effective ieps for children with autism. 2 overview individuals with disabilities education act...

Effective IEPs for Children with Autism

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Overview

• Individuals with Disabilities Education Act • Defining “appropriate” services

• Applied Behavior Analysis (ABA)• “Educating Children with Autism” – NRC study

• Individualized Education Plans (IEPs)• Components• Process

• Challenges of the Public School System• Challenges of Parents • Tips and Tools • Questions and Discussions

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Individuals with Disabilities Education Act (IDEA)

• Individuals with Disabilities Education Act (Reauthorized 2004)

• Section 1400: Findings & Purposes:

(A) to ensure that all children with disabilities have available to them a free appropriate public education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment and independent living

The challenge is defining “appropriate”

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• Section 1400: Findings & Purposes (new in 2004)

(E) supporting high-quality, intensive preservice preparation and professional development for all personnel who work with children with disabilities in order to ensure that such personnel have the skills and knowledge necessary to improve the academic achievement and functional performance of children with disabilities, including the use of scientifically based instructional practices, to the maximum extent possible;

Individuals with Disabilities Education Act (IDEA)

Defining “Appropriate” Special Education Services for Children with Autism

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Defining “Appropriate”

• 1987 Landmark research published by Dr. Ivar Lovaas, showed of 47% of children who underwent 40 hours per week of intensive 1-on-1 instruction called applied behavior analysis (ABA) achieved normal intellectual and educational functioning, with normal-range IQ scores and successful first grade performance in public schools. In contract, only 2% of the control-group children (n=40) achieved normal educational and intellectual functioning

• 1993 Follow-up by McEachin, Smith, & Lovaas

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• 1999 Glen Sallows, Tamlynn Graupner, Wisconsin Young Autism Project. Replication site for Lovaas findings; 42% of 24 children attained “best outcome” category after three years of intensive applied behavior analysis (IQ and social gains to the average/low average range)

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• 1999 Mental Health: A Report of the Surgeon General Dr David Satcher, M.D., U.S. Surgeon General, regarding autism states, "Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior." (only non-drug treatment referenced)

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• 2005 Jane S. Howard, Coleen R. Sparkman, Howard G. Cohen, Gina Green, Harold Stanislaw

Intensive Applied Behavior Analysis (ABA) was a substantially more effective treatment for a group of preschool children with autism than the mixture of methods that is provided in many education and treatment programs (known as “eclectic” methods).

www.behavior.org/autism/autism_janehoward.cfm

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• 2006 National Institutes of Mental Health: “Among the many methods available for treatment and education of people with autism, applied behavior analysis (ABA) has become widely accepted as an effective treatment”

• http://www.nimh.nih.gov/publicat/autism.cfm

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• What is Applied Behavior Analysis?

Applied behavior analysis ( ABA ) is the process of systematically applying interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree (Baer, Wolf & Risley, 1968/1987; Sulzer-Azaroff & Mayer, 1991)

http://www.centerforautism.com/aba/whatisaba.asp

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• What is Applied Behavior Analysis? (From the Center for Autism and Related Disorders, CARD):• Identification of goals and objectives • Establishment of a method of measuring target behaviors • Evaluation of the current levels of performance (baseline) • Design and implementation of the interventions that teach

new skills and/or reduce interfering behaviors • Continuous measurement of target behaviors to determine

the effectiveness of the intervention, and • Ongoing evaluation of the effectiveness of the intervention,

with modifications made as necessary to maintain and/or increase both the effectiveness and the efficiency of the intervention.

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• ABA can include a variety of teaching techniques • Discrete Trial Teaching • Verbal Behavior Training• Natural Environment Teaching• Pivotal Response Training• Picture Exchange Communication System• Errorless Learning• Fluency Based Instruction

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• Myths regarding Applied Behavior Analysis• Discrete Trial Teaching and “Lovaas” programs

are unnatural and restrictive • Child remains at chair/table for all of teaching

session• Verbal Behavior Training is better and more

natural than ABA• Children become robotic after ABA therapy• ABA does not allow for inclusion with typical

peers

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• Truths about Applied Behavior Analysis• Data intensive – it’s a lot of work!• Requires significant training and supervision of

service providers• Requires experienced professionals to direct and

oversee programs• Requires continuous evaluation, measurement,

and modification of programs to move children forward

• Basic premise: It’s not that the child can’t learn, it’s that we haven’t figured out how to teach him yet!

