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Priming as a Method of Coordinating Educational Services for Students With Autism

American Speech-Language-Hearing Association
Language, Speech, and Hearing Services in Schools
Authors:

Abstract and Figures

Purpose: The importance of coordination of educational services has been well documented in the literature. For students with disabilities, coordinated programs result in more rapid acquisition of targeted behaviors and the increased likelihood of long-term maintenance of gains. The purpose of this study was to assess whether "priming" or exposing students with autism and disruptive behaviors to school assignments before their presentation in class would affect academic performance and problem behaviors. Method: Two students diagnosed with autism who attended general education classrooms, both of whom exhibited numerous disruptive behaviors and low academic performance, participated in this study. A repeated reversals design was used to monitor student progress. Results: The results demonstrated decreases in problem behavior and increases in academic responding when priming sessions occurred. Clinical Implications: Application is discussed in terms of a mechanism for speech-language pathologists to assist classroom teachers with a systematic educational coordination plan that can quickly produce improved school performance.
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Clinical Forum
228 LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS • Vol. 34 • 228–235 • July 2003 © American Speech-Language-Hearing Association
0161–1461/03/3403–0228
LSHSS
W
ABSTRACT: Purpose: The importance of coordination of
educational services has been well documented in the
literature. For students with disabilities, coordinated pro-
grams result in more rapid acquisition of targeted behaviors
and the increased likelihood of long-term maintenance of
gains. The purpose of this study was to assess whether
“priming” or exposing students with autism and disruptive
behaviors to school assignments before their presentation in
class would affect academic performance and problem
behaviors.
Method: Two students diagnosed with autism who attended
general education classrooms, both of whom exhibited
numerous disruptive behaviors and low academic
ithout systematic specialized intervention,
students who are diagnosed as having
autism often exhibit disruptive behaviors
Priming as a Method of Coordinating
Educational Services for Students
With Autism
Lynn Kern Koegel
Robert L. Koegel
William Frea
Israel Green-Hopkins
University of California, Santa Barbara
and may have concomitant difficulties with academic
performance in inclusive and mainstreamed settings. A
number of researchers have focused on antecedent influ-
ences (prior events that influence behavior) and the
manipulation of antecedent variables to reduce problem
behavior and increase appropriate responding. For example,
numerous studies have employed functional assessments to
identify functional relationships between problem behaviors
and antecedent variables in the environment (Dunlap,
Foster-Johnson, Clarke, Kern, & Childs, 1995; Dunlap,
White, Vera, Wilson, & Panacek, 1996; Koegel & Koegel,
1995; Koegel, Koegel, & Dunlap, 1996; Lee, Sugai, &
Horner, 1999). The literature suggests that functional
assessment procedures are effective in identifying those
factors that produce and maintain problem behavior (Lee et
al., 1999).
Presently, the use of antecedent manipulation by
educators and families is not as common as might be
expected considering the amount of research demonstrating
the effectiveness of such procedures (Luiselli & Cameron,
1998). In addition to antecedents that occur just before the
problem behavior, research also shows that antecedents may
occur before the school day and provide a context for
behavior problems during the school day. That is, current
studies show that when a student is having academic
performance, participated in this study. A repeated reversals
design was used to monitor student progress.
Results: The results demonstrated decreases in problem
behavior and increases in academic responding when
priming sessions occurred.
Clinical Implications: Application is discussed in terms of a
mechanism for speech-language pathologists to assist
classroom teachers with a systematic educational coordina-
tion plan that can quickly produce improved school
performance.
KEY WORDS: autism, homework, disruptive behavior,
academic responding, listening comprehension
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Koegel et al.: Home–School Coordination 229
difficulties and/or behavior problems at school, both
teachers and parents are consistent in reporting that
deficiencies in coordination and communication across
environments are present (Epstein, Munk, Bursuck,
Polloway, & Jayanthi, 1999; Epstein et al., 1997). There-
fore, the literature suggests the importance of coordination
of services that focuses on providing consistent programs
and setting events that may produce subsequent improve-
ments in behavior and academic achievement at school.
One area of particular interest to educators and families
is homework and other educational services outside of the
student’s classroom setting. These outside-of-classroom
activities can be implemented either by the parent or by a
special education service provider such as a speech-
language pathologist. Previous studies concerning the
effectiveness of academic activities implemented outside of
the classroom setting have produced contradictory results.
