Erin Lash, MS, CCC-SLP Patricia McCoy, MA, CCC-SLP

Transcription

1 Erin Lash, MS, CCC-SLP Patricia McCoy, MA, CCC-SLP

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3 Lending Library: Books Journals DVDs Community Supports & Resource Database Admission to Special Topics Workshops & Guest Lecture Series Family Focus Positive Behavior Support Intervention Model WV AUTISM TRAINING CENTER Services for Families Family Coaching Sessions Person & Family- Centered Planning Team Building PBS Training Family & Educator Coaching Behavior Support Plan 2012

4 WV Autism Spectrum Disorders (ASD) Registry (The incidence of ASDs in WV) The College Program For Students with Asperger Syndrome Collaboration WV AUTISM TRAINING CENTER ADDITIONAL PROJECTS AND PROGRAMS WV Department of Education Office of Special Programs AUTISM TEACHER TRAINING PROJECT WV Collaborative Community of Practice on Autism Undergraduate and Graduate Course Work in Autism Marshall University (Teacher Certification) State and National Presentations Statewide Autism Mentor Training Autism Society of West Virginia West Virginia Team Autism

5 By definition, social skills are a set of rules people use to interact and communicate with one another. They are skills that assist a student in developing social relationships. Social skills are learned behaviors that allow an individual interact in ways that result in positive responses from others and avoid negative responses. (Bellini, 2008) 5

6 Turn-taking Sharing Offering/accepting help Conversation skills Play (allowing others to play, joining others and inviting others) Asking questions Responding to questions Staying on topic 6

7 Recognizing facial expressions Speaking with appropriate volume Expressing feelings Greeting others (initiating and responding) Complimenting others Considering the viewpoint of others Commenting Honoring personal space 7

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9 May include: An inability to interact with peers, leading to peer rejection, isolation and anxiety. Understanding social cues, including reading facial expressions and body language. Sharing joint attention Reciprocal imitation. Social exchanges due to the lack of pragmatic language competence. Even with adequate language skills, social skills may not be developed enough to use those language skills. SOCIAL SKILL DEFICITS CAN INVOLVE DIFFICULTIES IN BOTH SOCIAL UNDERSTANDING AND SOCIAL SKILLS EXPRESSION. 9

10 Individuals with autism have poor conversation skills. Their conversations may be one sided, lacking reciprocity. They may only talk about their interests. Shared interest is often absent. Individuals with autism may lack knowledge of conversation rules such as turn-taking; starting/stopping; reading nonverbal cues. Individuals with autism may lack eye contact. Or have unusual eye gaze. They may have difficulty asking and answering questions. 10

11 Children may have difficulty generalizing across environments. (What is taught in isolation stays in isolation!) Individuals with autism may have difficulty honoring personal space. Loudness levels may be inappropriate for a given setting. Children with autism may have difficulty tolerating the differences of others. 11

12 Individuals with autism have difficulty with Theory of Mind. * Knowing what others know * Recognizing that others can have different information and views from one s own * Being able to accurately guess the thoughts, beliefs, emotional state and intentions of others 12

13 Initiating an interaction, or doing so appropriately. Responding to social initiations. Beginning, maintaining, and ending conversations. Communicating their emotions effectively. Sharing a toy or game. Not accepting loss while playing. **It is a myth that individuals with autism do not desire social interactions. Many do desire social interaction but lack the skills to interact effectively. 13

14 Children with autism exhibit significant social skill deficits which may lead to academic, behavioral and emotional difficulties. In our social world we must interact with others in order to function in society: have a job, go to school, access community activities, etc. Relationships can increase the quality of life for the child with autism. Individuals with autism do not learn social skills through observation. Social skills must be taught! 14

15 Critical in supporting the individual, the environment, and the communication partner to maximize opportunities for interaction in order to overcome barriers that would lead to ever-decreasing opportunities and social isolation if left unmitigated FURTHERMORE: Individuals with ASD should be eligible for speech-language services regardless of age, cognitive abilities, or performance on standardized testing.

16 Collaboration: families, individuals, other professionals, support staff, etc. Identify priorities and build consensus to develop a service plan with functional outcomes. Provide services that lead to increased active engagement and build independence in natural learning environments. Facilitate peer-mediated learning Continuity of delivery across environments. *Pull-out services only when repeated opportunities do not occur in natural learning environments or to work on functional skills in more focused environments

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18 ASHA s position is that formal assessment may not accurately detect difficulties in social language skills. We are charged with avoiding the use of typical eligibility criteria, such as discrepancies, diagnosis, or age. We are further charged with using clinical judgment and informal, observational measures to determine the need for placement.

