Autism Supplement Susan Catlett, Ph.D Gail Cheramie, Ph.D Cissy Coleman M.Ed. Vickie Mitchell, Ed.D. Susan J. Sheridan, Ed.D Region 4 Education Service Center Important Historical Information • 1980’s - 1st autism supplement; Legislature directed TEA to form a focus group and provide guidance – Impetus: To address parent concerns that schools did not provide adequate programs • 1990s – Continued the supplement with minor revision of some items • 2007 – New supplement with added strategies and expansion of the other areas; Same impetus as above – Legislature again mandated TEA to form a group to review the supplement in light of new developments in the field of autism Autism Supplement 2007: Implications It does not: • Mandate a specific intervention strategy It does: • Require discussion and identification of intervention strategies • Make our jobs easier • Raise the bar for programming considerations • Mandate a specific degree or credential • Require qualified personnel and training Autism Supplement: “Strategies” • Each of the 11 items is referred to as a strategy. A strategy is a careful plan or method. • Thus the autism supplement identifies the methods/strategies we should be considering for educational programming • In order to address supplement: – Evaluate, Develop/Revise Goals/Objectives, Implement, Assess Progress 1. Extended Educational Programming • Define (Rules-Guidance Table) Extended educational programming for example: extended day and/or extended school year services, that consider the duration of programs/settings based on assessment of behavior, social skills, communication, academics, and selfhelp skills 1. Extended Educational Programming • Programming that continues beyond the school day (ESD) or school year (ESY) – Instructional and directly related to current IEP objectives – Determined by ARD committee based on data – Addresses the “educational needs” of the student Extended Educational Programming • Categories to consider for services: – – – – – Communication Social Skills Behavior Academics Self-help Skills • For each relevant category, determine skill level and whether recommended services and time are sufficient for the student to make progress Extended Educational Programming Considerations • Extended School Day (ESD) – Services after the regular school day • Extended School Year (ESY) – Summer – Transition times (e.g., holidays) Extended Educational Programming • Categories to consider for services: – – – – – Communication Social Skills Behavior Academics Self-help Skills • For each relevant category, determine skill level and whether recommended services and time are sufficient for the student to make progress Extended School Day • Data must support the need for services/strategies that extend beyond the regular school day • Data must be collected on an on-going basis to document the student’s performance on each objective • Analysis of the IEP and Progress is critical to determining the need for extended school day Extended School Day • Focus of Instruction for ESD – Goals and objectives that are currently addressed in the IEP • IEP must be written in measurable terms with an objective system of data collection for objectives • If not needed, then student is making reasonable progress with the current program in place… Extended School Day: Example - Strategy Not Needed • An analysis of the IEP goals and objectives reveals that progress is being made on __/__ objectives, thus there is no need for extended school day services at this time. The IEP can be met through the regular school day; the current services and duration of services are sufficient for the student to make progress. Extended School Day But what if… • New behaviors emerge that interfere with learning and development • Behaviors increase in severity, duration or frequency • Student is not making progress at a reasonable pace • Student does not maintain skill level • Then … Extended School Day • Consider meeting the needs within the school day with various options, for example: – – – – – Differentiated teaching strategies General education tutoring Related services Decreasing student-to-staff ratio Increasing special education instruction, etc. • Consider duration, intensity, and type of programming • After option(s) implemented, review progress • If there are still difficulties in making progress, extended school day may be considered Extended School Day: Example - Strategy is Needed • An analysis of the IEP goals and objectives reveals that adequate progress is being made in the following IEP objectives: ________, _______, _______. • There are ___ objectives in _____ which are not showing adequate progress and additional/other within-school-day services have been provided; thus, there is a need for additional instruction beyond the school day in this area. • In order to add ________, extended school day services are recommended for: ______ weeks, _____ minutes per day. Extended School Day: Further Considerations • “ Best Practices” = minimum 25 hours per week for young students with ASD – – – – – – – – Implications for PPCD Additional time for critical areas of need Speech, Occupational, Physical Therapy Academics – e.g., tutoring Self-sufficiency, self-care (e.g., lunch) Communication skills Social skills Behavioral skills Extended Educational Programming • How to determine need for ESD/ESY: – – – – – – Progress on objectives Formal and informal evaluation