Wednesday, January 21st, 2009
Effective and efficient programming for children with Autism Spectrum Disorders (ASD) is something you hear over and over again, especially if you are completing your graduate courses, a parent worrying about what is happening in your child’s classroom, a clinician diagnosing a child with ASD, or if you are a therapist designing a treatment plan for a child with ASD. We all want to know that effective and efficient programming is in place, but how? For years, technology or computer assisted intervention has been used to improve the quality and efficiency of instruction for students with disabilities, however the use of technology for students with autism still receives very limited attention.
Various aspects of technology can be used for children with autism to improve independence, adaptive skills, academics, social skills, receptive and expressive language skills, communication, motivation, attention, and many other areas of need. Chances are, you have heard of the term “assistive technology” (AT). However, there tends to often be confusion associated with AT in terms of what is actually considered assistive technology and who should be considered for assistive technology. First, let’s define AT… According to the Technology-Related Assistance for Individuals with Disabilities Act of 1988 (Public Law 100-407), an assistive technology means any item, piece of equipment, or product system, whether acquired commercially, off-the-shelf, modified or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities. Now, let’s consider who needs AT… When Congress reauthorized IDEA in 1997, they added the provision that ALL students on IEPs must now be considered for assistive technology. This means that an overwhelmingly huge number of 3+ million students were now eligible to be considered for AT. Unfortunately, this was another underfunded mandate and is often overlooked or ignored. Why is it ignored? People think it costs a lot of money, nobody knows how to use what is already available to them, it’s too complicated, there are too many technical issues, or the teachers that did know how to use it have moved on and nobody else is interested or has the time for training.
Processing visual information or pairing visual information with auditory information, tends to be a much more effective strategy for children with autism. When we use AT with children with autism, we are providing the targeted information through their strongest processing area, therefore providing more efficient and effective programming. That said when working with students with ASD, various aspects of technology from “low” tech to “high” tech should be considered in every aspect of their educational programming.
When deciding on what mode of AT you will use, it is important to determine which visual representation system is best understood by the student. You will also need to consider in what contexts the student needs to access information and make the most effective and efficient programming decisions based on functionality and portability of the assistive technology in those settings. Some examples of visual systems include objects, real life photographs, realistic drawings, line drawings, and text. Each of these examples can be used with assorted modes (low tech, high tech, etc.) of technology, as long as the student can readily comprehend the visual information. Some children may need different visual representation systems in different situations. The skills being taught and individual student tendencies and characteristics associated with ASD, will likely determine what systems and technology you end up using or finding particularly effective.
One child may need to use 3D objects for his visual schedule because the actual objects seem to provide the added information needed to guide him from one activity to the next. However, another child may have the same daily schedule, but will need line drawings because 3D objects are too distracting and he tends to focus on inconsequential details in real life photos.
A student who only needs a sticky note reminder to stay on task for homework at home, may also need a timer that can be pre-programmed at intermittent intervals to stay on task in the classroom at school.
Assistive technology devices can be grouped into three categories: low-tech, mid-tech, and high-tech. When exploring AT solutions for a student with autism, the team should first consider whether low-tech solutions can meet the needs of the student. In addition to low-tech solutions being more cost effective, these solutions tend to be the least intrusive and are almost transparent providing better generalization, more functionality, and often times a better quality of life (i.e. avoiding possible embarrassment for the student).
Various modes of technology strategies, commonly associated with working with children with autism, are defined with examples below:
“Low” Technology (”Light Tech”) – Visual support strategies that do not involve any electronic or battery operated device. Low tech solutions are typically low cost and easy to use and are often readily available in the classroom or home environment. Low tech strategies are often less complicated, usually smaller and lighter in weight and in size, and also simpler to make.
Examples: dry erase boards, reading frames, sticky notes, seat cushions, clipboards, manila file folders, photo albums, laminated pictures and/or symbols, highlighters, highlight tape, 3-ring binders, pencil grips, darker lines or raised lines on paper, color contrast paper, weighted pencils, graph paper, adaptive scissors, phone book for foot rest, etc.
“Mid” Technology – Battery operated devices or simple electronic devices requiring little training and advanced technology. Often they are fairly lightweight and quite portable, allowing the student to use them anywhere.
