What the DEC Recommended Practices Say About ASD: Suggestions for Interventionists

1. What the DEC Recommended Practices Say About ASD: Suggestions for Interventionists Ilene Schwartz Phil Strain Glen Dunlap

2. DEC Recommended Practices • Provide guidance about the most effective ways to improve learning outcomes and promote the development of children, birth – five • Highlight practices shown to result in better outcomes for children, families, and those who serve them • Research  practice

3. Framework • Using the DEC Recommended Practices as a guide, what policies & practices should be included in a comprehensive program for children with ASD? • Leadership • Assessment • Environment • Family • Instruction • Interaction • Teaming & Collaboration • Transition

4. Leadership • 14 practices • L7. Leaders develop, refine, and implement policies and procedures that create the conditions for practitioners to implement the DEC Recommended Practices.

5. Leadership • Good leaders are essential to implementing recommended practices and high quality programs • Leaders create and support environments in which practitioners can do their best work • Leaders create environments and implement policies and practices that retain and support practitioners

6. Assessment • 11 practices • A4. Practitioners conduct assessments that include all areas of development and behavior to learn about the child’s strengths, needs, preferences, and interests. • A9. Practitioners implement systematic ongoing assessment to identify learning targets, plan activities, and monitor the child’s progress to revise instruction as needed.

7. Environment • 7 practices • E3. Practitioners work with the family and other adults to modify and adapt the physical, social, and temporal environments to promote each child’s access to and participation in learning experiences.

8. Families • Three themes • Family centered practices • Family capacity building practices • Family and professional collaboration • Ten practices • F5. Practitioners support family functioning, promote family confidence and competence, and strengthen family-child relationships by acting in ways that recognize and build on family strengths and capacities. F5. Practitioners support family functioning, promote family confidence and competence, and strengthen family-child relationships by acting in ways that recognize and build on family strengths and capacities.

9. Instruction • 13 practices • INS6. Practitioners use systematic instructional strategies with fidelity to teach skills and to promote child engagement and learning. • INS7. Practitioners use explicit feedback and consequences to increase child engagement, play, and skills. • INS9. Practitioners use functional assessment and related prevention, promotion, and intervention strategies across environments to prevent and address challenging behavior.

10. Interaction • Five practices • Int 2. Practitioners promote the child’s social development by encouraging the child to initiate or sustain positive interactions with other children and adults during routines and activities through modeling, teaching, feedback, and/or other types of guided support. • Int 3. Practitioners promote the child’s communication development by observing, interpreting, responding contingently, and providing natural consequences to verbal and non-verbal communication and by using language to label and expand on the child’s requests, needs, preferences, or interests.

11. Teaming and Collaboration • Five practices • TC2. Practitioners and families work together as a team to systematically and regularly exchange expertise, knowledge, and information to build team capacity and jointly solve problems, plan, and implement interventions.

12. Transition • Two practices TR 2 -- Practitioners use a variety of planned and timely strategies with the child and family before, during, and after the transition to support successful adjustment and positive outcomes for both the child and family

13. What does this mean for children with ASD? • Programs need adults who can work together • Assessment must be thorough, on-going, include multiple domains, and influence instruction • Many instructional strategies can be used, data-based decision making is key • Social and communication behaviors are key • Environment modification can result in big changes • Transitions must be planned

14. These program elements yield best results for children with ASD when provided in the context of inclusive early education programs.

15. Myths About Inclusion • Too stimulating • Best for mildly involved • Harms “other’s” learning • Too costly • Compromises intensity response opportunities x fidelity of intervention delivered x social validity of goals x comprehensiveness of intervention x data-based decision-making = Quality Outcomes

16. When Does Inclusion Reap Possible Outcomes • Every day • All activities • Specially trained peers • Data tracking to make instructional decisions • Use of comprehensive curricula • Minimum of a 2:1 ratio

17. What Are the Mechanisms By Which Inclusive Settings Produce Positive Social Outcomes? Relationships and the: • “Cheers” effect increasing opportunities to respond/participate • Encouragement of life on the preschool edge • Attitudes of and Advocacy by peers (LEAP data) • Informal but powerful instructional episodes that occur among peers

18. So, The Only Clear Outcome Difference is Social… So What? • Best predictor of 3rd grade reading is having a friend when you are 3 • Preschool social relations also predict: • Continuing friendships • Longevity • Recovery from serious medical events • Employment status • Independent living • Adult mental wellness

19. Peer Mediated StrategiesLEAP’s Social Skills Curriculum • Getting Your Friends Attention • Sharing - “Giving Toys” • Sharing - “Requesting Toys” • Play Organizer • “You be the Mommy.” • Giving a Compliment • “I like your painting.”

