Best Practices in Transition: Critical Components Related to Educating Adolescents With Autism

1
Best Practices in Transition Critical Components
Related to Educating Adolescents With Autism

• Brandee El-Attar, M.S., Kate Dickey, M.S.
• Devereux CARES Consultants

2
Programming for Adolescents

• What is adolescence?
• Why is this a difficult period to plan for with
  students with ASD?
• What are our obligations as educators?
• What critical components are necessary to ensure
  success?

3
Legal requirements

• IDEA 2004 states that transition services must
• Begin no later than the first IEP to be in effect
  when the student is 16 and updated annually
  thereafter (PA requires from age 14)
• Be provided until
• The student turns 21, or
• The student graduates from high school with a
  regular diploma

4
IEP requirements

• Appropriate measurable postsecondary goals
• Based on age appropriate transition assessments
  related to training, education, employment, and,
  where appropriate, independent living skills
• Transition services (including courses of study)
  needed to assist the student in reaching those
  goals

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What are we planning for?

• Key Transition Areas
• Employment
• Postsecondary education
• Living arrangements
• Community participation
• Community mobility
• Financial independence
• Recreation and leisure
• Friendships and relationships

6
Employment

• Competitive employment
• Supported employment
• Self-employment
• Rehabilitation facility or workshop
• Day program, sheltered workshop, or activity
  center

7
Postsecondary education

• Four-year college or university
• Community college
• Trade or business schools
• Vocational-technical schools
• Specialized training in business and industry
• Continuing adult education

8
Living arrangements

• Individualized housing supports
• Providing support services to people living in
  their own apartments
• Matching individuals with disabilities to
  roommates without disabilities or with families
  that may be compensated for providing needed
  assistance
• Supplying in-home supports to people with
  disabilities and their families
• Assisting people with disabilities to become
  homeowners

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Best Practices in Transition Critical Components

• Create a student-centered transition plan
  (i.e.,PCFP)
• Cultivate student involvement and
  self-determination
• Align the curriculum with visions for post school
  life, the students transition plan, and the
  general education curriculum
• Provide students with paid and actual work
  experiences while still in school
• Establish interagency collaboration with adult
  service providers, employers, and post-secondary
  institutions
• Foster family involvement in the transition
  planning process

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Best Practices In Transition Critical Components

• Create a student-centered transition plan
• Why?
• Keeps the process focused on student preferences
• Key elements
• Use person-centered futures planning to create a
  vision
• Transition plan drives the IEP not an add on
• Revise plan annually to reflect changing needs
  and goals

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Supporting Families and Students Through
Person-Centered Futures Planning

• Person-centered futures planning (PCFP) is an
  ongoing process that brings together a group of
  committed individuals to help an individual with
  special needs plan and create a life that is
  personally fulfilling and productive
• This process can start at any time, but should
  begin minimally at 14 years

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Supporting Families and Students Through
Person-Centered Futures Planning

• The initial PCFP meeting at CARES typically takes
  two to three hours subsequent annual meetings
  usually last between one and two hours
• We try to have this meeting about one month
  before the IEP we have found that this process
  can help plan transition IEPs

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Supporting Families and Students Through
Person-Centered Futures Planning

• Meeting outcomes will also include
• A description of medical and physical needs
• The students and familys vision for post-21
  living, employment, social interactions, and
  community inclusion
• A description of the students preferences and
  strengths and needed supports
• Goals and objectives for employment education
• An action plan for the upcoming year
• See our wiki for our format www.autismhandbook.or
  g

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Best Practices in Transition Critical Components

• Cultivate student involvement and
  self-determination
• Why?
• Develops self-advocacy and self-determination
• Enhances quality of life
• Keeps plan focused on student preferences
• Key elements
• Involve student in IEP/transition planning
• Teach self-determination skills directly
• Student-led IEP meetings or increase
  participation in IEP meetings
• Teach self-advocacy
• Infuse instruction throughout the day

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Best Practices in Transition Critical Components

• Align the curriculum with visions for post school
  life
• AND
• Align the students transition plan with the
  general education curriculum
• Why?
• Curriculum during transition years must prepare
  students for all aspects of adult living
• At the same time, if transition plan is linked to
  general education
• More likely to graduate with regular diploma
• More likely to have continued inclusion with
  same-age peers without disabilities

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Best Practices in Transition Critical Components

