Presentation on theme: "Historical Information"— Presentation transcript:
1Providing Appropriate Services to Students with Autism Spectrum Disorders
2Historical Information Eugen Bleuer first coined the word “autism”Leo Kanner defined autism in 1943Dr. Hans Asperger studied children in who had characteristics similar to autism and later defined it as Asperger’s Syndrome.Bruno Bettelheim defined the term “frigid mothers” which was later discounted as a cause for autism.In 1908, Eugen Bleuler first coined the word "autism" to describe schizophrenic patients who screened themselves off and were self-absorbedAutism first defined by Leo Kanner in 1943 when he described 11 children who demonstrated significant problems in social interaction, issues with changes, good memory, echolalia, hypersensitivity to certain stimuli such as sound, and possible intellectual potential. Kanner introduced the term “early infantile autism”.Dr. Hans Asperger, during the same period, was studying families with children who were very similar to the children that Kanner was observing, but had a milder form of autism. These children did not exhibit the severe language delays. In 1944, he published an article, but his work was not widely known until his article was translated into English in 1989.Bruno Bettelheim wrote about three therapy sessions with children in The Empty Fortress. He called them autistic and claimed that their disorder was due to the coldness of their mothers, coining the term “frigid mothers”. He removed the parents from participating in the children's therapy.
3Causes of Autism Biological Genetics Neurological Abnormalities EnvironmentalEffects of Family ExperiencesMobility of FamilyBiologicalGenetics – research now indicates that genetics factors may play a role in the cause of autism.Neurological abnormalities – research is inconclusive, but some children with autism show some degree of central nervous system dysfunction. The exact nature is unknown.EnvironmentalEffects of family experiences – parents are not the cause of autism, but in many cases, the family dynamics will have an effect on the behavior and emotional issues children with autism will deal with.Families who are more mobile due to work and economic situations, parental management skills, family stress due to finances and family structure can possibly adversely affect a child with autism.
4Definition Autism Spectrum Disorders Pervasive Developmental Disorders (PDD)AutismAsperger’s SyndromePDD-NOSStatisticsPrevalence ratesU.S. Department of EducationSouth CarolinaAutism Spectrum Disorders (ASD), are known as Pervasive Developmental Disorders (PDDs). ASD can cause severe and pervasive impairment in thinking, feeling, language, and the ability to relate to others. These disorders are usually first diagnosed in early childhood and range from a severe form, called autistic disorder, through pervasive development disorder not otherwise specified (PDD-NOS), to a much milder form, Asperger syndrome. (NIMH).PDD-NOS is often diagnosed when a child has autistic symptoms but does not fit into any of the other ASD categories.Prevalance rate is estimated that 3.4 of every 1,000 children ages 3-10 years old have been diagnosed with ASD. It is reported that anywhere from 1 child in is diagnosed with autism. (Centers for Disease Control and Prevention)The U.S. Department of Education identified 12,222 children in that were identified through IDEA with autism compare to 65,396 in In , this number increased to 166,302 children identified with autism through IDEA reports to the Department of Education. (US Department of Education)South Carolina saw an increase from 141 students identified in to 1,500 in This is an increase of 964%. (US Department of Education)Early intervention will make a significant educational impact on the child and help reduce the symptoms of autism, but it is estimated that only 50% of children are diagnosed before kindergarten. (NIMH)
5Social Skill DeficitsInability to connect with other children and/or adultsLack of eye contactInappropriate outburstsUnwillingness to initiate playUnable to regulate behaviorsSocial skill deficits are one of the issues affecting children with autism. The inability to socially connect with other people affects every aspect of the child’s life, including school, home, community and in later years, the workplace. Children with autism are at a major disadvantage in negotiating the way to a successful and independent adult life without appropriate social skills.Problems with social skills may include avoidance of eye contact, unusual play with toys, inappropriate outbursts.Children with autism will rarely initiate peer interaction or willingly join in play.Children within the autism spectrum disorder will often have a difficult time regulating their emotions and behaviors, especially if they are placed in a strange environment or become frustrated.
6Language Difficulties Deficits in communication skillsEcholaliaProsodyPragmatic language deficienciesChildren with autism will have problems with communication skills. Some children may have mild problems, while others have very severe communication problems. Many children with autism develop language much later than their typically-developing peers. Current research suggests, however, that more than 70 percent of children with autism will develop some speech, most before they are five years old.Echolalia is an automatic response repeating language that is heard or as an unusual form of communication. Children with echolalia may repeat what they hear immediately (immediate echolalia) or some time after they have heard it (delayed echolalia). An example of immediate echolalia is: Adult: "Hello, what is your name?" Child: "your name?"An example of delayed echolalia is repeating television commercials verbatim, repeating phrases that parents use or repeating the dialogue from a video or TV program.Prosody refers to the intonation of speech. When we say a sentence, but emphasize different words, the meaning will change. Children with autism may use little to no intonation and have a robotic sound to their speech. If one says “HE took the pencil” and “He took the PENCIL”, two different meanings are implied.Pragmatic language is the process of communicating effectively with others. A child with autism may be able to talk about the planets in the solar system in great detail, but not be able to tell you what they did with their family over the weekend. Pragmatics also include turn-taking in conversations, maintaining eye contact during a conversation, and decoding non-verbal behaviors such as facial expressions and body language during a verbal exchange.
7Stereotypic Behaviors Self-stimulatory behaviorsObsessive interests on a single topicBehaviors develop around the ages of 2 to 3 years of age.Some children will have more subtle behaviors.Children with autism will often display unusual behaviors which can include self-stimulatory behaviors, preoccupation with interests, or the inability to process sensory experiences.Self-stimulatory or repetitive behaviors will include flapping the hands or arms, flipping fingers in front of the eyes, making repetitive sounds, jumping up and down, and/or rocking. Children will engage in these behaviors at different levels and at different times, such as when they are excited, anxious or agitated.Most behaviors will develop around the age of 2-3 years of age and often disappear or lessen as the child gets older and becomes more socially adept.Some children will have sutle behaviors such as tapping fingers, hair twisting or eye blinking.Some children with autism will have obsessive interests with a single topic. This topic will become all-consuming and the child may talk about little else. During academic time in school, the student may think of little else and not be able to attend to school work.
8Sensory Processing Issues Lack of response to painHypersensitive to soundsHypersensitive to touchDifficulty with bright lights and sunlightFood texturesChildren with autism often interpret sensory information differently than their normal-developing peers.Children may not respond to pain. Illnesses and injuries may go undetected because the child will not complain.Some children with autism will be hypersensitive to both sounds. Simple sounds such as the hum of a computer or a noisy lunchroom will cause the child distress. Children tend to cover their ears with the sounds that bother them.Children with autism may not be able to tolerate touch. A light touch on the arm to redirect the child during a reading lesson will cause the child to pull away. Many children will only wear certain types of clothing because of the texture of the material. Others will refuse to wear clothing with tags.Bright lights or sunlight may cause a child with autism distress. Many children will try to cover their eyes, possibly with a cap, to keep the bright light out.Children with autism are picky eaters and may choose not to try new foods. This may be a result of the texture or color of the food.It is important to remember that sensory issues may change depending on age, developmental level, stress, anxiety or comfort level with the individual working with the student.
9Assessment and Identification Process for Students with ASD
10Differential Diagnoses What is a differential diagnosis?DSM-IVThree main categories:Childhood AutismAsperger’s SyndromePDD-NOSSome conditions may be confusingly similar to autism and one must be careful when making a final determination about a child's disorder and any educational interventions. A differential diagnosis of autism must be made from mental retardation, schizophrenia, and developmental language/speech disorders. The first step in the educational setting in making a differential diagnosis is to understand the three main diagnostic categories under the umbrella of Pervasive Developmental Disorders (PDD). This is best accomplished by the DSM-IV (Diagnostic and Statistical Manual IV)
11Childhood AutismThe DSM-IV divides the criteria for childhood autism into 4 parts:Qualitative impairment in social interactionQualitative impairment in communicationRestricted, repetitive & stereotypic behaviors, interests and activitiesOnset prior to 3 years oldRule out other PDD syndromesDSM-IV Diagnosis for the three main categories of Pervasive Developmental Disorders.Childhood autism - A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3):Qualitative impairment in social interactionQualitative impairment in communicationRestricted, repetitive and stereotypic behaviorsOnset prior to 3 years oldRule out other PDD syndromes
12Impairment in Social Interaction Impairment in the use of multiple nonverbal behaviorsFailure to develop peer relationshipsLack of spontaneous interest with other individualsLack of social reciprocityQualitative impairment in social interaction, as manifested by at least two of the following:1. marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction.2. failure to develop peer relationships appropriate to developmental level3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)4. lack of social or emotional reciprocity
13Impairments in Communication Delay or lack of development of spoken languageInability to initiate a conversationStereotypic and/or repetitive use of languageLack of spontaneous play appropriate to the developmental levelQualitative impairments in communication as manifested by at least one of the following:1. delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others2. stereotyped and repetitive use of language or idiosyncratic language3. lack of varied spontaneous make-believe play or social imitative play appropriate to developmental level
14Stereotypic Behaviors Preoccupation with stereotypic patterns of interestInflexible adherence to specific, nonfunctional routinesRepetitive motor mannerismsPersistent preoccupation with parts of objectsRestricted, repetitive, and stereotyped patterns of behavior, interests, and activities, as manifested by at least of one of the following:1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus2. apparently inflexible adherence to specific, nonfunctional routines or rituals3. stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole body movements)4. persistent preoccupation with parts of objects
15Delays in Functioning Delays or abnormal functioning in: Social interactionLanguage and communicationSymbolic or imaginative playOnset prior to the age of 3Rule out for Rett’s Syndrome and Childhood Disintegrative DisorderDelays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.The disturbance is not better accounted for by Rett's disorder or childhood disintegrative disorder.
