The Scerts Manual, 2 Volume Set: A Comprehensive Educational Approach for Young Children with Autism Spectrum Disorders / Edition 1 available in Paperback
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- Brookes Publishing
A groundbreaking synthesis of developmental, relationship-based, and skill-based approaches, The SCERTS Model provides a framework for improving communication and social-emotional abilities in preschool and primary school students with autism spectrum disorders (ASD) and their families. Developed by internationally recognized experts, SCERTS supports developmental progress in three areas: Social Communication (communicating spontaneously and establishing relationships), Emotional Regulation (regulating emotional arousal to support learning and engagement), and Transactional Supports (elements that aid a child's progress as he or she works toward a goal).
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About the Author
Barry M. Prizant, Ph.D., has more than 25 years experience as a clinical scholar, researcher, and consultant to young children with autism spectrum disorders (ASD) and related communication disabilities and their families. He is an American Speech-Language-Hearing Association fellow and is a member of the Interdisciplinary Council on Developmental and Learning Disabilities. Formerly, he was Associate Professor of Psychiatry in the Brown University Program in Medicine, Professor in the School of Communication Sciences and Disorders at Emerson College, and Advanced Post-Doctoral Fellow in Early Intervention at University of North Carolina at Chapel Hill. He has developed family-centered programs for newly diagnosed toddlers with ASD and their families in hospital and university clinic environments. He has been an invited presenter at two State of the Science Conferences on ASD at the National Institutes of Health (NIH) and has contributed to the NIH Clinical Practice Guidelines for early identification and diagnosis of ASD. Dr. Prizant's current research and clinical interests include identification and family-centered treatment of infants, toddlers, and young children who have or are at risk for sociocommunicative difficulties, including ASD.
Amy M. Wetherby, Ph.D., is Professor and former Chair of the Department of Communication Disorders at Florida State University. She received her doctorate from the University of California-San Francisco/Santa Barbara in 1982. She has had more than 20 years of clinical experience in the design and implementation of communication programs for children with autism and severe communication impairments and is an American Speech-Language-Hearing Association fellow. Dr. Wetherby's research has focused on communicative and social-cognitive aspects of language difficulties in children with autism and, more recently, on the early identification of children with communicative impairments. She has published extensively on these topics and presents regularly at national conventions. She is a co-author of the Communication and Symbolic Behavior Scales (with Barry M. Prizant [Applied Symbolix, 1993]). She is the Executive Director of the Florida State University Center for Autism and Related Disabilities and is Project Director of U.S. Department of Education Model Demonstration Grant No. H324M980173 on early identification of communication disorders in infants and toddlers and Personnel Preparation Training Grant No. H029A10066 specializing in autism.
Emily Rubin is Director of Communication Crossroads, a private practice in Carmel, California. She is a speech-language pathologist specializing in autism, Asperger syndrome, and related social learning disabilities. As an adjunct faculty member and lecturer at Yale University, she has served as a member of its Autism and Developmental Disabilities Clinic. She has also served as an instructor for the Communication Sciences and Disorders Department of Emerson College in Boston, Massachusetts, where she has developed courses to prepare graduate-level students to address the needs of children with autism and their families. Her publications have focused on early identification of autism, contemporary intervention models, and programming guidelines for high-functioning autism and Asperger syndrome. She has participated as a member of the American Speech-Language-Hearing Association's Ad Hoc Committee on Autism Spectrum Disorders (ASD), a committee charged with developing guidelines related to the role of speech-language pathologists in the diagnosis, assessment, and treatment of ASD. She lectures internationally and provides consultation to educational programs serving children and adolescents with autism and related developmental disorders.
