1. Implementing Evidence-Based Practices in Schools
Dr. Cathy Pratt, BCBA-D
Director
Indiana Resource Center for Autism
Indiana Institute on Disability and Community
Indiana University
Phone: (812)
Fax: (812)

2. Instructional Approaches
A single instructional strategy should not drive a student’s program. What we want students to learn and how each learns best should guide our choice of instructional approaches and serve as the framework for how we teach a student. Process versus outcomes.

3. Strategies
One size does not fit all….need to find best fit for child and for family.
Business of Autism
Helping families make informed decisions.
Utilizing strategies that are evidence-based.

4. Process In Indiana History of Project Initial Focus on Secondary
Close to 100 Schools
Focus on Student Outcomes
School Assessment: APERS
School-wide Impact

5. Evidence-Based Practices
According to the National Professional Center on Autism funded by OSEP ( evidence-based practices include the following:

6. What are these evidence-based practices?
Antecedent-Based Interventions
Cognitive Behavior Intervention
Differential Reinforcement
Discrete Trial Teaching
Exercise
Extinction
Functional Behavioral Assessment
Functional Communication Training

7. What are these evidence-based practices?
Modeling
Naturalistic Intervention
Parent-Implemented Intervention
Peer-Mediated Instruction
Picture Exchange Communication System
Pivotal Response Training
Prompting
Reinforcement

8. What are these evidence-based practices?
Response Interruption/Redirection
Scripting
Self-Management
Social Skills Training
Social Narratives
Structured Play Groups
Task Analysis
Technology-Aided Instruction and Intervention

9. What are these evidence-based practices?
Time Delay
Video Modeling
Visual Support

10. More Websites http://www.nationalautismcenter.org/nsp/

11. Fidelity of Implementation

12. Learning Characteristics Associated With Autism Spectrum Disorders
Concrete/Hands On
Literal/Difficulty with Comprehension
Highly Distractible/Intensely Focused
Variability in Performance
Rule Bound/Insistence on Sameness
Immediate Perfection/Closure
Transitions/Unstructured Time Difficult
Organizational Difficulties
Need for Predictability and Routine
Need for Activities that Motivate
Need for Repetition

13. Engagement/Intensity of Instruction
Engage Often
Importance of Routines
Incidental Teaching: Every moment is a teachable moment.
At the same time, some children may need planned breaks.
Engage/read/talk to the child. Will talk about this within social narratives.

14. Classroom Schedule
Calendar
Reading
Daily 5
Lunch
Recess

15. Functional Behavioral Assessment:
A process for determining the relationship between a person’s internal/external environment and the occurrence of problematic behavior.

16. Hypothesis Statement (Problem Behavior Pathway)
Setting
Events
Triggering
Antecedents
Problem
Behavior
Maintaining
Consequence
Autism/Anxiety
Seizures
Medications
Allergies
Communication Limitations
Sensory Challenges
Lack Self-Regulation and Self-Management
Poor Social Skills
Certain Demands
Too Much Talking
Transitions: Leaving School Bus
Changes in Routines
Certain academic work…too much paperwork and being read to or lectured to.
Pinching
Yelling
Screaming
Elopement
Refusal
Kicking
Hitting
Ends an Activity
Gains Access to Desired Event/Activity
Attention
Sensory

17. (Problem Behavior Pathway)
Hypothesis Statement
(Problem Behavior Pathway)
Setting Triggering Problem Maintaining
Events Antecedents Behavior Consequence
Strengths/Skills:

18. Self-Management System
Increases Desired Behavior
Decreases Interfering Behavior
Teaches Students How To:
Monitor their own behavior
Record their own performance
Obtain reinforcement purposefully

19. Ultimate Goals Decrease Use of Paraprofessional
Enhance Skills Needed for Employment
Enhance Skills Needed for Post-Secondary Options
Enhance Quality of Life

20. Sample Self-Monitoring: Assignment Completion/
Check-in/Check-out

22. Direct Instruction
Direct, Systematic and Purposeful Instruction.

23. Exercise Now considered an evidence-based practice.
Build in structured play and exercise….swimming and other types of physical activity.

