Natural Supports for People with Autism Spectrum Disorder
description
Transcript of Natural Supports for People with Autism Spectrum Disorder
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Natural Supports for People with Autism Spectrum Disorder
Building Your Future ProjectIntensive Training
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Does anyone work with someone that you don’t understand?
What do you do about that?Group Discussion
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THE SOLUTION IS ALWAYS IN THE
PROBLEM
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Who better knows the expectations within the job…
An outside person or a co-worker!
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Key Questions
• What Are Natural Support?• Why Would I Use Natural Supports?• What is the Medium of Exchange for people
who are “typical” to connect with people with ASD?
• Are you in, What do you need to know, and How do we keep you coming back
• (Recruitment, Training and Maintenance)
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Social Competency Research• Students with adequate social skills are
more likely to have positive outcomes, while significant social difficulties place the child at risk for developing later problem behaviors (Koegel, Koegel, & Surratt, 1992).
• Venter, Lord, and Schopler (1992) conducted a study of children with autism and found that social skills during childhood were strong predictors of adult adaptive functioning.
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Social Competency Research• Educational programming for students
with ASD should include goals for improving social skills with both adults and peers (National Research Council, 2001).
• Weiss and Harris (2001) refer to the
scarcity of research targeting social skill development in adolescents and older students.– Many interventions targeting social skills
development have inadequately addressed the social validity of outcomes.
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Social Competency Research• The more traditional approaches to teaching social
skills have not been highly effective as indicated in a meta analysis conducted by Bellini et al., (2007).
• Many peer-mediated intervention programs are too
narrow in scope, such as the Circle of Friends approach, to produce significant long-term impact on participants.
• Efforts to successfully teach social skills to students with ASD can be undermined by problems with generalization to new settings, people, and materials (Parsons & Mitchell, 2002; Zager & Shamow, 2005).
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What Does This Research Mean To Us?
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Social Competency and ASDResearch summarized by Rogers (2000) indicate a shift in the field of ASD, from:
Adult-Directed Instructional StrategiesTO
Peer-Mediated Interventions
Numerous studies have demonstrated theeffectiveness of peer-mediated strategies to
facilitate social interactions.
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Social Competency and ASD• The National Research Council report
(2001) recommended that students with ASD be taught skills in natural contexts.
• One suggestion is the use of multiple peers in various settings to improve generalization (Kamps et al., 1997; Kamps et al., 2002).
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Social Competency and ASDAnother suggestion is providing more time for instruction and social interactionwith typically developing peers a strategythat will likely result in both quicker skillacquisition and better maintenance ofimprovements (Strain, Kohler, Storey, &Danko, 1994).
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Evidence Based Practices: Social Skills and Peer Mediated Instruction and Intervention
“Peer mediated instruction and interventionhas been shown to have positive effects onacademic, interpersonal and personal-socialdevelopment and may be the largest andmost empirically supported type of socialintervention for learners with ASD”
(Bass & Mulick, 2007; Maheady, Harper & Mailette, 2001; McConnell, 2002)
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Goals for Students with ASD
Socialization Skills
Independent Skills
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Development of the Concept
Local School District - 7000 Students
40 Miles North of Detroit, Oakland County, Michigan
Center Program for Students with Autism
13 Local School Districts in Oakland CountySend Students to the Autistic Program
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History of the Autistic Program
1987 - Elementary
1990 - Middle School
1992 - High School
1993 - Pre-Primary Program
1994 – 2nd Elementary
1996 - Post High School Program 1999 – 2nd Middle School
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Full Continuum Concepts
• Break Card
• Modifications – Ed Strats
• Visual Supports
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Two Things We Were Doing OK• 4th and 5th Grade Students coming down
during indoor recess.
• Weekly team meetings…True Brainstorming: all ideas are good ideas and the best idea in the room stays on the table
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Beginning Stages of Students with Students
• Letter, Number, and Color Games
• Common Goal for both sets of students
• Reinforcing to both students with ASD and general education students
• In beginning stages use food as a motivator
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Two Things We Were Doing OK• 4th and 5th Grade Students coming down
during indoor recess.
