Philadelphia AIMS: Autism Instructional Methods Study

+ Extended School Year

Ayan Hussein University of Georgia

Mentored by David Mandell, ScD

Penn Medicine, Dept. of Psychiatry The Children's Hospital of Philadelphia Center for Autism Research

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Background

What is the Extended School Year Program?

What is Philly AIMS?

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Background What is Autism? A complex developmental

disorder Prevalence of Autism: ◦ 1 in 110 children ◦ growing at a rate of 10-17 percent per year ◦ boy:girl 4:1

Exhibit impairments in communication, social interaction, repetitive patterns of behavior, unusual responses to sensory experiences and resistance to change

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Aim of Philly AIMS

Implement evidence-based autism interventions

Year 1:Structured Teaching vs. Strategies for Teaching based on Autism Research (STAR) Program

Year 2: practice effects? Year 03: Sustainable?

How? Work with existing K-2 grade

autism support classrooms

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Intervention Conditions STAR 3 teaching strategies ◦ Discrete trial training ◦ Functional routines ◦ Pivotal response training

Paired with curriculum content in 6 areas ◦ Receptive language ◦ Expressive language ◦ Spontaneous language ◦ Functional routines ◦ Pre-academic skills ◦ Play & social concepts

Structured Teaching Visual instructions +

verbal directions Specific classroom

setup Task have clear

beginnings and ends, and instructions on how to transition to the next activity

Reliance on physical prompts, which are gradually removed

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Example of Structured Teaching

Visual Schedule

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CCC Lab

Recess

Bathroom

Math

Reading

Spelling

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STAR ST p Teacher Characteristics N=18 N=15 Years of autism teaching experience (%) ≤3 years 61.1 60.0 .948 >3 years 38.9 40.0 Program fidelity by end of the observation period 57% 48% Low 0.12-0.49 0.17-0.42

.003 Moderate 0.5-0.68 0.43-0.54 High 0.69-0.92 0.55-0.71 Hours of training/support (hours) Low 15-44 0-11

.001 Moderate 45-62 12-23 High 63-72 23.25-27 Student Characteristics (n = 121) N=62 N=59 Male (%) 82.3 89.8 .231 Race/Ethnicity (%) Black 70.9 35.6

.001

Hispanic 1.6 15.3 White 19.4 32.2 Other 8.1 16.9 Student age in years (mean, SD) 6.2 (.43) 6.3 (.77) .738 DAS score at Time 1 (mean, SD) ADOS algorithm severity score at Time 1 (mean, SD) 6.7 (1.11) 6.7 (.95) .454

Classroom Characteristics (n=33)

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Change in DAS verbal by group

Overview of STAR Program

Utilizes Applied Behavioral Analysis (ABA) instructional methods such as: ◦ Discrete Trials (DT) ◦ Functional Routines (FR) ◦ Pivotal Response Training (PRT)

Areas of focus include receptive language, expressive language, spontaneous language, functional routines, academic, play and social skills

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Pivotal Response Training

A naturalistic intervention that uses the child’s interests to teach skills such as language and play.

Benefits: increase language and play skills, improve academic performance and reduce disruptive behavior in children with autism

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Example of PRT Sequence Cue Response Consequence Pause

Child reaches for a toy car held by the teacher Teacher holds the car and says “car” (attempting a verbal imitation)

Child says “car” Teacher lets the child hold the car

Child plays with the car for 5-10 seconds Teacher observes level of play to prepare for next trial.

**Language Trial

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Example of PRT Sequence Cue Response Consequence Pause

Child reaches for car on the track, child wants to spin the wheels. Teacher holds the car and says “Do this.”

Child imitates the teacher’s action and pushes the car

Teacher lets child hold the car and spin the wheels as a reward for responding

Child continues to play with car, while teacher observes and prepares for next cue.

**Play trial

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PRT Throughout the Day

Example Snack

Student Reaches for the pretzels in the middle of the snack table

Teacher Blocks student access to the pretzels and waits for spontaneous response

Student Says “eat please”

Teacher Allows the child to take a pretzel

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When presenting toys…

Be mindful of the child’s level

◦ Level I: Non-verbal or bubbling

Bubbles, balloons, music producing toys, squishy balls

◦ Level II: Single words to simple phrases Include train sets, farm sets, car with garage

◦ Level III: More complex language Items from Level I & II plus building sets, dress up, kitchen

sets with pretend foods

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My Role… Lets Play!!!

And collect data

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WHAT’S NEXT FOR PHILLY AIMS?

Continue to implement peer-reviewed interventions in the Great Philadelphia Area

Search for best ways to create partnership with the Philadelphia School District

Find ways to sustain the program Aim of Year 3 of Philly AIMS

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Thank you!

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