http://www.youtube.com/watch?v=RTEPx0B2HgA
Evidenced Based
Practices for Children
and Youth with ASD
Number of students
Michigan Students with an
ASD Eligibility Label
16000
14000
12000
10000
8000
6000
4000
2000
0
14,760
1,208
19 19 19 19 19 19 19 19 19 19 19 20 20 20 20 20 20 20 20 20 20 20
89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10
National Professional Development Center
on Autism Spectrum Disorders
A multi-university
center to promote
the use of evidencebased practices for
children and
adolescents with
ASD
NPDC Sites
• FPG Child Development Institute,
University of North Carolina at
Chapel Hill; PI: Sam Odom and Ann Cox
• Waisman Center, University of
Wisconsin- Madison
 PIs: Len Abbeduto and Linda Tuchman-Ginsberg
• M.I.N.D. Institute, University of
California at Davis; PI: Sally J. Rogers
www.fpg.unc.edu/~autismPDC
Goals of the NPDC
• Promote optimal learning for preschoolers,
elementary and secondary students with
ASD and support for their families through
use of evidence-based practices (EBP)
• Increase state capacity to implement EBPs
in early identification, intervention, and
education
• Increase the number of highly qualified
personnel serving children with ASD
through sustainable technical assistance
and professional development
NPDC and State Involvement
• 5 year project:
total number of states: 12
• Work with each state for 2 years
 Year 1 : master content and process, working with
NPDC staff
 Year 2 : begin training additional state personnel with
NPDC staff support
 Years 3+ : state continues activities
Cohort 1
Cohort 2
Cohort 3
Who Is Involved?
State Interagency
NPDC team
Planning Group
School Site
Teams
Training teams
for school sites
Families
Children
Admin
School com
What Does NPDC Provide?
Professional
Development
Technical
Assistance
Evaluation
EPB Content
Development
Content Development
Goal: to translate information about
evidence-based practices from
research into practical resources for
service providers
Content Development
Define criteria for “evidence”
Identify evidence-based practices in lit
Define how to do them
Web-based Module Contents
• Pre-Test/Post-Test
• Contextual Information
• Step by Step
Instructions
• Case Examples
• Video Examples
• Implementation Check
List
• Evidence-Base
• Resources
Collaboration with OCALI and NATTAP
for Module Development
• AIM
http://autisminternetmodules.org/index.php
Content Development
Products
•Project Website
•Assessment Instruments
•Autism Program Environment Rating Scale
(APERS)
•Autism Evidence-Based Practices Self
Inventory
•Fidelity Implementation Checklists
(BRIEFS)
•Web-based Modules: How to do each EBP
•Online Course Autism 101
What Does NPDC Provide?
Professional
Development
Technical
Assistance
Evaluation
EPB Content
Development
Professional Development
Goals:
Provide training to state
professional development
providers
Provide training activities to
practitioners in participating states
Support school sites that model
evidence-based practices
Professional Development
•To those on the model site teams,
local training teams, and state
training team:
•Online introductory course on ASD
•All materials: APERS, GAS, EBP
training modules, BRIEFS
•Intensive Summer Training
•TA support for model sites and local
training teams
•2 years of training, technical assistance
Professional Development
Intensive Summer Institute
1. Increase knowledge of EBP
2. Identify elements of high quality programs
3. Build networking, collaboration and skills
of members of state autism training team
4. Develop plans for model sites
and for dissemination across state
National Professional Development
Center on ASD
Professional
Development
Technical Assistance
Content
Development
Evaluation
NPDC Collaboration
with State Partners
Goals:
Develop outreach program
Provide ongoing site-based
training
Establish a network of
professional development
sites, trainees, and national
consultants
NPDC Collaboration
with State Partners
Begins with Support for Strategic Planning Activities
State Interagency Planning Group stakeholders
NPDC Staff
Liaison person
Provides Support to Local Training Teams
Provides Year 1 Training
Provides consultation and TA during Year 1 -2
Supports the team during Year 2 Training
Team takes over training Year 3 and after
Provides Support to Model Site personnel
Provides Year 1 Training
Provides consultation/TA during Years 1-2
Supports them with Year 2 Training
Team takes over Year 3 and after
What Does NPDC Provide?
Professional
Development
Technical
Assistance
Evaluation
EPB Content
Development
Evaluation:
Goals:
Assist trainees in establishing
a system for implementing
EBP
Collect follow-up data on use
of evidence-based practices,
practitioner skills, and child
and family outcomes
Evaluation
•Content
•Professional Development
•Technical Assistance
•Outcomes
•Child
•Family
•Practitioner
•Systems
Who has GAS?
Goal Attainment Scaling
Summarizing progress
on IEP objectives
Acknowledgements
• Dr. Sam Odom, PI of the NPDC,
Frank Porter Graham Center, UNC Chapel Hill
Problem
• Child MC – age 4 years – has 9 IEP goals in 5
developmental domains that involve 4
benchmarks each.
