It Takes a Team: 4 Steps to Building a Stronger Therapy Team

For students on the Autism spectrum, having a strong and reliable therapy team to support individual needs can be an important factor in student success. When members of a therapy team are collaborating seamlessly, a student is more likely to have high quality support across all areas of development (communication, social, cognitive, play, motor, and adaptive skills).

mixed working group looking at laptopThe pervasive nature of ASD across these areas means that multiple disciplines are necessarily involved in effective intervention (Donaldson and Stahmer, 2014). When we work together and have a narrow focus, we can help our students make a great deal of progress. Gone are the days of a Speech Language Pathologist, Physical Therapist or Occupational Therapist taking a student away for traditional pull out therapy and leaving no time for debriefing with the classroom team.

Who comprises the therapy team is determined on a case-by-case basis. You may be wondering where to start with this sometimes daunting task of building a strong and supportive team. Below I will discuss some strategies that are evidenced-based and the ways that I incorporate them into my busy life as a speech language pathologist.

Pairing
One of the first things that I always try to do is build rapport with staff, which is known as a behavioral principle called pairing. It is important to build rapport and/or pair with team members, especially if you are new to the team or if other new members have joined. It may sound like very basic advice, but as clinicians we are very busy and sometimes we feel that we do not have time for this piece. I am urging you to put this time with staff on the top of your priority list. Once you have a good rapport with team members, it allows you to share ideas and collaborate more easily and more effectively.

Sharing
The next tip I have is to share the goals your student is working on. If you are the teacher, share the student’s IEP goals with the paraprofessionals and explain why you are teaching particular tasks. Knowledge is power! If you are the occupational therapist, please share your student’s therapy goals with the team. Therapy takes place all day, across settings and across instructors. If the team does not know what the goals are, they will have no idea how to address them across the school day.

Reinforcement
Students and professionals benefit from reinforcement! People feel good about the work at hand when they receive positive reinforcement. Let the paraprofessional know that they are doing a great job with their student(s). Everyone likes to get praise for a job well done!

Data
Another way that we can assure that our collaboration is helping the student is by collecting daily data on skills from all domains (i.e. behavior, academic, communication). When we, as a team, create a data sheet that captures the skills and specific targets we are addressing, we can use this across the student’s day. When we take this data and analyze the progress, we can all make informed decisions about a student’s programming needs. I have included a free team-based daily data sheet from Stages Learning. You can use this data sheet to track a variety of skills.

In my 14 years practicing in the field, the majority of people that I encounter are driven by a desire to see their students. However, even with the best intentions, we may face barriers in collaborating with other staff members. Follow the tips mentioned above and reach out to colleagues who seem to need additional support. I try to continually assess the needs of the teams I work with throughout the year. Maybe the team needs a refresher on a certain skill area – see if you can work this into your yearly professional development time. When we work together as a team, we can help so many students achieve their goals!


ABOUT THE AUTHOR

rosemarie-griffin-headshotRosemarie Griffin, MA, CCC-SLP, BCBA is a licensed speech language pathologist and board certified behavior analyst. Currently she splits her time between a public school system and a private school for students with autism. She is passionate about lecturing on effective communication services for students with autism and has done so at the local and national level. Rosemarie also enjoys spending time with her family, playing the harp and shopping.

Article originally posted on Stages Learning Materials Blog.

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Medication Considerations

What do you do when your doctor recommends medication? In this month’s ASAT feature, Megan Atthowe, RN, MSN, BCBA, offers insight on a variety of approaches parents can take when medication is recommended for children exhibiting aggressive behaviors. To learn more about ASAT, please visit their website at www.asatonline.org. You can also sign up for ASAT’s free newsletter, Science in Autism Treatment, and like them on Facebook!


My son with autism has developed aggressive behavior, and his doctor is considering whether medication could help. What can I do to prepare for this conversation?
Answered by Megan Atthowe, RN, MSN, BCBA

doctor-563428_960_720First, you should know that there is no medication that specifically treats autism. Medications approved by the United States Food and Drug Administration (FDA) for other conditions can be useful only to lessen symptoms. That said, off-label use of pharmaceuticals is by no means unique to autism and is common practice for many health conditions. So while research on the use of particular psychotropic medications in the autistic population is growing, our body of knowledge is still limited. In addition, medications can and do affect every individual differently, and children can respond differently as they develop, so it is likely to take time to find the best medication at the appropriate dose. Medication management, in other words, is a complex and an ongoing process and one that is highly individualized. It is a good idea, then, to be prepared with the right information before every visit to your health care provider.

