The following program is a production of
the Fairfax Network, Fairfax County Public Schools. For me still, when a student comes in who is non-verbal, doesn't have any language other than maybe pulling you to what they want; or screaming and crying, which are ways of communicating but not functionally, it's a
daunting task. I'm excited, just like any other mom would be, for her to be going to kindergarten. I look at her and she's my baby. And now it's like she is a real person. But the fact that she's going to a regular kindergarten means that
she's come a really long way. I think if you look at early intervention -- I mean the whole purpose of it is to, you know, kind of get things taken care of early. Narrator: Grace may not know all the words but she likes to read. In a few short weeks she will say goodbye to her friends in this
preschool autism classroom, known as PAC and begin a journey to a mainstream
kindergarten program. There will be helped if she needs it but Grace is
ready to learn. As her mother said, Grace has come a long way. Parent: She didn't communicate at all. I mean, she just like, she didn't look at us. She didn't have any eye contact. She didn't play with toys appropriately so she didn't interact with toys even appropriately. So she was just inside of herself.
And that is what I think about kids with autism they're just inside of
themselves you know. And the only way she could express herself that anybody
would understand would be to yell and scream. But I would even call that communicating, that would just be expressing yourself. And that was getting her nowhere. So then
she'd start banging her head or running around, things like that. And now
she can count to ten, she can take deep breaths and stuff like that. But she still loses it.
But she knows how to express herself and she can say "I'm calm, I'm calm". Meanwhile she's crying but she says, ‘ "I'm calm, I'm calm". Todd Streff: How do you explain autism? I mean, that’s kind of a like trying to grab air. Sometimes it's just really difficult because there is such a wide
flavor, a wide variety. I often, when parents ask me “Todd, what do you think about it?" I think the look like a lot of typical kids, they just do everything in access. Every kid kind of loses themselves and kind of goes to their happy place. But our kids just stay there a lot longer. (music) Narrator: In the past, few public school systems
recognized the value of early, systematic instruction for toddlers who interact,
behave, and learn differently than most of their peers. Grace, and a lot of kids
like her, wouldn't have made such progress. Today, PAC, an evidence–based preschool autism program, believes early intervention impacts a child's learning and behavior
far into the future. That's why the instruction is intensive and systemic. For
a school district such as Fairfax County Public Schools, PAC is a financial and
academic commitment to small classes, skilled personnel, best practices, and
parent communication. Teacher: So, what comes next? You are a spelling person. Student: R Teacher: Good, good. Narrator: This video is a snapshot of what a
preschool autism classroom looks like. It may not be perfect but it's a place where
small wonders and big gains do happen, letter by letter ... step-by-step. Cristie DuChez: The way that I explain the difference between a preschool autism classroom and a preschool class-based classroom to parents, is a a preschool autism classroom teaches things in a very systematic manner. So we go through and we figure out what are the next steps in each
sequence of actions for different behaviors -- expressive language, receptive
language, motor imitation, matching skills, play skills, social skills. And a lot of times
in a preschool class-base classroom, the kids are just the expected to learn from
their environment and things are usually taught one time in a large group. They
might be retaught in a small group. But here we start in a very small group,
systematically teaching the skills in a two-on-one setting and then ultimately
work on generalizing those skills. Teacher: [student name], choose a song. Narrator: Christie DuChez and
her trained instructional assistants are teaching children to understand and
interact with the world around them. This will include teaching specific
skills such as how to respond to communication, to express their wants and
needs, and to follow directions. Thus lessen the barrier between their world
and others. Teacher: Nice [student name]. Look at you dancing.
You're not dancing. Narrator: According to DuChez, systematic instruction is a gateway to independent learning and living. To this educator, every moment is a teachable moment, and every moment counts. One strategy DuChez utilizes is the
“discrete trial teaching.” Teacher: What is this?
