Applying a Transdisciplinary Team Approach to the Systematic Instruction of Pivotal Milestones
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Transcript of Applying a Transdisciplinary Team Approach to the Systematic Instruction of Pivotal Milestones
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Applying a Transdisciplinary Team Approach to the Systematic Instruction of Pivotal Milestones Bruce, S., Vargas, C., Davidson, S., Sullivan, M., &Sikarova, R., Boston College
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Pivotal Milestones Associated with Symbolic Expression & Representational ThoughtImitationJoint AttentionDiscrimination-CategorizationObject PermanenceMeans-EndSelf-Recognition
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Study PhasesPhase I: Literature Review on 6pivotal milestones, systematic instruction, & transdisciplinary teaming
Phase II: Analysis of Commercial Assessment Tools appropriate for children with severe/multiple disabilities& Development of Informal Structured Assessments on each milestone
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Phase III: Assessment of 15 children with severe/multiple disabilities (including 6 with visual impairment & 2 who are deafblind) using 2 commercial assessments & 1 informal structured assessment on each selected milestone
Lesson Plans developed by team consensus (teachers & related service professionals)
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Phase IV: Instruction 5X weekly per child on each milestoneData collected each time lesson was taught by teacher and 2 related service professionals (SLP, OT, PT)
Video evidence for baseline + every 4 weeks per child & milestone instructed
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Commercial Assessments AnalyzedIdentified Each Item that Measured Each of the 6 MilestonesDevelopmental Assessment for Individuals with Severe Disabilities (DASH 2)Developmental Activities Screening Inventory (DASI-II)INSITECaller-Azusa-Scale GOregon Project for Visually Impaired & Blind Preschool Children
Carolina Curriculum for Infants/Toddlers with Special NeedsAssessment, Evaluation, and Programming for Infants and Children (AEPS)Early Learning Accomplishments Profile (ELAP)Vulpe (revised)Hawaii Early Learning Profile (HELP)
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Participant Results Shared TodayNicholas: Means-End
Jamie: Object Permanence
Winston: Discrimination (of objects & different actions on objects)
Leah: Joint Attention & Discrimination(of different actions on objects)
Jack: Means-End
*does not include video analysis
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Prompt/Performance LevelsH/H: hand over handH/H-C: hand over hand, continuous (T=teacher initiated, S = student initiated)H/H-F: hand over hand, frequentH/H-I: hand over hand, intermittent (PO = point, PU = push, PO&PU= point & push)P = physical promptMO = moving object promptM = model G = gesture promptV = verbal promptI = independentN = no responseR = refusal
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Nicholas
Age at baseline film: 4 years, 11 months
Disability Characteristics: Microcephaly, global developmental delays, failure to thrive, possible autism, (normal vision & hearing, ambulatory)
Assessment Results: Moves around an obstacle, pushes other objects away to get to desired object, inverts containers to get object out (e.g. he exhibits some means-end behaviors)
Lesson: Means-end: #1: Push red man to expel car; Lesson #2: Pick up, place and push red man
