Natural Supports for
People with Autism
Spectrum Disorder
Griffin-Hammis Module
Participants
Does anyone work with someone
you don’t understand?
What do you do about that?
Group Discussion
THE SOLUTION IS ALWAYS IN
THE PROBLEM
Who better knows the
expectations within the job…
An outside person or a
co-worker!
Key Questions
• What Are Natural Support?
• Why Would I Use Natural Supports?
• What is the Medium of Exchange for people
who are “typical” to connect with people with
ASD?
• Are you in, What do you need to know, and
How do we keep you coming back
• (Recruitment, Training and Maintenance)
Social Competency Research
• Students with adequate social skills are
more likely to have positive outcomes,
while significant social difficulties place
the child at risk for developing later
problem behaviors (Koegel, Koegel, &
Surratt, 1992).
• Venter, Lord, and Schopler (1992)
conducted a study of children with autism
and found that social skills during
childhood were strong predictors of adult
adaptive functioning.
Social Competency Research
• Educational programming for students
with ASD should include goals for
improving social skills with both adults
and peers (National Research Council,
2001).
EBP – HAVE TO USE
• Weiss and Harris (2001) refer to the
scarcity of research targeting social skill
development in adolescents and older
students.
– Many interventions targeting social skills
development have inadequately addressed the
social validity of outcomes.
Social Competency Research
• The more traditional approaches to teaching social
skills have not been highly effective as indicated in
a meta analysis conducted by Bellini et al., (2007).
(BRIAN)
• Many peer-mediated intervention programs are too
narrow in scope, such as the Circle of Friends
approach, to produce significant long-term impact on
participants.
• Efforts to successfully teach social skills to
students with ASD can be undermined by problems
with generalization to new settings, people, and
materials (Parsons & Mitchell, 2002; Zager &
Shamow, 2005).
What Does This Research
Mean To Us?
Social Competency and ASD
Research summarized by Rogers (2000)
indicate a shift in the field of ASD, from:
Adult-Directed Instructional Strategies
TO
Peer-Mediated Interventions
Numerous studies have demonstrated the
effectiveness of peer-mediated strategies to
facilitate social interactions.
Social Competency and ASD
• The National Research Council report
(2001) recommended that students with
ASD be taught skills in natural contexts.
• One suggestion is the use of multiple
peers in various settings to improve
generalization (Kamps et al., 1997;
Kamps et al., 2002).
LEARN FROM DISLIKE
Social Competency and ASD
Another suggestion is providing more
time for instruction and social interaction
with typically developing peers a strategy
that will likely result in both quicker skill
acquisition and better maintenance of
improvements (Strain, Kohler, Storey, &
Danko, 1994).
NOT COOL
Evidence Based Practices: Social Skills and
Peer Mediated Instruction and Intervention
“Peer mediated instruction and intervention
has been shown to have positive effects on
academic, interpersonal and personal-social
development and may be the largest and
most empirically supported type of social
intervention for learners with ASD”
(Bass & Mulick, 2007; Maheady, Harper & Mailette, 2001; McConnell, 2002)
Goals for Students with ASD
Socialization Skills
Independent Skills
Development of the Concept
Local School District - 7000 Students
40 Miles North of Detroit, Oakland County, Michigan
Center Program for Students with Autism
13 Local School Districts in Oakland County
Send Students to the Autistic Program
History of the Autistic Program
1987 - Elementary
1990 - Middle School
1992 - High School
1993 - Pre-Primary Program
1994 – 2nd Elementary
1996 - Post High School Program
1999 – 2nd Middle School
Full Continuum Concepts
• Break Card
• Modifications – Ed Strats
• Visual Supports
Two Things We Were Doing OK
• 4th and 5th Grade Students coming down
during indoor recess.
• Weekly team meetings…True Brainstorming:
all ideas are good ideas and the best idea in
the room stays on the table
Beginning Stages of Students
with Students
• Letter, Number, and Color Games
• Common Goal for both sets of students
• Reinforcing to both students with ASD and
general education students
• In beginning stages use food as a motivator
Two Things We Were Doing OK
• 4th and 5th Grade Students coming down
during indoor recess.
