Inclusion. Promoting Peer Interaction Of Young Children With ASD In Inclusive Classrooms: Research Foundations And Implementation Issues ABA Jam 2015

Transcription

1 Promoting Peer Interaction Of Young Children With ASD In Inclusive Classrooms: Research Foundations And Implementation Issues ABA Jam 2015 Joel Hundert Ph.D., BCBA-D, Behaviour Innovations Hamilton & Toronto, Ontario 1 AGENDA Background issues Brief review of interventions to increase peer interaction Research results on social script training Implications 2 Disclaimer: We Make Mistakes And Do Not Have All Of The Answers Two Major Forces Affecting Children With ASD ABA Inclusion 3 4 In The Early Years In Ontario The Impact Of Applied Behaviour Analysis 5 6 1

2 Explosion of ABA 7 from Shook & Flavell (2008) 8 Early Intensive Behavioural Intervention Is available in every province Is available in 61 countries Funds for IBI and ABA for autism increased from $14 million in 2000/01 to $183 million in 2012/13 (Report by Ontario Auditor General). The Impact Of Inclusion 9 10 The Vast Majority of Children With ASD Who Receive IBI Need Continued Help On Entry To School Somewhere between 6% (Bibby, Eikeseth, Martin, Mudford, & Reeves, 2002) and 47% (Lovaas, 1987) of children with ASD who received EIBI achieved average IQ and placement in regular class without support. 11 IQ Outcome of Children in Ontario IBI (Perry et al., 2008) Mean IQ of students With ASD after IBI (N = 127, M = 59.3, SD = 27.3) Hypothetical IQ of typical students 12 2

3 Inclusion in Ontario Of the students receiving special education programs and services, 81 per cent were reported to have been placed in regular classrooms. (Bennett and Wynne, 2006) 76% of children with developmental disabilities in a sample of 160 children attending day care were in an inclusive setting (Hundert, Maloney, Mundy, & Vernon, 1998) 13 Increase In Inclusion USA Percentage of US students with DD in general education classrooms for 80% or more of the school day 1989 / / / % 44.7% 61.4% From: Williamson, McLeskey, Hoppey, & Rentz ( 2006), 31 st DOE Annual Report To Congress (2009) 14 Although we are clear about why we feel that children with disabilities should be included in general education, we are less clear on how to structure classrooms and prepare children with autism to make such a placement in general education successful. 15 Mean Percent of Interactive Play Gains in Inclusive Preschool Settings (Hundert et al., 1998) Pre School Year Post TD in Inclusive (N = 63) Moderate in Inclusive (N = 66) Severe in Inclusive (N = 46) Severe in Segregated (N = 48) 16 Conclusions There tends to no spontaneous gains in the peer interaction of children with ASD in inclusive classroom (Harrower & Dunlap, 2001). Any increases in peer interaction tend to be due to a systematic intervention being introduced in the inclusive educational setting (Kretzmann, Shih, & Kasari, 2015). 17 Optimal Learning Arrangements For Children With Autism Learning is individualized with systematic instructional procedures. Systematic intervention typically needed for improved peer interaction and communication skills A Dilemma Typical Learning Arrangements In General Education Classrooms Taught as a group, locked step progression, infrequent and indirect measures. No need for a curriculum in these areas. 18 3

4 Challenge: Place & Hope Supported Inclusion Compared to their typically-developing classmates, children with ASD in general education classrooms tend to: Interact with peers less often (Guralnick, 1990; Jahr, Eikeseth, Eldevik, Aase, 2007; Kasari, Locke, Gulsrud, & Rotheram-Fuller, 2011); Be less accepted by peers (Kasari, Locke, Gulsrud, & Rotheram-Fuller, 2011). Have few friends (Howlin, 2000) Show more immature forms of play (Sigman & Ruskin, 1999) the provision of resources needed to ensure maximum learning in the context of natural environments (Strain, McGee, & Kohler, 2001, pp. 345). Supports directed towards the individual child with ASD Supports directed towards the classroom to accommodate a broader range of student needs Supporting a Student With ASD In A General Education Class Supporting a Student With ASD In A General Education Class 1. Support to the individual child with ASD Supporting a Student With ASD In A General Education Class 1. Directly support the individual child with ASD 2. Adjust the environment to accommodate a wider range of needs including the child with ASD

