Quiz 2 Flashcards
What are some things families might say about social behaviors?
“It’s hard to get his attention”, “He seems to be in his own world”, “Everything he does is on his own terms”
What are some things families might say about communication behaviors?
“He gets things by himself”, “He can’t tell me what he wants”, “He takes my hand and pulls me to whatever it is he wants”, “He repeats lines and songs but TV and videos but doesn’t use words to ask for things”
What might parents say about behaviors/restricted activities?
“He plays with all of his toys by lining them up”, “He studies things very carefully”, “He plays by dumping his blocks and then putting them back again - over and over”
What is the difference between a diagnosis and a label?
Diagnosis = in the medical field, typically from private setting, DSMV, determined by individual or team;
Label = based on federal law (IDEA), broad disability category, only used in public school system, must be determined by a team
Do you need a medical diagnosis to get educational services?
No
Is there one way to get an ASD diagnosis?
No, right now, there’s no simple medical test or procedure to make an ASD diagnosis; includes health, developmental, and behavioral histories; physical exam; developmental evaluation; assessment tool; etc
What entails a multidisciplinary evaluation?
-multiple pieces of data (interviews, direct & indirect, standardized measures)
-multiple assessments
-multiple informants (speech, psych, academic, OT, PT)
-want a holistic look at the child
Cognitive assessment
Considers skills and determine appropriate measure (verbal/nonverbal)
Administered by school psychologist
Wechsler (WISC), Woodcock-Johnson
Academic achievement assessment
-Traditionally done by the special education teacher
-WISC, Woodcock-Johnson
-ABLLS (Assessment of Basic Language and Learning Skills) - looks at a variety of skills to see what they have in terms of readiness for school, self-care, motor skills, social
Speech/language assessment
-Administered by SLP
-Look at language skills (receptive and expressive, social-pragmatic, narrative language, inferential thinking, word-finding, vocabulary)
Social/adaptive skills assessment
-Functional skills
-ADL - activity of daily living
-Social motivation, cognition, interest
-Ex: Assessment of Functional Living Skills (AFLS)
Social-emotional/behavior assessment
-Psychologist or BCBA
-If behavior is challenging, it would be prudent to conduct an FBA
OT/PT assessment
fine motor skills, gross motor skills
Depends on child’s skills and weaknesses
Vocational assessment
ex: AFLS
Autism Diagnostic Observation Schedule (ADOS-2)
-Standardized observation of behavior and play
-Looks at… behavior, social/conversation, play
-Given by a psychologist
-Can be lengthy to administer
-Play-based
-Sometimes a team approach (one practitioner playing with the child, one taking notes)
What is Theory of Mind (Social Perception-NEPSY-2)?
-Ability to take another’s perspective
-Understanding someone else’s feelings, beliefs, and desires
Indirect measures: Diagnostic rating scales
Autism Spectrum Rating Scale (ASRS)
-Medical diagnosis of ASD
-DSM
Social Responsiveness Scale (SRS-2)
-Social motivation, social cognition, social -awareness, restrictive behaviors, and repetitive behaviors
Indirect measures: Adaptive rating scales
Adaptive Behavior Assessment (ABAS-2)
-Takes less time
-Communication, community use, functional academics, health and safety, leisure, self care, self direction, social and work functioning
Vineland-3
-Lengthy (about 20-30 mins to complete)
-Looks at a lot of different domains
-Daily living, socialization, motor skills, maladaptive behaviors, etc.
Social Skills Improvement System (SSIS)
-Caregivers and teachers
-Social skills, problem behaviors, academic confidence
Family communication (especially when it comes to eligiblity)
-Be compassionate
-Think about the way you present the information
-Stop and check in to see how they are doing
-Offer support
-Forming a collaborative relationship with the family
-Build trust
-You want them to feel that you have their child’s best interests at heart
What do you think your experience as a parent might be with a newly diagnosed child?
Overwhelmed
Lost
Don’t know what’s actually going to help
So many results when you google “autism treatment”
What does it mean to for practices to be ‘evidence-based’?
