ks self-management winnipeg 2014

n Overview of Self-Management Strategies and their Effective use for Individuals with Developmental Disabilities and Autism Spectrum Disorders in School, Employment, and Community Settings

Keith Storey, Ph.D. Touro University

[email protected]

3 Key Points of Self-Management

1. Gives power to the person 2.  Increases generalization

•  Behaviors •  Times •  People •  Settings

3. Very flexible

What is Self-Management?

n Giving the person more control over their own life

n Control is given through teaching the person skills

n Giving the person specific strategies to control or modify their own behavior

n The terms self-regulation and self-control are often used interchangeably with self-management.

Self-management ideally involves:

n Recognizing one’s own problem n Translating problems into behaviors to be

changed n Finding natural contingencies or contriving

them to support change n Arranging the contingencies for change to

occur

Published Cases of Successful Self-Modification (From Watson & Tharp, 2007)

n  Increasing creative productivity (Herren, 1989). n  Improving study habits (Richards, 1976) n  Controlling weight (Mahoney, Moura, &Wade, 1973) n  Handling anxiety in social situations (Rehm &

Marston, 1968) n  Controlling nervous habits such as scratching, nail

biting, and hair pulling (Perkins & Perkins, 1976; Watson, Tharp, & Krisberg, 1972)

n  Overcoming depression (Hamilton & Waldman, 1983; Tharp, Watson, & Kaya, 1974)

n  Eliminating teeth grinding (Pawlicki & Galotti, 1978) n  Speaking up in class (Barrera & Glasgow, 1976) n  Exercising (Kau & Fisher, 1974)

Advantages to Self-Management

n  Involve the person in their own behavior change

n  Instead of always doing something to somebody you are helping them to do something independently and thus working with them

n For people with disabilities often the choices of what to do, where to go, who to be friends with is taken away – This gives back the control

Advantages to Self-Management

n Generalization of the behavior change can be enhanced – likely to use self management strategy in multi settings

n Example – Cleaning dining tables using a checking-off job tasks list can use same strategy for cleaning the kitchen area

n Avoid Learned Helplessness n  Less dependant on job coaches or other

support providers

Advantages of Self-Management

n Disadvantages of externally controlled procedures may be reduced such as:

n  Performing behavior only in presence of those

who administer consequences n  Teachers and others often miss a great deal of

behavior when applying reinforcement or punishment

Advantages of Self-Management

n Self-management procedures are effective with people with all types of disabilities

n People with very severe disabilities can learn to use self-management procedures effectively (Browder & Shapiro, 1985)

n Self-management procedures can and should be adapted to meet the individual needs of the person – not based on disability type

Disadvantages to Self-Management

n Could be stigmatizing to the person using the procedure

n May be time consuming up front teaching the

self-management skills

Components of Self-Management n  Self-management broadly refers to all processes

used by an individual to influence her or her behavior (Browder & Shapiro, 1985)

n  Self management techniques n  Antecedent cue regulation devices n  Self-monitoring n  Self-determined consequences n  Self-punishment n  Combination of techniques

n  Usually is part of an instructional package – not isolated

Self Management Techniques

n Antecedent cue regulation devices: n  Use of prompts and operations that lead the

user to the correct response n  ACR can be used to lead a person to perform

every stop within a task analysis n  To perform an entire task n  To perform a series of tasks in the correct

order over a longer period of time n  Checklists – arranged in order of task n  Modified clock face – task symbol in place of time n  Auditory prompts - Micro cassette tape or MP3 players

Self Monitoring Cards

Visual Schedule

This is too hard What do I do?

I raise my hand and ask for help

That was easier I am so glad

I asked for help

Antecedent cue regulation

Breathe out through the mouth

Breathe in through the nose

Repeat deep breaths 3 times

Antecedent Cue Regulation

Self-management techniques

n Self-monitoring n  Involves procedures that help a person to

identify a specific response n  Detects whether the response in question has

occurred n  Make some record of the response

n  Charts and checklists – tasks over a number of times

n  Manual counters – golf beads n  Timers – time spent on tasks


n Self-monitoring (continued) n  the use of a cell phone, personal digital

assistant (PDA) or other electronic device in which cues are programmed (such as a cell phone being programmed to give a signal and say “time to go to lunch” at noon and then signal and say “time to get back to work” at 12:30).

MONDAY PUT PLUS MARK WHEN CHECKED 1.  Look in mirror after eating lunch. 1.  Check face, mustache, shirt, and tie for

food. 1.  If there is food on face or mustache, wet

washcloth. 1.  Use wet washcloth to wash all food off

face and/or mustache. 1.  Brush any crumbs off short and tie.

