Embedding EBP into Daily Routines for Young Children (0-3)

Teri McGill M.Ed., BCBA Author

04/27/2020 Added

602 Plays

Description

Home Based Early Intervention services for young children with Autism or Developmental Delays are provided in the natural environment which is often in the family home. School based teams spend time doing Routine Based Interview (RBI) and other assessments with the family in order to learn about the child and the family's daily routines. Once outcomes are determined it is important for the team to go one more step and determine specific Evidence Based Practices that can be used during the family's daily routine to improve child outcomes. This webinar will describe a variety of Evidence Based Strategies that can be used with families during daily routines.

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[00:00:01.040]Welcome to the Tri-State Webinars Series.
[00:00:03.410]Today's webinar is Embedding Evidence Based Practices
[00:00:06.510]Into Daily Routines: for Young Children with ASD.
[00:00:11.270]My name is Terri McGill and I am a Regional Coordinator
[00:00:14.140]for the Nebraska ASD network.
[00:00:16.530]Before this job, I was an Early Childhood Special Ed teacher
[00:00:19.620]for 18 years in Lincoln, Nebraska.
[00:00:22.490]I'm excited today to talk to you about young kids
[00:00:25.520]and how we can embed evidence based
[00:00:28.000]practices into daily routines.
[00:00:35.610]The learner objectives today are participants
[00:00:37.910]will understand what qualifies an intervention
[00:00:40.350]as an evidence based practice.
[00:00:42.450]Be aware of a variety of evidence based practices
[00:00:44.820]that can be used for young children with autism
[00:00:47.520]and understand how to embed evidence based practices
[00:00:50.580]into daily routines to increase child outcomes.
[00:00:56.090]Today's webinar will describe a variety
[00:00:58.240]of evidence based practices that can be used
[00:01:00.550]with families during daily routines for children with ASD.
[00:01:06.800]First we're gonna talk about routines,
[00:01:10.310]a routine is a naturally occurring activity
[00:01:12.550]that happens with some regularity,
[00:01:14.850]including caregiver events and also those times
[00:01:17.740]when families are just simply hanging out.
[00:01:20.250]There are lots and lots of things that we could embed
[00:01:22.590]during those times that are not quite
[00:01:24.960]as structured in the home.
[00:01:27.690]An individual intervention within routine,
[00:01:30.300]so that next step is actually joining the child
[00:01:33.050]in whatever the child is engaged in
[00:01:35.350]and weaving those interventions
[00:01:36.900]into the child and family activity.
[00:01:39.200]So not necessarily having a time that's set aside
[00:01:43.670]for teaching in the home, but instead
[00:01:45.620]doing all those teaching pieces
[00:01:48.660]during those daily activities.
[00:01:53.960]Many of our providers who work with our families
[00:01:57.250]who have very young children with autism
[00:01:59.300]and other disabilities are going
[00:02:01.800]into the homes and starting by doing
[00:02:03.730]a Routine-Based Interview with the family.
[00:02:06.380]This is a semi structured interview and it's an interview
[00:02:09.470]in which the providers are gathering information
[00:02:11.620]about the child, but not just about the child,
[00:02:14.690]but also about that family's daily schedule,
[00:02:17.780]daily routine, daily activities.
[00:02:20.200]And this helps the team to determine priorities
[00:02:22.820]for the Individual Family Service Plan,
[00:02:25.180]but also determine priorities for what daily routines
[00:02:29.510]or activities might be best for families
[00:02:32.500]to be able to work with their child.
[00:02:37.410]Now that the team has completed assessment
[00:02:39.470]and has determined what outcomes they will work on
[00:02:43.140]with the child and what routines are best for the family,
[00:02:46.100]we can now move on and determine what evidence
[00:02:49.080]based practices will fit best with
[00:02:51.320]our outcomes and the daily routines.
[00:02:57.100]As educators of young children,
[00:02:58.730]we know there are many programs and strategies
[00:03:00.820]out there we could use to teach,
[00:03:02.850]but IDEA does require educators
[00:03:04.800]to use research based methods or those with evidence
[00:03:07.670]of effectiveness from publications
[00:03:10.290]in peer reviewed journals.
[00:03:13.040]The National Autism Center did a National Standards Project
[00:03:16.360]in order to determine evidence based practices.
[00:03:21.340]Research based methods that have shown evidence
[00:03:24.580]of effectiveness from publication
[00:03:26.320]in five or more peer reviewed journals
[00:03:28.780]is the criteria that they used.
[00:03:34.000]The National Autism Center really did the work for us
[00:03:37.000]in their National Standards Project.
[00:03:38.850]They came up with a list of established
[00:03:41.000]evidence based interventions
[00:03:42.810]based on the criteria we discussed earlier.
[00:03:45.750]We're gonna go through several of these
[00:03:47.450]different evidence based practices
[00:03:49.700]and how you can embed them during daily routines.
[00:03:56.540]The first evidence based practice we're gonna talk
[00:03:58.430]about is parent training.
[00:03:59.880]This is so important when we talk about
[00:04:01.790]our providers who go into the home
[00:04:03.850]because one of the big pieces of their job
[00:04:05.850]is to coach parents in order to be able
[00:04:08.680]to carry on the strategies during a variety
[00:04:11.610]of daily routines for that child.
[00:04:14.280]This is how we will see those improved student outcomes.
[00:04:21.430]When we do parent training,
[00:04:22.700]there's some important things that we need to keep in mind.
[00:04:25.740]So we wanna be sure that we are training
[00:04:27.750]our parents on how to implement various strategies
[00:04:30.550]and that's of course, after we determine
[00:04:32.640]the best routine or routines for that family.
[00:04:35.880]So when we're training them on a specific strategy,
[00:04:39.120]we first wanna describe that strategy or intervention.
[00:04:42.590]It is very helpful to have those steps in writing.
[00:04:46.170]You could have those steps visually using pictures
[00:04:49.450]if you want to, because we're gonna leave that house
[00:04:52.650]and we want our parents to continue
[00:04:54.380]to do that strategy after we're gone.
[00:04:57.360]So we're first gonna describe and then we're gonna model
[00:05:00.900]that strategy or that intervention.
[00:05:03.460]And we wanna be sure that we're modeling first
[00:05:06.250]so that they can see that being done.
[00:05:08.340]Then we're gonna ask our parents
[00:05:09.630]to try that strategy with that child,
[00:05:13.170]and we're gonna then provide them with some feedback.
[00:05:15.730]We're gonna be sure we're giving gentle feedback
[00:05:18.200]because this isn't easy for many of our families.
[00:05:20.420]Just like when we learn our strategies
[00:05:22.760]and different interventions, they're not easy for us.
[00:05:25.400]So we're gonna give that gentle feedback,
[00:05:27.340]have parents try again and then
[00:05:29.610]answer questions for the parent.
[00:05:31.710]So if when they try that and we give some feedback
[00:05:35.370]and they try it again, they may have some questions
[00:05:38.190]or we may have some more feedback that we give them.
[00:05:41.250]So this step could be repeated several times
[00:05:43.830]until we can see that the family's feeling comfortable
[00:05:46.600]with that intervention.
[00:05:48.330]Always, always be willing to jump in
[00:05:50.310]and model that strategy again
[00:05:51.970]for families, that's so important.
