Abstract
Children with developmental disabilities often have difficulty completing complex multistep tasks, such as daily living skills or leisure and play skills, which often occur in children’s homes. The use of visual supports can increase the predictability of routines and clarify behavioral expectations for children with developmental disabilities. Thus, increasing the likelihood that these children will independently engage in these complex tasks. Caregivers are important stakeholders, especially when it comes to interventions that occur in the family home. Therefore, it is important for researchers to continue to evaluate the effectiveness of caregiver-implemented interventions with visual supports in the home setting. The purpose of the current review was to systematically evaluate the use of caregiver-implemented visual support interventions using the categories of visual supports identified by (Rutherford et al., Autism 24:447–469, 2020). We reviewed 16 studies with 37 participants that examined caregiver-implemented visual supports in the home. We found that visual schedules were the most commonly used visual support. In the studies that included visual schedules, researchers instructed caregivers to use visual schedules to promote their child’s completion of daily living skills most often. Based on these findings, we discuss considerations for implementing these interventions, quality and social validity of caregiver-implemented visual support interventions, and areas of future research.
Similar content being viewed by others
References
Akers, J. S., Davis, T. N., Gerow, S., & Avery, S. (2020). Decreasing motor stereotypy in individuals with autism spectrum disorder: A systematic review. Research in Autism Spectrum Disorders, 77, 101611. https://doi.org/10.1016/j.rasd.2020.101611
Akers, J. S., Higbee, T. S., Pollard, J. S., Pellegrino, A. J., & Gerencser, K. R. (2016). An evaluation of photographic activity schedules to increase independent playground skills in young children with autism. Journal of Applied Behavior Analysis, 49(4), 954–959. https://doi.org/10.1002/jaba.327
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Amsbary, J., & AFIRM Team. (2017). Parent implemented intervention. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorders, FPG Child Development Center, University of North Carolina. Retrieved from http://afirm.fpg.unc.edu/parent-implemented.intervention
Banda, D. R., & Grimmett, E. (2008). Enhancing social and transition behaviors of persons with autism through activity schedules: A review. Education and Training in Developmental Disabilities, 43(3), 324–333. http://www.jstor.org/stable/23879794
Barton, E. E., & Fettig, A. (2013). Parent-implemented interventions for young children with disabilities: A review of fidelity features. Journal of Early Intervention, 35(2), 194–219. https://doi.org/10.1177/1053815113504625
Bellg, A. J., Borrelli, B., Resnick, B., Hecht, J., Minicucci, D. S., Ory, M., & Czajkowski, S. (2004). Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH Behavior Change Consortium. Health Psychology, 23(5), 443. https://doi.org/10.1037/0278-6133.23.5.443
Bryan, L. C., & Gast, D. L. (2000). Teaching on-task and on-schedule behaviors to high-functioning children with autism via picture activity schedules. Journal of Autism and Developmental Disorders, 30(6), 553–567. https://doi.org/10.1023/A:1005687310346
*Buschbacher, P., Fox, L., & Clarke, S. (2004). Recapturing desired family routines: A parent-professional behavioral collaboration. Research and Practice for Persons with Severe Disabilities, 29(1), 25–39. https://doi.org/10.2511/2Frpsd.29.1.25
Cannella-Malone, H. I., Miller, O., Schaefer, J. M., Jimenez, E. D., Page, E. J., & Sabielny, L. M. (2016). Using video prompting to teach leisure skills to students with significant disabilities. Exceptional Children, 82(4), 463–478. https://doi.org/10.1177/0014402915598778
Carroll, R. A., Joachim, B. T., St. Peter, C. C., & Robinson, N. (2015). A comparison of error-correction procedures on skill acquisition during discrete-trial instruction. Journal of Applied Behavior Analysis, 48(2), 257–273. https://doi.org/10.1002/jaba.205
Carter, S. L., & Wheeler, J. J. (2019). An analysis of social validity prevalence and measurement within education and training in autism and developmental disabilities. Journal of the Division on Autism and Developmental Disabilities Council for Execptional Children, 6(1), 48–57.
