The Use of Cell Phones to Address Safety Skills for Students With a Moderate ID in Community-Based Settings

Abstract

The purpose of this study was to examine the impact of a video modeling (VM) intervention in conjunction with a system of least prompts (SLP) to teach safety skills using cell phones to students with a moderate intellectual disability. A multiple-probe design across three participants was used to assess student acquisition in taking and sending a picture of a key identifier (i.e., a sign) during a role-play scenario in which students pretended to be lost in the community. Intervention sessions were conducted at the students’ middle school, at their community-based instruction site, and at an unfamiliar community location. All students successfully learned to take and send the picture in the community locations at the mastery criterion and generalized the skills at an unfamiliar community site. Implications of the use of VM to address the integration of technology with safety skill instruction and other areas of future research are discussed.

Keywords

community-based instruction (CBI)modeling natural environment

People with an intellectual disability (ID) have the right to access their local communities. For this reason, the issues involving dignity of risk versus erring on the side of caution when considering safety concerns continues to be a debate among service providers (Stock, Davies, Wehmeyer, & Lachapelle, 2011). Known benefits of increased opportunities for independent navigation in community settings include increased self-esteem, employment, access to community events, improved quality of life, and opportunities to contribute to society (Kelley, Test, & Cooke, 2013). Furthermore, safety skill instruction is an area valued by people with an ID (Agran, Krupp, Spooner, & Zakas, 2012). In regard to educational services, the 2004 Individuals With Disabilities Education Improvement Act (IDEIA) transition mandate references community participation as a key area of transition planning (IDEIA, 2004).

Although educators serve as advocates to prepare students for community participation, there are those concerned about the safety of individuals with disabilities in community settings. These concerns stem from the need for preventive actions taken by all people (e.g., locking doors) when going into the community. Furthermore, there is a gap in the literature regarding effective evidence-based practices for teaching the abstract concepts of safety skills to people with an ID (Stock et al., 2011; Taber, Alberto, Seltzer, & Hughes, 2003).

Safety Skill Instruction

Previous research examined strategies for teaching community safety skills to individuals with an ID in a number of areas, including street crossing and pedestrian skills (Batu, Ergenekon, Erbas, & Akmanoglu, 2004; Kelley et al., 2013; Mechling & Seid, 2011), first aid skills (Spooner, Stem, & Test, 1989), and use of public transit (Mechling & O’Brien, 2010). Although strategies to ensure safety skill instruction are broadly embedded into curricula for students with a moderate ID, there remains a need to explore interventions that address potential concerns about individuals in this disability category becoming lost in the community (Bergstrom, Najdowski, & Tarbox, 2012; Hoch, Taylor, & Rodriguez, 2009; Pan-Skadden et al., 2009; Taber, Alberto, Hughes, & Seltzer, 2002; Taber et al., 2003; Taylor, Hughes, Richard, Hoch, & Coello, 2004). Furthermore, the risk of becoming lost must be addressed when discussing community integration as well as when considering the emphasis of community-based instruction (CBI) as a prevalent instructional model for these students.

A child is defined as lost “when the child’s whereabouts are unknown . . . and the caregiver [is] alarmed for . . . 1 hour” (U.S. Department of Justice, 2002). Educational programs must address strategies to teach students with disabilities to successfully navigate their communities (Hoch et al., 2009; Kelley et al., 2013); therefore, safety skill instruction should be an integral part of their educational program. Specifically, systematic interventions that teach students appropriate safety skills may ease concerns about the student not knowing how to respond if he or she becomes lost. Ultimately, this may assist people with an ID in independently navigating their communities and provide them with new opportunities to access services, education, leisure activities, and other events (Bergstrom et al., 2012).

Effective strategies that teach what to do when lost in the community include behavioral skills training (e.g., establishing rules, role-playing; Bergstrom et al., 2012) and teaching students to tell someone they are lost and provide their caregiver’s name (Pan-Skadden et al., 2009). Additional research suggests that technology can be effectively used to address this issue. Previously, students were taught to respond to a pager from their caregiver and tell a naïve adult they were lost (Taylor et al., 2004). They additionally were taught to use mobile phones to communicate with their teachers (Hoch et al., 2009; Taber et al., 2002, 2003).

