The world of the “D`s”

Report
THE WORLD OF
THE “D’S”
ASD, ADHD, LD, DD & IDD
Emily Boncek M.S., CRC & Lucy Gafford M.S., CRC
Training Developed by
Jennifer Kaut M.Ed.,BCBA
Board Certified Behavior Analyst
DARS-DRS Developmental Disorder Specialist
Looking at July 2014 TEA DATA:






Our Total Numbers
Age Group with the Greatest Numbers
Rate of Growth
Percentage by Age, Grades and Severity Level
Numbers Graduating in 3 -5yrs. & 10 -12 yrs.
Possible Financial Effects
Created by: Jennifer Kaut, M.Ed. BCBA
Data obtained by TEA July 2014. Data reporting Levels of Severity are based on the DSM 5 definitions.
Data for Levels of Severity nor financial costs are not validated.
Number of ASD Elementary School Age Students: 24,932
2,308
5 yrs
3,396
3,675
3,719
4,011
4,055
3,768
6 yrs
7 yrs
8 yrs
9 yrs
10 yrs
11 yrs
Number of ASD Middle School Age Students: 9,809
3,590
3,242
2,977
12 yrs
13 yrs
14 yrs
Number of ASD High School Age Students: 8,275
2,643
2,300
15 yrs
2,054
16 yrs
1,278
17 yrs
18 yrs
Number of ASD 18 + Age Students:1,579
689
19 yrs
488
402
20 yrs
21 yrs
Percentange of ASD Students in Pre-K, Elem, Middle, High & 18 +
18 +(19-21)
3%
Pre-K(3-4)
6%
High School(15-18)
17%
Middle (12-14)
21%
Elem (6-11)
53%
Current Number of ASD Students
Ages 3-21 broken down by the DSM Level of Severity
25,000
20,000
Data provided by TEA July
2014. The levels are
estimates only. They are
not reported numbers
15,000
10,000
5,000
0
3-5 yrs (4,986)
6-14 yrs (32,433)
15-18 yrs (8,259)
19-21 yrs (1,579)
In total: 47,527
broken down by
level
Level 1 "Requiring Support"
1,114
14,296
3,662
87
19,159
Level 2 "Requiring Substantial Support"
2,122
5,938
1,540
114
9,714
Level 3 "Requiring Very Substantial Support"
1,750
12,199
3,057
1,378
18,384
DSM Definition of Level 1:
DSM Definition of Level 2:
DSM Definition of Level 3:
Social communication: Without supports in place, deficits in social
communication cause noticeable impairments. Difficulty initiating
social interactions, and clear examples of atypical or unsuccessful
response to social overtures of others. May appear to have
decreased interest in social interactions. For example, a person who
is able to speak in full sentences and engages in communication but
whose to- and-fro conversation with others fails, and whose
attempts to make friends are odd and typically unsuccessful.
Social communication: Marked deficits in verbal and nonverbal
social communication skills; social impairments apparent even with
supports in place; limited initiation of social interactions; and
reduced or abnormal responses to social overtures from others. For
example, a person who speaks simple sentences, whose interaction
is limited to narrow special interests, and how has markedly odd
nonverbal communication.
Social communication: Severe deficits in verbal and nonverbal social
communication skills cause severe impairments in functioning, very
limited initiation of social interactions, and minimal response to
social overtures from others. For example, a person with few words
of intelligible speech who rarely initiates interaction and, when he
or she does, makes unusual approaches to meet needs only and
responds to only very direct social approaches.
Restricted, repetitive behaviors: Inflexibility of behavior causes
significant interference with functioning in one or more contexts.
Difficulty switching between activities. Problems of organization and
planning hamper independence.
Restricted, repetitive behaviors: Inflexibility of behavior, difficulty
coping with change, or other restricted/repetitive behaviors appear
frequently enough to be obvious to the casual observer and
interfere with functioning in a variety of contexts. Distress and/or
difficulty changing focus or action.
Restricted, repetitive behaviors: Inflexibility of behavior, extreme
difficulty coping with change, or other restricted/repetitive
behaviors markedly interfere with functioning in all spheres. Great
distress/difficulty changing focus or action.
Percentage of Students with ASD by Level of Serverity
Level 3
39%
Level 1
40%
Level 2
21%
How Many Are We Sending for 18 + Services?
18 yrs:
Total: 2,296
19 yrs
Total: 688 (30%)
20 yrs
Total: 488(21%)
21 yrs.
Total: 392(17%)
Level 1: 434
71
Percentage that go on to 18 +
services: 16%
70
Percentage that go on to 18 +
services:35%
547
Percentage that go on to 18 +
services: 86%
10
Percentage that go on to 18 +
services:.02%
30
Percentage that go on to 18 +
services:15%
448
Percentage that go on to 18 +
services: 68%
6
Percentage that go on to 18 +
services:.01%
4
Percentage that go on to 18 +
services:.02%
382
Percentage that go on to 18 +
services: 58%
Level 2: 201
Level 3: 661
In the next 10-12 years…
Texas will TRIPLE the numbers of students graduating with Autism
2017-2019, Texas will have 9,838 students with Autism graduating.
2024-2026, Texas will have 32,433 students with Autism graduating
Number of ASD Students Graduating
3 to 5 years
10 to 12 years
32,433
9,838
3 to 5 years
10 to 12 years
Number of ASD Students Graduating
by Level of Severity
10 to 12 years
Level 3 (very substantial supports)
Level 2 (substantial supports)
Level 1(needs supports)
3 to 5 years
12,199
4,435
5,938
1,654
3,789
14,296
What Supports Did These Graduates Need in School and How Will These Reflect
Their Transition Needs?
(Predications based on the DSM 5 Levels of Severity)
LEVEL 1’s (Need Supports)
In 3 to 5 years

