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Planning a Comprehensive Program for Students with Autism Spectrum Disorders Using Evidence-Based Practices

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Planning a Comprehensive Program for Students with Autism Spectrum Disorders Using Evidence-Based Practices Education and Training in Developmental Disabilities, 2007, 42(4), 398–409 © Division on Developmental Disabilities Planning a Comprehensive Program for Students with Autism Spectrum Disorders Using Evidence-Based Practices Brenda Smith Myles Barry G. Grossman and Ruth Aspy University of Kansas The Ziggurat Group Shawn A. Henry and Amy Bixler Coffin Ohio Center for Autism and Low Incidence Abstract: This article outlines two compatible models of planning and implementing programs for students with autism spectrum disorders (ASD). The Ziggurat Model begins the process with an assessment of student strengths and concerns related specifically to ASD and identifies interventions across five tiers that match these strengths and concerns: (a) sensory and biological, (b) reinforcement, (c) structural and visual/tactile supports, (d) task demands, and (e) skills to teach. Content from the Ziggurat Model is then placed with the Comprehensive Autism Planning System (CAPS) to allow the student’s day to be operationalized and matched to student goals, state standards, and related benchmarks. This article overviews this process and offers a brief case study as an example. As educators and parents strive to develop with NCLB are the (a) Response to Instruc- meaningful educational opportunities for in- tion (RTI) movement, which emphasizes da- dividuals with autism spectrum disorders ta-based decision making and problem solv- (ASD), it is important to begin with a thor- ing, evidence-based interventions, student ough understanding of the student’s needs, performance, and continuous progress; and especially those related to the underlying (b) Statewide Positive Behavior Supports characteristics of ASD. Next, a comprehensive (SWPBS), whose goals are to support (a) daily schedule for the student is critical. A students’ social and academic competence, schedule should embed the supports needed (b) student behavior, (c) staff behavior, and for success as well as continual development (d) decision making (Sugai & Horner, of student skills and measurement of those 2007). skills with a vision of how this will affect the Fundamental to these recent educational student now and in the future (Mesibov & mandated movements is comprehensive plan- Shea, 2006; National Research Council, 2001) ning, program implementation, and monitor- This is achieved through well-organized plan- ing of student progress. To date, no system ning with clearly defined objectives and goals. has existed that can accomplish these lofty Far-reaching changes have occurred in the goals. The purpose of this article is to intro- educational system in recent years, beginning duce two linked comprehensive planning with the No Child Left Behind (NCLB) Act. models that meet the rigor required by NCLB, This legislation was designed to increase stu- RTI, and SWPBS: the Ziggurat Model (Aspy & dent achievement through accountability and Grossman, 2007) and the Comprehensive Au- scientifically based instruction provided by tism Planning System (CAPS; Henry & Myles, highly qualified and effective teachers (U.S. 2007). Figure 1 depicts the process of compre- Department of Education, 2002). Compatible hensive planning using the Ziggurat Model and CAPS. Correspondence concerning this article should What Is the Ziggurat Model? be addressed to Brenda Smith Myles, Ohio Center for Autism and Low Incidence, 5220 N. High Street, The Ziggurat Model is a guide for designing Building C1, Columbus, OH 43221. comprehensive interventions for individuals 398 / Education and Training in Developmental Disabilities-December 2007 Figure 1. The process of comprehensive planning for students with autism spectrum disorders using the Ziggurat Model and CAPS. with ASD. The premise of this model is that needs leads to interventions that are more underlying needs and characteristics related proactive and fundamental. In comparison, to the autism spectrum must be addressed. interventions that are solely designed to ad- Therefore, the Ziggurat Model is designed to dress surface behavior without consideration utilize students’ strengths to address true of the underlying ASD are potentially less ef- needs or underlying deficits that result in so- fective and less likely to result in sustained cial, emotional, and behavioral concerns. The behavior change. Ziggurat approach centers on a hierarchical As mentioned earlier, the process of inter- system, consisting of five levels that must be vention design should begin with an assess- addressed for an intervention plan to be com- ment of the presenting characteristics of ASD prehensive (see Figure 2). (see Figure 1). A thorough assessment of