lauren turner-brown, ph.d. kara hume, ph.d. assistant ... · fitt –family implemented teacch for...
TRANSCRIPT
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Kara Hume, Ph.D. Lauren Turner Brown, Ph.D.
Samantha Scott, LCSW
Lauren Turner-Brown, Ph.D.Assistant Director, UNC TEACCH Autism Program
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
FITT team
http://fitt.fpg.unc.edu/
Funded by grant R40 MC 22648 through the U.S. DHHS, Maternal and Child Health Research Program
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Overview
1. What is Family Implemented TEACCH for
Toddlers?
2. Parent coaching
3. Examples of FITT strategies
3. Research Findings
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
WHAT IS FITT?FITT is a family focused intervention for toddlers on the autism spectrum and their caregivers.
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
FITT Components
Embeds core values and principles of
TEACCHWorks with families and toddlers
during
Weekly in-home visits
Uses a combination of Structured
TEACCHING & Naturalistic
Strategies
Emphasizes parent coaching to
increase parent engagement
GOALS of FITTSupport family understanding of toddler with
ASD (reduce stress)
Increase toddler engagement (increase skills)
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
FITT Goals
We use core values and principles of
TEACCH to support family understanding
of ASD:
EXPERTISE OFFAMILIES
HELPING
FAMILIES TO BETTER
UNDERSTAND
AUTISM
HIGHLIGHTING
STRENGTHS IN TODDLERS
WITH ASD
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Why Target Family
Understanding of ASD?
Can lead to increased interaction with
toddler
Can result in reduced stress in caregivers
Can empower parents to advocate for
themselves and their toddler
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
TOYS or
OBJECTSPEOPLE
FITT Goals
We use FITT strategies with toddlers to
support engagement with:
PEOPLE &
TOYS or
OBJECTS
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Why Target Engagement?
Engagement with people Promotes social skills, language and communication skills
Engagement with toys and objects Promotes play skills, language, peer opportunities
Engagement with people AND toys at the same time! “Coordinated engagement” …..promotes language
learning!
Children who engage with people and objects together learn language more quickly than those who don’t.
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
FITT Components
Embeds core values and principles of
TEACCHWorks with families and toddlers
during
Weekly in-home visits
Uses a combination of Structured
TEACCHING & Naturalistic
Strategies
Emphasizes parent coaching to
increase parent engagement
GOALS of FITTSupport family understanding of toddler with
ASD (reduce stress)
Increase toddler engagement (increase skills)
OUR ROLE IN THE HOMECoaching and consulting with parents to increase
understanding of their toddler with ASD and
implement FITT strategies within their daily routine
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Home Visits
Weekly visits for 60-90 minutes across 6 months 10 minutes for discussion of new topic/parent concerns
15 minutes for table based activities
15 minutes for floor based activities
15 minutes for routines based activities
10 minutes for reflection and feedback, homework topics
and next steps
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Parent Coaching Goals
Promote parents confidence and competence
Identify parents priorities
Determine what parents already know and how they are implementing skills
Share new information and ideas
Work together to support child’s engagement in everyday activities
Help parents in accessing appropriate resources
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Coaching for FITT
Observation
FeedbackReflection
Action & Practice
Joint Planning
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
FITT Components
Embeds core values and principles of
TEACCHWorks with families and toddlers
during
Weekly in-home visits
Uses a combination of Structured
TEACCHING & Naturalistic
Strategies
Emphasizes parent coaching to
increase parent engagement
GOALS of FITTSupport family understanding of toddler with
ASD (reduce stress)
Increase toddler engagement (increase skills)
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Structured TEACCHing Strategies
Use structure to make
environment and
activities
understandable and
meaningful
Use strategies across
daily routines and
activities to support
increase of adaptive
skills
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Structured TEACCHing Strategies
Organized spaces for routines
1- or 2-step schedules to help with transitions
Structured early learning activities
Activity system with finished box
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Naturalistic Strategies
Emphasizes parent
responsiveness
Engages toddler in interactions in an effort
to reinforce skills and
behaviors
Used across daily
routines and activities
to support increase of
adaptive skills
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Naturalistic Strategies
• Build routines
• Use child’s interests
• Imitate child
• Provide choices
• Communication
obstacles
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
FITT STRATEGIES TO SUPPORT TODDLER ENGAGEMENT
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Examples of FITT Strategies
Schedules
Early learning activities (structure materials)
Table and floor routines
Finished
Imitating child
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Transition Objects First/Then
Pair associated and
concrete object
with verbal
explanation of
transition
Can provide extra
motivation during
transitions
FITT Strategies: Schedules
Support child’s understanding of what is next
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
FITT Strategies: Early Learning Activities
Support child’s understanding of how to play
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
FITT Strategies: Early Learning Activities
Support child’s understanding of how to play
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
EARLY LEARNING ACTIVITIES: Online FITT Resource
http://fitt.fpg.unc.edu/early-learning-activities-visual-supports
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
FITT Strategies: Table, Floor, and home routines
Develop routines to support engagement
Table play for more structured learning of new skills
Floor play for more naturalistic play and generalization of skills
Area for home routines such as dressing or diaper change
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
FITT Strategies: Finished Box
Support child’s understanding of time
Finished is an abstract concept
When is a cause & effect toy finished?
When is TV finished (it’s always there!)?
When are bubbles finished (I know there are more in
there!)?
FITT Strategies by Domain
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Finished Box
• Helps the child
understand activities
have a beginning and
an end
• Creates a familiar
routine to help children
give up activities or
materials
• Supports transitions
across activities
FITT Strategies by Domain
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Finished Box
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
FITT Strategies: Imitate the child
Support engagement/expand social & playskills
Start by joining child in play and imitating his/her
actions with toys and objects – duplicate materials
are great!
Imitating the child often get’s his or her attention.
Once the child is aware you are imitating him/her,
change the action or expand 1 step
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Imitate the Child
Imitates child
Puts first picture in
Changes action
Makes next one hop
Makes next one fly
Makes next one drive
Child watches
Puts several in
Then drives one!
Imitates child on last one (turn taking)
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Imitate the child
Using early learning activities at a table routine
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Initial Study Findings
In a small randomized controlled trial, we found
that, in comparison to community services, FITT
was associated with
Decreased parent stress
Increased parent well-being
Improved social communication skills in toddlers
(Turner-Brown, Hume, Boyd, & Kainz, 2016)
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Training providers in the community about
FITT
We offer 2-3 day FITT Training for professionals
Expanding FITT to include clinic based
services
TEACCH offers FITT to families across North
Carolina
Next Steps
FITT – Family Implemented TEACCH for Toddlers University of North Carolina TEACCH Autism Program
Thank you!