• Weekly team meetings…True Brainstorming:
all ideas are good ideas and the best idea in
the room stays on the table
Evolution of the Clarkston Autistic Program
Reverse Mainstream > > Moderated Behavior
Integration > > Behavioral Systems
Integration > > Academic Systems
Integration > > Socialization Systems
Reverse Mainstream > > Curriculum Makeover
Evolution of the Clarkston Autistic Program
Reverse Mainstream > > Moderated Behavior
Reverse Mainstream > > Curriculum Makeover
Integration > > Behavioral Systems
Integration > > Academic Systems
Integration > > Socialization Systems
The LINK Program
•
1990 – 17 Study Hall Volunteers
•
2002 – 800 General Education Students 72 Students
with ASD
•
Utilizing the Most Appropriate Resource in Public
Education to Teach Social Skills to Students with
ASD
Post High School Video
• Use to educate potential job
placement staff
• Assist parents in understanding
ultimate goal of the program
• Creates common understanding
about ASD and the workplace
Post High School
Vocational Placements
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Oakland University - Library
ACO Hardware
Independence Township Library
Bank One - Clarkston
Dunkin’ Donuts
Subway
Post High School
Vocational Placements
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•
•
F.Y.E. - Great Lakes Crossing
Target
OATS Horse Farm
C.C.A.
William Beaumont Hospital
The Greenery
Overtyme Restaurant
Goals for Students with ASD
Socialization Skills
Independent Skills
Two Ways to Address
A Socialization Deficit
• Utilize social skills curriculum to teach isolated
social skills to students with autism spectrum
disorder in specific settings and then practice
isolated skills in a generalized setting.
• Teach general education students about autism
spectrum disorder and specific information about
students with autism spectrum disorder in their
building. Develop tolerance and acceptance
within the general education population.
Students with autism spectrum disorder will then
be able to practice social skills in all settings
within the building gaining competency in natural
environments.
Peer to Peer Support Programs
Teach general education students about
Autism Spectrum Disorder and specific
information about students with autism
spectrum disorder in their building. Develop
tolerance and acceptance within the general
education population. Students with autism
spectrum disorder will then be able to practice
social skills in all settings within the building
gaining competency in natural environments.
Medium of Exchange
How to connect the typical person to
the person with ASD?
Definition of Medium of Exchange
• The medium of exchange is any material,
task, prop, interest area, etc. that connects
a person with ASD to a typical person
• Typically the medium of exchange is
something that does not require language
for the connection or interaction to occur
Medium of Exchange
Material
Person with ASD
Typical Person
Medium of Exchange
Rain Man Example
• Creating Connections
• Medium of Exchange as an Avenue
for Opportunity
• Organizing the Person with ASD
• Realization of Skills and Where
they fit within the Community
Available to the Person with ASD
Examples of Medium of Exchange
•
•
•
•
Work Talk
After Work Activities
Encyclopedic Interests
Computer Interests and Related
Technology
• Bowling and Other Leagues
• WII
• Intense Interests
The STATE of Michigan
Most Bowling Leagues
What Connects You with
Other People?
What are your
Characteristics/
Interests?
What
is the
Same?
What are
Characteristics
Interests of a
Significant
Person in your
Life?
This is the Concept of Medium
of Exchange
What it is for you is what it is
for the person with ASD
Connecting with Other People…
Isn’t That What This Is All About!
Medium of Exchange
Verbal Fascinations
• Movies - Matt
• Nose Game – Robert
• No Pink – Robert
Awakenings
Medium of Exchange
• Try to discover the interest areas of the
people with ASD to develop mediums
• Motor Planning and Organization
• Staff and Natural Supports may need to
initiate the medium in the environments for
Person with ASD
• Staff and Natural Supports are excellent
resources in developing new mediums
Care for the Person
Respect for the Disability
Natural Support Benefits to People
with ASD
•
•
•
•
•
•
Socialization Opportunities
Work Place Norms and Expectations
Independence
Larger Support Network
More Models of Work Tasks
Others Noticing Subtle Changes to the
Environment
Peer to Peer Benefits
Natural Supports
•
•
•
•
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Organizational Skills
Problem Solving Skills
Connection to Employment
Diversity
Responsibility
Collaboration
Self Esteem
Reciprocal Benefits
1. Opportunities for learning in
both populations.
