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Position of Person Submitting Request
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General Education Teacher
Special Education Teacher
Director of Special Services
Principal/Assistant Principal
Speech-Language Pathologist
Occupational Therapist
Physical Therapist
Counselor
Behavior Specialist
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Other:
General Education Teacher
Special Education Teacher
Director of Special Services
Principal/Assistant Principal
Speech-Language Pathologist
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Physical Therapist
Counselor
Behavior Specialist
School Psychologist
Other:
The teacher must be present for the entire virtual consultation and on-site consultation. Please make necessary arrangements.
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I understand
Would you like an on-site consultation?
Yes-I would like you to observe a specific student.
Yes-I would like you to observe a classroom or program.
Unsure, I would like to discuss my concerns with you.
Yes-I would like you to observe a specific student.
Yes-I would like you to observe a classroom or program.
Unsure, I would like to discuss my concerns with you.
Concern(s)
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Requestor's Name: ______ ______ Email: ______ Cell Phone Number: ______ School District: ______ Position: ______
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3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
PK-3 PK-4 K 1 2 3 4 5 6 7 8 9 10 11 12
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General Education Teacher Special Education Teacher Director of Special Services Principal/Assistant Principal Speech-Language Pathologist Occupational Therapist Physical Therapist Counselor Behavior Specialist School Psychologist Other
Teacher's Level of Experience
First year 1-5 6+
Director of Special Services' Email
What type of classroom setting will be observed?
General Education
Special Education
General Education
Special Education
What grade levels are represented in the classroom?
Select all that apply.
As a school district, you are required to obtain signed parent consent for observation before the on-site consultation occurs.
I understand
For the consultants' safety, school staff are required to wear masks during the on-site consultation.
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Does the student qualify for services under the category of autism?
Yes
No
In process
Does the student attend school the same length as his/her peers?
Full day
Reduced day
What is the student's placement?
Full-time general education
Part-time special education
Full-time special education
Full-time general education
Part-time special education
Full-time special education
What related services does the student receive?
Choose one or more:
What is the MAXIMUM number of students in the classroom at one time?
When you have ______ students in the classroom, how many adults (teachers and paraprofessionals) are in the classroom during that time?
What level of adult support is needed for the student?
1:1 support
Partial support
No additional support
1:1 support
Partial support
No additional support
Does the student have any health issues and/or medical diagnosis?
How does the student communicate?
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How does the student interact with others?
What level are the student's self-help skills (toileting, dressing, feeding self, grooming)?
Age-appropriate
Slightly delayed
Significantly delayed
Age-appropriate
Slightly delayed
Significantly delayed
What is the student's level of academic functioning?
Above grade level
On grade level
Slightly delayed
Significantly delayed
Above grade level
On grade level
Slightly delayed
Significantly delayed
Does the student have a Behavior Intervention Plan?
Yes
No
What are the student's strengths?
What are the student's preferred items and/or activities?
What specific interventions have been tried?
Reason(s) for consultation request
Reason(s) for consultation request
Describe the behavior(s) of concern
When, where, and with whom is the behavior most likely to occur?
When, where, and with whom is the behavior least likely to occur?
What do you hope to gain from this consultation?
What other relevant information would you like to share?
Upon submission of this form, you will be redirected to our scheduling page where you will select a time and date for the initial virtual consultation to discuss how we can best help you.
M-D-Y
Virtual Consultation Notes:
Scheduling Considerations:
M-D-Y
H:M
M-D-Y
Is this a virtual consultation only?
Yes
No
Functional Communication - When students cannot effectively communicate, they may use challenging behaviors to communicate their wants, needs, and feelings. All behavior is communicating something. For example, students might hit, kick, or run way to communicate a want or need. It is important to figure out what they are trying to communicate. Since a lack of functional communication can lead to challenging behavior, teaching functional communication needs to be a priority in the student's educational plan.
