transition to adulthood using comprehensive planning tools ...characteristics design 12 3 implement...
TRANSCRIPT
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Transition to Adulthood Using Comprehensive
Planning Tools: An Evidenced-Based
ApproachBrenda Smith Myles, Ph.D.
Ruth Aspy, Ph.D., & Barry G. Grossman, Ph.D.
The Ziggurat Groupwww.texasautism.com
Overview of Day
Overview of the issuesUnderlying CharacteristicsTransition – definition and requirementsIntroduce the Ziggurat Model● How to assess and address underlying characteristics● Five levels of intervention● Apply ZM to scenario
Introduce the Comprehensive Autism Planning SystemCommon evidenced-based intervention strategies
A Sign of Our Failure
A study of 114 adultsMeasure outcome●Good: (a) employed or engaged in
education/vocational training, (b) living independently, (c) two or more friends/steady relationship
● Fair: (a) or (b)● Poor or very poor outcome: neither (a) or (b)
Billstedt Gillberg, & Gillberg, 2005
A Sign of Our Failure
A study of 114 adultsGood Outcome: (a) employed or engaged in education/vocational training, (b) living independently, (c) two or more friends/steady relationship0
Billstedt Gillberg, & Gillberg, 2005
A Sign of Our Failure
A study of 114 adultsFair: Either (a) employed or engaged in education/vocational training, (b) living independently, (c) two or more friends/steady relationship8%
Billstedt Gillberg, & Gillberg, 2005
A Sign of Our Failure
A study of 114 adultsPoor or very poor outcome: ●Neither (a) employed or engaged in
education/vocational training, (b) living independently, (c) two or more friends/steady relationship
92%With no differences between individuals with autism who are considered high functioning and those with a more classic presentation
Billstedt Gillberg, & Gillberg, 2005
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The biggest predictor of employment for adults is a job experience during high school. Underlying
Characteristics
Impaired Theory of Mind- Mindblindness
Difficulty understanding the thoughts, feelings, and beliefs of othersDifficulty predicting the actions of othersDifficulty using words to describe one’s own feelingsDifficulty understanding non-literal language (e.g., sarcasm)
Weak Central Coherence
Tendency to focus on details and miss the big pictureDifficulty understanding social situations
Problem Solving
“One way of viewing a problem”Stuck thinkingSees facts instead of a wholeProblems with cause and effectDoes not see problems as having more than one optionProblem solving is often literal
Executive Dysfunction
Difficulty with changeProblems with regulating emotionAttention problemsDisorganized
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Top 10 Situations that Trigger Insistence on Sameness
• Annoying behavior
• Activity interrupted
• Losing a game• Object breaks• Event cancelled
• Event delayed• Materials run
out• Item misplaced• Sequence
changed• Momentary
separation
Green, Sigafoos, Pituch, Itchon, O’Reilly, & Lancioni (2006). Assessing Behavioral Flexibility in Individuals with Developmental Disabilities. Focus on Autism and Other Developmental Disabilities, 21(4) 230-236.
Special Interests and Obsessions
Narrow interestsNot permanentOften appear “uncontrollable”Role of the interest: interest; fun; security, comfort; relaxation; stress reduction
Transition
A Comprehensive Perspective
The Purpose of Special Education (IDEA)
To ensure that all children with disabilities have available to them a free appropriate public education that emphasizes special education and related services designed to meet their uniqueneed and prepare them for furthereducation, employment, and independent living
§300.1 (emphasis added)
Transition ServicesDefinition
‘transition services’ means a coordinated set of activities for a child with a disability.
The Ziggurat Model provides a process to develop a coordinated set of activities that matches individual characteristics to interventions.
IDEA (2004) emphasis added
Transition ServicesDefinition (continued)
Law(A) is designed to be a results-oriented process, that is focused on improving the academic and functional achievement of the child with a disability to facilitate the child's movement from school to post-school activities…
Ziggurat ModelUnderlying Characteristics Checklist
Individual Strengths and Skills Inventory
Intervention Ziggurat
IDEA (2004) emphasis added
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Transition Services Definition (continued)
Law(B) is based on the individual child’s needs, taking into account the child's strengths, preferences, and interests
Ziggurat ModelUnderlying Characteristics ChecklistIndividual Strengths and Skills InventoryGlobal Intervention Plan Guide (person-centered planning)
IDEA (2004) emphasis added
Transition Services Definition (continued)
Law(C) includes instruction, related services, community experiences, the development of employment and other post-school adult living objectives, and, when appropriate, acquisition of daily living skills and functional vocational evaluation.
