Embedded Intervention: Addressing Children

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Embedded Intervention Addressing Childrens
Goals in Daily Activities

• Amy M. Casey
• Center for Child Development
• Vanderbilt University Medical Center

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What is Embedded Intervention?

• A recommended approach for addressing the
  individualized goals of children with
  disabilities in their natural environments

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Why is This Important?

• Practical
• Learn new skills in context where theyll be used
• Multiple learning opportunities
• Classroom membership
• Independence
• Engagement

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What is Engagement?

• Participation, being active, being involved,
  playing, on-task behavior, learning
• Engagement is the amount of time that children
  spend involved with the environment (adults,
  peers, or materials) in a way that is appropriate
  given their age, abilities, and surroundings.

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The Importance of Engagement

• Improving engagement leads to positive change in
  childrens
• Behavior
• Interactions with others
• Thinking and reasoning skills

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Engagement in Children With Disabilities

• Compared to typically-developing peers, children
  with disabilities spend
• More time passively nonengaged
• Less time interactively engaged with adults
• Less time attentionally engaged with peers
• Less time in master-level engagement with
  materials

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Levels of Engagement

• Level 1 Nonengagement
• Unoccupied behavior
• Crying
• Whining
• Aggression
• Wandering aimlessly
• Staring blankly
• Needless waiting

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Levels of Engagement

• Level 2 Casual Attention
• Scanning the environment
• Attending to a range of things instead of paying
  attention to one object or person
• Level 3 Undifferentiated Behavior
• Repetitive actions or vocalizations
• Simple, low-level play

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Levels of Engagement

• Level 4 Focused Attention
• Intent watching or listening
• Limited motor activity
• Level 5 Differentiated Behavior
• Active interaction with the environment
• Playing
• Participating in routines

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Levels of Engagement

• Level 6 Constructive Behavior
• Materials
• Making, creating, or building something
• Intentionality
• Level 7 Encoded Behavior
• Social
• Using context-bound, understandable language

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Levels of Engagement

• Level 8 Symbolic Behavior
• Pretend play
• Talking about someone/something that is not
  present
• Level 9 Persistence
• Problem solving
• Challenge
• Changing strategies or using the same strategy
  repeatedly

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Engagement Continuum
Developmental Hierarchy
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Ways to Focus on Engagement

• Room arrangement/materials
• Fun activities
• Zone defense scheduling
• Incidental teaching

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Room Arrangement

• Break up the middle of the room
• Creates 4 zones
• Prevents wandering, running laps
• Scatter centers throughout zones instead of
  lining them up on walls
• Most nonengagement occurs in wide open spaces

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Materials

• Quantity
• Enough toys for everyone
• Matching toys to encourage parallel play
• Quality
• At or slightly above skill level
• Accessibility
• On low shelves
• Variety
• Swap toys/activities on regular schedule

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Activities

• Fun and exciting!!
• Interesting things to do and talk about
• Focus on process and skill development (not final
  product)
• Focus on promoting independence, social
  relationships, and engagement

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Zone Defense Scheduling

• Method for organizing adults
• Creates environment in which engagement is the
  focus

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ZDS Basics

• Man-to-man defense assignment to a specific
  player/child
• Zone defense assignment to an area of the
  court/classroom
• The ZDS prevents teachers from chasing specific
  children around the classroom

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ZDS Roles

• One adult is assigned to the scheduled child
  activity and is focused on child engagement
• One adult is in charge of extra classroom tasks,
  such as cleaning up, preparing the next activity,
  changing diapers, taking phone calls, helping a
  child who needs individual assistance, etc.

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ZDS Transitions

• During transitions between activities, one adult
  is at the old zone and one adult is at the new
  zone
• Children can transition at their own pace
• Children can begin the new activity as soon as
  they arrive at the zone

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Example 2-Person ZDS
Time Person 1 Person 2
800-815 Arrival Set Up
815-830 Set Up Story
830-845 Free Play Set Up
845-900 Set Up Circle
900-915 Small Toys Set up
915-930 Set Up Centers
930-945 Set Up Centers
945-1000 Snack Set Up
1000-1045 Set Up Bathroom and Outside/Hallway
1045-1100 Music Set Up
1100-1115 Set Up Art
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Incidental Teaching

• What to do when youre the adult assigned to
  focus on the ongoing activity and child
  engagement
• Method for basing interactions on a childs
  interest in order to elaborate on existing
  engagement

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Steps for Incidental Teaching

• 1. Arrange the environment
• 2. Catch the child engaged
• 3. Approach the child
• 4. Elicit elaboration of existing engagement
• 5. Provide reinforcement

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1. Arrange the Environment

• Provide
• Accessible materials
• Preferred toys
• A defined space
• Sufficient quantities
• Opportunities for peer interaction

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2. Catch the Child Engaged

• In any routine or activity
• With peers or materials

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3. Approach the Child

• Think about the childs level of engagement
• What are you aiming for? A higher level of
  engagement? If so, which one?
• Consider the childs learning style
• Is it better to interact with the child? Is it
  better to sit near him and engage in parallel
  play? Is it better to encourage a peer to
  approach him?

