cc >> I know it will just take
a moment for people to get settled.
Hi. My name is Linda
Tuchman-Ginsberg, and I'm delighted to be here this
afternoon to talk about teaching children and youth with autism
spectrum disorders, focusing on what works.
My background is in professional development and training and
technical systems and the translation of research to
practice. So I've had the wonderful
opportunity over the last five years to be the principal
investigator or co-principal investigator for Wisconsin's
involvement in a national professional development center
on autism spectrum disorders. And today I'm going to spend a
little bit of time giving you some background on the center,
talking about what we have learned through our search of
the research about what the research tells us are
evidence-based practices, but then to focus on the process of
how we have focused on developing materials and
providing training and technical assistance and professional
development to school districts and early childhood programs to
actually translate those practices that the research
tells us have an evidence base into their daily routines and
activities in programs and talk about some of those practices
that have helped us make that happen, and then look at some of
the evaluation to show the impact of that work and end by
sharing a little bit about some of the lessons we've learned
about being effective in this work.
So, the National Professional Development Center on Autism
Spectrum Disorders, as Marsha mentioned in the introduction,
is a three-university site project between the FPG Child
Development Institute at the University of North Carolina in
Chapel Hill with Sam Odom, a widely published researcher in
the field of autism, in addition to the Mind Institute at the
University of California Davis through their medical school
with Sally Rogers and Sally Ozonoff, also well-known in the
field of autism as the co-investigators for that site,
and then our Waisman Center partnership.
This project has been funded by the US Department of Education
Office of Special Education Programs.
It was part of their effort to say from the Department of
Education we know we need to be paying attention to what's
happening for children and youth with autism in our early
intervention, early childhood and K-12 systems.
So this is a list of our staff and partners, and I would just
like to point out and recognize our two staff members from
Waisman Center who've done the lion's share of the work in
directly supporting schools and implementing evidence-based
practices and that's Ellen Franzone and Kate Szidon and
formally Lana Collet-Klingenberg who's now at UW Whitewater but
had a significant impact on the early development of this
project. The goals of the national center
have been to promote development, learning and
achievement of children and youth with autism spectrum
disorders and to support their families, as I mentioned before,
through the use of evidence-based practices.
Secondarily, we looked at the practices that would help
improve the capacity of states to implement evidence-based
practices and increase the number of educational staff who
are highly qualified to serve children with autism spectrum
disorders. All of the work of this project
has been done in partnership with states.
Let's see, I'm not really used to using this thing.
That's Sam Odom, who's the director of the project.
I just wanted to make sure I pointed that out.
These are the states that we have worked with.
Over a five-year period we have worked with three sites, three
states at a time for four years, wrapping up our last year of
work with our 12th state. So through Wisconsin we have
supported Wisconsin in the first year, Texas in the second year,
and Vermont this year. So it's been so interesting to
know, be grounded in our Midwest Wisconsin, move down to Texas,
big state, and then have the opportunity to work in Vermont,
tiny state. So we've had really great
opportunities and experiences, but the bottom line for me is
children, schools and families, there are more similarities than
differences in the broad range of needs for children in our
school district. Our first task was to identify
the research that supports the evidence-based practices, and we
really, for this project, focused on what we called
focused interventions or individual practices, not a
comprehensive program like might be provided in an intensive
non-school-based program, but actually what are some of those
individual practices that would be practical for a team of
educators to be able to implement within the curriculum
of a school day that helped learners with autism actually
become engaged in learning and then be able to focus on
participating in the curriculum and sort of general education
activities to the extent possible.
So we looked at research that produced specific behavioral and
developmental outcomes for children that had been
demonstrated as effective in applied research and can be
successfully implemented in educational settings where
there's so many variables for so many children in play at once.
So we combed through the literature using some key words,
looked through the core features of autism, looked at both group
interventions that addressed the areas of autism specifically,
and then set our own criteria. And one of the things that I
have learned out in the field is there's this big emphasis on
intervention programs, schools, early intervention, intensive
programs, those funded by the waiver, by insurance, having a
focus on evidence-based practices, but there also
probably as many definitions of evidence-based practices as
there are initiatives saying we need to use evidence-based
practices. So one of our early activities
was to establish the criteria for this project, and you can
see from this slide that we looked at both experimental or
quasi experimental design studies and single subject
design. There's a lot more research and
literature on single subject design than there are with
experimental designs, and we thought we would be missing some
really important information if we didn't include both.
However, we were very focused on the importance of looking at at
least five different single subject studies by three
different researchers before we would include the research as
supporting our evidence base, and then we looked at the
combination. So we combed through the
literature, and, to date, we do have a new literature review
under search to see if there are new practices to add.
Last year or years ago we completed a second research to
make sure that all these practices still had the research
to support them, to continue to be on our list.
So this list is in alphabetical order, arranged by academics and
cognition, behavior, communication, play, social and
transition, meaning transitions between programs, and we looked
at what was available in early childhood, elementary, middle
and high school. So you can see that the
practices are spread out across the age span and the different
domains. What I would like to say about
this list, you will notice that there are a number of behavioral
interventions that are just core to engaging children with autism
in social skills, communication, being available to be ready for
learning such and engaging in learning, but there are also
quite a few that look at more naturalistic interventions.
