What the DEC Recommended Practices Say About ASD: Suggestions for Interventionists

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What the DEC Recommended Practices Say About ASD
Suggestions for Interventionists

• Ilene Schwartz
• Phil Strain
• Glen Dunlap

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DEC Recommended Practices

• Provide guidance about the most effective ways to
  improve learning outcomes and promote the
  development of children, birth five
• Highlight practices shown to result in better
  outcomes for children, families, and those who
  serve them
• Research ? practice

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Framework

• Using the DEC Recommended Practices as a guide,
  what policies practices should be included in a
  comprehensive program for children with ASD?
• Leadership
• Assessment
• Environment
• Family
• Instruction
• Interaction
• Teaming Collaboration
• Transition

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Leadership

• 14 practices
• L7. Leaders develop, refine, and implement
  policies and procedures that create the
  conditions for practitioners to implement the DEC
  Recommended Practices.

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Leadership

• Good leaders are essential to implementing
  recommended practices and high quality programs
• Leaders create and support environments in which
  practitioners can do their best work
• Leaders create environments and implement
  policies and practices that retain and support
  practitioners

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Assessment

• 11 practices
• A4. Practitioners conduct assessments that
  include all areas of development and behavior to
  learn about the childs strengths, needs,
  preferences, and interests.
• A9. Practitioners implement systematic ongoing
  assessment to identify learning targets, plan
  activities, and monitor the childs progress to
  revise instruction as needed.

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Environment

• 7 practices
• E3. Practitioners work with the family and other
  adults to modify and adapt the physical, social,
  and temporal environments to promote each childs
  access to and participation in learning
  experiences.

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Families

• Three themes
• Family centered practices
• Family capacity building practices
• Family and professional collaboration
• Ten practices
• F5. Practitioners support family functioning,
  promote family confidence and competence, and
  strengthen family-child relationships by acting
  in ways that recognize and build on family
  strengths and capacities. F5. Practitioners
  support family functioning, promote family
  confidence and competence, and strengthen
  family-child relationships by acting in ways that
  recognize and build on family strengths and
  capacities.

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Instruction

• 13 practices
• INS6. Practitioners use systematic instructional
  strategies with fidelity to teach skills and to
  promote child engagement and learning.
• INS7. Practitioners use explicit feedback and
  consequences to increase child engagement, play,
  and skills.
• INS9. Practitioners use functional assessment and
  related prevention, promotion, and intervention
  strategies across environments to prevent and
  address challenging behavior.

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Interaction

• Five practices
• Int 2. Practitioners promote the childs social
  development by encouraging the child to initiate
  or sustain positive interactions with other
  children and adults during routines and
  activities through modeling, teaching, feedback,
  and/or other types of guided support.
• Int 3. Practitioners promote the childs
  communication development by observing,
  interpreting, responding contingently, and
  providing natural consequences to verbal and
  non-verbal communication and by using language to
  label and expand on the childs requests, needs,
  preferences, or interests.

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Teaming and Collaboration

• Five practices
• TC2. Practitioners and families work together as
  a team to systematically and regularly exchange
  expertise, knowledge, and information to build
  team capacity and jointly solve problems, plan,
  and implement interventions.

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Transition

• Two practices
• TR 2 -- Practitioners use a variety of planned
  and timely strategies with the child and family
  before, during, and after the transition to
  support successful adjustment and positive
  outcomes for both the child and family

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What does this mean for children with ASD?

• Programs need adults who can work together
• Assessment must be thorough, on-going, include
  multiple domains, and influence instruction
• Many instructional strategies can be used,
  data-based decision making is key
• Social and communication behaviors are key
• Environment modification can result in big
  changes
• Transitions must be planned

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These program elements yield best results for
children with ASD when provided in the context of
inclusive early education programs.
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Myths About Inclusion

• Too stimulating
• Best for mildly involved
• Harms others learning
• Too costly
• Compromises intensity
• response opportunities x
• fidelity of intervention delivered x
• social validity of goals x
• comprehensiveness of intervention x
• data-based decision-making Quality Outcomes

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When Does Inclusion Reap Possible Outcomes

• Every day
• All activities
• Specially trained peers
• Data tracking to make instructional decisions
• Use of comprehensive curricula
• Minimum of a 21 ratio

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What Are the Mechanisms By Which Inclusive
Settings Produce Positive Social Outcomes?

• Relationships and the
• Cheers effect increasing opportunities to
  respond/participate
• Encouragement of life on the preschool edge
• Attitudes of and Advocacy by peers (LEAP data)
• Informal but powerful instructional episodes that
  occur among peers

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So, The Only Clear Outcome Difference is Social
So What?

