Tuesday, February 23, 2010

11 Autism Treatments That Really Work- Part II

Green Light to Three More Autism Treatments
I am including the next three treatments that earned the highest scores on the National Standards Report (2009, National Autism Center).     I will name each treatment, briefly describe it, and provide a hypothetical scenario of how the treatment could be implemented.  Treatments are listed in alphabetical order.  For the first three of the eleven established treatments, refer to the previous post at Teaching and Tech Tinkerings.

Joint Attention Interventions
-interventions that target sharing an experience about an object or event by pointing to show the object or event, showing items or activities to another person, and following another person's eye gaze

Alicia is a six year old with autism.  She is able to verbally ask for snacks she wants, but she does not yet point to items she is interested in.  Her mother is teaching her to choose her snack by pointing to show the one she wants. 

-demonstrating a desired behavior to the individual with autism through live or video modeling

Students in a middle school attend a social skills group in which they view videos of students modeling appropriate social behavior.

Naturalistic Teaching Strategies
-interventions in which the teacher mostly follows the child's direction to teach functional skills such as self-care, communication, and community skills in the natural environment (e.g. incidental teaching, embedded teaching)

Antonio, a kindergartener with autism, has a few favorite toys in the play center.  The speech therapist puts the toys out of Antonio's reach while playing with him and one of his classmates.  Antonio's classmate models how to verbally request the favorite items

Stay tuned to  Teaching and Tech Tinkerings of a Special Educator for the remaining 5 established treatments. 

Saturday, February 20, 2010

11 Autism Treatments That Really Work- Part I

The National Standards Report (2009) written by the National Autism Center, reviews studies on existing treatments for autism. The report categorizes treatments as “established,” “emerging,” or “unestablished.” The 11 established treatments are considered to be effective and beneficial to the individual with autism. The list below provides the name of each treatment, a brief description, and an example of how it may be implemented.  I have listed the interventions alphabetically.

Antecedent Package
-changing events that occur before a target behavior would typically occur.  The target behavior can be a behavior you want to see more or less of.  Examples include incorporating obsessional interests into activities, prompting, and errorless learning.

    Ellen is a seven-year-old first grader with Asperger’s Syndrome who frequently has tantrums when it is time for the class to begin a writing assignment. Given Ellen’s passion for locomatives, her teacher targets her behavior by encouraging Ellen to mark various locations she has visited via rail on a subway system map and bring in her photo collection of trains to serve as topics for her to write about.

Behavioral Package
-reducing challenging behaviors and introducing functional alternate behaviors (e.g. task analysis, token economy, discrete trial training, contingency contracting, chaining, shaping)

     Rashon, a nonverbal second grader with autism who enjoys music, hits himself in the head each time he ties his shoes incorrectly. The occupational therapist completes a task analysis in which she breaks down the skill of shoe-tying into its steps. She develops a plan for Rashon to experience the success of completing the shoe-typing task. That is, Rashon will learn to complete the last step in the shoe-tying process before he learns any other step. Through this process of backward chaining, the teacher will perform all of the steps leading up to the last step of tightening the two loops. Once Rashon has experienced success with this step, the teacher will complete the steps until the second to last step, and so forth until Rashon is able to successfully tie his shoes each time. At the same time, Rashon’s special education teacher suggests that they use a token economy system in which they give him a plastic token each time he completes the shoe-tying activity without self-injury. When he earns five tokens, he gets to choose from a variety of rewards which include musical activities.

Comprehensive Behavioral Treatment for Young Children
-treating children ages 0 through 9 with programs that have written instructions such as manuals, that specifically target the symptoms of autism spectrum disorder, and use a mixture of procedures from applied behavior analysis (e.g. incidental teaching, discrete trial training) Comprehensive behavioral treatments for young children include more than 25 hours per week of intensive intervention with a low student-to-teacher ratio. Of the eleven treatments, this one is the most difficult to explain as it combines many strategies from the ten other effective treatments listed in the report. Furthermore, the report does not list manuals that support this treatment.

