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Kim O’Connor
Case Study 1: An Evidence-Based Practice Review Report
Theme: Interventions for children with Special Educational Needs
What are the effects of video modelling interventions on the social and
communication skills of children with autism spectrum disorders who can
attend to an electronic screen?
Summary
Children with autism spectrum disorders (ASD) typically face difficulties developing
appropriate social and communication skills. Video modelling (VM) interventions
have emerged as a way to teach a range of behaviours and many studies have
explored the impact they may have for children with ASD. Such interventions may
offer children with ASD the opportunity to develop important life skills and learn
behaviours that will support their effective integration into mainstream schools or
specialist provision. A search of the literature identified six journal articles which met
inclusion criteria. These studies explored a variety of VM interventions to support social
and communication skills development. The target behaviours the research addressed
included play, imitation, gesturing and responding to an instructional cue. The studies
were evaluated and critiqued and the evidence subsequently weighted according to
Gough’s (2007) ‘Weight of Evidence’ Framework. General support for the positive
impact of VM interventions on social and communication skills was found.
Recommendations for implementation of VM interventions and areas for future
research are outlined.
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Introduction
Video Modelling
This review aims to systematically investigate the effects of VM interventions on the
social and communication skills of children with ASD. VM interventions first emerged in
the 1990s as a teaching strategy for children with ASD. VM involves a child watching a
model in a short video perform a target behaviour from a third person perspective and
subsequently imitating the behaviour (Charlop-Christy, Le & Freeman, 2000).
Researchers have explored variations in this format, such as video self-modelling,
where editing is used to show the child themselves performing a target behaviour that
is slightly above their current functioning level (Buggey, Hoomes, Sherberger &
Williams, 2011) or point-of-view modelling, where the camera angle and scene is from
the participant’s perspective (Tetreault & Lerman, 2010).
VM has been used to teach children with ASD a variety of skills, including academic
skills (Jowett, Moore & Anderson, 2012) and functional living skills (Shipley-Benamou,
Lutzker & Taubman, 2002). However, the majority of studies focus on teaching social
and communication skills (Mason, Ganz, Parker, Burke & Camargo, 2012). One of the
benefits of VM is that it requires limited training of staff to deliver and is low in cost, both
important considerations when weighing the practical implications of an intervention.
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Basis in Psychological Theory
Bandura’s (1977) work on social learning theory emphasises the role that observation
and modelling play in learning experiences. The concept of behaviour modelling as
outlined by Bandura has formed the basis of many of the intensive behavioural
interventions developed to help children with ASD (Corbett, 2003). VM evolved as a
variation of in vivo modelling and research has demonstrated it is comparably more
effective because skill acquisition is faster in VM interventions (Charlop-Christy et al.,
2000).
Autism is characterised by impairments in verbal and non-verbal communication, social
behaviour and interaction, and flexible thinking and behaviour, which may be shown in
restricted or repetitive activities (DfES, 2002). Often described as a triad of
impairments, these difficulties mean that children with ASD may engage in socially
inappropriate behaviours or may appear unresponsive. Given its documented impact
as a behaviour modelling intervention, VM is well-placed to target the difficulties that
children with ASD face.
The efficacy of VM may be explained by a number of factors, including the fact that it
reduces the range of stimuli to which a child is exposed, which may be particularly
effective for children with ASD who have difficulties responding to multiple cues in their
environment (Charlop-Christy et al., 2000), and the preference individuals with ASD
often display for electronic screen media (Mineo, Ziegler, Gill & Salkin, 2009).
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Rationale
Understanding and applying evidence-based practice is an important element of the
distinctive contribution educational psychologists can make (Cameron, 2006). The
increased government focus on accountability and re-structuring of many local authority
services means that thorough reviews of practice are both necessary and desirable.
When considering the future direction of educational psychology work, Fallon, Woods &
Rooney (2010) predict the need for specialist assessment, advice and intervention for
the most vulnerable children and young people with long-term complex needs. A focus
on interventions for children with special educational needs and disabilities (SEND) is
therefore timely.
In 2013, 16% of pupils in all schools in England were classified as having SEND
without a statement, and 2.8% with a statement (DfE, 2013). Of those pupils with a
statement, 22% were identified with ASD as the primary need, by far the most
frequently identified primary need. The prevalence of autism, and the continued
imperative for effective inclusion, suggests the need for educational psychologists to
have a thorough understanding of a wide range of effective provision in order to make
useful recommendations to schools on how best to support children with ASD.
Shukla-Mehta, Miller and Callahan (2010) reviewed the effectiveness of video
instruction on social and communication skill acquisition for children with ASD and
concluded that it was a promising intervention which required further research. VM with
other as model was found to be more efficient than video self-modelling, a finding
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supported by a later review of the effects of different types of VM interventions which
found VM with adult as model to be most effective (Mason et al., 2013b). A metaanalysis of point-of-view VM concluded that it was highly effective in improving
independent living skills for participants with ASD, though the evidence base did not
extend to social and communication skills (Mason, Davis, Boles & Goodwyn, 2013a).
A recent review of school-based interventions for ASD which focused on adolescents
and young adults (De Bruin, Deppeler, Moore & Diamond, 2013) concluded that VM
had a sufficient research base to be considered an evidence-based practice for this
age group. In considering the different effect sizes produced by the studies in the
review, the authors focus on the role of participant prerequisite skills in facilitating
effective learning from VM. They suggest that the ability to attend to a screen may be
necessary in order for the intervention to be effective, a finding echoed by Mason et al.
(2012) and Mason et al. (2013a). Further research on the specific conditions that
facilitate effective learning from VM is clearly needed, and with this in mind the present
review will focus on studies which demonstrate that participants were able to attend to
an electronic screen.
The proposed question for this review is:
What are the effects of video modelling interventions on the social and communication
skills of children with autism spectrum disorders who can attend to an electronic
screen?
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Critical Review of Evidence Base
A comprehensive literature search was carried out in December 2013 to locate all
studies relevant to the research question. A search was undertaken on three
databases (PsychINFO, ERIC and Medline) using the search terms outlined in Table 1.
Table 1
Search Terms
Intervention
Population
Video model*
ASD
VIG
Autis*
video-based*
Asperger*
autism spectrum
disorders
Following Durlak (2003), article titles and abstracts which contained a term from the
‘intervention’ column and a term from the ‘population’ column were identified. The
searches were limited so that only articles in peer-reviewed journals (as a control for
quality of research) and written in English (as resources for translation were not
available) were included in the search results. This search identified 373 articles, of
which 122 were duplicates. Using the inclusion and exclusion criteria outlined in
Appendix 1, 231 articles were excluded based on titles or abstracts. Twenty articles
were left for full-text screening, of which 14 of were excluded for reasons outlined in
Appendix 2. See Figure 1 for a flow diagram of the study selection process.
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Ancestral searches were conducted to identify papers within selected studies that might
be relevant to the review. No further papers were selected for full-text screening or
inclusion in this study.
