Research Based Instruction for Children with Autism: Instruction That Works and How to Access Quality Staff Training.

Transcription

1 Research Based Instruction for Children with Autism: Instruction That Works and How to Access Quality Staff Training Presentation by: Joel Arick, Joan Steiner, Brenda Nakada, Jennie Willis and Darby Lasley Oregon Program Autism Training Sites Project (ORPATS) Autism Teams Project and NWRESD More Information is available at 1

2 Presentation Topics What is ORPATS? What are Instructional Strategies that work? What about Parent Training? What does the Assessment Data Say? What is the Autism Teams Project? What is the Process to Access Training? 2

3 ORPATS: Oregon Program Autism Training Sites Current ORPATS STAFF: Joel Arick, Ph.D. Jennie Willis, M.S. Darby Lasley, M.S. Brenda Nakada, M.S. Karen Shepherd, M.S. John Gill, MS Misten Daniels, MS Middle School Pilot Sites (Social Skills Component Staff): Phyllis Coyne, Kimberly Raines-Schmeltzer, Annette Skowron-Gooch. Parent Training Project: Anna Dvortckak ODE STAFF: Nancy Latini 3

4 What is the ORPATS Project? ORPATS Staff are providing comprehensive workshops and extensive on-site hands-on training in research based instructional strategies to training site staff and autism specialists ORPATS Training Sites model appropriate curriculum content using behavioral methods and provide training on these research based practices Trained Autism Specialists provide hands-on training to other educators in their region at the training sites 4

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6 ORPATS A Training Network Established 42 Oregon Program Autism Training Sites (ORPATS) throughout the state. Training sites model research-based applied behavior analysis methods in addition to classroom curriculum Established a cadre of autism specialists to provide training to others at the ORPATS sites Maintained current sites and continue to develop new training sites throughout Oregon Collaborated with the Autism Teams Project to provide training to 25 Teams throughout Oregon Co-sponsored State-wide Conference on Educating Children with Autism in May of

7 ORPATS Highlights: Teams attended an ORPATS workshop 200+ Teams have accessed an ORPATS site for on-site, hands-on training 350+ Students were in attendance at the ORPATS sites receiving services Since 2003 over 80% of the ORPATS sites established continue to train others 7

8 Curriculum for EI/ECSE and Elementary Level Children Learning to communicate, understand language and social skills is the focus. Generalizing skills within functional routines at home and school is important. Developmental curriculum across all domains. Including: STAR Autism Program (Strategies for Teaching based-on Autism Research, Arick, Loos, Falco and Krug, 2004) Parent training component at the EI/ECSE Oregon Autism Training sites (Ingersoll and Dvortscak, Guilford Press, November 2009) Inclusion and mainstreaming Peer tutoring and peer buddies PECS (Pyramid Educational Consultants, 2005) Augmentative Communication Systems Structured Teaching Incidental Teaching Commercial academic programs 8

9 Curriculum for Middle and High School Students Independence is key School and Community Routines become more of a focus Social Skill Development is also a priority Continue to use ABA strategies to teach specific skills needed for independence on routines Generalize skills within routines FACTER Program (Arick, Nave, Hoffman, 2004) Adjusting the Image Curriculum (WESD, Columbia Regional Program) 9

10 Essential Elements of Support Needed for Students with Autism Student schedule - Each activity of the day identified for the student - Activities of the class consistent with the schedule - Pictures/words at students developmental level Staff schedule - Staff is scheduled to support student as needed - Direct instruction time is provided in order to implement curriculum Staff training Staff is trained to implement the student schedule Staff is trained in appropriate shaping/prompting/reinforcement techniques Staff is trained to implement the curriculum and adapt activities 10

11 Elements of Support (cont) Classroom activities should be adapted to meet the students need A reinforcement system should be available as needed to motivate and reward student for appropriate behavior A curriculum appropriate for the student s level should be implemented consistently 11

12 Research Indicates: Provide 1:1 intensive instruction in: Expressive language Receptive language Spontaneous Communication Pre-academics Play skills/social Interaction and Pre-Teach Functional routines THEN Generalize the skills taught into the child s school day and at home 12