Mobile Phones During Instruction

Mobile phones are increasingly being used as assistive technology for people with disabilities and may be a preferred instructional method given their social desirability (Bouck, Flanagan, Miller, & Bassette, 2012). Furthermore, cell phone use with individuals with an ID provides opportunities for digital normalization and life skills training (Kellems & Morningstar, 2010). Previous research explored strategies for teaching students with disabilities to use cell phone features (e.g., prompts) as a means to increase independence in daily living skills (Ayres, Mechling, & Sansosti, 2013; Bereznak, Ayres, Mechling, & Alexander, 2012; Stock et al., 2011), learn financial skills (Cihak, Alberto, Taber-Doughty, & Gama, 2006), and complete vocational tasks (Cihak, Kessler, & Alberto, 2008). Other mobile phone features (e.g., text to speech) and apps also support the communication needs of people with ID (Bradshaw, 2013).

Because mobile phones are transportable, can serve a multitude of purposes (e.g., making/receiving calls, providing prompts), and increasingly have a variety of salient features (e.g., cameras), their potential contribution to community safety skill instruction for people with disabilities is noteworthy (Ayres et al., 2013). In two studies, Taber and colleagues (2002, 2003) integrated the use of mobile phones to teach students to obtain assistance when lost in the community. Students were taught to dial or answer their cell phones and describe their locations. Although students were able to reach mastery criteria in using cell phones when lost, some experienced challenges in verbally identifying their specific locations to supervisory personnel. When prompted, most were able to describe their surroundings but offered vague and nonspecific answers (e.g., “I see a picture on the wall”) that hindered their supervisor’s ability to quickly identify students’ locations. In addition, some students’ limited communication skills hindered their ability to articulate their location (Taber et al., 2003).

Hoch et al. (2009) sought to expand research in this area by teaching students with autism to answer a cell phone and obtain assistance from an adult in the community using a communication card. Initially, students were taught to give a naïve adult both a communication card requesting assistance and a cell phone; however, the adults mistakenly believed the students intended to give them a phone that did not belong to them; therefore, the intervention was modified. In the modified phase, students only provided the naïve adult with the communication card requesting assistance and results demonstrated the students were successfully able to obtain assistance. Recommendations for future research included considering video as the instructional model due to increased efficiency in delivery.

Use of Video Modeling (VM) During Instruction

VM was previously used to successfully teach children with ID a variety of skills including activities of daily living (Cihak et al., 2006; Taber-Doughty et al., 2011; Walser, Ayres, & Foote, 2012), vocational jobs (Davies, Stock, & Wehmeyer, 2002), community skills (Branham, Collins, Schuster, & Kleinert, 1999), and safety skills (Mechling, Gast, & Gustafson, 2009). Although VM was effective to teach students with a moderate ID to acquire these skills, no study to date examined its role in teaching students to use a cell phone to convey their location in the community during safety skills instruction. Given this gap and the previous success of video technologies and cells phones used to increase learning in people with ID, the current investigation sought to determine whether VM could be used to increase students’ use of a cell phone to take and send a photo during a role-play scenario in the community in conjunction with a system of least prompts (SLP). An SLP was identified previously as an effective strategy for teaching students with disabilities behavioral chains (Cooper, Heron, & Heward, 2007) and were successfully implemented to teach cell phone use (Manley, Collins, Stenhoff, & Kleinert, 2008); however, an SLP was not implemented during safety skill instruction. Specifically, the present study examined whether the intervention would affect student ability to use a cell phone’s camera function to indicate their locations in school and two community sites.