Grades, benchmarks Levels of self-sufficiency Information from parents Levels of learning for certain skills (e.g., acquisition versus generalization) • Progress Monitoring Extended School Year • ESY usually associated with regressionrecoupment; not disability specific • ESY: Can be justified without consideration of regression if – Loss of acquired critical skill would be severe – Loss of skill would result in harm to the student or others Extended School Year • A skill is critical when the loss of that skill results or is expected to result in any of the following during the first 8 weeks of the next school year: – – – – Placement in a more restrictive setting Loss of acquired skills necessary for progress Less self-sufficiency/self-help skill areas Loss of access to community-based independent living skills instruction or environment provided by other sources – Loss of access to on-the-job training, sheltered employment, or competitive employment Extended School Year • Critical Skill Areas: – Muscular control – Mobility – Self-care – Communication – Social interaction – Impulse control Extended School Year • For some students with an ASD, without instruction, loss of acquired skills in critical areas (e.g., communication, social interaction, behavior) is likely • It is very likely that these students would need ESY services – Services should be targeted to the areas of critical needs based on current IEP objectives Extended School Year: Example - Strategy Not Needed • At this time _____ is making adequate progress in all critical areas. He has not shown any significant regression after school breaks. His family has plans for the summer that support his continued development in the critical areas. Extended School Year: Example - Strategy is Needed • _____ requires continued instruction in the following critical areas; _____, ______, ______. • Considering ____’s current functioning levels, these areas are likely to result in loss of skills. • Specific objectives from the current IEP to address these areas include: _____, _____, ____. 2. Daily Schedules • Definition (Rules-Guidance Table) Daily schedules reflecting minimal unstructured time and active engagement in learning activities, for example: lunch, snack, and recess periods that provide flexibility within routines, adapt to individual skill levels, and assist with schedule changes, such as changes involving substitute teachers and pep rallies 2. Daily Schedules • Minimal unstructured time means that IEP goals and objectives are being addressed throughout the day and across settings – Student remains meaningfully engaged throughout the majority of the school day • It must begin the minute the student arrives and end the minute he/she leaves • Time increments should be small • Schedule is student specific vs. teacher or classroom specific Daily Schedules: Data Collection • Regarding behaviors during unstructured times: – Increase in selfstimulatory behaviors? – Increase in off-task behaviors? – Increase in selfinjurious or aggressive behaviors? – Problems noted during transition periods? • Regarding the environment: – General education classroom – Hallways – Cafeteria – Playground – Large group settings – Job site – Restroom Daily Schedules Example - Strategy is Needed • Based on data collected ______ displays _______ (behavior) and has difficulty with ______ (transition), and _______ (task initiation). – Based on data collected, Johnny displays increased self-stimulatory behaviors in unstructured settings, has difficulty transitioning within the classroom, and does not independently initiate tasks. • A Daily schedule reflecting minimal unstructured time is needed. An example of the schedule is attached. Activity IEP Objectives Arrival Independently 1:6 follow visual schedule Greet peers and/or adults Attend to speaker 2:6 Imitate actions On-task behaviors Fluency Work with teacher Matching 1:1 Receptive ID Expressive ID On-task behaviors Acquisition Lunch Eat independently 1:22 Follow school 1:22 routines Maintenance Generalization Circle Time Ratio LOL Fluency Daily Schedules Example - Strategy Not Needed • Based on data collected Johnny does not exhibit behavioral difficulty in unstructured settings. He is able to effectively transition within and between classrooms, and is able to independently initiate tasks or do so with minor prompting from the teacher . • A Daily schedule reflecting minimal unstructured time is not needed. Johnny can follow the regular schedule of the day with natural environmental cues. Daily Schedules Example - Strategy Not Needed but Additional Support is Needed • A daily schedule reflecting minimal unstructured time is not needed, however support will be provided at the following times: • Structured recess/lunch/snack • Structured transitions (e.g., passing periods, arrival/dismissal) • Preparation for changes in routines (e.g., substitute teachers, pep rallies, assemblies) – plan needed 3. In-Home and CommunityBased Training • Define (Rules-Guidance Table) In-home and community-based training or viable alternatives that assist the student with acquisition of social/behavioral skills, for example: strategies that facilitate maintenance and generalization of such skills from home to school, school to home, home to community, and school to community In-Home and Community-Based Training Two Types of Acquisition (2) Acquisition • Facilitating the acquisition of