No, you didn't tell me
What is this? Student: Bus
Teacher: Yeah, bus. Student: School Bus
Teacher: It is a school bus. Cristie DuChez: Discrete-trial teaching happens, in art. It happens when we are walking in
the hallway. It happens when we are at circle time.
It happens when we're washing hands. It happens when we go to the bathroom.
It happens throughout the day. So at art table we're often working on requesting different materials, copying what we are doing, following receptive instruction. So it I say, "What do you need?" I've opened a trial. That's my 'A'. They have to look around the table see what materials they need: "I need
yellow paper. I need glue". And then the "C" would be me giving them the glue. On
the flip side if they're not doing what we need them to do or I'm not getting the
behavior I want, I'm going to give them feedback on it. It could be a simple shake of my head "no". It might be "hm, hm, you are not paying attention, try again". It really depends on what their behavior looks like as to what the feedback is gonna look like. (music) Teacher: Do everything I do. Cristie DuChez: A trial is the whole sequence of the A, B, and the C. That encompasses one trial. Teacher: Yay! You put in your peg and touched your head. So my instruction, their behavior and me closing the trial, either through delivery of reinforcement and praise, or through corrective feedback.
That is a trial. Teacher: Yeah, good talking. Cristie DuChez: If it's spot-on, perfect, wonderful -- I am going to come in with their favorite reinforcer so that they know that's
exactly what I wanted to see. I am going to pair it with my words and my language, so they start pairing me with the reinforcer. Because the end goal is that I am the reinforcer; that they don't need a bunch of tangible items for
reinforcements. And a lot of my older kids are at that point now where I can
just say "wow way to go dude, high five." Teacher: Get an orange paper for [student name]. (Student speaks)
Teacher: That was such such good listening. You can go ride Mickey car. Narrator: In order to strengthen optimum behaviors, DuChez uses reinforcements or small rewards and tokens to help children learn.
Todd Streff: So it is really looking at what happens before and what happens after the
behavior. And that is either going to strengthen their behavior, good or bad, and or it's going to a decrease it, good or bad. So we're
always looking at what impacts that behavior, what sets it in motion and how
does that also get reinforced and or how, also, does it decrease. Cristie DuChez: Kids in this classroom are on different schedules of reinforcement and we're teaching a new hard skill, they're
probably gonna get reinforced after every single time we're doing it, that they're getting it
right. And then we're gonna back it off. They might get it every couple of times. Or they might get it every three to four times. And then I might take it back
down to two if they are having a little bit of trouble. So it's a fluid schedule of
reinforcement for different kids but especially if it's difficult skill, and I
know they're going to have a hard time with it then, I will tell my IAs you
need to come in with reinforcements after every single trial.
Teacher: Oh nice job. You took another bite. Look at you chewing your food. (music) Narrator: There's always a goal driving the
teaching staff. These goals, created with parents, may target unique behaviors such
as the ability to stay calm, wait patiently, and application of appropriate
language. A low teacher to student ratio is key to mastering these goals and
skill sets. (music) Cristie DuChez: Center time is really for that systematic teaching opportunity. And so we really break down the skills and that's were
we teach them systematically. Teacher: Oh I like that you put your hands down. Cristie DuChez: We take turns being in the play area, we rotate through centers on a weekly basis. So one week I'll be in expressive language, one of my IAs will be in receptive language, one of my IAs will be in nonverbal
imitation. And the next week we will rotate so that every third week we're getting
through all of the center rotations. Student: I want the dinosaur.
Teacher: Ok, good choice. Cristie DuChez: Because the goal in kindergarten, and above, is that the teacher might tell you to go get your
backpack and put your homework in it and then get your lunch box and line up.
And so you have to hear all of these long instructions so we start with very
small one step instructions. Narrator: Notes are gathered and data is collected at every center and shared with parents. Teacher:That's not it. What shape is the hat? Cristie DuChez: Within the data notebook that the students transistion with and they are responsible for carrying from center to center, we take data on all of their IEP goals and objectives. And as they master one objective from their IEP, we go through and you know we
update it with a new data sheet and we are highlighting when they have mastered
a target on that objective and putting in the mastery date so that
when the data sheets go home to the parents, the parents are able to say
this is what my student has mastered in the last week; this is what my student has been working on. Parent: I think, and I'm not saying the other classes don't have it but the fact that it is a smaller ratio I think allows for a more intimate communication. We have a huge say, that's the other important thing. It's not just her telling us "this is what I
think should be the goals for Grace". She asked us what's important, what's going
on at home, what we want to work on at home. And then she incorporates them into
what goes on at school. So it's a team effort. Narrator: As teachers and instructional
aides use the strategy of discrete trial teaching, the foundation of each
instruction is built upon the principles of Applied Behavior Analysis. Todd Streff: Oftentimes you get asked what is ABA or what is Applied Behavior Analysis. There's a lot of textbook definitions and so forth. For me, I just kind of break it down to
it's just good teaching. You're breaking things down, you're being very systematic.
You have some goals that you're going for and a lot of what separates ABA,
the most in the research, is just the intensity at which it's given -- that it's
not something that you just do a couple hours a day. Parent: ABA has shown to work for my daughter. It has helped me as a parent understand and take a step back; how do I Iook at this rationally and help her -- not just get emotionally involved in what is happening Teacher: Oh, man. A bee fell down! Parent: And it has helped both my kids and they have different levels of autism. Narrator: Studies show ABA is the most effective intervention strategy. It achieves reliable, positive change in both
IQ scores and adaptive behavior scales for students with autism. Teacher: He has all the rest of the bees!
Student: Oh, man!
Teacher: What can you say after you play a game? Cristie DuChez: It's the systemic teaching of skills that are socially significant so that students can either increase certain behaviors so increasing language or play skills,
imitation. And often decreasing socially significant maladaptive behaviors, which
are those behaviors that we don't want to see -- those aggressive or
self-injurious behaviors. So decreasing those types of behaviors while
increasing the appropriate behaviours. Teacher: This is sitting. Teacher: How does [student's name] feel now?
Student: Sad
Teacher:How do you know he's sad? Student: He's crying.
Teacher: He is crying. Do you think maybe he's mad? Student: He's mad.
Teacher: Why do you think he is a little mad?
Student: Because he is crying. Teacher: Do you cry when you are mad? Parent: For Grace, when she was a little over two, she was running around in circles and having tantrums and screaming and
not talking. And six months later after having ABA at home and having it at school, it's worked out wonderfully. Cristie DuChez: You need to find where you're going. So the first center, you're going to be at the library reading books. When the timer goes off, you're gonna go play on the iPad and then you're gonna come work with Miss Christy, and then you're going to do your fine motor. Parent: Like I was saying about her stim, it helps us figure out, yeah, she has a stim -- jump, hopping up and down and flapping her hands. And so we figured out that when she was running around, what was the reason she was running around, what she
was getting out of it and how to treat it and how to help her. Teacher: This is cool sitting on the mat. Narrator: What comes before the behavior is as important as what comes after. Todd Streff: When we are looking at the antecedents, behaviors or consequences of kids, you know, that's kind of the technical language. I mean, really when we are talking about antecedents – what’s triggering the kid's behavior. Are they
frustrated because they don't understand what we want? Did we just
terminate something that they liked, they really wanted to continue to play with
that toy and it was time to go to work? So, those antecedents are really what
triggers, what kind of sets the behavior in motion: are they going to tantrum; are they just gonna vocalize; are they gonna be upset? So that's the behavior part. And then the consequences always. What happened after that behavior? Did you respond to them in
some way shape or form? Did you give them back their favorite toy which they are
more than happy if you do that. Or did you follow through and transition them
to where they may need to be? So it's really looking at what happens before and what happens after the behavior and that is either going to strengthen their
behavior, good or bad, and or it's going to decrease it, good or bad. So we are always
looking at what impacts that behavior what sets it in motion and how does that
also get reinforced and or how does it decrease. Cristie DuChez: So we either have to teach students socially appropriate behaviors to engage in or we need to
teach them when it's appropriate or inappropriate to engage in those
behaviors. So that's part of ABA as well -- as socially significant, those academic life
skills. And just teaching it in a very systematic manner. Todd Streff: We know if any behavior -- if it is for you or me or anybody else the longer you engage in that behavior, the
harder it is to address. (music) Narrator: When Grace first enrolled in Christie DuChez's all-day preschool autism class, there was a lot of crying and no functional
communication. Cristie DuChez: So my initial goals for Grace when she started at two, were to get some of that language under stimulus control since she was initially just
repeating and using echoics to communicate. Student: Smiling
Teacher: What about now?
