Preparing Paraeducators to Assist Students with Autism


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Preparing Paraeducators to Assist Students with Autism by Nancy French.

From the 2009 National Resource Center for Paraprofessionals Conference.

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Preparing Paraeducators to Assist Students with Autism

  1. 1. The Autism Spectrum Disorders Academy Paraeducator Training Resources 180 Cook St. #111 Denver, CO 80206 303-871-0832
  2. 2. ©Paraeducator Training Resources, Inc. 2009 A Child with Autism … “If you’ve seen one child with autism, you’ve seen one child with autism.” – Brenda Smith-Myles 2
  3. 3. ©Paraeducator Training Resources, Inc. 2009 Autism Spectrum Disorders Overview Module A: Overview and History of Autism 1. Myths vs. facts 2. History and definitions 3. Common characteristics 4. Research-based interventions Module B: Communication 1. Speech, language, and communication 2. Communication deficits 3. Supporting communication 4. No-tech, low-tech, and high-tech communication systems 5. Demonstrate a communication device 3
  4. 4. ©Paraeducator Training Resources, Inc. 2009 Overview - Continued Module C:Visual Supports Why visual supports? 1. 2. Functions of visual supports 3. Illustrate a variety of visual supports 4. How visual supports are used with students 5. Making visual supports Module D: Structured Teaching 1. Key features of structured teaching 2. Physical structures 3. Work systems 4. Prompting hierarchy 5. Discrete trial instruction, errorless learning, data collection 4
  5. 5. ©Paraeducator Training Resources, Inc. 2009 Overview - Continued Module E: Social Skills Social skills in naturalistic settings 1. 2. Joint action routines 3. Social stories, rule cards, Power cards 4. Pivotal Response Training 5
  6. 6. ©Paraeducator Training Resources, Inc. 2009 Questions to Be Addressed in Module A  What is autism? • What are the myths and facts about autism? • How has autism been identified throughout the years? • What labels are associated with the autism spectrum? • What causes autism? • What are the common characteristics of autism? • What are research-based interventions for ASD? 6
  7. 7. ©Paraeducator Training Resources, Inc. 2009 Myths vs. Facts 1. … eye contact 2. … touched 3. … all flap hands or look through fingers 4. … challenges across environments 5. … don’t communicate 6. … want friendships, don’t know how 7. … can’t learn 8. … genius / savant 9. … don’t have feelings 10. … contagious 11. … affectionate 12. … marry, have children, and friends 7
  8. 8. ©Paraeducator Training Resources, Inc. 2009 Myth vs. Fact - Continued 13. … are all boys 14. … could act “normal” 15. … have difficulty with social skills 16. … like same things as other people 17. … right treatments yield “normalcy” 18. … can live productive lives as adults 19. … will outgrow it 20. … families deserve pity 21. … have a “normal” person inside 22. … danger to society 23. … obsessive interests and rituals 24. … violent 8
  9. 9. ©Paraeducator Training Resources, Inc. 2009 Headline History of Autism 1940s • Roots in medicine and psychiatry • Emphasis on description • Not much happens in schools  1970’s • First special education law passes • Emphasis on “Childfind” • Deinstitutionalization • Schools gear up 1980s • More research on autism • Education gets a “heads-up” • Mainstreaming is the buzz word 9
  10. 10. ©Paraeducator Training Resources, Inc. 2009 Headline History of Autism 1990s • Autism label is listed as a disability • Numbers increase drastically • Inclusion is the new IDEA! 2000s • Use of scientifically researched practices • Education is a proven intervention • Teaching methods emphasize students’ strengths • Numbers continue to grow 10
  11. 11. ©Paraeducator Training Resources, Inc. 2009 What’s in a Label? • Autism • Asperger Syndrome • Autism Spectrum Disorder (ASD) • Pervasive Developmental Disorder (PDD) • Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS) / Atypical Autism • Childhood Disintegrative Disorder • Rhett Syndrome 11
  12. 12. ©Paraeducator Training Resources, Inc. 2009 Relationship Among Autism Spectrum Disorders - adapted from Lord & Risi (2000) Asperger Syndrome Autism Childhood Disintegrativ e Disorder Rhett Syndrome Pervasive Developmental Disorder – Not Otherwise Specified PDD-NOS Overlapping circles represent that symptoms overlap although the disorders do not. Autism appears in the center, other disorders extend in decreasing severity and in decreasing number of domains affected. 12
