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Manipulating establishing operations to test for stimulus control during mand training

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Manipulating establishing operations to test for stimulus control during mand training
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Gutierrez, Anibal, 1972-
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viii, 75 leaves : ill. ; 29 cm.

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Communication systems ( jstor )
Frost ( jstor )
Language development disorders ( jstor )
Learning ( jstor )
Mental stimulation ( jstor )
Philosophical psychology ( jstor )
Pictorial representation ( jstor )
Sign languages ( jstor )
Spoken communication ( jstor )
Tact ( jstor )
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non-fiction ( marcgt )

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Thesis (Ph. D.)--University of Florida, 2004.
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Includes bibliographical references.
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Printout.
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Vita.
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by Anibal Gutierrez Jr.

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MANIPULATING ESTABLISHING OPERATIONS TO TEST FOR STIMULUS
CONTROL DURING MAND TRAINING












By

ANIBAL GUTIERREZ JR.


A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL OF THE
UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE
REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY

UNIVERSITY OF FLORIDA


2004














ACKNOWLEDGEMENTS

I would like to express my sincere gratitude to the members of my committee,

Drs. Maureen Conroy, Brian Iwata, Scott Miller, Henry Pennypacker, and Timothy

Vollmer, for their support, guidance, and mentorship. I would also like to thank my

parents, Guadalupe and Anibal Gutierrez, and my wife, Melissa Hale, for their love,

support, and encouragement in all my endeavors. I would also like the thank the

collaborators of this study, John Borrero, Jason Bourret, Claudia Dozier, Dana Gadaire,

John Rapp, and Andrew Samaha, for all their contributions to the study.













TABLE OF CONTENTS
page

ACKNOW LEDGEM ENTS...................................................... .................................. ii

LIST OF FIGURES ...................................................................................................... v

CHAPTER

I INTRODUCTION ................................................................................................. 1

2 REVIEW OF THE LITERATURE ............................................. ................ .............. 9

Overview......................................................................................................................... 9
Forms of Communicative Behavior Taught to Individuals with Language Delays ..... 16
Sign Language ........................................................................................................ 16

3 M ETHOD ............................................................................................................ 24

P articip an ts.................................................................................................................... 24
Setting ..................................................................................................................... 24
Data Collection and Response Definition............................................... ............ 25
Interobserver Agreement......................................................................................... 25
M materials ................................................................................................................. 26
P rocedures..................................................................................................................... 26

4 RESULTS ............................................................................................................ 35

Phase 1 Preference Assessment Results.......................................... ...................... 35
Phase 2 Single Card Results.................................................................................... 35
Phase 4 M and Training Results .................................................. .......................... 41
Phase 5 Establishing Operations M manipulation Results............................ ........... 48
Phase 6a Representative Objects Training Results................................... ........... 52
Phase 6b Establishing Operations M manipulation .................................... .......... .. 54
with Representative Objects Results............................................ ......................... 54
Phase 7a Topographically Different Response Training
(Vocal + M and Training) Results ................................................ ....................... 57
Phase 7b Establishing Operation Manipulation with Topographically Different
Responses (Vocal + Card) Results............................................ .......................... 57

5 DISCUSSION ...................................................................................................... 61







REFEREN CES ................................................................................................................. 72

BIOGRAPH ICA L SKETCH .......................................................... ........................... 76














LIST OF FIGURES
Figure pae

1: Flow chart depicting the order of phases during the study.................................28

2: Percentage of 5-minute sessions of item manipulation during
free-operant preference assessment........................................................ 36

3: Percentage of 5-minute sessions of item manipulation during
free-operant preference assessment.......................................................... 37

4: Percentage of trials with picture card and distracter card selected
during the distracter card probe phase for Mario and Will...............................39

5: Percentage of trials with picture card and distracter card selected
during the distracter card probe phase for Malcolm and Millie......................40

6: Percentage of trials with picture card and distracter card selected
during the distracter card probe phase for Erin and Pablo...............................42

7: Percentage of trials with picture card and distracter card selected
during the distracter card probe and differential reinforcement
phases for M ario and W ill..................................................... ..............44

8: Percentage of trials with picture card and distracter card selected
during the distracter card probe and differential reinforcement
phases for M alcolm and M illie.............................................. ........................... 46

9: Percentage of trials with response emitted during the distracter
card probe and differential reinforcement phases for Erin and Pablo ...............47

10: Percentage of trials with picture card selected during the
establishing operation manipulation phase for Mario and Will.......................49

11: Percentage of trials with picture card selected during the
establishing operation manipulation phase for Malcolm and Millie .................51

12: Percentage of trials with item approached during the distracter
probe and differential reinforcement phases for Erin and Pablo................... 54







13: Percentage of trials with item approached during the
establishing operation manipulation phase for Erin and Pablo.........................56

14: Percentage of trials with response emitted during vocal
m and training for M illie..................................................................... 58

15: Percentage of trials with response emitted during the
establishing operation manipulation with topographically
different topographies phase (vocal + mand) for Mille.................................59













Abstract of Dissertation Presented to the Graduate School of the University of Florida in
Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy

MANIPULATING ESTABLISHING OPERATIONS TO TEST FOR STIMULUS
CONTROL DURING MAND TRAINING




By

Anibal Gutierrez Jr.

December 2004


Chair: Timothy R. Vollmer
Major Department: Psychology


Acquisition of verbal behavior is a major goal of interventions for children with

developmental disabilities. Although many training methods exist, little research has

focused on evaluating the effectiveness of those methods to produce functional

discriminated mands (requests). The purpose of this study was to manipulate the

establishing operation to test the efficacy of traditional mand training using two picture

cards. In this study, six individuals with developmental disabilities participated in a

training procedure designed to teach two separate mands for two separate reinforcers.

First, a simple discrimination was taught, in which using a correct card was reinforced

and using an incorrect card was not reinforced. Following training, an establishing

operations test was used to assess for discriminated manding, in which both of the

previously learned picture cards were placed together in front of the participant.
vii







Participants were given free access to one of the items they had been taught to mand for

but the other item was out of reach and in view (establishing operation). Responses that

occurred when the establishing operation was in place were reinforced with access to the

item and responses when the establishing operation was not in place were not reinforced.

Five of the six participants acquired discriminated manding using topographically similar

responses (picture cards or representative items). One participant did not acquire a

discriminated mand response until topographically distinct mands were taught (vocal and

picture card). Results of the study suggest that discrimination training is not necessarily

sufficient to teach discriminated manding when more than one card showing preferred

items is used. In addition, the establishing operation manipulation served as an

appropriate assessment tool for the identification of discriminated manding. Based on the

results of this study, practical implications, limitations, and future research extending the

results are discussed.












CHAPTER 1
INTRODUCTION

A delay in verbal behavior is one of the essential features of autism disorder and is

commonly observed in persons with mental retardation, with the more severely

impaired lacking any form of functional communication (American Psychiatric

Association, 2000; McCoy & Buckhalt, 1990). A large number of young children with

autism enter school programs without speech or other communicative behavior (Bondy

& Frost, 1994). In the population at large, language delays are common for children

under the age of 3 (10% to 15%) and by school age it is estimated that 3% to 7%

experience a language disorder (American Psychiatric Association, 2000).

The acquisition of language for children with developmental disabilities is seen as a

major goal of training programs because it is believed that language underlies most

learning in typically developing children (Sundberg & Michael, 2001) and the

acquisition of communication skills is often an indicator of long-term success (Bondy &

Frost, 1994; Lovaas, 1966), and social development (Carr & Kologinsky, 1983). In

order for children with developmental disabilities to learn to gain access to desired

items, communicate their needs and desires, request information, obtain others'

attention, and generally control their environments, it is important that they acquire a

functional form of communication (McCoy & Buckhalt, 1990).

Some teaching procedures aimed at increasing communicative behavior in children

with developmental disabilities have been designed to increase speech while others








have been used to develop nonvocal (e.g., sign-language) forms of communication

(Charlop-Christy, Carpenter, Le, LeBlanc, & Kellet, 2002). Vocal and nonvocal forms

of communication can both be conceptualized as forms of verbal behavior. Skinner

(1957) defined verbal behavior as "behavior reinforced through the mediation of other

persons" (p.14). Skinner goes on to explain that in defining verbal behavior "we do not,

and cannot, specify any one form, mode or medium. Any movement capable of

affecting another organism is verbal" (p.14).

Skinner (1957) outlined two broad categories of verbal behavior, the tact and the

mand. "A tact may be defined as a verbal operant in which a response of a given form is

evoked (or at least strengthened) by a particular object or event or property of an object

or event" (pp.81-82). In other words, the tact is a verbal response that names or

identifies an object or event. The occurrence of the tact is preceded by the object or

event the tact names or identifies. In contrast, the mand "is defined as a verbal operant

in which the response is reinforced by a characteristic consequence and is therefore

under the functional control of relevant conditions of deprivation or aversive

stimulation" (p. 36). In other words, a mand is a verbal response that specifies its

reinforcement. For example, the mand "water please" is reinforced by receiving water.

The mand is a special form of verbal behavior because it benefits the speaker by

producing access to specific items, often reinforcers. The mand enables an individual to

access reinforcers that are mediated by other individuals in the community. This is

contrasted with the tact, which does not produce this benefit to the speaker. Tacts

produce social approval and do not produce access to specific reinforcers. Because of its

usefulness, the mand is considered to be the first type of verbal behavior acquired by







children. The control over the environment provided by the mand makes it a reasonable

choice for the focus of early language training (Sundberg & Michael, 2001). In addition,

mands are likely to be learned quickly due to the fact that they are maintained by

specific and effective reinforcers (Bondy & Frost, 1994).

Because mands specify their reinforcer, mands are under the control of relevant

states of deprivation and satiation. These states of deprivation and satiation are called

establishing operations (EOs). Establishing operations (EOs) play a large role in the

occurrence of a mand. Michael (1982) defined EOs as "any change in the environment

which alters the effectiveness of some object or event as reinforcement and

simultaneously alters the momentary frequency of the behavior that has been followed

by that reinforcement" (pp.150-151). Skinner explained that when a response is

reinforced by a specific consequence, the likelihood of that response occurring is a

function of the deprivation associated with that reinforcer (Skinner, 1957). In other

words, establishing operations, such as deprivation or satiation, directly affect the

occurrence of a mand. For example, an individual is not likely to ask for food after

having eaten a large meal. The establishing operation is not in effect, the individual is

not food deprived, and the mand for food is not likely to occur.

Behavioral interventions have been used in developing training programs

designed to increase verbal behavior in children with developmental disabilities

(Charlop-Christy et al., 2002). Some interventions, such as mand-model procedures

(Mobayed, Collins, Strangis, Schuster, & Hemmeter, 2000), incidental teaching (Hart &

Risley, 1974; 1975; 1980; Hemmeter, Meyer, Ault, & Collins, 1996), and time delay

procedures (Halle, Marshall, & Spradlin, 1979; Halle, Baer, & Spradlin, 1981; Charlop,







Schreibman, & Thibodeau, 1985), have been used in an effort to increase speech, while

other interventions have been used to develop nonvocal communicative behavior for

children who did not develop speech normally. Because "any movement capable of

affecting another organism..." (Skinner, 1957 p. 14) is verbal behavior, verbal behavior

can be established for individuals with developmental disabilities by training different

topographies when vocal responses have not been acquired. Some of these interventions

include sign language (Carr, Binkoff, Kologinsky, & Eddy, 1978; Carr & Kologinsky,

1983; Schepis, Reid, Fitzgerald, Faw, Van Den Pol, & Welty, 1982), voice output

electronic devices (Durand, 1999; Schepis, Reid, Berhman, & Sutton, 1998), and

picture-communication systems (Hurlburt, Iwata, & Green, 1982; Sigafoos, Doss, &

Reichle, 1989; Bondy & Frost 1993, 1994, 2001; Frost & Bondy 1994; Schwartz,

Garfinkle, & Bauer, 1998; Liddle, 2001; Kravitz, Kamps, Kemmerer, & Potucek, 2002).

One highly specific form of mand training involves the use of symbol cards,

such as the Picture Exchange Communication System (PECS) training (Bondy & Frost,

1993, 1994, 2001; Frost & Bondy, 1994). The PECS training system teaches individuals

to hand a picture of an item to a communicative partner in exchange for the item.

Before the various training phases begin, an informal preference assessment is

conducted to identify the highly preferred items the individual will be taught to request.

During phase 1, individuals are physically guided to hand the instructor the picture of a

preferred item in exchange for access to the item. During phase 2, the physical guidance

is faded over time until the individual is able to independently initiate the exchange with

a variety of people. Training continues as the trainer gradually moves away from the

individual in order to establish more independent manding. Once the simple mand







response has been established for one item, additional pictures are introduced into

training to establish a larger manding repertoire. During this phase of training the

individual is taught to mand for several items using different picture cards. During

phase 3, the individual is taught to discriminate between two or more picture cards in

order to establish complex manding. During this phase, the individual is presented with

two or more picture cards at the same time, one picture card corresponding to a highly

preferred item and the other to a less preferred or "neutral" item. As PECS training

progresses, individuals are taught to build sentences by placing the picture on a

communication board with the words "I want on it, and also to respond to a direct

question such as "what do you want" by placing pictures on the communication board

(Bondy & Frost, 1994, 2001; Frost & Bondy, 1994; Schwartz et al., 1998).

When the complex mand training is complete, it is important to evaluate

whether individuals are able to request items they "want" or are randomly handing

picture cards. Because picture cards typically correspond to preferred items and known

reinforcers, it is possible that any response will result in access to a reinforcer and

individuals are not discriminating among the picture cards. In addition, individuals

might "scroll" through cards until the desired object is received. In either case, a true

complex discrimination has not been established.

One way to ensure that individuals are able to mand for specific items is to

conduct correspondence checks (Bondy & Frost, 1994, 2001; Frost & Bondy, 1994).

Correspondence checks involve placing two items in front of the individual as well as

the two corresponding picture cards. When the individual hands the therapist a card, the

trainer allows the individual to pick up the item he/she has manded for. If the individual







selects the appropriate item (i.e., the item that corresponds to the selected picture card),

the therapist allows the participant to consume or engage with the item. If the child

attempts to select an item that does not correspond to the selected picture card, the

trainer corrects the individual and prompts him or her to select the picture card

corresponding to the item they attempted to pick up. The correspondence checks are

conducted periodically during the PECS training.

Although correspondence checks as described by Bondy and Frost (1994, 2001)

may identify instances in which the PECS training has failed to produce discrimination

between two picture cards, it is not clear how efficient the correspondence checks are at

teaching complex discrimination between two or more picture cards. In addition, it is

not clear how often such correspondence checks should be conducted to ensure picture

card discrimination. It may be the case that infrequent checks may slow down the

acquisition of a large manding repertoire. Schwartz and colleagues (1998) reported that

it took students an average of 3 months (range = 1-6 months) to complete the

discrimination phase, which included the correspondence checks. In addition, it is not

known whether a student may have already learned the complex discrimination merely

as a result of simple discrimination training. If so, a potentially lengthy evaluation

process could be circumvented.

A more serious potential limitation of the correspondence checks is that it may

also be possible to establish a chain of responses that involves the individual handing

the incorrect card and then being prompted to hand the correct card, resulting in access

to the reinforcer. In other words, the individual may continue to hand the therapist the

wrong card and still ultimately, almost immediately, receive access to a preferred







reinforcer. This potential for chaining of incorrect responding may be another factor

slowing down acquisition of picture card discrimination between two or more picture

cards. Again, a repertoire of "scrolling" might be reinforced.

There are also potential limitations regarding the discrimination training that

takes place during phase 3 of PECS training. During this phase, individuals are taught to

discriminate between two or more picture cards. However during training, one picture

card corresponds to a highly preferred item while the other corresponds to a less

preferred or "neutral" item (Bondy & Frost, 1994, 2001; Frost & Bondy, 1994). It can

be argued that this form of discrimination is different from a discrimination between

two picture cards corresponding to preferred items. The need to discriminate between

two or more picture cards corresponding to preferred items may be encountered more

often during natural conditions when an individual will use a large picture vocabulary

made up primarily of reinforcers. It is the ability to discriminate between two or more

picture cards corresponding to preferred items that would indicate that the individual

has learned a functional mand as opposed to a generalized mand for a variety of items.

This skill is critical if the individual is to discriminate between the varieties of picture

cards that will ultimately be placed in the communication book as part of the

communicative vocabulary. It is not likely that the communicative vocabulary will

include mands for less preferred items, much less for neutral items. For this reason, it is

important that a discrimination between two or more picture cards corresponding to

preferred items is established as part of communication training.

In order to address these problems associated with teaching discriminated

manding in the context of two or more picture cards, it is necessary to evaluate the





8


extent to which individuals are manding or requesting specific items. In other words, it

is important to determine if individuals are learning to request items they "want" as

opposed to randomly handing over picture cards. The purpose of this study was to

manipulate the establishing operation to test the efficacy of traditional mand training

using two picture cards.













CHAPTER 2
REVIEW OF THE LITERATURE

Overview

Skinner (1957) defined verbal behavior as "behavior reinforced through the

mediation of other persons" (p.14). In addition, Skinner explained that any form of

behavior that affects another organism or is mediated by another organism is verbal

behavior. Therefore, vocal and nonvocal forms of communication were both

conceptualized by Skinner as forms of verbal behavior. Skinner (1957) outlined two

broad categories of verbal behavior, the "tact" and the "mand." A tact is "a verbal

operant in which a response of a given form is evoked (or at least strengthened) by a

particular object or event, or property of an object or event" (pp.81-82). In other words,

the tact names or labels an object or event. In addition, its occurrence is preceded by

the presentation of that object or event. For example, stating "that is a dog" is

considered a tact because it labels the presence of a dog. The tact is contrasted with the

mand, which is defined as "a verbal operant in which the response is reinforced by a

characteristic consequence and is therefore under the functional control of relevant

conditions of deprivation or aversive stimulation" (p. 36). In other words, the mand is a

requesting response, which specifies its reinforcer. For example, making the statement

"food please" is considered manding because it is requesting access to food.







Skinner (1957) distinguished between the two classes of behavior (tacts and mands)

and argued that they are functionally independent from each other. He explained that

tacts and mands are defined by their function or consequence. The mand enables an

individual to access reinforcers that are mediated by other individuals in their

community. The tact functions to produce social approval from individuals in their

community. Because tacts and mands are discriminated based on their function, it is

therefore possible for tacts and mands to share identical response topographies. For

example, the word "water" can function as mand if it is reinforced by access to water, or

as a tact if it is reinforced by social approval.

Because of the difference in the function of tacts and mands, being able to label an

item would not necessarily ensure that the same verbal response could be used to

request that item. Conversely, being able to utilize a verbal response to request would

not necessarily ensure that term could be used to label.

Some studies support the conceptualization that tacts and mands are functionally

independent (Lamarre & Holland; Sigafoos et al., 1989). Lamarre and Holland (1985)

taught one group of individuals to mand when prompted by the experimenter's question

"where do you want me to put the (object)?" Responses of "on the left" or "on the

right" were reinforced by proper placement of the item (left or right). A second group

of individuals were taught to tact when prompted by the experimenter's question

"Where is the (object)?" Correct responses were reinforced with praise and a marble.

Following training, emergence of the untrained response was assessed. Individuals who

had been taught to mand were presented with the question requiring a tact as a correct

answer "where is the (object)" and individuals who had been taught to tact were







presented with the mand question "where do you want me to put the (object)?" Results

of the study indicated that individuals taught the tact response did not acquire an

untrained mand response, and likewise, individuals taught the mand response did not

acquire the untrained tact response. In this case, the acquisition of one verbal operant

did not result in acquisition of the other.

In a similar study, Sigafoos and colleagues (1989) evaluated the independence of

tacts and mands, by examining whether teaching tacts facilitated the acquisition of an

untrained mand response. In this study, individuals were taught to tact food, beverage,

or utensils by pointing to symbols representing the items. Correct responses were

followed by descriptive praise. Once tacts for the items had been acquired, the

experimenters assessed for the acquisition of a manding response using the same

symbols. Items were presented outside the individual's reach and pointing to the

symbol corresponding to the item resulted in access to the item. Results of the study

showed that while individuals acquired a tact response using symbols, they were not

able to use symbols to mand for the same items. Again, responses taught as tacts did

not spontaneously occur as mands. Results of these studies lend experimental support

for Skinner's classification of mands and tacts as functionally independent verbal

operants. This is an important distinction for teaching because it shows that teaching

individuals to tact items will not result in their learning to mand for items. Furthermore,

it shows that it is necessary to teach mand responses under the appropriate conditions

using the specific items (the items manded for) as reinforcers in order to acquire a mand

response.







Teaching Verbal Behavior

Because language is believed to be critical in development (Sundberg & Michael,

2001) and identified as an indicator of long-term success for children with disabilities

(Bondy & Frost, 1994; Lovaas, 1966), behavior analysts have attempted to overcome

delays in verbal behavior using behavior analytic procedures. Behavior analysts have

applied Skinner's conceptualization of verbal behavior into training programs designed

to teach verbal behavior to non-verbal individuals. Methods used to teach verbal

responses go beyond vocalizations to include symbolic (Bondy & Frost 1993) and

gestural (Charlop-Christy, Carpenter, Le, LeBlanc, & Kellet, 2002) forms of

communication. In this chapter, two methods used by behavior analysts to teach verbal

behavior will be reviewed. The two methods reviewed are discrete trial training and

incidental teaching. In addition, three forms, or topographies, of verbal behavior

commonly taught to individuals with language delays will be outlined. These forms

include sign language, voice output devices, and picture communication systems.

Training Methods to Teach Verbal Behavior

Discrete Trial

One approach to teaching communicative behavior is the discrete trials method.

The discrete trials method involves conducting training sessions several days a week,

for several hours a day in a highly structured environment, in an effort to deliver

intensive communication training. Discrete trial sessions typically occur in a one to one

student to therapist ratio, where the therapist and child typically sit facing each other.

The therapist sits in close proximity to the child in order to deliver prompts, physically







prevent the child from leaving the training session if necessary, and deliver reinforcers

(Lovaas, 1966).

One of the proposed benefits of discrete trial training is that the methods allow

control over training variables (e.g., number of training trials and length of sessions).

By conducting a high number of training trials, discrete trial methods increase the

number of learning opportunities and possibly increase the rate of skill acquisition.

Lovaas (1987) provided children with 40 hours per week of intensive language and

behavioral intervention that produced improvements in communicative behavior as well

as improvements in academic skills. Simic and Bucher (1980) taught children to mand

for items using procedures similar to those described by Lovaas (1966). Training

resulted in increases in mands responses. However, mand responses did not readily

generalize to untrained settings (Simic & Bucher, 1980).

Although discrete trial training approaches have been successful at teaching

verbal behavior to individuals with language delays (Lovaas, 1966; 1987; Simic &

Bucher, 1980) there are some concerns regarding generalization of the skill to the

natural setting. The goal of communication training programs is to teach verbal

behavior that is functional and appropriate (Hart & Risley, 1968, 1980). However,

some researchers argue that discrete trial training results in mechanical and non-

functional verbal behavior due to a lack of response generalization to natural settings

(Harris, 1976; Hart & Risley, 1980; Charlop, Schreibman, & Kurtz, 1991). To

overcome the limitations of discrete trial training procedures, naturalistic language

interventions provide methods for teaching functional verbal behavior (Schepis et al.,







1998) designed to promote generalization of the skill to the natural setting (Hart &

Risley, 1980).

