UNC 2014- Recommended Practices and ASD (2)

Report
Using the DEC Recommended
Practices to Provide High Quality
Programs to Children with ASD
Ilene Schwartz, Ph.D.
[email protected]
Session Goals
• Participants will:
– Identify and describe the essential components of high
quality programs for young children with autism
– Participants will identify instructional practices and
strategies used in high quality early childhood programs
for children with autism
– Participants will evaluate their own programs and identify
areas of strength and areas of need related to providing
high quality intervention to children with autism
Autism is a collection of
overlapping groups of symptoms
that vary from child to child
Siegel, 1996, p.301
“No treatment method completely
ameliorates the symptoms of ASD and
no specific treatment has emerged as
the established standard of care for all
children with ASD.”
Stahmer, Scheibman, & Cunningham (2011, p. 230)
DEC Recommended Practices
• Provide guidance about the most effective
ways to improve learning outcomes and
promote the development of children, birth –
five
• Highlight practices shown to result in better
outcomes for children, families, and those
who serve them
• Research  practice
Framework
• Using the DEC Recommended Practices as a guide, what
policies & practices should be included in a comprehensive
program for children with ASD?
– Leadership
– Assessment
– Environment
– Family
– Instruction
– Interaction
– Teaming & Collaboration
– Transition
Leadership
• 14 practices
• L7. Leaders develop, refine, and implement policies and
procedures that create the conditions for practitioners to
implement the DEC Recommended Practices.
Leadership
• Good leaders are essential to implementing recommended
practices and high quality programs
• Leaders create and support environments in which
practitioners can do their best work
• Leaders create environments and implement policies and
practices that retain and support practitioners
Leadership
• What are the conditions that facilitate implementation?
– Training
– Coaching
– Support
– Clear policies and procedures
– Administrators that understand state and federal laws
and regulations
Leadership
• What does this mean for ASD?
– Understanding the difference between what IDEA Part C
and Part B may pay for and what is recommended
practices for young children with ASD
– Understanding a continuum of services practices and the
data associated with them
– Understanding how to integrate explicit instruction into
programs for young children
Assessment
• “Assessment is the process of gathering information to make
decisions. Assessment informs intervention and, as a result, is
a critical component of services for young children who have
or are at risk for developmental delays/disabilities and their
families. In early intervention and early childhood special
education, assessment is conducted for the purposes of
screening, determining eligibility for services, individualized
planning, monitoring child progress, and measuring child
outcomes. Not all of the practices that follow apply to all
purposes of assessment. For example, practice A9 focuses on
monitoring child progress but does not relate to assessment
for eligibility.”
Assessment
• 11 practices
• A4. Practitioners conduct assessments that include all areas of
development and behavior to learn about the child’s
strengths, needs, preferences, and interests.
• A9. Practitioners implement systematic ongoing assessment
to identify learning targets, plan activities, and monitor the
child’s progress to revise instruction as needed.
Assessment
• A4. Practitioners conduct assessments that include all areas
of development and behavior to learn about the child’s
strengths, needs, preferences, and interests.
• Gather information from a variety of sources
– Development
• Curriculum-based assessment
–
–
–
AEPS
Criterion-based measure that assesses skills in each
developmental domain (motor, adaptive skills, etc.)
Includes family component to assess developmental skills at home
Assessment
• A9. Practitioners implement systematic ongoing assessment
to identify learning targets, plan activities, and monitor the
child’s progress to revise instruction as needed.
• “Linked System”: Assess, Plan, Document, Monitor
– Plan
• When, where, and how will you teach? (Activity Matrix)
– Document
• Systematic data collection
– Monitor Progress
• Review visual representations (graphs) of collected data
• Make decisions based on what the data are telling you
Assessment
• DID YOU KNOW???
– Students whose teachers monitor progress regularly and
frequently have higher rates of learning as compared to
students whose teachers do not collect data
Assessment
• How often should I collect data?
– Often enough to use it to guide your instruction
• If you collect data 1X per month, then you would not
be ready to make a decision about changing
instruction before 3 months
– Often enough to represent the behavior
Assessment
• How do I know what data to collect?
