined in 1998 book Teaching Language to Children With Autism or Other Developmental Disabilities and formalized through publication of their assessment manual The ABLLS Protocol (Partington & Sundberg, 1998). This protocol in hands of someone familiar with functional analysis of verbal is a powerful tool not only in assessing deficits and strengths in verbal behavior, but in creating an intervention program for with deficit verbal repertoires. Note that I have not specifically stated children with autism because truth be known when assessment is used appropriately with with other developmental disabilities it is just as powerful in assisting to determine deficit repertoires. Although, sudden given rise to Skinner's analysis is due mainly to it's application in community, it seems important to remember that this is indeed verbal behavior. The analysis applies to all organisms when learning to become members of their verbal community and operants are apparent in every verbal community. Perhaps most important statement that must be made at this point is that along with this rise in popularity among analysts comes a large responsibility. The most important thing that Behavior Analysts could do for analysis, and more focally analysis of verbal is to properly educate people about history of analysis, basic and applied taking this opportunity to promote our science, and not just businesses. Behavior Analysts should not commit same sins that linguist, psychodynamic researchers and clinicians of past have committed. In an article by John Eshelman and Ernest Vargas (1988) pair speaks of promoting behaviorological analysis of verbal behavior. They note several issues of commission and omission that they account for general malaise surrounding radical behaviorist analysis of verbal behavior. Do we not commit same wrong when we allow public, for whatever reason, to call analysis of verbal the new method of ABA or to say that discrete trial training, direct instruction, precision teaching and milieu language training doesn't take into account analysis of verbal behavior a few comments I recently read on an parent internet list for with disabilities. Additionally again and again I have heard of clinicians in field and their new approach to verbal behavior. In meantime I see little about history of analysis or current work in this area of behavior. This does little justice to work of Vargas, Michael, Catania, Sidmund, Sundberg and countless less famous, but equally capable others who have contributed to our knowledge in analysis of verbal behavior. It seems to me to be no different when current analysts omit history upon which they base their current work to public and omission that Eshelman and Vargas speak about. …

Researchers have demonstrated the efficacy of picture prompts on the acquisition of intraverbals (Coon & Miguel in Journal of Applied Behavior Analysis, 45, 657-666, 2012; Goldsmith, LeBlanc, & Sautter in Research in Autism Spectrum Disorders, 1, 1-13, 2007; Ingvarsson & Hollobaugh in Journal of Applied Behavior Analysis, 44, 659-664, 2011; Ingvarsson & Le in The Analysis of Verbal Behavior, 27, 75-93, 2011; Miguel, Petursdottir, & Carr in The Analysis of Verbal Behavior, 21, 27-41, 2005; Partington & Bailey in The Analysis of Verbal Behavior, 11, 9-18, 1993). However, no one (to our knowledge) has determined the effects of picture prompts on the variability of responding during intraverbal categorization. We evaluated the use of a scenic picture prompt on response variability during the acquisition of intraverbal categorization with 4 children diagnosed with autism. All children mastered the task and initially demonstrated varied responding. However, responding eventually became invariant for all children. These results demonstrate the efficacy of a scenic picture prompt for teaching children with autism intraverbal categorization and for producing initial response variability. Additional research should be conducted to determine teaching procedures that promote continued varied responding for individuals with autism.