Abstract
Margie and Leo are young adults in a vocational training program for students with disabilities who are not pursuing traditional postsecondary education. Margie is 18 years old and has autism spectrum disorder (ASD). She is very interested in working at her favorite comic bookstore but has never held a job before, so she would likely require a job coach on-site. Leo, who is 20 years old and has ASD, has struggled to find and keep a job. Despite job training, Leo often needs reminders on how to complete a task, which has frustrated employers who have hired him previously. If given the opportunity, Leo would love to work with animals. Both of these students want to find jobs that are challenging, paid, and appeal to their interests.
As students with ASD become closer to finishing or aging out of the school system, transition skills, such as those related to employment and independent living, become a particular point of importance (Roux, Shattuck, Rast, Rava, & Anderson, 2015). In order to best prepare students with ASD for postsecondary life, it is necessary to equip them with vocational and daily living skills in order to gain more independence and successfully navigate this period of transition (Domire & Wolfe, 2014). Gaining independence not only helps alleviate the responsibilities of parents and caretakers but also builds the student’s confidence as a young adult. This is particularly important for students with ASD who do not have a goal of pursuing a 2- or 4-year postsecondary degree in institutions of higher education. Thus, throughout the article we refer to students with ASD who may have a co-occurring condition of intellectual disability (ID) based on below-average intelligence quotient scores and who spend the majority of their school instruction focused on preparing for transition to employment.
One common and effective approach used to teach vocational and independent living skills to students with ASD is technology-based intervention (Walsh, Holloway, McCoy, & Lydon, 2017). Such interventions include audio prompting (AP) and coaching, augmented and virtual reality, and video-based interventions, such as video modeling and video prompting (VP). These interventions have been shown repeatedly to be effective in teaching a variety of vocational and daily living skills to help students transition to independent living. Some examples include washing dishes (Gardner & Wolfe, 2015), cleaning (Wu, Cannella-Malone, Wheaton, & Tullis, 2016), and preparing food (Johnson, Blood, Freeman, & Simmons, 2013). Because these interventions are often carried out on portable electronic devices, they can be accessed and applied in a variety of settings, which allow students to have individualized instruction and self-prompting to help with the acquisition and long-term maintenance of skills (Bereznak, Ayres, Mechling, & Alexander, 2012). Additionally, prerecorded interventions can be used repeatedly with many students over several years, therefore reducing some of the instructor’s future workload once the intervention materials have been made.
Audio and Video Prompting
AP is an evidence-based practice (EBP) that can be used to teach a number of skills to students with disabilities, including behavior management and task completion skills (Savage & Taber-Doughty, 2017). By using a portable audio device, such as an iPod, AP delivers prerecorded verbal prompts to direct a student’s behavior. The target skill is typically broken down into small steps, allowing the student to complete a given step before moving on to the next one. The prompts, which explain each step, are either paused and resumed by the student or spaced out in the audio recording with silence or music. AP has been shown to be effective as a self-prompting or self-job-coaching strategy in teaching vocational and independent living skills to students with ASD. Some examples of skills include using an automated teller machine or copy machine (Taber-Doughty, 2005), handwashing (Mays & Heflin, 2011), and folding clothes (Bennett, Ramasamy, & Honsberger, 2013).
VP is another technology-based EBP for teaching a broad range of skills to students with ASD (Aljehany & Bennett, 2019). VP provides recorded instruction via modeling of the task completion accompanied with audio explanation. Similar to AP, VP breaks down a target skill into small steps, which are then presented in a video format via a tablet, computer, or smartphone. Each step is modeled for the student in short video clips, which enables the student to process and complete one step of the task prior to moving to another step. Although audio explanation typically accompanies the video model in VP instruction, research examining the salient features of VP found that it could be effective with or without the narration (Bennett, Gutierrez, & Honsberger, 2013). Regardless of formatting variations, VP has been effective in teaching numerous independent living and vocational skills, such as cooking (Johnson et al., 2013), photocopying and faxing (Bennett, Gutierrez, & Loughrey, 2016), functional mathematics (Kellems et al., 2016), and table and window washing (Wu et al., 2016). The effects of VP are further supported by meta-analytic findings showing that VP can be effectively used in teaching transition-related vocational skills to adolescents and young adults with ASD (Aljehany & Bennett, 2019).
