for slps and asds an update to the great 8 20 14% 20 … update to the great 8 for slps and asds ......
TRANSCRIPT
Slide 1
An Update to the Great 8
For SLPs and ASDsPresented by
Lynn M. Dudek M.S., CCC-SLP, MBA, BCBA
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Slide 2 Who am I?
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Slide 3 IntroductionWhy am I so passionate about supporting SLPs
treating ASDs?
What will you leave with today?
My Preservice Academic Course Content on ASD Adequately Prepared Me to
Serve Individuals with this Disability
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Following Graduation, I Would Rate My Knowledge of ASD as:
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Slide 4
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Slide 5
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Slide 6 Learner Objectives
After this course, participants will be able to list the necessary
components of comprehensive treatment for individuals with ASD.
After this course, participants will be able to explain the importance
of incorporating behavior-based strategies into treatment.
After this course, participants will be able to list 3-5 different types of
visual supports.
After this course, participants will be able to describe pros and cons
of AAC devices and communication apps.
After this course, participants will be able to discuss the importance
of collaboration with other professionals.
After this course, participants will be able to implement strategies to
increase motivation and compliance with those they serve.
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Slide 7 What are the Great 8?
Assessment
AAC
Behavioral Principles:
Reinforcement
Structure (schedules, visual supports)
Data
Social Skills
Sensory
Teamwork
Train your colleagues
Comprehensive Planning
Humor
Flexibility
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Slide 8
ASSESSMENT
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Slide 9 ASSESSMENT
The content validity of 57 outcome measurement tools was strong; however, there was minimal evidence of the tools' capacity to track outcomes of an intervention or progress over time. There was limited evidence for the measurement properties of standardized assessments and questionnaires that were developed for the general population, but applied to young children with ASD.
The majority of the tools identified (75/132; 57%) had no evidence that met the inclusion criteria of this review so their applicability for children with ASD could not be determined.
McConachie et. al, 2015
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Slide 10 ASSESSMENT
12 tools with a preponderance of positive evidence for three or more measurement properties (e.g., reliability, validity, responsiveness)were identified
McConachie et. al, 2015
1. Autism Diagnostic Observation
Schedule (ADOS)
2. Baby and Infant Screen for
Children with aUtIsm Traits-Part 2
(BISCUIT)
3. Behavior Summarized Evaluation-
Revised
4. Child Behavior Checklist
5. Childhood Autism Rating Scale
6. Home Situations Questionnaire-
Pervasive Development Disorders
version
7. MacArthur-Bates
Communicative Development
Inventory
8. Parenting Stress Index
9. Pervasive Developmental
Disorders Behavior Inventory
10.Preschool Imitation and Praxis
Scale (PIPS)
11.Psychoeducational Profile
12.Social Responsiveness Scale
(SRS)
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Slide 11 ASIEP-3
Autism Screening Instrument for Educational Planning-3 (Krug, Arick, & Almond, 2008)
2-0 to 13-11 years
5 Subtests:
Autism Behavior Checklist
Sample of Vocal Behavior
Interaction Assessment
Educational Assessment
Prognosis of Learning Rate
standard scores and percentile ranks
for each of five subtests
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Slide 12 ADOS-2
ADOS-2 (Lord, Rutter et. al, 2012)
Semi structured observational assessment
12 months to adulthood
4 modules
Modules 1 through 4 provide cutoff scores for autism and autism spectrum classifications.
Modules 1 through 3 provide a Comparison Score indicating level of autism spectrum-related symptoms compared to children with ASD who are the same age and have similar language skills.
Non-verbal to verbal
Special training required
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Slide 13 CARS-2
CARS-2 (Schopler &Van Bourgondien, 2010)
Two 15-item rating scales completed by the clinician (each designed for a different population)
An unscored Parent/Caregiver Questionnaire Structured interview
24 months of age and up
Cutoff scores, standard scores, and percentiles
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Slide 14 GARS-2
GARS-2 (Gilliam, 2013)Assists in identifying autism in and estimating its severity
3 through 22
56 items
6 subscales:
Restrictive/Repetitive Behaviors
Social Interaction
Social Communication
Emotional Responses
Cognitive Style
Maladaptive Speech.
Standard scores, percentile ranks, severity level, and probability of autism.