• Best predictor of 3rd grade reading is having a
  friend when you are 3
• Preschool social relations also predict
• Continuing friendships
• Longevity
• Recovery from serious medical events
• Employment status
• Independent living
• Adult mental wellness

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Peer Mediated StrategiesLEAPs Social Skills
Curriculum

• Getting Your Friends Attention
• Sharing - Giving Toys
• Sharing - Requesting Toys
• Play Organizer
• You be the Mommy.
• Giving a Compliment
• I like your painting.

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Social Skill Curriculum Teaching the Skills

• Describe Skill
• Demonstrate
• the Right Way
• Demonstrate
• the Wrong Way
• Child Practice with Adult
• Child Practice with Child
• Set up Reinforcement System

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What Really Stands in the Way?

• The way it is and professional inertia
• Edifice complex
• Equating quality with one-to-one, adult child
  ratios
• Some places, the lack of available EC settings
• Lack of oversight and lack of consequences for
  noncompliance
• Lack of institutional reinforcers for compliance

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Effective Instructional Strategies

• Critical Elements of Effective Educational
  Practice

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Some Background

• Effective instructional strategies for children
  with ASD are not different from effective
  instructional strategies for other children
• However, effective instruction for some children
  with ASD requires more precision, care and
  attention to fidelity
• Effective instructional strategies for young
  children with ASD are not different from
  effective instructional strategies for older
  children with ASD
• However, attention must be paid to developmental
  characteristics (and thus curricular priorities)
  of young as opposed to older children

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Elements of Effective Instruction for Children
with ASD

1. Individualization of supports and services
2. Systematic instruction
3. Comprehensible and/or structured environments
4. Specialized curriculum content (emphasis on
   social interactions and language)
5. Functional approach to challenging behaviors
6. Family engagement

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INS 6 Systematic Instruction

• Practitioners use systematic instructional
  strategies with fidelity to teach skills and
  promote child engagement and learning
• Careful planning and goal setting
• Careful planning of instructional procedures
• Careful data collection
• Careful implementation with fidelity
• Careful, ongoing evaluation (progress monitoring)
  and adjustment of instructional plan as necessary

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Instructional Procedures

• Defining instructional target
• Antecedents ---- specifying the contextual and
  antecedents under which target behavior should
  occur
• Behavior ---- determining how the behavior will
  occur (e.g., prompting)
• Consequences ---- specifying what consequences
  (e.g., reinforcers) will follow the behavior in
  order to make the behavior more likely to occur
  in the future

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Instructional Procedures

• Well-established evidence-based procedures, such
  as
• Functional communication training
• Peer-meditated instruction
• Incidental teaching
• And comprehensive programs, such as
• Pivotal Response Training
• EIBI (Lovaas etc.)

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INS 7 Explicit Feedback and Consequences

• Practitioners use explicit feedback and
  consequences to increase child engagement, play
  and skills
• The most fundamental and the most important
  principle in all education and all learning is
  the principle of Positive Reinforcement

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A Big Rule

• Positive reinforcement is NOT positive
  reinforcement if it does not serve to strengthen
  (increase) behavior.
• It is desirable for positive reinforcement to
  occur as naturally as possible, but positive
  reinforcement is not positive reinforcement if it
  does not serve to strengthen (increase) behavior.

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Considerations

• If you wish to implement effective instruction,
  you must be able to deliver a positive reinforcer
  contingently
• If you are unsure, you can identify positive
  reinforcers through preference (or reinforcer)
  assessments
• If your intervention plan is unsuccessful, the
  first place to look for a reason is the
  contingency
• Is the reinforcer really a reinforcer?
• Is it being used contingently?
• Are there competing reinforcers?

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INS 9 Functional Assessment and Positive
Behavior Support

• Practitioners use functional assessment and
  related prevention, promotion and intervention
  strategies across environments to prevent and
  address challenging behavior
• Functional assessment (or FBA) a process for
  identifying the function (purpose) of the
  challenging behavior and events in the
  environment that govern the behaviors occurrence
• Function-based interventions rely on a functional
  assessment to identify components (strategies) of
  a behavior support plan (positive behavior
  support)

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FA and PBS

1. Establish a team (caregivers, family,
   professionals, etc.) and agree on specific
   definitions and goals related to challenging
   behavior (to reduce) and social-communicative
   behaviors (to increase)
2. Design and implement feasible and valid data
   collection
3. Conduct functional assessment to identify
   functions of challenging behavior and
   contextual/antecedent influences
4. Design and implement a function-based behavior
   intervention plan
5. Monitor progress and modify plan as necessary

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And.

• Behavior intervention plans work best if they
• include multiple components ---- antecedent
  manipulations, instructional strategies, and
  effective consequences
• Include active participation of family members
• Are implemented with commitment and investment of
  all team members