Use of assistive technology, looking at peer mediated
interventions for enhancing social skills and the use of
social stories type of things. So there are practices that span
a broad range of areas. This list is available on the
materials for our website, and I will make sure that you have the
link to the website where you can not feel like you have to
capture every moment of this from looking at this list today
so that you can go back and revisit it.
And just to remind you, we think these evidence-based practices
are delicious. [LAUGHTER]
One of our professional development summer
institutes, this cake was made to celebrate.
So in case you wonder what to put on your next birthday cake.
[LAUGHTER] This grid, which I know is not
that easy to see either but it's also available in our
resources, shows how this project, evidence-based
practices, overlap with those of National Standards Project.
And at a glance, what it says is there are a lot of practices in
common. There are some we identified as
having an evidence base that were still identified as
emerging practices. So how did we go about
translating the research into practice?
We developed a number of learning materials on
evidence-based practices and a process for validating that
those practices were being implemented with what we call
fidelity, which means if the research says you follow step A,
B, C, D and E and that's what leads to an effective outcome,
then we were working with schools and staff to say are you
using all the steps. A lot of teachers say oh, yeah I
know what peer mediated interventions are, and then when
they looked at our checklist about all the steps that are
involved in really doing it accurately they said, oh, I did
this step but I didn't quite do this one, and we said, well,
let's try and see what happens if we add all of those steps and
see if you get a better outcome for the children that you're
working with. So that gives you an idea of
that translational piece where our aim is to bridge the gap.
So there are, as I mentioned, a number of resources that we
developed with our sort of what we're most proud of are these
online modules that include those step by step instructions
as well as a number of other supporting materials that I will
show you in a moment. That site is offline today.
I think they are doing some updating so I can't even link to
it to show you, but it's right there.
There are two ways to access it. One, through our site for this
project on the Waisman Center's website, or two, through our
national website through the FPG Institute at the University of
North Carolina. So those are the materials that
really support the professional development we've been providing
to schools but also are available for anybody to access
at no cost. So, those materials are there.
There's also been sort of an online course on the basics of
what is autism that the text of that is available, but through
the Waisman Center we've set up an online course that is free
and anybody can register, and more information about that is
also available on the Waisman Center's website listed below.
So these online modules that with think are the cornerstone
of our legacy and the heart of our work, talk about all of the
content, a description of what the practice is.
They include pre- and post-tests.
They have all downloadable information.
They have case study examples. They have resources.
They have suggested activities and discussion questions.
And they include those checklists for that step by step
implementation of those practices.
So they're just a tremendous resource.
They're embedded in part of the autism internet modules.
Rather than develop our own site, we wanted to post them in
a site that would be there when the project was gone, and the
autism internet modules include a tremendous number of
information and educational modules for parents, for people
with autism spectrums, for professionals who work with
them, and all of our modules are embedded under evidence-based
practices in that site. So we also were very careful
that they were all validated by some of the professionals who
actually did the research, and the way we wrote about them were
reviewed by, like for the picture exchange communication,
the developer of that, Andy Bondy, actually reviewed our
module very carefully and said, yes, this is true to our intent
of this system so thank you very much for getting this out there
in another way to people in a very user friendly way.
So then, as I've been talking about, we really focused on
using those checklists in our practices to get to
implementation. This is an example of what a
checklist might look like. And I know our aim was to be
user friendly and trying to merge details of research
findings, and user friendly we've learned is a very big
challenge. And so I think now that we've
got the basic core of what that is, we're focusing a little bit
more on making them a little bit more user friendly, but these
are very accurate and reflect what is really important to be
true to what the research says to implement these practices.
So this is for one on naturalistic interventions and
starts step by step through activities such as identifying a
target, collecting information on baseline which is probably a
theme through many of these practices, taking a look at
building in, how are we collecting data to see if we're
doing this. For the teachers and educators
who are working on it, there's a chance for them to check in with
themselves to say, how are we doing in learning this practice?
Are we integrating and using all of these steps?
So that's the core materials that support our professional
development activities, but we also look at a more
comprehensive model including the quality of the program.
And there is a graphic that goes with this that just disappeared.
It's on my screen. Interesting.
It was there when I, okay. So when we're looking at all
these comprehensive elements of program quality, we are looking
at the program quality, what the individual learner's goals are
through their IP, their strengths and history and their
teacher's knowledge. Let's see, oh, I see it comes in
in pieces. There you go.
And then we identify the evidence-based practices that
fit for that individual child. So we're really looking from an
individual child's perspective wrapping it around their
individual goals, not a curriculum for a whole class,
and then wrapping that into sort of a cyclical process of then
what are we going to do, how did it go and where do we want to go
back and refining these practices.
