marsha harper sherida gentry educational consultants west ky. educational cooperative

Comprehensive Program Planning for Students With ASD Using the

Ziggurat/CAPS Model

Brenda Smith Myles, PhDwww.asperger.net

Ruth Aspy, Ph.D. & Barry G. Grossman, Ph.D.www.texasautism.com

Adapted by:

Marsha HarperSherida Gentry

Educational ConsultantsWest Ky. Educational Cooperative

Terrible American Idol Auditions Nick Zitzmann

Recent Developments in ASD• 22% of people with ASD have IQ in the superior

range• 12% are full time employees• 1% are employed in the area they were trained • Ages 22 and up 73% live with parent(s)• 90% have difficulty holding jobs• 95% have difficulty developing and maintaining

relationships• Most did not have early intervention• Asperger disorder have a higher level of

depression and possible suicide

Why do we Need Comprehensive Planning?

• Almost never is there a single answer that fixes a problem for students with ASD

• One strategy will not work in all situations for all students

Why was the Ziggurat Model Developed?

• Difficulty “Seeing the Autism”• Tendency to apply one strategy to address

all needs• Tendency to ignore critical areas when

designing an intervention• Not a band-aid intervention

Tip of the Iceberg is generally all you see……..

But what is underneath is often more important

Ziggurat is a framework for designing comprehensive interventions for individuals

with autism spectrum disorders

Sensory Differences and Biological Needs

• Provide sensory diet/plan

• Monitor and address environmental stressors:– Sound, light, proximity,

personal space, textures

– Movement Needs

• Monitor and address:– Appetite/hunger– Arousal/activity level

(e.g. fatigue, over stimulation, etc.)

– Posture and movement

– Medical Needs

Sensory Issues• Smell• Taste• Touch• Visual input• Auditory• Vestibular (balance)• Proprioception (body awareness)

Emotional Reactivity• Displays emotional outbursts when

unsuccessful• Is stubborn or uncooperative• Often gets “stuck” in a situation• Is overly sensitive• Reacts overtly when sensory systems

needs are not met

Sensory Diet Is…….• A planned and scheduled activity program designed to

meet the child’s specific sensory needs (Yack et al., 1998)

• Incorporate naturally occurring opportunities for children to get the sensory stimulation they need (Willbarger, 1995)

• Interventions need to occur in ALL of the individual’s environments

NOTE: Assessments must be completed and interventions must be supervised by a trained occupational therapist. However, classroom teachers can be trained to implement the PLAN on a daily basis.

Medical Interventions• Work with medical professional as applicable• Be patient-investigate options (Encourage

parents to be proactive and talk to their Doctor)• Involve in planning/tracking medicine

administration as developmentally appropriate• Types of medications used: Antidepressants,

Antipsychotic, and StimulantsNOTE: ALL MEDICATIONS HAVE POTENTIAL SERIOUS SIDE EFFECTS –NEED TO BE CLOSELY MONITORED

Sensory Interventions• Coping and Relaxation Cards• Development of relaxation routine• Provision of “Cool down” area• Implementation of Break Cards System• Brushing and Joint compression protocol

(Wilbarger)• Provision of sensory items during targeted times

to increase focus or attention• Provide balance of activities for calming and

alerting-Needs to be used therapeutically to target specific needs throughout the day

Reinforcement Reminders• Involve students in the process of selecting rein

forcers• Start with high rates of reinforcement for new or

difficult skills• Use variable rates of reinforcement for

maintenance• Reinforce practice• Reinforce prompted behavior• Reserve some rein forcers to maintain their

effectiveness

Examples of Possible Reinforcements

SCHOOL• Review baseball

statistics in magazines or books

• Research baseball on the internet

• Time to browse baseball books in the library

HOME• Time to browse the

web• Trip to local baseball

card stores• Video games

Structure and Visual/Tactile Supports

Common Misperceptions• If an individual can read then he/she does

not need pictures or symbols• He’s in high school, he doesn’t not need

an individualized schedule• I can stop using a visual schedule when

my student learns the routine• If an individual has not looked at his/her

schedule in three weeks he/she does not need it anymore

Visual Schedules• Highly structured environments-provide an

opportunity for those with ASD to succeed.• Research shows visual schedules are

effective across age ranges, and settings• Increased predictability and understanding

result in:– Decreased problem behavior (i.e. off task,

disruptive, non-compliant, aggressive, tantrums and property destruction)

