Presentation on theme: "Increasing Learning Opportunities for Young Children with Autism Spectrum Disorders during Play and Daily Routines Jamie Owen-DeSchryver, Ph.D. & Amy."— Presentation transcript:
1 Increasing Learning Opportunities for Young Children with Autism Spectrum Disorders during Play and Daily RoutinesJamie Owen-DeSchryver, Ph.D. & Amy Matthews, Ph.D.Grand Valley State University
2 Introductions & Agenda FoundationsBrief introduction to the START projectBrief introduction to core characteristics of young children with ASDPrimary ContentIncreasing learning opportunities and engagement during daily routines and play activitiesIncreasing communication opportunities during daily routines and play activitiesIncreasing imitation skills during daily routines and play activities
4 Thinking Different about Autism Spectrum Disorders, Professional Development, and Statewide Support
5 Purpose of STARTSTART serves as a coordinating and supporting entity for schools and regional networks across the state of Michigan to increase access to local training and resources for students with autism spectrum disorder.
7 START Early Intervention Intensive Training Targets preschool age, ECSE classrooms supporting children with ASDStrategies:Are good for children with a variety of developmental disabilitiesWill benefit children 0-3Were developed based on review of Evidence-Based practices
10 Autism Spectrum Disorders Numbers of students with ASD are increasing1 in 150 (CDC)1 in 91 (Health Resources & Services Administration)Age of diagnosis is earlierThis leads to more and more students with ASD served in birth-3 and preschool-age programs
11 Autism Spectrum Disorders Fastest-growing developmental disability$90 billion annual cost90% of current costs are in adult servicesCost of lifelong care can be reduced by 2/3 with early diagnosis and interventionAutism Society of America, 2006
12 DSM-IV Definition Core Deficits of Autism Differences in socializationDifferences in behaviorDifferences in communication
14 Joint AttentionThe core symptoms of autism are represented in the triad of impairments. Yet the earliest sign of autism is often manifested as a deficit in joint attention, which has a significant and pervasive impact on all developmental domains.
15 Intervention for Young Children with ASD The Foundations
16 16 hours of total intervention A Model Program for Children with ASD age 0-3 Boulware, et al. (2006): Project DATA for ToddlersIntegrated playgroup (5 typical peers, 2 children with ASD, 3 children with other disabilities)3 hours per week (2, 1.5 hour sessions)Individualized instruction (1:1)6 hours per week (2 hours 3x/wk)Family support in home or community2 hours per week by Project DATA staff, 5 by family16 hours of total intervention
17 Barriers to Implementing this Model? FinancialPersonnelPhilosophicalStatus quoOther??Given these issues, what CAN we do?
18 Learning Opportunities We can increaseLearning OpportunitiesActive EngagementWe can provide supported opportunities for learning that lead to better outcomes for children
20 What does a Learning Opportunity Look Like? 1. Instruction/activity/ situation is presented to the child2. Child has an opportunity to respond3. Child is given feedbackAcknowledgement that response was correct or situation went wellCorrection/prompt to help the child give a correct response or improve the situation
21 Engaged TimeIt may not be possible to provide learning opportunities all the time, but we can increase time engaged.Engaged time: Active involvement in productive activities that lead to learning. Provide pre-teaching, interesting materials, and adult and peer support
22 Reaching Our Ultimate Goals Why do we work so hard to increase learning opportunities?IndependenceSocializationPreparation for typical school experiencesQuality of life
23 Increasing Learning Opportunities & Engagement during Daily Routines and Play Activities
24 Increasing Learning Opportunities & Engagement during Daily Routines & Play Activities Strategies for Daily Routines & Play Activities:Goal Cards (CAMPS)Teach Play Skills- 3 Rs; goal cardsIncorporate Child InterestsUse Visual Supports (play schedule books, sequencing cards, visual schedule, computer book)Strategies for the Playground or BackyardPreteach SkillsUse Visual Supports (schedule, first-then)Interrupt & Redirect
25 Strategies to Increase Learning Opportunities & Engagement: Goal Cards Preschool Age:C – Communication goalsL – Literacy goals (letters, pre-reading)A – Academic goals (numbers, shapes, colors)M – Motor goals (gross, fine)S – Social goalsBirth – 3:C – Communication (verbal, PECS or sign language; choice-making, yes/no)A – Academic/pre-academic (colors, pre-numeracy skills)M – Motor (gross, fine)P – Play (basic toy play skills, e.g., building, imitation, simple pretend play)S – Social (turn-taking; fill-ins, joint attention)
26 Goal Card for Bath Time C: Communication goal Requests water “on/off”, “duck”, “pour”, “yes/no”A: Academic/Preacademic goalCounts or sorts bath toys/objects, Fills in words in songs: “this is the way we wash our _____ tummy”, points to body partsM: Motor goalScoops and pours waterP: Play goalWashes a baby dollS: Social goalPlays peek-a-boo with caregiver using the washcloth; fills in or participates in game “ready, set, ___(go)” (then pours water out of a cup or drops a toy in the water to make a splash)
