Teaching in the Least Restrictive Environment... What does that mean for services??

There is a very careful balance to be struck in education, as in all aspects of life...
When we talk about providing special education services, we know the law, and we know that means these services should be provided in the Least Restrictive Environment. But what is that really?

Well, it means that if a student is able to function (make meaningful educational progress) in a general education classroom with some supports and modifications from the teacher, then that is where they belong. If the student requires an aide, then for them that is the learning environment with the least amount of restrictions where they will succeed. For some students the least restrictive environment may be a self contained classroom or even a specialized school. These decisions, like many others, are to be made based on the needs of the individual student. As educators we are saying that it is very important that students who receive special services have access to the general education curriculum and general education students whenever possible and appropriate. But with each step toward the general education end of the educational curriculum, how many supports and services are lost?

Does the least restrictive environment necessitate that a child has access to fewer services? Maybe... Don't provide more than is necessary or you're holding the person back, but provide enough for him to make a reasonable amount of progress. Again these decisions need to be made for each student, in a manner which is appropriate and for him/her but also feasible for the classroom and the types of accommodations they are able to provide. Surely we cannot expect that 1:1 instruction can be feasible at all times for a student in a general education classroom with 1 teacher and 20-30 other students, but if that is what that student requires, perhaps it is not their LRE. It all goes back to the individual, finding out what services are essential for a student, aligning those with the possible supports available in each setting, and determining from there what their placement should look like.

This all sounds very straight forward. Services needed = appropriate placement. Your child is struggling with reading and it is impacting his learning in all of his classes, perhaps a smaller class for language arts with specialized instruction or access to a resource room teacher would suffice. But for just a moment, let's think about a student whose needs are less cut and dry.

Let's look at a child with autism. Perhaps academically your child can hold his own, whether it be in a general education classroom or an inclusive setting where some degree of specialized services are provided. Is that classroom also able to provide for the the social, communication/language, and behavioral needs of your child? Should it be? What is the least restrictive setting for someone who can do the work but cannot express himself? Well we need a whole new scale to balance this one... because academic progress is simply not enough for this child.



There really is no perfect answer here. Of course it seems easy enough, that educators at every level should be able to provide social skills instruction or at least guidance, should be able to evoke language and should be able to provide reinforcement based behavioral supports for any student. And yet it isn't that easy. Without the proper supports, knowledge base and training, providing adequate supports to a child with autism in any setting is a challenge. Does this mean that because your child has autism he should only be instructed in a specialized setting regardless of his academic, social, language, and behavioral needs and abilities? Of course not. This simply means that schools will need to start bringing in the supports for their educators, setting up social skills training groups, providing access to highly trained specialists who can work individually with students as well as teachers. There is a wealth of knowledge, and a large research base which tells us exactly how to teach a child with autism, and there are many people with the training required to help these students succeed. The least restrictive environment for a student with autism may just be a general education classroom where the teacher has access to a Board Certified Behavior Analyst who can provide support, training, answer questions, etc. Maybe it's not. Perhaps the behavioral challenges or communication deficits are so great that they require more intensive services. It is all about the individual. And it is all about needs versus feasibility. There is no reason to say that a child with autism cannot find an educational balance just like any other student.

We just need a different scale.

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Be Thankful (And Prepared!)

Holidays can be hard for families of individuals on the autism spectrum. The change in routine and lack of structure/predictability for starters is enough to cause some serious difficulties. Add in less familiar foods, locations, and people... not to mention potential crowding and noise? You could really have a disaster on your hands! This is coming a bit too late for Thanksgiving (since your celebrations are likely already under way!), but you can take advantage of the gathering to capture photos, videos, and even begin to solicit help from your family and friends in preparing for your next holiday.

Holidays may not have to be quite as difficult if you take some precautionary steps (Disclaimer: some of these may take a bit of time and effort to complete/achieve but remember 1. There are likely MANY people who would love to help you with this, just ask family members, friends, and your child's teachers or other service providers to take part in this! 2. You can re-use the same materials each year, and some of the materials can be used for multiple holidays with a few tweaks!).

