CSD 690: Autism/Communication Case Study: Evan .

Maiko Hosokawa

Background Information and PLAAFP

Evan is a 7-year-old boy diagnosed with Autism Spectrum Disorder (ASD). He is in 2nd grade and
receives special education services in the resource setting. Evan is in his general education classroom
during circle/share time, guided reading, silent reading, and class celebrations. He also has independent
workstations in the general education room where he works independently on math and reading activities.
He receives special education services for math, reading, and writing, as well as social skills.

Evan’s mom reports her biggest concern is his distractibility and how his off-task behavior affects his
learning. She also would like to work on his ability to play with kids, discuss his day at school, and learn
to comprehend what he reads.

Strength
Evan demonstrates a variety of individual strengths as reported:
Evan monitors the attentional focus of a social partner as evidenced by JA 1.1
* Doing well with joint attention skills including making eye contact.
* Turning and orienting his body towards a person when making a request.
* Orienting his body toward a person when they are speaking.
* Following finger points to reference something to look at.
* Communicating his needs and wants, and asking for help.
* Being able to label emotions in pictures and on other people.

Evan prefers to be engaged with partners as evidenced by JA 4.7

* Being a happy boy with a wonderful smile and attitude, and a nice friend to everyone.
* Understanding social rules in play/leisure.
* Being able to play parallel next to peers with his own set of toys or materials.
* Taking turns well during a structured close-ended activity or game and plays.
* Being able to attend to group activities by staying seated the entire time.
* Asks questions, initiates comments and will respond to questions.

Evans shares intentions to regulate the behavior of others, social interaction and joint attention; JA 3.1, JA
3.2, JA 3.3
* Being able to initiate greeting peers and a comment to a person.
* Doing well with joint attention skills including making eye contact.
* Turning and orienting his body towards a person when making a request.
* Orienting his body toward a person when they are speaking
* Following finger points to reference something to look at.
* Having nice manners and appropriate facial expressions when happy or sad.
* Communicating his needs and wants, and asking for help.
* Being able to label emotions in pictures and on other people.
* Being able to play parallel next to peers with his own set of toys or materials.
* Taking turns well during a structured close-ended activity or game and plays.
* Being able to attend to group activities by staying seated the entire time.
* Asks questions, initiates comments and will respond to questions.

Evan demonstrates reciprocity when in speaker and listener roles to share experiences. JA 4.1
* Doing well with joint attention skills including making eye contact.
* Turning and orienting his body towards a person when making a request.
* Orienting his body toward a person when they are speaking.
* Following finger points to reference something to look at.
* Being able to play parallel next to peers with his own set of toys or materials.
* Taking turns well during a structured close-ended activity or game and plays.
* Being able to attend to group activities by staying seated the entire time.
* Asks questions, initiates comments and will respond to questions.
* Understanding social rules in play/leisure.

Evan initiates a variety of conversational topics. JA4.2

* Being able to initiate greeting peers and a comment to a person.
* Communicating his needs and wants, and asking for help.
* Asks questions, initiates comments and will respond to questions.

Evan uses behavioral strategies to regulate arousal level in solitary and social activities, during new and
changing situations and transitions. SR2.1, SR5.1, SR5.4
* Follows his daily picture schedule very well and transitions between activities nicely.
* Accepting changes in his routine with warning.
* Being aware of his daily schedule and carries his visual schedule with him independently from room to
room.
* Doing very well if a change needs to be made to his schedule without getting anxious or upset.
Someone will need to tell him or read a social story about the change.
* Independently re-directing himself to keep working by pointing to the visual on his desk.

Needs
The following describes Evan’s needs abased on parent and team reports and the SCERTS observation
form.
Evan needs to understand nonverbal cues and nonliteral meanings of teasing, sarcasm, and deception.
SU2.4
*Harder time reading social cues and body language to determine the meaning of what a person is saying.