Both AP and VP can be used effectively with students with ASD due in part to their formats of breaking down a task into small, manageable steps. This format helps reduce the cognitive load, or effort a student must put into remembering the next step of the task (Park, Bouck, & Duenas, 2019). Additionally, if the student needs to repeat the prompt, it is easy to restart or rewind the AP or VP clip. Although error correction may help increase initial skill acquisition, once students have begun to master a skill, they can self-prompt through AP or VP intervention, becoming more independent (Savage & Taber-Doughty, 2017; Yakubova, Leibowitz, Baer, Halawani, & Lestremau, 2019). Because AP and VP are portable, students can then take AP or VP recordings with them to a variety of settings to help with generalization and maintenance of acquired skills.
Mr. Harrington oversees Margie and Leo in their vocational training internship placements. He wants to prepare them to work independently without an on-site job coach, but given their lack of job experience, he is not sure that is possible. He recently heard about VP and how it can be used to teach students vocational skills. Mr. Harrington wonders if he can use it to help Margie and Leo acquire and maintain job skills at their internship placements. VP also reminds him a lot of another intervention, AP, so now Mr. Harrington is not sure which is the better intervention to use with his particular students.
Selecting a Prompting Intervention
Given that both AP and VP are EBPs, and share many similarities, it can be difficult for educators to know which to use. Although AP and VP are considered distinct interventions, the two share many of the same components. Most VP interventions include narration to accompany the video clips, which verbally prompts the behavior being shown in the clip using the same task-analysis language one would use for AP. Therefore, these verbal prompts included with VP are essentially AP with an added visual component. Nevertheless, it is important to note that AP and VP are considered distinct interventions in the research literature, meaning that a VP intervention with audio components is still considered just “VP” and not “VP plus AP.” Therefore, throughout the article we use the terminology VP to refer to VP with audio narration.
The major strength of AP compared to VP is that due to lack of visuals, it can be used in a greater variety of contexts, requiring only headphones or earbuds rather than a portable screen. AP can also be carried out on a variety of more cost-effective devices, such as an iPod or MP3 player, compared to VP, which typically requires a tablet, computer, or smartphone. This may be a particular benefit for budget constraints or for students who are prone to damaging equipment. In addition, being able to listen to prompts without watching it on the device’s screen removes the stigma sometimes associated with a student with a disability who receives constant adult prompting to help with independent task completion, particularly in competitive job and community sites.
The primary strength of VP is the visual aspect. Previous reviews of the VP literature have suggested that the visual aspect of VP helps to focus one’s attention on the salient features of the task during skill acquisition, which may be especially beneficial for students with ASD who tend to benefit from explicit, visual instruction (Aljehany & Bennett, 2019; Domire & Wolfe, 2014). As such, VP may be a more effective intervention to start with for students with ASD. Additionally, a large portion of the research on VP has focused specifically on students with ASD, finding it especially effective for this population (Aljehany & Bennett, 2019). Therefore, we suggest that educators begin with VP, perhaps fading to AP over time.
Fading From VP to AP
Given the similarities between AP and VP, once students begin to successfully acquire a skill with VP, educators may fade the VP to just the audio components (AP), which then students could use more easily in a variety of settings. In the past, some researchers have anecdotally observed that some students who acquired a skill using VP will stray from watching the video in later sessions, instead listening to only the audio components to remember the next step (Taber-Doughty, Patton, & Brennan, 2008; Yakubova et al., 2019). Given these students’ inattention to the visual aspect of the VP clip only upon skill mastery, this suggests that educators could reasonably fade VP to AP with time. The decision of when to fade is ultimately the educator’s decision, based on the student’s performance data, but one could begin to consider it once the student acquires the skill with VP (90% to 100% of steps correct). Given the similarities in the way that VP and AP interventions are created, it is feasible to alternate between the AP and VP intervention formats without a significant amount of additional time and effort. For example, an educator could use the same audio files that he or she had previously used to narrate the VP as stand-alone MP3 files that could be played on any digital audio device. Another way to fade VP to AP is to upload the VP on a smaller device, such as a smartphone, that the student could listen to while the device is in his or her pocket, so even though the video is playing, the student is not watching it. Regardless of which intervention strategy one chooses to use, implementing either AP or VP increases individualized, independent learning and reduces the need for constant support from job coaches or educators.
implementing either AP or VP increases individualized, independent learning and reduces the need for constant support from job coaches or educators
Additional Prompting Strategies
Depending on the intensity of support students need, some may require additional prompting strategies along with AP or VP to promote rapid skill acquisition, with the goal of eventually using AP or VP as a self-prompting strategy. Research has shown that pairing VP with error correction procedures in the form of least-to-most and most-to-least prompting or self-management strategies can result in rapid skill acquisition (Gardner & Wolfe, 2015; Yakubova et al., 2019). Findings from the most recent meta-analysis also pointed to the effectiveness of using error correction procedures when instructing with VP to promote rapid skill acquisition (Aljehany & Bennett, 2019). Once a student gains skill mastery, he or she may use AP or VP as a self-prompting maintenance support, thus reducing the need for adult prompting to complete a task in school, job, or home settings. When completing in-school job tasks, this can help a student learn to complete tasks without constant reliance on adult prompting. In community and job settings, this can help with both effectiveness and efficiency of task completion while reducing the need for job coaching.
