A research review by Jennifer Morrison (CUNY Queens College)
Giangreco, M. F. & Broer, S. M. (2007). School-based screening to determine overreliance on paraprofessionals. Focus on Autism and other Developmental Disabilties, 22, 149 – 158.
Purpose of the study: The purpose of this given study was to describe a 16 item screening tool designed to assist schools in determining overreliance on paraprofessionals and from here to lead to action plan in how to fix this growing problem.
Participants: The study participants included a total of 244 screening and planning team members that were part of 27 different schools. These individuals consisted of special education teachers (n= 44), general education teachers (n=40), general education administrators (n=32), special education administrators (n=31), paraprofessionals (n=29), parents (n=23), critical friends (n=21), consumers (n=17) and others (n=7).
Setting: The setting of the study was at 27 schools in six states: California, Connecticut, Kansas, New Hampshire, Wisconsin, and Vermont. Out of these 27 schools eleven of these were primarily rural, eight as suburban, and eight as urban. 95% of the children in the study primary placement were at a general education classroom with supports.
Target Behaviors: The given target behavior was to look at overreliance on paraprofessionals in a classroom settings. This overreliance in some cases could lead to interference with the general education teacher engagement or even with peer interaction, decision making by under qualified personnel, and more importantly the development of unnecessary dependence on the paraprofessional.
Procedure: The school initially signed up for participation in field testing by submitting an application online. The schools joined the project in staggered cohorts over 3 academic years. Once the school agreed to participate, they had to submit their demographic information and were sent copies of guidelines of the research. From here each team had a 2 hour time block to meet and use the screening tool. After giving it to individuals in the school, it was then sent back and the number and percentage of schools answering each question was calculated and rank order was determined by looking at responses which included: happens too frequently, happens sometimes, or for some of the time.
Results: From the screening tool, it was determined that the biggest concerns across schools was that paraprofessionals provide academic support in subjects where they are underskilled, students spend most of their time in close proximity to para’s, students are very dependent on the para’s presence, others communicate through the para instead of the child, the child is physically separated from the rest of the class (eg back of the room) and finally that the classroom teachers are minimally or superficially involved with some students.
Other concerns included: that para’s make curricular or instructional decisions or adaptations without the classroom teachers input, the students receive their primary instruction from para’s, and when it is time to report the students progress classroom teachers rely on para’s because they know more about the student in general.
Implications: This study has several implications to special education and general education classrooms. It has become practice in the recent past to increase the number of paraprofessionals in schools in order to provide support for children with disabilities. This is ok, however, this option is one of the most restrictive supports that can be offered and should be looked at and thought about more closely without becoming the first and best option. The given school district could also look at other supports before choosing this option such as coteaching, peer supports, etc. I know that personally I have worked as a paraprofessional in the past and worked with other paraprofessionals, and these problems that are listed in the results section happen very frequently in any school setting. This screening tool could be very useful to many school districts in order to screen for overreliance problems so that an action plan can be made in order to decrease this overreliance in the future. This study brings up a lot of important concerns, being that first and foremost those children become too dependent on the para to do ANYTHING in the classroom. Another important concern is that the lack of interaction that the general or special education teacher has with the given student. This can very easily happen when the para spends 6 hrs of the day with the child and the classroom teacher does not. This is one thing that should be carefully observed in any classroom setting that the classroom teacher spends some time everyday with the student so this does not happen.
One of the most important things to keep in mind when employed as a paraprofessional is to provide support when needed but also to take a step back when the child can be independent at a given task, in order to ensure that the child will not form this overreliance on the para having to be there at all times. If this technique is used, it could be possible in the future that the child will no longer need the para in the general education setting and will just be able to use other supports in the classroom, which is the ultimate goal.
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Saturday, January 26, 2008
Monday, January 21, 2008
Decreasing self-stimulatory hand-mouthing behavior: Research Review
Research Review by Michelle Rodgers (CUNY Queens College)
Title: Effects of providing sensory stimulation to decrease self-stimulatory behavior: using additional food to suppress hand-mouthing behavior
Citation: Yang, J.L. & Bruner, J.D. (1996). Effects of providing sensory stimulation to decrease self-stimulatory behavior:using additional food to suppress hand-mouthing behavior. Behavioral Interventions, 11, 119-130.
Purpose of this study: The goals of this study were three-fold:
First, the authors wanted to validate the functional relationship between sensory reinforcement and self-stimulatory behavior. Second, the authors wanted to determine what role sensory stimulation could play when provided as a treatment procedure. Third, the authors wanted to determine if food could serve as a sensory reinforcer to replace hand-mouthing behavior.
Participants: The participant in this study was a 30.5 year old nonverbal male with profound mental retardation.
