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Archive for the ‘Evidence Based Treatments’ Category

Our FREE journal club met on Monday night. We discussed Fallagant & Pence 2017. You may access the article here or here.

The introduction to the paper consisted of a nice review of some of the work done to date in this area. The authors discussed why the Preschool Life Skills are so essential. 

The authors also discussed using a Response to Intervention (RTI) model for teaching these skills. You can learn more about RTI here or here. Essentially, in Tier 1, skills would be taught to a larger group or entire class. In Tier 2, small group instruction would be provided to the students who didn’t acquire the skills in Tier 1. Then in Tier 3, 1:1 instruction would occur for the students who didn’t learn the skills in Tier 1 or Tier 2.

The research was scientifically sound in terms of demonstrating experimental control. The authors used a multiple baseline across behaviors and then replicated that over 6 students. Like most research, a few flaws existed. For example, by using a multiple baseline across behaviors, experimenters lose a little bit of experimental control when the student demonstrates response generalization to an untrained behavior.

The participants in the study may have come from a convenience sample which was most likely a university affiliated preschool program. Each of the special education teachers in the school held master’s degrees in special education. The assistant teachers all held bachelor degrees.

The data in the study consisted of measuring the life skills being taught: responding to name, requesting/manding adult attention, requesting/manding adult assistance, delay tolerance, denial tolerance, and independent versus prompted responses. The authors indicated they also collected data on challenging behaviors but those data were not presented in the paper. The authors also reported high IOA data as well as high fidelity data (which is not always reported).

The authors provided a great description of the modifications provided to students who did not acquire the skills in Tier 1, 2, or 3. For these students, this included the use of an AAC device (i.e., proloquo).

One of our big discussion points occured around the author’s use of least to most prompting during Tier 1. We discussed if the results would have been different had they used most to least prompting and decided this should be a point of focus in a future study!

Another area of discussion for us revolved around the authors’ use of only 8 trials per session. This hardly seemed like enough practice for a preschooler, let alone a pre-k student with disabilities (the children had autism, Down syndrome, or DD).

We discussed, and the authors mentioned, the use of AAC and whether the students would have acquired the skills in Tier 1 had the AAC been available during that phase of instruction.

We also discussed the lack of preference assessments and whether the authors’ use of social reinforcement may have been potent enough to reinforce skill acquisition.

And finally, we discussed the limited generalization observed to peers. Some of the kids generalized skills to the adults who are obviously more skilled than the peers. But we also discussed the fact that with such few learning trials (N=8), that the kids may not have developed fluency in the skills thereby limiting their ability to readily generalize the skills. And of course, the authors mentioned that they did not program for generalization so this may have impacted generalization as well.

Bottom line, these seem to be some essential skills that we could easily teach in classrooms to increase the social skills of students.

I have identified a few extra resources. First because of all the tolerance discussion, we should look at some of the original tolerance studies. The following studies utilized FCT combined with Tolerance training.

  1. Bird, F., Dores, A. P, Moniz, D., Robinson, J. (1989). Reducing severe aggressive and self-injurious behaviors with functional communication training. American Journal on Mental Retardation, 94, 37-48.
  2. Brown, K. A., Wacker, D. P., Derby, K. M., Peck, S. M., Richman, D. M., Sasso, G. M., Knutson, C. L., & Harding, J. W. (2000). Evaluating the effects of functional communication training on brief functional analyses of aberrant behavior. Journal of Applied Behavior Analysis, 33, 53-71.
  3. Carr, E. G., & Carlson, J. I. (1993). Reduction of severe behavior problems in the community using a multicomponent treatment approach. Journal of Applied Behavior Analysis, 26, 157-172. 
  4. Day, M. H., Horner, R. H., O’Neil, R. E. (1994). Multiple functions of problem behaviors: Assessment and intervention. Journal of Applied Behavior Analysis, 27, 279-289.
  5. Fisher, W. W., Thompson, R. H., Hagopian, L. P., Bowman, L. G., & Krug, A. (2000).  Facilitating toleraance of delayed reinforcement during functional communication training. Behavior Modification, 24(1), 3-29.
  6. Hagopian, L. P., Wilson, D., & Wilder, D. (2001). Assessment and treatment of problem behavior maintained by escape from attention and access to tangibles. Journal of Applied Behavior Analysis, 34, 229-232.
  7. Harding, J., Wacker, D. P., Berg, W. K., Barretto, A., & Ringdahl, J. (2005).  Evaluation of relations between specific antecedent stimuli and self-injury during functional analysis conditions.  American Journal on Mental Retardation, 110(3), 205-215.
  8. McConnachie, G., & Carr, E. G. (1997). The effects of child behavior problems on the maintenance of intervention fidelity. Behavior Modification, 21, 123-158.
  9. Symons, F. J., Fox, N. D., & Thompson, T. (1998). Functional communication training and naltrexone treatment of self-injurious behavior: An experimental case report. Journal of Applied Research in Intellectual Disabilities, 11, 273-292.

