Research in Developmental Disabilities 32 (2011) 2235–2242

Contents lists available at ScienceDirect

Research in Developmental Disabilities

Review article

Use of activity schedule to promote independent performance of

individuals with autism and other intellectual disabilities: A review
Takanori Koyama a, Hui-Ting Wang b,*
a
College of Education, University of Washington, Miller102, BOX 353600, Seattle, WA 98195, USA
b
Department of Special Education, National Taiwan Normal University, No. 162, Sec. 1, HePing East Road, Taipei 106, Taiwan

A R T I C L E I N F O A B S T R A C T

Article history: A literature review was conducted on the effectiveness of activity schedules. Twenty three
Received 18 April 2011 studies that a) were peer-reviewed, b) were experimental, c) implemented activity
Accepted 3 May 2011 schedule as a primary intervention, d) incorporated multiple activities, and e) aimed to
Available online 6 June 2011 teach learners to self-manage individual schedules were included in the review. The
results demonstrated the effectiveness of activity schedules for promoting independence
Keywords: and self-management skills for a broad range of individuals with intellectual disabilities.
Activity schedule An increase in engagement and on-task behavior was the most frequently cited outcome,
Independence
followed by independent task initiation or transition and self-scheduling. Failure to
Self-management
include social validity measures and caregivers as interventionists were discussed. A
Visual supports
Autism
corpus of the reviewed studies supports applications of activity schedule in school and
(group) home settings.
ß 2011 Elsevier Ltd. All rights reserved.

Contents

1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2235
2. Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2236
3. Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2238
4. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2239
4.1. Participant characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2239
4.2. Teaching formats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2239
4.3. Behavior change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2240
4.4. Reduction of prompt dependency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2240
4.5. Maintenance and generalization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2240
4.6. Social validity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2241
5. Implications for future research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2241
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2241

1. Introduction

Promoting independent performance of individuals with intellectual disabilities is one of the main themes in educational
as well as vocational settings. Independent functioning and reduction of dependency on supervising adults is essential for

* Corresponding author. Tel.: +886 2 7734 5019; fax: +886 2 2341 3061.
E-mail addresses: [email protected] (T. Koyama), [email protected] (H.-T. Wang).

0891-4222/$ – see front matter ß 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.ridd.2011.05.003
2236 T. Koyama, H.-T. Wang / Research in Developmental Disabilities 32 (2011) 2235–2242

