Myths and the Culture of Misunderstanding. Overview of Day. The Ziggurat Model Designing Comprehensive Behavior Interventions for Students with ASD

Transcription

1 The Ziggurat Model Designing Comprehensive Behavior Interventions for Students with ASD Ruth Aspy, Ph.D., and Barry G. Grossman, Ph.D. The Ziggurat Group, PA Ziggurat Webinar Day 1 Overview of Day Myths of HFA/AS Overview of comprehensive planning Introduce the Ziggurat Model How to assess underlying characteristics How to assess strengths and skills Myths and the Culture of Misunderstanding Belief in Myths Causes Harm 1

2 Myths Harm Myths result in delayed identification Myths result in delayed intervention Myths prevent students from being identified Myths prevent students from receiving services Culture of Misunderstanding Administration, Staff, Community, and Media Myths! Administration, Staff, Community, and Media Culture of Understanding Law and Research on Best Practice Facts Administration, Staff, Community, and Media 2

3 Epidemic of Understanding Power of the few (Malcolm Gladwell) Myth? If a child easily hugs others they probably do not have autism. Myths? Visual supports such as schedules are a crutch and should be discontinued as quickly as possible. 3

4 Myth: A student who earns passing grades does not have an educational need for special education Reality: Educational need does not equate to academic need Myth: A student who can pass the state exam does not have an educational need for special education Reality: Educational need does not equate to academic need a developmental disability significantly affecting verbal and non-verbal communication and social interaction, generally evident before age 3, that adversely affects a child s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences (c)(1)(i) IDEA Definition of Autism 4

5 Eligibility and the Myth of Educational Need Educational need extends beyond academics and includes social, emotional, and adaptive skills. This concept applies to both initial and reevaluations. Evaluation teams must always consider the functional performance of a student. Consider changing needs/demands (e.g., social demands in 7 th grade differ from 3 rd grade) Adverse Effect on Educational Performance Academic performance Communication functioning Social functioning Pragmatic language Organizational skills Group work skills Problem solving skills Emotion regulation Hygiene Behavior Attention challenges Daily living skills/ adaptive behavior List of some areas of educational performance impacted by disabilities Eligibility and Educational Need Unfortunately, school evaluation teams sometimes fail to consider educational factors beyond traditional academics. As a result, academically capable students with ASDs who display deficits in socialization and communication that impact educational progress often are not served. 5

6 Eligibility and Educational Need A child with Asperger s Disorder may be more verbal than other children with autism and may have average or above average intelligence, yet still be in need of services. - U.S. GAO. Special Education: Children with Autism, 23. Washington, D.C., January Myth: Students with Asperger s are not eligible for special education Reality: Asperger Syndrome is covered by Federal Law IDEA Definition of Autism a developmental disability significantly affecting verbal and non-verbal communication and social interaction, generally evident before age 3, that adversely affects a child s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences (c)(1)(i) 6

7 Myth of Asperger Syndrome and Eligibility Individuals with Asperger Syndrome have a pervasive developmental disorder. It is impossible to have a pervasive disorder and not be significantly impacted. While many of these individuals are highly intelligent and articulate, they have significant impairments and often require supports and services in order to make educational progress Myths? Asperger s Disorder is a mild form of autism. Asperger s Mild Autism? [Asperger s Disorder] cannot be regarded as a mild disorder. Many examples exist to demonstrate that it can impose a heavy burden on the [person], the family and the wider community. Frith,

8 Outcome Findings of a 2002 U.S. study of 405 children and adults on the spectrum (Seltzer and Krauss, 2002) Of adults 22 and older, 73% lived with their parents 90% could not gain or keep employment 95% had difficulty making and keeping friends Outcome Findings from a 2008 study (Cederlund, Hagberg, Billstedt, Gillberg, & Gillberg, 2008) Outcome for males with Asperger s were worse than expected (given their high IQs), but better than males with autism. A Study in Contradictions 22% have IQs in the superior to very superior range 12% are employed full-time** 1% of this 12% are employed in an area in which they were trained/educated **most did not have interventions at a young age Brenda Smith Myles 8

9 Why are we NOT focusing on academics? They are important, but Research Shows That Individuals with soft skills, including good social skills, sociability, good work habits, punctuality, conscientiousness and those who participated in extra curricular activities are more likely to make more money, be employed, and attain higher levels of education than those with good grades and high standardized test scores. Llears (2008). Do social skills matter? The contribution of noncognitive factors in explaining differences in educational attainment and earnings. Social Science Research, 37, The Purpose of Special Education (IDEA) To ensure that all children with disabilities have available to them a free appropriate public education that emphasizes special education and related services designed to meet their unique need and prepare them for further education, employment, and independent living (emphasis added) 9

