Autism: Resilience- promoting and deterring features at … · resilience: The resilience...
Transcript of Autism: Resilience- promoting and deterring features at … · resilience: The resilience...
Autism: Resilience-promoting and deterring
features at organizational, teacher, and child levels
Rebecca J Landa, PhD, CCC-SLP Anne-Michelle Engelstad, MEd
� Andrea Ford
� Kathryn Greenslade
� LeAnne Johnson
Research testers, videographers, coders, data management Families, teachers, administrators
R324A160228, Landa, PI
� Lauramarie Pope
� Fatima Salem
� Carrie Zetlmeisl
IES Goal 3 RCT EA-ES vs Workshops Teacher-implemented social-communication intervention Preschoolers with ASD
Measures added: Years 2 and 3
Resilience � “…developmental and dynamic, manifesting itself as a result
of a dynamic process within a given context” (Gu & Day, 2007, p. 1305)
Karol L. Kumpfer, 1999. Factors and processes contributing to resilience: The resilience framework.
3 Parts
Teacherfunc+oningatbaseline
Teachersimmersed
inadynamicsystem
Suppor+ngteacherresiliency
Part 1. Functioning at baseline
Risk factors
(-) Protective
factors (+)
What characteristics, attributes, assets or competencies increase risk of or protection from maladaptive outcome?
Teachers (pre-randomization) Teacher Data Total
(n=49)
Sex, % female 100%
Race, % white 89.8%
Ethnicity, % Latinx 2.0%
Highest degree achieved in education or related field
Bachelor’s 28.6%
Post-Baccalaureate 2.0%
Master’s 69.4%
Years teaching, M(SD) 8.57(7.6)
Years as teacher and/or IA in autism classroom, M(SD) 8.93(9.2)
Classroom Data Total (n=48)
Classroom type, % inclusive 70.8%
• Maslach Burnout Inventory (MBI) –Education Survey • Emotional Exhaustion • Depersonalization
• ASSET: Autism Self-efficacy Scale for Teachers • BRIEF-A: Behavior Rating Inventory of EF
• Behavior Regulation Index: inhibit, shift, emotional control, self-monitor
• Metacognition Index: initiation, working memory, planning/organization, task monitoring, and organization of materials
Measures
Self-Efficacy, Burnout, and Executive Function
Measures Total
(n=49)
ASSET (score range 0-100) 80.98(11.9) Range: 56.00-96.83
MBI (subscale scores range 0-6)
Emotional Exhaustion 2.24(1.2) Range: 0-5
Depersonalization 0.43(0.7) Range: 0-2
BRIEF-A (mean T score = 50; SD = 10) Behavior Regulation Index 48.43(10.4)
Range: 35-76
Metacognition Index 49.76(9.1) Range: 36-76
Correlations
ASSET
ASSET (Higher better)
MBI Emotional Exhaustion (Higher worse)
MBI Depersonalization (Higher worse)
MBI Personal Accomplishment (Higher better)
Pearson Correlation
1 - .099 - .107 .351*
Sig. (2-tailed) .500 .463 .013
N 49 49 49 49
BRIEF-A BRI
(Higher worse)
Pearson Correlation
- .063 .557** .312* - .267
Sig. (2-tailed) .667 .000 .029 .064
N 49 49 49 49
BRIEF-A MI
(Higher worse)
Pearson Correlation
- .361* .622** .327* - .398**
Sig. (2-tailed) .011 .000 .022 .005
N 49 49 49 49
**p<0.01, *p<0.05
Regression Analysis Results: Baseline predictors of Burnout and
Self-efficacy
Level of teacher education failed to predict levels of burnout or self-efficacy
Teaching for >10 years was associated with higher Maslach Burnout Inventory (MBI) Depersonalization scores than teaching for <5 years (p=0.015)
Part 2: Immersed in a Dynamic System
Cumulative risk New
initiatives Children with ASD
enter school all
year
Discontinuity of classroom staff
Not trained to address ASD behavior challenges
Lack of planning time- all the other paperwork
Diversity of child learning needs
Inappropriate curriculum
Teacher as classroom organizer
Child baseline
EA-ES (n=44)
Age in months, M(SD) 48.36(6.6)
Sex, % male 77.3%
Autism Severity ADOS CSS, M(SD) 8.59(1.4)
Nonverbal Cognition