This may be due to the fact that most of the measures were
self-reports and were difficult to interpret. However, there
does appear to be a correlation between the amount of time
a student engages in academic activities outside of the
classroom and academic achievement.
For students with disabilities, numerous factors contrib-
ute to the ability to perform and complete work accurately
outside of the classroom setting. For example, Salend and
Gajria (1995) suggested guidelines designed to improve
homework completion among students with learning
disabilities. They emphasized the importance of parent
involvement, an area that has been researched extensively
in terms of its effects on homework completion and
accuracy. Furthermore, Callahan, Rademacher, and Hildreth
(1998) found that parent involvement in implementing a
specific homework plan (such as a home-based self-
management strategy) for at-risk students significantly
increased the students’ homework completion and home-
work quality. In addition, reviews of research on parent
involvement in homework found that parent involvement
enhanced academic achievement of students with disabili-
ties and helped them develop positive attitudes toward
homework that directly influence achievement (Hoover-
Dempsey, Battiato, Walker, Reed, DeJong, & Jones, 2001).
Thus, for children with disabilities, the literature empha-
sizes the importance of parental involvement.
Although there has been an increase in the research on
homework practices of students with learning disabilities, it
has been asserted that much of the research does not
suggest specific intervention techniques concerning the
specific types of parent involvement that may produce more
effective outcomes (Callahan et al., 1998). Therefore, there
continues to be a need for effective strategies to increase
homework completion and accuracy to promote academic
responding and academic success. Furthermore, Hoover-
Dempsey et al. (2001) pointed out that, most importantly,
empirical research investigating the nature and processes of
interventions using parent involvement needs to be con-
ducted to strengthen the evidence concerning homework
practices. An additional problem that speech-language
pathologists and other special educators may face is that a
subgroup of parents are unable or unwilling to participate
in coordinated educational efforts.
Another gradual change in education is that students
with autism are increasingly being included or main-
streamed into regular education classes and are expected to
engage in the same activities as their typically developing
classmates. However, they often exhibit a wide variety of
problem behaviors in the classroom, causing disruptions to
general education classes as well as having severe conse-
quences on their academic progress (cf., Callahan &
Rademacher, 1999). Analyses of problem behavior in the
classroom have shown that many are associated with
curricular and instructional variables (Dunlap et al., 1996).
For example, a number of researchers have discussed the
functional relationships between the difficulty of tasks and
the display of problem behavior in individuals with
disabilities (Derby et al., 1992; Iwata et al., 1994; Lee et
al., 1999). Further, effective academic interventions and
manipulations such as student choice, meaningful outcomes,
shorter assignments, and so on can have a direct effect on
lowering problem behaviors (Dunlap & Kern, 1993; Koegel
et al., 1996; Lee et al., 1999). However, in mainstream and
inclusive settings, regular education teachers may not
readily incorporate these types of strategies.
PURPOSE
Accumulating research is demonstrating a clear associa-
tion between problem behaviors and academic performance
(Epstein et al., 1997; Koegel, Koegel, & Surratt, 1992). In
addition to problem behavior, students with disabilities have
difficulties sustaining motivation, practicing effective study
skills, and allocating and maintaining attention (Gajria &
Salend, 1995). Therefore, there is a significant need to
develop intervention techniques that attempt to solve the
problem of disruptive behavior, as well as the inefficiency
exhibited by students with disabilities during academic
activities. Researchers have suggested structuring the
academic activities outside of the classroom, including
recruiting parental involvement and consistent teacher
feedback to improve academic performance (Salend &
Gajria, 1995). Thus, the purpose of the present study was
to assess the effects of a program involving previewing or
“priming” classroom assignments either at home or during
special education services before they were presented in
class on academic responding and problem behavior.
METHOD
Participants
Two students, both of whom were diagnosed with
autism, participated in this study. The students were
selected because, according to school personnel, they
demonstrated problem behaviors in their regular education
classroom settings that were interfering with the teacher’s
ability to conduct a lesson, and they were at risk for a
more restrictive placement. All data were collected in
regular education settings where problem behavior was
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230 LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS Vol. 34 • 228–235 • July 2003
reported to occur. Individual student characteristics are
described below.
Student 1. Student 1 was aged 5;6 (years;months) at the
start of the study. He participated in full inclusion pre-
school and kindergarten classrooms with special education
speech and language services. Because of his numerous and
interfering problem behaviors, standardized testing was
difficult and test results were variable. Although his
communication was delayed, language samples demon-
strated that he was able to combine words to make
syntactically correct short sentences. He scored at the 18th
percentile on the Peabody Picture Vocabulary Test (Dunn &
Dunn, 1981). His global scale percentiles on the Kaufman
Assessment Battery for Children (Kaufman & Kaufman,
1983) ranged between the 5th and 11th percentiles.
