Effects of Video Self-Modeling and System of Least Prompts on Completion of Transitional Routines for a Student With Extensive Support Needs in Inclusive Settings

Abstract

Students with extensive support needs often require intensive individualized instruction across domains. Research suggests that students with extensive support needs can achieve greater independence when evidence-based practices are used to teach independent transitioning skills. This study investigated the effects of video self-modeling (VSM) and the system of least prompts (SLP) on independent completion of transitional routines for a student with extensive support needs in inclusive school settings. Using VSM and SLP, the student learned to complete three transitional routines with greater independence. Generalization of independent transitioning skills to music class was also measured. Results showed a functional relation between the VSM/SLP intervention and independent completion of transitional routines. The findings of this study provide several implications for practice for using VSM and SLP as a combined intervention to increase independent transitioning skills for students who previously relied on adult assistance to make transitions along with general education peers.

Keywords

inclusion video self-modeling system of least prompts extensive support needs transitional routines

Historically, students with extensive support needs have not received equally appropriate, accessible, and meaningful opportunities to learn in inclusive school settings (Taub et al., 2017). Students with extensive support needs are those who “require the most support to learn, often categorized as having intellectual disability, multiple disabilities, autism spectrum disorder, or related disabilities” (Kurth et al., 2018, p. 143). These students often require intensive, individualized instruction across academic, behavioral, essential, and/or social skills and benefit from adapted materials with differentiated methods of assessment to evaluate skill acquisition and transference of skills across settings (Kleinert et al., 2015). National trends in educational placements show that students with extensive support needs are not included in general education classrooms as frequently as students with high-incidence disabilities (Kurth et al., 2014; Morningstar et al., 2017). Data show students with extensive support needs (i.e., significant cognitive disabilities or low-incidence disabilities) are disproportionately represented in self-contained and more restrictive settings (Kleinert et al., 2015; Kurth et al., 2014; Morningstar et al., 2017) and may have limited access to general education curricula (Quirk et al., 2017). Researchers caution that access to general education curricula is more than access to physical locations. Rather, access should focus on general education context, content, high expectations, and progress in inclusive settings (Ryndak et al., 2009). Therefore, more research is needed to develop support for students with extensive support needs in inclusive settings (Ryndak et al., 2013).

When students with extensive support needs participate in inclusive settings, paraprofessionals typically provide substantial assistance and move with them throughout the school building (Giangreco et al., 1997). Paraprofessionals are sometimes assigned to work with children one-on-one, which can be a costly use of resources; however, if students gain independent skills, paraprofessionals can be used to support multiple students. Although paraprofessionals serve many valuable roles for students with extensive support needs, overreliance on paraprofessional support can be problematic for several reasons (Giangreco et al., 2005). First, students may become dependent on the paraprofessional’s prompts and may not respond to typical, naturally occurring prompts from a general education teacher (Giangreco & Broer, 2005). This can create a conflict of ownership, responsibility, and accountability between a general education teacher and the paraprofessional (Giangreco et al., 1997). Second, students with extensive support needs may become isolated from their peers due to the stigma of having an extra adult assistant in the classroom (Giangreco et al., 1997, 2005). Finally, paraprofessionals are often the least trained in evidence-based practices for students with disabilities, but they are often the ones providing the most extensive support (Brock & Carter, 2015). Therefore, research on interventions that promote students’ independence and rely less on paraprofessional support in inclusive settings is needed.

Students with extensive support needs in inclusive settings should follow classroom procedures like their general education peers; however, many students require support to transition between classroom routines and activities (Hemmeter et al., 2008; Lequia et al., 2014). Hume et al. (2014) defined transitioning as any time a child changes from one activity to another and listed several types of transitions students with disabilities face every day in school: transitions between staff, transitions between subjects, transitions between instructional formats, and transitions from one location to another. These students, especially those who are younger, are often seen holding the hand of a paraprofessional as they are guided through tasks and provided frequent verbal and physical prompts (Giangreco et al., 1997).