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• Handout: “Guidelines for Consumers of Applied Behavior Analysis services to Individuals with Autism”, Autism Special Interest Group, Association of Behavior Analysis, May 23, 1998, updated 2004:

• . . . All children and adults with autism and related disorders have the right to effective education and treatment based on the best available scientific evidence. Research has clearly documented the effectiveness of Applied Behavior Analysis (ABA) methods in the education and treatment of people with autism.

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• (continued) Planning, directing, and supervising effective ABA programs for people with autism requires specific competencies. Individuals with autism, their families, and other consumers have the right to know whether persons who claim to be qualified to direct ABA programs actually have the necessary competencies. Consumers also have the right to hold those individuals accountable for providing quality services, i.e., to ask them to show how they use objective data to plan, implement, and evaluate the effectiveness of the interventions they use.

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• Board Certified Behavior Analysts (BCBA)• National Standards for curriculum, experience

and supervision• Testing, certification, and national registry

• Behavior Analyst Certification Board:

www.bacb.com/

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Landmark Publication:

Educating Children with Autism

2001, National Research Council

AKA: “NRC Study”

www.nap.edu

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2001 Educating Children with Autism• Study undertaken by the National Research Council

at the request of the U.S. Department of Education’s Office of Special Education Programs (OSEP)

• Formed the Committee on Educational Interventions for Children with Autism

• Charged the committee to integrate the scientific, theoretical, and policy literature regarding autism treatment and develop recommendations

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Educating Children with Autism Recommendations:

• Children with any autistic spectrum disorder, regardless of level of severity or function, be eligible for special education services within the category of autism

• Educational services begin as soon as a child is suspected of having an autistic spectrum disorder


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• Services should include a minimum of 25 hours a week, 12 months a year, in which the child is engaged in systematically planned, and developmentally appropriate educational activity toward identified objectives

• Low student/teach ratios (no more than two young children with autistic spectrum disorders per adult in the classroom)

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• The content of the curriculum for children with autistic spectrum disorders should be based on sound research

• Education at home, at school, and in community settings remains the primary treatment for young children with autistic spectrum disorders

Education = Treatment

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• In summary, consider the following factors when determining whether educational programs are effective and appropriate for children with autism

• Intensity, intensity, intensity• Coordination across settings and service providers

(including home)• Student to teacher ratio• Continuous measurement• Ongoing evaluation

Individualized Education Plans: Components and Process

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IEP - Components

• General Info (name, age, address, phone)• Statement regarding how disability impacts

access to the general curriculum• * Students strengths and needs (relative to

content standards)• * Accommodations, modifications, and supports• Access skills• Behavior modification plan?

* Important area for parent input

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IEP - Components

• *Assessments:• Educational• Cognitive• Communication• Social/Emotional• Physical/Health• Vocational/Transition/Interest


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IEP - Components

• Determination of Eligibility• *Determination of Disability (make sure it says

Physical Disability – Autism)• *Goals and Objectives, to include baseline and

evaluation criteria• Placement alternatives (special classes,

community services, special programs, out of district, home/hospital)

• *Specialized instruction and related services plan


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IEP - Components

• Transportation as a related service• * Placement alternatives• * Recommended placement in Least Restrictive

Environment (LRE)• Placement rationale• Percentage of time in regular education• Participation in district-wide assessments• * How parent will be notified of progress• * Eligibility for Extended School Year (ESY)• Signature page


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IEP - Process

• IEP developed at least annually• School should coordinate date and time and

send you a written notice of meeting• School staff will be conducting assessments

and preparing prior to meeting • School may choose to develop a “draft”

document before the meeting• IEP Team composed of school staff, parents,

and parent’s representatives• Team should go through each component of

the IEP and discuss

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IEP - Process

• Parents should be prepared to provide meaningful input and challenge any aspect they do not agree with

• Signing the IEP indicates attendance only (not acceptance of the plan)

• Under IDEA, parents can proceed to dispute resolution if they do not agree with the IEP• Mediation• Resolution Session• Due Process

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IEP - Process

• Recommendation: • Do not “wait and see” or plan to use mediation or

due process to get appropriate services• Be involved from the beginning• Become the squeakiest of the squeaky wheels before

you even finish the IEP, and keep squeaking after it’s completed

• There are several examples in this community of families obtaining effective, appropriate treatment without an attorney and without paying out of pocket

Challenges of the Public Schools and Parents

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Challenges of the Public Schools

• Schools not responsible for providing “best” services (chevy vs. cadillac)

• Average cost of quality ABA programming nationwide is $50,000 - $75,000 annually (handout: Autism Rising)

• Funding of special education through the public schools not easily isolated/quantified

• Inclusion emphasis/misunderstanding • Staffing and training• Organizational structure• Archaic service delivery models

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Challenges of Parents

• You are not an education expert• You are not an autism expert• Autism is overwhelming in and of itself• Emotions and tempers easily flair• Adversarial situations are stressful and

exhausting (easier to avoid them)

YOU can be your child’s best and most effective advocate!

