10 Early Intervention Case Study Manual.txt

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The Donovan Family 
Case Study

Guidance and Coaching on 
Evidence-based Practices for 
Infants and Toddlers with ASD

Suzanne Kucharczyk

Evelyn Shaw

Linda Tuchman-Ginsberg

Developed in partnership with

Dathan Rush, Associate Director &

M�Lisa Shelden, Director

Family, Infant and Preschool Program (FIPP)

Center for the Advancement Study of Excellence (CARE)
in Early Childhood and Family Support Practices



The Donovan Family Case Study: 
Guidance and Coaching on Evidence-based Practices for Infants and Toddlers with ASD

i

The Donovan Family Case Study:

Guidance and Coaching on Evidence-based Practices for Infants and Toddlers with ASD

Suggested citation: Kucharczyk, S., Shaw. E., & Tuchman-Ginsberg, L. (2010). The Donovan 
family case study: Guidance and coaching on evidence-based practices for infants and 
toddlers with ASD. Chapel Hill: The University of North Carolina, Frank Porter Graham Child 
Development Institute, National Professional Development Center on Autism Spectrum 
Disorders.

Note: The Donovan Family Case Study appears as Appendix C in Kucharczyk, S., Shaw. E., Smith Myles, B., 
Sullivan, L., Szidon, K., & Tuchman-Ginsberg, L. (2010). Guidance & coaching on evidence-based practices for 
learners with autism spectrum disorders. Chapel Hill: The University of North Carolina, Frank Porter Graham 
Child Development Institute, National Professional Development Center on Autism Spectrum Disorders.

Design & Layout: Gina Harrison, FPG Publications Office

FPG #2929

The NPDC on ASD was a multi-university center (Frank Porter Graham Child Development Institute at The University 
of North Carolina at Chapel Hill, the M.I.N.D. Institute at University of California at Davis Medical School, and the 
Waisman Center at the University of Wisconsin) funded by the US Department of Education, Office of Special 
Education Programs (OSEP).

For additional information about the National Professional Development Center on Autism Spectrum Disorders, 
visit their website at http://autismpdc.fpg.unc.edu or email Suzanne.kucharczyk@unc.edu

The Frank Porter Graham Child Development Institute at The University of North Carolina at Chapel Hill is one of the 
nation�s oldest multidisciplinary centers devoted to the study of children and families. Our mission is to cultivate 
and share knowledge that enhances child development and family well being.

Advancing knowledge. Enhancing lives.



 

The Donovan Family 
Case Study:

Guidance and Coaching on 
Evidence-based Practices for 
Infants and Toddlers with ASD

The Donovan family 
case study was 
developed through 
a collaboration between 
the National 
Professional Development Center on 
Autism Spectrum Disorders (NPDC) 
and The Family, Infant and Preschool 
Program (FIPP) Center for the Advanced 
Study of Excellence (CASE) in 
Early Childhood and Family Support 
Practices, M�Lisa Shelden, P. T., Ph.D, 
Director and Dathan Rush, Ed.D., 
C.C.C.-S.L.P. Associate Director 
(http://www.fipp.org/programs/earlyIntervention.
html). The purpose of this 
case study is to describe the coaching 
process in the context of early intervention 
and to outline two parallel 
coaching processes. 

This case study provides a description 
of how an early intervention 
provider, Jillian, supports the Donovan 
family through coaching on the use 
of evidence-based practices with their 
two-year-old son, Joey, who has autism. 
As the early intervention provider 
works with the parents, she receives 
coaching support from both her supervisor, 
in the form of program-wide and 
individualized supervision, and from 
an experienced peer coach. Both the 
coaching of the family and the provider 
coaching processes occur in a three 
stage cycle outlined in the NPDC 
coaching manual, Guidance and Guidance 
and Coaching on Evidence-based 
practices for Learners with Autism Spectrum 
Disorders (Kucharczyk, S., Shaw, 
E., Smith Myles, B., Sullivan, L., 
Szidon, K., and Tuchman-Ginsberg, 
L., 2012). (http://autismpdc.fpg.unc.
edu/coaching-resources) These stages 
are: pre-observation, observation, and 
post-observation. For the purposes 
of this case study, pre-observation 
includes stating the purpose, defining 
the target for change, and identifying 
how the target will be observed and 
data captured; observation includes 
modeling and action by the coach and 
inviting partners (i.e., parents); and 
post-observation includes reflection, 
feedback, and evaluation. This framework 
helps to integrate the NPDC 
coaching process with the coaching 
approach to teaming in early intervention 
supported by FIPP.

The case study is structured 
chronologically. It describes the work 
the Donovan family and the early 
interventionists do together. First, is a 
description of the program to provide 
context. Then the steps of the early 
intervention process are outlined: 
Step 1.) information gathering, Step 
2.) outcome planning, Step 3.) intervention 
planning, Step 4.) implementation 
and ongoing assessment, and 
Step 5) evaluation and modification of 
the outcomes and intervention. 

The Clarksville 
Early Intervention Program

The Clarksville Early Intervention 
Program (EI Program) is situated in 
an urban area, which also provides 
services to nearby rural communities. 
The program serves families through 
home visits and in consultation with 
child care settings when relevant. A 
primary early intervention provider 
delivers services in collaboration with 
team members from other disciplines 
and the family. The team, including 
the primary provider and the other 
members of the team meet once a 



week for 1� hours to discuss issues related 
to their work which includes but 
isn�t limited to: brainstorming about 
resources for families, families whose 
dynamics puzzle or challenge them, 
and questions related to implementation 
and effectiveness of interventions 
for children.

The primary provider for Joey�s 
family, Jillian, has been working for 
the EI Program for the last two years. 
Previously, she worked for another 
agency in a different city for two years. 
Jillian completed her bachelor�s degree 
in early childhood education. While 
in college she took a number of special 
education classes. She holds an Infant, 
Toddler, and Family Specialist Certification 
through her state�s early intervention 
agency due to her education, 
experience, and continuing professional 
development credits. Jillian shares 
that she further developed her skills 
in using interventions for children 
with special needs on the job. The EI 
Program provides professional development 
throughout the year on topics 
that emerge as important through 
team discussions. Additionally, the EI 
Program director supervises all staff 
and facilitates the weekly team meetings 
discussed previously. During these 
times, Jillian brainstorms intervention 
ideas with her supervisor, as well as 
discusses areas of concern. 