16Asperger’s SyndromeThe DSM-IV divides the criteria for Asperger’s Syndrome into 6 parts:Qualitative impairment in social interactionRestricted, repetitive patterns of behaviorImpairment in other areas of functioningNo significant clinical language delayNo significant clinical cognitive developmentRule out other PDD disordersAsperger’s syndrome and High Functioning Autism are often confused and can be misdiagnosed. When making a differential diagnosis for Asperger’s and High Function Autism (HFA), it is often determined that the onset for Asperger’s is later, social and communication deficits are less severe, verbal IQ is higher than performance IQ, clumsiness is often seen, interests are more prominent, and outcome is often more positive.
17Impairment in Social Interaction Marked impairment in the use of nonverbal behaviorsFailure to develop peer relationshipsLack of spontaneous enjoyment and interest with other individualsLack of social reciprocityQualitative impairment in social interaction, as manifested by at least two of the following:marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interactionfailure to develop peer relationships appropriate to developmental levela lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)lack of social or emotional reciprocity
18Stereotypic Patterns of Behaivor Encompassing preoccupation with other interestsInflexible adherence to nonfunctional routinesStereotypic motor mannerismsPreoccupation with parts of objectsRestricted, repetitive, and stereotyped patterns of behavior, interests, and activities, as manifested by at least of one of the following:1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus2. apparently inflexible adherence to specific, nonfunctional routines or rituals3. stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole body movements)4. persistent preoccupation with parts of objects
19Additional Criteria Impairment in other areas of functioning No clinically significant delay in languageNo clinically significant delay in cognitive skillsMust rule out other PDD disabilities1. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.2. There is no clinically significant delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years).3. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood.4. Criteria are not met for another specific pervasive developmental disorder or schizophrenia.
20PDD - NOSUsed only when severe impairment in areas of social interaction, communication and stereotypic behavior but criteria for autism and Asperger’s syndrome can not be metRule out other PDD disabilities and schizophreniaMay have a later age of onsetThis category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills or when stereotyped behavior, interests, and activities are present but the criteria are not met for a specific pervasive developmental disorder, schizophrenia, schizotypal personality disorder, or avoidant personality disorder. This category includes “atypical autism” that do not meet the criteria for austistic disorder because of the late age of onset or atypical symptomatology.
21SCDE Criteria for Autism Definition:Autism means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, that adversely affects a child’s education performance……Definition - Autism means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age three, that adversely affects a child’s education performance.
22Definition Continued…… Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experience. The term does not apply if a child’s educational performance is adversely affected primarily because the child has an emotional disturbance, as defined in the section on emotional disability.Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experience. The term does not apply if a child’s educational performance is adversely affected primarily because the child has an emotional disturbance, as defined in the section on emotional disability
23Eligibility Criteria (Redbook) Must be made by a multidisciplinary evaluation team that includes a certified school psychologist and a speech language therapistDisturbances in development ratesDisturbances in response to sensory stimuliImpaired use of languageInability to relate to people, objects or eventsSignificant rating on standardized autism scaleMust adversely affect educational performanceEligibility Criteria - The multidisciplinary evaluation team must include a specialistknowledgeable in the education of students with suspected autism; a certified school psychologist, a licensed school psychologist, or a licensed psychoeducationalspecialist; and a speech-language therapist.This multidisciplinary team may determine that a student has autism and is eligiblefor special education and related services, if appropriate, if the evaluation informationcollected across multiple settings and from multiple sources verifies that the studentexhibits four of the five following indicators:(1.) present or previous disturbances in developmental rates and/or sequences;(2.) present or previous disturbances in responses to sensory stimuli;(3) impaired or unusual comprehension and/or use of, speech, language, and communication;(4) impaired abilities to relate to people, objects, or events; and(5) exhibits a significant rating on a standardized autism rating scale.b. The student’s autism adversely affects his or her educational performance.
24Evaluation Criteria Hearing & vision screening Speech and language assessmentDevelopmental historyThree 20-minute direct observations in two environments on two different daysScore on standardized autism rating scaleAny other important information related to the child’s suspected disabilityDocumentation that the child’s autism adversely affects his/her educational performance.Evaluation – The following evaluation components are required:a. Hearing and vision screenings conducted within the past twelve months. If there isdifficulty in obtaining valid results, placement should proceed based on availableinformation until valid results can be obtained.A speech and language assessment of functional communication administered by a speech-language pathologist within the past twelve months.c. A developmental history of the student that includes a summary of his or herdemographic, developmental, educational, and medical history obtained from a parent or primary caregiver.d. At least three twenty minute direct behavioral observations of the student in at least twoenvironments on at least two different days by more than one member of the multi-disciplinary evaluation team that records the nature and severity of the student’s learningand/or behavioral difficulties. (An observation in the home is strongly encouraged.)e. A standardized autism rating scale completed by an adult knowledgeable of thestudent and interpreted in consultation with a certified school psychologist, a licensedschool psychologist, or a licensed psychoeducational specialist.f. Other information related to the student's suspected disability must be obtained whenthe multidisciplinary team determines that the above requirements do not adequatelyassess the child’s current functional level. If a standardized individual measure ofintelligence is determined to be a helpful component of the evaluation process, the testmust be administered by a certified school psychologist, a licensed school psychologist,or a licensed psychoeducational specialist. A school district may accept a standardizedindividual measure of intelligence that has been directly administered within the pasttwelve months by a licensed clinical or counseling psychologist with training in theassessment of children and adolescents, if a standardized individual measure ofintelligence is determined to be a helpful component of the evaluation process.An assessment of academic achievement through the use of standardized tests orcurriculum-based procedures may also be conducted. An adaptive behavior scale may beuseful in describing the student's current level of functioning for program planning andplacement decision.g. Documentation of the evidence that the student’s autism adversely affects his or hereducational performance.
25Appropriate Assessments Basic Assumptions:Properly training evaluatorsEvaluate for not just eligibility, but for appropriate information to develop a quality educational planRemember that the testing is just a snapshot of what the child is performing at that moment in time.Basic assumptions for evaluating children with autismAll professionals involved with evaluating a child with autism must be professionally trained in order to provide an accurate diagnosis.The purpose of the assessment should not be just to evaluate for eligibility, but to gain appropriate information about the child to develop a quality intervention program that will address the child’s educational, social and physical strengths and weaknesses.Care must be given to keep in mind that testing is a snapshot of what the child is performing at that moment. Testing must be structured to obtain the best measure possible. Moving a child with autism to a small testing room with an unfamiliar individual will not yield appropriate assessment information.
26Medical EvaluationsIt is possible that the parents will have received some medical evaluations that might include:Audiologist will test hearingEEG to rule out brain abnormalitiesMetabolic screeningMRI/CAT ScanGenetic testingMedical tests will often help with an early diagnosis and assist in determining the appropriate types of intervention that might be necessary. These could include hearing, an EEG, metabolic, MRI, and genetic testing.An audiologist will test the hearing of the student to rule out any type of hearing disability. These specialists have many methods to test the hearing of a non-verbal child by measuring responses such as head turning and blinking when a sound is presented.An electroencephalogram (EEG) may be recommended to rule out possible brain abnormalities or tumors. This is a noninvasive procedure that may help to determine which part of the brain is causing problems.Metabolic screening will involve both blood and urine samples to see how the child metabolizes food. It also will help look at the impact on growth and development.A child could possibly undergo an MRI or CAT Scan to help diagnosis any structural problems with the brain. The MRI creates an image of the brain in very fine detail.Genetic testing involves the parents and the child to undergo a blood test to look for any abnormalities in the family’s genes which might cause some type of developmental disability.
27Standardized TestingMost likely the school psychologist will complete the following testing:Intelligence testsAchievement testsAutism rating scalesAdaptive behavior scalesStandardized testing is most likely completed by the school psychologist. These tests will include intelligence tests, achievement tests, rating scales and developmental inventories.Intelligence tests most commonly include the Stanford-Binet Intelligence Scale and the Wechsler Intelligence Scale for Children (WISC-IV). The WISC-IV will provide three scores. It is important to remember that IQ tests may not measure the true ability and aptitude of a child with an autism spectrum disorder.An achievement test such as the WIAT or Woodcock JohnsonRating scales and developmental inventories help to measure a child’s developmental growth, socialization skills, self-help abilities and coping skills. These scores are usually based on parent interviews, teacher interviews and evaluator observations. The most common rating scales are the Vineland Adaptive Behavior Scale and the Childhood Autism Rating Scale.