Figure 1
Flow Diagram of Study Selection Process
Records identified (n = 373)
Duplicates (n = 122)
Abstracts screened (n = 251)
Excluded, with reasons (n = 231):
Publication type (n = 25)
Language (n = 4)
Study type (n = 30)
Intervention (n = 18)
Participants (n = 14)
Date (n = 107)
Outcome measures (n = 33)
Full-text articles assessed for eligibility (n = 20)
Excluded, with reasons (n = 14):
Intervention (n = 4)
Participants (n = 10)
Studies included in synthesis (n = 6)
This review is based upon six papers (see Appendix 3). These studies were critically
analysed using Gough’s (2007) ‘Weight of Evidence’ Framework, summarised in Table
2. This appraises each paper in terms of its methodological quality, methodological
relevance and relevance to the review question. The weights for each factor are
averaged, giving an overall weight of evidence and providing a comprehensive
foundation for comparing all studies with respect to the review question.
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Table 2
Weight of Evidence Framework (Gough, 2007)
Weight of Evidence
Weight of
Weight of Evidence
Weight of
A
Evidence B
C
Evidence D
Generic judgement
about the
coherence, quality
and integrity of the
evidence
Review-specific
judgement about
appropriateness of
the evidence for
answering the
review question
Review-specific
judgement about the
relevance of the
focus of the
evidence for the
review question
Overall assessment
of the extent to
which a study
contributes evidence
to answer the review
question
(Methodological
relevance)
(Study focus
relevance)
(Methodological
Quality)
(Overall weighting)
A summary of each paper is detailed in Appendix 4, followed by details of the Coding
Protocol in Appendix 5. The weighting criteria are detailed in Appendix 6. The weighting
of each study is presented in Table 3.
Table 3
Weight of Evidence
Authors
Methodological Methodological
Quality
Relevance
Study
Focus
Relevance
Overall Weight
of Evidence
Medium
Kleeberger &
Mirenda
(2010)
Medium
Medium
Medium
MacDonald et
al. (2009)
High
Medium
Medium
Medium
High
Medium
Medium
Medium
Medium
Medium
Medium
Nikopoulos et
al. (2009)
Ozen et al.
(2012)
Medium
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Palechka &
MacDonald
(2010)
Medium
Low
Medium
Medium
Wilson (2013)
Medium
Low
High
Medium
Participants
The number of participants in each study ranged from one to four and ages ranged
from three to nine years old. The ethnic and socioeconomic background of participants
was not usually explained, although Wilson (2013) and Nikopoulos, Canavan and
Nikopoulou-Smyrni (2009) gave these details. Participants in four studies were partially
integrated into mainstream classrooms as well as receiving additional individualised
teaching (MacDonald, Sacramone, Mansfield, Wiltz & Ahearn, 2009; Kleeberger &
Mirenda, 2010; Ozen, Batu & Birkan, 2012; Palechka & MacDonald, 2010). This was
usually in the form of an intensive behavioural intervention programme. In the case of
Wilson (2013) and Nikopoulos et al. (2009), participants attended special schools.
Some studies detailed the additional support participants received in their routine
schooling. Wilson (2013) explains that all participants received speech-language and
occupational therapy services at school, while MacDonald et al. (2009) and Palechka
and MacDonald (2010) refer to participants’ prior experience with VM as an element of
their curriculum.
Design & Measures
All six papers used single-case design (SCD), which is a rigorous, scientific
methodology that can explore treatment effects with a small sample size (Horner et al.,
2005). SCD involves manipulation of an independent variable together with repeated
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measurement of a dependent variable before, during and after introduction of the
independent variable. The systematic structure of such a design provides a strong
basis for establishing causal inference (Kratochwill et al., 2010). Each study utilised a
slightly different design structure, though all included three demonstrations of
experimental effect (Horner et al., 2005).
Each study’s weighting in terms of methodological quality was assessed using an
adapted version of the SCD coding protocol devised by Kratochwill (2003). All six
studies were rated as fairly strong in their use of outcome measures that produce
reliable scores. This is due to the fact that all designs operationalized the target
behaviours to be measured as dependent variables as observable incidences and
used more than one assessor to record observations. Such practice is recommended
as a quality indicator for SCD, as is reporting inter-observer agreement rates, which
should be a minimum of 80% (Horner et al., 2005). Again, all six studies clearly
document this information. However, none of the studies triangulated observation data
with another method of measuring the same dependent variables, such as a checklist
or rating scale, which would have further increased the reliability of results obtained.
Most studies received a high rating for the quality of baseline data, which in SCD
functions as a form of within-participant control. It is recommended that a minimum of
three data points are collected during baseline phase in order that intervention effects
are clear demarcated (Kratochwill et al., 2010) which all studies achieved with the
exception of Palechka and MacDonald (2010) for one participant. In Wilson (2013), one
participant’s baseline data were hugely variable and, as a result, the study author
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decided to eliminate her from further analyses. As a result of this, her data were not
considered when giving a methodological quality rating to this study. Variability, level
and trend of baseline data were difficult to establish for one participant in Palechka and
MacDonald (2010).
Behaviours that are repetitive and limited in range are considered characteristic of
autism (Howlin, 2006). In reviewing the selected studies, it was therefore important to
consider the extent to which intervention effects were shown to be generalised or
maintained beyond the specific conditions of the intervention itself. Wilson (2013) and
Palechka and MacDonald (2010) were rated as low for methodological relevance
because they did not investigate generalisation or maintenance effects. Two weeks
after the treatment phase, Wilson (2013) did measure maintenance of behaviours but
only on two occasions which, for a single-case design, is insufficient to establish
experimental control (Horner et al., 2005). Two studies were rated as medium weight
because they collected follow-up data which allowed for maintenance of treatment
effects to be explored (MacDonald et al., 2009; Ozen et al., 2012). Kleeberger and
Mirenda (2010) were also rated as medium-weight evidence because they collected
data on the extent to which imitation behaviour generalised to actions that had not been
included in the intervention videos. Nikopoulos et al. (2009) included phases to explore
generalisation to new toys and to new subjects (where a different unknown adult
replaced the experimenter). Additionally, robust follow-up data was recorded. As a
result, this study was weighted as strong evidence for methodological relevance.
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Some studies included additional measures that increase the extent to which a
judgement can be made on how relevant the methodology was to establish treatment
effects of a VM intervention. Three studies reported reliability data on intervention
fidelity, where intervention sessions were recorded and assessed for how closely they
followed the intervention as planned (Kleeberger & Mirenda, 2010; Ozen et al., 2012;
Wilson, 2013). All three studies reported very high levels of intervention fidelity which
increases judgements of reliability.
Intervention
All studies made use of a VM intervention with other as model (Mason et al., 2012).
Intervention sessions were usually held daily and all studies described the location in
which sessions took place.Most studies received a medium weighting in terms of their
relevance to the review question. This is because they all outlined the way in which
either the intervention itself or the operationalised dependent variable was relevant to
the participants by including in their description of the participants a description of his or
her deficit in terms of the target behaviour. Documenting the social significance of goals
and the ecological validity of study aims is considered an important aspect of SCD
(Horner et al., 2005). Wilson (2013) received a high weighting in this regard because all
intervention and data collection for the study took place in the participants’ classrooms
using classroom materials. Additionally, the target social-communication behaviour for
each child was defined through a process of semi-structured assessment and a
corresponding social-communication skill hierarchy. Once a target had been identified
by research staff, each child’s teacher and parent was consulted to confirm whether
they endorsed the behaviour as an appropriate goal.