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Challenges of Parents • You are not an education expert (You are an

expert when it comes to knowing your child)• You are not an autism expert (Neither is the

school staff)!• Autism is overwhelming in and of itself (Your

quality of life will improve for yourself and your family if you obtain effective treatment)

• Emotions and tempers easily flair (Don’t sweat it. Where will these people be in 20 years?)

• Adversarial situations are stressful and exhausting (Your life will be less stressful if you obtain effective treatment for your child)

You MUST be your child’s best and most effective advocate!

Tips and Tools for Parents

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Tips and Tools

“School districts can always be counted on to do the right thing . . . after they have exhausted all other possibilities.”

Widely attributed to Winston Churchill

(sort of)

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Tips and Tools

Most important task for parents:

EDUCATE YOURSELVES!!!!

• Research appropriate and effective treatments for autism (research and evidence based)

• Know and understand your rights under IDEA• Know and understand the IEP process and how

services will actually be delivered afterward

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Tips and Tools

Second most important task for parents:

Decide what you want for your child

• After doing your research, what is best for your child and your family?

• If you don’t know where you are going, you probably won’t like where you end up!

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Tips and Tools

Third most important task for parents:

Prepare for your IEP meeting

• Ask for draft goals/objectives from the school prior to the meeting

• Obtain outside assessments and opinions to help you prepare – bring an advocate or friend

• Get into the weeds of the IEP and the program itself (visit the classroom, observe and ask questions)

• Develop your own list of goals and objectives

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Tips and Tools

Students strengths and needs• Focus on needs that support your position for

methodology, service delivery, or placement• Examples: Learning area free from distractions,

structured and predictable environment, one-to-one and small group instruction to acquire new skills, opportunities and facilitation to generalize learned skills, opportunities for facilitated peer interactions, frequent parent/home communication, etc.

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Tips and Tools

Accommodations, modifications, and supports• Focus on accommodations that support your

position for methodology, placement, or service delivery

• Examples: constant supervision, assistive technology, picture schedule, frequent reinforcement, sensory breaks, functional behavior assessments, consistent systems to identify and eliminate inappropriate behaviors proactively, etc.

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Tips and Tools

Assessments• Make sure assessments are objective and

compare your child to specific standards or percentiles that can be objectively applied to determine progress

• Avoid and question subjective commentary regarding performance and abilities

• Diagnostic assessments from JFK Partners in Denver or Children’s Hospital highly encouraged

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Tips and Tools - Assessment

• Highly recommended assessment tool:

Assessment of Basic Language and Learning Skills (ABLLS)

• Assessment, curriculum, and skills tracking guide• Developed by Drs. James W. Partington and Mark L.

Sundberg• Breaks skills down into 25 areas, up to 81 levels of

development • Very detailed, but simplifies/streamlines

development of goals and objectives

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Tips and Tools - Assessment

Assessment of Basic Language and Learning Skills (ABLLS)

• ABLLS training available nationwide throughwww.behavioranalysts.com

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Tips and Tools

Determination of Disability • Ensure Physical Disability – Autism is

designated, especially if it supports your position for methodology, placement, or service delivery

• Published research on effective treatment is related to the disability of Autism

• Autistic Spectrum Disorders INCLUDE:

PDD-NOS, Autism, Aspergers, Rett’s Disorder

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Tips and Tools

Goals and Objectives• Need to determine where child is (baseline) and

what the next reasonable step to teach is• Children usually have needs in many areas:

• Communication (expressive and receptive)• Academic/Cognitive• Social/Emotional• Physical• Life/Self Help Skills

FIVE Recommended Goal Areas for

IEPs

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Tips and Tools

Goals and Objectives• ABLLS assessment clearly outlines current level of

functioning and next steps to teach• Can generate 50-60 objectives (this is not excessive

for a child diagnosed with autism)• Number of goals and objectives should support and

be consistent with the methodology, placement, and service delivery model you are seeking

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Tips and Tools

Goals and Objectives• Objectives must be MEASUREABLE – you need to

understand how it is measured and when it will be considered met/mastered

• Make sure objectives always outline INDEPENDENCE as the final target

• Baselines need to be specific for each objective (where is she performing right now?)

