11 th Annual NW PBIS Conference Eugene, Oregon February 27 th, 2013 Morning Half-Day Workshop Teaching Routines To Support the Independence of Students with ASD/DD Joel Arick, Ph.D. and Sheldon Loman, Ph.D. Portions of the information in this handout were taken from the STAR Program Manual, published by Pro-Ed, Austin, TX (Arick, Loos, Falco, and Krug, 2004) and should not be copied without the authors permission. This handout is to be accompanied with a live training. It is not intended to be a stand-alone document. STAR Autism Support Inc 2010 www.starautismsupport.com
Clearing a path for people with special needs clears the path for everyone! 2
Repetitive Activities Autism 101 Characteristics Triad Emotional Vulnerability Difficulties with Changes in Routines Cognitive Differences Motor/Sensory Differences
Overview - Positive supports for students with ASD Visuals, structure and routines Communication supports Behavior is communication Sensory and emotional regulation supports
Visuals, Structure and Routines What are some ways to provide structure and supports across the day?
Structure and Supports Caution - students with ASD are often very literal Example Non-Example Quiet Mouth Zip Your Lip Put Trash in the Green Can Good Citizens Pick Up
Communication 1. A skill that must be taught and supported 2. All students with an ASD need communication supports Reminder Card Raise Hand Talk when teacher responds Use # 2 voice Talk once then listen if the student does not have the means to communicate what he wants and needs at that moment, he WILL use Behavior
Reinforcement What we know from PBIS Reinforcement of desired behaviors increase the frequency of those behaviors
**Reinforcement** What is reinforcement for the student with ASD?
Reinforcement Token Economy Systems can work for students with ASD Hands to self Quiet voice Complete work = Buy Soda
SCHOOL-WIDE POSITIVE BEHAVIOR SUPPORT Primary Prevention: School-/Classroom- Wide Systems for All Students, Staff, & Settings ~5% ~15% Tertiary Prevention: Specialized Individualized Systems for Students with High-Risk Behavior Secondary Prevention: Specialized Group Systems for Students with At-Risk Behavior ~80% of Students School Wide Positive Behavior Support Robert Horner and George Sugai - OSEP Technical Assistance Center on Positive Behavioral Interventions and Supports. www.pbis.org
Intensive Few Continuum of Support for ALL Targeted Some At what tier do you include students with ASD in your PBIS implementation? Students with ASD benefit from Universal supports and interventions All at all three tiers Dec 7, 2007
Tier 1 Universal Preventions Teach & encourage positive SW expectations Effective instruction Proactive SW support and reinforcement Parent engagement
Tier 1 Tips and Tweaks Must explicitly teach expectations with examples in all environments using visual supports and hidden curriculum Reinforce expected behaviors may need to adjust reinforcement Connect cause and effect Include self-regulation supports
Visual Organizer for Kick-off Day Break
Sample Matrix SETTING All Settings Hallways Playgrounds Cafeteria Library/ Compute r Lab Assembly Bus Respect Ourselves Be on task. Give your best effort. Be prepared. Walk. Have a plan. Eat all your food. Select healthy foods. Study, read, compute. Sit in one spot. Watch for your stop. Respect Others Be kind. Hands/feet to self. Help/share with others. Use normal voice volume. Walk to right. Play safe. Include others. Share equipment. Practice good table manners Whisper. Return books. Listen/watch. Use appropriate applause. Use a quiet voice. Stay in your seat. Respect Property Recycle. Clean up after self. Pick up litter. Maintain physical space. Use equipment properly. Put litter in garbage can. Replace trays & utensils. Clean up eating area. Push in chairs. Treat books carefully. Pick up. Treat chairs appropriately. Wipe your feet. Sit appropriately.
Sample Matrix - Arrival Expectation Be Responsible Be Respectful Be Safe Behavior Be on time Obey Supervisors Watch for cars Behavior Put your coat away Keep hands and feet to self Use cross walks and sidewalks Behavior Have your supplies Enter class quietly Walk at all times
Sample Matrix - Arrival Expectation Be Responsible Be Respectful Be Safe Behavior Be on time Obey Supervisors Watch for cars Behavior Put your coat away Keep hands and feet to self Use cross walks and sidewalks Behavior Have your supplies Enter class quietly Walk at all times
Sample Matrix Hallway Universal Expectation Behavior Respect Ourselves Walk Respect Others Use a quiet voice Keep arms distance Respect Property Pick up
Sample Matrix Hallway Universal Expectation Behavior Respect Ourselves Walk Respect Others Use a quiet voice Keep arms distance --- Respect Property Pick up
CLASSROOM EXPECTATIONS MATRIX Be Respectful Be Responsible Be Safe Use quiet voices Complete all assigned tasks Keep hands and feet to self Raise your hand and wait to speak Come to class on time When seated, keep 2 feet and 4 legs on floor Listen to instructions and directions Be prepared: have all materials Walk at all times
Entering Class Routine Morning Checklist Be Responsible Check Activity Put away backpack in locker Make lunch selection Turn in Homework Pick reward from menu Sit in assigned seat Review class expectations
Morning Checklist Be Responsible Activity My Morning Schedule Walk to Locker Open Locker Hang up Coat Put away Backpack Room 133 Walk to classroom Sit in assigned seat
Be Respectful What does it look like in class discussion? Raising your hand Talk when teacher responds Use # 2 voice Talk once then listen Use Polite words Class Discussion s Raise Hand Talk when teacher responds Use # 2 voice Talk once then listen Use Polite Words Prompting for all students Point to Discussion Poster and review BEFORE class discussion begin
Be Respectful Class Discussions Raise Hand Talk when teacher responds Use # 2 voice Talk once then listen Use Polite Words