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Another way in which some studies demonstrated additional relevance in terms of
working with participants with an ASD diagnosis was in involving familiar caregivers in
either the design or delivery of the intervention. Given the wide range of ways in which
ASD difficulties can present, it is not surprising that the involvement of parents and
professionals who know the child well is recommended for interventions (Simpson,
2005). For example, in Kleeberger and Mirenda (2010) all experimental sessions took
place in the participant’s home and his mother was always present. Familiar teachers
and teaching assistants participated in Wilson’s (2013) study as models in the videos
as well as delivering the intervention itself.
Outcomes
All of the studies collected observational data on incidence rates of target
behaviours. The types of social and communication skills targeted by each study are
shown in Table 4. Outcomes can be considered in terms of actions or verbalisations,
or a combination of the two, as most studies focused on these behaviours as
measurable indicators of social and communication skills. Effect sizes for each
outcome, calculated for each case, are also presented in the table. Percentage of
non-overlapping data (PND) was used as the evaluative effect size measure for this
review because of its validity and demonstrated applicability in a wide range of
contexts (Scruggs, Mastropieri & Casto, 1987; Scruggs & Mastropieri, 1994).
Scruggs and Mastropieri (1998) suggest descriptive labels that interpret the relative
strength of a PND effect size, and these interpretations are also included in the table.
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Table 4
Summary Table of Effect Sizes by Study
Type of
Outcome
Primary
Outcome*
Study** Effect
Size
Effect
Size
Type
Effect Size
Interpretation
77%
PND***
Effective
69%
PND
Questionable
14%
PND
Ineffective
96%
PND
Very effective
Gross motor
actions
Finger play actions
1
Toy play actions
Scripted actions
P1
2
Actions
97%
PND
Very effective
100%
PND
Very effective
Toy clean-up
behaviour P2
95%
PND
Very effective
Toy clean-up
behaviour P3
81%
PND
Effective
40%
63%
PND
NAP****
Ineffective
Weak
Verbalisat
ions
Combined
Actions &
Verbalisat
ions
Reaching to
request an object
P1
Pointing &
vocalising to share
attention P2
Using gesture to
request more P3
Using gesture to
request more P4
Scripted
verbalisations P1
Scripted
verbalisations P2
3
4
N/A
-
PND
NAP
PND
NAP
Questionable
Medium
Questionable
Medium
96%
PND
Very effective
97%
PND
Very effective
100%
PND
Very effective
Performing role in
a play scenario P2
100%
PND
Very effective
Performing role in
a play scenario P3
100%
PND
Very effective
2
5
Medium
Medium
-
53%
73%
54%
80%
Performing role in
a play scenario P1
Medium
Medium
Scripted actions
P2
Toy clean-up
behaviour P1
Study
Quality
Medium
Medium
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Scripted
vocalisations &
play actions P1
Scripted
vocalisations &
play actions P2
Scripted
vocalisations &
play actions P3
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100%
PND
Very effective
100%
PND
Very effective
100%
PND
Very effective
Medium
*P1 = Participant 1, P2 = Participant 2, etc.
**Study 1 = Kleeberger & Mirenda (2010); Study 2 = MacDonald et al. (2009); Study 3 = Nikopoulos et al.
(2009); Study 4 = Wilson (2013); Study 5 = Ozen et al. (2012); Study 6 = Palechka & MacDonald (2010).
***PND = percentage of non-overlapping data (Scruggs, Mastropieri & Casto, 1987). See text for
explanation of technique.
****NAP = non-overlap of all pairs (Parker & Vannest, 2009). These effect sizes are taken from the
original research paper by Wilson (2013).
Verbalisations
It appears that VM is a highly effective intervention for verbalisations. The PND for
MacDonald et al.’s (2009) study was 96% P1 and 97% P2, suggesting that VM was
extremely effective in teaching the two participants to make the appropriate
verbalisation to follow a play set script. Though both participants had a zero baseline
for the airport play set and one had a zero baseline for the zoo play set, with the
implication that PND ratings would automatically be high even if verbalisations only
slightly increased, it could be argued that if all intervention data points exceeded
zero, even if only marginally, this still demonstrates convincing treatment effect.
Follow-up data collected for the airport play set was still at relatively high levels,
suggesting maintenance of treatment effects over time. However, only one study
focused specifically on verbalisations and thus caution must be advised when
drawing conclusions on the effects of VM on verbal social and communication skills.
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Actions
The research evidence on the effects of VM on actions is much more variable. PND
effect sizes ranged from 40% (Wilson, 2013) to 100% (Nikopoulos et al., 2009) which
spans interpretations of intervention effects from ‘ineffective’ to ‘very effective’. There
are several considerations to bear in mind when evaluating the research evidence.
Despite demonstrating VM to be very effective on the whole, two participants in the
Nikopoulos et al. (2009) study presented a zero baseline phase. However, both this
study and MacDonald et al. (2009), with 96-97% PND, reported follow-up data that
suggested, on the whole, convincing maintenance of treatment effects. Additionally,
Nikopoulos et al. (2009) reported high levels of generalisation of behaviours across
toys and subjects for two participants. It should be noted, though, that the data for
the third participant was much more variable in terms of generalisation and
maintenance.
Data for the participants in Wilson (2013) were extremely variable and may partially
explain why overall the VM intervention was found to be questionable or ineffective.
For all three participants, data did not stabilise sufficiently so it would have been
advisable to run the intervention for longer or more frequently to allow a stable
pattern of data to emerge. It seems likely this may have happened given that data for
visual attention and intervention fidelity were high. Additionally, without robust
maintenance or generalisation data it is difficult to place much confidence in the
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study’s results. Addressing these limitations may have led to more convincing
reports of intervention effects.
PND ranged from 14% to 77% for Kleeberger and Mirenda (2010), representing
questionable intervention effects. In two conditions the effect of the VM intervention
was very clear: gross motor actions represented 77% PND and finger play actions
69% PND. For toy play actions, baseline behaviour was already relatively high and
very little change was demonstrated in the intervention phase, thus leading to a very
low PND of 14%. Additionally, relatively high generalisation of behaviours was
shown, particularly in the gross motor actions condition. There is, therefore, a rather
mixed picture of intervention effects in this study.
Combined actions and verbalisations
Two studies reported the effects of a VM intervention on a combined actions and
verbalisations variable. Both Ozen et al. (2012) and Palechka and MacDonald (2010)
collected data that demonstrated 100% PND for all participants, suggesting that VM
was very effective. While maintenance data for all three participants in Ozen et al.
(2012) were very high, results are perhaps somewhat compromised by the fact that
one participant’s mastery criterion level was set at 80% instead of the 100% level
used for the other two participants. The results for Palechka and MacDonald (2010)
are more convincing and the high proportion of attending to video that the three
participants demonstrated adds further weight to the results obtained. However,
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without investigation of generalisation or maintenance of target behaviours it is
difficult to be entirely convinced of treatment effects.
