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Dr. Chris’ Autism Journal
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Calling All IEP Participants… Some Tools for the Trade


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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-fileseared 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.

IEP cycleServing 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 spectrumteacher

  • 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:

Be preparedparents

  • 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.

parent teacher confCreating 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.

The Hidden Curriculum and Unwritten Social Rules


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photo_BrendaSmithMyles.jpgI attended the Geneva Centre for Autism conference last week and saw many interesting presentations and one that I found inspiring was a talk by Brenda Smith Myles.  She is the author of a book called The Hidden Curriculum: Practical Solutions for Understanding Rules in Social Situations.  There are a great deal of good books on autism and several with pracial information for intervention.  Few of these books, and few interventions, focus on what is not obvious but what might be extremely important. 

thomas and dash.jpg“The hidden curriculum refers to the set of rules or guidelines that are often not directly taught but are assumed to be known (Garnett, 1984; Hemmings, 2000; Jackson, 1968; Kanpol, 1989)” (from Brenda’s book on page 5).  This curriculum includes things like unspoken rules, slang, metaphors, body language, etc.  Most of us pick up on these things instinctively but it is often difficult for those with autism and other special needs to do this.   

In her talk, Brenda spoke of obscure social situations such as using087_040_Lara_Neighbor.jpg a public restroom or shower, using an elevator, and everyday conversations.  To many of us, these are situations that we have become accustomed to and we accept the social rules, even though we may not always think about them or discuss them.  She gives practical tips for teaching these hidden social rules to children and to adults and stresses the importance of making these a part of everyday life.

templeartpic.gifAnother good resource for learning about the hidden rules in social situations is a book that I have finally started reading by Dr. Temple Grandin and Sean Barron (click here for a very interesting podcast with Sean) called Unwritten Rules of Social Relationships: Decoding Social Mysteries Through the Unique Perspectives of Autism.  This insightful and intelligent book helps you see into the minds of people with Autism Spectrum Disorders and how they perceive these strange social situations and rules, and how they cope with these situations.  This book is helpful for professional, families, and those with a diagnosis themselves - fascinating book that I will probably recommend to many of my friends that are not in the field, it really demonstrates how different brains process information from various perspectives and that we can not take any knowledge for granted.000_51_Clark_reading.png

The only thing that is missing from this perspective is how to measure success, how to take data and assess what the child or adult has learned and what they have left to learn.  If anyone knows of a good hidden curriculum type of assessment or measurement, please post here, I would be very excited to take a look at something like that! 

B & E 3.JPGFrom looking at these 2 books and listenting to Brenda talk (and Temple on several occassions), I am reminded how important it is for us to look beyond the obvious in education.  This awareness of hidden information in our world can only advance the science of interventions and assist us with developing programs that result in real-world success.

Effectiveness = Accessibility + Implementation


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B and Trish.jpgI have been in many discussions lately about what makes an intervention effective and was asked the difficult question: How do you narrow it down to just 1 or 2 words?  This is very tough because effectiveness of intervention is dependent on many things including the scientific integrity, social validity, usability, motivation for students, funding and resources, etc.  The 2 things that I felt were critical for real effectiveness for children were accessibility and implementation. No matter how many papers are published on it, no matter how many professionals insist you do it, and no matter how much you think it will help your child, if you do not have quick accessibility to it and are not able to appropriately implement it, the intervention will not be effective.

So, what makes an intervention accessible or not? 100_0152.JPG First, if the intervention can ONLY be implemented by a particular person or agency, it is not accessible to most people.  Interventions should be readily available in various parts of the country (or even in other countries) and the intervention should be one that can be replicated easily by people not associated with the agency.  Second, an intervention should not require extensive amounts of training.  Training is necessary and critical for success for any intervention, but some of the popular treatments require time-consuming and very expensive training programs in order to implement.  In addition, training sessions are not often available to many people who want it and waitlists for these trainings is way too common.  If you cannot get training, the intervention is not really accessible to you and so, obviously, it stj-158.jpgwon’t work.  The third barrier to accessibility is money.  If the intervention requires an immense amount of 1:1 time from a qualified professional, or requires a large amount of materials, it can get very costly and many people do not have access to these kinds of intervention.  If a parent or school cannot afford it and the government or insurance do not cover it, the intervention is not accessible to most people.  The final and perhaps biggest problem is lack of resources.  In an ideal situation where you have access to all of the above, you are most likely going to find yourself on long waiting list (which can be up to 2 years in some places).  This problem prevents many children from getting the necessary intervention that they need and is an even bigger problem in rural areas where there is a paucity of service providers.

If you do not experience problems with any of the000_86_Eric_catching.png above accessibility issues, you should consider yourself extremely fortunate.  However, you should always think about the quality of implementation.  I have seen many programs start out great and basically fall apart over time.  This is because of staff turnover, difficulty finding and training staff, and clinical drift (i.e. the therapist is either not keeping up with the science, losing interest, or in some way losing focus on moving the intervention forward).  Another common problem with implementation is that most children’s needs change as they develop.  Interventions should grow with the child or you should move on to something else when that intervention is no longer appropriate.  Another problem with implementation is keeping up with all of the materials, data collection, and reporting.  This is a huge burden on therapists, parents, and schools.