3,749 students received their instruction in the least restrictive instructional setting. They were in their regular classroom approximately 80% of
the time. They may need to stay in school 1 or 2 more years to further develop life and social skills, if their academics, were the primary focus
during high school. They may need VR services in order to obtain/maintain employment or attend higher education
In 10 to 12 years

14, 296 students
LEVEL 2’s (Substantial Supports)
In 3 to 5 years

1,654 students received their instruction in a moderate restrictive instructional setting. They were in their regular classroom approximately 40% 79% of the time. They will most likely need 18 plus school services, as well as, VR services in order to obtain or maintain employment. These
students are at a crossroad: there are 3 directions these students can take.
1) If provided, intense intervention with the expectation of independence, they could move up to a Level 1
2) They stay the same and will most likely never reach full independence
3) Or due to a lack of intervention and supports, this group is at risk for dropping to a Level 3, thus needing lifelong supports.
In 10 to 12 years

5,938 students
LEVEL 3’s (Very Substantial Supports)
In 3 to 5 years

4,435 students received their instruction in the most restrictive instructional setting. They were in their regular classroom less than 40%. These
students will require intense long term supports.
In 10 to 12 years

12,199 students
2012’s Top 5 Reasons for ASD Unsuccessful closures…
1.
Making eligibility decisions largely based on a psychological report
 People with ASD need time to transition to new people & places and struggle to generalize skills from one environment to another. In this contrived
setting, with an unfamiliar person & place, it is not possible to get a valid snapshot of this person’s ability to work.
2.
Ignoring the validity of school assessments

