The Use of Self-Monitoring Interventions to Support Inclusion for Adolescents Diagnosed with Autism Spectrum Disorder

There are numerous benefits to inclusion in school settings for students diagnosed with autism (Harrower and Dunlap, 2001). However, there are also many challenges related to inclusion for many of those students and for the educators and the support staff in those settings. Problematic behavior displayed by students diagnosed with Autism Spectrum Disorder (ASD) is one such challenge.

Stephanie A.C. Kuhn, PhD, LP, BCBA-D

Stephanie A.C. Kuhn, PhD, LP, BCBA-D

Behavioral challenges that are present in the lower grades may become more of a disruption in the later middle school years and into high school. In addition, problem behavior that was not observed prior to adolescence may emerge or worsen. These behaviors can lead to alternative placements. There are many factors to consider when students are placed outside of the general education classroom setting.

The general education classroom is considered the Least Restrictive Environment (LRE) in most situations and the Individuals with Disabilities Education Act (IDEA) requires that students be placed in the LRE (IDEA; 2004). For some students, the level of academic instruction in the general education classroom may be appropriate, yet problem behavior may occur at a level that exceeds what can be tolerated in a general education classroom. In many cases, behavioral interventions can be effective in managing the problem behavior in the general education classroom for these students (Koegel, Matos-Freeden, Lang, & Koegel, 2012; Shapiro, Durnan, Post, & Levinson, 2002).

Evidence-based practice for assessment and treatment of problem behavior includes functional behavioral assessment (FBA) and function-based behavioral interventions (i.e., interventions designed based on the function, or reinforcer, maintaining the challenging behavior). These procedures have been demonstrated to be effective in school settings for individuals with ASD who display challenging behavior.

FBA procedures are designed to identify environmental events that both occasion and maintain challenging behavior. Function-based interventions can be designed based once the function of the behavior has been identified. These interventions often include an extinction component, which prescribes that the reinforcer responsible for maintaining the challenging behavior is no longer delivered following the problem behavior. For example, if the behavior is found to be maintained by escape, extinction would involve no longer allowing escape following the challenging behavior and maintaining the demand or task issued.

Extinction procedures have been demonstrated to be very effective. However, these procedures can be very difficult to implement in situations where the implementers do not have control over the delivery of the reinforcers. One situation where it can be difficult to implement extinction procedures is in inclusive education settings. If for example, an individual screams or throws materials in order to gain access to attention or escape tasks extinction would involve no longer providing attention or escape from tasks following screaming or throwing materials. In an inclusive setting, attention may be delivered inadvertently by peers. In addition, escape extinction may not be possible given the disruption to the other students when screaming or throwing occurs (i.e., making it difficult or impossible to maintain the task demand when these target behaviors occur). If the target behaviors continue to result in reinforcement it is likely that the behaviors will continue to occur. In these situations, strategies that do not rely on the reinforcer being withheld should be considered.

In addition, it is especially important to teach adolescents with ASD strategies that don’t rely on external agents such as teaching assistants, teachers, or parents to implement the treatment such that they can more independently reach their goals. An intervention that has been demonstrated effective in improving student academic and behavioral outcomes along with maintaining and generalizing these gains is self-monitoring or self-management. (Harrower & Dunlap, 2001). With these procedures, students with ASD are involved in setting goals for themselves and are subsequently taught to identify appropriate and inappropriate behaviors, to record those behaviors, to evaluate the data, and to deliver rewards to his/herself when certain criteria are met (Harrower & Dunlap, 2001). The effectiveness of self-management strategies has been demonstrated in full-inclusion classrooms (Callahan & Rademacher, 1999; Frea & Hughes, 1997.) In addition, there is support for self-management programs increasing independent functioning while reducing reliance on a one-to-one aide and maintaining effectiveness over long periods of time in a full-inclusion classroom setting (Koegel, Harrower, & Koegel, 1999).

Recent studies examining the use of technology-based self-monitoring interventions have produced promising results (Clemons, Mason, & Garrison-Kane, 2015; Crutchfield et al, 2015). These applications (i.e., “apps” on mobile devices) have been demonstrated to both increase task completion and decrease challenging behavior (Clemons, Mason & Garrison-Kane, 2015) and have been demonstrated as effective in high school settings with students with disabilities (Wills & Mason, 2014). In addition, although both pencil and paper and technology based self-monitoring applications have been demonstrated as effective in increasing independence in task completion, there is some evidence that students preferred the technology-based option (Bouck et al, 2014).