Conclusion and Recommendations
This review examined six single-case studies of the effects of VM interventions on
the social and communication skills of children with autism. Overall, VM was found to
be a very effective intervention in the majority of studies. It was used to teach
children a range of skills, from imitation and gesturing through to performing a role in
a socio-dramatic play scenario. VM was found to be very effective in promoting both
actions and verbalisations, although the research evidence on actions was not as
conclusively in support of VM.
There was some variation in the extent to which the results of each study could be
considered meaningful and reliable. The one study given a high weighting for
methodological quality reported data that indicated VM was an extremely effective
intervention for both actions and verbalisations (MacDonald et al., 2009). Nikopoulos
et al. (2009), the study that was rated highly for methodological relevance, also
demonstrated that VM was a very effective intervention for promoting cooperative
behaviours. Studies that did not report results as conclusively in favour of VM had
methodological limitations that may have influenced the reliability of the results
obtained (Kleeberger & Mirenda, 2010; Wilson, 2013).
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Given that a markedly restricted repertoire of activities and interests is characteristic
of autism (Corbett, 2003), it seems that VM is a valuable intervention to target
developing a wider range of social and communication skills. This may be
particularly pertinent in the case of play skills, which many of the reviewed studies
target, because of the documented difficulties children with autism face with pretend
play and imagination (Jarrold, 2003). In addition to its demonstrated impact, VM is a
cost-effective treatment that can be conducted in an educational setting with limited
input from external professionals. Compared to more resource-intensive treatments
such as applied behaviour analysis (Lovaas, 1987), VM may be an appealing
alternative, particularly given the increasing prevalence of tablet devices. The
possibility of personalising the content of the video for each child makes VM
particularly appropriate for the variable presentation of autism spectrum disorders
(Howlin, 2006).
One significant finding that emerged from the review was the high level of
generalisation and maintenance of behaviours targeted in the interventions. Results
from four studies suggested that the benefits of VM extended further than the
specific conditions of the intervention itself and provide further support for the value
of VM in increasing the repertoire of social and communication skills available to
children with autism.
There are several limitations to the quality of the evidence provided in this review.
The first is that none of the studies triangulated the observational method of data
collection with another measure, such as a parent or teacher questionnaire. A
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second limitation is that four of the six studies reviewed made use of a mastery
criterion in their design. The level at which ‘mastery’ is defined can vary, and
perhaps give a distorted view of the actual skill level of participants and therefore
potentially over-inflate the impact of VM. One example of this is that one of the
participants in Ozen et al. (2012) worked to a different level of mastery than the other
two, yet all three participants obtained 100% PND. A further limitation is that some
studies made use of verbal prompts and praise during the intervention, making it
difficult to isolate the effects of VM from those provided by social reinforcement. For
example, Kleeberger and Mirenda (2010) provided prompts to the participant to pay
attention to the video, and praised efforts when he attempted to imitate.
The present review aimed to contribute to a growing body of evidence on the specific
conditions in which VM interventions may be most effective. By reviewing studies
which included a way to assess visual attention for minimum standards, conclusions
can be drawn about particular children for whom VM may be a recommended
intervention. VM does indeed seem to be an effective intervention for children who
are able to attend.
Recommendations for further research
Single-case designs provide useful information about the process of skill acquisition
in individuals and findings can then be further developed in controlled effectiveness
trials (Kratochwill et al., 2010). One recommendation from this review is that VM
should be explored in group design studies with controls so that scaled-up effects of
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the intervention can be investigated. A further recommendation is that the effects of
VM need to be separated from potential mediator variables such as use of verbal
praise and prompts to engage participants. More studies exploring the effects of VM
alone would allow for critical reviews on the specific impact of this intervention. It
may be that use of praise or reinforcement and VM together form the most effective
treatment package, but further research is needed to establish the basis for
recommendations such as this.
This study has focussed on the effects of VM on social and communication skills for
children with ASD. A further avenue for research would be to explore the effects of
VM on other skills that may benefit children with autism, such as developing
academic or independent living skills. Finally, it would be interesting to explore the
effects of this intervention on developing the social and communication skills of
children with social, emotional and behavioural difficulties. VM may be a particularly
useful intervention in mainstream settings, where the limited resource implications
would make it an appealing strategy for teachers and other professionals.
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in England: January 2013. Retrieved 18 February, 2014, from
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/
225699/SFR30-2013_Text.pdf
22
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Kim O’Connor
Department for Education and Skills (DfES). (2002). Autistic Spectrum Disorders:
Good Practice Guidance. Retrieved 18 February, 2014, from
http://webarchive.nationalarchives.gov.uk/20130401151715/https://www.educ
ation.gov.uk/publications/eOrderingDownload/0597-2002-PDF1.pdf
Durlak, J. (2003). General guidelines for conducting a literature review. Appendix B
of Task force on evidence-based practice interventions in school psychology.
Fallon, K., Woods, K., & Rooney, S. (2010). A discussion of the developing role of
educational psychologists within Children’s Services. Educational Psychology
in Practice, 26(1), 1-23.
Gough, D. (2007). Weight of evidence: a framework for the appraisal of the quality
and relevance of evidence. Research Papers in Education, 22(2), 213-228.
Horner, R. H., Carr, E. G., Halle, J., McGee, G., Odom, S., & Wolery, M. (2005). The
use of single subject research to identify evidence-based practice in special
education. Exceptional Children, 71, 165-179
Howlin, P. (2006). Autism spectrum disorders. Psychiatry, 5(9), 320-324.
Jarrold, C. (2003). A review of research into pretend play in autism. Autism, 7(4),
379-390.
Jowett, E. L., Moore, D. W., & Anderson, A. (2012). Using an iPad-based video
modelling package to teach numeracy skills to a child with an autism
spectrum disorder. Developmental neurorehabilitation, 15(4), 304-312.
Kleeberger, V., & Mirenda, P. (2010). Teaching generalized imitation skills to a
preschooler with autism using video modeling. Journal of Positive Behavior
Interventions, 12(2), 116-127.
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Kratochwill, T. R. (2003). Task force on evidence-based interventions in
school psychology. Retrieved April 16, 2014, from
http://madison.k12.in.us/MCSWeb/CSSU/EBI%20Manual.pdf
Kratochwill, T. R., Hitchcock, J., Horner, R. H., Levin, J. R., Odom, S. L. &
Rindskopf, D. M. et al. (2010). Single-case designs technical documentation.
Retrieved from What Works Clearinghouse website:
http://ies.ed.gov/ncee/wwc/pdf/wwc_scd.pdf
Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual
functioning in young autistic children. Journal of consulting and clinical
psychology, 55(1), 3.
MacDonald, R., Sacramone, S., Mansfield, R., Wiltz, K., & Ahearn, W. H. (2009).
Using video modeling to teach reciprocal pretend play to children with autism.
Journal of Applied Behavior Analysis, 42(1), 43-55.
Mason, R. A., Ganz, J. B., Parker, R. I., Burke, M. D., & Camargo, S. P. (2012).
Moderating factors of video-modeling with other as model: A meta-analysis of
single-case studies. Research in developmental disabilities, 33(4), 1076-1086.
Mason, R. A., Davis, H. S., Boles, M. B., & Goodwyn, F. (2013a). Efficacy of Pointof-View Video Modeling A Meta-Analysis. Remedial and Special Education,
34(6), 333-345.