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Chart1
071280
227800
JuneJuneJuneJune
JulyJulyJulyJuly
H/H-C
M
V
I
Month
Percentage
Nicholas: Means-End Push "Red Man"
Sheet1
N's DATA
GRAPH #1: Push "Red Man"
Prompt LevelAprilMayJuneJulyOctoberNovemberDecember
H/H-C022
P
M7178
G
V280
I00
R/N
GRAPH #2: Behavior #1: Pick up "Red Man" and Place on Top of Garage
Prompt LevelAprilMayJuneJulyOctoberNovemberDecember
H/H-C456.35037.518.50
P031.350014.80
M00003.70
G2518.8003.733
V3037.50000
I00037.55267
R/N6.3257.4
Graph #3: Behavior #2:Push "Red Man"
Prompt LevelMayJuneJulyOctoberNovemberDecember
H/H-C00017130
P6.426.68306.633
M
G1673.30000
V77.4008.3200
I000504067
R/N172519.6
Graph #4: Behavior #3: Open Red Garage door (No Graph)
MayJuneJulyOctoberNovemberDecember
H/H-C
P
M
G
V
I
R/N
Sheet2
Sheet2
071280
227800
JuneJuneJuneJune
JulyJulyJulyJuly
H/H-C
M
V
I
Month
Percentage
Nicholas: Means-End Push "Red Man"
Sheet3
AprilAprilAprilAprilAprilAprilApril
450025300May
6.331.3018.837.506.3
50500000July
37.5000037.525
18.514.83.73.70527.4
00033067December
H/H-C
P
M
G
V
I
R/N
Month
Percentage
Nicholas: Means-End Behavior#1: Pick up "Red Man"
06.41677.40May
026.673.300June
08300017
17008.35025
136.60204019.6
0330067December
H/H-C
P
G
V
I
R/N
Month
Percentage
Nicholas: Means-End Behavior #2: Place and Push "Red Man"
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Chart2
AprilAprilAprilAprilAprilAprilApril
450025300May
6.331.3018.837.506.3
50500000July
37.5000037.525
18.514.83.73.70527.4
00033067December
H/H-C
P
M
G
V
I
R/N
Month
Percentage
Nicholas: Means-End Behavior#1: Pick up "Red Man"
Sheet1
N's DATA
GRAPH #1: Push "Red Man"
Prompt LevelAprilMayJuneJulyOctoberNovemberDecember
H/H-C022
P
M7178
G
V280
I00
R/N
GRAPH #2: Behavior #1: Pick up "Red Man" and Place on Top of Garage
Prompt LevelAprilMayJuneJulyOctoberNovemberDecember
H/H-C456.35037.518.50
P031.350014.80
M00003.70
G2518.8003.733
V3037.50000
I00037.55267
R/N6.3257.4
Graph #3: Behavior #2:Push "Red Man"
Prompt LevelMayJuneJulyOctoberNovemberDecember
H/H-C00017130
P6.426.68306.633
M
G1673.30000
V77.4008.3200
I000504067
R/N172519.6
Graph #4: Behavior #3: Open Red Garage door (No Graph)
MayJuneJulyOctoberNovemberDecember
H/H-C
P
M
G
V
I
R/N
Sheet2
Sheet2
071280
227800
JuneJuneJuneJune
JulyJulyJulyJuly
H/H-C
M
V
I
Month
Percentage
Nicholas: Means-End Push "Red Man"
Sheet3
AprilAprilAprilAprilAprilAprilApril
450025300May
6.331.3018.837.506.3
50500000July
37.5000037.525
18.514.83.73.70527.4
00033067December
H/H-C
P
M
G
V
I
R/N
Month
Percentage
Nicholas: Means-End Behavior#1: Pick up "Red Man"
06.41677.40May
026.673.300June
08300017
17008.35025
136.60204019.6
0330067December
H/H-C
P
G
V
I
R/N
Month
Percentage
Nicholas: Means-End Behavior #2: Place and Push "Red Man"
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Chart3
06.41677.40May
026.673.300June
08300017
17008.35025
136.60204019.6
0330067December
H/H-C
P
G
V
I
R/N
Month
Percentage
Nicholas: Means-End Behavior #2: Place and Push "Red Man"
Sheet1
N's DATA
GRAPH #1: Push "Red Man"
Prompt LevelAprilMayJuneJulyOctoberNovemberDecember
H/H-C022
P
M7178
G
V280
I00
R/N
GRAPH #2: Behavior #1: Pick up "Red Man" and Place on Top of Garage
Prompt LevelAprilMayJuneJulyOctoberNovemberDecember
H/H-C456.35037.518.50
P031.350014.80
M00003.70
G2518.8003.733
V3037.50000
I00037.55267
R/N6.3257.4
Graph #3: Behavior #2:Push "Red Man"
Prompt LevelMayJuneJulyOctoberNovemberDecember
H/H-C00017130
P6.426.68306.633
M
G1673.30000
V77.4008.3200