28Related Therapy Evaluations Students with autism are often eligible for related services. Qualified personnel with the school district can provide testing in the following areas:Speech-languageOccupational therapyPhysical therapyTherapy evaluations will include speech language, occupational and possibly physical therapy evaluations.Speech-language therapy is one of the most important assessments to guide intervention for a child with autism. The child with autism must not only learn how to speak if possible, but to learn how to communicate socially to other individuals. The speech-language evaluation must be able to provide the teacher and parents with appropriate information to assist the child in learning to use language in a meaningful way.An occupational therapist will focus on fine motor skills in the area of writing, self-care skills and sensory integration. The occupational therapist will assess the child in the area of touch, balance and spatial awareness.The physical therapist, if necessary, will help the child with autism develop coordination and movement through physical gross motor activities.
29Additional Areas for Assessment Direct observation is gathered by observing the child in many educational and if possible, family situations. Parents and care-givers must be actively involved in this part of the evaluation.Functional Assessments for behavior issues through direct observation and data collection.Direct observation is gathered by observing the child in many educational and if possible, family situations. Parents and care-givers must be actively involved in this part of the evaluation.Functional assessments will evaluate why a behavior or set of behaviors is occurring. This type of assessment will include observation of the child, collecting data on frequency, duration and intensity of behaviors and looking at the antecedents and consequences of the behaviors. Finding the purpose of a challenging behavior will enable the educator to teach a positive replacement behavior to the student.
30Helping Parents at the Start! Is this the first diagnosis of ASD?Do the parents have an IEE that needs to be considered?Do the parents have a copy of the school district’s evaluation?Has the appropriate personnel discussed the evaluation before the meeting with the parents?Have all appropriate team members been invited and agreed to attend?Do the parents have a copy of the Parent’s Handbook?Working with parents during the Eligibility & IEP meeting can set the stage for a productive meeting and a solid partnership in the years to come that will help the child benefit from a quality education. Some things to consider before the first meeting:1. While the parent may suspect that the child has a problem, this meeting could be the first diagnosis a parent receives. Administrators should be cognizant that the eligibility meeting could be very difficult.Parents may have received an evaluation from an independent organization before the child enters the school system. The school district, by law, must review and consider all information within this report.If the school district has tested the student, it is critical that the parent be able to have a copy of the complete evaluation before the meeting in order to review the findings. Ideally, the school psychologist should go over the report in advance of the eligibility meeting.If the parent disagrees with the school’s evaluation, they have the right to pursue an independent evaluation at no expense.At the eligibility meeting, the school must assure that the appropriate member’s of the team are present which will include a person that can interpret the test results to other team members. In addition to the parents, there must be an LEA, regular education teacher, and a special education teacher present. Any other individual with knowledge of the student should be invited. This may include outside agencies such as DDSN.Parents should have a copy of the South Carolina Department of Education’s parental handout.
31At the IEP Meeting Can be held with eligibility meeting Parents have the right to invite team membersProvide a draft IEP several days before the meetingStart with the goals and objectivesConsider all related servicesDiscuss and explain as needed the full continuum of services available under IDEA, beginning with placement in the general education settingUse the minutes to document discussions on goals, objectives, therapies and placements.An IEP meeting can be held at the same time as the eligibility meeting as long as all appropriate members are present.Parents have the right to invite members who have knowledge of the student to the meeting. As an administrator, it is appropriate to extend this opportunity to parents and ask if they would like the school to invite other individuals. Developing a collaboration working relationship will serve to strengthen the educational program for the child.Best practice is to provide a draft IEP to the parents several days in advance. This allows for the parent to review the goals and objectives the school district will be recommending for the child. It will build a foundation from which to work and improve upon during the meeting. Placement decisions should not be included on the draft at this time. A draft might include the strengths and weaknesses of the child, results of the assessments given and the goals and objectives.The first major part of the IEP meeting will be to agree upon the goals and objectives that will be the foundation of the child’s education. Goals and objectives drive the educational placement for the child.Related services must be considered for the child to benefit from special education services. Many children with autism will receive, but are not limited to, speech and occupational therapy.A full continuum of placement options must be discussed. General education must be considered first and foremost. During the discussion regarding general education, the team must consider what supports and supplementary services can be provided to enable the child to benefit for a regular classroom placement. Compelling evidence should be documented on why a child can not succeed in a general education setting.Minutes for the meetings should provide adequate detail to document the discussions on goals, objectives and placement.The school district, in cooperation with the parents, must develop an IEP that will confer educational benefit to the child. The IEP is a working document and it is possible that future meetings during the school year will be needed to amend the IEP based on the progress of the child.
33Collaborating with Parents/Families All parents dream of having a child who is successful in school.You will be working with parents who may be exhausted from the demands helping their child with autism and managing a family.Do not overlook the stressors that these families deal with on a regular basis.COLLABORATION IS THE KEY!probably no other disability has created such controversial issues regarding educational programming for students with autism spectrum disorders. Every parent dreams of their child being successful in school, graduating, going to college, living independently. Yet, we are working with parents who have children with a neurological disability in which many of those options will not happen. Depending on the severity of the disability, the parents may not do the simple things we take for granted: go out to eat, go on a vacation, see their child participate in extracurricular team activities, be recognized for outstanding achievements during high school, walk across the stage to receive a South Carolina diploma, attend college, marry and have grandchildren. Instead, you are working with parents who may be exhausted from the demanding focus of keeping a daily routine, can not find a sitter for afterschool daycare, worried about covering the cost of medications, and trying to find the elusive cure for autism. As an administrator, we can often overlook the stressors that families deal with on a daily basis. Collaboration is the key to successful programming for the student!
34Outcome-based Programming Schools must ensure that the student makes adequate progress toward IEP goals.Methodology that is used in the classroom must demonstrate that the student is benefiting from an education.No one methodology can “cure” autism.Look beyond the methodology and determine if the outcome for the student is effective!Outcome-based educational programming – schools must ensure that all students with disabilities make adequate progress toward their IEP goals. Methodology must demonstrate that each student is benefiting from his/her education. As administrators, you must look beyond the treatment and determine if the outcome of that intervention is effective.
35Communicate ClearlyConsider the family unit. Involve the necessary family members in the education of the student.Do not use educational jargon.Do not assume that the parents will ask questions. Take the time to ask if clarification is needed.Do not make judgments.Support statements with objective data.Consider the entire family unit – you often will deal just with one parent. Family involvement is critical to the successful education for the child. A good administrator will work to involve not only parents, but siblings and extended family members.Communicate clearly. Do not use educational jargon unless the family members present understand the terminology. Do not assume that a parent will ask if they do not understand. It is important during meetings to continue asking if anything covered needs clarified. Stay away from judgments and support statements about the child with behavioral and objective data.
36Present Information Positively Never start conversations with negative statements about the student.Always rephrase problems to present requests in a positive manner.Work to find a common solution that both the school and the parents will be able to find success.Always end the conversation with a positive statement or an encouraging statement about the student.Present information positively. Parents will quickly shut down if all they hear are negatives about their child. Rather than saying “John rarely turns in assignments and now he has an F in Reading”; it sounds much more positive to say “I have only received two assignments from John this semester. He is missing 6 assignments. I would be glad to provide him a chance to turn them in. Perhaps he needs some help in understanding the assignment? Can we work together in getting John to complete the work.”
37Active ListeningAll team members, including parents, need to be heard.Take the time to listen, even if you have heard it over and over.Do not take phone calls, work on , look at your watch during meetings.Set the time frame for the meeting if necessary.The common thread is an appropriate education for the child!Active listening – we can not collaborate with parents if we don’t listen to what they say. Each team member, including the parents, should have a chance to be heard. In many cases, you may have heard the same thing over and over again. You may have other meetings that are clouding your decisions. It is imperative that as an administrator, you make time to listen to the parents. Taking phone calls, working on , looking at your watch and not making eye contact will swiftly end any hope of building a collaborative team. An administrator that comes and goes during a meeting is nonverbally saying to the parent that their child is not as important at that time. Emergencies arise and it may be necessary to reschedule or have another administrator attend. It is appropriate to tell the parents before the meeting if you only have an hour and will need to reschedule. In many cases, you will know whether to anticipate a lengthy meeting and can work with the family to break it into two meetings. The common goal is an appropriate education for their child.
39Use of Medication for ASD Many students will be on some type of medication for:- Obsessive-compulsive disorder- Attentional issues- Behavioral concernsNo medication will cure ASD.Need to know the dosage and side effects to monitor effectiveness.A student can not be kept out of school “until the parent puts the student on medication.”Many students with ASD may be on medication to treat the different symptoms of autism such as obsessive-compulsive disorder, attentional issues, and behavioral concerns. As an educator, it is critical to know what medication the student is taking, the dosage and the side effects. It is important to note that all medications have benefits and limitations. No medication will “cure” autism. Helping parents monitor the side effects of the medication will assist in determining the best possible outcome for the student. Remember at no time can an educator tell a parent that the student needs to be referred for medication or that the student can not come back to school without medication.
