Guidance & Coaching on Evidence-based Practices for Learners with Autism Spectrum Disorders Suzanne Kucharczyk Evelyn Shaw Brenda Smith Myles Lisa Sullivan Kate Szidon & Linda Tuchman-Ginsberg Guidance & Coaching on Evidence Based Practices for Learners with Autism Spectrum Disorders i Guidance & Coaching on Evidence-based Practices for Learners with Autism Spectrum Disorders. Suggested citation: 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. Table of Contents 1. Introduction to Coaching. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 2. The Coaching Process: The Model and Method. . . . . . . . . . . . . . . . . . . . . . .9 3. Coaching Practices, Implementation Science and the National Professional Development Center on Autism Spectrum Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 Appendices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 A: Coaching Logs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 B: Guidelines and Activities for Professional Development. . . . . . . . . .23 C: The Donovan Family Case Study. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33 Chapter 1 Introduction to Coaching Coaching is a key ingredient for the successful implementation of evidence- based practices (EBP). Coaching helps educators make informed decisions about instruction and program organization that will lead to intervention practices that help children and youth learn more effectively. Coaching is relationship-based and is developed within the cultural context of organizations (Dunst, Trivette & Hamby, 2010; Fixsen, 2009; Fixsen, Blasé, Naoom & Wallace, 2009; Fixsen & Blasé, 2008; Joyce & Showers, 2005; Knight, 2009; Metz & Bartley, 2012). The National Professional Development Center on Autism Spectrum Disorders (NPDC) along with a growing number of school based initiatives (e.g., Response to Intervention and Positive Behavioral Intervention Supports) has a strong focus on coaching as a professional development strategy (Knight, 2009; Scott & Martinek, 2006). Beyond the context of schools and other educational programs, research has found coaching to be a critical tool used to directly support families of young children as they generalize interventions into their child’s daily routines. In schools, centers, and homes coaching is a critical, relational process used to support the fidelity of implementation of EBP (Basu, Salisbury & Thorkidlsen, 2010; Rush & Shelden, 2011). NPDC committed to the use of coaching to meet the Center goals to provide state partners with sustainable, outcome-based professional development and technical assistance that optimized existing resources for effective delivery of services to learners with autism spectrum disorder (ASD). Coaching was applied in school and early intervention settings. For professional development to be effective and result in systemic implementation of evidence-based practices, commitments such as administrative investment and support, staff commitment, staff time and support resources are required. Fixsen and colleagues (Fixsen & Blasé, 2008; Knight, 2009; Metz & Bartley, 2012) suggest that implementation happens in six nonlinear stages: exploration, installation, initial implementation, full implementation, innovation, and sustainability. These activities occur in cycles and rely on data to inform decision-making about what is and isn’t working toward meeting implementation goals. Coaching is integral to such a change process. The NPDC processes, including coaching, are implemented as each program, school, classroom, educator, and family moves through these stages of implementation. See Chapter 3 for additional information on coaching within the system change framework of implementation science (Fixsen & Blasé, 2008; Metz & Bartley, 2012). The NPDC, in partnership with participating states, has engaged in a number of activities designed to increase the use EBP and improve programming for learners with ASD. Coaching relationships were developed throughout most NPDC activities to help state partners build the capacity of their training and technical assistance systems and to support educators in model sites to implement EBP effectively. Teams completed an online course in autism foundations and participate in a week-long NPDC Summer Institute to prepare for their year of engagement with NPDC. NPDC staff completed the Autism Program Environmental Rating Scale (APERS) or the Autism Program Environmental Rating Scale-Infants and Toddlers (APERS-IT) to inform decision making about targets for program improvement. Teams then reviewed the Individualized Family Service Plans (IFSP) or Individualized Education Plans (IEPs) for selected learners and evaluated information in order to perform Goal Attainment Scaling (GAS) on identified priority outcomes and goals for each learner (Cardillo & Choate, 1994). Following these activities, each team chose a few of the EBP that addressed each learner’s goals and helped build their team’s capacity. NPDC has developed criteria and identified 24 evidence-based practices shown to be effective in demonstrating outcomes for children and youth with autism spectrum disorders. For each of these practices, an educational module has been developed and posted on this site: http://www.autisminternetmodules. org/. These modules are designed to provide guidance to professionals and parents in implementing these practices with fidelity. See Chapter 3 for more information about these program components. After these preparatory activities were completed, participating NPDC teams engaged in a year-long coaching process using EBP module materials including Implementation Checklists designed to demonstrate the use of each practice with fidelity over time. The following sections describe the coaching process used by NPDC, including (a) a description of coaching, (b) underlying assumptions, (c) descriptors/non-descriptors, (d) elements for successful coaching, (e) communication and (f) potential barriers to coaching. Coaching Definition According to Gentry, Denton, and Kurz (2008) coaching is a form of embedded sustained professional development for practicing educational professionals. Two individuals participate in the process: the inviting partner and the coach. The inviting partner, an educator, early intervention provider, family member, or other professional, is focused on improving her instruction by enhancing or developing skills. The coach engages in focused pre- observation conversations with the inviting partner, observes her while working, and then uses questioning and other communication skills to build a coaching relationship to empower her partner to reflect on her practices. In addition, the coach teams with the inviting partner to help her incorporate EBP into her teaching or intervention so that children and youth will learn more effectively (Knight, 2009). These processes contribute to the development of intellectual capacity in schools (Neufield & Roper, 2003) and early intervention settings (Basu et al., 2010; Peterson et al., 2007; Rush et al., 2010) as professional knowledge is shared to refine existing skills and focus on the acquisition of new techniques. Through coaching, educators learn to work and think together about the impact of their behavior on learner achievement and outcomes (Showers, 2005). NPDC staff utilized coaching processes to support training and technical assistance (TA) providers who in turn coached educators and early intervention personnel with the goal of fostering mentor and peer coaching relationships that would continue after the NPDC staff were no longer working in the state. Coaching generally consists of three steps that occur on a scheduled basis: pre-observation conference, observation, and post-observation conference. The pre-observation and post- observation conferences generally last 15-to-20 minutes. The length of the observation is based on the amount of time necessary to take data and model and/or observe practices that were identified during the pre-observation conference. The inviting partner, working with the coach, selects a coaching target to improve and/or a behavior to change. During the pre-observation Coaching generally consists of three steps that occur on a scheduled basis: pre-observation conference, observation, and post-observation conference … Each of these steps plays an important role in ensuring successful outcomes from the coaching process; none of these stand alone. conference, the coach assists the inviting partner in refining the target and defining an observation plan, including the method that will be used