000_25_Abby_smiling2.pngReading this may make you feel a bit like there is not hope for a quality intervention, but there most certainly is hope!  Many clinics and school programs are well aware of these issues and are doing the necessary research and product development to help by increasing accessibility and developing plans for effective implementation over time.  Technology is one solution that may address many of these issues.  For instance, the use of video and the iJ computer.jpgnternet allows us to provide web-based training for providers.  This technology also allows for remote consultation for individual children.  Portable devices such as cell phones and iPods may allow for quicker access to video modeling, learning programs, and data collection and sharing.  Computers have opened the door to interventions that are not only accessible to most people, but that are also effective, motivating, and provide richer data and reports than other interventions.  The future of intervention must plan for accessibility and implementation, and technology may be the best road map for getting us there.

Meet Timo!


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timo.jpgTimo is a friendly animated tutor who helps children with autism, hearing impairments, developmental delays and other language problems to learn communication, conversation and reading in fun computer programs.  Animated Speech’s software is designed to give speech pathologists, educators and parents who work with these children an important new tool to build comprehension and vocabulary skills.

baldi.jpgThe initial concept for Timo was developed by Dr. Dom Massaro and Dr. Michael Cohen with a grant from the National Science Foundation.  Originally, Timo was called Baldi, and the once university lab project soon became a commercially available product.  Dan Feschbach, the company’s CEO, has grown the company and they now have 3 products available for varying levels of language learning. 

Team Up With Timo: Vocabulary teaches identification, comprehension, and expression of more than 650 woridScreenSection.jpgds including animals, human body, weather and much more.  The program offers pre and post tests for assessing progress and has 6 other levels of learning to teach the vocabulary.  The unique aspect of this program is Timo, who engages the child in conversation using the child’s own name!  The child’s voice can also be recorded so that the child’s parents and other team members can review it after the child’s session.  Rewards are given in response to correct answers and include a large variety of brief animations.  This program has many options for customization and is best for early language learners through about 4th grade vocabulary.

library.pngIf you are looking for more customization, ASC also offers Team Up With Timo: Lesson Creator.  In this program, teachers and professionals and create custom vocabulary and language lessons for the child to do on the computer.  You can use any pictures you want including the ones in the Timo vault, or upload your own.  This is an excellent way to build individualized, personalized lessons for your child.  index5_04.png

For older children or for children who have more language skills, they have Team Up With Timo: Stories, designed by Dr. Lauren Franke and Pamela Connors, speech-language experts.  This program teaches listening skills, comprehension, vocabulary, retelling stories, and reading skills.  Research has shown that being able to retell a story at age 4 is predictive of later success in school.  Storytelling also helps children participate in daily life with friends, family and school.  This program is based on research in language development and uses the Narrative-based language intervention (NBLI) approach that combines storytelling with skill-based activities.   

Timo products are available online and a free trial is provided.

 

 

Social Stories Research


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087_040_Lara_Neighbor.jpgAn interested blogger asked the following question and I think it is a great one, so I thought I would respond, and hopefully this will help her, and others:

Educational professionals often teach social skills using social stories in one:one situations, not realizing that these skills do not generalize to the playground, the classroom, the community, etc. Where is there additional research to validate this position?

It is true that educational professionals often use social stories and that the skills do not always generalize to natural settings.  This is actually true about many treatment approaches.  If generalization is not planned, it is likely that it will NOT happen!  This whome_pic1.jpghat we call the train and hope approach and it is pretty common to see that with social stories.  However, if used appropriately and well-planned, this approach can be effective, although it is not clear in the research how effective.

Most studies I have read have shown that social stories are pretty effective for teaching 000_55_Clark_petting.pngspecific concepts to children such as language, social skills, play, vocational, and self-help skills.  The majority of these studies show that the approach is effective, but they also tend to use the social stories in conjunction with other approaches (e.g. modeling, rehearsal, feedback, etc.).  I have not seen many studies that solely look at social stories and those that do tend to show that some children are successful, while others may not be.

The biggest issue with the social stories research is that data on maintenance and generalization are not always reported and when they are, they tend to have modest or no maintenance and generalization.

In clinical practice, I have seen social stories work, but again, they are typicallB & E.JPGy used in conjunction with other practices and generalization of the skills is specifically planned out.

Although there are a large number of studies on this approach, I have not been able to identify a randomized efficacy study or even a study using more than 3-4 children.  If anyone knows of a study like this, please let me know and I will post it here!

000_134_Going_Potty.pngIn sum, I would suggest that if social stories are used that the facilitators do the following 3 things to maximize their success:

1) Make them motivating!  You can do this by doing the social stories in PowerPoint or similar programs on the computer and adding in sound, music, etc. to keep it interesting for the child.  You can also incorporate things that the child likes into the social story to get them interested in it.  I once worked with a boy who loved music, particularly The Beatles.  He had some difficulties with his peers during lunchtime, so we opted to try social stories.  Initially, he hated them, but read them anyway and could answer all of the questions we asked him about the stories.  But alas, he did not generalize at all beatles1.gifto the actual lunch time experience.  Next, we made a PowerPoint slide and incorporated The Beatles music and even some cartoon pictures of the band from their old cartoon.  He found this very amusing and was very attentive.  He did not generalize this initially, but he started to tell his friends about the story.  So, we decided to have the boy sit down at the computer and show the slides to his classmates one at a time and then talk about the social story.  That seemed to work, not sure which part, but it did work, and the behavior was maintained for the rest of the school year.

2) Track Progress!  Often, social stories are just used without any data tracking system.  It is important to figure out what you are trying to change and to objectively measure it.  It is the only way you will know if it works.

000_108_Abby_pushing.png3) Plan for Generalization!  Don’t just wait for it to happen, figure out what your next steps will be to generalize the behavior.  Will you add more social stories?  Will you add more environments and situations?  Will you change the words or pictures to the stories?  Will you do the stories with different people? 

 

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