Using Systematic Instruction to Teach Daily Living Skills.

1. Using Systematic Instruction to Teach Daily Living Skills.  Karena Cooper-Duffy, PhD Trish Davis, MS, CCC-SLP Western Carolina University Autism Botswana 6/8/18

2. Agenda • Understanding learners with autism • Identifying functional skills • Systematic instruction strategies • Practicing systematic instruction

3. Definitions of autism • The Autism Society of America defines autism spectrum disorder as a complex developmental disability that usually appears during the first 3 years of life and is the result of a neurological disorder that affects the normal functioning of the brain. Mirenda and Iacono (2009)describe three primary symptoms of ASD as • (1) significant difficulties with social interactions, • (2)Delayed or abnormal functioning in verbal and nonverbal communication • (3) unusual patterns of behavior. • The general ability to maintain oneself independently in typical life environments is reduced. • Assistance and on going support is needed.

4. Learning Characteristics • Attention to Stimuli • Observational and Incidental learning • Memory • Skill synthesis • Generalization • Self-regulation

5. Think about a person you work with who has autism.

6. McGill Action Planning System • What is the person’s history? • What is the dream for the person? • What is your nightmare for the person? • Who is the individual? • What are the person’s strengths, gifts, and abilities? • What are the individual’s needs? • What would the person’s ideal day at school look like and what must be done to make it happen?

7. For the person you identified describe their…. Strengths Needs Likes Dislikes

8. Types of skills to teach • Simple discrete behaviors • Continuous-Ongoing behaviors • Complex-Chained behaviors • Functional routines • Point to a picture, id weather words, use switch to turn page, blink yes/no response, greet, • Eating, mopping, polishing, writing D, clap to a beat, exercises, stirring, sing days of week, counting repetitions • Complete steps to locate a web page, follow picture directions to cook, print a page from computer, dial phone #, set the table • Arrival, departure, lunchtime

9. What functional skills would you like to teach your student? • Functional skills are any skill that you will need to do for the student if they cannot do it for themselves.

10. Systematic instruction is • A repeatable, predictable, organized process which reflects currently accepted best practices using performance data to make educated modifications to instruction (Snell, 2015). • Systematic instruction is a process for teaching that has long been used with students with severe disabilities. Its major components include clearly identifying learning targets as behavioral objectives; breaking these objectives into their components through a task analysis: using prompts, reinforcement, and error correction to facilitate learning; and collecting and recording performance data to monitor learning progress ( Westling, Fox & Carter, 2015)

11. Create complete instructional objectives. • Who the learner is • What the person is doing • Under what conditions • How often or long the behavior should occur • What is the criteria? • (Westling & Fox, 2015)

12. Examples • Joe will put his jacket on before going out to play with 80% accuracy 3 times a week. • Within 5 minutes after eating, Sam will wash her dishes with 90% accuracy. • Jake will hold his mouth open during tooth brushing for 1 minute while the teacher brushes his teeth.

13. Learning

14. Phases of learning • Acquisition • Fluency • Maintenance • Generalization

15. Instructional Prompts • Any teacher behaviors that cause the student to know how to do a behavior correctly. • Teacher behaviors presented to increase the probability of correct responding

16. Instructional Prompts (clues, cues or prompts) • Gesture Prompts • Verbal prompts • Specific verbal prompts • Nonspecific verbal prompts • Prerecorded auditory prompts • Pictorial visual prompts • Words, symbols, signs • Match to sample • Model prompts • Physical prompts • Partial & full • Mixed Prompts • Hop on • Nonverbal prompts -pointing, head nods, hand motions • Read the word restroom, pick up the stamper • What do you need to do next? • Using an Ipod, app, cell phone with prerecord instructions. Video of how to do skill • Picture schedule of the events of the day • Picture and word instruction for a task. • Six birds = the number 6 • A peer can demonstrate turning a page or using a computer to locate a website. • Hand over hand assistance writing the first letter of the students name • Tapping the students elbow to make a choice of 2 lunch foods.