Do you know how often the aggression actually occurs? Bringing data like this to the visit can be very helpful. You may want to ask your son’s teachers to share any information they have about the aggression with your health care provider, too. (They would need your consent to talk with him/her or to share any confidential information such as behavior data.) If you have not been keeping track of the aggression, now is a good time to start, even if there are only a few days until your visit. An easy way to do this is to use a calendar. Record specifics about when the aggression happens, what the behavior is like, how long it lasts, and whether you have noticed any recent changes. It is difficult for anyone to recall these details accurately, especially if the behaviors happen frequently, so writing them down will help you to share the most meaningful information you can with your health care provider. If your son’s school team is not already collecting data, perhaps they should start as well.

In addition to information about the current levels of the behavior, be prepared to describe how the school and your family are addressing the behavior and how long that plan has been in place. Has your son’s team considered or tried Applied Behavior Analysis (ABA) to treat the behavior? Research supports ABA as an effective intervention for decreasing problem behaviors such as aggression as well as for teaching children with autism new skills. It is important to be sure that a qualified behavior analyst is supervising any ABA interventions, as they must be implemented correctly to be effective. Your health care provider may be able to refer you to a local ABA provider, or you can find a list of board certified behavior analysts at the Behavior Analysis Certification Board’s website.

Before your visit, prepare a list of the names and doses of any medications your son takes, as well as any over-the-counter medications, vitamins, or other supplements. If your son receives other therapies, share what they are with your health care provider. He or she will want to ensure that any new medication is safe to take and will not interact with other medications.

If you and your health care provider decide to start your son on a medication, decide what the goal is. How will you know when the medication has been effective? How will you know if it is ineffective? Be specific and write the goal down. Schedule a date when you will check in with your health care provider on your son’s progress. He or she may have specific suggestions about what type of data to keep.
Finally, there are some important questions that you should have the answers to before you leave. Make sure that you ask any questions you have—a responsible health care provider will want to know that you understand how to use the new medication correctly. If you think of questions later, do not hesitate to call and ask your physician, nurse, or pharmacist.

Key Questions:

  • What is the name of the medication?
  • What is the medication used for?
  • When and how should I give it to my son, and how much do I give?
  • Should I give this medication with food?
  • What effects should I expect to see?
  • What are common side effects?
  • How long will it be until I notice the desired effects and side effects
  • What side effects are serious, and what should I do if I notice them?
  • Will side effects lessen over time?
  • Is there anything I should avoid giving my son while he is on this medication?
  • If I decide that I would like to stop giving him the medication, what should I do?
  • What should I do if I miss a dose?

Please note that there is information about research related to medications elsewhere on the ASAT website.

ABOUT THE AUTHOR

Megan Atthowe, MSN, RN, BCBA, LBA, is a registered nurse and behavior analyst who has worked with people with autism and other special needs in educational, home, and healthcare settings for over 15 years. Currently she consults to educational teams who serve students with autism in public schools.

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Tip of the Week: Teaching Language—Focus on the Stage, Not the Age

CHILD IN SPEECH THERAPYTeaching language skills is one of the most frequent needs for children with autism, but also one of the most misunderstood skillsets amongst both parents and practitioners. The desire to hear your learner speak in full sentences can be overwhelming, making it especially difficult to take a step back and consider what it means to communicate and how communication skills develop in neurotypical children. Many times we get hung up on what a child should be capable of communicating at a certain age, rather than focusing on what they are capable of communicating at this stage of development.

Many practitioners and curricula utilize Brown’s Stages of Language Development.* Brown described the first five stages of language development in terms of the child’s “mean length of utterance” (or MLU) as well as the structure of their utterances.

Brown_Grammatical_Structures_ChartFrom aacinstitute.org

 

Sometimes it is necessary to compare a child to his or her same-age peers in order to receive services or measure progress, but it can be detrimental to focus on what a child should be doing at a specific age instead of supporting them and reinforcing them for progress within their current stage.

