Teaching Pretend Play Skills to a Student with Autism Using Video Modeling with a Sibling as

Model and Play Partner

Author(s): Kara A. Reagon, Thomas S. Higbee and Katie Endicott
Source: Education and Treatment of Children, Vol. 29, No. 3 (AUGUST 2006), pp. 517-528
Published by: West Virginia University Press
Stable URL: http://www.jstor.org/stable/42899899
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 EDUCATIONAND TREATMENTOF CHILDREN Vol.29,No. 3 2006

Teaching Pretend Play Skills to a Student with

Autism Using Video Modeling with a Sibling as
Model and Play Partner

Kara A. Reagon, Thomas S. Higbee, and Katie Endicott

Utah State University

Abstract
We taughta four-year-oldboy diagnosedwithautismand his olderbrother
to engagein fourpretendplay scenariosusingvideo modeling.The older
brotheractedin thevideomodelswitha typically developingpeer.Boththe
and
participant his successfully
sibling engaged in thefourscenariosduring
as wellas maintenance
intervention and generalizationprobesconductedin
theirhome. Thiscase studyillustratedthatsiblingsofchildrenwithautism
can perform in video modelsas well as engagein pretendplay withtheir
siblingwithautism.In addition,the childwithautismmay benefitfrom
as indicatedby theintervention
interventions
sibling-oriented data and the
parentand siblingsurveyquestionspresented in thecurrentstudy.
KeyWords:videomodeling,
pretendplay,autism,sibling
*****

A growingbody ofliteraturesupportsthebeneficialeffectsofvideo
-/^modeling procedures to teach studentswith autism a varietyof
skills including perspective taking (Charlop-Christy& Daneshvar,
2003, LeBlanc et al., 2003), language (Charlop & Milstein, 1989,
Charlop-Christy,Le & Freeman, 2000, Lowy Apple, Billingsley &
Schwartz,2005, Nikopoulos & Keenan, 2003, Nikopoulos & Keenan,
2004, Wert & Neisworth,2003), daily living skills (Charlop-Christy,
Le & Freeman, 2000, Haring, Kennedy, Adams, & Pitts-Conway,
1987, Shipley-Benamou,Lutzker & Taubman, 2002), play (D' Ateno,
Mangiapanello, & Taylor,2003, Taylor,Levin & Jasper,1999), and
academic skills (Kinney,Vedora & Stromer,2003). In video modeling
interventions, footageis createdthatdepicts one or more individuals
engagingeffectively in a sequence ofbehaviors.The learnerviews the
videotape/DVD and is given the opportunityto imitatethe observed
responses. Video modelingresearchillustratesthatparticipantsrapidly
acquire the targetskills with skill maintenanceover long periods of

UtahState
to ThomasŠ. Higbee,Dept.ofSpecialEd. andRehab.,
Correspondence
2865OldMainHill,Logan,UT84322-2865.
University, Fax:435-
Phone:435-797-1933.
E-mail:
797-3572. tom.higbee@usu.edu

Pages 517-528

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518 REAGON, HIGBEE, and ENDICOTT

