The Impact of Deafness on the Use of Evidence- Based...

TASN-Autism & Tertiary Behavior Supports

2013-2014 Webinar Series

12/11/2013

1

The Impact of Deafness on the Use of Evidence-

Based Practices (EBPs) in Children with ASD: Part 1

Presented by

Dr. Stacey Jones Bock, Ph.D.

Dr. Christy Borders

Illinois State UniversityTASN Autism and Tertiary Behavior Supports is funded through Part B funds administered by the Kansas State

Department of Education's Special Education Services. TASN Autism and Tertiary Behavior Supports does not

discriminate on the basis of race, color, national origin, sex, disability, or age in its programs and activities. The

following person has been designated to handle inquiries regarding the non-discrimination policies: Deputy Director,

Keystone Learning Services, 500 E. Sunflower, Ozawkie, KS 66070, 785-876-2214

Impact of Deafness on

the Use of EBPs in

Children with ASD:

Part 1Stacey Jones Bock & Christy Borders

Illinois State University



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What is an evidence-based

practice?

• Using research to inform practice

• Education

• No Child Left Behind (2002)

• Individuals with Disabilities Education

Improvement Act (2004)

Defining Evidence-Based

Practices• What are they?

• Debated for years

• Pressure for districts to provide effective services

• National Academy of Science (NAS)

• Created committee to identify evidence-based practices for children

with autism

• Stated that scientific research consisted of:

• Empirical investigation

• Linking findings to a theory of practice

• Providing a coherent chain of reasoning

• Replicating and generalizing across studies



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What can EBP interventions do?

Increase

Behavior

�Academic tasks

�Communication skills

�Higher Cognitive Functions

�Interpersonal skills

�Learning Readiness tasks

�Motor skills

�Personal Responsibility tasks

�Play skills

�Self Regulation

�Placement

Decrease

Behavior

�Problem Behaviors

�Restricted, Repetitive,

Nonfunctional patterns of

behavior, interests and

activities

�Sensory or Emotional

Regulation

Recent EBP Activity

• Efforts have been made to critically review the

research and further identify evidence-based

practices.

• Two Centers published their findings:

• The National Autism Center’s National

Standards Report

• National Professional Development Center on

Autism Spectrum Disorders



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National Standards Project

� Established a set of standards for

effective, research-validated

educational and behavioral

interventions for children with ASD

� Investigated the research behind

the interventions

� Developed the Scientific Merit

Rating Scale (SMRS)


• SMRS

• Objectively evaluate research methods to

determine effectiveness

• Research design

• Measurement of the dependent and

independent variable

• Participant eligibility

• Treatment generalization



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� Four critical factors

� Professional judgment

� Data based decision making

� Values and preferences of families

including the student when feasible

� Capacity to accurately implement

interventions


� Reviewed 7,038 studies

� Excluded:

� Studies after 2007

� Did not include a numerical measure of

effectiveness

� Did not follow common methodology

� Not published in peer reviewed journal

� Language other than English

� 775 studies retained for final

analysis



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� 11 intervention practices were

considered evidence-based.

� Similar interventions grouped into

same category

� Schedules

Categories of Treatments

As determined by the National Autism Center:

• Established Treatments

• Sufficient evidence to confidently determine a treatment

produces favorable outcomes

• Emerging Treatments

• Some evidence of effectiveness but not enough to be confident

that they are truly effective

• Unestablished Treatments

• No sound evidence of effectiveness



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Established Treatments

• Antecedent Package

• Behavioral Package

• Comprehensive Behavioral Treatment for Young Children

• Joint Attention Intervention

• Modeling

• Naturalistic Teaching Strategies

• Peer Training Package

• Pivotal Response Treatment

• Schedules

• Self-management

• Story-based Intervention Package

National Professional Development

Center on Autism Spectrum

Disorders• Used rigorous criteria to determine whether a practice was

evidence-based.

• Defined evidence-based practice based upon intervention efficacy

established through peer-reviewed research in scientific journals.

• Criteria:

• 2 high quality experimental or quasi-experimental group design studies

for the intervention practice.

• 3 different investigators or research groups conducting at least 5 high

quality single subject research designs

• 1 high quality randomized or quasi-experimental group design study

and 3 high quality single subject design studies conducted by at least 3

different investigators or research groups, across the group and single

subject design studies.



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NPDC on ASD

• 24 interventions that meet their definition

• Created modules for each of these interventions

• Overview

• Age of effectiveness

• Goals that should be addressed

• Settings it can be used effectively in

• The evidence-base

• Steps for implementation

24 Practices Identified by

NPDC• Antecedent-Based Interventions

• Computer-Aided Instruction

• Differential Reinforcement

• Discrete Trial Training

• Extinction

• Functional Behavior Assessment

• Functional Communication Training

• Naturalistic Interventions

• Parent-Implemented Intervention

• Peer Mediated Instruction and Intervention

• Picture Exchange Communication

• Pivotal Response Training

• Prompting

• Reinforcement

• Response Interruption/Redirection

• Self-Management

• Social Narratives

• Social Skills Groups

• Speech Generating Devices (SGD/VOCA)

• Structured Work Systems

• Tasks Analysis

• Time Delay

• Video Modeling

• Visual Supports



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Commonalities of EPBs

• In-depth coverage of the commonalities

Interventions Found to be

EBPs by Both Centers• Antecedent-Based

Instruction

• Differential Reinforcement

• Discrete Trial Instruction

• Visual Supports

• Functional Communication Training

• Video Modeling

• Naturalistic Intervention

• Task Analysis

• Parent Implemented Interventions

• Peer Mediated Instruction

• Social Narratives

• Prompting

• Reinforcement

• Self-Management



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•What are Deaf Education

Evidence-Based

Practices?

