Answering Wh-Questions with the Support of Graphic Organizers: Effects on 8th Graders with Autism Spectrum Disorder

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Setting

This study took place in a public-school classroom setting. Baseline and intervention sessions were conducted in a specialized support classroom designed to provide instruction to students receiving special education services. Environmental materials included a chair and desk of appropriate size for each participant and a chair for the interventionist.

The interventionists sat at a 45- to 90-degree angle across the table from the student. Each session lasted no longer than 30 minutes.

During the baseline and intervention phase of training, the teacher and student were present. The first author and independent observer attended periodically to conduct data collection for inter-rater reliability. The generalization phase included the implementation of a graphic organizer into an inclusive general education social studies classroom at the eighth-grade level. Prior to the intervention, baseline probes were taken in the general education setting for just one component of the treatment package (answering wh-questions) for each participant. The probe information is included in the data reporting.  

Instrumentation and Materials

The district assesses all students on the Istation Internet-based assessment Indicators of Progress (ISIP; Mathes & Torgesen, 1998). The ISIPprovides assessments and curriculum lessons in reading and math, and the district uses it to obtain students’ independent reading levels so teachers may provide targeted reading instruction. Typical grade-level peers score between 278 and 289 in comprehension on the ISIP reading ability assessment. This assessment was utilized with participants to ensure that text selection for intervention was on a level commensurate with each participant’s score and at an independent reading level. Participants recruited for this study had scores ranging from 240 to 277 in comprehension on the ISIP reading ability assessment. These scores were used to analyze texts for readability, vocabulary, and decoding. Passages were identified from leveled readers that closely aligned to the topics to help control for external bias and maintain the intervention’s fidelity. The texts chosen for the study covered general topics for eighth-grade social studies content based on the general education scope and sequence and state curriculum standards.

A series of eight words for sorting and eight teacher questions based on the social studies passage were developed by the researcher. The questions had two questions from each category: who, what, where, what doing/what for which matched the categories on the graphic organizer used in the intervention. Participants were provided with the graphic organizer template at the beginning of the session (Figure 1), a reading book appropriate for the participant, and a bookmark to track reading if needed for the intervention sessions. Participants were also provided with a visual schedule or “to-do” sheet detailing which reading needed to occur and how many questions needed to be answered after the reading.

Who	What
Where	What Doing/What Purpose

Figure 1. Graphic Organizer

Experimental Design

The study used a single-subject multiple-baseline (A-B and generalization) design across participants to investigate the impact of a graphic organizer on answering wh-questions in a staggered phase change design. There were three phases in the study including baseline, intervention and generalization.

Baseline phase. The data collection at baseline for answering wh-questions used a concurrent design with a staggered phase change in the participants’ classrooms. Typical instruction procedures in the school’s general education social studies classroom involved the teacher lecturing on content while the students had access to a note page or summary of reading high points on their desks. Standard practice was for students to read passages or to listen to the lecture and answer wh– questions about the content. Thus, baseline procedures comprised of the standard instructional practices without having the graphic organizer present. Data collection for the baseline phase for wh-questions began at the same time for all participants. Once data stability, a minimum of four data points, was reached for the first participant and intervention was introduced, baseline continued for the remaining participants. This cycle was repeated for participants two, three, and four until the last participant entered the intervention phase.  

Intervention phase. Intervention was conducted until a change occurred in the measured behaviors. The intervention phase for the second participant began when the data points for the first participant’s intervention phase showed an upward trend evident after 3 to 5 data points. This rolling introduction of the intervention phase was used for the remaining two participants. Intervention sessions were conducted in the same location as the baseline phase.

The interventionists introduced the materials for the lesson at the beginning of each session and stated the topic. This allowed the participants to preview the material for any unknown words and ask questions for clarification. Then, the participants were instructed to read the passage. When the participants were finished, the interventionists provided the index cards that contained individual words from the reading. The participants were instructed to place the words in one of the four categories on the graphic organizer.

