Facilitating Pretend Play Skills for Youngsters with Autism through Literacy-Based Interventions ISAAC, 2012 Joanne M. Cafiero Cynthia Pearl.

Facilitating Pretend Play Skills for Youngsters with Autism through

Literacy-Based InterventionsISAAC, 2012

Joanne M. CafieroCynthia Pearl

Rationale for Project

• High engagement in repeated readings using adapted literature

• Absence or low levels of pretend play• Absence or low levels of interactive play• Prior Action Research on Pretend Play with

Preschoolers with ASD

Facilitating Pretend Play through Literacy Interventions

• Environments: – self-contained ASD program in general education

environment– Home

• Inclusion opportunities:– in Specials, Recess and planned activities with

typical peers• Partnership with teacher, family and consultant• Action Research Model

Action Research

• Research conducted within the environment that results will be utilized

• Goals, research questions taken from IEP or questions of practitioners

• Can be messy and evolving• Utilizes qualitative and quantitative

measurements• Facilitates immediate implementation of results

Why is Pretend Play Important?

• Play is the “work” of childhood• Presumes perspective taking• Skills correlate with language development• Evolves from solitary to parallel to interactive

in typical children

Why is literacy important?

• Visual medium targets strengths.• Current research dictates that providing

opportunity facilitates literacy learning.• Literacy and AAC are inextricably entwined.• Reading and writing can segue into functional

communication.

Teaching Pretend Play Scripts to Pre-K students with ASD Through Adapted Literature

(Cafiero, Manthey-Silvio& Pearl, 2007; Cafiero & Pearl, 2009)

– Collected language samples from typical kids– Developed adapted literature (text above;

adapted text below) from sample– Read book in group reading for 3 weeks– Videotaped independent unprompted play for

baseline and 5 intervention probes

Joanne M. Cafiero PhD, 2011

It’s Time to Play with My Toy Carsby Cindy Pearl

Pretend Play: Time to Get Gas

• Book read in group instruction.• Each student had his/her own book.• Related Balanced Literacy activities with target

words & sentences daily.• Videotaped baseline, intervention and 3

probes of individual students• Data taken from videotapes

Pretend-play Behaviors: Gas Station: Actions

Putting man in car

Driving to gas pump

Putting in nozzle; filling up

Leaving gas station

Joanne M. Cafiero PhD, 2010

Pretend-play Behaviors: Gas Station: Scripts

“This is my car”

“Uh-oh, I’m out of gas.”

“I’m putting in gas.”

“I’m putting in more gas”

“Gas is finished, bye-bye.”

Joanne M. Cafiero PhD, 2010

Joanne M. Cafiero PhD, 2010

Joanne M. Cafiero PhD, 2010

Integrated Literacy Activities Using Balanced Literacy Model

• Word Study Using Target Words– Word building– Phonics– Phonemic awareness

• Writing Using Target Words– Sentence building– Close writing activities

• Self-Selected Reading– Books made available for independent reading

Thematic Curricular Unit: Car Wash

MathCounting carsColor identificationMatching PCS (PCS-PCS; PCS-word; word-word)Patterning with target words

CommunicationRequesting play itemsUsing target language in play

Fine MotorCutting, pasting Using pencilsManipulating

Gross MotorCar playRiding car play

TechnologyInteractive vocabulary on P2GWord match & other technology games.

SocializationAppropriate toy play in inclusive environments

Results: Teaching Pretend Play Through Adapted Literature

• Qualitative:– “crystal clear” speech and spontaneous

generating of appropriate language.– Longer periods of engaging in targeted pretend

play behaviors– Fewer off-task and stereotypic and self-stimulatory

behaviors– Maintained play and language at 18 month probe

Joanne M. Cafiero PhD, 2011

Pretend Play Skill Maintenance: 1.5 years later

• Students maintained play scheme skills without book; more skills with book present

• Students who learned scripts (Baby to Bed) maintained the non-linguistics (lullabye, “shhh”, kiss good night)

• Students independently requested to play and generalized to novel objects & environments

New Findings: 3 years later

• Students from original study requested opportunities to pretend play with targeted items when given the opportunity.

• Target students maintained 20-40% of scripts and 100% of actions

• Target students selected Pretend Play activity as highly preferred reinforcer

Facilitating Pretend Play Toy Cars: Phase 2

• Primary Autism Class

• Implemented intervention with modeling and literature

• Did not include robust literacy extension activities

• Baseline & 3 Video Probes

Identifying Specific Play Behaviors

• Observed typically developing kids engaging in the targeted pretend play– Pretend play included concrete figures, objects

• Charted actions and scripts• Took photos of identified actions• Created literature using photos and scripts

Pretend Play Skill Acquisition

Javier Olivia Mark Aidan0%

5%

10%

15%

20%

25%

30%

35%

BaselineIntervention

Observations

• Increases in play actions• No Increases in play language (scripts)• Demonstrated interest in play schemes when

others were engaged with it.• More interest in interactive play than in

previous pilot study with younger CWA

Pretend Play in the home: My Restaurant

• Restaurant theme selected from favorite pretend play activity of two typical brothers, 8-9 years old

• Videotape of Restaurant play; actions & scripts identified

• Selected 10 of most appropriate actions & scripts for book

• Photographed boys engaged in activity for book: excluded adults and prompts

Pretend Play: Teddy & Kenneth

• Twin boys, 9 years old, Dx ASD• Non-verbal & limited speakers• Participated in structured literacy program in

school• Majority of play time is solitary screen time

(iPad, TV, videos)• Engaged parents – Read story 2x/day– Played restaurant 1x/day

My Restaurant

• Parents and caregiver read story 2x day• Once with props; acting it out• Once without• Limited related literacy activities around target

vocabulary (sentence building)• Weekly coaching and videotaped probes

My Restaurant

Bethany is a customer in My Restaurant

32

Hi. Welcome to My Restaurant.

33

Here is your menu.

34

Bethany reads the menu.

35

Can I take your order?

36

What do you like to drink?Bethany says “I want some water, please.”

37

Here is your drink.

38

What would you like to eat? Bethany says: “I’d like a pizza”.

39

Here is your pizza.

40

Bethany eats her pizza.

41

Here is your check.

42

Bethany pays the check.

43

I put the money in my pocket.

44

Thank you, please come back.

45

TheEnd

My Restaurant: Measuring Outcomes

• Simple data collection method• Weighted prompts for coding % independence– 3 fully independent– 2 Gestural prompt– 1 Verbal prompt– 0 No response

• Observations of activity around theme noted anecdotally

My RestaurantActions Scripts

Greets customer “Hi, Welcome to My Restaurant”

Gives menu to customer “Here is your menu”

Takes order “Can I take your order”

Brings drink “What would you like to drink?”

Brings pizza “What would you like to eat?”

Waits for customer to finish eating

Brings check “Here is your check.”

Takes money

Puts in pocket “Thank you, Please come back.”

% Independence in Pretend Play: Kenneth

Baseline Probe 1 Probe 2 Probe 3 Probe 40%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

ActionsScripts

% Independence in Pretend Play: Teddy

Baseline Probe 1 Probe 2 Probe 3 Probe 4 Book Probe

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

ActionsScripts

Results:

• Increases in % independence in actions• Increases in % independence using scripts• More novel pretend play around toy foods• Increased engagement with play partners• Increases in independent performance of play

actions and scripts with book present

What We Learned:

• Data collection should represent smaller increments of performance

• Applying gentle pressure by putting hand on shoulder breaks autistic inertia in some children

• Total package (story, word study, cross curricular activities) total immersion may be the factor that defines greater levels of Pretend Play skill acquisition