Autism Spectrum Disorder (Part 2): Evidence-Based Practices

Assessment

1. Define autism spectrum disorder:

Autism spectrum disorder (ASD) is a lifelong developmental disability that is determined by a
broad range of conditions and can result in developmental delays and behavioral
differences. There are three primary components to ASD that include difficulties with
communication, difficulties with social interaction, and restricted or repetitive patterns of
thought and behavior.

a. List the two primary characteristics of ASD.

i. One primary characteristic of ASD is a deficit in social communication and social
interaction. Some individuals with ASD may be extremely verbal but not able to pick
up on the nuances of facial expressions, while others may be completely non-verbal
and have great difficulties with expressive language. Because of social challenges,
individuals with ASD have challenges with making friends and with communicating
socially.
ii. Another characteristic of ASD is that individuals have restricted, repetitive patterns of
behavior, interests, or activities. For example, they may stem by flapping hands, or
may have difficulty handling changes in routine or schedules. Many have highly
focused interest and unbalanced attention to areas they find interesting and
engaging vs. not interesting or relevant to them, and they may have atypical
responses to sensory input.

b. Explain why ASD is referred to as a “spectrum disorder.”

ASD is referred to as a “spectrum disorder” because it is an umbrella term that covers a
wide variety of symptoms that range in type and severity. Each individual with ASD
manifests his/her characteristics differently and to different degrees. Individuals can
range in their level of impact from high functioning (Asperger’s) to very low functioning
(non-verbal).

2. Identify and briefly describe the four steps educators can use to make an informed
decision when selecting an EBP.
 1. Identify and define the target behavior:
The target behavior is the behavior that has been deemed as a behavior that the teacher
(or service provider) would like to change. This behavior must be directly observable,
measurable (in duration and frequency) and clearly defined. The setting must also be
clearly identified.
2. Collect baseline data:
Once the behavior is identified and defined, data collection takes place. During this step,
a service provider records how frequently and for how long a behavior occurs. This
should typically take place over the course of at least four days to ensure that the
behavior is indeed indicative of a regular pattern. This data collection provides a
baseline of behavior to compare against once the interventions are put into place.
3. Set Goals/Outcomes:
A specific and measurable goal needs to be specified in the child’s IEP or ISP and
should include when or where the desired behavior will take place, what it should look
like, and what the duration and frequency should be.
4. Select an EBP​:
After identifying the behavior, collecting data, and setting goals/outcomes, service
providers and educators need to choose which evidence based practice can best
address the target behavior. Each student will be different, so interventions will be
different. The items that need to be considered are:
i. the strengths and challenges of the student
ii. what strategies have already been tried with that student (successfully or
unsuccessfully)
iii. the goals of the student goal (i.e., what the student is expected to achieve and in
what learning domain)
iv. how experienced the service providers or educators are with specific EBPs
v. whether the team has access to resources like specific equipment or trained
professionals that would be required to successfully implement an EBP

3. Five EBPs are sometimes referred to as foundational strategies.

Foundational strategies are the interventions that form the basis of interventions for ABA
therapies. They are at the heart/core of the practice of evidence based practices (and best
teaching practices) and can be used to target very specific behaviors or teach certain skills.
They can also be incorporated into a larger intervention program because they form the
basis for all other EBPs.

a. List and briefly describe the five strategies.

i. Reinforcement​: There are two types of reinforcement that both deliver a desired
consequence immediately after positive/expected behavior is performed in order to
increase the likelihood of that behavior being repeated again in the future.

Positive reinforcement: ​This is done when a motivating/reinforcing consequence is

added​ right after the behavior is shown. For example, a teacher gives a tangible
item (e.g. a glass of water, a toy, a pencil, etc.), access to an activity, or a social
reward/praise.

An example of this is if a student is raising his hand, a teacher will make a point to
call on him/her so that student learns to raise hands when he/she has a question or a
point to make. This type of reinforcement can even be paired with positive praise by
saying something like, “Thank you for raising your hand, Mark. What is your
question?”

Negative reinforcement: ​This is when an unwanted object or condition is

r​emoved/taken away​ after the student has engaged in desired behavior.

