ASD Consultation Toolkit

Transcription

1 ASD Consultation Toolkit Effective Consulting to Support Students with Autism Spectrum Disorders in Inclusive Settings Karen M Stiles PhD Michelle Avila Bolling PhD, NCSP

2 Overview Enhanced Understanding New definition and changing criteria Varying topology Changing outcomes Effective Consultation Creates meaningful change in teacher beliefs, skills and practices Improves strategy implementation Promotes sustainability High-Quality Resources Evidence-Based Ready-to-use Practical Organized Easy to access

3 Improved Outcomes for Students Enhanced Understanding Improved Outcomes for Students High-Quality Resources Effective Consultation

4 Overview Dealing with a wide range of problems and situations Ease of accessibility Sources for accurate, timely information updates and scientific critique Focus on general education 4

5 Overview Rapidly expanding number of high-quality readily available teaching and educational materials Volume of web sites and information available in public domain, both good and bad, is overwhelming 1999: study counted 100,00 autism Web sites 2014: Google search yields 17.7 million hits Weeding out fact from fiction Problem worse due to lack of mainstream medical treatments

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7 Enhanced Understanding

8 Changing Definitions of Autism Insert Photo New vs. Old Definitions 8

9 Autism Spectrum Disorder New Definition Major Criteria 3 2 Deficits in Social Reciprocity+ Communication Combined 9

10 DSM III (1980) Infantile Autism Onset before 30 months Pervasive lack of responsiveness to others Gross deficits in language development If speech is present, peculiar speech patterns Bizarre responses to environ, e.g., resistance to change, peculiar attachments Absence of delusions, hallucinations 10

11 DSM-5 Autism Spectrum Disorder A. All of the following: Symptoms must occur in early developmental period Deficits in social-emotional reciprocity (or present earlier in development) e.g., abnormal social approach, failure of normal back and forth conversation to reduced sharing of interests, emotions, affect and response to total lack of initiation Deficits in non-verbal communicative behaviors Deficits in developing and maintaining relationships 11

12 DSM-5 Autism Spectrum Disorder (cont d) (B) Any two of the following: Stereotyped object use Insistence on sameness Restricted fixated interests (abnormal intensity or focus) Hyper or Hypo reactivity to sensory environment 12

13 DSM-V Criteria Social Communication and Interaction (all) Deficits in Social- Emotional Reciprocity Deficits in Nonverbal Social Communication Deficits in Relationship Skills Severity of Deficits Ratings 3- Requiring very substantial support 2- Requiring substantial support 1- Requiring Support Restrictive and Repetitive Behavior (2+) Stereotyped Patterns Rigidity Restricted Interests Sensory Impairments

14 Autism Spectrum Disorders (ASD) Large constellation of defining behaviors Marked by behavioral deficiencies and excesses No single typical or exclusionary behavior Symptoms range mild severe Age onset varies but can often be diagnosed by age 2 Wide variation in symptoms and course over time Defining features deficits in social-communication along with restricted, repetitive patterns of behavior, interest, activity 14

15 Autism Spectrum Disorders (ASD) Not one, but many disorders Underlying biological similarities Biomarkers Neurodevelopmental whole-body disorder

16 Study Links 15q duplication and autism Autism Research,

17 Co-Morbid Conditions Anxiety Disorders Mood Disorders Tic Disorders Neurological Impairments Learning Disabilities Communication Disorders Cognitive Impairment

18 Co-Morbid Conditions (cont d) GI Disturbances Sleep and Feeding Disorders Seizures and Epilepsy Sensory Problems Anxiety ADHD Disruptive Behaviors

19 ASD Recovery Until recently considered hopeless and incurable Reluctance to establish early diagnosis Wide variation in presentation and course over time Research on effectiveness of early intervention (Denver-reference) Optimal outcome data (Fein et al, 2013)

20 Improved Consultation Skills

21 Consultation to Build Capacities NASP Model for Comprehensive and Integrated School Psychological Services (NASP Practice Model, 2010) Advocates for the provision of systems-level services to build capacities of educational personnel Meaningful and sustainable change teacher beliefs, skills and practices Focus on general education setting

22 School Psychologists (SPs) Increasing Educator Capacities SPs desire more time for indirect service delivery (Reschly & Wilson, 1995) school year data (Bolling, 2013) 72.6 % reported delivering PL Average of 3.5 PL engagements Securing administrator support is a facilitator PL (Bolling, 2013) Administrators endorsed a preference for SPs to provide more teacher training (Gilman & Gabriel, 2004; Senft & Snyder, 1980) Elementary principals requested more more preventive mental health services and more training from SPs (Senft & Snyder, 1980)

23 Standards for Professional Learning (PL) Standard Description Learning Communities Communities of learners establish, own and commit to PL goals aimed at continuous improvement. Leadership Resources Data Skillful leaders provide support and engage in advocacy to develop the capacity of learners. Resources are prioritized, monitored and coordinated. Various data sources are used to plan, assess, and evaluate Learning Designs Implementation Outcomes PL is based on sound theoretical models and established research in the domain of concern. Systems change research is considered, along with necessary supports for sustained implementation. Outcomes are aligned with professional standards of practice and student curriculum standards. Note. From Standards for Professional Learning, by Learning Forward, 2011, Oxford, OH: Author.