Students with extensive support needs can benefit from transition supports. Transition supports are “any technique used to support students with a disability using changes in or disruptions to activities, settings, or routines” (Hume et al., 2014, p. 35). Transition supports can decrease the amount of time spent in transitions to optimize instructional hours in a school day (Guardino & Fullerton, 2014). During routine school transitions, students rely on teacher prompting to give initial directions, but students with extensive support needs often require frequent prompts to transition successfully. As an established evidenced-based practice for students with extensive support needs, the system of least prompts (SLP) is an instructional strategy that can be used to teach transitions. When using SLP, a teacher provides a specific stimulus followed by a hierarchy of at least two prompt levels, in which the student has an opportunity to respond independently (Doyle et al., 1988). If the student responds correctly and independently, then reinforcement is delivered (e.g., praise); however, if an error occurs then the adult provides the least intrusive prompt and another opportunity for the student to respond. Teachers move up the hierarchy toward the most intrusive prompt until the student responds correctly and receives reinforcement again (Doyle et al., 1988). One of the benefits of using SLP is that the student gains more practice performing the target behavior correctly instead of repeating trials for which the student’s response was incorrect (Wolery et al., 1986). In a recent review of SLP, Shepley et al. (2019) examined 123 peer-reviewed studies including 413 participants and found that more than half (53%) of the studies were conducted in school settings. In addition, this review suggested that SLP was most effective for chained tasks (sequential steps) rather than discrete tasks (one step). Therefore, SLP could help reduce prompt dependence and serve as a viable strategy to help students with extensive support needs transition between tasks or activities, and SLP could potentially be more effective if combined with assistive technology.

The use of technology has the potential to bridge the gap between prompt dependence and independence in general education classrooms (Ayres et al., 2013). Specifically, instructional technology can be used to teach new skills through the use of visual and audio components (Ayres et al., 2016). Video modeling is an instructional technology that can help students learn academic, social, and daily living skills (Norman et al., 2001; Park et al., 2019) and has been identified as an evidence-based practice for students with autism (Wong et al., 2015). Video modeling provides a visual model of the target behavior via video recording and playback (Wong et al., 2015), and it can be efficient for parents and teachers because recorded videos can be made quickly and easily on mobile devices, replayed, or edited (Banda et al., 2007). There are two suggested formats for video modeling: video self-modeling (VSM) and video modeling with others as model (Hall et al., 2019). Research has shown minimal differential effects between these two types (Mason et al., 2012).

Hart and Whalon (2012) examined the effectiveness of VSM delivered using an iPad^® on the academic responding of a high school student with autism and intellectual disability. The researchers used an ABAB withdrawal design to analyze the frequency of correct, unprompted responses with and without the use of VSM. Results indicated a functional relation between the VSM and number of correct and unprompted academic responses when introduced at each of the intervention phases. This study highlighted the effects of VSM as an intervention to increase independent, academic engagement; however, the study was not conducted in an inclusive classroom where independent skills are in higher demand. In another study, Spriggs et al. (2015) paired video modeling with activity schedules to increase independence for high school students with autism during transitions between activities in a resource classroom. The researchers developed video models on an iPad^® to support students’ acquisition and generalization of novel skills (e.g., check writing, algebra, paragraph writing, table setting), as well as independence during transition activities. The researchers used a multiple probe across participants design to analyze students’ percentage of independent steps correct on a task analysis. Findings indicated students were able to independently transition within and between tasks. In a study similar to this study, Cihak et al. (2010) used an ABAB withdrawal design to evaluate the effects of VSM delivered via a handheld device (i.e., video iPod^®) and SLP for four students with autism during transitions throughout the school building. Results showed all students transitioned with greater independence throughout the school building when VSM and SLP were used; however, within-classroom transitions were not addressed.

Research on video modeling and VSM has shown positive effects for supporting students with disabilities (Ayres & Langone, 2005; Bellini & Akullian, 2007); however, few studies have been conducted in general education settings (e.g., Buggey, 2005; Thiemann & Goldstein, 2001). More research on VSM and SLP during transitional routines for students with extensive support needs included in general education classrooms is needed. Therefore, the purpose of this study was to investigate the effects of VSM plus SLP on the completion of transitional routines for a student with extensive support needs in inclusive school settings. The study addressed the following research questions:

Research Question 1 (RQ1): What is the effect of VSM and SLP on the percentage of steps completed independently in transitional routines for a student with extensive support needs in an inclusive school setting?

Research Question 2 (RQ2): To what extent is a student with extensive support needs able to generalize the acquired skill of transitioning between classroom activities and locations in the school in a special area class (i.e., art, music, physical education) without the use of VSM and SLP?