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Slide 15 MacArthur-Bates Communicative
Development Inventory - 3
MacArthur-Bates CDI-3 (Dale, 2007)
Long & Short form Parent Questionnaire
8 to 37 months (older if they have a developmental delay)
CDI: Words and Gestures (for use with children 8–18 months)
CDI: Words and Sentences (for use with children 16–30 months)
CDI-III (for use with children 30–37 months)
Standardized assessment
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Slide 16 Social Responsiveness Scale - 2
SRS-2, (Constantino,2012)
Identifies the presence and severity of social impairment within the autism spectrum and differentiates it from other disorders
2.5 years through adulthood
5 Subtests
Social Awareness
Social Cognition
Social Communication
Social Motivation
Restricted Interests and Repetitive Behavior
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Slide 17 Assessment of Basic Language and
Learning Skills-Revised
ABLLS-R (Partington, 2006)
Birth to 12 years
Criterion-referenced
Leads right to goal development
Identify deficiencies in language, academic, self-help, and motor skills
Time consuming
Specific items to be used for assessment
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Slide 18 VB-MAPP-2
The Verbal Behavior Milestones Assessment and
Placement Program-2 (Sundberg, 2008)
170 Milestones are assessed and Barriers
Transition Assessment and Task Analysis and Skills
Tracking
Mand, Tacts, Early Echoics
Listener Responding, Visual Perceptual
Independent Play, Spontaneous Vocal
Classroom Routines, Group Skills
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Slide 19 Assessment
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Slide 20 Assessment
What about the kids with higher functioning skills???
Language tests for form and function
Pragmatic assessments for use
Observe across many settings
Use standardized assessments
Interview parents and teachers
1:1 formal settings WILL NOT work!
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Slide 21 Assessment
Pragmatic Assessment
Using language for different purposes
Changing language according to the needs of a listener or situation
Following rules for conversations and storytelling
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Slide 22 Assessment
Pragmatic Assessment
Using language for different purposes
greeting (e.g., hello, goodbye)
informing (e.g., I'm going to get a cookie)
demanding (e.g., Give me a cookie)
promising (e.g., I'm going to get you a cookie)
requesting (e.g., I would like a cookie, please)
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Slide 23 Assessment
Pragmatic Assessment
Changing language according to the
needs of a listener or situation, such as
talking differently to a baby than to an adult
giving background information to an unfamiliar listener
speaking differently in a classroom than on a playground
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Slide 24 Assessment
Pragmatic Assessment
Following rules for conversations and storytelling, such as
taking turns in conversation
introducing topics of conversation
staying on topic
rephrasing when misunderstood
how to use verbal and nonverbal signals
how close to stand to someone when speaking
how to use facial expressions and eye contact
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Slide 25 Assessment - Play
Absence of play skills
Play does not vary
Lack of spontaneous play
No social or “make believe” play
Elaborate or intricate building
THINK ABOUT THE SKILLS YOU NEED TO PLAY…
Early Social (1st six months of
life)
Peek-a-boo, early turn
taking, smiles.
Simple Pretend (18-24/36
months)
Realistic use of objects.
Advanced Pretend (2-4 years)
Pretend play, play out
scripts.
Over 4 years old
More complex, use
language to narrate and
plan play.
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Slide 26
AAC
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Slide 27 AAC
“The currently accepted evidence in the literature suggests that no
specific skills are prerequisite for successful use of AAC in the broadest
sense. AAC is an intervention approach that can be the beginning of
communication development for an individual. A number of AAC
options are available to begin the intervention process.”
“AAC is probably right for an individual when he or she presents with a
severe expressive communication impairment that interferes with or
prevents development and use of oral language.”
“AAC interventions are used whenever individuals are unable to rely
on speech to meet all of their daily communication needs.”
ASHA
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Slide 28
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Slide 29 APPS
iCommunicate
4x10 grid or task
completion picture
10,000 included SymbolStix, reap
pictures, or online image
Dynamic visual schedules,
storyboards, communication
boards, routines, flash cards,
choice boards, speech cards
Record voice
$49.99 iPad only
My Choice Board
Up to 6 picture choices with
phrase “I want”.
