DERIVED TEXTUAL CONTROL IN ACTIVITY SCHEDULES: CONDITIONAL
DISCRIMINATION TRAINING VERSUS SUPERIMPOSITION AND FADING
Evelyn Clare Sprinkle
B.A., California State University, Sacramento, 2007
THESIS
Submitted in partial satisfaction of
the requirements for the degree of
MASTER OF ARTS
in
PSYCHOLOGY
(Applied Behavior Analysis)
at
CALIFORNIA STATE UNIVERSITY, SACRAMENTO
SPRING
2011
DERIVED TEXTUAL CONTROL IN ACTIVITY SCHEDULES: CONDITIONAL
DISCRIMINATION TRAINING VERSUS SUPERIMPOSITION AND FADING
A Thesis
by
Evelyn Clare Sprinkle
Approved by:
__________________________________, Committee Chair
Caio F. Miguel, Ph.D
__________________________________, Second Reader
Becky Penrod , Ph.D
_____________________________________, Third Reader
Jill Young, Ph.D
____________________________
Date
ii
Student: Evelyn Clare Sprinkle
I certify that this student has met the requirements for format contained in the University
format manual, and that this thesis is suitable for shelving in the Library and credit is to
be awarded for the thesis.
__________________________, Graduate Coordinator___________________
Jianjian Qin, Ph.D
Date
Department of Psychology
iii
Abstract
of
DERIVED TEXTUAL CONTROL IN ACTIVITY SCHEDULES: CONDITIONAL
DISCRIMINATION TRAINING VERSUS SUPERIMPOSITION AND FADING
by
Evelyn Clare Sprinkle
Children with autism are frequently taught to follow picture activity schedules to increase
independence in task engagement and transitions. As textual behavior allows for greater
independence and efficiency in responding, schedules should rapidly become textual in
form. Previous research has shown the effectiveness of conditional discrimination
training and superimposition and fading procedures in establishing textual control. The
current study evaluated the relative effectiveness of these procedures in establishing
derived textual control in activity schedules. Participants included three children with
autism (ages 3, 8 and 10 years). Following the demonstration of proficiency in picture
activity schedules, participants were exposed to superimposition and fading and
conditional discrimination training in an alternating treatments fashion. Pretest-posttest
measures were used to evaluate emergent relations among stimuli. Results indicated that
conditional discrimination training was superior to stimulus fading for one participant.
iv
The remaining participants showed no clear difference between the procedures related to
derived textual control.
_______________________, Committee Chair
Caio F. Miguel, Ph.D
_______________________
Date
v
ACKNOWLEDGMENTS
The author would like to thank her thesis committee, Dr. Caio Miguel, Dr. Becky Penrod,
and Dr. Jill Young for their efforts in the development and fulfillment of this project.
Specifically, the author would like to thank Dr. Caio Miguel for his ongoing and
dedicated commitment to the completion of this study. The insight and information I
have received from Dr. Miguel has been invaluable to my professional development. In
addition, I would like to express my appreciation for the feedback and support from the
Sacramento State Verbal Behavior Research Lab; the encouragement of my peers, family
and friends has helped to make this experience unforgettable. As a final note, I would like
to thank my research assistants for their assistance in IOA and treatment integrity data
collection.
vi
TABLE OF CONTENTS
Page
Acknowledgments ……………………………………………………………………… vi
List of Tables ……………………………………………………………………………..x
List of Figures …………………………………………………………………………....xi
Chapter
1.
INTRODUCTION ……………………………………………………………….…..1
Textual Activity Schedules …………………………………………………….....2
Establishing Textual Control ………………………………………………..........3
Superimposition and Fading ……………………………………………...4
Conditional Discrimination Training ……………………………………..9
2.
METHOD ……………………………………………………………………..........16
Participants ………………………………………………………….……….......16
Settings and Materials ……………………………………………….………......17
Dependent Measures ………………………………………………….……...….18
Experimental Design ………………………………………………….…………19
Interobserver Agreement (IOA)…………………………………………...……..20
Treatment Integrity ……………………………………………………….……..21
Procedures …………………………………………………………....…..……...22
Stimulus Preference Assessment ……………….………………..……...22
Pre-Assessment of Schedule Following Behavior ……………...……….23
vii
Training Schedule Following ………………………………………...….24
Textual Control Tests ………………………………………………...….27
Textual Behavior Tests ……………………………………………..…...28
Emergent Relations Tests …………………………………………….....29
Conditional Discrimination Training ……………………...…………….30
Superimposition and Fading …………………………………………….34
3.
RESULTS ……………………………………………………………….…….........38
Training……………………………………………………….…………….........38
Schedule Following ………………………………………………...…...38
Training Conditions …………………………………………...………...40
Testing……………………………………………………………………...…….44
Textual Control …………………………………………...……………..44
Textual Behavior/ Reading ………………………...……………………46
Emergent Relations Testing ………………………..……………….…...47
4.
DISCUSSION ………………………………………………………..…….….…....50
Limitations ……………………………………………………………...……….55
Future Research ……………………………………………………………...….58
Applied Implications …………………………………………………………….59
Appendix A.
Sample Data Sheets …………………………………………...………...61
Appendix B.
Modified RAISD ……………………………………......………………65
Appendix C.
Stimulus Sets for Participants …………………………...…...…………67
viii
References ………………………..…………………………………………………….68
ix
LIST OF TABLES
Page
1.
Table 1
Interobserver Agreement………………………………………………..21
2.
Table 2
Treatment Integrity……………………………………………………...22
3.
Table 3
Order of Experimental Conditions…………………………………........20
4.
Table 4
Trials to Criterion and Number of Errors……………………………….40
5.
Table 5
Stimulus Sets per Participant …………………………………………...67
x
LIST OF FIGURES
Page
1.
Figure 1 Conditional Discrimination Training: Sample Procedure………………...31
2.
Figure 2 Superimposition and Fading: Sample Progression……………..…………36
3.
Figure 3 Training Results: Schedule Following……………………………………39
4.
Figure 4 Training Results: Training Conditions………………….. ……………….43
5.
Figure 5 Textual Control Tests……………………………………………………..45
6.
Figure 6 Emergent Relations Tests…………………………………………………49
7.
Figure A1 Sample data sheet – Activity Schedule Training………………………..61
8.
Figure A2 Sample data sheet – Conditional Discrimination Training and
Emergent Relations Tests…………………………………………………………..62
9.
Figure A3 Sample data sheet – Superimposition and Fading ……………………..63
10. Figure A4 Sample data sheet – Textual Behavior Tests …………………………..64
xi
1
Chapter 1
INTRODUCTION
Autistic Disorder affects many children, and is linked to impairment in many
areas of functioning. Some of these deficits include difficulty engaging in independent
play, beginning or completing tasks (e.g., self help skills), initiating social interaction,
and carrying out daily routines (American Psychiatric Association, 1994). One
intervention used to teach these skills is activity schedules.
Activity schedules have been shown to increase independence in children’s skills
related to the sequential completion of activities (McClannahan, MacDuff & Krantz,
2002). McClannahan and Krantz (1999) recommend the use of a three ring binder,
comprised of multiple pages with each page containing the representation of a single
activity. Each activity in these schedules is represented by a visual cue (McClannahan &
Krantz, 2010). This cue can be presented in either picture or word format and through
learning, becomes a discriminative stimulus for selection and completion of a particular
activity. Activity schedules can take many forms such as linear (e.g., multiple pictures
presented on one surface) or binder (e.g., one picture presented per page) formats, and
may be comprised of pictures or written words, but each consists of a presented series of
stimuli depicting the activities to be completed (e.g., written list of physical fitness
exercises). These schedules signal that the learner will complete all activities in the order
in which those activities are presented (MacDuff, Krantz & McClannahan, 1993). When
presented with an activity schedule, a child is taught to reference each activity by either
2
looking at or touching the pictorial or textual representation of each activity (e.g.,
touching the picture of a puzzle prior to retrieving and completing the actual puzzle).
After referencing the activity, the child is taught to complete the corresponding activity
(e.g., picking up each puzzle piece and fitting it into the puzzle). The child is then taught
to reference and complete the next activity presented on the schedule. In the event that an
activity does not have a built in completion point (e.g., a puzzle is completed when all
pieces are in place), the child may play until motivation to do so decreases, or until a
supervising adult or preset timer indicates the time to play is up. The child completes all
necessary steps for each activity on the schedule, in either the presence or absence of
supervision and reinforcement for activity completion. Activity schedules have been used
to teach academic skills such as worksheet completion (Bryan & Gast, 2000; Massey &
Wheeler, 2000), play skills such as independent play activities (e.g., McClannahan &
Krantz, 2010), physical activity skills such as walking a treadmill (Birkan, McClannahan
& Krantz, 2007) and the completion of self care or daily living skills including tooth
brushing and meal preparation (Anderson, Sherman, Sheldon & McAdam, 1997) in
multiple populations, such as children with autism (e.g., Bryan & Gast, 2000), adults with
developmental disabilities (Anderson, et al, 1997) and children with developmental
delays (Zimbelmann, Paschal, Hawley, Molgaard & St.Romain, 2006).