• End of year IEP meeting – mother asks,
“Overall, how much progress did he make on his
plan this year?”
• How can the classroom
teacher easily summarize?
Problem
• School District has added additional funds to
support all 36 students in inclusive education in
High Point middle school in some general ed
classes.
• At end of year, asks Resource Teacher for
summary of progress of these 36 children so
that they can compare progress of included
children to progress of center based children at
the other middle school in district.
• How can the Resource Teacher easily
summarize progress of the 36 students?
An answer?
Goal Attainment Scaling
Goal Attainment Scaling (GAS)
• What is it?
 A method for measuring amount of progress
made on a goal, objective, or benchmark.
 Content free
 Allows progress to be easily summarized
across multiple goals or students
 Not a substitute for objective measurement or
progress – it’s a supplement
Description of GAS
• Care provider establishes goals/benchmarks/
objectives that are measured on a continuum.
 After getting his work, James will independently
complete all 15 steps on the bicycle brake assembly
task 90% of the time when working in the bike shop.
 At start of each class, Sasha will turn in her
completed homework assignment in biology class on
time 85% of days in a one month period.
 Julia will use 10 different words spontaneously during
free play activity with typical peers.
Goal Attainment Scaling
Much more than expected = +2
More than expected = +1
Expected outcome = 0
Less than expected = -1
Much less than expected = -2
Baseline level
How to Develop a GAS
• Select learning objective.
• Identify the current – baseline - level of performance.
• Identify the expected level at end of teaching period.
• Generate the additional outcome points on the scale.
• Examine progress using the GAS when you evaluate
learning according to your benchmarks on a regularly
designated schedule (monthly, bimonthly).
• Summarize the child’s or group’s overall progress at
the end of the year by averaging the final GAS score.
GAS Data for NPDC target students 2009
Individual goals of approx 30 students
Use this form for the activity
Level
Of
Attainment
Goal 1
Goal 2
Goal 3
Much less than
expected
-2
Somewhat less
than expected
-1
Expected level
of outcome
0
Somewhat more
than expected
+1
Much more than
expected
+2
Comments
.
.
Activity: Shaping the behavior of
those we love
• Use the form in your packet
• Identify a behavior you would like to see increase –
write a measurable objective for this for six months from
now – BE REALISTIC!
• Write the current baseline level of this behavior
• Describe a much better than expected outcome(+2)
• Identify a much worse than expected outcome (-2)
• Identify the midpoints
Sharing
Student Goal Attainment Scaling Form
Example
Level
of
Attainment
Goal 1:
Identify need to reduce
anxiety in classroom
settings
Goal 2:
Follow schedules of leisure
activities independently
Goal 3:
Initiate verbal interaction with
peers to join an activity
Much less than
expected
-2
UU always requires visual teacher
prompts to leave the area when
anxious and to use a visual story to
regain composure.
UU engages in internet use for every
leisure break, ignoring a schedule of
daily leisure activity choices.
UU exhibits anxious behavior when near
a peer, joining only when visually
prompted in 5 of 10 opportunities.
Somewhat less
than expected
-1
UU independently goes to
appropriate area in the classroom
when anxious and uses a visual
story to regain composure 50% of
the time during a two-week interval.
UU complies with allowed internet
use on the leisure activity schedule
on 4 of 10 days and chooses other
leisure activities from his schedule.
When visually prompted, UU will always
join peer in desired activity.
Expected level
of outcome
0
UU independently goes to an
appropriate area at school when
anxious and uses a visual story to
regain composure 90% of the time
during a two-week interval
UU complies with allowed internet
use on the leisure activity schedule
on 8 of 10 days and chooses other
leisure activities from his schedule.
UU, verbally, will initiate interaction with
peers to join an activity in 4 of 10
opportunities without prompting.
Somewhat more
than expected
+1
UU verbally states “I need a break”
when anxious without prompts and
takes a walk to look at his visual
story, returning to scheduled
activity without disruption 3 times a
week for 2 months.
UU complies with allowed internet
use at home on 5 of 10 days.
UU, verbally, will initiate interaction with
peers to join an activity in 8 of 10
opportunities without prompting.
Much more than
expected
+2
UU uses strategies (stress ball or
fidgit) to reduce anxiety in the
classroom and stay focused on
scheduled activity 3 times a week
for 2 months.
UU creates and follows a weekly
internet use schedule at school and
at home with 80% fidelity for 2
months.
UU will invite a peer to play a computer
game during computer time at school
without prompts in 2 of 4 opportunities..
Is this extra work?
• NO –




benchmarks are already written
assessments will occur as already planned
Additional benchmarks can carry over into next year
?