• Weekly team meetings…True Brainstorming: all ideas are good ideas and the best idea in the room stays on the table
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Evolution of the Clarkston Autistic Program
Reverse Mainstream > > Moderated Behavior
Integration > > Behavioral Systems
Integration > > Academic Systems
Integration > > Socialization Systems
Reverse Mainstream > > Curriculum Makeover
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Evolution of the Clarkston Autistic ProgramReverse Mainstream > > Moderated BehaviorReverse Mainstream > > Curriculum Makeover
Integration > > Behavioral Systems
Integration > > Academic Systems
Integration > > Socialization Systems
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The LINK Program
• 1990 – 17 Study Hall Volunteers
• 2002 – 800 General Education Students 72 Students with ASD
• Utilizing the Most Appropriate Resource in
Public Education to Teach Social Skills to Students with ASD
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Post High School Video• Use to educate potential job
placement staff
• Assist parents in understanding ultimate goal of the program
• Creates common understanding about ASD and the workplace
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Post High School Vocational Placements
• Oakland University - Library• ACO Hardware • Independence Township Library• Bank One - Clarkston• Dunkin’ Donuts• Subway
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Article Written about Marty at O.U.
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Post High School Vocational Placements
• F.Y.E. - Great Lakes Crossing• Target• OATS Horse Farm• C.C.A.• William Beaumont Hospital• The Greenery• Overtyme Restaurant
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Goals for Students with ASD
Socialization Skills
Independent Skills
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Two Ways to Address A Socialization Deficit
• Utilize social skills curriculum to teach isolated social skills to students with autism spectrum disorder in specific settings and then practice isolated skills in a generalized setting.
• Teach general education students about autism spectrum disorder and specific information about students with autism spectrum disorder in their building. Develop tolerance and acceptance within the general education population. Students with autism spectrum disorder will then be able to practice social skills in all settings within the building gaining competency in natural environments.
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Peer to Peer Support ProgramsTeach general education students about Autism Spectrum Disorder and specificinformation about students with autism spectrum disorder in their building. Develop tolerance and acceptance within the generaleducation population. Students with autismspectrum disorder will then be able to practice social skills in all settings within the building gaining competency in natural environments.
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Medium of Exchange
How to connect the typical person to the person with ASD?
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Definition of Medium of Exchange
• The medium of exchange is any material, task, prop, interest area, etc. that connects a person with ASD to a typical person
• Typically the medium of exchange is something that does not require language for the connection or interaction to occur
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Medium of Exchange Material
Person with ASD Typical Person
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Medium of ExchangeRain Man Example
• Creating Connections• Medium of Exchange as an Avenue
for Opportunity• Organizing the Person with ASD • Realization of Skills and Where
they fit within the Community Available to the Person with ASD
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Examples of Medium of Exchange • Work Talk• After Work Activities• Encyclopedic Interests• Computer Interests and Related
Technology• Bowling and Other Leagues• WII• Intense Interests
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The STATE of MichiganMost Bowling Leagues
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What Connects You with Other People?
What are yourCharacteristics/
Interests?
What are CharacteristicsInterests of a Significant
Person in yourLife?
What is the Same?
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This is the Concept of Medium of Exchange
What it is for you is what it is for the person with ASD
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Connecting with Other People…
Isn’t That What This Is All About!
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Medium of ExchangeVerbal Fascinations
• Movies - Matt
• Nose Game – Robert
• No Pink – Robert
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AwakeningsMedium of Exchange
• Try to discover the interest areas of the people with ASD to develop mediums
• Motor Planning and Organization• Staff and Natural Supports may need to
initiate the medium in the environments for Person with ASD
• Staff and Natural Supports are excellent resources in developing new mediums
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Care for the Person
Respect for the Disability
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Natural Support Benefits to People with ASD
• Socialization Opportunities• Work Place Norms and Expectations• Independence• Larger Support Network• More Models of Work Tasks• Others Noticing Subtle Changes to the
Environment
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Peer to Peer BenefitsNatural Supports
• Organizational Skills• Problem Solving Skills• Connection to Employment• Diversity• Responsibility• Collaboration• Self Esteem
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Reciprocal Benefits1. Opportunities for learning in both populations.
2. Growth occurs in both populations.
3. Cost effective and productive.
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Questions or Concerns about Medium of Exchange
Determine a Medium of Exchange for the Students You Work With
P.O.C. – 20 Minutes
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Recruitment of the Natural Supports
Do I Have to do This or Worse are You Going to Make Me Do This?
My Plate is Full and How Will this Help?