I000504067
R/N172519.6
Graph #4: Behavior #3: Open Red Garage door (No Graph)
MayJuneJulyOctoberNovemberDecember
H/H-C
P
M
G
V
I
R/N
Sheet2
Sheet2
071280
227800
JuneJuneJuneJune
JulyJulyJulyJuly
H/H-C
M
V
I
Month
Percentage
Nicholas: Means-End Push "Red Man"
Sheet3
AprilAprilAprilAprilAprilAprilApril
450025300May
6.331.3018.837.506.3
50500000July
37.5000037.525
18.514.83.73.70527.4
00033067December
H/H-C
P
M
G
V
I
R/N
Month
Percentage
Nicholas: Means-End Behavior#1: Pick up "Red Man"
06.41677.40May
026.673.300June
08300017
17008.35025
136.60204019.6
0330067December
H/H-C
P
G
V
I
R/N
Month
Percentage
Nicholas: Means-End Behavior #2: Place and Push "Red Man"
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Nicholas
Key Findings:
Lesson #1: Push red man (after adult places): Achieved with modeling in the first month.Lesson #2, Behavior #1: Pick up red man: Started at 0% independence, achieved 69%.independenceBehavior #2, Place & push red man:Started at 0% independence, achieved 69%independence
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JamieAge at baseline: 5 years, 8 months
Disability Characteristics: Multiple congenital anomalies, microcephaly, developmental delays,visual impairment (20/90), frequent ear infections (6+ this year), urinary tract infections (3+ this year), non-ambulatory
Assessment Results: Can find a partially hidden object IF she sees it hidden
Lesson: Object permanence: Lesson #1: Using differentcovers; Lesson #2: Solving A-B error
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Chart1
1000000March
6.312.50253323
5.71.44.3274714.3
6.302518.83812.5
H/H-C
P
G
V
I
R
Month
Percentage
Jamie: Object Permanence Locating Object with Sound Cue
Sheet1
Jamie
Graph 1Object Permanence: Locating Object with Sound Cue
MarchAprilMayJune
H/H-C1006.35.76.3
P012.51.40
G004.325
V0252718.8
I0334738
R2314.312.5
Graph 2Object Permanence: A-B Error with Intermitent Sound Cue
JulySeptemberOctoberNovemberDecember
H/H-C
P029000
G
V
I10071779071.4
R18.29.828.5
M004.500
Sheet2
Sheet2
1000000March
6.312.50253323
5.71.44.3274714.3
6.302518.83812.5
H/H-C
P
G
V
I
R
Month
Percentage
Jamie: Object Permanence Locating Object with Sound Cue
Sheet3
0100July0
2971September0
07718.24.5
0909.80
071.428.50
P
I
R
M
Month
Percentage
Jamie: Object PermanenceA-B Error with Intermittent Sound Cue
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Chart2
0100July0
2971September0
07718.24.5
0909.80
071.428.50
P
I
R
M
Month
Percentage
Jamie: Object PermanenceA-B Error with Intermittent Sound Cue
Sheet1
Jamie
Graph 1Object Permanence: Locating Object with Sound Cue
MarchAprilMayJune
H/H-C1006.35.76.3
P012.51.40
G004.325
V0252718.8
I0334738
R2314.312.5
Graph 2Object Permanence: A-B Error with Intermitent Sound Cue
JulySeptemberOctoberNovemberDecember
H/H-C
P029000
G
V
I10071779071.4
R18.29.828.5
M004.500
Sheet2
Sheet2
1000000March
6.312.50253323
5.71.44.3274714.3
6.302518.83812.5
H/H-C
P
G
V
I
R
Month
Percentage
Jamie: Object Permanence Locating Object with Sound Cue
Sheet3
0100July0
2971September0
07718.24.5
0909.80
071.428.50
P
I
R
M
Month
Percentage
Jamie: Object PermanenceA-B Error with Intermittent Sound Cue
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JamieKey Findings:
Lesson #1: Locating object with sound cueAble to perform with independence at 39% of opportunities, additional success with just verbal or gestural cue. Moved to Lesson #2: A-not-B Error after 4 months.
Lesson #2: A-not-B error: Achieved independence 72-100%. May have reached satiation.