Icons from app library, web
searches, personal photo library
Ability to show a picture is not
available
Record voice
$9.99 iPad only
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Slide 30 APPS
iComm
Free version has 9 categories of
pictures, paid version has 20
Add own pictures
Record short voice messages
Confirm picture choice with
YES/NO option
Paid version is $7.99 iPad only
My Talk Tools Mac, Windows, Tablets,
Smartphones
12,000 Symbolstix and 1000 Public Library, plus own pictures
Mac, Windows, Tablets (iPad), Smartphones
Backup and save work
Quick Words folders for social interaction
Extreme customization
$39.99
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Slide 31 APPS
LAMP
1-Hit, Transition, and Full
vocabularies (83 to 3000+ words)
Language Acquisition through
Motor Planning
Vocabulary builder
Built on motor planning
Word Finder feature
iShare for SGD and iPads
$299 iPad and PRC devices
Tap Speak Choice
Text to speech or voice recording
Direct access or scanning
Pixon® symbol set, designed by
Gail Van Tatenhove
Anti-Stimming mode
Backup service available
Customize board sizes (4, 6, to 24
icons) with 101 pages and 1700
buttons
$49.99 iPad only
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Slide 32 APPS
COMPASS Screen is split into toolbar,
navigation bar, and page area (where communication happens)
Pages can be organized by Core Words, Quick Fires, customizable pages
Visual Scene Layout or Grid Layout
Levels Questionnaire for assist in set up (concepts, literacy, page organization)
Folder-based organization system
$179.99 For use on iPad of T10 SGD
TouchChat
Gateway© and Pixon™ and
10,000 Symbolstix© symbols
In-app purchases (voices)
Fully customizable grid sizes
Web-based tech support
$149.99 basic, $299.99
recommended version
For iPad
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Slide 33 APPS
GO TALK
Standard Pages, Scene Pages
(with hot spots), Express Pages
1, 4, 9, 16, or 25 Communication
Locations per page
Text to speech or voice recording
Embed videos into the pictures
$79.99 for iPad
Proloquo2Go
Crescendo™ vocabulary levels
and 23 different grid sizes
20,000 symbols or photos
Multi-lingual options
Share and backup vocabularies
Inflection popups and negative
forms of verbs
Word Finder in Crescendo
vocabulary version 5.0
$219.99 for iPad
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Slide 34 AAC FACTS
The use of AAC does not affect motivation to use natural speech and can,
in fact, help improve natural speech when therapy focuses simultaneously
on natural speech development and use of AAC in a multimodal
approach (Millar, Light, & Schlosser, 2006; Sedey, Rosin, & Miller, 1991).
Intervention for minimally verbal school-age children with ASD that
included use of an SGD increased spontaneous output and use of novel
utterances compared with the same interventions that did not include use
of an SGD (Kasari et al., 2014).
AAC can help decrease the frequency of challenging behaviors that may
arise from frustration or communication breakdowns (Carr & Durand, 1985;
Drager, Light, & McNaughton, 2010; Mirenda, 1997; Robinson & Owens,
1995).
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Slide 35 CONSIDERATIONS FOR AAC
Everyone Deserves A Voice
AAC Near Me
Students who use AAC need their communication systems within
arm’s reach at all times.
If you can see the student, you should also be able to see their
AAC.
It’s never okay to turn it off or take it away.
Speak AAC
Immerse them in an environment that is rich in AAC use
throughout the day.
Point to the AAC symbols as you speak.
Use the AAC device or app OR make a non-electronic mock-up.
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Slide 36 CONSIDERATIONS FOR AAC
Speaking style
Narrate what we are doing & thinking
Avoid asking lots of questions
Describe what they are doing
Refrain from putting them on the spot or quizzing them
Use a natural conversational tone
Inject humor
Talk to them just like we do with our students who speak
Expectation
Set the Bar High Provide
Support
Engage Them in High Quality Instruction
Focus on Progress, Not Perfection
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Slide 37 CONSIDERATIONS FOR AAC Support
Waiting patiently for at least 5-10 seconds if they need extra time to process what we’ve said & respond.
Resist the urge to repeat, rephrase, or prompt.
Responding to the intent of their message, not the form.
Expanding on what they say by adding a word or two
Tempting communication but not forcing it
Using AAC whenever you talk to the student
FAQs
“She just plays around or stims on it & says random words! Can’t I take it away when it distracts other kids?”
