Transition to Adulthood Using Comprehensive Planning Tools ...Characteristics Design 12 3 Implement 4 Steps to Designing a Comprehensive Intervention Plan UCC-HF or UCC-CL Not a fine

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Transition to Adulthood Using Comprehensive

Planning Tools: An Evidenced-Based

ApproachBrenda Smith Myles, Ph.D.

Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

The Ziggurat Groupwww.texasautism.com

Overview of Day

Overview of the issuesUnderlying CharacteristicsTransition – definition and requirementsIntroduce the Ziggurat Model● How to assess and address underlying characteristics● Five levels of intervention● Apply ZM to scenario

Introduce the Comprehensive Autism Planning SystemCommon evidenced-based intervention strategies

A Sign of Our Failure

A study of 114 adultsMeasure outcome●Good: (a) employed or engaged in

education/vocational training, (b) living independently, (c) two or more friends/steady relationship

● Fair: (a) or (b)● Poor or very poor outcome: neither (a) or (b)

Billstedt Gillberg, & Gillberg, 2005


A study of 114 adultsGood Outcome: (a) employed or engaged in education/vocational training, (b) living independently, (c) two or more friends/steady relationship0



A study of 114 adultsFair: Either (a) employed or engaged in education/vocational training, (b) living independently, (c) two or more friends/steady relationship8%



A study of 114 adultsPoor or very poor outcome: ●Neither (a) employed or engaged in

education/vocational training, (b) living independently, (c) two or more friends/steady relationship

92%With no differences between individuals with autism who are considered high functioning and those with a more classic presentation


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The biggest predictor of employment for adults is a job experience during high school. Underlying

Characteristics

Impaired Theory of Mind- Mindblindness

Difficulty understanding the thoughts, feelings, and beliefs of othersDifficulty predicting the actions of othersDifficulty using words to describe one’s own feelingsDifficulty understanding non-literal language (e.g., sarcasm)

Weak Central Coherence

Tendency to focus on details and miss the big pictureDifficulty understanding social situations

Problem Solving

“One way of viewing a problem”Stuck thinkingSees facts instead of a wholeProblems with cause and effectDoes not see problems as having more than one optionProblem solving is often literal

Executive Dysfunction

Difficulty with changeProblems with regulating emotionAttention problemsDisorganized

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Top 10 Situations that Trigger Insistence on Sameness

• Annoying behavior

• Activity interrupted

• Losing a game• Object breaks• Event cancelled

• Event delayed• Materials run

out• Item misplaced• Sequence

changed• Momentary

separation

Green, Sigafoos, Pituch, Itchon, O’Reilly, & Lancioni (2006). Assessing Behavioral Flexibility in Individuals with Developmental Disabilities. Focus on Autism and Other Developmental Disabilities, 21(4) 230-236.

Special Interests and Obsessions

Narrow interestsNot permanentOften appear “uncontrollable”Role of the interest: interest; fun; security, comfort; relaxation; stress reduction

Transition

A Comprehensive Perspective

The Purpose of Special Education (IDEA)

To ensure that all children with disabilities have available to them a free appropriate public education that emphasizes special education and related services designed to meet their uniqueneed and prepare them for furthereducation, employment, and independent living

§300.1 (emphasis added)

Transition ServicesDefinition

‘transition services’ means a coordinated set of activities for a child with a disability.

The Ziggurat Model provides a process to develop a coordinated set of activities that matches individual characteristics to interventions.

IDEA (2004) emphasis added

Transition ServicesDefinition (continued)

Law(A) is designed to be a results-oriented process, that is focused on improving the academic and functional achievement of the child with a disability to facilitate the child's movement from school to post-school activities…

Ziggurat ModelUnderlying Characteristics Checklist

Individual Strengths and Skills Inventory

Intervention Ziggurat


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Transition Services Definition (continued)

Law(B) is based on the individual child’s needs, taking into account the child's strengths, preferences, and interests

Ziggurat ModelUnderlying Characteristics ChecklistIndividual Strengths and Skills InventoryGlobal Intervention Plan Guide (person-centered planning)


Transition Services Definition (continued)

Law(C) includes instruction, related services, community experiences, the development of employment and other post-school adult living objectives, and, when appropriate, acquisition of daily living skills and functional vocational evaluation.

