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Autism Spectrum Disorders: Strategies for the School-Based SLP






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  • Geschwind, 2009: broad-based neurodevelopmmental or brain-based disorder result of genetic events occurring prior to birth
  • Kanner: 1943; Asperger: 1944; Wing: 2005; Grinker: “Unstrange Minds: Remapping the World of Autism”
  • Autism Diagnostic Observation Schedule; toddlers to adults; 30-45 min., developmental levels and language skills
  • Also: Asperger Syndrome Diagnostic Scale (Myles, Book, Simpson, 2003) Questionnaire, ages 5-18; SS and %iles; targets intervention goals
  • Impaired ability in formation of prototypes; organizing information into different categories; difficulty determining saliency, esp. in visual processing
  • Stanley Greenspan
  • Tom Buggey uses video modeling for PBS
  • Tom Buggey suggests putting stories on a PowerPoint, send to teachers and parents and hard-copy into student’s notebook
  • Major reason to promote with administration and teachers
  • Goal for Educators!
  • *Nancy Alarcon

Autism Spectrum Disorders: Strategies for the School-Based SLP Autism Spectrum Disorders: Strategies for the School-Based SLP Presentation Transcript

  • Autism Spectrum Disorders: Strategies for the School-Based SLP
    Melanie W. Hudson, M.A., CCC-SLP
    National Director
    EBS Healthcare
  • Understanding Asperger’s Syndrome and the SLP’s Role in Assessment and Intervention
  • Defining Autism
    DSM- IV-TR, 2000
    Behavior Disorder
    Brain disorder with genetic basis
    Social interaction
    Verbal/non-verbal communication
    Restricted range of interests and activities
  • Prevalence of Autism
    1970s: 2-5 per 1000
    2000: 1/500 (DSM-IV-TR, 2000)
    2003: 34-60 per 1000 (Fombonne)
    2007: 1/150 births (CDC)
    2008: 1/91 (Kogan, Strickland, et.al)
    2009: 1/91 (Bloomberg, et.al)
    (Prelock, 2010)
  • The Concept of Autism:
    Richard Grinker: Anthropological Explanation
    Leo Kanner: Differential Diagnosis with Schizophrenia
    Hans Asperger: Genetic and Biological Factors
    Lorna Wing: Spectrum Concept
  • 4. Rett’s Disorder
    5. Childhood Disintegrative Disorder
    Autism Disorder
    Asperger’s Disorder
    PDD - NOS
    Autism Spectrum Disorder
  • Asperger’s Disorder
    Qualitative impairment in social interaction in at least 2 of the following:
    Marked impairment in the use of multiple nonverbal behaviors such as eye contact, facial expression, body postures, and gestures to regulate social interaction;
    Failure to develop peer relationships appropriate to developmental level;
    Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people;
    Lack of social or emotional reciprocity
  • Asperger’s Disorder (cont’d)
    Restricted repetitive and stereotyped patterns of behavior, interests, and activities as manifested by at least 1 of the following:
    Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus;
    Apparently inflexible adherence to specific, nonfunctional routines or rituals;
    Stereotyped and repetitive motor mannerisms;
    Persistent preoccupation with parts of objects
    (Diehl, S., 2008)
  • Early Diagnosis is Critical
    Early identification of children who are “at risk” for ASD facilitates early intervention
    Early intervention is essential for better outcomes
    (Diehl, 2008)
  • Autism impacts:
    Social Interaction
  • SLP Role in Assessment and Intervention
    Prioritize goals for achieving social communication
    Honor and adapt to a family’s individual needs and cultural context
    Recognize evidence-based practice
    Understand the communication demands of the classroom
    (ASHA, 2006c)
  • Assessment Tools:
    Structured parent interviews
    Extensive observations of the child in a variety of settings – with one preferably made in the home environment
    Observations by more than one evaluator, either separately or jointly conducted
    Observations made at different times
  • Assessment for ASD Child with Higher Skills
    More traditional tools do not get at underlying pragmatic challenges
    Narrative assessment allows for observation of breakdown in personal story-telling ability, use of internal responses and solutions to problems
    Also consider: Test of Language Competence, The Word Test, Test of Problem-Solving, and pragmatic subtests of CASL
    ADOS is “gold standard” for assessment; requires face-to-face training (videotaped training is available); based on DSM criteria
    (Prelock, 2010, live chat on ASHA Web site)
  • Other Tools
    “The Pragmatic Protocol”, Prutting and Kirchner
    Developed in 1982 to provide an overall communication index for school-age children, adolescents and adults
    Consists of 30 pragmatic aspects of language
    Considers role of each participant in structuring the interaction and evaluate results accordingly
  • Pragmatic Protocol
    How Does it Work?