time (e.g. Charlop & Milstein,1989, Charlop-Christy& Daneshvar,

2003,Haring,Kennedy,Adams, & Pitts-Conway,1987). Two common
characteristicsof children with autism, excellent memory and
echolalia, may enhance positive response to video modeling because
exact duplicationof the model is desired (Charlop & Milstein,1989).
Technological advances have made video modeling a readily
accessible interventionthat is easy to use and has minimal costs
(Charlop & Milstein, 1989; Charlop-Christy,Le & Freeman, 2000;
Goldsmith & LeBlanc, 2004). Charlop-Christyet al. (2000) directly
compared video modeling with in vivo modeling to teach 5 children
with autism (ages 7-11) tasks such as labeling emotions,greetings,
independent and cooperative play, conversationalspeech, and daily
livingskills.Childrenhad fasteracquisitionand bettergeneralization
in thevideo modeling conditionthanin the in vivo conditionand the
authorssuggested thatthe video modeling conditionwas more time
and cost efficient for4 out of the 5 participants.
In addition to cost and time effectiveness, theremay be several
to
potentialadvantages using video models to teach individuals with
autism. One potential advantage is the systematicrepetitionthat
can be provided by showing the same video model numerous times
(Charlop & Milstein,1989, Taylor,Levin & Jasper,1999) as opposed
to small variationsthatmay arise withlive models. Video models can
convenientlyemploy strategiesthathelp promotegeneralizationsuch
as programmingmultipleexemplars,incorporatingcommon stimuli,
and naturalcontingenciesand environments(e.g. Charlop & Milstein,
1989,Charlop-Christy& Daneshvar, 2003, Haring, Kennedy,Adams,
& Pitts-Conway,1987) by arrangingthese aspects in the creationof
the video. Finally,videotaping allows use of a varietyof models that
mightnotbe available formultipletrialswithlive modelingincluding
typicalpeers (Nikopoulos & Keenan, 2003), siblings(Taylor,Levin &
Jasper,1999),and selfas model (Wert& Neisworth,2003).
Siblingsmaybe particularlyvaluable as video models,especially
when targetingplay skills. First,siblingsofchildrenwithautismmay
oftenattemptto engage theirbrotheror sisterin play or conversation
thoughtheymay do so ineffectively. Theymay also expressan interest
in helping to teach theirsiblingnew skills (Taylor,2001) and theyare
the most frequentlyavailable play partner.While researchershave
demonstratedthat siblings of children with autism can effectively
implementbehavioral interventions(e.g., Celiberti & Harris, 1993;
Schreibman,O'Neill and Koegel, 1983), only one study on video
modelinghas used siblingsboth as model and conversationalpartner
to teach play (Tayloret al., 1999).
Tayloret al. (1999) used a video modelingintervention to increase
theplay commentsoftwo childrenwithautismdirectedtowardstheir

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VIDEO MODELING FOR PRETEND PLAY 519

siblings.Each participantviewed video models of his siblingand an

adult engagingin scriptedverbalexchangesinvolvingplay materials.
Participantsthen practiced the scripted verbal exchanges with an
adult with the materialsfromthe video present.Probe sessions with
no video model were then conducted with the participantand his
sibling to measure the number of scripted play commentsdirected
towards the sibling.The resultsof the study indicated that the first
participantsuccessfullylearned to make the scriptedplay comments
in each of the threetargetedplay activities. An additional forward-
chaining component was added to the treatmentpackage for the
second participantin an attempt to increase the length of play-
related comments.The second participantalso made more sibling-
directedplay-relatedcommentsfollowingvideo modeling including
unscripted statementsin addition to the scripted play statements.
Thus, video modeling proved to be a successful interventionfor
producingsibling-directedplay commentsforboth participants.
The purpose of the currentcase study is to replicatethe effects
demonstratedby Tayloret al. (1999) ofusing siblingsas video models
and play partnerswith a 4-year-oldchild with autism in a pretend
play context. However, the currentstudy differsfromTaylor et al
studyin severalways. First,thecurrentstudyremovesthecomponent
of practicewithadults afterviewing thevideo models to determineif
theinterventions can be simplifiedwithoutdetrimentto effectiveness.
Second, all sessions in this study were conducted at a centerbased
program instead of the participants'home as in Tayloret al; follow-
up, however was conducted in the child's home. Finally,measures of
appropriateplay are incorporatedin the currentstudy but were not
included in Tayloret al.
Method

and Setting
Participants
A 4-year-oldboydiagnosed withautismparticipatedinthisstudy.
He scored in the mild to moderate range on the Childhood Autism
RatingScale (Schopler,Reichler,& Renner,2002). He could receptively
and expressivelylabel numerousobjects,requestpreferreditems,and
greet others.However, he did not engage in pretend play with his
siblings or peers. Sessions occurred at a university-basedpreschool
programforstudentswith autism. The brotherwas the play partner
throughoutthestudy,whichoccurredduringthesiblingsrecessbreak
fromhis on-campuselementaryschool. Generalizationand follow-up
sessions occurredin theparticipant'shome and included a 6-year-old
brotherand their32-year-oldmotheras play partnersfor2 scenarios.