– Increased independence

Examples of Visual Supports• Individualized visual schedules at the

appropriate level• Video self modeling, prompting• Cartooning• Pictorial social stories• First___then______ visual • Pictorial task analysis• Pictorial directions

Tasks DemandLevel of Demand

Easy Challenging/EmergingToo DemandingIndependent skills

with or without modification and structural supports

Possible with Assistance

ZONE OF PROXIMAL DEVELOPMENT

Tasks Demands and Skills to Teach

Tasks Demands-3 Questions1. Are you asking for performance of a skill

that is too hard?2. Are you asking for performance of a skill

that has not been taught?3. Are you asking for a task to be

accomplished without the necessary supports?

Examples of Task Demand Interventions

• Provide written instructions

• Allow us of laptop or other device to take notes

• Give extra time for written work

• Provide organizational skills support

• Use coping cards• Create Circle of friends or

peer buddy/mentor

• Provide high interest activities to encourage social interaction

• Highlighted text• Provide “safe place or

cool down”• Allow for breaks• Prepare for change• Minimize transitions

Skills To Teach-Resources To Teach the Seemingly Obvious

• The Hidden Curriculum• Mind Reading: The Interactive Guide to

Emotions• Teaching Children with Autism To Mind-

Read• Prescription For Success• Out and About• The Transporters

Examples of Skills To Teach Interventions

• Teach student to identify body cues that indication stress or anxiety and associated relaxation technique including calming sensory strategies

• Teach student to use certain visual supports• Provide direct, explicit social skills training to

address social skills deficits (can be done during speech language time)

• Teach student the right time to talk and other social prioritized social skills

Why Comprehensive Planning With The Ziggurat and CAPS Models?• Fewer behavior problems• More Instructional time• Increased compliance with law• Increased engagement time• Faster IEP development• Better IEPS• More positive/collaborative relationship with

parents• Improved collaboration among staff

Who is Involved in Comprehensive Planning

• Parents• Student• General ed. teacher• Sp. Ed. teacher• Paraprofessional• Speech Language Pathologist• Occupational Therapist• School Psychologist• Administrator• Other as Needed

Keys to Comprehensive Intervention Planning

• CHARACTERISTICS: Look at characteristics of ASD that student exhibits

• DESIGN: A quality plan is designed to target the Autism comprehensively

• IMPLEMENT: A quality plan is implemented with fidelity (IT REQUIRES FOLLOW THROUGH!!!!!!!)

4 Steps to Designing a Comprehensive Intervention Plan

1 2 Characteristics

3Design

4 Implement

Step 1: Complete UCC-Underlying Characteristic Checklist

• Helps you to see the autism• Provides a snapshot of how autism is expressed

for an individual• A descriptive instrument• Can be completed by a team (recommended)• Provides a tool for assessing progress/change• Two Forms UCC-CL (Classic typical autism),

UCC-HF (High Functioning, Asperger’s)NOTE: This is not a diagnostic instrument used

for intervention planning and implementation

Step 1: The UCCCharacteristics

• Social• Communication• Repetitive patterns• Associated Features• Sensory• Motor• Cognitive• Emotional Vulnerability• Medical and Biological

Factors

Interventions

Step 1 (Forms must be purchased)

Let’s Meet Michael

Complete the UCC-HF for Michaelusing the informationyou have learned…..

