1. Embedded Intervention: Addressing Children’s Goals in Daily Activities Amy M. Casey Center for Child Development Vanderbilt University Medical Center

2. What is Embedded Intervention? A recommended approach for addressing the individualized goals of children with disabilities in their natural environments

3. Why is This Important? Practical Learn new skills in context where they’ll be used Multiple learning opportunities Classroom membership Independence Engagement

4. What is Engagement? Participation, being active, being involved, playing, on-task behavior, learning Engagement is the amount of time that children spend involved with the environment (adults, peers, or materials) in a way that is appropriate given their age, abilities, and surroundings.

5. The Importance of Engagement Improving engagement leads to positive change in children’s Behavior Interactions with others Thinking and reasoning skills

6. Engagement in Children With Disabilities Compared to typically-developing peers, children with disabilities spend More time passively nonengaged Less time interactively engaged with adults Less time attentionally engaged with peers Less time in master-level engagement with materials

7. Levels of Engagement Level 1: Nonengagement Unoccupied behavior Crying Whining Aggression Wandering aimlessly Staring blankly Needless waiting

8. Levels of Engagement Level 2: Casual Attention Scanning the environment Attending to a range of things instead of paying attention to one object or person Level 3: Undifferentiated Behavior Repetitive actions or vocalizations Simple, low-level play

9. Levels of Engagement Level 4: Focused Attention Intent watching or listening Limited motor activity Level 5: Differentiated Behavior Active interaction with the environment Playing Participating in routines

10. Levels of Engagement Level 6: Constructive Behavior Materials Making, creating, or building something Intentionality Level 7: Encoded Behavior Social Using context-bound, understandable language

11. Levels of Engagement Level 8: Symbolic Behavior Pretend play Talking about someone/something that is not present Level 9: Persistence Problem solving Challenge Changing strategies or using the same strategy repeatedly

12. Engagement Continuum Unsophisticated Sophisticated Nonengaged Casual Attention Undifferentiated Focused Attention Differentiated Constructive Encoded Symbolic Persistence LEVELS Developmental Hierarchy

13. Ways to Focus on Engagement Room arrangement/materials Fun activities Zone defense scheduling Incidental teaching

14. Room Arrangement Break up the middle of the room Creates 4 zones Prevents wandering, running laps Scatter centers throughout zones instead of lining them up on walls Most nonengagement occurs in wide open spaces

15. Materials Quantity Enough toys for everyone Matching toys to encourage parallel play Quality At or slightly above skill level Accessibility On low shelves Variety Swap toys/activities on regular schedule

16. Activities Fun and exciting!! Interesting things to do and talk about Focus on process and skill development (not final product) Focus on promoting independence, social relationships, and engagement

17. Zone Defense Scheduling Method for organizing adults Creates environment in which engagement is the focus

18. ZDS Basics Man-to-man defense: assignment to a specific player/child Zone defense: assignment to an area of the court/classroom The ZDS prevents teachers from chasing specific children around the classroom

19. ZDS Roles One adult is assigned to the scheduled child activity and is focused on child engagement One adult is in charge of extra classroom tasks, such as cleaning up, preparing the next activity, changing diapers, taking phone calls, helping a child who needs individual assistance, etc.

20. ZDS Transitions During transitions between activities, one adult is at the old zone and one adult is at the new zone Children can transition at their own pace Children can begin the new activity as soon as they arrive at the zone

21. Example 2-Person ZDS TimePerson 1Person 2 8:00-8:15ArrivalSet Up 8:15-8:30Set UpStory 8:30-8:45Free PlaySet Up 8:45-9:00Set UpCircle 9:00-9:15Small ToysSet up 9:15-9:30Set UpCenters 9:30-9:45Set UpCenters 9:45-10:00SnackSet Up 10:00-10:45Set Up Bathroom and Outside/Hallway 10:45-11:00MusicSet Up 11:00-11:15Set UpArt

22. Incidental Teaching What to do when you’re the adult assigned to focus on the ongoing activity and child engagement Method for basing interactions on a child’s interest in order to elaborate on existing engagement

23. Steps for Incidental Teaching 1. Arrange the environment 2. Catch the child engaged 3. Approach the child 4. Elicit elaboration of existing engagement 5. Provide reinforcement

24. 1. Arrange the Environment Provide Accessible materials Preferred toys A defined space Sufficient quantities Opportunities for peer interaction

25. 2. Catch the Child Engaged In any routine or activity With peers or materials

26. 3. Approach the Child Think about the child’s level of engagement What are you aiming for? A higher level of engagement? If so, which one? Consider the child’s learning style Is it better to interact with the child? Is it better to sit near him and engage in parallel play? Is it better to encourage a peer to approach him?