Mason, R. A., Ganz, J. B., Parker, R. I., Boles, M. B., Davis, H. S., & Rispoli, M. J.
(2013b). Video-based modeling: Differential effects due to treatment protocol.
Research in Autism Spectrum Disorders, 7(1), 120-131.
Mineo, B. A., Ziegler, W., Gill, S., & Salkin, D. (2009). Engagement with electronic
screen media among students with autism spectrum disorders. Journal of
autism and developmental disorders, 39(1), 172-187.
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Kim O’Connor
Nikopoulos, C. K., Canavan, C., & Nikopoulou-Smyrni, P. (2009). Generalized
Effects of Video Modeling on Establishing Instructional Stimulus Control in
Children With Autism Results of a Preliminary Study. Journal of Positive
Behavior Interventions, 11(4), 198-207.
Ozen, A., Batu, S., & Birkan, B. (2012). Teaching Play Skills to Children with Autism
through Video Modeling: Small Group Arrangement and Observational
Learning. Education and Training in Autism and Developmental Disabilities,
47(1), 84.
Palechka, G., & MacDonald, R. (2010). A comparison of the acquisition of play skills
using instructor-created video models and commercially available videos.
Education and Treatment of Children, 33(3), 457-474.
Scruggs, T. E., Mastropieri, M. A., & Casto, G. (1987). The quantitative synthesis of
single-subject research methodology and validation. Remedial and Special
Education, 8(2), 24-33.
Scruggs, T. E., & Mastropieri, M. A. (1994). The utility of the PND statistic: A reply to
Allison and Gorman. Behaviour Research and Therapy, 32(8), 879-883.
Scruggs, T. E., & Mastropieri, M. A. (1998). Summarizing single-subject research
issues and applications. Behavior Modification, 22(3), 221-242.
Shipley-Benamou, R., Lutzker, J. R., & Taubman, M. (2002). Teaching daily living
skills to children with autism through instructional video modeling. Journal of
Positive Behavior Interventions, 4(3), 166-177.
Shukla-Mehta, S., Miller, T., & Callahan, K. J. (2010). Evaluating the effectiveness of
video instruction on social and communication skills training for children with
autism spectrum disorders: A review of the literature. Focus on Autism and
Other Developmental Disabilities, 25(1), 23-36.
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Simpson, R. L. (2005). Evidence-based practices and students with autism spectrum
disorders. Focus on Autism and Other Developmental Disabilities, 20(3), 140149.
Tetreault, A. S., & Lerman, D. C. (2010). Teaching social skills to children with
autism using point-of-view video modeling. Education and Treatment of
Children, 33(3), 395-419.
Wilson, K. P. (2013). Teaching Social-Communication Skills to Preschoolers with
Autism: Efficacy of Video Versus In Vivo Modeling in the Classroom. Journal
of autism and developmental disorders, 43(8), 1819-1831.
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Doctorate in Educational and Child Psychology
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Appendix 1
Inclusion and Exclusion Criteria
Inclusion Criteria
The study must be
published in a peerreviewed journal
Exclusion criteria
The study is not published in
a peer reviewed journal (eg
dissertation or grey
literature)
2. Language
The study must be written
in English
The study is not written in
English
3. Type of study
The study must contain
primary empirical data
The study does not contain
primary empirical data (eg a
‘how to’ guide or review)
1. Type of
publication
4. Intervention
5. Participants
a) The intervention
must be video
modelling with other
as model
The intervention is a
different form of video
modelling (eg video selfmodelling or point-of-view
video modelling)
b) The intervention
must not be run in
combination with
other interventions
The intervention is run in
combination with other
interventions or is part of a
combined intervention
package (eg PECS or Social
Stories)
c) The video-based
instruction must
form the
intervention (i.e. an
independent
variable)
The video-based instruction
does not function as the
independent variable (eg
video used as a stimulus or
method of recording)
a) All participants must
have an ASD
diagnosis
Not all participants have an
ASD diagnosis
b) Participants are
screened for their
ability to attend to
video or study
adequately
accounts for
participants’ ability
to attend to video
There is no explicit mention
of pre-screening
participants, participants are
unable to attend to video for
a sufficient length of time or
description of attending
does not allow for a
conclusion to be drawn
27
Doctorate in Educational and Child Psychology
for an appropriate
length of time (eg
through a variable
measuring visual
attention)
Kim O’Connor
about whether participants
attended or not
c) Must be pre-school
or primary school
age children
Are secondary age
adolescents or older, or are
below pre-school age
6. Date
Studies have been
published from 2009
onwards
Studies are published earlier
than 2009
7. Outcome
Measures
Primary outcome
measures are related to
social and
communication skills
Primary outcome measures
are not related to social and
communication skills (eg life
skills or academics)
Rationale for Inclusion & Exclusion Criteria:
1. Excluding research that has not been peer-reviewed is a way to ensure reviewed
papers have met minimum quality standards.
2. Resources are not available for translation.
3. There must be primary data available for the review to synthesise.
4. (a) Previous meta-analyses have suggested looking at types of video modelling
separately (Shukla-Mehta et al., 2010; Mason et al., 2013b). A recent meta-analysis
has looked at point-of-view video modelling (Mason et al., 2013a). (b) The review
aims to explore the effects of VM interventions alone. (c) The review aims to explore
the effects of VM and thus it should be operationalized as the independent variable.
5. (a) The review focuses specifically on effects for children with ASD. (b) This
review aims to explore the particular circumstances in which VM is effective by
focusing on participant characteristics, specifically the ability to attend (De Bruin et
28
Doctorate in Educational and Child Psychology
Kim O’Connor
al., 2013; Mason et al., 2012; Mason et al., 2013a). (c) A recent meta-analysis
looked at studies conducted with 12-22 year olds (De Bruin et al., 2013). To ensure
findings are applicable to an educational setting, participants must be pre-school age
(3 years old) at a minimum.
6. A comprehensive meta-analysis exploring the effects of video instruction on the
social and communication skills of children with ASD searched until 2009 (ShuklaMehta et al., 2010).
7. The review aims to explore the effects on social and communication skills in
particular.
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Doctorate in Educational and Child Psychology
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Appendix 2
Studies excluded at full-text
Name of Study
Reason for exclusion
Axe, J. B., & Evans, C. J. (2012). Using video modeling to
teach children with PDD-NOS to respond to facial
expressions. Research in Autism Spectrum Disorders,
6(3), 1176-1185.
5b. There is no
information given about
participants’ ability to
attend.
Boudreau, E., & D’Entremont, B. (2010). Improving the
pretend play skills of preschoolers with autism spectrum
disorders: The effects of video modeling. Journal of
Developmental and Physical Disabilities, 22(4), 415-431.
5b. Study does not
adequately demonstrate
that participants
attended.
Brim, D., Townsend, D. B., DeQuinzio, J. A., & Poulson, C.
L. (2009). Analysis of social referencing skills among
children with autism. Research in Autism Spectrum
Disorders, 3(4), 942-958.
4b. Video modelling is
part of a combined
package intervention
(including visual and
manual prompting).