19 Observe your student in natural social settings to determine their strengths and needs. Document positive and negative social behaviors. You can create a list of desirable social skills for the classroom and create your own assessment You can identify the behaviors that will be targeted for intervention. You should detail both strengths and weaknesses. Assessment is conducted in natural and structured environments. Assessment is conducted through observation, interview and completion of social skills rating forms. 19

20 The child has the skill or behavior but does not use it. For example: Timmy often talks to himself in a loud voice when he is sitting at his desk. He uses a whispered voice when asking a question in class. The child does not know how to perform the skill. For example: Timmy has not been taught appropriate loudness levels for various situations. 20

21 Direct Observation (across environments) Self Report, student Interviews Peer, Teacher, Parent Interviews Super Skills Profile of Social Difficulty J. Coucouvanis Or similar checklists Play skills checklists Probe data 21

22 Use probe data, taking occasional samples rather than using continuous collection. Check for the presence or absence of a skill as it emerges Consider the variables that can be measured: Number of conversational turns? Addresses a relevant question to a peer? Spontaneous offering of information? Appropriate physical proximately? Listening and responding appropriately to a peer?

23 Focus on an observable outcomes: We know Rebecca has difficulty engaging peers in social conversations. We know that Andrew has difficulty keeping an appropriate distance from his peers Describe the desired outcome: We will know when Rebecca has improved her skills when she engages 3 separate peers in a social conversation. We will know Andrew has demonstrated success when he converses with a peer for 5 minutes while maintaining an appropriate distance. EVALUATE

24 Identify the Individual s Strengths: It is often easier to focus on deficits Identifying social strengths allows you to build new skills through those strengths Identify and Prioritize the Individual s Needs: Pick social skills that are the most critical to the individual (quality of life!) Build momentum by also working on a few skills that can be mastered quickly (leads to faster reinforcement) 24

25 Continue to periodically track skills/behavior using similar data collection methods Direct Observation, Interviews, Rating Scales, Super Skills Profile, etc. ALWAYS CONSIDER: Developmental level Interests Sensory Issues Preferences Learning styles 25

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27 Conversational Effectiveness Profile Name: Date: Birth Date: C.A.: Note: For all responses, use the following behavioral rating score: 1. Behavior is appropriate. 2. Behavior is somewhat inappropriate. 3. Behavior is extremely inappropriate. Social Interaction This section is designed to compare the individual s ability to interact with others as well as the style of interaction the individual frequently employs. 1. Interaction with adults. 2. Interaction with age-appropriate peers. 3. Interaction with younger children. 4. Ability to interact with many individuals simultaneously 5. Ability to establish multiple friendships 6. Participation in group activities. 7. Passive tendencies 8. Aggressive tendencies 9. Responsiveness 10. Ability to handle being left out hy/

28 For addressing social language competence skills

29 will develop social understanding skills as measured by the benchmarks listed below. Engage in appropriate cooperative social play interactions initiated by others. Engage in cooperative social play interactions by allowing others to make changes or alter the play routine. Engage in appropriate turn-taking skills by attending to peer s turn and waiting for own turn. Will appropriately acknowledge an interaction initiated by others by giving an appropriate response, either verbal or nonverbal. Will refrain from interrupting others by exhibiting appropriate social interaction skills.

30 will increase social-emotional skills as measured by the benchmarks listed below. Identify various emotional states in themselves and others Will state why a person might be feeling a particular emotion. Will identify various simple emotional states in self. Will state why he/she might be feeling a particular emotion. Will identify an appropriate response to a particular emotional state. Will respond to emotional cues of others.

31 will increase social communication skills as measured by the benchmarks listed below. initiate communicative interactions with others initiate varied appropriate topics with others initiate communicative interactions with others by asking questions engage in conversational turn-taking with others across 3-4 conversational turns (topics initiated by self /others). call attention to communicative partner prior to communicating ask questions of others regarding topics initiated by self or others to sustain conversation for conversational turn-taking

32 Teach the skills first in a structured setting with numerous opportunities for practice. Some skills, such as joint attention, are best taught with one partner at a time. After the skill is mastered in a structured setting, work to generalize the skills across environments as quickly as possible. This will require pull-out as well as inclusive service deliveries.

