The SCERTS® Model

Report
The Scerts Model
a framework for working with children with social
communication disorders and delays- including autism
spectrum disorder
By Marla Bosch M.A.SLP © R-SLP
Speech Language Pathologist
August 2014
The SCERTS Model
 The SCERTS® Model Collaborators
 Barry Prizant, Ph.D.
 Amy Wetherby, Ph.D.
 Emily Rubin, MS http://www.commxroads.com/
 Amy Laurent, Ed.M, OTR/L
Objectives of presentation
 Review of the neurology of social disorders
including ASD.
 To introduce the key elements of the SCERTS
framework
 To show how the SCERTS framework links with
ASD and social communication disorders.
AND
 Hitting the ground running! Working together as a
team to provide the Supports needed for our
children to be socially and emotionally ready to
learn.
The SCERTS Model
Scerts:
 Is a lens to support the assessment and
programming framework for children with autism
and/or developmental needs.
 Acknowledges that most learning during childhood
takes place “…in the social context of daily
activities and experiences” - therefore everyday,
natural routines in the home and early childhood
setting are used
 Acknowledges that caregivers and familiar adults
play a critical part in supporting a child’s learning.
The first step: Understanding social
communication disorders and ASD
Children with a diagnosis of ASD have delays or
difficulties in:
the development of communication
the development of social relationships
play and imagination
Many young children with ASD under- or over-react
to sensory information… why?
.
The role of the brain: Social motivation theory of Autism
 Children with disordered social language show
physical neurological differences in the way they
process social stimuli.
 When neurotypical infants look at peoples faces,
regions in the limbic system “light up” with endorphins
and intrinsically reward that child.
 MRI demonstrates that children with ASD process
objects in the same way that their neurotypical peers
process social stimuli.
The Social Motivation Theory of Autism
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329932/
Social motivation models of ASD posit that early-onset impairments in social attention
set in motion developmental processes that ultimately deprive the child of adequate
social learning experiences and that the resulting imbalance in attending to social and
non-social stimuli further disrupts social skill and social cognition development.
When we are
not biologically
motivated to
seek social
relationships,
our skills
diminish due
to lack of
experience
and practice.
The neurology of social competence
 By 6 months of age, a child begins to follow gaze and
can recognize when they have lost a caregiver’s
attention. A neurotypical infant will show distress when
a caregiver’s eyes shift away.
The neurology of social
competence
 By 10 months of age, a child begins to shift gaze from a
caregiver to objects of reference to predict and
anticipate the actions of others.
The neurology of social
competence
 By 12 months of age, a child will initiate shared
attention on desired items or items that are of interest
to the child.
 http://autismspeaks.player.abacast.com/asdvideogloss
ary-0.1/player/autismspeaks
 (social interaction typical video)
The neurology of social competence
 The social motivation theory… these capacities ensure
that a neuro-typical child:
 is drawn toward social vs. non-social stimuli,
 derives pleasure from this engagement,
 notices attention shifts of others,
 initiates bids for engagement, actions, and objects of
interest
 Practices ways of getting MORE social attention… they
become skilled.
Unique neurological differences in social
communication development in ASD
 Children with Autism Spectrum Disorder (ASD) show limited neural sensitivity
to social stimuli and tend not to look toward people’s faces.
 Children with these vulnerabilities tend not to look toward others or tend to
look at the mouths of the speaker.
 Limited shared positive affect is an early indicator of these differences.
 Children at risk for ASD miss gaze shifts between people and objects. They
have difficulty predicting actions and initiating bids for engagement.
 http://autismspeaks.player.abacast.com/asdvideoglossary0.1/player/autismspeaks
 (on website: social interaction #3 ASD and both for #6)
 (And repetitive behaviors and restricted interests #2)
Unique neurological differences in social
communication development in ASD
 Similarly, when neurotypical children hear speech sounds,
these are processed as social or intentional stimuli, while
children with vulnerabilities simply hear sounds, making the
intentions of individual words more ambiguous.
 Individuals with social and emotional vulnerabilities may
process social stimuli (e.g., faces, speech sounds) in
regions of the brain typically reserved to process images
and sounds that are non-biological. This makes predictions
of actions, intentions, and emotions less efficient and more
intellectual.
 Shape video:
http://www.youtube.com/watch?v=n9TWwG4SFWQ
Unique neurological differences lead to…
 Secondary challenges or what have previously been
referred to as “Autistic Behaviors” arise as a result of a
history of repeated failure with social interactions & a limited
repertoire of conventional strategies for coping with these
challenges. As well, children with ASD also frequently
present with developmental delays in speech and language
and physical skills.
Remember: all behavior serves a function.
 For example, self regulating behaviors such as head
banging or spinning: child may be trying to achieve
endorphins that they do not get from social engagement.
Lining up buses on the carpet? The child may need to be
soothed by visual rhythm.
Temple Grandin
 Templin Grandin Video:
http://www.youtube.com/watch?v=XcWx8UVhzpQ
Essentially, three primary characteristics are recognized as defining
autistic spectrum disorder (ASD):
1. deficits in social interaction
2. deficits in communication
3. restricted repertoire of interests and behaviors
Developmental Dimensions Addressed in SCERTS
1. Social Communication (SC); two core challenges have been identified :
a. Capacity for joint attention
b. Capacity for symbol use
2. Emotional Regulation (ER)
a. Self-regulation
b. Mutual regulation
3. Transactional Support (TS) = The IPP for the educators and families
a. Interpersonal support
b. Educational and learning supports
c. Family support
SCERTS Core Values:
1.
Development of spontaneous, functional communication abilities and
emotional regulatory capacities
2.
Principles and research on child development frame assessment and
educational efforts. Goals and activities are developmentally appropriate and
functional.
3.
All domains of a child’s development (e.g., communicative, socio-emotional,
cognitive, and motor) are viewed as interrelated and interdependent.
Assessment and educational efforts must address these relationships.
4.
All behavior is viewed as purposeful serving a variety of functions (e.g.,
communication, emotional regulation). For children who display
unconventional or problem behaviors, there is an emphasis on developing a
range of supports for emotional regulation.
5.
A child’s unique learning profile of strengths and weaknesses determines
appropriate accommodations for facilitating competence in the domains of
social-communication and emotional regulation.
6.
Natural routines across home, school, and community environments provide
the contexts for learning and for developing positive relationships. Progress is
measured in daily experiences and routines.
SCERTS Model:

The SCERTS curriculum guides the SCERTS Assessment Process (SAP) and is:
designed to yield a developmental profile consistent with the child’s functioning in natural
environments and involves direct observation of child in natural activities and settings.
The primary domains of SCERTS address these priorities:

SC - Social Communication; Supporting a student’s ability to communicate, comprehend,
and collaborate with others.

ER – Emotional Regulation; Supporting a student’s ability to cope, make transitions, and
actively engage in the classroom

TS – Transactional Support; learning accommodations and curriculum modifications
embedded in the natural environment to foster SC and ER
**We always keep in mind developmental progression and neurology when
we create activities/programs and work towards outcomes**
Reviewing the challenges of SC and ER for a
child with a social disorder
 SC - Social Communication; students with ASD show limited
initiations, difficulty with social forms of language, and
limited understanding of social norms and perspectives,
 ER – Emotional Regulation; Difficulty predicting that others
are a source of engagement or support leads to both underarousal and over-arousal; this, paired with limited ability to
learn how to cope from others leads to unconventional
coping strategies.
 TS – Transactional Support; the “invisible” nature of ASD
makes it difficult for communicative partners to recognize the
need to externalize one’s thoughts and create
accommodations.
SCERTS
Social Communication
• The goal for all children is to become competent and
confident communicators so they can be part of social
activities and learning
• Children who communicate effectively have more
opportunities for play and learning and are more able to
enjoy social relationships
SCERTS communication stages
The Scerts program and assessment is based on the
child's communication stage:
Social Partner – the child may or may not
communicate intentionally using gestures and
vocalisations
Language Partner – the child is communicating
using words, gestures and/or symbols
Conversational Partner – the child uses words,
phrases and sentences. They are learning about
conversations
(SC) Social Communication
Goals are targeted in
 Joint Attention
The ability to share attention,
emotion and intention with others
 Symbol Use
The ability to understand and use
objects, pictures, words or signs
SCERTS: (ER)
Emotional Regulation
 the ability to attend to, process and filter environmental
and sensory information
 the ability to stay focused, engaged and being able to
adapt to different situations
When children are emotionally well regulated they are
ready and ‘available’ for learning
Frequently observed coping strategies or signs of
dysregulation in children with ASD










