Activity Based Instruction

1. Activity Based Instruction Goal: to improve children’s acquisition and use of important motor, social, affective, communication, and intellectual behaviors that, in turn are integrated into response repertoires that are generative, functional, and adaptable. (Bricker & Cripe, 1992). • Generative repertoire: responses that can be adapted to meet novel or challenging conditions. • Functional repertoire: responses that are useful in the natural environment. • Adaptable repertoire: responses that can be modified accommodate the physical or social restraints of a situation.

2. Theoretical Basis of ABI • Both the immediate and larger socio-cultural environment influence a child’s development. • The child must be actively engaged to learn. • Children learn best in functional and meaningful activities. “Activity, culture, & concept are interdependent..” Brown & Duguid, 1989.

3. Characteristics of Instruction The experiences provided to children are child-initiated, routine, or planned activities that: A. Emphasize environmental transactions B. Are meaningful and functional C. Are developmentally appropriate D. Are designed to produce change in repertoires

4. Differences Between ABI & Other Naturalistic Approaches • Although individual children’s objectives are recognized and coordinated within activities, the focus is directed to the group as opposed to the individual. • ABI addresses the global needs of the child, not just language. • The primary vehicle for training is the use of activities that children choose or enjoy.

5. Components of ABI Instruction Routine Planned, or Child-Initiated Activities Embedded Intervention Targets Logical Antecedent & Consequences Generative Functional Skills

6. Guidelines for the AB Interventionist • Permit the child to initiate activities whenever possible. • Follow the lead or initiation unless the behavior is too repetitive, regressive, or does not lead toward goals. • Introduce planned activities that have meaning. • Monitor involvement and interest in activities, and change or rearrange when motivation wanes. • Constantly observe behavior and act on opportunities to enhance their problem solving skills.

7. Designing an ABI Lesson/day • Describe children by: age, abilities, strengths and weaknesses • Identify priority goals • Describe setting (including resources and changes throughout the day) • Use observation to highlight individual: behaviors, interests, activities initiated, friends • Build an activity by skill matrix • Develop an antecedent/behavior consequence schedule (identify common antecedents, consequences, and reinforcers) • Establish a systematic monitoring system

8. Preterm Infants • Definition: fetuses who develop in extrauterine settings at a time when their brains are growing more rapidly than at any other time in their life. • Need care available only in the specialized, medical-technology environments of new-born intensive care units (NICUs). • NICU patients are at high risk for: organ impairments (including lung disease or bronchopulmonary dysplasia), intraventricular hemorrhage, ROP, and necrotizing enterocolitis. • Even healthy preterm infants are at increased risk for future problems: Specific LD low IQs self-regulatory problems. Visual motor problems language disorders. ADD/ADHD behavior disorders.

9. Brain Development • 6-weeks : human cortex begins to develop and neurons are “created.” • 8 to 24-weeks : most neuron have developed and migrated to specific locations. • 24 weeks: neuronal maturation and organization increase dramatically. • 7-weeks: first synaptic contacts are established. • End 2nd trimester: increase in brain weight and head shape; Fetal behavior becomes more complex: • 40 weeks: myelinization peaks, but continues until the child is 9-years-old.

10. 1st Generation NICU Interventions • Counteraction of sensory deprivation by extra stimulation. • Prevention of disturbances in mother-infant bonding. • Provision of compensatory experiences. • Resolution of emotional crises of premature delivery. • Making up for feared developmental delays. • Improvement in parental responsiveness to infants’ deficient capacity to elicit care.

11. 2nd Generation NICU Interventions *Put the focus on the relationships of infants, families, and professionals * The nature of the preterm infant in the NICU requires relationship-based care from a: • Brain developmental Perspective • Evolutionary Perspective • Neurobehavioral Perspective • Psychological Perspective

12. Focus of 2nd Generation Interventions Infants as collaborators in their own care, striving to follow a developmental trajectory Professionals use: Behavioral observation Behavioral interpretation

13. Aspects of Modern NICU Care • Consistency of caregiving • Structured day • Calm, organized pace of intervention • Support during transitions between caregiving activities • Appropriate positioning • Individualized feeding support • Opportunities for skin-to-skin holding • Collaborative care • Quiet, soothing environment • Family comfort • Developmental support

14. Low Birth Weight Infants • 7% of US births are LBW (<2500g) • 1% of births are VLBW (<1500g) • In US, LBW is the #1 cause of our high infant mortality rate • Risk factors associate with LBW: Minority status Low SES Low pre-pregnancy weight Medical risks during pregnancy Poor access to health care preterm birth (<34 weeks gestation are often VLBW)

15. Child Development & LBW • Overall increased rates of health, neurodevelopmental, and psychological problems. • 3x as likely to be MR. • 2x as likely to have behavior disorders. • 2x as likely to die before 28-days. • Co-occurrence of LBW and environmental disadvantage places children at highest risk for delay.

16. Components of Effective Interventions • Intensity • Timing • Direct versus indirect • Environmental maintenance of gains: • Comprehensiveness • Attention to individual differences • Sensitivity to cultural differences Gains are greatest in homes who are at the most environmental risk as determined by maternal IQ or maternal education The lower the BW, the smaller the effects of intervention on IQ

17. Additional References Als, H. (1997). Early Intervention for preterm infants in the newborn intensive care unit. In M. J. Guralnick (Ed.) The Effectiveness of Early Intervention (pp. 47-76). Baltimore, MD: Brookes. Blair, C., & Ramey, C. T. (1997). Early Intervention for low-birth-weight infants and the path to second generation research. In M. J. Guralnick (Ed.) The Effectiveness of Early Intervention (pp. 77-97). Baltimore, MD: Brookes Jackson, P. L., & Vessey, J. A. (1992). Primary care of the child with a chronic condition. St. Louis, MO: Mosby.