• 

Self-management tool

Rules

1.  I complete my work as best as I can. 2.  I am quiet and kept my hands and feet to

myself. 3.  I am on-task during instruction and quietly

get another activity if I finish my work. Ratings: 1. Lady bug, 2. Wasp, 3. Funnel Web Spider

Ratings

1. LadyBug: I followed the rules 100% during this period!

2. Moth: I did not follow the rules for the entire time, I followed the rules 80% of the time but no serious infractions.

3. Funnel Web Spider: I broke one or more rules and engaged in a high level of disruption (On-task only 60% of the time).

Example of Self-Recording System

Example of Self-Recording System

Date: ________

Period 1 Period 2 Period 3 Period 4 Period 5 Period 6 Period 7 Y N Y N Y N Y N Y N Y N Y N When I am upset, I will use a self-calming strategy with help

from my teacher

Y N Y N Y N Y N Y N Y N Y N When angry, I will follow the steps to express anger, with helpfrom my teachers

Y N Y N Y N Y N Y N Y N Y N I will complete my assigned work

Y N Y N Y N Y N Y N Y N Y N I will work only on assigned work

Y N Y N Y N Y N Y N Y N Y N I will cooperate and follow directions Teacher Initial:

Teacher: Student:

Total Y:_____Total N:_____Point Balance:_____

Today I earned _______ points!

Examples of Self-Recording System

When the timer sounds, place a + beside the number if you were on-task and a 0 beside the number if you were not on-task.

Monday Tuesday Wednesday Thursday Friday 1 1 1 1 1 2 2 2 2 2 3 3 3 3 3 4 4 4 4 4 5 5 5 5 5 6 6 6 6 6 7 7 7 7 7 8 8 8 8 8 9 9 9 9 9 10 10 10 10 10

Self Monitoring Cards


n Self-determined consequences n  Self-Delivery of coins or tokens – take tokens

upon completion of task and exchange for an item or activity that the person values

n  Analysis of performance records – learn to view the data in light of reinforcing value

n  Self-recruited feedback – submit self-monitored record to supervisor

Self-punishment

n Rarely used because reinforcement techniques are usually viable alternatives

n  Less likely to evoke undesirable side effects n  Rubber band on wrist n  Response cost

General Self-Management Steps (Koegel, Koegel, & Park, 1992)

n Getting Ready

n Teaching Self-Management

n Creating Independence


n Getting Ready n  Define behaviors n  Measure behaviors n  Choose a reinforcer n  Select an initial goal

n Teaching Self-Management n  Get materials n  Identify the behavior n  Record the behavior n  Reinforce self-management


n Creating independence n  Increase amount of time your student self-

manages behavior n  Fade your student’s reliance on prompts n  Increase the number of responses necessary for

a reward n  Fade the presence of the treatment provider

Implications for Instruction

n  Include a self-management from the start if warranted

n  Instituted after fading of instructional procedures

n Environment must be considered – n  Device (e.g.,checklist, ipod, picture board etc.)

should not draw undue negative attention n  Looking at what devices are currently being

used for person’s without disabilities and modify as needed

Self -Instruction

n With self-instruction a student can learn to give themselves instructions rather than waiting for instructions from the teacher

n For visual learners, incorporating visual prompts of the instructions can be beneficial

Sample of Teaching Procedure for Self-Instructions n Teacher performs task while talking

aloud n The student performs task given the

teacher’s instructions n Student performs task while instructing

himself/herself aloud n Student performs task while whispering

the instructions n Student performs task while saying the

instructions to himself/herself

Using “Auditory Prompts” as a Support System in Work and Community Environments from Post & Storey (2002) What are “auditory prompts”? n  Auditory prompts consist of verbal

commands using single word or multiple word phrases to encourage and guide an individual to complete a task.

