The College of Wooster Open Works Senior Independent Study Theses 2019 Perseveration or Perseverance: Investigating Interpretations of Echolalia, Self-Stimulatory Behaviors, and Intervention Approaches for Children Who Have Autism Ashlynn Rae Kufleitner The College of Wooster, [email protected] Follow this and additional works at: https://openworks.wooster.edu/independentstudy Part of the Communication Commons, Disability Studies Commons, and the Speech Pathology and Audiology Commons Recommended Citation Kufleitner, Ashlynn Rae, "Perseveration or Perseverance: Investigating Interpretations of Echolalia, Self- Stimulatory Behaviors, and Intervention Approaches for Children Who Have Autism" (2019). Senior Independent Study Theses. Paper 8581. This Senior Independent Study Thesis Exemplar is brought to you by Open Works, a service of The College of Wooster Libraries. It has been accepted for inclusion in Senior Independent Study Theses by an authorized administrator of Open Works. For more information, please contact [email protected]. © Copyright 2019 Ashlynn Rae Kufleitner PERSEVERATION AND PERSEVERANCE: INVESTIGATING INTERPRETATIONS OF ECHOLALIA, SELF-STIMULATORY BEHAVIORS, AND INTERVENTION APPROACHES FOR CHILDREN WHO HAVE AUTISM by Ashlynn Rae Kufleitner An Independent Study Thesis Presented in Partial Fulfillment of the Course Requirements for Senior Independent Study: The Department of Communication March 24th, 2019 Advisor: Joan E. Furey, Ph.D. ABSTRACT The broad purpose of this study was to examine professionals’ perceptions of self- stimulatory behaviors in school-age children who have autism and the relation of these behaviors to communication. More specifically, I investigated whether and how speech-language pathologists and applied behavior analysis therapists address these behaviors during therapy by analyzing what factors may influence the selection of intervention methods and how these methods may be used to shape restrictive behaviors into functional communication. Through pursuing this topic, I hoped to increase research concerning the ways that echolalia and self- stimulatory behaviors are perceived by clinicians who work with clients on the autism spectrum and how clinicians approach these behaviors in therapy. Data for this study were collected using a quantitative, electronic survey that was completed by 52 speech-language pathologists and 2 applied behavior analysis therapists. The results revealed that professionals believe that self- stimulatory behaviors can be both purposeful and communicative. In addition, participants reported that they believed the needs and opinions of clients and their families were the most important factors to consider when deciding interventions for self-stimulatory behaviors. Key Words: autism, self-stimulatory behaviors, speech-language pathologist (SLP), applied-behavior analysis therapist (ABA therapist), echolalia ii ACKNOWLEDGMENTS As my time at the College of Wooster nears its end, I would like to take the time to thank those who have walked with me through every step of the I.S. process, and at the end of it all, are still standing by me. I am so lucky and grateful to have had you all in my life. First, I would like to thank Dr. Joan Furey. When everything about senior year seemed so complicated and impossible, thank you for chats about cats and sprinkles. Thank you for gifting me the dark chocolate you don’t like when I’ve had a bad day. Thank you for being my advisor – for listening to every I.S. fear and every grad school worry – and guiding me through college for four years. I sincerely appreciate you, and our wonderful CSD department, for all the support. Thank you, Tessa Hall, for being our CSD Scream Sponge™. Thank you for your kindness, your honesty, your amazing deciphering skills, and for always believing in us. My Fairlawn Farm (Zoe, Hayley, and Brian) thank you for laughing, and crying, with me. Thank you for listening to my countless rants, raising drinks for celebration or for forgetting, and for being understanding when I had to stay at my carrel to get any work done. Would it make you feel any better if I told you that you guys are too fun to be around? I would also like to thank my fellow CSD Wugs (especially Rachel & Bekah) for all the love and support throughout I.S. and grad school applications. They call undergrad competitive, but I’ve never felt more supported and welcomed than at Wooster. And Ian, thank you for sushi dates, late night phone calls, and your unwavering support. I cannot wait to see what amazing adult things you all will do, and the impact you will make on the parts of the world lucky enough to be around you. Last, but absolutely not least, I would like to thank my family. Mom, thank you for being my closest friend and role model and for sharing your love and mastery of words. Dad, thank you for teaching me how to stay determined and be confident in myself. Tanner and Tucker, you two are the whole reason I am where I am today. Thank you for sharing your world with me. iii TABLE OF CONTENTS CHAPTER I: INTRODUCTION .................................................................................................... 1 Purpose Statement ....................................................................................................................... 1 Rationales .................................................................................................................................... 1 Definitions................................................................................................................................... 3 Background ................................................................................................................................. 3 Description of Method ................................................................................................................ 4 Conclusion .................................................................................................................................. 4 CHAPTER II: LITERATURE REVIEW ....................................................................................... 6 Theories of Self-Stimulatory Behaviors ..................................................................................... 6 Sensory Over-Arousal and Under-Arousal ............................................................................. 7 Anxiety .................................................................................................................................... 8 Lack of Engaging Stimuli ....................................................................................................... 8 Echolalia ..................................................................................................................................... 9 Echolalia and Language Development ................................................................................... 9 Echolalia as a Social Behavior .............................................................................................. 10 Stigma Surrounding Self-Stimulatory Behaviors ................................................................. 11 Therapy Techniques for Management of Self-Stimulatory Behaviors ..................................... 13 Extinguishing Self-stimulatory Behaviors ............................................................................ 13 Sensory extinction and overcorrection.................................................................................. 14 iv Exercise. ................................................................................................................................ 15 Replacement Behaviors ........................................................................................................ 20 Applied Behavior Analysis ................................................................................................... 22 Family and Client-Centered Care ............................................................................................. 25 Conclusion ................................................................................................................................ 30 CHAPTER III: METHOD ............................................................................................................ 31 Justification of Method ............................................................................................................. 31 Participants ................................................................................................................................ 32 Procedures ................................................................................................................................. 34 Instrument ................................................................................................................................. 34 CHAPTER IV: RESULTS AND DISCUSSION ......................................................................... 35 Results ....................................................................................................................................... 35 Professionals’ Knowledge of Language Development and ABA Techniques ..................... 35 Relationship of Self-Stimulatory Behaviors to Communication .......................................... 36 Professionals’ Perceptions of Self-Stimulatory Behaviors ................................................... 38 How Professionals Address Self-Stimulatory Behaviors in Therapy ..................................