Research Question 3 (RQ3): To what extent do the student and teachers rate the use of VSM and SLP as acceptable for facilitating independent transition in an inclusive school setting?

Method

Participant

Theo (pseudonym) was an 8-year-old Caucasian male with Down syndrome who did not independently transition between tasks and activities in an inclusive elementary school classroom. During transitional times in the classroom, Theo did not respond to the general education teacher’s cue to move to the next activity and waited for his paraprofessional to prompt him through the sequence of steps required to complete each transitional routine. The paraprofessional often completed steps for him so that he could move quickly and keep up with his general education peers. Theo’s support needs were defined by his present levels of performance in combination with a review of records. We completed the Support Intensity Scale–Children’s Version (SIS-C; Thompson et al., 2016), a standardized assessment to measure Theo’s intensity of support needs. The standard score is computed by combining the raw item rating scores for the main three dimensions of support intensity (type, frequency, daily support time) across the different activity areas (home, school, community). Based on the SIS-C results, his standard score of 89 corresponded with a standardized percentile rank of 23, meaning that his overall support needs were more intense than 23% of children with intellectual and developmental disabilities of the same age. His highest needs were school participation (6/9 areas) and school learning (4/9 areas). These scores along with his medical and behavioral needs as measured by the SIS-C qualified him as having extensive support needs. Theo communicated with speech. Prior to the study, he had not used assistive technology or an iPad^® during his school day for any reasons. Theo was selected for participation based on the following inclusion criteria: (a) diagnosed with a disability, (b) had extensive support needs, (c) enrolled in elementary school inclusion classroom, and (d) needed frequent paraprofessional prompting throughout transitional routines.

Setting

Theo received academic instruction from a special education teacher, paraprofessional, and general education teacher in an inclusive general education classroom. The classroom consisted of one general education teacher and one special education paraprofessional with 19 total students. Theo was included in the general education classroom for the full school day and only pulled out twice a week for speech therapy and occupational therapy. He participated in his general education classroom for academic instruction (e.g., phonics instruction, math groups, other classroom activities), which was led by the general education teacher with assistance from his paraprofessional and intermittent support time with the special education teacher. Theo was also included with general education peers during special area classes (i.e., art, music, and physical education), lunch, recess, and special school events. Intervention sessions took place in Theo’s general education classroom during the time allotted for each transitional routine. Sessions were conducted when the teacher directed the whole class to transition to another activity.

Experimenter

The lead researcher, and first author, for this study was a doctoral student with more than 10 years of experience as a special education teacher and inclusive program director. The lead researcher was licensed in both general and adapted curriculum for special education in the U.S. state in which the study was conducted and had experience supporting students with disabilities in self-contained, resource, and inclusive settings in both public and private schools. The lead researcher served as the interventionist and the primary data collector by watching playbacks of recorded sessions. In addition, a graduate student assisted in procedural fidelity data collection, and another doctoral student assisted in secondary data collection.

Materials

Materials included an iPad^®, MacBook Pro^® laptop, iMovie^®, and a GoPro^® video camera. An iPad^® was used to record individual video clips of the student completing the essential steps for each transitional routine. Using a MacBook Pro^® laptop and iMovie^®, the lead researcher combined individual video clips into one streamlined video without audio for the student to watch as a VSM. Theo watched VSMs on the iPad^®, showing streamlined videos of himself completing each transitional routine prior to the occurrence of each transitional routine. A GoPro^® video camera was used to record all sessions for data collection purposes.

Dependent Variables

The dependent variables were (a) the percentage of steps completed independently in a transitional school routine in classroom/school settings and (b) the percentage of steps completed independently in a transitional routine in special area classes. A transitional routine was defined as the essential steps (listed as a task analysis) needed to move to another activity or task independent of adult prompting. Three transitional routines (see Figure 1) were used for this study: (a) entering the classroom at the beginning of the school day, (b) moving from group instruction (i.e., phonics instruction) on the carpet to independent work (i.e., phonics activity or worksheet) at assigned seat, and (c) lining up for lunch. Transitional routines were measured using frequency recording for the total number of steps completed independently out of the total number of steps and converted to a percentage for each session by totaling the number of steps completed independently over the total number steps and multiplying by 100 for each transition. Only steps that Theo completed independently within the designated time limit (e.g., 5–10 s per step) were counted as complete.

