iPad® Video Prompting to Teach Young Adults With Disabilities Independent Living Skills: A Maintenance Study

Abstract

The purpose of this study was to evaluate the effectiveness of an iPad® as a prompting device for teaching five daily living skills to three young adults with disabilities. Identified target tasks were (a) making spaghetti, (b) cleaning the dining room, (c) making macaroni and cheese, (d) cleaning the front porch, (e) cleaning the back porch, (f) cleaning the living room, and (g) mailing a letter. A multiple probe across behaviors design demonstrated use of the iPad® was associated with immediate and significant gains in the percentage of steps completed correctly for each identified target task. All four participants were able to maintain task acquisition without the use of the iPad®.

Keywords

iPad®transition daily living skills video prompting video modeling autism fragile X

Opportunities to live independently are increasing for individuals with disabilities. To live independently, these individuals must be able to perform essential daily living functions such as meal preparation and personal hygiene. Mastery of these skills not only results in successful independent living but also allows for a higher quality of life (Cannella-Malone et al., 2006). Video modeling (VM) is an evidence-based method for teaching daily living skills (Bellini & Akullian, 2007).

VM teaches behaviors and skills by showing videos in which models demonstrate the steps necessary to complete a task (Bellini & Akullian, 2007). The models may be peers, educators, family members, or the learners themselves. After watching a video of the model completing the entire skill, the learners are prompted to imitate what they have seen (Buggey, 2005; Cannella-Malone et al., 2006; Delano, 2007; Kellems, Mourra, et al., 2016; McCoy & Hermansen, 2007). Due to its effectiveness with transition-aged individuals, the National Technical Assistance Center on Transition (NTACT) has listed VM as a research-based practice (NTACT, 2016).

A variation of VM is video prompting (VP). VP breaks the video into steps that can be viewed in small clips. An individual watches a clip and is then given an opportunity to perform that particular step. The difference between VM and VP is how the student interacts with the instruction—with VP the student watches then imitates a single step at a time; with VM the student watches then replicates the entire skill (Kellems et al., 2015). VP has the potential to enhance skill acquisition and generalization in addition to reducing the likelihood of prompt dependence.

VP can be an effective way of teaching job skills. A study by Van Laarhoven, Johnson, Van Laarhoven-Myers, Grider, and Grider (2009) used a multiprobe multiple baseline across behaviors design to teach three job-related tasks (a) cleaning the public restroom, (b) mopping the floor/emptying the garbage, and (c) cleaning kennels. Findings indicated that VP was effective across all participants and skills. VP can also be used to teach daily living skills. Domire and Wolf (2014) conducted a review of the literature related to using VP to teach daily living skills to children with disabilities. Findings from their review demonstrated that VP was effective at teaching a wide range of skills. Individuals were able to maintain and in most cases generalize the acquired skills; however, information related to maintaining skills over longer periods of time was limited. A recent study by Kellems and colleagues (2016) used VP via an iPad to teach nine adults with disabilities three different functional math skills which included (a) calculating a tip (15%), (b) calculating item unit prices, and (c) adjusting a recipe for more or fewer people. Results of these studies indicated that VP and VM can effectively be used to teach life skills to children and adults with disabilities.

Although teaching individuals independent living skills is important to autonomous living, it is equally important that these individuals maintain the skills that they have learned. Several studies exploring the effectiveness of VP to teach students with disabilities various skills have also explored whether the acquired skills are maintained. Taber-Doughty and colleagues (2011) used VP to teach novel cooking skills to three secondary students. Findings indicated that VP was an overall effective method of instruction for all of the participants, and they were all able to maintain the skills 1 week after the intervention was removed. Maintenance data were collected 7 days after the intervention was removed which may indicate that the gains made may not be durable and could potentially decrease over a longer period of time. As a result, additional research may be necessary.

