Treino remoto de habilidades comportamentais em uma mãe na implementação de ensino por tentativas discretas em uma criança com autismo
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Data
2022-05-27
Autores
Matsunaka, Mayara Paula da Silva
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Crianças com autismo constituem uma população que pode apresentar repertório verbal mínimo, ou seja, déficits na comunicação e déficits interpessoais. O desenvolvimento de programas que possam ofertar condições relevantes para a aprendizagem e emergência de repertórios verbais, assim como os repertórios necessários para aplicação desses programas por parte dos cuidadores, são temas relevantes de pesquisa. O ensino por tentativas discretas (DTT) é uma modalidade de ensino estruturado, que consiste na apresentação ao aprendiz do estímulo discriminativo e na resposta do aprendiz seguida pela consequência programada. Um intervalo entre tentativas é realizado e prompts são esvanecidos para garantir respostas independentes. A Instrução por Múltiplos Exemplares (MEI) é uma forma de estruturar o ensino de comportamento verbal com diferentes funções (de ouvinte, rotular objetos, fazer pedidos) apresentando, de forma rotativa, diferentes controles de estímulos (palavra ditada, figura) e diferentes topografias de respostas (vocalização, apontar). A literatura tem registrado que o MEI tem induzido comportamento verbal novo, com ênfase em tato emergente. Uma questão de pesquisa seria verificar se o MEI induziria a emergência de mando e se os resultados seriam semelhantes se os procedimentos fossem aplicados por uma cuidadora, demonstrando quais as necessidades de treinamento de habilidades comportamentais. O treinamento de habilidades comportamentais (BST) é um pacote de treinamento que consiste em quatro passos: 1) Fornecer instrução; 2) Fornecer modelo; 3) Ensaio; e 4) Feedback. Esta pesquisa objetivou verificar os efeitos do BST para ensinar habilidades comportamentais a uma cuidadora (mãe). Além disso, verificar se, após o ensino de habilidades comportamentais à mãe, se ela aplica um protocolo de ensino baseado em tentativas discretas e em MEI no ensino de comportamento de falante (tato e mando) em uma criança com TEA. Os procedimentos foram apresentados pela cuidadora à criança, em ambiente doméstico, após BST específico para isso, via remota. As sessões foram registradas para posterior análise. Foram alvo de análise as habilidades da cuidadora que permitiram a aplicação do procedimento de forma correta, considerando as variáveis necessárias de instrução adicional e níveis de ajuda. A cuidadora aprendeu a aplicar as etapas do ensino de habilidades verbais estruturado em MEI corretamente. A necessidade de orientações (instruções do tipo 1, instruções do tipo 2, modelo, ensaio, feedback e orientações via WhatsApp) à cuidadora iniciou em alta frequência e, ao longo do procedimento, foi decrescendo. Ou seja, ela foi ficando cada vez mais independente. Também foram alvo de análise a aprendizagem de repertório verbal pela criança que demonstrou a emergência de repertório verbal novo. Nos três pré-testes, o desempenho em tato e mando foram nulos. Nos pós-testes, tato e mando se mantiveram com porcentagem de acerto superior a linha de base em todos os conjuntos para pelo menos duas das avaliações. O conjunto 2, que recebeu o MEI, apresentou aumento da porcentagem de acertos em ouvinte, tato e mando. A cuidadora reconheceu a estratégia como efetiva e eficiente. Os resultados podem viabilizar o uso de procedimentos testados em laboratório em ambientes mais aplicados, sob orientação remota.
