Clinical Field Experience

Clinical Field Experience

Description

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(For this exercise, I completed 10 hours in a self contained high school classroom.)

Allocate 5 hours to complete the clinical field experience.

Complete two or more field experiences from the following Focused Field Experience Activity List, in an ASD classroom:

FOCUSED FIELD EXPERIENCE ACTIVITY LIST

  • Collaborate to enhance opportunities for students with ASD. (ACSI7.S1)
  • Apply strategies to resolve conflict and build consensus. (ACSI7.S2)
  • Coordinate processes that encourage collaboration needed for transition between settings. (SEDAS7.S1)
  • Provide leadership in collaborating with individuals and families around the issues of sexuality. (SEDAS7.S2)
  • Collaborate with families and other team members in non-judgmental ways to make informed decisions about interventions and life planning. (SEDAS7.S3)
  • Promote collaborative practices that respect the family’s culture, dynamics, and values and the impact the diagnosis may have on the family. (SEDAS7.S4)
  • Connect families and professionals to educational and community resources. (SEDAS7.S5)

Reflect upon your field experience choices in a 250-500-word summary.

APA format is not required, but solid academic writing is expected.

You are required to submit this assignment to LopesWrite.

Document the hours and locations that you spend in the field on your Clinical Field Experience Verification Form.

Submit the Clinical Field Experience Verification Form with the last assignment by the assignment due date. Directions for submitting can be found on the College of Education site in the Student Success Center.Chapter 4 Other Considerations for the Consultant 33L.A. Ruble et al., Collaborative Model for Promoting Competence and Success for Students with ASD, DOI 10.1007/978-1-4614-2332-4_4, © Springer Science+Business Media, LLC 2012 Overview: Effective consultation requires attention to many factors outside the immediate consultant– teacher interaction. Chapter 4 reviews infl uences on the con-sultation and coaching processes and identifi es outcomes to consider. Consultant factor and teacher factors are described, as well as parent and student factors. In this chapter, we describe the following: 1. A framework for teacher training 2. Consultant characteristics that impact consultation 3. Teacher characteristics that impact consultation 4. Parent and student considerations For decades, educational researchers have searched for answers to the question “What makes good teachers?” Some teachers are naturals. They make teaching look easy—keeping a classroom of students engaged and on task. But most teachers have to learn ways to instruct a classroom of students, adapt and modify teaching strate-gies and materials, and manage student behavior effectively. The effort to stay cur-rent and learn new teaching methods based on research is more diffi cult than ever today because teachers are responsible for all learners— those with and without dis-abilities. As more and more information becomes available, sorting through infor-mation on research-supported practices can be overwhelming. Assuring that all students learn is a daunting task and requires ongoing commitment to professional development. But as we have noted in Chap. 3 , professional development is not enough for optimal outcomes. The focus of this chapter is to describe the multiple factors that infl uence outcomes, including consultant, teacher, and student factors. We begin with a description of a theoretical model for teacher training. Chapter 4 Other Considerations for the Consultant 55 344 Other Considerations for the Consultant A Framework for Teacher Training A model that shows the various sources of infl uence on teacher training outcomes is provided in Fig. 4.1 (adapted from Sparks, 1988 ) . It is helpful to be aware of this model because consultation is a complex task, and Fig. 4.1 shows the many pieces of the puzzle that must be considered. We have selected parts of the model that we believe affect teacher and student outcomes and used these parts in our development of COMPASS (future applied research will continue to study, adapt, and refi ne the model). A brief explanation of each of the pieces is provided. In this model, out-come variables—the most important part of the framework, are referred to as prod-uct variables. Product variables can include outcomes that relate to the teacher, parent, or student. For COMPASS, we selected goal attainment scaling (GAS) as the primary student outcome. GAS is a good alternative for measuring child-specifi c educational outcomes when goals are individualized. Teacher outcomes might include the teacher’s instructional methods or style, the • teacher’s sense of self effi cacy or competence, or the quality of the student’s individual education program (IEP) plan. COMPASS is designed to improve IEP quality, which is thought to act as a mediating variable for student outcome. That is, IEP quality helped explain student outcomes because we found a positive correlation with student goal attainment scores. These variables in Fig. 4.1 serve as examples of areas that might change as a result of consultation, but other out-comes can also be targeted. Fig. 4.1 Framework for teacher training A Framework for Teacher Training Parent or caregiver outcomes might include parent and teacher alliance or the • amount of stress the parent feels. One parent told us that her stress was reduced because it was reassuring to know that a knowledgeable team was actively involved and working with her child. More research is needed on secondary effects of COMPASS on parents and caregivers. Recall that student outcomes are the primary focus of COMPASS. GAS serves as • the primary mode of curriculum-based assessment of student attainment of IEP objectives and COMPASS outcome. Chapter 8 includes information on how we measured this outcome and developed the GAS Form. Figure 4.2 shows the COMPASS mediation model that we tested (Ruble, Dalrymple, & McGrew, 2010a ) using parts described in Fig. 4.1 . A mediator is a variable that helps explain the relationship between two other variables. In our model we examined only two possible mediators—or as we call them, active ingredients—of the COMPASS intervention: (1) the quality of the student’s IEP and (2) teacher adherence to the teaching plans. IEP quality is described in more detail in Chap. 5 . Teacher adher-ence is covered in Chap. 7 . It is important to have a theoretical model to test because it helps us to carefully and systematically examine what infl uences outcomes. If we study the model pre-dictions and obtain the expected results, we can then make sure to include aspects that have been found to be important for positive student learning in our interven-tions. If we don’t fi nd the expected results, then we know what we should exclude and what factors are not necessarily important and infl uential. Of course, this assumes that we have all the relevant and important variables in the model. When comparing the model we tested in Fig. 4.2 with the original model in Fig. 4.1 , it is clear that we examined a limited set of potential variables that could infl uence out-comes. More research on those other potential factors is needed. The following section discusses the other factors in more detail. Three categories of infl uences on outcomes are proposed in the original model in Fig. 4.1 . The fi rst is presage variables , which refer to the characteristics of the con-sultant that are expected to have infl uence on outcome variables. Throughout this manual information on important consultant factors is provided (e.g., level 1 compe-tence). COMPASS was developed based on current theories of effective consultation Fig. 4.2 COMPASS mediation model tested 364 Other Considerations for the Consultantand communication between adult collaborators and learners. Chapters 6 – 8 provide specifi c steps to help ensure that a successfully collaborative partnership is estab-lished with the teacher and parent. However, other infl uences from a consultant have to be taken into account and are described further in this chapter. Additional features that infl uence consultation effectiveness come from process variables as well as context variables . The process variables are the activities we discuss in Chaps. 6 – 8 specifi cally. These variables represent the elements of the COMPASS consultation package (e.g., respectful communication, empathic listen-ing, appropriate goal setting). Context variables include teacher (e.g., autism knowl-edge), student (i.e., language ability), family (e.g., economic resources), and school characteristics (e.g., supportive special education director) that infl uence consulta-tion outcomes. As an example, preliminary fi ndings from our COMPASS consulta-tion intervention research analyzed data on some of these factors and how well they predicted student goal attainment outcomes. Although the fi ndings need to be replicated in a different sample, we found that the following context variables of the student and teacher predicted outcomes. For the student, IQ level, language ability, and autism severity were predictors of his or her outcomes. But only IQ exhibited predictive power to explain student outcomes beyond the contribution of the COMPASS consultation intervention. In other words, the consultation was able to account for and adapt to differences in language and autism severity so that outcomes remained similar. For teacher-related context variables, we found that teacher engagement pre-dicted child outcomes beyond the effects of the COMPASS intervention. For this reason, we included the Teacher Engagement Scale in the forms section in Chap. 8 . Improving the instructional engagement of teachers may be another active ingredi-ent that needs to be studied further. One other teacher context variable identifi ed as important was teacher exhaustion. Surprisingly, we found that students whose teach-ers reported more exhaustion, which is representative of burnout, made less prog-ress. More research is clearly needed to better understand the impact of burnout in teacher instruction and student outcome. Together, these variables are thought to have impact on the product or outcomes of consultation. The focus of the rest of the chapter is to provide general descriptions of issues that consultants should consider. Consultant Characteristics: External Vs. Internal Consultants Consultants can be internal or external to a school, and each has advantages and disadvantages. Internal consultants might be autism specialists who have completed additional professional development training and workshops and developed exper-tise in this particular area. Large school systems often have designated autism experts on staff. External consultants, on the other hand, might come from local, regional, state, or outof-state areas. Some state Departments of Special Education hav Consultant Characteristics: External Vs. Internal Consultantscounties. The work reported in this manual is based on COMPASS consultants who were external to the school system. External consultants are more common for schools located in rural areas. Particular issues should be considered depending on whether the role of a consultant is external or internal to the organization. Issues to consider include entry, confi dentiality, evaluation of the teacher, and willingness to participate in consultation. Entry Acceptance of the consultant is easier to achieve for internal rather than external con-sultants. An advantage of the internal consultant is that the (s)he is likely to have more information about the challenges and resources and to be better able to identify sup-ports and the feasibility of the consultation plans that the teacher may not consider. Internal consultants may be better able to meet more frequently with the teacher and obtain data more easily and on a more continuous basis. They may also have more information about the student, the parents, and the teacher that may impact outcomes. There are some disadvantages for internal consultants, however. One disadvan-tage may be a lack of role clarity. The consultant may have other responsibilities and titles that may affect the relationship with the teacher and, as a result, dampen outcomes. Teachers who are peers, for example, may be less likely to request or accept help and be more defensive and