HANDS in Autism® Model
1
Implementation and sustainability of the demonstration classroom requires a joint effort of both the implementation team and the recipient team, as well as the development of a program that is founded on EBPs and sensitive to the need for individualization and adaptations driven by needs. The HANDS in Autism® Model has proven to be a comprehensive training model and process supporting a multidisciplinary, school-based team approach in the effective implementation of EBPs that culminates in both improved staff and student outcomes. Future directions involve evaluation of the transportability of the HANDS in Autism® Model and Training Process to standardize the Model for school administrators, district consultants, related service providers, and school specialists with the opportunity to progressively and collaboratively learn and support a process within a comprehensive framework. HANDS in Autism® Model: Tiffany Neal, Naomi Swiezy, Anne Fletcher, Megan Stevenson, and Iryna Ashby HANDS in Autism® Interdisciplinary Training & Resource Center, Indiana University School of Medicine For more information about the program, visit our website www.HANDSinAutism.org ¤ Core components and focus of the training program: With recognition that no single intervention or strategy is equally effective with all individuals and the desire to provide personnel with a “toolbox” approach to interventions, core components of the HANDS in Autism® Model focus upon: (1) individual strengths-- training focused on building strengths and successes of individuals with an emphasis on proactive planning and teaching practical skills (Iovannone, Dunlap, Huber, & Kincaid, 2003); (2) collaboration: training and collaboration delivered across community stakeholders for consistency, coordination, and positive (Baker, Bauman, Bishop, DiMauro, Finlayson, et. al., 2005; Swiezy, Stuart, & Korzekwa, 2008); (3) data-driven decision making-- training content related to data-driven decision making practices across all settings to affect best outcomes through systematic planning and individualization of efforts (Iovannone, Dunlap, Huber, & Kincaid, 2003; NRC, 2001); (4) scientifically-based strategies--information and training based upon current research in related fields with relevance to ASD and similar developmental disabilities and with a focus on effectively blending scientifically-based strategies (Horner, Carr, Strain, Todd, & Reed, 2002; Matson, Benavidez, Compton, Paclawskj, & Bagilo, 1996; National Autism Center [NAC], 2001, 2009; Odom, Brown, Frey, Karasu, Smith-Carter, & Strain, 2003); (5) interactivity--format of training opportunities based upon implementation and systems training research that indicate the need to appeal to varied learning styles (Fixsen, Naoom, Blase, Friedman, & Wallace, 2002) and need for more interactive strategies to ensure use in the natural setting (McClannahan, & Krantz,1993; Joyce & Showers, 2002); (6) practical and accessible training--provision of accessible materials, training, technology and consultative staff in efforts to decrease barriers, increase support and improve implementation and utilization of the strategies taught; (7) process- driven methods--emphasis on understanding the fluid and integrated process for effectively educating individuals by incorporating data- driven strategies, research-based methods, collaboration and individualized needs to develop effective programming (Iovannone, Dunlap, Huber, & Kincaid 2003; NRC, 2001) (see Fig. 2). ¤ Theory of Change Logic Model Changes are driven by two main forces, the implementation team and the recipient team. Through a multi-year iterative process of change implementation, we have found the following components to be integral within an implementation team such as that of the HANDS in Autism® Team: (1) trained interdisciplinary staff-- extensive background and experience in psychology and education with concentration in ABA as well as training of school personnel, professionals from other related fields (e.g., medical), families, and individuals on the spectrum; (2) evolving curriculum, initial measures and accompanying resources--a comprehensive curriculum with focus on EBPs and collaborative approach to students’ needs; (3) developed implementation model- -rooted in ABA, the implementation model is at the cornerstone of the project blending a number of EBPs to ultimately support the independence of students in academic, social, and functional areas; (4) technological assets--the team has a strong technological foundation to support a variety of formats, programming and resources to appeal to a large diversity of consumers; (5) long-standing training and technical support experience across settings-- the team has developed close ties with a number of local schools and numerous university departments (e.g., the HANDS in Autism® intensive summer training program is offered as a Master’s level course through several major universities). However, to be beneficial, inputs need to be reciprocated. As such, schools need (1) sensitivity to and desire for change; (2) administrative support and accountability at all levels extending from building to special education directors; (3) maintenance and commitment to a team-based approach teams (i.e., special education teacher, paraprofessional, teacher of related arts, related service provider, behavioral or itinerant consultant, building level administrator, director of special education); and (4) establishment of a structure that supports ongoing learning and collaboration (see Fig. 3). ¤ Evaluation for success Finally, program implementation requires ongoing evaluation at multiple levels, each of which is important for overall success and sustainability. The following evaluation distribution implemented by the HANDS in Autism® Model is based on Kirkpatrick’s model (Kirkpatrick & Kirkpatrick, 2004) (see Table 1). Autism spectrum disorder (ASD) is currently the fastest-growing developmental disability in the United States with a prevalence of 1 in 50 (Centers for Disease Control and Prevention, 2013). This increase has likewise affected education agencies as the educational classifications of ASD have grown in frequency (Loiacono & Palumbo, 2011). Due to the significant role of schools in the education and support of students with ASD, it is crucial to ensure that school professionals are trained in evidence-based practices (EBPs). Additionally, it is clear that in order to be effective school personnel must not only have awareness of EBPs, but have the level of knowledge necessary to implement such strategies with fidelity (Fixsen, Naoom, Blasé, Friedman, & Wallace, 2005). Though intensive training and hands-on experience has been confirmed by various researchers to lead to effective implementation of EBPs and application of knowledge (Grey, Honan, McClean, & Daly, 2005; Parsons & Reid, 1995), few programs have been established nationwide to support staff in this manner. The HANDS in Autism® Interdisciplinary Training & Resource Center was created with a mission to fufill this need and further bridge the research to practice gap through the development of a curriculum and training process that provides effective and efficient educational and technical support to professionals working with and supporting individuals with an ASD across multiple settings. Aligned with the mission of the HANDS in Autism® Center, implementation and development of collaborative classrooms and programs consist of a hands-on learning and training process in the naturalistic educational setting guided by a comprehensive curriculum rooted in applied behavior analysis (ABA) and built from EBP in the field of autism (see Fig. 1). Such premises underlie the HANDS in Autism® Model and associated Training Process both of which are used in the development of demonstration classrooms that serve as training hubs within regional areas for which school personnel, community providers, medical professionals, parents, and caregivers can witness such practices in action. Currently, there are nine collaborative classrooms in various stages of implementation across Indiana. Conclusions and Future Directions References 1. Centers for Disease Control and Prevention. (2013). Autism spectrum disorders (ASD). Retrieved from http://www.cdc.gov/ncbddd/autism/index.html 2. Baker, S., Bauman, M., Bishop, M., DiMauro, N., Finlayson, G., Glied, S, et. al. (2005). Spectrum Disorders (ASD) Road Map. Washington, DC: National Institute of Mental Health. 3. Fixsen, D., Naoom, S., Blase, K., Friedman, R., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: Louis de la Parte Florida mental Health Institute, University of South Florida. 4. Grey, I., Honan, R., McClean, B., & Daly, M. (2005). Evaluating the effectiveness of teacher training in Applied Behavior Analysis. Journal of Intellectual Disabilities, 9, 209-226 5. Horner, R. H., Carr, E. G., Strain, P. S., Todd, A.W., & Reed, H. K. (2002). Problem behavior interventions for young children with autism: A research synthesis. Journal of Autism & Developmental Disorders, 32, 423-446. 6. Iovannone, R., Dunlap, G., Huber, H., & Knicaid, D. (2003). Effective educational practices for student with autism spectrum Disorders. Focus on Autism and Other Developmental Disabilities, 18(3), 150-165. 7. Kirpatrick, D., & Kirkpatrick, J. (2004). Evaluating training programs: the four levels (3rd ed.). San Fransisco, CA: Berrett-Koehler Publishers, Inc. 8. Loiacono, V., & Palumbo, A. (2011). Principals who understand Applied Behavior Analysis perceive they are better able to support educators who teach students with autism. International Journal on Special Education, 26(3), 212-222. 9. Matson, J.L., Benavidez, D.A., Compton, L.S., Paclawskj, T., & Bagilo, C. (1996). Behavioral treatment of autistic persons: A review of research from 1980 to the Present. Research in Developmental Disabilities, 17(6), 433-465. 10. McClannahan, L. E, & Krantz, P. J. (1993). On systems analysis in autism intervention programs. Journal of Applied Behavior Analysis, 26(4), 589–96. 11. National Autism Center (NAC). (2009). National standards report. Randolph, MA. 12. National Research Council (NRC). (2001). Educating Children with Autism. Washington, DC: National Academy Press. 