The Autism Society Event and Education Recordings Archive

Many students with autism spectrum disorders (ASD) receive services from educators licensed in emotional disorders (ED). There is some question as to the efficacy of ED strategies in meeting the needs of the students with ASD and vice-versa. This session compares and contrasts evidence-based classroom strategies in the two areas. Most states do not have a teacher license or endorsement in the area of autism leaving many special teachers to struggle to meet the needs of a cross-categorical array of students on their caseload. Both students with Autism Spectrum Disorders (ASD) and Emotional Disorders (ED) are challenging to educate. Research indicates the problems typically demonstrated by youth with ASD are much different from students with ED. Both populations have complex needs but their needs are different. Practitioners in the field may be confused about the selection of effective versus questionable intervention strategies for either population. Serving students with ASD and ED successfully within their local schools requires consistent application of known best practices in academic instruction and behavior management. Prominent among reform efforts are the requirement for educators to adopt practices supported by research. This presentation will present issues and factors that relate to identifying and using evidence-based practices for both students with ASD and ED. This session will highlight ED and ASD teacher competencies necessary for educating students. The material presented in this session will contribute to improved practice in meeting the needs of students with ED and ASD.
Overview of Session
•         Federal Definitions
•         Characteristics
•         Evidence-Based Practices
•         Interventions
o       Universal strategies
o       Behavioral Intervention
o       Social Skills Intervention
Federal Definitions
ED
Need to have one or more of the following…
o        Inability to learn
o        An inability to build or maintain satisfactory interpersonal relationships with peers and teachers
o        Inappropriate types of behavior or feelings under normal circumstances
o        A general, pervasive mood of unhappiness or depression
o        A tendency to develop physical symptoms or fears associated with personal or school problems
ASD
“Autism” means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age 3, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences. The term does not apply if a child’s educational performance is adversely affected primarily because the child has an emotional disturbance.
Characteristics
ED

Inability to learn	Inability to build or maintain relationships	Inappropriate types of behaviors or feelings	Pervasive mood of unhappiness or depression	Physical symptoms or fears
•          Under achieve academically •          Comorbidity with learning disabilities •          Impact on all areas of learning, including academics, social, and vocational	•          Starts fights •          Disruptive •          Short temper •          Brags •          Steals •          Defiance •          Damages property •          Swears •          Becomes part of deviant peer group •          Walker, et al. (1995)	•          Reality distortion •          Hallucinations or delusions of grandeur •          Inappropriate laughter, crying sounds, or language •          Self-mutilation •          Developmentally inappropriate sexual acting out or inappropriate self-stimulation •          Rigid, ritualistic patterning •          Perseveration or obsession with specific objects •          Overly affectionate behaviors towards unfamiliar persons •          Physically or verbally abusive •          Impulsive or violent, destructive, or intimidating behavior •          Threatening behaviors or excessively antagonistic	•          Perfectionist •          Pervasive sad disposition •          Fails to express emotion •          Changes in eating or sleeping patterns	•          Tardiness •          Truancy •          Isolating self •          Physical symptoms; chronic headache, stomach-ache, etc.

ASD

(1) Social interaction	(2) Communication	(3) Restricted repetitive & stereotyped patterns of behavior, interests, & activities
•          marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction •          failure to develop peer relationships appropriate to developmental level •          a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people) •          (d) lack of social or emotional reciprocity	•          delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime) •          in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others •          stereotyped and repetitive use of language or idiosyncratic language •          (d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level	•          encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus •          apparently inflexible adherence to specific, nonfunctional routines or rituals •          stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements) •          (d) persistent preoccupation with parts of objects

Compare and Contrast

ASD	Both	ED
•         Developmental disability •         Communication Challenges •         Restricted repetitive & stereotyped patterns of behavior, interests & activities •         Sensory differences	•         Socialization •         Learning difficulties	•         Inappropriate types of behavior/ feelings •         Pervasive mood of unhappiness or depression •         Physical symptoms or fears