Method

Participants

Three secondary-age students (ages 13–17) with a moderate ID participated in this study (see Table 1 for demographic information). Upon receiving institutional review board (IRB) approval, students were selected to participate through a purposive sample (i.e., recommendation by their special education teacher). Inclusion criteria included the following: parental consent for each student, involvement in CBI at least 2 to 3 times per week for 1.5 to 3 hr per session, independent mobility, and goals focused on increasing independence in the community based on their teacher’s recommendation. The exclusion criterion included students with active behavioral plans. All students participated in the same self-contained classroom at the time of the study.

Table 1.

Students’ Demographic Information.

Student/gender	Age/grade	Ethnicity	IQ	Woodcock Johnson Test of Achievement	Time in general education	Secondary disability	Adaptive Behavior Assessment System (ABAS)-II
Mary/female	14/7th	African American	56^a	1. 4-1. 7	Less than 40%	None	N/A
Ben/male	15/8th	Caucasian	56^b	K. 7-1. 2	None	Language disability	70
Will/male	13/8th	Caucasian	46^b	K. 7-1. 7	None	Language disability	48

Kaufman. ^bWechsler.

Mary

Mary was a 14-year-old female in seventh grade with a moderate ID. She received special education services in a self-contained classroom and the community for the majority of each day and spent less than 40% of her time in general classroom settings. Specifically, she was included in family and consumer sciences and art for 9 weeks of the 18-week semester and participated in a general education physical education class with a paraprofessional on alternating days. Mary was verbal and described anecdotally by her teacher as friendly with peers (e.g., volunteered to help fellow students with schoolwork) and compliant with requests. Her teacher recommended Mary for the study due to her compliant nature, willingness to follow directions in the community, and the associated benefits of having increased independence in the community. When assessed on her ability to use the cell phone prior to baseline, she was able to turn on the phone and take a picture independently but was unable to send the picture.

Ben

Ben was a 15-year-old eighth-grade male student with a moderate ID. Ben received all special education services in a self-contained classroom and community settings. Ben also experienced a language disability and frequently struggled with articulation. According to anecdotal teacher reports, he was sociable with his classmates and teachers, demonstrated a good sense of humor, and worked hard to do his best. His teacher recommended him as a participant given that he would eagerly follow the researchers’ instructions in the community. When going to community sites during the study, Ben enjoyed demonstrating his knowledge of navigating the public bus (e.g., waiting the correct distance from the road at the bus stop and pulling the rope to stop the bus at the community location). Prior to baseline, it was determined that Ben was able to turn the cell phone on independently but was unable to take or send a picture.

Will

Will was a 13-year-old eighth-grade male student with a moderate ID and secondary language disability. He received all special education services in a self-contained classroom and community settings. Will was verbal but tended to only speak in one- or two-word phrases and in a quiet voice that was difficult to hear. His teacher anecdotally described him as quiet with a good sense of humor and noted he enjoyed dancing and music. Similar to Mary and Ben, the teacher suggested him for the study given his tendency to comply with task demands from new people (i.e., the researchers) and display appropriate behavior during CBI. His teacher also indicated that Will would benefit from the opportunity to learn new skills that would increase his independence in the community. When provided with the cell phone prior to baseline, Will was able to turn the phone on but was unable to take and send a picture.

Setting

All students attended the same junior high school of approximately 1,000 students within a school district of 57,000 located in a small urban area in the Midwest. The study took place over 3 months and across five settings: the students’ classroom, the school hallway, the school library, a familiar community location, and an unfamiliar community location.

School classroom

This setting contained four rows of desks facing the front of the room. A table and computer were situated near the back of the classroom for student use. Behind the computer desk was a round table with six chairs available for the two paraprofessionals to use during small group instruction. Students watched all video across all phases in this setting.

School hallway

Baseline sessions were conducted in the hallway right outside of the classroom. The hallway was approximately 15-feet wide and approximately 50 feet long with doorways to four other classrooms spaced approximately every 45 feet on both sides. Baseline sessions occurred when other students in the school building were in class.