    Observation of individuals engaged in spontaneous, unstructured conversation with positive neutral partner
    15 minutes of videotaped interaction
    Each aspect is judged as appropriate, inappropriate or not observed
    Consider sociolinguistic background of the individual being observed
  • Communication Acts
    Verbal Aspects:
    Speech Acts
    Topic Maintenance
    Lexical selection
    Stylistic Variations
  • Communication Acts:
    Non-verbal Aspects:
  • Communication Acts
    Paralinguistic Aspects:
    Intelligibility of speech
  • Conversational Effectiveness Profile-Revised(Kowalski, T., 2010)
    Documents relative strengths and weaknesses in social-pragmatic communication inherent in Asperger’s
    Comprised of 6 domains (social interaction, social communication, academic communication, perspective-taking, social-emotional)
    Diagnostician rates each area on 3-point scale (appropriate, somewhat appropriate, extremely inappropriate)
    May be used in a variety of settings
  • Understanding the Influence of Language and Cognition in ASD
  • Language Impairments in ASD
    Difficulty with pragmatic aspects of language may be present across the spectrum:
    Conversational discourse
    Understanding and telling stories
    Nonverbal aspects of communication, including prosody, facial expression, body language
  • Language Profiles and Cognitive Mechanisms: The Links
    Theory of Mind: Ability to interpret mental states in people and relate to their behavior, (put yourself in someone else’s shoes)
    Executive Functions: Skill set for planning, guiding problem-solving, and regulation of behavior
    Impairments in both found among range of children with ASD
    (Tager-Flusberg, 2010)
  • Theory of Mind and Language
    Necessary to interpret others’ mental states to communicate effectively
    Joint attention skills at the root of Theory of Mind
    Significantly impaired in ASD population
  • Findings Related to Theory of Mind
    After accounting for age, IQ, and general language level:
    Theory of Mind was a significant predictor of child’s ability to maintain discourse topic
    Theory of Mind was significant predictor of socialization scores on the Vineland
    Theory of Mind was a significant predictor of severity of autism symptoms
    (Tager-Flusberg, 2003)
  • Findings Related to Executive Functions
    Related to language and other co-morbid symptoms (ex. ADHD)
    More significant impairments in children with ADHD symptoms
    (Tager-Flusberg, 2010)
  • Clinical Implications: Assessment
    Language-Theory of Mind-Executive Functions: Mutually influencing cognitive functions, impaired to a different degree in each child
    Influences academic performance and peer relations
    Effective assessment will evaluate ALL aspects
    Child can perform well on test but still have everyday problems
    (Tager-Flusberg, 2010)
  • EF and Social Adaptation Measures
    Standardized Assessment: NEPSY-2 (Korkman et al., 2007) for ages 3-16
    BRIEF: Parent report measure, 86 items, for ages 2-18
    Social Maturity Scale- Teacher rating, 7 items, correlates with Theory of Mind (Peterson et al., 2007)
    (Tager-Flusberg, 2010)
  • Clinical Implications: Treatment
    Organizational Skills
    Reading Comprehension
    Asking and Responding to Questions
    Following Directions
    Conversational Skills
    Peer Relationships
  • Service Delivery Models
    Service Delivery Models:
    A Continuum
  • SLP Role in Intervention
    Prioritize the goals for achieving social communication
    Honor and adapt to a family’s individual needs and cultural context
    Recognize evidence-based practice
    Understand the communication demands of the classroom
    (ASHA, 2006c)
  • SLP Role in Intervention
    Partner with families
    Collaborate with teams
    Engage in professional development
    Advance the knowledge base
    Advocate to promote communication and independence
    (ASHA, 2006c)
  • Interventions with varying levels of evidence (National Standards Project, 2009)
  • Continuum of Interventions: Social Pragmatic Developmental (Prelock, 2010)
  • Contemporary Behavioral Approaches
    Give children choices
    Share control of teaching opportunities
    Use preferred activities and materials
    (Prelock, 2010)
  • Service Delivery is Dynamic Process
    Change intervention models based on:
    Individual progress
    Changing communication demands
    Response to treatment
    (Prelock, 2010)
  • Planning Intervention
    Consider each of the following:
    Functional, spontaneous communication
    Social instruction in various settings throughout the day
    New skill acquisition that then includes generalization and maintenance (a skill remains a “trick” until it is performed across settings, people and materials)
    Play skills that include peer and peer interaction
    Functional assessment and positive behavior support to address problem behaviors
    Functional academic skills
    (Diehl, 2008)
  • Positive Behavior Support
    Teaching the child an appropriate way to communicate results in reducing challenging behavior and increases communication skills
    Created because of dissatisfaction with traditional methods for addressing severe behavior problems
    Directly targets the relationship between challenging behavior and communication
    Focuses on intervention in natural contexts
    Shifts focus from restricting behavior with narrowly defined settings and expectations