Van Laarhoven, Kraus, Karpman, Nizzi, and Velentino (2010) also explored whether teaching individuals with disabilities to fold clothes and make pasta using VP would be maintained over time. Findings from the study indicated that although VP was effective at increasing independent task completion for both participants, only one of the participants was able to maintain the acquired skills over time by performing them 6 weeks later without using the intervention at the same level as they did with the use of the intervention. These studies indicate that using VP to teach students with disabilities is an effective tool for teaching various life skills via mobile devices and these gains can be maintained for a short period of time.

Over the past several years, technology has advanced rapidly, opening up additional opportunities with portable media devices such as iPads®, iPods®, iPhones®, smartphones, and tablets, which are now capable of creating and playing videos. These advances in technology have improved instruction for individuals with disabilities and expanded the potential for VP (Kellems & Morningstar, 2012).

However, the current research has not fully explored whether the skills are maintained after the videos are removed and if so, for what period for time. Further research is needed to investigate how successful skills taught using VP are maintained among different populations and for what periods of time. In addition, because portable media devices can be used to present VP and have shown some success in improving teaching tasks to students with disabilities (Kellems & Morningstar, 2012), the effectiveness of VP delivered on a portable media device should also be examined. The current study expands the VP research in these key areas.

The purpose of the current study was to determine whether individuals with disabilities may not only acquire but also maintain the learned skills over time. In this study, the modeled task was presented via a mobile device to determine the effects of VP on producing behaviors that were durable and maintained over time. The iPad® was selected to deliver the intervention due to its ease of use and its widespread availability in schools. This study was designed to extend the existing research in several ways: first, to add to the increasing body of research supporting the use of mobile devices such as iPads® to deliver VP interventions; second, to add to the current knowledge base by exploring whether the intervention leads to behaviors that are maintained (i.e., whether participants will be able to perform the target tasks once learned without utilizing the iPad®). Three questions guided the research:

Research Question 1: Will VP delivered via an iPad® lead to skills acquisition as measured by an increase in the percentage of skill steps completed correctly?

Research Question 2: After skills acquisition, will participants be able to complete the skills without the use of the iPad® (maintenance)?

Research Question 3: Is VP delivered through a mobile device a socially appropriate way of providing instruction?

Method

Participants

Three young adults ranging from 19 to 20 years old were recruited from a community living program for 18- to 21-year-olds. These individuals met the following criteria: (a) current eligibility for special education services; (b) deficits in adaptive behavior; (c) current level of cognitive functioning below 69 on a standardized measure (i.e., Wechsler Intelligence Scale for Children–Fourth Edition [WISC-IV]); (d) demonstrated need for the intervention as determined by their teacher, the district autism specialist, and/or their parent or guardian; (e) ability to attend to the video; and (f) fine motor skills necessary to operate the iPad®. The last two criteria were confirmed by the participant’s successful completion of preliminary training. The participants varied in both expressive and receptive communication ability as measured through anecdotal and observational data collected by the researcher.

Juan

Juan was 20 years old at the time of the study. Juan’s primary diagnosis was fragile X syndrome. He scored a 54 on the Wechsler Adult Intelligence Scale–Fourth Edition (WAIS-IV) and 49 in communication, 58 in daily living, 52 in socialization, and 54 in motor skills on the Vineland Adaptive Behavior Scale (ABS). Juan also received a score of 70 in motor skills, 30 in social interaction (very limited), 66 in personal living skills (very limited to negligible), 34 in community living skills (very limited), and 40 in broad independence (very limited) according to the Scale of Independent Behavior (SIBR). Juan has limited expressive communication, using only one-word utterances. His receptive ability allowed him to understand and follow simple instructions, but he did not complete any tasks without being prompted. Juan’s targeted tasks included making spaghetti, cleaning the dining room, and making mac and cheese.

Robert

Robert was 19 years old at the time of the study and his primary diagnosis was Autism. On the WAIS-IV, he scored a 46 in full IQ, 68 composite score in verbal comprehension, 65 in perceptual reasoning, 63 in working memory, and 68 in processing speed. Robert also scored an 86 in communication, 88 in daily living, 89 in socialization, 92 in motor skills, and an 87 composite score in adaptive behavior on the Vineland ABS. On the SIBR, he scored a 55 in motor skills, 64 in social interactions, 54 in personal living skills, 56 in community living skills, and 46 in broad independence (very limited). Robert has limited expressive ability; he communicates in single sentences which sounded scripted. His receptive ability was limited for understanding both verbal and written instructions. Robert was a nonreader and functionally dependent on prompts in all aspects of his life. Robert’s targeted tasks included making mac and cheese, cleaning the back porch, and cleaning the front porch.

