Introduction
The child in this case study, a young female diagnosed with moderately severe autism, hypotonia, and a mild to moderate range of development delay herein named Mary, typifies the stereotypical social constructs of the school district in which the child lives. The general perspective of educators, administrators, and the school board psychoeducational consultant who sit on Individual Placement Review Committees (IPRC), which are positions of public trust, use norm-referenced assessments and observations of teachers, who do not practice differentiated instruction, to pigeon-hole children with cognitive and socio-emotional delays, such as Mary, into self-contained classrooms, as was the situation with this case study’s child. Placement into self-contained classrooms, which are not usually within a child’s neighborhood school, is based on recommendations by school board psychoeducational consultants where smaller teacher-student ratios and direct instruction are identified as warranted. Self-contained classes for children with developmental disabilities in Mary’s school district, and others, are restricted to kindergarten curriculum throughout their elementary school years, a fact that not provided to parents/guardians unless the specific question “What curriculum will my child be taught?” is asked. Based on my experience, few parents/guardians ever think to ask this question. Hence, segregated classrooms established for children identified as having a “Development Delay” or “Intellectual Disability” exclude the intellectually stimulating richness of phonetics, phonics, spelling, sentence construction, environmental science, social studies, computer labs, continuous diverse social interactions, augmentative technological communication devices, and exposure to higher expectations that typically developing children enjoy (PDSB, 2009; Driscoll and Nagel, 2008; Allen and Cowdery, 2009).
Mary’s case is presented here in the interest of social justice within education. The rationale for studying the case of Mary is based on the research-based concept of universal design for learning that specifically attests to the benefits of planning and development of a classroom, indeed an entire school, to meet the needs of a diverse population of students that is flexible, supportive, and adjustable, thereby increasing full access to the curriculum for all learners. In this way, universal design for learning ensures developmentally appropriate practices, including differentiated instructional strategies and adapted activities to meet the needs of individual children such as Mary, and ultimately for the benefit of all children to enable continuous, progressive growth in all domains of development (Allen and Cowdery, 2009; Driscoll and Nagel, 2008; Bennett, Dworet, & Weber, 2008).
Relevant Facts
Mary is generally a happy six-year-old child, with supportive and loving parents, who have provided a richly stimulating home environment with books, age appropriate computer software, dolls, as well as drawing and building materials. Every summer Mary’s parents enroll her in an integrated summer camp, with one-to-one support, during which she transforms into a socially outgoing, verbally expressive child. In contrast, Mary was not verbally expressive or socially adept within the self-contained classroom in the non-neighborhood school to which she was bused with other children with developmental disabilities. Her gross and fine motor development appears slow, awkward, and uncoordinated. Within the self-contained class for developmentally challenged children, only kindergarten curriculum was prescribed, even for the children in this special class who were twelve years of age. Mary’s IEP stated her exceptionality as developmentally challenged, and included a few consultative supports with her special education teacher on an as needed basis: speech language pathologist, occupational therapist, and physical therapist, and nothing more such as augmentative communication devices and software. The classroom’s lack of stimulation combined with low expectations for learning created a situation in which Mary began to imitate the odd behaviors of her lower functioning peers.
Mary’s parents acknowledged they had trusted their child’s educators’ advice to place their daughter in a self-contained classroom the year before. At the end of Mary’s first year of kindergarten, the teacher told Mary’s parents that she could either be held back another year in kindergarten, without additional staff support, or placed in a special classroom where there is a better teacher-student ratio for more direct instruction. Thinking their daughter’s educators had their child’s best interests at heart and in mind, plus believing the educators knew which instructional practices were developmentally appropriate for their child to continue her growth in all domains, they agreed to the placement.
Subsequently, through information obtained from The Geneva Center in Toronto, Ontario the parents shockingly discovered that research-based evidence attested to inclusive education that combined developmentally appropriate practices with natural and augmentative electronic assistive supports to obtain the best possible outcome for children with development delay and/or autism, rather than the school board’s placement in a self-contained classroom without access to the richness of their typically developing peers’ curriculum. Motivated by their intent to have their daughter transferred to a regular classroom in her neighborhood school; the same one her neurotypical brother attended, the parents had another psychoeducational assessment performed by a Psychoeducational consultant affiliated with an organization specializing in providing programming and therapies for children with physical and cognitive exceptionalities, including autism – a third party without financial or political ties to the school board.