    Increases quality and quantity of meaningful and positive interchanges
    (Diehl, 2008)
  • Positive Behavior Support
    Review of single-subject intervention in more than 100 studies demonstrated its effectiveness in reducing challenging behavior (Carr,1999)
    Average behavior reduction for single-subject studies for children with autism was 94.6% (Horner, 2000)
    (Diehl, 2008)
  • Positive Behavior Support
  • Positive Behavior Support
  • Visual Strategies and Supports
    Things that are seen that enhance the communication process (ex. body language, calendars, maps, etc.)
    Compliment the learning style of the child with ASD
    Not transient such as oral or picture language
    Much evidence to support
    (Diehl, 2008)
  • Types of Visual Strategies and Supports
    Choice Boards
    Environmental Organizers (labels on shelves, bins, etc.)
    Visual sorting tasks (ex. categorization)
    Word Wall
    (Diehl, 2008)
  • Word Wall
    Acts as a reference and scaffold for written work; reinforces theme vocabulary
    High-frequency words and most commonly misspelled words on permanent wall for child to see
    Theme or unit words should be available for more interactive activities (ex. key rings)
    (Diehl, 2008)
  • Priming (Pre-Teaching)Diehl, 2008
    Previewing classroom assignments before being presented in class
    Parents or special educators can implement
    Use on daily basis
    Done as pull-out session the day before or at home the night before
    Familiarize student with material in relaxed, non-threatening manner
    High reinforcement for learning
    (Wilde, L.D., Koegel, L.K., & Koegel, R.L., 1992)
  • Priming
  • Priming
  • Examples of Priming
    Semantic Webbing
    Reading checklist
  • Reading Checklist (Diehl, 2008)
  • SQ3R
    Survey: Chapter Headings, bold-faced headings, pictures, captions; Guess what text is about
    Question: Read search questions or comprehension questions at end of chapter
    Read: Read to answer questions
    Recite: Try to answer questions from memory
    Review: Verify and support answers by rereading
  • Social Stories (Carol Gray)
    To bridge or scaffold social understanding gap
    Effective in enhancing perspective-taking
    Allow parents and professionals to better understand child’s perspective
    May be used to address broad range of situations
    Available from:http://www.thegraycenter.org/Social_Stories.html
  • Teaching Social Stories(Gray,C.)
    Introduce story in quiet place
    Review daily before targeted situation
    Keep data on student responses during story and targeted situation
    Revise or add to story as needed
    Revise the review schedule as student shows it can be faded. Decrease verbal support
    Keep stories available to student
    (Diehl, 2008)
  • Comic Strip Conversations
    A conversation between 2 or more people using simple drawings
    Use dry erase boards, chalk boards, paper
    Depicts ideas such as everyone talking at once, listening as part of a group, interrupting, LOUD or quiet words, who is saying what, who is listening, thoughts
    Beginning evidence-supported
    (Diehl, 2008)
  • Comic Strip Conversations
  • Video Modeling(Charlop-Christy, 2004)
    Watching a video of adults or children modeling particular target behaviors
    Helps focus child’s attention on relevant stimuli in video
    With practice and rehearsing, child begins to retain and display targeted language and behavior
    Fosters generalization of behaviors
    Established evidence-supported
    (Diehl, 2008)
  • Steps for Video Modeling
    Select and define the targeted behavior (ex. asking a question during class)
    Complete a task analysis to itemize the steps
    Observe target script for typically-developing children
    Present each step slowly with exaggerated acting
    Provide at least 2 observations before assessing learning
    Create short scripts allowing for reciprocal communication exchange
    Gather input from parents, teachers and child to guide development of the video model
    (Courtesy, M. Mount, 2009)
  • Video Modeling
    Considerations (Charlop-Christy & Kelso, 1997):
    Consider a motivating theme in the conversation or play being modeled
    Camera is strategically located to present facial expression or show hands carrying out a particular task
    Pause the video to highlight target expressions
    Prompt child’s attention as needed by saying something like “watch the T. V.” or “Look”
    Immediately following the video viewing, ask the child to do what they watched
    Debrief the child reviewing what was seen and heard, identifying any new language heard as well as noting prosody and emotional expression of the “models”
  • Video Modeling Considerations:
    Talk about possible variations of events so the child has opportunities for flexible learning and thinking
    Encourage and reinforce attempts to demonstrate the modeled behavior
    Rewind to review important parts
  • Self Management Strategies(Koegel, R.L., Koegel, L.K., & Parks, D.R.,1995)
    Promote independence and responsibility for behavior
    Improve social interactions
    External control does not result in lasting change
    (Diehl, 2008)
  • Steps to Self-Management
    Discriminate between appropriate and inappropriate behavior
    Evaluate behavior (ex. happy/sad face)
    Monitor behavior over time (checking in at various times of the day, etc.)