Incidental Teaching

A second approach of teaching communicative behavior is to use naturalistic

language interventions, or incidental teaching methods, that aim to teach language skills

in the child's natural environment. Naturalistic language interventions involve using

naturally occurring opportunities to teach communication (Schepis et al., 1998) that is

useful or functional (Carr,1982). Hart and Risley (1974) describe incidental teaching as

language training that is conducted during normal childhood activities involving toys

and other children.

Several studies (Hart and Risley 1968; 1974; 1975; 1980) have evaluated the

effectiveness of incidental teaching procedures to establish and maintain verbal

behavior. Hart and Risley (1968) evaluated the effectiveness of incidental teaching by

making children's access to free-play materials contingent on vocal request using color-

noun combinations (e.g., "brown crayon"). Fifteen children participated in the study

during which teachers made access to free-play materials (e.g., balls, snacks, blocks,

and toy animals) contingent on vocal requests using color-noun combinations. Teachers

placed their hands over the materials and prompted the response by asking the child

"what do you want" while delivering praise and access to the requested materials

contingent on correct responding. In this case, making access to play items contingent

on verbal responses resulted in an increase in the frequency of children's verbal

responses.







A follow-up study (Hart & Risley, 1974) extended the incidental teaching

procedure to include the use of more complex sentences. In this study, access to the

materials in the natural environment was made contingent on the use of compound

sentences (e.g., "I want a block, so I can play with it"). Results of this study replicated

the findings of the previous study, showing a marked increase in the verbal responses

when access to materials was made contingent on responding. In addition, maintenance

of responding occurred following the removal of the reinforcement contingency. The

results of both studies lend credence to the use of incidental teaching methods to

increase verbal responding.

Additional studies by Hart and Risley (1975, 1980) provide further support for

the use of incidental teaching. For one, incidental teaching methods were useful in not

only increasing verbal responses directed towards the teacher, but were additionally

useful in increasing verbal responses directed towards other children in the class (Hart

& Risley, 1975). Also, Hart and Risley (1980) were able to demonstrate that with

incidental teaching procedures, disadvantaged, language-delayed children were able to

increase several aspects of verbal behavior such as elaborations, the variety of words

used, and the frequency of complex sentences used.

Incidental teaching methods offer several benefits over alternative teaching

methods. The primary benefit of incidental teaching is that it promotes generalization

of verbal behavior across the natural environment (Hart & Risley, 1980). Hart and

Risley (1980) point to several features of incidental teaching that utilize generalization

techniques outlined by Stokes and Bear (1977). One important variable of incidental

teaching that may result in generalization is the variety of stimulus conditions under







which the training occurs. For one, incidental teaching procedures aim to establish vocal

responding in the natural conditions in which the behavior is to occur and is to be

maintained. Second, the occurrence of incidental teaching is conducted throughout the

day at various times and settings. The variability in training schedule limits the

development of stimulus control based on setting or time. Finally, conditions present

during incidental teaching are less discriminable than the conditions present during

typical training sessions. Incidental teaching procedures allow for training to occur

whenever the opportunities present themselves in the availability of the reinforcer and

child initiation.

A second benefit of incidental teaching is that it allows the child to initiate the

teaching opportunity as well as specify the reinforcer, which can vary from moment to

moment, based on the child's preference. Throughout the day a child can initiate

interactions with a wide variety of stimuli resulting in a variety of training

opportunities. Given the benefits of incidental and discrete trial approaches, one

possibility for future application would be to merge or combine the two approaches.

Forms of Communicative Behavior Taught to Individuals with Language Delays
Sign Language

Often, children with developmental delays do not acquire vocal-verbal skills

despite intensive training (Carr & Kologinsky, 1983; Carr, 1982; Carr et al., 1978).

Therefore, individuals with language delays are often taught to use signs to request

items as well as label items in their environment. Sign language training procedures

involve teaching children to communicate by way of sign configurations using their

hands, typically based on the American Sign Language for the deaf (Carr et al., 1978).







Carr and colleagues (1978) used prompting and fading techniques to teach sign

language to four autistic children who lacked communicative behavior. Children were

taught the signs for five food items following an auditory and visual presentation of the

food item. Correct responses were reinforced with praise and a small amount of the

food item. If the child did not respond correctly, the correct response was physically

guided and the response was reinforced with praise only. The physical prompt was

faded until the child signed following the auditory and visual prompt. Following

training, children were presented with the auditory and visual prompt and correct

responses were not reinforced. Results showed that nonvocal children were able to

acquire verbal behavior utilizing sign language, and did so to communicate a request for

food items.

Additional research shows that sign language can be successfully taught using

incidental teaching strategies (Schepis et al., 1982). In this case, direct care staff taught

autistic children sign language to gain access to preferred items. Signs were taught

using auditory prompting, manual guidance, and reinforcement sequence, while

participants were in their natural setting. Results showed that incidental teaching of sign

language was effective at increasing the use of manual signs. In addition, the results

were maintained at 5- and 17-week follow-up observations.

Voice Output Devices

Voice output devices have recently been developed to assist children with

language delays to acquire verbal behavior (Schepis et al., 1998). Voice output devices,

also known as voice output communication aids (VOCAs) involve the activation of a

device that produces recorded speech. Some advantages of VOCAs over other







communication systems (e.g., signing and picture communication systems) is that they

allow for the recording of a variety of messages that can be understood by individuals

who are not familiar with the user of the device (Schepis et al., 1998). This differs from

sign language which may not be interpretable by persons who are not familiar with

American Sign Language.

Schepis and colleagues (1998) evaluated the effectiveness of VOCAs to teach

children to request items, make statements, social comments, and answer yes and no

questions. Four children were taught to use the devices using a prompt sequence that

began with verbal and gestural prompts and graduated to physical prompts when

necessary to physically guide correct responses. Results showed an increase in the

frequency of communicative behavior for all 4 children. In this case, VOCAs were an

effective tool to teach verbal behavior to children with language delays

Additionally, Durand (1999) conducted a series of studies to evaluate the use of

assistive devices to teach individuals with language delays to gain access to objects and

activities. Students were taught to use a voice output device through verbal and physical

prompts which were gradually faded using delayed prompting as training progressed.

Results showed an increase in the unprompted use of the voice output devices as well as

a reduction in problem behavior exhibited by the children. In addition, the use of the

devices generalized to untrained settings.

Picture Communication Systems

Another alternative to teaching vocal-verbal behavior for individuals with

disabilities is the use of picture or iconic communication systems. This approach

involves teaching students to point to graphic symbols (Hulburt et al., 1982; Sigafoos et







al., 1989) or exchange pictures or symbols (Bondy & Frost, 1993, 1994, 2001; Frost &

Bondy, 1994; Schwartz et al., 1998; Liddle, 2001; Kravits et al., 2002). One advantage

of picture communication systems that has been proposed is that it does not require

some of the orientation (e.g., eye contact) and imitation skills (vocal or motor) that

other communication systems require (Bondy & Frost, 1994, 2001) possibly resulting in

faster acquisition. Also, because picture communication systems use two-dimensional

pictures of items that are easily recognized, it is not necessary to find a communicative

partner that is able to understand the form of communication as might be the case with

sign language (Schwartz et al., 1998).

One specific form of picture communication systems is the Picture Exchange

Communication System (PECS) developed by Bondy and Frost (1993, 1994, 2001).

One of the proposed advantages of PECS is that because the individual has to hand the

cards to a "listener," the behavior is directed towards a communicative partner (Bondy

& Frost, 1993, 1994, 2001). A second benefit of the PECS training is that because

requesting is the first skill taught, powerful reinforcers maintain communicative

responding. In addition, the PECS system does not require any prerequisite behavior

and the training is based on child initiation of the communicative response (Scwartz et

al., 1998). Bondy and Frost (1993, 1994, 2001) reported on the successful

implementation of PECS training for children with language delays, and several studies

have evaluated the effectiveness of PECS training to teach verbal behavior to

individuals with language delays and have found positive increases in communication

as a result of training (Schwartz et al., 1998; Liddle, 2001; Kravitz et al., 2002).







Bondy and Frost (1993) reported on the successful implementation of PECS

training for 74 students in Peru. In a similar publication, Bondy and Frost (1994)

reported that of 85 children who had been taught to use picture cards using PECS

training at the Delaware Autism Project, over 95% learned to use two or more pictures

to request items. Data for one individual were reported, which showed acquisition of the

request response using picture cards. After 11 months of PECS training, the individual's

vocal speech had improved and was able to communicate using only vocal speech.

Several studies have been conducted to evaluate the effects of PECS training on

picture card responding as well as vocal responding (Schwartz et al., 1998; Liddle,

2001; Kravitz et al., 2002). Schwartz and colleagues (1998) evaluated the effectiveness

of PECS training on children's use of picture cards to communicate with adults and

peers. In addition, the effects of PECS training on children's vocal behavior was

evaluated. In study 1, 31 children were taught to use picture cards to mand for items

using PECS. Children were taught to use the picture cards with teachers and peers to

receive access to items. Training was conducted using forward and backward prompting

techniques to teach the children to place picture cards on a poster board next to a

symbol meaning "I want," and hand the board to the communicative partner. This

response was reinforced with access to the item represented by the picture card.

Training continued until responding reached the mastery criterion of 80% or higher

independent correct responding over 3 sessions. Results showed that all the children in

the study learned to use the picture cards with adults and peers in the classroom. Results

also showed that, on average, acquisition of the 5 phases of the PECS training

(Exchange, Distance and Persistence, Discrimination, Sentence Building, and Peers)







required 14 months (range 3-28) of training. In study 2, 18 children who had

participated in study 1 were observed during snack time and free choice time.

Communicative behavior (gestures, vocalizations, manual signs, PECS exchanges, and

verbal) was recorded for each child. Results of study 2 showed that children who had

been taught to use picture cards in the classroom also used the picture cards during

snack time and free choice time. In addition, results showed that 44% of the children in

study 2 demonstrated unprompted, non-echolalic spoken communication.

Liddle (2001) taught 21 children with language delays to use the PECS to

request and label items in their classroom. The training sequence included 6 phases of

PECS training (Exchange, Distance and Persistence, Discrimination, Sentence Building,

Answering Questions, and Commenting). Results showed that, of the 21 children who

participated in the training, 20 completed phase 1 and learned to request items using

PECS cards, however, only 8 children completed phase 6. Results also showed that, on

average, children received PECS training for 10 months (range 1-15). In addition,

results showed that 42% of the children were observed to have increases in

vocalizations, with some children using single words.

Kravitz and colleagues (2002) evaluated the effects of PECS training on the

spontaneous verbal behavior of one child with autism. The participant was able to

communicate using 1 to 2-word utterances when prompted with very low frequency of

independent responding. The child was taught to use picture cards using the PECS

system during two free play activities at school (centers and journal) and at home.

Training was implemented using a multiple-baseline design across settings. Results

showed acquisition of the picture card response to gain access to preferred items as well








as an increase in spontaneous language (vocal and picture card) following the

introduction on PECS training across three settings.

Although the literature includes a wide range of examples of mand training (Carr et

al., 1978; Kravits, et al., 2002; Liddle, 2001; Schepis et al., 1998; Sigafoos et al., 1989;

Schwartz et al., 1998), such training usually involves a specific mand in a specific

context. An experimental question remains regarding the effectiveness of training to

produce appropriate, or discriminated manding. In most cases, the success of mand

training is evaluated based on the participant's ability to make the desired

communicative response (e.g., hand a card). In other words, if a child hands a "cookie"

card to the therapist, and then gains access to the cookie, it is presumed that the child

was appropriately manding for a cookie. However, on closer examination, the

appropriateness of the individual's mand cannot be entirely presumed based upon his

response. Rather, it remains unclear if the child is actually requesting a "cookie" or if

the response of handing a card has been sufficiently reinforced with access to preferred

items, such that a child hands a card in order to gain access to reinforcement in general.

Because the picture cards typically correspond to preferred items, a response using any

card will result in access to a reinforcer. If individuals are not able to discriminate

among the picture cards they have been taught to use to request items, then training has

not resulted in a functional, discriminated mand response.

Unlike vocal mand training or sign language training, picture card training uses the

same response form (handing a card). Therefore, when teaching students to use picture

cards to mand for items, it is possible that individuals may learn to hand any picture

card to receive access to any item, rather than to gain access to specific items. Teaching








students to use picture cards to request items may be limited by an individual's ability

to discriminate between picture cards. Therefore, it may be necessary to evaluate the

extent to which individuals are able to discriminate between picture cards in order to

assess the effectiveness of mand training using picture cards. The current study was

designed to evaluate the extent to which mand training using picture cards will result in

discriminated manding in the context of two picture cards. The technique of this study

was to manipulate the establishing operation to test the efficacy of traditional mand

training using two picture cards. Although the relative merits of picture card systems

can be debated, additional research is warranted due to the widespread use of these

systems












CHAPTER 3
METHOD

Participants

Six individuals who did not ordinarily request items either vocally or nonvocally

participated in the study. Mario was a 13-year-old male diagnosed with mental

retardation, Millie was a 4-year-old female diagnosed with Autism, Will was a 5-year-

old male diagnosed with Autism, Malcolm was a 6-year-old male also diagnosed with

Autism, Pablo was a 20-year-old male diagnosed with mental retardation, and Erin was

a 16-year-old male diagnosed with Down syndrome. Participants had minimal exposure

to picture cards prior to the start of the study as picture cards had been placed in some

classrooms (e.g., picture card for bathroom outside the bathroom). However, formal

training of picture card communication system use had not taken place for any

participant prior to the start of the study. Teachers or staff referred all participants

following an announcement at the school that the study was underway to teach and

evaluate communication using picture cards. These were the first six individuals

referred.

Setting

All sessions were conducted at the participant's school. Blocks of sessions lasted

for approximately 30 minutes and were conducted 3-5 days per week. During sessions,

participants were seated at a table across from the therapist and data collectorss.

Sessions were conducted in a small room reserved for the study. Sessions







Except for the preference assessment, sessions consisted of ten trials. During

each trial the participants were presented with the opportunity to emit a mand and

receive access to preferred items. After participants were allowed access to items for

approximately 30 seconds or were allowed to consume the food items, the card position

was counterbalanced in an array of two quasi randomly and the cards were presented to

the participant to start the next trial (specific procedures varied by condition, to be

explained below).

Data Collection and Response Definition

Two trained graduate and undergraduate observers independently recorded

correct and incorrect responses. During training, correct responses were defined as

handing the therapist the picture card or approaching (reaching for) the representative

item. Incorrect responses were defined as handing the therapist the distracter card or

approaching (reaching for) the empty board or empty hand. During the EO

manipulation (explained later), observers recorded the card that was handed to the

therapist or the representative item approached. During the EO manipulation with

topographically different responses (explained later), observers recorded the response

emitted by the participant, handing picture card or vocal response.

Interobserver Agreement

During all phases of the study, two trained observers collected data

simultaneously and independently during 34% of the sessions. Interobserver agreement

was calculated by dividing the number of agreements by the number of agreements plus

disagreements in each session and multiplying by 100%. An agreement was defined as a







trial in which both observers recorded the same occurrence of behavior. Mean

agreement for all sessions was 99% (range, 80% to 100%).

Materials

Two picture cards and two other distracter cards were used during training. The

picture cards corresponded to preferred items that were identified for each participant

during a preference assessment. Distracter cards contained an "X" or an "O" on them.

Procedures

Participation in each phase of the study was determined by participant

performance in the prior phase. As participants completed each phase, they either

moved on to the next phase of mand training or moved to a supplemental training phase.

Figure 1 shows the order of phases for the study.

Phase 1: Preference Assessment

The purpose of this phase was to identify items to be used as reinforcers. A free operant

preference assessment (Roane, Vollmer, Ringdahl, & Marcus, 1998) was conducted in

order to identify highly preferred items for each participant. Participants were presented

with an array of food and leisure items during one or two 5-minute sessions. Separate

assessments were conducted for Will and Millie to identify preferred items or activities

as well as consumable items. The two separate preference assessments were conducted

to avoid a possible "displacement" of non-consumable items that might function as

reinforcers by consumable items (DeLeon, Iwata, & Roscoe, 1997). Data collectors

recorded the amount of time participants spent interacting with each item. Items with

which participants spent the most amount of time were chosen as preferred items to be

used during mand training.







Phase 2: Single Card

The purpose of this phase was to establish a card-handing repertoire.

Participants were seated with a single picture card in front of them. During this phase,

handing the therapist the picture card resulted in access to the item for approximately 30

seconds or (when food or drink was the preferred item) a small amount of the

consumable item. Participants were taught to use picture cards to mand for preferred

items during this phase using a four step sequence (5-second pause, verbal instruction,

physical model, physical guidance).

Phase 3: Distracter Card Probe

We conducted a probe for all participants in which a picture card with a picture

of an item on it and a card with an "X" or an "O" on it were presented. The purpose of

this phase was to evaluate whether participants were more likely to select a card with a

picture on it, as a point of comparison to a subsequent differential reinforcement phase.

Participants were seated with the two cards in front of them (picture card and card with

an "X" or an "O"). During this phase, responding using either card resulted in access to

the preferred item. After the participant responded, the item was delivered and both

cards were removed. Access to the preferred item lasted for approximately 30 seconds

and in the case of consumable items, a small amount was delivered. After each trial, the

position of the cards was reassigned quasi randomly, the cards were then presented to

the participant again, and the next trial began.





























































Figure 1: Flow chart depicting the order of phases during the study.


Phase 7a
Topography Different
Response Training


Phase 7b
Establishing Operations
Manipulation with
Topographically Different
responses


Phase 6b
Establishing Operations
Manipulation with
Representative Items








Phase 4: Differential Reinforcement (Mand Training)

The purpose of this phase was to differentially reinforce responses using picture

cards, in order to establish a simple discrimination between the target card and distracter

cards or at least to provide a history of reinforcement for the picture card response.

There was no intention to show acquisition, as in some cases there already was a bias

towards selecting the cards with pictures. During differential reinforcement sessions,

only responses using the picture card resulted in reinforcement while responses using

the distracter card resulted in extinction. The experimental design was a concurrent

schedules design, in which experimental control is demonstrated by differential

responding across choice alternatives (Sidman, 1960). During these sessions the

participant was seated with two cards placed in front of him or her, the picture and the

distracter card. Requests using the picture card resulted in access to the item for

approximately 30 seconds or a small amount of the edible item. Requests using the

distracter card resulted in extinction (and a brief time-out from the session) during

which the therapist removed the cards and turned away from the participant for

approximately 5 seconds. After each trial the position of the cards was reassigned quasi

randomly and the trial was restarted. Participants were taught to use picture cards to

mand for two different preferred items during this phase. Participants who passed this

phase were deemed to have completed the initial discrimination screening and had

demonstrated performance of the discrimination skills necessary to move to phase 5 of

the study.







Phase 5: Establishing Operation Manipulation

The purpose of this phase was to evaluate the effectiveness of the initial mand

training to establish complex manding in the presence of two picture cards, each

corresponding to preferred items. Four participants who completed the initial

discrimination screening and acquired the discrimination skills taught in phase 4

participated in this phase. The EO manipulation phase differed from the differential

reinforcement phase in two respects. First, the two previously trained picture cards were

placed in front of the participants, there were no distracter cards present. Second,

participants had free access to one of the items they were previously taught to mand for

during differential reinforcement. The EO phase was conducted using a combination of

a concurrent schedule and multi-element design (Sidman, 1960) in which we compared

the effects of the EO (EO on vs. EO off) on manding. During EO manipulation sessions,

participants were allowed free access to one of the items they were previously taught to

mand during the differential reinforcement sessions, while access to a second item was

restricted. The mand for the second item also had been taught previously. For example,

if a participant was previously taught to mand for the radio and a drink, during this

phase the participant was allowed free access to the radio during the session (radio EO

off) and access to the drink was restricted (drink EO on), or vice versa. When access to

one of the items was restricted (e.g., radio) and the EO for that item was on (e.g., radio

EO on), access to the other item was made available (e.g., drink) and the EO for that

item was off (e.g., drink EO off). Sessions in which one EO was on or off were

alternated. Also, during the EO manipulation phase, requests using the picture card

corresponding to the restricted item resulted in access to that item for approximately 30







seconds or a small amount of the consumable item. Requests using the picture card

corresponding to the item to which the participant already had access resulted in the

therapist removing the cards for approximately 30 seconds (but they maintained access

to the item they already had). This was done to avoid "teaching" during the EO phase.

After each trial the position of the cards was reassigned quasi randomly and a new trial

was started.

Phase 6a Representative Objects Training

The purpose of this phase was to establish a simple discrimination

(representative object versus distracter) for two participants who did not develop a

simple discrimination with picture cards. Two participants (Pablo and Erin) who did not

pass the initial discrimination screening in phase 4 participated in this phase.

Representative objects corresponding to preferred items (e.g., empty bag of chips) and a

blank board or a therapist's empty hand (distracters) were used to teach the initial

discrimination. Responding by touching or reaching for the representative object

resulted in access to a small amount of the item while responses of touching or reaching

for the blank board or therapist's empty hand resulted in extinction during which the

therapist turned away from the participant for approximately 5 seconds. After each trial

the position of the cards (or empty hand) was reassigned quasi randomly and the trial

was restarted.

Phase 6b Establishing Operation Manipulation with Representative Objects

The purpose of this phase was to evaluate the effectiveness of mand training

using representative objects to establish complex manding in the presence of two

representative items each corresponding to preferred items. This phase was similar to







the EO manipulation in phase 5, and was used to test the complex discrimination for

the two participants (Pablo and Erin) using representative objects. This EO

manipulation phase differed from the EO manipulation in phase 5 in one respect,

representative objects corresponding to preferred items were placed in front of the

participants instead of picture cards. During EO manipulation sessions, participants

were allowed free access to one of the items they were previously taught to mand

during phase 6a, while access to a second item was restricted. The mand for the second

item had also been taught previously. For example, if a participant was taught to mand

for the radio and a drink, during this phase the participant was allowed free access to the

radio during the session (radio EO off) and access to the drink was restricted (drink EO

on), or vice versa. When access to one of the items was restricted (e.g., radio) and the

EO for that item was on (e.g., radio EO on), access to the other item was made freely

available (e.g., drink) and the EO for that item was off (e.g., drink EO off). Sessions in

which one EO was on or off were alternated. Also, during the EO manipulation phase,

requests using the representative object corresponding to the restricted item resulted in

access to that item for approximately 30 seconds or a small amount of the consumable

item. Requests using the representative items corresponding to the item the participant

already had access to resulted in the therapist removing the representative items for

approximately 30 seconds (but they maintained access to the item they already had).

This was done to avoid "teaching" during this phase. After each trial the position of the

cards was reassigned quasi randomly and a new trial was started.