-Practices or treatments that have been found to be effective by rigorous and replicated research
-Gone through extreme/rigorous research, replicated many (e.g., 500) times
-Direct and controlled analyses
-Highest level
-Acceptable research design: single subject, group designs (experimental)
-Examples: ABA, Floortime
What does it mean for practices to be ‘scientifically-based’?
-Refers to “cause and effect” research related to using observable and measurable outcomes
-Replication (Hasn’t been replicated as much as EBPs)
-Approval of peer-reviewed journals
-Not quite the level of EBPs - does not have the magnitude of studies as EBPs
-Doesn’t have the strength of EBPs
What does it mean for practices to be ‘research-based’?
-Programs or practices that have been studied but not necessarily replicated, controlled, or peer-reviewed
-Less rigorous designs
-Small “N” - small sample size (e.g., 10 versus 100; 50 versus 500)
-Provide preliminary data for effectiveness
-Little evidence of generalizability
-At the beginning stages
Why might research for treatment for children with ASD be challenging?
-Because every child with autism is so different
-Could be effective for one child, but not at all effective for another
-Needing a large sample size
What is the bottom line when it comes to implementing certain practices?
-There is a lot of confusion among the terms evidence-based, research-based, and scientifically-based
-Teachers needs to be implementing practices that have been shown to improve outcomes for students with ASD and that have wide consensus among researchers on the effectiveness of the approach
-Not everything you’re going to do as an educator is going to be EBP
-That’s ok as long as it works for the student(s) you are working with
-Think about the individual and what works for each individual
What is Behavioral theory?
-Sees autism as the presentation of behavioral deficits that are biologically-based but are able to be changed by interactions with the environment
-Grounded in the science of behavioral analysis
-Everything that a child does is a behavior for a reason (every behavior has a function)
-Prompting, shaping, reinforcement
Behavioral theory: What is prompting?
What do i have to do to get you started
Ex: hand gesture, saying certain things
Behavioral theory: What is shaping?
Changing behavior in a positive way
Behavioral theory: What is reinforcement?
Ex: high five, praise, toy
What are examples of behavioral theory?
DTT, PRT, Incidental Teaching
What is developmental theory?
-Neurological differences lead to delays in development (language, cognitive, social, self-help, motor, etc.)
-Pretty much the opposite of behavioral theory
-More naturalistic (natural environment) than other approaches
-Child driven choices, novel materials, student-directed
-Child is more in charge of what is happening
-Reciprocal and functional communication
What is a developmental theory EBP?
Floortime
What is perceptual cognitive theory?
-Based on the belief that students with ASD have sensory, perceptual, and thinking differences due to brain dysfunction
-Children are over-stimulated
-How can we teach them/get them to learn independently to not be overstimulated
-Believes in teaching through structured routine environments, explicit instructions, limited verbalizations
-Visual cues and supports
-Focus on attention and imitation
What is a perceptual cognitive theory approach?
TEACCH
What is a multi-theoretical approach?
-Treatment does not have to be based on only ONE theory
-Best case scenario = taking a little bit from each theory
-We are still learning and unfortunately there is still some disagreement in the field
-Educators need to be trained in a variety of approaches!
-Not all children with ASD are the same!