Molly

Molly was 20 years old at the time of the study. Molly’s primary diagnosis was autism spectrum disorder. She scored 40 in full IQ, 47 in verbal comprehension, 45 in perceptual reasoning, 50 in working memory, and 50 in processing speed on the WISC-IV. On the Vineland ABS, Molly scored 70 in communication, 75 in daily living, 93 in socialization, 62 in motor skills, and 69 composite score in adaptive behavior. She also received a 23 in motor skills, 42 in social interactions, 46 in personal living skills, 35 in community living skills, and 25 in broad independence. Molly has significantly limitations in her ability to express herself. Most of her communication was echolalic or unintelligible; when she did express herself, she used one-word utterances. Her limited receptive ability required simple one-word instructions, which she sometimes had a difficult time understanding. Molly needed a significant level of support to complete tasks and activities across all settings. Molly’s tasks were making mac and cheese, cleaning the living room, and mailing a letter.

Setting

The study was conducted in a community living program for individuals 18 to 21 years old, located in a suburban school district of approximately 15,000 students in the western United States. The community living program served approximately 45 young people eligible for services under the Individuals with Disabilities Education Act (IDEA). Two apartments in a large apartment complex housed the program, serving both as classrooms and as instructional settings for teaching various life skills. Each of the apartments was fully furnished and organized like a traditional three-bedroom apartment including a fully stocked and functional kitchen. The intervention sessions occurred during the school day at the apartment. During the intervention session, there were approximately three staff and five students in the apartment.

The study was planned and implemented by the lead researcher with assistance from three other professionals. Everyone involved in the study had extensive experience in working with students with disabilities; two of them were certified special education teachers and one was an undergraduate student majoring in family and human services. All intervention and social validity data were collected by a member of the research team.

Resources

A distinctive aspect of this study was that the videos were filmed, edited, and delivered using only an iPad®. A short video clip was filmed for each step in the task analysis for all selected target tasks. Utilizing the iMovie app (Apple Inc., Version 2.0) on the iPad®, clips were edited for content and length. Each video clip began with a 3-s photo representing the entire step (e.g., the boiling water step showed a pot of water boiling). A short voiceover was added to each clip that began after the initial 3-s photo: For instance, the clip for setting the timer included a voice explicitly stating the length of time to be set.

The videos were filmed and delivered at the community living program apartments using a 16 GB iPad® 2, operating on iOS 5.1.1 on the camera application. The iPad® dimensions were 9.5 in. (height) × 7.31 in. (width) × .34 in. (depth). Edited video clips were added to a presentation created using the Keynote application (Apple Inc., Version 2.0). One slide was created for each of the identified steps, containing the written title of the step at the bottom, a photo representation of the step, and the edited video segment. To view the video, the participant would touch the screen. If viewing the static picture was a sufficient instruction or reminder for the step, the participant could move on to the next step by making a swiping motion on the touchscreen. Audio was played through the built-in speakers. Each iPad® had a protective case with a stand so that it could be viewed when set on a flat surface.

Models for the videos were selected based on (a) their ability to correctly complete the selected target task and (b) the participant’s likelihood of relating to the model. The models used for the videos in the study were the district autism specialist and a research assistant. The videos were filmed from a third-person perspective. When appropriate, explicit verbal explanations for each step were provided by the model.

Dependent Variables

The dependent variable for this study was the percentage of independent steps completed correctly for each selected target task. A task analysis was conducted for each of the selected tasks, and data were collected each session to see whether the steps of the task were completed independently. The selected tasks were (a) making spaghetti, (b) cleaning the dining room, (c) making macaroni and cheese, (d) cleaning the front porch, (e) cleaning the back porch, (f) cleaning the living room, and (g) mailing a letter. The steps for each task can be seen in Table 1.