[00:05:56.450]It's important that we think outside the box
[00:05:58.560]in order to provide additional supports
[00:06:00.900]for our families when we're not in the home.
[00:06:03.480]So one thing you could do is a video model
[00:06:05.750]and leave it with your parents.
[00:06:07.410]So this would work, of course, if your parents
[00:06:10.050]have access to technology, it's a great way
[00:06:12.940]for them to go back and review the strategy
[00:06:15.840]in case they have questions or aren't sure
[00:06:17.760]if they're doing it right.
[00:06:19.410]Like I mentioned earlier, you can leave pictures
[00:06:21.870]or written steps of that strategy
[00:06:23.800]that they can also refer to later on when you're not there.
[00:06:27.380]And then the last thing is so important,
[00:06:29.720]we wanna be sure to Zoom in or call our parents
[00:06:32.650]in between visits so that we can ask them
[00:06:35.070]how things are going.
[00:06:36.140]We can answer questions for them,
[00:06:38.370]or if we're on a Zoom meeting, we could actually review
[00:06:41.010]the video model again and make sure
[00:06:43.460]that it's all making sense to the parents.
[00:06:46.570]This step is so important because many of our providers
[00:06:49.610]are only there a few times a month,
[00:06:51.830]and it's really important that our families
[00:06:54.170]feel comfortable in doing the interventions
[00:06:57.460]with their child throughout the day.
[00:07:00.000]If we wait until the next visit
[00:07:01.880]to find out that the parents aren't comfortable,
[00:07:04.440]then we've lost a lot of time
[00:07:07.040]and we don't wanna lose that time.
[00:07:08.760]We wanna be sure that we have those interventions
[00:07:11.130]occurring throughout the days, every day, if possible.
[00:07:14.910]And one way we can do that is to Zoom in
[00:07:17.430]and check in with our families
[00:07:18.990]and make sure things are going okay.
[00:07:23.600]If during one of those check-ins
[00:07:25.120]or during one of your visits, you find out
[00:07:27.350]that things really aren't going okay,
[00:07:29.570]then it's really important that we take the time
[00:07:31.650]to troubleshoot with our parents.
[00:07:33.770]If the family's not implementing the strategy,
[00:07:36.330]we really need to have discussions
[00:07:39.160]and really need to work with the parents
[00:07:40.870]to find out why that's not happening.
[00:07:43.110]It could be that the strategy isn't fitting
[00:07:45.060]into the family routine, which means we might
[00:07:47.500]need to look at a different activity during their day
[00:07:50.270]in order to do that strategy.
[00:07:52.560]If the child's not responding to the intervention,
[00:07:55.530]could mean that the family is trying to do the intervention,
[00:07:58.580]but our child is not responding to that,
[00:08:01.010]and that really means that we probably need
[00:08:03.180]to pick a different strategy in order
[00:08:07.480]to make progress towards that specific skill for our child.
[00:08:11.360]If the family is struggling to remember to implement,
[00:08:14.050]then we need to provide additional supports
[00:08:16.650]in order to help the family remember.
[00:08:19.250]And at the end of the webinar,
[00:08:20.440]I will show you a simple matrix that you can use
[00:08:23.380]with your families, and you can leave it there with them
[00:08:25.970]so that they can refer back to that to remind them.
[00:08:29.420]What strategy they might wanna try
[00:08:31.280]during certain daily routines
[00:08:33.250]or activities throughout their day.
[00:08:35.150]And that did the family try but was not sure
[00:08:37.590]they were implementing it correctly
[00:08:39.820]and this is why the check-ins are so important.
[00:08:42.350]We don't want families to stop and just give up
[00:08:45.240]because honestly doing anything with your child
[00:08:47.830]is honestly better than nothing and that's a great thing.
[00:08:52.400]But if we check in, they have a chance to ask us questions
[00:08:55.915]and we can then help make sure that they're comfortable
[00:08:59.100]and feeling confident in doing
[00:09:01.450]those strategies with their child.
[00:09:06.530]Now it's time for polling question number one,
[00:09:09.280]steps to train and coach parents
[00:09:11.400]on using a new evidence based practice
[00:09:13.780]include which of the following, check all that apply.
[00:09:17.070]Describe the strategy, also have it in writing
[00:09:19.670]or pictures for the parent.
[00:09:21.150]Model the strategy, have the parents
[00:09:23.750]try the strategy and then tell them what they did wrong
[00:09:27.390]and not to do it again.
[00:09:32.290]I'm sure all of you got this right,
[00:09:34.930]on the left side in the red are the strategies
[00:09:37.640]you should have checked.
[00:09:39.280]The one we should not have checked,
[00:09:40.920]is tell them what they did wrong and not to do it again.
[00:09:44.260]So clearly we're not gonna do that to our families,
[00:09:47.390]so we're going to make sure that we give gentle feedback,
[00:09:50.830]have the parent try it again,
[00:09:52.580]and then answer any questions for the parent.
[00:09:55.210]If the parent is still struggling with the strategy
[00:09:58.470]and continues to have questions,
[00:09:59.810]you wanna just keep practicing with them
[00:10:02.190]and then always be willing to model
[00:10:03.890]that strategy again for families.
[00:10:07.670]Now we're gonna move on and talk about
[00:10:09.780]using evidence based practices during daily routines.
[00:10:13.220]Now I want to just interject here
[00:10:15.010]that if you happen to work with kids who are older,
[00:10:17.470]who are going to a center based classroom
[00:10:19.240]or a preschool classroom or even school aged students.
[00:10:23.050]All of the evidence based practices
[00:10:24.650]that we're gonna talk about are very appropriate
[00:10:26.780]for our individuals who are in preschool
[00:10:30.350]or who might even be older, and all of them
[00:10:33.050]can fit into a variety of routines.
[00:10:35.010]Today we're talking about daily routines in the home,
[00:10:37.890]but you can actually modify these and use them
[00:10:40.220]during daily routines in school also.
[00:10:45.020]As we get started here, I just wanna mention
[00:10:47.560]that there are four pieces that are really important
[00:10:50.040]to include in programming for students
[00:10:52.300]with autism, especially our young kids.
[00:10:55.000]These are joint attention, intentional communication,
[00:10:58.430]and we are today gonna talk about manding,
[00:11:00.600]requesting and also show
[00:11:02.340]some receptive communication pieces.
[00:11:05.280]Imitation, which is so important for our individuals
[00:11:08.290]with autism, and then of course,
[00:11:09.680]beginning play with objects.
[00:11:13.620]The next evidence based practice we're gonna talk about
[00:11:15.890]is joint attention interventions.
[00:11:20.460]So for each of the interventions
[00:11:21.930]that we're gonna talk about from here on out,
[00:11:24.120]I'm gonna show you some sample child outcomes.
[00:11:26.610]So these are outcomes that this
[00:11:28.220]evidence based practice would work well for
[00:11:31.200]and also then we're gonna talk about
[00:11:32.930]routines that could work well.
[00:11:34.540]So obviously lots of these strategies
[00:11:38.350]will fit into a lot of different routines
[00:11:40.170]and also will hit a lot of different outcomes.