• YES BUT–
 Adding higher benchmarks is easy! Just increase the criterion –
85% vs 95%, 2 times an hour vs. 4 times an hour, doing with a
peer vs with 3 peers, doing X in snacktime vs. in snacktime and
circle.
 generating the above goal points allows you to reflect more
growth
 Process may result in more focused teaching
 ?
Break and small group activity
• Identify one crucial IEP goal/objective for
one target student
• Go through the GAS process as a group
• Write it out on the form
• Think about how this will influence your
teaching with that student
Evidence-Based Practices:
What’s the fuss all about?
As a consumer • Your doctor suggests surgery to you as
the first approach for a non-lie threatening
chronic condition. What is your response?
• Your first grade daughter Marci has been
struggling with reading. She doesn’t yet
reliably associate letters with sounds. The
teacher wants to use a sight word
approach due to Marci’s excellent
memory. What is your response?
Evidence Based Practices
• What does it mean?
• It’s been tested and found to be effective
• Why does it matter?




It’s the law
It’s the most efficient way to teach
Most efficient way to learn
Better chance of success
Evidence Based Practices (EBP)
• If there is no evidence, does it mean the
practice is ineffective?
• If the child progresses, isn’t that evidence
of effectiveness?
• What are the risks of using practices that
are not evidence based?
NPDC Definition of EBP
• The teaching practice has been tested and found to be
effective in:
(1)Two randomized or other well-controlled (quasiexperimental design) studies.
AND/ OR
(2) Five single-subject design studies conducted by at
least three different researchers
What has to be considered when
applying an EBP? Fidelity!
• Medicine







Condition
Patient
Drug/procedure
Dosage
How administered
Measure of efficacy
When to change
approaches
• Education/intervention






Content/behavior
Student
Teaching approach
How much time daily
Specific procedures
Data collection and
examination
 When to change
approaches
Efficacy vs. Effectiveness
• Efficacy is the systematic evaluation of
whether a treatment works
• Effectiveness is the extent to which the
treatment works in natural settings – “real
world” applications
• Clinical utility is the applicability, feasibility,
acceptability, and usefulness of the
intervention in a specific setting
Utility of EBP’s
• Some EBP’s may have a strong evidence
base but be less useful in educational
settings.
• Use professional judgment to determine
what is most feasible and applicable to
your unique context / student.
NPDC Tools to Help with
EPB Implementation
APERS
EBP Inventory
Briefs and Modules
Examples
APERS – EBPs in place in the classroom
EBP Inventory – Your own learning goals
Briefs and Modules – EBPs for individual
learning objectives
Choosing an evidence-based
practice for a student
Ask: What is our goal/objective targeting?
• Consider the specific IEP goals and related
objectives
Ask: What are our options?
• Look at the domain that the specific goal relates
Next, make a decision based on:
•
•
•
•
•
•
•
The skills being taught
Your professional wisdom
The learner’s learning style
The learner’s temperament
The learner’s interests and motivators
Supports already in place
History of what has and hasn’t worked
IEP Application Goal - Communication
Goal:
Sam will improve
expressive communication
skills across the school day.
Related Objective:
When he sees a preferred
object, Sam will request a
desired item during snack
and/or free choice time
three times per day for two
consecutive weeks.
• Sam is in an inclusive kindergarten setting.
• Sam does not like talking to most people and
he is difficult to understand.
• Last year’s IEP efforts to increase his use of
speech using differential reinforcement and
naturalistic approaches were not successful.
• Sam is already using pictures for a visual
schedule at school.
• One of Sam’s classmates uses PECS, and
Sam is interested in the pictures.
How do we decide which
EBP to use?
Ask: What is the goal targeting?
• Expressive Language
Ask: What are the options?
IEP Application Goals –
BEHAVIOR/COMMUNICATION
Goal:
Rosita will improve
communication skills.
Related objective:
When Rosita shows distress
during learning tasks, she
will use words, not self
injury to request a break or
assistance 85% of
opportunities over two
consecutive weeks.
Let’s say we know this…
• Through the FBA process, the team
determined that Rosita was head banging
and self biting during lengthy teaching
interactions to end the interaction.
• Rosita does have oral language, but tends
to not talk very much.
• Rosita is interested in print and can read
simple words and short sentences.
• Rosita enjoys peer interaction more than
adult interaction.
How do we decide which
EBP to use?
Ask: What is our objective targeting?
• Expressive Language/Pragmatics
• Behavior
Ask: What are our options?
Choosing an EPB to teach a skill
involves:
•
•
•
•
•
•
•
The skills being taught
Your professional wisdom
The learner’s learning style
The learner’s temperament
The learner’s interests and motivators
Supports already in place
History of what has and hasn’t worked
Integrating EBP’s
• Few practices are ever really used in
isolation.
• Prompting and reinforcement, for example,
are used in almost all of the other practices.
