START EBP Summer Institute 2011

1. START EBP Summer Institute 2011 WELCOME

2. Agenda Day One • Setting the “stage” • Spotlighting evidence based practice • Act I: Horizon Elementary • Act II: Clawson Middle School Day Two • Act III: Holt High School • A script for implementing EBP • Practice with your crew

3. The START EBP Implementation Project… is the culmination of many years of work supporting the implementation of evidence based practices in schools along with the recent collaborative partnership project with the National Professional Development Center on Autism Spectrum Disorders from 2009-2011. Our aim is to train and support school building teams to create student IEP goals that best reflect the needs of the student and match those goals to evidence based practices that will help the students and team meet those goals.

5. How do families and professionals learn about practices for individuals with ASD

6. Families & professionals are seeking information about autism treatment • If you type in the words “autism and treatment” in Google you get: 17,800,000 results in .09 seconds

7. We have warnings for many things in our society

10. But there is not a good warning system to let families and professionals know when intervention practices that haven’t been thoroughly studied are being promoted Elephant Therapy!

11. Currently not enough evidence… • Injection of immunological substances • Vitamin therapy • Hormone therapy • Facilitated communication • Biofeedback • Hyperbaric oxygen chamber therapy • Auditory integration • Massage of the scalp • Prism lenses • Complex rhythmic drumming • Electromagnetic therapy • Holding therapy • Dolphin therapy

12. When families seek treatment for a child diagnosed with cancer or diabetes, they aren’t given a long list of interventions that someone somewhere believes to be effective, and told to choose from that list on their own; they can usually expect to be informed about treatments that are based on sound scientific research. Why do we settle for less when the diagnosis is ASD? Retrieved from asatonline.org (2011)

13. So many treatments, so much information

14. Problem: People may want to “try everything” • A “try everything” mindset leads one to believe that treatment of autism is based upon the quantity of interventions, as opposed to the quality of interventions • Celiberti et al., The Road Less Traveled: Charting a Clear Course for Autism Treatment (http://www.researchautism.org/uploads/roadless.pdf ) (p. 5)

15. Problem:Choosing non-evidence based interventions • Primum non nocere: FIRST DO NO HARM • Example: Facilitated Communication – Potentially Harmful Therapy • Lilienfeld, S. (2007). Psychological treatments that cause harm. Perspectives on Psychological Science, 2, 53-70.

16. Problem:Choosing non-evidence based interventions • Time, money, energy that is NOT directed toward evidence-based intervention

17. Solution • Teach people to be good consumers of information through understanding the scientific process… yes, really. • Teach people to collect data in a rigorous way and control for confounding variables. • If you don’t partner with families and providers, they will proceed without you. Its better to work with them (S. Harris, years ago)

18. Understanding and Using Evidence Based Practices

19. What are EBPs all about? All students in public education should have access to scientifically based practices (NCLB, 2001).

20. What is scientifically based research? You must have reliable evidence that a program or practice works. NCLB requires experimental studies that are similar to the medical model of research used by scientists. These studies require many steps to prove strong evidence of effectiveness. • Well designed studies that use random samples of the population • Trials must also include a random “control group” for comparison • Valid and reliable outcome measures • Data on long-term outcomes • Trials in more than one site of implementation

21. Using EBPs in Schools • What are examples of universal EBP practices for all students? • Behavioral expectations • Evidence based approaches to teaching reading • What is the environmental context for all students attending school? • General education curriculum, instruction, social interaction, transitions

22. 23 3-Tiered Model of Support Few Some Universal EBPs TIER 1 All

23. When to Use EBPs Specific to Students with ASD Specific EBPs for students with ASD are deficit driven and based on the student’s lack of progress. Deficits and lack of progress become IEP goals. Students aren’t making progress in… • Academic learning • Socialization • Communication • Behavior expectations

24. 23 3-Tiered Model of Support Few Targeted and Intensive EBPs Intervention TIER 2 & 3 Some Universal EBPs TIER 1 All

25. EBPs Specific to Students with ASD (and other students?) • What are examples of targeted or intensive practices? • Self-management systems • Video modeling • Discrete trial teaching • PECS • Functional communication training (FCT)

26. Finding information about Practices that are Evidence-Based

27. The National Professional Development Center on ASD • The National Professional Development Center on Autism Spectrum Disorders is a multi-university center to promote the use of evidence-based practice for children and adolescents with autism spectrum disorders. http://autismpdc.fpg.unc.edu/content/evidence-based-practices

28. National Standards Project • "In a field rife with fads, pseudoscience, and popular, yet unproven, interventions, the findings of the National Standards Project are a welcome and much-needed counterbalance to much of the hyperbole for both professionals and families." --- Peter Gerhardt, Ed.D. http://www.nationalautismcenter.org/

29. The Association for Science in Autism Treatment ASAT is a not-for-profit organization of parents and professionals committed to improving the education, treatment, and care of people with autism. Since autism was first identified, there has been a long history of failed treatments and fads, levied on vulnerable individuals as well as on their families. Since ASAT was established in 1998, it has been our goal to work toward adopting higher standards of accountability for the care, education and treatment of all individuals with autism. http://www.asatonline.org/intervention/treatments_desc.htm