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Steps for Recruitment• Provide information about ASD and
specific people with ASD in the job to other people
• Provide interested volunteers the opportunity
• Organize and schedule the natural supports throughout the day
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Peer to Peer and Other Natural Supports Recruitment
• All People Make Great Supports
• After-Work Activities
• Management Needs to Be Involved
• What can this help us with? Will this move me forward in the organization?
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How and Where Do You Find Natural Supports for People with
ASD?
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How and Where?Staff Meetings
Participation in Peer to Peer Support Programs During School
Ask for VolunteersFind the Co-Workers Looking for a Challenge
Get a Commitment Agreement
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Questions or Comments about Recruitment of Peers or Other
Natural Supports?
Where will your team recruit natural supports? POC – 15 Minutes
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Natural Supports Training
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Natural Supports Introductions
• Natural support’s name• Natural support’s hours of employment• Hobbies• Family members• Why they want to be a natural support
for people with ASD
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Group Discussion about Autism Spectrum Disorder
• Ask the natural supports what they know about Autism Spectrum Disorder
• Write ideas on the board• Engage natural supports in discussion
about ASD
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Information About ASD
• Approximately 1 in 110• Rapidly Increasing in Numbers of Students• 4 times more common in males than females• Cause is Unknown• You are born with autism spectrum disorder• You can’t catch it
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Autism and IdiosyncraticBehavior - Rain Man
• Over-reaction to changes of schedule
• Personal Property is Valued/Obsession
• Material Organization is more important than Object/Material
• May use idiosyncratic speech
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Characteristics of ASD• Social Skill Issues
• Communication
• Intense Interests and Repetitive Behavior
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Characteristics of ASDSocial Skill Issues
• Peer Relationships
• Sharing Information
• Misunderstanding of Social Situations
• Reciprocal Social Interactions
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Characteristics of ASDCommunication
• Verbal and Non-verbal
• Talk about Interests
• May not seem interested in what others are talking about
• May say inappropriate words
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Characteristics of ASD - Intense Interest and Repetitive Behaviors
• Intense Interest in Certain Topic Areas
• May Like to Do the Same Thing Over and Over
• May Like Things to Stay the Same – Difficult with Transition
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• Visual Supports• Communication Systems• Self Management Systems• Case Conference (Team Process)
Strategies that Work with People with ASD
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David’s Yes/No Communication System
Yes No
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Ryan’s Communication System
Food Drink Bathroom
More Help Other
Break Yes No
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Self Management
Systems
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Self Management
Systems
Return Merchandise
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Self Management Systems
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Natural Supports and Case Conferences
• Weekly or Monthly Meetings
• Problem Solving Focus
• May Include the Person with ASD
• Teaching Support Strategies in the Case Conference that will Generalize to the Work Environment
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Translation of Meeting Mechanics
• Enhance understanding of ASD• Translate understanding to the person with
ASD• Change Graphics to facilitate the discussion
in the location they are
• Case conference – peer to peer problem solving format
• 2 hour presentation
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Case Conference Information Sheet
• Each staff fills out the sheet at the beginning of the case conference
• The facilitator collects the sheets and determines if there are any patterns in the answers
• The information from the sheet generates the discussion using the board
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Case Conference Information Sheet You do not need to put your name on this sheet. This is an information sharing sheet used to enhance the information presented during this case conference Please answer the following questions as openly and honestly as possible. If you do not have an answer or if you have an answer but it is hard to put into words just do your best. 1. The best experience with (Student with ASD) this month is when ___________________________________________________ ___________________________________________________ 2. Something I wasn’t sure how to handle this month was ________ ____________________________________________________ 3. I was frustrated by (Student with ASD) this month when he/she ____________________________________________________ 4. The biggest accomplishment that (Student with ASD) made while I was supporting him/her was _____________________________ ____________________________________________________ 5. The biggest accomplishment that I have made being a (Peer to Peer Support) is ______________________________________ 6. Are you interested in continuing to be a (Peer to Peer Support) Yes No If yes, which student would you like to support________ 7. What three suggestions would you give to the (Peer to Peer Supports) supporting the (Student with ASD) ____________________________________________________ ____________________________________________________ ____________________________________________________ (Give the students directions about where to put the sheets when completed. Ensure confidentiality.)