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Tips and Tools

Example of poorly written objective: Johnny will complete his backpack routine with assistance in 50% of opportunities

• What does “with assistance” mean• Why only 50%?

Re-written: Johnny will complete his back pack routine independently. Criteria: Zero-prompt task analysis

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Tips and Tools

Example of poorly written objective: Johnny will improve fine motor skills by holding and using scissors

• What does “improve” mean• What does “using” mean

Re-written: Johnny will cut on a line across a sheet of paper independently

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Tips and Tools

Example of poorly written objective: Johnny will identify a variety of shapes and colors

• How many is “a variety”

Re-written: Johnny will receptively identify eight different colors and four different shapes. Criteria: 90% accuracy across three sessions

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Tips and Tools

Goals and Objectives• A poorly written objective supports minimal

progress and accountability• Under IDEA, student needs to make “meaningful

progress” as outlined in the IEP• If the IEP is subjective, slight improvement can be

supported as “progress” by the school district

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Tips and Tools

Specialized instruction and related services plan• This page outlines WHO will provide services and

for how many hours• Includes: Speech therapist, OT/PT, augmentative

communication specialist, behavior specialist, SPED teacher, para, regular education teacher

• Important to advocate for FULL TIME programs in the pre-school and kindergarten years (Per the NRC Study, Educating Children with Autism)

• Advocate for supervision and skilled/trained professionals – request outside help

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Tips and Tools

Placement alternatives and recommended placement in Least Restrictive Environment (LRE)• Discuss what alternatives are available• School will usually not accept alternate placement

without further elevation/administration involvement

• Exception is severe behavioral problems

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Tips and Tools

How parent will be notified of progress• Establish feedback system (daily/weekly/

monthly) to track child’s progress• Ensure data collection systems are established,

understood, and agreed upon by all members of the team (including parents)

• Modify program if progress not being made (3-6 weeks is a good measuring point)

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Tips and Tools

Eligibility for Extended School Year (ESY)• Under Colorado Department of Education policy,

ESY services are provided to maintain learned skills ONLY

• NRC Study conflicts with this policy by recommending 25 hours per week of services year round

• Come prepared with documentation to show learning progress and regression during school breaks, demonstrate how child’s individual needs and disability require consistent service delivery

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Tips and Tools - Implementation

The IEP is only the first step, actual implementation is the true test of the program’s adequacy• Observe what is going on in the classroom • For each activity during the day, ask the

following questions:• What is the learning objective?• Does child know what is expected of him/her?• Does child have pre-requisite skills to be

successful?

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• If the activity is not meaningful (previous questions cannot be answered), recommend improvement or other activity (1 on 1 teaching)

• Progress should be evident in 3-4 weeks; if not, question teaching technique, skill of para, pre-requisite skill, etc.

• Don’t wait until the end of the year to question progress!

• Become the squeaky wheel

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• Try to work your concerns with the staff directly• Follow up, in writing (not e-mail) to identify your

concerns and whether or not they are being addressed

• Concerns should be related to the IEP• If an area of concern is identified that is not

covered in the IEP, request a meeting to discuss and/or draft new document

• Formalizing communication usually results in service improvement - lets the District know you are serious

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Tips and Tools - Resources

Parent Resources Wrightslaw at http://www.wrightslaw.com/

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Parent Resources (Recommended Reading):

Behavioral Intervention for Young Children With Autism: A Manual

for Parents and Professionals (by Catherine Maurice)

A Work in Progress: Behavior Management Strategies & A Curriculum for Intensive Behavioral Treatment of Autism (Paperback) by Ron Leaf, John McEachin, Jaisom D. Harsh

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• Alpine Autism Center (719) 955-3767• Stephanie Meador, M.Ed, BCBA

• Other licensed BCBA’s in Colorado Springs:• Dr. David Hatfield• Jennifer Williams, MS• LaRee Kelly Warner, MA

• Behavioral Psychologist:• Dr. Marcia Braden

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Summary

• Parents: the more involved you are, the better your child’s services will be

• Educate yourself regarding effective treatment, teaching techniques, and the definition of “meaningful progress”

• Remember the components of effective programming: intensity, student to teacher ratio, coordination across settings, continuous measurement, and ongoing evaluation

• Become the squeaky wheel

Questions and Discussions

effective ieps for children with autism. 2 overview individuals with disabilities education act...

Documents

appropriate slide

autism slide

appropriate services

lovaas slide

education of people

appropriate social behavior

group of preschool children

autism states