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Ziggurat Model: A Functional Approach to Autism Planning Overview of the Ziggurat Model and the Comprehensive Autism Planning System (CAPS) Educators Summer Symposium - 2009 Breakout session presented by Brittany Schmidt Center for Disabilities, ASD Program

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What IS a Ziggurat?

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zig gu rat noun (among the ancient Babylonians and Assyrians) a temple of Sumerian origin in the form of a pyramidal tower, consisting of a number of stories and having about the outside a broad ascent winding round the structure, presenting the appearance of a series of terraces.

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Do I have to learn one more intervention?? No! The ZM (Ziggurat Model) is a format for taking the information you know about characteristics, organizing your observations then taking intervention ideas and organizing the above into a comprehensive plan that has, at the core, the characteristics of the individual.

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Introduction Doctors Barry Grossman and Ruth Aspy www.texasautism.com The Ziggurat Model (ZM) is a unique process and framework for designing a comprehensive intervention plan. An essential strength and underlying feature of the Ziggurat is that it is designed to address true needs or underlying deficits of students with autism spectrum disorders (ASD). 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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Components of the Ziggurat Model Five levels in a hierarchical structure Sensory Differences and Biological Needs Reinforcement Structure and Visual/Tactile Supports Task Demands Skills to Teach Three Assessment Tools The Underlying Characteristics Checklist (UCC) (this one will be covered today) Individual Strengths and Skills Inventory (ISSI) ABC-Iceberg (ABC-I) The Ziggurat Worksheet (so will this one) 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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Strengths of the Ziggurat Model Outlines evidence-based practices Incorporates a functional behavioral assessment Emphasizes a proactive, positive approach Incorporates ongoing assessment Promotes collaboration and communication among parents and professionals 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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Intervention Ziggurat (IZ) IZ facilitates the development of targeted, comprehensive positive interventions Incorporates five critical levels: 1.Sensory Differences and Biological Needs 2. Reinforcement 3.Structure and Visual/Tactile Supports 4.Task Demands 5. Skills to Teach 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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Intervention Ziggurat SEE HANDOUT

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Sensory Differences and Biologic Needs Sensory differences are not currently included as core symptoms of ASD. Impact of sensory differences to the individual pose some of the greatest challenges. Motor differences (muscle tone, oral-motor, repetitive movements, motor planning) Biologic Needs (hunger, pain, illness, sleep) Field of OT - Sensory Systems & Sensory Integration: (proprioceptive, vestibular, tactile/touch, visual/sight, auditory/sound, gustatory/taste)

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Sensory/Biologic - continued Modifying the environment to ensure physical health and comfort and optimal sensory arousal level may be critical to the success of an intervention program.

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Reinforcement Defined as a situation or event that follows a particular behavior, resulting in an increased likelihood that a behavior will recur in the future (Bregman & Gerdtz, 1997, p. 611) Provided that a consequence is desirable, the behavior will be displayed more in the future Essential to process of acquiring new skills 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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Structure and Visual/Tactile Supports Based on core characteristics of HFA/AS Intense drive to find order and make sense of their world Tend to conceptualize ideas and experiences in a visual way Visual information may be used to address a variety of needs For instance, visual supports shown to improve communication skills (Thieman & Goldstein, 2004) 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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Task Demands (or; removing obstacles) Is it appropriate to expect John to be able to sit in a classroom for 45 minutes? What are the social demands for Maria at work? Can Marty copy information from the board? Does Miguel have the skills to handle a field trip to the art museum? 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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Skills to Teach Autism spectrum disorders are lifelong conditions that require intervention throughout the lifespan. Only when the sensory system is calm, reinforcement is available, the environment is made predictable through structure and visual/tactile supports, and task demands are carefully designed can skills be effectively taught and demonstrated. 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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Interdisciplinary Approach Implementation may require the expertise or participation of several people One of the benefits of using Ziggurat Model Provides a big picture and brings service providers together so all working towards a common goal Helps all players see how they are contributing to overall process 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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Moving From Assessment to Intervention Design 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D. Assessment Tools Underlying Characteristics Checklist (UCC) Individual Strengths and Skills Inventory (ISSI) ABC-Iceberg (ABC-I) Comprehensive Intervention Planning Ziggurat Worksheet (ZW) Incorporates the five levels of the Intervention Ziggurat Addresses underlying needs identified with the UCC Includes three points of intervention (A-B-C) Implementation Implement intervention Evaluate outcomes

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Why Use the Ziggurat Model The five tiers of the Intervention Ziggurat and the three points of intervention (A-B-C) are based on an understanding of the characteristics and needs of individuals with HFA/AS. Use of ZM (UCC, ISSI, ABC-I, and ZW) facilitates the identification of needs and provision of comprehensive treatment through an interdisciplinary approach. 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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Why Use the Ziggurat Model The Ziggurat Model is not a set of intervention techniques. It is a framework for decision making. The model does not describe how to intervene. It describes how to design an intervention using a set of evidence-based strategies. 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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Strengths of the Ziggurat Model Provides a process and framework for designing an intervention Addresses characteristics of ASD Emphasizes and enhances evidence-based strategies Facilitates comprehensive intervention design 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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Strengths of the Ziggurat Model Incorporates assessment Emphasizes a positive approach Facilitates the design of proactive interventions Facilitates interdisciplinary interventions Prevents a band-aid approach to intervention Prevents punitive approaches 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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UCC CL and HF Informal assessment tool designed by Aspy and Grossman designed to identify characteristics across a number of domains. It is not designed for diagnosis. The results are used to develop a comprehensive intervention incorporating each of the five levels of the Ziggurat.