Ziggurat ModelIntervention Ziggurat

Transition IEP Requirements

Age 14 (or younger, if determined appropriate), a statement of the transition service needs that focuses on the student's courses of study (such as participation in advanced-placement courses or a vocational education program); and

Age 16 (or younger, if determined appropriate), a statement of needed transition services, including, if appropriate, a statement of the interagency responsibilities or any needed linkages.

Adapted from: (Authority: 20 U.S.C. 1414(d)(1)(A))

Transition in Texas

Beginning at any age. . . Futures planning for integrated living, work, community, and educational environments that considers skills necessary to function in current and post-secondary environments

Texas Commissioner’s Rules Concerning Special Education Chapter 89 Subchapter AA

The Ziggurat ModelZiggurat n:

(zig·gu·rat) from Assyrian ziqquratu, height, pinnacle

1. a temple having the form of a terraced pyramid of successively receding stories, erected by the ancient Assyrians and Babylonians

2. a framework for designing comprehensive interventions for individuals with autism spectrum disorders

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Why was the Ziggurat Model Developed?

Difficulty “Seeing the Autism”Tendency to apply one strategy to address all needsTendency to ignore critical areas when designing an intervention

Sensory Differences and Biological NeedsSensory Differences and Biological Needs

Skills to TeachSkills to Teach

Task DemandsTask Demands

Structure and Structure and Visual/Tactile SupportsVisual/Tactile Supports

ReinforcementReinforcement

© Ruth Aspy, Ph.D., Barry G. Grossman, Ph.D.

Intervention Ziggurat

InterventionsCharacteristics

Sensory Differences and Sensory Differences and Biological NeedsBiological Needs



StructureStructure and Visualand Visual/Tactile Supports/Tactile Supports



Underlying Characteristics Checklist (UCC)

SocialCommunicationRepetitive Patterns

Associated FeaturesSensoryMotorCognitiveEmotional VulnerabilityMedical and Biological Factors

Characteristics Interventions

Sensory Differences and Sensory Differences and Biological NeedsBiological Needs



Structure and VisualStructure and Visual/Tactile Supports/Tactile Supports


The Ziggurat Model

Sensory and Biological NeedsReinforcementStructure and Visual/Tactile SupportsTask DemandsSkills to Teach

2008 ASA

Literary AwardWinner

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Why Comprehensive Planning With The Ziggurat and CAPS Models?

Fewer behavior problemsMore instructional timeIncreased compliance with lawIncreased engagement timeFaster IEP developmentBetter IEPsMore positive/collaborative relationship with parentsImproved collaboration among staff

Who is Involved in Comprehensive Planning?

●Parents●Student●General Education Teacher●Special Education Teacher●Para-professional●Speech Language Pathologist●Occupational Therapist●School Psychologist●Administrator●Other as needed

Keys to comprehensive intervention planning

Characteristics Design ImplementImplementDesignCharacteristics

1 2 3 4

4 Steps to Designing aComprehensive Intervention Plan

1

Helps you to “see” the autismProvides a “snapshot” of how autism is expressed for an individualA descriptive instrumentCan be completed by a teamProvides a tool for assessing progress/change

Underlying Characteristics Checklist The UCC Areas

SocialRestricted Patterns of Behavior, Interests, and ActivitiesCommunicationSensory DifferencesCognitive DifferencesMotor DifferencesEmotional VulnerabilityKnown Medical or other Biological Factors

1

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SocialBehavior, Interests, and ActivitiesCommunicationSensoryCognitive MotorEmotionalBiological

Individual Strength and Skills Inventory

Social – UCC-CL Social - ISSI

[3] Shows little interest in or response to praise

[8] Has difficulty imitating the actions or words of others

• Engages in conversational turn taking with parents

• Works near peers in classroom

DesignCharacteristics

1 2 3Implement

4

Steps to Designing a Comprehensive Intervention Plan

UCC-HF or UCC-CL

Not a fine line. When in doubt, review the items from both and select the one that is the best fit.