Evidence Based Practices
•         The use of interventions, strategies, and supports that have research documenting their effectiveness.
•         Practices that are informed by research in which the characteristics and consequence of environmental variables are empirically established and the relationship directly informs what a practitioner can do to produce a desired outcome.  Strain & Dunlap (2006) Center for Evidence-Based Practice.
ED Recommendations
•         Environmental supports
•         Ongoing program and student evaluation
•         Coordinated community support mechanisms
•         Effective parent and family involvement
•         Proven academic support system
•         Validated social skills instruction
•         Effective behavior management strategies
Simpson, 2007
ASD Recommendations
•         Functional spontaneous communication
•         Play skills
•         Functional academic skills
•         Cognitive development
•         Social skills
•         Proactive approaches to behavior
National Research Council, 2001
ED Evidence Based Practices
•         Teacher praise and reinforcement
•         Opportunities to respond during instruction
•         Positive behavior support
o       Functional behavioral assessment-based interventions
•         Self-management
•         Social skills instruction/teaching desired replacement behavior
•         School-wide PBS systems
Lewis, Hudson, Richter, and Johnson, 2004
ASD Evidence Based Practices
•         Behavioral Intervention Strategies
•         Computer-aided Instruction
•         Differential Reinforcement of Other/Alternative Behavior
•         Discrete Trial Training
•         Extinction
•         Functional Behavior Assessment
•         Functional Communication Training
•         Independent Work Systems
•         Naturalistic Interventions
•         Parent-Implemented Interventions
•         Peer-Mediated Instruction/Intervention
•         Pivotal Response Training
•         Positive Behavior Support
•         Response Interruption/Redirection
•         Self-Management
•         Social Narratives/Stories
•         Social Skills Training Groups
•         Speech Generating Devices
•         Stimulus Control/Environmental Modification
•         Video Modeling
•         Visual Supports
National Professional Development Center, 2008
Compare and Contrast

ASD	Both	ED
•         Communication •         Play Skills •         Cognitive Development	•         FBA •         PBS •         Social Skills •         Self Management •         Academic Skills	•         Praise

Interventions
Universal Strategies of Proven Classroom Effectiveness
•         Teachers should be aware of student characteristics.
•         Establish predictable schedule and routine.
•         Provide & teach clear expectations.
•         Monitor antecedents in the classroom.
•         Teach appropriate behaviors.
•         Teach self-regulatory skills and strategies.
•         Ensure correct curricular placement and instructional alignment.
•         Maintain brisk and enthusiastic pace of instruction.
•         Maintain high rate of student engagement.
•         Ensure high rates of correct student responses.
•         Regularly assess teacher/pupil performance.
•         Eliminate ineffective practices.
•         Give students choices.
•         Go to the problem to resolve it.
PBIS.org
Behavior Intervention
The behavior we observe provides many pieces to the puzzle, however it doesn’t give us the whole story. It’s just the tip of the iceberg. It’s easy to jump to conclusions and intervene based on what we experience. We need to closely exam the underlying issues that may be related to the challenging behavior.
Behavior Support Plan Components

Antecedent/setting event interventions	Alternative skill instruction	Responses to problem behavior	Long-term supports
•         Modify/eliminate problem antecedent and/or setting events •         Introduce positive antecedents/setting events	•         Teach general skills to expand overall competence •         Teach replacement skills that serve the same purpose as the problem behavior •         Teach coping and tolerance skills	•         Reduce outcomes for problem behavior •         Provide instructive feedback/introduce logical consequences •         Develop a crisis management plan	•         Make lifestyle changes •         Implement strategies to sustain support

Bambara and Kern, 2005
Functional Behavior Assessment

Antecedents	Behavior	Consequences
Events that occur before behavior	Behavior of concern	Events that occur after behavior