to collect data and observe practices. The coach’s role is to follow, as closely as possible, the plan for observation that she and the inviting partner agreed upon. During the observation, the coach must observe, model and/or collect data in a manner that will allow for the creation of a clear record that will be discussed in the post-observation discussion. Following an observation, the coach provides feedback during the post-observation conference according to prearranged guidelines. Each of these steps plays an important role in ensuring successful outcomes from the coaching process; none of these stand alone. For example, omitting a pre- observation conference may result in the coach taking data or observing irrelevant information. Failure to engage in a post-observation conference will prevent an inviting partner from engaging in problem solving that may help change the inviting partner’s behavior. Three types of coaching relationships— mentor coaching, peer coaching, and reflective consultation are introduced below. Mentor Coaching In mentor coaching, the coach shares knowledge and experience with the inviting partner to help him develop or improve skills. The coach offers guidance and suggestions taking an active role in defining target behaviors, as well as observational methods, with the inviting partner during the pre-observation conference. The coach’s role is to follow, as closely as possible, the plan for observation that she and the inviting partner agreed to and to maintain a clear record of the observation in order to have a valuable post-observation discussion. During the post-observation conference, the coach not only interprets data collected during the observation, but also may provide direction on methods to further improve a coaching target or suggest a new target. Even though the mentor provides direction, the mentor/ inviting partner relationship should not serve as means of evaluating an inviting partner’s performance. Mentor coach relationships within NPDC were developed between TA providers, state liaisons, or other experts in the field as identified by the partners. Peer Coaching In peer coaching, the process is reciprocal; each member of the pair coaches the other, taking turns serving as the inviting partner and coach. The coach’s role is non-authoritarian. A good coach serves as a guide introducing questions that allow the inviting partner to select and define a coaching target and data collection method during the pre-observation conference. As in mentor coaching, the coach follows the observation protocol described in the pre-observation conference. During the post-observation conference, the coach offers nonjudgmental comments and avoids providing suggestions to assist the inviting partner in reflecting on her skills. In the context of NPDC, peer coaching partnerships formed between various team members including a teacher and a therapist, a general and special education teacher, a teacher and transition services representative, and/or family members and a teacher. In early intervention, the professional may be joined by a mentor or peer coach during a home or community- based visit. There is a parallel process whereby the early intervention professional serves as a mentor or peer coach to an inviting family member to support them in learning to implement EBP within daily routines and activities. More information about this approach to coaching is included in the companion document on implementing EBP through coaching practices in early intervention. Reflective Consultation Reflective consultation is a variation on a coaching relationship that may be used by an administrator or supervisor in supporting a mentor or peer coach. This process utilizes many of the elements of peer to peer and mentor coaching, but may not include an onsite observation. A reflective consultation session provides a TA provider or mentor coach the opportunity to reflect upon her experiences as a coach and gain insights for improving or changing aspects of her coaching practices. This may be particularly important when there are challenges in the coaching relationship or when a coach is newly learning coaching skills. Questioning, reflective listening, and an action plan are essential to this type of coaching support (Rush, Shelden, & Raab, 2008). These sessions would typically occur between a coaching sequence of pre-observation, observation, and post-observation so that the coach can reflect upon what occurred during that sequence and address challenges that occurred. Within the NPDC, this type of reflective consul tation occurred between the NPDC staff member supporting a technical assistance coach within a state. Also, it was an effective method for a supervising NPDC staff member to support staff who were engaged in assisting state teams in learning to implement peer to peer and mentor coaching practices within their training and technical assistance activities. Elements of Successful Coaching The following items are essential to coaching success: (a) trust and mutual respect, (b) training, (c) willingness to change, and (d) professional attitude. Trust and Mutual Respect A reasonable level of trust is built, in part, by understanding which topics people are comfortable discussing and how to approach topics that may be somewhat sensitive. By understanding topic-comfort levels, coaches and inviting partners can more easily relate to each other. Trust between coaching pairs occurs as a result of respecting each other’s professional skills. Partners discuss goals and targets in a confidential and professional manner. Trust and mutual respect are evident between the coach and inviting partner when they • develop and share a consistent terminology • agree on location for pre- and post-observation conferences • listen actively, reflectively, and empathetically • express feelings honestly • understand their partner’s level of concern and comfort • are open to exploring and understanding each other’s belief systems Training Organizational commitment to training is imperative in creating an environment that supports effective implementation of coaching and the systemic changes that sustain these practices (Joyce & Showers, 2002; Fixen, 2009). Training considerations include: • Relevance—This professional development vehicle should allow educators to gain or perfect skills that are shown to positively impact learning by toddlers, children and youth. That is, coaching content should be based on educator acquisition and use of EBP and overall program improvement. • Location—Coaching training should be conducted at sites that facilitate professional growth, including homes, schools or nearby college settings. • Time—Coaching partners need time to practice under optimal conditions. The more practice opportunities that are provided, the more likely that coaching will become habit. Partners need time to observe and confer with each other. It is helpful to build time for coaching needs into typical work day routines. • Content—Coaching instruction includes content on communication, identifying target behaviors and outcomes, implementing evidence-based practices, data collection methods and effective instruction techniques. Willingness to Change Coaching is predicated on a willingness to change and take risks. Inviting partners must be willing to alter existing behaviors or add new techniques to their repertoires. Not only must they attempt new skills, but ultimately they must work to ensure that these behaviors are mastered and maintained. Typically, this includes a transitional period when the inviting partner may feel clumsy or awkward as the partners are working toward mastery of new learning. Professional Attitude Coaching partners use coaching time to improve their craft. Pre-observation and post-observation conference topics are relevant to changing behavior to influence learner outcomes; conferences do not focus on personal information. Coaching pairs react to each other on a professional level, actively listening and responding to coaching topics identified within the coaching partnership. Communication Collaborations between a coach and inviting partner require effective communication skills. It is essential that coaching partners learn to convey clear expectations and feedback within partnerships by using (a) open questions, (b) leveling statements, and (c) communication conventions. Communication is impeded when either partner engages in these types of communication behaviors: anticipating, avoiding, cross-examining, denying others’ reality, diagnosing, judging, lecturing, moralizing, or