27 Goal Card for Riding in the Car C: Communication goalVerbalizes or signs for seatbelt “on/off”, music “on/off”, window “up/down”, signs “all done” before having seat belt removedA: Academic/Preacademic goalLabels or points to objects in the environment (red car, yellow house, big truck, moon, etc.); points to picture that indicates destinationM: Motor goalClaps hands “yeah, we’re here”, uses pointer finger to touch colorforms/window decals on windowP: Play goalSings songs with caregiver, “if you’re happy…”; looks at book/listens to book on tape; moves or plays with window decalsS: Social goalWaving to people or objects (“wave bye-bye to the truck”)
28 Goal Card for Putting Shoes On C: Communication goalLabels “shoes,’ “socks”, requests “help me”, signs “all done” when finished putting shoes onA: Academic/Preacademic goalLabels or points to colors (where’s the red shoe?); counts “how many shoes do you have?”; finds item, “where’s the BIG shoe”M: Motor goalPushes foot into shoe; straps velcro; pulls on socks using two handsP: Play goal“Yay, you have your shoes on, let’s pretend we’re ice-skating”, “let’s hop like a bunny”, “let’s tiptoe”S: Social goalResponds to absurdities: e.g., caregiver putting shoe on her head; fills in words: “all ____ (done)” time to ___(go)”
29 Goal Card for Breakfast C: Communication goalChooses items (food, bowl, etc.,) either verbally or by pointingA: Academic/Preacademic goalSits in a chair for the meal, labels or points to colors/pictures on placematM: Motor goalHolds and uses spoon, uses a cup, drinks from strawP: Play goalPretends to feed stuffed animal/animal figurine; feeds baby dollS: Social goalShares food (hands food to caregiver/sibling when requested); takes turns (“my turn/your turn”);
30 Strategies to Increase Learning Opportunities & Engagement: Identify and Teach Appropriate Play SkillsChildren with ASD often:Have play skill deficitsHave a small play repertoireEngage in stereotyped behavior when given the opportunity to play
31 Identify and Teach Age-Appropriate Play Activities (Examples for children ages 2-3)
32 Basic Play Skill Targets DomainExample Play ActivitiesEarly toy playPut together/take apartPut in/ take outPlay with blocks and manipulativesBuilds/connectsMakes pretend objectsPlay with vehiclesOne action play with vehiclesPlays in a scene with vehiclesPlay with figures or stuffed animalsOne action play with figuresPlays in a scene with figuresPretend PlayPretends with one objectPretends without props
33 For More Information on Basic Play Skill Targets Teach 2 PlaySmith, M. (2001). Teaching playskills to children with ASDThe Assessment of Basic Language and Learning Skills (ABLLS)
34 Blanc et al., 2005The effects of adult guidance during play were beneficial for children with ASD, children with CI and for typical children, but more particularly for children with autism.Children with autism showed more complex, and higher developmental levels of play when they were supported/ prompted by adults.
35 An Applied Behavior Analysis (ABA) Approach to Presenting Instruction 3 RsRequest(Stimulus)ResponseReaction(Consequence)One to one teaching trialAt lunchWalking to speechVideo 191, 194, supernanny calling35
36 The 3 Rs are the same as a “Learning Opportunity” 36
37 Using the 3 Rs 100% Success is expected A child will be assisted until he is successfulFailure is not an optionDon’t make a request unless you are going to follow through37
38 What Does this Look Like with Play Targets? REQUEST: Make the request“Put the cups together”“Stack the blocks”“Make a train”“Fly the airplane”“Feed the baby”RESPONSE: If the child doesn’t respond, or responds incorrectly, prompt the correct responseREACTION: Praise and reward the child for the correct response
39 Incorporating an ABA Approach within Classroom Activities McBride & Schwartz (2003)- embedded instructional episodes (“Learning Opportunities” or “Request, Response, Reaction sequences”) into ongoing classroom routines and activitiesTeachers identified individualized IEP/IFSP goalsAddressed the target goals during classroom activities using an ABA approach
40 Goal cards can also focus on play: Building with Blocks C: Communication goalRequests block; says “uh-oh” when blocks fallA: Academic/pre-academic goalTouch counts blocks (with help); labels colors of blocksM: Motor goalCoordinates motor movements to build towerP: Play goalCrashes tower with toy car; imitates tower or model made by caregiver; figurine “jumps” off of towerS: Social goalHands block to caregiver; plays peek-a-boo behind the tower
41 and developmental approaches Strategies to Increase Learning Opportunities & Engagement: Incorporate Child InterestsBraiding the ABAand developmental approaches
42 Developmental Practices DAP Position Statement (NAEYC.org)Pivotal Response Treatment (Koegel et al., 2003)Naturalistic InstructionCapitalizes on children’s interests; natural consequencesTargets functional skills
43 Developmentally Appropriate Practice National Association for the Education of Young Children, 2009 (naeyc.org)Teaching to enhance development and learning“Developmentally appropriate teaching practices provide an optimal balance of adult-guided and child-guided experiences… child-guided experience proceeds primarily along the lines of children’s interests and actions, with strategic teacher support” (p. 17).
