Newsletter
Volume 31 | 2008 | Number 3
Effective School-Based Programs for Children with Autism
By Dr. Ilene Schwartz, BCBA, University of Washington
Best Practices in Applying Indicators of Quality Programs
Providing intervention to young children with ASD is complex. There are issues to be considered around where instruction should occur, who should provide the instruction, what should be taught, and how it should be taught. In order to organize the myriad of issues and decisions that are involved in planning a high quality program, we have identified six characteristics that are common across these programs. These six program characteristics are listed below and described in detail in the following pages:
- Supports and Services are Individualized Based on Child Need
- Well Designed and Normalized Environments
- Appropriate Curricular Content Across Domains
- Systematic Instruction and Data-Based Decision Making
- Functional Approaches to Problem Behavior
- Family Involvement and Support
Supports and Services are Individualized Based on Child Need
Since Evelyn Deno and colleagues suggested a cascade of services in 1964 a goal of special education and school psychology has been to insure that services provided for young children have been individualized to support and keep the child in the least restrictive environment. That is, the child’s program (the goals and objectives developed for an individual child) dictates the placement. It is clear that one type of program (e.g., inclusion, self-contained) for children with ASD will not meet the needs of every child with ASD. It is up to the IFSP or IEP team to determine where the best placement for each individual child should be, what services and supports are necessary, what objectives need to addressed, and what instructional strategies will be most effective.
For young children with ASD, several aspects must be considered based on child preferences, learning characteristics, and family preferences: 1) where instruction will occur, 2) who will deliver the instruction, and 3) what general supports will be necessary for the child to maintain a level of engagement that is likely to be intense enough to lead to better outcomes. Individual child characteristics are a critical part of determining the components of an individualized program. The needs and the curriculum will be developed based on the individual assessment for each child and revised frequently based on data from progress monitoring. That is, not all children with ASD will need specialized instruction requiring very individualized supports for every curriculum area. However, the team should consider the individual learning characteristics when determining the best place for instruction to occur for a specific objective. Learning characteristics will also assist in determining the best way to structure learning opportunities. For some children, an environment in which few distractions are present will best facilitate some instruction. But for others, it may be necessary for instruction to occur in a setting in which distractions are present to help facilitate learning across environments.
It is clear the needs of all children with ASD will not be met in the same setting. In fact, it is likely that the needs of any one student will not be met in any one environment, suggesting that teams examining the best placement for a child consider more than one environment. For example, while it might be best to teach a child to expressively call his friends by name in a one-to-one setting using pictures, it is equally favorable to ensure the child has an opportunity to perform the same skill when he sees the friend in the lunch room. Likewise, the literature suggests we may see more robust results (i.e., quicker acquisition and increased generalization) and provide better outcomes for children if we teach them new skills in a variety of settings (e.g., general education, community, and self-contained) and with a variety of materials.
With the recent developments and controversies around discrete trial training, a more likely decision to be made when identifying individualized supports is who will be delivering the instruction. Much attention has been given to the research examining intensive one-to-one behavior intervention. As mention earlier, the literature is not clear if one-to-one behavior intervention alone is the best or provides the least restrictive environment for all students with ASD. In fact, there is some literature to suggest that responders to early intervention were those children who were able to benefit from group instruction where non-responders did not have those skills necessary to reference peers or work in a group (Sandall, et al., 2007). Providing all instruction one-to-one setting should not be the standard. Access to typically developing children and the opportunity to interact successfully with typically developing children every day is an important component of a high quality program for children with ASD. Determining what types and amounts of supports are necessary to facilitate this interaction is an important role for team members.
Appropriate Curricular Content Across Domains
Given that ASD is a spectrum disorder, it makes sense that identifying appropriate curriculum for students with ASD must be individualized for each student. The literature provides us guidance to identifying curriculum for students with ASD along two continua: a) identifying which domains need specialized, systematic instruction and b) deciding to what level the child should be accessing the general education curriculum.
The literature, particularly the NRC report, is clear on the critical domains to consider when planning curriculum and instruction for children with ASD. These areas include: communication, social, cognitive, play/leisure, and adaptive behavior. All areas should be assessed and considered for specialized, systematic instruction. Yet for some children, specially designed instruction in all curriculum areas will not be necessary or beneficial. Some students will benefit educationally from accessing the same general education curriculum as their same aged peers with accommodations and some minor modifications, while others benefit from more major adaptations in the curriculum (functional skills). For example, when considering those students with ASD, but with few cognitive or adaptive behavior delays, it is likely that curriculum development and specialized, systematic instruction will be necessary in the areas of communication and social, but not in other academic areas. However, some students may need specially designed instruction across all domains.