Phase 7a Topographically Different Response Training (Vocal & Card)

The purpose of this phase was to develop two distinct mand forms (vocal &

card). Only one individual (Millie) participated in phase 7 because she was the only one

of the five participants in phases 5 or 6b who showed no sensitivity to the EO

manipulation. It is possible that the topographical similarity between handing responses

may have impeded discrimination during the EO manipulation (Carbone, personal

communication). One picture card and two distracter cards were used during a training

phase. The picture card corresponded to a preferred item and distracter cards contained

an "X" or an "0" on them. The participant was also presented with vocal mand training

designed to produce differential responding during the EO phase. During this phase, the

participant was taught to request an item using a picture card and was taught to request

a second item by saying the word corresponding to the item (e.g., saying "chips"). The

participant was taught to respond vocally by first presenting a vocal prompt (e.g., "say

chips") and delivering the reinforcer (chips) following the imitative response ("chips")

(Bourret, Vollmer, & Rapp, 2004). During the vocal manding sessions, the participant

was seated at a table and no cards were present. Requests using the vocal mand resulted

in access to a small amount of the item. Requests using any other word resulted in

extinction during which the therapist turned away from the participant for

approximately 5 seconds. The participant was taught to use the picture card to mand for

the item corresponding to the picture (music) and to vocal mand to mand for the item

corresponding to the vocal mand (chips). The participant was taught to use the picture

card to mand for the preferred item during this phase using a three-prompt sequence

(verbal instruction, physical model, physical guidance) followed by access to the item.







The participant was taught to mand vocally using prompts and modeling followed by

access to the item.

Phase 7b Establishing Operation Manipulation with Topographically Different
Responses (Vocal & Card)

The purpose of this phase was to test for complex discrimination using two

distinct response forms (vocal & card) instead of card versus card. Two topographically

different responses were used to overcome the possible discrimination problem caused

when topographically similar responses were used. For the one participant (Millie), the

EO manipulation was similar to that used in study phase 5, however, only one picture

card was placed in front of the participant. There were no distracter cards present and

the participant had free access to one of the items she was previously taught to mand for

during phase 7a, while access to a second item was restricted. The mand for the second

item had also been taught previously. During this phase, requests using the mand

corresponding to the restricted item resulted in access to that item for approximately 30

seconds or a small amount of the consumable item. Requests using the mand

corresponding to the item to which the participant already had access resulted in the

therapist removing the card for approximately 30 seconds (while the participant

maintained access to the item she previously had).













CHAPTER 4
RESULTS


Phase 1 Preference Assessment Results

Figure 2 shows the outcomes of the free-operant preference assessment for

Mario and Will. The item identified as most preferred for Mario was the radio and most

preferred for Will were cookie and radio A second item (drink) was identified for Mario

based on multiple observations not related to this study and was used during the

subsequent training sessions. Figure 3 shows the outcomes of the free-operant

preference assessment for Millie, Erin, and Pablo. The items identified as most

preferred for Millie were music and chips, for Erin were drink and chips, and most

preferred for Pablo were chips and drink. A preference assessment was conducted for

Malcolm (not shown in a figure); results of that assessment identified T.V. and chips as

most preferred items for Malcolm. The observers inadvertently only recorded the

outcome of the assessment, therefore percentages of session time data are not available

for Malcolm, and, hence, are not depicted graphically.

Phase 2 Single Card Results

All participants acquired the single card response within one very brief session

(data not depicted in figures). In all cases, the last several responses occurred with no

prompting.








100


BO

a MMario


40


20 -


Rai lI NmIuipper PImy MIagrzin PhMneboIk Talk





'1 -1









C |



r mril tvI bui s br Ik trains coil ty tV ll






100 -


90

s o W ill


40


20


crli pt chi l tl chip pretzs tortlla chips sklttlel mArn






Items


Figure 2: Percentage of 5-minute sessions of item manipulation during free-operant
preference assessment.













Millie


QS
ti
I

..
O
a,
~1D
e~J

E


E
a
PI


Millie


chllp mrr Ae top plans la iak tch-a- dIrtnk
sketch
1130

BD

150 Erin

40 -

20


ch ip I frink bIll kEV~ iri utulf m nil music
animal bemk


Pablo


S-I--


Irfnk


kill


nullytly


blue


Items


Figure 3: Percentage of 5-minute sessions of item manipulation during free-operant
preference assessment.


.......






38

Phase 3 Distracter Card Probe Results

Figure 4 shows the percentage of trials with cards selected for Mario and Will

during the distracter card probe phase. The filled circles represent responses using what

would eventually be the picture card and the open circles represent responses using the

distracter card. Recall that during the distracter card probe phase, responding using

either the picture card or the distracter card resulted in reinforcement, access to the

preferred item. The top two panels show the percentage of cards selected by Mario. The

first panel shows responses using the radio and the distracter card and the second panel

shows responses using the drink and the distracter card during the distracter card probe

phase. During the distracter card probe phase, Mario selected both the picture card and

the distracter card during both radio and drink sessions but showed a slight bias for the

picture card during the drink (M=63%) and radio sessions (M=68%). The next two

panels of figure 4 show the results for Will during the distracter card probe phase. The

third panel shows responses using the cookie card and the distracter card and the fourth

panel shows responses using the radio card. During the distracter card phase, Will

responded using the distracter card almost exclusively during the cookie (M=95%)

sessions and showed a bias for the distracter card during the radio (M=73%) sessions.

Figure 5 shows the percentage of trials with cards selected for Malcolm and

Millie during the distracter card probe phase. The top two panels show the percentage

of cards selected by Malcolm. The first panel shows responses using the T.V. and

distracter card and the second panel shows responses using the chips and distracter card.

During the distracter card probe phase, Malcolm showed a bias for the picture card, he

responded using the T.V. card more often (M=72%) than the distracter card during the








100
80
60
40
20
0


) 100 -
80-
R 60 -
40 -
20-
B o-


1 2 3 4 5 6 7 8 9 10 11 12 13

Mario






Drink

1 2 3 4 5 6 7 8 9 10 11 12 13
1 2 3 4 5 6 7 8 9 10 11 12 13


. 100 -
CI
80 distracter card
lo 60-
0
Q 40 -
6)D picture card
20
I 20 I.,


1 2 3 4

100
80 -
60 -
40 -
20
2O --


Cookie


5 6 7 8 9 10 11 12


1 2 3 4 5 6 7 8 9 10 11 12


Figure 4: Percentage of trials with picture card and distracter card selected during the
distracter card probe phase for Mario and Will.


I








100 -
80 -

60 -
40 -
20 -
0


100

80 -
60
40-

20 -
0-



100
80 -
60 -

40
20
0-


100 -
80 -
80

60
40
20
0
-


1 2 3 4 5


SMalcolm






1 2 3 4 5 6

Sessions







Chips
S,
1 2 3 4


"0
T



rj,
u
"3






* -


'0
cs
U~
(S
u
r,
(u


Music
---'-- 0 ----- ------ i-----.----0----------"-----


Sessions
Figure 5: Percentage of trials with picture card and distracter card selected during the
distracter card probe phase for Malcolm and Millie.


Millie


T.V.


^





41

T.V. sessions and selected the chips card almost exclusively (M=92%) during the chips

sessions. The next two panels of figure 5 show the data for Millie. The third panel

shows responses using the chips and distracter card and the fourth panel shows

responses using the music and distracter card. Millie responded using the chips card

exclusively during the chips sessions (M =95%) and the music exclusively during the

music sessions (M=100%).

Figure 6 shows the results for Erin and Pablo during the distracter card probe

phase. The top two panels show the percentage of cards selected by Erin. The first panel

shows responses using the chips and the distracter card and the second panel shows

responses using the drink and the distracter card. Erin selected both the picture card and

the distracter card during both drink (M= 53% selection of drink) and chips (M=43%

selection of chips) sessions. The next two panels of figure 6 show the results for Pablo.

The third panel shows responses using the chips and distracter card and the second

panel shows responses using the drink and distracter card. Pablo selected both the

picture card and the distracter card during both chips (M=48% selection of chips) and

drink (M=50% selection of drink) sessions.

Phase 4 Mand Training Results

Figure 7 shows the percentage of trials with cards selected for Mario and Will

during the distracter card probe and differential reinforcement phases. In the differential

reinforcement phase, the filled circles represent correct responses (responses using the

picture card) and the open circles represent incorrect responses (responses using the

distracter card). Recall that during the differential reinforcement phase, only responses

using the picture card resulted in reinforcement while responses using the distracter











picture card






ditracter card
distracter card


100 -

80 -

60-

40 -

20

0

100 -

80

60

40

20

0

100

80

60

40

20
0


7

Erin


Chips


1 2 3 4 5 6 7


Chips


Pablo


Drink


3
Sessions


Figure 6: Percentage of trials with picture card and distracter card selected during the
distracter card probe phase for Erin and Pablo.


Drink


100

80

60 -

40 -

20 -

0 -


- ----"-----








DR + Ins + Book


100 -
80
60
40
S20
o 0-


100 -
80 -
U 6 60
40
S20






80
" 60


S2O 0



100

aS 80

60
40
20
0


13 14 15 16 17

Will





\ Radio
ci---o---o


1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Sessions



Figure 7: Percentage of trials with picture card and distracter card selected during the
distracter card probe and differential reinforcement phases for Mario and Will.


1 3 5 7 9 11 13 15 17 19 21 23 25 27 29






44

card resulted in extinction. The top two panels show the percentage of cards selected by

Mario. The first panel shows responses using the radio and the distracter card and the

second panel shows responses using the drink and the distracter card during the

distracter card probe and differential reinforcement phases. Mario selected the

distracter card more often than the picture card when differential reinforcement was

implemented during the radio sessions and drink sessions (M=60%). We observed that

during this phase, Mario was not looking at the cards. He was handing the therapist a

card without looking down at the card he was handing. We then provided Mario with

instructions during the radio sessions to hand the picture card in order to gain access to

the radio. However, this manipulation was not effective at producing 100% correct

responding (M=73%) and Mario was still not looking at the cards consistently. In order

to ensure that Mario would look at the cards before handing them to the therapist, we

placed the cards in a small photo album to create a communication book. This required

that Mario open the book and find the correct card to hand to the therapist. This

intervention was immediately effective at producing 100% correct responding during

the radio and drink sessions. The next two panels of figure 7 show the data for Will.

The third panel shows responses using the cookie card and the distracter card and the

fourth panel shows responses using the radio card. When differential reinforcement was

implemented, Will responded more often using the picture card rather than the distracter

card during both cookie (M=85%) and radio (M=86%) sessions.

Figure 8 shows the results for Malcolm and Millie during the distracter card

probe and differential reinforcement phases. The first two panels show the results for

Malcolm. The first panel shows responses using the T.V. and distracter card and the









100
80 -
60 -
40 -
a 20
0-
o


% 100 -
80 -
60 -
40 -
20-
1j 0-





60


=40
o o
100
Sso





S60







40
20


0
S100
6 80

P-I 60
40
20

0


Differential Reinforcement


T.V.


7 8 9 10 11 12



^ ~~^M a lcolm


1 2 3 4 5 6 7 8 9 10 11 12


Distracter
Phase


Differential Reinforcement







o-. Chips


Millie


Music


1 2 3 4 5 6


Sessions


Figure 8: Percentage of trials with picture card and distracter card selected during the
distracter card probe and differential reinforcement phases for Malcolm and Millie.


1 2 3 4 5


'


.


Jzc~c~L~


IlL





46
second panel shows responses using the chips and distracter card. When differential

reinforcement was implemented, Malcolm responded using the picture card for the

majority of the trials during both the T.V. (M=92%) and chips (M=93%) sessions. The

next two panels of figure 8 show the results for Millie. The third panel shows responses

using the chips and distracter card and the second panel shows responses using the

music and distracter card. When differential reinforcement was implemented, Millie

responded using the picture card rather than the distracter card during both the chips

(M=95%) and music (M=97%) sessions. Recall that Millie had already responded

mostly using the picture card even prior to differential reinforcement (see phase 4).

Figure 9 shows the results for Erin and Pablo during the distracter card probe and

differential reinforcement phases. The first two panels show the results for Erin. The

first panel shows responses using the drink card and the distracter card and the second

panel shows responses using the chips card and the distracter card. When differential

reinforcement was implemented, Erin responded using both the picture card and the

distracter card during the drink (M=53%) and chips (M=51%) sessions. The next two

panels of figure 9 show the results for Pablo. The third panel shows responses using the

chips card and the distracter card and the fourth panel shows responses using the drink

card and the distracter card. When differential reinforcement was implemented, Pablo

responded using both the picture card and the distracter card during the drink (M=53%)

and chips (M=51%) sessions.

In summary, when differential reinforcement was implemented for responding

using picture cards, four out the six participants responded using the picture card to gain








Distracter
oo10 Phase

80 -
60-


40 -
20 -


0




100
80
60
40
20
0


1 2 3


Differential Reinforcement


picture card


Erin


Drink


4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19


~~a')-oj


1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19


3 4


Differential Reinforcement


Chips


5 6 7 8 9 10 11 12 13 14 15 16 17 18


Pablo







Drink


1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18


Sessions


Figure 9: Percentage of trials with response emitted during the distracter card probe and
differential reinforcement phases for Erin and Pablo.


Distracter
Phase


, 100
Oc so
80-
60-

40




io
-







80
60

40


20


1 2


I I


Chips


<^


0


"g~,





48

access to preferred items. This was not intended to be a demonstration of acquisition

(recall that two individuals already selected picture cards prior to differential

reinforcement). Rather, differential responding was a pre-requisite to getting to the EO

test. The four individuals who responded differentially demonstrated the prerequisite

skills necessary for inclusion in phase 5 of the study, Establishing Operation

Manipulation. Differential reinforcement was not sufficient to teach the simple

discrimination between the picture card and distracter card for Erin and Pablo. Thus,

Erin and Pablo participated in phase 6.

Phase 5 Establishing Operations Manipulation Results

Figure 10 shows the percentage of trials with the picture card selected for Mario and

Will during the EO phase. The filled circles represent responses using the picture card

in sessions when the participant did not have access to the item (EO on), and the open

circles represent responses using the picture card in sessions when the participant

already had access to the item (EO off). Recall that EO on and EO off sessions were

alternated between the two cards. So, the EO on session for one card was the EO off

session for the other card. Responses using the picture card when the EO was on

resulted in reinforcement while responses using the picture card when the EO was off

resulted in the therapist removing the cards for approximately 30 seconds (but the

participants maintained access to the item they already had). After each trial the position

of the cards was reassigned quasi randomly and a new trial was started. The first two

panels show the results for Mario, the first panel shows responses using the radio card

when the radio EO was on and off and the second panel shows responses using the

drink card when the drink EO was on and off. During the radio EO on sessions, Mario















100

80

60


cJ















0)





*1


;.hi


40

20

0


100

80 -


40 -

20

0-
o

100

80

60

40

20

0


100 -

80 -

60


- =


t
EO on



EO off

19 1 1 Radio

1 3 5 7 9 11 13 15 17 19 21 23 25


Mario


Drink


1 3 5 7 9 11 13 15 17 10 21 23 25 27


1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23


Will


1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

Sessions


Figure 10: Percentage of trials with picture card selected during the establishing
operations manipulation phase for Mario and Will.


I


Radio






50
responded using the radio card 100% of the time. Mario responded using the drink card

during the drink EO on sessions approximately 80% of the time during the first 8

sessions and 100% of the time the remainder of the sessions (overall M=89%) and 0%

of the time in sessions when the EO was off (overall M= 0%). The next two panels of

figure 10 show the results for Will. Initially, during the cookie EO on session Will

responded using the cookie card slightly more often when the EO was on than when the

EO was off. However, during the last 5 sessions Will responded using the picture card

only when the EO was on (Overall M=92%). During the radio EO on sessions, Will

responded using the radio card most of time (M=88%) and rarely during the radio EO

off.

Figure 11 shows the percentage of trials with the picture card selected for

Malcolm and Millie during the EO phase. The first two panels show the results for

Malcolm. During the T.V. EO on sessions, Malcolm responded using the T.V. card

more often (M=83%) than when the EO was off. Malcolm responded using the chips

card during the chips EO on sessions more often (M=83%) than when the EO was off.

The last two panels of figure 11 show the results for Millie. During the chips EO on,

Millie responded using the chips card (M= 55%) versus (44%) during chips EO off and

the music card (M=82%) when the EO was off.

In summary, results of this phase showed that 3 of the 4 participants accurately

manded for two different items using picture cards in the context of two picture cards.

Three participants (Mario, Malcolm, and Will) were able to respond using a picture card

representing an item when the establishing operation for that item was on and did not

typically respond using the picture card for an item when the establishing operation was










100

80

o EO on

40
SEO off
S20 T.V.


E 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31
rA 100 -
100
1 80- Malcolm



40 -

220 Chips
0o

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31
0 100

a 80

60

140 -

S 20- o Chips

0. 0
6JD o -- -- a -- ^ -- -- '------' ----- -----
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

100 -

o Millie

60 -

40 -

20 Music

0 -
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Sessions
Figure 11: Percentage of trials with picture card selected during the establishing
operations manipulation phase for Malcolm and Millie.





52

off. One participant (Millie) did not learn to mand for two items using picture cards in

the context of two picture cards. Millie responded using a picture card representing an

item when the establishing operation was on and off. This pattern of responding

suggested that Millie had not acquired the complex discrimination between the two

picture cards that was necessary for discriminated manding in the context of two picture

cards. It was necessary to teach Millie a discriminated manding response in order for

her to effectively mand for two different items. Therefore, Millie participated in phase 7

of the study, where she was taught to mand using two topographically different

responses in order to teach a discriminated mand response in the context of two

different items.


Phase 6a Representative Objects Training Results

Recall that the purpose of this phase was for the 2 individuals who did not learn

the simple discrimination in phase 4 (Pablo and Erin) to make available an extremely

obvious discrimination in order to move toward the EO test, which was of primary

interest. Figure 12 shows the percentage of item approached for Erin and Pablo during

the representative objects distracter probe and differential reinforcement phases. Filled

circles represent approach responses to the representative object and open circles

represent approach responses to a blank cardboard. The first two panels show the results

for Erin. The first panel shows approach responses to the chips representative object and

the second panel shows approach responses to the drink representative object. When

differential reinforcement was implemented, Erin approached the representative object

100% of the time during both chips and drink sessions. The last two panels of figure 12

show the results for Pablo. When differential reinforcement was implemented, Pablo









Distracter
Phase


100

80

60

40 -

20 -
0
-a

U

100

80

^ 60

40

20

0



100

so -

60

40

20





S100
I 80








60

40
20








0O*
0-


Differential Reinforcement


representative item


blank cardboard


Chips


11 13 15 17 19 21 23 25


Erin


1 3 5 7 9 11 13 15 17 19 21 23 25


Differential Reinforcement


1 3 5 7 9 11 13 15 17 19 21 23 25 27 29


Sessions
Figure 12: Percentage of trials with item approached during the differential
reinforcement phase for Erin and Pablo.


1 3 5 7 9


. Cl3 .L _~





54

approached the representative object most of the time during the chips sessions

(M=83%) and the drink sessions (M=88%). During the last 11 chips differential

reinforcement sessions Pablo was presented with a choice of approaching the

representative object or the therapist's empty hand and this manipulation resulted in

100% of the approaches being made to the representative item. This manipulation was

conducted during the last 12 drink differential reinforcement sessions and this resulted

in 100% of the approaches being made to the representative item during the last 7

sessions. The reason for this change was that the main purpose of the study, which was

to conduct the EO manipulation between two relevant objects, so the use of a blank

board versus an empty hand was somewhat incidental unless we were unable to see

differentiated responding. Given that the empty hand produced 100% allocation to the

representative item, Pablo, like Erin, was ready for phase 6b. There is no claim that

Pablo and Erin were "taught" this discrimination. Rather, a very easy discrimination

was identified in order to move to the EO test manipulation.

Phase 6b Establishing Operations Manipulation
with Representative Objects Results

Figure 13 shows the percentage of trials with the representative object

approached for Erin and Pablo during the EO phase. The filled circles represent

approach responses to the representative object in sessions when the EO was on and the

open circles represent responses to the representative object in sessions when the EO

was off. Approach responses to the representative object the participant did not already

have access to (EO on) resulted in reinforcement while approach responses to the

representative object the participant already had access to (EO off) resulted in the










100
80
60 -
40-
20 -

0

100
<


Co 800
so -


40 -

S20



S100
80
r2 60 -
t 40 -
~2-

o ~0
O o


100 -
e
0 80-
U
S60 -

oP 40
20 -
0


Erin


Drink


1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
If AkA-


Chips


1 2 3 4 5 6 7 8 9


Pablo




Drink
,, 0 ,


1 2 3 4 5 6 7 8 9

Sessions


Figure 13: Percentage of trials with item approached during the establishing operation
manipulation phase for Erin and Pablo.


t
EO off
Chips
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15





56

therapist removing the representative objects for approximately 30 seconds (but they

maintained access to the item they already had). After each trial the position of the

representative objects was counterbalanced quasi randomly and a new trial was started.

The first two panels show the results for Erin, the first panel shows approach responses

to the representative object for chips and the second panel shows approach responses to

the representative object for drink. During the chips EO on sessions, Erin responded by

approaching the chips representative object 89% of the time, which was slightly higher

than during chips EO off. During the drink EO on sessions, Erin responded by

approaching the drink representative object 33% of the time, which was slightly higher

than during drink EO off. The next two panels of figure 13 show the results for Pablo.

Pablo responded by approaching the chips representative object during the chips EO on

sessions 100% of the time and 30% of the time during chips EO off sessions. He

selected the drink representative object most of the time when the EO was on

(M=68%)during the drink EO on sessions and 0% of the time during the drink EO off

sessions.

In summary, results of this phase showed that both participants were more likely

to mand for items when the EO was on (versus off for that item) using representative

items in the context of two representative items. Erin and Pablo were able to respond by

approaching the representative item for which the EO was on, the item they did not

have access to, more often than when the EO was off in the context of two

representative items.





57

Phase 7a Topographically Different Response Training
(Vocal + Mand Training) Results

During phase 5 (Establishing Operations Manipulation) only one of the 4

participants, Millie, did not mand using the appropriate picture card. Her behavior in

phase 4 (Differential Reinforcement) indicated that Millie was able to mand for items

using picture cards, however, the establishing operation manipulation demonstrated that

Millie had not learned to mand for specific items in the context of more than one picture

card. In other words, Millie had not learned to discriminate from among the picture

cards. In an effort to teach Millie to mand for the relevant item during the establishing

operation manipulation and to teach her to respond differentially to gain access to

preferred items, we taught Millie a topographically different response to establish the

discrimination between mands for preferred items. Figure 14 shows the vocal mand

training data for Millie. Closed circles represent independent responses, saying "chips"

and the open circles represent prompted responses when Millie was instructed to say

"chips" to gain access to the chips using a model prompt. Millie responded

independently using the vocal mand "chips" as training progressed (M=66%) and by the

last 4 sessions she was responding independently on average 85% of the time (100% in

the final session).

Phase 7b Establishing Operation Manipulation with Topographically Different
Responses (Vocal + Card) Results

Figure 15 shows the data for Millie during the EO with two topographically

different responses phase. The top panel shows the results for the chips utterance. The

closed circles represent vocal responses, saying "chips," when she did not have access












S100 Independent
.C 80 -
r 60
o 40
20 -
SPrompted
1 2 3 4 5 6 7 8 9 10 11 12
Sessions



Figure 14: Percentage of trials with response emitted during vocal mand training for
Millie.


to the chips but had access to the music (chips EO on) and the open circles represent

responses saying chips when she already had access to the chips but did not have access

to the music (chips EO off). The Xs represent responses during booster sessions.

