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Effects of a computerized therapeutic recreation program on knowledge of social skills of male youth with emotional and behavioral disorders.

Introduction

The number of youth in the United States affected by emotional and behavioral disorders (E/BD) is significant. As many as one in 5 youth may have an E/BD that can be identified and treated through educational and/or mental health services (Department of Health and Human Services, 2003). E/BDs are "... characterized by behavioral or emotional responses in school programs so different from appropriate age, cultural, or ethnic norms that the responses adversely affect educational performance, including academic, social, vocational or personal skills" (Invitation to Comment, 1993, p. 7938).

Social skills problems are commonly experienced by youth with E/BDs (Mathur, Kavale, Quinn, Forness, & Rutherford, 1998). Social skills are learned behaviors that help individuals to interact appropriately with other people and assist them in avoiding negative responses (Gresham & Elliot, 1984), thus helping them gain social acceptance (Gallagher, 1995). Children with limited social skills are likely to demonstrate behaviors that reflect negative attitudes, limited interpersonal relationships, and these behaviors subsequently lead to fewer social interactions and isolation, particularly during leisure participation (Guralnick, Connor, Hammond, Gottman, & Kinnish, 1996a, 1996b; Hughes, et al., 2000).

According to Goldstein and McGinnis (1997), because youth with E/BDs lack social skills, many of them experience loneliness, isolation and an increased tendency to perceive other people as threatening or hostile. Limited positive social experiences result in a failure to learn socially acceptable behaviors; therefore, youth with E/BDs often exhibit repeated inappropriate behaviors in social situations (Mathur, et al., 1998). Social skills training programs are designed to help youth improve their behavior by teaching positive behaviors through non-aversive methods, such as modeling and reinforcement (Elliot & Gresham, 1993).

An array of effective social skills programs exist, the most effective of which are based on operant and social learning procedures (Elliot & Gresham, 1993). When developing interventions based on operant theory, the focus is on observable behaviors and consequent events that come about as a result of reinforcement (Elliot & Gresham, 1993). Social learning theory is grounded in the argument that most social behavior is learned when a person observes another's behavior and the consequences generated as a result of the observed behavior (Bandura, 1977). Bandura referred to this process as observational learning and argued that observational learning occurs when an individual acquires social skills through observing a model's behavior.

One forum for providing social skills training based on a combination of the social learning and operant models is through computerized therapeutic recreation programs. Therapeutic recreation (TR) is defined as "the provision of Treatment Services and the provision of Recreation Services to persons with illnesses or disabling conditions" (American Therapeutic Recreation Association, 2004). Although many TR Specialists work in nursing homes, mental/ behavioral health, and physical rehabilitation facilities, an increasing number are providing services to students receiving special education services in school-based settings (McKenney & Ashton-Shaeffer, 2002). When provided as a related service, TR can help students develop social skills, learn socially acceptable behaviors, and develop and improve communication skills (Lawson, Coyle, & Ashton-Shaeffer, 2002).

As computers have become common in American education, it is no longer unusual to see them used as part of special education programs (Cheney, 1990). Rieber (1992) suggested that computer-assisted instruction (CAI) offers powerful learning environments, especially via animated programs that can promote opportunities for multiple practice occasions and incidental learning, and develop intrinsic motivation to learn. Advancements in technology generate possibilities for skill development for individuals with disabilities through experiential learning presented via CAI (Tennyson, 1994). Interactivity available via CAI programs are intended to engage mental processes, enhance performance and productivity, and have individuals become active participants in the learning process (Jih & Reeves, 1992).

Generally, researchers have reported that CAI programs are effective learning aids (Wolfe, 1997). Children have access to increasingly sophisticated computer technology in educational settings (Judge, 2001) and CAI has been shown to be successful for children with and without disabilities in acquiring and improving skills related to: (a) reading (Lynch, Fawcett, & Nicolson, 2000; van Daal & Reitsma, 2000), (b) spelling (van Daal & Reitsma, 2000), (c) word recognition and vocabulary acquisition, (Lynch, et al., 2000), (d) mathematics (Nicol & Anderson, 2000), (e) safety (Lee, McGee, & Ungar, 2001), (f) functional life skills of individuals with disabilities (Cafiero, 2001; Langone, Shade, Clees, & Day, 1999), (g) social-problem solving (Bosworth, Espelage, & DuBay,1998; Goldsworthy, Barab, & Goldsworthy, 2000), (h) matching (Hitchcock & Noonan, 2000), and (i) social skills (Goldsworthy, et al., 2000; Margalit, 1995).