less inclined to provide data on student prog-ress if the student is having diffi culty achieving set goals. A second consideration is that internal consultants may have diffi culty making demands on administrators or may have supervisory status over the teacher. They also may be in a position to more likely consult with or involve administrators or those with supervisory responsibil-ity or other power fi gures. Another concern is that teachers may be reluctant to engage the internal consultant because of worries of how to terminate the consulta-tion and what effects that might have on ongoing relationships. Thus, it is essential that the role of the consultant be made explicit and be distin-guished from other roles played within the organization. For example, a school psychologist who normally provides therapeutic services to students may want to explain that the role of consultant is different from that of therapist, and that the goal is not for the school psychologist/consultant to take over and assume responsibility of therapy for the student. A helpful summary of the relative advantages and disadvantages for internal and external consultants is provided by Brown, Pryzwansky, and Schulte ( 2006 ) . Similar to internal consultants, outside consultants also face unique advantages and disadvantages. Disadvantages include less knowledge about the history of the issues or contextual factors and resources and more diffi culty identifying helpful linkages to address any problems that may arise. Another disadvantage is a depen-dency on information as given by the teacher, rather than from multiple sources that can 384 Other Considerations for the Consultant However, there also are several potential advantages for an external consultant. First, teachers may fi nd it easier to share information with an external consultant and may be less defensive if a child is not making progress or recommendations are not being followed. An outsider may be afforded a perception as “expert” compared to a familiar internal consultant and thus, have more infl uence. An external consul-tant may also be better positioned to test how ready a teacher is to make change and obtain resources for change because of the lack of familiarity of the consultant to the system; an external consultant brings a wider perspective that may be helpful for leveraging participation and commitment of resources for making change. Confi dentiality Establishing an effective relationship with the teacher is integral to consultation. Understanding the role of the teacher in the classroom and as part of the school is an active goal of the consultant. Also critical is the establishment of a nonhierarchi-cal relationship within which issues and concerns can be discussed openly and in a nonjudgmental fashion. Equally and extremely important is dealing with confi den-tiality— explicitly, clearly, and repeatedly. It is necessary for the teacher to know that consultation will not be discussed with others, including supervisors, principals, or any superiors. For external consultants, this will be an easier objective to meet; for internal consultants, it may be more diffi cult, especially if the consultant is part of the administrative structure. In this latter case, the consultant needs to be aware of his/her authority over the consultee and limitations that follow. Under these circumstances, there may be barriers to discussing the questions and issues with the teacher because the consultation may not viewed by the teacher as strictly confi dential or voluntary and may be used as part of teacher evaluation. Because it is not possible to establish a coordinated, nonhierarchical relationship, teachers may be more reluctant to open up and share information that will help the consultant to be more aware of the teacher’s perceptions, roles, and feelings. Thus, each issue—confi dentiality, evaluation, and willingness to participate should be discussed with the teacher. Evaluation of the Teacher Internal consultants must take great care to assure administrators that information shared during the consultation remains confi dential. Potential confl icts of interest should be anticipated and discussed up front with the teacher and with administra-tors. Internal consultants likely take on several roles in schools. A school psycholo-gist, for example, may conduct evaluation of students for special education services. They may also be responsible for assisting teachers with students with behavioral problems. Information learned during consultation may impact decision-making about referrals for evaluation. Supervisors may seek out consultants for feedback on 60 Teacher Characteristicsteacher performance. Issues related to teacher evaluation that come from internal or external consultants should be discussed up front and communicated to all for clear understanding. Willingness of Teacher to Participate Early in consultation research, it was assumed that the consultee had the power to decide whether or not to initiate consultation. Today, the picture is different. Often, it is the decision of a team, parent, or supervisor to initiate and seek consultation from a person external or internal to the system. It can be argued that an internal consultant shares in the responsibility for the student, as both the teacher and the consultant are employees of the same system. For nonvoluntary consultation, teachers may need to assess their own willingness to enter into the consultation process. The consultant needs to consider the balance in time and effort required by the teacher to be part of the process, the use of social infl uence strategies, and the transfer of ownership of the problem during the consultation process. Teachers who are better informed of the consultation process and expected outcomes will be more aware, and thus likely more committed, to the process, expectations, and outcomes. Teacher Characteristics Teachers have several activities that they must participate in that either directly or indirectly relates to student instruction. A variety of factors can infl uence the out-comes of consultation; several are discussed below. Accountability Today teachers are accountable for many student-related activities. They are accountable for how well the student responds to his/her educational program. They are expected to provide research-supported practices for all students. And they are expected to be able to provide data on how well students are achieving their educa-tional objectives. Accountability of the outcomes of instructional practices is refl ected in federal law and state standards. Because teachers have numerous respon-sibilities, it is important to acknowledge with the teacher the pressure in meeting all of these expectations. Helping the teacher to understand that the outcomes of the consultation is a shared responsibility between the consultant and the teacher is important. However, ultimately, the teacher is the primary professional responsible for the student’s educational program. A goal of consultation, then, is to communi-cate to the teacher that the outcomes of the COMPASS consultation are consistent with the teacher’s goal for the student— which is increased responsiveness of stu-de 404 Other Considerations for the Consultant Assessment Standards vary state-by-state. States have academic content standards that empha-size areas of learning and achievement. Teachers have to be knowledgeable of port-folio assessment and alternative assessment strategies. In the spring, teachers may change focus from IEP objectives to skills related to portfolio or alternate assess-ment. Often, the skills targeted in these assessments do not correspond to the objec-tives or skills targeted by the IEP. It is helpful to discuss this with the teacher and help her or him see the link between IEP objectives and state academic content standards. Thus, a consultant needs to have knowledge of state standards in order to assist the teacher in seeing the links. Individual Education Programs The Individual Education Program is the road map that puts into place the direction and course to be taken for the student. It creates the foundation from which decisions regarding assessment, teaching plans, and accommodations and modifi cations occur. Given the high importance placed on IEPs, we were surprised to fi nd little guidance on working with teachers on IEPs as part of consultation. We did fi nd, much to our regret, that IEP quality was generally poor across states, districts, schools, and teach-ers (Ruble, McGrew, Dalrymple, & Jung, 2010b ) . This is important because we also found that the quality of the IEP was associated with how well the children responded to their educational program. Thus, it is important for consultants to review with teachers the quality of the IEP (how measurable are the objectives; how clear are the descriptions of present levels of performance; how clear are the environmental sup-ports?). Chapter 5 covers IEPs in more detail, includes a checklist to consider when reviewing IEPs with teachers, and provides a more comprehensive discussion of this issue, as IEP quality is associated with student outcomes. Time Time has been acknowledged as a critical factor in school-based services and a major issue infl uencing consultation outcomes. Acceptability research suggests that logisti-cal issues such as time and administrative support infl uence teacher’s perceptions (Sheridan & Steck, 1995 ) and that administrators need information on the importance of parent–teacher collaboration. The COMPASS consultation and teacher coaching package takes into account the need to be sensitive to teacher time. Direct interactions require about 3 h for the initial COMPASS consultation and 4–6 h for followup ses-sions that last about 1–1.5 h each, totaling a maximum of 9 h throughout the year. Data from our study suggest that the intervention does not negatively interfere with teacher time or cause stress. Some teachers still may be concerned about the amount of time re Teacher Characteristicsother forms. Thus, it is necessary to plan the consultation and coaching sessions taking into account teacher time constraints and fi t within the schedule and the student’s routines. Because we have conducted experimental research on the COMPASS consultation package, we have distilled the necessary elements of paperwork to maximize teacher involvement to the critical aspects of the intervention and minimize teacher involvement in those areas not related to outcome. Role As Classroom Manager In our research, something that became apparent from observing several classrooms was the teacher role in the classroom. Some classrooms have an equal number of adults to students, while other classrooms may have two adults and 20 students. Classrooms vary as much as the differences in students with autism. But some of the common elements observed are teaching assistants and therapists who may work with a student within the classroom or stay with a student throughout the day. As consul-tant, it is important to explore with the teacher his/her perception of his/her role in the classroom and how this perception may infl uence effectiveness. Teachers who are new to the profession may be intimidated by teaching assistants who are older than themselves or who have worked in classrooms for many years. The teacher’s role should be one of manager—someone who teaches students and also oversees the teaching assistants and ensures that student IEP objectives are clearly communicated to all who work with the students and are being monitored systematically and continu-ally. It is the teacher, after all, who is legally responsible for the IEP. Teacher As Consultant/Collaborator Special education teachers may be expected to be able to monitor IEP objectives in all school environments, including general education classrooms and other special areas. In addition, special education teachers are also expected to be able to collaborate with their peers, other classroom teachers, and therapists as well as transfer their own skill and knowledge to classroom teaching assistants. The ability to work well with general education teachers, classroom assistants, and special area teachers provides additional skills not necessarily associated with the ability to work directly with the student. Nevertheless, it is important to take into consideration the skills necessary to work with others because students with autism attend all types of