An example of this is when a student is removed from the classroom during rowdy
competitive class games because he experiences extreme anxiety (and melts down)
due to his heightened sensitivity to the noise and chaos. Because he is in a separate
setting during this time, he remains calm and neutral.

ii. Prompting​: A student may need reminders as he/she learns a new skill or behavior,
so a teacher uses prompting in order to help the student achieve an optimal level of
success, and to increase the chances that the student will give a correct response
and will decrease feelings of frustration and stress. There are five types of prompts:

1. Gesture—Includes pointing at or touching an object. An example is when a

teacher points to an area where a student is supposed to go, or nods to indicate
whether a student is behaving in an expected/unexpected way​.
 2. Verbal cue—Includes verbal hints and directions. These are the most common
types of prompts. An example is “go get your homework folder out of your bag.”
3. Visual cue—Includes illustrations, photos, and objects
4. Modeling—Includes demonstrating or showing a child how to perform a skill. An
example is when a teacher explicitly shows a student how to highlight bolded words
in a text and then asks him/her to do it on their own.
5. Physical—Includes physically directing or touching a child to help him perform a
behavior or skill (e.g. hand over hand guidance for writing letters or cutting with
scissors)

iii. Time delay:​ This EBP is used in tandem with prompting. It is when a teacher gives a
prompt and then immediately provides the correct answer in order to teach a new
behavior or skill. As experience with the skill/behavior progresses, the teacher then
increases the time that the student has to independently respond to the prompt. The
goal is to reduce the time between prompt and response until there are no prompts
altogether. There are two types of prompts:

Constant time delay​—Teachers use a fixed amount of time between a

question/instruction and a response/prompt. After the student has been cued to
perform a task and does not comply, the student is prompted at a set interval
(typically 3–5 seconds). For example, if a teacher is teaching a student a word for
“water”, then the teacher will show the student a picture and immediately say “water.”
Over time, the teacher would delay the wait time and ask the student to point to the
card that has a picture of water on it.

​ Teachers gradually increase the waiting time between a

Progressive time delay—
question/instruction and a response/prompt. For example, if a teacher is teaching a
student a word for “water”, the teacher will show the student a picture and
immediately say “water.” Over time, the teacher would provide the prompt and the
word “water” at regular intervals (e.g. 3 seconds) until the student correctly identified
water, at which point, positive reinforcement would be implemented.

iv. Modeling: This is when a teacher or a peer shows a student how to perform a skill or
behavior in order to help the student understand how to correctly perform that action.
 This is a successful EBP when it is paired with prompting and reinforcement. An
example is when a peer shows a student how to ask for a desired item using
“please” and “thank you.”

v. Task analysis: This is when a complex or multi-step skill or behavior is broken down
into smaller parts so each part can be taught at one time. There are two types of task
analysis:

1. Forward chaining​—This is when the steps are taught in chronological order. The
first step of the skill is taught, and once that step is successfully learned, then the
second step is taught, and so forth until the entire skill is taught. The benefit of
this strategy is that a student understands the sequence of events in a behavior.
An example of this is when a student is taught how to wash his/her hands by first
turning on the right faucet, then the left faucet, etc.
​ This is when the last step of the skill is taught first, and once
2. Backward chaining—
mastered the previous step is taught; this process continues until the student can
successfully perform the entire skill sequence. The advantage of this strategy is
that a student can appreciate the whole picture and end goal for a behavior or
skill. This strategy can be used to teach life skills like tying shoes, putting on a
shirt, etc.

b. For each video below, identify which foundational strategy is being used.

Video 1: Drawing Butterfly

There are multiple strategies being used together in this video to teach the student the
steps for how to draw a butterfly:

Modeling​: First, the teacher uses explicit instruction through modeling to draw each part
of the butterfly.

Task Analysis (Forward Chaining)​: The teacher prompts the student to draw her own
butterfly and uses a series of steps show the student a step by step process. Throughout
the process, the teacher asks the student how many parts the butterfly had, or which
part comes first.
 Positive Reinforcement:​ The teacher provides a lot of praise (social rewards) throughout
the entire process.

Video 2: Tying Shoes

There are multiple strategies being used together in this video to teach the student the
steps for how to tie her shoes:

Modeling​: The teacher uses an analogy of the tree and the bunny. She shows the
student how to perform each step with a separate model pair of shoes.

Task Analysis (Forward Chaining)​: The teacher shows the student how to tie her shoes
with a series of steps to break down the master task.

Positive Reinforcement:​ The teacher provides praise (social rewards) and sets the
student up so she can confidently try the process on her own next time.

c. For each scenario presented in the table below, select one strategy to address the
student’s needs and explain why you chose that strategy. Select a different
strategy for each scenario.

Scenario Strategy Justification for Selection

Selected

Trevor, a 14-year-old boy, is Visual Support By giving Trevor a visual schedule

having difficulty transitioning from (either with pictures or words,
one activity to another. depending on age and ability), he
would be able to prepare himself
for the transitions of the day. He
would be prepared and would be
able to more easily transition to the
next activity.
 Carly, a six-year-old, has difficulty Task Analysis Carly would benefit by a step by
putting on her coat by herself. step breakdown of the process of
putting on her coat. The steps
would include; take your jacket off
the rack, hold jacket with one hand
(left hand, e.g.), put other arm in
the hole, etc. By using this
strategy, Carly would understand
the task in more easily digestible
steps.