Mouthing or chewing on objects or fingers
Holding or hording familiar and comforting objects
Toe walking and rocking/ Hand flapping
Humming or sub-vocalizing
Avoiding eye contact
Turning away, bolting, or removing oneself from a
distressful situation
Use of scripted language, delayed echolalia & repetitive
questions (e.g., “what’s next,” don’t touch me”).
Emotions expressed through echolalia, as opposed to emotional
words.
Preoccupation with specific topics or areas of interest
Adherence to sameness, rigidity in following “rules, inflexibility
Emotional Regulation
 Mutual regulation –
the child’s ability
to seek support from others
to help them regulate
 Self regulation –
strategies used by the child to self
regulate
Emotional Regulation
1. Helping your child regulate emotions video.
http://www.autismspot.com/videos/Understanding-Feelings-and-HowRegulate-Emotions
2. Occupational Therapists are excellent resources to help us
understand emotional and sensory regulation.
3. CARC: Zones of Regulation in November 2014!
In a nut shell:
 To ensure a child's active engagement, there is a
strong emphasis on preventing problem behaviors that
interfere with learning and the development of
relationships. Families and educational teams learn
about essential interpersonal modifications,
environmental arrangement, and visual supports and
how they can be embedded in natural, functional, and
meaningful contexts.
SCERTS
Transactional Supports are:
• the planned supports and strategies that are used to
help the child participate and learn
• the supports and strategies used when working on the
child’s goals in Social Communication and Emotional
Regulation
• support to families and to the team
Transactional supports are often referred to
as
the “adult” goals
T ransactional S upport
Transactional Support: the planned supports and strategies that we use to help the child participate in social interactions and everyday activities AND the
planned supports that we put in place to help us support each other
Interpersonal support
Support to families
How the communication partners (adults and peers) adjust
their language, interaction styles and how they provide
models of play and behaviour
The SCERTS framework recognizes that the needs and priorities of caregivers and change over
time as they learn more about ASD and how they can support their child.
Interpersonal support goals
A family support plan includes:
work across all the child’s goals in social communication (SC)
and emotional regulation (ER)
Educational/learning supports such as provision of information and resources.
Coaching/modeling of strategies to facilitate the child’s development
include the partner responding to the child’s signals,
encouraging interaction with peers and setting the stage for
engagement
Emotional support such as facilitating partnerships with other services as needed and helping
the parent learn skills to cope with the challenges
Learning support
Support among professionals
The environment, routines and activities are structured to
encourage social communication and emotional regulation
Children with ASD are challenging at times to work with and professionals also need to be
supported through professional development and learning, as well as being available to
support each other emotionally.
Learning support goals
A professional support plan includes:
work across all the child’s goals in SC and ER include visual
supports and adaptation of activities to meet the child’s
Educational support such as team meetings, attendance at workshops/seminars
Handout 1.4
Professionals need to be flexible, responsive to changes, and respect decisions made by the
family
Emotional support such as informal discussion, supervision and mentoring arrangements
1
Transactional Support includes
 Interpersonal Support - the strategies
used by adults when interacting with
the child e.g., using gesture.
 Learning Support – the environment,
routines and activities are structured
to encourage social communication and emotional
regulation, e.g. modifying an activity to ensure
success for the child
Examples of Interpersonal support
(The “Hanen” strategies of your program!)
An adult partner needs to
 be responsive
- notice and respond to child’s attempts to communicate
 foster initiation




- offer choices at the right level
set the stage for engagement
- be at the child’s level (nose to nose)
adjust the amount of language used
- use simple sentences
model appropriate behaviour
Repeat repeat repeat
Examples of: Learning supports
 Structured activities e.g. clear beginning
and end to the activity
 Visual supports - to organise the day
 Sensory Supports
 Using motivating toys and activities
 Adjustments to activities so that
the child has success
Start small!
 Look at how far you have already come! There are lots of great
Supports in place!
 By identifying the gaps and breakdowns in a child’s SC and ER
during our daily routines… we have a place to start.
 Trying to “throw in “ visuals or to panic and re-work entire routines
is not the answer.
 We start with ONE routine or SKILL or OBJECTIVE at a time, look
closely at what transactional supports we can provide… and then
jump in!
 This is not an overwhelming process… but more a LENS to look at
ways we adjust and support a child based on their social and
emotional needs. We accommodate. They learn!
A Review of Transactional Supports used in
classroom settings for SC and ER.