And here are some extra resources on Preschool Life Skills

  1. Hanley et al 2007
  2. Luczynksi & Hanly (2013)
  3. Luczynski, Hanley, & Rodriguez (2014)
  4. Beaulieu, Hanley, & Roberson 2012
  5. Beaulieu, Hanley, & Roberson 2013
  6. Hanley, Fahmie, & Heal 2014 (in headstart)
  7. Francisco & Hanley (2012)
  8. Robison, Mann, & Ingvarsson (in press)
  9. Dogan et al 2017 (training parents)
  10. Halfdanardottier, Sveinbjornsdottir & Ingvarsson (in process but looking at life skills in older students)
  11. Ala’i-Rosales et al 2018
  12. Fahmie & Luczynski 2018 (review of studies)

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We are super excited to share with our followers the new data collection software program we have been utilizing.

BIP Track combines intuitive tools into one comprehensive portal. Our team of BCBAs, RBTs, and BTs are able to collect, analyze, and report on behavior and skill acquisition program data in real time.

One of our BCBAs, Sara Hult, worked with the developers, Gene & Dave, to help the software meet all of our needs. Our team has tried every data collection tool on the market, and none of those programs could meet our needs.

Here are some of the features that set BIP Track apart from “the others”

  • live reporting available on any client at any time
  • track multiple clients at one time
  • graphs automatically update (insert your trend lines!)
  • IOA data collection is built in
  • track multiple types of data including frequency, duration, and interval recording
  • student self-evaluations are available for your self-management plan
  • supervisor notes may be submitted as they occur
  • therapist SOAP notes are created as the session progresses
  • link IEP goals to trackables and skill acquisition programs
  • HIPAA compliant even when sharing SOAP and supervisor notes!
  • dashboard and interface are user-friendly

We are so pleased with this product that in March of this year, our entire team moved over to BIP Track and we couldn’t be happier.

Disclaimer: we do not receive any income from BIP Track!

 

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The field of special education and behavior analysis lost a great man last week. Stan Deno, Ph.D. served on faculty in the College of Education and Human Development at The University of Minnesota (commonly referreStan Denod to as The U) from 1970 (or so) until he retired in 2009. During that time, Stan developed a framework for monitoring student progress towards their academic goals. His work in Curriculum Based Measurement (CBM) is the foundation for DIBELS (Dynamic Indicators of Basic Early Literacy Skills; Good & Kiminski, 2002) which has been used in thousands of schools across the country.

Stan also trained many students including undergraduate, masters level, and doctoral level. Two of his students, Doug and Lynn Fuchs, have led the way in developing Response to Intervention (RTI) an evidence-based approach to identifying students with learning disabilities and behavior disorders.

If you don’t know Stan or haven’t read his work, you should make time to do so. Without a doubt, his work has influenced the way we monitor progress in schools and the way we address instruction for students with learning and behavioral needs.

I have many fond memories of Stan. I feel so lucky to have studied with him during my time at The U. He worked diligently to help me slow down when I spoke (I talk fast and southern and it was difficult for him to understand me). He also modeled for me the act of thinking carefully before speaking. If you know me, you know I still am working on this skill!

Stan trusted me to serve as his Teaching Assistant (TA) in the Intro to ABA class. He taught me how to teach adult learners and how to give meaningful feedback on their written work. During this time, he also taught me the importance of technology in the classroom to increase graduate student participation and responding. I am a much better teacher now because of Stan.

I took several classes from Stan. The most memorable included the course on Single Subject Design. In this course, Stan introduced me to the work of Alan Kazdin and he taught me to conduct experimentally sou
nd research studies as well as how to read research and interpret and apply it in my own work. His influence enabled me to write successful grants, publish my own science, and go on to teach my own students. Stan also served on my dissertation committee where he modeled for me how to help students improve their research ideas, study procedures, and how to interpret results accurately. I was so fortunate to learn so much from him.