• Key elements of Curriculum
• Balance between high academic expectations while
  addressing functional needs
• Utilize existing general education classes and
  services (e.g., vocational education)
• Community-based instruction for learning
  functional skills (in real-life settings)
• College campus based or community-based programs
  for providing services to students age 18-21
• Age appropriate setting
• Ongoing inclusion with same-age peers
• Opportunities for work experiences and
  postsecondary education with support
• See www.thinkcollege.net

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Best Practices in Transition Critical Components

• Establish interagency collaboration with adult
  service providers, employers, and post-secondary
  institutions
• Why?
• Fosters seamless transition to adult life
• Creates opportunities for post school success
• Key elements
• Invite agency representatives to IEP/transition
  meetings
• Form school-agency partnerships and pool resources

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Best Practices in Transition Critical Components

• Provide students with paid and actual work
  experiences while still in school
• Why?
• Results in immediate and long-term post school
  employment
• Key elements
• Real life experiences through
• Internships
• School sponsored part-time jobs
• Vocational education

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Best Practices in Transition Critical Components

• Foster family involvement in the transition
  planning process
• Why?
• Families serve as the bridge to adult life
• Families can assist the student in voicing
  preferences and goals for adult life
• Key elements
• Provide critical information to families
• Establish partnership in the planning process
• Use person-centered planning
• Respect family values and culture

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Developing Competencies for Adulthood From
Planning to Practice

• Assessment strategies
• Instructional methods and activities to promote
  independence
• Program components to optimize student growth
  

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General Assessment and Program Planning

• Thorough assessment provides information that can
  be used for
• Diagnosis/verification (and subsequent special
  education eligibility decisions)
• Educational programming/intervention planning
  (i.e., strengths and needs)
• Present levels of performance/measurement of
  progress

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Common Areas of Skill Assessment Across Most
Young Students With Autism

• Communication skills
• Social skills
• Play skills
• Academic
• Motor skills

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Additional Areas of Emphasis for Adolescents With
Autism

• Functional Communication
• Expressive
• Requesting reinforcers
• Requesting assistance
• Requesting breaks
• Requesting clarification
• Requesting bathroom
• Affirmation, rejection, and protestation
• Commenting (responsive and spontaneous)
• Answering and asking questions

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Additional Areas of Emphasis for Adolescents With
Autism

• Receptive
• Understanding verbal directions with gestures
  and/or contextual cues
• Understanding verbal directions without gestures
  and/or contextual cues
• Following pictorial and/or written directions and
  schedules
• Waiting

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Additional Areas of Emphasis for Adolescents With
Autism

• Social Skills
• Initiating and responding to greetings
• Gaining attention appropriately
• Avoiding violation of others personal space
• Accepting feedback and/or correction
• Using please and thank you
• Responding to social questions
• Refraining from disruptive behaviors

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Additional Areas of Emphasis for Adolescents With
Autism

• Functional Academics
• Reading
• Money Handling (understanding the exchange of
  money to purchase, using a debit card, using a
  wallet)
• Writing (name, notes/letters)
• Math Concepts (understanding concepts of more or
  less, using a calculator, reading a clock and
  manage time)

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Additional Areas of Emphasis for Adolescents With
Autism

• Self-Care
• Feeding
• Independent Toileting and Self-Care Routines
• Consistently Washing Hands
• Dressing Skills

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Additional Areas of Emphasis for Adolescents With
Autism

• Domestic Skills
• Simple Food Preparation
• Cleaning Skills
• Taking Care of Clothing

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Additional Areas of Emphasis for Adolescents With
Autism

• Recreation and Leisure
• Solitary Activities
• TV, Music, Computer, Books and Magazines,
  Electronic Games, Art, Puzzles, Sports and
  Exercise, and so on
• Group Activities
• Table-Top (cards, games, art)
• Gross Motor (walks, sports, games)

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Additional Areas of Emphasis for Adolescents With
Autism

• Community
• General Skills (waiting, using transportation)
• Single-Item Purchases
• Multi-Item Purchases
• Food Related Activities
• Recreational Activities

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Additional Areas of Emphasis for Adolescents With
Autism

• Health and Safety
• Refraining from dangerous behaviors
• Communicating effectively when feeling ill
• Cooperating with medical interventions and
  personnel
• Participating in regular exercise routines
• Acting upon sexual feelings appropriately

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A Closer look at Human Sexuality