24. Communication Challenge For All
Opportunities Must be Embedded Across the Day and Across the Grades
Not Simply About Services of SLP
Everyone has to encourage communication.

25. Communication May be nonverbal or minimally verbal
Difficulty with practical conversation
Echolalic: immediate or delayed
Pronoun difficulties
Repetitive language
Difficulty with sarcasm…very literal
Interrupts others

26. Communication Difficulty starting, joining or ending conversation
Difficulty asking for help
Difficulty staying on topic
Unusual voice or speech
When instructions given to whole group, may not understand they apply to him/her as well
Slow in processing information

27. Overview – Functional Communication
FCT is used to decrease the incidence of interfering behaviors and to replace subtle, less clear communicative forms with clearer communicative forms.
Teaching functional communication will increase an individual’s independence and decrease some challenging behaviors.

28. How FCT Works
An FBA is conducted to identify the purpose of the challenging behavior.
A more desirable or acceptable form of communication for the child to use as a replacement for the challenging behavior is identified.

29. Challenging behaviors are ignored and only replacement behaviors are acknowledged and prompted. Again, can not ignore challenging behaviors that are potentially dangerous.

30. FCT
Can use any or all modalities to teach functional communication – speech, pictures, sign language, gestures, writing.
Create opportunities for communication by controlling access to materials or sabotaging a routine.

31. FCT
Offer opportunities for requesting (choices, small portions, etc.).
Teach communication within functional routines.

32. Naturalistic Language Strategies
Activities are child-centered and take place during naturally occurring routines and activities.
3/4-5/2011

33. Naturalistic Language Strategies
This teaching strategy is a hybrid approach that promotes communication/language development through environmental arrangement; responsive communication partners; and prompting, modeling, and reinforcement.
3/4-5/2011

34. Naturalistic Language Strategies
Naturalistic language strategies promote more complex skill acquisition and generalization and maintenance of skills.
3/4-5/2011

35. Examples of Naturalistic Interventions
Learner-directed activity – learners select what they want to do within the environment.

36. Examples of Naturalistic Interventions
Goal is to label animals. Different animal toys are offered, but the child decides to work on an animal insert puzzle. Staff then encourages the child to label each puzzle piece representing an animal.

37. Examples of Naturalistic Interventions
Routine activity – routine activities take place on a regular basis.

38. Examples of Naturalistic Interventions
Goal – Jeff is to use words to request: “open.” During snack time, staff present several tasty options in a clear, partitioned container in small portions. This presentation gives Jeff several opportunities throughout snack time to request “open.” Staff will open the container, and he can select his snack option.

39. Picture Exchange Communication System (PECS)
PECS is a behaviorally-based, alternative (aided) communication system.
Children and adolescents with ASD use visual-graphic systems to communicate with others.
3/4-5/2011

40. Picture Exchange Communication System (PECS)
PECS has been shown to promote speech development and production in previously nonverbal learners.
3/4-5/2011

41. Total Communication
May use a combination of sign, words, and pictures.
Sabotage during routines...instead of just giving a child a cookie. Prompt them to ask. Instead of just tickling, prompt them to ask.

42. Repetition Teaching and practicing across settings and people.
Hundreds may be required.
Assists with generalization.
Do not confuse rote memorization with true comprehension.

43. Receptive Communication
If child does not follow directions, try to say it in a different way.
Sometimes we use too many words.
Sometimes we are too abstract.
Saying the same thing over and over again that has not worked will not be successful.
Fewer words. Visuals. Gestures. Prompting.

44. The majority of students with ASD are VISUAL learners.

45. Visual strategies can benefit all children by enhancing the individual’s understanding.
Learn more quickly
Reduce aggressive or self-injurious behavior
Decrease frustration and anxiety
Learn to adjust to changes
Complete tasks by themselves
Gain independence
Visual strategies can benefit all students- at risk, ADHD, LD, EH, etc.
It can benefit your own children or spouse at home -- chore lists, sport schedules, morning and bedtime routine.
All students are more independent with visual supports.