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34 Jason is a fifth grader with a diagnosis of Autism. He is verbal, but has difficulty in the area of social communication and expressive language. Jason receives instruction in the resource classroom, with speech therapy support. His regular education classes include: Math, PE, lunch, music. and health. He appears to have no friends, spends a great deal of time alone (in class, at lunch, and during free time). He loves SpongeBob, and will talk incessantly about the characters when conversing with peers. Jason often corrects peers openly when he feels they are in error. When he does interact with others, he does not honor personal space conventions or read non-verbal communication signals. Jason enjoys the company of familiar adults but when he meets a new person he looks down and refuses to speak. However, Jason appears to want to have friends at school and in the neighborhood. When Jason returns home, he does not relate any of the day s school experiences to his parents or siblings.

35 Jason will improve his social communication and expressive language skills by: Introducing himself to unfamiliar adults and peers by establishing and maintaining eye contact and saying, Hi, my name is Jason. Speaking to peers about 2 or more different topics, changing the topic based on the peer s reaction. Maintaining a conversation with a peer for a minimum of three conversational turns in structured and unstructured opportunities. Commenting on actions in games or activities.

36 Jason will develop social understanding skills by: Engaging in appropriate turn-taking skills by attending to peer s turn and waiting for own turn Appropriately acknowledging an interaction initiated by others by giving an appropriate response, either verbal or non-verbal. Understanding the need to change language according to the needs of the listener (ie: baby, classroom/playground, peers, adults, giving background information). Using specific scenarios, identifying where communication broke down and how to repair the situation. Exploring topics of interest expressed by peers.

37 Jason will increase social communication skills by: initiating communicative interactions with others engaging in conversational turn-taking with others across 3-4 conversational turns calling attention to communicative partner prior to communicating spontaneously seeking assistance/ asking for help/ seeking additional information given visual prompts. introducing topics of conversation to a peer. Using appropriate voice level or tone of voice.

38 Identifying and describing the meaning of 8 non-verbal communication behaviors (smiling, frowning, turning away, rolling eyes, crossing arms, etc.) Can state likes/dislikes to others. Can answer questions related or unrelated to specific interests. Asking 3 appropriate questions during communicative interactions with peers. Suggesting 3 or more ways to start an interaction with another person. Relating 3-5 events that took place during the school day.

39 Teach the difference in and appropriate times for introductions or greetings. Teach a variety of types of greetings and practice what type of greeting is appropriate in what setting and with whom (classrooms, lunch, recess, play group, etc.) Have Jason role play and practice with peers in a structured setting and then generalize it to other settings (arrival at school in the morning, during unstructured time in his classroom, greeting peers in the lunch room or at recess, etc.). Teach and practice the parameters of personal space. Teach the importance of nonverbal signals during conversations.

40 To address and expand on these goals in a structured setting: Generate a list of questions Jason can ask a peer (e.g. What do you like to do? Where do you go to school? Do you like sports? What TV shows do you like? ) Script what Jason should say (consider using a Social StoryTM, or a written script). Practice listening to Jason s response and then respond with an appropriate/related response. Discuss ways in which his response could be changed. Pretend to talk to different people in different situations. Practice explaining as particular task (ie: playing a game, washing your hands, etc) to a variety of pretend listeners.

41 Teach spontaneous initiation of conversation with peers, demonstrating appropriate attention getting strategies, eye contact, and body positioning. Teach the skill to wait and listen to a peer s response and provide a relevant comment/question. Talk about what peers might be discussing at the time (playing baseball, the newest video game, etc). Role play, research, add related topics, etc.

42 Social Stories Social Scripting Video-tapes/role playing Lunch/Recess Club Visual directions Visual cues and prompts Power cards Comic strip Conversations

43 Social Stories are short stories written for the person with autism that give the what, when, who and why aspects of social situations. They provide information on what people in a given situation are doing, thinking or feeling, the sequence of events, the identification of significant social cues and their meaning, and the script of what to do or say. Social Stories were developed by Carol Gray, a special educator, through her work with students with autism. Social Stories can provide social information to teach appropriate social behavior that is governed by unwritten and unspoken rules and nonverbal cues. 43

44 Think about and picture the goal of the Social Story Gather information about the topic Tailor the text Teach with the title * The main goal of social stories is to teach social cues and rules. Be accurate, personal, brief, and at the individual s functional level!

45 There are many ways to greet someone at school. When I see someone I know, I will try to smile and say hi or hello. They may say hi or hello back to me. I can ask someone How are you today? They may stop to talk with me. In the morning, I will try to say good morning! to someone. At dismissal time, I will try to say good-bye or see you tomorrow! Sometimes, if I am just passing someone I know, I can smile, wave, or just nod my head. Most people like it when I smile at them. Smiling can make people feel good. When I say hi or good-bye to someone, it makes them happy. People like to feel happy.