[00:11:42.150]So these are just examples, so when we talk about
[00:11:45.170]joint attention, some of the outcomes
[00:11:47.430]that might be really, really good
[00:11:50.670]for doing joint attention interventions,
[00:11:52.980]is Susie will look at mom or dad
[00:11:54.840]when they walk into the room.
[00:11:56.470]Paige will respond to her name
[00:11:57.970]by coming to mom when she calls her name.
[00:12:00.550]Danny will shift to look towards a sound,
[00:12:02.850]a toy, or a person in his environment,
[00:12:05.410]or Zach will give eye contact when he needs something.
[00:12:08.700]So these are all joint attention pieces,
[00:12:11.560]so we're gonna wanna be sure the intervention lines up
[00:12:14.200]with that, that's why we gonna choose
[00:12:15.920]to use joint attention interventions for these outcomes.
[00:12:21.300]When teaching joint attention,
[00:12:23.060]we want to look at two specific pieces,
[00:12:25.360]responding joint attention and initiating joint attention.
[00:12:28.740]With really young kids, we're going to want to start
[00:12:31.500]with teaching, responding joint attention first.
[00:12:34.460]There are many daily routines throughout the day
[00:12:36.780]that you can teach joint attention.
[00:12:38.730]These are just a few examples,
[00:12:40.600]during play time, you can use a preferred toy
[00:12:43.030]in order to get your child to shift.
[00:12:45.340]You can sabotage and activity so that the child needs help.
[00:12:49.220]So if you're playing with a windup toy,
[00:12:51.220]you wind it up and it goes.
[00:12:52.800]But when it stops, if they can't wind it up,
[00:12:55.490]they now need you to help.
[00:12:57.360]So we're going to engage in some time delay.
[00:13:00.000]So once they hand us the toy, we're gonna wait
[00:13:03.030]until they engage with us and look towards us
[00:13:06.000]before we wind the toy back up.
[00:13:09.230]During bath time or dressing time,
[00:13:11.170]you can play peekaboo with a towel or a shirt.
[00:13:13.980]During meal time, you can hold a bottle
[00:13:15.740]or a sippy cup up by your eyes.
[00:13:18.060]During other daily routines, when mom and dad
[00:13:20.700]are busy and kids are playing, mom and dad
[00:13:23.330]can call a child's name to see if they will respond,
[00:13:26.500]or they could call a child to see if they will respond
[00:13:29.660]and actually come into the other room
[00:13:31.730]to see what mom or dad wants.
[00:13:37.490]Now we're gonna watch a video, and mom and dad
[00:13:40.090]are doing the dishes and they're going
[00:13:42.130]to call Paige's name, Paige is in the other room,
[00:13:45.040]and they want to see if she'll respond
[00:13:46.490]to her name and come to the kitchen.
[00:13:57.260]Here are six different levels of response
[00:13:59.700]training for joint attention.
[00:14:01.320]I just want you to realize that the first three levels
[00:14:04.130]are all about shifting.
[00:14:06.060]They are not about eye contact and sometimes,
[00:14:09.730]and I was just as guilty of it as others.
[00:14:12.340]We start teaching joint attention with eye contact,
[00:14:15.640]so I just want you to note that there are three levels
[00:14:18.570]that are actually prerequisites
[00:14:20.280]for eye contact for some of our kids.
[00:14:22.610]So we first wanna teach them to shift,
[00:14:25.030]then we're gonna teach eye contact
[00:14:27.110]following a point and following a gaze.
[00:14:31.550]Now we're gonna watch Danny and his mom, Sarah.
[00:14:34.720]Sarah's going to tap on a toy while Danny
[00:14:37.550]is engaged in playing with something else.
[00:14:40.210]The whole idea here is we want Danny to shift to that tap,
[00:14:43.890]and Danny does shift right away.
[00:14:46.350]He actually then says no, because he's decided
[00:14:49.990]he's not so sure about that toy,
[00:14:52.000]but he does in the end engage, so let's watch.
[00:15:01.420]So Danny did a great job of shifting,
[00:15:03.590]and that's what we wanna see our kids do.
[00:15:05.820]Even if he doesn't like the toy,
[00:15:07.330]he's still engaged with the toy
[00:15:09.210]for at least a short amount of time,
[00:15:11.430]other forms of joint attention would be our initiating
[00:15:14.160]or our active joint attention.
[00:15:16.170]And some of these are a little bit higher
[00:15:18.400]and then there's a few that some of our kids,
[00:15:20.240]when they're even eight, nine months, you'll start to see.
[00:15:22.850]But coordinated gaze shifts showing with an eye gaze,
[00:15:26.250]so they'll look at something, real little's,
[00:15:28.220]will do this one, if they are looking at something,
[00:15:31.730]they might look over at it and then look back at you.
[00:15:35.010]But when we're teaching this,
[00:15:36.350]we need to be sure we can first get eye contact
[00:15:38.890]that level four in response training
[00:15:41.240]because we have to first get eye contact
[00:15:43.870]and then we're gonna shift our eye contact
[00:15:46.390]and see if the child will shift with us.
[00:15:49.640]Protodeclarative pointing is actually pointing
[00:15:51.610]to show our comments, so it's not pointing to request.
[00:15:54.370]It's actually pointing to show us something
[00:15:56.720]or comment about something.
[00:15:58.450]Bringing an object for help is when you might
[00:16:00.480]see our kids do when they're young.
[00:16:03.880]This one's of the earlier initiating joint attention skills,
[00:16:08.420]and that's because there's motivation behind it, right?
[00:16:10.720]They want something and they need your help for that,
[00:16:13.760]so that's bringing the bubbles to you for opening it.
[00:16:16.280]They're motivated to use those bubbles,
[00:16:18.430]so they're bringing it to you for help
[00:16:20.300]and so that is a long, that is basically
[00:16:22.590]our requesting in our manding
[00:16:23.840]that we're gonna talk about later.
[00:16:25.420]Then there's making choices, pointing to request,
[00:16:28.350]and then bringing object for show.
[00:16:33.340]There are some simple strategies
[00:16:34.930]that you can coach parents on to use
[00:16:37.050]throughout the whole day with their kids.
[00:16:39.060]Spotlighting is one from relationship
[00:16:41.380]development intervention and I love spotlighting
[00:16:44.170]'cause it's simply throwing in something unexpected
[00:16:46.450]so that child will turn towards you and look.
[00:16:48.980]So spotlighting can be as simple, ah,
[00:16:51.610]and once you do that, the child turns and looks,
[00:16:54.300]you get a fleeting eye glance, and then you reinforce that.
[00:16:57.290]Okay, so, "Oh, you're looking at me,
[00:16:59.157]"you need me to open the bubbles".
[00:17:01.240]Okay, so that's something that you could do.
[00:17:03.490]Time delay is when we pause and wait and that will work
[00:17:06.730]for our initiating an active joint attention.
[00:17:09.740]So if they bring you the bubbles that they want,
[00:17:12.440]you might open them up and blow a few bubbles,
[00:17:15.310]put the lid back on, give it to them,
[00:17:17.260]and then when they bring them back to you for more,
[00:17:19.830]you're gonna pause and wait.
[00:17:22.050]And because you opened them last time,
[00:17:24.220]now the kids are like, why didn't you open it this time?
