START Orientation Young Children with Autism Spectrum Disorders

1. START Orientation Young Children with Autism Spectrum Disorders Amy Matthews, Ph.D. & Jamie Owen- DeSchryver, Ph.D. Grand Valley State University

2. Agenda for Today • Orientation to START and Early Childhood (EC) Training • Evidence-Based Practices for Young Children with ASD • Critical Components of Effective Programs • Foundations of ASD • Identification and Diagnosis • Next Steps

3. Assumptions • Early childhood programming is not a foreign concept • You know some basic information about autism spectrum disorders • You have experience working as a team • You are interested in young children with ASD

4. Who is here?Why Are we here?

6. Latest CDC Report If 1 in 68 children have an autism spectrum disorder… • The average elementary building will have 4-5 children with ASD • The average middle school building will have 8-9 students • The average high school will have about 14-15 students *Center-based programs

7. Latest CDC Report Autism is no longer a low incidence disorder

8. We need to change our approach to educating young children with ASD

9. START Primary Components

10. Team-based Intensive Training

11. START Intensive Training Intensive yearlong training with multidisciplinary school based teams in the areas of teaming and problem solving, effective educational programming for students with Autism Spectrum Disorders, and systems change.

12. Making Professional Development EffectiveLang & Fox (2003) • Traditional professional development (training without follow up to support implementation) yields a 5-10% implementation of strategies success rate • With follow up, that number can rise to 75-90%

13. Overview of Intensive Training

14. Logistics • Location • All trainings will run from 8:30-3:30 • Breaks in am and pm • Lunch will be provided • CEUs will be offered • Binders for each participant and flashdrive for each sub team • We will always leave with an action plan

15. Snow Days START Training is canceled if… “insert decision here” • Sub team leaders provide a contact phone number at home or cell to start the phone tree • Get home/cell numbers from your team members

16. ACTION PLAN You will complete a team action plan at each meeting

17. Everyone is at a Different Stage of Learning • During this training we will talk about how to teach… • Early Learners • Emerging Learners • Transitioning Learners

18. Everyone is at a Different Stage of Learning • Participating in this training, everyone is at a different stage… • Early Learners • Emerging Learners • Transitioning Learners

19. Everyone is at a Different Stage of Learning • Evaluate what you hope to get out of this training • Content – I am an early learner and I just need some information to get started! • Implementation – I am an emerging learner. I know quite a bit, but I want to better implement effective practices in my classroom • Specific skills – I am a transitioning learner and I think my classroom is running pretty well; now I want to tackle some more advanced practices • CEUs – I have to get CEUs and this is as good as anything else

21. Where do we get information about evidence-based approaches? • National Research Council Report • http://www.nap.edu/openbook.php?isbn=0309072697 • National Autism Center • National Standards Project (http://www.nationalautismcenter.org) • National Professional Development Center on ASD (NPDC) • (http://autismpdc.fpg.unc.edu/) • Ohio Center on Autism and Low Incidence (OCALI) • AIM website (http://www.autisminternetmodules.org)

22. Where do we get information about evidence based practices? National Autism Center National Standards Project

23. AIM website (http://www.autisminternetmodules.org)

25. Evidence-Based Practices (NPDC) Independence • Self-management • Structured work systems Social • Peer-mediated intervention • Social skills training groups Motivation • Functional behavior assessment • Functional communication training Behavioral • Discrete trial training (DTT) • Differential reinforcement • Extinction • Prompting • Reinforcement • Response interruption/ redirection • Stimulus control • Task analysis • Time delay

26. Evidence-Based Practices (NPDC) Communication • Speech generating devices • PECS Technology • Computer-aided instruction Parent • Parent-implemented interventions Visual • Visual supports • Video modeling • Social narratives Natural environment • Pivotal Response Training (PRT) • Naturalistic interventions

27. A list of intervention strategies is not enough; interventionists need to identify child needs, develop plans to address needs, and match needs to instructional strategies (Strain, Schwartz & Barton, 2011)

