Gentle Teaching Evaluation Network G-TEN

1. Gentle Teaching Evaluation NetworkG-TEN International Alliance to Produce Evidence – Simple Yet Scientific James W. Conroy, Ph.D. The Center for Outcome Analysis www.eoutcome.org

2. Outline • Purpose • Why Measure and Measure What? • Paradigms and Resistance • The Scientific Literature – Paradigm War • Things are Changing, Especially in the Americas • Now is a Very Good Time to Seek Evidence in a Cooperative International Venture • Dimensions We Must Measure • Interactions, Qualities of Life (including feeling safe and loved), Behavior, Person-Centeredness • How to Move Forward: Pilot Studies, Home, Funding, Nations, Studies COA September 2007

3. Purpose • Today – to share our thinking about how to get new, reliable, valid scientific evidence • Aiming toward publishing studies • And obtaining serious funding from USA organizations – government and foundations • GTEN – what is our best strategy toward production of good evidence across our nations? COA September 2007

4. Why Seek Evidence? • We have a common belief in Gentle Teaching • We all hope that it will spread, and negative approaches and aversives will end • We will need more evidence to bring the skeptics and the “undecideds” along • Yet we must overcome powerful past rejection by behavioral scientists • GTEN – is there hope of achieving this? COA September 2007

5. The Controversy in the “Scientific” Literature, 1980s and 1990s • Why all the resistance, skepticism? • Because GT threatens established thinking and funding? • Look at this title from one of the critics: • Bailey, J.S. (1992) Gentle teaching: trying to win friends and influence people with euphemism, metaphor, smoke, and mirrors. J Appl Behav Anal. 1992 Winter; 25(4): 879–883. COA September 2007

6. The Controversy in the “Scientific” Literature, 1980s and 1990s • McGee, J. J., Menolascino, F. J., Hobbs, D. C., & Menousek, P. E. (1987). Gentle teaching: A non-aversive approach to helping persons with mental retardation. New York: Human Sciences Press. • McGee, J. J., & Gonzalez, L. (1990). Gentle teaching and the practice of human interdependence: A preliminary group study of 15 persons with severe behavioral disorders and their caregivers. In A. C. Repp & N. N. Singh (Eds.), Perspectives on the use of nonaversive and aversive interventions for persons with developmental disabilities (pp. 237-254). Sycamore, IL: Sycamore. • Caregiver’s Interactional Observation System (CIOS) and the Person’s Interactional Observation System (PIOS) COA September 2007

7. 1989 JABA • J Jordan, N N Singh, and A C Repp (1989). An evaluation of gentle teaching and visual screening in the reduction of stereotypy. J Appl Behav Anal. 1989 Spring; 22(1): 9–22. • Extremely complex behavioral research design with just 3 “subjects” • “…gentle teaching was found to be more effective than task training for 2 subjects but less effective for the 3rd “ • Published anyway – because their Discussion conclusions were negative about GT • Footnote on Singh – Therapy Malls in big institutions and DOJ witness history COA September 2007

8. 1992 Review of the Controversy • A J Cuvo (1992). Gentle teaching: on the one hand ... but on the other hand. J Appl Behav Anal. 1992 Winter; 25(4): 873–877. • Perhaps the most balanced review of the early controversy. • This would be worthwhile reading because it explains the harshness of the attacks on GT. COA September 2007

9. Most Recently, 2003: • Polirstok, Susan Rovet EdD; Dana, Lawrence PhD; Buono, Serafino Dot.; Mongelli, Vita Dottssa.; Trubia, Grazia Dottssa. Improving Functional Communication Skills in Adolescents and Young Adults with Severe Autism Using Gentle Teaching and Positive Approaches. Topics in Language Disorders. 23(2):146-153, April/May/June 2003. • Described positive findings, both for individuals and workers. • Working with 18 young people in Sicily. COA September 2007

10. More Recent Rigorous Study in England • Cullen C. & Mappin R. (1998). An examination of the effects of gentle teaching on people with complex learning disabilities and challenging behaviour. Br J Clin Psychol. 1998 May;37 ( Pt 2):199-211. • 13 students, 7 staff observed • 13 weeks “pre” and 23 weeks “post” • 45 hours direct observational data on handheld computers, 75 hours of video • “Wherever there were differences between gentle teaching and IEP these were in favour of gentle teaching, although they were generally relatively minor in terms of clinical (rather than statistical) significance.” NOTE the disclaimer • Conclusions: all effects of GT unimportant, may be “useful adjunct” • But who did the training, and how was it reinforced? COA September 2007

11. Scientific Revolutions • Thomas Kuhn’s “The Structure of Scientific Revolution” 1963 • The source of the phrase “Paradigm Shift” • When the prevailing “model” or “paradigm” fails to explain something – an anomaly • Sometimes a new worldview is required • But there will be powerful resistance • The thinking which was the cause of our success in the past often becomes the reason for our failure in the future.” - Einstein COA September 2007