Some ideas to help everyone get through the holidays with a few smiles (or at least a few less tears):

1. Using Schedules: You know your son/daughter relies on following a structured routine and the holidays are difficult since they interrupt the regular routine. Solution? Create a holiday routine! You would be amazed what a simple written or picture schedule can do for some children. Break down the day into clear activities, but allow yourself some wiggle room (avoid having a start time if it cannot be guaranteed).

2. Going Beyond Social Stories: Social stories are used for many things, though they are not fully supported by research when they stand alone, they can still be a useful tool for showing our loved ones on the spectrum what to expect during out of the ordinary events like holiday celebrations!
How to personalize your holiday story:

• Use photo books: Create a book your child can look at which will tell them exactly what to expect and remind them of what fun things will happen. The book can start off with a calendar which counts down the days until the event, then a picture schedule which shows what will occur on the day. Break down the steps of the schedule and include photos of your child whenever possible (try to catch them when they're happy, if you can't take pictures of familiar and preferred people who are!) Each schedule item can have it's own page(s) with photos and a brief explanation of the task and any expectations on the part of the student (e.g., We will drive to Nana's house. Nana's house is far and I will be in the car for a long time. I can bring my favorite books, movies, and snacks for the car ride. I will keep on my seat belt the whole time and everyone will be so proud of me! etc.) Whenever you can try to involve your child in creating the book, they can help write the text, decorate, etc. Making this process a fun one and associating the book and the holiday with something fun and rewarding will be a step in the right direction!
• Use videos: Some children with autism prefer watching videos to looking at books/pictures and creating a home video for them to watch could be another great tool (or you could do both!) Some ideas for this include: Having a "mock party" and video taping you and your child walking through all the steps of the day. OR having a favorite family member tape brief clips of themselves (and your child during times when he/she is happy - let's try to capture smiles rather than tears for the purposes of this video) going through each step of the "schedule."

3. Building in Choices: If there is something you are dreading or unsure about, don't you remind yourself of ways you can make it better if necessary (e.g., bring your favorite dessert, sneak off to make a phone call, go out with friends afterwards)? Well same goes for our kids of course! Allow your child to help choose the music, the seating order, etc. The types of choices which will be meaningful to your child will vary of course, but don't forget this is their holiday too :)

4. Build in Breaks: Some children may need time away from the crowd/stressful event and that is OK! Perhaps they can go for a walk with a favorite relative, have a short movie break in an isolated room, etc. You know your child, help make this day successful for them by giving them what they need (or they may just find a way to make it known and get it anyway and their way may be less preferred for you...).

7. Have Your Child Actively Participate In The Day! Making the day special for everyone is so important which goes hand in hand with building in choice making opportunities! This can include having them help prepare meal or dessert items, having them create special gifts or cards for family members they can pass out (and receive lots of social attention for!), give your child jobs throughout the day (some which tie in social opportunities and others which allow for breaks from social interactions), etc. There is so much to do, why not show your child how important he/she is?

8. Preparing Your Family: Your families are undoubtedly always looking for ways to help, but may not know exactly what to do. This often looks like: a well intentioned family member who does EVERYTHING for your child even if he/she can do it independently, guessing what your child wants rather than expecting language, reinforcing behaviors you are looking to extinguish, etc. While it can be incredibly frustrating to have others "sabotage" your efforts with your child, just remember they have the best intentions any may simply need your help discovering what to do. Send out a mass email to all your friends and family who will be attending the party which includes information about what they can expect to see from your child, what to do/not to do, and let them know what you need from them. They are in your lives because they care about you and your family, help show them how to put their good intentions to good use! (Don't forget to tell them something your child loves that they can do to make them feel special and pair that person with reinforcement ... it could be as simple as a preferred greeting or handshake, a topic they like to discuss, etc.)

9. Preparing Your Child: You've done all this leg work for this specific day, what else do you need to do?

• Work with your school or other service providers to develop social skills for interacting with family members. Some important ones: having a conversation, taking turns, waiting, playing a game with others ... there are SO many social skills we each use during any gathering, but try to give your child a head start with some pre-celebration training if it hasn't already taken place.
• Build in opportunities throughout the year to show your child that schedules can change, that sometimes the answer is no, and that they will be OK! Help them develop adaptive skills for communicating their wants, needs, frustrations, fears, as well as coping skills for self soothing and calming then assist them in applying those skills when things change or do not go their way. Bring your concerns to your teacher/service provider to help them ready your child for "real life."