    Self-reinforce behavior when expected behavior met (ex. earning points)
    (Diehl, 2008)
  • Choice Chart
  • Peer Mediated Intervention
    Peers used in variety of roles:
    Buddy system
    Established evidence
    (Diehl, 2008)
  • Peer Mediated Interventions
    Proximity: Placing typical peers who are socially competent with children with ASD, directing them to play with their peers without specific training
    Biggest outcome here is that children will be actively engaged with someone and they will stop or limit the stereotyped behaviors you often see
  • Peer Mediated Interventions
    Prompting and Reinforcing: Combination strategy where socially competent peers are trained to prompt a child with disabilities to play and then to reinforce the child’s responses
  • Peer Mediated Interventions
    Antecedent Prompting: Child with ASD is paired with a socially competent peer who is instructed to remain in proximity to the child with ASD; teacher provides periodic prompts to the child with ASD to engage in social interaction
    (Simpson et al., 1997)
  • Four Steps to Support Peer MediatedIntervention:
    Introduce the skill to a typical peer, describing and providing a rationale (describe the skill)
    Demonstrate the skill for the typical peer (demonstration)
    Rehearse skill with the interventionist
    Typical peer practices/rehearses the skill with another child, then works with the child with ASD after interventionist is certain he is ready
  • Relationship Development Intervention
    Goal is to provide comprehensive program for developing relationship skills
    Based on developmental model that begins with basic relationship exercises
    Uses 10 skill areas that encompass the qualities of children who are successful in developing and maintaining friendships
    Uses 6 stages from novice to Partner
    Developed by Steven Gutstein and later collaboration with Rachelle Sheely
    (Diehl, 2008)
  • Inclusion Strategies for ASD (Diehl, 2008)
    Classroom Organization
    Use consistent routines
    Delineate spaces (labeling)
    Use abundance of visual supports
    Prepare for transitions
    Specify endings and new starts to activities
  • Inclusion Strategies (cont’d.)
    Before Teaching Supports
    Establish signal words to get attention
    Give assignments in written form
    Use priming strategies
    Pair strong interests as motivators (ex. put dinosaur sticker on top of worksheet)
  • Inclusion strategies (cont’d.)
    During Teaching Supports
    Use signal words for stressing important information
    Keep essential questions and concepts in the forefront
    Avoid lengthy verbal instructions
    Use visual supports (daily schedules, choice boards, etc.)
    Provide models (work first math problem together)
  • Watch for attention, stress, fatigue and provide alternate pleasurable assignments during that time
  • Inclusion Strategies (cont’d.)
    Facilitating Independent Work
    Provide visual instructions
    Provide specific roles for collaborative work
    Assign peer buddies
    Avoid burning out one student
    Use timer, or something to delineate time/amount
    Allow keyboard for writing assignments
  • Inclusion Strategies (cont’d.)
    Student Organizers
    Use daily planners and teach independent use
    Laminate daily schedule to use with soluble markers
    Color-code folders for each subject
    Label sections in folder for homework, completed work, etc.