Figure 1.

Task analyses for transitional routines during baseline, intervention, and generalization.

Interrater Reliability

Interrater agreement (IRA) data were collected to measure the reliability of the dependent measure using the same data sheet the lead researcher used during the intervention phases. The lead researcher trained a secondary data collector prior to the start of the baseline phase by watching videos of three sessions to compare data recordings of observed behavior. Further IRA training included double scoring a video of the participant completing a transitional routine and comparing for discrepancies in recorded levels of independence for each step observed. IRA was conducted for 36% of sessions overall with 42% of the baseline, 30% of intervention, 33% of maintenance, and 100% of generalization sessions. IRA was calculated using an item-by-item method whereby an agreement was recorded if both observers scored an item the same way and a disagreement was recorded if items were not scored identically. Percentage agreement for each session was calculated by dividing the number of agreements by the number of agreements plus disagreements and multiplying by 100. Overall, IRA was 93.5% (95.1% baseline, 100% intervention, 83.3% maintenance, and 80% generalization).

Social Validity

Social validity data were collected through teacher and student questionnaires to evaluate the social acceptability and feasibility of the intervention procedures, the short-term and extended outcomes, and goals. The teacher and paraprofessional questionnaires had five questions based on a 5-point Likert-type scale (i.e., 1 = strongly disagree to 5 = strongly agree; Table 1S, online supplemental material). The student questionnaire consisted of five questions, read aloud, with “yes” or “no” answers represented by a “thumbs up” or “thumbs down” icon. The lead researcher used a dictate-to-scribe or gestural pointing format for responses, which were recorded on the questionnaire.

Experimental Design

This study used a multiple probe across routines design (Cooper et al., 2020) to analyze Theo’s percentage of steps completed independently for each transitional routine. The transitional routine for which Theo was least independent was targeted first for intervention. At a minimum, five data points were collected during baseline, and after a stable trend was observed, the first routine (i.e., transitional routine) moved to the intervention phase. During this time, the remaining transitional routines remained in baseline. Intermittent baseline probes were administered at a minimum of every fourth session and concurrently as each transitional routine moved to the intervention phase. Data were collected daily during each session or transitional routine. Each of the three transitional routines had a varying number of steps. Steps completed were scored as follows: independent, not completed, or prompted (noting the level of prompting required). The lead researcher graphed the percentage of independently completed steps in each transitional routine for each phase: baseline, intervention, and maintenance. Following the intervention phase, maintenance data were collected until the end of the study across all three transitional routines. Visual analysis was used to determine trends, changes in level, stability, and functional relations between the independent and dependent variables (see Figure 2). Once Theo’s responses showed an increasing trend for the first transitional routine and met mastery criteria (100%) for the number of independently completed steps in a transitional routine for two out of three consecutive sessions, the transitional routine moved to the maintenance phase. The second transitional routine then moved to the intervention phase. This systematic process continued until all of the transitional routines were in the maintenance phase. In addition, a generalization probe was taken once before and once after the intervention to measure the number of independently completed steps for similar transitional routines (e.g., stopping an activity in art class and lining up) but in special area classes.

Figure 2.

Percentage of steps completed independently during transitional routines.

To supplement visual analysis, intervention effects were assessed between baseline and intervention by calculating Tau-U for each routine and the Tau-U aggregate across routines (Parker et al., 2011). Tau-U has outperformed other non-overlap indices and can account for undesirable trends in baseline (Parker et al., 2011). Tau-U can be interpreted as follows: <0.20: small change, 0.20 to 0.60: moderate change, 0.60 to 0.80: large change, and >0.80: large to very large change (Vannest & Ninci, 2015).

Procedures

Preference assessment

Prior to the start of intervention, an informal preference assessment was conducted to determine potential reinforcers (e.g., praise, tangible). Theo chose four total preferred reinforcers, which were presented visually on laminated cards of him doing the following: (a) dribbling a bouncy ball, (b) taking a walk outside with his paraprofessional, (c) reading his favorite book, and (d) visiting his favorite office staff worker in the school’s front office. One of the preferred reinforcers was chosen prior to the start of each transition and delivered intermittently, and when time did not permit the activity following the completion of each transitional routine, he could use the visual reinforcement card at a different time in the school day. Theo typically picked the same reinforcers after the same routines consistently (i.e., going for a walk after morning routine, bouncing the ball after transitioning from phonics to table, and visiting an office staff member after lining up for lunch) and rarely chose to read his preferred book.

