Ilene Schwartz, Ph.D., BCBA-D University of Washington

Transcription

1 Ilene Schwartz, Ph.D., BCBA-D University of Washington

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5 Autism is the Fastest-Growing Developmental Disability More common than pediatric cancer, diabetes and AIDS combined Autism increased 172% during the 1990 s Prevalence rate of 1 in 88 births Currently 1 to 1.5 million Americans have autism (Centers for Disease Control and Prevention, 2007, 2009, 2012)

6 Clinical Diagnosis of Autism Spectrum Disorder (ASD) DSM IV criteria, used by qualified personnel, includes impairments in the following areas: Social interaction Communication Restricted/Repetitive patterns of behavior, interests, activities Symptoms are present before 3 years of age

7 Autism Spectrum Disorders Autism affects how a child plays, learns, communicates and behaves. Early behavioral warning signs of autism include: No back and forth sharing of sounds, smiles, facial expressions (by 6 months) No big smiles or warm joyful expressions directed to another person (by 9 months and beyond) No babbling by 12 months No back and forth gestures such as pointing, showing, reaching, waving (by 12 months)

8 Children with ASD require Instruction to be more explicit Reinforcement to be more explicit and perhaps extrinsic to start More opportunities to practice with feedback Planned instruction to facilitate generalization

9 Preschool students with autism: Are children first Have diverse strengths and needs Most often need explicit instruction across curricular domains May be gifted academically or have mental retardation Will need specialized instruction in social skills and communication

10 Components of an Effective Program (Dawson & Osterling, 1997) Appropriate curriculum including attending, imitation, communication, play, and social interaction. Highly supportive teaching environment and generalization strategies. Predictability and routine. Functional approach to challenging behavior. Transition support Family involvement

11 Educating Children with Autism National Research Council, 2001 Report was developed at OSEP s request

12 Characteristics of Effective Programs Entry into program as soon as ASD is seriously considered Active programming 25 hours a week, year round Small group and 1:1 programming Family component Low student/teacher ratios (no more than 2 children with ASD per adult in classroom Program evaluation and assessment

13 Content of Programs should include Social skills Expressive, receptive, and non verbal communication skills Functional communication system Engagement and flexibility in developmentally appropriate activities Fine and gross motor skills

14 Content (continued) Cognitive skills, including play Replacement of problem behaviors with socially acceptable alternatives Independent organizational skills and other behaviors that support participation in general education settings

15 DATA Project Developmentally Appropriate Treatment for Autism We are in our 15th continuous year of operation Currently funded by local school district and fund raising

16 Project DATA was born Initially funded by an OSEP model demonstration grant The goal was and continues to be blending approaches to meet individual needs The blended approaches were ABA, ECSE, and ECE

17 Project DATA Extended, Intensive Instruction Technical and Social Support for Families Integrated Early Childhood Experience Collaboration and Coordination Quality of Life Influenced Curriculum

18 Forest Plot of IQ Effect Sizes for EIBI Studies

19 National Autism Center (2010) Evidence Guidelines Established Emerging Unestablished Ineffective/Harmful

20 Established Treatments Antecedent Package Behavioral Package Comprehensive Behavioral Treatment for Young Children Joint Attention Intervention Modeling Naturalistic Teaching Strategies Peer Training Package Pivotal Response Treatment Schedules Self Management Story-Based Intervention Package

21 Emerging Treatments AAC Cognitive Behavioral Intervention Developmental Relationship-based Interventions Exercise Exposure Package Imitation-based interaction Initiation Training Language Training

22 Emerging (continued) Massage/touch therapy Multi-component package Music therapy Peer mediated instructional arrangement PECS Reductive Package Scriping

23 Emerging (continued) Sign Instruction Social communication intervention Social skills package Structured teaching Technology based treatment Theory of Mind training

24 University of North Carolina

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26 What do all have in common? Intensity Fidelity Well trained staff Comprehensive curriculum Individualization Theoretical Integrity Data Data Data

27 What about the data? Data must be collected regularly on all active goals/objectives In inclusive classrooms, data once a week for all objectives In extended day or segregated special education classrooms, daily data Data must be used to evaluate progress Data-based decision making

28 What are the big issues How do we provide (and pay for) services? Currently, children 0-3 receive 1.5 hours a week of services, NRC recommends 25. Most preschool programs provide 10 a week of services, NRC recommends 25.

29 How do we determine what services should be provided? Do we pay for research or intervention? What types of research methods should we use? What is evidence?

30 What do effective services look like for families from culturally and linguistically diverse families? Language of intervention Location of intervention Parent-child interaction

31 Questions?