teasing. Open Questions Open questions are invitations to respond with an elaborated comment of a listener’s choice. They elicit responses beyond a yes or no or statement of fact. When questions take a form that encourages elaborated responses, it is more likely that varied methods for improving teacher performance will emerge from discussion between partners (Rush et al., 2008). Open questions typically begin as follows: • Tell me about … • How do you … ? • What did you … ? Questions are open if their wording does not constrain the form of the reply. Examples of open questions are the following: • What can you tell me about your experience with your behavior management system? • How do you think the data recording system is working? • What happened when that behavior occurred earlier? • What did you do when your plan didn’t work? Questions are closed if their wording implies that only a short answer response is necessary. Questions that begin with are, do, have, should, will, would, or can invite only a yes or no in response. Those that begin with when, where, or who ask for a one or two-word reply. Examples of closed questions are the following: • Would they behave better if you used another behavior management system? • Are you satisfied with the data recording system? Do you want to change it? • When did that behavior occur earlier? • Are you sure you implemented your plan right? Leveling Statements Leveling statements acknowledge that two parties may have legitimate and conflicting claims. Leveling statements employ the following strategies: • Acknowledgement of another’s claims as valid, • Assumption of other party’s competence, and • Desire for compromise or negotiation. Leveling is an appropriate communication technique that can be used if coaching pairs have different opinions that are legitimate ideas or complaints. Leveling statements serve to clarify claims so parties can negotiate and compromise without one getting the better of the other. Leveling is likely to result in a win-win outcome. Conventions of Communication Collaborative communication is enhanced when communication conventions for social and non-verbal communication skills are effectively applied to a coaching partnership. The use of these conventions help partners feel they have been listened to and are understood. Table 1 lists the elements of non-verbal skills and social conventions that promote respectful, engaging and dynamic communication partnerships. Potential Barriers to Coaching Two potential barriers exist to coaching: time and lack of administrator support. Although both can interact to impede coaching, each is examined separately. Time Coaching consists of three steps: the 15- to 20-minute pre- and post- observation conferences and observation that occur on a scheduled basis. Inviting partners and mentors who engage in coaching must have scheduled time to accommodate these steps. In mentor and peer coaching in schools, the inviting partner must have available joint planning or released time allocated by the administrator, to participate in the pre- and post-observation conferences. The second coaching step, observation, requires that the coach have time to observe when the inviting partner is engaging in the targeted behavior or outcome. It is important that this scheduled time for coaching become a part of the coaching pair’s work routines. If coaching pairs do not use scheduled time, it is likely that other school or program activities may take precedence over this type of staff development. When coaching occurs in a home environment, setting aside clear times and expectations for how that time will be used is critical to ensure that coaching fits into the family’s routines and activities so that the family dynamic is not unnecessarily disrupted. Lack of Administrator Support Coaching is unlikely to succeed unless district, school building, and early intervention program administrators recognize the importance of coaching as an effective professional development approach that has an impact on learner outcomes and provide support to the staff and families engaged in this process. Administrators can provide support in several ways, including (a) arranging joint planning or release time, as needed; (b) providing recognition of coaches in meetings; and (c) respecting confidentiality maintained by the inviting partner and coach around the coaching process and targets. Without administrator support, educators may view this type of staff development as one more task unrelated to teaching or intervention. Without administrative support partners may not meet frequently enough to allow the inviting partner to practice new behaviors or partners may not engage in coaching at all. It is important for administrators to Table 1. Conventions of Communication Nonverbal Skills Attention Cues Focus on the speaker to the exclusion of other legitimate bids for notice. Attention is demonstrated when one partner speaks, the other turns both body and face toward that partner, looking into the speaker’s eyes at intervals as long as the speaker continues. Response Cues Are active listener behaviors that confirm interest in a speaker’s message. The listening partner alternates nodding agreement, smiling, or using appropriate facial expressions as the speaking partner makes a succession of points. Focus on Content Ensures understanding by questioning to determining that all information is clear. This helps the partners establish that all facets of coaching targets, data collections, and procedural issues are clear. Focus on Feelings Helps the coach listen to the inviting partner’s voice tone to determine if it matches with content. In addition, the coach also looks at movement, posture, and facial expressions. Social Conventions Turn Taking Let one speaker finish before the other starts without interrupting either by word or gesture. Proximity Space is at culturally determined intervals in which two or more people feel comfortable standing or sitting across from one another or side by side. Nonverbal Encouragers Are ways to indicate involvement and listening without speaking. Examples are nodding head, smiling, maintaining eye contact, touching an arm, or patting a shoulder. Note taking is also a nonverbal encourager. Taking notes indicates to the speaker that content is important enough to write down. Verbal Encouragers Are brief responses that prompt the speaker to continue talking and convey interest? These include: “yeah,” “go on,” “really,” “I understand, “right,” “uh-huh,” “yes,” and “I see.” be aware of the potential barriers to coaching. Thus, it is necessary that coaches meet with administrators to discuss coaching and brainstorm methods to ensure its success. To minimize the barriers of administrative support and time, the NPDC approach to professional development included administrators and other team members who could support coaching-friendly environments and the implementation of EBP to improve learner outcomes. Furthermore, training on coaching was embedded throughout the professional development provided by NPDC, beginning with the Summer Institute. See Chapter 3 for description of NPDC program components. Summary Mentor and peer coaching offer a means of targeted professional development for practicing educators and early interventionists. The implementation of successful coaching requires an understanding of the complexities of coaching elements including the (a) steps of the coaching process, (b) elements of effective coaching relationships, (c) effective communication strategies, and (d) barriers to coaching. I can’t say enough as to how this partnership has truly transformed and encouraged me professionally in my coaching skills! Overall I feel I can more effectively measure and manage my coaching role with a feeling of more confidence and reassurance to the staff. I am so appreciative of the modeling and the contributions of this research and knowledge base. Absolutely! I could write even more on how this process has shaped and transformed me professionally, well... and personally as it’s helped manage the stress and anxiety I sometimes feel by having a formal tool to work from that is evidence based, incremental and very effective with direct support. —Johanna Colson; MSEd., BCBA, Behavior Specialist for Culpeper Schools Chapter 2 The Coaching Process: The Model and Method Overview The coaching process consists of three cyclical steps: pre-observation conference, observation, and post- observation conference. Within the professional development and technical assistance