– Type of data collected should be linked to the child’s
individual goals & objectives
– Collecting data should be linked to instruction and needs
to occur in as natural of setting as possible
Environment
•
“Young children who have or are at risk for developmental delays/disabilities
learn, play, and engage with adults and peers within a multitude of environments
such as home, school, child care, and the neighborhood. Environmental practices
refer to aspects of the space, materials (toys, books, etc.), equipment, routines,
and activities that practitioners and families can intentionally alter to support
each child’s learning across developmental domains. The environmental practices
we address in this section encompass the physical environment (space,
equipment, and materials), the social environment (interactions with peers,
siblings, family members), and the temporal environment (sequence and length of
routines and activities). They relate not only to supporting the child’s access to
learning opportunities but also ensuring their safety. It is important for
practitioners to remember that these environmental dimensions are inextricably
intertwined for young children who have or are at risk for developmental delays/
disabilities and their families. Through implementation of the environmental
practices, practitioners and families can promote nurturing and responsive
caregiving and learning environments that can foster each child’s overall health
and development.”
Environment
• 7 practices
• E3. Practitioners work with the family and other adults to
modify and adapt the physical, social, and temporal
environments to promote each child’s access to and
participation in learning experiences.
Environment
• E3. Practitioners work with the family and other adults to
modify and adapt the physical, social, and temporal
environments to promote each child’s access to and
participation in learning experiences.
– Curriculum modifications
– Change to ongoing activity or materials to facilitate or maximize
a child’s participation in planned activities or routines
– Increased participation will enable child to take advantage of
developmental opportunities and consequently develop and
learn (Building Blocks)
Environment
• Curriculum modifications – 1 example
– Environmental Support
• Alter the physical, social, and temporal environment
to promote learning
• For more curriculum modifications, see “Building Blocks for
Teaching Preschoolers with Special Needs”
Environment
• Modifications
– Physical environment
• IF a child has difficulty lining up by the door to go to
the bus….
– Put a line of tape in front of the door to cue children where
to put their feet
• IF a child has a difficult time putting toys away after
play…
– Use photographs of the toys taped to shelves or containers.
Make cleaning up a matching game!
Environment
• Modifications
– Social Environment
• IF a child has a hard time staying near other children…
– Plan activities where the child needs to stay in close
proximity to a friend to complete the activity
» “Buddy” art
» Double swing
» Partner songs
Environment
• Modifications
– Temporal Environment
• If a child does not participate in centers during free
choice time…
– Create a picture schedule to help the child plan their time
and keep them on task
• If a child has difficulty making transitions…
– Provide a consistent cue to the group or child as a warning
that the activity will come to an end soon
– Provide the child with a picture or object that represents the
next activity
Family
Practitioners support family
functioning, promote family
confidence and competence,
and strengthen family-child
relationships by acting in
ways that recognize and
build on family strengths and
capacities.
Recommended Practice F6:
Practitioners engage the family in opportunities
that support and strengthen parenting
knowledge and skills and parenting
competence and confidence in ways that are
flexible, individualized, and tailored to the
family’s preferences.
For Children with Autism
• Effective early intervention programs – high
level of family involvement
• Goal:
– Build capacity in skills, strategies, and tools used
to promote best outcomes
– Within ongoing family routines
Family Support
Component of effective programming
Systematic and On-going
Based on families’ priorities
Parent Perspective
“Home visits were an imperative part of my early
intervention with my son. Especially since my son,
like most kids, will often react differently in other
environments, and with other adults, then he does
with me (especially professionals). The home is the
heart of the action. It is where you can possibly run
into a tantrum, or a small everyday challenge which
might not present in the classroom. And for me
personally, I wanted her to take a good look at our
house set-up and make sure it was conducive for
[my son’s]needs, understanding, and skills.”
Instruction
•
“Instructional practices are a cornerstone of early intervention and early
childhood special education. Teachers, other practitioners, family members, and
other caregivers use instructional practices to maximize learning and improve
developmental and functional outcomes for young children who have or are at
risk for developmental delays/disabilities.
Instructional practices are intentional and systematic strategies to inform what to
teach, when to teach, how to evaluate the effects of teaching, and how to support
and evaluate the quality of instructional practices implemented by others.
Instructional practices are a subset of intervention activities conducted by
practitioners and parents. We use the term “instructional practices” rather than
the terms “teaching practices” or “intervention” because instruction is the
predominant term used in the research literature to refer to intentional and
systematic strategies to maximize learning.
The recommended instructional practices below are written from the perspective
of the practitioner. They may also be implemented by families or others who
interact with the child, often with support of the practitioner”
Instruction
• 13 practices
• INS6. Practitioners use systematic instructional strategies with
fidelity to teach skills and to promote child engagement and
learning.
• INS7. Practitioners use explicit feedback and consequences to
increase child engagement, play, and skills.
• INS9. Practitioners use functional assessment and related
prevention, promotion, and intervention strategies across
environments to prevent and address challenging behavior.
