etadd_47(3) - Division on Autism and Developmental Disabilities

Education and 

Training 

in 

Autism 

and 

Developmental 

Disabilities 

Volume <strong>47</strong> Number 3 

Focusing on individuals with 

autism, intellectual disability and other developmental disabilities 

DAD 

D 

September 2012

Education and Training in Autism and Developmental Disabilities 

The Journal of the <strong>Division</strong> on Autism and Developmental Disabilities, 

The Council for Exceptional Children 

Editor: Stanley H. Zucker 

Arizona State University 

Mary Lou Fulton Teachers College 

Consulting Editors 

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Editorial Assistant: Kathleen M. Corley 

Arizona State University 

Mary Lou Fulton Teachers College 

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Robert S. Rueda 

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Exceptional Child Education Resources. 

Education and Training in Autism and Developmental Disabilities Vol. <strong>47</strong>, No. 3, September 2012, Copyright 2012 by the <strong>Division</strong> on Austim 

and Developmental Disabilities, The Council for Exceptional Children. 

<strong>Division</strong> on Autism and Developmental Disabilities 

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Education and Training in Autism and Developmental 

Disabilities 

VOLUME <strong>47</strong> NUMBER 3 SEPTEMBER 2012 

Preparing Children with Developmental Disabilities for Life in the 

Community: A Tanzanian Perspective 255 

ANGI STONE-MACDONALD 

Two Approaches to Phonics Instruction: Comparison of Effects with Children 

with Significant Cognitive Disability 269 

ELIZABETH GRACE FINNEGAN 

Comparing Teacher-Directed and Computer-Assisted Constant Time Delay for 

Teaching Functional Sight Words to Students with Moderate Intellectual Disability 280 

MARI BETH COLEMAN, KEVIN J. HURLEY, and DAVID F. CIHAK 

Group Delivered Literacy-Based Behavioral Interventions for Children with 

Intellectual Disability 293 

DANA KEETER and JESSICA L. BUCHOLZ 

Using Video Modeling to Teach Young Children with Autism Developmentally 

Appropriate Play and Connected Speech 302 

SARAH CLIFFORD SCHEFLEN, STEPHANNY F. N. FREEMAN, and TANYA PAPARELLA 

Effects of a Video Model to Teach Students with Moderate Intellectual 

Disability to Use Key Features of an iPhone 319 

KATHRYN WALSER, KEVIN AYRES, and ERIKA FOOTE 

Comparing the Effects of Video Prompting with and without Error Correction 

on Skill Acquisition for Students with Intellectual Disability 332 

HELEN I. CANNELLA-MALONE, JOE E. WHEATON, PEI-FANG WU, 

CHRISTOPHER A. TULLIS, and JU HEE PARK 

Cognitive Strategy Instruction for Functional Mathematical Skill: Effects for 

Young Adults with Intellectual Disability 345 

YOUJIA HUA, BENJAMIN S. T. MORGAN, ERICA R. KALDENBERG, and MINKOWAN GOO 

Increasing Comprehension for Middle School Students with Moderate 

Intellectual Disability on Age-Appropriate Texts 359 

JORDAN SHURR and TERESA TABER-DOUGHTY 

Grade-Aligned Math Instruction for Secondary Students with Moderate 


DIANE M. BROWDER, BREE A. JIMENEZ, and KATHERINE TRELA 

Review of Academic Mathematics Instruction for Students with Mild 


CASEY HORD and EMILY C. BOUCK 

Manuscripts Accepted for Future Publication in Education and Training in 

Developmental Disabilities 254 

The <strong>Division</strong> on Autism and Developmental Disabilities retains literary property rights on copyrighted articles. Up 

to 100 copies of the articles in this journal may be reproduced for nonprofit distribution without permission from 

the publisher. All other forms of reproduction require permission from the publisher.

Manuscripts Accepted for Future Publication in Education 

and Training in Autism and Developmental Disabilities 

December 2012 

Promoting independence through assistive technology: Evaluating audio recorders to support 

grocery shopping. Emily Bouck, Rajiv Satsangi, Whitney Bartlett, and Pei-Lin Weng, Purdue 

University, 5146 BRNG Hall, 100 N. University Street, West Lafayette, IN <strong>47</strong>907. 

Teaching café waiter skills to adults with intellectual disability: A real setting study. Atilla Cavkaytar, 

Anadolu University, Faculty of Education, Department of Special Education, Eskisehir, 26<strong>47</strong>0, 

TURKEY. 

Data-based decisions guidelines for teachers of students with severe intellectual and developmental 

disabilities. Bree Jimenez, Pamela Mims, and Diane M. Browder, University of North Carolina at 

Greensboro, 421 School of Education Building, PO Box 26170, Greensboro, NC 27402-6170. 

Using video self-modeling via iPads to increase academic responding of an adolescent with autism 

spectrum disorder and intellectual disability. Juliet Hart and Kelly Whalon, Arizona State University, 

Mary Lou Fulton Teachers College, PO Box 37100, M/C 3151, Phoenix, AZ 85069-7100. 

Parents’ participation in special education in the context of implicit ideologies and socioeconomic 

status. Priya Lalvani, Dept. of Early Childhood, Montclair State University, 1 Normal Avenue, 

Montclair, NJ 07043. 

Efficacy of individualized clinical coaching in a virtual reality classroom for increasing teachers’ 

fidelity of implementation of discrete trial teaching. Krista Vince Garland, Eleazar Vasquez III, and 

Cynthia Pearl, Dept. of Child, Family, and Community Sciences, University of Central Florida, 4000 

Central Florida Blvd., Orlando, FL 32816-0165. 

Increasing literacy skills for students with developmental and intellectual disability: Effects of 

integrating comprehensive reading instruction with sign language. Larissa Beecher and Amy 

Childre, 200 Charlotte Drive, Bonaire, GA 31005. 

Effects of a treatment package to facilitate English/Language Arts learning for middle school 

students with moderate to severe disabilities. Pamela J. Mims, Angel Lee, Diane M. Browder, 

Tracie-Lynn Zakas, and Susan Flynn, Dept. of Human Development and Learning, East Tennessee 

State University, 303 Warf Pickel, Johnson City, TN 37614-1707. 

Maintaining vocational skills of individuals with autism and developmental disabilities through 

video modeling. Toni Van Laarhoven, Lauren Winiarski, Erika Blood, and Jeffrey M. Chan, Dept. 

of Special and Early Learning, Northern Illinois University, DeKalb, IL 60115. 

Research to practice in autism, intellectual disability, and developmental disabilities. Stanley H. 

Zucker, Cindy Perras, Darlene E. Perner, and Richard Gargiulo, Arizona State University, Mary Lou 

Fulton Teachers College, PO Box 871811, Tempe, AZ 85287-1811. 

Address is supplied for author in boldface type.

Education and Training in Autism and Developmental Disabilities, 2012, <strong>47</strong>(3), 255–268 

© <strong>Division</strong> on Autism and Developmental Disabilities 

Preparing Children with Developmental Disabilities for Life 

in the Community: A Tanzanian Perspective 

Angi Stone-MacDonald 

University of Massachusetts Boston 

Abstract: Special education is relatively new in Tanzania. The Irente Rainbow School (IRS) in Lushoto, 

Tanzania, where this ethnographic case study was conducted, is the first school for children with developmental 

disabilities in the area. Their curriculum stresses skills important in family life and the rural economy of 

Lushoto. The purpose of the study was to explore how local context and beliefs about disability influenced how 

participants understood their roles at the school and how they implemented curriculum. The ethnographic case 

study employed qualitative research techniques to ensure credibility and triangulation of data and research was 

conducted over a ten-month period. 

The Rainbow staff created a natural setting to teach and practice daily living and vocational skills to prepare 

students for home and work. The curriculum was based on the local community funds of knowledge, and the 

pedagogy on practices that were supported by the local culture. As special education evolves, programs will 

change to meet the needs of local populations. Knowledge of local context is critical to give children with 

disabilities the best opportunity for an education and meaningful participation in their community. 

Students with disabilities around the world 

learn first from their families and their environments. 

Curriculum should be both culturally 

and socially relevant, providing individuals 

with the knowledge relevant to their local 

community and skills that they will be able to 

use after completing school. Evidence-based 

practice is a wonderful starting point for curriculum 

development, but in unique locations, 

like rural Tanzania, it is also essential to 

focus on the needs of the local community. 

Since the 1980s, the focus on education for 

people with disabilities intensified through 

the work of the United Nations. At the same 

time, a shift toward inclusive education for 

students with disabilities worldwide occurred 

in 1994 after the acceptance of the Salamanca 

Statement on Principles, Policy, and Practices 

in Special Education by ninety-two governments 

and twenty-five international organizations. 

Given that all children have a right to a 

This research was supported in part by a grant 

from Fulbright IIE. Correspondence concerning 

this article should be addressed to Angi Stone-Mac- 

Donald, Department of Curriculum and Instruction, 

University of Massachusetts Boston, 100 Morrissey 

Blvd., Boston, MA 02125. 

quality education, the issue of effective educational 

practice becomes important. 

In the United States and the United Kingdom, 

the use of evidence-based practices to 

improve the quality of education and to 

strengthen practices that are proven to increase 

learning for students has guided the 

development of curriculum (Brusling, 2005). 

Davies (1999) characterized evidence-based 

practices as practices supported by a research 

base. Evidence-based education describes systematic 

guidelines for research to establish 

evidence-based practices (Hargreaves, 1996). 

The National Center for Special Education 

Research (NCSER) in the United States, as 

part of the Institute for Education Sciences 

(IES), funds research to establish evidencebased 

practices that have been validated as 

effective for students with disabilities (“The 

National Center for Special Education Research 

(NCSER) Home Page,” 2008). The 

What Works Clearinghouse program and website 

were developed by IES to disseminate 

studies in education and catalog evidencebased 

practices. Universities educate future 

teachers about evidence-based practices for 

students with developmental disabilities and 

school districts expect teachers to teach the 

Life in the Community: A Tanzanian Perspective / 255

curriculum and standards using evidencebased 

practices. 

Curricula exist in schools around the world, 

but the content and pedagogy of those curricula 

differ. Curricula is defined by curriculum 

theorists as “planned learning experiences” or 

a “structured series of intended learning outcomes” 

(Johnson Jr., 2007, p. 130). These two 

definitions look at the process of learning and 

the outcomes. Other scholars look at curricula 

in terms of the specific content that is prescribed 

for learning (Eisner, 1965; Gagné, 

1966). Curricula are often prescribed and 

distributed by national, state, or local educational 

authorities to use in schools. Schools 

are where curricula are used and curricula are 

designed for these specific formal settings 

(Marsh, 1997). 

Since P.L. 94–142, the Education for All 

Handicapped Children Act, curricula in the 

United States for students with disabilities 

have been guided by the Individual Education 

Plans (IEPs) required for each student with a 

disability. In recent years, IEPs have been written 

so that students with disabilities access 

the general education curriculum. Since the 

passage of the No Child Left Behind Law 

(NCLB), educators in the United States have 

been urged to use evidence-based practices 

that have been validated through rigorous scientific 

studies. Scholars and policymakers now 

seek to identify evidence-based practices and 

the standards for determining an evidencebased 

practice (Odom, et al., 2005). 

While efforts to establish evidence-based 

practices may have benefited educational programs 

for students with disabilities in the 

United States, it is unclear how evidencebased 

practices used in the United States 

might translate to other countries and cultures 

and what might be considered best practice 

in Tanzania. Evidence-based practices can 

be validated to work with specific populations 

with certain types of disabilities, but the practices 

may not be viable when the local context 

and the concept of disability in a particular 

culture differ. 

Functional Curricula 

Traditionally, students with more significant 

disabilities and some level of cognitive impairment 

are provided with curricula that focus 

on functional academics, functional life skills, 

and vocational skills to prepare them for life 

after school, rather than a strictly academic 

curriculum that might be in place if students 

are preparing to attend college (Browder & 

Cooper-Duffy, 2003). The emphasis in the 

functional curriculum is on students’ learning 

skills to improve their quality of life. In this 

case, functional is a term used to describe activities 

in which people without disabilities 

would engage independently in natural settings. 

Such activities as shopping at a grocery 

store or riding a bus are considered functional 

(Dymond & Orelove, 2001). The content of 

the functional curriculum reflects existing academic 

curricula as well as skills and knowledge 

necessary for life and work in an inclusive 

community (Brown, et al., 1979; Schmalle 

& Retish, 1989). The rationale for the functional 

curriculum is that students with developmental 

and severe disabilities need explicit 

instruction in life skills and functional academics, 

because they do not typically acquire 

them through daily interaction with peers and 

adults (Halpern & Benz, 1987; Snell, 1997). 

Several researchers have emphasized the need 

to use functional curricula in recognition that 

students with disabilities are not well prepared 

for adult life (Bouck, 2004; Cronin, 1996; 

Dever & Knapezyk, 1997; Polloway, Patton, 

Smith, & Roderique, 1991). Nevertheless, 

there have been few studies conducted on 

effective curricula and strategies to help students 

with significant disabilities access the 

general education curriculum and there is 

limited knowledge about evidence-based practices 

that address general education access 

(Agran, Cavin, Wehmeyer, & Palmer, 2006; 

Nietupski, Hamre-Nietupski, Curtin, & Shirkanth, 

1997). 

In developing countries, students with disabilities 

are often taught from a functional 

curriculum to provide them with the skills and 

knowledge to participate in society (Kisanji, 

1995b). While functional skills are important, 

schools in many developing countries also focus 

on basic academic skills. 

In Tanzania, as in other developing countries, 

the non-governmental organizations 

(NGOs) and donor agencies have coordinated 

programs and provided the resources to 

help local communities and regions set up 

educational programs for people with disabil- 

256 / Education and Training in Autism and Developmental Disabilities-September 2012

ities. Scholars have argued that donor agencies 

frequently did not take local culture and 

interests into account in the past, even when 

implementing small-scale local programs 

(Chaudhry & Owen, 2005; Kalyanpur, 1996). 

Donor agency-sponsored programs have often 

come directly from the West, and have been 

transplanted to developing countries. They 

have been implemented by a mixture of local 

staff and imported consultants. Because the 

donors have provided the funding, they have 

had the ability to influence the types of programs 

used (Kisanji, 1998). In many cases, the 

programs implemented combined curricula 

and pedagogy used in the schools for typically 

developing students and were based on the 

needs of typically developing students and 

pedagogical practices common to the school 

systems from developed countries. These curricula 

and pedagogy did not address local context 

or specifically look at what was needed for 

students to be successful in their daily lives, 

such as instruction in a functional curriculum. 

The curricula tended to focus on rote academic 

instruction (Stone-MacDonald, 2010). 

Special Education in Tanzania 

In many African countries, people with disabilities 

receive few of the many services provided 

to other society members due to a variety 

of cultural beliefs about disability, lack of 

money and resources, and economic priorities 

that marginalize people with disabilities in favor 

of those believed to be more able to contribute 

to the economic growth of the countries 

(Deku, 2002; Ingstad, 1995; Kristensen, 

Omagor-Loican, & Onen, 2003). In Tanzania, 

this is especially true. People with disabilities 

have fewer opportunities and options for life 

in their communities (Stone-MacDonald, 

2010). However, the spirit of Ujamaa, the system 

of socialism aimed at enhancing communities 

and communal cooperation in Tanzania, 

has given some people with disabilities 

more opportunities than people with disabilities 

in other African countries. 

Many communities in Tanzania do not have 

the support personnel or the services available 

to meet the needs of all individuals with disabilities. 

Children with disabilities lack both 

adequate medical and educational services 

(Ihenacho, 1985). Nevertheless, the govern- 

ment of Tanzania has committed on paper to 

provide health and educational services to 

people with disabilities (Ministry of Labour 

Youth Development and Sports, 2004). 

Each year progress has been made to understand 

the issues faced by people with disabilities 

in Tanzanian society and to address 

those needs, starting by educating more children 

with disabilities and training teachers to 

be special educators. There are educational 

opportunities and schools for Tanzanian children 

with disabilities, but those options are 

limited and may not be preparing them for 

the transition to adult life and participation in 

their communities. According to the 2002 

census, there are approximately 34,569,232 

people in Tanzania. Of those people, about 10 

percent have disabilities, similar to the estimate 

by the World Health Organization 

(WHO) (United Republic of Tanzania, 2003). 

Nevertheless, in 2005 only 1% of students with 

any kind of disability attended school (Karakoski 

& Stroem, 2005). In a study of special 

education services in Tanzania in 2005, researchers 

found that only 821 teachers had 

credentials to teach students with special 

needs and none of those teachers held bachelors’ 

degrees. Since that time, two higher 

education programs in Tanzania have started 

offering bachelor’s degrees in special education 

and the first class of students will graduate 

in October 2011. 

This ethnographic case study was conducted 

at the Irente Rainbow School (IRS) in 

Lushoto, Tanzania during 2008–2009. The 

purpose of the study was to explore how local 

context and beliefs about disability played a 

role in how participants understood their 

roles at the school and how the curriculum 

was implemented. By analyzing this particular 

case of how disability and special education 

are understood within a local context, a 

deeper understanding of the role of local context 

in the United States and other countries 

can be achieved. The following research questions 

focused my study: (a) What are the local 

funds of knowledge about disability and the 

role of people with disabilities in the community 

in Lushoto, Tanzania? (b) How are these 

funds of knowledge manifested in curriculum 

and daily teaching practices at the Irente Rainbow 

School? (c) How do the interactions 

between the Irente Rainbow School and the 


Lushoto community illustrate beliefs about 

disability in this community? 

Method 

Research Design 

The ethnographic case study aimed to explain 

how the school activities and curriculum reflected 

local culture and needs in this rural 

Tanzanian community. To develop this ethnography, 

I observed and participated in the 

daily activities of the school and community 

for a total of 13 months over two research 

periods; I conducted interviews using a representative 

sampling of parents, teachers, and 

community members; I collected documents 

relevant to daily work at the school, life in the 

community, and the development of the local 

and national curricula; and I used video and 

feedback interviews to record additional data 

at the school and check my understanding. I 

also employed several techniques to ensure 

credibility of my findings, which will be discussed 

below. Constructivist grounded theory 

methodology was determined to be most appropriate 

for capturing the experiences and 

perceptions of the teachers, students, family 

members, and community members in order 

to gather a richer understanding of the total 

context (Charmaz, 2006). This methodology 

allows a researcher to identify a process or 

phenomenon to study and focus on a few key 

local concepts or features (Glaser & Strauss, 

1967). 

Grounded theory allowed me to accurately 

develop categories and explain the experiences 

of the particular case under investigation 

and then to make general statements that 

may be useful in similar situations. Using this 

methodology, preconceived categories were 

avoided initially. Initial data analyses lead to 

emerging categories and themes. The categories 

rose out of the data and were recorded 

using in vivo codes. In vivo codes are terms 

used as codes that are taken directly from 

participants’ words and actions (Glaser & 

Strauss, 1967; Strauss & Corbin, 1998). Coding 

continued until clear themes emerged 

and categories became saturated. Follow-up 

interviews and continuous observation were 

used to verify the hypothesized themes and 

data to support the themes. I used triangula- 

tion to confirm themes as well as to validate 

my data between sources, using interviews, observations, 

and document analysis. 

This approach allowed me to capture the 

uniqueness of the situation, gather a richer 

understanding of the total context, and make 

assertions that may be applicable in other settings. 

To understand the context, one must 

explore how the participants’ world is constructed 

and the processes therein (Charmaz, 

2005b). 

Context of the Study 

Founded in 2005, Irente Rainbow is unique in 

Tanzania as a special school for children with 

developmental disabilities because the students 

live with their families, as opposed to 

attending a boarding school. The skills that 

the students learn at school are immediately 

transferred to life at home. The school curriculum 

is purposefully designed to prepare students 

to become productive members of the 

local rural community through an emphasis 

on the local environment and culture. 

Irente Rainbow School in Lushoto, Tanzania, 

a rural town of approximately 10,000 people, 

currently serves 28 children, aged 6–25, 

with developmental disabilities including 

mental retardation, autism, hydrocephalus 

and cerebral palsy. Although the local Lutheran 

Church founded the school, approximately 

half the children are Christian, while 

the other half are Muslim. The school aims to 

provide students with the academic, vocational, 

social, and cultural knowledge and 

skills to be active members of the community. 

Therefore, local context and cultural beliefs 

about disability are vitally important to understand 

regarding the design and implementation 

of the curriculum. 

Formalized special education is relatively 

new in Tanzania and this is the first school for 

children with developmental disabilities in the 

area. The school started in 2005. Most students 

at IRS did not attend school before 

2005, because public primary schools would 

not accept them. 

Data Collection and Analysis 

Interviews were conducted with 15 families, 13 

school staff, and four local leaders. Informal 


discussions were held with 12 additional 

teachers and families. I used a representative 

sampling of teachers, parents, and community 

members to document experiences across socioeconomic 

status and age and severity of a 

child’s disability. Observation, interviews, and 

document collection occurred over my entire 

research period. 

Data analysis occurred throughout the 

study using the constant comparison method 

from the tradition of constructivist grounded 

theory for data analysis (Charmaz, 2005a, 

2006; Glaser & Strauss, 1967; Strauss & 

Corbin, 1990). In this case study, the educational 

process for students at the Irente Rainbow 

School was the focus. Key concepts included 

cultural beliefs about disability, various 

influences on the curriculum, and the participation 

of the students in the local community. 

Initial decisions about data collection 

were guided by my knowledge of the phenomenon 

and further decisions about data collection 

were made during the process based on 

the analysis of data gathered (Glaser & 

Strauss, 1967). 

To ensure credibility of my findings, I utilized 

prolonged engagement in the field including 

daily visits to the school over ten 

months, participant observation, interviews, 

and document collection. I also used a research 

assistant to help with transcription and 

translation to check for the accuracy of meanings. 

Finally, I used five peer debriefers, who 

had knowledge of special education, research 

methodology, and the school and local community, 

to review the data and coding. To 

ensure the validity of the data I used five strategies 

outlined by McMillan and Schumacher 

(2006): prolonged time in the field; in-depth 

interviews; triangulation of interviews; observation, 

and documents; member checks; and 

peer debriefing. 

Results 

Conceptual Framework 

Using grounded theory, a unique conceptual 

framework that combines the work of three 

groups of scholars explaining the global and 

local forces impacting the school, community, 

the curriculum, and the pedagogy emerged. 

Bronfenbrenner’s bioecological model (1992) 

was employed to explain how community 

characteristics on a global level influence the 

views of disability and community life. Within 

the local context, the content of the curriculum 

at IRS is based on local funds of knowledge 

important to family life and local culture. 

Funds of knowledge illuminate the 

critical skills necessary for survival and success 

as members of the Lushoto community 

(González, Moll, & Amanti, 2005). Figure 1 

represents the overall model of the study 

showing the relationships among Bronfenbrenner, 

funds of knowledge, and Rogoff’s 

cultural traditions of instruction (Stone-Mac- 

Donald, 2010). 

To understand the pedagogy of the school, 

I examined the instructional traditions described 

by Rogoff and colleagues (2007). At 

the school, they use the instructional model of 

intent community participation to teach social 

and vocational skills. In this model, adults and 

students work together on daily activities in 

their community and learning occurs through 

feedback, modeling, and participation. On 

the other hand, math and literacy were taught 

using rote methods based on assembly-line 

instruction (which is the common form of 

teaching employed in most Tanzanian public 

schools). This model views the teacher as the 

expert, pencil and paper activities are common, 

and students demonstrate their knowledge 

through questions and answers. 

At the Irente Rainbow School, the teachers 

utilized and augmented the “funds of knowledge” 

the students gain from family and the 

community. Gonzalez et al. (2005) define 

“funds of knowledge” as “historically accumulated 

and culturally developed bodies of 

knowledge and skills essential for household 

or individual functioning and well-being” (p. 

72). In order to be successful participants in 

the community, Irente Rainbow School teachers 

“must look beyond the school itself to 

understand local meanings and the impact of 

schooling” (Gonzalez et al., p. 40). While students 

with disabilities may be seen as lacking 

basic skills and “viewed with a lens of deficiencies 

[and as] substandard in their socialization 

practices, language practices, and orientation 

toward scholastic achievement,” the acquisition 

and application of these funds of knowledge 

may help them to be more successful 

members of society (Gonzalez et al., p. 34). At 


Irente Rainbow School, funds of knowledge 

inform teaching practices to provide locally 

and culturally relevant lessons. The understanding 

of community funds of knowledge 

informs the preparation of students with disabilities 

for integration into their communities 

after schooling. 

Each community has a different set of skills 

and knowledge that need to be acquired to 

participate socially and economically in daily 

life. Table 1 shows an extensive list of the 

community funds of knowledge important in 

Lushoto that informed teaching and learning 

in the school and community. 

This list illustrates the knowledge that is 

most important for all individuals to have to 

participate as culturally, socially, and economically 

active members of the community. In 

Lushoto, self-care and vocational skills are 

the most important skills to have for daily 

life. Academic skills are also important, but it 

is possible to survive and work with minimal 

skills–functional literacy and functional 

Figure 1. Visual Representation of the Study. 

knowledge of money. One student’s mother 

made and sold charcoal to support her five 

children and two grandchildren without a 

husband. Her children helped her, but she 

was unable to read or write. A member of the 

school staff helped me to explain the intricacies 

of informed consent to this mother in her 

local language. She could recognize money 

and exchange it in the denominations with 

which she commonly worked in her business. 

Beyond her work, she bartered for some of 

her goods and grew her own food at home on 

her farm. While she is living in poverty, she is 

surviving and her children have their basic 

needs met on a daily basis. To this mother, 

functional skills are more critical to survival 

than academic skills. In her experiences in 

this local community, she has not seen how 

academic skills have helped the people she 

knows to do any better than she does in life. 

Opportunities are simply limited and functional 

skills are most important to be success- 


TABLE 1 

A Sample of Community Funds of Knowledge in Lushoto 

ful socially and economically in this community 

(Stone-MacDonald, 2010). 

Themes 

Household 

Skills 

Sewing 

Cooking 

Sweeping 

Washing dishes 

Washing the floor 

Setting the table 

Fetching water 

Caring for children 

or elderly 

Fixing broken 

utensils/tools 

Washing clothes 

Agriculture 

Skills 

Feeding a goat 

Cleaning animal 

areas 

Using a 

machete 

Using a hoe 

Planting seeds 

Preparing a 

garden 

Harvesting 

produce 

Shucking corn 

Carrying leaves 

and produce 

Beliefs about Disability. The local beliefs and 

values about disability in Lushoto are complex 

and center around beliefs about God’s role in 

peoples’ lives. In Lushoto, most people understand 

the role of medical and health issues in 

the cause of disabilities, but people also believe 

that there is a God or another force that 

influences the medical problems. In this culture, 

people believe that God has a plan for 

everything and that having a child with a disability 

is mpango wa Mungu (God’s plan). 

While it is not easy to have a child with a 

disability, this is part of the role God designated 

in the society for the parents of children 

with disabilities, by giving them the children, 

and such parents should feel blessed. One 

father said: 

For me personally, I believe that causes of 

disability are part of God’s plan, because 

children with disabilities are not only our 

children. We Tanzanians, even in Europe, 

at another time you were surprised that 

even livestock were born with disabilities, 

but this is part of God’s plan. 

In an interview, a teacher stated that in a 

Personal 

Care Skills Social Skills 

Bathing 

Dressing 

Using the toilet 

Brushing teeth 

Washing hands 

with a 

pitcher 

Hair care 

Shining shoes 

Greeting people 

Receiving guests 

Washing hands 

for guests 

Helping neighbors 

Riddles and myths 

Singing 

Cell phone use 

Material 

Knowledge 

Carpentry 

Masonry 

Shoemaking 

Repairing tools 

and machines 

Brick making 

Plumbing 

Making charcoal 

Cutting trees 

Academic 

Skills 

Counting 

Measuring 

Writing 

Recognizing name 

Identifying/using 

money 

Reading 

Knowing days of 

week/time of day 

Knowing historical 

and current 

political figures 

Listening to stories 

passage in the book of John, Jesus commands 

his people to take care of all society and to 

support the weak and raise them up. She explained 

that the Bible tells God’s people that 

it is their responsibility to care for children 

with disabilities and that God has a plan. The 

Bible passage justifies their work. 

The children had disabilities because they 

were fulfilling a role for God. Based on strong 

religious beliefs, both Muslims and Christians 

see children with disabilities as part of God’s 

plan. Individuals talk little about curses or 

witchcraft and see these beliefs as part of their 

past. Christian and Muslim beliefs about foster 

care and support for families permeate local 

culture, but do not necessarily involve active 

membership in the community. People still 

turn to traditional healers and medical doctors 

to treat the symptoms of a child’s disability. 

School staff teaches community members 

and parents about the difference between an 

illness that can be cured and a disability that is 

permanent, but can be treated and the symptoms 

reduced after intervention, therapy, and 

education. People commonly hold both traditional 

and religious beliefs about the causes 

of disability, and these beliefs were not necessarily 

mutually exclusive in the traditional culture. 

These findings are consistent with the 

existing literature (Devlieger, 1994, 1999; 

Kisanji, 1995a; Kiyaga & Moores, 2003). Islam 


or Christianity had been interconnected with 

traditional beliefs for several decades in the 

local culture. While local beliefs systems and 

Christian belief systems required that children 

with disabilities be cared for in the families, 

this did not always happen due to shame. 

Shemweta (2008) found: 

In the [Wasambaa] culture disability is, 

therefore, held as unpleasant situation that 

exists and that must be accepted. Parents 

and the community feel compelled to take 

care of their disabled children and adults. 

. . . Due to the communal life practiced by 

the [Wasambaa], the problem and effects 

of intellectual impairment to the children 

were handled by the community, not only 

by the family or parents. If parents were not 

able to cultivate or plant seeds, due to the 

problem of the defected child, the people 

around filled the gap and brought even 

food to the particular family. 

Children are to be cared for by their families 

and protected based on cultural and religious 

beliefs, but local practice does not require 

that children with disabilities be given an education 

or active role in the community 

(Stone-MacDonald, 2010). 

Models of Disability. In the study, I considered 

four models of disability to explain how 

disability is understood in the Lushoto community. 

The medical model represented the 

most positivist view that disability is caused by 

a medical diagnosis and that problems can be 

addressed through rehabilitation services and 

medical care (Kaplan, 1999). The pluralistic 

model presented by Susan Peters looks at disability 

as a social construction which is both 

viewed and addressed with the local context 

and set of beliefs in that culture. This model, 

she argues, empowers the individual and his 

or her family to take control and make their 

own decision about how the disability will impact 

their future (Peters, 1993). 

In Lushoto, the medical model, the rehabilitation 

model, and the pluralistic model were 

all apparent in the beliefs of local stakeholders. 

People recognized that medical causes 

existed for people’s disabilities and that those 

disabilities could hinder their ability to participate 

in their community or do work. 

Despite these widely stated beliefs, the out- 

reach staff and others at the Irente Rainbow 

School believe more work is needed to persuade 

the general public in Lushoto that supporting 

individuals with disabilities to participate 

in the community is the correct path. In 

the outreach program, the staff works with 

parents and district villages to educate them 

about the rights of people with disabilities and 

how these individuals can be part of the community. 

Teachers and parents saw the school 

as a path to rehabilitation for their children. 

One church leader explained: 

The opportunity of the school or the role of 

the school in society is to show that it is 

completely possible that these children go 

to school like other children and the school 

has helped also in the education [of the 

community] through words and actions to 

see that “it is possible, it can be done” and 

indeed the meaning of the school is to push 

other schools and teachers to show respect 

for those who do this work and to recognize 

that in our district there is a school that 

provides this service. Therefore, I can say 

that in our community or in society the 

school demonstrates to the society that children 

have rights to receive an education 

like all other children. It is a school like any 

other school, therefore [Rainbow] is indeed 

showing that [to society]. 

Through educating the children at the school 

and through its work in the outreach program, 

the diocese demonstrates that it cares 

about these children and their future in the 

community. Rehabilitation would provide 

skills and knowledge to do work and participate 

socially in the community. Finally, some 

teachers and parents recognized the importance 

of their beliefs and how their local culture 

embraced these children and helped 

them find their place through education and 

knowledge of cultural practices. Several models 

of disability are present in Lushoto because 

community members themselves have different 

beliefs about disability and different understandings 

of the role of people with disabilities 

in the community. 

The Irente Curriculum. The school’s pedagogy 

can be explained through two traditions 

of instruction described as didactic instruction 

and intent community participation (Rogoff, 


et al., 2007). At the school, students are taught 

academic subjects such as math and literacy 

using didactic instruction or rote methods of 

instruction and learn this knowledge through 

lecture and direct instruction with the teacher 

as the expert. A Rainbow teacher explained 

how the students at Rainbow learned their 

numbers very slowly over a few years, when she 

taught the child the number one first, and 

then moved to two and then three. One 

teacher said: 

In class one, students begin to count 1–10, 

this is core of kindergarten, but here a child 

is doing 1–10 and this is his third year in the 

class. Therefore, you must first begin with 

one and then go to two, and then three. 

But, in Standard one [in the primary 

school], it is totally different. You are able to 

teach a student one, two, three and he/she 

will understand after you do exercises on 

one, two, three for a few days. 

The following section from field notes illustrates 

the difficulty some students have with 

counting: 

Using blocks, [the teacher] asked Sebastian 

to count 3 blocks and show what 3 is. Willy 

was supposed to show two blocks and Theo 

was supposed to show 4 blocks. When Sebastian 

was wrong, she asked the class if he 

was right, but he had shown 2. He finally got 

it on the 3rd try with help. Vincent modeled 

how to count the blocks and showed him 

how to move them to the side after he 

counted them. Willy and Jally also needed 

more than one try and scaffolding to show 

their numbers. 

In these lessons, students have fewer opportunities 

to work together and help each other in 

the learning process. In this excerpt, “sema” 

means say, so she was telling the students, “Say 

one, say two, say three,” and so on and they 

then said the number after the command. In 

the next example, a teacher showed Rose a 

picture of the letter a. 

Teacher: Herefu huu ni nini? (Which vowel 

is this?) 

Rose: No response 

Teacher: Sema “a” (Say “a”) 

Rose: A 

Teacher: Tena (again) 

Rose: A 


Rose: A 


Rose: A 

Teacher: Wote (everybody) 

Whole class: A 


Whole class: A 

This type of call and response for an individual 

student and the whole class was very 

common and occurred daily in different subjects. 

The rigidity of communication is evident, 

but it is also important to note that the 

language is in isolation and not connected to 

real tasks or how one would typically use language. 

The students can chant vowels and 

syllable patterns, but do not understand how 

those exercises connect to reading stories or 

signs in the community. 

Vocational and social skills are taught 

through intent community participation. This 

tradition supports the collective nature of the 

culture and encourages adults and students to 

learn from and support each other. These 

children can learn better through seeing and 

doing, rather than being told. Students learn 

the tasks most important to daily life, participating 

in them using the same tools and procedures 

as adults. A Rainbow teacher explained 

their participation structure: 

Smaller children learn from the bigger ones 

because we have shown the bigger ones how 

to begin and the smaller children like this 

very much. So, the students strive to go to 

the garden and continue to do the work on 

their own. Even cleaning tasks, the younger 

ones watch the older students sweep and 

mop and do it themselves. The teachers 

have stopped doing this work. The younger 

students learn a lot from the older students 

and if a younger student sees an older student 

doing something independently, they 

like to do it too. 

Students work side by side with teachers doing 

the work. Students are never forced to participate, 

but are allowed to watch. But frequently 

students want to try and help, as well as practice 

the task because their teacher and peers 


are doing the task. Furthermore, the work the 

students do at school supports the daily operation 

of the school and is not solely for practice, 

but for a purpose. Students are gaining 

and practicing skills that they use at home on 

a regular basis to contribute to their family 

socially and economically. 

The curriculum was based on the national 

curricula, the Montessori principles, and 

knowledge of local skills that were needed in 

the community. The curriculum was originally 

enacted without the national curriculum for 

students with intellectual disability, and 

school administration utilized their knowledge 

of the primary school curriculum and 

the local knowledge about farming, animal 

husbandry, cleaning, carpentry, self-care skills, 

and social skills students would need to be 

accepted in the community as active members. 

This collection of knowledge and skills 

was determined through an informal process 

by stakeholders to find the community funds 

of knowledge (González, et al., 2005; González, 

et al., 1995). Community funds of 

knowledge were then utilized in the educational 

process at the Irente Rainbow School. A 

parent explained what his child has learned 

since he came to Rainbow and his contribution 

to the family: 

He works, like when his sister is not here, if 

you tell him, he washes the dishes well and 

they are very clean. If he got work in a hotel, 

he could go there and wash dishes. He goes 

to the Mosque on Fridays and he can go by 

himself without any problems. We send him 

to the store. We can give him a piece of 

paper with the name of the item if he 

doesn’t understand and he can give it to 

the storekeeper and he will get whatever he 

needs. 

This student can support his family, but the 

family also supports his learning needs by using 

a piece of paper to write down the item. 

Together, they are both learning and participating 

in daily life. 

The School is Educating the People. The 

Irente Rainbow School has been dynamic in 

changing the beliefs of people in the local 

Irente and Lushoto community to view people 

with disabilities positively and to help support 

children with disabilities and their families. 

Educational services and support services 

through the community-based outreach rehabilitation 

program have occurred through the 

work of the church, rather than the government. 

In Tanzania, students with disabilities 

have been slow to receive their rights to an 

education and have fewer opportunities to 

participate in public primary schools if able. 

On the other hand, the local village government 

leaders in Irente and some areas of the 

outreach program have been quite supportive 

of the Rainbow School, and the outreach 

classrooms, giving more children with disabilities 

the opportunity to have an education 

even if they cannot come to Lushoto. The 

presence of the students as community members 

increases the likelihood that the community 

as a whole will accept people with disabilities 

as full members. 

Nevertheless, there are counterexamples of 

how Lushoto and Irente face difficulties in 

finding acceptance and community membership 

for students with disabilities. One local 

researcher stated, 

During the research, the researcher faced 

several problems. Some of the interviewees, 

especially in the rural areas, hesitated to 

give relevant information as they feared to 

be punished by the government, especially 

those who have children with intellectual 

impairment. Hence it was time consuming 

job to convince them that they were safe 

enough, and their information would be 

helpful to the society (Shemweta, 2008, p. 

12). 

There are church leaders and diocese employees 

who do not show respect for or value 

individuals with disabilities in their community. 

Education and disability awareness training 

needs to occur for all diocese employees if 

students are going to successfully take diocese 

jobs and participate in the diocese as active 

members. 

Is the Community Ready to Include People with 

Disabilities? The stakeholders in the school 

believe that the students can participate in the 

community and are learning the skills needed 

to participate actively in the community and 

in their families. The parents, teachers, and 

community members also believe that the 

community as a whole is not ready to give the 


students opportunities to work and be active 

adults in the community. As long as the students 

stay in their families and work or participate 

in the local areas or neighborhoods 

where they live, they will be accepted. The 

community is unsure about greater visibility 

for these students and needs more education 

and assurance about their skills and abilities. 

One church leader explained: 

The opportunity of the school or the role of 

the school in society is to show that it is 

completely possible that these children go 

to school like other children and the school 

has helped also in the education [of the 

community] through words and actions to 

see that “it is possible, it can be done” and 

indeed the meaning of the school is to push 

other schools and teachers to show respect 

for those who do this work and to recognize 

that in our district there is a school that 

provides this service. Therefore, I can say 

that in our community or in society the 

school demonstrates to the society that children 

have rights to receive an education 

like all other children. It is a school like any 

other school, therefore [Rainbow] is indeed 

showing that [to society]. 

There is still a disconnect among community 

members between having skills and being able 

to do the job. Students with disabilities from 

the school can demonstrate their skills to help 

a carpenter, clean a shop, or wash dishes, but 

thus far when school administrators try to find 

jobs for these students both in church institutions 

and in community institutions, people 

are not welcoming and worry about the risks 

of employing a person with a disability, such as 

poor behavior or reduced productivity. The 

lack of formal employment options in the 

country, particularly in rural areas, exacerbates 

this problem. 

Students can stay at home with their families 

in the extended household after school, 

but will need some way to earn money for 

basic supplies and to reduce their burden on 

their family. In this community, the needs are 

very basic, but the chances for employment 

outside the home are few and the possible pay 

is also small. Students have the best chance to 

earn money by making or growing things and 

selling them in the market. Families are sup- 

portive of their children and believe that they 

can participate in the family and community, 

but it has taken time and education to convince 

the parents and the community members. 

The children have the skills to facilitate 

participation and acceptance, but must be 

given the chance. 

Discussion and Implications 

Despite the current emphasis on evidencebased 

practice in special education (Arnove, 

2003), there is a great need to educate students 

with disabilities to be members of the 

community and to provide them with the skills 

and knowledge to be active in the community. 

Given these circumstances, curriculum must 

be responsive to the local needs of the students 

and their community, as well as individual 

needs of the students. The curriculum at 

the school, as it is enacted by the teachers, 

should reflect the community’s funds of 

knowledge. 

This research can serve both as a study to 

support the work at the Irente Rainbow 

School and a case study for understanding 

how local beliefs and practices influence curriculum 

and community integration for students 

with disabilities in other rural communities 

especially in Tanzania, throughout 

Africa and in developing countries. This study 

can help to explain the unique situation in 

Lushoto, Tanzania and be used in the development 

of a protocol for understanding the 

local context, which can be useful in other 

settings. The findings from the study also provide 

an opportunity to critically examine how 

to provide opportunities for individuals with 

disabilities in local communities for integration 

in order to support them, their families 

and their community. This study has implications 

for practice in Tanzania and the United 

States, but it also has global implications for 

teacher education and training around the 

world. The conceptual framework utilizing 

the adaptations of the three theories could be 

used to better understand the community, the 

content, and the pedagogy that could be most 

useful for particular schools, communities, or 

cultural groups. Funds of knowledge have 

been applied in several settings, but it continues 

to be an important model for learning 

about and applying relevant knowledge im- 


portant for educating students in a culturally 

responsive way. Funds of knowledge should be 

applied to more settings to understand how 

students with disabilities and their families 

who are also culturally diverse can most benefit 

from the curriculum they are learning. 

This study can also provide lessons about 

how to improve teacher training outside the 

United States by American-based professors 

and educators. When conducting training 

seminars in schools outside one’s language 

and culture, teacher trainers should attempt 

to work with the person translating before 

the presentation. The translator needs to be 

aware of what will happen in the presentation 

and the goals for the teachers. In the ideal 

situation, the trainer would work with someone 

familiar with the teachers, school, and/or 

content to provide feedback on the training 

and its cultural relevancy. 

Natural settings are important for learning 

skills used in daily life. Primary schools with 

self-contained classrooms in Tanzania can use 

the findings from this study to examine how 

their classroom settings and curricula could 

be modified to meet the needs of their students. 

Planting a garden or building a goat 

enclosure for students to practice would be 

relatively simple in a typical primary school. 

Furthermore, helping to serve tea and clean 

up would be natural activities that already occur 

and students could participate in these 

activities. Implementing the lessons learned in 

this study in a Tanzanian context would be 

feasible because several pieces are already 

available. The critical variable would be the 

buy-in of families and teachers to this mode of 

instruction (Stone-MacDonald, 2010). 

This study has applicability in the United 

States as well. First, the results show that local 

context is important and knowledge of local 

context in designing functional curricula for 

students with developmental disabilities is essential. 

A curriculum must address not only 

the various domains in functional academics, 

life skills, social skills, and vocational skills 

(Patton, Cronin, & Jairrels, 1997), but the 

manner in which these domains are addressed 

needs to reflect the local context. To accomplish 

these goals, teachers need to know the 

important community funds of knowledge 

that impact their students and their families. 

Second, classrooms should represent natu- 

ral settings for that community. Students acquire 

and maintain skills better when they 

learn and practice in community-based settings 

(Westling & Fox, 2000). In some special 

school in Tanzania, students practice cooking 

at school on wood or charcoal stoves because 

these are the two most common (and economical) 

ways to cook food in Lushoto. If 

most students in a city in the United States 

would do their laundry at a laundromat, the 

school should provide machines that resemble 

laundromat machines, rather than washboards 

or a set of stacked machines with different 

controls or machines that do not use 

coins. In addition, students can benefit from 

participating in authentic work at the school 

that has purpose for them and the productivity 

of the school, as well as teaching the students 

particular work skills like answering the 

phone or filing papers. 

The current standards-based reform movement 

is pushing for the use of evidence-based 

practices for all students regardless of their 

individual characteristics, needs, culture, or 

context. While evidence-based practices may 

be important in special education, the decision 

about which specific practice to use 

should be based on the student, teacher, and 

the context. One-size-fits-all education does not 

work without context. Instruction and curriculum 

must have meaning and purpose for 

students, teachers, and the community. 

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Received: 9 August 2011 

Initial Acceptance: 12 October 2011 

Final Acceptance: 14 December 2011 




Two Approaches to Phonics Instruction: Comparison of 

Effects with Children with Significant Cognitive Disability 

Elizabeth Grace Finnegan 

St. Thomas Aquinas College 

Abstract: The effects of two systematic methods of phonics instruction for children with significant cognitive 

disability were compared. Fifty-two participants, aged 5–12 years were randomly assigned to one of three 

treatment groups: (i) a synthetic phonics instruction, (ii) an analogy phonics instruction group, and (iii) a 

control group. Participants in the synthetic and analogy phonics groups received twelve sessions of individual 

instruction. Findings suggest that for many students with significant cognitive disability systematic phonics 

instruction is beneficial. Further research should focus on the maintenance and generalization of phonics skills 

acquired by children with significant cognitive disability. 

Under the Individuals with Disabilities Act 

(IDEA, 2004), a small percentage of children 

with disabilities take alternate assessments instead 

of the general statewide assessment. 

These students are defined as students with 

significant cognitive disability (IDEA, 2004). 

Research on how best to teach core academic 

subjects to this population is sparse. Existing 

research shows that students with significant 

cognitive disability can learn and acquire new 

skills (Browder, Fallin, Davis, & Karvonen, 

2003). However, research is still needed to 

substantiate which methods of instruction are 

effective in enabling students with significant 

cognitive disability to meet standards in academic 

subjects such as reading and mathematics. 

This study compared the effects of two 

approaches to phonics instruction in teaching 

children with significant cognitive disability to 

read. 

This research was conducted while Elizabeth 

Grace Finnegan was a student in Department of 

Health and Behavioral Studies, Teachers College, 

Columbia University, New York as part of her dissertation 

requirements. Correspondence concerning 

this article should be addressed to Elizabeth 

Grace Finnegan, St. Thomas Aquinas College, 125 

Route 340, Sparkill, NY10976. Email: efinnegan@ 

stac.edu 

Effectiveness of Phonics Instruction 

Explicit, systematic instruction in phonics has 

been established as being beneficial for students 

in the beginning stages of reading and 

for students with difficulties learning to read 

(Chall, 1996; National Reading Panel, NRP, 

2000). Hoover and Gough (1990) proposed 

that “decoding” skills and linguistic comprehension 

need to be dissociated in order for 

children to gain substantial skills in either, but 

for reading to be effective they need to be 

combined. Ehri, Nunes, Stahl and Willows 

(2001) found all methods of phonics instruction 

to be effective but systematic methods 

have been found to be more effective than 

methods than were not, with synthetic instruction 

having the largest effect (d 0.45). 

