A New Frontier: Changing how Virginia Supports Educators Serving Students with Autism

1

A New Frontier: A New Frontier: Changing how Virginia Changing how Virginia

Supports Educators Supports Educators Serving Students with Serving Students with

AutismAutism Samantha Hollins, Virginia Department of EducationDawn Hendricks, Virginia Commonwealth University

Carol Schall, Virginia Commonwealth University

Issues, Trends and Issues, Trends and Future Directions for Future Directions for Students with Autism Students with Autism

in Virginia’s Public in Virginia’s Public SchoolsSchools

Samantha Marsh HollinsSamantha Marsh HollinsVirginia Department of Virginia Department of

EducationEducation2

RoadmapRoadmap

•What is ASD?•Hot Topics • How do we work with it in schools?

• How does this affect policy?

• What is happening right now that can influence what we are doing?

• What are we doing to support public schools in Virginia?

3

Continuum of Autism-Related Disorders

Autism Spectrum DisordersDSM-V, 2012

Autism ContinuumAutism ContinuumHeterogeneityHeterogeneity

Measured IQSevere Gifted

Social Interaction

Aloof PassiveActive but

Odd

CommunicationNon-verbal Verbal

SensoryHyposensitive Hypersensitive

Adapted from Dalrymple, Porco, & Chung

Motor SkillsUncoordinated CoordinatedFine motor

Gross motor

Qualitative Impairment in Social InteractionQualitative Impairment in Social Interaction

At least 2 of these broad characteristics must be present

• Marked impairment in the use of multiple nonverbal behaviors

• Failure to develop age-appropriate peer relationships

• Lack of spontaneous seeking to share interests and achievements with others

• Lack of social or emotional reciprocity

At least 1 of these broad characteristics must be present• Delay in, or lack of, spoken language

development

• In verbal children, marked impairment in conversational skills

• Stereotyped and repetitive use of language

• Lack of spontaneous age-appropriate make believe or social imitative play

Qualitative Impairment in CommunicationQualitative Impairment in Communication

Restricted, Repetitive, and Stereotyped Restricted, Repetitive, and Stereotyped Patterns Patterns

of Behaviorof BehaviorAt least 1 of these broad characteristics

must be present• Preoccupation with at least one restricted pattern

of interest to an abnormal degree

• Inflexible adherence to non-functional routines or rituals

• Stereotyped and repetitive motor mannerisms

• Preoccupation with parts of objects

Rising Wave:Rising Wave:Exponential IncreasesExponential Increases

13,137

11,705

10,094

9,136

7,854

6,749

5,674

4,7513,966

3,3502,702

2,226

0

2000

4000

6000

8000

10000

12000

14000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

356% Increase from 2000 to 2011

162, 327 Students with Disabilities

Source: VDOE Spec EdDec 1, 2011 Child Count

2011 Child Count by Primary Disability Label

Population TrendsPopulation Trends

Population TrendsPopulation Trends

HOTTOPIC

Interventions for Interventions for Children with ASD Children with ASD

Richard L. Simpson: Evidence-Based Practices and Students with Autism Spectrum Disorders

Focus on Autism and Other Developmental DisabilitiesVolume 20, Number 3, Fall 2005

14

Scientifically Based Scientifically Based Practices Practices

Skill Based Cognitive

Applied Behavior Analysis

Learning Experiences: An Alternative Program for

Preschoolers and ParentsDiscrete Trial Teaching

Pivotal Response Training

15

Promising PracticePromising PracticeInterpersonal Relationships Skill Based Cognitive

Physiological, Biological,

Neurological

Play-oriented strategies

Picture Exchange Communication

System

Cognitive behavioral

modification

Sensory integration

Incidental Teaching Cognitive learning strategies

Structured Teaching Social stories

Augmentative alternative

communicationSocial decision

making strategies Assistive technology

Joint action routines16

Limited Supporting Information for Limited Supporting Information for PracticePractice

