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Self-Management: An Evidence-Based Strategy to Increase Self-Monitoring for Individuals with Autism-Spectrum Disorders

TESE 541 Research Presentation
by

Prema Trettin

on 20 November 2013

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Transcript of Self-Management: An Evidence-Based Strategy to Increase Self-Monitoring for Individuals with Autism-Spectrum Disorders

Self-Management
Executive Function & Self-Management
What is Self-Management?
 In its simplest form, students are instructed to observe specific aspects of their own behavior and provide an objective recording of the occurrence or nonoccurrence of the observed behavior.

An important benefit of self-management is the focus on skill building to teach students to be more independent, self-reliant, and responsible for their own classroom behavior. By learning self-management techniques, students can become more self-directed and less dependent on external control and continuous supervision.
Disclaimer
Our sources were primarily published in medical and academic journals between 1998 and 2011, with some outliers.

We found working definitions for key terms at the website of the National Center for Learning Disabilities, or NCLD and the "Autism Speaks" Websites.

References
MacDougall, D. (1988). Research on Self-Management Techniques Used By Students With Disabilities in General Education.
Remedial & Special Education
, 19(5), 310.
Shapiro, H. (1981). Implementing P.L. 94-142 in the high school: A successful in-service training model.
Education, 102,
47–52.
Singh, N. N., Lancioni, G. E., Manikam, R., Winton, A. W., Singh, A. A., Singh, J., & Singh, A. A. (2011). A Mindfulness-Based Strategy for Self-Management of Aggressive Behavior in Adolescents with Autism. 
Research In Autism Spectrum Disorders, 5(3),
1153-1158.
Wilkinson, L. E.. "Self-management for high-functioning children with autism spectrum disorders" 
Intervention in School and Clinic 43
(2008): 150-157.
Wilkinson, L. A. (2008). Self-Management for Children With High-Functioning Autism Spectrum Disorders. 
Intervention in School and Clinic,43(3)
, 150. doi:10.1177/1053451207311613
http://www.autismspeaks.org/family-services/tool-kits/asperger-syndrome-and-high-functioning-autism-tool-kit/executive-functioni
http://www.ncld.org/types-learning-disabilities/executive-function-disorders/executive-functioning-learning-disabilities (Author: Sheldon H. Horowitz, EdD) 
http://www.ncld.org/types-learning-disabilities/executive-function-disorders/what-is-executive-function
An Evidence-Based Strategy to Increase Self-Monitoring For Individuals With ASD.
TESE 541: Introduction to Autism Spectrum Disorders
A presentation by:
Sonia Berkovich
Avital Pakravan
Prema Trettin

Definition
Also Known As: Behavioral Self-Control, Behavioral Self-Management, and Self-Determination
Self-Management is an alternative to Teacher-, Parent-, or OT-managed contingency procedures and can be used with
everyone
, not just those with exceptionalities.

Self-management
"generally involves activities designed to change or maintain one’s own behavior."

Executive function
can be thought of as the cognitive system that controls other cognitive processes including set-shifting, (or cognitive flexibility) inhibition of responses, self-monitoring & planning.”
Technical Definition:
Technique History
1970s: "
Behavioral Self-Control
" interventions in school settings first appeared in the research literature in the early 1970s.

1980s: researchers began to use "
Behavioral self-management"
as the preferred term.

1990s: researchers increasingly used the term "
self-determination."

Present-Day: the technique is simply referred to as "S
elf-Management"
What's In a Name?
Technique History
Initial BSC interventions were based on cognitive-behavioral models that emphasized, to varying degrees, the reactive effects of cognitive factors (e.g., awareness and self-talk) and behavioral factors (e.g., antecedents, observable actions, and consequences) in promoting self-directed behavior.
What is it?
Effect on Learning
Difficulty with:
Making plans
Keeping track of time and finishing work on time
Keeping track of more than one thing at once
Meaningfully including past knowledge in discussions
Evaluating ideas and reflecting on work
Changing our minds and make mid-course corrections while thinking, reading and writing
Asking for help or seeking more information when needed
Engaging in group dynamics
Waiting to speak until we’re called on
What that
really
means:
Proper Executive Functioning is:
conscious, purposeful and thoughtful.
Involves activating, orchestrating, monitoring, evaluating and adapting different strategies to accomplish different tasks.
Includes an understanding of how people tap their knowledge and skills and how they stay motivated to accomplish their goals.
Requires the ability to analyze situations, plan and take action, focus and maintain attention and adjust actions as needed to get the job done.
Cole, C., & Bambara, L. (1992). Issues surrounding the use of self-management interventions in the schools.
School Psychology Review, 21,
193–202.
Coyle, C., & Cole, P. (2004). A videotaped self- modeling and self-monitoring treatment program to decrease off-task behavior in children with autism.
Journal of Intellectual & Developmental Disability
, 29, 3–15.
Happe ́, F., Booth, R., Charlton, R., & Hughes, C. (2006). Executive function deficits in autism spectrum disorders and attention-deficit/hyperactivity disorder: Examining profiles across domains and ages.
Brain & Cognition, 61
, 25–39.
Kanfer, F.H., & Karoly, P. (1972a). Self-Control: A behavioristic excursion into the lion's den.
Behavioral Therapy, 3,
398-416.
Kanfer, F.H., & Karoly, P. (1972b). Self-Regulation and its clinical application: Some additional considerations. In R.C. Johnson, P.R. Dokecki, and O.H. Mowrer (Eds.),
Conscience, contract and social reality
(pp. 428-437). New York: Holt, Reinart & Winston.
Koegel, L., Koegel, R., Harrower, J., & Carter, C. (1999). Pivotal response intervention: Overview of approach.
Journal of the Association for Persons with Severe Handicaps, 24,
174–185.
Effect on Social Skills
Difficulty With:
1. Explaining ones behaviors
2. Understanding emotions
3. Predicting the behavior or emotional state of others
4. Understanding the perspectives of others
5. Inferring the intentions of others
6. Understanding that behavior impacts how others think &/or feel
7. Joint attention and other social conventions
8. Differentiating fiction from fact
(http://www.ncld.org/types-learning-disabilities/executive-function-disorders/what-is-executive-function)
(http://www.autismspeaks.org/family-services/tool-kits/asperger-syndrome-and-high-functioning-autism-tool-kit/executive-functioni)
Successful
Self-Management
Is conscious, purposeful and thoughtful.
Involves activating, orchestrating, monitoring, evaluating and adapting different strategies to accomplish different tasks.
Includes an understanding of how people tap their knowledge and skills and how they stay motivated to accomplish their goals.
Requires the ability to analyze situations, plan and take action, focus and maintain attention and adjust actions as needed to get the job done.
(http://www.ncld.org/types-learning-disabilities/executive-function-disorders/executivefunctioning-learning-disabilities)
Self-Managing Aggression with "SoF"
Aggression interferes with goals and interpersonal relationships at home.
Mindfulness-based strategy for adolescents with autism spectrum disorder
"Soles of Feet"