Step 2: Complete ISSI-Individual Strengths and Skills Inventory

• Social • Behavior, interests and activities• Communication• Sensory • Cognitive• Motor • EmotionalNOTE: ISSI is a great resource to use for

development of Present Level of Performance

Step 2(Form can be copied from Ziggurat Manual)

Complete the ISSI for Michaelusing the informationyou have learned…..

Questions To Consider When Prioritizing Areas From the UCC

• What are the student’s short term and long term goals? (Choose from overall UCC categories- Social, Restricted Patterns of Behavior, Communication, Sensory, Cognitive, Motor, and Emotional Vulnerability)

• In what settings does the individual need to function?• Which UCC areas have the greatest impact on the ability

to function in multiple settings?• Which UCC areas would have the greatest impact on

increasing independent functioning?• Which UCC areas would have the greatest impact on

his/her sense of well-being?

Michael’s Short Term/Long Term Goals

Short Term- 1. Increase appropriate social communication2. Improve perspective taking of other’s thoughts and

feelings (mind blindness)3. Improve sensory processing (auditory and tactile)Long Term-1. Participate in appropriate reciprocal verbal exchange

maintaining topic when applicable (e.g. greetings, ask a question, answer a question, make a request, initiate, maintain and terminate conversation appropriately).

2. Recognize the feelings and perspectives of others and how his behavior effects others.

3. Develop self-regulatory behaviors

• After completing questions to consider when prioritizing the UCC areas, what are Michael’s priority areas of concern?

What are Michael’s Prioritized UCC areas?

Michael’s - Prioritized UCC Areas

Social CommunicationSensoryCognitive

Questions To Consider When Prioritizing Items From the UCC

• Which items have the greatest impact on the prioritized UCC areas of concern?

• Which UCC items address more pivotal underlying needs?

What are Michael’s Prioritized UCC Items?

Michael’s Prioritized Items From His UCC

#1 Mind blindness#9 Difficulty understanding non-verbal communication#25 Difficulty with rules of conversation#28 Difficulty starting, joining, ending conversations#39 Difficulty talking about others interests#42 Responds in an unusual manner to sounds, pain, and touch#53 Poor organizational skills#89 Difficulty organizing stress and anxiety

Tying it all together!

Marrying the Underlying Characteristics and Strengths to

Interventions

UCC ISSI

Intervention Design Helper © Ruth Aspy, Ph.D., and Barry G. Grossman, Ph.D.

Student: Date: Intervention Design Helper: Use this form to assist in developing the intervention plan to be recorded on the Ziggurat Worksheet. Start in either column. After both columns are complete, indicate next to each intervention on which level(s) of the Ziggurat the intervention falls: Sensory/Biological (SB); Reinforcement (R); Structure &Visual/Tactile Supports (SVT); Task Demands (TD); Skills to Teach (ST).

Underlying Characteristic(s) Interventions

Intervention Design Helper: Use this form to assist in developing the intervention plan to be recorded on the Ziggurat Worksheet. Start in either column. After both columns are complete, indicate next to each intervention on which level(s) of the Ziggurat the intervention falls: Sensory/Biological (SB); Reinforcement (R); Structure &Visual/Tactile Supports (SVT); Task Demands (TD); Skills to Teach (ST).

Underlying Characteristic(s) Interventions

Step 3: Interventions for Michael

Underlying Characteristic

Interventions

Social#1 Mind blindness#39 Difficulty talking about others interests#53 Poor organizational skills

•Develop a rein forcer menu with Michael and provide a chart for him (make sure you incorporate his special interest)• New skills should be reinforced across settings in order for Michael to generalize them. • Provide Michael with a list of conversation cues. Have him keep a list in his binder to refer to in class. Reinforce Michael for using appropriate conversational manners.• Provide a problem solving flow chart as a visual support for Michael.•Teach Michael to recognize the right time to talk• Establish Circle of Friends to practice social skills• Teach parents, peers- Circle of Friends, teachers to narrate ( i.e., describe out loud what others are thinking) • Teach Michael to read others thoughts and feelings (mind blindness)