There are many reasons why phonics instruction 

has not been an integral part of 

reading instruction for children with significant 

cognitive disability. Three of those reasons, 

institutional beliefs, historical exclusion 

from research studies, and strength of literature 

supporting sight word instruction, will be 

discussed. 

Institutional Beliefs 

Within the educational community there are a 

number of institutional beliefs that have 

shaped reading instruction for children with 

significant cognitive disability. A belief that 

children with cognitive disability were not ca- 

Effects of Systematic Phonics / 269

pable of learning to read, a belief that children 

needed prerequisite skills in order to 

learn to read and a belief that other skills were 

more important to learn. These beliefs originated 

in the historical treatment of individuals 

with severe disabilities (Winzer, 1993) and 

in the subsequent writings of influential researchers. 

Dolch and Bloomster (1937), for 

example, concluded that a child must have a 

mental age of seven or above to benefit from 

phonics instruction. Kliewer and Biklen 

(2001) pointed to developmental research as 

responsible for creating a curriculum founded 

upon a hierarchy of sub-skills, for example 

attending skills must be secure before more 

advanced skills such as reading are taught. 

These beliefs effectively reduced the opportunities 

for children with significant cognitive 

disability to acquire literacy skills. 

Recent surveys indicate that parents and 

teachers rate academic skills like reading, below 

skills such as communication skills, 

grooming skills and social skills (Agran, Alper, 

& Wehmeyer 2002; Flowers, Ahlgrim-Delzell, 

Browder, & Spooner, 2005) for children with 

significant disabilities. Opportunities for students 

with significant cognitive disability to 

develop literacy skills have continued to be 

replaced with lessons on functional skills, therapy 

skills, or avoided altogether (Kliewer & 

Landis, 1999). 

Historical Exclusion from Research Studies 

In past studies on reading instruction children 

with significant cognitive disability were not 

included. Chall’s (1996) major synthesis of 

research regarding effective reading instruction 

concluded that first and second graders, 

and students with a low IQ who received training 

in phonics, were ahead of their peers who 

used basal readers on word recognition and 

oral reading. In considering this synthesis retrospectively, 

it is not clear whether this includes 

students with significant cognitive disability 

or not. Low IQ could mean lowaverage, 

below average, or slow learner. 

Students with significant cognitive disability 

were not necessarily receiving schooling at the 

time this synthesis was conducted and probably 

not included in the studies. 

Children with significant cognitive disability 

continue to be excluded from major reviews 

of the literature. The NRP (2000) did not 

examine students whose IQs fell outside of 

average range because the studies involving 

these groups did not meet other criteria for 

inclusion in their analysis. Such exclusion 

makes it difficult to substantiate which methods 

of reading instruction meet the educational 

needs of children with significant cognitive 

disability. 

Literature Supporting Sight Word Instruction 

There are more published studies on sight 

word instruction for children with significant 

disabilities than phonics instruction. In a 

meta-analysis of 32 single-subject studies on 

the instruction of sight words, Browder and 

Xin (1998) found that there were considerable 

effects for sight word training. Most of 

these studies measured the number of words 

children could read correctly, and did not 

ascertain whether or not participants could 

use the words in a generalized way. In comparison, 

Joseph and Seery (2004) found only 

seven studies published over a period of 

twelve years on phonics-based instruction for 

students with significant cognitive disability. 

Phonics Instruction for Children with Significant 

Cognitive Disability 

Although research on phonics instruction for 

children with significant cognitive disability 

has been sparse, studies have shown that it can 

be effective. Four single-subject design studies 

examined the effectiveness of direct instruction 

with children with moderate intellectual 

disability. Participants in the studies had IQ 

scores of between 38–76 (Barbetta, Heward, & 

Bradley, 1993; Bradford, Shippen, Alberto, 

Houchins, & Flores, 2006; Flores, Shippen, 

Alberto, & Crowe, 2004; Waugh, Fredrick, & 

Alberto, 2009). The samples in these studies 

were small: six participants (Flores et al., 

2004), three participants (Bradford et al., 

2006), five participants (Barbetta et al., 1993) 

and three participants (Waugh et al., 2009). 

Notably, Waugh et al. (2009) conducted a 

study to determine if letter-sound correspondence 

was taught systematically would the participants 

be able to sound out new words using 

those letter sounds? The researchers found 

that participants were able to master some sets 


of words, and in the short term were able to 

read previously unseen words, but had difficulty 

recalling them over time. Students were 

only able to read a few novel words after 

twelve weeks of intervention, and it was discussed 

whether teaching letter-sound correspondence 

in isolation with no reference to 

the meaning of the words was a factor in the 

participants’ limited success. Two other studies 

demonstrated that phonics instruction 

could be effective (Bradford et al., 2006; 

Flores et al., 2004), while the fourth (Barbetta 

et al., 1993) was inconclusive. 

In addition, Conners, Atwell, Rosenquist 

and Sligh (2001) investigated the cognitive 

processes involved in phonological decoding. 

The study included children with IQ scores of 

at least 40 but less than 70, and concluded that 

the ability to rehearse phonological information 

in the working memory seemed to offer a 

better advantage in word decoding than overall 

IQ. 

A comprehensive phonics-based direct instruction 

reading program was found to be 

effective in improving early reading and language 

skills for participants with significant 

cognitive disability (Allor, Mathes, Roberts, 

Jones, & Champlin, 2010). Twenty-eight students 

in grades 1–4 (mean age of 9.46 years) 

with IQ scores ranging from 40–55 were randomly 

assigned into either a treatment or a 

control group. The treatment group received 

the intervention based on Early Interventions in 

Reading, Level 1 (Mathes & Torgesen, 2005) 

for two years. Results were significant for 

blending words and segmenting words on The 

Comprehensive Test of Phonological Processing 

(Wagner, Torgesen, & Rashotte, 1999), phonemic 

decoding on the Test of Word Reading 

Efficiency (Torgesen, Wagner, & Rashotte, 

1999) and word attack skills on The Woodcock 

Language Proficiency Battery (Woodcock, 1991), 

demonstrating that teaching phonics using direct 

instruction was effective in increasing participants’ 

word attack and other reading skills. 

Method 

Participants 

Fifty two participants, aged 5–12 years of age 

from five schools in the New York metropolitan 

area, all eligible for alternate assessment as 

determined by their Individual Education 

Plan (IEP) team and thereby considered to 

have a significant cognitive disability were included. 

Schools were selected on their willingness 

to be involved with the study. Sixty-eight 

students were invited to participate in the 

study and informed consent was secured from 

fifty-four participants’ legal guardians. Permission 

was also given for the school district to 

release IQ scores where available. Two participants 

were not included in the data analysis, 

as the researcher was not available to complete 

the intervention with them. 

Demographic information was collected 

through a survey sent home to participants’ 

parents. The mean age of the participants was 

8.661 years (SD 2.560). IQ scores were collected 

on 29 participants (M 55.96, SD 

12.65). Seven of the participants were considered 

to be non-verbal. All participants continued 

to receive reading instruction, which varied 

widely from their teacher (see Table 1). 

Participants were randomly assigned to one 

of three treatment groups: synthetic phonics 

treatment group, analogy phonics treatment 

group, or a control group. One-way analyses 

of variances (ANOVAs) showed no significant 

differences on age or IQ between the three 

treatment groups. Chi-square tests were conducted 

to compare the treatment groups on 

the categorical variables of gender and ethnicity, 

and showed no significant differences. Demographic 

information is summarized in 

Table 2. 

Design 

An experimental pretest/posttest one-way 

ANOVA design with multiple performance 

measures was used. 

Independent variable. The independent 

variable was the treatment variable or instructional 

intervention. In the synthetic phonics 

treatment condition participants learned individual 

letter sounds and how to blend them to 

make a word (e.g., /b/, /a/, and /t/ make 

bat). In the analogy phonics treatment condition, 

participants learned the sounds of common 

consonants e.g., /b/ and common 

“rimes” e.g., /at/. By combining a visual 

“rime” with common letter-sound correspondences 

participants learned to read words 

with similar patterns (e.g., bat, mat, cat). The 


TABLE 1 

Reading Programs Used to Teach Reading to Participants 

Reading Program/Instruction 

control group continued with their regular 

reading program with no additional instruction. 

Dependent variables. Measures of reading 

achievement directly related to word identification 

and decoding skills were used. Two 

subtests on Woodcock-Johnson III Diagnostic 

Reading Battery (WJIII DRB, Schrank, et al., 

2004) were used: (i) Letter-Word Identification 

measures the ability of the respondent to 

identify letters and words, (ii) Word Attack 

measures the ability of the respondent to apply 

phonic skills to decode non-words. Together 

the two tests form a basic reading skills 

Synthetic 

Phonics 

Number of Participants using Program 

Analogy 

Phonics Control Total 

Letter-sound recognition using flashcards 2 3 1 5 

Letter-sound recognition and sight-words 5 5 5 15 

Dolch Sight Words (Dolch, 1948) 0 2 1 3 

Edmark Reading Series (Edmark, 1992) 2 3 4 9 

Reading Milestones (Quigley, McNally, 

Rose, & King, 2001) 

0 1 3 4 

Merrill Reading Series (Mercer, 

Rudolph, & Wilson, 1998) 

1 1 1 3 

Wilson Reading Program (Wilson, n.d.) 0 2 0 2 

My Sidewalks-modified by teacher (Juel, 

Patatore, & Simmons, 2008) 

7 4 2 13 

Authentic Children’s Literature with 

teacher-made questionnaires 

1 1 1 3 

TABLE 2 

Demographic Characteristics of Participants 

Characteristic 

Synthetic 

(n 17) 

Treatment Group 

Analogy 

(n 18) 

Control 

(n 19) 

Female 41% 39% 41% 

Ethnicity 

Caucasian 69% 55% 70% 

African American 0% 11% 0% 

Hispanic 19% 12% 12% 

Asian 12% 0% 18% 

Other 0% 22% 0% 

cluster with a mean reliability of 0.93 in the 

age range of 5–19 years. The cluster has a 

strong correlation with the Kaufman Test of 

Educational Achievement (KTEA) (Kaufman 

& Kaufman, 1985), and the Wechsler Individual 

Achievement Test (Wechsler, 1992), evidence 

of concurrent validity. 

The initial items on the WJIII DRB tests did 

not require respondents to give verbal answers 

but required them to point to answers. Four of 

the non-verbal participants did not progress 

beyond these items. For items in which respondents 

were required to read a word, items 

were presented randomly in groups of three 

words, and read aloud by the researcher. Nonverbal 

participants were asked to point to the 

word read aloud. 

Two measures created by the researcher 

were also used. Training word identification 

measured the number of words participants 

read correctly after those words had been explicitly 

taught to and practiced by participants. 

Transfer word identification measured 

the number of words participants read correctly 

which had a similar phonetic structure 

to the training words but had not been practiced 

by participants during the study. Forty 

training words and forty transfer words were 

selected using the following procedure. The 

Dolch High Frequency Reading List (Dolch, 


TABLE 3 

Word Lists 

List No. Training Words Transfer Words 

1 at, cat, mat, pat, rat, bat, hat, sat, vat, fat 

2 fan, pan, can, tan, van an, ban, man, ran, dan 

3 it, hit, sit, fit, lit pit, kit, bit, quit, wit 

4 got, pot, hot, lot, not dot, rot, tot, cot, jot 

5 old, cold, hold, told, scold bold, gold, mold, fold, sold 

6 bank, blank, plank, sank, thank clank, rank, spank, tank, yank 

7 behind, blind, find, kind, wind bind, grind, hind, mind, rind 

8 art, artist, chart, dart, start depart, martin, part, smart, tart 

1948) and Fry’s 300 Instant Sight Words (Fry 

& Kress, 2006) were compared. Words common 

to both lists were categorized according 

to their phonetic structure, and additional 

words with the same phonetic structure were 

added to each group. Words with a common 

phonetic structure were grouped into eight 

lists and sequenced to reflect other methods 

of phonics instruction in which words are sequences 

in an order that facilitates systematic 

and cumulative learning. Words with short 

vowels were introduced first, followed by 

blends and vowel combinations in the order 

shown in Table 3. Non-verbal participants 

were presented with three words and then 

asked to point or indicate which word was 

being spoken by the researcher. 

Cronbach’s alpha was used to calculate internal-consistency 

for all four measures used 

in the study. For the first 24 items in Letter- 

Word Identification p xx’ .948, for the first 

ten items in Word Attack p xx’ .761, for the 

first ten items in training word identification 

p xx’ .924 and for the first ten items in transfer 

word identification p xx’ .924. 

Intervention 

To determine the starting point of the intervention, 

scores on the pretest for training 

words were used. If a participant read 60% or 

less of the words in a list correctly then intervention 

started with that list. If a participant 

read 80% or more of the words in a list correctly 

then pretesting continued. The intervention 

took place in the participant’s classroom, 

and was administered individually to 

participants, by the researcher who was 

trained and experienced in phonics instruction 

using sound-symbol association. Participants 

in the synthetic and analogy treatment 

groups received twelve sessions of phonics instruction, 

lasting 15–20 minutes, a time commensurate 

with instructional time recommended 

for typically developing children in 

phonics (NRP, 2000). The instruction in both 

conditions followed the same format. Participants 

were asked to imitate and practice the 

letter sounds and words presented on 5”x7” 

flashcards in bold Ariel font size 96 and read 

aloud to the participant. After practicing the 

letter sounds and words, participants were 

given a matching exercise in which they 

matched the words they had learned to pictures. 

Participants were praised for correct responses. 

For incorrect responses the sound or 

word was modeled again. 

Results 

Main Analysis 

One-way Analyses of the Variance (ANOVAs) 

were performed to compare pretest scores on 

all four dependent variables. No significant 

differences were found between the three 

treatment groups. Means in all the posttest 

measures were higher than the means in the 

pretest for all three groups (Table 4). Pearson 

r correlations for pretest and posttest measures 

of the dependent variables (Table 5) 

showed that the scores were highly correlated 

on all four measures. The pattern of pretest 

and posttest correlations for the total sample 

and each of the treatment groups support the 

assumption of linearity and homogeneity of 


TABLE 4 

Means and Standard Deviations on Dependent Variables 

Measures 

within-group regression. Analyses of the covariance 

(ANCOVAs) were used to compare the 

posttest scores of the three treatment groups 

on all four dependent variables. One-way AN- 

COVA showed no significant difference between 

the treatment groups in posttest scores 

after controlling for pretest scores on either 

Letter-Word Identification or the Word Attack. 

One-way ANCOVA for training word 

identification showed a significant difference 

between treatment groups in posttest scores 

after controlling for pretest scores, F(2,48) 

16.353, p .01. Pairwise comparisons using 

Bonferroni’s corrected values for the means 

(synthetic M 6.36, analogy M 5.29, control 

M 3.32) showed a significant difference 

between the adjusted means of the synthetic 

phonics treatment group and the control 

group. The difference between the adjusted 

Synthetic (n 17) Analogy (n 18) Control (n 17) 

Pre Post Pre Post Pre Post 

Letter-Word ID 14.59 16.24 15.28 16.78 13.82 14.06 

(11.59) (11.50) (7.29) (7.75) (9.44) (9.06) 

Word Attack 1.62 4.12 1.67 3.61 1.78 2.29 

(3.11) (5.26) (1.61) (2.33) (1.24) (2.73) 

Training Word 4.95 11.18 3.94 9.78 3.41 3.94 

(10.69) (11.24) (8.19) (9.74) (4.96) (5.73) 

Transfer Word 4.00 7.35 3.00 5.19 2.06 3.23 

(9.75) (11.04) (7.75) (7.94) (3.83) (4.08) 

TABLE 5 

Correlations of Pretest and Posttest Variables 

Synthetic Phonics 

(n 17) 

mean scores was 5.639, (ES 0.542). There 

was also a significant difference between the 

adjusted means of the analogy phonics treatment 

group and the control group. The difference 

between the adjusted mean scores was 

5.281, (ES0.508). In both the treatment 

groups (synthetic phonics and analogy phonics) 

the means were higher than the mean of 

the control group. There was not a significant 

difference between the adjusted mean of the 

synthetic phonics group and the analogy phonics 

groups. Pairwise comparisons are reported 

in Table 6. 

One-way ANCOVA for transfer word identification 

showed that there was a significant 

difference between treatment groups on posttest 

scores after controlling for pretest scores, 

F(2,48) 4.293, p .05. Pairwise comparisons 

using Bonferroni’s corrected values for 

Analogy Phonics 

(n 18) 

Control 

(n 17) 

Total Sample 

(N 52) 

Pre/Post .97** .95** .98** .96** 

Letter-Word Identification 

Pre/Post .97** .82** .72** .90** 

Word Attack 

Pre/Post .93** .94** .96** .90** 

training words 

Pre/Post .96** .88** .91** .92** 

Transfer words 

** Correlation is significant at the 0.01 level (two-tailed). 


TABLE 6 

Pairwise Comparisons on Posttest Scores for Training and Transfer Word Identification 

(I) Group (J) Group 

the means showed a significant difference between 

the adjusted means of the synthetic 

phonics treatment group and the control 

group. The difference between the adjusted 

mean scores was 3.039, (ES 0.330). Posttest 

scores were significantly higher in training 

word identification in children with significant 

cognitive disability for both the synthetic 

and analogy phonics treatment groups than 

that of the control group, with the posttest 

scores of the synthetic phonics treatment 

group being significantly higher than those of 

the analogy phonics treatment group. The 

scores of the synthetic phonics treatment 

group were also significantly higher than the 

control group in transfer word identification. 

Additional Analyses 

Two further questions arose in the course of 

the study that warranted further investigation. 

First, even though the experimental groups 

did not differ significantly from the control on 

either Letter-Word Identification or Word Attack, 

did participants’ performance on those 

measures improve over the course of the 

study? Paired-samples t tests were conducted 

to pretest and posttest scores. Significant differences 

were found between the mean of the 

pretest and the mean of the posttest for the 

synthetic phonics treatment group t(16)2.384, 

p .030, .05 and the analogy phonics 

treatment group t(17) 2.519, p .022, .05 

on Letter-Word Identification. Significant differences 

were found between the mean of the 

Mean Error 

Difference (I-J) Std. Sig. 

Training Word Identification 

Control Synthetic 5.639* 1.110 .000 

Analogy 5.281* 1.091 .000 

Synthetic Analogy .359 1.092 1.000 

Transfer Word Identification 

Control Synthetic 3.039* 1.046 .017 

Analogy 1.176 1.027 .774 

Synthetic Analogy 1.863 1.027 .228 

* The mean is significant at the .05 level. 

pretest and the mean of the posttest for all 

three treatment conditions on Word Attack; 

synthetic phonics treatment group t(16)3.955, 

p .001, .01, analogy phonics treatment 

group t(17) 6.115, p .000, .05 and 

control t(16)2.273, p .037, .05. Using 

estimated values for age and grade equivalency 

provided by the WJIII DRB (Table 7) it 

can be seen that on Letter-Word Identification 

improvement was commensurate with the 

time spent on instruction, about 12 months. 

However, on Word Attack age and grade 

equivalencies for the synthetic and analogy 

phonics treatment groups went up a full year. 

Secondly, were there individual differences 

among participants with significant cognitive 

disability in their response to systematic phonics 

instruction? Nine participants in the 

study scored zero on the pretests and posttests 

on both training word identification and 

transfer word identification. ANOVAs were 

conducted to compare these nine participants 

with the other forty-three participants in the 

study on age, IQ and pretest scores on the 

four dependent variables. There were significant 

differences on the Letter-Word identification 

pretest F(1,51) 13.264, p .05 and 

the Word Attack pretest F(1,51) 4.679, p 

.05. It was also detected that five participants 

in the study had scores greater than 20 words 

correct on the pretest for training word identification. 

ANOVAs showed there were significant 

differences between these five participants 

and all the other participants on all four 

pretests, but no significant differences were 


TABLE 7 

Means for WJIII DRB Pretest and Posttest Scores with Estimated Age and Grade Equivalencies 

Measures Synthetic (n 17) Analogy (n 18) Control (n 17) 

Mean Age 9.42 8.06 8.52 

Letter-Word Identification 

Pretest 14.59 15.28 13.824 

(6-1/K.8) (6-1/K.8) (6-0/K.7) 

Postest 16.24 16.78 14.06 

(6-2/K.8) (6-3/K.9) (6-0/K.7) 

Word Attack 

Pretest 1.83 1.67 1.78 

(5-8/K.2) (5-8/K.2) (5-1/K.0) 

Postest 4.12 3.61 2.29 

(6-9/1.4) (6-9/1.4) (5-8/K.2) 

detected on the variables of age. There was 

insufficient data to account for these differences. 

Discussion 

Significant effects were found on the measure 

of training word identification for both the 

synthetic and analogy phonics treatment 

groups compared to the control group, indicating 

that participants who received a systematic 

approach to phonics instruction outperformed 

those students who did not. No 

significant effects were found between the adjusted 

means of the two groups which received 

phonics instruction suggesting that neither 

approach was superior in increasing the number 

of words the participants could read. Significant 

effects were also found on transfer 

word identification for the synthetic phonics 

treatment groups compared to the control 

group. No significant effects were found on 

transfer word identification for the analogy 

phonics treatment group compared to the 

control group. These results imply that participants 

in the synthetic phonics treatment 

group were better able to apply the decoding 

skills they had learned during the intervention 

to words they were unfamiliar with, and support 

the findings of Waugh et al. (2009) where 

participants with intellectual disability were 

able to read novel words with a similar structure 

to those taught in the course of the study. 

However, no significant effects were found 

between the synthetic phonics treatment 

group and the analogy treatment group which 

suggests that either there are no additive effects 

to synthetic phonics instruction or that 

differences between the groups could not be 

detected due to either small sample size or the 

relatively brief length of the intervention. 

The synthetic phonics approach may have 

been more effective in teaching generalized 

decoding skills for a number of reasons. The 

approach emphasized the alphabetic code, introducing 

one letter at a time rather than a 

segment of a word. Participants could track 

each letter in a word and sound it out rather 

than having to recognize segments of word by 

sight. Slowly introducing one concept at a 

time may have been a beneficial aspect of this 

approach especially to children with significant 

cognitive disability who learn at a slower 

rate than typically developing children. Participants 

in this study were only required to read 

short one-syllable words, three to five letters 

long. The brevity of the words could also be a 

factor in participants’ success. 

For many years sight word instruction has 

been the favored method of reading instruction 

for children with significant cognitive disability. 

This study suggests that children with 

significant cognitive disability are able to benefit 

from systematic phonics instruction. The 

analogy phonics approach which more closely 

resembles sight word instruction was not 

shown to be as effective as the synthetic phonics 

approach. 

No significant differences were found between 

groups for either the measure of Letter- 


Word Identification or Word Attack on the 

WJIII DRB. Comparisons of pretest and posttest 

means revealed that participants’ scores in 

the synthetic and analogy phonics treatment 

groups did improve significantly. On Word 

Attack all three treatment groups showed significant 

gains in the means of their pretest 

and posttest scores. This would suggest that 

the classroom instruction the participants in 

the control group received allowed them to 

make adequate progress. This is inconsistent 

with findings in the main analysis which suggest 

that systematic phonics instruction was 

more effective in teaching children to read 

new words. It is possible that the gains could 

have been made due to internal threats such 

as practice effects of testing or maturation of 

the participants. The sudden increases in age 

and grade level equivalences on Word Attack 

may have been due to the fact that participants 

were receiving explicit instruction in a 

skill they had not been taught before, and 

they were applying this skill to their existing 

knowledge of letters and words. 

Limitations of the Study 

Although the results of this study suggest the 

effectiveness of systematic phonics instruction, 

homogeneity of the sample cannot be 

assumed. There may be factors related to the 

schools in this study that may differentiate 

them from other schools. It was not practical 

to analyze data to determine if differences 

existing between classes, age groups or reading 

programs concurrently used all of which 

could have influenced the results. 

A longer intervention period may have 

yielded clearer differences between the treatments 

groups if in fact they did exist, reducing 

the likelihood of a Type II error. Allor et al. 

(2010) showed more significant results in the 

effectiveness of their phonic based reading 

intervention, which was conducted over a two 

year period. The WJIII DRB may not have 

been sensitive enough to detect variation between 

the participants’ performance and 

progress resulting in an analysis that found no 

significant differences between treatment 

groups on standardized measures. 

Finally, this study used an experimental design 

to compare differences between groups. 

Experimental designs are valuable in that they 

allow us to find the most effective interventions 

for a group. Their limitation lies in that 

their results focus on the overall group benefits. 

With low-incidence populations, exceptionality 

is not unusual and this study showed 

that some participants were unresponsive to 

the intervention in that they did not make 

gains on either training word identification or 

transfer word identification. Parsing out these 

data is necessary to understand individual differences 

within the sample and to guide decisions 

on designing educational programs that 

are individualized and fit the needs of each 

child. 

Implications for Practice 

Evidence that systematic phonics design is 

beneficial to children with significant cognitive 

disability has implications for curricular 

design and for teacher training. The researcher 

found that participants maintained 

their interest in the learning activities during 

the intervention. The participants received 

one-to-one instruction and were rewarded 

with a sticker for their participation and effort. 

The sessions were short in length and 

there were a high number of opportunities for 

participants to interact with and respond to 

the learning materials. The materials were designed 

so that they were easy to read, easy to 

manipulate, and appealing to look at. These 

factors may have contributed to the success of 

the study. 

The training and transfer words for the 

study were chosen because they corresponded 

to the high frequency words found in the 

Dolch (1948) sight word list. It is important to 

acknowledge that children with significant 

cognitive disability may have a limited capacity 

to store and retrieve words, and care must be 

taken when designing curricula to ensure that 

students’ unique needs are met. The participants 

also received one-on-one instruction. 

This has implications for policy on the ratio of 

teachers to students in classrooms where children 

with significant cognitive disability are 

placed. 

Implications for Further Research 

There are many questions that still need to be 

answered in addressing how best to teach chil- 


dren with significant cognitive disability to 

read. There is a need to replicate existing 

studies with larger sample sizes. It is also important 

to isolate questions in regard to reading 

instruction so that a better picture can be 

formed on how children with significant cognitive 

disability learn to read. There may be 

factors apart from IQ, e.g. memory and attending 

skills, which can predict reading 

achievement. This may have implications for 

determining which students should receive instruction 

in phonics and other isolated reading 

skills. In regards to children with significant 

cognitive disability, the pressure to 

change how reading instruction was conducted 

came from legal mandates to include 

all children in statewide assessments. Further 

research must examine whether children with 

significant cognitive disability are reaching 

meaningful goals. Longitudinal studies are 

needed to examine whether educational reforms 

are in the best interests of children with 

significant cognitive disability. It is an issue of 

insuring “academic skills have meaningful application 

to students’ lives” (Nietupski, Nietupski, 

Curtin, & Shrikanth, 1997, p.50). 

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Received: 6 July 2011 

Initial Acceptance: 19 September 2011 





Comparing Teacher-Directed and Computer-Assisted 

Constant Time Delay for Teaching Functional Sight Words to 

Students with Moderate Intellectual Disability 

Mari Beth Coleman 

University of Tennessee 

David F. Cihak 

University of Tennessee 

Kevin J. Hurley 

Knox County Schools 

Abstract: The purpose of this study was to compare the effectiveness and efficiency of teacher-directed and 

computer-assisted constant time delay strategies for teaching three students with moderate intellectual disability 

to read functional sight words. Target words were those found in recipes and were taught via teacher-delivered 

constant time delay or through a PowerPoint presentation set up with a delay interval followed by a controlling 

prompt. These conditions were compared using an alternating treatments design. For the purposes of generalization, 

students were given the task of following recipes for snacks containing previously targeted sight words. 

Results indicated both strategies were effective; however, the teacher-directed strategy was slightly more efficient 

in terms of trials to criterion. The findings are encouraging given that students with moderate intellectual 

disability often depend on one-on-one instruction and may benefit from instruction with PowerPoint software. 

Literacy may open doors to independence 

and employment not available through other 

modalities for individuals with intellectual disability. 

Often, however, individuals with moderate 

and severe intellectual disability are 

faced with disadvantages with regard to acquiring 

literacy skills (Snell & Brown, 2006). 

Often, students with moderate intellectual disability 

have difficulty with attention including 

shorter attention span, loss of attention, distractibility 

and difficulty in attending to relevant 

stimuli (Westling & Fox, 2004). Problems 

with memory may be present including difficulties 

with storage and retrieval of information 

stored in short and long-term memory. 

This results in an individual’s inability to generalize 

and maintain skills due to a lack of 

adequate opportunity to practice a new skill 

(Westling & Fox). These learning characteristics 

often lend themselves to the student hav- 

Correspondence concerning this article should 

be addressed to Mari Beth Coleman, A416 Jane and 

David Bailey Education Complex, 1122 Volunteer 

Boulevard, Knoxville, TN 37996-3442. Email: 

mbc@utk.edu 

ing higher rates of success with functional 

rather than traditional literacy skills. 

Functional literacy, or the ability to perform 

reading and communicative tasks necessary to 

perform daily routines in various environments 

(Alberto, Frederick, Hughes, McIntosh, 

& Cihak, 2007), may provide an individual 

with an intellectual disability the ability to 

have control over choices in his life. Teaching 

literacy skills that are part of a functional 

curriculum allows students to participate in 

learning skills that can be used to enhance 

independence in their home, school and community 

(Brown et al., 1979). 

With increasing focus on standards-based 

education being set forth by the No Child 

Left Behind (NCLB) Act and the Individuals 

With Disabilities Education Improvement Act 

(IDEA), individualized education programs 

(IEP) are emphasizing goals and objectives 

directed towards teaching individuals with disabilities 

to perform chronological-age-appropriate 

functional skills in natural environments 

(Brown et al., 1980). Therefore, special 

education teachers require a need for instructional 

approaches that ensure students with 

disabilities demonstrate annual yearly prog- 


ess in a variety of subjects including reading. 

By teaching functional literacy, teachers and 

students can meet both objectives set forth by 

NCLB and IDEA. 

A variety of response-based prompting strategies 

have been shown to successfully increase 

sight word reading abilities with students who 

have moderate intellectual disability. These 

strategies include the system of least prompts 

(SLP; increasing assistance), most-to-least 

prompting (MLP; decreasing assistance), and 

antecedent prompting and fading procedures 

(Billingsley & Romer, 1983). One prompting 

procedure demonstrated to be effective in increasing 

sight word recognition is constant 

time delay (CTD). The CTD procedure was 

established as a means of shifting stimulus 

control from a prompt to the target stimulus 

through the insertion of a fixed amount of 

time between the presentation of the stimulus 

and the delivery of a controlling prompt that 

ensures the student completes the response 

correctly (Touchette, 1971). Numerous studies 

have demonstrated CTD to be an effective 

and efficient strategy for teaching sight words 

to individuals with disabilities (Gast, Ault, Wolery, 

Doyle & Beringer, 1988; Gast, Wolery, 

Morris, Doyle & Meyers, 1990). 

Another strategy demonstrated to be effective 

for teaching sight words is computerassisted 

instruction (CAI). Lee and Vail 

(2005) taught sight words to elementary-aged 

students with intellectual disability or developmental 

delays using a specialized software 

program, Word Wizard. This multimedia program 

delivered instruction with a 5-second 

time delay procedure. Instruction was successful 

in teaching sight words and incidental information. 

While this type of software offers 

many benefits, it is not readily available to 

most teachers. Another option for CAI is the 

use of PowerPoint software. 

Coleman-Martin, Heller, Cihak, and Irvine 

(2005) demonstrated the effectiveness of using 

PowerPoint software to teach reading decoding 

using the Nonverbal Reading Approach 

with three students who had severe 

speech impairments and either a physical disability 

or autism and an intellectual disability. 

Instruction was conducted across three conditions: 

teacher only, teacher and CAI, and CAI 

only. Results indicated that PowerPoint software 

can be used as an instructional tool for 

teaching reading to students with disabilities. 

Because PowerPoint software is widely available 

and easy to use, it offers many advantages over 

specialized software programs. PowerPoint presentations 

can increase a student’s opportunities 

to practice reading skills in multiple settings, 

including home for students who have a 

computer with PowerPoint or the free Power- 

Point player software (Coleman, 2009). Additionally, 

research in a small number of studies 

demonstrates that PowerPoint can be combined 

with CTD for sight word instruction. 

Yaw et al. (2011) used PowerPoint software 

with a 2-second delay to teach Dolch words to 

a sixth-grade student with Autism. During assessment 

trials, the student interacted with 

PowerPoint presentations that were visually 

identical to teaching PowerPoint’s but lacking 

auditory presentation of the words. He was 

instructed to read each word before the 2-second 

delay expired while another software 

program, GarageBand, recorded his responses. 

This intervention was effective in increasing 

word recognition at a rapid rate. Anecdotally, 

the authors noted that the student enjoyed 

interacting with the PowerPoint presentation. 

Based on this study, the authors proposed that 

PowerPoint is an effective and efficient method 

to provide increased opportunities for students 

to respond and receive feedback. 

While Yaw et al. (2011) taught traditional 

reading words via the use of PowerPoint with 

CTD, Mechling, Gast, and Krups (2007) used 

PowerPoint with 3-second CTD presented on a 

SMART Board to teach sight word reading of 

grocery words to a small group of high school 

students with moderate intellectual disability. 

This strategy was effective for teaching students 

to read target words and match grocery 

item photos to the target grocery word. Since 

the intervention occurred in a group format, 

observational learning was assessed and demonstrated 

that students were able to learn 

each other’s words and to acquire incidental 

information about target words. 

Results from these studies indicate that 

PowerPoint presentations with built-in constant 

time delay may improve word reading for students 

with disabilities. This is consistent with 

other research that indicates the effectiveness 

of CAI. One of the benefits of CAI is that it 

can provide structured independent practice 

in the classroom without requiring extensive 

Teacher-Directed and Computer-Assisted Constant Time Delay / 281

amounts of teacher supervision time. The purpose 

of this study was to compare the effectiveness 

and efficiency of two constant time 

delay interventions: teacher-directed instruction 

and computer-assisted instruction for 

teaching functional sight words to students 

with moderate intellectual disability. 

Method 

Participants 

Three elementary-aged students with moderate 

intellectual disability participated in this 

study. All students were enrolled in a rural 

pre-K through fifth-grade public school in the 

Southeastern United States. The school consisted 

of 524 students, the majority of whom 

were Caucasian. Approximately 66.8% of the 

total school population received free/reduced 

lunch including all three of the participants 

in the study. Selection criteria for participation 

in the study included: (a) receiving 

25 hours of special education services in a 

self-contained classroom weekly, (b) having 

an IEP goal that targeted functional literacy, 

(c) having no prior experience learning 

through the use of a constant time delay procedure, 

(d) scoring a low percentage of accuracy 

on a pretest of 40 functional words, and 

(e) receiving a recommendation from the 

classroom teacher. 

At the time of the study, Joe was a 10-yearold 

male identified as having a moderate intellectual 

disability with a secondary disability 

of language impairment. Using Wechsler Intelligence 

Scale for Children, Fourth Edition 

(WISC-IV), Joe had a full-scale IQ scored of 

48. He received small-group instruction due 

to high level of support needed for acquisition 

of academic skills. Joe received one hour of 

speech/language services each week. No 

adaptive behavior scores were available for 

this participant. 

When the study began, Kyle was a 12-yearold 

male diagnosed with multiple disabilities 

including autism, seizure disorder, speech/ 

language impairment, and intellectual disability. 

Using the WISC-IV, Kyle received a fullscale 

score of 46 with a verbal comprehension 

score of 59. Using the Wechsler Individual 

Achievement Test, Second Edition (WIAT-II) 

Kyle received a word reading standard score 

of 40. Kyle’s standard scores on the Adaptive 

Behavior Assessment System-Second Edition 

(ABAS-II) were a general adaptive composite 

score of 56, a conceptual score of 50, a social 

score of 61, and a practical score of 70. Kyle 

received intensive small-group instruction to 

meet his academic and social needs. Kyle also 

received one hour of occupational therapy 

and speech/language services each week. 

Jake was 10-years-old at the time of the 

study. Jake is diagnosed with a primary disability 

of intellectual disability and a secondary 

disability of speech impairment. Using the 

WISC-IV, Jake had a full-scale IQ score of 44. 

When tested using the Woodcock Johnson 

Test of Cognitive Abilities (WJ-III), Jake’s basic 

reading and broad reading skills scored 37 

and 31 respectively. ABAS-II scores indicated a 

general adaptive composite score of 70, conceptual 

score of 65, social score of 81, and 

practical score of 72. Jake also received one 

hour of speech/language services each week. 

Setting 

All phases of the study occurred in a selfcontained 

classroom for students with moderate 

to severe disabilities consisting of 11 students 

with varying intellectual disability, an 

interning teacher, a teaching assistant, and a 

classroom teacher. The interning teacher 

served as the primary researcher for all intervention 

sessions. Teacher-directed CTD intervention 

occurred in a one-to-one teacher to 

student format at a kidney-shaped table located 

on one side of the classroom. Computer-assisted 

CTD intervention occurred at one 

of two classroom computers located in the 

corner of the classroom. Dividers were placed 

between computers to limit any observational 

learning between participants. 

Materials 

Materials used during teacher-directed CTD 

consisted of 11 functional cooking words for 

each condition printed at 96-point font on a 

4 6 inch note card. Words for one condition 

targeted making an English muffin pizza and 

words for the other condition targeted making 

instant pudding. Each card contained a 

picture of the corresponding word which was 

faded after the student reached criterion us- 


TABLE 1 

Target Vocabulary Words by Condition for Each Student 

Student 

ing the preferred CTD condition. Computerdirected 

CTD used a Macintosh desktop computer 

to present a PowerPoint slideshow 

consisting of the same 11 words used during 

teacher-directed CTD for each condition. 

Words for both conditions were presented in 

lower case since those letters occur more commonly 

in books and other reading materials. 

The researcher used an audio recorder to 

verify student responses, record the duration 

of each session, and for the purposes of collecting 

data for interobserver reliability and 

procedural integrity. 

Design 

Two conditions, teacher-directed CTD and 

computer-assisted CTD, for teaching recognition 

of sight words were compared using an 

alternating treatments design. This design allows 

comparison of the effectiveness and efficiency 

of more than one intervention on the 

dependent variable (Alberto & Troutman, 

2006). The experimental conditions for this 

study were (a) baseline, (b) intervention consisting 

of comparison of teacher-directed CTD 

and computer-assisted CTD, (c) preferred 

CTD condition where sight words from the 

least efficient instructional condition were 

taught using procedures from the more efficient 

condition, (d) faded picture prompts 

where picture stimuli were removed, and 

Conditions Target Words 

TD CAI Pudding-Pizza 

Joe Pudding Pizza pour - spoon 

whisk - sauce 

Kyle Pudding Pizza bowl - tomato 

pudding - pepperoni 

Jake Pizza Pudding refrigerate - microwave 

add - heat 

serve - spread 

minute - slices 

stir - cheese 

cold - half 

milk - bread 

Note. CAI computer-assisted instruction; TD teacher-directed instruction. 

(e) generalization during which students were 

asked to read words to complete a functional 

task. 

Baseline. Students were assessed on recognition 

of 40 functional words using flashcards. 

Words targeted skills for making an English 

pizza and instant pudding (see Table 1 for a 

list of target words). Each word was presented 

and the student was asked to read the word. If 

the student could not read the word correctly, 

the word was placed in an unknown word pile. 

The researcher did not provide any feedback 

or assistance. Students were tested on the unknown 

words two more times to ensure that 

the words were unknown to him or her. Of 

the unknown words, 11 words on which the 

student received 0% correct responses were 

chosen for each task (pudding or pizza) to 

be taught during each condition (computerassisted 

or teacher-directed). To decrease the 

possibility of practice effects, and given that 

only words with 0% accuracy were selected for 

intervention, the three sessions of preassesment 

were used as baseline data. 

Intervention. Students participated in two 

instructional conditions which were counterbalanced 

to reduce possible carryover effects. 

A total of 11 target words were presented for 

each condition. The instructional conditions 

taught functional word sets that could be used 

to complete two food preparation tasks. One 

task included learning words that would allow 


the student to successfully make instant pudding, 

while the other targeted words allowed 

the student to create an English muffin pizza. 

During the teacher-directed condition, Kyle 

and Joe learned functional words for completing 

the pudding task while Jake learned the 

words for completing the pizza task. During 

the computer-assisted condition, Kyle and Joe 

learned the words for completing the pizza 

task whereas Jake learned the words for completing 

the pudding task. Table 1 lists students 

by conditions. Students participated in both 

instructional conditions until 90% or higher 

accuracy was achieved for three consecutive 

sessions in each condition. The instructional 

condition that resulted in the student reaching 

criterion in fewer sessions is referred to as 

the preferred CTD strategy. Data were collected 

using event recording and permanent 

product recoding procedures. All sessions 

were audio taped for the purposes of response 

verification, interobserver reliability and procedural 

integrity. During the teacher-directed 

CTD, the interning teacher recorded the 

number of functional sight words read correctly 

and number of words read incorrectly. 

During the computer-assisted CTD condition, 

student responses were audio taped and 

scored for correctness later. The number of 

functional sight words read correctly was divided 

by the total number of words presented 

to calculate the percentage of accuracy. 

Teacher-directed CTD. During teacher-directed 

CTD, each student was presented 11 

words per session on flashcards that contained 

the word along with a picture representing the 

word (e.g., “pour” contained a picture of a 

hand pouring from a pitcher). Each teacherdirected 

session began with the teacher saying, 

“Let’s practice reading,” followed by the 

teacher reminding students, “Remember if 

you do not know what the answer is, wait and I 

will tell you.” During the first teacher-directed 

session, a 0-sec delay was implemented in 

which the teacher presented the card, ensured 

a look response, and said “What’s the 

word?” The correct response was modeled immediately 

followed by, “What’s the word?’ to 

solicit student practice. During subsequent 

sessions, the teacher began the session as 

described, but silently counted to 4-second 

between saying, “What’s the word?” and modeling 

the correct response. To keep the con- 

ditions similar, all student responses resulted 

in modeling of the correct response and time 

for student to practice the correct response. 

After every two words were presented, the 

teacher told the students “Remember if you 

do not know what the answer is, wait and I will 

tell you.” Verbal praise for correct responses 

was not provided. Instead, at the completion 

of each session, students received verbal recognition 

for their participation. 

Computer-assisted CTD. During the computer-assisted 

CTD, the students participated in 

completing a teacher-developed CTD Power- 

Point presentation. Figure 1 displays an example 

of the PowerPoint presentation. Procedures 

were similar to the teacher-directed condition, 

except audio on all slides was prerecorded 

using the researcher’s voice. Each PowerPoint 

session began with a slide saying, “Let’s practice 

reading,” followed by a slide that reminded 

students, “Remember, if you do not 

know what the answer is, wait and I will tell 

you.” During the first session, a 0-second delay 

was used in which the computer presented the 

target word along with a representative picture, 

presented the task request, “What’s the 

word?” and immediately presented the word 

again while modeling the correct response. 

This was followed by, “What’s the word?” to 

solicit a student response. During subsequent 

sessions, the computer began the session as 

described but a 4-sec wait occurred between 

the task request, “What’s the word?” and the 

presentation of the correct response. Multiple 

PowerPoint presentations were created during 

which word order was randomized to prevent 

students learning the word order. All student 

responses resulted in modeling of correct response 

with a prompt to practice the correct 

response. After two sight words were presented 

and correctly modeled, the PowerPoint 

told students, “Remember if you do not know 

what the answer is, wait and I will tell you.” 

Student responses were recorded using a digital 

voice recorder. At the completion of each 

session, students received verbal recognition 

for their participation. 

Preferred CTD condition. The condition in 

which students reached criterion with the fewest 

trials was determined to be the preferred 

condition. Once criterion of 90% accuracy 

for three consecutive sessions was reached in 

one condition, the word list from the nonpre- 


Figure 1. Example of PowerPoint Slides used during CAI 3-Second Delay Condition. 

ferred condition (i.e., condition in which criterion 

was not met) was combined with the 

word list from the preferred condition and 

instruction continued until students reached 

criterion of 90% accuracy for three consecutive 

sessions. 

Faded Picture Prompt condition. After reaching 

criterion using the preferred CTD procedure, 

the picture stimulus was removed from 

all flashcards or PowerPoint slides. The preferred 

condition minus the pictures continued 

to be implemented similar to procedures 

described above. This phase continued until 

the students read 90% of words correctly for 

three consecutive sessions. 

Generalization. During the generalization 

phase, students read the words in order to 

prepare a snack. A task analysis (see Table 2) 


TABLE 2 

Steps for Completing Generalization Tasks 

was created consisting of steps containing 

the functional words taught to the student 

during both conditions. Both reading the 

word and performing the steps of the task 

analysis were observed and recorded. The 

interning-teacher recorded the number of 

words used correctly to make the particular 

snack. If the student correctly read and used 

the word, the teacher provided verbal praise. 

However, if the student did not read or 

use the word correctly, then the teacher 

prompted the student by reading the word. 

Prompting occurred after 5s of wait time. If 

student could not complete the step within 

the 5s, the step was recorded as incorrect and 

the student was prompted regarding that specific 

word. 

Social Validity 

Task Student Condition Steps 

Instant Pudding Kyle CAI 1. pour the pudding in a bowl 

2. add a cup of cold milk 

3. use a whisk to stir 

4. stir the pudding for a minute 

5. refrigerate for 5 minutes 

6. serve the pudding 

English Muffin Pizza Joe TD 1. put tomato sauce on half the bread 

Jake 2. spread sauce with a spoon 

3. put cheese on top 

4. add 4 slices of pepperoni 

5. heat in microwave 

6. eat the pizza 

Note. CAI computer-assisted instruction; TD teacher-directed instruction. 

At the end of the study, participants completed 

a Likert scale survey describing their 

experiences and preference for each of the 

CTD methods. The classroom teacher and 

teacher’s assistant completed a Likert scale 

survey describing their attitudes for each of 

the CTD methods along with their feelings on 

the efficiency and effectiveness for using each 

of the methods. Student responses were recorded 

and shared with both the teacher and 

teaching assistant to ensure reliability. 

Results 

During baseline, students did not read any of 

the target words correctly. During the teacherdirected 

CTD condition, the mean percentage 

of words ready correctly increased to 

78.11% and students reached criterion with a 

mean of 19 sessions. During the computerassisted 

CTD condition, the mean percentage 

of words read correctly increased to 77% and 

students reached criterion with a mean of 24 

sessions. Although the percentage of words 

read correctly was similar, students acquired 

the targeted words quicker during the teacher-directed 

condition. However, individual 

differences did occur. Table 3 displays the 

participants’ mean percentages of correct responses 

during each condition. 

Joe. During baseline, Joe did not read any 

of the target words correctly. During the 

teacher-directed CTD condition, the mean 

percentage of words read correctly increased 

to 82% and Joe reached criteria after five 

sessions. During the computer-assisted CTD 

condition, his mean percentage of words read 

correctly increased to 82% and he reached 

criterion after seven sessions. Although the 

percentage of words read correctly was the 

same, Joe acquired the targeted words more 

efficiently during the teacher-directed CTD 

condition. Therefore, the teacher-directed 

CTD procedures were re-implemented to 


TABLE 3 

Mean Percentage of Correct Responses 

Joe Kyle Jake 

TD 

% correct 82% 77.38% 75.83% 

# of sessions 5 8 6 

CAI 

% correct 82% 78% 72.8 


Preferred TD 

% correct 91% – 88.75% 

# of sessions 4 – 4 

CAI 

% correct – 90.75% – 

# of sessions – 4 – 

Faded Picture Prompt 

% correct 94% 79% 94% 


Generalization 

% correct 100% 91% 100% 

Note. CAI computer-assisted instruction; TD 

teacher-directed instruction. 

teach the words related to making a pizza. 