Table 1.

Task Analysis for Selected Tasks.

Making spaghetti	Cleaning dining room	Making mac and cheese	Cleaning back porch	Cleaning front porch	Cleaning living room	Mailing a letter
1. Wash hands 2. Get spoon 3. Get pot 4. Get hot mitts 5. Get measuring cup 6. Get strainer 7. Get spaghetti 8. Get parmesan cheese 9. Get sauce 10. Fill pot with our cups of water 11. Turn to HIGH 12. Wait until water boils 13. Add noodles to pot 14. Set timer to 9 min 15. Stir noodles 16. Put on mitts 17. Drain noodles 18. Measure one cup of sauce 19. Put sauce on noodles 20. Put spaghetti on plate	1. Get supplies 2. Dust ceilings corners/walls 3. Dust pictures and fan 4. Clean table 5. Move chairs 6. Vacuum around table 7. Return chairs 8. Put napkins in basket 9. Clean window 10. Put away supplies	1. Wash hands 2. Pull up sleeves 3. Get utensils 4. Get ingredients 5. Fill pot with four cups of water 6. Turn to HIGH 7. When water boils, turn stove to medium 8. Add mac to water 9. Set time to 10 min 10. Stir mac 11. Turn on fan 12. When timer sounds, drain mac 13. Stir in cheese packet 14. Put on plate 15. Clean up	1. Get supplies 2. Dust around outside door 3. Stack chairs 4. Wipe off table 5. Wash sliding door 6. Water plant box 7. Dust plant stand 8. Sweep patio	1. Get supplies 2. Dust around outside door 3. Wipe railing 4. Shake-out rugs and sweep 5. Sweep ramp 6. Dust ceiling and walls 7. Move rug and vacuum 8. Clean mirror 9. Mop front entry	1. Get supplies 2. Turn off fireplace 3. Dust TV 4. Wipe off desk 5. Clean craft table 6. Dust air conditioner 7. Wipe off fireplace 8. Take out recycling	1. Get supplies 2. Fold paper into thirds 3. Place paper into envelope 4. Place stamp on postcard 5. Place postcard in envelope 6. Write address on envelope 7. Place stamp on envelope 8. Seal envelope 9. Place in mailbox 10. Put away supplies

Data collection

Two measures were used to collect data on the dependent variable. First, discrete-categorization (Kazdin, 2011) was used to record each step of the task analysis as completed correctly or completed incorrectly. A task was considered completed independently if the individual (a) began the task within 5 s and (b) completed it correctly. Data were used to determine the percentage of steps participants completed successfully for each task. A second measure was used to collect the social validity data.

The researchers collected all primary data using direct live observations, completing the data collection sheet as each participant performed each task. Another researcher filmed all of the data collection sessions for use in establishing interobserver agreement (IOA).

Experimental Design

The study utilized a multiple probe across behaviors design with three participants. Kennedy (2005) recommends a multiprobe multiple baseline design for studying the maintenance process because the design allows the researchers to document the change in each participant’s performance on the target behavior while keeping subsequent tiers in baseline.

The multiple-probe design may also prevent the participants from displaying negative reactions such as boredom, as well as limiting the possibility that the training would produce an increase in the baselines of the young adults who have not received the intervention due to the intermittent rather than continuous data collection (Barlow, Nock, & Hersen, 2009).

Procedures

Pre-intervention

Target tasks were identified for each of the young adults by a collaborative process that included discussions with the participants, their teachers and, when applicable, their parents. During the initial screening process, those with knowledge of or involvement with the participants’ individualized education plans helped identify daily living skills that could be targeted for the intervention. For each task identified, one of the teachers or researchers was filmed correctly completing the task. From this video, a task analysis was created by watching a video of the task and listing all of the discrete steps. These initial videos were only used to assist in the creation of the task analysis and not as part of the actual intervention videos. Once completed, the initial task analysis was reviewed by an outside expert in special education (significant disabilities) to verify its accuracy. The target tasks and the number of steps in each task analysis can be found in Table 1.

