ABLLS-R, AFLS, VBMAPP, ESDM, PEAK!?!? CHOOSING THE RIGHT ASSESSMENT FOR YOUR LEARNER WITH AUTISM Session 3 Early Learners

MegAN MILLER, PHD, BCBA-D Author

08/20/2021 Added

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ABLLS-R, AFLS, VBMAPP, ESDM, PEAK!?!? CHOOSING THE RIGHT ASSESSMENT FOR YOUR LEARNER WITH AUTISM Session 3 early learners

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[00:00:03.110]Hi everyone, this is Dr. Megan Miller.
[00:00:06.440]Welcome to session three, best practices
[00:00:09.480]and assessment for early learners.
[00:00:11.740]This is the third and last session in our series,
[00:00:14.810]choosing the right assessment for your learner.
[00:00:19.200]In today's session,
[00:00:20.830]we are going to look at some assessment considerations
[00:00:23.760]for early learners, when I say early learners,
[00:00:27.050]I typically mean ages three to five.
[00:00:29.350]Some of the video examples
[00:00:30.620]will be of children younger than that,
[00:00:32.300]but the concepts still apply.
[00:00:34.920]Within that, we're going to talk a little bit
[00:00:36.560]about the Early Start Denver Model,
[00:00:38.520]the First Words Project, Autism Navigator,
[00:00:40.820]and ESI, RIE parenting, and the ADOS and SORF.
[00:00:45.690]We'll also go over the appropriateness
[00:00:47.960]of looking at certain skills based on developmental level.
[00:00:52.260]And we will end with a case example,
[00:00:54.820]similar to what we did in session two,
[00:00:56.740]but this one is focused on that early learner profile.
[00:01:02.810]So first let's talk about the Early Start Denver Model.
[00:01:06.670]This is a model that combines the developmental research
[00:01:10.290]with the research in behavior analysis.
[00:01:14.020]It is an excellent resource for understanding research,
[00:01:17.950]broadly speaking, relating to autism.
[00:01:20.400]The book has a ton of citations,
[00:01:22.360]both from the developmental literature
[00:01:24.000]and the behavior analytic literature.
[00:01:26.000]The book that I have here on this slide is from 2010.
[00:01:30.410]They have another book for parents
[00:01:32.410]that was published more recently,
[00:01:34.570]and they've been conducting research
[00:01:36.650]for the past at least 10 years.
[00:01:40.140]So you can also get additional research
[00:01:43.160]if you did a Google scholar search
[00:01:44.810]on the Early Start Denver Model.
[00:01:48.210]It provides wonderful information
[00:01:50.160]about how to structure sessions,
[00:01:52.110]and this can even apply to the school day,
[00:01:54.270]especially if you're looking
[00:01:55.390]at when you're working in centers or having pullouts
[00:01:58.910]and having more one-on-one time.
[00:02:01.600]And also when you're doing play-based activities
[00:02:03.890]with your students.
[00:02:05.120]In addition to that though,
[00:02:06.290]they have a whole entire aspect of their model.
[00:02:10.330]It's not necessarily described in this book,
[00:02:12.260]but it is described in the literature and on their website,
[00:02:15.270]that's focused on group instruction.
[00:02:17.120]So they've done specific work
[00:02:19.090]on how to incorporate this model within the classroom.
[00:02:23.740]It also provides wonderful ideas for the order
[00:02:27.060]that skills should be taught in.
[00:02:28.710]They put the skills in a much more broken down fashion,
[00:02:33.180]and then the VB-MAPP or the ABLLS.
[00:02:34.810]And it really looks at how does language
[00:02:38.640]and communication develop for children.
[00:02:42.930]And then how does that interact with an autism diagnosis.
[00:02:46.960]And it's based on looking at the research,
[00:02:48.740]not just on practice and people's experience
[00:02:52.610]with what they're seeing with their clients.
[00:02:55.950]And there's also a really, really crucial section
[00:02:59.770]at the beginning of the book
[00:03:01.260]that describes the social piece.
[00:03:02.760]So we'll talk about that in a bit more detail
[00:03:04.820]on a future slides.
[00:03:07.420]Like this one.
[00:03:08.597](Megan laughs)
[00:03:09.430]So these are a couple of quotes from the book.
[00:03:11.070]It says, "Children with autism often are less inclined
[00:03:14.367]"to initiate interaction with people
[00:03:16.407]"and tend to focus on a narrow range of activities."
[00:03:19.437]"Infants, thus actively shape the amount
[00:03:21.507]"and type of social exchanges with caregivers."
[00:03:24.717]"A child with autism may not respond with pleasure,
[00:03:27.147]"eye contact, or laughter."
[00:03:28.877]"If social partners feel as if their initiations
[00:03:31.337]"are not positive for the child,
[00:03:33.147]"they may well decrease their initiations."
[00:03:35.590]So this is looking at the cycle of social interactions,
[00:03:38.220]even from infancy and how looking just as what we know
[00:03:43.260]about behavior analysis and learning,
[00:03:45.570]if something's not reinforced, it won't continue.
[00:03:48.690]So for the parents, this isn't trying to place blame
[00:03:51.240]on the parents or anything like that,
[00:03:52.550]it's not the refrigerator mother theory or anything.
[00:03:55.300]It's just an observation that as a parent
[00:03:58.490]or any other social partner in a child's life,
[00:04:01.010]if you're trying to initiate interactions with a learner
[00:04:04.490]and you're not getting any sort of response from them,
[00:04:06.850]your interactions will decrease.
[00:04:09.760]What this means is what we typically do,
[00:04:14.370]especially as neurotypicals,
[00:04:16.550]and people not diagnosed with autism
[00:04:18.890]or any other neuro-diverse diagnosis,
[00:04:22.320]we may not understand what interactions are motivating
[00:04:26.850]and reinforcing for the child that we're working with.
[00:04:31.650]What that also means is we need to do more detective work
[00:04:35.080]on our side to figure out
[00:04:36.560]how to connect with those learners
[00:04:38.890]to get those positive interactions going
[00:04:41.060]and build that trusted relationship
[00:04:42.600]that I was talking about in session one and session two.
[00:04:47.610]Why is this important?
[00:04:48.860]Why is it important to understand
[00:04:50.460]what's going on with the social piece
[00:04:52.120]and how this can affect the intervention being provided?
[00:04:57.520]Well, Kuhl, In 1993,
[00:04:59.630]showed that social interactions are integral to learning,
[00:05:02.210]especially for that age, the birth to five,
[00:05:05.390]most learning happens through play and social interactions.
[00:05:08.570]So they've done research to look at how skills are acquired
[00:05:12.150]and maintained and when there's play
[00:05:14.240]and social interaction involved, it's much more successful
[00:05:17.600]than if you're just trying to present structured,
[00:05:21.930]isolated teaching to a young child.
[00:05:25.800]It's a fundamental requirement having this social piece
[00:05:28.990]in picking up and learning from the natural environment.
[00:05:34.320]Another part of the social piece
[00:05:35.690]that's important is the development of neural pathways.
[00:05:39.320]This is discussed in great detail in the book,
[00:05:41.737]"I Am Not a Neurologist," so giving that disclaimer,
[00:05:44.730]but this is just a summary from when I read the section,
[00:05:47.930]what stood out to me.
[00:05:49.560]So even if you're not a neurologist,
[00:05:52.840]especially if you're a behavior analyst,
[00:05:54.350]we know reward and feedback from the environment is crucial,
[00:05:58.170]that's a big part in learning
[00:06:00.410]and how responses increase over time.
[00:06:04.860]What happens at a very young age
[00:06:07.280]is we're developing different neural pathways,
[00:06:10.310]one of those pathways is hypothesized
[00:06:12.630]to be the object pathway.
[00:06:14.630]So as we interact with objects,
[00:06:16.310]we have neural pathways developing,
[00:06:18.230]relating to those objects.
[00:06:21.180]Oops, sorry, I thought I had one more bullet point there.
[00:06:25.280]So what the hypothesis,
[00:06:27.010]this is all theoretical at this point,
[00:06:29.800]but the hypothesis is, learners diagnosed with autism,
[00:06:34.060]autistic children, their object pathways are more developed,
[00:06:40.070]but this happens for babies in general,
[00:06:41.760]you can see that they're focused on different objects
[00:06:44.800]and how things work and things like that.
[00:06:47.690]What's not happening though for autistic children,
[00:06:50.530]the theory goes, is the development of neural pathways
[00:06:53.670]relating to social interaction.
[00:06:56.800]If we don't have that reward
[00:06:59.130]and feedback from the environment around social interaction,
[00:07:02.700]those neural pathways also will not develop.
[00:07:06.000]So it's really important to think about
[00:07:07.780]how you're structuring your classroom
[00:07:09.480]and your assessments to build those social interactions.
[00:07:12.930]How well are you assessing that social piece
[00:07:15.690]and looking at the basic language
[00:07:18.020]and interaction for your learners,
[00:07:19.600]especially the early learners.
[00:07:21.580]If we're so focused on objects,
[00:07:23.920]teaching different academics with flashcards
[00:07:27.060]and materials and all of these objects,
[00:07:29.120]really coming in strong with different reinforcers
[00:07:31.290]that are all object based, we run the risk of continuing
[00:07:35.670]to really develop those object pathways
[00:07:38.570]at the cost of not developing the social interaction,
[00:07:41.830]social pathways, which could obviously cause difficulty
[00:07:45.290]for a learner down the road.
