Use of VSM to teach children with autism.

1. 15th International Conference on Autism, Intellectual Disability &
Developmental Disabilities
Tom Buggey, Ph D
Professor/Siskin Chair of Excellence in Early Childhood
Special Education
The University of Tennessee Chattanooga/
Siskin Children’s Institute’s Center for Child and Family Studies
Tom.buggey@siskin.org
Tom Buggey, Ph D
Professor/Siskin Chair of Excellence in Early Childhood
Special Education
The University of Tennessee Chattanooga/
Siskin Children’s Institute’s Center for Child and Family Studies
Tom.buggey@siskin.org

2. VVSSMM iinn 44 mmiinnss..

3. VViieewwiinngg OOnneesseellff -- DDeeffiinniittiioonnss
• Self-Observation: Viewing oneself performing at
present levels – good, bad, ugly – e.g. watching game
films.
Mostly positive research findings;
However, it has also been linked to
decrease in self-efficacy/confidence.
I do not recommend this for kids with
disabilities except for rare
Circumstances (and when you are
absolutely certain a child’s ego can
take it.)

4. • Allowing people to view themselves performing a skill or
task that is slightly beyond their present ability or
exhibiting behavior that is more appropriate. = All
positive.

5. TTwwoo FFoorrmmss ooff SSeellff--MMooddeelliinngg
DDoowwrriicckk,, 11997777
• Positive Self-Review: Reinforcing already known skills
to improve performance/ fluency
Laura Wilkinson
Gold medal Platform Diver
• Feedforward: Video of skills not yet learned.
Introducing a new skill or behavior.

6. VViiddeeoo MMooddeelliinngg FFoorrmmaattss
• Peer/Adult - Easy to get typically developing kids to
serve as models. There are commercial versions that
mainly focus on social skills:
Watch Me Learn@, Model Me Kids@, and Teach2Talk@
• Point-of-View - Activities are
carried out from the viewer’s
perspective by holding camera at
eye level.
Hine & Wolery, 2006

7. BBoorrnn aaggaaiinn aass aann aauuttiissmm
rreesseeaarrcchheerr
• I was presenting in KY regarding the first study
related to autism when someone asked me if I had
read “Thinking in Pictures”
• I went home and read it… And that was that.

8. “I THINK IN PICTURES. Words are like a second language to me. I translate
both spoken and written words into full-color movies, complete with sound,
which run like a VCR tape in my head. When somebody speaks to me, his words
are instantly translated into pictures. Language-based thinkers often find this
phenomenon difficult to understand, but in my job as an equipment designer for
the livestock industry, visual thinking is a tremendous advantage. Visual thinking
has enabled me to build entire systems in my imagination.”
Temple Grandin - from Thinking in Pictures
And the rest is hhiissttoorryy.. AAllll ssttuuddiieess ssiinnccee 11999977
hhaavvee bbeeeenn wwiitthh cchhiillddrreenn oonn tthhee ssppeeccttrruumm

9. • Bandura’s extensive research lends two findings
related to self-modeling:
1. The best models are those closest to the viewer in all
attributes Including ability.

10. BBaanndduurraa ((ccoonn’’tt))
• 2. Self-efficacy = The person’s perception of their
ability is directly related to success.
Modeling for Children with Autism is problematic.

11. MMooddeelliinngg--CChhiillddrreenn wwiitthh
AAuuttiissmm
Modeling requires:
Attention to the model including eye-contact, interest, and
proximity.
Often children with autism will be actively avoiding eye-contact
and moving away from potential models.
Other humans as models are just
problematic.
Also, limitations in social skills makes
picking up on language pragmatics
especially difficult – meaning is often
Lost.

12. WWhhyy VViiddeeoo MMooddeelliinngg -- AAuuttiissmm?
1. The Visual Learner
“I THINK IN PICTURES. Words are like a second language to me. I translate both
spoken and written words into full-color movies, complete with sound, which run like
a VCR tape in my head. When somebody speaks to me, his words are instantly translated
into pictures.
Temple Grandin - from Thinking in Pictures
Supported by research – (Bauman, 1999; Quill, 1997)
Temple
has
changed!

13. WWhhyy VViiddeeoo MMooddeelliinngg -- AAuuttiissmm?
2. Sustained attention/limits distractions
Children with autism can watch TV for hours.
Provides a focus that can be excessive. But it is a
focus and extraneous sounds and movements do not grab
attention as in other situations.
3. No social obligations
Videos place no social pressure on the child, whereas human
interaction does. Real people – avoidance; Same people on-screen
– no avoidance. (a plus for all forms of video modeling.)