10. OK, it's the day of... Now what?!

• Bring comfort items, your holiday video/ social story/ schedule.
• Run through the expectations with your child.
• Bring your camera and get more evidence that holidays are fun so you can convince your child next time if needed!
• Keep calm and remain positive to show your child this is not a stressful day!
• Hope for the best and try to enjoy your day! Accept the little victories and use the challenges as learning opportunities for yourself, your child, and your family.

I'm sure I've said this too many times already in my other posts, but since every person with autism is so different, just remember that these are simply suggestions and that they may help some of your children more than others, and some of these suggestions may not work at all for your child! The important thing to do is to look at how your child is currently participating in holidays/celebrations, identify the challenges and start there. Find out how to make those challenges easier, how to avoid them altogether, or how to teach your child to cope with them. Remember, you are not alone so don't forget to ask for help!!

I hope you are all having a wonderful Thanksgiving and best wishes to you all!

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Curriculum? Benchmarks? How do you plan ahead when every student and every day is different?

There is a saying; if you know someone with Autism... you know one person with Autism. Plain and simple. Are there common characteristics which can be observed? Of course, otherwise there would be no way to determine the diagnosis. However making any generalized statements about what individuals with Autism need (unless they are extremely broad and/or basic such as: individualized instruction, social skills training, speech and language therapy and/or instruction, etc.) is generally inaccurate and at times could even be called inappropriate.

Here's the thing: if I make a statement such as "students with Autism are great at math because it is very logical, concrete, and the rules are constant," some people would say "Yes, that is my child/student," while lots of other parents and/or teachers would find that to be the opposite for their child/student. We simply cannot make these types of claims as educators and professionals in the field because no two individuals on the spectrum present with the same needs.

Now, to get off my soapbox and back to the topic at hand...

The fact that our students with Autism have more differences than similarities, leaves us as educators with a predicament. How can we establish a curriculum to be used for our classroom, school, or program in general if all of our learners have different skill sets and needs?

Could we create a very basic functional curriculum which would allow us to teach students the skills they absolutely need (e.g., basic functional math, reading, and writing skills, a range of basic to advanced language, communication, and social skills, self help and daily living skills, job readiness skills, etc.)? Well we could try, and yet we would need to find a way to account for how different even those "basic skills" would look for each child, and determine how much or little each skill would be broken down within our set curriculum.

Let's take the skill of brushing your teeth for example. Well, first we need our baseline, determining where we are starting. Some students may refuse to allow a toothbrush or toothpaste in or around their mouth. Some students may consume large quantities of toothpaste. Some students may perform the sequence but do so without applying adequate pressure needed to effectively clean their teeth. Other students may only thoroughly brush some areas within their mouth or brush all areas but for too short a time. Others still may perform the whole sequence, but forget to clean up the materials afterwards and leave toothpaste residue on their mouths. In considering this comprehensive curriculum you are writing, let's select just one of these above listed skills to target and see how it can be broken down.

Tolerates and complies with an adult brushing their teeth.
Within this "skill" here are some of the considerations and possible variations and sub-skills:

• Remaining seated for 2 minutes (or standing appropriately at the sink/in the bathroom for the same amount of time)
• Following verbal directions related to brushing teeth (e.g., "Open your mouth," "Spit," "Turn your head,"etc.)
• Tolerating toothbrush without toothpaste near face/mouth
• Tolerating toothbrush without toothpaste in mouth
• Tolerating toothbrush without toothpaste on tooth surface
• Tolerating brush in mouth with flavored toothpaste (use a shaping procedure for beginning with a small amount and gradually building up to whole length of bristles)
• Tolerating toothbrush in mouth with any toothpaste 
• Note: This is not an essential skill, as flavored toothpastes still provide the benefits of oral hygiene. If this skill is worked on, it may be better to do so once the individual is further along and is already brushing his/her own teeth.
• Tolerating brushing one surface x amount of times or for x seconds
• Tolerating brushing all surfaces x amount of times or for x seconds
• Note: these next two sub-skills are optional, the same benefits could be acquired using a mouthwash.
• Tolerating toothbrush on tongue
• Tolerating brushing tongue x amount of times

So, there we have it, that is how one skill could be written into your curriculum in a comprehensive manner so it can meet the needs of most of your learners. The problem? It is still only addressing the needs of most but not all learners. It seems an impossible task to develop a truly comprehensive curriculum for individuals with this spectrum disorder, why? Because there is a wide spectrum of needs as well.