  13. 13. ©Paraeducator Training Resources, Inc. 2009 Diagnosing Autism Spectrum Disorders • Difficult to diagnose • Atypical development in young children may be related to other things • No blood tests • No DNA markers known yet • Extensive observation is necessary • There are so many differences in children with ASD - don’t all have the same characteristics or behaviors 13
  14. 14. ©Paraeducator Training Resources, Inc. 2009 Study Group Directions • Look at handout H9 – Study Group Assignments to see which interventions or practices your group will read about. • Identify one or two of the most important characteristics of the intervention or practice. • Find the rating the intervention has been given and try to understand why it received this label, based on the information you are provided. • Be ready to explain to your “Home Group” why it was given that rating. 14
  15. 15. ©Paraeducator Training Resources, Inc. 2009 Jigsaw Directions Step 1: Home Group Step 2: Study Step 3: Back to Home Pairs Group Step 4: Whole Group Debrief 15
  16. 16. ©Paraeducator Training Resources, Inc. 2009 Questions to Be Addressed in Module B • What is communication? • How are speech, language, and communication related to one another? • What problems with communication are sometimes evident in students with ASD? • What can a paraeducator do to support communication? • How can paraeducators assist students who use unaided (no-tech), and aided (low-tech and high-tech) systems? 16
  17. 17. ©Paraeducator Training Resources, Inc. 2009 What Is Communication? Communication is when someone sends a message to another person and the message is received and understood. Everyone Communicates! • Communication is not just speech. • Communication may occur through behavior, signs, gestures, pictures, body language, symbols, vocalizations, etc. • Communication often relies on language • Language is a system of symbols and rules that govern the use of the symbols to convey meaning. 17
  18. 18. ©Paraeducator Training Resources, Inc. 2009 Communication Problems Associated with ASD • Limited inclination to share enjoyment, interests, or achievements with other people • Primary purposes for communication tend to be: • requests (get someone to do something) • protests (get someone / something to stop) 18
  19. 19. ©Paraeducator Training Resources, Inc. 2009 Communication and Behavior • Lack of other communication system– few words, symbols, signs, or meaningful gestures – may result in behaviors we see as problematic • Adults need to understand behavior –look deeper to understand the communication that is occurring • Behaviors may communicate: • Frustration • Fear or other emotional upset • Discomfort – need to escape noise, light, sensory irritation • Boredom • Physical needs – thirst, hunger, bathroom • Protest • A request • Many other things…. 19
  20. 20. ©Paraeducator Training Resources, Inc. 2009 Communication Deficits in Students with Autism Major Deficits 1. The capacity for joint attention 2. The capacity for symbol use 3. Verbal communication 4. Nonverbal communication Prizant, Schuler, Wetherby, & Rydell, 1997 20
  21. 21. ©Paraeducator Training Resources, Inc. 2009 Support communication  Everyone communicates  Communicate with students  Expect them to respond  Focus on positive aspects of what they can do  Encourage communication with peers  Let the other kids experiment with a variety of ways to communicate  Create communication opportunities  Be a supportive communication partner  Eye contact  Your volume and tone of voice  Listening & watching  Other avenues  Be an interpreter 21
  22. 22. ©Paraeducator Training Resources, Inc. 2009 Echolalia is… • A literal repetition of others’ speech either • Immediately (immediate echolalia) • May / may not include understanding of the meaning of the message • Later (delayed echolalia) • Reflects an ineffective attempt to connect language meaning with an event • May be equivalent to a single word, or longer utterance 22
  23. 23. ©Paraeducator Training Resources, Inc. 2009 Functions of Echolalia • Some research suggests that echolalia may be an early but productive, stage of language development • It may be a language learning strategy – eventually leading to more efficient communication • It may be child’s best effort to communicate • We should honor the effort, try to understand the intent and help the child move forward in language development 23