Ziggurat ModelIntervention Ziggurat
Transition IEP Requirements
Age 14 (or younger, if determined appropriate), a statement of the transition service needs that focuses on the student's courses of study (such as participation in advanced-placement courses or a vocational education program); and
Age 16 (or younger, if determined appropriate), a statement of needed transition services, including, if appropriate, a statement of the interagency responsibilities or any needed linkages.
Adapted from: (Authority: 20 U.S.C. 1414(d)(1)(A))
Transition in Texas
Beginning at any age. . . Futures planning for integrated living, work, community, and educational environments that considers skills necessary to function in current and post-secondary environments
Texas Commissioner’s Rules Concerning Special Education Chapter 89 Subchapter AA
The Ziggurat ModelZiggurat n:
(zig·gu·rat) from Assyrian ziqquratu, height, pinnacle
1. a temple having the form of a terraced pyramid of successively receding stories, erected by the ancient Assyrians and Babylonians
2. a framework for designing comprehensive interventions for individuals with autism spectrum disorders
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Why was the Ziggurat Model Developed?
Difficulty “Seeing the Autism”Tendency to apply one strategy to address all needsTendency to ignore critical areas when designing an intervention
Sensory Differences and Biological NeedsSensory Differences and Biological Needs
Skills to TeachSkills to Teach
Task DemandsTask Demands
Structure and Structure and Visual/Tactile SupportsVisual/Tactile Supports
ReinforcementReinforcement
© Ruth Aspy, Ph.D., Barry G. Grossman, Ph.D.
Intervention Ziggurat
InterventionsCharacteristics
Sensory Differences and Sensory Differences and Biological NeedsBiological Needs
Skills to TeachSkills to Teach
Task DemandsTask Demands
StructureStructure and Visualand Visual/Tactile Supports/Tactile Supports
ReinforcementReinforcement
© Ruth Aspy, Ph.D., Barry G. Grossman, Ph.D.
Underlying Characteristics Checklist (UCC)
SocialCommunicationRepetitive Patterns
Associated FeaturesSensoryMotorCognitiveEmotional VulnerabilityMedical and Biological Factors
Characteristics Interventions
Sensory Differences and Sensory Differences and Biological NeedsBiological Needs
Skills to TeachSkills to Teach
Task DemandsTask Demands
Structure and VisualStructure and Visual/Tactile Supports/Tactile Supports
ReinforcementReinforcement
The Ziggurat Model
Sensory and Biological NeedsReinforcementStructure and Visual/Tactile SupportsTask DemandsSkills to Teach
2008 ASA
Literary AwardWinner
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Why Comprehensive Planning With The Ziggurat and CAPS Models?
Fewer behavior problemsMore instructional timeIncreased compliance with lawIncreased engagement timeFaster IEP developmentBetter IEPsMore positive/collaborative relationship with parentsImproved collaboration among staff
Who is Involved in Comprehensive Planning?
●Parents●Student●General Education Teacher●Special Education Teacher●Para-professional●Speech Language Pathologist●Occupational Therapist●School Psychologist●Administrator●Other as needed
Keys to comprehensive intervention planning
Characteristics Design ImplementImplementDesignCharacteristics
1 2 3 4
4 Steps to Designing aComprehensive Intervention Plan
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Helps you to “see” the autismProvides a “snapshot” of how autism is expressed for an individualA descriptive instrumentCan be completed by a teamProvides a tool for assessing progress/change
Underlying Characteristics Checklist The UCC Areas
SocialRestricted Patterns of Behavior, Interests, and ActivitiesCommunicationSensory DifferencesCognitive DifferencesMotor DifferencesEmotional VulnerabilityKnown Medical or other Biological Factors
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SocialBehavior, Interests, and ActivitiesCommunicationSensoryCognitive MotorEmotionalBiological
Individual Strength and Skills Inventory
Social – UCC-CL Social - ISSI
[3] Shows little interest in or response to praise
[8] Has difficulty imitating the actions or words of others
• Engages in conversational turn taking with parents
• Works near peers in classroom
DesignCharacteristics
1 2 3Implement
4
Steps to Designing a Comprehensive Intervention Plan
UCC-HF or UCC-CL
Not a fine line. When in doubt, review the items from both and select the one that is the best fit.
