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Research Based Instruction for Children with
Autism: Instruction “That Works”
and
How to Access Quality Staff Training
Presentation by:Joel Arick, Joan Steiner, Brenda Nakada,
Jennie Willis and Darby Lasley
Oregon Program Autism Training Sites Project (ORPATS)
Autism Teams Project
and NWRESD
More Information is available at
www.rpats.ed.pdx.edu
Presentation Topics
• What is ORPATS?
• What are Instructional Strategies “that work”?
• What about Parent Training?
• What does the Assessment Data Say?
• What is the Autism Teams Project?
• What is the Process to Access Training?
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ORPATS:
Oregon Program Autism Training
Sites
Current ORPATS STAFF:
• Joel Arick, Ph.D.
• Jennie Willis, M.S.
• Darby Lasley, M.S.
• Brenda Nakada, M.S.
• Karen Shepherd, M.S.
• John Gill, MS
• Misten Daniels, MS
Middle School Pilot Sites (Social Skills Component Staff): Phyllis Coyne, Kimberly Raines-Schmeltzer, Annette Skowron-Gooch.
ODE STAFF: Nancy Latini
Parent Training Project: Anna Dvortckak
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What is the ORPATS Project?
• ORPATS Staff are providing comprehensive workshops and extensive on-site “hands-on” training in research based instructional strategies to training site staff and autism specialists
• ORPATS Training Sites model appropriate curriculum content using behavioral methods and provide training on these research based practices
• Trained Autism Specialists provide hands-on training to other educators in their region at the training sites
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ORPATS
A Training Network
• Established 42 Oregon Program Autism Training Sites (ORPATS) throughout the state.
• Training sites model research-based applied behavior analysis methods in addition to classroom curriculum
• Established a cadre of autism specialists to provide training to others at the ORPATS sites
• Maintained current sites and continue to develop new training sites throughout Oregon
• Collaborated with the Autism Teams Project to provide training to 25 Teams throughout Oregon
• Co-sponsored State-wide Conference on Educating Children with Autism in May of 2009
ORPATS Highlights: 2009-2010
• 500+ Teams attended an ORPATS
workshop
• 200+ Teams have accessed an ORPATS
site for “on-site, hands-on” training
• 350+ Students were in attendance at the
ORPATS sites receiving services
• Since 2003 over 80% of the ORPATS
sites established continue to train others
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Curriculum for EI/ECSE and
Elementary Level Children• Learning to communicate, understand language and social skills is
the focus.
• Generalizing skills within functional routines at home and school is
important.
• Developmental curriculum across all domains.
• Including:
– STAR Autism Program (Strategies for Teaching based-on Autism Research,
Arick, Loos, Falco and Krug, 2004)
– Parent training component at the EI/ECSE Oregon Autism Training sites
(Ingersoll and Dvortscak, Guilford Press, November 2009)
– Inclusion and mainstreaming
– Peer tutoring and peer buddies
– PECS (Pyramid Educational Consultants, 2005)
– Augmentative Communication Systems
– Structured Teaching
– Incidental Teaching
– Commercial academic programs
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Curriculum for
Middle and High School Students
• Independence is key
• School and Community Routines become more
of a focus
• Social Skill Development is also a priority
• Continue to use ABA strategies to teach specific
skills needed for independence on routines
• Generalize skills within routines
• FACTER Program (Arick, Nave, Hoffman, 2004)
• Adjusting the Image Curriculum (WESD, Columbia
Regional Program)
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Essential Elements of Support
Needed for Students with Autism• Student schedule
- Each activity of the day identified for the student
- Activities of the class consistent with the schedule
- Pictures/words at students developmental level
• Staff schedule- Staff is scheduled to support student as needed
- Direct instruction time is provided in order to implement
curriculum
• Staff training– Staff is trained to implement the student schedule
– Staff is trained in appropriate shaping/prompting/reinforcement techniques
– Staff is trained to implement the curriculum and adapt activities
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Elements of Support (cont)
• Classroom activities should be adapted to meet the students need
• A reinforcement system should be available as needed to motivate and reward student for appropriate behavior
• A curriculum appropriate for the student’s level should be implemented consistently
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Research Indicates:
Provide 1:1 intensive instruction in:– Expressive language
– Receptive language
– Spontaneous Communication
– Pre-academics
– Play skills/Social Interaction and
– Pre-Teach Functional routines
THEN
Generalize the skills taught into the child’s
school day and at home
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Research Also Says that Effective
Instructional Strategies to Teach this
Content are the Applied Behavioral
Analysis Strategies of:
•Discrete Trial Training
•Pivotal Response Training
•Functional Routines
Source: Simpson, R. (Focus on Autism and
Other Developmentally Disabled, Fall 2005)
Curricula and Research-Based
Instructional Strategies
The STAR Program
Strategies for Teaching based on Autism Research
(Arick, Loos, Falco and Krug, 2004)
STAR Program
• The STAR Autism Program teaches children with autism the critical skills identified by the 2001 National Research Council. The ABA (Applied Behavior Analysis) instructional methods of discrete trial training, pivotal response training and functional routines form the instructional base of this comprehensive program for children with autism.
• The STAR Program includes detailed lesson plans, teaching materials, data systems and a curriculum-based assessment for teaching in the six curricular areas of receptive language, expressive language, spontaneous language, functional routines, academics, and play & social skills.
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STAR Student Learning Profile:
A Curriculum-based Assessment
• Shows the overall scope and sequence for the a research based Program
• Provide guidelines for determining which lesson to focus on for each student
• Shows instructional strategies that are most effective for lesson
• Shows which lessons can be taught simultaneously
• Establishes baseline and summarizes student’s instructional progression
PECS
Picture Exchange Communication System
(Frost and Bondy, 1994)
PECS
• PECS was developed in 1985 as a unique augmentative/alternative communication intervention package for individuals with autism spectrum disorder and related developmental disabilities. First used at the Delaware Autistic Program, PECS has received worldwide recognition for focusing on the initiation component of communication. PECS does not require complex or expensive materials. It was created with families, educators, and resident care providers in mind, so is readily used in a range of settings.
• PECS begins by teaching an individual to give a picture of a desired item to a “communicative partner", who immediately honors the exchange as a request. The system goes on to teach discrimination of pictures and how to put them together in sentences. In the more advanced phases, individuals are taught to answer questions and to comment.
Edmark Reading Program
Edmark Reading Program• The Edmark Reading Program has been designed for students
with learning or developmental disabilities and those who have
not succeeded with other reading methods. For 30 years, this
trusted program has been highly regarded by teaching
professionals as the very best program available.
• The Edmark Reading Program uses a whole-word approach,
with short instructional steps, consistent repetition, and positive
reinforcement to ensure that students experience immediate
success. Multiple learning modalities are incorporated into this
highly effective process with a variety of lesson formats that
keep students motivated and involved. Graphics, content, and
presentation are appropriate for readers of all ages. Graphics
can be turned off for adult or older students.
ELSB
Early Literacy Skill Builders
(Attainment Company)
Early Literacy Skill Builders
•ELSB is a language-rich literacy curriculum for students with moderate to significant developmental disabilities, including autism.
•The Early Learning Skills Builder program incorporates systematic instruction to teach both print and phonemic awareness. ELSB is a multi-year program with seven distinct levels and ongoing assessments so students progress at their own pace.
Handwriting Without Tears
http://www.hwtears.com/
Touch Math
http://www.touchmath.com/
Structured TEACCH (University of North Carolina):
Use of Independent Work Systems
Visual Supports
Simple Book Schedule
Simple Beginning Wall Schedule
Written Schedule
Portable Schedule
Mini-Schedule for Hand washing
Choice Wheel
Parent Training Component
Strategies based on:
“Teaching Social Communication to Children with Autism”
By Brooke Ingersoll and Anna Dvortcsak
Published in 2010
Project ImPACT
• Improving Parents As Communication Teachers
• Encompasses the parent training curriculum
Guiding Principles
• Intervention is naturalistic (parents should be able to implement intervention within daily routines)
• Typical development is used to guide selection of treatment strategies.