Interpersonal relationship Skill-based Cognitive

Physiological, Biological,

NeurologicalOther

Gentle Teaching Van Dijk

Curricular approach

Cognitive ScriptsScotopic

Sensitivity Syndrome

Music therapy

Option Method Fast ForWord CartooningAuditory

Integration Training

Art therapy

Floor Time Power Cards Megavitamin Therapy

Pet/Animal Therapy Feingold Diet

Relationship development intervention

Herb, mineral and other

supplements17

Not Recommended Not Recommended Interpersonal Relationship Skill based

Holding Therapy Facilitated Communication

18

HOTTOPIC

LegislationLegislation• Paraprofessional Training in Behavior Management (HB

325)• Assistive Technology Follows the Student Legislation (HB

382)• Tax Credit to Nonprofit Bill (HB 321)• Health Insurance Regulations

• BCBA and BCaBA certification

• PBS Facilitators

• General Assembly Session upcoming…

HOTTOPIC

Proposed New DSM-VProposed New DSM-V

• Elimination of PDD NOS• Elimination of Rett’s• Elimination of Aspergers Disorder• Expected out in May, 2013

Proposed DSM-V CriteriaProposed DSM-V Criteria

Must meet criteria 1, 2, and 3:interactions,

• 1.  Clinically significant, persistent deficits in social communication and as manifest by all of the following:

• a.  Marked deficits in nonverbal and verbal communication used for social interaction:

• b.  Lack of social reciprocity;

• c.  Failure to develop and maintain peer relationships appropriate to developmental level

• 2.  Restricted, repetitive patterns of behavior, interests, and activities, as manifested by at least TWO of the following:

• a.  Stereotyped motor or verbal behaviors, or unusual sensory behaviors

• b.  Excessive adherence to routines and ritualized patterns of behavior

• c.  Restricted, fixated interests

• 3.  Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)

HOTTOPIC

26

Presenting Issues in Virginia

• Research: 1 in every 88 children are diagnosed with an ASD• Still under diagnosing and age of diagnosis still lags behind the

national average

• Autism became the 4th largest primary disability category on the Dec 1, 2010 child count

• Surpassed Emotional Disturbance

• No longer a low-incidence disability

• Complaints, Due Process, Mediation: • Complaints: 40% involved children with Autism

• Mediation Sessions: 10% involved children with Autism

• Due Process Hearing Requests: 90% involved children with Autism

27

Presenting Issues in Virginia

• Joint Legislative Audit and Review Commission• JLARC is the oversight agency of the Virginia General

Assembly, established to evaluate the operations and performance of State agencies and programs.

• General Assembly commissioned a review of the statewide service delivery system for children and adults with ASD

• 21 recommendations in the report that directly or indirectly involved VDOE

• 5 out of the 21 JLARC recommendations are directed at VDOE

• Recommendation 11 - Improve service delivery and build local capacity

What was VDOE’s Vision and Response?

28

What is the Vision?• Virginia will be a national leader in effectively preparing

students with ASD to acquire the knowledge and skills necessary to achieve positive post school outcomes

• College ready

• Career ready

• Ability to self advocate

• Actively engaged and responsible citizens of their communities

• Independent to the maximum extent possible

30

Our Building Blocks• Build a strong coalition of stakeholders• Make significant resource investments • Leverage relationships with Virginia Colleges and

Universities • Embrace identified weaknesses as “opportunities”• Focus on research and evidence based practices • Embedded approach to technical assistance and

professional development• Harness the power of distance education and online

tools

Virginia Department of Education ASD Guidance Documents

31

32

VDOE Strategy• Develop a PREMIER technical

assistance, professional development and educational research center for ASD in the Commonwealth of Virginia

ResourcesResources

Virginia Department of Education Autism Resources

www.doe.virginia.gov/special_ed/disabilities/autism

Virginia Commonwealth University Autism Center for Excellence (VCU ACE)

www.vcuautismcenter.org

Scaling Up: Professional Scaling Up: Professional Development for Educators Development for Educators Who Serve Students with Who Serve Students with Autism Spectrum DisorderAutism Spectrum Disorder

Dr. Dawn Hendricks, Dr. Dawn Hendricks, Director of TrainingDirector of Training

34

How does the VCU ACE Increase Knowledge, Skills and Abilities in Evidence Based Practices in ASD

for the Wide Range of Professional and Paraprofessional Educational

staff in Public Schools?

