Participants and SettingStudent

Stu (name is a pseudonym), age 21, entered the university program with a diagnosis of significant disability based on a high school evaluation team report (ETR). Selecting and managing course work was part of the educational programming of the PSE program. Therefore, Stu advocated for and requested to enroll in the behavioral management class and gave assent to participate in the study. The class was Stu’s first college class and he needed support with accessing and learning course content. He would sleep during class, look out the window, and occasionally laugh out loud, most likely to gain peer attention.

According to the Kaufman Test of Education Achievement (Kaufman & Kaufman, 2004), form A, Stu read at a 6th–8th grade level, his reading comprehension standard score was 59, and listening comprehension was 76 (average range: 85–115). Stu independently used a power chair to arrive at his classes and communicated through an augmentative and alternative communication (AAC) device. Stu typed his responses on the AAC, including the tests and social validation scores.

Teacher, Job Coach, and Settings

The classroom teacher was an associate professor, Caucasian male with 10 years of teaching experience at the higher education level. The study took place in an applied behavior analysis (ABA) class required for a junior special education cohort. There were approximately 34 students in the class during the study. The study took place during whole group teacher-led instruction at the same time each morning. An entire class session typically lasted 130 min; however, the 30-min teacher proximity and picture prompt intervention was used only during the beginning of class time. The study was conducted over a period of 12 weeks with sessions occurring once a week. The job coach was a senior undergraduate special education student. The generalization setting was a local drugstore where Stu worked once a week for 2 hr. Data collection in this setting was also 30 min in duration at the beginning of the shift.

Materials

The authors used a picture prompt card that was 3.5 x 6.5 in. The teacher selected lesson objectives from chapters in the book Managing Classroom Behavior Using Positive Behavior Supports (Scott et al., 2011). To measure improvement in learning the instructor administered a pre- and posttest. Questions were taken from the book Applied Behavior Analysis for Teachers (9th ed.; Alberto & Troutman, 2012). The same questions were used for the pre- and posttest.

Pre- and posttest scores were measured as the percentage of correct responses as well as the number of items correct on 18-item multiple choice quizzes. The same test was administered on the first and last days of class. During the pretest and posttest, students were not allowed to use the textbook. According to Stu’s accommodation plan, a university professor independently administered the tests in another setting on campus. As part of his established academic programming, Stu used a “look back” procedure (a type of error correction strategy used in the college’s postsecondary program) from the Qualitative Reading Inventory-5 (QRI-5) reading assessment to retrieve answers from the textbook on 9 out of 18 questions during the posttest.

Data Collection and Training

Three advanced undergraduate students trained in ABA served as observers and were trained by the first author. To control for observer drift, the teacher met with the three observers on a biweekly basis for retraining. The third observer was the job coach. To ensure accuracy of pre- and posttest scores a faculty member who did not participate in the study independently scored the pre- and posttest. All observations lasted a total of 30 min and sessions occurred after the first 5 min of class. A 1-min momentary time sampling recording system was used for on-task behavior. During this time the teacher’s use of proximity and picture prompts was recorded for treatment adherence.

Dependent MeasuresOn-Task Behavior

On-task behavior included using the AAC device (for Stu) and for everyone, looking at and/or writing responses on a worksheet, head and body facing peers while discussing academic material, and tracking the teacher during teacher-led instruction (Faul et al., 2012). On-task behavior also included Stu’s answering questions on signal and following teacher directions related to the material being covered in class. In the generalization setting, on-task behavior was defined as engaging in the task (i.e., stocking shelves, picking up boxes), eyes on the job coach when given directions, and eyes on the task.

Interobserver Agreement

Interobserver agreement was assessed only in the classroom setting for 100% of baseline and intervention sessions by having a second observer simultaneously collect data. On-task behavior was calculated using an interval agreement formula, the number of intervals of agreement, divided by the total number of intervals and multiplied by 100%. The unit of measurement was percentage of 1-min intervals. Mean interobserver agreement for on-task behavior across the two study conditions was 91.1% and 94.6% (range: 90.6%–100%). Total count interobserver agreement for correct answers (smaller sum divided by larger sum) was used for pre- and posttest scores. Interobserver agreement was 100%.

Experimental Design and Procedure

An alternating treatments design with a baseline phase throughout the study was used to assess the effectiveness of the intervention. The two conditions were alternated each class meeting. Phase changes were determined by a minimum of three data points during baseline.

Baseline

During this condition, the teacher lectured on ABA content, used questions to assess student understanding, and showed videos of behavioral concepts. The students volunteered responses by raising their hands. The teacher remained at the front of the room near his desk and did not use teacher proximity or the picture prompt for the entire session. Baseline for the generalization setting consisted of the job coach supervising Stu at the drugstore and observing him from approximately 7 ft while he stocked shelves. Teacher proximity with the picture prompt card was not used. After three data points were collected the teacher and job coach implemented proximity with the picture prompt strategy.

Training Session with Picture Prompt

The teacher had previously attended a 1-day training on the Good Behavior Game including a 15-min presentation on the use of picture prompts. After baseline and before the first intervention data point, the teacher read a script to Stu and the class that covered the procedures of the picture prompt: (1) introduced OK/Not OK by referring to the lanyard card; (2) explained to the student and class that you will use the picture prompt to send messages; (3) provided examples of messages, “When you see me touch ‘OK,’ it means you’re on task and should keep it up! If you see me touch ‘Not OK,’ you are off-task and think about what needs fixing; (4) the teacher modeled some behaviors that may receive “OK” or “Not OK”; (5) the teacher used OK/Not OK cues without verbal interruptions that distracted the rest of the students in the classroom. Stu used his AAC device indicating a “Yes” that he understood each procedure. The training took approximately 5–10 min to complete.

Picture Prompt and Proximity Intervention

During this condition the teacher followed the procedures during baseline except he wore a Motivaider device that vibrated every 5 min. After the cue of the Motivaider he walked within an arm’s length of Stu pointed towards “OK” portion of the card when Stu was on task or pointed to “Not OK” when Stu was off task. The procedure lasted for approximately 5 s. To avoid stigmatization the teacher also used the picture prompt with the entire class. The classroom was divided into six quadrants. After cueing Stu, the teacher stood in each quadrant for approximately 5 s and pointed to the card in view of the group of students. The teacher did not systematically use proximity for the other individual students in the classroom. In the generalization setting the job coach followed the same procedures as the classroom teacher.

Treatment Adherence

A procedural checklist was developed to measure the accuracy with which the teacher used the picture prompt and proximity intervention. Independent observers checked each step as either present or absent before each intervention session. Checks for the intervention were scored during 100% of sessions and consisted of the five steps listed above. The observers also marked whether the teacher pointed to “OK” or “Not OK.” Treatment adherence was calculated by dividing the number of steps present by the total number of steps and then multiplying by 100%. Treatment integrity data indicated that the teacher implemented all procedural steps of the teacher proximity with picture prompt with 100% adherence on all occasions.

Social Validity

At the completion of the study, the teacher and Stu completed a 5-question social validity survey regarding the acceptability and usefulness of the teacher proximity with picture prompt strategy. The survey consisted of 4-point Likert scale responses indicating 1 (not at all), 2 (somewhat), 3 (fairly), 4 (very). The questions consisted of the ease of implementation, perceived intervention effectiveness, and likelihood of future intervention use.