Title: It Can Be Done: Translating Evidence Based Research into Educational Programs for Children with ASD
1It Can Be Done Translating Evidence Based
Research into Educational Programs for Children
with ASD
- Dr. B.J. Freeman, Professor Emerita,
- UCLA School of Medicine
- Dr. Ron Leaf, Co-Director, Autism Partnership
- Dr. Joanne Foland, Director of Education
Support Services for Opportunity Schools - Ms. Glenda McHale, Autism Programs Coordinator,
Greater Anaheim SELPA - 2008 NATTAP Conference
- Columbus, Ohio
2 Review of Methodologies Recommended
- Simpson (2004 2005) reviewed issues and factors
that relate to identifying and using effective
practices with children with ASD.
3- Thirty-three commonly used interventions for
children with ASD were evaluated and organized
into 5 categories - Interpersonal/Relationship-based
- Skill-based
- Cognitive
- Physiological/Biological/Neurological
- Other
4- In addition to descriptions, they also examined -
- Reported outcomes
- Qualifications of persons implementing the
intervention - How, where, when intervention is best carried out
- Potential risks
- Costs
- Methods of evaluating effectiveness
5- Interventions treatments were then graded as
falling into one of four categories - Scientifically-based practice
- Promising practice
- Practice having limited supporting information
- Not recommended
6- Interventions/treatments graded as
Scientifically-based Practice - Skill-based
- Applied Behavior Analysis
- Discrete Trial Training
- Cognitive
- Learning Experiences An Alternative Program for
Preschoolers and Parents
7- Interventions/treatments graded as Promising
Practice - Interpersonal/Relationship-based
- Play-oriented strategies
- Skill-based
- Picture Exchange Communication System
- Incidental teaching
- Structured teaching (e.g., TEACCH)
- Augmentative/alternative communication
- Assistive technology
- Joint action routines
8- Cognitive
- Cognitive behavioral modification
- Cognitive learning strategies
- Social Stories
- Social decision-making strategies
- Physiological
- Sensory Integration
9- Interventions/treatments graded as practices
having Limited Supporting Information - Interpersonal/Relationship-based
- Gentle Teaching
- Options Method
- Floor Time
- Pet/Animal Therapy
- Relationship Development Intervention
10- Skill-based
- Van Dijk curricular approach
- FastForword
- Cognitive
- Cognitive scripts
- Cartooning
- Power Cards
11- Physiological/Biological/Neurological
- Scotopic Sensitivity Syndrome
- Auditory Integration Training
- Megavitamin Therapy
- Feingold Diet
- Herb, mineral, other supplements
12- Practices Not Recommended
- Interpersonal/Relationship-based
- Holding therapy
- Skill-based
- Facilitated communication
13- Conclusion
- The field must move forward by identifying
objectively verifiable interventions.
14What is Being Done?
- Many studies ask parents about the number of
treatments/interventions used. - One study (Stahmer et al, 2005) reported results
of focus groups in community early intervention
studies in California.
15- Most educators reported that both evidence based
and non-evidence based programs were used. - When evidence based programs were used,
significant modifications were reported. - All providers highlighted a lack of adequate
training and preparation for teachers and
paraprofessionals.
16- Hess, Morrier, Heflin Ivey (2008) surveyed 185
teachers in Georgia representing 226 children
with ASD in preschool to grade 12. -
- They reported the top 5 strategies in order of
use were
17- Gentle Teaching
- Sensory Integration
- Cognitive-Behavioral Modification
- Assistive Technology
- Social Stories
18- Less than 10 were based on scientifically
validated practices, and 40 were not even
mentioned in Simpsons extensive review. - Why the discrepancy?
- Too expensive
- Lack of training
19- It can be done
- Dr. Leaf will describe evidence based programs.
- Dr. Foland will discuss issues from an
administrators point of view. - Ms. McHale will discuss issues of day-to-day
implementation.
20The Law Requires a Chevy . . .
- Education should provide a
- Rolls Royce with Maserati speed.
- Dr. Joanne Foland, Director
- Education Support Services
- for Opportunity Schools
21- Cost Effective
- Best Practices
- Defensible
- Stand the test of time
- Decreased litigation
22Cost Effective
- Model Classroom for Students with ASD
- Savings to the District
- - Current cost for 8 one-to-one Instructional
Assistants 224,000.00 - - Cost for 1 teacher and 4 one-to-one
Instructional Assistants in the Model Classroom
145,186.00 - Total Savings to the District78,814.00
23- Certificated
- 14,175 (insurance for certificated)
- 7,507.20 (STRS, Medicare, workers comp
unemployment) - Total Certificated 21,682.20
-
- Classified
- 28,350 (insurance for two 6-hr aides)
- 25,850 (salary for two 3¾ aides)
- Total Classified 54,200.00
24- Non-Public Agency Consultation 15,000 (11
months of consultation services) - Grand Total Savings to the District (or cost not
incurred) 90,532.20
25Other Issues Solved
- Offers Students Research-Based Instruction
- Assists Teachers in Implementing Research-Based
Practices - Serves as a Demonstration Site
- General Staff Training
- Decreased Meetings with Angry Parents
- Reduced Staff Turnover
- Eliminate Excessive Staff
- Eventually Reduce Student Services
- LITIGATION!!!