Textual Activity Schedules
Activities are initially represented on schedules as pictures, but as children begin
to recognize text, written words corresponding to activities can be used to replace those
pictures (Miguel, Yang, Finn & Ahearn, 2009). This use of written words to create a
3
schedule is frequently observed in the behavior of typically developed persons, and is a
skill that many people use throughout their lives such as when following a daily schedule,
event planner or “to do” list (McClannahan & Krantz, 2010). In addition, McClannahan
and Krantz (1999, 2010) provide support for the use of textual schedules by asserting that
textual representation of activities is more efficient than pictorial representation in terms
of selection from and engagement in a variety of actions and activities. As such, the
transfer of control from pictures to written words in the context of activity schedules
should be targeted when children begin to develop early reading skills (McClannahan &
Krantz, 2010), and should be facilitated by the most efficient method available. When
control over responding in the presence of schedules moves from pictures to text, both
pictures and written words should be equivalent in that they would evoke similar
responding (i.e., completing the depicted activity). When a learner starts to follow a
written schedule, their behavior is said to be under control of textual stimuli (Skinner,
1957).
Establishing Textual Control
Learners following picture activity schedules complete a series of activities when
presented with pictures representing those activities. Their responses, including selecting
and completing each activity are occasioned by the corresponding picture. The selection
of a particular activity is under control of the picture corresponding to that activity.
Similarly, when learners follow a written schedule, their responses are under control of
the corresponding written words. Several studies have examined ways to transfer control
over responding from pictures to textual stimuli (i.e., written words) in relation to various
4
tasks, including mands (Rosales & Refeldt, 2007), vocal and non-vocal responding
(Birkan et al, 2007), and independent play activities (Miguel et al., 2009). Within the
context of activity schedules, two teaching methods including superimposition and fading
and conditional discrimination training have been indicated by research as effective in
establishing textual control.
Superimposition and Fading
One way to transfer the control from pictorial to textual stimuli is through the use
of superimposition and fading (e.g., McClannahan & Krantz, 1999). Fading involves the
transfer of control from one stimulus to another via gradual stimulus change (Catania,
2007). Through this teaching procedure, pictorial and textual stimuli are presented
together, and control over responding is transferred through gradual stimulus change to
only textual stimuli. For example, pictures are initially presented with superimposed text,
and those pictures are then systematically reduced so that stimuli are comprised of
smaller pictures and text, and eventually consist solely of text. While learners respond to
textual stimuli following exposure to this procedure, it remains unclear whether or not the
procedure produces comprehension of the written word (Sidman, 1994), or if instead, the
written word merely functions as another trained visual stimulus which occasions
responding. When a student comprehends a written word, the written word and a picture
corresponding to that word should be interchangeable, or substituted for one another.
Learners who demonstrate comprehension, or equivalence between stimuli, match
pictures and printed words accurately. They may be said to “understand” written words
(Sidman, 1971). If comprehension is not produced by the teaching procedure, and the
5
written word is simply another visual stimulus which occasions responding, there is
limited value in transferring control over responding to the written word, as control could
simply have been transferred to an arbitrary stimulus. In order to determine the relative
efficacy of a given procedure used to establish textual control, researchers must consider
additional skills which may emerge following the use of a particular teaching method.
When a skill is not directly taught in a given procedure, yet that skill is present
immediately following the procedure as determined by testing, that skill is derived and is
a product of the teaching procedure used. For example, testing whether learners match
printed words to pictures could show evidence that the teaching procedure produced
comprehension of written words. When devoting resources to teaching learners with
special needs, the production of derived skills benefits practitioners as well as the learners
themselves. The tendency of a procedure to produce derived skills should be taken into
account during teaching. While studies using conditional discrimination training to
establish textual control examine the emergence of derived skills, studies using
superimposition and fading have not.
In a recent study evaluating the transfer of control from pictures to written words
in activity schedules, Birkan et al (2007) used superimposition and fading to establish
textual control over the vocal and motor responding of a six year old autistic boy. The
targeted responses during this study were sight word reading, or the emission of textual
behavior (Skinner, 1957), while completing each activity in a schedule. During training,
printed words of familiar activities were superimposed over pictures corresponding to
those activities. The pictures were then systematically faded by decreasing their size over
6
a progression of steps, each of which removed 1 cm. strips from the top and bottom of
each picture, for three sets of activity cards including both pictures and written words.
The participant progressed through fading steps following two consecutive sessions with
100% correct vocal responses (textual behavior) in the presence of the stimuli assigned to
a given set. For example, after two consecutive 100% performances on step 1, the
participant would progress to step 2. This procedure was implemented until the
participant was responding to the printed word alone. Correct responses consisted of the
participant producing a vocal response that corresponded to the superimposed text prior
to completing the activity depicted on the schedule. The participant responded correctly
in the presence of the printed words for 93% of activities following the superimposition
and fading procedure. A total of 30 sessions was required to establish textual behavior
and textual control over schedule following behavior. Additionally, the authors reported
that skills were maintained at a 44-day follow up, and responding generalized to textual
stimuli of different font sizes and colors. Stimulus equivalence (i.e., comprehension of
stimuli and substitutability for one another) among written word and pictorial stimuli was
not tested in the study. In other words, experimenters did not test the participant on
matching of written word to picture or vice versa.
The results of Birkan et al (2007) are limited by the design and the potential
mediation of the fading procedure by the vocal response. The effects of the stimulus
fading (superimposition and fading) procedure cannot be distinguished from the effects
of requiring the participant to produce the vocal response corresponding to each item in
the schedule. When the participant was required to attend to the presented stimulus, and
7
to simultaneously produce a vocal response, the auditory stimulus produced by the
response could have served as a discriminative stimulus for listener behavior of
identifying or reorienting to that stimulus (Horne & Lowe, 1996), or as a discriminative
stimulus for completing the designated activity. During the study, the participant learned
to produce a vocal response in the presence of both the picture and the printed word, and
following the production of that response also learned to engage in the activity indicated
by the picture, printed word and response produced auditory stimulus. As such, this
procedure could have facilitated learning by simultaneously teaching speaker behavior
when the participant was required to emit a vocal response, and listener behavior when
the participant would orient to the text/picture when hearing its name, as well as listener
behavior in the form of activity completion. If the speaker behavior (i.e., reading) acted
as a discriminative stimulus for activity completion, the activity completion may never
have come under sole control of the written word. Instead, the listener response of
activity completion could have been under control of the auditory product of the
participant’s vocal response.
Several other studies showed support for the efficacy of superimposition and
fading while teaching social skills and community skills (e.g., Corey and Shamow, 1972;
Krantz & McClannahan, 1998; Mueller, Palkovic & Maynard, 2007). For example, Corey
and Shamow taught sight word reading to non-reading, typically developed children, ages
4 to 5.5 years using a fading procedure. They initially paired pictures with written words,
and systematically faded the pictures in a progressive fashion by darkening the pictures
over 6 steps until only the word was visible. Following training, children accurately read
8
written words aloud. Results indicated that control over vocal responding was transferred
from one visual stimulus to another (e.g., from pictures to printed words).
As with the
experiment conducted by Birkan et al (2007), participants were not required to
demonstrate matching of written words to pictures or vice versa, and as a result, this
study provides no evidence that participants comprehended written words.
In another study using stimulus fading procedures with activity schedules, Krantz
and McClannahan (1998) first taught three children ages 4 to 5 years with autism textual
behavior by requiring them to engage in textual behavior when presented with two cards
containing written words. These words were comprised of mands for social interaction
(i.e., “Look” and “Watch me”). Participants’ vocal responses in the presence of textual
stimuli were reinforced. Participants were then trained to complete picture activity
schedules containing 16 independent play activities. Following activity schedule
training, participants were required to complete picture schedules in which the previously
learned textual stimuli (e.g., “Watch me”, “Look”) had been imbedded. For example,
participants would be presented with a picture activity schedule with cards containing
written words placed on pages in addition to the picture of the activity to be completed.
Textual stimuli contained words that when produced by participants, were mands for
social interaction (e.g., “Watch me”). These written words (e.g., “Look”) were
systematically faded as participants demonstrated success by removing portions of the
written word cards. Over the course of the study, participants were taught to read written
words which consisted of mands for social attention. These written stimuli were
imbedded in independent play schedules so that participants were prompted via text to
9
mand for social attention during completion of schedules. Textual prompts were faded so
that participants continued to mand for social attention when completing play schedules.
Following the fading procedure, all participants continued to demonstrate social
interactions for activities taught using the prompt.
Conditional Discrimination Training
A recently evolved method for establishing textual control and reading
comprehension is the use of conditional discrimination training (e.g., Miguel et al, 2009;
Sidman, 1994). This method teaches participants to select pictures and written words in
the presence of the spoken name corresponding to the target stimulus (e.g., picture of
written word), and often results in the emergence of matching picture to words and words
to pictures, as well as textual behavior (i.e., sight reading). If learners are taught to follow
picture activity schedules, and are then taught that pictures and written words are
equivalent or substitutable for each other, they should then follow written schedules. The
advantage of this procedure is that, in addition to control by the text, it produces
untrained or derived stimulus relations between pictures and printed words, which are
identified via pre and posttest measures. Conditional discrimination training is based on
the stimulus equivalence literature (e.g., Sidman 1994; Lynch & Cuvo, 1995; Vause,
Martin, Yu, Marion & Sakko, 2005; Toussaint & Tiger, 2010; Walker, Rehfeldt &
Ninness, 2010). Conditional discrimination training includes the training of two relations,
and results in the emergence of four derived (i.e., untrained) relations among stimuli
(e.g., Sidman, 1994), thus maximizing learning. When all stimuli (i.e., spoken word,
pictures and printed stimuli) are interchangeable in a certain context, such as within a
10
matching procedure, they are considered members of an equivalence class (Sidman,
1994). When these same stimuli exert the same control over behavior however, they are
said to be functionally equivalent (Catania, 2007). It has been suggested that when
stimuli are members of an equivalence class, establishing control over a response by one
member of the class will lead to control over the same response by other members of the
equivalence class in the absence of direct training (Goldiamond, 1962). In order to
examine the transfer of function of the members of established equivalence classes,
specific tests of control over responding by the various class members would need to
occur (Sidman, Wynne, Maquire & Barnes, 1989).