Baseline

During baseline, participants did not have access to the iPad® but were presented with the necessary materials and an opportunity to perform the task in the area the task would be naturally completed. The area was the same in baseline, intervention, and maintenance phases. Each participant was given one prompt to begin the first step. If after 5 s the participant did not begin the task, the step was marked as not completed, and the participant was asked to turn away while the step was completed by one of the researchers. The participant was then instructed to continue with the task. These procedures were followed until the task was completed. The researchers applied these multiple opportunity baseline procedures for all of the tasks with all individuals. If the participant completed a step out of order that did not change the outcome of the task (getting the pot before getting the spoon), it was counted as correct. If, however, the order of the step did matter (noodles were drained prior to cooking them), the step was counted as incorrect. Baseline lasted approximately 2 weeks for each task. The established criteria for moving from baseline to intervention were three consecutive stable data points.

iPad® training

After all of the baselines had been established and prior to the introduction of the intervention, one-on-one model-lead-test procedures were used to teach participants how to operate the iPad®, access the Keynote program, and open the correct presentation containing all of the videos. After the training was complete, the researchers determined participants’ ability to access the videos by whether they could independently turn on the iPad®, locate and open the Keynote application, open a presentation (not related to any of the selected target tasks), and navigate through the presentation, playing the videos for each step. All of the participants had previously operated an iPad®. After the model-lead-test instruction, all of the participants were able to independently access the intervention via the Keynote app. Participants needed to demonstrate 100% mastery in one session prior to moving to the intervention phase. Three participants demonstrated mastery after one session with one participant needing three training sessions to reach mastery.

VP procedures

Prior to each session, participants were taken to the area where the target task was to be completed, given the iPad®, and verbally instructed to turn it on and access the correct intervention video. The instructions were given all at once. A participant who did not initiate turning on the iPad® or opening the Keynote app was verbally prompted again. All of the participants were able to access the intervention videos from verbal prompts, and none of them required more than two prompts per session. The iPad® was placed on the kitchen counter for cooking tasks and on the kitchen table for cleaning tasks. After the device was activated, the participant opened the Keynote program, which displayed a static picture for each step and played a video if the participant wanted it. Thus, students could choose to watch videos for only the steps they needed help learning. After each slide, the student completed the step. The keynote presentation was available only during the intervention phase; the student could not watch it in its entirety prior to any session.

A student who had not begun the modeled step after 5 s was prompted to do what they had viewed in the video. If participants had a question, they were referred to do what they saw on the video. At no point were participants ever prompted to complete the specific step from the task analysis. The only prompts provided for completing the steps on the task analysis came directly from the iPad®. For food preparation tasks, the participant was allowed to eat the food as a natural reinforcer after completing the task correctly. No reinforcer was provided for the tasks unrelated to food.

The task was considered mastered when a participant completed 80% of the steps correctly for three consecutive sessions. When the young adult reached the established skill acquisition level on the first selected behavior, the intervention was then introduced for the second target behavior, while the third remained in baseline with data probes conducted.

Maintenance

During the maintenance phase, the iPad® was not available for participants to use. Maintenance probes were conducted on the first task after the participant demonstrated skill acquisition for the second task. After skill acquisition was demonstrated on the third task, a maintenance probe was conducted on the first and second tasks. Maintenance probes were collected on the third task approximately 24 to 45 days after the last intervention session. Maintenance data were collected for Juan 30 and 64 days after the last intervention session for making spaghetti, 70 days for cleaning the dining room, and 26 days for making mac and cheese. Maintenance data were collected for Robert 15 and 49 after the last intervention session for making mac and cheese, 18 days for cleaning the back porch, and 24 days for cleaning the front porch. Maintenance data were collected for Molly 23 and 47 days after the last intervention session for making mac and cheese, 12 days for cleaning the living room, and 45 days for mailing a letter. The conditions during maintenance were the same as the baseline conditions in that the participant did not have access to the iPad®.

