3/20/2018. Agenda. This presentation is based on the collaborative work by staff at The New England Center for Children

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1 Presented by: Erin Dyett, MS, BCBA, LABA Carly Eby, PhD, BCBA-D, LABA This presentation is based on the collaborative work by staff at The New England Center for Children Trainings are updated regularly based on the most recent information and research in the areas of Applied Behavior Analysis and education of children with autism. Areas of Need in Autism Agenda Challenges Critical Partner Outcome measures 1

2 Autism: Areas of Need Social Interaction Skills Repetitive Behavior / Restricted Interests This Photo by Unknown Author is licensed under CC BY-SA Autism: Challenges MOTIVATION UNDERSTANDING COMPLEX CONCEPTS NEED FOR FREQUENT PRACTICE Autism: Challenges DIFFICULTY ATTENDING UNIQUE LEARNING STYLE DIFFICULTY GENERALIZING SKILLS 2

3 Applied Behavior Analysis (ABA): Standard of Care for Autism The successful remediation of core deficits of ASD, and the development or restoration of abilities, documented in hundreds of peer-reviewed studies published over the past 50 years, has made ABA the standard of care for the treatment of ASD (BACB, 2014, p. 5). Behavior Analyst Certification Board [BACB] (2014). Applied behavior analysis treatment for autism spectrum disorder: Practice guidelines for healthcare funders and manager (2 nd Ed.). Retrieved from: What is ABA? Widely recognized and effective for treating autism Uses the scientific principles of learning Increases functional behavior and useful skills Decreases harmful or interfering behavior Concerned with generalizing and maintaining learning : Every child is unique Comprehensive: Looks at the needs of the whole child CRITICAL PROGRAM COMPONENT Comprehensive ABA Service Delivery : BACB Practice Guidelines for ASD BCBA caseload size 6-12 supervised by a BCBA or BCBA-D Often 1:1 staff to student ratio Target skills across domain areas hours per week sessions with naturalistic opportunities 3

4 Essential Core of for Students with Autism (Lovannone et al., 2003) Partner Special Educator Systems al Assistants Students Administrative Support BCBA Space Training and Mentorship Partner Classes Comprehensive ABA Service Delivery 4

5 Comprehensive ABA Service Delivery PARTNER PROGRAM COMPONENT Highly- Qualified Clinical Supervisor: NECC Masters or doctoral level clinician (BCBA/ BCBA-D) On site one day per week Teacher/Coordinator: NECC Experienced Master s Special Education Teacher Certified in Severe Special Needs Education Full-time 1:1 Tutors: District Bachelor s level preferred Schedule: Student hours plus one hour per day Intensive training upfront On-going training and coaching Partner staff qualifications Minimal qualifications for program personnel were adapted from several sources: Shook, G.L., & Favell, J.E. (1996). Identifying qualified professionals in behavior analysis. In C. Maurice, G. Green, & S. Luce (Eds), Behavioral Intervention for Young Children with Autism. Austin, TX: PRO-ED. Lovaas, O.I. (1996). The UCLA Young Autism of Service Delivery. In C. Maurice, G. Green, & S. Luce (Eds), Behavioral Intervention for Young Children with Autism. Austin, TX: PRO-ED. Autism Special Interest Group (SIG), Association for Behavior Analysis (1998) Guidelines for Consumers of Applied Behavior Analysis Services to Individuals with Autism. 5

6 Autism Spectrum Disorders Reinforcement Procedures Initial Tutor Training Preference Assessments Data Collection Teaching Procedures (DTT, TA, IT) Proactive Behavior Strategies Treatment of Challenging Behavior Play and Social Skill Interventions Behavior Training Parents Strategies Modifications Tutor Supervision and Support in vivo training and modeling from NECC Teacher Regular classroom and student observations by BCBA development throughout the year Weekly team meetings Monthly student data review Comprehensive ABA Service Delivery 6