Examples: tape or digital recorders, electronic dictionaries or organizers, audio books, special lighting or acoustical treatments, amplification systems, adapted keyboards, audible word scanning devices, Language Master, overhead projectors, smartboards, timers, calculators, wrist watch timers, simple voice output devices (buttons, switches), etc.
“High” Technology – These are usually the more complex technological support strategies and also typically require more expensive equipment and more sophiscated training. When low and mid-tech solutions are not effective for the student, it may be necessary to consider high-tech options. However, remember that the most expensive solution may not be the best option for each student; each student requires individualized consideration and evaluation and what will work for one student may not work for the next student.
Examples: video camera systems, talking calculators, word processors, various software, scanners, reading pens, computers and adaptive hardware, complex voice output devices, alternative keyboards, mouse emulators, scanners, text-to-speech software, screen reading software, speech recognition software, augmentative communication devices, digital whiteboard devices, etc.
It’s no surprise that research in neuroscience has demonstrated that we all process information differently from one another. With three primary brain functions in regards to learning and processing information, you can imagine the vast differences in how each individual student in just one particular classroom will absorb information. Universal design for learning means using instructional tools, materials, and methods that remove the barriers to learning and thus, making it possible for all students to succeed. A universally-designed curriculum offers multiple means of representation (give learners various ways of acquiring information and knowledge), multiple means of expression (provide alternatives for learners to demonstrate what they know), and multiple means of engagement (tapping into interests, motivation, interests, etc.). Technology can reduce the amount of effort required to implement the components of UDL in the classroom, enabling educators to create lesson plans and transform curriculum in efficient and flexible ways to meet the various needs of all students.
Posted in General Thoughts | 6 Comments »
Friday, January 9th, 2009
It is sometimes difficult to make sense of all of the data that is collected on a child in a special education program. The first issue is consistency and standardization. There is no excepted assessment protocol that is used in ALL schools for ALL children, it varies immensely from school district to school district. Another issue is that the data is often not presented to the families in a meaningful way and the assessment is often not directly tied to IEP goals, so at times, it is not clear what is being assessed or why. Similarly, it is not always clear which assessments to use to get meaningful outcome data.
If your child does get assessed, the terminology in these reports can be daunting. Here is a brief overview of some of the terms you may see:
* A raw score is almost always the number of items that the child answered correctly on the assessment. By itself, this has no meaning if you are not familiar with the specific assessment.
* A standard score is one that has been calculated from the raw score to fit into a normal distribution. In most cases, the mean is 100, and the standard deviation is 15. In special education, children are often at extreme ends of the distribution (either way above or way below the mean) in areas of exceptionality (for instance, a child with autism will likely score below the mean in social communication).
* The z score is the number of standard deviations above and below the mean. If a z score is -1.9, that means the child scored 1.9 standard deviations below the mean.
* Percentile rank is the percentage of scores in a particular group of people. Percentile ranks range from 99th (highest) to 1st (lowest). If your child has a percentile rank of 82, they did better than 82% of the population (could be their class or district, could be the general population for that age group, etc, depends on the assessment).
* The age equivalent is estimate of the age level that matches how your child did on the assessment. This is almost always shown in years and months. If your child is 10 years old and receives an age equivalent score on a language assessment of 6 years, 2 months. That means that your child’s language (as measured by that assessment) is similar to a typically developing child at the age of 6 years, 2 months. This is probably one of the more useful pieces of data, as this can help guide your decisions for what content is most appropriate for teaching your child and building her language skills.
* The grade equivalent is similar to age equivalent, but by grade level, rather than a specific age.
* A report card often has a completely different set of scoring than standardized measures. These vary so much, that it is impossible to review them all here. The most common (with older kids) is A (highest grade), B, C (pass), D, or F (fail). Younger grades often use things like S (satisfactory), E (excellent), U (unsatisfactory) or other types of grading. Report cards are done at a state, district, or sometimes even school level (especially in private schools). The report card shows how your child is doing compared to other children at that grade level.
* The IEP (see Manya’s Posting) is not really a report of how well the child is doing, but what needs to be worked on to make the child successful, so the IEP is not the outcome measure, per se, but the plan for improving the child’s skills.