27. 4. Elicit Elaboration of Existing Engagement Options are More engagement (continue the behavior for a longer amount of time) Higher engagement (use more sophisticated behavior) Skill development (work toward a developmental goal)

28. 5. Provide Reinforcement Natural reinforcement The activity or outcome appeals to the child’s interests and intrinsic motivation Verbal reinforcement Be specific Tangibles

29. Using Incidental Teaching Incidental teaching comes naturally to most teachers, but it can always be used more often Our research shows that rates of incidental teaching are low before awareness training; after training teachers are able to increase their rates of incidental teaching to changing criterion levels

30. Classroom Modifications Modify the environment Create opportunities for engagement Ensure that activities are appealing and have a variety of materials available Sabotage is not necessarily a bad thing Example: Set out all needed materials except for one, requiring children to ask for the missing item or problem solve

31. How would you address his goal to use word approximations?

32. Classroom Modifications Modify the task demands Ask the child to do something that is slightly above his current skill level (and provide as few prompts as possible) to encourage higher engagement Ask the child to do something that is slightly below his current skill level (and provide reinforcement) to encourage more engagement

33. How would you encourage higher engagement?

34. Classroom Modifications Modify your expectations Rather than focusing on the goal of the activity, focus on one of the child’s goals Example: Maggie’s goal is to use words to request items or help. During art, do not focus on getting Maggie to make the expected product. Instead, focus on providing multiple opportunities for her to request materials.

35. Classroom Modifications Use multiple routines to address the same goal Create opportunities for peer interaction Example: Have peers without disabilities use a buddy system to help a child with disabilities take his coat off after playing outside

36. How would you encourage more engagement?

37. Is It Working? Measure class-wide engagement with the Engagement Check II Measure an individual child’s engagement with the Scale for Teachers’ Assessment of Routines Engagement (STARE)

38. Engagement Check II Method for teachers to determine percentage of children engaged during activities

39. Engagement Check II (McWilliam, 1999)

40. Engagement Check II Procedure Every 5 minutes, count and record The number of children who are nonengaged The total number of children present At the end of the observation, calculate The number of children who were engaged in each interval The percentage of children engaged across the session

41. STARE Method for teachers to document their impressions of an individual child’s engagement in each classroom routine Helps teachers determine With whom or what the child was engaged Complexity of child’s engagement

43. STARE Procedure Observe child in routine Rate amount of time spent with adults, peers, and materials Can rate high in more than one Rate complexity of engagement How the child spent the majority of his or her time (not the highest level observed)

44. Other Strategies for Embedding Prompts Time delay Reinforcement Peer-mediated strategies

45. Prompts Something the teacher does before the child responds They increase the likelihood that a child will respond in a certain way Types Physical Verbal Gestural

46. Time Delay Wait time Allows the child to respond independently before the teacher provides support

47. Reinforcement Reinforcers = things (words, activities) that follow a behavior Reinforcers are what teachers do immediately after the child’s behavior or response

48. Positive Reinforcement Positive reinforcement – something that follows a specific response and increases the likelihood that the response will happen again Example: Child asks for ball and teacher gives it to him. Example: Child puts coat on and teacher says, “Wow – you zipped your coat!” and puts a star on her chart.

49. Differential Reinforcement of Other Behavior Catch the child displaying a desired behavior (doing something good) and let him or her know about it Use this when you’re trying to decrease a challenging behavior by providing positive reinforcement for replacement (incompatible) behavior Example: For a child who flits from one activity to another, provide feedback when the child stays at an activity and plays

50. Peer-Mediated Strategies Peer management Peer modeling Peer tutoring

51. Tips for Embedding Use multiple routines to address the same goal When goals are functional, they will naturally occur in multiple routines The Examination of the Implementation of Embedded Intervention through Observation (EIEIO) can be used to assess the frequency with which goals are addressed

53. Tips for Embedding Plan when (during which routines) specific goals will be targeted and who is responsible Higher priority goals (as decided by the family) should be planned to occur in more routines The Intervention Matrix can be used as a one-page summary of intervention priorities and planned implementation times

55. Summary Focus on engagement by Arranging your classroom to promote participation Providing interesting materials and fun activities Organizing the adults in the classroom Using incidental teaching Consult with service providers to identify the most useful strategies for embedding intervention into daily routines

56. For Additional Information Contact Amy Casey at amy.m.casey@vanderbilt.edu 615-936-3986 Visit our websites www.IndividualizingInclusion.us www.VanderbiltImprovingEngagement.us www.vanderbiltchildrens.com/engagementclassroom