13. Odom, S. L., Brown, W. H., Frey, T., Karasu, N., Smith-Canter, L. L., & Strain, P. S. (2003). Evidence based practices for young children with autism: Contributions from single-subject design research. Focus on Autism & Other Developmental Disabilities, 18,166-175. Background Demonstration Classroom Development and Sustainability: HANDS in Autism® Model Sustainable project implementation requires a multi-layered approach that revolves around systemic and systematic change of the teaching environment. Fig. 1 outlines the main concepts of such environment. Level/ Type Description Evaluation Alignment Examples Level 1: Reaction Reaction of the classroom participants to the training and project implementation to be utilized for program assessment and potential ongoing modifications Satisfaction. Satisfaction with the HANDS in Autism® Model and Training Process as assessed through the internally developed Classroom Staff Training Satisfaction (CSTS, HANDS in Autism®, 2010) and ongoing interviews/ discussions with school administrators and school-based team members Level 2: Learning Measurement of the change in knowledge following the training process as assessed through pre/post mechanisms Knowledge of ASD. Assessment of knowledge and understanding of ASD assessed via the internally developed Autism Knowledge Survey-Revised (AKS-R, HANDS in Autism®, ©2005) Application of evidence-based practices for students with ASD. Assessment of school personnel’s application of HANDS in Autism® Model training and curriculum knowledge via the Assessment of Knowledge-Expanded (AoK-E, HANDS in Autism®, ©2007) Level 3: Behavior Measurement of the implementation of the knowledge gained within the training setting and generalization to novel situations and settings Fidelity of implementation. Measurement of the fidelity of implementation by teachers through the use of internally developed HANDS Skill Training Checklist (HANDS in Autism®, ©2008) specific to the content of each module within the HANDS in Autism® Model, and structured observations via the use of the internally developed Classroom-wide Data Rating (C-wDR; HANDS in Autism®, ©2009) Level 4: Results Measurement of overall changes within the classroom milieu and programming which occur subsequent to the training School, Staff, & Student Outcomes. Assessment of outcomes as described in the logic model via a combination of internally developed and established measures. Implementation of EBPs. Assessment of the presence of EBPs in the school setting through the use of the internally developed School WORK (HANDS in Autism®, ©2009) Table 1: Evaluation distribution Fig 1: HANDS in Autism® House Curriculum Fig. 2: Sustainable Implementation Logic Fig. 3: HANDS in Autism®: Theory of change logic model A Comprehensive Framework and Training Process for Effective Implementation and Sustainability
Transcript of HANDS in Autism® Model
Implementation and sustainability of the demonstration classroom requires a joint effort of both the implementation team and the recipient team, as well as the development of a program that is founded on EBPs and sensitive to the need for individualization and adaptations driven by needs. The HANDS in Autism® Model has proven to be a comprehensive training model and process supporting a multidisciplinary, school-based team approach in the effective implementation of EBPs that culminates in both improved staff and student outcomes. Future directions involve evaluation of the transportability of the HANDS in Autism® Model and Training Process to standardize the Model for school administrators, district consultants, related service providers, and school specialists with the opportunity to progressively and collaboratively learn and support a process within a comprehensive framework.
HANDS in Autism® Model:
Tiffany Neal, Naomi Swiezy, Anne Fletcher, Megan Stevenson, and Iryna AshbyHANDS in Autism® Interdisciplinary Training & Resource Center, Indiana University School of Medicine
For more information about the program, visit our website www.HANDSinAutism.org
¤ Core components and focus of the training program:With recognition that no single intervention or strategy is equally effective with all individuals and the desire to provide personnel with a “toolbox” approach to interventions, core components of the HANDS in Autism® Model focus upon: (1) individual strengths-- training focused on building strengths and successes of individuals with an emphasis on proactive planning and teaching practical skills (Iovannone, Dunlap, Huber, & Kincaid, 2003); (2) collaboration: training and collaboration delivered across community stakeholders for consistency, coordination, and positive (Baker, Bauman, Bishop, DiMauro, Finlayson, et. al., 2005; Swiezy, Stuart, & Korzekwa, 2008); (3) data-driven decision making-- training content related to data-driven decision making practices across all settings to affect best outcomes through systematic planning and individualization of efforts (Iovannone, Dunlap, Huber, & Kincaid, 2003; NRC, 2001); (4) scientifically-based strategies--information and training based upon current research in related fields with relevance to ASD and similar developmental disabilities and with a focus on effectively blending scientifically-based strategies
(Horner, Carr, Strain, Todd, & Reed, 2002; Matson, Benavidez, Compton, Paclawskj, & Bagilo, 1996; National Autism Center [NAC], 2001, 2009;
Odom, Brown, Frey, Karasu, Smith-Carter, & Strain, 2003); (5) interactivity--format of training opportunities based upon
implementation and systems training research that indicate the need to appeal to varied learning styles
(Fixsen, Naoom, Blase, Friedman, & Wallace, 2002) and need for more interactive strategies to ensure use in the natural setting (McClannahan, & Krantz,1993; Joyce & Showers, 2002); (6) practical and accessible training--provision of accessible materials, training, technology and consultative staff in efforts to decrease barriers, increase support and improve implementation and utilization of the strategies taught; (7) process-driven methods--emphasis on understanding the fluid and integrated process for effectively educating individuals by incorporating data-driven strategies, research-based methods, collaboration and individualized needs to develop effective programming (Iovannone, Dunlap, Huber, & Kincaid 2003; NRC, 2001) (see Fig. 2).