TYPES OF ASSESSMENT
Intellectual, Educational: The purpose of these assessments is to determine the child’s overall, verbal, or non-language intellectual ability. Skills that are typically measured include language skills, processing speed, memory, abstract thinking, planning, motor skills, spatial abilities, organization, social understanding and judgment, and common sense. IQ scores are often (but not always) associated with these assessments. IQ scores show a child’s intellectual ability compared to other children their age. IQ scores are more stable for older children than for younger children and change from childhood to adulthood. Many factors may contribute to IQ, so it is important to take them for what they are and to not make more of them than what they are. IQ and academic achievement are highly correlated, but success in life is not as highly correlated with high IQs, and many researchers believe that success may relate more to social-emotional intelligence than to IQ. An IQ score can be very helpful though in determining a child’s ability to do well in a mainstream classroom. Here is a breakdown of IQ scores, the classification, and the percent included (this is taken from a table in the book THE SPECIAL EDUCATOR’S BOOK OF LISTS: 2nd EDITION by Roger Pierangelo, PhD (Wiley Publishers) on page 219) (great book, btw, I highly recommend it!):
IQ Range Classification % Included
130 and over Very superior 2.2
120-129 Superior 6.7
110-119 High Average 16.1
90-109 Average 50.0
80-89 Low Average 16.1
70-79 Borderline 6.7
69 and below Intellectually deficient 2.2
Some of the most commonly used intelligence assessments include (list from the above referenced book - click on the link above to order the book from Amazon) (the book also gives a nice review of what is included in each of these assessments and the authors insights regarding benefits and weaknesses of each assessment):
1) The Wechsler Scales of Intelligence (WPPSI for Preschool; WISC for school age; WAIS for adults)
2) The Stanford Binet
3) Kaufman Assessment Battery for Children (K-ABC)
4) Kaufman Brief Intelligence Test (KBIT)
5) Columbia Mental Maturity Scale (CMMS)
6) McCarthy Scales of Children’s Abilities
7) Slosson Intelligence Test
8) Comprehension Test of Nonverbal Intelligence (CTONI)
9) Woodcock-Johnson Test of Cognitive Ability (WJ)
10) Brigance Diagnostic Inventory of Basic Skills
11) Kaufman Test of Educational Achievement (KTEA)
12) Peabody Individual Achievement Test (PIAT)
13) Wechsler Individual Achievement Test (WIAT)
14) Wide Range Achievement Test (WRAT)
15) Woodcock-Johnson Tests of Achievement
There are a few other measures that I have come across when working in schools and clinics that were not listed in the book:
16) The Leiter Non-Verbal Intelligence Scale
17) Developmental Profile 3 (DP-3)
18) Developmental Assessment of Young Children (DAYC)
19) Reynolds Intellectual Assessment Scales (RIAS)
20) Universal Nonverbal Intelligence Test (UNIT)
21) The Assessment of Basic Language and Learning Skills (ABLLS)
Reading Assessments: These assessments are excellent for determining a child’s grade level for reading and identifying strengths and limitations for program planning.
1) Gates-MacGinitie Silent Reading Test (GMRT)
2) Gray Oral Reading Test (GORT)
3) Durrell Analysis of Reading Difficulty (DARD)
4) Gates-McKillop-Horowitz Diagnostic Reading Tests
5) Gilmore Oral Reading Test
6) Slosson Oral Reading Test (SORT)
7) Spache Diagnostic Reading Scales
8) Woodcock Reading Mastery Tests (WRMT)
9) Test of Reading Comprehension (TORC)
10) Nelson-Denny Reading Test (NDRT)
Written Language: These assessments refer to the child’s ability to put their thoughts down on paper and includes the motor act of handwriting and the cognitive ability to put thoughts into writing.
1) Picture Story Language Test (PSLT)
2) Test of Early Written Language (TEWL)
3) Test of Written Language (TOWL)
Math: These tests measure the child’s abilities to solve problems, interpret results, and apply math skills.
1) Key Math Diagnostic Arithmetic Test (KEY MATH)
2) Test of Early Mathematics Ability (TEMA)
3) Test of Mathematical Abilities (TOMA)
Problem Behaviors: These tests are used to assess the level of problem behaviors exhibited by a child and to measure progress from interventions targeted at reducing these behaviors.