Center of Disease Control and Prevention. (2021a). Increase in developmental disabilities among children in the United States. U.S. Department of Health and Human Services. https://www.cdc.gov/ncbddd/developmentaldisabilities/features/increase-in-developmental-disabilities.html
Center of Disease Control and Prevention. (2021b). Health needs and sse of services among children with developmental disabilities. U.S. Department of Health and Human Services. https://www.cdc.gov/ncbddd/developmentaldisabilities/features/developmental-disabilities-among-us-children.html
Chan, J. M., Lambdin, L., Van Laarhoven, T., & Johnson, J. W. (2013). Teaching leisure skills to an adult with developmental disabilities using a video prompting intervention package. Education and Training in Autism and Developmental Disabilities, 48(3), 412-420. https://www.jstor.org/stable/23880997
*Clarke, S., Dunlap, G., & Vaughn, B. (1999). Family-centered, assessment-based intervention to improve behavior during an early morning routine. Journal of Positive Behavior Interventions, 1(4), 235–241. https://doi.org/10.1177/2F109830079900100406
Cook, B., Buysse, V., Klingner, J., Landrum, T., McWilliam, R., Tankersley, M., & Test, D. (2014). Council for Exceptional Children: Standards for evidence-based practices in special education. Teaching Exceptional Children, 46(6), 206. https://doi.org/10.1177/0040059914531389
*Dettmer, S., Simpson, R. L., Myles, B. S., & Ganz, J. B. (2000). The use of visual supports to facilitate transitions of students with autism. Focus on Autism and Other Developmental Disabilities, 15(3), 163-169https://doi.org/10.1177/108835760001500307
Feldman, M. A., Atkinson, L., Foti-Gervais, L., & Condillac, R. (2004). Formal versus informal interventions for challenging behaviour in persons with intellectual disabilities. Journal of Intellectual Disability Research, 48(1), 60–68. https://doi.org/10.1111/j.1365-2788.2004.00578.x
*Fichtner, C. S., & Tiger, J. H. (2015). Teaching discriminated social approaches to individuals with Angelman syndrome. Journal of Applied Behavior Analysis, 48(4), 734–748. https://doi.org/10.1002/jaba.237
Gabor, A. M., Fritz, J. N., Roath, C. T., Rothe, B. R., & Gourley, D. A. (2016). Caregiver preference for reinforcemenr-based interventions for problem behavior maintained by positive reinforcement. Journal of Applied Behavior Analysis, 49, 215–227. https://doi.org/10.1002/jaba.286
García-Villamisar, D. A., & Dattilo, J. (2010). Effects of a leisure programme on quality of life and stresss of individuals with ASD. Journal of Intellectual Disability Research, 54(7), 611–619. https://doi.org/10.1111/j.1365-2788.2010.01289.x
*Gerencser, K. R., Higbee, T. S., Akers, J. S., & Contreras, B. P. (2017). Evaluation of interactive computerized training to teach parents to implement photographic activity schedules with children with autism spectrum disorder. Journal of Applied Behavior Analysis, 50(3), 567-581https://doi.org/10.1002/jaba.386
Gerow, S., Hagan-Burke, S., Rispoli, M., Gregori, E., Mason, R., & Ninci, J. (2018). A systematic review of parent-implemented functional communication training for children with ASD. Behavior Modification, 42(3), 335–363. https://doi.org/10.1177/0145445517740872
*Goldman, S. E., Glover, C. A., Lloyd, B. P., Barton, E. E., & Mello, M. P. (2018). Effects of parent implemented visual schedule routines for African American children with ASD in low-income home settings. Exceptionality, 26(3), 162-175. https://doi.org/10.1080/09362835.2017.1294984
*Greene, L., Kamps, D., Wyble, J., & Ellis, C. (1999). Home-based consultation for parents of young children with behavioral problems. Child & Family Behavior Therapy, 21(2), 19-45.https://doi.org/10.1300/J019v21n02_02
*Harding, J. W., Wacker, D. P., Berg, W. K., Lee, J. F., & Dolezal, D. (2009). Conducting functional communication training in home settings: A case study and recommendations for practitioners. Behavior Analysis in Practice, 2, 21–33. https://doi.org/10.1007/BF03391734