3.
Instead sending for a psychological even though the school assessment was recent and accurate.
Problem behaviors that were identified but not treated
 2 main types: Challenging behaviors or social skill deficits.
4.
Problem behaviors that were identified but treated with psychotherapy
 Research tells us that traditional psychotherapy has little success at decreasing problem behaviors and increasing skill deficits. It is unlikely that an
ASD individual can replicate a skill learned in a contrived setting and generalize it. Furthermore, the only way to decrease problem behavior is
determine what factor/s are maintaining them, and address the environment in which it is occurring.
5.
Failure to recognize characteristics of ASD
 63 year old consumer “failed to cooperate” when he would not work anywhere but the one county he has lived in his entire life. ASD causes rigid
patterns of behaviors and inability to be flexible.
rd
 Consumer “refused services” after his 3 new counselor introduced herself. Inability to transition is part of ASD.
 Consumer “failed to cooperate” when he missed several appointments. Social phobia & severe anxiety is a characteristic of ASD.
 Consumer was closed because he was “happy” with his Whataburger job and did not want to change (he got it himself). ASD causes a person to resist
change.
 Consumer stopped showing up to DARS appointments after being fired. Closed as “refused services”. Once a negative event occurs, people with ASD
will associate all involved with that negative experience.
Created by: Jennifer Kaut M.Ed.,BCBA
What’s with all this Autism Stuff?? Why does it
matter to me? I don’t have that many on my
caseload!
WHY? Because anything you
do for ASD, is best practice for
ANY developmental disorder.
They are the largest
disability population and we
are the least successful with
them….
OLD Way
What WORKS
Immediately sending for psychological
If they are not college bound, what will this tell you?
Using the same psychological tools
If you need a diagnosis for Autism, use the ASD
psychological battery
Traditional vocational assessment
Viewing these consumers in a contrived setting will not
give you an accurate assessment of work abilities,
many are not “generalists”
No other vocational assessment options
IN PROGRESS: Environmental Work Assessment that
measures HOW a work envirnoment either increases
the disability characteristics or decreases.
Treating with psychotherapy
Only use if the mental illness is barrier not the
developmental delay
Not treating social skill deficits and/or challenging
behaviors
Use Applied Behavior Analysis (ABA) providers to
address these issues BEFORE work. IN PROGRESS:
Updated policy
Using CRP’s who have little experience with
developmental disorders
IN PROGRESS: Creating ASD/DD CRP specialists
No choices if the consumer needed specialized support
that was not therapy but outside the duties of a job
coach
IN PROGRESS: ASD/DD Supports
Simply put:
ABA is a methodology whose goal is to
socially significant
behavior.
So what is “socially significant behaviors”?
Any behavior that effects a person’s quality of life
Communication
Verbal
Language
Academics
Self Help Skills
Social Skills
Vocational
Skills
Problem
Behaviors
• Applied: ABA takes what we know about behavior
and uses it to bring about real-world, meaningful
change
• Behavior: Behaviors are defined in observable and
measurable terms in order to assess change over
time
• Analysis: Behaviors are analyzed within the
environment to determine what factors are
influencing the behavior
3 levels:
• BCaBA: Bachelor’s + behavior classes +supervised hrs.+
board exam
• BCBA: Master’s + behavior classes +supervised hrs