Cardon, T. A., & Wilcox, M. J. (2011). Promoting imitation
in young children with autism: A comparison of reciprocal
imitation training and video modeling. Journal of autism
and developmental disorders, 41(5), 654-666.
5c. Participants are as
young as 20 months.
Charlop, M. H., Gilmore, L., & Chang, G. T. (2008). Using
video modeling to increase variation in the conversation of
children with autism. Journal of Special Education
Technology, 23(3), 47.
5b. There is no
information given about
participants’ ability to
attend.
Charlop, M. H., Dennis, B., Carpenter, M. H., & Greenberg,
A. L. (2010). Teaching socially expressive behaviors to
children with autism through video modeling. Education
and treatment of children, 33(3), 371-393.
5b. Study does not
adequately demonstrate
that participants
attended.
Dupere, S., MacDonald, R. P., & Ahearn, W. H. (2013).
Using video modeling with substitutable loops to teach
varied play to children with autism. Journal of applied
behavior analysis, 46(3), 662-668.
4a. The intervention is
point-of-view video
modelling.
Lydon, H., Healy, O., & Leader, G. (2011). A comparison of
video modeling and pivotal response training to teach
pretend play skills to children with autism spectrum
disorder. Research in Autism Spectrum Disorders, 5(2),
872-884.
5b. There is no
information given about
participants’ ability to
attend.
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Doctorate in Educational and Child Psychology
Kim O’Connor
Marzullo‐Kerth, D., Reeve, S. A., Reeve, K. F., &
Townsend, D. B. (2011). Using multiple-exemplar training
to teach a generalised repertoire of sharing to children with
autism. Journal of applied behavior analysis, 44(2), 279294.
4b. Video modelling is
part of a combined
package intervention
(including hand-overhand guidance).
McHugh, L., Bobarnac, A., & Reed, P. (2011). Brief Report:
Teaching Situation-Based Emotions to Children with
Autistic Spectrum Disorder. Journal of autism and
developmental disorders, 41(10), 1423-1428.
5b. There is no
information given about
participants’ ability to
attend.
Plavnick, J. B., & Ferreri, S. J. (2011). Establishing verbal
repertoires in children with autism using function-based
video modelling. Journal of applied behavior analysis,
44(4), 747-766.
5b. Two participants
were unable to attend to
video screens.
Sancho, K., Sidener, T. M., Reeve, S. A., & Sidener, D. W.
(2010). Two variations of video modeling interventions for
teaching play skills to children with autism. Education and
Treatment of Children, 33(3), 421-442.
4a. The intervention is
point-of-view video
modelling.
Scheflen, S. C., Freeman, S. F., & Paparella, T. (2012).
Using Video Modeling to Teach Young Children with
Autism Developmentally Appropriate Play and Connected
Speech. Education and Training in Autism and
Developmental Disabilities, 47(3), 302-318.
5b. Study does not
adequately demonstrate
that participants
attended.
Tereshko, L., MacDonald, R., & Ahearn, W. H. (2010).
Strategies for teaching children with autism to imitate
response chains using video modeling. Research in Autism
Spectrum Disorders, 4(3), 479-489.
5b. Participants were
unable to attend to
video modelling in its
typical form.
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Doctorate in Educational and Child Psychology
Kim O’Connor
Appendix 3
Reviewed studies
Kleeberger, V., & Mirenda, P. (2010). Teaching generalized imitation skills to a
preschooler with autism using video modeling. Journal of Positive Behavior
Interventions, 12(2), 116-127.
MacDonald, R., Sacramone, S., Mansfield, R., Wiltz, K., & Ahearn, W. H. (2009).
Using video modeling to teach reciprocal pretend play to children with autism.
Journal of Applied Behavior Analysis, 42(1), 43-55.
Nikopoulos, C. K., Canavan, C., & Nikopoulou-Smyrni, P. (2009). Generalized
Effects of Video Modeling on Establishing Instructional Stimulus Control in
Children With Autism Results of a Preliminary Study. Journal of Positive
Behavior Interventions, 11(4), 198-207.
Ozen, A., Batu, S., & Birkan, B. (2012). Teaching Play Skills to Children with Autism
through Video Modeling: Small Group Arrangement and Observational
Learning. Education and Training in Autism and Developmental Disabilities,
47(1), 84.
Palechka, G., & MacDonald, R. (2010). A comparison of the acquisition of play skills
using instructor-created video models and commercially available videos.
Education and Treatment of Children, 33(3), 457-474.
Wilson, K. P. (2013). Teaching Social-Communication Skills to Preschoolers with
Autism: Efficacy of Video Versus In Vivo Modeling in the Classroom. Journal
of autism and developmental disorders, 43(8), 1819-1831.
Appendix 4
Summary of Reviewed Studies
32
Doctorate in Educational and Child Psychology
Study and
Aims
Kleeberger
& Mirenda
(2010)
Sample1
Design
N = 1 child (1M)
Multiple-baseline
design across three
Age: 4 years old
imitation activities:
gross motor, finger
Identification:
Aimed to
play and toy play.
examine the Participant had a
Three songs or
effectivenes diagnosis of autism; activities were
s of video
he rarely imitated
selected for each.
modelling to without specific
teach a pre- prompts to do so.
All baseline and
schooler
probe sessions
with autism Participant Info:
occurred 1-3 times a
imitation
Participant
week. Order of
skills.
attended a preactivities was
school and
counterbalanced to
received a homecontrol for order
based treatment
effects. Intervention
programme.
for each activity was
introduced in a timeLocation: USA.
lagged structure.
Generalisation
probes for actions not
modelled in the
videos took place at
various times
throughout the
experimental
process.
1
N = number, M = male, F = female, P = participant.
Kim O’Connor
Intervention
Measures
Outcomes
Video modelling: nine
videos were made
depicting an adult model
directing the activity and
two adults who played
the roles of children. The
children imitated the adult
activity. Videos ranged in
length from 1-4 minutes.
Sessions were held once
daily.
The researcher
and a research
assistant scored
for occurrence of
target behaviours.
Inter-observer
agreement data
was collected.
During baseline, participant’s
mean gross motor and finger
play imitation actions were
approximately zero. Toy play
imitation actions were around
40%.
Target behaviour:
Imitation of the gross
motor, finger play or toy
play behaviours shown in
the video models.
Follow up
measures: no
follow-up data was
collected.
Gross motor and finger play
imitations increased significantly
during the intervention phase.
Toy play imitations increased
slightly from baseline levels.
Generalisation probes
demonstrated some increase
compared to baseline levels,
which were a similar pattern to
the baseline levels described
above for the three activities.
During the intervention phase,
there was some increase in
generalisation for novel toy play
and finger play actions, and a
more marked increase for novel
gross motor actions.
33
Doctorate in Educational and Child Psychology
Study and
Aims
MacDonald
et al. (2009)
Aimed to
use video
modelling to
teach
children
with autism
to engage
in reciprocal
pretend
play with
typically
developing
peers.
Kim O’Connor
Sample1
Design
Intervention
Measures
Outcomes
N = 2 children (2M)
Multiple-probe design
across three play
sets.