Heckaman, K., Conroy, M., Fox, J., & Chait, A. (2000). Functional assessment-based intervention research on students with or at risk for emotional and behavioral disorders in school settings. Behavioral Disorders, 25(3), 196–210. https://doi.org/10.1177/019874290002500307
Hong, E. R., Ganz, J. B., Mason, R., Morin, K., Davis, J. L., Ninci, J., Neely, L. C., Boles, M. B., & Gilliland, W. D. (2016). The effects of video modeling in teaching functional living skills to persons with ASD: A meta-analysis of single-case studies. Research in Developmental Disabilities, 57, 158–169. https://doi.org/10.1016/j.ridd.2016.07.001
Horner, R. H., Carr, E. G., Halle, J., McGee, G., Odom, S., & Wolery, M. (2005). The use of single-subject research to identify evidence-based practice in special education. Exceptional Children, 71(2), 165–179. https://doi.org/10.1177/001440290507100203
Kaiser, A. P., Hancock, T. B., Cai, X., Michael, E., & Hester, P. P. (2000). Parent-reported behavioral problems and language delays in boys and girls enrolled in Head Start classrooms. Behavioral Disorders, 26(1), 26–41.
Kazdin, A. E. (1980). Acceptability of time out from reinforcement procedures for disruptive child behavior. Behavior Therapy, 11(3), 329–344. https://doi.org/10.1016/S0005-7894(80)80050-5
Kennedy, C. H. (2005). Single-case designs for educational research (1st ed.). Allyn & Bacon.
Kern, L., Choutka, C. M., & Sokol, N. G. (2002). Assessment-based antecedent interventions used in natural settings to reduce challenging behavior: An analysis of the literature. Education and Treatment of Children, 113–130. https://www.jstor.org/stable/42900519
Knight, V., Sartini, E., & Spriggs, A. D. (2015). Evaluating visual activity schedules as evidence-based practice for individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 45(1), 157–178. https://doi.org/10.1007/s10803-014-2201-z
Koegel, L., Matos-Freden, R., Lang, R., & Koegel, R. (2012). Interventions for children with autism spectrum disorders in inclusive school settings. Cognitive and Behavioral practice, 19(3), 401–412. https://doi.org/10.1016/j.cbpra.2010.11.003
Koyama, T., & Wang, H. T. (2011). Use of activity schedule to promote independent performance of individuals with autism and other intellectual disabilities: A review. Research in Developmental Disabilities, 32(6), 2235–2242. https://doi.org/10.1016/j.ridd.2011.05.003
*Krantz, P. J., & MacDuff, M. T. (1993). Programming participation in family activities for children with autism: Parent's use of. Journal of Applied Behavior Analysis, 26(1), 137. https://doi.org/10.1901/jaba.1993.26-137
Kratochwill, T. R., Hitchcock, J. H., Horner, R. H., Levin, J. R., Odom, S. L., Rindskopf, D. M., & Shadish, W. R. (2013). Single-case intervention research design standards. Remedial and Special Education, 34(1), 26–38. https://doi.org/10.1177/0741932512452794
Kurnaz, E., & Yanardag, M.(2018). The effectiveness of video self-modeling in teaching active video game skills to children with autism spectrum disorder. Journal of Developmental and Physical Disabilities, 30(4), 455-469. https://doi.org/10.1007/s10882-018-9596-y
Leaf, J. B., Cihon, J. H., Alcalay, A., Mitchell, E., Townley-Cochran, D., Miller, K., Leaf, R., Taubman, M., & McEachin, J. (2017). Instructive feedback embedded within group instruction for children diagnosed with autism spectrum disorder. Journal of Applied Behavior Analysis, 50(2), 304–316. https://doi.org/10.1002/jaba.375
*Lequia, J., Machalicek, W., & Rispoli, M. J. (2012). Effects of activity schedules on challenging behavior exhibited in children with autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 6(1), 480-492. https://doi.org/10.1016/j.rasd.2011.07.008
Libby, M. E., Weiss, J. S., Bancroft, S., & Ahearn, W. H. (2008). A comparison of most-to-least and least-to-most prompting on the acquisition of solitary play skills. Behavior analysis in practice, 1, 37–43. https://doi.org/10.1007/BF03391719