Booster sessions consisted of supplemental mand training (of the sort done in phase 4

for cards and 7a for vocals) and were conducted when Millie returned to sessions after

having missed school for a substantial amount of time. The bottom panel of figure 15

shows the results for the music picture card. The closed circles represent responses

using the music picture card when Millie did not have access to the music but did have

access to the chips (music EO on) and the open circles represent responses using the

music card when she already had access to the music but not chips (music EO off). In

the first sessions, Millie responded by saying chips and using the music card more often














Chips


1 7 13 19 25 31 37 43 49 55 61 67 73 79 85 91 97 103 109 115


Millie


Music


1 7 13 19 25 31 37 43 49 55 61 67 73 79 85 91 97 103 109 115

Sessions


Figure 15: Percentage of trials with response emitted during the establishing operation
manipulation with topographically different topographies phase (vocal + mand) for
Millie.


B
B
W
(y
m
E
o
pll
m
a
pc~


cc
O


SIS


cu
F4






60

when the EO was off but as sessions continued Millie responded more often when the

EO was on for both the chips (M=77%) and the music (M=84%).

In summary, results of this phase showed that Millie accurately manded for two

different items using a picture card and a vocal response in the context of two preferred

items. Millie was able to respond using a picture card representing an item or a vocal

response for an item when the establishing operation for that item was on and rarely

responded using the picture card or the vocal response for an item when the establishing

operation for that item was off.












CHAPTER 5
DISCUSSION

The purpose of this study was to determine if mand training resulted in

discriminated manding using picture cards when more than one picture card was

available. In other words, at the completion of mand training, individuals ideally would

be able to selectively mand for desired items using a picture card. An establishing

operation (EO) manipulation phase was used to assess for discriminated manding. The

EO manipulation was designed to determine if individuals manded for a preferred item

that they did not have access to (for which the EO was in place) and conversely did not

mand for items that they had access to (for which the EO was not in place).

The results of this study showed that for three participants (Mario, Malcolm, and

Will) mand training using picture cards resulted in discriminated manding in the context

of two picture cards. For these individuals, the mand response was under the control of

the establishing operation (i.e., they most frequently manded for the items they were

deprived of and not for the items they had access to).

For one participant, mand training using picture cards did not result in

discriminated responding. Millie successfully completed the mand training phase of the

study using picture cards, but did not accurately discriminate between two picture cards

when presented with the EO manipulation. Rather, she continued to mand for the item

that she already had access to. At the end of the mand training phase, Millie's data

suggested that mand training had been effective in teaching her to mand for two items





62

using picture cards. However, the establishing operation manipulation phase showed

that mand training had not been effective in teaching discriminated manding in the

context of two picture cards.

Subsequently, in order to establish discriminated manding, Millie was presented

with additional discrimination training. During additional training, Millie was taught to

use two topographically different responses (picture cards and vocal). Following this

additional training, Millie was able to mand appropriately for the two items during the

EO manipulation. The mand response using two topographically different responses

was under the control of the establishing operation (i.e., Millie more frequently manded

for the item she was deprived of than for item she had access to).

For two individuals, (Erin and Pablo), mand training using picture cards was not

successful using simple reinforcement procedures. Erin and Pablo did not acquire the

discrimination between the picture card and distracter card. Therefore, in order to

establish a mand response, Erin and Pablo were no longer presented with picture cards,

but instead were presented with representative items and much more obvious distracters

in order to ensure discrimination. Both Erin and Pablo acquired the discrimination

between the representative items and the blank board (Erin) or an empty hand (Pablo).

In addition, both responded appropriately in the EO manipulation phase (i.e., Erin and

Pablo more frequently manded for the item when they were deprived of it than when

they were not). Although Erin's results reflected frequent "errors," the mand response

using representative items was under the control of the establishing operation, although

only to a small (but consistent) degree.






63

In the present study, three individuals displayed complex discriminated manding

using picture cards. In addition, the implementation of an EO manipulation phase

yielded additional validity to the appropriateness of discrimination training in teaching

individuals to mand for preferred items. Conversely, three individuals were unable to

acquire discriminated manding (Erin, Pablo) or complex discrimination (Millie) using

picture cards. For two (Erin and Pablo), a discrimination between the picture cards and

distracter cards was never acquired during training. For Millie, discrimination between

the picture cards and distracter cards was established in training, but did not result in

discriminated responding when presented with the EO manipulation. In both cases, lack

of appropriate responding warrants further interpretation.

One possible explanation for a lack of appropriate responding in three

participants (Erin, Pablo, and Millie) is that there may have been a lack of control over

the stimuli controlling responding. Mcllvane and Dube (2003) explain that the stimulus

the experimenter has designed to control responding and the stimulus that is

functionally controlling responding may not be the same. For example, when presented

with a picture card, the stimulus intended to control behavior is the two-dimensional

drawing on the face of the card. However, the actual stimulus controlling behavior

could be some other stimulus such as the colors, shape, etc. The degree to which the

experimenter's intended stimuli and the stimuli relevant to the participant are the same

is called Stimulus Control Topography (SCT) Coherence (Mcllvane & Dube, 2003).

According to McIlvane and Dube's (2003) conceptualization, Erin's, Pablo's,

and Millie's failure to acquire discriminated responding may be a function of the

experimental conditions rather than some inherent inability on the participant's part to





64
discriminate. In other words, there was an apparent lack of SCT coherence. For Millie,

the participant who responded inappropriately in the EO manipulation, it is possible that

the specific two-dimensional drawing on the picture cards was not controlling behavior.

It is relevant to point out that when the distracter card was used, Millie showed a

preference for the picture card. In this case, the stimuli controlling behavior may have

been a less strictly defined stimulus, perhaps picture cards in general. Regarding Erin

and Pablo, again SCT coherence may not have occurred. Erin and Pablo may have

learned to hand over cards independent of the stimulus on the card. Thus, cards per se

had acquired stimulus control properties.

Such an explanation lends credence to the subsequent interventions for Erin,

Pablo, and Millie. In all cases, the presented stimuli themselves were altered and may

have produced coherence between the experimenter's intended stimuli and the stimuli

controlling behavior. For Millie, SCT congruence may have been established with the

addition of a topographically distinct response (vocal vs. picture card). By using two

response topographies, each associated with a different reinforcer, discriminated

manding during the EO manipulation phase was established. Similarly, SCT coherence

may have been established for Erin and Pablo with the addition of representative items.

In this case, stimulus control was no longer linked to a single stimulus (cards) but had

been established between representative items and alternative items (i.e., blank board or

empty hand).

In addition to SCT incongruence, the schedule of reinforcement during training

may be a variable contributing to inappropriate responding for Erin and Pablo. During

the study, the intended schedule of reinforcement was a fixed-ratio 1 (FR 1) or





65

continuous reinforcement (CRF) for correct responses, in which each correct response

resulted in reinforcement, and incorrect responses resulted in extinction (Ferster &

Skinner, 1957). Although not systematically included as a component in this study,

schedules of reinforcement inevitably produce specific patterns of responding. In this

case, a post-hoc analysis of the reinforcement schedule reveals that while responding

with the appropriate card was reinforced on an FR1 schedule, responding in general

(i.e., handing cards to the experimenter) may have been maintained on a variable-ratio

(VR) or intermittent schedule of reinforcement (Ferster & Skinner, 1957). During a VR

schedule of reinforcement, the number of responses required for reinforcement varies

according to a series of ratios having an average value (Ferster & Skinner, 1957). Pablo

gained access to the reinforcer on average of 53% of the trials during the chips sessions

and 47% of the trials during the drink sessions. Erin gained access to the reinforcer on

average of 53% of the trials during the drink sessions and 51% of the trials during the

chips sessions. This is approximately a VR 2 schedule of reinforcement for Pablo (VR

1.9 for chips and VR 2.1 for drink) and Erin (VR 1.9 for drink and VR 2 for chips).

Variable-ratio or intermittent schedules of reinforcement maintain higher rates of

responding than fixed schedules of reinforcement and are more resistant to extinction

(Skinner, 1953). A VR 2 schedule of reinforcement may have been sufficient to

maintain the response of handing either of the two cards, while minimizing the salience

of differential reinforcement.

Another possible explanation for Millie's initially undifferentiated responding

during the EO phase is that she may not have been emitting the verbal operant intended

by the experimenter. The goal of this study was to teach the mand response





66
(requesting). However, Skinner (1957) describes other verbal operants (e.g., tacts,

echoics, etc.) each serving its own function. In the case of Millie, failure to respond

appropriately during the EO manipulation was initially interpreted as inability to

appropriately mand using the picture card. It is, however, possible that Millie may have

been acting (labeling) items she had by using the picture card. This would explain why

during the EO manipulation she most frequently handed the picture card corresponding

to the item she already had access to (EO off) rather than manding for the item she did

not have access to (EO on). A second, but similar, possibility is that Millie was emitting

a mand response but may have been manding for "more" of the item she had access to,

such as when a restaurant costumer asks for a refill before his drinking glass is empty.

The results of this study have several implications for the practical use of mand

training using picture cards. At present, picture card training has been used successfully

to treat language delays and increase communicative behavior (Schwartz et al., 1998;

Liddle, 2001; Kravitz et al., 2002). Despite the literature on the application of picture

card training, far less literature has been focused on factors related to the effectiveness

and efficiency and, conversely, the ineffectiveness and inefficiency with which picture

card training produces discriminated manding. Literature describing picture card

training outlines methods of teaching discrimination, and this procedure is typically

comparable to the methods presented in this study. However, despite typical

discrimination training, half of the present participants failed to acquire discriminated

manding.

In three cases, modifications to the initial training procedure were made to

establish appropriate responding. Modifications included the addition of





67

topographically dissimilar responses (picture cards and vocal), as well as modification

of the stimuli (from cards to representative items). From a practical standpoint,

clinicians utilizing picture cards in isolation may fail to produce discriminated manding

with some participants. Rather than focusing on extensive, repeated exposure to picture

cards, manding may be more quickly and accurately established with modifications in

the training procedure.

Additionally, results of this study revealed that mand training may not be

sufficient to establish a discriminated mand (as in the case of Millie). Therefore, the use

of a post-training assessment, such as the EO manipulation, may be of practical use in

determining if the desired response has been established. For Millie, the use of a book

full of picture cards may have "fooled" others into believing she was successfully

making complex discrimination given that she likely would have pulled out cards and

handed them to an adult. The EO manipulation showed that more training was needed.

The results of this study contribute to the literature on communication training

for individuals with language delays. However, there are several potential limitations of

the study that should be taken into account when interpreting the results. One potential

limitation was the possible variation of schedules of reinforcement in effect during

some phases of the study. As previously discussed, the actual delivery of reinforcement

on a VR schedule for 2 participants (Erin and Pablo) may have resulted in inappropriate

responding during the discrimination training phase. The schedule of reinforcement

designed to be in effect throughout the study was a fixed-ratio 1 (FR 1) or continuous

reinforcement schedule (CRF) for correct responding. Under optimal conditions, the





68

schedule of reinforcement intended by the experimenter would be the schedule of

reinforcement controlling responding.

An additional limitation of the study was the lack of experimental control during

the representative drink item training phase for Pablo. During this phase, the initiations

of two variables (differential reinforcement and presenting the empty hand) were

implemented at the same time. By introducing two variables at the same time, it remains

unclear which variable was responsible for the acquisition of the mand response during

this training phase. The results of this phase were interpreted such that using

representative items resulted in the acquisition of the mand response for the drink.

However, it is possible that the presentation of the empty hand may also have been an

important variable in establishing responding. A preferred alternative would have been

to present each variable independently. However, because the goal of this phase was to

create a discrimination in order to move to the EO test, determining which variable

(differential reinforcement or presenting the empty hand) was responsible for the

acquisition of the mand response was not undertaken.

A third limitation of the study is the isolated occurrence of a participant (Millie)

who demonstrated incorrect responding during the EO manipulation. Though not a

limitation of this study's experimental design, the fact that only one participant

displayed opposite effects in this phase makes it difficult to determine the extent to

which such responding may occur in others. The results of Millie's response patterns in

the EO phase were interpreted as a potential need to conduct assessments (similar to the

EO phase) to determine if participants acquire discriminated manding using the

discrimination training. However, given that only one participant displayed such





69

patterns, it is unclear how prevalent inappropriate responding during the EO

manipulation would be among individuals who successfully complete mand training

using picture cards.

A fourth limitation of this study is that criteria for participant selection were not

sufficiently stringent to yield participants appropriate for all intended phases of the

study. The participants selected were all individuals with developmental delays as well

as language delays. However, two participants, Erin and Pablo, did not acquire the

discrimination during training using picture cards. Although Erin and Pablo were able

to hand the picture cards to the therapists, other pre-requisite skills that may be

necessary for successful picture card communication training (e.g., attending to the

image on the card, discriminating colors and shapes) may not have been present in their

repertoire. Therefore, it was never possible to have Pablo and Erin complete the EO

manipulation phase using picture cards. Had more stringent participant selection

procedures been established (perhaps an assessment of pre-requisite skills) all selected

participants may have been able to complete all phases of the study.

The results of this study yield additional questions that may be examined

through future research. One finding in the present study was that Millie was unable to

engage in discriminated manding in the context of two picture cards, but was able to do

so with two topographically different responses (picture cards vs. vocals). This finding

is worth further evaluation in that it suggests teaching topographically different

responses may be beneficial for some learners who are acquiring communicative

responses. If so, response forms such as sign language and vocalizations may have

advantages over picture cards, in that signs and vocals inherently involve unique





70

response forms across "words." Future studies may compare the acquisition and

generalization of communicative skills by teaching topographically similar responses as

compared to topographically different responses. For example, an experimenter may

conduct discrimination training sessions using topographically similar responses (e.g.,

two picture cards) for 2 preferred items, while concurrently teaching 2 topographically

different responses (e.g., picture cards and sign language) for 2 different preferred

items. Such a comparison would allow researchers to determine if there is a difference

in acquisition time (or number of trials) when using similar or different topographies of

responding. Similarly, an EO manipulation and/or generalization probes following

training, might yield additional information regarding the efficacy of each training

method.

Another finding in the present study was that two participants (Erin and Pablo)

were unable to complete discrimination training using picture cards, yet were able to

acquire responding using representative items (a seemingly easier discrimination task).

Given the importance of communicative skills for persons with developmental

disabilities, it seems relevant to identify which form of communication training is most

appropriate for each individual. Researchers may attempt to develop assessment

procedures in order to identify which is the most appropriate form of communication

for each individual, so that extended periods of time are not spent in discrimination

training without success. Assessments could include discrimination training probes of

multiple topographies of communication (e.g., signing, vocalization, picture cards) in

order to identify which form an individual acquires most rapidly. In addition, social

validity screening would be conducted to evaluate which mode of verbal behavior





71

parents and teachers find to be most useful (Wolf, 1978). Similarly, students could be

allowed to "choose" communication modes by having one mode reinforced in one area

of the room and another mode in another area of the room.

Finally, future research may extend the results of the present study by evaluating

whether discriminated mand responses acquired through discrimination training persist

under less controlled settings. The ultimate goal of any communication training is that

the individual will be able to communicate in his or her natural environment.

Therefore, an extension of the present study may include generalizations probes in more

natural settings (e.g., classroom, home). The EO manipulation phase could be easily

replicated in natural settings by providing access to one of the items, while withholding

access to the other. Then, in the presence of two or more picture cards, if the individual

hands over the picture card of the unavailable item, then generalization outside the

experimental setting would be demonstrated.












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Analysis, 11, 203-214.













BIOGRAPHICAL SKETCH

Anibal Gutierrez Jr. was born in Panama City, Panama, in 1972 to Guadalupe and

Anibal Gutierrez. Anibal lived in Panama until the age of 9 when he and his family

moved to Miami, Florida. Anibal attended the University of Florida and in 1996

graduated with a Bachelor of Arts degree in anthropology. In 1997, he entered a graduate

program in psychology at the University of Florida. He was awarded his Master of

Science degree in psychology in 2001.







I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.



Timothy R. Vollmer, Chair
Associate Professor of Psychology

I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.



Henry S. Pennypacker, Co-Chair
Professor Emeritus of Psychology

I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.



Brian A. Iwata
Professor of Psychology

I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.



Scott A. Miller
Professor of Psychology

I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.



Maureen Conroy
Associate Professor of Special Education







I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.



Timothy R. Vollmer, Chair
Associate Professor of Psychology

I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and i~fully adequa t n scope and quality,
as a dissertation for the degree of Doctor of Philosophy.



Henry S. Penny cker, Co-Chair
Professor Emeritus of Psychology

I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.



Byi'an A. Iwata /
Professor of Psychology

I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doct r of Philosophy.



Scott A. Miller
Professor of Psychology

I certify that I have read this study and that in my opinion it conforms to
acceptable standards of scholarly presentation and is fully adequate, in scope and quality,
as a dissertation for the degree of Doctor of Philosophy.



Maureen Conroy
Associate Professor of Special Education







This dissertation was submitted to the Graduate Faculty of the Department of
Psychology in the College of Liberal Arts and Sciences and to the Graduate School and
was accepted as partial fulfillment of the requirements for the degree of Doctor of
Philosophy.



December, 2004
Dean, Graduate School















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MANIPULATING EST AB LIS HING OPERATIONS TO TEST FOR STIMULUS CONTROL DURING MAND TRAINING By ANIBAL GUTIERREZ JR. A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY UNIVERSITY OF FLORIDA 2004

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ACKNOWLEDGEMENTS I would like to express my sincere gratitude to the members of my committee, Dr s Maureen Conroy Brian Iwata Scott Miller Henry Pennypacker and Timothy Vollmer for their support guidance, and mentorship. I would also like to thank my parents Guadalupe and Anibal Gutierrez, and my wife Melissa Hale for their love support, and encouragement in all my endeavors I would also like the thank the collaborators of this study, John Borrero Jason Bourret Claudia Dozier Dana G a d ai re John Rapp and Andrew Samaha for all their contributions to the study. 11

PAGE 3

TABLE O F CONTENTS ACKNOWLEDGEMENTS ... . ... ................. .. ...... . ... ... ... .... ... .... ... .. . .... ......... ... .. .. ... .. .. ii LIST OF FIGURES . .. ... ... .. ... ... ............ ................. .... ... . .............. ................ ............ .. . V CHAPTER 1 INTRODUCTION ... ..... . ... .. .. .. ... .... ... .................. .. ........ .. ... .. .... .. .......... .. .. .. .. . . ...... 1 2 REVIEW OF THE LITERATURE . . . .. .. ... .. ........ ... ... .............. ... .... ... . ..... .. .. ...... ... 9 Overview . ..... . . .. . . . .. . ........... ...... .. ..... .. ...... ... .... .. ... . .... . .... . ....... .......... .. . . ....... . . . 9 Forms of Communicative Behavior Taught to Individuals with Language D elays ..... 16 Sign Language ... .. ..... .. ................... .. ... ............. .. ...... ... . ..... ... ....... .. ..... .... ... .... ... ... .. 16 3 METHOD .. ...... .. ... .... ....... .. ... ................. .... ........................ ... .. ... ......... ... ................ 24 Participant s .. ... ... ... ... .......... .. .. ........ .... ... ................ ...... .. ..... .. ... .. .... ...... . .. ... ... .... . .. 24 Setting ...... . .. ........ .... .... ....... .... .. .... ...... ... .. .. . .. ..... . .. .... ... ... ... .. .... ... ..... ..... . .... ..... ..... 24 D a ta Collection and Response D efi niti o n ... ...................... .. .. .. .. .................................. .. 25 Interobserver Agreement. ... ... . .. ..... . ... .. ... . ......... ....... ... .. .. .. ... .. ... ....... ... .... ... ..... .. .. 25 Materials ..... .. ...... . . .... .. ... . ... ..... ... .. . ............... ... ... .... .... .. ... .. ... .. . .......... .. ... ......... . . 26 Procedures .. ................................ ....................... . ........ .... ... ......... . ... . ... ... . ... ..... . ... 26 4 RESULTS .. ... .... ... .. . .... .. ......... . .... .. ... . .... ...... .. ... . .. . ... . ... .. .......... .. ............ .. .... 35 Ph ase 1 Pr efere n ce Assessment R esults .... ..... ....... ..... .... .. ...... .. ... ......... ... .. .... ... ... .... ... 35 Phase 2 Single Card R esu lt s ..... .. ..... . . ... ...... . ... .. ............... . .... .. ... ........... ..... .. ... ... 35 Phase 4 Mand Trai nin g Results .. .... ........ .. .... .. . .. ..... ................ .............. .. . ....... .... 41 Phase 5 Establishing Operations Manipulation R esults .. .. ............... .... ....... .... .... .. .... .. .. 48 Pha se 6a R eprese nt at i ve Obj ects Training Re s ult s ................... .......... .. ......... ... ... .... .... 52 Pha se 6b Establishing Op eratio n s Manipulation ............................ ... .... .. .... .... ............. 54 with Repr esentative Objects R es ult s ............. .. ................. .. ....... .... ...................... ... ....... 54 Ph ase 7a Topographically Different Response Training (Vocal + Ma nd Training ) R esu lt s ............................. .... .. ... .. ...... .. .. ........ ... ...... ....... ... 57 Phase 7b Establishing Operation Manipulation with Topographically Different Re spo n ses (V ocal+ Card) Results ........................... .... .. .. ......... .. .. ...... ......... .............. 57 5 DISCUSSION ...... .... .............. ... .. ... ...... .......... ....... ..... . ... . .. ........ ... .... ...... ... ... .. . 61 lll

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REFERENCES ...... .... .. .. . ...... ... ..... .. ..... .. ... ... ....... . .... . .............. . ...... . .... . ....... ....... .. 72 BIOGRAPHICAL SKETCH .. .. ......... ...... .. ...... ...... ...... .. .. .. .. ... .. .. .. . .... ... .. .. ....... .......... 76 IV

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LIST OF FIGURES Figure l: Flow chart depicting the order of phases during the study ... .. .. ....... .... ..... ........ 28 2: Percentage of 5-rninute sessions of item manipulation during free-operant preference assessment. .... .. ...... .... . .... ..... .............. .. ......... 36 3 : Percentage of 5-rninute sessions of item manipulation during free-operant preference assessment .. ........ ...................... .. ... ..................... 37 4 : Percentage of trials with picture card and distracter card selected during the distracter card probe phase for Mario and Will ............................ ... 39 5: Percentage of trials with picture card and distracter card selected during the distracter card probe phase for Malcolm and Millie .......... ..... .. . .... .40 6 : Percentage of trials with picture card and distracter card selected during the distracter card probe phase for Erin and Pablo .......................... .. ... 42 7 : Percentage of trials with picture card and distracter card selected during the distracter card probe and differential reinforcement phases for Mario and Will ....... ......... .............. .... .. ..... ......... .. .. ............. .44 8: Percentage of trials with picture card and distracter card selected during the distracter card probe and differential reinforcement phases for Malcolm and Millie .. ..................... ... .. ............. .. ......... .. ..... .................... .46 9 : Percentage of trials with response emitted during the distracter card probe and differential reinforcement phases for Erin and Pablo .............. .. 47 10: Percentage of trials with picture card selected during the establishing operation manipulation phase for Mario and Will. ....................... 49 11 : Percentage of trials with picture card selected during the establishing operation manipulation phase for Malcolm and Millie ............. .... 51 12: Percentage of trials with item approached during the distracter probe and differential reinforcement phases for Erin and Pablo .......... .. ........ .. 54 V

