Association for Behavior Analysis International

Intervention research targeting students with impairments in both vision and hearing is limited. Ferrell et al. (2014) concluded that there is a "dire need" for research to improve educational practices for this population. Systematic instruction comprised of attention cues, response prompting, reinforcement, and corrective feedback is recommended for teaching various skills to this population. However, there is little current, well-developed research that meets requirements of quality research as specified by the What Works Clearinghouse (2020). The system of least prompts (Shepley et al., 2019), comprised of a prompting hierarchy, and constant time delay (Browder et al., 2009) are methods of systematically fading prompts that are well-researched with other populations (e.g., intellectual disabilities, autism). However, there is no current research demonstrating the effectiveness of these response prompting procedures with students who are deafblind. This session contributes to the evidence for the efficacy of these procedures with students who are deafblind. Four studies will be presented; two using the system of least prompts and one using constant time delay. The final study is a national survey of federally-funded providers in the state deafblind technical assistant project network, with the aim of gauging their use and knowledge of the system of least prompts.

Practicing BCBAs, researchers, graduate students

This study evaluated the system of least prompts, consisting of a prompt hierarchy comprised of touch, partial physical, and full physical prompts, to teach tangible symbols for preferred activities to three children with complex support needs and multiple disabilities, including deafblindness. A multiple probe design across three symbols and replicated across participants was used to evaluate the response prompting procedure for skill acquisition. Intervention sessions were conducted in the children’s typical home or school settings. The system of least prompts resulted in increased skills for participants. Although there were mixed results overall, all three children increased their independent use of tactile symbols. Two participants increased symbol use for all symbols. The third increased use of one symbol. There was a functional relation between the systems of least prompts intervention package and symbol use for two of three children. This study extends the recent body of research on the system of least prompts to include individuals with deafblindness and grows the limited research-base in the field of deafblindness.

To date, few evidence-based practices (e.g., in orientation and mobility, communication, literacy) have been identified for working with students who are deafblind (Ferrell, Bruce, & Luckner, 2014). No evidence-based practices have been identified for teaching basic self-help skills such as dressing (Ferrell et al., 2014; Parker, Davidson, & Banda, 2007). The present study examined the efficacy of the system of least prompts (least-to-most prompting) to teach three functional self-help skills (i.e., hand washing, hand drying, and an entry routine) to four school-aged students with vision and hearing impairments and multiple disabilities. The participants received individualized instruction in each of their classrooms as part of ongoing classroom routines (i.e., routines in which the targeted student was not independent and required prompting). A multiple probe across participants design was used to evaluate the effectiveness of the system of least prompts to teach the aforementioned self-help skills. Though mastery criterion was not achieved, all participants increased the level of independence within the targeted self-help skills. Effect sizes, both PND (Range 73 to 100%) and Tau-U (Range 0.6818 to 1.0), indicated the system of least prompts was an efficacious instructional practice.

A multiple probe design across three word sets was used to investigate constant time delay to teach reading sight words. The design was replicated across participants, including an elementary-age student with impairments in vision and hearing and a middle school-aged student with dual sensory impairments and intellectual disability. Participants were required to have documented impairments in both vision and hearing, have sufficient vision to read printed words, be involved with the federally funded state deafblind project, and be below grade level in sight word reading. The research question was: Will students who have impairments in both vision and hearing, and other disabilities, increase sight word reading when taught using constant time delay? The dependent variable was correct reading of sight words across three balanced word lists. Baseline consisted of five initial data points with an additional three data points immediately prior to intervention in the later baselines of the multiple probe design. Introduction of constant time delay resulted in immediate improvement in reading all word sets across both participants. Interobserver agreement and procedural reliability were collected for a minimum of 30% of sessions across all conditions and participants (exceeding 80%). Social validity measures contribute to the generality of the results.

This study evaluated state deafblind project technical assistance providers reported use of systematic instruction, specifically a prompting hierarchy, and whether they taught its use to families and educators of children with deafblindness. We examined providers’ perceptions about their correct implementation of prompting and accuracy of describing key components of a prompting hierarchy. In a survey of 151 possible providers, those who reported not using systematic instruction were asked to report which instructional methods they used or taught. A majority of respondents reported using systematic response prompting historically. Fewer than half reported providing assistance with the goal of increasing use by others; of this group, 78.9% rated themselves as confident or very confident that they could coach others in correct use of a prompt hierarchy. However, only one accurately answered all questions about key components of a prompt hierarchy; two others answered all questions, but one, correctly. Survey responses indicated that providers in the field of deafblindness reported focusing on child-guided instructional methods and modifications to the environment, including materials, based on child characteristics. Responses suggested systematic instruction is uncommonly and inaccurately used and providers listed few instructional methods, of any type. We discuss implications of limited use of response prompting.