[00:17:26.540]And they may look up at you like,
[00:17:28.160]why aren't you opening it up?
[00:17:29.720]And so, if they don't look up towards you,
[00:17:32.930]then put those bubbles in their line of vision
[00:17:35.050]and bring those bubbles up to your eyes.
[00:17:37.380]See if you can get just a quick fleeting
[00:17:40.100]glance of eye contact and then reinforce
[00:17:42.310]that and blow those bubbles.
[00:17:44.710]One of the strategies that Bernice de La Cruz
[00:17:47.250]uses in her assessment and teaching guide
[00:17:50.620]is to move the child's arm towards the item.
[00:17:54.370]So when Sarah was tapping on the frog toy with Danny,
[00:17:57.300]if he had not turned, she would take his arm
[00:18:00.370]and move it over and hold his arm above
[00:18:03.370]or his hand above that toy.
[00:18:05.660]By moving the child's arm, their body will shift with that.
[00:18:10.580]So that's a really, really great strategy
[00:18:12.940]for trying to get kids to shift
[00:18:15.450]and then also, I described it earlier,
[00:18:17.970]get in that child's line of vision
[00:18:19.680]or that joint line of regard
[00:18:21.590]and then able to get eye contact that way.
[00:18:26.070]Okay, so if you can't get their eye contact,
[00:18:27.861]you gotta to get down in their line of vision,
[00:18:29.380]and then you might point to see if they'll follow
[00:18:32.430]or you're gonna get that item down there
[00:18:34.560]and you're going to then bring it up towards your face
[00:18:37.090]to get them to look up towards your face.
[00:18:38.710]And again, with all of these, we're trying to get
[00:18:41.070]a quick fleeting glance and reinforce it.
[00:18:45.600]We're not looking for them staring at us then,
[00:18:48.840]so we wanna really reinforce any
[00:18:50.710]quick fleeting eye glance that we get.
[00:18:55.150]Now we're gonna move on to the next evidence based practice,
[00:18:57.730]and that's functionally equivalent replacement behaviors.
[00:19:01.050]It's a lot of words that you don't need
[00:19:02.470]to worry too much about.
[00:19:03.790]What we're talking about here
[00:19:05.130]is making sure that we replace those inappropriate
[00:19:08.300]or negative behaviors with something
[00:19:10.380]that's gonna get kids the same result.
[00:19:12.610]So that's what we're talking about here
[00:19:14.390]and I'll give you some examples.
[00:19:17.380]When we teach those replacement behaviors,
[00:19:19.240]we wanna be sure that it's the right behavior
[00:19:21.300]to get that child what they are wanting or needing.
[00:19:24.400]Oftentimes behavior is communicative and purposeful.
[00:19:27.790]We can't just stop a behavior,
[00:19:29.670]we have to teach a replacement behavior to that student.
[00:19:32.880]Functional communication fits under this, okay,
[00:19:36.020]we want our kids to not scream
[00:19:38.970]or tantrum or bite or scratch because they want something.
[00:19:44.160]We want to teach them a way to request that item,
[00:19:47.750]another word for requesting is manding.
[00:19:50.500]So we're gonna talk a little bit about manding,
[00:19:54.800]some sample outcomes that will work well for manding
[00:19:58.700]and also some of the other
[00:20:00.540]communication outcomes that you might have.
[00:20:03.140]John will communicate his wants and needs at meal times
[00:20:05.750]and during other times of the day.
[00:20:07.270]So that could be an outcome,
[00:20:08.710]Sally will say single words for what she wants.
[00:20:11.640]Molly, will use a simple sign
[00:20:13.320]to ask for a preferred snack.
[00:20:15.480]Bridget will say two or more words,
[00:20:17.670]when asking for items, Noah will go to mom to ask
[00:20:20.890]for a toy or a snack.
[00:20:22.060]So all of those are outcomes that manding
[00:20:27.470]or teaching requesting will really, really help.
[00:20:32.950]So let's talk about daily routines
[00:20:35.740]that manding could fit into.
[00:20:37.270]Now this is another one, just like joint attention
[00:20:39.520]that literally you can do throughout the whole day,
[00:20:41.940]but we wanna pick some specific times
[00:20:44.340]for the parents to target this.
[00:20:46.630]And once parents get good at it, I promise you
[00:20:49.270]they're gonna be doing it all day long,
[00:20:50.710]just like teachers are in school.
[00:20:52.370]So, we want them to request preferred items,
[00:20:55.870]you could do that during meal time.
[00:20:57.360]So having parents hold back some of those preferred items
[00:21:00.780]so that kids have to request them several times
[00:21:03.020]during that meal, during different daily activities.
[00:21:05.900]So ask for the missing or needed items,
[00:21:08.020]so if they want their favorite juice
[00:21:10.940]but they don't have their cup.
[00:21:12.370]So now they have to ask for their cup
[00:21:14.130]in order to get their juice.
[00:21:15.950]And also they wanna go outside, but they need their shoes.
[00:21:20.440]So they need to ask for their shoes
[00:21:22.490]and we're gonna talk about, and I'm gonna show you videos
[00:21:24.730]of ways we can show parents how to do this.
[00:21:27.000]Bath time, requesting favorite toys
[00:21:29.050]for parent or child to put in the tub.
[00:21:32.030]And then outside, requesting you to swing more
[00:21:36.130]or to go in the wagon.
[00:21:37.730]All of those times throughout the day
[00:21:40.300]are great to embed manding.
[00:21:46.150]Just some quick information on what is a mand.
[00:21:48.250]So remember a mand is the same as requesting,
[00:21:50.820]but the principle behind a mand is you want something.
[00:21:53.430]So there's motivation there, you say it and then you get it.
[00:21:56.960]So examples are you're hungry, you say banana
[00:22:00.150]and someone gives you a banana.
[00:22:02.070]There's couple other examples here,
[00:22:03.690]like you need to open a door so you ask for the key.
[00:22:06.330]You're motivated to get in that room, okay?
[00:22:09.000]So someone gives you that key
[00:22:10.440]and then you can get in the room, okay.
[00:22:13.390]Another example that I think as adults
[00:22:15.020]that we might understand or maybe is part
[00:22:18.530]of our world is that if you have a bottle of wine
[00:22:21.950]but you don't have a wine opener, okay or a corkscrew,
[00:22:25.300]you're gonna need to ask for that corkscrew.
[00:22:27.170]So you're gonna ask for that corkscrew
[00:22:28.690]'cause you're motivated to open that wine.
[00:22:30.900]Okay, so asking for the corkscrew, of course is that mand.
[00:22:34.974]So what's most important about a mand to understand
[00:22:38.930]or that requesting is that we request things that we want.
[00:22:41.660]Generally, when kids are young,
[00:22:43.470]this is where they start with their language.
[00:22:45.890]Asking for the things that they love
[00:22:48.240]and that they want during their day.
[00:22:50.110]So there's typically motivation behind,
[00:22:53.450]that beginning to use that language,
[00:22:56.330]whether it's vocal language,
[00:22:57.610]whether it's sign, whether it is handing pictures,
[00:23:00.610]whatever it is, they want something,
[00:23:03.320]and so they need to mand for that or request that.