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4. Elicit Elaboration of Existing Engagement

• Options are
• More engagement (continue the behavior for a
  longer amount of time)
• Higher engagement (use more sophisticated
  behavior)
• Skill development (work toward a developmental
  goal)

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5. Provide Reinforcement

• Natural reinforcement
• The activity or outcome appeals to the childs
  interests and intrinsic motivation
• Verbal reinforcement
• Be specific
• Tangibles

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Using Incidental Teaching

• Incidental teaching comes naturally to most
  teachers, but it can always be used more often
• Our research shows that rates of incidental
  teaching are low before awareness training after
  training teachers are able to increase their
  rates of incidental teaching to changing
  criterion levels

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Classroom Modifications

• Modify the environment
• Create opportunities for engagement
• Ensure that activities are appealing and have a
  variety of materials available
• Sabotage is not necessarily a bad thing
• Example Set out all needed materials except for
  one, requiring children to ask for the missing
  item or problem solve

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How would you address his goal to use word
approximations?
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Classroom Modifications

• Modify the task demands
• Ask the child to do something that is slightly
  above his current skill level (and provide as few
  prompts as possible) to encourage higher
  engagement
• Ask the child to do something that is slightly
  below his current skill level (and provide
  reinforcement) to encourage more engagement

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How would you encourage higher engagement?
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Classroom Modifications

• Modify your expectations
• Rather than focusing on the goal of the activity,
  focus on one of the childs goals
• Example Maggies goal is to use words to request
  items or help. During art, do not focus on
  getting Maggie to make the expected product.
  Instead, focus on providing multiple
  opportunities for her to request materials.

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Classroom Modifications

• Use multiple routines to address the same goal
• Create opportunities for peer interaction
• Example Have peers without disabilities use a
  buddy system to help a child with disabilities
  take his coat off after playing outside

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How would you encourage more engagement?
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Is It Working?

• Measure class-wide engagement with the Engagement
  Check II
• Measure an individual childs engagement with the
  Scale for Teachers Assessment of Routines
  Engagement (STARE)

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Engagement Check II

• Method for teachers to determine percentage of
  children engaged during activities

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Engagement Check II(McWilliam, 1999)
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Engagement Check II Procedure

• Every 5 minutes, count and record
• The number of children who are nonengaged
• The total number of children present
• At the end of the observation, calculate
• The number of children who were engaged in each
  interval
• The percentage of children engaged across the
  session

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STARE

• Method for teachers to document their impressions
  of an individual childs engagement in each
  classroom routine
• Helps teachers determine
• With whom or what the child was engaged
• Complexity of childs engagement

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STARE Procedure

• Observe child in routine
• Rate amount of time spent with adults, peers, and
  materials
• Can rate high in more than one
• Rate complexity of engagement
• How the child spent the majority of his or her
  time (not the highest level observed)

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Other Strategies for Embedding

• Prompts
• Time delay
• Reinforcement
• Peer-mediated strategies

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Prompts

• Something the teacher does before the child
  responds
• They increase the likelihood that a child will
  respond in a certain way
• Types
• Physical
• Verbal
• Gestural

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Time Delay

• Wait time
• Allows the child to respond independently before
  the teacher provides support

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Reinforcement

• Reinforcers things (words, activities) that
  follow a behavior
• Reinforcers are what teachers do immediately
  after the childs behavior or response

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Positive Reinforcement

• Positive reinforcement something that follows a
  specific response and increases the likelihood
  that the response will happen again
• Example Child asks for ball and teacher gives it
  to him.
• Example Child puts coat on and teacher says,
  Wow you zipped your coat! and puts a star on
  her chart.

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Differential Reinforcement of Other Behavior

• Catch the child displaying a desired behavior
  (doing something good) and let him or her know
  about it
• Use this when youre trying to decrease a
  challenging behavior by providing positive
  reinforcement for replacement (incompatible)
  behavior
• Example For a child who flits from one activity
  to another, provide feedback when the child stays
  at an activity and plays

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Peer-Mediated Strategies

• Peer management
• Peer modeling
• Peer tutoring

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Tips for Embedding

• Use multiple routines to address the same goal
• When goals are functional, they will naturally
  occur in multiple routines
• The Examination of the Implementation of Embedded
  Intervention through Observation (EIEIO) can be
  used to assess the frequency with which goals are
  addressed

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Tips for Embedding

• Plan when (during which routines) specific goals
  will be targeted and who is responsible
• Higher priority goals (as decided by the family)
  should be planned to occur in more routines
• The Intervention Matrix can be used as a one-page
  summary of intervention priorities and planned
  implementation times

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Summary

• Focus on engagement by
• Arranging your classroom to promote participation
• Providing interesting materials and fun
  activities
• Organizing the adults in the classroom
• Using incidental teaching
• Consult with service providers to identify the
  most useful strategies for embedding intervention
  into daily routines

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For Additional Information

• Contact Amy Casey at
• amy.m.casey_at_vanderbilt.edu
• 615-936-3986
• Visit our websites
• www.IndividualizingInclusion.us
• www.VanderbiltImprovingEngagement.us
• www.vanderbiltchildrens.com/engagementclassroom