2. Growth occurs in both
populations.
3. Cost effective and productive.
Questions or Concerns about
Medium of Exchange
Determine a Medium of Exchanges for the
Students You Work With
P.O.C. – 20 Minutes
Recruitment of the Natural
Supports
Do I Have to do This or Worse are You
Going to Make Me Do This?
My Plate is Full and How Will this Help?
Steps for Recruitment
• Provide information about ASD and
specific people with ASD in the job to
other people
• Provide interested volunteers the
opportunity
• Organize and schedule the natural
supports throughout the day
Peer to Peer and Other Natural
Supports Recruitment
• All People Make Great Supports
• After-Work Activities
• Management Involvement
• What can this help us with? Will this move
me forward in the organization?
How and Where Do You Find
Natural Supports for People with
ASD?
How and Where?
Observation of Environment
Staff Meetings
Participation in Peer to Peer Support
Programs During School
Ask for Volunteers
Find the Co-Workers Looking for a Challenge
Get a Commitment Agreement
Questions or Comments about
Recruitment of Peers or Other
Natural Supports?
Where will your team recruit natural supports?
POC – 15 Minutes
Natural Supports Training
Natural Supports Introductions
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•
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Natural support’s name
Natural support’s hours of employment
Hobbies
Family members
Why they want to be a natural support
for people with ASD
Group Discussion about Autism
Spectrum Disorder
• Ask the natural supports what they
know about Autism Spectrum Disorder
• Write ideas on the board
• Engage natural supports in discussion
about ASD
Information About ASD
• Approximately 1 in 110
• Rapidly Increasing in Numbers of Students
• 4 times more common in males than
females
• Cause is Unknown
• You are born with autism spectrum disorder
• You can’t catch it
Autism and Idiosyncratic
Behavior - Rain Man
• Over-reaction to changes of schedule
• Personal Property is Valued/Obsession
• Material Organization is more important
than Object/Material
• May use idiosyncratic speech
Characteristics of ASD
• Social Skill Issues
• Communication
• Intense Interests and Repetitive
Behavior
Characteristics of ASD
Social Skill Issues
•
Peer Relationships
•
Sharing Information
•
Misunderstanding of Social Situations
•
Reciprocal Social Interactions
Characteristics of ASD
Communication
•
Verbal and Non-verbal
•
Talk about Interests
•
May not seem interested in what
others are talking about
•
May say inappropriate words
Characteristics of ASD - Intense
Interest and Repetitive Behaviors
•
Intense Interest in Certain Topic
Areas
•
May Like to Do the Same Thing Over
and Over
•
May Like Things to Stay the Same –
Difficult with Transition
Strategies that Work with People
with ASD
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Visual Supports
Communication Systems
Self Management Systems
Case Conference (Team Process)
David’s Yes/No
Communication System
Yes
No
Ryan’s Communication
System
Food
Drink
Bathroom
More
Help
Other
Break
Yes
No
Natural Supports and Case
Conferences
• Weekly or Monthly Meetings
• Problem Solving Focus
• May Include the Person with ASD
• Teaching Support Strategies in the Case
Conference that will Generalize to the
Work Environment
Case Conference
Information Sheet
• Each staff fills out the sheet at the
beginning of the case conference
• The facilitator collects the sheets
and determines if there are any
patterns in the answers
• The information from the sheet
generates the discussion using the
board
Case Conference Information Sheet
You do not need to put your name on this sheet. This is an
information sharing sheet used to enhance the information presented
during this case conference
Please answer the following questions as openly and honestly as
possible. If you do not have an answer or if you have an answer but
it is hard to put into words just do your best.
1. The best experience with (Student with ASD) this month is when
___________________________________________________
___________________________________________________
2. Something I wasn’t sure how to handle this month was ________
____________________________________________________
3. I was frustrated by (Student with ASD) this month when he/she
____________________________________________________
4. The biggest accomplishment that (Student with ASD) made while I
was supporting him/her was _____________________________
____________________________________________________
5. The biggest accomplishment that I have made being a (Peer to
Peer Support) is ______________________________________
6. Are you interested in continuing to be a (Peer to Peer Support)
Yes No If yes, which student would you like to support________
7. What three suggestions would you give to the (Peer to Peer
Supports) supporting the (Student with ASD)
____________________________________________________
____________________________________________________
____________________________________________________
(Give the students directions about where to put the sheets when
completed. Ensure confidentiality.)