Identify what the student wants/needs to communicate. Motivation drives communication. Figure out what the student is trying to communicate or the student will not be motivated to communicate with you. Mode of communication - The team, including the family, needs to decide what type of communication system to target with the student. Some examples include: pointing, talking, Picture Exchange Communication System (PECS), and Augmentative & Alternative Communication (AAC). The type of communication system depends on the strengths of the student, training of the team, and available resources for implementation. Creating a plan - Write down the steps for implementing the communication system so everybody on the team is consistent. The plan needs to include the items to target, materials needed, time during the day to practice, who is responsible, and how you are going to collect data to see if the system is working. Delivering Instruction - Using frequent verbal instructions and verbally repeating instructions can often lead to challenging behavior.
Keep verbal instruction clear and concise by telling the student exactly what you want him to do, e.g., "First line up, then lunch", "Put away" or "Get marker". Avoid instructions that start with "Can" or "Will." These are questions and often result in yes/no answers and can be confusing for students. Limit verbal instructions to 2-3 word phrases. Give the instruction only one time before prompting the student through the task. If possible pair verbal instructions with pictures. Positive Reinforcement - The process of giving the student something he/she likes in response to a desired behavior. When you pair positive reinforcement with a behavior, the frequency of the behavior will likely increase. Using positive reinforcement can be very effective in reducing challenging behavior and teaching new skills.
Target behavior - Decide what behavior to target for reinforcement. The behavior needs to be specific so everybody knows exactly what to reinforce. For example, instead of, "The student will sit during circle time," be more specific, "The student will sit on his spot for five seconds ." Select reinforcers - The reinforcers need to be specific to the student, something that is motivating to him. Use reinforcers that you can use in the moment, so the student does not have to wait to receive them. Use stronger reinforcers for activities or skills that are more difficult for the student. Rewards are more effective in small amounts, given more frequently than larger amounts, given less often. Reinforcement will be more effective if you use a variety of reinforcers. Continually identify new reinforcers to try with him. The more variety he has, the better. Reinforcement schedule - The team needs to determine how often the student is going to receive reinforcement. You can use the 50% rule for determining the frequency. Divide the time between behaviors in half and that's how often you should reinforce the behavior. For example, if you're working on getting your student to sit in circle time and he currently gets up every 30 seconds, divide the time in half (15 seconds) and that is how often you need to give reinforcement for sitting. Fading - It is important to know how to fade the reinforcement or the student will start depending on the reinforcer every time they perform the target behavior. You can fade the reinforcer by using a token reinforcement system, expecting more before giving the reinforcer or using intermittent reinforcement. With intermittent reinforcement, some, but not all behaviors are reinforced and the timing and frequency of the reinforcement varies. Token Reinforcement System- A system in which a student earns tokens for target behaviors. Once the student has collected a predetermined number of tokens, the tokens are then traded for a preferred item or activity. Token reinforcement systems can teach delayed gratification for preferred activities. They also assist students in understanding time and what is expected of them. Token reinforcement systems are often used to teach students a new skill and/or to help them through a difficult or less preferred task.
Before beginning an activity, present the token reinforcement system to the student with all of the tokens off. Ask the student, "What do you want to work for?" Remember, it must be motivating to the student! Place the picture or write the word of the item/activity that the student is working for directly underneath the words "I am working for". Clearly state how many tokens the student must earn in order to gain access to the item/activity. Begin the activity. Provide the student with a token when he or she engages in the target behavior. You may provide reinforcement for single actions or answers, for each task completed, or for a specified number of responses. Be flexible! When the student earns the required number of tokens, provide the item/activity immediately for a specified amount of time, even if the activity or project is not fully completed. Never take a token or reward away from a student . The purpose of this system is to reinforce positive behavior. Once they have earned it, it is permanent. If the student is not engaged in the desired action, then they simply do not earn another token. This system is set up for encouraging success and keeping the student engaged in appropriate behavior, rather than focusing on negative behavior. Errorless Teaching - An instructional strategy that ensures students always respond correctly. It consists of modifying the task while also prompting the student to ensure his response is correct. Through errorless teaching, challenging behavior will decrease due to the increase in the student's rate of success.