PAGE 6

13: Percentage of trials with item approached during the establishing operation manipulation phase for Erin and Pablo ... ....... .. . .... .. .. 56 14: Percentage of trials with response emitted during vocal mand trajning for Millie .. .. . ....... ................. ........ .. .... ........ ... .... .. ... .. 58 15: Percentage of trials with response emitted during the establishing operation manipulation with topographically different topographies phase (vocal + mand) for Mille .. .. . .. .................. ... .. 59 VI

PAGE 7

Abstract of Dissertation Presented to the Graduate Schoo l of the University of Florida in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy MANIPULATING EST AB LIS HING OPERATIONS TO TEST FOR STIMULUS CONTROL DURING MAND TRAINING Chair: Timothy R. Vollmer Major Departme n t: Psycho l ogy By Anibal Gutierrez Jr. December 2004 Acquisition of verbal behavior is a major goal of interventions for children with developmental disabilities. Although many training methods exist, little research has focused on evaluating the effectiveness of those methods to produce functional discriminated mands (requests). The purpose of this study was to manipulate the establishing operation to test the efficacy of traditional mand training using two picture cards. In this study, six individuals with developmental disabilities participated in a training procedure designed to teach two separate mands for two separate reinforcers. First, a simple di sc rimination was taught in which u s in g a correct card wa s reinforced and using an incorrect card was not reinforced. Following training an establishing operations t es t was u se d to assess for discriminated mandin g, in which both of the previously learn ed picture cards were placed together in front of the participant. Vll

PAGE 8

Participants were given free access to one of the items they had been taught to mand for but the other item was out of reach and in view (establishing operation). Responses that occurred when the establishing operation was in place were reinforced with access to the item and responses when the establishing operation was not in place were not reinforced. Five of the six participants acquired discriminated manding using topographically similar responses (picture cards or representative items). One participant did not acquire a discriminated mand response until topographically distinct mands were taught (vocal and picture card). Results of the study suggest that discrimination training is not necessarily sufficient to teach discriminated manding when more than one card showing preferred items is used In addition, the establishing operation manipulation served as an appropriate assessment tool for the identification of discriminated manding Based on the results of this study practical implications limitations and future research extending the results are discu sse d V1ll

PAGE 9

CHAPTER 1 INTRODUCTION A delay in verbal behavior is one of the essential features of autism disorder and is commonly observed in persons with mental retardation, with the more severely impaired lacking any form of functional communication (American Psychiatric Association, 2000 ; McCoy & Buckhalt, 1990). A large number of young children with autism enter school programs without speech or other communicative behavior (Bondy & Frost, 1994). In the population at large language delays are common for children under the age of 3 (10 % to 15 % ) and by school age it is estimated that 3 % to 7 % experience a language disorder (American Psychiatric Association 2000). The acquisition of language for children with developmental disabilities is seen as a major goal of training programs because it is believed that language underlies most learning in typically developing children (Sundberg & Michael 2001) and the acquisition of communication skills is often an indicator of long-term success (Bondy & Frost 1994 ; Lovaas 1966), and social development (Carr & Kologinsky 1983). In order for children with developmental disabilities to learn to gain access to desired items communicate their needs and desires, request information obtain others' attention and generally control their environments it is important that they acquire a functional form of communication (McCoy & Buckhalt, 1990). Some teaching procedures aimed at increasing communicative behavior in children with developmental disabilities have been designed to increase speech while others 1

PAGE 10

2 have been used to develop nonvocal (e.g., sign-language) forms of communication (Charlop-Christy, Carpenter, Le, LeBlanc, & Kellet, 2002). Vocal and nonvocal forms of communication can both be conceptualized as forms of verbal behavior. Skinner (1957) defined verbal behavior as "behavior reinforced through the mediation of other persons" (p.14 ). Skinner goes on to explain that in defining verbal behavior "we do not and cannot, specify any one form, mode or medium. Any movement capable of affecting another organism is verbal" (p.14). Skinner (1957) outlined two broad categories of verbal behavior, the tact and the mand. "A tact may be defined as a verbal operant in which a response of a given form is evoked ( or at least strengthened) by a particular object or event or property of an object or event" (pp.81-82). In other words, the tact is a verbal response that names or identifies an object or event. The occurrence of the tact is preceded by the object or event the tact names or identifies. In contrast, the mand is defined as a verbal operant in which the response is reinforced by a characteristic consequence and is therefore under the functional control of r e levant co ndition s of deprivation or aversive s timulation (p. 36). In other words, a mand is a verbal response that specifies its reinforcement. For example, the mand "wa ter please" i s reinforced by receiving water. The mand i s a specia l form of verbal behavior because it benefit s the speaker by producing access to spec ifi c items often reinforcers The mand e n ables an individual to access reinforcers that are mediated by other individu als in th e community. This is co ntra sted with the tact, which does not produce this benefit to the speaker. Tacts produce socia l approva l and do n o t produce access to specific rei nfor cers. Because of its usefulness the mand is co n sidered to be the first type of verbal behavior acq uir ed by

PAGE 11

3 children. The control over the environment provided by the mand makes it a reasonable choice for the focus of early language training (Sundberg & Michael 2001). In addition mands are likely to be learned quickly due to the fact that they are maintained by specific and effective reinforcers (Bondy & Frost, 1994). Because mands specify their reinforcer, mands are under the control of relevant states of deprivation and satiation. These states of deprivation and satiation are called establishing operations (EOs). Establishing operations (EOs) play a large role in the occurrence of a mand. Michael (1982) defined EOs as "any change in the environment which alters the effectiveness of some object or event as reinforcement and simultaneously alters the momentary frequency of the behavior that has been followed by that reinforcement" (p p.150-151). Skinner explained that when a response is reinforced by a specific consequence the likelihood of that response occurring is a function of the deprivation associated with that reinforcer (Skinner, 1957). In other words, establishing operations such as deprivation or satiation directly affect the occurrence of a mand For example, an individual is not likely to ask for food after having eaten a large meal. The establishing operation is not in effect, the individual is not food deprived and the mand for food is not likely to occur. Behavioral interventions have been used in developing training programs designed to increase verbal behavior in children with developmental disabilities (Charlop-Christy et al., 2002). Some interventions such as mand-model procedures (Mobayed, Collins, Strangis Schuster & Hemmeter, 2000) incidental teaching (Hart & Risley, 1974 ; 1975; 1980 ; Hemmeter, Meyer, Ault & Collins 1996 ), and time delay procedures (Halle, Marshall, & Spradlin 1979 ; Halle, Baer & Spradlin 1981; Charlop

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4 Schreibman, & Thibodeau, 1985), have been used in an effort to increase speech, while other interventions have been used to develop nonvocal communicative behavior for children who did not develop speech normally. Because "any movement capable of affecting another organism ... (Sldnner, 1957 p. 14) is verbal behavior, verbal behavior can be established for individuals with developmental disabilities by training different topographies when vocal responses have not been acquired. Some of these interventions include sign language (Carr, Binkoff, Kologinsky, & Eddy, 1978; Carr & Kologinsky 1983; Schepis, Reid Fitzgerald, Faw, Van Den Pol, & Welty, 1982), voice output electronic devices (Durand 1999; Schepis, Reid, Berhman, & Sutton, 1998), and picture-communication systems (Hurlburt, Iwata & Green 1982; Sigafoos, Doss & Reichle, 1989; Bondy & Frost 1993, 1994 2001 ; Frost & Bondy 1994; Schwartz, Garfinkle & Bauer 1998 ; Liddle 2001; Kravitz Kamps Kemmerer & Potucek 2002). One highly specific form of mand training involves the use of symbol cards, such as the Picture Exchange Communication System (PECS) training (Bondy & Frost, 1993 1994, 2001; Frost & Bondy 1994) The PECS training system teaches individuals to hand a picture of an item to a communicative partner in exchange for the item. Before the various training phases begin an informal preference assessment is conducted to identify the highly preferred items the individual will be taught to request. During phase 1 individua l s are physically guided to hand the instructor the picture of a preferred item in e xchan g e for access to the item. During phase 2 the physica l guidance is faded over time until the individual is able to independently initiate the exchange with a variety of people Trainin g c ontinues as the trainer gradually moves away from the individual in ord e r to es t a bli h more independent mandin g On c e the simple mand

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5 response has been established for one item, additional pictures are introduced into training to establish a larger manding repertoire. During this phase of training the individual is taught to mand for several items using different picture cards. During phase 3 the individual is taught to discriminate between two or more p ic ture cards in order to establish complex manding. During this phase the individual is presented with two or more picture cards at the same time one picture card corresponding to a highly preferred item and the other to a less preferred or neutral item As PECS training progresses individuals are taught to build sentences by placing the picture on a communication board with the words "I want_ on it, and also to respond to a direct question such as "what do you want by placing pi c tures on the communication board (Bondy & Frost 1994 2001; Frost & Bondy 1994; Schwartz et al., 1998) When the complex mand training is complete it is important to evaluate whether individuals are able to request items they "want or are randomly handing picture cards. Because picture cards typically correspond to preferred items and known reinforcers it is possible that any response will result in access to a reinforcer and individuals are not discriminating among the picture cards. In addition, individuals might "sc roll through cards until the desired object is received. In either case, a true complex discrimination has not been established. One way to ensure that individuals are able to mand for specific items is to conduct correspondence checks (Bondy & Frost 1994 2001; Frost & Bondy 1994 ) Correspondence checks involve placing two items in front of the i ndividual as well as the two corresponding picture cards. When the individual hands the therapist a card, the trainer allows the individual to pick up the item he/she has manded for. If the indi v idu a l

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6 selects the appropriate item (i.e ., the item that corresponds to the se lected picture card), the therapist allows the participant to consume or engage with the item. If the child attempts to select an item that does not correspond to the selected picture card, the trainer corrects the individual and prompts him or her to se le ct the picture card corresponding to the item they attempted to pick up The correspondence checks are conducted periodically during the PECS training. Although correspondence checks as described by Bondy and Frost (1994, 2001) may identify instances in which the PECS training has failed to produce discrimination between two picture cards, it is not clear how efficient the correspondence checks are a t teaching complex discriminations between two or more picture cards. In addition, it is not clear how often such correspondence checks should be conducted to ensure picture card discrimination. It may be the case that infrequent checks may slow down the acquisition of a large manding repertoire. Schwartz and colleagues (1998 ) reported that it took students an average of 3 months (range = 1-6 months) to complete the discrimination phase, which included the correspondence checks In addition, i t is not known whether a student ma y have already learned the complex discrimina tio ns merely as a result of simple discrimination training. If so, a potentially lengthy evaluation process could be circumvented. A more serious potential limitation of the correspondence checks is that it may also be possible to establish a chain of responses that involves the individual handing the incorrect card and then being prompted to hand the correct card resulting in access to the reinforcer. In other words, the individual may continue to hand the therapist the wrong card and still ultim ately, almost immediately receive access to a preferred

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7 reinforcer. This potential for chaining of incorrect responding may be another factor slowing down acquisition of picture card discriminations between two or more picture cards. Again, a repertoire of "scro lling might be reinforced. There are also potential limitations regarding the discrimination training that takes place during phase 3 of PECS training. During this phase, individuals are taught to discriminate between two or more picture cards. However during training, one picture card corresponds to a highly preferred item while the other corresponds to a less preferred or neutral item (Bondy & Frost 1994 2001; Frost & Bondy 1994). It can be argued that this form of discrimination is different from a discrimination between two picture cards corresponding to preferred items. The need to discriminate between two or more picture cards corresponding to preferred items may be encountered more often during natural conditions when an individual will use a large picture vocabulary made up primarily of reinforcers. It is the ability to discriminate between two or more picture cards corresponding to preferred items that would indicate that the individual has learned a functional mand as opposed to a generalized mand for a variety of items. This skill is critical if the individual is to discriminate between the varieties of picture cards that will ultimately be placed in the communication book as part of the co mmunicative vocabulary. It is not likely that the communicative vocabulary will include mands for less preferred items, much less for neutral items For this reason it is important that a di sc rimination between two or more picture cards corresponding to preferred items i s established as part of communication training. In order to address the se problems associated with teachin g discriminated manding in the context of two or more picture cards, it is neces sary to evaluate the

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8 extent to which individuals are manding or requesting specific items In other words, it is important to determine if individuals are learning to request items they "wa nt" as opposed to randomly handing over picture cards. The purpose of this study was to manipulate the establishing operation to test the efficacy of traditional rnand training using two picture cards.

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CHAPTER 2 REVIEW OF THE LITERATURE Overview Skinner (1957) defined verbal behavior as "behavior reinforced through the mediation of other persons (p.14). In addition, Skinner explained that any form of behavior that affects another organism or is mediated by another organism is verbal behavior. Therefore vocal and nonvocal forms of communication were both conceptualized by Skinner as forms of verbal behavior. Skinner (1957) outlined two broad categories of verbal behavior the tact" and the "mand. A tact is "a verbal operant in which a respon s e of a given form is evoked (or at least strengthened) by a particular object or event or property of an object or event (pp 81 82). In other words, the tact names or labels an object or event. In addition its occurrence is preceded by the presentation of that object or event. For example stating that is a dog" is considered a tact because it labels the presence of a dog. The tact is contrasted with the mand which is defined as a verbal operant in which the response is reinforced by a characteristic consequence and i s therefore under the functional control of relevant conditions of deprivation or aversive stimulation (p 36). In other words the mand is a requesting response whi c h specifies its reinforcer. For e x ample making the statement food please is considered manding because it is requesting access to food. 9

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10 Skinner (1957) distinguished between the two classes of behavior (tacts and mands) and argued that they are functionally independent from each other. He explained that tacts and mands are defined by their function or consequence. The mand enables an individual to access reinforcers that are mediated by other individuals in their community. The tact functions to produce social approval from individuals in their community. Because tacts and mands are discriminated based on their function, it is therefore possible for tacts and mands to share identical response topographies. For example the word "water can function as mand if it is reinforced by access to water, or as a tact if it is reinforced by social approval. Because of the difference in the function of tacts and mands, being able to label an item would not necessarily ensure that the same verbal response could be used to request that item. Conversely being able to utilize a verbal response to request would not necessarily ensure that term could be used to label. Some studies support the conceptualization that tacts and mands are functionally independent (Lamarre & Holland ; Sigafoos et al. 1989). Lamarre and Holland (1985) taught one group of individual s to mand when prompted by the experimenter s que s tion "where do you want me to put the (object)?" Responses of "on the left or on the right were reinforced by proper placement of the item (left or right) A second group of individuals were taught to tact when prompted by the experimenter s question Where is the (object)? Correct responses were reinforced with praise and a marble. Following trainin g, emer g ence of the untrained response was assessed. Individuals who had be e n taught to m a nd were presented with the question requiring a tact as a c orre c t answ e r where is the (object) and individuals who had b e en taught to tact were

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11 presented with the mand question "where do you want me to put the (object)? Results of the study indicated that individuals taught the tact response did not acquire an untrained mand response and likewise, individuals taught the mand response did not acquire the untrained tact response. In this case, the acquisition of one verbal operant did not result in acquisition of the other. In a similar study Sigafoos and colleagues (1989) evaluated the independence of tacts and mands, by examining whether teaching tacts facilitated the acquisition of an untrained mand response. In this study, individuals were taught to tact food, beverage, or utensils by pointing to symbols representing the items. Correct responses were followed by descriptive praise Once tacts for the items had been acquired the experimenters assessed for the acquisition of a manding response using the same symbols. Items were presented outside the individual's reach and pointing to the symbol corresponding to the item resulted in access to the item. Results of the study showed that while individuals acquired a tact response using symbols, they were not able to use symbols to mand for the same items. Again, responses taught as tacts did not spontaneously occur as mands Results of these studies lend experimental support for Skinner s classification of mands and tacts as functionally independent verbal operants This is an important distinction for teaching because it shows that teaching individuals to tact items will not result in their learning to mand for items. Furthermore it shows that it is necessary to teach mand responses under the appropriate conditions using the specific items (the items manded for) as reinforcers in order to acquire a mand response.

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12 Teaching Verbal Behavior Because language is believed to be critical in development (Sundberg & Michael 2001) and identified as an indicator of long-term success for children with disabilities (Bondy & Frost, 1994 ; Lovaas, 1966) behavior analysts have attempted to overcome delays in verbal behavior using behavior analytic procedures. Behavior analysts have applied Skinner's conceptualization of verbal behavior into training programs designed to teach verbal behavior to non-verbal individuals Methods used to teach verbal responses go beyond vocalizations to include symbolic (Bondy & Frost 1993) and gestural (Charlop-Christy Carpenter Le, LeBlanc & Kellet, 2002) forms of communication. In this chapter two methods used by behavior analysts to teach verbal behavior will be reviewed. The two methods reviewed are discrete trial training and incidental teaching In addition three forms, or topographies, of verbal behavior commonly taught to individuals with language delays will be outlined. These forms include sign language voice output devices, and picture communication systems. Training Methods to Teach Verbal Behavior Discrete Trial One approach to teaching communicative behavior is the discrete trials method. The discrete trials method involves conducting training sessions several days a week, for several hours a day in a highly structured environment, in an effort to deliver intensive communication training. Discrete trial sessions typicaJly occur in a one to one student to therapist ratio where the therapist and child typically sit facing each other. The therapist sits in close proximity to the child in order to deliver prompts physically

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13 prevent the child from leaving the training session if necessary, and deliver reinforcers (Lovaas 1966) One of the proposed benefits of discrete trial training is that the methods allow control over training variables (e.g ., number of training trials and length of sessions) By conducting a high number of training trials, discrete trial methods increase the number of learning opportunities and possibly increase the rate of skill acquisition Lovaas (1987) provided children with 40 hours per week of intensive language and behavioral intervention that produced improvements in communicative behavior as well as improvements in academic skills. Simic and Bucher (1980) taught children to mand for items using procedures similar to those described by Lovaas (1966). Training resulted in increases in mands responses. However mand responses did not readily generalize to untrained settings (Simic & Bucher, 1980). Although discrete trial training approaches have been successful at teaching verbal behavior to individuals with language delays (Lovaas 1966; 1987; Simic & Bucher 1980) there are some concerns regarding generalization of the skill to the natural setting. The goal of communication training programs is to teach verbal behavior that is functional and appropriate (Hart & Risley 1968 1980). However some researchers argue that discrete trial training results in mechanical and non functional verbal behavior due to a lack of response generali z ation to natural settings (Harris 1976 ; Hart & Risley 1980 ; Charlop Schreibman & Kurtz 1991) To overcome the limitations of discrete trial training procedures naturalistic language interventions provide method s for teachin g functional verbal behavior (Schepi s et al.

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14 1998) designed to promote generalization of the skill to the natural setting ( Hart & Risley 1980). Incidental Teaching A second approach of teaching communicative behavior is to use naturalistic language interventions, or incidental teaching methods, that aim to teach language skills in the child's natural environment. Naturalistic language interventions involve using naturally occurring opportunities to teach communication (Schepis et al., 1998 ) that is useful or functional (Carr,1982). Hart and Risley (1974) describe incidental teaching as language training that is conducted during normal childhood activities involving toys and other children. Several studies (Hart and Risley 1968 ; 1974 ; 1975 ; 1980) have evaluated the effectiveness of incidental teaching procedures to establish and maintain verbal behavior. Hart and Risley (1968) evaluated the effectiveness of incidental teaching by making children's access to free-play materials contingent on vocal request using color noun combinations (e.g., "brown crayon"). Fifteen children participated in the study during which teachers made access to free-play materials (e.g., balls, snacks, blocks and toy animals) contingent on vocal requests using color-noun combinations. Teacher s placed their hands over the materials and prompted the response by asking the child "what do you want" while delivering praise and access to the requested materials contingent on correct responding. In this case, making access to play items contingent on verbal responses resulted in an increase in the frequency of children's verbal responses.

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15 A follow-up study (Hart & Risley, 1974) extended the incidental teaching procedure to include the use of more complex sentences. In this study, access to the materials in the natural environment was made contingent on the use of compound sentences (e.g., I want a block so I can play with it"). Results of this study replicated the findings of the previous study showing a marked increase in the verbal responses when access to materials was made contingent on responding. In addition maintenance of responding occurred following the removal of the reinforcement contingency. The results of both studies lend credence to the use of incidental teaching methods to increase verbal responding. Additional studies by Hart and Risley (1975 1980) provide further support for the use of incidental teaching. For one incidental teaching methods were useful in not only increasing verbal responses directed towards the teacher but were additionally useful in increasing verbal responses directed towards other children in the class (Hart & Risley, 1975) Also Hart and Risley (1980) were able to demonstrate that with incidental teaching procedures, disadvantaged, language delayed children were able to increase several aspects of verbal behavior such as elaborations, the variety of words used and the frequency of complex sentences used. Incidental teaching methods offer several benefits over alternative teaching methods. The primary benefit of incidental teaching is that it promotes generalization of verbal behavior across the natural environment (Hart & Risley, 1980) Hart and Risley (1980) point to several features of incidental teaching that utilize generalization techniques outlined by Stokes and Bear (1977). One important variable of incidental teaching that may result in generalization is the variety of stimulus conditions under

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16 which the training occurs. For one, incidental teaching procedures aim to establish vocal responding in the n at u ra l co ndition s in which the behavior is to occur and is to be maintained Second the occurrence of incidental teaching is conducted throughout the day at various times and settings. The variability in training schedule limits the de ve lopment of stimulus control based on setting or time. Finally, condition s pre se nt durin g incidental teaching a re le ss discriminable than the co nditions pre se nt durin g typi ca l training sessions. Incid e ntal teaching procedures a llow for trainin g to occur whenever the opportunities pre se nt themselves in the availability of the reinforcer a nd c hild initiation. A seco nd benefit of incidental teaching i s that it a llow s the c hild t o initiate t he t eac hin g opportunity as we ll as s p ec i fy the rein forcer, which can vary from moment to m o m e nt ba se d on the c hild s pr efere nce Throughout the d ay a child can initiate int erac tion s with a wide variety of stimuli r es ultin g in a variety of trainin g opportunities. Given th e b e n efits of incid e nt a l a nd di screte trial ap proa c h es, one possibility for future app li ca ti o n wo uld b e to merge or comb in e the two approaches. Forms of Communicative Behavior Taught to Individuals with Language Delays Sign Language Often c hild re n with developmental delays do n ot ac qui re vocal-verbal ski ll s despite intensive t rai nin g (Carr & Kologinsky 1 983; Can 1 982; Carr et a l. 1 978). Therefore, indi vidua l s w ith l a n guage delays are ofte n taught to use signs to request items as we ll as l abe l items in their e nvi ronment. Sign l anguage training procedures involve teaching c hildr e n t o co mmunic ate by way of s i gn co nfi g u ratio n s using th ei r h a nd s typically b ased o n t h e Ame 1i can Sign Language for the d eaf (Carr et a l. 1 978).