Evan needs to understand and use a variety of advanced relational words, a variety of sentence
constructions, and connected sentences in oral and written discourse. SU5.1, SU5.4, SU5.5
*Lack of variety in his compliments
*Using utterance that typically range from l to 8 words in length
*Some difficulty with accurate pronoun and other grammatical structure use
*Ability to focus on directions and increase his understanding of vocabulary and concepts that are
imbedded in directions

Evan needs to follow conventions for shifting topics in conversation. SU6.2

*Maintaining conversations with others
*The variety and appropriateness of the topics he initiates
*Doesn’t independently ask questions about others interest to gain more information
*Needs to mentally stay in conversations with active turn taking, and responding to questions when first
asked in order to better maintain conversations

Evan needs to follow conventions for ending conversation. SU6.3

*Need reminders to appropriately end conversations before turning to leave
*Needs to mentally stay in conversations with active turn taking, and responding to questions when first
asked in order to better maintain conversations
Evan needs to describe plausible causal factors for emotions of self and others. JA2.7
*More difficulty with determining a cause for that emotion
*Imitating emotions when asked to do so

Evan needs to initiate and maintain conversations that relate to partners' interests. JA4.3
*Maintaining conversations with others
*The variety and appropriateness of the topics he initiates
*Comments, questions and responses to others can often be off topic
*Needs to mentally stay in conversations with active turn taking, and responding to questions when first
asked in order to better maintain conversations

Evan needs to provide needed information based on partners' knowledge of topic. JA4.5
*Doesn’t independently ask questions about others interest to gain more information
*Comments, questions and responses to others can often be off topic
*Needs to mentally stay in conversations with active turn taking, and responding to questions when first
asked in order to better maintain conversations

Evan needs to increase the skills to make friendships with partners who share interests and play with kids
with less adult supervision or prompting. JA4.8
*Attempts in play activities with peers that are set up by teachers is limited

Evan needs to increase language skills (advanced words, vocabulary words).

*32/60 sight words
*Weakness with understanding how words are related
*Lack of variety in his compliments
*Using utterance that typically range from l to 8 words in length
*Some difficulty with accurate pronoun and other grammatical structure use
*Ability to focus on directions and increase his understanding of vocabulary and concepts that are
imbedded in directions

Evan needs to stay on task for an extended period of time (10-15 minutes).
*Difficulty with listening intently and understanding various vocabulary and concepts imbedded in
directions which adds to his difficulty with direction following
*Frequently show that his mind is elsewhere by giving a blank stare and not responding to others. This
affects his ability to answer questions and follow directions.
*Needs to mentally stay in conversations with active turn taking, and responding to questions when first
asked in order to better maintain conversations
*When Evan becomes off task or lethargic, he is not able to communicate that his brain is not ready to
work, and doesn't use his break cards to stop and take a break to get his brain back on track.

Assessment Suggestions
These two additional assessment tools/strategies may be administered:
KABC-II: Norm-referenced general IQ test which includes non-verbal tests form. Since Evan has fewer
vocabulary skills, the non-verbal form may be used. KABC scores Evan’s strengths which help him
learning and help his classroom teachers instruct him. A general IQ test is important to look at the overall
learning abilities, strengths, and weaknesses.

CASL: CASL doesn’t require reading or writing, but assesses spoken language. To assess Evan’s spoken
expressive and receptive language and comprehension, this will be a good tool. I refer this assessment
because the report does not clearly mention his sensory needs and diet, which is one of the main
 conditions of ASD. CASL identifies Autism Spectrum and other language disorders which Evan may
have.

Based on the above information regarding Evan’s attention to task a referral or consultation from OT may
be appropriate. Even though Evan hasn’t shown a lot of sensory needs that are associated with ASD, such
as diet, auditory, hand flapping, jumping, etc. but consultation from OT would substantiate that sensory
needs were not impacting his ability to learn in his environments.

Goals, Objectives, and Activities

Short-Term Goal #1 _____

Evan will increase understanding the direction in the classroom from a level of being unable to follow the directions or
being lost, to a level of being able to follow 2-step directions at least 70% of the opportunities with the target words
presented with visual cues by staff.

Obj. 1 During his daily routines, when given a visual cue, Evan will follow 1-step direction which includes the following
targeted words: ordinal words, propositions, directional terms, which are used in the classroom: FIRST, SECOND, NEXT,
THEN, IN, ON, UNDER, IN FRONT OF, BEFORE, AFTER, BEHIND, BACK, LEFT, RIGHT, TOP, BOTTOM, BY,
TO, FROM, UP, DOWN, HERE, THERE, THIS, and THAT, with 85% of the opportunities consecutive sessions over 3
consecutive sessions/samples with the clinician, in the classroom setting, or at home measured by staff and parents.