46 My name is Jason. I am in the Fifth grade. Playing a Game I like to play a game! It can be fun to play games with other children. I can ask other children to play. I can say Do you want to play a game? Or, someone might ask me to play a game. They can say Do you want to play a game?. Sometimes I win the game Sometimes I lose the game.

47 Video modeling involves demonstrating desired behaviors through active video representation of the behaviors. A video modeling intervention typically involves an individual watching a video demonstration and then imitating the behavior of the model. Video self-modeling (VSM) is a specific application of video modeling, where the individual learns by watching her own behavior. Video modeling and VSM effectively promote skill acquisition.

48 Uses video recording and display technology Provides a visual model of the Target Behavior or Skill 4 General Types of Video Modeling Basic Video Modeling Video Self-Modeling Point-of-View Video Modeling Video Prompting The National Professional Development Center on Autism Spectrum Disorders ( 48

49 The student with autism might choose 2-3 friends to participate. If he is unable to choose, observe and approach several empathetic peers. Students sit in a designated area away from too may distractions. While the students eat, the facilitator promotes conversation around a specific topic which targets a chosen social skill objective.

50 Role-playing is an effective and fun way to teach appropriate social behavior. A particular social activity can be targeted and students take parts or roles to play. For example, students could role-play what would happen at a school dance, going out to eat in a restaurant, going to the Mall, going to get a haircut, etc. 50

51 Small Talk: play the roles of students at a lunch table, practice making chit chat about common ageappropriate topics Social Stress: role play a mock scenario where a person becomes stressed in a social situation. What do they do? Who do they tell? Where do they go? Switch roles and let other kids model too! Asking for Help: role play scenarios of difficulty where the student has to practice effectively asking for help 51

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53 Brainstorm a list of questions or conversation starters that will help students when they are talking with others. Write them down. Some things on your list may be general questions to ask everyone. Other conversation starters may be for specific people. Keep a list. Carry it in a pocket. Practice.

54 Power Cards are visual aids that incorporate your student s special interest/hero in teaching social skills. Power cards can be done on a single sheet of paper or in booklet form. A scenario is written in first person describing how the hero solved a problem. 54

55 Think before you say anything. Say it in your head first before you say it out loud. If you can t think of something nice to say then don t say anything. You do not have to say every thought out loud that you think. 55

56 Comic strip conversations are simple drawings that depict a conversation. They identify what people say and do and emphasize what people may be thinking. They can be child or adult constructed. They can be drawn or developed using real pictures. 56

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60 For I had At I

61 Carry Strips for Appropriate Loudness Levels

62 Social Emotional Observational Record (Mc Graw Hill) Social Skills Rating System (AGS) The Autism Social skills Profile (Bellini, 2006) The Social Skills checklist (Quill, 2000) Skill Streaming (Research Press) Walker Social Skills Curriculum (Pro-Ed) b/documents/ProfileofSocialDifficulty.pdf

63 TOPL (Test of Pragmatic Language) CELF-4 now has a checklist for Pragmatics PLAI (Pragmatic Language Inventory) OWLS (Oral and Written Language Scales) have pragmatic questions embedded within the test Super Duper SEE (Social Emotional Eval)

64 American Speech-Language-Hearing Association. Bellini, S. (2003). Making (and keeping) friends: A model for social skills interaction. The Reporter, 8 (3), Steps to Independence, Fourth Edition. Copyright 2004 by Paul H. Brookes Publishing Co. Coucouvanis, J. (2005). Super Skills Profile of Social Difficulty Hanzlick, H., Petersen, L., Rogers L. Moving Toward Functional Social Competence. Minnesota Region 10 Low Incidence Autism Spectrum Disorder (ASD) project.

65 Lakeside Center for Autism. Hogdon, L. (2007). Six tips for Teaching conversation Skills with Visual Strategies. Working with Autism Spectrum Disorders & Related Communication & Social Challenges. Osisek, R. (2011). Social Language Deficits in Children with Autism Spectrum Disorders: Assessment and Remediation. Advance Magazine Webinar.

66 Quill, K. (2000). DO-WATCH-LISTEN-SAY: Social and communication intervention for children with autism. Baltimore, MD. Brookes Publishing. Speech-Language Pathology: Services in WV Schools (2011). Office of Special Programs, West Virginia Department of Education. The ASHA Leader. (January 17, 2012) Vol.17, No. 1 American Speech Language Hearing Association.

