Slide 1

An Update to the Great 8

For SLPs and ASDsPresented by

Lynn M. Dudek M.S., CCC-SLP, MBA, BCBA

lynn.dudek@asdslp.com

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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

37%

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Following Graduation, I Would Rate My Knowledge of ASD as:

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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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