un- When designing a comprehensive program, derlying characteristics helps parents and pro- it is essential to consider the context of the un- fessionals to plan a program that takes into derlying autism spectrum disorder. This is over- account the individual’s strengths and needs. looked all too often. Targeting underlying Further, assessment of underlying characteris- Figure 2. The five levels of the Intervention Ziggurat. Planning / 399 tics provides insight into which skills should The Intervention Ziggurat be taught and how to design instruction in order to facilitate learning and bring about The Intervention Ziggurat (IZ) is the center- meaningful and long-lasting change. The Un- piece of the Ziggurat Model and is the frame- derlying Characteristics Checklist (UCC) of- work on which comprehensive interventions fers a comprehensive perspective as a basis for are built. The IZ is comprised of five critical program planning. levels structured into a hierarchy: Sensory Dif- ferences and Biological Needs, Reinforce- ment, Structure and Visual/Tactile Supports, The Underlying Characteristics Checklist Task Demands, and Skills to Teach (see Fig- ure 2). The first level, Sensory Differences and The UCC is an informal assessment designed Biological Needs, addresses basic internal fac- to identify ASD characteristics for the purpose tors that impact functioning. The second level of intervention. There are two versions of the addresses motivational needs prerequisite to UCC, one intended for use with individuals skill development. The third level draws on who are high functioning (UCC-HF), includ- individuals’ strength of visual processing and ing those with Asperger Syndrome (AS), and addresses their fundamental need for order one for use with those with a more classic and routine. The final two levels of the IZ presentation (UCC-CL) in cognition and emphasize the importance of expectations speech-language skills. The UCC is comprised and skill development in light of the charac- of eight areas. The first three represent the teristics of individuals with ASD. autism spectrum triad, social, restricted pat- The IZ helps parents and educators avoid terns of behavior interests and activities, and overlooking critical areas that impact the ef- communication. Characteristics often associ- fectiveness of any intervention plan. Each of ated with ASD are addressed in the next four the levels is essential and contributes to the areas: sensory differences, cognitive differ- effectiveness of the others. Thus, if needs on ences, motor differences, and emotional vul- all levels are not addressed, the intervention nerability. The eighth underlying area is will not be as effective and skills will not de- known medical and other biological factors. Based on the results of completing the velop. The following is a brief discussion of UCC, a comprehensive intervention plan is the five levels of the Intervention Ziggurat. developed that targets ASD characteristics by Sensory differences and biological needs. The incorporating each of the five levels of the first level of the IZ represents what is, in one Ziggurat. The UCC may be completed by par- sense, the basis of all behavior—biology. Con- ents, teachers, or other service providers, in- sideration of biological factors is especially dividually or as a team. important in the case of ASD due to the strong genetic and neurological underpinnings of this disorder. Unmet sensory and biological needs will result in changes in behavior, high- The Individual Strengths and Skills Inventory lighting the importance of including strate- The Individual Strengths and Skills Inventory gies to address these needs. (ISSI) was designed to accompany the UCC. While sensory differences and biological The ISSI parallels the first seven areas of the needs are not included as symptoms of ASD in UCC. The purpose of this tool is to ensure the current diagnostic manual (Diagnostic and that underlying strengths and skills are incor- Statistical Manual of Mental Disorders of the porated in the intervention design process. American Psychiatric Association [APA], For example, one student may have a strength 2000), they often present some of the greatest in imitation whereas another has an intense challenges for individuals on the spectrum. interest in and knowledge of animals. These For example, anxiety (Pfeiffer & Kinnealey, assets can easily become keys to addressing 2003), distractibility, overactivity, impulsivity, underlying skill deficits. An example of a com- perseveration, delayed receptive and expres- pleted ISSI is provided in the case example of sive language skills, poor social skill develop- Michael. ment, and poor eye contact have all been 400 / Education and Training in Developmental Disabilities-December 2007 related to impaired sensory functioning effective reinforcement systems are in place. (Stackhouse, Graham, & Laschober, 2002). Other
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