What Levels of Ziggurat are covered?Reinforcement, Struct. V/T Supports,Skills to Teach,

Step 3: Interventions for MichaelUnderlying

CharacteristicsInterventions

Communication

#9 Difficulty understanding non-verbal communication#25 Difficulty with rules of conversation#28 Difficulty starting, joining, ending conversations

•Use of video to help Michael learn conversational manners and related skills• Provide Michael with a list of conversation cues. Have him keep the list in his binder so he can refer to it in class. Reinforce Michael for using appropriate conversational manners.• Use Comic Strip Conversations to help Michael understand what the listener (whole class) is thinking and feeling when he interrupts or dominates a conversation. • Provide speech therapy services to address pragmatic (social) language skills such as conversational manners (e.g., transition statements taking turns while talking, staying on topic, recognizing off-topic statements, using appropriate, voice tone and volume, showing good listening skills), recognizing the listener’s non-verbal messages, and code-switching skills.• Reinforce Michael for using appropriate conversational manners

What Levels of Ziggurat are covered?Reinforcement, Struct. V/T Supports,Skills to Teach, Task Demands,

Underlying Characteristics

Interventions

Sensory

#42 Responds in an unusual manner to sounds, pain, and touch#89 Difficulty managing stress and anxiety

•Can teach Michael relaxation techniques including calming sensory strategies.• Using portable coping cards to help Michael to calm in all school settings.• Reinforce Michael for using relaxation/calming skills • Use of stress thermometer to teach Michael about anxiety and how to recognize the signs that indicate when he needs to use his coping strategies• Teach Michael to identify body cues that indicate stress/anxiety and relaxation/calming strategies• Teach Michael how to use problem solving sheet• Practice skills in a familiar environment

What Levels of Ziggurat are covered?Reinforcement, Struct. V/T Supports, Skills to Teach, Task Demands, Sensory,

Underlying Characteristics

Interventions

Cognitive •

#53 Has poor organizational skills

•Reinforce Michael for completing homework and his checklist• Initially, provide adult assistance with organizational skills• Use high interest activities to encourage participation• Develop CAPS for all academic settings

What Levels of Ziggurat are covered?Reinforcement, Struct. V/T Supports

Step 3: Complete the Ziggurat Intervention

Michael’s Ziggurat Worksheet

Step 4: LETS TALK ABOUTCAPS

Comprehensive Autism Planning System

Making the Program a Reality

Time* Activity

Targetedskill

short-termobjective

Structure/ Modification Reinforcement Sensory

StrategiesSocial Skills/

CommunicationDataCollection

Generalization Plan

COMPREHENSIVE AUTISM PLANNING SYSTEM (CAPS)(Henry and Myles, 2007)

CAPS is the framework tying the daily schedule to the underlying characteristics identified in the UCC and the interventions outlined in the Ziggurat Worksheet

Time* Activity

Targetedskill

short-termobjective

Generalization Plan

Time and Activity-Include everything that is a priority area for the student when planning for implementation! (Academics, transitions both inside and outside classroom, etc.)

Time* Activity

Targetedskill

short-termobjective

Generalization Plan

Develop skills to teach based on State Standards, IEP Goals, and Ziggurat InterventionsSkills/STO-Can pull from IEP (Academic and Nonacademic subject matter)

Time* Activity

Targetedskill

short-termobjective

Generalization Plan

Refer to Structure and Visual/tactile Supports or the Task Demands sections of the Ziggurat Worksheet

Time* Activity

Targetedskill

short-termobjective

Generalization Plan

Taken from the Reinforcement or Visual/Tactile Supports on the Ziggurat Worksheet

Time* Activity

Targetedskill

short-termobjective

Generalization Plan

Taken from the Sensory and Biological Needs or Skills To Teach or Task Demands section of the Ziggurat Worksheet

Time* Activity

Targetedskill

short-termobjective

Generalization Plan

Taken from the Structure and Visual/Tactile Supports or Task Demands or Skills to Teach sections of the Ziggurat Worksheet

Time* Activity

Targetedskill

short-termobjective

Generalization Plan

Should match the information from the IEP and Skills/STO section of the CAPS needed to determine if the student is making progress

Time* Activity

Targetedskill

short-termobjective

Generalization Plan

How will the student generalize each skill into different environments/situations?