+board exam
• BCBA-D: Doctorate +board exam
All must have degree’s in Education, Sp. Education,
Psychology , Social Work or Behavior Analysis.
What they can do:
• BCaBA/graduate student in a behavior analysis program
• Cannot do assessments
• Can only conduct intervention plans supervised by a BCBA & all
reports on progress must be signed by a BCBA
• BCBA:
• Can do assessments
• Can do all interventions
• BCBA-D:
• Can do assessments
• Can do all interventions
How do I find one in my area?
2 ways:
1. Check Rehab Works
2. www.bacb.com (click on the page that says “find
certificates”)
• Has a problem behavior that presents a barrier to
employment
• You need to DECREASE these behaviors
• Has a deficit in social skills that present a barrier to
employment.
• You need to INCREASE these behaviors
What if it looks like there is several problem behaviors and several
deficits?
You can call in a behaviorist to assess:
• Skill level
• Social skill level
• Communication ability
• Environments that would support their autism
• Environments to avoid
• Determine the function of any problem behaviors
• Identify triggers
• Identify preferred interests & reinforcers
• Determine if they have natural supports
• IF needed, provide a treatment plan to address these behaviors
Their parents are glued to them and speak for my
consumer
Parents might sabotage what we are doing
Need more information to develop a plan
CCSA is a great pairing with a FBA
A behaviorist would work with ALL environments- if the
environment presents a barrier to employment then we
can address it.
What is the work goal?
EX. If your consumers work goal is to work at a gaming
company that provides tele-work or cubicles, little
interaction, low lighting, then what social skills does he
need? If he can respond when spoken to, follow
supervisor’s instructions, accept feedback, has
transportation and shows up dressed appropriately, then
does he have a barrier?
Autism DOES NOT = ABA
Challenging
Behavior
Skill Deficits
• Social Skills Support
(Consumer does not have challenging behavior but displays skill
deficits)
• Social Skill Assessment (up to 4 hrs)
• Intervention (group or individual up to 30 hrs)
• Behavioral Intervention
(Consumer has challenging behaviors that need to be decreased)
• Functional Behavior Assessment(FBA) (up to 8 hrs)
• Behavior Intervention Plan(BIP) (group or individual up to 30 hrs)
***Any combination of individual or group can be used but the
total is not to exceed 30 hours ***
• ABA is short term
• You should see progress
• Receive frequent updates on the mastery of the
consumer’s goal
• A good therapist will redo the plan if progress is not
shown quickly
• You should see generalization of skills in all environments
• People in the environment that is being treated should be
trained in any plan or recommendations
RPM: Chapter 5 (5.3.7)
• Located after Mental Restoration Services
Rehab Works
• Level 1- Evaluation Services
• Level 2-Behavior Analysis (will be changed to APPLED
Behavior Analysis)
DARS
COMMON MYTHS REVIEWED
MYTH: YOU MUST BE AT LEAST 16 YEARS OLD TO APPLY FOR DARS SERVICES
MYTH: HIGH SCHOOLS SHOULD REFER A STUDENT TO DARS ONLY WHEN THEY ARE A
SENIOR
MYTH: DARS IS A SCHOLARSHIP PROGRAM
MYTH: DARS CAN’T ASSIST A TRANSITION AGED STUDENT WITH FINDING WORK, UNTIL
THEY GRADUATE HIGH SCHOOL
MYTH: DARS IS A LONG TERM SERVICE PROVIDER
MYTH: DARS PROVIDES EMERGENCY SERVICES
MYTH: DARS CAN’T WORK WITH A STUDENT IF THEY ARE RECEIVING 18+ SERVICES WITH
THE HIGH SCHOOL
MYTH: APPLIED BEHAVIOR ANALYSIS(ABA) SERVICES ARE RELEVANT ONLY TO
INDIVIDUALS DIAGNOSED WITH AN AUTISM SPECTRUM DISORDER
MYTH: ABA CAN ONLY BE APPLIED TO BEHAVIOR PROBLEMS