classrooms, often have teaching assistants, and must have teaching plans that include plans for generalization as part of their IEP objectives. Generalization plans often include teaching the student to perform the skill in different environments, with different people, and with different cues. Nevertheless, on an individual level, we found that some teachers had diffi culty implementing the teaching plans in classrooms outside of their own. It was unclear if this diffi culty related to acceptability, skills, time, or other issues. For students with au 424 Other Considerations for the Consultantspecial education teacher implementing teaching plans when involvement or collabo-ration with another teacher was necessary. Thus, it is important for the consultant to discuss with the teacher specifi c strategies to engage other teachers, therapists, and assistants as early in the planning process as possible. The consultant may also need to work with the teacher to convey the priority of individualization of the IEP goals within the total school environment. School prin-cipals vary tremendously in their understanding of the education of special needs students. The teacher often becomes an advocate for the student in obtaining accom-modations in the halls, cafeteria, bus area, or playground. Some schools have strict school-wide disciplinary or behavioral rules that apply to each and every student. One school we examined required students to get “cards” for various infractions that led to a consequence of losing minutes at recess the following day. For a young student with autism, just receiving a card caused so much anxiety that the rest of the day was a loss. The consultant and the teacher worked out an individualized plan that would still help the student learn acceptable behavior but was based on positive behavior supports that were not counterproductive to his learning. Parent and Student Considerations Another role of the consultant is to assist teachers with understanding the different roles that parents and teachers hold regarding the student with autism. Teachers have knowl-edge of and responsibility for many students, often focus on student defi cits or skills to be learned, have limited one-on-one contact with the student, are motivated to use research-supported practices, and have chosen to work with students with disabilities. Parents, on the other hand, have different perspectives and experiences. They are experts on their own child and hold a more comprehensive view of the whole child. They are responsible for the child 24 h each day for their lifetime. Living harmoni-ously with the child and family is a key motivator. Research suggests that parents of students with autism experience more stress compared to parents of students with other developmental disabilities. Unlike teachers who have chosen to work with students with disabilities, parents did not choose to have a child with ASD. Although the roles are different for teachers and parents, both are equally valid. Parents, as part of COMPASS consultation, play a key part in helping school person-nel understand the student’s history, how certain behaviors may have developed, how family members respond, what is important and relevant for the family, and what supports are available to the family. Perhaps the most important role of the parent is that the parent speaks for, and often in the place of the student, who may be voiceless, literally. The student’s perspective is presumably represented by everyone, but if the student is not involved or not able to be involved, this responsibility falls most heav-ily on the parents. The consultant and teacher share goals of empowering parents and caregivers because they are the lifelong advocates for the student. Teachers who work well and communicate clearly with all parents demonstrate awareness, knowl-ed Parent and Student Considerationsfacilitates positive and satisfying partnerships. It also assists with generalization of student skills across environments and more consistent teaching approaches. Student Characteristics Much research has been completed on the characteristics of children with autism and how these characteristics relate to treatment outcomes. Intelligence, language, social abilities, and autism severity have been found to be associated with how well chil-dren respond to early intervention. Our preliminary research suggests that most stu-dent characteristics did not predict educational outcomes above and beyond the impact of the COMPASS intervention. This makes sense because COMPASS inter-ventions are designed to be personalized to the student. The identifi cation of teaching objectives and teaching strategies takes into account the student’s present levels of performance, personal and environmental strengths and challenges, and parent and teacher concerns. We did fi nd, however, that IQ predicted student outcomes and that more work needs to be done in implementing effective intervention strategies. As students with autism are diverse, so are families. Particular attention to differ-ences between the experiences and values of the consultant and those that may be a result of culture, ethnicity, race, economic and educational background differences in families must be given. In summary, the ability to provide effective consultation and coaching is diffi cult. Multiple factors affect consultation. Some of the infl uences are under the con-trol of the consultant, but many are not. It is the job of the consultant to be aware of all the various factors and use this knowledge continuously in evaluating progress toward outcomes. Questions to consider prior to beginning a consultation and coach-ing relationship with a teacher are provided in Table 4.1 . Without clear outcomes at the start, it will be nearly impossible to monitor all the factors. But with authentic, open communication between the teacher and consultant combined with clearly stated goals that are observable and measurable, signifi cant progress can result on behalf of the student. Table 4.1 Questions to consider prior to consultation • What are consultation and coaching outcomes trying to achieve for the teacher, the student, and others? • How will you measure progress toward the outcome(s)? • How will you plan to monitor progress with the teacher using the measurement system? • Are you an external or internal consultant, and have you thought about the implications? • If you are internal, how will you • Address role clarity with the teacher and with administrators? • Discuss expectations of consultation and how it will terminate? • Discuss issues of confi dentiality with the teacher? • How will you assure the teacher that you are not evaluating her/him or sharing information with superiors? • Overview: This chapter provides more details that assist with the activities that are described in Chaps. 7 and 8 . The consultant facilitates the consultation by guiding the participants in using all the available information about the student to select objectives in communication, social, and work skills. Objectives must be well writ-ten using suggestions provided in this chapter. In this chapter we describe the following: 1. Best practices in educating students with autism using the National Research Council (NRC) recommendations and the Individuals with Disabilities Education Act mandates 2. How to write good IEP objectives 3. How to apply the concepts of maintenance and generalization of skills and include activities that address these concepts in a teaching plan 4. How to use an IEP checklist 5. Various ways to use the IEP checklist According to the Individuals with Disabilities Education Act (IDEA), autism is defi ned as a developmental disability that signifi cantly affects verbal and nonverbal communication and social interaction, is generally evident before age 3, and adversely affects a student’s educational performance. Other characteristics associ-ated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences (American Psychiatric Association, 2004 ) . Although students with autism share the label, they vary from one another according to intellectual ability (Chakrabarti & Fombonne, 2005 ; Jonsdottir et al., 2007 ) , communication and social interaction skills (Castelloe & Dawson, 1993 ; O’Brien, 1996; Prizant & Wetherby, 2005; Wing & Gould, 1979 ) , and other devel-opmental domains (Beglinger & Smith, 2001 ) such as fi ne and gross motor skills, academic skills, and sensory processing abilities. Further, the characteristics of autism tend to change with age (Lord & Risi, 1998 ) . Children, who were nonverbal at age 4, for example, may be verbal at age 10, but still not be able to engage in Chapter 5 Writing Effective Individual Education P Chapter 9 COMPASS Case Studies L.A. Ruble et al., Collaborative Model for Promoting Competence and Success for Students with ASD, DOI 10.1007/978-1-4614-2332-4_9, © Springer Science+Business Media, LLC 2012 Overview: Chap. 9 provides case study examples of the COMPASS consultation and coaching procedural steps for three children with autism spectrum disorder who vary by age, cognitive functioning level, verbal skill, and primary classroom placement. In this chapter, we: 1. Provide a detailed case study using Steps A and B of the COMPASS Consultation Action Plan (Fig. 9.1 ) and the COMPASS Coaching Protocol for a preschool child who is nonverbal and has behavioral issues. 2. Present two abridged case studies; fi rst, a second grader who is minimally verbal and who splits his time equally between the special education classroom and general education classroom, and second, a third grader who has ageappropriate language skills and is in the general education classroom for most of the day. This chapter provides COMPASS consultation and coaching case studies for three students who vary in cognitive and language abilities. Although all share social and communication impairments, they also have unique strengths and chal-lenges that must be taken into account in their personalized teaching plans. The fi rst case study, which follows a 5-yearold named Anthony, is an extended example of a complete COMPASS Consultation Action Plan and the four coaching sessions that followed. We provide the completed COMPASS Challenges and Supports Form for Caregivers and Teachers for Anthony, as well as the completed Goal Attainment Scale (GAS) Form and teaching objectives. The second case study, of Ethan, is an abridged example. The joint summary form is not included, but the GAS Form and teaching objectives are. The third case study, of Gary, is also abridged. In this third example, we provide suggested actions for the reader to consider. We encourage the reader to consider what teaching strate-gies he or she would employ before reading what the consultant did. It should become clear from these case examples that although the systematic approach outlined in this manual was followed, the consultant also allowed for Chapter 9 COMPASS Case Studies 207 1869 COMPASS Case Studies fl exibility, teacher-directed problem solving, and creativity. Even though no two teaching plans were identical in these case studies, evidence-based practices were applied within the context of the COMPASS framework. Case Study 1: Anthony Background Information At the time of his COMPASS consultation, Anthony was a 5-year-old African American boy who was diagnosed with autism at age 2 by autism specialists located in a university-based tertiary diagnostic center. He attended an inclusive public school preschool program in an urban area of a midwestern state and received approximately 12 h a week of special education services under the educational eli-gibility of autism. Anthony’s parents were recently separated. Anthony resided with his biological mother, 2-year-old sister, and infant brother in the home of the maternal grandpar-ents. His father was a cook in a restaurant, and his mother was unemployed outside the home. Anthony’s preschool special education teacher, Ms. Caudill, was a Caucasian female who had taught for 12 years. She had been in her current position for 5 years. She was certifi ed to teach mild and moderate special education K-12. Although she had no formal or supervised coursework in autism, she had attended several professional conferences in autism such as a TEACCH training, a Picture Exchange Communication workshop, training on applied behavior analysis, social stories training, video modeling training, and numerous national conferences