13 Research Also Says that Effective Instructional Strategies to Teach this Content are the Applied Behavioral Analysis Strategies of: Discrete Trial Training Pivotal Response Training Functional Routines Source: Simpson, R. (Focus on Autism and Other Developmentally Disabled, Fall 2005) 13

14 Curricula and Research-Based Instructional Strategies

15 The STAR Program Strategies for Teaching based on Autism Research (Arick, Loos, Falco and Krug, 2004)

16 STAR Program The STAR Autism Program teaches children with autism the critical skills identified by the 2001 National Research Council. The ABA (Applied Behavior Analysis) instructional methods of discrete trial training, pivotal response training and functional routines form the instructional base of this comprehensive program for children with autism. The STAR Program includes detailed lesson plans, teaching materials, data systems and a curriculum-based assessment for teaching in the six curricular areas of receptive language, expressive language, spontaneous language, functional routines, academics, and play & social skills.

17 STAR Student Learning Profile: A Curriculum-based Assessment Shows the overall scope and sequence for the a research based Program Provide guidelines for determining which lesson to focus on for each student Shows instructional strategies that are most effective for lesson Shows which lessons can be taught simultaneously Establishes baseline and summarizes student s instructional progression 17

18 PECS Picture Exchange Communication System (Frost and Bondy, 1994)

19 PECS PECS was developed in 1985 as a unique augmentative/alternative communication intervention package for individuals with autism spectrum disorder and related developmental disabilities. First used at the Delaware Autistic Program, PECS has received worldwide recognition for focusing on the initiation component of communication. PECS does not require complex or expensive materials. It was created with families, educators, and resident care providers in mind, so is readily used in a range of settings. PECS begins by teaching an individual to give a picture of a desired item to a communicative partner", who immediately honors the exchange as a request. The system goes on to teach discrimination of pictures and how to put them together in sentences. In the more advanced phases, individuals are taught to answer questions and to comment.

20 Edmark Reading Program

21 Edmark Reading Program The Edmark Reading Program has been designed for students with learning or developmental disabilities and those who have not succeeded with other reading methods. For 30 years, this trusted program has been highly regarded by teaching professionals as the very best program available. The Edmark Reading Program uses a whole-word approach, with short instructional steps, consistent repetition, and positive reinforcement to ensure that students experience immediate success. Multiple learning modalities are incorporated into this highly effective process with a variety of lesson formats that keep students motivated and involved. Graphics, content, and presentation are appropriate for readers of all ages. Graphics can be turned off for adult or older students.

22 ELSB Early Literacy Skill Builders (Attainment Company)

23 Early Literacy Skill Builders ELSB is a language-rich literacy curriculum for students with moderate to significant developmental disabilities, including autism. The Early Learning Skills Builder program incorporates systematic instruction to teach both print and phonemic awareness. ELSB is a multi-year program with seven distinct levels and ongoing assessments so students progress at their own pace.

24 Handwriting Without Tears

25 Touch Math

26 Structured TEACCH (University of North Carolina): Use of Independent Work Systems

27 Visual Supports

28 Simple Book Schedule

29 Simple Beginning Wall Schedule

30 Written Schedule

31 Portable Schedule

32 Mini-Schedule for Hand washing

33 Choice Wheel

34 Parent Training Component

35 Strategies based on: Teaching Social Communication to Children with Autism By Brooke Ingersoll and Anna Dvortcsak Published in 2010

36 Project ImPACT Improving Parents As Communication Teachers Encompasses the parent training curriculum Guiding Principles Intervention is naturalistic (parents should be able to implement intervention within daily routines) Typical development is used to guide selection of treatment strategies. Children learn social communication through affectladen interactions with responsive caregivers. Techniques are based on applied behavior analysis

37 Parent training is a primary intervention strategy Parent Training Model View: Parents childrearing knowledge and specific skills can directly enhance their child s development Goals: Provide systematic instruction in strategies to help parents accomplish specific goals or outcomes for their child

38 3 Main Focuses of Parent Training Enhance parents skills in engaging their child in play and social interaction Teach parents strategies to help their child acquire developmental skills Help parents manage child s behavior during ongoing daily routines

39 Intervention Techniques Parents are taught techniques through: Written materials (Manual) Didactic presentation Video examples Group discussion of how techniques can be used during daily activities Homework