Once the participants had sorted the words (regardless of accuracy) onto the graphic organizer, the interventionists presented eight index cards, each containing a question related to the reading. At the end of each session, the interventionists reviewed the number of correct responses with the participants and provided verbal praise for correct answers. Sessions for intervention were conducted weekly.

Follow-up phase. After the intervention phase concluded and a minimum of a 1-week break was given due to the statewide testing calendar, three follow-up sessions were conducted for each participant. This follow-up phase was conducted in an inclusive general education classroom for social studies or in the special education classroom depending on time of day. Classroom procedures were similar to a typical lesson format described in the baseline phase. It consisted of a traditional teacher lecture with note page or reading summary document on their desk but also included a graphic organizer with word sorting cards to help answer wh-questions related to the lesson. These sessions were completed either in the general education classroom or in a special education classroom following the class period. The general education teachers’ schedules and participants’ comfort levels determined where the sessions were conducted.

Interventionists

Teacher interventionists. Two teachers provided intervention to the participants. These teachers were the participants’ current support teachers and were certified in K–12 special education and 4–8 generalist. The female teacher had 14 years of teaching experience while the male teacher had four years of teaching experience. The participants’ special education teachers served as the interventionists to (1) minimize the potential heightened anxiety of the participants with ASD due to changes in personnel, (2) increase the participants’ abilities to transfer the learned skills across tasks by conducting the intervention with familiar teachers in the setting where they were expected to perform the skills, and (3) increase the flexibility of the intervention session scheduling of the teachers.

Interventionist training.The first author trained each teacher responsible for intervention in the following areas: (a) creation and use of the graphic organizer, (b) data collection procedures, and (c) steps in the intervention implementation. Training involved a combination of approaches to ensure student understanding and success upon implementation as well as a discussion of presentation of materials. Both interventionists demonstrated the ability to present the material for intervention following the protocol in the training session at 100% mastery based on researcher observation. The first author addressed both nonverbal body language and paraverbal language to maximize the neutral presentation of information. While nonverbal language consists of body language and gestures, paraverbal language refers to a person’s tone, volume, and cadence of speech. Training in paraverbal language was given to minimize unintended teacher influence.

During training, the interventionists had opportunities to ask questions and practice the intervention and receive implementation feedback. Total training time was estimated at 30 minutes per interventionist and was completed prior to implementing it with the student participants. Training occurred at each interventionist’s junior high campus during the planning period. Training sessions were recorded on an Apple iPad®.

An instructional specialist employed by the district served as an independent observer and teacher fidelity rater. The independent observer was present for two intervention sessions per participant. Following observation of two sessions, the independent observer then viewed the electronic recording of the training sessions and rated sessions according to the checklist for lesson presentation to ensure fidelity across support teachers.         

Data Collection and Analysis

This study measured reading comprehension as the dependent variable. In doing so, it used a graphic organizer designed with four categories corresponding to the topics of the wh-questions asked following a reading passage. Topic headings were; who, what, where and what for. Data obtained for answering wh-questions were graphed as percent correct for analysis. Data collection involved noting responses to wh-questions. Effect sizes were also calculated using the Percentage of Non-overlapping Data (PND). Interpretation ranges for effectiveness with PND are: 91% to 100% highly effective, 71% to 90% moderately effective, 50% to 70% minimally effective, and below 50% not effective.

Interobserver Agreement

Interobserver agreement (IOA), defined as the agreement between independent observers on intervention responses, was calculated to ensure integrity of the measurement process. The first author served as the primary observer, and an instructional specialist supporting the campus served as the secondary observer. The IOA consisted of four sessions for answering wh-questions. During the follow-up phase, the primary and secondary observers scored three sessions for answering wh-questions. The primary and secondary observers privately recorded correct and incorrect responses of answering wh- questions.

