Transcript linking research to real life . SART: Strategy Assessment and Revision Tool A Tool for Evaluating, Revising, or Creating Plans PART FIVE Co-Developers Wendy Szakacs OCALI Regional.

linking research to real life
.
SART: Strategy Assessment and Revision Tool
A Tool for Evaluating, Revising, or Creating Plans
PART FIVE
Co-Developers
Wendy Szakacs
OCALI Regional Consultant
Chris Filler
OCALI Program Director
Lifespan Transitions Center
A division of the ESC of Central Ohio
Consideration of Response Cost
Individual
Environment
Behavior
Assessment
• T.J.
• Workshop
• Enclave
• Talking out very loudly. Frequently.
For Attention. For Help. For Avoidance
• Earning tokens for raising hand
Behavior Specialist:
“Let’s Try Adding a Response Cost Strategy”
• A penalty is assessed for ‘inappropriate’
behavior
• Results in Loss of: points, tokens, recess,
computer time, etc.
• Could include a process of losing more
points for each incidence of the
inappropriate behavior
T.J.’s Response Cost Plan
• Staff reports that T. J. yells out for help. Yells out for
attention. And sometimes seems to yell out for no
particular reason.
• The plan is to reduce the yelling by using a response
cost system.
• Currently: T.J. earns TV time for working. He earns 30
minutes of time in the morning and 30 in the afternoon.
• New Plan: T.J. will lose five minutes of his TV time each
time he yells out during work.
• Staff will track each time he yells out and will reduce his
TV time accordingly
Positive
Reinforcement:
Nope
Individualized,
Motivating: May be
individualized, but
generally not
building intrinsic
motivation
Not the Focus.
Focus is on what
NOT to do
Predictable and
Consistent:
Sensory: Not
considered
Visual/Tactile:
Not
necessarily.
Sometimes a
visual is added
Teaches What To
Do:
Can be
Response
Cost
Implemented
with Consistency
Should be used
in a consistent
manner
Response Cost
T.J.’s
SART
YES?
NO?
MAYBE?
Uses for SART
HELP PREDICT OUTCOME: To help decide if an
intervention will have positive outcomes for an individual
REVISE: To help revise an intervention that doesn’t
seem to be working
FACILITATE DISCUSSION. To aide discussion with staff
and family members about an intervention/strategy
DETERMINE WHAT IS MISSING. To assist professionals and
family members in processing what s/he might be missing
in making a strategy successful
Try It Yourself using the SART Worksheet
Read about “Rose” and the team’s plans
OR
Choose a Person you are working with and a strategy
being used or considered.
Determine if the strategy includes each element using the
guiding questions sheet
In Column 2, decide if the strategy reflects the element
(“Yes” , “No”, or “Maybe”)
In Column 3, describe how factor is, is not, or is
somewhat included.
In Column 4, describe what you might be able to do to
include or improve the element if necessary
Rose and Personal Space
Rose is 35 years old. She participates in a day program where she spends most of the time at the facility
with an occasional day trip. The program is expanding it’s community based services and structure over
the next several months.
Rose likes ‘girly’ things. Nail polish, lace and ribbons on her clothing, and especially lotions with a flowery
smell. Can’t seem to get enough. She enjoys being in the kitchen and tries to help with cooking and
other activities. However, she is quite a picky eater. She likes taking walks and car rides. Some staff
say that they think she watches to see who might possibly be going out for a walk or ride in hopes that
she can tag along. She loves looking at photographs and will thumb through magazines and point to
pictures. Sometimes repeatedly.
Rose, like so many at the day program, struggles with communication. She uses one or maybe two word
phrases to request or comment or sometimes it is not clear what it means.
Rose is a sweet gal. She seems to be quite accustomed to the routine of the day program and goes along
with the flow generally. The only real issue of concern is her lack of ‘respect’ for other’s personal space.
She will come and stand very close, sit close and will touch others arms and face. She does this in her
group home as well as the day program. It is hard to know how to redirect her or to make her
understand that this is not OK with other people.