26Validation by Outside Consulting Firm
- Exemplary and cost-effective support services for
students with autism are in place. - Effective program alternatives to nonpublic
school and agency services have been developed. - District has extraordinary programs that are
models of what districts throughout the state
should strive for.
27If You Build It, Will They Come?
Glenda McHale Autism Program
Coordinator Greater
Anaheim SELPA
NATTAP 2008
28A confluence of factors have intensified interest
and urgency in building effective educational
programs for children with autism.
- Public Awareness/Interest
- Litigation
- Increased Prevalence
- Impact on Education
- Research Findings
29Individuals With Disabilities Education Act (IDEA)
- IDEA ensures
- - Free, Appropriate Public Education (FAPE)
- - Supports and Services
- - Least Restrictive Environment (LRE) Ages 3-22
30Litigation
- Autism not identified as disability
- Lack of adequate assessment
- Inappropriate goals and objectives
- Failure to demonstrate adequate progress/
educational benefit - Failure to address behavior
- Insufficient intensity of intervention
- Inadequately trained staff
- Lack of appropriate methodologies and technical
support - Lack of local program development (one size fits
all)
31Where to Begin . . .
- Research Review, Expert Input
- Determine clear, philosophical direction
- Collaboration
- Comprehensive Training
- Commitment (Buy-in)
32The Reality of . . . Having to do MORE with less
- Budgets State Federal
- -Impacts school districts, Regional Center, CDC
- Mediations and hearings
- -Time and monies
- -More is not always better
- -Reactive vs. proactive
- Staff training supervision
- Retention Recruitment
- -Burn out
- Parent support
- Educational system is responsible for all needs
33Impact on Education
- 75 of total number of cases under age 18
- Fastest growing disability
- 7,000 vs 24,000 80,000 year
- Encroachment
- Hiring, training maintaining staff
- Difficulty maintaining quality of programs and
services as growth in prevalence exceeds capacity - Lack of educational control/accountability
- Intensity of services for early intervention
- Building capacity preschool ? age 21/22
(long-term planning)
34ABA ProgramTRAINING MODEL
- Didactic (2days) 12 hours _____ Written
Exams - Intensive Practicum (5 days) 30-40 hours _____
Performance Rubric - Coached Practice 60 hours _____ Assignments
- (60 hours)
- _____ Performance Rubric
- _____ Total
- Case Assignments Modules Assignments
- Ongoing Supervision Building Reinforcement
- Behavior/Reinforcement
- Instructions/Prompting
- Overlap Services Behavior Management Shaping
- Performance Review Staff Development
- Curriculum
- Clinics Data Collection
35ABA Program Training Model Model Classroom
- 1 Month Internship (teams)
- Highly-skilled mentor staff
- Intensive training
- Individualized
36Model Classroom Training Outcomes
- Increased staff understanding and skill
- Enhanced consultation outcomes
- Improved intervention
- Increased student outcomes
- Decreased staff stress
- Improved classroom structure, organization,
management - Enthusiasm, empowerment, effectiveness of staff
- Reduction in staff to student ratio
- Multiplication of training effect
37 SELPA 2008
- Regional Classrooms
- Non-severe Special Education
- - Improved staff training
- - Integration of specialized instructional
strategies and methodologies - General Education (Inclusion)
- - Increased numbers
- Clinic-Based Services
- Consultation/Technical Support
- Capacity Building, Training, Staff Development
- Parent Education/Collaboration
38Organization of PersonnelAutism Programs
Department
- Autism Program Coordinator
Coordinator -
-
- SDC Autism Behavior SELPA
NPA - Teacher(s) Specialists Specialist Case
- Supervisor
-
- Assoc Assoc Assoc
- Case Case Case
- Supervisor Supervisor Supervisor
- Tutors
- Direct Line
- Field Staff
Overall Program Design, Coordination, Training,
Staff Supervision, Case Supervision, Consultation
Case Supervisor Individual Case
Development and Supervision
Associate Case Supervisors Case Management
Consultation Inclusion Support Clinic
Management
39Autism Services
- Individual Consultation
-
ABA Tutor Student Technical
Regional -
Mentoring ABA Support
Program - Staff and
Program Coordina - Training Super Develop
tion -
vision ment
Satellite/District - Collaboration
Clinic - with other
Coordination - SELPAs OCDE
IEP - Non Public
Development - Agency Coordination
Greater and
meeting participation - and Liaison
Anaheim
- SELPA
Individual Case - Autism
Supervision -
Services
- Capacity Building
- Due
40Outcomes
- High-Quality, Effective Programs
- Program Infrastructure
- Service Delivery Models that address broad range
of needs - Ongoing training and staff development
- Ongoing collaboration with experts
- Credibility in Community
- Reduction in costs
- - Reduced litigation
- - In house personnel
41Challenges
- Recruitment/Retention of staff
- Job Classification
- Secondary Education Programs
- Specialized Programs across the Spectrum
- Maintaining Quality
42The Journey Continues