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520 REAGON, HIGBEE, and ENDICOTT

Materials
The universitybased preschool classroom common space was
used forthe play area and forfilmingand viewing the video models.
The space included a televisionand DVD playeron a stand,whitedry
erase board, a large table and 4 small chairs. Sonic Vegas and DVD
Architectsoftwarewas used to createtheDVDs on an IBM compatible
personal computer.The video models were viewed on a 19-inchcolor
televisionand were played on a MitsubishiDVD player.Play materials
used in the studywere not available to the participantexcept during
experimentalsessions. Detailed play scriptsare available fromthe
authorsupon request.
The firefighter scenario was approximately 70 seconds long
and included two firefighter jackets and hats, a yellow garden hose,
and a girl baby doll. The firefighter scenario contained 4 scripted
statements(3-4 word length) and actions. The cowboy scenario
7
was approximately25 seconds long and included two cowboy hats
and handkerchiefs,two toy guns, and a sheriff'sbadge. The cowboy
scenario contained 4 scripted statements(2-5 word length) and 7
actions. The teacher scenario lasted approximately20 seconds and
included a pointerand a white board with writtenletters,numbers,
and shapes. The teacherscenario contained6 scriptedstatements(2-5
word length) and 5 actions. The doctor scenario was approximately
30 seconds in durationand used a FisherPriceMedicalKit (i.e., blood
pressurecuff,stethoscope,thermometer, syringe,bandage, otoscope).
The doctorscenariocontained5 scriptedstatements(2-5 word length)
and 6 actions.The participant's7-year-oldbrotheracted in 2 of the 4
video models while 3 othertypicallydeveloping childrenacted in the
othertwo videos.
and Measurement
ResponseDefinition
A response was scored as a modeled behavior (action) if the
participantperformedthe correctaction modeled in the video within
5 seconds of his sibling's correspondingaction or verbal statement
duringtheplay sequence.Aresponsewas scoredas a scriptedstatement
iftheparticipantverballystatedall ofthewords in thescriptfromthe
video model within 5 seconds of his sibling's correspondingverbal
statementor action.Spontaneous words were coded iftheparticipant
stated a novel word or sentence contextuallyrelated to the ongoing
scenario.(For example, "I'll drive" while climbinginto firetruckwas
scored as 2 unscriptedwords. However, "there'sa fire"while playing
cowboy was not scored due to contextualmismatch.)A second trained
observerindependentlytranscribedand/orcoded 30% of all sessions.
Interobserveragreementwas calculated by dividingthetotalnumber

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VIDEO MODELING FOR PRETEND PLAY 521

of agreementsby the totalnumberof agreementsplus disagreements

and multiplyingby 100 in orderto geta percentageforsessions scored
forreliability.Interobserveragreement(IO A) formodeled behaviors
ranged from86-100%.TOA forscriptedstatementsand spontaneous
words was 100%.
Two satisfactionsurveyswere administeredas indices of social
validity.A parentsatisfactionsurveyconsistedof 4 questions with a
four-pointLikertratingscale withanchors1 (not at all), 2 (somewhat/
a little),3 (mostly/some),or 4 (totally/a lot). Two additional yes/no
questions and 2 open ended questions were included in the parent
satisfactionsurvey.A sibling satisfactionquestionnaire with 7 yes/
no questions and 3 open ended questions was administeredto the
participant'sbrotherat the completionof the study.
Procedures
The experimentaldesign forthis case study was an AB design
replicated across four play scenarios. The four video modeling
scenarioswere taughtin sets oftwo withfirefighter and cowboy being
introducedfirstand doctorand teacherbeginningapproximatelyone
monthlater.Actions and scriptedstatementsvaried across scenarios
but all procedures were identical. Sessions occurred once per day,
mostschool days based on siblingavailability.The siblinglearned his
lines and participatedin creationofthevideo models priorto baseline
sessions foreach scenario.
Baseline. The participant and his sibling were instructedto
"Go play." The materialswere available foreach play scenario but
no video models were shown. No systematicconsequences were
delivered following any response(s). The sibling was instructedto
say his lines and performhis part regardlessof what his brotherwas
doing. The sibling was also instructednot to help his brother.The
baseline sessions lasted approximately3 minutesforeach ofthe4 play
scenarios.
Videomodeling.The participantand his sibling were instructed
to "WatchT.V." and were shown a video model depictingone of the
4 pretendplay scenarios.Then,theywere instructedto "Go play."All
necessarymaterialsfromthe video were available. Neitherthe adult
norsiblingprovided otherinstructions, prompts,or reinforcersduring
play. The participant and his sibling were allowed up to 3 minutesto
engage in each play scenarios or less time iftheycompletedall of the
scripted statements and actions depicted thevideos.
in
Follow up. Follow up sessions to assess maintenance and
generalizationwere identical to baseline but were conducted in the
participant'shome with a differentsibling and the mother as play