Universal Transactional Supports:

Songs: Most children do great with songs allowing us to use them in a variety of
ways. We can use songs to help them transition from one activity to the next such as a
“Clean Up Song”, “A Sit Down Song”, “A Line Up Song” and more. We can use songs to
help us learn about Pre-Literacy and Early Math Skills such as: “ABC Song”, “All The
Letter’s Make a Sound Song”, “The Numbers Rumba”, “Five Monkeys Jumping on the
Bed” and more.

Phrases: Using the same phrases each time you do something specific is a wonderful
Transactional Support. “Give me 5!”; or “Eyes on me”

Routines: All children learn by using routines. We use routines throughout our whole
day. Sticking with the same routine and using the same phrases will help your child not
only understand but also communicate.

Visuals: daily schedules, Help Boxes… etc etc etc… Visuals are amazing tools for every
child.
Classroom Based Transactional Supports to help with emotional regulation:
With the use of various transactional supports and a progression of
teaching for both understanding and expressing of emotions.
1. Describe your child’s emotions at specific times (“mad……Bobby is mad!”)
2. Teach your child methods for expressing this emotion in a functional manner
and/or coping with this emotion (“mad…….take a break” or “happy….sad I’m
happy!”)
3. Describe your child’s emotions during a day (“..Bobby feels sleepy”)
4. Describing others’ emotions (“Daddy is happy!”)
5. Teaching your child that his/her actions affect your emotions (“Bobby jump
on sofa…. Mommy sad”)
Some Fun Transactional Supports:
1. Emotion word picture symbols
2. Coping strategies picture symbols
3. Songs such as the “Feelings Song”
4. Feelings charts
Sensory Supports
We all needs ways to help integrate our sensory systems
and to help our neurological systems take in the
environment around us. Sensory integration is very
important for children with autism in order to help them be
at their optimal emotional arousal level for learning and
engaging socially. A great way to help your child with their
sensory needs is to engage in sensory times throughout
your day.
Your OT will be an excellent resource for helping to
determine the sensory needs of a specific child. Often a
child’s needs will change based on many factors
including: familiarity of routine, the activity itself, partners,
mood, time of day, etc.
Sensory Activity/Requesting Pages: These pages can help our children request
the type of sensory input they want and where. This gives the child awareness
and ownership towards their sensory needs. This will help them use their language
to ask for a sensory break in replacement of sensory-seeking behaviors. You can
place pages like this in plastic sleeves and in your sensory folder or binder. Point to
the pictures as you talk and engage in sensory activities with your child. Help your
child call your name, request more and request the specific body part.
a. “Tickles”: can be used with a massager toy
or without
b. “Scratches”: we all love a good back scratch!
c. “Brushes”: can be used with a sensory brush
d. “Squeezes”: for deep pressure can applied by
your hands
 Sensory
Time
Schedule
Pictures
and
Labels: create your own “Sensory Time” symbols with
Boardmaker. You can create your own, laminate them
and then use them to add to your child’s visual
schedule, to label an area in your house and/or to label
bins of sensory objects and toys. Also work on your
child using the language and requesting the language.
Classroom idea: a new way to look at the rice table!
Sensory Boxes: Using sensory boxes throughout your day is
also a great way to help your child emotional regulate. Using a
plastic container and then fill it up with: water, sand, dry rice,
popcorn kernels, dry beans, etc. You can then add in scoops,
shovels, animals, funnels and more. Playing with a
sensory box two to three times a day is a great way to help bring
your child’s emotional arousal level down.
Play Doh: Playing with Play-Doh is another
way to help regulate your child’s
great
emotions.
Using Visuals
We as adults all rely on visual helpers every day. We
use calendars, day timers, street signs, grocery lists,
maps, and so on. Using visual cues in our
environment allows us to plan, organize, and most of
all be independent. Visuals are equally important to
children because they are just beginning to learn
how things work in the world.
Why do visual supports make it easier for children to understand and
communicate?
•
•
•
•
•
Words “disappear” right after we say them, visuals hold time and space.
Visuals direct attention to themselves and hold attention.
Visuals allow more time to process the information.
Visuals assist in remembering.
Using the same words every time a visual is shown, teaches your child
those words.
Anything we see that helps us with communication by giving us
information with our eyes is a visual support. The type of visual that works
best with each individual child depends on what is meaningful to the child.
The most widely recommended visuals are those that are used to provide
children with information.
**Visuals increase independence! We are Independence Facilitators!
Visuals can be presented in several formats, depending on your child’s level of
understanding. Ranging from most concrete to most abstract, possible visuals are:
Objects – this would be considered the first level of visual representations and
would include the actual objects (e.g., for some children, seeing a sandwich in
their parent’s/teacher’s hand tells them “it’s time for lunch.”)
Colour photographs – this would consist of coloured photographs of the
concrete objects (e.g., for some children being shown a photograph of a bus
means “we’re going to daycare” OR “we’re going home”)