IOA

During baseline, intervention, and maintenance observations (Barlow et al., 2009), IOA was conducted on 20% of baseline, 20% of intervention, and 100% of maintenance sessions for each participant across all of the selected tasks. The procedure was to have a second observer analyze and score the videos of these intervention sessions using the established data collection sheet. The point-by-point agreement ratio (number of agreements divided by number of agreements plus disagreements and multiplied by 100) was used to calculate IOA (Kazdin, 2011). During the study, IOA was 100% for the selected sessions.

Procedural fidelity

Through baseline, intervention, and maintenance procedures, researchers used a fidelity checklist to maintain procedural fidelity, ensuring that the intervention was implemented as designed. Procedural fidelity data were collected on every session across all conditions. At each intervention or maintenance session, an independent observer completed the checklist to ensure that the intervention was implemented with fidelity and that established VP procedures were followed during the intervention phase of the study. An example of an item on the checklist is that the iPad® was available and ready for the student to use at the start of each intervention session. The fidelity checklist covered both the researcher’s implementation of the intervention and the participant’s use of it. The point-by-point agreement ratio (the number of agreements divided by number of agreements plus disagreements and multiplied by 100) was used to calculate procedural fidelity (Kazdin, 2011). These data indicated the intervention was implemented with 100% fidelity across all phases and intervention sessions.

Social validity

Social validity questionnaires were completed by all three participants and two of their teachers. The social validity questionnaire consisted of seven open-ended questions and was designed to measure utility and social appropriateness, along with the efficacy of using an iPad® to deliver the VP intervention. The participants were asked five questions: (a) What did you think about watching the videos on the iPad? (b) What did you think about watching the videos as you worked? (c) What difference did watching the videos have on your job? (d) Would you like watching more videos at work showing you how to do things? (e) Who have you told about using the iPad® at work? The teachers were asked the same questions in addition to whether they thought it was socially acceptable for the participants to watch the videos as they worked.

The participants completed one version of the questionnaire, and the teachers completed another version. Participants completed their surveys after the generalization phase ended for all of their tasks. Teachers completed the surveys after all of the students completed the generalization phase. The students had the survey read to them and provided verbal responses, with the teachers providing written responses and the researchers following up with probing questions for both groups. After data collection, a qualitative coding framework was established to assist in identifying common themes (Coffey & Atkinson, 1996). After the surveys were coded, major themes were identified by locating items mentioned multiple times.

Results

Data indicated that VP delivered through an iPad® was effective in promoting rapid skill acquisition in all three young adults across all of the selected tasks. Maintenance probes showed all three of participants maintained or improved the level of skill acquisition achieved during the intervention phase without using the iPad®. Maintenance probes also demonstrated that the participants were able to maintain skill acquisition from 12 to 70 days after the last intervention session, demonstrating the durability of the intervention.

Juan

As shown in Figure 1, the selected target tasks for Juan were making spaghetti, cleaning the dining room, and making macaroni and cheese. Although none of the selected target tasks was entirely new to Juan, baseline data showed that he was not completing any of the steps correctly for any of the target tasks. He required three sessions to reach criteria on the two cooking tasks and five sessions to reach criteria on the cleaning task. Juan maintained an 80% correct performance for making spaghetti after 30 days and again after 64 days. On cleaning the dining room, Juan maintained 86% correct performance after 70 days. On making mac and cheese, Juan displayed 90% correct performance during maintained 26 days after the last intervention session.

Figure 1.

Percentage of steps correctly completed for Juan.

Robert

As shown in Figure 2, making macaroni and cheese, cleaning the back porch, and cleaning the front porch were selected as target tasks for Robert. As with Juan, none of the selected target tasks was new to Robert, but during baseline, he was unable to complete any of the steps correctly. Once the iPad® was introduced, he reached criteria after three intervention sessions on both cleaning the back porch and cleaning the front porch. He required six sessions to reach criteria on making mac and cheese. Robert was able to maintain 87% correct performance for making mac and cheese 15 and 49 days after the last intervention session and 18 days when cleaning the back porch. Robert maintained 100% correct performance cleaning the front porch for 24 days.