However, cognitive areas on the Learning Accomplishment
Profile (LAP, 1992) were 2–20 months below his age level.
On the Leiter International Performance Scale (Leiter &
Arthur, 1982), his nonverbal IQ was 4 months below his
chronological age.
Student 1 also demonstrated a number of pragmatically
inappropriate behaviors that were being targeted by his
speech-language pathologist as well as by the child’s
individualized education plan (IEP) team. These included
screaming words out of context (i.e., refrigerator,
ChuckECheese, cheeseburger), laughing out of context,
lying and rolling on the floor, knocking papers off his desk
or work area, and running out of the classroom. These
behaviors occurred at a rate of approximately two per
minute throughout the day. At home, he exhibited regular
aggression toward his infant sibling, but no aggression was
observed at school. Student 1 exhibited stereotypic behavior
including repetitively waving leaves and strings in front of
his eyes. In addition, he frequently asked the teacher for
permission to leave the room to go to the bathroom to
escape classroom activities. In the bathroom, he repeatedly
turned on the water to obtain an irritable screeching noise
from the pipes, then put his ear next to it, or filled the sink
with paper towels and water.
Student 2. Student 2 was 15 years old at the start of the
study. He participated in both regular and special education
pullout classes in the speech/language and resource room.
Although Student 2 had difficulty engaging in social
conversation, he could speak in full grammatically correct
sentences to express his needs and desires, could read
simple stories, and was able to write short sentences.
Before Child 2 began participating in the study, the
Vineland Adaptive Behavior Scales (Sparrow, Balla, &
Cicchetti, 1984) were administered and his standard scores
were as follows: 31 on the communication domain, <20 on
the daily living skills domain, and a standard score of <20
on the socialization domain. In addition, he was a gifted
musician and played in the school’s jazz band.
The speech-language pathologist was targeting a number
of pragmatically inappropriate behaviors for Student 2.
These included his humming in a loud voice throughout
classroom activities, making statements such as “I don’t
like this” in a loud voice during the lesson, leaving the
classroom area without permission, and pretending to play
his trumpet (with sound effects) during the lesson.
Setting
Data were collected for Students 1 and 2 in inclusive
educational settings. Student 1’s data were collected in an
inclusive preschool setting during summer session with
mostly typically developing children and in a regular
education public school kindergarten classroom. Student 2’s
data were collected in a regular education high school
classroom. Priming sessions for Student 1 were conducted
in the evenings at home. Priming sessions for Student 2
took place during a free period in his schedule in a small
high school room dedicated for pullout special education
services.
In all sessions, the student’s class teacher was present
while a data collector(s) sat in the back corner of the
classroom behind the student to observe behavior and
academic responding. Classroom periods in which the
student exhibited the most disruptive behavior were
targeted for intervention. Data on academic responding for
Student 1 in his preschool were collected during desk time
while he worked on letter identification and letter writing.
For Student 1’s kindergarten class, disruptive behavior data
were collected during activity time wherein specific
activities were provided to the students. Data were not
collected on academic responding for Student 1 in kinder-
garten because the activity, such as block building, was
inversely related to appropriate behavior. Data for Student
2 were collected in his regular education writing class.
Intervention
Each student’s priming program was developed and
coordinated by the student’s speech-language pathologist.
Specifically, the speech-language pathologist used the
manual, Increasing Success in School Through Priming
(Wilde, Koegel, & Koegel, 1992), as a general guideline
for implementing the priming intervention.
Intervention sessions occurred on a daily basis for each
student. For Student 1, all sessions were implemented in
the evenings by his parents. For Student 2, whose parents
were unable to implement the priming sessions, a special
education staff member worked with the student during
daily “pullout” sessions. Task materials were picked up
(from the researcher, as the teacher was blind to the
conditions in this study) on a daily basis for each student
by either the parent (for Student 1) or the special education
staff member (for Student 2). Materials were returned to
the researcher the following morning. During the priming
sessions, the task to be presented in class the following day
was targeted. During nonpriming sessions, in order to
control for attention, an assignment was provided but it
was not the assignment to be included in the next class
day. Length of priming sessions was left up to the indi-
vidual primer, but was reported to be approximately 1 hour
per day. The teacher, the parent, and the special educator
were all blind to the conditions and hypothesis of the
study. Only the researchers who were conducting the
experiment were aware of the experimental conditions and
administered instructions to the parents and teachers in the
experiment.