Joe’s mean percentage of words read correctly 

was 91% and he required four sessions to 

reach criterion. When the picture prompt was 

removed, Joe’s mean performance increased 

to 94% following three sessions. During the 

generalization phase, Joe read and completed 

100% of the task analysis correctly to make a 

pizza. See Figure 2 for Joe’s results. 

Kyle. During baseline, Kyle did not read 

any of the target words correctly. During the 



to 77.38% and Kyle reached criteria after 

eight sessions. During the computer-assisted 

CTD condition, his mean percentage of words 

read correctly increased to 78% and he 

reached criterion after seven sessions. Although 

the percentage of words read correctly 

was nearly the same, Kyle acquired the targeted 

words more efficiently during the computer-assisted 

CTD condition. Therefore, the 

computer-assisted CTD procedures were reimplemented 

to teach the words related to 

making a pudding. Kyle’s mean percentage of 

words read correctly was 90.75% and he required 

four sessions to reach criterion. When 

the picture prompt was removed, Kyle’s mean 

performance decreased to 79% but reached 

criterion in six sessions. During the generalization 

phase, Kyle read and completed 91% 

of the task analysis correctly to make instant 

pudding. See Figure 3 for Kyle’s results. 

Jake. During baseline, Jake did not read 

any of the target words correctly. During the 

Figure 2. Joe’s percentages correct of targeted vocabulary with computer-assisted instruction (CAI) and 

teacher-directed (TD) conditions. 


Figure 3. Kyle’s percentages correct of targeted vocabulary with computer-assisted and teacher directed 

conditions. 



to 75.83% and Jake reached criteria after six 

sessions. During the computer-assisted CTD 

condition, his mean percentage of words read 

correctly increased to 72.8% and he reached 

criterion after seven sessions. Although the 

percentage of words read correctly was similar, 

Jake attained the targeted words more 

efficiently during the teacher-directed CTD 

condition. Therefore, the teacher-directed 

CTD procedures were re-implemented to 

teach the words related to making a pizza. 

Jake’s mean percentage of words read correctly 

was 88.75% and he required four sessions 

to reach criterion. When the picture 

prompt was removed, Jake’s mean performance 

increased to 94% following three sessions. 

During the generalization phase, Jake 

read and completed 100% of the task analysis 

to make a pizza. See Figure 4 for Jake’s results. 


Students completed a one-on-one survey with 

the researcher to measure the social validity 

and student approval of the CTD conditions. 

All students agreed that they enjoyed using 

the computer to practice reading, thought the 

computer helped them improve their reading, 

and enjoyed making the snack. Students all 

expressed interest in using the computer 

again for reading instruction. Two out of the 

three students agreed that they enjoyed working 

individually with the teacher during teacher-directed 

CTD sessions. Kyle was the only 

participant that was unsure how he felt toward 

the teacher-directed CTD condition. He also 

was the only student who reached criterion 

more efficiently during the computer-assisted 

CTD condition. All participants expressed enjoyment 

in their participation of making the 

snack at the completion of the study. 

A teacher survey was designed to assess the 

classroom teacher and teaching assistant’s approval 

and social validity of the strategies 

used. Both teachers strongly agreed with each 

of the questions on the survey. The classroom 

teacher additionally responded that she noticed 

the participants’ increase in completion 

of other classroom responsibilities in order to 

participate in their sessions for the study. 

Interobserver Reliability and Procedural Integrity 

All sessions were recorded using a digital audio 

recorder for the purposes of interobserver 

reliability and procedural fidelity. Interobserver 

reliability and procedural fidelity data 

were collected on a minimum on 33% of sessions 

for each student. To determine the percentage 

of interobserver reliability, the num- 


Figure 4. Jake’s percentages correct of targeted vocabulary with computer-assisted (CAI) and teacher directed 

(TD) conditions. 

ber of agreements was divided by the number 

of agreements plus disagreements. Procedural 

integrity was determined by rating the researcher’s 

adherence via a checklist of intervention 

procedures. Means for interobserver 

reliability and procedural integrity were 100%. 


The purpose of this study was to compare the 

effectiveness and efficiency of teaching functional 

sight words to students with moderate 

intellectual disability using teacher-directed 

and computer-assisted constant time delay. 

Results indicated both conditions were effective 

in teaching sight word reading to all three 

students. However, the results showed two of 

the three students learned words more efficiently 

during the teacher-directed CTD condition 

in terms of trials to criterion. 

Of the three participants, the student with 

autism, Kyle, was the only student to reach 

criteria more quickly during the computerassisted 

CTD condition. This difference could 

be due to Kyle’s difficulty in maintaining 

higher teacher demands during the teacherdirected 

CTD condition compared to the 

computer-assisted CTD condition. This is consistent 

with Coleman-Martin, et al. (2005) 

which demonstrated preference for learning 

via PowerPoint for a student with autism. Fur- 

ther research may be necessary to confirm this 

finding. Alternatively, Joe and Jake both displayed 

a preference for the teacher-directed 

CTD condition. Joe’s data indicated that both 

conditions were equally effective for teaching 

sight words. He achieved 91% during the 

third session for each condition. However, in 

the teacher-directed condition, he continued 

at 91% for two more sessions, thus reaching 

criterion, while he fell back to 82% accuracy 

for one session. Therefore, teacher-directed 

CTD was only slightly more efficient for Joe. 

In terms of effectiveness, Joe reached 100% 

accuracy on his last session of computerassisted 

CTD whereas he did not reach 100% 

during teacher-directed instruction. Jake’s 

data displayed a clear fractionation between 

the two conditions after the third session. His 

data indicate that computer-assisted instruction 

may not be the best strategy for him. This 

could be due to many factors including increased 

adult attention or difficulty attending 

to computerized stimuli. Jake seemed to have 

difficulty focusing on the computer presentations 

rather than other classroom activities, 

whereas he was more attentive during teacherdirected 

instruction. Nonetheless, he was able 

to reach criterion with computer-assisted instruction. 

In terms of time efficiency, teacher-directed 

CTD sessions were shorter in average duration 


(average of 1.9 minutes during teacherdirected 

CTD condition and 2.5 minutes during 

computer-assisted CTD condition). This is 

due to the structured pace of the PowerPoint 

presentations compared to the researcher being 

able to eliminate pauses upon correct student 

responding or pauses between the end 

of one trial (word) and the next trial in the 

teacher-directed condition. Additionally, the 

PowerPoint presentations took more time to 

prepare than the flashcards. However, once 

slides for a word were created in PowerPoint, it 

was easy for the researcher to copy and paste 

them into new presentations. For teachers, 

once a PowerPoint presentation is created, it 

can be used for multiple students from year to 

year for the time investment to have a larger 

payoff. The bigger time factor was direct 

teacher instructional time. During computerassisted 

CTD, the teacher did not have to 

instruct each student individually. The Power- 

Point presentations were used to instruct multiple 

students in a one-on-one format without 

direct teacher one-on-one instruction. Thus, 

average teacher time during computer-assisted 

CTD instruction was 0 minutes as compared 

to 1.9 minutes multiplied by 3 students 

for an average of 5.7 minutes each day for 

teacher-directed CTD. 

Limitations 

There are several limitations of this study. The 

first limitation is the lack of ability to generalize 

findings given the small number of participants 

and absence of female participants. A 

second limitation stemmed from difficulties 

associated with technology. Sessions occurred 

while other students were engaged in other 

activities. Jake was easily distracted by activities 

occurring in the classroom while working on 

the computer. The time required to make the 

PowerPoint presentations was also a factor. 

Slides were created by an interning teacher. 

He reported that slides initially were timeconsuming 

but required less time to complete 

after his proficiency with PowerPoint software 

increased. A final limitation was student absences 

during the study, which could have 

possibly affected word acquisition. During the 

study, Jake received two days of out of school 

suspension between the collection of baseline 

data and the implementation of the interven- 

tion procedures. Joe also was absent quite frequently 

throughout the intervention procedures. 

Kyle’s participation and motivation 

were affected due to his behavior during other 

classroom activities. 

Future Research 

Further research is needed to verify the results 

of this study and to examine a larger number 

of participants, especially females and students 

with a variety of ability levels. Future 

research should focus on words that can be 

applied in a larger variety of activities to increase 

the utility of computer-assisted CTD in 

a variety of contexts. Future studies could include 

the use of computer-assisted CTD to 

teach chained tasks or to learn other functional 

academic skills such as money recognition, 

community survival words, etc. In addition, 

further studies should be conducted 

comparing the effectiveness of teacher-directed 

CTD and computer-assisted CTD to 

delineate which condition is most appropriate 

for students with autism. 

Conclusion 

This study extended current research by using 

individually-presented PowerPoint’s with embedded 

constant time delay for the instruction 

of recipe words for students with moderate 

intellectual disability. Previous research has 

demonstrated computer-assisted CTD to be an 

effective strategy for teaching multiplication 

facts (Wilson, Majsterek, & Simmons, 1996), 

Dolch words (Yaw et al., 2011) or grocery 

words presented on a SMART Board to a small 

group of students (Mechling et al., 2007). Additionally, 

this study is unique in that it compared 

computer-assisted and teacher-assisted 

constant time delay. Finally, this study extends 

the literature by demonstrating generalization 

of recipe words taught through a combination 

of constant time delay strategies to the task of 

food preparation. 

This study presents many possibilities for 

effective teaching strategies in a classroom setting. 

Although the teacher-directed CTD condition 

was more efficient, results indicated 

that both teacher-directed CTD and computer-assisted 

CTD strategies can be used to teach 

sight words effectively. This supports Cole- 


man-Martin et al. (2005) by demonstrating 

that, for most students, initial teaching should 

begin with teacher-directed instruction with 

computer-assisted instruction used for further 

practice and reinforcement of skill development. 

When used in conjunction with other 

forms of instruction, technology, specifically 

PowerPoint software, can strengthen a student’s 

ability to learn sight words. CTD is an effective 

and efficient method for teaching sight words 

due to the reduced amount of student guessing 

(Wolery, Ault, & Doyle, 1992). Because 

computer-assisted instruction allows the student 

to work independently, presentation of 

CTD using PowerPoint can allow instruction to 

occur while freeing the teacher to work with 

other students. This is especially beneficial 

considering that finding meaningful learning 

tasks which can be completed individually by 

students with moderate intellectual disability 

often poses a challenge to teachers. Furthermore, 

students who have computers at home 

could be afforded the opportunity to practice 

skills at home if PowerPoint presentations are 

sent home on a CD-ROM or flash drive. 

The effectiveness of computer-assisted CTD, 

student engagement during CAI sessions, and 

specified interest during assessment of social 

validity suggest that technology can be used 

effectively with students who have moderate 

intellectual disability. As technology becomes 

more sophisticated, greater possibilities of enhancing 

student learning will become possible. 

In addition, as people use technology in 

everyday life, students with moderate intellectual 

disability need to be able to do the same. 

Using PowerPoint software, a form of technology 

not generally considered for meeting the 

needs of students with moderate intellectual 

disability, may provide these students with 

unique learning opportunities that may enhance 

skill development and, thus, increase 

quality of life. 

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Received: 21 September 2011 

Initial Acceptance: 17 November 2011 

Final Acceptance: 15 January 2012 




Group Delivered Literacy-Based Behavioral Interventions for 

Children with Intellectual Disability 

Dana Keeter 

Scoggins Middle School, 

Paulding County School District 

Jessica L. Bucholz 

University of West Georgia 

Abstract: This study was conducted to examine the effects literacy-based behavioral interventions have on 

improving the behavior of students with intellectual disability. A second purpose of this study was to determine 

if literacy-based behavioral interventions could be an effective intervention strategy when used simultaneously 

with a group of students targeting the same behavior. A multiple baseline design across small groups was used 

to assess whether the group delivered story intervention would decrease the negative behaviors of the five 

participants in this study. Results showed that the behaviors decreased for all five students. 

In the early 1990s, Gray and Garand developed 

social stories to be used specifically as 

an intervention to help children with autism 

understand, correctly participate in, and respond 

to various social situations. Students 

with autism are not the only children who 

struggle with social skills deficits. Children 

with emotional behavioral disorders, attention 

deficit hyperactivity disorder (ADHD), intellectual 

disability, and learning disabilities also 

struggle with understanding and appropriately 

responding in social situations (Brown, 

2001; Hall, Peterson, Webster, Bolen, & 

Brown, 1999; Vaughn, Haager, Hogan, & 

Kouzehanani, 1992). Students with different 

disabilities have difficulties functioning in social 

situations and may benefit from a social 

story intervention. 

Gray and Garand (1993) used social stories 

that were presented to one student targeting 

one specific behavior. They developed 

suggested guidelines for writing a social 

story. According to Gray (1995), a social 

story should be an individually written story 

that describes a specific situation in which the 

child is having difficulty, social cues that are 

relevant to the situation, and expected re- 


be addressed to Jessica L. Bucholz, University of 

West Georgia, Department of Collaborative Support 

and Intervention, 1601 Maple Street, Carrollton, 

GA 30118. 

sponses to the situation. Gray also suggests 

specific types of sentences to be used when 

writing a social story along with a ratio of 

each type of sentence. Gray describes the sentence 

types as descriptive, perspective, directive, 

and affirmative. Social stories are a relatively 

easy strategy to implement with a 

student. They are not time intensive in their 

development or use and can be used for a 

wide variety of situations and behaviors (Reynhout 

& Carter, 2006). Social stories can also 

be used with individuals with a wide range of 

ages. Finally, social stories can be developed 

for children in the mild to moderate range of 

cognitive functioning and who have basic language 

skills (Gray & Garand). 

Gray and Garand (1993) developed social 

stories to help children with autism correctly 

use social skills to participate in social 

situations. Social skills are described as “the 

cognitive functions and specific verbal and 

nonverbal behaviors that an individual engages 

in when interacting with others” (Gut & 

Safran, 2002, p. 88). Difficulty in understanding 

and responding in social situations can 

occur in a number of ways, including, sharing, 

taking turns, conflict resolution, adapting to 

routines, making choices, understanding body 

language, facial expressions, and gestures 

(Gut & Safran). Gut and Safran (2002) list 

other social skills which are a critical component 

to the school setting, such as, “coping 

skills (i.e., expressing anger appropriately); 

work habits (i.e., using class time efficiently); 

Group Delivered Literacy-Based Behavioral Interventions / 293

and peer relationships (i.e., interacting appropriately 

with a variety of children on a regular 

basis)” (p. 88). 

In the literature reviewed, only seven studies 

were found that examined the use of social 

stories with individuals who had been identified 

as having disabilities other than autism. 

Of these seven studies, one of the studies (Staley, 

2001) included participants with a diagnosis 

of autism. The other participants in the 

study however, had one or more additional 

disabilities, such as learning disorders or intellectual 

disability. Moore (2004) worked with a 

student who had a learning disability but was 

also identified as having autism spectrum disorder. 

Finally, one study (Soenksen & Alper, 

2006) used social stories with a student they 

labeled as having hyperlexia, but received special 

education services under the category of 

autism spectrum disorder. Because these studies 

involved students who were identified as 

having other disabilities in addition to autism 

they were included in the following summary. 

Staley (2001) used social stories with five 

male students who were educated in a selfcontained 

special education classroom. Two 

of the participants were identified as having 

Down syndrome, one had a pervasive developmental 

disorder, one had autism, and one was 

diagnosed as having Fragile X syndrome. The 

goal was to improve the eating behaviors of 

the five participants. Specifically, the goal was 

to teach the participants to use a napkin and 

to chew food with a closed mouth. The results 

of this study found that the social story 

alone was not effective for getting the participants 

to change their eating behaviors. When 

the social story was combined with the use 

of a primary reinforcer (e.g., cereal or potato 

chips) there was an immediate positive 

change in behavior. In this case, social stories 

were not shown to be effective for individuals 

with disabilities other than autism nor 

were they effective for participants who were 

on the autism spectrum. 

Moore (2004) used a social story with a 

4-year-old boy with a learning disability, autism 

spectrum disorder, and receptive speech and 

language delays. The participant in this case 

study had difficulty with his bedtime routine. 

The boy pleaded to sleep with his mother, 

would wake in the middle of the night to demand 

milk, and would throw a tantrum if his 

demands were not met. A story was written to 

teach the young boy a new bedtime routine. 

Additionally, it reminded him of the rewards he 

could earn if he followed the new routine without 

throwing a tantrum. Moore concluded the 

intervention as a whole appeared to be effective 

at changing the participant’s sleep routine. 

However, the impact of the social story on the 

behavior is unclear due to lack of concrete data 

and the use of other reinforcers as part of the 

intervention. 

Toplis and Hadwin (2006) used a social 

story to address the lunchtime behavior of five 

students who were identified as having challenging 

behavior within a school setting. Three boys 

and two girls with an average age of 7 years 5 

months participated in the study. The researchers 

used an ABAB design to evaluate the effectiveness 

of a social story on the target behavior 

of independently walking to the school dining 

area and sitting within two minutes of being 

dismissed from class. The stories in this study 

followed Gray’s (1995) basic sentence ratio. Toplis 

and Hadwin found the social story intervention 

to be effective for three of the five children 

who participated in the study. Two of the 

children continued to require prompts to enter 

the dining room and sit as directed. 

Soenksen and Alper (2006) used a multiple 

baseline design across settings to evaluate the 

effectiveness of a social story to teach a 

5-year-old boy identified as having hyperlexia, 

who was served under the category of autism 

spectrum disorders, to appropriately gain the 

attention of his peers. The intervention was a 

combination of written and verbal cues embedded 

into a social story which was written 

to follow Gray’s (1995) guidelines. The target 

behavior was defined as verbally saying a 

peer’s name and/or looking at a peer’s face 

while talking to him or her. Results of the 

study indicated an increase in frequency with 

which the student would appropriately gain a 

peer’s attention across multiple settings (e.g., 

recess, choice time, and math). The appropriate 

behavior was maintained 49 days after the 

intervention and maintenance phases ended. 

Bucholz, Brady, Duffy, Scott, and Kontosh 

(2008) used social stories and literacy-based 

behavioral interventions (LBBI) with three 

adults with cognitive disability in the workplace 

environment. Bucholz and colleagues 

used the term LBBI for the stories that were 


used in the study that did not follow Gray’s 

(1995) guidelines in regard to sentence type 

or ratio and therefore were not technically 

social stories. One participant was a 57-yearold 

male with Down syndrome and an IQ of 30 

who worked in a job training facility. The 

second two participants worked at the same 

sheltered workshop. The second participant 

was a 48-year-old female who had severe intellectual 

disability. The third participant was a 

26-year-old female with severe intellectual disability. 

The goal of their research was to determine 

if social stories and LBBI were an 

effective strategy for individuals with intellectual 

disability in a work environment. The 

target behaviors included returning to work 

on time from break and asking for more work or 

assistance when necessary. The authors concluded 

that the social stories and LBBI were 

effective at changing the target behaviors for 

individuals with intellectual disability. Additionally, 

the change in behavior was maintained for 

the two female participants who worked at the 

same sheltered workshop setting. 

Kalyva and Agaliotis (2009) used a group design 

to evaluate the effectiveness of a recorded 

social story intervention for teaching students 

with learning disabilities to successfully resolve 

interpersonal conflicts. Sixty-three children with 

a mean age of 10 years 7 months participated in 

this study. Forty-one of the participants were 

male and 22 were females. The students were 

randomly assigned to the experimental group 

or the control group. The experimental group 

consisted of 19 boys and 12 girls while the control 

group consisted of 22 boys and 10 girls. The 

researchers read one of three different stories to 

the experimental group at each phase of the 

study. The stories were written to describe an 

interpersonal conflict and participants were 

asked what strategies they might use to handle 

the situation. The teachers of the participants 

were asked to complete the Matson Evaluation 

of Social Skills with Youngsters Teacher Form in 

order to gain information about each child’s 

appropriate and inappropriate social behaviors. 

Results of this study found that the social stories 

were effective for helping the students in 

the experimental group use more positive conflict 

resolution strategies when compared to the 

control group. Furthermore, the students in the 

experimental group continued to use more appropriate 

strategies two months after the inter- 

vention was ended while the control group continued 

to select less appropriate strategies. 

Schneider and Goldstein (2009) conducted 

one study not involving students with autism. 

Their research included three male participants 

in grades first through third. Each of the 

participants were diagnosed with language impairments, 

had impaired verbal and social 

communication, but could communicate verbally. 

These students displayed problem behaviors 

in the classroom which included 

aggression, noncompliance and impulse control. 

The students received speech and language 

therapy, but they did not receive services 

to address their problem behaviors. The 

primary target behavior addressed in this 

study was appropriately participating in the 

target activity which included following directions, 

completing work, making eye contact, 

and raising a hand. A multiple baseline design 

across participants was used to determine the 

effectiveness of the story intervention. 

Schneider and Goldstein concluded that the 

social story intervention was effective in increasing 

on-task behaviors for children with 

language impairments although the change in 

behavior did vary for each student. Positive 

changes were maintained after intervention 

ceased and the students generalized the ontask 

behavior to different activities and situations 

throughout the day. 

Almost all of these seven research studies 

concluded that social stories were an effective 

strategy to be used with participants with a 

variety of disabilities, not only those with autism 

spectrum disorders. This research indicates 

that social stories or LLBI may not 

need to be restricted to students with autism 

to be effective. Based on the limited research 

available studying the use of social stories 

with participants with disabilities other than 

autism, the need for additional research is 

warranted (Bucholz et al., 2008; Reynhout & 

Carter, 2006). 

Gray (1995) recommends for social stories 

to be specific to one individual participant, however, 

if more than one student has the same or 

similar social difficulties, it could be beneficial 

for educators to develop one story or LBBI that 

could be used by multiple children at the same 

time. Various strategies such as modeling, roleplaying 

(Stickel, 1990), video modeling (Graetz, 

Mastropieri, & Scruggs, 2006), social skills 


games (Williams White, Keonig, & Scahill, 

2007), and social skills classes (Roy, 1993) have 

been successfully implemented to increase social 

skills in a group setting. The literature reviewed 

revealed only one research study (Kalyva 

& Agaliotis, 2009) that explored the use of a 

social story or a LBBI with more than one 

individual at the same time. 

The first purpose of this study was to determine 

if LBBI are an effective intervention 

strategy when used with students with intellectual 

disability. A second purpose of this study 

was to determine if a LBBI is an effective 

intervention strategy when used simultaneously 

with a group of students targeting the 

same or similar social situation or behavior. In 

this study the term LBBI is used because the 

stories do not follow Gray’s (1998) specific 

guidelines as they were not individually written 

for only participant at one time. 

Method 

Participants and Setting 

Five middle school students participated in 

this study. All students attended a self-contained 

classroom for all academic subjects. All 

students in this class have been identified as 

having mild/moderate intellectual disability. 

Students attended connections classes (art, 

PE, home economics, etc.) in a general education 

setting with paraprofessional support. 

Students were placed in two groups. One 

group consisted of two students and the second 

group contained three students. The students 

in these groups exhibited similar behaviors 

to be targeted with the LBBI. 

Group A included two students who “called 

out” during class. Carol was a 14-year-old, female 

in the eighth grade. Her cognitive level 

was in the mild intellectual disability range as 

determined by the school psychologist. Carol 

read on a fourth grade level, while her reading 

comprehension skills were at a second 

grade level. Carol’s math skills were at a third 

grade level. Brittany, the second member of 

Group A, was a 14-year-old girl in the seventh 

grade. Her cognitive level was in the moderate 

intellectual disability range as determined by 

the school psychologist. Brittany read at the 

primer level and her math skills were at a first 

grade level. Brittany received occupational 

therapy for 45 minutes per month. 

Group B consisted of three participants who 

exhibited “off task” behaviors. Bryan was a 

16-year-old male in the eighth grade. His cognitive 

level was in the moderate intellectual 

disability range as determined by the school 

psychologist. This student was nonverbal and 

used an augmentative and alternative communication 

(AAC) device for communication. 

He also received 45 minutes of speech services 

each week. Although he had an AAC device, 

he rarely used it, preferring to point and make 

unintelligible verbalizations. Bryan was working 

on matching letters and numbers, counting 

objects, and matching functional symbols 

and signs. Connor, the second member of 

Group B, was a 12-year-old male in the sixth 

grade. His cognitive level was in the moderate 

intellectual disability range as determined by 

the school psychologist. He also received 45 

minutes of speech services each week. Connor 

read at a primer level and his math skills were 

at a first grade level. Zeke, the third member 

of Group B, was a 12 year-old male in the sixth 

grade. His cognitive level was in the mild intellectual 

disability range as determined by 

the school psychologist. Zeke read at a third to 

fourth grade level. His reading comprehension 

and math skills were at a third grade level. 

Behavioral Measures 

The stories written for these students followed 

Gray’s (1998) guidelines for sentence type and 

ratio. However, these stories differed from 

Gray’s guidelines because they were not individualized 

for one specific student; rather they covered 

a few examples of the targeted behavior in 

more generalized terms for a small group of 

students. Therefore, the interventions in this 

study are referred to as LBBI and not social 

stories. Stories were individualized in that they 

stated the name of the school, the names of the 

classroom teachers, and targeted only one specific 

behavior. The reading and comprehension 

level was kept at a basic level in order for the 

students in the group to understand the story. A 

mixture of real pictures and drawings were used 

in each story. The classroom teacher or classroom 

paraprofessional read the LBBI to the 

target group once per day in the morning prior 

to the time period where data were to be col- 


lected. Stories were read in a quiet location away 

from the other students. 

Behaviors targeted in this research study 

were blurting out behaviors and off-task behaviors. 

Blurting out behaviors were defined 

as talking without being called on by the 

teacher or paraprofessional, talking when the 

teacher or paraprofessional was talking or instructing, 

or talking while another student was 

speaking. Off-task was defined as not being engaged 

in the assignment, playing with objects 

during instruction, and/or staring at the desk or 

looking around the room during work time. 

The independent variable in this study was the 

use of a literacy-based behavioral intervention. 

Experimental Design 

A multiple baseline across groups research 

design was used to evaluate the effectiveness 

of a literacy-based behavioral intervention 

written for a small group of students. Two 

separate groups of participants targeting different 

behaviors were studied. The target behavior 

for Group A was blurting out. The target 

behavior for Group B was being on-task 

during assigned work times. Baseline data 

were collected on both groups before the 

group LBBI was initially implemented with 

either group. The data collection method utilized 

for both groups was a whole interval 

recording method. The interval period was 

10 s for observation with 5 s allowed for recording 

data for a 15 minute observation period 

each day. Data were collected three days 

per week on Monday, Wednesday, and Friday. 

In the event of a school holiday or closure, the 

data were collected the following day to maintain 

consistency in data collection. 

The first group LBBI was presented to 

Group A in the special education classroom. 

Data were collected three times per week by 

the researcher and paraprofessional on the 

effectiveness of the LBBI on each individual 

student’s behaviors in the group. Once a positive 

change was observed with the participants 

in Group A, the second LBBI was presented 

to Group B in the special education 

classroom and data were collected on the associated 

behaviors for the individual students. 

The LBBI continued to be read to Group A 

and data were still collected on Group A participants’ 

behaviors. 

Two weeks after Group A’s intervention 

phase ended and one week after Group B’s 

intervention phase ended, maintenance data 

were collected to determine if the appropriate 

behaviors for each participant had increased 

or decreased with the removal of the LBBI. 

Additionally, generalization data were collected 

by the researcher and paraprofessional 

in settings other than the special education 

classroom, such as the cafeteria, art, and during 

physical education. 

Interobserver Agreement 

The paraprofessional in the mild/moderate 

intellectual disability (MI/MO) classroom was 

trained to collect data along with the classroom 

teacher in order to provide interobserver 

agreement for the study. The classroom 

teacher/researcher instructed the paraprofessional 

on the targeted behaviors, data collection 

procedures, and interval recording procedures. 

The paraprofessional was required to 

record a positive mark if a behavior was exhibited 

at any time during the interval. The classroom 

teacher and paraprofessional practiced 

several times prior to collecting baseline data 

to maintain accuracy and consistency among 

raters. In addition, interobserver agreement 

data continued to be collected throughout the 

research study. Data were collected one day 

per week by both the classroom teacher and 

paraprofessional during the same 15 minute 

time frame to assess interobserver agreement 

for the study. 

Interobserver agreement data were collected 

once per week for 9 weeks, representing 

33% of the observations. Interobserver 

agreement was calculated by totaling the number 

of intervals which both observers recorded 

each targeted behavior, dividing that total by 

disagreements plus agreements, and multiplying 

that result by 100 to arrive at a percentage 

(Kennedy, 2005). For Brittany, the average 

interobserver agreement was 99.33%, with a 

range of 96%–100%. For Carol, the average 

interobserver agreement was 100%. For Zeke, 

the average interobserver agreement was 

100%. For Connor, the average interobserver 

agreement was 100%. For Bryan, the average 

interobserver agreement was 99.33% with a 

range of 96%–100%. 


Results 

Figure 1 depicts the rate of behavior for the 

five participants. All five participants (both 

groups A and B) demonstrated a reduction in 

Figure 1. Blurting out and off task behaviors. 

their respective disruptive behaviors after the 

LBBI was introduced, although the level of 

improvement varied for all five participants. 

The average daily percentages were calculated 


y determining the number of intervals the 

target behavior was observed during each data 

collection period divided by the total number 

of intervals and multiplying by 100. The total 

average for each phase of the study was calculated 

by totaling the data collection period 

averages over one particular phase (baseline, 

intervention, maintenance, or generalization 

phase) and dividing by the number of collections 

within the phase. For Brittany, blurting 

out was observed on average of 39.2% of the 

intervals (range 23%–52%) during the baseline 

phase. Throughout the intervention 

phase of the study, blurting out behaviors decreased 

to an average of 17% of the intervals 

(range 10–30%). This is an average decrease 

of 22.2%. For Carol, blurting out was observed 

an average of 18.3% of the intervals (range 

18%–25%) during the baseline phase. 

Throughout the intervention phase of the 

study, blurting out was observed an average of 

11.4% of the intervals (range 5–16%), an average 

decrease of 6.9%. 

The LBBI also improved the behaviors for 

the students in the second group, group B. 

For Zeke, off-task behaviors were observed an 

average of 58.6% of the intervals (range 55%– 

63%) during the baseline phase. Throughout 

the intervention phase of the study, off-task 

behaviors were observed an average of 35% of 

the intervals (range 27–50%), a decrease of 

23.6%. For Connor, off-task behaviors were 

observed an average of 45.7% of the intervals 

(range 42%–50%) during the baseline phase. 

Throughout the intervention phase of the 

study, off-task behaviors were observed an average 

23% of the intervals (range 13–45%). 

Connor’s behavior decreased an average of 

22.7% during the intervention phase. For 

Bryan, off-task behaviors occurred during an 

average of 83% of the intervals (range 78%– 

87%) during baseline. Throughout the intervention 

phase of the study, off task behaviors 

were observed during an average of 55% of 

the intervals (range <strong>47</strong>–67%), a decrease of 

28%. 

Maintenance 

Maintenance data were collected two weeks 

after the intervention phase ended for Group 

A and one week after the intervention phase 

ended for Group B. Maintenance data were 

collected on a Monday, Wednesday, and Friday. 

For Brittany, blurting out behaviors were 

observed during an average of 10% of the 

intervals (range 10–12%). This average is 7% 

less than her average during the intevention 

data collection period. For Carol, blurting out 

behaviors were observed during an average of 

5% of the intervals (no range). This average is 

6.4% less than her average (11.4%) during 

the intervention period. For Zeke, off-task behaviors 

were observed during an average of 

28% of the intervals (range 27–30%). This 

average is 7% less than his average during the 

intevention observation period. For Connor, 

off-task behaviors were observed during an 

average of 14% of the intervals (range 13– 

16%). This average is 9% less than his average 

during the intervention observational period. 

For Bryan, off-task behaviors were observed 

during an average of <strong>47</strong>% of the intervals (no 

range). This is 8% less than the average rate of 

behavior observed during the intervention observation 

period. 


Generalization data were collected once a day 

for 4 days during connection classes by the 

special education classroom teacher. The generalization 

results were consistent with the intervention 

data for each student. For Brittany, 

blurting out behaviors ranged from 10%–23% 

of the generalization observation intervals (average 

of 16.2%). Her rate ranged from 10% to 

30% during the intervention phase. For Carol, 

blurting out behaviors ranged from 5%–13% 

of the generalization observation intervals (average 

of 9.4%). Carol’s rate of behavior 

ranged from 5%–16% during the intervention 

phase. For Zeke, off-task behaviors ranged 

from 27%–50% of generalization observational 

intervals (average of 36.5%). During 

the intervention phase his behavior ranged 

also ranged from 27%–50% of the intervals. 

For Connor, off-task behaviors ranged from 

13%–33% of generalization observational intervals 

(average of 21.5%). During the intervention 

phase off-task behavior were observed 

from a low of 13% to a high of 45% of the 

observational intervals. For Bryan, off-task behaviors 

during generalization observations 

ranged from <strong>47</strong>%–63% of intervals (average 

of 56.66%). This is similar to his rate during 


the intervention phase when his off-task behavior 

ranged from <strong>47</strong>% to 67% of the observation 

intervals. Bryan was absent for one of 

the four generalization data collection dates. 


The purpose of this study was to examine the 

effects of LBBI on the behaviors of small 

groups of students with intellectual disability. 

While these stories used the sentence types 

suggested by Gray (1995) they are not true 

social stories because they were not individually 

written for only one partipant. Research 

has indicated that social stories or LBBI are 

useful for teaching new routines (Moore, 

2004), addressing work related behavior (Bucholz 

et al., 2008), or teaching conflict resolution 

skills (Kalyva & Agaliotis, 2009). 

In this study LBBI led to all participants 

demonstrating a reducation in their target behaviors. 

The greatest reduction of target behavior 

occurred for Brittany as she decreased 

her calling out from an average of 39.2% to 

18.7%. Brittany’s target behaviors continued 

to decrease even after the intervention phase 

ended (maintenance phase–average 10%). 

Also, the target behaviors continued to decrease 

in her connections classes throughout 

the study (generalization data–average 

16.2%). Bryan’s target behavior, being off 

task, reduced from a high of 83% to 60%. 

After the intervention phase ended, Bryan 

continued to decrease his target behaviors 

(maintenance phase–average <strong>47</strong>%). In addition, 

he continued to decrease the instances 

of the target behavior during his connections 

classes (generalization data–average 56.7%). 

It is believed that his results would have been 

reduced even further if he did not have frequent 

absences. Bryan was absent for 13 out of 

20 data collection dates during the baseline 

phase, two out of eight data collection dates 

during the intervention phase. Bryan was absent 

a total of 17 out of 36 data collection 

dates for the entire research study (<strong>47</strong>%). 

While the research on social stories has 

focused on students with autism, this study was 

conducted to expand the research on this type 

of intervention, specifically literacy-based behavioral 

interventions, to middle school students 

with mild/moderate intellectual disability. 

The stories were written to follow the 

sentence type guidelines suggested by Gray 

(1998), but they differ in that they are written 

to target more than one student at a time. 

One impact of these students’ intellectual disability 

was a lower level of comprehension and 

difficulty in retaining information that is read 

or heard. One recommendation would be to 

include comprehension questions after the 

story is read to ensure the participants’ understanding 

of the story. 

The positive outcomes of this research are 

especially important due to the lack of research 

that has been done on LBBI and social 

stories with students who have disabilities 

other than autism. These results indicate that 

using LBBI with students with intellectual disability 

can result in positive changes in behavior. 

Additionally, these positive outcomes are 

important because it is the first research study 

that utilized only one LBBI with a group of 

students targeting one behavior, the one 

other group study (Kalyva & Agaliotis, 2009) 

used three different stories to target social 

skill behaviors. Because of the relative ease to 

develop and implement the story strategy, the 

results of this research can expand the type of 

behaviors that can be positively impacted by 

using LBBI. 

As this is the only one of two research studies 

that has targeted a group of students, additional 

research is needed to validate the 

effectiveness of using LBBI with small groups 

of students. Additional research is also needed 

to study the effectiveness of using LBBI with 

students having disabilities other than autism. 

Limitations 

A limitation to this study is that all students are 

in the same classroom for all academic classes. 

It is unknown if results would have been different 

had the students been in different classrooms 

with different teachers. An attempt to 

remedy this limitation was to utilize the paraprofessional 

in reading the stories in a small, 

separate location. 

Another limitation was the length of the 

intervention phase. The target behaviors may 

have continued to decrease if the intervention 

phase had continued. Also, the length of time 

between the intervention phase and the maintenance 

phase could have been longer to ensure 

that the behaviors had continued to decrease 


with the removal of the intervention and continued 

to be maintained at a lower rate. 

The present study investigated whether 

LBBI would improve the behaviors for five 

students with intellectual disability. The results 

are encouraging and provide empirical 

support for the use of LBBIs for individuals 

with inteellectual disability. However, additional 

research is needed to further evaluate 

the effectiveness for LBBI for individuals with 

various types of disabilities. 

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0320-x 

Received: 29 June 2011 

Initial Acceptance: 30 August 2011 

Final Acceptance: 11 October 2011 




Using Video Modeling to Teach Young Children with Autism 

Developmentally Appropriate Play and Connected Speech 

Sarah Clifford Scheflen, Stephanny F. N. Freeman, and Tanya Paparella 

University of California, Los Angeles 

Abstract: Four children with autism were taught play skills through the use of video modeling. Video instruction 

was used to model play and appropriate language through a developmental sequence of play levels integrated 

with language techniques. Results showed that children with autism could successfully use video modeling to 

learn how to play appropriately with toys in both structured and generalized situations, although the speed with 

which the progression was made was not uniform. In addition, some children showed an increase in the 

frequency and complexity of their language used when playing. 

Lack of symbolic play is an important defining 

characteristic of children with autism spectrum 

disorders regardless of cognitive functioning 

levels (APA 1994; Thorp, Stahmer, & 

Schreibman, 1995). Play in children with autism 

has been described as delayed in rate of 

acquisition, different in complexity and form, 

repetitive and stereotypical, and lacking in 

diversity from the play of typical children 

and from children with other developmental 

disabilities (Baron-Cohen, 1987; Jarrold, 

Boucher, & Smith, 1993; Stanley & Konstantareas, 

2007; Ungerer & Sigman, 1981; Whyte 

& Owens, 1989; Wullf, 1985). Some common 

behavioral observations include obsessively arranging 

toys according to physical characteristics, 

repeating scripts, engaging in repetitive 

The authors gratefully acknowledge the assistance 

of Karla Kirshon for her tireless observations 

and coding. We thank Nisha Bansal, Kelly Goods, 

Jenny Lee, and Crystal Lee for their classroom and 

data assistance. We thank Dr. Steven Forness and 

Joanne Kim, M.Ed. for their comments on earlier 

drafts of this paper. In particular, we wish to thank 

the children and families who participated in the 

investigation. The play and language training videos 

used in this study were produced professionally by 

Teach2Talk, LLC (www.teach2talk.com). Video 

transcripts can be accessed by contacting the corresponding 

author. Correspondence concerning this 

article should be addressed to Sarah Clifford 

Scheflen, 77-4<strong>47</strong> Semel Institute for Neuroscience & 

Human Behavior, UCLA, 760 Westwood Plaza, Los 

Angeles, CA 90024-1759. 

functional acts on a toy (door opening, button 

pushing), or showing extreme fixation on one 

toy in particular, one part of a toy, or a small 

set of toys (Paterson & Arco, 2007). 

Symbolic play serves many developmental 

roles. Of particular interest however, is the 

relationship between play skills and language 

skills. Language in autism is also delayed in 

acquisition, different in complexity and form, 

repetitive and stereotypical, and lacking in diversity. 

These concerns include general delays 

in expressive and receptive language, echolalia, 

use of scripted speech and jargon in place 

of novel and natural language, and difficulties 

with abstract language. Children with autism 

also display social-cognitive deficits in their 

linguistic and communicative development, i.e., 

social and communicative gestures, pragmatics, 

initiating and maintaining reciprocal conversations, 

eye contact and exhibiting poor listening 

skills (Lord, 1985; Rutter & Garmezy, 1983; 

Sigman, Mundy, Sherman, & Ungerer, 1986). 

The concurrent correlation between language 

skills and symbolic play skills is supported 

by numerous studies. Baron-Cohen (1987) 

found that children with autism who engaged 

in symbolic play had significantly higher verbal 

mental ages than those who did not. Sigman 

and Ungerer (1984) found that both 

receptive and expressive language skills were 

related to play in children with autism (even 

though in typical children and children with 

mental retardation, only receptive language 

was related to play). 


Accordingly, recent research has investigated 

the possibility of teaching play skills to 

children with autism given the potential benefits 

of improved language development. For 

example, one study with a randomized control 

group design used a developmental sequence 

to teach play through scaffolding and adultdirected 

prompting with language as an outcome. 

This method required the instructor 

to identify the child’s current level of functioning 

within identified developmental sequences 

and then target intervention in a developmentally 

appropriate sequence (Kasari, 

Freeman, & Paparella, 2006). The child’s play 

repertoires were assessed on an adaptation 

of Lifter’s Developmental Play Assessment 

which is based on longitudinal descriptive 

studies of unstructured and structured play 

among children without disabilities (Lifter, 

Sulzer-Azaroff, Anderson, & Cowdery, 1993; 

Lifter, 2000) and was modified by Kasari et al. 

(2006) for children with autism. Significant 

improvements in both play and language 

skills were observed. Clearly, teaching play 

has potential for improving not only play development 

but for language development as 

well. 

Barton and Wolery (2008) recently reviewed 

the literature on interventions for promoting 

pretend play in children with disabilities. 

Only 16 studies were found (ten studies 

with a focus on autism), the methodologies 

were varied, and samples sizes were all below 

ten with the exception of one study (Kasari et 

al., 2006). The theoretical viewpoint of each 

study was not identified in the review and the 

review authors state that the studies did not 

describe the teaching procedure with replicable 

precision. All 16 studies, however, appeared 

to use some combination of physical, 

modeling, or verbal prompting of pretense 

behaviors. They also used prompting hierarchies, 

scripts, and typical models, and only 

one study used video modeling. 

Video modeling has been shown to be effective 

in teaching a wide variety of skills to 

children with autism. Video modeling typically 

involves the child being shown a videotape 

of a model engaging in the targeted behavior 

that the child is assisted and prompted 

to subsequently imitate. The videotape is usually 

edited to focus on specific behaviors, and 

repeated clips of the same model or multiple 

exemplars of the behavior are shown. Discrete 

trial sessions are used, followed by generalization 

probes and periodic reviews of the models 

as necessary (Hine & Wolery, 2006). Instruction 

using video modeling has been 

shown in one case to be more effective than 

live, or in vivo, modeling (Charlop & Milstein, 

1989). Researchers have advanced a number 

of theories for the efficacy of video modeling 

as an instructional technique for children with 

autism. Some reasons may be that video modeling 

plays to typical strengths of children with 

autism (including their strong memory and 

visual skills) (Charlop & Milstein). It has also 

been theorized that eliminating the social 

context associated with in vivo modeling (and, 

as suggested by Stahmer, Ingersoll, and 

Carter, 2003, avoiding failure by children who 

do not learn from social interactions) allows 

children with autism who have sensory and 

attention issues and are easily distracted, to 

filter out extraneous stimuli (Zihni & Zihni, 

2005). Many children with autism like audiovisual 

displays and readily attend to them, so 

simply watching the video models may also 

result in intrinsic reinforcement (Paterson & 

Arco, 2007). 

Video modeling may also have some structural 

advantages in that it allows the exact 

same, carefully selected model to be systematically 

repeated, avoiding accidental deviations 

in an in vivo environment. This increases the 

predictability and controllability of the model. 

Further, a wide range of models (peers, siblings 

and adults) can be used repeatedly and, 

if needed (as in the case of self-modeling), 

filtering for the most correct models can occur 

spontaneously and immediately. McCoy 

and Hermansen’s (2007) literature review of 

the type of model used in videos for teaching 

children with autism concluded that adults, 

peers, and self modeling all could be effective 

in producing positive results. Video modeling 

also allows for a wide range of naturalistic 

settings and environments that would be impossible 

or impractical to reproduce in a 

clinic or school setting. Video modeling also 

enhances generalization of the targeted skill 

through the use of multiple models featuring 

the same stimuli across a variety of naturalized 

contexts, persons and environments (Charlop- 

Christy & Daneshvar, 2003; Haring, Kennedy, 

Adams, & Pitts-Conway, 1987). Finally, video 

Video Modeling for Appropriate Play and Connected Speech / 303

modeling may be both cost and time effective, 

since the same video models can be reused 

with one child as well as with multiple children. 

Video modeling has also been shown in 

numerous studies to be an effective instructional 

methodology for developing play, but a 

number of factors still remain unexplored. 

Charlop and Milstein (1989) used video modeling 

to increase use of scripted conversation 

about toys and found generalization across 

novel conversations, toys and partners, but 

neither scripted nor novel motor play was 

studied. Taylor, Levin, and Jasper (1999) 

taught two children with autism to engage in 

play-related statements with siblings, using a 

forward chaining procedure to teach a longer 

series of comments, but focused only on playrelated 

statements and not motor play skills 

themselves. D’Ateno, Mangiapanello, and 

Taylor (2003) were able to increase a child’s 

use of complex play sequences, including 

both verbal and motor play; but no data was 

presented on generalization of the learned 

sequences to different toys or settings. Nikopoulus 

and Keenan (2003, 2004), were able to 

successfully decrease latency in initiating social 

play and increase appropriate play using 

video modeling instruction in the majority 

of their subjects, but generalization tended to 

be limited only to toys depicted in the video 

models. MacDonald, Clark, Garrigan, and 

Vangala (2005) used video modeling to teach 

thematic pretend play skills to two preschool 

children with autism but only scripted, rather 

than unscripted play, increased significantly. 

Reagon, Higbee, and Endicott (2006) extended 

the use of video modeling to teach 

pretend play skills to one participant using a 

sibling as a video model but findings were 

limited by a quasi-experimental, A-B research 

design. Hine and Wolery (2006) extended 

the findings of Charlop and Milstein (1989) 

to show that point-of-view modeling could 

also be used to teach play skills without experimenter-implemented 

reinforcement, but 

both subjects in the study were highly verbal, 

and readily imitated in vivo actions of adults 

with materials prior to intervention. Furthermore, 

the play taught was limited to two scenarios 

(gardening and cooking), and did not 

address the developmental sequence of play 

by teaching skills in a progression from more 

concrete to more abstract and imaginary acts. 

Paterson and Arco (2007) showed that video 

modeling led to increased frequency of independent 

motor and verbal play actions in two 

boys with autism using both related toys and 

unrelated toys, but both subjects showed prior 

proficiency with the toys, and the study did 

not address the developmental sequence of 

play. 