The IOA for the intervention phase was 100% for all sessions rated. Both the primary and secondary observers indicated 100% agreement for wh-questions answered across sessions observed for each participant with each interventionist. During follow-up probes, the IOA was also 100%, as both observers indicated 100% agreement across participants.

Social Validity

Social validity relates to the acceptability of the goals, methods, and outcomes of treatments by consumers (Wolf, 1976). A questionnaire was developed to support the work of Reichow, Doehring, Cicchetti, and Volkmar (2011). Six of the seven indicators met by the questionnaire were: (a) consumers are satisfied with results, (b) clinically significant behavior changes are achieved, (c) a socially important dependent variable exists, (d) the study is time and cost effective, (e) independent variable intervention was conducted by people who typically come into contact with the participant, and (f) intervention occurred in a natural environment. The only criterion not addressed was the comparison between students with and without disabilities. The questionnaire was distributed to the parents, teachers, and participants at the study’s conclusion. The results of the questionnaire were analyzed by reporting value ratings on all six questions across audiences. Results were compared according to question and audience.

Results

Figure 2 illustrates the data on the use of a graphic organizer to answer wh-questions. Data were collected on the percentage of questions answered correctly. Data results for answering wh-questions mirrored those noted in Bethune and Wood (2013) with participants experiencing an increase in the number of questions answered correctly during intervention and follow-up phases. Prior to intervention, baseline probes for wh-questions were conducted in the general education setting. Ethan was the only participant who answered one question correctly in that phase. Due to schedule restrictions with state and district-wide testing, no more than a total of 8 sessions were conducted per participant. Data were graphed using Microsoft Excel and visually inspected for level stability and trends, compared to the participants’ baseline measures, and interpreted. Data were visually analyzed for immediacy of effect.

Figure 2: Percentage of correctly answered wh-questions.

Triangles represent maintenance probes for answering wh-questions. Squares represent baseline and intervention responses for wh-questions.

Results for Each Participant

Jack. Baseline data for Jack was 0% in the specialized setting and 0% for general education probes. During intervention, data for answering wh-questions ranged from 75% to 100%. Jack’s data for the maintenance phase probes was 100%.  Median for Jack during intervention was 93.9%. The data also showed a stable and flat trend line. There was an immediacy of effect upon introducing the intervention. The PND score was100% which is interpreted as a highly effective effect size.

Kevin. Baseline data for Kevin was 0% in the specialized setting and 0% for general education probes. During intervention, data for answering wh-questions ranged from 25% to 62.5%, with an overall average of 42%. Kevin’s data for the maintenance phase probes was 100%. Median for Kevin during intervention was 37.5%. There was also some variability in the data with an upward trend. There was an immediacy of effect upon introducing the intervention. The PND score was 100% which is interpreted as a highly effective effect size.

Ethan. Baseline data for Ethan was 0% in the specialized setting and 12.5% for general education probes. Ethan was able to answer one question asked of him in both settings prior to intervention at the time of observation. During intervention, data for answering wh-questions with the graphic organizer ranged from 50% to 100%. Ethan’s data for follow-up phase was 100%. Median for Ethan during intervention was 100%. Stability would have been met with one additional data point in the 20% range. There was some data some variability in the data with a mostly flat trend line. However, the last data point appeared to be an outlier as Ethan’s accuracy greatly decreased compared to the previous intervention data. There was an immediacy of effect upon introducing the intervention. Despite the outlier, the PND score was 100%, which is interpreted as a highly effective effect size.

Daniel. Baseline data for Daniel was 12.5% in the specialized setting and 0% for general education probes. Daniel was able to consistently answer one to two questions in the specialized setting prior to intervention. During intervention, Daniel answered all wh-questions during all sessions yielding 100%.  Data for the follow-up phase were also 100%. Median for Daniel during intervention was 100% with, all of his intervention sessions at 100%. Trend data indicated a flat line; and upon introducing the intervention there was an immediacy of effect. The PND score was100% which is interpreted as a highly effective effect size.