“But he’s even not paying attention when I model AAC! Why bother?”
“The AAC device/app is too overwhelming. Wouldn’t it be better to use something simpler?”
praacticalaac.org
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Slide 38
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Slide 39 CONSIDERATIONS FOR AAC
Data collection: How often is the device being used, what words
are frequently and infrequently used, what time blocks are the high
and low use times?
Data analysis: Built in analysis to change intervention. Increase
training, and increase outcomes.
Easy and reliable back-up: INVALUABLE!!! Don’t wait until it is too
late!
Alphabet access: Not only for group activities like Hangman but
literacy development – for all learners.
Exploration: Allow time to “play” with this new language system.
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Slide 40 CONSIDERATIONS FOR AAC
Stick it out or try out AAC?
Unfamiliar listener
Out of context
With back turned
Abandon speech??
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Slide 41 ENSURING SUCCESS WITH AAC
HOW TO TEACH AN AAC USER?
Introduce words – 80/20ish.
Teach the word with explicit instruction activities – games, books,
videos, lots of exposure. Semantic instruction is important.
Elaborate on word meanings with varied and fun practice
activities – aided language input
Provide repeated exposure
Check, teach and re-teach all while planning for generalization.
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Slide 42 ACTIVITY USING AAC
Cooking Group
Word of the Week
Staff Training and AAC Challenge
Note Cards
Core Word Boxes
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Slide 43
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Slide 44
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Slide 45 BUT WHAT ABOUT…
The 17 year old, non-verbal, severely cognitively
impaired boy with no functional communication who
has been at home for 5+ years ?
WHAT DO WE DO FOR HIM?
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Slide 46
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Slide 47
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Slide 48
BEHAVIOR
PRINCIPLES
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Slide 49 APPLIED BEHAVIORAL ANALYSIS
ANTECEDENTS BEHAVIOR CONSEQUENCES
Child needs to use the
bathroom
Child says “potty” to
parent
Child uses bathroom and
feels relief
Starts raining Put up an umbrella Stays dry
Student called on to
read aloudStudent throws book Sent to principles office
Driver sees a red light Driver stops car Driver avoids crash
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Slide 50 APPLIED BEHAVIORAL ANALYSIS
ANTECEDENTS – Happen before the behavior
MOTIVATION
BEHAVIOR – What we DO
Dead Man’s Test
Can a dead man engage in the behavior? If the answer is yes, it is not a behavior
Some examples might be “will not tantrum during transitions” or “will sit quietly during story time”.
CONSEQUENCE – Happens after the behavior
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Slide 51
WHAT THE FUNCTION OF THE
BEHAVIOR???Access to attention
Access to tangibles
Escape from attention/demand
Automatic/Sensory
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Slide 52
Escape/Avoidance: The person engages in behavior(s) in order to
get out of doing something he/she does not want to do.
Attention Seeking: The person engages in behavior(s) to obtain
attention from individuals in their environment.
Seeking Access to Materials: The person engages in behavior(s) in
order to get a preferred item or participate in a preferred activity.
Sensory Stimulation: The person engages in behavior(s) because it
provides feedback that they desire.
FUNCTIONS OF BEHAVIOR
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Slide 53
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Slide 54 VERBAL BEHAVIOR
Speech
Sign Language
Picture Exchange System
AAC Devices
Gestures
Eye gaze/shift
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Slide 55 VERBAL OPERANTS
MAND
TACT
INTRA-VERBAL
ECHOIC
LISTENER RESPONSE
IMITATION
MATCH TO SAMPLE
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Slide 56 VERBAL OPERANTS
MAND
Wants a cookie – signs “cookie”
Wants pushed on a swing –says “push me”
Wants to know where mom is – says “where is mommy?”
Motivation is key
Reinforcement is direct – the item the child says.
TACT
Smells cookies in the oven –says “cookie”
Hears a marching band – says “music”
Sees a kitten – says “kitty”
Feels the fur of a dog – says “soft”
Behavior is verbal – not PECS
Antecedent is sensory, reinforcement is non-specific
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Slide 57 VERBAL OPERANTS
INTRA-VERBAL
Mom asks “what’s your favorite dessert?” - child says “strawberries”
Teacher says “twinkle twinkle little” – child says “star”
Child 1 says “what’s your name” – Child 2 says “Katie”
Behavior is verbal but not the same as the antecedent.