7 PARTNER PROGRAM COMPONENT Multiple Layers of Support Benefits: Access to a wide array of expertise Behavior analysts with decades of experience Speech and language pathologists Occupational therapist support specialist Experts in specific subject areas provide training Peer Reviews Share resources NECC Executive Board Directors for other departments Department Executive Director Regional Directors Contract Leaders Clinical Supervisors Lead Teachers Comprehensive ABA Service Delivery Education s programs for each student based on their skills and needs Teaching strategies environment 7

8 Comprehensive ABA Service Delivery PROGRAM COMPONENT and : The Autism Encyclopedia Evaluate Assess Teach Assess 8

9 Teach Teach 9

10 Teach Teach Teach 10

11 Teach Evaluate Comprehensive ABA Service Delivery 11

12 Intensive Additional program supports are needed Multiple learning opportunities Frequent data collection Carefully selected inclusion periods Proactive adult support for Students with Autism Empirically valid teaching procedures Discrete trial, incidental teaching, task analysis data collection and monitoring for the student Data guides decision making ally promotes maintenance and generalization Empirically Valid Teaching Procedures: Discrete Trial o Skills are broken down into smaller units of behavior o o o Individual skills are taught in a highly structured teaching environment Multiple practice opportunities provided during each teaching session Help from teacher provided initially, then faded out systematically o Errorless teaching procedures o Frequent feedback and reinforcement 12

13 Discrete Trial : Video Empirically Valid Teaching Procedures: Incidental Teaching Incidental Teaching Incidental Teaching is when the natural environment is arranged to attract the child to desired materials and activities, the teacher is available to provide attention, praise, and instruction when the child initiates interaction with materials. (Hart & Risley, 1982) Why use incidental teaching? As a supplement to discrete trial training to promote generalization of skills As a way to vary the instructional setting for the child For learned skills to used under the relevant context 13

14 Incidental Teaching: Video Comprehensive ABA Service Delivery Pictures 14

15 Comprehensive ABA Service Delivery PARTNER PROGRAM COMPONENT Function Based Treatment of Behavior Function-based Why is it occurring? Teach alternative to replace problem behavior Proactive strategies ed on prevention Reinforcement and motivation Consistent implementation Data-based clinical decisions Peer review process Comprehensive ABA Service Delivery 15

16 Faded supports Data-based decisions Modifications to GE curriculum Preview / review opportunities Supplemental performance monitoring Balance of support and independence Comprehensive ABA Service Delivery PARTNER PROGRAM COMPONENT Collect data to: Assess progress in skill development Make prompt data-based decisions Report progress on IEP goals/objectives Determine next steps Assess the effects of behavior interventions Assess consistency of implementation 16

17 Comprehensive ABA Service Delivery Support and Training for Families Daily home-school communication Weekly parent/family training in the home Monthly clinic meetings to review student progress Example of a Home Log 17

18 Typical Parent Clinic Agenda Example of a Home Training Schedule for a Young Child with Autism Comprehensive ABA Service Delivery 18

19 PARTNER PROGRAM COMPONENT Successful Teamwork/ Who plays a role? NECC Lead Teacher - Special educator NECC Clinical Supervisor - BCBA 1:1 Paraprofessionals on the Partner General education teachers Administrators Parents Specialists (e.g., OT, SPL, PT) Design instruction as a team Communic ation Skills Social Skills Academics Independent Functioning Self-Help Motor Skills 19

20 Team Defined Roles Scheduled communication times Data-based decision making Feedback and support Assume nothing! Student Outcomes Skill acquisition in school community Reduction in challenging behavior Reduced out-of-district placement Skill Acquisition 94% Objectives Met/Made 20

21 93% Participated in Activities with Peers 64% Included in a General Education Class Reduction in Challenging Behavior 87% behaviors decreased Placement Outcomes for Children Leaving Partner s Out of District, 15% Public School Special Education, 65% Public School General Education, 20% 21

22 43 Partner s 5 States 249 Students Partner s Today Questions??? 22