Development and Implementation of AP and VP Interventions
Developing and implementing AP and VP interventions follow similar steps, so the following guide can be applied to either intervention, with the only major difference being that one will have to record the modeling of a task with VP; the audio components of each could be identical (see Table 1). For information regarding the development of AP or VP, see Table 2. Educators who are completely novel to video-based interventions may find it helpful to refer to Weng, Savage, and Bouck (2014), who provided a detailed task analysis of making individualized VP and video modeling clips using an iPad. Although Weng et al. used an iPad to illustrate the process of making videos, the procedures apply to the majority of the electronic devices used in schools and daily life, such as smartphones, video cameras, and tablets. The procedures outlined in Weng et al. emphasize the ease and simplicity of making videos for instructional purposes with little to no prior background in creating instructional video clips. Weng et al. also provided samples of iOS applications that educators could use to make video clips, in addition to using the camera included with any electronic device. Information about troubleshooting during and after the video recording also appears in Weng et al. for reference. Educators may develop AP following the same procedures without adding the visual modeling; however, some types of programs used to record and play AP may differ slightly. Savage (2014) provided some applications that educators could use to audio record the instruction and a task analysis of creating AP using the GarageBand application on an iPad or iPhone. Therefore, the following sections focus primarily on providing guidance to educators and vocational support staff on when and how to use either prompting intervention, how to fade VP to AP, and eventually, how to promote independent vocational task completion in job and community settings.
Recording Script for Leo’s Animal-Feeding Task
Note. For the video prompting, Mr. Harrington’s friend, who is helping him record his modeling, records from first-person point of view and pauses the recording after each step. Then Mr. Harrington moves to the setting of the next step and resumes recording.
Steps to Develop an Audio Prompting (AP) or Video Prompting (VP) Intervention
Educator’s Familiarity and Training in AP or VP Strategies
AP and VP are, essentially, explicit and direct instruction (with modeling for VP) provided in a technology-based format. Therefore, to develop and implement AP or VP, one needs only an everyday electronic device, such as a computer with a microphone, tablet, or smartphone, and a basic-level understanding of how to operate the device and teach a student how to operate the device to be used for AP or VP. Before beginning, educators should ensure that the device used to play the AP or VP is functioning properly and that the environment where the student will use the AP or VP is not too noisy, preventing the student from listening to the audio instruction. Alternatively, teachers can provide students with noise-canceling headphones.
Identify the Learners and Target Skill(s)
Just as no EBP works for every student, AP or VP as an EBP works for the majority of students but may not work for all. Therefore, it is important to identify potential learners who are able to pay attention for the short duration of the self-prompting video or audio clips, have the gross and fine motor skills needed to navigate through the device, and have vision and hearing abilities. To develop target skills focused on transition to postsecondary life, one may choose topics across the domains of postsecondary education and training, employment, or independent living skills. It may help to consult the student’s transition plan within an individualized educational program to understand his or her long-term goals of independent postsecondary life and the steps the student needs to take in order to reach these goals. For example, if a student has a transition goal related to independent living, it may be beneficial to create an AP or VP intervention to teach the student how to cook a meal, shop for groceries, or do laundry. AP or VP can also be used to teach vocational skills, either as a stand-alone tool or as a supplemental support tool to students in vocational training programs. Examples of such tasks include how to operate a cash register, answer phones, schedule appointments, and serve and interact with customers. Due to the versatility and relative simplicity of creating these interventions, they can be used to teach virtually any task.
