Content area
Purpose
This paper is a commentary that aims to address themes arising from the paper by Vascelli and Iacomini (2024); including compassionate teaching, barriers to component teaching and interdisciplinary working.
Design/methodology/approach
This opinion piece explores broader considerations of this research, such as the importance of efficient and effective teaching, social validity and the value of interdisciplinary collaboration.
Findings
This commentary discusses areas to consider the importance of identifying effective reinforcing consequences to maximise effective teaching and considerations for ensuring that the skills are embedded into everyday life, alongside discussion on some of the barriers around teaching discrete and component skills in isolation.
Originality/value
This commentary discusses how vital it is to involve caregivers, analyse caregiver contingencies and assess social validity to remain focused on teaching applied, socially significant skills.
Research has shown that the acquisition of functional life skills, including daily living and self-care skills as well as household tasks, by individuals with learning disabilities is a positive predictor of community involvement, employment and independent living (Carter et al., 2011; Harr et al., 2011; Test et al., 2009). Teaching individuals with learning disabilities functional skills, which are composed of complex chains of behaviour, remains a significant challenge for carers and practitioners alike. The breaking down of functional composite skills into their component skills is a critical part of being able to programme for individuals with intellectual disabilities. It is crucial to ensure the practitioner performs the level of task analysis correctly and to identify the steps where dysfluencies can be found. The task analysis within the paper by Vascelli and Iacomini (2024; this issue) found the specific motor skill of reaching behind to locate the sleeve opening, which was the source of dysfluency in the participant’s ability to complete the full composite skill. Precision teaching (PT) has led the way in thinking about component motor skills, for example, with its work on the Big 6+6 (Twarek et al., 2010) and the positive impact that training these component motor skills can have on composite functional skills (Vascelli et al., 2020). These seemingly subtle skills, which so many people take for granted, are the foundation of all functional skills but are so often not specifically targeted with individuals with learning disabilities in the UK. The ability to identify the very specific motor skill dysfluency and then target that motor skill dysfluency presents an opportunity for efficient and effective teaching, particularly when papers such as Twarek et al. (2010), Vascelli et al. (2020) and now the paper by Vascelli and Iacomini (2024; this issue) have shown that teaching these skills in isolation has a beneficial effect on the composite functional skills.
Many individuals with learning disabilities can require a significant number of learning opportunities to master a single new behaviour. Using PT to offer frequent learning opportunities facilitates the progression of dysfluent skills to fluent levels by allowing for numerous repetitions (Lindsley, 1990). This approach accelerates the acquisition of these skills over potentially shorter periods compared to more naturalistic and opportunistic teaching methods. A case in point is the way Vascelli and Iacomini (2024) arranged instruction in a way that allowed their participant to engage in 20 learning repetitions in a PT session every day rather than only providing the participant with one learning opportunity per day when putting their jacket on. Therefore, this repetitive practice can be a very efficient form of teaching, leading to functional gains in a shorter period.
Creating an activity where the learner only practises the dysfluent movement is also compassionate for the individual. Specifically, putting a jacket on may be a discriminative stimulus for going out, which may be a preferred activity. Therefore, practising putting on their jacket repeatedly to increase learning opportunities could lead to issues if the reinforcing consequence (such as going outside) is not consistently provided. This inconsistency may be confusing for the individual and could potentially lead to a negative educational experience. Practising the entire sequence of putting on a jacket to improve specific behaviours requires significantly more effort, as it involves completing all the steps leading up to the target step that needs to be learned. Instead, focusing on the difficult component skill in isolation reduces the effort needed and increases the number of trials for the target skill. This approach leads to faster acquisition of the skill and, consequently, greater independence.