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Koegel et al.: Home–School Coordination 231
On a daily basis, the classroom teacher provided
assignments that would be presented the following day to
the researchers, and then either provided that assignment or
a control assignment (equated for difficulty) to the person
who would implement the priming sessions. For Student 1,
tasks consisted of recognition, writing, and phonics for
each letter of the alphabet in preschool and activities such
as stacking blocks, stringing beads, and making patterns
with small blocks in the kindergarten classroom. For
Student 2, tasks consisted of grammar and writing activities
in his English class, with specific writing assignments
related to particular topics the teacher assigned. The primer
was instructed to familiarize the student with the material
in a relaxed, nondemanding manner. Primers were told not
to worry if the student did not completely understand the
material and not to punish the student during the sessions.
Each day, before the start of school, the researcher col-
lected the materials and asked the primer whether the
materials had been reviewed.
Dependent Measures
Data were collected on two student behaviors—disrup-
tive behavior and academic responding. Data were collected
using a time sample procedure wherein the student was
observed for 10 seconds and data were collected for 5
seconds. Data were collected for approximately 10 to 15
minutes during the academic period that was either primed
or not primed. The following criteria were used to measure
the two behavioral components:
Appropriate behavior: Problem behaviors were
individually defined for each subject in the partici-
pants’ sections and data were collected on intervals
with appropriate behavior (i.e., the absence of the
problem behaviors). The data collectors were in-
structed to write a plus (+) if only appropriate
behaviors occurred during a 10-second interval, and a
minus (–) if any problem behaviors occurred during
that interval. Based on these data, an overall percent-
age of appropriate behavior was calculated for each
session.
Academic responding: Data collectors were instructed
to mark a plus (+) if the student exhibited only
appropriate and correct academic responding during
the 10-second interval, and a minus (–) if the student
exhibited any inappropriate or incorrect academic
responding. Appropriate academic responding was
recorded as occurring when the student engaged
correctly in the activity according to the teacher’s
instructions and within the range of classroom
expectations. An overall percentage of appropriate
academic responding was calculated for each session.
Reliability
Reliability measures were collected by observers who
were naive to the experimental hypothesis of the study. To
obtain a reliability percentage, agreements were divided by
agreements plus disagreements (Barlow & Hersen, 1984).
Reliability data were collected on 16 sessions (8 for
appropriate behavior and 8 for appropriate/correct respond-
ing). Interrater agreement for appropriate behavior was 90%
(range 83% to 100%) and 81% for academic responding
(range 81% to 88%).
RESULTS
Figure 1 shows the percentage of appropriate behavior
and correct academic responding for Student 1. Percentages
are shown for both students in sessions with and without
priming. Results for Student 1 show that when priming
sessions occurred, increases in academic responding were
observed. In addition, reductions in problem behavior when
priming occurred were noted. Specifically, the solid circles
in Figure 1 represent the percentage of intervals with
correct academic responding. The open squares in Figure 1
represent the percentage of intervals with appropriate
behavior. Specifically, during classroom sessions with no
priming, percentages of appropriate behavior for Student 1
were low, averaging 35% (range, 0%–61%). In contrast, in
those sessions where priming occurred, appropriate behavior
was substantially higher, averaging 83% (range 72%–
100%). Correct academic responding averaged 30% (range,
50%–0%) in sessions with no priming. However, when
priming occurred, correct academic responding was
consistently higher, averaging 70% (range 60%–75%).
Sessions with priming for Student 2 produced similar
results, as shown in Figure 2. As can be noted from the
open squares, the percentage of appropriate behavior for
Student 2 averaged 49% (range 28%–78%) in the absence
of priming. Priming had a rapid and sustained effect on
Student 2, immediately producing an increase in appropriate
behavior, with an average of 95% (range 91%–100%)
appropriate behavior. Similar to Student 1, during sessions
when no priming occurred, appropriate behavior showed a
decreasing trend across the sessions. In contrast, high levels
of appropriate behavior occurred throughout the sessions
when priming was implemented for Student 2. Data
collected on the correct academic responding of Student 2
showed that in the absence of priming, a significant
decrease in correct academic responding occurred, with a
mean of 67%. However, when priming sessions were
conducted, correct academic responding was significantly
enhanced, averaging 98% across sessions (range 95% to
100%).