14. TThhrreeee PPrreerreeqquuiissiitteess ffoorr MMAAXX RReessuullttss
MMaayybbee

15. SSeellff--rreeccooggnniittiioonn
• Onset 14-18 mos.
• We test for this by reversing
viewfinder on camcorder and
looking for reaction. The “sticking out the tongue test”.
Side note:
- The only child in a 1-2 yr old preschool room who acted for
camera = little boy with Down Syndrome.
- The only child under 4 where we had success = 2 ½ yr old girl
with DS who sat and watched herself adoringly.

16. 33 CCoommppoonneennttss ooff aa VVSSMM
mmoovviiee
• 1. Positively label the behavior - helps child discern the
target behavior. “Here’s Tony talking nicely with his
friends!” We usually follow this with cheering/clapping.
• 2. Self-modeling - Child behaving/performing well.
• 3. Reinforcement at end/re-label behavior - “Nice playing,
Tony!”
• Other possible elements: Self-talk/congratulations;
internal narration (could be distracting); background music
(ambient-mood enhancing).

17. FFiillmmiinngg

18. How to CCaappttuurree FFoooottaaggee ffoorr
FFeeeeddffoorrwwaarrdd VViiddeeooss
• Imitation – Great for language. Have children
imitate advanced language skills. Keep one step
ahead of morphological development.
• Role Play – Fun! Act out behaviors in
full Hollywood fashion. Get a director’s
chair and clacker.
• Capture Rare Behaviors – Used with children
who are not responsive. Camera keeps rolling.
Include child and family in planning when possible

19. CCuutt aanndd ppaassttee wwoorrddss
Mav. Age 3.0 Apraxia Lang Dev. 23-24 mos.
Stuttering

20. t Social skills/trraannssiittiioonnss//eeaattiinngg

21. MMaakkee ffiillmmiinngg aa ffuunn
eexxppeerriieennccee
Keeping with the positive nature of VSM, make filming as fun as possible.
1.Involve child and family in planning when appropriate
2.Role play = play it up. You can role play too.
3.Emphasize that the child will be the STAR of a movie.
I’m amazed at how many young children get the idea of “movie
producer = clacker, beret, director’s chair, and stage commands.
THUS, make the filming a learning experience, too. If you are doing role-play
Or imitation it IS instruction.

22. PPllaannnniinngg:: SSttoorryybbooaarrddiinngg
• Identify the target/replacement behavior
(something measurable/observable).
• Determine best method for capturing the
behavior.
• Determine video scenes.
o Task-analyze the target or replacement behavior.
o Each step becomes a scene.
o Or, each trigger of negative behavior becomes a scene.

23. SSaammppllee SSttoorryybbooaarrdd
MMoorrnniinngg RRoouuttiinnee
*Drawn freehand with child and family assistance

24. TTaannttrruumm SSttoorryybbooaarrdd
SSeellff--ttaallkk mmaayy ccoommpplliimmeenntt VVSSMM
1 2
Teacher can’t call on everybody. If I don’t
get called, I will get another turn.
If somebody jumps line, I will ask them nicely to
go back. If that doesn’t work, I will tell teacher.
3 4
Sometimes I get problems wrong.
Everybody does. It’s OK. I get a lot right.
Not now, Scott.
I can’t always do what I want. Maybe
later it will be time for that.

25. FFoooodd AAvveerrssiioonn
RReelluuccttaanntt eeaatteerrss
• 1. Set up camera during lunch or snack and film child eating.
• 2. Edit film by selecting exemplars of desired behavior and
chain them together.
If the behavior is to eat specific food, take footage of the food
and pair it with video of the child putting spoon to mouth
(Cheating).
If the behavior is spoon-to-mouth, try peer modeling or point of
view. You could also cheat by doing close-ups of peers’
mouths paired with appropriate antecedent behavior by your
child.

26. EEddiittiinngg

27. EEddiittiinngg:: IInn--CCaammeerraa EEddiittiinngg
CCaammccoorrddeerr ttoo VVCCRR oorr DDVVDD PPllaayyeerr AArrrraannggeemmeenntt
• Make a copy of the original tape and save it. Do all editing from the copy.
• If you want to add an intro and ending (recommended), you can just state the behavior (“Let’s
listen to John talking nicely!”) at the start of the tape while covering the lens. You can also
prepare a poster stating the behavior and/or praising the observer, e.g. “John is a Super Star!”
“Here’s John talking nicely!!” Just talk while taping the poster.
*It is very important to use “pause” instead of “stop.” This will give you smooth transitions. If you press stop, it
creates a second or so of static between segments.
1. Connect
2. Have VCR on “play”, “record”, & Pause
3. Scan the footage in camcorder until you find
what you want on your video.
4. Camcorder press “play” and “pause”
5. Release both “pause” buttons to record and press
“pause” buttons again when your scene is ended.
6. Repeat

28. CCaammccoorrddeerr ttoo CCoommppuutteerr
iMovie@ iMovie HD@
MovieMaker@
1. Connect Camcorder
2. Cut and paste
3. Click and drag

29. Video downloads to here
Cut & Paste to timeline
Bells & whistles
Also Cut & Paste
Editing window: 2 markers can be dragged to highlight
anything you want cut - press delete - it’s gone.

