Presentation on theme: "THE WORLD OF THE “D’S” ASD, ADHD, LD, DD & IDD Emily Boncek M.S., CRC & Lucy Gafford M.S., CRC Training Developed by Jennifer Kaut M.Ed.,BCBA Board Certified."— Presentation transcript:
THE WORLD OF THE “D’S” ASD, ADHD, LD, DD & IDD Emily Boncek M.S., CRC & Lucy Gafford M.S., CRC Training Developed by Jennifer Kaut M.Ed.,BCBA Board Certified Behavior Analyst DARS-DRS Developmental Disorder Specialist
DSM Definition of Level 1:DSM Definition of Level 2:DSM Definition of Level 3: Social communication: Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful response to social overtures of others. May appear to have decreased interest in social interactions. For example, a person who is able to speak in full sentences and engages in communication but whose to- and-fro conversation with others fails, and whose attempts to make friends are odd and typically unsuccessful. Restricted, repetitive behaviors: Inflexibility of behavior causes significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning hamper independence. Social communication: Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or abnormal responses to social overtures from others. For example, a person who speaks simple sentences, whose interaction is limited to narrow special interests, and how has markedly odd nonverbal communication. Restricted, repetitive behaviors: Inflexibility of behavior, difficulty coping with change, or other restricted/repetitive behaviors appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts. Distress and/or difficulty changing focus or action. Social communication: Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others. For example, a person with few words of intelligible speech who rarely initiates interaction and, when he or she does, makes unusual approaches to meet needs only and responds to only very direct social approaches. Restricted, repetitive behaviors: Inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly interfere with functioning in all spheres. Great distress/difficulty changing focus or action.
How Many Are We Sending for 18 + Services? 18 yrs: Total: 2,296 19 yrs Total: 688 (30%) 20 yrs Total: 488(21%) 21 yrs. Total: 392(17%) Level 1: 434 71 Percentage that go on to 18 + services: 16% 10 Percentage that go on to 18 + services:.02% 6 Percentage that go on to 18 + services:.01% Level 2: 201 70 Percentage that go on to 18 + services:35% 30 Percentage that go on to 18 + services:15% 4 Percentage that go on to 18 + services:.02% Level 3: 661547 Percentage that go on to 18 + services: 86% 448 Percentage that go on to 18 + services: 68% 382 Percentage that go on to 18 + services: 58%
In the next 10-12 years… Texas will TRIPLE the numbers of students graduating with Autism 2017-2019, Texas will have 9,838 students with Autism graduating. 2024-2026, Texas will have 32,433 students with Autism graduating
What Supports Did These Graduates Need in School and How Will These Reflect Their Transition Needs? (Predications based on the DSM 5 Levels of Severity)
What’s with all this Autism Stuff?? Why does it matter to me? I don’t have that many on my caseload! WHY? Because anything you do for ASD, is best practice for ANY developmental disorder. They are the largest disability population and we are the least successful with them….
OLD WayWhat WORKS Immediately sending for psychologicalIf they are not college bound, what will this tell you? Using the same psychological toolsIf you need a diagnosis for Autism, use the ASD psychological battery Traditional vocational assessmentViewing these consumers in a contrived setting will not give you an accurate assessment of work abilities, many are not “generalists” No other vocational assessment optionsIN PROGRESS: Environmental Work Assessment that measures HOW a work envirnoment either increases the disability characteristics or decreases. Treating with psychotherapyOnly use if the mental illness is barrier not the developmental delay Not treating social skill deficits and/or challenging behaviors Use Applied Behavior Analysis (ABA) providers to address these issues BEFORE work. IN PROGRESS: Updated policy Using CRP’s who have little experience with developmental disorders IN PROGRESS: Creating ASD/DD CRP specialists No choices if the consumer needed specialized support that was not therapy but outside the duties of a job coach IN PROGRESS: ASD/DD Supports
Simply put: ABA is a methodology whose goal is to socially significant behavior.
So what is “socially significant behaviors”? Any behavior that effects a person’s quality of life Communication Verbal Language Academics Self Help SkillsSocial Skills Vocational Skills Problem Behaviors
A pplied: ABA takes what we know about behavior and uses it to bring about real-world, meaningful change B ehavior: Behaviors are defined in observable and measurable terms in order to assess change over time A nalysis: Behaviors are analyzed within the environment to determine what factors are influencing the behavior
3 levels: BCaBA: Bachelor’s + behavior classes +supervised hrs.+ board exam BCBA: Master’s + behavior classes +supervised hrs +board exam BCBA-D: Doctorate +board exam All must have degree’s in Education, Sp. Education, Psychology, Social Work or Behavior Analysis.
What they can do: BCaBA/graduate student in a behavior analysis program Cannot do assessments Can only conduct intervention plans supervised by a BCBA & all reports on progress must be signed by a BCBA BCBA: Can do assessments Can do all interventions BCBA-D: Can do assessments Can do all interventions
How do I find one in my area? 2 ways: 1. Check Rehab Works 2. www.bacb.com (click on the page that says “find certificates”) www.bacb.com
Has a problem behavior that presents a barrier to employment You need to DECREASE these behaviors Has a deficit in social skills that present a barrier to employment. You need to INCREASE these behaviors
What if it looks like there is several problem behaviors and several deficits? You can call in a behaviorist to assess: Skill level Social skill level Communication ability Environments that would support their autism Environments to avoid Determine the function of any problem behaviors Identify triggers Identify preferred interests & reinforcers Determine if they have natural supports IF needed, provide a treatment plan to address these behaviors
Their parents are glued to them and speak for my consumer Parents might sabotage what we are doing Need more information to develop a plan CCSA is a great pairing with a FBA A behaviorist would work with ALL environments- if the environment presents a barrier to employment then we can address it.
