1. Supporting Effective Inclusion through the Use of Evidence-based Practices for Preschoolers with ASD ANN SAM, PH.D. ANN COX, PH.D.

2. Objectives  Describe how the characteristics of children with ASD impact and be addressed by inclusive learning settings.  Identify 27 focused interventions as effective for children with ASD  Describe 2 evidence-based practices (EBPs) which support inclusive practices in classrooms with children with ASD  Video Modeling  Social Narratives  Know where to access internet supports for learning more about EBPs

3. Who We Are

4. Characteristics of Young Children with ASD & Inclusive Settings

5. Autism Spectrum Disorder (DSM-5)  Developmental disability  Not recognizable at birth  Typically lifelong  Complex Disorder  Many areas affected  Wide range of impairment  Mild to severe across areas Restricted and Repetitive Behaviors (RRB) Social Communication and Interaction Learn the Signs. Act Early. www.cdc.gov/actearly

6. Snapshot: ASD in the US  1 in 68 children overall (at age 8)  1 in 42 boys  1 in 189 girls  1 in 63 white children  1 in 81 black children  1 in 81 Asian/Pacific Islander  1 in 93 Hispanic children  1 in 3 with ASD also have Intellectual Disability

7. How Characteristics of Child with ASD Might Impact an Inclusive Classroom

8. How an Inclusive Classroom Might Be Particularly Supportive to Learning Needs of Child with ASD?

9. What Interventions Work for Children with ASD?

10. What Are Evidence-based Practices?  Focused interventions that:  Produce specific behavioral and developmental outcomes for a child  Have been demonstrated as effective in applied research literature  Can be successfully implemented in educational settings  Are used for a limited amount of time (Odom, Colett-Klingenberg, Rogers, & Hatton, 2010)

11. Update on EBPs for Children with ASD and Families  Wong et al. 2014 recently updated Odom et al. (2010) EBP review  http://autismpdc.fpg.unc.edu/how-do-i-find- out-more-about-ebps http://autismpdc.fpg.unc.edu/how-do-i-find- out-more-about-ebps  Began with pool of 29,150+ articles and reduced to 456 articles  27 EBPs identified

12. Age of Participants in Studies

13. Outcomes

14. Evidence-based Practices (2014)  Antecedent-based interventions  Cognitive behavioral intervention  Differential reinforcement  Discrete trial training  Exercise  Extinction  Functional behavior assessment  Functional communication training  Modeling  Naturalistic interventions  Parent implemented interventions  Peer mediated instruction and intervention  Picture Exchange Communication System  Pivotal response training  Prompting  Reinforcement  Response interruption/redirection  Scripting  Self-management  Social narrative  Social skills training  Structure play groups  Task analysis  Technology aided instruction and intervention  Time delay  Video modeling  Visual supports

15. Evidence-based Practices (2014)  Antecedent-based interventions  Cognitive behavioral intervention  Differential reinforcement  Discrete trial training  Exercise  Extinction  Functional behavior assessment  Functional communication training  Modeling  Naturalistic interventions  Parent implemented interventions  Peer mediated instruction and intervention  Picture Exchange Communication System  Pivotal response training  Prompting  Reinforcement  Response interruption/redirection  Scripting  Self-management  Social narrative  Social skills training  Structure play groups  Task analysis  Technology aided instruction and intervention  Time delay  Video modeling  Visual supports

16. Instructional Domains  Social  Communication  Behavior  Joint attention  Play  Cognitive  School readiness  Academic  Motor  Adaptive vocational  Mental health

17. Matrix of EBPs by Outcome and Age

18. Let’s Look at 2 EBPs Especially Supportive of Learning in Inclusive Classrooms  Video Modeling  Social Narratives

19. Video Modeling

20. What Is It?  Video modeling is a method of instruction that uses video recording and display equipment to provide a visual model of the targeted behavior or skill.  Effective with all ages (birth to 22 years).  Research supports use with preschoolers to achieve the following outcomes:  Social  Communication  Joint Attention  School-readiness  Play  Motor  Adaptive  Academic

21. Types of Video Modeling  Basic video modeling  Self-modeling  Point-of-view video modeling

22. Steps for Implementing Select type of VM Simplify task into smaller skills Select reinforcers Choose video equipment Create model and record video Introduce viewing equipment to learner Train team members Plan Arrange environment Choose a time to show video Show video Implement activity to engage skill or behavior Use Collect and analyze data for target behavior Fade video model Determine next steps based on learner progress Monitor

23. Plan  Select type of VM  Simplify task into smaller skills  Select reinforcers  Choose video equipment  Create model and record video  Introduce viewing equipment to learner  Train team members

24. Meet Eli

25. Target Behaviors EnvironmentNumber of Initiations Notes Comments to Peers0Solitary Play Greet Peers0Off Task Initiate to Peers at Lunch0Self Talk