In addition to our love of research, behavior analysis, and helping students learn, Stan and I both shared the diagnosis of cancer. I received my diagnosis in 2002 some time after he received his diagnosis and treatment. I stopped by the U to visit Stan while I was in town later that same year. We shared how hard living as a survivor can be and we shared how crushing the diagnosis can be. It was then that Stan shared with me the theory of the Sword of Damocles. It took some time for me to truly understand this concept as a new survivor. But oh do I understand it now, 14 years later.

My heart sank to my stomach last week when I learned of Stan’s passing. But, I have joy in knowing how much he taught me and how much he has taught the special education world. Stan will be missed.

The family asks that in lieu of flowers contributions be made in memory of Stanley Deno to: “Stan Deno CBM Research” fund #20003 at the University of Minnesota Foundation.

Online gifts can be made at:  www.give.umn.edu/giveto/standeno

Or mail this giving form to:

University of Minnesota Foundation
P.O. Box 860266
Minneapolis, MN 55486-0266

 

References

Good, R.H., & Kkaminski, R.A. (2002). Dynamic Indicators of Basic Early Literacy Skills (6th ed.). Eugene, OR: Institute for the Development of Educational Achievement. Available: http://dibels.uoregon.edu.

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Logo2012 was a great year for the Applied Behavioral Strategies blog. We had almost 100,000 visitors in total. Here is a list of the most visited blog postings last year. The great news is that I wrote some of the most visited posts in 2011. I am pleased that my posts remain relevant for readers.

#5. Early Morning School Routines. Who doesn’t need help with this? Seriously, it is THE most stressful time of the day for my house.

#4 Just Say No. I can see why this one has staying power. Almost daily, I hear myself saying “Parents need to learn to say no.” You don’t even have to state a reason. Just know that your child needs to learn to accept being told no. (And despite how it may feel or sound, it will NOT be the end of the world.)

#3 Autism Awareness Apps. I really need to update this link. I will be sure to do so in time for April give aways. Keep in mind that I’m also presenting on this topic at SXSW in Austin, TX in March, 2013.

#2. Do You Use Visual Schedules? Wow. I am pleased that this topic is still a hit. If you aren’t using visual schedules, you should! In my home, we use a homework whiteboard every day and it makes our afternoons a BREEZE!

#1. Using ABA to Teach Math. I had no idea when I wrote this post that it would become so popular. The great news is that ABA may be used for a variety of skills!

I cannot thank you enough for your readership! Keep the reading, following, sharing, ideas, feedback, and questions for Ask Missy Monday coming!

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Ginger rated her behavior during carpet time

Hi! and welcome to What Works Wednesdays where a success story from clinical files is shared. Today’s story is about a little girl named Ginger who happens to be a typically developing 3rd grade. Ginger’s teacher contacted Applied Behavioral Strategies to assist her with Ginger’s behavior because Ginger had difficulty paying attention during morning meeting, sitting quietly during group instruction, and staying on task during independent seat work.

Record Review

A review of Ginger’s academic records indicated that she was performing at grade level in all areas. While she had some struggles learning to read, with focused intervention, she has remained on a 3rd grade reading level. Ginger is also very active and has difficulty keeping her hands, arms, and legs still. Finally, Ginger is highly distractable. Her focus is disrupted by butterflies, peers walking by, and particles on the floor.

Ginger’s teacher felt overwhelmed because she had tried verbal reminders, notes home to parents, and seating arrangements. She felt that none of these strategies worked effectively.

Student Interview

The behavior analyst asked Ginger why she had difficulty sitting quietly, completing her seat work, and listening to teacher instruction. She responded that, “I try to sit still and listen but my friend talks to me” and “I try to do my work but I have to sharpen my pencil” and “I sit away from my friend but she comes to sit next to me”.

ABC Observation and Analysis

Direct observation revealed that a variety of consequences followed these target behaviors. Sometimes Ginger received a verbal warning, sometimes the class received a reminder, and some times, no consequence occurred at all.

Self-Management

The behavior analyst needed more time to complete the assessment

so she developed a brief self-monitoring plan for Ginger to use until the assessment and behavior intervention plan could be completed. The self-monitoring plan consisted of Ginger evaluating her own behavior following each instructional activity. Her teacher reviewed the evaluation and confirmed if the evaluation matched reality. Ginger received praise and positive feedback for desired behaviors and her parents provided additional positive attention each day when Ginger shared her rating at home.