Research has suggested that teaching beyond the child’s current stage results in errors, lack of comprehension, and difficulty with retention. Here are some common errors you may have witnessed:

  • The child learns the phrase “I want _____ please.” This phrase is fine for “I want juice, please” or “I want Brobee, please,” but it loses meaning when overgeneralized to “I want jump, please” or “I want play, please.” It’s better to allow your learner to acquire hundreds of 1-2 word mands (or requests) before expecting them to speak in simple noun+verb mands.
  • The child learns to imitate only when the word “say” is used. Then the child makes statements such as “say how are you today,” as a greeting or “say I’m sorry,” when they bump into someone accidentally. Here, the child clearly has some understanding of when the phrases should be used without understanding the meanings of the individual words within each phrase.
  • The child learns easily overgeneralized words such as “more.” This is useful at times, but the child can start using it for everything. Instead of saying “cookie” he’ll say “more.” Instead of saying “train,” he’ll say “more.” And he may say “more” when the desired item is not present, leaving the caregiver frustrated as he/she tries to guess what the child is requesting. Moreover, as language begins to develop, he may misuse it by saying things such as “more up, please.”
  • The child learns to say “Hello, how are you today?” upon seeing a person entering a room. A child comes into the classroom and the learner looks up, says “Hello, how are you today?” The child responds, “Great! Look at the cool sticker I got!” Your learner then doesn’t respond at all, or may say “fine,” as he has practiced conversations of greeting.

These are only a few of the common language errors you may see. While you may want your learner to speak in longer sentences, your goal should be to have them communicate effectively. With this goal in mind, it becomes essential to support them at their current stage, which means it’s essential to assess them and understand how to help them make progress.

This is why I always use the VB-MAPP to assess each child and make decisions about language instruction. I need to have a full understanding of how the learner is using language, and then move them through each stage in a clear progression. I may want the child to say “Hello, how are you today?” But when I teach them that, do they understand those individual words? Do they comprehend what today means as opposed to yesterday or tomorrow? Do they generalize the use of “how” to other questions?

As you make treatment decisions for your learner, think about their current stage and talk about how to support your child with both a Speech Language Pathologist and an ABA therapist.

*Brown, R. (1973). A first language: The early stages. London: George Allen & Unwin Ltd.

WRITTEN BY SAM BLANCO, MSED, BCBA
Sam is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently a PhD candidate in Applied Behavior Analysis at Endicott College. She is also a lecturer in the ABA program at The Sage Colleges.

 

 

Focus on Generalization and Maintenance

On more than one occasion, I’ve been in the situation that a student will only demonstrate a skill in my presence. And I’ve heard from other colleagues that they have had similar experiences. This is highly problematic. When it happens with one of my students, there is only one person I can blame: myself.  A skill that a student can only demonstrate in my presence is a pretty useless skill and does nothing to promote independence.

TeacherSo what do you do when you find yourself in this situation? You reteach, with a focus on generalization. This means that, from the very beginning, you are teaching with a wide variety of materials, varying your instructions, asking other adults to help teach the skill, and demonstrating its use in a variety of environments. Preparing activities takes more time on the front-end for the teacher, but saves a ton of time later because your student is more likely to actually master the skill. (Generalization, after all, does show true mastery.)

Hopefully, you don’t have to do this, though. Hopefully, you’ve focused on generalization from the first time you taught the skill. You may see generalization built into materials you already use, such as 300-Noun List at AVB press.

Another commonly cited issue teachers of children with autism encounter is failure to maintain a skill. In my mind, generalization and maintenance go hand-in-hand, in that they require you to plan ahead and consider how, when, and where you will practice acquired skills. Here are a few tips that may help you with maintenance of skills:

  • Create notecards of all mastered skills. During the course of a session, go through the notecards and set aside any missed questions or activities. You might need to do booster sessions on these. (This can also be an opportunity for extending generalization by presenting the questions with different materials, phrases, environments, or people.)
  • Set an alert on your phone to remind you to do a maintenance test two weeks, four weeks, and eight weeks after the student has mastered the skill.
  • Create a space on your data sheets for maintenance tasks to help you remember not only to build maintenance into your programs, but also to take data on maintenance.

Considering generalization and maintenance from the outset of any teaching procedure is incredibly important. Often, when working with students with special needs, we are working with students who are already one or more grade levels behind their typically developing peers. Failing to teach generalization and maintenance, then having to reteach, is a waste of your students’ time.

WRITTEN BY SAM BLANCO, MSED, BCBA

Sam is an ABA provider for students ages 3-15 in NYC. Working in education for twelve years with students with Autism Spectrum Disorders and other developmental delays, Sam utilizes strategies for achieving a multitude of academic, behavior, and social goals. Sam is currently a PhD candidate in Applied Behavior Analysis at Endicott College. She is also a lecturer in the ABA program at The Sage Colleges.

 

 

The Difference Between Saying A Child with Autism vs. Autistic Child

In the autism community, one of the most fiercely debated topics is how to refer to people on the spectrum. Here’s the difference between saying a child with autism vs. autistic child. While some prefer the term ‘people with autism’, others lean towards ‘autistic person’. Then there are those who remain indifferent, and prefer to take a tomato [tomayto]; tomato [tomahto] view of things. More than simply conveying meaning, words convey sentiment and ultimately shape how people are perceived.