Table 2 summarizes the percentage of correctly answered wh-questions at baseline and intervention, noting mean, median, and range for each participant.

Table 2. Mean, Median, and Range of Wh-Questions Data

	Baseline				Intervention
Participant	Mean	Median	Range		Mean	Median	Range
Jack	0	0	0		90.7	93.9	75-100
Kevin	0	0	0		42.25	37.5	25-62.5
Ethan	0	0	0-1		87.5	100	50-100
Daniel	1.2	1	1-2		100	100	0

Procedural/Implementation Fidelity

This study also examined whether there was a functional relationship between teacher training, implementation of intervention fidelity, and participant success. Evidence shows teachers were trained to implement the intervention. Procedural fidelity measures included data evaluating two components identified in the work of Lynch and O’Donnell (2005). The first component was related to process components which address the quality of delivery. This fidelity measure was included in the intervention description as the interventionist received training prior to implementation (Lynch & O’Donnell, 2005). Intervention fidelity was measured through observation using the Fidelity of Implementation Checklist (Table 3), which denoted areas covered in the training of teachers prior to implementation of the intervention. The checklist allowed for consistency of implementation and assessed for procedural fidelity across interventionists during intervention. Two intervention sessions were observed by the first author and the second observer. The first author and the second observer then reviewed the recorded training session independent of each other and scored components using the checklist for implementation. Fidelity of Intervention was achieved at 76.5% for both interventionists. The observers marked 13 of the 17 steps as Yes to indicate the steps were completed by the interventionists. The four steps that were marked No were steps related to the use of the “to-do” list. As noted in Table 3, these steps were not needed for the intervention presentation as the participants understood the steps in the task after the first presentation session.  

All participants understood the process after the first session and were able to sort words on the graphic organizer independently. Answering wh-questions increased across all participants during the intervention, which could be correlated to the use of a consistent routine established by the interventionists and the checklist.

Procedural fidelity processes also includedmeasures in the structure of intervention. The following were evaluated (Lynch & O’Donnell, 2005): (a) adherence to the unit of study—Was the unit delivered as written? (b) exposure—Were length, time, and skills received as intended? (c) program differentiation—Were there differences from the standard curriculum? Data for 20% of the sessions during intervention were assessed. Measures in the structure of intervention included monitoring the session lesson plans and analyzing the completed data sheets to ensure adherence to the unit of study and time sequence outlined in the intervention description. The third area under structure of intervention measures did not present fidelity concerns since the curriculum was state approved for grade-level social studies.

Table 3. Fidelity of Intervention Implementation Checklist Results

Category	Step	Interventionist
		1	2
Session setup	Place the table and chairs in their proper positions.	Y	Y
	Prepare the “to-do” list.	Y	Y
	Place the materials for the session (“to-do” list, graphic organizer, and reading text) on the table.	Y	Y
Procedures for beginning intervention	Greet the student.	Y	Y
	Present the session topic. Teacher will state the topic. Teacher will ask the participant to preview material for any unknown vocabulary.	Y	Y
	Present the session “to-do” list.	Y	Y
	Check for understanding. Teacher will ask the participant to read the “to-do” list.	N	N
	Verbally direct the student to the reading material and graphic organizer.	Y	Y
	Allow the student time to read the passage.	Y	Y
Procedures following reading of the passage	Refer to the “to-do” list to indicate what has been concluded and what is next.	N	N
	Present 8 cards with words on them for sorting.	Y	Y
	Allow the student to sort the cards on the graphic organizer.	Y	Y
	Remove the organizer to the side of the work space.	Y	Y
	Use the “to-do” list to indicate what is next.	N	N
	Ask the student the set of questions.	Y	Y
	Record responses as correct or incorrect.	Y	Y
	Refer to the “to-do” list to indicate the conclusion of the session.	N	N
Note: Y = yes, N= no. The “to-do” list was not needed for any participants following the initial intervention session.

