Paul A. BatesISP, La Cueva High School Jaime Wedel, PhD Pyramid Consultant
APA Criteria for Evaluating Treatment Guidelines APA- (summarized from http://www.apa.org/practice/evaluate.pdf)Base recommendations on broad and carefulconsideration of empirical literatureConsider the level of methodological rigor and clinicalsophistication of research supporting the interventionThink about the treatment conditions to which theintervention has been compared (inc. no treatment)Look at evidence regarding treatment patient matchtreatment-Specify the outcomes the treatment is intended toproduce evidence should be provided for eachoutcome produce-
Genetic pre-disposition Activated by environment 1 in 110 students affected Cognitive and social deficits Communication disorder (Ryan, et al., 2011)
Repetitive activities Poor eye contact Difficulty socializing with others Resistance to change in routines Unusual responses to sensory input (Ryan, et al., 2011)
The combination of rate of prevalence and breadth of the spectrum increases the odds that today’s teachers will encounter students that are diagnosed with ASD. Students with ASD are found in ISPs, CRL classes, A and B level classes, general education classes, and twice exceptional programs.
Six Evidence-Based interventions for ASD Treatment and Education of Autistic and Communication related Handicapped Children (TEACCH) Social Stories Picture Exchange Communication System (PECS) Developmental Individual- Difference, Relationship-Based Model (DIR) (continued)
Applied Behavior Analysis (ABA) Discreet Trial Training or Instruction (DTT or DTI)
TEACCH approach is broad based approach that involves StructuredTeachingUses the individuals skills, interests, and needs when designingtreatment programs individuals’Individuals are seen as having language and other processing deficits,and strengths in visual processing, recognizing detail s, and memory sovisual strategies are frequently used details,TEACCH views autism as an irreversible organic disorder, so thetreatment involves focusing on strengths to allow for greaterindependenceOther methodologies are often used in treatment sessions –
Four Components:1. A structured and organized space2. Schedules that help explain the task3. Work systems that define expectations4. A task organization guide Google Images
Stories must be brief and to the point Have a perspective expressed by a character with which the student can relate The inappropriate behavior in the story should be replaced with new appropriate behavior Should be presented, if possible, before a new activity The student’s receptive and expressive communication skills should be considered
Picture Exchange Communication SystemAn instructional method for teaching initial communication skills tochildren with autismGoals of PECS (Bondy and Frost 2002) ––Student initiates conversation ––Student learns to find and approach a communication partner ––Using single pictures avoids student confusion about what is beingcommunicatedProblems PECS aims to avoid (Bondy and Frost 2002) ––Child doesn’t depend on adult prompts ––Student doesn’t need to know how to imitate actions, makeconsistent eye contact, or sit quietly in a chair to learn––Lessons start working on communication right away, not onmatching pictures to objectsA picture is not a PECS!
Should be taught in partnership Taught to the point of generalization Student must be taught to discriminate between two or more objects Students have to be taught: (a) the art of the exchange and (b) that the PEC has value
DIR refers to the Developmental, Individual Difference, Relation ship based modeldeveloped by Greenspan and WilderA lack of social relationship skills is seen as limiting developmentSix milestone skills (e.g. ability to engage in relationships, ability to have a two wayconversation) are taught in three parts (parent engagement to make the child feelsafe, professional use of Floor Time to facilitate development, parents learn how to workon their own styles of responding to the milestones seehttp://www.floortime.org/ft.php?page=Our%20Approach )Practitioners generally work on the floor with the student in se veral 20-30 minutesessions a day several 20- -Try to Follow the child s lead and Open and close circles of communication “child’slead” “ -Try to make interactions fun and keep them going practitioners may playdumb, interfere with the child, hide a toy, etc. to encourage response goingFloor Time is sometimes used between units of DTT therapy in int ensive programmingintensive ment ) – communication” – responses
Focuses intently on socio-emotional functioning, communication skills, thinking and learning processes, motor skills, body awareness, and attention span. Google Images
Follows a Functional Behavior Analysis Entails changing physical environment and eliminating sensory issues Focuses on one or at most a few behaviors Deals more with behavior than academics It is very intense and requires correcting behavior every time it occurs
Goal is to teach new skills Has four necessary ingredients: 1. Present specific stimulus 2. Have the student perform the task 3. Present reinforcement 4. Have a specific time period after which the trial is repeated The teacher should work in partnership withparents so the skills are generalized!