Program Quality

Last year, the Clarksville EI Program 
partnered with technical assistance 
providers from a regional University�s 
early intervention support program. In 
order to inform the beginning of their 
coaching work with the EI team, the 
University support program suggested 
that the EI Program take part in 
Autism Program Environment Rating 
Scale � Infants & Toddlers (APERS-
IT) in order to systematically assess 
the program�s core strengths and 
areas requiring priority attention. The 
APERS-IT is composed of components 
which, as a whole, illustrate 
quality early intervention practices 
for infants and toddlers with autism. 
These components are in the following 
domains: physical environment, 
activity and daily routines, positive 
relationships, communication, intervention 
(e.g., imitation, joint attention, 
play), behavior, coaching teaming, and 
assessment and IFSP development. 
APERS-IT data are collected through 
observations, interviews, and record 
reviews. APERS-IT data are used 
to inform the collaborating partners 
about areas of strength and areas that 
they might want to target for growth. 

To complete the APERS-IT, 
observations were conducted of two 
interventionists during one home 
visit each. One interventionist was 
also a service coordinator; the other 
was a speech-language pathologist. 
Interviews were conducted with the 
director of the program, parents and 
interventionists from both home visits. 
The Individualized Family Service 
Plans (IFSP) for both families observed, 
were reviewed along with other 
relevant records. 

The APERS-IT revealed that 
two of the program�s strengths were 
teaming and a strong foundation in 
evidence-based practices for children 
with autism with a specialization in 
practices focusing on communication 
development. Teaming was evident in 
the weekly meetings during which individual 
practitioners have the opportunity 
to gain insight into each other�s 
work and brainstorm possible responses 
to specific challenges. In addition, 
through their weekly meetings the 
team has the opportunity to recognize 
specific needs that require attention 
from the program as a system (e.g., 
difficultly communicating with other 
agencies, parents needing information 
on transition). 

Following the review of the 
APERS-IT findings and summary, 
technical assistance providers and 
the program coordinator developed a 
list of the EI Program�s priority areas 
which required improvement and 
attention. These included: systematizing 
data collected by providers and 
supporting families in collecting and 
using data, ensuring that providers 
implement evidence-based practices to 
fidelity, and further developing coaching 
processes. 

Up to this point, providers across 
the program understood their role as 
being experts in child development 
for infants and toddlers with disabilities/
developmental delays, including 
autism. Most of their work in the 
home was spent with the child while 
the parent often sat close by watching. 
The technical assistance providers 
and program director wanted to help 
the early intervention team members 
shift their roles so that the program 
practices more fully engaged families. 
The program director and technical 
assistance providers developed a professional 
development plan for coaching 
providers so that they learned to 
partner with families to coach them in 
learning to implement evidence-based 
practices.



This professional development 
plan included ensuring that providers 
were confident in their own use of specific 
EBP. The team of providers and 
families chose specific EBP relevant 
for each child. Providers gathered 
resources such as the Learning Modules 
on the Autism Spectrum Disorders 
(ASD) Toddler Initiative website 
(http://asdtoddler.fpg.unc.edu/) and 
Autism Internet Modules on the 
OCALI website (http://www.autisminternetmodules.
org/) and briefs 
and implementation checklists on the 
NPDC website (http://autismpdc.
fpg.unc.edu/content/briefs). In addition 
to self-study, technical 
assistance providers 
observed home visits (in 
person or through video) 
and coached providers on 
their work with families 
at least once a month. 
Providers with extensive 
family coaching experience 
were paired with less 
experienced providers so 
that they could use a peer 
coaching model. 

The Donovan Family

The Clarksville EI Program 
continued to develop 
its strengths and attend to 
areas needing growth as 
it began to work with the 
Donovan family. Mike, 
Pat and their two-year old 
son Joey recently moved 
to a farm within the EI 
program�s service area. The 
Donovans had started the 
EI evaluation process prior 
to moving after developmental 
screening conducted by Joey�s 
pediatrician raised flags. After more 
extensive assessments were done, Joey 
was diagnosed with autism. Prior to 
moving, the Donovans contacted the 
EI Program and were seen by Jillian 
upon arriving. Together they began a 
five step process.

Step 1: Information Gathering

During this step, the primary provider 
gathered pertinent information about 
the family, including their preferences, 
their routines, Joey�s preferences, and 
family activities. 

Information Gathering Resources

The team reviewed information from 
multiple sources, including standardized 
and authentic assessments, in 
order to better understand Joey�s 
development in the areas of cognition, 
speech and language, motor, social 
emotional development and adaptive 
skills. In addition other tools were used 
to better understand Joey�s strengths 
and needs within the context of his 
family as well as family priorities. Using 
the Interest-Based Everyday Activity 
Checklist (Swanson, Raab, Roper, & 
Dunst, 2006), the early intervention 
team learned that Joey loves to play 
in and with water, so much 
so that the family has been 
required to lock toilet lids 
and decrease the temperature 
of the hot water tank in 
their home because of Joey�s 
interest in turning faucets 
on and off. 
http://www.fipp.org/Collateral/
casetools/casetools_
vol2_no5.pdf

A copy of the Interest-
Based Activity Checklist 
completed for Joey and his 
family follows. 





Figure 1. 

Interest-Based Activity Checklist











The family also shared that Joey 
likes to be outside. Using the Asset-
Based Context Matrix (Wilson & 
Mott, 2006) http://www.fipp.org/Collateral/
casetools/casetools_vol2_no4.
pdf, the team learned more information 
about the natural learning opportunities 
(i.e., activities and routines 
embedded in the family�s day) important 
to Joey and his family. They 
learned that Joey�s mom and dad are 
farmers and the family enjoys growing 
all of their own food. The Donovans 
have a large extended family. Joey has 
10 cousins close to his age who live 
within 30 minutes from his new home. 
The Donovans attend church every 
Sunday with their extended family 
members and then share Sunday dinners 
together. Mike and Pat also stated 
that Joey is not fond of napping and 
does not sleep through the night. 



Figure 2.