The primary aims of this investigation were 

threefold. The first aim was to extend the 

work of Kasari et al. (2006) who have shown 

that adhering to a developmental sequence is 

effective when teaching play skills to children 

with autism which in turn relates to language 

improvements. The second aim was to integrate 

the work of D’Ateno et al. (2003), Mac- 

Donald et al. (2005), and Paterson and Arco 

(2007), who have demonstrated that video 

modeling is an effective methodology to teach 

play skills to children with autism, including 

symbolic and imaginative play. The final aim 

was to integrate a language-based approach 

that incorporates specific language instruction 

and outcome into the methodology. We 

attempted to achieve these aims by using a 

multiple-baseline single-subject design on 

four children, teaching language and play 

skills through video modeling using a hierarchal 

developmental sequence and a language 

model that incorporated play-connected, 

developmentally–appropriate language. Play 

outcomes included immediate and generalized 

performance of the learned play skills 

across other environments and toys than those 

presented in the video models. Language outcomes 

focused on increased complexity of language 

used during the children’s unstructured 

play as well as standardized language 

assessments. 

Specifically, we sought to (a) teach play 

skills to children with autism through video 

modeling using a developmental sequence, 

(b) to assess generalization of play skills 

learned through this video modeling instruction 

across environments and materials, and 

(c) to assess whether and to what extent incorporating 

language in the video modeling 

could teach language skills to those children 

which would generalize across environments 

and materials. 


Method 

Participants 

Four male children participated in this investigation. 

The investigation was conducted at a 

day treatment program for children with autism. 

The program features an integrative and 

cross-disciplinary team approach to treatment. 

All four children were enrolled five days a 

week for six hours per day throughout the 

investigation. Each child received approximately 

the same treatment during the course 

of investigation, which was based on applied 

behavior analysis principles utilizing a staff 

ratio of nearly 1:1 and incorporating behavior, 

speech, recreational, and occupational therapy 

(individualized). Thus, “treatment” as a 

confounding variable was held constant. Most 

importantly, none of the children received 

separate instruction on play skills during the 

investigation. The program staff was blind to 

the hypotheses of the investigation. 

Participants were randomly selected from 

the program; two were selected from a classroom 

comprised of 2–3 year olds recently diagnosed 

with autism, and two were selected 

from a classroom comprised of children with 

increased cognitive challenges and poor language 

skills. We stratified the selection to get 

a wider range of play skills, cognitive skills and 

language skills. Informed consent was obtained 

from each of the child’s parents or 

guardians prior to admission to the investigation. 

See Table 1 for diagnosis, demographic, 

and initial developmental characteristics. 

The Preschool Language Scale, 4th Edition 

(PLS-4) was also carried out at the end of the 


Instructional Video 

A video model was created for each of the 

developmental levels of play on the Kasari et 

al. (2006) scale (Table 2), except levels 3 and 

4 were combined into one level and model, 

levels 7 and 9 were combined into one level 

and model, and levels 15 and 16 were combined 

into one level and model. These levels 

were combined due to difficulties in accurately 

and consistently assigning play acts between 

levels. Each video model depicted three 

play acts or sequences at that level of play, 

each using a different toy or set of toys, accompanied 

by scripted language which not 

only related to the modeled play act or sequence 

(e.g., “put in” when inserting a puzzle 

piece) but also consisted of a length of utterance, 

syntax and morphology appropriate for 

a typically–developing child who had 

achieved the level of play being modeled. 

All of the video models were developed 

based on the authors’ experience and were 

validated by observing the play and accompanying 

language of typically–developing children 

of various developmental levels who were 

provided with the selected toys and prompted 

to “play.” The primary author is a licensed 

clinical speech therapist with over 10 years 

experience with program development and 

speech therapy with children with autism. The 

video models were acted by the second author 

seated in a child–sized chair at the child-sized 

table in a speech therapy room. The acting 

author has over 10 years of experience engaging 

in play intervention with children with 

autism. The camcorder was focused primarily 

on the toys modeled rather than the adult 

actor (e.g., tight shots in which the toys were 

the primary focus and only the adult actor’s 

hands and arms were shown), except for the 

level 6 (Pretend Self) play video models, in 

which toys are extended towards self, and the 

combined levels 15 (Sociodramatic) and 16 

(Fantasy) play, where the entire body of the 

adult actor was included in the model. 

Experimental Design and Procedural Overview 

We used a single subject multiple baseline 

design across the four children. 

Baseline. A 15 minute free play session was 

observed to assess the child’s mastery and 

emergence level of play in a generalized setting 

(their classroom in the program) with a 

standard set of toys, including a peg board, 

puzzles, shape sorters, ring stackers, baskets, 

building blocks, a doctor kit, dress–up 

clothes, doll house with furniture and figures, 

play kitchen with food, plates and utensils, 

play farm with animals and assorted vehicles. 

The third baseline session (regardless of the 

number of baseline sessions) was in the 

speech therapy room for every child to ensure 

that their play was not specific to the environment. 

The observer used the developmental 


TABLE 1 

Demographic Characteristics 

play scale and a Mean Length of Utterance 

(MLU) was calculated. 

Instruction phase. Children were brought 

into a therapeutic environment/room twice 

weekly for 15 minutes (unless absent from the 

program). All training sessions were conducted 

in the speech therapy room. The training 

session involved video model viewing and 

structured toy play time at the table. Video 

models represented play skills at each level of 

the developmental play scale, with each video 

model also incorporating language appropri- 

Ian Jeremy Ryan Jonah 

Age in months 59 69 37 37 

First Diagnosis pediatrician parent concern psychiatrist psychiatrist 

Regional Center* Autism Autism Autism Autism 

School** 

PEP-R*** 

Autism Autism Autism Autism 

Perception 21 m 38 m 48 m 34 m 

Imitation 22 m 30 m 41 m 37 m 

Cognitive Verbal 36 m 33 m 35 m 41 m 

Cognitive Perform 

Vineland II 

39 m 31 m 29 m 48 m 

Communication 76 SS 54 SS 94 SS 76 SS 

Daily Living Skills 55 SS 53 SS 91 SS 69 SS 

Social Skills 63 SS 55 SS 82 SS 74 SS 

Motor Skills 70 SS 70 SS 93 SS 88 SS 

Composite 

PLS-4**** 

63 SS 55 SS 87 SS 73 SS 

Overall 50 SS/20 m 50 SS/25 m 92 SS/34 m 94 SS/34 m 

Auditory Comp 50 SS/22 m 50 SS/25 m 109 SS/44 m 96 SS/37 m 

Expressive Comm 50 SS/19 m 50 SS/25 m 76 SS/27 m 93 SS/35 m 

MLU between 0–1 between 0–1 between 0–1 2–3 words 

Play Levels Mastered 1 (Indisc Act) 4 (Pres. Co.) 6 (Pret. Self) 8 (Child Ag) 

2 (Discr Act) 5 (Gen. Co.) 

No initiating No initiating 

Qualitative Descrip. communication communication Sev. apraxia Requesting 

Maximum prompts No conversation/ 

for one word pragmatics Basic requests No comments 

No word 

Stereotyped 

combinations Poor verbal 

utterances No questions 

Stereotyped 

Echolalic Imitation Echolalic 

utterances 

Echolalic No comments Echolalic 

* The State Regional Center system uses a licensed clinical psychologist to determine diagnosis and 

eligibility. Autism is 299.0 DSM Category. 

** The State Education Code eligibility category is “Autism or Autistic-Like Characteristics” 

*** Psychoeducational Profile Revised (PEP-R), (Schopler et al., 1990) 

**** Preschool Language Scale, 4th Edition (PLS-4) (Zimmerman, Steiner, & Pond, 2002). 

ate for the developmental level of play modeled. 

For example, for one of the toy presentations 

at the level 8 (Child as Agent), an 

actress had a figure and sat the figure in a 

chair. The language used was, “Sit down boy.” 

Each skill was modeled with three different 

sets of toys. Each child watched a video at the 

next most advanced level, after the level in 

which the child had demonstrated mastery in 

a generalized setting. The video was shown on 

a desktop computer with a monitor measuring 

19” diagonally at a viewing distance of approx- 


TABLE 2 

Play Scale – Developmental Levels of Play – Kasari et al. (2006) 

Level Categories Definitions 

1 Indiscriminate Actions All objects are treated alike (e.g., objects are mouthed) 

Differentiates among conventional objects, preserving their 

physical characteristics, or single objects (e.g., rolls round 

2 Discriminative Actions 

beads, squeezes stuffed animal) 

Separates configurations of objects (e.g., takes all pieces out 

3 Takes Apart Combinations 

of puzzle) 

Re-creates combinations of objects according to their 

presentation configuration (e.g., puts puzzle pieces into 

4 Presentation Combinations 

puzzle; nests the nesting cups) 

Creates combinations of objects that result in simple, nonspecific 

configurations such as container/contained 

5 General Combinations 

relations (e.g., puts beads & puzzle pieces in the cup) 

Relates objects to self, indicating a pretend quality to the 

6 Pretend Self 

action (e.g., brings empty cup to mouth to drink) 

Preserves unique physical characteristics of objects in the 

Specific Combinations – 

(physical attributes) configuration (e.g., stacks nesting 

7 

Physical Attributes 

cups, strings beads) 

Extends familiar actions to doll figures, with child as agent 

8 Child as Agent 

of the activity (e.g. extends cup to doll’s mouth) 

Preserves unique conventional characteristics of object in 

Specific Combinations – 

the (conventional attributes) configuration (e.g., places 

9 

Conventional Attributes 

cup on saucer; places string of beads on self) 

Extends same familiar action to two or more figures (e.g., 

10 Single Scheme Sequences 

extends cup to baby doll, to stuffed lamb, to interactant) 

Uses one object to stand in place for another (e.g., puts 

11 Substitutions With Object 

bowl on head for a hat) 

Pretends to use something that is not there (e.g., shakes an 

12 Substitutions Without Object imaginary salt shaker) 

Moves doll figures as if they are capable of action (e.g., 

moves figure to load blocks in a truck; puts mirror into 

13 Doll as Agent 

doll’s hand as if to see itself) 

Extends different actions to same figure (e.g., feeds doll 

14 Multischeme Sequences 

with spoon, wipes it with cloth, then puts to bed) 

Adopts various familiar roles in play theme (e.g., plays 

15 Sociodramatic Play 

house, assigning the various roles 

Adopts roles of fantasy characters (e.g., plays ‘‘Superman’’ 

16 Thematic Fantasy Play 

assigning the various roles) 

imately one meter in front of the computer. 

The child watched three different toy models, 

two times each. Each toy model was approximately 

30 seconds long. Thus, the procedure 

was as follows. First, the child watched a specific 

toy being modeled by the video twice and 

then, immediately afterward, the child was led 

to a child-sized seat at a child–sized table on 

which the exact toys, or toys nearly identical to 

those modeled in the video models, were 

placed within easy reach. The child was given 

approximately two minutes to play. Second, the 

child was shown the video model again twice 

(next toy set) and then the child was brought 

to the table and those new toys were presented 

and the child was given approximately two 

minutes to play. Third, the child was shown the 

video model the third time (third set of toy 

presentations) and the child was brought back 

to the table with the third toy set and the child 

was given about two minutes to play. During 

the toy play at the table, the child was 

prompted with, “Time to play!” and the clinician 

provided no other prompts, but did pro- 


vide limited verbal reinforcement (e.g., “great 

job” or “you did it”) when the child correctly 

imitated a play act. The entirety of each training 

session was videotaped and subsequently 

reviewed by either one or two research staff 

members. 

Maintenance. Maintenance observations 

were carried out in the same therapeutic 

room (speech therapy room) where the instruction 

sessions were conducted (on the 

same day schedule as the instruction sessions 

were held). Any and all of the toys that had 

been presented were made available for the 

child. The child was permitted to play for 10 

minutes without prompts. 

Generalization. Generalization observations 

were carried out twice weekly during the training 

phase in each child’s program classroom 

for 10 minutes during the same free play time 

as the baseline observations (the classrooms 

have a specific set time during the day when 

the children can engage freely with a toy– 

approximately 10–15 minutes). This generally 

occurred on different days than the training 

days. 

Mastery. Mastery was achieved if a child 

was observed to carry out the targeted mastered 

level of play with three different toys not 

featured in the video models, both in the 

structured setting and in the generalized setting. 

All training sessions (and the third baseline 

session) were conducted in a medium-sized 

speech and language therapy room. The video 

models were shown using a desktop computer. 

A one–way mirror allowed for observation. 

All baseline (except the third baseline 

session) and generalization probes were conducted 

in the participants’ classrooms which 

were typically sized classrooms with one–way 

mirrors allowing for observation. 

Participants generally attended the program 

for 10 to 12 weeks. Thus, the participants 

had generally two training sessions and 

two generalization sessions per week of the 

treatment phase. We began with Ian. Ian’s 

instructional level was level 3 and he was thus 

taught using a level 3/4 video model. Ian 

mastered his first level at level 4 (week 3.5) 

and then Jeremy began intervention. We considered 

mastery at level 3 enough to start 

Jeremy. Jeremy mastered his first level at instructional 

trial 4 (week 5.5) and then Ryan 

began intervention. Ryan, at trial 2 (week 6), 

mastered his level and then we began Jonah. 

Ryan had a slight dip/loss, but we had already 

began Jonah and thus continued with Jonah 

while we instructed Ryan at the higher level. 

Procedural Fidelity 

We assessed the procedural fidelity of the intervention 

in two ways. First, we formally assessed 

whether the intervention procedures 

were administered with precision and consistency 

across children and sessions (Detrich, 

1999). We did so by creating a checklist that 

was used by the third author to score every 

fifth training session and every fifth generalization 

probe or maintenance probe. A single 

checklist was used, which consisted of six questions 

designed to identify whether the clinician 

followed the protocol in a training session 

and five questions designed to identify 

whether the clinician followed the protocol in 

a generalization probe or maintenance probe. 

All the checklists logged indicated that the 

protocol had been adhered to in each training 

session, generalization probe and maintenance 

probe with 100% accuracy. This is not 

surprising given the nature of the intervention, 

which required a set of very simple procedures 

to be implemented (which were implemented 

primarily by the first author). 

We also informally assessed the design of 

the intervention. Each member of the research 

staff participated in training sessions 

prior to commencement of the investigation 

to review experiment design and procedures. 

The video models utilized were not independently 

validated, but were created as a collaborative 

process in which the video models 

were rerecorded until the authors were satisfied 

that the models adhered to the scripted 

play acts and verbalizations. Finally, the video 

models were based not only on the authors’ 

experience but also on observation of typically 

developing children playing with the selected 

toys at various developmental levels. 

Dependent Variables 

Two target variables were selected for measurement: 

(a) play actions, used to derive the 

highest and the average level of play achieved 

in each session, and (b) appropriate play– 


elated utterances, which were used to derive 

the mean length of utterance (MLU) for each 

session. 

Play: Coding Measures 

The investigation used the Kasari et al. (2006) 

play scale composed of sixteen distinct developmental 

levels of play. This play scale was 

based on the developmental play scale developed 

by Karin Lifter and used in her Developmental 

Play Assessment (Lifter, 2000). Brief 

definitional summaries of the developmental 

play levels are in Table 2. It is to be noted that 

one child needed instruction at level 3 to 

begin, and that no child was instructed at level 

15/16. For level 7, the child had to master 

both level 7 and level 9 to be moved to level 8. 

Therefore, after mastering level 8, the children 

were then instructed at level 10. To 

establish reliability, prior to the start of the 

investigation, one undergraduate research 

student and the first author participated in 

group training sessions led by the second author, 

who has been deemed reliable on the 

coding system in a number of previous studies. 

Once training was complete and reliability 

was established by consensus, the undergraduate 

research student and the first author 

then coded multiple play sessions. First, they 

coded prior tapes of children who had been 

involved in previous studies on play and had 

participated in free play sessions (names removed, 

consent provided from prior studies). 

Second, they coded children in the program 

who were not participating in this investigation 

by observing them during free-play sessions 

in the classroom. The undergraduate 

research student coded all of the children. 

The first author served as a reliability standard. 

Single measure intraclass correlation coefficients 

were used to calculate reliability on 

25% of the sample (38 sessions randomly chosen 

from baseline, training, and generalization). 

Each coefficient was calculated for play 

category using the types (not frequency) of 

play displayed during that session. Coefficients 

were 1.00 for the following: Takes 

Apart/ Presentation Combinations, Substitutions 

with Object, Substitutions without Object, 

Doll as Agent, and Mutischeme Sequences. 

General Combinations .98; 

Pretend Self .97; Physical/ Conventional 

Combinations .74; Child as Agent .99; 

and Single Scheme Sequences .84. 

An appropriate play action was defined as 

the child’s performing one or more connected 

play actions using the toys provided, 

other than play at level 12 (Substitution Without 

Object), where play actions did not need 

to incorporate a provided toy if appropriate 

(e.g., pretending to play guitar). An appropriate 

play action was coded by assigning a level 

of developmental play to any play action. As a 

result, a single play action could both contain 

more than one related discrete action (e.g., 

sequences, which consisted of a series of connected 

discrete play actions) and be coded at 

more than one play level. For example, if a 

child placed a doll on a block pretending that 

the block was a bed for a doll while verbalizing 

“go to sleep,” it would be coded as two appropriate 

play actions, one play action at level 8 

(Child as Agent) for placing the doll on the 

bed, and one play action at level 11 (Substitution 

With Object) for substituting the block 

for the bed. Both the toy utilized and the play 

action(s) performed were recorded (as well as 

the utterance, whether or not appropriate, as 

discussed below). No distinction was made between 

play actions modeled in the video models 

(i.e., scripted play acts) and novel play 

actions (i.e., unscripted play acts), as the 

coder was blind to the instruction on the 

video models. The highest level of play 

achieved was derived for each session by examining 

all appropriate play actions for the 

session, and recording the appropriate play 

action scored at the highest level of play. The 

average level of play achieved for each session 

was calculated by summing the play levels recorded 

for each play related action by a child 

during a session and then dividing by the total 

number of play related actions exhibited by a 

child during the session. Appropriate play actions 

at level 3/4 were assigned a value of 3.5, 

appropriate play actions at level 7/9 were assigned 

a value of 8, and appropriate play actions 

of 15/16 were assigned a value of 15.5. 

For example, the average level of play 

achieved in which the child exhibited four 

appropriate play actions for the session, two at 

level 3/4, one at level 6, and one at level 10, is 

5.75 (((2*3.5)(1*6)(1*10))/4). 


Language Coding Measures 

An appropriate play–related utterance was defined 

as an intelligible verbalization of one or 

more English words (or an intelligible approximation 

thereof) by the participants immediately 

before, during or immediately after an 

appropriate play act, and the verbalization 

had to be related to or in connection with the 

play action. Verbalizations made immediately 

before, during or immediately after any action 

or sequence by the participant which was not 

coded as an appropriate play action were recorded 

but not coded as an appropriate play– 

related verbalization, even if they related 

to and were in connection with the (non– 

appropriate play) action. Verbalizations that 

were related to an appropriate play action but 

made more than three seconds prior to, or 

three seconds after, the play action were recorded 

but not scored (the incidence of such 

verbalizations was extremely low). All verbalizations 

during a session were logged, regardless 

of whether they constituted an appropriate 

play–related utterance. Due to the 

difficulty in definitively categorizing utterances 

and the coder being blind to the instruction 

on the video models, no distinction 

was made between play–related utterances 

modeled in the video models (i.e., scripted 

utterances) and novel or different utterances 

(i.e., unscripted utterances). 

Average MLU was calculated for each session 

by dividing the total number of morphemes 

uttered during all appropriate play– 

related utterances made during the session by 

the total number of all appropriate play– 

related utterances made during the session. 

The total number of morphemes spoken during 

any particular utterance was determined 

in accordance with the procedures set forth in 

the Guide to Analysis of Language Transcripts, 

Second Edition, (Retherford, 1993) 

which represents the standard methodology 

employed by speech language pathologists 

when measuring mean length of utterance 

(e.g., counting the utterance of one plural 

noun forms as two morphemes, and counting 

the utterance of one verb in predicate form as 

two morphemes). 

The first author (MS, CCC-SLP) trained the 

undergraduate student to measure MLU. The 

undergraduate student transcribed and calcu- 

lated MLU for all sessions. The first author 

checked every transcription (100%) and confirmed 

any discrepancies with the undergraduate. 

Results 

Intervention Outcomes 

Average play skills are presented graphically 

within video modeling intervention (instruction, 

baseline, and maintenance) and during 

generalization (no baseline or maintenance). 

Average MLU is presented graphically within 

video modeling intervention (instruction, 

baseline, and maintenance) and during generalization 

(no baseline or maintenance). Figure 

1 shows Ian’s progress (play observed in 

instruction, play in generalized observation, 

MLU observed in instruction, MLU in generalized 

observation), Figures 2, 3, and 4 show 

Jeremy’s, Ryan’s, and Jonah’s progress respectively. 

During the intervention, all four children 

were able to progress through multiple 

levels of play (Table 2) and all generally maintained 

those gains in the limited maintenance 

phase of the investigation. Please keep in 

mind that the figures present ‘average’ level of 

play and thus, a child might have an average 

level lower than their mastered level (e.g., a 

child has the 3 higher level acts with 3 novel 

toys but other play acts are at other levels and 

thus, an average is obtained; see Jeremy’s initial 

instructional point). Recall that none of 

the four children received level 7 instruction 

(as it was included with the video model for 

level 9). 

Figure 1 displays Ian’s steady progression in 

both the instructional and generalized situations 

based on average level of play achieved. 

Prior to the intervention, his average level of 

play was 1.8 (range of 1–2). Ian was initially 

instructed at level 3/4 and progressed 

through each level until emergence at level 8 

where the intervention ended. In the maintenance 

phase, the average level of play Ian 

displayed was 6.8 (the range of play acts 

through maintenance observation went as low 

as level 5 and as high as level 10). Further, as 

noted, the highest level of play observed during 

any play session (trial, generalization, and 

maintenance) was level 10. Ian had a slight 

drop in his average play level during the first 


Figure 1. Ian’s Progress in Play Skills and MLU. Ian’s baseline was 3 sessions (1.5 weeks), instruction and 

generalization were 17 sessions (8.5 weeks), and maintenance was 3 sessions (1.5 weeks) with a total 

of 40 sessions (11.5 weeks). In training session #2, Ian mastered play levels 3/4. In training session 

#7, Ian mastered play level 5. In training session #22, Ian mastered play level 6. At training session 

#30, Ian was at level 8 (not mastered/left at this level). The highest level of play observed in any 

session was level 10. 

maintenance session, but advanced his play 

without instruction back to his average level of 

play during instruction. In terms of generalized 

play, Ian clearly generalized his skills in 

the classroom environment (without prompting) 

consistent with his play instruction. Ian’s 

language also significantly increased in 

amount during the instruction phases of the 

intervention. In examination of all 3 baseline 

sessions, he had an MLU of 0.0. Across all the 

intervention sessions, his average MLU was 

about 1.8, and then about 1.9 during the three 

maintenance phase observations. During generalized 

free play, Ian continued to use language 

fairly consistently even without an 

adult. Ian’s PLS-4 receptive scores improved 

to <strong>47</strong> months and expressive scores to 33 

months. 

Figure 2 shows Jeremy’s play skills during 

baseline, instruction, and maintenance 

phases. Jeremy’s baseline sessions yielded an 

average level of play at 4.9 (range of 1–5). 

Instruction for Jeremy began at level 6 (play 

acts at level 5 was sufficient for ‘mastery’). He 

progressed to emergence in level 10 by the 

end of intervention. His average play level 

progressed across the sessions. It was noted 

that Jeremy’s highest level of play observed 

during any play session was level 13. Jeremy 

advanced his play slightly during baseline 

prior to instruction and again during the first 

intervention sessions with only little instruction. 

Clearly, however, Jeremy advanced significantly 

as instruction was presented. Similar 

to Ian, in the maintenance phase, on the first 

session, Jeremy’s play overall was not as complex 

but at the second session, his average play 

level returned to the intervention average 

(range from 2–13 in those two sessions). Figure 

2 displays Jeremy’s progress in play during 


Figure 2. Jeremy’s Progress in Play Skills and MLU. Jeremy’s baseline was 7 sessions (3.5 weeks), instruction 

and generalization were 13 sessions (6.5 weeks), and maintenance was two sessions (1 week) with a 

total of 35 sessions (11 weeks). In training session #4, Jeremy mastered play level 5. In training 

session #7, Jeremy mastered play level 6. In training session #12, Jeremy mastered play level 8. At 

training session #13, Jeremy was at level 10 (not mastered/left at this level). The highest level of play 

observed in any session was level 13. 

the generalization sessions as well. Although 

his play skills in generalized sessions were not 

as developmentally high as in the instruction 

sessions, he clearly showed progress in his play 

skills. In terms of MLU, Jeremy was primarily 

non-verbal (MLU 0) throughout baseline 

and for the first 5 weeks of the intervention, 

after which his average MLU increased from 

week 6 and through the end of the intervention. 

Jeremy’s average MLU was 1.7 (session 

range of 0–2.7) during intervention, and his 

average MLU in the maintenance phase was 

1.6. In generalized sessions, Jeremy began to 

use some language even before he showed 

that language in the instructional sessions. 

This was positive and continued in the generalized 

sessions fairly consistently. Jeremy’s 

PLS-4 receptive scores improved to 39 months 

and expressive scores improved to 41 months. 

Ryan showed a progression during the intervention 

phase which was notably main- 

tained in the generalization sessions based on 

average level of play achieved (Figure 3). It is 

to be noted that during Ryan’s baseline, he 

exhibited single acts at level 7/9, but his average 

level of play was 4.9 (range 2–7/9). Thus, 

we began instruction at level 6. He immediately 

showed mastery of this level in generalized 

situations after one training session, so we 

moved to instruction at level 7/9 and he progressed 

through emergence at level 10. In the 

maintenance phase, the highest level of play 

exhibited by Ryan was level 14, and his average 

level of play was 9.8 (range of 2–14). Ryan was 

primarily non-verbal (MLU 0) throughout 

baseline, but made rapid initial gains in his 

MLU during the intervention phase (MLU 

1.7, with session range of 0–3.0) and in the 

generalized sessions. Those gains which were 

maintained in the maintenance phase 

(MLU 2.9) with variation in his MLU from 

session to session. His PLS-4 scores improved 


Figure 3. Ryan’s Progress in Play Skills and MLU. Ryan’s baseline was 10 sessions (5 weeks), instruction was 

10 sessions (5 weeks), generalization was nine sessions (absent one), and maintenance was two 

sessions (1 week) with a total of 31 sessions (11 weeks). In training session #1, Ryan mastered play 

level 6. In training session #8, Ryan mastered play level 8. At training session #10, Ryan was at level 

10 (not mastered/left at this level). The highest level of play observed in any session was level 14. 

to 50 months receptively and 37 months expressively. 

Figure 4 shows that Jonah had the most 

advanced play skills of the participants prior 

to intervention. His baseline play skills were 

mastered at level 8 and his average level of 

play was 6.7. Thus, we started instruction at 

level 10. Again, note that although instruction 

targeted level 10, Jonah’s average level of play 

in any session may have been lower. Over the 

course of the intervention, Jonah made gains 

in his average level of play, and he carried 

those gains over into his maintenance phase 

and generalized sessions. During the intervention, 

Jonah progressed from level 8 through 

mastery of level 13 on his last session and thus, 

emergence at level 14. At the highest point 

(during maintenance phase), he exhibited 

play at level 15/16. His average level of play on 

the last maintenance observation was 13.5. 

Jonah’s MLU prior to intervention was 1.0; he 

made rapid gains during the intervention 

phase (MLU 2.5, with session range of 1.5– 

2.9), maintained MLU usage in the generalized 

sessions, and maintained gains in the 

maintenance phase (MLU 2.2). Both his 

receptive and expressive PLS-4 scores improved 

to 44 months. 


The purpose of a social validity assessment is 

to determine if the intervention was socially 

relevant. Social relevance includes whether an 

outcome is significant, appropriate, and important 

(Wolf, 1973). We did not formally 

assess the social significance of the goals, as 

play and language skills are unequivocally fundamental 

to the development of children. We 

also did not formally assess the social appropriateness 

of the procedures used in this investigation 

as all of the participant’s families 


Figure 4. Jonah’s Progress in Play Skills and MLU. Jonah’s baseline was 11 sessions (5.5 weeks), instruction 

was nine sessions (4.5 weeks), generalization was eight sessions (absent one), and maintenance was 

two sessions (1 week) with a total of 30 sessions (11 weeks). In training session #3, Jonah mastered 

play level 8. In training session #6, Ryan mastered play level 10. In training session #7, Ryan 

mastered play level 12. At training session #8, Ryan mastered play level 13 on the last session. Ryan 

left at play level 14. The highest level of play observed in any session was level 15/16. 

indicated on the consent form that the investigation’s 

procedures were acceptable to them 

and video modeling has been established as 

both time and cost effective. (Bellini & Akullian, 

2007; Charlop-Christy, Le, & Freeman, 

2000; Hine & Wolery, 2006). 

We did, however, ask adults at an autism 

conference to judge the intervention to formally 

establish social validity. The regional 

conference focused on intervention strategies 

for children with autism and other developmental 

disorders. Of the audience, 124 of 136 

adults (parents, educators, and therapists) responded 

to our request. The individuals were 

asked to code a randomly–chosen selection of 

clips of the four participants, one each during 

baseline, intervention and maintenance 

phases. The individuals were asked to qualitatively 

judge the overall frequency and appropriateness 

of the participants’ play and play– 

related language. All respondents were blind 

to the investigation and its purpose. A one– 

minute clip was systematically selected from 

each of the four participants (e.g., the second 

minute of each participant’s second baseline 

trial was used for that participant’s baseline 

clip). The resulting twelve clips (three from 

each of the four participants) were placed in a 

random order, and shown to the coders in a 

single session. The coders were asked to code 

each clip using a five-point Likert scale for 

each of the following questions: Was the child 

engaged with toys? Was the child playing with 

the toys appropriately? How much language is 

the child using appropriately? Did the child 

look like he was having fun? See Figure 5. The 

average ratings by the naïve adults were examined 

using paired sample t-tests between baseline 

and treatment and between baseline and 

maintenance. Significant differences were 

identified across all four children and rating 

categories (engagement, play, language, and 


Figure 5. Social Validity: Average ratings across the four participants at baseline, during instruction phases, 

and during maintenance by naïve observers on engagement, play, use of language, and if the child 

looks like he is having fun. 

4 Always/A Lot 

3 Almost Always/Quite a Bit 

2 Sometimes/Medium Amount 

1 Almost Never/Very Little 

0 Never/None 

From baseline to intervention* showed significant change at p < .05 (Jonah play), p < .01 (Ian 

engagement and play), and p < .001 (for all other participants on four ratings) with the exception 

of one non-significant finding for Ian in his language. From baseline to maintenance**, significant 

changes were observed at p < .05 (Jonah play), p < .01 (Ian language) and p < .001 (for all other 

participants on four ratings). 

fun), except for language ratings on Ian’s 

baseline to intervention. The naïve adults 

rated the children as having significantly better 

play skills and engagement during the 

maintenance phase. Although language improvement 

was rated as having the least qualitative 

change, the observer ratings increased 

by an average of one Likert scale point. 


The purpose of this study was to examine if a 

video modeling methodology could be effective 

in teaching both play and language skills 

to young children with autism. In an area that 

is termed a “core deficit,” a deficit that defines 

the disorder and is naturally difficult for such 

children, the four children in this study made 

significant gains. In addition, their mean 

length of utterance and language scores also 

improved significantly over the course of the 

intervention. These findings were both socially 

validated by unbiased and un-informed 

observers who clearly noted a qualitative 

change in the children’s play and language 

use in general. 

As reported by Paparella and Kasari (2004) 

and Kasari, Freeman, and Paparella (2001), 

children can be taught play skills and language 

can concurrently develop and be main- 


tained; however, these types of targeted, discrete 

interventions are not easily available 

and the developmental knowledge of play sequences 

is not clinically mainstreamed. 

Clearly, best results would be obtained primarily 

in a clinical setting such as ours, from 

professionals with training and experience on 

play and language in the instruction of children 

on the autism spectrum or with other 

developmental disabilities. If this best case is 

not available or attainable, video modeling 

might be effectively implemented by parents 

or lesser–trained caregivers of children with 

autism when given proper written instruction. 

Furthermore, video modeling could serve as a 

useful adjunct to traditional therapies and instruction, 

which are in limited supply – and 

the costs of which are significant for families 

already struggling with the financial burden of 

a child with a developmental disability. 

As noted by other researchers, video modeling 

can be scaled to instruct multiple children 

at the same developmental level and with 

the same approximate existing skill sets. Further, 

the methodology seems to be particularly 

efficacious for persons with autism. Although 

the initial investment in properly 

preparing video models and developing accompanying 

instructional methodology could 

be high, once prepared, the video models are 

relatively easy to reuse to address the need for 

repetitive presentation. Further, video models 

offer a restricted field of focus and high motivation 

(Charlop & Milstein, 1989; Corbett & 

Abdullah, 2005; Dorwick & Jesdale, 1991; 

Stahmer et al., 2003; Paterson & Arco, 2007; 

Zihni & Zihni, 2005). 

A primary weakness of the investigation is 

the sample size; however, the extensive data 

collected over the 10 week period allows for 

the examination of change over time. The 

data collection, detailed coding, and social 

validity were relative strengths of this investigation. 

Another relative strength was that 

each child participated in the same therapeutic 

program, receiving the same treatment, 

throughout the examination, meaning that 

no child received play intervention through 

the program (although language development 

was a strong focus of the program), and 

that no child received unknown, other services 

that might have affected the child’s play 

and language skills. Play benefits could thus 

be attributed primarily to the treatment, and 

language benefits could be at least partially 

attributed to the treatment. Because each participant 

was also receiving intensive speech 

therapy two times per week for 30 minutes per 

session individually or in a group, the results 

on appropriate play–related utterances and 

mean length of utterance and overall language 

should be interpreted with caution. Another 

limitation of the investigation was that 

no follow–up probes were conducted to measure 

whether the participants retained the 

skills generalized during the course of the 

investigation. 

Although numerous studies have investigated 

video modeling as a methodology to 

teach play and language skills in a variety of 

children, including the generalization of acquired 

skills, none have combined the three 

components that this study employed: video 

modeling, a developmentally sequenced approach 

to teaching play, and a MLU outcome. 

Further research into the efficacy of video 

modeling to teach play and language skills is 

warranted in order to determine the most 

effective way to ensure generalization and retention 

of learned skills. Of particular interest 

would be studies to determine if additional 

benefits might be gained through even more 

fine-grained instruction matched to more specific 

developmental levels. 

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Final Acceptance: 21 November 2011 




Effects of a Video Model to Teach Students with Moderate 

Intellectual Disability to Use Key Features of an iPhone 

Kathryn Walser, Kevin Ayres, and Erika Foote 

University of Georgia 

Abstract This study evaluated the effects of video modeling on teaching three high school students with moderate 

intellectual disability to perform three activities on an iPhone 3GS. This study is a replication and extension 

of the Hammond, Whatley, Ayres, and Gast (2010) study in which researchers taught this same set of skills 

using a slightly different format of instruction and a less complex hand-held device. In the current study, a 

multiple probe design across three behaviors, replicated across three participants, was used to evaluate the effects 

of video modeling on participants’ capacities to (a) take a photograph of a person, (b) look at photographs by 

starting a slideshow, and (c) access and view a video. Generalization to a more complex home screen 

arrangement featuring multiple unused buttons not present during intervention was also measured following 

intervention. Results of the present study indicate that video modeling was effective in teaching target behaviors 

in a near-errorless fashion. Additionally, during generalization, students were able to navigate to each of the 

three tasks despite the addition of 14 other distracter buttons, not previously present without additional 

training. 

The Individuals with Disabilities Improvement 

Act defines assistive technology (AT) devices 

as those tools that help students with disabilities 

function in their environment (Wright, 

2004). The range in what qualifies as a “device” 

is broad and can include things from 

specialized eating utensils to computer software 

that converts speech to text. Some of 

these are everyday items that simply require a 

low tech modification (e.g., fattening a pencil 

with a rubber grip) while others are more 

complex and specialized (e.g., Dynavox augmentative 

communication systems). In many 

cases the technology is specialized in some 

way, either by design or modification, to promote 

independence. 

Depending on how dynamic an individual’s 

The research reported here was supported by the 

Institute of Education Sciences, U.S. Department of 

Education, through Grant R324A100094 to the University 

of Georgia. The opinions expressed are those 

of the authors and do not represent views of the 

Institute or the U.S. Department of Education. Correspondence 

concerning this article should be addressed 

to Kevin Ayres, Department of Special 

Education, The University of Georgia, 516 Aderhold 

Hall, Athens, GA 30602-7153. Email: 

kayres@uga.edu 

needs are, the life-span of an AT device may 

be limited. Many years ago, Phillips and Zhao 

(1993) noted shifting user needs as one of 

the primary reasons individuals stopped using 

an AT device. Further, Brookes (1998) suggested 

that some families may decide not to 

utilize AT for their children because of the 

increased focus on the child and disability. 

Much of the research cited by Parette and 

Scherer (2004) focused on the stigma associated 

with AT and the influence on the user. 

The fear that AT may magnify the visual perception 

of an individual’s disability weighs 

heavily in the decision to use or forgo AT. 

However, solutions exist in more typical formats. 

Applications currently exist for the iPod 

and iPhone that put communication options 

(e.g., speech-to-text) in a “normal” device that 

does not look atypical across multiple environments. 

Within today’s technology-dependent 

population, the ubiquity of people using an 

iPhone or listening to an iPod in public is 

striking. 

Shifting AT emphasis toward device options 

used more frequently by the general public 

may reduce the stigma typically associated 

with AT and increase user adoption. Abner 

and Lahm (2002) noted teacher reluctance to 

iPhone Usage and Students with MOID / 319

implement AT with which they themselves 

have little familiarity. Therefore, adapting a 

device like an iPod or iPhone that has widespread 

usage within the general population is 

a logical step. Thus, beginning to train individuals 

to use a handheld device (e.g., an iPod 

or iPhone) to take advantage of the flexible 

range of software supports becomes the next 

challenge. 

Video modeling on computers, handheld 

devices, and other tools has been used across 

disciplines and across settings to teach a variety 

of skills. In 2002, Davies, Stock, and Wehmeyer 

examined the use of a handheld, selfdirected 

visual and auditory prompting system 

to improve the independent performance of 

community-based vocational tasks. In addition, 

the researchers tried to determine if the 

use of the handheld systems would also reduce 

the amount of support needed from 

teachers or job coaches. They reported that 

the handheld prompting systems resulted in 

increases for each student’s independent 

functioning in community-based tasks, but 

more importantly, the study demonstrated the 

handheld systems reduced the amount of support 

time required by the teacher or job coach 

for each student. 

In two studies, one with middle school aged 


(Hammond et al., 2010) and the second with 

elementary-aged students with autism (Hammond, 

Muething, Ayres, & Gast, in review), 

researchers examined the use of video modeling 

to teach students to access activities on 

iPods. The intention was, in part, to evaluate 

the use of video modeling with fine motor 

tasks that may be more difficult for users to 

discriminate. In both cases, all students 

learned the target tasks, but important limitations 

were identified in the initial study (Hammond 

et al., 2010). These researchers used 

single opportunity probes (Cooper, Heron, & 

Heward, 2007) to evaluate student performance 

of the steps of their task analyses (e.g., 

accessing music, accessing videos, and accessing 

photographs). This may have artificially 

suppressed baseline responding because if a 

student failed at the first step, they would not 

have had a chance to demonstrate whether 

they could perform subsequent steps. While 

the students’ mastered the skills, their performance 

deteriorated over time. During main- 

tenance probes, the researchers noted the 

lower levels of responding and implemented 

“booster” sessions of video modeling to help 

the students regain criterion level performance. 

In a subsequent study, Hammond et al. (in 

review) used the same instructional methodology 

and incorporated multiple opportunity 

probes rather than single opportunity probes. 

This allowed participants to make an error on 

a step and have a chance to respond to the 

later steps in the task analysis (TA). The effects 

of intervention were evaluated with a 

multiple baseline design across behaviors replicated 

across participants. After learning one 

of the target skills, two of the participants 

generalized those steps to the other tasks that 

shared many of the same procedural steps. As 

a result of the design’s structure, this generalization 

did not weaken Hammond et al.’s 

(2010) experimental control. However, it did 

suggest that the trio of behaviors being taught 

may have shared too many critical features to 

serve as target behaviors in this research context 

where ideally you would want skills that 

are functionally independent to safeguard 

against carry-over threats (Wolery, Gast, & 

Hammond, 2010). 

The current study is a replication and extension 

of Hammond et al. (in review). Capitalizing 

on the foundation laid with the structure 

of the research design, this study used the 

same multiple baseline design across behaviors 

replicated across participants to evaluate 

the effects of video modeling on student acquisition 

of three skills on an iPhone 3GS. 

The purpose of the replication is to apply a 

similar procedure to a more complex device 

and evaluate generalization to untrained interfaces. 

The research questions addressed 

here include: (1) What effect does video modeling 

have on the acquisition of taking a 

photograph of a person, viewing photographs 

in a slideshow, and viewing a video in iTunes?; 

and (2) If students acquire the skills via video 

modeling in an environment of reduced distracters 

(e.g., only the minimum number of 

buttons on the screen) will the student generalize 

this without training to an environment 

filled with distracters (e.g., screen filled with 

icons)? 


Method 

Participants 

Four high school students, all identified as 

having moderate intellectual disability 

(MOID), initially agreed to participate in the 

study. However, due to health concerns and 

multiple absences, the fourth participant had 

to leave the study. All participants were selected 

because they had IEP goals related to 

recreation and leisure that fit with the target 

objectives of the project (e.g., visual discrimination 

and following instructions). Participants 

additionally possessed the following prerequisite 

skills: (a) visual acuity and manual 

dexterity sufficient to place the tip of a finger 

ona1cmby1cmtarget on the face of an 

iPhone; and (b) ability to sit for at least 15 

minutes. 

The first participant, Holly, was a loquacious 

21 year and 5 month old female at the 

onset of the study with a diagnosis of Down’s 

Syndrome and MOID. Holly displayed deficits 

in reading for informational purposes and 

counting mixed dollar bills. However, Holly 

possessed strengths in learning to expressively 

state sight words, sound out unfamiliar words, 

and her ability to manage personal items (e.g., 

purse, insulin materials, and cell phone). 

Prior to the study, Holly had experience using 

a family member’s iPhone 3GS to send and 

receive text messages. However, Holly’s performance 

was dependent upon assistance with 

reading and typing messages on the iPhone. 

The Vineland Adaptive Behavior Scales 

(VABS; Sparrow, Balla, Cicchetti, & Doll, 

1984) indicated that she showed standard 

scores of 63 for daily living, 86 for socialization, 

and 62 for communication with a composite 

of 68. The Differential Ability Scales 

(DAS; Elliott, 2005) indicated that Holly 

scored a <strong>47</strong> in the verbal cluster, a 57 in the 

nonverbal reasoning cluster, 50 in the spatial 

cluster, a <strong>47</strong> in the general cognitive ability, 

and a 51 in the special nonverbal composite. 

Jake, the second participant, was 17 years 

and 9 months old at the introduction of the 

study with a diagnosis of Fragile X and MOID. 

Jake displayed anxiety and attention-seeking 

behaviors (e.g., hand-biting, using inappropriate 

language). This behavior was avoided 

throughout the study via verbal reassurances 

and redirection along with sustained involvement. 

Jake displayed deficits in attention and 

impulse control, oftentimes negatively impacting 

his ability to acquire new information and 

skills. Jake possessed strengths in computer 

and calculator proficiency. The DAS (Elliott, 

2005) indicated that Jake scored a 76 in the 

verbal cluster, a 53 in the nonverbal reasoning 

cluster, and a 61 for the overall general cognitive 

ability score. 

The final participant, Norman, was 18 years 

old at the beginning of the study. He displayed 

deficits in adaptive behavior that impacted 

his educational progress as he tended 

to be easily distracted. Norman’s strengths included 

his ability to recall key parts of stories 

that were read to him and his ability to learn 

and recall sight words. Norman also enjoyed 

cooking with his class. On the VABS (Elliott, 

2005) he scored standard scores of 62 for daily 

living, 66 for socialization, and <strong>47</strong> for communication 

with a composite of 56. Results from 

the Wechsler Intelligence Scale for Children – 

Third Edition (Wechsler, 1991) indicated a 

verbal intelligence quotient (IQ) of 54, performance 

IQ of 46, and a full scale IQ of 46. 

Materials and Settings 

Students viewed video models on a 15” Mac- 

Book Pro laptop. The videos were viewed in 

QuickTime (QuickTime, 2011) and were 

cued for the student prior to the session’s 

commencement. Videos depicted the hands 

of an actor using an 8 GB iPhone 3GS running 

iOS 4. The duration of the three video models 

varied: 28 s for watching a video, 18 s for 

taking a photograph of a person, and 26 s for 

looking at photographs. During baseline and 

initial instruction, the iPhone screen only displayed 

four soft buttons at the bottom of the 

screen that included one of the target buttons, 

the orange iPod button. Soft buttons are those 

that could not be changed and were located 

on the bottommost horizontal toolbar. The 

rest of the screen contained only two icons: 

one to initiate the iPhone’s camera and one to 

view the photograph album. Five high interest 

photographs were included in the photograph 

album and, similarly, for watching a 

video, five high interest videos were imported 

into iTunes. Due to one participant, Jake’s, 

changing preference throughout the study, a 


sixth and seventh video were added to match 

his changing taste and therefore motivation to 

seek the videos. 

This study was conducted in a rural public 

high school in the South. All sessions took 

place in an empty classroom located next to 

the school’s gymnasium approximately 20 ft 

by 20 ft in dimension. Only the participating 

student and data collectors were in the room 

during each session. The researcher providing 

instruction always stood to the side of the 

student so as to be readily available to interrupt 

and correct errors during the multiple 

opportunity probe trials and to collect data. 

The researcher collecting interobserver agreement 

(IOA) and procedural fidelity data always 

stood to the other side of the participant 

in order to see their physical movements and 

the screen of the iPhone. During all instructional 

sessions, students sat at a desk and the 

researcher handed them the phone with a 

black screen prior to the beginning of the 

session. 

Response Definitions and Data Collection 

The primary dependent measure was independent 

performance of each step of the target 

skills (See Table 1 for task analyses). A step 

was considered independent if the student 

initiated the step within 5softhetask direction 

or completion of the previous step and 

completed that step in a topographically correct 

manner within 5 s. Failure to initiate a 

step within 5 s resulted in that step being 

scored as a latency error. If a student initiated 

the step but failed to complete it within5sthe 

response was scored as a duration error. If the 

student initiated an incorrect topography 

within the latency time frame, that step was 

scored as a topographical error. Keeping with 

protocol for multiple opportunity probes, in 

the case of all errors across all conditions, the 

student was interrupted, their line of vision 

was redirected away from the device, and the 

device was advanced to the conclusion of that 

step prior to having their attention redirected 

back to the iPhone. This ensured that for each 

step, the student was presented with correct 

discriminative stimulus and had the opportunity 

to respond. Interobserver agreement 

(IOA) and procedural fidelity were collected 

by a second data collector during at least 20% 

of all sessions, for each participant, in each 

condition. IOA was calculated using the pointby-point 

method (number of agreements divided 

by the number of agreements plus disagreements, 

multiplied by 100) and a 

minimum acceptability for reliability levels 

was 85%. Procedural fidelity data were calculated 

based on the number of behaviors correctly 

performed by the investigator, divided 

by the number of planned investigator behaviors, 

multiplied by 100 (Billingsley, White, & 

Munson, 1980). Investigator behaviors which 

were assessed during baseline, Pre-Video Modeling, 

and Post-Video Modeling sessions included 

the following: delivery of the general 

attentional cue, delivery of the task direction, 

correct issuance of the iPhone with a black 

screen, and the investigator’s attendance to 

latency, allotted response duration, error interruption, 

error restart, and issuance of corrective 

feedback. 