practices of the NPDC, coaching processes facilitated the inviting partner’s implementation of the evidence-based practices that had been selected to meet the individual goals for a child or youth. These goals are developed through GAS, a process that ensures the goals were measurable across a continuum of steps leading to a targeted change (Cardillo & Choate, 1994). Coaching also supports a team in addressing the strengths and areas of growth identified in the APERS/ APERS – IT. Through the use of individual child goals developed through GAS, APERS/APERS-IT reports and the NPDC EBP Modules, there are ample opportunities and resources for assisting professionals in selecting targets for change within a coaching partnership. This chapter describes each of these coaching activities including (a) the inviting partner’s role, (b) the coach’s role, and (c) the use of the coaching log and how it is applied within NPDC professional development practices. For NPDC, coaching activities were primarily carried out during at least a minimum monthly, onsite visit by a local, mentor coach and supported by ongoing phone calls and emails. In addition, an NPDC staff member provided monthly, reflective consultation to the mentor coach as well as made periodic onsite visits one to three times a year. The reflective consultation relationship was supported with ongoing email and phone communication. Within a program or school, peer coaching occurred both intentionally and organically as team members worked together to support one another in implementing EBP and improving outcomes for children and youth. Pre-observation Conference Once the type of coaching has been decided (e.g., mentor, peer coaching), coaching partners can hold the pre-observation conference to establish the ground rules for the inviting partner and coach to follow during the observation. The pre- observation may occur as a beginning step to a monthly visit. In addition to the monthly visit, additional preparation for an observation may occur with phone and/or email communication in-between monthly visits. During this coaching stage the target for change and how the target is to be measured are identified. Within the NPDC process, targets were related to the processes of implementing evidence-based practices with fidelity and improving environmental variables to support a child’s learning and acquisition of goals. If mentor coaching was the preferred model, the coach will assume an active role in either defining the target for change or guiding the inviting partner to identify a target. If peer coaching is used, the inviting partner defines the target that the coach will observe in the inviting partner’s classroom or program and how those behaviors are to be documented. Both the coach and inviting partner may agree to use modeling during the observation. Modeling allows the inviting partner to actively observe the implementation of an EBP and the coach to provide in the moment feedback. Modeling may be particularly valuable during a home visit where the early intervention coach supports the family in implementing practices throughout their daily routines and activities. Similarly, the coach models skills for teachers to encourage carry over into daily lessons and activities. The final activity of a pre-conference is for the inviting partner and coach to identify where the coach will leave the data and coaching log so that the inviting partner can review them before the post-observation conference. In both mentor and peer coaching models, the inviting partner also describes in detail the lesson or activity to be observed and the etiquette for the observer to follow (e.g., where to sit in a classroom or family home). The coach offers clarifying statements to ensure that the targeted outcome of the observation is documented in a meaningful manner. That is, the targeted outcome is defined and an agreement is reached about how that outcome is to be recorded so that the information can be used to facilitate learner engagement, skill acquisition or refinement. For example, the coach and inviting partner decide which steps of a particular EBP will be observed and recorded on the Implementation Checklist for that EBP. Decisions made during the pre-observation conference are recorded on the Coaching Log by the coach. (Appendix A: Coaching Logs.) Observation During the observation, each member of the coaching pair has specific responsibilities. First, coaching partners agree druing the pre-observation meeting on the observation guidelines. The coach is then responsible for collecting the agreed-upon data and completing the Observation portion of the Coaching Log. (Appendix A: Coaching Logs.) As previously discussed, and if appropriate, the coach may also model the targeted practice for the inviting partner (e.g., show the inviting partner how to implement an aspect of an EBP and provide direct, in the moment, feedback on the inviting partner’s success and/or challenges in implementing the targeted change. Etiquette Rules of common courtesy allow the coach to enter the classroom, home or other environment within which the inviting partner is implementing Table 2. Responsibilities During the Pre-observation Conference Mentor Coaching Peer Coaching Activity IP* C* IP C State the purpose of the lesson or activity. X X Define the coaching target for change. X X Identify the data recording system to be used during the observation. X X X X Operationalize desired instructional behavior. X X Determine if modeling will be used during observation. X X X X Establish mastery and maintenance criteria. X X Establish etiquette. X X Negotiate dates and times of observation and post- observation conference. X X X X Complete pre-observation conference section of the Coaching Log. X Verify understanding of the lesson purpose, coaching objective, and teacher behavior to be observed. X Confirm the recording method, and if it meets the coaching target; otherwise negotiate another method. X Negotiate where to deliver data after the pre-observation conference. X X X X Clarify etiquette. X X Summarize the conference, X X Confirm dates for observation and post-observation conference. X X *IP=Inviting Partner C=Coach EBP and record data without disrupting activities in the inviting partner’s setting. Both the inviting partner and coach have specific agendas and predefined roles. Of particular importance is preparing students, young children, family members and other professionals for the coach’s participation. Students, children and family members need to know that the coach will be observing the inviting partner, not them. Table 3 includes the rules of etiquette to help the coach in observing and collecting data. Post-observation Conference The post-observation conference serves as both ending and beginning points. It concludes the coaching session because it completes the cycle of pre-observation conference, observation, and post-observation conference. This phase, however, also begins the next action part of the coaching process because it is during this conference that the inviting partner develops a plan of action to improve future instruction or intervention. This plan will be implemented and its effects measured during the next observation. The Coaching Log is completed during the post-observation conference. The post- observation conference should occur as soon after the observation as possible. The post-observation conference provides (a) the inviting partner with someone with whom to discuss new ideas, (b) interactions to promote reflection and change improvements, and (c) professional interchange between partners. These types of communication interactions support the inviting partner to reflect upon their experiences and plan for future action. They also provide the coach with information to most effectively support an inviting partner. Coaching partners discuss the data and observation notes as professionals. If the mentoring model of coaching is used, the coach summarizes and interprets the data while soliciting self- evaluative statements from the inviting partner. In addition, the coach offers feedback and suggestions. Evaluation of the inviting partner’s use of the EBP or other targeted change may shape future coaching targets. In peer coaching, the coach delivers the data to the inviting partner and explains the information using effective communication methods, such as open questions and leveling statements without giving evaluative or interpre Table 3. Rules of Etiquette for Inviting Partner and Coach Rules of Etiquette for Inviting Partner Rules