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Case Conference Mechanics and Outcomes
• Utilize meeting mechanics – always use the board
• Positives – Concerns – Brainstorming• Information from the board is written on
the Case Conference information sheet• Copies are made for each staff member,
person with ASD, and parent or guardian if appropriate
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In an effort to keep the parents, staff and peers students informed of the effective strategies that work for (Student with ASD Name) had a case conference on (Date )
Some positive things discussed about (Student with ASD)were: _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________
Some concerns that were raised about (Student with ASD) were: _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________
_______________________________________________________ The action plan to resolve the concerns for (Student with ASD) is: _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________
If you have any questions or concerns please contact caseload teacher _______________________ ______________________ (Staff Person’s Signature) (Date)
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ETA Communication Sheet Marty Date: ________________________________ Staff Member from ETA: ___________________________________________ Technical Information: Questions about the Student: Staff Member from Clarkston Community Schools: ___________________________________________ Information about Autism? Questions about the Softwear: Questions about ETA? Other Concerns or Comments:
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Time sheet for ETA Worker: ______________________________
Staff Person: ____________________________
DATE TIME IN TIME OUT TOTAL HOURS ADDITIONAL INFO
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Utilizing MRS and Transition Coordinators as Facilitators of Work
Place Case Conferences
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Maintenance of the Peer to Peer and Natural Supports
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Have you ever volunteered for any organization?
What made you continue to stay with volunteering?
Group Discussion
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Natural Supports Maintenance
• Employee of the Month• Work Talk• After Work Celebrations• League Opportunities• Fantasy Football• Sports Pools• Lotto Pools
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People with ASD must be Approachable• Socially Appropriate Dress
-Barbie Boots-Jelly Bean Jogging Suit
• Behavioral Issues-Stereotypical Behaviors
• Social Issues– Picking Nose – Spitting
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The Network• Do the natural supports go beyond
the work environment?• Personality of the Person with ASD• Climate of the Employment
Community• Dan and the Casino• Ryan’s Party
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Develop an On-Line LINK Social Network
• Track Graduated LINKS• Allow Networking Between LINKS• Post Opportunities for Graduated LINKS by
RCN• Provide Parents List of Graduated LINKS
by RCN• Social Network will be Hosted by a Person
with ASD
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Imagine the Possibilities• Co-Workers Understanding of ASD• Community College Opportunities• University Opportunities• Semi-Independent and Independent Living
Arrangements• Social Opportunities• Community Opportunities
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Define Natural Supports in Terms of the Workplace Rather Than…
Alternatives to Traditional Job Coaching
Marc Gold & Associatesmarcgold.com
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Reconsideration of Job Analysis
Focus on Cultural Analysis of the Employment Environment rather than
a Focus on Job AnalysisMarc Gold & Associatesmarcgold.com
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Natural Supports – Two Powerful Forces that Affect the Success
1. Features of Naturalness – Gain Access
2. Individual Needs – Assure The Needs of the Individual are Met
Marc Gold & Associatesmarcgold.com
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7 Phase Sequence for Balancing Naturalness and Individual Needs
• Determine Natural Ways• Determine Natural Means• Identify Natural People• Facilitate Successful Performance• Support/Substitute for Natural People• Suggest More Effective Natural Means• Adapt/Modify Natural Ways
Marc Gold & Associates marcgold.com
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Determine Natural Ways• Methods of Performance for Targeted Job Tasks• Step by Step Procedures• The Culture of the Workplace• The Manner in Which Workers Interact• The Managerial Style of the Setting• All Other Natural Features which Describe the
Unique Characteristics of Performance and Behavior Desired by the Employer
Marc Gold & Associates marcgold.com
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This Phase is Crucial…
1. Information for New Employee to Fit In2. Easier for Supervisors and Co-Workers to
Provide Assistance and Troubleshoot Problems Due to the Similarity of Performance
Marc Gold & Associatesmarcgold.com
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Purpose of Socialization as an Instructional Variable
• Modeling
• Participation
• Social Learning Theory
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Social Learning TheoryAlbert Bandura
• Attention
• Retention
• Reproduction
• Motivation
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Determine Natural Means
1. Ask the Employer to Describe the Procedures Used
2. Observe Teachings Done by Employees in the Setting
3. Ask to be Taught How to Perform the Job Task by the Persons Who Would Naturally Assist the Jobs to be Performed
Marc Gold & Associatesmarcgold.com
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How Did You Learn How to Write an IEP?