Previous research has examined the effects of training simple vocal responding
(Wirth & Chase, 2002) in the presence of one member of a previously established
stimulus class and has observed transfer of function to other members of that class. Wirth
and Chase first trained college students to make nonsense vocalizations in the presence of
arbitrary stimuli. Stimulus classes between previously taught and additional arbitrary
stimuli were then established via MTS procedures. After testing showed the
establishment of equivalence classes among stimuli, newly taught members of these
classes were then tested to determine if control over nonsense vocalizations transferred to
other members of the established classes. Transfer of functional control was
demonstrated. McVeigh and Keenan (2009) examined the transfer of stimulus control
over a more complex non-vocal response consisting of detailed drawing in the presence
of various members of established equivalence classes. Results indicated that some
11
control was transferred, and the authors suggested that complexity of the tasks may have
effects on the extent of derived stimulus control.
Rosales and Rehfeldt (2007) used conditional discrimination training to establish
derived textual mands by two 34 and 58 year old developmentally disabled adults. A
mand is a verbal operant that is evoked by a motivating operation and is followed by a
particular reinforcing stimulus (Michael, 2004). A derived mand is a mand that is not
directly taught to a learner. So, derived textual mands are mands made in the form of
written words, which had not been taught in that form. During this study, participants
were initially taught to request for items using the Picture Exchange Communication
System (PECS; Bondy & Frost, 1994), which is a system used to support non-vocal
learners in acquiring verbal behavior. Through a specific sequence of teaching
conditions, students learn a variety of verbal operants, including mands (i.e., requests).
Participants were then taught to engage in a chained task, consisting of completing the
steps to either play a CD on a portable CD player, or to make a pitcher of Kool-Aid®.
Participants were then instructed to complete the task, but items required to complete the
task were removed. Access to these items was granted contingent on participants
exchanging a PECS icon corresponding to the item. During conditional discrimination
training, all participants were taught to conditionally relate the dictated name, picture
(PECS icon) and printed name of various items necessary for completion of the
previously taught chained task. Participants were first taught to select the picture (B) in
the presence of the dictated name (A) and were then taught to select the printed word (C)
in the presence of the dictated name (A). Following this training, participants
12
demonstrated matching of pictures to corresponding written words (BC) and vice versa
(CB). Additionally, participants demonstrated derived mands for items using written
words. In other words, participants requested for items using both PECS icons and
printed words. Equivalence between stimuli was measured by the correspondence
between textual mands and required items, as well as during tests of matching printed
words and pictures. This type of posttest was a measure of reading comprehension in
that, if participants could to match printed words to pictures or substitute one for the other
(e.g., mand via written word or picture), they comprehended the meaning of the written
words (Sidman, 1994). While participants had previously requested for necessary items
using only pictures, following conditional discrimination training, they requested for
these items using text as well, and demonstrated the effectiveness of this method for
teaching comprehension in adults with disabilities.
In a related study, Rehfeldt and Root (2005) used conditional discrimination
training to teach three adults with severe mental retardation to engage in derived mands
for preferred items. Researchers first tested the participants’ ability to select pictures and
corresponding written words when presented with the dictated name of a stimulus.
Textual behavior (i.e. reading a printed word), tacting pictures, matching pictures to text
and text to pictures, and derived requesting were also examined during pre and posttests.
Tests of derived requesting included whether a participant would request for a preferred
item using a textual label corresponding to that item. Following pretesting, researchers
taught participants to request for preferred items using the Picture Exchange
Communication System (Bondy & Frost, 1994). Following PECS training, participants
13
were taught to conditionally discriminate both pictures and printed names of preferred
items (i.e., were taught to select pictures or written words in the presence of the dictated
name of those items). All relations tested during pretesting were again tested following
training as a posttest measure. Results indicated that all participants made derived textual
mands for at least two of three items.
In the only study to use conditional discrimination procedures to teach children
with autism to respond to written words in activity schedules, Miguel et al. (2009)
examined the emergence of derived stimulus control and stimulus relations. Participants
were also tested on the emergence of textual behavior (i.e., reading aloud). Participants
that had not previously responded correctly to textual stimuli or engaged in textual
behavior learned to do so following conditional discrimination training. During this
study, two 6 year old children with autism were taught to complete a picture activity
schedule. Derived textual control (e.g., responding to written activity schedules) was
evaluated via pre and posttests measures in a multiple baseline design across picture sets.
Pre and posttests of textual activity schedule following consisted of experimenters
presenting and activity schedule comprised solely of printed words and instructing
participants to complete the schedule. Textual control was demonstrated by completion
of the activity currently depicted on the schedule as a written word. During pretests of
textual control, children did not respond in the presence of textual stimuli. Pre and
posttest measures of stimulus equivalence examined correct matching of printed words
(C) to pictures (B) and vice versa, as well as textual behavior (i.e., sight word reading).
Equivalence relations pre and posttests were conducted via a visual-visual MTS format
14
for measures of comprehension (BC and CB). Additionally, the participants’ oral reading
responses were tested by asking the participants to read aloud individually presented
printed words. During pretests of equivalence, participants did not reliably match pictures
to printed words, printed words to pictures, or accurately read aloud printed words.
Conditional discrimination training procedures were then implemented. During
this training participants were taught to select first pictures and then written words in the
presence of their dictated names. For example, the experimenter would dictate a name
and the participant would select the corresponding stimulus (e.g., either picture or written
word) from an array. Participants were taught to select pictures and printed words in the
presence of dictated names using a progressive prompt delay across two stimulus sets of
three stimuli each.
Following conditional discrimination training, posttests of equivalence were
conducted and were identical to pretests. During posttests, participants selected printed
words in the presence of their respective pictures and vice versa and accurately read
printed words aloud. The results demonstrated the efficacy of conditional discrimination
training at establishing derived stimulus relations and textual behavior. Participants also
completed written activity schedules (i.e., textual as opposed to picture schedules)
accurately following conditional discrimination training, showing evidence that this
procedure was effective at establishing derived textual control over schedule following.
While both conditional discrimination training and superimposition and fading
procedures have been shown to be effective in establishing textual control over behavior
in activity schedules, these procedures have not been directly compared. Anecdotally,
15
practitioners report use of superimposition and fading procedures for this purpose. In
addition, measures of emergent relations (i.e., matching pictures and printed words and
sight reading) for superimposition and fading procedures have not been previously
reported. As such, it would be important to determine if the stimulus fading procedure
resulted in equivalence among stimuli. The primary purpose of the present study is to
evaluate the efficacy of the stimulus superimposition and fading procedure as compared
to that of conditional discrimination training in establishing textual control over behavior
in the context of activity schedules. A secondary purpose of the present study is to
evaluate whether both procedures produce emergent relations among pictorial and written
stimuli, and produce emergent textual behavior.
16
Chapter 2
METHOD
Participants
Three children diagnosed with autism participated in the study. Larry was a 10
year, 11 month old boy who participated in home school, and had had extensive previous
experience with 1:1 teaching using the methods of applied behavior analysis. Laura was
an 8 year, 11 month old girl whom attended a public school district special education
classroom for children with autism and other diagnoses. Laura also had extensive
experience with 1:1 behaviorally based teaching methods. Virginia was a 3 year, 4 month
old girl, who was enrolled in a mainstream preschool class. Virginia had some
experience (e.g., less than one year) in 1:1 behaviorally based teaching. All participants
communicated using a minimum of three to five word sentences and demonstrated
listener skills such as selecting items from an array. Participants also demonstrated
speaker skills in that they were able to produce tacts of items or pictures. Additionally, all
demonstrated simple intraverbals such as answers to simple questions. All participants
had a limited sight word vocabulary. Larry had previous experience with, and could
independently complete picture activity schedules, while Laura and Virginia were taught
to follow schedules over the course of the study. All participants were able to sit for up
to five minutes in structured teaching settings.
17
Setting and Materials
Sessions were conducted in a designated area within each participants’ home.
Each area included open space for engaging with leisure/independent play items, as well
as a table with two chairs. A video camera or additional researchers were present for all
sessions for data collection purposes.
Materials included a variety of preferred items (e.g., edibles) and activities (e.g.,
games, puzzles). Activity schedules for all participants consisted of vertical, linear
presentation of three activities. One set of three cards corresponding to activities was
used for conditional discrimination training (CDT), and one set of three cards
corresponding to activities was used for superimposition and fading (SF) procedures.
Items identified as preferred by each participant’s primary caregiver were
counterbalanced across sets for length of words/total number of letters in words within
each set. Twelve laminated cards (3 x 5 in.) including six photographs of the activities
for each participant, and six cards printed with corresponding names were presented to
each participant during the study (Please see Appendix C). These twelve cards were used
during pre and posttest measures of textual control, textual behavior and stimulus
equivalence, and were also used during conditional discrimination training. Cards used
during the superimposition and fading procedure also contained pictures and
corresponding words of items and activities identified during the preference assessment,
but a total of 36 additional cards were used during the stimulus fading procedure.
Additional cards used in the superimposition and fading procedure included both the
printed name and systematically smaller portions of the pictures used for this procedure.