in early childhood education. She had also accessed informal training from various sources such as books, a behavioral consultant, and the Internet. At the time, she had both assessment and teaching experiences with a total of nine children with autism. She used visual schedules, structured work tasks, communication boards, sensory modulation strategies, and social stories for students with autism. She also used discrete trial training, structured teaching methods, and playbased/incidental teaching methods throughout the day. Discrete trial was conducted one-on-one across several sessions, and play-based methods were used in short sessions. Ms. Caudill reported that her strengths in working with students with autism included the ability to adhere to a program or plan, the use of a variety of ideas that drew from her wide repertoire of skills and experience with children who have a variety of disabilities, and her ability to analyze student behavior and data. Ms. Caudill reported that it was a challenge to fi nd time to schedule collaborative meetings for developing and implementing programs for her students with autism. Email was used for most information sharing. For parent communication, she used three methods: discussion during Anthony’s drop-off time on a daily basis, home notes on a weekly basis or an occasional note or call from Anthony’s mother, and discuss Case Study 1: Anthony Ms. Caudill reported that the most challenging aspects of working with a student with autism were “having cohesion across a team” and “providing consistency across team members.” She felt that other school personnel needed to learn more about the importance of consistency for students with autism and how to interpret behavior as communication. In summary, she indicated that she would like more training in team building and developing work tasks for cognitive skill development for students with autism who had limited verbal skills. Each step of the COMPASS Consultation Action Plan is described below. Also, Table 9.1 illustrates the entire process for the action plan. Step A. Activities Prior to a COMPASS Consultation Step A. 1. Gather Information about the Student Using COMPASS Challenges and Supports Form for Caregivers and Teachers Anthony’s mother and teacher completed the COMPASS Challenges and Supports Form for Caregivers and Teachers. In addition to these forms, other assessment information was gathered using standardized and criterion-based tools. Information from Direct Evaluation Anthony completed standardized cognitive and language assessment conducted by the consultant in the classroom. Observational data also were collected on Anthony’s learning and work behavior skills. His teacher thought that Anthony would be bet-ter able to complete tasks in a familiar environment. Despite this assumption, Anthony had diffi culty throughout the assessment. He required physical prompting, verbal cuing, and environmental arrangement (i.e., placing his table in the corner away from distractions) to complete tasks. He tried repeatedly to escape from the Table 9.1 COMPASS consultation action plan for students with autism Step A—Activities prior to a COMPASS consultation (covered in Chap. 6 ) 1. Gather information about the student from consultant observations and from the caregiver and teacher reports using the COMPASS Challenges and Supports Form for Caregivers and Teachers 2. Complete COMPASS Challenges and Supports Joint Summary Form Step B—Activities during a COMPASS consultation (covered in Chap. 7 ) 1. Discuss COMPASS Consultation Training Packet 2. Discuss COMPASS Consultation Joint Summary 3. Identify and come to consensus on three prioritized objectives and write measurable objectives 4. Develop COMPASS teac 1889 COMPASS Case Studieschair and vocalized sounds (grunts) of refusal. He often pushed items away. His teacher remained close and assisted with reminders and verbal cues to Anthony. Eventually, work-reward routines were established and his engagement in tasks improved. Test results revealed a standardized score (SS) of 50 for General Conceptual Ability (i.e., cognitive functioning) using the Differential Abilities Scale; and a SS of 68 for Listening Comprehension and 53 for Oral Expression using the Oral and Written Language Scales. Adaptive behavior reported by his teacher indicated a SS of 52 for Communication, 40 for Daily Living Skills, 56 for Socialization, and 62 for Motor Skills based on the Vineland-II. In summary, all of Anthony’s test scores fell within the signifi cantly below average range (more than two standard deviations below the mean) based on standardized test results. These fi ndings indicate that in addition to autism, Anthony also has comorbid intellectual disability. Two autism-specifi c instruments were also used to obtain additional information on social and communication skill development specifi c to autism. The Childhood Autism Rating Scale (CARS) was used to gather information on the severity of autism. The Autism Diagnostic Observation Schedule (ADOS) was also used to gather information on Anthony’s communication, social, and play skills. The CARS indicated a score of 38, suggesting moderate-to-severe autism. The ADOS scale for communication indicated a lack of vocalizations directed to others and use of gestures. He did use a sign for “more,” but he did not look toward the person. For social interaction, he did not make eye contact with others or direct facial expressions toward others. He also did not show items to share enjoyment in interactions or initiate any joint attention with the examiner. He did follow the examiner’s pointing gesture toward a toy and tried to imitate by pointing as well. For play skills, he played functionally with cause and effect toys and pretended to give a doll a drink from a cup. Stereotyped behaviors were also observed as he showed hand and fi nger mannerisms. It was diffi cult to obtain his interest to attend to objects and he became distressed if preferred objects were removed. Criterion-based assessment was used to obtain descriptions of Anthony’s learn-ing skills. The Learning Skills Checklist (item 8 available in the COMPASS Challenges and Supports Form for Caregivers and Teachers of Chap. 6 ) indicated that the following skills were emerging (he could do with some cues/prompts, but not independently) for Anthony: (a) ability to understand the concept of “fi nished;” (b) recognize and indicate a need for help; (c) indicate to another that he is fi nished; (d) understand “rewards” as a consequence of work; (e) understand the concept of “wait;” (f) refocus attention in face of distractions; (f) initiate work and play activi-ties; (g) perform tasks involving multiple materials; (h) use trial and error; and (i) use selfcorrection. The only skill he failed to demonstrate was the ability to work independently for short periods. Observation of Anthony’s engagementrelated behaviors as he was being instructed by his teacher was completed using the Autism Engagement Rating Scale in Chap. 8 . Engagement with his teacher was quite discrepant compared to his behaviors with the evaluator. 189Case Study 1: Anthonyfrequently cooperative and attentive to the activities. He functionally used some, but not all, tools or objects. He required some prompts (verbal, gestural, and physical) to complete tasks throughout the activity. For the most part, there was consistency between the teacher’s goals and Anthony’s goals during the instruction. In other words, both were focused on the same activity, and Anthony was not attending to another object or activity in the classroom. Step A. 2. Complete COMPASS Challenges and Supports Joint Summary Form The COMPASS Challenges and Supports Form for Caregivers and Teachers was completed by his parents and teacher separately. They were collected and summa-rized into a single document using the COMPASS Challenges and Supports Joint Summary Form prior to the COMPASS consultation, which is replicated later in this chapter. Anthony’s mother had not completed all the forms prior to the consul-tation, thus information was collected as the consultation ensued. This is not typi-cal, but does happen on occasion and the consultant needs to be able to respond fl exibly when unanticipated issues arise. The information provided and also col-lected during the consultation was reviewed during Step B of COMPASS consultation. Step B: Activities During a COMPASS Consultation Step B. 1. Discuss COMPASS Consultation Training Packet A. Introductions and Sign In At the consultation were Anthony’s teacher, a teaching assistant, his mother, and the consultant. Introductions were made and the purpose and outcomes of the COMPASS consultation were described. Each member received two packets used during the consult. The fi rst packet, the COMPASS Consultation Training Packet, provided information on the overview of the COMPASS model, explana-tion of best practices, expected outcomes from the consultation, and forms to create the COMPASS balance between challenges and supports and a teaching plan. The second packet was the summarized information (COMPASS Challenges and Supports Joint Summary Form) collected from both Anthony’s teacher and parents. B. Explanation of COMPASS The instructions for completing Step B of COMPASS Consultation Action Plan provided in Chap. 7 were followed. The Abridged Protocol for Step B of the COMPASS Consultation Action Plan and scripts provided in the forms section were copied and used as a guide by the consultant during the consultation. 211 1909 COMPASS Case Studies C. Explanation of Purpose/Outcomes of COMPASS Consultation After the COMPASS model was explained, the next steps of covering the spe-cifi c purpose of the consultation and expected outcomes were provided using the scripts. D. Overview of Best Practices An explanation of best practices was presented next. Little interaction between the consultant and participants took place up to this point. Most of the informa-tion was shared one-way and was intended to set up the next discussion activity. The consultant did check in with the participants and ask if they had any ques-tions as information was presented. Step B. 2. Discuss COMPASS Challenges and Supports Joint Summary Form Next, the COMPASS Challenges and Supports Joint Summary Form was provided to each participant (see page 192). The consultant made notes on comments pro-vided by Anthony’s mom and teacher as the information was reviewed. The discus-sion clarifi ed areas of concern, brought out strengths, and generally contributed to everyone’s better understanding of how Anthony engaged at home, school, and in the community. The discussion began with a review of Anthony’s strengths and interests. The consultant used this information to remind the participants that Anthony has several personal protective factors and supports that can be used to reinforce and motivate him. Overall, he enjoys music and singing. He seeks tactile input such as hugs, deep touches, and rough play. He enjoys rocking, swinging, and running. His mother reported that he can be “obsessive” with small animals, and this interest can interfere with activities at home, however. His mother also reported that he has rela-tive strengths in responding to and engaging in joint attention with adults. Another signifi cant strength for Anthony is the ability to identify pictures. He uses pictures to understand work routines and the daily schedule. In review of Anthony’s personal challenges, many issues were noted with per-sonal management and adaptive behavior skills. Areas marked with a “3” or “4” denoted signifi cant challenges. Several behaviors were marked as concerns by his mother and teacher within the areas of adaptive skills. Fears and frustrations were noted and included going to new places as well as being told “no” for a desired request. His teacher also noted that being asked to complete a new task he did not understand frustrated him. Most notable during the consultation was the report from his teacher and parent on the frequency, severity, and intensity of problem behavior. His teacher reported that he aggressed toward others more than 12 times daily on average. Hitting occurred, but not as much as pinching. The problem behaviors were so severe that his teachers and teaching assistants were concerned about the safety of the other students in the classroom and therefore felt that an adult needed to be by him at all times. The consultant made