5 Overview of Interventions to Increase Peer Interaction Purpose of Targeting Peer Interaction GOAL: Increase in initiated, sustain, and reciprocal interaction OUTCOME: friendship and social acceptance Challenge 1: Skill Deficits Children with ASD tend to show more immature forms of play and often lack skills on how to initiate and maintain peer interaction (Bellini et al., 2007) Lack of Skills for Peer Interaction Challenge 2: Motivational Problem Challenge 3: Not Preferred Play Partners Child-child interactions rely on a balanced contribution of both parties to sustain (Koegel, Koegel, Frea & Fredeen, 2001)

6 Challenge 4: The Setting Adult-Mediated Targeted Interventions A behaviour analyst may not be in a position to have impact on the amount, quality, or duration of interventions for students with ASD even if working for a school system Peer-Mediated Targeted Interventions Examples Social stories (e.g., Chan & O Reilly, 2008; MacDonald, Sacramore, Mansfield, Witz, & Ahearn, 2009 ) Video modeling (e.g., Hine & Wolery, 2006; Palechka & MacDonald, 2010) Observational learning (e.g., Taylor & DeQuinzio, 2012; Ozen, Batu, & Birkan, 2012 ) Outcomes Classwide Interventions Peer-mediated was more effective than adultmediated (Kasari Rotheram-Fuller, Locke, & Gulsrud, 2012 ). Tend not to generalize to new play partners in new settings or to new play activities (Heflin & Alaimo, 2007; Kasari Rotheram-Fuller, Locke, & Gulsrud, 2012) Tend not be conducted in inclusive classrooms (Kasari & Smith, 2013; Pimentle,Hoher, Caragii, 2014) 35 Correspondence Training Peer Buddies Classwide Social Skills Program Social Script Training 36 6

7 Behaviour Innovations (416) Classwide Interventions Classwide Interventions Correspondence Training (Morrison, Sainato, Peer Buddy Approach (Laushey & Benchaaban, & Endo, 2002; Risley & Hart, 1968) Heflin, 2000) Select a target social behaviour for children Guide each child to say how s/he will play in situation Praise target behaviour when it occurs in situation Have children report on what they did do and reinforce reported use of social behaviour Rules: 1. Play with your buddy 2. Stay with your buddy, 3. Talk to your buddy Children with autism demonstrated significantly higher social interaction and rates of turn-taking in the peer buddy condition Classwide Social Skills Program Components Inclusive groups / classes of children Curriculum of skills (e.g., K version) Listening To Others Problem-Solving Joining-In Sharing Helping Others Lesson Format Lesson Format Present the rationale of the skills Model the skill Identify the sub-skill components 41 Child adult practice Child child practice Presenting a non-exemplar Child child practice Correspondence Training Reinforcement Home note 42 7

8 Outcome Increased interactive play in playground of students at risk for behaviour/emotional disorder (Hundert et al., 1999) Increased the interactive play of 14 children with developmental disabilities in inclusive day care to levels comparable to peers but did not generalize to different play setting or maintained over time (Hundert & Houghton, 1992) Social Script Training Goldstein and Cisar (1992) Social Script Training: What Do We know? Increase in the frequency of peer interaction of children with ASD (Goldstein & Cisar, 1992; Koegel, Vernon, Koegel, Koegel, and Paullin, 2012; Neeley, Neeley, Justen, & Tipton-Sumner, 2001; Thorp, Stahmer & Schreibman, 1995) Increase in communication during play (Granz et al., 2012; Ganz & Flores, 2008) Generalization to use of script in different settings (Goldstein & Cisar, 1992; Ganz & Flores, 2008) 45 Did not generalized to untrained peers (Granz et al., 2012) 46 Elements of Social Script At Preschool Select a theme that: 1. Taps the interests/compulsion or of child compulsions w/ ASD of child 2. w/ Is at ASD the ability level of the child with 2. ASD Is at the ability level of the child with ASD 3. Is of interest to potential playmates 4. Involves interdependence between two play partners