40Types of Medications Used AntidepressantsBenzodiazepinesStimulantsAntipsychotic medicationsAny behavioral changes should be noted so that the parent can provide accurate information to the physician.a. . Antidepressants are often used to treat depression and obsessive-compulsive or ritualistic behaviors. The drug will reduce the frequency and intensity of the behavior, decrease tantrums and irritability and potentially improve the student’s responsiveness. Side effects might include headache, insomnia, dizziness, and drowsiness. Medications include Elavil, Wellbutrin, Zoloft, Luvox, Prozac and Anafranil.b. Benzodiazepines are used to treat behavioral problems. Students might take Xanax, Ativan or Valium. Side effects include drowsiness, fatigue, lack of muscle coordination (ataxia), and dizziness. If a physician discontinues one of these drugs, the student may have withdrawal symptoms. The safety of these medications have not been proven in children with autism.c. Antipsychotic medications will help the student control hyperactivity, aggression and other behavioral problems. These medications might include Risperdal, Zyprexa, Seroquel and Clozaril. Side effects that could be noticed are agitation, anxiety, drowsiness, and headache.Stimulants will help the student better focus on educational programming and decrease impulsivity. These drugs include Ritalin, Adderall, and Dexedine. Side effects may include high blood pressures, insomnia, loss of appetite, abdominal pain, and nervousness.A child with ASD may not respond in the same way to medications as typically developing children. Teachers should report any changes and keep a record of observations that a parent can take to the doctor. Many times doctors will prescribe the lowest dose possible to be effective. In order for the doctor to know if the dosage is working, educators need to be responsive to the parents with written observations and data on how the child performs during the school day.
41Behavioral Difficulties and Appropriate Discipline Options Define behavioral issues in terms of frequency, duration and intensity.Must consider all options to help the student regulate behavior.Teachers working with students who have ASD must be appropriately trained to handle the behaviors.Students with ASD may not be able to appropriately interpret feedback they receive!All children will experiment with behavior at some point in childhood. The behavioral difficulty comes with the frequency, duration and intensity of the behavior in relation to the chronological age of the child. Every parent may experience a child during the “terrible twos”, but if the same intense behavior is occurring many years later and interfering with the child’s education, it becomes a problem. There is not a magic cure, but rather options to change the interfering behavior. Teachers working with students with ASD should be appropriately trained to deal with the variety of behaviors that the student may exhibit.It is important for administrators and teachers to understand that students with ASD may not be able to interpret the normal feedback that is given when interfering behaviors occur.
42Must be consistent in behavioral procedures! Behavior TermsPositive ReinforcementNegative ReinforcementShapingPromptingGeneralizationMust be consistent in behavioral procedures!When a behavior results in a positive or negative reinforcement (i.e., getting something that is wanted or being able to escape or be removed from a situation that is considered unpleasant) that behavior is more likely to continue or increase. If a behavior does not get reinforced or results in something happening that is considered unwanted or unpleasant (e.g., being ignored or punished), the behavior is more likely to decrease. For most children, this teaching occurs very naturally, as they seek feedback and learn from these often-subtle behavioral interactions with the social world in which they live. Children with autism typically have difficulty accurately attending to, interpreting and utilizing the feedback that automatically exists in their world. Applied behavioral analysis and subsequent treatments analyze these interactions and sequences of behavior, making explicit the rules, consequences, and expectations that others understand more automatically, in an effort to teach more adaptive, useful, and maintainable behaviors and skills. Behavioral intervention teaches a child not only to "know" the rules of what is expected, but to use their skills and behaviors more automatically, modifying behavior and adding new behaviors using well understood and established behavioral principles such as reinforcement, shaping, prompting and prompt-fading, and generalization. With this technology, target behaviors are broken into very small, separate components and each skill is taught systematically in a way that is likely to be effective for that child, typically individually at first, utilizing specific prompts and reinforcements (referred to "errorless learning") until the child reaches a predetermined level of mastery that is designed to increase likelihood of maintenance and generalization. Successes are built upon, with constant systematic modification of the program as the child demonstrates progress, eventually adding a behaviorally sequenced generalization plan to transfer the skills into other settings and situations. The success of any behavioral program rests upon the clarity of target goals and objectives, the purposeful choice of teaching tools and lessons, the appropriate choosing of reinforcement and reinforcement schedules, the appropriate use and fading of prompts and reinforcements, the purposeful inclusion of behavior generalization, and the consistent application of behavioral principles.Behavioral treatment may be as intense and broad as the hour per week of professionally managed applied behavior analysis (ABA) programs currently recommended for young children with autism or as limited as a behavioral analysis and treatment for one target goal, such as increasing the initiation of social contact with a peer. Greater gains have generally been shown for younger children who receive more intensive treatment. Behavioral intervention, even intensive applied behavior analysis, is not magic nor is it a cure for autism. Such programs involve a great deal of time, energy, and hard work and often a significant change in behavior for the entire family. The research is quite promising, however, that with intensive behavioral intervention, most children with autism make significant gains in their skills and behaviors to better function within their family, school, and community, with some appearing quite similar to their "typical" peers.
43Improving BehaviorTeach choices – focus on positive replacement behaviors.Teach communication skills thru speech, gestures, pictorial programs, communication devices.Reward positive behavior.Be concise and clear when talking to the child.Improving behavior1. Teach choices – provide the child with positive options. Focus on positive replacement behaviors.2 . Teach communication skills thru speech, gestures, pictorial programs, communication devices.3 . Reward positive behavior. Catch the child being good! Find rewards that the child will like and reward the positive behaviors.4 . Be concise and clear when talking to the child. Do not be wordy in asking what you want the child to do.
44Using the FBAA Functional Behavior Assessment is the process of gathering and analyzing information about the student's behavior and the circumstances in order to determine the purpose or intent of the actions. The purpose of a FBA is:Appropriate placement & servicesInformation for positive behavior supportsIdentify positive interventionsDevelop appropriate substitute behaviorsDefinition provided in slide.The purpose is to: -determine the appropriateness of placement and services- provide information that will be used to design effective positive behavior support plans - identify positive interventions to reduce the undesirable behavior - develop appropriate behaviors to be substituted in replacement of the inappropriate ones.
45Administrators must remember….. Behaviors will occur in response to specific stimuli;Behaviors are ruled by consequences;Behaviors are a form of communication;Behaviors will have a purpose which is usually to get something such as attention or to avoid/escape something such as doing class work.When conducting the FBA, administrators must remember: -behaviors occur in response to an identifiable stimuli -behaviors are ruled by the consequences that follow them -behavior is a form of communication (we just need to figure out what it says... "I am tired.", "I am bored.", "I'm still upset at what happened earlier", etc.) -"misbehavior" may actually be adaptive given the circumstances (e.g., "My teacher is a ineffective manager of student behavior. S/he can't protect me from the thugs in my class. I better misbehave so that the aggressive kids like me and won't victimize me.") -behaviors serve a function & have a purpose, usually: -to get something (e.g., attention, money, good grades) -to avoid/escape something (e.g., punishment, embarrassment)
46Documentation for FBAMust be a clear, concise, observable and measurable definition;Description of the events that predict when the behaviors will occur;Description of the consequences that maintain the behavior;List of hypotheses that describe the function maintaining the behavior.The FBA is considered complete when the following things have been documented:an clear, observable and measurable definition of the problem behaviorevents that predict when problem behaviors will occur and will not occurconsequences that maintain problem behaviorsone or more hypotheses about the function maintaining problem behaviorData from direct observations supporting the hypotheses.
47Development of the BIP Also known as a Positive Behavior Support Plan Developed by the IEP team which includes the parent and if appropriate, the studentKey elements include:- Basic information about student- Description of problem behavior- Summary of the FBA- Description of the interventions to be implemented- Written description of how data will be collected- Crisis plan, if needed- Timeline and plan for evaluation of the interventions- Signatures of all team membersAfter the FBA is completed, the parent and other members of the IEP team, need to complete a Behavior Intervention Plan (BIP). The BIP might be referred to as Positive Behavior Support Plan. The elements listed below will help the IEP team in providing active communication between home and school about the behaviors. The key elements listed below will also provide accountability with administrators, educators and parents in improving the problem behavior.
48REMEMBER!! If the intervention isn’t working, the team needs to reconvene to review the BIP. The BIP is a working document that can change as necessary.It is important to remember that if an intervention is not working, the team must reconvene to revise the BIP. The BIP is a working document that can be changed as necessary!
49Sensory IntegrationAbility of the child to modulate or regulate sensation as it comes in.Students may overreact to some types of sensory stimuli, but under react to others.Many students crave sensations and will seek it out from other students or adults.Some students will have meltdowns.No child is alike and some children will react differently to sensory stimuli on different days (Greenspan)Sensory integration is the ability of the child to modulate or regulate sensation as it comes in (Greenspan). Students may overreact to sights, touch and temperature but yet underreact to pain and sounds. Many students crave sensations so much that they will seek it out from another person. Other children may simply meltdown at the sound of the lawnmower outside the classroom window. No one child is alike and often children may react differently to sensations on different days.
50Questions to assess for appropriate programming …. Can the student self-regulate behavior?Is there a sensory preference?When does the student best learn?Does the student express appropriate affect to sensory input?How does the student manage transitions?What interests the student?Do sensory issues interfere with self-care skillsHow does the student handle social situations?Questions for the administrator & educator to assess in order to provide appropriate programming (Wetherby)Is the student able to self-regulate behavior and emotions?Does the student have a sensory preference in attention and learning?Is there a predictable time of day or type of activity when the student is most and least able to learn?Does the student express an appropriate range of affect in response to sensory input?How does the student manage transitions and changes in daily routines?What motivates and interests the student?Are the student’s self-care skills limited by sensory issues?How does the student handle social interactions?