Student: Happy Cristie DuChez: And by stimulus control, I mean her talking when we want her to talk and not her just repeating what we're saying because that's not functional language. And she didn't possess a lot of play skills when she first started. Narrator: Like her classmates, there were always high expectations and attainable goals for Grace. Teacher: Good morning, Miss Ward. Cristie DuChez: We went to music class for the first time in a different classroom in a different place where we had never been before and they sat down. And they listen to what the music teacher was saying. And I sat there with
tears in my eyes and thought this is what it's all about. They are generalizing the skills that I am teaching them to a new environment, to a new teacher with new skills and it literally filled my heart and I was like this is it. This is it for me. This is a hard job. But I see the rewards. I see the small rewards. I see kids developing language. I see kids kids developing play skills. I see them learning to feed themselves which seems like such a nominal task but for some
kids that's a big deal. Learning to potty train and that's not a
glamorous task but it's something we that work on here. And you see the fruits of
your labor and you know some of these kids I've been with for three years and
to see where they started to where they are now, I couldn't be
prouder of them. (music) Todd Streff: So let’s assume some magic pill takes away their autism or some other intervention, you still have to teach what's there. And so if you have a five year old who is still developmentally a
two year old, we still have three years of gap to close, or to try to close.
We still have to give them language. We still need to give them good adaptive behavior and so the hard part is, nothing is gonna do the hard work. There is no you know there's
no discussion of any of those quick fix a panacea programs that say that they're
gonna catch the kid up. Teacher: [student name] pop a balloon.
Student: I did it. Teacher: You found a duck. What does a duck say?
Students: Quack, quack. Teacher: And on that farm he had a ...
Student: A duck
Teacher: e-i-e-i-o. Parent: She was a mess and she still is a mess. But she is a lot better. Just a month ago, she had a half an hour tantrum and I'm
not talking about like a neurotypical has a tantrum like I just don't want anything.
I'm talking a drop to the floor, kicking and screaming, pushing me away
getting up, running off, screaming, getting upset ... Students Singing: Along came Mr. Alligator as quiet as can be ... Parent: But I would have to say that this program has been the number one thing that has made my daughter who she is today
compared to the child that was locked inside of herself. Narrator: The children who enrolled in Fairfax County’s first preschool autism class are now in secondary school. Here are the trends:
students many times need fewer special education services; students are better communicators; students have fewer behavior issues. Learning is a process but with a
consistent, intensive, and yes, systematic approach, there's lots of progress in a
PAC classroom. As for Grace, she is ready to transition
from a preschool autism classroom to kindergarten. She has the tools to
respond to teachers and classmates, to socialize and behave well. And she's
thinking ahead. Grace told her teacher, Miss Christie, that she might become an artist when she grows up. Parent: My goal for her is for her to have the best life possible. I'm not taking it very seriously that it necessarily an artist but the fact that
she can think that far into the future and that she's come out of her shell
where she was when she was two and a half. It is just a beautiful thing to me. (music)