Obj. 2 Given an object or a picture of object, Evan will explicitly describe the locations of objects using the targeted
words with 70% of the opportunities over 3 consecutive sessions/samples with the clinician, in the classroom setting, or at
home measured by staff and parents.

Obj. 3 Given the target words and visual prompts, Evan will follow 2-step directions involving two different actions
combined with target word with 70% of the opportunities over 3 consecutive sessions/samples with the clinician and
classroom setting, or at home as measured by staff and parents.

Rationale:
i. Why you chose that specific behavior:
The receptive/expressive language is important to follow the 1- and 2-step directions in the classroom. The target
words were chosen on the basis of 1st grade sight words and the frequencies of each words used in the directions in
the classroom. Learning the target words which are often used in directions prevent him being lost in the class and
further difficulties in the academic setting and his life.
ii. Why you chose it as a new or generalization skill:
It is a new skill for him as well as for generalizing the skill. He learns the target words, which may be new to him, to
follow directions. He also generalizes the skills from the individual session with the clinician to the classroom
setting.
iii. Why you chose that specific condition:
The target words are all over the world, and he needs be able to understand whenever and wherever, and given by
whoever. Conditions to expand will include the comfortable or less distracting environment to more distracting
environment which is more challenging to him.
iv. Why you chose that specific prompt level:
Visual cues easily describe the target words as well as the least restrictive support. Visual cues are easier to fade out.
v. Why you chose that criterion:
Understanding and performing 1-step directions is the basic of the scaffolded obj. 2 and 3; highly required.
Expressive language skill is harder than receptive language skill; it is okay with the accuracy of lower than 85%.
 70% is the least level of master level to move on to maintain the skills as a next step. Objective 3 is the most
challenging objective for him with 2-step directions. He may struggle but has to be able to perform well enough to
follow the classroom instructions. 70% is the least level of master level to move on to maintain the skills as a next
step.
vi. Why you chose that particular person responsible for measuring the goal:
Because these skills should be generalized for Evan’s success. Generalization with whoever, whenever, and
wherever. However, to establish the comfortable environment for Evan, the clinician, paras, teachers and parents are
chosen as his familiar people. The target words are shared with the specific people who measures the objectives and
goal to keep consistencies.
Learning Supports: 1. LS3.1 Uses support to define steps 2. LS3.3 Uses visual support to enhance
3 Partner uses visual and within a task smooth transitions between activities
organizational support
Rationale: Evan has shown difficulties to Rationale: Transition involves multi-tasks
Rationale: Because Evan follow the instructions, and the multi-step in the classroom such as submitting the
learns the directional new instructions are much harder for him. papers in the basket, then sit in your seat in
words, pictures describing the Visual and organizational support helps front of the whiteboard. For Evan, it’s
meaning of words helps him to him to identify what to do first, and next. more smooth to go over the tasks before
understand the instruction. Since visual support is the low level of transitions and check after each task.
support, it is easier to fade out and not
destructive in the classroom.
Interpersonal Supports: 1. IS6.1 Uses nonverbal cues to support 2. IS6.2 Adjusts complexity of language
6 Partner adjusts language understanding input to child’s developmental level
input
Rationale: Rationale:
Rationale: Because Evan will learn directional words Because Evan will learn directional words
Evan will work on several that are frequently used in the class, but that are frequently used in the class, but
target words and will have not all, staff will give him nonverbal cues not all, staff will replace difficult words to
difficulties with advanced (visual or gestural) when he needs the target words. Also, when Evan is given
words. It is helpful for him to additional support. (Eg. when he is in front the multi-step instructions not in opposite
have target words. of the class and does work on the board, or order (Eg. Come sit in front of the board
he goes across the room to submit paper to after you put the paper in the box.), staff
the box and looks at the staff to check.) will rephrase in the order to help him
comprehend.

Activity #1: Seek and Hind. / Scavenger Hunt. / Where is it?