Asset-Based Context Matrix Assessments









Family Routines and Priorities

During this process, the Donovans 
and EI team developed calendars of 
the family�s current day in order to pin 
point areas for support and intervention. 
Pat and Mike included activities 
and routines that occur on a typical 
day for them and Joey. With the 
EI team they identified challenging 
routines and prioritized which needed 
more immediate attention. These 
activities are recorded on the My Calendar
� form, developed and available 
through FIPP, and included at the end 
of this document. Mike and Pat also 
shared their priorities of learning more 
about Joey�s diagnosis of autism and 
how to help their family understand 
Joey better. Mike and Pat are anxious 
that Joey will not sit down at the dinner 
table for family meals, which they 
find particularly troublesome when the 
entire extended family shares meals 
together on the weekend. Joey�s parents 
also worry that his lack of sleep 
contributes to some of his agitation.

Observation of 
Families and Children

Once the above information was gathered, 
a member of the early intervention 
team observed a family mealtime 
with Mike, Pat and Joey. During the 
mealtime, Joey was agitated and would 
not join his parents at the table. Mike 
and Pat demonstrated strategies they 
had tried in the past and the practitioner 
had a few ideas that they implemented 
during the observation. Joey�s 
parents showed their frustration with 
the situation as well as their willing



ness to consider new approaches. The 
EI provider wondered if Joey might 
be making more attempts to communicate 
than the information she had 
gathered prior to the observation suggested. 
Overall, everyone felt they had 
better ideas about how to get started 
on improving the family�s mealtimes.

Step 2: Outcome Planning

At the IFSP meeting, the EI team, including 
the primary EI provider, speech 
language pathologist, the service coordinator, 
and family used the information 
gathered to support the outcome planning 
process. During the IFSP meeting, 
the service coordinator reviewed 
and summarized the information that 
the Donovan family had shared as well 
as discussed the observations made by 
the EI provider during the home visit.
Together, the family and team decided 
upon the following outcomes:

1. Joey will join the family for 
meals at the dinner table on 
the weekends.
2. Mike and Pat will know how 
to put Joey to bed for naps and 
at bedtime.
3. Joey will help his parents water 
the garden and houseplants.
4. Mike and Pat will feel comfortable 
discussing Joey�s diagnosis 
of autism with family 
and friends.


 Goal Attainment Scaling

As part of the meeting, the team 
worked with Pat and Mike to select 
the priorities above for the IFSP 
outcomes. Next, the team and family 
followed the Goal Attainment Scaling 
(GAS) process (Cardillo & Choate, 
1994). The Goal Attainment Scaling 
process has been used by NPDC 
in schools and early intervention 
programs in addition to Individual 
Education Plans (IEP) or IFSP. The 
GAS is a tool used to help document 
progress on IFSP outcomes. Teachers 
and early intervention providers 
who have worked with NPDC using 
the GAS report that the process helps 
them to link data with goals/outcomes, 
to think ahead, and to consider 
generalization opportunities from 
the beginning. By linking data collection 
and generalization of the skill 
directly to goals/outcomes, teams are 
more effective in their implementation 
of EBP. Joey�s parents appreciated 
that the process helped them to have 
a sense of where their child might be 
heading after a goal/outcome is met. 
The GAS process helped the team 
create goals based on the priority IFSP 
outcomes that were meaningful to 
the family and were measurable and 
observable. In addition, the family and 
team were able to project out expectations 
for Joey and the family over six 
months and beyond.

The team and family followed the 
steps in the GAS process described below. 
They included the highest priority 
outcomes for the family at the moment. 
In addition, Mike and Pat chose with 
the team the next priorities they might 
focus on in their work together. These 
included Joey�s participating in Sunday 
services at the Donovan�s church, helping 
Joey get more sleep during the day, 
and continuing to work on communication 
approaches that help Joey express 
himself and better understand his 
mom and dad. They decided to develop 
goals from the priority outcomes listed 
above. These include the 4 goals related 
directly to Joey and one for the family 
to keep track of Pat�s successes. 

1. Develop Goals: They developed 
these observable and 
measurable goals from the 
priority outcomes.

a. During family dinners, 
Joey will sit at the dining 
room table either eating 
or quietly playing with a 
toy for at least 10 minutes 
for 2 out of 3 dinners.

b. When mom or dad is 
working in the garden, 
Joey will participate by 
watering a plant through 
the use of a 2-step visual 
sequence (1. Walk to 
garden plot while holding 
child size watering 
can filled with water, 
2. Water plant) with 
prompts as needed for 3 
out of 4 naturally occurring 
opportunities.

c. During playtime with mom 
or dad (e.g., bath time, 
outdoor water play), Joey 
will make a choice among 
preferred play objects (e.g., 
water wheel, bucket, squirt 
duck, boat) by pointing, 
touching, or approximating 
name of object for or 8 out 
of 10 naturally occurring 
opportunities for 3 consecutive 
days. 

d. Joey will be in bed (no 
wandering or opening/
closing drawers) by 9:30 
for bedtime routine of 
reading with mom or dad 
on 5 out of 5 week nights. 
Lights out and Joey quiet 
by 10:00. Joey will wake 
up once in the night and 



be taken directly back to 
bed for quiet time.

e. (This goal is a companion to 
Joey�s goal that the family 
and EI team wrote as 
an aligned goal for mom.) 
Joey�s Mom starts reading 
to him at 9:00 and spends 
30 minutes reading to 
Joey before �lights out� (or 
lights go out) at 9:30. She 
spends up to 15 minutes 
with Joey (lights out, quiet 
time) to help him get to 
sleep. Joey�s Mom sleeps 
in her own bed. She wakes 
up no more than once in 
the middle of the night 
with Joey. She spends no 
more than 10 minutes 
helping him get back to 
sleep. (5 out of 7 nights)

Note: The family and team identified 
an additional family support 
outcome (i.e., Mom and Dad feel 
comfortable discussing Joey�s diagnosis 
of autism with family and friends). 
Rather than scaling this goal, Mike, 
Pat, and the early intervention provider 
strategized various approaches 
and resources in order to build their 
confidence and comfort in discussing 
autism with others. 