Case Conference Mechanics
and Outcomes
• Utilize meeting mechanics – always use
the board
• Positives – Concerns – Brainstorming
• Information from the board is written on
the Case Conference information sheet
• Copies are made for each staff member,
person with ASD, and parent or guardian if
appropriate
In an effort to keep the parents, staff and peers students informed
of the effective strategies that work for (Student with ASD Name)
had a case conference on (Date
)
Some positive things discussed about (Student with ASD)were:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Some concerns that were raised about (Student with ASD) were:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
The action plan to resolve the concerns for (Student with ASD) is:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
If you have any questions or concerns please contact caseload teacher
_______________________
(Staff Person’s Signature)
______________________
(Date)
Utilizing MRS and Transition
Coordinators as Facilitators of
Work Place Case Conferences
The Change Has to Happen
Maintenance of the Peer to
Peer and Natural Supports
Have you ever volunteered for
any organization?
What made you continue to
stay with volunteering?
Group Discussion
Natural Supports
Maintenance
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Employee of the Month
Work Talk
After Work Celebrations
League Opportunities
Fantasy Football
Sports Pools
Lotto Pools
People with ASD must be Approachable
• Socially Appropriate Dress
-Barbie Boots
-Jelly Bean Jogging Suit
• Behavioral Issues
-Stereotypical Behaviors
• Social Issues
– Picking Nose
– Spitting
The Network
• Do the natural supports go beyond
the work environment?
• Personality of the Person with ASD
• Climate of the Employment
Community
• Dan and the Casino
• Ryan’s Party
Develop an On-Line LINK
Social Network
• Track Graduated LINKS
• Allow Networking Between LINKS
• Post Opportunities for Graduated LINKS by
RCN
• Provide Parents List of Graduated LINKS
by RCN
• Social Network will be Hosted by a Person
with ASD
Imagine the Possibilities
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Co-Workers Understanding of ASD
Community College Opportunities
University Opportunities
Semi-Independent and Independent Living
Arrangements
• Social Opportunities
• Community Opportunities
To Date…Over 200 Formalized
Peer to Peer Support Programs
In Michigan
The Power of Natural Supports
Summer 2012
Work Experience
Student with ASD
Natural Support
Natural Supports – Two Powerful
Forces that Affect the Success
1. Features of Naturalness – Gain
Access
2. Individual Needs – Assure The
Needs of the Individual are Met
Marc Gold & Associates
marcgold.com
7 Phase Sequence for Balancing
Naturalness and Individual Needs
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Determine Natural Ways
Determine Natural Means
Identify Natural People
Facilitate Successful Performance
Support/Substitute for Natural People
Suggest More Effective Natural Means
Adapt/Modify Natural Ways
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Determine Natural Ways
• Methods of Performance for Targeted Job
Tasks
• Step by Step Procedures
• The Culture of the Workplace
• The Manner in Which Workers Interact
• The Managerial Style of the Setting
• All Other Natural Features which Describe the
Unique Characteristics of Performance and
Behavior Desired by the Employer
Marc Gold & Associates
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This Phase is Crucial…
1. Information for New Employee to Fit In
2. Easier for Supervisors and Co-Workers to
Provide Assistance and Troubleshoot
Problems Due to the Similarity of
Performance
Marc Gold & Associates
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Purpose of Socialization as an
Instructional Variable
• Modeling
• Participation
• Social Learning Theory
Social Learning Theory
Albert Bandura
• Attention
• Retention
• Reproduction
• Motivation
Determine Natural Means
1. Ask the Employer to Describe the
Procedures Used
2. Observe Teachings Done by Employees
in the Setting
3. Ask to be Taught How to Perform the Job
Task by the Persons Who Would
Naturally Assist the Jobs to be Performed
Marc Gold & Associates
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How Did You Learn How to
Write an IEP?