1) Behavioral Observations (this is the most commonly used measure - often done through a Functional Behavioral Analysis (FBA) on a specific behavior problem)
2) Interview Methods are often used to supplement behavioral observations and help the behavior analyst or psychologist get a better understanding of the environment and possible behavioral triggers surround a particular behavior - can also be used to diagnosis
3) Psychological Tests are administered by the school psychologist and are used to properly place the child in an appropriate classroom and to identify issues to work on with the child in his IEP. These can include projective drawing, apperception tests, sentence completion tests, and rating scales.
Adaptive Behaviors are the life skills needed for the child to function in school, home, and in the community. These include things like communication, health, safety, self-care, leisure, work, social understanding, fine and gross motor, functional academics, and community knowledge. Here are some popular assessments (also from book referenced above):
1) AAMR Adaptive Behavior Scale - Residential and Community
2) AAMR Adaptive Behavior Scale - School
3) Adaptive Behavior Evaluation Scale (ABES)
4) Vineland Adaptive Behavior Scale (VABS)
Visual and Auditory Perception: These are extremely important measures for children who may have difficulty responding to the teaching materials typically available in classrooms and to qualify children for assistive technology or other tools to help give them access to the teaching materials. These are typically administered by an occupational or speech therapist.
1) Developmental Test of Visual-Motor Integration (VMI)
2) Test of Gross-Motor Development (TGMD)
3) Bender Visual-Motor Gestalt Test (BVMGT)
4) Developmental Test of Visual Perception (DTVP)
5) Motor-Free Visual Perceptual Test (MVPT)
6) Goldman-Fristoe-Woodcock Test of Auditory Discrimination
7) Test of Auditory Perceptual Skills (TAPS)
8) Wepman Test of Auditory Discrimination (ADT)
9) Detroit Tests of Learning Aptitudes (DTLA)
10) Slingerland Screening Tests for Identifying Children with Specific Language Disability
Early Childhood Assessments are developed specifically for children under the age of 5 years (often used with a new diagnosis).
1) Bayley Scales of Infant Development
2) Preschool Language Scale (PLS)
3) Metropolitan Readiness Tests (MRT)
4) Boehm Test of Basic Concepts (BTBC)
5) Bracken Basic Concept Scale (BBCS)
6) Preschool Evaluation Scale (PES)
7) Kindergarten Readiness Tests (KRT)
8) Batelle Developmental Inventory (BDI)
9) Communication and Symbolic Behaviors Scale (CSBS)
10) Mullen Scales of Early Learning
Motor skills are often assessed to identify the need for an occupational therapist and to develop specific programs to help children with motor skill difficulties. Gross motor skills include those that require larger movements (e.g. running, dancing, balance, etc.) and fine motor skills include those require more finger movements (e.g. writing, cutting, musical instruments, etc.). Here are some assessments that are often used (from the book):
1) Milani-Comparetti Motor Development Test
2) Miller Assessment for Preschoolers (MAP)
3) Quick Neurological Screening Test (QNST)
4) Sensory Integration and Praxis Test (SIPT)
5) Purdue Perceptual Motor Survey (PPM)
Autism/Asperger Severity measurements are used to make an initial diagnosis, but area also used to confirm the child’s diagnosis at various points in their development. Here are some of the measurements that I have used personally in my research, clinical, and education work:
1) Childhood Autism Rating Scale (CARS)
2) Gilliam Autism Rating Scale (GARS)
3) Gilliam Asperger’s Disorder Scale (GADS)
4) Autism Diagnostic Observation Scale (ADOS)
5) Autism Diagnostic Interview (ADI)
6) Modified Checklist for Autism in Toddlers (M-CHAT)
7) Asperger Syndrome Diagnostic Scales (ASDS)
8) Autism Screening Instrument for Educational Planning
9) Differential Assessment of Autism and Other Developmental Disorders
10) Pervasive Developmental Disorders Screening Test
There are also a great deal of language assessments that are administered to identify speech, language disorders, and to identify speech-language and behavioral services that might be needed to help the child advance in their language and communication. These assessments are extremely common with children who have an ASD diagnosis. I am not a speech therapist, and this list is by no means comprehensive, but here are some of the language measurements that I have used or seen used by speech therapists:
1) Peabody Picture Vocabulary Test
2) Peabody Expressive Vocabulary Test