[00:23:08.230]Like I just said, manding can come in many forms.
[00:23:10.610]Okay, so it could be vocal or speaking
[00:23:12.620]for our very young early learners.
[00:23:14.260]It could be a gesture reaching towards
[00:23:17.110]that cookie is a mand that you want that cookie.
[00:23:20.680]So for those really early learners, we have to start there.
[00:23:24.300]Okay, sign language, using a picture system,
[00:23:27.370]using a voice output device.
[00:23:30.360]All of those things are all
[00:23:32.200]different ways that you can mand.
[00:23:34.400]There are also though what we call defective mands,
[00:23:36.837]and these are less pleasant forms of mand
[00:23:38.880]that we see a lot with our little kids
[00:23:41.300]and all little kids because they're all learning
[00:23:43.630]how to use their language.
[00:23:45.350]And so things like grabbing, screaming,
[00:23:48.440]climbing, hitting, pinching, biting.
[00:23:50.810]All of those behaviors are oftentimes
[00:23:53.510]what we call a defective mand.
[00:23:55.370]So they are communicating, they want or need something,
[00:23:57.930]but they don't have the appropriate way to do it.
[00:24:00.070]And that's why we are going to teach how to mand
[00:24:04.410]or how to request that functionally
[00:24:06.090]equivalent replacement behavior.
[00:24:10.690]Sometimes when I get to this slide,
[00:24:12.350]people are a little bit surprised.
[00:24:14.520]There are things called general mands,
[00:24:16.770]and one of the most popular general mands
[00:24:18.900]that's used with kids with autism is the word more.
[00:24:22.170]And oftentimes we start by teaching our kids
[00:24:25.680]with autism to sign or say more.
[00:24:28.240]The problem with that is our kids with autism
[00:24:30.680]aren't very good at moving past the word more
[00:24:34.450]to use more specific language.
[00:24:36.660]They sort of get stuck in using just more
[00:24:39.760]so when we start teaching mands,
[00:24:41.390]we really want to teach specific words.
[00:24:44.780]So instead of teaching kids to mand for more,
[00:24:47.800]we want to teach them to ask for a cookie
[00:24:50.440]or cracker or milk, and then once they get
[00:24:53.760]some of those mands, then we can add
[00:24:56.670]more or please to that.
[00:25:01.540]Now we're gonna watch two videos of manding,
[00:25:03.660]you're gonna see example of Danny using the more
[00:25:08.050]when he's manding and then you can see what I do.
[00:25:10.950]And then Paxton is our second little guy
[00:25:13.620]and he is manding for M&Ms, but he does not have
[00:25:17.540]the M sound very clearly yet.
[00:25:19.440]So we are accepting approximation
[00:25:21.270]and then that would be shaped along the way.
[00:25:25.350]We wanna be sure that we're manding
[00:25:26.760]throughout the day in the natural environment.
[00:25:29.500]There's many, many times that our kids are excited
[00:25:32.790]about an activity or they want something,
[00:25:35.120]and those are all opportunities for manding.
[00:25:37.540]Here's some examples, your child could mand
[00:25:40.380]for you to push the truck by saying, fast.
[00:25:43.260]They could then mand for going through the door
[00:25:45.720]by saying open, or they could be mand
[00:25:49.210]for water while washing their hands.
[00:25:51.570]Now these might be vocal mands, they might be sign language.
[00:25:55.220]They might be handing a picture
[00:25:57.430]or using a voice output device.
[00:26:01.730]Now we're going to watch a great example
[00:26:03.770]of manding in the natural environment.
[00:26:10.460]The next evidence based practice
[00:26:12.150]we're going to talk about is pivotal response treatment.
[00:26:16.980]Pivotal response treatment or PRT
[00:26:18.920]was developed by Bob and Lynn Koegel.
[00:26:21.200]PRT targets pivotal areas of a child's development,
[00:26:24.750]when we're talking about our really little kids.
[00:26:26.730]We're gonna be working on those first two levels,
[00:26:29.260]motivation and responsivity to multiple cues.
[00:26:32.810]As far as motivation goes, that's that level
[00:26:35.620]where a child is motivated for something
[00:26:38.080]and really wants it, so we really want them
[00:26:40.030]to vocalize for what they want.
[00:26:43.990]Pivotal response treatment was originally developed
[00:26:46.470]by Bob and Lynn Koegel in order to use
[00:26:49.400]for first word development and as a parent training.
[00:26:53.380]And the beautiful part of PRT
[00:26:55.440]and why it fits so well for our families at home
[00:26:58.810]is because it's done in the natural environment.
[00:27:00.880]You follow your child's lead, reinforcement is natural
[00:27:04.900]and is contingent on a specific behavior.
[00:27:07.580]So for the level of motivation
[00:27:09.910]we're gonna expect in that child to vocalize
[00:27:12.520]for what it is that they want.
[00:27:14.780]And your team would work with your SLP
[00:27:18.050]to figure out what would be expected,
[00:27:20.120]are we just looking for a sound?
[00:27:21.670]Are we looking for an approximation of a word?
[00:27:24.730]What is it that we're looking for?
[00:27:27.380]And the really great thing about pivotal response
[00:27:32.030]is that it's really, really fun because it is
[00:27:34.030]in the natural environment.
[00:27:35.640]And I do caution people when we start doing PRT
[00:27:39.900]that we do expect our child to vocalize something.
[00:27:43.170]So they might get mad at first because now
[00:27:45.340]they have to do something in order to get the good stuff.
[00:27:47.980]So you may have kids that get upset at first,
[00:27:51.090]and that's the hardest part about pivotal response,
[00:27:53.810]is you have to be strong and hold out.
[00:27:55.780]Now, if you Google the "Supernanny" episode,
[00:27:58.410]you will see that process.
[00:27:59.850]You will see the little guy getting upset
[00:28:01.980]and Lynn working with the parent and how in the end,
[00:28:06.670]it really results in that child starting
[00:28:08.840]to use words on demand when he wants to request something.
[00:28:12.430]So it's really, really a great episode
[00:28:15.120]and I highly recommend that you take a look at that.
[00:28:20.550]We're just gonna touch briefly on the next
[00:28:22.330]evidence based practice of echoic training.
[00:28:24.680]And this is an evidence based practice in which
[00:28:29.037]we want children to repeat what we're saying.
[00:28:31.890]So it could be simple, sounds like bah, bah, bah,
[00:28:35.210]or it could be a single word
[00:28:37.530]or a phrase like, "Say, go big red".
[00:28:43.330]There are many different routines throughout the day
[00:28:45.440]that families could work on echoic training.
[00:28:48.110]Car rides are a great time to work on it,
[00:28:50.630]so as parents are driving or in the passenger's seat,
[00:28:53.490]they can say a variety of different sounds
[00:28:56.740]or words that they want their child to repeat.
[00:28:59.510]So, "Sally say, go", or,"Say, moo",
[00:29:03.040]or "Say, mmm", or bah, bah, bah.
[00:29:05.730]All of those things can be done while
[00:29:07.230]you're riding in the car.
[00:29:08.750]Outside play is a great time to work on echoic training
[00:29:11.560]because there's lots of natural sounds that kids make.
[00:29:14.550]When they're playing outside in a variety of activities.