18
All cards measured 3 x 5 inches, and all text was printed in black in 72 point Arial font.
All pictures were printed in color on white backgrounds. Please refer to Appendix C for
pre and posttests cards/pictures for Sets SF and CDT.
Additional materials were presented to Larry during the stimulus fading
procedure. Larry was exposed to nine additional cards, including text, colored text,
pictures and various combinations of text and pictorial stimuli as described below.
Dependent Measures
The primary dependent variable of interest in the study was derived textual
control, which was measured by the percent of correct schedule following responses
made in the presence of printed words during pre and posttests. Responses during textual
control probes were scored as correct when a participant responded by selecting and
engaging in an activity in the presence of written words on the activity schedule.
Conversely, responses on tests of textual control were scored as incorrect in the event that
participants either selected or engaged in activities not currently depicted on the schedule,
or if participants failed to respond in the presence of textual stimuli. Additional
dependent variables included the emergence of textual behavior (i.e., reading written
words aloud) and emergent relations indicative of reading comprehension, such as
accurately matching pictures to printed words and vice versa. Pre and posttests of
emergent stimulus relations measured the percentage of correct independent responses
made in the presence of the sample stimulus. Emergent relations trials were scored as
correct when a participant selected the printed word that was a positive comparison to the
sample picture (BC) or selected the picture that was a positive comparison to the sample
19
printed word (CB). Tests for emergent relations (e.g., BC and CB) were conducted in a
basic matching to sample (MTS) format (see below). Textual behavior trials were scored
as correct when the participants produced the correct vocal response in the presence of
the printed word (CD), and were conducted in a simple discrimination format. In
addition, both the number of trials to meet training criterion and the total number of
errors made were examined as a measure of the relative efficacy of the two teaching
methods.
Experimental Design
An alternating treatments design was employed (Barlow & Hayes, 1979) in order
to compare both procedures, with pre and posttests measuring changes in dependent
measures (i.e., measures of textual control and emergent relations). Each of six activities
was assigned to one of two sets for each participant. Each of these activity sets was
comprised of three activities which was assigned to one treatment condition (i.e.,
conditional discrimination or superimposition and fading).Please see Appendix C for pre
and posttests stimulus sets for each participant.
The same linear schedule was used for all training conditions, and stimulus cards
corresponding to activity sets (e.g., Sets CDT and SF) were varied based on condition.
Pre- and posttests were used to evaluate the emergence of textual control, textual
behavior, and emergent stimulus relations. Please refer to Table 3 for a complete list of
all conditions in the order in which they were presented.
20
Table 3
Order of Experimental Conditions
Order
Condition
Testing/Teaching Procedure
________________________________________________________________________
1
Pretests of Schedule Following
Task Analysis
2
Training Schedule Following*
Task Analysis
3
Pretests of Textual Control
Task Analysis
4
Textual Behavior Pretests
Simple Discrimination
5
Emergent Relations Pretests
Matching to Sample
6
Alternating Treatment Conditions
Superimposition and Fading;
Conditional Discrimination Training
7
Posttests of Textual Control
Task Analysis
8
Posttests of Textual Behavior
Simple Discrimination
9
Posttests of Emergent Relations
Matching to Sample
* Activity schedule following trained only if participants failed to demonstrate schedule
following during assessment.
Interobserver Agreement (IOA)
An additional independent observer scored testing and training sessions via either live
observation video recording during 72.9% of all sessions. An agreement was defined as
both the experimenter and the independent observer scoring either an incorrect, correct or
21
prompted response on a single trial. A disagreement was defined as a difference in
scoring by the experimenter and the second observer on any given trial. IOA was
calculated by dividing the number of agreements by the total number of agreements plus
disagreements and multiplied by 100. Mean IOA was 97.1% across participants. Table 1
contains individual IOA values for each participant.
Table 1
Interobserver Agreement (IOA)
Laura
Virginia
Larry
All
% Blocks with IOA
78
72
67.8
72.9
IOA%
99.6
93.8
97.9
97.1
77 – 100
54 – 100
IOA Range
77 – 100
55 – 100
Treatment Integrity
Treatment integrity was a measure of correct implementation of training as
designed. Trials were scored as correct by the independent observer if the experimenter
presented stimuli according to the pre-randomized arrangement of the stimuli, presented
the correct discriminative stimulus during MTS, and delivered reinforcement or
implemented error correction procedures according to participants’ response. An
incorrect trial was recorded if the experimenter failed to complete any of the above as
outlined. Treatment integrity was assessed by dividing the number of correctly
22
implemented trials by the number of correctly implemented plus incorrectly implemented
trials multiplied by 100. Treatment integrity was assessed for an average of 66.9% of
training and testing blocks across participants. Mean treatment integrity was 99.4%
across participants. Please see Table 2 for individual participant values.
Table 2
Treatment Integrity (TI)
Laura
Virginia
Larry
All
% Blocks
78
55
67.8
66.9
TI
99
99.6
99.7
99.4
89 – 100
89 – 100
TI Range
89 – 100
89 – 100
Procedures
Stimulus Preference Assessment
The purpose of this procedure was to identify potential reinforcers for each
current experimental session. This assessment was conducted once at the beginning of
each experimental session. Parents or caregivers of each participant completed a modified
version of the Reinforcer Assessment Inventory for Individuals with Severe Disabilities
(RAISD; Fisher, Piazza, Bowman & Almari, 1996) prior to the beginning of the study
(see Appendix B). Based on the RAISD, a number of potential reinforcers were selected
to be presented to each participant in a brief multiple stimulus preference assessment
23
without replacement (MSWO; Higbee, Carr & Harrison, 2000). Only edible items were
included in this assessment. Prior to the beginning of each session, participants were
exposed to a brief MSWO (i.e., one trial) including edible items from the RAISD and
were allowed to choose their preferred reinforcer. A minimum of three preferred edible
items were randomly placed in a line approximately 10 cm. apart on the table in the
experimental area. Each participant was instructed to select one item from the array. For
each training session, the first item selected was used as the reinforcer for the remainder
of that session. In the event that a participant vocally requested a different edible item
throughout the session, the request was honored.
The RAISD was also used to identify items and activities to be included within
activity schedules. Tangible, non-edible items identified as preferred by each
participant’s primary caregiver were counterbalanced across sets for length of words/total
number of letters in words within each set. See Table 5 (Appendix C) for stimulus sets
for each participant.
Pre-assessment of Schedule Following Behavior
This phase was conducted in order to ensure that all participants were able to
follow a picture activity schedule. During this pre-assessment phase, participants were
presented with a minimum of two, three item picture activity schedules, so that each
picture used throughout the course of the study was presented once during this preassessment phase. In the event that participants correctly followed schedules, they were
exposed to additional three item schedules to ensure consistent demonstration of this
skill. Pictures of items identified via the RAISD were used in this phase. Each
24
participant was presented with pictures corresponding to items in both previously
identified activity sets (i.e., Set SF and Set CDT). An experimenter sat in the room for
data collection purposes, but did not interact with the participant following the
presentation of the initial instruction, “Do your schedule.” Correct responses consisted of
participants approaching the schedule, referencing and selecting the item or activity,
completing the activity, removing the picture, and repeating the process until all activities
were completed. A response was defined as incorrect when a participant failed to respond
in the presence of the presented schedule, or completed any of the above outlined steps
for an activity not corresponding to that currently depicted on the schedule. When a
participant completed 80% or more of all required steps to follow a picture activity
schedule in the absence of prompting, they then progressed to the next phase of the study.
When participants failed to demonstrate schedule following behavior at criterion levels,
they were trained to complete the steps listed above. Pretests for activity schedule
following were terminated when the participant failed to respond correctly, or did not
respond within two minutes of the presentation of the instruction.
Training Schedule Following
During this phase, participants were trained to complete all steps of the PAS,
including approaching the schedule, referencing and selecting the item or activity,
completing the activity, returning to the schedule and repeating the process until all
activities were completed, in a manner adapted from that described by MacDuff et al
(1993).
25
Teaching began with a vocal instruction (i.e., “check your schedule”, etc.). The
instructor then waited five seconds for the participant to begin responding to the
instruction. In the event that the participant did not respond within five seconds, or
responded incorrectly to the instruction by engaging in any response other than
referencing the schedule, the instructor then prompted the participant to begin the
sequence of activities.
All prompts were delivered from behind the participant, and were initially manual
prompts (e.g., hand over hand). The hierarchy of prompts included manual, spatially
faded and proximity prompts. Prompts were first faded from manual prompts to spatial
fading (e.g., the location of the manual prompt was changed), and then to shadowing
(e.g., experimenters moved with participants but did not provide physical guidance),
following which physical proximity of the researcher to the learner was faded to
distances of two feet, and finally, five feet. No prescribed vocal or gesture prompts were
provided during training. Prompts were faded according to the outlined progression when
participants demonstrated on-task and on-schedule behavior for a minimum of 80% of
steps for each prompting progression, for two consecutive schedules. The activity
schedule training phase was considered complete following two consecutive
demonstrations of schedule following, including a minimum of 80% of responses being
both on-task and on-schedule, with researchers faded to five feet from participants.
Participants were trained to complete activity schedules consisting of three items.
The order of activities was pre-randomized for each presented schedule in such a way
that no one activity consistently preceded or followed another. Steps required to
26
complete each schedule included: 1) approaching the schedule 2) pointing to the first
picture, 3) gathering necessary materials, 4) completing the activity, 5) putting the
materials away, and 6) removing the picture and placing it in the all done pocket. Steps 2
through 6 were then completed for each of the subsequent activities, for a total of 16
steps required to complete one full schedule.