skills/behavior (critical) that can only be acquired if they are taught simultaneously in multiple environments – Adaptive skills (e.g., toilet training) – Reduction of self-injurious behavior (e.g. head-banging) – Communication (e.g., requesting) 3. In-Home and CommunityBased Training • Service provided in the student’s home or environments that serve as an extension of the home • Service provided in community settings Viable Alternatives… • • • • • Visuals for home Schedule for home Communication notebook Parent observation at school Videotapes of teacher working with student • Conferences regarding home concerns • Community-based instruction In-Home and Community-Based Training Two Types of Acquisition (1) Acquisition • Facilitating the acquisition of skills/behavior previously learned in another environment – If a skill/behavior is not exhibited at home but is exhibited at school, then it needs to be acquired at home. – If a skill/behavior is not exhibited at school but is exhibited at home, then it needs to be acquired at school. – If a skill/behavior is not exhibited in the community but is exhibited at school or home, then it needs to be acquired in the community. In-Home and Community-Based Training Issues regarding generalization: • If the student has acquired the skill at school then why is he or she not using it at home or the community – Cues, Materials, Environment, People – Behavioral Issue • What is the difference between the student’s ability and actual performance of a skills? – Can the student…? – Does the student…? Evaluation to Determine Need • Analysis of IEP objectives, observation of student (across environments), interviews, and checklists • Evaluation is conducted prior to ARD meeting (data is needed to make determination) In-Home and Community-Based Training • Bob uses a picture communication system at school for toileting • He does not demonstrate this skill at home • The in-home trainer (IHT) will implement this same system at home • Same data collection chart/system will be used at home as is at school Progress Assessment • Charts will be reviewed, analyzed and procedure modified as needed at beginning of each IHT visit • When criterion has been met (as identified on IEP document) in-home training on this objective will be discontinued In-Home and Community-Based Training Example – Parent Declined Strategy • The IHT evaluation supports the need for IHT to address ____. The parent declines the service at this time. • Progress toward objectives _____ indicate the need for IHT/CBT. The parent declines IHT/CBT at this time. Consider: Support is being provided to the parent in terms of parent training. In-Home and Community-Based Training Example - Strategy Not Needed • IHT/CBT is not needed. Progress on IEP goals and objectives is consistent across settings • Identify the viable alternatives being used • Consider support being provided to the parent in terms of parent training, if needed 4. Positive Behavior Support (PBS) • Define (Rules-Guidance Table) Positive behavior support strategies based on relevant information for Example: • • antecedent manipulation, replacement behaviors, reinforcement strategies, and data-based decisions; and a Behavior Intervention Plan developed from a Functional Behavioral Assessment that uses current data related to target behaviors and addresses behavioral programming across home, school, and community-based settings 4. Positive Behavior Support (PBS) • PBS involves research-based strategies designed to enhance the capacity of schools to educate all students, especially students with challenging behaviors, by adopting a sustained, positive, preventative instructional approach to school-wide discipline and behavior management. Positive Behavior Support • PBS involves the assessment and re-engineering of environments so that individuals with maladaptive behaviors: – experience reductions in these behaviors – increase in functional communicative alternative behaviors and – improve their social, personal, and professional quality of lives Positive Behavior Support • Involves the procedures for increasing behaviors that are associated with ABA • Focuses on identifying the function of behaviors, and teaching replacement behaviors Positive Behavior Support • • • • • Antecedent manipulation Replacement behaviors Reinforcement strategies Data-based decisions Behavior Intervention Plan (BIP) developed from a Functional Behavior Assessment (FBA) 5. Futures Planning • Define (Rules-Guidance Table) • Helping parents and their child begin to think about future environments for integrated living, work, community, and postsecondary education by examining the student’s strengths, needs, preferences and interests • Helping children and their families plan for transition services into adult life Futures Planning • §89.1055(e)(5) Content of the IEP – beginning at any age, consistent with subsections (g) of this section, futures planning for integrated living, work, community, and educational environments that considers skills necessary to function in current and post-secondary environments;... g = Transition Transition Planning §89.1055(g) Content of the IEP For each student with a disability, beginning at age 16 (prior to the date on which a student turns 16 years of age) or younger, if determined appropriate by the ARD committee, the following issues must be considered in the development of the IEP, and if appropriate, integrated into the IEP... 9 areas to consider Transition Planning 1. 