So when we look at program quality, we have identified a
number of indicators in that classroom or program environment
that are conducive to a child making success, and there was an
instrument called the autism program evaluation rating scale
that was developed for this project that is not publicly
available yet that looks at these elements of a classroom
environment to see how those environments are organized in
the context and climate of the school to actually support
learning success for children with autism spectrum disorders.
And we use this at the beginning and the end of our engagement
with the school district to look at the environment as well as
the individual practices. When we are looking at
individual students, we have been starting with their IEP
goals, and one of the things that we have discovered that a
lot of IEP goals are not written in a way that you can really
measure if progress is being made, particularly relevant to
these evidence-based practices. So what we've done is started
with the IEPs and really helped teachers, not change the IFSB
because the general intention and area is really good, but to
make modifications to scale it more discreetly so that we can
go back and measure if progress towards these goals are being
made as a result of using these practices.
And for the children that have participated in our project,
we've identified three priority goals.
And we've used something called goal attainment scaling which
focuses on sort of a continuum of what you expect that behavior
to look like, and for children with autism we have really,
really broken it down a lot. And as this one shows you, one
of the key elements we've really focused on in breaking things
down is how much prompting is being provided, how much doing
for and what's the process that's helping that child learn
to do this, this student learn to do this skill more
independently or to assess. To be successful, how much
support do they really need? And that's what this process has
been invaluable for. I could talk hours for all of
these aspects. So then we know that that's how
we're trying to work, and the one thing we know is that, and
this is where the whole field of professional development is
going now, that you can't just go to a training and someone
says here's what that practice is, now do it.
We have discovered that the coaching process, along with
professional development on the content, is essential to schools
and educators and teams of professionals learning how to
change their professional practices.
So coaching has been an integral part of how we have worked with
the schools and other early childhood programs in
implementing this project. So we know that coaching is what
helps sustain professional development, refines skills and
it's a vehicle for developing that partnership and trusting
relationship between someone who knows the content and has an
idea of how to support and help a team or individual teacher or
educator or therapist know what it's going to take to be able to
practice in that way and to be available to them and have that
trusting relationship. And mostly it includes sort of
conferencing ahead of time, being on site to observe and
then being able to meet afterward for discussions.
And this is just an example of how our staff supported local
coaches and school districts because our project is going to
come and go, and we thought it was really important to support
those who would be available for ongoing coaching when our
project ended and we were no longer available.
So we met with the coaches once a week, or once a month, and
then the coaches work with their teams at least once month but
more periodic basis. So I think I already mentioned
that we know that coaching has the best promise for bringing
around change. So what have we learned from our
work? These slides are going to tell
us a little bit about what we've used about teachers' increased
use of evidence-based practices, improvements in quality program
and also changes in outcome for learners.
This is sort of our data from our first couple of years, but I
think that without spending a lot of time, the tables are
quite clear to show that from pre- and post-test measures that
teachers are using more evidence-based practices if we
look at before and after their involvement with our project.
This slide shows the specific evidence-based practices that
they're using more of, and one of the most dramatic on this to
me is the use of visual supports.
It is one of the most simple interventions, and it makes such
a huge difference in the ability of a student with autism to
navigate their way through a school day and learning
activities. And so it was amazing how basic
starting with that for so many people was and how powerful that
was in making change. As an example: we looked at
program quality through our rating scale and the program
quality improved, pre- and post-engagement.
At the elementary school with, actually, communication among
team members within school from administrators with families
being one of the areas that showed some of the greatest
areas of improvement, and just qualitatively in our
communications with school it was quite clear that that was a
huge area of need to improve communication among everybody
involved to sort of implement these practices and being able
to identify if they're making a difference.
In the high school, there was also change.
And, again, looking in areas that are comparable.
We also took a look at student learning about their engagement.
So each of those five line bars on that table are addressing how
we scaled those objectives that I showed you from those.
So this shows you that a large number of the kids actually met
their goals or exceeded them, and a few of the children made
progress but did not meet their basic goal.
And so some of the children that we worked with were really
complicated learners, and so part of it was helping schools
learn to set goals that actually would show change and
achievement and be realistic and then providing the steps and the
appropriate support. So in wrapping up, just wanted
to highlight a couple of lessons that were learned.
One is that in working with a school or a program,
administrative buy-in and support is essential because it
really takes time to bring people together to do this work
and that a team approach works best.
By definition, that team includes families, but we mean
families when we say that. And that individual team members
really need to understand what the content of the
evidence-based practices are and what they looked like when
they're practiced to fidelity. And if you're not familiar with
the content, then it's really hard to have a common ground for
communication about whether the team is effectively implementing
all the different steps in the process of that practice.
Coaching, professional development and ongoing support
are essential and that use of data is essential to informed
decision making and action. And I know there's huge
initiatives in public education right now to focus more on using
data to inform educational decisions, so this project fits
right in with that, but we know that day-to-day, upfront staff
working with kids have so many things to think about and
collecting data is really important but it's really hard
for them, realistically, to figure out how to do it.
So we really spend a little bit of time thinking about how can
we make it easy but make it important and part of the
process. So, thank you very much.
We have time for questions now. [APPLAUSE]