17. National Autism Center (2009) list the following behavioral interventions as effective. • Antecedent interventions • Live or video modeling • Naturalist teaching strategy- stimulating environment, modeling how to play, encouraging conversation, providing choices, and natural reinforcers. • Peer teaching • Visual scheduled – words, pictures, photographs, schedules, that communicate a specific set of steps to complete a task. • Self-management • Social stories – written descriptions of the situation in which specific behaviors are expected to occur.

19. What are some of the prompts you could use with your student?

20. Prompts or Stimuli • Target Stimuli – is the discriminative stimulus that is expected to ultimately control the occurrence of the behavior. (natural cue) • Controlling stimuli – is is one that controls the student’s responsiveness to the target stimulus given the student’s current skills or ability level. • The stimuli the student can respond to; paired with the target stimuli.

21. Prompts need to be faded!!

22. Systematic instruction strategies • Constant Time Delay • System of Least Prompts • Graduated guidance

24. Constant Time Delay • Usually used with simple discrete behaviors. • Errorless learning with one prompt given over and over. • Zero delay - The teacher offers a cue and immediately gives the response to teach the child the correct response. The teacher reinforces the child’s correct response. • 5 second delay- After several trials the teacher offers the initial cue and waits 5 seconds for the child to give the correct response. Praise is then given for the correct response.

25. How to use Constant Time Delay • The teacher identifies the skill to teach, the cue (1) and the motivators. • Teacher provides an attention cue- “Lets get ready to read.” attention cue • Then a task direction – “Read the card” (target stimulus). Immediately the teacher reads the word and the student repeats the word (controlling stimulus). The teacher praises the student. This is repeated for 5 -10 instructional sessions. (zero delay) Several days of practice. • After several days at zero delay. The task direction is given (target stimulus), the teacher waits 5 sections for the student to respond. If no response after 5 seconds then the controlling prompt is used. The student gives the correct response the teacher offers praise. Data is recorded. • If an incorrect response is given the teacher returns to the zero delay condition. Data is recorded.

26. Demonstration

28. Which of the skills did you select for your learner that could be taught with time delay? Which prompt would you use?

29. SYSTEMATIC INSTRUCTION PLAN (SIP) Student: __Paul ____ Date Plan Started:_ Aug 21, 2010______ Target skill:__Painting__________ Routine:_Leisure___________ Specific Objective ___Paul will paint objects using a variety of paint brushes during art class and leisure time for the semester with 60 % accuracy for 2 out of 4 sessions. Format Materials: _3 different size paintbrushes, paint, water, napkin, objects, and table Setting and Schedule for Instruction: MWF, leisure class 9:00- 9:30, and T 10:00 in art Teacher and location Ms. Duffy, Mr. Gull art teacher and 2 different assistant teachers, and Fred his friend. Instructional Procedure PROMPTING Specific Prompt or prompts to Be Used (List in sequence): physical/Specific verbal Type of Prompt System (Check which applies) System of Least Prompts X Time Delay __X____ Constant OR _______Progressive Most to Least intrusive prompts ______ Graduated guidance _____ Stimulus Fading or Shaping ______ Chaining _______ Backward OR ______ Forward Other (Describe):_____________________________________________ Fading Schedule 5 second delay_ FEEDBACK Correct Responses: Super, spreading the paint! Fading schedule for praise Only praise difficult steps Error Correction : Full physical prompting of the missed step Generalization & Maintenance Plan 3 different size brushes and paint colors, different objects to paint, and 4 different people to teach the skill in 2 different classes.

31. System of Least Prompts is • used with a task analysis or a chain of behaviors (e.g. brushing teeth, making a bed) • a hierarchy of prompts are used on each step of the task analysis (g, v, m, p) until the learner makes the needed response. • always give the learner an opportunity to make the correct response before any prompting on each step of the task analysis. • Used with natural cues located in the naturally occurring next step of the task analysis.

32. Using the least intrusive prompt first and progress to more intrusive prompts until the learner responds. No more than 3 –4 prompts in the hierarchy. • Encourage the learner after correct and independent responses. • Decrease praise as the learner responds to the natural cues. • Three to five second delay between prompts.