2. 3. 4. 5. 6. 7. 8. 9. Student involvement Parental involvement, if student is younger than 18 years of age Parental involvement if the parent is invited by the student (who is at least 18 years of age and is his/her own legal guardian) Postsecondary education options Functional vocational evaluation Employment goals and objectives Availability of age-appropriate instructional environments for students at least 18 years Independent living goals and objectives Appropriate referral to agency services What It Looks Like Elementary... • Collaborate with parents to identify potential future environments for integrated living, work, community, and education after high school • Identify skills necessary to function in the present and future environments Transition Planning • Age 16 or younger, if determined appropriate by the ARD committee • When is “younger” appropriate? • Transition specialist – Find one Futures Planning • Remember: a plan is NOT an outcome. A plan is just a plan until it is implemented, monitored, reviewed and revised during the journey to meet the “plan goals”. Futures Planning Example - Strategy is Needed • IEP goals and objectives have been identified in the following areas: _____, ______ to facilitate transition and futures planning Futures Planning Example - Strategy Not Needed • Given the students age this strategy is not needed at this time – Parents have been provided with agency information to consider – ____ISD offers regular parent meetings and transition fairs to disseminate information regarding agency and transition services 6. Parent/Family Training and Support • Define (Rules-Guidance Table) Parent/family training and support provided by qualified personnel with experience in Autism Spectrum Disorders (ASD), that, for example: • • provides a family with skills necessary for a child to succeed in the home/community setting (A); Continued… 6. Parent/Family Training and Support • • includes information regarding resources, for example: parent support groups, workshops, videos, conferences, and materials designed to increase parent knowledge of specific teaching/management techniques related to the child's curriculum; and (B); facilitates parental carryover of in-home training, for example: strategies for behavior management and developing structured home environments and/or communication training so that parents are active participants in promoting the continuity of interventions across all settings (C). 6. Parent/Family Training and Support • • • • • • • Training in specific skills Information about the disorder Information about resources Individualized to meet the needs of the family Based on evaluation Delivered in appropriate environments Delivered by personnel with experience in working with students with ASD Evaluation to Determine Need • Focus on parent need • Analysis of IEP objectives, observation of student, interviews, and checklists • Evaluation is conducted prior to ARD meeting (data is needed to make determination) Assessment • Do your assessment before and after the training to see results • How might you assess success of parent training? • Perhaps use an unmarked Likert Scale Parent/Family Training and Support: Example - Strategy is Needed • Parent/Family training and support is needed in the area of _____ based on the evaluation and analysis of the IEP • This will consist of: – Providing information regarding local resources – Demonstrating strategies being used at school which should also be used at home Parent/Family Training and Support: Example - Strategy Not Needed • Parent/Family training and support is not needed at this time • Parent/Family possesses the necessary skills and knowledge to assist in the student’s educational programming 7. Staff-to-Student Ratio • Define (Rules-Guidance Table) Suitable staff-to-student ratio appropriate to identified activities and as needed to achieve social/behavioral progress based on the child’s developmental and learning level (acquisition, fluency, maintenance, generalization) that encourages work towards individual independence…for example: • • • adaptive behavior evaluation results (A); behavioral accommodation needs across settings (B); and transitions within the school day (C). Level 1: Acquisition • Beginning of learning process • Introduction of new skills and behaviors • Significant assistance provided • High rate of reinforcement necessary • Goal: To initially establish a desired response. – Brushing teeth occurs with prompts and reinforcers Level 2: Fluency • Refers to rate at which a response occurs • Assistance begins to decrease • Reinforcement given only for demonstrating response within designated period of time • Goal: To establish a normative rate. – Brushing teeth occurs within three minutes and reinforcement is delivered Level 3: Maintenance • Response occurs in absence of teaching • Adding reinforcement no longer necessary • Necessary for achieving independence • Goal: To maintain behaviors over time – Brushing teeth occurs independently within three minutes and in the absence of reinforcement Level 4: Generalization Response occurs: – with different people – using different materials – in variety of locations – using different directions Goal: To achieve independence • Brushing teeth occurs independently within three minutes in the absence of reinforcement at different