James W. Partington, Ph.D., BCBA-D
Behavior Analysts, Inc.
Walnut Creek, CA
Lisa Squadere-Watson
Parent of Child with ASD
Abstract
Children with a diagnosis of autism frequently have major deficits in their ability to perform a wide range of skills necessary for routine daily activities. These deficits in functional living skills often limit the individual’s options to participate in many family and community activities. The present study demonstrates the effectiveness of a parent-based intervention to teach functional living skills to a 10-year, 6 month-old boy diagnosed with an autism spectrum disorder. Data were collected on the Basic Living Skills, Home Skills and Community Participation Skills protocols of the AFLS assessment. The boy’s parents then implemented a teaching program to develop their son’s skills in each of those areas. The same data were also collected on his typically developing brother when he was 12 years, 6 months of age. Data are presented following one and two years of intervention. The data demonstrate that the boy made significant progress in many skill areas of the assessment, but his skills at 12 years, 6 months of age were still below those of his typically developing brother at that same age.
Subjects
Two brothers who lived in the same household served as subjects for this study. The family consisted of the two boys and their parents. The oldest is a typically developing boy who was 12 years, 6 months of age during the initial assessment of functional skills. He attended a private regular education school. His younger brother has a diagnosis of an Autism Spectrum Disorder (ASD) and was 10 years, 6 months of age at the time of the initial assessment. The child with ASD has been receiving ABA/VB services since he was three years of age. He has ongoing instructional services provided by educators in school, and has instructors engaging him in learning activities after school and on weekends.
Procedure
Both children’s skills were initially assessed by their mother using three of the protocols of the Assessment of Functional Living Skills (The AFLS): The Basic Living Skills Protocol, The Home Skills Protocol, and the Community Participation Skills Protocol. The AFLS is a criterion-referenced assessment that measures 735 skills in 24 areas. Data were collected on both the number of skill items that were scored as having reached the highest criterion (mastered) or met at least partial level of development (partial). Following the initial assessment, the parents made a coordinated effort to develop a variety of functional living skills for the child with ASD. Instruction was provided primarily during the course of conducting routine daily living activities. Additional outings were arranged with parents and home-based instructors to expose the child to a variety of community settings and activities (e.g., shopping, travel in community). No specific instruction was provided to the oldest boy other than those provided during typical family interactions. One year following the initial assessment, the children’s mother updated the assessments of the child with ASD. Two years following the initial skills evaluations, the skills of both children were again evaluated on the same protocols by their mother. Additionally, the children’s skills were also evaluated on the AFLS School Skills Protocol (337 skills in eight areas). The assessment of the school skills was conducted with input from both parents and educators.
Results
At age 10 years, 6 months, the child with ASD initially had mastered 94 of the 225 (41.8%) items on the Basic Skills Protocol, 39 of the 251 (15.5%) items on the Home Skills Protocol, and 26 of the 259 (10.0%) items on the Community Participation Skills Protocol. At 11 years, 6 months of age, his scores increased to 132 (58.7%), 84 (34.5%), and 60 (23.2%), respectively. At age 12 years, 6 months, his scores increased to 134 (59.6%), 95 (37.8%), and 69 (26.6%) on those same assessment protocols. The change in the number of mastered items from 10 years, 6 months to 12 years, 6 months of age represent an increases of 42.6% on Basic Living Skills, 143.6% on Home Skills, and 165.4% on the Community Participation Skills.
The typically developing child at age 12 years, 6 months of age had mastered 201 of the 225 items (89.3%) on the Basic Skills Protocol 165 of the 251 items (65.7%) on the Home Skills Protocol, and 216 of the 259 items (87.3%) on the Community Participation Skills Protocol.
The scores were compared for both brothers at 12 years, 6 months of age. The typically developing boy had mastered 201 items, and his brother with ASD had mastered 134 items (66.7% of those mastered by his brother) on the Basic Skills Protocol. The typically developing boy had mastered 165 items, and his brother with ASD had mastered 95 items (57.6%) on the Home Skills Protocol. The typically developing boy had mastered 216 items, and his brother with ASD had mastered 69 items (31.9%) on the Community Participation Skills Protocol.
Discussion
The results demonstrate that the brother with ASD made significant changes in his skills in basic living, home and community participation skills as measured by the corresponding AFLS® protocols. The greatest increases in the number of skills mastered over a two-year period were in the Community Participation Skills (165.4% increase) and Home Skills (143% increase). It was reported by the parents that the focus on the particular skills were a direct result of having the specific skills delineated in the AFLS® protocols. Although in hindsight, it was obvious that the child was unable to do many of the tasks prior to intervention, the identification of the lack of specific skills resulted in a concerted effort to ensure that he was taught the specific skills.
The data also indicate that although the child with ASD made significant progress in all skill areas, his level of performance remained below those demonstrated by his typically developing brother at 12 years, 6 months of age. He was only able to perform 66.7% of the basic living skills, 57.6% of the home skills, and 31.9% of the community participation skills mastered by his brother at the same age.
Further research is needed to identify the most effective methods for teaching functional skills to individuals of all ages and at various levels of developmental delay. Additionally, it will be helpful for researchers to identify ages at which each of the particular skills are developed by typically developing children such as to provide developmentally appropriate target for instruction in these critical life skills.
Presented at ABAI 40th Annual Conference in Chicago, May 2014.
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