Shawnee Mission School District Autism Specialist Top 5 Strategies for Supporting Students with Autism Spectrum Disorders Across School Environments Autism

Shawnee Mission School District Autism Specialist

Top 5 Strategies for Supporting Students with Autism Spectrum

Disorders Across School Environments

Autism SpecialistsShawnee Mission School District


Housekeeping

• Strategies – list your top five

• Soap Box rules- – 30 seconds on the soap box– Stay on topic (look ahead and find your

soapbox area)– Only present soapbox items during slide

transitions


The Top Five Strategies

• Visual Supports

• Work Systems

• Communication

• Positive Behavior Supports

• Environmental Structures


Prompting

• Prompts are hints or cues meant to increase desired behaviors or to decrease undesirable behaviors.

• Prompts are like crutches – a type of artificial support that you don’t want or need forever.

• Fading must occur quickly and is accomplished by gradually reducing the strength of the prompt.


Prompting

• Most to least prompting is used when teaching a new skill.

• Least to Most prompting is used when a skill has already been learned.


Levels of Prompting

• Point – teacher points to achieve desired result

• Gesture – teacher makes a motion to prompt for the desired result (teaching cup – the teacher makes a “drink” gesture)

• Model – (full or partial) – teacher models desired result (teaching “clap” – teacher claps)

• Partial – requires physical guidance to achieve desired result (a nudge at the elbow)


Levels of Prompting

• Full - gives full physical assistance to achieve desired result (hand over hand assistance)

• Verbal – (full or partial) – teacher models desired result (teaching cup, teacher says, “What’s this? Say “cup”.)



• Visual Supports• Work Systems• Communication• Positive Behavior Supports• Environmental Structures


What Are Visual Supports

• … those things we see that enhance the communication process.



• Environmental Cues– furniture arrangement– location of objects– signs, signals, labels, menus



• Traditional Tools for Organization and Giving Information– calendars, daily planners– schedules, TV guides, movie listings– maps– written instructions and directions


Why Use Visual Supports

• Some individuals with pervasive developmental disorders experience difficulty attending to, modulating, or understanding auditory stimuli

• Some individuals with pervasive developmental disorders demonstrate difficulty attending to the communication message while blocking out background noises


Someone You Know Can Benefit

• “He knows what to do, we do it everyday”• “He understands everything I say”• “He is too high for that”• “He won’t use them”• “He’s choosing not to do it”

• The use of visual supports is not determined by the individual’s ability to talk, they are valuable to both verbal and non-verbal students.


Benefits in Implementing Visuals Supports

• Provides an understanding of the environment and expectations

• Increases the opportunities for communicating

• Elicits initiation of an interaction• Increases the ability to self-manage

behaviors• Provides structure to allow the

understanding and acceptance of change


Benefits in Implementing Visuals Supports

• Clarifies verbal information, enhances comprehension

• Helps establish and maintain attention• Presents information in a form that can be quickly

and easily interpreted• Supports transitions between activities or

locations• Provides a concrete method of teaching concepts

such as time, sequences, and cause/effect


Determining the Level of Visual Representation

• Objects

• Representational objects

• Photos

• Color drawings (including picture icons)

• Black and white line drawing

• Words


Specifically Designed Tools to Meet Specific Needs

• Visual Schedules• Labels• Boundary Setting • Choice Boards• Task Organizers• Activity Completion Signals• Social Stories• Additional Visual Management Tools


Data Collection

• Documentation of how the visual support has impacted the behavior– Increase in the replacement or target behavior– Decrease of the inappropriate behavior– Increase in level of independence


Demonstration

• Please refer to your examples packet



• Visual Supports

• Work Systems• Communication• Positive Behavior Supports• Environmental Structures


Work Systems

• Promote independence for all students

• Provide a structured format in which instructional control can be established

• Provide a systematic routine in which the student both generalizes and practices a mastered skill


In addition….

• Predictable thereby reducing anxiety

• Adaptable to any setting –promoting generalization

• Provide students the opportunity to be around peers thereby increasing the opportunity to develop pragmatic language skills


Choosing the activitiesfor a Work System

• Activities have a clear beginning and ending

• Activities are mastered (fluent) or near mastery (fluency)


Setting up the system• All materials necessary for completing the

activity and/or meeting objective are available • Each activity is clearly labeled by a picture,

letter, number, etc.• A schedule strip with a matching symbol of the

activities is available• Activities are lined up in the same order as they

appear on the strip• A location is picked and clearly labeled for

finished work


Prompting within the Work System

• The overwhelming majority of prompting is nonverbal and done from behind the student.