During a minimum of 20% of both baseline 

and intervention sessions for all students, a 

second observer collected interobserver 

agreement (IOA) and procedural fidelity. Procedural 

fidelity was based on a checklist of 

expected researcher behaviors for each session. 

The number of correctly performed researcher 

behaviors was divided by the number 

of expected behaviors and multiplied by 100. 

Procedure 

General procedure. This study is composed 

of two conditions (baseline and video modeling 

intervention). All sessions in both conditions 

contained an initial probe trial to measure 

performance on the target skill 

(sometimes referred to as a “cold” probe). 

During Video Modeling, students had the 

cold probe followed by Video Modeling Instruction 

and a Post-Video Modeling Practice 

trial. In all cases students participated individually 

in sessions lasting 5 to10 minutes 3 to 4 

times per week. Once the materials for a task 

had been arranged, participants were given 

the task direction for one of three target skills 

(e.g., “Take a photograph of a person,” “Look 

at photographs,” or “Watch a video”) while 

simultaneously being handed the iPhone with 

a black screen indicating the need to initiate 

the target task. The phone was in a stand-by 

position similar to how it would be in if some- 


TABLE 1 

Task Analyses for all Tasks 

Watch a Video 

Screen Appearance Task Analysis 

Screen Black 1. Push HOME button 

2. Slide LOCK to the 

Lock Screen 

right 

Orange iPod Bottom 

Right 3. Hit iPod button 

Varies 4. Hit VIDEO button 

Video List 5. Select target video 

Target Video Begins 

Look at Photographs 

Screen Black 1. Push HOME button 


Lock Screen 

right 

Home Screen 3. Hit FLOWER button 

Photograph List 4. Click a photograph 

Photograph 

Enlarged 5. Click the PLAY button 

Slide Show Begins 

Take a Photograph 

of a Person 

Screen black 1. Push HOME button 


Lock screen 

right 

Home Screen 3. Hit CAMERA button 

4. Point camera at a 

Display of Camera person 

Person in “View” 5. Click CAMERA button 

* Hammond, D. L., Whatley, A. D., Ayres, K. A., & 

Gast, D. L. (2010). Effectiveness of video modeling 

to teach iPod use to students with moderate intellectual 

disabilities. Education and Training in Autism 

and Developmental Disabilities, 45(4), 525– 

538. 

one had just pulled it from his or her pocket. 

Once students began intervention and received 

Video Modeling instruction, they were 

asked to engage in a single opportunity practice 

trial (Post Video Modeling Practice) to 

allow the student to rehearse the task and 

measure their ability to respond soon after 

viewing a model. Any error which occurred 

during single opportunity probes immediately 

terminated the session. Data from the practice 

trials were recorded, but did not count toward 

skill mastery. 

Baseline and Pre-Video Modeling Probe sessions. 

Pre-Video Modeling Probes were conducted 

in a multiple opportunity format (Cooper, 

Heron, & Heward, 2007). Thus, if an error 

occurred, the observer monitoring student 

performance would fix the error and prepare 

the iPhone for the next step without the student 

seeing. The observer would then tell the 

student to “keep working.” Students were initially 

presented with the iPhone with a blank 

screen and given the task direction (e.g. “Let’s 

take a photograph.”) to indicate which target 

task to initiate. Data were collected after the 

delivery of the task direction on each student 

to measure independent and accurate performance 

of each step of the target task. If a 

duration error occurred, the student’s attention 

was directed away from the phone as the 

instructor simultaneously completed the current 

step in the TA, preparing the phone for 

the student to complete the next step in the 

TA. The student’s attention was then verbally 

redirected back to the task. If a sequential or 

topographical error occurred, the instructor 

would undo the error in addition to preparing 

the phone for the student to complete the 

next step in the TA as the student looked 

away. Corrective feedback was not provided 

during probe trials; however, descriptive verbal 

praise was given for correct responses 

(during Baseline Pre-Video Modeling as well 

as during Pre-Video Modeling conducted during 

intervention. Praise was delivered on a 

variable ratio schedule after the average of 

every third correct response (VR-3). Once students 

reached criterion on a task, the reinforcement 

schedule was thinned to every fifth 

step for all target tasks (FR-5). Under the FR-5 

schedule of reinforcement, a student received 

descriptive verbal praise once they completed 

the entire target task. After three stable data 

points had been collected across three consecutive 

sessions across a minimum of two days 

for the first task for each participant, Video 

Modeling Instruction began. For the second 

and third tasks, instruction began only after 

the student demonstrated 100% independence 

on the previous task for at least one 

session. During intervention, once a student 

completed the Pre-Video Modeling Probe, he 

or she moved into Video Modeling for that 

skill. 

Video Modeling. Video Modeling sessions 

consisted of three parts (Pre-Video Modeling 

probe trials, Video-Modeling, and Post-Video 

Modeling Practice), implemented within one 


session. These Pre-Video Modeling trials were 

conducted identical to those conducted during 

the baseline condition and described previously. 

However, Post-Video Modeling Practice 

trials were conducted differently. Video 

Modeling Instruction began if a student did 

not complete the target task with 100% accuracy 

during Pre-Video Modeling Probes. After 

the probe trial, if students were to receive 

video instruction, the computer was placed in 

front of them. Once their attention was secured, 

they were then instructed to “Watch 

this,” by the instructor, as the video was 

started. Each of the 3 videos depicted navigation 

of the iPhone, in first person perspective, 

to take a photograph of a person, look at 

photographs, or watch a video. Post-Video 

Modeling trials Practice took place immediately 

following Video-Modeling instructional 

trials and consisted of a single opportunity 

practice trial. 


A multiple probe across behaviors, replicated 

across participants was used to evaluate a functional 

relation between the dependent variable 

and the video-based intervention (Gast & 

Ledford, 2010). Experimental control was 

demonstrated through the replication of effects 

of the video modeling procedure as the 

introduction of the independent variable was 

staggered based on a predetermined criterion 

across three tasks for each of the three participants 

in the study. 

Results 

Reliability 

IOA and procedural fidelity data were collected 

during 22% of baseline sessions and 

29% of Video Modeling sessions. During all 

sessions in which IOA were collected, the 

mean percent agreement was 100%. The 

mean procedural fidelity was 98.92% (range: 

88.9–100%) for all investigator behaviors 

across all experimental conditions. Instances 

in which procedural fidelity data were below 

100% included the instructor’s lack of adherence 

to the pre-determined latency established 

between the issuance of the task direction 

or naturally occurring discriminative 

stimulus within the task itself and the instructor’s 

error correction statement. 

Effectiveness of a Video Model 

Figures 1, 2, and 3 present data on the percentage 

of steps completed accurately and independently 

for Holly, Jake, and Norman, respectively, 

across all three skills. Norman and 

Jake demonstrated 0% independent responding 

during baseline probes for all target behaviors 

whereas Holly demonstrated some 

skill with the iPhone based on prior experience. 

All students ultimately mastered the 

skills and demonstrated an ability to generalize 

to the more complex discriminations required 

when more icons were added to the 

iPhone screen. Table 2 shows the types of 

errors students made across trials. Intervention 

Probes were single opportunity, thus, as 

soon as an error was emitted, the trial was 

finished. An analysis of the types of errors 

made, latency, duration, and topographic, was 

conducted. Types of error emitted by participants 

were variable across conditions and participants. 

Latency and topographical errors 

were the most frequently made type of mistakes 

across all participants and conditions. 

Holly. Holly’s baseline performance on 

taking a photograph accelerated across the 

condition. The decision was made to begin 

intervention after the sixth session because it 

did not appear likely that she was going to 

complete step 3 (hitting the camera button) 

or 5 (clicking the camera button) without instruction. 

Her performance on the other skills 

also accelerated but leveled out at 60% until 

intervention was provided for those skills. 

Upon introduction of video modeling for taking 

a photograph of a person, Holly continued 

to make the error of holding down a 

button for too long for the first and third step 

of the TA. As a result of doing this on the first 

step, the iPhone’s voice command would initiate. 

When doing this with the third step, the 

screen of the iPhone would go into edit mode 

and all of the buttons would become inactive. 

As a result, a verbal prompt (e.g., “Don’t hold 

so long.”) was added after Holly made the 

error during step 1 of the fourth Post-Video 

Modeling trial. Following this additional verbal 

model, a mass trial then occurred for step 

1 and the proper way to touch the button. 


Figure 1. Holly multiple baseline graph. Dotted line throughout graphs indicates a change in condition, from 

baseline to video modeling intervention. The circle around the data point on session X indicates the 

inclusion of the aforementioned verbal prompt (e.g., “Don’t hold so long.”), added after Holly 

made the error during step 1. 


Figure 2. Jake multiple baseline graph. Dotted line throughout graphs indicates a change in condition, from 

baseline to video modeling intervention. 


Figure 3. Norman multiple baseline graph. Dotted line throughout graphs indicates a change in condition, 

from baseline to video modeling intervention. 


TABLE 2 

Number and Percentages of Errors across Conditions 

This same verbal prompt was used for the 

same error made in step 3. Following the fifth 

trial, step 3 was then mass trialed in the same 

manner. Holly correctly completed all steps in 

the sixth intervention session but then her 

performance deteriorated before rebounding 

to mastery level performance. Once she 

achieved mastery with taking a photograph 

and her baseline data were stable for the other 

two behaviors, intervention began on accessing 

and looking at photographs. Immediately 

following intervention, Holly met criterionlevel 

performance. Additional baseline data 

were collected on watching videos to confirm 

stable performance and intervention was then 

begun. Similar to her performance on looking 

at photographs, Holly immediately demonstrated 

mastery performance after intervention 

began. 

During generalization to evaluate performance 

with an iPhone screen filled with distracters, 

Holly demonstrated 100% correct 

Baseline Probe Pre-Video Modeling Probe Post-Video Modeling Probe Total 

L D T L D T L D T Errors 

Holly 

Look 0 12 18 0 0 2 0 0 0 32 

Take 1 4 8 0 4 8 0 3 4 32 

Watch 0 7 23 1 1 5 0 0 2 39 

Total Errors 1 23 49 1 5 15 0 3 6 103 

Jake 

Look 11 0 9 0 0 2 0 0 0 22 

Take 28 2 2 4 0 1 0 0 1 38 

Watch 18 0 2 15 0 3 3 0 1 42 

Total Errors 57 2 13 19 0 6 3 0 2 102 

Norman 

Look 12 1 2 24 2 3 5 0 0 49 

Take 14 3 7 0 0 4 0 0 0 28 

Watch 14 1 3 11 2 8 1 0 8 48 

Total Errors 40 5 12 35 4 15 6 0 8 125 

Total Errors* 98 30 74 55 9 36 9 3 16 330 

Mean Percentage** 

Look 23.5% 43.3% 39.2% 43.6% 22.2% 19.4% 55.6% 0% 0% 31.2% 

Take 43.8% 30% 23% 7.3% 44.4% 36.1% 0% 100% 31.3% 29.7% 

Watch 32.7% 26.7% 37.8% 49.1% 33.4% 44.5% 44.4% 0% 68.7% 39.1% 

Key: (L) Latency Errors; (D) Duration Errors; (T) Topographical Errors; * Represents total 

number of errors across all participants for each error type and condition; ** Represents percentage of error 

type across all participants for each condition for each target behavior. 

performance for taking a photograph, 80% 

for looking at photographs, and 80% for 

watching a video. Her error in the latter two 

skills occurred on steps unrelated to the addition 

of the distracter buttons, but instead were 

topographical errors that occurred as a result 

of holding the button down for too long on 

the home screen, resulting in the iPhone going 

into edit mode. 

Jake. Following a stable baseline condition 

across all skills, Jake began video modeling for 

watching a video. Upon introduction of video 

modeling to the behavior of watching a video, 

Jake required two intervention sessions before 

he began to show improvement. After four 

training sessions he achieved mastery and during 

generalization to the iPhone screen with 

multiple distracters, he continued to show 

100% independent performance. 

After mastery on watching a video and a 

continued stable baseline was reached with 

the other skills, intervention began for look- 


ing at photographs. Jake only required a single 

training session before showing criterion 

level performance. During generalization for 

looking at photographs, Jake completed 100% 

of the task independently. With mastery met 

on watching a video and a stable baseline for 

taking a photograph, video modeling was introduced 

on this last skill. He quickly demonstrated 

100% performance for taking a photograph 

but his responding deteriorated 

markedly and required an additional seven 

training sessions to meet and hold criterion 

level performance. Jake’s decrease in performance 

occurred simultaneously with an increase 

in agitation and anxious behaviors 

(e.g., hand-biting), seen across sessions and 

classroom contexts with his special education 

teacher. He correctly responded with 100% 

accuracy during measurement of his generalization 

to the screen with multiple distracters. 

Norman. Norman displayed zero to low 

levels of accurate responding across skills in 

baseline. Intervention was introduced first to 

looking at photographs. However, in observing 

Norman, it became apparent that he had 

minimal experience with any piece of handheld 

technology (e.g., iPod, iPhone, camera, 

etc.). As a result, all errors initially made during 

baseline and intervention trials may have 

resulted from his hesitation to touch the 

phone (e.g., when and if he held it, he held it 

very gingerly out of fear of breaking the device). 

Upon introduction of intervention for the 

first task, it was apparent that Norman attended 

to the screen when the video models 

were playing, yet his performance both prior 

to and after the video model remained at 0%. 

In response, a different phone was taken out 

when in the presence of Norman after the 

third session at 0% and it was conversationally 

described to him that he would not break the 

cell phone when he touched it. Norman was 

then allowed to punch the buttons when told, 

“Do this,” as the instructor hit the buttons. 

Norman was reminded of this conversation 

prior to the beginning of the next instructional 

session. The conversation was repeated 

again after the errors continued to be duration 

and he appeared to still be afraid of 

breaking the iPhone while maintaining a 0% 

responding level. The second conversation occurred 

before the seventh instructional trial. 

Results of the seventh trial, 100% independent 

during the Pre-Video Modeling, indicated 

that he had been attending to the video 

model, but had been fearful to break the unknown 

piece of technology. He was never instructed 

specifically what to do, only that he 

should not be afraid to touch the screen and 

the buttons. Criterion was mastered in 19 sessions 

for Norman. During the generalization 

session for looking at photographs, Norman 

completed 100% of the task independently. 

Subsequently, during the sixth video modeling 

session for looking at photographs, the 

addition of a verbal prompt (“Go on”) was 

used to encourage Norman to touch and interact 

with the phone. This persisted with his 

second skill, watching a video, but was not 

required for the final skill of taking a photograph. 

Once criterion was met for looking at 

videos, he began intervention on watching videos. 

The same hesitance was encountered and 

he required the verbal prompt to engage with 

the phone. Following this prompt he required 

three more sessions to reach mastery. With a 

stable baseline still evident for taking photographs, 

intervention was introduced. He immediately 

increased his independent performance 

and reached 100% independence after 

two intervention sessions. Norman demonstrated 

100% independent performance during 

the generalization probe across all tasks. 


All participants mastered all target skills. 

Video modeling appeared to be a contributing 

factor to their learning and replicated the 

findings of Hammond et al. (2010) with a 

more complicated device. In addition, the 

practice and training procedures may have 

been responsible for the students learning to 

make discriminations of target buttons in 

more complex arrays. However, these findings 

still need to be considered in light of certain 

limitations. 

Limitations. While all students acquired 

the tasks and generalized the skills to more 

complex displays these results need to be interpreted 

with caution given the long latency 

to change in participant behavior. Prior to the 

commencement of this study, only one participant, 

Holly, had previous experience with an 

iPhone or a personal cell phone of any kind. 


Holly’s previous experience with the device, 

though limited, left her at an advantage for 

accurately guessing which step could be next 

during the baseline condition. For example, 

on the final step of the first task (taking a 

photograph of a person), only one button was 

left on the screen which would correctly complete 

the task. As a result of limited choices, 

Holly would oftentimes look at the phone for 

a couple of seconds prior to tilting her head 

and saying a phrase such as, “maybe this one,” 

before hitting the correct button. In essence, 

Holly’s guesses and successes resulted in her 

learning steps of the skill during the baseline 

condition. These likely occurred as a result of 

her prior experience and familiarity with the 

iPhone’s mechanisms which the other two 

participants lacked. The second observed limitation 

with Holly involved the appearance of 

slow effects of the video model for the first 

task, taking a photograph of a person. Despite 

the onset of intervention, Holly took six sessions 

to hit criterion level and 14 to reach 

criterion as a result of the iPhone’s sensitivity 

to a user’s finger pressure for an extended 

duration. Holly consistently made topographical 

errors related to holding a button for too 

long across three steps which resulted in an 

error along with variable rates of data. Oftentimes, 

Holly was hitting the correct button to 

complete the target task correctly; however, 

her extended pressure on the button resulted 

in a topographical error upon the iPhone going 

into edit or voice command mode. 

Neither Norman nor Jake had ever used a 

cell phone or similar device (e.g., iPod). 

Therefore, Norman and Jake demonstrated a 

period of adaptation that should have been 

addressed prior to baseline. Their reluctance 

to do anything except hold the device may 

have artificially suppressed baseline responding. 

However, once students began intervention 

on their first target behaviors, behaviors 

in baseline remained relatively low (even after 

they has been de-sensitized to the device) thus 

possibly moderating an adaptation effect suppressing 

baseline responding. Norman’s performance 

climbed slightly as he was now doing 

the first step of the task analysis. Similarly, 

Jake’s remained at low levels until he was 

given intervention on those skills. Despite having 

to verbally prompt Norman during intervention 

that it was “okay to use the phone,” 

the sustained low level responding during 

baseline indicates that any suppression was 

likely minimal and should not completely discount 

the contributions of intervention to 

changes in the dependent variable. This is 

especially apparent with the last skill for Norman 

where he immediately achieve criterion 

level performance once provided intervention 

and did not require any verbal prompting. 

Further, the low baseline and immediate increases 

for Jake’s second two skills point to the 

impact of video modeling. 

While video modeling has been used to 

teach a wide range of skills to students with 

developmental disabilities (Mechling, 2005), 

there are certain aspects of behavior that are 

difficult to convey to a learner via video. In the 

case of Holly, she could observe the general 

topography of the target response (pressing a 

button), she could not see how hard the 

model pressed the button. She may have been 

able to count how long the button was held 

(one of the factors that causes the iPhone to 

move to voice control) but this would still not 

have helped her identify how hard the button 

was pressed. Therefore the decision was made 

to incorporate other instruction to help her 

learn the correct pressure. Following this instruction 

at sessions 13 and 14, no further 

assistance was required. The small increases in 

responding for all untrained tasks prior to 

video modeling instruction were attributed to 

the overlap in steps across the three task analyses. 

Aside from these threats to internal validity, 

all of history and maturation threats 

were controlled for via the time-lagged introduction 

of intervention and maintenance of 

stable, low baselines prior to intervention. Procedural 

fidelity and IOA were high. 

Implications for Practice. The current investigation 

adds to the extant literature on video 

modeling as an instructional tool and further 

provides evidence related to video modeling 

for fine motor tasks with multi-step discriminations. 

These practices can be reasonably 

adapted to other fine motor recreational leisure 

type skills as well as vocational (e.g., operating 

office equipment) to independent 

home living tasks (e.g., operating microwaves, 

computers, etc.). The findings also suggest 

that some limitations exist for the types of 

skills that educators may use video modeling 

to teach. In the case of the current examina- 


tion, some aspects of the target behavior could 

not adequately be captured in a video to allow 

a student to imitate (e.g., pressure on a button). 

In these instances, educators will need to 

recognize the limitations and incorporate 

other sound instructional methods. 

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Received: 29 June 2011 

Initial Acceptance: 30 August 2011 

Final Acceptance: 1 November 2011 




Comparing the Effects of Video Prompting with and without 

Error Correction on Skill Acquisition for Students with 

Intellectual Disability 

Helen I. Cannella-Malone, Joe E. Wheaton, Pei-Fang Wu, 

Christopher A. Tullis, and Ju Hee Park 

The Ohio State University 

Abstract: This study used an iPod Touch to compare the effects of video prompting with and without error 

correction on the acquisition of two daily living skills across three students with moderate to profound 

intellectual disability and an extremely limited daily living skills repertoire. An adapted alternating treatments 

design within a multiple probe across participants design was used to demonstrate that the inclusion of error 

correction from the outset of intervention increased the efficiency of skill acquisition for at least one task for two 

students. For the third student, some skill acquisition was observed using video prompting both with and 

without error correction, but more stable responding was achieved using in vivo instruction. 

Many individuals with intellectual disability 

experience deficits in daily living skills (e.g., 

Jacobson & Ackerman, 1990; Kraijer, 2000), 

which may have negative effects on their quality 

of life (Parmenter, 1994) and limit independent 

functioning in their natural environments. 

The ability for individuals with 

intellectual disability to acquire desired living 

and working opportunities may be unattainable 

until they can independently complete a 

variety of daily living skills (Heller, Bigge, & 

Allgood, 2005). 

One method of teaching daily living skills to 

individuals with intellectual disability is the 

use of video prompting, which has been used 

to teach such skills as cooking (Graves, Collins, 

Schuster, & Kleinhart, 2005), shopping 

(Van Laarhoven, Johnson, Van Laarhoven- 

Myers, Grider, & Grider, 2009), and household 

chores (e.g., Cannella-Malone et al., 

2006; Van Laarhoven & Van Laarhoven- 

Meyers, 2007). When teaching with video 

prompting, a participant watches one step of a 

task and then has the opportunity to complete 

that step before the next task step is shown. 


be addressed to Helen I. Cannella-Malone, A348 

PAES Building, 305 W 17 th Avenue, Columbus, OH 

43210. Email: malone.175@osu.edu 

For example, Sigafoos et al. (2005) used video 

prompting to teach three adults with developmental 

disabilities to use a microwave oven to 

make popcorn. Following intervention, two of 

the three participants were able to use a microwave 

to make popcorn without the video 

prompt and maintained the skill for at least 10 

weeks. 

Although video prompting appears to be a 

promising instructional technology, much of 

the research on video prompting indicates 

desktop or laptop computers are used as the 

prompting device. A few studies have successfully 

investigated the effects of using handheld 

devices to teach individuals with intellectual 

disability, but the small number of such studies 

limits the generalization of their results, 

and the authors noted that further investigation 

is required (e.g., Cihak, Kessler, & Alberto, 

2008; Davies, Stock, & Wehmeyer, 

2002a, 2002b, 2004). For example, Mechling, 

Gast, and Seid (2009) used a personal digital 

assistant (PDA) with picture, auditory, and 

video prompts to teach cooking skills to students 

with autism spectrum disorders. Portable 

technologies (e.g., PDAs, iPads, iPod 

Touches) have the potential to provide individuals 

with a device they can use across their 

daily environments and with a variety of skills. 

The increased accessibility provided with por- 


table video aids may lead to greater competence 

and independence. 

In the last several years, researchers in special 

education have started to investigate using 

the iPod Touch as a means of presenting 

video prompts. For example, Van Laarhoven 

and her colleagues (2009) successfully taught 

a young man with moderate developmental 

disabilities to use an iPod Touch to independently 

navigate video prompts in order to 

complete a vocational task at his job site using 

video prompting paired with error correction. 

One advantage of using an iPod Touch over 

other devices is that they can be loaded with a 

wide variety of applications across a range of 

topics (e.g., educational, communication, entertainment), 

so individuals with disabilities 

could be taught to use the device for numerous 

purposes. Additionally, they are portable 

and are ubiquitous in our society, which keeps 

their cost reasonable and may make them a 

feasible purchase for schools. 

In addition to exploring the use of portable 

devices such as the iPod Touch, one area requiring 

further research is the use of error 

correction during instruction using video 

prompting. The purpose of error correction is 

to provide individuals with direct and explicit 

feedback to prevent future errors from occurring. 

Within the video prompting literature, 

two error correction procedures have been 

employed (Goodson, Sigafoos, O’Reilly, Cannella, 

& Lancioni, 2007; Van Laarhoven et al., 

2009). In one procedure, video prompting is 

used alone—without error correction—until 

a participant demonstrates a plateau in skill 

acquisition, at which point error correction is 

introduced. For example, Goodson et al. 

(2007) attempted to teach four adults with 

developmental disabilities to set a table using 

video prompting. When only one adult 

learned the skill with video prompting alone, 

an error correction procedure was implemented 

with the remaining three adults, resulting 

in skill acquisition. With this procedure, 

if an adult made an error, they were told 

it was incorrect and watched the video a second 

time. If the adult responded incorrectly a 

second time, the experimenter completed the 

step and instructed the adult to watch the 

completion of the step. This procedure was 

repeated with all incorrectly completed steps. 

In the second error-correction procedure, 

error correction is provided from the outset of 

intervention, rather than following a plateau 

in skill acquisition. For example, Van Laarhoven 

et al. (2009) successfully used video 

prompting with error correction to teach jobrelated 

tasks to a young man with developmental 

disabilities. They used similar error 

correction procedures as those of Goodson et 

al. (2007), but error correction was provided 

with the participant’s first error after intervention 

was started, rather than waiting for his 

performance to plateau. 

Although providing error correction following 

a plateau in skill acquisition (Goodson 

et al., 2007) and providing error correction 

from the outset of intervention (Van Laarhoven 

et al., 2009) both appear to be effective, 

the question remains whether one method 

will lead to more efficient skill acquisition. 

Additionally, using a handheld device such as 

an iPod Touch to present the video prompts 

requires further exploration. As such, the purpose 

of this study was to examine the following 

research questions: (a) Can individuals 

with moderate to profound intellectual disability 

acquire daily living skills using video 

prompting presented on an iPod Touch? and 

(b) Is video prompting with error correction 

provided from the outset of intervention more 

effective or efficient at teaching daily living 

skills than video prompting with error correction 

added when skill acquisition plateaus? 

Method 

Participants 

Three adolescent students with moderate to 

profound intellectual disability were selected 

for participation because they (a) could perform 

few daily living skills (see Vineland ageequivalents 

in Table 1), (b) had specific educational 

goals related to daily living skills, and 

(c) were recommended by their educational 

teams. Participants’ vision and hearing were 

within the normal range. 

Matt was a 15-year-old male with a profound 

intellectual disability and Noonan syndrome. 

He had no systematic form of communication, 

and his teacher reported that he was very passive 

(i.e., requiring high levels of physical 

prompting to complete tasks), did not attend 

well to instructions or activities, rarely initi- 

Video Prompting and Error Correction / 333

TABLE 1 

Student Vineland Adaptive Behavior Scales 

(Sparrow, Balla, & Cicchetti, 1984): Age 

Equivalents (presented in years-months) 

Name 

Communication 

Vineland Subdomains 

Daily 

Living 

Skills Social 

Adaptive 

Behavior 

Composite 

Matt Below 0–1 1–10 1–7 1–9 

Ann 1–4 2–7 3–3 2–3 

Mark 1–8 3–2 3–6 2–9 

ated interactions with others in his environment, 

and would throw or push items away 

with which he did not wish to engage. Matt 

could follow one-step instructions, select between 

“more” and “finished” when presented 

with a two button switch, hold writing utensils, 

throw things in the garbage, feed himself and 

wipe his mouth when finished, and request to 

use the restroom. In addition to daily living 

skills, his Individualized Education Program 

(IEP) goals included navigating to and entering 

a predetermined location, selecting the 

correct item from an array when instructed by 

his teacher, assisting with setting up an activity, 

and participating in an activity for at least 

10 min. 

Ann was a 15-year-old female with a moderate 

intellectual disability, Trisomy X syndrome, 

and mild cerebral palsy. She spoke in 

two- to three-word utterances and engaged in 

echolalia. She had poor balance as a result of 

the cerebral palsy, but could complete various 

gross motor skills. Her teacher reported that 

she could follow one-step directions, select 

between “more” and “finished” when presented 

with a two button switch, sort and verbally 

label colors, remain on task for more 

than 5 min, greet her peers and teachers, and 

feed herself. In addition to daily living skills, 

her IEP goals included shredding paper, following 

simple directions, sorting at least 24 

items, presenting an identification card when 

asked, coloring within the lines of a drawing, 

and discriminating between two colors. 

Mark was a 15-year-old male with a moderate 

intellectual disability and autism. He spoke 

in two- to three-word utterances, which were 

often echolalic in nature. His teacher reported 

that Mark required several verbal 

prompts to remain on task and would engage 

in challenging behavior (e.g., dropping to the 

floor, grabbing, pinching, eloping) to gain 

attention or access a tangible item. Mark 

could turn the pages in a book when it was 

read to him, follow one-step instructions, 

build with blocks, match colors, feed himself, 

wash his hands, dress himself, and request to 

use the restroom. In addition to daily living 

skills, his IEP goals included creating patterns, 

following a pattern, and expanding the length 

of his verbal utterances to four to five words. 

Setting 

This study was conducted in an urban selfcontained 

school serving students with moderate 

to profound intellectual and physical 

disabilities between the ages of 5 and 22. All 

three students were served in the same classroom 

with five other students. Sessions for 

table washing were conducted in the school 

cafeteria, which contained large rectangular 

tables and chairs. Students cleaned the table 

closest to the entrance of the cafeteria. Sessions 

for sweeping were conducted in the students’ 

classroom, which contained a large table 

with chairs (sitting on linoleum) and a 

rectangular carpet. 

Materials 

Each student completed two tasks: sweeping 

with a manual sweeper (sweeping) and table 

washing. For the sweeping task, a Bissell manual 

sweeper was used, which “swept” debris 

into two dust compartments when moved forward 

and backward. Because this manual 

sweeper was used by the classroom staff only to 

clean visible debris—rather than for general 

cleaning purposes—small strips of paper (approximately 

10 pieces) were placed on the 

carpet for the students to clean. For table 

washing, each student used one container of 

soapy water, one of clean water, one wash 

cloth, a roll of paper towels, and a garbage 

can. All materials for this task—except the 

garbage can—were placed on a rolling cart 

placed next to the table. The garbage can was 

placed next to the cart. 

A second generation Apple iPod Touch was 


TABLE 2 

Task Analyses Including Video Duration 

Sweeping 

used as the prompting device in this study. An 

auxiliary speaker (iMainGo 2 Handheld 

Speaker) was connected to the iPod Touch in 

order to increase the volume of the verbal 

instructions. 

Task Selection and Video Development 

The target tasks were identified by the students’ 

teachers and addressed specific daily 

living skill goals in their IEPs. Table washing 

and sweeping, were judged to be equivalent 

because the (a) number of steps needed to 

complete each task, (b) average duration of 

each clip, and (c) gross and fine motor movements 

in each task were either equivalent or 

very nearly so. The tasks did not include any 

common steps. 

Because the students needed one-step, simple 

instructions, a task analysis was created 

Time 

(secs) Washing the 

Pick up sweeper from corner of room 6 Pick up wash cloth off of cart 6 

Bring sweeper to the section of floor to be swept 9 Place wash cloth in container of soapy 

water 

7 

Put the sweeper on the floor in front of the pile 9 Take wash cloth out of soapy water 5 

Lean handle backward and rotate hands 6 Squeeze wash cloth over container 11 

Move sweeper backward and forward until the 

floor is clean 

16 Bring wash cloth to the table 4 

Walk to garbage can with sweeper 13 Wash table by moving wash cloth back 

and forth across entire table top 

26 

Turn sweeper upside down, holding over 

garbage can 

10 Bring wash cloth back to cart 5 

Open bottom tray door 7 Place wash cloth in container of clean 

water 

4 

Shake garbage into can 6 Take wash cloth out of clean water 4 

Close bottom tray door 3 Squeeze wash cloth over container 9 

Rotate sweeper 7 Place wash cloth back on cart 7 

Open bottom tray door 7 Go to roll of paper towels 4 

Shake garbage into can 6 Rip off two paper towels 13 

Close bottom tray door 3 Bring paper towels to table 4 

Turn sweeper right side up 7 Dry table by moving paper towels 

back and forth across entire table 

top 

15 

Put sweeper back in corner 12 Throw away paper towels in garbage 

can 

7 

Time 

(secs) 

Note: Average clip length was: table washing, 8.2 s (range 4.4–26 s, sum 127 s); sweeping, 8.3 s (range 

3.8–16.5 s, sum 131 s). 

with the aid of the teachers. For example, the 

task of wetting and wringing out a washcloth 

was broken down into picking up the washcloth, 

dipping it into the water, taking it out of 

the water, and wringing it out. Each of the 

final task analyses consisted of 16 steps (see 

Table 2). 

The individual steps were filmed using a 

digital video camera and edited by the first 

author using iMovie (Apple Corp., 2009). 

Each step was videotaped from the perspective 

of a spectator, meaning that the students saw 

another person (i.e., an adult female) completing 

each step. At the beginning of each 

video clip, a verbal prompt was included 

that stated what the student was to do. For 

example, the video for the first step of 

sweeping started with the direction, “First, 

pick up the sweeper from the corner of the 

room.” This instruction was immediately fol- 


lowed by the adult female model completing 

that step. 

Once the videos were created and edited, 

they were uploaded to our developmental 

server so they could be added to the iPod 

Touch using the sync feature in iTunes. The 

video clips were then accessible using the 

video application already in the iPod Touch. 


There were three dependent measures. The 

primary dependent measure was the percentage 

of steps completed correctly for each task. 

During baseline, a correct response was defined 

as completion of each step within 30 s of 

the initial instruction (e.g., “Wash the table.”) 

or within 30 s of the completion of the previous 

step. During intervention, a correct response 

was defined as completion of a step 

within 30 s (or 60 s) of the end of the video 

prompt. Two steps (i.e., “wash the entire table” 

and “sweep the carpet until clean”) took 

longer than 30 s to complete, so a correct 

response was scored if those steps were completed 

within 60 s. 

Two secondary dependent measures included 

(a) the percentage of steps requiring 

error correction, and (b) the number of sessions 

required to reach criterion. The percentage 

of steps requiring error correction 

was defined as the number of steps per session 

requiring error correction divided by the total 

number of steps, then multiplied by 100. Mastery 

criteria were set at three consecutive sessions 

with 100% correct responding for each 

task, and the number of sessions to reach 

mastery was counted. 

Data Collection 

Data were collected on the percentage of steps 

completed correctly and the percentage of 

steps requiring error correction on a sessionby-session 

basis. Sessions were conducted individually 

with each student and schedules were 

determined by their daily activities. Each student 

received instruction at least three, with a 

maximum of eight, times per week. Typically, 

only one session was conducted per day. 


This study used an adapted alternating treatments 

design (Wolery, Bailey, & Sugai, 1988) 

within a multiple-probe across participants design 

(Horner & Baer, 1978) to demonstrate a 

functional relation between the intervention 

and subsequent changes in behavior. The 

adapted alternating treatments design was 

used to examine the effects of the two independent 

variables (i.e., video prompting with 

or without error correction) on the acquisition 

of the two skills. The multiple-probe 

across participants design was used to replicate 

the findings across multiple participants. 

Interobserver Agreement and Procedural Integrity 

Interobserver agreement (IOA) data were collected 

by independent observers during 30%, 

25%, and 32% of all phases for Matt, Ann, and 

Mark, respectively. Independent observers 

were trained by the first author, who explained 

the task analysis for each task, provided 

the observer with data sheets and explained 

how to complete them, and provided 

examples of correct and incorrect responses. 

IOA was calculated on a session-by-session basis 

by dividing the number of agreements by 

the number of agreements plus disagreements 

and multiplying by 100. IOA was 99% (range 

94–100%) for Matt, 99% (range 90–100%) 

for Ann, and 99% (range 94–100%) for Mark. 

Procedural integrity data were collected by 

independent observers during an average of 

29% (range 25–32%) of the sessions for all 

students across all phases. The procedures for 

each session were listed sequentially on a 

checklist and a secondary observer marked off 

which steps were completed correctly or incorrectly. 

Procedural integrity was calculated by 

dividing the number of steps completed correctly 

by the total number of steps and multiplying 

by 100. Mean procedural integrity was 

99% (range 90–100%) for all students. 

Procedure 

Baseline. During baseline, students were 

individually brought to the area where the 

task was to be performed and told to complete 

the task. For example, a student was taken to 

the table to be washed and told to “Wash the 


table.” During the session, the trainer recorded 

the number of steps the student completed 

correctly using single opportunity response 

probes (Snell & Brown, 2006). If the 

student did not initiate the first step of the 

task within 30 s or complete subsequent steps 

within 30 s of a previous step, the session was 

terminated. At the end of each session, the 

student was given noncontingent access to a 

choice of reinforcer. 

Video prompting without error correction (sweeping). 

Students completed the sweeping task 

using video prompting without error correction. 

When using video prompting, the iPod 

Touch was held by the trainer so as to be both 

easily operated by the trainer and easily 

viewed by the student. The students did not 

operate the iPod Touch. Once the student was 

attending to the screen, the trainer said: 

“Watch this.” The trainer then started the first 

video clip. When the video clip ended, the 

trainer said: “Now you do it.” If the student 

failed to correctly complete the step within 30 

(or 60) s, the trainer completed—or corrected—the 

step as unobtrusively as possible and 

proceeded to show the next clip using the 

same procedures as the first step. Students 

were only expected to complete one step at a 

time. No additional instructions, feedback, or 

prompts were delivered. At the completion of 

each session, the students were given noncontingent 

access to a choice of reinforcer. 

Video prompting with error correction (table washing). 

Students completed the table washing 

task using video prompting with error correction. 

In this condition, procedures were identical 

to the video prompting without error 

correction condition except error correction 

procedures were implemented if the student 

began a step incorrectly or did not complete a 

step correctly within 30 (or 60) s of watching 

the video. Error correction consisted, of interrupting 

the student if the step was attempted 

incorrectly saying: “Sorry, [name], that’s not 

quite right. Watch this.” The video clip was 

then shown a second time. When the video 

clip ended, the trainer said: “Now you do it.” 

The student was then given another 30 (or 60) 

s to complete the step. 

If the second viewing of the video clip did 

not evoke a correct response, three hierarchical 

least-to-most prompts were provided. The 

first prompt was a model, in which the trainer 

instructed the student to: “Watch me,” then 

completed the step correctly. If the student 

failed to show progress after three sessions 

using modeling, verbal direction was added, 

in which the trainer repeated the auditory 

prompt given in the video while modeling the 

correct response. Finally, if the student still 

was not performing a particular step after 

three sessions, full physical prompting was 

added. When using physical prompting, the 

experimenter repeated the auditory prompt 

given in the video while physically guiding the 

student to complete the step. All error correction 

decisions were made on a step-by-step 

basis. In other words, if a student was unsuccessful 

with one step in the entire task, only 

that step received the tiered error correction. 

Video prompting with error correction for both 

tasks. Once video prompting with error correction 

was shown to be more effective, it was 

added to the sweeping task. The procedures 

used were identical to those in the video 

prompting with error correction condition 

used for table washing. 

In vivo instruction. If the data for video 

prompting with error correction plateaued 

below mastery levels, in vivo instruction was 

implemented. A most-to-least prompting procedure 

was used in which a verbal direction 

was provided for each step, and the student 

was given 10 s to initiate a correct response. If 

the student did not initiate a response or began 

to respond incorrectly, a physical prompt 

was used to complete the step. After three 

sessions with the physical prompt, this was 

faded to a gestural prompt. Finally, the verbal 

prompt given to initiate each step was faded as 

the student began to chain steps of the task 

together. 

Results 

Matt 

Percent correct data for Matt are presented in 

the top panel of Figure 1 and the percent of 

steps with error correction in the top panel of 

Figure 2. During baseline, Matt did not initiate 

any steps for either sweeping or table washing. 

When video prompting with and without 

error correction were implemented, performance 

with both tasks steadily increased and 

the error correction prompts used with table 


Figure 1. Percent correct responding across sweeping (video prompting only) and table washing (video 

prompting with error correction) for Matt, Ann, and Mark. 


Figure 2. Percent of steps with error correction for Matt, Ann, and Mark. 


TABLE 3 

Number of sessions needed to reach criterion (i.e., three sessions with 100% correct responding) and the 

percent of steps completed correctly in the final session for each phase. 

Student Task 

Matt Criterion met (Number 

of Sessions) 

Percent Correct in Last 

Session 

Ann Criterion met (Number 




Mark Criterion met (Number 




Sweeping Without 

Error Correction 

washing steadily decreased. In session 91, performance 

of table washing (using video 

prompting with error correction) continued 

to increase, but performance of the sweeping 

task (using video prompting without error 

correction) plateaued. When comparing 

video prompting without error correction to 

video prompting with error correction, Matt 

performed an average of 41.5% (range 13– 

56%) of the sweeping steps correctly with 

video prompting alone and 41.4% (range 

0–69%) of the table washing steps correctly 

with video prompting plus error correction. 

When error correction was added to the 

sweeping task, his performance decreased 

slightly, completing an average of 34% (range 

19–44%) steps correctly, and the number of 

error correction prompts needed for the table 

washing task also increased with this changed 

condition. When both the table washing and 

sweeping tasks were moved to in vivo instruction, 

his performance on both tasks increased; 

he completed an average of 55.6% (range 

38–75%) of the sweeping steps correctly and 

an average of 65.9% (range 56–75%) of the 

table-washing steps correctly. Matt did not 

meet mastery for either task prior to the termination 

of this study, as noted in Table 3. 

Sweeping With 

Error Correction 

(additional 

sessions) 

Ann 

Table Washing 

With Error 

Correction 

In Vivo (additional 

sessions, task) 

Not met (46) Not met (17) Not met (61) Not met 

(28, Sweeping) 

Not met 

(28, Washing) 

44% 38% 69% Sweeping: 75% 

Not met (20) Not met (24) Met (33) 

Table Washing: 63% 

n/a 

56% 75% 100% n/a 

Not met (15) Not met (30) Met (32) Met (21, Sweeping) 

25% 69% 100% 100% 

Percent correct data for Ann are presented in 

the second panel of Figure 1 and the percent 

of steps with error correction in the second 

panel of Figure 2. During baseline, of the 

steps initiated, Ann completed 25% correctly 

for sweeping and an average of 16% (range 

6–19%) correctly for table washing. When 

video prompting was implemented (either 

with or without error correction), both tasks 

showed a stable increase, but table washing 

(using video prompting with error correction) 

was completed more successfully than sweeping 

(using video prompting without error correction) 

beginning in session 15. Additionally, 

the percentage of steps requiring error correction 

for table washing steadily decreased over 

the course of the intervention. When video 

prompting was used without error correction 

for the sweeping task, Ann performed an average 

of 51.8% (range 31–63%) of the steps 

correctly. When error correction was added to 

sweeping, she performed an average of 66.2% 

(range 50–81%) of the steps correctly and 

demonstrated a stable decrease in the percentage 

of steps requiring error correction in 

the first 15 sessions, though this stabilized af- 


ter the 15 th session. With table washing (which 

always used error correction), she performed 

an average of 81.7% (range 31–100%) of steps 

correctly, with the final five sessions maintained 

at 100% correct responding. The number 

of sessions Ann needed to reach mastery is 

presented in Table 3. Ann did not meet criterion 

with the sweeping task (though ended 

her last session completing 75% of the steps 

correctly) and met mastery with table washing 

in 33 sessions. 

Mark 

Overall percent correct data for Mark are presented 

in the bottom panel of Figure 1 and 

the percent of steps with error correction in 

the bottom panel of Figure 2. During baseline, 

of the steps he initiated, Mark completed an 

average of 0.6% (range 0–6) correctly for 

sweeping and an average of 1.4% (range 

0–13%) correctly for table washing. When the 

intervention was introduced, there was a clear 

differentiation between video prompting with 

and without error correction, with video 

prompting with error correction showing a 

steeper increase. When video prompting with 

error correction was introduced with table 

washing, Mark completed an average of 66.1% 

(range 6–100%) of the steps correctly, and 

completed the final three sessions with 100% 

accuracy. He also had a stable decrease in the 

percentage of steps requiring error correction. 

Conversely, when video prompting without 

error correction was introduced with 

sweeping, Mark completed an average of 

17.6% (range 6–25%) of the steps correctly. 

When error correction was added, his performance 

improved, but plateaued between 69 

and 75% (M 57.8%, range 25–75%). The 

decrease in the percentage of steps requiring 

error correction also decreased at a fairly slow 

rate. Finally, when in vivo instruction was implemented 

with sweeping, he reached mastery 

and ended this phase with three sessions at 

100% correct responding (M 87.8%, range 

75–100%). 

The number of sessions Mark needed to 

reach mastery is presented in Table 3. Mark 

did not meet criterion with the sweeping task 

using video prompting with or without error 

correction across 45 sessions (ending the 

video prompting with error correction condi- 

tion completing 69% of sweeping steps correctly), 

but did master the skill with in vivo 

instruction after an additional 21 sessions. He 

met mastery with table washing in 32 sessions. 


In this study, an iPod Touch was used to compare 

the effects of video prompting with and 

without error correction across two tasks and 

three individuals with moderate to profound 

intellectual disability. All students improved 

their performance over baseline levels, but 

only Ann and Mark met mastery using video 

prompting with error correction for table 

washing. Additionally, skill acquisition was 

slightly more efficient when error correction 

was included with the video prompts from the 

outset of intervention for two of the three 

students. For Matt, the inclusion of error correction 

with video prompting had a minimal 

effect, and in vivo instruction was used to increase 

his correct responding with both skills. 

All three participants attended to the iPod 

Touch and did not appear to have any trouble 

viewing the video prompts on the small 

screen. 

One possible reason that video prompting 

without error correction was less effective for 

all three participants was the lack of feedback 

on the accuracy of their performance. For 

example, both Matt and Ann consistently 

made the same error for certain steps in the 

sweeping task, yet during the video prompting 

without error correction phase, neither received 

any corrective feedback and continuously 

practiced this error. It is possible that 

the use of the error correction procedures 

would have remedied this problem, by providing 

opportunities for students to emit the correct 

response following the viewing of the 

video clip, thus enhancing the stimulus control 

the video prompt has on correct responding 

(Wordsell et al., 2005). 

Video prompting (with and without error 

correction) was the least effective for Matt. 

Anecdotally, it was noted that several of the 

steps in each task were physically challenging 

for him to complete. For example, he consistently 

struggled with washing and drying the 

entire table, squeezing the cloth, sweeping the 

carpet until it was clean, turning the sweeper 

over, shaking the dirt out of the sweeper, and 


opening the tray door on the sweeper. All of 

the tasks he struggled with were more physically 

demanding and required either high levels 

of gross (e.g., wash entire table) or fine 

(e.g., open tray door) motor movements. Of 

the three students, Matt had the most significant 

physical disabilities and had an extremely 

limited daily living skills repertoire. For individuals 

who have intellectual disability, the 

types of skills being taught and the requirements 

of the responses affect the acquisition 

of new skills (Mechling & Gustafson, 2009). 

Thus, it is likely that the skill requirements of 

the two tasks influenced his results. On the 

other hand, although he did not master the 

tasks, he made substantial progress. 

Although all students made progress with 

the sweeping task using video prompting without 

error correction, the fact that none of 

them reached criterion with this task, even 

after the error correction procedures were 

implemented, suggests that including error 

correction from the outset of intervention is 

more effective. Sigafoos, O’Reilly, and Lancioni 

(2010) indicate that individuals with significant 

disabilities generally take longer to 

learn new skills, suggesting that educators 

should focus their energy on teaching skills 

correctly from the beginning of instruction. 

