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OSERS. Office of Special Education and Rehabilitative Services. Disseminating Effective ABA Training To Parents Of Children With Autism In Geographically Remote Areas. Linda Heitzman-Powell, Jay Buzhardt, Lisa Rusinko, Josh Turek, & Sylvia Maack University of Kansas Medical Center

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Presentation Transcript
slide1

OSERS

Office of Special Education and Rehabilitative Services

Disseminating Effective ABA Training To Parents

Of Children With Autism In

Geographically Remote Areas

Linda Heitzman-Powell, Jay Buzhardt, Lisa Rusinko, Josh Turek, & Sylvia Maack

University of Kansas

Medical Center

Juniper Gardens Children’s Project

NARRTC 2010 Annual Conference

Alexandria, VA

NIDRR

National Institute on Disability and Rehabilitation Research

autism spectrum disorders
Autism Spectrum Disorders

Autism is a neurobiological disorder that affects 1 in 110 individuals, affects communication, socialization and behavior

An individual with ASD accrues about $3.2 mill. in costs throughout life (April, Archives of Pediatrics & Adolescent Medicine, Ganz; Science Daily, 2008).

Approximately 50% of children with ASD who are diagnosed early and receive appropriate treatment will mainstream in a public school setting without an aide.

When access to appropriate treatment is denied, only 2% of affected children will achieve this level of success.

barriers to treatment
Barriers to Treatment

ABA is currently the most effective treatment for children with Autism

Must be implemented with high fidelity

Over 59 million people live in rural/remote areas of the US alone (U.S. Census, 2000)

Over 20% of the population

Children in rural areas have Autism, too.

Autism is as prevalent in rural areas as urban areas (Montes & Halterman, 2006)

Trained ABA professionals are less accessible in rural areas than in urban areas

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OASIS Training Program

for Parents

Online and

Applied

System for

Intervention

Skills Training

slide5

OASIS Training Program

for Parents

Online Training

Applied Training

  • Introduce ABA concepts and principles through online training tutorials
  • Apply concepts through hands-on training during coaching sessions delivered via live interactive television (telemedicine)

Buzhardt, J., & Heitzman-Powell, L. (2005). Training Behavioral Aides with a Combination of Online and Face-to-Face Procedures. Teaching Exceptional Children, 37, 5, 20-26.

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Each module consists of:

Web-based activities

Telemedicine coaching sessions

Training covers:

Background information about Autism Spectrum Disorder

Basic ABA principles and procedures

How to collect and analyze data for data-based intervention decision making

How to work with treatment teams and other providers

OASIS Training Curriculum

online activities for each module
Online Activities for Each Module

Online tutorial

20-item online assessment

Daily completion of Problem Behavior Recording form

Weekly completion of Incidental Teaching form

telemedicine activities for each module
Telemedicine Activities for Each Module

Parent(s) bring child to local school, hospital, or community center that has Polycom video conferencing equipment

Review tutorial content, assessment, and answer questions

Review incidental teaching and problem behavior forms

Parent(s) practice ABA procedures described in tutorial with their child

Trainers provide immediate feedback and guidance

Each module has at least one parent skill assessment

Requires at least 80% mastery before moving to the next module

oasis evaluation
OASIS Evaluation
  • Research Questions
    • Can parents learn ABA from a distance with the OASIS Training Program?
      • To what degree do they gain knowledge about ABA principles and procedures?
      • To what degree do they make observable gains in implementing ABA procedures and teaching strategies?
      • To what degree do gains sustain over time?
evaluation design
Evaluation Design

Pre/post assessments across 6 families

Children between 2 - 5 years old

Within 6 months of initial ASD diagnosis

Summary of activities

1-3 initial baseline (pretest) skill assessments

KU Medical Center; 30 minutes

At least 16 weeks of training

Posttest skill assessment

About 2 weeks following completion of training

Follow-up skill assessment

6 months (5 completed; 1 next week)

1 year (1 completed)

evaluation measures
Evaluation Measures

Knowledge gains

Posttest performance following each tutorial

20 items

Global pre- to posttest performance

48 items, 6 selected from each module

Skill gains

Demonstrate key skills in each targeted area

Total of 47 key skills across all areas

Assessed during sessions and at baseline, posttest, and follow-ups

Same assessments administered at baseline, posttest, and follow-up

do parents improve their implementation of aba procedures and techniques with their own child

Do parents improve their implementation of ABA procedures and techniques with their own child?

How do those skill gains sustain overtime without ongoing training?

how much travel will be saved by using the oasis distance training model with 10 trainees
How much travel will be saved by using the OASIS distance training model with 10 trainees?

(957 x 2) x 16 sessions = 30,624 miles of travel

P6: [(259 x 2)16] *.55 = $4558 in cost savings

challenges

Challenges

  • Significant family commitment over a 16 week period
    • Weekly travel with child to telemedicine site
      • Arranging care for siblings
    • Telemedicine sites’ hours of operation
    • Frequent schedule changes
  • Coordinating with telemedicine site
    • Most sites not designed for intervention sessions
  • Occasional network problems
  • Maintaining long-distance contact with families over an extended period
future directions
Future Directions

Impact on child outcomes

Investigate implementation with other technologies

Common web-based video conferencing software (Skype, Ovoo, etc.)

Further reduce travel, family’s response cost, and coordination with telemedicine sites

Booster sessions for sustainability

Identifying strategies for reducing costs

Develop OASIS for multicultural dissemination

acknowledgements
Acknowledgements

Appreciation goes out to…

The trainers for their help in evaluating this training program

The children and their parents who participated

The funding agencies that have helped make this work possible: Johnson County Developmental Supports, the Sunflower Foundation of Kansas, OSERS, and NIDRR

Drs.Monika Suchowierska and Kenda Morrison who played an integral role in helping develop the original training program