51Sensory DietsRecommended for students who have sensory modulation difficulties.Can involve sight, hearing, touch, smell, taste, balance and weight.Occupational therapist can often provide guidance to help the student handle their sensory processing issues.Sensory Diets –Because children with ASD often have sensory modulation problems, sensory integration therapy is often recommended. The sensory issues may involve sight, hearing, touch, smell, taste, balance and weight. Most often an occupational therapist will recommend a sensory diet to assist the student in handling the sensory processing problems.
52Tips on Sensory DietsWill include both environmental and curriculum adaptationsShould not be done in isolation, but rather incorporated throughout the school day by all individuals that interact with the studentShould be part of the student’s IEP or 504 planAdjust as behaviors change over timeSensory diets will include modifications to curriculum as well as environmental adjustments.Sensory diet activities can do many things for a student during a school day. It can calm an over-aroused student, increase the activity of an under aroused student, prevent uncomfortable reactions to sensory input, reduce self-stimulatory behavior, increase classroom productivity for the child, and teach the child self-regulation strategies. Sensory diets should not be done in isolation. It should be incorporated throughout the school day by all individuals who interact with the student. The sensory diet should be part of the IEP or 504 plan and will need to be adjusted as the student’s behaviors change.
53Examples of a Sensory Diet Have student sit on wiggle ball or jump on a trampoline.Allow frequent breaks throughout the day.Provide easy access to stress balls and fidget toys that are squishy, soft, textured.Allow chewing on crunchy, chewy itemsDesignate an area in the room to stomp feet or pace.Never take physical education or recess away from a studentAllow use of a bean bag chair and/or listen to music, read.Minimize verbal directions.Use ear plugs or head phones.Use social stories.Limit the visual material hanging from ceiling or walls.Limit amount of visual information on worksheet.Use a lamp instead of overhead fluorescent lighting.Examples of a sensory diet:Have student sit on wiggle cushion or ball.Allow frequent breaks throughout the day.Have student jump on trampoline.Use stress balls and fidget toys.Allow chewing on crunchy, chewy itemsDesignate an area in the room to stomp feet or pace.Never take physical education or recess away from a studentProvide easy access to small hand fidgets (i.e. squishy, soft, textured, soft).Allow student to sit in a bean bag chair.Minimize verbal directions.Use ear plugs or head phones.Allow time for student to listen to favorite music .Use social stories about what might happen or sounds that can be heard in the room.Limit the amount of visual material hanging from ceiling or walls.Keep amount of visual information on worksheet to a minimum.Use a lamp instead of overhead fluorescent lighting.
54Including Students with ASD in General Education Classrooms
55Present Levels of Performance A narrative summary describing the student’s current achievement in their area of need.Determined by an evaluation, baseline data, observations, parental concerns.Serves as bridge between the evaluation process and the writing of goals and objectives.Must address strengths and needs and how the disability affects the student’s involvement in the general education curriculum.Will address transition if the student is 13 or older.Present Levels of Performance, Goals and Benchmarks for a student with autismPresent Level of Performance - The Present Level of Educational Performance (PLOP) is a narrative summary describing the student's current achievement in the areas of need as determined by an evaluation, baseline data, observation, and/or parental concerns. In understandable terms, the PLOP explains the data, areas of need, and how the disability affects the student’s progress in the general curriculum. The summary must be sufficient to provide a foundation for education planning, a starting point for instruction. It will serve as a bridge between the evaluation process and the annual goals written for the student. It specifically addresses the student's strengths and needs. It explains the needs of the student and states how the student's disability affects his or her involvement and progress in the general curriculum. The PLOP contains current specific, measurable, objective baseline information for each area of need affected by the disability. In addition, it links the evaluation results, the expectations of the general curriculum, and the goals for the student. If a student is thirteen or older, the PLOP must address the transition needs of the student in the areas of instruction, employment and post-school adult living, community services, and related services.
56Purpose of the PLOP Identify student’s needs Provide a baseline to establish goalsShould be stated in measurable and concise termsList & describe most recent evaluationsDescribe current performance and how student performs in general curriculumUse all relevant information from not only tests, but observations, parental and student input, class performance and other types of district assessments.The purpose of the PLOP is to identify a student's needs and establish a baseline from which to develop meaningful and measurable goals. The team should state present levels of performance in terms that are specific and measurable; list and describe most recent evaluation results that are educationally relevant; provide baseline data for each area of need; describe current, not past, performance; and describe how the student performs in the general curriculum. The baseline data will come from criterion-referenced tests, standardized evaluations, classroom performance, observations, parental and student input, and/or state-district-wide assessments.
57Impact on Gen EdMust be a statement on how the disability impacts the student’s involvement in the general curriculum.Examples:- "needs organizational skills for completing work on time" - "need for reading skills impedes completion of work at grade level" - "behavior prevents independent work on general education assignments"Finally there must be a statement on how the disability impacts the student’s involvement in the general curriculum. Examples include: "needs skills to perform independent tasks required for daily living" "auditory processing needs affects ability to take notes during lectures" "needs organizational skills for completing work on time" "requires assistance to interact with other children during group play" "need for reading skills impedes completion of work at grade level" "has difficulty participating in general physical education class" "needs skills to pass classes required for graduation by year’s end" "behavior prevents independent work on general education assignments"
58Example -Teacher records show that Jonah turns in a weekly average of 60% of his math assignments, and 50% of his English assignments (100% expected). Fewer than 75% of assignments turned in are complete. Jonah appears capable of completing the work as given. This performance jeopardizes completion of his coursework for graduation.Examples:Teacher records show that John turns in a weekly average of 60% of his math assignments, and 50% of his English assignments (100% expected). Fewer than 75% of assignments turned in are complete. He appears capable of completing the work as given. This performance jeopardizes completion of his coursework for graduation.
59Example -In unstructured settings and transitional times of the day, Yasmin’s activity level increases and she more likely violates school rules, or becomes agitated and angry. Yasmin does not de-escalate behavior and is not willing to discuss situations afterward. Disciplinary records indicate 8 disciplinary removals in the past 10 school days and 27 in 3 previous months, causing her to fall behind in her schoolwork. Yasmin’s reading fluency is interrupted by substitutions. Yasmin does not efficiently use context or phonics clues which affect her progress in reading as indicated by her performance on third grade classroom oral reading benchmark tests."In unstructured settings and transitional times of the day, Joanne’s activity level increases and she more likely violates school rules, or becomes agitated and angry. Joanne does not de-escalate behavior and is not willing to discuss situations afterward. Disciplinary records indicate 8 disciplinary removals in the past 10 school days and 27 in 3 previous months, causing her to fall behind in her schoolwork. Joanne’s reading fluency is interrupted by substitutions. Joanne does not efficiently use context or phonics clues which affect her progress in reading as indicated by her performance on third grade classroom oral reading benchmark tests."
60Example -Dennis is having difficulties in math. He is unable to meet the general education standards in the area of understanding and applying a variety of problem- solving strategies. He can compute additional problems when using touch math. He has difficulty processing story problems when they are read to him in a one-to-one situation. He does not understand the relationship of the language in the problems and the computation. Dennis needs to learn to set up and solve story problems. He was not able to complete any of the addition or subtraction story problems on the second grade math assessment.Charlie is having difficulties in math. He is unable to meet the general education standards in the area of understanding and applying a variety of problem-solving strategies. He can compute additional problems when using touch math. He has difficulty processing story problems when they are read to him in a one-to-one situation. He does not understand the relationship of the language in the problems and the computation. He needs to learn to set up and solve story problems. He was not able to complete any of the addition or subtraction story problems on the second grade math assessment.
61Goals & ObjectivesDescription of what a student with autism can reasonably expect to accomplish within a school year with the provision of special education services.Will provide the general direction for instruction for the student.Direct relationship between the present levels of performance and the goals/objectives section.Goals are descriptions of what a student can reasonably be expected to accomplish within a school year with the provision of special education services. They provide the general direction for instruction. There is a direct relationship between the information provided in the Present Levels of Performance section and the goals and objectives the IEP team will write.
62The Three M’s of Good Goal Must be meaningful. Necessary for student’s success in current & future environmentsMust be measurable. Serves as the foundation to develop the benchmarks.Must be monitored. Need the data to look at the effectiveness of the student’s educational program.Three characteristics of a well-written goal:1. It must be meaningful – the goal must be necessary and important for the student’s success in current and future environments including both school, home and community. The goal must be at a level of performance that is reasonable for the student to accomplish2. It must be measurable – The goal must be written to reflect behavior that is measurable. The goals will serve as part of the foundation to write benchmark objectives.3. It must be monitored – All goals should be monitored on a regular basis in order for the IEP team to make decisions regarding the student’s education. It also serves to make determinations on the effectiveness of the student’s educational program.
63Benchmarks or Objectives Milestones that specify what a student needs to accomplish to reach the annual goal.May reflect the district’s standards.Must be measurable and observable.Will represent the content or performance the student must accomplish.Should be reasonable and within the student’s ability to master.Benchmark (short-term) Objectives serve as the milestones which specify skill or performance levels a student needs to accomplish toward reaching their annual goal. These benchmarks often will reflect the school districts standards. They represent the actual content or performance the student is to accomplish at a specific interval or grade level.These benchmarks are measurable and observable steps between a student's present level of educational performance and the annual goals established for the student. They measure progress toward meeting the goals.