notes about this information and refrained from offering suggestions because the aim of Case Study 1: Anthonyinformation, not problem solving. Problem solving takes place following the identifi cation of prioritized teaching objectives. The consultant did make notes to come back to this issue. Also, the consultant mentally noted that as a consequence of the problem behaviors, Anthony’s development of pivotal skills was hindered. He had reduced opportunities to be independent and to learn how to interact with other children in the classroom. A review of the teacher- and parent-reported social skills indicated that Anthony had weaknesses in most areas of imitating, turn-taking, joint attention, and playing. Most social interactions involving children were weak. Due to behavioral concerns, his teacher and teaching assistants were concerned about him interacting and being in close proximity to his classroom peers. The consultant made notes on these con-cerns so that social skills, as replacement skills for aggression, would be discussed and included as a priority in the teaching plan. A review of Anthony’s communication means and functions indicated that he used physical means to communicate all messages. He was essentially nonverbal, and instead took adults to the objects and activities he desired. To express refusals, confusion, and feelings of anger, he yelled, hit, and scratched and occasionally shook his head “no.” He used a picture to communicate when he was fi nished. The consultant helped the participants understand the connection between his problem behaviors and lack of communication skills. The consultant made notes to ensure that communication skills related to requests and refusals would be addressed as a priority. Anthony’s responses to sensory input in his environment revealed areas of agree-ment, but also differences between school and home report, which is to be expected. He had particular issues with auditory, tactile, taste, and vestibular input. He feared some noises and was distracted by others. He had many tactile sensitivities reported by his teacher that included mouthing objects. Eating was a major issue. He had limited food preferences such as chicken nuggets, pretzels, chips, and sausage. He did eat bananas and apples. Anthony’s learning skills were discussed. His teacher reported that he did not start or complete any tasks independently. Often when presented with an undesired task, he aggressed. His teacher created a choice board from which he could choose what work activities he would complete. The consultant reminded the participants that if Anthony did have the ability to start and complete undesired tasks, then prob-lem behaviors would decrease. The consultant made notes to ensure that learning skills be discussed as a priority skills. At the conclusion of reviewing the joint summary information, the consultant reviewed the concerns listed at the start of the consultation and considered them against the information just reviewed. Anthony’s mother and teacher both reported concerns with peer interactions and aggression. Anthony’s teacher also reported issues with developing adaptive and independent skills. All concerns reported by Anthony’s teacher and mother confi rmed the issues brought out using the joint summary form and noted by the consultant. The next section provides the discussion on how consensus was achieved 1929 COMPASS Case Studies Case Study 1: Anthony COMPASS Challenges and Supports Joint Summary Form 1. Student’s Likes, Strengths, Frustrations and Fears Likes/Preferences/Interests: Teacher: Caregiver: Activities: • Music • Music and singing • Art activities • Singing familiar songs Objects/Toys: • Farm animals/animals • Animals (obsessed with them) • Will look at a book briefl y if • about animals Strengths or abilities Teacher: Caregiver: • Lovable, shows affection • Memory! He never forgets some things • Learns new tasks quickly • Good eye contact to familiar adults • Watches—really observant • Receptive vocabulary is a relative strength • Good gross motor skills Frustrations Teacher: Caregiver: • Anthony has diffi culty communicating why he is frustrated • He gets very angry when he is denied a want, is not allowed to change his schedule or have an item, or does not understand a task Fears Teacher: Caregiver: • Not sure on this one • New situations either excite him or make him anxious • Sometimes loud noises upset him Case Study 1: Anthony 2. Adaptive Skills These skills were marked as very diffi cult. Personal Management Teacher Caregiver Performing basic self care independently (such as toileting, dressing, eating, using utensils) X X Entertaining self in free time Changing activities—transitioning X X. Varies daily Sleeping Comments: Anthony used to be transported in a wagon due to running off. He does not go anywhere without holding hands. Any change causes him to be upset. Tool use is a problem and most things go in his mouth. Responding to others Teacher Caregiver Following 1 or 2 step direction X X Accepting “no” X X Answering questions X X Accepting help Accepting correction X X Being quiet when required X Comments: He can respond to simple directions. Understanding group behaviors Teacher Caregiver Coming when called to group X Staying within certain places—lines, circles, chairs, desks X X Participating with the group X Talking one at a time Picking up, cleaning up, straightening up, putting away Comments: When he initiates to come to group, he does not tantrum. Staying in certain places is improving. At Walmart or Kroger, he has to be in shopping cart for fear of running off. He may tremble if at a new place due to fear. Understanding community expectations Teacher Caregiver Understanding who is a stranger X X Going to places in the community (place of worship, stores, restaurants, malls, homes) X X Doesn’t go Understanding safety (such as streets, seatbelts) X X Managing transportation (Cars/buses) X X. Doesn’t go Comments: His mom reports that these 1949 COMPASS Case Studies 3. Problem Behaviors* These behaviors were marked as problematic. Teacher Caregiver 1. Acting impulsively, without thinking X X 2. Hitting or hurting others X X 3. Damaging or breaking things that belong to others X X 4. Screaming or yelling X X 5. Having sudden mood changes X X 6. Having temper tantrums X X 7. Having a low frustration tolerance; becoming easily angered or upset X X 8. Crying easily 9. Being overly quiet, shy, or withdrawn 10. Acting sulky or sad 11. Being underactive or lacking in energy 12. Engaging in behaviors that may be distasteful to others, such as nose-picking or spitting 13. Touching him/herself inappropriately 14. Engaging in compulsive behaviors; repeating certain acts over and over 15. Hitting or hurting him/herself 16. Becoming overly upset when others touch or move his/her belongings 17. Laughing/giggling at inappropriate times (e.g., when others are hurt or upset) 18. Ignoring or walking away from others during interactions or play 19. Touching others inappropriately 20. Engaging in unusual mannerisms such as hand-fl apping or spinning X X 21. Having to play or do things in the same exact way each time 22. Having diffi culty calming him/herself down when upset or excited X X 23. Other: _______________________________________ *Items are based on the Triad Social Ski Case Study 1: Anthony 4. Social Skills (S = strength; W = weakness) How well does the child : With adults With children Teacher Caregiver Teacher Caregiver Social awareness 1. Look toward a person who is talking to him/her S W S W 2. Accept others being close to him/her S S S W 3. Watch people for extended periods of time W W W S 4. Respond to another person’s approach by smiling or vocalizing S S S W 5. Initiate interactions for social reasons W W W W Joint attention skills 6. Look at something another person points to S S W W 7. Show something to a person and look for person’s reaction W W W W 8. Point at an object or event to direct another person’s attention to share enjoyment S S W W 9. Share smile by looking back and forth between object and person W W W W Imitation 10. Imitate sounds another person makes S W S W 11. Imitate what another person does with an object (e.g., person makes toy airplane fl y, child repeats action) S S S W 12. Imitate body movements of others (such as, clap when others clap, play Simon Says) S S S W 13. Imitate and expand upon other’s actions with toys (e.g., peer beats drum, child beats drum and also starts to march) S NR W W Play 14. Take turns within familiar routines (e.g., rolls a ball back and forth) W W W W 15. Share toys W W W W 16. Play interactively around a common theme W W W W 17. Repair breakdowns during interactions (such as, child repeats or changes own behavior when other person seems confused or ignores) S W S W 18. Pretends to do something or be something (such as, that a plate is a hat by putting it on, to be a policeman, to have a tea party, that a doll is a teacher) 1969 COMPASS Case Studies 5. Communication Skills The following are descriptions of words or actions your child/student uses to communicate: Making requests Teacher Caregiver 1. Food Takes you by the hand; gets it himself Mom agreed with teacher for most messages 2. Objects Takes adult to area where object is Often just gets it 3. An activity Takes adult to where activity occurs May just do it, like go outside to play 4. To use the toilet Does not indicate or show awareness of Does not do 5. Attention Not sure; he seldom appears to want attention May climb in my lap 6. Help Uses a picture; needs to be prompted Whines 7. To play Takes object Does by himself 8. Information Does not request information Does not do 9. A choice Does not do Does not do Expressing refusals Teacher Caregiver 1. “Go away” Yells, hits, scratches Yells, hits, scratches 2. “No, I won’t do it” or “I don’t want it” Yells, hits, scratches, occasionally signs “NO” Yells, hits, scratches, occasionally signs “NO” 3. “I want to be fi nished” or “I want to stop doing this” Same as question 1, is beginning to touch fi nished picture Does not do Expressing thoughts Teacher Caregiver 1. Greeting to others Does not do May look 2. Comments about people/environment Does not do Does not do 3. Confusion or “I don’t know” Yells, hits, bites, scratches if confused Yells, hits, bites, scratches if confused 4. Comments about errors or things wrong Does not do Does not do 5. Asks about past/future event Does not do Does not do 6. Agreement Takes object Takes object Expressing feelings Teacher Caregiver 1. Angry/mad/frustrated Yells, slaps hits, bites Yells, slaps hits, bites 2. Pain, illness, or hurt Yells, slaps hits, bites Have to guess 3. Happy/excited Smiles Will laugh and jump 4. Hurt feelings/upset Yells, hits, slaps Yells, hits, slaps 5. Afraid Same as question 4; cries, cowers Trembles 6. Sad Same as question 4; does cry but as part of a tantrum Cries Comments: Pinching is reduced this year and he is scratching instead. He may also throw himself on the ground. Case Study 1: Anthony 6. Sensory Challenges These items were identifi ed as being applicable to your child/student: Sound/Auditory Teacher Caregiver Has been diagnosed with hearing problem at some time Reacts to unexpected sounds Fears some noises Distracted by certain sounds Confused about direction of sounds Makes self-induced noises Fails to listen or pay attention to what is said to him/her Talks a great deal Own talking interferes with listening Overly sensitive to some sounds Seeks out certain noises or sounds Other:_____________________________________ _____________ □ □ ⌧ □ □ ⌧ □ □ □ □ □ □ □ ⌧ ⌧ □ □ □ □ □ □ □ □ □ Taste Teacher Caregiver Has an eating problem Dislikes certain foods and textures Will only eat a small variety of foods Tastes/eats nonedibles Explores environment by tasting Puts most things in his/her mouth Constant chewing on something Other: can’t have milk; lactose intolerant; does not eat sugars; eats chicken nuggets; grain cereal; sausage; pretzels; chips; banana/apple; drinks apple juice and water. ⌧ ⌧ ⌧ ⌧ ⌧ ⌧ □ ⌧ ⌧ ⌧ ⌧ ⌧ ⌧ ⌧ □ ⌧ Sight/Vision Teacher Caregiver Has trouble discriminating shapes, colors Is sensitive to light—squints, wants to wear hats or sunglasses Has trouble following with eyes Does not make much eye contact Is distracted by some or too much visual stimuli Becomes excited when confronted with a variety of visual stimuli Dislikes having eyes covered Excited by vistas and open spaces Hesitates going up or down