Effect Sizes
Effect sizes were calculated for each dependent variable
for each student using the formula, effect size equals the
mean of the no priming condition minus the mean of the
priming condition, divided by the standard deviation of the
no priming condition (Kromrey & Foster-Johnson, 1996).
Accordingly, effect sizes were –2.5 for appropriate class-
room behavior for Student 1; –3.3 for appropriate class-
room behavior for Student 2; –1.95 for correct academic
responding for Student 1; and –2.44 for correct academic
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232 LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS Vol. 34 • 228–235 • July 2003
responding for Student 2. According to Cohen (1988,
1992), considering a large effect size to be of the order of
magnitude of –.8, these effect sizes are all very large,
suggesting that the influence of priming was practically
significant.
CLINICAL IMPLICATIONS
The purpose of the present study was to investigate the
effects of priming academic assignments on the occurrence
Figure 2. Percentage of appropriate behavior and appropriate/correct academic responding for Student 2 in high school during
sessions with priming (P) and those without priming (NP). Open squares represent behavior; closed circles represent academic
responding.
Figure 1. Percentage of appropriate behavior and appropriate/correct academic responding for Student 1 in preschool and kinder-
garten during sessions with priming (P) and those without priming (NP). Open squares represent behavior; closed circles represent
academic responding. The break in the abscissa refers to the point where summer school ended.
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Koegel et al.: Home–School Coordination 233
of problem behavior and level of academic responding in
students with autism. The results indicate that the occur-
rence of problem behavior decreased and academic re-
sponding increased when priming preceded curricular
activities, and these procedures can be easily coordinated
by special educators. These results are consistent with
previous research demonstrating the effectiveness of
antecedent modifications in reducing problem behaviors
(e.g., Dunlap et al., 1995; Dunlap et al., 1996; Lee et al.,
1999; Moes, 1998).
The findings of this study expand the research in the
use of antecedent techniques commonly discussed in
curricular interventions. Previous research in this area has
focused on techniques to heighten student interest in
curricular activities (Dunlap et al., 1995), the integration of
choice-making opportunities (Koegel, Dyer, & Bell, 1987;
Moes, 1998), or modification of the level of difficulty
associated with the task (Lee et al., 1999). In addition,
priming has been used to improve the social functioning of
students with autism in school settings (Zanolli, Daggett, &
Adams, 1996). Modification of antecedents in previous
studies proved to be effective at increasing on-task behav-
ior and even strengthening academic performance. This
study adds to the existing literature on antecedents showing
that improvements in inclusive settings may also occur
without the need for curricular revisions if priming is
implemented.
A number of factors may have contributed to the success
of the priming as they relate to problem behavior and
increasing academic performance. As previously noted,
priming consists of low-demand activities that include high
potential for reinforcement. Therefore, the results of this
study may be partially explained through an analysis of the
reinforcement potential during priming. That is, previous
reviews on problem behavior associated with academic
assignments have identified the problem behavior to be
linked with level of difficulty, time for completion, and
inability to perform accurately on assignments (Sawyer,
Nelson, Jayanthis, Bursuck, & Epstein, 1996). For students
with autism or other related disabilities, high-demand tasks,
particularly those involving complex language use, often
lead to avoidance and escape-driven behavior. The priming
sessions, which were low demand, may have resulted in
enough acquisition to provide some reinforcement during
the subsequent classroom lesson.
Second, the priming sessions included numerous sources
of reinforcement. Research suggests that problem behavior
is maintained by the negative reinforcement of escaping
from aversive stimuli and through positive reinforcement in
obtaining reinforcing stimuli (Lee et al., 1999). Therefore,
priming with a low-demand version of the high-demand
task will effectively reduce the need for escape-driven
behavior. In addition, the high degree of reinforcement
involved in priming sessions decreases the student’s
inclination to search for sources of reinforcement outside of
the academic task. Consequently, on the basis of reinforce-
ment properties, priming increases the probability that the
student will engage in the same behavior (i.e., appropriate
behavior) and demonstrate the same skills when similar
performance is required at a later time (Hoover-Dempsey et
al., 2001). Priming, therefore, addresses both factors shown
to maintain problem behavior.