• Ignoring it will not help!
• Discrepancies exist between emotional, social,
  and
  cognitive abilities AND physical and sexual
  development
• Devereuxs guiding philosophies
• All individuals will have sexual feelings as they
  progress through adolescence and/or adulthood
• All individuals should be allowed to express
  their sexuality in appropriate ways, and receive
  guidance when needed
• Parents are the best teachers for these skills,
  but their efforts should be supported by
  educators

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A Closer Look at Human Sexuality

• Some concepts to teach always address the who,
  when, and wheres
• Public versus private
• Touching (greetings, gaining attention, showing
  affection)
• Conversations
• Dressing/undressing and nudity
• Dating and related social behavior
• Adolescents- Introducing yourself, maintaining
  conversations, reading social cues, using manners
  
• Young adults- asking someone out on a date,
  accepting rejection, dating behavior, and so on
• Self-pleasuring when appropriate
• Timing of instruction depends upon the student in
  conjunction with their family
• Time and place considerations
• Safe and effective techniques
• Consider teaching a routine

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Additional Areas of Emphasis for Adolescents With
Autism

• Vocational
• Office/Clerical Work
• Janitorial
• Food Services
• Horticultural/Lawn Maintenance
• Customer Service
• Stocking
• Laundry
• Industrial
• Performance Parameters (independence, duration,
  accuracy, generalization, and rate)

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Additional Areas of Emphasis for Adolescents With
Autism

• Beginning of Self-Awareness and Determination
• Making choices
• Assessing their own appearance and performance
• Managing reinforcement/reward systems
• Assessing and communicating preferences
• Participating in meetings

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Assessment and Program Planning

• Assessment and program planning must also take
  into account Quality of Life (QoL) considerations
• QoL is a term used to describe an individual's
  satisfaction with his or her life and general
  sense of well-being. It is often measured as
  physical, psychological and social well-being.

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Variables that Affect QoL

• Physical well being/health
• Social connectedness with family, friends, and
  co-workers
• Control and choice with variables that impact
  your life/self-determination
• Satisfaction with employment or school,
  residential living, and community inclusion
• Levels of independence across environments
• Ability to communicate effectively with others
• Level of contact with reinforcers

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Evidence-based Ways to Increase QoL (Dennis Reid,
2010)

• We can maintain happiness and enhance personal
  growth by
• Providing frequent choice opportunities
• Assessing preferences and using preference-based
  teaching procedures
• Eliminating and/or modifying highly undesirable
  tasks and routines

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Focus Upon Quality of Life Indicators

• Choices and control
• Opportunities to participate in preferred
  activities
• Community inclusion
• Peer relationships
• Relationships with family members
• Increased independence across settings
• Expressive and receptive communication
• Are they happy most of the time?

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Important Overarching Considerations

• Assess Specific Skills
• Describe Learning Style
• Identify Student Preferences
• Describe Strengths and Needs
• Solicit Family Input

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Planning an Educational Program

• What is Functional?
• If a student does not perform the task, will
  someone else have to do it?
• Is it immediately needed?
• Is it frequently needed?
• Is it needed across settings and situations?
• Is it age-appropriate?
• Will it lead to greater independence?
• Will it enhance the students quality of life?

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Planning an Educational Program

• What are the most important skills to target?
• What teaching strategies will be utilized?
• What are the familys needs and preferences? How
  will the family be involved?
• What are the least restrictive effective learning
  environments?
• How much instructional time will be needed?

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Effective Instructional Strategies

• Include components of Applied Behavior Analysis
  (ABA) strategies
• Empirically-supported interventions
• Reinforcement systems
• Prompting procedures
• Various lesson formats (incidental teaching,
  natural environment teaching, discrete trial,
  shaping, chaining, whole or partial task
  presentation)
• Error correction strategies
• Incorporate choice conditions and preferences as
  much as possible
• Ongoing progress monitoring

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Positive Behavioral Support

• Functional Behavioral Assessment (FBA) and
  Positive Behavior Support Plans (PSBP)
• FBAs are implemented to determine the function or
  functions of undesirable behaviors.
• A PBSP is developed based directly upon the
  outcomes of the FBA with input from both
  educational staff and families
• Among other components, the written PBSP contains
  a description of antecedent modifications,
  functionally equivalent alternative responses
  (and teaching strategies), differential
  reinforcement systems, and consequences designed
  to eliminate or minimize reinforcement after
  undesirable responses
• Objective data is used to determine program
  effectiveness and to guide modifications in the
  PBSP