Black and white photographs – this level would consist of the same
photographs but in black and white
Colour line drawings – these are picture symbols that are often used with
children who are able to understand at this level of abstraction
Black and white line drawings – these are also picture symbols and serve the
same purpose as coloured lined drawings
Miniature objects – these are smaller versions of the objects
Schedules help alleviate your child’s anxiety and improve your child’s
understanding and cooperation
Schedules provide your child with information about:
• what regular activities are happening that day
• what is the sequence of events to come
• what new activities will occur
• what is not happening
• when it is time to stop one activity and start another
Which Visuals to Use
• use a maximum of six or seven visuals in the sequence
• identify times of the day which are noticeably different from each other (e.g., when
location changes or when activities change)
• choose symbols that are general enough that they cover the range of possibilities
for the activity (e.g., “lunch time” rather than a specific food)
• label pictures with the exact words that you and others will use to refer to the
activity
Where to Put a Schedule
• mount in a visible place where the schedule can be referred to easily (e.g., at their
classroom desk, in your child’s bedroom) keep it accessible for your child to refer
to on his own
How to Use a Schedule
choose a specific time(s) of the day where you can go over the pictures on the
schedule with your child and name the pictures in order
remove each picture once the activity is completed (e.g., snack time is finished)
show the picture of the upcoming activity especially if your child does not wish to
change activities (e.g., tidy up, then go outside)
show changes in the regular routine by changing the pictures and describing the
change (e.g., no daycare, today stay home)
Choice Boards
provide information about what options are available
may be used to broaden your child’s play interests
prompt your child to make a request or choice
clarify spoken language
How to Use Activity Choice Boards:
• if using the choice board to expand your child’s play interests place some pictures
of activities that he does not usually choose
• if you are trying to encourage your child to make a choice independently, place
pictures of activities or toys that he already likes and a picture of a non-preferred
activity —
• to ensure that he is making a choice start by placing 2 pictures of possible
activities your child may choose from on a board and gradually add more pictures
your child may indicate his choice by vocalizing, verbalizing, or gesturing give your
child the indicated choice (e.g., activity, object, food) immediately to reinforce
having made a choice
Visual Picture Schedule- a process:
So at the beginning, you may have a morning schedule with a new picture for each
activity “boots off”, “lunch kit out” coat on hanger”.
Once your child understands this routine and uses the language, then it is time to
make a change.
You can use a “morning time” picture (representing the entire routine) instead.
Once the child understands and uses even more language, you may move to a
schedule where the pictures are smaller but the words are bigger to increase preliteracy development.
The next step would be to move this schedule into a small binder like a “Day
Planner”.
The following step would be to move it to a written schedule with small pictures next
to the words. You could even have your child write/trace the words each morning.
The main goal would be moving them to a day planner. We all use day planners and
most schools start using them in first or second grade so you are preparing them for
a life of organization.
A beginner schedule with more detailed steps
-Moving from actual photos to picture symbols.
Visuals for Turn Taking!
Visuals for sharing
Visuals for getting through the tough stuff: FIRST/THEN
Task Scripts can be used to further support an activity after a transition
By breaking the task into visual steps
Visual Activity Boards
If you use visual activity boards at home,
you also want them to change as your child
makes progress. A great example would be
a Play-Doh® activity board (one of our
favs). Your first board may have your color
choices and a few actions like “open, roll,
cut”. Then once your child is understanding
and using these requesting words, you
may want to add some prepositions such
as “in, out”. With activity boards, it is
limitless. You can add words to work on
higher requesting skills like, “Mommy I
want more purple Play-Doh® please” or
words focusing on commenting such as,
“like, cool, don’t like, favorite, wow”. Again
there are endless possibilities depending
on your goals for your child.
Couple examples of Play-Doh® activity
boards:
Making choices: Within art you can
work on making choices about what
art to do and then making choices for
items within your art project. Such as
“finger paints or water paints” or
“green or red.” Show your child the
picture of finger paints and water
paints and say “finger paints or water
paints” if they don’t make a choice
then take their finger and point to one
and say it. Then play it. You can do
the same with colors choices.
Remember if you don’t have a picture
for it then you can use the actual
objects.
Time based schedules
A schedule with multiple school events with
increased text size and decreased picture
size
Visuals can even be used for Play plans!
Song choices!
Subject + verb + noun Visuals:
Visuals used to target vocabulary growth, sentence structure, and to
increase expressive language- requesting and commenting.
A written Schedule
Universal Supports:
All behavior serves a function: at the heart
of SCERTS