Method: Discrete Trial Training (DTT)

Rationale: DTT is effective for children with ASD to gain skills of
language as well as life skills. Evan will learn the target vocabulary words
to say, to place objects, and essentially to follow instructions. DTT breaks
steps down and also discriminates other learning tasks. DTT is also effective
to generalize the skills.

Setting: In therapy room, classroom, or at home

Rationale: Evan will learn the target words and generalize the skills the
places where he spends time most during a day.

Materials:
 Visual cards with pictures and target words
  Objects or toys Evan likes, and the vocabulary cards
 Classroom pictures
Rationale: Directional and positional words are hard to explain verbally.
So, visuals (pictures and objects) are helpful to learn the conditions and
words.

Script:
Staff: (Place a car next to the toy box.) Touch a car.
Evan: (Touch a car.)
Staff: Touch a box.
Evan: (Touch a box.)
Staff: Touch a car next to the box.
Evan: (Touch a car)
Staff: The car is next to the box. Where is the car?
Evan: (no response)
Staff: Say “Next to the box”.
Evan: Next to the box.

Staff: Place a bear in front of the toy box.

(Show the “in front of” card.)
Evan: (Place the bear.)

Staff: Touch the plant.

Evan: (Touch the plant.)
Staff: Where is the plant?
Evan: (no response)
Staff: Say “on the shelf”. / Say “next to the globe”.
Evan: On the shelf. / Next to the globe.
Staff: Where is the planet?
Evan: On the shelf. / Next to the globe.

Short-Term Goal #2 _____

Evan will increase his social skills from a level of not having friends who share interests or play with, needing reminders to
end conversations, and utilizing less variety and appropriate conversations when he initiates, to a level of initiating the
variety and appropriate conversations and ending the conversations during the individual session and in the classroom and
hallways as well as at home in 70% of opportunities.

Obj. 1 Following structured interviews of 5 familiar peers regarding their interests, Evan will list at least 7 pairs of the
topics or interests per familiar peer(s) or family members during social skills sessions, in bi-weekly samples over a one
month period as measured by the clinician.

Obj. 2 Following demonstration of an awareness of familiar peers interest(s) and utilization of pre-taught attention-getting
phrases, Evan will appropriately initiate conversations or play with 2 familiar peers without prompts by adults at least 75%
of opportunities in bi-weekly samples over a one month period as measured by staff and family.