[00:29:18.220]So if they are pushing trucks around, you can say zoom,
[00:29:22.350]or if they're going up the ladder for the slide,
[00:29:24.660]you can say up, up, up, or whoosh, or go, go, go, go.
[00:29:29.570]All those different echoics can be used
[00:29:33.520]and at bedtime, if you have a child that's a little higher
[00:29:36.040]than just repeating sounds.
[00:29:38.310]You can have them repeat labels in a bedtime story.
[00:29:41.040]So pointing to dog and tell your child, say dog, say cat.
[00:29:45.810]So there's many different ways we can embed
[00:29:48.270]echoic training into the daily routines.
[00:29:52.980]The next evidence based practice
[00:29:54.620]is comprehensive behavioral treatment for young children
[00:29:57.750]or early intensive behavioral intervention.
[00:30:02.400]So when we talk about comprehensive behavioral
[00:30:04.800]treatment for young children, we're talking about
[00:30:07.700]applied behavior analysis or ABA.
[00:30:09.940]Don't be afraid of ABA, these are things
[00:30:12.280]that you do all the time when you're working with kids.
[00:30:15.130]So it shouldn't be scary, it's,
[00:30:17.757]"The process of systematically applying interventions
[00:30:20.557]"based upon principles of learning theory
[00:30:22.997]"to improve socially significant behaviors
[00:30:25.497]"to a meaningful degree".
[00:30:27.260]So, below are listed all the pieces of ABA,
[00:30:30.830]ABA is not a program, it is a group of principles
[00:30:34.540]that we're gonna apply and when it comes
[00:30:36.990]to working with kids with autism,
[00:30:38.590]systematically applying them makes a huge difference.
[00:30:42.050]Our kids do need intense and a lot of intense instruction
[00:30:47.330]and also a lot of repetition,
[00:30:49.840]which we'll talk about a little bit at the end
[00:30:51.500]of how we can maybe have families working on that.
[00:30:54.360]But there's a lot of different pieces here
[00:30:56.660]that are part of that and many of them,
[00:30:58.530]I'm sure you've heard of.
[00:31:00.250]We're gonna talk about a few of them with a few examples.
[00:31:05.680]Here are some possible sample outcomes that we might use.
[00:31:08.840]Simple, discreet trial for,
[00:31:11.480]or other ABA principles in order to work on.
[00:31:14.780]So, Molly will make more vocalizations
[00:31:16.900]and say simple words during the day,
[00:31:18.630]so that could be an echoic piece.
[00:31:20.700]Meg will follow simple directions.
[00:31:22.930]John will play by himself for short periods of time.
[00:31:26.130]Josh will play with toys in a coordinated way
[00:31:28.620]in the evening, and Molly will pay attention
[00:31:31.630]to the adult and Brady will respond
[00:31:34.050]quickly when the adult talks to him.
[00:31:39.600]One of the ABA principles we might use
[00:31:41.580]with young children in order to.
[00:31:44.810]So there's a really fun and easy way
[00:31:46.770]to do some simple discrete trials with our early learners,
[00:31:49.600]and that's called an object sort.
[00:31:51.710]And we're gonna talk a little bit more about that
[00:31:54.150]in the next few slides and I'll also show you
[00:31:56.010]some video examples of what that is.
[00:31:58.490]But first, let's look at what daily routines,
[00:32:01.940]this might work best in.
[00:32:03.810]Probably a time where a parent could sit down
[00:32:06.750]with that child and do a little playtime with them.
[00:32:10.900]So a structured playtime earlier in the day,
[00:32:13.190]or an evening playtime or even a sibling homework time.
[00:32:17.620]So if that child has older siblings
[00:32:19.390]that have a homework or study time,
[00:32:21.150]it'd be a good time to pull that child to do that.
[00:32:23.790]Maybe before nap time or before bedtime.
[00:32:26.520]So there's a lot of different times
[00:32:28.800]that you could embed this, but this is a little bit
[00:32:31.330]more of a structured activity.
[00:32:32.630]The parent would sit down with a child and do.
[00:32:36.610]This is such a great place to start with early learners.
[00:32:39.150]They still are simple discrete trials,
[00:32:41.740]but in a really fun and easy way.
[00:32:44.260]It's nice to start with kids who struggle with attention.
[00:32:47.250]They struggle to sit, they're really not playing
[00:32:49.780]with toys or objects right now.
[00:32:51.640]They struggle to follow directions,
[00:32:53.260]you guys probably know with our real littles,
[00:32:55.500]those are the things we're talking about.
[00:32:57.420]So we're gonna start with what's called
[00:32:59.000]Context Controlled Responses.
[00:33:00.590]You don't have to remember that language,
[00:33:02.810]when I show you what they are,
[00:33:04.210]they will make perfect sense to you.
[00:33:06.230]But what we're talking about are materials
[00:33:08.930]that actually elicit the response.
[00:33:10.670]So it's not necessarily that I'm saying to the child,
[00:33:13.030]do this, and I'm modeling it.
[00:33:14.880]It's the context of the materials
[00:33:16.800]that actually elicits the response,
[00:33:19.290]usually based on a history of learnings
[00:33:21.740]and you'll see what I mean when I show you an example.
[00:33:25.830]When we do simple discrete trial
[00:33:28.380]with context controlled responses,
[00:33:30.840]we are wanting to teach our kids to be able to sit.
[00:33:34.400]To attend and to follow simple adult directions.
[00:33:38.500]Now they're not really following our directions,
[00:33:41.050]it's actually the context of the materials
[00:33:43.360]that elicits their response, but we are pairing
[00:33:46.530]our direction with that response, and in doing that,
[00:33:50.680]then we'll be able to teach our kids
[00:33:52.200]to respond to us in the future.
[00:33:54.640]Context controlled responses are those things
[00:33:56.910]that you always see embedded in toddler toys.
[00:34:00.290]Push buttons, put things in, take things out,
[00:34:03.040]opening clothes, tapping and rolling.
[00:34:05.690]All of those responses are what we consider
[00:34:08.480]context controlled responses.
[00:34:12.390]Now we're gonna watch a video, and this is simply
[00:34:14.880]to model what the object store might look like.
[00:34:17.790]So I am actually going to just present items
[00:34:20.620]to Paige and she's going to respond, mostly here.
[00:34:24.070]I just want you to see what kinds of materials
[00:34:26.430]we might be using, some of them are a little bit higher
[00:34:29.480]than context controlled responses,
[00:34:31.810]but I want you to see the kinds of things
[00:34:33.730]that you could gather to do an object sort with a child.
[00:34:40.940]So this is a video of Danny doing
[00:34:43.170]a few context controlled responses
[00:34:45.250]and I show this because Danny actually got stuck.
[00:34:48.090]He wanted to keep doing the pop beads over and over,
[00:34:50.760]and that's okay and that's why I'm showing this
[00:34:53.740]because I want you to know that this should be flexible
[00:34:56.330]and this should be fun.
[00:34:57.430]And if a child wants to do something over several times,
[00:35:00.260]we can do that and then we can move on
[00:35:02.210]to something else later.
[00:35:03.730]The other interesting thing with Danny, is I said,
[00:35:06.097]"My turn", for him to give me the pop beads
[00:35:08.750]and you can see how he'll respond to that.
