Case Study

Teaching Children to Make Age-Appropriate Eye Contact While Requesting

Portia Curriculum
Domain: Communication
Skill Category: Manding
Task Code: MN-07
Task Name: Manding with Eye Contact

 

Abstract

Eye contact is essential in achieving social communication. Children with autism often demonstrate a restricted range of non-verbal behaviors (i.e. eye gaze, vocalizations, and pre-linguistic gestures) (Stone et al, 1997). Impairment in the use of eye contact for non-verbal communication has been argued as a main characteristic of autism (American Psychiatric Association, 1994).

Introduction

The Learner is a 4-year-old girl diagnosed with autism. She is currently receiving 25 hours of Intensive Behavioral Intervention (IBI) per week. Before she commenced IBI services at The Portia Learning Centre she demonstrated significant barriers within social skills and failed to make eye contact. The purpose of the intervention was to establish reciprocal gaze behavior with others.

 Design

The study was conducted using a single case AB design.

 Baseline Data Summary

The pre-intervention condition was conducted to determine how the Learner communicates her wants and needs. Baseline data was collected using The Assessment of Basic Language & Learning Skills (ABLLS-R) and Verbal Behaviour Milestones Assessment & Placement Program (VB-MAPP).  The Learner scored 13 out of a possible score of 96 on her barriers assessment. The learner’s initial assessment revealed defective social skills and failure to make eye contact as significant barriers.  Before commencing ABA therapy at The Portia Learning Centre, the Learner would request non-verbally, by gesturing or pointing to various items and activities.

Data Collection/Measurement

Baseline data was collected using the two assessment tools to determine potential absent, weak or impaired social skills as well as barriers surrounding failure to make eye contact or attend to people.

 

Method

The case study used a single case AB design. During the baseline phase the Learner failed to make age-appropriate eye contact with others as well as attend to other people. The intervention phase consisted of teaching the Learner to request with eye contact using the Portia Curriculum goal MN-07 “Mands with Eye Contact”.

The instructor therapists gathered reinforcing items and activities to help contrive motivation for the Learner request with eye contact.  While the instructor therapist is manipulating a reinforcing activity (i.e. ball run), the Learner would demonstrate motivation for a ball and would make eye contact with the instructor therapist and request “ball”. If the Learner demonstrated motivation for a toy by reaching and saying “ball” with no eye contact the instructor therapist would withhold access to the ball until the Learner made eye contact.  Once the Learner was successful in making frequent eye contact while requesting the Learner would then begin to work on requesting with sustained eye contact (2 seconds).

 

Results

Figure 1.  Percentage of Requests with Eye Contact

 

 

Figure 2.  Percentage of Requests with Sustained Eye Contact (2 seconds)

 

The percentage of requests with eye contact is shown in Figure 1.  During the first month of the intervention the Learner was successful 50% of the time when requesting with eye contact. Throughout the first three months of the intervention the percentage of the Learner’s requests with eye contact demonstrates a gradual increase. After approximately three months of the intervention the Learner was consistently making eye contact while requesting, which is represented by an upward trend. The percentage of requests with sustained eye contact is shown in Figure 2. During the second phase of the intervention the Learner was making age-appropriate eye contact just below the mastery criterion. As you can see, the Learner was sustaining eye contact at a steady, increasing trend.

 

Discussion

The results indicate that the intervention was successful in teaching a child with autism to make age-appropriate eye contact with others. It was hypothesized that children with autism show deviant patterns of non-verbal communication and reciprocal gaze behaviour with others. The instructor therapists were successful in establishing reciprocal gaze behaviour with others using social and motivational variables. Withholding motivating and potent items/activities is crucial when teaching a child with autism reciprocal eye gaze behaviour. The subject was able to maintain social behaviour with others and is presently requesting using 4-5 words with eye contact.

References 

Stone, W., Ousley, O., Yoder, P., Hogan, K., & Hepburn,S. (1997). Nonverbal Communication in Two and Three Year Old Children with Autism. Journal of Autism and Developmental Disorders, 27, 677-696

 Author

Whitney Crate and Margherita Curcio 

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