[00:07:47.010]Again, this is all theoretical,
[00:07:48.810]but for me as a practitioner at least,
[00:07:51.070]if I'm looking at the risks involved,
[00:07:53.190]I definitely wanna make sure I'm balancing
[00:07:55.050]at the very least, having a lot of time spent
[00:07:58.930]to build those social interactions
[00:08:01.160]and let those social pathways develop.
[00:08:02.880]I do not wanna be the person responsible
[00:08:05.410]for only assessing things relating to objects
[00:08:07.750]and only using objects that are reinforcing
[00:08:10.650]and not building up that social connection.
[00:08:13.090]I want to make sure I'm covering both sides,
[00:08:16.280]even if it's theoretical at this point,
[00:08:18.760]I don't wanna run the risk of being the person
[00:08:20.930]that messes up the development of these pathways.
[00:08:25.500]Another piece to the Early Start Denver Model
[00:08:27.720]that's not necessarily relating to the assessment,
[00:08:30.290]but I think it's important to understand,
[00:08:32.010]especially when we're talking about early learners,
[00:08:34.310]is the joint activity routine.
[00:08:36.170]So with Early Start Denver Model,
[00:08:37.510]you do your assessment and every 12 weeks you reassess.
[00:08:41.560]When you're in that 12 week period,
[00:08:43.970]you're providing your intervention.
[00:08:45.780]Most of your intervention is presented
[00:08:47.500]in this framework of the joint activity routine.
[00:08:49.940]And there's two different types of routines,
[00:08:51.750]there's play-based routines,
[00:08:53.660]and then there's sensory social routines
[00:08:55.320]that are more focused around like songs
[00:08:57.540]and different physical activities.
[00:08:58.940]And the book covers those in great detail.
[00:09:02.410]So the way the joint activity routine works,
[00:09:04.250]is you have a clear setup,
[00:09:05.530]which is the beginning of the interaction.
[00:09:07.540]As much as possible that's child led
[00:09:09.930]with different materials in the room
[00:09:11.730]and the child chooses what to interact with.
[00:09:14.410]Obviously in a classroom setting,
[00:09:15.880]you might be a little bit more limited, but like I said,
[00:09:18.530]you could really set this up nicely during a center times,
[00:09:22.060]or any one-on-one pullouts that you might have
[00:09:24.160]where you can have different materials available
[00:09:26.380]and follow the child's lead to see what they interact with.
[00:09:30.130]The second step is to develop a theme,
[00:09:32.070]so you go back and forth a few times
[00:09:34.110]just doing the same thing.
[00:09:35.920]So if for example, your learner chose drawing,
[00:09:38.860]you might just make like certain marks on the paper,
[00:09:41.470]or if there's a certain character they like to draw,
[00:09:43.820]you might do something with that.
[00:09:45.050]You might have a song you're singing
[00:09:47.320]and you're drawing as you sing the song,
[00:09:49.070]but there's some theme that you're developing
[00:09:51.370]and you're just going back and forth with that a few times.
[00:09:54.990]The third step is to have variations.
[00:09:57.270]So the point of the variation
[00:09:59.120]is to give an opportunity to extend the activity.
[00:10:01.960]So once you've developed that theme,
[00:10:03.900]you're gonna switch things up a little bit.
[00:10:05.390]Maybe you change the lyrics to your song
[00:10:07.420]and draw something different,
[00:10:08.710]maybe you were drawing straight lines,
[00:10:10.130]and now you're going to draw horizontal lines.
[00:10:12.540]So you change what you're doing
[00:10:14.240]and that can extend the amount of time
[00:10:15.710]you're in the activity
[00:10:17.480]and the skills that you're working on.
[00:10:19.340]It also allows more language to occur.
[00:10:21.670]It increases flexibility for the child,
[00:10:24.120]and it can maintain motivation.
[00:10:25.840]If you have novelty involved within the theme,
[00:10:29.470]they're likely to maintain their interest longer.
[00:10:31.970]Now, obviously some children it's the opposite,
[00:10:34.460]when things change, they have difficulty with it,
[00:10:37.260]but that's where you'd be working
[00:10:38.330]on that increasing flexibility piece.
[00:10:41.410]And then the last step
[00:10:42.330]of the joint activity routine is your closing.
[00:10:44.670]So as the energy of the activity naturally dies down.
[00:10:47.710]You just close up that particular activity
[00:10:50.090]and move on to the next activity.
[00:10:51.980]In a school setting, you might have natural closings
[00:10:54.310]based on your schedule.
[00:10:56.080]Some learners are more than happy,
[00:10:58.520]their esteem, their interest stays high forever
[00:11:01.830]on one activity, so you may need to do
[00:11:03.830]some type of transition where you have a timer
[00:11:06.620]or something like that and that you end the activity,
[00:11:09.210]as opposed to watching.
[00:11:11.934]For example, if you were doing centers
[00:11:14.350]and it was a 15 minute center
[00:11:16.130]and the learner initially chooses Play-Doh
[00:11:17.950]and after like two minutes,
[00:11:19.190]you can see they're looking around the room,
[00:11:21.470]they're not really responding very quickly,
[00:11:23.170]they're just not that interested.
[00:11:24.780]Then you would close up that activity
[00:11:26.810]and have a new activity start
[00:11:29.200]until your center time is finished.
[00:11:35.160]So this is a video example of the joint activity routine.
[00:11:38.100]And I just want you to observe
[00:11:39.500]and look at how this might be a little bit different
[00:11:42.020]from what you sometimes see,
[00:11:43.620]especially for behavior analysis,
[00:11:45.680]with it, there being a nice shared agenda
[00:11:48.010]where the adult is leading a little bit,
[00:11:50.230]but she's mostly following the child's lead
[00:11:52.210]and then they're connecting
[00:11:53.260]and sharing the interaction with the activity,
[00:11:55.990]as opposed to having the adult completely running the show.
[00:12:00.800]So again, this isn't 100% assessment related,
[00:12:03.720]but I wanna show this video
[00:12:04.900]so you can get an idea of what it might look like
[00:12:07.810]if you decided to use Early Start Denver Model
[00:12:10.260]as one of your assessments and then intervention.
[00:12:18.108](learning toy rattles)
[00:12:18.941]Here.
[00:12:21.810]Wanna play blocks?
[00:12:33.528]Yes.
[00:12:37.510]Gonna build a tower.
[00:12:39.440]One, two, three, four.
[00:12:52.420]Notice here that the child could care less
[00:12:54.850]about the blocks and she's kind of doing her own thing.
[00:12:57.470]And the adult doesn't make the child come over
[00:12:59.550]and play with the blocks,
[00:13:00.480]she changes up what they're gonna do.
[00:13:08.132]You found a new toy.
[00:13:13.509]I found one too.
[00:13:18.264]Hit the drum.
[00:13:19.257](teacher hitting)
[00:13:24.905](teacher and toddler hitting)
[00:13:29.265](teacher laughs)
[00:13:31.626]Stop.
[00:13:33.899]Go.
[00:13:34.732](teacher hitting)
[00:13:37.265]Go, go, go.
[00:13:41.560]So in this part right here, they're building that theme
[00:13:44.070]and just having that back and forth.
[00:13:46.459](teacher and toddler hitting)
[00:13:47.383]Stop.
[00:13:49.843]Go.
[00:13:50.676](teacher and toddler hitting)
[00:13:55.867]Stop.
[00:13:57.215](toddler hits)
[00:14:00.529]Go.
[00:14:02.076]Stop.
[00:14:11.110]Go.
[00:14:11.943]Go.
[00:14:12.776](teacher and toddler hitting)
[00:14:18.171]You then see she's starting to put in the variation
[00:14:20.110]even just by pausing to give the child
[00:14:22.410]a chance to say the different things like stop and go.
[00:14:25.427](teacher and toddler hitting)
[00:14:32.481](teacher and toddler hitting)
[00:14:35.795]Go.
[00:14:38.550]Okay, now let's go fast.
[00:14:39.914]Fast.
[00:14:40.747](teacher hitting)
[00:14:43.783]Fast, fast, fast, fast, fast-
[00:14:46.531](toddler shouts)
[00:14:52.604]Slow.
[00:14:53.652](teacher hitting)
[00:14:56.530]Okay, it's kind of a long video,
[00:14:57.920]so I'm gonna stop it there.
[00:14:59.620]But you can see in this example,
[00:15:02.020]the different skills they're working on
[00:15:03.383]like following instructions, having her request,
[00:15:07.060]even that social interaction,
[00:15:08.710]there's a lot of gaze shifting going on
[00:15:10.610]and sharing of different facial expressions.
[00:15:12.880]So there's tons of skills being worked on
[00:15:14.680]even in this rather simple activity.
[00:15:17.160]And from an assessment perspective,
[00:15:18.820]when you put in those pauses
[00:15:20.350]and you try those different things,
[00:15:21.620]seeing how the child responds to that,
[00:15:23.950]do they initiate on their own?
[00:15:25.810]Do they just sit there and wait for you?
[00:15:27.600]Are they flexible with changing up
[00:15:29.560]the activity to do something else?
[00:15:31.610]All of those are really important pieces
[00:15:33.590]when we're looking at our assessment
[00:15:35.310]and deciding what intervention,
[00:15:37.400]what programs we're gonna work on.