A Child with Autism vs. Autistic Child

As a parent and someone whose life has been impacted by autism, you’re likely to have your own thoughts on the topic. The way you refer to your child, as either a child with autism or an autistic child, says something about how you see your child’s condition. 

Unpacking the term a ‘child with autism’

Autism is not something which defines our special children. This is the same thinking that would be applied when describing someone with any other illness or disability. A good example is when referring to a cancer sufferer, you’d say ‘someone with cancer’. This acknowledges that the person is more than their illness, and places emphasis on the fact that first and foremost they’re a person.

The well known autism blogger Autism Daddy had this to say on why he tends to use the terminology ‘child with autism’: “Anyway, the same way you say “she has cancer” I say “Kyle has autism”. It doesn’t define him as a person, it’s just something that he has and he has to live with and fight…the same way you fight cancer.”

Another important idea which this term conveys is that autism is merely one trait which makes up who a child is. It highlights the fact that there are many other facets and intricacies which make up a special child’s personality. Another parent blogger explains the significance of not focusing solely on your child’s autism: “I have a son with autism, twinkling green eyes, long brown hair, the cutest smile, an infectious laugh, and an apparent lifelong obsession for the freakin Wiggles. Not an autistic son.”

Unpacking the term an ‘autistic child’

The term ‘autistic child’ conveys the idea that autism is an integral and defining part of who a child is. This isn’t necessarily a negative way of describing someone, it’s simply a different way of perceiving the condition. The important distinction is that a term like ‘autistic’ implies that the child would be completely different if not for autism. In other words, autism makes a child who they are. Some also argue that this term is perhaps more reflective of reality as unlike an illness, autism will always be part of who this child is. And in that way, autism does make special children who they are.

Alex Lowery wrote a compelling piece in which he explains why he identifies more closely with the term autistic: “Personally, I don’t see anything offensive about the term “autistic.” I use it quite frequently to describe others and myself on the spectrum… Why is it considered offensive to say someone is autistic? And why is it better to say that they “have” autism? To me, that kind of implies that autism is an illness that needs to be cured — which it isn’t.”

Like Lowery, some people on the spectrum find the term ‘people with autism’ offensive because they perceive autism as a part of who they are. Unlike an illness, autism isn’t something someone simply ‘has’ and can recover from. Autism is a lifelong battle; an indelible part of one’s identity and the way one sees the world. And for those who perceive autism in this way, ‘autistic’ conveys these ideas clearly.

What does the research say?

In 2015, a variety of people were surveyed – including those with the condition, family members and professionals – to get a better sense of the autism community’s preferences.  The survey clearly shows that there has been a shift towards language which in some way identifies autism as an integral part of a person’s identity.

All those surveyed identified with terms like ‘on the autism spectrum’ and ‘Asperger syndrome’. However, a significant distinction can be found when it comes to terms like ‘autistic’ and ‘Aspie’. According to the survey, those with the condition prefer identity-first terminology like ‘autistic’ while family members didn’t.  The survey also found that terms like ‘low functioning’ and ‘classic autism’ are strongly disliked by most people surveyed.

What can we learn from all this?

It’s important to be aware of the language used to describe autism, and to take into account the preferences of those with the condition. But perhaps the biggest takeaway is that just as perceptions about autism are continually evolving and changing so too is language. We all need to be aware of this, and to accept that there isn’t such as thing as a correct way to describe autism. It’s largely a matter of personal preference.

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Why All Parents Should Use Token Economies

Why All Parents Should Use Token Economies

As parents, we want our kids to want to have good behavior. They should want to behave because it’s the right thing to do, right? Yeah right. This is why all parents should use token economies.

Have you met a 3 year old with an innate desire to good for this world? It’s in there somewhere but at age 3, it’s more like threenager-ville. Little humans do what gets them what they want. They behavior in a certain way to achieve a certain outcome.

A threenager is likely to tantrum to get access to their favorite toy, TV show, candy, a left shoe they can see on the other side of the room — you name it. They are acting a certain way (tantrum) to achieve a certain outcome (getting whatever they want).

What can we do about this? Is there any way to teach them to behave?! Well, we can make sure they get what they want not by having a tantrum, but by engaging in desired behaviors.

We can use positive reinforcement in a more structured and specific way than just handing out praise and rewards willy-nilly.

The definition of a token economy is: a behavior change system consisting of three major components: (a) a specified list of target behaviors; (b) tokens or points that participants receive for emitting the target behaviors; and (c) a menu of backup reinforcer items.