Analysis of the Facts
The results of the new psychoeducational assessment specified that Mary showed a keen interest in learning how to use the computer, and had developed good computer skills likely as a result of her home environment. Thus, the Psychoeducational consultant suggested that computer programs be used to advance Mary’s skills in language and math. For example, computer software that promotes Mary’s phonological awareness, phonics, auditory processing, linguistic concepts and basic math concepts, were some of the Psychoeducational consultant’s recommendations for adaptive technology, as well as any other assistance that would enable her better access to the Ontario curriculum, such as text to speech software, and age appropriate web sites. These recommendations would eventually become the basis for the school board to successfully apply for Special Equipment Amount funding from the Ontario Ministry of Education’s Special Education Branch to purchase a laptop computer with software and staff training in order to provide augmentative communication and curriculum adaptations for Mary’s use in a mainstream classroom. Unfortunately, this did not occur until the equivalent of her grade 11th year because her parents found out vicariously about the SEA funding while talking with an Education Officer at the Ministry of Education about a complaint specifically about their daughter’s lack of access to electronic augmentative communication at school (OME, 2009). School Principals are supposed to request and complete the SEA paperwork. Sadly, none of the elementary school, middle school, or high school Principals launched the process on their own accord. The parents had to put pressure on the high school Principal to get the SEA paperwork completed. Once submitted, the SEA funding was granted and augmentative electronic equipment (laptop and various software) were purchased and the educational assistant trained in their use – all to better support Mary’s learning and accessing the same curriculum as her neurotypical peers.
When Mary was in her 4th year of school in the segregated classroom, a Case Conference was held with the special organization’s Psychoeducational consultant in attendance to provide support to Mary’s parents. Based on the arguments and facts of the new psychoeducational assessment derived through the triangulation of criterion- and norm-referenced assessments as well as direct observation in play situations over three visits to the Psychoeducational consultant’s office, Mary was transferred half way through the school year to a grade five class in her neighborhood public school for the start of the next school year. Mary’s IEP was updated to reflect more specifics about her identification. For example, her exceptionality definition was changed from developmentally challenged to Exceptional Communication – Autism, which in itself enabled the school district’s autism itinerant teachers to provide their expertise services to the regular classroom grade five teacher, and helped to provide an education assistant (EA) as one-to-one support for Mary in the classroom environment.
Suggestions for Appropriate Future Practices
First and foremost, the classroom environment must support the creation of a learning atmosphere of inclusiveness where children participate equally in motivating active learning groups within the safety and comfort of a caring community culture that “promotes respect for diversity and character values” (Gibbs, 2001, p. 11). Within this “positive culture for learning and human development,” the grade five teacher, as well as teachers throughout Mary’s education, must include within the daily classroom routine the process of getting to know their students, “their families, and the various cultural and language communities that they come from”, thus “enabling them to reach goals that are both challenging and achievable” (Gibbs, 2001, p. 11). Indeed, the classroom community in from pre-kindergarten and beyond, must provide caring and supportive positive expectations, and encourage active participation of all children in the atmosphere of a learning community that consists of the children, administrators, educators, support staff both from the education system and the larger community, as well as parents/guardians through collaboration. As a means to encourage community in the classroom, there must be visible rules of conduct and behavior incorporating text with images. These rules of conduct, paired with daily community building activities, would assist all the children to further their social-emotional development (Gibbs, 2001).
An Autism Spectrum Disorder (ASD) Behavioral Intervention Plan (BIP) should have been created through the collaboration of an ASD Resource Team, comprised of the ASD itinerant teacher assigned to the public school, the area ASD co-ordinator, the School-Based Team, which included the Special Education Teacher, the school Principal, Vice-Principal, the EA, school board speech-language pathologist, behaviorists, occupational therapist, and physical therapist, as well as input from Mary’s parents (PDSB, 2007). The ASD-BIP, a plan of current and future most appropriate practices and strategies to foster Mary’s development, would include a functional behavior analysis. The functional behavior analysis would include a list of the behaviors in need of change and the perceived functions of those behaviors. For example, behaviors in need of change could include time management, ability to follow directions, easily distracted with a loss of focus on tasks, talking out of turn, difficulty waiting, and pinching, hitting, grabbing, slapping self on the face, as well as repetitive vocalizations. The corresponding perceived functions of the behaviors would be attention seeking, communication, transitions/change, avoidance, anxiety/frustration, and self-stimulation.