Lindly, O. J., Chavez, A. E., & Zuckerman, K. E. (2016). Unmet health services need among us children with developmental disabilities: Associations with family impact and child functioning. Journal of Developmental & Behavioral Pediatrics, 37(9), 712–723. https://doi.org/10.1097/DBP.0000000000000363
Lloyd, J. W., & Heubusch, J. D. (1996). Issues of social validation in research on serving individuals with emotional or behavioral disorders. Behavioral Disorders, 22(1), 8–14. https://doi.org/10.1177/019874299602200105
*Lorimer, P. A., Simpson, R. L., Smith Myles, B., & Ganz, J. B. (2002). The use of social stories as a preventative behavioral intervention in a home setting with a child with autism. Journal of Positive Behavior Interventions, 4(1), 53-60. https://doi.org/10.1177/109830070200400109
Lory, C., Rispoli, M., Gregori, E., Kim, S. Y., & David, M. (2020). Reducing escape-maintained challenging behavior in children with autism spectrum disorder through visual activity schedule and instructional choice. Education and Treatment of Children, 43(2), 201–217. https://doi.org/10.1007/s43494-020-00019-x
Loughrey, T. O., Contreras, B. P., Majdalany, L. M., Rudy, N., Sinn, S., Teague, P., Marshall, G., McGreevy, P., & Harvey, A. C. (2014). Caregivers as interventionists and trainers: Teaching mands to children with developmental disabilities. The Analysis of Verbal Behavior, 30(2), 128–140. https://doi.org/10.1007/s40616-014-0005-z
Mancil, G. R., Conroy, M. A., Nakao, T., & Alter, P. J. (2006). Functional communication training in the natural environment: A pilot investigation with a young child with autism spectrum disorder. Education and Treatment of Children, 615-633. https://www.jstor.org/stable/42900556
Matson, J. L., & Francis, K. L. (1994). Generalizing spontaneous language in developmentally delayed children via a visual cue procedure using caregivers as therapists. Behavior Modification, 18(2), 186–197. https://doi.org/10.1177/01454455940182003
McDuffie, K. A., & Scruggs, T. E. (2008). The contributions of qualitative research to discussion of evidence-based practice in special education. Intervention in School and Clinic, 44(2), 91–97. https://doi.org/10.1177/1053451208321564
Meadan, H., Ostrosky, M. M., Zaghlawan, H. Y., & Yu, S. (2009). Promoting the social and communicative behavior of young children with autism spectrum disorders: A review of parent-implemented intervention studies. Topics in Early Childhood Special Education, 29(2), 90–104. https://doi.org/10.1177/0271121409337950
Mechling, L. C., Gast, D. L., & Seid, N. H. (2010). Evaluation of a personal digital assistant as a self-prompting device for increasing multi-step task completion by students with moderate intellectual disabilities. Education and Training in Autism and Developmental Disabilities, 45(3), 422–439. https://www.jstor.org/stable/23880115
Mechling, L. C., & Gustafson, M. (2009). Comparison of the effects of static picture and video prompting on completion of cooking related tasks by students with moderate intellectual disabilities. Exceptionality, 17(2), 103–116. https://doi.org/10.1080/09362830902805889
Moes, D. R., & Frea, W. D. (2002). Contextualized behavioral support in early intervention for children with autism and their families. Journal of Autism and Developmental Disorders, 32(6), 519–533. https://doi.org/10.1023/A:1021298729297
Neidert, P. L., Dozier, C. L., Iwata, B. A., & Hafen, M. (2010). Behavior analysis in intellectual and developmental disabilities. Psychological Services, 7(2), 103. https://doi.org/10.1037/a0018791
Pierce, K. L., & Schreibman, L. (1994). Teaching daily living skills to children with autism in unsupervised settings through pictorial self-management. Journal of Applied Behavior Analysis, 27(3), 471–481. https://doi.org/10.1901/jaba.1994.27-471
Rao, S. M., & Gagie, B. (2006). Learning through seeing and doing: Visual supports for children with autism. Teaching Exceptional Children, 38(6), 26–33.