of Etiquette for Coach Provide a location where the coach can observe the targeted practice with minimum disruption to the setting (e.g. classroom, home). Observe from the location identified by the inviting partner and be respectful of the environment. Do not interrupt the observation with calls, texts or emails. Prepare students, young children, parents and other professionals for the coach’s arrival, including a plan to minimize interaction with the coach. Follow agreed upon protocol for how to introduce yourself and respond if a student, young child or family member attempts to interact with the coach. Prepare materials and space for agreed upon data collection. Collect only agreed upon data, if engaging in peer coaching. Begin the lesson at the agreed upon time. Arrive and leave at the agreed upon time. Limit the inclusion of the coach in the lesson or activity, except where modeling is involved. Do not participate in the lesson or activity if not agreed upon in advance. As agreed upon, observe demonstrations or modeling of implementation of EBP and participate as planned. As agreed upon, demonstrate or model an aspect of an EBP or other targeted change. Signal the coach to leave if it becomes apparent that the lesson or activity will not yield helpful information. As agreed upon, leave when signaled that the activity will not yield helpful information. tive statements. The coach follows the inviting partner’s lead in discussing the lesson or activity, elicits self-evaluative statements with open questions, and prompts the inviting partner to develop a plan of action for the next coaching session. If the inviting partner wants suggestions about improving instruction or intervention, the coach guides the inviting partner toward answers by asking questions such as whether (a) the inviting partner has encountered a similar situation and, if so, how it was handled; or (b) the inviting partner may have a resource material or person available. The coach, without acting as an expert, leads the inviting partner to suggest ways to improve instruction. In an early intervention setting, the inviting partner may want to focus on the partnership with the parent or other family members in implementing the targeted change as well as the content of the EBP. While the aim is to support the parent or other family members in implementing the EBP, it is also important to address how the inviting partner brings her knowledge and experience with EBP to the parent partnership. When presenting the data and notes from observation to the inviting partner, the coach might say the following: • “You said that you were displeased about how often you provided reinforcement. Could you explain what you meant by that?” • “Tell me about a similar situation you’ve encountered? Tell me how you handled that situation?” • “I wonder if you recall any articles or reports by other teachers about ways to handle that specific situation.” • “I noticed that you were uncertain about when to model for the parent and when to let the parent explore how to implement the practice on her own.” Table 4 provides an overview of the responsibilities of the inviting partner and coach during peer coaching and mentor coaching. Coaching Log The Coaching Log (Appendix A) serves as a record of the coaching relationship. This one-page document records all of the aspects of the pre-observation conference, observation, and post-observation conference conducted by a coaching partner. The log is completed by the coach and is maintained by the inviting partner as a confidential record of his progress toward coaching targets. The Coaching Log was integrated into the NPDC technical assistance documentation and was designed to reflect NPDC materials and processes, including data from the Implementation Checklists and the GAS established for targeted outcomes for participating learners. NPDC also created a Reflective Consultation Log (Appendix A) to record the reflective coaching conversation that occurred between an NPDC staff member and a mentor coach. The Reflective Consultation Log includes space to note the topic of interest, alternatives discussed, actions steps planned and supports needed for follow up. Summary Overall, the coaching process facilitates professional development for educational professionals and parents. The pre-observation, observation, and post-observation conferences are vehicles by which coaching participants actively seek self-improvement. Table 4. Responsibilities during the Post-observation Conference Mentor Coaching Peer Coaching Activity IP C IP C Review data collected by the coach. X X Make evaluative statements based on data. X X X Make statements regarding improvement. X X X Request advice from coach. X Determine future plans. X X X Solicit future plans through reflection and questioning. X X Chapter 3 Coaching Practices, Implementation Science and the National Professional Development Center on Autism Spectrum Disorders As mentioned throughout Chapters 1 and 2, elements of coaching have been integrated throughout many aspects of the professional development and technical assistance provided by NPDC to partnering states. Coaching relationships and practices were operationalized as relevant for the stage of implementation, beginning with the initial state application process and planning with an Interagency Autism Planning Group and continuing throughout project implementation and evaluation. This chapter describes in more detail how NPDC coaching activities fit into the systems change framework of implementation science and six non-linear stages: exploration, installation, initial implementation, full implementation, innovation, and sustainability (Fixsen, 2009; Metz & Bartley, 2012). Readiness for Change Prior to involvement in the NPDC on ASD, applying states made a determination regarding their “readiness for change” as recommended by Fixsen et al. (2008). The states used the application process to identify their capacity (e.g., strengths, weaknesses, and potential opportunities) and the teams of educators, families, and administrators that were ready to invest in and participate in the activities of the NPDC. The lead state applicant, in conjunction with the NPDC staff, was accountable for insuring that they created an environment that would nurture and sustain meaningful change for the existing system of educational services and supports for children and youth with ASD. Exploration The activities of the Interagency Autism Planning Group (IAPG) illustrate the NPDC and state partnership in the stage of exploration. This stage of implementation change identifies a need, and explores whether implementation is feasible and what additional program development or problem solving may be needed before committing to further implementation (Fixsen et al., 2009; Metz & Bartley, 2012). IAPG Meeting During the IAPG meeting, state level leaders worked with NPDC staff to develop a two-year strategic plan outlining specific goals for a comprehensive professional development process, including coaching, to support the implementation of EBP. In addition, the plan included statewide goals for a sustainable system that would promote change and continue beyond the end of the NPDC formal partnership. Statewide resources were highlighted, specific action plans were developed, and benchmarks were set to monitor progress. During the IAPG meeting, the NPDC coaching manual and philosophy were shared with state level leaders and training teams. In addition, expectations for model site participation included the identification of local TA providers who would serve as coaches to the local program team. Installation Once needs were identified and possible interventions explored, the state, in conjunction with the NPDC, establishes resources needed to implement the EBP and prepares participants. This is considered the installation phase (Fixsen, 2009; Metz & Bartley, 2012). Online Course Installation began with an 8-session online course, Foundations for Autism Spectrum Disorders, which was developed as an up-to-date source of information about ASD. The sessions cover content on characteristics of ASD, screening and assessment of ASD, factors affecting learning and development, and promoting positive and reducing interfering behaviors among others. All model site team members and TA providers/coaches were required to complete the course prior to initiating work with the NPDC in classroom or home settings. To support the integration and application of the online content, NPDC staff created learning opportunities for NPDC participants