Middle school library

Phase 1 of the intervention took place at the school library that was located at the front of the school across from the main office. Students were familiar with the library and used it on a weekly basis. During Phase 1 intervention, sessions were held in the aisles between the bookshelves near the front of the library. The bookshelves were approximately 10 feet high, and students could not see over them. Sessions typically took place during the morning when classes and other students were not scheduled to be in the library.

Department store (familiar CBI location)

Phase 2 intervention sessions took place at a local large-chain discount store where students frequently participated in CBI. At this location, students were instructed in various departments (e.g., grocery, office) based on the targeted instructional activity for the day. Sessions were conducted in the morning, and there were typically approximately one to three other customers in proximity to the students during sessions.

Grocery store (unfamiliar CBI location)

Phase 3 probe sessions took place in a local grocery store across various aisles (e.g., bread, frozen foods). The grocery store was a local chain store. Similar to the department store, sessions were conducted in the morning. Typically, there were approximately one to two other customers near the students during the data collection sessions. The grocery store was not part of the students’ routine CBI.

Materials

Cell phone

A Verizon Wireless Samsung SCH-u340 was the phone used for the study. This flip phone was 3.5″ × 1.8″ × 0.77″ and weighed 2.82 oz. The camera was mounted at the top of the phone when it was flipped open. When opened, the screen was on the top half of the phone and buttons used to navigate the various phone features were on the bottom half. Specifically, two rows of three buttons were on the button half of the phone above the number keypad. The top row of buttons included a left button, ok button, and right button. Surrounding the “ok” button was a square that included arrow buttons pointing up, down, right, and left. Directly below this row was the second row of buttons that included a send, clear, and end button. Below these was a traditional phone keypad. This phone was selected due to ease of taking a picture and ability to purchase minutes for the phone without requiring a yearly contract.

Videos

Two videos were developed for the VM intervention. The first was 19 s and showed an adult model stating that she was lost. The adult modeled she was lost by looking confused (i.e., turned her head from side to side) and verbally indicating she was not sure what to do. The video then illustrated the model acknowledging she should find a key identifier (i.e., a sign, such as one posted on the wall close to her) of which she could take a picture to send to the teacher to detect where she was located. The second video was 3 min 17 s long and included an up-close view of the cell phone and keypad. It showed the phone and the model’s finger demonstrating the buttons on the phone to be pressed to take and send the picture. In addition to the visual model, auditory prompts detailing the steps of the task analysis were included. Students only had access to the videos when watching them prior to each intervention session.

Independent and Dependent Variables

The independent variable (i.e., video model in conjunction with a five-level SLP) was used to determine the student’s ability to demonstrate appropriate safety skills. During the VM intervention, students watched two video clips. The first video provided a model demonstrating the following steps: (a) The model acknowledged she was lost, (b) the model noted that she could take a picture to send to help her instructor know where she was, and (c) the model pointed directly to a key identification point (i.e., a sign, such as one posted on the wall close to the student) to help her teacher identify her location. The student then immediately watched the second video that showed, from the phone’s perspective, the sequence of buttons that needed to be touched on the cell phone to successfully take and send a picture based on task analysis steps (see Table 2). The role-play was initiated when the first author gave the instructional cue “Show me what to do when you’re lost” and researchers removed themselves from the students’ immediate line of vision. If the student was not able to complete a step independently during any phase of the intervention, the first author ended the role-play session by approaching the students to assist them. The SLP was then used to assist the student in successfully sending the picture. The dependent variable was the percentage of task analysis steps the student completed independently prior to the researcher ending the role-play. The level of prompting needed for the student to successfully complete any of the steps was recorded.

Table 2.

Steps of Task Analysis for Taking Picture of Location and Sending It to Teacher.