*Reagon, K. A., & Higbee, T. S. (2009). Parent‐implemented script fading to promote play‐based verbal initiations in children with autism. Journal of Applied Behavior Analysis, 42(3), 659-664. https://doi.org/10.1901/jaba.2009.42-659
Reichow, B., Volkmar, F. R., & Cicchetti, D. V. (2008). Development of the evaluative method for evaluating and determining evidence-based practices in autism. Journal of Autism and Developmental Disorders, 38(7), 1311–1319. https://doi.org/10.1007/s10803-007-0517-7
Reinert, K. S., Higbee, T. S., & Nix, L. D. (2020). Creating digital activity schedules to promote independence and engagement. Behavior Analysis in Practice, 13(3), 577–595. https://doi.org/10.1007/s40617-020-00437-8
Resnick, B., Inguito, P., Orwig, D., Yahiro, J. Y., Hawkes, W., Werner, M., Zimmerman, S., & Magaziner, J. (2005). Treatment fidelity in behavior change research: A case example. Nursing Research, 54(2), 139–143.
Roberts, M. Y., & Kaiser, A. P. (2015). Early intervention for toddlers with language delays: A randomized controlled trial. Pediatrics, 135(4), 686–693. https://doi.org/10.1542/peds.2014-2134
Rutherford, M., Baxter, J., Grayson, Z., Johnston, L., & O’Hare, A. (2020). Visual supports at home and in the community for individuals with autism spectrum disorders: A scoping review. Autism, 24(2), 447–469. https://doi.org/10.1177/2F1362361319871756
Sam, A., & AFIRM Team. (2015). Visual supports. Chapel Hill, NC: National Professional Development Center on Autism Spectrum Disorder, FPG Child Development Center, University of North Carolina. Retrieved from http://afirm.fpg.unc.edu/visual-supports. https://files.eric.ed.gov/fulltext/ED595398.pdf
Schlosser, R. W., Wendt, O., & Sigafoos, J. (2007). Not all systematic reviews are created equal: Considerations for appraisal. Evidence-Based Communication Assessments and Interventions, 3, 138–150. https://doi.org/10.1080/17489530701560831
Sham, E., & Smith, T. (2014). Publication bias in studies of an applied behavior-analytic intervention: An initial analysist. Journal of Applied Behavior Analysis, 47, 663–678. https://doi.org/10.1002/jaba.146
*Slattery, L., Crosland, K., & Iovannone, R. (2016). An evaluation of a self-management intervention to increase on-task behavior with individuals diagnosed with attention-deficit/hyperactivity disorder. Journal of Positive Behavior Interventions, 18(3), 168-179. https://doi.org/10.1177/1098300715588282
Sloman, K. N., Vollmer, T. R., Cotnoir, N. M., Borrero, C. S., Borrero, J. C., Samaha, A. L., & Peter, C. C. S. (2005). Descriptive analyses of caregiver reprimands. Journal of Applied Behavior Analysis, 38(3), 373–383. https://doi.org/10.1901/jaba.2005.118-04
Snodgrass, M. R., Chung, M. Y., Meadan, H., & Halle, J. W. (2018). Social validity in single-case research: A systematic literature review of prevalence and application. Research in Developmental Disabilities, 74, 160–173. https://doi.org/10.1016/j.ridd.2018.01.007
Spriggs, A. D., Mims, P. J., van Dijk, W., & Knight, V. F. (2017). Examination of the evidence base for using visual activity schedules with students with intellectual disability. The Journal of Special Education, 51(1), 14–26. https://doi.org/10.1177/2F0022466916658483
*Sreckovic, M. A., Hume, K. A., & Regan, T. E. (2020). Use of work systems to increase the independence of adolescents with autism spectrum disorder. Career Development and Transition for Exceptional Individuals, 43(4), 240-256. https://doi.org/10.1177/2165143420948766