Identify Natural People
• Identify and Enlist the Natural People
Who Typically Support New
Employees to Perform Their Jobs
• Most Novel Aspect of the Natural
Supports for Traditional Providers of
Supported Employment Services
Marc Gold & Associates
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In the Past…Job Developers
Often Promised Employers…
1. Job Trainers Would Provide all the Assistance
Necessary for Successful Performance
2. They Would Have No Investment in the Initial
Training or Support of the Employee
3. Job Trainers Would Act as an Interpreter for
All the Information, Rules, Policies and
Activities
4. This Role Placed the Job Coach Between the
Employer and the Employee
Marc Gold & Associates
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Similar to Issues with the Overreliance on the use of
Paraprofessionals in the Schools
Unnatural dependence on
an adult not associated with
the environment
This Practice Resulted in
Isolation of Supported
Employees in their Own Work
Settings
Marc Gold & Associates
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Facilitate Successful Performance
• Initial and Ongoing Assistance to the
Supported Employee
• Job Developers(Facilitators) Must Now
Decide the Degree of Naturalness Which Will
Be Used for Initial Training
• Strongly Suggested…Unless There Are
Clear Indications to the Contrary, Natural
Procedures Be Utilized Initially
Marc Gold & Associates
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Strong Rationale For the Job
Developer (Facilitator) to Take Risk
Allow Natural Means a Chance to
Be Effective
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Dignity of Risk
Robert Perske
The concept of “dignity of risk” is we
allow our children, and ourselves, to
make choices and the accompanying
mistakes, failures… because this is
how we learn. This is how we build
our self-esteem and self-worth.
Our Dignity.
A Reasonable Trade-Off…
To Accept the Lessened
Performance Through Naturalness
Over That Available Through
Powerful Training Procedures
Marc Gold & Associates
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So Why Would This Be So
Difficult…
Constraints to the Initial Use of Naturalness
• Job Developer and Employment Facilitator
are Different People
• Impact of the Employee’s Disability
Requires the Facilitator to Model Effective
Techniques for the Natural Supporters
• Fragile Situations in Relation to Employer’s
Low Expectations of Success
• Modifications to Job Sites and/or Job
Stations
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Support/Substitute for Natural People
• Demonstrate a More Powerful Technique
• Negotiate a Time for Discussion and
Feedback with the Natural Supporter
(Case Conferences)
• Offer Training Formally and Informally
(Awareness of ASD)
• Shadow the Natural Support and Offer OnGoing Feedback
Marc Gold & Associates
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Suggest More Effective Natural Means
• Reconsideration of the Natural Means Used
by Employers to Teach and Motivate
Employees to Perform Their Jobs
• Teaching Style of One Co-Worker May Differ
Significantly from Another and Further Yet
from a Supervisor
• Consideration…Various Strategies Which
Seem to be Working and Who Uses Them
• Specific Suggestions to Specific Natural
Supports…Each Different
Marc Gold & Associates
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Again…How Did You Learn How
to Write an IEP?
Think about it…IEP’s are written
differently in different districts and
ISD’s. Why?
Adapt/Modify Natural Ways
• Decisions of Adapting, Modifying or
Negotiating for Flexibility in the Natural
Ways the Work Place Operates
• Considered Last Because They Are Often
the Most Consistent and Unchanging
Features of the Work Places
Marc Gold & Associates
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Job Analysis Process in
Supported Employment is a…
Human Service Activity Designed
to Assist Facilitators To:
Marc Gold & Associates
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1. Organize the Information to be
Performed by the Supported Employee
2. Recognize the Natural Ways, Means
and People Used by the Employer to
Typically Perform and Teach the Job
3. Develop a Plan for Balancing the
Natural Features of Support Available
at the Job Site
4. Form Relationships Necessary to
Accomplish the 7 Phase Sequence
Marc Gold & Associates
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Job Analysis Begins…
After the Employer Has Given
Approval for the Job to Begin and
Before the Supported Employee
Begins to Work
Marc Gold & Associates
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Why Would A Job Analysis Be
Performed By A Human
Service Provider?
At This Time, The Funding and
Responsibility for the Provision of
These Supports Rest with Human
Service Agencies
Marc Gold & Associates
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Summary
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•
•
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•
•
Medium of Exchange
Recruitment
Training
Maintenance
Staff Responsibility
Development of a Natural Support
System
Activities and Profile of Change
Thank You!
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