UCC-HF or UCC-CL

UCC-CL

UCC-HF

HFA/AS“Classic”Autism

Average Skills

Anna – Sample UCC Items

Social[1] Mindblindness[5] Has difficulty making or keeping friends[7] Is naïve, easily taken advantage of, or bullied

Restricted Patterns[14] Has eccentric or intense preoccupations[18] Has problems handling transition and change

Communication[25] Has difficulty with rules of conversation[27] Has difficulty using gestures and facial expressions

Emotional Vulnerability[76] Is easily stressed-worries obsessively[77] Appears to be sad or depressed

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Anna - Individual Strengths and Skills Inventory

Social● Enjoys interacting with

others● Is an avid reader and

enjoys sharing information with others

● Wants to have friends● Responds well to

authority

Behavior, Interests, and Activities● Knows a lot about

fantasy literature● Beginning to

understand when to share and how much to share


Communication● Excellent verbal skills● Not shy about talking

with others● Excellent vocabulary

Sensory● Somewhat tolerant of

various sensory input across various environments

● Beginning to recognize when she is becoming overloaded


Cognitive● Above average IQ● Can use

organizational sequences, when taught

● Flexible, especially when primed

Motor● Good skills related to

case register operation, inventory, and shelving books


Emotional● Beginning to recognize

the feelings of others● Wants to respond to

others’ feelings

Biological● Excellent health

Sensory Differences and Biological Needs

Skills to Teach

Task Demands

Structure and Visual/Tactile Supports

Reinforcement3 Sensory Differences and Biological Needs

“The last thing one knows in constructing a work is what to put first”

-Blaise Pascal

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Provide a sensory dietMonitor and address environmental stressors:● Sound, light,

proximity/personal space, textures

● Movement needs

Monitor and address:● Appetite/hunger● Arousal/activity level

(e.g., fatigue, hyper)● Posture and

movement● Medical needs

Sensory Issues

Asperger Syndrome and Sensory Issues

Sensory Issues

SmellTasteTouchVisual InputAuditoryVestibular (balance)Proprioception (body awareness)

Individuals with AS have more difficulties with modulation and

emotional reactivity when compared to their counterparts with autism

Brenda Smith Myles

Emotional Reactivity

Displays emotional outbursts when unsuccessfulIs stubborn or uncooperativeOften gets “stuck” in a situationIs overly sensitiveReacts overtly when sensory systems needs are not met

Brenda Smith Myles

Sensory Diet Is ...

A planned and scheduled activity program designed to meet specific sensory needs (Yack et al., 1998)Incorporates naturally occurring opportunities for children to get the sensory stimulation they need (Willbarger, 1995)

Miller & Robbins, 2005

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Coping Cards

Take 2 deep breathswith your eyes closed

Press hands together and count to 10 slowly

Amy Bixler, 2006

Reinforcement

“If there is no reinforcer, there is no lesson”

-Andrew Bondy

Reinforcement Reminders

Reinforcement increases the likelihood of a behavior

“The way positive reinforcement is carried out is more important than the amount”

-B.F. Skinner

Selecting Reinforcers

“Individuals on the spectrum may not be as motivated by money as their neurotypicalcoworkers are. . . Their motivation to work will be directly related to the extent to which they enjoy the work. . . A good match is of critical importance.”