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68 Social Skills Difficulty Social experiences Social understanding Perspective taking Possible effects on Literacy and Comprehension/Related Difficulties Literal comprehension ( due to limited world knowledge and word knowledge) Inference, including the meaning of an unknown word from context Understanding of narratives including plot, action and cause and effect Hard to relate to characters and situations in stories, integrate or connect the story with personal experience and understand the appropriateness of character actions and reactions (which are normally based on knowledge of the social world, personal experience, social interactions and social judgment) Understanding of a character s thoughts, feelings, behaviors and motivation, as well as interactions between characters Iland, E. (2011). Drawing a Blank: Improving Comprehension for Readers on the Autism Spectrum. Kansas: Autism Asperger Publications

69 RLA.O select defining characteristics, construct background knowledge and develop reading skills to understand a variety of literary passages and informational texts by West Virginia, national and international authors: myth fantasies biographies autobiographies science fiction tall tales supernatural tales historical fiction

70 RLA.O exhibit effective oral communication skills (e.g., rate, audience, etiquette, standard English) through the presentation of readers theater choral reading personal narratives recitations (poetry, historical documents) dramatizations RLA.O compare and contrast personal experiences to oral/visual information.

71 SS.O assume a role in a mock trial proceeding to demonstrate the trial by jury process. SS.O explain the roles of consumers and suppliers in the United States economy and apply the concepts of sales, expenses and profits to a real life event (e.g., bake sale as a fund raiser, sports events, concession stand, snack machines)

72 SC.O cooperate and collaborate to ask questions, design and conduct investigations to find answers and solve problems. SC.O explore the connections between science, technology, society and career opportunities.

73 The SLP may serve as a related service provider providing specialized instruction and support as deemed appropriate by the IEP team after reviewing assessment results, observations, and other information. Specialized instruction may be direct, indirect or a combination of these based upon the communication needs of the identified student. The SLP can function as an important liaison among teacher(s), classroom support personnel, parents, and others in determining and implementing the most appropriate communication system within the school setting.

74 Therapy services provided in an individual or small group setting, with intensive specialized instruction in specific skills or strategies focusing on remediation of articulation, language, voice, fluency or swallowing deficits. The nature and severity of the speech-language impairment may necessitate service delivery in a pull-out situation. A pull-out service delivery model may be provided for short lengths of time to focus on the acquisition of a specific skill or in conjunction with an integrated or indirect model as determined by student need.

75 Individualized service provided in a less restrictive setting and does not remove the student from the general or special education classroom The student receives direct speech therapy while continuing to receive classroom instruction. The teacher becomes an integral part of the process learning to reinforce speech-language goals, assess student progress, and specific techniques that will benefit the student as well as other students in the classroom.

76 The SLP has exposure to classroom communication including: levels of adult and child communication, daily routines, the language of the curriculum, vocabulary demands, and the student s coping strategies. The general or special education teacher and SLP jointly plan, teach, and assess the student s progress within the classroom setting. The teacher employs strategies learned, uses prompts or cues the SLP has demonstrated, or monitors students for use of a particular skill. This information is especially helpful in determining the educational impact of a speech or language impairment

77 Instruction for students with disabilities facilitates the development of skills that are required for success in life. Opportunities are provided to practice daily living or work skills during community trips with monitoring and support provided by teachers and other staff. The SLP may participate in these outings if the functional setting provides opportunities to monitor the generalization of skills or provides opportunities for structured practice. The SLP may also provide consultation services to the teachers who are providing community-based instruction.

78 Indirect services or consultative services are necessary when a student s IEP indicates that support is needed for school personnel on behalf of the student as part of accommodations, modifications or supplemental support services. Services may include providing information and demonstrating effective instructional and facilitation procedures as well as analyzing, adapting, or modifying instructional materials and assistive technology for targeted students. While providing consultative services on behalf of a child, the SLP will monitor the student s progress..

79 This model is appropriate for students who are nearing dismissal from speech-language services, students with severe disabilities or students whose teachers require additional support to create materials, implement specific communication strategies, or modify augmentative/alternative communication (AAC) equipment. The classroom teachers may request assistance as they plan, monitor student progress or make decisions regarding the presentation or selection of materials.

80 Consultative services may be provided to family members and may include information on speechlanguage development, home programs, recommended environmental changes or parent support groups. Information, home programs, and demonstration that can positively impact communication development or maintenance skills may be offered