What is the work goal? EX. If your consumers work goal is to work at a gaming company that provides tele-work or cubicles, little interaction, low lighting, then what social skills does he need? If he can respond when spoken to, follow supervisor’s instructions, accept feedback, has transportation and shows up dressed appropriately, then does he have a barrier?
Social Skills Support (Consumer does not have challenging behavior but displays skill deficits) Social Skill Assessment (up to 4 hrs) Intervention (group or individual up to 30 hrs) Behavioral Intervention (Consumer has challenging behaviors that need to be decreased) Functional Behavior Assessment(FBA) (up to 8 hrs) Behavior Intervention Plan(BIP) (group or individual up to 30 hrs) ***Any combination of individual or group can be used but the total is not to exceed 30 hours *** Challenging Behavior Skill Deficits
ABA is short term You should see progress Receive frequent updates on the mastery of the consumer’s goal A good therapist will redo the plan if progress is not shown quickly You should see generalization of skills in all environments People in the environment that is being treated should be trained in any plan or recommendations
RPM: Chapter 5 (5.3.7) Located after Mental Restoration Services Rehab Works Level 1- Evaluation Services Level 2-Behavior Analysis (will be changed to APPLED Behavior Analysis)
DD Regional Point of Contacts… Region 1Rick Bullard Region 2Gena Swett Region 3Dae Eun Region 4Marilyn Gilbreath Region 5Emily Boncek
2014 Statewide Developmental (ASD/DD/IDD/ADHD) Disorders Team Region 1 TOTAL: 7 & 2 VACANT w/CRPs: 13 Region 2 TOTAL: 14 w/CRPs: 24 Region 3 TOTAL: 12 w/CRPs: 20 Region 4 TOTAL: 7 & 1 VACANT w/CRPs: 9 Region 5 TOTAL: 16 w/CRPs: 23 Ellen Dingus Wichita Falls Trinetta Powell Plano Michael Marler Round Rock VACANT Conroe Ruby Wilkins/ Cinda Alvarado San A. Northeast Jonathan Perkin(UPS) Abilene Tina Shaffer Garland Elsa Perez/Stanley Bell South Austin Veronica Comeaux North Houston Erlinda Leal/Blanca Perez/Becky Ashton San A North Mary Ellen Pate San Angelo Diana Terry Ft. Worth South Lori Charlton Cleburne Debbie Browne East Austin Karen Williams Southwest Houston Steven Martinez/Alma Alvarez San A South Della Moore & David Enrique El Paso Central Kelly Holloway Lewisville Patrice Rabalais Beaumount Eligio Hinojosa Houston Central Debbie Rodriguez San A West Ashley Richardson Lubbock South Mary Faltaous Carrollton Teresa Frechette Temple Kristie Sekmistrz South Houston Sherri Eddy Harlingen Debbie Edwards Lubbock West Kellie Harrison/Lucy Gafford(AM) Denton Jennifer McCurley Tyler Catherine Guillory Houston West Gabby Martinez McAllen VACANT Odessa Katharine Bowdre Sherman Lhea Homesley Waco Solomon Ambani Houston West Leigh Ann Godinez McAllen VACANT Amarillo Deanna Layfield Dallas Southeast Giovanne Bell College Station Nichole Rideux Humble Sasha Esparza/Michael Day Corpus Christi Angela Gonzalez Dallas Northeast LeAnn Bolwerk Longview Nick Boyko Texas City Jacqueline Gutierrez/Esmeralda Lopez Laredo Jennifer Reynolds/Brian Loftus/Virginia Shutt Arlington Susan Payne Paris/Texarkana Salynda Bryson Rosenberg Maricela Ponce New Braunfels Jacklyn Meade Fort Worth West Kelley Downey Lufkin Regional Point Person: Rick Bullard El Paso Area & Back up: David Enrique Regional Point Person: Gena Swett Back up’s: Audra Ressel & Lucy Gafford Regional Point Person: Dae Shin Regional Point Person: Marilyn Gilbreath Back up’ s Nick Boyko Regional Point Person: Emily Boncek Back up: Blanca Perez Additional Regional staff: Joe Morris, Mike Lawson Shannon Johnson (trainer) Additional Regional staff: Rosla Hocker, Betty Davis Additional Regional staff: Merry Straube,,Frank Donaldson, Kelly Yarbrough Additional Regional staff: Stephanie Jenkins Additional Regional Staff: Ron Garza, David Dehoyos, Johnny Weddington Team Lead: Jennifer Kaut M.Ed., BCBA Total ASD VR Counselors: 56 (updated 9/4/14) Total CRPs: 33(updated 9/4/14) Total: VR/CRP: 89
2014 Statewide Developmental (ASD/DD/IDD/ADHD) Disorders Team CRPs Region 1 Region 2 Region 3 Region 4 Region 5 ASD CRP TOTAL: 6 ASD CRP TOTAL: 10 ASD CRP TOTAL: 8 ASD CRP TOTAL: 2 ASD CRP TOTAL: 7 -Texas Employment Consultants -El Paso Helping People -Strassler Employment Services -After Mile Inc. -Ability Solutions -Burkhart Center (pending CRP status) -LauchAbility -Autism Treatment Center -Easter Seals-temple mays -UNT JobFit -Life Path Systems -Ability Solutions -Association for Independent Living -Bryant Guidry -Spectrum Services - Work Ready -Client Services of East Texas -Dverse Solutions -Goodwill(Central) -Debby Puckette -Bruce Bloom -Ability Solutions -Opportunity Center -Austin Dog Alliance -Easters Seals Greater Houston -University of Houston at Clearlake -Job Adventures -Goodwill (South TX) -Compass Resource Group -Autism Treatment Center -Gatehouse Supportive Services -HELP -Business Resource Center