40 Roles in Parent Training Parent s role: Primary intervention provider Practice techniques Implement intervention in the home/community Teacher s role: Coach Model Techniques Provide Feedback

41 Intervention Strategies Developmental Techniques (Interactive) Increase engagement Increase initiations Provide the child the opportunity to initiate and respond without having to do so in a specific way Behavioral Techniques (Direct) Teach specific skills Language, imitation or play

42 Overview of Curriculum

43 How Program is Being Used State-wide Across Oregon Used in Early Childhood/Early Intervention programs in all 8 regions of the state Programs trained have received the published curriculum through the ORPATS grant Updating the curriculum provided an opportunity for teams to network on strategies for using this program.

44 How Program is Being Used Across Oregon Teams in each region present to parents 1-3 times each year (Groups range from 6-10 families) Most present in a group format to allow families to network together EI programs have also adapted to a home visit model

45 Student Outcomes Oregon Outcome Study (Arick, Young, Loos, Falco and Krug, 2004) Randomized Clinical Trial: University of Pennsylvania Pre-school ORPATS Assessment Project: Initial results 45

46 Autism Outcome Study Oregon Department Of Education Portland State University Parents Children with ASD EI/ECSE, Regional Programs School-age Programs 46

47 Outcome Study: Components Assessment Feedback: Parents and Teams Training Follow Up 47

48 Training provided during the Autism Outcome Study Research-based Program Curriculum utilizing the instructional techniques of:» Discrete Trial Training (DT)» Pivotal Response Training (PRT)» Functional Routines (FR) 48

49 Study Participants Two Cohorts of Children Participated: Cohort One: 67 children Tracked progress for 52 months Across the state of Oregon At out-set of study they were between 2-6 years of age At conclusion of study they were between 7-11 years of age Cohort Two: 56 children Tracked progress for 18 months Across the state of Oregon All children were 3 years of age at out-set of study All recently identified within a 6 month period 49

50 Assessments/Surveys Standardized assessments were given by an independent team of assessors. These assessments were all videotaped with randomly selected videotapes scored for reliability. Standardized assessments given: Battelle Cognitive Battery Vineland Adaptive Behavior Scale Expressive One-Word Picture Vocabulary Test Oregon Department of Education Academic Alternate Assessment Autism Screening Instrument for Educational Planning (ASIEP-2): Autism Behavior Checklist Sample of Vocal Behavior Social Interaction Assessment Educational Assessment Parent and Teacher Surveys given annually Classroom Observation Checklist 50

51 VB Gain/Loss 120 Cohort #1 Verbal Language Age Gain Baseline to Summer 2003 (Approx. 52 months) VB Gain Baseline Language Age (top number) VB Gain (bottom number) 51

52 Expressive Language Progress Results for Cohort One (older cohort): 91% of the children made expressive language gains. Many of the children doubled their previous language age. 36% of the children made at least one month of expressive language age gain for each month of instruction provided during the first 18 months of the study. No significant difference was found between the chronological age of the children and the progress they made. A moderate correlation was found between the beginning language age level of the child and the progress made. However many of the children who started with very little language more than doubled their language age over the life of the study. 52

53 Student Outcomes Students in both cohorts gained skills in: Expressive Langauge Receptive Language Pre-academic Skills Play and Social Skills Spontaneous Language and Independence on Functional Routines 53

54 JOURNAL ARTICLE ABOUT THE STUDY: (Cohort #1) Arick, J., Young, H., Falco, R., Loos, L., Krug, D., Gense, M., & Johnson, S. (2003). Designing an outcome study to monitor the progress of students with autism spectrum disorder. Focus on Autism and Other Developmental Disabilities, 18, (2), Website: Autism Outcome Study Report (cohort #1 & 2) 54

55 Research Study: Randomized Control Trial of the STAR Program Year 1 Cohort School District of Philadelphia and University of Pennsylvania Federal Research Grant STAR classroom student outcomes better than control group classrooms Year 2 Cohort 48 classroom teachers volunteered to participate and learn STAR 55