9 Lack of Generalization A meta-analysis suggested that schoolbased social skills interventions for students with ASD has a moderate effect on producing lasting improvement in students social behaviors and a low effect on producing effects that generalize across settings (Bellini et al., 2007). 49 The Effect Of Social Script Training and Peer Buddies On Generalized Interactive Play Joel Hundert, Sarah Rowe, & Erin Harrison McMaster University Published in Focus on Autism and Other Developmental Disabilities (2014) 50 Purpose To examine effects of introducing social script training and peer buddies for children with ASD in inclusive classrooms, To probe for generalization of peer interaction outside of theme-specific activities. Participants Name Age VABS - Composite IQ Setting Noah 4 y 8m Jr K class Katie 5y 10m Preschool Molly 5y 11m K class Design Procedures Non-concurrent multiple baseline A training and a generalization session was run each day Measurement = interactive play collected on a 15 sec momentary time sampling basis IOA of 93.1% Procedural fidelity of 98.4% 53 Baseline Social Script Training Social Script Training + Peer Buddies To counterbalance for possible order effects, Molly received baseline, peer buddies alone, social script training alone and then social script training + peer buddies 54 9

10 Behaviour Innovations (416) Procedures Calendar Script Materials:! Noah: Pirate game (e.g., toy treasure, cards, etc.)! Katie: Calendar teaching game (e.g., demonstration calendar, pointer, velcro-backed days of week, months, number dates, etc.)! Molly: Grocery shopping (e.g., cash register, money, shopping baskets, produce, etc.) Social scripts! Custom designed, description of all non-verbal behaviors/actions plus an example of verbal actions! Designed specifically to fit the child s level of development and interests 56 Peer Buddies R E S U L T S An initial 20 min presentation Rules: stay with, play with, and, talk to your buddy. Posted daily schedule Reinforcement for pairs caught following the rules Recipe For Dancing Implications Each script needs to be individualized Teaching how to play does not increase play initiations (Koegel, Kuriakose, Singh, & Koegel, 2012) Need a way to increase initiations as well as a way to produce play interactions 59 Need partners and a party to be organized (inclusion) Need to have compelling music and know how to dance (e.g., social script training) Need to know how to invite or be invited to dance (e.g., peer buddies) May lead to positive social relationship and friendship 60 10

11 Promising Approaches Need to be: a) effective; b) practical; c) acceptable in a school setting. 1. Train educators how to develop and implement social script training and peer buddies. 2. Priming Training Educators (Hundert, 2007; Hundert & Hopkins, 1992) Trained preschool teachers to develop interventions to increase peer interaction of children with developmental disabilities in inclusive classroom There was a increase in interactive play that generalized to a new play setting. Effects were very modest Undergraduate students were used to introduce play scripts for children with ASD at school during lunchtime (Koegel, Vernon, Koegel, Koegel, & Paullin, 2012). 63 Preschool teachers can be trained to develop and implement interventions to increase the interactive play of children with developmental disabilities (Hundert, 2007; Hundert & Hopkins, 1992) 64 Priming At Home For Copy Of Presentation Correlation (r =.65) between frequency of parent play dates and measured interaction at school (Frankel, Gorospe, Chang, & Sugar, 2011) Priming conducted in preschool just before play session, increased play of two children with ASD (Zanolii, Daggett, & Adams, 1996) Same play, same play partners?

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