[00:15:42.160]The next thing I wanted to talk about
[00:15:43.550]from an assessment perspective is the First Words Project.
[00:15:47.090]So this is a research project at Florida State University
[00:15:50.500]led by Amy Wetherby, Dr. Amy Wetherby,
[00:15:54.160]one of the really fascinating pieces
[00:15:57.330]of resource that they created is called the 16 by 16,
[00:16:01.820]and that's hyperlinked here.
[00:16:03.030]I'm not going to click on it
[00:16:04.320]and show it to you because we won't have time.
[00:16:07.040]But I do encourage you to click on this link
[00:16:09.530]in the PowerPoint and look at the different
[00:16:12.520]16 by 16 lookbooks that they have.
[00:16:15.370]Right now they have a gesture as one,
[00:16:17.290]and they have the actions with objects.
[00:16:19.130]And then eventually they'll have one
[00:16:20.640]on social connectedness, cooperation, and critical thinking.
[00:16:24.260]And each of the lookbooks, it tells you month by month,
[00:16:28.350]what you would expect a learner to be doing in these areas.
[00:16:32.070]So in their first month of life,
[00:16:33.910]what are the different gestures
[00:16:35.440]that a baby should be engaging in?
[00:16:37.450]Maybe not any.
[00:16:38.656](Megan laughs)
[00:16:39.489]Maybe some.
[00:16:40.322]So you can go through this lookbook and see.
[00:16:42.040]And at the very end, if you do like add a glance,
[00:16:45.740]it gives you this sort of like one page document
[00:16:48.760]that lists out everything and it's really helpful.
[00:16:51.790]Now, obviously most of you are working,
[00:16:54.040]if you're working with early learners,
[00:16:55.450]they're three to five years old.
[00:16:57.030]However, it's important to understand
[00:16:59.420]the skills in the 16 by 16, it's 16 things by 16 months.
[00:17:03.900]When you look at these skills,
[00:17:05.830]the areas that are addressed,
[00:17:08.300]we often skip over so many things.
[00:17:11.260]So for example, pointing is one of the gestures
[00:17:14.680]that a lot of people try to work early.
[00:17:16.880]They try to teach that really early on,
[00:17:18.860]there's about five or six different gestures
[00:17:21.240]that develop before pointing.
[00:17:22.940]So if you have a learner who's not engaging
[00:17:24.980]in those five or six gestures, and they're three years old
[00:17:27.590]and you're trying to work on pointing,
[00:17:29.260]you're missing some prerequisite skills.
[00:17:31.650]So the 16 by 16 is really helpful,
[00:17:34.150]both from an intervention standpoint
[00:17:35.810]of what goals you could work on
[00:17:37.100]and having operationally defined items,
[00:17:39.560]but also looking at assessment,
[00:17:41.480]okay, can my learner do these 16 things?
[00:17:44.920]And if not, go in the order
[00:17:46.890]that they're presented within the packets.
[00:17:51.610]So as a behavior analyst or a teacher,
[00:17:53.700]we should be incorporating these types of things
[00:17:55.183]within our assessment process.
[00:17:58.460]Another thing that I wanted to talk about
[00:18:00.730]relating to Dr. Wetherby's research
[00:18:02.870]is the Autism Navigator
[00:18:05.680]and early social interaction intervention.
[00:18:08.440]So in Autism Navigator, which there's a website,
[00:18:12.040]autismnavigator.com, and in the research that Dr. Wetherby
[00:18:15.220]has done on their early social interaction,
[00:18:18.140]active engagement is one of the key things
[00:18:20.510]that they talk about and they provide training on.
[00:18:23.410]They focus on parents, obviously,
[00:18:25.890]if you're working in the classroom setting,
[00:18:27.350]you're not going to have as much opportunity
[00:18:29.540]to work with parents, but this is really helpful
[00:18:32.300]if you do have the opportunity to work with parents,
[00:18:34.650]some of the things you could be teaching them.
[00:18:36.540]And then also just for yourself or your paraprofessionals,
[00:18:39.880]the things that you should be working on with your learners.
[00:18:43.040]So this says, utilizing parents
[00:18:44.630]to implement teaching strategies
[00:18:46.010]and supports to promote active engagement
[00:18:48.020]as early as possible, may have the greatest potential
[00:18:50.830]to change children's developmental trajectories.
[00:18:53.580]And the research and resources that Dr. Wetherby puts out,
[00:18:56.570]they provide a lot more information
[00:18:58.160]about what active engagement is.
[00:19:00.160]Basically it's the idea that the child
[00:19:02.100]is actively engaged within their environment,
[00:19:06.160]whether that's following the natural routine,
[00:19:09.660]even playing in a way that they may prefer to play.
[00:19:13.310]Whatever it is, that their attention is actively focused
[00:19:17.430]and they're interacting with those
[00:19:19.030]in the environment around them.
[00:19:22.570]So, like I mentioned, in Autism Navigator,
[00:19:25.490]there is quite a lot of resources as well.
[00:19:28.210]There's a focus on coaching the family,
[00:19:30.830]they look at everyday activities
[00:19:33.130]and how you can build an intervention
[00:19:35.520]around those everyday activities.
[00:19:37.430]Transactional supports,
[00:19:38.670]which is what things you could put into the environment
[00:19:41.020]to help support the child
[00:19:42.430]in actively engaging within their environment.
[00:19:45.750]That active engagement piece.
[00:19:47.280]And they provide resources for coaching effectively.
[00:19:50.020]So whether you're a teacher
[00:19:51.190]that might need to coach your paraprofessionals,
[00:19:53.270]or if you have the opportunity to work with the parents,
[00:19:56.060]it provides a lot of wonderful information on how to provide
[00:19:59.320]that coaching and create a more collaborative situation,
[00:20:05.080]as opposed to a situation
[00:20:07.310]that might be difficult to navigate.
[00:20:09.940]I also have the links here for the growth charts,
[00:20:12.960]which are similar to the 16 by 16, a little bit more,
[00:20:18.850]this is where things get really broken down.
[00:20:20.810]And they go, I'm pretty sure from birth until like two,
[00:20:26.480]I think, and they're broken down by different areas.
[00:20:30.280]So it's not just gestures,
[00:20:31.630]but there's different aspects of the child's life
[00:20:34.230]like social communication,
[00:20:35.540]play, imitation, and things like that.
[00:20:38.140]So the growth charts can be really helpful,
[00:20:40.040]again, from that assessment process,
[00:20:41.690]looking at those and what a child is typically doing
[00:20:45.070]at those ages in those areas
[00:20:47.290]and how that compares to the students
[00:20:49.060]that you're working with.
[00:20:50.540]There's also a link here to the course options
[00:20:52.810]and a link to learn more
[00:20:53.910]about the early social interaction intervention.
[00:20:58.810]But just to tell you a little bit more
[00:21:00.210]about early social interaction,
[00:21:02.250]it's a family centered capacity building approach.
[00:21:05.610]So they involve the parents,
[00:21:07.450]they have active participation in assessment
[00:21:09.650]and intervention.
[00:21:10.930]They encourage reflection by the team
[00:21:12.810]to figure out what's going well and what needs to change.
[00:21:18.115]The focus is that building a relationship
[00:21:20.976]with the child increases responsiveness.
[00:21:23.300]So they're really focused on helping the families
[00:21:26.460]learn how to connect with their children
[00:21:28.050]and increase responsiveness to the environment around them.
[00:21:31.890]The learning occurs in natural environment,
[00:21:34.010]so the activities are individualized to the child
[00:21:36.610]based on typical routines
[00:21:38.170]and based on the unique needs of the family.
[00:21:40.710]The intervention is throughout the day,
[00:21:42.340]and this increases the ownership by the family.
[00:21:44.760]So instead of having different people come in
[00:21:46.940]and provide intervention, they're focused on building
[00:21:49.860]capacity with the families, as it says here.
[00:21:52.490]So again, in a school setting,
[00:21:54.920]these are things that you can hopefully think about,
[00:21:57.150]how you can support the families
[00:21:58.940]and the children when they're not at school,
[00:22:00.600]but also just within your classroom.
[00:22:02.230]If you picture your classroom as a home environment
[00:22:05.210]and how you can set up that natural learning
[00:22:07.340]and build active engagement within your classroom.
[00:22:13.705]The early social interaction is developed
[00:22:16.230]from the naturalistic developmental
[00:22:18.110]behavioral interventions framework.
[00:22:20.340]So if you're familiar with SCERTS,
[00:22:22.970]which is social communication,
[00:22:24.550]emotional regulation, and transactional supports.
[00:22:27.800]basically what they did is the SCERTS model existed,
[00:22:30.810]which is developed for schools.
[00:22:33.600]So if you're a teacher watching this
[00:22:35.440]and you're not working with early learners,
[00:22:37.730]this would be what you would wanna use.
[00:22:39.840]And even if you are working with early learners,
[00:22:41.580]if they're more advanced
[00:22:43.000]then you might be using SCERTS as well,
[00:22:44.670]but it's a whole assessment
[00:22:45.930]and they have planning books and everything,
[00:22:48.310]it's super helpful for setting up your classroom.
[00:22:51.430]And then the early social interaction model
[00:22:53.640]also uses evidence-based strategies
[00:22:56.240]to coach and train the families
[00:22:58.740]on how to engage with their children.