Stoner, J. B., Angell, M. E., House, J. J., & Bock, S. J. (2007). Transitions: Perspectives from parents of young children with autism spectrum disorder (ASD). Journal of Developmental and Physical Disabilities, 19(1), 23–39. https://doi.org/10.1007/s10882-007-9034-z
Symon, J. B. (2005). Expanding interventions for children with autism: Parents as trainers. Journal of Positive Behavior Interventions, 7(3), 159–173. https://doi.org/10.1177/10983007050070030501
Tomeny, K. R., McWilliam, R. A., & Tomeny, T. S. (2020). Caregiver-implemented intervention for young children with autism spectrum disorder: A systematic review of coaching components. Review Journal of Autism and Developmental Disorders, 7(2), 168–181. https://doi.org/10.1007/s40489-019-00186-7
*Vaughn, B. J., Clarke, S., & Dunlap, G. (1997). Assessment‐based intervention for severe behavior problems in a natural family context. Journal of Applied Behavior Analysis, 30(4), 713-716. https://doi.org/10.1901/jaba.1997.30-713
What Works Clearinghouse. (2017). What works clearinghouse: Standards handbook, version 4.0. U.S. Department of Education, Institute of Education Sciences, National Center for Education Evaluation and Regional Assistance. Retrieved from https://ies.ed.gov/ncee/wwc/Docs/referenceresources/wwc_standards_handbook_v4.pdf.
What Works Clearinghouse. (2020). What works clearinghouse: Standards handbook, version 4.1. U.S. Department of Education, Institute of Education Sciences, National Center for Education Evaluation and Regional Assistance. Retrieved from https://ies.ed.gov/ncee/wwc/Docs/referenceresources/WWC-Standards-Handbook-v4-1-508.pdf
Wolf, M. M. (1978). Social validity: the case for subjective measurement or how applied behavior analysis is finding its heart 1. Journal of Applied Behavior Analysis, 11(2), 203–214. https://doi.org/10.1901/jaba.1978.11-203
Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., Kucharczyk, S., Brock, M. E., Plavnick, J. B., Fleury, V. P., & Schultz, T. R. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45(7), 1951–1966. https://doi.org/10.1007/s10803-014-2351-z
Zablotsky, B., Black, L. I., Maenner, M. J., Schieve, L. A., Danielson, M. L., Bitsko, R. H., Blumberg, S. J., Kogan, M. D., & Boyle, C. A. (2019). Prevalence and trends of developmental disabilities among children in the United States: 2009–2017. Pediatrics, 144(4).
Zimmerman, K. N., Ledford, J. R., & Barton, E. E. (2017). Using visual activity schedules for young children with challenging behavior. Journal of Early Intervention, 39(4), 339–358. https://doi.org/10.1177/1053815117725693
Funding
No funding was received to assist with the preparation of this manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethics Approval
All study procedures received approval from the Institutional Review Board (IRB).
Conflict of Interest
The authors do not have any conflict of interest to disclose.
Consent to Participate
Written informed consent was obtained from parents or legal guardians.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Avery, S.K., Akers, J.S., Gerow, S. et al. The Use of Caregiver-Implemented Visual Supports for Individuals with Developmental Disabilities: A Systematic Literature Review. Rev J Autism Dev Disord (2023). https://doi.org/10.1007/s40489-023-00390-6
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s40489-023-00390-6