According to Cheney (1990), there are three categories of applications of computer technology for students with E/BDs: (a) academic skills instruction, (b) behavior modification, and (c) social or interpersonal skills training. TR facilitation techniques are chosen based on individual participant needs. Youth with E/BDs might benefit from TR facilitation techniques designed specifically to develop social and interpersonal skills. Computerized TR programs provide one means for addressing students' social skills deficits. According to Deavours (1997), through computerized TR programs, children experience outcomes such as discovering effects of actions through active simulation and the development of social skills through learning to play cooperatively.

Although a paucity of studies exist specifically related to CAI as a means for teaching social skills, recent studies have demonstrated effects of computerized TR programs on self-determination (Dattilo, Williams, Guerin, & Cory, 2001) and social skills of children with disabilities (Dattilo, Williams, & Cory, 2003). Dattilo et al. (2001) employed a multiple probe single-subject design replicated across 4 participants (ages 10-14 years) to assess effects of a computerized leisure education program on self-determination in leisure. Although none of the participants achieved a score of at least 80% at baseline on two consecutive sessions, all 4 participants achieved scores of at least 80% on three consecutive sessions during the intervention, thus demonstrating replication of effects. Intervention effects were maintained during follow-up probes for all participants 4-8 weeks after the intervention.

Using a multiple baseline single-subject design across participants, Dattilo, et al. (2003) extended the research conducted by Dattilo et al. (2001). The authors sought to determine to what degree participants (3 males, ages 6-15 years) responded to a computerized program designed to teach social skills necessary for participation in recreation activities. An immediate level change was observed for all participants upon initiation of the intervention. Scores eventually accelerated until all participants achieved the criteria of at least two consecutive sessions at 80%. Follow-up scores up to 5 weeks after the intervention for all 3 participants were similar to their scores toward the end of the intervention, thus demonstrating maintenance of effects. The authors concluded that results indicated that the computerized program increased participants' knowledge of social skills used during recreation participation. Purpose of the Study

Recent studies have demonstrated effects of computerized leisure education programs on self-determination of children with disabilities (Dattilo, et al., 2001) and social skills (Dattilo, et al., 2003); however, no studies have been conducted using a computerized TR program with children with EB/Ds. The purpose of this research was to examine effects of a computerized TR program on an indicator of knowledge of social skills of male youth with E/BDs. Knowledge of social skills was discerned with the use of the Social Interaction in Leisure Assessment (SILA), a computerized assessment used to determine participants' knowledge of social skills in leisure (Table 1). The research question and associated hypothesis are presented below:
Table 1

Questions presented on the Social Interaction in Leisure Assessment

1. Click on the picture where Beebee lets you know what she's thinking.

2. Which picture shows Beebee paying attention?

3. Which voice is too loud?

4. Which voice is too fast to understand?

5. Which picture shows Beebee letting you know what she thinks?

6. Which picture shows Og standing too close to Beebee?

7. What should Beebee ask Og to show she is paying attention?

(a) "Are you going to a party?" Or (b) "Who went bowling with you?"

8. Which picture shows Beebee being assertive?

9. Are these birds paying attention to each other?

10. What do friends do? (a) Talk to each other. Or
(b) Ignore each other.

11. What do friends do? (a) Are mean to each other. Or
(b) Have fun together.

12. What do friends do? (a) Listen to each other. Or
(b) Lie to each other.

13. What to friends do? (a) Make each other laugh. Or
(b) Are mean to each other.


Research Question

What are the effects of a computerized therapeutic recreation program on knowledge of social skills of 4 male youth, ages 11-12, identified within a school system as having emotional or behavioral disorders?

Hypothesis

Participants with emotional or behavioral disorders who attend a computerized therapeutic recreation program (4 x wk, 30 min sessions) will demonstrate higher SILA scores during the intervention when compared to baseline and maintain these higher scores for up to 6 weeks post intervention.