Q: How did your thinking about autism change in the course of the developing the
SCERTS Model?

Old: focusing on each child's stereotypical or repetitive patterns of behavior and
considering these behaviors to be central to their disability. We neglected the
function that they served for the child, simply discarding them as "autistic
behaviors."

NEW: I now see many of these behaviors as an artifact of each child's drive to
cope with predicting the actions of other people, social expectations in less
predictable environments, and making transitions.

NEW: Many children with autism are coping with a heightened degree of stress
and have developed repetitive, soothing behaviors as coping behaviors.

Old: I used to ignore or discourage these behaviors

New: I have learned to understand their function, change my behavior in an effort
to prevent these behaviors, and model replacement strategies that may be more
socially appropriate and more effective.
A review:
Developmental Dimensions Addressed in SCERTS
1. Social Communication (SC);
1. What level is my child communicating?
(Social Partner Stage/ Language Partner Stage/ Conversational Partner)
a. Capacity for joint attention
b. Capacity for symbol use
2. Emotional Regulation (ER)
a. Self-regulation
b. Mutual regulation
3. Transactional Support (TS) = The IPP for the educators and families
a. Interpersonal support
b. Educational and learning supports
c. Family support
t
d
i
The team can use SCERTS to:
•
assess the child’s strengths and needs in the areas of social compentcy and emotional
regulation.
•
set goals for the child in social communication and emotional regulation for home and the
early childhood setting
•
plan activities that are meaningful and purposeful, at home and at the early childhood setting
•
provide a balance of free play and structured activities.
•
identify the transaction support the communication partner will use (the adult goals)
•
monitor a child’s progress
•
ensure that we share successes and challenges and support each other
•
Allow the child’s behaviour teach you what is working and what isn’t.
•
**The Full Scerts Program is recommended, as is a 1-3 day training.
•
www.scerts.com
This powerpoint as well as the following SCERTS
assessment and planning sheets will be available through
CARC website.
 1. What is my child’s developmental stage?
 (handout)
 2. Set our objectives for this child- in areas of
 Social Communication AND
 Emotional Regulation
 (handout on Frequently used Objectives and Supports).
 3. How will we accommodate these objectives? What will our
transactional supports look like?
 (Handout: Practice Principles for Success)
 (Handout: Educational Planning Grid)
 4 Also posted: emotional key ring; several visual activity boards,
and a first- then visual.
 My email: [email protected]
“When you change you way you look at things,
the things you look at change.” Wayne Dyer
 When children engage in more challenging behaviors, I
have learned to move beyond the simplistic response of
ignoring these undesirable behaviors to a more humbling
process of recognizing that the antecedents may lie in
my behavior, a variable that can easily be changed. For
example, had I provided a clear and predictable end point,
motivating and meaningful materials, and visual and
organizational supports, the child may not have engaged in
that challenging behavior.
 I also have learned that these moments of challenging
behaviors present clear teachable opportunities for us to
model emotional expression and appropriate coping
strategies.

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