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Day One o Setting the stage o Spotlighting evidence based practice o Act I: Horizon Elementary o Act II: Clawson Middle School Day Two o Act III: Holt.

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Presentation on theme: "Day One o Setting the stage o Spotlighting evidence based practice o Act I: Horizon Elementary o Act II: Clawson Middle School Day Two o Act III: Holt."— Presentation transcript:

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2 Day One o Setting the stage o Spotlighting evidence based practice o Act I: Horizon Elementary o Act II: Clawson Middle School Day Two o Act III: Holt High School o A script for implementing EBP o Practice with your crew

3 is the culmination of many years of work supporting the implementation of evidence based practices in schools along with the recent collaborative partnership project with the National Professional Development Center on Autism Spectrum Disorders from Our aim is to train and support school building teams to create student IEP goals that best reflect the needs of the student and match those goals to evidence based practices that will help the students and team meet those goals.

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6 If you type in the words autism and treatment in Google you get: 17,800,000 results in.09 seconds

7 We have warnings for many things in our society

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10 Elephant Therapy!

11 Injection of immunological substances Vitamin therapy Hormone therapy Facilitated communication Biofeedback Hyperbaric oxygen chamber therapy Auditory integration Massage of the scalp Prism lenses Complex rhythmic drumming Electromagnetic therapy Holding therapy Dolphin therapy

12 When families seek treatment for a child diagnosed with cancer or diabetes, they arent given a long list of interventions that someone somewhere believes to be effective, and told to choose from that list on their own; they can usually expect to be informed about treatments that are based on sound scientific research. Why do we settle for less when the diagnosis is ASD? Retrieved from asatonline.org (2011)

13 So many treatments, so much information

14 A try everything mindset leads one to believe that treatment of autism is based upon the quantity of interventions, as opposed to the quality of interventions Celiberti et al., The Road Less Traveled: Charting a Clear Course for Autism Treatment (http://www.researchautism.org/uploads/roadless.pdf ) (p. 5)http://www.researchautism.org/uploads/roadless.pdf

15 Primum non nocere: FIRST DO NO HARM Example: Facilitated Communication – Potentially Harmful Therapy Lilienfeld, S. (2007). Psychological treatments that cause harm. Perspectives on Psychological Science, 2,

16 Time, money, energy that is NOT directed toward evidence-based intervention

17 Teach people to be good consumers of information through understanding the scientific process… yes, really. Teach people to collect data in a rigorous way and control for confounding variables. If you dont partner with families and providers, they will proceed without you. Its better to work with them (S. Harris, years ago)

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19 All students in public education should have access to scientifically based practices (NCLB, 2001).

20 You must have reliable evidence that a program or practice works. NCLB requires experimental studies that are similar to the medical model of research used by scientists. These studies require many steps to prove strong evidence of effectiveness. Well designed studies that use random samples of the population Trials must also include a random control group for comparison Valid and reliable outcome measures Data on long-term outcomes Trials in more than one site of implementation

21 What are examples of universal EBP practices for all students? Behavioral expectations Evidence based approaches to teaching reading What is the environmental context for all students attending school? General education curriculum, instruction, social interaction, transitions

22 All Some Few 3-Tiered Model of Support Universal EBPs TIER 1

23 Specific EBPs for students with ASD are deficit driven and based on the students lack of progress. Deficits and lack of progress become IEP goals. Students arent making progress in… Academic learning Socialization Communication Behavior expectations

24 All Some Few 3-Tiered Model of Support Targeted and Intensive EBPs Intervention TIER 2 & 3 Universal EBPs TIER 1

25 What are examples of targeted or intensive practices? Self-management systems Video modeling Discrete trial teaching PECS Functional communication training (FCT)

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27 The National Professional Development Center on Autism Spectrum Disorders is a multi-university center to promote the use of evidence-based practice for children and adolescents with autism spectrum disorders. t/evidence-based-practices

28 "In a field rife with fads, pseudoscience, and popular, yet unproven, interventions, the findings of the National Standards Project are a welcome and much-needed counterbalance to much of the hyperbole for both professionals and families." --- Peter Gerhardt, Ed.D.