[00:23:03.900]So, one quote from an article in 2014 by Dr. Wetherby,
[00:23:07.820]says, "Our multi-site randomized control trial
[00:23:10.447]"of the ESI model was the only parent implemented
[00:23:13.207]"intervention that reported differential treatment effects
[00:23:15.687]"on standardized measures of child outcomes,
[00:23:18.257]"including social communication,
[00:23:19.827]"developmental level and adaptive behavior."
[00:23:22.290]So the whole point of sharing this,
[00:23:24.530]even though it's an invention
[00:23:26.810]and it's focused on parents,
[00:23:28.230]is if you're working with early learners,
[00:23:30.710]especially age three to five, but also if earlier somehow,
[00:23:34.610]it's important to be familiar with this research.
[00:23:38.110]If you're not serving autism, it may not be as important,
[00:23:40.800]but they incorporate learners
[00:23:43.360]with a lot of different types differences
[00:23:45.500]so they don't have to just have an autism diagnosis.
[00:23:48.300]But if you're working in a school setting
[00:23:51.330]or any other type of intervention setting,
[00:23:53.420]and you're not familiar with Dr. Wetherby's research
[00:23:55.740]on early social interaction, you should be.
[00:23:58.438](Megan laughs)
[00:23:59.271]So that's why I have it in here as part of our last session,
[00:24:02.850]to help encourage you to look at this research
[00:24:05.210]and make sure your assessment process
[00:24:07.470]and your intervention process
[00:24:08.750]is just staying on top of the latest research
[00:24:11.400]that's been published,
[00:24:12.960]relating to best practices for autism.
[00:24:18.500]Another thing I wanted to talk about
[00:24:20.200]when we're looking at assessment for early learners
[00:24:22.540]is the ADOS and SORF.
[00:24:24.490]So the ADOS, as I've mentioned before,
[00:24:26.690]is a diagnostic measure.
[00:24:29.160]And the SORF is also a diagnostic measure
[00:24:31.610]that's being researched by Dr. Wetherby.
[00:24:35.083]I put a link at the end of the slides,
[00:24:36.960]there's a whole section on Autism Navigator website
[00:24:40.000]about the SORF, they did a lot of trainings on it
[00:24:42.330]during COVID to help disseminate information to people.
[00:24:46.240]But the reason I say, even though these are diagnostic,
[00:24:49.950]that they're a resource is the different skills
[00:24:52.690]listed on here are all things
[00:24:54.570]that are in either the ADOS or SORF or both,
[00:24:57.880]as things that we look for as red flags.
[00:25:01.870]And when we're sort of playing
[00:25:04.650]'cause the ADOS is a play-based
[00:25:06.690]and SORF looking at a one hour home observation of play
[00:25:09.800]and different activities that the parents do.
[00:25:12.930]So we're looking at, does the child engage
[00:25:15.870]or not engage in these different responses.
[00:25:19.030]And that's how we determine whether
[00:25:20.930]or not an autism diagnosis should be given.
[00:25:24.140]So if these are the operational behaviors
[00:25:26.470]that we're looking at, these also should be things
[00:25:28.760]we're assessing and then programming to address,
[00:25:31.960]to help support our learners
[00:25:33.590]in developing skills that will help them
[00:25:35.350]be more independent in the environment.
[00:25:37.590]I'm not saying these have to be worked on
[00:25:40.010]to teach your learner how to mask their autism
[00:25:42.270]or cure their autism or anything like that.
[00:25:44.780]But these are things that tend to interfere with learning
[00:25:49.280]and independence over time.
[00:25:51.640]And that's like part of the diagnostic process
[00:25:54.160]is identifying, oh, these are the things
[00:25:56.470]that give this person an autism diagnosis.
[00:26:00.170]So if your assessment process
[00:26:01.420]doesn't incorporate these things,
[00:26:03.750]then you could be missing out on crucial skill opportunities
[00:26:07.260]that you could be working on with your learners.
[00:26:09.710]So the list is kind of long,
[00:26:11.550]I'm not gonna go through each of these,
[00:26:14.370]but I do just want you to have a look at this slide,
[00:26:18.870]pause it if you need to and think about,
[00:26:21.010]do the things that you're assessing right now
[00:26:23.530]take into account any of these skills,
[00:26:25.820]and if not, start doing that.
[00:26:28.220]One of my favorite ones
[00:26:29.650]is this make eye contact when blocked.
[00:26:31.800]What this means, and this is part of the ADOS assessment,
[00:26:34.610]when they're playing, if you just put your hand
[00:26:37.680]in front of what they're playing, what do they do?
[00:26:40.214](Megan laughs)
[00:26:41.047]Do they look at you like,
[00:26:41.880]"Hey, why are you blocking what I'm doing?"
[00:26:43.340]Do they just sit there?
[00:26:44.420]Do they move your hand?
[00:26:45.530]Do they throw a fit?
[00:26:46.700]That seems like such a simple thing to test out,
[00:26:50.760]but it's rarely assessed, it's definitely not on any
[00:26:53.080]of the commercially based assessments
[00:26:54.440]we talked about in session one.
[00:26:56.330]So things like that,
[00:26:57.490]just different little baited opportunities
[00:26:59.960]where you could see, hmm,
[00:27:01.130]how does my student respond when this thing happens?
[00:27:04.310]And if they're not responding in a way
[00:27:07.130]that demonstrates that they understand
[00:27:09.650]like the communication partner aspect
[00:27:11.210]and how to problem solve and navigate their
[00:27:13.340]way through those situations, then that would mean,
[00:27:16.270]okay, this is something we're going to need to work on.
[00:27:18.610]And if we can start out at an early age,
[00:27:21.450]working on these things, as they get older,
[00:27:23.740]it'll be less likely that they interfere
[00:27:25.830]or cause an increase in challenging behavior
[00:27:28.940]from not having those problem solving skills
[00:27:31.140]and those social skills
[00:27:32.560]and those communication skills to navigate this environment
[00:27:37.160]where these different things are happening
[00:27:38.827]and they never just naturally developed those skills.
[00:27:45.220]Under RIE parenting, which was one of my favorite things.
[00:27:47.950]This is a quote from Janet Lansbury about RIE parenting.
[00:27:51.250]It says, "We perceive
[00:27:53.337]"and acknowledge them to be unique, separate people.
[00:27:56.397]"We enhance our awareness by observing them,
[00:27:58.817]"allowing them the bit of space they need
[00:28:00.647]"to show us who they are and what they need."
[00:28:03.070]I just love this quote so much.
[00:28:05.710]She's talking about parents observing their little babies,
[00:28:08.860]but this could be applied to everything.
[00:28:11.680]Whether we're talking about teachers
[00:28:13.470]observing their students.
[00:28:15.090]Or just humans observing humans in general.
[00:28:18.890]We can enhance our awareness just by observing people,
[00:28:22.190]giving them the space to show us
[00:28:23.950]who they are and what they need.
[00:28:25.620]And a lot of the times we're doing the opposite.
[00:28:28.330]We kind of come in right away
[00:28:30.740]thinking we know what the child needs,
[00:28:32.550]we know what the student needs.
[00:28:34.000]And we sort of put our own biases
[00:28:35.960]and our own preferences onto the space
[00:28:38.390]instead of just sitting back
[00:28:39.600]and seeing what is it that this learner needs from me
[00:28:42.960]and how can I support them?
[00:28:45.070]So even though RIE is a parenting model,
[00:28:48.660]I think it can be easily translated into behavior analysis
[00:28:52.810]and also the work that we do in the classrooms.
[00:28:55.590]So what is RIE?
[00:28:56.500]It's a resource for infant educators.
[00:28:59.060]And I put the link for RIE
[00:29:00.470]in the last slides with resources.
[00:29:03.460]On the site, they describe it as a baby centered approach,
[00:29:06.990]which I think we could just translate
[00:29:08.560]that to person centered.
[00:29:10.760]It involves observing, which equals the discovery
[00:29:16.577]of who the human is as their own person.
[00:29:18.240]This is critical for the work that we do,
[00:29:20.820]especially with autism, but any other disability
[00:29:24.440]allowing us to see who is this human?
[00:29:27.100]Who is this person that I get to work with and teach.
[00:29:30.550]As opposed again, to just coming in with our own biases
[00:29:33.510]and our own preferences about
[00:29:35.020]what we're going to do for things.
[00:29:37.490]Sports casting is a technique that they train parents
[00:29:41.820]and educares to engage in,
[00:29:44.020]which really is just the same as narrating events,
[00:29:46.550]which is a really common intervention strategy
[00:29:50.430]within the naturalistic developmental
[00:29:52.390]behavior interventions.
[00:29:54.520]There's a heavy focus on expression of emotions.
[00:29:57.790]And with this it means you're meeting the needs
[00:30:00.210]of the learner, you're holding space for whatever emotion
[00:30:03.500]they're feeling at that time,
[00:30:05.060]and you're providing them support
[00:30:06.630]to navigate and work through the emotion.
[00:30:08.820]A lot of the times we do the opposite,
[00:30:11.730]not just as teachers or behavior analysts,
[00:30:14.080]but just society in general,
[00:30:15.930]doesn't really hold space for expression
[00:30:17.790]of a lot of different emotions, especially at a young age,
[00:30:20.410]there's a lot of attempts to stifle and push things down
[00:30:22.940]and get people to just shift and always try to be positive
[00:30:25.700]and happy all the time, and that's just not how life is.