locations and with a variety of people, materials, and instructions Levels of Learning (LOL) • What do the LOL look like? and… • What about staff requirements & student grouping with respect to the LOL? Additional Considerations • In-class support – Teacher – Paraprofessional – Peer • Co-teach • Supervision or escort during transitions • Peer supports Staff-to-Student Ratio Example - Strategy is Needed • Given ______’s levels of learning, the following ratios are suggested for the implementation of the IEP: ____ for IEP objectives at the acquisition level; ___for IEP objectives at the fluency level; ___for IEP objectives at the maintenance level; and ___ for IEP objectives at the generalization level. The range of staff-to-student ratio would be 1:1 – 1:___. Staff-to-Student Ratio Example - Strategy Not Needed • Given _____’s level of learning and adequate progress in the IEP and in the general school setting no specified staffto-student ratio is required at this time. 8. Communication Interventions • Define (Rules-Guidance Table) Communication interventions, including language forms and functions that enhance effective communication across settings, For example: augmentative, incidental, and naturalistic teaching 8. Communication Interventions • Interventions that support the development of communication skills • Not limited to speech-language pathology services Communication Forms • • • • • • • Physical Objects Sign language Pictures Line drawings Speech/Verbal Independent writing, typing or pointing to printed words Little empirical or conceptual research comparing them with each other Communication Functions • Expressive Skills – – – – – – – – – Requesting Rejecting Labeling/naming Getting attention Commenting Giving information Seeking information Expressing feelings Function, feature, or class/category Communication Functions • Receptive Skills – – – – Responding to “wait” Responding to transitional cues Function, feature, or class/category Understanding directions and complex language • Social Routines – – – – – Initiating and stopping Reciprocity Maintaining a topic Choosing a topic Understanding and using nonverbal language • Pragmatic Skills Communication Interventions • Augmentative (used to compensate for an impairment; speech replaced or augmented by) – Picture choices – Visual reminders of options/process – Voice output devices • Incidental teaching – structuring and sequencing objectives within ongoing typical activities to take advantage of interest and motivation (e.g., snack out of reach) Communication Interventions • Naturalistic teaching - using communication interaction between adult and student in the naturally occurring activities of the child’s environment to promote more complex language in natural and relevant situations (e.g., at snack table expanding communication) Communication Techniques • • • • Offer choices Emphasize motivation and interest Provide multiple opportunities Clarify the process visually (also social scripts) • Obtain student’s attention before communicating • Limit language when necessary • Teach a (functionally-equivalent, socially appropriate) way to communicate to replace socially inappropriate behaviors How to determine the need • It is highly likely that this strategy would be identified as “needed” • FIE, speech and language evaluations, IEP analysis Communication Interventions Example - Strategy is Needed • Communication goals and objectives in the areas of _____ are needed and are addressed in the IEP • Interventions for these objectives include but are not limited to _____ Communication Interventions Example - Strategy is Needed • Communication goals and objectives in the areas of receptive and expressive communication are needed and are addressed in the IEP • Interventions for these objectives include but are not limited to a picture exchange system, choice boards, and discrete trial training for labeling/naming Communication Interventions Example - Strategy Not Needed • Student is able to effectively understand and use language both expressively and receptively • Social communication skills are addressed under social skills strategies and supports 9. Social Skills Supports and Strategies • Define (Rule-Guidance Table) Social skills supports and strategies based on social skills assessment/curriculum and provided across settings, For example: trained peer facilitators (e.g., circle of friends), video modeling, social stories, and role playing 9. Social Skills Supports and Strategies • Social skills are a set of behaviors used to interact and communicate with others • An integral part of and defined by the community and culture Social Skills To Learn • impulse control • willingness to do nonpreferred things • personal responsibilitybelongings • personal responsibility-actions • concept of friendship • response to suggestions • requests To Teach • self-regulation • self-monitoring • reading, interpreting, & responding to social cues • appropriate communication with communication partner • environmental regulation skills • self-advocacy skills • play skills • manners and listening Evaluation to Determine Need • Observations in naturalistic settings • Structured observation in a situation designed to elicit a type of social skill (e.g., turn taking game vs conversation) • Rating scales or checklists (standardized and informal) • Direct assessment such as a test of pragmatic skills • Self-report scales