64Two Tests for Effectiveness Stranger Test - The goal or benchmark should be written so someone who did not write it can pick up the IEP and use it to develop appropriate instructional plans.So What Test –Consider the importance of the goal or benchmark . Ask and answer the question, "Is the skill indicated in this goal, or benchmark really an important skill for the student to learn?" The IEP team should ask another question, "Is this skill/ behavior one that the student's age-appropriate peers engage in?"Stranger Test - Both goals and benchmarks should be written so they can pass the "Stranger Test." The goal or benchmark should be written so someone who did not write it can pick up the IEP and use it to develop appropriate instructional plans.So What Test – This test means that the IEP Team considers the importance of the goal or benchmark . The IEP Team needs to answer the question, "Is the skill indicated in this goal, or benchmark really an important skill for the student to learn?" If the answer is, "No" then the goal or benchmark is probably inappropriate. The IEP Team must also consider the importance of the goal in light of social or age-appropriate relevance. The IEP team should ask another question, "Is this skill/behavior one that the student's age-appropriate peers engage in?" If the answer is "Yes" then this goal or benchmark should be considered.
65Key points to considerNumber of goals will depend on student’s individualized needs.Don’t write so many goals/objectives that a teacher is unable to appropriately teach during the year.Prioritize goals.Include general education teachers, parents and the student, when appropriate.The number of goals depends on the student's needs. The IEP team should not write so many goals that a teacher is unable to appropriately teach during the school year. Prioritize goals as essential and immediate needs of the student. Parents and general education teachers must be included in the writing of the goals and objectives. Students may be able to provide input into establishing goals and objectives. Students should always be considered as part of the IEP when appropriate.
66Example -PLEP: Joey displays difficulties writing his thoughts on paper. He has very creative ideas but does not understand sentence construction or how to develop paragraphs. He needs to use punctuation and capitalization consistently. Joey received 12 out of 50 points on the district's assessment for expressive writing. He needs to learn to write the four different sentence types (simple, compound, complex, and compound-complex) correctly and integrate them into a paragraph.Annual Goal:In 36 weeks Joey will write at least a six sentence paragraph using at least three different sentence types scoring 45/50 on the writing rubric.Benchmarks:1. Write simple sentences2. Write compound sentences3. Write complex sentences4. Write compound-complex sentences
67Another Example -PLEP: Michelle is working on enhancing reading fluency. Michelle has difficulty identifying words in isolation. When reading a test, she uses context clues and picture clues to identify words unfamiliar to her. When reading words in isolation, she attempts to dissect the word phonetically, but has difficulty drawing closure to the word and pronouncing the word as a whole. Michelle studied the DISSECT strategy in seventh grade. It appears she still uses this strategy with some limited success.When asked to read passages from her US History textbook, Michelle read at an average rate of 82 words per minute with 96% accuracy in word identification. This compares to a norm of words per minute with 98-99% accuracy for high school juniors. During this reading probe, Michelle stated that she can read faster when she reads aloud. It seems that her literal comprehension also improves when she is able to read aloud. She used a ruler as a guide to enable her to read line by line.PLEP: Michelle is working on the standard of the general education curriculum to enhance reading fluency. Michelle has difficulty identifying words in isolation. When reading a test, she uses context clues and picture clues to identify words unfamiliar to her. When reading words in isolation, she attempts to dissect the word phonetically, but has difficulty drawing closure to the word and pronouncing the word as a whole. Michelle studied the DISSECT word identification strategy in seventh grade. It appears she still uses this strategy with some limited success.When asked to read passages from her government textbook, Michelle read at an average rate of 82 words per minute with 96% accuracy in word identification. This compares to a norm of words per minute with 98-99% accuracy for high school juniors. During this reading probe, Michelle stated that she can read faster when she reads aloud. It seems that her literal comprehension also improves when she is able to read aloud. She used a ruler as a guide to enable her to read line by line.
68Goals and Benchmarks for Michelle Annual Goal: Given sample passages of at least 200 words or more from high school level textbooks, Michelle will read grade levels materials at an average rate of 100 wpm with 98% accuracy or better in word identification.Objectives:1. Michelle will read 200 word passage 90 wpm/98% accuracy2. Michelle will read 200 word passage 95 wpm/98% accuracyAnnual Goal: Given sample passages of at least 200 words or more from high school level textbooks, Michelle will read grade levels materials at an average rate of 100 wpm with 98% accuracy or better in word identification.Objectives:1. Michelle will read 200 word passage 90 wpm/98% accuracy2. Michelle will read 200 word passage 95 wpm/98% accuracy
69Appropriate Placement Options What is the LRE for students with autism?LRE is the educational environment providing the greatest access to general ed programs and to students without disabilities.The correct placement will allow a student with autism to benefit from an appropriate education.All placement options must be considered, starting with the general education setting.Examples include the regular classroom as well as the lunchroom, assemblies, recess, afterschool programs.Appropriate placement optionsThe Least Restrictive Environment (LRE) is the educational environment providing the greatest access to the general education programs and students without disabilities. The correct educational placement will allow student with autism to benefit from an appropriate education. The IEP team should base placement options on the specific needs of the student, what type of individualized assistance the student will need in the general education setting and a review of the continuum of servicesThe general education environment is the first consideration in the continuum of services. This setting includes the general education curriculum, as well as the nonacademic and extracurricular activities in which nondisabled students participate. Examples of the general education environment should include the instructional classroom, school-sponsored field trips, assemblies, breakfast and lunch breaks, recess and all activities that are offered to students by a school district. This also includes afterschool care, clubs and athletic programs.
70Considerations for LRE Need to consider the role of supplementary aids and services.Provide a continuum of alternative placements to meet the needs of students with autism.Must include a statement of the extent the student will not participate with nondisabled peers in the general education setting.An IEP Team may determine a student with autism cannot be educated appropriately in the general education setting, even when supplementary aids and services are available. It is the responsibility of the school district must make sure that a continuum of alternative placements is available to meet the needs of students with autism. A district can not say that they don’t provide classes for students with autism. The IEP team must include an explanation of the extent, if any, to which the student will not participate with nondisabled students in the general education settings and in extracurricular and nonacademic activities.
71Applied Behavior Analysis (ABA) Defined as the process of systematically applying interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree, and to demonstrate that the interventions employed are responsible for the improvement in behaviorIt is the application of the science of behavior to meet a certain end. Examples include improving the quality of a behavior by teaching the student to initiate play with others or to stop a ritualistic behavior that interferes with learning.(Baer, Wolf & Risley, 1968; Sulzer-Azaroff & Mayer, 1991).Applied Behavior Analysis (ABA) for students in the regular education classroomThe framework for Applied Behavior Analysis has been around for a very long time. Applied behavior analysis is defined as the process of systematically applying interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree, and to demonstrate that the interventions employed are responsible for the improvement in behavior (Baer, Wolf & Risley, 1968; Sulzer-Azaroff & Mayer, 1991).It is the application of the science of behavior to meet a certain end. In relation to working with students with ASD, it could be used to increase or decrease a particular behavior such as raising his/her hand to ask the teacher a question, to improve the quality of a behavior by teaching the student to initiate play with others at recess, to stop an old behavior such as a ritualistic behavior that interferes with learning, or teach a new behavior like choosing a library book to read.
72Seven Essential Elements of ABA Program must be applied.Program must be behavioral.Program must be analytic.Program must be technological.Program must be conceptually systematic.Program must be effective.Program should display generality.Baer, Wolf, and Risely (1968)It is a framework for teaching students with ASD, not a program that will “cure” autism. In one of the initial studies with ABA, Baer, Wolf, and Risely (1968) outlined seven essential elements of an ABA-based program:1. The program must be applied. The behaviors should have some social significance for helping the student with ASD experience success in the regular education classroom. A teacher might look at the skills a student would need to work in a cooperative learning group for a social studies assignment.2. The program must be behavioral. The environment and physical events need to be recorded with precision. What type of seating arrangement in a regular classroom does the student need? The teacher needs to work systematically with the student to become familiar with everyday routines so that he/she can be successful interacting with both the teacher and the students in the classroom.3. The program must be analytic. There must be clear evidence that the intervention is responsible for a change in a behavior. Data needs to be collected from the beginning to determine if the student is successful in the needed academic and social tasks required in the regular classroom. If success is not apparent, then the student’s team must look at what skills need more immediate attention.4.The program must be technological. The techniques that the teacher uses should be described completely enough to allow for duplication by another individual. The administrator and teacher must plan for the times when the adults that are in the classroom happen to be absent due to illness, professional leave, etc. Trained substitutes, while difficult to get, should be considered.5.The program must be conceptually systematic.. The program needs to have fidelity in working with the student and the goals purposeful so the student can succeed in the regular classroom.6.The program must be effective. The program should seek to change the targeted behavior if the intervention is not working. If the student is not progressing appropriately, the IEP team must reconvene to determine if goals need to be adjusted.7.The program should display some generality. A change in behavior should be seen in a wide variety of environments. The skills that a student learns to be successful in one subject area with one particular teacher should be generalized to other teachers and classrooms. Most students in general education classrooms do not spend the entire day in one setting with one teacher. Plans must be made for generalization or the student with ASD will not experience success.
