By definition, autism is a developmental disorder which sets in during the early days of an infant and remains for the rest of their life causing a child to have unique features from normally developing children such as retarded socialization, delayed milestones in cognition and communication, selective eating habits and sometimes frequent illnesses such as constipation. Children with these characteristics are popularly referred to as autistic children, and they often experience difficulties in developing functional skills to enhance independence as well as challenges in relating with their peers. It is critical to conduct assessments for social plus adaptive behaviors, so that appropriate diagnosis and formulation of interventions are offered to this population. In this context, adaptive behavior includes social, practical as well as conceptual skills necessary to actualize daily functions. Due to such limitations, autistic children require more systematic training for them to gain dependence in carrying out basic survival activities like dressing, feeding, and sewing.
Functional skills can be defined as practical, and helpful skills that are taught to autistic children so that they can be beneficial in various life situations. The success of teaching these skills on autistic children varies from child-to-child depending on their symptoms and deficiencies while normally developing children learn the same skills readily from their immediate environment and might not need further training. When individuals have self-care skills, which include functional skills, their dependency on caregivers and other people is minimal. Training children with autism basic self-care skills are crucial because they are key, they are applied to daily routines, enhance self-esteem and positive attitude, and most importantly, these abilities improve the quality of life. Among the self-care skills that should be taught to autistic children include dressing, cooking simple foods, and cleaning up. The goals of training functional skills should be relevant to the child’s environment, cognitive ability, family values and the child’s age. Of importance to note is that the needs of all autistic children are not uniform and hence even their pace of learning a functional skill is dependent on personal characteristics.
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With the understanding of the needs of autistic children, the approaches used to teach them the necessary skills should be effective in realizing the set goals. The importance of incorporating behavioral teaching objectives with continuing and routine activities of preschool children is acknowledged by specialists in special education in early childhood. Embedded instruction approaches describe the integration of behavioral learning objectives into routine and ongoing activities of learners resulting in enhanced learner learning, engagement as well as increased independency in daily routines or activities and transitions. These results are realized when activities carried out with the inclusion of instructional procedures intended to teach priority skills are implemented during naturally-occurring events, transitions or routines in the classroom. Applying this approach means that children do not practice the skills learned in isolation, but in a coexisting and successive manner within ordinary settings.
Recent research on the application of embedded instruction to train functional skills to a kindergarten child with autism aimed at examining the effectiveness of the embedded approach in training three skills to an autistic preschool child. The method of multiple probing was used to assess the impact of embedded instruction on acquiring skills and retaining them. The participant of the study showed typical features of autism such as minimal verbal communication and minimal interaction with classmates. Also, he followed a picture schedule and only followed simple instructions. At the commencement of the study, three target behaviors were identified so that they would be assessed afterward for any improvements. The key criterion for selecting the targets is that they could be included in the daily classroom activities of the participants. Consideration of the fit between the target behavior and activities, routines or transitions were made to ensure relevance and effectiveness. The target behaviors were enabling the child to express their needs by use of a graphical symbol, helping the child feed using a spoon and the child being able to remove his coat and hanging it on the cubby. The target behaviors are common activities that the child was involved in continually in the classroom. The instructor maintained close proximity to the child during activities or periods that the target behavior was expected to be implemented to remind the participant of the expected behavior.
The results of this study demonstrated that the child learned the targeted behaviors and also maintained them during subsequent sessions for data collection. The variations in behavior change were however slight at the beginning of the study and increased as time progressed. Teachers who observed the participant in class noted that the method of intervention used was appropriate, beneficial to the participant and easy to use too. Teachers also reiterated their willingness to implement the embedded approach with other children but after some training.
The study by Rakap & Balikci, (2017) is however limited in some ways. First is the use of one number of the participant which limits the effectiveness of the study and applicability of the results because other children or group interventions may not portray similar effectiveness. It is necessary to conduct similar studies with broader variations in children and settings to enable generalization of the findings. Besides, implementation of embedded instruction was by a researcher within classrooms meant for autistic children. As much as the possible natural environment was maintained, the presence of the researcher is likely to have caused an influence on the child introducing biases in the study (Rakap & Balikci, 2017).
Another method of teaching functional skills is most-to-least prompting which is described as an introduction of education using prompts that enable the learner to provide the right responses while gradually reducing the prompts until when they are not used anymore. In this approach, prompts are classified from the one that needs the most control over the individual’s behavior to the one with less control. A study conducted by Çetrez-Iscan, Nurçin & Fazlioglu (2016) explored the effect of most-to-least prompting approach on dressing abilities of autistic students. After sessions of training on skills acquisition and follow-up for sustainability, the findings showed that the most-to-least model was effective in teaching functional skills to autistic children. Furthermore, the students retained the learned skills after being taught, and the skills could also be generalized to other populations and settings. Still, this study was limited by the number of participants because they were only three (Çetrez-Iscan, Nurçin, & Fazlioglu, 2016).
In yet another research by Aykut, (2012), the efficiency and effectiveness of most-to-least Prompt Procedure and Constant-Time Delay in teaching daily skills were compared. Constant-Time Delay involves regularly timed delays before giving a prompt to learners. The trainer increases waiting time between instructions and prompts to offer students time to respond. There is usually no delay during the beginning of training but over the training session, the delay period increases. In the study, students were required to learn skills in cooking soup and sewing and hence experimental research design was applied in collecting data. Different training sessions were conducted, one on constant-time-delay and the other on most-to-least, followed by maintenance sessions and generalization sessions.
Significant improvement in behaviors was clear from both procedures although no outright variations in effectiveness were realized between one procedure and another (Aykut, 2012). However, Most-to-least prompts proved to be more efficient compared to constant-time-delay when considering the number of instructional trials used for the objective to be achieved. On the other hand, Aykut, (2012) found that most-to-least had comparatively fewer mistakes than constant-time-delay until the objective was met. The retention of skills was also equal to both methods of teaching.
Autistic children have needs and want just like other children, but they have limited abilities to achieve their needs. This calls for training in functional skills that will aid them to socialize and carry out other survival activities. Training can include one method such as Constant-Time Delay, Most-to-least or an embedded approach which mostly incorporates the other two methods. Whichever the method used, key components of training functional skills need to include; initial training for skills acquisition, maintenance, and generalization. The studies reviewed in this paper illustrate the various applications of the methods of training autistic children with functional skills and their comparison. Further, social validation results from classroom teachers and other observers showed that all the methods produced positive results that would benefit the participants. However, more studies can be carried out to improve on the existing ones and also overcome some of the common limitations such as few participants that make it harder to generalize findings.
References
Aykut, C. (2012). Effectiveness and Efficiency of Constant-Time Delay and Most-to-Least Prompt Procedures in Teaching Daily Living Skills to Children with Intellectual Disabilities. Educational Sciences: Theory and Practice , 12 (1), 366-373.
Çetrez-Iscan, G., Nurçin, E., & Fazlioglu, Y. (2016). Effect of Most-to-Least Prompting Procedure on Dressing Skill of Students with Autism. Educational Research and Reviews , 11 (18), 1766-1774.
Rakap, S., & Balikci, S. (2017). Using embedded instruction to teach functional skills to a preschool child with autism. International Journal of Developmental Disabilities , 63 (1), 17-26.
