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?