OAR (2006). Life Journey through Autism: A Guide for Transition to Adulthood www.researchautism.org

Reinforcement Reminders

“You may not have to look any further than [a] ... special interest to find the perfect reward”

-Sakai, 2005, p. 52

Reinforcement Menu

Time to browse books in the school library

15 minutes to research on the internet on baseball/sports statistics/events

10 minutes of reviewing baseball statistics in personal magazine/books

My School Rewards

Amy Bixler, 2006

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Home Reinforcement Menu

30 minutes of video games

Trip to local baseball card store

30 minutes of time to browse the web

My Home Rewards

Amy Bixler, 2006Structure and Visual/Tactile Supports

“And it is best if you know a good thing is going to happen, like an eclipse or getting a microscope…And it’s bad if you know a bad thing is going to happen like having a filling or going to France. But I think it is worst if you don’t know whether it is a good thing or bad thing which is going to happen.”

- From: The Curious Incident of the Dog in the Night Time, by Mark Haddon, 2003


“I like everything still. It gives you a full feeling. It gives you a full attention. With something quick, you don’t get the full idea of it. With something still, you take a look at it and you get to know the whole look and feeling”

-Warden from Rage for Order (BBC, 1996)

Common Misperceptions

If an individual can read then he/she does not need pictures or symbolsHe’s in high school, he does not need an individualized scheduleI can stop using a visual schedule once my student learns the routineIf an individual has not looked at his/her schedule in three weeks he/she does not need it anymore

Visual Schedules

Highly structured environments –provide an opportunity for those with ASDs to succeedIncreased predictability and understanding results in:●Decreased problem behavior● Increased independence

Bopp, K., Brown, K., Mirenda, P. (2004). Speech-Language Pathologists’ roles in the delivery of positive behavior support for individuals with developmental disabilities. American Journal of Speech-Language Pathology 13, 5-19.

Visual Schedules

Research on visual schedules shows that they are:Effective across age rangesEffective across settings

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Visual Schedules

Schedules are effective in decreasingoff-task behaviorsdisruptive behaviornoncomplianceaggressiontantrumsproperty destruction

Mini Schedule

Morning Checklist

Pick reward from your menu

Take out book

Turn in morning work

Complete work

Take out morning work√

Put away backpack√ActivityCheck

Making Coffee

Visual Schedule Visual Schedule

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Screaming

Outside voice

Talking voice

Soft voice/ whisper

No talking

Rating Description Setting

Emergency only

In the parking lot

With customers

Working with employees

Person is talking to meBuron, K.D., & Curtis, M. (2003). The Incredible 5-Point Scale. Shawnee Mission, KS: AAPC.

Incredible Five Point ScaleWait Card

Stress Thermometer

When I make a mistake

Most stressed ever

No stress

Ask for help

When I have hard homework

Putting stuff in my backpack after bus arrives

Call my mom for help

Pack before bus time

Video-Based InstructionalProcedures

Improve daily living skillsPromote generalization

Van Laarhoven, T. & Van Laarhoven-Myers, T. (2006). Comparison of three video-based instructional procedures for teaching daily living skills to persons with developmental disabilities. Education and Training in Developmental Disabilities, 41(4), 365-381.

Video Instruction How to Make Popcorn

Open plastic bag

Unfold bag

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How to Make Popcorn

Place in microwave and start time

Remove from microwave

Open carefully to eatTask Demands

“Just imagine your most stressful day that you’ve ever, ever had . . . your worst day is his best day”

-Parent of child with Asperger’s

I’m in the obstacle removal business

“We don’t fix things that aren’t broken, we remove obstacles for kids with infinite potential”

- Eric Blackwell

Task Demands

Easy Challenging/Emerging (possible with assistance)

Zone of Proximal DevelopmentLe

vel o

f Dem

and

Too demanding(independent skills-with or without modification and structural supports)


Supp

orts

Task Demands

Skills

Skills to Teach

Task Demands and Skills to Teach

Demands Ability

Too Demanding

Demands

Ability

Group Work

15

Supp

orts

Task Demands

To Balance –Reduce Demands, Add Supports &/or Skills

Skills

Skills to Teach

Demands Ability

Group Work

Provide written instructionsAllow use of laptop to take notesGive extra time for written workTeach to use a Personal Digital Assistant (PDA)Provide organizational skills supportE-mail assignments, reminders

Examples of Task Demand Interventions


Use coping cardsCreate Circle of FriendsProvide narrationProvide high interest activities to encourage social interaction

Provide peer buddy/mentorGive highlighted textProvide monitoring teacher/contactProvide “safe place”Allow for breaksPrepare for changeMinimize transitions


Skills to Teach

“The teacher who does not understand that it is necessary to teach autistic children seemingly obvious things will feel impatient and irritated”

-Hans Asperger

The Seemingly Obvious

What is it about the situation that comes naturally to everyone else but is missing for this person? Why is it that others do not show the same behavior?