Amy C. Laurent is a pediatric occupational therapist who holds a master's degree in special education. Currently in private practice, she is a New England affiliate of Communication Crossroads and of Childhood Communication Services. Ms. Laurent specializes in the education of children with autism spectrum disorders (ASD) and related developmental disabilities. Through her practice, she provides comprehensive evaluations, direct therapeutic services, and consultations to educational programs for children with ASD. She also provides extensive educational and emotional support for families of children with ASD. Ms. Laurent has co-authored several journal articles and frequently lectures throughout the United States on topics related to therapeutic and educational intervention for children with ASD. Her areas of clinical interest include therapeutic intervention as it relates to the development of self-regulation and social-adaptive functioning across contexts (e.g. school, home, and community settings).
Dr. Rydell has been in the field of autism and communication disorders for more than 24 years in public school, hospital, university, administration, and private practice settings. Dr. Rydell is the owner and director of Rocky Mountain Autism Center, a private center dedicated solely to working with children with autism spectrum disorders and their families. The center provides comprehensive center-, community-, and home-based assessments, programs, interventions, and training to individuals with autism, their families, and professionals. Dr. Rydell earned his doctoral and master's degrees in the field of communication disorders and special education, with a primary program emphasis in autism and early childhood education. Dr. Rydell is a Fulbright Senior Specialist grant recipient (2005) and has previously co-authored five book chapters and numerous research articles on autism and unconventional verbal behaviors. In addition, he frequently speaks at international, national, and state levels on topics related to autism.
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Dimensions of Educational Practices
As just noted, a continuum approach requires scrutiny of educational practice along a variety of dimensions. Table 6.1 presents these dimensions as organized in four major categories: teaching practices, learning contexts, child characteristics, and programmatic goals. We now discuss these dimensions with examples relative to different categorical approaches. It will be evident that these dimensions are not mutually exclusive.
Theoretical and Research Underpinnings
A broad continuum that has framed discussions about different approaches is whether an approach draws from developmental research and practice or from behavioral research and practice or both. All treatment and educational approaches have the potential to draw from the extensive literature on the development of children with and without disabilities and the literature on developmentally appropriate practice in educational settings. On one end of the continuum, however, approaches may not draw from child development research and may teach children primarily in a one–to–one adult–child teaching format, with a focus on increasing or decreasing skills based on a prescriptive program or on professionals' prior decisions about what a child needs to learn and how teaching is to occur. On the other end of the continuum, developmental research is used to provide a foundation for making decisions about goals and teaching strategies to be used to achieve those goals, as well as for making decisions about appropriate contexts for learning. Approaches for working with children with ASD vary greatly in this dimension.
Traditional ABA approaches draw primarily from operant learning theory and behavioral research and practice, whereas contemporary ABA approaches integrate practices from developmentally based early childhood practice while still relying on a learning theory framework for accounting for and documenting behavioral change in children. However, contemporary ABA practices (e.g., as exemplified by the works of Koegel and Koegel, McGee, Strain, and Schreibman) may not be guided by frameworks based on the extensive research in child development to the same extent as developmentally based approaches such as the DIR Model and the SCERTS Model (Prizant & Rubin, 1999). Nevertheless, information about developmental sequences and developmental support based on child development research has had a significant influence on contemporary ABA practices. For example, primary contexts of intervention now include play–based interaction with peers and natural activities and routines, with a focus on initiated communication and age–appropriate play.
Approaches that draw most heavily from child development research and practice use developmental frameworks and developmental processes as the core foundation for determining goals, measuring progress, and selecting developmentally appropriate teaching practices. For example, the SCERTS Model is driven largely by developmental research in language and communication development, social development, development of social–emotional capacities such as emotional regulation, and development of sensory processing capacities. As noted, priority goals in the SCERTS Model are identified in the areas of social communication, emotional regulation, and transactional support. The SCERTS Model has a strong developmental focus; however, a child's functional needs and family priorities are factors that are considered along with goals guided by research on child development. Furthermore, teaching strategies based on effective learning processes derived from developmental research are infused into educational opportunities for children with ASD.