Figure 2.

Percentage of steps correctly completed for Robert.

Molly

As shown in Figure 3, Molly’s learning tasks consisted of making macaroni and cheese, cleaning the living room, and mailing a letter. Like the other participants, she was not able to complete any of the steps for any of the tasks correctly at baseline, although she had encountered all the tasks previously. When she used the iPad®, Molly reached criteria after three sessions when cleaning the living room and mailing a letter. For the mac and cheese task, she required four sessions to reach criteria. Molly was able to demonstrate a 92% correct performance during maintenance making mac and cheese after 23 days and 47 days. She also was able to demonstrate maintenance by cleaning the living room at 100% after 12 days and mailing a letter at 90% after 45 days.

Figure 3.

Percentage of steps correctly completed for Molly.

Social Validity

A major theme from the student social validity questionnaires was that the student participants enjoyed using the iPads® to learn; generally, they liked using the device, and specifically they enjoyed watching the videos presented in the study. The word fun was used by all of the students. Students also reported they thought the iPad® was an effective way to teach daily living skills. One student added “helpful” to the assessment of “fun.” Finally, the students indicated they would like to use the iPads® more in the future.

One theme that emerged from the teacher questionnaires was that the students seemed to enjoy using the iPads®. All of the teachers indicated that they would like to use iPads® more in the future. One teacher remarked, “We have a few staff [members] who use the iPad® with other students and have been taking notes on how to use the iPad®. We would love to see more videos available and used more frequently.” It should be noted that a teacher stated she was unable to tell whether the students gained significant skills by using the iPad®, but their attitudes were generally “more pleasant and excited when they had days that they got to use the iPad®.” Results from the social validity data demonstrated that both the participants and the teachers considered using an iPad® to be a socially acceptable way of teaching daily living skills.

Discussion

The purpose of this study was to examine whether skills learned using VP delivered through an iPad® to teach independent living skills to three young adults with disabilities were maintained. Data analysis showed a functional relation between VP delivered through the iPad® and the percentage of steps correctly completed for each of the identified target tasks with these gains being maintained over time. Results also demonstrated the learned skills were maintained up to 70 days after the final intervention session. Social validity data indicated teachers, instructional aides, and students all had positive attitudes toward the intervention and viewed use of iPads® as an effective and efficient way of teaching daily living skills to young adults with disabilities.

Building on the work of Mechling and Gustafson (2008) and Kellems and Morningstar (2012), the current study indicated rapid immediate gains for each participant that were maintained. All three of the participants reached criteria on two of the tasks after three iPad® sessions. When mastery criteria were not reached immediately, an additional one to three sessions were required. This rapidity demonstrates the powerful potential of the method. Findings from the current study are consistent with other studies finding immediate and substantial gains that are maintained over time with VP (Sigafoos et al., 2005; Van Laarhoven et al., 2009). The current study extends the current research by demonstrating that the gains in task performance were maintained up to 70 days after the last intervention session. These findings demonstrate not only that VP on mobile devices is effective but also that its effectiveness is durable over time.

Another interesting aspect of the study was that a single static picture was displayed for each step, and a video was available for participants who desired it. Thus, students could choose to watch videos for only the steps they needed help learning, which varied with each student. While no data were collected specifically on whether the addition of a static picture had an impact on the overall effectiveness of the intervention, there was anecdotal evidence that suggested that after the initial exposure to the video on subsequent views the static picture was enough of a prompt and the student decreased the number of steps they viewed videos for. Hence, the current study builds on work related to the effectiveness of providing instruction through static pictures, as well as video (Alberto, Cihak, & Gama, 2005) demonstrating that in some instances static pictures can be as effective as VM and that some individuals perform better with static pictures and others with video.

In relation to the social validity findings, the fact that both students and teachers anticipate future use of videos created and displayed on an iPad® adds to the overall validity of the intervention in addition to the fact that the teachers viewed the intervention as socially appropriate to the extent of noting the use of the iPads® to view instructional videos does not need to be limited to a classroom.