• Verbal prompts are only used when the student is engaged in the actual activity, never while in the process.



• Only nonverbal prompts are used when the student is involved with the process of the work system.

• The process includes the following– Picking from the schedule– Matching the schedule symbol to the activity

symbol– Placing the activity on the table



– Putting the completed activity in the finished area

– Choosing the next activity from the schedule



• When the term “prompt” is used in describing the work system, it is assumed that the prompt will be whatever level of nonverbal is needed – i.e. hand over hand, point, gesture, etc.


Be’ware

• When you continue to use high levels of prompting throughout teaching, it will appear that the child is learning when in fact…

THEY ARE ACTUALLY PROMPT DEPENDENT


Teaching the student to use the system

• The student is seated at his desk.• The schedule is to the side of the student• The adult stands behind the student.• Using prompts, the adult directs the

student to pick up the first symbol from the schedule.

• Standing behind the student, the adult guides the student towards the work system



• Standing behind the student, the adult guides the student towards the activity with the corresponding symbol.

• The student places the symbol on the matching activity, picks up the activity and carries it back to the table.

• Once the student is seated, the adult prompts him to take the activity out of its work holder.



• At this point, the adult may use some verbals if the student needs assistance, encouragement or reinforcement as it relates to the task…..not the process of the work system

• The adult may stand behind the student while he works, or the adult may sit beside or across from him



• Once the student has completed the activity, prompt him to put it back in the work holder (from behind; nonverbal)

• Prompt the student to place the activity in the finished box.

• Prompt the student back to the schedule.

• Repeat the above sequence until the student has completed all activities


One More Thing

• Remember that any time you make a change in a student’s program such as moving the task from the speech room to the classroom, or changing the interaction from student to adult to student to peer, it may be necessary to move briefly to a higher prompt level and to a higher rate of reinforcement.


Considerations

• Data collection sheet• Who will collect the data• How often will the data be collected• Where will the data be stored• Criteria for program change• Who will determine the reinforcement• Who will provide the reinforcement• Types of schedules; types of work holders


Demonstration

• Please refer to your examples packet



• Visual Supports• Work Systems

• Communication• Positive Behavior Supports• Environmental Structures


Communication and AutismTwo most common errors

(1) Assuming communicative competence

(2) Mistaking problems in communication for problems in behavior


Visually Cued Instructionand

Communication

Use of visual tools to teach:

(1) Social communication

(2) Comprehension

(3) Initiation

Marriner, Nola. http://www.talklc.com/handout/Visually_Cued_Instruction.html#Symbol%20Exchange


Social Communication

The functional use of language in social contexts

Social communication includes the whys and hows and do’s and don’ts for:

Gaining attention

Taking turns

Interrupting

Shifting topics

Nonverbal rules (eye contact, distance, gestures, facial expressions)


Visually cued instruction and social communication

• Direct/explicit instruction; repeated practice

• Social stories, cartooning, strategy cards

• Model

• Role play

• Social forums


Social StoryPersonal Space

People have an area around their body called “personal space.”

Every person has personal space

I have personal space.

My Mom has personal space.

My teachers have personal space.

My friends have personal space.

Personal space is like an invisible bubble.

Personal space goes out from the arm to fingertips.

People should stay out of a person’s personal space.

My teachers have personal space.

I should stay out of my teacher’s personal space.

I should stay at least an arm’s length from my teacher.

My friends have personal space.

I should stay out of my friend’s personal space.

I should stay at least an arm’s length from my friend.

I will try to stay of someone else’s personal space.

Everyone will be happy if I stay out of their personal space.


Comprehension

Process of attaching meaning to an acoustic signal

speech sound

word discrimination

word knowledge

short./long term memory

attention span

environmental interference


Symptoms that there might be a comprehension problem

• Unresponsive

• Inappropriate responses


Visually cued instruction and comprehension

(1) Adult points to symbol (2) Student places hand over adult’s hand

(3) Adult verbalizes (4) Student listens






Initiation

Initiation of communication is:• Purposeful• Spontaneous• Unprompted!!!!


Visually cued instructionand initiation of communication

(Symbol Exchange)

Interactive communication method Requires an exchange of a symbol between the student

and a communication partner Individuals learn to communicate in order to obtain highly

motivating objects or events


Symbol Exchange and Prompting

• No verbal prompting……ever!