46. This is one of the most important interventions that can be used !

47. Individual 5 point scales

52. SHOW them what TO DO!

54. Visual Supports
5 point scale

55. How to Line Up

56. Rules for Reinforcement
Reinforcers must be individually determined.
Based on observation of behavior change.
When teaching or strengthening a new behavior, reinforce frequently.
When maintaining behavior, use intermittently.
Must directly follow behavior.
Specifically state why a behavior is being reinforced.
Created 2006 IRCA

57. Reinforcers Can identify through various means what is reinforcing.
Primary includes edible and sensory
Secondary includes a tangible, privilege or activity.
Generalized conditioned reinforces are items that can be used in exchange for a wide range of back-up reinforcers such a money, tokens, stickers.
Created 2006 IRCA

58. Reinforcement Systems
Created 2006 IRCA

59. Reinforcement Systems
Created 2006 IRCA

60. Reinforcement Schedules
Variable
Fixed
Created 2006 IRCA

61. Shaping
Reinforcing successive approximation toward the desired goal. Expectations for success and reinforcement are gradually increased.
Example: picking a toy up. Putting a shoe on.
Don’t expect immediate perfection.
Created 2006 IRCA

62. Differential Reinforcement Schedules
Differential Reinforcement of Higher Rates of Behavior (DRH).. to increase low social initiations
Differential Reinforcement of Lower Rates of Behavior (DRL)…to decrease self-stimulatory behaviors
Differential Reinforcement of Other Behavior (DRO)… to increase non-occurrence of out of seat behavior

63. Differential Reinforcement Strategies
Differential Reinforcement of Incompatible Behavior (DRI)…reinforcing behavior that is physically incompatible. Eating at table versus walking around house.
Differential Reinforcement of Alternative Behaviors (DRA)…to increase hand-raising versus talking out in class.

64. Rapport/Praise and Feedback
Specify Behavior Praised
Rapport Building
Positives Outweigh Negatives
Coach parents and others in telling child what to do; not what not to do.
Created 2006 IRCA

65. Errorless Learning
Teaching tasks correctly upfront. Does not allow child to get into incorrect patterns of behaving.
Corrective feedback is less effective.
Created 2006 IRCA

66. Extinction Ignoring a Behavior Extinction burst.
Should not use with dangerous behavior.
Use with other strategies.
Choose your battles.
Created 2006 IRCA

67. Prompts No Universal Prompt Hierarchies Fading Prompt Dependency
Types: Verbal, Visual, Modeling, Physical, Gestural
May use different prompts for different situations.
Created 2006 IRCA

68. Discrete Trial Teaching
Great to use for teaching specific tasks.
Mass trials.
Can be used individually or in group.
Prompt to Response to Consequence
Have to make sure generalization and maintenance are planned.
Created 2006 IRCA

69. Premack Principle
A less preferred behavior, followed by a highly preferred behavior, becomes stronger.
If-then…..
Created 2006 IRCA

70. Task Analysis Task broken down into discrete steps
Observe a number of competence individuals
Consult with experts
Perform the task yourself
Develop task analysis of common home activity.
Created 2006 IRCA

71. 3/4-5/2011

72. Sequence of Dressing
3/4-5/2011

73. Chaining Backward: Last part of chain is taught first.
Forward: First step is taught first until mastery.
Total Task: Training assistance provided for steps not mastered.
Created 2006 IRCA

74. Behavioral Momentum
Deliver 3 to 4 highly preferred activities or requests and then introduce a less preferred tasks with support.
Created 2006 IRCA

75. Choice Making
Identify preferred and non-preferred objects or activities
Determine if choices are acceptable.
Present Choices
What opportunities do you see for building choice into the day? How would you guide parents on this?
Created 2006 IRCA

76. Social Challenges A primary challenge of those on the autism spectrum.
According to Gresham and Elliot, socially acceptable learned behaviors enable a person to interact with others in ways that elicit positive responses and assist in avoiding negative responses.