Instruction
• Children with ASD often require
– Instruction to be more explicit
– Reinforcement to be more explicit and perhaps extrinsic
to start
– More opportunities to practice with feedback
– Planned instruction to facilitate generalization
Instruction
• Guiding principles
– Children with ASD are children first and have the same
basic needs as typically developing children
– There is no single right way to educate a child with ASD;
child and family characteristics must be considered in
intervention planning
– Knowledge is power. One of the most effective
techniques for empowering families and educators is to
provide them with accurate information
– All interventions must be built on evidence-based
practices and must include ongoing data collection and
evaluation
– Effective interventions must be comprehensive and of
sufficient intensity to yield educationally meaningful
outcomes
Instruction
• What is an evidence-based practice?
– Specific teaching procedures that practitioners or
caregivers use to promote learning and development or
decrease challenging behaviors
– An instructional strategy that:
• Has a base of high quality research
– With a range of different individuals
– In a range of places
– Over a range of behaviors
• Has been shown to result in measurable educational,
social, or behavioral benefit
Instruction
• The National Professional Development Center on ASD has
established a resource to promote the use of evidence-based
practices with students with ASD
• Conducted a rigorous review of the literature to identify
specific EBP’s
• Identified 27 EBP’s and created briefs for each practice
– Overview
– Step-by-step instructions for implementation
– Implementation checklist
– Evidence base
Instruction
• Practices identified have been used to target:
– Academic/pre-academic
– Behavior
– Cognitive
– Communication
– Joint Attention
– Motor
– Play
– Self-Help/Adaptive
– Social
– Vocational
•
http://autismpdc.fpg.unc.edu/content/evidence-based-practices
Instruction
• INS6. Practitioners use systematic instructional strategies
with fidelity to teach skills and to promote child engagement
and learning.
– Discrete trial teaching
– Naturalistic teaching
Instruction
• Discrete trial teaching
– Instructional strategy used commonly in ABA programs
– Break skills into smaller parts
– Response or teaching episode is initiated by teacher
– Provide and fade “help” to ensure success
– Success teaching a variety of skills
Instruction
• Discrete trials can be
– Embedded
• Occurs within the context of activities and routines
• Requires systematic planning by the teacher
– “Decontextualized”
• Materials are presented without competing stimuli
• Multiple trials are presented successively
• Place to start but not END!
Instruction
A discrete trial is a teaching loop with 3 distinct components:
Interaction
• These interactional practices are the basis for
fostering all children’s learning. For children
who have or are at risk for developmental
delays/disabilities, they represent a critical set
of strategies for fostering children’s socialemotional competence, communication,
cognitive development, problem-solving,
autonomy, and persistence.
Interaction
Practitioners promote the
child’s social development by
encouraging the child to
initiate or sustain positive
interactions with other
children and adults during
routines and activities
through modeling, teaching,
feedback, and/or other types
of guided support.
Why are social skills important?
Successful peer
interactions lead to
better academic and
language skills
Having preschool friends
reduces challenging
behaviors and mental
health issues
Having preschool friends
predicts good physical
health, continuing
friendships and better
employment outcomes
43
Focus: Social Skills
• Core deficit of ASD
• Reciprocal friendships
will not develop just by
placing children with
autism in the same
room as children
without autism
Strategies
•
•
•
•
•
•
Buddy Day
Social Skills Instruction
Visual Supports
Naturalistic Instruction
Explicit instruction
Consequence & antecedent strategies
Teaming and Collaboration
• Educational programs and services for young
children who have or are at risk for
developmental delays and disabilities, by their
nature, always involve more than one adult.
The quality of the relationships and
interactions among these adults affects the
success of these programs.
Teaming and Collaboration
Practitioners use communication and group
facilitation strategies to enhance team
functioning and interpersonal relationships with
and among team members.
Collaborative Teams
• Assessment,
treatment planning,
service delivery
conducted by more
than one discipline
• Importance of
natural
environments
• Role Release, Role
Support, & Role
Exchange
Characteristics of Effective
Collaborative Teams
Shared Philosophy
Adequate meeting time
Sharing expertise
Effective use of collaborative skills
Sharing workload (Wolery & Odom, 2000)
Requires administrative support!
Transition
Practitioners use a variety of planned and timely
strategies with the child and family before,
during, and after the transition to support
successful adjustment and positive outcomes for
both the child and family.
Children with Autism
• May struggle with transitions
• Benefit from antecedent strategies,
predictability and clear expectations
TYING IT ALL TOGETHER:
COMPREHENSIVE PROGRAM FOR
CHILDREN WITH ASD
Project DATA Model
Extended,
Intensive
Instruction
Technical and
Social Support
for Families
Integrated Early
Childhood
Experience
Collaboration
and
Coordination
Quality of Life
Influenced
Curriculum
Questions?

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