30. MMyy pprreeffeerrrreedd mmeetthhoodd
• Camcorder to Imovie HD (mac-based) to DVD
Or iPad

31. iiPPaadd == ccaammccoorrddeerr,, eeddiittiinngg,,
vviieewwiinngg iinn oonnee ppaacckkaaggee..

32. ““CChheeaattiinngg”” ((ssppeecciiaall eeffffeeccttss//ssttuunntt ddoouubblleess))
• We can use editing to depict events that never happened.
1. Tommy wouldn’t slide, but we got him to sit with peer at the
top + short clip of him at the bottom of slide + clip of 2 peers
coming down clipped at the waist. = He’s sliding.
2. Tommy pushing a truck down a sidewalk + peer pushing truck
back at same spot = two children playing.
3. Eating: We used a video of a close-up of a peer’s mouth when
inserting spoon with food and paired this with a clip of a child
manipulating silverware at lunch….

33. MMoorree ttrriicckkeerraattiioonn –– ffoorr aa
ggoooodd ccaauussee
• Tantrums – Child can’t role-play = film a triggering event
scenario & cut to a scene of the child behaving well.
• Eating – Using spoon. Place spoon in child’s hand. Use best
footage of spoon in proximity to food. Use close up of peer’s
mouth and Spoon.
• Washing hands – footage of peer washing/drying hands
sandwiched between scenes of child entering and leaving
washroom.
• We’ve used peer voices overlaid on the child’s video. Can
the child self-recognize own voice???
• Sliding – footage at child at top of slide and at bottom. In
between = footage of a peer sliding with only lower half
showing.

34. VViieewwiinngg

35. • Bottom line = It doesn’t seem to matter.
• You could try video priming = showing the video
immediately prior to when the behavior is likely to
occur. = before lunch and snack for eating.
Socialization prior to center time, etc.
• We typically show the videos at a time that causes
the least disruption and provides an opportunity to
have the child watch in an environment as free of
distractions as possible.

36. PPrriimmiinngg

37. OOnnee ffiirrmm rruullee::
• Do Not Make Comments!

38. The YYiinn--YYaanngg ooff WWoorrkkiinngg wwiitthh
PPrreesscchhoooolleerrss wwiitthh AASSDD
• Over the past 2 yrs. we have worked with 14 children
6 of whom were four, 4 were three, 4 were 2 1/2.
• All of the four yr olds made nice gains in either social
skills, language, or eating. Three of these could fit
into that “magical” category.
• Not one of the three yr olds showed any gain.
• Age? Maybe, but we showed the videos to the
children after they turned four and still nothing??
• Age-inappropriate behavior – social interactions????

39. HHoowweevveerr,, TThhee MMNN PPrreesscchhooooll PPrroojjeecctt
Child Age
Yrs/mos
Behavior Baseline VSM Maintenance
Jess 2-1 Switch activation 12.4 secs 2.6 secs 2.4 secs
Nevin 2-6 Crying during
diaper change
Cried 20 of 21
events
0 crying 0 crying
Nolan 2 -7 Word use. Longer
utterances
12 words 41 words + 5 3-
word sentences
-
Yaquin 2-9 Spoon to
mouth/20 mins.
1 21.12 20
Abe 2-10 Signs/words 2 signs w/
prompts only.
Rare one-word
utterances
Using 2 signs
spontaneously + 3
word combo.
-
1Aho 2-10 Use of signs and
new words
5 signs – 0 words 14 new signs
17 words
-
Gideon 2-10 Putting backpack
and coat in cubby
0/4
w/out cues
2/9
w/out cues
-
Eijah 3-0 Audible words per
1/2hr
0 5.33
Nolan 3-7 Self-advocates 0 60% 60%
“ “ Express needs 25% 75% 70%
3-9 Pedaling
trike/non-refusal
0/0 100% /100% 100% /100%

40. Peter 3-9 Food variety - - No increase
“ “ Good transitions 0 3/4 3/4
Ron 3-10 Off-task 27 events per day 8 per day 7 per day
Lucille 3-10 On floor, kicking
during transition
6 per day 1 per day - no
kicking
>1 per day - no
kicking
Emma 3-11 Words heard/20
mins.
4.33 4 -
“ “ 1Handwash
Check-ins/
prompts
89 secs-63.17 4 secs.
4.6
-
Tevon 4 School departure
(“goodbye” to bus)
5.33mins. 2.50 mins. 2.50 mins
Jerome 4-0 Sitting in grp 0 5 mins. 6 mins.
Lawrence 4.1 Screaming 8.6 10.8 -
Emily 4-2 Hands to self/line 30% 80% 80%
Jason 4-4 Heel/toe walking 0 55% 65%
“ “ Stairs 0 75% 80%
Isaac
4-6 Time on task
/prompts
Walking to room
from lib
6 secs/
31.67
97.86 secs/ 1.43 -
“ “ “ Gym
transitions/promp
ts
2.5 secs/
8.33
133.85 secs/
1.15
“ “ “ Bathroom
transition/prompt
s
18.3 secs/
15.67
205.38 secs/
2.85