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Leah
Age at baseline: 7 years, 0 months
Disability Characteristics:Trisomy 18, congenital cardiac disease, bronchial malacia, seizures, 20/190 vision, moderate-severe hearing loss, hypertonia in extremities, hypotonia
Assessment Results: Very attentive to people, but very seldom to objects. Does same action on all objects-batting/forceful tapping.
Lesson: Joint attention with adult and over object, discrimination of different actions on 3 different objects
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Chart1
May0100
June0100
July3.696.4
8092
October5.794
November199
December0100
G/V
V
I
Month
Percentage
Leah: Joint Attention Eye Contact with Adult
Sheet1
Leah's Data
Graph #1: Eye Contact with Adult
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C
H/H-I
P
G/V8
V003.605.710
I10010096.4929499100
R
N
GRAPH #2: Eye Contact with Object
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C
H/H-I
P02.90001.53.8
G014.72400015.4
V011.82714.316.2160
MO5029.4017.901.50
I5041486883.78281
R
N
GRAPH #3: Action on Pop Tube
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C/T67100440158.7518
H/H-C/S330561008591.382
GRAPH #4: Action on Gumball Machine Toy
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C6918.709.550
H/H-I060000
P2312.528.59.53250
M7.661423.8260
G0628.54.750
V018.70000
I03128.552.42650
N5
GRAPH #5: Action on Pop-Up Toy
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C63.664.333.333.3330
H/H-I:PO935.767445775
H/H-I:PU900224.80
H/H-I:PO & PU00004.825
P1800000
M
G
V
I
N
Sheet3
Sheet2
Sheet2
May0100
June0100
July3.696.4
8092
October5.794
November199
December0100
G/V
V
I
Month
Percentage
Leah: Joint Attention Eye Contact with Adult
0005050
2.914.711.829.441
02427048
0014.317.968
0016.2083.7
1.50161.582
3.815.40081
P
G
V
MO
I
Month
Percentage
Leah: Joint AttentionEye Contact with Object
6733
1000
4456
0100
1585
8.7591.3
1882
H/H-C/T
H/H-C/S
Month
Percentage
Leah: DiscriminationAction on Pop Tube
MayMayMayMayMayMayMayMay
690237.6000June
18.7612.56618.731July
0028.51428.5028.5September
9.509.523.84.7052.4October
50322650265
005000050December
H/H-C
H/H-I
P
M
G
V
I
N
Month
Percentage
Leah: DiscriminationAction on Gumball Machine Toy
MayMayMayMayMay
63.699018
64.335.7000
33.367000
33.3442200
33574.84.80
0750250
H/H-C
H/H-I:PO
H/H-I:PU
H/H-I:PO & PU
P
Month
Percentage
Leah: DiscriminationAction on Pop-Up Toy
-
Chart2
0005050
2.914.711.829.441
02427048
0014.317.968
0016.2083.7
1.50161.582
3.815.40081
P
G
V
MO
I
Month
Percentage
Leah: Joint AttentionEye Contact with Object
Sheet1
Leah's Data
Graph #1: Eye Contact with Adult
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C
H/H-I
P
G/V8
V003.605.710
I10010096.4929499100
R
N
GRAPH #2: Eye Contact with Object
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C
H/H-I
P02.90001.53.8
G014.72400015.4
V011.82714.316.2160
MO5029.4017.901.50
I5041486883.78281
R
N
GRAPH #3: Action on Pop Tube
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C/T67100440158.7518
H/H-C/S330561008591.382
GRAPH #4: Action on Gumball Machine Toy
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C6918.709.550
H/H-I060000
P2312.528.59.53250
M7.661423.8260
G0628.54.750
V018.70000
I03128.552.42650
N5
GRAPH #5: Action on Pop-Up Toy
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C63.664.333.333.3330
H/H-I:PO935.767445775
H/H-I:PU900224.80
H/H-I:PO & PU00004.825
P1800000
M
G
V
I
N
Sheet3
Sheet2
Sheet2
May0100
June0100
July3.696.4
8092
October5.794
November199
December0100
G/V
V
I
Month
Percentage
Leah: Joint Attention Eye Contact with Adult
0005050
2.914.711.829.441
02427048
0014.317.968
0016.2083.7
1.50161.582
