Team Based Learning: Decision Making Across the Educational Lifespan for Children with Autism

1. Team Based Learning: Decision Making Across the Educational Lifespan for Children with Autism Tammy Blake, OTD, OTR/L Connie Johnson, PT, DscPT Patricia Laverdure, OTD, OTR/L, BCP Deborah Rose, PT, DPT March 9, 2019

2. Objectives • Develop knowledge and skills that enable OT and PT practitioners to engage their school teams’ collective knowledge and expertise, provide evidence of best practices, and interpret policy and legislative mandates to problem-solve and make clinical decisions for students with autism and their families across the lifespan • Analyze influencing factors that impact a student’s educational experience • Discuss best practices in designing evaluation and choosing evidence based assessments and outcome measures across a student’s educational experience   • Establish collaborative tools develop intervention plans and strategies to optimize performance, health, wellness and/or quality of life.

3. Analyze Influencing Factors: International Classification of Function Model

4. Analyze Influencing Factors: Common Language

5. Clear Decision Making Processes • Support implementation of effective evidence based interventions • Overcome implementation barriers • Facilitate data based decision making (US Department of Education, 2016)

6. Collaborative Decision Making Process

7. Gather Data • What are the student’s, family’s, and school team’s concerns about his/her participation in the learning environment? IDEA and ESSA ~ Relevant and functional data across school environments ~ Data must come from multiple sources ~ Data must point to functional outcomes

8. Identify Strengths and Challenges • Given what is known about the student’s diagnostic, developmental, and contextual factors that influence participation, consider the influences that might be impacting the student’s participation. IDEA and ESSA ~ Address function and participation in the classroom OT PT Guidelines ~ What does student want and need to do to actively and meaningfully participate

9. Evaluation • Authentic evaluation • Natural contexts and environments • Natural activities IDEA and ESSA ~ Address all areas of suspected disability ~ Evaluate skills that “directly assists” in determining educational needs ~ Use a variety of strategies

10. Strengths vs. Impairment Based Approach Strengths Impairment Focus on disability rather than curricular demands, context, environment, and teacher expectation Focus on deficit rather than participation Leads to remedial approach Limits generalization of skill • Identifies environmental supports and constraints • Identifies gaps between student performance and supports • Identifies internal and external assets, competencies, and resources • Engages student’s motivation improving goal attainment, satisfaction, and QOL.

11. Strengths vs. Impairment Based Approach Strengths Impairment Focus on disability rather than curricular demands, context, environment, and teacher expectation Focus on deficit rather than participation Leads to remedial approach Limits generalization of skill • Identifies environmental supports and constraints • Identifies gaps between student performance and supports • Identifies internal and external assets, competencies, and resources • Engages student’s motivation improving goal attainment, satisfaction, and QOL.

12. Assessment IDEA and ESSA ~ Test scores do not always paint the full picture ~ Scores do not “qualify” a student for services ~ Must provide a clear baseline • Select tests and measures that avoid discrimination and bias (language, racial or cultural characteristics) • Reflective of the student’s aptitude, achievement

13. Autism What it is and what it’s not

14. What is Autism? Health Condition Autism Activities Completing in tasks in isolation; Restrictive, repetitive and stereotyped routines Participation Limitations in social participation and activities school, home and community settings Body Function/Structure Decreased sensory processing, strength, coordination, motor planning, balance, mobility Personal Factors Limitation and restrictions in emotional regulation, volition, interests, task initiation, self-determination Environmental Factors May require accommodation for access curriculum, work sites, social environments

15. Costs of Autism Spectrum Disorders in the United Kingdom and the United States (Beauscher, 2014)

16. Assessment Toolbox

17. Team Based Learning Activity • Everyone’s perspective is important. • Choose the best answer of the multiple choice questions. • Decision making entails consideration of environmental and personal factors that vary greatly. • Consider each answer and select the one you feel provides the best overall answer. • Give reasons for your decisions, perhaps used to defend your decision making in an IEP, evaluation, staffing with team members. • Consider, in your decision-making process, evidence based decision making, and implicit and explicit reasoning.

18. Identify Goals and Outcome Measures • Focus shifts from impairment to participation • Identify participation of meaning for the child, teacher and caregivers • Describe participation in terms of engagement and the supports that enhance it and the barriers that inhibit it • Describe the interaction between the supports and the barriers and its impact on meaningful and desired participation • Prioritize successful and inhibited participation IDEA and ESSA ~ Goals based on clear baseline data ~ Identify the impact of interventions ~ Inform decision making

19. Data Collection • Ongoing • Explicit • Visual IDEA and ESSA ~ Enables ongoing progress measurement ~ Enables appropriate trajectory changes when necessary

20. (Srinivasan, Pescatello, & Bhat, 2014)

21. References • Beauscher, 2014 • Johns Hopkins the Hub • Sudha M. Srinivasan, Linda S. Pescatello, Anjana N. Bhat; Current Perspectives on Physical Activity and Exercise Recommendations for Children and Adolescents With Autism Spectrum Disorders, Physical Therapy, Volume 94, Issue 6, 1 June 2014, Pages 875–889, https://doi.org/10.2522/ptj.20130157 • Srinivasan, S., Pescatello, L., & Bhat, A. (2014). Current perspectives on physical activity and exercise recommendations for children and adolescents with autism spectrum disorders. Physical Therapy, 94(6), 875-889. • US Department of Education, 2016