Break the target skill into steps - Select the target skill and break it down into small steps. Decide which step the student can do and which step the student cannot do. Target the step the student cannot do yet. Prompts - When working on the new skill, help the student get it right from the beginning. You can modify the task to make it easier or help the student using a prompt to get it correct. Use short and simple verbal instructions. The goal is to use the least amount of assistance you can to help him respond correctly. Prompts can be visual, such as modeling exactly what you want him to do or pointing to the correct response. You can also use hand over hand physical assistance to choose the correct answer if needed. Fading prompts - Prompts should be gradually faded as the task becomes more familiar to the student. Eventually, you can evaluate whether the student has learned the task by prompting him the first four times and on the fifth time give the same instruction without a prompt. If the student is successful at least 90% of the time, he has learned the task. If he is unsuccessful, prompt him to get it right and continue to work on that task. Errors - Even with errorless teaching, errors may still occur. If a student makes an error, the teacher may withhold reinforcement and present a new instruction or withhold reinforcement and present the same instruction again providing an immediate full prompt of the correct answer. Errors should never be followed by negative comments, reinforcement, or presentation of a reward. Taking data - It is important to take data on skills you are targeting with your student. The data needs to indicate if the student got it right or wrong and what types of prompts were or were not used for each trial. Break - Many students with challenging behavior have difficulty knowing what to do when they are overwhelmed and feeling anxious. As a result, their behavior may escalate. Teaching a student how to effectively take a break is a critical skill to decrease challenging behavior. It must be done in a systematic way or it could inadvertently reinforce the challenging behavior rather than decrease it.
Identify early signs of stress - Recognize the initial signs that the student needs a break by identifying what the student does or says when he is starting to get stressed or overwhelmed (e.g., rocks back and forth, talks more, talks less). Communicate to everyone on the team what the initial signs are. When you begin to see the signs, start the break process. The earlier you recognize the signs and start the process, the more effective it will be. Communicate "break" - As soon as you see the student's initial signs, indicate it is time for a break. Eventually you will teach him how to ask for a break, but in the beginning you will need to tell him he needs a break. Make the communication simple by saying "break", showing him a picture of break, or both. In the beginning do not present it as a choice, just take him for a break. Break area - Creating an appropriate break area is crucial. The break area should: Be an area with few distractions, containing only items that the student can use to relax. Not contain reinforcers. Reinforcers stay in the work area. If the break area is too rewarding, the student will start having challenging behaviors in order to get to the break area. Have a visual support indicating how to relax (e.g., take deep breaths, think of something different, squeeze muscles). Have a physical border so the student can clearly see the designated area. (e.g., masking tape around the area, a mat or rug). Limit interaction - When the student is in the break area, do not talk to or interact with him. The only interaction with the student should be through the visual support. Physically guide the student to the items in the break area (e.g., guide the student to sit on the bean bag or to rock in the chair).
Transitioning from the break - When you start seeing the student deescalate, the break is almost finished. When the student has deescalated, tell the student "break over" and show him what is next using his visual schedule.
Scheduling a break - As the student is more independent with the process, begin putting a break on his schedule throughout the day. If the student is spending a lot of time in the break area during the day, be sure he is not getting reinforcement in the break area or using the break to avoid work.
Visual Supports - A visual support refers to the use of a picture or other visual like photographs, drawings, objects, written words, or lists to communicate information. Visual supports benefit everyone, but they are a common strategy used to teach and support students with autism. Visual supports clarify expectations, prepare students for transitions and change, provide motivation, decrease verbal directions, teach routines, increase independence, decrease anxiety, and help students feel included.