10 The Ziggurat Model Ziggurat n: (zig gu rat) from Assyrian ziqquratu, height, pinnacle 1. a temple having the form of a terraced pyramid of successively receding stories, erected by the ancient Assyrians and Babylonians 2. a framework for designing comprehensive interventions for individuals with autism spectrum disorders Three Areas of Expertise for Effective Intervention Planning Characteristics of ASD Range of effective interventions Comprehensive planning process 10

11 Why was the Ziggurat Model Developed? Difficulty Seeing the Autism Tendency to apply one strategy to address all needs Tendency to ignore critical areas when designing an intervention Intervention Ziggurat Ruth Aspy, Ph.D., Barry G. Grossman, Ph.D Characteristics Interventions Ruth Aspy, Ph.D., Barry G. Grossman, Ph.D. 11

12 Underlying Characteristics Checklist (UCC) Characteristics Social Communication Repetitive Patterns Interventions Associated Features Sensory Motor Cognitive Emotional Vulnerability Medical and Biological Factors The Ziggurat Model 2008 ASA Literary Award Winner Sensory and Biological Needs Reinforcement Structure and Visual/ Tactile Supports Task Demands Skills to Teach 12

13 Why Comprehensive Planning With The Ziggurat and CAPS Models? Fewer behavior problems More instructional time Increased compliance with law Increased engagement time Faster IEP development Better IEPs More positive/collaborative relationship with parents Improved collaboration among staff Who is Involved in Comprehensive Planning? Parents Student General Education Teacher Special Education Teacher Para-professional Speech Language Pathologist Occupational Therapist School Psychologist Administrator Social Worker Other as needed 5 Steps to Designing a Comprehensive Intervention Plan Characteristics Design 5 Implmt. 13

14 IEP Development Requirements 614(d)(3)(A) Requires the IEP Team consider: Strengths of the child Concerns of the parents Evaluation results Academic, developmental, and functional needs of the child [emphasis added] UCC ISSI Global Guide Evalua4on Data Present Levels of Func4onal Performance IEP Team Considera4ons: Parent Concerns, Transi4on, and Person- Centered Planning Provides a snapshot of ASD Iden4fies strengths and skills Iden4fies meaningful priori4es Ziggurat Worksheet CAPS Special Educa4on Supports, Related Services/Accommoda4ons and Behavior Interven4on Plan Opera4onalized IEP: Student Schedule with Embedded Benchmarks/Short- term Objec4ves and Supports Ensures development of a comprehensive plan Ensures implementa4on of the comprehensive plan Underlying Characteristics Checklist 1 Helps you to see the autism Provides a snapshot of how autism is expressed for an individual A descriptive instrument Can be completed by a team Provides a tool for assessing progress/ change 14

15 1 The UCC Areas Social Restricted Patterns of Behavior, Interests, and Activities Communication Sensory Differences Cognitive Differences Motor Differences Emotional Vulnerability Known Medical or other Biological Factors 1 UCC-HF for HFA and AS 1 UCC-CL for Autistic Disorder 15

16 1 UCC EI for Birth to 5 Individual Strengths and Skills Inventory 2 Social Behavior, Interests, and Activities Communication Sensory Cognitive Motor Emotional Biological Additional Uses of the UCC and ISSI Reevaluation (informal) 16

17 Additional Uses of the UCC and ISSI Assessment recommendations UCC Item Strategies Recommended IEP goal Difficulty expressing thoughts and feelings Using picture books, video, mirror, photos, identify basic emotional expressions. Video Bryan in actual interactions. Identify emotional expressions. Ask how he was feeling and show him expressions that match that feeling With prompting and modeling using visual supports, imitate identified emotions 8 out of 10 times. Additional Uses of the UCC and ISSI Consultation 17

18 UCC to IEP UCC to IEP UCC Item Has difficulty recognizing the thoughts and feelings of others IEP Objective Identify feelings of others in context by correctly predicting the feelings of others in a story or video 8 out of 10 times UCC to IEP UCC Item Lacks tact or appears rude IEP Objective Correctly identify laughter as expected or unexpected in a given situation 8 out of 10 times 18

19 UCC to IEP UCC Item Problems with transition and change IEP Objective Given a reinforcer, utilize individualized daily schedule by checking of each activity as completed 95% of the time Task Demands Structure and Visual /Tactile Supports Reinforcement Sensory Differences and Biological Needs Case Example Bryan 19