    Keep “obsessive” stuff in one place with written instructions on when to use it
    “Post-its” help with things that pop up during the day
    Keep 2 sets of texts, one each for home and school
    Keep written rules consistent
    Use technology whenever possible
  • Collaboration and ASD
    “I believe that you don’t make major input with children with complex disabilities unless it is collaborative”
    (Sylvia Diehl, 2010)
  • Learning Spanish (Diehl, 2010)
  • Contextualized Learning
    Language needs to be infused throughout a child’s day in order for learning to occur.
  • Why Collaborate?
    “ASHA recognizes that the provision of speech, language, and hearing services in educational settings is moving toward service-delivery models that integrate intervention with general education programming, often termed inclusion.”
    (American Speech-Language-Hearing Association [ASHA], 1996)
  • Why Collaborate?
    Federal Law tells us that we should focus on the services we provide rather than “a place” where the students go.
    (IDEA, 2004 [118 Stat. 2649])
  • Why Collaborate?
    Effective schools research indicates that collaboration within the school staff increases student achievement.
    (Thompson, 2002)
  • Principles of Learning are Supported in a Collaborative Model
    Learning that is meaningful to the learner is acquired more readily and is retained longer
    Learning is influenced by the frequency with which the stimuli are encountered and the same or similar response is made
    In general, practice in varied contexts can both increase retention of learning and extend its range of utility
    Transfer is facilitated where the learning situation resembles the application situation, or where the learning is practiced in various “realistic” contexts
    Observing the actions of another person can lead to the acquisition of new learning or the facilitation or inhibition of prior learning
    Group discussion and decision can facilitate change
    (Ehren and Ehren, 2004)
  • The Classroom is a Natural Setting
    Services delivered in a classroom provide:
    More opportunities to communicate
    More variety of communication opportunities
    More variety of communication partners
    More resemblance to real life
    Less disruption in a student’s day that is disruptive to learning
    Models for teachers
    Seamless transfer (carryover) of skills
    (adapted from Ehren and Ehren, 2004)
  • Advantages of Classroom-Based Intervention
    No time wasted in transition (some behavior problems are related to transition)
    Child stays in LRE
    Teachers have more frequent opportunities for planned teaching
    Classroom offers many opportunities to interact with and learn from peers
    (Hadley & Schuele, 1998; Garfinkle & Schwartz, 2002; Brinton & Frijiki, 2004; Case-Smith & Holland, 2009)
  • Collaboration is not a Replacement for Isolated Intervention
    It is designed to assess and treat communication impairments within natural settings
    It can supplement or extend services offered in a traditional pull-out model
    (ASHA Relevant Paper, 1990)
  • Why Use Pull-Out Model?
    Allows intensive 1:1 treatment
    Useful for some intervention approaches
    May be best environment to establish new behaviors (ex. discrete trial training)
    Should be purposeful, planned and short-term
    (Case-Smith & Holland, 2009; Moore & Montgomery, 2008)
  • Myths About Service Delivery
    Individual therapy is always the best option
    Communication problems should only be addressed by the “expert”
    SLPs need to protect their territory
    People who advocate a collaborative model are trying to get out of work
    (Haynes, Moran & Pindzola, 2006)
  • Barriers to Collaboration
    Graduate students are taught medical model
    New SLPs are inexperienced in collaboration
    Parents expect medical/clinical model
    Teachers/Administrators expect pull-out model
    Team planning is time-consuming
    Turf Conflicts
    Teachers don’t want to/know how to collect data
  • To facilitate collaboration among the educators of preschool and school-age children in developing functional social communication skills within the classroom context
    (Frassinelli, Superior, & Meyers, 1983)
  • SLPs in the Classroom
    Always look at academic and social issues from a language perspective; trust teachers to know curriculum and standards; SLPs role is to facilitate interactions and learning.