Token economies can possibly take the form of sticker charts, chore charts, marble jars, etc. You need a physical token that your child can earn when they engage in the desired behavior. You do NOT need to go out and spend $50 at the nearest school supply store making a big fancy chart. You can draw 5 circles on a piece of paper. When they do the desired behavior, draw a check mark in the circle. Done. Grab that piece of junk mail off the kitchen counter and a half-eaten, I mean half-broken, crayon.

The next step is to define the behaviors. Again, you don’t need a big fancy dictionary. Just pick one to three behaviors that will earn the tokens. You need your Little to understand this so it can’t be a big grown up idea like ‘being responsible’ or ‘showing respect’. What does that mean to a Little? Be specific. You earn a token for: (1) following instructions without yelling; (2) eating 5 bites of every food Mom puts in front of you; and (3) putting on your shoes when instructed to.

Pick your battles. You may have a list of 20+ things your Little could stand to improve. I’m pretty sure I have a list of 20+ things to put myself on a token economy. Let’s prioritize and make it understandable by the kiddo.

Lastly — what can they earn with these tokens? You can give choices before earning and they can decide at the beginning or at the end. You can make a fancy menu of reinforcers — Chuck E Cheese is the perfect example of this. This many tickets = this super awesome toy.

Or, you can just say: get all the stickers, get 5 check marks, get 10 marbles and earn a fun activity. You can pick from: extra screen time, trip to the library, a new toy from the dollar spot, etc.

All of that in short form:

  1. Pick 1-3 behaviors and make sure your Little understands what they are.
  2. Have an actual token they can earn and set a goal.
  3. Provide the reward when they reach that goal. Make it a big deal!

Tips:

  • When you first start out, set the goal low. If it’s too hard to achieve, that won’t motivate anyone, especially a Little who is struggling with those behaviors to begin with.
  • Over time, raise the goal. Make the reward bigger for a bigger goal, smaller for a smaller goal. Play with it to see what is successful for your Little and doable for you in your busy day.
  • Make every token earned a big deal — lots of praise and excitement.
  • Don’t spend a lot of time and money setting up a fancy system. Like all things we do as parents — as soon as we get a good system down, our Little changes things up on us and we have to be flexible. My own daughter sees a strip of printer paper and thinks I’ve made her a new sticker chart. That’s how fancy sticker charts are at my house!
  • Be creative!
    • My aunt gave this idea from her life: She had a picture of a poodle and her daughter glued cotton balls on it. When she filled the picture, they actually got the poodle!
    • My sister let her oldest pick out his marbles for a marble jar on a special shopping trip to the craft store (less than $5 — don’t go overboard, folks!). That helped him buy into the process form the get go.
    • Cut up a picture of the prize like a puzzle. They get a puzzle piece as a token. The finished puzzle earns the prize!
    • Look in the app store. Seriously — there are many apps for reward charts.
    • Google ‘behavior chart’. You’ll find a gazillion cute templates if that’s what you’re into — cutesy.
    • I once made a necklace for a student who was really into jewelry. It was a laminated sticker chart necklace and she loved it.

One last thought: Someday you will find that things are going well and the token economy goes by the wayside. Remember it when a new problem behavior crops up and you are once again at your wit’s end. Start over. Pick new behaviors, new rewards, same system.

Don’t take my word for it — this is just the tip of the iceberg in behavior analytic research supporting token economies.

If you’re not a crafty person, you can always check out our reward chart here

Citations:
Cooper, J., Heron, T., & Heward, W. (2007). Basic Concepts. In Applied Behavior Analysis(2nd ed., pp 560-567). Columbus: Pearson.

Kazdin, A. E. (Ed.). (1977). The token economy: A review and evaluation. Plenum Publishing Corporation.

Kazdin, A. E. (1982). The token economy: A decade later. Journal of Applied Behavior Analysis15(3), 431-445.

Skinner, B. F., Ferster, C. B., & Ferster, C. B. (1997). Schedules of reinforcement. Massachusetts: Copley Publishing Group.

Reitman, D., Murphy, M. A., Hupp, S. D., & O’Callaghan, P. M. (2004). Behavior change and perceptions of change: Evaluating the effectiveness of a token economy. Child & Family Behavior Therapy26(2), 17-36.