Methods

Research Design

A multiple probe single-subject research design replicated across participants was used to assess changes in participants' knowledge of social skills as a result of the intervention. Single-subject research is used to observe and document changes in the behavior of an individual as the result of participating in an intervention (Tawney & Gast, 1984). According to Dattilo, Gast, and Schleien (1993), "Single-subject research requires careful identification and measurement of dependent variables (behaviors in need of treatment) that are influenced by the systematic application of independent variables (treatments)" (p. 182). Treatment effects are evaluated by allowing each participant to serve as her or his own control (McCormick, 1995). The multiple probe single-subject research design replicated across participants addresses effects of the independent variable on responses for different participants (Kucera & Axelrod, 1995). Once a stable baseline has been observed for 1 participant, the intervention is applied to that participant while maintaining baseline conditions for the other participants. When the first participant demonstrates improvement, then the intervention is applied to that participant in addition to a second participant. This process continues until all participants are receiving the intervention.

Setting

The instructional setting was a specialized middle school, located in the southeastern United States, where educational and therapeutic services are provided to emotionally handicapped and severely emotionally disturbed students in grades 6-8 for students. Within the school, a comprehensive behavior management system is offered so that students are provided with positive behavior support and a range of clinical services designed to address the social, emotional, behavioral and academic needs of the students. Intensive services are provided to facilitate reintegration of students back into the regular school setting.

Participants

Participants included 4 male students (ages 11-12; 1 African-American, 1 Haitian, 2 Hispanic) identified as having EB/Ds and receiving special education services in an educational center located in the southeastern United States. All 4 participants were enrolled in classes for Emotionally Handicapped/ Severely Emotionally Disabled (EMH/SED) students. They were selected if they were identified as having a behavior disorder and parents would give permission for research participation. Participants were given the following pseudonyms to maintain confidentiality: Ricardo, Lazaro, Pedro and Bosco.

Ricardo. Ricardo was a 12 year old Haitian male enrolled in eighth grade with an IQ score of 59. Ricardo lived with his biological mother and his step-father, both of whom are of Haitian descent. Upon enrollment into the EMH/SED classes, teachers and school counselors observed and documented Ricardo demonstrating disruptive, aggressive and violent behavior. Ricardo was uncooperative with his teachers, required regular verbal cues to remain focused on assignments and activities, and was consistently redirected for negative comments directed at his peers. Ricardo enjoyed listening to music; however, he particularly enjoyed participating in sports such as wrestling, softball and football.

Lazaro. Lazaro was an 11 year old Hispanic male enrolled in sixth grade with an IQ score of 75. Lazaro lived alone with his biological mother. Upon enrollment into the EMH/SED classes, Lazaro was documented as demonstrating difficulty following directions, comprehending instructions and remaining on task. In addition, Lazaro demonstrated behaviors that appeared to be performed for seeking acceptance from his peers. For example, Lazaro was repeatedly redirected for imitating his peers or expressing his feelings toward them in an inappropriate manner. Lazaro's recreation interests included art, playing computer games, playing basketball and watching movies.

Pedro. Pedro was a 12 year old Hispanic male enrolled in seventh grade with an IQ score of 60. Pedro lived with both of his biological parents and resided in a migrant camp while participating in this study. Upon enrollment into the EMH/SED classes, Pedro was documented as demonstrating uncooperative, defiant and attention seeking behaviors. In addition, Pedro demonstrated difficulty following directions or remaining focused on tasks for extended periods of time. Pedro's recreation interests included playing sports, in particular soccer, playing computer games, and socializing with friends.

Bosco. Bosco was a 12-year-old African-American male enrolled in seventh grade with an IQ score of 64. At the time of this study, Bosco resided with his biological mother and identical twin brother. Upon enrollment into the EMH/SED classes, Bosco was documented as disruptive, uncooperative, attention seeking, and unconcerned with other people's feelings. Bosco was redirected frequently for initiating fights with his peers. Bosco's recreation interests included playing basketball and computer games.

Research Team

The research team consisted of 5 participants, a therapeutic recreation (TR) specialist/faculty supervisor who supervised 1 undergraduate and 1 graduate TR student. Both students had previous experience working with students with E/BDs in schools and were members of the Holistic Education for the Advancement of Recreational Therapy in Schools program at Florida International University. The TR students administered assessments and facilitated sessions each day under the guidance and supervision of the faculty supervisor. The students sat with the participants each day as they participated in the intervention. After data were collected, one of the students would report results to the faculty supervisor who recorded the data on graphs before instructing the students about the next procedure. In addition, 3 other TR specialists who had conducted several studies examining effects of computerized leisure education programs on youth with developmental disabilities helped to develop the educational software and provided input on study design.