  • Administrative Support
    Administrators must be willing to:
    Provide meeting time for collaboration by all team members
    Maintain sufficient number of support staff
    Understand that collaboration is efficient use of educational resources but not a method to reduce amount or expense of special services
    Understand that SLP caseloads may need to be reduced
    (ASHA Relevant Paper, 1990)
  • Breaking Down Barriers
    Work with university programs to teach collaboration strategies; teach a “workload “ approach* to service delivery
    Learn about collaboration and try it gradually
    Explain benefits of collaboration to parents; have parents tell other parents their child’s success stories
    Explain to teachers that collaboration meets the student’s needs; we are there to meet their needs and not our own
  • Planning
    “A meeting to infuse goals is more important than an individual session”
    Sylvia Diehl
  • Team-Teaching/Co-Teaching
    Requires a significant amount of respect and trust between teachers
    Avoid the same teacher always taking the lead instructional role
    Take turns “leading” the lessons and instructional units
    Requires long-range planning
    Requires commitment of classroom teacher to always be present
    (adapted from Green, 2008)
  • Benefits of Thematic Units
    Increase in student achievement
    Helps student to connect learning both within the topic and across other subjects (generalization)
    Enables student to understand big concepts of curriculum and apply them in many ways
    Promotes depth of learning
    (Thompson, 2002; Marzano, 2001)
  • Interventions with Case Studies
    Social interaction
  • Ken
    8 years old
    Talks constantly about video games
    Academically on grade level
    Other children play with him in short spurts until they tire of his bossy behavior
    Needs personal assistant to move from one activity to another
    Disruptive when routine changes
  • Hunter
    17-years old
    In regular HS academic program with SpEd support
    Other students tolerate but do not seek him out
    Pleasant appearance and no behavior issues except during fire drill
  • “The absence of evidence is not evidence of absence” (Paula Kluth, 2010)
  • References
    American Speech-Language-Hearing Association. (2006c). Roles and responsibilities of speech-language pathologists in diagnosis, assessment, and treatment of autism spectrum disorders across the life span: Position statement. Available from http://www.asha.org/policy.
    American Speech-Language-Hearing Association. (2006b). Knowledge and skills needed by speech-language pathologists for diagnosis, assessment, and treatment for autism spectrum disorders across the life span. Available from http://www.asha.org/policy.
    American Speech-Language-Hearing Association. (2006a). Guidelines for speech-language pathologists in diagnosis, assessment, and treatment of autism spectrum disorders across the life span. Available from http://www.asha.org/policy.
    American Speech-Language-Hearing Association. (1990). A Model for Collaborative Service delivery for Students With Language-Learning Disorders in the Public Schools [Relevant Paper]. Available from www.asha.org/docs/html/RP1991-00123.html
  • References
    American Speech-Language-Hearing Association. (1996). Inclusive practices for children and youths with communication disorders [Position Statement]. Retrieved March 1, 2010 from http://www.asha.org/docs/html/PS1996-00223.html
    Bondy, A., & Frost, L. (1998). Picture Exchange Communication System. Topics in Language Disorders, 19, 373–390.
    Diehl, S. (2008). Working with children with autism: Resource manual. ASHA Autism online web event, March 2010.
    Ehren, T. & Ehren, B. (2004). Therapy Services in the Classroom: Creating Students Success. ASHA Telephone Seminar, September 14, 2004.
    Green, Charlette. (2008). SLPs Collaborating in General Education: Practicing Seamless Education. Presentation to North Carolina Public Schools.
    Individuals with Disabilities Education Act. (2004). Public Law 108-446. Retrieved March 1, 2010, from http://www.copyright.gov/legislation/pll08-446.pdf
    Kowalski, T. (2010) Social-pragmatic success for asperger syndrome and other related disorders. Orlando, FL: Professional Communication Services.
    Marzano, R.J., Pickering, D.J., & Pollock, J.E. (2001). Classroom instruction that works. Alexandria, VA: Association for Supervision and Curriculum Development.
  • References
    Montgomery, J. (1990). Effective Collaboration and Consultation Services for Speech and Language Hearing Handicapped Children. Short Course at California Speech Language Hearing Association Annual Conference, Monterey, CA.
    Moore-Brown, B. (1989). The Speech/Language Specialist-Critical Support for Teaching Literacy. Presentation at the California State Federation/Council for Exceptional Children Annual Conference, Costa Mesa, CA.
    Paul, R. (2010). Communication Intervention Programs. ASHA Autism Online Web event.
    Prelock, P. (2010). Assessment and Intervention in Autism Spectrum Disorders: The role of the SLP. ASHA Autism online web event
    Sancibrian, C. (2010). Navigating the service delivery continuum. ASHA Autism Online web event.
    Tager-Flusberg, H. (2010). Language and Cognition in Autism Spectrum Disorders. ASHA Autism Online web event.
    Thompson, M., & Thomason, J. (2002). Leadership, achievement, and accountability. Boone, NC: Learning Concepts.
    Wiig, E.. (1992) Language intevention with school-age children: Models and procedures that work. Chicago, IL: Riverside Publishing Co.