Step	Task
1	Flip phone open
2	Press power button (in red letters)
3	Wait for home page to load
4	Press OK button to access menu options
5	Press the number 3 to access camera
6	Point camera viewfinder at appropriate sign/location (e.g., Sporting Goods)
7	Hold camera still and press OK button to snap picture
8	Press OK button (Send option) to save picture and to access list to add recipients
9	Click the upper right button (Add option) to access options for contacts
10	Click OK button to choose highlighted From Contacts option
11	Scroll to teacher’s name from list of contacts
12	After highlighting teacher’s name, click OK button (contact’s name will be checked)
13	Click the upper left button (Done option) to add recipient’s name to list
14	Click OK button
15	Click OK button (Send option) to send picture and wait in place until teacher arrives

Design and Data Collection

A multiple-probe across-students design was used to examine the effects of the independent variable on acquisition of safety skills. This design allowed investigators to determine whether a functional relationship existed between the independent and dependent variables (Kennedy, 2005) and is frequently used to control for potential carryover effects (Alberto & Troutman, 2006). The SLP was also used to determine the level of assistance needed to complete each step in the completion of a given task while minimizing student frustration (Cooper et al., 2007). Fifteen discrete task analysis steps were identified for using the cell phone’s camera function to take and send a picture. Event recording was used to record the level of prompting required for each discrete step of the task analysis. During each session, data collectors (i.e., first and fifth authors) separately recorded if a step was completed independently. If a student was not able to complete a step independently, the session was stopped and the student was provided assistance using the SLP to send the picture, and the level of prompt needed for each step was recorded. The SLP was delivered in the following order: verbal only, verbal and gesture, verbal and model, verbal and partial physical, and verbal and full physical prompt.

Procedures

Baseline

Baseline data were collected in the middle school hallway. Students were asked whether they were willing to participate in a role-play where they would pretend to be lost. Once assent was obtained, students were given the Verizon Wireless Samsung SCH-u340 phone and instructed to send a picture to the instructor using the cell phone provided. Specifically, the instructional cue “Show me what you do when you’re lost” was provided as the researchers removed themselves from students’ immediate line of vision. No training on how to use the cell phone was provided in this phase. Baseline data were gathered using the task analysis steps. Once baseline stability was demonstrated, students proceeded to the first phase of intervention.

Phase 1: Middle school library

All data collection during this phase took place at the school library. Prior to the targeted activities, students watched the two videos demonstrating how to recognize that they were lost and what to do (i.e., identify a sign and then take and send a picture to the instructor). Videos were kept on a flash-drive which students only had access to during interventions and were watched individually by students on the classroom computer. Following confirmation of assent to participate, students were asked to sit at the computer, and the researcher accessed the first video for the student to watch. Once the first video was completed, the second video followed immediately. Auditory instructions were provided through headphones attached to the computer. After watching the videos, students were given the cell phone and instructed to go to the school library. The first author gave each student the cue “Show me what to do when you’re lost” and removed herself from the students’ line of vision. Researchers monitored each student for signs of frustration in completing the role-play.

If the student was unable to complete the task of taking and sending the picture, the first author ended the role-play and used the SLP to help the student complete the task. Specifically, prompts were delivered starting with the least intrusive and progressing as needed to the most intrusive. For example, the researcher would provide a verbal prompt stating the step of the task analysis as written (e.g., “Click the upper right button (Add option) to access options for contacts”). If the student struggled with the step, the researcher would verbally restate the step and include a gesture prompt by pointing to the button the student needed to press. If the student did not press the correct button, the researcher would move to a modeling prompt and verbally state the task analysis step again while she modeled pressing the correct button. The researcher would then navigate the phone back to the step the student was struggling with and observe if the student could complete the step. If the student did not complete the step after having it modeled, a partial physical prompt was provided to help gently guide the student’s finger so that it was directly over the button that needed to be pressed and then verbally prompted the student to press it. If the partial physical prompt was not effective, the researcher would progress to a full physical prompt and gently guide the student’s finger to the correct button and provide hand-over-hand assistance to ensure the student pressed the correct button while verbally stating the step. Following successful completion of all steps, students viewed the picture they sent when it was received on the first author’s phone and received verbal reinforcement. Once students achieved 80% correct independent responding for three consecutive sessions, each was probed for generalization in a familiar setting during Phase 2 at the local large-chain department.