What is it that has not occurred to me to teach?

That is the seemingly obvious. That is the thing to teach.

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Hidden Curriculum

The set of unwritten rules that no one has been directly taught, but everyone knows. Violations of these rules can make an individual a social outcast.Phrase associated with hidden curriculum:● “I shouldn’t have to tell you but … “● “Everyone knows that … “● “It’s obvious … “

Hidden Curriculum

Differs across● Age●Who you are with●Gender●Culture

Other Hidden Curriculum Areas

Airplane/airportFriendsEatingPublic/private swimming poolsSchool rulesBathroom/shower/locker room

Bathroom/Shower/Locker Room

Understand the urinal rules

The HC Curriculum Series

The Hidden Curriculum ● Calendar● Book● DVD

Designing A Global Intervention Plan

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Designing a Global Intervention

Select Key UCC Areas Select Key UCC items to addressDevelop interventions for each level of the ZigguratEnsure that intervention is complete

UCC Areas

SocialRestricted PatternsCommunicationSensory DifferencesCognitive Differences

Motor Differences Emotional Vulnerability Known Medical/Biological Factors

Anna-Select UCC AreasVision

What is the short and long-term vision for the individual?

Short-term●Develop meaningful relationships●Be successful at school and work

Long-term●Make friends●Attend university●Live independently●Have meaningful career

Anna- Select UCC AreasVision

VisionWhich UCC areas would have the greatest impact on achieving this vision?

SocialRestricted PatternsCommunicationEmotional Vulnerability

Remember to stay on target

Anna-Select UCC AreasSettings

In what settings does the individual participate?

●General education●Job (bookstore)●Socialize with peers (drama

club)●Home

Anna- Select UCC AreasSettings

SettingsWhich UCC areas have the greatest impact on the individual’s ability to function in multiple settings?SocialRestricted PatternsCommunicationEmotional Vulnerability


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Anna- Select UCC AreasQuality of Life

What is most important to the individual? What provides a sense of well-being?●Acting●Friends●Independence●Achievement

Anna- Select UCC AreasQuality of Life

Quality of LifeWhich UCC areas have the greatest impact on the individual’s quality of life?SocialRestricted PatternsCommunicationCognitive DifferencesEmotional Vulnerability


Anna- Select UCC AreasKey UCC Areas

Based on your answers to the questions, place a mark next to the key UCC areas.

Social Restricted PatternsCommunicationEmotional Vulnerability


Select Key UCC areas

Select Key UCC items to addressDevelop interventions for each level of the ZigguratEnsure that intervention is complete

Select Key UCC Itemsfrom UCC Areas

Select key UCC items for each of the Selected UCC areas.

Choose items that are essential (necessary for progress) and developmentally appropriate.

Emphasize items that are more pivotal (building blocks for additional skills). Avoid selecting redundant items.

Select UCC Items for Anna

Communication #25, 27Emotional Vulnerability#76, 77

Social#1, 5, 7Restricted Patterns#14, 18

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Anna - Selected UCC Items

[1] Mindblindness[5] Has difficulty making or keeping friends[7] Is naïve, easily taken advantage of, or bullied[14] Has eccentric or intense preoccupations[18] Has problems handling transition and change

[25] Has difficulty with rules of conversation[27] Has difficulty using gestures and facial expressions[76] Is easily stressed-worries obsessively[77] Appears to be sad or depressed




Anna-Intervention Design Activity: Marrying the Underlying Characteristics and Strengths to Interventions

Interventions 3

Anna - Intervention DesignSensory and Biological

Have Anna use 5-Point Scale to recognize stress level. Provide paperclips for Anna to indicate stress. Anna should take a break, get a drink, take a walk to calm.