Preparing VSM videos

The video models included a sequence of Theo completing the steps to each transitional routine in the setting where the transitional routine typically occurred. During initial observations, even with maximum level prompting, Theo did not complete steps independently following teaching with prompting through the sequence of steps. To avoid the student learning the steps prior to intervention, video clips were taken in isolated, nonsequential steps. In addition, all videos were recorded before baseline began to ensure that Theo did not acquire the skills immediately prior to the intervention by being heavily prompted through the steps. The lead researcher combined these short video clips using iMovie^® on a MacBook Pro^® laptop into one streamlined video of the target student completing the steps for each transitional routine in order and stored it in the photo application on an iPad^®.

Baseline

During baseline, the lead researcher asked the general education classroom teacher and peers not to prompt Theo during transitions between tasks and activities. His paraprofessional was not in the classroom during baseline or intervention to control for her prompting or presence impacting the study. Although this was different from the “business as usual” condition prior to baseline, eliminating adult and peer prompting was necessary to establish a baseline of Theo’s independent completion of steps within each transitional routine. This study used a multiple opportunity method (Cooper et al., 2020) that allowed Theo the opportunity to perform each step even if he did not complete the previous step. In baseline, the lead researcher completed the step for Theo if he did not complete the step within a set time frame (e.g., hanging a book bag on a hook should take no more than 10 s, as determined by observations of typically developing students in the classroom). If a step in the transitional routine was completed for Theo, it was not coded as independent; however, each remaining step could be completed independently.

VSM and SLP

During the intervention phase, Theo watched a VSM with a complete sequence of the upcoming transitional routine prior to the transition. The lead researcher provided an attentional cue (e.g., stating Theo’s name) and said, “Time to watch the video of you [insert name of transitional routine here].” Theo then watched the VSM of himself completing a transitional routine, which lasted less than 1 min. At the start of each transition, the general education teacher gave an instructional cue to the whole class (e.g., “Turn in your morning work when you are finished.”). The lead researcher observed Theo to determine whether he performed the steps of each transitional routine independently with a response interval of 5 to 10 s. If he did not perform a step independently in 5 to 10 s, the lead researcher delivered a prompt following the SLP hierarchy in the following order: gestural, verbal, model via video (only showing that step using a video clip), and partial physical prompt with 5 s between each.

Maintenance and generalization

Maintenance data were collected after intervention phases to measure the extent to which Theo completed the transitional routines in the same setting for the same routine after the VSM and SLP intervention was removed. At least two maintenance probes were conducted following intervention with at least 2 days between sessions. Generalization data were collected to determine the extent to which Theo completed a similar transitional routine in a different setting (e.g., music).

Procedural Fidelity

A member of the research team used a checklist to assess procedural fidelity on the implementation of the VSM and SLP intervention by watching video recordings of the sessions. Procedural fidelity was collected throughout baseline and intervention. During baseline, procedural fidelity was collected to ensure video models were not shown, prompting was not provided for incomplete steps, and that the researcher completed steps that the participant did not so that he had an opportunity to complete the next step in the sequence independently. Separate data were recorded on the use or nonuse of VSM and SLP for each step of the transition in each phase. Procedural fidelity was assessed during 37% of baseline and 39% of intervention sessions across each transitional routine. Procedural fidelity across all conditions was 100%.

Results

Results for each transitional routine are displayed in Figure 2. The graph shows percentage of steps completed independently across baseline, VSM and SLP, and maintenance phases. Based on visual analysis of graphed data, results indicated a functional relation between the VSM and SLP intervention and Theo’s increased independence in completing transitions in an inclusive setting. Based on guidelines from Cooper et al. (2020), a functional relation was established because prediction from the stable, low-level baseline for the first transitional routine (morning routine); verification from subsequent baselines; and replication of immediacy of effect across all three tiers indicated that a change in the dependent variable did not occur until the VSM and SLP intervention condition. Supplemental to visual analysis, the aggregate Tau-U reflects a very large change in percentage of steps completed across all routines (1.00, p < .001, 90% CI = [0.70, 1.00]).