Research Materials

Social Interactions in Leisure Assessment (SILA). The SILA is a 13-item computerized assessment designed to determine participants' knowledge of social interactions in leisure (Dattilo et al., 2001). Participants choose between two responses to a particular situation, one of which is correct. It takes approximately 5 minutes to complete the SILA. A computerized assessment of knowledge provides an appealing modality for participants, and the consistency and accuracy of a computerized assessment can enhance the internal validity of a study (Dattilo et al., 2001).

The SILA was composed of questions that were directly related to the content presented in the computerized program. Therefore, content validity was established since there was a direct correspondence between material taught and assessed via the SILA. While a comparison to other established measures of social skills was not undertaken to determine reliability, the SILA was used in a previous study (Dattilo et al., 2003). One indicator of reliability reported in that study was that multiple SILA scores reported across 3 participants (ranging from 19-27 data points) were stable over time (similar to data reported in this study).

Computerized TR software. The program, "BeeBee," involves a "cavewoman" (Beebee) journeying through three distinct environments (cave, glacier, and jungle) in which she is confronted with different situations that require social interactions while participating in recreation activities. After BeeBee encounters a situation, the participant reads or listens to a statement with two options from which to choose to complete the sentence. Social skills instructional information includes situations that are presented in the form of written words that, when highlighted, include narration. If the participant chooses the correct option, animated characters, such as bats and penguins, provide reinforcement and BeeBee continues her journey. If the participant's choice is incorrect, an animated character, such as a tiger or wooly mammoth, chases BeeBee back to a location where she is provided with clues to help her choose the correct response. Examples of skills taught through the computerized program include the following: paying attention, speaking at an appropriate volume, speaking at an appropriate speed, letting other people know what you are thinking, standing at an appropriate distance to other people, behaving assertively, and listening to other people.

The software was developed using primarily Macromedia's Authorware [TM]. Other software was used to create and edit sound effects (e.g., Macromedia's SoundEdit[TM]) and animations (e.g., Macromedia's Director[TM]). Additionally, the program was designed with Embedded voice-overs and recorded spoken instructions so that people without reading skills could use the program.

Research Procedures

A schedule was developed with the assistance of a teacher and a librarian for participants to attend sessions at least three times per week. Each day, a member of the research team arrived at the school between 9:00-10:00 a.m. with a laptop computer loaded with the program or a copy of the software that could be used in a computer located in the school library and remain at the school until 1:00 p.m. During sessions, research team members met with each participant individually on a 1:1 basis.

During the baseline condition, the SILA was administered to determine participants' knowledge of social skills in leisure. Each session during baseline lasted approximately 30 minutes; five of which included administering the SILA and 25 of which included the participant playing the baseline game. The baseline game was identical to the game used for the intervention except that instructional information on social skills was omitted and feedback was not provided to participants. Stability was determined by calculating the median level of data points and determining whether 80% fell within 20% of the median value (Dattilo et al., 1993). Once SILA scores stabilized during baseline, the intervention was implemented.

During the intervention condition, participants played the computerized TR program. Procedures identical to those used during baseline condition were implemented during intervention condition except that the computerized TR software was used. The intervention involved use of the computerized TR software that included the instructional information on social skills. Each intervention session lasted approximately 30 minutes. Once participants completed an intervention session they were administered the SILA so that a score could be ascertained. Participants did not receive additional social skills training during their school days while participating in the intervention.

Once participants demonstrated mastery of content (indicated by three consecutive sessions of at least 85% on the SILA), the follow-up condition was initiated. Follow-up condition involved administration of the SILA four times over the course of 5 weeks after completion of the intervention to assess whether participants retained knowledge learned during the intervention.

