Now that I shared my thoughts on segregated schools and 1:1 ABA therapy in isolation, I would like to share an alternative approach to providing ABA interventions for children with ASD. Early intervention professionals are familiar with Activity Based Interventions or Activity Based Instruction (ABI) and Routines-Based Intervention (RBI) (see the work of Diane Bricker and Robin McWilliam for more info). These approaches provide a framework for embedding individualized interventions for young children with disabilities within the context of everyday routines and activities in the home, school, and community. It is my very strong opinion that we should use frameworks such as these to embed ABA interventions within natural contexts for young children with ASD and school-age children as well. We know that children learn best when they are actively engaged in everyday routines and activities. However, it may be difficult to engage children with ASD in everyday routines across home, school, and community contexts without the use of ABA interventions and other active engagement strategies. Merging ABA interventions with ABI and RBI is a wonderful way to provide intensive ABA interventions within the natural environment. This allows children to learn within everyday contexts without having to be segregated from their typically developing peers and removed from classrooms that provide rich learning opportunities. Below, I summarized the steps discussed in detail in my book (Bringing ABA into Your Inclusive Classroom) that a BCBA or other professional with expertise in ABA and special education can follow for designing ABA interventions for implementation in the natural environment:
1: Conduct assessments (strengths/interests; present levels of performance for all domains that will be addressed in the ABA intervention program; parent and teacher priorities; list of everyday classroom, home, and/or community routines).
2: Set ABA intervention goals that are meaningful, observable, measurable, positively stated, developmentally appropriate, and have a criteria for mastery
3: Design ABA interventions that can be implemented across a variety of home, school, and/or community contexts and align data collection procedures. Consider the strengths and interests of the student when designing interventions.
4: Create a matrix that lists the ABA goals horizontally and the everyday routines vertically and put x's in the boxes to indicate which goals will be implemented during which routines. For example, during small group reading the teacher may be able to address communication goals, social goals, behavioral goals, and/or academic goals.
5: Provide training, modeling, and coaching to the primary interventionist (teacher or caregiver) to assist with implementing the ABA interventions within the context of everyday routines and provide support with data collection procedures.
6: Monitor the student's progress at least bi-weekly to make instructional decisions.
I completely agree. It just does not make sense that natural environment teaching should stop when a child turns three! If our priorities and ideals are to teach young children with disabilities and delays in natural settings, taking into account their developmental needs, then why do those ideals and priorities change post age three? We need to train our new teachers from the start that ABA and DTT can be imbedded naturally. The principles of ABA can maintain fidelity in the natural environment, including classroom settings, for all ages. This is not only true for the highest functioning students, but can be applied for many students across the spectrum!
ReplyDeleteThank you Emily!
ReplyDeleteI am concerned by your emphasis on on provision of ABA based approaches for autistic students in the mainstream classroom. Autism, as the cliche goes, is a spectrum. Some who are severely limited by their autism, and the substantial numbers with autistic disorder and intellectual disability (41-44% of the entire spectrum according to 2 CDC surveys) may not function well in the mainstream classroom and it can in fact be harmful.
ReplyDeleteI live in the Canadian province of New Brunswick where total classroom inclusion for all has dominated our education system for 2 decades. Many have not been helped by the inclusion for all approach.
My now 16 year old son, with severe Autistic Disorder, and profound developmental delays, was one of those for whom the classroom was not the appropriate learning environment. In Grade 1 he came home self inflicted bite marks on his hands and wrists almost daily until we requested his removal from the mainstream classroom. Since then he has received his ABA based instruction in cubicle or small classrooms. The biting stopped immediately and he began to enjoy school and to learn.
Today he still receives his ABA based instruction with an autism trained (UNB-CEL Autism Training program vetted by ASAT President Dr. David Celiberti)while spending time with other challenged students in a resource center room to start the day and for meals. He also interacts with others students in common areas like the school swimming pool, library etc. Conor loves school and packs his lunch the night before.
Inclusion sure ... evidence based inclusion ... that recognizes that not all students are created the same. Some have more severe challenges, some have challenges that render the mainstream classroom inappropriate for their primary learning location. True inclusion should mean inclusion in a real education that benefits the child and accommodates any special challenges the child might face. Ideologically based, everyone in the mainstream classroom is not inclusion at all. It can deprive those most in need of a real education and can be harmful.
Harold L Doherty
Fredericton, NB, Canada
Facing Autism in New Brunswick
Mr. Doherty,
DeleteBelieve me when I say that I understand everything you shared, and I appreciate you taking the time to share your concerns with me. The reason why I push and push the idea of bringing ABA into inclusive classrooms is because it seems that in many places, it is not even an option. I feel that until we bring the science of ABA into inclusive practice, and until we actually implement all of what is known about best practices when including students with disabilities, how can we say inclusion doesn't work or inclusion is only for the more mild students? With that said, the truth is that many schools just have too far to go to get to the point that they actually are providing quality, individualized supports within inclusive classrooms. In these instances, pulling students out of the general education classrooms is necessary to provide appropriate learning opportunities and to prevent harm as you described. However, I am committed to working with educators to move the field forward so that more and more kids can be served well in inclusive settings in schools and in the community. I am well aware that in the meantime there is a need for separate classrooms and/or schools, and maybe there always will be. I just am not ok with giving up with increasing the quality of inclusive education.
With much respect,
Deb
It seems to me that the purpose of this blog is to educate parents, teachers, and other school professionals on effective inclusive practices. There is a big difference between a "Mainstream Classroom" and an "Inclusive Classroom." In an inclusive classroom, teachers make every effort to implement research-based strategies that will ensure successful academic and social engagement for students with disabilities (in this case, students with Autism). In order for inclusion to be beneficial for a student with Autism, it is imperative that the general education teacher collaborates with the special education teacher (in some cases, co-teaching may be appropriate).
DeleteMr. Doherty, I understand that your experience with inclusion has been very discouraging. Unfortunately, there can be devastating consequences when students with ASD are not given the supports that they need in an inclusive setting. It is possible that your son's first grade teacher was overwhelmed by having a student with Autism included into their classroom. Research from all over the world shows that most general education teachers do not feel adequately prepared to include students with disabilities. If this is accurate, then it is possible that your son's first experience in an inclusive educational setting was not successful due to a lack of training for the teacher. It is likely that this teacher did not know how to effectively engage him in academic and social activities. As a result, your son could have felt angry, isolated, and overwhelmed, which would have then led to the self-injurious behaviors. However, this does not mean that inclusion cannot be successful.
It is unfortunate, Mr. Doherty, that this is the only experience with inclusive practices that you and your family have had. When teachers are properly trained, inclusion can be highly successful in improving the lives of both students with ASD and typically developing peers. The goal of this blog is to help educate teachers so that others do not have the same negative experiences with inclusion that your son has had. It is obvious that you are very knowledgeable about the benefits of ABA for individuals with ASD. Embedding those strategies into inclusive settings can help students to generalize vital academic, social, and communication skills. In addition, it can provide students with ASD the opportunity to interact with typically developing peers and, hopefully, form true friendships with these peers. I hate that your son had such a negative experience with inclusion because it really can be quite wonderful.