3.815.40081
P
G
V
MO
I
Month
Percentage
Leah: Joint AttentionEye Contact with Object
6733
1000
4456
0100
1585
8.7591.3
1882
H/H-C/T
H/H-C/S
Month
Percentage
Leah: DiscriminationAction on Pop Tube
MayMayMayMayMayMayMayMay
690237.6000June
18.7612.56618.731July
0028.51428.5028.5September
9.509.523.84.7052.4October
50322650265
005000050December
H/H-C
H/H-I
P
M
G
V
I
N
Month
Percentage
Leah: DiscriminationAction on Gumball Machine Toy
MayMayMayMayMay
63.699018
64.335.7000
33.367000
33.3442200
33574.84.80
0750250
H/H-C
H/H-I:PO
H/H-I:PU
H/H-I:PO & PU
P
Month
Percentage
Leah: DiscriminationAction on Pop-Up Toy
-
Chart3
6733
1000
4456
0100
1585
8.7591.3
1882
H/H-C/T
H/H-C/S
Month
Percentage
Leah: DiscriminationAction on Pop Tube
Sheet1
Leah's Data
Graph #1: Eye Contact with Adult
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C
H/H-I
P
G/V8
V003.605.710
I10010096.4929499100
R
N
GRAPH #2: Eye Contact with Object
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C
H/H-I
P02.90001.53.8
G014.72400015.4
V011.82714.316.2160
MO5029.4017.901.50
I5041486883.78281
R
N
GRAPH #3: Action on Pop Tube
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C/T67100440158.7518
H/H-C/S330561008591.382
GRAPH #4: Action on Gumball Machine Toy
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C6918.709.550
H/H-I060000
P2312.528.59.53250
M7.661423.8260
G0628.54.750
V018.70000
I03128.552.42650
N5
GRAPH #5: Action on Pop-Up Toy
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C63.664.333.333.3330
H/H-I:PO935.767445775
H/H-I:PU900224.80
H/H-I:PO & PU00004.825
P1800000
M
G
V
I
N
Sheet3
Sheet2
Sheet2
May0100
June0100
July3.696.4
8092
October5.794
November199
December0100
G/V
V
I
Month
Percentage
Leah: Joint Attention Eye Contact with Adult
0005050
2.914.711.829.441
02427048
0014.317.968
0016.2083.7
1.50161.582
3.815.40081
P
G
V
MO
I
Month
Percentage
Leah: Joint AttentionEye Contact with Object
6733
1000
4456
0100
1585
8.7591.3
1882
H/H-C/T
H/H-C/S
Month
Percentage
Leah: DiscriminationAction on Pop Tube
MayMayMayMayMayMayMayMay
690237.6000June
18.7612.56618.731July
0028.51428.5028.5September
9.509.523.84.7052.4October
50322650265
005000050December
H/H-C
H/H-I
P
M
G
V
I
N
Month
Percentage
Leah: DiscriminationAction on Gumball Machine Toy
MayMayMayMayMay
63.699018
64.335.7000
33.367000
33.3442200
33574.84.80
0750250
H/H-C
H/H-I:PO
H/H-I:PU
H/H-I:PO & PU
P
Month
Percentage
Leah: DiscriminationAction on Pop-Up Toy
-
Chart4
MayMayMayMayMayMayMayMay
690237.6000June
18.7612.56618.731July
0028.51428.5028.5September
9.509.523.84.7052.4October
50322650265
005000050December
H/H-C
H/H-I
P
M
G
V
I
N
Month
Percentage
Leah: DiscriminationAction on Gumball Machine Toy
Sheet1
Leah's Data
Graph #1: Eye Contact with Adult
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C
H/H-I
P
G/V8
V003.605.710
I10010096.4929499100
R
N
GRAPH #2: Eye Contact with Object
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C
H/H-I
P02.90001.53.8
G014.72400015.4
V011.82714.316.2160
MO5029.4017.901.50
I5041486883.78281
R
N
GRAPH #3: Action on Pop Tube
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C/T67100440158.7518
H/H-C/S330561008591.382
GRAPH #4: Action on Gumball Machine Toy
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C6918.709.550
H/H-I060000
P2312.528.59.53250
M7.661423.8260
G0628.54.750
V018.70000
I03128.552.42650
N5
GRAPH #5: Action on Pop-Up Toy
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C63.664.333.333.3330
H/H-I:PO935.767445775
H/H-I:PU900224.80
H/H-I:PO & PU00004.825
P1800000
M
G
V
I
N
Sheet3
Sheet2
Sheet2
May0100
June0100
July3.696.4
8092
October5.794
November199
December0100
G/V
V
I
Month
Percentage
Leah: Joint Attention Eye Contact with Adult