44 Incorporate Child Interests If you’re working with a child who likes Thomas the Tank Engine, how can you teach important skills using Thomas?Communication - requests ThomasAcademic – sorts engines by color; completes a Thomas puzzle with helpMotor - jumps over ThomasPlay - re-enacts a scene from a Thomas videoSocial – tolerates turn-taking with Thomas
45 Strategies to Increase Learning Opportunities & Engagement: Use Visual Supports Visual supports can be used to teach early play skillsEarly learners may not understand symbolic representations in picturesInitially, these students may require additional repetition, prompting and feedback (the 3 Rs) to use the visual supports effectively
46 Visual Supports: Play Schedule Book Identify specific functional play targets for the student; use pictures to cue the activities
47 Play Schedule Book: Where are you going with it?
48 Play Schedule Book: Where are you going with it?
49 Visual Supports Play Sequences Create picture schedules of play scenarios with sequenced steps3-Step Sequencing Cards:Cooking
56 Interrupting and Redirecting Get in the way!Make the path to the desired item or equipment through youPrompt and reinforce the child for appropriate play
57 SUMMARY Increasing Learning Opportunities & Engagement during Daily Routines & Play Activities Strategies for Daily Routines & Play Activities:Goal Cards (CAMPS)Teach Play Skills- 3 Rs; goal cardsIncorporate Child InterestsUse Visual Supports (play schedule books, sequencing cards, visual schedule, computer book)Strategies for the Playground or BackyardPreteach SkillsUse Visual Supports (schedule, first-then)Interrupt & Redirect
58 Increasing Communication Opportunities during Daily Routines & Play Activities
59 Increasing Communication Opportunities during Daily Routines & Play Activities Identify and teach a Functional Communication systemIncrease motivation for communication (natural and contrived events)Plan for and create communication opportunities (e.g., MITS approach, multiple domains)Prompt and fade support
60 CommunicationCommunication needs to be taught throughout the day, every day, by all adults in all environmentsCommunication should be a TOP priority of 0-3 programmingDecreases problem behaviorsAssociated with better prognosis
61 Each Child should have a Functional Communication System The ability to request:Desired items (e.g., “Want train”)Necessary items (e.g., “I need a fork”)Assistance (e.g., “Help please”)Attention (e.g., “Watch me!”)Actions (e.g., “Swing me”)Information (e.g., “What is it?”)Negative reinforcement – removing something unwanted (e.g., “Go away”, “Take a break”)
62 What is the “Right” Communication System? 1. Individualized2. Total communication3. What’s better, signing or pictures?4. Should we use alternative systems or just focus on language development?
63 Using Natural Events to Increase Motivation for Communication When is a child most likely to be hungry? Thirsty?If the child is thirsty, what has become more valuable?What behaviors might the child show?Good communication behaviors: opening cabinet, going to sink, getting a cupPoor communication behaviors: screaming, cryingThis scenario provides us with opportunities to teach requesting (e.g., cup, open cabinet, pour juice, etc.)