Reinforcement is non-specific
ECHOIC
SLP says cookie – child says “cookie”
Mom says “I want eat” –child says “I want eat”
Teacher says “my turn” –child says “my turn”
Exact repetition of antecedent
Must be verbal
Reinforcement is non-specific
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Slide 58 VERBAL OPERANTS
LISTENER RESPONSE
We call this receptive language
IMITATION
Do this___
MATCH TO SAMPLE
Match things that go together because they share similar
characteristics
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Slide 59 PAIRING
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Slide 60 PAIRING
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Slide 61 REINFORCEMENT AND PUNISHMENT
POSITIVE AND NEGATIVE (ADD AND TAKE AWAY)
REINFORCEMENT
Occurs when a stimulus change immediately follows a
response and increases the future frequency of that type of
behavior in similar conditions.
PUNISHMENT
Occurs when a stimulus change immediately follows a
response and decreases the future frequency of that type of
behavior in similar conditions.
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Slide 62 IMPORTANT!!!
THERE’S AN IMPORTANT DIFFERENCE BETWEEN A REINFORCER AND A PREFERRED ITEM!!
There are things we like and things we will work for – make sure you know the difference.
What you think is reinforcing may really be preferred!
WHAT DO YOU PREFER – FOR WHAT WILL YOU WORK??
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Slide 63 VISUAL SUPPORTS
ADVANTAGES
Concrete
Predictive
Decreases unwanted
behaviors
Builds Independence
Promotes success
ADVANTAGES
Transportable
Removes verbal
component
Makes time stand still
Aids in transitions and
changes
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Slide 64 VISUAL SUPPORTS
“A tool that enables the child to keep track of the day’s events and activities and at the same
time helps him or her to develop an understanding of time frame and appreciation of environmental sequences”
Twachtman-Cullen, D. (1995)
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Slide 65 VISUAL SUPPORTS
WHERE IS YOUR CHILD VISUALLY?
Object Stage
Photo Stage
Picture Symbolic Stage
Line Drawing Stage
Text Stage
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Slide 66 VISUAL SUPPORTS
OBJECT STAGE PHOTO STAGE
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Slide 67 VISUAL SUPPORTS
PICTUR
E SYMBOLIC
LINE DRAWINGS
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Slide 68 VISUAL SUPPORTS
TEXT STAGE
Using text and photos
Pokemon Eat
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Slide 69 TYPES OF SUPPORTS
Video
Photos
Cartooning
Structured Teaching
Priming
Modeling
Virtual Worlds
Schedules
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Slide 77
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Slide 78 VISUAL SUPPORTS
Schedules
FIRST
THEN
Made with Boardmaker™ and the Picture Communication Symbols
©1981-2004
Mayer-Johnson LLC - P.O. Box 1579, Solana Beach, CA 92075 U.S.A.
Phone 800-588-4548 or 858-550-0084.
www.mayer-johnson.com
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Slide 79 VISUAL SUPPORTS
Cartooning
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Slide 80 VISUAL SUPPORTS
Structured Teaching
RED
(place objects here)
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Slide 81
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Slide 82 VISUAL SUPPORTS
Other supports
Social Stories TM (Carol Gray)
Power Cards (Elisa Gagnon)
Incredible 5 Point Scale (Kari Dunn Buron)
Timers
Charts
Checklists
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Slide 83 VISUAL SUPPORTS
Other supportsSocial Stories TM (Carol Gray, 2000)
I am at school and it is Circle Time. The teacher will like it if I listen to her. I will try to sit, listen, and pay attention to the teacher. If I need to leave the circle I may sit in my beanbag chair or sit on my big pillow. These are good choices. My teacher or my aide will help me stay in circle or sit on my beanbag or pillow.
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Slide 84 SOCIAL STORIES There are three types of sentences used in writing social stories:
Descriptive sentences: objectively define anticipated events where a situation occurs, who is involved, what they are doing, and why. (e.g., When people are inside, they walk.)
Perspective sentences: describe the internal status of the person or persons involved, their thoughts, feelings, or moods. (e.g., Running inside could hurt me or other people.)