Data on participants’ on-schedule and on-task behavior was collected during each
step of each schedule completed. Correct responses for on-task behavior consisted of
participants engaging in at least one of the following: attending to materials or the
schedule, manipulating materials appropriately, and transitioning between activities. Ontask responses were scored as incorrect if participants engaged in any response other than
those listed above (e.g., stereotypy or other forms of behavior excesses) for longer than
five seconds. On-schedule behavior was scored as correct when participants were
engaged in the activity, or were completing any steps required to engage in the activity
currently depicted on the schedule (e.g., selecting the item). On-schedule responses were
scored as incorrect when participants engaged in other responses, including behavior
excesses or when they engaged in activities not currently depicted on the schedule for
longer than five seconds. In the event that participants engaged in inappropriate behavior
(e.g., stereotypy), or paused for more than five seconds they were immediately returned
to the previous step in the schedule, and were then prompted to initiate the following (i.e.,
previously incorrect) step. Participants were initially prompted to engage in both on-task
and on-schedule behavior while completing schedules.
27
Textual Control Tests
The purpose of this phase was to test if written words evoked activity completion prior to
and after training with stimulus fading and conditional discrimination. During this
condition, all pictures in the participants’ activity schedules were replaced with
corresponding written words. All items corresponding to printed words were present in
the room within four feet of the participant. The experimenter presented the activity
schedule and instructed the participant by stating, “Do your schedule”. Schedules were
placed on a table (Virginia and Larry) or attached to the wall (Laura) in the work area,
based on requests by participants’ parents/caregivers within two feet of the location from
which the experimenter issued the initial instruction The experimenter remained in the
room for data collection purposes, but did not interact with the participant in any way
other than to deliver the initial instruction. Correct responses consisted of participants
approaching the schedule, referencing and selecting the item or activity when presented
with the printed word, completing the activity, removing the picture, and repeating the
process until all activities were completed. Incorrect responses consisted of the
participants failing to respond in the presence of the presented written schedule, or
completing any of the required steps for an activity not corresponding to that currently
depicted on the schedule. In the event that the participant did not begin to complete the
schedule (i.e., initiated schedule following) within two minutes from the delivery of the
instruction, the pretest for textual control was terminated and responses were scored as
incorrect. Pretests for textual control were not terminated for any participant, as all
28
participants approached the schedule. No participant selected or engaged in activities
after referencing written words.
Textual Behavior Tests
Pretests and posttests for textual behavior, or reading a printed word aloud were
completed for stimulus sets used for both conditional discrimination training and stimulus
fading procedures. These tests consisted of the experimenter presenting the participant
with the printed word and requiring each participant to read it (CD). This relation was
tested successively by presenting one card at a time. The experimenter held up one card
containing a printed word, and asked “What is it?” Responses were scored as correct if
participants produced a recognizable vocal approximation of the printed word, (e.g.,,
recognizable vocalization corresponding to the sample), or correctly read the word aloud.
Responses were scored as incorrect if participants either failed to respond, or if they did
not accurately read the word. All responses during pretesting, regardless of accuracy,
resulted in neutral social feedback (e.g., “OK”). In order to ensure continued engagement
on the part of the participant, maintenance trials were conducted after every two to three
test trials. These maintenance trials consisted of previously mastered instructions (e.g.,
“touch your nose.”) and edible items were delivered contingent upon correct responses.
Textual behavior testing was conducted in 9-trial blocks for each set of stimuli (i.e., Set
SF and Set CDT); one nine-trial block was conducted per set, with one block of
pretesting conducted for each set of stimuli. Stimuli were presented in a pre-randomized
order, so that each sample stimulus was presented a total of three times in a simple
discrimination format.
29
Emergent Relations Tests
Pretests and posttests for emergent relations were completed for stimuli sets used
for both conditional discrimination training and within stimulus fading procedures, both
before and after training, and after textual control tests. Tests of emergent relations were
conducted using a typical MTS format, during which the participant selected the printed
word in the presence of the picture (CB), or in the presence of the picture, selected the
printed word (BC). During MTS tests of emergent relations, participants were required to
engage in an observing response consisting of touching the presented sample stimulus
card (Dinsmoor, 1985). The observing response then produced an array of three
comparison stimuli, which were positioned equally in each position on the board, and
oriented to the other cards an equal number of trials. Responses were scored as correct
when participants retrieved the corresponding comparison. Trials were scored as
incorrect when the participant selected an incorrect comparison stimulus, or failed to
respond within five seconds from the presentation of the comparison stimuli. All
responses during pretesting, regardless of accuracy, resulted in neutral social feedback
(e.g., “OK”). In order to ensure continued engagement on the part of the participant,
maintenance trials were conducted after every two to three test trials. These maintenance
trials consisted of previously mastered instructions (e.g., “touch your nose.”) and edible
items were delivered contingent upon correct responses, and occurred in addition to the
9-trial block completed for each relation. Testing was conducted in 9-trial blocks for
each relation described above (e.g., BC, CB, CD for each set of stimuli); each participant
was exposed to a block comprised of nine testing trials, plus three to four maintenance
30
trials. In the event that a participant scored higher than chance levels during a given
pretest, a second identical pretest was administered to ensure that previous responding
was solely due to chance.
Conditional Discrimination Training
Conditional discrimination training was conducted in a manner consistent with
that described by Miguel et al. (2009). Each participant was exposed to conditional
discrimination training for one set of activities (i.e., Set CDT). Figure 1 contains a
sample procedure for conditional discrimination training. In this example, the relation
taught is selection of the picture in the presence of the dictated name (AB). The
experimenter required an observing response (e.g., eye contact, correct responding to a
simple instruction such as “Give me five”). Following the observing response, the
experimenter presented the auditory stimulus (e.g., dictated name), and presented the
three stimulus array. The participant then selected the positive comparison. Selection
was either independent or occurred following a prescribed gesture prompt.
31
Relation (AB): Selection of picture in presence of spoken name
Observing response:
Eye contact by participant or simple instruction following (e.g., “Give 5”)
Dictated name stimulus delivered by experimenter:
Puzzle
Comparison Stimulus Array:
Selection Response: Remove comparison corresponding to sample from array.
Figure 1. Sample procedure for conditional discrimination training. Relation displayed is
selection of the positive comparison picture to the sample dictated name stimulus (AB).
32
During conditional discrimination training, participants were taught to select
either the picture (B) or printed word (C) when presented with the dictated name of a
given activity or item (A). A progressive one second prompt delay procedure was used
Each training phase consisted of six steps, with each step incorporating a one second
increase in the prompt delay. In step 1, the experimenter immediately provided a gesture
prompt (i.e., pointing) to the correct comparison stimulus following the presentation of
the dictated name. In step 2, the experimenter delivered the dictated name and then
waited 1 second before delivering the gesture prompt. The delay was systematically
increased by one second per step so that for step 3, the delay was two seconds, for step 4
the delay was three seconds, and so forth. In other words, the delivery of the prescribed
prompt was systematically delayed by one second per step until no prompt was
prescribed (i.e., independent responding was expected). This increase in the time between
the presentation of the stimulus and the gesture prompt continued until step 6. In step 6,
no prompts were provided. The experimenter provided the dictated name, and then
waited five seconds. Trials for step 6 were scored based on whether the participants
selected a positive or negative comparison to the sample. If participants failed to respond
within five seconds, the trial was scored as incorrect.
The experimenter delivered social praise (e.g., “Good job” or “That’s right”)
contingent upon each prompted or unprompted correct response, or selection of correct
comparison in the presence of the sample. In addition, tokens were delivered
contingently upon responses that occurred prior to the delivery of the prescribed prompt.
These tokens were drawn on to a token board by the experimenter following each
33
positive comparison in the presence of the sample. For example, the experimenter would
quickly draw a star on a token board while providing social praise. Preferred edibles were
delivered following a specific number of unprompted responses that occurred prior to the
delivery of the prescribed prompt. If a participant gave an incorrect response, an error
correction procedure was implemented. This error correction procedure consisted of the
experimenter representing the dictated name of the stimulus and immediately prompting
(i.e., zero delay) selection of the positive comparison using a gestural prompt (i.e.,
pointing to the correct response). No participant failed to respond to the initial gesture
prompt provided in the error correction procedure.
For steps 2 through 5, a differential reinforcement procedure was implemented
following the first independent response made by each participant (Karsten & Carr,
2009). Once each participant responded correctly in the absence of prompting, only
independent responses were followed by the delivery of a secondary reinforcer. All
responses emitted following the prescribed prompt were followed by the delivery social
praise. All relations were trained using a three stimulus array. Three cards were
presented to the participant, and were positioned on each trial in such a way that each
stimulus was presented an equal number of trials (e.g., three trials per block) in each of
three positions (e.g., left middle and right). Each relation was trained in 9 trial blocks
until each participant achieved 89% (8 out of 9) or greater accuracy across two
consecutive blocks in the absence of prompting.
34
Superimposition and Fading Procedure
Stimulus fading was conducted in a manner adapted from that described by
Birkan et al (2007). Each participant was exposed to this procedure for one set of
activities (i.e., Set SF). The stimulus fading procedure was comprised of 12 steps. In the
first step, the entire picture of an item or activity was presented on a card, with the textual
label corresponding to that item superimposed over the picture. Additionally, three
items, each corresponding to one picture with superimposed text were presented to the
participant in a three stimulus array. These stimuli were positioned on each trial in such a
way that each stimulus was presented for three trials per block in each position (e.g., left,
center and right). Participants were shown the picture with superimposed text, were
required to engage in an observing response consisting of touching or removing the
picture from the stimulus board, and were provided with the instruction to “find it” or
“get it.” Participants were then required to select the item corresponding to the picture.