[00:30:28.620]So in RIE, there's a big focus on
[00:30:30.360]whatever's happening is valid
[00:30:32.840]and whatever you're feeling is valid
[00:30:34.420]and this is how you can navigate things
[00:30:36.320]when you're feeling that way.
[00:30:37.760]So there's a saying, it's valid to feel the way you feel,
[00:30:42.130]it's how you choose to respond to that
[00:30:44.090]that could be an issue.
[00:30:45.620]So if you're feeling mad and you punch a wall,
[00:30:48.960]probably not the best idea,
[00:30:50.310]but if you're feeling mad and you stomp your foot
[00:30:52.320]and say, "I'm mad," that's probably a bit better.
[00:30:55.990]And then lastly, there's a focus on setting boundaries,
[00:30:58.640]a lot of times people think when you're so heavily focused
[00:31:01.370]on observing and allowing the child to exist
[00:31:03.950]as the human that they are
[00:31:05.620]and you're holding space for them and all that,
[00:31:07.940]it means they can just walk around
[00:31:09.570]and just walk all over people
[00:31:11.080]and there's no rules or boundaries or anything.
[00:31:14.380]But that's not the case, especially with RIE,
[00:31:17.240]their focus is on being consistent and leading clearly.
[00:31:20.510]So of course, as the teacher, or as a parent,
[00:31:23.440]there are going to be things
[00:31:24.900]that have to be put into place as boundaries,
[00:31:26.840]like maybe the lights always stay on
[00:31:28.900]or the door has to stay open or closed,
[00:31:31.140]or we sit in this spot or we do this thing.
[00:31:33.660]Whatever it is that is necessary,
[00:31:35.570]especially from a safety standpoint,
[00:31:37.840]those boundaries are set,
[00:31:39.540]they're explained and they're consistently held.
[00:31:42.280]And even if a child is having difficulty, it's acknowledged,
[00:31:46.696]"I see you're having a difficult time
[00:31:48.007]"staying safe right now, I'm going to help you with that."
[00:31:50.850]As opposed to just doing things to them
[00:31:53.620]and pushing them around through the environment.
[00:31:56.230]So RIE, again, isn't necessarily specific to assessment,
[00:32:01.320]especially the observing piece
[00:32:03.400]and that expression of emotions piece are critical
[00:32:06.380]when we're looking at assessing our learners,
[00:32:08.220]especially our early learners.
[00:32:09.920]So this is another resource that I would highly encourage
[00:32:12.610]if you're not familiar with it,
[00:32:14.180]to look at and learn more about so that you can incorporate
[00:32:17.100]that both within your assessment process
[00:32:19.230]and in the work that you're doing as a teacher.
[00:32:23.640]So next, we're going to look at appropriateness
[00:32:26.460]based on developmental skills,
[00:32:28.050]and then we'll go over our case study.
[00:32:31.240]So these are just some common things
[00:32:33.480]that I see people work on from the VB-MAPP or the ABLLS,
[00:32:36.580]and they're things I've worked on myself too.
[00:32:39.820]But then we also have to question, are they appropriate?
[00:32:43.760]Are they, especially based on the developmental skills
[00:32:46.590]that are being presented by the learner?
[00:32:49.140]So a lot of times, especially for early learners,
[00:32:51.410]three to five people are just really fast
[00:32:53.600]to get in a man training program.
[00:32:55.790]And by man training, I mean the typical withholding of items
[00:32:59.290]and waiting for a sign, a picture exchange,
[00:33:02.170]or a vocalization to get the item.
[00:33:05.950]However, if you have a child who loses interest easily
[00:33:09.400]or engages in limited initiations,
[00:33:11.750]that type of program is probably not going to be appropriate
[00:33:15.170]as an early program for your learner.
[00:33:17.150]You're usually going to need to work on things
[00:33:19.040]a lot earlier on in Early Start Denver Model first
[00:33:23.130]before you try to do a program like that.
[00:33:26.450]Another program that's pretty typical to see
[00:33:28.550]for early learners is echoic training
[00:33:30.560]or stimulus stimulus pairing,
[00:33:32.180]where you're modeling certain sounds,
[00:33:33.770]and then trying to get the learner to echo you.
[00:33:36.260]However, if your child has few to know sounds
[00:33:39.760]or engages in little to no gaze shifting
[00:33:42.270]or shared enjoyment,
[00:33:43.860]those probably aren't going to go very well.
[00:33:46.508](Megan laughs)
[00:33:47.341]First, you're going to wanna figure out
[00:33:48.620]how to engage in naturally reinforcing activities
[00:33:53.310]that could build up that connection with adults
[00:33:56.520]or other people in their environment
[00:33:58.550]and that just naturally would produce more sounds.
[00:34:01.610]And then you could start working
[00:34:02.920]more on the echoic training.
[00:34:05.140]Matching is also one that we typically start
[00:34:08.980]with when we're working with early learners.
[00:34:10.720]And if you remember in the slides from session one,
[00:34:13.550]these are all things I had listed
[00:34:14.980]in the early learner profile.
[00:34:16.100]So again, I'm not being critical, I'm just saying before
[00:34:19.200]you implement these with your learners,
[00:34:21.050]make sure you're assessing and looking at,
[00:34:22.760]is this the best thing, is this most appropriate
[00:34:25.390]for my learner based on the skills they're presenting with?
[00:34:28.570]If you have a learner who clutches
[00:34:30.810]matching items in a natural environment,
[00:34:32.860]meaning they're constantly,
[00:34:34.000]already naturally finding things that match,
[00:34:36.200]they're finding the two spoons or the blocks or whatever,
[00:34:39.640]they can match, you don't have to do
[00:34:41.620]probably a matching program with them,
[00:34:43.780]they're already doing it,
[00:34:44.930]they're showing that they understand
[00:34:46.850]visually that things go together.
[00:34:48.750]So you can probably work on something else.
[00:34:50.580]Now some people might still wanna work on matching
[00:34:53.190]from more of just like a following instruction
[00:34:55.560]or bigger activity that might be going on in the classroom.
[00:34:59.360]And that might be okay.
[00:35:00.330]But if you're trying to do it just for the pure,
[00:35:02.690]can they match objects?
[00:35:04.160]Can they match pictures?
[00:35:06.030]They're showing you already that they can,
[00:35:08.360]they're doing it on their own.
[00:35:10.070]Even if they don't do it sitting down at a table
[00:35:12.240]with the artificial materials
[00:35:13.760]that you've put in front of them,
[00:35:15.490]they're showing they have that skill.
[00:35:17.880]Puzzles, if you have a learner
[00:35:20.580]who's already spontaneously doing puzzles on their own,
[00:35:23.480]again, probably not a program you need to start with then
[00:35:26.070]because they've already got that skill.
[00:35:28.230]Object Imitation.
[00:35:30.480]If you have a child who rarely attends to adults,
[00:35:34.080]starting with object imitation right out of the gate,
[00:35:36.410]probably isn't going to go very well.
[00:35:38.440]They're not even going to pay attention
[00:35:39.790]to the model being presented.
[00:35:41.510]So first you would need to work more on,
[00:35:43.590]again with naturalistic fun, play-based interactions,
[00:35:47.140]getting more attention to an adult,
[00:35:48.820]having that trusted connection with the learner.
[00:35:52.220]Receptive commands.
[00:35:54.070]If you have a child who refuses to engage,
[00:35:56.560]even with preferred items or activities,
[00:35:58.460]when an adult gives it to them,
[00:36:00.470]it's highly unlikely they're going to engage
[00:36:02.650]in a receptive command program.
[00:36:04.860]So if they love jumping on the trampoline
[00:36:06.760]and you say, "Hey, go jump on the trampoline."
[00:36:08.970]And they're like, "Nope, I'm out of here."
[00:36:11.194](Megan laughs)
[00:36:12.220]Just simply because an adult told them to do it,
[00:36:15.300]telling them to touch their nose or clap their hands
[00:36:17.450]isn't likely going to go any better.
[00:36:19.220]So first you would need to work on again,
[00:36:20.810]building up that trusted connection with the learner
[00:36:24.340]and getting them to just engage in things
[00:36:27.890]on adult led a time that that's preferred to them first,
[00:36:32.050]if they won't let an adult lead
[00:36:33.480]even in preferred situations,
[00:36:35.550]then you're not going to get very far.
[00:36:38.520]Compliance training I have in quotes
[00:36:40.810]because hopefully people aren't working
[00:36:42.930]on compliance training at this point in 2021,
[00:36:46.500]which is when I'm filming this.
[00:36:48.150]But basically the idea is readily following instructions
[00:36:51.950]as needed for the classroom
[00:36:53.470]or whatever natural environment setting they're in.
[00:36:55.780]If you have a learner
[00:36:56.770]who has really sticky attention to objects.
[00:36:58.640]So when they have certain objects in front of them,
[00:37:00.970]they're just so focused on that object,
[00:37:02.960]they don't even know that there's someone talking to them.
[00:37:06.710]Following instructions probably isn't gonna go very well.
[00:37:09.090]So you first have to work on again,
[00:37:11.150]developing that connected relationship,
[00:37:13.740]and then you can start to work on following instructions.
[00:37:18.270]The majority of your teaching time
[00:37:20.830]is done at the table with discrete trials,
[00:37:23.410]where again, it's just artificial structured materials
[00:37:27.140]and boom, boom, boom, trying to present a lot of things.