Because error correction with sweeping was 

not added until performance of the target 

behavior plateaued, the students were not 

able to practice the correct responses for the 

steps, and, in some cases, actually practiced 

incorrect responses. One could argue that unlearning 

incorrect behavior decreases learning 

efficiency, resulting in the need for a more 

intensive teaching strategy (i.e., in vivo instruction, 

which both Matt and Mark needed). 

Therefore, using error correction from the 

outset is likely to limit the errors a student 

might make, thereby decreasing the likelihood 

of practicing incorrect responses and 

potentially increasing the efficiency of instruction. 

Even though results of this study were positive, 

there are several limitations to consider 

when interpreting these data. First, although 

efforts were made to identify equivalent tasks, 

it appears from the data that sweeping was 

more difficult than table washing. Additionally, 

because we did not counterbalance the 

two conditions (e.g., two participants complet- 

ing table washing with video prompting with 

error correction and sweeping with video 

prompting alone and the third participant 

completing table washing with video prompting 

alone and sweeping with video prompting 

with error correction), there was no additional 

control in place to address potential 

differences in task difficulty. It is possible that 

video prompting alone could have led to mastery 

with the table washing task. Future research 

could address this issue by conducting 

a more thorough equivalency analysis and/or 

by counterbalancing the conditions. 

Related to the first limitation, it was noted 

after the study was underway that several of 

the steps in the task analyses had been broken 

down into components that were too small. 

For example, in the table washing task, putting 

the cloth into the water, taking the cloth 

out of the water, and squeezing the cloth were 

presented as three separate steps. As we observed 

our students completing these steps, it 

became clear that these steps would have been 

better presented as one step, which would 

have been more natural and practical. Future 

researchers should test their task analyses for 

both completeness and practicality as this may 

impact skill acquisition and task equivalence. 

A third limitation is the manner in which 

the baseline probes were conducted. In this 

study, participants were only given a single 

opportunity to respond correctly (Snell & 

Brown, 2006). In other words, as soon as they 

missed a step or stopped responding, that 

baseline session was terminated. In other studies 

examining video prompting, a multiple 

opportunity method (Snell & Brown, 2006) 

has been used in which steps completed incorrectly 

were corrected and steps not attempted 

were completed by the researcher 

while the participant’s view was blocked. Although 

using the single opportunity method 

may demonstrate depressed baseline levels, 

when all three students began the intervention, 

they engaged in fairly low levels of responding 

that increased gradually, suggesting 

that even if low, the baseline measures were 

not unreasonable. 

As future researchers explore the use of 

video prompting with portable technology, it 

will be important to compare the effects 

across various devices. For example, although 

vision problems were not reported for any of 


our students, it may have been difficult for 

them to discern the salient features of the 

video prompts on the iPod Touch screen. It is 

possible that the students would have done 

better if they had been able to watch a larger 

video. It might also be possible for individuals 

with physical disabilities to manipulate the 

slightly larger screen of an iPad rather than 

the smaller screen on the iPod Touch. As 

technology progresses, it will be possible to 

use devices that are in between laptop computers 

and handheld devices in size, such as 

the iPad. Future researchers may want to compare 

skill acquisition using an iPod Touch 

versus an iPad to determine if acquisition is 

more efficient with one device over the other. 

There are several additional lines of future 

research that should be pursued. Although 

this study did provide further investigation 

into the use of video prompting with error 

correction, replicating this study with different 

tasks and students would be useful. Additionally, 

a component analysis of which aspects 

of the error correction procedure were 

the most salient will be important to investigate 

so that the most efficient procedures may 

be implemented. Another line of research 

would be to determine if individuals with intellectual 

disability could be taught to manipulate 

the small computer interfaces, such as 

the iPod Touch, independently. 

In summary, this study compared the use of 

video prompting with and without error correction 

using the iPod Touch and found that 

the inclusion of error correction from the 

outset of intervention was beneficial for two of 

the three students. The data also present another 

demonstration that video prompting is 

an effective technology for teaching new skills 

to individuals with moderate to profound intellectual 

disability. 

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Received: 23 August 2011 






Cognitive Strategy Instruction for Functional Mathematical 

Skill: Effects for Young Adults with Intellectual Disability 

Youjia Hua, Benjamin S. T. Morgan, Erica R. Kaldenberg, and Minkowan Goo 

The University of Iowa 

Abstract: This study assessed the effectiveness of a three-step cognitive strategy (TIP) for calculating tip and 

total bill for young adults with intellectual disability. In the context of pre- and posttest nonequivalent-groups 

design, 10 students from a postsecondary education program for individuals with disabilities participated in the 

study. A teacher delivered six lessons to students in the experimental group using the working instructional 

model for teaching learning strategies. Results indicate that the experimental group outperformed the comparison 

group on items that assessed the ability to calculate tip and total bill. Students from the experimental 

group also generalized the procedural knowledge to tasks that required using percent values in different contexts. 

Four of the students from the experimental group maintained the use of the strategy 8 weeks after the 


Self-determination, the ability to control one’s 

own life without relying on caregivers, is an 

important educational outcome for individuals 

with disabilities as they transition to adult 

living (Field & Hoffman, 2002; Wehmeyer, 

Agran, & Hughes, 1998). Self-determination is 

often associated with the success achieved in 

the areas of living, employment, and education 

(Halpern, 1993). One set of skills that is 

necessary to fulfill the expectation of independent 

functioning in these areas is financial 

autonomy including the ability to earn, budget, 

and spend money (Browder & Grasso, 

1999). Unfortunately, individuals with disabilities 

often have difficulties with money management 

skills (Yan, Grasso, Dipipi-Hoy, & Jitendra, 

2005). These difficulties, in turn, 

affect all aspects of adult life. For example, the 

National Longitudinal Transition Study (Wagner 

et al., 1991) examined the financial management 

activities performed by young adults 

with learning disabilities who had been out of 

the schools for up to two years and found that 

very few participants had checking accounts 

(8.1%), a credit card of their own (8.1%), or 


be addressed to Youjia Hua, Department of Teaching 

and Learning, N256 Lindquist Center, The University 

of Iowa, Iowa City, IA 52242. Email: youjiahua@uiowa.edu 

other investments (0.4%). The results of the 

study indicate that young adults with learning 

disabilities are not engaged in some of the 

essential money management activities that 

most adults will need. 

Researchers suggest that one important reason 

why individuals with disabilities have limited 

opportunities to reach financial autonomy 

is that they lack essential functional 

mathematical skills (Patton, Cronin, & Bassett, 

1998). Mathematical deficiencies are as 

common as difficulties in reading for individuals 

with disabilities (Deshler, Ellis, & Lenz, 

1996). Researchers found that students with 

learning difficulties tend to acquire mathematical 

skills at a slower rate and have difficulties 

with skill retention and generalization 

(Miller & Mercer, 1997). Limited mathematic 

literacy for students with learning difficulties 

appears in elementary school and persists 

throughout their adulthood (e.g., Kirby & 

Becker, 1988). As a result, social and economic 

independence of adults with disabilities 

is negatively affected (Lerner, 1993). In 

order to prepare these individuals for the demand 

and challenges of adult life, postsecondary 

mathematical curriculum should focus on 

the skills that will be used on the job, at home, 

and in the community (Deshler et al., 1996; 

Patton et al., 1998). 

In addition to a functional skills oriented 

Functional Mathematical Skill / 345

mathematics curriculum, postsecondary learners 

also need evidence-based instruction. 

Analysis of reviews of literature suggests that 

young adults with learning difficulties benefit 

from teacher-directed explicit instruction 

(Deshler et al., 1996). Explicit instruction is 

characterized by beginning the teaching sequence 

with a review of the prerequisite skills 

followed by teacher modeling and guided and 

independent practice (Archer & Hughes, 

2010). During instruction, the teacher presents 

information in small steps, uses full range 

of examples and nonexamples, elicits frequent 

student responses, and provides immediate 

feedback (e.g., Miller & Hudson, 2007). 

The effectiveness of explicit instruction for 

students with learning difficulties has been 

well documented. For example, Swanson and 

Hoskyn (2001) conducted a meta-analysis of 

180 published intervention studies and found 

that interventions that included components 

of explicit instruction resulted in larger effect 

sizes than those in the comparing conditions. 

Likewise, the research synthesis by Baker, Gersten, 

and Lee (2002) indicates that interventions 

using teacher directed explicit instruction 

had a positive, moderately strong effect 

on the mathematics performance of lowachieving 

students. 

On the other hand, researchers found that 

using explicit step-by-step structured instruction 

is not sufficient for students with disabilities 

when teaching mathematical skills to 

solve real-life problems as successful problem 

solving requires learners to use effective strategies 

that utilize both cognitive and metacognitive 

process (Montague, 1997; Reid & Lienemann, 

2006). Strategies are often defined as a 

series of sequenced procedures that allow an 

individual to complete a task using the awareness 

and action of planning, implementing, 

and evaluating the process and outcome 

(Reid & Lienemann, 2006). Unfortunately, 

students with disabilities have difficulties selecting 

and applying appropriate strategies to 

solve problems because they have a limited 

awareness of the potential usefulness of the 

strategies for a given task. Even when they 

have an idea of the appropriate strategy to 

use, they use it ineffectively because they often 

take too much effort to retrieve procedures, 

operations, and basic mathematic facts, leav- 

TABLE 1 

Three-Step TIP Strategy 

T: Take a look at the total bill and enter it on the 

calculator. 

I: Identify the tip by multiplying the total by 15%. 

P: Plus the total and find out how much to pay. 

ing little cognitive resources to process new 

information (Maccini & Hughes, 1997). 

Research in the area of cognitive strategy 

suggest that students with learning difficulties 

can benefit from strategy instruction focusing 

on mathematical word problems (e.g., Case, 

Harris, & Graham, 1992; Montague, 1992) 

and computation problems (e.g., Brown & 

Frank, 1990; Rivera & Smith, 1988). However, 

research in the area of functional mathematical 

skill acquisition for postsecondary students 

with disabilities is sparse and unable to 

guide practice. Recent reviews (Browder & 

Grasso, 1999; Yan et al., 2005) on teaching 

money skills for students with disabilities highlighted 

the needs for additional research that 

include (a) learners at postsecondary level 

with academic skills and (b) interventions that 

address more complex money management 

skills that require using mathematical computation 

skills. While the utility of strategy instruction 

has yet to be proven in the area of 

functional mathematical skill acquisition it 

seems to be a logical intervention in this domain 

for young adults with intellectual disability. 

The purpose of this study was to assess the 

effectiveness of a three-step strategy (TIP) for 

calculating tip and total bill for learners with 

disabilities in a postsecondary education program. 

The TIP strategy includes three essential 

steps that can be used to calculate tip and 

total bill in a variety of contexts (e.g., restaurant, 

hotel, cab). Table 1 presents the three 

steps of the TIP strategy. The mnemonic device 

(TIP) may serve as a natural cue to 

prompt learners to use the strategy in the 

applied setting. The study extends the literature 

by examining the utility of strategy instruction 

as a means for teaching a functional 

mathematical skill to students with disabilities 

at postsecondary level. Specifically, we sought 

to answer the following research questions: 


TABLE 2 

Participants Demographic Data by Experimental Condition 

1. Can young adults with disabilities acquire 

and apply the TIP strategy to calculate tip 

and total bill? 

2. Will the learners generalize the procedures 

of the TIP strategy to solve functional 

mathematical problems involving 

percentage values? 

Method 

Variable Gender Age Ethnicity Disability IQ 

Experimental Group 

Student One Female 21 Caucasian Severe LD, ADHD 82 

Student Two Female 22 Caucasian MR 65 

Student Three Male 22 Caucasian ASD 74 

Student Four Female 18 Caucasian ASD 77 

Student Five Female 18 Caucasian ASD 80 

Comparison Group 

Student One Female 24 Caucasian ASD, ADHD 65 

Student Two Male 22 Caucasian ASD 72 

Student Three Female 20 Caucasian MR, ADHD 63 

Student Four Female 21 Caucasian Severe LD 92 

Student Five Male 23 Caucasian ASD 69 

Note. IQ full scale intelligence quotient scores reported for the Wechsler Intelligence Scale for children. 


Participants were students enrolled in two 

classes from a post-secondary education program 

for young adults with learning and 

intellectual disability at a Midwestern university. 

The program provided an integrated 

collegiate experience including academic 

coursework, career development, student life, 

and community life. The program academic 

coordinator suggested that some students 

needed additional help with functional mathematical 

skills in the area of calculating tips 

and total bill. At the time of the study, all 

participants took a life skill class as part of the 

program curriculum. The class covered a variety 

of skills including social interactions, domestic 

skills, pre-vocational and vocational 

skills, as well as daily living skills. Students did 

not receive any instruction on how to calculate 

tip and total bill from the courses offered 

by the program before the intervention. 

We did not get permission from the pro- 

gram to randomly assign the students to 

groups as the two classes had different schedules 

and vocational placement throughout the 

day. Instead we used a pre- and posttest nonequivalent-groups 

design to examine the effects 

of the intervention on acquisition of the 

tip and bill calculation skill of the participants. 

To ensure that the participants possessed the 

prerequisite skills and had difficulties with 

tip and total bill calculation, we required the 

students to meet the following inclusion criteria. 

First, students were able to complete the 

mathematical computation tasks accurately 

using a calculator. Second, students must 

have completed the word problems requiring 

them to calculate the tip and the total bill 

on the pretest with accuracy lower than 

50%. Five students from one class met the 

inclusion criteria and participated in the study 

as an experimental group. We also enrolled 

five students who met the inclusion criteria 

from the other class as a comparison group. 

Table 2 presents a detailed description of 

each student, including age, gender, ethnicity, 

IQ score, and disability category. We conducted 

an analysis of variance (ANOVA) to 

evaluate comparability of the two groups before 

the intervention as this research design 

does not control for interactions between subject 

selection and other factors including 

school history and maturation (Campbell & 

Stanley, 1966). The ANOVA tests showed that 

there were no significant differences between 

Functional Mathematical Skill / 3<strong>47</strong>

TABLE 3 

Examples of Types of Problems Used on Pretest, Posttest, and Maintenance Check 

the two groups of students with regard to their 

pretest (F [1, 8] .20, p .67), IQ scores (F 

[1, 8] .32, p .58), or age (F [1, 8] 2.42, 

p .16). 

A program instructor who had two years 

of experience teaching functional life skills 

delivered the strategy instruction to the 

experimental group three times a week 

(i.e., Monday, Wednesday, and Friday) during 

the regularly scheduled class time. Each 

lesson lasted for approximately 30–35 minutes. 

The total duration of the intervention 

was two weeks (i.e., six lessons). During the 

intervention, students in the comparison 

group attended their regularly scheduled 

classes. 

Materials 

Problem type Example 

Target item Mike had a dinner at a restaurant and the bill was $35.63. He paid the bill with 

additional 15% for the tip. 

(a) How much was the tip? 

(b) How much did he pay in total? 

Generalization Item 

Different context The price for a can of soda is $2.99 and the sales tax is 6%. 

(a) How much is tax? 

(b) How much total will you pay for the soda? 

Different operation The book is on sale for 20% off. The price for the book you want to buy is $20.00. 

(a) How much money will you save from the sales? 

(b) How much is the book now? 

Different value Your bill for your dinner is $127.56 and you really enjoyed the service. You want to 

give the waiter a 20% tip. 

(a) How much is the tip? 

(b) How much is the total you will pay? 

We developed three equivalent probes for the 

pretest, posttest, and maintenance check. 

Each probe contained 16 items including 

(a) 10 target items that assessed students’ 

ability to calculate tip and total bill in a variety 

of situations (e.g., restaurant, delivery, taxi 

fare) and (b) six generalization items that 

assessed students’ ability to solve problems 

using percentages in a different context 

(e.g., calculate sales tax), requiring different 

operation (e.g., calculate sales price), or using 

different percentage values. Table 3 presents 

examples of each type of problem on the 

three tests. Each target and generalization 

item on the probes contained two questions 

that were related to the two steps of the problem 

solution. Therefore, the total available 

number of problems from the target items was 

20 and 12 from the generalization items. The 

order of the different types of items on the 

tests was randomized (Case et al., 1992). We 

also developed additional worksheets that 

only contained target items for guided and 

independent practice during the intervention. 

General Procedure 

The instructor of the course delivered the 

intervention to the experimental group using 

the scripted lesson plans developed by the 

researcher. Each scripted lesson plan included 

a step-by-step protocol, teacher wording, 

examples, student worksheets, and overhead 

transparencies. Before each lesson, the 

researcher and the teacher went over the lesson 

plan together and simulated the teaching 

process using the script. 

Each lesson followed the structure of an 

explicit instruction lesson. For example, the 

teacher began each lesson with a review of the 

previous lesson and a description of the learning 

objectives and expectations. Following the 


opening of the lesson, the teacher modeled 

skills using clear, consistent and concise language. 

Then the students practiced the skill 

with teacher prompts. After the students successfully 

completed the tasks, the teacher 

gradually faded prompts and the students 

practiced the skills independently. Before the 

conclusion of the lesson, the teacher reviewed 

the skills and gave a preview of the upcoming 

lessons. The teacher also embedded some critical 

presentation techniques throughout the 

instruction including eliciting frequent unison 

responses, monitoring student responses, 

providing feedback, and maintaining appropriate 

pace of the lessons. 

TIP Strategy Instructional Procedure 

The development of the TIP strategy intervention 

was based on the features of the working 

instructional model for teaching learning 

strategies described by Deshler and colleagues 

(1996). We chose this model because it addresses 

the learning needs of students with 

disabilities and its effectiveness has been well 

documented (Montague & Dietz, 2009). The 

TIP strategy contained six instructional stages 

including pretest and making commitments, 

describing the strategy, modeling the strategy, 

verbal elaboration and rehearsal, controlled 

practice and feedback, and advanced practice 

and feedback. 

Stage 1. The purpose of this stage was to 

(a) review the pretest results, (b) provide a 

rationale for learning the strategy, and (c) 

obtain commitment from the students to 

learn the new strategy. At the beginning of the 

lesson, the teacher communicated the pretest 

results to the students and compared students’ 

performances to the mastery criteria. 

The teacher also asked the students to identify 

the examples and situation, in which they 

used ineffective tip calculation. The teacher 

and the students then discussed the purpose 

and importance of learning a new strategy and 

its relevance to their ability to live independently. 

At the end of the first lesson, the 

teacher made a commitment to the students 

to teach the strategy effectively and prompted 

the students to commit to learning the strategy 

with effort and time. 

Stage 2. The purpose of the lesson at this 

stage was to describe the TIP strategy. First, 

the teacher described the utility of the strategy. 

For example, the teacher and the students 

discussed where and when the TIP strategy 

should be used. The teacher also 

described situations in which TIP strategy was 

not appropriate. After the initial overview of 

the strategy, the teacher described why and 

how each step of the strategy was used while 

emphasizing the importance of using selfinstruction 

to regulate the use of the strategy 

(e.g., “What we say to ourselves as we take 

each step will help us use the strategy and 

solve the problem.”). At the end of the lesson, 

the teacher discussed how to remember each 

step of the strategy by using the acronym 

TIP and asked the students to make their own 

cue cards containing each step of the TIP 

strategy. 

Stage 3. The purpose of this lesson was for 

the teacher to model the use of TIP strategy. 

The teacher first demonstrated the cognitive 

processes and acts required to carry out each 

step of the strategy while “thinking aloud” 

using the following types of statements: (a) 

problem definition (“The problem asks me 

how much I tip and how much I will pay in 

total.”); (b) strategy use (“It says tip. It means 

I can use TIP strategy to calculate the tip and 

bill. How do I spell TIP?”); (c) self instruction 

(“Where do I find the total of the bill? Find 

the number that says ‘total’.”); and (d) self 

monitoring (“I am not done yet. I will need to 

figure out how much in total I have to pay.”). 

Following initial modeling, the teacher involved 

the students to perform each step of 

the strategy by eliciting frequent choral response. 

The students were prompted to (a) 

self-talk using the actual words they would say 

to use the strategy themselves (e.g., “The second 

step is the second letter of the tip. Everyone 

all together, what is the second letter of 

tip?”) and (b) carry out the physical act of 

each step (e.g., “Yes. The total is ___ and you 

enter it on the calculator. Now look at your 

calculator. All together, tell me the number 

on your calculator”). At the end of the lesson, 

the teacher told the students that in order to 

make the strategy work they need to practice 

the new strategy and complete each step 

much faster. 

Stage 4. The purpose of the lesson at this 

stage was to ensure that each student understood 

and memorized each step of the TIP 


strategy. The teacher asked the students to 

explain the purpose of the TIP strategy and 

provided examples of when the strategy can 

be used. The teacher then checked student 

comprehension by asking them to verbally describe 

in their own words what they would do 

during each step. Following verbal elaboration, 

the teacher used “rapid-fire practice” to 

promote student memorization of each step 

of the strategy (Deshler et al., 1996). Using 

this activity, the teacher asked the students 

to name the steps of the TIP strategy in succession 

individually. As students became 

more fluent with the verbalization of each 

step, the teacher gradually increased the difficulty 

of the activity by increasing the speed 

and calling on students randomly. The 

teacher also gradually erased words from each 

step on the board until all three steps were 

invisible. The teacher reminded the students 

to use the letters in TIP to help them remember 

the steps. After the majority of the students 

memorized the steps, the teacher asked 

the students to rehearse the steps with a partner. 

The teacher conducted an individual oral 

quiz at the end of the class. To reach the 

mastery criterion, the student must have (a) 

described the purpose of the TIP strategy and 

(b) named and explained each of the three 

steps in order without referring to a cue card 

or receiving additional prompts. If a student 

did not reach the 100% accuracy criterion on 

the oral quiz, the teacher provided additional 

feedback and asked the student to return to 

the seat and practice it with a partner. The 

teacher used a verbal practice checklist to 

track students’ attempts at passing the oral 

quiz. 

Stage 5. The purpose of the lesson was to 

ensure that students mastered the use of the 

TIP strategy with guided practice. During the 

guided practice, the teacher and the students 

collaboratively completed two problems. Initially, 

the teacher told the students to use the 

TIP strategy by saying “You see the word tip in 

the question. That will help you remember 

the TIP strategy and its three steps. Each letter 

represents one step. You need to tell yourselves 

each step so that you will know how to 

find the answers.” At the beginning of the 

second problem the teacher only reminded 

the students of the strategy by asking “What 

strategy will you use and tell yourself what the 

first step is and complete it.” The teacher also 

frequently checked the accuracy of each step 

by eliciting choral responses (e.g., “Tell me, 

what’s the number on your calculator?”). After 

successful completion of the two problems 

collaboratively, the teacher provided the students 

with an opportunity to practice the skill 

independently. As the students worked on the 

four problems independently, the teacher 

monitored student performance by walking 

around the room, provided feedback to the 

students, and prompted the students to use 

think-aloud process. At the end of the class, 

the teacher collected and graded students’ 

independent work. All students completed 

the four problems on the worksheets independently 

with a minimum accuracy of 95% or 

above. 

Stage 6. The purpose of the learning stage 

was to provide students with additional opportunities 

to practice the strategy independently. 

As the students worked on the independent 

worksheets containing 10 problems 

requiring calculating tip and total bill the 

teacher continued to monitor student performances 

of the tasks. At the conclusion of the 

lesson, the teacher collected their work and 

praised their performance. 


The dependent variables were total number of 

problems answered correctly on the target 

items (i.e., items that required calculating 

tip and total bill) and the generalization 

items. We also analyzed the total number of 

procedural errors (i.e., no answer, guessing, 

and wrong operation) students made as identification 

of mathematical error patterns can 

help educators improve instruction and student 

learning (Case et al., 1992; Montague, 

1992). 


Students in both experimental and comparison 

groups took the test before the intervention 

(pretest) and immediately following the 

intervention (posttest). Students in the experimental 

group also took a maintenance test 8 

weeks after completion of the intervention. 

To ensure assessment integrity, the researcher 

developed a scripted protocol to administer 


TABLE 4 

Total Number of Items Answered Correctly by Students in the Comparison and Experimental Group 

Variable 

Pretest 

M(SD) 

the tests. At the beginning of each test, the 

teacher asked the students to complete the 

tasks with the following statement: “This is not 

a test or an assignment. It will not count towards 

your grades. Try your best to answer 

these questions. If you don’t know how to 

answer the question, make an ‘X’ on it and go 

to the next one. You have 15 minutes to work 

on these problems. It is okay if you don’t 

finish all the questions in 15 minutes. If you 

finish early, raise your hand and I will collect 

your worksheets. If you need a calculator, 

please raise your hand and I will give you 

one.” At the end of the 15 minutes, the 

teacher stopped the test and collected students’ 

answer sheets. A graduate student 

graded the probes. 

Reliability and Procedural Integrity 

The researcher developed procedural checklists 

for individual lessons based on the 

scripted lesson plans. The researcher trained 

a graduate student to observe the lessons and 

check the treatment integrity data using the 

procedural checklists. The procedural integrity 

was calculated by the total number of steps 

completed by the teacher divided by the total 

number of available steps on the procedural 

checklist. We collected treatment integrity 

data for all of the intervention sessions and it 

was 100% across the sessions. One graduate 

student who was not involved in the data collection 

and was blind to the participants in 

both comparison and treatment groups conducted 

the interobserver reliability checks for 

all of the probes independently. Interobserver 

agreement was calculated by total number of 

agreements divided by agreements plus disagreements 

multiplied by 100%. Given the 

Comparison Experimental 

Posttest 

M(SD) 

Pretest 

M(SD) 

objective nature of the answers, the mean 

agreement for total number of questions answered 

correctly on the target items were 99% 

(range between 92% to 100%) and 100% on 

the generalization items. 

Results 

Posttest 

M(SD) 

Maintenance 

M(SD) 

Target .00 (.00) .20 (.45) .40 (.89) 19.60 (.89) 16.80 (6.61) 

Generalization .20 (.45) .40 (.89) .00 (.00) 10.20 (1.30) 7.60 (5.32) 

Table 4 presents the means and standard deviations 

of total number of questions answered 

correctly by the students on the pretest, 

posttest, and maintenance probe. 

Students in the comparison group scored an 

average of 0 on the target items on the pretest 

and .20 on the posttest with a gain score of .20. 

With regard to the generalization items (Table 

5), students in the comparison group 

scored an average of .20 on the pretest and .40 

on the posttest with a gain score of .20. Students 

in the experimental group scored an 

average of .40 on the target items on the 

pretest and 19.60 on the posttest with a gain 

score of 19.20. With regard to the generalization 

items, students in the experimental 

TABLE 5 

Analysis of Gain Scores on the Target and 

Generalization Items between the Comparison and 

Experimental Group 

Variable 

Target Items 

Gain Score 


Items Gain 

Score 

* p .001 

Comparison 

M (SD) 

Experimental 

M (SD) 

Mean 

Difference 

.20 (.45) 19.20 (.45) 19.00* 

.20 (1.10) 10.20 (1.30) 10.00* 


Figure 1. Total number of procedural errors (represented by bars) on the target items committed by students 

(number above bars) from experimental and comparison group. 

group scored an average of 0 on the pretest 

and 10.20 on the posttest with a gain score of 

10.20. A comparison of the gain scores between 

the comparison and experimental 

group using an ANOVA indicated that the 

differences on both target (F [1, 8] 1289.29, 

p .001) and generalization items (F [1, 8] 

172.41, p .001) were statistically significant. 

In addition, students from the experimental 

group answered an average of 16.80 target 

items and 7.60 generalization items correctly 

on the maintenance probe. 

We also analyzed the types of errors participants 

made on both target and generalization 

items (see Figure 1 and 2). All five students in 

the comparison group made procedural errors 

on the target and generalization items, 

accounting for 100% of the total errors on the 

pre- and posttest. Similar error patterns occurred 

on both types of items on the pretest 

by all five students in the experimental group, 

accounting for 98% and 100% of the total 

errors on the target and generalization items. 

During posttest, students in the experimental 

group did not have any procedural errors on 

the target items and four of them had a procedural 

error on one of the generalization 

items. In addition, four students from the 

experimental group completed the target 

items on the maintenance probe without mak- 


Figure 2. Total number of procedural errors (represented by bars) on the generalization items committed by 

students (number above bars) from experimental and comparison group. 

ing any procedural errors. With regard to 

their completion of the generalization item 

on the maintenance probe, three students 

made errors due to lack of procedural knowledge. 


Learning how to calculate tip is a useful skill 

for young adults with disabilities. The TIP 

strategy addressed a common but important 

problem that young adults with disabilities 

were frequently encountering in postsecondary 

settings. At the time of the study, all of the 

participants were living on a university campus 

independently for the first time. Greater independence 

and change in their support network 

may have presented significant challenges 

for these students who lacked necessary 

functional money management skills in postsecondary 

settings (Hughes & Smith, 1990). 

For example, two of the most frequent ineffective 

tipping approaches described by the 

students at the beginning stages of strategy 

instruction were guessing and giving fixed 

amount of money as tip regardless of the total 

bill (e.g., always gave two dollars as a tip). All 

of the students acknowledged that the ineffec- 


tive strategies were impediments to their inclusion 

and functioning in the community 

and workplace. 

Participants’ lack of effective strategies to 

solve this type of functional mathematical 

problem was verified by the results of the pretest. 

Initially, all of the errors committed by 

the participants were due to lack of procedural 

knowledge; in other words they did not 

know the steps involved in calculating tip and 

total bill. The utility of the TIP strategy became 

evident as learning the strategy resulted 

in improved performance and corresponding 

reduction in the number of errors due to lack 

of an effective strategy (Case et al., 1992; Montague, 

2001). Four of the students from the 

experimental group also maintained the use 

of strategy 8 weeks after the intervention. 

More impressively, students in the experimental 

group generalized the procedural knowledge 

they gained from the TIP strategy to 

tasks that required using percentage values in 

different contexts, evidenced by significant reduction 

of the procedural errors on the test 

immediately following the intervention. In addition, 

three of the students maintained the 

skill generalization after the intervention. 

Therefore, this study extended the utility of 

strategy instruction in the area of functional 

mathematical skill with postsecondary students 

who had intellectual disability. 

Several features of the TIP strategy and instruction 

contributed to the effectiveness of 

the intervention in the study. First, the content 

and the design of the TIP strategy 

bridged the gap between the demands of the 

functional mathematical skills in the applied 

settings and the skill deficit of the students 

with disabilities. Successful tipping requires 

an individual to use an effective strategy that 

utilizes both cognitive and metacognitive 

process. For example, the individual will first 

recognize the situation when a tip calculation 

is necessary, then determine the steps and 

operations involved in the computation, and 

complete the procedures while retrieving 

and applying the knowledge of basic math 

facts. Simply teaching young adults with intellectual 

disability the three steps involved 

in the tip and total bill calculation may not 

result in acquisition and functional use of 

the procedures as participants in the study 

lacked an effective strategy to guide the exe- 

cution of this process that is highly metacognitive. 

For example, error analysis of the pretest 

indicated that all of the errors on the 

pretest were due to lack of procedural knowledge, 

suggesting that the participants had difficulties 

with selecting task-appropriate strategies 

and coordinating the procedures. In 

order to meet the demands of the functional 

skills, we developed the TIP strategy that addressed 

both cognitive and metacognitive 

learning needs of the learners in the study. 

The mnemonic device (TIP) served as a natural 

cue to activate learners’ awareness of the 

strategy and helped the learners store and 

retrieve information from the long-term memory. 

Each step of the strategy then prompted 

learners to take both overt action and use 

cognitive processes (e.g., problem definition, 

self-instruction, self-monitoring) to facilitate 

the execution of the procedures to calculate 

tip and total bill. 

Second, the strategy development model 

and the instructional procedures we used in 

the study also contributed to the student 

gains. We delivered the strategy instruction 

following the working instructional model for 

teaching learning strategies developed by 

Deshler and colleagues (1996). This strategy 

development model addressed both motivational 

and cognitive characteristics of students 

with learning difficulties. Given the long history 

of difficulties in the area of mathematics, 

motivation is an important factor that contributes 

to the successful acquisition of new skills 

for adults with disabilities (Deshler, Schumaker, 

& Lenz, 1984). In order to encourage 

the learners to be involved in and take ownership 

of the strategy, we made learning more 

relevant to their personal goals. At the beginning 

of the intervention, the teacher discussed 

the utility and benefits of the TIP strategy with 

the students. Throughout instruction, the 

teacher also emphasized that independent 

money management skill was a result of personal 

effort in learning and the use of the 

strategy. In addition to motivation, modeling 

was the other critical component of the strategy 

instruction (Montague & Dietz, 2009). 

During modeling, we emphasized the covert 

processes involved in the successful application 

of the TIP strategy using “think aloud.” 

Teacher’s verbalization of the thought processes 

gave learners the opportunities to ob- 


serve both cognitive (e.g., self instruction, 

paraphrase) and metacognitive processes 

(e.g., analyze the task, develop a plan, evaluate 

the outcome) required to carry out each step 

of the strategy, thus improving learners’ 

knowledge of the procedure and reason for 

each individual step of the strategy (Reid & 

Lienemann, 2006). 

Similar to findings from previous research, 

all the students in the experimental group 

generalized the procedural knowledge they 

gained from the TIP strategy to solve functional 

mathematical problems that involved 

using percentage values in a different context 

immediately following the intervention (Case 

et al., 1992; Hutchinson, 1993; Jitendra & 

Hoff, 1996). Researchers found that requiring 

students to perform the strategy fluently increased 

the likelihood that the learners will 

successfully generalize the skill to the untaught 

context (Schmidt, Deshler, Schumaker, 

& Alley, 1989). When a learner can 

perform a strategy with automaticity the individual 

will be able to decrease the cognitive 

requirement with regard to the details of the 

solution and instead allocate more cognitive 

resources to identify the similarity between 

trained and novel tasks, thus fostering generalization 

(Fuchs & Fuchs, 2003). In the current 

study, we provided students with frequent 

opportunities to respond to the tasks that facilitated 

understanding and memorization of 

individual steps and application of the strategy. 

Moreover, the teacher monitored learners’ 

responses and provided feedback to ensure 

that learners performed the skills with 

speed and accuracy before proceeding to the 

next stage of learning. On the other hand, the 

results of the study pointed to the necessity of 

programming for generalization in order for 

young adults with disabilities to transfer and 

adapt the strategy to solve for problems that 

require similar solutions. For example, four of 

the participants from the experimental group 

had a procedural error on the posttest that 

assessed their ability to solve the problem using 

similar procedures with different operation 

(i.e., calculate sales price based on the 

discount rate). Instead of using subtraction, 

the participants added the discounted value to 

the original price of the product. Their rigid 

execution of the strategy without modification 

supported research findings that learners with 

learning difficulties are less likely to use the 

cognitive mechanism appropriately to generalize 

and adapt the strategies to solve for tasks 

that vary in complexity and purpose (Montague, 

2008). 

Limitation and Future Research 

Results of this study must be interpreted 

within the context of its limitations. First, we 

used a quasi-experimental design in which we 

chose students from an intact class as the experimental 

group and a relatively comparable 

group of students from the other class as a 

comparison sample. Although the pretest differences 

and participants’ demographics between 

the two groups were below the recommended 

one-half standard deviation, it is still 

possible that some unknown variables that differentiate 

the two groups other than the intervention 

were responsible for the observed 

effects (Gersten, Baker, & Lloyd, 2000). Researchers 

also need to determine whether 

other individuals with intellectual disability 

would benefit from this cognitive strategy as 

young adults with intellectual disability have 

large discrepancies of needs and proficiency 

levels in mathematical and functional skills 

(Patton et al., 1998). In addition, replicating 

studies with small samples allows researchers 

to discover the causal relationship between 

the intervention and the dependent variables 

(Gersten et al., 2000; Gersten, Fuchs, Coyne, 

Greenwood, & Innocenti, 2005). 

Second, the results of the study point to the 

need of programming for maintenance as 

part of the strategy instruction. Although all of 

the participants in the experimental group 

improved their accuracy of all of the tasks on 

the posttest, the accuracy of target (student 1) 

and generalization items (student 1 and 3) on 

the maintenance probe was much lower than 

the posttest, suggesting that the learners did 

not maintain the skill of using TIP strategy 

over time. Therefore, providing ongoing practice 

opportunities that facilitate maintenance 

of the skills for learners with disabilities may 

be a critical component of the strategy instruction 

to promote long-term use of the strategy 

(Deshler et al., 1996). 

Third, we did not assess learners’ ability to 

perform the task in natural setting (e.g., cal- 


culate tip and total bill after a meal in a restaurant). 

Researchers recommend that providing 

opportunities to use the strategy in real 

context is a key component to ensure that 

learners have mastered functional use of 

money (Browder, Spooner, Ahlgrim-Delzell, 

Harris, & Wakeman, 2008). Future researchers 

need to include both training and probing 

of functional skills for generalization to real 

life situations using simulations, role play, and 

training in multiple settings. On the other 

hand, although we did not directly assess 

learners’ ability to perform the task in real life 

situations three students from the experimental 

group reported that they applied the TIP 

strategy in the restaurant and calculated the 

tip and total bill using the calculator from 

their cell phones. As an assistive technology to 

compensate for the difficulties with mathematic 

computation, the use of cell phone 

calculator may be more appropriate for young 

adults with disabilities because of its portability, 

compatibility, and social appropriateness 

(Raskind, 1998). With an increasing availability 

and use of cell phone, teaching learners to 

use a cell phone calculator may be a logical 

extension of the TIP strategy we implemented 

in the study. 

Practical Implication 

Teaching functional living skills will prepare 

young adults with disabilities to be successful 

in daily living, places of employment, and education 

(Alwell & Cobb, 2009). Such instruction 

will improve their quality of life and opportunities 

that may result in self-determination 

(Carter, Lane, Pierson, & Stang, 2008). Compared 

to the typical duration and intensity level 

of teaching functional life skills for young adults 

with disabilities (i.e., three to four months at an 

intensity of a few times per week; Alwell & Cobb, 

2009), the TIP strategy required only six sessions 

with a total duration of approximately three 

hours. In addition, the teacher expressed satisfaction 

with the strategy and instructional procedures. 

He indicated that he wanted to use the 

TIP strategy instruction procedures in the upcoming 

year. 

The results of the study also indicate that 

the TIP strategy instruction may be a promising 

strategy to teach learners with disabilities 

to solve for problems that required using per- 

centage values in a variety of contexts. It is 

possible that educators can enhance the utility 

and impact of the TIP strategy by including 

procedures that promote the use of strategy 

beyond the context in which it was taught and 

teach learners how to modify the components 

of the strategy to meet the new and different 

task demand (Deshler et al., 1996; Fuchs & 

Fuchs, 2003; Maccini, McNaughton, & Ruhl, 

1999; Montague, 1997; Montague & Dietz, 

2009). 

Conclusion 

Previous research has demonstrated the effectiveness 

of cognitive strategy instruction in 

academic areas for students with learning 

disabilities. This study extended the research 

by utilizing the strategy instruction in the 

area of functional mathematical and problem 

solving skills with postsecondary students 

with severe learning disabilities and mild 

mental retardation. Researchers should continue 

this line of research for young adults 

with intellectual disability with a focus on generalization 

and a more flexible use of the 

strategy. 

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Received: 18 May 2011 

Initial Acceptance: 21 July 2011 

Final Acceptance: 28 September 2011 




Increasing Comprehension for Middle School Students with 

Moderate Intellectual Disability on Age-Appropriate Texts 

Jordan Shurr 

Central Michigan University 

Teresa Taber-Doughty 

Purdue University 

Abstract: Students with moderate intellectual disability experience a lack of comparable access to literature as 

compared to their nondisabled peers (Browder et al., 2009; Kliewer, 1998). Problems in access for many of these 

students may be attributed to low expectations and inadequate support on behalf of students as well as a lack 

of sufficient literacy skills instruction. Given these issues, the literature students are able to access often is not 

representative of their chronological age. Literacy interventions such as read-alouds have been successfully used 

in special and general education alike to provide students access to literature beyond their present skill level. 

Using a multiple-probe design, investigators read typical age-appropriate texts and examined the effectiveness of 

pairing texts with the picture symbols and discussion in improving student comprehension. Discussion and 

implications of the findings within this study are included. 

Literacy is traditionally described as the act of 

reading, decoding, and comprehending language 

(Hoover & Gough, 1990). Literacy affords 

several social and personal benefits 

which impact an individuals overall quality of 

life including perceived competence, control 

over life choices, personal independence, 

tools for organization, as well as access to content 

for learning, information, and leisure 

(Downing, 2005), and has a profound impact 

on the day-to-day activities of individuals 

throughout the life span (Downing, 2005). 

Literacy can also serve as a primary means to 

access and participate in one’s own culture 

through activities such as reading a newspaper 

to understanding the issues of importance to a 

particular community or reading a popular 

novel series (e.g. Harry Potter) to recognize 

references and commentary made by others 

who have read it (Browder et al., 2009; Janks, 

2010). 

Students with moderate intellectual disability 

experience limited access to literature 

(Downing, 2005; Erickson & Koppenhaver, 


be addressed to Jordan Shurr, Department of Counseling 

and Special Education, 321 Education and 

Human Services Building, Central Michigan University, 

Mt. Pleasant, MI 48859. Email: shurr.jordan@ 

gmail.com 

1995; Kliewer, Biklen, & Kasa-Hendrickson, 

2006). Major obstacles for accessing literature 

include inadequate literacy instruction and 

materials, low expectations for success, and 

negative social attitudes toward disability 

(Browder et al., 2009; Downing, 2005; Kliewer, 

1998; Kliewer et al., 2006). Insufficient access 

to literacy supports, such as assistive technology 

or reading instruction, and inadequate 

instructional time have also been cited as access 

hindrances. A lack of adequate supports 

and attention to reading instruction result in a 

limited personal interaction with literature for 

these students (Downing, 2005). In addition, 

persons with intellectual disability often experience 

difficulties with memory, generalization, 

motivation, and adaptive behavior frequently 

make literacy challenging (Browder, 

Trela, & Jimenez, 2007; Browder et al., 2009; 

Downing, 2005; Kliewer, 1998; Kliewer & Landis, 

1999; Turnbull, Turnbull, & Wehmeyer, 

2010). For older students, difficulty accessing 

literature may occur due to the discrepancy 

between an individual’s needed supports and 

his or her age. Older students with intellectual 

disability, for example, often have support 

needs (e.g., representative pictures accompanying 

text, simplified text, text repetition) 

more similar to young early readers without 

intellectual disability than the support needs 

of their same aged peers without disabilities. 

Comprehension of Typical Texts / 359

This needs-age discrepancy may limit the availability 

of such supports and therefore access 

to literature (Browder et al., 2009; Downing, 

2005). Due to the importance of literacy as it 

relates to quality of life (e.g. perceived competence, 

independence) in general and on a 

day-to-day basis, students with moderate intellectual 

disability should have increased opportunities 

for access to literature. 

Literacy access for students with moderate 

intellectual disability can be described simply 

in two parts: (a) access to literature through 

reading and (b) access to literature through 

methods other than reading (Browder et al., 

2009). A substantial and growing body of special 

education research focuses on helping 


improve their access to literature through increased 

attention on reading skills. This includes 

research on using phonics to increase 

abilities in word decoding and fluency (Joseph 

& McCachran, 2003; Waugh, Fredrick, & 

Alberto, 2009), a meta-analysis of research on 

the effectiveness of sight word instruction 

(Browder & Xin, 1998), as well as use of a 

mixed approach to reading instruction (Allor, 

Mathes, Roberts, Jones, & Champlin, 2010; 

Otaiba & Hosp, 2004). Overall, research indicates 

that students with moderate intellectual 

disability are able to learn reading skills, which 

in turn increases their access to literature. 

However, especially for middle and high 

school students with moderate intellectual disability, 

reading skills alone often are not sufficient 

to access age or grade-level texts. As 


age and the literature appropriate for their 

age increases in complexity and content, access 

to this literature via reading skills often 

declines (Browder et al., 2009). Access to typical 

age-appropriate texts, the type of literature 

accessed by same-aged peers without disabilities, 

is important for students with 

moderate intellectual disability. In their work 

on general education content, including typical 

age-appropriate literature and students 

with significant intellectual disability, Browder 

et al. (2007) detailed four reasons for promoting 

access. These include (a) to foster competence 

and improve the quality of life, (b) promote 

high expectations for students, (c) 

provide equitable access to instructional materials, 

and (d) to increase opportunities to 

exercise self-determination. When age-appropriate 

literature is available for these students, 

the benefits include access to the cultural 

icons and ideas relevant to their age group 

(e.g. superhero’s, movie stars), appropriately 

mature content, (Browder et al., 2009) rich 

vocabulary, and exposure to advanced literacy 

skills (Kluth & Darmondy-Latham, 2003). 

Access to literature through methods other 

than reading includes listening to stories read 

aloud either by way of technology (e.g. book 

on tape, computer screen reader) or by an 

adult or peer, also called a read-aloud. Hearing 

text read aloud allows students with moderate 

intellectual disability to access the content of 

literature irrespective of their reading skills. 

This allows students to access general ageappropriate 

texts that are otherwise out of 

reach. Wehmeyer (2006) describes the successful 

use of technology to provide access to 

the novel Moby Dick to an adult with a significant 

intellectual disability and limited reading 

skills. The participant in Wehmeyer’s research 

indicated that this application allowed him to 

enjoy previously inaccessible literature for leisure. 

Several studies successfully used readalouds 

to increase access to literature for students 

with moderate and severe intellectual 

disability (Bellon, Ogletree, & Harn, 2000; 

Browder, Trela, & Jimenez, 2007; Lawhon & 

Cobb, 2002; Skotko, Koppenhaver, & Erickson, 

2004). Browder et al. (2007) found when 

teachers read age-appropriate adapted stories 

out loud, they were able to cultivate a leisure 

interest in literature, improve communication 

skills, and increase the comprehension abilities 

of older students with intellectual disability. 

In a study of the read-aloud behaviors of 

mothers to their daughters with Rett Syndrome, 

researchers found an effective and appropriate 

context was created to practice communication 

skills as well as comprehension 

and interaction skills (Skotko et al., 2004). 

Similarly, Bellon et al. (2000) found readalouds 

increased the spontaneous communication 

of a young child with autism. In addition 

to creating a context for communication 

skills, read-alouds were also found to provide 

opportunities for children to observe and interact 

with an effective model of literate behavior. 

Modeling literate behaviors such as 

this was found to be a powerful approach to 

teaching reading to young children (Lawhon 


& Cobb, 2002). Generalization, the ability to 

make sense of or complete a task under unfamiliar 

conditions, was also associated with 

read-alouds as text and concepts can be presented 

in multiple and unique ways (Browder 

et al., 2007; Bellon et al., 2000). In these studies, 

additional supports (e.g. picture symbols 

and discussion) were provided to increase student 

comprehension and engagement with 

the text. 