For step one, participants were immediately provided with a gesture prompt (e.g.,
the experimenter pointed to the correct item/activity), with 100% of the picture presented.
For step 2, the top and bottom five percent of each picture was removed (i.e., total of
10%), while the superimposed textual label remained constant. The experimenter
presented the visual stimulus and then waited one second prior to delivering the gesture
prompt. For each consecutive step, 10% of the picture was removed, and a progressive
one second delay between the delivery of the visual stimulus and the gesture prompt
occurred. Gesture prompts from the experimenter were completely faded by step 6,
during which participants were required to select the correct item or activity within five
35
seconds. For example, in step 3, 20% of the picture was removed (i.e., 80% of the picture
of the item will be visible), and a two second delay will occurred between the delivery of
the visual stimulus and the gesture prompt. In step 4, 30% of the picture was removed,
and the gesture prompt was delayed by three seconds. In step 5, 40% of the picture was
removed and a four second delay occurred between presentation of the visual stimulus
and the prompt. No prompt was delivered beginning in step 6, when 50% of the picture
was removed. For each consecutive step, an additional 10% of the picture was removed,
so that or step 7, 60% of the picture was removed, in step 8, 70% of the picture was
removed, in step 9, 80% of the picture was removed, and in step 10, 90% of the picture
was removed. This pattern continued until step 11, during which only 5% of the picture
was shown, and the textual stimulus remained constant. In step 12, no portion of the
picture corresponding to the item was visible, and no prompts were delivered. Figure 2
contains a visual display of a sample fading progression for the superimposition and
fading procedure.
36
Step 1. Full picture
Step 2. 10% picture removed
PUZZLE
PUZZLE
Step3. 20% picture removed
Step 4. 30% picture removed
PUZZLE
PUZZLE
Step 5. 40% picture removed
Step 6. 50% picture removed
PUZZLE
PUZZLE
Step 7. 60% picture removed
Step 8. 70% picture removed
PUZZLE
Step 9. 80% picture removed
PUZZLE
Step 10. 90% picture removed
PUZZLE
Step 11. 95% picture removed
PUZZLE
Step 12. 100% picture removed
PUZZLE
Figure 2. Sample superimposition and fading progression.
PUZZLE
37
For steps 6 through 12, when participants failed to respond within the five second
time period, the trial was scored as incorrect, an error correction procedure was
implemented. This procedure consisted provision of the experimenter representing the
sample stimulus and immediately providing a gesture prompt indicating the selection of
the positive comparison.
Reinforcement and error correction procedures for stimulus fading procedures
were identical to those described above for conditional discrimination training.
Additionally, responding via selection of an item in the presence of a given visual
stimulus was trained in nine trial blocks. Mastery criteria of each step were 89% on two
consecutive blocks. The criterion to return to the previous step was three consecutive
incorrect responses.
38
Chapter 3
RESULTS
Training
Schedule Following
Prior to the introduction of training procedures, participants schedule following
behavior was assessed. Larry followed a picture activity schedule and completed all steps
with an average accuracy of 97% across six separate pretests. As such, he did not
complete training of schedule following, and progressed to pretesting of textual control.
Laura and Virginia did not follow the picture schedule and were taught to complete the
required steps via graduated guidance prior to completing pretests of textual control.
Please see Figure 3 for results of picture activity schedule training for Laura (upper
panel) and Virginia (lower panel). Solid squares indicate on-task responding and open
diamonds indicate on-schedule behavior. Laura and Virginia required 13 and ten trials
(i.e., presentations of picture schedules) respectively to learn to follow a picture activity
schedule to criterion performance. Both performed at criterion levels at a two week
follow up.
39
Figure 3. Block – by – block data of acquisition of activity schedule following for Laura
and Virginia. Percentage of correct responses for both on-task and on-schedule behavior
for Laura and Virginia.
40
Training Conditions
Figure 4 contains results of training for Laura, Virginia and Larry. Solid circles
represent the percent per block of positive comparisons to the sample when participants
selected pictures in the presence of the dictated name in conditional discrimination
training (i.e., relation AB). Solid triangles indicate the percentage of positive selections of
the printed word in the presence of the dictated name (AC). Open diamonds indicate the
percent of selections of the positive comparison to the sample in the stimulus fading
procedure. Table 4 depicts the number of trials to meet criterion performance levels and
the number of errors made for each procedure.
Table 4
Trials to Criterion and Errors - Conditional Discrimination Training (CDT) and
Superimposition and Fading (SF)
Trials to Criterion
_________________________
Participant
CDT
Total Errors
_______________________
SF
CDT
SF
________________________________________________________________________
Laura
261
225
16
11
Virginia
216
243
3
9
Larry
216
603
4
75
41
Laura acquired the selection of picture in the presence of the spoken name (AB)
in 15 blocks, and acquired selection of the printed word in the presence of the spoken
name (AC) in 14 blocks of teaching using the conditional discrimination procedure. She
learned to select items in the presence of stimuli corresponding to Set SF (i.e., pictures
with superimposed written words faded to only written words) in 25 teaching blocks.
Laura completed training for both procedures within the outlined 12 steps.
Virginia acquired selection of picture in the presence of the dictated name (AB)
and selection of printed word in the presence of the spoken name (AC) in 12 blocks of
training for each relation. She required 27 blocks of teaching to achieve mastery criteria
for the stimulus fading procedure, and completed both training procedures in the above
outlined 12 steps.
Larry acquired the selection of the picture (AB) and printed word (AC) in the
presence of the spoken name in 12 blocks each. Conversely, he did not meet mastery
criteria using only stimulus fading procedures; when required to select the correct
item/activity at step 12 when only the written word was presented, Larry’s performance
decreased significantly. Per the outlined error correction procedures which moved Larry
to the previously learned step, he was returned to step 11 (5% picture shown), during
which time, he again selected the correct item or activity for at least 8 of 9 trials within
two blocks. Larry was then provided with an additional fading step, during which 2.5%
of the picture was shown with the printed word superimposed. While Larry met mastery
criteria for this step, performance again decreased below criterion levels when Larry was
42
presented with only the printed word, and was required to select the corresponding
stimulus.
An additional modification for Larry included the presentation of the 2.5%
picture, with the superimposed printed word in colored text, with each stimulus (i.e.,
printed word) printed in a different color (e.g., blue, red, black). This measure was
implemented based on the hypothesis that Larry was selecting activities/items when
viewing the small percentage of the colored picture remaining on the stimulus card. If
Larry was selecting based on picture , reinforcing selection responses in the presence of
colored text and picture, with one color assigned to each stimulus, could have facilitated
correct responding when pictures were removed and only the printed word was present.
When pictures were faded and only the colored printed word was presented however,
Larry’s performance was again observed to decrease below criterion levels. Larry had
already met performance criteria for set CDT, and continued to select stimuli
corresponding to the dictated name. As such, the stimuli corresponding to Set SF were
then taught via conditional discrimination training using stimulus fading. For example,
Larry was presented with the written word and the corresponding dictated name of the
stimulus and then required to select the positive comparison from an array of actual
items/activities. Following the introduction of this procedure, Larry achieved mastery
criteria within 81 trials (i.e., nine blocks).
43
Figure 4. Block – by – block acquisition data for Laura, Virginia and Larry. * indicate
mastery criterion achieved for given relation or teaching procedure (i.e., CDT - AB, CDT
- AC, or SF).
44
Testing
Textual Control
Figure 5 depicts performance on pre and posttests of textual control for Laura,
Virginia and Larry. These tests measured the percentage of correct schedule following
responses made in the presence of printed words. Light grey bars represent pretest scores,
while charcoal bars represent posttest scores. Exact scores for pre and posttests are
located directly above the corresponding bar. Pre and posttest percentages of correct
responding in the presence of printed words are separately indicated for stimuli trained
via both conditional discrimination training and superimposition and fading.
During pretesting, Laura did not follow a textual/printed schedule. Both training
conditions resulted in derived textual schedule following. Laura correctly completed 94%
of steps required to follow a printed schedule following stimulus fading, and 88% of
steps following conditional discrimination.
Virginia did not follow a schedule consisting of printed words during pretests of
textual control. She correctly completed 100% of steps required (i.e., referencing each
presented activity card, selecting and completing the activity corresponding to the card,
returning to the schedule, removing the activity card, and repeating the process for all
subsequent activities) to follow a schedule consisting of printed words following
superimposition and fading procedures, and also completed 93% of steps required to
follow a textual schedule following conditional discrimination training. Both Laura and
Virginia demonstrated similarly accurate scores for derived textual control following
exposure to both procedures.
45
Figure 5. Pre and posttests of textual control for Laura, Virginia and Larry. Scores are
grouped by training procedure.
46
Larry did not follow a textual/written activity schedule following during pretests
of textual control. In contrast with the similar scores of derived textual control across
training methods demonstrated by both Laura and Virginia, Larry showed a greater
percentage of correct responses on tests of textual control after exposure to conditional
discrimination training (100% correct responding across activities) than following
superimposition and fading (22% correct responding across activities).
Textual Behavior/Reading
Figure 6 contains pre and posttest scores of textual behavior (CD) for all
participants. These tests measure the percentage of correct sight word reading responses.