[00:35:13.970]So, Danny asked for his turn because I said my turn.
[00:35:18.600]So what we should probably do is get
[00:35:20.980]in a habit of saying, give instead of my turn.
[00:35:24.010]And that's because we're generally
[00:35:25.490]not taking a turn with the materials.
[00:35:27.250]It's not a turn-taking kind of thing,
[00:35:29.170]we're actually asking for them back so we can move on.
[00:35:32.130]So it's probably better to get
[00:35:33.570]into the habit of saying, give, it's a tough habit to break.
[00:35:36.650]I'm continuing to work on it.
[00:35:38.950]Now, here we're gonna see, Emma doing her object sort
[00:35:41.740]with mom in the morning before they get
[00:35:43.490]their day really going and you are gonna hear
[00:35:46.700]Rachel say my turn, but I want you to watch
[00:35:49.750]because she takes a turn with the item
[00:35:52.280]and she's also working hard to switch that to give.
[00:35:54.900]But she did a great job of taking a turn with that item.
[00:35:59.860]After our kids start using the object sort,
[00:36:02.050]then we can also start to develop
[00:36:03.690]some structured play boxes.
[00:36:05.670]Using play box is a great way to get kids to sit
[00:36:09.450]and complete a task or an activity
[00:36:11.690]and that's really important
[00:36:13.090]when our little ones are at home.
[00:36:15.060]And that's so mom and dad can walk away
[00:36:17.030]and check on another sibling, maybe put a load of laundry in
[00:36:20.670]maybe start making dinner, those kinds of things.
[00:36:23.320]So these play boxes are a great way
[00:36:25.160]to teach kids to sort of entertain themselves.
[00:36:27.980]So these are simple put in, the one in the top right
[00:36:31.170]is a pole and then put in,
[00:36:33.430]there's another put in on the bottom.
[00:36:35.240]There's also an example of a Lego one,
[00:36:38.250]so put on top and push, you could use regular blocks
[00:36:42.880]and just have them stack them.
[00:36:44.380]They can match or not match,
[00:36:46.310]it's totally up to what the strengths are of your child.
[00:36:50.350]You can make several of these and mom and dad
[00:36:52.340]could line them up and have the kids work through them.
[00:36:55.390]And again, it really helps to teach kids
[00:36:57.880]to persist through and complete an activity.
[00:37:01.910]In your handouts, you have a variety
[00:37:04.300]of other pictures of some examples of play boxes.
[00:37:08.140]Some are very simple for those really early learners
[00:37:10.480]and then there's some that are getting
[00:37:11.680]a little bit more difficult.
[00:37:14.990]Now it's time for polling question number two,
[00:37:17.630]context controlled responses are simple
[00:37:19.810]responses that happen due to a history
[00:37:22.440]of learning and the context of the materials.
[00:37:25.070]Is this A true, or B, false?
[00:37:30.070]The answer is A, true, this is actually the definition
[00:37:33.430]of a context controlled response is that
[00:37:36.530]the context of the materials and the history
[00:37:38.930]of the learning are what elicit that response.
[00:37:43.710]The next thing we're gonna talk about
[00:37:45.150]or continue talking about is imitation
[00:37:47.440]and some simple discrete trial.
[00:37:49.440]So we're gonna talk about how we can use
[00:37:52.410]those simple discrete trials again,
[00:37:54.020]within some of those daily activities.
[00:37:55.950]And remember, there's all kinds of them,
[00:37:57.640]and they're listed there a variety of daily activities
[00:38:00.910]that you actually could incorporate
[00:38:03.110]some real simple discreet trial.
[00:38:07.380]Here are a variety of sample child outcomes
[00:38:10.010]that we might use, simple discrete trial and imitation for.
[00:38:14.220]Taylor will play with babies with her cousins.
[00:38:16.430]John will play with animals with his brother.
[00:38:19.190]Emma will cooperate when getting dressed.
[00:38:21.390]Gracie will put a toothbrush in her mouth when mom shows her
[00:38:24.540]and Emma will use a washcloth after mom demonstrates.
[00:38:29.310]Here's some other sample child outcomes
[00:38:31.860]that we could use simple, discrete trial
[00:38:34.340]with imitation or do some receptive language training
[00:38:38.270]in order to hit these goals.
[00:38:40.340]Susie will sit to do an activity,
[00:38:42.960]that's a great one for those little
[00:38:44.320]object sort boxes I just showed you.
[00:38:46.730]Maggie will play with toys in a variety of ways.
[00:38:49.330]Brady will watch little brother
[00:38:51.350]or parent and do what they do, so imitation.
[00:38:54.660]John will sit at the table with the family
[00:38:57.140]doing those objects sorts helps to teach
[00:38:59.790]those kids how to sit, so that fits for that too.
[00:39:02.610]Joey will recognize names with a variety of items
[00:39:06.140]in the home in order to follow simple directions.
[00:39:11.900]Now we're gonna watch a video of Joey doing just that.
[00:39:15.360]He's getting ready for bath time,
[00:39:17.180]and so his mom is going to ask him to find one of his toys,
[00:39:21.500]so he has to discriminate between those toys
[00:39:24.050]and put it in the bathtub.
[00:39:25.970]Now, after Joey does that
[00:39:28.110]and they actually get in the bathtub, which we won't see,
[00:39:31.480]mom then is actually working on Joey
[00:39:34.040]labeling those items and that way,
[00:39:36.490]working a little more on that expressive language.
[00:39:41.780]Now we're gonna move on to polling question number three.
[00:39:44.770]Discrete trials can only be done at a table
[00:39:47.840]and are not fun, is this A true, or B false?
[00:39:52.560]Hopefully you got this one correct, the answer is B, false.
[00:39:57.530]So, like I said, discrete trials can be done anywhere
[00:40:00.970]and for at home you're gonna wanna make sure,
[00:40:04.570]depending on your little one that the family's working with.
[00:40:08.730]If they need an area that's less distracting,
[00:40:10.740]it just might be a little corner on a rug,
[00:40:13.860]some families like to use a little table,
[00:40:16.040]so a kid sized table that they can
[00:40:18.590]move over to a corner, so it's less distracting.
[00:40:20.860]But that's completely up to the family.
[00:40:24.920]So we're gonna continue with some imitation,
[00:40:27.570]but we're gonna do some imitation with some objects.
[00:40:30.710]And that's because we really wanna work
[00:40:32.660]on some play skills for our young kids with autism.
[00:40:35.570]So remember when we do imitation,
[00:40:38.100]we're gonna say, do this, and we're gonna model
[00:40:40.800]pushing the car, but we're not gonna say push the car.
[00:40:43.300]We're just gonna say, do this and model it.
[00:40:46.180]We're gonna help them by providing a prompt.
[00:40:48.160]So, it could be a hand over hand prompt
[00:40:50.100]if our little one needs it
[00:40:51.350]and then reinforce them immediately.
[00:40:55.720]When we talk about using imitation
[00:40:58.120]in the natural environment, remember
[00:40:59.630]that you can use imitation to teach
[00:41:01.790]so many different skills.
[00:41:03.700]On the left are those object imitation pieces
[00:41:06.480]where we're teaching kids to imitate with an object
[00:41:08.720]so that we can build some play skills.