• Use physical prompting from a most to least hierarchy to ensure successful communication


Five Phases of Symbol Exchange

(1) Physically prompted exchange

(2) Increasing Spontaneity, Search and Locate and

Persistence behaviors

(3) Discrimination between symbols

(4) Sentence Structure

(5) Additional communication functions and vocabulary


Symbol ExchangePhase 1

Objective - upon seeing a “highly

preferred” item, the student will pick up a representation of the item, reach toward a communicative partner, and release it in the communicative partner’s hand

Outcome: Student approaches people to initiate communication


Symbol ExchangePhase I Training

No verbal prompts Use no more than 1 preferred item presented 1

at a time Provide 30 opportunities throughout the day 2 trainers are necessary

Physical Prompter

Communicative Partner

Child


Visually cued instructionand Symbol Exchange

Trial Pick Up Reach Release

1 + P

+ P + P

2 + P

+ P + P

3 + P

+ P + P

4 + P

+ P + P

5 + P

+ P + P


PLEASE

• Do not stop using symbol exchange because the student begins to speak



• Visual Supports• Work Systems• Communication

• Positive Behavior Supports• Environmental Structures


Positive Behavioral Support

• Positive behavioral support (PBS) is a way of thinking about behavior. It broadens intervention from only one approach--reducing challenging behavior-- to multiple approaches: changing systems, altering environments, teaching skills, and appreciating positive behavior.

» Ruef and Poston, 1998


Positive Behavioral Supports

• Broad term that describes a comprehensive, research based, proactive approach to behavior support aimed at producing comprehensive change for students with challenging behavior.

» Ruef, Higgins, Glaeser, and Patnode, 1998


Strategies

• Alter the classroom environment

• Increase predictability and scheduling

• Increase choice making

• Make curricular accommodations

• Appreciate positive behaviors

• Teach replacement skills

» Ruef, Higgins, Glaeser, and Patnode, 1998


Development of the PBS Plan

• Establish a team

• Determine function of behavior– Remember all behavior serves an important

function for the individual. – All behavior is communication.

• to get something they want or need – request items, activities, or attention

• to avoid something they do not want – protest, escape/avoidance

• to meet sensory needs


Functional Assessment

• Functional Assessment: a means of assessing the functions of the problem behavior.

• Gathering Information – interview– direct observation– data collection– creating situations

» Carr et al., 1995


Behavior Change Procedure

• List all the behaviors of concern

• Prioritize the behavior• Select a target behavior• Determine the history of

the behavior• Determine the

antecedent and consequences

• Determine causal factors• Behavior, Autism and

Communication Disorders, Fundamentals of Autism, (1995), p.28

• Select an alternative behavior of which the person is capable

• Develop a management plan

• Implement the plan• Review, analyze

and possibly alter interventions


Defining a Behavior

• Physical characteristics (what it looks like, sounds like, etc.)

• Cycle (when does it start and stop)

• Course ( are there precursors, does it start gradually or suddenly)

• Strength ( how often, how long, how severe)

• Adapted from Willis, T., La Vigna, G., and Donnellan, A., (1991). Behavior assessment guide. Institute for Applied Behavior Analysis, Los Angeles, CA.


Is the Problem a Problem

• Is it dangerous to the person doing it

• Is it dangerous to others

• Is it dangerous to the environment

• Is it seriously disruptive

• Does it make the person appear in a negative way to others

• Does it interfere with independence


An Ounce of Prevention is Worth a Pound of Cure

• Make sure rules and consequences are known• Have high expectations• Apply reinforcers and consequences

consistently• Make changes in environment, teaching

methods, curriculum and staff before behavior problems start

• Break the chain of inappropriate behavior that may lead to a display


An Ounce of Prevention is Worth a Pound of Cure

• Engage students in meaningful, age appropriate, and functional tasks

• Teach choice making and honor choices

• Plan ahead…..Idle time invites problems

• Structure the environment and time

• Behavior, Autism and Communication Associates, Fundamentals of Autism, (1995). P. 29.