56 Philadelphia Stories of Success Rachel, a K-2 teacher.. recalls how the program resulted in tremendous progress for one of her students with autism. I began teaching receptive language first. This student learned to imitate the words I said when giving him a reward. Eventually the child was able to learn more words by associating them with pictures on a card. Through this technique, the child added 50 nouns to his vocabulary and, to the delight of his parents, began speaking much more at home. 56

57 Philadelphia Stories of Success I teach in West Philadelphia and have been using the STAR curriculum for the past year and a half. This curriculum requires a lot of training, planning, and organization in order run effectively; however, the benefits are remarkable to the students in my classroom. Each student s quality of life has been greatly improved by learning to complete some of the daily tasks we would normally take for granted. (Megan) University of Pennsylvania School of Medicine, University of Pennsylvania Health System (2010). Simply Because: A Community Health Report, Project Director: Dr. David Mandell 57

58 Pre-school Age Non-verbal Students: Initial Progress Results Descriptive Study with 3 different assessment periods Initial assessment, 9 month re-assessment, and 18 month re-assessment Administering the ASIEP-3, and the Receptive and Expressive forms of the Peabody All students are primarily non-verbal at initial assessment period The data shown in this report are from the Educational Assessment sub-test of the ASIEP-3.

59 Students Currently have 28 students enrolled in the study. Plan to have 40 pre-post assessments completed by the end of next year. Students must be new to using The STAR Program and babbling, at the most using 1 word Current students are receiving 4 days a week of Early Childhood Special Education services in an RPATS training site. At this time we have 9 students that have had both an initial assessment and 9 month re-assessment

60 Ability to sit in chair Initial 9 month students were unable to sit in chair at initial assessment, All students were able to at 9 month assessment!!

61 Receptive Language Responding safety commands name, stand up, sit down, and Come here Receptive Labels show me and give me Following one and two step directions Jump, and point to the cup, and give me car

62 Receptive Language Initial 9 month Out of the 9 students, 7 students made progress. Students are learning that language has meaning.

63 Expressive Language Student shows desire by reaching Uses 1 word Answers simple questions Uses yes and no Uses sentences with 3 4 words

64 Students are emerging in their understanding of the power of expressive language. Expressive Language Initial 9 month students demonstrated progress, 4 students remained at the same level. Half of the nonverbal students began using language to communicate!

65 Body Concepts Ability to walk Able to imitate Skip, hop, and walk backwards

66 Body Concepts Initial 9 month of the students demonstrated progress!! Our students are learning what they need to attend to in the environment!

67 Speech Imitation Makes vocal sound Imitates vocalizations, ah and m Imitates 1 and 2 words Imitates full sentences

68 Speech Imitation Initial 9 month of the students made progress, 3 stayed the same.

69 Overall Progress This score calculates how the student performed on the whole assessment

70 Overall Progress Initial 9 month of the students showed progress! This tells us that our students are learning how to learn. It is building a foundation for our students as they continue on in their education.

71 Autism Teams Project A collaboration between the Oregon Department of Education, Northwest Regional ESD and Lane ESD

72 Autism Team Project Staff Joel Arick, Consultant Misten Daniels, Workshop Presenter/Consultant John Gill, Workshop Presenter/Consultant Darby Lasley, On-site Consultant Sue Mathisen, Lane ESD Director of Special Education Brenda Nakada, On-site Consultant Karen Shepherd, NWRESD Coordinator Joan Steiner, NWRESD Director of Special Education Jennie Willis, On-site Consultant Other Staff Associated with the Project: Nancy Latini, Associate Superintendant, ODE Eric Richards, Salem School District

73 Purpose of the Project: To increase the statewide capacity of school districts and ESD teams to implement evidence based practices for students with ASD; To provide training and the needed materials Te reach 25 educational teams To make the 2 day STAR workshop available to additional staff outside of the designated teams.