So where does this leave us? There are plenty of options and here are a few; you could instruct without a set curriculum and just make individualized educational decisions every step of the way, you could use assessments for each basic skill as a way to develop an individualized curriculum, or you could choose to create a set of curriculum as your guideline allowing for goals to be added or skipped over for each learner as appropriate.

Beginning my own Autism Spectrum Disorders high school program this year, I have been faced with this dilemma, and to be honest, over the last 3 months I've tried each of these options. Ultimately I've decided that writing up a curriculum checklist with as much detail as I can have and creating blank "extension" charts where I can add on additional skills to each instructional area is the best way for me to ensure that I'm taking systematic and logical steps toward long terms goals. It's also the best way for me to stay organized and keep a running record of skill acquisition for each of my learners.

Below are a few samples of the curriculum checklist I have been developing:

Sample page from Functional Math Curriculum

Sample skills from Money Skills section of Functional Math Curriculum

Considerations:

1. Don't reinvent the wheel. There are lots of wonderful resources, programs, and sets of curriculum out there which you can reference in creating your own!
2. Try to avoid establishing "levels" of learners and grouping skills based on those levels. Each student progresses in a different manner and with the likely reality of splinter skills, you will still be unable to compare your learners as they may have high/moderate/low level skills in each area. It is often best to just sequence the skills based upon which is a prerequisite for the next skill.
3. Don't ever be "finished." Like anything else in the field, this should be an ever growing-changing document which you improve as your knowledge base grows.

Have any of you had success writing their own curriculum for teens or adults with Autism? Please share your tips :)

Happy curriculum writing everyone!

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Changes, Why WOULN'T this be hard??

Do our students need to be more flexible? Or do we?

Very often when we discuss challenges faced by individuals with Autism, we note rigidity and the need to adhere to a strict schedule or routine. Is this the truth? Yes, this is an ENORMOUS challenge for so many children and adults on the Autism Spectrum. But really... how many typically developing people do you know who react favorably when they have a sudden disruption to their plans?

Perfect example:
Yesterday morning I arrive to work slightly later than anticipated (Hint: setting event... I'm already stressed), as I walk up the steps to the high school I scroll through my email and BOOM. Our principal has emailed the entire high school announcing a training for the afternoon. Hold on...I didn't know about this training... I thought we had parent conferences again today!? Wait, did I get the dates wrong and schedule parent appointments for the wrong day??  This parent had a very specific schedule and we struggled to fit her in, I can't believe I did this!

Ok, so here we have it. Clearly not a calm, rational, flexible response to a sudden change to my perceived schedule for the day. Opposite really - full on panic, frantic, disorganized thoughts about everything I had to do to fix this. I mean no, I didn't throw a chair, hit my head on the front door, or even run screaming into my principal's office, but I was not responding well to this disruption, even though it was the way most people I know would... and the way many of my student's would. (In the event that you are interested, everything worked out, the email was not intended for the entire high school faculty, phew!)
So we have established that accepting changes to our schedules, routines, and plans are generally not preferred for most people. Still the question remains, are we being too rigid and holding our students with Autism to a higher standard than we hold ourselves?

Here are two things to consider:

1. Above I mentioned some of the behaviors I did not display, property disruption... aggression... self injury ... throwing a tantrum in the main office... that's where the problem really lies. Yes, many of our students with Autism may be reacting in a very typical manner to a major change by becoming upset or stressed, but what happens next, engaging in maladaptive behaviors as a response to these changes or emotions, that is why it is a "big deal" that our students are rigid and that is where our efforts need to be focused. Generally people learn different strategies to manage their emotions, stress level, and are able to regulate their emotional responding as a result. However, someone who lacks the communication skills I had when I asked my principal for clarification about the training email, or who is unable to develop or research coping strategies and put them into practice in times of distress really won't fare as well. These are the kinds of skills we need to assess and teach early on. Don't wait for a problem to arise before teaching students to request help or clarification, to express their frustration or other emotions appropriately, or relaxation strategies for times of need! Some of our learners may need support in identifying when to use these new skills (though ideally you are teaching them within the correct context) so be prepared to give that support through visual cues and reminders!
2. The change I described above, was kind of a big deal for me. It would have entailed quite a bit of work for me including contacting parents, rescheduling meetings, etc. not to mention that phone calls at 6:30 am to reschedule a meeting for later that day would probably not be well received and let's be honest, no one likes getting yelled at... If I had described an example where someone else took my unofficial, self-assigned parking spot, or where someone switched all of my pens from black to blue (Note: I have a very serious distaste for blue pens so I would NOT be happy about this), then a panicky reaction would be much less typical or appropriate. Or if I said my principal emailed us in the morning and said there was a special surprise breakfast for staff or we did not have to arrive until 12pm, most of us would be pretty excited, there would be no panic, no frantic thoughts. For our students, starting work at 8:07 instead of 8:00 or having a different breakfast...these minor changes or even in some cases favorable changes, they are met with the same degree of rigidity, the same level of agitation, and often the same display of maladaptive behaviors.

As you can probably tell this is a topic I could seriously write a book about... There are so many types of challenges, warning signs, approaches to interventions, etc. and it really can't all fit into one blog post!

Sample page from my upcoming curriculum!

However, the key points are:

1. GET SOME DATA!!! I'm working on creating an assessment tool for Accepting Changes, Delays, etc. It's still a work in progress but look for it in my TpT store soon! But seriously, write down what the change was, other possible setting events or environmental factors, the method of communicating the change, how much warning was given, and exactly what the student's response was (not to mention what your response was afterward). This will all be very useful to you in determining your next steps.
2. Remember that like any other time you are assessing or treating an individual with Autism, any approach you take should be one geared towards that specific learner's needs and with their safety, and well-being in mind!
3. Let's not call it sabotage... but really you should plan for changes and disruptions to your routine! By incorporating these changes naturally, preparing your learners for truly unplanned disruptions, and providing yourself with opportunities for observation and evaluation, you will be on your way to helping students become more flexible, as well as finding out sooner (and within a controlled, safe setting) rather than later if deviating from the routine is problematic for your learner.
4. (Seriously do this one!) Before you move forward with any type of intervention or even more systematic assessment, just think: Would I or another person without a disability respond that way? How would it be the same/different? What is it about this learner's response that needs to be addressed? And finally: Who is being too rigid, Is it the student.. or is it me?

Have a wonderful weekend everyone, and I hope there are no traffic jams, unexpected storms, or other undesirable changes to your plans!

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Happy Friday (The Saturday Morning Edition)

Whew, what a Friday! Our first Community Based Instruction outing, first High School Pep Rally, best day ever :)

If you have ever taught, raised, met someone with Autism, you know how many challenges you face entering an unstructured setting filled with the unknown. The "unknown" is pretty terrifying for us educators, service providers, family members... We are the best planners really, always making lists, schedules, visual aids, social stories and videos, making sure we know the best ways to get in and out, going to the setting in advance to prepare ourselves and our children/students for possible challenges and triggers. But we can never fully prepare for an outing, for a stop somewhere outside of our controlled environments. There are many unknowns...

"Will it be noisy?", "Will there be a crowd?", "Will there be small children or infants nearby?", "Will someone approach my child/student?", "Will my child/student wander off?", "Will we have to wait long?", "Will there be a traffic jam?", "Will we have to drive a different route?", "Will everything we planned for be available, or will something be missing/broken/out of stock?"...

"What will I do if something doesn't go according to my plan?"

Despite the stress and challenges we face as the planners, we need to remember to pack that up silently and be our most enthusiastic and positive selves for our kids. Never underestimate how your own worries and stresses can impact them. If we create a fearful, stressful environment that can increase anxiety for our perceptive learners. Parents know this better than anyone, it's truly amazing to watch a parent put on their brave face when walking into a challenging situation, knowing well the emotions happening inside of them.