Social Validity

For the final research question, a social validity questionnaire designed to obtain information from the stakeholder groups to address three factors was used. The indicators of (a) satisfaction and (c) evidence of socially important variables were used as identified in Reichow et al. (2011). The social validity indicator, (b) significant behavior change, was achieved based on the intervention and outcome results. Additional data answered whether the use of a graphic organizer proved useful to the participants which further addressed indicators (b) and (c). The overall design of the study addressed the final indicator (d) overall time and cost effectiveness (Reichow et al., 2011).

All four students, both teachers, and two parents completed their questionnaires (80% return rate). Overall results from students indicated they felt the intervention was explained well (n = 2) or explained pretty well (n = 2). Three of the students indicated that the intervention was very important to them in comprehending reading passages in social studies content. The fourth student indicated it was somewhat important to comprehending reading passages. Teachers reported high satisfaction in all areas for the intervention and high value in the intervention continuing to make a difference in comprehension. One teacher reported being very satisfied with the overall intervention results and both teachers reported yes on positive progress with continued intervention. Both parents indicated the intervention would continue to make a difference in comprehension, seeing the importance of using it to teach comprehension, and that their child had expressed frustration with schoolwork periodically in the past. Results suggest using graphic organizers in an inclusive general education classroom for students with ASD yields high social validity in six of the seven criteria identified by Reichow et al. (2011).

Discussion

The purpose of this study was to extend the existing research in reading comprehension for students with ASD. Specifically, the degree of impact of graphic organizers on reading comprehension as measured by answering wh-questions in social studies content. The aim was to provide evidence that supported the use of graphic organizers in content areas other than reading to benefit students with ASD in gaining knowledge and skills in a variety of core content classes. Results of the data gathered for the three research questions demonstrated graphic organizers have the potential to help students with ASD understand content more successfully, teacher training on implementation of the strategy may impact student success, and teachers, participants and parents see the strategy as holding relatively high social validity.

Research question (RQ) 1 hypothesized whether there was a functional relationship between the use of graphic organizers and reading comprehension measured by evaluating the answering of wh-questions in grade level social studies content for students with autism. The intervention yielded increases for all participants in answering wh-questions. There was an immediacy of effect observed with all four participants upon introducing the intervention phase, and there were no overlapping data when comparing the baseline data against the intervention data, thus, yielding highly effective intervention effects across all participants. These results support similar findings by Bethune and Wood (2013), Iguatova (2013), and O’Conner and Klein (2004). Their studies measured the participants’ abilities to answer questions about text read. They reported an increase in answering questions and found functional relationships between the use of graphic organizers and correct responses to questions.

RQ2 addressed whether teachers could be trained to implement the intervention with fidelity. Findings indicated teachers utilized the checklist for intervention with 76.5% fidelity (13 of 17 steps). All four participants learned the sequence of the intervention after the first session, and three participants (Ethan, Jack, and Daniel) were able to set up the intervention with no teacher prompting and worked independently through the sessions after the second session. Kevin required verbal prompting to begin reading through the fourth session. However, a strength for this study was that the participants quickly showed they did not require a “to-do” list. Therefore, the “to-do” steps were not presented as the participants perceived them as unnecessary and unauthentic. While the percentage of correct adherence to the fidelity of intervention procedures was lower due to the omission of four steps deemed as unnecessary by the interventionists, overall satisfaction and ease of intervention was strengthened.

RQ3 addressed whether participants, parents, and teachers found the use of graphic organizers in an inclusive setting for students with ASD as socially valid. Using the components identified in the research of Reichow et al. (2011), results received from the three groups indicated strong social validity for the intervention. Areas of strength included (a) easy to implement the intervention, (2) required little to no time or materials, (3) resulted in immediate behavior changes and (4) the intervention was valuable to student success.