Deaf Education –

Behavior and Social Interaction



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Managing Student Behavior

and Social InteractionKnowledge

• 51. Processes for establishing ongoing interactionsof students who are deaf or hard of hearing with peers and

role models who are deaf or hard of hearing.

• 52. Opportunities for interaction with

communities of individuals who are deaf or hard of hearing on

the local, state, and national levels.

Skills

• 53. Prepare students who are deaf or hard of hearing in the

appropriate use of interpreters.

Planning and Managing the Teaching and

Learning Environment

Knowledge

• 45. Deaf cultural factors that may influence classroom management of students

who are deaf or hard of hearing.

• 46. Model programs, including career/vocational and transition, that have been

effective for students with hearing losses.

Skills

• 47. Manage assistive/augmentative devices appropriate for students

who are deaf or hard of hearing in learning environments.

• 48. Select, adapt, and implement classroom management strategies for students who are deaf or hard of hearing that reflect understanding of

each child's cultural needs, including primarily visual Deaf culture where appropriate.

• 49. Design a classroom environment that maximizes opportunities for visually oriented and/or auditory learning in students who are deaf

or hard of hearing.

• 50. Plan and implement instruction for students who are deaf or hard of hearing and who have

multiple disabilities and special needs.



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Deaf Education Pedagogy

• Bilingual/Bicultural Strategies

• Literacy Instruction

• Language Instruction (speech or visual)

• Audiological Equipment

• Modeling

• Shaping

• Prompting

• Language, speech, listening, reading

Our Initial Study

• In 2011, we sent a survey to teachers of the deaf in

Illinois

• Which Evidence-based practices are you…

• Familiar with?

• Using?

• If you are familiar with it, how effective is it with our

population?



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Purpose of the Study

• The purpose of this study is to identify

current teaching practices and knowledge

of evidence-based practices in teachers of

both the deaf and hard of hearing and ASD

fields.

Disability Categories Experienced

0

10

20

30

40

50

60

70

80

90

100

Pe

rce

nta

ge

of

DH

H T

ea

che

rs

Disability Categories Experienced as a DHH Teacher



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ASD EBPs to Consider for D/HH

Children with Complex Needs

What are antecedent-based

interventions?

•Basically—things you can

implement to stop or minimize

the behavior before it actually

begins.



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Antecedent-Based Interventions

(ABI)

• Designed to modify the environment before the

behavior occurs

• Interfering

• On-task behaviors

• Typically after a FBA has been conducted

• Observe in the setting where problem behavior

occurs

• Determine changes to environment

� Steps involved in implementation

� Step One – identify student’s reinforcers

� Step Two – identify interfering behavior and

collect information (where, with whom, specifics)

� Step Three – pair the intervention with the ABI

strategy

� Step Four – collect data and use for decision-

making

Antecedent-Based Interventions

(ABI)



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� Learner preferences

� Altering the environment

� Implementing pre-activity interventions

� Using choice-making

� Altering how instruction is delivered

� Enriching the environment

ABI Strategies

ABI Strategies

• Learner preferences

• Incorporate student’s special interest

into a task or activity



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ABI Strategies – cont.

� Altering the environment

� Countless ways

� Add visuals

� Change the visual structure by defining areas

� Change seating

� Add space between students

� Visual timers

• Pre-activity interventions

• Pre-teaching materials

• Providing transition warnings

• mini schedules/task organizers

• Used with activities associated with

unwanted behavior




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� Altering instruction delivery

� One of the most important

� One of the most difficult

� Change is hard

� Written vs. verbal

� Creating visual material

� Less verbals more

gestures/modeling/prompting


Functional Communication

Training• Designed to decrease unwanted behaviors by replacing them with

meaningful or functional communication

• Emphasis is on functionality instead of form

• Relies on knowing the function behind the behavior

• Functional Behavior Assessment is always performed first



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ABI – Steps 1 and 2

• Step One

• Identify reinforcers.

• Example - Nick

• Step Two

• Indentify unwanted behavior

• Played on computer

• Wouldn’t help with chores

• Not learning independent functioning skills

ABI – Steps 3 and 4

• Step Three

• Match an ABI that meets the function

• Didn’t understand the request

• Frustration ensued

• Given a task organizer

• Choice board

• Step Four

• Collect data

• Chore chart!



12/11/2013

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Part 1: Summary

•History of EBPs

•Why and how complex learners

can benefit

•Discussion of ABI

•Part 2

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