One of our biggest fears as planners, is that we will miss something, something will go wrong and there will be a meltdown, and people will not understand. Over the years I have run into this often, but for every 9-11 call, judgmental onlooker, unsympathetic comment, threatened lawsuit over an exploding container of cottage cheese, there are those few understanding strangers who offer their help, move others out of the way, or even just pretend nothing is happening as you carry a crying child/adult through their checkout aisle, not to go unmentioned are the store managers who order a clean up of the crashed olive oil display case and refuse any reimbursement for their damaged products.

Through it all we know how essential these experiences are, for our learners and children to become members of their communities, to open up their worlds..

Yesterday? One of those great days where all the planning paid off, all the unknowns turned into positive experiences, a success over all :) Not only did we have a wonderful outing and make a few new friends and connections in our local shops and library, but later we conquered my greatest fear - a pep rally with 1,800 students attending! Our boys cheered on all their classmates, one student even gasped and cheered through the suspense of the egg race! We even had our first PBSIS winner with a CiCis Pizza gift card :)

Fantastic Friday, and looking forward to a restful weekend (full of course of developing programs, data sheets, materials, and plans for the upcoming week)!

Never forget the days that go well, when we are pleasantly surprised. Never let the days that don't go so well deter you from making some changes and trying again.

Best wishes all, and as always if you need any suggestions please feel free to comment or email me directly!

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Don't underestimate these teens!

As some of you may have read, I have recently started a BRAND NEW self-contained Autism classroom in a public High School. Fitting into a school with 1,800 students has certainly been a challenge for myself and my students. Loud, crowded hallways, lots of unfamiliar faces, a giant maze-like building, and of course SO MANY anxiety-provoking changes to our routines since we are all arriving to the school for the first time.

In spite of all of the challenges, there have been so many amazing victories! While my boys are thrilled each time they make a new adult friend around the building, the days that I count as victories are those in which other students make an effort to get involved with our classroom. So far we have had 3 wonderful victories:

1. Two High School seniors have socialized with and eaten lunch with our students at least once per week since the second week in school :) and P.S. this is seriously ALL my boys chat about when they return to class. Little charmers constantly updating me on who is the prettiest girl they saw in the lunch room, who they "almost love like a girlfriend," and which girl gave them a high five in the hallway!! Love them!
2. I have been interviewed on three occasions by members of the school paper, two of the interviews have been with the same student who told me helping my students fit in is a task "near and dear to his heart!" This student has since coordinated with myself, two other teachers of special needs classes at the High School, as well as our principal to begin setting up a Buddy Program (all his idea)!
3. Today, following a meeting with my case manager, I reached out to various arts and music teachers to find out if anyone could help me find students who may be interested in doing some fun, artsy groups with my boys. BOOM! Before I knew it one teacher tracked me down with a previous student of hers looking to make a difference during her independent study. She completely blew me away with her enthusiasm and intuition into helping learners with special needs despite no previous experience! Such a wonderful day to be in public education :)

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Welcome :)

Hello everyone!

I'm so pleased to welcome you to my new blog: Autism, the Teen Years.

I have been working in Special Education, teaching adolescents and adults with Autism for the last 8 years. Like many people I know, these students have truly changed my life. My Mother was a teacher, so naturally I grew up knowing I would never become a teacher (let's be honest... what teenage girl really wants to turn into her mother? Mom - I love you and of course I want to be just like you now that I'm a little wiser!) In my junior year of college, after the shoe store I worked in closed and I sought out some practical experience in the social work world (one of the many careers I dabbled in throughout college) an experience in a center for children and adults with Autism opened my eyes and my heart to exactly what I had been searching for.

After 8 years in a specialized setting, I took on a new challenge and fantastic opportunity to start a new self-contained Autism Spectrum Disorder program in a public high school. Truth? Changes to our routines are pretty terrifying for everyone, not just our kids... Luckily for everyone I've been relatively melt-down free so far :)

Anyway, so welcome to my page. Over the years I've had many challenging, comical, and rewarding experiences with  my students, their families, and my many interesting colleagues (again, we should probably be honest and say many of us in the field are as quirky as they come... quirky and awesome of course). I can't wait to share my stories with you all and hope that some of my posts can help you in your own experiences as well.

Look for my next post coming VERY soon!

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