0005050
2.914.711.829.441
02427048
0014.317.968
0016.2083.7
1.50161.582
3.815.40081
P
G
V
MO
I
Month
Percentage
Leah: Joint AttentionEye Contact with Object
6733
1000
4456
0100
1585
8.7591.3
1882
H/H-C/T
H/H-C/S
Month
Percentage
Leah: DiscriminationAction on Pop Tube
MayMayMayMayMayMayMayMay
690237.6000June
18.7612.56618.731July
0028.51428.5028.5September
9.509.523.84.7052.4October
50322650265
005000050December
H/H-C
H/H-I
P
M
G
V
I
N
Month
Percentage
Leah: DiscriminationAction on Gumball Machine Toy
MayMayMayMayMay
63.699018
64.335.7000
33.367000
33.3442200
33574.84.80
0750250
H/H-C
H/H-I:PO
H/H-I:PU
H/H-I:PO & PU
P
Month
Percentage
Leah: DiscriminationAction on Pop-Up Toy
-
Chart5
MayMayMayMayMay
63.699018
64.335.7000
33.367000
33.3442200
33574.84.80
0750250
H/H-C
H/H-I:PO
H/H-I:PU
H/H-I:PO & PU
P
Month
Percentage
Leah: DiscriminationAction on Pop-Up Toy
Sheet1
Leah's Data
Graph #1: Eye Contact with Adult
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C
H/H-I
P
G/V8
V003.605.710
I10010096.4929499100
R
N
GRAPH #2: Eye Contact with Object
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C
H/H-I
P02.90001.53.8
G014.72400015.4
V011.82714.316.2160
MO5029.4017.901.50
I5041486883.78281
R
N
GRAPH #3: Action on Pop Tube
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C/T67100440158.7518
H/H-C/S330561008591.382
GRAPH #4: Action on Gumball Machine Toy
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C6918.709.550
H/H-I060000
P2312.528.59.53250
M7.661423.8260
G0628.54.750
V018.70000
I03128.552.42650
N5
GRAPH #5: Action on Pop-Up Toy
Prompt LevelMayJuneJulySeptemberOctoberNovemberDecember
H/H-C63.664.333.333.3330
H/H-I:PO935.767445775
H/H-I:PU900224.80
H/H-I:PO & PU00004.825
P1800000
M
G
V
I
N
Sheet3
Sheet2
Sheet2
May0100
June0100
July3.696.4
8092
October5.794
November199
December0100
G/V
V
I
Month
Percentage
Leah: Joint Attention Eye Contact with Adult
0005050
2.914.711.829.441
02427048
0014.317.968
0016.2083.7
1.50161.582
3.815.40081
P
G
V
MO
I
Month
Percentage
Leah: Joint AttentionEye Contact with Object
6733
1000
4456
0100
1585
8.7591.3
1882
H/H-C/T
H/H-C/S
Month
Percentage
Leah: DiscriminationAction on Pop Tube
MayMayMayMayMayMayMayMay
690237.6000June
18.7612.56618.731July
0028.51428.5028.5September
9.509.523.84.7052.4October
50322650265
005000050December
H/H-C
H/H-I
P
M
G
V
I
N
Month
Percentage
Leah: DiscriminationAction on Gumball Machine Toy
MayMayMayMayMay
63.699018
64.335.7000
33.367000
33.3442200
33574.84.80
0750250
H/H-C
H/H-I:PO
H/H-I:PU
H/H-I:PO & PU
P
Month
Percentage
Leah: DiscriminationAction on Pop-Up Toy
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LeahKey Findings:
Behavior #1: Joint Attention - eye contact with adultAchieved 90-100%-maintained existing skill
Behavior #2: Joint attention - visual attention to objectAchieved over 80% independent for 3 months
Behavior #3: Discrimination - action on pop tube-coactiveDecreased need for hand-over-hand/continuous
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LeahKey Finding, continued:
Behavior #4: Discrimination - action on gumball machine toyStarted at 0% independence, achieved 50%
Behavior #5: Discrimination - action on pop-up toyReduced need for hand-over-hand/continuous
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WinstonAge at Baseline: 8 years, 6 months
Disability Characteristics: Isodicentric 15,mitochondrial disorder, seizures, severe developmental delays, hypotonia (non-ambulatory), vision loss (20/400), hearing loss-inconsistent response to sounds
Assessment Results: Looks toward lighted objects and a few highly reflective surfaces. Immediately opens mouth in feeding (anticipation).