• Task analysis, too, is used prior to teaching
skills through video modeling, visual
supports, etc.
• Teams are encouraged, through coaching
and mentoring, to explore the overlap of
practices.
Integrating EBP’s
Examples:
• Video modeling can be used to teach a selfmanagement system. (model site example : )
• A social narrative can be written to explain the
routine of a social skills training group.
• A speech generating device may be used by a
learner in the context of a peer-mediated
intervention.
Integrating EBP’s
• The understanding required to use
practices concurrently, while still
being mindful of fidelity of
implementation, is an important
component in the development of
skillful teachers and practitioners.
ID IEP goal and standard
Break down into
teachable steps
Teaching
Flowchart
ID the EBP
Review the Brief & Module
Design the data system
Develop the teaching plan; inform and train others
Gather baseline data
Implement plan & data collection system; review often
Don’t tell me I have to keep
data!
Developing helpful data systems
Why is data critical for EBP use?
• Collection of performance data tells us:
•
•
•
•
•
What should we be teaching?
Is our instruction successful?
Is the student making progress?
Do we need to change the teaching plan?
Is it time to introduce a new skill?
The many ways to measure learning
•
•
•
•
•
Event recording: frequency counts,%%
Latency recording: time elapsed
Did it happen at all? Yes-no
For chains: number of independent steps
Assessing steps before independence:
levels of prompts, precision (for shaping)
• Once skills are mastered: thinning
reinforcement schedules, generalization to
other skills, settings, environs, partners
Assessing progress
• Don’t start the new practice until you have
baseline data!!!
 Assess skill a few times in your current way of
teaching first; to determine the baseline rate
• Summarize data immediately to make it
useful: rates, percents, simple graphs
Goal:
Child will
verbalize
to request
objects
Note the stopping
Points!
Sherer and
Schreibman 2005
Goal involving a sequence
• When instructed to wash his hands
verbally or on picture schedule, Hal will go
to bathroom and complete 85% or more of
the steps of handwashing independently
90% of requests.
Daily Data chart for sequences
How to summarize? 7 levels; 14% each;
Steps
Turns on
water
Wets hands
soaps
rinses
Turns off
water
Dries hands
Turns off lite,
leaves
Indep
Minimal P
Partial P
Full P
Daily Data chart for sequences
How to summarize? Weights: I=3, MP=2, PP=1, FP=0
Steps
Indep
Turns on
water
3
Wets hands
3
soaps
Minimal P
Partial P
2
rinses
0
Turns off
water
Dries hands
Turns off lite,
leaves
Full P
1
2
1
Take home points
• EBPs represent the most effective teaching
practices in ed science
• Start with these, as written
• Pick them carefully, by student age, setting, and
content area
• Get baseline data before you begin a new
practice or implement a change!!
• Measure as you go – don’t continue ineffective
teaching
• Assume students will progress when well taught
Relationship between EBP and State
Standards
• Standard defines content – skills to be
learned
• EBP defines teaching practice – the
teaching procedures used to teach the skill
• EBP is not about curriculum !
Content
+
From standards
EBP
=
Learning!
Academics
Behavior Communication
& Cognition
Evidence-Based Practices
1. Antecedent-based Interventions
2. Computer Assisted Instruction
3. Differential Reinforcement
4. Discrete Trial Training
5. Extinction
6. Functional Behavioral Assessment
7. Functional Communication Training
8. Naturalistic Interventions
9. Parent Implemented Interventions
10. Peer Mediated instruction
11. Picture Exchange Com. System
12. Pivotal Response Training
13. Prompting
14. Reinforcement
15. Response Interruption/Redirection
16. Self-Management
17. Social Narratives
18. Social Skills Groups
19. Speech Generating Devices
20. Structured Work Systems
21. Task analysis
22. Time delay
23. Video Modeling
24. Visual Supports
E
C
E
L
M
H
E
C
E M
L H
E
C
E
L
M
H
Play
E
C
E
L
Social
M
H
E
C
E
L
M
H
Transition
E
C
E
L
M
H
NPDC Tools to Help with
EPB Implementation
APERS: EBPs in place in the classroom
EBP Inventory: Your own learning goals
Briefs and Modules: EBPs for individual
learning objectives
IAPG, NPDC and State Partners will
develop:
•
•
•
•
6 dispersed demo sites
Local training teams to support sites
Statewide survey to identify EBP needs
Merged NPDC training info and State
content (standards, best practices)
• Unified state TA network and content
Outcomes
• NPDC materials will contribute to
systematic approach for state
• NPDC process will help increase number
of well trained para and professionals
• NPDC + IAPG will increase amount,
quality and consistency of training in the
state
Let’s Take A Look At The Briefs
• Available at:
http://autismpdc.fpg.unc.edu/content/briefs
• START Website:
http://www.gvsu.edu/autismcenter
• Briefs