35

TrainingTraining

36

37

Training

On what do we train?

How do we move beyond

training?

Who do we train?

How much training?

Where do we train?

How do we train?

Training Training

Anyone Who Lives with…Anyone Who Lives with…Works with… SupportsWorks with… Supports

• Special Educators• General Educators• Related Service Personnel• Paraprofessionals• Administrators• Psychologists• Family Members and Friends• Medical Professionals• Early Intervention Service Providers• Adult Service Providers

39

University / College University / College Coursework Coursework

Certificate Programs in ASDCertificate Programs in ASDAverett University Danville

Old Dominion University NorfolkSTATE

George Mason University Fairfax

*Radford University Radford

James Madison University HarrisonburgSTATE

*Rappahannock Community CollegeGlenns and Warsaw

Longwood UniversityFarmville

Regent University Virginia BeachSTATE

Lynchburg CollegeLynchburg

*University of Mary Washington FredericksburgSTATE

Mary Baldwin University Staunton

Virginia Commonwealth University RichmondSTATE

Applied Behavior Analysis Applied Behavior Analysis ConsortiumConsortium

• 4 Universities• GMU• ODU• VCU • Lynchburg

• Begin Fall 2012• Provide coursework and supervision in the form

of practicum courses • Tuition assistance not available

Applied Behavior Analysis Applied Behavior Analysis ConsortiumConsortium

• Year 1• 30 students• Program ran by GMU• ODU, VCU and Lynchburg provide sites

• Year 2• ODU, VCU and Lynchburg operate with GMU as a unified

consortium• Annual cohort

Not-for-CreditNot-for-Credit

44

Online CoursesOnline Courses

• Foundations of ASD• Module One: Overview of Autism Spectrum Disorder

and the Primary Characteristics• Module Two: Secondary characteristics, Learning

Styles and Autism across the Lifespan

• Strategies for Supporting Positive Behaviors in Students with ASD

• Module One: Functional Assessment• Module Two: Behavior Intervention Planning

Paraprofessionals in Autism Paraprofessionals in Autism Resource and Advancement Project Resource and Advancement Project

(PARAPro)(PARAPro)• Enhance the knowledge of paraprofessionals

related to the characteristics and learning needs of students with autism spectrum disorder

• Build skills related to implementing teacher directed instruction and behavioral support strategies

• Assist local educational agencies in providing teachers and administrators with guidance on the supervisory relationship with paraprofessionals

Paraprofessionals Paraprofessionals

47

Paraprofessionals in Autism Paraprofessionals in Autism Resource and Advancement Project Resource and Advancement Project

(PARAPro)(PARAPro)

Online course and live training:

Autism Spectrum Disorders for Paraprofessionals: Providing Effective Instruction and Support

Paraprofessionals Trained Paraprofessionals Trained April May June July August September

138 153 154 402 300 200 enrolled

120 live training

49

WebcastsWebcastsNational and State ExpertsNational and State Experts

• Autism: An Evolving DiagnosisDate: 9/11/2012 Presenter(s): Maria Urbano

• A Successful Employment Experience for Individuals with Asperger’s Syndrome: What it Takes

Date: 10/9/2012 Presenter(s): Tamara Eastman, Peter Skirbunt, Ph.D.

• Introduction to the Hidden Curriculum – Part 1Date: 11/13/2012 Presenter(s): Brenda Smith Myles, Ph.D.

Resources Resources

51

Eligibility

FamilyEvidence

Based Practices

Adulthood

Diagnosis

Technology

Providing Technical Assistance and

Building Local Capacity in School Divisions

Carol Schall, Ph.D., Director of Technical Assistance, Virginia Commonwealth University Autism Center for Excellence

52

If you do what you have always If you do what you have always donedone

You will get what you have always gotten

What have we done …What have we done …• One shot consultation• Train and hope• Short term consultation• Send away to private school• More adults• More money• Multiple consultants• More Training

13,137 + Students with

ASD1,000 More Every Year!