20 Target the Disability For students with ASD, the majority of the IEP objectives should target underlying needs in the areas of social understanding/functioning and communication. Failure to address critical areas of need places districts in peril of legal recourse. Alternative Perspective: Using the Ziggurat and CAPS Models Bryan 20

21 Bryan UCC and ISSI Sample UCC Items Has problems handling transition and change Has strong need for closure or difficulty stopping a task before it is completed Has eccentric or intense preoccupations Difficulty understanding nonverbal communication Tends to be less involved in group activities Interprets words or conversations literally Has difficulty following instructions Responds in an unusual manner to sounds Seeks activities that provide touch, pressure, or movement Individual Strengths and Skills Inventory Social Caring and giving Comforts peers Makes gifts for others Communication Able to hold a conversation on preferred topics Behavior Copes with change in routine with adequate advance notice Cognitive Intelligent Creative Enjoys reading Biological Energetic Sleeps well Goes to bed easily 21

22 Designing a Global Intervention Plan 3 Designing a Global Intervention UCC Selected UCC Areas Selected UCC Areas Selected UCC Items Bryan-Select UCC Areas Vision What is the short and long-term vision for the individual? Long-term Short-term Have friends Attend college Increased independence Improved coping skills Play with peers at recess Accurately identify feelings of self and others Participate in group work 22

23 Select UCC Areas UCC Selected UCC Areas UCC Areas Social Restricted Patterns Communication Sensory Differences Cognitive Differences Motor Differences Emotional Vulnerability Known Medical/ Biological Factors Vision Bryan- Select UCC Areas Vision Which UCC areas would have the greatest impact on achieving this vision? Social Communication Emotional Vulnerability Remember to stay on target 23

24 Bryan- Select UCC Areas Settings In what settings does the individual participate? School (e.g., classroom, PE, lunchroom, hallways) Home Community (e.g. church, grocery store, mall) Bryan- Select UCC Areas Settings Settings Which UCC areas have the greatest impact on the individual s ability to function in multiple settings? Social Communication Emotional Vulnerability Remember to stay on target Bryan- Select UCC Areas Quality of Life What is most important to the individual? What provides a sense of well-being? Make friends Feel safe Preferred activities (animals, art projects, etc.). 24

25 Bryan- Select UCC Areas Quality of Life Quality of Life Which UCC areas have the greatest impact on the individual s quality of life? Social Restricted Patterns Emotional Vulnerability Remember to stay on target Bryan- Select UCC Areas Key UCC Areas Based on your answers to the questions, place a mark next to the key UCC areas. Social Restricted Patterns Communication Emotional Vulnerability Select UCC Items Selected UCC Areas Selected UCC Items 25

26 Select Key UCC Items from UCC Areas Select key UCC items for each of the Selected UCC areas. Choose items that are essential (necessary for progress) and developmentally appropriate. Emphasize items that are more pivotal (building blocks for additional skills). Avoid selecting redundant items. Bryan- Selected UCC Items [1] Mindblindness [5] Has difficulty making or keeping friends [14] Has eccentric or intense preoccupations [18] Has problems handling transition and change [19]Has strong need for closure or difficulty stopping a task before it is completed [29] Has difficulty asking for help [39] Has difficulty talking about others interests [76] Is easily stressed-worries obsessively [87] Has difficulty identifying, quantifying, expressing, and/or controlling emotions Strengths of the Ziggurat and CAPS Models 26

27 Strengths of the Ziggurat and CAPS Models 1. Provides a process and framework for designing an intervention plan Make everything as simple as possible but not simpler - Albert Einstein Strengths of the Ziggurat and CAPS Models 2. Addresses underlying characteristics of ASD by utilizing strengths and building skills Strengths of the Ziggurat and CAPS Models 3. Emphasizes and enhances evidence-based strategies 27

28 Strengths of the Ziggurat and CAPS Models 4. Facilitates comprehensive intervention design and implementation Strengths of the Ziggurat and CAPS Models 5. Facilitates use of proactive interventions 6. Facilitates interdisciplinary interventions Strengths of the Ziggurat and CAPS Models 7. Consistent with Positive Behavioral Interventions and Supports (PBIS) and other guidelines State standards Response to Intervention Individualized Evidenced based strategies Functional assessment Comprehensive Skill development Improves environment Team building Facilitates transitions 28

29 Contact Information Ruth Aspy, Ph.D Barry G. Grossman, Ph.D