33. How to teach least prompts • The teacher creates a task analysis for the skill. Also the teacher identifies the prompt hierarchy (controlling stimulus) to be used for instruction and some motivators. • The teacher gives the natural cue (target stimulus) to start the lesson – Lets read our schedule book. • The teacher goes to step one of the task and waits 3-5 seconds for the student to complete the first step. If the student does not complete step one after 5 seconds, the teacher will prompt with the first level of prompting. If the student does not respond the teacher uses the second level of prompting. This continues until all the levels of prompting have been used and the student completes the step. This process is repeated for the remaining steps of the task analysis. • If the student performs the step of the task analysis with no prompting lots of praise is given and the next step is prompted. • If the student makes an error the most intrusive level of prompting is used to correct the student on the step.

34. Demonstration

35. SYSTEMATIC INSTRUCTION PLAN (SIP) Student: __Paul ____ Date Plan Started:_ Aug 21, 2010______ Target skill:__Painting__________ Routine:_Leisure___________ Specific Objective ___Paul will paint objects using a variety of paintbrushes during art class and leisure time for the semester with 60 % accuracy for 2 out of 4 sessions. Format Materials: _3 different size paintbrushes, paint, water, napkin, objects, and table Setting and Schedule for Instruction: MWF, leisure class 9:00- 9:30, and T 10:00 in art Teacher and location Ms. Duffy, Mr. Gull art teacher and 2 different assistant teachers, and Fred his friend. Instructional Procedure PROMPTING Specific Prompt or prompts to Be Used (List in sequence): Indep opportunity 2.gesture 3. Specific verbal 4. Full physical Type of Prompt System (Check which applies) X System of Least Prompts Time Delay ______ Constant OR _______Progressive Most to Least intrusive prompts ______ Graduated guidance _X____ Stimulus Fading or Shaping ______ Chaining _______ Backward OR ______ Forward Other (Describe):_____________________________________________ Fading Schedule 3 – 5 second delay_ FEEDBACK Correct Responses: Super, picking up the brush! Fading schedule for praise Only praise difficult steps Error Correction : Full physical prompting of the missed step Generalization & Maintenance Plan 3 different size brushes and paint colors, different objects to paint, and 4 different people to teach the skill in 2 different classes.

37. Select one of the skills you identified for your student that is a chain of behaviors. • Select 3 prompts that can be used to teach this skill. • Select a way to motive this student to participate.

38. Graduated guidance • Instructional approach used with continuous behaviors, discrete behaviors or chained behaviors. (eating, walking, • Used to teach students with severe physical disabilities. • Uses very intrusive prompting until the learner begins to initiate or demonstrate independent responses.

39. How to implement graduated guidance • The teacher identifies the skill to teach and the type of prompting to be used. The prompting needs to be a most to least intrusive prompt hierarchy ( Full physical, partial physical and gesture/verbal). • The student is given full physical assistance on the skill using hand over hand until the student begins to make the movements themselves. As the student begins to make the correct movements the teacher decreases assistance by offering partial physical assistance at the wrist. As the student continues making the correct response the teacher will only offer partial assistance at the elbow and finally only assistance with a verbal/gesture prompt.

40. Demonstration

41. Select a continuous behavior that can be taught with graduated guidance. • Select a motivator.

44. References Browder, D. (2001). Curriculum and Assessment for Students with Moderate and Severe Disabilities. New York: Guilford Press. Browder, D.  & Spooner, F. ( 2011). Teaching Students with Moderate to Severe Disabilities. New York, NY., Guilford Press.  Mirenda, P., & Iacono, T. (2009). Autism spectrum disorders and ACC. Baltimore: Brooks. Snell, M. (2015). Instruction of Students with Severe Disabilities. New York: Merrill. Westling, D., Fox, L. & Carter, E. (2015). Teaching Students with Severe Disabilities. Upper Saddle River: Pearson/ Merrill Prentice Hall