the successful inclusion of students with disabilities (Servatius, Fellows, & Kelly, 1992). In early childhood education settings,
children’s independent performance might result in increased instructional time, efficient and effective learning, increased
opportunities for peer interaction, and decreased teacher supervision (Dunlap, Dunlap, Koegel, & Koegel, 1991; Miles, Cole,
Jenkins, & Dale, 1998; Schmit, Alper, Raschke, & Ryndak, 2000). In a vocational setting, the ability to perform job tasks in the
absence of supervising personnel increases the chance for people with disabilities to secure employment (Wehmeyer, Agran,
& Hughes, 1998).
Unfortunately, individuals with intellectual disabilities may learn to depend on caregivers, teachers, and supervising adults
to initiate a task or activity (Copeland & Hughes, 2000). They may fail to respond to the natural cues that prompt them to
perform a task and instead rely on external cues. Such external cues are typically provided through verbal instructions,
modeling, and gestures from adults. Of these adult-delivered prompts, verbal cues are most difficult to fade, thereby impeding
independent performance of learners. Prompt dependency is a concern because many intervention packages rely heavily on
adults’ cues when instructing students with disabilities (MacDuff, Krantz, & McClannahan, 1993), thus running the risk of failing
students to respond to natural stimuli. Reliance on adult-directed, external cues needs to be minimized in instruction, if
individuals with intellectual disabilities are to function in less restrictive environments (Mechling & Gast, 1997).
Another issue reported among individual with disabilities, children with autism spectrum disorder (ASD) in particular, is
procedural learning. Mostofsky, Goldberg, Landa, and Denckla (2000) found that the ability to learn sequential tasks is
impaired in high-functioning individuals with ASD. Although many children with ASD demonstrate cognitive strengths in
rote memory and nonverbal tasks, they may have difficulty performing a complex task that involves multiple steps. In
addition, children with autism have been reported to exhibit problems in independent transitioning between activities
(Clarke, Dunlap, & Vaughn, 1999). They may get fixated on one activity and be unwilling to transition. Problems in transitions
may be manifested by aggressive, noncompliant, and self-injurious behaviors.
One instructional strategy to promote independent behavior and curtail prompt dependency is activity schedule.
McClannahan and Krantz (1999) defined activity schedule as a visual support strategy that uses visual cues such as
photographs and written words and teaches a learner to follow a sequence of tasks or activities independently. A potential
benefit of activity schedule is that stimulus control can be transferred from a supervising adult to a picture (Copeland &
Hughes, 2000). Once individuals with disabilities learn to respond to picture cues, picture cues can guide their behavior in
the absence of a supervisor. Supervising adults do not need to repeat verbal directions or provide physical guidance, thereby
avoiding the issue of prompt dependency. Researchers have investigated the use of multiple picture prompts as a way to
teach a sequence of behaviors, and found that people with disabilities can learn to use picture prompts in order to perform
not just a simple action but also a complex behavior chain.
There have been three activity schedule related review studies. Stromer, Kimball, Kinney, and Taylor (2006) provided a
descriptive summary of activity schedule studies with and without multimedia computer supports for children with autism.
Bopp, Brown, and Mirenda (2004) summarized the research on visual schedules (i.e., activity schedules) and discussed the
role of speech-language pathologists in the delivery of positive behavior support (PBS) for individuals with developmental
disabilities. Banda and Grimmett (2008) conducted the most comprehensive review, focusing on the effectiveness of activity
schedules on individuals with autism spectrum disorder. There is no theoretical ground, however, to limit the use of activity
schedules to individuals with this diagnostic category. Indeed, activity schedule may be a useful tool beyond its popular
application for any individual who is in need of greater independence. The present study aimed to conduct a comprehensive
review on activity schedule for individuals with autism and other developmental disabilities in an attempt to summarize the
outcomes of the existing research. More specifically, the purpose of the present study was to derive implications on: a)
populations for whom activity schedules could be effective (e.g., age, diagnosis, intellectual functioning), b) symbol types,
activities, and settings that could be incorporated into the schedule, and c) major behavior changes that may reasonably be
expected as a result of activity schedule intervention.

2. Method

A literature search was conducted using PsycInfo and Google Scholar. The search key words included activity schedule,
visual schedule, and picture schedule. In addition, an ancestral search from selected studies was conducted.
To be included in the present study, publications had to: a) be from peer-reviewed journals, b) be experimental studies, c)
implement activity schedule as a primary intervention strategy alone or in combination with other instructional strategies
such as video modeling (e.g., Dauphin, Kinney, & Stromer, 2004) and correspondence training (e.g., Morrison, Sainato,
Benchaaban, & Endo, 2002), d) use a schedule to represent multiple activities (studies that used multiple picture cues to
represent tasks within a single activity, such as cooking, were excluded), e) aim to teach learners to self-manage individual
schedules (studies were not included, if pictures were merely presented to learners as a means to increase behavior
compliance (e.g., Dettmer, Simpson, Myles, & Ganz, 2000), and f) be studies whose participants were unfamiliar with activity
schedules at the beginning of the interventions [which excluded studies such as Krantz and McClannahan (1998) and Miguel
and Yang (2009)].
Twenty three studies that met the above criteria were analyzed independently by the two authors with the following 11
categories, which created 253 cells: age, number of participants, diagnosis, IQ, symbol, setting, activity, behavior change,
generalization, maintenance, and social validity (Table 1). The discrepancies were discussed and corrected to ensure the
accuracy of the results.
Table 1
Summary of results.