Morning Routine

During baseline, Theo’s independently completed steps in the morning routine transition were stable and low-level, with percentages ranging from 0% to 20% (M = 4%). During the VSM and SLP intervention, Theo’s performance for completing steps in the morning routine transition indicated a high-level, increasing trend, with percentages ranging from 60% to 100% (M = 84.31%). After 13 sessions, Theo met mastery criteria of 100% for two consecutive sessions. During maintenance, Theo’s performance for independently completing steps in the morning routine transition remained stable and high for two consecutive weeks. Tau-U for the morning routine transition reflects a very large change in behavior (1.00, p < .001, 90% CI = [0.49, 1.00]).

Leisure Activity to Academic Work

During baseline, Theo’s independently completed steps in the leisure activity to academic work transitional routine were stable and low-level, with percentages ranging from 0% to 25% (M = 15.63%). During the VSM and SLP intervention, Theo’s performance for completing steps in the leisure to academic work routine transition immediately increased to a high level, with percentages ranging from 75% to 100% (M = 94.44%). After three sessions, Theo met mastery criteria of 100% for two consecutive sessions. During maintenance, Theo’s performance for independently completing steps in the leisure activity to academic work transition remained stable and high at 100% for two consecutive weeks. Tau-U for the leisure activity to academic work transition reflects a very large change in behavior (1.00, p < .001, 90% CI = [0.53, 1.00]).

Lining Up for Lunch

During baseline, Theo’s independent completion of steps in the lining up for lunch transitional routine was variable, with percentages ranging from 0% to 14% (M = 18.63%). During the VSM and SLP intervention, Theo’s performance for completing steps in the lining up for lunch transitional routine immediately increased to a high level, with percentages ranging from 75% to 100% (M = 95%). After two sessions, Theo met mastery criteria of 100% for two consecutive sessions. During maintenance, Theo’s independent completion of steps in the lining up for lunch transitional routine remained stable and high for two consecutive weeks. Tau-U for the lining up for lunch transition routine reflects a very large change in behavior (1.00, p = .003, 90% CI = [0.53, 1.00]).

Generalization

To assess generalization across settings, Theo’s independent completion of steps was observed in a classroom different from his first-grade classroom. He was observed in a music class alongside his same first-grade peers. Generalization data indicated that, for the music class, there was a higher percentage of steps completed independently after the intervention had been implemented (i.e., baseline generalization = 20%, intervention generalization = 50%).

Social Validity

Although the general education teacher and paraprofessional were not directly involved in implementing the VSM and SLP intervention, they indicated that they saw positive changes in Theo’s independent completion of transitional routines in the classroom as a result of the intervention (see online supplemental Table 1S). They also noted that the intervention was feasible and that they would use the intervention in the future. Theo also recognized his improved performance as noted on his social validity questionnaire. He marked that he liked using the iPad^® and indicated the VSM helped him understand how to complete the steps in each of the transitional routines.

Discussion

The purpose of this study was to investigate the effects of VSM and SLP on completion of transitional routines for a student with extensive support needs in inclusive settings. Visual analysis of graphed data indicated a functional relation between the VSM and SLP intervention and an increased percentage of steps completed independently in transitional routines within an inclusive setting. In addition, data showed a decrease in the amount of time required to complete each transition because Theo was able to move through the steps quicker when doing them independently as opposed to having to be prompted through each step. Generalization of independent transitioning skills for lining up was observed in music class, although lower than intervention. Theo maintained independent transitioning skills for 2 weeks after the VSM and SLP intervention was removed. This study extends previous literature investigating VSM with SLP as an intervention package because it is only the second study to use both combined rather than individually to teach independent transitioning skills. Although replication across additional participants would provide stronger evidence, this study’s design was replicated across transitional routines and showed that VSM and SLP was an effective intervention for the participant to increase independent completion of transitions in an inclusive classroom setting.

Prior studies have supported the use of technology to teach students with disabilities (Alper & Raharinirina, 2006; Ayres et al., 2013; Okolo & Diedrich, 2014). Specifically, video modeling and video prompting have been used to teach a variety of skills, such as social, daily living, and academic skills (Norman et al., 2001; Park et al., 2019). The participant in this study was taught to view a VSM on an iPad^® prior to beginning each transitional routine and responded well to using instructional technology to increase independence across transitional routines. In addition, multiple evidence-based practices have been combined for use with students with extensive support needs including interventions combining VSM and SLP. For example, one previous study found a functional relation between VSM combined with SLP and the number of independent transitions students with autism made between locations in a school (Cihak et al., 2010). This study extends these results by showing VSM and SLP as an effective multicomponent, intervention package for students with extensive support needs to make independent transitions.