24 School Psychologist Suitability to Enact the Standards Equipped to facilitate learning communities Prepared to fill leadership roles Competent to understand data and evaluate outcomes Well-suited to develop learning designs A human resource to support implementation 40% of school psychologists reported doing PL on Autism in (Bolling, 2013)

25 Consultation Guiding Principles Relatedness- Feelings of connectedness with and social interactions between members of the group Authenticity- Genuine and authentic applications of practical content in the setting Autonomy- Consultee-directed learning through opportunities to make meaningful choices and influence the learning process Responsiveness- Sustained efforts to assess, attend to, and meet consultee needs Equity- Valuing all participants as having equal importance and equal power Based on the EPL model of consultation developed by Truscott and colleagues (Truscott et al, 2012)

26 Consultation Guide

27 The complete article can be accessed from the website. Truscott, S.D., Kreskey, D.D., Bolling, M.A., Psimas, L., Graybill, E.. Albritton, K., & Schwartz, A. (2012). Creating consultee change: Theory-based learning and behavioral change processes in school-based consultation. Consulting Psychology Journal: Practice and Research, 64,

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31 2. Identify Existing & Needed Competencies 3. Assess Internal & Contextual Variables

32 Assessment for Understanding Student Personnel Environment Curriculum Family Perspective 32

33 Assessment for Understanding: Student Situation-Specific Cross-Context Standardized vs. Non-Standardized Tools Assess for Accommodations Proficiency Strengths and Weaknesses Special Interests Barriers to Teaching and Learning 33

34 Assessment for Understanding: Student Ideally conduct across a range of environments and situations Mix of information and sources to create holistic profile Home and parental input vital Standard tests and approaches may not be viable Typical tools often curriculum-driven and lack focus on primary areas of difficulty Basal and ceiling procedures may mask deficits and competencies 34

35 Assessment for Understanding: Student Barriers to Teaching and Learning Difficulty seeing cause & effect relationships Focus on details Difficulty sequencing Difficulties with understanding of time Compulsiveness Distractibility Attending Visual thinking 35

36 Assessment for Understanding: Student Barriers to Teaching and Learning Theory of Mind Weak Drive for Central Coherence Executive Dysfunction Motor & Sensory Dysfunctions Motivations and Interests Preoccupations Anxiety 36

37 Assessment for Understanding: Student Theory of Mind Empathising Appreciating the perspective of others Forming and sustaining relationships Social prediction Social curiosity Interpreting the intentions of others Predicting and understanding consequences & impact of behavior on others 37

38 Assessment for Understanding: Student Weaknesses in Central Coherence See and make connections in a range of contexts Generalise skills - seeing the relationship between what is expected and what is already known Focus attention Appreciate alternative perspectives Cope with environmental variables or that which is unknown or unfamiliar Choose and prioritise Organise and plan 38

39 Assessment for Understanding: Student Executive Dysfunction Goal-directed activities Systematic problem solving Flexibility of thought and behavior Controlling inappropriate impulses and self-control The guiding of behavior by mental models or internal representations Shifting set 39

40 Assessment for Understanding: Student Sensory and Motor Dysfunction Movement and Balance Tactile Visual Auditory Taste & Smell 40

41 Toolkit Assessment Resources- Interview Tools

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43 Toolkit Assessment Resources- Interview Tools

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45 Assessment for Understanding: Personnel Attitudes and Beliefs Priorities and Concerns Knowledge Skills Support Competing Demands 45

46 Toolkit Assessment Resources- Interview Tools

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48 Toolkit Assessment Resources- Observation Tools

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50 Toolkit Assessment Resources- Observation Tools

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52 Toolkit Assessment Resources- Observation Tools

53 Assessment for Understanding: Environment (EIC-ASD) Physical Structure Calming Areas Sensory Considerations Schedules and Predictability Use of Schedules Visual Supports Transitions Customized Daily Schedule Environmental Distractions Respect for Students Independence 53

54 Go to:

55 EIC-ASD 55

56 Assessment for Understanding: Curriculum Functional Spontaneous Communication Social Skills Play Skills Cognitive Development Functional Academics Proactive Strategies to Problem Behaviors [National Research Council, 2001] 56