Children with autism constitute a population that may present minimal verbal repertoire, in other words, communication deficits and i nterpersonal deficits. The development of programs that can offer relevant conditions to learning and emergence in verbal repertoires as well as the necessary repertoires for the application of these programs by caregivers are important topics to this rese arch. Discrete trial teaching (DTT) is a structured teaching modality that consists in the presentation of the discriminative stimulus to the learner and the learner’s response followed by the programmed consequence. An interval between attempts is perfor med and the prompts are faded out to guarantee independent responses. The Multiple Exemplar Instruction is a way to structure the verbal behavior teaching with different functions (listener, namingobjects, making requests) presenting, in a rotating way, d ifferent stimulus controls (dictated words, figure) and different topographies of responses (vocalizations, pointing). The literature has shown that the MEI has induced new verbal behavior with emphases in the emergence of tact. One research question would be the verification if the MEI would induce the emergence of mand and if the outcomes would be similar if applied by a caregiver, showing what are the behavior skill training needed. The behavior skills training (BST) is a set of training that consists in four steps: 1) Provide instruction; 2) Provide model; 3) Rehearsal; and 4) Feedback.This research aimed to verify the effects of BST to teach behavioral skills to a caregiver (mother). Besides, verify if, after teaching the mother behavioral skills, if sh e applies a protocol of teaching based in discrete trials and in MEI in the teaching of speaker behavior (tact and mand) in a child with ASD. The procedures were presented to the child by the caregiver, in a home environment, after remotely BST specific fo r this purpose. The sessions were registered for further analysis. The skills of the caregiver that allowed the application of the procedure correctly, considering the variables needed to additional instruction and level of help were the aim of the analysi s. The caregiver learned correctly to apply the steps of the teaching of verbal skills structured in MEI. The necessity of orientation (type 1 instructions, type 2 instructions, model, rehearsal, feedback and orientation via WhatsApp) to the caregiver bega n with high frequency and it was decreasing throughout the procedure. In other words, she was getting more independent. The learning of verbal repertoire by the child that presented the emergence of new verbal repertoire was aim of analysis as well. In the three pre performance in tact and mand was null. In the three post-- tests, the tests, tact and mand remained with a percentage of correct responses superior the baseline in all the sets, to at least two of the evaluations. Set 2, that received MEI, present ed an increase in the percentage of correct responses in listening, tact and mand. The caregiver recognized the strategy as effective and efficient. The outcomes may enable the use of procedures tested in laboratories in more applied environments, under re mote orientation.
Children with autism constitute a population that may present minimal verbal repertoire, in other words, communication deficits and i nterpersonal deficits. The development of programs that can offer relevant conditions to learning and emergence in verbal repertoires as well as the necessary repertoires for the application of these programs by caregivers are important topics to this rese arch. Discrete trial teaching (DTT) is a structured teaching modality that consists in the presentation of the discriminative stimulus to the learner and the learner’s response followed by the programmed consequence. An interval between attempts is perfor med and the prompts are faded out to guarantee independent responses. The Multiple Exemplar Instruction is a way to structure the verbal behavior teaching with different functions (listener, namingobjects, making requests) presenting, in a rotating way, d ifferent stimulus controls (dictated words, figure) and different topographies of responses (vocalizations, pointing). The literature has shown that the MEI has induced new verbal behavior with emphases in the emergence of tact. One research question would be the verification if the MEI would induce the emergence of mand and if the outcomes would be similar if applied by a caregiver, showing what are the behavior skill training needed. The behavior skills training (BST) is a set of training that consists in four steps: 1) Provide instruction; 2) Provide model; 3) Rehearsal; and 4) Feedback.This research aimed to verify the effects of BST to teach behavioral skills to a caregiver (mother). Besides, verify if, after teaching the mother behavioral skills, if sh e applies a protocol of teaching based in discrete trials and in MEI in the teaching of speaker behavior (tact and mand) in a child with ASD. The procedures were presented to the child by the caregiver, in a home environment, after remotely BST specific fo r this purpose. The sessions were registered for further analysis. The skills of the caregiver that allowed the application of the procedure correctly, considering the variables needed to additional instruction and level of help were the aim of the analysi s. The caregiver learned correctly to apply the steps of the teaching of verbal skills structured in MEI. The necessity of orientation (type 1 instructions, type 2 instructions, model, rehearsal, feedback and orientation via WhatsApp) to the caregiver bega n with high frequency and it was decreasing throughout the procedure. In other words, she was getting more independent. The learning of verbal repertoire by the child that presented the emergence of new verbal repertoire was aim of analysis as well. In the three pre performance in tact and mand was null. In the three post-- tests, the tests, tact and mand remained with a percentage of correct responses superior the baseline in all the sets, to at least two of the evaluations. Set 2, that received MEI, present ed an increase in the percentage of correct responses in listening, tact and mand. The caregiver recognized the strategy as effective and efficient. The outcomes may enable the use of procedures tested in laboratories in more applied environments, under re mote orientation.
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Palavras-chave
Treinamento de habilidades comportamentais, Operantes verbais, Intervenção remota, Cuidadora, Autismo, Behavioral skills training, Verbal operants, Remote intervention, Caregiver, Autism