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Identify Natural People
• Identify and Enlist the Natural People Who Typically Support New Employees to Perform Their Jobs
• Most Novel Aspect of the Natural Supports for Traditional Providers of Supported Employment Services
Marc Gold & Associatesmarcgold.com
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In the Past…Job Developers Often Promised Employers…
1. Job Trainers Would Provide all the Assistance Necessary for Successful Performance
2. They Would Have No Investment in the Initial Training or Support of the Employee
3. Job Trainers Would Act as an Interpreter for All the Information, Rules, Policies and Activities
4. This Role Placed the Job Coach Between the Employer and the Employee
Marc Gold & Associatesmarcgold.com
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Similar to Issues with the Over-reliance on the use of
Paraprofessionals in the SchoolsUnnatural dependence on an adult within the general
education environment
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This Practice Resulted in Isolation of Supported
Employees in their Own Work Settings
Marc Gold & Associatesmarcgold.com
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Facilitate Successful Performance• Initial and Ongoing Assistance to the
Supported Employee• Job Developers(Facilitators) Must Now
Decide the Degree of Naturalness Which Will Be Used for Initial Training
• Strongly Suggested…Unless There Are Clear Indications to the Contrary, Natural Procedures Be Utilized Initially
Marc Gold & Associatesmarcgold.com
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Strong Rationale For the Job Developer (Facilitator) to Take Risk
Allow Natural Means a Chance to Be Effective
Marc Gold & Associatesmarcgold.com
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Dignity of Risk Robert Perske
The concept of “dignity of risk” is we allow our children, and ourselves, to make choices and the accompanying mistakes, failures… because this is how we learn. This is how we build
our self-esteem and self-worth. Our Dignity.
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A Reasonable Trade-Off…
To Accept the Lessened Performance Through Naturalness
Over That Available Through Powerful Training Procedures
Marc Gold & Associatesmarcgold.com
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Constraints to the Initial Use of Naturalness • Job Developer and Employment Facilitator
are Different People• Impact of the Employee’s Disability
Requires the Facilitator to Model Effective Techniques for the Natural Supporters
• Fragile Situations in Relation to Employer’s Low Expectations of Success
• Modifications to Job Sites and/or Job Stations
Marc Gold & Associatesmarcgold.com
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Support/Substitute for Natural People
• Demonstrate a More Powerful Technique• Negotiate a Time for Discussion and
Feedback with the Natural Supporter• Offer Training Formally and Informally• Shadow the Natural Support and Offer On-
Going Feedback
Marc Gold & Associatesmarcgold.com
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Suggest More Effective Natural Means• Reconsideration of the Natural Means Used
by Employers to Teach and Motivate Employees to Perform Their Jobs
• Teaching Style of One Co-Worker May Differ Significantly from Another and Further Yet from a Supervisor
• Consideration…Various Strategies Which Seem to be Working and Who Uses Them
• Specific Suggestions to Specific Natural Supports…Each Different
Marc Gold & Associatesmarcgold.com
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Again…How Did You Learn How to Write an IEP?
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Adapt/Modify Natural Ways• Decisions of Adapting, Modifying or
Negotiating for Flexibility in the Natural Ways the Work Place Operates
• Considered Last Because They Are Often the Most Consistent and Unchanging Features of the Work Places
Marc Gold & Associatesmarcgold.com
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Job Analysis Process in Supported Employment is a…
Human Service Activity Designed to Assist Facilitators To:
Marc Gold & Associatesmarcgold.com
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1. Organize the Information to be Performed by the Supported Employee
2. Recognize the Natural Ways, Means and People Used by the Employer to Typically Perform and Teach the Job
3. Develop a Plan for Balancing the Natural Features of Support Available at the Job Site
4. Form Relationships Necessary to Accomplish the 7 Phase Sequence
Marc Gold & Associatesmarcgold.com
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Job Analysis Begins…
After the Employer Has Given Approval for the Job to Begin and Before the Supported Employee
Begins to WorkMarc Gold & Associatesmarcgold.com
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Why Would A Job Analysis Be Performed By A Human
Service Provider?
At This Time, The Funding and Responsibility for the Provision of These Supports Rest with Human
Service Agencies
Marc Gold & Associatesmarcgold.com
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Summary• Medium of Exchange• Recruitment• Training • Maintenance• Staff Responsibility• Development of a Natural Support
System
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Activities and Profile of Change
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