Additional Tips

The form was printed and put onto Ginger’s favorite color of construction paper. Then it was laminated so that one side showed the seat work and the other side showed the carpet time. Using a dry erase marker, Ginger could self-rate each day and then the chart could be wiped clean for the next day.

Ginger rated her behavior during seat work

Success

After 2 weeks, the assessment had to be put on hold because Ginger’s behavior improved. As with any student, Ginger continues to have difficulty when substitute teachers are present. However, this simple intervention worked to focus on Ginger’s strengths by reinforcing desirable behaviors.

Readers, have any of you tried self-management? What worked? Parents, have any of your children been placed on self-management plans? Did you like it? Did your child?

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Hi and welcome to Ask Missy Mondays where I respond to a question from readers. Today’s post is in response to multiple requests and questions about social stories and visual supports. Common questions include:

  1. I thought the story had to be written in first person? (e.g., “I like” versus “Charlie likes”)
  2. I thought the story had to be just like Dr. Gray says (A specifically defined style and format: sharing accurate social information and affirming something positive about the child)
  3. Is there any research to support social stories or visual supports?
  4. We do ABA.  Social stories aren’t behavioral.
  5. My child cannot read so why should we have a story?

Overview

Social stories and visual supports serve a specific purpose of providing visual information to individuals so that they can be successful in difficult situations. Some examples of difficult situations include:

  • Non-preferred but required activities (e.g., shopping, haircuts, blood draws)
  • Changes to routine (schedule is disrupted, substitute teacher, different bus route, school cancellations)
  • Novel situations (first time to hospital, first time on an airplane, first time to a play or show, storms)
  • Special but routine situations (dr. appointments, dentist appointments, hair cuts)

 

Individualized

Social stories and visual supports should be individualized to the user. While it may  not be convenient for a teacher to create 12-15 stories/visual supports, what works for one person may not be appropriate for another. When developing stories and visual supports keep the following considerations in mind:

  • age of the individual (resources must be age appropriate for the user)
  • reading ability (adjust the text of the visual depending on the reading level)
  • visual acuity (content should be selected based on the individual’s vision and ability, 3D versus 2D, color versus black and white)
  • attention span (the length and detail of the story or visual support)

Content

While Dr. Gray has created a trademark, there are many options beyond what she describes. Because social stories and visual supports should be individualized, the content should be determined based on the individual’s needs. For example, a mom here in CT created a social story for her child regarding Hurricane Sandy. The story included information about the storm, how it would affect trees and power, and how power could be restored. The story was developed for her son because the issue of losing power is important for him. He becomes upset if he cannot turn on lights or play on computers. However, another child may be scared of the wind or scared of the heavy rain. That child would need a story that focuses on the wind and the rain and how to make the noise go away. And then another child may not fully understand why she cannot go to school. Because she cannot read, her story may show a picture of wind and rain and a picture saying “no school”. The story would end with a picture of the little girl at home working with her ABA therapist.

Research

We have written about visual supports before: here, here, and here. We recommend only evidence-based strategies for our readers. So obviously there is ample research to support social stories and visual supports. A research group has developed a list of evidence-based practices for individuals with autism. Social narratives and visual supports are both on the list. For additional information on those practices and to read the research visit here.

ABA and Social Stories and Visual Supports

ABA, applied behavioral analysis, is simply the application of behavioral principles, to everyday situations, that will, over time, increase or decrease targeted behaviors. For additional information on ABA, visit our website. Thus, the use of visual supports and social stories does not preclude someone from doing ABA. Similarly, implementing ABA does not preclude someone from using visual supports and social stories.

I hope this helps to answer the many questions about social stories and visual supports. If you have a behavioral question for me email me directly at askmissy at applied behavioral strategies dot com. Thanks!

 

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Hi! and welcome to What Works Wednesdays where we share a success story from our clinical files. Today, we are going to take a pause from our personal stories and share a resource with our readers. The resource is called the What Works Clearinghouse from the Institute of Educational Sciences (IES). the website for the resource is http://ies.ed.gov/ncee/wwc/.

 

Educators (special education and general education alike) are required to use evidence-based strategies in their teaching as required under the No Child Left Behind Act and the Individuals with Disabilities Education Improvement Act. Educators often find it difficult to determine what strategies have evidence.

As a result, the Institute for Educational Sciences (which also happens to hand out research money to educational researchers) developed the clearing house as a resource. The criteria used to determine if a methodology may be listed in the Clearinghouse is very stringent. However,  if you are ever in doubt about teaching methodologies and “what works”, their website is a good place to start.

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