Age (year) N Diagnosis IQ Symbol Setting Activities Behavior change G SV M

Anderson et al., 1997 22/21/37 3 MR moderate, L,P group home various + engagement, self-scehduling
severe, severe
Bambara and Ager, 1992 31/43/57 3 DD W,L home leisure or play + engagement, self-scheduling -
disruptive behavior
Betz, Higbee, and Reagon, 2008 4/5 6 A P school leisure or play + engagement, self-scheduling V V

T. Koyama, H.-T. Wang / Research in Developmental Disabilities 32 (2011) 2235–2242

Bevill et al., 2001 4/5 4 2DD/A/lg mild (n = 1) P school leisure play + engagement, self-scehduling -
prompt
Browder and Minarovic, 2000 27/30/31 3 MR mild, moderate, W job site vocational tasks + task initiation V
mild
Bryan and Gast, 2000 7-8 4 A L school academic + on-task, % of steps completed V V
Carson, Gast, and Ayres, 2008 18/20/20 3 3MR(one 2moderate, mild P school/job site vocational tasks + independent transition V V
had ADHD)
Cihak, 2011 13/11/12/13 4 A P school various + transition
Clarke et al., 1999 10 1 A average W,L home self-help + engagement - disruptive
behavior, time completing routine
Dauphin et al., 2004 3 1 A&ADHD W,P home leisrue or play + on-task, self-scheduling
Dooley et al., 2001 3 1 A L school various + transitions - disruptive behavior
Flannery and Horner, 1994 17 1 A moderate W school academic + correct response - disruptive
behavior
Irvine, Singer, Erickson, 15/16/17/18 4 2 Down, 2 moderate, mild, L school/home self-help + task initiation V
0and Stahlberg, 1992 no specific moderate, moderate
Krantz, MacDuff, 6/7/8 3 A P home various + engagement, social initiations - V
and McClannahan (1993) disruptive behavior
MacDuff et al., 1993 9/9/11/14 4 A P group home various + engagement V
Machalicek et al., 2009 6/7/12 3 A P school leisure or play + engagement - disruptive
behavior
Martin et al., 1987 16-19 5 MR moderate W,L school vocational tasks + transition
Massey and Wheeler, 2000 4 1 A L,P school various + engagement - disruptive V V V
behavior, prompt
Morrison et al., 2002 3/5/5/4 4 A P school leisure or play + engagement, self-scheduling - V
prompt
Newman et al., 1995 14/16/17 3 A mild W other various + transition V
Spriggs et al., 2007 13/13/12/13 4 Williams, moderate L school academic + engagement V V
ADHD, 2
no specific
Watanabe and Sturmey, 2003 22/40/30 3 A W other various + engagement, self-scheduling - V
disruptive behavior
Wheeler and Carter, 1998 6 1 A P school various + engagement - disruptive V V V
behavior
69

MR, mental retardation; DD, developmental disability; A, autism; lg, language delay; AD, articulation disorder.
L, line drawing; P, photographs; W, words.
G, generalization; SV, social validity; M, maintenance.

2237
2238 T. Koyama, H.-T. Wang / Research in Developmental Disabilities 32 (2011) 2235–2242

3. Results

The two authors yielded reliability of 95.7%. All results were reconfirmed and described as following.
The corpus of the literature search based on the criteria above yielded 23 studies with 69 participants. Table 2 lists
participant characteristics by age, diagnosis, and intellectual functioning by IQ. Decision rules were as following: (A) When
participants’ age was not specified, but an age range was given, the average of the age range was used for age category; (B)
Down syndrome and Williams’ syndrome were included in the ‘‘Others’’ category instead of Cognitive Impairment; (C)
Asperger’s syndrome was included in the ‘‘Autism’’ category; (D) One participant with dual diagnoses, autism and attention
deficit hyperactivity disorders (ADHD), was included in the Autism category; (E) Intellectual functioning was determined
only based on the reported IQ classification from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition
(DSM-IV) and scores from autism rating scales (e.g., Gilliam Autism Rating Scale, GARS; Childhood Autism Rating Scale,
CARS) were not considered; (F) If there were inconsistent descriptions on the level of intellectual functioning within the
same article or only a range was given, a milder functioning level was chosen.
Table 3 summarizes types of symbols, settings, and activities used in activity schedule studies. Symbols refer to types of
symbols used to represent activities. Settings indicate where the studies took place. Activities show types of activities that the
participants engaged in while using an activity schedule. Multiple entries were allowed when studies used more than one
teaching format. If ‘‘pictures’’ were used to represent activities, there were considered as ‘‘line-drawings’’ instead of

Table 2
Participant characteristics.

n = 69 participants

Age of participants
Preschool (0–5 y) 17 (24.6%)
Elementary (6–11 y) 15 (21.7%)
Middle school (12–17 y) 21 (30.4%)
Adults (18 y+) 16 (23.2%)

Diagnosis
Cognitive impairment 14 (20.3%)
Autism 41 (59.4%)
Developmental disability 5 (7.2%)
Others 5 (7.2%)
Not specified 4 (5.8%)

Intellectual functioning
Average (IQ above 70) 1 (1.4%)
Mild (IQ 50–69) 8 (11.6%)
Moderate (IQ 35–49) 17 (24.6%)
Severe (IQ 20–34) 2 (2.9%)
Not specified 41 (59.4%)
*
Numerals represet the number of participants.