2. Current Performance: Next, 
the team identifies Joey�s and 
the parent�s current performance 
on these goals by 
reviewing existing data and 
collecting additional data until 
they are sure of their starting 
point.

3. Scaling the Goals: After 
determining baseline, the team 
and family determine how to 
change conditions and criteria 
to decide what it would look 
like if Joey (or family) were 
short of meeting the goal or 
exceeded expectations. Scaling 
the goals helped the team 
and family have a clear picture 
of what success would look 
like and when interventions 
weren�t working and needed to 
be adjusted. Additionally, scaling 
helped them consider how 
a goal would be part of a larger 
plan for Joey and his family. 
The team completed the rest 
of the priority outcomes in the 
following way.

Table 1.

Developing Mealtime Goals 

Much less than expected

(Present Level of Performance)

During all mealtimes Joey gets up from the table and comes back to it to take 
one bite at a time. Joey does not sit down at the dining room table.

Somewhat less than expected

(Benchmark)

Expected level of outcome

(Outcome)

During family dinners, Joey will sit at the table either eating or quietly playing 
with a toy for at least 10 minutes for 3 out of 4 dinners a week.

Somewhat more than expected 
(Exceeds Outcome)

Much more than expected 
(Far Exceeds Outcome)







Table 2.

Joey�Mealtime

Much less than expected

(Present Level of Performance)

During all mealtimes Joey gets up from the table and comes back to it to take 
one bite at a time. Joey does not sit down at the dining room table.

Somewhat less than expected

(Benchmark)

During family dinners, Joey will sit at the dining room table either eating or 
quietly playing with a toy for at least 5 minutes for 3 out of 4 dinners a week.

Expected level of outcome

(Outcome)

During family dinners, Joey will sit at the table either eating or quietly playing 
with a toy for at least 10 minutes for 3 out of 4 dinners a week. 

Somewhat more than expected 
(Exceeds Outcome)

During weekend dinners with extended family, Joey will sit at the table either 
eating or quietly playing with a toy for at least 5 minutes for 34 dinners a 
month.

Much more than expected 
(Far Exceeds Outcome)

During weekend dinners with extended family, Joey will sit at table outside 
either eating or quietly playing with a toy for at least 10 minutes for 3 out of 4 
dinners a month.





Table 3.

Joey�Bedtime

Much less than expected

(Present Level of Performance)

Joey wanders the room (rocking/opening closing drawers) while Mom or Dad 
read books, play music and sing to Joey. He falls asleep by midnight and wakes 
up 2 to 3 times a night.

Somewhat less than expected

(Benchmark)

Joey spends no more than 5 minutes wandering the room before laying down 
for bedtime routine of reading with Mom or Dad at 10:00. Lights go out and 
Joey is quiet before 10:45 on 3 out of 5 week nights.

Expected level of outcome

(Outcome)

Joey will be in bed (no wandering or opening/closing drawers) by 9:30 for 
bedtime routine of reading with Mom or Dad on 5 out of 5 week nights. Lights 
go out and Joey is quiet by 10:00. 

Somewhat more than expected 
(Exceeds Outcome)

Joey will be in bed (no wandering or opening/closing drawers) by 9:30 for 
bedtime routine of reading with Mom or Dad on 6 of 7 nights. Lights go out and 
Joey is quiet by 9:45. 

Much more than expected 
(Far Exceeds Outcome)

Joey will be in bed (no wandering or opening/closing drawers) by 9:30 for 
bedtime routine of reading with Mom or Dad on 7 of 7 nights. Lights go out and 
Joey is quiet by 9:45.







Table 4. 

Parents�Bedtime





Much less than expected

(Present Level of Performance)

Joey�s Mom, Pat, spends up to an hour and a half singing, humming, playing 
songs and reading stories to Joey at bedtime. She falls asleep in Joey�s room 
and wakes with him 2 or 3 times a night. When he wakes up in the middle of 
the night, she sings to him to help him get back to sleep. 

Somewhat less than expected

(Benchmark)

Joey�s Mom, Pat, starts reading to him at 9:00 and spends 30 minutes reading to 
Joey before lights go out at 9:30. She spends up to 30 minutes with Joey (lights 
out, quiet time) to help him get to sleep. Pat sleeps in her own bed. When Joey 
wakes up in the middle of the night, she walks him to bed and spends no more 
than 20 minutes helping him get back to sleep. 

(4 out of 7 nights) 

Expected level of outcome

(Outcome)

Joey�s Mom, Pat, starts reading to him at 9:00 and spends 30 minutes reading to 
Joey before lights out at 9:30. She spends up to 15 minutes with Joey (lights out, 
quiet time) to help him get to sleep. Pat sleeps in her own bed. When Joey wakes 
up in the middle of the night, she walks him to bed and spends no more than 10 
minutes helping him get back to sleep. 

(5 out of 7 nights)

Somewhat more than expected 
(Exceeds Outcome)

Joey�s Mom, Pat, starts reading to him at 9:00 and spends 20 minutes reading 
to Joey before lights out at 9:20. She spends up to 10 minutes with Joey (lights 
out, quiet time) to help him get to sleep. Pat sleeps in her own bed. When Joey 
wakes up in the middle of the night, she walks him to bed, and spends no more 
than 5 minutes helping him get back to sleep. 

(6 out of 7 nights) 

Much more than expected 
(Far Exceeds Outcome)

Joey�s Mom, Pat, starts reading to him at 9:00 and spends 20 minutes reading 
to Joey before lights out at 9:20. She spends up to 10 minutes with Joey (lights 
out/quiet time) to help him get to sleep. Pat sleeps in her own bed. When Joey 
wakes up in the middle of the night, she walks him to bed and spends no more 
than 1 minute helping him get back to sleep.

(7 out of 7 nights). 







Table 5. 

Joey�Watering the Garden





Much less than expected

(Present Level of Performance)

Joey enjoys water and water play indoors and out. He engages in water play by 
himself. He does not participate with the family as they take care of the garden. 

Somewhat less than expected

(Benchmark)

When mom or dad are working in the garden, Joey will participate by watering 
a plant through a 1 step visual sequence (1. when handed a child size 
watering can, water the plant) with prompts as needed for 3 out of 4 naturally 
occurring 
opportunities.