stairs, curbs, or climbing equipment Upset by things looking different (spills, spots) Makes decisions about food, clothing, objects by sight Closely examines objects or hands Wants environment in certain order Other:___________________________ 1989 COMPASS Case Studies(continued) Touch/Tactile Teacher Caregiver Has to know someone is going to touch ahead of time Dislikes being held or cuddled Seems irritated when touched or bumped by peers Explores environment by touching objects Dislikes the feel of certain clothing Refuses to touch certain things Over or under dresses for the temperature or is unaware of temperature Doesn’t like showers or rain on self Mouths objects or clothing Refuses to walk on certain surfaces Dislikes having hair, face, or mouth touched Upset by sticky, gooey hands Touches items with feet before hands Doesn’t like to hold hands Pinches, bites, or hurts himself Other:_____________________________________ _____________ □ □ □ ⌧ □ ⌧ □ □ ⌧ □ □ □ □ □ ⌧ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ Smell/Olfactory Teacher Caregiver Sensitive to smells Smells objects, food, people, toys more than usual Explores environment by smelling Reacts defensively to some smells Ignores strong odors Seeks out certain odors Other:_____________________________________ _____________ □ □ □ □ □ □ □ □ □ □ □ □ □ □ Movement/Vestibular Teacher Caregiver Seems fearful in space (teeter-totter, climbing) Arches back when held or moved Spins or whirls self around Moves parts of body a great deal Walks on toes Appears clumsy, bumping into things and falling down Avoids balance activities Doesn’t like to be around people in motion Bumps into things and/or people Other:_poor balance___________________________________ ______________ □ ⌧ ⌧ □ ⌧ □ □ □ □ ⌧ □ ⌧ ⌧ □ ⌧ □ □ □ □ □ Visual/Perceptual motor Teacher Caregiver Has trouble with paper/pencil activities Has diffi culty with time perception Has diffi culty with body in space—moving appropriately Has problems with use of some tools Has problems organizing materials and moving them appropriately Is distracted by doors and cupboards being open, holes, or motion Other:___________________________ Case Study 1: Anthony 7. Sensory Supports These items were identifi ed as being applicable to your child/student: Sound/Auditory Teacher Caregiver Likes music Likes to sing and dance ⌧ ⌧ ⌧ ⌧ Taste Teacher Caregiver Has defi nite eating preferences Other:_____________________________________ _____________ ⌧ □ □ □ Sight/Vision Teacher Caregiver Enjoys watching moving things/bright objects Enjoys patterns or shiny surfaces Likes TV, videos, video games Likes the computer Other:_____________________________________ _____________ ⌧ ⌧ □ ⌧ □ □ ⌧ □ □ □ Touch/Tactile Teacher Caregiver Likes to be touched Likes hugs and cuddling when he/she initiates it Likes to play in water Likes baths or swimming pools Seeks out mud, sand, clay to touch Prefers deep touching rather than soft Prefers certain textures of clothing Likes being rolled or sandwiched between blankets/cushions Likes rough and tumble play Other:_____________________________________ _____________ ⌧ ⌧ ⌧ □ □ □ □ □ ⌧ □ □ □ □ □ □ □ □ □ □ □ Movement/Vestibular Teacher Caregiver Enjoys rocking, swinging, spinning Likes being tossed in the air Likes to run Likes and needs to move Likes to climb; seldom falls Other: __poor balance___________________________________ ___ ⌧ □ ⌧ ⌧ ⌧ ⌧ □ □ □ □ □ □ Visual/Perceptual motor Teacher Caregiver Relies on knowing location of furniture, stationary objects Likes to draw and reproduce fi gures Other:___________________________ 2009 COMPASS Case Studies 8. Learning Skills Learning/Work skill Teacher Caregiver 1. Child clearly understands the end goal of an activity, recognize what he/she must do to be fi nished, and persists on the task to completion W W 2. Child realizes when he/she is running into diffi culty and has some way of letting the adult know he/she needs help W W 3. Once an activity is under way, the adult can walk away from the child and he/she will keep working until fi nished, maintaining at least fairly good attention to what he/she is doing W W 4. Child fi nishes work and remembers on his/her own to let the adult know (e.g., by bringing workto adult, calling adult, raising his/her hand) W W 5. Child looks forward to earning a reward, knows it’s next, works toward it, may ask for it or go get it on his/her own when work is fi nished W W 6. Child is able to wait briefl y for a direction (anticipates that he/she is about to be asked to do something), is able to wait briefl y for his/her turn with a toy (anticipating that it’s about to return him/her), and/or wait for something to happen W W 7. Child may be distracted by outside sights and sounds or inner distractions (evident perhaps in singing to him/herself, gazing off, lining up materials) but is able to refocus attention to work on his/her own after a short time and without a prompt or reminder from the adult W W 8. Child shows interest in and curiosity about materials, handles them without prompting or nudging from the adult to get started. When one activity is fi nished he/she will look for another W W 9. Child can organize his/her responses to perform tasks when multiple materials are in front of him/her (e.g., a stack of cards for sorting) W W 10. Child recognizes when one strategy is not working and tries another way W W 11. Child recognizes his/her own mistakes and goes back and corrects them (e.g., takes little peg out of big hole to make room for correct peg) W W 222 Case Study 1: Anthony 9. Environmental Challenges Describe challenges noted in the Forms or reported during the consultation: □ Behavioral/Knowledge/Attitude of Other People Variables (e.g., inability to communicate clearly to the student, teach skills necessary for the activity, establish positive work or play routines). Teaching assistants lack training. • □ Procedural/Organizational (e.g., noisy environments, lack of visual sup-ports, lack of effective transition routines). Lots of auditory and visual distractions in the classrooms. • Lack of consistency between home and school. • □ Temporal (e.g., lack or ineffective use of visual supports to understand passage of time or when activity is fi nished). □ Spatial (e.g., lack of personal space or clear boundaries). Relatively large classroom of students. • □ Other Living in temporary and less familiar setting. • Parents experiencing confl ict and are stressed. • A lot of unstructured time at home. • New baby brother. • Lacks involvement in community activities outside home. • Does not receive any in-home services. • There is limited time for the teacher to plan with teaching assistants. • 2029 COMPASS Case Studies 10. Environmental Supports Describe environmental supports of the child/student. Environmental supports are factors that facilitate learning. Examples are positive routines, use of rewards, and use of visuals supports. □ Behavioral/Knowledge/Attitude of other people variables (e.g., is able to communicate clearly to the student, teach skills necessary for the activity, establish positive work or play routines). Teacher with a lot of specialized training in autism. • Many sociable peers in his classroom. • Teacher who likes to use technology and who has expressed desire to • learn more about teaching methods. □ Procedural/Organizational (e.g., uncluttered environments, visual supports for understanding work routines, positive transition routines). Teacher who uses a lot of visual supports, including signs and gestures, • to communicate. Teacher uses visual schedules and pictures to help understand and to • communicate with others. Teacher who builds choice into Anthony’s activities. • Teacher who knows Anthony well and knows what motivates and frustrates • him. □ Temporal (e.g., visual supports to understand passage of time or when activity is fi nished). Teacher uses visual schedules and pictures to help understand the order of • events. □ Spatial (e.g., personal space to work and calm down, clear boundaries). □ Other Teacher and mother who desire the same outcomes for Anthony. • Mother who is seeking a more permanent living situation. • Case Study 1: Anthony 11. Summary of Concerns Social and play skills Teacher Caregiver 1. “Normalized” play routines: move away from repetitive and self-stimulating type of play 1. Interacting with peers. 2. Increase appropriate peer interactions 2. Communication skills Teacher Caregiver 1. Express emotions without hurting others 1. 2. 2. Learning skills Teacher Caregiver 1. Completing requested tasks 1. 2. Independent work: only works with adult direction at the time 2. Adaptive skills Teacher Caregiver 1. Personal care routines: would like to see Anthony gain more independence 1. 2. 2. Other (if there is another area) Teacher Caregiver 1. Controlling temper 1. Anger 2. 2. Step B. 3. Identify and Come to Consensus on Three Prioritized Objectives and Write Measurable Objectives After the joint summary and parent and teacher priorities were reviewed in detail, three teaching objectives were identifi ed. The consultant reminded the participants that a goal of the COMPASS consultation was to identify a social skill, a work or learning skill, and a communication skill to teach. The consultant also reminded the teacher and mother that often there is agreement in what they both report, but that sometimes there was disagreement and that this is expected. School settings are very structured and sometimes children respond very well to this structure. But at the same time, while home is less structured, children might respond better there. The differences in reporting are consi 2049 COMPASS Case Studieswith autism respond differently at home and at school. When there are signifi cant differences, issues of generalization might be discussed. In the case of Anthony, the reader will notice that the teacher was a better observer/reporter compared to his mother. Sometimes this is the case, but usually not. Because of Anthony’s aggression, much discussion followed about the underlying reasons and purposes of his behavior problems and the parents’ and teacher’s main concern about aggression. The consultant reviewed the concept of replacement skills to help Anthony’s teacher and parent understand that with better work skills, com-munication skills, and social interaction skills, Anthony’s aggression will reduce. The iceberg illustration in the COMPASS Consultation Training Packet was used to facilitate this discussion. At the tip of the iceberg, descriptions of Anthony’s aggressive behaviors were written. These included hitting, pinching, and slapping. Below the iceberg, the team hypothesized reasons for the aggression. To help develop reasons for aggression, his communication skills were reviewed again to remind par-ticipants of the importance of identifying the communicative functions of behavior. Three primary functions were hypothesized: (a) wanting a desired activity or object and being told “no;” (b) wanting to be fi nished with an undesired activity; and (c) refusing to start an activity. Anthony’s personal challenges included lack of negotia-tion skills that stem from communication problems and a lack of understanding the impact of his problem behaviors on others. A lack of motivation to “please” others was also discussed as a contributor to the aggression. At the same time, as objectives designed to reduce behavior were discussed, the consultant encouraged the team to consider skills to be enhanced. As a result, objectives that focused on starting and completing a task, initiating a variety of requests, and interacting with peers by increasing play skills were discussed as potential prosocial and replacement skills for aggression. After much discussion, the replacement skills and teaching objectives in Table 9.2 were identifi ed and written as measurable IEP objectives. Information on how to write measurable objectives is provided in Chap. 5 . Developing the Goal Attainment Scale After the objectives were written in measurable terms, they were then added to the GAS Form. Recall from Chap. 8 that the GAS Form is used to facilitate progress monitoring as the teaching plans were implemented. Anthony’s present levels of Table 9.2 Anthony’s COMPASS/IEP objectives 1. When presented with a task menu, Anthony will start and complete three 2-3 minute tasks each day without aggression with one adult verbal cue (e.g., time to work) and gestural/picture cues across 2 weeks 2. During