[18] Has problems handling transition and change

[76] Is easily stressed -worries obsessively

InterventionsUnderlying Characteristic(s)

Anna - Intervention DesignSensory and Biological

* Ensure that Anna has a book or headphones during scheduled breaks and lunch (calming).* Inform all supervisors and fellow employees that Anna may need time for calming activities.

[18] Has problems handling transition and change

[76] Is easily stressed -worries obsessively


Which Level or Levels?

• Use Anna’s interests in Harry Potter and Lord of the Rings when scheduling Anna’s placement in the bookstore. During high traffic times place her in the Fantasy section, if possible.


Skills to Teach

Task Demands


Reinforcement

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Anna - Which Underlying Characteristic(s)?

* Have Anna use 5-Point Scale to recognize stress level. Provide paperclips for Anna to indicate stress. Anna should take a break, get a drink, take a walk to calm.






* Provide an individualized daily schedule with indicator of any known changes to the routine.


Which Level or Levels?

Use video to demonstrate how to interact with pleasant and unpleasant customers. Supplement with script.


Skills to Teach

Task Demands


Reinforcement


Use video to demonstrate how to interact with pleasant and unpleasant customers. Supplement with script.





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Interventions

Anna

Use Anna’s interests in Harry Potter etc when scheduling her placement in the bookstore. During high traffic times place her in the Fantasy section

[76] Is easily stressed—worries obsessively

Knows a lot about fantasy literature

Comprehensive Autism Planning System

4Chocolate & Peanut Butter

2008 Literary Award

The Ziggurat Modelby Aspy & Grossman

by Henry & Myles

COMPREHENSIVE AUTISM PLANNING SYSTEMS (CAPS) (Henry and Myles, 2007)

Time Activity Skills/ STO

Structure/ Modifications Reinforcement Sensory

Strategies Social Skills/

Communication

Data

Collection

Generalization





Communication

Data

Collection

Generalization

CAPS is the framework tying the daily schedule to the CAPS is the framework tying the daily schedule to the

underlying characteristics identified in the UCC underlying characteristics identified in the UCC and the interventions outlined in the Ziggurat Worksheet.and the interventions outlined in the Ziggurat Worksheet.

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Students often move and new teams have to get to know these students, reinventing the wheel is not fair to the student or the teacher.Simply, what works for the individual was not being shared.

Why Was CAPS Developed?

Time and Activity

This includes:● All activities● Transitions that require supports of any nature● Breaks and lunch built into the schedules

Required Tasks

This includes:● All tasks that must be accomplished as a part of an

activity● For example, work in an office (activity) might require the

following activities: answering email, writing up requisition forms, posting to accounts, answering the phone, developing budgets

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Needed Employee Training

Type of training needed and training materials should be specifiedTraining can be group, individual, global or activity-specific● For example, a person may be assigned to

be a coach or go to person during break

Reinforcement

Taken from the Reinforcement or Structure and Visual/Tactile Supports sections of the Ziggurat Worksheet

Social Skills/Communication

Drawn from the following Ziggurat Worksheet sections:●Structure and

Visual/Tactile Supports

●Task Demands●Skills to Teach

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Sensory/Biological Supports

Taken from the Sensory and Biological Needs or Skills to Teach or Task Demandssections of the Ziggurat Worksheet

Environmental Supports/Modifications

Taken from the Structure and Visual/Tactile Supportsor the Task Demandssections of the Ziggurat Worksheet● Visual schedule, list of tasks,

coach, etc …

Natural Supports

Available in the typical work environment. Instruction may be needed on how and when to use the support.

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Data Collection

How to determine if the adult is doing well on the job●May include weekly

or daily meetings, notes, job evaluations, etc..