[00:37:29.960]If your child profile is that they're high energy
[00:37:33.370]or they're seeking a lot of movement activities,
[00:37:35.940]that style of programming
[00:37:37.740]probably isn't going to go very well.
[00:37:39.730]And with early learners in general, ages three to five,
[00:37:42.610]hopefully you're incorporating a lot of movement.
[00:37:45.190]And again, more play-based type learning anyway,
[00:37:50.250]but sometimes we can get more instruction
[00:37:53.500]and if we're sitting in one spot.
[00:37:55.440]So I'm not saying don't ever sit down
[00:37:57.150]or do discrete trials or sit at a table,
[00:37:59.600]but you should consider how much of that you're doing,
[00:38:02.400]especially based on your child profile.
[00:38:05.290]So this list, again,
[00:38:07.600]there's nothing wrong with any of these programs.
[00:38:09.670]It's just making sure
[00:38:11.360]that you're looking at your child profile.
[00:38:13.270]I just gave one or two examples of,
[00:38:15.680]well, this profile would indicate
[00:38:17.200]not working on this thing yet.
[00:38:19.120]There's a lot of different things
[00:38:20.640]that could come up in a child profile
[00:38:22.190]and your assessment where your typical programs
[00:38:24.780]that you might be doing for that age
[00:38:26.870]aren't going to go very well.
[00:38:28.530]This is just a starting point of examples to consider,
[00:38:32.040]but I hope that you're encouraged
[00:38:34.270]when you're looking at the programs
[00:38:36.090]you typically work on with your early learners,
[00:38:38.330]that you're starting to think about these things.
[00:38:39.917]"Oh, is this, even though this is something
[00:38:42.387]"I typically would do based on this specific child,
[00:38:45.577]"is this the best fit for them?"
[00:38:49.280]When we look at their research,
[00:38:50.720]there's also a lot of information in the research
[00:38:54.330]about different skills that we work on
[00:38:56.670]that might not be the best to work on.
[00:38:59.590]So Sherer and Schriebman in 2005,
[00:39:02.250]did a study for pivotal response to see,
[00:39:05.400]they did some archival data
[00:39:07.240]and they looked at what makes a learner
[00:39:08.930]respond to pivotal response versus not respond.
[00:39:12.670]And what they found was at the start of intervention,
[00:39:16.130]the responders and the non-responders both had
[00:39:19.780]the equal level of intervention.
[00:39:22.210]However, once intervention was complete,
[00:39:25.390]those learners that responded to pivotal response
[00:39:28.380]had developed functional language.
[00:39:32.120]They also looked at play with toys
[00:39:34.040]and responders engaged in functional but limited play.
[00:39:39.470]And they looked at social behaviors.
[00:39:41.100]They were equal at the start of intervention,
[00:39:43.400]responders developed maintenance of social engagement
[00:39:46.170]and some initiation.
[00:39:47.800]So basically what they were finding is, they didn't know,
[00:39:50.970]obviously at the beginning of the research,
[00:39:52.540]whether a child was going to be a responder
[00:39:54.320]or a non-responder, they went back and looked afterwards,
[00:39:57.157]"Okay, what set these learners apart?"
[00:39:59.670]And the two key findings here
[00:40:01.760]are that responders engaged in functional play.
[00:40:06.010]And they also develop maintenance
[00:40:07.640]of social engagement in some initiation.
[00:40:10.280]What that means for intervention
[00:40:11.950]and assessment is you should be looking at
[00:40:14.900]how well your learner is engaging in functional play
[00:40:18.470]and functional to them, like they're playing
[00:40:20.770]and having fun even if we don't understand it.
[00:40:23.430]Are they engaging in a way,
[00:40:25.180]even if it's like spinning wheels on a car,
[00:40:28.500]if it looks like play
[00:40:29.948](Megan laughs)
[00:40:30.781]that's all that matters.
[00:40:31.970]And then that social engagement with some initiation,
[00:40:35.930]are they doing that?
[00:40:37.480]If they're not, then you should be heavily
[00:40:39.930]focusing on those things because that is going to be
[00:40:43.120]a better predictor of outcomes down the line
[00:40:46.030]than any academic skill you could work on
[00:40:48.280]or any other skill you might think you need to teach.
[00:40:51.240]If you have learners who are already engaging
[00:40:53.200]in functional play or engaging in some social engagement,
[00:40:56.390]make sure you're not stifling it.
[00:40:58.617](Megan laughs)
[00:40:59.450]If they're initiating,
[00:41:00.283]make sure you're giving space for that
[00:41:01.750]and allowing that to happen.
[00:41:03.270]What tends to happen is we get to adult led
[00:41:06.540]and we suppress a lot of the responding
[00:41:08.710]that our children should be engaging in, in the first place,
[00:41:11.470]especially at the age of three to five.
[00:41:13.570]So makes sure the way you're structuring your classroom
[00:41:16.030]and your assessments that you're giving space
[00:41:18.820]for functional play and social engagement with initiation.
[00:41:22.370]If you're not allowing for those opportunities
[00:41:24.730]and you're creating teaching settings
[00:41:26.790]where you're actually pushing those away
[00:41:28.540]and pushing those down,
[00:41:29.910]you could be negatively affecting
[00:41:31.710]the outcomes of your learners.
[00:41:33.770]'Cause those were critical skills for positive outcomes,
[00:41:36.530]at least relating to pivotal response.
[00:41:40.690]So this summarizes what I just said in my soapbox,
[00:41:43.800]but responders again,
[00:41:44.890]had a functional play and approach behaviors.
[00:41:47.680]And non-responders had avoidant behaviors
[00:41:49.970]and self-stimulatory behaviors.
[00:41:52.390]So what they did is they looked at having
[00:41:55.190]self-initiation training and they were able to change
[00:41:57.800]the trajectory for one non-responder,
[00:41:59.680]that was just one study that was done in 2003.
[00:42:02.930]So they worked on building up those initiations
[00:42:07.070]and then the learner went from a non-responder
[00:42:10.660]to a responder.
[00:42:11.690]So just to reiterate, when you're setting up your classroom
[00:42:16.000]and your assessments, make sure you're looking
[00:42:18.000]at how much space they're giving for functional play
[00:42:20.860]and approach and initiation.
[00:42:22.760]And if you have learners who are very avoidant,
[00:42:29.570]make sure you're looking at how you can support them
[00:42:31.990]to help them navigate and be less avoidant
[00:42:34.800]of the different aspects of the environment.
[00:42:37.340]The self stimulatory behaviors is a whole separate soapbox,
[00:42:41.670]that I would love to see more research on
[00:42:44.210]because at least relating to this,
[00:42:46.260]because a lot of the research now,
[00:42:48.710]'cause this was done in 2005,
[00:42:50.690]is showing that the self-stimulatory behaviors
[00:42:53.010]don't interfere as much as people used to think they did.
[00:42:55.510]So I'm not gonna go a whole lot into that,
[00:42:58.490]but definitely make sure you're giving space
[00:43:00.180]for functional play and initiations.
[00:43:05.510]Appropriateness relating to behavioral expectations,
[00:43:08.690]so a lot of the times we have toddler tantrums,
[00:43:12.970]especially for the three-year-olds you might have,
[00:43:14.700]but even the three to five range.
[00:43:17.220]What tends to happen with toddler tantrums is again,
[00:43:20.780]people try to just shut those down and make them not happen
[00:43:24.460]when it's a natural process that we all go through.
[00:43:27.190]So instead we should be looking at
[00:43:28.790]how can we teach this child how to navigate
[00:43:32.330]the emotions they're having
[00:43:34.932]and how to regulate what's going on for them.
[00:43:37.640]So also making sure you're picking your battles
[00:43:40.610]and you're learning how to support the child
[00:43:42.580]and not just trying to extinguish things,
[00:43:44.360]that you're really giving them the supports they need
[00:43:46.930]and helping them navigate in that moment of difficulty.
[00:43:49.990]This is an area I could talk about for hours,
[00:43:52.220]so I'm just going to keep it there
[00:43:53.984](Megan laughs)
[00:43:54.817]and make sure you're assessing skill deficits too.
[00:43:56.610]This is one of those where I have like a bunch
[00:43:58.630]of additional trainings, if you want more information,
[00:44:01.630]feel free to email me.
[00:44:03.820]And then when we're looking at our behavioral expectations
[00:44:06.650]around attending, responding, and learning behaviors,
[00:44:10.660]we have situations, especially for that younger age
[00:44:13.740]where you may have a very short attention repertoire,
[00:44:16.900]that's pretty typical for younger learners.
[00:44:19.280]And we can work on slowly building that up.
[00:44:21.610]We need to make sure that we're helping them
[00:44:24.380]stay actively engaged and not trying to expect them
[00:44:27.310]to attend for 10 to 15 minutes to one task
[00:44:30.310]that other children their age wouldn't be able to do.
[00:44:33.300]They may respond and consistently, is it functional?
[00:44:36.410]Is it motivating?
[00:44:37.420]We should be asking ourselves.
[00:44:38.940]And sometimes that's just part of the learning process.
[00:44:41.270]When learners are learning a new skill,
[00:44:43.770]especially at a young age,
[00:44:44.940]they may have inconsistent responding,
[00:44:46.700]and it's not that big of a deal,
[00:44:48.370]but we also have to make sure
[00:44:49.410]that what we're teaching them is functional
[00:44:51.050]and motivating to get that more
[00:44:52.590]consistent responding happening.