Behavior specialists say she does this to gain attention, to communicate or maybe for other random
reasons (boredom?).
Due to the expansion of the day program into the community, there is a plan to help Rose learn that she
really should not get into people’s personal space. The plan is simple. When Rose touches a person’s
arm, face or other body part (and was not ‘invited’ to do so), the person will tell Rose, “I do not like
that.”, will step away, out of her reach , and give her no further attention. The idea is that Rose will soon
learn that touching people without their permission will push people away and will not get their attention.
This strategy should result in a decrease in the touching behaviors.
What do you think of the plan?
Use SART to examine the plan and to revise it for improvement.
SART Guiding Questions for Use
of the Worksheet
Use the Guiding Questions sheet to help
determine how each element of the SART is
included in your chosen strategy.
SART Global Thinking
Using SART to Develop Problem Solving Plans
SART Support Plans
• SART elements can also be used to create plans
• Instead of evaluating a specific strategy with SART:
• Start with the person, their strengths and their
interests
• Include an issue of concern
• Use the SART factors to identify a variety of supports
and strategies
Support Plans and SART
Using SART Factors to Develop a Supportive Environment
Positive
Reinforcement
Individualized
& Motivating
Sensory
Sensitive
Teaches
‘What To Do’
Predictable and
Consistent
PERSON
Visual/Tactil
e
Strengths
Interests
Concern
Reliable
Implementation
Support Plans and SART
Using SART Factors to Develop a Supportive Environment
Positive Reinforcement:
What specific reinforcement can
we add to the person’s supports
that helps them through tough
times AND to learn new skills?
Individualized &
Motivating:
What does the person have
in his/her life that improves
quality of life and is specific
to their preferences and
interests? Does not need to
earn!
Sensory Sensitive:
How can we make the
person’s world (not just one
special room) more sensory
sensitive to their particular
needs and desires?
Visual/Tactile:
How can we add more
visual information to
support the person to
understand, to
communicate with us, to
predict?
Teaches ‘What To Do’:
What specific new skills can we
help the person learn to replace
difficult behaviors and to
expand opportunities in the
community? How will we teach?
Predictable and Consistent:
Are the supports we use and
the daily routines/schedules
predictable for the person? If
not how can we improve the
predictability?
PERSON
Strengths
Interests
Concern
Reliable Implementation:
Are the support staff in all
environments (including
natural supports) supporting
the person in a similar
manner? Or does the
person end up adjusting to
our style? How to improve?
Darrin Screams
Darrin is 32 years old. He participates in a Combo Day program and Workshop where he spends time
working on piece work part of the day and in leisure activities for part of the day. The program is
expanding it’s community based services and structure over the next several months so that Darrin
will be having more opportunity to explore the community.
Darrin likes sports…especially the Ohio Teams. He is drawn to anything that has the logos or colors that
represent the Browns, Cavs, Indians, OSU, etc. He also loves music. He lights up when music is
played, instruments are around, or the music therapist is visiting. He enjoys ‘helping out’ the handy
man at the facility. He wants to hold the tools and tries to find a way to help. However, when there is
lots of noise involved he will back off and leave the room holding his ears. Some staff report that
noise, crowds, and confusion can be very difficult for Darrin. Several explain that he walks in circles,
paces, and scans the environment for someone he knows.
Darrin, like many people with autism, has difficulty communicating. He uses very few words. But most of
the time seems to understand much of what is being said. Although the records indicate that Darrin
never learned to read, staff observes him intently looking at the calendar, looking at staff notes, going
through magazine articles, and other written text.
Darrin is a described as a ‘nice guy’ by most people. Generally Darrin is not even noticed. He just goes
with the flow of the day. However, in the last several months, something has been changing. Darrin
has started screaming, which is quite upsetting. It is happening more often. Sometimes he walks into
the workshop or the day program and starts screaming as soon he arrives. Sometimes when he is
working he might start screaming. Sometimes during transition. Staff generally goes to him quickly
when this starts and try to help. They may move him to new location, they may try to help him finish
what he is doing or they may try to distract him by offering a snack or having him go into the sensory
break area. Sometimes he calms quickly, sometimes not.