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17 Carr and colleagues (1978) used prompting and facling techniques to teach sign language to four autistic children who lacked communicative behavior. Children were taught the signs for five food items following an auditory and visual presentation of the food item. Correct responses were reinforced with praise and a small amount of the food item. If the child did not respond correctly, the correct response was physically guided and the response was reinforced with praise only The physical prompt was faded until the child signed following the auclitory and visual prompt. Following training, children were presented with the auditory and visual prompt and correct responses were not reinforced Results showed that nonvocal children were able to acquire verbal behavior utilizing sign language, and did so to communicate a request for food items. Additional research shows that sign language can be successfully taught using incidental teaching strategies (Schepis et al., 1982) In this case, direct care staff taught autistic children sign language to gain access to preferred items. Signs were taught using auditory prompting manual guidance and reinforcement sequence, while participants were in their natural setting. Results showed that incidental teaching of sign language was effective at increasing the use of manual signs. In addition the results were maintained at 5 and 17-week follow up observations Voice Output Devices Voice output devices have recently been developed to assist children with language delays to acquire verbal behavior (Schepis et al. 1998). Voice output devices also known as voi c e output c ommuni c ation aids (VOCA s ) involve the a c tivation of a device that produces recorded speech. Some advanta g es of VOCAs over other

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18 communication syste ms (e.g., signing and picture communication systems) is that they allow for the recording of a variety of messages that can be understood by individuals who are not familiar with the user of the device ( Schepis et al., 1998). This differs from sign language which may not be interpretable by persons who are not familiar with American Sign Language Schepis and colleagues (1998) evaluated the effectiveness of VOCAs to teach children to request items, make statements, social comments, and answer yes and no questions Four children were taught to use the devices using a prompt sequence that began with verbal and gestural prompts and graduated to physical prompts when necessary to physically guide correct responses. Results showed an increase in the frequency of communicative behavior for all 4 chi ldren In this case, VOCAs were a n effective tool to teach verbal behavior to children with language delays Additionally, Durand (1999) conducted a series of studies to evaluate the use of assistive devices to teach individuals with language delay s to gain access to objects and activities. Students were taught to use a voice output device through verbal and physical prompts which were gradua Jiy faded u si n g delayed prompting as training progre ssed. Re s ult s s howed an increase in the unprompted u se of the voice output devices as well as a reduction in problem beh av ior exhibited by the c hildren. In addition, th e u se of the devices generalized to untrain e d setti ng s Picture Communication Systems Another alternative to teaching vocal-verbal behavior for individuals with disabilities is the use of picture or iconi c comm uni catio n systems. This approach involves teaching stude nt s to point to graphic symbols (Hulbmt et al., 198 2; Sigafoos e t

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19 al., 1989) or exchange pictures or symbols (Bondy & Frost, 1993, 1994 2001; Frost & Bondy, 1994; Schwartz et al., 1998; Liddle, 2001; Kravits et al., 2002) One advantage of picture communication systems that h as been proposed is that it does not require some of the orientation (e.g., eye contact) and imitation skills (vocal or motor) that other communication systems require (Bondy & Frost 1994, 2001) possibly resulting in faster acquisition. Also because picture communication systems use two-dimensional pictures of items that are easi ly recognized, it is not necessary to find a communicative partner that is able to under sta nd the form of communication as might be the case with sign l a ngua ge (Schwartz et al., 1998). One specific form of picture communication systems is the Picture Exchange Communication System (PECS) developed by Bondy and Frost (1993, 1994 2001). One of the proposed advantages of PECS is that because the individual has to hand the cards to a "liste n er," the behavior is directed towards a communicative partner (Bondy & Frost 1993 1994, 2001). A second benefit of the PECS training is that because requesting is the first skill taught powerful reinforcers maintain communicative responding. In addition, th e PECS system does not require any prerequisite behavior and the training is based on c hild initiation of the communicative response (Scwartz et al. 1998). Bondy and Frost (1993 1994, 2001) reported on the successful implementation of PECS training for chi ld ren with l anguage delays and severa l studies have eva lu ated th e effectiveness of PECS trainin g to t eac h verbal behavior to individuals with l anguage delays and have found positive increases in communication as a result of trainin g (Schwartz et al., 1998 ; Liddl e, 2001; Kravit z e t al. 2002)

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20 Bondy and Frost (1993) reported on the successful implementation of PECS training for 74 students in Peru. In a similar publication, Bondy and Frost (1994) reported that of 85 children who had been taught to use picture cards using PECS training at the Delaware Autism Project, over 95 % learned to use two or more pictures to request items. Data for one individual were reported, which showed acquisition of the request response using picture cards. After 11 months of PECS training the individual's vocal speech had improved and was able to communicate using only vocal speech. Several studies have been conducted to evaluate the effects of PECS training on picture card responding as well as vocal responding (Schwartz et al. 1998 ; Liddle 2001 ; Kravitz et al. 2002). Schwartz and colleagues (1998) evaluated the effectiveness of PECS training on children s use of picture cards to communicate with adults and peers. In addition, the effects of PECS training on children's vocal behavior was evaluated. In study 1, 31 children were taught to use picture cards to mand for items using PECS Children were taught to use the picture cards with teachers and peers to receive access to items Training was conducted using forward and backward promp t ing techniques to teach the children to place picture cards on a poster board next to a symbol meaning I want ," and hand the board to the communicative partner. This response was reinforced with access to the item represented by the picture card. Training continued until responding reached the mastery criterion of 80 % or higher independent correct responding over 3 sessions. Results showed that all the children in the study learned to use the picture cards with adults and peers in the classroom Result s also showed that, on average acquisition of the 5 phases of the PECS training (Exchange, Distance and Persistence Discrimination Sentence Building, and Peers )

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21 required 14 months (range 3-28) of training. In study 2, 18 children who had participated in study 1 were observed during snack time and free choice time. Communicative behavior (gestures, vocalizations manual signs, PECS exchanges, and verbal) was recorded for each chi ld Results of study 2 showed that children who had been taught to use picture cards in the classroom also used the picture cards during snack time and free choice time. In addition results showed that 44% of the children in study 2 demonstrated unprompted non-echolalic spoken communication. Liddle (2001) taught 21 childre n with l a n guage delays to u se the PECS to request and label items in their classroom The training sequence included 6 phases of PECS training (Exchange, Distance and Persistence Discrimination Sentence Build i n g, Answering Questions and Commenting) Results showed that, of the 21 children who participated in the training, 20 comp l eted phase 1 and learned to request items using PECS cards, however only 8 chi ld ren comp l eted phase 6. Re s ult s also showed that on average children received PECS training for 10 months (ra nge 1 15). In addition results showe d that 42 % of the children were observed to have increases in vocalizations, with some c hildren using single words. Kravitz and colleagues (2002) evaluated the effects of PECS training on the spontaneous verbal behavior of one child with autism. The participant was ab l e to comm unicate using 1 to 2-word utterances when prompted with very low frequency of ind e pendent responding. The c hild was tau g ht to u se picture cards usin g the PECS syste m during two free play activities at schoo l (centers and journal) and at hom e. Training was impl emented using a multiple-baseline design across settings. Results s how ed acquisition of the picture card response to ga in access to preferred items as well

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22 as an increase in spontaneous language (vocal and picture card) following the introduction on PECS training across three settings. Although the literature includes a wide range of examples of mand training (Carr et al., 1978; Kravits, et al. 2002; Liddle, 2001 ; Schepis et al., 1998; Sigafoos et al., 1989; Schwartz et al., 1998) such training usuaJly involves a specific mand in a specific context. An experimental question remains regarding the effectiveness of training to produce appropriate, or discriminated manding. In most cases, the success of mand training is evaluated based on the participant's ability to make the desired communicative response (e.g. hand a card). In other words, if a child hands a "c ookie" card to the therapist, and then gains access to the cookie it is presumed that the child was appropriately manding for a cookie. However on closer examination the appropriateness of the individual's mand cannot be entirely presumed based upon his response. Rather, it remains unclear if the child is actuaJly requesting a "coo kie" or if the response of handing a card has been sufficiently reinforced with access to preferred items such that a child hands a card in order to gain access to reinforcement in general. Because the picture cards typically correspond to preferred items a response using any card will result in access to a reinforcer. If individuals are not able to discriminate among the picture cards they have been taught to u se to request items then training h as not resulted in a functional, discriminated mand response. Unlike vocal mand trainin g or s ign language trainin g, picture card training uses the same response form (handing a card). Therefore, when teachin g students to use picture cards to mand for it e m s, it is possible that individual s may learn to hand any picture card to receive access to any item rather than to gai n access to specific items. Teaching

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23 students to use picture cards to request items may be limited by an individual's ability to discriminate between picture cards Therefore it may be necessary to evaluate the extent to which individuals are ab l e to discriminate between picture cards in order to assess the effectiveness of mand training using picture cards. The current study was designed to evaluate the extent to which mand training using picture cards will result in discriminated manding in the context of two picture cards. The technique of this study was to manipulate the establishing operation to test the efficacy of traditional mand training using two picture cards Although the relative merits of picture card systems can be debated additional research is warranted due to the widespread use of these systems

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CHAPTER 3 METHOD Participants Six individuals who did not ordinarily request item s either vocally or nonvo ca ll y participated in the study. Mario was a 13-year-old male diagnosed with ment a l retardation Millie was a 4-year-old female diagnosed with Autism Will was a 5-year old male diagnosed with Autism Malcolm was a 6-year-old male also dia g nosed with Autism, Pablo was a 2 0 -year-o ld male diagnosed with ment a l retardation and Erin was a 16-ye ar-o ld male di ag n osed wit h Down sy ndr ome. Pai tic ip a nt s had minimal exposure to pi c ture cards prior to th e s trut of the study as picture cards had been placed in so me c l assroo m s (e.g., pictur e caid for bathroom outside the bathroom). Howev e r formal tr a inin g of pi c tur e card communication sys tem u se h a d not tak e n pl ace for a n y p a rti cipa nt prior to th e start of the st udy. Teachers or staff referred a ll parti cipa nt s following an announcement at the school th at the st ud y was underwa y to teach a nd eva lu a t e co mmuni ca tion u s in g picture car ds. Th ese were th e first six individual s refe rr ed. Setting All sessio n s were co ndu cted a t the participant s sc h oo l. Blocks of s ess i o n s l asted for approxima t e l y 3 0 mi nut es a nd were co ndu cted 3-5 days p er week. Durin g sess i ons participants were seate d a t a t a bl e across from the th erap i s t and d a ta co ll ec tor (s). Se s sio n s were co ndu c t ed in a s m a ll room reserved for th e s tud y Sessions 2 4

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25 Except for the preference assessment, sessions consisted of ten trials. During each trial the participants were presented with the opportunity to emit a mand and receive access to preferred items. After participants were allowed access to items for approximately 30 seconds or were allowed to consume the food items, the card position was counterbalanced in an array of two quasi randomly and the cards were presented to the participant to start the next trial (specific procedures varied by condition, to be explained below) Data Collection and Response Definition Two trained graduate and undergraduate observers independently recorded correct and incorrect responses. During training, correct responses were defined as handing the therapist the picture card or approaching (reaching for) the representative item Incorrect responses were defined as handing the therapist the distracter card or approaching (reaching for) the empty board or empty hand. During the EO manipulation (explained later) observers recorded the card that was handed to the therapist or the representative item approached. During the EO manipulation with topographically different responses (explained later) observers recorded the response emitted by the participant handing picture card or vocal response. Interobserver Agreement During all phases of the study two trained observers collected data simultaneously and ind e p e ndently during 34 % of the sessions. Interobserver agreement was calculated by dividing the number of agreements by the number of agreements plus di sagreeme nts in each sess ion a nd multiplyin g by 100 %. An agreement was defined as a

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26 trial in which both observers recorded the same occurrence of behavior. Mean ag reement for all sessio n s was 99 % ( range 80 % to 100 % ) Materials Two picture cards a nd two other distra cte r cards were used during training. The picture cards corresponded to preferred items that were identified for each participant durin g a preferen ce assessment. Distracter cards co ntained a n "X" or an O on them. Procedures Participation in each pha se of the study was determined by particip a nt performance in the prior ph ase. As participants completed each pha se, the y e ith er moved on to the n ext pha se of mand training or moved to a s upplemental training phase Figure 1 s ho ws the order of phases for the st ud y. Phase 1: Preference Assessment The purpo se of thi s ph ase was to identify items to be u se d as reinforcers A free operant preference assessme nt ( R oa n e Vollmer, Rin g d ah l & Marcus 1998 ) was co ndu cted in orde r to identify highly preferred items for eac h participant. Parti cipa nt s were presented wit h an array of foo d a nd l eis ur e items durin g one or two 5-minute sess ion s. Separate assessme nt s were co ndu cted for Will an d Millie to identify preferred item s o r act i vities as we ll as cons um ab l e items The two separate preference assessme nt s were conducted to avoi d a possible "d i sp l aceme nt of non co n s um ab l e it ems that might function as reinforcers by co n sumab l e item s (DeLeon Iwata & Roscoe 19 97). Data collectors recorded the amou nt of time participa n ts spe nt interacting with each item Items with which participants spent th e most amo unt of time were chosen as preferred items to be used during mand training

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27 Phase 2: Single Card The purpo se of this ph ase was to establish a cardh a nding repertoire. Participants were seated with a s ingle picture card in front of th em Du ri n g this phase, hancling the therapist th e picture card resulted in access to the item for approximately 30 seco nd s or (w hen food or drink was the preferred item) a s m a ll amo unt of the co n s um a ble item. Parti cipa nt s were taught to u se picture cards to m a nd fo r preferred items during this phase u si n g a four step sequence (5-seco nd pause, verbal instruction phy s i ca l model phy s i ca l g uidanc e). Phase 3: Distracter Card Probe We conducted a probe for a ll participants in w hi c h a picture car d wit h a picture of a n item on it a nd a card with an "X" or an O on it were presented. The purpose of thi s phase was to evaluate whether participants were mor e likely to se l ect a card w ith a picture on it, as a point of comparison to a subsequent diffe re ntial reinforcement phase. Participants were sea t e d w ith the two car d s in front of them (p i ct ur e card a nd car d wit h a n "X" o r a n "O"). During this phase, responding using eit h er card resulted in access to the preferred item. After the participant responded, the item was delivered a nd both car d s were removed. Access to the preferred item l asted for approximate l y 3 0 seconds a nd in th e case of co n s um ab l e items, a s m a ll amo unt was delivered. After eac h trial, the position of the cards was reassigned quasi ra ndoml y the cards were then prese n ted to the participant aga in a nd t h e n ext trial began

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Phase 7a Topography Different R es pon se Training Phase 7b Establishing Operations Manipu l a ti o n with Topographica ll y Diff ere nt responses No 28 Phase 1 Preference Assessment Phase 2 Single Card Training Phase 3 Distracter Card Probe Phase 4 Mand Training Phase 5 Establis hin g Op era tion s Manipu l ation Mand Training Complete Figure 1 : Flow c h art depicting the order of phases during th e st udy Phase 6a Repres e ntative Objects Training Phase 6b Establishing Operations Manipulat i on with R ep r ese ntativ e Items

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29 Phase 4: Differential Reinforcement (Mand Training) The purpose of this phase was to differentially reinforce responses using picture cards in order to establish a simple discrimination between the target card and distracter cards or at least to provide a history of reinforcement for the picture card response. There was no intention to show acquisition as in some cases there already was a bias towards selecting the cards with pictures. During differential reinforcement sessions only responses using the picture card resulted in reinforcement while responses using the distracter card resulted in extinction The experimental design was a concurrent schedules design, in which experimental control is demonstrated by differential responding across choice alternatives (Sidman 1960). During these sessions the participant was seated with two cards placed in front of him or her the picture and the distracter card. Requests using the picture card resulted in access to the item for approximately 30 seconds or a small amount of the edible item Requests using the distracter card resulted in extinction (and a brief time-out from the session) during which the therapist removed the cards and turned away from the participant for approximately 5 seconds. After each trial the position of the cards was reassigned quasi randomly and the trial was restarted. Participants were taught to use picture cards to mand for two different preferred items during this phase. Participants who passed this phase were deemed to have completed the initial discrimination screening and had demonstrated performance of the discrimination skills necessary to move to phase 5 of the study.

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30 Phase 5: Establishing Operation Manipulation The purpose of this phase was to evaluate the effectiveness of the initial mand training to establish complex manding in the presence of two picture cards each corresponding to preferred items. Four participants who completed the initial discrimination screening and acquired the discrimination skills taught in phase 4 participated in this phase. The EO manipulation phase differed from the differential reinforcement phase in two respects. First, the two previously trained picture cards were placed in front of the participants, there were no distracter cards present. Second participants had free access to one of the items they were previously taught to mand for during differential reinforcement. The EO phase was conducted using a combination of a concurrent schedule and multi-element design ( Sidman 1960 ) in which we compared the effects of the EO (EO on vs. EO off) on manding. During EO manipulation sessions participants were allowed free access to one of the items they were previously taught to mand during the differential reinforcement sessions while access to a second item was restricted. The mand for the second item also had been taught previously. For example if a participant was previously taught to mand for the radio and a drink during this phase the participant was allowed free access to the radio during the session (rad i o EO off) and access to the drink was restricted (drink EO on), or vice versa When access to one of the items was restricted (e g. radio) and the EO for that item was on (e.g. radio EO on) access to the other item was made available (e.g drink) and the EO for that item was off (e.g. drink EO off) Sessions in which one EO was on or off were alternated Also during the EO manipulation phase requests using the picture card corresponding to the restricted item resulted in access to that item for approximately 30

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31 seconds or a small amount of the consumable item. Requests using the picture card corresponding to the item to which the participant already had access resulted in the therapist removing the cards for approximately 30 seconds (but they maintained access to the item they already had). This was done to avoid "teaching" during the EO phase. After each trial the position of the cards was reassigned quasi randomJy and a new trial was started. Phase 6a Representative Objects Training The purpose of this phase was to establish a simple discrimination (representative object versus distracter) for two participants who did not develop a simple discrimination with picture cards. Two participants (Pablo and Erin) who did not pass the initial discrimination screening in phase 4 participated in this phase Representative objects corresponding to preferred items (e.g., empty bag of chips) and a blank board or a therapist's empty hand (distracters) were used to teach the initial discrimination Responding by touching or reaching for the representative object re s ulted in access to a small amount of the item while responses of touching or reaching for the blank board or therapist 's empty hand resulted in extinction during which the therapist turned away from the participant for approximately 5 seconds. After each trial the position of the cards (or empty hand) was reassi g ned quasi randomly and the trial was restarted. Phase 6b Establishing Operation Manipulation with Representative Objects The purpose of this pha se was to evaluate the effectiveness of mand trainin g usin g representative objects to establish complex mandin g in the presence of two representative it e ms each corresponding to pr eferre d items. This phase was similar to

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32 the EO manipulation in phase 5, and was used to test the complex discriminations for the two participants (Pablo and Erin) using representative objects. This EO manipulation phase differed from the EO manipulation in phase 5 in one respect, representative objects corresponding to preferred items were placed in front of the participants instead of picture cards. During EO manipulation sessions participants were allowed free access to one of the items they were previously taught to mand during phase 6a, while access to a second item was restricted. The mand for the second item had also been taught previously For example if a participant was taught to mand for the radio and a drink, during this phase the participant was allowed free access to the radio during the session (radio EO off) and access to the drink was restricted ( drink EO on), or vice versa. When access to one of the items was restricted (e .g. radio) and the EO for that item was on (e.g., radio EO on), access to the other item was made freely available (e.g drink) and the EO for that item was off (e.g., drink EO off) Session s in which one EO was on or off were alternated. Also during the EO manipulation phase requests using the representative object corresponding to the restricted item resulted in access to that item for approximately 30 seconds or a small amount of the consumable item Requests using the representative items corresponding to the item t he participant already had access to resulted in the therapist removing the representative items for approximately 30 seconds (b ut they maintained access to the item they already h a d ). This was done to avoid "teac hing during this phase. After each trial the position of the cards was reassigned quasi randomly and a new trial was starte d.

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33 Phase 7a Topographically Different Response Training (Vocal & Card) The purpose of this phase was to develop two distinct mand forms (vocal & card). Only one individual (Millie) participated in phase 7 because she was the only one of the five participants in phases 5 or 6b who showed no sensitivity to the EO manipulation. It is possible that the topographical similarity between handing responses may have impeded discrimination during the EO manipulation (Carbone, personal communication). One picture card and two distracter cards were used during a training phase. The picture card corresponded to a preferred item and distracter cards contained an "X" or an O on them. The participant was also presented with vocal mand training designed to produce differential responding during the EO phase During this phase the participant was taught to reque st an item using a picture card and was taught to request a seco nd item by saying the word corresponding to the item (e.g., saying "c hips "). The participant was taught to respond vocally by first presenting a vocal prompt (e.g., "say chips") and delivering the reinforcer (chips) following the imitative response ("chips") ( Bourret Vollmer, & Rapp 2004). During the vocal manding sessions, the participant was seated at a table and no cards were present. Reque s t s u s ing the vocal mand resulted in access to a sma ll amount of th e item. Requests using any other word resulted in extinction durin g which the therapist turned away from the participant for approximately 5 seco nd s. The participant was taught to u se the picture card to mand for the item corresponding to the picture (music) and to vocal mand to mand for the item corresponding to the vocal mand (c hips). The participant was tau g ht to use the picture car d to mand for the preferred item during this phase u s in g a three prompt sequence (verba l instruction, physical model, physical guidance) fo ll owed by access to the item

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34 The participant was taught to mand vocally using prompts and modeling followed by access to the item. Phase 7b Establishing Operation Manipulation with Topographically Different Responses (Vocal & Card) The purpose of this phase was to test for complex discriminations using two distinct response forms (vocal & card) instead of card versus card. Two topographically different responses were used to overcome the possible discrimination problem caused when topographically similar responses were used. For the one participant ( Millie ), the EO manipulation was similar to that used in study phase 5 however only one picture card was placed in front of the participant. There were no distracter cards present and the participant had free access to one of the items she was previously taught to mand for during phase 7a while access to a second item was restricted. The mand for the second item had also been taught previously. During this phase, requests using the mand corresponding to the restricted item resulted in access to that item for approximately 30 seconds or a small amount of the consumable item. Requests using the mand corresponding to the item to which the participant already had access resulted in the therapist removing the card for approximately 30 seconds (while the participant maintained access to the item she previously had).

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CHAPTER4 RESULTS Phase 1 Preference Assessment Results Figure 2 shows the outcomes of the free-operant preference assessment for Mario and Will. The item identified as most preferred for Mario was the radio and most preferred for Will were cookie and radio A second item ( drink) was identified for Mario based on multiple observations not related to this study and was used during the subsequent training sessions. Figure 3 shows the outcomes of the free-operant preference assessment for Millie Erin, and Pablo. The items identified as most preferred for Millie were music and chips, for Erin were drink and chips, and most preferred for Pablo were chips and drink. A preference assessment was conducted for Malcolm (not shown in a figure); results of that assessment identified T.V. and chips as most preferred items for Malcolm The observers inadvertently only recorded the outcome of the assessment, therefore percentages of session time data are not available for Malcolm and, hence are not depicted graphically. Phase 2 Single Card Results All participants acquired the single card response within one very brief session (data not depicted in figures). In all cases, the last several responses occurred with no prompting 35

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36 ,Cll Bil till Mario 40 21l ll 1CD Qi) 5 .... 6D Will 0 Qi) IQJ) ei: 2D .... = D Qi) ... ,. llu C,J :. Qi) lllll Bil till Will 41l 21l ll chlJII -~tzel chlll ktttle m&m Items Figure 2: P erce nt age of 5-minute sessio n s of it e m m a nipul a tion durin g free-operant preference assessme nt.