The ability to find a similar activity to the target component motor skill must be done very carefully, and this brings into question the need for interdisciplinary work. Professionals such as physiotherapists, occupational therapists and speech and language therapists thoroughly understand muscles and motor movements relevant to their expertise. This is very important, as, for example, there may be other prerequisite motor movements that need to be learned that carers and other professionals, such as special education teachers or behaviour analysts, may need to be made aware of. However, access to interdisciplinary teamwork is often challenging and infrequent in the UK. The shortage of relevant professionals, combined with isolated working conditions and difficulties in obtaining appropriate referrals, creates barriers to benefiting from the expertise of other professionals.
Interdisciplinary work can also present other challenges, such as differences in ideologies and terminology. Moreover, professionals with behavioural backgrounds often have limited opportunities to enhance their skills in collaborating with other professionals (Slim and Reuter-Yuill, 2021). For instance, reinforcement can be a controversial issue for some professionals. Reinforcement, defined as a consequence following a behaviour that increases its future frequency (Cooper et al., 2020), and its connection to skill learning is still poorly understood and rarely prioritised in teaching practices within the UK for professionals working with individuals with learning disabilities. The paper by Vascelli and Iacomini (2024) discussed using praise and a preferred activity following the PT session. However, praise should not automatically be considered a reinforcing consequence without being regularly assessed for reinforcing effectiveness. Some studies have shown that stimuli can vary in reinforcing effectiveness over time, with social stimuli potentially being less consistent in their impact (Butler and Graff, 2021). I have worked with individuals where, through careful analysis, we discovered that praise was not a reinforcer and, in rare cases, actually had the opposite effect on some of them. Therefore, the assumption that praise is a consequence that will have reinforcing effects could lead to less-than-optimal outcomes for individuals with learning disabilities.
With highly structured teaching scenarios using extrinsic consequences, the question of social validity has to be raised. Discrete Trial Teaching (DTT), which incorporates highly structured teaching contingencies, has been criticised widely for being too structured and lacking social validity for carers (Koegel and Koegel, 2006). There are many similarities between DTT and PT that use frequency-building activities, such as the mass practice of the skill away from the naturalistic setting, so it is wise to take heed of the criticisms and investigate how they can be addressed. This paper aimed to improve the composite behaviour by practising a component skill that, at first glance, may appear unrelated and non-functional to some unfamiliar with the end goal and the benefits of reaching fluency (Binder, 1996). In other disciplines, teaching skills through non-functional activities has been frowned upon. For example, within the speech and language therapy profession, controversy has surrounded the use of non-speech oral motor treatments, which aim to improve the control of individual oral motor movements through exercises to impact speech production (Ruscello, 2008).
Linking the specific underlying skill to the functional, composite skill is vital to get the caregiver or teaching assistant’s buy-in. The people delivering the interventions require explanation and understanding to see the relevance of the skills targeted, to increase fidelity with teaching procedures and to ensure that they can see that working on this skill will lead to functional gains for their student. Ensuring the connection between the movement targeted and the end goal is important; many people take these component movements for granted and, without explicit instruction, may not see the connection.
The aim of the paper by Vascelli and Iacomini (2024) is for the participant to be able to demonstrate a functional skill, and therefore, we must look at how this skill will generalise to the naturalistic setting. The paper used an environmental modification of placing the jacket in a different place in a particular position. The analysis of the caregiver contingencies is essential when considering the addition of environmental adaptations. The initial measurements conducted in this study were with Paul putting on the jacket from a coat hanger. However, the authors do not detail whether this is the usual location of the jacket within the family home. If this is the usual location, the environmental adaptation used in this study would result in parents always having to relocate the jacket from the coat hanger and position it correctly every time for Paul to be able to put the jacket on correctly. The response effort required to set this environmental modification may lead to caregivers still putting the jacket on for Paul straight from the coat hanger. The need for these environmental modifications must be carefully considered, and the caregiver contingencies must be analysed to ensure the skills taught will be functional within the naturalistic setting. Otherwise, we risk skills not being used and not encountering the natural reinforcement contingencies within the environment. Involving caregivers, analysing caregiver contingencies and assessing social validity is vital to ensuring we adapt our interventions to remain focused on teaching applied, socially significant skills.
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