Limitations and Suggestions for Future Research

Although results from this study support and extend the body of research related to the effectiveness of VP for teaching skills to individuals with disabilities, several limitations should be noted. One limitation of the study is that the typical rules for a multiple-probe design were not followed because three initial baseline data points were not collected in each tier. It should be noted that each task stayed at zero and later probes verified the original prediction of the initial baseline data point. The fact that no data were collected related to whether the participants watched the video or only looked at the static picture should also be considered as a limitation.

A second limitation is that the current study included only three participants: two males and one female. This may affect the ability to generalize these findings to a broader population. The study was also conducted within the setting of the community living program apartments, which serve as classrooms. It may be difficult to generalize the skills to other settings.

A final limitation of the study is that no data were collected to determine whether the learned behaviors generalized to participants’ homes or other settings. Although the intervention was implemented in a natural setting with the potential for generalization to other settings, logistics prevented this from being measured during the current study.

Although VM has been established as an evidence-based practice, specific aspects need further research as technology advances. One promising area of new technology is cloud-based storage, available on services such as YouTube or Vimeo, which will separate the videos from the device and store them on the cloud so that they can be accessed from any mobile device. Future research should explore whether delivering videos through the cloud, which allows multiple mobile devices to access the same videos without loading them separately onto each device, has any impact on overall task acquisition or treatment implementation. Future studies should also explore the delivery of video instruction through other tablet devices, smartphones, portable gaming systems, and other technology capable of playing video. Further studies are needed to determine whether the findings of this study and others can be replicated on other devices.

Future research is needed is to explore whether video-based instruction can be used during the initial intervention sessions and later be replaced by static pictures, which can then be faded as the skill is mastered. This represents a tiered approach related to the intensity of the intervention. In our study, it appeared that students relied on the videos more during initial intervention sessions. It would be worthwhile to establish this with empirical data.

Another area that needs to be explored further is what the best method of instruction for the iPad® training. The instruction in the current study was delivered in a one-on-one setting. Future studies should explore whether this instruction could be delivered in group settings in addition to exploring what instructional methods are best suited for the training on how to use the iPad®.

One final area that warrants further research is the impact specific video elements such as voiceover and written instructions have on the overall effects of the video. Adding additional video elements can be done quickly and has the potential to add significantly to the overall effectiveness of VP. Researchers should conduct studies to determine whether adding specific video elements affects overall effectiveness as measured by how long it takes to reach mastery and how long the skills are maintained.

Implications for Practice

Findings from the study have several implications for current practitioners. First, most practitioners have access to the technology used in the study; special education teachers commonly have several iPads® in their classroom for student use. This study shows that iPads® appear to be an effective way of teaching a wide variety of skills to young adults. The current study provides a framework for easily developing, filming, and implementing a VP intervention using a device that most practitioners have readily available. No additional materials are needed to create and deliver such videos to students. Findings from the study give practitioners an affordable way to assist individuals with disabilities develop and maintain necessary life skills

While social validity data from this study supported the acceptability of the procedures, it did not address the practicality. The level of training needed to implement the intervention should be considered. The researchers from the current study have found practitioners can be trained in about 5 hr on how to develop, film, edit, and implement VM and VP interventions; researchers in this study required about 45 min to film and edit each intervention video. Practitioners need to consider whether they would have time to do this with all of their competing responsibilities. This becomes easier if teachers regard this intervention not as competing with their other responsibilities, but as enhancing their current practices. Moreover, teachers should consider the videos that can be used with many different students for years to come, thus saving time in the long-term perspective.

Conclusion

Over the past few decades, independent living opportunities for individuals with disabilities have increased (Lipscomb et al., 2017). As independent living opportunities increase, so, too, must the support provided to foster independence. One way to do this is by teaching daily living skills using research-based practices. One important aspect is making sure that skills taught will be maintained over time. Results of the study indicated that VP delivered through an iPad was an effective way to teach daily living skills that were maintained over time without the use of the iPad.

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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