12. Current paradigm does not “work” for some observations – anomaly and crisis. Not all in the community will care about anomaly – too comfortable The proponents of the “new” are reviled, criticized, distrusted – Threat! Competing camps form a. One camp seeks to defend the old institutional constellation. b. One (or more) camps seek to institute a new paradigm Polarization: civil scientific discourse fails – Demonization, stridency, desperate defense – paradigm wars Circular arguments - Each group uses its own paradigm to defend its paradigm – circular discussions Finally, the new does replace the old, and the guardians of the old “suddenly” embrace the new as though they had thought of it themselves Gentle Teaching has been immersed in a paradigm war But this paradigm shows every sign of success – allies have sprung up – we will live to see it become the established belief system To speed this up, evidence developed within the scientific method will help COA September 2007

13. Is the Paradigm Changing At Last? • There’s reason to believe so • Look at the insurgencies into the bastions of resistance • Look at the organizations that have embraced positive approaches (not the same thing but emerged from GT thinking) e.g. Herb Lovett • Look at the rise of aversive regulations, concerns, surveys, government requirements COA September 2007

14. Even the ABA (Association for Behavioral Analysis)….. • Now has a Special Interest Group, the PBS • ABA International Newsletter • Volume 29 | 2006 | Number 2 • Positive Behavior Supports • The Positive Behavior Support (PBS) SIG addresses the interests of members engaged in experimental and applied analyses of behavior who are proponents of positive behavior support. Established in January 2005, the goals of the SIG are to promote and disseminate positive behavior support within ABA, and to ensure that PBS is aligned with the science of behavior. COA September 2007

15. PBS - SIG • The PBS SIG currently has approximately 40 formal members….electronic listserv with over 70 recipients, many of whom belong to both ABA and the Association for Positive Behavior Support (APBS). • Goals of the PBS SIG are to: • Increase the number and visibility of PBS presentations at the ABA convention • Disseminate accurate information about PBS to ABA’s membership • Promote methodologically sound, data-based PBS research • Encourage open dialogue among behavior analysts and proponents of PBS • www.pbsaba.org • www.pbsaba.org/newsletter COA September 2007

16. Association for Positive Behavioral Support, APBS.org • http://www.apbs.org/main.htm • Affiliated with TASH • TASH has 20 years of commitment to positive approaches • Should GTI interact with the new emerging groups with similar values? • Or should GTI simply be aware that the world is changing toward our values? COA September 2007

17. USA – Nationwide AwarenessIs Finally Emerging • Aversives Survey3.pdf COA September 2007

18. Old – Behaviorism Mechanistic Ghost in the machine We can shape any person’s behavior All means are fair, if justified by ends New – GT & Positive Humanistic Presumes humanity We can make a real connection with any person The process is often as important, sometimes more important, than the outcomes Old Paradigm, New Paradigm COA September 2007

19. Dual Dimensions of Measurement COA September 2007

20. Simple Rating Scale:The Person Being Supported COA September 2007

21. Simple Rating Scale:The Caregivers COA September 2007

22. Input, Process, and Outcomes Input Effort, Resources, Time, Emotional Investment, Hope Process Safe, Loving, Positive, Supportive, Persistent, Patient Outcomes Relationships, Qualities of Life, Behavior Change Measure GT Here? (Or is GT Here?) Feedback After Success/Failure COA September 2007

23. We Have Good Measures for the Collateral Outcomes • Control of one’s own life (DCI) • Person-centered planning (EPP) • Qualities of life (QOL Then & Now) • Family perceptions of quality life and service • Qualities of work life for the caregivers (QOWL) • If we can get decent measures of Safe and Loved from both perspectives, these other outcomes will make a very strong case. COA September 2007

24. Paradigm Shift – What It’s Like • What Animal is This? • Duck? Or Rabbit? The switch is what a Paradigm Shift feels like. COA September 2007

25. I’ve Already Seen…. • Two and a half paradigm shifts • I came in at the end of the Medical Model in 1970 • I witnessed and studied the decline of belief in a need for segregation – deinstitutionalization • I took part in the self-determination movement from its inception, studying and demonstrating • And now the largest system of grants ever given from the USA’s major funding source, “Money Follows the Person,” $500 million, is aimed at individual control of resources (SD) in community settings. • I believe that the time of GT’s ascension is coming fast. COA September 2007

26. We Are Going to Live to See it Happen • The signs are clear • Our task is to gently develop and offer the evidence • People have begun to want to believe • Gentle nudges and good solid science are all that’s needed • Our international cooperation via GTEN will be very important – and FUN! COA September 2007

27. We Need Partners • This idea is now a year old • We’ve been studying and thinking • Siddhartha’s motto: • I can think, I can wait, I can fast • I think the time is right to move forward with real data, real pilot studies, and plans for large-scale evaluative research. • Cross-nations: GTEN COA September 2007

28. Comments and Ideas • All ideas welcome • Testers of these instruments needed • Critiques needed • Thank you for your attention and for the honor of appearing before you at this conference COA September 2007

29. COA September 2007

30. Perceived Qualities of Life:“Before S-D and Now” COA September 2007

31. How “Person-Centered” is the Planning Process? COA September 2007

32. How Many Friends? COA September 2007

33. Who Are YourClosest Friends? COA September 2007

34. COA September 2007