57 Assessment for Understanding: Curriculum Has research been conducted to evaluate the specific treatment or strategy being used? Does teaching include assessment of current level of performance (baseline rate) with strategy to improve beyond this? Are methods specified for data collection and progress monitoring? What specific skills are being addressed? 57

58 Assess for Understanding: Family Intervention Priorities and Goals Baseline Skills and Developmental Profile Strengths, Interests, Motivations, Needs Successes and Failures 58

59 Toolkit Assessment Resources

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62 Toolkit Assessment Resources

63 Download the FBA Data Tool Explore the Demo on how to use it Once data is entered, the tool produces excellent graphs and visuals to describe behavoor

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66 4. Skill Development & Implementation

67 Intervention: Overview Comprehensive Treatment Models Focused Treatment Practices National Consensus Reports Scientific Reviews State Quality Indicators National Technical Assistance Centers

68 Intervention: Comprehensive Treatment Models Ziggerat SCERTS TEACCH Early Start Denver (ESDM) 68

69 Intervention: Comprehensive Programs Ziggurat 69

70 Intervention: Comprehensive Programs Ziggurat Model 70

71 Intervention: Comprehensive Programs Ziggurat Model Individual strengths and skills inventory Strategy and priority planning Specific Intervention Plan Guide Comprehensive Autism Planning Systems Young Children Older Children and Adolescents Vocational (V-CAPS) 71

72 Intervention: Comprehensive Programs SCERTS Social Communication, Emotional Regulation and Transactional Support Emphasizes collaborative decision making Focuses on development of communication Enhancing ability student to maintain well regulated emotional state for learning and interacting Maximizing positive social experiences Focus on helping children overcome challenges 72

73 Intervention: Comprehensive Programs Early Start Denver Model (ESDM) Comprehensive behavioral treatment Designed for months Developmental curriculum Normal sequence of skill development Specific teaching procedures for content delivery Integration of relationship-focused with ABA 73

74 Intervention: Comprehensive Programs Early Start Denver Model (ESDM) Naturalistic ABA strategies Strong parental involvement Focus on shared engagement joint attention Interpersonal exchange + joint activity Language and communication taught inside a positive, affect-based relationship First scientifically-validated comprehensive treatment 74

75 Intervention: National Consensus Reports National Research Council (2001) American Academy of Pediatrics (2007) Autism Education Standards, UK (2012) NPCDC-ASD (2014) 75

76 Intervention: National Consensus Reports National Research Council (2001) Education of Young Children with Autism AAP Clinical Practice Guidelines (2007) Comprehensive and specific Defining characteristics Detailed program description Recently reaffirmed by AAP (2012) 76

77 Intervention: National Consensus Reports Autism Education Trust (2007) What is Good Practice in Autism Education? Identified major themes and essential practices e.g., Monitoring Progress, Curriculum Adaptation, Staff Knowledge & Training 77

78 Intervention: National Standards Project National Autism Center May Institute Completed in 2009 Evaluated Comprehensive Treatment Packages Classified existing treatments based on scientific evidence for effectiveness Established =strong support (11) Emerging = weaker support, possibly effective (22) Unestablished = no sound evidence (5) 78

79 National Standards Project: Established Treatments Antecedent Package Behavioral Package Comprehensive Behavioral Treatment for Young Children Joint Attention Intervention Modeling Naturalistic Teaching Peer Training Schedules Self Management Pivotal Response Training Story-Based Interventions 79

80 National Standards Project: Emerging Treatments (examples) Augmentative Communication Cognitive-Behavioral Intervention Developmental Relationship-Based Exposure Therapy PECS Language Training PECS Peer-mediated Instruction Music Therapy Massage 80

81 Intervention: National Standards Project Available Publications (free download) Report of NSP Findings and Conclusions A Parent s Guide to Evidence-Based Practice in Autism Evidence-Based Practice and Autism in the Schools Educator Manual 81

82 Intervention: State Quality Indicators Educational guidelines developed at the state level to promote quality education for students with ASD First produced by the state of New York in 2002 (APQI) Self-review and quality improvement guide Comprehensive and straightforward Fourteen dimensions: Educational process (7) + Program characteristics and supports (7) 82

83 Intervention: National Technical Assistance Centers National Professional Development Center on Autism Spectrum Disorders Early Childhood Technical Assistance Center 83