structured play, Anthony will imitate adult play activities for fi ve actions (actions with objects) with at least three different preferred objects (dinosaurs, animals, doll) each day across 2 weeks 3. Anthony will make 10 different requests per day independently (go home, eat, help, more, fi nished, various objects/activities) or as a response to a question (“what do you want?”) using sign, pictures, or verbalization on a d Case Study 1: Anthonyperformance were described at the −2 level for each of the three objectives. Next, the objective as written for goal attainment was placed at the 0 level. This was the skill he was expected to achieve by the end of the school year. Measurable increments of behavioral change were noted at levels −1, +1, and +2. Notice that the items that are in parentheses denote how the skill level may vary, and that if the child meets expectations noted in at least one area denoted by the parenthesis, progress is made at that level. For example, Anthony is expected to be able to start and complete three 2–3 min tasks each day without aggression with one adult verbal cue (e.g., time to work) and gestural/picture cues across 2 weeks by the end of the school year. If he is making progress toward this skill, he may be able to complete one (as indicated in the parentheses) instead of three tasks with no aggression or need two (as indicated in the parentheses) instead of one verbal cue to start. If he is able to accomplish the goal, but with fewer work items or more cues, then he is above baseline and is making progress. Goal Attainment Scale Form for Anthony −2 Present level of performance −1 Progress 0 Expected level of outcome (GOAL) +1 Somewhat more than expected +2 Much more than expected Aggresses when given a task he does not want to do. Is diffi cult to motivate. Does not have a more appropriate way to communicate refusals or to negotiate When presented with a task menu, Anthony will start and complete three (1) 2–3 min tasks each day without aggression with one (2) adult verbal cue (e.g., time to work) and gestural/picture cues across 2 weeks When presented with a task menu, Anthony will start and complete three 2–3 min tasks each day without aggression with one adult verbal cue (e.g., time to work) and gestural/picture cues across 2 weeks When presented with a task menu, Anthony will start and complete three (4) 2–3 min tasks each day without aggression with one (0) adult verbal cue (e.g., time to work) and gestural/picture cues across 2 weeks When presented with a task menu, Anthony will start and complete three (6) 2–3 min tasks each day without aggression with one (0) adult verbal cue (e.g., time to work) and gestural/picture cues across 2 weeks Has diffi culty imitating others, especially children using actions with objects. Likes objects he can manipulate Anthony will imitate play activities for fi ve (2) minutes with at least three (1) different preferred objects (dinosaurs, animals, doll …) each day across 2 weeks Anthony will imitate adult play activities for 5 min with at least three different preferred objects (dinosaurs, animals, doll…) each day across 2 weeks Anthony will imitate adult play activities for fi ve (7) minutes with at least three (4) different preferred objects (dinosaurs, animals, doll …) each day across 2 weeks Anthony will imitate adult (peer) play activities for fi ve (10) minutes with at least three (6) differ-ent preferred objects (dinosaurs, animals, doll …) each day across 2 weeks (continued)2 2069 COMPASS Case Studies −2 Present level of performance −1 Progress 0 Expected level of outcome (GOAL) +1 Somewhat more than expected +2 Much more than expected May use aggression as a way to request. Relies on adult prompts to make requests Anthony will make 10 (5) different requests per day independently (with verbal cues) or as a response to a question (go home, eat, help, more, fi nished, various objects/activities) using sign, pictures, or verbal on a daily basis for 2 weeks Anthony will make 10 different requests per day independently (go home, eat, help, more, fi nished, various objects/activities) or as a response to a question (“what do you want?”) using sign, pictures, or verbalization on a daily basis for 2 weeks Anthony will make 10 (15) different requests per day independently (go home, eat, help, more, fi nished, various objects/activities) or as a response to a question (“what do you want?”) using sign, pictures, or verbalization on a daily basis for 2 weeks Anthony will make 10 (20) different requests per day independently (go home, eat, help, more, fi nished, various objects/activities) or as a response to a question (“what do you want?”) using sign, pictures, or verbalization on a daily basis for 2 weeks Step B. 4. Develop COMPASS Teaching Plans for each Measurable Objective Depending on the amount of time necessary for completing steps 2 and 3, adjustments may need to be made for completing step 4 of the COMPASS Consultation Action Plan. For Anthony’s consultation, because a signifi cant amount of time was required to identify the replacement skills for aggression and to develop the objec-tives, little time was left for developing teaching plans for the second and third skills during the time allocated for the consultation. As a result, the consultant asked the teacher to work on the teaching plans and those not fi nished or unclear were com-pleted at the fi rst coaching session. For each objective, the team identifi ed Anthony’s personal and environmental challenges that would hinder attainment of the skill and identifi ed Anthony’s per-sonal and environmental supports to consider for teaching the skill and adding to his teaching plan. The three objectives and teaching plans are outlined below. Teaching Plan for Objective 1 Objective 1: When presented with a task menu, Anthony will start and complete three 2-3 min tasks each day without aggression with one adult verbal cue (e.g., time to work) and gestural/picture cues across 2 weeks. (continued)2 Teaching Plan for Objective 1 Personal and Environmental Challenges and Supports for Teaching Plan 1 Personal challenges Environmental challenges • Uses aggression to communicate many wants/needs/refusals, including confusion • Has low expressive language skills • Has limited repertoire of preferred tasks—most work tasks are unpreferred • Lacks motivation to please others • Lacks motivation for many objects/activities • Is in an integrated setting with a lot of other students • Has many physical distractions in the environment • Has living arrangements at home that have changed and are a bit unstable • Has new baby brother at home Personal supports Environmental supports • Likes animals and small animal toys he can hold in his hand • Has better receptive compared to expres-sive language skills • Understands many pictures • Uses a picture to indicate being fi nished consistently • Has mother and teacher who want same outcomes • Has teacher and assistant who know Anthony well • See teaching plan for specifi c supports and strategies to teach this skill The teaching plan for objective 1 developed with the team is below: Teaching Plan 1. Review the Evidence-based Online Resources for Teachers in the forms section of Chap. 7 , in particular those on structured work systems and structured teaching. 2. Develop and keep current a task menu that indicates to Anthony his work tasks. Be sure these are tasks he is familiar with and can do independently. 3. For each work task, have a visual task analysis (pictures) that displays each step of the task or have the tasks structured so he knows what to do. Provide visual cues of how much work he is to do or how he is to know when he is fi nished (i.e., sort the cars by color until they are all in the right bowls). 4. Refer to videos of structured teaching methods available online at: http://www.autisminternetmodules.org/user_mod.ph p and at http://autismpdc.fpg.unc.edu/content/structuredwork-systems . 5. Begin with short work tasks with a learned visual that represents the work task and a visual that shows the reward he will receive following the work task. 6. For the rewards, gather items and place in a basket (due to low motivation, he may do best if allowed to choose the reward he will receive for completing work task prior to starting the work activity). Avoid rewards that are an “obsession” for him, such as small fi gurines and birds. Show him that after he works again, he gets the reward again. As the work is interspersed with rewards, gradually shape to include more work tasks between rewards. 2 2089 COMPASS Case Studies 7. If needed, use timer picture from Boardmaker or an auditory timer to indicate length of time he plays with the reward. 8. Once work activity routine is established, show the assistants how to implement the routine. Teaching Plan for Objective 2 Objective 2: During structured play, Anthony will imitate adult play activities for 5 actions (actions with objects) with at least three different preferred objects (dinosaurs, animals, doll…) each day across 2 weeks. Personal and Environmental Challenges and Supports for Teaching Plan 2 Personal challenges Environmental challenges • Lacks joint attention skills • Lacks motivation to please others • Lacks motivation for many objects/activities • Is in an integrated setting with a lot of other students • Physical distractions in the environment • Living arrangements at home have changed and are unstable Personal supports Environmental supports • Likes animals and small animal toys he can hold in his hand • Has better receptive compared to expressive language skills • Can imitate some actions with objects (drink from a cup) • Likes praise and hugs • Mother and teacher want same outcomes • Teacher and assistant know Anthony well • Has many social peers in his classroom • See teaching plan for specifi c supports and strategies to teach this skill Teaching Plan 1. Refer to the Evidence-based Online Resources for Teachers in the forms section of Chap. 7 , especially those on discrete trial training, prompting, and peermediated instruction. 2. Assemble objects that Anthony likes. Decide if you would like to use two iden-tical objects so he can see what to do while simultaneously doing it or use one object with which to take turns. 3. Get Anthony’s attention and imitate an action with the object (make a plane fl y, a bear walk, a dog run, a rabbit hop, a car roll, etc.). Be creative and try out different things. 4. Give the object to Anthony and cue him “You do it” or a phrase you prefer to use to verbally cue him to perform the action with the object. If he has the same object, you might say, “Let’s play, do this.” 5. Use a system of least prompts and avoid physical assistance as much as possible. As long as he is watching, give him time to respond, otherwise cue him to look. 2 Teaching Plan for Objective 3 6. If he does the behavior, reward him with smiles, humming, and/or acknowledg-ment; if not, repeat from the second step. 7. If Anthony is taking turns imitating with one object, two objects are not needed. 8. Twirling and spinning things are highly preferred and interfering. They are not used to work on this skill, but might be used as reward if he understands when to give them up. Keep the toys that are allowed for spinning and reinforcement separate from those being used to teach appropriate use and imitation. 9. Generalize the verbal cues to include phrases paired with a gesture of holding a hand out to indicate “my turn.” 10. Once the skill is mastered with one adult, generalize the skill to other adults and then begin to include a peer. Teaching Plan for Objective 3 Objective 3: Anthony will make 10 different requests per day independently (go home, eat, help, more, fi nished, various objects/activities) or as a response to a question (“what do you want?”) using sign, pictures, or verbalization on a daily basis across 2 weeks. Personal and Environmental Challenges and Supports for Teaching Plan 3 Personal challenges Environmental challenges • Uses aggression to communicate many wants/needs/refusals, including confusion • Has low expressive language skills • Lacks motivation to please others • Lacks motivation for many objects/activities • Is in an integrated setting with a lot of other students, making it diffi cult to provide intensive instruction • Has teaching assistants who are not trained • Lacks consistency between home and school and use of visuals Personal supports Environmental support • Likes animals and small animal toys he can hold in his hand • Better receptive compared to expressive language skills • Understands many pictures • Has teacher who uses pictures/gestures to communicate • Has access to pictures that can be used to express himself to others • Has mother and teacher who want same outcomes • Has teacher and assistant who know Anthony well • See teaching plan for specifi c supports and strategies Teaching Plan 1. Refer to the Evidence-based Online Resources for Teachers in the forms section of Chap. 7 , especially those on picture exchange communication system (PECS), functional communication training, and pivotal response training. 