The basis for the effect of priming on academic perfor-
mance may be somewhat different. Recent studies have
associated increased enjoyment in doing assignments with
higher academic responding (Moes, 1998). Because priming
involves high amounts of reinforcement, the student may
associate enjoyment received from reinforcement with the
academic assignment. An alternate explanation is based on
evidence that students with learning disabilities demonstrate
a lack of motivation concerned with academic task comple-
tion (Gajria & Salend, 1995). Again, because of sources of
reinforcement, priming may provide the necessary motiva-
tion to complete the task. Furthermore, in completing the
task, the student builds confidence specific to the task,
enabling enhanced performance on similar tasks. This
finding is supported by research showing that students with
learning disabilities often feel that they do not have the
ability to complete an academic assignment (Bryan,
Burstein, & Bryan, 2001). Therefore, priming may be an
effective way to heighten student confidence, thereby
increasing ability to perform. Additionally, difficulty in
allocating and maintaining attention, often a result of
language disabilities, during academic tasks is another
barrier to academic performance of individuals with
learning disabilities (cf., Gajria & Salend, 1995). Priming
sessions in the present study involved reinforcing those
times when the student maintained attention to the task,
and introduced the student to the complex language
involved in the task during typical school instruction.
Consequently, attention was maintained throughout the
priming session, as well as throughout the activity sessions
in class.
LIMITATIONS AND FUTURE RESEARCH
There are several limitations and potential areas for
further research in the present study. For example, the
priming sessions conducted in this study were not moni-
tored. Monitoring of priming sessions may provide an
indication of variables, such as level of reinforcement,
acquisition of skills, or other variables that may have
contributed to the success of the priming sessions. Addi-
tionally, a lack of attention on behalf of the parent may
indicate a deficiency in the parent’s involvement in the
priming session. Interestingly, recent research has shown
that parent involvement that includes positive parental
attitudes may be related to the development of the student’s
positive attitude toward the assignment (Callahan et al.,
1998; Hoover-Demsey et al., 2001). Consequently, if, in the
priming sessions, parents did not exhibit positive attitudes
toward the academic tasks and did not attend to the
reinforcement potential, the student may not have devel-
oped his or her own positive attitude. Without a positive
attitude associated with the activity, escape-driven behavior
may be more likely to occur. Additionally, the lack of
positive attitudes for the student may adversely affect
confidence levels and motivation specific to the academic
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234 LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS Vol. 34 • 228–235 • July 2003
task. Therefore, studies should address the need to monitor
the reinforcement and parent attitudes during priming
sessions. Finally, in this study, the priming was imple-
mented on a daily basis. It would be interesting to assess
the effects of the priming when implemented less fre-
quently, such as a biweekly basis.
Given the numerous behavioral difficulties observed in
individuals with autism and those with other learning
disabilities, effective strategies to reduce such problems are
essential to enabling participation of individuals with
disabilities in full inclusion classrooms. In this study,
priming proved to be an effective antecedent-based inter-
vention to promote more appropriate functioning of
individuals with autism in classroom settings. This inter-
vention technique may be ideal for speech-language
pathologists to coordinate or implement, especially in light
of the rapid improvements that resulted from the interven-
tion. Appropriate behavior is vital to the progress of
individuals with autism in school. Effective tools for
increasing that behavior is critical if these students are to
adapt to and benefit from full-inclusion educational
settings. The technique demonstrated here is just one
effective tool for modifying behavior and academic
performance. Therefore, future research assessing the
effects of integrating various antecedent techniques may be
beneficial.
In summary, the present study further expands effective
techniques for producing improvements in behavior and
academic responding for students who are included in
regular education classrooms. The procedure can easily be
incorporated into the school curriculum and can be orga-
nized or implemented by special education school staff
such as the speech-language pathologist. In addition, the
positive effect of the intervention in reducing problem
behaviors and increasing learning can be evidenced
immediately, thereby creating more opportunities for the
student to be successful in an inclusive school setting.
ACKNOWLEDGMENTS
Portions of the research reported in this article were supported
by Research Grant MH28210 from the National Institute of Mental
Health and by U.S. Department of Education Grant 5830-257-LO-
B. The authors would like to thank Roberta Savage for her
assistance with the data collection for this manuscript.
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Received May 19, 2002
Accepted March 26, 2003
DOI:10.1044/0161-1461(2003/019)
Contact author: Lynn Kern Koegel, PhD, Clinical Director,
Autism Research and Training Center, C/C/S Psychology Program,
University of California, Santa Barbara, Santa Barbara, CA 93106-
9490. E-mail: koegel@education.ucsb.edu
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