UCC-HF or UCC-CL
UCC-CL
UCC-HF
HFA/AS“Classic”Autism
Average Skills
Anna – Sample UCC Items
Social[1] Mindblindness[5] Has difficulty making or keeping friends[7] Is naïve, easily taken advantage of, or bullied
Restricted Patterns[14] Has eccentric or intense preoccupations[18] Has problems handling transition and change
Communication[25] Has difficulty with rules of conversation[27] Has difficulty using gestures and facial expressions
Emotional Vulnerability[76] Is easily stressed-worries obsessively[77] Appears to be sad or depressed
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Anna - Individual Strengths and Skills Inventory
Social● Enjoys interacting with
others● Is an avid reader and
enjoys sharing information with others
● Wants to have friends● Responds well to
authority
Behavior, Interests, and Activities● Knows a lot about
fantasy literature● Beginning to
understand when to share and how much to share
Anna - Individual Strengths and Skills Inventory
Communication● Excellent verbal skills● Not shy about talking
with others● Excellent vocabulary
Sensory● Somewhat tolerant of
various sensory input across various environments
● Beginning to recognize when she is becoming overloaded
Anna - Individual Strengths and Skills Inventory
Cognitive● Above average IQ● Can use
organizational sequences, when taught
● Flexible, especially when primed
Motor● Good skills related to
case register operation, inventory, and shelving books
Anna - Individual Strengths and Skills Inventory
Emotional● Beginning to recognize
the feelings of others● Wants to respond to
others’ feelings
Biological● Excellent health
Sensory Differences and Biological Needs
Skills to Teach
Task Demands
Structure and Visual/Tactile Supports
Reinforcement3 Sensory Differences and Biological Needs
“The last thing one knows in constructing a work is what to put first”
-Blaise Pascal
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Sensory Differences and Biological Needs
Provide a sensory dietMonitor and address environmental stressors:● Sound, light,
proximity/personal space, textures
● Movement needs
Monitor and address:● Appetite/hunger● Arousal/activity level
(e.g., fatigue, hyper)● Posture and
movement● Medical needs
Sensory Issues
Asperger Syndrome and Sensory Issues
Sensory Issues
SmellTasteTouchVisual InputAuditoryVestibular (balance)Proprioception (body awareness)
Individuals with AS have more difficulties with modulation and
emotional reactivity when compared to their counterparts with autism
Brenda Smith Myles
Emotional Reactivity
Displays emotional outbursts when unsuccessfulIs stubborn or uncooperativeOften gets “stuck” in a situationIs overly sensitiveReacts overtly when sensory systems needs are not met
Brenda Smith Myles
Sensory Diet Is ...
A planned and scheduled activity program designed to meet specific sensory needs (Yack et al., 1998)Incorporates naturally occurring opportunities for children to get the sensory stimulation they need (Willbarger, 1995)
Miller & Robbins, 2005
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Coping Cards
Take 2 deep breathswith your eyes closed
Press hands together and count to 10 slowly
Amy Bixler, 2006
Reinforcement
“If there is no reinforcer, there is no lesson”
-Andrew Bondy
Reinforcement Reminders
Reinforcement increases the likelihood of a behavior
“The way positive reinforcement is carried out is more important than the amount”
-B.F. Skinner
Selecting Reinforcers
“Individuals on the spectrum may not be as motivated by money as their neurotypicalcoworkers are. . . Their motivation to work will be directly related to the extent to which they enjoy the work. . . A good match is of critical importance.”
OAR (2006). Life Journey through Autism: A Guide for Transition to Adulthood www.researchautism.org
Reinforcement Reminders
“You may not have to look any further than [a] ... special interest to find the perfect reward”
-Sakai, 2005, p. 52
Reinforcement Menu
Time to browse books in the school library
15 minutes to research on the internet on baseball/sports statistics/events
10 minutes of reviewing baseball statistics in personal magazine/books
My School Rewards
Amy Bixler, 2006
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Home Reinforcement Menu
30 minutes of video games
Trip to local baseball card store
30 minutes of time to browse the web
My Home Rewards
Amy Bixler, 2006Structure and Visual/Tactile Supports
“And it is best if you know a good thing is going to happen, like an eclipse or getting a microscope…And it’s bad if you know a bad thing is going to happen like having a filling or going to France. But I think it is worst if you don’t know whether it is a good thing or bad thing which is going to happen.”