-We need to create individualized approaches for students
All approaches should be…
Data-driven
Generalized
School and home communication
Address self-determination
Foster independence
Functional
Least restrictive
INDIVIDUALIZED
ABA = Applied Behavior Analysis
-Focuses on the principles that explain how learning takes place
-Positive reinforcement: when a behavior is followed by a reward, the behavior is more likely to be repeated
-If you don’t have a strong reinforcer, they are not going to learn what you are trying to teach them
-Techniques for increasing useful behaviors and reducing those that may cause harm or interfere with learning
-Behavioral approach
DTT = Discrete Trial Training
-One-to-one instructional approach used to teach skills in a planned, controlled, and systematic manner
-Targets specific skills/behaviors
-Skills taught in small, repeated steps
-Each trial has a definite beginning and end
-Three term contingency: ABC
-Positive praise and/or tangible rewards used to reinforce behaviors
-Data collection
-teacher/therapist directed
-Can mix in skills that the child has already mastered/known tasks
-Behavioral approach
-Ages 2-9
PRT = Pivotal Response Training
-Method of systematically applying the scientific principles of ABA to teach learners with ASD
-Behavioral approach
-Pulls from ABA, but more natural than DTT
-Builds on learning initiative and interests
-Develops communication, language, play, and social behaviors
-Four pivotal learning variables: motivation, responding to multiple cues, self-management, and self-initiations
-Teacher-directed
-Play-based, data-based
-Naturalistic
-More natural, less structured
-Ages 2-16
PECS = Picture Exchange Communication System
-Developed at the Delaware Autistic Program (DAP) and was designed to teach young children to communicate in a social context
-Learners are taught to give a picture of a desired items to a communicative partner in exchange for the item
-Specifically designed for students with autism, but can be used with kids with other diagnoses that impact communication, like ID
-Learn to associate the representation of an object, and that you need to bring a picture to the adult to then get what you want/what you’re asking for
What are the 6 phases of PECS instruction?
1) Teaching the physically assisted exchange
2) Expanding spontaneity
3) Simultaneous discrimination of pictures
4) Building sentence structure
5) Responding to, “What do you want?”
6) Commenting in response to a question
RDI = Relationship Development Intervention
-Program for educating and coaching parents and teachers of children with ASD
-Mission = restore the guided participation relationship, the basis for dynamic intelligence
-Prepares parents and teachers to act as participant guides, creating daily opportunities for the child to respond in more flexible, thoughtful ways to novel, challenging, and increasingly unpredictable settings and problems
TEACCH = Treatment and Education of Autistic and Related Communication - Handicapped and Related Children
-Executive functioning, attention, structure and organizational skills are major targets
-Relies on visual representations
-Link picture with action
-Combines
–Social learning theory → Self-efficacy and an individual’s understanding of a situation as a major cause of their behavior
–Cognitive behavioral approach → individual’s understanding
–Developmental framework → different levels of understanding for different individuals
Interactive
DIR/Floortime
-Program that meets the current developmental level and emotional interests of the child
-DIR = developmental, individual-difference, relationship-based approach
-Parents and a team of professionals
-Join the child in his world of emotional interests and bring him into a shared world to promote higher levels of emotional and intellectual functioning, as well as strengthening processing capacities
-Not that easy to do in schools
What is language?
Formal symbol system with structural qualities including morphology, semantics, and syntax
Language can be…
Oral speech, sign language, written language
What is receptive language?
-Ability to understand or comprehend the rules of language
-Includes the ability to link word meaning to communication cues and social content in order to understand a message
What is expressive language?
-Ability to use the rules of language
-Ability to use oral and written language in a conventional way
What is speech?
-One type of expressive language
-Ability to use all speech sounds
What is communication?
-Interactive exchange between 2 or more people to express needs, feelings, and ideas
-Fundamental social skill
-Can be expressed verbally (spoken, signed, AAC device, written language) and nonverbally (pictures, gestures, emotion, behaviors)
An effective communicator has…
Motivation to interact with others
Desire to express something
Means of communication
What is the difference between language, speech, and communication?
-You can communicate without language (nonverbal communication)
-You can use language without communicating (e.g., talk to yourself)
-You can use speech without communicating
-You can use language without speech (written language, sign language)
-You can communicate without speech (written language, facial expression, gestures)
Communication in younger children
Eye gaze, gestures, facial expressions (smile), vocalizations
By 12 months - point and gesture to ask for things
By 18 months - make others laugh, call attention to themselves, comment on environment, engage in reciprocal turn-taking
Communication in older children
Develop ability to combine nonverbal and verbal means of communication to initiate, maintain, and repair reciprocal conversations
Communicate needs, express ideas, seek information, share experiences and feelings
Develop the ability to understand that others have thoughts, ideas, and feelings that differ from their own
Theory of mind
Social perspective taking
Language in younger children
By school age - word and sentence meaning (semantics), language structures (syntax) and use them
By 2 yr - use some words and understand parents, rely on contextual clues
Pre-k - rapidly acquir vocab, use language structures they hear
Language in older children
Abstract vocabulary continues to develop
Learn to use more complex sentence types
Acquisition of literacy skills - reading and writing
Social communication features in DSM
-Difficulties with nonverbal communication - eye contact, gestures, facial expressions, body language
-Difficulties with reciprocity - atypical way of approaching and interacting, conversations, reduced sharing of interests and feelings
-Difficulty understanding social perspectives
What is echolalia?
