Cynthia Lopez 02-15-14

1. Early Intensive Behavior Treatment (EIBT) for Children with Autism: A Multiple Case Study of Long-Term Outcomes Cynthia Lopez 02-15-14

2. Introduction to Autism • American Academy of Pediatrics places the current rate of diagnosis at 1 in 88 children (2012). • Overall there has been a 600% increase in the last 20 years (Autism Speaks, 2009). • Autism is more common than pediatric cancer, diabetes, and AIDS combined based on the current figures (Autism Speaks, 2008). • Programs known as Early Intensive Behavior Intervention (EIBI) are considered “well established” and should be the intervention of choice for preschool age children (National Standards Project, 2009; Rogers & Vismara, 2008).

3. Framework of EIBT programs: Center-based or in-home services • Children enter programs between the ages of 3 and 4.5 • 1:1 teaching ratio • 35-40 hours a week of therapy • Targeted skills: functional communication, play, social, self-help, adaptive behaviors, and pre-academic • Skills are worked on in the home, school, and community • Parent training • When a child reaches school age the inclusion process begins

4. Significance of the Study • As the numbers increase so does the importance of examining long term outcomes of early intervention programs. • Parents, caregivers, educators, and service providers may benefit from the information provided about outcomes for students who received EIBT services. • Little information is available regarding how parents view the treatment outcomes

5. Participants • A purposive sampling of parents whose children received EIBT were selected • Students who achieved placement in a general education classroom without aide support • Students who exited into these placements during the years 2006-2010 were selected • Researchers place the number of students who achieve best outcomes from early intensive behavioral intervention below 50% (Anderson et al. 1987; Lovaas, 1987; Smith, Groen, & Wynn, 2000 )

6. Academic Outcomes

7. Academic Outcomes Note. A=exceed competency, above grade level, B=competent, at grade level, and N=not yet competent, below grade level

8. Summary of Findings • RQ1: How are students doing academically? • Outcomes varied as did parent perceptions of student success • Parents described feeling as sense of accomplishment and pride • Perceptions of success were impacted by the type of communication parents had with school personnel RQ2: Quality of service after exiting? • Exiting was an emotional process but most felt they were prepared • Insufficient communication with teachers and support personnel was a barrier for some parents

9. Summary of Findings • RQ3: How are student’s doing socially? • Parents set up supportive social communities • Students had friends at school • Concerned about transitioning into JH impacting friendships • RQ4: Level of participation in goals? • Passive players but most satisfied • RQ5: Compare participation in goals to EIBT • Uncertainty in understanding how to select goals • Some parents described a lack of direct collaboration with current IEP team members to identify needs

10. Discussion • Student academic outcomes were widely variable, high and low achievers. • confirms previous research that response to interventions vary greatly among this population (Zachor & Itzchack, 2010). • Academic achievement likely impacted by individual student skills and teacher skill levels. • Social outcomes were more evenly matched across students, all had established friendships at school and extracurricular activities. • Examining outcomes for the oldest students revealed ongoing social deficits and the potential need for new interventions and training in junior high.

11. Discussion • Parent perceptions of support by classroom teachers or support personnel impacted how they viewed success. • Parents who felt connected to student progress through regular updates were more likely to be satisfied with educational services. • Communication allowed parents to assist students with completing work, understand areas of difficulty, and stay updated on classroom performance and modifications.

12. Implications for Practice-Parents • Effective Communication strategies identified by parents included: • Receiving graded homework, weekly newsletters, and regular meetings • Improving communication and collaboration between parents and teachers. • Providing parents with training on Spec Ed terminology and law • Meeting with parents prior to creating IEP goals

13. Implications for Practice-Educators • Teacher training specific to Autism and individual student needs. • Parents in the study identified that at least one of their child’s teachers had no knowledge of and had never worked with a child who had ASD. • Time for collaboration. • Teachers need to support of specialists (speech therapists, occupational therapists, BICMs, etc.) to identify effective strategies for teaching • Professional development for administrators who assign students to teachers. • Administrators should provide parents the opportunity to visit classrooms and meet teachers prior to starting school

14. Implications for Practice-Students • Ongoing social skills training. • Parents of students transitioning to JH expressed concerns with their child’s ability to navigate new social groups and expectations • Districts provided assessment and recommendations for social skill support for JH students • School size. • Parents sought out small schools and class sizes • Private school, charter school, interdistrict transfer (k-5) enrollment of 88 students), and intradistrict transfer • Extracurricular activities. • Children were involved in sports, music, church groups, and clubs

15. For More Information • Cindy Lopez (209) 957-7777x32 email: cjlopez@peoplepc.com • To access the dissertation: Proquest dissertation and abstracts database at http://pqdtopen.proquest.com • Title:Early Intensive Behavior Treatment (EIBT) for Children with Autism: A Multiple Case Study of Long-Term Outcomes, 2013