Visual supports such as picture symbols or 

photographs accompanying text proved to be 

beneficial in increasing access to the content 

of literature for students with intellectual disability 

(Browder, Mims, Spooner, Ahlgrim- 

Delzell, & Lee, 2008; Browder et al., 2009; 

Light, Roberts, Dimarco, & Greiner, 1998; 

Sevcik, Romski, & Wilkinson, 1991). Slater 

(2002) reported the advantages of using picture 

symbols added to texts for both comprehension 

and word identification. Light, Roberts, 

Dimarco, Greiner (1998) also reported 

positive effects of visual supports for increasing 

the receptive communication of students 

with autism. In a study on low achieving English 

language learners, Liu (2004) found cartoon 

images added to high-level texts to be a 

successful in increasing comprehension. The 

positive relationship between using images to 

increase literacy comprehension is echoed in 

the general education literature (Hibbing & 

Rankin-Erickson, 2003). A preliminary study 

on students with moderate intellectual disability 

suggested that visual symbols alone are not 

sufficient to support student comprehension 

of high-level texts read aloud. An additional 

intervention, text discussion, which involves a 

dialogue about certain key elements of a text, 

was found to successfully increase comprehension 

(Kucan & Beck, 1997; Moats, 2002). This 

may include clarifying questions, summary of 

main events and ideas, and situation of the 

text to familiar concepts for the student. This 

present study looks to combine visual supports 

and discussion to read-alouds, as an intervention 

to enhance the comprehension abilities 

of students with moderate intellectual disability 

on typical age-appropriate texts. This research 

inquiry attempts to increase the research 

base in non-reading access supports for 

this population to typical age-appropriate 

texts. 

Method 

Participants 

Participants in this study included four middle 

school students ranging in age from 12–15 

who were served in a self-contained classroom 

(less than 60% of their instructional day) setting 

in a suburban junior high school in a 

Midwestern state. Participants were nominated 

by their teacher based on the following 

criterion: (a) presence of a moderate intellectual 

disability, (b) ability to verbalize or physically 

identify a choice, (c) a lack of success 

with any one specific reading strategy, and (d) 

a willingness to participate. Five students were 

initially identified for participation. Following 

nomination, students were assessed on their 

ability to answer five basic three-option multiple-choice 

questions. Due to the emphasis on 

multiple-choice questions as a measure of 

comprehension in this study, 80% accuracy on 

this assessment was required for inclusion in 

this study. Four students met the criteria for 

inclusion and expressed interest in participating. 

Table 1 provides a summary for each 

participant. 

Sarah. Sarah was a 14-year old, 8 th grade 

female identified as having a moderate intellectual 

disability and a language impairment. 

Sarah’s IQ score was 54. Her most recent Individual 

Education Program (IEP) indicated 

she was able to use a large vocabulary of sight 

words and complete simple reading activities 

independently but was typically not able to 

read new or unfamiliar words. Sarah spent the 

majority of her school day with the classroom 

staff and students. Weekly activities included 

functional academic work in the classroom, 

prevocational tasks within the school and 

community, as well as instructional outings to 

various sites within the community (e.g. grocery 

store, library, and restaurants). She participated 

in some general education classes 

throughout the school week such as choir and 

home economics classes. In terms of literacy, 

Sarah was exposed to age-appropriate materials 

such as magazines and an adapted newspaper 

(News-2-You ® ), literacy supports such as 

books on tape and picture communication 

symbols, and instructional materials such as 

simple language-oriented reading and writing 

worksheets. Upon arrival to the classroom 


TABLE 1 

Participant Characteristics 

Student Age Ethnicity IQ Primary Disability Secondary Disability 

Sarah 14 Caucasian 54 a 

Moderate ID Language Impairment 

Ellen 14 Caucasian 52 b 

Moderate ID Language Impairment 

William 15 Caucasian 42 c 

Deaf, Language Impairment, Moderate ID, 

Multiple 

Speech Impairment 

Louis 12 Caucasian * Moderate ID Language Impairment 

a WISC-IV b SB5 c UNIT 

* IQ score not available 

each day, Sarah was observed working independently 

on academic worksheets or actively 

participating in group activities. Her personality 

could be described as bubbly as she spoke 

freely through her comments and questions. 

Ellen. Ellen was a 14-year old, 7 th grade 

female identified with a moderate intellectual 

disability (IQ 52) and a language impairment. 

Ellen’s most recent IEP noted she was 

able to read some basic elementary level sight 

words but experienced difficulty identifying 

words she had not memorized. Most of Ellen’s 

school day was spent with the classroom staff 

and students. She engaged in functional activities 

on a weekly basis including math and 

reading in the classroom, prevocational tasks 

within the school and community, as well as 

instructional outings to various sites within the 

community (e.g. grocery store, library, and 

restaurants). Ellen participated weekly in 

some general education classes such as choir. 

In terms of literacy, Ellen was exposed to ageappropriate 

materials such as magazines and 

an adapted newspaper (News-2-You ® ), literacy 

supports such as books on tape and picture 

communication symbols, and instructional 

materials such as simple language-oriented 

reading and writing worksheets. Ellen was a 

relatively quiet and shy young lady but was 

observed to be both willing and eager to work 

when asked. 

William. William was a 15-year old male in 

the eighth grade. He received special education 

services for students with multiple disabilities 

and was identified as having a moderate 

intellectual disability (Stanford-Binet IQ 

42), experienced a hearing disability, and 

speech and language disabilities. William’s 

most recent IEP indicated he was able to in- 

dependently read some elementary level sight 

words. Verbal communication was very limited 

for William. He used a speech-generating device 

(Dynavox), as well as gestures and a limited 

verbal vocabulary (yes/no) to communicate. 

The majority of William’s day was spent 

with the classroom staff and students engaged 

in functional activities such as academics in 

the classroom, prevocational tasks within the 

school and community, as well as instructional 

outings to various sites within the community 

(e.g. grocery store, library, and restaurants). 

In terms of literacy, William was exposed to 

age-appropriate materials such as magazines 

and an adapted newspaper (News-2-You ® ), literacy 

supports such as books on tape and 

picture communication symbols, and instructional 

materials such as simple language-oriented 

reading and writing worksheets. Although 

not always clear, William was very 

reliant on and fairly efficient in navigating 

and using his speech generating device to 

communicate in single word utterances typically 

to answer a question or make a comment. 

Although relatively quiet, William demonstrated 

a good sense of humor and was willing 

and eager to participate in school activities 

when requested. 

Louis. Louis was a 12-year old 7th grade 

male diagnosed with Down syndrome. His disability 

labels included a moderate intellectual 

disability and language impairment. Louis has 

recently lived in three different states over the 

past four years thus his official IQ score and 

school records were unavailable. His most recent 

IEP indicated that he was able to read 

and comprehend basic elementary sight 

words. Louis spent most of his school day with 

the classroom staff and students in functional 


academic activities in the classroom, prevocational 

tasks within the school and community, 

as well as instructional outings to various sites 

within the community (e.g. grocery store, library, 

and restaurants). Louis enjoyed participating 

in general education classes on a 

weekly basis including choir. In terms of literacy, 

Louis was exposed to age-appropriate materials 

such as magazines and an adapted 

newspaper (News-2-You ® ), literacy supports 

such as books on tape and picture communication 

symbols, and instructional materials 

such as simple language-oriented reading and 

writing worksheets. Despite his recent move to 

this school from out of state, Louis was very 

outgoing and amiable with the adults and his 

peers in the school. Although sometimes difficult 

to understand, he readily spoke with 

classroom visitors and friends. Overall, Louis 

was observed to be willing and eager to comply 

with work requests, he occasionally needed 

to be reminded or redirected in order to complete 

tasks. 

Setting 

Study activities were conducted at a large table 

in the students’ self-contained classroom. 

within the local seventh and eighth grade junior 

high school. Participants sat across from 

the first author at a table located in the back 

of the classroom. The classroom included a 

small kitchen near the entrance, a bathroom, 

ten student desks arranged in rows facing an 

interactive whiteboard, a teacher desk, a small 

computer lab with three computers on a side 

wall, and a table surrounded by five chairs in 

the back of the room. Approximately eight 

students and three classroom staff members 

were present in the room and engaged in 

various group (e.g., calendar, cleaning tasks) 

and independent activities (e.g., independent 

worksheets, simple reading tasks) throughout 

the study. Despite the various activities occurring 

simultaneously, the classroom was relatively 

calm and free from major distractions. 

Independent and Dependent Variables 

The independent variable was a combined intervention 

with visual support as well as discussion. 

The visual support, a picture symbol strip 

containing five photos representative of key 

elements within the text (e.g. character, setting) 

was presented to the student at the beginning 

of each session. A brief discussion 

about text content and the pictures contained 

within the picture strip occurred prior to and 

immediately following the text read-aloud. 

The dependent variable was the student’s response 

to a series of four multiple-choice 

questions about the text content. Questions 

were asked individually and students were able 

to respond verbally, by pointing to the correct 

answer, or through a combination of the two 

responses. If a student failed to respond 

within ten seconds, the question was asked 

again. 

Materials 

Texts. Texts for the read-alouds were selected 

from the SRA Specific Skills Series: Getting 

the Main Idea (Boning, 1997), Book G. 

This SRA instructional series contained short 

expository and narrative high-interest texts designed 

by content and readability for seventh 

grade students (McGraw Hill, n.d). All stories 

were comparable in difficulty and relative 

length. The SRA booklet was chosen due to 

the age targeted in both content interest and 

ability level. Additionally, this text was used 

due to the similarity in difficulty and length 

among texts. Fifteen stories were randomly 

selected from the booklet. The selected stories 

ranged in length from 78–108 words with a 

mean of 97 and median of 95 words per story. 

Topics were varied and included a biography 

of Astrid Lindgren, the author of Pippi Longstocking, 

to facts about Neptune’s largest 

moon Triton. 

Comprehension Questions. Each text was accompanied 

by five, three-option multiplechoice 

questions. Each question was literal in 

nature, based on understanding the facts in 

the story, and framed as one of six wh- questions 

(who, what, when, where, why, and 

how). Table 2 provides a sample of questions 

and answers used for one of the texts. The 

questions were created based on Piontek’s 

(2008) nine criteria for creating valid and reliable 

multiple-choice questions (see Table 3). 

To ensure adherence to the criteria, each 

question was independently checked against 

the criteria. Suggested adjustments were made 

to the questions, which were followed by an 


TABLE 2 

Sample questions for a story about San 

Francisco’s cable cars 

1) When were the cable cars first installed? 

A. 1999 

B. 1815 

C. 1873* 

2) How are the cable cars powered? 

A. by a cable that runs underneath the 

streets* 

B. by a diesel gas engine 

C. by electric power lines above the cars 

3) Where were the cable cars first installed? 

A. near the large beach in Hong Kong 

B. in the dense forests of New Zealand 

C. on the steep hills of San Francisco* 

4) Who has parties, weddings, and political 

rallies on the cable cars? 

A. Canadians 

B. San Franciscans* 

C. Soldiers 

* correct answer 

independent review by another rater to assure 

that the adjustments matched the criterion. 

To ensure consistency in readability between 

the stories and the questions in-text or textrelated 

words and phrases were used for the 

questions and options. A basic review of the 

questions was also conducted using the Flesch- 

Kincaid grade level equivalence in Microsoft 

Word. Each set of questions registered below a 

seventh grade reading level. 

TABLE 3 

Criteria for Multiple Choice Questions* 

1 Stem is a clearly described question, problem, 

or task. 

2 Stem is concise as possible. 

3 Only relevant information included in stem. 

4 No negatives used in stem. 

5 Only one correct answer. 

6 No irrelevant clues with correct response. 

7 Distractors are plausible but wrong. 

8 No “all of above” option 

9 Correct answer letter alternated among 

questions 

Note. Stem refers to the question statement. Distractors 

refers to the incorrect answer choices. 

* (Piontek, 2008) 

Physical Selection Sheet. An 8½-by-11 inch 

paper with 100-font printed letter options (A, 

B, & C) were presented to students allowing 

them to physically point to their answer following 

the presentation of a multiple-choice 

question. Students could answer questions by 

physically pointing to a letter on this paper, 

verbally answering the question, or both. If 

students failed to respond within ten seconds 

of hearing the question and multiple-choice 

answers, the researcher repeated the question 

and answers. None of the students required 

additional prompting to respond. 

Picture Symbol Strip. A visual support of five, 

4-by-4 inch color photos secured to a 4-by-20 

inch strip of poster board accompanied each 

story. Each picture represented one of the key 

elements of the text. The key elements and 

representative photos were selected through a 

search of Google images by the first author 

and reviewed by two independent reviewers 

for correspondence with the story. Each reviewer 

was asked to match each picture symbol 

strip with the story it represented while presented 

randomly. Both reviews resulted in 

100% agreement of the representation of the 

picture supports for each of the individual 

stories. 

Research Design 

A multi-probe across participants design (Kennedy, 

2005) was used to assess the effectiveness 

of the intervention on student’s listening 

comprehension. This design was selected because 

it enabled replications across students 

while controlling for any possible treatment 

effect. In addition, this design negated the 

need for a lengthy consecutive baseline that 

could be overly frustrating for students due to 

the comprehension difficulty of the material 

prior to intervention. 


Event recording (Kennedy, 2005) was used to 

record each response to the comprehension 

questions. Immediately following a student response, 

investigators recorded the letter chosen 

by the student. Event recording was selected 

due to the quick and easily identifiable 

nature of the dependent variable. 


Procedure 

Baseline. In this multiple probe design, students 

received from three to six sessions of the 

baseline treatment. During baseline sessions, 

one story was read aloud to each student. 

Students were then presented with four related 

multiple-choice questions. Students 

were provided up to ten seconds to respond to 

the first question without prompting. After 

ten seconds without a response, the question 

was repeated with an additional ten-second 

pause. Student responses included pointing to 

the letter on the letter choice sheet or saying 

the letter out loud. Following a response to 

the first question, the next question was asked 

and the same procedures were followed. 

Intervention. During intervention, students 

were presented with the picture symbol strip 

corresponding to the text presented during 

that session. Upon presentation of the picture 

strip, students were asked to verbally describe 

each photo. An investigator provided verbal 

feedback by agreeing with or clarifying student 

comments depending on each response. 

Next, the investigator pointed to each picture 

and described what it specifically represented. 

For example, when presented with a photo of 

Jupiter’s moon Triton, the investigator commented, 

“Here is Jupiter. Do you see how it 

looks rough? Scientists nicknamed it the cantaloupe 

moon because it looks rough like a 

cantaloupe. Do you see that?” After each 

photo was described, the text was read aloud 

to the student. Next, each photo was reviewed 

as it related to the text. The description process 

was interactive as students often commented 

or asked questions and received responses. 

Following the description, students 

were presented with the first of five comprehension 

questions followed by a ten-second 

pause for a response before asking the next 

question. If a student failed to respond within 

ten seconds, the question was repeated and an 

additional ten seconds provided for a response. 


Prior to the first baseline session and following 

the final intervention session, each student 

and the teacher was interviewed by the 

first author to determine his or her perceived 

TABLE 4 

Social Validity Questions for Students 

Pre Is it sometimes hard for you to 

understand what you hear? 

Pre Is it sometimes hard for you to 

understand stories that you hear? 

Pre Does anything help you understand what 

you hear? 

Pre Do picture symbols help you understand 

things that you hear? 

Pre Do you like to listen to stories read aloud? 

Pre What kinds of stories do you like? 

Post Did looking at the pictures help you 

understand the story? 

Post Did talking about the pictures help you 

understand the story better? 

Post Did you like looking at and talking about 

the pictures? 

Post Would you like to use this intervention at 

school? 

Post Did you like the stories? 

Post Which was your favorite story? Why? 

Post Which was your least favorite story? Why? 

Note. Pre questions asked prior to the study, 

Post questions asked following the study 

value of text comprehension, to assess 

whether or not each liked the intervention, 

and to gain insight on the practicality for the 

intervention’s use in the classroom (Horner 

et al., 2005). Informal interview questions (see 

Tables 4 and 5) were used to assess the students’ 

and the teacher’s perspectives regarding 

the independent and dependent variables. 

Interobserver Agreement and Treatment Fidelity 

To ensure data validity, the first author and a 

trained classroom paraprofessional simultaneously 

yet independently documented each student’s 

responses to comprehension questions 

during baseline and intervention conditions. 

Interobserver agreement was conducted for 

25–60% of baseline sessions with an average 

of 38% of sessions covered. For the intervention 

phase, interobserver agreement was conducted 

for 33–44% of sessions with an average 

of 36% of all baseline intervention sessions 

covered. Responses were compared to calculate 

reliability. Matching responses were labeled 

agreements and those not matching 


TABLE 5 

Social Validity Questions for the Teacher 

Pre Is auditory comprehension difficult for your 

students? 

Pre What types of interventions have you used to 

help your students comprehend what they 

hear? 

Pre What seems to work best? 

Pre Do picture symbols help your students 

understand things they hear? 

Pre How often is auditory comprehension 

important for your students throughout 

their day? 

Pre What kind of stories do your students like? 

Post Did the picture symbols and discussion seem 

to help your students understand things 

that they heard? 

Post What do you think of this as an 

intervention? 

Post Is it effective? 

Post Is it practical? 

Post Would you use it in the classroom? 

Post What modifications would you make? 

Post Where the stories appropriate for your 

students? Why? 

Post What did you think about the use of 

multiple choice as a test of 

comprehension? 

Note. Pre questions asked prior to the study, 

Post questions asked following the study 

were considered disagreements. Reliability 

was calculated by the sum of agreements divided 

by the sum of the agreements plus disagreements 

and multiplied by 100. Interobserver 

agreement for all students in both the 

baseline and intervention phase was 100%. 

Due to the simplicity of observation of the 

dependent variable no disagreements were recorded. 

Treatment fidelity was measured during the 

intervention sessions through the observations 

of a classroom paraprofessional to confirm 

the correct use of the intervention procedures. 

As the researcher conducted 

intervention sessions, the paraprofessional recorded 

completion of each step on a procedural 

checklist (see Table 6). An average of 

36% of the intervention sessions with a range 

of 33–44% among students were monitored 

for treatment fidelity. Treatment fidelity was 

calculated by the sum of completed steps di- 

TABLE 6 

Procedural Fidelity Checklist 

1 Present Picture strip 

2 Ask student what he/she sees 

3 Comment/discuss each picture 

4 Read story 

5 Comment/discuss each picture 

6 Ask comprehension question 1 

7 Point to letter choice while naming answer 

options 

8 Allow student 10 seconds to respond; If no 

response, repeat question and wait 10 

more seconds. If still no response, ask if 

student wants to continue (student may 

verbally say or point to answer). 

























vided by the sum of the completed steps plus 

incomplete steps multiplied by 100. For all 

sessions documented, treatment fidelity was 

100%. Due to the simplicity of the procedure, 

no disagreements were recorded. 

Results 

Figure 1 illustrates the overall effectiveness of 

the intervention on comprehension of the typical 

age-appropriate stories. Visual analysis revealed 

repeated gains in reading comprehension 

from the baseline to intervention 


condition for each student. With the exception 

of a few sessions, baseline remained stable 

or exhibited downward trending. Intervention 

indicated stability or upward trending 

across all students. 

Figure 1. Comprehension Accuracy across Participants. 

Louis. Louis’s baseline remained at and 

below 50% accuracy with a downward trend 

and an overall average of 42% accuracy on 

comprehension questions. With the introduction 

of intervention, this level rapidly in- 


creased to 85% representing a 43% rise over 

the baseline mean. Visual analysis showed considerable 

and stable progress during the intervention 

phase ranging from 50% to 100% 

accuracy. 

Sarah. Sarah’s baseline accuracy ranged 

from 25%–75% with an average and median 

score of 50% over four baseline sessions. With 

the introduction of intervention, this level 

rapidly increased to 89% representing a 39% 

increase over the baseline mean. Visual analysis 

showed noteworthy and stable comprehension 

accuracy during intervention ranging 

from 75%–100%. 

Ellen. Ellen’s baseline scores indicated her 

comprehension accuracy ranged from 25%– 

75% with an average of 45%. With the introduction 

of intervention, this level rapidly increased 

to 75% representing a 30% increase 

over the baseline mean. Visual analysis revealed 

considerable and stable comprehension 

accuracy during intervention ranging 

from 50–100%. 

William. William participated in six baseline 

sessions and demonstrated a relatively stable 

and low accuracy on comprehension questions. 

His average baseline accuracy was 17% 

with a median of 0% and a range of 0%–75%. 

With the introduction of intervention, this 

level rapidly increased to 75% representing a 

58% increase over the baseline mean. Visual 

analysis indicated considerable and stable 

comprehension accuracy during intervention 

ranging from 50–100%. 


Social validity interviews confirmed the functionality, 

social acceptance, and the practicality 

of the intervention used during this study. 

In the pre-study interview, the teacher indicated 

the importance of her student’s comprehension 

abilities on a daily basis. This sentiment 

was confirmed by two of the four 

students. When asked about supports used to 

aid in auditory comprehension, the teacher 

mentioned that multiple supports including 

picture symbols, gestures, and object use were 

necessary. One student, Ellen, also mentioned 

she would “ask the teacher to help” when she 

did not understand something. Prior to the 

study, the teacher and students agreed that 

pictures or other visual symbols help them 

understand what they heard. Following the 

intervention, students were asked to identify 

their favorite stories. Three students chose 

various favorites (e.g. the stories about dolphins, 

cable cars, and horse shoes) while William 

mentioned he liked them all. Two students 

expressed a specific story they liked the 

least, one did could not think of a least favorite, 

and Sarah mentioned that she “just liked 

them all.” The teacher echoed her satisfaction 

with the stories used. The use of age appropriate 

content and new, informative topics for 

students were cited as reasons. Students all 

responded they would like to use the picture 

symbol plus discussion intervention support 

more at school. The teacher also favored the 

intervention and saw it as a realistic intervention 

for the classroom. She added that she 

would likely use the intervention with groups 

of students simultaneously rather than in individualized 

instructional settings so as to 

maximize classroom support staff, while still 

providing the intervention. 


In light of the multiple access barriers for 

middle school students with moderate intellectual 

disability to typical age-appropriate 

texts, intervention research is essential 

(Browder et al., 2009; Downing, 2005; Kliewer, 

1998; Kliewer et al., 2006). Access to age appropriate 

literature is essential for these students 

to experience the vocabulary-rich, sufficiently 

mature, and socially acceptable texts 

with increased comprehension (Browder 

et al., 2009; Kluth & Darmondy-Latham, 

2003). Additionally, access to these texts foster 

an improved quality of life, promote high expectations, 

provide equitable access to instructional 

materials, and increase self-determination 

opportunities (Browder et al., 2007) 

Unfortunately, the use of effective strategies 

and appropriate materials are often not available 

to these students (Browder et al., 2009; 

Downing, 2005; Kliewer, 1998; Kliewer et al., 

2006). 

This study investigated the effect of a combined 

visual- and discussion-based intervention 

on the comprehension abilities of middle 

school students with moderate intellectual disability 

when they were read typical age-appropriate 

texts. The intervention’s positive effect 


was repeated across all participants in the 

study. Social validity interviews confirmed the 

importance of a comprehension-related intervention 

to the students and their teacher. Additionally, 

the interviews indicated the ease of 

use and practicality of this intervention for the 

classroom. Results indicate the intervention 

was successful in enhancing the comprehension 

abilities of students when read typical 

age-appropriate texts. 

Data also point to the usefulness of this 

particular intervention for increasing the 

comprehension abilities of students with moderate 

intellectual disability when read texts 

appropriate for their age. While all students 

performed more accurately during the intervention 

phase, Sarah displayed the most consistent 

and stable change in performance 

from baseline to intervention. During the 

baseline phase she was generally less than 80% 

accurate. But during intervention, her responses 

were consistently between 80% and 

100%. She had the highest intervention average 

scores of the students with the third highest 

average growth. During all sessions, Sarah 

appeared interested and was very cooperative. 

She appeared to enjoy looking at the pictures 

and discussing the content. Frequently, she 

made comments about the pictures regarding 

what she saw, or how they related to the story. 

Later, Sarah indicated she enjoyed hearing all 

of the stories read out loud. On most occasions, 

Sarah answered the questions by stating 

the corresponding letter. 

Louis, the student with the most intervention 

sessions also experienced a rapid and 

relatively stable increase in comprehension 

scores between baseline and intervention 

phases (43% increase). Louis was typically willing 

to begin the sessions, but preferred, and 

was allowed, to finish any seatwork (worksheet, 

reading activity) before coming to the 

back table to work with the researcher. Louis 

listened intently as the stories were read and 

answered the questions quickly and with confidence. 

He rarely needed to hear the questions 

or options twice before responding. 

Louis answered questions by pointing to the 

corresponding letter on the answer selection 

sheet. 

Ellen also performed more accurately during 

intervention than in the baseline phase 

(39% increase). Ellen seemed to enjoy the 

individual sessions and on occasion spent the 

first few minutes prior to beginning talking 

about what she did or was planning to do in 

the current week. On a few occasions, Ellen 

did not answer the questions within ten seconds 

and needed to hear them again. She 

frequently answered by verbalizing the correct 

answer by name, often in shorthand, speaking 

just the key words of the answer choice. For 

example, in a question about why plants and 

animals need to adapt to the desert, she correctly 

responded, “so little water” for the answer 

choice (c) there is so little water. 

William exhibited the most growth (58% 

increase in the mean accuracy from baseline 

to intervention) of all participants in the 

study. Four out of his six baseline sessions 

resulted in 0% accuracy in his comprehension 

of the texts. He was typically quiet but came 

willingly and usually paused for a few seconds 

before answering the comprehension questions. 

On a few occasions, during the discussion, 

William responded to the question, 

“What do you see?” with a one word utterance 

through his speech generating device. It was 

sometimes difficult for the researcher to see 

the connection between his selected word and 

the content of the photo; however, William’s 

comprehension accuracy during the intervention 

phase suggests he did have a good understanding 

of the stories and was making a connection, 

which he considered valid and or 

logical, although unfamiliar to the investigator. 

William answered the comprehension 

questions typically by pointing to the letter on 

the physical selection sheet. 

Hibbing and Rankin-Erickson (2003) suggest 

that students benefit from visual representations 

accompanying unfamiliar texts. In 

the current investigation, images appeared to 

help students attend to the key content within 

the stories. In addition, discussing the pictures 

with students helped attach contextual meaning 

from the story to the pictures. These findings 

are consistent with Kucan and Beck’s 

(1997) review of articles on the effects of discussion 

on reading comprehension. These authors 

found that teacher supported discussion, 

such as that used in the study, was 

effective in enhancing the comprehension 

abilities of students without disabilities. Additionally 

in regards to discussion, Moats (2002) 

described the benefits of modeling and prac- 


ticing discussion in relation to texts to increase 

and support the development of comprehension 

for older students who struggle 

with reading. 

Limitations and Future Research 

One limitation of this study was the exclusive 

use of multiple-choice questions as a measure 

of student comprehension. While the students 

in this study did prove their ability to accurately 

respond in a multiple-choice format 

prior to participation, the complexities involved 

in using multiple-choice responses to 

express comprehension could exclude other 

students with moderate or severe intellectual 

disability from replicating the effects of the 

intervention. For instance, one student, who 

may have benefited from this intervention, 

was specifically excluded from this study due 

to her repeated inaccuracy in answering the 

novel multiple-choice questions. And several 

other students in the classroom were not recommended 

for participation by the teacher 

due to their inconsistency in responding to 

questions. Future research in this area should 

focus on an expanded approach for assessing 

student comprehension of read aloud texts. 

While two individuals separately reviewed 

the photo sets to ensure the accuracy of their 

representative connection to the texts, this 

evaluation did not sufficiently address the 

need for consistency in identifying the critical 

representative concepts of a text or selecting 

accurate representations from photos. In this 

study, main ideas and concepts were selected 

from each story by the first author. These 

main ideas and concepts were then used as 

the basis for selecting representative photos. 

While this process did prove reliably representative 

among the raters and popular among 

the students for the short texts used, it may 

not have the same effect on more elaborate 

texts (e.g. novels, biographies). Future research 

should include more precise and formulaic 

approaches to the process of selecting 

key themes and representative images for text. 

The discussion portion of the intervention 

was loosely based. Sessions began by asking 

each student to comment on the photos and 

continued with an unscripted description of 

each photo followed by a conversation with 

the student regarding how the photos repre- 

sented the texts. While the discussion appeared 

to have a beneficial effect on the student’s 

comprehension abilities of the texts 

read aloud, the lack of structure utilized is 

deemed a limitation in terms of research replication 

and application in the classroom. Unstructured 

discussions have the potential to 

not only vary in methodology and results, but 

also to detract from the main purpose of the 

intervention, which is to help students comprehend 

text read out loud. Future research 

in the combined picture symbol plus discussion 

intervention should examine the use of 

structure interviewing strategies to provide increased 

consistency in the discussion portion 

of this intervention. 

Fifteen short expository and narrative high 

interest stories were used as the age-appropriate 

literature in this study. While the content 

appeared to hold students’ interest and attention, 

using longer texts such as age-appropriate 

novels, magazine articles, or newspapers 

may provide more credibility to the robustness 

of the present intervention. Future studies using 

this intervention should explore its effectiveness 

with longer, more commonly accessed 

texts such as popular adolescent 

novels, academic textbooks, or newspapers. 

Finally, caution should be used when interpreting 

the results of this study due to the 

small number of participants involved. While 

this study contributes to the literature on access 

for students with moderate intellectual 

disability to age-appropriate texts, additional 

research on this particular intervention and as 

well as variations of it, should be conducted to 

promote generalizability of these results. 

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Grade-Aligned Math Instruction for Secondary Students with 

Moderate Intellectual Disability 

Diane M. Browder 

University of North Carolina at Charlotte 

Katherine Trela 

Marist College 

Bree A. Jimenez 

University of North Carolina at Greensboro 

Abstract: The purpose of this study was to examine the effects of grade-aligned math instruction on math skill 

acquisition of four middle schools with moderate intellectual disability. Teachers were trained to follow a task 

analysis to teach grade-aligned math to middle school students using adapted math problem stories and graphic 

organizers. The teacher implemented four math units representing four of the five National Council of Teachers 

of Mathematics recommended math standards (i.e., algebra, geometry, measurement, and data analysis/ 

probability; NCTM, 2002). A multiple probe across unit design was used to examine the effects of the math 

instruction on the number of steps completed on each math standard task analysis. Results indicated a 

functional relationship between math instruction and student behavior with an overall increase in independent 

correct responses. Implications for practice and future research are discussed. Limitations and suggestions for 

future research and practice are discussed. 

One of the key concepts introduced in guidance 

for including students with disabilities in 

No Child Left Behind (2002) is that the target 

for some students with significant cognitive 

disability might be “alternate achievement” 

that is different in scope or complexity, but 

still aligned with grade level standards. Many 

states provide curricular frameworks or extensions 

for each grade’s state standards to indicate 

how to access content like mathematics 

and English/language arts. To teach to the 

standards, instructional teams must still deter- 

We thank the teachers and leaders of the Charlotte 

Mecklenburg School System and to the parents 

and students for their partnership in this research. 

Support for this research was provided in part by 

Grant No. H324M03003 of the U.S. Department of 

Education, Office of Special Education Programs, 

awarded to the University of North Carolina at 

Charlotte. The opinions expressed do not necessarily 

reflect the position or policy of the Department 

of Education, and no official endorsement should 

be inferred. Correspondence concerning this article 

should be addressed to Bree A. Jimenez, University 

of North Carolina at Greensboro, 421 School of 

Education Building, PO Box 26170, Greensboro, 

NC 27402-6170. Email: bajimene@uncg.edu 

mine what the student will learn and how to 

teach it. 

Although teachers have been required to 

help all students make adequate yearly progress, 

there have been few models for conducting 

standards-based instruction for students 

with moderate/severe intellectual disability especially 

in the area of mathematics. Textbooks 

on educating students with severe disabilities 

provide minimal information on teaching 

mathematics besides money and measurement 

(Ryndak & Alper, 1996, 2003; Snell & 

Brown, 2000, 2006; Westling & Fox, 2000, 

2004). There also have been few research 

studies to guide these interventions. Browder, 

Spooner, Ahlgrim-Delzell, Wakeman, and 

Harris (2008) used guidelines from Horner 

et al. (2005) and Gersten et al. (2005) to 

identify high quality evidence-based mathematics 

research with students with a moderate/severe 

intellectual disability published between 

1975 and 2005. Sixty-five articles yielded 

54 single-case and 14 group studies (some 

articles had 1 study). Although limited in 

scope, these studies provide evidence that this 

population can learn mathematics. A total of 

493 individuals with disabilities participated in 

Grade-Aligned Secondary Math / 373

these studies including 336 individuals with 

moderate intellectual disability (mental retardation), 

64 individuals with severe intellectual 

disability, 24 individuals with autism, 13 individuals 

with unspecified developmental disability, 

and one individual with multiple disabilities. 

These studies also indicate that 

interventions derived from principles of applied 

behavior analysis, such as systematic 

prompting with feedback, can be highly effective 

for teaching math content. 

Browder et al. (2008) also found that most 

studies have focused on numbers and operations 

or money skills. These content areas are 

only a small sample of the recommended content 

for mathematics. In practice, teachers 

also typically focus on repetitive practice of 

computational skills, based on the belief that 

students master readiness skills before engaging 

in higher order math lessons (Woodward 

& Montague, 2002). With this focus, many 

students will not have access to the standards 

that will be included in states’ alternate assessments 

based on academic achievement standards 

which must align to the content standards. 

Most states organize their standards by 

major strands of academic learning similar to, 

or the same as, those identified by the National 

Council of Teachers of Mathematics 

(NCTM). In 1989 and again in 2000, NCTM 

identified five main components of math instruction 

including (a) numbers and operations, 

(b) measurement, (c) data analysis and 

probability, (d) geometry, and (e) algebra. 

Most recently, the Common Core Standards 

in mathematics have defined a set of outcomes 

in these areas that are being adopted 

by most states in the United States. 

One option for promoting learning across 

more content areas is to apply the practices 

used effectively in mathematics for students 

with moderate and severe intellectual disability 

across more state standards. Browder et al. 

(2008) identified one of these practices to be 

task analytic instruction with systematic 

prompting. In this review on mathematics, 

task analyses primarily were used to teach 

students to make a purchase from a store or 

vending machine (Aeschleman & Schladenauffen, 

1984; Browder, Snell, & Wildonger, 

1988; Haring, Kennedy, Adams, & Pitts-Conway, 

1987). Two studies have applied task analytic 

instruction to teach grade-aligned state 

standards in mathematics. Jimenez, Browder, 

and Courtade (2008), used a multiple probe 

across participants design to demonstrate that 

three high school students with moderate intellectual 

disability could learn to solve an 

algebraic equation. In addition, students were 

able to complete their problem solving in an 

inclusive high school general education setting 

beside peers who were working on similar 

equations and to generalize them across materials 

(i.e., job tasks). Browder et al. (2010) 

used a similar strategy to teach students 

multiple standards selected from the middle/ 

secondary level. Students were randomly assigned 

to receive the standards-based instruction 

intervention in either mathematics or 

science in a pretest/posttest control group 

design. Students who received the mathematics 

intervention made higher gains on the 

curriculum-based math measure. 

Although both of these studies provide 

promise for teaching middle or high school 

mathematics standards, Jimenez et al. (2008) 

only addressed one skill within one standard 

(solving a simple algebraic equation) and 

Browder et al. (2010) used a randomized trials 

design which provided evidence of group differences, 

but did not reveal whether all students 

mastered the content. One contribution 

that the Browder et al. study offered was that 

the mathematics problems were presented as 

real life problems that were read aloud to the 

students. 

Literature on general mathematics instruction 

for middle school students suggests that 

skill development may be promoted by linking 

math and language arts (Zambo, 2005). Specifically, 

stories that are written within a context 

familiar to the student may provide a 

framework, or schema, upon which the student 

may naturally organize information in 

order to solve the problem (Anderson, Spiro, 

& Anderson, 1978). Pugalee (2005) developed 

a strategy for teaching mathematics with 

stories that build on research-based recommendations 

for teaching this content to students 

with learning disabilities. This approach 

includes (a) an advance organizer linking new 

information with prior learning, (b) walking 

through the story to model thinking about the 

math concept, (c) building skills by allowing 

the student the opportunity to practice applying 

new information, (d) generalization in 


TABLE 1 

Student demographic information 

Student Age Sex IQ Score 

which students develop stories or scenarios 

that embed this new information and (e) assessing 

students’ performance. 

Since students with moderate and severe 

intellectual disability may not read, teachers 

may need to follow a protocol for an interactive 

read-aloud. Browder, Trela, and Jimenez 

(2007) demonstrated how to promote active 

participation in literature adapted from middle 

and high school novels for students with 

moderate/severe intellectual disability or autism. 

In this approach, the story is introduced 

with some attention grabber (e.g., students 

may listen to whale calls in a story about the 

ocean). Then the teacher involves the student 

in the read-aloud, for example, by having the 

student complete repeated story lines or answer 

questions. Similarly, in a math story problem, 

the teacher can engage the student with 

the theme (e.g., sample donuts for a problem 

about how many donuts were purchased), 

have the students engage with the key math 

facts (e.g., finding each number), and then 

work together to find the solution. 

The purpose of the current study was to 

extend the work on teaching upper level 

mathematics standards to students with moderate 

and severe intellectual disability through 

using read-alouds of math problems with task 

analytic instruction to find the solution. To 

promote generalization across math problems, 

graphic organizers were introduced to 

help students perform the steps of the problem 

solving. Although not often used in research 

with students with moderate/severe intellectual 

disability, graphic organizers have 

been found to promote comprehension of 

expository text for students with learning disabilities 

(Garjria, Jitendra, Sood, & Sacks, 

2007.) We theorize that the combination of a 

Test 

administered Classification Communication skills 

Claire 13 Female 40 WISC III Moderate intellectual disability Verbal 

Kiernan 13 Male 40 WISC III Moderate intellectual disability Non-verbal, uses AC 

Everett 13 Male 30-40 DAS Severe intellectual disability Non-verbal, learning 

to use AC 

Todd 11 Male 41 UNIT Moderate intellectual disability Verbal 

read-aloud of a math word problem, a graphic 

organizer, and task analytic instruction in the 

steps to solve the problem will be effective in 

promoting math learning for different types 

of standards for students with moderate and 

severe intellectual disability. 

Method 


The study was conducted in a large urban 

school system in the southeastern United 

States. The intervention was conducted by the 

special education teacher in a self-contained 

middle school classroom for students with 

moderate/severe intellectual disability. Participants 

were identified by recruiting a middle 

school special education teacher and asking 

her to nominate four students who met the 

following eligibility criteria (a) full scale IQ 

55, (b) adequate vision and hearing to interact 

with the materials, (c) an ability to communicate 

verbally or with an augmentative 

communication system, and (d) consistent attendance 

(absent less than two times per 

month). All students in the study participated 

in the state’s large scale assessments by taking 

the alternate assessment based on alternate 

achievement standards for all content areas. 

As shown in Table 1, students ranged in age 

from 11 to 13 and had IQs from 30–41. All IQ 

scores were obtained from students’ most recent 

psychological evaluations. 

All assessments were conducted by a graduate 

level member of the research team in the 

special education classroom with the four target 

students. The teacher included other students 

in the instructional group besides the 

target students and typically implemented the 


lesson with the entire class (8–10 students). 

Teacher trainings occurred in a university 

conference room. 

Materials 

Figure 1. Sample math story and graphic organizer for Geometry. 

Instructional materials. Middle school mathematics 

standards were selected using the 

state’s mathematics standards. These stan- 

dards were simplified for instruction with the 

target population and reviewed by a university 

level mathematics content expert to ensure 

that each target skill was aligned with the target 

standard. The research staff then created 

sets of word problems for each standard using 

the same problem solving method (e.g., solving 

an equation; comparing graphed data) 

but with different applications (e.g., shop- 


ping, dining out, voting) and differing numbers. 

Because of the students limited numeracy 

skills, the problems used numbers 

from 1–10. Each word problem was typed with 

key vocabulary (e.g., character in the word 

problem story) paired with pictures using a 

picture symbol software program (i.e., Writing 

with Symbols©). Eight problems per math 

standard (i.e., algebra, data analysis, geometry, 

and measurement) were given to the 

teacher, with a total of 32 math stories provided. 

These adapted word problem stories 

were printed in color and placed in page protectors 

for durability. The teacher was provided 

a binder divided by each standard which 

was called a unit (e.g., Geometry Unit). 

Within each divided section of the binder, the 

teacher was provided the graphic organizer 

for that unit (standard) and the adapted stories 

that corresponded to the unit. The 

graphic organizers were printed in color and 

laminated for durability. Velcro was used to 

manipulate numbers on the graphic organizer 

if the student was not able to use a visa-vi 

marker to write numbers. Additional manipulatives 

were provided as necessary to complete 

the math lessons (e.g., paper money for measurement, 

green and red chips for the algebra 

prompt, nonpermanent markers for geometry). 

Teachers were also provided a poster size 

graphic organizer for each of the units to use 

for group instruction. Figure 1 shows a sample 

adapted story and graphic organizer from the 

geometry unit for which the standard focused 

on finding points, line segments, and points 

on a plane. 

Dependent Variable 

The dependent variable was the number correct 

math responses made by the student during 

the unit (e.g., algebra) assessment probe. 

To investigate changes in student behavior in 

response to teacher’s use of the story-based 

math problems, four assessments of student 

responses were used (see Figure 2). The graduate 

assistant conducted one to two assessment 

probes with each student per week. A 

task analysis was created for the steps for each 

math standard (see Table 2). For each of the 

four math tasks, task analytic assessments were 

developed (Browder, Spooner, & Jimenez, 

2011). During each of the assessments, the 

researcher displayed the needed materials 

and posed a question for the student to solve 

(e.g., “Show me how to ___ (find point A).” 

The student was given five seconds to begin 

each step of the task analysis. If the student 

did not complete a step, the researcher completed 

the step and said, “Keep going.” Students 

received praise for paying attention and 

working on the tasks. No task specific prompts 

or feedback were given. Each step of the task 

analysis was scored as correct () or incorrect 

(). For generalization, students were probed 

on math problem stories that had not been 

used during instruction, but required the 

same mathematical problem solving skill (e.g., 

steps to solve an equation.) 

Experimental Design and Analysis 

A single subject design was used to demonstrate 

a functional relationship between the 

mathematics intervention and the dependent 

variable which was acquisition of math responses. 

Specifically, the design was a multiple 

probe across four math units (standards) with 

concurrent between participant replications 

for the four target participants who received 

instruction as a group (Gast, 2010; Horner & 

Baer, 1978). During baseline, the math responses 

were probed for each student at minimum 

of three sessions or until data was consistent 

for three sessions. Following baseline, 

instruction began on Unit 1 (i.e., Geometry 

standard) for all four students. Students received 

task-analytic math lessons by the special 

education teacher. Prior to the students moving 

from Unit 1 to Unit 2 (i.e., Algebra), all 

individual students’ data had to show a 

change or trend after receiving instruction for 

a minimum of 5 weeks instruction on that 

unit. Once the students were ready to move to 

Unit 2, the students were each probed on Unit 

2, Unit 3, and Unit 4 responses. After students’ 

data for Unit 2 showed a change in 

level or trend after receiving a minimum of 

five weeks instruction, Unit 3 (i.e., Data-Analysis) 

and Unit 4 (i.e., Measurement) were 

probed. Unit 3 was then taught following the 

same guidelines for Units 1 and 2, before Unit 

4 was introduced. Prior to Unit 4 being 

taught, Unit 4 was probed. Instruction contin- 


ued for a minimum of five weeks and until all 

student data showed a change in level and 

trend. Maintenance probes (units 1–3) of previous 

units were conducted every two to three 

weeks after intervention throughout the duration 

of the study. No maintenance of Unit 4 

was taken due to the ending of the school 

year. Only independent correct student responses 

were graphed and used for visual analysis 

of the data. 

Figure 2. Sample Student Assessment in Geometry. 

Procedure 

Baseline and Ongoing Probes. During baseline, 

the graduate research assistant served as 

the primary data collector. Inter-observer 

agreement was taken on one of the three baseline 

sessions by a second member of the research 

team. Students were individually assessed 

for each of the four units of instruction 

during each baseline probe. All baseline probes 


TABLE 2 

Content Standards, Alternate Achievement, and Task Analyses Used in Math 

National Standard 

(NCTM) based on 6-8 th 

grade bands 

Algebra: Represent and 

analyze mathematical 

situations and 

structures using 

algebraic symbols. 

Geometry: Specify 

locations and describe 

spatial relationships 

using coordinate 

geometry and other 

representational 

systems. Use 

visualization, spatial 

reasoning, and 

geometric modeling to 

solve problems. 

Measurement: Apply 

appropriate techniques, 

tools, and formulas to 

determine 

measurements. 

Data Analysis and 

Probability: Formulate 

questions that can be 

addressed with data 

and collect, organize, 

and display relevant 

data to answer them. 

Competency Goal(s) from 

state standard course of 

study standards 

Use and evaluate algebraic 

expressions. Solve simple 

(one- and two-step) 

equations or inequalities. 

Represent problem 

situations with geometric 

models. Identify, predict, 

and describe dilations in 

the coordinate plane. 

Develop flexibility in solving 

problems by selecting 

strategies and using 

mental computation, 

estimation, calculators or 

computers, and paper and 

pencil. 

Collect, organize, analyze, 

and display data 

(including box plots and 

histograms) to solve 

problems. 

followed the same guidelines described under 

the description of the dependent variable. No 

feedback was given to students during baseline 

probes. Data was graphed and visually 

inspected after each session. After baseline, 

the same procedures were followed to continue 

to probe whatever unit was receiving 

instruction. That is, one or two times a week 

prior to the lesson, the graduate student con- 

Alternate Achievement 

standards addressed in 

this study Task Analysis 

Solve simple one-step 

equations that relate 

to stories about daily 

events. 

Identify and describe 

the intersection of 

figures in a plane. 

Draw line segments 

and a coordinate 

plane to demonstrate 

spatial sense for 

familiar contexts like 

grocery store. 

Develop numbers sense 

for real numbers. 

Develop flexibility in 

solving mathematical 

problems by selecting 

strategies and using 

appropriate 

technology. Use next 

dollar strategy to 

solve problems 

related to everyday 

transactions. 

Collect, organize and 

display data to solve 

problems from 

familiar events. 

ducted the task analytic assessment for that 

unit. At the end of a unit, all units were reprobed 

before the next was introduced. 

Intervention 

Identify problem statement. Identify 

first, second, and last fact in story. 

Name unknown quantity “x”. Place 

facts in correct sequence on 

Equation Prompt. Identify 

operation needed to solve problem. 

State solution to problem. State 

solution in story context. 


points on map using facts from 

story. Draw line segments formed 

from identified points. Identify 

plane formed from line segments. 

State solution to problem. State 

solution in story context. 


dollar amount from fact in story. 

Count number of one dollar bills 

equal to given dollar amount. 

Count out one more dollar, (if 

verbal, may say “and one more” 

while counting one more). State 

solution to problem. State solution 

in story context. 

Identify problem statement. Record 

data from story on graph. Identify 

choice with “more”. State solution 

to problem. State solution in story 

context. 

The mathematics intervention included (a) 

mathematics word problem stories based on 

familiar activities, (b) a graphic organizer and 


manipulatives for the mathematics concept 

(e.g., a template for solving the linear equation), 

and (c) step by step training in the task 

analysis to identify and organize key facts and 

solve the problem stated in the written story. 

The special education teacher participated in 

four professional development workshops. A 

general education mathematics teacher from 

the teacher’s middle school also attended the 

training and served as an ongoing resource 

person for understanding the mathematics 

content. Three of the four workshops involved 

training on the mathematics intervention and 

the fourth served as a debriefing for the study. 