  24. 24. ©Paraeducator Training Resources, Inc. 2009 Assisting Students with Echolalia  Adults can assist a student who is using echolalia to communicate  Step 1: try to understand the communicative intent  Step 2: provide supports that help him/her get his/her message across 24
  25. 25. ©Paraeducator Training Resources, Inc. 2009 Echolalia Activity Directions:  To learn some ways to support students who are echolalic  form groups of about 5 people  assemble the puzzle pieces in your set  when you make a match, stop for a moment, read aloud, and discuss the suggested way to assist  Before you go on to the next piece, stop and discuss how you see yourself using this suggestion with students you know. 25
  26. 26. ©Paraeducator Training Resources, Inc. 2009 No-Tech / Unaided Communication Systems • American Sign Language (ASL) • Learn 8 signs for common needs: • All done – finished • Pizza • Work • Drink • Bathroom • Sad • More • Cookie • Signed Exact English (SEE) • “Home Signs” • gestures made up by the student • Supporting a student that uses ASL, SEE, “Home Signs” or gestures 26
  27. 27. ©Paraeducator Training Resources, Inc. 2009 Aided Communication Systems (Low-Tech)  Involves objects or pictures  Involves storage of objects or pictures  Involves displaying objects or pictures for communication purposes 27
  28. 28. ©Paraeducator Training Resources, Inc. 2009 A Picture-Based Communication Approach  Two adults are often involved at the start, each in a different role  No verbal prompts  Present one picture at a time  Do not plan to do it all in one session – plan many sessions across the day  Use different items paired with corresponding symbols or pictures in different sessions  Modify the picture or symbol to match motor skills of student  Two teaching methods:  Backward Chaining  Two-Person Prompting 28
  29. 29. ©Paraeducator Training Resources, Inc. 2009 Monitoring Progress Date Trial Pick Up Reach Picture Type of Release the Picture toward or Activity picture or or communicati Object object to the Object on partner Used communicati with picture on partner or object in hand 1 1:1 2 1:1 3 1:1 4 1:1 5 1:1 6 1:1 7 1:1 8 1:1 9 1:1 10 1:1 Key: + = Independent ; FP=Full Physical Prompt; PP=Partial Physical Prompt 29
  30. 30. ©Paraeducator Training Resources, Inc. 2009 High Tech, Assistive, Alternative and Augmentative Communication Devices Name of Why a student How Strengths / Device would use this it works Limitations kind of device 30
  31. 31. ©Paraeducator Training Resources, Inc. 2009 Questions to be answered in Module C  What are visual supports?  What do they do?  Why should a student use visual supports?  Which ones make sense for students with ASD?  How do I get them or make them?  How do I use them? 31
  32. 32. ©Paraeducator Training Resources, Inc. 2009 What are visual supports? • Things you can see, for example… • You! • use gestures / body movements to communicate meaning. • smile and frown • nod your head • shake your head side to side • hold out your hand • Point • hold objects up for someone else to see • Environmental cues! • Pictures, posters, photos, books, labels, signs, objects, logos • Things you make to address student needs! • Schedules • Calendars • Choice boards • Rule charts • Lists • Instructions 32 • Behavior cues
  33. 33. ©Paraeducator Training Resources, Inc. 2009 What Do Visual Supports Do For Students with ASD? • Provide information • Establish the rules for behavior • Give directions • Illustrate what their choices are • Prepare students for what comes next • Show what will happen later • Demonstrate how classes or activities will begin and end • Help students get through the day without adults telling them every step 33
  34. 34. ©Paraeducator Training Resources, Inc. 2009 Show & Tell Questions: • Why would a student use this kind of visual support? • How does it work? • What are the limitations and strengths of this type of visual support? • How did the student first learn to use the device? 34
  35. 35. ©Paraeducator Training Resources, Inc. 2009 Notes Page for Activity 3.1 Examples AS3.1a • This is an example of___________________________ • A student would use this to______________________ • The limitations and strengths are__________________ • To teach a student to use this, I would_____________ AS3.1aa • This is an example of___________________________ • A student would use this to______________________ • The limitations and strengths are__________________ • To teach a student to use this, I would_____________  See Handouts for additional space to write about examples of visual supports 35