MSEL-VR Standard Score, M(SD)
25.16(10.6)
October - April
Integrated targets
Language
Imitation
Joint attention
Peer engagement
Concept development
Environmental engineering
Optimize for meaning construction
NDBIs
17
Burnout
Executive Function
Self-Efficacy Coach-reported extrinsic
barriers (Survey)
Fidelity of implementation
Coach-reported barriers (Survey)
Measurement
teacher
Coach-rated Barriers Survey (Landa & Wilson, 2019)
Coach-reported barriers: Ranks of the 6 survey categories
Sorted by frequency experienced ò Sorted by intensity, when experiencedò
Students with ASD Time and resources
Educator Preparedness Educator Engagement
Time and Resources Students with ASD
Educator Team Cohesion Educator Team Cohesion
Educator Engagement Educator Preparedness
Administrative-related Decisions and Support
Administrative-related Decisions and Support
Factors supporting teacher resiliency
Flexibility, adaptability, and openness (44) Effective teaching skills (32) Commitment (25) Reflection (21) Relationships (21) Focus on learning and improvement (9)
Defining risk load Measure Subscale Cut-off #, (x%) at
risk
EA-ES
BRIEF-A Clinically elevated: Defined by manual
Behavior Regulation Index T score >65 2, (10%)
Metacognition Index T score >65 1, (5%)
MBI Critical Levels: Leiter & Maslach, 2016
High Exhaustion (Emotional Exhaustion) z= Mean + (SD*0.5) 7, (35%)
High Cynicism (Depersonalization) z= Mean + (SD * 1.25) 2, (10%)
ASSET Mean + (SD*1.25) 1, (5%)
Coach-perceived Risk Factors
Personal Barriers Mean + (SD*1.25) 2, (10%)
Environmental Barriers Mean + (SD*1.25) 3, (15%)
10 EA-ES teachers (50%) at risk on at least one of the above measures
Results
After four months of training, attaining median FOI of >88% was not predicted by baseline burnout, self-efficacy, or EF.
Part 3: Supporting teacher resiliency
Small amount of stress can tip things for teachers with lots of stressors
If we create resilience-supporting systems, move the fulcrum
• Coach focus group • A-priori codes established from existing
literature on teacher resiliency (e.g., Beltman, Mansfield, & Price, 2011; Mansfield, Beltman, Price & McConney, 2012)
Notion of Prevention � Alter the environment
� Alter the effects of risk factors (new skills and perspectives, create community of practice)
� Strengthen protective factors (social supports, improve self-efficacy)
Workshops Social supports Resources/ideas/solutions
Coaching Proactive problem solving
Reflection
EBP Differentiated instruction
Toolkit of teaching practices
Child engagement in
instruction
Confidence Motivation
Supporting Resiliency
Resilience
Effective Teaching Skills
Flexibility and Adaptability
Commitment
Reflection
Relationships
Openness Organization
and Preparation
Focus on Learning and Improvement
Positive and Optimistic
Self-confident and has Self-
Efficacy
Ability to Problem Solve
Effective teacher
Informed administrator
Spread
Buffering risk � Creating conditions for resiliency
� Build systems favorable to teacher success
� Know what you want teachers to do
� Properly train them to do it (Vygotsky is relevant here; teacher learning is a developmental process)
� Make it possible for them to do it and keep doing it � IAs � Teacher placement � Preschool curriculum
Implications � Resiliency-promo+ngcoaching
� Individualize� Concreteanda>ainablegoalssetbyteacher-coach
collabora+on� Gradualwithdrawalofsupports(maybeheavyatfirst)
� AdministratorsupportandunderstandingofuniquedemandsofteachingpreschoolerswithASD
� Needtosupportteachers(notremovetheirIA’s,notmovethemaround,nurturethemintoleadershiprolestosupportotherteachersjustlearningEBP)
� Addressingteachera>ri+on(Tait,2008)&promote“qualityreten+on”(Gu&Day,2007,p.1314)