• Children learn social communication through affect-laden interactions with responsive caregivers.
• Techniques are based on applied behavior analysis
Parent Training Model
• View: Parents’ childrearing knowledge
and specific skills can directly enhance
their child’s development
• Goals: Provide systematic instruction in
strategies to help parents accomplish
specific goals or outcomes for their child
Parent training is a primary intervention
strategy
3 Main Focuses of Parent
Training• Enhance parents’ skills in engaging their
child in play and social interaction
• Teach parents strategies to help their child
acquire developmental skills
• Help parents manage child’s behavior
during ongoing daily routines
Intervention Techniques
• Parents are taught techniques through:
– Written materials (Manual)
– Didactic presentation
– Video examples
– Group discussion of how techniques can be
used during daily activities
– Homework
Roles in Parent Training
• Parent’s role: Primary intervention
provider
– Practice techniques
– Implement intervention in the
home/community
• Teacher’s role: Coach
– Model Techniques
– Provide Feedback
Intervention Strategies
• Developmental Techniques (Interactive)
– Increase engagement
– Increase initiations
– Provide the child the opportunity to initiate
and respond without having to do so in a
specific way
• Behavioral Techniques (Direct)
– Teach specific skills
• Language, imitation or play
Overview of Curriculum
How Program is Being Used
Across Oregon
State-wide
• Used in Early Childhood/Early Intervention
programs in all 8 regions of the state
• Programs trained have received the
published curriculum through the ORPATS
grant
• Updating the curriculum provided an
opportunity for teams to network on
strategies for using this program.
How Program is Being Used
Across Oregon
• Teams in each region present to parents
1-3 times each year (Groups range from 6-
10 families)
• Most present in a group format to allow
families to network together
• EI programs have also adapted to a home
visit model
Student Outcomes
• Oregon Outcome Study
(Arick, Young, Loos, Falco and Krug, 2004)
• Randomized Clinical Trial:
– University of Pennsylvania
• Pre-school ORPATS Assessment Project:
– Initial results
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Autism Outcome Study
Parents
Oregon
Department
Of Education
Portland
State
University
Children
with ASD
EI/ECSE,
Regional Programs
School-age Programs
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Feedback:
Parents and Teams
Follow Up
Training
Assessment
Outcome Study:
Components
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Training providedduring the
Autism Outcome Study
Research-based Program Curriculum
utilizing the instructional techniques of:
» Discrete Trial Training (DT)
» Pivotal Response Training (PRT)
» Functional Routines (FR)
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Study Participants
• Two Cohorts of Children Participated:
Cohort One: 67 children– Tracked progress for 52 months
– Across the state of Oregon
– At out-set of study they were between 2-6 years of age
– At conclusion of study they were between 7-11 years of age
Cohort Two: 56 children– Tracked progress for 18 months
– Across the state of Oregon
– All children were 3 years of age at out-set of study
– All recently identified within a 6 month period
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Assessments/Surveys
• Standardized assessments were given by an independent team of assessors.
These assessments were all videotaped with randomly selected videotapes scored for reliability.