MYTH: ABA SERVICES ARE ONLY EFFECTIVE FOR YOUNG CHILDREN
DD Regional Point of Contacts…
Region 1
Rick Bullard
Region 2
Gena Swett
Region 3
Dae Eun
Region 4
Marilyn Gilbreath
Region 5
Emily Boncek
2014 Statewide Developmental (ASD/DD/IDD/ADHD) Disorders Team
Team Lead: Jennifer Kaut M.Ed., BCBA
Total ASD VR Counselors: 56 (updated 9/4/14)
Total CRPs: 33(updated 9/4/14)
Total: VR/CRP: 89
Region 1
Region 2
Region 3
Region 4
Region 5
TOTAL: 7 & 2 VACANT
w/CRPs: 13
TOTAL: 14
w/CRPs: 24
TOTAL: 12
w/CRPs: 20
TOTAL: 7 & 1 VACANT
w/CRPs: 9
TOTAL: 16
w/CRPs: 23
Ellen Dingus
Wichita Falls
Trinetta Powell
Plano
Michael Marler
Round Rock
VACANT
Conroe
Ruby Wilkins/ Cinda Alvarado
San A. Northeast
Jonathan Perkin(UPS)
Abilene
Tina Shaffer
Garland
Elsa Perez/Stanley Bell
South Austin
Veronica Comeaux
North Houston
Erlinda Leal/Blanca Perez/Becky Ashton
San A North
Mary Ellen Pate
San Angelo
Diana Terry Ft. Worth South
Lori Charlton Cleburne
Debbie Browne
East Austin
Karen Williams
Southwest Houston
Steven Martinez/Alma Alvarez
San A South
Della Moore & David Enrique
El Paso Central
Kelly Holloway
Lewisville
Patrice Rabalais
Beaumount
Eligio Hinojosa
Houston Central
Debbie Rodriguez
San A West
Ashley Richardson
Lubbock South
Mary Faltaous
Carrollton
Teresa Frechette
Temple
Kristie Sekmistrz
South Houston
Sherri Eddy
Harlingen
Debbie Edwards
Lubbock West
Kellie Harrison/Lucy Gafford(AM)
Denton
Jennifer McCurley
Tyler
Catherine Guillory
Houston West
Gabby Martinez
McAllen
VACANT
Odessa
Katharine Bowdre
Sherman
Lhea Homesley
Waco
Solomon Ambani
Houston West
Leigh Ann Godinez
McAllen
VACANT
Amarillo
Deanna Layfield
Dallas Southeast
Giovanne Bell
College Station
Nichole Rideux
Humble
Sasha Esparza/Michael Day
Corpus Christi
Angela Gonzalez
Dallas Northeast
LeAnn Bolwerk
Longview
Nick Boyko
Texas City
Jacqueline Gutierrez/Esmeralda Lopez
Laredo
Jennifer Reynolds/Brian Loftus/Virginia Shutt
Arlington
Susan Payne
Paris/Texarkana
Salynda Bryson
Rosenberg
Maricela Ponce
New Braunfels
Jacklyn Meade
Fort Worth West
Kelley Downey
Lufkin
Regional Point Person:
Rick Bullard
Regional Point Person:
Gena Swett
Regional Point Person:
Dae Shin
Regional Point Person:
Marilyn Gilbreath
Regional Point Person:
Emily Boncek
El Paso Area & Back up: David Enrique
Back up’s: Audra Ressel & Lucy Gafford
Back up’ s Nick Boyko
Back up: Blanca Perez
Additional Regional staff:
Joe Morris, Mike Lawson
Shannon Johnson (trainer)
Additional Regional staff:
Rosla Hocker, Betty Davis
Additional Regional staff:
Stephanie Jenkins
Additional Regional Staff:
Ron Garza, David Dehoyos, Johnny
Weddington
Additional Regional staff:
Merry Straube, ,Frank Donaldson, Kelly
Yarbrough
2014 Statewide Developmental (ASD/DD/IDD/ADHD) Disorders Team CRPs
Region 1
Region 2
Region 3
Region 4
Region 5
ASD CRP
TOTAL: 6
ASD CRP
TOTAL: 10
ASD CRP
TOTAL: 8
ASD CRP
TOTAL: 2
ASD CRP
TOTAL: 7
-Texas Employment Consultants
-El Paso Helping People
-Strassler Employment Services
-After Mile Inc.
-Ability Solutions
-Burkhart Center (pending CRP status)
-LauchAbility
-Autism Treatment Center
-Easter Seals-temple mays
-UNT JobFit
-Life Path Systems
-Ability Solutions
-Association for Independent Living
-Bryant Guidry
-Spectrum Services
- Work Ready
-Client Services of East Texas
-Dverse Solutions
-Goodwill(Central)
-Debby Puckette
-Bruce Bloom
-Ability Solutions
-Opportunity Center
-Austin Dog Alliance
-Easters Seals Greater Houston
-University of Houston at Clearlake
-Job Adventures
-Goodwill (South TX)
-Compass Resource Group
-Autism Treatment Center
-Gatehouse Supportive Services
-HELP
-Business Resource Center

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