Settings: The setting was the large dining room within the state care facility in which the participant resided. The participant typically sat with three of his classmates.Target behaviors: Hand mouthing was defined as momentary insertion of any finger covering the first knuckle between the lips.
Procedure: Data were collected twice a day during baseline and treatment conditions. The data were collected during a structured morning activity and during a less structured activity in the afternoon. During the baseline phase, the participant received his usual meals, with no additional food given. Any hand-mouthing that was observed and recorded were never stopped or interrupted. During the intervention phase, the participant was given his usual meals. However, he was also given additional portions of bread, fruit and milk. He was able to eat as much or as little as he wanted. Data was collected for three months after treatment was employed.
Results: The participant’s hand-mouthing behavior decreased from 67% in morning activities to 13% after treatment, His hand-mouthing behavior in the afternoon decreased from 47% to 17%. During the follow-up, the participant averaged 12.5% hand-mouthing behavior in the morning and 10.4% in the afternoon. The participants weight was also observed. The participant gained 19.5 pounds during this study and was within his ideal body weight. In addition to the behavior decrease, the participant’s hands healed and he was able to sleep longer throughout the night. He no longer needed insomnia medication or restraints to prevent tissue damage to his hands.
Implications: In this particular case, the functional analysis of the hand-mouthing behavior allowed the authors to conclude that food would be a viable replacement. This study is somewhat limited in its generality to other individuals engaging in hand-mouthing behavior because there was only one participant. Although increased food intake worked for this individual it may not work for others.
However, with that being said, increased food decreased the hand mouthing and was less labor intensive for the staff at the facility. Permitting extra food at meal times was an easy solution to the hand-mouthing behavior and was not aversive to the participant nor did it pose an ethical dilemma for the staff as the restraints had. On the other hand, with increased food comes weight gain. This particular individual happened to need to gain weight but other participants may end up with a health problem. It is therefore suggested that individuals undergoing this increase in meals to prevent hand-mouthing, get additional exercise and perhaps some foods that provide chewing sensations without significant calories, for example chewing gum.
Title: Effects of providing sensory stimulation to decrease self-stimulatory behavior: using additional food to suppress hand-mouthing behavior
Citation: Yang, J.L. & Bruner, J.D. (1996). Effects of providing sensory stimulation to decrease self-stimulatory behavior:using additional food to suppress hand-mouthing behavior. Behavioral Interventions, 11, 119-130.
Purpose of this study: The goals of this study were three-fold:
First, the authors wanted to validate the functional relationship between sensory reinforcement and self-stimulatory behavior. Second, the authors wanted to determine what role sensory stimulation could play when provided as a treatment procedure. Third, the authors wanted to determine if food could serve as a sensory reinforcer to replace hand-mouthing behavior.
Participants: The participant in this study was a 30.5 year old nonverbal male with profound mental retardation.
Settings: The setting was the large dining room within the state care facility in which the participant resided. The participant typically sat with three of his classmates.Target behaviors: Hand mouthing was defined as momentary insertion of any finger covering the first knuckle between the lips.
Procedure: Data were collected twice a day during baseline and treatment conditions. The data were collected during a structured morning activity and during a less structured activity in the afternoon. During the baseline phase, the participant received his usual meals, with no additional food given. Any hand-mouthing that was observed and recorded were never stopped or interrupted. During the intervention phase, the participant was given his usual meals. However, he was also given additional portions of bread, fruit and milk. He was able to eat as much or as little as he wanted. Data was collected for three months after treatment was employed.
Results: The participant’s hand-mouthing behavior decreased from 67% in morning activities to 13% after treatment, His hand-mouthing behavior in the afternoon decreased from 47% to 17%. During the follow-up, the participant averaged 12.5% hand-mouthing behavior in the morning and 10.4% in the afternoon. The participants weight was also observed. The participant gained 19.5 pounds during this study and was within his ideal body weight. In addition to the behavior decrease, the participant’s hands healed and he was able to sleep longer throughout the night. He no longer needed insomnia medication or restraints to prevent tissue damage to his hands.
Implications: In this particular case, the functional analysis of the hand-mouthing behavior allowed the authors to conclude that food would be a viable replacement. This study is somewhat limited in its generality to other individuals engaging in hand-mouthing behavior because there was only one participant. Although increased food intake worked for this individual it may not work for others.
However, with that being said, increased food decreased the hand mouthing and was less labor intensive for the staff at the facility. Permitting extra food at meal times was an easy solution to the hand-mouthing behavior and was not aversive to the participant nor did it pose an ethical dilemma for the staff as the restraints had. On the other hand, with increased food comes weight gain. This particular individual happened to need to gain weight but other participants may end up with a health problem. It is therefore suggested that individuals undergoing this increase in meals to prevent hand-mouthing, get additional exercise and perhaps some foods that provide chewing sensations without significant calories, for example chewing gum.
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