Directive sentences: are individualized statements of desired responses stated in a positive manner. They may begin “I can try…” or “I will work on…” Try to avoid sentences starting with “do not” or definitive statements. (e.g., I will try to walk in inside.)
A social story should have 3 to 5 descriptive and perspective sentences for each directive sentence.
Avoid using too many directive sentences. They will be lost without adequate contextualization.
Write in first person and on the child’s developmental skill level. Remember to use pictures that fit within the child’s developmental skill level to supplement text.
Broek, E., Cain, S.L., Dutkiewicz, M., Fleck, L., Grey, B., Grey, C., et al. (1994). The
Original Social Story Book. Arlington, TX: Future Education. www.thegraycenter.org
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Slide 85 VISUAL SUPPORTS
Power Cards (Elisa Gagnon, 2001)
Monkey wants everyone to know that it is very important to be able to handle anger appropriately. Monkey started working on controlling his temper when he was a very small chimp and he has advice for all little boys who feel angry.
The next time you feel angry, try doing these things that helped Monkey:
1. Ask an adult if you can go to a quiet spot and calm down for a few minutes.
2. Get a piece of paper and pencil and draw for a few minutes to calm down.
3. Talk to an adult, like mom or Ms. Lynn, and work on a solution.
Practice these things and you’ll be swinging just like Monkey.
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Slide 86 VISUAL SUPPORTS
1. Ask an adult if you can go to a quiet spot and calm down for a few minutes.
2. Get a piece of paper and pencil and draw
for a few minutes to calm down
3. Talk to an adult, like mom or Ms. Lynn,
and work on a solution.
Power Cards
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Slide 87 VISUAL SUPPORTS
Incredible 5 Point Scale (Kari Dunn Buron,2003)
Screaming, out of control
Yelling, outside voice
Normal voice, just talking
Whisper, soft voice
No talking
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Slide 88
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Slide 89 VISUAL SUPPORTS
Timers
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Slide 90 VISUAL SUPPORTS
I followed my schedule.
I followed my schedule by myself (no
reminders)
Get in van.
Get lunch bag.
Get backpack.
Eat breakfast.
Get dressed.
Brush teeth.
Go to bathroom.
ACTIVITYCOMPLETE
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Slide 91 VISUALLY BASED INTERVENTIONS
Web-based resources
https://www.iidc.indiana.edu/pages/visualsupports
Subject-based visuals
http://praacticalaac.org/praactical/free-resources-for-
making-aac-and-visual-supports/
Too many resources to list
https://ccids.umaine.edu/resources/visual-supports/
Links for visuals, Social Stories TM , classroom and individual
http://milestones.org/online-resources/tool-kits/visual-
supports/
Has a visuals tool kit
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Slide 92
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Slide 93 DATA
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Slide 94 OPERATIONAL DEFINITIONS
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Slide 95 DATA SHEETS
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Slide 96
SOCIAL SKILLS
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Slide 97 WHY SOCIAL SKILLS
Communication = Form, Content, and FUNCTION!!!!!
Social interactions = social, emotional, and cognitive development
Social skills deficits = poor outcomes
Social relationships = positive psychological states
Most children with ASD do not receive adequate social skills programming
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Slide 98 SUCCESSFUL SOCIAL SKILLS PROGRAMS
1. Start with a good assessment
2. Target a specific skill
3. Are individualized to the needs of the child
4. Occur more frequently and intensively
5. Match instructional strategies to the skill deficit
6. Are direct
7. Have a good framework for a clinician to operate within
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Slide 99 WHAT TO TEACH?
EASY – EVERYTHING!!!
Early social behaviors
Practice to go from skill to competence
Don’t forget about peers
Gestures
Know what “kids are saying these days”
Should we be teaching eye contact?
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Slide 100
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Slide 101
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Slide 102
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Slide 103 WHAT TO TEACH?
WHAT ELSE?
When to shhhhhh
How to speak to different people
Appropriate refusal through gestures
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Slide 104
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Slide 105 SOCIAL SKILLS
Academic knowledge ≠Social knowledge
Knowing a skill ≠Skill competence
Use of a skill 1:1 ≠ Generalization
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Slide 106 SOCIAL SKILLS
Social Skills Curricula
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Slide 107 FIND YOUR TRIBE
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Slide 108
SENSORY
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Slide 109 SENSORY
Classroom
•Seating
•Lighting
•Flooring
•Distractions
•Calming
•Fidgeting
•Alerting/Focusing
•Transitions
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Slide 110 SENSORY
Seating•proper child-seat-desk ratio.