Video modelling: one
session per participant
was conducted daily. Two
adults were videotaped
acting out a sequence of
pretend play. Participants
watched the video twice
and then were directed to
the relevant play
materials and told, “It’s
time to play”. They were
given 4 minutes to play.
Video viewing sessions
continued until mastery
was reached on that play
set.
All sessions were
videotaped and
scored afterwards
for occurrence of
the target
behaviours. Interobserver
agreement data
was collected.
P1 – Achieved mastery level of
scripted actions and scripted
verbalisations on all three play
sets and this was maintained at
follow-up. He also showed a
mean increase in unscripted
verbalisations and a significant
increase in cooperative play and
reciprocal verbal interaction
chains.
Age: 5 & 7 year
olds
Identification:
Diagnosis of
autism; both
engaged in solitary
play.
Each was matched
with a typically
developing peer to
assess reciprocal
interaction.
Participant Info:
Children attended a
pre-school that
combined
individualised
teaching with some
integrated
mainstream
classroom time.
Baseline, training and
probe phases
comprised 4 minute
play sessions. The
play sets were
introduced one after
the other, with
children in each pair
required to perform at
or above mastery
level on scripted
verbalisations and
scripted play actions
before training began
on the next play set.
The sets were taught
in the same order for
both children.
Target behaviours:
(a) Scripted
verbalisations, (b)
scripted play actions.
Follow up
measures: one
month following
mastery of the
airport and zoo,
three follow-up
probes were
conducted on the
airport set. Further
follow-up probes
on other play sets
were conducted
after a new play
set was mastered.
P2 – Achieved mastery level of
scripted actions and scripted
verbalisations on most of the
three play sets and this was to
some extent maintained at
follow-up. He did not reach
mastery for scripted
verbalisations for the grill play
set. He also showed a mean
increase in unscripted
verbalisations and a significant
increase in cooperative play and
reciprocal verbal interaction
chains.
Location: USA.
34
Doctorate in Educational and Child Psychology
Study and
Aims
Nikopoulos,
Canavan &
NikopoulouSmyrni
(2009)
Sample1
Design
N = 3 children (1F,
2M)
Multiple-baselineacross-subjects
design.
Kim O’Connor
Intervention
Video modelling: an
unfamiliar typically
developing peer was
Age: 7-9 year olds
used as a model in a 30
Two to three baseline second video in which the
Identification:
or intervention
experimenter was shown
Aimed to
Independent
sessions were
switching off a television,
demonstrat diagnoses of
conducted on any
and leading the model to
e the effects autism; teacher
given day for each
a toy. After the model had
of video
reports identified all child. After mastery
played with the toy for 10
modelling
were often
was achieved,
seconds, the
on
noncompliant in
children were
experimenter gave the
establishing response to
transferred to a
instruction, “Play is
stimulus
instructions and
generalisation across finished” and the model
control and task-related
toys condition and
put the toy away in a box.
responding requests.
then, upon successful Participants watched the
to an
completion of three
video once, then
Participant Info:
instruction.
consecutive sessions, encountered the same
Children attended a a generalisation
scenario as the one in the
special school for
across subjects
video.
children with severe condition.
Target behaviour: Toy
learning difficulties.
clean-up behaviour.
Location: UK.
Measures
Outcomes
A latency
recording system
was used to
measure the
child’s initiation of
the appropriate
motor response to
the experimenter’s
instruction. Interobserver
agreement data
was collected.
During baseline, none of the
participants responded to the
instruction “Play is finished”.
After the video modelling
intervention was introduced, all
children met mastery criterion
within 5 to 7 sessions.
Follow up
measures: one
month after the
final measurement
had been taken a
follow-up
assessment was
conducted for four
sessions across
four different toys.
Generalisation across toys was
variable between participants.
Latency to respond remained
low for two participants in the
generalisation across subjects
condition and at follow-up. The
third participant’s performance
was extremely variable in these
two phases.
35
Doctorate in Educational and Child Psychology
Study and
Aims
Ozen, Batu
& Birkan
(2012)
Sample1
Design
N = 3 children (3M)
Multiple probe design
across behaviours.
Aimed to
examine if
video
modelling
was an
effective
way of
teaching
sociodramat
ic play skills
to
individuals
with autism
in a small
group
arrangemen
t.
Identification:
Children with
autism; study
reports participants
had problems
attending to play
activities with peers
as well as initiating
and continuing
communication with
others.
Age: 9 year olds
Participant Info:
Children attended a
special early
intervention
programme and
had individual
support whilst
attending a
mainstream school.
Location: Turkey.
Kim O’Connor
Intervention
Video modelling: three
different scenarios were
scripted (canteen, doctor,
Three different play
teacher) with three roles
scenarios were used in each. Three students
with settings that
played the roles of the
corresponded (eg the participants for each
teacher scenario
scenario and carried out
phase took place in a each of the steps
classroom). Each role necessary for the script.
in a scenario was
Participants were given a
broken into steps.
role and watched the
Training, probe and
video, then were told the
maintenance
criteria needed for a good
sessions were
performance (eg make
conducted weekly.
eye contact).
Probe sessions were
Target behaviour:
conducted for each
scenario in turn as
Performing the steps of a
participants met
role in a play scenario.
mastery criterion for
that scenario.
Observational
learning data was
also collected.
Measures
Outcomes
Sessions were
recorded and the
percentage of
correctly
performed steps in
each scenario was
calculated. Interobserver
agreement data
was collected.
During baseline, all three of the
participants performed
moderately well in the canteen
scenario, with an average of
40% correct responses, but did
not score in the other two
scenarios.
Follow up
measures: two
weeks after the
training sessions
were completed,
maintenance
sessions were
conducted.
P1 – Achieved mastery level on
all three scenarios and
maintained this level of
performance during
maintenance sessions. He took
comparatively longer to reach
mastery level than the other
participants, and had a different
percentage criterion to indicate
mastery (80% instead of 100%).
He also showed a high level of
observational learning.
P2 & P3 – Achieved mastery
levels on all three scenarios and
maintained this level of
performance during
maintenance sessions. They
also showed high levels of
observational learning, although
this was slightly lower for P3
than the other two participants.
36
Doctorate in Educational and Child Psychology
Study and
Aims
Palechka &
MacDonald
(2010)
Sample1
Design
N = 3 children (1F,
2M)
Multi-element design
within participant and
across model types.
Additionally, multiple
probe design across
participants.
Kim O’Connor
Intervention
Video modelling: an
identical version of each
CAV was created with an
Age: 4-5 year olds
adult using the same
Compared
figurines to model the
Identification:
the effects
behaviour chain of
of a
Children with a
completing the script
commerciall diagnosis of autism; To compare ICV to
using the figurines and
y available
all were selected
CAV models, two
play set. Participants
children’s
based on reports of scripts were taught
were told, “It’s time to
video (CAV) their lack of
using one video of
watch the movie” and
relative to
appropriate socioeach format for each watched the video two
an
dramatic play skills participant. Each
consecutive times. Next,
instructorand all had
participant completed the participant was
created
increasing play
mastery probes for
instructed to sit in front of
video model skills targeted on
both scripts before
the play set and was told,
(ICV) on the their IEPs.
training of another
“It’s time to play”. At the
acquisition
participant began.
end of the 5-minute
of play skills Participant Info:
Scripts were equated session the participant
for children All were enrolled in for difficulty. Sessions was told, “Playing is all
with autism. a centre-based
were conducted daily. done”.
programme that
Mastery criterion
Target behaviour:
provided early
levels were set.
intensive
Scripted vocalisations
behavioural
and scripted play actions.
intervention.