26. Create Video Model

27. Use  Arrange environment  Choose a time to show video  Show video  Implement activity to engage skill or behavior

28. Show Video

29. Monitor  Collect and analyze data for target behavior  Fade video model  Determine next steps based on learner progress

30. Collect and Analyze Data

31. Independently Playing with Peer

32. Analyze Data

33. Social Narratives

34. What Is It?  Social narratives describe social situations for learners with ASD by providing relevant cues, explanation of the feelings and thoughts of others in the social situation, descriptions of appropriate expectations.  Effective to use with learners with ASD from 3 t o22 years of age.  Research supports use with preschoolers to achieve the following outcomes:  Social  Communication  Joint Attention  Behavior  Play  Adaptive  Aademic

35. Types of Social Narratives

36. Outcomes Associated with Social Narratives  Making choices  Playing appropriately with materials  Playing with peers  Increasing hand raising  Increasing social interactions  Initiating requests  Initiating comments  Increasing appropriate responses  Increasing compliments  Reducing tantrums  Decreasing problematic behaviors  Increasing sportsmanship  Increasing on-task behaviors  Understanding expectations

37. Steps for Implementing Identify social situation for the intervention Select type of social narrative Write social narrative following criteria for selected type Design the appropriate display for the social narrative Identify times or activities to use social narratives Plan Introduce the social narrative to learner Learner or adult reads social narrative Review key concepts with learner Learner participates in identified social situation If appropriate, discuss participation in social situation Use Collect data on target behaviors Determine next steps based on learner progress Monitor

38. Plan  Identify social situation for the intervention  Select type of social narrative  Write social narrative following criteria for selected type  Design the appropriate display for the social narrative  Identify times or activities to use social narratives

39. Plan - Types of Social Narratives SOCIAL STORIES™ Social stories ™ help learners with ASD understand a particular social situation by explaining the situation, relevant cues, and other people’s perspective of the situation. POWER CARDS Power Cards use a learner’s special interest to increase social understanding

40. Plan – Writing Social Stories ™

41. Plan – Writing Power Cards  Incorporate a learner’s special interest.  Functional behavioral assessment recommended to determine problematic behavior issues and reasons for issues.  Include a brief story scenario and outline rules.

42. Use Social Narratives  Introduce the social narrative to learner  Learner or adult reads social narrative  Review key concepts with learner  Learner participates in identified social situation  If appropriate, discuss participation in social situation

43. Use – Reading Social Narratives  Preview and read social narrative with learner.  Read immediately prior to the identified social situation.  Read social narrative multiple times and regularly.

44. Use: Learner Participates in Social Situation

45. Monitor Social Narratives  Collect data on target behaviors  Determine next steps based on learner progress

46. Implementing EBPs Now what? Next steps? How do you know what to do?

47. EBP EI Resources  ASD Toddler Initiative  http://asdtoddler.fpg.unc.edu/ http://asdtoddler.fpg.unc.edu/  Step-by-step directions for planning, implementing, and monitoring  Practice Scenarios  Implementation Checklists  Parent and Practitioner Guide  EBP Fact Sheet

48. EBP Briefs  National Professional Development Center on Autism Spectrum Disorder  http://autismpdc.fpg.unc.edu/  Overview  Evidence base  Steps for implementing  Implementation checklist  Sample data collection forms (optional)

49. AFIRM  E-learning modules for 27 EBPs  http://afirm.fpg.unc.edu/ http://afirm.fpg.unc.edu/  Target audience  Special educators  General education teachers  Related service personnel  Early interventionism  Planning, using, monitoring EBPs

50. AFIRM Structure  4 lessons  Basics of EBP  Plan for EBP  Use EBP  Monitor EBP  Key components of EBPs  Step-by-step process for applying practice

51. AFIRM Content  Engaging case examples  Multimedia presentation of content  Interactive assessments  Free professional

52. AFIRM Supplemental Materials  Implementation checklist  Step-by-step practice guide  Parent’s guide  Tip sheet for professionals  Data sheets  Evidence-base

53. AFIRM Certificates

54. How to Use… Some Ideas Plan implementation Check on my own knowledge Use to observe video of my implementation Professional development hours Self Use to observe video of a team member’s implementation Use to practice step-by-step with team Use to identify weak spots and strengths Use to guide professional development resources Team Use to plan implementation with family Have parent use as they observe my implementation Use to give family feedback on their implementation of a practice Family

55. Resources  NPDC on ASD: http://autismpdc.fpg.unc.edu/http://autismpdc.fpg.unc.edu/  ASD Toddler Initiative: http://asdtoddler.fpg.unc.edu/http://asdtoddler.fpg.unc.edu/  AFIRM modules: http://afirm.fpg.unc.edu/http://afirm.fpg.unc.edu/

56. Questions? Ann.sam@unc.edu Ann.cox@unc.edu