Table 3
Teaching formats.

n = 23 studies

Symbols
Objects 0 (0%)
Photographs 12 (52.2%)
Lind drawings 9 (39.1%)
Words 8 (34.8%)

Setting
Home 4 (17.4%)
Group home 2 (8.7%)
School 14 (60.9%)
Job site 1 (4.3%)
Other (after school programs) 2 (8.7%)

Activities
Academic 3 (13.0%)
Leisure or play 6 (26.1%)
Self-help 2 (8.7%)
Vocational tasks 3 (13.0%)
Various (more than two above activities) 9 (39.1%)
*
Numerals represent the number of studies. Multiple entries were allowed, when studies used more than one teaching format.
 T. Koyama, H.-T. Wang / Research in Developmental Disabilities 32 (2011) 2235–2242 2239

Table 4
Behavior change.

n = 23 studies

Engagement, on-task behavior 15 (65.2%)

Disruptive, self-injurious behavior 8 (34.8%)
Task initation or transition 7 (30.4%)
Learning to self-schedule 7 (30.4%)
*
The number of studies that exmined each behavior outcome. Multiple entries were allowed, when studies reported more than one outcome measures.

‘‘photographs.’’ Activities from the same activity category (e.g., vacuuming, washing dishes, wiping table) were considered as
one type of activities rather than ‘‘various’’ activities.
Table 4 describes major behavior outcomes of the activity schedule studies. Multiple entries from the same study were
allowed, as most studies reported several outcomes.

4. Discussion

4.1. Participant characteristics

The present study revealed that activity schedules have successfully been applied with a variety of individuals. The
participants ranged from preschool students (17 participants; 24.6%) in an early intervention program, to middle school
students (21 participants; 30.4%) learning vocational skills, and to adults (16 participants; 23.2%) living in a group home.
Although more than half of the participants had a diagnosis of autism or related disorder (41 participants; 59.4%), autism was
not the only category to which activity schedule has shown successful applications. That is, representing a series of activities
in a visual format can promote independent performance of not only individuals with autism diagnosis but also with other
types of intellectual disabilities (e.g., intellectual impairment, Down syndrome). Notably, two studies (Anderson, Sherman,
Sheldon, & McAdam, 1997; Wheeler & Carter, 1998) taught children and adults with severe intellectual disabilities to follow
schedule. Furthermore, Anderson et al. (1997) taught adults living in a group home to choose and engage in recreational
activities independently. The implication is that activity schedules can be a useful tool in promoting independence and,
possibly, self-determination of individuals with significant cognitive challenges. Activity schedule does not limit its use to a
specific age range, diagnosis, or intellectual functioning, but can be adapted to accommodate a variety of types of individuals.