• Standardized assessments given:
– Battelle Cognitive Battery
– Vineland Adaptive Behavior Scale
– Expressive One-Word Picture Vocabulary Test
– Oregon Department of Education Academic Alternate Assessment
– Autism Screening Instrument for Educational Planning (ASIEP-2):
• Autism Behavior Checklist
• Sample of Vocal Behavior
• Social Interaction Assessment
• Educational Assessment
• Parent and Teacher Surveys given annually
• Classroom Observation Checklist
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Cohort #1 Verbal Language Age Gain
Baseline to Summer 2003 (Approx. 52 months)
-20
0
20
40
60
80
100
120
Baseline Language Age (top number) VB Gain (bottom number)
VB
Gai
n/L
oss
VB Gain 5 1 1 2 -3 -2 0 24 5 11 32 33 68 1 2 16 22 47 6 30 39 6 11 12 46 4 33 34 12 -16 4 18 56 100 23 46 108 39 68 50 88 19 94 64 49 102 85
11 12 13 13 14 14 16 16 17 17 17 17 17 18 18 18 18 18 19 19 19 20 20 20 20 21 23 23 25 26 26 26 26 26 27 28 28 30 30 32 32 33 34 35 36 41 43
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Expressive Language Progress
• Results for Cohort One (older cohort):
– 91% of the children made expressive language gains. Many of the children doubled their previous language age.
– 36% of the children made at least one month of expressive language age gain for each month of instruction provided during the first 18 months of the study.
– No significant difference was found between the chronological age of the children and the progress they made.
– A moderate correlation was found between the beginning language age level of the child and the progress made. However many of the children who started with very little language more than doubled their language age over the life of the study.
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Student Outcomes
• Students in both cohorts gained skills in:
• Expressive Langauge
• Receptive Language
• Pre-academic Skills
• Play and Social Skills
• Spontaneous Language and
• Independence on Functional Routines
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JOURNAL ARTICLE ABOUT THE STUDY: (Cohort #1)
Arick, J., Young, H., Falco, R., Loos, L., Krug,
D., Gense, M., & Johnson, S. (2003). Designing an
outcome study to monitor the progress of students with
autism spectrum disorder. Focus on Autism and Other
Developmental Disabilities, 18, (2),75-87.
Website: Autism Outcome Study Report
(cohort #1 & 2)
www.autismstudy.pdx.edu
Research Study:
Randomized Control Trial of the STAR Program
School District of Philadelphia and
University of Pennsylvania
Federal Research Grant
Year 1 Cohort
– STAR classroom student outcomes better than control
group classrooms
Year 2 Cohort
– 48 classroom teachers volunteered to participate and
learn STAR
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Philadelphia Stories of Success
Rachel, a K-2 teacher ….. recalls how the program resulted
in tremendous progress for one of her students with
autism. “I began teaching receptive language first. This
student learned to imitate the words I said when giving
him a reward.” Eventually the child was able to learn
more words by associating them with pictures on a card.
Through this technique, the child added 50 nouns to his
vocabulary and, to the delight of his parents, began
speaking much more at home.
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Philadelphia Stories of Success
I teach in West Philadelphia and have been using the
STAR curriculum for the past year and a half. This
curriculum requires a lot of training, planning, and
organization in order run effectively; however, the
benefits are remarkable to the students in my classroom.
Each student’s quality of life has been greatly improved
by learning to complete some of the daily tasks we would
normally take for granted. (Megan)
University of Pennsylvania School of Medicine, University of Pennsylvania Health
System (2010). Simply Because: A Community Health Report, Project Director:
Dr. David Mandell 57
Pre-school Age Non-verbal Students: Initial Progress Results
• Descriptive Study with 3 different assessment periods
• Initial assessment, 9 month re-assessment, and 18 month re-assessment
• Administering the ASIEP-3, and the Receptive and Expressive forms of the Peabody
• All students are primarily non-verbal at initial assessment period
• The data shown in this report are from the Educational Assessment sub-test of the ASIEP-3.
Students
• Currently have 28 students enrolled in the study. Plan to have 40 pre-post assessments completed by the end of next year.
• Students must be new to using The STAR Program and babbling, at the most using 1 word
• Current students are receiving 4 days a week of Early Childhood Special Education services in an RPATS training site.
• At this time we have 9 students that have had both an initial assessment and 9 month re-assessment
Ability to sit in chair
0
2
4
6
8
10
12
1 2 3 4 5 6 7 8 9
Initial
9 month
3 students were unable to sit in chair at initial
assessment, All students were able to at 9
month assessment!!