Light grey bars represent scores on pretest 1. Medium grey bars represent scores for
pretest 2. Pretest 2 was conducted if participants performed above chance levels during
pretest 1. No participant performed above chance levels on pretest of textual behavior.
Solid black bars represent posttest scores and dark grey bars represent posttest 2 scores
(Laura only). Scores are presented with emergent stimulus relations tests, with each
relation presented separately for each teaching procedure.
During pretests, Laura did not accurately read printed words for either set of
stimuli. Following conditional discrimination training, Laura read printed words with
100% accuracy. She did not read printed words following the superimposition and fading
procedure. During pretests of textual behavior, Virginia did not read words accurately.
Following conditional discrimination training, she accurately read printed words (CD) on
all posttest trials. Virginia accurately read printed words aloud on 67% of trials during
posttesting for stimuli taught via the superimposition and fading procedure. Larry did not
47
read words during pretests including stimuli for either Set SF or Set CDT. He reliably
read words (i.e., demonstrated textual behavior) for 89% of trials following conditional
discrimination as compared to 11% of trials following stimulus fading.
Emergent Relations Testing
Figure 6 contains pre and posttest scores of emergent stimulus relations for all
participants. These tests measured percentage of correct matches to sample for BC and
CB relations. Light grey bars represent scores on pretest 1. Medium grey bars represent
scores for pretest 2 (Larry and Virginia). Solid black bars represent posttest scores and
dark grey bars represent posttest 2 scores (Laura only). Scores for single blocks of tests of
matching picture to printed word (BC) and printed word to picture (CB). Each relation
(i.e., BC, CB) is presented separately for the corresponding training procedure.
During pretests, Laura scored between 22% and 33% on matching pictures to printed
words (BC) and matching printed words to pictures (CB) for both Set CDT and Set SF,
respectively. During posttests, Laura matched picture to printed words and printed words
to pictures with 100% accuracy following conditional discrimination training. Laura
matched pictures to printed words with 100% accuracy, and printed words to pictures
with 77% accuracy after exposure to stimulus fading.
Virginia matched pictures to printed words with 33% accuracy during pretest for
stimuli assigned to both training conditions. For stimuli taught via conditional
discrimination training, she initially showed 44% accuracy matching printed words to
pictures, but a second pretest showed only 22% accuracy, indicating that accuracy of
pretest responses was likely due to chance. Pretest scores of matching printed words to
48
pictures for set SF also indicated chance responding (i.e., 33% accuracy). Following
conditional discrimination training, Virginia matched pictures to printed words (BC) and
vice versa (CB) with 100% accuracy. Virginia’s data also show similar results for Set SF;
she matched pictures to printed words with 100% accuracy and matched printed words to
pictures with 89% during posttesting for stimuli taught via the superimposition and
fading procedure.
Larry matched pictures to printed words (BC) and printed words to pictures (CB)
with 33% accuracy during pretests of stimulus relations for stimuli trained via
superimposition and fading. For stimuli trained via conditional discrimination, he
matched pictures to printed words (BC) with 44% accuracy, and matched printed words
to pictures (CB) with 67% accuracy during the initial pretest. A second pretest of this
relation yielded scores of 33%, indicating chance responding. During the first pretest of
this relation, Larry’s first three responses corresponding to a particular position in the
stimulus array (i.e., left side) regardless of the picture placed in that location. Following
the first three responses during this test, he then allocated all subsequent pretest responses
to the middle position of the stimulus array. Following training, Larry matched pictures
to printed words (BC) and vice versa (CB) with 100% accuracy across stimuli and
training procedures.
49
Figure 6. Pre and posttest scores for measures of stimulus relations. Relations tested
include matching picture to printed word (BC), printed word to picture (CB) and reading
printed words aloud (CD), and are grouped by training procedure.
50
Chapter 4
DISCUSSION
The current study replicates and extends previous research related to establishing
textual control over responding in activity schedules. Specifically, the current study
replicated the work of Miguel et al (2009) by showing the emergence of derived textual
control, derived textual behavior and derived stimulus relations resulting from
conditional discrimination training. The findings of Birkan et al (2007) were extended to
show that superimposition and fading alone (i.e., in the absence of vocal verbal behavior
by the participant) sometimes, though not always, results in textual control through direct
training.
Laura and Virginia both followed written/textual schedules with a slightly higher
percentage of correct responses during posttests of textual control following
superimposition and fading as compared to conditional discrimination training. For
Laura, 6% more accuracy during posttests was observed for Set SF than for Set CDT.
Similarly, Virginia showed 7% greater accuracy of step completion for Set SF than for
Set CDT. Larry however, made far more correct responses during posttests following
conditional discrimination training. He responded correctly during posttests of textual
control to 78% more steps for Set CDT than for Set SF. Laura and Virginia’s results
indicate that both superimposition and fading and conditional discrimination training
resulted in derived stimulus control over responding in the context of activity schedules,
which consisted of schedule following behavior in the presence of printed words only.
51
Conversely, Larry’s results indicate that superimposition and fading did not result in
textual control over schedule following. Larry’s results indicate the superiority of
conditional discrimination training related to textual control.
In terms of trials required to meet mastery criteria and number of errors made,
Laura and Virginia’s data again demonstrate the similarity of both procedures. During
training, Laura required slightly fewer trials (i.e., four blocks less) to meet mastery
criteria during superimposition and fading procedure than during conditional
discrimination training. Conversely, Virginia required fewer trials (i.e., three blocks less)
to meet criterion for conditional discrimination training. During training, Larry required
nearly three times as many trials to meet criteria for Set SF (i.e., 67 blocks) than for Set
CDT (i.e., 24 blocks).
Emergent relations posttest performance showed that participants could match
pictures to printed words and vice versa. Conditional discrimination training produced
posttest results indicating that all stimuli belonged to an equivalence class. In addition,
posttests showed the emergence of textual behavior (i.e., reading, or relation CD) across
participants. Superimposition and fading resulted in the correct selection of printed
words in the presence of corresponding pictures (BC) across all participants. The correct
selection of pictures in the presence of printed words (CB) was also observed, though less
consistently across participants (Laura – 77%, Virginia – 89% and Larry – 100%).
Textual behavior or reading (CD), however, rarely emerged following superimposition
and fading (Laura – 0% and Larry – 11%), with the exception of Virginia, who
demonstrated some reading follow this procedure (67% correct responses). For Virginia
52
especially, these procedures were equally effective in establishing derived stimulus
relations. Following both training procedures, she correctly related pictures to printed
words and vice versa, and also read printed words, though textual behavior was
demonstrated at a lesser extent following superimposition and fading. Laura also
conditionally related pictures to printed words and printed words to pictures. She read
printed words following conditional discrimination training, but was not able to do so
following stimulus fading. Thus, conditional discrimination training produced BC, CB
and CD (i.e., reading) performances, and superimposition and fading produced BC and
CB performances, but not CD for Laura. As such, conditional discrimination training was
determined to be slightly superior in terms of producing textual behavior.
Larry’s results indicate that conditional discrimination training was far superior to
superimposition and fading, in terms of trials to criterion, number of errors, and derived
textual control. Following exposure to conditional discrimination procedures, he
conditionally related pictures to printed words and vice versa, read written words, and
followed written activity schedules. Conversely, superimposition and fading did not
result in derived textual control, and while Larry matched picture to printed words and
vice versa following this procedure, he did not read the printed words. It is possible that
Larry was able to match picture to printed words and vice versa following stimulus
fading simply due to the repeated pairings of pictorial and textual stimuli. Following
exposure to over 600 trials in which written words and pictures were paired, it is possible
that Larry was able to match pictures to printed words and vice versa solely as a result of
this extensive pairing. This would support the findings of previous research that has
53
shown that when selection of stimulus compounds (i.e., pairs) results in the formation of
a stimulus class, and components of those compounds are then recombined to form novel
compounds, participants reliably select new compounds comprised of members of the
original class (Debert, Matos & McIlvane, 2007). Larry’s results also indicate that the
formation of stimulus classes does not necessarily result in the formation of functional
classes. While his posttest results indicate that Larry matched pictures and printed words,
he did not follow a schedule comprised of printed words. When stimuli are equivalent or
are members of the same equivalence class, they are substitutable for each other within a
given context (Sidman, 1994). While stimulus equivalence can be demonstrated via
matching of pictures and printed words, these stimuli are not necessarily functionally
equivalent (Catania, 2007). Functional equivalence among stimuli indicates that each
stimulus belonging to an equivalence class will exert the same control over responding
via direct or derived means (Goldiamond, 1962). Laura and Virginia’s results support
previous research that indicates that training a particular response in the presence of one
member of an equivalence class results in the derived control over that response by
another member of the class (Wirth & Chase, 2002). Larry’s results, however, contrast
this finding. When Larry successfully matched pictures to printed words and printed
words to pictures in emergent relations posttests, he demonstrated that these stimuli were
members of the same equivalence class. He also demonstrated the functional equivalence
of the stimuli trained via conditional discrimination training when he showed textual
control of responding in activity schedule completion. He did not, however, demonstrate
textual control for stimuli for stimuli trained via superimposition and fading, even though
54
he was able to match pictures and printed words for theses stimuli. These results indicate
that even though stimuli became equivalent or members of the same equivalence class
they did not serve the same function. These results support earlier findings that suggest
that in some cases, transfer of functional control may depend on the difficulty or
complexity of the task over which functional control is to be transferred (McVeigh &
Keenan, 2009).