29 ASAT is a not-for-profit organization of parents and professionals committed to improving the education, treatment, and care of people with autism. Since autism was first identified, there has been a long history of failed treatments and fads, levied on vulnerable individuals as well as on their families. Since ASAT was established in 1998, it has been our goal to work toward adopting higher standards of accountability for the care, education and treatment of all individuals with autism. esc.htm

30 To make it easier to remember the steps of the project, just remember building 2 target students 3 IEP goals per target student 4 Evidence Based Practices (EBPs) to address the IEP goals

31 Description of the student Developing the GAS goals from the IEP Selecting the EBP Implementation Plan & Process Ongoing Review & Adjustments Expansion to other students

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33 Expanding Childrens IEP Goals through the Goal Attainment Scale (GAS) Goal Attainment Scale (GAS) is designed to document progress on IEP goals, objective, and benchmark. Provides a summative rating to evaluate outcomes for students

34 Much less than expected Present level of performance Somewhat less than expected Progress toward goal Expected level of outcome Annual Goal Somewhat more than expected Exceeds annual goal Much more than expected Far exceeds annual goal Dan is inconsistently performing job tasks. He needs verbal, gesture and visual prompting to complete a task. Given a 5-step vocational task and visual supports, Dan will complete 3/5 steps independently over 3 consecutive probe days. Given 2 different 5-step vocational tasks and visual supports, Dan will complete 4/5 steps independently over 3 consecutive probe days. Given 3 different 5-step vocational task and visual supports, Dan will complete 4/5 steps independently over 3 consecutive probe days. Given any familiar 5-step vocational task and visual supports, Dan will complete 4/5 steps independently over 3 consecutive probe days.

35 Description of Scaling Consists of a five point range of performance for students: Much less than expected (present level) Somewhat less than expected Expected level of outcome (annual goal) Somewhat more than expected Much more than expected

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37 To make it easier to remember the steps of the project, just remember building 2 target students 3 IEP goals per target student 4 Evidence Based Practices (EBPs) to address the IEP goals

38 Review Checklist Discuss Building and Student Selection

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40 Condition-- Under what condition and using what support should the skill be demonstrated? Behavior Use verbs to describe behavior What competency / skill should change? Observable behavior Criteria Describes level of mastery such as much or how well the behavior is demonstrated Writing Measurable Goals: Formula for Success

41 Condition Circumstances the student will need in order to perform the expected skill (when, where, with whom, type of activity, with what support, etc.) When given a verbal request During transition periods During a social conversation During class discussions When shown a three choices When prompted (specify type and # ) When given a check schedule card When prompted (specify type and #) to a visual schedule Using peers / peer to peer support Using a choice modification strategy During lunch (math, science, etc)

42 BehaviorUse verbs to describe behavior Choose / select Raise hand Remain in seat / area Answer questions Request Locate / find Put on / Take off Respond to (describe) Complete task Transition to next activity Look at Wait to be called on Ask for help Ask a peer Follow direction

43 Criteria Describes level of mastery such as much or how well the behavior is demonstrated 9 out of 10 opportunities 6 items 75% accuracy Increase by 10% 3 times a day On 9 consecutive attempts For 15 minutes at a time Within 5 minutes 4 times weekly 3 out of 5 days 4 class periods

44 Marci will have improved functional communication skills for indicating wants and needs. Marci will use a system of words, pictures, gestures to indicate basic wants and needs during classroom activities. (8 of 10 trials) Marci will use a picture schedule to follow daily classroom routines with minimal prompting. (8 of 10 trials) Marci will use a system of words, pictures, gestures to participate in conversational routines with peers. (8 of 10 trials)