Next, a list of target replacement behaviors would be provided through the team collaboration with hypothesis statements that support the behavior analysis (PDSB, 2007). The target replacement behaviors should include the use of a functional communication system to indicate/request her wants and needs, to raise her hand and wait for an adult to respond, to follow adult directions, and to stay focused on a task or activity. An example of a hypothesis statement for the behaviors of grabbing, hitting, and/or pinching is that she resorts to these behaviors to gain attention when she wants to communicate something immediately, such as frustration or anger about the task she is being asked to do, or wants something tangible such as an item. Jorgensen et al (2006) refer to aggressive behaviors, such as those described above, as being triggered by one or more of nine possible antecedents (p.228-229):
“Authoritative requests or demands from adults;
Use of directives such as no, don’t, stop, or you need to;
Being asked to complete work that is too difficult or uninteresting;
Requests to do something that [the child] does not want to do;
Confusing, noisy, over-stimulating environments;
Being in loosely structured environments with other students who are
misbehaving;
Losing in a competitive activity or feeling incompetent after a particular
performance;
Perceiving that adults are disappointed or frustrated with [them];
Activities or environments that provide little structure or boundaries.”
The ASD Resource and School Teams would further collaborate on strategies designed to prevent problem behaviors including environmental and organizational supports such as entry plans modeled by adults and more socially advanced peers, with daily consistency (PDSB, 2007). Jorgensen et al (2006, p. 211) describe preventative strategies as “positive approaches to behavioral support” where staff are taught to understand the “complex interrelationships among behavior, communication, and sensory and movement differences” within the context of implementing instructional strategies. Consequently, preventative instructional strategies would include environmental supports such as visual supports in the form of images paired with text to help her stay focused on a task, and should be used to organize the classroom resource materials to enable more independence. A digital watch and time timer would be used to help her with time management (Time Timer, 2010). For example, Mary would be direct taught how to match the time on the digital watch to one of the times listed on a sheet and then asked to circle that time. If the time on the digital watch does not match a time listed on the sheet, she will be taught that this indicates that she is late for class. Natural consequences for lateness must be derived based on teacher, itinerant teacher, administrator, and parental input. Whereas the time timer reminds her how much time is left before the next activity begins.
Furthermore, a self-monitoring checklist should be direct taught to Mary and used for each class: homeroom, music, and gym. In class, Mary would be direct taught to use visual supports (images paired with text) to indicate I need help, I need a break, as well as use of a talk card to indicate when she would like to speak with the teacher. There are also visual supports (images paired with text) for work by self and work with teacher/peers as well as finished, which are also direct taught to help her understand when she will be working independently or in a group, and when she will work with an adult for teaching or instruction purposes (PDSB, 2007).
When Mary tries to engage in conversation not related to her work or becomes distracted in the classroom, she can be redirected to her task using a first…then visual support (images paired with text). For example, the support staff would print on a laminated first…then… card: Math…Computer, where the latter is a preferred activity. The EA and teacher can wear lanyards with visual picture symbols with text for sit, line up, quiet, voice volume meter, etc. to visually cue directives and decrease verbal directions (PDSB, 2007). Mary would also benefit from use of a stability ball to enhance her focus and concentration, which, according to The Geneva Center (2003), provides vestibular input that serves to keep the brain’s level of arousal at optimal intensity for learning. All supply teachers must be made aware of these supports prior to entering the classroom.
In order to facilitate transitions and change, tidy up should begin five minutes early. In addition, transition anxieties would be eased through the use of a time timer or digital timer to give a five-minute warning of when to prepare for the next activity or class, and a visual go to class (music or gym) on her desk. Furthermore, to encourage independence, the expectation must include that Mary will transition to music and gym class independent of adult support, and will follow the natural cues of her typically developing peers (Jorgensen et al, 2006). When it is known that a change will occur that results in increased anxiety for Mary, movement breaks should be provided paired with preferred activities that she is familiar with; work activities will be chunked into smaller steps, and/or first…then… visual supports will be utilized for added predictability, all followed with praise and/or a tangible reinforcement, such as computer or iPod listening time, for the accomplishment (The Geneva Center, 2003). Over time the tangible reinforcement should be faded so that praise serves as the reinforcement for accomplishment. Then, again over time, the praise should be faded while pairing with encouraging self-awareness of her inner sense of accomplishment, thus allowing for growth of her own intrinsic sense of achievement.
The facilitation of Mary’s ability to request as well as to enhance both receptive and expressive language skills should be achieved with input from the school board’s speech language pathologist who will provide recommendations for language skill development and communication strategies specific to Mary’s needs. In addition, the use of sentence strips such as I want…, tell me…, and show me… will provide a means for the teacher and EA to visually cue the use of language (The Geneva Center, 2003). Furthermore, building talk time into Mary’s daily schedule will give her the opportunity to talk about the topic of her choice, but at a predetermined time of day as indicated on her daily visual schedule, which pairs images with text. Another practice to help facilitate Mary’s focus of attention during social communication is to encourage her to make eye contact when initiating and/or engaging in conversation with others and to maintain eye contact to demonstrate that engagement (The Geneva Center, 2004).