There are several commercially available self-monitoring applications (i.e., “apps”). One example, I-Connect, uses alarms, calendars, checklists and prompts as intervention components. Another, Score It, has components for both students and teachers to rate behavior using a rating scale. There appear to be various opportunities to design function-based behavioral interventions to decrease challenging behavior of individuals with ASD in inclusive environments using both traditional and the newer technology based self-management interventions. For example, students can rate if an antecedent for challenging behavior was present, if they responded with challenging or appropriate behavior, and apply consequences based on the response that occurred (i.e., access reinforcement such as a break or withhold reinforcement). This combination of technology, self-management procedures, and effective function-based treatment procedures is promising. In addition, the preliminary evidence suggests that the student prefers the technology. Furthermore, the use of the program on a personal device may be less stigmatizing than other interventions and the technology-based self-monitoring interventions may allow the student greater independence.

Overall, the use of function-based technology-based self-management interventions may result in greater benefits to the student and the classroom as a whole. As these applications continue to be developed, researched, and become more widely used, they will provide teachers and support professionals new and innovative ways to not only include students in the general education classroom, but to enable them to be more independent and successful.

 Stephanie A. Contrucci Kuhn, PhD, LP, BCBA-D, is an Assistant Professor in the Education and Educational Psychology Program at Western Connecticut State University and provides behavioral clinical and consultation services through her private practice, Kuhn Behavioral Services, LLC. For more information, please contact Dr. Kuhn at skuhn@wcsu.edu or Stephanie@kuhnbehavioralservices.com.

References

Bouck, E. C., Savage, M., Meyer, N. K., Taber-Doughty, T., & Hunley, M. (2014). High-tech or low-tech? Comparing self-monitoring systems to increase task independence for students with autism. Focus On Autism And Other Developmental Disabilities, 29(3), 156-167.

Callahan, K., & Rademacher, J. A. (1999). Using self-management strategies to increase the on-task behavior of a student with autism. Journal Of Positive Behavior Interventions, 1(2), 117-122.

Clemons, L. L., Mason, B. A., Garrison-Kane, L. G., & Wills, H. P. (2015). Self-monitoring for high school students with disabilities: A cross-categorical investigation of I-Connect. Journal of Positive Behavior Interventions. Advance online publication.

Crutchfield, S. A., Mason, R. A., Chambers, A., Wills, H. P., & Mason, B. A. (2015). Use of a self-monitoring application to reduce stereotypic behavior in adolescents with autism: A preliminary investigation of I-Connect. Journal Of Autism And Developmental Disorders, 45(5), 1146-1155.

Frea, W. D. , & Hughes, C. (1997). Functional analysis and treatment of social-communicative behavior of adolescents with developmental disabilities. Journal of Applied Behavior Analysis, 30, 701-704.

Harrower, Josh & Dunlap, Glen. (2001). Including Children with Autism in General Education Classrooms A Review of Effective Strategies. Behavior modification. 25. 762-84.

Koegel, L. K., Harrower, J. K., & Koegel, R. L. (1999). Support for children with developmental disabilities in full inclusion classrooms through self-management. Journal Of Positive Behavior Interventions, 1(1), 26-34.

Koegel, L., Matos-Freden, R., Lang, R., & Koegel, R. (2012). Interventions for children with autism spectrum disorders in inclusive school settings. Cognitive And Behavioral Practice, 19(3), 401-412.

Shapiro, E. S., Durnan, S. L., Post, E. E., & Levinson, T. S. (2002). Self-Monitoring Procedures for Children and Adolescents. In M. R. Shinn, H. M. Walker, G. Stoner (Eds.), Interventions for academic and behavior problems II: Preventive and remedial approaches (pp. 433-454). Washington, DC, US: National Association of School Psychologists.

United States. (2011). Individuals with Disabilities Education Improvement Act of 2004. [Bethesda, MD :ProQuest]

Wills, H. P., & Mason, B. A. (2014). Implementation of a self-monitoring application to improve on-task behavior: A high-school pilot study. Journal Of Behavioral Education, 23(4), 421-434.

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