Receptive Language
• Responding safety commands –
– “name,” “stand up,” “sit down,” and “Come here”
• Receptive Labels – “show me” and “give me”
• Following one and two step directions
– “Jump,” and “point to the cup, and give me car”
Receptive Language
0
2
4
6
8
10
12
1 2 3 4 5 6 7 8 9
Initial
9 month
Out of the 9 students, 7 students made
progress. Students are learning that
language has meaning.
Expressive Language
• Student shows desire by reaching
• Uses 1 word
• Answers simple questions
• Uses “yes” and “no”
• Uses sentences with 3 – 4 words
Expressive Language
0
2
4
6
8
10
12
1 2 3 4 5 6 7 8 9
Initial
9 month
5 students demonstrated progress, 4 students remained at the same level.
Half of the nonverbal students began using language to communicate!
Students are emerging in their understanding of the power of expressive language.
Body Concepts
• Ability to walk
• Able to imitate
• Skip, hop, and walk backwards
Body Concepts
0
2
4
6
8
10
12
1 2 3 4 5 6 7 8 9
Initial
9 month
7 of the students demonstrated progress!! Our students are learning what they need to “attend to” in the environment!
Speech Imitation
• Makes vocal sound
• Imitates vocalizations, “ah” and “m”
• Imitates 1 and 2 words
• Imitates full sentences
Speech Imitation
0
2
4
6
8
10
12
1 2 3 4 5 6 7 8 9
Initial
9 month
6 of the students made progress, 3 stayed the same .
Overall Progress
• This score calculates how the student
performed on the whole assessment
Overall Progress
0
10
20
30
40
50
1 2 3 4 5 6 7 8 9
Initial
9 month
8 of the students showed progress! This tells us that our students are “learning how to learn.” It is building a foundation for our students as they continue on in their education.
Autism Teams Project
A collaboration between the Oregon Department of Education,
Northwest Regional ESD and Lane ESD
Autism Team Project Staff
• Joel Arick, Consultant
• Misten Daniels, Workshop Presenter/Consultant
• John Gill, Workshop Presenter/Consultant
• Darby Lasley, On-site Consultant
• Sue Mathisen, Lane ESD Director of Special Education
• Brenda Nakada, On-site Consultant
• Karen Shepherd, NWRESD Coordinator
• Joan Steiner, NWRESD Director of Special Education
• Jennie Willis, On-site Consultant
Other Staff Associated with the Project:
Nancy Latini, Associate Superintendant, ODE
Eric Richards, Salem School District
Purpose of the Project:
• To increase the statewide capacity of school districts and
ESD teams to implement evidence based practices for
students with ASD;
• To provide training and the needed materials
• Te reach 25 educational teams
• To make the 2 day STAR workshop available to
additional staff outside of the designated teams.
Workshops Dates/Teams:
• April 2010: SOESD– 3 teams
• May 2010: Umatilla Morrow ESD– 3 teams
• August 23-25, 2010: Linn Benton ESD– 9 teams
• October 2010: High Desert ESD– Teams: To be determined
• October 2010: Northwest Regional ESD– Teams: To be determined
Initial Trainings
• Three day “hands on” training
• Support to assess students and put programs together;
• One day follow up consultation in the classroom;
• Visit existing ORPATS sites
Set Up Day:Team members work together to develop student programs and schedules.
Curriculum provided to each
team:• Complete STAR kit
• Level I and II STAR training DVDs
• STAR Curriculum notebooks
• Visuals to support routines (Routines in a Bag)
• Token boards
• PECS Starter Kits
• Handwriting Without Tears materials
• Boardmaker Plus
• Carol Grey’s “The New Social Stories Book” and CD
• Coming soon: Sunshine Literacy Kit
• Room dividers
Pivotal Response Training
Materials:• Simple toys to support turn
taking, requesting and functional play (ball poppers, marble runs, cause and effect toys)
• Play sets to facilitate imaginary play (shopping basket/food, playmobile sets)
• Books and Puzzles
• Board games
Advanced Workshop and Network
Meetings
• April/May 2011
• Will be held in same locations as initial workshops
• Focus on questions and training needs determined by the original teams post implementation
• Team network opportunities and participation in a facilitated discussion on future directions and training needs across the state.