Other major bodies of research and literature relevant to underlying theoretical and research foundations are family systems theory and family–centered intervention. The SCERTS Model is heavily influenced by family systems theory and is consistent with family–centered intervention practices (e.g., Mahoney & Perales, 2005) as well as research on PBS as reported in the contemporary ABA literature (Fox et al., 2000). Greenspan and Wieder's (1998) DIR model is based on Greenspan's (1992) model of emotional development, with priority goals identified in social–emotional capacities and related abilities. The DIR model does not draw directly from research or literature on ABA practices.
Degree of Prescription versus Flexibility in Teaching
Some approaches are prescriptive, in that teaching practices and goal sequences are clearly specified with recommendations to follow them faithfully. This may include how teaching materials are to be presented, how the teaching environment is to be structured or arranged, which types of child responses are considered acceptable or correct,and how adults should respond to acceptable as well as unacceptable responses. In prescriptive approaches, children's behavior may also be defined as on task or off task.
Such terms are used in specific reference to how a child's behavior relates to a specified activity or to the teacher's agenda, regardless of its relevance to events in the situation or a child's focus of attention or intention. For example, if a child comments on the noise of a truck outside the window or requests a toy on a shelf within sight, the child may simply be redirected back to the task at hand, despite the potential for using the child's interests and spontaneous communication as teachable moments. In contrast, other approaches may not follow a predetermined agenda or prescription for teaching. On this end of the continuum, there are greater possibilities for flexibly creating learning opportunities and for spontaneously capitalizing on teachable moments based on a child's focus of attention and interest and how activities and events evolve. In the examples mentioned in the previous paragraph, the child may be brought to the window to observe the truck, with a short conversation about what it is doing, or the toys may be brought down from the shelf to encourage further spontaneous communication. For this dimension, middle–ground approaches may have some degree of structure with specified goals that are predetermined. However, the child's partner is better able to depart from a prearranged agenda either for short periods or for longer periods, depending on the potential for creating and capitalizing on new and more effective learning opportunities regardless of the original agenda. In general, this approach is characteristic of the SCERTS Model.
Use of Directive versus Facilitative Interactional and Teaching Styles
A facilitative style, which currently is advocated by developmental and some contemporary behavioral literature, is characterized by
- Following a child's attentional focus
- Offering choices and alternatives within activities
- Responding to and acknowledging children's intent
- Modeling a variety of communicative functions, including commenting on a child's activities
- Expanding and elaborating on the topic of a child's verbal and nonverbal communication
An extreme facilitative style is known as following the child's lead, in which minimal direction is provided on the part of the communicative partner. When primarily a facilitative style is used, an underlying assumption is that a child's spontaneous and self–directed behavior is sufficiently organized and goal directed such that the partner can create productive learning opportunities with appropriate responses and guidance but with minimal intrusion or redirection.
On the other end of the continuum is a directive style of interaction and teaching. As the name implies, this style is characterized by greater imposition by the partner on the child to communicate, respond, and behave in a particular manner. Directive styles are characterized by
- Frequent attempts to bring the child's attention to events or activities chosen by the partner
- A large proportion of questions designed to elicit specific answers or directions designed to have the child respond or perform in a particular manner
- Frequent use of more intrusive prompting strategies (physical or verbal) to support the child to respond correctly
- Evaluative comments indicating whether the child's responses are appropriate or Correct
The ultimate goal of this style of teaching is for the child to comply with the partner's directives to achieve goals designated by the partner.