PBS Summation

• Identify the purpose of challenging behavior• Teach appropriate alternative responses that

serve the same function as the challenging behavior

• Consistently reward positive behaviors• Minimize rewards for challenging behaviors• Minimize the physiological, environmental, and

curricular factors that trigger challenging behaviors

» Ruef, Higgins, Glaeser, and Patdone


How to Make Kids Worse Over Time

• Withdraws or Changes Request/ “Negotiates”

• Large Threats

• Small Threats/Warnings

• Verbal Prompts

• Request in Question Form

– ADULT

• Tantrums/Aggression Stops”

• Meltdown

• Argue

• Delay

• Ignore

– STUDENT

Melisa Genaux, M.Ed. Jordan School District, 2007


Adult Behavior

• Asking

• Nagging

• Arguing

• Threats



Precision Direction Format

• Directions given in statement form

• 2x only

• Start with stating name

• Verbal cue that a consequence is coming

• Wait time

• Pre-planned consequence



Precision Directions‘Compliance’

“Name, direction please.”• WAIT 3-5 seconds (typical student)• 7-10 seconds (student with delay)

Compliance

Reinforce

“You are following directions”



Precision Directions‘Non Compliance’

“Name, direction please.”• WAIT 3-5 seconds (typical student)• 7-10 seconds (student with delay)

Non Compliance

“Name, you need to direction.”

Non Compliance

Pre-planned Consequence

Label the behavior – “That’s not following directions.”Label the consequence – “That’s _____.” (time out, loss of token, etc)



Pre-Planned Consequences

• “When consequences are arranged in a hierarchy consisting of small steps, and are designed to be inconvenient for the student by affecting his or her agenda, they are much more likely to be effective in reducing the rate of inappropriate behavior. After students learn the consequence system, most will stop the misbehavior after the second step.”



Addressing Problem Behaviors

• Increase Compliance in 3 Ways:– Use Precision Directions– Reinforce Compliance– Consequence Hierarchy (think small and

inconvenient)



Address Target Behaviors in 3 Ways

• Reinforce the absence of the misbehavior (“quiet mouth”; hands to self”; “staying on topic”; etc)

• Reinforce the replacement behavior (teach the student what to do instead and reinforce; what is the function?)

• Reductive Procedures (pre-planned consequences for misbehavior)



Demonstration

• How to give precision directions



• Visual Supports• Work Systems• Communication• Positive Behavior Supports

• Environmental Structures


Environmental Structures

• Physical Structure

• Scheduling

• Task Demands

Love,S. (2004). Professional Seminar: Behavior management for individuals with autism. Asheville TEACCH Center.


Physical Structure for Individuals

• Clearly defined space for individuals to keep belongings• Sufficiently sized work space clear of distracters• Appropriately sized and sturdy furniture• Individual work areas clearly defined and differentiated

from group work areas• Individual work areas clearly defined and differentiated

from other areas within the classroom• Work materials organized and easily accessible



Physical Structure for the Classroom

• Furniture should be spaced sufficiently for movement• Location of work area in least distractible setting• Use furniture or other means to define separate spaces within the

classroom (tape on floor, bookcases, etc)• Keep windows, doors, and other tempting materials less accessible• Set up work and leisure areas to allow for adult supervision• Leisure / free time area clearly defined and separate from work area• Identify areas in the room with simple label• In summary

– Think: “Does the layout of furniture and materials assist in the development of behaviors and skills which we want the individuals to have?”



Scheduling• Clearly outline and post schedule to allow staff and students to

understand expectations• Allow for shorter work periods in certain areas both physical and

task to prevent undue stress and acting out• Schedule activities to meet the individual’s educational and physical

needs• Balance independent, group, and leisure activities according to the

individual's abilities• Schedule transitions to assist in the prevention of conflict or

behavior problems• Clearly indicate for the student what to do and where to go in

transitions between locations, activities, and/or people• In summary

– Think: “I am making the world predictable and reinforcing for the individual, and can he or she anticipate events or changes in daily events?” Love,S. (2004). Professional Seminar: Behavior management for

individuals with autism. Asheville TEACCH Center.


Task Demands

• Keep tasks organized for easy modification to make either easier or more difficult

• Vary presentation of tasks, so a more preferred task is offered first to ease the individual into work time

• Independent tasks should include only mastered tasks and activities that are easier than those which are currently being taught

• Monitor reinforcers and activities for satiation

• In summary– Think: “Am I adjusting my expectations for the individual to avoid

behavior problems?”


Documents

Shawnee Mission School District Autism Specialist Top 5 Strategies for Supporting Students with Autism Spectrum Disorders Across School Environments Autism