  36. 36. ©Paraeducator Training Resources, Inc. 2009 Teaching Students to Use their Visual Supports 1. Introduce 2. Demonstrate 3. Act it out 4. Video 5. Prompt (but not too much) 6. Use it in multiple settings 7. Signs that it is working:  Fewer tantrums  You repeat your directions less  Child initiates actions  Child uses more positive social behaviors  You feel less stressed  Student feels less stressed  The day goes better overall Others notice that you’re smiling more  Maybe more…..  36
  37. 37. ©Paraeducator Training Resources, Inc. 2009 Making Visual Supports • What kinds of visual supports are necessary? • When do you make them? • Where do you get the materials? • Develop a relationship with Velcro! • Use real objects • Use pictures • Organization • Lamination • Simplicity 37
  38. 38. ©Paraeducator Training Resources, Inc. 2009 Questions Addressed in Module D • What is structured teaching? • How can I create structure in unstructured situations? • How do I navigate among the levels of prompting and assistance? • How do I teach students using discrete trial methods? • What is errorless learning? • How do I document a student’s progress on lessons taught through structured approaches? 38
  39. 39. ©Paraeducator Training Resources, Inc. 2009 Structured Teaching • An intervention philosophy or approach • Developed by TEACCH at the University of North Carolina • Allows for numerous instructional methods (e.g. picture exchange techniques, sensory integration strategies, music/rhythm interventions, discrete trial) • 3 Key features: • Structures the physical environment • Incorporates visual instruction, visual organization, and visual clarity in tasks • Employs systematic teaching methods, to: • make it easier to learn • decrease confusion/anxiety • provide positive behavioral supports • Considers a student’s special interests • Relies on data to make or change programming • Increases independent functioning in many environments 39
  40. 40. ©Paraeducator Training Resources, Inc. 2009 Jig for Table Setting 40
  41. 41. ©Paraeducator Training Resources, Inc. 2009 Physical Structure • Depends on student needs and environment • Needs vary • Some environments provide substantial structure • Some environments provide little structure • Fading • Physical Structures: • Define where that environment begins and ends • Clarify what happens in that location • Protect the “space” needs • Provide a safe place for belongings • Reduce outside noise • Limit visual distractions • Reduce internal distractions • Room Design • Provides specific places for activities • Affects performance of tasks • Separates materials for specific functions 41
  42. 42. ©Paraeducator Training Resources, Inc. 2009 Visual Schedule Example 42
  43. 43. ©Paraeducator Training Resources, Inc. 2009 Grid Paper 43
  44. 44. ©Paraeducator Training Resources, Inc. 2009 Example of a Work System 1. Question: What work? Answer: Rug Rats, Itsy Bitsy Spider, etc. 2. Question: How Much Work? Answer: 4 things. 3. Question: How do I know I’m making progress? Answer: Take cards off and match to corresponding folders that contain work. 4. Question: What happens next? Answer: Name card tells me to check my schedule. 44
  45. 45. ©Paraeducator Training Resources, Inc. 2009 Discrete Trial Terms • Cause-effect learning vs. observational learning • Discrete trial instructional method • Stimulus • Discriminative stimulus • Prompting stimulus • Verbal prompting • Modeling • Physical prompting • Gestural prompting • Positional prompting • Response • Reinforcing stimulus • Inter-trial interval • Generalization 45
  46. 46. ©Paraeducator Training Resources, Inc. 2009 Data Sheet B 46
  47. 47. ©Paraeducator Training Resources, Inc. 2009 Word Splash Response St i m us ul 47
  48. 48. ©Paraeducator Training Resources, Inc. 2009 Questions to Be Addressed in Module E • What types of social skills need to be taught to students with ASD? • How can I embed social skills into daily classroom routines? • How do I create and use social stories? • How do I pair the student’s special interests with social skills to make the skills more appealing? • How do I create and use social scripts and power cards? • How do I keep data on the student’s use of social skills? 48