In the current study, participants tacted items/activities prior to training and
played in the presence of picture activity schedules following teaching of activity
schedule following. During conditional discrimination training, participants were taught
to select pictures and printed words in the presence of dictated names. Posttests
examined the emergence of textual behavior and the transformation of function of printed
words. Results showed that conditional discrimination training resulted in this transfer of
function through membership in an established equivalence class. Specifically, in the
absence of stimulus pairing, printed words evoked the same response (i.e., schedule
following) that had previously been evoked by other members (i.e., pictures) of the same
stimulus class. In superimposition and fading procedures, participants who had
previously been taught to follow schedules in the presence of pictures were trained to
select items when presented with stimuli comprised of both pictures and superimposed
printed words. Pictures were extensively paired with printed words during training, with
pictures being slowly faded. Following this pairing, two of three participants followed
textual activity schedules. Rather than indicate derived functional transfer, these results
show that repeated pairings combined with the fading of picture prompts produced
55
textual schedule following through direct training. Equivalence classes were formed via
compound stimulus training (Debert, et al, 2007); the repeated presentation of stimulus
pairs (i.e., pictures and printed words) led to matching corresponding printed words and
pictures when presented separately.
In summary, conditional discrimination training procedures established derived
textual control, textual behavior and the formation of equivalence classes across
participants. Stimulus fading procedures produced similar results in terms of stimulus
equivalence, and directly established textual control for two participants. Textual
behavior, however, was not reliably established following this procedure. The results of
the current study indicate that conditional discrimination training may be superior to
superimposition and fading procedures in terms of amount of derived relations.
Limitations
While the current study demonstrates strong experimental control, some
limitations must be considered. Firstly, while Larry eventually met criterion for the
superimposition and fading procedure, he required multiple trials and troubleshooting
measures to do so, such as an additional fading step and the use of colored text. Even
with the additional fading steps, Larry did not demonstrate criterion performance in the
absence of the dictated name of each activity/item by the experimenter. Only after Larry
was provided with the dictated name as well as the printed word of the sample stimulus
was he able to accurately select the item/activity in the absence of the picture. Since
Larry’s posttests were completed following mastery of Set SF using multiple teaching
procedures, the effects of the stimulus fading procedure cannot be separated from those
56
of conditional discrimination training. Due to the use of multiple teaching procedures, the
results of Larry’s posttests should be interpreted with caution in regards to stimuli
associated with the superimposition and fading procedure. It is possible that all derived
relations, including matching pictures to printed words, printed words to pictures and
reading printed words resulted from the brief (i.e., nine block) exposure to the dictated
name by the experimenter provided immediately prior to posttesting. As a possible
control for this in future research, if similar performances are observed, posttests of
textual control, textual behavior and emergent relations should be conducted prior to
initiating conditional discrimination training. After completion of conditional
discrimination training, a second posttest of textual control, textual behavior and
emergent relations should be conducted. This would allow researchers to observe the
effects of the superimposition and fading procedure separately from those of conditional
discrimination.
A second limitation that should be noted is the additional learning that may have
occurred in the participants’ natural environments. It is possible that additional learning,
such as sight word reading, letter recognition, activity/item naming or other skills could
have been acquired through other teaching methods. For example, Virginia attended a
mainstream preschool class and might have been exposed to some of the written words
used during the various procedures over the course of the study, which could account for
the elevated performance in posttests of textual behavior following the superimposition
and fading procedure that was observed in Virginia only. Both Laura and Larry did not
demonstrate textual behavior following this procedure, but Virginia did for 67% of trials.
57
Further limitations include both the number of steps and number of stimuli
required to complete the superimposition and fading procedure in this study. While 12
steps were developed to counterbalance the number of steps required to complete each
procedure, there were more steps than would typically occur in a clinical environment.
Each step required separate stimuli, which resulted in a larger number of stimuli required
to complete the superimposition and fading procedure. In addition, no criteria for
independence probes were implemented for either procedure. It may be possible that all
participants would have met mastery criteria more rapidly for both procedures with such
criteria in place. Anecdotally, all participants began responding correctly prior to the
prescribed prompt when prompts were delayed by only two seconds in the conditional
discrimination training. This means that independent responding was observed for at
least 8 out of 9 trials by the third prescribed step of this training procedure. It is possible,
that with criteria for independence probes in place, one procedure would have been
shown to be far superior to the other in terms of trials required to meet mastery criteria.
A final factor to consider includes each participant’s learning history.
Considerations such as each participant’s reinforcement history and experience with a
particular teaching strategy may have affected their performance in the current study
(Pipkin & Vollmer, 2009; Coon, 2010), especially for those participants who had an
extensive history with learning via methods of applied behavior analysis. For example,
the participants in the current study had varying amounts of exposure to teaching. Larry
had extensively participated in behaviorally based interventions for over 7.5 years at the
start of the study. Laura and Virginia had participated in behaviorally based interventions
58
for nearly 6.5 and less than one year, respectively, prior to the start of the study. Without
a thorough review of previous teaching methods, it is impossible to determine each
participant’s experience with a particular teaching methodology. Larry’s results in
particular suggest that extra-experimental history may have had an effect on his
performance in the current study.
Future Research
Future research will surely seek to replicate the current study. In addition, future
research should examine the effects of a prompt fading procedure more likely to be
encountered in clinical practice. The prompt fading procedure in the current study did not
include criteria for probing of independence of either teaching procedure. While this was
done intentionally to eliminate any potential confounds related to differences in
requirements to meet mastery criterion, it does not resemble independence probes
common to applied practice. Future replications of the current study might seek to probe
independence for one method (e.g., superimposition and fading) when independence is
demonstrated for the other (e.g., conditional discrimination training). Such independence
might be considered as demonstrated when participants respond correctly prior to the
prescribed prompt on a given number of trials within a nine trial block.
Additionally, future research should seek to further clarify the relationship between
stimulus and functional classes by comparing conditional discrimination training and
stimulus fading procedures in terms of established functional and stimulus equivalence
Future research should examine the transfer of control by members of equivalence
classes, in addition to the transfer of function of systematically more complex tasks (e.g.,
59
two item schedules versus five item schedules). A more detailed understanding of the
transfer of control over various types of responding would further assist practitioners in
modifying teaching methods to maximize learning and derived control as well as derived
stimulus relations.
Applied Implications
The current study has multiple implications for applied practice. Of primary
importance is the finding that, for two of three participants, both conditional
discrimination training and superimposition and fading procedures produce textual
control within activity schedules. For children with autism, use of a less intrusive, more
flexible and less potentially socially stigmatizing schedule (e.g., written schedule) is
preferred. Both procedures (i.e., CDT and SF) examined in this study can establish
following such as schedule, though performance may vary based on student’s learning
history. If a student has a strong reinforcement history with one type of procedure (e.g.,
stimulus pairing versus conditional discrimination training), practitioners would do well
to teach via methods that complement and/or capitalize on that history.
Both teaching procedures produced picture and printed word matching, though
performance differed slightly across participants and training procedures, with
conditional discrimination training indicated as slightly superior. Additionally, the
behavioral mechanism behind these matching skills varies across procedures.
Conditional discrimination training produced derived stimulus relations, while relations
shown during posttests following stimulus fading procedures were directly taught via
repeated stimulus pairings. Also, practitioners striving to establish vocal verbal
60
repertoires in their students should prioritize teaching via conditional discrimination
training, as that procedure reliably produced textual behavior (i.e., reading) while
superimposition and fading did not. As a final note, practitioners should develop
programming using teaching methods that maximize learning in the least amount of time,
with the greatest potential for resultant derived skills, while taking individual learning
and reinforcement histories into consideration.
61
APPENDIX A
Sample Data Sheets
Figure A1. Sample data sheet for activity schedule training, and pre and posttests of
textual activity schedule following (i.e., textual control).
62
Figure A2. Sample data sheet used for conditional discrimination training, and pre and
posttests of stimulus relations (BC) and (CB).
63
Figure A3. Sample data sheet used for training with superimposition and fading
procedure.
64
Figure A4. Sample data sheet used for testing of textual behavior (i.e., relation CD).
65
APPENDIX B
Modified RAISD
Modified RAISD – to be completed by parents/caregivers prior to the beginning of the
study
Preferred Items Assessment
The purpose of this survey is to obtain information about the foods that you believe
would be useful as rewards for your child.
If you have signed the consent form, please answer the following questions regarding
your child’s preferences:
1. Some children really enjoy foods like crackers, chips, pretzels, cereal, cookies, candy,
etc. What are the specific foods your child likes to eat the most?










_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
2. Please go back to the list in question number one, and place a number in each box to
rank these foods from most favorite (1) to least favorite (10).
66
3. Are there any foods that your child is allergic to? _____________________________
________________________________________________________________________
4. Are there any foods that you would prefer your child not eat during our study?
________________________________________________________________________
________________________________________________________________________
5. Some children really enjoy playing with toys like blocks, books, musical toys,
figurines, balls, puzzles, toy cars, etc. What are the specific toys your child likes to play
with?










_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
6. Please go back to the list in question number one, and place a number in each box to
rank these foods from most favorite (1) to least favorite (10).
67
APPENDIX C
Stimulus Sets for Participants
Table 5.
Stimulus Sets per Participant
Participant
Training Condition
______________________________________________________
CDT
Printed Word
Laura
Virginia
Larry
SF
Picture
Printed Word
coloring
sticker
puzzle
cutting
books
paste
machine
music
sing
stickers
drawing
puzzle
DS
toys
blocks
books
dinosaur
puzzles
Picture
68
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