Implications for Practice

Using teachers as primary implementers strengthened the existing relationships with campus grade-level staff and minimized further anxiety potentially produced for students with ASD when introduced to new personnel. Additionally, findings showed high social validity for the intervention with relatively low teacher preparation and training required. By incorporating the intervention into a teacher’s existing planning time, it has the potential to be highly beneficial for students with autism while minimizing the additional strain on teachers’ planning processes for lesson preparation.

Limitations and Directions for Further Research

While the intervention procedure implemented in the current study yielded strengths, there are notable limitations and implications for future research. One potential limitation was that the participant intervention phases were concluded at a set number of sessions rather than extending sessions across participants. The intervention sessions were limited, and follow-up probes were delayed due to district testing schedules and the teachers’ lesson schedules. As a result, probes for follow-up were not collected until some weeks following the conclusion of the intervention, and the delay varied for each participant with the first participants experiencing a longer break than the last participant. Ethan’s data specifically, denotes a significant limitation in the 8^th session. Future research is needed to determine if differences exist when the participants are in the intervention phase for more than eight sessions and when the participants receive the same break period across tiers before the follow-up phase begins.   Extended intervention sessions are important to ensure data stability using the 80%-20% rule (Gast, 2010; Haegele & Hodge, 2015) across all participants.

Further, the intervention may have been strengthened by investigating the use of different visual supports. As students with ASD continue to have access to inclusive settings, it will be important for researchers to continue to extend the work of Kim et al. (2004) by conducting investigations using cognitive mapping or mnemonic devices.  A consideration for future researchers is to design a similar study utilizing a graphic organizer for answering wh-questions from a text passage that is read aloud by a teacher. This would allow investigators to measure a student’s ability to respond after listening to the text instead of reading it independently. Future research should also consider using other visual support strategies in academic subject areas beyond social studies with varying ages of students. Findings would provide direction on implementation for practitioners across multiple content and grade levels. One additional area that would strengthen the results of this study is to replicate the study with more than four students as using a small participant pool limits the generalizability of the findings.

In closing, the findings from this study show that with a little time and effort, teachers can implement the use of graphic organizers in a way that allows students to successfully answer wh-questions during social studies lessons.  By using socially valid strategies that are not time consuming to develop, to train, or to implement, they have the potential to increase a teacher’s willingness to use those strategies for students with ASD. Graphic organizers are concrete tools that can assist teachers in authentically engaging students with ASD in their classrooms and, therefore, potentially maximize the student’s academic potential.

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About the Authors

Karin R. Kliemann, Ph.D. is a Special Education Curriculum Coordinator for the Arlington Independent School District. Her focus is on supporting teachers in the application of evidenced based practices for students with autism as well as students with an emotional disturbance. She provides professional learning opportunities for teachers, administrators and other staff members in the areas of functionally analyzing behavior, teaching replacement behavior, and use of visual strategies for increased success. Dr. Kliemann also facilitates district-wide support services for social emotional learning for the special education department.

Miriam C. Boesch, Ph.D. is an Associate Professor of Special Education in the Department of Educational Psychology at the University of North Texas. Her research focuses on augmentative and alternative communication (AAC). Specifically, Dr. Boesch engages in AAC research to assess teacher preparation needs, compare strategies suitable for individuals with autism and complex communication needs, and reduce challenging behaviors. She teaches courses on autism, intervention strategies, and behavior management. Dr. Boesch is also the co-author of the book: Implementing Effective Augmentative and Alternative Communication Practices for Students with Complex Communication Needs: A Handbook for School-Based Practitioners.

Endia J. Lindo, Ph.D. is an Associate Professor of Special Education in the College of Education at Texas Christian University and core faculty in the Alice Neeley Special Education Research and Service (ANSERS) Institute. Her research focuses on improving the reading outcomes of students with disabilities. Of particular interest are approaches to teaching reading, improving the implementation and sustainability of research-based interventions, enhancing educators’ cultural competence, and understanding the influence of social and familial factors on students’ educational outcomes.