77. Social Skills
Difficulty recognizing non-verbal behavior, body language, and facial expressions
Difficulty waiting
May prefer solitary play
Social rules may be confusing
May appear to be in own world
May prefer to play with toys then with people

78. Social Skills Difficulty making and maintaining friends
Socially awkward
May appear rude
May intrude on personal space
May not understand turn taking

79. Strategies Overview Social Narratives Social Skills Training/Groups
Video Self-Modeling
Peer-Mediated Instruction

80. Power Card Strategy
The Power Card Strategy uses the child’s special interests to motivate and improve specific behaviors.
3/4-5/2011

81. Acts as a cognitive rehearsal
Summarizes steps the special hero wants the student to remember in specific situations
Acts as a cognitive rehearsal
This is very similar to a social story, but takes advantage of the child’s special interest or super hero to gain buy in from the student.
3/4-5/2011

83. Power Card Clifford wants all of the children to be safe, so remember:
Never run away from the playground.
Stay with the children and teachers.
Have fun and play with other boys and girls.

84. Power Card Strategy Using the Bathroom
Superman and the Bathroom
During his many flights to help people in need, Superman has found it necessary to stop and use the bathroom once in a while. He knows it is important to go when he needs to, and he doesn’t wait for someone to ask him if he has to go. He knows that it is important for superheroes to take care of their bathroom needs on their own.
3/4-5/2011

85. Superman would like for you to consider these three facts:
1. When you are at home, don’t wait for someone to ask if you need to go to the bathroom. Just go when you need to go. (Don’t ask, just go.)
2. When you are at school, tell your teacher that you need to go to the bathroom. Try to go every time there is a scheduled break, even if you don’t feel you need to. (Tell teacher, then go.)
3/4-5/2011

86. Superman would like for you to consider these three facts:
3. If you are away from home, tell an adult you are with that you need to use the bathroom and have them show you where it is located. (Tell adult, have them show where.)
Superman is proud of young men who can take care of their own bathroom needs!
3/4-5/2011

87. 3/4-5/2011

88. Video Self-Modeling
Mode of teaching that uses video recording and display equipment to provide a visual model of the targeted behavior.
Videos on teeth brushing, washing hands, etc.

89. Social Skills Groups
Used to teach individuals with ASD ways to appropriately interact using small groups of 2 to 8. Pros and cons of this approach.

90. Peer-Mediated Instruction
Used to teach typically developing peers ways to interact with and help learners with ASD in increasing social opportunities within natural environment. May need to support siblings in playing with their brother/sister on the autism spectrum.

91. Play
Structure play to teach the child how to follow directions, interact with others, imitate, attend for increasing periods of time, and so forth.
Again, engagement is critical and should be fun.

92. Importance of Imitation
Imitation is a critical developmental milestone.
Imitation is central to the understanding of self and others.
3/4-5/2011

93. Importance of Imitation
Imitation helps children and adolescents acquire and practice important social and communication skills.
Imitation is often an important component of play.
3/4-5/2011

94. Generalization Teach Sufficient Examples
Training in Multiple Settings with Multiple People
Training Loosely
Use Intermittent Reinforcer
Created 2006 IRCA

95. Parent Implemented Intervention
ASD impacts the entire family.
Be reasonable and realistic.
Realize they may be balancing multiple family member needs.
Coach and demonstrate.
Encourage them to take care of themselves and of other family members. Give them permission to do so.

96. Parent Implemented Interventions
Minimize guilt.
Understand the big picture of family life.
Providing resources so parents can educate siblings and other family members.

97. Change Process Takes Time Takes Strong Leadership Entire School Effort
Embed within Other Initiatives
Measured Outcomes

98. Finally:
Individuals with autism spectrum disorders present complex challenges. There is no easy answer. Because of the differences in these individuals there is no standard approach that will work with all. At the same time, good instruction works with all students. Think in terms of universal design.
Created 2006 IRCA