  49. 49. ©Paraeducator Training Resources, Inc. 2009 Social Skills • • Difficulties include: • • • • May not be motivated by social reinforcement • LEAP identifies five key social skills to teach young children with ASD: 1. Getting your friend’s attention 2. Sharing – e.g. giving a toy 3. Sharing – e.g. requesting a toy 4. Play organizer – e.g. let’s play zoo, you be zookeeper 5. Giving a compliment • These are not all of the social skills that a student needs to know, but they: • Are a good foundation • Are critical life skills • Are important predictors of future success • As important to teach as academics • Build on strengths to encourage children with ASD to socialize 49
  50. 50. ©Paraeducator Training Resources, Inc. 2009 Age-Equivalent Example of LEAP Social Skills – Older Students 50
  51. 51. ©Paraeducator Training Resources, Inc. 2009 Other Social Skills Students May Need Preschool 1. 2. 3. 4. 5. Elementary School 1. 2. 3. 4. 5. Middle School 1. 2. 3. 4. 5. High School 1. 2. 3. 4. 5. 51
  52. 52. ©Paraeducator Training Resources, Inc. 2009 How Do I Include Social Skills into Classroom Routines? 52
  53. 53. ©Paraeducator Training Resources, Inc. 2009 Principles of Social Stories Social Stories: • Don’t work with every student. • When they do work, they really work! • Help students understand social situations. • Include four types of sentences: 1. Descriptive 2. Perspective 3. Directive 4. Affirmative 53
  54. 54. ©Paraeducator Training Resources, Inc. 2009 Do’s and Don'ts of Social Stories Do: • Keep it simple. • Choose one social situation per story. • Choose something that is difficult for student. • Write it from the child’s perspective. • Keep it positive. • Include pictures to illustrate the words. • Read the story at a teachable moment. • Provide repeated exposure to the story. • When a problematic situation occurs, remind student what to do using words from the story. Avoid: • Trying to do more than one situation in a story. • A lot of “bossy” statements. • Negative statements. Adapted from Carol Gray’s Social Stories and from Autism Inspiration; 54
  55. 55. ©Paraeducator Training Resources, Inc. 2009 Special Interests • Special interests can be: • An object • A subject • Students with ASD tend to have interests that are different from their peers: • in focus (pictures of bowling balls) • in intensity (they ALWAYS have to play with or want to talk about Thomas the Tank Engine) • Including special interests increases • Success • Motivation • Engagement 55
  56. 56. ©Paraeducator Training Resources, Inc. 2009 How Do I Create and Use Social Scripts and Power Cards? Social Scripts: • Can be written using the child’s favorite cartoon character or movie star as the main character of the story. • Can be written in the form of directions for what to do in social situations. • Can be used to teach a specific skill. Power Cards: • Small card that gives the key points of navigating a difficult social situation. • Include a picture or mention of the child’s special interest. • Students carry the cards with them and use them to remind themselves of what to do in a given situation. 56
  57. 57. ©Paraeducator Training Resources, Inc. 2009 Documenting Use of Social Skills • Data should inform WHAT is taught. • Data help us know HOW we should teach social skills by showing us what worked most effectively in the past. • Data help us know WHEN the skill is mastered and, therefore, WHEN we can move on. 57
  58. 58. ©Paraeducator Training Resources, Inc. 2009 Accepting Item 58
  59. 59. ©Paraeducator Training Resources, Inc. 2009 Cooperative Play Name: Caesar Objective: Caesar will play build a tower that is 8 blocks in height by taking turns with a peer during block center Criteria: 8 blocks in height, 2 minute duration, 3/5 times across 3 trials Date Prompting Minutes Date Prompting Minutes Date Prompting Minutes 1/3 I G/V PP FP R 0 I G/V PP FP R I G/V PP FP R 1/5 I G/V PP FP R 0 I G/V PP FP R I G/V PP FP R 1/7 I G/V PP FP R 30 secs. I G/V PP FP R I G/V PP FP R 1/9 I G/V PP FP R 1 minute I G/V PP FP R I G/V PP FP R 1/11 I G/V PP FP R 1 minute I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R I G/V PP FP R Key: I = Independent G/V = Gestural/ Verbal PP = Partial Physical Assistance FP = Full Partial Assistance R = Refusal 59
  60. 60. ©Paraeducator Training Resources, Inc. 2009 Sharing 60