Lesson: Discrimination of objects and actions on actions in a controlled play space
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Chart1
12.50
100
434567
210
51500
1033
Look
Touch with Hand
Look & Touch
Object
Percentage
Winston: Discrimination of Objects Measured by Intentional Acts on Objects in a Structured Play Space
Sheet1
Winston Data
GRAPH #1: Discrimination of Objects Measured by Intentional Acts on Objects in a Structured Play Space
CupsBallRed MylarRed PomponGreen PomponSlinky
Look11432511
Touch with Hand2.50451500
Look & Touch00670033
Sheet2
Sheet2
12.50
100
434567
210
51500
1033
Look
Touch with Hand
Look & Touch
Object
Percentage
Winston: Discrimination of Objects Measured by Intentional Acts on Objects in a Structured Play Space
Sheet3
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WinstonKey Findings: Most intentional behavior was on (a) red mylar and (b) green pompom
He located these 2 items even when placed l/3 - 1/2way into play space.
Further analysis of video revealed that hedifferentiated green pompom for combination of touch and taste.
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JackAge at baseline: 10 years, 11 months
Disability Characteristics: microcephaly, hydrocephalus, global developmental delays, diabetes, seizures, adrenal gland insufficiency, cerebral palsy, mild unilateral hearing loss
Assessment Results: Purposeful reach, will work to access object out of reach or when obstacle is present, doesnt yet request adult assistance
Lesson: Solving means-end problems-push down and push up on remove control car control
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Chart1
0000100
06.11.5092.3
1.97.63.83.882.6
0.68.5010.580.2
7.6017.384.2
4.431.12.24.457.7
H/H
P
G
V
I
Month
Percentage
Jack: Means-EndReach Toward Remote Control
Sheet1
MayJuneJulyOctoberNovemberDecember
H/H001.90.67.64.4
P06.17.68.5031.1
G01.53.8012.2
V003.810.57.34.4
I10092.382.680.284.257.7
Push Down
MayJuneJulyOctoberNovemberDecember
H/H005.81.22.70
P0011.7600
G005.8000
V03.68.88.500
I10096.367.68497.2100
Push Up
MayJuneJulyOctoberNovemberDecember
H/H10094.18010094.197
P0020000
G
V
I05.8005.80
R3
Sheet2
Sheet2
0000100
06.11.5092.3
1.97.63.83.882.6
0.68.5010.580.2
7.6017.384.2
4.431.12.24.457.7
H/H
P
G
V
I
Month
Percentage
Jack: Means-EndReach Toward Remote Control
Sheet3
0000100
0003.696.3
5.811.75.88.867.6
1.2608.584
2.700097.2
0000100
H/H
P
G
V
I
Month
Percentage
Jack: Means-EndPush Down
10000May
94.105.8June
80200July
10000October
94.105.8November
97003
H/H
P
I
R
Month
Percentage
Jack: Means-End Push Up
-
Chart2
0000100
0003.696.3
5.811.75.88.867.6
1.2608.584
2.700097.2
0000100
H/H
P
G
V
I
Month
Percentage
Jack: Means-EndPush Down
Sheet1
MayJuneJulyOctoberNovemberDecember
H/H001.90.67.64.4
P06.17.68.5031.1
G01.53.8012.2
V003.810.57.34.4
I10092.382.680.284.257.7
Push Down
MayJuneJulyOctoberNovemberDecember
H/H005.81.22.70
P0011.7600
G005.8000
V03.68.88.500
I10096.367.68497.2100
Push Up
MayJuneJulyOctoberNovemberDecember