to reflect on online course content; then NPDC staff gave feedback on the content and responded to the reflections. This activity was enhanced through reflective consultation with state leads to support them in facilitating such discussions in the future. Summer Institute During the intensive, three to five day, summer institutes, formal training included key elements of the coaching process. The process was taught using small group activities, role play and explicit instruction in the NPDC approach to coaching. In addition, coaching activities were embedded in presentations on EBP. For example, during these presentations two or more NPDC staff trainers modeled elements of the coaching process, including the pre-observation planning conference, inviting partner input, defining the coach’s role, the post-observation conference and developing a coaching log. In addition, independent activities were included in the coaching manual as a resource for teams to begin the coaching process when they returned to their school sites in the fall. Initial Implementation Installation is followed by initial implementation of the intervention. States and their model sites moved into this phase of change by beginning to use the knowledge and skills learned through the NPDC professional development process (i.e., online course, Summer Institute) with support from their designated coaches and the larger interagency team. The activities initiated during the initial implementation were essential to the work that was conducted throughout the NPDC processes and the coaching relationships that were developed to implement EPB to fidelity. This included a focus on data collection and data driven decision making based on information from Goal Attainment Scaling (GAS), APERS/APERS-IT, and EBP Implementation Checklists included in the online Internet Modules. Goal Attainment Scaling GAS is a system used by NPDC to assess the amount of progress learners with ASD made on select goals over an academic year (Cardillo & Choate, 1994). The development of these goals for each of the targeted learners was one of the first activities that a coach and model site team engaged in together, establishing baseline data and beginning the relationships that would inform the remainder of the NPDC experience. In addition, families were included in this phase of implementation by helping to select priority goals for their child. Autism Program Environment Rating Scale The APERS is an environmental rating tool that was used to rate both inclusive and self-contained programs for learners with ASD at the preschool, elementary, middle, and high school levels. The NPDC used the APERS to measure baseline program quality at the beginning of the academic year (early in the fall) or toward the end of the previous academic year (late in the spring). The APERS was used again in the spring as a post-measure to measure change in program quality. This tool was developed to assess program quality for family participation, interdisciplinary teaming and other variables in the settings where a child or youth spends time including classroom environment, structure and schedule, classroom climate, curriculum and instruction, communication, social relationships, independence, functional behavior and assessment practices. The APERS-IT is an adaptation of the APERS for early intervention settings, including the home. During the administration of the APERS, NPDC staff included elements of the coaching process when providing feedback to site teams and state TA providers. This included techniques for sharing APERS feedback to site level teams and working with trainers to develop improvement plans based on APERS identified areas of need to improve program quality. APERS’ data was used continuously throughout the coaching relationships as a source of data for pre-observation, observation and post-observation conferences. Following the administration of the APERS, TA teams were guided on how to utilize the coaching process to begin implementation of EBP, completion and monitoring of GAS and conducting monthly technical assistance visits (i.e., selecting goals and targets, measurable descriptions of behavior, ongoing data collection). Evidence Based Practice Internet Learning Modules. The EBP learning modules are a dynamic instructional tool for educators and parents to learn about each of the 24 practices identified by NPCD. Each module contains an overview of the practice, steps for implementing the practice, implementation checklists, the evidence base for the practice, optional data sheets, video and case study examples, frequently asked questions, a glossary of terms, discussion questions, suggested activities, and a pre- and post- module assessment. http://www.autisminternetmodules.org/. Coaching partnerships supported the inviting partner in developing a deeper understanding of a particular EBP and the steps required to implement that practice to fidelity. The Step-by- Step Instructions and Implementation Checklists were used to help the coaching partners identify the focus of an observation during a pre-conference planning session. The debriefing that occurred during a post-observation conference helped the inviting partner refine her implementation of a particular EBP. Monthly Technical Assistance Calls Coaching practices were embedded in the monthly contacts between NPDC team members and state TA providers and coaches. During these routine calls, NPDC staff modeled coaching through use of reflective consultation focused on supporting the coach’s role with the model site team. Activities included establishing discussion points, reviewing progress on implementation plans, addressing challenges, monitoring data, and establishing topics for future calls. Sometimes, video examples were reviewed during monthly technical assistance calls to demonstrate progress or challenges in implementation of EBP. These reflective conversations were recorded on the Reflective Consultation Logs. Coaching Resources for NPDC Teams Resources to assist in applying the NPDC coaching approach are available on the NPDC website http:// autismpdc.fpg.unc.edu/ and listed in Appendix B: Coaching Manual Guidelines and Professional Development Materials. This includes the Coaching Manual as well as supporting materials and forms. The monthly calls to site teams were also used to identify target topics for the Community of Practice (CoP) forums, and promote postings related to coaching on the CoP website. The CoP was designed to encourage networking, discussion and reflection across sites and states. Full Implementation, Innovation, and Sustainability The NPDC’s mission placed an emphasis on sustainability. The project facilitated the spread of practices and ongoing, professional development across the state. The goal was to have teams move toward advancing their knowledge and creating a sustainable system. This included the state teams working toward school wide expansion of the model sites and into other parts of the state. Prior year model site teams provided peer support to expansion sites through professional development opportunities and peer coaching. This expansion and the ongoing partnerships that were promoted encompass the innovation and sustainability phases of the Fixsen (2009) implementation model. Following the first year with NPDC these activities cycled through a second year with the first cohort sites and the expansion sites. During this period, year one sites shared their experiences and knowledge with cohort two sites during the Summer Institutes and cross-site visits; plus the CoP forum was available for cross-site and cross-state networking. Sustainability occurred as the states continued with expansion. At the end of the second year, each state reviewed their IAPG Plan to capture and revise their plans for sustainability of NPDC elements, including coaching practices, beyond the end of their formal partnership with NPDC. Summary This process provides a mechanism for sustained practice. Participants following this process engage in ongoing and meaningful implementation of EBP for students with ASD in an integrated system that supports this endeavor. References Basu, S., Salisbury, C. L., & Thorkildsen, T. A. (2010). Measuring collaborative consultation practices in natural environments, Journal of Early Intervention, 32(2), 127- 150. Cardillo, J. E., & Choate, R. O. (1994). Illustrations of goal setting. In T. Kiresuk, A. Smith, & J. Cardillo, (Eds.). Goal attainment scaling: Applications, theory, and measurement (pp. 15-37). Hilldale, NJ: Lawrence Erlbaum