CHAPTER II

REVIEW OF RELATED LITERATURE AND STUDIES

To determine the level of effectiveness of using Instructional Video Material in

improving the self-help skills of selected autistic children, the researchers present the

following related literatures and studies from books, and journals. In addition, there are

also related foreign and local publications and unpublished thesis cited in this chapter to

further support the effectiveness of its use.

Related Literature

Leo Kanner, a Boston physician, first used the word ‘Autism’ in 1943 when he

reported on a group of children with deficits in social communication. He was the first to

desire autistic children as having the ability to relate themselves in an ordinary way to

people situations from the beginning of life. (Chowdhury, 2009)

It is a complex developmental disability that typically appears during the first three

years of life and is the result of a neurological disorder that affects the normal functioning

of the brain, impacting development in the areas of social interaction and communication

skills. They typically show difficulties in verbal and nonverbal communication, social

interactions, and leisure or play activities. It is one of the five disorders that fall under the

umbrella of PDD. (Wagner, 2010)

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Although symptoms and severity can vary widely, parents often first notice

delays in language development or in the child’s ability to relate to others or engage in

social interaction. They actually avoid close physical contact such as hugging or

cuddling, preferring solitary behavior or being left alone rather than engaging in

explorative behaviors or other social interaction. Also, they often lack the ability to

engage in spontaneous or imaginative play, and may show strong attachment to inanimate

objects rather than people. Rituals and the insistence on sameness or resistance to change

are common in individuals with autistic disorder. Changes in their environment or routine

may be very difficult. (O’Brien, et al., 2008)

One symptom of autism is the significantly different way a child with autism

develops. Children without special needs develop at a relatively even pace across all of

the many areas of development. A child's skills at a given age may be slightly ahead of or

behind most other children's and still be well within normal limits. Their rate of

development is quite different, particularly in communication, social, and cognitive skills.

In contrast, motor development--the ability to walk, hop, climb stairs, and manipulate

small objects with the fingers--may be relatively normal or only slightly delayed.

(http://featofnc.moonfruit.com/#/about-autism/4525484337)

The primary goals of treatment are to maximize the child's ultimate functional

independence and quality of life by minimizing the core ASD features, facilitating

development and learning, promoting socialization, reducing maladaptive behaviors, and

educating and supporting families. Optimization of health care is likely to have a positive

effect on repetitive progress, functional outcome, and quality of life. (Meyers, 2007)
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The treatment for autism is a combination of early intervention, special education,

family support, and in some cases, medication to help some autistic children lead more

normal lives. They are taught to maintain a regular, predictable daily routine, with

consistent times for waking up, dressing, personal grooming, personal hygiene and going

to bed. (Frisch, 2006)

Learning about self-care is really about empowering. To empower means to

enable self and others to reach their greatest potential for health and well-being. With

empowerment comes a feeling of well-being and effectiveness. (Zerwekh & Claborn,

2011)

Learning self-help skills can be challenging for people with autism, but is

essential for independence. With an encouraging tone, behavior analysts and

psychologists emphasize that it's worthwhile to devote the extra time and effort now to

teach skills rather than have your child be dependent on others. (Anderson, et al., 2008)

Learning self help or life skills for children with autism calls for parental

involvement which is vital for the success of acquiring new skills. As soon as the child is

diagnosed with autism, self help or life skills instruction should begin. Because of the

range and combination of behaviors which may be present in a child with autism, no

single approach is effective with all individuals who have the disorder. Because of poor

fine motor skills, some of the most basic self-help and life skills are difficult for children

to master. Parents must initiate self help skills because it is unlikely the child will dress

independently or button their coat in anticipation of the praise.

(www.brighttots.com/Autism/Self_help_skills)
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Occupational therapy is often provided to promote development of self-care skills

(e.g., dressing, manipulating fasteners, using utensils, personal hygiene). Occupational

therapists also assist in promoting development of play skills, modifying classroom

materials and routines to improve attention and organization, and providing prevocational

training. (Wagner, 2010)

In terms of personal hygiene, the process may take longer and parents may have

to give daily specific instructions of how to keep skin and hair clean. Many autistic

children have problems with fine motor control and need assistance with brushing their

teeth and washing their hair. With effort, perseverance and patience, most autistic

children can master the life skills of personal grooming, personal hygiene and toilet

training. (Roome, 2010)

According to an article by Evans (2005), autistic children tend to be visual

learners. Therefore, a visual structure to the overall learning environment should be

carefully designed in order to allow the child to clearly see and comprehend expectations

of him or her. This should include clearly defined workstations and other basic elements

of the classroom. Visual schedules are also an important part of the classroom's visual

structure, as they allow the autistic child to benefit from a predictable routine where the

expectations are laid out specifically in a visual way. This minimizes unexpected

occurrences and allows students to anticipate and prepare for transitions in their day.