SOESD Workshop Feedback
• 13 participants rated it a 5 = Outstanding (59%)
• 7 participants rated it a 4 = Excellent (32%)
• 2 participants rated it a 3 = Good (9%)
Wow! This was amazing. It was great to come to this training as part of a team and walk
away all ready to go for some real students. The district I came with has really been hit
hard by budget cuts and has been unable to purchase anything. To go to this training with
the very motivated and experienced teacher, her IA, and the SLP and leave with
everything needed to set up the classroom for discrete trial, pivotal response and
functional routines for kids…it is wonderful. This experience has been so valuable for all
of us. Thank you!” (ASD Consultant, Douglas ESD)
Umatilla Morrow ESD Workshop
Feedback
• 30 rated it a 5 = Outstanding (77%)
• 8 rated it a 4 = Excellent (20.5%)
• 1 rated it a 3 = Good (2.5%)
“This was great! What a super addition to the program. The PRT bin will be especially
helpful. All autism teams across the state would benefit from a program set-up day.” (ASD
Specialist, Umatilla-Morrow ESD)
“Excellent presenters, great information! Each time I attended I learned more. More of this
is needed, especially in rural areas” (Speech Language Pathologist)
Linn Benton Workshop
Feedback:
• 35 participants rated it a 5 = Outstanding (74%)
• 12 participants rated it a 4 = Excellent (26%)
• “Thank you so much for including the materials we needed to get started right away in the classroom. Without them it would be very hard with the limited time we have to get everything together. They are a wonderful gift for our students. Thank you again.” (anonymous)
• “Loved having the 3rd day to work with my team and pull it all together. The materials provided were helpful to get going…Continue with the 3rd day training.” (anonymous)
Many Thanks……
The ATP Staff would like to give a special thanks
to the following:
• all the workshop hosts for their help in arranging
workshop locations, registration and other many details;
• all the participating teams for their enthusiasm and input
during these workshops;
• The Oregon Department of Education for their ongoing
support in providing evidence based practices to
students with ASD across our state.
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HOW TO OBTAIN TRAINING FOR YOUR STAFF?
Oregon School districts can access ORPATS training by contacting their Regional Autism Coordinator.
See the ORPATS website (www.rpats.ed.pdx.edu) for contact information.
Workshops are offered through the ORPATS grant. All districts are welcome to the workshops. See the training schedule on
the ORPATS website.
Autism Teams Project is on-going throughout the 2010-11 school year. Contact your Regional Autism Coordinator if
interested in participating or see the training schedule on the ORPATS website.
Upcoming Oregon
ORPATS/TEAMS Workshops
Pre-School/Elementary/Middle School (Discrete Trial, Pivotal Response Training and
Functional Routines)
• October 13th-14th, 2010 (Albany, OR)
RPATS 2 Day Workshop - 8:30am-3:30pm
Location: Linn-Benton-Lincoln ESD, Albany, OR
Contact: Leslie Howard 541-812-2771
Email: [email protected]
• October 18th-20th, 2010 (High Desert ESD)**
Contact: Katherine Procter 541-693-5715
• October 21st-22nd, 2010 (Gresham SD)
Contact: Kara Magee-Arick
Email: [email protected]
• October 27th-29th, 2010 (Northwest Regional ESD)**
Contact: Karen Shepherd 503-614-1671
Upper Elementary, Middle and High School (Functional Curriculum Methods)
• October 27th, 2010 FACTER Workshop(Gresham SD)
Contact: Kara Magee-Arick
Email: [email protected]
• **These two workshops are open to others following the initial registration of the assigned Autism
Teams. 85