Expected level of outcome

(Outcome)

When mom or dad are working in the garden, Joey will participate by watering a 
plant through use of a 2 step visual sequence (1. Walk to garden plot while holding 
child size watering can filled with water, 2. Water a plant) with prompts as needed 
for 3 out of 4 naturally occurring opportunities.

Somewhat more than expected 
(Exceeds Outcome)

When mom or dad are working in the garden, Joey will participate by watering 
a plant through a 3 step visual sequence with prompts as needed for 3 out of 4 
naturally occurring. 

Three step visual sequence includes:

1. Hold child size watering can while parent fills with water, 

2. Walk to garden plot while holding can, 

3. Water a plant

Much more than expected 
(Far Exceeds Outcome)

When mom or dad are attending to plants indoors, Joey will participate by 
watering an indoor plant with mom or dad through a 3 step visual sequence with 
prompts as needed for 3 out of 4 naturally occurring opportunities. 

Three step visual sequence includes:

1. Hold child size watering can while parent fills with water, 

2. Walk to plant while holding can, 

3. Water a plant.







Step 3: Intervention Planning 
and EBP Selection 

Once the priority outcomes are 
determined and scaled, the team and 
the family discuss what EBP to begin 
implementing together. The team 
reviewed the list of EBP from the 
NPDC website http://autismpdc.fpg.
unc.edu/content/briefs. They learned 
that 10 of the 24 EBP were found to 
have efficacy with infants and toddlers 
with ASD so they focus on these as 
most relevant for Joey�s goals. These 10 
are: reinforcement, prompting, visual 
supports, functional communication 
training, pivotal response training, 
naturalistic interventions, parent 
implemented intervention, discrete 
trail training, activity work systems, 
and Picture Exchange Communication 
System. 

Choosing EBP for Donovan Family

Their decision about which EBP to 
select was further informed by information 
gathered including: child 
development assessments, the priority 
outcomes, Joey�s history (what has 
worked in the past), family resources 
and needs, and the EI Program and 
provider resources. To prepare for 
implementation, the team identified 
the professional development needs related 
to (1) learning, in depth, foundational 
EBP and (2) learning to better 
partner and support families through 
coaching in the use of EBP. Given the 
program�s need to further develop the 
fidelity of implementation of EBP, the 
team is interested in learning, in depth, 
some foundation EBP. In addition, 
they recognize their need to learn to 
better communicate through coaching 
the use of EBP with families. Further, 

Table 6.

Joey�Communication





Much less than expected

(Present Level of Performance)

Joey will take his parents� by the arm to what he wants and/or 
squeals to let them know that he wants an object.

Somewhat less than expected

(Benchmark)

During playtime with mom or dad (e.g. bath time, outdoor water 
play), Joey will make a choice among preferred play objects 
(e.g. water wheel, bucket, squirt duck, boat) by pointing, touching, 
or approximating name of object for 4 out of 10 naturally 
occurring opportunities for 3 consecutive days. 

Expected level of outcome

(Outcome)

During playtime with mom or dad (e.g., bath time, outdoor water 
play), Joey will make a choice among preferred play objects (e.g., 
water wheel, bucket, squirt duck, boat) by pointing, touching, or 
approximating name of object for 8 out of 10 naturally occurring 
opportunities for 3 consecutive days.

Somewhat more than expected 
(Exceeds Outcome)

During playtime with mom or dad (e.g. bath time, outdoor water 
play), Joey will make a choice among preferred play objects (e.g. 
water wheel, bucket, squirt duck, boat) by pointing, touching, or 
approximating name of object for 8 out of 10 naturally occurring 
opportunities for 5 consecutive days.

Much more than expected 
(Far Exceeds Outcome)

During playtime with a relative other than mom or dad (e.g. bath 
time, outdoor water play), Joey will make a choice among preferred 
play objects (e.g., water wheel, bucket, squirt duck, boat) by 
pointing, touching, or approximating name of object for 8 out of 10 
naturally occurring opportunities for 3 consecutive days. 







Joey and the family�s priority outcomes 
and described goals suggest that some 
of the foundational EBP would be a 
great fit. Thus, the team and family decide 
to begin by focusing on prompting, 
reinforcement, and visual supports. 
In addition, Jillian will review parent-
implemented intervention and self-
management interventions to support 
Joey�s mom, Pat, given the toll that 
bedtime is taking on the family.

Identifying Roles 
and Coaching Needs 

A team is assigned to support Joey 
and his family. Jillian is the primary 
provider who will be the main contact 
for the family. Other team members, 
including a speech-language pathologist 
and occupational therapist, are 
available to join Jillian during routine 
team meetings and on joint visits as 
needed. Jillian will visit the Donovans 
in their home or in the community 
once a week on average with additional 
visits as needed. Community 
settings will be those frequently visited 
by the Donovans, especially those that 
they have identified as priorities. These 
settings include the Donovan�s church 
and the local grocery store.

Identify Training/Coaching Needs

While Jillian and the team support the 
Donovans, the team will receive support 
from the EI Program. Jillian will 
continue to receive supervision and 
support from the EI program director 
once a week. She will also meet once a 
week with the team to discuss particular 
successes or concerns. Since Jillian 
is interested in building her skills as 
a coach to families, she has asked another 
primary provider, Meg, to have 
lunch with her once a week to discuss 
her work with families, including the 
Donovans. Meg and Jillian have also 
received support from their supervisor 
for Meg to observe Jillian during 
home visits once a month. Thus, Meg 
will serve as a peer coach to Jillian as 
she coaches the family. Meanwhile, 
the staff of the Clarksville EI Program 
will continue to receive coaching and 
consultation from the regional University�s 
early intervention support 
program. Through these relationships, 
coaching becomes a vehicle through 
which ongoing learning takes place 
on a variety of levels, the overall EI 
Program, the providers, the Donovans, 
and ultimately Joey.