Leanne Page, M.Ed, BCBA
 has worked with kids with disabilities and their parents in a variety of settings for over 10 years. She has taught special education classes from kindergarden-grade 12, from self-contained to inclusion. Leanne has also managed a center providing ABA services to children in 1:1 and small group settings. She has extensive experience in school and teacher training, therapist training, parent training, and providing direct services to children and families in a center-based or in-home therapy setting. Since becoming a mom, Leanne has a new mission to share behavior analytic practices with a population she knows needs it- all moms of littles! Leanne does through her site parentingwithaba.org and through her book ‘Parenting with Science: Behavior Analysis Saves Mom’s Sanity”.  You can contact her at lpagebcba@gmail.com.

To All Autism Parents

This is for all autism parents who’ve once heard “your child has autism.”

This comment from my experiences has came with different emotions for different people. Sadness of the uncertainty…Happiness about finally knowing what the diagnosis was… And often a neutral look where I cannot see any expression.

To All Autism Parents

Over the years I’ve been contacted by thousands of parents asking for advice about their child’s autism diagnosis based on my experiences navigating the world growing up on the autism spectrum. During those times there have been many of these emotions I’ve seen from parent.

I was thinking about this recently when a mom reached out to me online telling me that her child was just diagnosed with autism. I asked her some preliminary questions such as “When were they diagnosed” and the follow up hit me when she said “my 2-year-old was diagnosed with autism today.”

This was one of the first times I ever talked to a parent the actual day of their child’s diagnosis. She told me more about how she was feeling right now. How her heart was breaking for her child. How she had seen signs for so long and how it had finally become confirmed.

Then she said I inspired her and I honestly didn’t know what to say. For her to contact me had left me at a loss for words. I took a few minutes to compose myself before following up. I than wrote this letter to the mom saying…

“Thank you for your kind words. Remember that you are never alone in this community and there are so many people who you can rely on. Many of them will have already walked similar roads to yours. Lean on these people. Listen to their stories and most importantly, cherish each and every single day that you have with your child. We are learning more about autism everyday to provide them with supports to see them progress.

I know today may have left you with so many different emotions. My parents had those same feelings when I was diagnosed with autism when I was 4. But my parents were able to get through that day and so will you. You will become a champion for your child and their greatest advocate they will ever have. I wish you nothing but the best for you and your child in the future.

Your friend, Kerry 

 

She followed up hours later with gratitude and saying that she would look into the Tool Kit. To this day I’ve been thankful to this mom for sharing her story with me. Stories like hers is why I’m an advocate today. For those other parents out there whose child is diagnosed I hope this message I shared will be helpful for you as well. If I can ever be a resource you can message me on my Facebook Fan Page here.

My hope by sharing my successes and challenges on the spectrum is that I can provide our community with resources that they can use to help their children. That’s one of my hopes that won’t be changing anytime soon.

Kerry Magro is an award winning national speaker and best-selling author. Kerry has become a rolemodel in the disabled community. Non-verbal at 2.5 and diagnosed with autism at 4, Kerry has overcame countless obstacles to get to where he is today. A recent Masters graduate from Seton Hall University, he currently is CEO and Founder of KFM Making a Difference, a non-profit corporation focused on disability advocacy and housing.

 Today Kerry travels the country sharing his story and telling our society to define their lives and their dreams in the best way they can. Of his highlights include publishing 2 best-selling books (Defining Autism From The Heart and Autism and Falling in Love) and working on the 2012 Motion Picture Joyful Noise. Kerry currently resides in New Jersey and works in New York as the Social Media Coordinator for Autism Speaks.

Educating for Inclusion

I am a special education teacher interested in learning more about educating for inclusion. How can I set up my small groups to target skills that will serve my students well in the classroom?  

Answered by Renita Paranjape, M.Ed., BCBA, Director, Intake, IBI and Group and Transition Services, Geneva Centre for Autism

Presenting a special guest post by Renita Paranjape from ASAT.  

Preparing students for group instruction in inclusion classrooms requires careful consideration of the responses required in that setting as well as the strengths and needs of the child with autism. What follows are some considerations that may ease the transition of students from one-to-one instruction to group-based instruction within inclusion classrooms.

Educating for Inclusion

Investigate the next setting

Take time to visit and observe group instruction in the inclusion classroom. There are a few questions to keep in mind when observing the inclusion setting, including:

  • What is the content of the group instruction?
  • How large are the groups?
  • How does the teacher engage the students (e.g., visual stimuli, choral responding)?
  • How long are the group activities?
  • How often are students required to respond during group?
  • Are there reinforcement systems in place within the group lessons?
  • What are the teacher’s general behavioral and learning expectations of the students during group instruction?

Once you have a clear idea of what transpires during group instruction, attempt to replicate, as closely as possible, the activities observed in the inclusion environment during small-group lessons.