29. Evidence-Based Practice • NOT just about interventions found to have strong research support (Cook et al., 2009) • Decision making process that informs all professional decisions (Sakett et al., 2000) • Professional wisdom is part of selecting, adapting, monitoring, and implementing EBP (Cook et al., 2008) • Family and individual input is critical (Strain et al., 2012)

30. Critical Program Components Empirically-Supported Treatments Discrete trial teaching PECS Prompting Pivotal Response Teaching Reinforcement Social narratives Video modeling Comprehensive Programs Children’s Toddler School Early Start Denver Model Walden Toddler Program Project DATA Early Intensive Behavioral Intervention (EIBI)

31. Critical Components

32. Critical Components Perhaps it is not unique features of model programs, but common features that result in positive outcomes (Boyd, Hume, McBee, Alessandri, Gutierrez, Johnson, Sperry & Odom, 2013) This is not the same as “eclectic”

33. What are the Critical Components of Effective Programs? • Early is better (by 3½) • Intervention at identification • Identification/intervention before age 3 • Intensity matters (at least 25 hours/wk, full year, with low ratio) • Active engagement/Structured teaching time • Minimal “free time” • Lots of learning opportunities • Each moment is a teachable moment • Family participation • Individualized goals, regularly monitored National Research Council, 2001

34. Critical Components:Intensity • Most model programs range from 25-40 hours per week • Intensity/number of hours may not matter as much as quality of hours of intervention • Multiple and varied embedded learning opportunities • Active engagement (Strain et al., 2011)

35. Critical Components:Curriculum • Exposure to typical curriculum and activities • Targets core skills that have long-term impact on independence and quality of life, including child’s success and happiness in school, home & community “Interventions are increasingly focused on behaviors that immediately improve the child’s independent functioning in natural settings (e.g., toilet training, verbal requesting) or behaviors that are essential for learning other important skills and long-term outcomes (e.g., imitation, joint attention)” (Strain, Schwartz & Barton, 2011, p. 327)

36. Critical Components:Individualized Approach • Individualized goals, regularly monitored • Practices are matched to individual needs • Focus on generalization • Data-based decision making is employed

37. Critical Components:Foundations • Providing opportunities with typical peers (Strain et al., 2011) • The opportunity to interact successfully, not just be in the same room, with typically developing peers on a regular basis is a necessary component of effective intervention programs for all children with ASD, especially young children. (Strain et al., 2011)

38. Critical Components:Teaching Practices • Focus on predictability and routine • Functional approach to problem behavior • Team approach • Skilled interventionists • Transition planning (Strain et al., 2011)

39. All practices must align with… • Law • IDEA • Literature • Evidence Based Practice • Student Data • Outcomes

40. We Know What Works

41. Why would public school programs have trouble adjusting to fit the recommendations and needs for young children with ASD?

42. Implementation challenges in public school settings • Ratios (ECSE classrooms) • Intensity/Time (0-3 and 3-6) • Training of staff • Philosophy • Getting families involved

43. Ways to Increase Intervention Other sources of increasing service hours • Insurance • Medicaid / MIChild • Parent Training/Coaching • Innovative projects in collaboration with universities, CMH, and within school districts/counties (e.g. Project DATA)

44. Systems Change • Big change only happens when we change whole systems • We did what we did when we knew what we knew • Once we know different, we are accountable

45. Getting Critical Mass Getting enough people moving in the right direction in order to move the whole system forward This is what the START Project is all about !

46. Big Ideas for Early Intervention • Identify and intervene early • Use evidence based practices • Increase learning opportunities (i.e. opportunities to respond with feedback) and student engagement • Use effective instructional delivery (3 Rs: Request, Response, Reaction) • Focus on meaningful, functional goals and tasks (independence and socialization) • Establish an effective classroom structure to ensure learning

47. Big Ideas for Early Intervention • Establish positive patterns of behavior early on • Prevent problem behaviors with antecedent strategies • Provide lots of meaningful integration opportunities • Use data to confirm progress and make programming decisions • Carefully plan for transition to elementary • Work as a team and include families

48. Working Together This Year: What is our goal? Help you develop a program that allows children to make the most progress

49. What would a highly effective classroom for young children with ASD look like? • Effective Practices Assessment Tool for Young Children with ASD

50. Early Childhood Assessment Tool