The middle ground on this continuum would be selective use of directive or facilitative elements depending on the nature of the activity, a child's ability relative to demands of activity, and the child's emotional regulatory status. For example, in teaching a child to tie his or her shoes, a more directive approach may initially be necessary as acquisition of this skill may initially require hand–over–hand direction due to the visual motor and motor planning requirements. However, in fostering social–communicative abilities for this same child, a less directive approach would be warranted due to the very different nature of learning to participate in social–communicative interactions. The SCERTS Model has a strong bias toward more facilitative styles of fostering social communication and emotional regulation. (The concept of a facilitative style was first introduced in the child language development literature and does not refer to the method known as facilitated communication [Biklen, 1990], an AAC approach used for individuals with ASD and other severe communication disabilities.) The justification is that research has demonstrated that the benefits of a more facilitative style include the following
- Providing a child with a sense of social control and communicative power, which has been found to result in increased initiations and more elaborate communicative attempts (Mirenda & Donnellan, 1986; Peck, 1985)
- Following the child's attentional focus and motivation, which reduces problems of noncompliance and may result in increased learning due to motivation and affective involvement
- Providing elaborated information and feedback appropriate to the child's level and attentional focus, which supports the child's communicative and language development through modeling of vocabulary and more varied language forms and functions. For example, Mirenda and Donnellan (1986) found that compared with a directive style, the use of a facilitative style resulted in higher rates of student–initiated interactions, question asking, and conversational initiation in students with ASD. Rydell and Mirenda (1991) found that higher frequencies of generative utterances, initiations, and increased comprehension followed adult–facilitative utterances.
Facilitative strategies have also been found to increase communicative initiation and social–affective signaling of children with ASD with limited or no language abilities (Dawson & Adams, 1984; Peck, 1985; Tiegerman & Primavera, 1984). Appropriateness of style along the continuum of facilitativeness to directiveness is a child–specific issue and can only be determined by observing the effect of partner style on interactions. Relative to a child's typical abilities, a good stylistic match should result in
- Increased self-regulation of attention (i.e., ability to maintain a mutual focus of attention with minimal prompting)
- Active involvement in selecting and participating in activities
- Frequent verbal and nonverbal communicative initiations
- More elaborate communicative initiations
- Positive affective involvement with the partner
A style may be thought to be more facilitative when these characteristics can be observed in children's behavior. For example, for a highly active and distractible child, a style that promotes a mutual attentional focus and more active involvement, even though it may have some directive qualities (e.g., physical prompting, limit setting), must be viewed as facilitative for that child. This same style, however, may have detrimental effects for a child with a lower activity level and greater attentional regulation. As Marfo (1990) noted, the function of adult directiveness in supporting interactions is of overriding concern, not the presence or absence of features thought to be directive. In the SCERTS Model, we advocate incorporating facilitative features in play and teaching interactions and gradually modifying style along the facilitativeness–directiveness continuum until an optimal match is found.
Excerpted from Chapter 6 of The SCERTS™ Model A Comprehensive Educational Approach for Children with Autism Spectrum Disorders, by Linda Wollesen, R.N., M.A., & Karen Peifer, Ph.D.
Copyright © 2005 by Paul H. Brookes Publishing Co. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Table of Contents
- Social Communication
- Emotional Regulation
- Transactional Support
- SCERTS Model Programmatic Priorities and Milestones
- Continuum of Current Intervention Approaches and the SCERTS Model
- The SCERTS Assessment Process: Overview and Implementation
- The SCERTS Assessment Process: Using the SAP-O Forms and Criteria
- Guide to the SCERTS Model Educational Practices, Part I: Core Values and Guiding Principles, Practice Guidelines, Goal Setting, and Transactional Support
- Guide to the SCERTS Model Educational Practices, Part II: Transactional Support: Interpersonal Support and Learning Support and Learning and Playing with Peers
- Transactional Support: Support to Families and Support Among Professionals
- Linking Transactional Support Goals to Social Communication and Emotional Regulation Goals
- Enhancing Social Communication, Emotional Regulation, and Transactional Support at the Social Partner Stage: From Assessment to Program Implementation
- Enhancing Social Communication, Emotional Regulation, and Transactional Support at the Language Partner Stage: From Assessment to Program Implementation
- Enhancing Social Communication, Emotional Regulation, and Transactional Support at the Conversational Partner Stage: From Assessment to Program Implementation
Appendix: SCERTS Assessment Process-Quality Indicators
Index, Volumes I and II