64 Using Contrived Events to Increase Motivation for Communication Create a situation that makes something more valuableGive the child his yogurt without a spoonGive the child only a small amount of her drinkBefore recess, provide the child with only one of his bootsHand the child a preferred item that’s been placed in a clear box that she can’t open on her own
65 Other Strategies to Increase Motivation for Communication In sight, but out of reachBegin favorite activity, then pause for communicationMissing materialsOffer choicesDisplay pictures of preferred items and activities throughout the environmentExpectant lookShow an interesting but unfamiliar item, prompt the child to ask questions (e.g., “What is it?”)Place preferred item in child’s sight, but out of reach (e.g., on a shelf)Begin a favorite activity and then pause (e.g., push the child in a swing, then facing the child grab the swing to stop it and wait until the child says “swing,” “push me,” etc.).Provide only some of the materials required for an activity (e.g., paint but no brush).Present the child with choices (e.g., “Do you want juice or water?”).Display pictures of preferred items and activities (e.g., picture of trains)Glance at materials and then look at the child expectantly (e.g., put an unopened juice box on the table during snack then look questioningly at the child).Show an interesting but unfamiliar item, have the child ask questions (e.g., “What is it?”)
66 MITS: Creating Learning Opportunities for Communication Multiple Incidental Teaching Sessions (MITS) (Charlop-Christy & Carpenter, 2000)Child initiates request by using adult as tool (child grabs adult’s arm and attempts to reach to the upper shelf for the cars)Adult verbally models “I want cars” and hands child one carAdult immediately implements two more trials of requesting: adult verbally models “I want cars” and provides more cars to the child after each appropriate request
67 Increasing Communication Skills Plan for and create communication opportunitiesFocus on initiation of communication--requesting is more important than labelingIdentify motivating items from multiple domains (not just food)Supernanny communication
68 Communication Targets from Multiple Domains Foods/Drinks/Snacks:ChipsPretzelsJuiceWaterToys with Multiple Pieces:PuzzlesPlay-dohTrain tracksCarsInteractive/Motor Activities:TicklesSwingingTrampoline“blanket slide”Bouncing on therapy ballToys Requiring Help:BubblesBalloonsSpinning tops, toys
69 How to Teach Requesting Using Sign Language Begin with the preferred item presentFirst opportunity: Provide a freebie while verbally labeling the item, “bubbles”!Next opportunity:Model the sign while verbally labeling the item, “bubbles”Then physically prompt the student to sign for the item; label it again, “bubbles”Provide the item and label it again, “bubbles”
70 Teaching Verbal Requesting Again, the first opportunity is a freebieThe label is provided, “tickle”Child receives item/activity immediately upon approximating the word
71 SUMMARY: Increasing Communication Opportunities during Daily Routines & Play Activities Identify and teach a Functional Communication systemIncrease motivation for communication (natural and contrived events)Plan for and create communication opportunities (e.g., MITS approach, multiple domains)Prompt and fade support
72 Increasing Imitation Skills during Daily Routines and Play Activities
73 Increasing Imitation Skills during Daily Routines and Play Activities Strategies to Increase ImitationReciprocal imitationTeach imitation using the 3 RsObservational play with matched toy setsObservational play through video modeling
74 ImitationDue to impairments in joint attention & possibly, due to differences in a region of the brain that holds “mirror neurons” children with ASD often show deficits in imitationLike other early learner skills, imitation may need to be systematically taught
75 For Children who Show Limited Awareness of Others: Use Reciprocal Imitation Reciprocal imitation involves the adult (or a peer) imitating the actions of the child using matched or similar toys (appropriate play actions, not inappropriate behaviors)
76 Teach Imitation Using the 3Rs Adult: Says “Do this” and pushes a busChild: (no response)Adult: physically assists child to push the bus and says “This is pushing the bus”
77 Learning through Observation Learning observationally, or learning from the environmentWatching peers and/or adults and imitating their behaviors
78 SUMMARY: Increasing Imitation Skills during Daily Routines and Play Activities Strategies to Increase ImitationReciprocal imitationTeach imitation using the 3 RsObservational play with matched toy setsObservational play through video modeling
79 THANKS!! Please complete an evaluation form Our Contact Information:Jamie Owen-DeSchryver, Ph.D.Amy Matthews, Ph.D.Souls
80 Selected ReferencesBlanc, R., Adrien, J., Roux, S., Barthelemy, C. (2005). Dysregulation of pretend play and communication development in children with autism. Autism, 9,Boulware, G., Schwartz, I., Sandall, S & McBride, B. (2006). Project DATA for toddlers: An inclusive approach to very young children with Autism Spectrum Disorder. Topics in Early Childhood Special Education, 26,McBride, B.J. & Schwartz, I.S. (2003). Effects of teaching early interventionists to use discrete trials during ongoing classroom activities. Topics in Early Childhood Special Education, 23, 5-17National Association for the Education of the Young Children (NAEYC, 2009). Developmentally Appropriate Practice in early childhood programs serving children from birth to age 8. Draft Position Statement, adopted 2009.