Independent Activity Schedules Claire Maher Choutka, M.Ed., BCBA Clinical Director Bureau of Autism Services

Agenda What is an independent Activity Schedule? Why use one, or “so what”? Review research in activity schedules Pre-requisite skills Teaching the schedule Sample schedules

What is an Independent Activity Schedule? It may be…. Picture schedule Text list Photos On a computer or Ipad, cell phone, PDA Not used to teach compliance- for school children are often shown a pic sym of sit quietly, follow in line- that is not what we are talking about today.

Now you chain multiple tasks or activities together. The schedule is an expansion of the teaching the steps of a task- tooth brushing or taking a shower—think getting ready to go out. Brush teeth, take shower, comb hair, get dressed, find keys. Now you chain multiple tasks or activities together. Often used with individuals with ASD but not limited to people with ASD. Assists with transitions between activities- big problem, knowing what’s next?

The “so what” test? Why use an independent activity schedule? Adults with disabilities very often depend on caregivers and supervising adults to initiate activities. They are prompt dependent Do not respond to natural cues- need verbal prompting- hard to fade. To function is less restrictive environments- need less reliance on others. With activity schedule stimulus control shifts to picture or text. Supervising adults do not need to repeat directions, prompt, over-prompt, provide physical guidance, etc.

What does the research say? Koyama and Wang (2011) did lit review of 23 studies Peer-reviewed Implemented as a primary intervention strategy (could be with others interventions such as video modeling) Taught people to self-manage schedules Did not include studies where tasks were within one activity such as cleaning a room or cooking a meal. Researched in school and group home settings as well as employment settings. Children and adults can use these. Leisure, school or work (chores, too). Not to teach the components in schedule. Not much on family members as interventionists- one study.

In the research… Adults living in a group home were taught leisure activities- DOWN TIME is a problem! Used for job skills School activities- think of college work- did you have a to do list? Don’t use the schedule to teach the activity- that’s where you use the task analyses and that type of data collection. After activity is learned it can be added to independent schedule.

Outcomes? Increase in task engagement and on-task as well as independence. Self-scheduling Task initiation Increased peer interaction Decreased staff supervision Decrease in SIB and disruptive behaviors In a vocational setting the ability to work or perform tasks w/o supervision increases the likelihood of employment

Maintenance and Generalization? In the Koyama and Wang review 26% of studies examined maintenance and 39% looked at generalization. When generalization was examined people were able to work on novel tasks or novel settings w/o more training. Social validity- that is, those who implement the schedules found them worthwhile- feasible and acceptable.

List and Choice Watanabe & Sturmey, 2003 looked at choice making in adults ages 22,40,30 on voc tasks and found- “engagement was substantially higher” when they wrote down the order of their own tasks. In baseline- staff chose order, in choice and maintenance the participants chose. Using choice was socially acceptable. increased engagement and completion.

Details, Details In Stromer, Kimball, Kinney, Taylor, 2006, the authors discussed activity schedules in a powerpt with a countdown clock. Clock is useful to signal end to activity if it does not have a discrete end- end of a puzzle, end of a chapter, end of a playlist, etc. Competence must be defined- they used 80% of steps w/o prompting. Authors suggest teaching in several formats- lists and computer.

How to? Where rubber meets the road Decide what type of activities to start? Leisure Work Home/chores After work activity? What routine will you look at? Independent skills?

Start small Remember- Always collect data! Design your data collection sheet- may actually mirror the schedule list with plus and minus and prompt level Remember- you want to fade prompts especially verbal Teach how to follow and explain the schedule-photo, notebook, computer, etc.

My notes to a team-Harry Adult 1. List 5 things he can do independently for at least 5 minutes by him/herself- read a book, listen to a book on tape, play a card game. Teach the person where to find these activities in the room—guessing the family room in a box or a shelf? 2. Teach him how to do these activities to completion (end of music CD, emptied dishwasher, end of chapter in book on tape, etc. ) and then put them items away. Use only preferred activities to start to create the interest and motivation to do this. 3. Teach Harry how to link them by using photos of them in a photo album so he goes to page one and sees, for example, a photo and the text, “Read a book.” Try to limit verbal prompting so the photo and the text are the cue for engaging in the activity. 4. Add another photo so it’s 2 activity photos followed by a snack photo. Add the third activity to the album. Three activities plus a snack is about 20 minutes. Progress! Each activity should be on a different page of a small photo album or a notebook. The photos can be digital pictures or graphics clipped from the web.

Consider the person’s ISP goals If a goal is to master a morning routine- consider putting it in an independent schedule. If goal is to interact more with others- consider asking adding in a leisure schedule a cue to ask someone in to play cards or play a video game, watch the “Bachelor”, etc.

Many ways to slice this… Make a powerpoint with participant of schedule Use photos in small photo book Use notebook with list Use the above with a cache of activities from which to select Ipad Cell phone

Picture Sample

Same schedule in text Listen to book on tape Check email on computer/play computer game Eat a snack

Adult- after out of house sample Empty dishwasher Put away silverware Read a magazine Call mom at work

Another sample HR job setting- Open office mail, distribute office mail to others, scan returned resumes, email to approp. dept, then file returned job applications, file items in the In Bin, take a break- find a friend to go for walk or listen to music.

After you have the schedule working…. Fading the schedule? It depends- In study of 3 students with mild to moderate ID and school and community job tasks -task shifts were higher when book present, also novel tasks were done when book present (Carson, Gast, Ayres, 2008) Add choice- participant choice in the order of activities.

Next Week… Considerations and Recommendations for Behavior Specialist Services when coordinating with other services Same time, Same place