training early childhood care providers in the principles...

Stephanie Weber, PsyD The Kelly O’Leary Center for Autism Spectrum Disorders

Division of Developmental and Behavioral Pediatrics

Leadership Education in Neurodevelopmental and related Disabilities

(LEND) Program

Cincinnati Children’s Hospital Medical Center

May 2013

Training Early Childhood Care

Providers in the Principles and

Skills of Applied Behavior

Analysis

Aims

1) Discuss rationale and development of this

community-based training

2) Outline the steps taken for implementation

3) Review evaluation of pilot program

4) Discuss future directions of program

Project Aims

To provide training for Early Childhood Care

Providers on Applied Behavior Analysis (ABA)

principles within the Early Intensive Behavioral

Intervention (EIBI) autism classroom – Basic instruction in ABA, behavior management & reduction,

and skill acquisition techniques

To evaluate the program and consider expanding it

to reach more area providers

Ohio

17.8% of children have a special health care need

compared to 15.1% nationally (483, 467)

MCHB Core Outcome #5: CSHCN who can easily

access community based services

0-5 years old

59.8% (65.9% Nationwide)

Childhealthdata.org

Development

Development

LEND program

– Learn the Signs. Act Early.

The Kelly O’Leary Center (TKOC)

– Early Intensive Behavioral Intervention (EIBI)

classroom

Implementation:

Building Community Capacity

Increase knowledge of providers in the area of

Autism Spectrum Disorders (ASDs)

Build provider skills to demonstrate competence

in delivering interventions in early childhood

settings

Facilitate greater collaboration with community

providers

University of Wisconsin Extension (2010)

Development: Program Development Model

Situation

Priorities

Needs

Providers to have more

knowledge/skills on ASDs

Assets

LEND Training program

offers leadership training

for building community

partnerships

Stakeholder engagement

Agencies seek out TKOC

for trainings

Development

LEND Goals &

MCH Competencies

Cincinnati’s autism

climate

Development

Trainees &

Staff

Time

Community

Partners

LEND

Training and

Research

INPUTS

SITUATION: Providers in childhood care centers need more in-depth training and experience

with children with special needs, especially disabilities such as autism spectrum disorders

Trainees & Staff:

LEND & Behavior

Assistants in EIBI

Time: 60 hours; 2 hours/week

Community Partnerships: Regional Autism Advisory

Council

LEND Training & Research:

Established section of LEND

Training

Proposed research project to LEND

– Refined with Directors

– Established target population

Project accepted

– Identified appropriate LEND trainees/disciplines

Recruitment initiated

– Step Up to Quality credentialing obtained

– Area childcare centers contacted

Development

Trainees &

Staff

Time

Community

Partners

Assess

LEND

Trainee

knowledge

Design

evidence-

based

program

LEND

Training and

Research

INPUTS OUTPUTS

SITUATION: Providers in childhood care centers need more in-depth training and experience

with children with special needs, especially disabilities such as autism spectrum disorders

Implementation

Semester One

– Recruited LEND Trainees

– Trained on ABA/EI approaches

– Developed curriculum

Semester Two

– Implemented curriculum with participants from area

childcare agencies through team teaching

Implementation

Activities for Trainees

Literature Search

– EI literature (play, social skills, language building)

Needs assessment

– Evaluate what materials/resources were needed

Interview of families and experts

– EIBI parents

– The Kelly O’Leary Center providers

– Director of Regional Autism Advisory Council

(RAAC)

Activities for Trainees

Developed/Refined Pre- and Post-program measures

Developed curriculum

3 Modules

Evaluated program

Activities for Trainees

Classroom Participation

Activities for Trainees

Conduct Training

– Six 2-hour sessions

Module I: Knowledge Building

Module II: Skill Building

Module III: Classroom participation

Trainees &

Staff

Time

Community

Partners

Assess

LEND

Trainee

knowledge

Design &

deliver

evidence-

based

program

LEND

Training and

Research

INPUTS OUTPUTS

Assess

community

provider

knowledge

and skills

LEND

Trainees

&

Child Care

Providers

(Ages 2-8)

SITUATION: Providers in childhood care centers need more in-depth training and experience

with children with special needs, especially disabilities such as autism spectrum disorders

Implementation

Knowledge Building

Pre-test:

32 items

Session 1:

1) Overview of ASDs

2) Overview of Reinforcement & Punishment

Implementation

Knowledge Building

Session 2:

1) Functions of Behavior

2) Speech & Occupational Therapy Interventions

Session 3:

1) Academic Interventions

2) Behavioral Interventions

Implementation

Skill Building

Positive Behavior Support Planning

Skill Acquisition programs

Discrete Trial Training

Task Analyses

Implementation

Classroom Participation

Skill Acquisition programs

Discrete Trial Training

Task Analyses

Implementation

Trainees &

Staff

Time

Community

Partners

Assess

LEND

Trainee

knowledge

Design &

deliver

evidence-

based

program

Participants

increase

knowledge of

child

development

Participants

gain

confidence

Participants

use

evidence-

based

approaches

in childcare

settings

Improved

child

behaviors

LEND

Training and

Research

INPUTS OUTPUTS OUTCOMES

Participants

gain skills for

working with

children with

ASDs

Participants

identify

appropriate

actions to

take

LEND

Trainees

&

Child Care

Providers

(Ages 2-8)

Reduced

stress &

increased

identification

LEND

Trainees gain

skills in

teaching/MCH

Competencies

SITUATION: Providers in childhood care centers need more in-depth training and experience

with children with special needs, especially disabilities such as autism spectrum disorders

Evaluation

Assess

community

provider

knowledge

and skills

Expansion of

inclusion of

children with

ASDs

Participation

5 of 6 participants completed program

Evaluation

4 of 5 attended all 6

sessions as planned;

1 participant completed a

missed session during

other clinic hours

Evaluation: Community Participants

71.8

46.8

40.6 43.7

71.8 75

62.5

75

62.5

78

0

10

20

30

40

50

60

70

80

90

100

Participant 1 Participant 2 Participant 3 Participant 4 Participant 5

Pretest

Posttest

Evaluation: LEND Trainees

50

97

63

83

100

90

0

10

20

30

40

50

60

70

80

90

100

Trainee 1 Trainee 2 Trainee 3

Pretest

Posttest

Participant remarks

One participant liked the “focus on practical

understanding and skill development.”

Another said, “In the early childhood field there is

little to none that is given to use in preparing to have

a classroom where there could be an autism

diagnosis. The information was so helpful and more

classes need to be provided for early childhood

educators.”

Evaluation

Barriers

– Badge Process

– LEND Trainee time frame

Evaluation

Autism Speaks grant submission

LEND project 2013-2014

Next Steps

Recruitment

Implementation

Evaluation

Follow Up

Future Directions

Taylor-Powell, E., Steele, S., & Douglah, M. (2010). Planning a program evaluation. Retrieved April

2013 from University of Wisconsin-Extension-Cooperative Extension, Program Development

and Evaluation Unit Web site: http://www.uwex.edu/ces/pdande/evaluation/evaldocs.html.

References