[00:41:10.710]On the right in the top are those motor skills
[00:41:13.840]that we can teach, great for outside time,
[00:41:17.700]or if there's a motor time that parents
[00:41:19.900]are doing with their kids during the day or in the evening
[00:41:22.440]and then also we can teach those adaptive skills.
[00:41:26.540]So those life skills for littles, okay.
[00:41:30.280]So wiping their face, okay, or putting a toy in the box.
[00:41:33.990]Okay, or putting their cup in the sink.
[00:41:36.040]All of those can be taught with imitation,
[00:41:40.540]now we're going to watch a couple examples
[00:41:43.050]of simple discrete trial imitation
[00:41:46.170]with an object to do some beginning play.
[00:41:51.220]So with Oli and Hayden, we just saw a simple one step.
[00:41:55.100]We modeled it with a toy and they responded.
[00:41:58.540]With Oli, we did some prompting,
[00:42:00.610]with Hayden, she didn't need the prompting,
[00:42:03.000]and that's a really great way
[00:42:04.320]that you can start to build those skills.
[00:42:06.670]After Oli learns to walk the animal,
[00:42:09.130]he could also learn to put the animal in a truck.
[00:42:11.530]Then he can walk the animal to the truck and put it in.
[00:42:14.490]Hayden could learn how to feed
[00:42:16.280]the baby and cover the baby up
[00:42:18.020]and then we could put together,
[00:42:20.020]feed the baby, give the baby a kiss,
[00:42:22.410]and then put that baby to bed.
[00:42:24.440]Now here Rachel and Emma are going to demonstrate
[00:42:28.660]doing just a little quick little imitation session
[00:42:33.071]while she's getting dressed.
[00:42:36.060]So this is in the morning when she gets up
[00:42:38.690]and so mom's gonna work some little imitation in here.
[00:42:49.430]Okay, so we got to go over
[00:42:52.330]several different evidence based practices,
[00:42:54.780]but I also want you to look at a way
[00:42:56.420]to help organize this for families.
[00:43:00.600]So you have a blank one of these matrixes in your handouts,
[00:43:04.480]and this is just a really nice way
[00:43:06.150]to help families organize when
[00:43:08.590]they're gonna work on certain skills.
[00:43:10.270]Now you could pick one skill for your family to work with,
[00:43:13.480]and especially if this is a new kiddo,
[00:43:15.210]you're working with the families new to this.
[00:43:17.040]Maybe we're just gonna work on requesting,
[00:43:18.870]but we are gonna systematically
[00:43:22.950]put some opportunities for requesting
[00:43:25.010]in several different activities
[00:43:26.740]or daily routines for the family,
[00:43:28.720]or if you're gonna work on several
[00:43:30.340]different skills like this one.
[00:43:31.870]They're working on manding, imitation
[00:43:34.210]and then receptive language and some echoics.
[00:43:37.490]So they've got the target skills on the left
[00:43:41.450]and those were just boxes
[00:43:42.680]added to the form that I'm gonna give you.
[00:43:44.630]And then there's the daily routine,
[00:43:47.340]so a wake up routine and then,
[00:43:49.660]we're gonna do some echoics and some imitation during that.
[00:43:52.630]Breakfast, we're gonna do some manding.
[00:43:55.210]We can even do some echoic, some imitation and receptive
[00:43:57.770]so there's lots we can do during that.
[00:43:59.990]Now, I don't want you to overwhelm
[00:44:01.500]your families, this is a lot, okay.
[00:44:03.630]But you may pick a couple of things
[00:44:05.207]and a couple of different activities
[00:44:07.200]that you want them to do, and then every time you're there,
[00:44:10.160]you can adjust this, okay, and add different things.
[00:44:13.500]One of the cool things about these is that
[00:44:16.020]you can also have parents check off, okay,
[00:44:18.330]so we can see if they've done it
[00:44:20.510]and they can share with us what they did.
[00:44:22.350]So that's checkoff column on the right,
[00:44:24.750]you don't have to use that, but you can
[00:44:26.320]if you want to or if the parent wants to, so they remember.
[00:44:30.590]The other thing is once we get parents
[00:44:32.500]to start learning how to do these interventions
[00:44:35.410]and we start having them practice
[00:44:36.990]during certain activities or daily routines.
[00:44:40.320]What generally will happen
[00:44:41.630]is they'll start doing them during all
[00:44:43.380]different times of the day.
[00:44:44.960]And so we shift their thinking
[00:44:46.900]into when is there an opportunity to do this skill?
[00:44:50.500]And I know because that's how I learned
[00:44:53.070]and that's how I got my self shifted in my master's program.
[00:44:57.140]We had to do these types of matrixes
[00:44:59.910]for our students in our classroom.
[00:45:01.940]And it was very time consuming at first,
[00:45:04.040]but it actually then changes your thinking
[00:45:07.420]into always looking for the opportunity to embed a skill.
[00:45:10.730]And we would love for our parents
[00:45:12.210]to get to the point where they're always
[00:45:14.100]recognizing those opportunities as much as they can.
[00:45:17.700]So this is a nice way to help organize it for your families.
[00:45:22.260]So in conclusion, it's really important
[00:45:24.790]that we determine those individual outcomes
[00:45:27.190]for a student's educational plan,
[00:45:29.130]that we determine the family's daily routines
[00:45:31.850]that will lend to working on specific child outcomes,
[00:45:34.520]and that will work for the family.
[00:45:36.190]And don't forget to go the next step
[00:45:39.780]and determine what evidence based practices
[00:45:42.060]will be most effective to teach
[00:45:43.890]those outcomes during those daily routines.
[00:45:48.710]Believe it or not, there's a little bit more
[00:45:50.220]additional information for you that I'm gonna share.
[00:45:53.920]So you have additional handouts
[00:45:55.710]on a few more of the evidence based practices
[00:45:58.060]that work really well at home.
[00:45:59.930]Story-based interventions, scripting
[00:46:02.380]for some of our play pieces,
[00:46:04.100]some of the antecedent interventions.
[00:46:05.860]So our families, many, many
[00:46:08.000]could benefit from learning how to use some schedules
[00:46:11.000]and some visuals for their kids at home.
[00:46:13.040]And so there's some examples of those
[00:46:14.570]in your additional handouts.
[00:46:16.560]How to use a little simple reinforcement
[00:46:19.720]system with their kids at home.
[00:46:21.520]And then like I said, there were some
[00:46:23.200]additional play box ideas for those early learners.
[00:46:26.530]Also you have handouts on joint attention,
[00:46:29.080]providing communication and language opportunities,
[00:46:32.540]and then that blank embedding opportunities
[00:46:34.770]during daily routine sheet.
[00:46:36.530]All those are available for you as handouts.
[00:46:41.370]Listed here are a variety of other Tri-State webinars
[00:46:44.600]that are archived on the Nebraska,
[00:46:47.010]Kansas, and Colorado websites.
[00:46:49.630]And these are really specific to early childhood,
[00:46:51.890]so you might enjoy watching some of these yourselves,
[00:46:54.390]and many of these are really great ones
[00:46:56.510]to share with your parents.

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Embedding EBP into Daily Routines for Young Children (0-3)

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