Phase 2: Department store

Prior to generalization sessions, students viewed the VM intervention. Immediately following, one role-play practice session was conducted in the school hallway. At the department store, students were given the instructional cue, and researchers removed themselves from the student’s immediate vicinity (e.g., moved to the next aisle over). If the student displayed difficulty in sending the picture during the sessions, the role-play was ended and the SLP was used to guide the student through the task analysis steps. After students demonstrated 80% correct independent responding for three consecutive sessions, they were probed for generalization at an unfamiliar community location (i.e., grocery store).

Phase 3: Local grocery store

The purpose of this final phase was to determine whether students were able to generalize their skills to an unfamiliar community setting. The same procedures used in the department store were used in this novel setting. The mastery criterion for this phase was 80% of correct independent responding for three consecutive sessions.

Interobserver Agreement (IOA) and Treatment Integrity

Interobserver data were collected independently and simultaneously by a second trained observer and primary investigator. IOA was calculated by dividing the number of agreements by the number of agreements plus disagreements and dividing by 100. During baseline, data were collected during 60% of the sessions for Mary, 86% of the sessions for Ben, and 83% of the sessions for Will. During intervention, IOA was collected during 100% of the sessions for the three students across the three phases (school library, department store, and grocery store). Agreement of independent performance was 100% for all sessions for all three students.

Treatment integrity was assessed during 25% to 40% of intervention sessions. A checklist (see Table 3) that indicated the procedures was developed to ensure appropriate steps were followed. Using the checklist, a second trained observer noted whether each step was followed. Treatment integrity data were collected for an average of 31% of the intervention sessions for Mary, 36% of the sessions for Ben, and 33% of the sessions for Will and was 100% for all three students.

Table 3.

Treatment Integrity Checklist.

Intervention checklist	Yes	No
1. Obtains child assent prior to each intervention session
2. Shows video clips of task analysis steps prior to each intervention session
3. Delivers appropriate level of prompting, from least to most
4. Codes collected data with level of prompt provided
5. Delivers cue, “Show me what to do when you are lost,” prior to data collection
6. Conducts one intervention session in front of student prior to removing himself or herself from student’s immediate line of vision
7. Removes himself or herself from student’s immediate line of vision when role-playing being lost
8. Shadows student closely when role-playing being lost
9. Offers assistance when student begins to wander off or becomes frightened

Data Analysis

Visual analysis was used to evaluate the impact of the VM and SLP intervention on independent completion of the task analysis steps. An examination of a functional relationship was determined through changes in level, trend, and variability between phases (Kennedy, 2005). Visual analysis was confirmed through the percentage of nonoverlapping data (PND) calculations between baseline, intervention, and the generalization phases (Parker, Hagan-Burke, & Vannest, 2007).

Results

The results demonstrate that all students increased their ability to perform the task independently. Gains were made between baseline and Phase 1, and all were able to generalize the skill to an unfamiliar community setting (see Figure 1).

Figure 1.

Percentage of steps completed independently when taking and sending a picture during a role-play of being lost in the community for Mary, Ben, and Will after viewing the video model.

Mary

An analysis of Mary’s data revealed that in baseline, the average percentage of steps completed independently was 53%. Visual analysis indicated that Mary’s performance increased considerably during intervention. Specifically, the percentage of steps performed independently increased to 87% during Phase 1 and consistently reached 100% by Phases 2 and 3. The PND between baseline and intervention data across the three phases was 90%. PND was 100% between baseline and the generalization probes conducted in Phase 3.

Ben

During baseline, Ben completed an average of 40% of the steps independently. Visual analysis revealed a considerable increase during intervention. After intervention, Ben completed an average of 91% of the steps independently during the three intervention phases. In addition, during Phases 2 and 3, Ben’s performance was consistently at 100%. PND between baseline and Phase 1 was 92% and was 100% between baseline and the generalization probes in Phase 3.