Behavior specialists have been consulted and say that Darrin screams to gain attention, to get help, to
avoid work or to communicate something else. Basically, they are not sure.
What do you think could be done? Use SART to develop supports.
Support Plans and SART
Using SART Factors to Develop a Supportive Environment
Positive Reinforcement:
Have visual choice options of music
and sports magazines and sensory
room available. Offer the options at
high risk times BEFORE screaming
starts (at arrival, when transitioning).
When he makes a choice, honor it
immediately.
Individualized & Motivating:
Develop a daily schedule that
Darrin helps create.
Add music and choices of
types of music throughout the
day.
Include tasks that involve
tools. Teach him to use. Can
he learn to build something to
sell?
Sensory Sensitive:
Avoid loud overwhelming
environments. Opportunities
to proactively move to quiet
locations.
Job in quiet office area.
Build in movement activities.
Teaches ‘What To Do’:
Teach Darrin to use choice
board for a break, a different
option or help instead of
screaming. Present it to him
frequently. Lots of
opportunities.
Provide option for telling us
“no”
Predictable and Consistent:
Choice Board should look the
same in all locations Darrin
can predict what will happen
when he uses this board.
A schedule that is consistent
and similar each day adds
predictability.
Darrin
Visual/Tactile:
Visual Schedules of
daily routines.
Pictures and Words. Is
he a reader?
Ohio Sports, Music,
Tools, Perhaps a
reader, Follows
routines.
Screaming- more
frequent and
concerning
Reliable Implementation:
Train Staff on Visual
Schedule, Choice Board,
Supporting Darrin in Job,
Data Collection
YOUR TURN
DEVELOP a SART Global Thinking Plan
for someone you know.
Use SART Global Worksheet to begin
identifying ideas to support a person that
struggles with challenges that impact his/her
ability to access new opportunities
References
Bremer, C.D. & Morocco, C.C. (2003). Teaching for understanding. Research to Practice Brief, 2(4).
http://www.ncset.org/publications/viewdesc.asp?id=1309
Browder, D. & Cooper-Duffy, K. (2003). Evidence-based practices for students with severe disabilities and the
requirement for accountability in “no child left behind”. The Journal of Special Education, vol. 37, pp. 157-163.
Carroll, C., Patterson, M., Wood, S., Booth, A., Rick, J., & Balain, S. (2007, November). A conceptual framework for
implementation fidelity. Implementation Science, 2(40).
http://www.implementationscience.com/content/2/1/40
Flores, M. M., & Ganz, J. B. (2007). Effectiveness of direct instruction for teaching statement inference, use of facts, and
analogies to students with developmental disabilities and reading delays. Focus on Autism and Other Developmental
Disabilities, 22, 244-251.
Kranowitz, C. S. (1998). The out-of-sync child: Recognizing and coping with sensory integration dysfunction. New York:
Perigee Book.
May-Benson, T.A. & Koomar, J.A. (2010). Systematic review of the research evidence examining the effectiveness of
interventions using a sensory integrative approach for children. American Journal of Occupational Therapy, 64, 403-413.
Mechling, L. (2007). Assistive technology as a self-management tool for prompting students with intellectual disabilities to
initiate and complete daily tasks: A literature review. Education and Training in Developmental Disabilities, 42(3), pp.
252-269.
Simonsen, B., Fairbanks, S., Briesch, A., & Myers, D. (2008). Evidence-based practices in classroom management:
Considerations for research to practice. Education and Treatment of Children, Vol. 31, pp. 351-380.
Simpson, R.L. (2005). Evidence-based practices and students with autism spectrum disorders. Focus on Autism and
Other Developmental Disabilities, 20, 3, p. 140.
linking research
to real life.
A division of the ESC of Central Ohio