2 2109 COMPASS Case Studies 2. Begin to teach independent initiation; start with what he can currently do and expand. Begin with PECS. Also, implement naturalistic strategies based on functional communication training and pivotal response training. 3. Review with the teaching assistants the teaching methods of PECS online at: http://www.autisminternetmodules.org/mod_list.php . 4. Identify activities, objects, and other items that Anthony might like. 5. Develop a communication board with Boardmaker or photos that Anthony can pair with desires/needs. 6. Expand to other teaching situations to elicit requests, such as sabotaging a situ-ation (e.g., place desired objects in view but out of reach or in a clear container with a tight lid). He really enjoys hand puppets. A clear container with a tight lid and a desired object inside can be used so that he has to ask for help. 7. Obtaining the object will be the reinforcer for Anthony to make the request. 8. Show you understand by complying with requests immediately and praising him. 9. Make sure that the team is clear on the method he needs to use to indicate the request (for instance, picture with verbalization or picture only). If he is not mak-ing requests independently or is being taught to request new items, he may need a second person who prompts him from behind when requesting with a picture. 10. Collaborate with the speech language pathologist in teaching this goal through-out the day and embed it within as many activities as possible. The more prac-tice and success Anthony has, the quicker he will be able to learn this skill. Summarize and Close Next, the consultant distributed the COMPASS Consultation Satisfaction Questionnaire and COMPASS Fidelity Checklist to the parent and teacher. Because time was short, the consultant left the forms with the teacher and parent and asked that they be faxed when completed. The consultant also asked that an IEP meeting be arranged within the next 2 weeks so that the new objectives would be added. The fi rst coaching session was scheduled. Within a week of the consultation, a report of the consultation was sent via mail and email to the teacher and via mail to the parent. Enclosed with the report was information on dealing with sleeping and behavior problems. The parentfriendly resource materials came from the COMPASS series available online at www.ukautism.org . Also included in the report was a description of the teaching objec-tives, personal and environmental challenges and supports, and teaching plans. The consultant made some observations of the parent, teacher, and teaching assis-tant following the consultation. Anthony’s mother and teacher were quite involved during the discussion. They shared information and were active contributors; his teacher shared slightly more information than his mother. Both his teacher and mother appeared to benefi t from additional insight into Anthony’s needs and behav-ior. His mother, especially, needed more supports. There was much turmoil at home and Anthony, his mother, and siblings were living in temporary arrangements with the maternal grandmother due to a recent separation from Anthony’s father. Thus, it was not clear how much Anthony’s mother’s interactions during the consultation 2 Coaching Session 1were affected by stress from other problems and current living arrangements. When asked for possible replacement skills to teach, both his teacher and his parent needed assistance to generate ideas. Both his mother and teacher appeared extremely frustrated. When asked about the need for respite care at home, his mother became teary. The consultant solicited input directly by reviewing the information shared in the COMPASS Challenges and Supports Joint Summary Form and reminded them of the communication, social, and learning skills weaknesses that are being manifested as aggression. Anthony’s teacher also appeared to be concerned about the number of children in her classroom overall and the number who had IEPs. The consultant reassured her that the teaching plans would be feasible and able to be implemented within the classroom. The teaching assistant was less involved, but reported how helpful the consultation was in helping her understand Anthony. Coaching: Implementing Plans, Monitoring Progress, and Making Adjustments Plan implementation and progress monitoring occurred throughout the year. As the plan was implemented, fl exibility was encouraged for adjustments to be made readily and quickly as necessary depending on progress data. The four coaching sessions presented in this section took place about every 6 weeks. Coaching sessions can occur more frequently, but a minimum of four sessions is necessary. Recall that the coaching sessions are designed to facilitate teacherimplemented plans and procedures rather than consultant-implemented plans. A careful balance between consultant expertise in autism and teacherdirected teaching plans must be considered. As much as possible, the consultant encourages and supports ideas from the teacher using guided and Socratic questioning techniques discussed in Chap. 7 . The implementation steps of the coaching sessions as described in Chap. 8 were followed (Table 9.3 ). Coaching Session 1 During the fi rst coaching session, much time was spent clarifying the teaching objectives and designing the teaching plans. To assist with these activities, the Session 1 Coaching Protocol provided in the forms section of Chap. 8 was followed. During the fi rst coaching session, Ms. Caudill reported that the team was concerned Table 9.3 Abridged COMPASS coaching protocol See Chap. 8 , Table 8.1 for full description of the procedural steps of the COMPASS Coaching Protocol 1. Observe the student demonstrating each targeted skill/objective/goal 2. Review the Goal Attainment Scale (GAS) Form 3. Complete the Teacher Interview for Coaching Form for each objective 4. Complete summary activities 5. Obtain completed evaluation and fi delity forms 2 2129 COMPASS Case Studiesabout Anthony’s level of aggression and that it might be unrealistic to expect him to meet the objective. The objective was slightly modifi ed so that he was expected to start, but not complete, a task independently. It was clear that the teacher might have challenges in convincing her teaching assistants that Anthony could be successful beyond their expectations. This objective was added to the IEP. The consultant, however, with agreement from the teacher, retained the original objective developed during the consultation. The GAS Form based on the original objectives was reviewed with the teacher. Following this discussion, an observation of the instruc-tion was conducted and also videotaped for each of the three targeted objectives for review with the teacher. Following the observation, the consultant and teacher met in a conference room and completed steps 3, 4, and 5 of the coaching protocol. Step 1: Observe the Student Demonstrating Each Targeted Skill/Objective/Goal The consultant and teacher observed videotape of Anthony and his teacher working on one of the three skills that were discussed during the consultation: “When pre-sented with a task menu from which to select work tasks, Anthony will start and complete three 2–3 min tasks each day without aggression with one adult verbal cue (e.g., time to work) and gestural/picture cues across 2 weeks.” We observed him completing a work task with multiple verbal and gestural cues from the teacher and no aggression. For the skill of learning to imitate play activities with at least three different preferred objects, opportunities to teach had not been created, according to Ms. Caudill. Therefore, we did not see a videotape of this skill. Instead, we observed this directly in the classroom. It was quite impressive to see Anthony sit down with Ms. Caudill, watch her imitate with an object, and then immediately imitate the same action with the object. He imitated at least two different objects. When given a toy dog, he was more focused on playing with the bird in a repetitive manner by fl icking its wings repeatedly. But after some delay, Anthony was observed to imitate appropriate action with the toy dog. For the third skill, observation showed Anthony selecting a fi nished card and handing it to his teacher. More discussion about the skills follow. Step 2: Review the Goal Attainment Scale Form Goal attainment ratings were collected on the three primary skills. During the fi rst coaching session, the GAS Form was introduced to Ms. Caudill and some of it was adjusted based on her input. For the fi rst skill of “when presented with a task menu,” a goal attainment score of −2 was observed. His teacher reported, however, that most of the time, Anthony was making progress and would fall at a −1 level. 2 Coaching Session 1 For the second skill of “learning to imitate play activities with at least three dif-ferent preferred objects,” a GAS score of -1.5 was observed. His teacher, however, reported that most consistently he is scoring at a −2 level. For the last skill of “initiating requests,” a GAS score of −2 was observed. His teacher reported that Anthony consistently initiates about 2 to 3 requests daily independently. Step 3: Complete the Teacher Interview Form for Each Objective During the discussion with Ms. Caudill, the Teacher Interview for Coaching Form was completed. A copy of the form was provided to her to follow along. For the fi rst skill of “when presented with a task menu,” Ms. Caudill expressed concern that the objective appears to be two separate skills—to start an independent work task and to complete an independent work task. The consultant suggested that in the IEP, the skill may be broken down into two separate skills. For the consulta-tion, however, it was preferred to keep them together as one skill because work completion was the primary aim, and starting a work task was the fi rst step in learning to complete a work task independently. She agreed and reported that she worked on this skill on a daily basis. She also indicated that she was keeping data on this skill and needed no assistance with data collection (see the Activity-based Data Sheet below). She as well as the speech therapist both teach this skill. The speech therapist spent about 2 days a week in the classroom. Next, the teaching plan was reviewed. The teacher was mainly using a discrete trial approach and a lot of adult-directed prompting. Thus, the consultant reviewed the method of structured teaching as an alternative, evidencebased method that would support the development of independence. The consultant referred to the original consul-tation report that included online references, including video of structured teaching methods and ideas of developing further structured teaching types of activities. 235 2149 COMPASS Case Studies Activity-Based Data Sheet Student’s Name: Anthony Skill/Behavior: Start and complete work tasks. Dates: Oct 5–16 Criterion Level: three 2–3 min work tasks with one adult verbal cue and gestural and visual cues Coaching Session: 1 Prompt: ( circle ) I = Independent; V = Verbal; Vi = Visual; G = Gestural; P = Physical Instructions : In the section above, describe the skill/behavior, criterion level,* and circle the prompt(s) for the objective. Using the table below, list the prompts used, tally the number of times the student demonstrated the skill at the criterion level (# passed), and tally the number of opportunities provided (# opportunities). For the bottom row, tally the total number of times passed and the total number of opportunities. Day M T W TH F M T W TH F Date 10/5 10/6 10/7 10/8 10/9 10/12 10/13 10/14 10/15 10/16 Activities Independent work time in the morning Prompt 5V 5V 5V 5V 5V 4V 4V 3V 3V 3V 4P 4P 4P 4P 3P 3P 3P 2P 2P 1P # Passed 0 0 0 0 0 0 0 0 0 0 # …