Tuesday 22 November 2011

IEP? Time to get your underpants on over your trousers.....

As discussed in my previous blogpost, the Individual Education Plan (IEP) is the main mechanism for monitoring and reviewing progress against agreed targets.  What seems to me to be crucial about the IEP is that meaningful, realistic targets are agreed with parents at the outset and that a timescale clearly details the period during which interventions will be monitored as well as a date at which progress in meeting targets will be reviewed.

This is the IEP that was drawn up for the elder of the two daughters whose Mum we are supporting.


Targets
Success criterion
Intervention
Outcome
He will understand and respond to facial expression and body language
Appropriate response seen on 10 occasions
Modelling expressions
Using emotion cards
*
He will use appropriate language in conversation
Appropriate use of language seen on 10 occasions
Role play appropriate use of formal and informal language
*
He will work well as part of a team
Seen to work co-operatively with others on 10 occasions
Set group tasks and place child in group
*


*Nothing was recorded in the ‘outcome’ column

What strikes me about this is the extent to which parents are at the mercy of the school.  If parents aren’t used to report writing or developing and reviewing planning documents, how can they be expected to critically analyse an IEP to make sure it makes sense?  If you are a parent in that situation, you trust the school and the SENCO to be doing their jobs…..clearly though, this school wasn’t up to the job.

One of the first things you will notice is that the document – the IEP of a girl – uses the pronoun ‘he’ throughout.  This probably tells you all you need to know about the level of care and attention used in developing the document and the commitment of the school to addressing this child’s needs L
There are other causes for concern, for example, the targets themselves are so general as to be completely unachievable. I would suggest that they need to be broken down developmentally to focus on the component parts that make up the whole, one at a time.  So, for example, ‘working well as part of a team’ depends upon mastery of competencies such as social referencing, co-regulation and joint attention (see previous blogposts).
In typical children, these developmental steps take years to master and the ultimate goal (teamwork) will not be achieved unless the foundational steps that underpin it are sufficiently mastered.  I call this ‘Vygotsky’s Law’ after the father of developmental psychology who introduced this concept.
We know that social referencing, co-regulation and joint attention are all impaired in autism, so we can see that ‘working well as part of a team’ makes no sense as a target for a child who does not have the lower level competencies in place.  The same could be said for the other two targets, as both of these require underpinning competencies to be in place.
In terms of the interventions suggested, I am not aware of any research (peer reviewed or otherwise) which demonstrates that any of them would successfully address the difficulties outlined.  For example, I know of no studies showing that using emotion cards helps a child with autism either to respond better to facial expressions or to improve their social communication (which is the ultimate purpose of being able to read facial expressions – it is not an end in itself).  Recognising facial expressions from a card or from the face of an animated train is one thing, but using the information transmitted in a facial expression to inform thinking and action is quite another.  I’ll quote from one of my favourite people with autism, Janine Collins, Research Associate, University of Maine, who reinforces this point when she writes, ‘Methods of teaching proceed as if being able to state, identify a statement describing, or select a picture depicting when and where to use a skill is the same as being able to actually initiate the skill when needed. This allows for no real way to build one's capacity to deal with social nuance and novelty.’
Then there is the issue of measuring progress.  The success criteria given in the IEP above are pretty meaningless.  Increases in frequency of a behaviour tell us nothing about whether the child exhibits the behaviour consistently across various settings and contexts (i.e. in different environments with different levels of challenge and with different communication partners). 
David Sponder, an RDI Consultant, Educational Psychologist, and Board Certified Behaviour Analyst (BCBA) gave an excellent webinar about measurable outcomes (archived on the RDI Platform for those of you with access to it).  Here is an abridged example he shared comparing measuring progress in developing joint attention by increases in frequency of a behaviour vs. measuring progress by using ‘foundation and elaboration’. 
Measuring by frequency
·        Benchmark 1
‘Student will demonstrate evidence of receptive joint attention 2/5 opportunities during periods of unplanned, unstructured social interactions with age mates each day for a period of 3 weeks.
·        Benchmark 2
‘Student will demonstrate evidence of receptive joint attention 3/5 opportunities during periods of unplanned, unstructured social interactions with age mates each day for a period of 3 weeks.
·        Benchmark 3
‘Student will demonstrate evidence of receptive joint attention 4/5 opportunities during periods of unplanned, unstructured social interactions with age mates each day for a period of 3 weeks.
Measuring by ‘foundation and elaboration’
·        Benchmark 1
Student will respond to joint attention by focusing on the shared referent when the communication partner engages the pupil directly.
·        Benchmark 2
Student will respond to joint attention by focusing on the shared referent when the joint attention bid is expressed to a group and not directly to the pupil.
·        Benchmark 3
Student will respond to joint attention by focusing on the shared referent when the joint attention bid is expressed to a group and the pupil overhears it or oversees it.
Conclusion
We can see that the ‘foundation and elaboration’ measures give us far more information about the level and quality of mastery of the developmental milestone of responding to joint attention. 
If we look at autism from a child development perspective, we can see that the IEP targets do not take account of the underpinning competencies that need to be mastered in order to facilitate the emergence of the desired skill.
We also know that there is a lack of evidence to support the efficacy of any of the proposed interventions.
This IEP hasn’t really got anything going for it at all……..yet it has been submitted to a panel of experts and the panel has used it to help them conclude (with nothing recorded in the ‘outcomes’ column) that this child’s needs are being met at school.
It really is a system that is heavily loaded against parents………where a school is not cooperating with a request for statutory assessment and/or in developing, implementing and monitoring IEPs, think how much knowledge, perseverance, assertiveness and organisation it takes for parents to be able to make sure that the school is doing its job properly, not to mention the emotional resilience needed to keep on fighting your child’s corner in the face of professionals and so-called ‘experts’ who are not on your side (and are often being defensive about their role).


You really have to have your underpants on over your trousers to be on top of all that…………..

7 comments:

  1. NICE! Can I reference this at some point on the blog I am writing for Tools of the mind???:) Kathy

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  2. Thanks Declan.

    Sure Kathy, reference away :) Great ToTM blog by the way. I tried to leave a comment a couple of days ago but am having trouble with comments...something to do with google sign in.

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  3. This is why assessment tools such as the SCERTS framework are so useful, as it is autism-specific and breaks targets down developmentally. The targets address the Triad and only four are picked to last the tear. Then they have small achievable targets which involve settings and the team around tge child. Sc is social communication, er is emotional regulation (mutual then self-) then ts is transactional support... What do we bring o the party, including health, education and parents. The target is met once observed over three settings at least three times. Worth looking at, SCERTS training is inexpensive and we find it very helpful especially for relevant and helpful IEP writing!

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  4. I like SCERTS - in fact there was a trainig course in London recently that I would like to have gone on, but just cant fit it in at the moment :(

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  5. Just found your blog via the IEP link you'd put on the NAS forum for someone.... I've got a post on the forum re my background (redform1ca); the high school have never, to this day, produced a copy of my son's IEP! He's now "supposed" to be at another school... will keep an eye on your blog, as it's really helpful. Thanks!

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  6. Hi trashsparkle

    There's a more recent post on my blog (the current post) about IPSEA, the charity that helps parents to challenge bad educational practice. If you're still having problems, maybe you could contact them? I hope things get sorted out for you.

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