(SoF) Method
: Individual learns to stop, focus the mind on the body, calm down, and then make a choice about how to react to the thought, event, or situation that triggered the aggressive behavior.

"SoF" provides the individual with an internalized response that is portable, easy to master, and can be accessed in almost any situation

In this specific case study, three families were involved and used the SoF method. They found is extremely helpful and successful in their homes.

Advantage
: utilizes mindfulness strategies, allows child to be in charge of their own actions

Disadvantage
: might take longer than traditional methods such as psychopharmacological methods; method taught to parent who then teaches child
SoF Procedure
If you are standing, stand in a natural rather than an aggressive posture, with the soles of your feet flat on the floor
If you are sitting, sit comfortably with the soles of your feet flat on the floor
Breathe naturally, and do nothing
Cast your mind back to an incident that made you very angry. Stay with the anger
You are feeling angry, and angry thoughts are flowing through your mind. Let them flow naturally, without restriction. Stay with the anger. Your body may show signs of anger (e.g. rapid breathing)
Now, shift all your attention fully to the soles of your feet
Slowly, move your toes, feel your shoes covering your feet, feel the texture of your socks, the curve of your arch, and the heels of your feet against the back of your shoes.
If you do not have shoes on, feel the floor or carpet with the soles of your feet.
Keep breathing naturally and focus on the soles of your feet until you feel calm
Practice this mindfulness exercise until your can use it wherever you are and whenever an incident occurs that may otherwise lead to you being verbally or physically aggressive.
Remember that once you are calm, you can walk away from the incident or situation with a smile on your face because you controlled your anger.
Alternatively, if you need to, you can respond to the incident or situation with a calm and clear mind without verbal threats or physical aggression
Why Use
Self-Management?
Self-Management
In Action
The following steps provide a general guide for preparing and implementing a self-management plan in the general education classroom.

They should be modified as needed to meet the individual needs of the student.
Basic Structure for Self-Management Techniques
Step 1: Identify preferred behavioral targets.

Step 2: Determine how often students will self-manage their behavior.

Step 3: Meet with the student to explain self-management, identify goals, and establish preferred rewards contingent upon achieving those goals.

Step 4: Prepare a student self-recording sheet

Step 5: Model the self-management plan, and provide the student with an opportunity to practice the procedure.
Step 6: Implement the self-management plan.

Step 7: Meet with the student to determine whether the behavioral goals were attained.

Step 8: Provide the rewards when earned.

Step 9: Incorporate the plan into a school–home collaboration scheme by sending the self- recording sheet home for parent review.

Step 10: Fade the intervention by increasing the length of intervals between self-monitoring cues.
(Wilkinson, 2008)
Self-management strategies can fail due to student and teacher resistance, poor training, or a lack of appropriate reinforcement. Successful implementation of self-management procedures requires that students be motivated and actively involved in the self-monitoring activities. In order for self-management to be an effective intervention, the procedures must be acceptable to all parties and implemented with integrity. If not fully supported, it is better to focus on a more suitable behavior management approach.
 
Self-management is considered a pivotal skill that can generalize adaptive behavior, promote autonomy, and produce broad behavioral improvements across various contexts for many children with autism spectrum disorders. Once students achieve competency with self-management, they can apply their newly learned self-regulation skills to other situations and settings, thereby facilitating generalization of appropriate behaviors in future environments with minimal or no feedback from others. 
How
Self-Management Helps!
Giving people skills to think about their actions (either for before or after the fact)
Making a physical or mental check list

This self-monitoring procedure involves providing a cue or prompt and having students discriminate whether they engaged in a specific behavior at the moment the cue was supplied. Research indicates that the activity of focusing attention on one’s own behavior and the self-recording of these observations can have a positive reactive effect on the behavior being monitored.
Basic Self-Management Form
How Is Self-Management Used?
(Wilkinson, 2008)
(Wilkinson, 2008)
(Singh, 2011)
(Singh, 2011)
(Cole, Marder, & McCann, 2000)
(Happé, Booth, Charlton, &Hughes 2006) 
(http://www.ncld.org/types-learning-disabilities/executive-function-disorders/executive-functioning-learning-disabilities)
(Wilkinson, 2008)
(Wilkinson, 2008)
(McDougall, 1998)
(Kanfer & Karoly, 1972a, 1972b; Rachlin, 1974; Skinner, 1953)
In an early BSC study with elementary students, Glynn, Thomas, and Shee (1973) proposed a four-component model of BSC.
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