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37 ,00 80 160 Millie 4D 20 0 mut1lc ..... r1n1< kdch ,00 80 Millie 160 5 40 20 ,.._ 0 0 ch l lltl llr lnk 9l
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38 Phase 3 Distracter Card Probe Results Figure 4 shows the percentage of trials with cards selected for Mario and Will during the distracter card probe phase The filled circles represent responses using what would eventually be the picture card and the open circles represent responses using the distracter card. Recall that during the distracter card probe phase responding using either the picture card or the distracter card resulted in reinforcement access to the preferred item. The top two panels show the percentage of cards selected by Mario. The first panel shows responses using the radio and the distracter card and the second panel shows responses using the drink and the distracter card during the distracter card probe phase. During the distracter card probe phase, Mario selected both the picture card and the distracter card during both radio and drink sessions but showed a slight bias for t he picture card during the drink (M=63 % ) and radio sessions (M=68 % ) The next two panels of figure 4 show the results for Will during the distracter card probe phase. The third panel shows responses using the cookie card and the distracter card and the fourth panel shows responses using the radio card. During the distracter card phase Will responded using the distracter card almost exclusively during the cookie ( M=95 % ) sessions and showed a bias for the distracter card during the radio ( M=73 % ) sessions. Figure 5 shows the percentage of trials with cards selected for Malcolm and Millie during the distracter card probe phase. The top two panels show the percentage of cards selected by Malcolm The first panel shows responses using the T.V. and distracter card and the second panel shows responses using the chips and distracter card During the distracter card probe phase Malcolm showed a bias for the picture card he responded using the T.V card more often (M=72 % ) than the distracter card during the

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39 100 picture card 80 i 6 0 40 20 i distracter card Radio 0 "'O 1 2 3 4 5 6 7 8 9 10 11 12 13 t 100 Mario ,.. 80 'r/'l "'O 60 :. 40 u 20 .: Drink ..... 0 1 2 3 4 5 6 7 8 9 10 11 1 2 13 r,;. ,.. ci: 100 'vJ c 80 distracter card 60 0 40 IOJ) 20 Cookie ..... C 0 (J 1 2 3 4 5 6 7 8 9 1 0 1 1 12 :. 100 Will 80 60 40 20 Radio 0 1 2 3 4 5 6 7 8 9 1 0 11 12 Figure 4 : Percentage of tria l s wit h picture card and distracter card se l ected during the distracter card probe phase for Mario and Will.

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40 100 80 60 40 20 T.V. 0 "O 1 2 3 4 5 6 t 100 80 Malcolm r'1 "O 60 :. 40 u 20 Chips ..... 0 1 2 3 4 5 6 "1 Se ss ions 100 c: 80 60 0 40 eJl 20 Chips ..... C 0 1 2 3 4 (j :. 100 Millie 80 60 40 20 Music 0 1 2 3 4 Sessions Figure 5: Percentage of trials wit h picture card and distracter card selected during the distracter card probe phase for Malcolm and Mi l lie.

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41 T.V. sessions and selected the chips card almost exclusively ( M=92 %) durin g the chips sessions. The next two p a nel s of figure 5 show the data for Millie. The third panel shows responses using the chips and distracter card a nd the fourth panel shows responses using the music and distracter card. Millie responded using the chips card exclusively during the chips sessions ( M =95 %) a nd the music exclusively during the music sessions ( M=l00 %). Figure 6 shows the results for Erin and Pablo during the distracter card probe phase The top two panels show the percentage of cards selected by Erin. The first panel shows responses using the chips and the distracter card and the second panel shows responses using the drink and the distracter card. Erin selected both the picture card and the distracter car d during both drink (M= 53 % se lection of drink) and chips (M =4 3 % se lection of chips) sessions. The next two panels of figure 6 show the results for P ab lo. The third panel shows responses using the chips and distracter card and the second panel s hows response s usin g the drink and distracter card Pablo selected both the picture car d and the distract er card durin g both chips (M =48 % se lection of c hip s) a nd drink (M=50 % selection of drink) sessions. Phase 4 Mand Training Results Figure 7 s how s the p erce nta ge of trials with car d s se l ec ted for Mario and Will durin g th e di s tra c ter car d probe and differential reinforcement phases. In the differential reinforcement phase, the filled c ircle s represent correct responses (res pon ses u s in g the picture card) and th e o p e n c ir c l es represent in correc t responses (responses u s in g th e di s tract er card). R eca ll that durin g th e differ e nti a l reinforcement phase only r espo n ses u si n g the picture car d resulted in reinforcement w hil e responses u sing the distracter

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42 100 picture card 80 i 60 40 20 i distracter card Drink "'O 0 2 3 4 5 6 7 1j 100 Erin 80 "'O 60 :. ei: 40 u ..c 20 Chips .. 0 2 3 4 5 6 7 r,j_ 100 ei: c 80 E-4 -.. 60 0 40 ei: 20 Chips .. C 0 2 3 4 5 :. 100 Pablo 80 60 40 20 Drink 0 2 3 4 5 Sessions Figure 6: Percentage of trials with picture card and distracter card selected during the distracter card probe phase for Erin and Pablo.

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43 DR + Ins + Book 100 Distracter DR Ins Phase i. 80 60 0--0 picture card 40 "'O 20 ...... 0 (,J 3 5 7 9 11 13 15 1 7 19 2 1 23 25 27 29 r;/'J 100 "'O 80 Mario ei: / ~ / X> u 6 0 ,, 40 P 0. ' = 0--0 ...... 20 Drink (,J 0 1 3 5 7 9 11 1 3 15 17 1 9 21 23 25 27 29 -= ...... Distracter 100 O(hase _p--o -r,;_ 80 ei: / c 60 ~/ 40 ~ "' distracter card 0 2 0 /' "' OJ) 0 ei: 1 2 3 4 5 6 7 8 9 10 11 1 2 1 3 14 15 1 6 17 ...... = 100 Will (,J "'_,, / ~ 80 o 60 40 c/?, ~o 20 // 0 1 2 3 4 5 6 7 8 9 10 11 1 2 1 3 14 1 5 1 6 17 Sessions Figure 7 : Percentage of trials with picture card a nd distracter card se l ected durin g the distracter card prob e and differential re in forcement phases for Mario and Wi ll.

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44 card resulted in extinction. The top two panels show the percentage of cards selected by Mario. The first panel shows responses using the radio and the distracter card and the second panel shows responses using the drink and the distracter card during the distracter card probe and differential reinforcement phases. Mario selected the distracter card more often than the picture card when differential reinforcement was implemented during the radio sessions and drink sessions ( M=60 %) We observed that during this phase Mario was not looking at the cards. He was handing the therapist a card without looking down at the card he was handing We then provided Mario with instructions during the radio sessions to hand the picture card in order to gain access to the radio. However this manipulation was not effective at producing 100 % correct responding (M=73 % ) and Mario was still not looking at the cards consistently. In order to ensure that Mario would look at the cards before handing them to the therapist we placed the cards in a small photo album to create a communication book. This required that Mario open the book and find the correct card to hand to the therapist. This intervention was immediately effective at producing 100 % correct responding during the radio and drink sessions. The next two panels of figure 7 show the data for Will. The third panel shows responses using the cookie card and the distracter card and the fourth panel shows responses using the radio card. When differential reinforcement was implemented Will responded more often using the picture card rather than the distracter card during both cookie (M=85 % ) and radio (M=86 % ) sessions. Figure 8 shows the results for Malcolm and Millie during the distracter card probe and differential reinforcement phases The first two panels show the resu lts for Malcolm. The first panel shows responses using the T.V. and distracter card and the

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45 Differential Reinfo re e ment 100 Distracter 80 Phase 60 40 "'O 20 T.V. Q.} ..... 0 Q.} 1 2 3 4 5 6 7 8 9 1 0 1 1 1 2 -Q.} rJj 100 "'O 80 :. 60 u Q.} 40 :. 20 = ..... 0 2 3 4 5 6 7 8 9 10 11 1 2 ..c ..... Distracter Differential Reinforcement 100 ______. Phase 7'J 80 -60 c: 40 ;,... 20 0 Q.} 0 OJ) 1 2 3 4 5 6 ..... = 100 Q.} Millie :. 80 Q.} 60 40 20 Music 0 1 2 3 4 5 6 Sessions Figure 8: Per ce nta ge of trials with picture card and distract e r card se l ected during the distracter card probe and differential reinforcement phases for Malcolm and Millie.

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46 second panel shows responses using the chips and distracter card. When differential reinforcement was implemented, Malcolm responded using the picture card for the majority of the trials during both the T.V. (M=92%) and chips (M=93%) sessions. The next two panels of figure 8 show the results for Millie. The third panel shows responses using the chips and distracter card and the second panel shows responses using the music and distracter card. When differential reinforcement was implemented Millie responded using the picture card rather than the distracter card during both the chips (M=95%) and music (M=97 %) sessions. Recall that Millie had already responded mostly using the picture card even prior to differential reinforcement (see phase 4). Figure 9 shows the results for Erin and Pablo during the distracter card probe and differential reinforcement phases. The first two panels show the results for Erin. The first panel shows responses using the drink card and the distracter card and the second panel shows responses using the chips card and the distracter card When differential reinforcement was implemented Erin responded using both the picture card and the distracter card during the drink (M=53%) and chips (M=51 %) sessions. The next two panels of figure 9 show the results for Pablo The third panel shows responses using the chips card and the distracter card and the fourth panel shows responses using the drink card and the distracter card. When differential reinforcement was implemented Pablo responded using both the picture card and the distracter card durin g the drink (M=53 % ) and c hip s (M=51 % ) sess ion s. In summary, when differential reinforcement was implemented for responding u si n g picture cards, four out th e six participants responded usin g th e picture card to gai n

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100 80 60 40 20 Distracter Phase 47 Differential Re info re e ment picture card stracter card Erin Drink 0 +---.--.....---lr-,---,--,-----,----,---,----r--.---.----,r-----,----,--,---,-.----. 100 80 60 40 20 0 100 80 60 0 40 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2 3 4 5 e Distracter Phase Chips 7 a g 1 o 11 1 2 13 14 15 1 e 17 1 s 1 g Differential Re info re e ment Chips 0 -+----.---,------,---.-------1-~-.--~-.--~-.....-----.--..----,--,---,---,------, 100 80 60 40 20 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Pablo )<)-~ < )( > <><>< Drink 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Sessions Figure 9: Percentage of trials with response emitted during the distracter card probe and differential reinforcement phases for Erin and Pablo.

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48 access to preferred items. This was not intended to be a demonstration of acquisition (recall that two individuals already selected picture cards prior to differential reinforcement). Rather differential responding was a pre-requisite to getting to the EO test. The four individuals who responded differentially demonstrated the prerequisite skills necessary for inclusion in phase 5 of the study Establishing Operation Manipulation. Differential reinforcement was not sufficient to teach the simple discrimination between the picture card and distracter card for Erin and Pablo. Thus Erin and Pablo participated in phase 6. Phase 5 Establishing Operations Manipulation Results Figure 10 shows the percentage of trials with the picture card selected for Mario and Will during the EO phase. The filled circles represent responses using the picture c ard in sessions when the participant did not have access to the item (EO on) and the open circles represent responses using the picture card in sessions when the participant already had access to the item (EO off) Recall that EO on and EO off sessions were alternated between the two cards. So the EO on session for one card was the EO off session for the other card. Responses using the picture card when the EO was on resulted in reinforcement while responses using the picture card when the EO w as off resulted in the therapist removing the cards for approximately 30 seconds ( but the participants maintained access to the item they already had ) After each trial the po s ition of the cards was reassigned quasi randomly and a new trial was started. The first two panels show the results for Mario the first panel shows responses using the radio card when the radio EO was on and off and the second panel shows responses using the drink card when the drink EO was on and off. During the radio EO on sessions, Mario

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49 100 --~------<----~-.,_---4 .._.. ~--411--.--~-------~---BO 60 40 100 80 60 40 20 100 80 60 40 20 100 80 60 40 2 0 1 i EO o n E O off Radio 3 5 7 9 11 13 15 17 19 21 23 25 Mario Drink 1 7 1 g 21 23 25 27 Cookie 1 2 3 4 5 6 7 8 9 1 0 11 12 13 14 15 16 17 1 8 1 9 20 21 22 23 Will Radio 1 2 3 4 5 6 7 8 9 1 0 11 1 2 1 3 14 15 1 6 1 7 1 8 1 9 2 0 2 1 22 23 Sessions Figure 10: Percentage of trials wit h picture card selected during the establishing operatio n s manipulation phase for Mario a nd Will

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50 responded using the radio card 100% of the time. Mario responded using the drink card during the drink EO on sessions approximately 80 % of the time during the first 8 sessions and 100 % of the time the remainder of the sessions (overall M=89 % ) and 0 % of the time in sessions when the EO was off (overall M= 0%). The next two panels of figure 10 show the results for Will. Initially, during the cookie EO on session Will responded using the cookie card slightly more often when the EO was on than when the EO was off. However, during the last 5 sessions Will responded using the picture card only when the EO was on (Overall M=92%). During the radio EO on sessions, Will responded using the radio card most of time (M=88 % ) and rarely during the radio EO off. Figure 11 shows the percentage of trials with the picture card selected for Malcolm and Millie during the EO phase. The first two panels show the results for Malcolm. During the T.V. EO on sessions, Malcolm responded using the T.V. card more often (M=83%) than when the EO was off. Malcolm responded using the chips card during the chips EO on sessions more often (M=83 % ) than when the EO was off. The last two panels of figure 11 show the results for Millie During the chips EO on Millie responded using the chips card (M= 55 % ) versus (44 % ) during chips EO off and the music card (M=82 % ) when the EO was off. In summary, results of this phase showed that 3 of the 4 participants accurately manded for two different items using picture cards in the context of two picture cards. Three participants (Mario, Malcolm, and Will) were able to respond using a picture card representing an item when the establishing operation for that item was on and did not typically respond using the picture card for an item when the establishing operation was

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5 1 100 80 50 EO on 40 "'O E O off 20 i T.V CJ 0 3 5 7 g 1 1 1 3 1 5 1 7 1 g 21 23 25 27 29 3 1 r.,_J 1 0 0 "'O '80 Malcolm ei: u 50 '40 = 20 C hip s CJ 0 3 5 7 g 1 1 1 3 1 5 1 7 1 g 21 23 25 27 29 31 100 '(I)_ BO ei: 60 c 40 0 20 C hi ps 10.f) 0 ei: 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 = 100 CJ '80 60 40 20 Music 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Sess ion s Figure 11: Percentage of trials with picture card selected during the establishing operations manipulation phase for Malcolm and Millie.

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52 off. One participant (Millie) did not learn to mand for two items using picture cards in the context of two picture cards Millie responded using a picture card representing an item when the establishing operation was on and off. This pattern of responding suggested that Millie had not acquired the complex discrimination between the two picture cards that was necessary for discriminated mantling in the context of two picture cards. It was necessary to teach Millie a discriminated mantling response in order for her to effectively mand for two different items Therefore Millie participated in phase 7 of the study, where she was taught to mand using two topographically different responses in order to teach a discriminated mand response in the context of two different items. Phase 6a Representative Objects Training Results Recall that the purpose of this phase was for the 2 individuals who did not learn the simple discrimination in phase 4 (Pablo and Erin) to make available an extremely obvious discrimination in order to move toward the EO test, which was of primary interest. Figure 12 shows the percentage of item approached for Erin and Pablo during the representative objects distracter probe and differential reinforcement phases. Filled circles represent approach responses to the representative object and open circles represent approach responses to a blank cardboard The first two panels show the results for Erin. The first panel shows approach responses to the chips representative object and the second panel shows approach responses to the drink representative object. When differential reinforcement was implemented Erin approached the representative object 100 % of the time during both chips and drink sessions. The last two panels of figure 12 show the results for Pablo When differential reinforcement was implemented Pablo

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53 Disuacter Differential Reinforcement 100 Phase 80 t representative item 60 40 20 blank cardboard Chips "'O 0 1 3 5 7 9 11 13 15 17 19 21 23 25 c.i e 100 Erin c.. 80 c.. < 60 s 40 20 0 ..... 1 3 5 7 9 11 13 15 17 19 21 23 25 Disuacter Differential Reinforcement -r,i 100 -~~ -\ ,/\ ,, 80 c 60 i;.,.. 40 y 0 o' 20 Cl / Chips eJ) 0 ..... 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 = item vs c.i tand :.. 100 / VV -j'\ ,, Pablo 80 ., ,, / 60 40 t\ ; , 20 / 0... ~/P,, Drink 0 1 3 5 7 9 11 1 3 15 17 19 21 23 25 27 29 Sessions Figure 12: Percentage of trials with item approached during the differential reinforcement phase for Erin and Pablo.

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54 approached the representative object most of the time during the chips sessions (M=83%) and the drink sessions (M=88%). During the last 11 chips differential reinforcement sessions Pablo was presented with a choice of approaching the representative object or the therapist 's empty hand and this manipulation resulted in 100 % of the approaches being made to the representative item. This manipulation was conducted during the last 12 drink differential reinforcement sessions and this resulted in 100 % of the approaches being made to the representative item during t he last 7 sessions. The reason for this change was that the main purpose of the study, which was to conduct the EO manipulation between two relevant objects, so the use of a blank board versus an empty hand was somewhat incidental unless we were unable to see differentiated responding. Given that the empty hand produced 100 % allocation to the representative item, Pablo like Erin was ready for phase 6b. There is no claim that Pablo and Erin were "taught" this discrimination Rather a very easy discrimination was identified in order to move to the EO test manipulation. Phase 6b Establishing Operations Manipulation with Representative Objects Results Figure 13 shows the percentage of trials with the representative object approached for Erin and Pablo during the EO phase. The filled circles represen t approach responses to the representative object in sessions when the EO was on and the open circles represent responses to the representative object in sessions when the EO was off. Approach responses to the representative object the participant did not already have access to (EO on) resulted in reinforcement while approach responses to the representative object the participant already had access to (EO off) resulted in the

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55 100 80 60 "'0 40 t EO off ..c 20 Chips CJ 0 0 :. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 C. C. 1 00 < "'0 80 Erin :. 60 u 40 :. 20 Drink = ... CJ 0 2 3 4 5 6 7 8 g 1 0 1 1 1 2 1 3 14 1 5 ..c 100 ... 80 r'1 60 ..... 40 c 2 0 Chips 0 0 2 3 4 5 6 7 8 9 '=J) 100 ... C Pablo 80 CJ :. 60 40 2 0 Drink 0 2 3 4 5 6 7 8 9 Sessions Figure 13: Percentage of tria l s with item approached during the establis hin g operation manipulation pha s e for Erin and Pablo.

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56 therapist removing the representative objects for approximately 30 seconds (but they maintained access to the item they already had). After each trial the position of the representative objects was counterbalanced quasi randomly and a new trial was started The first two panels show the results for Erin the first panel shows approach responses to the representative object for chips and the second panel shows approach r esponse s to the representative object for drink. During the chips EO on sessions Erin responded by approaching the chips representative object 89 % of the time which was slightly higher than during chips EO off. During the drink EO on sessions Erin responded by approaching the drink representative object 33 % of the time which was slightly higher than during drink EO off. The next two panels of figure 13 show the results for Pablo Pablo responded by approaching the chips representative object during the chips EO on sessions 100 % of the time and 30 % of the time during chips EO off sessions. He selected the drink representative object most of the time when the EO was on (M=68 % )during the drink EO on sessions and 0 % of the time during the drink EO off sess10ns. In summary results of this phase showed that both participants were more likely to mand for items when the EO was on (versus off for that item) using represent a tive items in the context of two representative items Erin and Pablo were able to re s pond b y approaching the representative item for which the EO was on, the item they did not have access to more often than when the EO was off in the context of two representative items

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57 Phase 7a Topographically Different Response Training (Vocal + Mand Training) Results During phase 5 (Establishing Operations Manipulation) only one of the 4 participants, Millie, did not mand using the appropriate picture card. Her beha vior in phase 4 (Differential Reinforcement) indicated that Millie was able to mand for items using picture cards however the establishing operation manipulation demonstrated that Millie had not learned to mand for specific items in the context of more than one picture card. In other words Millie had not learned to discriminate from among the picture cards. In an effort to teach Millie to mand for the relevant item during the establishing operation manipul atio n and to teach her to respond differentially to gain access to preferred items we taught Millie a topographically different response to establish the discrimination between mands for preferred items Figure 14 shows the vocal mand training data for Millie. Closed circles represent independent responses, saying "c hips and the open circles repre se nt prompted responses when Millie was instructed to say "c hips to gain access to the chips using a model prompt. Millie responded independently using the vocal mand chips as training progressed (M=66 % ) and by the la s t 4 sessions she was responding independently on average 85 % of the time (100 % in the final session) Phase 7b Establishing Operation Manipulation with Topographically Different Responses (Vocal + Card) Results Figure 15 shows the data for Millie during th e EO with two topographically different responses phase. The top panel s hows the results for the chips utterance The c lo sed circles represent vocal responses saying "c hip s," when she did not hav e access

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58 ..c ...... "'O r,J_ 100 c a 80 60 0 40 r,J_ = 20 IQJ) 0 0 ...... r,J_ = 1 2 3 4 5 6 7 8 9 10 11 12 Sessions Figure 14: Percentage of trials wit h response emitted during vocal mand training for Millie. to the c h ips but had access to the music (chips EO o n ) and the open circles represent responses saying chips when s he already h a d access to the chips but did n ot h ave access to the music (c hip s EO off). The Xs represent responses during booster sessions Boo ster sessions consisted of supplemental mand training ( of the sort done in phase 4 for cards and 7a for vocals) and were conducted when Millie returned to sessions after having missed school for a substantial amou nt of time The bottom panel of figure 15 shows the results for the music picture card. The closed circ l es represent responses using the music picture card when Millie did not have access to the music but did have access to the chips (music EO on) and the ope n circles represent responses using the music card w h en she already had access to the music but not chips ( music EO off) In the first sessions Millie responded by saying chips and using the music card more often

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59 Chips 7 13 19 25 31 37 43 49 55 61 67 73 79 85 91 97 103 109 115 ei: c Music 0 7 1 3 19 25 3 1 3 7 4 3 49 55 61 67 7 3 79 85 91 97 1 03 109 115 Sessions Figure 15: Percentage of trials with response emitted during the establishing operation manipulation with topographically different topographies phase (vocal+ mand) for Millie.

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60 when the EO was off but as sessions continued Millie responded more often when the EO was on for both the chips (M=77 % ) and the music (M=84 % ). In summary results of this phase showed that Millie accurately manded for two different items using a picture card and a vocal response in the context of two preferred items Millie was able to respond using a picture card representing an item or a vocal response for an item when the establishing operation for that item was on and rarely responded using the picture card or the vocal response for an item when the establishing operation for that item was off.