Given the recent legislation, No Child Left Behind, schools are mandated to show how all children “access the general education curriculum.” Ryndak and Alper (2004) provide a framework to consider when deciding on appropriate curriculum that meets the needs of all children while meeting the mandate to access the general education curriculum. This model asks educational teams to consider: 1) identifying what typically developing children are learning (i.e., the general education curriculum), and 2) identifying the functional needs of the child. The first is typically done through examining the learning targets or state standards for the same age peers. The second is done through identifying targets through family assessments, environmental inventories, person-centered plans, and/or futures planning. By examining both avenues, the team is likely to provide opportunities for learning content same or similar to same age peers while considering the functional needs of the child and family.
Systematic Instruction and Data-Based Decision Making
The literature provides educational teams with many evidenced-based instructional strategies to teach young children with ASD. However, knowing the list of strategies is not sufficient. Systematic instruction is the process of identifying appropriate instructional procedures for teaching, matching them with what is being taught and where it is being taught, collecting ongoing evaluation data to monitor progress, and making decisions about instruction based on evaluation data.
To date, most of the systematic procedures validated for instruction of students with autism have been procedures that use Applied Behavior Analysis methods and principles. A range of strategies based on ABA principles have been empirically validated including: intense structured approaches or discrete trial training (Lovaas, 1987; McEachin, Smith, & Lovaas, 1993), naturalistic strategies (McGee, Almeida, Sulzer-Azaroff, & Feldman, 1992; McGee & et al., 1985), self-management (L. K. Koegel, Koegel, Hurley, & Frea, 1992; R. L. Koegel & Koegel, 1990), prompt fading, and modeling (Charlop & Milstein, 1989; Charlop, Schreibman, & Tryon, 1983; Ihrig & Wolchik, 1988). This is also true for the general education curriculum. Behavioral strategies often employed in general education include choice making (Foster-Johnson, Ferro, & Dunlap, 1994) and use of positive reinforcement during direction instruction (Stein & Davis, 2000).
Data collection and evaluating the data to make changes in the instructional procedures is a critical and necessary component of any program for children with ASD. Without data collection, the team is unable to 1) decide the appropriate strategy and conditions to provide instruction and 2) whether or not those instructional procedures are effective. Moreover, Drasgow and Yell (2000) found that schools using data to make decisions about instruction was a major factor in a successful due process hearing when the disagreement was about appropriate methodologies used for instruction.
Functional Approaches to Problem Behavior
Children with ASD who exhibit problem behaviors are more likely to be excluded and isolated from child care, preschool, and other early school settings. Given the nature of ASD (deficits in communication and social skills) many children who are diagnosed with autism also exhibit challenging behavior. A lot of attention has been given over the last decade to the use of positive behavior supports to manage behavior for children who exhibit problem behavior. Positive behavior support is an approach to intervention that evolved from a call from advocates and the field to eliminate the use of highly punitive interventions to control behavior and to adopt a more preventative approach towards challenging behavior (Horner, Dunlap, Koegel, Carr, Sailor, Anderson, Albin, & O’Neill, 1990). PBS is grounded in the concept that all behavior is communicative and serves a purpose (O’Neill, Horner, Albin, Sprague, Storey, & Newton, 1997) and to successfully design an intervention that is effective, it is necessary to identify the purpose (i.e., function) of the behavior. The use of functional behavior assessment (FBA) to identify the purpose of the behavior is critical to better matching an intervention that will serve the purpose and teach the child a new skill to replace the existing problem behavior (Carr & Durand, 1985; Wacker et al, 1990). For example, if a child drops to the floor when asked to wash his hands, the teacher allows him to go to snack table without washing his hands, then the child escapes having to wash his hands. Subsequently, the student may, when asked to wash his hands, again drop to the floor and tantrum. When planning an intervention, we could teach the child to request for help – reducing problem behavior.
Family Involvement and Support
Research has demonstrated that family participation in a child’s school program has a positive impact on a child’s. Children with autism provide more of a challenge often exhibiting difficulties generalizing skills from one environment to another or from the presence of one person to another making skill acquisition difficult. Research has shown that for children with special needs, parent participation leads to a number of positive outcomes including greater generalization and maintenance gains, and more continuity in intervention programs. Given the importance of parent participation and these unique learning and behavioral needs of children with autism, it is critical that schools partner with families to provide the best learning opportunities for children with autism.