and interviews • Interview (those who know individual) Social Skills Example - Strategy is Needed • Highly likely this strategy will be identified as “needed”. • The following social skills have been identified as areas of need: _____, _____. These skills are reflected in the goals and objectives. The strategies/supports used to address these needs will include: _____, _____, ______. Social Skills Example - Strategy Not Needed • Student’s social skills are sufficient and no additional interventions are needed at this time • Natural supports in the home, community and school environment are adequate to facilitate social skills at this time • Consider close monitoring of progress 10. Professional Educator/Staff Support • Define (Rules-Guidance Table) Professional educator/staff support For example: training provided to personnel who work with the student to assure the correct implementation of techniques and strategies described in the IEP 10. Professional Educator/Staff Support • Training and support: General – In techniques and strategies to implement the IEP; also in foundational strategies • Training and support: Specific – A training or support service particular to this student – based on his/her particular needs • Example: – PBS in general – Developing a behavior intervention plan for a specific student Professional Educator/Staff Support • Document all professional development workshops related to: – ASD in general (e.g., characteristics) – Techniques and strategies for students with ASD and other developmental disabilities – Techniques and strategies in curriculum (e.g., reading, math, writing) Professional Educator/Staff Support • Document all training/support related to a particular student: – Staffing – Assistance from an ASD or behavioral consultant, speech therapist, school psychologist, etc. – Access to information and resources Professional Educator/Staff Support Example - Strategy is Needed • It is highly likely that this strategy would be identified as “needed” • Examples of what might be written on the supplement: – The teacher and paraprofessional will document training activities and support. – The teacher and paraprofessional have access to support personnel and will document support activities. 11. Teaching Strategies • Define (Rules-Guidance Table) Teaching strategies based on peer reviewed, [and/or] research-based practices for students with ASD, For example: those associated with discrete-trial training, visual supports, applied behavior analysis, structured learning, augmentative communication, or social skills training 11. Teaching Strategies • Research-based practices required by NCLB; Peer review required by IDEA 2004 • Parents will expect that we follow research-based and peer-reviewed practices • When confronted with “fringe” strategies, research-based practices & student data are the answer Teaching Strategies • Commissioner’s rules – it is noted that research-based … are used “to the extent practicable” • In special education, research-based practices do not automatically equal the criteria set forth in US Department of Education Evidence-Based Practices in Special Education • Single-subject research: – the practice is operationally defined – the context in which the practice is to be used is defined – the practice is implemented with fidelity – results document the practice to be functionally related to change in dependent measures – the experimenter effects are replicated across a sufficient number of studies, researchers, and participants, to allow confidence in the findings Evidence-Based Practices in Special Education • Documented by at least five published studies in peer-reviewed journals • Conducted by at least three different researchers across three different geographical locations • The combined studies include at least 20 total participants before a practice should be deemed as “evidence-based” • Use of multiple baseline, reversal, or alternating treatment designs • Social validity About the Variety of Researched Approaches It is increasingly evident that there is no single best-suited and universally effective method for all children and youth with ASD. The best programs appear to be those that incorporate a variety of objectively verified practices and that are designed to address and support the needs of individual students . . . (National Research Council, 2001; Olley, 1999) Data Collection is Key • • • • On-going process Tracks level of support Tracks shaping of behavior Tracks level of learning with specific skills/objectives • Explains the intervention selected (e.g., signs vs. pictures) • Data Collection forms – (handouts) How to Determine the Need • Ongoing data collection and analysis • FIE, FBA, IEP analysis • Quantify the degree to which student makes progress – Levels/types of support – Levels/types of prompts – Level of instruction • Use data to determine the teaching strategy for certain areas Teaching Strategies Example - Strategy is Needed • It is highly likely that this strategy would be identified as “needed” • Example: – The following teaching strategies will be used to implement the IEP: _______, _________, ________. Teaching Strategies Example - Strategy Not Needed • The student is served in the general education class and making adequate progress in the IEP • The instructional strategies, and accommodations used in that setting are sufficient for the student to make progress at this time