Michael’s CAPS

Comprehensive Autism Planning System

Activity

Targetedskill

short-termobjective

Generalization Plan

Independent Work

Task completion

Taken from prioritized UCC items #1, 9,25,28,39,42,53 and 89

•Task organizer (prompt to use)•Organization calendar (prompt to use)•Systematic fading procedures for independent use•Plot flow chart•Peer buddies

Taken from STRUCT. & V/T Supp. From Z Worksheet

•Calming skills•Appropriate conversation•Completing homework/ in class work (from reinforcement menu)•Focus on special interest of baseball stats

Taken from Rein. Int. from the Z worksheet

•Relaxation techniques•Coping cards•Stress thermometer

Taken from sensory/bio. Needs from the Z Worksheet

•Asking for help when stuck•Plot flow chart

Taken from STRUCT. & V/T Supp. From Z Worksheet

•Used Task organizer Yes/no

•Used Organizational calendarYes/no

These match skills/ STO of the CAPS

•Train circle of friends•Train student on how to use all supports•Train parents and staff on all supports

See social skills/ communication section on the CAPS

What do we do if the student needs more support than the Global Intervention Plan provides?

We develop a Specific Intervention Plan

Designing a Specific Intervention Plan

• Students can have more than one specific intervention plan

• There must always be a global plan in place first- many times this will prevent the student from having a specific plan for behavior!!!!!!

Designing a Specific Intervention Plan

Step 2- ABC- Iceberg

Step 3- Complete the Ziggurat Worksheet

Step 1- Complete UCC and ISSI

Step 4- Complete CAPS

Let’s Think about Michael’s Specific Behaviors

What is the function of his behavior?

Function of Michael’s Behavior

• Escape or Avoid P.E. or team oriented contact sports

• Over stimulated by noise levels, activity levels, and close proximity of others

Noise level in the gymAsked to play a team sport

Shuts down and becomes escalated during team oriented sports (i.e. P.E.)

Sits out on the sidelinesAppears agitatedRepeatedly blames others for intentionally “hurting” him Escalates to arguing and finally sMichaelps off leaving gym

Isolation from peersMisses instruction in P.E.Teacher thinks he is overreacting and being a sore loser

#1 mind blindness, #9 difficulty understanding others nonverbal communication, #28 has difficulty staring, joining, and/or ending a conversation, #42 responds to unusual manner to sounds, pain and touch, #89 Difficulty managing stress and anxiety

Social story or comic book conversations regarding social behaviors in P.E.

Pre-teaching of activities that will be presented in P.E. so they are not new to him (physical activity, rules, social situations, etc.)

•Implement “break pass” system if he becomes over stimulated

Use his conversation cards to assist him in staying on topic with peers

•Use coping cards and visuals to cue him to relax prior to him becoming escalated

Reinforce Michael with baseball activity when he uses his calming skills appropriately

•Teach him to use his break passes and calming routine•Train small group of peers to support him in P.E.

Simplifying Marsha’s and Sherida’s Way

Darth Vader’s Ziggurat Worksheet

I’m in the obstacle removal business

“We don’t fix things that aren’t broken, we remove obstacles for kids with infinite potential.”

Eric Blackwell

Resources to Purchase for Comprehensive Planning

http://www.asperger.net/bookstore_9971.htm

Contact Information

• Brenda Smith Myles, Ph.D.brenda-myles@mac.com

• Ruth Aspy, Ph.D.aspy@texasautism.com214-227-7741

• Barry G. Grossman, Ph.D.grossman@texasautism.com

www.asperger.net

www.texasautism.com

“Souls”

marsha harper sherida gentry educational consultants west ky. educational cooperative

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