- From: The Curious Incident of the Dog in the Night Time, by Mark Haddon, 2003
Structure and Visual/Tactile Supports
“I like everything still. It gives you a full feeling. It gives you a full attention. With something quick, you don’t get the full idea of it. With something still, you take a look at it and you get to know the whole look and feeling”
-Warden from Rage for Order (BBC, 1996)
Common Misperceptions
If an individual can read then he/she does not need pictures or symbolsHe’s in high school, he does not need an individualized scheduleI can stop using a visual schedule once my student learns the routineIf 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 ASDs to succeedIncreased predictability and understanding results in:●Decreased problem behavior● Increased independence
Bopp, K., Brown, K., Mirenda, P. (2004). Speech-Language Pathologists’ roles in the delivery of positive behavior support for individuals with developmental disabilities. American Journal of Speech-Language Pathology 13, 5-19.
Visual Schedules
Research on visual schedules shows that they are:Effective across age rangesEffective across settings
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Visual Schedules
Schedules are effective in decreasingoff-task behaviorsdisruptive behaviornoncomplianceaggressiontantrumsproperty destruction
Mini Schedule
Morning Checklist
Pick reward from your menu
Take out book
Turn in morning work
Complete work
Take out morning work√
Put away backpack√ActivityCheck
Making Coffee
Visual Schedule Visual Schedule
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Screaming
Outside voice
Talking voice
Soft voice/ whisper
No talking
Rating Description Setting
Emergency only
In the parking lot
With customers
Working with employees
Person is talking to meBuron, K.D., & Curtis, M. (2003). The Incredible 5-Point Scale. Shawnee Mission, KS: AAPC.
Incredible Five Point ScaleWait Card
Stress Thermometer
When I make a mistake
Most stressed ever
No stress
Ask for help
When I have hard homework
Putting stuff in my backpack after bus arrives
Call my mom for help
Pack before bus time
Video-Based InstructionalProcedures
Improve daily living skillsPromote generalization
Van Laarhoven, T. & Van Laarhoven-Myers, T. (2006). Comparison of three video-based instructional procedures for teaching daily living skills to persons with developmental disabilities. Education and Training in Developmental Disabilities, 41(4), 365-381.
Video Instruction How to Make Popcorn
Open plastic bag
Unfold bag
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How to Make Popcorn
Place in microwave and start time
Remove from microwave
Open carefully to eatTask Demands
“Just imagine your most stressful day that you’ve ever, ever had . . . your worst day is his best day”
-Parent of child with Asperger’s
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
Task Demands
Easy Challenging/Emerging (possible with assistance)
Zone of Proximal DevelopmentLe
vel o
f Dem
and
Too demanding(independent skills-with or without modification and structural supports)
© Ruth Aspy, Ph.D., Barry G. Grossman, Ph.D.
Supp
orts
Task Demands
Skills
Skills to Teach
Task Demands and Skills to Teach
Demands Ability
Too Demanding
Demands
Ability
Group Work
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Supp
orts
Task Demands
To Balance –Reduce Demands, Add Supports &/or Skills
Skills
Skills to Teach
Demands Ability
Group Work
Provide written instructionsAllow use of laptop to take notesGive extra time for written workTeach to use a Personal Digital Assistant (PDA)Provide organizational skills supportE-mail assignments, reminders
Examples of Task Demand Interventions
Examples of Task Demand Interventions
Use coping cardsCreate Circle of FriendsProvide narrationProvide high interest activities to encourage social interaction
Provide peer buddy/mentorGive highlighted textProvide monitoring teacher/contactProvide “safe place”Allow for breaksPrepare for changeMinimize transitions
Examples of Task Demand Interventions
Skills to Teach
“The teacher who does not understand that it is necessary to teach autistic children seemingly obvious things will feel impatient and irritated”
-Hans Asperger
The Seemingly Obvious
What is it about the situation that comes naturally to everyone else but is missing for this person? Why is it that others do not show the same behavior?
What is it that has not occurred to me to teach?
That is the seemingly obvious. That is the thing to teach.
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Hidden Curriculum
The set of unwritten rules that no one has been directly taught, but everyone knows. Violations of these rules can make an individual a social outcast.Phrase associated with hidden curriculum:● “I shouldn’t have to tell you but … “● “Everyone knows that … “● “It’s obvious … “
Hidden Curriculum
Differs across● Age●Who you are with●Gender●Culture
Other Hidden Curriculum Areas
Airplane/airportFriendsEatingPublic/private swimming poolsSchool rulesBathroom/shower/locker room
Bathroom/Shower/Locker Room
Understand the urinal rules
The HC Curriculum Series
The Hidden Curriculum ● Calendar● Book● DVD
Designing A Global Intervention Plan
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Designing a Global Intervention
Select Key UCC Areas Select Key UCC items to addressDevelop interventions for each level of the ZigguratEnsure that intervention is complete
UCC Areas
SocialRestricted PatternsCommunicationSensory DifferencesCognitive Differences
Motor Differences Emotional Vulnerability Known Medical/Biological Factors
Anna-Select UCC AreasVision
What is the short and long-term vision for the individual?