Data Collection and Analysis

Data were collected three or four times per week and graphed for visual inspection. Each SILA score for each participant was plotted on a separate graph following each session. Median scores within each condition of each participant were calculated, and trends within conditions were determined using the split-middle method (Tawney & Gast, 1984). According to Tawney and Gast, the steps for split-middle method include: (a) divide the data in half, (b) divide each half in half, (c) find the middle value for each half of the data series and draw a line parallel to the abscissa that intersects the half way line, (d) draw a line that passes through the intersection found on the previous step, and (e) adjust the quarter intersect line so that there is an equal number of data points above and below the line to find the split-middle line. Trends were determined to be decelerating (a downward trend line with subsequent data points closer to the abscissa than previous points), zero-celerating (a flat trend line parallel to the abscissa), or accelerating (an upward trend line with subsequent data points further from the abscissa than previous points). In addition, data were collected through the use of social validity questionnaires administered to participants and teachers. Success was determined based on a visual analysis of graphed data and an analysis of data gleaned from social validity questionnaires.

Validity and Reliability

Procedural reliability is the ability to implement a given intervention consistently across setting, participant or facilitator (Bisesi & Raphael, 1995). The same intervention and outcomes across participants should be measured over time to appropriately draw conclusions about effects of the intervention (Bisesi & Raphael, 1995). In this study, procedures used during baseline, intervention and follow-up conditions were identical. In addition, the same software was used for each session during each condition. Finally, the same facilitators were present for each session.

The SILA was composed of questions that were directly related to the content presented in the computerized program. Therefore, content validity was established since there was a direct correspondence between material taught and assessed via the SILA. While a comparison to other established measures of social skills was not undertaken to determine reliability, the SILA was used in a previous study (Dattilo et al., 2003). One indicator of reliability reported in that study was that multiple SILA scores reported across 3 participants (ranging from 19-27 data points) were stable over time (similar to data reported in this study).

Social Validity

Social validation is at the core of behavioral analysis and involves the process of making objective measurement socially relevant (Wolfe, 1978). Baer and Schwartz (1991) suggested that social validation should augment, rather than replace "hard" data. For this study, social validation occurred by evaluating the social significance of the goals of the study and the social appropriateness of procedures. One month prior to implementation of the intervention, the computerized TR program was shown to participants' teachers and an assistant principal and they were asked whether they found the intervention to be useful tool for teaching social skills to their students. Furthermore, to assess social appropriateness of the intervention, participants' were asked to complete questionnaires to ascertain whether they enjoyed the intervention, what they liked or disliked about the intervention, and any suggestions they had to improve the intervention during and after completion of the intervention.

Results

To determine effects of the computerized TR program, SILA data were graphed and visually inspected. Median scores were calculated to determine level for each condition (e.g., baseline, intervention, follow-up) for each participant. The principle investigator used the split-middle method to determine trends of data within and between conditions (Table 2).

SILA Performance

Ricardo. Ricardo's baseline scores remained stable after three observations resulting in a median score of 61 on the SILA. Upon initiation of the intervention, an immediate level change was observed as his score reached 84. Although in the second session of the intervention Ricardo's score dropped to 61, in the remaining sessions he achieved a score of 100. Researchers did not ascertain a reason for the dropped score. During 19 intervention sessions, Ricardo's median score was 100. His median score was 100 for four follow-up probes that occurred 1, 2, 3 and 5 weeks post intervention.

Lazaro. During baseline, Lazaro's scores remained stable after four observations resulting in a median score of 80 on the SILA. Upon initiation of the intervention an immediate level change occurred, and during 19 intervention sessions Lazaro's median score was 100. His median score for four follow-up probes that occurred 1, 2, 3 and 5 weeks post intervention was 100.

Pedro. Pedro's baseline scores remained stable after eight observations resulting in a median score of 80 on the SILA. Although there was not an immediate change in behavior for Pedro (a level change started to occur on the ninth day of the intervention), eventually his scores accelerated resulting in Pedro's median score increasing slightly over baseline to 84 for the intervention, and his median score to 84, with a median score of 92 for the last three sessions. His median score for four follow-up probes that occurred 1, 2, 3 and 5 weeks post intervention was 100.

Bosco. Bosco's baseline scores remained stable after 15 observations resulting in a median score of 76 on the SILA. Although Bosco's trend was zero-celerating, there was a slight acceleration of Bosco's scores toward the end of baseline condition. Upon initiation of the intervention, an immediate level change was observed and during 3 intervention sessions, a median score of 96 was recorded. His median score that occurred 1, 2, 3 and 5 weeks post intervention was 96.