¤ Theory of Change Logic ModelChanges are driven by two main forces, the implementation team and the recipient team. Through a multi-year iterative process of change implementation, we have found the following components to be integral within an implementation team such as that of the HANDS in Autism® Team: (1) trained interdisciplinary staff--extensive background and experience in psychology and education with concentration in ABA as well as training of school personnel, professionals from other related fields (e.g., medical), families, and individuals on the spectrum; (2) evolving curriculum, initial measures and accompanying resources--a comprehensive curriculum with focus on EBPs and collaborative approach to students’ needs; (3) developed implementation model--rooted in ABA, the implementation model is at the cornerstone of the project blending a number of EBPs to ultimately support the independence of students in academic, social, and functional areas; (4) technological assets--the team has a strong technological foundation to support a variety of formats, programming and resources to appeal to a large diversity of consumers; (5) long-standing training and technical support experience across settings-- the team has developed close ties with a number of local schools and numerous university departments (e.g., the HANDS in Autism® intensive summer training program is offered as a Master’s level course through several major universities).
However, to be beneficial, inputs need to be reciprocated. As such, schools need (1) sensitivity to and desire for change; (2) administrative support and accountability at all levels extending from building to special education directors; (3) maintenance and commitment to a team-based approach teams (i.e., special education teacher, paraprofessional, teacher of related arts, related service provider, behavioral or itinerant consultant, building level administrator, director of special education); and (4) establishment of a structure that supports ongoing learning and collaboration (see Fig. 3).
¤ Evaluation for successFinally, program implementation requires ongoing evaluation at multiple levels, each of which is important for overall success and sustainability. The following evaluation distribution implemented by the HANDS in Autism® Model is based on Kirkpatrick’s model (Kirkpatrick & Kirkpatrick, 2004) (see Table 1).Autism spectrum disorder (ASD) is currently the fastest-growing developmental disability in the United States with a
prevalence of 1 in 50 (Centers for Disease Control and Prevention, 2013). This increase has likewise affected education agencies as the educational classifications of ASD have grown in frequency (Loiacono & Palumbo, 2011). Due to the significant role of schools in the education and support of students with ASD, it is crucial to ensure that school professionals are trained in evidence-based practices (EBPs). Additionally, it is clear that in order to be effective school personnel must not only have awareness of EBPs, but have the level of knowledge necessary to implement such strategies with fidelity (Fixsen, Naoom, Blasé, Friedman, & Wallace, 2005). Though intensive training and hands-on experience has been confirmed by various researchers to lead to effective implementation of EBPs and application of knowledge (Grey, Honan, McClean, & Daly, 2005; Parsons & Reid, 1995), few programs have been established nationwide to support staff in this manner.
The HANDS in Autism® Interdisciplinary Training & Resource Center was created with a mission to fufill this need and further bridge the research to practice gap through the development of a curriculum and training process that provides effective and efficient educational and technical support to professionals working with and supporting individuals with an ASD across multiple settings.
Aligned with the mission of the HANDS in Autism® Center, implementation and development of collaborative classrooms and programs consist of a hands-on learning and training process in the naturalistic educational setting guided by a comprehensive curriculum rooted in applied behavior analysis (ABA) and built from EBP in the field of autism (see Fig. 1). Such premises underlie the HANDS in Autism® Model and associated Training Process both of which are used in the development of demonstration classrooms that serve as training hubs within regional areas for which school personnel, community providers, medical professionals, parents, and caregivers can witness such practices in action. Currently, there are nine collaborative classrooms in various stages of implementation across Indiana.
Conclusions and Future Directions
References1. Centers for Disease Control and Prevention. (2013). Autism spectrum disorders (ASD). Retrieved from http://www.cdc.gov/ncbddd/autism/index.html
2. Baker, S., Bauman, M., Bishop, M., DiMauro, N., Finlayson, G., Glied, S, et. al. (2005). Spectrum Disorders (ASD) Road Map. Washington, DC: National Institute of Mental Health.