Short-term●Develop meaningful relationships●Be successful at school and work
Long-term●Make friends●Attend university●Live independently●Have meaningful career
Anna- Select UCC AreasVision
VisionWhich UCC areas would have the greatest impact on achieving this vision?
SocialRestricted PatternsCommunicationEmotional Vulnerability
Remember to stay on target
Anna-Select UCC AreasSettings
In what settings does the individual participate?
●General education●Job (bookstore)●Socialize with peers (drama
club)●Home
Anna- Select UCC AreasSettings
SettingsWhich UCC areas have the greatest impact on the individual’s ability to function in multiple settings?SocialRestricted PatternsCommunicationEmotional Vulnerability
Remember to stay on target
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Anna- Select UCC AreasQuality of Life
What is most important to the individual? What provides a sense of well-being?●Acting●Friends●Independence●Achievement
Anna- Select UCC AreasQuality of Life
Quality of LifeWhich UCC areas have the greatest impact on the individual’s quality of life?SocialRestricted PatternsCommunicationCognitive DifferencesEmotional Vulnerability
Remember to stay on target
Anna- Select UCC AreasKey UCC Areas
Based on your answers to the questions, place a mark next to the key UCC areas.
Social Restricted PatternsCommunicationEmotional Vulnerability
Designing a Global Intervention
Select Key UCC areas
Select Key UCC items to addressDevelop interventions for each level of the ZigguratEnsure that intervention is complete
Select Key UCC Itemsfrom UCC Areas
Select key UCC items for each of the Selected UCC areas.
Choose items that are essential (necessary for progress) and developmentally appropriate.
Emphasize items that are more pivotal (building blocks for additional skills). Avoid selecting redundant items.
Select UCC Items for Anna
Communication #25, 27Emotional Vulnerability#76, 77
Social#1, 5, 7Restricted Patterns#14, 18
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Anna - Selected UCC Items
[1] Mindblindness[5] Has difficulty making or keeping friends[7] Is naïve, easily taken advantage of, or bullied[14] Has eccentric or intense preoccupations[18] Has problems handling transition and change
[25] Has difficulty with rules of conversation[27] Has difficulty using gestures and facial expressions[76] Is easily stressed-worries obsessively[77] Appears to be sad or depressed
Designing a Global Intervention
Select Key UCC areas
Select Key UCC items to addressDevelop interventions for each level of the ZigguratEnsure that intervention is complete
Anna-Intervention Design Activity: Marrying the Underlying Characteristics and Strengths to Interventions
Interventions 3
Anna - Intervention DesignSensory and Biological
Have Anna use 5-Point Scale to recognize stress level. Provide paperclips for Anna to indicate stress. Anna should take a break, get a drink, take a walk to calm.
[18] Has problems handling transition and change
[76] Is easily stressed -worries obsessively
InterventionsUnderlying Characteristic(s)
Anna - Intervention DesignSensory and Biological
* Ensure that Anna has a book or headphones during scheduled breaks and lunch (calming).* Inform all supervisors and fellow employees that Anna may need time for calming activities.
[18] Has problems handling transition and change
[76] Is easily stressed -worries obsessively
InterventionsUnderlying Characteristic(s)
Which Level or Levels?
• Use Anna’s interests in Harry Potter and Lord of the Rings when scheduling Anna’s placement in the bookstore. During high traffic times place her in the Fantasy section, if possible.
Sensory Differences and Biological Needs
Skills to Teach
Task Demands
Structure and Visual/Tactile Supports
Reinforcement
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Anna - Which Underlying Characteristic(s)?
* Have Anna use 5-Point Scale to recognize stress level. Provide paperclips for Anna to indicate stress. Anna should take a break, get a drink, take a walk to calm.
InterventionsUnderlying Characteristic(s)
Anna - Selected UCC Items
[1] Mindblindness[5] Has difficulty making or keeping friends[7] Is naïve, easily taken advantage of, or bullied[14] Has eccentric or intense preoccupations[18] Has problems handling transition and change
[25] Has difficulty with rules of conversation[27] Has difficulty using gestures and facial expressions[76] Is easily stressed-worries obsessively[77] Appears to be sad or depressed
Anna - Which Underlying Characteristic(s)?