4.2. Teaching formats

Teaching formats and scheduled activities were as diverse as characteristics of the participants. Empirical studies on
activity schedule have used three types of symbols to represent activities: photographs, line drawings, and written words.
Interestingly, no study used objects to represent activities. This absence may be explained in respect of a hierarchy of
symbols (Mirenda & Locke, 1989). Generally speaking, written words have the weakest association with their referents – an
object or idea to which a symbol, such as a written word, refers – among two-dimensional symbols (i.e., photographs, line
drawing, and written words). On the other hand, research on a hierarchy of symbols implies that object symbols (e.g., shoes
referring to the meaning of going outside) are the easiest to understand. The reason that no activity schedule study used
object symbols may be due to researchers’ presumption that mastery of activity schedule requires a minimum level of
symbol understanding. In other words, individuals may need to have cognitive ability to understand the association between
a (two-dimensional) symbol and its referent in order to learn activity schedule.
School was the most popular site in which the studies on activity schedule were conducted (14 studies; 60.9%).
Cumulative results imply that activity schedule may be a useful instructional tactic to promote student independence in a
school setting. Bryan and Gast (2000), for example, taught elementary school students in a resource room to rotate between
four literacy centers independently using an activity schedule. Activity schedules were also examined in group homes as well
as participants’ own homes, and they have been shown to increase the level of engagement and independence. Activities
schedule can improve the quality of lives of individuals with disabilities, given the state that many group home residents
with intellectual disabilities have a low level of engagement and participation in daily activities (Anderson et al., 1997), or
that children may struggle to get through daily routines (e.g., changing clothes, brushing teeth) in the home (e.g., Clarke et al.,
1999).
The review of literature also found that a wide range of activities have been incorporated into the schedule. When activity
schedules were used in school, activities tended to be play choices (6 studies; 26.1%) for preschool children, academic tasks
(3 studies; 13.0%) such as language arts and spelling for school-age children, and vocational tasks (3 studies; 13.0%) for older
students. Activity schedules, when used in a group home, can promote independent performance of adults with intellectual
disabilities on recreational activities and self-help tasks (2 studies; 8.7%) (e.g., housekeeping, personal care). Furthermore,
many studies incorporated activities for the entire day or school day, which consisted of activities from more than one
category (9 studies; 39.1%) (e.g., from work time to leisure activity to lunch). One important caveat is that these studies did
not use activity schedules to teach how to do activities but used them to help individuals with disabilities transition between
2240 T. Koyama, H.-T. Wang / Research in Developmental Disabilities 32 (2011) 2235–2242

activities independently. In other words, the participants knew how to conduct activities prior to the beginning of the studies
but needed help with transitioning.

4.3. Behavior change

Four major categories of behavior outcomes have been reported: a) an increase in the rate of engagement or on-task
behavior (15 studies; 65.2%), b) a decrease in disruptive or self-injurious behavior (8 studies; 34.8%), c) learning to self-
schedule (7 studies; 30.4%), and d) independent task initiations and transitions (7 studies; 30.4%). The most frequently
examined behavior change was engagement and on-task behavior. Engagement and on-task behavior are similarly defined
in the activity schedule literature, which refer to the state that a participant is engaged in a planned activity or task as
described on the schedule. An increased rate of engagement in targeted activities may be of particular importance, because
research suggests that children’s level of engagement is correlated with development in communication and social skills as
well as reduction of stereotypic behavior (Libby, Powell, Messer, & Jordan, 1997; Thorp, Stahmer, & Schreibman, 1995). One
interesting caveat from Bryan and Gast (2000), Martin, Elias-Burger, and Mithaug (1987) and Spriggs, Gast, and Ayres
(2007), however, was that their participants’ rates of on-task behavior dropped to the baseline (pre-treatment) level, when
activity schedules were removed. Reinstitution of activity schedules immediately raised performance back to the post-
treatment level. In other words, the participants were able to maintain on-task behavior only with the presence of an
activity schedule.
A decrease in self-injurious and disruptive behavior may be a collateral effect of activity schedule. Five out of seven
studies that examined a change in self-injurious or disruptive behavior reported a reduction (e.g., Machalicek et al., 2009),
whereas two studies reported either no change or an increase (e.g., Anderson et al., 1997). Although the results were mixed,
one could conclude that the more time spent on on-task behavior is likely to lead to less time engaging in maladaptive
behavior.
The effects of activity schedule on independent task initiations and smooth transitions between activities
were reported in seven studies. Issues with transitions, or resistance to environmental changes, are well known
among individuals with autism spectrum disorder (American Psychiatric Association, 2000). The results indicated that
activity schedule may be an effective tool to support smooth transitions. A 3-year-old boy with a diagnosis of PDD in
Dooley, Wilczenski, and Torem (2001), for instance, exhibited disruptive behaviors in his preschool class. Functional
assessment by the first author showed that his tantrums occurred during transition times. His disruptive behaviors
showed immediate reduction and his compliance increased, after the child was taught to use a schedule for activity
transitions.
The authors of seven studies successfully taught the participants to make their own schedules (e.g., Watanabe & Sturmey,
2003). The participants’ tasks in those studies involved not only following a schedule but also creating one for themselves by
making activity choices. Teaching self-scheduling is important in respect of promoting autonomy and self-determination of
individuals with intellectual disabilities. Merely following a schedule made by another person is a form of behavioral
compliance, whereas true independence is achieved when individuals with intellectual disabilities can plan and follow
activities on their own. Another benefit of teaching self-scheduling is that incorporating choices may increase the
effectiveness of an activity schedule. Watanabe and Sturmey (2003), indeed, examined the effects of choice-making
opportunities when creating a schedule. They found that providing choices increased the participants’ engagement in
various activities in an adult service program.