73Major Elements of ABASelection of the interfering behavior or skill deficitIdentification of goals/objectivesEstablishment of method to measure target behaviorsEvaluation of current levels of performanceDesign and implementation of interventionsContinuous measurement of target behaviorsOngoing evaluation of the effectiveness of the intervention(Sulzer-Azaroff & Mayer, 1991)The major components of ABA instruction include (Sulzer-Azaroff & Mayer, 1991):- selection of interfering behavior or behavioral skill deficit- identification of goals and measurable objectives- establishment of a method of measuring target behaviors- evaluation of the current levels of performance (baseline)- design and implementation of the interventions that teach new skills and/or reduce interfering behaviors- continuous measurement of target behaviors to determine the effectiveness of the intervention, and- ongoing evaluation of the effectiveness of the intervention, with modifications made as necessary to maintain and/or increase both the effectiveness and the efficiency of the intervention.
74ABA & Socially Significant Behaviors Used to increase behaviors, such as social interactions;Used to teach new skills, such as communication or social skills;Used to maintain behaviors, such as self- control;Used to generalize or transfer behaviors to other settings;Used to restrict interfering behaviors; andUsed to reduce ritualistic behaviors.ABA generally focuses on the process of behavior change with respect to the development of specific “socially significant behaviors". Socially significant behaviors" include reading, academics, social skills, communication, and adaptive living skills. Adaptive living skills include gross and fine motor skills, eating and food preparation, toileting, dressing, personal self-care, domestic skills, time and punctuality, money and value, home and community orientation, and work skills.ABA methods are used to support persons with autism in at least six ways:1. to increase behaviors (eg reinforcement procedures increase on-task behavior, or social interactions);2. to teach new skills (eg, systematic instruction and reinforcement procedures teach reading and math skills, functional life skills, communication skills, or social skills);3.to maintain behaviors (eg, teaching self control and self-monitoring procedures to maintain and generalize age-appropriate social skills);4.to generalize or to transfer behavior from one situation or response to another (eg e.g., from communicating with the teacher at school, to interacting with classmates on the playground,);5. to restrict or narrow conditions under which interfering behaviors occur (eg, modifying the learning environment); and6. to reduce interfering behaviors (eg, ritualistic behavior).
75Measurement through ABA ABA focuses on reliable measurement.Behaviors must be defined objectively.Vague terms should not be used, such as “acting out”, “tantrums”, “aggressiveness”.Antecedents and consequences are manipulated to teach appropriate skills and eliminate inappropriate behaviors.ABA is critical to helping the student with autism to be successful in the regular education setting.(Sulzer-Azaroff & Mayer, 1991)ABA focuses on the reliable measurement and objective evaluation of observable behavior. Reliable measurement requires that behaviors are defined objectively. Vague terms such as anger, acting out, aggressiveness or tantrums are redefined in observable and quantifiable terms, so their frequency, duration or other measurable properties can be directly recorded (Sulzer-Azaroff & Mayer, 1991). For example, a goal of "Initiating social interaction with classroom peers" might be defined as: "looking at classmate and verbalizing an appropriate greeting."Treatment approaches grounded in ABA are an important piece of the educational interventions for students with autism. In general, the ABA framework utilizes manipulation of antecedents and consequences of behavior to teach new skills and eliminate maladaptive and excessive behaviors. ABA is one of the critical pieces of a student’s educational need to experience success in the regular education setting.
76Accommodations for the General Education Curriculum Supplementary Aids and Services - Must be discussed during the development of the student’s IEP. Must determine what aids, services, and other supports can be provided in general education classes or other educational settings to allow students with autism to be educated with nondisabled peers to the maximum extent appropriate.Accommodations and Modifications: Accommodations are supports/services provided to help a student with autism succeed in the general curriculum. Modifications are changes made to the content and performance expectations for students with autism.Potential accommodations for the general education curriculumSupplementary Aids and Services: Supplementary aids and services must be discussed during the development of the student’s IEP. The team will need to determine what aids, services, and other supports can be provided in general education classes or other educational settings to allow students with autism to be educated with nondisabled peers to the maximum extent appropriate.Accommodations and Modifications: Accommodations are supports or services provided to help a student with autism succeed in the general curriculum. Modifications are changes made to the content and performance expectations for students with autism.
77Six Types of Accommodations Physical ArrangementInstructional PresentationBehaviorOrganizationAssignmentsTest-TakingSix types of Accommodations:1. Physical Arrangement – seating near the teacher, standing near the student when giving directions, seating away from distracting noises or high traffic areas,2. Instructional Presentation – providing peer tutoring, graphic organizers, providing key words on the board or a written outline, notetaker, repeating directions or have the student repeat the directions back to the teacher, tape record the lesson, use a variety of multi-sensory modes to teach a lesson, use of the computer, break lessons and tests into shorter segments3. Organization – student writes homework in assignment book and teacher signs, extra set of books at home, study guide to assist with key points for test, send home weekly progress reports.4. Behavior – use time for task completion, giving extra privileges and rewards, allowing for short breaks between assignments, allowing student time out of seat to run errands, keep classroom rules clear and concise,5. Assignments – extra time, reducing reading level of assignments, adapting amount of homework (only doing the even numbers in math), structured routine for completing homework (math on Monday, ELA on Tuesday), only one test per day to prepare for, assignments can be printed on computer, allowing students to print, credit for oral responses and participation.6. Test-Taking – give exam orally, take home tests, allowing extra time, reading test item to student, giving frequent short quizzes, using more objective items (fewer essay responses)
78Progress Monitoring How will the goal or objective be measured? Progress monitoring will determine how the data collected with be used in decision- making situations.Progress monitoring will help to determine if the student with ASD is achieving his/her goals.Benchmarks can be used for progress monitoring.Progress monitoringWhen the IEP Team writes a goal, it is critical to determine how the goal will be measured. Progress monitoring will guide how the data will be collected to make decisions about the progress of the student on the goal and will establish the plan for examining the data collected. Progress monitoring will allow the IEP Team to assess whether the student with autism is achieving his or her goals. IEP Teams need to consider the benchmarks that have been written as steps toward the annual goal. These benchmarks can be used as progress monitoring if they represent equal steps toward the annual goal.
79Factors to consider - Who will be responsible for data collection; The setting where data will be collected;The method of data collection;The measurement conditions;The monitoring schedule for data collection;A decision-making strategy to determine under what conditions a student's performance is sufficiently delayed to warrant an instructional change;The number of times per year the parents will receive communication about the student's progress toward the goal (as often as nondisabled peers); andThe method for informing the parents of the progress.Several factors need to be considered when setting up the progress monitoring plan:1. Who will be responsible for data collection;2. The setting where data will be collected;3. The method of data collection;4. The measurement conditions;5. The monitoring schedule for data collection;6. A decision-making strategy to determine under what conditions a student's performance is sufficiently delayed to warrant an instructional change;7. The number of times per year the parents will receive communication about the student's progress toward the goal (as often as nondisabled peers); and8. The method for informing the parents of the progress.
80Examples -Goal 1: In 9 weeks, Carl will wait for his turn during a variety of classroom activities for three out of four times successfully for three consecutive weeks.Monitoring Strategy: The frequency of measurement is one randomly selected day per week; the behavior measure is Carl's turn taking behavior. The data will be collected by the classroom teacher in the classroom across all classes.The data will be charted with a goal line. The decision- making plan is to examine instructional intervention when Carl is below goal line for two consecutive weeks. Carl’s parents will be notified each time Carl is below the goal line for the two consecutive weeks and will receive a progress report four times a year with his report card.Example -Goal 1: In 9 weeks, John will wait for his turn during a variety of classroom activities for three out of four times successfully for three consecutive weeks.Monitoring Strategy: The frequency of measurement is one randomly selected day per week; the behavior measure is John's turn taking behavior. The data will be collected by the classroom teacher in the classroom across all classes.The data will be charted with a goal line. The decision- making plan is to examine instructional intervention when John is below goal line for two consecutive weeks. John’s parents will be notified each time John is below the goal line for the two consecutive weeks and will receive a progress report four times a year with his report card.
81Example -Goal 1: In 3 weeks, when given a choice of topics daily, Joan will write two paragraphs in a daily journal in the general education ELA classroom, scoring 5/6 points for a period of five consecutive days using the Six-Trait Writing rubric.Monitoring Strategy: The frequency of measurement will be five times per week and the measure is written expression as determined by points from the classroom rubric for Six-Trait Writing as applied to the daily journal. The regular classroom teacher will score Joan's writing by using the rubric. The data will be charted. A goal line will be drawn and decisions will be based on a goal line comparison. Joan's parents will receive a progress report four times a year with her report card.Goal 1: In 3 weeks, when given a choice of topics daily, Diana will write two paragraphs in a daily journal in the general education ELA classroom, scoring 5/6 points for a period of five consecutive days using the Six-Trait Writing rubric.Monitoring Strategy: The frequency of measurement will be five times per week and the measure is written expression as determined by points from the classroom rubric for Six-Trait Writing as applied to the daily journal. The regular classroom teacher will score Diana's writing by using the rubric. The data will be charted. A goal line will be drawn and decisions will be based on a goal line comparison. Diana's parents will receive a progress report four times a year with her report card.