Will

The percentage of steps Will completed independently during baseline averaged 6.7%. Visual analysis indicated that performance considerably increased during intervention to an average of 95% across all three phases. During Phase 1, he completed an average of 87% of the steps independently, and during Phases 2 and 3, he consistently completed 100% of the steps independently. PND between baseline and intervention and generalization phase was 100%.

Results indicate minimal prompting was required to achieve the mastery criterion, and students acquired the skill of taking and sending the picture quickly (i.e., during Phase 1). Mary was able to complete all steps independently within two sessions, Ben required three sessions, and Will required four sessions. During the first session in Phase 1, Mary needed verbal prompting to complete Steps 8 to 15 of the task analysis and was then able to complete all steps independently in subsequent sessions. During the second session of Phase 1, Ben needed verbal and gestural (plus verbal) prompting to complete Steps 9 to 15 but was then able to complete all sessions independently. Finally, during Phase 1, Will needed verbal and gesture prompts to complete various steps of the task analysis (e.g., verbal prompts were provided for Step 4 and Steps 8–11 in the first session), but after the third session of Phase 1, he completed all steps independently.

Social Validity

Students were informally interviewed by the first author at the completion of the study to assess their thoughts about the intervention. All students reported enjoying learning to use the phone’s camera feature and the videos. Each also indicated that knowing how to send a picture was an important skill if ever really lost in the community. Ben described being distracted when watching the video at first but stated it became easier over time. In her written interview response, the teacher stated, “The educational opportunity for my students was a great real life tool. The students were motivated to learn with a video lesson and then use the actual object.”

Discussion

This purpose of this study was to expand previous research exploring the use of cell phones to address safety of people with ID in the community. The results demonstrate that VM was effective in teaching students to send a picture independently across multiple community sites including an unfamiliar setting. Results indicate a strong functional relationship between intervention and the dependent variable while the study design controlled for carryover effects. These results support previous work demonstrating that VM/prompting is an effectual approach to help teach students with ID critical life skills (e.g., safety skills; Ayres et al., 2013). This research also adds to the literature exploring community safety skill instruction using cell phones. Students watched two brief videos (~4 min) and learned to take and send a picture and successfully generalized these skills to an unfamiliar community location (i.e., grocery store). The gesture (plus verbal) prompt was the most intensive prompt required for any student across all phases of the study. Furthermore, all students were able to complete 100% of the steps independently during at least one session during Phase 1. Finally, the same video was effective for all students indicating that the differentiation required in teaching this skill was minimal.

Implications for Practitioners

Social interconnectedness is a need all teenagers have, and cell phones can be used to address this while providing adolescents with opportunities for autonomy and independence (Hallgren, Nygard, & Kottorp, 2011). For people with an ID, the social desirability of having and using a cell phone or other technology can help also increase opportunities for independence of navigation and mobility in community settings (Kelley et al., 2013). When considering how technology may assist in meeting the diverse needs of individuals with disabilities, identifying economical options is critical given the financial limitations people with ID may face. This study found that incorporating an inexpensive cell phone into critical safety skill instruction was effective and that students were able to quickly acquire how to use the cell phone’s camera feature during a role-play activity. This finding is particularly relevant for teachers seeking to address community safety skill instructional goals with limited resources (e.g., lack of district funding, students cannot afford their own phones). Furthermore, the students’ ability to take a picture is a skill that not only addresses safety skill instruction. For example, this skill could be generalized to other contexts (e.g., taking pictures to post on a classroom Facebook page).

These results are also meaningful when examining effective instructional strategies that help increase independence for students with disabilities in community settings. Previous research exploring what to do when lost focused on using individualized instructional methods and tasks that may be challenging for students with an ID such as, locating a naïve adult for assistance, or describe their location over the phone which required students to communicate verbally (e.g., Hoch et al., 2009, Taber et al., 2002, 2003). This study addressed these limitations and taught students to use the camera feature, which is a component that is frequently available on many phones, yet does not require Internet access. When thinking about the overall needs of individuals with ID, it is important to identify economical options that are accessible to those who may have limited resources. This study also extends the literature addressing the deficits of research focused on community safety skill instruction by identifying a cost-effective and social desirable alternative option. Furthermore, the intervention used provided an avenue for students to advocate for their needs independently to a trusted adult. The intervention ensured that the students only communicated they were lost to someone they could trust which is an important consideration when determining with whom individuals should interact if lost in the community.