Using “Auditory Prompts” as a Support System in Work and Community Environments from Post & Storey (2002)

How are recorded auditory prompts used? n  Recorded auditory prompt systems can be used to

transfer instruction onto a portable electronic device (MP3, smart phone, ipod, ipad, etc.) and used as a teaching tool to:

n  support the teaching of a new skill, n  provide on going reinforcement to make the

learned skill permanent n  maintain focus on task and filter out some auditory

distractions n  provide independence from constant direct

supervision

Using “Auditory Prompts” as a Support System in Work and Community Environments from Post & Storey (2002) How is a recorded auditory prompt system used? n  Auditory prompts are recorded on an electronic

device and listened to through attached headphones:

n  The recording device should be portable enough to be easily worn without interfering with the work task

n  The spacing and delivery of prompts are tailored to the work pace, skill level, and specific support needs of the individual

Using “Auditory Prompts” as a Support System in Work and Community Environments from Post & Storey (2002) What kinds of prompts are used in an auditory prompt

system? n  An auditory prompt system may involve: n  the recording of step by step instructions for completing a

specific task n  a recording of phrases that compliment performance and /or

encourage continuation of work n  a recording of questions directing self-evaluation of work

performance n  a recording of selected music embedded with intermittent

prompts that deliver positive reinforcement or instructional guidance

n  An audio recording paired with picture prompts n  a recording using a combination of the above

Visual paired with audio task analysis for handheld device. (Davies et al.)

HOW TO DESIGN AN AUDITORY PROMPT SYSTEM Step by Step Instructions from Post & Storey (2002) n  Create a Task Analysis for the targeted task. This

analysis involves breaking down the targeted task into small incremental teachable steps.

n  Using understandable language, write these steps in script form for recording.

n  For the script reading, choose a familiar voice known to produce a positive response from the student, or experiment with various voices for clarity and positive effect

n  Record the step-by-step instructional prompts. Insert necessary wait time needed to perform the task. The spacing of prompts can be determined by observing the student’s work pace. Spacing may need to be adjusted once the student becomes comfortable with the system.

HOW TO DESIGN AN AUDITORY PROMPT SYSTEM Step by Step Instructions from Post & Storey (2002) n  One option is to insert prompts of encouragement, praise,

or evaluation within the “wait time” between instructional prompts. Such prompts used might be “You are doing a fine job” or “Keep up the good work”. An example of an evaluation prompt for teaching the use of a clothes dryer might be “Are all the clothes in the dryer?”

n  A second or additional option is to embed recorded music between instructional prompts. Studies using music had the students select their favorite recordings or used classical music or recordings that produced a calming effect.

n  Once the recording is ready, introduce the recorded auditory prompt system by first demonstrating how to physically operate the device with the headsets.

n  After the above modeling, have the student’s practice putting on the equipment.

HOW TO DESIGN AN AUDITORY PROMPT SYSTEM Step by Step Instructions from Post & Storey (2002) n  Determine that the students can operate the on/off

controls. For this step, a recording containing the student’s favorite music could be used. If needed, make modifications to the operation icons/controls, etc. Making only the on/off controls available for pressing may be necessary for some students. Modifications may include: n  Removing any fast forward controls to prevent

inadvertent pressing, n  Color-coding the on and off control for easier

reference, n  Using a remote switch carried in the participant’s

pocket that contained only an on/off option.

HOW TO DESIGN AN AUDITORY PROMPT SYSTEM Step by Step Instructions Taken from Post & Storey (2002) n  Once the student has demonstrated competence in the

use of the system, allow the student to independently use the auditory prompt system. Closely monitoring the student using the system may be necessary initially. However, fading personal assistance can be managed according to the support needs of the student.

n  Many studies showed student being able to learn the targeted task and no longer needing to use the prompt system once the specific skill was learned. The prompt system was then only reintroduced if the skill was to be performed in a different setting. A few studies indicated the need for continuous use of the auditory prompt system to maintain the improved performance.

HOW TO DESIGN AN AUDITORY PROMPT SYSTEM Step by Step Instructions from Post & Storey (2002) n  Once the student has mastered the on/off operation, have

the students practice removing the equipment. n  Now instruct the students to independently put on the

recording device and headset. Introduce the recorded script containing the task analysis.

n  Have the students press the on control, listen to the first step, then turn off the device and perform the step.

n  If the student has difficulty performing the task, ask the student to repeat the recorded instructions out loud, then perform the step.

n  If there is still confusion, model the performance of the step for the student, or give enough assistance necessary to enable the student to perform the step. Continue in this way until the student demonstrates accuracy in performing the step.

Troubleshooting Tree from Post, Montgomery, & Storey (2009)

Client Not Performing Job

Task

Follows direction But forgets Steps

of Task

Follows instructions and completes task

but poor accuracy and

quality

Follows and remembers

directions but becomes

distracted easily and often

Does not follow directions and does not respond to oral

prompts of reminders or

encouragement appears disoriented

Develop task analysis

Record step by step

instructions

Record selected music and insert self

evaluation prompts

Recorded selected music and embed with

prompts of encouragement

Explore Other Options

The Use of Auditory Prompting Systems for Increasing Independent Performance of Students with Autism in Employment Training

Software Apps- Pictello http://www.assistiveware.com/pictello.php

n  Easy to use and requires no literacy skills to locate and read stories.