84 Toolkit Intervention Resources- Universal Accommodations

85 Toolkit Intervention Resources- Universal Accommodations: Visual Supports

86 Paper Dolls To Teach Feelings

87 Toolkit Intervention Resources- Universal Accommodations: Visual Supports

88 Powerpoint on Visual Schedules 0 Objects Pictures Mini Schedule

89 Powerpoint on Visual Schedules Whole Class First Then Individual Schedules Suggestions for storage

90 Toolkit Intervention Resources- Universal Accommodations: Visual Supports

91 Toolkit Intervention Resources- Universal Accommodations

92 Toolkit Intervention Resources- Universal Accommodations: Social Stories

93 Toolkit Intervention Resources- Universal Accommodations: Social Stories Download Specific Stories

94 Toolkit Intervention Resources- Universal Accommodations: Social Stories Link to Many

95 Toolkit Intervention Resources- Universal Accommodations

96 Toolkit Intervention Resources- Universal Accommodations: Five Point Scales

97 Sample Five Point Scale

98 5 Point Scale Whole Class Implementation

99 Toolkit Intervention Resources- Behavioral Concerns 99

100 Toolkit Intervention Resources- Behavioral Interventions

101 Toolkit Intervention Resources- Behavioral Interventions: Token Economy

102 Toolkit Intervention Resources- Behavioral Interventions

103 Toolkit Intervention Resources- Behavioral Interventions: Modifying Antecedents There are a variety of antecedent instructional accommodations you make to address different concerns.

104 Toolkit Intervention Resources- Behavioral Interventions

105 Toolkit Intervention Resources- Behavioral Interventions

106 Toolkit Intervention Resources- Behavioral Interventions

107 Toolkit Intervention Resources- Behavioral Interventions

108 Toolkit Intervention Resources- Social/Emotional Concerns

109 Toolkit Intervention Resources- Social/Emotional Interventions

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111 Toolkit Intervention Resources- Social/Emotional Interventions

112 Toolkit Intervention Resources- Social/Emotional Interventions

113 Toolkit Intervention Resources- Social/Emotional Interventions

114 Toolkit Intervention Resources- Social/Emotional Interventions

115 Toolkit Intervention Resources- Functional Skills

116 Toolkit Intervention Resources- Functional Skills: Social Communication

117 Toolkit Intervention Resources- Functional Skills: Social Communication

118 Toolkit Intervention Resources- Functional Skills: Social Communication

119 Mousetrial is a website to work on receptive language skills in a variety of categories--->

120 Toolkit Intervention Resources- Functional Skills: Social Communication

121 Toolkit Intervention Resources- Functional Skills: Social Communication

122 Toolkit Intervention Resources- Functional Skills: Social Communication We like this book and Amazon lets you preview at no cost.

123 Toolkit Intervention Resources- Functional Skills

124 Toolkit Intervention Resources- Functional Skills: Academic - READING

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126 Toolkit Intervention Resources- Functional Skills: Academic - MATH

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128 Toolkit Intervention Resources- Functional Skills: Academic - WRITING

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130 Toolkit Intervention Resources- Functional Skills

131 Toolkit Intervention Resources- Functional Skills: Leisure Skills

132 Toolkit Intervention Resources- Functional Skills: Leisure Skills

133 Toolkit Intervention Resources- Functional Skills: Leisure Skills

134 Toolkit Intervention Resources- Functional Skills: Leisure Skills

135 Toolkit Intervention Resources- Functional Skills: Leisure Skills

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137 Toolkit Intervention Resources- Functional Skills: Leisure Skills

138 Toolkit Intervention Resources- Functional Skills

139 Toolkit Intervention Resources- Functional Skills: Developing Self Help Skills

140 Toolkit Intervention Resources- Functional Skills: Developing Self Help Skills

141 Toolkit Intervention Resources- Functional Skills: Developing Self Help Skills

142 Toolkit Intervention Resources- Functional Skills: Developing Self Help Skills

143 Toolkit Intervention Resources- Functional Skills: Developing Self Help Skills

144 Toolkit Intervention Resources- Functional Skills: Developing Self Help Skills

145 Toolkit Intervention Resources- Functional Skills: Developing Self Help Skills

146 Toolkit Intervention Resources- Functional Skills: Developing Self Help Skills

147 Toolkit Intervention Resources- Functional Skills

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149 5. Evaluate, Trouble-shoot, & Support

150 Toolkit Follow-up Resources- Progress Monitoring

151 Toolkit Follow-up Resources- Progress Monitoring- Severity Improvement

152 Toolkit Follow-up Resources- Progress Monitoring- Toileting

153 Toolkit Follow-up Resources- Progress Monitoring- Graphing just about anything

154 Toolkit Follow-up Resources- Implementation & Sustainability

155 Link Intervention to IEP Goals

156 Link Intervention to IEP Goals 156

157 Link Intervention to IEP Goals 157

158 Toolkit: For Parents 158

159 Toolkit: For Parents 159

160 Feedback 160

161 Disclosure Presenters have no relevant financial relationships with commercial interests or entities presented or included on website.

162 Questions and Discussion