74 Workshops Dates/Teams: April 2010: SOESD 3 teams May 2010: Umatilla Morrow ESD 3 teams August 23-25, 2010: Linn Benton ESD 9 teams October 2010: High Desert ESD Teams: To be determined October 2010: Northwest Regional ESD Teams: To be determined

75 Initial Trainings Three day hands on training Support to assess students and put programs together; One day follow up consultation in the classroom; Visit existing ORPATS sites

76 Set Up Day: Team members work together to develop student programs and schedules.

77 Curriculum provided to each Complete STAR kit Level I and II STAR training DVDs STAR Curriculum notebooks Visuals to support routines (Routines in a Bag) Token boards PECS Starter Kits Handwriting Without Tears materials Boardmaker Plus Carol Grey s The New Social Stories Book and CD Coming soon: Sunshine Literacy Kit Room dividers team:

78 Pivotal Response Training Simple toys to support turn taking, requesting and functional play (ball poppers, marble runs, cause and effect toys) Play sets to facilitate imaginary play (shopping basket/food, playmobile sets) Books and Puzzles Board games Materials:

79 Advanced Workshop and Network Meetings April/May 2011 Will be held in same locations as initial workshops Focus on questions and training needs determined by the original teams post implementation Team network opportunities and participation in a facilitated discussion on future directions and training needs across the state.

80 SOESD Workshop Feedback 13 participants rated it a 5 = Outstanding (59%) 7 participants rated it a 4 = Excellent (32%) 2 participants rated it a 3 = Good (9%) Wow! This was amazing. It was great to come to this training as part of a team and walk away all ready to go for some real students. The district I came with has really been hit hard by budget cuts and has been unable to purchase anything. To go to this training with the very motivated and experienced teacher, her IA, and the SLP and leave with everything needed to set up the classroom for discrete trial, pivotal response and functional routines for kids it is wonderful. This experience has been so valuable for all of us. Thank you! (ASD Consultant, Douglas ESD)

81 Umatilla Morrow ESD Workshop Feedback 30 rated it a 5 = Outstanding (77%) 8 rated it a 4 = Excellent (20.5%) 1 rated it a 3 = Good (2.5%) This was great! What a super addition to the program. The PRT bin will be especially helpful. All autism teams across the state would benefit from a program set-up day. (ASD Specialist, Umatilla-Morrow ESD) Excellent presenters, great information! Each time I attended I learned more. More of this is needed, especially in rural areas (Speech Language Pathologist)

82 Linn Benton Workshop Feedback: 35 participants rated it a 5 = Outstanding (74%) 12 participants rated it a 4 = Excellent (26%) Thank you so much for including the materials we needed to get started right away in the classroom. Without them it would be very hard with the limited time we have to get everything together. They are a wonderful gift for our students. Thank you again. (anonymous) Loved having the 3 rd day to work with my team and pull it all together. The materials provided were helpful to get going Continue with the 3 rd day training. (anonymous)

83 Many Thanks The ATP Staff would like to give a special thanks to the following: all the workshop hosts for their help in arranging workshop locations, registration and other many details; all the participating teams for their enthusiasm and input during these workshops; The Oregon Department of Education for their ongoing support in providing evidence based practices to students with ASD across our state.

84 HOW TO OBTAIN TRAINING FOR YOUR STAFF? Oregon School districts can access ORPATS training by contacting their Regional Autism Coordinator. See the ORPATS website ( for contact information. Workshops are offered through the ORPATS grant. All districts are welcome to the workshops. See the training schedule on the ORPATS website. Autism Teams Project is on-going throughout the school year. Contact your Regional Autism Coordinator if interested in participating or see the training schedule on the ORPATS website. 84

85 Upcoming Oregon ORPATS/TEAMS Workshops Pre-School/Elementary/Middle School (Discrete Trial, Pivotal Response Training and Functional Routines) October 13th-14th, 2010 (Albany, OR) RPATS 2 Day Workshop - 8:30am-3:30pm Location: Linn-Benton-Lincoln ESD, Albany, OR Contact: Leslie Howard Leslie.Howard@lbesd.k12.or.us October 18th-20th, 2010 (High Desert ESD)** Contact: Katherine Procter October 21st-22nd, 2010 (Gresham SD) Contact: Kara Magee-Arick Kara_magee_arick@gbsd.gresham.k12.or.us October 27th-29th, 2010 (Northwest Regional ESD)** Contact: Karen Shepherd Upper Elementary, Middle and High School (Functional Curriculum Methods) October 27th, 2010 FACTER Workshop(Gresham SD) Contact: Kara Magee-Arick kara_magee_arick@gbsd.gresham.k12.or.us **These two workshops are open to others following the initial registration of the assigned Autism Teams. 85