Step 4: Implementation and 
Ongoing Assessment

Coaching with the family occurs 
through a cyclical process that aligns 
the NPDC coaching process with 
the five coaching styles of interaction 
developed by Rush & Shelden (2011).
The process includes: pre-observation/
initiation, observation and action, 
and post-observation/reflection and 
evaluation (Kucharczyk, S., Shaw, E., 
Smith Myles, B., Sullivan, L., Szidon, 
K., and Tuchman-Ginsberg, L., 2012). 
A parallel process takes place as an 
experienced EI provider, Meg, coaches 
Jillian. Jillian has informed Pat and 
Mike about the structure of the team 
meetings and Meg�s role as a peer 
coach. The following is an example of 
this component of the coaching process. 
This is a snapshot of an ongoing 
process and interaction style between 
the Donovans and Jillian and Jillian 
and Meg. More description of these 
stages is available in the Chapters 
1-3 of the Guidance and Coaching for 
the Implementation of Evidence-based 
practices for Children and Youth with 
Autism Spectrum Disorders. Additional 
resources are available on the Family, 

Figure 3. 

Coaching Process



Infant and Preschool Program (FIPP) 
Center for the Advanced Study of Excellence 
(CASE) in Early Childhood 
and Family Support Practices website 
http://www.fipp.org/products.html. 
The following snapshot highlights how 
Jillian and the Donovans work together 
within the three phase coaching 
process used by the NPDC and the 
five coaching styles of interaction used 
by FIPP CASE.

Table 7.

Coaching Snapshot

Coaching the Donovans

Coaching Jillian

Pre-observation/Initiation

Jillian asks the parents to remind her of what their mealtimes are like 
currently. Pat and Mike describe Joey as a good eater. He loves fruits 
and vegetables. He does not join the family at the dinner table. He grazes 
throughout the day. He walks around while eating, especially when eating 
outdoors (searching for mud puddles). They�ve tried offering Joey preferred 
foods, keeping Joey in a booster seat which caused massive tantrums like 
last Sunday, and closing off doors in the kitchen to contain Joey.

 Jillian suggests that they reschedule their visit time so that she 
can come during lunch. They talk about how Jillian is helping Pat and Mike 
prompt Joey during playtime with graduated guidance and reinforcing Joey 
right away for responses they want to see. The parents and Jillian decide 
to try to work on these interventions during meal time with the goal of having 
Joey sit at the table with a toy or eating for a few minutes. 

 When Jillian returns to her office, she reviews the Prompting 
Implementation Checklist for graduated guidance to begin to plan for her 
next visit with the Donovan family (http://autismpdc.fpg.unc.edu/sites/
autismpdc.fpg.unc.edu/files/Prompting_Checklist-Graduated.pdf)

Jillian meets with Meg to discuss her work with the 
Donovans. Jillian shares that she�s feeling good about her 
work with them. They are an engaged family although 
she�s worried that,, Pat is very overwhelmed and hitting 
her limit. Jillian shares that she�s worried that she may 
be pushing mom. She�s not sure how to gauge the pace 
by which they should be moving with working on implementing 
the practices they agreed to. Meg asks Jillian 
reflective questions to better understand her concern. She 
asks Jillian to share the moments when Pat has seemed 
overwhelmed, how Jillian might address this concern with 
mom and dad, how she might include them in the decision 
about pacing that would work well for them. They discuss 
the next session. Jillian asks Meg if she would be available 
to come observe the home visit. The family is aware 
that Meg will be coming every few weeks to observe and 
support Jillian. Meg asks Jillian what she would like her 
to focus on during the visit. Jillian and Meg agree that she 
should observe how Jillian does with pacing and responding 
to the Donovans� ability to take on new information. 
After their meeting Jillian calls Pat to make sure that the 
extra visitor won�t be an issue.







Coaching the Donovans

Coaching Jillian

Observation & Action/Engagement

Jillian returns to the Donovan home a few days later as scheduled with 
Meg, her coach. She brings a family friendly version of the graduated guidance 
checklist (INSERT LINK) in case the family wants to discuss implementing 
the steps. Before starting, Jillian, Mike, and Pat review the plan for 
the visit. They will begin the lunch routine and Jillian will begin to observe. 
If she sees opportunities to model, she will. Joey�s parents can ask for her 
feedback and immediate help at any time during her observation. 

Jillian observes that Pat doesn�t seem as relaxed as she usually does 
during play sessions. She also notices that while Mike is preparing the 
food options for Joey, Joey is already being prepared for the meal. Jillian is 
concerned that the amount of wait time might be undermining the family�s 
meal time success. She makes a mental note of these observations.

 Lunch is ready. Pat remarks that they are offering only his most 
preferred foods (carrots, apples, and strawberries) to help ensure success 
as she learned to do when she and Jillian were talking about favorite toys 
to use to work on new skills. Jillian reinforces Pat�s generalization from 
their previous conversations. Mike asks Jillian what she thinks about how 
to transition Joey to the table. Jillian suggests they try to minimize their 
talking to him and use what they know works in play�gently physically 
leading him towards the table. Joey has a tough time transitioning. He is 
busy inspecting the water in the dog�s water bowl. Jillian suggests they 
find a visual to show him (they have used Boardmaker symbols in playtime). 
Everyone quickly scans for a visual to use. Pat suggests they show 
him the strawberry he is to eat. �Genius!� Jillian exclaims and Mike smiles. 
Pat shows Joey the strawberry while gently helping him up and physically 
guiding him to the table. She helps him into his chair. Joey eats the strawberry 
and as soon as it�s done is fussing to be let down. Jillian immediately 
steps in and guides Joey�s hand to the next piece of fruit on his plate. As 
he eats it, she cuts up the rest into smaller pieces and says to his parents 
�I�m cutting them so we have more opportunities to keep him busy here�. 
For the next few pieces she again guides Joey to feed himself at the table. 
She then asks Pat to give it a try. Before Pat begins, Jillian reminds her to 
guide Joey to the fruit before he�s likely to become frustrated with sitting at 
the table. A few minutes later Joey has had enough. Pat, Mike and Jillian 
all agree that it�s time to let him down. He�s done well. 

 They move to the living room where the parents and Jillian hone 
their use of prompting and reinforcement as they interact with Joey and his 
toys. The session is coming to a close. Mike engages Joey in a preferred 
activity, playing at the water table outside, so that the three can reflect on 
their work together.

Meg finds an unobtrusive place to sit and observe Jillian 
with the Donovans. She checks with Pat and Mike to 
ensure they are comfortable with her presence. Meg sees 
Joey giving her a sideways glance. She smiles in return 
and says �Hi Joey�. He shifts his attention to lunch and 
doesn�t return to her.

