Comprehensive ABA Programs Comprehensive ABA Programs for Preschoolers with Autismfor Preschoolers with Autism

PCDI -1970PCDI -1970 http://www.pcdi.org/ http://www.pcdi.org/

Structure and Context– Includes early intervention, preschool and school, services to

families, community=based, family style group homes, and career development and supported employment programs for adults.

– 3 dissemination sites: SHLI, IEA, NYCLI Diagnosis and Assessment

– Diagnosis of autism by DSM IV and direct observation of using PCDI’s own assessment methods. Skills or skill deficits are unrelated to program legibility.

Staffing and Administration– Bachelor’s or master’s degrees in psych or ed. Doctoral

students participate in interns– Early intervention 1:1; school program 1:1.5– All behavior analysts, no related services– Executive Directors, Director, trainer, Special ed teacher, aides– Staff training consists of preservice workshops; monthly

workshops; and hands-on training throughout employment

PCDI -1970PCDI -1970 Curriculum

– More than 600 individualized programs in community participation; expressive.receptive language, handwriting, leisure skills, motor/verbal imitation; peer interaction, physical education, reading, self care, social skills.

– Some are based on commercially available curricula: Edmark, Sensible Pencil, other are based on their own published research.

– Children rotate across all staff members in the classroom and across activity areas and rooms

– Teaching procedures: discrete trial, incidental teaching, activity schedules, script/script fading, video/audio modeling, peer interaction, small group

– 30 individualized program per year per child– All children are taught vocal language; only 1-2

students in their 30 years of operation needed an augmentative communication system

– No related services –all skills are taught by behavior analysts

– @weekly data collection on skill acquisition and generalization

PCDI - 1970PCDI - 1970 Integration

– Prerequisites for transition include: – 1. exhibiting sustained engagement with learning and

leisure materials– 2. systematically following adults instructions– 3. responding favorably to delayed reinforcement– 4. displaying generalized responses – 5. low levels of disruptive behavior– When these pre-requisites are met, children are

systematically transitioned to regular ed settings; always attending both programs at once and gradually transitioning from PCDI to the regular ed setting.

– Follow up services are offered– Community integration and peer modeling are used

with all children Use of Aversives

– Disruptive behavior is addressed through differential reinforcing more productive behavior

– Severe problems that do not respond to positive reinforcement procedures are treated with other procedures such as response cost, time out and facial screens may be used

PCDI - 1970PCDI - 1970 Family Involvement

– Weekly home visits– Goals are set for home– Parents are taught to teach children in school setting first

and then at home -Parents collect data– Parents also have monthly school visits in which they spend

the entire day at PCDI with their child

Outcome– Out of 41 children who entered the program before 60

months of age, 8 are enrolled in preschool or early intervention programs, 14 have made transitions to publish schools and 19 are enrolled at PCDI

– Most students did not achieve basal scores on PPVT– Percentage of students who make successful transitions

varies from 42%-62%.

Extensive Program Assessment– Written protocol for assessing training and staff– Notebook reviews by outside consultant – All consumers are surveyed on quality of service e.g., child

study teams, parents, staff members

The Douglas School -1989The Douglas School -1989http://dddc.rutgers.edu/http://dddc.rutgers.edu/

Structure and Context– DDDC founded 28 years ago has 4 divisions: the

original Douglass School, Douglass Outreach, the Division of Adult and Transitions Services, and the Division of Research and Training.

– Preschool has 3 classes, proper class (1:1, 25 hrs per week 10-15 at home with parent); small group preschool (2:1) small wonders class (integrated class)

Diagnosis and Assessment– Diagnosis of autism or PDD-NOS by DSM IV and CARS

Staffing and Administration– Executive director, director, division director,

Supervisor of education, coordinator of speech and language, Special ed teachers, aides, ST, OT, PT, APE, home programmers, grad students

– Yearly in-services, ongoing-hands-on training, attendance at COSAC, yearly conference

The Douglas School -1989The Douglas School -1989

Curriculum– Individualized teaching procedures– Speech-language services– Teacher made curriculum materials– Commercially made curriculum; Levine’s

Great beginning for early language training, ploudre’s CLAS preschool, Earlly’s AIMS pre-reading, Edmark Reading, PACE-Match program, Sensible Pencils, PECS, First Words, IGS curriculum by ROmanczyk

– Trial by trial data collection

The Douglas School -1989The Douglas School -1989

Integration– Careful progression of skills from basic

compliance, self control, attention to task, learning senility to others, ability to maintain oneself in a group

– transition process consists of sometimes having the child attend both programs; other they prepare the student by simulating the transition environment at school

– follow up services are offered Use of Aversives

– Rich schedules of reinforcement for productive behavior

– Functional alternate response training– For severe behavior problems, other procedures are

used such as removal of attention ,brief exclusionary, time out, overcorrection

The Douglas School -1989The Douglas School -1989 Family Involvement

– Twice a month home visits– Parents are taught to teach children at home– Parents have monthly clinics in which they can

observe their child in class for 30 minutes and then discuss the observation with team members

– Discussion groups for parents and siblings– Parent meetings four times a year

Outcome– 13 children who began teacher at 48 months 10

were in regular ed classes. These children had a mean IQ of 78at intake

– 14 started at 50 months 13 were in special ed classes

– Children who entered the program with Iqs in the normal range (80) were more likely to transition than those with lower IQ (48)

Alpine Learning Group -1989Alpine Learning Group -1989http://www.alpinelearninggroup.org/http://www.alpinelearninggroup.org/

Structure and Context– Provides services for 25039 learner4s ages 3-21.