Given that VP has shown especially strong evidence of effectiveness for students with ASD, Mr. Harrington decides to try using VP first and then maybe fade to AP once Margie and Leo begin to acquire the skills. Margie’s vocational training internship is at a convenience store. Given this placement, and her long-term goal of working at a comic bookstore, Mr. Harrington creates VP clips based on retail skills. These include examples of how to take inventory, work a cash register, and direct customers to a particular section of the store. Since Leo is interested in working with animals, his internship is at a local animal shelter. After consulting with the employers at the shelter about Leo’s tasks, Mr. Harrington creates three videos including steps and modeling on how to clean a dog’s kennel, walk and return dogs to their kennels, and feed dogs or cats based on varying diets. For both Margie and Leo, Mr. Harrington breaks the skills down into task analysis steps and has a friend record him modeling these steps using his iPhone. Then he edits the video clips using the iMovie application on his laptop and records a voiceover narration for each of the steps. Once the VP is complete, Mr. Harrington uploads the clips to Margie’s and Leo’s student iPads. Mr. Harrington was initially apprehensive about creating the clips, but he is able to use devices he is already familiar with (iPhone and laptop) and is pleased to find that the program he uses to edit the VP clips is free and relatively user-friendly.
Teach Students How to Use AP or VP
Once the AP or VP clips are made, educators should teach students how to navigate through the device to access and use the video or audio clips so that students are able to self-prompt through the intervention. Educators may use systematic explicit instruction, which is used to teach any other skills to students with ASD, to train students how to use the AP or VP strategies (S. Shepley, 2017). Educators may need to create a task analysis of how to use AP or VP on a given electronic device, teaching students to complete each step of the vocational task after each audio or video prompt prior to moving to the next prompt (see Table 3). Educators may need to refer to S. Shepley (2017) for additional guidance on a sample task analysis of training students to self-instruct with mobile technology. Another resource for teachers in finding other strategies of systematic explicit instruction and EBPs is available via the National Professional Development Center on ASD (https://afirm.fpg.unc.edu/afirm-modules). Once the student reaches 100% mastery criterion of operating the AP or VP clips independently, the intervention can begin.
Margie’s Task Analysis Checklist for Using VP
Use Prompts and Reinforcement
While the student is still acquiring the skill, additional prompting from educators may be needed. If the student seems unsure of what to do, first start by prompting him or her to play or replay the AP or VP clip. This will help to promote self-prompting. If the student is not able to replay the clip or struggles to complete the next step even after watching or listening to the prompt the second time, least-to-most or most-to-least prompting may be necessary depending on the student’s learning needs and the prompting that he or she typically receives in his or her school or vocational training environment. Least-to-most and most-to-least prompting each follow a prompting hierarchy, moving from providing prompts with the least assistance to providing those with the most assistance and from most assistance to least, respectively. The hierarchy, starting with the prompt that provides the least assistance, is a direct verbal prompt, followed by increasing levels of assistance: direct verbal plus gestural prompt, verbal plus modeling prompt, verbal plus partial physical prompt, and verbal plus full physical prompt. Both types of prompting have been shown to be effective both individually and in combination with other interventions (Leaf et al., 2016; C. Shepley, Lane, & Ault, 2018). Nevertheless, least-to-most prompting has been associated with more rapid skill acquisition than most-to-least (Libby, Weiss, Bancroft, & Ahearn, 2008). In addition to educator prompting, some students may benefit from having a printed support checklist that includes a list of the steps from the AP or VP task analysis (Table 1) used to complete the task. Alternatively, the educators may present the checklist on a student’s device electronically on a notepad or smart notes application. Students can then check off each step as they complete it with the AP or VP clips. Throughout the intervention, verbal praise should be given for completing steps correctly, responding to AP or VP, or staying on task. Once the student completes the full sequence of the task steps, educators should provide additional positive individualized reinforcement based on the student’s interests.
Mr. Harrington introduces Margie to the VP intervention using a task analysis checklist (see Table 3), which explains how to locate the files on her iPad and how to play and pause the clips. Although not her long-term goal, Margie is able to intern at a convenience store where she can practice acquiring retail skills using the VP. Mr. Harrington is present during much of her internship to oversee her use of VP. He often has to prompt her to play or restart the clips when she gets frustrated on which next step to complete. Margie relies on the visual aspects of the clips, watching the modeling closely. Once Margie begins to perform all of her tasks at 90% accuracy or greater, Mr. Harrington tries to fade to AP, but Margie’s performance falls significantly. Nevertheless, he uploads the VP to her iPhone instead, which is more easily portable than her iPad. By the end of her internship, Margie completes each of the tasks 100% correctly with the VP. Mr. Harrington plans to teach Margie how to generalize her acquired skills to new settings, such as with a different cash register using the suggestions provided in subsequent sections.
