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The Effectiveness of Picture with Direct
Verbal Instructions versus Video PeerModeling with Voice-over
Instructions as Teaching
Strategies on ProperHand Washing among
Children with
AutismGuanHing, Ma. Socorro S., R.N., M.A.N. 1;Mendoza, Mark Joseph G1.; Mendoza,
Mary Angeli D.1; Meneses, Johanna Danielle Z.1; Menos, Corhinne Bianca R.1;
Mercado, Marivi Grace V.1; Merquita, Kevin Mikhael B.1
1
College of Nursing, University of Santo Tomas, Manila, Philippines
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Autism
Complex developmental disorder
Affect how a child sees the world and learns
Dysfunction in the central nervous system
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Children with autism
Impairment in cognition, perception and
sensorimotor function
Short attention span
More visual than auditory
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Children with autism
Traditional way of teaching
Picture prompts and verbal instructions
Development of new teaching
strategiesVideo modeling, peer modeling, video
peer modeling and in vivo teaching
Improving social skills
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Handwashing
Primary intervention for preventing disease
transmission
Step in achieving proper personal hygiene
and management of ones own wellness
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Purpose
The purpose of this study is to compare the
effectiveness of two audio-visual interventions
namely, pictures with direct verbal
instructions and video peer modeling with
voice over instructions, to teach children with
autism the technique of proper hand washing
as prescribed by the Department of Health(DOH).
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RESEARCH DESIGN and
METHODOLOGY
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Inclusion Criteria
High functioning Filipino autistic children
Mental age of 4-6
Enrolled in the chosen SPEd school
Absence of knowledge and skill of proper
hand washing
With basic imitation skills
No previous exposure to any video
modeling intervention
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Research Instrument
Researcher designed hand washing
checklist based on the DOHs guidelines
on proper hand washing to measure accuracy & consistency
Consists of 16 target steps
Validated by experts
Reliability coefficient computed using
Cronbachs alpha
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Ethical Consideration
Consent
Assent
Freedom from psychological harm
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Methodology
Pre-test
Establish rapport
Participants were asked to performhand washing according to their own
knowledge
Pre-test accuracy scores was observedand measured using the checklist tool
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Intervention Period (Experimental)
Participants were escorted one by oneto the wash area
Peer modeling video with voice-over instructionsdemonstrating proper hand washing was shown
Initiation of hand washing afterstep has been taught
onsistency of performance of hand washing
was observed and measured
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Intervention Period (Control)
Participants were escorted one by oneto the wash area
Step by step pictures withdirect verbal instructions were given
Initiation of hand washing afterstep has been taught
Consistency of performance of hand washing
was observed and measured
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Methodology
Post-testParticipants were escorted one by one to
the wash area
They were asked to perform hand washingwithout guidance of instructional material
Post-test accuracy scores was observed
and measured using the checklist tool
Data was gathered, tabulatedand applied statistical treatment
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PRESENTATION,ANALYSIS and
INTERPRETATION of DATA
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Significant difference betweenusing pictures with direct verbal
instructions and video peer
modeling with voice over
instructions in teaching children
with autism the proper hand
washing technique as to accuracy:
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Pretest and Posttest scores of control
group
Pretest posttest T-value P-value
Mean SD Mean SD
Controlgroup
15.07 3.515 25.27 4.682 *5.667 0.000
Table 2. Significant difference in the Pretest and Posttest scores of the control
group
Significant at = 0.05
There is a significant difference in the
results of accuracy scores.The use of pictures with direct verbal
instruction is an effective strategy in
teaching proper hand washing technique.
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Pretest and Posttest scores of
experiment group
Pretest posttest T-value P-value
Mean SD Mean SD
Experiment
group
17.73 4.713 26.87 4.257 *6.883 0.000
Table 3. Significant difference in the Pretest and Posttest scores of the
experiment group
Significant at = 0.05
There is a significant difference in the
results of accuracy scores.
The use of video with voice over instruction is an effective
strategy in teaching proper hand washing technique.
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Posttest scores of the control and
experiment group
Control Group Experiment Group T-value P-value
Mean SD Mean SD
Pretest 25.27 4.682 26.87 4.257 -0.979 0.336
Significant at = 0.05
There is no significant difference in their
posttest scores.
Interventions done for both groups are
effective in teaching proper hand washing to
children with autism.
Table 4. Significant difference in the accuracy posttest scores in the proper
hand washing by children with autism in the control and experiment group
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Significant difference betweenusing pictures with direct verbal
instructions and video peer-
modeling with voice overinstructions in teaching children
with autism the proper hand
washing technique as to the:
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Consistency per session
Sessions Mean SD T-value P-value
1 11 3.047
*2.314 0.036
2 12 2.712
1.911 0.077
3 13 2.171
1.581 0.136
4 13 2.160
0.972 0.348
5 14 2.463
Overall mean 12.6
Table 5. Significant difference in the consistency scores of the control group in
each session
Significant at = 0.05
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significant difference betweenfirst and second session.
As the session continues, there is
no significant difference.
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Consistency per session
Sessions Mean SD T-value P-value
1 10 4.499
1.825 0.089
2 11 4.301
1.640 0.123
3 12 2.949
1.214 0.245
4 13 2.232
1.551 0.143
5 14 1.767
Overall mean 12
Table 6. Significant difference in the consistency scores of the experiment
group in each session
Significant at = 0.05
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no significant difference in their
performance
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Overall consistency of the performance of
proper hand washing
Mean SD T-value P-value
Control group 12.6 1.140 0.688 0.511
Experiment Group 12 1.581
Significant at = 0.05
There is no significant difference in the overall
mean score in consistency of performing
proper hand washing between control and
experiment group
Table 7. Significant Difference of the Overall Mean Consistency score of the
Control and Experiment Group
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CONCLUSION,IMPLICATION
AND RECOMMENDATION
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Conclusion and Implication
The researchers conclude that the use of
pictures with direct verbal instructions and
video peer-modeling with voice over
instructions are equally effective in teaching
the DOH-prescribed hand washing technique
among children with autism. Thus, both
strategies may be used in teaching thetechnique.
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Recommendations
Nursing & Special Education
Nursing & Special School Administration
revise Step 8
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Recommendations
Nursing research
The study may be used as a reference
point in the development of new and
enhanced teaching strategies among
children with disabilities.
Future nurse researchers may improve
the elements used in this study.
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Mendoza, Mark Joseph G.([email protected])
Mercado, Marivi Grace V.([email protected])
Merquita, Kevin Mikhael B.