Setting up the group

Here are some pointers for setting up group instruction:

  1. Group children according to their skill level so that those who require skill building in more foundational skills are grouped together, while the students with more advanced skills are placed together.
  2. Alternatively, you may want to consider mixing students by skill level, so that students with more advanced skills can serve as a model for students who require models of responses during the lesson.
  3. All students should have a clear view of the teacher and the instructional material, with distracting items kept to a minimum.
  4. One adult should be the “teacher,” delivering all instructions in front of the group and providing the reinforcers to the students.
  5. Position other adults behind the group to serve as “prompters” of responses. These adults should stand, not sit, behind the students, fading their proximity to the students as independence increases. These adults should only prompt if necessary, and the students should be expected to follow the instructions provided by the teacher who is leading the group.
  6. Have available the student’s individualized motivation system in view of the student. The teacher leading the lesson should provide the reinforcers to the students based on the student’s individualized program.
  7. The other adult or “prompter” can also record data on the responses of the learners during group instruction.
  8. The teacher of the group and the prompters should communicate regularly before and after the group lessons to identify roles and student goals. Discussion should not occur during the lesson.

Readiness skills for small group instruction

The following are a few examples of what learners may benefit from in order to participate in group instruction, but they are not necessarily prerequisites. Some of these goals require group instruction in order for the goals to be taught, whereas other goals can be introduced in smaller groups or in one-to-one instruction.

  1. Attending to the teacher with peers present. In most ABA programs, attending is one of the first foundational skills that is taught. This is accomplished either by teaching students to provide eye contact or teaching them to orient toward the communicative partner. Once this skill is established, the next step for group instruction would be to teach attending even when there are peers present and when the teacher is standing and moving around the classroom.
  2. Tolerating the presence of peers. Since small-group instruction requires the presence of other students, it is important to assess whether the student can sit alongside a peer without being distracted.
  3. Sitting for longer periods of time without frequent breaks. Group instruction will require the student to sit for longer periods of time. Collect baseline data on how long the student will sit appropriately before accessing a reinforcer; then systematically increase that time so that the student can sit for longer periods of time to earn access to a bigger reinforcer (e.g., recess).
  4. Remaining on task for longer periods of time. This may seem similar to number 3 above, but it is not only important to consider how long your students can sit appropriately, but also how long your students will work efficiently before becoming off task and or requiring breaks. In small group settings, students are typically required to complete independent seatwork for upwards of 15 minutes or more. As a readiness skill, assess how long your students can remain on task and systematically increase how long they are required to work independently.
  5. Preparing the student for thinner schedules of reinforcement. Consider your students’ current schedule of reinforcement and develop a plan to thin that schedule. This would apply primarily to appropriate behaviour, such as attending and sitting appropriately, as correct responses in group would likely be reinforced on a continuous schedule initially.
  6. Responding to name and following distal instructions. Can your students respond to their names from varying distances and in different contexts? Can they follow directions given from afar? In addition to being able respond to their name in a classroom setting, students must also learn to not respond in certain situations. Distinguishing between, and responding to, instructions such as “everybody,” “[student’s name]” and “[other student’s name]” are key foundational skills for small-group instruction.
  7. Following complex instructions. Your students should not only be able to complete one-step directions (e.g., “Get a pencil”), and two-step directions (“Get a pencil and write your name”), but they should also be taught to follow even more complex directions (e.g., “Get a pencil, turn to page 5 of your workbook, and write your name at the top”).
  8. Waiting for attention and instructions. When a student makes the transition from one-to-one instruction to a group setting, the teacher’s focus is no longer solely on one student, but he or she is balancing his/her attention from one student to another. It is important to teach the student how to occupy his or her time without engaging in stereotypic, or other challenging behavior, as the teacher’s attention is diverted.
  9. Hand raising. Hand raising is a skill that requires attending, performing a gross motor action, inhibition of responding until cued by teacher, and discrimination of instructions. Initially, students can learn to raise their hands to access a preferred item with an embedded prompt in the instruction (e.g., “Raise your hand if you want candy!”). The instructions can then become increasingly more complex and students can learn to raise their hands to answer questions, to refrain from raising their hands when they are not able to answer a particular question, to request an item they might need for a task, and to volunteer to participate in an activity.
  10. Observational Learning. One of the benefits of small-group instruction is the abundance of opportunities to learn appropriate responses by attending to the responses of other members of the group. Often times, students with autism need explicit instruction in attending to the responses of others, in differentiating whether those responses were appropriate based on teacher feedback, and in being able to repeat those correct responses when directed by the teacher.
  11. Choral Responding. Another key response of small-group instruction is being able to say responses aloud and in unison with other students. For example, the teacher may say, “Everyone tell me what is two times two,” and all of the students would be expected to say, “Four.” This skill can first be introduced in one-to-one instruction.