Multiple-probe across participants. During baseline, median scores ranged from 61 and 80 across the 4 participants. Upon initiation of the intervention, an immediate level change occurred for Ricardo and was replicated across Lazaro and Bosco, but not Pedro. Since Pedro demonstrated a level change on the ninth day of intervention, Ricardo's accelerated trend and increased median scores were replicated across all participants. Although scores at follow-up for all 4 participants were similar to their scores toward the end of the intervention, ranging from 84 to 100 (Figure 1), all participants, except Bosco, maintained scores of 100 during follow up that were equal or greater than the last several sessions of the intervention.

Social Validity. Based on results of the social significance questionnaire, the teachers and assistant principal expressed support for the intervention and stated that it appeared appropriate for the students selected to serve as participants. Results of the social appropriateness questionnaires administered throughout and at the completion of the study indicated that 4 participants enjoyed the intervention the first two weeks; however, after approximately 2 weeks they began to respond to being asked what they disliked about the intervention with answers such as, "it takes too long" and it gets "boring." Suggestions included adding different "levels" to make it more interesting, adding "monsters" or "dinosaurs," and adding "more characters."

Discussion

Based on their research examining effects of computerized leisure education programs on self-determination of children with disabilities, Dattilo et al. (2001) concluded that further research was needed to determine whether leisure-related skills, such as social skills, might be achieved through a computerized leisure education program. Consequently, Dattilo et al. (2003) extended the research by examining effects of a computerized leisure education program on 3 boys, two of whom have moderate intellectual disabilities, and one with achondroplasia (dwarfism) and hydrocephalus. The purpose of the present study was to further extend the research by examining knowledge of social skills with the use of a computerized assessment tool to determine knowledge of social skills in leisure among male youth with E/BDs.

Since the SILA provides two options for participants for each response, a random selection of answers should result in a score of approximation. Participants had median baseline scores that ranged 61 to 80. Although Lazaro and Pedro's median baseline SILA scores were relatively high (80) their social skill behavior deficits warranted their participation in the leisure education program. Consistent increases in SILA scores provided support that there were positive effects across participants for social knowledge acquisition.

Limitations

It may be helpful to consider when examining these results that the SILA is composed of questions directly related to content presented via the computer program helping to establish face validity, and participants as well as service providers identified the intervention to be socially appropriate and important. However, caution is advised when interpreting results because a comparison of SILA to other measures of social knowledge was not undertaken, reliability indices were not calculated, and attempts to ascertain whether correct responses were indicative of knowledge of social interaction did not occur. Future research might incorporate other measures of knowledge of social skills pre- and post-intervention to help examine validity of findings associated with the SILA.

Furthermore, in this study, no attempt was made to ascertain whether the learning of social skills translated into the demonstration of social skills. According to Mathur, et al. (1998), "The effectiveness of social skills instruction needs to go beyond skill acquisition to ensure maintenance and generalization of learned social skills" (p. 194). Although assessment of social skills knowledge acquisition is important, future research is needed to determine transference of knowledge gains to actual demonstration of social skills within a leisure context by youth with EB/Ds.

While the authors are encouraged by the results of the current study, it is difficult to generalize these findings beyond the small scope of the study due to the inherent lack of external validity of single-subject research designs. Additional replication will be needed before larger conclusions can be drawn related to the effectiveness of computerized social skills instruction.

Recommendations for Practice and Future Research

One approach to meeting the needs of participants with E/BDs is through a process of observational learning (McKenney, 2004). Observational learning occurs when a participant learns skills through observing another person's behavior (Bandura, 1977). Promoting observational learning might accomplished through the use of traditional activities, such as role-play activities. Participants observe a facilitator or their peers perform appropriate social skills before demonstrating knowledge of the skills performed or performing the skills themselves.

TR professionals are encouraged to find new ways to enhance traditional means of facilitating learning, either through computer software or other media, to help their participants improve their social or recreation related skills. Health care consumers are increasingly sophisticated and are usually capable of choosing among many interrelated treatment options. As a profession, therapeutic recreation should strive to offer cuttingedge programming in addition to tried and true traditional interventions to develop comprehensive social skills training programs. While this study required participants to work individually at the computer, TR professionals may consider having participants work in dyads or small groups that might facilitate application of social skills. Furthermore, "virtual reality" programs can be developed that focus on social situations and promote practice and applications of skills.

The educational software used in this study features a relatively primitive interface compared to the cutting edge videogames available to more and more youth. As computer technology, in general, and authoring software, in particular, continue to rapidly evolve, TR professionals, educators, and researchers interested in developing educational software must continue to develop their technical skills.

While it is becoming increasingly apparent that educational software can be used to teach recreation related skills (e.g., social skills, choice-making skills), little has been done to investigate the generalizability of this knowledge. Researchers might consider finding ways to investigate if participants who acquire recreation-related knowledge use that information to improve the quality and frequency of recreation participation.

Conclusion

Social skills are learned behaviors that help people to interact appropriately with other people (Gresham & Elliot, 1984). As the number of youth identified as having E/BDs continues to rise, the use of social skills training is becoming an increasingly important aspect of educational services. One use of computer technology for youth with E/BDs is the provision of social or interpersonal skills training (Cheney, 1990). As computer technology becomes a more frequently accessed tool for special education services, computerized TR programs, such as "BeeBee", can be used in the provision of simulated social skills training through recreation for youth with E/BDs. As demonstrated in this study, such programs may result in increases in scores associated with the assessment designed to measure social knowledge acquisition across youth with E/BDs.

The immediate level changes for 3 participants, the eventual acceleration of appropriate social behaviors for all 4 participants, and achievement of the learning criteria for all participants provides support that those participants learned sufficient information to be successful on a performance measure associated with knowledge of social skills objectives (SILA). Follow-up probes taken up to 5 weeks post intervention showed that scores achieved toward the end of the intervention were maintained for 3 of the participants with 1 participant's scores decreasing slightly but continuing to be above baseline measures. The follow-up data provides support that the participants remembered the information they learned about social skills after instruction had ended.

Considering previous research demonstrating positive effects of computer-based education programs and findings of this study, there is support for development, implementation, and further research on effects of computer-based TR programs on acquisition of knowledge and skills relevant to recreation participation for youth with EB/Ds. Furthermore, although maintenance of effects were observed in this study, future research using computerized TR programs might be developed that emphasize participants' demonstration of social skills in addition to knowledge acquisition. This might be accomplished through the development of computerized programs designed to maintain participants with E/BDs attention for longer periods of time. Compared to their peers who do not have E/BDs, youth with E/BDs have been shown to prefer novel stimuli (Orris, 1969) and have displayed higher initial attention to novel stimuli (DeMeyer-Gapin & Scott, 1977). Results of the social appropriateness questionnaires reflect a need to develop programs that would provide novel stimuli, thus perhaps resulting in longer periods of participation. Perhaps computerized social skills programs, such as the computerized TR program, could be further developed with an emphasis on more novel stimuli, thus extending the importance of CAI as a means for teaching social skills. Novel stimuli might be chosen and incorporated into CAI based on interests relevant to particular age groups or based on interests common to students at any particular time.

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This research was conducted in part through funds provided by the Florida International University College of Education Dean's Grant program. Views herein are those of the authors and do not necessarily represent the funding agency. Appreciation is extended to the students who participated in the study (their names have been changed to provide confidentiality), their families, and the teachers who helped coordinate therapeutic recreation services.

Alexis McKenney, Florida International University; John Dattilo, Pennsylvania State University Lynne Cory, University of Georgia; Richard Williams, East Carolina University
Table 2.

Summary of Mean Scores Between Conditions for Participants

           Behavior   Baseline     Baseline    Baseline
            Median      Trend     Stability     Change

Ricardo       61                     100%        Yes
Lazaro        80                     100%        Yes
Pedro         80                     100%         No
Bosco         76                     93%         Yes

           Intervention    Intervention    Intervention
              Median           Trend        Stability

Ricardo         100                            95%
Lazaro          100                            100%
Pedro           84                             100%
Bosco           96                             100%

           Follow-up   Follow-up    Followup
            Median       Trend     Stability

Ricardo       100                     100%
Lazaro        100                     100%
Pedro         100                     100%
Bosco         96                      75%

Note. (a) = zero-celerating trend; (b) = decelerating trend
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Author:McKenney, Alexis; Dattilo, John; Cory, Lynne; Williams, Richard
Publication:Annual in Therapeutic Recreation
Date:Jan 1, 2004
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