Associates. Dunst, C. J., Trivette, C. M., & Hamby, D. W. (2010). Meta-analysis of the effectiveness of four adult learning methods and strategies. International Journal of Continuing Education and Lifelong Learning, 3(1), 91-112. Gentry, L. B., Denton, C. A., & Kurz, T. (2008). Technology-based mentoring provided to teachers: A synthesis of the literature. Journal of Technology and Teacher Education, 16(3), 339-373. Fixsen, D. L., & Blasé, K. A. (2008). Drivers framework. Chapel Hill: The University of North Carolina, Frank Porter Graham Child Development Institute, The National Implementation Research Network. Fixsen, D. (2009). National Implementation Research Network: Consultation and Coaching. Retrieved on April 12, 2010 from: http://www.fpg.unc.edu/~NIRN/ implementation/07/07a3_consandcoac.cfm Fixsen, D. L., Blasé, K. A., Naoom, S. F., & Wallace, F. (2009). Core implementation components. Research on Social Work Practice, 19, 531-540. Knight, J. (2009). Coaching: The key to translating research into practice lies in continuous, job-embedded learning with ongoing support. Journal of Staff Development, 30(1), 18-22. Metz, A., & Bartley. L. (2012). Active implementation frameworks for program success: How to use implementation science to improve outcomes for children. Zero to Three, 32(4), 11-18. Neufield, B., & Roper, D. (2003). Coaching: A strategy for development instructional capacity. Washington, DC: Education Matters Inc. Peterson, C. A., Luze, G. J., Eshbaugh, E. M., Jeon, H.-J., & Kantz, K. R. (2007). Enhancing parent-child interactions through home visiting: Promising practice or unfulfilled promise? Journal of Early Intervention, 29(2), 119-140. Rush, D., & Shelden, M. (2011). The early childhood coaching handbook. Baltimore, MD: Paul H. Brookes Publishing Company. Rush, D., Shelden, M., & Raab, L. (2008). A framework for reflective questioning when using a coaching interaction style. Casetools, 4(1), 1-7. Retrieved on April 12, 2010 from http://www.fippcase.org/casetools/casetool_vol4_no1.pdf Joyce, B., & Showers, B. (2002). Student achievement through staff development (3rd ed.). Alexandria, VA: Association for Supervision and Curriculum Development. Scott, T. M., & Martinek, G. (2006). Coaching positive behavior support in school settings: Tactics and data-based decision making. Journal of Positive Behavior Interventions, 8(3), 165-173. Zwart, R. C., Wubbels, T., Bergen, T., & Bolhuis, S. (2009). Which characteristics of a reciprocal peer coaching context affect teacher learning as perceived by teachers and their students? Journal of Teacher Education, 60(3), 243-257. Appendices Appendix A Coaching Logs /Activity Coaching Log for Reflective Consultation Conference Inviting Partner: Coach: Aspect of EBP addressed (e.g., selection, implementation, data collection, evaluation): Reflective Consultation Conference Date: Time: Length: Topic or Concern: ________________________________________________ Supporting Information (including examples of what has occurred): Check one q New Topic q Revisited Topic If revisited, actions from previous conference: Alternatives Discussed: Notes Action Steps for Inviting Partner: Supports Needed from Coach between Conference Sessions: Next Meeting Date: ____ Time: ____ Appendix B Guidelines and Activities for Professional Development The NPDC Coaching Manual and related materials were developed to support technical assistance (TA) providers and educational professionals as they work together to effectively implement evidence-based practices in their settings. Materials available for self-directed learning or directed professional development include: • Coaching manual • PowerPoint™ presentation with and without narration • 2 videos of pre-observation, observation and post-observation conferences • 3 videos of reflective consultation • 2 videos of students in classrooms for use in professional development activities Guidelines NPDC staff shared the coaching manual and PowerPoint™ presentation with TA providers before they begin their work at model and expansion sites. One option for introducing TA providers to the manual and PowerPoint™ was during the Summer Institute. In addition, state partners accessed to the manual and presentation on the state page of the NPDC website. These materials give TA providers self-directed, learning opportunities with as much NPDC support as is necessary for each TA provider. All coaching materials were then shared with inviting partners to ensure that they were comfortable with their roles and the process of coaching, as well as preparing them to take on the role of coaching in their schools and beyond. The process of coaching, through the use of the manual, was revisited as needed during monthly check-ins with TA providers and during site visits with TA providers and NPDC staff. During these times, NPDC staff sought to understand the coaching relationship between TA providers and inviting partners. Further, NPDC staff explicitly asked TA providers if there are elements of the coaching process they need support with and provide that support to the greatest extent possible. Finally, supporting TA providers is a form of reflective consultation and, in some instances, mentor coaching. Thus, NPDC staff familiarized themselves with their own coaching/consultation strengths and areas of growth and sought support as needed. Suggestions for Professional Development Activities The following pages include examples of activities that can be conducted one-on-one, in small group, and with larger groups for the purpose of supporting TA providers and school professionals in learning the elements and skills involved in coaching. These activities should be modified to meet the specific needs of the participants. ACTIVITY I—Free Writing on Being Coached/Coaching Purpose To connect participants to the upcoming content on coaching through their own knowledge and experience of coaching When to Use Prior to delivering content on coaching Participants Participants work as individuals Materials Paper, pen/pencil, handout with questions Process 1. Ask participants to reflect on their experience of being coached whether that occurred formally or informally (examples: coaching from mentor, coaching from supervisor, coaching from a peer). 2. Give participants about 5-10 minutes to reflect on the following issues. a. Briefly describe the coaching experience: who?, what?, where?, how? b. What characteristics of the relationship between you and the coach stand out to you? c. What aspects of the coaching were particularly helpful? d. What aspects of the coaching, if any, seemed to hinder your progress? e. What elements of your experience will you be bringing into your current role (as coach, inviting partner, etc)? 3. Large group debrief a. Ask individuals to share thoughts for questions a-e while writing these down on flip chart. b. Discuss in groups the commonalities. c. Discuss how these commonalities relate to the upcoming content on coaching. d. Return to these lists as elements come up during the rest of the discussion and activities on coaching. . ACTIVITY II—Role-play in a Fish Bowl Purpose For participants to (a) practice coaching, being coached, and evaluating the coaching; (b) recognize the different aspects of the coaching process; and/or (c) increase their comfort with using the coaching log When to Use After a discussion of each of the content areas: pre-observation conference, observation, and post-observation conference. These can be repeated so that participants have an opportunity to role-play from each perspective if time allows Participants Each participant takes one role: coach, inviting partner, or observer. Participants role play from each perspective during three rounds. Materials Videos of up to three examples of coaching, copy of coaching log for each participant, list of responsibilities for each participant Process 1. Bring together triads of participants and ask them to choose roles for the first round (1 coach, 1 inviting partner, 1 observer). 2. Whole group watches video of student in preparation for role-play. 3. Provide a few minutes for participants to write down notes after video. 