Lauren Turner-Brown, Ph.D. Kara Hume, Ph.D. Assistant ... · FITT –Family Implemented TEACCH for...

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 team

http://fitt.fpg.unc.edu/

Funded by grant R40 MC 22648 through the U.S. DHHS, Maternal and Child Health Research Program

http://fitt.fpg.unc.edu/


Overview

1. What is Family Implemented TEACCH for

Toddlers?

2. Parent coaching

3. Examples of FITT strategies

3. Research Findings


WHAT IS FITT?FITT is a family focused intervention for toddlers on the autism spectrum and their caregivers.


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 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


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


TOYS or

OBJECTSPEOPLE

FITT Goals

We use FITT strategies with toddlers to

support engagement with:

PEOPLE &

TOYS or

OBJECTS


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 Components



during




Strategies




ASD (reduce stress)


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


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


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


Coaching for FITT

Observation

FeedbackReflection

Action & Practice

Joint Planning


FITT Components



during




Strategies




ASD (reduce stress)



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


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


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


Naturalistic Strategies

• Build routines

• Use child’s interests

• Imitate child

• Provide choices

• Communication

obstacles


FITT STRATEGIES TO SUPPORT TODDLER ENGAGEMENT


Examples of FITT Strategies

Schedules

Early learning activities (structure materials)

Table and floor routines

Finished

Imitating child


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 Strategies: Early Learning Activities

Support child’s understanding of how to play


FITT Strategies: Early Learning Activities

Support child’s understanding of how to play


EARLY LEARNING ACTIVITIES: Online FITT Resource

http://fitt.fpg.unc.edu/early-learning-activities-visual-supports

http://fitt.fpg.unc.edu/early-learning-activities-visual-supports


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 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


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


Finished Box


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


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)


Imitate the child

Using early learning activities at a table routine


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)


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


Thank you!

Date post:	24-Jun-2020
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