Underlying Characteristics: The underlying characteristics of the disability related to the behavior
ASD	ED
•         Communication Challenges •         Socialization Challenges •         Restricted repetitive and stereotyped patterns of behavior, interests, and activities •         Sensory Challenges	•         Academic challenges & learning disabilities •         Issues/side effects with medications •         Co morbidity with mental health disorders Environmental events in home •         Abuse & neglect •         Homelessness •         Parental mental health & substance abuse •         Trauma •         Media •         Risk factors associated with poverty

Example #1

Antecedents	Behavior		Consequences
Peer Talking	Student hits and kicks peer		Peers give student attention
Underlying Characteristics:
ASD		ED
Challenge Communication Teach how to communicate with peersIntervention:  Manipulate antecedents as necessary & teach alternatives.		Challenge: Aggression Teach appropriate way to gain attention Intervention:  Manipulate antecedents as necessary & teach alternatives.

Example #2

Antecedents	Behavior		Consequences
Loud classroom Math Worksheet	Student is disruptive & refuses to work		Teachers sends student out of room
Underlying Characteristics:
ASD		ED
Challenge: SensoryIntervention: Manipulate antecedents as necessary as the environment is too over stimulating for student to focus. May be reinforced by connecting work to special interests.		Challenge: Academic difficulty Intervention: Manipulate antecedents as necessary (example: adapt difficult assignment) & reinforce with praise & other reinforcement strategies for participating appropriately.

Example #3

Antecedents	Behavior		Consequences
Peer Laughing	Student is verbally aggressive to laughing peer		Peer gives student attention
Underlying Characteristics:
ASD		ED
Challenge:  Socialization Lacks theory of mindIntervention: Manipulate antecedents & teach perspective of laughing kid so they understand others motives.		Challenge: Impulsivity Intervention: Manipulate antecedents & teach to problem solve difficult situations or to ignore others through self-management.

Social Skills Intervention
Why is social competence important?
•         Predictive of job success in adulthood
•         Associated with better mental health
•         Associated with a decrease in problematic behavior
Classification of social skills
•         Acquisition challenges- lack know how
•         Performance challenges- have know how but don’t do
•         Fluency challenges -knows how and wants to but is awkward or unpolished or isn’t able to generalize skill
•         Competing behaviors- internalizing  and externalizing behaviors
Resource:  Walker, Ramsey, and Gresham, 2004
Goals of intervention

1. Promote social skills acquisition
   
2. Enhance skill performance
   
3. Facilitate generalization and maintenance of skills
   
4. Remove or reduce competing problem behaviors
   

Example #1

Peer Pressure: Several peers ask a student to put a tack on a chair and student does it.
Underlying Characteristics:
ASD	ED
Student lacks an understanding of others motives and can be easily taken advantage of/and bullied.	Student seeks to be part of and affiliated with a peer group.

Example #2

Student is angry about not being able to be the first person in line.
Underlying Characteristics:
ASD	ED
Acquisition Challenge Doesn’t Understanding feelings of others – doesn’t realize that everyone wants a turn at being first in line.	Performance Challenge Lacks skill to deal with feelings. Feels like it is not fair.

Example #3

Student has been taught in one-on-one setting to raise hand to ask for help appropriately but continues to blurt out when in classroom with peers.
Underlying Characteristics:
ASD	ED
Fluency challenges Knows how but isn’t able to generalize skill.	Competing behaviors Knows how and when to raise hand but blurting out is more reinforcing.

How to teach social skills
•         Identify Social Skill Deficits/Skills to Teach
•         Identify Acquisition, Performance, Fluency, or Generalization Deficits
•         Select Intervention
•         Implement Intervention
•         Assess and Modify Intervention as Necessary
•         Teach for Generalization
So…there is overlap and differences between the disability areas of ASD and ED in characteristics and in evidence based practices. What teachers need to make sure they are aware of when working with students with different needs within their classroom is the underlying issues and how these contribute to intervention choices. As teachers, our goal is to meet the individual needs of all of our students.

Learning Objectives: