autism: resilience- promoting and deterring features at … · resilience: the resilience...

Autism: Resilience-promoting and deterring

features at organizational, teacher, and child levels

Rebecca J Landa, PhD, CCC-SLP Anne-Michelle Engelstad, MEd

�  Andrea Ford

�  Kathryn Greenslade

�  LeAnne Johnson

Research testers, videographers, coders, data management Families, teachers, administrators

R324A160228, Landa, PI

�  Lauramarie Pope

�  Fatima Salem

�  Carrie Zetlmeisl

IES Goal 3 RCT EA-ES vs Workshops Teacher-implemented social-communication intervention Preschoolers with ASD

Measures added: Years 2 and 3

Resilience �  “…developmental and dynamic, manifesting itself as a result

of a dynamic process within a given context” (Gu & Day, 2007, p. 1305)

Karol L. Kumpfer, 1999. Factors and processes contributing to resilience: The resilience framework.

3 Parts

Teacherfunc+oningatbaseline

Teachersimmersed

inadynamicsystem

Suppor+ngteacherresiliency

Part 1. Functioning at baseline

Risk factors

(-) Protective

factors (+)

What characteristics, attributes, assets or competencies increase risk of or protection from maladaptive outcome?

Teachers (pre-randomization) Teacher Data Total

(n=49)

Sex, % female 100%

Race, % white 89.8%

Ethnicity, % Latinx 2.0%

Highest degree achieved in education or related field

Bachelor’s 28.6%

Post-Baccalaureate 2.0%

Master’s 69.4%

Years teaching, M(SD) 8.57(7.6)

Years as teacher and/or IA in autism classroom, M(SD) 8.93(9.2)

Classroom Data Total (n=48)

Classroom type, % inclusive 70.8%

•  Maslach Burnout Inventory (MBI) –Education Survey •  Emotional Exhaustion •  Depersonalization

•  ASSET: Autism Self-efficacy Scale for Teachers •  BRIEF-A: Behavior Rating Inventory of EF

•  Behavior Regulation Index: inhibit, shift, emotional control, self-monitor

•  Metacognition Index: initiation, working memory, planning/organization, task monitoring, and organization of materials

Measures

Self-Efficacy, Burnout, and Executive Function

Measures Total

(n=49)

ASSET (score range 0-100) 80.98(11.9) Range: 56.00-96.83

MBI (subscale scores range 0-6)

Emotional Exhaustion 2.24(1.2) Range: 0-5

Depersonalization 0.43(0.7) Range: 0-2

BRIEF-A (mean T score = 50; SD = 10) Behavior Regulation Index 48.43(10.4)

Range: 35-76

Metacognition Index 49.76(9.1) Range: 36-76

Correlations

ASSET

ASSET (Higher better)

MBI Emotional Exhaustion (Higher worse)

MBI Depersonalization (Higher worse)

MBI Personal Accomplishment (Higher better)

Pearson Correlation

1 - .099 - .107 .351*

Sig. (2-tailed) .500 .463 .013

N 49 49 49 49

BRIEF-A BRI

(Higher worse)

Pearson Correlation

- .063 .557** .312* - .267

Sig. (2-tailed) .667 .000 .029 .064

N 49 49 49 49

BRIEF-A MI

(Higher worse)

Pearson Correlation

- .361* .622** .327* - .398**

Sig. (2-tailed) .011 .000 .022 .005

N 49 49 49 49

**p<0.01, *p<0.05

Regression Analysis Results: Baseline predictors of Burnout and

Self-efficacy

Level of teacher education failed to predict levels of burnout or self-efficacy

Teaching for >10 years was associated with higher Maslach Burnout Inventory (MBI) Depersonalization scores than teaching for <5 years (p=0.015)

Part 2: Immersed in a Dynamic System

Cumulative risk New

initiatives Children with ASD

enter school all

year

Discontinuity of classroom staff

Not trained to address ASD behavior challenges

Lack of planning time- all the other paperwork

Diversity of child learning needs

Inappropriate curriculum

Teacher as classroom organizer

Child baseline

EA-ES (n=44)

Age in months, M(SD) 48.36(6.6)