Measures
Outcomes
All sessions were
recorded and
scored for the
occurrence of the
target behaviours,
as well as in some
sessions the total
duration of
attending to video
and attending to
toys during video
viewing.
Percentages were
calculated. Interobserver
agreement data
was collected.
During baseline, all three
participants demonstrated very
few of the scripted behaviours
and statements for the ICV
across both scripts.
Follow up
measures: no
follow-up data was
collected.
All three also reached mastery
level with the ICV, and
comparatively quicker than the
number of sessions it took them
to reach mastery with the CAV.
P1 took 12 sessions to reach
the mastery phase, P2 took 4
sessions and P3 took 16
sessions.
All participants also consistently
attended to the video during the
training phase, although P3
attended less on average than
P1 and P2.
Location: USA.
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Study and
Aims
Wilson
(2013)
Sample1
Design
Intervention
Measures
Outcomes
N = 4 children (2F,
2M)
Aimed to
examine the
relative
efficacy of
video
modelling
compared
to in-vivo
modelling in
teaching
socialcommunicat
ion skills to
pre-school
children.
Age: 3-5 year olds
Alternating
treatments design
with baseline and
replication across
participants.
Video modelling: each
child’s teacher served as
the adult model and a
teaching assistant as
facilitator in a threeminute video in which the
child’s target behaviour
was modelled.
Research
assistants blind to
the study’s
hypotheses
collected data
using
observational
methods to record
occurrences of
behaviour. An
automated interval
indicator allowed
for data on visual
attention to be
collected which
was then analysed
with a pairedsamples t test.
Inter-observer
agreement data
was collected.
During baseline, most
participants showed limited
initiation of their target
behaviour. However, the
baseline for one participant (P2)
did not stabilise and so results
were not analysed for her in
terms of intervention effects.
Identification: All
participants had a
diagnosis of autism
which was
supported by
experimenteradministered
measures; teacher
and parent reports
identified strengths
and limitations with
regard to socialcommunication
skills.
Participant Info:
Participants were
recruited from two
pre-schools which
served students
with a range of
developmental
disabilities.
Location: USA.
Baseline measures
were taken three
times per week
during five-minute
observations for a
minimum of five data
points. Treatment
sessions took place
on average three
times per week for a
minimum of five
sessions and a
maximum of fifteen
sessions. Both video
and in-vivo
treatments were
provided on each day
of data collection,
with at least 1 hour
between treatments,
and with the order of
treatments
randomised daily.
Target behaviour: A
target socialcommunication behaviour
was determined and
operationally defined for
each child using semistructured assessment
procedures and a
corresponding socialcommunication skill
hierarchy. P1: reaching to
request an object; P2:
pointing and vocalising to
share attention; P3: using
gesture to request more;
P4: using gesture to
request more.
Follow up
measures: two
weeks after the
treatment phase,
maintenance
sessions were
conducted for two
days.
Introduction of the treatment for
P1 resulted in an upward trend
in the data and a slightly
increased level, although effects
were not immediate. For P3,
there was also a delayed
response to video modelling
which was then followed by an
upward trend and increased
level. Results were maintained
for both children. For P4, video
modelling resulted in a more
immediate and pronounced
upward trend and increased
level, although maintenance
was more questionable.
On the whole, participants
showed a significant preference
for the video model in terms of
visual attention data.
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Appendix 5
Coding Protocols
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Appendix 6
Weighting of Studies
A: Methodological Quality
This rating is based on the rating given to each of the studies according to an
adapted coding protocol for single-participant design (Kratochwill, 2003). Section II of
the coding protocol allows for a scrutiny of key features of the methodological quality
of a study. A rating system defines features that mark a study as strong evidence,
promising evidence, weak evidence or no evidence. The elements of Section II
under consideration for Weight of Evidence A are: reliability and validity of
measurement, quality of baseline and quality of evidence of primary outcomes
assessed through visual analysis of data.
Each subsection was rated from 0-3 with a score of ‘0’ indicating no evidence, ‘1’
indicating ‘weak evidence’, ‘2’ indicating ‘promising evidence’ and ‘3’ indicating
‘strong evidence’. These 3 weightings were averaged to give an overall measure of
methodological quality.
To receive a ‘High’ weighting for ‘methodological quality’ a study must receive an
average rating of 2.5 or above.
To receive a ‘Medium’ weighting for ‘methodological quality’ a study must receive an
average rating between 1.5 and 2.4.
To receive a ‘Low’ weighting for methodological quality a study must receive an
average rating of 1.4 or below.
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B: Methodological Relevance
This weighting considers whether the methodological design was suitable for
evaluating the effect of video modelling interventions on the social and
communication skills of children with ASD.
In order to receive a ‘High’ weighting for methodological relevance the study must
have made use of a multiple baseline design or included at least three attempts to
demonstrate intervention effect (Horner et al., 2005). The study must have included
generalisation and maintenance or follow up sessions with at least three data points
for each phase.
In order to receive a ‘Medium’ weighting for methodological relevance the study must
detail three attempts to demonstrate intervention effect, as well as either
generalisation or maintenance or follow up sessions with at least three data points
for the phase.
In order to receive a ‘Low’ weighting for methodological relevance the study may not
have demonstrated intervention effect three times. Generalisation or maintenance
data may not be included, or may be less than three data points.
C: Study Focus Relevance
This weighting considers whether the focus and character of the study contribute
towards answering the review question.
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In order to receive a ‘High’ weighting for relevance the study sample must be
comprised of children with a diagnosis of autism. The significance of the intervention
for the child must have been established. The social or communication skill
operationalized as the dependent variable must have been identified as relevant by a
child’s teacher, parent or other caregiver. A teacher, parent or relevant figure in the
child’s education should have contributed to the design or delivery of the
intervention.
In order to receive a ‘Medium’ weighting for relevance the study sample must be
comprised of children with a diagnosis of autism. Either the significance of the
intervention or the relevance of the dependent variable for the child must have been
established. A teacher, parent or relevant figure in the child’s education may have
contributed to the design or delivery of the intervention.
In order to receive a ‘Low’ weighting for relevance, the study sample must be
comprised of children with a diagnosis of autism. The significance of the intervention
or the relevance of the dependent variable for the child may have been established.
A teacher, parent or relevant figure in the child’s education may have contributed to
the design or delivery of the intervention.
D. Overall Weight of Evidence
To calculate an overall weight of evidence studies were given scores of
‘1’ for ‘Low’ weightings, ‘2’ for ‘Medium’ weightings and ‘3’ for ‘High’ weightings.
These scores were then averaged to give an overall weight of evidence score.
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To receive a ‘High’ overall weighting a study must receive an average score of at
least 2.5.
To receive a ‘Medium’ overall weighting a study must receive an average score of
between 1.5 and 2.4.
To receive a ‘Low’ overall weighting a study must receive an average score of less
than 1.4.
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