Labels - Communicate where activities take place and items belong, e.g., center areas, toys and materials. If using pictures, add the word to the picture. Use the same format for all labels to provide consistency. For toy and material shelves, use actual pictures of the items. Label the container and the shelf to support the materials being returned to their proper place. Keep labels at student's eye level. Classroom Visual Schedule - Provide students with information about the daily activities, sequence of events, and any schedule changes. Make sure the students can understand the activities (use words, picture, or both). If your schedule is flexible, avoid using specific times along with the activities, just ensure the order is correct. Make sure you can manipulate the schedule, in case changes occur. Update the schedule as soon as you know of any upcoming changes. The schedule should be visible and accessible to everybody in the classroom. If the student moves from room to room, make the schedule portable. Rules/Expectations - A visual support that provides the students with a clear, consistent description of the classroom expectations. Limit the number (if you cannot remember them, neither can they). Use positive language -ex: "walk" instead of "don't run". Make it visible at students' eye level. Written on their level (use words, pictures, or both). Individual Visual Schedule Use the format the student can comprehend on his worst day. Display so visible and accessible to student. Make it portable if the student travels to different rooms. Have a symbol for changes in daily activities-ex: star for field trip, fire drill, guest, speaker, or assembly. Cross off, move, or remove picture or word to show when the activity is finished. Show full-day or half-days. Add personal interest if need to draw the student's attention to the schedule. Mini Schedule - A visual support that explains what is happening within a task, activity, or class period e.g., play, centers, PE. Supplements the daily schedule. Use for activities with multiple steps or open ended. Can be used to teach new skills like washing hands. Display in the area where the information is needed-ex: washing hands visual would be next to the sink. Keep it visible to the student. Cross off, move, or remove picture or word to show when activity is finished. First/Then Board - A visual support used to teach students to follow directions, complete new and/or difficult tasks, and during transitions. Use few words, "First coat, then swing" or "First lunch, then recess". Avoid repeating verbal instructions, redirect to the first/then board. Provide preferred activity immediately following the completion of the "first" task. Use prompts to help the student complete the task if needed. Choice Board - A visual support that shows the student what options are available, e.g., songs at circle time, activities during recess, calming strategies, reinforcers. May need to start with a few options and build up number of options available. The Zones of Regulation - A systematic, cognitive behavior approach used to teach self-regulation by categorizing all the different ways we feel and states of alertness we experience into four concrete zones. The Zones curriculum provides strategies to teach students to become more aware of, and independent in controlling their emotions and impulses, managing their sensory needs, and improving their ability to problem solve during conflicts. The Zones of Regulation incorporates Social Thinking® (www.socialthinking.com ) concepts and numerous visuals to teach students to identify their feelings/level of alertness, understand how their behavior impacts those around them, and learn what tools they can use to manage their feelings and states.
The Incredible 5-Point Scale - A visual strategy that can be applied to a variety of behaviors and responses to behaviors, including feelings of anxiety, obsessions, concepts of personal space and feelings of anger. It can be used to teach students self-awareness and social understanding. A 1-5 scale is used to break down abstract ideas into simple numbers and colors, which matches the learning styles of many students with autism spectrum disorders (ASD). The 5-Point Scale is particularly successful with students with ASD who have some social readiness skills and can identify numbers or colors. For more information, see www.5pointscale.com .
De-escalating Behavior - Once a student's behavior has escalated to a point he/she is not able to reason with you, follow the following procedures to de-escalate the behavior.
Ensure safety of children and staff. Remove any dangerous items. Attempt to get the student to a safe environment. Remove other students if needed. Ensure adults are not left alone with the student when an outburst occurs. Limit the number of adults involved. The person with the most experience with de‐escalation techniques should take the lead. The lead person should be the only one communicating with the student. The other adult should manage the other students. Provide adequate space. Stay at least two arm's length away from the student. Back up one step if the student asks for more room (e.g., "stay away", "back off"). Avoid touching the student. Show open, accepting body language. Hold your body at an angle rather than facing the student directly; avoid direct eye contact. Keep your hands open and visible to the student. Avoid confrontational body language such as crossing arms or clenching fists. Keep verbal interactions respectful. Stay calm. Verbally ignore; avoid comments such as "no hitting". Avoid use of teasing, reprimands, sarcasm or an angry tone of voice. Keep communication simple. Keep vocabulary simple and sentences brief and direct. Allow sufficient time for student to think about and respond before continuing and/or repeating. Avoid assuming that the student is simply ignoring you. Instead calmly repeat several times if necessary (as long as the behavior is not escalating). Deliver message through visuals when possible. Remind the student of what to do rather than focusing on what not to do. For example: First sit in your chair, then you can have your music. Reinforce calm or approximation of calm and other desired behaviors. Modify previous expectations - If the student got overwhelmed with the expectations, simplify what you want the student to do. Professional Development - Find opportunities for your team to get more training on supporting students with autism. For more information on upcoming training through the Oklahoma Autism Center, go to www.autismcenterok.org .