Limitations and Future Research

A number of limitations were identified during this study. First, the quality of pictures was not analyzed. The adult model emphasized holding the camera steady while taking the picture; however, Will struggled with this, and several of his pictures were blurry. In addition, all students learned to take a picture of a sign as demonstrated in the video. Future research may explore incorporating various salient stimuli within the environment (e.g., front of store, street signs showing a specific corner) instead of just focusing on a sign. It may also be of interest for future studies to explore how GPS technology could be used during safety skill instruction.

A second limitation was that the intervention was not systematically faded. Specifically, students reviewed the videos prior to all sessions; therefore, before each session, students were reexposed to the intervention and maintenance was not assessed. By Phase 3, no student required prompting during the review sessions at school. Furthermore, when watching the videos during Phase 3, both Ben and Will would verbally state the instructions along with the model indicating they had memorized the steps and may not have needed to watch the video. Future research should explore maintenance of skills when the VM intervention is faded and to what degree.

A third limitation was student awareness that each was role-playing being lost and students were not required to independently identify when they were lost. Students were taught to demonstrate the chain of steps in the task analysis to take and send the picture when the instructional cue “Show me what to do when you’re lost” was given. As students were able to master this relatively quickly even in unfamiliar settings, future research may want to expand upon this and explicitly focus on teaching students how to identify when they are lost and then determine the appropriate action (e.g., ask for help, send a picture, call someone).

Future research may also want to explore the role of video prompting instead of VM in regard to safety skill acquisition training. For this study, students used VM and watched an entire video prior to each session; however, video prompting may be more effective. This may be of interest particularly for students with a higher severity of ID or those who struggle with following multiple-steps instruction. It would also be of interest to compare prompting and modeling in students of various ability levels and determine whether one method increased acquisition. Video prompting could also be a helpful strategy when attempts to fade the intervention are made through systematic removal of certain video prompts once mastery is demonstrated.

Incorporating the VM/prompting on the mobile device in lieu of having students watch it on the classroom computer might also be investigated. For example, previous research identified the importance of repurposing everyday technologies such as a mobile phone to serve as assistive technologies for students with disabilities (Bouck et al., 2012; Bouck, Jasper, Bassette, Shurr, & Miller, 2013), and this may be particularly applicable when considering the ways cell phones can provide assistance during safety skill instruction. It would be of interest to explore how VM/prompting could be delivered on a cell phone while permitting students to also use other cell phone features (e.g., answer/make a call, take a picture to let teacher know where they are) during instruction. These features are common on many phones and would provide multiple opportunities for students to gain access to a socially appropriate method of assistance (Bouck et al., 2013) while increasing opportunities for independence and safe access to the community.

The phone used for this study had buttons instead of a touchscreen and required a 15-step task analysis to take and send a photo. Given new technologies (e.g., iPad, iPhone), it may be of interest to explore how students could use phones with touchscreens to take a picture and how this could be taught with VM or prompting. This could be particularly useful for students who already use mobile devices to meet other needs (e.g., communication). Finally, in this study, students (i.e., those without active behavior plans) appeared to be positively reinforced when able to view the picture they took and sent. This could be an area for further research when considering how to effectively meet the needs of children who need safety skill instruction but have more intense behavioral needs (e.g., behavior plans). For all students, particularly those with intensive behavioral needs, it is important to consider potent reinforcement during safety skill instruction and consequences that occur naturally as part of instruction. Because viewing the picture is a natural consequence, showing the students the picture after they get it could potentially increase motivation. Future studies might seek to identify other types of natural consequences that capitalize on the use of technology and can be applied easily in community settings during safety skill instruction.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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