1. Transfer Interventions from the Ziggurat to the CAPS-TR

Identify the Time, Activity and Required tasks

2. Identify Employee Training

Identify who is to be trained and training materials

8:00 Enter work Time in All; OCALI video

3. Transfer Interventions from the Ziggurat to the CAPS-TR

Items can be used in more than one activity

4. Identify Data to Be Collected Mason

15 year old with AUNon-verbal – uses sign language (inconsistently). Learning how to use communication device.Attends self-contained classroom for all core subjectsPrescribed medication to address anxiety, sleep, and digestion difficultiesWorks in the attendance office

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Mason (continued)

Prefers to be alone. Has no friends. Responds to unexpected change with pacing or hitting/shoving adults.Becomes aggressive (hit or push adults) when unable to communicate wants and needs. Displays repetitive behaviors (e.g., opens and closes doors, lines up items). Becomes aggressive when redirected.

Mason (continued)

Perfectionist. Becomes upset when makes mistakes or when others do not perform tasks “just right.”

Mason’s Services

Speech and language therapyGroup social skillsOccupational therapy consultation

Mason’s ISSI

SocialInteracts with his sister or parentsSuccessfully attends PE and lunch in gen. ed. setting

Behavior, Interests, and ActivitiesLikes routine and predictabilityInterested in animated movies, computer games, and electronics catalogues Can take apart and put back together a hand-held radio

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Mason’s ISSI (continued)

CommunicationHas about 100 signsStarting to use AAC device to express wants/needs

SensoryNot bothered by smellsEnjoys activities involving running/moving/ spinning


CognitiveDoes well with puzzles and sequencing/ patterning/matching Can follow 1-2 step directions when presented concretely

MotorIs able to navigate climbing equipment/ heights with much ease Is beginning to use word processor


EmotionalGood relationship with familyIs a happy young man overall

BiologicalHealth needs are known (has ongoing medical care)

DesignCharacteristics

1 2 3Implement

4

Steps to Designing a Comprehensive Intervention Plan


Select Key UCC Areas Select Key UCC items to addressDevelop interventions for each level of the ZigguratEnsure that intervention is complete

UCC Areas

SocialRestricted PatternsCommunicationSensory DifferencesCognitive Differences

Motor Differences Emotional Vulnerability Known Medical/Biological Factors

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Mason- Select UCC AreasVision

What is the short and long-term vision for the individual?

Short-term● Communicate consistently using his AAC device● Participate in small group social activities in the

classroom, school, or home environments Long-term

● Successful employment● Live independently● Develop friendships● Improve coping skills

Mason- Select UCC AreasVision

Vision

Which UCC areas would have the greatest impact on achieving this vision?

SocialCommunicationEmotional VulnerabilityRemember to stay on target

Mason- Select UCC AreasSettings

In what settings does the individual participate?

●School●Home●Warehouse

Mason- Select UCC AreasSettings

SettingsWhich UCC areas have the greatest impact on the individual’s ability to function in multiple settings?SocialRestricted PatternsCommunicationCognitiveEmotional VulnerabilityRemember to stay on target

Mason- Select UCC AreasQuality of Life

What is most important to the individual? What provides a sense of well-being?●Watching movies●Playing video games●Looking through electronics

catalogues

Mason- Select UCC AreasQuality of Life

Quality of LifeWhich UCC areas have the greatest impact on the individual’s quality of life?SocialRestricted PatternsCommunicationCognitiveEmotional VulnerabilityRemember to stay on target

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Mason- Select UCC AreasKey UCC Areas

Based on your answers to the questions, place a mark next to the key UCC areas.

SocialRestricted PatternsCommunicationCognitiveEmotional Vulnerability




Select Key UCC Itemsfrom UCC Areas

Select key UCC items for each of the Selected UCC areas.

Choose items that are essential (necessary for progress) and developmentally appropriate.

Emphasize items that are more pivotal (building blocks for additional skills). Avoid selecting redundant items.