These six program characteristics do not describe comprehensive programs for students with ASD, but rather they are a tool that teams can use to assist in the planning process. Parents and providers can use these recommendations as a starting place for planning and evaluating school programs for children with ASD. As in planning every program for children with disabilities, it is essential to consider individual needs and strengths of a child and the priorities of the family in this planning process. A program that uses these recommendations as guidelines would be well on the way to designing programs that are effective, meet the needs of children and families, and are legally defensible according to IDEA.
References
- Carr, E. G., & Durand, V. (1985). Reducing behavior problems through functional communication training. Journal of Applied Behavior Analysis, 18, 111–
- Charlop, M. H., & Milstein, J. P. (1989). Teaching Autistic Children Conversational Speech Using Video Modeling.Journal of Applied Behavior Analysis, 22(3), 275-285.
- Charlop, M. H., Schreibman, L., & Tryon, A. S. (1983). Learning through observation: The effects of peer modeling on acquisition and generalization in autistic children. Journal of Abnormal Child Psychology, 11(3), 355-366.
- Drasgow, E. & Yell, M. (2001). Functional behavioral assessments: Legal requirements and challenges. School Psychology Review. Vol 30(2), 239-251.
- Foster-Johnson, L., Ferro, J., & Dunlap, G. (1994). Preferred curricular activities and reduced problem behaviors in students with intellectual disabilities. Journal of Applied Behavior Analysis, 27, 493-504.
- Horner, R. H., Dunlap, G., Koegel, R. L., Carr, E. G., Sailor, W., Anderson, S., Albin, R, & O’Neill, R. (1990). Toward a technology of "nonaversive" behavioral support. Journal of the Association for Persons with Severe Handicaps, 15 (3), 125-132.
- Ihrig, K., & Wolchik, S. A. (1988). Peer versus Adult Models and Autistic Children's Learning: Acquisition, Generalization, and Maintenance. Journal of Autism & Developmental Disorders, 18(1), 67-79.
- Koegel, L. K., Koegel, R. L., Hurley, C., & Frea, W. D. (1992). Improving social skills and disruptive behavior in children with autism through self-management. Journal of Applied Behavior Analysis, 25(2), 341-353.
- Koegel, R. L., & Koegel, L. K. (1990). Extended Reductions in Stereotypic Behavior of Students with Autism through a Self-Management Treatment Package. Journal of Applied Behavior Analysis, 23(1), 119-127.
- Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3–9.
- McEachin, J. J., Smith, T., & Lovaas, O. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal on Mental Retardation, 97, 359–372.
- McGee, G. G., Almeida, M., Sulzer-Azaroff, B., & Feldman, R. S. (1992). Promoting reciprocal interactions via peer incidental teaching. Journal of Applied Behavior Analysis, 25, 117–126.
- McGee, G. G., Krantz, P. J., & McClannahan, L. E. (1985). The facilitative effects of incidental teaching on preposition use by autistic children. Journal of Applied Behavior Analysis, 18(1), 17-31.
- National Research Council (2001). Educating Children with Autism. Washington DC: National Academy Press.
- O’Neill, R. E., Horner, R. H., Albin, R. W., Sprague, J. R., Storey, K., & Newton, J. S. (1997). Functional assessment and program development for problem behavior. A practical handbook (2nd ed.). Pacific Grove, CA: Brooks/Cole.
- Ryndak, D. L. & Alper, S. K. (2003). Curriculum and instruction for students with significant disabilities in inclusive settings. Boston: Allyn and Bacon
- Sandall, S., Ashmun, J., Schwartz, S., Davis, C.A., Williams, P., Leon-Guerrero, R.M., Boulware, G., & McBride, B. (2007). Differential response to school based programs for children with ASD. Submitted for publication.
- Stein, M., & Davis, C. A. (2000). Direct instruction as a positive behavioral support. Beyond Behavior, 10, 7–12.
- Wacker, D. P., Steege, M., Northup, J., Reimers, T., Berg, W. K., & Sasso, G. (1990) Use of functional analysis and acceptability measures to assess and treat severe behavior problems: An outpatient clinic model. In A. Repp, and N. Singh(Eds). Perspectives on the use of nonaversive and aversive interventions for persons with developmental disabilities. (pp. 349-359).Sycamore, IL: Sycamore Publishing Company.