Training Outcomes Related to Training Components

Training OutcomesTraining Components

Knowledge of Content

Skill Implementation

ClassroomApplication

Presentation/ Lecture

10% 5% 0%

PlusDemonstration

30% 20% 0%

Plus Practice

60% 60% 5%

Plus Coaching/ Admin SupportData Feedback

95% 95% 95%

Joyce & Showers, 2002

Our modelOur model

School Divisions # of Students Identified with ASD

Arlington County 362Botetourt County 45Greensville County 24Hampton 256Newport News 285Henrico County 598Northern Neck Regional

49

Richmond City 202Wise County 35TOTALS 1856

Top Down and Bottom UpTop Down and Bottom Up

Administrative SupportAdministrative Support

Practice and CoachingPractice and Coaching

Data and FeedbackData and Feedback

Aggregate Results of Aggregate Results of SurveySurvey

What Have We Learned?What Have We Learned?

• Survey of Staff

• Response from among the 11 divisions represented in the 8 projects

• n = 1071

Two Surveys:Two Surveys:Administrators and Direct Administrators and Direct

Service ProvidersService Providers

Does the time spent on activities meet the Does the time spent on activities meet the needs of students with ASD?needs of students with ASD?

What activities are most important when What activities are most important when working with students with ASD?working with students with ASD?

FindingsFindings• Administrators

• Most involved in special education, inclusion, behavior management

• Schools most successful at providing special education, speech/language, inclusion

• Most important to students with ASD, special education, inclusion, behavior management

• Gap• Behavior Management

FindingsFindings

• Direct Services• Spend most time on reading, math, play/leisure, independence,

and inclusion

• Needs more time on language/communication, independence, social skills, behavior management

• Identified most successful for the most respondents: reading, social skills, communication

FindingsFindings• Identified most important for students with ASD by most

respondents: behavior management, social skills, language/communication, independence, daily living

• Gap• Behavior management, independence, daily living

72

From Planning to From Planning to ImplementationImplementation

• Convene an Autism Services Improvement Team (ASIT) in each division

• In collaboration with ASIT members, assess current status in division

• Develop Autism Services Improvement Plan (SIP)

• Implement strategies detailed in SIP• Evaluate outcomes based on SIP

73

Service Improvement PlanService Improvement Plan• Vision• Mission• Beliefs• Goals• Milestones• Phases• Tasks• Measurement

74

Sample Goals from Service Sample Goals from Service Improvement PlanImprovement Plan

• Identify a scope and sequence and effective methods for teaching social skills to develop social competence in three secondary schools (one per year) within the division.

• Maximize access to the instructional day by effectively utilizing supports and differentiated instruction

• Increase consistent implementation of evidence-based practices (EBPs) by all APS staff.

• The average age of ASD identification will be reduced from 6 years old to 3.5 years old.

75

Goal 1- Initial Milestones and TasksSchool Division will have effective transitional

procedures to support all students with ASD from the time of identification through exit from Exceptional

Educational services.• Phase 1:• A transition criteria will be used at transition meetings at

transition IEP meetings from Part C to preschool, preschool to elementary school, elementary to middle, middle to high, and high to post-secondary activities

• Tasks:• Develop concrete transition criteria from Part C, to preschool

• Develop concrete transition criteria from preschool to elementary

• Develop concrete transition criteria to and from more restrictive to less restrictive environments

76

MeasurementMeasurement

• Review data from survey: what is keeping kids with ASD from being included in less restrictive environments

• Review meetings with parents and professionals to address what criteria is needed for a specific classes

77

CoachingCoaching

• Training in identified skill or practice• Pre-coaching conference• Observation with coaching• Post coaching conference• Fidelity checklist for practice or skill• Fidelity checklist for coaching session

78

What about the other What about the other divisions?divisions?

• Communities of Learning in Autism• One in each region (some regions share)• Collaboration with T/TAC and other regional

efforts• First Annual, (we hope) CoLA Summer

Institute, June 20 – 22, 2012

79

Comprehensive Statewide Comprehensive Statewide Systems ChangeSystems Change

• Vision• Training• Embedded Technical Assistance• Spread beyond Intervention Sites

80