3) Receptive One-Word Vocabulary Test
4) Expressive One-Word Vocabulary Test
5) Assessment of Sound Awareness and Production (ASAP)
6) Hodson Computerized Analysis of Phonological Patterns (HCAPP)
7) Language Proficiency Test (LPT)
8) Lindamood Auditory Comprehension Test
9) Oral and Written Language Scales (OWLS)
10) Test for Auditory Comprehension of Language (TACL)
11) Test of Pragmatic Language (TOPL)
12) Woodcock Language Proficiency Battery
13) Boehm 3- Preschool
14) Boehm Test of Basic Concepts
15) Clinical Evaluation of Language Fundamentals (CELF)
16) MacArthur Communication Development Inventories
17) Preschool Language Scale
18) Reynell Developmental Language Scales
19) Test of Early Language Development (TELD)
20) Test of Narrative Language (TNL)
21) Utah Test of Language Development
There are not a great deal of assessments for testing social skills, but there are a few that I think are great to use with children with ASD:
1) Social Communication Questionnaire (SCQ)
2) Social Responsiveness Scale (SRS)
3) Social Skills Rating System (SSRS)
4) Social-Communication, Emotional Regulation, Transactional Supports Assessments (SCERTS)
There you have it, a not so brief overview of assessment in special education. If anyone knows of other assessments that they use in their professional work, or that have been used on their children, please share, particularly if you find that one has really helped you. I am currently looking for good measurements for social skills, if you know of some, please let me know!
Happy New Year Everyone!!!
Posted in General Thoughts, Resources | 2 Comments »
Thursday, January 8th, 2009
How do you know your IEP is a good one? It’s simple, it’s on the child’s table, wrinkled, splattered with juice, it’s dog-eared with turned up corners and is coffee stained throughout it’s many pages. These are the signs of hard work, daily lesson planning, ongoing documentation and evaluation, individualized instruction, effective and meaningful goals, dedicated teachers… And well, let’s face it, it’s what every parent wants for their child who’s participating in the special education programs in our public schools across the country.
An IEP is an Individual Education Plan, it is essentially a contract between the school and the parents of the child with special needs. An IEP shapes the child’s education and guides delivery of support and services while also providing a system of checks and balances for all of the people involved in the child’s program. Essentially the purpose of the IEP is to provide an individualized document that will structure and organize the programing for the child with autism or other special needs and will allow the entire team a way of determining if the student is making meaningful progress.
There is no doubt that the IEP is the most important document in Special Education. To create an effective and meaningful IEP, the parents, teachers, other school staff, and often other outside service professionals must come together and look closely at the child’s unique and individual needs. Each team member will contribute in some way their experience, knowledge, and committment to this particular child to design an educational plan that will allow the child, as much as possible, access to the general education curriculum while preparing the child for employment and independence to the greatest extent possible. Without fail, the design and implementation of each student’s IEP requires ongoing teamwork and careful communication among all IEP team members.
The team needs to work together to make a plan that is easily understood by all of the child’s IEP team members and the people who are involved in working with the child on a regular basis, this would include the parents, the paras, and the even the substitute teachers. Goals and objectives should be clearly outlined and include data collection procedures so that the team can objectively measure the child’s progress. The team needs to be careful to not write an IEP that is too complicated, long, overwhelming, limited, etc. for the people who are implementing it. The IEP should be as clear and as concise as possible. However, with it’s clarity and concise attributes, the IEP also needs to be as close to perfect as the team can possibly get it which does take a certain amount of time and detail. All parties coming to the table to meet for the child’s IEP need to come with an open mind and be ready to negotiate and compromise. Parents should know however, that if they are in disagreement about something that is suggested or written in the IEP, they need to speak up immediately and make sure their disagreement is noted.