[00:44:54.730]And then repetition
[00:44:55.830]and routine is just a critical part of learning
[00:44:59.980]that we need to make sure we're incorporating
[00:45:02.010]and to help with,
[00:45:03.090]especially anything that involves rote memorization.
[00:45:06.090]We need to take advantage of that as much as possible,
[00:45:08.400]as much as you would see in a regular classroom,
[00:45:11.500]educational setting, how much repetition and routine.
[00:45:14.130]We all do it, we make up songs, we make up little names,
[00:45:17.280]things to memorize stuff all the time.
[00:45:20.560]And when we go throughout our day,
[00:45:22.910]we are most effortless when we have a set
[00:45:25.300]routine in place to follow.
[00:45:27.110]So making sure to take advantage of that
[00:45:29.480]in learning as well.
[00:45:32.270]Okay.
[00:45:34.150]So there's our case example for this round.
[00:45:38.660]So what we're going to do, I want you to watch this video.
[00:45:42.100]This guy is about 18 months in the video.
[00:45:44.420]I want you to look at this and think about,
[00:45:47.420]even though again, it's younger,
[00:45:49.320]it's just a good example for things we might even see
[00:45:52.190]with three to five year olds in our classroom,
[00:45:54.660]look at his skills
[00:45:55.790]and think about what you would further assess with him.
[00:45:59.170]And then we're going to talk about a few things with him.
[00:46:08.452](indistinct)
[00:46:17.640]I said that way.
[00:46:19.096](toddler laughs)
[00:46:21.513]I said no.
[00:46:24.969]They go oink, we go oink.
[00:46:29.606](toddler shouts)
[00:46:35.185]They can't catch you.
[00:46:37.928]Catch you?
[00:46:39.426](speaks faintly)
[00:46:41.124](indistinct)
[00:46:45.010]Sure.
[00:46:46.200]They're swimming.
[00:46:49.670]So this is kind of a long video too,
[00:46:51.580]so I'm going to go ahead and pause it there.
[00:46:53.830]But what we're gonna do is, on the next slide,
[00:46:58.220]we're going to talk about when people see this video,
[00:47:00.850]or just in general, when they're looking
[00:47:02.580]at working with early learners,
[00:47:04.380]what are some of the things they would typically assess?
[00:47:08.950]So typically people would use the VB-MAPP
[00:47:12.160]with a child like this, if they're informed,
[00:47:17.850](Megan laughs)
[00:47:18.761]and not saying you're not informed if you use a VB-MAPP.
[00:47:21.130]But what I mean is if they're really focused on,
[00:47:25.880]especially the naturalistic developmental
[00:47:27.640]behavior interventions,
[00:47:29.010]they might use Early Start Denver Model.
[00:47:32.950]He was engaging in quite a bit more skills
[00:47:36.130]than a lot of the early learners that we might encounter.
[00:47:39.500]But these are the skills
[00:47:40.490]that are frequently suggested to work on
[00:47:42.540]when people watch this video, articulation,
[00:47:45.780]joint attention, mandating, imitation,
[00:47:48.610]receptive language, barriers to learning echoics
[00:47:52.990]and VB-MAPP for developmental.
[00:47:56.000]Articulation is questionable because he's only 18 months,
[00:47:59.000]and then each of these other ones
[00:48:01.050]may be things that we could work on with him.
[00:48:04.470]But what I wanna show you is, these are all,
[00:48:08.160]again, things that you would see
[00:48:09.280]in your commercially-based assessments.
[00:48:12.838]Fine, I'm not saying work on it or don't work on it.
[00:48:15.950]You only saw 40 seconds of the child,
[00:48:18.250]these all could be assessed further,
[00:48:20.300]and you may develop IEP goals
[00:48:22.340]based off of these things, you might not.
[00:48:24.480]What I want you to see though is what you could be missing
[00:48:28.180]by only focusing on those commercial assessments.
[00:48:32.010]So this is a case where understanding
[00:48:34.510]your population is incredibly important.
[00:48:37.290]If you look at the skills
[00:48:38.273]then you can click on the link here,
[00:48:40.780]for the CDC, is articulation really important at this age.
[00:48:46.280]Again, he was about 18 months in that video,
[00:48:48.860]but I went up to 21 months
[00:48:50.760]just for the purposes of this presentation.
[00:48:54.030]If you go through the skills for a typical 21 month old,
[00:48:58.670]what is he missing and what's weak?
[00:49:00.890]You're going to find a lot more going on
[00:49:03.670]than what we would see in our typical assessments.
[00:49:05.990]If we just focused on Early Start Denver Model or VB-MAPP.
[00:49:10.020]Additionally, if you click on the autism diagnosis link,
[00:49:13.410]you can see what are some of the observable behaviors
[00:49:16.710]from that video clip associated with the diagnosis.
[00:49:19.940]And you could review that slide
[00:49:21.920]that had the ADOS and SORF list.
[00:49:24.240]And see what are some of the things that he might be doing
[00:49:27.980]that we would need to work on.
[00:49:30.580]In a 40 second video clip, you're not going to see all that,
[00:49:33.450]but this is the kind of learner profile where,
[00:49:37.230]just again, trying to use those
[00:49:39.190]commercially-based assessments,
[00:49:40.470]you're going to miss a whole lot of stuff
[00:49:43.310]that you could be working on.
[00:49:45.480]Oh my gosh, you're so cute.
[00:49:47.840]So I'm gonna show you an example,
[00:49:50.800]what I had for this particular child when I met him,
[00:49:55.259]I was like, "Yeah, the VB-MAPP and early start
[00:49:58.077]"just isn't gonna cut it for him."
[00:50:00.130]His mom had a difficult time even deciding
[00:50:04.020]if she was gonna try to pursue a diagnosis for him.
[00:50:06.510]But she sent me this video of him
[00:50:08.670]where he wanted some water or something to drink
[00:50:12.350]and instead of coming to her and requesting it,
[00:50:14.340]she's taking a video of him
[00:50:15.510]just standing in front of the fridge,
[00:50:16.980]yelling at the refrigerator.
[00:50:18.540]He never wants to look at her.
[00:50:20.350]He doesn't even seem to know that she exists.
[00:50:22.780]And he just thinks yelling at the refrigerator
[00:50:25.440]is magically gonna magically make water appear,
[00:50:27.570]so for me, knowing what I knew at the time
[00:50:30.840]about the diagnostic assessments I was using,
[00:50:32.960]the ADOS and the SORF, I was like,
[00:50:34.907]"Oh, we need to see how he does
[00:50:37.157]"with just understanding communicative,
[00:50:39.467]"intent and communicate with partners?
[00:50:41.127]"And how does he shift his attention?"
[00:50:42.850]And all of those types of things.
[00:50:44.380]But I wouldn't have come up with any of that
[00:50:46.310]if I didn't have familiarity with those assessments,
[00:50:49.520]the diagnostic assessments.
[00:50:51.100]So I assessed each of these things on my own
[00:50:54.310]without really using a commercially-based assessment,
[00:50:56.650]it was just, these are probably areas of weakness for him
[00:50:59.950]based on that refrigerator video.
[00:51:01.610]I need to assess them more.
[00:51:03.150]So when I was there in person,
[00:51:05.140]I wanted to assess his eye gaze and interaction with me.
[00:51:07.910]So this first video is just seeing
[00:51:09.560]how well does he shift attention back
[00:51:11.930]and forth between two people.
[00:51:15.124](toddler roaring)
[00:51:17.291](Megan blows)
[00:51:18.604](toddler roars)
[00:51:19.810](Kelsey roars)
[00:51:21.165](toddler roars)
[00:51:23.544](Kelsey roars)
[00:51:26.388](toddler roars)
[00:51:27.221](Megan roars)
[00:51:30.930]So that looks pretty good.
[00:51:32.650]Mom's sitting on one side, I'm sitting on the other
[00:51:34.650]and he's shifting his attention back
[00:51:36.550]and forth between the two of us pretty well.
[00:51:38.990]So this next video, I'm going to pause it when I get there.
[00:51:44.349]In this next video I wanted to see
[00:51:45.910]how he would do with requesting from mom
[00:51:48.670]when she didn't just give him the bucket of items,
[00:51:51.610]especially based on what was happening
[00:51:53.150]in that refrigerator video.
[00:52:08.781]I wanna have those.
[00:52:11.504](toddler shouts)
[00:52:13.540]Looks like you might want something.
[00:52:19.073]I wanna play with them.
[00:52:21.504]I wanna play with them.
[00:52:23.905]Yeah, which one?
[00:52:25.142]I wanna play with them.
[00:52:27.643]I wanna play with them.
[00:52:28.913](speaks faintly)
[00:52:31.131]Hey.
[00:52:33.292]The tiger (indistinct).
[00:52:42.237]Let me play with them.
[00:52:44.683]Let me play with them.
[00:52:45.516](toddler hits)
[00:52:48.292]So you can see in this video,
[00:52:49.850]his initial thing was to just try to take
[00:52:51.660]the whole container from mom,
[00:52:53.430]then he eventually does say he wants to play with them.
[00:52:55.710]And when mom is trying to wait
[00:52:58.050]and see if he'll request a specific item,
[00:53:01.080]he just keeps repeating, "I want to play with them."