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522 REAGON, HIGBEE, and ENDICOTT

partners.Follow up data forall fourscenarios were collected on the

same day and up to threeminuteswere allottedforplay.
Results

Participant performancefor each of the four targeted play

scenariosis presentedin Figure 1 forthefirefighter (upper panel) and
cowboy (lower panel) scenarios and Figure 2 for the doctor (upper
panel) and teacher (lower panel) scenarios. Data are presented as
the percentage of actions/scriptedstatementsperformed and the
frequencyof spontaneous words produced during each condition.
In the firefighterscenario,the participantacquired both the specified
actionsand scriptedstatementsand performedthemconsistentlyover
time.In the cowboy scenario,the participantacquired approximately
40% of the actions while scripted statementsincreased over time
rangingfrom50-100%over the last halfof the video modeling phase.
The participantrapidly acquired the actions forthe doctor scenario,
and scriptedstatementsincreased over the course ofthephase to 60%
during¿he last video modeling session. In the teacherscenario,both
actionsand scriptedstatementsincreasedover thecourse ofthevideo
modeling phase to approximately60%. Responding during follow
up sessions was similarto treatmentforall scenarios indicatingthat
play skillsmaintainedover timeand generalizedto a new settingand
new partners.The numberof spontaneous words varied greatlyfrom
session to session across all scenarios and was generallysimilar to
levels observed duringbaseline sessions.
Video footagefroma sample of interventionsessions indicated
that the brotherstook approximately120 seconds to complete the
firefighter scenario(range= 103 s - 130 s), 60 s forthe cowboy scenario
-
(range= - 64 s), 90 s forthe doctorscenario (range= 80 122 s), and
45
35 s forthe teacherscenario (range= 28 - 47 s). Only one contextually
inappropriate scripted statementoccurred (i.e., "there's a fire!" at
the beginningof the cowboy scenario). Additionally,the participant
statedthesibling'sline,"Be careful"once,in thefirefighter scene when
the sibling forgotit. These two statementsare not included in the
depicted data because theydid not meet the criteriaforcontextually
appropriatenessand matchto thescriptand role.No differences were
observed across scenarios,regardlessof whetherthesiblingserved as
thevideo model or not.
Several factorsindicate generalizationof skills during the last
followup session,which occurredat theparticipant'shome. All ofthe
play materialswere available in the living room and the instruction
"Go play" was given to the participantand his trained sibling. No
video models were shown. They independentlymoved from one
play scenarioto anotherwithoutadult prompts.Afterthe participant

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VIDEO MODELING FOR PRETEND PLAY 523

(upperpanel) and cowboy(lowerpanel)

Figure1. Resultsforthefirefighter
play scenarios.
Scriptedplayactions(closeddiamond)and statements (open
thepercentage
circle)represent ofvideo-modeled actions/statementsemitted
duringplayand arescaledon theprimary Y-axis.Frequency ofspontaneous
words (open triangle)are scaled on the secondaryY-
contextually-related
axis.

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524 REAGON, HIGBEE, and ENDICOTT

Figure2. Resultsforthedoctor(upperpanel)and teacher(lowerpanel)play

scenarios.Scriptedplay actions(closed diamond) and statements (open
thepercentage
circle)represent ofvideo-modeled emitted
actions/statements
duringplayand arescaledon theprimary Y-axis.Frequency ofspontaneous
words (open triangle)are scaled on the secondaryY-
contextually-related
axis.