45 Chris will improve his social communication skills in the classroom setting. Chris will raise his hand when he needs assistance or wants to share important information. (90% of time) Chris will ask for help and accept teacher response when he doesnt understand something. (80% of time) With gestural prompts from peers and adults, Chris will limit conversational ideas appropriate to the setting. (90% of time)

46 Goal Attainment Scaling Present Level Benchmark Annual Goal More than Expected Much More than Expected

47 Expanding Childrens IEP Goals through the Goal Attainment Scale (GAS) Goal Attainment Scale (GAS) is designed to document progress on IEP goals, objective, and benchmark. Provides a summative rating to evaluate outcomes for students

48 1. Review students IEP Goals with teacher/parents 2. Identify 3 priority goals for each target student must be observable and measurable must be agreed on by family and team 3. Collect data on present level of performance

49 Description of Scaling Consists of a five point range of performance for students: Much less than expected (present level) Somewhat less than expected (benchmark) Expected level of outcome (annual goal) Somewhat more than expected Much more than expected

50 First: Write the annual goal Second: Identify the current level

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52 Changing Prompt Level Physical prompt (-2) Gestural prompt (-1) Verbal prompt (0) Visual prompt (+1) Independent (+2) Changing Setting One setting in school (-1) Two settings in school (0) 2 school settings plus 1 community setting (+2) Changing People No adults (-2) Familiar adult (-1) Unfamiliar adult (0) With one peer (+1) Across multiple peers (+2)

53 Measurement can be collected: Within a class period Across days During a 15-min probe By specific number of opportunities given

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55 Jon is a preschool student with autism Jons annual goal reads, When entering the classroom in the morning and with a visual prompt Jon will greet at least one peer by saying hi or waving for 4/5 mornings for 2 consecutive weeks. The classroom team took data prior to the meeting for everyday for two weeks and determined that Jon never greets peers or professionals

56 -2 Much less than expected (Present Level of Performance) Somewhat less than expected (Progress toward goal) 0 Expected level of outcome (Annual Goal) +1 Somewhat more than expected (Exceeds annual goal) +2 Much more than expected (Far exceeds annual goal) When he enters class, Jon does not greet his peers or teaching staff. When entering the classroom in the morning and with a verbal prompt and picture cue, Jon will greet at least one peer by saying hi or waving for 4/5 mornings for a week When entering the classroom in the morning and with a visual prompt, Jon will greet at least one peer by saying hi or waving for 4/5 mornings for 2 consecutive weeks. When entering the classroom in the morning without a prompt, Jon will greet at least one peer by saying hi or waving for 4/5 mornings for 2 consecutive weeks. When entering school in the morning and without a prompt, Jon will greet at least two peers by saying hi or waving for 4/5 mornings for 2 consecutive weeks.

57 Dan is a high school school student with autism Dans annual goal reads, Given 2 different 5-step vocational tasks and visual supports, Dan will complete 4/5 steps independently over 3 consecutive probe days. The classroom team took data prior to the meeting for three days a week for two weeks and determined that Dan is inconsistently performing job tasks. He never completes steps to tasks independently, needing frequent verbal, gesture and visual prompting.

58 -2 Much less than expected (Present Level of Performance) Somewhat less than expected (Progress toward goal) 0 Expected level of outcome (Annual Goal) +1 Somewhat more than expected (Exceeds annual goal) +2 Much more than expected (Far exceeds annual goal) Dan is inconsistently performing job tasks. He needs verbal, gesture and visual prompting to complete a task. Given a 5-step vocational task and visual supports, Dan will complete 3/5 steps independently over 3 consecutive probe days. Given 2 different 5-step vocational task and visual supports, Dan will complete 4/5 steps independently over 3 consecutive probe days. Given 3 different 5-step vocational task and visual supports, Dan will complete 4/5 steps independently over 3 consecutive probe days. Given any familiar 5-step vocational task and visual supports, Dan will complete 4/5 steps independently over 3 consecutive probe days.