Obj. 3 Following direct teaching of verbal prompts for conversation ending phrases, Evan will appropriately end
conversations with his familiar peer with visual prompts at least 75% of opportunities in bi-weekly samples over a one
month period as measured by staff and family.
Rationale:
i. Why you chose that specific behavior:
One of the reasons I chose the social skills is because Evan’s mother wants him to have and play with friends. Then,
having peer friends who most likely will be his advocate. Learning to communicate will increase ability to meet his
goals and develop positive relationships his life and enable him to with his others who can advocate or assist him in
the future.
ii. Why you chose it as a new or generalization skill:
I chose it because knowing people around him and the relationships with him is important to have communications.
This is a new skill for him. With the ideas, Evan will be introduced the attention-getting phrases to initiate
conversations about the appropriate topics, which are identified, and learns the end-conversation phrases. He will use
the skills with some specific familiar people but generalize between people as well as the environment.
iii. Why you chose that specific condition:
For him, social skills with his familiar people are easier to build the skills and generalize with less anxiety. Before he
establishes the social skills with various people, this can be the first step to build his confidence and safe
environment to practice the skills.
iv. Why you chose that specific prompt level:
I chose the visual cues so the conversation won’t be stopped, and he can naturally continue the conversations.
v. Why you chose that criterion:
75% is considered as the satisfied level of gaining a new skill and reachable. With some people, 75% can be
considered Evan successfully generalizes the skills with several people.
vi. Why you chose that particular person responsible for measuring the goal:
The clinician, staff, and family members were chosen because these people are the closest and the most familiar and
safest people who advocate Evan. Also, these people know the relationships and the shared topics between his peers
and Evan.
Learning Supports: 1. LS1.2 Creates turn-taking 2. LS1.3 Provides predictable 3. LS1.4 Offers repeated
opportunities and leaves sequence to activity learning opportunities
1 Partner structures spaces for child to fill in
activity for active Rationale: Evan needs to clear Rationale: More
participation Rationale: Throughout the instruction to start, maintain, opportunities, Evan
social skills activities, Evan and end the conversation. He improves fasters and have
Rationale: Evan needs will learn turn-taking as well. needs to be given the visual cue more practices. As DTT
safer environment and Staff will navigate Evan have to start and end conversation shows its effectiveness of
supportive friends to conversations, but what he appropriately, and the visual mass trial training,
improve social skills. says and plays with peers are cue will be gradually faded repeated learning
Adult needs to support his choices from the options he out. Staff guide him with opportunities helps him
him create the decided with the staff in predictable sequence of the learn various
opportunities he can advance. Conversations and conversation so Evan can opportunities of
practice with his friends. play always requires turn prepare starting and ending conversations with some
This does not only taking. Therefore, it is phrases he’s learned. Also, the peers.
support Evan but also his important and supports him to predictable sequence is helpful
friends to have social learn through the activities for his peers who are in the
interaction with Evan. although the turn-taking is not activity for him.
a target goal.
Interpersonal Supports: 1. IS5.1 Provides guidance for 2. IS5.3 Provides guidance and
success in interaction with feedback as needed for
5 Partner provides peers success in activities
developmental support
Rationale: Same as above. Rationale: Evan will be guided
to start and end the
Rationale: Evan needs conversations and given the
developmentally positive feedback. As DTT is
appropriate support at his effective with error-less mass
level. Evan is 7 years old trials, Evan will improve his
and still young. Because social skills through error-less
of his lower level of repetitive practice with
language skills, he also guidance and positive
needs additional feedback.
appropriate support
based on his
developmental level.
Activity #2: I am an interviewer!!! / Welcome to Evan’s Conversation Circle!
-Evan interviews his family members and familiar peers what they like talking
about. Clinician guides the interview sessions. Later, Evan makes the table or list of
pairs who likes talking about what topics.
-Evan will be taught good ways to talk with his family and peers about specific
topics and makes cards which he can look at and choose from when he has
conversation circles.
-Evan will be taught conversation starters.
-Conversation circle participants have the topic cards around their necks which help
Evan start and end conversations, and choose topics.
Rationale: 7-years- old children, not only Evan, also needs to learn turn
taking, listening to others. So, the small conversation circles are beneficial for all
participants. Parents will also learn how to guide the conversation at home. By
specifying the topics for each person Evan interacts, he can practice with minimal
distractors but have some differences to have variations. He also learns people have
various favorite/unfavorite and appropriate/inappropriate topics in social
communications. In addition, he will have sequence of the conversations including
the conversation starter (attention getter), ending phrases, personal space during
conversation, and eye contact. Through conversation circles, Evan learns not only
the conversation phrases but also manners and eye contact which are important to
learn for Evan.

Setting: A small group interview sessions/conversation circle guided by the clinician.

When Evan becomes able to advance the next step, generalize in the hallways,
classroom, and/or quiet space.
Rationale: The small group with only familiar people is less distracted and easier to maintain conversations. 7-
years- old children, not only Evan, also needs to learn turn taking,
listening to others. So, the small conversation circles are beneficial for
all participants. Parents will also learn how to guide the conversation
at home.

Materials:
 Communication cards.
 Topics list.
 Topics of conversation with someone.
 Visual cue to have conversation.
Rationale: By deciding topics and write them down, Evan can choose
topics from the list. The list works as a visual cue to support Evan. The
visual cards around neck help him keep paying attention and eye contact. Because participants have conversation,
visual cues are less destructive.
Script:
Hi, .
Good morning, .
Do you like ?
Can I play with you?
What are you playing?
Bye, .
What did you do last weekend?
What do you do this/next weekend?
I am Evan.
I like to play .
I want to do .
Can I have .

Rationale: Script will be made with Evan together.

Progress monitoring

STG 1
The team decided upon a progress monitoring system data collection sheet incuding the student’s
name, a grade level or age, cue levels, and the target positional/directional words. A multiple
baselines graph will be used to mark progress in meeting his goal. The baselines, goals and a
graph of progress will be shared with stakeholders (parents/family & educational staff) in a
formal meeting.
STG 2 (Same as STG 1)