82Social Stories First defined by Carol Gray in 1991 Defined as a “situation, skill or concept in terms of relevant social cues, perspectives, and common responses in a specifically defined style and format.”“ The goal of a Social Story is to share accurate social information in a patient and reassuring manner that is easily understood by its audience. Half of all Social Stories developed should affirm something that an individual does well. Although the goal of a Social Story should never be to change the individual’s behavior, that individual’s improved understanding of events and expectations may lead to more effective responses.”(www.thegraycenter.org)Carol Gray first defined the term “Social Story” in On her website, , she describes the Social Story as “a situation, skill, or concept in terms of relevant social cues, perspectives, and common responses in a specifically defined style and format. The goal of a Social Story is to share accurate social information in a patient and reassuring manner that is easily understood by its audience. Half of all Social Stories developed should affirm something that an individual does well. Although the goal of a Social Story should never be to change the individual’s behavior, that individual’s improved understanding of events and expectations may lead to more effective responses.”
83Social Stories continued…. A means for teaching social skills to children with ASD .Provides a student with appropriate information about a situation that he/she may find difficult or that may lead to behavior concerns because the student finds the event confusing.The situation is described in detail and focus is given to the important social cues, the actual event and the potential reaction the student might expect to occur and why.Goal is to increase the student’s understanding of the situation, which in turn will hopefully make him/her more comfortable. The story will suggest some appropriate responses for the situation in question.(www.thegraycenter.org)Social Stories are a means for teaching social skills to children with ASD . Social stories provide a student with appropriate information about a situation that he/she may find difficult or that may lead to behavior concerns because the student finds the event confusing. In the Social Story, the situation is described in detail and focus is given to the important social cues, the actual event and the potential reaction the student might expect to occur and why. The educator’s goal in utilizing a social story is to increase the student’s understanding of the situation, which in turn will hopefully make him/her more comfortable. The story will suggest some appropriate responses for the situation in question.
84Social Stories continued….. Will help the student predict actions of others.Presents information in structured manner.Utilizes words, pictures and symbols.Allows the child to practice needed skills with the teacher before a situation arises.Written from the viewpoint of the child.Focus on what is causing the behavior.The expected response should be clearly defined.Social Stories can assist the student in predicting the actions of others during specific situations. The stories will also present information on social situations in a structured and consistent manner which is critical for students with ASD. Social Stories often give the students the social information through not only words, but pictures and symbols as opposed to verbalization. Finally, Social Stories assist the teacher to help the student practice the needed skills before a difficult situation arises.A Social Story is written from the viewpoint of the child. Higher functioning children can assist in the writing of the story, may often be able to talk about the situations where they are having difficulty and actually assist the teacher and/or parent in writing the story. For those students who are nonverbal or lower functioning writing a story will require the teacher or administrator to do a more careful observation. Focus of the story should not be on the behavior itself, but what is causing the behavior of the given situation. For example, if a young child may begin to tantrum or cry when when he goes to the bus and discovers that the regular bus driver is out sick. You do not write about the behavior which is the tantrum or crying. A better approach would be to write a Social Story about being scared to step on the bus with an unknown person. The Social Story would involve what is the appropriate response if the student doesn’t know the person. What are some options for a social story in this situation? Is it possible to have pictures of the substitute bus drivers, can the bus driver come into the school if time permits to meet the student or can the school arrange for alternative transportation. If the student is verbal, the Social Story might include questions for the student to ask the unknown bus driver. It is critical that the expected response is clearly defined.
85Writing a Social Story Write in first person and present-tense. Use descriptive sentences that address the “wh” questions.Use perspective sentences that address the emotions and thoughts of other students and adults.Tailor the desired responses specifically to the student through the use of directive sentences.Provide control sentences written by the student to help him remember the situation and how to deal with it. Most effective with higher functioning students with ASD.Writing a Social StoryWriting a Social Story can be both fun and challenging. It should be in first-person and present-tense to provide a student with as much information about a social situation, so he/she is better prepared to face, and act appropriately in, that situation. In writing a Social Story, there are several guidelines to follow in creating the sentences:Descriptive sentences objectively address the “wh” questions: where the situation takes place, who is involved, what they are doing, and why they may be doing it.Perspective sentences provide details about the emotions and thoughts of other students, teachers, administrators and school personnel.Directive sentences are the desired responses tailored specifically to the student.Control sentences are authored by the student himself as something of a mnemonic device -- a sentence to help him remember the story or deal with the situation. These are not used in every story and are typically used only with fairly high functioning children.
86Example -This Social Story would be appropriate for a young child during times where the class moves to the carpet to hear the teacher read a story to the whole class.Sitting on the CarpetSometimes our class sits on the carpet. (descriptive) We sit on the carpet to listen to stories and for group lessons. (descriptive) My friends are trying hard to listen so they can enjoy the story or learn from the lessons. (perspective) It can be hard for them to listen is someone is noisy or not sitting still. (descriptive) I will try to sit still and stay quiet during our time on the carpet. (descriptive)(www.polyxo.com/socialstories/introduction.html)Below is a sample social story taken from the website This Social Story would be appropriate for a young child during times where the class moves to the carpet to hear the teacher read a story to the whole class.Sitting on the CarpetSometimes our class sits on the carpet. (descriptive) We sit on the carpet to listen to stories and for group lessons. (descriptive) My friends are trying hard to listen so they can enjoy the story or learn from the lessons. (perspective) It can be hard for them to listen is someone is noisy or not sitting still. (descriptive) I will try to sit still and stay quiet during our time on the carpet. (descriptive)Always make sure that you are write the Social Story with the child in mind. It is important to use age-appropriate vocabulary and an appropriate font size. If you are working with a young child it may mean putting a single idea on each page with the text and an illustration. A middle school student who can read might require a longer story with regular-size fonts and no illustrations
87Presentation Styles - Social Story Illustrations - Illustrate pages of the story with photographs or illustrations. Do not clutter the page.Symbols -- The words can be illustrated with symbols rather than pictures. The use of Boardmaker by the Mayer-Johnson Company and PECS, the Picture Exchange Communication System, are good choices for symbol illustrations.Social Stories on tape – A teacher can be record a story depending on the functioning level of the student. Add a verbal cue to help the student turn the page. This allows for more independence.Video -- A video could be made of the student and peers acting out appropriate scenarios. If necessary, a written story could be provided along with the video. The Gray Center and Special Minds Foundation in South Carolina have teamed together to make a series of Storymovies that are available for educators.(www.specialminds.org)Presentation styles for the Social StoryThere are many ways to present the Social Story. The administrator or educator must adapt the story to the specific individual needs of the student. Some options might be:Illustrations -- The teacher, parent or child can illustrate each page of the story. Photographs can be used. Photographs or illustrations will make the story more interesting and provide any visual support the student may need. Depending on the needs of the student, the illustrations should be simple, not complex. In some cases, with a lower functioning student, actual items can be used to go along with the story and illustrations. The page should not be cluttered with pictures and words.Symbols -- The words in the story can also be illustrated with symbols rather than pictures. These symbols will represent words and ideas that the student is familiar with. The use of Boardmaker by the Mayer-Johnson Company and PECS, the Picture Exchange Communication System, are good choices for symbol illustrations in Social Stories.Social Stories on tape -- A Social Story can be recorded depending on the functioning level of the student. A verbal cue may need to be provided to cue the student to turn the page. This option enables the student to be more independent.Video -- A short filmed video could be made of the student and peers acting out appropriate scenarios rather than providing a written story. If necessary, a written story could be provided along with the video. The Gray Center and Special Minds Foundation in South Carolina (http://www.specialminds.org) have teamed together to make a series of Storymovies that are available for educators.
88Visual Schedules Provides predictability for a student with ASD. Allows for the student to know “what happens next”.Will help reduce anxiety.Helps the student understand how the school day is set up.Serves as a good behavior tool.Helps to increase choice-making.Gives the student input into the order of school assignments.Providing a structure and daily routine in the classroom will allow students with ASD to be more productive. Predictability and organization are key in helps students understand the relationship between their behavior and the consequences. For example, after completing a reading assignment, the student will have ten minutes to play a game on the computer. The purpose of providing a visual schedule to a student with ASD is to give him or her that predictability and structure to anticipate what will happen next. It serves to reduce anxiety and give the student a vision of how the school day will be set-up. It can serve as a behavior tool for students to first complete a more difficult or undesirable task, followed by a fun or desirable activity. Visual schedules can also increase choice-making skills by allowing the student to have input into the order of school assignments that must be completed during the day.
89Examples of Visual Schedules A three-ring binder that is portable for the student to move from class to class.A large pictorial poster that indicates by pictures the activities a student needs to complete during the morning and/or afternoon.A pocket chart that is located on a wall near the student’s desk.A chart that is attached to the top of the student’s desk with pictures that can be adjusted during the day to match the activities the student will participate inA laminated portable page that includes vocabulary, rather then pictures, and a clock with the time of each activity or class.Photographs with a concrete object representing the photograph for a more cognitively involved student.Teachers must tailor the visual schedule to fit the individualized needs of the student as well as the whole class. Schedules can be as simple or as complex as necessary to benefit the educational level of the student. Examples might include:A three-ring binder that is portable for the student to move from class to class.A large pictorial poster that indicates by pictures the activities a student needs to complete during the morning and/or afternoon.A pocket chart that is located on a wall near the student’s desk.A chart that is attached to the top of the student’s desk with pictures that can be adjusted during the day to match the activities the student will participate inA laminated portable page that includes vocabulary, rather then pictures, and a clock with the time of each activity or class.Photographs with a concrete object representing the photograph for a more cognitively involved student.