     At the Sunshine Preschool, the speech language pathologist employs incidental teaching. She arranges the play area so that Jake’s favorite toys are out of his reach. He must communicate in order to obtain these toys. He is rewarded for requesting his favorite toy, the jack-in-the-box, when the teacher hands him the toy upon his request. 
     Throughout the day, a classroom assistant, Mr. Garrison, works with Jake on a variety of skills through discrete trial training. For example, Jake learns to identify his classmates in photos. Mr. Garrison asks, “Who’s this?” as he shows the photo of a student. If Jake responds correctly, Mr. Garrison says, “Good job” and gives him a token toward earning a reward from his menu of reward choices. If Jakes answers incorrectly (was unresponsive, gave an approximate or partial answer, or was uncooperative), he gives a pre-determined response such as, “No. It’s Sarah” and does not provide a reward token. Mr. Garrison records the number of correct and incorrect responses. He uses the data to determine when Jake has mastered learning a student’s name and can move on, when different prompts are needed, and if rewards need to be changed.

The next few posts at Teaching and Tech Tinkerings of a Special Educator will address the remaining
8 established treatments. Teaching and Tech Tinkerings will soon include links to treatment resources.

Sunday, February 14, 2010

Autism Teaching No-No's

The National Autism Center has released its National Standards Report.  What practices should educators, parents, and others avoid in treating students with autism? 
  • Academic Interventions (defined as traditional teaching methods such as providing cloze sentences and answering prereading questions)
  • Auditory Integration Training
  • Facilitated Communication
  • Gluten- and Casein- Free Diets (which were determined to be harmful in some cases)
  • Sensory Integration

Future posts at Teaching and Tech Tinkerings of a Special Educator will target "Established Treatments" and "Emerging Treatments."  For a free copy of the National Autism Center's report, visit their site.

Saturday, February 13, 2010

International Special Educator Burnout Study

A doctoral student is studying special educator burnout in various nations to develop research that will help prevent exhaustion of special education teachers. Visit the International Special Educator Burnout Study to complete a brief contact form and share your thoughts about special educator burnout.

Friday, February 12, 2010

The Preventing Harmful Restraint and Seclusion in Schools Act

A 7 year old dies after being held face-down for hours.

A 13 year old hangs himself in a seclusion room. 

A 4 year old with cerebral palsy and autism experiences bruising and post traumatic stress disorder after her teachers restrain her in a chair with leather straps. 

These are just some of the findings of the United States Government Accountability Office's May 2009 report  initiated by the Hon. George Miller, chairman of the Committee on Education and Labor. Chairman Miller is sponsoring the Preventing Harmful Restraint and Seclusion in Schools Act, which is awaiting Congressional approval. Tenets of the Act include permitting restraint or seclusion only under these conditions:
  • With appropriate training of staff
  • Given parental permission
  • Only when injury is imminent (to self, students, or school employees)
  • Parent notification must be provided after restraint or seclusion are employed
The Act prohibits
  • Mechanical restraints
  • Chemical restraints
  • Restraints that restrict breathing.
Mechanical restraints include securing body parts with duct tape or chair straps. Chemical restraints are defined by the Act as medications used for behavioral control beyond administration in accordance with a physician's prescription. Under the Act, students may not be denied food, water, or access to toileting facilities.

The Act specifies that restraint and seclusion may not be written into any student's education plan, including behavior plans, individualized education plans (IEP's), and individualized safety plans.

Click here to see an overview of the Act. 

Thursday, February 11, 2010

Adapting a Worksheet

Here are a couple of great ideas for adapting worksheets for students with special needs. The students use the same worksheet as their general education peers with some creativity on the part of the teacher in differentiating to meet the student's needs.

Check out the worksheet adaptations here:
The Autism Teacher: Adapting a worksheet - an example

While you're there, you might want to subscribe to "The Autism Teacher."

What's in a Name?

The fifth edition of the Diagnostic and Statistical Manual (DSM-V), slated for release in 2014, will alter our current system of identifying individuals with autism and Asperger's syndrome. In the current DSM-IV, autism and Asperger's are listed under the umbrella category of pervasive developmental disorder, which would be renamed autism spectrum disorders in the fifth edition.   Asperger's would be completely removed from the nomencleture as members of the American Psychiatric Association cite lack of clarity and consistency in using the Asperger's diagnosis versus using a diagnosis of high-functioning autism.  DSM-V may instead provide a severity scale that categorizes the extent of social and communication impairment and the degree of fixated interests and repetitive behaviors.


Sunday, February 7, 2010

DonorsChoose- Worth the Wait

How did I get a multi-function color printer and cartridges for our classroom?

In mid-January, I began to give up hope that the project I submitted to DonorsChoose in September would be funded.  But just before it's deadline, I received an e-mail that my project was fully funded.  We will be publishing our thank you notes (thanks to our donors) on our new printer.

Oh No! All That Snow!