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UCC Completed by parents and staff. Completion of the UCC is an intervention in itself! Increased awareness of the characteristics and the impact on the individual leads to decreased frustration on the part of the team.

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UCC-CL or HF CL = Classic HF = High Functioning

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General Intervention Plan UCC/ISSI Intervention Ziggurat (Ziggurat Worksheet)

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Specific Behavioral Concerns UCC/ISSI ABC-I Intervention Ziggurat (Ziggurat Worksheet)

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Using the UCC Video Which UCC will you use? CL or HF? Continue the video

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Designing a General or Global Program Users first prioritize concerns from several areas identified on the UCC using the guiding questions on the Global Intervention Plan Instructions Using guided questions on the Global Intervention Plan Instructions, specific items are then selected from the prioritized UCC areas 2008 Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.

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General Intervention Plan UCC/ISSI Intervention Ziggurat (Ziggurat Worksheet)

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Global Intervention Plan Establishing Priorities From the list of UCC concerns select items to address for intervention. These items are transferred to the Ziggurat Worksheet.

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Establishing Priorities Which UCCs have the greatest impact? Difficulty understanding non-verbal communication may be more fundamental and important than understanding jokes. Which UCCs address more pivotal underlying needs? Think about the ultimate goal of intervention. Short and long-term goals be developed.

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Intervention Design Helper A simple worksheet you can choose to use if the Global Intervention Plan isnt needed or desired.

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General Intervention Plan UCC/ISSI Intervention Ziggurat (Ziggurat Worksheet)

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Intervention Ziggurat/Ziggurat Worksheet Facilitates the development of targeted, comprehensive positive interventions. Incorporates the five critical levels, structured in a hierarchy. The first three levels depict internal and environmental factors. Sensory/Biologic Reinforcement Structure and Visual Tactile Supports

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IZ BASE/1 st Level: Sensory Differences and Biologic Needs Addresses basic internal factors that impact all functioning. 2 nd Level: Reinforcement Addresses motivational needs prerequisite to skill development. 3 rd Level: Structure and Visual/Tactile Supports Draws on the strength of visual processing and addresses the need for order and routine that is fundamental to individuals with ASD.

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Top Two Levels The top two levels of the IZ focus on understanding expectations in light of the characteristics of individuals with an ASD and targeting appropriate skills to develop. Task Demands and Skills to Teach

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Specific Behavioral Concerns UCC/ISSI ABC-I Intervention Ziggurat (Ziggurat Worksheet)

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The ABC-Iceberg (The ABC-I) A behavioral assessment approach using the Ziggurat Model Incorporates the relationship between the characteristics of autism spectrum disorders and behavior Aspy and Grossman (2008)

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Iceberg Analogy Way of describing critical aspects of objects or circumstances that are not apparent without careful observation. TEACCH applied this analogy to aid in the understanding of behaviors observed in individuals with an ASD. Interventions based on the iceberg concept are designed to address underlying deficits or characteristics associated with autism.

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ABC-I Model Applied to Social Isolation Aspy and Grossman (2008)

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ABC-I Model Applied to Meltdowns Aspy and Grossman (2008)

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CAPS Shawn Henry and Brenda Smith Myles The Comprehensive Autism Planning System (CAPS) is designed to provide an overview of a students daily schedule by time and activity as well as the supports that he/she needs during each period. Following the development of the students IEP, all educational professionals who work with the student develop the CAPS.

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continued Thus, the CAPS allows professionals and parents to answer the all-important question for students with an ASD: What supports does the student need for each activity? The CAPS is a list of a students daily tasks and activities, the times they occur, along with the all-important delineation of the supports needed to support student success. In addition, the CAPS includes space for making notations about data collection and how skills are to be generalized to others settings.

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CAPS The CAPS is founded on the recognition that students with an ASD have complex needs in multiple areas. It is individualized. Comprehensive: takes into account all activities of the day to ensure that supports are integrated throughout. Flexible: can be used with students from preschool to college at home and school.

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Addressing Current Mandates and Trends Accountability AYP Targeted skills to teach Data collection across the day IEP goals as well as state standards Scientifically based instruction Instruction embedded with the necessary supports to ensure progress RtI/evidenced based interventions Student performance Continuous progress monitoring

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Components Time, Activity, Targeted Skills to Teach Structure/Modifications Reinforcement Sensory Strategies Communication Social Skills Data Collection Generalization Plan

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Ziggurat and the CAPS Begins with the completion of the UCC and ISSI. Information obtained is incorporated into the CAPS to ensure that the students needs and interventions are addressed throughout the day with data collection and a plan for generalization built in.

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Handouts Blank CAPS Completed CAPS CAPS with visual support examples shown