Effective teaching strategies to include in small-group instruction

The research in small-group instruction has identified specific strategies that have been found to be particularly effective for learners to acquire skills in a group setting (e.g., Heward & Wood, 1989; Kamps et. al, 1991).

  1. Creating many opportunities for learners to respond: Given that the density of instructions will likely be less in a group situation than in a one-to-one teaching interaction, it is important to create as many opportunities as possible for your students to practice responding, and, in turn, acquire skills. Ensure that there are many instructions delivered for each student.
  2. Frequent rotation of materials: This is a necessary strategy to help alleviate boredom with the content of the curriculum, and it also helps to promote generalization of responding across various stimuli.
  3. Interspersing known targets with unknown targets: This strategy creates a momentum for responding fluently, provides the opportunity for reinforcement to occur, and also ensures that mastered targets are maintained.
  4. Choral responding: Having your students respond in unison is a useful strategy, and is important to target, because it occurs frequently in most general education settings. It is beneficial for learners, as it allows them to have more opportunities to respond, as well as allows them to be cued by their fellow classmates rather than their teacher.
  5. Random responding: Random responding refers to presenting instructions in an unpredictable format so that students are not aware of when they might be called upon. This method can improve attention and motivation, as students will not be able to predict when it is their turn to respond.
  6. Repeating peer responses: Requesting that students repeat the correct responses of their classmates can help further observational learning skills by requiring students to attend to and assimilate the responses of others.
  7. Student-to-student interaction: Another effective teaching strategy is to promote interaction among students. Specifically, students can learn to listen and repeat each other’s responses to general curriculum-related questions, ask peers to clarify if an instruction was missed, or ask peers for items needed for a task.

Small-group instruction can be a highly effective way to prepare students for less restrictive settings. With appropriate environmental manipulations, as well as effective teaching strategies, students who participate in group instruction can acquire skills needed for fuller inclusion.

References

Carnahan, C., Musti-Rao, S., & Bailey, J. (2009). Promoting active engagement in small group learning experiences for students with autism and significant learning needs. Education and Treatment of Children, 32(1), 37-61.

Harrower, J. K., & Dunlap, G. (2001). Including children with autism in general education classrooms: A review of effective strategies. Behavior Modification, 25(5), 762-784.

Heward, W. L., Gardner, R., Cavanaugh, R. A., Courson, F. H., Grossi, T. A., & Barbetta, P. M.(1996). Everyone participates in class: Using response cards to increase active student response. Teaching Exceptional Children, 28(2), 4-10.

Heward, W. L., & Wood, C. L. (2009). Let’s make some noise! Using choral responding to improve the effectiveness of group instruction. In W. L. Heward, Exceptional children: An introduction to special education (9th edition) (pp 158-159). Upper Saddle River, New Jersey: Merrill-Pearson Education.

Kamps, D. M., Walker, D., Dugan, E. P., Leonard, B. R., Thibadeau, S. F., Marshall, K., & Grossnickle, L. (1991). Small group instruction for school-aged students with autism and developmental disabilities. Focus on Autism and other Developmental Disabilities, 6(4), 1-18.

Ledford, J. R., Gast, D. L., Luscre, D., & Ayres, K. M. (2008). Observational and incidental learning by children with autism during small group instruction. Journal of Autism and Developmental Disorders, 86-103.

Rotholz, D. A. (1990). Current considerations on the use of one-to-one instruction with autistic students: Review and recommendations. Focus on Autism and other Developmental Disabilities, 5(3), 1-5.

 

Renita Paranjape, MEd, BCBA, is a Board Member of ASAT. Renita joined the ASAT Board of Directors in 2015. Prior to serving as a Board Member, Renita served as ASAT’s Social Media Coordinator. Renita received her Master’s degree in Developmental Psychology and Education from the University of Toronto, and completed courses in Behavior Analysis from the University of North Texas, in 2009. Since 2002, Renita has worked in the fields of ABA and ASD in several capacities, including supervising an ABA program in a private school, supervising ASD consultants in public schools, and managing an ABA program in group homes serving adults with severe behavior disorders. In her current role, Renita has been fulfilling the role of Director of Intake, IBI Services, and Group and Transition Services at Geneva Centre for Autism in Toronto. Renita is passionate about the dissemination of science based treatments for autism, and working with families to access those resources.