Practices that educators and EAs should also use to help maintain and increase expected behaviors are reinforcements such as high fives, verbal praise where labeling the behavior specifically is critical such as good getting to gym class on time or good tidying up all your books and pencils, and gesturing thumbs up while smiling, a nod, etc., which are short in duration and frequent for expected behaviors (The Geneva Center, 2003). Another reinforcement practice would be to create a printed visual list (images with text) of what Mary would like to do with tokens she earns and how many tokens it would take to earn something, thus embedding numeracy into a routine that would engage her interest. A list of reinforcers, which should be interchanged and faded as Mary’s skills develop, should be generated with input from Mary, school staff, and her parents (The Geneva Center, 2003).
Promoting skill development in each subject area of all grade levels includes the implementation of the accommodations outlined in Mary’s Individual Education Plan (IEP), which are divided into instructional, environmental, and assessment categories (OME, 2004). Instructional accommodations are to be based on her learning style and cognitive processes as Mary is a strong visual learner and a good tactile-kinesthetic learner who requires longer processing time, with difficulty processing auditory input that is not supported by visuals in the form of images. Thus, like most children with ASD, she has difficulty with auditory comprehension. Taking her learning style and cognitive processes into consideration, instructional accommodations should include utilizing peer tutoring, concrete/hands-on materials such as manipulatives for math, extra time for processing, high structure, more frequent breaks, providing a work sample on her desk, visual cueing (images paired with text), visually uncluttered worksheets with ample space to print answers, computer options to complete worksheets, reinforcement incentives, and use of a time timer (The Geneva Center, 2003).
Environmental accommodations include providing a quiet space for calming and regrouping, which could be the library or resource room, providing opportunities for movement breaks and sensory breaks, using personalized visual daily schedules that pair images with text, and minimizing background noises. Assessment accommodations include providing computer options for activities and projects, extended time limits, oral responses including audio tapes, prompts to return her attention to task, reduced/uncluttered format, reducing the number of tasks used to assess, observational assessments, and portfolio of best samples of work (The Geneva Center, 2003). To reiterate, Mary may demonstrate knowledge through a variety of methods such as orally, gesturing to the correct answer, using assessments generated within software programs such as Crick’s Clicker 6 and/or ClozePro, or iPad apps such as PTyper (a word prediction typing app) or the Proloquo2Go app, having someone scribe, and/or circling or highlighting the answer.
Academic and skill development will be further encouraged by utilizing her topics of interest as motivation to engage in tasks, such as allowing her to choose a book or comic about The Fantastic Four on which to do a diorama. Using videos and real-life images or drawings should be used as often as possible to support her visual learning style. Concrete materials should be used as much as possible to support her tactile-kinesthetic learning style. Highlighting key words, mathematical signs, color-coding, underlining, etc. are other examples of providing visual supports or cueing to enhance focus of expectations and promote student success (The Geneva Center, 2003). When introducing a new topic, work must be chunked into smaller steps to prevent visual overload, and that Mary finds manageable. If needed, a small break between the steps should be provided before returning to the next step. Backward chaining is another way to teach Mary the steps necessary to complete an activity. For example, the staff would model to Mary all the steps except the last one, which Mary would do. Then the staff would move Mary on to completing the last two steps, and so on, until she can successfully complete the task herself, independently (The Geneva Center, 2003).
Furthermore, academic and skill development for Mary will be enhanced through structured, scaffolded, direct instruction where there is a beginning, middle, and end built into each task she is asked to undertake (The Geneva Center, 2003; Jorgensen et al, 2006). For improved compliance, Mary should have a balance between non-preferred with preferred activities and projects, and/or challenging activities and projects with those that are easier. Computer options using software such as Premier, text to speech, MS Word, Widgit’s SymWriter and Crick’s Clicker 6, plus access to age-appropriate educational web sites should be used daily to extend Mary’s learning as they are excellent tools for visual learners and help develop hand-eye coordination (Jorgensen et al, 2006).
Social scripts to help reduce and extinguish pinching and other aggressive behaviors would include the following text paired with images/symbols, one sentence per line, with plenty of space between the lines for an uncluttered look: Sometimes I get frustrated. When I get frustrated it is not okay to [pinch/hit/grab] others. I can say, “I’m frustrated.” I can ask to take a break. I can…., etc. where acceptable choices are given as alternative behaviors, and Mary is asked to contribute ideas to the alternative choices when she is calm and not agitated (The Geneva Center, 2004).