Sex, % male 77.3%

Autism Severity ADOS CSS, M(SD) 8.59(1.4)

Nonverbal Cognition

MSEL-VR Standard Score, M(SD)

25.16(10.6)

October - April

Integrated targets

Language

Imitation

Joint attention

Peer engagement

Concept development

Environmental engineering

Optimize for meaning construction

NDBIs

17

Burnout

Executive Function

Self-Efficacy Coach-reported extrinsic

barriers (Survey)

Fidelity of implementation

Coach-reported barriers (Survey)

Measurement

teacher

Coach-rated Barriers Survey (Landa & Wilson, 2019)

Coach-reported barriers: Ranks of the 6 survey categories

Sorted by frequency experienced ò Sorted by intensity, when experiencedò

Students with ASD Time and resources

Educator Preparedness Educator Engagement

Time and Resources Students with ASD

Educator Team Cohesion Educator Team Cohesion

Educator Engagement Educator Preparedness

Administrative-related Decisions and Support

Administrative-related Decisions and Support

Factors supporting teacher resiliency

Flexibility, adaptability, and openness (44) Effective teaching skills (32) Commitment (25) Reflection (21) Relationships (21) Focus on learning and improvement (9)

Defining risk load Measure Subscale Cut-off #, (x%) at

risk

EA-ES

BRIEF-A Clinically elevated: Defined by manual

Behavior Regulation Index T score >65 2, (10%)

Metacognition Index T score >65 1, (5%)

MBI Critical Levels: Leiter & Maslach, 2016

High Exhaustion (Emotional Exhaustion) z= Mean + (SD*0.5) 7, (35%)

High Cynicism (Depersonalization) z= Mean + (SD * 1.25) 2, (10%)

ASSET Mean + (SD*1.25) 1, (5%)

Coach-perceived Risk Factors

Personal Barriers Mean + (SD*1.25) 2, (10%)

Environmental Barriers Mean + (SD*1.25) 3, (15%)

10 EA-ES teachers (50%) at risk on at least one of the above measures

Results

After four months of training, attaining median FOI of >88% was not predicted by baseline burnout, self-efficacy, or EF.

Part 3: Supporting teacher resiliency

Small amount of stress can tip things for teachers with lots of stressors

If we create resilience-supporting systems, move the fulcrum

•  Coach focus group •  A-priori codes established from existing

literature on teacher resiliency (e.g., Beltman, Mansfield, & Price, 2011; Mansfield, Beltman, Price & McConney, 2012)

Notion of Prevention �  Alter the environment

�  Alter the effects of risk factors (new skills and perspectives, create community of practice)

�  Strengthen protective factors (social supports, improve self-efficacy)

Workshops Social supports Resources/ideas/solutions

Coaching Proactive problem solving

Reflection

EBP Differentiated instruction

Toolkit of teaching practices

Child engagement in

instruction

Confidence Motivation

Supporting Resiliency

Resilience

Effective Teaching Skills

Flexibility and Adaptability

Commitment

Reflection

Relationships

Openness Organization

and Preparation

Focus on Learning and Improvement

Positive and Optimistic

Self-confident and has Self-

Efficacy

Ability to Problem Solve

Effective teacher

Informed administrator

Spread

Buffering risk �  Creating conditions for resiliency

�  Build systems favorable to teacher success

�  Know what you want teachers to do

�  Properly train them to do it (Vygotsky is relevant here; teacher learning is a developmental process)

�  Make it possible for them to do it and keep doing it �  IAs �  Teacher placement �  Preschool curriculum

Implications �  Resiliency-promo+ngcoaching

�  Individualize�  Concreteanda>ainablegoalssetbyteacher-coach

collabora+on�  Gradualwithdrawalofsupports(maybeheavyatfirst)

�  AdministratorsupportandunderstandingofuniquedemandsofteachingpreschoolerswithASD

�  Needtosupportteachers(notremovetheirIA’s,notmovethemaround,nurturethemintoleadershiprolestosupportotherteachersjustlearningEBP)

�  Addressingteachera>ri+on(Tait,2008)&promote“qualityreten+on”(Gu&Day,2007,p.1314)