Teaching Parents to Interact Successfully with their Children with Autism Spectrum Disorder (ASD)

Transcription

1 Teaching Parents to Interact Successfully with their Children with Autism Spectrum Disorder (ASD) Presented by: Catherine B. Zenko, M.S., CCC-SLP University of Florida Center for Autism and Related Disabilities (CARD) & Dept. of Speech, Language Hearing Sciences ASHA National Convention, November 2011, San Diego, CA Who am I? Introductions SLP, consultant, teacher, author, wife, mother Who are you? What to Expect Basic review of ASD Characteristics Best Practices Discuss a Clinician-to-Coach Model of Service Delivery Parent Instruction, Live Coaching, Video Feedback Pros & Cons Questions/Discussion The Autism Spectrum Disorders Continuum Persons with autism will possess characteristics in any combination and with varying degree of severity. Mild/more able Autism Society of America Moderate Severe/Less Able Autism Spectrum Disorders Developmental Disability (not visible at birth) Neurological in nature Found in all cultures and economic groups Differences in socialization Incidence Rates Estimates between 1 in 110 and 1 in 250 children Repetitive behaviors, interests and activities Autism Differences in communication Four times more common in boys? Rates appear to be on the rise 1

2 Educating Students with Autism (National Research Council, 2001) Summary of Best Practices for children with ASD Guideline for EBP according to the experts Six Types of Priority Instruction (NRC, 2001) (1) Functional, spontaneous communication; (2) Social instruction in various settings throughout the day; (3) Play skills with a focus on play with peers and peer interaction; (4) New skill acquisition and generalization and maintenance in natural contexts; (5) Functional assessment and positive behavior support to address problem behaviors; and (6) Functional academic skills when appropriate Effective Interventions Should Begin as soon as the individual is suspected of having ASD or related disabilities Actively engage the child in learning for a full school day, 5 days a week (MINIMUM) Be individualized National Research Council, 2001 Include ongoing assessment of the child s progress Teach skills in context (for example; in the places and situations in which they are expected to be used) Effective Interventions (cont d) Should Have a plan for how to teach generalization of skills Have a plan for how to teach maintenance of skills Include interactions with typically developing children/ adults Focus on functional, spontaneous communication (initiation) Include social instruction throughout the day National Research Council, 2001 How Does an SLP Follow These Recommendations? Build capacity in others Parents/Caregivers ** Siblings Educators Other Providers Peers Become a COACH Paradigm Shift Only way to get the recommended amount of intervention time = recruit help from others Must engage parents/caregivers in the therapy sessions Clinician works with the child WHILE modeling for the parents what to do at home Gradually shifts the intervention to have the parents lead the session while the SLP coaches them 2

3 3-Step Clinician-to-Coach Model Adapt the Plan-Do-Review concept created by the HighScope Early-Childhood Curriculum to teach adults ( Include Step 1: Direct Parent Instruction (Plan) Step 2: Coaching (Do) Step 3: Video Feedback (Review) Step 1a: Plan Part A: Parent Instruction Choose a full parent-training curriculum: 2 Examples: Hanen More than Words and the FIRST WORDS Project or Select relevant topics that coincide with current therapy and take time to teach the parents specific strategies Hanen More Than Words Highly-structured parent training group Includes lesson plans for SEVEN 2 ½ hour information sessions Includes THREE home visits with coaching and video feedback Must be a certified Hanen SLP to run the group FIRST WORDS Project at Florida State University Model early identification and intervention program Offer a range of services to local families Parent Education Sessions Infant-Toddler Playgroups led by SLP: Topic driven Individualized sessions with SLPs Referrals Communication and Language Monitoring Step 1b: Plan Step 1b: Plan- Video Part B: Review the Lesson Plan before observing Help parent plan an activity to do with their child and practice the skill you taught them Review the plan before you start the observation and video Answer any questions they may have before starting the observation 3

4 Step 2: Coach Step 2: Coach- Video 1 Sit back and watch Call in plays from the sidelines if necessary- indirectly Provide positive feedback and encouragement May need to jump in and model to ensure success Back out as soon as possible Help parents find the perfect balance to push their child to achieve without hitting the frustration wall Step 2: Coach- Video 2 Step 2: Coach- Video 3 Step 3: Video Feedback (VF) Step 3: VF- Video 1 Let parents tell you what they thought, saw and felt Help them see what worked and what needs improvement Add feedback as necessary Use the Socratic teaching method The more parents talk and discover for themselves the more powerful the results 4

5 Pros/Cons Questions/Comments PROS Teaching parents = more quality intervention time for child Video feedback is proven intervention tool Parents become more confident Your ideas? CONS Time consuming Difficult to bill Need to get creative Need parent/caregiver buy-in ready to work Your ideas? Resources First Words : The Hanen Center: The University of Florida Center for Autism and Related Disabilities: References Bellini, S., & Akullian, J. (2007). A meta-analysis of video modeling and video self-modeling interventions for children and adolescents with Autism Spectrum Disorders. Exceptional Children, 73(3), Bellini, S., Akullian, J., & Hopf, A. (2007). Increasing social engagement in young children with autism spectrum disorders using video self- modeling. School Psychology Review, 36(1), Cardon, T.A. & Wilcox, M.J. (2010). Increasing play skills in children with autism through video modeling. Poster presented at the annual conference of the American Speech-Language Hearing Association (ASHA) Conference, Philadelphia, PA. References (cont d) Janzen, J.E., & Zenko, C.B. (2012). Understanding the Nature of Autism, 3 rd edition. Austin, TX: Hammill Institute on Disabilities. Kaiser, A. P., Hancock, T. B., & Nietfeld, J. P. (2000). The effects of parent-implemented enhanced milieu teaching on the social communication of children who have autism. Early Education and Development, 11(4), National Research Council (2001). Educating children with autism. National Academy Press: Washington, DC. Rocha, M. L., Schreibman, L., & Stahmer, A. C. (2007). Effectiveness of training parents to teach joint attention in children with autism. Journal of Early Intervention, 29(2), References (cont d) Seung, H. K., Ashwell, S., Elder, J. H., & Valcante, G. (2006). Verbal communication outcomes in children with autism after in-home father training. Journal of Intellectual Disability Research: JIDR, 50(Pt 2), Sussman, F. (1999). More than words: A guide to helping parents promote communication and social skills in children with autism spectrum disorder. Toronto, ON: The Hanen Centre. Wetherby, A. M., & Woods, J. J. (2006). Early social interaction project for children with autism spectrum disorders beginning in the second year of life: A preliminary study. Topics in Early Childhood Special Education, 26(2),