-The repetition of others’ speech that may occur immediately after hearing a message or significantly later
-Often used for functioning communication
-Non-interactive ritualized speech
-It is a means to learn language and communication
What is perseverative speech?
Persistent repetition of a word, phrase, or topic with no clear communication intent
What is incessant questioning?
Repeatedly asking one or more questions and persisting even after answered multiple times
What percent of individuals with ASD remain nonspeaking?
Approximately 30%
What are some benefits of AAC devices?
-Increased communication competence and functional communication
-Increased rate of development of speech in comparison to those who do not use AAC
-Decreased rate of problem behavior associated with poor communication skills and associated communication frustration
What is an operational definition of behavior?
-Describes what the behavior(s) of interest look like in a way that is observable, measurable, and repeatable
-Be careful not to generalize the behavior (ex: David throws a fit)
-Instead, give a specific definition (ex: David screams “no” and attempts to hit the teacher with his hand)
What is the importance of operational definitions?
We want to be very specific about what the behavior looks like
We need to be able to have interobserver agreement
So someone else can identify what you’re talking about
What is a functional behavior assessment?
A process schools use to figure out what’s causing challenging behavior
What does ABC stand for?
Antecedent - what precedes the behavior
Behavior
Consequence - what follows the behavior
Why do we conduct FBAs?
To find the function of the behavior
There is a reason behind every behavior
What do we use to conduct FBAs?
Interviews, observations, and assessments
What are some common functions of behavior?
Escape/avoidance
Gaining attention
Access to items
Access to preferred activities
Sensory stimulation
What are some common challenges for students with ASD?
Time of day
Presence of specific peers
Specific classroom subject
Transitions from preferred to non-preferred activities
Requests to stop a behavior
Punishment
Medication changes
Family stressors or circumstances
Environmental changes (general or at home or school)
Think of 2-3 ways to address transitions from preferred to non-preferred activities
Visual schedule of day (or next activities)
First, then board
Timer
Provide choice, if possible
Think of 2-3 ways to address the presence of specific peers
Position them on different sides of the room
Prompt to use coping skill (leave room if escalating)
What are antecedent interventions?
-Preventing behaviors from occurring by changing environmental factors
-Interventions we implement before the behavior occurs
-Preventatively (Don’t want to only think about “what should I do if the child is aggressive” - want to think “what can I do before they become aggressive”)
-Altering the manner in which instruction is provided
-Enriching the environment so that learners with ASD have access to sensory stimuli that serve the same function as the interfering behavior
-Replacement - use the behavior in a way that is function and that they can be learning at the same time
-Implementing pre-activity interventions (e.g., issuing a cue about the next activity, providing information about schedule changes)
What are some examples of antecedent interventions?
-Arranging the environment (ex: physical seating arrangements)
-Changing the schedule/routine
-Structuring time
-Using highly preferred activities/items to increase interest level
-Offering choices
Should we make small changes or big changes?
Sneak in some small, flexible changes and then slowly grow/increase them
What is positive reinforcement?
-Providing a consequence immediately following a behavior that is likely to maintain or increase the occurrence of that behavior in the future
-Not always just the teacher reinforcing the behaviors - other things in the environment can reinforce it (ex: other students)
Things you think of as punishment can in fact be positive reinforcers
Ex: yelling at a student can actually increase the behavior you are addressing because the student is positively reinforcing by the negative attention received
Do all students find the same things positively reinforcing?
NO!
You need to know what is positively reinforcing to the student with ASD so you know what consequence to provide when the students meets behavior, social, and academic expectations
Can reinforcers change?
Yes
-What is reinforcing one day, may not necessarily be reinforcing the next day, week, or month
-Changing up positive reinforcers is usually necessary