* Provide an individualized daily schedule with indicator of any known changes to the routine.
InterventionsUnderlying Characteristic(s)
Which Level or Levels?
Use video to demonstrate how to interact with pleasant and unpleasant customers. Supplement with script.
Sensory Differences and Biological Needs
Skills to Teach
Task Demands
Structure and Visual/Tactile Supports
Reinforcement
Anna - Which Underlying Characteristic(s)?
Use video to demonstrate how to interact with pleasant and unpleasant customers. Supplement with script.
InterventionsUnderlying Characteristic(s)
Anna - Selected UCC Items
[1] Mindblindness[5] Has difficulty making or keeping friends[7] Is naïve, easily taken advantage of, or bullied[14] Has eccentric or intense preoccupations[18] Has problems handling transition and change
[25] Has difficulty with rules of conversation[27] Has difficulty using gestures and facial expressions[76] Is easily stressed-worries obsessively[77] Appears to be sad or depressed
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Interventions
Anna
Use Anna’s interests in Harry Potter etc when scheduling her placement in the bookstore. During high traffic times place her in the Fantasy section
[76] Is easily stressed—worries obsessively
Knows a lot about fantasy literature
Comprehensive Autism Planning System
4Chocolate & Peanut Butter
2008 Literary Award
The Ziggurat Modelby Aspy & Grossman
by Henry & Myles
COMPREHENSIVE AUTISM PLANNING SYSTEMS (CAPS) (Henry and Myles, 2007)
Time Activity Skills/ STO
Structure/ Modifications Reinforcement Sensory
Strategies Social Skills/
Communication
Data
Collection
Generalization
COMPREHENSIVE AUTISM PLANNING SYSTEMS (CAPS) (Henry and Myles, 2007)
Time Activity Skills/ STO
Structure/ Modifications Reinforcement Sensory
Strategies Social Skills/
Communication
Data
Collection
Generalization
CAPS is the framework tying the daily schedule to the CAPS is the framework tying the daily schedule to the
underlying characteristics identified in the UCC underlying characteristics identified in the UCC and the interventions outlined in the Ziggurat Worksheet.and the interventions outlined in the Ziggurat Worksheet.
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Students often move and new teams have to get to know these students, reinventing the wheel is not fair to the student or the teacher.Simply, what works for the individual was not being shared.
Why Was CAPS Developed?
Time and Activity
This includes:● All activities● Transitions that require supports of any nature● Breaks and lunch built into the schedules
Required Tasks
This includes:● All tasks that must be accomplished as a part of an
activity● For example, work in an office (activity) might require the
following activities: answering email, writing up requisition forms, posting to accounts, answering the phone, developing budgets
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Needed Employee Training
Type of training needed and training materials should be specifiedTraining can be group, individual, global or activity-specific● For example, a person may be assigned to
be a coach or go to person during break
Reinforcement
Taken from the Reinforcement or Structure and Visual/Tactile Supports sections of the Ziggurat Worksheet
Social Skills/Communication
Drawn from the following Ziggurat Worksheet sections:●Structure and
Visual/Tactile Supports
●Task Demands●Skills to Teach
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Sensory/Biological Supports
Taken from the Sensory and Biological Needs or Skills to Teach or Task Demandssections of the Ziggurat Worksheet
Environmental Supports/Modifications
Taken from the Structure and Visual/Tactile Supportsor the Task Demandssections of the Ziggurat Worksheet● Visual schedule, list of tasks,
coach, etc …
Natural Supports
Available in the typical work environment. Instruction may be needed on how and when to use the support.
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Data Collection
How to determine if the adult is doing well on the job●May include weekly
or daily meetings, notes, job evaluations, etc..
1. Transfer Interventions from the Ziggurat to the CAPS-TR
Identify the Time, Activity and Required tasks
2. Identify Employee Training
Identify who is to be trained and training materials
8:00 Enter work Time in All; OCALI video
3. Transfer Interventions from the Ziggurat to the CAPS-TR
Items can be used in more than one activity
4. Identify Data to Be Collected Mason
15 year old with AUNon-verbal – uses sign language (inconsistently). Learning how to use communication device.Attends self-contained classroom for all core subjectsPrescribed medication to address anxiety, sleep, and digestion difficultiesWorks in the attendance office
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Mason (continued)
Prefers to be alone. Has no friends. Responds to unexpected change with pacing or hitting/shoving adults.Becomes aggressive (hit or push adults) when unable to communicate wants and needs. Displays repetitive behaviors (e.g., opens and closes doors, lines up items). Becomes aggressive when redirected.