•feet should rest comfortably on the floor
•the table shouldbe a forearm's length away from the chin
• i.e. with elbow resting on table, the fist should fit under the chin
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Slide 111 SENSORY
Lighting•Research has found that fluorescent lights are not conducive to optimal learning
•especially for students with ADHD
•Autism Spectrum.
•Use incandescent lighting
•Natural light - if you can find it!
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Slide 112 SENSORY
Flooring•Carpeted floors absorb noise
•Use area rugs, carpet squares under chairs
•Tennis balls on chair-legs to help absorb noise
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Slide 113 SENSORY
Distractions•Eliminate clutter/visual distractions (from ceiling, cover shelves, limit wall decorations), noise, interruptions, or distractions.
•Position (distractible) student so he faces away from the action (door, window, reading group, busy bulletin boards, etc.)
•Keep chalkboard/dry erase board clean.
•Create an "office" by placing a cardboard screen on/around desk.
•Allow student to sit/work in a small tent or large box (away from door).
•Store toys, manipulatives, learning materials in opaque containers on shelves.
•Have students use earplugs or headphones to drown out distracting noises.
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Slide 114 SENSORY
Distractions•Provide repetition and strong organizing informationthat is: Simple, Clear, Direct.
•Initially give one step instructions at a time, slowly increasing the number of steps.
•Try whispering: model the behavior you want students to demonstrate.
•Have student repeat directions.
•Provide physical prompts and gestures.
•Make things predictable.
•Don't rush.
•Have periodic "calm down time" with lights dimmed.
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Slide 115 SENSORY
Calming•Use low level lighting or dim the lights; turn off fluorescent lights, try lamps.
•Watch fish in a fish tank.
•Use a soft voice and slow down your movements and speech.
•Play soft music.
•Allow headphones or provide "white noise".
•Hand play in tactile media (beans, rice).
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Slide 116 SENSORY
Calming•Hand massage (especially muscles at the base of the thumb).
•Play with resistive materials like clay or Theraputty.
•Have squeezing/stretching objects available (Koosh, Theraputty, play doh, hand fidgets, Theraband).
•Use deep pressure, joint compressions, heavy work.
•Use bean bag animals, weighted vests, blankets, ankle weights, lap weights (with instruction from OT or PT).
•Reading/working while lying on stomach, leaning through elbows.
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Slide 117 SENSORY
Calming•Give firm bear hug, self hug, try holding breath.
•Clasp hands at mid-line -- squeeze or rub them or push and pull.
•Make small rhythmic arm or leg movements.
•"Steamroller" or "sandwich" student (rolling therapy ball over student with firm,
steady pressure).
•Perform slow wall, table, chair or hand to hand push-ups.
•Provide more variety in seatwork.
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Slide 118 SENSORY
Fidgeting
•Provide frequent breaks in seatwork; reinforce student for completing each segment of work.
•Provide more variety in seatwork.
•Allow opportunities for movement in the class, e.g., Brain Gym.
•Allow students to kneel, stand, or lie on floor to do work.
•Put a non-slip surface or mat on the chair.
•Try a seat cushion or "Move 'N Sit".
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Slide 119 SENSORY
Fidgeting
•Redirect student. Hand child an object or book, redirecting the movements to a constructive task.
•Allow student to straddle chair (less likely to tip over).
•Have a "fidget box" available or allow student(s) to keep a small object in desk (small Koosh, rubber ball, sticky toy, pipe cleaner, sandpaper square, etc.).
•For students who are continually tapping a pencil on the desk, model tapping on arm shoulder or thigh - and smile. Now you have quiet tapping.
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Slide 120 SENSORY
Alerting/Focusing•(THINK: bright colors, high contrast, loud, dysrhythmic, light touch, vibration,
bouncy activities, contact sports, rough play, rotation movements, wide open
spaces.)
•Use bright lighting.
•Use lots of visual cues: prompts photographs, illustrations.
•Clear auditory cues ("eyes here"). Avoid verbal cues when student is confused.
•Play loud, fast-paced music before a lesson.