H/H10094.18010094.197
P0020000
G
V
I05.8005.80
R3
Sheet2
Sheet2
0000100
06.11.5092.3
1.97.63.83.882.6
0.68.5010.580.2
7.6017.384.2
4.431.12.24.457.7
H/H
P
G
V
I
Month
Percentage
Jack: Means-EndReach Toward Remote Control
Sheet3
0000100
0003.696.3
5.811.75.88.867.6
1.2608.584
2.700097.2
0000100
H/H
P
G
V
I
Month
Percentage
Jack: Means-EndPush Down
10000May
94.105.8June
80200July
10000October
94.105.8November
97003
H/H
P
I
R
Month
Percentage
Jack: Means-End Push Up
-
Chart3
10000May
94.105.8June
80200July
10000October
94.105.8November
97003
H/H
P
I
R
Month
Percentage
Jack: Means-End Push Up
Sheet1
MayJuneJulyOctoberNovemberDecember
H/H001.90.67.64.4
P06.17.68.5031.1
G01.53.8012.2
V003.810.57.34.4
I10092.382.680.284.257.7
Push Down
MayJuneJulyOctoberNovemberDecember
H/H005.81.22.70
P0011.7600
G005.8000
V03.68.88.500
I10096.367.68497.2100
Push Up
MayJuneJulyOctoberNovemberDecember
H/H10094.18010094.197
P0020000
G
V
I05.8005.80
R3
Sheet2
Sheet2
0000100
06.11.5092.3
1.97.63.83.882.6
0.68.5010.580.2
7.6017.384.2
4.431.12.24.457.7
H/H
P
G
V
I
Month
Percentage
Jack: Means-EndReach Toward Remote Control
Sheet3
0000100
0003.696.3
5.811.75.88.867.6
1.2608.584
2.700097.2
0000100
H/H
P
G
V
I
Month
Percentage
Jack: Means-EndPush Down
10000May
94.105.8June
80200July
10000October
94.105.8November
97003
H/H
P
I
R
Month
Percentage
Jack: Means-End Push Up
-
JackKey Findings: Behavior #1, Reach toward remote control:Independence reduced from 100% to 59%. Was it novelty effect? Did he decrease after learning that behavior #3 was difficult?
Behavior #2, Means-End-Push down on remote control: Started at 100%, regressed to 68% in 3rd month,improved in 4th-6th, resulting in 100% again in 6th month (teacher reports that he typically exhibits ups anddowns in performance)
-
JackKey findings, continued
Behavior #3, Means-End-Push up on remote control: Still requires hand-over-hand support, but has learned to request by reaching for adult-after trying to push down (see video)
This marks means-end achievement at trial & error level.
*Application: Jack is now enjoying a trial on an electric wheelchair
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DisseminationBruce, S. & Zayyad, M. (in press). Assessment and instruction of self-recognition. TEACHING Exceptional Children. In Progress:Bruce, S. & Zayyad, M. (in revision). The development of object permanence in children with severe disabilities.Bruce, S., Campbell, C. & Sullivan, M. Supporting children with severe disabilities to achieve means-end.Bruce & others: Articles on analysis of commercial assessment tools, discrimination-categorization findings, Imitation findings and joint attention (including non-visual JA) findings.
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Other Materials at Our DisplayInformal Structured Assessments (also in handouts)Lesson Plans on all 15 childrenVideo sampling of lessons on the 5 featured children (see desktop folders)List of materials used in the lessons with ordering information