Select UCC Items for Mason

Cognitive#71Emotional Vulnerability#92, 96, 99

Social#6, 8Restricted Patterns#29Communication#32, 33, 44

Mason- Selected UCC Items

[6] Difficulty maintaining personal space[8] Has difficulty waiting[29] Has strong need for closure[32] Has little or no speech[33] Has difficulty expressing wants and needs[44] Communicates needs through behaviors

[71] Demonstrates learned skills inconsistently[92] Is anxious or easily stressed[96] Exhibits aggression/meltdowns in response to minor changes[99] Has difficulty tolerating mistakes




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Sensory

Underlying Characteristics Checklist[32] No speech/nonverbal[92] Is anxious or easily

stressed[96] Exhibits aggression/

meltdowns in response to minor changes

Interventions● Use 5-Point Scale to

monitor/stress/anxiety level

● Use picture/word calming cards/icons

● Sit in a rocking chair and/or deep breathing when feeling anxious

● Use AAC device to express himself

● Frequent breaks

Reinforcement

Underlying Characteristics Checklist● [13] Has difficulty waiting● [32] No speech/nonverbal● [33] Has difficultly

expressing wants/needs● [44] Communicates needs

through behavior● [71] Demonstrates learned

skills inconsistently

Intervention (Reinforce for/ when…)● Demonstrates skills

across settings● Using AAC device to

ask for help or express wants/needs

● Using AAC device instead of aggression

● Using skills to join an activity

● Critical skills (waiting)


Task Demands Skills to Teach

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Mason

Sit in rocking chair and/or deep breathing when feeling anxious

[92] Is anxious or easily stressed

Enjoys activities involving running/ moving/spinning

Frequent breaks (walking, rocking chair, drink of water)

Mason

Incorporate the use of “change in schedule” card/ icon on device

[96] Exhibits aggression/meltdowns in response to minor changes

Starting to use AAC device to express wants/needs

Use “Wait” and “Break”card/icon

Strengths of the Ziggurat and CAPS Models

Provides a process and framework for designing a comprehensive individualized intervention plan

“Make everything as simple as possible but not simpler”

- Albert Einstein


Addresses individual underlying characteristics of ASD by utilizingstrengths and building skills


Uses reinforcement and other positive behavior supports


Skills to Teach

Task Demands


Reinforcement





Communication

Data

Collection

Generalization

Reinforcem

ent

32

Data are collected and analyzed to identify behaviors to be taught and to measure progress in developing skills


Skills to Teach

Task Demands


Reinforcement


Data are collected and analyzed to measure student progress






Communication

Data

Collection

Generalization

Data C

ollection

Plan for transfer and generalization of skills






Communication

Data

Collection

Generalization

Generalization

Plan for transfer and generalization of skills


Which of these would you leave out if you want skills to transfer?


Skills to Teach

Task Demands


Reinforcement

Other Strengths of the Ziggurat and CAPS Models

Emphasizes and enhances evidence-based strategies Facilitates use of proactive interventions

Other Strengths of the Ziggurat and CAPS Models

Facilitates interdisciplinary interventionsPromotes collaboration among parents, and the community

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Transition Resources

Organization for Autism Research (OAR) www.researchautism.orgfree transition manual and DVD for professors

Wrightslaw www.wrightslaw.com

Person-Centered Planning: A Tool for Transition http://ncset.org/publications/viewdesc.asp?id=1431

Video Jug http://www.videojug.com/

Transition Resources

OCALI/Easter Seals videos on employment (available on YouTube)●Changes in the workplace● Social interaction on the job● Starting a new job● Autism & Employment

Transition Resources Contact Information

Ruth Aspy, Ph.D. [email protected]

Barry G. Grossman, [email protected]

www.texasautism.com

Brenda Smith Myles, Ph.D. [email protected]

Documents

Transition to Adulthood Using Comprehensive Planning Tools ...Characteristics Design 12 3 Implement 4 Steps to Designing a Comprehensive Intervention Plan UCC-HF or UCC-CL Not a fine