In the first two workshops, the teacher received 

training in the first two units (algebra 

and geometry); in the third workshop two 

units were trained (data analysis and measurement.) 

During each workshop, the research 

team provided an introduction to the “big 

idea” of the unit (e.g., geometry addressed 

spatial organization and vocabulary related to 

coordinate planes) and a review of current 

research in teaching mathematics to support 

special educators’ understanding of the mathematics 

standard. The general mathematics 

teacher was asked to provide examples of how 

this standard was typically taught. The researcher 

modeled one lesson, and then the 

special education teacher was given an opportunity 

to practice implementing the lesson 

with feedback until the read-aloud, use of the 

graphic organizer, and task-analytic instruction 

could be presented without error. Although 

the math and special education teachers 

also practiced planning inclusive co-taught 

math lessons, these were not implemented 

during the course of the study due to logistics 

of the setting. 

Following each of the first three professional 

development workshops, the special education 

teacher implemented the lessons in 

the special education classrooms with the target 

students in a group format. The teacher 

adapted the materials for any students’ individual 

needs (e.g., poster size version of the 

number line in algebra, use of popsicle sticks 

to draw line segments in geometry). During 

each lesson, the teacher read the word problem 

story aloud as students followed using 

their copies of the story. Then, each student 

was given the opportunity to perform each 

step of the task analysis while the other stu- 

dents in the group watched. The teacher used 

least intrusive prompting as needed for the 

student to make each target response (non 

specific verbal direction, specific verbal direction, 

model, and physical guidance) and provided 

praise for each correct response. The 

teacher varied the order of student responding 

each day. Materials contained a variety of 

stories so that the problem to be solved and 

specific numbers to compute varied while 

keeping the basic math strategy (e.g., use of a 

bar graph) constant. The teacher continued 

instruction, adding her own stories as needed, 

until the next unit was introduced. The researcher 

observed the teacher to assess procedural 

fidelity by observing whether each step 

of the task analysis was presented correctly. A 

procedural fidelity checklist was also used for 

the teacher training days to be sure the researchers 

included the overview, model, and 

teacher practice. A graduate assistant who was 

not an author recorded these data. 

Results 

Procedural Fidelity 

Procedural fidelity was recorded for all four 

math workshops and found to be 100%. The 

special education teacher was observed eleven 

times (i.e., two to three times for each unit) to 

assess fidelity of teaching the task analyses. 

Procedural fidelity was computed as percentage 

of steps taught correctly. The teacher implemented 

the lesson plans with 100% fidelity 

for all lessons observed. Two researchers concurrently 

scored fidelity of the lessons for 36% 

(four) of the observations. Agreement between 

the observers was 100%. 

Inter-rater Reliability 

The primary data collector was a graduate 

research assistant who was a special education 

doctoral student. Independent scoring by two 

observers was performed on 40% of all assessment 

probes administered. Interobserver 

agreement was computed as agreements divided 

by agreements plus disagreements. The 

percent agreement was 99% and adherence to 

the task analytic assessment protocol was 

100% for all sessions observed. 


Student Achievement 

Figures 3–6 provide the total number of correct 

responses across each of the four math 

units. Within each unit of instruction skill 

maintenance is reported. 

Claire. During unit 1: geometry, Claire increased 

the number of independent correct 

responses from baseline (M 1.3, range from 

1 to 2) to intervention (M 5.1, range from 3 

to 7). During unit 2: algebra, Claire increased 

in the total number of correct responses from 

baseline (M 3, range from 0 to 5) to intervention 

(M 3.9, range from 0 to 7). During 

unit 3: data-analysis, Claire increased in the 

total number of correct responses from baseline 

(M .6, range from 0 to 1) to intervention 

(M 4.3, range from 2 to 7). Finally, 

during unit 4: measurement, Claire increased 

in the total number of correct responses from 

baseline (M .33, range from 0 to 1) to 

intervention (M 2, range from 0 to 6, see 

Figure 3). 

Kiernan. During unit 1: geometry, Kiernan 

increased the number of independent correct 

responses from baseline (M 1) to intervention 

(M 6, range from 3 to 9). During unit 

2: algebra, Kiernan increased in the total 

number of correct responses from baseline 

(M 1.7, range from 1 to 3) to intervention 

(M 6.3, range from 1 to 10). During unit 3: 

data-analysis, Kiernan increased in the total 



(M 4.3, range from 2 to 7). Finally, during 

unit 4: measurement, Kiernan increased in 

the total number the number of correct responses 

from baseline (M .5, range from 0 

to 1) to intervention (M 2.6, range from 0 to 

4, see Figure 4). 

Everett. During unit 1: geometry, Everett 

increased the number of independent correct 

responses from baseline (M .33, range from 

0 to 1) to intervention (M 1.7, range from 0 

to 3). During unit 2: algebra, Everett increased 

in the total number of correct responses 

from baseline (M 1, range from 0 to 

3) to intervention (M 4.7, range from 1 to 

7). During unit 3: data-analysis, Everett increased 

in the total number of correct responses 

from baseline (M .2, range from 0 

to 1) to intervention (M 2.7, range from 0 to 

5). Finally, during unit 4: measurement, Ever- 

ett increased in the total number of correct 


(M 1.4, range from 0 to 2, see Figure 

5). 

Todd. During unit 1: geometry, Todd increased 

the number of independent correct 


(M 7.4, range from 3 to 9). During unit 

2: algebra, Todd increased in the total number 

of correct responses from baseline (M 

4, range from 2 to 5) to intervention (M 7.6, 

range from 4 to 10). During unit 3: dataanalysis, 

Todd increased in the total number 

of correct responses from baseline (M .8, 

range from 0 to 2) to intervention (M 7.3, 

range from 5 to 9). Finally, during unit 4: 

measurement, Todd increased in the total 



(M 9.3, range from 7 to 10, see Figure 6). 

Table 3 indicates the mean number of correct 

responses students had from baseline to 

intervention across each unit of math instruction. 

Data for generalization of math skills are 

also reported in Table 3. All students had 

higher mean responses during intervention, 

maintained most steps of the math task analysis 

over time (e.g., geometry–18 weeks), and 

generalized the skills to untaught problems. 


At the final workshop, the teacher was asked 

to complete an adapted intervention rating 

profile (Snyder, 2002) to indicate level of satisfaction 

with the training and instructional 

materials. The teacher responded to seven 

items about the intervention using a six-point 

Likert scale (i.e., 1 strongly disagree; 6 

strongly agree). The teacher agreed or 

strongly agreed with all items (mean of 5.75) 

that the math lesson plan trainings were helpful 

on clarifying how to write lesson plans that 

access the general curriculum in secondary 

grades. She felt that the lesson plans were 

practical and strengthened her skills as a 

teacher. 


This study demonstrated that not only can 

students with moderate and severe intellectual 

disability learn new math skills aligned to 


grade-level content, they can learn new math 

skills across the math strandards (e.g., algebra, 

geometry). This adds to the work of Browder 

Figure 3. Student data across math units for Claire. 

et al. (2010) showing that a method of standards-based 

instruction that can be applied 

across different standards. Like Browder et al. 


Figure 4. Student data across math units for Everett. 


Figure 5. Student data across math units for Kiernan. 


Figure 6. Student data across math units for Todd. 


TABLE 3 

Student mean scores across phase of intervention and unit of instruction 

this study used read-alouds of word problems, 

a graphic organizer, and task analytic instruction 

in how to solve the problem. This study 

adds to the earlier study by demonstrating 

that each of four students made gains on each 

mathematical standard. 

Although standards-based instruction is required 

for students to meet state expectations 

on alternate assessments, there are few research 

models for this type of instruction. 

Since the Browder et al. 2008 review, researchers 

have continued to focus teaching purchasing 

and computations. Collins, Hager, and 

Galloway (2011) focused on computation of 

sales-tax, but within general education mathematical 

content. Skibo, Mims, and Spooner 

(2011) used student response cards and least 

intrusive prompting to teach number identification 

to students with moderate and severe 

intellectual disability. Zisimopoulos (2010) 

used a picture fading technique to teach students 

with moderate intellectual disability to 

recall multiplication facts. While each of these 

studies provides an important contribution to 

understanding how to teach mathematics to 

this population, the current study provides 

evidence of a method to teach skills that align 

with grade-level content standards. 

This study taught students how to respond 

to word problems. The NCTM promotes a 

problem-solving approach to mathematics 

(2000). Van de Walle (2004) proposes that 

learning to solve story problems in mathematics 

is the basis for learning to solve more real- 

Kiernan Reese Everett Claire 

Geometry Baseline 1.3 1 .33 4 

Intervention 5.1 6 1.7 7.4 

Generalization 4.6 7.6 3.8 9 

Algebra Baseline 3 1.7 1 4 

Intervention 7.1 6.3 4.7 7.6 

Generalization 7 9 6 10 

Data Analysis Baseline .6 .6 .2 .8 

Intervention 4.3 4.3 2.7 7.3 

Generalization 5 5 3 8.7 

Measurement Baseline .33 .5 0 .6 

Intervention 2 2.6 1.4 9.3 

Generalization 4.5 n/a n/a n/a 

world problems. Fuchs, Fuchs, Finelli, Courey, 

and Hamlett (2004) note that mathematical 

problem solving involves students applying 

skills to novel situations. Teaching word problems 

can teach students the “when” and “why” 

to apply mathematical skills. 

In contrast, we did not teach students how 

to identify the type of problem to be solved 

which is typically the focus of research on 

teaching word problems. Instead, the teacher 

presented the graphic organizer to cue the 

student what type of problem this was (e.g., 

data comparison versus algebraic equation.) 

Browder et al.’s (2008) review revealed only 

one study that focused on teaching students a 

problem-solving schema. Neef, Nelles, Iwata, 

and Page (2003) taught math problem solving 

to one student with a moderate intellectual 

disability (i.e., a second participant had mild 

intellectual disability). Neef et al. taught students 

“precurrent operations” to facilitate 

problem solving. Specifically, the students 

learned to identify five components of word 

problems: the initial set, the change set, the 

operation, the result set, and the solution. 

Students used a graphic organizer worksheet 

to enter known information and find the solution. 

The intervention included massed 

practice trials with a teacher model. Both students 

demonstrated generalized problem solving. 

Much more research is needed to determine 

how best to teach this population to 

recognize the type of problem presented in 

the math story. 


A second limitation of the current study is 

that while all students made gains, the gains in 

the measurement unit were minimal for three 

of the four students. This may have been an 

artifact of the specific task analysis on counting 

the next dollar amount. While the other 

task analyses only required the students to 

solve one problem, because the next dollar 

task analysis was short, students solved three 

problems and the data were added together. If 

the student could not perform some steps, this 

would occur all three times. Students may also 

have been less motivated to repeat these responses 

three times with no reinforcement for 

correct responding. 

A third limitation is that while the stories 

were focused on real life math applications 

(e.g., going to the movies, shopping), the 

teacher did not assess generalization to these 

contexts. The students did show generalization 

to untrained story problems. It is unknown 

whether they also would have generalized 

these to community contexts. While the 

teacher did use some generalization activities 

(e.g., voting to practice data compilation), no 

data were collected. 

Implication for Practice and Future Research 

This study provided evidence to support that 

students with moderate and severe intellectual 

disability can learn middle school mathematics 

standards with a read-aloud of word problems, 

task analytic instruction to solve the 

problem, and graphic organizer. The stories 

used helped focus the instruction on real life 

applications that are important to make the 

standards-based instruction meaningful (e.g., 

going to the movies.) In replicating these lessons 

with students, educators should consider 

stories that apply to students’ local environments 

(e.g., story on Charlotte Speedway 

would not be relevant in some contexts.) The 

graphic organizers may also need to be modified 

for students’ visual or physical limitations. 

For example, the teacher found some 

students responded better if the graphic organizer 

was enlarged to poster size. 

Future research is needed to determine if 

this strategy may be applicable to standards in 

other grade levels (e.g., elementary or high 

school), to students with other types of disabilities, 

and to other state standards. Research 

also is needed to determine if this method is 

the most effective for repetitive skills like 

counting money since this produced the lowest 

gains. Additionally, research evidence is 

needed to determine if this read-aloud problem 

solving strategy could be embedded in a 

general education context. For example, 

could peers conduct the read-aloud? Finally, 

research also is needed on how students generalize 

the acquisition of mathematics standards 

to everyday activities. 

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Initial Acceptance: 18 September 2011 





Review of Academic Mathematics Instruction for Students 

with Mild Intellectual Disability 

Casey Hord 

University of Cincinnati 

Emily C. Bouck 

Purdue University 

Abstract: Mathematics education–like all education–faced changes in recent years including increasing 

expectations, and these expectations have impacted all students, including students with mild intellectual 

disability. To explore the impact of the changes on mathematics education on students with mild intellectual 

disability, the authors reviewed the literature from 1999–2010 on academic mathematics interventions for 

students with mild intellectual disability. Of the seven articles found, the majority focused on interventions 

designed to improve knowledge of mathematical facts and computational procedures. One study included an 

intervention involving metacognition and diagramming of mathematical relationships to help students solve 

word problems. Results suggest a dissonance between the mathematics focus of mathematics professional 

organizations and federal and state policies regarding higher order mathematics and perhaps current practice 

for students with mild intellectual disability, as reflected in the research literature. 

Mathematics education is a core content area 

with direct benefits for advanced education 

and employment for all students (Algozzine, 

O’Shea, Crews, & Stoddard, 1987; Maccini, 

McNaughton, & Ruhl, 1999; National Council 

of Teachers of Mathematics [NCTM], 2000; 

No Child Left Behind [NCLB], 2002; Xin, 

Jitendra, & Deatline-Buchman, 2005). Although 

mathematics education has always 

been important, its stake in education has 

risen over the past few decades. Recent federal 

education laws mixed with rising expectations 

of national professional organizations and 

changes in educational policy altered what is 

expected of all students, including students 

with disabilities (NCTM; NCLB; Teuscher, 

Dingman, Nevels, & Reys, 2008; Woodward, 

2004). 

The latest reauthorization of the Elementary 

and Secondary Education Act (ESEA)– 

called No Child Left Behind (NCLB, 2002)– 

required all students to participate in each 

state’s accountability system, meaning students 

were to be tested annually in grades 3–8 

and once again in high school in reading, 


be addressed to Casey Hord, PO Box 210002, 

Teachers/Dyer Hall, University of Cincinnati, Cincinnati, 

OH 45221. Email: casey.hord@uc.edu 

mathematics, and science. Further, schools 

were to show Adequately Yearly Progress 

(AYP) to account for all students’ improvement 

as well as that of particular subgroups, 

such as students with disabilities, on their 

state’s accountability system (i.e., typically the 

large-scale general assessment in the reading, 

mathematics, and science) (Yell & Drasgow, 

2005). Not only were students with disabilities 

included in the general education law but also 

the latest reauthorization of Individuals with 

Disabilities Education Act (IDEA, 2004) 

aligned itself with NCLB regarding students 

with disabilities participating in the accountability 

system as well promoting access to the 

general education curriculum (Turnbull, 

Huerta, & Stowe, 2006). 

Also contributing to rising expectations for 

students with disabilities in mathematics education 

were changes in high school graduation 

requirements, including exit exams 

(Ysseldyke et al., 2004) and mandated upper 

level mathematics classes (Teuscher et al., 

2008), as well as increasingly rigorous content 

area standards proposed by professional organizations 

(e.g., NCTM, 2000) and the recent 

Common Core Standards (Council of Chief 

State School Officers and National Governors 

Association, 2010). Exit exams, affecting 28 

states as of 2010, require a student to pass a 

Mathematics and Students with MID / 389

test to graduate from high school; failure can 

result in a certificate of attendance rather 

than a diploma (Center on Education Policy 

[CEP], 2010; Reardon, Arshan, Atteberry, & 

Kurlaender, 2010). Regarding courses in high 

school, some states now require students to 

pass high school algebra and/or geometry to 

earn a diploma (Mack 2010; Teuscher et al.). 

Beyond the NCTM standards, typically adopted 

by states for their grade level mathematics 

standards, 2010 resulted in a majority of 

states adopting the Common Core standards 

for all students (CCSSO and NGA Center, 

2010). The Common Core addresses standards 

for students in grades K-12 in expanded 

literacy and mathematics and focus on college 

and career readiness (CCSSO & NGA). 

Students with Mild Intellectual Disability 

Given the increased emphasis on not only 

mathematics education but also rigorous 

mathematics education for all students, one 

must question how much access to the general 

education curriculum and what type of instruction 

are students with disabilities receiving. 

Increasing expectations for higher standardized 

test scores for students with 

disabilities, including students with mild intellectual 

disability (MID), not only led to intense 

pressure for teachers to help students 

raise test scores, but also a need for researchers 

to develop interventions for helping students 

with MID and their teachers respond to 

the pressure for high test scores (Maccini, 

Mulcahy, & Wilson, 2007; Popham, 2001; 

Woodward, 2004). More importantly, it is necessary 

to understand the access students with 

MID are being given to the general education 

curriculum to determine if these students are 

being given an opportunity to leave K-12 education 

with the procedural and conceptual 

understanding of mathematics they need be 

successful in postsecondary (i.e., academic, 

occupational, or daily living) settings and as 

participating citizens in a democracy (Cohen, 

1999; Lesh, Post, & Behr, 1988; NCTM, 2000; 

Patton, Cronin, Bassett, & Koppel, 1997; Vergnaud, 

1983). 

In the United States, a student with MID is 

an individual who has “significantly subaverage 

general intellectual functioning, existing 

concurrently with deficits in adaptive behavior 

and manifested during the developmental period, 

that adversely affects a child’s educational 

performance” (IDEA, 2004). According 

to Polloway, Patton, Smith, and Buck (1997) 

students with MID experience “related limitations 

in two or more of the following applicable 

adaptive skill areas: communication, selfcare, 

home living, social skills, community use, 

self direction, health and safety, functional 

academics, leisure, and work” (p. 298). In 

schools, students with MID typically have IQs 

between 55 and 70, although the American 

Association on Intellectual and Developmental 

Disabilities (2011)–a major organization in 

the United States that advocates for individuals 

with intellectual disability–classifies individuals 

with IQs between 50 to 75 range as 

having MID (Bouck, in press). 

Researchers identified general characteristics 

of students with MID including slow academic 

growth, low academic performance, 

and poor post-secondary outcomes (Parmar, 

Cawley, & Miller, 1994; Sabornie, Evans, & 

Cullinan, 2006). Researchers hypothesized 

some of these difficulties are likely due to 

challenges students with MID face in working 

memory, particularly with storing information 

(Allen, Baddeley, & Hitch, 2006; Baddeley, 

2003; Schuchardt, Gebhard & Mäehler, 2010). 

While some information is available for understanding 

students with MID, often in research 

students with MID are aggregated with students 

with moderate and severe intellectual 

disability or with students with other high 

incidence disabilities such as learning disabilities 

and emotional/behavior disorders (Polloway, 

Lubin, Smith, & Patton, 2010). Practitioners 

and researchers would benefit from 

more disaggregated data on students with 

MID regarding characteristics, interventions, 

and outcomes specific to this population. 

Mathematics Instruction for Students with MID 

Historically, mathematics instruction for students 

with MID has been divided into two 

main areas, not unlike the general dichotomy 

of curriculum for this population of students: 

a functional curriculum and an academicallyoriented 

approach (Alwell & Cobb, 2009; 

Browder, Spooner, Wakeman, Trela, & Baker, 

2006). Although a recent review exists on 

functional mathematical curriculum received 


y students with intellectual disability (note, not 

disaggregated for students with MID) (Browder, 

Spooner, Ahlgrim-Delzell, Harris, & Wakeman, 

2008), the last thorough review on academic 

mathematical instruction for students with mildto-moderate 

intellectual disability predates the 

current decade and hence current reforms 

(Butler, Miller, Lee, & Pierce, 2001). 

Butler and colleagues (2001) reviewed the 

literature on mathematics education for students 

with mild-to-moderate intellectual disability 

published between 1989 and 1998. In 

the 16 articles found for these two populations 

during the time frame, Butler et al. found a 

shift in instructional focus from a curriculum 

based on basic skills (e.g., numeracy, mathematical 

symbols, equality, etc.) to a focus on 

computational fluency and mathematical 

problem solving (e.g., tasks involving organization 

and analysis of information). Further, 

Butler et al. noted the increased attention to 

developing students’ procedural and conceptual 

understanding, such as research supporting 

teaching students with mild-to-moderate 

intellectual disability through use of strategy 

instruction for problem solving, self-regulation, 

and the concrete-semiconcrete-abstract 

teaching sequence. The shift in instructional 

methods coincided with recommendations for 

shifting emphasis in mathematics education 

in general, as supported by the National 

Council of Teachers of Mathematics (1989) as 

well as supported the position of researchers 

in special education who called for greater 

attention to problem-solving and the development 

of conceptual understanding (e.g., Jitendra 

& Xin, 1997; Woodward & Howard, 1994). 

The shifting emphasis of instructional 

methods for students with intellectual disability 

also aligned with research suggesting students 

with MID may possess strengths in mathematics 

regarding higher level thinking skills, 

such as the ability to create and maintain strategies, 

utilize metacognitive skills, and develop 

at least some levels of conceptual understanding 

of mathematical relationships on an abstract 

level (Baroody, 1996; Erez & Peled, 

2001). In a group study including twenty-four 

elementary, middle, and high school students 

with mild-to-moderate intellectual disability, 

some students were able to independently create 

more efficient strategies (e.g., short-cuts 

such as “counting on”) after receiving explicit 

instruction for less efficient, more time-consuming 

strategies (e.g., “counting all”) when 

working on single digit addition problems 

(Baroody). Erez and Peled also found some 

middle and high school students with mild-tomoderate 

intellectual disability used metacognitive 

skills, such as reexamining choices 

made during problem solving processes and 

basing future actions upon these reflections, 

to solve addition word problems. Some of 

these students also independently developed 

an understanding of the structure of these 

problems and the abstract mathematical relationships 

within the problems (e.g., part-partwhole) 

(Erez & Peled). 

While schools are expected to prepare students 

with MID for daily responsibilities once 

they leave K-12 education, students with MID 

also need a variety mathematical skills to meet 

demands placed upon them by educational laws 

(i.e., IDEA, 2004; NCLB, 2002) and high school 

graduation requirements (Teuscher et al., 

2008). Students with disabilities, including students 

with mild intellectual disability, need access 

to opportunities to develop conceptual understanding 

for success with more complex 

mathematics in middle school, high school, and 

post-secondary education (Lesh et al., 1988; 

Vergnaud, 1983; Woodward & Montague, 

2002). While Butler et al. (2001) indicated students 

with MID were receiving instruction more 

rooted in mathematical concepts than in previous 

years, the question remains regarding 

whether students with MID continued to receive 

instruction needed to develop the foundation in 

mathematics for success when considering both 

procedural and conceptual understanding. The 

specific research question for this study is: What 

is the nature of the academic instruction the 

students with MID have received in mathematics 

in the past 11 years? 

Method 

A systematic review of the literature was completed 

of academic mathematics interventions 

for students with MID from 1999 to 2010. The 

researchers chose this period of time as Butler 

et al. (2001) reviewed research on this topic 

through 1998 and multiple reforms impacting 

mathematics education occurred in the last 

decade (e.g., Common Core Standards, 2010; 

IDEA, 2004; NCTM, 2000). Studies were in- 


cluded if (a) the sample included at least one 

student with MID enrolled in school (i.e., a 

student between the ages of 3 and graduation 

or exiting school and was referred to as a 

student with MID by the authors of the study 

and/or the IQ reported in the study was between 

50 and 75); (b) the study focused on an 

academic mathematics intervention, operationally 

defined as an intervention targeting a 

skill area for advancement in school mathematics 

rather than daily living skills such purchasing 

groceries or counting money; (c) the 

article was published in a peer-reviewed journal 

in English between 1999 and 2010; and 

(d) the research occurred in the United 

States. Common reasons articles were excluded 

included (a) the description of the 

participants was unspecified; (b) the data for 

participants with MID were aggregated with 

data for other disabilities and could not be 

isolated; (c) the term MID (or something 

equivalent) was used by the authors, but all 

participants had IQs outside of the 50–75 

range; and/or (d) the studies were conducted 

in foreign countries where MID is defined 

differently (often with IQs up to 85) (e.g., 

Kroesbergen & Van Luit, 2005). Articles focused 

on assessment (e.g., identification of 

students for special education services); descriptions 

of characteristics of students with 

disabilities; and position papers were also excluded. 

Multiple methods were used to locate articles 

meeting the criteria. First, a keyword 

search was completed utilizing four electronic 

databases: PsychInfo, ERIC, Wilson Select, 

and ProQuest. Due to the number of terms 

used synonymously with MID, articles that 

used the terms mild mental retardation, developmental 

disability, cognitive disability, 

mild intellectual disability, and mild cognitive 

impairment were included in the study (Sandieson, 

1998). For the keyword search, math* 

was combined with the following terms: mental 

impairment, mild cognitive, mild intellectual, 

mild mental retardation, and mild developmental. 

The researchers also used the 

search terms, intellectual and cognitive 

disab*, and evaluated the IQ of the participants 

within these studies. 

Next, the researchers reviewed both general 

and special education journals for articles 

meeting the criteria published between the 

years 1999 and 2010. A hand search was completed 

by looking for relevant articles in the 

following journals: Journal for Research in Mathematics 

Education, Exceptional Children, The Journal 

of Special Education, Remedial and Special 

Education, and Education and Training in Autism 

and Developmental Disabilities. During the 

hand search, the researchers evaluated articles 

by looking for the search terms described 

above as well as any terms that might be relevant 

to this study (e.g., students with mild 

disabilities, math difficulties, etc.), but not 

specifically included in the search terms in the 

computer database search. Finally, the researchers 

completed an ancestral search using 

the references of the articles meeting criteria 

for inclusion in this study. All of the articles 

were located in electronic databases using keyword 

searches except for one article which was 

located by hand-searching the selected journals. 

The ancestral search did not result in 

finding any articles that met inclusion criteria. 

Results 

Seven studies were found addressing academic 

mathematics interventions for students 

with MID published between the years 1999 

and 2010 (see Table 1). The participants 

ranged in ages from children in elementary 

school to a 23-year-old adult in an after high 

school program. The majority of the studies 

on mathematics instruction and students with 

MID (i.e., six of seven) were focused on procedural 

instruction; in other words, mathematics 

facts or computation involving basic 

arithmetic (e.g., addition, subtraction, multiplication, 

and division facts and traditional 

algorithmic procedures). The other study– 

focused on conceptual instruction–involved 

an intervention based on the use of mathematical 

models, prompts for cognition/metacognition 

related to problem structure and 

algebraic procedures for solving word problems. 

Procedural Instruction 

Flashcards. Flashcards were used in four of 

the six studies focused on procedural instruction, 

each designed to improve the mathematical 

fact knowledge of students with MID (Dihoff, 

Brosvic, Epstein, & Cook, 2005; Hayter, 


TABLE 1 

Studies of Mathematics Interventions for Students with MID: 1999–2010 

Citation Intervention 

Sante, 

Laughlin, 

& Weber 

(2001) 

Neef, Nelles, 

Iwata, & 

Page 

(2003) 

Dihoff, 

Brosvic, 

Epstein, & 

Cook 

(2005) 

Hayter, Scott, 

McLaughlin, 

& Weber 

(2007) 

Bouck, 

Bassette, 

Taber- 

Doughty, 

Flanagan, 

& Szwed 

(2009) 

Rao & Mallow 

(2009) 

Rao & Kane 

(2009) 

Flashcards for learning 

multiplication facts 

Meta-cognitive and 

model-based 

instruction for 

addition and 

subtraction word 

problems 

Students received 

feedback from the 

teacher while 

completing multiple 

choice questions in 

response to 

flashcards 

Flashcards for leaning 


Pentop computer for 

teaching 

multiplication 

computation 

Simultaneous 

prompting system 

for automatic recall 

of multiplication 

facts 

Simultaneous 

prompting system 

for regrouping 

during decimal 

subtraction 

Scott, McLaughlin, & Weber, 2007; Rao & 

Mallow, 2009; Sante, McLaughlin, & Weber, 

2001). Sante and colleagues conducted a sin- 

#of 

Subjects 

with 

MID Setting Design Results 

2 Middle school 

self-contained 

classroom 

1 After high school 

program for 

students with 

intellectual 

disabilities 

55 Elementary 

school 

2 High school selfcontained 

classroom 



classroom 



classroom 



classroom 

Multiple baseline 

across 

participants 


across 

behaviors 

Group 

comparison 


across 

participants 


across 

participants 


across 

participants 


across 

participants 

Students’ rate of 

accuracy with 


improved. 

Student’s word problem 

solving performance 

improved. 

Students’ retention of 

arithmetic facts 

(addition, 

subtraction, 

multiplication & 

division) improved. 

The skills learned 

were maintained by 

the participants for 

about one-to-two 

weeks. 

Student showed higher 

motivation and 

improved accuracy 

on multiplication 

facts. 

Students’ performance 

with multiplication 

computation 

improved and was 

maintained by the 

participants. 

Students’ accuracy and 

speed for recalling 


improved and was 

maintained and 

generalized. 

Students maintained 

and generalized the 

skill of successful 

decimal subtraction 

procedures. 

gle subject design study focused on improving 

multiplication facts that included two sixthgrade 

participants with MID and ADHD. Both 


participants performed at a third-grade mathematics 

level and were educated in a self-contained 

special education mathematics class. 

The researchers found sixteen-to-seventeen 

sessions of presenting flashcards with one 

digit factors and providing feedback regarding 

correctness of answers improved the multiplication 

factual knowledge of the students, 

and the researchers recommended using this 

approach to enhance mathematical performance. 

Hayter and colleagues also used a single 

subject research design to study the impact of 

flashcards (containing factors ranging from 

four to ten) followed by informing the student 

of the answer on helping high school students 

with MID learn multiplication facts. After 

eleven sessions, the researchers reported an 

increased accuracy with multiplication facts 

and, after the participants experienced success, 

their motivation to solve the tasks improved. 

After the participants were encouraged 

by their success, they made their own 

flashcards for studying for another class. 

Also using a single-subject research design, 

Rao and Mallow (2009) evaluated flashcards 

as an intervention to help a middle school 

student with MID learn multiplication facts, 

but combined the visual aspect of flashcards 

with teacher prompts (i.e., the teacher provided 

the answer along with the presentation 

of the flashcard). The intervention supported 

growth in the participant’s factual knowledge 

of multiplication facts with factors ranging 

from zero to twelve, and improved his speed 

and accuracy. The participant was able to 

maintain his knowledge of multiplication facts 

for over a three-month period and made generalizations 

to situations when the student 

needed to recall multiplication facts while 

solving long division problems using a traditional 

algorithm as well as from the special to 

the general education classroom. 

The final flashcard study involved a group 

comparison of 55 elementary school students 

with MID (Dihoff et al., 2005). Dihoff et al. 

used flashcards with multiple choice answers 

listed on the flashcards to fact questions for 

addition, subtraction, multiplication, and division. 

The researchers prompted elementary 

school students with MID when incorrect to 

consider the alternative choices on the flashcards. 

In some situations, the researchers pro- 

vided similar prompts using a bubbled answer 

sheet with wax covers over each answer 

choice. After students removed the wax coating 

of their answer choice, a star under the 

wax coating indicated correct answer while a 

lack of a star prompted the participants they 

were incorrect. In both cases, the participants 

were able to keep making choices until they 

found the correct answer. The participants 

were able to retain the knowledge they gained 

from the practice along with the prompts and 

feedback for time periods ranging from five 

days to two weeks. 

Computational instruction. In one of two 

studies focused on computation instruction, 

Rao and Kane (2009) used a single subject 

design to study teacher prompts for two middle 

school students with MID to follow procedures 

for using traditional algorithms for subtracting 

decimals. The participants were given 

step-by-step instructions for each procedure 

involved (e.g., recognizing the need for regrouping 

as well as how to complete the regrouping 

procedures). The skills for completing 

the traditional algorithm for subtracting 

decimals were maintained for the remainder 

of the school year and generalized to subtraction 

problems with different regrouping requirements 

and to real-world situations such 

as using a spreadsheet for solving moneyrelated 

problems associated with personal finances 

and business budgets. 

In another single subject study, Bouck, Bassette, 

Taber-Doughty, Flanagan, & Szwed 

(2009) used technology as an intervention to 

improve participants’ computational knowledge. 

Bouck and colleagues evaluated the 

FLYPen TM –a pentop computer produced by 

LeapFrog–as a tool to improve the multiplication 

fluency of three middle school students 

with MID. The technology benefited students 

with both learning multiplication facts as well 

as multiplication computation skills with involving 

a single-digit numbers and two-digit 

numbers (e.g., 35 7). The immediate feedback 

students received from the technology 

when they made a mistake was noted as helping 

students. 

Conceptual Instruction 

In the one conceptual instruction study, Neef, 

Nelles, Iwata, & Page (2003) used a single 


subject design to provide an intervention for 

two students–one student with MID–on how 

to solve addition and subtraction word problems. 

Neef and colleagues described their intervention 

as teaching precurrent skills (i.e., 

“responses that increase the effectiveness of a 

subsequent or ‘current’ behavior in obtaining 

a reinforcer,” p. 21). The participants placed 

mathematical signs and problem elements in 

a mathematical model that included a box for 

each number or variable in the problem, the 

mathematical operations sign, and the equal 

sign. After placing the known problem elements 

and correct mathematical signs in the 

model, the participants were instructed to use 

basic algebraic procedures to solve for the 

unknown in simple equations such as “A ? 

C” (p. 25). Students were encouraged to 

think about the structure of the problem via 

prompting from the teacher such as “How 

many objects did (name) start out with, end 

up with, get, lose, etc.” (p. 27). The participants’ 

word problem solving accuracy improved 

after receiving the intervention. Maintenance 

of skills was not tested by the 

researchers due to time constraints nor was 

the generalization of the skills to other problem 

types. 


Given the current emphasis on mathematics 

education for all students, including students 

with MID, it is imperative to determine the 

nature of existing research on mathematical 

interventions for these students and use this 

knowledge to inform further practice and research. 

This study focused on research in the 

past decade involving academic mathematical 

interventions for students with MID–a population 

lacking in attention (Polloway, 2006; 

Polloway et al., 2010)–from age three to exiting 

school. The results suggest two main findings: 

(a) little attention in research to academically-based 

mathematical interventions for 

students with MID with no current studies 

focusing on mathematics standards at or 

above middle school levels of general education 

curriculum, and (b) of the limited existing 

research, most studies are primarily focused 

on procedural instruction (e.g., 

mathematical facts and computational flu- 

ency) rather than conceptual understanding 

(e.g., problem-solving). 

The limited research on mathematics education 

for students with MID is discouraging 

although perhaps not surprising. Even though 

mathematics received increased attention in 

the past decade due the educational climate 

(e.g., NCLB, 2002), historically less research 

has been conducted on students with disabilities 

and mathematics than literacy (Fuchs & 

Fuchs, 2005; Fuchs et al., 2007). The lack of 

attention in the last decade to mathematics 

education and students with MID is problematic 

for multiple reasons, including difficulty 

in articulating evidence-based mathematical 

practices for this population without a research 

base as well as the dissociation with 

current practice and policy regarding the importance 

of mathematics education, especially 

rigorous mathematics education for all students 

(IDEA, 2004; NCLB, 2002; NCTM, 2000; 

Woodward, 2004). Clearly, this systematic review 

highlights the need for more research in 

academic mathematical intervention for students 

with MID, although from the existing 

recent research we can gleam the prioritized 

pedagogical approaches. 

Procedural and Conceptual Instruction 

Within the limited existing research on mathematics 

for students with MID, the majority 

(n6) focused on procedural instruction 

rather than conceptual understanding. In 

other words, current research prioritized the 

memorization of mathematical facts or steps 

taken to complete mathematics problems 

(e.g., using a traditional algorithm) rather 

than understanding mathematical concepts 

and using reasoning skills to make and explain 

decisions made during problem solving 

processes (NCTM, 2000). The lack of attention 

in research to conceptual understanding 

for this population of students is also at odds 

with the current mathematics policy, educational 

reforms, and recommendations by general 

and special education researchers (Lesh 

et al., 1988; National Math Advisory Panel Report, 

2008; NCTM, 2000; Ostad, 1998; van 

Garderen, 2007; Vergnaud, 1983; Woodward, 

2004; Woodward & Montague, 2002). Special 

education researchers have recommended 

greater emphasis on developing critical think- 


ing skills about mathematics and deeper conceptual 

understanding of mathematical ideas 

to empower students with knowledge that is 

transferable to various situations rather than 

knowledge of procedures specific to certain 

mathematical situations (van Garderen, 2007; 

Woodward & Montague, 2002). Mathematical 

reasoning and conceptual understanding can 

help students achieve higher levels in mathematics 

and face increased expectations for academic 

performance in K-12 education 

(IDEA, 2004; NCLB, 2002; NCTM, 2000; 

Woodward, 2004). 

While some might question the need for 

more rigorous focused mathematics education 

for students with MID, it is imperative for 

multiple reasons: (a) these students are capable 

of being successful with these pedagogical 

approaches if given a chance (Baroody, 1996; 

Jimenez, Browder, & Courtade, 2008; Erez & 

Peled, 2001; Neef et al., 2003), (b) a decreased 

focus on procedures or rote recall is 

consistent with research suggesting students 

with MID struggle with working memory 

(Schuchardt et al., 2010), and (c) helping 

these students to be successful on high-stakes 

assessments (NCLB, 2002; Woodward, 2004). 

First, although limited in quantity, the little 

research on more conceptual instruction for 

students with intellectual disability demonstrated 

success. Neef et al. taught students 

with MID how to use basic algebraic procedures 

(e.g., solving for the unknown) while 

solving word problems. Related, in a study by 

Jimenez et al., students with IQs below 50 were 

successful with solving for an unknown in an 

algebraic equation (e.g., 3 a 5). These 

findings, when considered along with those of 

Baroody (1996) and Erez and Peled (2001), 

suggest students with MID possess a number 

of skills related to higher order mathematical 

understanding and the field may need to raise 

its expectations for what these students can– 

and should be expected–to do. 

Second, students with MID struggle with 

working memory (Schuchardt et al., 2010). 

Rather than focus on instructional approaches 

steeped in storage and recall, practitioners 

can focus on conceptual understanding 

and use technology to circumvent student 

struggles (NCTM, 2000; Woodward & Montague, 

2002). Students with MID experience 

success using calculators (Bouck et al., 2009; 

Horton, Lovitt, & White, 1992). Calculators 

can be used as a cognitive prosthesis (Edyburn, 

2006) and teachers can then potentially 

devote more instructional time to developing 

a thorough and deep understanding of mathematical 

ideas and connections between those 

ideas–instruction consistent with recommendations 

by NCTM (2000) and even special 

education researchers (Woodward & Montague). 

Last, higher level mathematical ability and 

understanding is needed by students with 

MID if they are expected to take general largescale 

assessment (Bouck, 2007). Given that 

students with MID across all grade levels typically 

take the same assessment as their peers 

without disabilities (Bouck; Yell & Drasgow, 

2005; Ysseldyke et al., 2004), instruction in 

mathematics for this population needs to focused 

on the areas that can promote student 

success. If these students are expected to take 

the general large-scale assessment, they 

should be given general education academic 

instruction to increase the opportunity for 

success (Bouck, 2007). While assessment 

should not drive instructional practice 

(Faulkner & Cook, 2006; Shepard, 2010), students 

with MID have to be given a fighting 

chance to be successful by covering the content. 

Hence, research should focus on how to 

help students with MID be successful in mathematics 

classes if the field of education continues 

the practice of high stakes testing. 

Implications for Practice 

The results of this review of the literature 

suggest practices exist that assist students with 

MID in ascertaining basic facts as well as conceptual 

understanding of mathematical ideas, 

although more research is needed on the latter. 

Multiple studies in the review suggest 

teachers can rely on flashcards as an educational 

tool for teaching mathematical facts to 

students with MID (Dihoff et al., 2005; Hayter 

et al., 2007; Rao & Mallow, 2009; Sante et al., 

2001). However, teachers need to make careful 

decisions about how much time is devoted 

to memorization of facts as compared to critical 

thinking about mathematical ideas and 

the connections between these ideas (NCTM, 

2000; van Garderen, 2007; Woodward & Montague, 

2002). 


Neef and colleagues (2003) demonstrated 

some of the benefits of diagramming information 

in word problems. Diagramming and 

other forms of visual representation may also 

be included in instruction to give students 

with MID opportunities for access to more 

challenging mathematics (van Garderen, 

2006). By teaching students with MID methods 

for storing information on paper while 

working through challenging, multistep problems, 

teachers give these students an important 

tool for overcoming deficits in working 

memory which may have previously contributed 

to the struggles of some students with 

MID in mathematics (Allen et al., 2006; Baddeley, 

2003; Barrouillet, Bernardin, Portrat, 

Vergauwe, & Camos, 2007; Schuchardt et al., 

2010). Instructional principles applied by 

Neef and colleagues may be also applicable to 

various situations in which students with MID 

are likely to need help with storing and organizing 

information and using metacognition 

to complete proper analysis of the mathematical 

problem and the steps taken to solve it. 

Teachers can apply these principles to multiple 

mathematical situations as well as in other 

content areas when students with MID feel 

overwhelmed with the amount and complexity 

of information they need to store, organize, 

and process. 

Limitations and Future Directions 

A challenge exists when studying students with 

MID due to variation in ways of defining and 

labeling intellectual disability, and thus researchers 

face dilemmas when determining 

criteria for participant inclusion (Sandieson, 

1998). In this study, the criteria was based on 

IQ scores which can be problematic due to 

variation of student performance that often 

occurs within the 50–75 IQ range (Cawley & 

Parmar, 1995; Fletcher, Blair, Scott, & Bolger, 

2004). However, the researchers chose IQ for 

determination of inclusion of participants due 

to the ambiguity of the MID label especially 

when considering studies done outside the 

United States where a student can be labeled 

as having MID due to having an IQ of up to 85 

in countries (e.g., the Netherlands). While it 

is necessary to be specific about participant 

characteristics when reporting findings, the 

drawback of excluding studies done in foreign 

countries, as well as following strict guidelines 

for participant IQs, is the exclusion of some 

important studies in mathematics for students 

with disabilities completed recently by researchers 

in other nations (e.g., Chung & Tam, 2005; 

Kroesbergen & Van Luit, 2003; Kroesbergen & 

Van Luit, 2005). Therefore, some important 

studies to the field may have been excluded due 

to the strict, yet necessary, inclusion criteria set 

by the researchers in this study. 

Aside from difficulties with defining and 

labeling students with MID, the lack of information 

on characteristics of students with 

MID also presents a challenge. To better study 

students with MID, it may be necessary to 

more thoroughly investigate the characteristics 

of students with MID by specifically studying 

this population (as in Schuchardt et al., 

2010) rather than aggregating data with other 

populations which is a common problem and 

has made it difficult to determine the characteristics 

and outcomes for students with MID 

(Polloway et al., 2010). Also, due to the lack of 

research on mathematics and students with 

MID, it may be important for researchers to 

examine the performance of these students 

using qualitative research designs to gain insight 

into the specifics of how students with 

MID understand and reason about mathematics. 

After a foundation of research regarding 

mathematical reasoning as well as the characteristics 

(e.g., memory and processing abilities) 

of students with MID has been established, 

interventions may be more effectively 

developed. Eventually, considering that teachers 

are expected to use evidence-based practices 

to guide their instruction, researchers 

need to provide a more thorough research 

base regarding effective interventions for students 

with MID so teachers can have a better 

foundation upon which to build their instructional 

practices. 

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Education and Training in Autism and 

Developmental Disabilities 

Editorial Policy 

Education and Training in Autism and Developmental Disabilities focuses on the 

education and welfare of persons with autism and developmental disabilities. 

ETADD invites research and expository manuscripts and critical review of the 

literature. Major emphasis is on identification and assessment, educational programming, 

characteristics, training of instructional personnel, habilitation, prevention, 

community understanding and provisions, and legislation. 

Each manuscript is evaluated anonymously by three reviewers. Criteria for acceptance 

include the following: relevance, reader interest, quality, applicability, 

contribution to the field, and economy and smoothness of expression. The review 

process requires two to four months. 

Viewpoints expressed are those of the authors and do not necessarily conform to 

positions of the editors or of the officers of the <strong>Division</strong>. 

Submission of Manuscripts 

1. Manuscript submission is a representation that the manuscript is the author’s 

own work, has not been published, and is not currently under consideration for 

publication elsewhere. 

2. Manuscripts must be prepared according to the recommendations in the Publication 

Manual of the American Psychological Association (Sixth Edition, 2009). 

3. Each manuscript must have a cover sheet giving the names and affiliations of all 

authors and the address of the principal author. 

4. Graphs and figures should be originals or sharp, high quality photographic 

prints suitable, if necessary, for a 50% reduction in size. 

5. Five copies of the manuscript along with a transmittal letter should be sent to the 

Editor: Stanley H. Zucker, Mary Lou Fulton Teachers College, Box 871811, 

Arizona State University, Tempe, AZ 85287-1811. 

6. Upon receipt, each manuscript will be screened by the editor. Appropriate 

manuscripts will then be sent to consulting editors. Principal authors will receive 

notification of receipt of manuscript. 

7. The Editor reserves the right to make minor editorial changes which do not 

materially affect the meaning of the text. 

8. Manuscripts are the property of ETADD for a minimum period of six months. 

All articles accepted for publication are copyrighted in the name of the <strong>Division</strong> 

on Autism and Developmental Disabilities. 

9. Please describe subjects (or any other references to persons with disabilities) 

with a people first orientation. Also, use the term intellectual disability (singular) 

to replace any previous term used to describe the population of students 

with significant limitations in intellectual functioning and adaptive behavior as 

manifested in the developmental period.

14th International 

Conference on Autism, 

Intellectual Disability & 


Research to Practice 

Council for Exceptional Children 

<strong>Division</strong> on Autism & 


On behalf of the Board of Directors for CEC‛s <strong>Division</strong> on Autism and Developmental Disabilities, may 

I extend an invitation to join us in Kona, Hawaii, January 23-25, 2013, for this premier professional 

learning opportunity! 

 

The 14 th International Conference on Autism, Intellectual Disability and Developmental Disabilities 

will integrate research and practice, reflecting the need for evidence-based strategies and 

interventions within this diverse field. 

The program features more than 100 lecture and poster presentations. Noted speaker sessions 

include: 

Helping Children with Developmental Disabilities Learn: A New Model for Integrating 

Technology in 21st Century Classrooms 

Evidence-Based Practices for Students with Intellectual Disability and ASD 

Sense and Sensabilities: An Inside View on Sensory Issues, What They Look Like, Avoiding 

Them, and Working Through Ones That Occur 

Good Blood, Bad Blood: Science, Nature, and the Myth of the Kallikaks 

A Model for Social Skills Instruction for Students with ASD 

Conference delegates may also attend an in-depth pre-conference training institute on ASD, led by 

Dr. Brenda Smith Myles. Continuing Education Units (CEU‛s) will be available for conference 

delegates. 

Our Conference will be held at the beautiful Sheraton Kona, Resort & Spa at Keauhou Bay on the 

big island of Hawaii. 

For further information, please contact: 

Cindy Perras 

Conference Co-ordinator 

CEC-DADD 

cindy.perras@cogeco.ca 

www.daddcec.org

etadd_47(3) - Division on Autism and Developmental Disabilities

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