The largest snowstorm in Northern Virginia's recorded history has created excitement for many students who, so far, have received two snow days.  For students on the autism spectrum disorder (ASD), however, such an overwhelming change in schedule may be unwelcome.  Students with ASD have difficulty with changes in routine- altering schedules, caregivers, locations of activities, and the activities themselves are enough to stir intense anxiety in many children with ASD. 

How can we quell snow day fears of our students with ASD?
1)  Be proactive.  In advance of snow days, talk about what happens when school is canceled.  Create social stories and review possible scenarios for early dismissal, delayed school opening, and school cancelations. 
2)  Provide students with a list of activities they can do at home on a snow day.
3)  Provide a sample schedule for parents that they can use in the home on snow days.
4)  Request that parents show their students visually on the calendar that school is canceled by crossing out the word or picture of school and drawing or writing "snow." 
5)  Model using schedules throughout the day in the classroom.  Model crossing out items when they change and writing what the replacement activity will be.

Friday, February 5, 2010

Cartoons as Writing Prompts

Need a creative way to motivate young writers?  Here is variation on a writing prompt.  Use a photograph or a cartoon as a writing prompt.  After offering your students a few prompts, you may choose to have them create their own labeled photos and cartoons as springboards for writing or as literacy activities themselves.

Pikistrips offers an easy way to create cartoon strips.  You will need to create a free account.

a comic strip!

Google Earth: A Whole New World

Despite our initial frustrations with Google Earth crashing our system, the Google Earth program packed a positive punch with our students that will leave a lasting impression on how they view the world. 

We are currently investigating how maps connect us to people and places as an International Baccalaureate unit of study. As a techie, I of course wanted to bring in Google Earth because it looks cool and it has a wow factor. It certainly would motivate my students. For this reason alone, I decided to use the program.

But my students taught me that the costs of using the program (having it crash several times, having my laptop crash, and eventually having to get a new laptop) did not overshadow the benefits. Here are the Google Earth features and a sample of the corresponding concepts and skills they learned:

Day/night feature: The Earth’s rotation causes day and night and that when it is daytime where we live, it is nighttime in some other parts of the world.
Zoom feature: A map provides a birds-eye view of a place through the zoom feature.
Fly-to and street view features: We can connect with people through maps by flying to student neighborhoods and neighborhoods of people in Tokyo, Japan
Weather feature: The weather is different in different locations. Our weather in Alexandria is similar to the weather in Tokyo because we are at a similar latitude, yet different because we are at a different longitude.

My students have never mastered this content with the depth of understanding and level of interest before than they did through using Google Earth.

Technology Integration-Reflections of a Tech Geek

Lights out. LCD projector beaming. Laptop connected. Students eagerly awaiting the promised moment. Finally, it’s here. Eight students with special needs are going to get to virtually fly to their school and then to their homes via Google Earth. The program is running. We fly onto our continent and zoom into our country…and then our state…and then…we have no internet connection. The excited faces turn to dread. It is a familiar feeling. I troubleshoot while I have them recite their Seven Continents song, but I am unable to get a connection. Our virtual field trip is suddenly cancelled. Our lesson on our global addresses turns into a social skills lesson on coping with frustration. We have to use a variety of paper maps find our homes, but no one gets to actually see their home or how it fits into the scheme of the globe. The very technology I was using to give my lesson a boost also was a bust. (Yes, the next day, I am able to pull students individually to show them the Google Earth lesson. But, at what cost? My students were confused about the lesson’s intent. About the order of the lesson. I had already given them a roadmap for where we were going and then suddenly changed it. Yes, this happens in life. But I do not wish to make this a habit in my teaching.) This led me to think: At what cost am I integrating technology? At what benefit?

I think that it is reasonable to develop solid routines for students when you are setting up technology activities or transitioning from one program to another. However, is it reasonable to always plan a backup activity for technology breakdowns? Given the amount of time it takes to create a strong tech integrated lesson and the other demands we face, how can we ensure fewer breakdowns in our technology? How can we cope when the technology does fail? Not only is it a dissappointment for the teacher, but the students are highly frustrated when the technology fails. The answer is not as simple as putting in a one-time request to HelpDesk. We will always have glitches with our technology as long as we work with dynamic, everchanging, growing, and complex systems.

Benefits Costs
Gains student attention Setup time
Teaches students 21st century skills Tech breakdowns
Is multisensory (can be auditory, visual, and hands-on) Takes a long time to create documents specific to class or individual student needs
Adds variety and novelty (especially helpful for our students with ADD)Technology changes quickly over time-What will we buy into next- will we be able to use what we have created now in another five years?