4. Pre-observation Instructions: instruct teams to role-play a pre-observation conference with the idea that the student video they saw would be the observation. a. Coaches take the role of coach, including completing the coaching log with the inviting partner. b. Inviting partner take the role of teacher, including completing out the coaching log with the coach. c. Observer will use the table, Responsibilities During the Pre-observation Conference, on which to take notes: i. Responsibilities covered ii. Responsibilities missed iii. Elements that are positive or interesting in the conversation to share with the coach and inviting partner. d. Provide groups approximately 10 minutes to role play. e. Debrief: i. Give triads a few minutes to share their experiences and observations ii. Large group triads: (1) Ask coaches: What did you find most challenging? How did you/might you deal with those challenges? (2) Ask inviting partners: What did you find most helpful? (3) Ask observers: From what you saw, what was most critical for a successful session? 5. Post-observation conference Instructions: re-watch the student video after providing content on observations and post-observation conference. a. Ask participants to change roles. i. Coach to become observer. ii. Inviting partner to become coach. iii. Observer to become inviting partner. b. Coaches to take the role of coach including filling out the coaching log with the inviting partner. c. Inviting partner to take the role of educator including filling out the coaching log with the coach. d. Observer to use the Responsibilities During the Post-observation Conference to take notes on: i. Responsibilities covered. ii. Responsibilities missed. iii. Elements that are positive or interesting in the conversation to share with the coach and inviting partner. e. Give groups about 10 min to role play. f. Debrief: i. Give triads a few minutes to share their experiences and observations. ii. Large group triads: (1) Ask coaches: What did you find most challenging? How did you/might you deal with those challenges? (2) Ask inviting partners: What did you find most helpful? (3) Ask observers: From what you saw, what was most critical for a successful session? ACTIVITY III—Using the Coaching Log Purpose For participants to gain awareness of the coaching log elements and how to fill them in When to Use After discussion on coaching log Participants All participants practice as individuals in a large group. Alternately, small groups, dyads, triads, etc. can work on one coaching log together. Materials Coaching log handouts pre-filled in for video; video of coach and inviting partner during pre-observation Process 1. Hand out coaching logs that are pre-filled to some extent with important discussed information left blank. 2. Watch video. 3. After watching video instruct participants time to fill in the missing information on the coaching log. 4. Option: After giving participants a few minutes have participants work in small groups/dyads, triads filling in any gaps. 5. Debrief: Discuss in large group any questions participants have. ACTIVITY IV—Open/Closed Questions Purpose For participants to recognize the impact of open ended questions When to Use During discussion of communication competencies of coaches Participants All participants in large group Materials Flip chart paper and pen Process 1. Begin by telling participants that you will start a true story about yourself and they will have an opportunity to ask questions in order to learn more. 2. Begin a story about yourself that would be of interest for others to learn more and would provide for opportunities to ask questions. Examples of one person’s beginning: “Once, I was walking with my family by the river and I fell through the bridge.” 3. Ask participants what else they would like to know about the story. 4. Write their questions on a piece of paper. 5. When time/questions have been exhausted: a. Mark all of the yes/no questions and respond to them. b. Mark the open ended questions and respond to them c. Ask participants the difference in information they received from the two levels of questions. ACTIVITY V—Open/Closed Questions in Coaching Context Purpose For participants to recognize the impact of open ended questions When to Use During discussion of communication competencies of coaches Participants All participants in large group Materials Video of coaching pre-observation conference or post-observation conference Process 1. Watch video of coaching pre-observation or post-observation. 2. Watch clips of video rich with questions. a. Review with participants which questions elicited what level of information from inviting partner. b. For examples of closed questions, ask participants to suggest alternate questions. ? ACTIVITY VI—Critiquing the Coaching Process Purpose For participants to practice observing and identifying the various elements of the coaching process When to Use After providing much of the content on coaching process Participants Participants work in small groups Materials Video of coaching process and handouts with list of the elements of the coaching process Process 1. Provide handouts to participants. 2. Watch video. 3. Ask participants to jot down which elements were or were not present. Also, ask participants if present elements could be improved upon and how. 4. Review in large group. ACTIVITY VII—Coach/Inviting Partner Responsibilities Purpose For participants to: recognize the different responsibilities of a coach and inviting partner during pre-observation, observation and post-observation; and recognize the timeline during pre- and post-observation conferences. When to Use After discussing the roles and responsibilities of coaching and inviting partners during mentor coaching and peer coaching Participants Participants work in small groups Materials Strips of paper and tape—each strip of paper has “responsibility” printed for either mentor or peer coaching and either inviting partner or coach. Process 1. Provide groups with strips of paper so that roles for coach and roles for inviting partner are mixed up. 2. Instruct groups to post the strips of paper on wall according to coach or inviting partner. Ask groups to list responsibilities as much as possible on a timeline (what comes first, second and so on) with an understanding that some responsibilities are necessary throughout the entire conference. 3. Alternately, give some groups responsibilities during mentor coaching and others responsibilities during peer coaching. In debrief, review the differences. 4. Alternately (especially if time is limited), give some groups responsibilities for pre-observation conference, others for observation and others for post-observation conference. Review differences as a large group. ACTIVITY VIII—TA Providers Self-Coaching Purpose For TA providers to reflect on what they have learned in the content on coaching and formulate a plan to address these competencies in their work When to use At the end of presentation on coaching for TA providers Participants Participants work individually and in dyads Materials Handouts with reflection questions— Sentence stems: 1. In my role as a coach, it will be important for me to bring the following to the coach/inviting partner relationship … 2. I am confident that as a coach I … 3. I am concerned about … 4. I will address these concerns by … 5. When I come across challenges as a coach, I will seek support in … Process 1. Provide TA providers with handouts. 2. Give TA providers 10–15 minutes to reflect on the questions and write their responses. 3. Ask TA providers to meet in pairs to discuss their plans and to coach each other by asking opened questions that guide the other person towards an understanding of their strengths, needs, and support structure. Appendix C 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 Coaching for the Implementation of Evidence-based practices for Children and Youth 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 1½ 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, 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 NPDCwebsite 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 scaling: Applications, Theory, and Measurement (pp. 15-37). Hilldale, NJ: Lawrence Erlbaum Associates. 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 ¾ 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 C:\Documents and Settings\kucharcz\Local Settings\Temporary Internet Files\Content.IE5\M40JQVBP\MP900407293[1].jpg C:\Documents and Settings\kucharcz\Local Settings\Temporary Internet Files\Content.IE5\CBS367XJ\MP900407271[1].jpg C:\Documents and Settings\kucharcz\Local Settings\Temporary Internet Files\Content.IE5\M40JQVBP\MP900407293[1].jpg C:\Documents and Settings\kucharcz\Local Settings\Temporary Internet Files\Content.IE5\L1MSAQ49\MP900407291[1].jpg C:\Documents and Settings\kucharcz\Local Settings\Temporary Internet Files\Content.IE5\L1MSAQ49\MP900407291[1].jpg 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