Method Participants and Setting: The study was conducted at a private school for children with developmental disabilities. The participants were 3 female assistant teachers and 3 male students (ages 5-9) diagnosed with autistic disorder.
At baseline, the paraprofessionals displayed skills less than 50% of the time (paraprofessional 1 M = 43%, paraprofessional 2 M = 32%, paraprofessional 3M- 40%). With training provided through performance feedback, each paraprofessional rapidly acquired instructional skills, achieving the terminal criterion in 4 sessions paraprofessional 1 - 4 sessions paraprofessional 2 - 5 sessions paraprofessional 3 – 4 sessions At follow-up, the performance of the 3 paraprofessionals was maintained at 90-100%. (Leblanc, et al.)
Teachers are inundated with paper work such as IEPs, progress reports, PDDs, etc.There are many formal and informal meetings involving parents, administrators and ancillary staff.Paraprofessionals work closely with special needs students and develop a bond because they provide for the essential needs of students.Involving the paraprofessional in DTT allows the teacher to take the role of observer.
The students received instruction on learning programs that were specified in their individualized educational plans (e.g., identifying letters, labeling objects, answering questions). The assistant teachers implemented 10 trials of 3 programs (total = 30 trials) in a single session lasting 10- 15 minutes. Sessions were conducted in a therapy room that contained two chairs, a small table, and materials used during instruction. Only the student, assistant teacher, and an observer were present during sessions that were scheduled 1-2 times each week (Leblanc, et al., 2005).
Ten instructional skills: 1. Arrange the environment 2. Direct the student to the session 3. Orient the student 4. Secure the student’s attention 5. Present the trial or task 6. Deliver the appropriate prompts 7. reinforce the student’s accurate response continued
8. Correct the student’s inaccurateresponse9. Pause three to five seconds10. Record data following each completedtrial(Leblanc, et al. 2005).
Some children are diagnosed with ASD as young as two years old. It takes time, trial and error to match up the child with the most effective intervention. Some behaviors that disrupt the education process are caused by the frustration of not being able to communicate. Early intervention can alleviate some frustration and get the child on the right path before starting school.
Intervention upon diagnosis Intervention that is systematically planned, approximately 25 hours a week A training plan that includes repeated short intervals Family should be included with parental training There should be ongoing assessment Inclusion with typically developing children (Stansberry-Brunsahan, Collet Klingenberg, 2010)
1. Functional, spontaneous communication2. Social Instruction3. Play skills, including peers4. Cognitive development5. Behavior problems6. Functional academic skills Google Images(Stansberry-Brunsahan, Collet-Kilngenberg, 2010)
Stansberry-Brunsahan, Collet-Klingenberg, 2010)
Frost, L. & Bondy, A. (2002). The picture exchange communication system training manual, Newark, DE: Pyramid Educational Products. ISBN 1-928598-05- 6. Leblanc, M., Ricciardi, J. N., & Luiselli, J. K. (2005). Improving discreet trial instruction by paraprofessional staff through an abbreviated performance feedback intervention. (Education & Treatment of Children (ETC), 28)(1), 76- 82. Retrieved from EBSCOhost. Ryan, J. B., Hughes, E. M., Katisyannis, A., McDaniel, M., & Sprinkle, C. (2011). Research-based educational practices for students with autism spectrum disorders. (Teaching Exceptional Children, 43)(3), 56-64. Retrieved from EBSCOhost. Stansberry-Brusnahan, L. L., & Collet-Klingenberg, L. L. (2010). Evidence-based practices for young children with autism spectrum disorders: guidelines and recommendations from the National Resource Council and National Professional Development Center on autism spectrum disorders. (International Journal of Early Childhood Special Education (INT-JECSE), 2)(1), 45-56. Retrieved from EBSCOhost. Pictures were used by permission from Google Images
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