3. Fixsen, D., Naoom, S., Blase, K., Friedman, R., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: Louis de la Parte Florida mental Health Institute, University of South Florida.
4. Grey, I., Honan, R., McClean, B., & Daly, M. (2005). Evaluating the effectiveness of teacher training in Applied Behavior Analysis. Journal of Intellectual Disabilities, 9, 209-226
5. Horner, R. H., Carr, E. G., Strain, P. S., Todd, A.W., & Reed, H. K. (2002). Problem behavior interventions for young children with autism: A research synthesis. Journal of Autism & Developmental Disorders, 32, 423-446.
6. Iovannone, R., Dunlap, G., Huber, H., & Knicaid, D. (2003). Effective educational practices for student with autism spectrum Disorders. Focus on Autism and Other Developmental Disabilities, 18(3), 150-165.
7. Kirpatrick, D., & Kirkpatrick, J. (2004). Evaluating training programs: the four levels (3rd ed.). San Fransisco, CA: Berrett-Koehler Publishers, Inc.
8. Loiacono, V., & Palumbo, A. (2011). Principals who understand Applied Behavior Analysis perceive they are better able to support educators who teach students with autism. International Journal on Special Education, 26(3), 212-222.
9. Matson, J.L., Benavidez, D.A., Compton, L.S., Paclawskj, T., & Bagilo, C. (1996). Behavioral treatment of autistic persons: A review of research from 1980 to the Present. Research in Developmental Disabilities, 17(6), 433-465.
10. McClannahan, L. E, & Krantz, P. J. (1993). On systems analysis in autism intervention programs. Journal of Applied Behavior Analysis, 26(4), 589–96.
11. National Autism Center (NAC). (2009). National standards report. Randolph, MA.
12. National Research Council (NRC). (2001). Educating Children with Autism. Washington, DC: National Academy Press.
13. Odom, S. L., Brown, W. H., Frey, T., Karasu, N., Smith-Canter, L. L., & Strain, P. S. (2003). Evidence based practices for young children with autism: Contributions from single-subject design research. Focus on Autism & Other Developmental Disabilities, 18,166-175.
Background
Demonstration Classroom Development and Sustainability:
HANDS in Autism® ModelSustainable project implementation requires a multi-layered approach that revolves around systemic and systematic change of the teaching environment. Fig. 1 outlines the main concepts of such environment.
Level/Type Description Evaluation Alignment Examples
Leve
l 1:
Reac
tion Reaction of the classroom participants to
the training and project implementation to be utilized for program assessment and potential ongoing modifications
Satisfaction. Satisfaction with the HANDS in Autism® Model and Training Process as assessed through the internally developed Classroom Staff Training Satisfaction (CSTS, HANDS in Autism®, 2010) and ongoing interviews/discussions with school administrators and school-based team members
Leve
l 2: L
earn
ing
Measurement of the change in knowledge following the training process as assessed through pre/post mechanisms
Knowledge of ASD. Assessment of knowledge and understanding of ASD assessed via the internally developed Autism Knowledge Survey-Revised (AKS-R, HANDS in Autism®, ©2005)
Application of evidence-based practices for students with ASD. Assessment of school personnel’s application of HANDS in Autism® Model training and curriculum knowledge via the Assessment of Knowledge-Expanded (AoK-E, HANDS in Autism®, ©2007)
Leve
l 3: B
ehav
ior
Measurement of the implementation of the knowledge gained within the training setting and generalization to novel situations and settings
Fidelity of implementation. Measurement of the fidelity of implementation by teachers through the use of internally developed HANDS Skill Training Checklist (HANDS in Autism®, ©2008) specific to the content of each module within the HANDS in Autism® Model, and structured observations via the use of the internally developed Classroom-wide Data Rating (C-wDR; HANDS in Autism®, ©2009)
Leve
l 4: R
esul
ts
Measurement of overall changes within the classroom milieu and programming which occur subsequent to the training
School, Staff, & Student Outcomes. Assessment of outcomes as described in the logic model via a combination of internally developed and established measures.
Implementation of EBPs. Assessment of the presence of EBPs in the school setting through the use of the internally developed School WORK (HANDS in Autism®, ©2009)
Table 1: Evaluation distribution
Fig 1: HANDS in Autism® House Curriculum
Fig. 2: Sustainable Implementation Logic
Fig. 3: HANDS in Autism®: Theory of change logic model
A Comprehensive Framework and Training Process for Effective Implementation and Sustainability