[00:53:03.120]And then he eventually hits her.
[00:53:05.390]So he does have some level of regulation
[00:53:09.200]in that he didn't just get upset right away
[00:53:11.400]when she didn't give him the toys.
[00:53:13.480]But he wasn't really problem-solving
[00:53:15.560]and giving her the specific requests she was looking for.
[00:53:18.090]Now, keep in mind, this was just to assess
[00:53:20.080]and see what he would do.
[00:53:21.500]If we were working on teaching,
[00:53:22.970]she would be doing a lot more
[00:53:24.330]to prompt coach him through it.
[00:53:25.860]But we were just trying to see
[00:53:27.700]what's his problem solving and how well does he request.
[00:53:32.110]I'm gonna go ahead and go to the next slide
[00:53:33.570]and pause the video and explain what we're doing in that.
[00:53:37.624]Sing to me.
[00:53:39.090]So in this one, what I wanted to do
[00:53:42.270]while I'm assessing the gaze and interaction is see how well
[00:53:46.440]he'll maintain an interaction with me if I go away.
[00:53:51.223](Megan laughs)
[00:53:52.056]So at the time of assessing this little guy,
[00:53:54.980]I also had a son around his age
[00:53:58.260]and if I was playing with my son and I left,
[00:54:00.790]he would follow me.
[00:54:02.070]And it wasn't just me, anyone he was playing with,
[00:54:04.780]he would follow them and be like, "Hey, what's going on?"
[00:54:07.120]So I wanted to see,
[00:54:08.180]did he understand if a communication partner moves away,
[00:54:12.615]to sustain that interaction by joining them,
[00:54:15.450]or what would he do?
[00:54:16.650]So in this video, we're singing a song
[00:54:18.610]and I just sort of scooch away to see what he's gonna do.
[00:54:24.677](indistinct)
[00:54:31.253]♪ Go ♪
[00:54:32.624]♪ Go ♪
[00:54:34.087]♪ Go ♪
[00:54:35.816]♪ Go ♪
[00:54:40.183]♪ Go ♪
[00:54:41.843]♪ Go ♪
[00:54:43.492]♪ Go ♪
[00:54:45.078]♪ Go ♪
[00:54:48.054]♪ Go ♪
[00:54:58.492]It's open, not closed anymore.
[00:55:02.502]Not closed anymore.
[00:55:06.640]You singing with me?
[00:55:14.184](speaks faintly)
[00:55:20.886](toddler shouts)
[00:55:22.680]Okay.
[00:55:23.999]So you can see in this that he at least
[00:55:25.130]was looking over at me, like, "What is she doing?
[00:55:27.277]"Why'd she go over there?"
[00:55:28.740]But he doesn't get in my face,
[00:55:30.890]he doesn't try to join me or see what I'm doing or anything,
[00:55:33.530]he just seems kind of confused about what just happened.
[00:55:36.570]So this showed me, there's some skill deficits there
[00:55:39.340]with understanding how to persist
[00:55:41.440]and sustain an interaction, and developmentally as well,
[00:55:46.470]because like I said, my son was the same age as him
[00:55:48.780]and would do all of those things.
[00:55:51.110]So that would be stuff I would find
[00:55:52.710]either from my own experience or from the CDC list
[00:55:55.890]and other information about just overall language
[00:55:59.790]and communication development for his age.
[00:56:02.970]So this last video.
[00:56:04.450]It's broken.
[00:56:06.209]In this video, again, I was just trying to assess
[00:56:08.600]what he would do with this getting attention,
[00:56:11.180]persistence and sustained interaction.
[00:56:14.180]This one's a little bit longer,
[00:56:15.630]but I want you to see what happens
[00:56:17.980]when we're doing a more clearly structured activity.
[00:56:22.790]So the first one, he was singing a song to me
[00:56:24.820]and I sort of just walked away,
[00:56:26.330]and there wasn't like a clear routine or anything going on.
[00:56:29.240]But in this one, there is a clear routine,
[00:56:30.870]we're playing with a certain toy
[00:56:32.130]that he has expectations around.
[00:56:34.110]And I want you to see the difference.
[00:56:36.420]It's broken?
[00:56:40.760]Let me see, I'll fix it.
[00:56:43.010]I saw the dinosaur, James.
[00:56:45.926]I big saw a big dinosaur, James.
[00:56:47.667]You saw a big dinosaur, where?
[00:56:53.277]It came over here.
[00:56:54.910]Uh-oh.
[00:56:59.892]There we go.
[00:57:00.725](speaks faintly)
[00:57:03.795]It's a spider, it's a spider, it's a spider.
[00:57:06.838]It's a spider?
[00:57:09.511]Oh no, it's a spider.
[00:57:12.572](toddler shouts)
[00:57:13.737]Go away.
[00:57:15.372](toddler shouts)
[00:57:16.451]Crash.
[00:57:18.176](toddler roars)
[00:57:19.431]Oh, it's a scary dinosaur.
[00:57:21.825]Oh no.
[00:57:27.260]I'm going this way
[00:57:30.024]No, gonna go on the track.
[00:57:33.150]Oh okay, thanks for coming to get me,
[00:57:37.497]I got distracted.
[00:57:39.390]James.
[00:57:40.640](indistinct)
[00:57:50.599]Play with James.
[00:57:52.479]Come on, that's finished.
[00:57:56.090]So I already saw that he would
[00:57:58.000]quickly tell me to come back.
[00:57:59.460]So now I wanna see what his persistence is like
[00:58:01.730]and what attempts he's gonna make
[00:58:03.490]to get my attention when I'm not responding.
[00:58:07.710]So Kelsey, you can prompt and say,
[00:58:09.185]"I don't think she heard you."
[00:58:10.018]I don't think she heard you.
[00:58:11.547]You better go see, you can say, "Megan."
[00:58:19.680]It looks like she's still having fun playing trains,
[00:58:21.970]you could go see what she's doing.
[00:58:25.376](indistinct)
[00:58:28.379]Chimney on the track.
[00:58:32.110]So for him, the play routine that we're doing
[00:58:35.200]is the trains are talking to each other
[00:58:36.940]and he's definitely still doing that.
[00:58:38.800]But again, he's not queuing into whether
[00:58:40.910]or not I'm paying attention,
[00:58:42.620]so now I'm going to keep pushing
[00:58:44.670]and see how long is it going to take for him
[00:58:46.990]to really get my attention and not just focus on the items.
[00:58:52.170]I don't think she heard you.
[00:58:56.430]I don't think she heard you.
[00:58:57.520]Maybe you need to say, "Megan, excuse me."
[00:59:04.780]Tell him to get closer.
[00:59:05.690]You need to get closer,
[00:59:06.780]I don't think she heard you.
[00:59:10.217]You need to get closer and say,
[00:59:11.537]"Megan, excuse me."
[00:59:14.234]Will you share it with me?
[00:59:16.581]Will you share it with me?
[00:59:17.840]She still doesn't hear you.
[00:59:19.951]What are you gonna do?
[00:59:20.784]Come on and share it with me.
[00:59:23.338]Wanna share it with me?
[00:59:26.210]Say Megan-
[00:59:27.210]Oh hi.
[00:59:29.486]I saw you looking.
[00:59:30.319]Hello, we gonna go on the track?
[00:59:31.690]Yeah-
[00:59:32.523]Okay, let's go.
[00:59:34.784]She going over there.
[00:59:38.230]So it took quite a bit of time,
[00:59:39.900]but he eventually shifted his gaze up to look at me
[00:59:43.080]to check in and see, was I paying attention.
[00:59:47.430]Now this again was an assessment,
[00:59:50.140]I had mom prompting him a little bit
[00:59:51.770]just to move it along,
[00:59:54.010]to make sure we weren't frustrating him or anything,
[00:59:56.100]but we didn't explicitly tell him like,
[00:59:57.497]"Hey, you need to look at her."
[00:59:58.970]'Cause I wanted to see would he problem solve
[01:00:01.000]and come up with it on his own,
[01:00:02.390]seeing how long it took,
[01:00:03.730]now I knew that this was something we could work on
[01:00:06.220]and we would do more explicit instruction around that,
[01:00:08.540]like, "Hey, if someone's not responding,
[01:00:09.977]"you should look up at them
[01:00:11.427]"to see if they're paying attention to you."
[01:00:16.070]So that's it for this session,
[01:00:19.390]I hope that gave you some good ideas
[01:00:21.700]of things to think about.
[01:00:23.280]Especially at the end there with a video example
[01:00:26.810]of a learner, you may not have a whole lot
[01:00:30.980]from the early learner assessments
[01:00:33.390]that would be appropriate.
[01:00:35.950]You might have to think outside of the box
[01:00:37.810]and really look at the diagnostic assessments for the child
[01:00:42.530]and just the typical skill development from like the CDC
[01:00:47.430]and other places to determine
[01:00:49.320]what you need to further assess.
[01:00:51.570]If you have any questions about this session
[01:00:54.160]or any of the other sessions that we did,
[01:00:56.420]you can email me at the email on the screen.
[01:00:59.850]Thanks everyone.

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ABLLS-R, AFLS, VBMAPP, ESDM, PEAK!?!? CHOOSING THE RIGHT ASSESSMENT FOR YOUR LEARNER WITH AUTISM Session 3 Early Learners

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