Seat Work Seat Work 1. Stay on task 2. Finish your work 3. Stay in seat until you have permission to be up 4. Quietly move to next work
Reinforcement for Seat Work Contingent Activities Can be as simple as First, Then First Then Make sure it is a choice Must be honored Finish Work Read quietly
Evidenced Based Treatments Experts in the field consider Applied Behavior Analysis or ABA as an effective treatment for Autism Spectrum Disorder. So..how can schools use these effective treatments with their students with ASD? 30
Purpose of The ABA Programs Provide 1:1 intensive instruction in: Expressive Language Receptive Language Spontaneous Communication Pre-academics Play skills/social Interaction Pre-Teach Functional Routines Then generalize the skills taught into the student s school day and at home 31
Implement an Evidence Based Curriculum For Students Who Need a More Intensive Program A research-based comprehensive curriculum can provide consistency of implementation for school programs. The STAR Program (Arick, Loos, Falco and Krug, 2004) is one example. It uses the: ABA Instructional Methods of Discrete trial training Pivotal response training Functional routines 32
Discrete Trial Training 33
Discrete Trial Training (DT) Skills are taught in a logical sequence building on previously learned skills. Concepts taught are identified, then broken down into specific elements for instruction. Each session consists of a series of discrete trials, using a four-step sequence: a) instructional cue b) child response c) consequence d) pause 34
Example DT Trial (Correct Response Trial) Strategy Cue Response Consequence Pause Application Teacher provides instructional cue Student responds Teacher praises and gives child a positive reinforcer There is a pause Example Teacher says, Do this and models ringing the bell. Student rings bell Teacher says Ringing bell, praises student & gives student a reinforcer Student uses R+ and teacher pauses before next cue 35
Pivotal Response Training (PRT) 36
PRT: Some Illustrations (from Initial Level ) Cue/Opportunity to Respond Response Consequences Pause Expressive Language Trial -Child reaches for a toy car held by a teacher -Teacher holding car says car (attempting to elicit a verbal imitation) -Child says car. -Teacher lets the child hold car. -Child continues to play with car for 5-10 seconds. -Teacher observes level of play to prepare for the next trial. Play Trial -Child reaches for a toy car on a track to spin the wheels. -Teacher holding car says do this and pushes the car. -Child imitates the teacher s action and pushes the car. -Teacher lets the child hold the car and spin the wheels as a reward for pushing it appropriately. -Child continues to play with car for 5-10 seconds. -Teacher observes level of play to prepare for the next trial. 37
Functional Routines ORGANIZING THE STUDENT S DAY FOR SUCCESS 38
What Are Functional Routines? Activities students do throughout the school day All routines have a beginning, middle and end Snack Sit at table Eat food Clean up Students need to be taught skills to make the routine both functional and meaningful Snack Share/talk to friends Request/make choices about what they want to eat Follow directions (clean-up) Opportunity to generalize skills learned in DT/PRT lessons Snack Requesting (PRT) Counting food items (DT-academic programs) 39
Why are Routines Important? Teaches essential skills needed for independence throughout the student s life. Students exhibit fewer behavior problems when engaged in appropriate and meaningful routines throughout the day. Less down-time for students! Routines tell students what to do Routines create teachable moments throughout the school day Provide structure to the student s day Can assist families with community activities and home routines Provides opportunities for inclusion Provides access to the general education environment even when the student may not be able to complete the academic work 40
Routines can be Taught across all Levels Routines become increasingly more complex at each level Example: Arrival Routine Initial Level: Child walks within 2 feet of adult, adult says walk with me Mid-Level: Child walks slightly ahead of adult and finds their own way to class; child says hi to adult and child during the arrival routine Advanced-Level: Child walks to classroom with other children; child goes to desk in mainstream/inclusion class and gets out work Routines are provided in each of the following areas Transition routines Self-care routines Work routines Inclusion routines Group Routine Free-time routines Play/social interaction routines Academic routines 41
Example Natural Cue: Cue/Response/Consequence/Pause Arrival Routine Cue (Natural Cue) Response Consequence Pause Classroom door (adult moves behind child) Child opens classroom door and enters Able to enter classroom Child focuses on next environmental cue (adult determines need to prompt attention to natural cue) 42
Example Embedded Cue: Arrival Routine Cue (Embedded cue) Response Consequence Pause (after child enters classroom) Adult stands faceto-face with child and says, Hi Child looks at adult and communicates Hi Adult smiles and moves out of child s way Child focuses on next environmental cue (adult determines need to prompt attention to natural cue) 43
How to Teach Routines Student Response Pre-teaching During Routine Teaching Environmental Supports What step do you want the student to complete? Skill Acquisition: DT PRT Communication Systems During routine instruction should include: Prompting/fading strategies Reinforcement strategies Data collection to guide instruction Provide supports throughout the routine: Environment (room arrangement) Tasks (task strips) Time (visual schedules) Target these skills during routines 44
A Complete Set Of Slides and Handouts will be Provided During the Session Video examples of each strategy will be shown during the session. Ideas and materials from Routine Essentials (Magee et. al., 2013) will be shared.