The use of instructional video material is a teaching method used to promote

desired behavior and interactions. It is also very useful when the student has mastered

individual skills but does not know how to combine them. Its basic concept is learning

through observation. One of its benefits is that a student can learn without actually being
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in the various situations. It is an effective visual strategy for teaching behaviors or skills

to students with autism. Peers, adults, or the learners themselves can serve as models on

the video. (Texas State-wide Leadership for Autism, 2010)

According to Field (2009), video modeling holds much potential as an evidence-

based intervention that promotes that acquisition, maintenance, and generalization of a

variety of skills and behaviors in students with ASD. It is a promising strategy from

which many different individuals with ASD have been demonstrated to achieve

substantial benefit, and it should be readily considered in the school environment.

Video modeling is a promising behavioral intervention that has myriad

applications for students with ASD. It uses visual cues, an effective strategy for

instructing students with ASD, who are often visual learners, and modeling, an evidence-

based strategy that is effective across ages and populations. Research has demonstrated

that video modeling can be a valuable tool for instructing children with ASD in a variety

of skills, and that once a skill is learned through this process, it is maintained over time

and generalized across settings. Recent research qualifies video modeling as an

evidence-based intervention, which has implications for its use with students with ASD

in the school setting (Bellini & Akullian, 2007).

Related Studies

A study on “Language and Learning Skills and Symptoms in Children with

Autistic Spectrum Disorders” by Gupta, et al. (2008) stated that although a number of

efficient standardized skill assessments are available for children with autism, these
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assessments typically do not generate information that is precise enough to identify

specific behaviors to teach. Educational research has increasingly focused on the value of

matching instructional strategies to the student's current skill level.

According to Balasbas, et al. (2005) in their study on the “Learning Abilities of

Selected Children with Autism and Behavior Modification Techniques Employed by

Parents and Teachers”, commonly used behavior modification are positive reinforcement,

shaping, molding, over-stimulation / over-correction and pushing through. These

employed at different combinations to stimulate the child’s interest and learning abilities.

They have concluded that there is a significant difference in the behavior modification

techniques used by parents and teachers.

In the “Autism Literature Review” conducted by the National Center for Autism

Studies for the Literature Review of Autism by Dunlop, et al. (2005), the following key

findings were derived: autism endorses the need to intervene early, consistently and in an

informed way with a pronounced focus on the generalization of skills into understanding

from the outset. All children should have access to appropriate support from the time of

parents’ first concerns.

The study of Callahan, et al. (2009) entitled the “Use of instructional video

material as an intervention for teaching skills to children with ASD gaining increased

momentum in applied settings” concluded that video instruction, comprised of video

modeling, video self-modeling, and point-of-view video, has been utilized in various

fields of study with various populations and target behaviors. Literature on the use of

instructional video material were reviewed to determine its effects on the acquisition and
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generalization of social and communication skills for students with ASD to determine

whether empirical findings support instructional video material as an evidence-based

practice.

McCoy and Hermansen (2007) in their study, “Video modeling for individuals

with autism: A review of model types and effects”, explored the relative efficacy of

different types of Video Models, and found out that all types of models are effective, but

some are more effective than others. Self and peer models appear to have the greatest

effectiveness in video modeling for students with ASD.

In addition, Charlop-Christy, et al., (2000) found out that video modeling is

more effective than in vivo modeling for children with ASD. They planned both video

and in vivo modeling interventions for five children ages 7-11 with ASD with varying

degrees of severity and compared the results. In four out of five children, video modeling

facilitated faster acquisition of skills. As taken from their study, “A comparison of video

modeling with in vivo modeling for teaching children with autism”.

Buggey (2007) suggests in his study. “Video self-modeling applications at school

and at home” that Video Self-Modeling (VSM) in particular is effective because the

individual’s central role in the video sequence builds confidence and is highly

motivating. It also supposes that video modeling may improve motivation, proposing that

the method itself is intrinsically reinforcing to some children with ASD.

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Synthesis

A number of the literature and studies presented supported the effectiveness of

Video Modeling and the use of Instructional Video Material in improving certain skills

among children with ASD. This claim is largely based on the fact that children with

autism are visual learners and that it is also caused by reinforcement from modeling.

According to most theories, children with ASD are conditioned to follow things they see

and observe. Eventually, they absorb the idea, turn it into a personal habit and that habit

would end up being a routine.

On the other hand, the study differed from the stated literature and studies given

the restrictions that were considered for the study. In comparison with this particular

study, studies have shown that researches were done over long periods of time as

opposed to the limited time allotment for this study, some would last months, others

spanning years. Also, in this regard, the number of respondents was fairly limited and

intentionally kept small to have management over that population whereas previous

studies have considered larger numbers of respondents for the purpose of acquiring

widened bases for interpretation of findings. Finally, the study chose to limit itself on the

aspects of Hygiene, Dressing and Grooming and Feeding, whereas other studies explored

several aspects of the respondents including cognitive, motor, social, speech and

language skills.