successful transitions: tips for making change a positive ...€¦ · making transitions successful...
TRANSCRIPT
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Successful Transitions: Tips for Making Change a Positive Experience
Nancy Defina-Marchese, M.A., BCBA
Executive Director and Founder, Breakthrough Autism
www.breakthroughautism.ca
Sunday, January 6, 2013
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My Story
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How about you?
• Tell me about yourself
• What do you hope to learn today?
• Ground rules:
• Got a question? Ask it.
• Participation is key to learning
• Have fun
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Agenda• Why are transitions challenging sometimes?
• 3 Key Tips for making daily transitions more successful
• Assessment to determine what transition skills your child needs to work on and which transition skill strengths that your child has
• How to prepare those in the new environment for your child
• How to prepare your child for the new environment
• Strategies that can be used in the classroom to assist with transitions
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Transitions
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Why are transitions a challenge sometimes?
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Transitions
• Most transitions that we initiate with individuals with autism involve moving from a preferred activity to a non-preferred activity
• This probably even applies to most individuals in general
• So of course, it can be challenging!
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Exercise #1• Think of a transition that is difficult for an individual with
autism
• Write down:
• What were they doing before the transition? Was this a preferred or non-preferred activity?
• What happened during the transition? How long did it take?
• What were they doing after? Was this a preferred or non-preferred activity?
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Transitions
• Even if the child is transitioning to a preferred activity, deficits in understanding language can also make transitions challenging.
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Making Transitions Successful
• Step 1: Minimize the number of transitions per day
• Step 2: Start with small transitions during the individual’s daily routine using the tips that we’re going to discuss this tonight
• Step 3: Then tackle the major life transitions (e.g., camp, school, work). We’ll talk about this next time
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Tip #1• Make the environment that the individual is transitioning to
more fun!
• Use preferred items to guide the individual as they move from one activity to the next
• Deliver preferred items for “transitioning” nicely
• Change aspects of the next environment (e.g., is the work too hard? can I make the activity more interesting)
• Introduce the occasional preferred to preferred activity transition
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Exercise #2
• Go back to your example of the transition that was challenging:
• How you make the environment and the transition itself more fun?
• What can you do to reinforce transitioning “nicely”?
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Tip #2
• Increase predictability about the upcoming transition
• Use a count down, visual timer
• Visual supports (e.g., first/then, visual schedule, visual timer)
• Use priming exercises (e.g., social stories, watch a video model)
• Key = practice, practice, practice
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Tip #2 - Visual Supports
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Tip #2 - Visual Supports
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Tip #2 - Visual Supports
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Tip #2 - Visual Timer
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Tip #2 - Social Stories
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Tip #2 - Video Model
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Tip #2 - Video Model Example
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Exercise #3
• Go back to your example of the transition that was challenging:
• How you could you use a strategy from Tip #2 to make transitions more successful?
• Caution: Don’t use Tip #2 alone. Remember, you need to use Tip #1! You need to address the issue of moving from a preferred to a non-preferred activity first.
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Tip #3
• Once you’ve started implementing tip #1 and #2 and all is well.....Practice unexpected transitions
• Use the visual schedule to help:
• Occasionally change the order of activities
• Introduce a surprise card
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Tip #3 - Surprise Card
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Summary
• Transitions can be challenging because:
• Involves moving from a preferred activity to a non-preferred activity
• Inability to understand the language involved in the transition
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Summary• How to make transitions successful:
• Minimize the # of transitions
• Start with small and successful transitions
• Tip #1: Make the transition and next activity more fun
• Tip #2: Increase predictability about the transition
• Tip #3: Introduce a surprise card
• See tip sheet for summary of these
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Assessment of Transition Skills
• Verbal Behavior-Milestones Assessment Placement Program (Sundberg, 2008) - Transitions Subtest
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Assessment of Transition Skills
• VB-MAPP Areas to consider:
• Instructional Control (e.g., following instructions)
• Challenging behaviour
• Ability to follow classroom routines
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Assessment of Transition Skills
• VB-MAPP Areas to consider (con’t):
• Functional Communication Skills (e.g., requesting for items, requesting for the removal of things)
• Social skills (e.g., how the child initiates social skills, how the child responds to instructions from other children)
• Ability to work independently on academic tasks
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Assessment of Transition Skills
• VB-MAPP Areas to consider (con’t):
• Generalization of Skills across time, settings, behaviours, materials, and people
• Range of items and events that function as reinforcers
• Rate of acquisition of new skills
• Retention of new skills
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Assessment of Transition Skills
• VB-MAPP Areas to consider (con’t):
• Learning from the natural environment
• Transfer between the verbal operants without training (e.g., learn as name as a request and can use it as a label)
• Adaptability to change
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Assessment of Transition Skills
• VB-MAPP Areas to consider (con’t):
• Spontaneous behaviours (e.g., doesn’t require an adult to prompt it)
• Self-directed play and leisure skills
• General self-help skills
• Toileting skills
• Eating skills
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Assessment of Transition Skills
• VB-MAPP Transitions Subtest: complete this subtest well in advance of the transition (even 6-12 months before)
• Based on these results consider areas to teach your child ahead of time
• Summarize the results for the next environment
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Preparing the next environment
• It’s not just about preparing your child but also preparing the next environment
• Start with setting up a meeting with the next environment asap
• Prepare a list of questions to ask ahead of time
• All key players should be at the meeting
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Preparing the next environment
• Some questions to consider:
• What types of support will my child be offered in this environment (both staffing and materials)?
• What steps will be taken to adjust the environment to suit my child’s needs (e.g., curriculum adjustment, augmentative communication systems)?
• What types of experience do the staff have in working with children with autism?
• see www.breakthroughautism.ca In the News Section for more questions
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Preparing the next environment
• Develop a formal transition plan
• How many hours will your child start in the next environment?
• Will those hours be gradually increased?
• What will the first few days look like?
• Will there demands be faded in slowly?
• If your child exhibits challenging behaviour, what is the plan for this?
• Be proactive!
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Preparing the next environment
• Prepare the peers in the next environment:
• Peer awareness training
• Peer buddies
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Preparing the next environment
• Peer awareness training:
• Introduce activities to the peers in “child-friendly” language to teach them about autism in general
• Teach the peers specific strengths and areas of need about the child with autism that will be in their class
• Encourage discussion about the topic
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Preparing the next environment
• Peer buddies:
• Great for modelling skills
• Great for prompting the child to engage in social skills
• Great for delivering reinforcement
• Consider peer mediated social skills interventions
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Preparing the next environment
• Who should be the buddy for peer buddies:
• “The helper” in the class
• A child who is persistent
• Even a little bossy
• Has age appropriate interests
• Is a social butterfly
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Preparing the next environment
• Skills to target for peer buddies program (adapted from Pierce and Schreibman [1995]):
• Paying attention
• Child’s choice
• Varying toys
• Models of appropriate social behaviour
• Encourage conversation
• Turn taking
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Preparing the next environment
• Key to peer buddies program (adapted from Pierce and Schreibman [1995]):
• Peer buddy delivers instructions
• Peer buddy delivers the prompts and/or models behaviour
• Peer buddy deliver the reinforcement
• You teach the peer buddy what to do
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Preparing your child
• Consider the VB-MAPP transitions assessment
• What are the key skills that your child needs to work on to get prepared for the next environment?
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Preparing your child• Key skills that your child can learn ahead of time to help make them
successful in a group setting (adapted from Hanley et al., 2007):
• Instruction following (e.g., responding to name, one step instructions, two step instructions)
• Functional communication (e.g., “help me, please”, “excuse me”, “may I...”)
• Tolerance for delay (e.g., waiting 30 sec. for adult- or peer-mediated event)
• Friendship skills (e.g., saying thank you when you get something, offering or sharing, comforting others in distress)
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Preparing your child• How to teach group skills:
• Introduce each skills by verbally describing it (if appropriate)
• Model the skill
• Immediately, practice the skill with your child
• Provide immediate feedback during the practice
• Set up opportunities during the day to practice in “real-life”
• Provide immediate feedback during these times
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Preparing your child
• Consider priming exercises for specifics about next environment:
• Visits to the next environment
• Start introducing aspects of the schedule of the new environment beforehand (e.g., circle time, snack time)
• Video Modelling and/or pictures
• Social stories
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Preparing your child• Key considerations for model:
• If possible have a peer be the model
• Use items that will appear in the actual environment
• Allow the child to see the model getting reinforcement
• Show clear demonstration of the steps that you want the child to perform
• Practice right after
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Preparing your child• Key considerations for social
stories:
• The child should have at least basic conversation skills
• Include real pictures when possible
• Include the reinforcers in the story
• Break down the steps clearly
• Practice right after
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Summary
• Keys to preparing for major life transitions:
• Do a comprehensive assessment on the child’s skills
• Prepare the next environment
• Prepare the child for the next environment
• Remember: It’s never too early to start planning!
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Tips for helping your child to succeed in the classroom
• The initials days/weeks at school should all focus on helping establish to your child that school can be fun!
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Tips for helping your child to succeed in the classroom
• First, consider your child’s schedule:
• How can you set up your child’s schedule for success?
• Prepare a schedule ahead of time that slowly increases your child’s hours of the day at school
• Then begin to increase the hours at school based on your child’s success
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Tip #1: Scheduling
• First, consider your child’s schedule (con’t):
• Consider also what subjects/activities your child should start out with at school.
• Start them during activities/subjects that they find enjoyable (e.g., if your child likes music, start them during music class).
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Tip #2: Classroom Strategies
• Second consider strategies that can be implemented in the classroom to set-up them for success:
• Remember all of the visual strategies that we talked about
• Modelling using peers or adults can be a very effective strategies
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• Behavioural Skills Training (especially great for social skills):
• Instructions
• Model
• Role play
• Feedback
Tip #2: Classroom Strategies
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• Self-regulation:
• Set-up a goal system for key areas that the child can receive reinforcement for
• Teach them how to monitor their own behaviour and give themselves points or stamps or checkmarks when they perform the skill
• Then they can “cash” the points/stamps/checkmarks in for a reinforcer
Tip #2: Classroom Strategies
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Self-regulation exampleIF I GET.... I CAN HAVE ...
3 goals
2 goals
1 goal
no goals I need to try again.
MY GOALS circle one
1 YES NO
2 YES NO
3 YES NO
Today I did a great job..... Next time I will try to...
My Daily Goals
****Disclaimer: this needs to be individualized for each child’s needs and may or may not be appropriate depending on the child’s needs
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• Class-wide reinforcement systems:
• Fantastic way to help all children in the class
• Select a common goal for all of the children
• Research shows that children will even start to regulate each other’s behaviour and help each other out
• Suggestive praise also works well
Tip #2: Classroom Strategies
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• Individualized Education Plan (IEP):
• Important to spend time to develop a truly “individualized” plan (not just cookie cutter strategies)
• Consider what is doable in the classroom
• Select a goal and break it down into small steps
Tip #3: Curriculum Selection
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• Individualized Education Plan (IEP) (con’t):
• What type of adult or peer assistance is necessary to set the child up for success?
• Are other resources required (e.g., computers, smartboards)
• Ensure that there are provisions for reinforcement
• Caregivers and teachers can work on the same skills at the same time to maximize the child’s success
Tip #3: Curriculum Selection
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• Consider playdates, birthday parties, etc. for opportunities for smaller group interactions
• Implement the peer buddy system
• Depending on your child’s skill level, think about the “hidden curriculum” (i.e., nonverbal language, unspoken social skills)
• E.g., http://www.amazon.ca/The-Hidden-Curriculum-Understanding-Situations/dp/1931282609
Tip #4: Making Friends
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• Important to teach safety skills at school and at home. Consider some of the following:
• Abduction prevention (stranger danger)
• Concept of privacy (e.g., private vs. public)
• Walking nicely (i.e., not bolting)
• Not touching hazardous materials
Tip #5: Safety Skills
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• Behavioural Skills Training is a fantastic way to teach safety skills.
Tip #5: Safety Skills
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Summary• Keys to helping your child be successful in the classroom:
• Establish school as a fun place!
• Consider altering the schedule to set your child up for success
• Implement behavioural strategies to teach your child a variety of skills
• Take the time to be involved in the IEP to ensure appropriate curriculum selection
• Work together with the school to help your child make friends
• Consider teaching your child important safety skills
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Thanks for your participation!
Sunday, January 6, 2013