Promote Long-Term Independence
The goal of using VP or AP is to promote student independence by increasing self-prompting and decreasing reliance on educator or coach prompting. In order to continue promoting independence in vocational settings, educators should consider taking steps to ensure that the acquired skills are applicable over time, in a variety of environments, either with or without the accompanying AP or VP. Such steps include planning for generalization to new environments and equipment and fading self-prompts to promote independent task completion and maintenance with no or less noticeable devices.
Plan for generalization
Educators should consider how to promote generalization so that students can continue to use the AP or VP clips in different contexts. Depending on the specific skill, students can practice outside of the usual vocational training or classroom setting while supports, such as least-to-most or most-to-least prompting or self-monitoring checklists, are still in place. This way, students can begin to apply these skills to new settings while still benefiting from help if they need it. Some students may need the AP or VP to be in place to generalize, but some may not need the support (S. Shepley, Spriggs, Samudre, & Sartini, 2019). For example, S. Shepley et al. (2019) found that some students needed to use the intervention to complete multiple examples of the task to generalize the skill, whereas others did not need it to help with generalization. Educators may also need to provide task direction for some students to facilitate generalization (Smith et al., 2016). Therefore, if a student uses AP or VP to learn how to operate a cash register or answer the phone by using a sample register or phone in a classroom environment, educators can promote generalization by having the student use a different cash register or phone in more authentic settings, with the originally created AP or VP as a guide. In order for students to truly master the skill and be able to perform it independently, they need to learn how to apply the skill across contexts and in authentic work sites.
Fade self-prompts
Ultimately, the goal is for the student to learn to perform the skill independently, without the AP or VP at all. Once a student acquires the skill by self-prompting through the AP or VP with an accuracy of 90% to 100%, consider ways to fade these prompts. For example, if the student reaches 90% to 100% accuracy on a skill using VP, consider fading to the audio components only, effectively making it AP instead, which entails less visual attention and more portable technology. As mentioned, one way to do this is to upload the VP on a smaller, pocket-sized device so that the student can listen to the audio component of VP with headphones or earbuds while the screen is in his or her pocket and thus the video is not shown. That way, if the student needs to refer to VP, he or she can return to it easily. After the student demonstrates at least two or three sessions of accurate task completion with AP, educators can consider fading the self-prompting interventions altogether. One way to do this is to combine mastered steps into larger chunks, therefore reducing the number of steps and details within each step until the VP or AP is no longer needed. Another way to chunk is to have the student watch or listen to the clip in a whole sequence prior to task completion, which could serve as a refresher. Research findings showed students with ASD reached 100% accuracy in independent task completion with VP or AP only and naturally started to fade while maintaining accurate task completion (Mays & Heflin, 2011; Yakubova et al., 2019). These findings demonstrate that students can acquire skills within a few sessions of using AP and VP interventions, with some students naturally fading the intervention upon skill mastery. Nevertheless, other students may benefit from teachers’ gradual fading process to maintain the skill acquisition.
During Leo’s internship, he is able to practice the skills using VP on his iPad. Mr. Harrington is present to prompt Leo to stay on task using least-to-most prompting when necessary. Mr. Harrington records Leo’s accuracy for each step of the task analysis, marking when Leo completes steps correctly and independently and when he requires additional prompting (Table 4). After two consecutive sessions of 100% accuracy with VP, Mr. Harrington decides to fade to AP by saving the VP on Leo’s iPod Touch. Leo listens to the audio of the VP with headphones, while keeping the iPod Touch displaying the video in his pocket. Leo continues to complete the tasks accurately with the AP and no longer requires Mr. Harrington’s supervision or prompting. The employers at the animal shelter remark at how quickly Leo has learned the skills and are thinking of offering him a part-time paid job at the shelter.
Mr. Harrington’s Data Collection of Leo’s Animal-Feeding Task Using VP, AP, and Least-to-Most Prompting
Note. AP = audio prompting; VP = video prompting; I = independent complete; V = verbal prompt; M = modeling prompt.
Conclusions
AP and VP are both EBPs that have been shown to help students with ASD acquire important transition-related vocational and independent living skills. Furthermore, the format allows for previously recorded AP or VP interventions to be used repeatedly, benefiting both the educator, who can reuse the same AP or VP recording with many students over years, and the students, who can continue to carry the intervention with them throughout many settings by using portable electronic devices. Given the particular strengths and needs of students with ASD, it may be beneficial to begin with VP and fade to AP over time. For those who require more support, VP may be necessary throughout skill acquisition and can then be used on a smaller, pocket-size device in a variety of settings in the long term. AP and VP interventions hold promising results for helping students work on goals related to transition to employment and independent living in both school and authentic work settings.