In addition, the use of simple data collection charts, such as a self-graphing data sheet, should be used to ascertain if in fact the positive behavior strategies are encouraging improvements to task behavior over time. The EA or teacher would place an X on the chart when an occurrence of off-task behavior is displayed by Mary. Thus, over a number of days, changes in her behavior will be evident (Allen and Cowdery, 2009). Furthermore, it is important that all the above strategies and practices that are directly taught to Mary are done so often and implemented with consistency. It will be the consistent application of routines and expectations that will be the key to long term success for Mary (The Geneva Center, 2003; Jorgensen et al, 2006).
Conclusion
Researchers agree, finding Mary’s and other children’s learning mode strength(s) and providing scaffolded learning through the use of differentiated instructional strategies to build on those strengths is the developmentally best practice (Gregory and Chapman, 2002; The Geneva Center, 2003; Jorgensen et al, 2006; Driscoll and Nagel, 2008; NAEYC, 2009). Allen and Cowdery (2009, p. 112) support this approach in their statement, “With appropriate learning opportunities, minority children and children with all kinds of impairments [such as Mary’s] can be helped to realize their potential.” Therefore, from an ecological perspective, responsive and collaborative administrators, teachers, special education teachers, itinerant teachers, EAs, OTs, PTs, speech-language pathologists, behaviorists, psychoeducational consultants as well as parents/guardians, who utilize observation and differentiate instruction in the school environment and at home, will encourage children’s natural learning preferences regardless of ability or disability (Gregory and Chapman, 2002; Weiss et al, 2005; Driscoll and Nagel, 2008). Lastly, facilitating improvements to procedural routines is developmentally appropriate practice for all children. Allen and Cowdery (2009, p. 388) attest to this in their statement, “it is desirable that all children experience an organized environment and an orderly routine that provides an overall structure in which learning takes place; the environment is dynamic and changing but predictable and comprehensible from a child’s point of view.”
References
Allen, K.E. and Cowdery, G.E. (2009). The Exceptional Child, Inclusion in Early Childhood Education, Sixth Edition. Thomson Delmar Learning, Clifton Park: NY.
Bennett, S., Dworet, D., and Weber, K. (2008). Special Education in Ontario Schools, Sixth Edition. Highland Press.
Driscoll, A and Nagel, N.G. (2008) Early Childhood Education, Birth-8, The World of Children, Families, and Educators, Fourth Edition, Pearson Education Inc.
Gibbs, J. (2001). Tribes. A New Way of Learning and Being Together. Windsor, CA: Center Source Systems
Gregory, G. H. and Chapman, C (2002). Differentiated Instructional Strategies, One Size Doesn’t Fit All. Thousand Oaks, CA: Corwin Press, Inc.
Jorgensen, C.M., Schuh, M.C., and Nisbet, J. (2006). The Inclusion Facilitator’s Guide. Paul H. Brookes Publishing Co.
NAEYC (2009). Key Messages of the Position Statement. Reprinted from Developmentally Appropriate Practice in Early Childhood Programs Serving Children from Birth through Age 8, Third Edition, Carol Copple & Sue Bredekamp, eds. Copyright 2009 by the National Association for the Education of Young Children. http://www.naeyc.org. Retrieved on Nov. 30, 2009 from http://www.naeyc.org/files/naeyc/file/positions/KeyMessages.pdf
OME (2004). Ontario Ministry of Education. The Individual Education Plan (IEP), A Resource Guide 2004.
OME (2009). Ontario Ministry of Education. Special Education Funding Guidelines. Special Equipment Amount (SEA) 2009-10. Spring 2009.
PDSB (2007). Peel District School Board, ASD Resource Team, Positive Behavioral Intervention Plan. April 24, 2007 version.
The Geneva Center (2003). Autism Intervener Certificate Training Program, Level 1. Spring 2003.
The Geneva Center (2004). Autism Intervener Certificate Training Program: Social Skills, Level 2. Spring 2004.
Time Timer (2010). Time Timer LLC. Retrieved on February 18, 2010 from http://www.timetimer.com/
Weiss, H.B., Kreider, H., Lopez, M.E., and Chatman, C.M. (2005) Preparing Educators to Involve Families From Theory to Practice, Thousand Oaks CA: Sage Publications Inc.
Enabling Non-Biased Education 