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Visual Enhancement Strategies

• Why Use Them?
• We all use visual supports everyday
• Daytimers and calendars
• Post-it notes/lists/signs
• Menus
• Visual/written instructions
• Placement of materials
• Tables and graphs
• Most individuals with an ASD are visual learners

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Visual Enhancement Strategies- Visual Schedules

• Visual Schedules can be used to
• provide information on the sequence of activities
• teach new skills and routines
• enhance an individuals independence
• incorporate choice conditions into a routine
• teach coping with changes in routines

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Individual or Group Schedule- Pictures
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Individual Schedule- Daytimers
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Using Schedules to Mediate Choice Conditions

• Recreation and leisure
• Jobs/chores
• Academic tasks
• Social activities

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Using a Schedule to Incorporate Choices
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Visual Enhancement Strategies- Visual Reward
Systems

• What am I working for?
• What do I need to do to get reinforced?
• When will I get reinforced?

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Visual Enhancement Strategies- Visual Reward
Menus
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Visual Enhancement Strategies- Visual Reward
Menus
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Visual Enhancement Strategies- Visual Reward
Systems- DRA
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Visual Enhancement Strategies- Visual Reward
Systems- DRA
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Visual Enhancement Strategies- Visual Reward
Systems DRO
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Visual Enhancement Strategies- Visual Reward
Systems DRL
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Visual Enhancement Strategies- Visual Reward
Systems- Contract
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Teaching Social Skills Using Visual Supports

• Social Stories
• Comic Book Conversations
• Videotaped Models
• Visual Cues

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Social Stories
61
Teaching Communication Skills Using Visual
Supports

• Requesting Help
• Requesting a Break
• Indicating Yes or NO
• Waiting
• Following Simple Directions

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Examples of Visuals for Teaching Communication
63
Visual Supports to Enhance Independence in Task
Completion

• Written instructions
• Picture sequence books
• Activity schedules
• Secondary environmental cues
• Job/chore boards
• Visual timers
• Check my work cards
• Organize and label materials and make clear
  boundaries for different areas in the environment

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Visual Sequence Book
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Labeled Work Bins
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Community-Based Instruction

• What is CBI?
• Its a process that provides frequent and highly
  structured learning opportunities outside of an
  individuals classroom, immediate work
  environment, and home.

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General Objectives of CBI

• Teach skills that are specific to community
  settings (e.g., waiting in line at the grocery
  store, ordering from a menu, and so on)
• Generalize acquired skills to new environments
• Establish or maintain good behavior in new (and
  usually less structured) settings
• Increase an individuals interactions with
  typically developing individuals

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Vocational Exploration

• Ongoing Assessment
• General strengths and needs
• Specific vocational skills
• Related critical skills (communication, social,
  hygiene and appearance, behavioral)
• Preferences
• Situational assessments and time studies

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Vocational Exploration

• Community-Based Vocational Experiences
• Training Sites
• Work Enclaves
• Individual Work Sites with Support
• Competitive Employment

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Comprehensive Staff Training, Support, and
Supervision

• Pre-service and inservice training and workshops
• Use of individual performance checklists
• Use of weekly classroom checklists
• Ongoing supervisory feedback and support
• Regular team meetings

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Family Inclusion and Support

• Partnerships among families and educators are
  critical at the individual student and
  program-level
• IEP and Futures Planning Meeting
• Program Planning Meetings and PTO
• Educational Activities (such as tours of other
  programs, seminars and workshops, structured
  observations, home visits)
• Family Education and Training Program (PA
  Transition Grant 2009-10)

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Family Inclusion and Support

• Facilitation of Linking Families to Appropriate
  Agencies/Supports
• OMH/MR, OVR
• Guardianship Issues
• Estate Planning
• Respite Services
• Devereux CARES Transition Wiki www.autismhandbook.
  org

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Putting it all Together.

• Successful Transition Means
• Planning for the students future in a way that
  is meaningful to them (i.e.,PCFP)
• Aligning the students vision for the future with
  curriculum and school/ community based
  opportunities to enhance skills
• Focusing on skills for life provide students
  with paid and actual work experiences while still
  in school

74
Putting it all Together.

• Establishing interagency collaboration with adult
  service providers, employers, and post-secondary
  institutions early on
• Fostering family involvement in the transition
  planning process
• Continually cultivate student involvement and
  self-determination