4.4. Reduction of prompt dependency

Another important implication, although not mentioned explicitly in most studies, is that many participants learned to
use activity schedules in the absence of supervisors. Supervising adults typically begin with providing physical guidance for
learners to follow schedules, but the prompts are gradually faded so that individuals with disabilities learn to manage
activity schedules on their own. Self-managing an activity schedule means that an individual is able to engage in a sequence
of activities as depicted on the schedule, go back to the schedule when the previous activity is completed, and move onto the
next activity, all without supervision. Bevill, Gast, Maguire, and Vail (2001) and Morrison et al. (2002), for example, reported
that preschool children with autism and other developmental disabilities initially required physical prompts to master
schedule-following but decreased the amount of prompts over time.

4.5. Maintenance and generalization

Only six studies (26.1%) examined maintenance and eight studies (39.1%) examined generalization of schedule-following
behavior. When generalization was examined, however, the participants demonstrated the ability to maintain on-task
behavior with new activities or in novel settings without requiring additional training. For example, the students in Spriggs
et al. (2007) maintained the same level of on-task and on-schedule behavior (engagement in academic tasks) in novel
settings (at a different time of the day and in a different classroom) and activities (a different set of academic tasks). The
results from a small number of studies indicate that individuals who learn to use an activity schedule may apply it in
different situations.
 T. Koyama, H.-T. Wang / Research in Developmental Disabilities 32 (2011) 2235–2242 2241

4.6. Social validity

Whether supervising adults think that the treatment is effective, valuable, and easy to implement is an important
measure of success (Baer & Schwartz, 1991). In activity schedule literature, socially valid intervention means that
supervising adults – caregivers, teachers in classroom, and job coaches in vocational settings – need to believe that activity
schedules promote independent performance of learners. Seven of the 23 studies (30.4%) examined social validity of activity
schedules and all reported positive results. Some of the reported outcomes included that classroom teachers noticed positive
behavior change and that employers perceived activity schedules to decrease the amount of supervision. Activity schedule
interventions appear to be well accepted by practitioners.

5. Implications for future research

The present study also drew several implications for future research. Given the significance of user (e.g., teachers,
parents) acceptance in determining the effectiveness of activity schedules (as well as all other instructional tools), future
studies should involve a measure of social validity. Only 30.4% of the previous studies reported social validity (feasibility and
acceptability) of their interventions; however, inclusion of a social validity measure is requirement for quality studies. It is
also important from a practical perspective, because evidence-based instructional strategies remain ineffective, unless
practitioners perceive them as effective and useful.
In addition, most participants in the reviewed studies were taught to use an activity schedule by researchers, teachers in
school, or supervising adults in a group home. In fact, Clarke et al. (1999) was the only study in which schedule-following was
taught by a parent instead of researchers or teachers. In the future, it will be interesting to see if activity schedules are equally
effective for increasing engagement and reducing challenging behavior in a home environment when taught by caregivers.
This question is important in order to bridge a gap between research and practice.
Finally, the effects of incorporating technology may be worth investigating further. Davies, Stock, and Wehmeyer (2002),
for instance, tested a palmtop technology device with individuals with intellectual disabilities in a vocational setting. The use
of the device resulted in improvement in task accuracy and reduction in the amount of dependency on others. With fast
advancement in technology innovation in 21st century, creating a schedule on a high-tech device like iPhone and iPad may
enhance acceptance of individuals with disabilities in their communities and promote their self-management skills.

Acknowledgement
The authors would like to thank the Council for Exceptional Children awarding ‘‘Herbert J. Prehm Student Presentation
Award’’ to the conference poster based on the content of this paper, presented at the Council for Exceptional Children
Convention and Expo in 2009.

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1
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