 Meg makes a note about Jillian�s effective 
reinforcement of mom and dad throughout the visit. It�s 
immediate and specific, something she and Jillian have 
discussed doing more often in the past.

 Meg notices the anxiety in mom�s behavior that 
Jillian mentions. She wonders why Jillian hasn�t checked 
in with mom during the visit. 







Coaching the Donovans

Coaching Jillian

Post-observation/Reflection, Feedback & Evalution

Jillian begins by asking the parents, �So how do you feel that went?� Pat 
and Mike agree that it was much better than expected. Pat shares that 
she was very nervous because most meals feel like a battle to her. Jillian 
attempts to support Pat by saying how hard it must be to prepare for 
unavoidable activities that are so difficult and that she has high hopes that 
based on today they will be able to make it easier for the family. Jillian 
asks Pat and Mike to reflect on what they all did during mealitme that 
worked and what didn�t work. Pat and Mike are quick to recognize the 
need for visuals to help Joey transition. Jillian again praises Pat�s in the 
moment creativity. Mike mentions that he hadn�t thought of cutting the 
food smaller to give Joey more opportunities to engage in eating and is excited 
to do more that. Jillian reminds both parents that they were smart to 
have very reinforcing food for Joey. As a team they decide to continue to 
have these food choices for a while until Joey becomes more comfortable 
staying longer in the chair. They will begin to add in a few less preferred 
options as he and the family gain success. Makes makes a mental note to 
have Joey�s favorites ready at the following Sunday�s dinner

 Since the parents didn�t bring up the issue themselves, Jillian 
decides to give them some feedback on Joey�s activities prior to meal 
time. She suggests that as they build in opportunities for Joey�s success 
through the favorite foods and visuals they could also think about what 
he�s doing just before lunch. She reminds Joey�s parents that if Joey is 
very much engaged (such as in water play) before mealtime or if he�s 
very disengaged and frustrated the transition to mealtime is likely to be 
more difficult. The parents agree and consider how to manage the time 
prior to mealtime. Pat suggests this might be a good time for her to play 
with Joey in the living room with the door closed to the kitchen where 
Mike can be preparing lunch. Mike also suggests that on days that he is 
traveling for work that he can have prepared lunches ready for Joey in 
the refrigerator. Jillian takes notes of these decisions to share with the 
parents before she leaves.

 Pat, Mike, and Jillian plan for their next session. Jillian asks if 
they would like to continue their focus on mealtime. They agree that this 
continues to be a priority. Jillian suggests that since they were able to use 
some of the steps of graduated guidance during mealtime that they could 
fine tune this practice. She shows Pat and Mike the graduated guidance 
resource she brought. She reviews the different steps as they worked on 
play routines. They decide to go over the steps at the beginning of their 
next session together and just before they transition Joey to mealtime.

Meg asks how Jillian thought the session went. Jillian 
is happy with her work with Joey�s parents. Given Pat�s 
frustration with mealtime before her observation, she was 
worried it would be more difficult. She was pleased to see 
Pat and Mike engaged, problem solving, and noticing successes. 
She�s also really excited that Joey sat at the table! 

 Meg agrees those were great positives and asks 
Jillian to reflect on her work and coaching of the parents. 
Jillian wonders if she modeled too much for Mike and Pat. 
Perhaps she could have given them more opportunity to be 
at the table with Joey. Meg reminds Jillian that this was a 
particularly challenging family routine and that her instinct 
to help ensure success was probably a good one. Meg 
talks to Jillian about how to provide support to Pat without 
interrupting Meg�s interaction with Joey. They discuss 
ways to give mom and dad opportunities to practice working 
with Joey at the table. Meg also points out to Jillian her 
effective use of reinforcement with mom and dad throughout 
the session. They make a plan for how to coach mom 
and dad at the table during the next session.

 Next, Meg asks how she gauged the parents, 
especially Pat�s, level of frustration during the session. Jillian 
says she felt her frustration at the beginning. She also 
says that she felt Pat get frustrated during their reflection 
time and that it seemed to get better when they made a 
plan to continue to work on mealtime and made a plan to 
continue to use graduated guidance. Meg asks Jillian why 
she didn�t ask Pat and Mike directly about these observations 
so she can better gauge their work together? Jillian 
is not sure. Perhaps she�s worried she won�t know what to 
do if they say they are overwhelmed. 

 Meg and Jillian brainstorm ways to have this 
conversation with the parents and different approaches 
she could take based on their answer. One would be to 
use the implementation checklists for the practices she�s 
teaching them to breakdown their work into more manageable 
pieces. They take out a checklist to plan this out. 

 Meg and Jillian discuss when she might watch 
Jillian implementing the practices to check her own fidelity 
and any trouble spots







Step 5: Evaluation and 
Modification of Planning 
Process and Intervention 
Outcomes

Throughout their work, Jillian and the 
Donovans monitor their and Joey�s 
progress by evaluating and sometimes 
modifying their process. To monitor 
hers and the family�s implementation 
of evidence-based practices, she uses 
EBP Implementation Checklists. She 
reviews the step-by-step directions 
prior to working with the family. She 
also uses this detailed version with her 
peer coach who observes her implementation 
of the practices during 
home visits. Through this data, she 
is better able to hone her use of the 
practice and thus better able to teach 
the practice to care givers. EBP Implementation 
Checklists are found on 
the NPDC on ASD website (http://
autismpdc.fpg.unc.edu/content/briefs). 
Early Intervention-specific EBP learning 
modules and resources can also be 
found on the ASD Toddler Initiative 
website (http://asdtoddler.fpg.unc.
edu/).

In addition to the EBP Implementation 
Checklists, the parents and 
Jillian take data related to the family�s 
GAS goals and they review these 
goals frequently. Data collection tools 
are developed as a team, so that they 
are easy for the family to integrate 
into their lives and gather all of the 
information needed to determine if 
progress is being made. Based on the 
information from the data sheets, 
Jillian supports the family to make 
decisions about how to modify their 
implementation approaches. Examples 
of these data sheets follow. In addition 
to informing week to week decisions, 
the information gathered from these 
data sheets is reviewed and evaluated 
during IFSP meetings in order to 
inform changes in the plan. 