Mason (continued)
Perfectionist. Becomes upset when makes mistakes or when others do not perform tasks “just right.”
Mason’s Services
Speech and language therapyGroup social skillsOccupational therapy consultation
Mason’s ISSI
SocialInteracts with his sister or parentsSuccessfully attends PE and lunch in gen. ed. setting
Behavior, Interests, and ActivitiesLikes routine and predictabilityInterested in animated movies, computer games, and electronics catalogues Can take apart and put back together a hand-held radio
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Mason’s ISSI (continued)
CommunicationHas about 100 signsStarting to use AAC device to express wants/needs
SensoryNot bothered by smellsEnjoys activities involving running/moving/ spinning
Mason’s ISSI (continued)
CognitiveDoes well with puzzles and sequencing/ patterning/matching Can follow 1-2 step directions when presented concretely
MotorIs able to navigate climbing equipment/ heights with much ease Is beginning to use word processor
Mason’s ISSI (continued)
EmotionalGood relationship with familyIs a happy young man overall
BiologicalHealth needs are known (has ongoing medical care)
DesignCharacteristics
1 2 3Implement
4
Steps to Designing a Comprehensive Intervention Plan
Designing a Global Intervention
Select Key UCC Areas Select Key UCC items to addressDevelop interventions for each level of the ZigguratEnsure that intervention is complete
UCC Areas
SocialRestricted PatternsCommunicationSensory DifferencesCognitive Differences
Motor Differences Emotional Vulnerability Known Medical/Biological Factors
28
Mason- Select UCC AreasVision
What is the short and long-term vision for the individual?
Short-term● Communicate consistently using his AAC device● Participate in small group social activities in the
classroom, school, or home environments Long-term
● Successful employment● Live independently● Develop friendships● Improve coping skills
Mason- Select UCC AreasVision
Vision
Which UCC areas would have the greatest impact on achieving this vision?
SocialCommunicationEmotional VulnerabilityRemember to stay on target
Mason- Select UCC AreasSettings
In what settings does the individual participate?
●School●Home●Warehouse
Mason- Select UCC AreasSettings
SettingsWhich UCC areas have the greatest impact on the individual’s ability to function in multiple settings?SocialRestricted PatternsCommunicationCognitiveEmotional VulnerabilityRemember to stay on target
Mason- Select UCC AreasQuality of Life
What is most important to the individual? What provides a sense of well-being?●Watching movies●Playing video games●Looking through electronics
catalogues
Mason- Select UCC AreasQuality of Life
Quality of LifeWhich UCC areas have the greatest impact on the individual’s quality of life?SocialRestricted PatternsCommunicationCognitiveEmotional VulnerabilityRemember to stay on target
29
Mason- Select UCC AreasKey UCC Areas
Based on your answers to the questions, place a mark next to the key UCC areas.
SocialRestricted PatternsCommunicationCognitiveEmotional Vulnerability
Designing a Global Intervention
Select Key UCC areas
Select Key UCC items to addressDevelop interventions for each level of the ZigguratEnsure that intervention is complete
Select Key UCC Itemsfrom UCC Areas
Select key UCC items for each of the Selected UCC areas.
Choose items that are essential (necessary for progress) and developmentally appropriate.
Emphasize items that are more pivotal (building blocks for additional skills). Avoid selecting redundant items.