•Play music with a rapid or dysrhythmic beat.
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Slide 121 SENSORY
Alerting/Focusing•Have student put cool water on face.
•Hand play in tactile media.
•Explore different textures.
•Use hand-held vibrators (never over the neck or behind the ears).
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Slide 122
TEAMWORK
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Slide 123 TRAININGS
Basic Trainings
IT Training
Clinical Documentation
Principles of Applied Behavior Analysis
AAC and Devices
Second Stage Training
Positive Reinforcement Strategies
Meet with Behavioral Consultants
Clinical Mentorship – weekly trainings based on staff feedback (evaluation, social assessments, goal setting)
Specialty Trainings
Device Training with PRC
representative
Funding source training to
obtain devices
HBS/CPI Training
Out of Department Training
BCBAs
CPST/Behavioral Health Team
Behavior Support
Teachers, Aides, Floaters
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Slide 124
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Slide 125 Sensory and Biological
Provide a sensory diet
Monitor and address environmental stressors:
Sound, light, proximity/personal space, textures
Movement needs
Monitor and address:
Appetite/hunger
Activity level (e.g., fatigue, hyper)
Posture and movement
Medical needs
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Slide 126 Reinforcement
Provide reinforcement
Contingent on expected behavior
Frequent and consistent
Self-selected
Gradually decrease use
Provide range of reinforcers
Concrete, activities, privileges
Use restricted interests
Pair social with tangible reinforcement
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Slide 127 Structure and Visual/Tactile Supports
Create predictability
Prepare for change
Provide routine
Walk through new activities
Use visual supports to hold information still
Video
Stories and cartoons
Schedules and checklists
Graphic/tactile organizers
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Slide 128 Task Demands
Remove obstacles
Social
Sensory
Restricted patterns
Cognitive
Communication
Motor
Emotional
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Slide 129 Skills to Teach
Address skill deficits
Social
Sensory
Restricted patterns
Cognitive
Communication
Motor
Emotional
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Slide 130
HUMOR &
FLEXIBILITY
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Slide 131
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Slide 132
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Slide 133
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Slide 134 Resources
Kasari, C., Kaiser, A., Goods, K., Nietfeld, J., Mathy, P., Landa, R., . . . Almirall, D. (2014).
Communication interventions for minimally verbal children with autism: A sequential
multiple assignment randomized trial. Journal of the American Academy of Child and
Adolescent Psychiatry, 53, 635–646.
Carr, E., & Durand, M. (1985). Reducing behavior problems through functional
communication training. Journal of Applied Behavior Analysis, 18, 111–126.
Drager, K. D. R., Light, J., & McNaughton, D. (2010). Effects of AAC interventions on
communication and language for young children with complex communication
needs. Journal of Pediatric Rehabilitation Medicine: An Interdisciplinary Approach, 3, 303–
310.
Mirenda, P. (1997). Supporting individuals with challenging behavior through functional
communication training and AAC: Research review. Augmentative and Alternative
Communication, 13, 207–225.
Robinson, L., & Owens, R. (1995). Functional augmentative communication and
behavioral change. Augmentative and Alternative Communication, 11, 207–211.
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Slide 135 Resources
McConachie H, Parr JR, Glod M, Hanratty J, Livingstone N, Oono IP, et al. Systematic
review of tools to measure outcomes for young children with autism spectrum
disorder. Health Technol Assess 2015;19(41)
AHSAWeb. “Augmentative and Alternative Communication.” Augmentative and
Alternative Communication. Accessed September 23, 2017.
http://www.asha.org/NJC/AAC/
PracticalAAC. “AAC101Handout.” PracticalAAC. Accessed September 23, 2017.
http://praacticalaac.org
Millar, D. C., Light, J. C., & Schlosser, R. W. (2006). The impact of augmentative and
alternative communication intervention on the speech production of individuals with
developmental disabilities: A research review. Journal of Speech, Language, and Hearing
Research, 49, 248–264.
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Slide 136 Resources
Cohen, S. (2004). Social Relationships and Health. American Psychologist, 59(8), 676-684.
http://dx.doi.org/10.1037/0003-066X.59.8.676.
Quill, K. (1995). Teaching Children with autism: Strategies to enhance communication and
socialization. Boston, MA. Cengage Learning.
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