Jillian periodically requests feedback 
about the coaching process from 
Joey�s parents and her coach. She asks 
the parents about what is working 
for them (e.g., would they like more 
modeling, less modeling, more paper 
resources, more observations). She also 
asks her peer coach, Meg, to observe 
the specific skills she would like to 
make sure she�s using effectively (e.g., 
listening actively, asking open ended 
questions, providing feedback effectively). 
During one session, she asked 
the parents if she could videotape their 
time together so that she could review 
the content with her peer coach and 
supervisor and get their feedback. The 
parents shared with Jillian that they 
appreciate her commitment to improving 
her skills and this gives them 
confidence in her abilities. 

Summary

This case study illustrates the parallel 
processes of coaching of an early 
intervention provider and the coaching 
of a family as they partner to implement 
evidence-based practices for a 
child with autism spectrum disorders. 
Coaching is supported by the use of 
resources used by the NPDC such as 
a program quality tool (APERS � IT), 
the goal attainment scaling process, 
EBP learning modules, and implementation 
checklists. The EI Program 
and interventionist use these resources 
along with those developed by FIPP to 
effectively support the Donovan family 
through five steps: (1) information 
gathering, (2) outcome planning, (3) 
intervention planning, (4) implementation 
and ongoing assessment, and (5) 
evaluation. These coaching and intervention 
practices smoothly fit into the 
steps of the Part C Early Intervention 
processes. They add specificity to focus 
on improving outcomes for infants and 
toddlers with ASD and their families.

References

Cardillo, J. E., & Choate, R. O. (1994). 
Illustrations of goal setting. In T. 
Kiresuk, A. Smith, & J. Cardillo, 
(Eds.). Goal attainment Sscaling: 
Applications, theory, and measurement 
(pp. 15-37). Hilldale, NJ: 
Lawrence Erlbaum Associates.

Kucharczyk, S., Shaw, E., Smith Myles, 
B., Sullivan, L., Szidon, K., and 
Tuchman-Ginsberg, L. (2012). 
Guidance and coaching on evidence-
based practices for learners with 
Autism Spectrum Disorders. Chapel 
Hill: The University of North Carolina, 
Frank Porter Graham Child 
Development Institute, National 
Professional Development Center 
on Autism Spectrum Disorders. 

Rush, D. D, & Shelden, M. L. (2011). 
The early childhood coaching handbook. 
Baltimore, MD: Paul H. 
Brookes Publishing Company.



Table 7.

Time at Dinner Table

Goal: During family dinners, Joey will sit at the dining room table either eating or quietly playing with a toy for at least 10 min for 2/3 dinners.

 

Date

Mom & Dad/

Extended 
(circle)

Time at Table 
(min)

Notes (e.g., ate, 
played, what helped, 
what was hard?)

5/27

Mom &/or Dad

Extended

2min

Ate for a min with airplane 
in his hand/used airplane 
to move Joey to table/ate for 
another min with mom giving 
Joey airplane after every bite

5/28

Mom &/or Dad

Extended

1min

What do we do when dinner is 
not ready but he�s ready to eat? 
Had to put food on table but 
mom wasn�t ready to sit and 
help.

Mom &/or Dad

Extended

Mom &/or Dad

Extended

Mom &/or Dad

Extended

Mom &/or Dad

Extended

Mom &/or Dad

Extended

Mom &/or Dad

Extended








Table 8.

Watering the Garden

Goal: When mom or dad are working in the garden, Joey will participate by watering a plant through the use of a 2 step visual sequence (1. 
walk to garden plot while holding a child size watering can filled with water, 2.water plant) with prompts as needed for � opportunities.

Date

5/27

5/28 

6/1

6/2

6/3

6/4

6/4

Step 3. 
Water plant

NO (spilled 
all of water 
before getting 
to plant)

With lots of 
help got most 
of water on 
plant

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Step 2. Walk 
to garden plot 
while holding a 
child size watering 
can filled 
with water

.

(YAY!!!)

.

.

(needed lots of 
help today)

.

.

Step 1. Hold 
child size 
watering can 
can while mom/
dad fills it with 
water

.

(YAY!)

.

Who helped?

Dad

Mom

Dad

Dad

Dad

Mom

Mom








Table 9.

Communication

During playtime with mom or dad (e.g., bath time, outdoor water play) Joey will make a choice among preferred play objects (e.g., water wheel, 
bucket, squirt duck, boat) by pointing, touching, or approximating name of object for 8/10 opportunities for 3 consecutive days. 

Date

Play Objects 
Available

Object 
Chosen

How 
Chosen

Amount 
of Help 
Given

Who 
Helped

Notes

5-28

Water wheel, bucket, 
hose, squirt duck

hose

point

I G 

T P 

 V No

Dad 

J started 
screaming for 
hose so I used the 
steps to help him 
point it out.

5-28

(bath)
whale, boat, sponge, 
cup

whale

point

I G 

T P 

 V No

Dad

J kept looking 
at the whale so 
I helped him by 
moving his hand 
to it

5-28

Same as above

Cup

�Cuh�

I G 

T P 

 V No

Dad

J yelled for the cup 
so I said �cup� a 
few times and he 
did it too!!! J

5-28

Same as above

Whale

Grab

I G 

T P 

 V No

Dad

I showed J the cup 
and whale and 
he grabbed the 
whale without 
screaming!

5-29

Outside playing in 
creek(sticks, a cup, 
bucket, rocks)

Stick

Tried to 
grab

I G 

T P 

 V No

Mom

J reached for stick. 
I said �Stick, you 
want stick?� And 
pointed at it

5-29

Creek (sticks, a cup, 
bucket, rocks)

Cup

�Cuh�

I G 

T P 

 V No

Mom

I was holding the 
cup. J wanted the 
cup. I said �Cup?� 
and he said it!!! 



I � independently/ no help was needed G � gesture point to the object

T- gently touch Joey�s elbow and guide him to the object V � model by verbally naming the object

P � place Joey�s hand on the object No � Refused / Didn�t do it



Table 10.
Frequency Recording Sheet





Figure 4.
My Calendar� Assessment Tool