30. The START EBP Implementation Project is easy as 1-2-3-4 To make it easier to remember the steps of the project, just remember “1-2-3-4.” • 1building • 2 target students • 3IEP goals per target student • 4Evidence Based Practices (EBPs) to address the IEP goals

31. Presentation Script for 3 Groups • Description of the student • Developing the GAS goals from the IEP • Selecting the EBP • Implementation Plan & Process • Ongoing Review & Adjustments • Expansion to other students

32. What you need to know about the GAS before we start…

33. Expanding Children’s IEP Goals through the Goal Attainment Scale (GAS) Goal Attainment Scale (GAS) is designed to document progress on IEP goals, objective, and benchmark. Provides a summative rating to evaluate outcomes for students

34. Dan is inconsistently performing job tasks. He needs verbal, gesture and visual prompting to complete a task. Given a 5-step vocational task and visual supports, Dan will complete 3/5 steps independently over 3 consecutive probe days. Given 2 different 5-step vocational tasks and visual supports, Dan will complete 4/5 steps independently over 3 consecutive probe days. Given 3 different 5-step vocational task and visual supports, Dan will complete 4/5 steps independently over 3 consecutive probe days. Given any familiar 5-step vocational task and visual supports, Dan will complete 4/5 steps independently over 3 consecutive probe days.

35. Description of Scaling Consists of a five point range of performance for students: Much less than expected(present level) Somewhat less than expected Expected level of outcome (annual goal) Somewhat more than expected Much more than expected

36. Day Two: Afternoon

37. The START EBP Implementation Project is easy as 1-2-3-4 To make it easier to remember the steps of the project, just remember “1-2-3-4.” • 1building • 2 target students • 3IEP goals per target student • 4Evidence Based Practices (EBPs) to address the IEP goals

38. A script for implementing evidence based practices Review Checklist Discuss Building and Student Selection

39. Writing, Implementing, and Monitoring Goals

40. Writing Measurable Goals: Formula for Success • Condition--Under what condition and using what support should the skill be demonstrated? • Behavior—Use verbs to describe behavior • What competency / skill should change? • Observable behavior • Criteria— Describes level of mastery such as much or how well the behavior is demonstrated

41. Writing Measurable Goals • Condition—Circumstances the student will need in order to perform the expected skill (when, where, with whom, type of activity, with what support, etc.) • When given a verbal request • During transition periods • During a social conversation • During class discussions • When shown a three choices • When prompted (specify type and # ) • When given a check schedule card • When prompted (specify type and #) to a visual schedule • Using peers / peer to peer support • Using a choice modification strategy • During lunch (math, science, etc)

42. Writing Measurable Goals Behavior—Use verbs to describe behavior • Choose / select • Raise hand • Remain in seat / area • Answer questions • Request • Locate / find • Put on / Take off • Respond to (describe) • Complete task • Transition to next activity • Look at • Wait to be called on • Ask for help • Ask a peer • Follow direction

43. Writing Measurable Goals Criteria— Describes level of mastery such as much or how well the behavior is demonstrated • 9 out of 10 opportunities • 6 items • 75% accuracy • Increase by 10% • 3 times a day • On 9 consecutive attempts • For 15 minutes at a time • Within 5 minutes • 4 times weekly • 3 out of 5 days • 4 class periods

44. Examples • Marci will have improved functional communication skills for indicating wants and needs. • Marci will use a system of words, pictures, gestures to indicate basic wants and needs during classroom activities. (8 of 10 trials) • Marci will use a picture schedule to follow daily classroom routines with minimal prompting. (8 of 10 trials) • Marci will use a system of words, pictures, gestures to participate in conversational routines with peers. (8 of 10 trials)

45. Examples • Chris will improve his social communication skills in the classroom setting. • Chris will raise his hand when he needs assistance or wants to share important information. (90% of time) • Chris will ask for help and accept teacher response when he doesn’t understand something. (80% of time) • With gestural prompts from peers and adults, Chris will limit conversational ideas appropriate to the setting. (90% of time)

46. Goal Attainment Scaling Much More than Expected More than Expected Annual Goal Benchmark Present Level

47. Expanding Children’s IEP Goals through the Goal Attainment Scale (GAS) Goal Attainment Scale (GAS) is designed to document progress on IEP goals, objective, and benchmark. Provides a summative rating to evaluate outcomes for students

48. Prior to Developing GAS • Review student’s IEP Goals with teacher/parents • Identify 3 priority goals for each target student • must be observable and measurable • must be agreed on by family and team • Collect data on present level of performance

49. Description of Scaling Consists of a five point range of performance for students: Much less than expected(present level) Somewhat less than expected (benchmark) Expected level of outcome (annual goal) Somewhat more than expected Much more than expected

50. Second: Identify the current level GAS Levels First: Write the annual goal