41. CCaavveeaattss
1. Never go too far beyond the child’s developmental
level. Make sure it’s doable.
2. Always have full disclosure and informed consent
including disposition of video when intervention is
over. Peers too.
3. You can prompt as must as you want during filming,
but do not get pushy during viewing. Never say
things like, “Look how good you are doing there!” or
“See, you can do it.” Let the videos speak for
themselves.

42. AA RReecceenntt TThhoouugghhtt::
• What happens when the targeted behavior is
physically unpleasant for the child (albeit not so
with typical peers)?
• Can socializing, handling a spoon, or even eating
some food be truly aversive and thus
inappropriate?
• Raises ethical question, but a practical question too
= Can VSM overcome biology?

43. VViissuuaall SScchheedduulleess
AA vveerryy ssiimmppllee ffoorrmm ooff sseellff--mmooddeelliinngg

44. Sometimes: a bit of “magic”
10
15
20
25
30
35
40
45
50
55
60
65
1
Time getting ready for school
0 1
Baseline VSM
Fading
VSM
Day 1 2 3 4 5 6 7 8 9 10 11 12 14 15 16 17 18 19 20 21 22 23 24 25

45. 30
30
25
20
15
10
0
30
30
25
20
15
10
0
Baseline VSM Maintenance Follow-up
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 35 36
Days of Observation
Scott
Aaron
Tantrums: Duration
Seven-year-olds with mild autism

46. Eating lunch:
Six-year-old with moderate autism
David
Baseline VSM Maintenance
100
90
80
70
60
50
40
30
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Days

47. VVSSMM ggooeess ccoommmmeerrcciiaall
• I phone app Therad – embeds short clips of
appropriate behavior into big-screen movies???
$14.99. I would bet that this doesn’t work well and
could backfire????
• Pollymovies@ – Alaska - $1400 for training and
support.
Think of how much money you saved today.
This one is amazing:
iPad app = INNERVOICE AAC+VSM for $2.99

48. TThhee FFuuttuurree
• Laura Casey – Look at Me Now@
• Virtual Reality

49. PPoossssiibbllee AApppplliiccaattiioonnss
AAdddd YYoouurr oowwnn
• Attention Disorders
• Depression
• Aggressive / disruptive behaviors
• Stuttering
• Elective Mutism
• Responding behaviors - Students with autism
• Motor Problems - “Shirley”
• Language development
• School to community transition (job interviews, task performance…)
• Cognitive skill training
• Parenting skills
• Literacy - phonemic awareness/letter recognition/oral reading
• And, if you want to make millions, think about the application in sports
where mental imagery is so important.

50. RReessoouurrcceess
Websites:
• http://siskinvsm.org - mine: videos, presentations, and articles.
• http://depts.washington.edu/pdacent/archive/videometa.pdf - Bellini & Akullian’s 2007
meta-analysis of SM studies.
• http://www.creating-futures.org/ Peter Dowrick’s site at the U of Hawai’i Manoa. Video
Futures and ACE Reading
• Look at Me Now@ http://lookatmenow.org/ - Commercial self-
Modeling site.
Commercial Peer-modeling sites:
• http://www.modelmekids.com/
• http://www.socialskillbuilder.com/
• http://www.watchmelearn.com/
Books:
• http://www.woodbinehouse.com/main.asp_Q_product_id_E_978-1-890627-88-1_A_.asp
My Book
• URL was too long - Video modelling and behaviour analysis: a guide for teaching social
skills ... By Christos Nikopoulos, Michael Keenan

51. LLiimmiittaattiioonnss ooff VVSSMM UUssee
• Little is known for certain (lots of evidence though), but:
1. Age. There must be a lower limit with child characteristics
being a determining factor (cognitive skills, interest in
video, self-recognition and excitement, other).
2. Cognitive development: Problematic with children with
concurrent mental retardation.
3. Interest/attention: If children show little interest in the video
or cannot sustain interest while watching, it probably won’t
work.
However, it still may be worth a try. Worst case scenario = You
end up with a nice, positive video of the child. There have
been no reports of negative consequences.

53. These studies are those found in which
VSM was a primary intervention or was
compared to another method. Studies
where VSM was part of a package
were not included.