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VIDEO MODELING FOR PRETEND PLAY 525

and his trained sibling finishedplaying, another sibling asked the

participantto play. This sibling had no prior trainingor experience
with the play materials and scriptsand had not viewed the video
models. In response to the request, the participantspontaneously
played the roles that had previously been played by his sibling in
previous sessions (e.g., patientin thedoctorscenario).The participant
also initiatedplay withhis motherand was able to performthedoctor
and teacherscenarioswithher as well.
Results fromthe parent satisfactionsurvey indicated that the
motherwas totallysatisfiedwith the video modeling program.She
gave thehighestnumericalratingforeach questionand respondedthat
she would use thevideo modeling programagain and recommendit
to otherfamilies.The siblingreportedthatactingin thevideo models
and playing with his brotherwas fun and thathe had learned how
to play with him. Since therewas only one participantin this study
who was receivingclinicalservicesfromtheexperimenters, the social
validity measures were not anonymous and may have been impacted
by social desirability.
Discussion
The currentstudyextendstheliteratureon siblinginterventions
and video modelingin severalways. The resultssupportthefindings
fromTayloret al. (1999) that siblingsof childrenwith autism can be
taughtto serve as video models and conversation/play partners.The
potential benefits of using siblings in video modeling interventions
include ready availability,parental support and willingnessto have
themparticipate,and theincreasedlikelihoodofgeneralizationofplay
skills at home. Additionally,our satisfactiondata suggest thatvideo
modeling produced positive outcomes forthe sibling and family,in
addition to thestudentwithautism. Withrespectto video modeling,
thisstudydid not use extraneousreinforcement or repeated practice,
indicating that the video modeling procedure alone was effectivein
producing scripted and unscripted statements and appropriateplay
actions with a sibling. Video viewing and play for two scenarios
averaged less than 5 minutes in duration indicatingthat this was a
timeefficient intervention.Additionally,afterreviewingthe scriptat
home, creation of the video models took three or fewer"takes" for
each scenariowithminimalverbal and visual cues and praise.
The amount of contextually-related spontaneous words varied
substantially from session to session with some higher rates of
responding in baseline than in treatment sessions. While contextually-
relatedstatementswere not formallycategorized,it appeared thatthe
majorityof statementsthat occurred during baseline were simple

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526 REAGON, HIGBEE, and ENDICOTT

labels or descriptionsof the props used in the play scenario (e.g.,

"hose", "gun", etc.). Following the video modeling intervention, the
contextually-related statements appeared to be composed of more
complex statementsand questions and responses to verbal queries "
from the play partner (e.g. "Where's the fire?","What shape?",
Whatnumberis it?" ). Futurestudiesmightcode typeofcontextually-
relatedspontaneous statementsfora more detailed analysis.
While the results of this preliminary investigation are
encouraging,severalmethodologicallimitationsneed tobe mentioned.
First,the effectswere demonstratedusing only a quasi-experimental,
A-B researchdesign. While the effectivenessof the interventionwas
replicatedacross fourplay scenarios,a multiplebaseline design across
play scenarioswould have significantly strengthenedthe conclusions
that could be drawn. Second, the procedures were evaluated with
only a single participant. Future research should investigatethese
procedures using a more rigorous experimentaldesign and with
additional participantsto confirmtheir utility. Additional studies
might also attemptto identifythe prerequisiteskills that students
need to benefitfromvideo modeling interventions. A thirdweakness
of the studyis thelack of data forunscriptedbut appropriateactions,
thougha review of a small sample of available footageindicatedthat
novel play actionsoccurredin the doctorscenario.
In summary, technology-based interventionssuch as video
modeling have been successfullyused to teach studentswith autism
a wide varietyof skillsincludingthoseneeded to successfullyengage
in pretendplay with otherchildren.Recentadvances in digitalvideo
technologyhave made thetools necessaryto createvideo models (e.g.,
digitalvideo cameras,DVD burners)readilyaccessible and affordable
for educational professionalsand parents. The portabilityof these
tools and the generalizationof skills demonstratedin thiscase study
suggest that professionalsand parents can collaborate across home
and school settingsto incorporatemultiplefamilymembersto teach
pretendplay achievingpositiveoutcomesforthefamilyas well as the
child with autism.
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