Diagnosis and Assessment– Diagnosis of autism, Vineland, PPVT, IQ

Staffing and Administration– 3 directors, 1 head teacher, Teacher (certified),

instructor (bachelor’s)– 1:1 in preschool– No related service providers– 40 hour yearly pre-service– Research meetings are held twice a month– Comprehensive annual employee performance

evaluation is conducted with all staff –use PCDI’s evaluation protocol

Alpine Learning Group -1989Alpine Learning Group -1989

Curriculum– 600 individualized programs in the areas of attending,

community, expressive language, fine/gross motor, handwriting, imitation, leisure, pre-academic, reading, receptive language, science, self-care, socialization, social studies, work studies

– Classes of 2-4 children; learning periods are 30-45 minutes, most preschool programs are taught by all instructors

– Use some published curriculum such as Edmark, explode the code, starting comprehension, manual of exercises for expressive reasoning, Continental press mathematics, Reader Rabbit, Words and Concepts II.

– Trial by trial data collection– Monthly clinics with director of educational

programming

Alpine Learning Group -1989Alpine Learning Group -1989

Integration– Pre-requisites: receptive and expressive

language skills, minimal disruptive behavior.– Supported inclusion program after pre-requisites

have been met –gradually transition for Alpine to general education –follow up services are provided

– Peer modeling for all children Use of Aversives

– Functional assessment and alternate behaviors are taught

– Extinction, DRO, DRL, response cost

Alpine Learning Group -1989Alpine Learning Group -1989

Family Involvement– Weekly home visits during first 6 months of enrollment

–doctoral level clinical director– Twice per month thereafter by home programmer– Participation in didactic parent training course– Parents are required to teach their children at home

and collect data– Lecture series is offered to extended family members– Sibling education and support group– 3 hours of observation per month –open door policy– Mandatory monthly meetings

Outcome– 26 preschoolers -7 transitioned to public school (27%)– Average age of enrollment was 3.11 and remained for

at least 24 months

Cost $3000-$3500/month 11 sites in US (2 in Europe) Clinic-Supervised Treatment

– Student therapists (1:1 thx, high grade in college course on learning theory/BA, 25 hours training, 1-hr/week team clinic with each family)

– Senior therapist (selected based on performance, oversees 3 teams with case supervisor)

– Case supervisor (selected based on performance, 1500 hrs tx, attend weekly clinic, oversees 3-4 senior therapists)

– Project director (doctoral level, 9-month internship, attend weekly clinic, oversees 15 children)

The UCLA Young Autism ProjectThe UCLA Young Autism Projecthttp://www.lovaas.com/http://www.lovaas.com/

Parent-Directed Treatment– Parents recruit therapists and are trained via workshops

Parents are responsible for overseeing the child’s program– Consultants are case supervisors (have received 25 hrs on

providing workshops, weekly supervision from project director)

– First workshop is 3 days, 6 hours/day Models procedures and parents/staff practice Later send 15 page summary report Followup workshop every 3 months Available by phone in between workshops

The UCLA Young Autism ProjectThe UCLA Young Autism Project

40 hours/week 1:1 thx Children under 3 start with 20 hours/week First year mostly DTT

– Then more naturalistic teaching in group settings Thx usually lasts 3 years Sessions include

– Frequent opportunities for success– Individually selected reinforcement– Diverse programs– 2-5 min working on a program/1-2 min break– 10-15 min break at end of each hour– 1-2 hour break in middle of day– Treatment begins at home

Phases of Treatment– Phase 1 (2-4 weeks): Establish rapport, reinforce compliance; decrease problem behavior

maintained by escape, increase attention and motivation– Phase 2 (First Year): Direction-following, imitation, matching, play, vocal im, self-help– Phase 3 (Second Year): Communicative language, abstract concepts, interactive play– Phase 4: (Third Year): Socialization, adjustment to school & community

Outcome : approximately 50% transition to general education settings

The UCLA YAP CurriculumThe UCLA YAP Curriculum

The Comprehensive Application of Behavior Analysis to Schooling Affiliated with Teachers’ College at Columbia U, Developed by Dr. Doug Greer 25 years old Developed in over 15 schools For children with autism, other disabilities, typically developing children Programs can be accredited as “CABAS Research and Demonstrations schools” Grad students get CABAS Board Certification Oldest school, Fred S. Keller School Most schools are part of the public school district Classroom ratios vario based on gov regs and verbal behavior of learners Uses the CABAS Accelerated Independent Learner (AIL) Curricula

– Strong influence of Skinner’s analysis of verbal behavior– Picture schedules used sometimes

CABAS®CABAS®http://www.tc.columbia.edu/hbs/SpecialEd/http://www.tc.columbia.edu/hbs/SpecialEd/