Serving the entire spectrum of autism is not easy to do in one classroom, but teachers everywhere are up to the challenge as long as they have the support and teamwork required to do so. The individual needs of students on the spectrum are unique and can vary quite extensively from one child to another. It’s not uncommon to see a child’s IEP state that he or she will have SLP services 2 times a week, OT services for 20 mintues each week, attend adapted PE one hour a week, participate in small group social skills twice a week for 20 minutes, play therapy sessions throughout the school year, home visits each month, and positive behavior support planning throughout the year and across all settings. It’s also not uncommon to attend 10 IEP meetings in 2 years for the same child, while at the same time another child may only have 2 meetings across the entire preschool program. What really makes a difference is how involved the parents can and want to be and how supported and resourceful the school is in providing effective and accountable programs for the children in the special education programs.
Students with autism take the term “individualized” to the greatest extent imaginable. There is definitely no cookie cutter approach for designing an effective curriculum for a child with autism or any child with special needs. Clearly, assessment and ongoing evaluation are critical in understanding what the child can and cannot do. For the student with ASD, this likely means a great deal of time will be spent on the present levels of performance (PLOP) so that the team knows where the child currently is and what the next steps should look like for the child.
IEP Goal Recommendations for Teachers:
Lower functioning or younger children on the spectrum
- functional communication skills
- play skills
- social interaction skills
- adaptive behavior, daily living, or self help skills
- academic skills
- behavior support plans
Higher functioning or older students with autism or Asperger Syndrome
- social skills/friendship skills
- pragmatic language and conversation skills
- organizational skills
- academic skills
- indpendence skills
- employability and vocational skills
- self advocacy and determination skills
- behavior support plans
Behavior Intervention Plans (BIP) - sometimes a box on the IEP is checked if the student’s behavior is “impeding learning for self or others”. If this is checked off, then a separate document should be attached to the IEP and should lay out a very clear plan for dealing with challenging behavior. Below are the essential components to a BIP.
- description of the problem behavior
- position statement regarding the function of the behavior
- triggers, setting events, antecedents
- prevention strategies
- replacement behaviors
- proactive instructional strategies
- reactive consequence strategies
- safety plans
- long term prevention strategies
- re-evaluation and on-going monitoring plans and schedules
IEP Meeting Recommendations for Parents:
- have a copy of your child’s current IEP and current goals
- provide a list of your child’s strengths and weaknesses
- share goals you feel need to be addressed
- communicate clearly your ideas of what you want for your child
- ask for any test/assessment results before the meeting
- bring hard copies of any new information or outside evaluations
Know your rights
- read up on the current laws pertaining to what you are requesting of the school
- investigate law cases and bring copies to the meeting, if possible provide before the meeting
- read up on current research and recommendations published in peer reviewed journals and manuals, provide this information to your school team, they may not know!
Be an advocate for your child
- understand and articulate what you feel is important for your child
- if the IEP team says no to what you feel is a reasonable request, continue to work on it and take it one step further, continue until the team can reach an agreement
- nobody knows your child the way you do, work hard with your school team to create an equal partnership - you are the expert on your child, they are the expert on teaching, an equal partnership between parents and teachers is beneficial to the child in so many ways.
- as a last resort, when the IEP team just can’t find a way to come to an agreement on something you feel is very important, at least know ahead of time the process and further steps you can consider taking to ensure that your priorities for your child are not lost in the shuffle… starting with pre-mediation with an advocate, mediation, due process, etc.
Creating an equal partnership between parents and teachers is a critical component to developing a “good” IEP. As much time and energy that goes into writing the IEP should also go into building positive and receptive relationships between the home and the school. It is not a lot to ask that the teachers and the school administrators see the parents as an equal partner in this process and as an expert on autism and this particular student. There is nothing more discouraging for a parent than to come to their child’s IEP meeting and the IEP is already written, very little input from the parent was considered, and being told at the onset of the meeting that “we only have 50 minutes.” Likewise the parents should come to the meetings believing that the teachers have every best intention in providng effective instruction for their child and that the progress of that child is just as important to the teachers as it is to the parents. Every teacher runs into a situation where no matter what they do, it will never be enough. Excellent school to home communication prompted by the teachers is critical for facilitating active involvement of parents while at the same time it’s the parent’s job and responsibility in this partnership to become a knowledgeable advocate for their child.
Good IEPs, the ones that are dog-eared and coffee stained, are the ones that come from a delicate balance of parent and teacher involvement. Open lines of communication are critical in creating and managing this delicate balance. Parent and teacher partnerships are the key to a successful school year.
Posted in General Thoughts | 3 Comments »