Considering the limited research on interventions to support independent transitions within inclusive classrooms settings for students with extensive support needs, this study contributes to the literature by combining VSM and SLP as an intervention. In isolation, each of these practices have been established as evidence-based practices (Browder et al., 2014; Wong et al., 2015); however, more research on the combined use of VSM and SLP together was warranted. The results of this study also showed that Theo improved independent completion of steps in transitional routines and required less prompting overall from the beginning of the intervention through maintenance. Finally, results from social validity measures noted the general education teacher and paraprofessional rated the VSM and SLP intervention as feasible and effective at improving the participant’s independent transitioning skills across behaviors. Theo also responded in favor of using a technology-aided intervention and indicated that it helped him become more independent in making transitions in his classroom.

Limitations and Implications for Future Research

This study had several limitations. First, only one student participated in the study. Although the multiple probes across routines design established a functional relation between the independent and dependent variables for one participant, replicating the results across more participants would increase generality of the findings (Cooper et al., 2020). Second, the study combined two interventions (VSM and SLP) in a multicomponent package; thus, the effects of each intervention are unknown. Future studies could conduct a component analysis to examine the impact of each intervention. Third, the study was conducted toward the end of a school year, limiting the amount of time to collect maintenance and generalization data. Future studies should conduct more robust measures of maintenance and generalization.

There are several additional implications for future research. First, other studies suggest that intervention effects may be limited if fading is not planned as part of the intervention (Brock & Carter, 2013; Cihak et al., 2010). Future research should investigate fading supports that can lead to greater student independence. In addition, more research on VSM and SLP is needed in academic and social skill areas. Future research should investigate ways to modify VSM and SLP across different skills within inclusive classrooms. This study showed Theo was able to achieve and maintain higher levels of independence with completing the steps in transitional school routines when a researcher delivered the intervention. Previous research involving training paraprofessionals to deliver interventions shows that, with effective training, paraprofessionals are capable of using evidence-based practices for students with intellectual disabilities (Brock & Carter, 2015). Research is needed to determine the best format for training and supporting paraprofessionals, specifically for students with extensive support needs in inclusive classrooms.

Implications for Practice

Results from this study provide several implications for practice. Throughout the study, a reduction in the amount of time to complete each transition was observed. When less time is spent addressing transitional routines, teachers can have more time for academic and social skills instruction. Thus, interventions such as VSM and SLP are recommended. Second, results from this study highlight the promising application of VSM and SLP in general education classrooms to promote independent transitioning. Although a researcher implemented the intervention in this study, these findings are relevant to general education teachers and paraprofessionals who support students with extensive support needs in inclusive classrooms. Often students with extensive support needs who access the general education classroom are accompanied by a paraprofessional rather than the special education teacher because the latter remains in the self-contained or resource classroom serving other students. Planning time is needed for observation and feedback between the special education teacher or general education teacher and paraprofessional to develop knowledge and skills in using VSM and SLP and ensure implementation fidelity is consistent over time. Finally, this study investigated a possible solution, given adequate training, for teachers and paraprofessionals who seek to support students with extensive support needs in making independent transitions within inclusive classrooms and other school settings.

Supplemental Material

sj-pdf-1-pbi-10.1177_1098300721990291 – Supplemental material for Effects of Video Self-Modeling and System of Least Prompts on Completion of Transitional Routines for a Student With Extensive Support Needs in Inclusive Settings

Supplemental material, sj-pdf-1-pbi-10.1177_1098300721990291 for Effects of Video Self-Modeling and System of Least Prompts on Completion of Transitional Routines for a Student With Extensive Support Needs in Inclusive Settings by Elizabeth N. Reyes, Charles L. Wood, Virginia L. Walker, Ashley P. Voggt and Amanda R. Vestal in Journal of Positive Behavior Interventions

Footnotes

Action Editor: Grace Gengoux

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.

Supplemental Material

Supplemental material for this article is available on the Journal of Positive Behavior Interventions website with the online version of this article.

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