59 Sam is an 5 th grade student with autism who is included in a general education classroom for most of the day. Sams annual goal reads, When presented with a conversational attempt from a peer support student, Sam will respond and then continue the conversation by asking a follow-up question for 80% of opportunities over 3 consecutive days. A paraprofessional in the general education classroom took data for 5 days prior to the meeting. Peers initiated with Sam over 30 times, but Sam would just smile or laugh instead of responding verbally.

60 -2 Much less than expected (Present Level of Performance) Somewhat less than expected (Progress toward goal) 0 Expected level of outcome (Annual Goal) +1 Somewhat more than expected (Exceeds annual goal) +2 Much more than expected (Far exceeds annual goal) When presented with a conversational attempt from a peer, Sam will respond and then continue the conversation by asking a follow-up question for 0% of opportunities over 3 consecutive days across 3 different peers. When presented with a conversational attempt from a peer, Sam will respond and then continue the conversation by asking a follow-up question for 40% of opportunities over 3 consecutive days. When presented with a conversational attempt from a peer, Sam will respond and then continue the conversation by asking a follow-up question for 80% of opportunities over 3 consecutive days. When presented with a conversational attempt from a peer, Sam will respond and then continue the conversation by asking a follow-up question for 80% of opportunities over 3 consecutive days across 3 different peers. When presented with a conversational attempt from a peer, Sam will respond and then continue the conversation by asking a follow-up question for 80% of opportunities over 3 consecutive days across 3 different peers in 2 different settings.

61 Jack is a high school student with autism Jacks annual goal reads, When arriving at school, Jack will walk to the classroom with verbal and visual prompts 4 out of 5 days for 3 consecutive weeks. The classroom team took data prior to the meeting for everyday for two weeks and determined that Jack dropped, refused to get up, and had to be lifted into a wheelchair and wheeled to the classroom 9 out of the 10 days.

62 -2 Much less than expected (Present Level of Performance) Somewhat less than expected (Progress toward goal) 0 Expected level of outcome (Annual Goal) +1 Somewhat more than expected (Exceeds annual goal) +2 Much more than expected (Far exceeds annual goal) Jack drops to the ground upon arrival and during various times throughout the day. When arriving at school, Jack has to be lifted into a wheelchair and wheeled to the classroom 9/10 days. When arriving at school, Jack will walk to the classroom with verbal and visual prompts 2 out of 5 days for three consecutive weeks. When arriving at school, Jack will walk to the classroom with verbal and visual prompts 4 out of 5 days for three consecutive weeks. When arriving at school, Jack will walk to the classroom independently 4 out of 5 days for three consecutive weeks. Throughout the school day, Jack will walk through the school building independently 4 out of 5 days for three consecutive weeks.

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64 Practice Writing GAS Goals GAS Template

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67 Think about the context Does the EBP make sense for that environment? Think about the student Characteristics & Interests Strengths & Needs Think about the future Will it promote independence and socialization Will it lead to sustained learning or behavior change

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69 Student CharacteristicsEBP s to Consider If your student likes or learns best from repetition -Discrete trial teaching -Video modeling

70 Student Characteristics EBP s to Consider If your student likes or learns best from visual strategies -Visual supports -Video modeling -PECS -Social narratives

71 Student Characteristics EBP s to Consider If your student needs to improve independent skills -Self-management -Prompting -Structured work systems -Video modeling

72 Student Characteristics EBP s to Consider If your student has significant challenging behavior -Antecedent-based interventions -Functional communication training -Functional behavior assessment

73 Student Characteristics EBP s to Consider If your student does not have an effective communication system -Functional communication training -Speech generating devices/VOCA -PECS

74 EBPs are NOT usually used in isolation… Self-management requires reinforcement Video modeling may require prompting FCT requires FBA Professionals should be prepared to understand and implement a combination of EBPs

75 Review and Discussion of EBPs


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