20. Describe Skill Demonstrate the “Right Way” Demonstrate the “Wrong Way” Child Practice with Adult Child Practice with Child Set up Reinforcement System Social Skill Curriculum – Teaching the Skills

21. What Really Stands in the Way? • The way it is and professional inertia • Edifice complex • Equating quality with one-to-one, adult child ratios • Some places, the lack of available EC settings • Lack of oversight and lack of consequences for noncompliance • Lack of institutional reinforcers for compliance

22. Effective Instructional Strategies Critical Elements of Effective Educational Practice

23. Some Background • Effective instructional strategies for children with ASD are not different from effective instructional strategies for other children • However, effective instruction for some children with ASD requires more precision, care and attention to fidelity • Effective instructional strategies for young children with ASD are not different from effective instructional strategies for older children with ASD • However, attention must be paid to developmental characteristics (and thus curricular priorities) of young as opposed to older children

24. Elements of Effective Instruction for Children with ASD • Individualization of supports and services • Systematic instruction • Comprehensible and/or structured environments • Specialized curriculum content (emphasis on social interactions and language) • Functional approach to challenging behaviors • Family engagement

25. INS 6: Systematic Instruction “Practitioners use systematic instructional strategies with fidelity to teach skills and promote child engagement and learning” • Careful planning and goal setting • Careful planning of instructional procedures • Careful data collection • Careful implementation with fidelity • Careful, ongoing evaluation (progress monitoring) and adjustment of instructional plan as necessary

26. Instructional Procedures • Defining instructional target • Antecedents ---- specifying the contextual and antecedents under which target behavior should occur • Behavior ---- determining how the behavior will occur (e.g., prompting) • Consequences ---- specifying what consequences (e.g., reinforcers) will follow the behavior in order to make the behavior more likely to occur in the future

27. Instructional Procedures • Well-established evidence-based procedures, such as: • Functional communication training • Peer-meditated instruction • Incidental teaching And comprehensive programs, such as: • Pivotal Response Training • EIBI (“Lovaas” etc.)

28. INS 7: Explicit Feedback and Consequences “Practitioners use explicit feedback and consequences to increase child engagement, play and skills” • The most fundamental and the most important principle in all education and all learning is the principle of Positive Reinforcement

29. A Big Rule • Positive reinforcement is NOT positive reinforcement if it does not serve to strengthen (increase) behavior. • It is desirable for positive reinforcement to occur as naturally as possible, but positive reinforcement is not positive reinforcement if it does not serve to strengthen (increase) behavior.

30. Considerations • If you wish to implement effective instruction, you must be able to deliver a positive reinforcer contingently • If you are unsure, you can identify positive reinforcers through preference (or reinforcer) assessments • If your intervention plan is unsuccessful, the first place to look for a reason is the contingency • Is the reinforcer really a reinforcer? • Is it being used contingently? • Are there competing reinforcers?

31. INS 9: Functional Assessment and Positive Behavior Support “Practitioners use functional assessment and related prevention, promotion and intervention strategies across environments to prevent and address challenging behavior” • Functional assessment (or FBA) = a process for identifying the function (purpose) of the challenging behavior and events in the environment that govern the behavior’s occurrence • Function-based interventions rely on a functional assessment to identify components (strategies) of a behavior support plan (positive behavior support)

32. FA and PBS • Establish a team (caregivers, family, professionals, etc.) and agree on specific definitions and goals related to challenging behavior (to reduce) and social-communicative behaviors (to increase) • Design and implement feasible and valid data collection • Conduct functional assessment to identify functions of challenging behavior and contextual/antecedent influences • Design and implement a function-based behavior intervention plan • Monitor progress and modify plan as necessary

33. And…. • Behavior intervention plans work best if they: • include multiple components ---- antecedent manipulations, instructional strategies, and effective consequences • Include active participation of family members • Are implemented with commitment and investment of all team members