Alexa, a three-year-old girl, swings Modeling Alexa would benefit from being
her doll around instead of playing shown how to play with her doll in
with it as intended (e.g., feeding an expected way. It might even
it). help her to have a neuro-typical
peer teach her this skill instead of
a teacher in a social play setting.

4. Visual supports and PECS are effective strategies to address communication needs
of children with ASD. Briefly explain how each strategy can address this need.

Visual Supports:​ Visual supports can include photographs, drawings, symbols, labels, clipart, or
manipulatives. They can help a child with ASD by helping them to understand what is
expected of them, where to go, what to do, where to go, etc. Specifically, Visual Supports
can help a student:
--learn the steps in a new skill
--understand the behavioral expectations of them (e.g. no talking area, reading area, etc.)
--understand where they should place/find items
--follow the steps in their daily schedule and routine
--follow the steps to a task or skill they have already learned (e.g. how to wash their hands,
etc.)
PECS:
PECS helps individuals communicate and interact by teaching them to exchange a picture/symbol
for a desired item. For example, if they want a glass of water, they must find their picture of water
and give it to their communicative partner for a glass of water. This method helps students with
communication challenges to be able to let someone else know what they are thinking or what items
they desire, and this reduces undesired behavior as students no longer feel as frustrated when they
are not understood. Further, this helps children engage in social communication with others, and
helps students use the child’s preferred objects and play routines. It also helps students express
choice when they would otherwise not be able to articulate their preferences or desires.

5. Discuss the differences between a focused intervention and a comprehensive

treatment program.

A focused intervention​ is one that is implemented for a short period of time. It is used to
decrease challenging behaviors that may include aggression, self-injury, or extreme
disruptiveness. These interventions are put into place after standard teaching practices have
not proven effective in decreasing the challenging behaviors.

A comprehensive treatment program​ is one that is continued for an extended period of time
and aims to produce a broader spectrum of functioning. For example, these treatment
programs target adaptive behaviors, communication, and social skills.​ These programs
include focused interventions as well as other interventions, and are used for extended periods
of time.

6. Promoting independence is often a goal for students in high school. Briefly describe
how each of the following strategies can promote independence.

High school students are typically more independent than elementary and middle school
students, with the goal being that they perform tasks almost completely independently as
they transition beyond high school. However, they may still need explicit instruction and
additional supports to be able to perform tasks independently. Two EBPs in particular are
proven to be successful with students of an older age bracket in teaching independence and
self-monitoring. They include self-management strategies and technology-aided instruction
and intervention.

A. Self-management strategies

Self-management strategies are proven to be effective in students ages 15–22 in the realm
of addressing behavioral, school readiness, and vocational outcomes. They may also be
effective with students ages 3–14 in improved social, communication, academic, and play
outcomes.

There are four types of self-management strategies that can be used together to address
various challenges. They include:

Self-monitoring​: In this strategy, students typically use checklists to analyze their own
behavior and record the results. This strategy will help a student to become more
self-aware, and will help a student change the frequency, intensity or duration of a behavior,
but it will not teach a student a new behavior.

Self-instruction​: This strategy is also referred to as self-talk or self-statements. This is

because students actually talk themselves through a task or activity in order to get through
the activity smoothly and in an expected way. They typically repeat a script that has been
taught to them. This helps students become more independent because they can overcome
challenges related to anxiety, or help them through performing a task/chore without the
assistance of another person.

Goal-setting​: ​Students learn how to analyze their current challenges and strengths, and set their
own goals. Then they learn to monitor their progress toward achieving that goal. This helps
students become more meta-cognitive and aware of what they can achieve, and how they can
work towards achieving those realistic goals.
Self-reinforcement​: Students select a reward of some sort that is motivating to them (this can be
something tangible that they want, or an activity they would like to participate in). They then
reward themselves for reaching or surpassing their goal. This teaches students that working
produces rewards, and it helps them stay motivated and focused.

B. Technology-aided instruction and intervention

This strategy incorporates technology to help students achieve a goal. As technology

becomes more and more accessible, students find this type of intervention extremely
motivating. Further, the piece of technology equipment can serve as the other “person” in
the communication exchange, and the student does not require the presence or help of
someone else. For example, an online checklist with verbal prompts can help a student
follow the steps in setting a table, or an online homework app can help a student record and
monitor his assignments.