Pictello offers an easy visual story creation wizard . n  An advanced editor gives full control of the editing capabilities.

USES

n  Social stories to teach skills or to recall events. n  Talking books. n  Teaching narrative skills as part of a literacy or language skills

curriculum. n  Schedules, Task instructions, etc. n  Includes voices which can be swapped at no costs for British

voices that can be downloaded through WiFi by Pictello. n  Pictello does not require an active Internet connection for story

creation or playback. n  A universal version that will also support the iPad is in

development as are localized versions in other languages. These will be free upgrades.

Each page in a Pictello can contain a picture, up to five lines of text, and a recorded sound or text-to-speech using high-quality voices. Stories can be shared using iTunes File Sharing or via WiFi with other Pictello users through a free account on the Pictello Sharing Server.

Proloquo Software AAC device www. http://www.proloquo2go.com Create stories, messages, and edit text.

References Alberto, P. A., Sharpton, W. R., Briggs, A., & Stright, M. (1986). Facilitating task

acquisition through the use of a self-operated auditory prompting system. Journal of the Association for Persons with Severe Handicaps, 11, 85–91.

Briggs, A., Alberto, P., Sharpton, W., Berlin, K., McKinley, C., & Ritts, C. (1990). Generalized use of a self-operated audio prompt system. Education and Training in Mental Retardation, 25, 39–50.

Browder, D. M., & Shapiro, E. S. (1985). Applications of self-management to individuals with severe handicaps: A review. Journal of the Association for Persons with Severe Handicaps, 10, 200-208.

Davies, D., Stock, S. & Wehmeyer, M. (2002). Enhancing independent task performance for individuals with mental retardation through use of a handheld self-directed visual and audio prompting system. Education and Training in Mental Retardation and Developmental Disabilities 37, 209-218.

Davis, C. A., Brady, M. P., Willliams, R. E., & Burta, M. (1992). The effect of self- operated auditory prompting tapes on the performance fluency of persons with severe mental retardation. Education and Training in Mental Retardation, 27, 39–50.

Koegel, L. K., Koegel, R. L., & Parks, D. R. (1992). How to teach self-management to people with severe disabilities: A training manual. Santa Barbara, CA: University of California, Santa Barbara.

Montgomery, J., Storey, K., Post, M., & Lemly, J. (2011). The use of auditory prompting systems for increasing independent performance of students with autism in employment training. International Journal of Rehabilitation Research, 34, 330– 335.

Post, M., Montgomery, J., & Storey, K. (2009). A decision tree for the use of auditory prompting strategies. Journal of Vocational Rehabilitation, 31, 51-54.

Post, M., & Storey, K. (2002). Review of using auditory prompting systems for persons who have moderate to severe disabilities. Education and Training in Mental Retardation and Developmental Disabilities, 37, 317-327.

Post, M., Storey, K., & Karabin, M. (2002). Cool headphone for effective prompts: Supporting students and adults in work and community environments. Teaching Exceptional Children, 34(3), 60-65.

Sarafino, E. P. (2011). Self-management: Using behavioral and cognitive principles to manage your life. Hoboken, NJ: Wiley.

Storey, K., & Post, M. (2012). Positive behavior supports in classrooms and schools:

Effective and practical strategies for teachers and other service providers. Springfield, IL: Charles C. Thomas Publisher, Inc.

Tollison, P. K., Synatschk, K. O., & Logan, G. (2011). Self-regulation for kids K- 12: Strategies for calming minds and behavior. Austin, TX: Pro-Ed.

Trask-Tyler, S. A., Grossi, T. A., & Heward, W. L. (1994). Teaching young adults with developmental disabilities and visual impairments to use tape-recorded recipes: Acquisition, generalization, and maintenance of cooking skills. Journal of Behavioral Education, 4, 283–311.

Vohs, K. D., & Baumeister, R. F. (2010). Handbook of self-regulation: Research, theory, and applications (2nd ed.). New York: Guilford Press.

Watson, D. L., & Tharp, R. G. (2007). Self-directed behavior: Self-modification for Personal adjustment (9th ed.). Belmont, CA: Wadsworth/Thomson Learning.

Workman, E. A., & Katz, A. M. (1995). Teaching behavioral self-control to students. Austin, TX: Pro-Ed.

ks self-management winnipeg 2014

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