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CHAPTERS DISCUSSION The purpose of this study was to determine if mand training resulted in discriminated manding using picture cards when more than one picture card was available. In other words, at the completion of mand training individuals ideally would be able to selectively mand for desired items using a picture card. An establishing operation (EO) manipulation phase was used to assess for discriminated manding. The EO manipulation was designed to determine if individuals manded for a preferred item that they did not have access to (for which the EO was in place) and conversely did not mand for items that they had access to (for which the EO was not in place). The results of this study showed that for three participants (Mario Malcolm and Will) mand training using picture cards resulted in discriminated manding in the context of two picture cards. For these individuals the mand response was under the control of the establishing operation (i.e ., they most frequently manded for the items they were deprived of and not for the items they had access to) For one participant mand training using picture cards did not result in discriminated responding. Millie successfully completed the mand training phase of the study using picture cards but did not accurately discriminate between two picture cards when presented with the EO manipulation. Rather she continued to mand for the item that she already had access to At the end of the mand training phase Millie's data suggested that mand training had been effective in teaching her to mand for two items 61

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62 using picture cards. However the establishing operation manipulation phase showed that mand training had not been effective in teaching discriminated manding in the context of two picture cards Subsequently in order to establish discriminated manding Millie was presented with additional discrimination training. During additional training, Millie was taught to use two topographically d iffe rent responses ( pi ct ure cards and vocal). Following this additional training, Millie was able to mand appropriately for the two items durin g the EO manipulation. The mand response using two topographically different response s was under the control of the establishing operation ( i.e. Millie more frequently manded for the item she was d e priv e d of than for item s he h a d access to). For two individuals, (Eri n a nd P a bl o), mand training u si n g picture car d s was not successful using simple reinforcement procedures Erin and Pablo did not acquire the di scri mination betwe e n the picture card and distra cter car d Therefore in order to establish a mand re spo n se, Erin a nd P a blo were no lon ger presented with picture car d s, but instead were pre se nted with representative item s a nd much more obv iou s d istracters in order to e n s ur e di scri min a tion Both Erin and Pablo ac quir ed th e di scrimi n atio n between the representative it e m s a nd the blank board (E rin ) or a n e mpty h a nd ( P ab l o). In a ddition both responded ap propriately in th e E O m a nipul a tion ph ase (i e., Eri n an d P ab lo more frequently m a nd e d for th e item when they were d e pri ve d of it than when they were not ). Although Eri n 's res ult s r e fl ecte d frequent "errors," the mand re spo nse u si n g representative it e m s was und er th e co ntrol of the esta bli s hin g operation a lth o u g h on l y to a smal l (b ut consistent) degree

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63 In the present study, three individuals displayed complex discriminated manding using picture cards. In addition, the implementation of an EO manipulation phase yielded additional validity to the appropriateness of discrimination training in teaching individuals to mand for preferred items Conversely three individuals were unable to acquire discriminated manding (Erin, Pablo) or complex discrimination (Millie) using picture cards. For two (Erin and Pablo) a discrimination between the picture cards and distracter cards was never acquired during training. For Millie, discrimination between the picture cards and distracter cards was established in training but did not result in discriminated responding when presented with the EO manipulation. In both cases, lack of appropriate responding warrants further interpretation. One possible explanation for a lack of appropriate responding in three participants (Erin Pablo, and Millie) is that there may have been a lack of control over the stimuli controlling responding Mcllvane and Dube (2003) explain that the stimulus the experimenter has designed to control responding and the stimulus that is functionally controlling responding may not be the same For example, when presented with a picture card the stimulus intended to control behavior is the two-dimensional drawing on the face of the card. However, the actual stimulus controlling behavior could be some other stimulus such as the colors shape, etc. The degree to which the experimenter s intended stimuli and the stimuli relevant to the participant are the same is called Stimulus Control Topography (SCT) Coherence (Mcllvane & Dube, 2003). According to Mcllvane and Dube's (2003) conceptualization, Erin's, Pablo's, and Millie s failure to acquire discriminated responding may be a function of the experimental conditions rather than some inherent inability on the participant's part to

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64 discriminate. In other words, there was an apparent lack of SCT coherence. For Millie, the participant who responded inappropriately in the EO manipulation, it is possible that the specific two-dimensional drawing on the picture cards was not controlling behavior. It is relevant to point out that when the distracter card was used, Millie showed a preference for the picture card. In this case, the stimuli controlling behavior may have been a less strictly defined stimulus perhaps picture cards in general. Regarding Erin and Pablo, again SCT coherence may not have occurred. Erin and Pablo may have learned to hand over cards independent of the stimulus on the card. Thus, cards per se had acquired stimulus control properties. Such an explanation lends credence to the subsequent interventions for Erin Pablo and Millie. In all cases the presented stimuli themselves were altered and may have produced coherence between the experimenter s intended stimuli and the stimuli controlling behavior. For Millie, SCT congruence may have been established with the addition of a topographically distinct response (vocal vs. picture card). By using two response topographies each associated with a different reinforcer, discriminated manding during the EO manipulation phase was established. Similarly SCT coherence may have been established for Erin and Pablo with the addition of representative items In this case stimulus control was no longer linked to a single stimulus (cards) but had been established between representative items and alternative items (i.e., blank board or empty hand). In addition to SCT incongruence the schedule of reinforcement during training may be a variable contributing to inappropriate responding for Erin and Pablo. Durin g the study the intended schedule of reinforcement was a fixed ratio 1 (FR 1) or

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65 continuous reinforcement (CRF) for correct responses, in which each correct response resulted in reinforcement, and incorrect responses resulted in extinction (Ferster & Skinner 1957). Although not systematically included as a component in this study, schedules of reinforcement inevitably produce specific patterns of responding. In this case, a post-hoc analysis of the reinforcement sc hedule reveals that while responding with the appropriate card was reinforced on an FRI schedule responding in general (i.e., handing cards to the experimenter) may have been maintained on a variable-ratio (VR) or intermittent schedule of reinforcement (Ferster & Skinner, 1957 ). During a VR schedule of reinforcement, the number of responses required for reinforcement varies according to a series of ratios having an average value (Ferster & Skinner, 1957). Pablo gained access to the reinforcer on average of 53 % of the trials during the chips sessions and 47 % of the trials during the drink sessions. Erin gained access to the reinforcer on average of 53% of the trials during the drink sessions and 51 % of the trials during the chips sessions. This is approximately a VR 2 schedule of reinforcement for Pablo (VR 1.9 for chips and VR 2.1 for drink) and Erin (VR 1.9 for drink and VR 2 for chips). Variable-ratio or intermittent schedu l es of reinforcement maintain higher rates of responding than fixed schedules of reinforcement and are more resistant to extinction (Skinner, 195 3) A VR 2 sc h edu l e of reinforcement may have been sufficient to maintain the response of h a nding either of the two cards, while minimizing the sa lience of differential reinforcement. Another possible exp lanation for Millie 's initially undifferentiated responding during the EO phase i s that s h e may not h ave been emitti n g the verbal operant intended by the experimenter. The goa l of this study was to teach the mand response

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66 (requesting). However, Skinner (1957) describes other verbal operants (e.g., tacts, echoics, etc.) each serving its own function. In the case of Millie, failure to respond appropriately during the EO manipulation was initially interpreted as inability to appropriately mand using the picture card. It is however, possible that Millie may have been tacting (labeling) items she had by using the picture card. This would explain why during the EO manipulation she most frequently handed the picture card corresponding to the item she already had access to (EO off) rather than manding for the item she did not have access to (EO on). A second, but similar, possibility is that Millie was emitting a mand response but may have been manding for "more" of the item she had access to, such as when a restaurant costumer asks for a refill before his drinking glass is empty The results of this study have several implications for the practical use of mand training using picture cards At present picture card training has been used successfully to treat language delays and increase communicative behavior (Schwartz et al., 1998 ; Liddle 2001; Kravitz et al. 2002). Despite the literature on the application of picture card training far less literature has been focused on factors related to the effectiveness and efficiency and, conversely the ineffectiveness and inefficiency with which picture card training produces discriminated manding. Literature describing picture card training outlines methods of teaching discriminations and this procedure is typically comparable to the methods presented in this study However despite typical di s crimination training half of the present participants failed to acquire discriminat e d manding In three cases modifications to the initial training procedure were made to es tabli s h appropriat e r es pondin g. Modifications includ e d the addition of

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67 topographically dissimilar responses (picture cards and vocal) as well as modification of the stimuli (from cards to representative items) From a practical standpoint, clinicians utilizing picture cards in isolation may fail to produce discriminated manding with some participants Rather than focusing on extensive, repeated exposure to picture cards manding may be more quickly and accurately established with modifications in the training procedure. Additionally, results of this study revealed that mand training may not be sufficient to establish a discriminated mand (as in the case of Millie). Therefore, the use of a post training assessment such as the EO manipulation may be of practical use in determining if the desired response has been established For Millie the use of a book full of picture cards may have fooled" others into believing she was successfully making complex discriminations given that she likely would have pulled out cards and handed them to an adult. The EO manipulation showed that more training was needed The results of this study contribute to the literature on communication training for individuals with language delays. However there are several potential limitations of the study that should be taken into account when interpreting the results One potential limitation was the possible variation of schedules of reinforcement in effect during some phase s of the study As previously discussed the actual delivery of reinforcement on a VR schedule for 2 participants (Erin and Pablo) may have resulted in inappropriate responding during the discrimination training phase The schedule of reinforcement de s igned to be in effect throughout the study was a fixed ratio 1 (FR 1) or continuous reinforcement sc hedule (CRF) for correct respondin g. Und e r optimal co ndition s, th e

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68 schedule of reinforcement intended by the experimenter would be the schedule of reinforcement controlling responding. An additional limitation of the study was the lack of experimental control during the representative drink item training phase for Pablo. During this phase the initiations of two variables (differential reinforcement and presenting the empty hand) were implemented at the same time. By introducing two variables at the same time, it remains unclear which variable was responsible for the acquisition of the mand response during this training phase. The results of this phase were interpreted such that using representative items resulted in the acquisition of the mand response for the drink. However it is possible that the presentation of the empty hand may aJso have been an important variable in establishing responding. A preferred alternative would have been to present each variable independently. However because the goal of this phase was to create a discrimination in order to move to the EO test determining which variable (differential reinforcement or presenting the empty hand) was responsible for the acquisition of the mand response was not undertaken. A third limitation of the study is the isolated occurrence of a participant (Millie) who demonstrated incorrect responding during the EO manipulation Though not a limitation of this study's experimental design the fact that only one participant displayed opposite effects in this phase makes it difficult to determine the extent to which such responding may occur in others. The results of Millie's response patterns in the EO phase were interpreted as a potential need to conduct assessments (similar to the EO phase) to d e termine if participants acquire discriminated mantling usin g the di scriminatio n training. However, give n that only one participant displayed s u c h

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69 patterns, it is unclear how prevalent inappropriate responding during the EO manipulation would be among individuals who successfully complete mand training using picture cards. A fourth limitation of this study is that criteria for participant selection were not sufficiently stringent to yield participants appropriate for all intended phases of the study The participants selected were all individuals with developmental delays as well as language delays. However, two participants, Erin and Pablo, did not acquire the discrimination dming training using picture cards. Although Erin and Pablo were able to hand the picture cards to the therapists, other pre-requisite skills that may be necessary for successful picture card communication training (e.g., attending to the image on the card, discriminating colors and shapes) may not have been present in their repertoire Therefore, it was never possible to have Pablo and Erin complete the EO manipulation phase using picture cards. Had more stringent participant selection procedures been established (perhaps an assessment of pre-requisite skills) all selected participants may have been able to complete all phases of the study. The results of this study yield additional questions that may be examined through future research. One finding in the present study was that Millie was unable to engage in discriminated manding in the context of two picture cards but was able to do so with two topographically different responses (picture cards vs. vocals). This finding is worth further evaluation in that it suggests teaching topographically different responses may be beneficial for some learners who are acquirin g communicative responses If so response forms such as sign language and vocali z ations may have advantages over picture cards in that signs and vocals inherently involve unique

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70 response forms across words Future studies may compare the acquisition and generalization of communicative skills by teaching topographically similar responses as compared to topographically different responses For example, an experimenter may conduct discrimination training sessions using topographically similar responses ( e.g., two picture cards) for 2 preferred items while concurrently teaching 2 topographically different responses (e.g ., picture cards and sign language ) for 2 different preferred items Such a comparison would allow researchers to determine if there is a difference in acquisition time (or number of trials) when using similar or different topographies of responding. Similarly an EO manipulation and/or generalization probes following training might yield additional information regarding the efficacy of each training method. Another finding in the present study was that two participants (Erin and Pablo ) were unable to complete discrimination training using picture cards yet were able to acquire responding using representative items (a seemingly easier discrimination task ) Given the importance of communicative skills for persons with developmental disabilities it seems relevant to identify which form of communication training is mo s t appropriate for each individual. Researchers may attempt to de v elop a s sessment procedures in order to identify which is the most appropriate form of communication for each individual, so that extended periods of time are not spent in discrimina t ion training without success Assessments could include discrimination training probes of multiple topographies of communication ( e g ., signing vocalization picture cards ) in order to identify which form an individual acquires most rapidly. In addition social validity screening would be conducted to evaluate which mode of verbal beha vi or

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71 parents and teachers find to be most useful (Wolf 1978 ) Similarly students c ou l d be allowed to choose communication modes by having one mode reinforced in one area of the room and another mode in another area of the room Finally future research may extend the results of the present study by e v alu a ting whether discriminated mand responses acquired through discrimination training per sis t under less controlled settings. The ultimate goal of any communication training is that the individual will be able to communicate in his or her natural environment. Therefore an extension of the present study may include generalizations probes in more natural settings (e.g ., classroom home). The EO manipulation phase could be easil y replicated in natural settings by providing access to one of the items while withholding access to the other. Then in the presence of two or more picture cards, i f the indi v idual hands over the picture card of the unavailable item then generalization outside the experimental setting would be demonstrated.

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REFERENCES American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4 th ed ). Washington, DC : Author. Bondy, A. S. & Frost L.A. (1993). Mands across water : A report on the application of the picture-exchange communication system in Peru The Behavior Analyst, 16 123-128. Bondy, A. S & Frost, L. A. (1994). The picture exchange communication system. Focus on Autistic Behavior, 9 1-19. Bondy, A. & Frost, L. (2001). The picture exchange communication s y stem Behavior Modification, 25 725-745. Bourret, J., Vollmer T. R. & Rapp J. T (2004) Evaluation of a vocal mand assessment and vocal mand training procedures. Journal of Applied Behavior Analys i s R 129-244. Carr, E G. (1982). Sign language. In R. L. Koegel A. Rincover & A L. Egel (Eds.) Educating and understanding autistic children. New York: College-Hill Press Carr, E.G Binkoff, J. A., Kologinsky, E., & Eddy M. ( 1978). Acquisition of sign language by autistic children. 1: Expressive labeling. Journal of Applied Beha v ior Analysis, 11, 489-501. Carr E.G. & Kologinsky, E. (1983 ) Acquisition of sign language by autistic children II: Spontaneity and generalization effects. Journal of Applied Beha v ior Analysis, 16, 297-314. Charlop M J ., Schreibman L. & Thibodeau M. G (1985) Increasing spontaneous verbal responding in autistic children using a time delay procedure. Journ a l of Applied Behavior Analysis, 18, 155-166. Charlop-Christy M J ., Carpenter M. Le L. LeBlanc L.A. & Kellet, K. ( 2002). Using the picture exchange communication system (PECS ) with children with autism : Assessment of PECS acquisition speech social-communicative behavior and problem behavior. Journal of Applied Behavior Analysis, 35, 213-231. 72

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73 DeLeon, I. G., Iwata, B. A., & Roscoe, E. M. (1997). Displacement of leisure reinforcers by food preference assessments. Journal of Applied Behavior Analysis, 30, 475-484 Durand, V. M. (1999). Functional communication training using assistive devices: Recruiting natural communities of reinforcement. Journal of Applied Behavior Analysis, 32, 247-267. Ferster, C. B., & Skinner, B. F. (1957) Schedules of Reinforcement. Englewood Cliffs NJ: Prentice Hall. Frost, L.A., & Bondy A S. (1994).The picture exchange communication system training manual. Cherry Hill, NJ: PECs Halle, J. W., Baer, D., & Spradlin J. (1981). Teacher s generalized use of delay as a stimulus control procedure to increase language use in handicapped children. Journal of Applied Behavior Analysis, 14, 389-409. Halle J. W. Marshall, A. & Spradlin, J. (1979) Time delay : A technique to increase language use and facilitate generalization in retarded children. Journal of Applied Behavior Analysis, 12, 431-439. Harris, S. L. (1976) Teaching language to non-verbal children with emphasis on problem of generalization. In C. M. Franks & G. T. Wilson (Eds.), Behavior Therapy Theory and Practice. New York: McGraw-Hill. Hart B. M & Risley T. R. (1968). Establishing the use of descriptive adjectives in the spontaneous speech of disadvantaged preschool children Journal of Applied Behavior Analysis, 1, 109-120 Hart, B., & Risley, T. R (1974) Using preschool materials to modify the language of disadvantaged children. Journal of Applied Behavior Analysis, 7, 243 256 Hart, B. & Risley T. R. (1975). Incidental teaching of language in the preschool. Journal of Applied Behavior Analysis, 8, 411-420 Hart B ., & Risley T. R. (1980). In vivo language intervention: Unanticipated general effects. Journal of Applied Behavior Analysis, 13, 407-432 Hemmeter M. L. Meyer S ., Ault M J ., & Collins B C. (1996). The effects of teacher-implemented language instruction within fre e time activities Education and Training in Mental Retardation and Developmental Di s abilities, September, 203 212.

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74 Hurlburt, B. I., Iwata, B. A., & Green, J. D. (1982). Nonvocal language acquisition in adolescents with severe physical disabilities : Bliss symbol versus iconic stimulus formats Journal of Applied Beha vior Analysis, 15, 241-258. Kravitz T. R., Kamps, D M. Kemmerer K., & Potucek, J. (2002) Brief report: Increasing communication skills for an elementary-aged student with autism using the picture exchange communication system. Journal of Autism and Developm ental Disorders, 32, 225-230. Lamarre, J., & Holland, J G (1985). The functional independence of mands and tacts. Journal of the Experimental Analysis of Behavior, 43, 5-19. Liddle, K. (2001). Implementing the picture exchange communication system (PECS). International Journal of Language and Communication Disorders, 36, 391-395. Lovaas, I. (1966). A program for the establishment of speech in psychotic chi ldr en. In J. K. Wing (Ed.), Early c hildhood autism. Clinical, educational and social aspects. New York: Pergamon Press Michael J. (1982). Distinguishing between discriminative and motivational functions of stimuli. Journal of the Experimental Analysis of Behavior, 37, 149-155. McCoy J F. & Buckhalt J. A. (1990). Language acquisition. In J. L. Matson (Ed.), Handbook of behavior modification with the mentally retarded., 445-466. New York: Plenum Press. Mcllvane W. J. & Dube W V. (2003). Stimulus control topography coherence theory: Foundations and extensions. The Behavior Analyst, 26, 195-213. Mobayed K. L. Collins, B. C. Strangis D. E., Schuster J. W. & Hemmeter M L. (2 000) Teachin g parents to employ mand model procedures to te ac h their c hildr e n requestin g. Journal of Early Intervention, 23, 165-179 Schepis M M ., Reid D. H. Berhman M M. & Sutton K. A. (1998). Incr eas ing commun i cative int erac tions of youn g children with autism using voice output communication aid and naturalistic teachin g. Journal o f Applied Behavior Analysis, 3 1, 561-578. Schepis M. M. Reid D H. Fitzgerald, J. R. Faw G.D., Van Den Pol R. A ., & W e lty P. A. ( 198 2). A program for increasing manual s ignin g by autistic a nd profoundly retarded youth within th e daily environment. Journal of Appli e d B e havi or Analysis, 15 3 6 3 3 79. Schwartz I. S Garfinkle A. N. & Bau e r J (1998). Th e pi c tur e exc h a n ge comm unic a tion sys t e m : Communicative outcomes for yo un g c hildr e n with di sabi liti es. Topics in Ear ly C hildh oo d Sp ec ial E du ca tion, 1 8, 144 159.

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75 Sidman, M. (1960) Tactics of scientific research Evaluating experimental data in psychology Boston : Authors Cooperative, Inc Sigafoos J ., Doss S ., & Reichle J. (1989) Developing mand and tact repertoires in persons with severe developmental disabilities using graphic symbols Research in Developmental Disabilities, 10, 183-200. Simic J. & Bucher B. (1980). Development of spontaneous manding in language deficient children Journal of Applied Behavior Analysis, 13, 523-528 Skinner B. F. (1957) Verbal behavior Englewood Cliffs NJ: Prentice Hall. Skinner B F. (1953) Science and human behavior. New York: The Free Press Stokes T. F. & Baer D. M. (1977). An implicit technology of generalization. Journal of Applied Behavior Analysis, 10, 349-367. Sundberg M L. & Michael J (2001). The benefits of Skinner s analysis of verbal behavior for children with autism Behavior Modification, 25, 698-724. Wolf M M. (1978). Social validity: The case for subjective measurement or how applied behavior analysis is finding its heart. Journal of Applied Behavior Analysis, 11 203-214.

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BIOGRAPHICAL SKETCH Anibal Gutierrez Jr. was born in Panama City Panama in 1972 to Guadalupe and Anibal Gutierrez. Anibal lived in Panama until the age of 9 when he and his f amil y moved to Miami Florida. Anibal attended the University of Florida and in 1996 graduated with a Bachelor of Arts degree in anthropolog y. In 1997, he entered a gradu a te program in psychology at the University of Florida. He was awarded his Master of Science degree in psychology in 2001.

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I certify that I have read this study and that in my opinion it conforms to acceptable standards of scholarly presentation and is fully adequate, in scope and quality, as a dissertation for the degree of Doctor of Philosophy. Timothy R Vollmer, Chair Associate Professor of Psychology I certify that I have read this study and that in my opinion it conforms to acceptable standards of scholarly presentation and is fully adequate, in scope and quality as a dissertation for the degree of Doctor of Philosophy. Henry S. Pennypacker Co-Chair Professor Emeritus of Psycholog y I certify that I have read this study and that in my opinion it conforms to acceptable standards of scholarly presentation and is fully adequate, in scope and quality as a dissertation for the degree of Doctor of Philo so phy. Brian A. Iwata Professor of Psychology I certify that I have read this study and that in my opinion it conforms to acceptable standards of scholarly presentation and is fully adequate in scope and quality, as a dissertation for the degree of Doctor of Philosophy. Scott A. Miller Professor of Psychology I certify that I have read this study and that in my opinion it conforms to acceptable standards of scholarly presentation and is fully adequate, in scope and quality as a dissertation for the degree of Doctor of Philosophy Maureen Conroy Associate Professor of Special Education

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I certify that I have read this study and that in m y opinion it conform s to acceptable standards of scholarly presentation and is full y adequate in s c ope and qu a lit y, as a dissertation for the degree of Doctor of Philosophy. Timothy R. Vollmer Chair Associate Professor of Psychology I certify that I have read this study and that in m y o inion i t conf or m s to acceptable standards of scholarly presentation and i lly adequa n sc op e a n d qua lit y as a dissertation for the degree of Doctor of Phil ophy Henry S. Pel111J cker Co-Chair Professor Emeritus of Psychology I certify that I have read this study and that in m y opinion i t conforms to acceptable standards of scholarly presentation and is full y ad e qu a te in sc o pe a nd qu a li ty, as a di s sertation for the degree of Doctor of Philosophy L14ytq{_ B an A. Iwata / Professor of Psychology I certify that I have read this study and that in my opinion it conforms to acceptable standards of scholarl y presentation and is full y adequate in s cope and qualit y, a s a dissertation for the degree of Doc ~~ Scott A Miller Professor of Psychology I certify that I have read this study and that in my opinion it confo1ms to acceptable standards of scholarly presentation and is fully adequate in scope and qualit y, as a dissertation for the degree of Doctor of Philosoph y. Maureen Conroy Associate Professor of Special Education

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This dissertation was submitted to the Graduate Faculty of the Department of Psychology in the College of Liberal Arts and Sciences and to the Graduate School and was accepted as partial fulfillment of the requirements for the degree of Doctor of Philosophy December 2004 Dean Graduate School

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