Select UCC Items for Mason
Cognitive#71Emotional Vulnerability#92, 96, 99
Social#6, 8Restricted Patterns#29Communication#32, 33, 44
Mason- Selected UCC Items
[6] Difficulty maintaining personal space[8] Has difficulty waiting[29] Has strong need for closure[32] Has little or no speech[33] Has difficulty expressing wants and needs[44] Communicates needs through behaviors
[71] Demonstrates learned skills inconsistently[92] Is anxious or easily stressed[96] Exhibits aggression/meltdowns in response to minor changes[99] Has difficulty tolerating mistakes
Designing a Global Intervention
Select Key UCC areas
Select Key UCC items to addressDevelop interventions for each level of the ZigguratEnsure that intervention is complete
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Designing a Global Intervention
Select Key UCC areas
Select Key UCC items to addressDevelop interventions for each level of the ZigguratEnsure that intervention is complete
Sensory
Underlying Characteristics Checklist[32] No speech/nonverbal[92] Is anxious or easily
stressed[96] Exhibits aggression/
meltdowns in response to minor changes
Interventions● Use 5-Point Scale to
monitor/stress/anxiety level
● Use picture/word calming cards/icons
● Sit in a rocking chair and/or deep breathing when feeling anxious
● Use AAC device to express himself
● Frequent breaks
Reinforcement
Underlying Characteristics Checklist● [13] Has difficulty waiting● [32] No speech/nonverbal● [33] Has difficultly
expressing wants/needs● [44] Communicates needs
through behavior● [71] Demonstrates learned
skills inconsistently
Intervention (Reinforce for/ when…)● Demonstrates skills
across settings● Using AAC device to
ask for help or express wants/needs
● Using AAC device instead of aggression
● Using skills to join an activity
● Critical skills (waiting)
Structure and Visual/Tactile Supports
Task Demands Skills to Teach
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Mason
Sit in rocking chair and/or deep breathing when feeling anxious
[92] Is anxious or easily stressed
Enjoys activities involving running/ moving/spinning
Frequent breaks (walking, rocking chair, drink of water)
Mason
Incorporate the use of “change in schedule” card/ icon on device
[96] Exhibits aggression/meltdowns in response to minor changes
Starting to use AAC device to express wants/needs
Use “Wait” and “Break”card/icon
Strengths of the Ziggurat and CAPS Models
Provides a process and framework for designing a comprehensive individualized intervention plan
“Make everything as simple as possible but not simpler”
- Albert Einstein
Strengths of the Ziggurat and CAPS Models
Addresses individual underlying characteristics of ASD by utilizingstrengths and building skills
Strengths of the Ziggurat and CAPS Models
Uses reinforcement and other positive behavior supports
Sensory Differences and Biological Needs
Skills to Teach
Task Demands
Structure and Visual/Tactile Supports
Reinforcement
COMPREHENSIVE AUTISM PLANNING SYSTEMS (CAPS) (Henry and Myles, 2007)
Time Activity Skills/ STO
Structure/ Modifications Reinforcement Sensory
Strategies Social Skills/
Communication
Data
Collection
Generalization
Reinforcem
ent
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Data are collected and analyzed to identify behaviors to be taught and to measure progress in developing skills
Sensory Differences and Biological Needs
Skills to Teach
Task Demands
Structure and Visual/Tactile Supports
Reinforcement
Strengths of the Ziggurat and CAPS Models
Data are collected and analyzed to measure student progress
Strengths of the Ziggurat and CAPS Models
COMPREHENSIVE AUTISM PLANNING SYSTEMS (CAPS) (Henry and Myles, 2007)
Time Activity Skills/ STO
Structure/ Modifications Reinforcement Sensory
Strategies Social Skills/
Communication
Data
Collection
Generalization
Data C
ollection
Plan for transfer and generalization of skills
Strengths of the Ziggurat and CAPS Models
COMPREHENSIVE AUTISM PLANNING SYSTEMS (CAPS) (Henry and Myles, 2007)
Time Activity Skills/ STO
Structure/ Modifications Reinforcement Sensory
Strategies Social Skills/
Communication
Data
Collection
Generalization
Generalization
Plan for transfer and generalization of skills
Strengths of the Ziggurat and CAPS Models
Which of these would you leave out if you want skills to transfer?
Sensory Differences and Biological Needs
Skills to Teach
Task Demands
Structure and Visual/Tactile Supports
Reinforcement
Other Strengths of the Ziggurat and CAPS Models
Emphasizes and enhances evidence-based strategies Facilitates use of proactive interventions
Other Strengths of the Ziggurat and CAPS Models
Facilitates interdisciplinary interventionsPromotes collaboration among parents, and the community
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Transition Resources
Organization for Autism Research (OAR) www.researchautism.orgfree transition manual and DVD for professors
Wrightslaw www.wrightslaw.com
Person-Centered Planning: A Tool for Transition http://ncset.org/publications/viewdesc.asp?id=1431
Video Jug http://www.videojug.com/
Transition Resources
OCALI/Easter Seals videos on employment (available on YouTube)●Changes in the workplace● Social interaction on the job● Starting a new job● Autism & Employment
Transition Resources Contact Information
Ruth Aspy, Ph.D. [email protected]
Barry G. Grossman, [email protected]
www.texasautism.com
Brenda Smith Myles, Ph.D. [email protected]